BACKGROUND: The transtheoretical model is a framework to explain smoking uptake and cessation in adolescence. Decisional balance is proposed as a driver of stage movement. PURPOSE: The purpose of this study was to examine the factor structure and measurement equivalence/invariance (ME/I) of the decisional balance scale. METHODS: In this study, we used confirmatory factor analysis followed by measurement equivalence/invariance testing to examine the factorial validity of the decisional balance scale in adolescent smokers and nonsmokers. RESULTS: Unlike previous studies, we found that a four-factor solution splitting cons into esthetic and health cons significantly improved the fit of model to the data. ME/I testing showed that the same structure and measurement model held for both smokers and nonsmokers, girls and boys, and across the three occasions the scale was administered. CONCLUSIONS: Cons showed strong evidence that it constituted two separate first order factors. Decisional balance for smoking in adolescence has good evidence of factorial validity.

Original publication




Journal article


Int J Behav Med

Publication Date





158 - 163


Adolescent, Adolescent Behavior, Decision Making, Factor Analysis, Statistical, Female, Humans, Male, Psychological Theory, Psychology, Adolescent, Psychometrics, Schools, Smoking, Surveys and Questionnaires