Validity of a Functional Assessment for Smoking Treatment Recommendations Questionnaire

Introduction: Smoking is the leading cause of preventable death in the United States and imposes a substantial economic cost. Despite the well-established potential harm, relapse rates remain high during quit attempts. In the realm of applied behavior analysis, functional assessment has long been recognized as a reliable method to increase effectiveness of treatments for a variety of problem behaviors. Functional assessment may aid in designating targeted treatment for smokers based on the maintaining function(s) of the behavior. Method: The current study (N = 414) sought to assess the reliability and validity of the Functional Assessment of Smoking for Treatment Recommendations (FASTR) and provide preliminary evidence towards a hypothesized factor structure. The full FASTR included five subscales derived from the field of functional behavior assessment: 1) Automatic Positive Reinforcement, 2) Social Positive Reinforcement, 3) Automatic Negative Reinforcement, 4) Social Negative Reinforcement, and 5) Antecedent Stimuli. Results: The full battery of subscales was found to be adequately reliable and valid, with overall sample reliability coefficients ranging from α = 0.69 to α = 0.90. Confirmatory factor analysis of the 5-factor model produced acceptable fit indices (CFI = 0.908, TLI = 0.896, RMSEA = 0.059, SRMR = 0.071). Conclusions: A 5-factor model performed favorably across several fit indices, providing preliminary validity data. Further research should aim to replicate the observed factor structure in other samples and establish the clinical utility of the FASTR.