Development and Validation of the Stress Burden of Electronic Cigarette Smoking Scale (SBECSS) Among Adult Dual Users.

BACKGROUND: The present study aimed to develop and evaluate the preliminary validity of the Stress Burden of Electronic Cigarette Smoking Scale (SBECSS), a new measure designed to assess the level of stress burden associated with the co-occurring perceptions of electronic cigarette (e-cigarette) use and efforts to quit within an individual. METHOD: To achieve this, 400 adult dual users of combustible cigarettes and e-cigarettes (52.8% female; 90% non-Hispanic White; Mage = 37.8, SD = 9.7) participated in an online survey. Items were developed in accordance with the operational definition, reviewed by field experts, and evaluated post-data collection for inter-item correlations and theoretical alignment. RESULTS: Confirmatory factor analysis was conducted to compare the unidimensional, two-factor correlated, second order, and bifactor models. Factor analysis supported a unidimensional factor structure (X2[170] = 343.557, p < 0.001; RMSEA = 0.051 [90% CI: 0.043, 0.059], p = 0.413; CFI = 0.970; SRMR = 0.021), and measurement invariance was supported across sex. The SBECSS demonstrated construct validity with measures of e-cigarette related and affective processes. CONCLUSIONS: These findings suggest that the SBECSS is a reliable and valid tool for measuring and understanding the stress burden of using or quitting e-cigarettes among dual tobacco users.