TOBACCO QUESTIONS IN HEALTH INTERVIEW SURVEY 03-04 May 2016, Ankara Tuğba KANDAR 02.12.2018

Outline History Survey process Questionnaire Turkey Health Survey Tobacco Use Module 02.12.2018

History 2008 - EHIS vawe 1, GATS 2010 - National needs 2012 - National needs, GATS 2014 - EHIS vawe 2 3 02.12.2018

Survey process Translation of Eurostat manual, Comparing 2012 questions with new recommended questions, Evaluation of Tobacco Questions for Surveys (TQS), Discussing draft questionnaire with related public institutions, Training for interviewers, controllers,

Implementing survey in 9 740 households with Harzemli program established by TurkStat software experts, Creating SAS analysis for using by regional offices while survey is continuing, Detail analysis after finished implementing, Publishing news release on September 2015, Sending micro data to Eurostat.

Questionnaire Sections MODULE A Health Status 1. Health status 2. Diseases and chronic conditions 3. Accidents and injuries 4. Absence from work 5. Physical and sensory limitations 6. Personal care activities 7. Household activities 8. Pain 9. Mental health MODULE B Health Care Services 1. Use of inpatient and day care 2. Outpatient care/home care 3. Use of medicine 4. Preventive services 5. Unmet needs for health care MODULE C Heallth Determinants 1. Weight and height 2. Physical activity/ exercise 3. Consumption of fruits and vegetables 4. Use of Tobacco 5. Use of alcohol 6. Use of drug 7. Social Support 8. Provision of informal care or assistance 02.12.2018

Tobacco Use Module 1. Do you smoke? (EU) Yes, daily Yes, occasionally Not at all I left (MoH) Because request of MoH, “I left” was added to questions. 2. How long ago you stopped smoking? (MoH) ……..        months Respondent who said “I left” in the previous question answered this question. MoH wanted this question to see whether stop smoking project to succeeded or not. 7 02.12.2018

3. Family problems 4. Personal problems The following questions added by TurkStat for continuing of last series. 3. For the first time, when did you try to smoke any tobacco product? (TurkStat) ----- age 4. What is the reason behind that you started to use tobacco? (TurkStat) 1. Interest 2. Desire 3. Family problems 4. Personal problems 5. Impact of girlfriend/boyfriend 6. Impact of friend 7. Impact of members of family 8. Impact of radio, television, press 9. For fun 10. No special reason 98. Others 8 02.12.2018

5. Regularly (at least 100 times a year), have you ever smoked any tobacco products? (TurkStat) 1. Yes 2. No 6. Regularly, at which age did you start to smoke tobacco products ? (TurkStat) ----- age 9 02.12.2018

7. What kind of tobacco product do you mostly consume? (EU) Manufactured cigarettes Hand-rolled cigarettes Cigars Pipefuls of tobacco Waterpipe 98. Other 8. On average, how many cigarettes do you smoke each day? (EU) ---- number of cigarettes Eurostat only asks number of daily smoked cigarettes. If we added TQS questions related with this, respondent burden would increase. 10 02.12.2018

10. Which latest method did you use to stop smoking?(MoH) Smokeless tobacco is not very common in our country. Because of this, questions related to smokeless tobacco was not used. 9. In the past 12 months, have you ever tried to stop smoking? (TQS-MoH) 1. Yes 2. No 10. Which latest method did you use to stop smoking?(MoH) I left myself I called 171 (smoking cessation hotline) I left with the help of doctors I left with the help of doctors and medicine I left with medicine 98. Other 11 02.12.2018

11. How often are you exposed to tobacco smoke indoors? (EU) 1. Never or almost never 2. Less than 1 hour per day 3. 1 hour or more a day Because the request of the Ministry of Health, TQS 9th question was not used. 12 02.12.2018

12. In the past 30 days, did you see anyone who is using tobacco in …… 12. In the past 30 days, did you see anyone who is using tobacco in ……..? (MoH)   09:00-17:00 17:01-02:00 1 Yes 2 No 3 I have not Restaurant Patisserie Cafe 4 Saloon 5 Bar 98 Other 13 02.12.2018

14. Where tobacco products are often used at home? (MoH) Kitchen 13. How often does anyone use tobacco in your house? (TQS, MoH, Turkstat) Almost every day At least once a week At least once a month Less than once a month Never 14. Where tobacco products are often used at home? (MoH) Kitchen Balcony/terrace Everywhere 14 02.12.2018

Some figures The percentage of individuals' status of smoking tobacco products by sex and age groups, 2010, 2012, 2014 [15+ yaş - age]   (%) 2010 2012 2014 Total Male Female Daily smoker 25.4 39.0 12.3 23.2 35.9 10.8 27.3 41.8 13.1 Occasional smoker 4.1 4.5 3.7 3.6 4.3 2.9 5.2 5.6 4.8 Non-smoker 17.1 23.0 11.5 14.3 19.8 8.9 17.7 23.8 11.8 Never smoker 53.4 33.5 72.6 59.0 40.0 77.3 49.8 28.7 70.3 Turkey Health Interview Survey 02.12.2018

Turkey Health Interview Survey The distribution of reasons behind starting tobacco use of individuals by sex, 2010, 2012, 2014 [15+ yaş - age]   (%) 2010 2012 2014 Toplam Erkek Kadın Total Male Female Interest 34.5 34.6 34.3 42.3 43.9 38.2 36.2 37.2 34.0 Desire 23.3 25.5 18.3 26.5 27.8 23.2 16.8 13.2 Family problems 4.0 2.8 6.8 3.8 2.3 7.7 3.9 7.6 Personal problems 5.0 4.2 7.1 4.4 3.6 6.6 5.3 4.5 7.0 Impact of friend 22.7 23.7 20.5 16.0 16.3 15.2 29.4 30.4 27.2 For fun 3.2 3.1 3.3 1.6 1.5 1.9 2.7 No special reason 1.7 2.0 2.5 Turkey Health Interview Survey 02.12.2018

Cross tables Obesity*Tobacco use, 2014 [15+ yaş - age] (%) Tobacco Use   (%) Tobacco Use Obesity Daily Less than daily Never Left Underweight 3.2 3.3 5.5 2.2 Normal weight 47.7 41.4 42.9 31.9 Overweight 34.5 35.8 30.7 40.4 Obese 14.6 19.6 20.9 25.5 Turkey Health Interview Survey 02.12.2018

Turkey Health Interview Survey Alcohol*Tobacco use, 2014 [15+ yaş - age]   (%) Tobacco Use Alcohol Use Daily Less than daily Never Left Yes 48.5 6.9 17.5 27.1 No 16.9 4.4 65.6 13.1 Turkey Health Interview Survey 02.12.2018

Thanks you for your attention. 02.12.2018