American Indian Adult Tobacco Survey – Methodology and Cost Estimates

American Indian/Alaska Native populations consistently have the highest commercial tobacco use rates compared to all other populations within the US. Many American Indian tribes in the U.S. argued that such aggregate findings do not provide tribal-specific rates because the tools and methods used to collect such data are not culturally appropriate. In 2000 CDC Office on Smoking and Health funded a project to develop a culturally competent adult commercial tobacco questionnaire, and interviewer training and implementation manuals for use within American Indian communities through a collaborative effort of, five Tribal Support Centers, the CDC, tribal members, and native researchers. This collaboration provided a forum for tribes to work on an equal footing with the federal government, gave voice to the concept of tribal self-determination, and respected tribal sovereignty.

High tobacco use prevalence and scarcity of data necessitated the development of a more effective means to gain a comprehensive understanding of attitudes, behaviors, and beliefs about tobacco use within American Indian communities. The AI ATS was designed to be comparable to the standard Adult Tobacco Survey administered by the states; however, the AI-ATS utilizes a unique methodology that increases the effectiveness and cultural competence of population-based surveillance among tribal communities. Specific sampling considerations, the realities of data collection, and cost estimates will be examined along with discussion detailing the experience of fielding the AI ATS in various tribal communities.