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Motivation rulers for smoking cessation: a prospective observational examination of construct and predictive validity
Open Access Articles
  • Edwin D. Boudreaux, University of Massachusetts Medical School
  • Ashley F. Sullivan, Harvard Medical School
  • Beau W. Abar, University of Massachusetts Medical School
  • Steven L. Bernstein, Yale University
  • Adit A. Ginde, University of Colorado School of Medicine
  • Carlos A. Camargo, Jr., Harvard Medical School
UMMS Affiliation
Department of Emergency Medicine
Publication Date
Document Type
Adult; Female; Humans; Male; Middle Aged; Motivation; Prospective Studies; Psychometrics; Reproducibility of Results; Self Efficacy; Smoking Cessation; Socioeconomic Factors; Tobacco Use Disorder; United States

BACKGROUND: Although popular clinically, the psychometric properties of motivation rulers for tobacco cessation are unknown. This study examined the psychometric properties of rulers assessing importance, readiness, and confidence in tobacco cessation.

METHODS: This observational study of current smokers was conducted at 10 US emergency departments (EDs). Subjects were assessed during their ED visit (baseline) and reassessed two weeks later. We examined intercorrelations between the rulers as well as their construct and predictive validity. Hierarchical multinomial logistic regressions were used to examine the rulers' predictive ability after controlling for covariables.

RESULTS: We enrolled 375 subjects. The correlations between the three rulers ranged from 0.50 (between Important and Confidence) to 0.70 (between Readiness and Confidence); all were significant (p < 0.001). Individuals in the preparation stage displayed the highest motivation-ruler ratings (all rulers F 2, 363 >/= 43; p < 0.001). After adjusting for covariables, each of the rulers significantly improved prediction of smoking behavior change. The strength of their predictive ability was on par with that of stage of change.

CONCLUSION: Our results provide preliminary support for the psychometric soundness of the importance, readiness, and confidence rulers.

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Copyright 2012 Boudreaux et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI of Published Version
Addict Sci Clin Pract. 2012 Jun 8;7(1):8. doi: 10.1186/1940-0640-7-8. Link to article on publisher's site
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Link to Article in PubMed
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Citation Information
Edwin D. Boudreaux, Ashley F. Sullivan, Beau W. Abar, Steven L. Bernstein, et al.. "Motivation rulers for smoking cessation: a prospective observational examination of construct and predictive validity" Vol. 7 Iss. 1 (2012) ISSN: 1940-0632 (Linking)
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