- Volume 14 Issue 11
DOI QR Code
Tobacco Use and Quit Behaviour Assessment in the Global Adult Tobacco Survey (GATS): Invalid Responses and Implications
- Jena, Pratap Kumar (Project STEPS, Public Health Foundation of India, New Delhi, and Heath Systems Research India Initiative) ;
- Kishore, Jugal (Department of Community Medicine, Maulana Azad Medical College) ;
- Pati, Sanghamitra (Indian Institute of Public Health) ;
- Sarkar, Bidyut Kanti (Department of Epidemiology and Public Health, University College London, and Public Health Foundation of India (PHFI)) ;
- Das, Sagarika
- Published : 2013.11.30
Background: Tobacco use and quit attempts are two key indicators of the Global Adult Tobacco Survey (GATS) that assess quit attempts among current as well as former tobacco users. The relevant data have inherent policy implications for tobacco cessation programme evaluation. This study aimed to review the concepts of quit attempt assessment and quantifying invalid responses considering GATS-India data. Materials and Methods: GATS assessment of tobacco use and quit attempts were examined in the current literature. Two categories of invalid responses were identified by stratified analysis of the duration of last quit attempt among current users and duration of abstinence among former users. Category A included absolute invalid responses when time-frame of assessment of current tobacco use and less than former tobacco use were violated. Category B included responses that violated the unit of measurement of time. Results: Current daily use, current less than daily use and former use in GATS were imprecisely defined with overlapping of time-frame of assessment. Overall responses of 3,102 current smokers, 4,036 current smokeless users, 1,904 former smokers and 1,343 former smokeless users were analyzed to quantify invalid responses. Analysis indicated overall 21.2% (category A: 7.32%; category B: 17.7%) and 22.7% (category A: 8.05%; category B: 18.1%) invalid responses among current smokers and smokeless users respectively regarding their duration of last quit attempt. Similarly overall 6.62% (category A: 4.7%; category B: 2.3%) and 10.6% (category A: 8.6%; category B: 3.5%) invalid responses were identified among former smokers and smokeless users respectively regarding their duration of abstinence. Conclusions: High invalid responses for a single assessment are due to the imprecise definition of current use, former use and quit attempt; and failure to utilize opportunity of direct data entry interface use during the survey to validate responses instantly. Redefining tobacco use and quit attempts considering an appropriate timeframe would reduce invalid responses.
Quit attempt;validity;global adult tobacco survey;India
- DiClemente CC, Prochaska JO, Fairhurst SK, et al (1991). The processes of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change. J Consulting Clin Psychol, 59, 285-304.
- Fiore MC, Keller PA, Curry SJ (2007). Health system changes to facilitate the delivery of tobacco-dependence treatment. Am J Prev Med, 33, 349-56. https://doi.org/10.1016/j.amepre.2007.09.001
- Fong GT, Cummings KM, Borland R, et al (2006a). The conceptual framework of the International Tobacco Control (ITC) policy evaluation project. Tob Control, 15, 3-11. https://doi.org/10.1136/tc.2005.014464
- Fong GT, Cummings KM, Shopland DR, et al (2006b). Building the evidence base for effective tobacco control policies: the international tobacco control (ITC) policy evaluation project. Tob Control, 15, 1-2. https://doi.org/10.1136/tc.2005.014381
- Global Adult Tobacco Survey - GATS (2007). The Global Adult Tobacco Survey.
- Gilpin E, Pierce JP (1994). Measuring smoking cessation: problems with recall in the 1990 california tobacco survey. Cancer Epidemiol Biomarkers Prev, 3, 613-7.
- Giovino GA, Biener L, Hartman AM, et al (2009). Monitoring the tobacco use epidemic. Overview: optimizing measurement to facilitate change. Prev Med, 48, 4-10. https://doi.org/10.1016/j.ypmed.2008.08.007
- Global Adult Tobacco Survey Collaborative Group (2011). Tobacco Questions for Surveys: A subset of key Questions from the Global Adult Tobacco Survey (GATS), 2nd Edition. Atlanta, GA: Centers for Disease Control and Prevention.
- Global Tobacco Surveillance System (GTSS) (2009). Global Adult Tobacco Survey (GATS): Indicator Guidelines: Definition and Syntax. Geneva: World Health Organization.
- Gritz ER, Schacherer C, Koehly L, et al (1999). Smoking withdrawal and relapse in head and neck cancer patients. Head Neck, 21, 420-7. https://doi.org/10.1002/(SICI)1097-0347(199908)21:5<420::AID-HED7>3.0.CO;2-U
- Hughes JR (2007). Effects of abstinence from tobacco: valid symptoms and time course. Nicotine Tob Res, 9, 315-27. https://doi.org/10.1080/14622200701188919
- International Institute for Population Sciences-IIPS (2010). The Global Adult Tobacco Survey (GATS) India, 2009-2010. New Delhi: IIPS, Ministry of Health and Family Welfare, Government of India.
- International Agency for Research on Cancer- IARC (2007). IARC Handbooks of Cancer Prevention, Tobacco Control, Vol. 11: Reversal of Risk after Quitting Smoking. Lyon: IARC.
- International Tobacco Control (ITC) Policy Evaluation Project (2007). ITC Surveys Tool for India.
- Jardin BF, Carpenter MJ (2012). Predictors of quit attempts and abstinence among smokers not currently interested in quitting. Nicotine Tob Res, 14, 1197-204. https://doi.org/10.1093/ntr/nts015
- Jena PK, Kishore J, Bandyopadhyay C (2012). Prevalence and patterns of tobacco use in Asia. Lancet, 380, 1906.
- Jena PK, Kishore J, Sarkar BK (2013). Global Adult Tobacco Survey: a case for change in definition, analysis and interpretation of “Cigarette” and “Cigarettes per Day” in completed and future surveys. Asian Pac J Cancer Prev, 14, 3299-304. https://doi.org/10.7314/APJCP.2013.14.5.3299
- Joseph AM, Rice K, An LC, et al (2004). Recent quitters’ interest in recycling and harm reduction. Nicotine Tob Res, 6, 1075-77. https://doi.org/10.1080/14622200412331324893
- Kishore J, Jena PK, Bandyopadhyay C, et al (2013). Hardcore smoking in three South East Asia countries and its implication: results from global adult tobacco survey. Asian Pac J Cancer Prev, 14, 625-30. https://doi.org/10.7314/APJCP.2013.14.2.625
- McEwen A, Hajek P, McRobbie P, West R (2006). Manual of smoking cessation: a guide for counsellors and practitioners. London: Wiley-Blackwell.
- Pierce JP, Farkas AJ, Gilpin EA (1998). Beyond stages of change: the quitting continuum measures progress towards successful smoking cessation. Addiction, 93, 277-86. https://doi.org/10.1046/j.1360-0443.1998.93227711.x
- Prochaska JO, DiClemente CC, Norcross JC (1992). In search of how people change: Applications to addictive behaviors. Am Psychol, 47, 1102-14. https://doi.org/10.1037/0003-066X.47.9.1102
- Starr G, Rogers T, Schooley M, et al (2005). Key Outcome Indicators for Evaluating Comprehensive Tobacco Control Programs. Atlanta, GA, Centers for Disease Control and Prevention.
- Tobias MI, Cavana RY, Bloomfield A (2010). Application of a system dynamics model to inform investment in smoking cessation services in New Zealand. Am J Public Health, 100, 1274-81. https://doi.org/10.2105/AJPH.2009.171165
- US Department of Health and Human Services (2004). The health consequences of smoking: a report of the Surgeon General. Atlanta, Ga: USDHHS, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
- Vangeli E, Stapleton J, Smit ES, et al (2011). Predictors of attempts to stop smoking and their success in adult general population samples: a systematic review. Addiction, 16, 2110-21.
- West R, Mcewen A, Bolling K, Owen L (2001). Smoking cessation and smoking patterns in the general population: A 1-year follow-up. Addiction, 96, 891-902. https://doi.org/10.1046/j.1360-0443.2001.96689110.x
- West R, Sohal T (2006). “Catastrophic” pathways to smoking cessation: findings from national survey. Br Med J, 332, 458-60. https://doi.org/10.1136/bmj.38723.573866.AE
- West R, Zatonski W, Przewozniak K, et al (2007). Can we trust national smoking prevalence figures? Discrepancies between biochemically assessed and self-reported smoking rates in three countries. Cancer Epidemiol Biomarkers Prev, 16, 820-2. https://doi.org/10.1158/1055-9965.EPI-06-0679
- West R (2006). Feasibility of a national longitudinal study ("The Smoking Toolkit Study") to monitor smoking cessation and attempts at harm reduction in the UK, 1-35.
- West R (2009). The multiple facets of cigarette addiction and what they mean for encouraging and helping smokers to stop. COPD, 6, 277-83 https://doi.org/10.1080/15412550903049181
- West R (2006). Theory of Addiction. Oxford: Blackwells.
- Wolburg (2006). College students' responses to antismoking messages: Denial, defiance, and other Boomerang Effects. J Consumer Affairs, 40, 294-323. https://doi.org/10.1111/j.1745-6606.2006.00059.x
- World Health Organization (1998). Guidelines for controlling and monitoring the tobacco epidemic. Geneva, Switzerland: World Health Organization.
- Zhou X, Nonnemaker J, Sherrill B, et al (2009). Attempts to quit smoking and relapse: Factors associated with success or failure from the ATTEMPT cohort study. Addict Behaviors, 34, 365-73. https://doi.org/10.1016/j.addbeh.2008.11.013
- A Cross-Country Comparison of Knowledge, Attitudes and Practices about Tobacco Use: Findings from the Global Adult Tobacco Survey vol.15, pp.12, 2014, https://doi.org/10.7314/APJCP.2014.15.12.5035