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Brian A. Primack, MD, EdM; Melanie A. Gold, DO; Galen E. Switzer, PhD; Renee Hobbs, EdD; Stephanie R. Land, PhD; Michael J. Fine, MD, MSc

Arch Pediatr Adolesc Med. 2006;160:369-374.

Objectives  To develop a smoking media literacy (SML) scale by using empiric survey data from a large sample of high school students and to assess reliability and criterion validity of the scale.

Design  On the basis of an established theoretical framework, 120 potential items were generated, and items were eliminated or altered on the basis of input from experts and students. Cross-sectional responses to scale items, demographics, smoking-related variables, and multiple covariates were obtained to refine the scale and determine its reliability and validity.

Setting  One large Pittsburgh, Pa, high school.

Participants  A total of 1211 high school students aged 14 to 18 years.

Main Outcome Measures  Current smoking, susceptibility to smoking, attitudes toward smoking, and smoking norms.

Results  Factor analysis demonstrated a strong 1-factor scale with 18 items ( = 0.87). After controlling for all covariate data, SML had a statistically significant and independent association with current smoking (P = .01), susceptibility (P<.001), and attitudes (P<.001), but not norms (P = .42). Controlling for all covariates, an increase of 1 point on the 10-point SML scale was associated with a 22% decrease in the odds of being a smoker and a 31% decrease in the odds of being susceptible to smoking.

Conclusions  Smoking media literacy can be measured with excellent reliability and concurrent criterion validity. Given the independent association between SML and smoking, media literacy may be a promising tool for future tobacco control interventions.

Author Affiliations: Center for Research on Health Care (Drs Primack, Gold, Switzer, and Fine), Division of General Internal Medicine, Department of Medicine (Drs Primack, Switzer, and Fine), and Division of Adolescent Medicine, Department of Pediatrics (Dr Gold), University of Pittsburgh School of Medicine, Pittsburgh, Pa; Temple University School of Communications and Theater, Philadelphia, Pa (Dr Hobbs); Graduate School of Public Health, University of Pittsburgh (Dr Land); and Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Health Care System (Dr Fine).

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