This study examines the effectiveness of a stepped approach for increa
sing response rates to a mailed follow-up smoking survey among newly e
nlisted women in the navy. The effect of the steppes approach on respo
nse rates and on the characteristics of respondents was evaluated. Als
o, costs were estimated for each of the steps to determine their relat
ive 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 of demographics
or baseline smoking, although nonrespondents ware less educated and h
eavier smokers than on-time and reluctant respondents. Strategies docu
mented here could well apply to survey efforts with other hard-to-reac
h populations.