Abstract
Accurate smoking prevalence data is critical for monitoring, surveillance, and evaluation. However, estimates of prevalence vary across surveys due to various factors. This study examines smoking prevalence estimates for 18–21 year olds across six U.S. national telephone, online and in-person surveys for the years 2013 and 2014. Estimates of ever smoking ranged from 35% to 55%. Current smoking ranged from 16% to 30%. Across the three modalities, household surveys were found to yield the highest estimates of smoking prevalence among 18 to 21 year olds while online surveys yielded the lowest estimates, and this was consistent when stratifying by gender and race/ethnicity. Assessments of the joint effect of gender, race/ethnicity, educational attainment and survey mode indicated that the relative differences in the likelihood of smoking were consistent across modes for gender and education groups. However, the relative likelihood of smoking among minority groups compared with non-Hispanic Whites varied across modes. Gender and racial/ethnic distributions for most surveys significantly differed from the U.S. Census. Over and underrepresentation of certain demographic subpopulations, variations in survey question wording, and social desirability effects may explain modality differences in smoking estimates observed in this study. Further research is needed to evaluate the effect of survey mode on variation in smoking prevalence estimates across national surveys, particularly for young adult populations.
Highlights
Accurate smoking prevalence data is critical for monitoring, surveillance, and evaluation
Longitudinal Cohort (TLC) [2] and the 2013 Young Adult Cohort (YAC) [3, 15]; the two inperson computer assisted interviewing (CAI) surveys were the Substance Abuse and Mental Health Administration’s (SAMHSA) 2013 and 2014 National Surveys of Drug Use and Health (NSDUH); the two telephone surveys were from the Centers for Disease Control and Prevention (CDC) National Adult Tobacco Survey (NATS) from 2012–2013 and 2013–2014
Ever use elicited from the two online surveys are at the lower end of sample estimates, at 39% for the Truth Longitudinal Cohort (TLC) and 35% for the YAC
Summary
Accurate smoking prevalence data is critical for monitoring, surveillance, and evaluation. Monitoring ever and past 30-day tobacco use among young adult populations is critical for capturing initial smoking activity among this group. Many young people in this age range are: 1) gaining the ability to purchase tobacco legally for the first time; 2) being targeted with tobacco industry marketing[7, 8] and 3) exploring identities and seeking out new experiences, related to substance use.[9] Since 2004, data finds that smoking initiation is highest among young adults age 18–21 and has not declined at the same rate as youth in recent years.[10] Recognizing this fact, states have increasingly passed Tobacco 21 laws restricting tobacco sales to those aged 21 and over[11] and recent initiatives have focused on similar legislation at the federal level.[12] Given these trends, it is especially important to understand and monitor this 18–21 year old age group separate from other age groups. The current study adds to the literature on whether and to what extent survey modality influences estimates of smoking prevalence by addressing the following questions: 1. What are the point estimates of ever and current (past 30-day) smoking for 18–21 year-olds in the U.S from six national surveys administered during the same time period?
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