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Survey Overview

American Indian Adult Tobacco Survey

(December 2005)

Rationale

• National surveys in the United States have shown the prevalence of smoking among the American Indians (AI) to be higher than 30%.^{1, 2}
• These national surveys produce aggregate data to determine the prevalence of commercial tobacco use in AI populations. Therefore, the estimates do not truly represent commercial tobacco use in a specific American Indian tribe.
• The purpose of the American Indian Adult Tobacco Survey (AI ATS) is to collect tribal-specific data that will help determine tobacco use in specific tribes and guide the development of tribal-specific interventions.
• The tribal-specific data can benefit tribes by providing information to determine health priorities, direct program planning, and evaluation, and develop specific intervention strategies and policies.
• The AI ATS will facilitate the collection of tribal-specific tobacco-related data by providing a culturally competent tool that respects the culture and sovereignty of tribes and their villages.

Background/History

• Acknowledging the high prevalence of commercial tobacco use in specific AI tribes and the lack of tribal- specific data, the Office on Smoking and Health (OSH) convened representatives from Tribal Support Centers, tribes, and the AI community to participate and advise OSH on survey development.
• One of the suggestions from these representatives was for the Tribal Support Centers to secure approval or support from tribes for the project.
• In 2002, OSH awarded five Tribal Support Centers funds to conduct the AI ATS in the American Indian community.
• In conjunction with the Tribal Support Centers, OSH developed a questionnaire that was modeled after the current state-based Adult Tobacco Survey.
• The AI ATS was further tested through focus groups and cognitive interviewing to produce culturally appropriate surveys that address important tobacco control topics within the AI community.

The Survey

• In 2005, the Office of Management and Budget granted approval to CDC and the Tribal Support Centers to conduct the survey within the American Indian community.
• The AI ATS was designed as both surveillance and evaluation tools to provide tribal-specific information regarding trends in tobacco use, cessation efforts, exposure to secondhand smoke, and tobacco-related knowledge and practices among adults 18 years of age and older who reside within their respective tribal community.
• The AI ATS covers several topic areas including prevalence of commercial tobacco use; types of commercial tobacco use; factors associated with commercial tobacco use, such as age of initiation; tobacco-related healthcare visits; secondhand smoke exposure; workplace policies on smoking; health risks of smoking; and attempts to quit and methods used.
• The AI ATS will provide tribal-specific data that can be used to guide tribal tobacco control efforts.
• Data from the survey can be used to help direct culturally appropriate program planning, evaluate programs and develop policy; tailor interventions, allocate resources, obtain funding, and monitor industry marketing tactics for specific U.S. tribes.
• Each tribe that conducts the survey has the option of adding additional questions that focus on ceremonial or sacred tobacco use; purchase patterns, tobacco-related asthma, diabetes, and cardiovascular disease; smoking during pregnancy; cigarette brand preference; or other important tobacco-related issues.

Current Activities

• The AI ATS was first conducted in 2005 among 11 tribes by trained local tribal interviewers. The data collected are owned exclusively by the tribes or villages that participate in the surveys, not by states or the federal government.
• The 11 tribes that conducted the AI ATS, found that the face-to-face method was the most appropriate way to administer the survey within their communities. However, telephone interviews may be conducted.

References

1. Centers for Disease Control and Prevention. Cigarette Smoking Among Adults—United States, 2004. MMWR, 2005: 54(44):1121–1124.
2. Substance Abuse and Mental Health Services Administration. (2005). Results From the 2004 National Survey on Drug Use and Health: National Findings (Office of Applied Studies, NSDUH Series H-28, DHHS Publication No. SMA 05-4062). Rockville, MD.

For Further Information

Centers for Disease Control and Prevention
National Center for Chronic Disease Prevention and Health Promotion
Office on Smoking and Health
E-mail: tobaccoinfo@cdc.gov
Phone: 1-800-CDC-INFO

Media Inquiries: Contact CDC's Office on Smoking and Health press line at 770-488-5493.

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