Design and Validation of a Tobacco Survey for the Multi*

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DESCRIPTION (provided by applicant): The parent grant (5R01TW005964-03) funded a successful collaboration between Loma Linda University (LLU), Ministry of Health (MOH) Lao People's Democratic Republic (PDR) and the Adventist Development and Relief Agency (ADRA) Laos from 2002-2004 that has resulted in training six promising Lao MOH and DRA health professionals in tobacco control research methods during a 28-unit graduate level certificate program. This FIRCA application now includes the six trainees as foreign collaborators in pioneering tobacco research in Lao PDR. Among the 47 ethnic groups in Lao PDR - many found in minority populations throughout Southeast Asia - the regional terms for "cigarette", "pipe", and "tobacco" in rural areas are often not accurately known by local health professionals or researchers (including our trainees). The current absence of such basic information substantially hinders progress in conducting valid surveys of tobacco use n this multiethnic population. Our aim is to conduct a three-year research and capacity building program to validate (Phase I), design (Phase II), and pilot test (Phase III) a survey of tobacco use among adults (ages 8 and older) in the multiethnic population of Lao PDR. Phase I (Year One) will validate questionnaire items and picture cards of tobacco use in published qualitative (ethnography, key informant interviews, validating focus groups) and quantitative (correlation with biomarkers of cotinine and exhaled carbon monoxide) studies of 1200 adults sampled (multi-stage cluster design) from the language groups (Khamu, Ekhor, Lao, Hmong, Talieng) and regions that contain the major ethnic groups of Lao PDR. B. Phase II (Year Two) incorporates the findings from Phase I into the design of a comprehensive questionnaire to measure tobacco use, knowledge/attitudes about tobacco use, second-hand smoke, quit attempts, health status, and women's health. This phase will include the publication of qualitative (focus groups, key informant interviews) studies of tobacco-related knowledge and beliefs among 350 adults sampled from language groups and regions that contain the major ethnic groups of Lao PDR. C. Phase III (Year Three) involves a pilot test of the survey designed in Phases I and II among 500 adults sampled from language groups and regions that contain the major ethnic groups of Lao PDR. Publication of these pilot test data will establish a comprehensive tobacco questionnaire that can be used in large-scale revalence studies and/or to provide baseline data for interventions targeted at specific regions and ethnic subgroups. These collaborative studies will build the capacity of local investigators to conduct large-scale studies of tobacco use in ethnic groups found in Lao PDR and throughout Southeast Asia.