title: Validation of a Measure of Normative Beliefs About Smokeless Tobacco Use.
abstract: BACKGROUND
  Validated methods to evaluate consumer responses to modified risk tobacco products (MRTPs) are needed. Guided by existing literature that demonstrates a relationship between normative beliefs and future intentions to use tobacco the current research sought to (1) develop a measure of normative beliefs about smokeless tobacco (ST) and establish the underlying factor structure, (2) evaluate the structure with confirmatory factor analysis utilizing an independent sample of youth, and (3) establish the measure's concurrent validity.
  
  
  METHODS
  Respondents (smokers and nonsmokers aged 15-65; N = 2991) completed a web-based survey that included demographic characteristics, tobacco use history and dependence, and a measure of attitudes about ST adapted from the Normative Beliefs about Smoking scale. A second sample of youth (aged 14-17; N = 305) completed a similar questionnaire.
  
  
  RESULTS
  Exploratory factor analysis produced the anticipated three-factor solution and accounted for nearly three-quarters of the variance in the data reflecting (1) perceived prevalence of ST use, (2) popularity of ST among successful/elite, and (3) approval of ST use by parents/peers. Confirmatory factor analysis with data from the youth sample demonstrated good model fit. Logistic regression demonstrated that the scales effectively discriminate between ST users and nonusers and are associated with interest in trying snus.
  
  
  CONCLUSIONS
  Assessment of MRTPs for regulatory purposes, which allows messages of reduced risk, should include measurement of social norms. Furthermore, surveillance efforts that track use of new MRTPs should include measures of social norms to determine how norms change with prevalence of use.
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo NY; sarah.adkison@roswellpark.org.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Adkison
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo NY;
authors.forename: Richard J
authors.initials: RJ
authors.lastname: O'Connor
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo NY;
authors.forename: Maansi
authors.initials: M
authors.lastname: Bansal-Travers
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC;
authors.forename: K Michael
authors.initials: KM
authors.lastname: Cummings
authors.affiliation: Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA;
authors.forename: Vaughan W
authors.initials: VW
authors.lastname: Rees
authors.affiliation: Department of Psychiatry, University of Minnesota, Minneapolis, MN.
authors.forename: Dorothy K
authors.initials: DK
authors.lastname: Hatsukami
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D040261:Harm Reduction; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D040541:Marketing; D008875:Middle Aged; D015995:Prevalence; D015203:Reproducibility of Results; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D012938:Social Perception; D019460:Tobacco Industry; D014029:Tobacco Use Disorder / Q000453:epidemiology* / Q000517:prevention & control / Q000523:psychology; D014030:Tobacco, Smokeless / Q000009:adverse effects / Q000706:statistics & numerical data