Measuring support for tobacco control policy in selected areas of six countries

Objective-To explore the validity, reliability, and applicability of using a short, psychometrically sound survey instrument to measure population att itudes toward tobacco control policies. Design-Surveys. Subjects and setting-Student respondents attending university in Australia (n = 403), Hong Kong (n = 336), the Netherlands (n = 351), South Africa (n = 291), the United Kingdom (n = 164) and the United States (n = 241); total n = 1786. Main outcome measure-The Smoking Policy Inventory (SPI), a 35-item scale. S PI scores were adjusted for age, income, gender, and smoking status. Estima tes of internal consistency and tests of factorial invariance were conducte d in each sample. Results-Across all six countries, the SPI was found to be highly reliable a nd to have a consistent factor structure, indicating that the SPI scale rep resents a higher order construct that assesses general attitudes about toba cco control policy with five dimensions. In general, the degree of endorsem ent of anti-tobacco policies as measured by the SPI reflected the extent an d strength of tobacco control legislation in those countries. Dutch student s were the least likely, and Australian and Hong Kong students the most Lik ely, to support tobacco control policies. Conclusions-It is possible to develop appropriate and meaningful measuremen t tools for assessing support of tobacco control policies. Strong evidence was found for internal reliability and structural invariance of the SM. The SPI may be a useful mechanism for monitoring ongoing policy initiatives, m aking cross-cultural comparisons, and evaluating population receptiveness t o proposed policy approaches.