Implementation and analysis of the Short Supplemental Youth Tobacco Survey focusing on North Carolina's American Indian youth (grades 6-12)

Background: Although North Carolina (NC) has the largest American Indian (AI) population east of the Mississippi, there are no data regarding the prevalence of tobacco use among AI youth in this state. The Short Supplemental Youth Tobacco Survey (SSYTS) was created to address this information gap in NC. Methods: The SSYTS contains 29 questions, 24 from the statewide YTS and 5 created specific to AI youth regarding tribal affiliation, commercial vs. ceremonial/traditional tobacco use, frequency of participation in AI events, and traditional use among family members. Schools with an AI population of at least 10% were invited to participate. 273 second and third period classes of 6th-12th grade students were randomly selected for a target sample size of 2860, to obtain point estimates with ±5 confidence intervals. Results: Approximately 4692 students from 273 classrooms in 24 schools from 7 counties were surveyed. AI students were more likely to have smokers in the household (61% vs. 50%), have smoked in the past 30 days (26% vs. 16%), and think that smoking should be allowed in some or more areas of restaurants (47% vs. 39%) compared to other races. Among AI students 33% reported never having used tobacco, and of those using tobacco 24% reported use for ceremonial reasons. Conclusion: Data obtained from this study will be beneficial for targeted interventions and for seeking prevention funding. Lessons learned will be used to expand the current methods and improve representation from the 8 NC AI tribes.