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Smoking Behavior: A Comparision Between the Health Interview Surveys of the US and Hungary. Julianna Boros¹ and Deborah Rose, Ph.D² NCHS Data Users Conference, July 15, 2002. ¹National Center for Epidemiology, Hungary ²National Center for Health Statistics, United States.
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Smoking Behavior: A Comparision Between the Health Interview Surveys of the US and Hungary Julianna Boros¹ and Deborah Rose, Ph.D² NCHS Data Users Conference, July 15, 2002 ¹National Center for Epidemiology, Hungary ²National Center for Health Statistics, United States Centers for Disease Control and Prevention National Center for Health Statistics
2000 Hungarian and UShealth interview surveys Interchange between Hungary and the US • Technical assistance from US to Hungary funded by the World Bank • US staff to Hungary for: bidding conference, questionnaire review, training, pretest, and field interviews • Hungarian staff to US for: field pretest, interviewer training, and consult with data editors and analysts
2000 Hungarian and UShealth interview surveys Two separate surveys: • Hungarian Health Interview Survey(OLEF 2000) • US National Health Interview Survey (NHIS) In the field: • Hungary – Fall 2000 • US – January through December 2000
2000 Hungarian and UShealth interview surveys Methodology - similarities: • Multi-stage, stratified random sample of households, representative of whole country • Personal interview in household, by trained interviewers • Analysis software must incorporate complex sample design
2000 Hungarian and UShealth interview surveys Methodology - differences: • Format: Laptop interview in the US; paper questionnaire in Hungary • Respondent info: All household members, a randomly sampled adult, and a randomly sampled child in US; one sample adult per household, Hungary
Hungary Sample size: 5,503 adults Response rate: 79% United States Sample sizes: 38,633 households; 100,618 persons; 32,374 sample adults Response rates: 88.9% household response; 72.1% sample adult conditional response Sample sizes and response rates SOURCE: Hungarian Health Interview Survey (OLEF 2000) and US National Health Interview Survey (NHIS)
Smoking questions Hungarian • Do you smoke? • Do you smoke every day or only occasionally? United States • Have you smoked at least 100 cigarettes in your entire life? • Do you now smoke every day, some days, or not at all?
Hungary Now smokes cigarettes Smokes every day or occasionally United States Has smoked at least 100 cigarettes in entire life Now smokes every day or some days Definition of “current smoker”
Fig 1. US and Hungarian smoking prevalence, by age Percent US Hungary 18-24 25-44 45-64 65+ Age in years SOURCE: Hungarian Health Interview Survey (OLEF 2000) and US National Health Interview Survey (NHIS)
US male US female HU male HU female Fig 2. US and Hungarian smoking prevalence, by age and sex Percent 18-24 25-44 45-64 65+ Age in years SOURCE: Hungarian Health Interview Survey (OLEF 2000) and US National Health Interview Survey (NHIS)
Fig 3. US and Hungarian smoking prevalence, by education US Hungary Percent Grade 1-8 Grade 9-11 HS grad College+ SOURCE: Hungarian Health Interview Survey (OLEF 2000) and US National Health Interview Survey (NHIS)
US male US female HU male HU female Fig 4. US and Hungarian smoking prevalence, by education and sex Percent Grade 1-8 Grade 9-11 HS grad Any college+ SOURCE: Hungarian Health Interview Survey (OLEF 2000) and US National Health Interview Survey (NHIS)
Smoking comparison • Smoking prevalence about 30% higher in Hungary • Differences more pronounced by age in Hungary than in the US • Smoking prevalence higher in males than females in both countries • Very low smoking prevalence in older Hungarian females due to cultural constraints SOURCE: Hungarian Health Interview Survey (OLEF 2000) and US National Health Interview Survey (NHIS)
Switch to Hungarian portion SOURCE: Hungarian Health Interview Survey (OLEF 2000) and US National Health Interview Survey (NHIS)
Lessons learned from collaboration • Differences between professions (doctor, sampling statistician, epidemiologist) greater than differences between countries • Higher methodological standards for government surveys than commercial polls • Overall patterns by age, sex, and education were similar between Hungary and US • Cultural differences in physical activity, diet and self-report of cancer limited comparability of questions • Collaboration and contrast helped each country to better understand which topics and questions best met its needs.
NCHS websitewww.cdc.gov/nchs/Hungarian websitewww.antsz.hu/oek