International Journal of Behavioral Medicine

, Volume 16, Issue 2, pp 158-163

First online:

The Factor Structure and Factorial Invariance for the Decisional Balance Scale for Adolescent Smoking

  • Boliang GuoAffiliated withDivision of Primary Care & Public Health, University of Birmingham
  • , Paul AveyardAffiliated withDivision of Primary Care & Public Health, University of Birmingham Email author 
  • , Antony FieldingAffiliated withDepartment of Economics, University of Birmingham
  • , Stephen SuttonAffiliated withDepartment of Public Health and Primary Care, Institute of Public Health, University Forvie Site

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The transtheoretical model is a framework to explain smoking uptake and cessation in adolescence. Decisional balance is proposed as a driver of stage movement.


The purpose of this study was to examine the factor structure and measurement equivalence/invariance (ME/I) of the decisional balance scale.


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.


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.


Cons showed strong evidence that it constituted two separate first order factors. Decisional balance for smoking in adolescence has good evidence of factorial validity.


Decisional balance scale TTM Factor structure Measurement invariance test Longitudinal study