Measuring Smoking Knowledge, Attitudes and Services (S-KAS) among clients in addiction treatment.

Addiction treatment programs are increasingly working to address prevalent and comorbid tobacco dependence in their service programs. However, at present, there are few published measurement tools, with known psychometric properties, that can be used to assess client-level constructs related to tobacco dependence in addiction treatment settings. Following on previous work that developed a staff-level survey instrument as part of a National Drug Abuse Treatment Clinical Trials Network platform study, “Addressing Tobacco through Organizational Change (ATTOC),” this report describes the development and measurement characteristics of the Smoking Knowledge, Attitudes and Services (S-KAS) for use with clients in addiction treatment settings. For the development of this version of the scale, 250 clients enrolled in residential drug abuse treatment programs were surveyed. Examination of the rotated factor pattern indicated that the latent structure was formed by one knowledge factor, one attitude factor, and two “service” factors reflecting program services and clinician services related to tobacco dependence. Standardized Cronbach’s alpha coefficients for the four scales were, respectively, .57, .75, .82, and .82. In conclusion, the proposed scales have reasonably good psychometric characteristics, although the knowledge scale leaves room for improvement, and will allow researchers to quantify client knowledge, attitudes and services regarding tobacco dependence treatment. Researchers, program administrators, and clinicians may find the S-KAS useful in changing organizational culture and clinical practices related to tobacco addiction, in program evaluation studies, and in tracking and improving client motivation.