Adult tobacco survey - 19 States, 2003-2007.

PROBLEM/CONDITION: Tobacco use is the leading cause of preventable death in the United States. REPORTING PERIOD: This report includes data collected during February 2003-November 2007. DESCRIPTION OF THE SYSTEM: The Adult Tobacco Survey (ATS) is a state-administered, random-digit--dialed telephone survey of the noninstitutionalized U.S. population aged >or=18 years. ATS collects data on tobacco use, smoking cessation, secondhand smoke exposure, risk perception and social influences, health influences, and tobacco-related policy issues in the United States. ATS was developed primarily for evaluation of state tobacco control programs rather than for surveillance and offers states a great deal of flexibility in terms of when and how often the surveys can be conducted. During 2003-2007, a total of 33 state ATSs were conducted by 19 states, with sample sizes ranging from 1,301 to 12,734 completed and partially completed interviews. RESULTS: ATS data indicate that during 2003-2007, 13.3%-25.4% of adults smoked cigarettes (median: 19.2%); fewer adults smoked cigars (median: 6.4%) or used smokeless tobacco (median: 3.5%). The majority of tobacco users used one tobacco product (median: 82.5%). In most states, approximately half of cigarette smokers reported that they would try to quit in the next 6 months (median: 58.4%), and approximately half made an attempt to quit in the preceding year (median: 46.8%). The majority of adults (i.e., smokers and nonsmokers combined) reported that smoking should not be allowed at all in workplaces (median: 77.6%), restaurants (median: 65.5%), public buildings (median: 72.5%), or indoor sporting events/concerts (median: 72.1%). One third of adults reported smoking should not be allowed at all in cocktail lounges or bars (median: 33.1%). The percentage of adults who reported having smoke-free policies at work or home ranged from 51.2% to 75.2% (median: 61.7%). INTERPRETATION: These data indicate that respondents support certain state tobacco control measures; for example, the majority of adults in participating states were supportive of smoke-free policies as well as of an increase in tobacco excise tax. However, one of every five tobacco users in the participating states used multiple tobacco products, a behavior that was more common among young adults. Therefore, these data also underscore a continued need for monitoring and evaluating evidence-based, comprehensive U.S. tobacco control programs and policies. PUBLIC HEALTH ACTIONS: State ATSs can be used by states to monitor and evaluate comprehensive statewide tobacco control programs. Continued surveillance of tobacco use and tobacco control outcome indicators are needed to monitor, evaluate, and improve state programs that address tobacco use, cessation, and secondhand smoke exposure.

Balancing quality and cost for Adult Tobacco Telephone Surveys.

OBJECTIVES: To demonstrate the ability to cost-effectively coordinate Adult Tobacco Survey stakeholder interests while reducing the risk of potential bias. METHODS: Key smoking indicators were compared across 2 surveys and analyzed based on modifications to calling protocols. RESULTS: Mixed results were found when comparing smoking rates across 2 surveys, by early, mid, and late respondents, and by the number of rufusals. Significant cost sayings can be obtained by reducing the number of telephone call attempts. CONCLUSIONS: Few significant differences may encourage reductions in protocol, but this must be weighed against the possibility of cost-saving measures resulting in biased estimates.