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Title: Development and validation of a 21-item challenges to stopping smoking (CSS-21) scale
Authors: Thomas, Dennis;Mackinnon, Andrew J;Bonevski, Billie;Abramson, Michael J;Taylor, Simone E;Poole, Susan G;Weeks, Gregory R;Dooley, Michael J;George, Johnson
Issue Date: 31-Mar-2016
EDate: 2016-03-31
Citation: BMJ Open 2016; 6(3): e011265
Abstract: OBJECTIVE: Identification of challenges associated with quitting and overcoming them may improve cessation outcomes. This study describes the development and initial validation of a scale for measuring challenges to stopping smoking. METHODS: The item pool was generated from empirical and theoretical literature and existing scales, expert opinion and interviews with smokers and ex-smokers. The questionnaire was administered to smokers and recent quitters who participated in a hospital-based smoking cessation trial. Exploratory factor analysis was performed to identify subscales in the questionnaire. Internal consistency, validity and robustness of the subscales were evaluated. RESULTS: Of a total of 182 participants with a mean age of 55 years (SD 12.8), 128 (70.3%) were current smokers and 54 (29.7%) ex-smokers. Factor analysis of the 21-item questionnaire resulted in a 2-factor solution representing items measuring intrinsic (9 items) and extrinsic (12 items) challenges. This structure was stable in various analyses and the 2 factors accounted for 50.7% of the total variance of the polychoric correlations between the items. Internal consistency (Cronbach's α) coefficients for the intrinsic and extrinsic subscales were 0.86 and 0.82, respectively. Compared with ex-smokers, current smokers had a higher mean score (± SD) for intrinsic (24.0 ± 6.4 vs 20.5 ± 7.4, p=0.002) and extrinsic subscales (22.3 ± 7.5 vs 18.6 ± 6.0, p=0.001). CONCLUSIONS: Initial evaluation suggests that the 21-item challenges to stopping smoking scale is a valid and reliable instrument that can be used in research and clinical settings to assess challenges to stopping smoking.
DOI: 10.1136/bmjopen-2016-011265
PubMed URL:
Type: Journal Article
Subjects: Smoking
Appears in Collections:Journal articles

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