A nationwide mobile phone survey for tobacco use in Tanzania: Sample quality and representativeness compared to a household survey

Gulam Muhammed Al Kibria; Frank Kagoro; George Pariyo; Joseph Ali; Farida Hassan; John W Kilambo; Irene Petro; Vidhi Maniar; Michelle R Kaufman; Andres Vecino-Ortiz; Saifuddin Ahmed; Honorati Masanja; Dustin G Gibson

doi:10.1016/j.pmedr.2024.102609

A nationwide mobile phone survey for tobacco use in Tanzania: Sample quality and representativeness compared to a household survey

Prev Med Rep. 2024 Jan 12:38:102609. doi: 10.1016/j.pmedr.2024.102609. eCollection 2024 Feb.

Authors

Affiliations

¹ Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States.
² Ifakara Health Institute, Dar es Salaam, Tanzania.
³ Center for Optimising Antimalarial Therapy, University of Cape Town, Cape Town, South Africa.
⁴ The Global Health Network, Center for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.
⁵ Serum Africa Medical Research Institute, Kampala, Uganda.
⁶ Berman Institute of Bioethics, Johns Hopkins University, Baltimore, MD 21205, United States.
⁷ Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States.
⁸ Department of Population, Family & Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States.

Abstract

We investigated the feasibility of an interactive voice response (IVR) survey in Tanzania and compared its prevalence estimates for tobacco use to the estimates of the 'Global Adult Tobacco Survey (GATS) 2018'. IVR participants were enrolled by random digit dialing. Quota sampling was employed to achieve the required sample sizes of age-sex strata: sex (male/female) and age (18-29-, 30-44-, 45-59-, and ≥60-year-olds). GATS was a nationally representative survey and used a multistage stratified cluster sampling design. The IVR sample's weights were generated using the inverse proportional weighting (IPW) method with a logit model and the standard age-sex distribution of Tanzania. The IVR and GATS had 2362 and 4555 participants, respectively. Compared to GATS, the unweighted IVR sample had a higher proportion of males (58.7 % vs. 43.2 %), educated people (secondary/above education: 43.3 % vs. 21.1 %), and urban residents (56.5 % vs. 40 %). The weighted prevalence (95 % confidence interval (CI)) of current smoking was 4.99 % (4.11-6.04), 5.22 % (4.36-6.24), and 7.36 % (6.51-8.31) among IVR (IPW), IVR (age-sex standard), and GATS samples, respectively; the weighted prevalence (95 % CI) of smokeless tobacco use was similar: 3.54 % (2.73-4.57), 3.58 % (2.80-4.56), and 2.43 % (1.98-2.98), respectively. Most differences in point estimates for tobacco indicators were small (<2%). Overall, the odds of tobacco smoking indicators were lower in IVR than in GATS; however, the odds of smokeless tobacco use were reversed. Although we found under-/over-estimation of the prevalence of tobacco use in IVR than GATS, the estimates were close. Further research is required to increase the representativeness of IVR.

Keywords: Data collection; Interactive voice response; Mobile phone survey; Survey findings; Tobacco use.