Metacognitions About Smoking: Psychometric Properties of the Italian Version of the Metacognitions About Smoking Questionnaire.

This study aimed to evaluate the factor structure, internal consistency and concurrent validity of the Italian version of the Metacognitions about Smoking Questionnaire (MSQ), utilizing the framework of the Self-Regulation Executive Function model. A total of 532 smokers completed the Italian-translated version of the MSQ, the Fagerstrom Test for Nicotine Dependence, the Severity Dependence Scale, the Depression Anxiety and Stress Scale-21. To test the factorial structure of the MSQ, a series of confirmatory factor analyses (CFAs) were run; correlational analyses and structural equation modelling (SEMs) approaches were undertaken to evaluate the concurrent validity. The 12-item MSQ with four factors was confirmed: positive metacognitions about cognitive regulation (PM-CR), positive metacognitions about emotional regulation (PM-ER), negative metacognitions about uncontrollability (NM-U) and negative metacognitions about cognitive interference (NM-CI). The MSQ showed an overall satisfactory fit index (TLI = 0.949, CFI = 0.963, RMSEA = 0.082 [0.064-0.101]). Internal consistency was satisfactory. MSQ factors are associated with higher nicotine/cigarette dependence and emotional distress, supporting the concurrent validity of the tool. Specific metacognitions about smoking were associated with different clinical outcomes related to smoking. A higher engagement on PM-CR and on NM-U was positively associated with nicotine/cigarette dependence. A higher engagement on PM-ER and NM-CI was associated with greater emotional distress. The 12-item Italian version of the MSQ could be a promising tool to assess specific metacognitions about smoking in both research and clinical contexts. Metacognitions about smoking may be a suitable therapeutic target to reduce the levels of nicotine/cigarette dependence and emotional distress among smokers.