# Presentation: 750506

## 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**

**1****National Center for Epidemiology, Hungary**
**2****National Center for Health Statistics, United States**

**Centers for Disease Control and Prevention**
**National Center for Health Statistics**

## 2000 Hungarian and UShealth 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 UShealth 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 UShealth 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 UShealth 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

## Sample sizes and response rates

**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

- 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?

## Definition of “current smoker”

**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

## Fig 1. US and Hungarian smoking prevalence, by age

- Percent

- 18-24

- 25-44

- 45-64

- 65+

- US

- Hungary

- SOURCE: Hungarian Health Interview Survey (OLEF 2000) and US National Health Interview Survey (NHIS)

- Age in years

## Fig 2. US and Hungarian smoking prevalence, by age and sex

- Percent

- 18-24

- 25-44

- 45-64

- 65+

- SOURCE: Hungarian Health Interview Survey (OLEF 2000) and US National Health Interview Survey (NHIS)

- Age in years

## Fig 3. US and Hungarian smoking prevalence, by education

- Percent

- Grade 1-8

- Grade 9-11

- HS grad

- College+

- US

- Hungary

- SOURCE: Hungarian Health Interview Survey (OLEF 2000) and US National Health Interview Survey (NHIS)

## 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 websitewww.cdc.gov/nchs/Hungarian websitewww.antsz.hu/oek