Reliability And Validity Of Russell Reason For Smoking Questionnaire Among Rural Male Smokers

BackgroundCigarette smoking is one of the most preventable factors contributing to chronic and non-communicable diseases. As the world’s largest tobacco producer and consumer, China was facing the heavy economical and public health burden caused by tobacco. The rural residents formed64%of China’s population. And the smoking rate in rural male residents was generally higher than that of the urban men. Therefore, it is urgent for our country to implement effective national tobacco control policies, especially in the rural areas.The identification and characterization of the various reasons motivating people to smoke can aid in developing public policies for smoking prevention and control, as well as establishing individualized smoking cessation strategies. The Russell’s Reasons for Smoking Questionnaire (RRSQ) was most widely used in China to characterize the individuals’ smoking motives. However, when we utilize a self-report instrument to determine motives for health behaviors, it is essential that the response to the assessment should be evaluated for validity and reliability in the population in which it is used, in order to get sound psychometric properties. Despite of the widespread use of the RRSQ in China, there is limited information on psychometric properties study performed on the scale.Therefore, it will make a significant sense to identify smoking motives accurately if we perform this study to assess the reliability and validity of the RRSQ in China rural area.ObjectivesTo detect the reliability and validity of Russell’s Reasons for Smoking Scale in China rural male smokers; MethodsA questionnaire survey was used.9villages from the3health research bases of Shandong University were selected. A total of6760subjects were enrolled in our study, and those who were smokers were asked to complete the RRSQ. Item analysis was firstly used to detect and remove the ill items, and then exploratory factor analysis (EFA) was performed to develop the factor structure. The feasibility of the theoretical structure was assessed through confirmatory factor analysis (CFA). The absolute fit indices, incremental fit indices and parsimonious fit indices were used to evaluate the overall model fit, and the construct reliability(CR) and average variance extracted (AVE) were calculated to assess the fit of internal structural model. The reliability analysis included correlation coefficient and Cronbach’s a coefficient.Main results1. Items6,19and23were removed from the scale after a series of item analysis.2. Through exploratory factor analysis in calibration sample, a21-item modified version of RRSQ (MRRSQ) was developed, accounting for about62.43%of total variance.3. In validation sample, confirmatory factor analysis was conducted to test the construct validity of the RRSQ and MRRSQ.3.1The overall model fit:Both the absolute fit indices and incremental fit indices indicated a good model fit:χ2/df=2.509, RMSEA=0.051, SRMR=0.047, CD=0.998. And the parsimonious fit indices of the MRRSQ, including AIC and BIC, were both lower than those of the RRSQ, indicating the model was parsimonious than the original one.3.2The fit of internal structural model:The construct reliability (CR) of the MRRSQ and each factor was0.938and greater than0.5, respectively. The average variance extracted (AVE) of the MRRSQ and each factor was0.426and0.294to0.583, respectively.4. The correlation coefficients of MRRSQ between factors were0.30～0.63, the correlation coefficients between each factors and the scale were0.64～0.88. The Cronbach’s a coefficients for the MRRSQ questionnaire and factors were0.89and Conclusions1. The dimension of "psychological image" was not fit for the rural male smokers for its poor item discrimination.2. The MRRSQ fit well, and was parsimonious than the original RRSQ.3. The reliability and construct validity of the MRRSQ were found to be good, though the convergent validity of MRRSQ is lower than accepted value because of its low AVE. The MRRSQ appears to be adequate for the smoking motives survey in China rural male smokers.