Health behavior (nutrition, smoking habits, alcoho

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SMOKING BEHAVIOR IN HUNGARY AND IN THE USA

• Julianna Boros1 (boros.oek_at_antsz.hu)
• Deborah Rose, PhD2 (drose_at_cdc.gov)
• 1National Center for Epidemiology, Hungary
• 2National Center for Health Statistics, USA

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History of the cooperation

• 1998 the Hungarian Ministry of Health starts
  preparations for the Hungarian Health Interview
  Survey (OLEF2000)
• 1999 MoH asks the NCHS for methodological support
  
• 1999- NCHS starts providing on-site and
  distance-based technical assistance to the
  Hungarian partner

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Technical support

• Survey design
• Finalization of survey questionnaire
• Sample design
• Training of survey personnel
• Monitoring of data collection
• Data editing
• Data file preparation
• Analysis and report preparation

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General characteristics of OLEF2000

• Personal interviews (paper questionnaire)
• Internationally harmonized instruments
• Target population 7000 people aged 18
  (multi-stage stratified random sample--one sample
  adult per household)
• Response rate 79 (5503 individuals)
• Refusal rate 7.5

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Chapters of the questionnaire

• Health status (functionality, perceived health,
  quality of life, chronic conditions, mental
  health)
• Health behavior (nutrition, smoking habits,
  alcohol consumption, physical activity, sexual
  behavior, multiple lifestyle risk)
• Health care utilization
• Health care expenditures
• Medicine consumption
• Demographic and socioeconomic characteristics

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Switch to NCHS portion
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Logistic regression model

• Dependent variable odds of smoking vs.
  non-smoking
• Explanatory variables
• Age
• Education
• Financial status
• Employment
• Weekly working hours
• Social support
• Religion

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Smoking and education
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Smoking and age
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Smoking and financial status
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Smoking and social support
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Smoking and religion
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Benefits of the cooperation

• For NCE
• quick introduction of survey technology
• accelerating learning process
• For NCE and NCHS
• validation of analytical methods
• judging the appropriateness of public heath
  priorities

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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.

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US NCHS websitewww.cdc.gov/nchs/Hungarian NCE
websitewww.antsz.hu/oek