The ABOUT™ Toolbox: toward the development of consumer-reported outcome measures that matter
Tobacco harm reduction promotes the substitution of reduced-risk products (RRPs) for cigarettes by adult smokers who would otherwise continue to smoke, while preventing RRP initiation among non-users. To operationalize this public health strategy, there is a need to understand the motivations, perceptions, and behavioral patterns of using RRPs. A prerequisite for this is to have accurate estimates of these underlying perceptions and behaviors, which require adequate measurement tools to be put in place. This work presents the rationale for the development of the ABOUT™ (Assessment of Behavioral OUtcomes related to Tobacco and nicotine products) Toolbox, a portfolio of self-report instruments developed to support population perception and behavior assessment of RRPs. The ABOUT™ Toolbox has been developed using best measurement practices, including generation of a conceptual model, evaluation of content validity, use of an appropriate psychometric model, cross-cultural measurement equivalence, and appropriate access of the validated instruments (original and translations). Moreover, the Toolbox fits into an underpinning behavioral conceptual model, designed to understand switching or transition behaviors, which encompasses several levels of assessment (i.e. individual, product, and environment). The ABOUT™ Toolbox will initially include five self-report instruments focusing on individual level (perceived risk, perceived dependence, product experience, use history, health and functioning). In this work, we focus on the rationale and guiding principles supporting the ABOUT™ Toolbox initiative, while specific instruments will be presented in detail in separate presentations. Making the ABOUT™ Toolbox accessible to the tobacco research and public health community is paramount to addressing tobacco harm reduction challenges. Wider use of the Toolbox could help to rapidly build an evidence base that would allow comparisons of study findings across a wide spectrum of RRPs. In turn, this would potentially enable public health and regulatory communities to make informed decisions for future regulation of RRPs.