A protection motivation theory-based scale for e-cigarette use assessment among Chinese college students: Development and validation.

Introduction: Electronic cigarettes (e-cigarettes) have gained increasing popularity among young adults worldwide, particularly among college students who represent a key target population for e-cigarette marketing. Understanding cognitive factors that influence e-cigarette use susceptibility is critical for developing effective prevention strategies. This study aimed to develop and validate a scale based on the Protection Motivation Theory (PMT) to assess cognitive factors related to e-cigarette use susceptibility among Chinese college students for prevention purposes.

Methods: A cross-sectional survey design was employed and data were collected among 303 students aged 18-24 years from universities in China during February 2023. A 21-item PMT scale was adapted from a previous study on Chinese youth tobacco use. Construct validity was assessed using confirmatory factor analysis (CFA). Internal consistency reliability was evaluated using Cronbach's α. Structural equation modeling was used to examine associations between PMT constructs and e-cigarette use susceptibility. Statistical significance was set at p<0.05, and all tests were 2-tailed. Power calculations indicated adequate sample size for the planned analyses. Concurrent validity was examined by correlating PMT constructs with e-cigarette use susceptibility.

Results: After removing one item, the final 20-item scale demonstrated good model fit in the CFA (GFI=0.917, CFI=0.933, RMSEA=0.055). Internal reliability was acceptable to good (Cronbach's α=0.52-0.83). The overall Cronbach's α coefficient was 0.831. All PMT constructs were significantly correlated with e-cigarette use susceptibility in the expected directions (p<0.05).

Conclusions: The PMT-based scale is a valid and reliable measure to investigate e-cigarette use related cognitions among Chinese college students, and can be used as a tool to guide prevention efforts. The study supports the utility of applying PMT to e-cigarette research in different socio-cultural contexts.