Does telephone audio computer-assisted self-interviewing improve the accuracy of prevalence estimates of youth smoking? Evidence from the UMass Tobacco Study

Despite their advantage for obtaining representative samples of adolescents, telephone surveys have been regarded as an inferior method for collecting data on youth tobacco use because they yield lower estimates than school-based, self-administered surveys. Although no gold standard for smoking estimates exists, the lower estimates in telephone surveys have been attributed to underreporting due to youths' concern that parents or others may overhear their responses. Telephone audio computer-assisted self-interviewing (T-ACASI) is a cost-effective method for obtaining a representative sample of youths and provides increased privacy for the respondent. We hypothesize that using T-ACASI would encourage youths to report more fully smoking behavior compared to traditional interviewer-administered telephone methods. Our analysis further assesses whether respondent age, gender, race/ethnicity, and parental attitude toward smoking moderated the relationship between survey mode and smoking reports. Using data from a statewide tobacco use survey that randomly assigned youth respondents to either T-ACASI or interviewer-administered modes, we find that youths were more likely to report smoking behaviors in T-ACASI mode and that this was especially true for girls, particularly those who believed their parents would disapprove strongly of their smoking. The findings suggest that traditional telephone surveys may underestimate smoking prevalence in most girls by a factor of two, and that a technique for ensuring privacy for these respondents is an important component of effective telephone survey methodology.