Elsevier

Preventive Medicine

Volume 27, Issue 6, November 1998, Pages 808-814
Preventive Medicine

Regular Article
An Instrument for Assessing the Quality of Tobacco-Control Policies: The ACT-L Scale

https://doi.org/10.1006/pmed.1998.0363Get rights and content

Abstract

Background.Efforts to prevent and decrease tobacco use and tobacco-related disease include improving the quality of tobacco-control laws to make them more stringent in controlling tobacco advertising, youth access, and exposure to environmental tobacco smoke (ETS). However, because there are no instruments to empirically evaluate the quality of such laws, it has been difficult to demonstrate that their quality is associated with decreased youth access or tobacco-related morbidity. We present the first instrument for empirically assessing the quality of tobacco-control policies.

Methods.Recommendations for the content of an ideal, comprehensive tobacco-control policy were used as the 55 items in the Assessment of the Comprehensiveness of Tobacco Laws Scale (ACT-L Scale). Raters evaluated 71 tobacco-control laws with the scale; 70 of these were actual California laws and 1 was a model law from Americans for Non-smokers' Rights (ANR).

Results.Interrater (r= 0.64–0.89) and internal-consistency (r= 0.63–0.88) reliability of the scale and subscales were high, and validity was established by demonstrating that the ANR model law received a significantly higher total score (mean = 18.75) than all actual laws (mean = 2.04). California tobacco-control laws were poor in all areas (youth access, ETS, tobacco advertising).

Conclusions.The ACT-L scale can be used to compare and evaluate the quality of tobacco-control laws, highlight areas in which further policy efforts are needed, quantify improvement in such policies, and empirically demonstrate the positive health impact of high-quality tobacco-control laws.

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Supported by funds provided by the Cigarette and Tobacco Surtax Fund of the State of California through the Department of Health Services Tobacco Control Section program (TCS) Grant 94-20962.

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To whom correspondence and reprint requests should be addressed at the Behavioral Health Institute, California State University, San Bernardino, 5500 University Parkway, San Bernardino, CA 92407. E-mail:[email protected].

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