An efficient method to conduct large population survey in a low resource setting: Tamil Nadu tobacco survey

Vidhubala E., Divyraj Prabhakar S., Sundaramoorthy C., Hemanth Raj E., Hemant Deepak Shewade, Pranay Lal


Background: Resource allocation for tobacco surveillance in low-income settings like India is a challenge. The current study describes an efficient method to conduct a large population-based tobacco survey in an Indian state.

Methods: Tamil Nadu Tobacco Survey (TNTS) was conducted in Tamil Nadu, the sixth most populous state in India, between March and November, 2015. About 100,000 subjects aged 15 years and above, representing both urban and rural populations within 32 districts, were included. The Global Adult Tobacco Survey (GATS) questionnaire was modified and translated into the local language (Tamil) to develop the survey questionnaire, which was pre-tested in 1,690 participants in three districts in November 2014. The survey was conducted through research collaboration between 31 educational institutions and three NGOs. Once collected, data were double-entered using an open access tool (Epidata).

Results: The quality and the accuracy of the data was ensured at every level and the data was double entered to minimise the entry error. Among a total number of 32,945 participating households, 111,363 eligible individuals were identified, of which 99,825 individuals completed the survey. The overall Household Response Rate (HRR) was 91.23% (range within districts: 72-99%). The overall Individual Response Rate was 89.24% (range within districts: 73-99%). The unweighted population almost equally represented the weighted population in the selected demographic variables such as age, gender, and type of residence.

Conclusions: TNTS was conducted in an efficient manner utilizing local resources, without compromising on quality. This method can be replicated in any setting with the low or limited resource. 


Tamil Nadu tobacco survey, Methodology, Low resource setting, MPOWER, FCTC

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WHO Framework Convention on Tobacco Control. World health organization, 2004. Available at: Accessed on 4 August 2017.

Ministry of Health & Family Welfare Government of India: Directorate general of health services, National Tobacco Control in India, Government of India, New Delhi. Available at: content/1356_3_NationalTobaccoControlProgramme.aspx?format=Print&format=Print. Accessed on 4 August 2017.

Lal P, Srinath S, Goel S, Singh RJ, Sharma D, Kumar R, et al. Unravelling India’s tobacco epidemic - priorities and recommendations for the second round of Global Adult Tobacco Survey (GATS). Global health promotion. 2015;22:7–19.

World Health Organization Regional Office for South-East Asia. Surveillance and Monitoring: Global Tobacco Surveillance System. Available at: Accessed on 4 August 2017.

International Institute of Population Sciences. National family health survey 1992–93. Mumbai: IIPS, 1995.

International Institute of Population Sciences. National family health survey 1998–99. Mumbai: IIPS, 2000.

International Institute of Population Sciences. National family health survey 2005–06. Mumbai: IIPS, 2007.

International Institute of Population Sciences. National family health survey 2015–66. Mumbai: IIPS.

National Sample Survey Organization. 52nd round of national sample survey on household expenditure. Ministry of Statistics and Programme Implementation, Government of India, New Delhi, 1997.

Srivastava A, Pal H, Dwivedi SN, Panjdey A, Pande JN. National household survey of drug and alcohol abuse in India (NHSDAA), Ministry of Social Justice and Empowerment, Government of India, New Delhi and UN Office on Drug and Crime, Regional Office for South Asia, 2004.

World Health Organization, regional Office for South- East Asia. Global Adult Tobacco Survey (GATS): India Country Report. New Delhi: WHO-SEARO, 2009. Available at: http//www.searo.who. int/LinkFiles/RegionalTobaccoSurveillanceSystems GATSIndia.pdf. Accessed on 4 August 2017.

India Population-World meters, 2016. Available at: india-population. Accessed on 8 August 2017.

Birth Rate, Death Rate, Infant Mortality and Total Fertility Rate: India and States. National Commission on Population, Govt of India, 2010.

The government of Tamil Nadu. Available at: Accessed on 12 August 2017.

Urban Local Bodies. Commissionerate of Municipal Administration, Govt. of Tamil Nadu. Available at: Accessed on 4 August 2017.

Global Adult Tobacco Survey Collaborative Group. Tobacco Questions for Surveys: A Subset of Key Questions from the Global Adult Tobacco Survey (GATS), 2nd Edition. Atlanta, GA: Centers for Disease Control and Prevention, 2011. World Health Organization, Regional Office for South- East Asia.

World Health Organization. WHO report on the global tobacco epidemic: The MPOWER Package. World Health Organization; 2008.

Tamil Nadu Government Gazette- Extraordinary, Notification. Government Of Tamilnadu. 2013. Available at: https://foodsafetynews.files.wordpress. com/2013/05/pan-masala_ban.pdf. Accessed on 4 August 2017.

Government of India. Ministry of youth affairs and sports. Department of national sevices scheme. Available at: Accessed on 27 September 2017.

Shewade HD, Vidhubala E, Subramani DP, Lal P, Bhatt N, Sundaramoorthi C, et al. Openaccess tools for quality-assured and efficient data entry in a large, state-wide tobacco survey in India, Global Health Action. 2017;10:1.