The development and psychometric evaluation of the Smokeless Tobacco Expectancies Scale (STES).

Abstract

Expectancies regarding the effects of various psychoactive substances are important predictors of the initiation and maintenance of substance use. Although measures of outcome expectancies exist for several addictive substances, there is currently no measure to assess smokeless tobacco (ST) expectancies in an adult population. This paper presents two studies leading to the development and psychometric evaluation of the Smokeless Tobacco Expectancy Scale (STES). Initially, 155 individuals listed all outcomes they expected to occur if they were to use ST products. From these responses, an initial pool of potential STES items was identified. The STES was then administered to two samples totaling 813 individuals (265 ST users, 270 cigarette smokers, and 278 non-tobacco users). The first study consisted of 315 participants who completed a 68-item measure. An exploratory factor analysis identified 10 items that may account for individuals’ ST expectancies. Items loaded on two factors: 1) Negative Health Consequences, and 2) Positive Reinforcement. A confirmatory factor analysis on an independent sample (n = 498) supported the proposed factor structure. Furthermore, in both samples, the STES accurately discriminated ST users from smokers and non-users. Findings are discussed in terms of the potential uses of the STES for advancing the understanding of ST use.

Application of the Smokeless Tobacco Expectancies Questionnaire to Snus

“…Model fit for each sample was within the acceptable range for most statistics (see Table 2). Consistent with Gottlieb et al 20 these data also produced RMSEA values above recommended values, but below the threshold for bad fit. Minimum discrepancy (chi-square/degree of freedom) was slightly above the recommended cutoff point for the young adult and older adult samples though this was expected given the large sample size (typical in samples larger than 400; see Table 2).…”

“…In addition, each scale was independently associated with an intention to purchase snus in the next 30 days while controlling for covariates. That the pattern of item loadings mirrors the prior work, 20 and is consistent with work on cigarette expectancies, 12,13 suggests that adapting such expectancies measures to other emerging tobacco products such as electronic cigarettes, cigars, and hookah should be relatively straightforward and provide useful cross-product comparisons. Future research should develop appropriate measures and evaluate expectancies across tobacco product types and prospectively examine their predictive validity for product uptake.…”

“…20 The wording of each item was adjusted to ensure respondents were aware the questions were measuring perceptions about a particular smokeless tobacco product class (snus) rather than smokeless tobacco products more generally. Response options ranged from 1 `very unlikely' to 10 `very likely'.…”

“…To fill this gap, Gottlieb and colleagues developed the Smokeless Tobacco Expectancies Scale (STES). 20 Their research provided initial development and validation of 2 underlying expectancy constructs: Negative Health Consequences (NHC) and Positive Reinforcement (PR) associated with use. This research assessed smokeless tobacco generally; however, product-specific measures may be necessary because consumers may perceive conventional smokeless tobacco products, such as moist snuff, differently from snus.…”

“…This research assessed smokeless tobacco generally; however, product-specific measures may be necessary because consumers may perceive conventional smokeless tobacco products, such as moist snuff, differently from snus. 21 For example, Bahreinifar et al 20 conducted 8 focus groups among smokers and found that participants viewed snus as different from “chewing tobacco”, and Adkison et al 22 found that perceptions of greater prevalence of smokeless tobacco use (typically associated with greater product use) were inversely associated with an interest in trying snus. Existing measures of snus expectancies 18,19 were developed in the Scandinavian context, which may not reflect beliefs in North America, where views about snus are likely to be colored by traditional chewing tobacco and moist snuff.…”