Comparative Appraisal of Randomized Response Technique vs. Direct Interview Method in Assessment of Burden of Tobacco and Alcohol Use among Adolescents

In countries like India, the major source of error in the reporting of sensitive events (e.g., tobacco and alcohol use) among adolescents is deliberate misreporting. To estimate its burden, the commonly used direct interview method involves problems in reporting. To cope, the randomized response technique (RRT) is an alternative approach that uses a random device to provide more privacy to respondents. So, it may be worthwhile to compare RRT with the direct interview method in the assessment of the burden of ever tobacco and alcohol use among Indian adolescents. A cross-sectional survey on ever tobacco and alcohol use among adolescents was conducted on 796 students of 9th to 12th class (401: RRT; 395: Direct interview) from conveniently selected three schools of Delhi/National Capital Region, during November 2014 to November 2016. As per conventional use of RRT, two types of questions, one related to “sensitive attribute” and the other “an unrelated question” were used to estimate ever tobacco and alcohol use. For the first time, a new random device (i.e., randomly arranged questionnaires) was proposed and used under RRT, which is user-friendly and appropriate for time-bound applications. For comparison, the estimates of both ever tobacco use and ever alcohol use were obtained, which could also facilitate comparative change in effect size with increasing sensitivity. The prevalence of ever tobacco use under RRT approach and Direct Interview method was 18.6% (95% CI: 13.33-24.01) and 10.1% (95% CI: 7.15-13.10) respectively, where as that of ever alcohol use was 22.8% (95%CI: 17.08-28.5) and 9.1% (95% CI: 6.27-11.95) respectively. Further, comparative results showed that as contents in used substance become more sensitive, under estimation of burden under direct interview method may become higher [i.e., ever tobacco use: 8.5% (95% CI: 3.43-13.65); Ever alcohol use: 13.6% (95% CI: 8.34-19.03)]. The proposed new random device under RRT, as a set of randomly arranged questionnaires containing either sensitive or unrelated questions, consists of most of its recommended properties. The findings under the present study suggest that the randomized response technique may serve as a versatile method for gaining access to more accurate information on sensitive topics.