tm use of nhis and cps to assess children’s exposure to secondhand smoke angela trosclair, ms...
TRANSCRIPT
TM
Use of NHIS and CPS to AssessChildren’s Exposure to Secondhand Smoke
Angela Trosclair, MSOffice on Smoking and Health
National Conference On Tobacco or HealthBoston, MA
December 10 2003
TM
0
10
20
30
40
50
60
1955 1957 1959 1961 1963 1965 1967 1969 1971 1973 1975 1977 1979 1981 1983 1985 1987 1989 1991 1993 1995 1997 1999 2001
Year
Pe
rce
nt
Trends in Cigarette Smoking* Among Adults (18+) by Gender—United States, 1955-2001
Source: 1955 Current Population Survey; 1965-2001 NHIS*Estimates since 1992 include some-day smoking
Males
Females
TM
Health Information in NHIS
• Access to health care
• Health care utilization
• Health conditions
• Immunizations
• AIDS knowledge
• Health behaviors
—Cigarette smoking
— Physical activity
— Alcohol use
• Limitation of activity
• Injuries
• Health insurance
TM
Ever Smokers: Adults aged 18 and older who reported lifetime smoking of 100 or more cigarettes
Current Smokers: Among ever smokers, persons smoked cigarettes every day or some days
Case Definitions - NHIS
TM
• Used by Office on Smoking and Health (CDC), the lead federal agency in tobacco control, to measure national prevalence on smoking among adults and trends over time
• Guides intervention activities at a variety of settings
• Demographic/socio-economic information available
• Used in numerous research & other publications
• Issue: information on other tobacco products available only periodically
Usefulness
TM
• Self-reports by respondents
• Limited call-backs to respondents
• Centralized administration of data collection and dissemination (Census Bureau, NCHS)
• Issue: Complex sampling & data management process
Simplicity
TM
• Systematic redesign and content update every 10-15 years to accommodate changing data needs
• 2 modules (Basic, Supplements) enable timely response to new data needs
• Issue: extensive redesign in 1997 – difficult for continuous data trending from earlier years
Flexibility
TM
• Nationally representative large sample
• Weighting of data to produce nationally representative estimates
• Blacks and Hispanics over sampled since 1995
• Issues– Multiple years’ data are combined for
racial/ethnic sub-groups– Excludes persons in military, institutionalized,
homeless, or living abroad
Representativeness
TM
• Early release of data highlights: 6 months after data collection
• Public data sets available 11 months after data collection
• Re-engineering project underway to shorten it to 6 months (to be completed by 2004)
• Issue: Detailed report (Advance Data) on cigarette smoking for 1997-1998 published in 2003
Timeliness
TM
• On-going contracts with U.S. Census Bureau for data collection
• Annual on-going surveillance system for cigarette smoking
• Public data sets available for each year
• Responsiveness to new data needs: supplemental modules
Stability
TM
During the past week, has anyone smoked cigarettes, cigars, or pipes anywhere inside your home?
0 days (< 1day/week/rarely) or 1-7 days/week
This question does not allow the capture of information on resident vs. visitor smokers. The original battery of questions will be asked in the 2005 Cancer Control Supplement
11,442 children were able to be matched to a corresponding adult, with only 1934 children with no matching adult (83.1% of the sample of adults with children was available for analysis)
.
Summary of Findings —NHIS 2000Cancer Control Supplement
Children’s Exposure based on 1 question
TM
In regression analyses—
• residents in the West and Northeast were less likely to expose their children to SHS in the home
• Hispanics, NH-Blacks, and NH-Other Races were less likely to expose their children NH-Whites
• Odds of exposure increase with decreasing level of educational attainment of the mother
• Single-mother households more likely to expose their children
Summary of Findings — 2000 NHIS, Children <= 6 yrscontinued
TM
• Monthly employment survey of about 50,000 (1998/1999) to 57,000 (1992/1993) households representative of the non-institutional population of the United States living in households. Armed forces members are also interviewed.
• All household members 15+ years are interviewed. As this is a workforce survey younger adult respondents are eligible.
• Periodically, tobacco-related measures are collected including 3 months each in 1992/1993, 1995/1996, 1998/1999, 2001/2002, and 2003. Proxy responses allowed for basic tobacco use.
• Non-response rates for supplement self respondents ranged from 35% to 39% in 1998/1999 and 32% to 34%in 1995/1996
Current Population Survey Sample DesignTobacco Use Supplement
TM
Ever Smokers: Adults aged 18 and older who reported lifetime smoking of 100 or more cigarettes
Current Smokers: Among ever smokers, persons who smoked cigarettes every day or some days
Case Definitions - CPS
TM
Home Smoking Bans
Not allowed if all adult (15+ yrs) household members agree that “no one is allowed to smoke anywhere”
Allowed if all adult (15+ yrs) household members agree that “smoking is allowed in some places or at some times” OR “smoking is permitted anywhere”
Discrepancy/Unknown if there is disagreement between adult household members or if member(s) fail to respond to the question
CPS-TUS Data Definitions
TM
9.9%
5.7%
2,151 (92/93)
1,282 (98/99)
Discrepancy/
Uncertain/
Disagreement
45.0%
29.8%
9,751 (92/93)
6,695 (98/99)
Smoking
Allowed
45.0%
64.5%
9,750 (92/93)
14,497 (98/99)
No Smoking
Allowed
Unweighted Frequencies of Home Smoking Rules for Households With at Least 1 Child <= 6 Years
1992/1993 vs. 1998/1999
TM
Summary of Findings Smoking Rules in Households With at Least 1 Child <= 6 Years
CPS-TUS 1992/1993 vs. 1998/1999
• Overall (among HHs with smokers and those without), 34% reduction in prevalence of HHs where smoking allowed
• Among HHs with at least one smoker, 16% reduction in prevalence of smoking being allowed in the home
• Among HHs where no adult residents smoke, 41.2% decrease in prevalence of smoking being allowed in the home
TM
Summary of Findings Smoking Rules in Households With at Least 1 Child <= 6 Years
and at Least 1 Smoker -- CPS-TUS 1998/1999
• HHs where the mother had at least a college education were less likely to report that smoking was allowed in the home
• HHs where the mother was Hispanic or NH-Asian were less likely to report that smoking was allowed in the home
• Middle and high-income HHs were less likely to report that smoking was allowed in the home
• Among Census Regions, HHs in the Pacific, Mountain, South West and South Atlantic were less likely to report smoking being allowed in the home than HHs in the North East and South East
TM
Limitations CPS-TUS Analysis of Home Smoking Rules in
Households With Children <= 6 Years
• CPS-TUS home smoking rule question does not capture extent to which visitors smoke in the home
• Translation of proportion of households with children <= 6 years allowing smoking anywhere or in some places at some times to number of children in that age group exposed is methodologically difficult
• CPS-TUS has considerable undercoverage for non-White households (e.g. completion of the TUS is very low for Hispanic households overall)
• Smoking being allowed in HHs with young children may be increasingly underreported as mass media campaigns make this a sensitive topic
TM
Introduction of CDC's Web-Based Tobacco Survey Database
The Question Inventory on Tobacco (QIT)
Angela Trosclair, MSLinda Pederson, PhD
Pascale Wortley, MD, MPHMichael Schooley, MPH
TM
What is QIT?
• QIT includes data from 13 different health surveys (most from 1990 or later)
• QIT includes data from both national and state surveys
• QIT includes data collected from both youth and adults
TM
How can QIT be used?
• QIT can be used to locate survey questions and their response formats
• QIT can be used to locate data and documentation for secondary data analyses
• QIT can be used to gather ideas for future survey development
TM
Demonstration of Objectives
1) A review of QIT’s key features
2) A simple search by category and keyword
TM
A Simple Search by Category and Keyword
TM
Search of Category, Media/Advertising, and Keyword, Actors
TM
Results
TM
Question Details for 1st Result
TM
Survey Details for 1st Result
TM
Angela Trosclair, [email protected]
The Question Inventory on Tobaccohttp://www.cdc.gov/tobacco/qit