Field Tobacco Control Research Across Himalayan Terrain, India — GATS-3

Client

The Ministry of Health & Family Welfare (MoHFW), Government of India, commissioned GATS-3 — the third round of the global adult tobacco survey — to track adult tobacco use nationally, with the International Institute for Population Sciences (IIPS), Mumbai, as technical lead across 28 states and 8 union territories.

Market Xcel was engaged as the tobacco control research field agency for Group 2: Himachal Pradesh and Uttarakhand. As hill states with difficult terrain and dispersed settlements, MoHFW needed a partner who could deliver the same statistical rigour here as in easier, plains-based geographies.

Objective of the Study

GATS-3 was designed to provide India with its third longitudinal snapshot of adult tobacco use since 2009-10, with Group 2 responsible for delivering robust state-level estimates for HP and Uttarakhand as part of this tobacco prevalence survey. The core objectives were to:

• Generate reliable national and state/UT-level estimates of adult tobacco use prevalence, covering both smoking and smokeless forms

• Track change in key tobacco control indicators against the GATS-1 (2009-10) and GATS-2 (2016-17) baselines

• Evaluate the on-ground effectiveness of tobacco control policy under COTPA and the National Tobacco Control Programme (NTCP)

• Produce sex-disaggregated data (male/female) and area-disaggregated data (rural/urban) at the national level

• Deliver state-level, sex-disaggregated estimates specifically for Himachal Pradesh and Uttarakhand

Research Methodology

GATS-3 used a stratified probability sampling design covering all adults aged 15 and above, across rural and urban areas of both states, with one adult randomly selected per sampled household to ensure nationally comparable, statistically robust estimates. Data were collected through a CAPI-based health survey implemented on Android tablets, with built-in validation checks, daily transmission to IIPS's central server, and GPS-enabled public health survey fieldwork to verify each location's spatial coordinates.

Execution was run in two phases — mapping and listing, followed by the main survey — under a dedicated state-level core team supported by trained field teams, reflecting the discipline of a large-scale public health research case study run to national standards. A layered monitoring structure, from field supervisors up to the Project Coordinator, kept data quality and timelines aligned with IIPS's real-time oversight standards throughout.

Research Outcome

Market Xcel's Group 2 field operation delivered a complete, quality-validated dataset for Himachal Pradesh and Uttarakhand, built around IIPS's real-time monitoring standards — a clear example of national tobacco surveillance field operations executed to spec in genuinely difficult terrain. Key outcomes included:

• Full household listing and GPS-mapped coverage across both states, with sketch maps and geo-coordinates submitted for every sampled location — a model of health survey data collection in remote areas

• Complete CAPI-based data collection, with individual interviews covering every GATS-3 module

• Daily data transmission to the IIPS central server was maintained throughout fieldwork, despite variable connectivity in high-altitude areas

• A fully quality-validated final dataset, including secondary editing of open-ended and 'Other' category responses

• Consistent, on-time weekly progress reporting to IIPS for the full duration of the engagement

Challenges and Actions Taken

Mountainous Terrain Slowing Mapping and Listing

Himachal Pradesh and Uttarakhand's hilly, remote PSUs meant mapping and listing routinely needed more than the standard two-day minimum per PSU, with winter snowfall further restricting access to certain locations.
Action Taken: Field schedules were rephased around seasonal accessibility, prioritising higher-altitude PSUs ahead of the winter window and deploying terrain-suitable vehicles with five-passenger capacity, dedicated to each team, to reduce inter-PSU travel time.

Sourcing a Tobacco-Free Workforce in High-Prevalence Regions

GATS-3 mandated that all field staff remain tobacco-free throughout the project, a difficult condition to meet in states with historically high tobacco use among the working-age population.
Action Taken: Recruitment built in a 10-15% buffer to absorb attrition and performance-based replacements, and core staff were secured on stamp-paper continuity commitments to protect staffing through the full project lifecycle.

Unreliable Connectivity for Daily Data Transmission

The daily data transmission mandate depended on stable internet connectivity, which was inconsistent across remote, hilly PSUs, putting real-time data quality checks at risk.
Action Taken: A full-time IT Consultant was available around the clock during fieldwork to troubleshoot tablet and transmission issues on the ground, keeping the daily upload cadence intact and IIPS's field-check feedback loop uninterrupted.

Local Language Requirements for Survey Instruments

Survey schedules had to be translated into local dialects — Pahari, Garhwali, and Kumaoni — before training could begin, adding a language-localisation step not required in single-dialect states.
Action Taken: Bilingual translation of all instruments was initiated over a month before state-level training, ensuring that the Investigator Schedule, Supervisor Schedule, and Tablet Manual were fully localised and IIPS-approved before Training of Trainers commenced.

Business Impact

By delivering a complete, real-time-validated dataset for Himachal Pradesh and Uttarakhand under some of the toughest field conditions in the GATS-3 programme, Market Xcel gave MoHFW and IIPS a dependable state-level evidence base for two hill states that are otherwise underrepresented in national health surveillance. The data extends India's 15-year longitudinal tobacco-use trendline alongside GATS-1 and GATS-2, feeds directly into COTPA and NTCP policy evaluation, and supports India's reporting obligations under the WHO Framework Convention on Tobacco Control — reinforcing Market Xcel's standing as a government health survey implementation partner and provider of public health field research services capable of running technology-driven demographic surveys in demanding mountain terrain without compromising on quality.

Contact us to know how Market Xcel can support your next large-scale public health or demographic research programme.