The Modified Reasons for Smoking Scale: factorial structure, validity and reliability in pregnant smokers

Background Smoking during pregnancy can cause several maternal and neonatal health problems. Identifying the motivational profile could give insight in the smoking behavior of pregnant women. Aims and objectives The main... [ view full abstract ]

Background
Smoking during pregnancy can cause several maternal and neonatal health problems. Identifying the motivational profile could give insight in the smoking behavior of pregnant women.

Aims and objectives
The main aims were to test the factorial structure, validity and reliability of the Dutch version of the Modified Reasons for Smoking Scale (MRSS) and to understand reasons for continued smoking during pregnancy.

Method
A longitudinal study was executed, data of 97 pregnant smokers were included. Structural equation modeling was performed to assess the construct validity of the MRSS: an exploratory factor analysis was conducted, followed by a confirmatory factor analysis.
Test-retest reliability (<16 weeks and 32-34 weeks pregnancy) and internal consistency were assessed using the intraclass correlation coefficient and the Cronbach’s alpha, respectively. Mann Whitney U-tests were performed to examine associations between the MRSS subscales and nicotine dependence, daily consumption, emotional condition and intention to quit.
The study was approved by the Ethical Committee of Ghent University Hospital.

Findings
We found a factorial structure for the MRSS of 11 items within 5 subscales: tension reduction, social function, pleasure, addiction and habit. ‘Tension reduction’ was the most important reason why pregnant women smoked, followed by ‘pleasure’ and ‘addiction’.
Reasons for smoking remained fairly stable during pregnancy for both time points. Internal consistency for all scales was acceptable to good.
There were significant associations between dependence and the subscales ‘tension reduction’ and ‘addiction’ and between daily consumption and the subscales ‘addiction’ and ‘habit’.

Conclusions and implications
Validity and reliability of the MRSS was shown in multiple subpopulations and in smokers with a diversity of smoking characteristics. We found that the scale is also appropriate to use in pregnant smokers.
Further research should focus on the implementation of the MRSS in prenatal smoking cessation counseling. Results should be used in designing tailored advice, taking into account the reasons why pregnant women smoke.