The impact of survey and response modes on current smoking prevalence estimates using TUS-CPS: 1992-2003

This study identified whether survey administration mode (telephone or in-person) and respondent type (self or proxy) result in discrepant prevalence of current smoking in the adult U.S. population, while controlling for key sociodemographic characteristics and longitudinal changes of smoking prevalence over the 11-year period from 1992-2003. We used a multiple logistic regression analysis with replicate weights to model the current smoking status logit as a function of a number of covariates. The final model included individual- and familylevel sociodemographic characteristics, survey attributes, and multiple two-way interactions of survey mode and respondent type with other covariates. The respondent type is a significant predictor of current smoking prevalence and the magnitude of the difference depends on the age, sex, and education of the person whose smoking status is being reported. Furthermore, the survey mode has significant interactions with survey year, sex, and age. We conclude that using an overall unadjusted estimate of the current smoking prevalence may result in underestimating the current smoking rate when conducting proxy or telephone interviews especially for some sub-populations, such as young adults. We propose that estimates could be improved if more detailed information regarding the respondent type and survey administration mode characteristics were considered in addition to commonly used survey year and sociodemographic characteristics. This information is critical given that future surveillance is moving toward more complex designs. Thus, adjustment of estimates should be contemplated when comparing current smoking prevalence results within a given survey series with major changes in methodology over time and between different surveys using various modes and respondent types.