This study examined the effectiveness of a stepped approachfor increasing response rates to a
mailed follow-up smoking survey among newly enlisted women in the navy. The effect of the
stepped approach on response rates and on the characteristics of respondents was evaluated.
Also, costs were estimated for each of the steps to determine their relative benefits. Results
showed that the stepped approach was effective in more than doubling the survey response rate
among smokers. Reluctant respondents did not differ from on-time respondents in terms of demo-
graphics or baseline smoking, although nonrespondents were less educated and heavier smok
ers than on-time and reluctant respondents. Strategies documented here could well apply to sur
vey efforts with other hard-to-reach populations.
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