OMB #2127-0646 Expiration Date: August 31, 2011
NATIONAL ALCOHOL CRACKDOWN QUESTIONNAIRE
Hello, I'm calling on behalf of the U.S. Department of Transportation. This is not a sales call. We are conducting a national study of Americans' driving habits and attitudes. The interview is voluntary and the information you provide us will be used for statistical purposes only. We will not collect any personal information that would allow anyone to identify you.
(Interviewer reads): Please note a federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-0646. Public reporting for this collection of information is estimated to be approximately 10 minutes per response, including the time for reviewing instructions, completing and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave, S.E., Washington, DC, 20590
Q6. How often do you drive a motor vehicle? Almost every day, a few days a week, a few days a month, or a few days a year?
Almost every day.............1
Few days a week.................2
Few days a month.............3
Few days a year.................4
(VOL) Never................5 SCREEN OUT
Other(SPECIFY)...............97
(VOL) Don't know...........98
(VOL) Refused.................99
Q7. Is the vehicle you drive most often a car, van, motorcycle, pickup truck, sport utility vehicle, or other type of truck? [NOTE: IF RESPONDENT DRIVES MORE THAN ONE VEHICLE OFTEN, ASK:] "What kind of vehicle did you LAST drive?"
Car...............................1
Van or minivan........................2
Motorcycle........................3 SKIP TO Q9
Pickup truck..........................4
Sport Utility Vehicle.............5
Other truck(SPECIFY)..................6
Other(SPECIFY)....................7
(VOL) Don't know.....................8
(VOL) Refused....................9
Q8. When driving this (car/truck/van), how often do you wear your seat belt? [READ ANSWERS] [IF ASKED IF THIS APPLIES TO SHOULDER BELTS OR LAP BELTS SAY SHOULDER BELTS]
All of the time...............1
Most of the time..................2
Some of the time..............3
Rarely............................4
Never.........................5
(VOL) Don't Know.................8
(VOL) Refused................9
Q9. Now I'm going to ask you a few questions about alcohol use. During the past 30 days have you had at least one drink of any alcoholic beverage, including liquor, beer, wine or wine coolers?
Yes........................1
No............................2 SKIP TO Q13
(VOL) Don’t Know.........8 SKIP TO Q13
(VOL) Refused..............9 SKIP TO Q13
Q10a. During the past 30 days, have you driven a motor vehicle within two hours after drinking any alcoholic beverages, even if you had only a little?
Yes........................1
No............................2 SKIP TO Q13
(VOL) Don’t Know.........8 SKIP TO Q13
(VOL) Refused..............9 SKIP TO Q13
Q10b. How many days out of the past 30 days did you drive within two hours after drinking any alcoholic beverages?
__________ (Range=01-30) DON’T KNOW =98 REFUSED=99
Q11. On the most recent occasion when you drove within two hours after drinking alcoholic beverages, how many drinks (of beer, wine, liquor) did you have?
ENTER NUMBER of DRINKS _____ (01-90)
(VOL)Don't know....................98
(VOL)Refused.......................99
Q12a. In the past 30 days, did you drive when you thought you had too much to drink to drive safely?
Yes........................1
No............................2 SKIP TO Q13
(VOL) Don’t Know.........8 SKIP TO Q13
(VOL) Refused............9 SKIP TO Q13
Q12b. About how many times in the past 30 days did you drive when you thought you had too much to drink to drive safely?
ENTER NUMBER: _____ (01 - 30)
Never..................00
(VOL)Don't know..............98
(VOL)Refused.................99
Q13. In the past 30 days, have you seen police on the roads you normally drive: [READ LIST]
More often than usual.........1
Less often than usual.........2
About the same, or................3
Never............................4
(VOL)Don't know...............8
(VOL)Refused......................9
Q14. Suppose you drove a motor vehicle after drinking alcohol and the amount of alcohol in your body was more than what the law allows for drivers. How likely is it that the police would stop you? Would the police be...........?
Very Likely To Stop You,...............1
Somewhat Likely To Stop You, or...........2
Not Likely To Stop You.....................3
(VOL) Don’t Know........................8
(VOL) Refused........................9
Q15. Do you think the chances of being stopped have changed in the past month? That is, compared to a month ago, do you think a driver who had been drinking alcohol is more likely, less likely or about as likely to be stopped by the police?
More likely...................1
Less likely......................2
About the same................3
(VOL)Don't know..................8
(VOL)Refuse...................9
Q16a Now, I would like to ask you a few questions about educational or other types of activities. In the past 30 days, have you seen or heard any messages that encourage people to avoid driving after drinking? This could be public service announcements on TV, messages on the radio or your phone, signs on the road, news stories, communication via the internet including computer games, or something else.
Yes.............1
No.................2 SKIP TO Q16d
(VOL)Don’t know......8 SKIP TO Q16d
(VOL)Refused.........9 SKIP TO Q16d
Q16b. Where did you see or hear these messages?
[DO NOT READ--MULTIPLE RESPONSES ACCEPTED]
TV..................................1
Radio..................................2
Friend/Relative.....................3 SKIP TO Q16d
Newspaper..............................4 SKIP TO Q16d
Personal observation/on the road....5 SKIP TO Q16d
Billboard/signs........................6 SKIP TO Q16d
I’m a police officer/judge..........7 SKIP TO Q16d
Internet/online/computer game/email
(Not from friend)/social network/
mobile phone........................8 SKIP TO Q16e
Other (specify____).....................97 SKIP TO Q16d
Don’t know.........................98 SKIP TO Q16d
Refused...............................99 SKIP TO Q16d
Q16c. Was the (TV/radio) message a commercial (or advertisement), was it part of a news program, or was it something else? [MULTIPLE RECORD]
Commercial/Advertisement..............1
Public Service Announcement..............2
News story/news program...............3
Something else (specify):......7
(VOL) Don’t know.................8
(VOL) Refused.................9
Q16d. Have you read or seen anything on the internet or your phone that encourages people to avoid driving after drinking?
Yes.............1
No.................2 SKIP TO Q17a
(VOL)Don’t know......8 SKIP TO Q17a
(VOL)Refused.........9 SKIP TO Q17a
Q16e. Was the message you read or saw on the internet or your phone a…Read List – Multiple Response)
News story..............1
Internet Ad.........2
Internet game.........3
Social network message like Facebook or
Twitter .........4
Internet video from something like YouTube.........5
Something else (specify):......7
(VOL) Don’t know.................8
(VOL) Refused.................9
Q17a. Yes or No--in the past 30 days, have you seen or heard of any special effort by police in your community to reduce driving under the influence or drunk driving?
Yes..........................1
No..............................2 SKIP TO Q17e
(VOL) Don’t know.............8 SKIP TO Q17e
(VOL) Refused...................9 SKIP TO Q17e
Q17b. Is this special effort by police to reduce driving under the influence or drunk driving, occurring only during daytime hours, nighttime hours or both daytime and nighttime hours?
Daytime hours...............1
Nighttime hours.........2
Both .......................3
(VOL)Don’t know..........8
(VOL)Refused...............9
Q17c. Where did you see or hear about that special effort?
[DO NOT READ--MULTIPLE RESPONSES ACCEPTED]
TV..................................1
Radio..................................2
Friend/Relative.....................3 SKIP TO Q17e
Newspaper..............................4 SKIP TO Q17e
Personal observation/on the road....5 SKIP TO Q17e
Billboard/signs........................6 SKIP TO Q17e
I’m a police officer/judge..........7 SKIP TO Q17e
Internet/online/computer game/email
(Not from friend)/social network/
mobile phone........................8 SKIP TO Q17f
Other (specify):.....................97 SKIP TO Q17e
(VOL) Don’t know..................98 SKIP TO Q17e
(VOL) Refused.........................99 SKIP TO Q17e
Q17d. Was the (TV/radio) message a commercial (or advertisement), was it part of a news program, or was it something else? [MULTIPLE RECORD]
Commercial/Advertisement..............1
Public Service Announcement..............2
News story/news program...............3
Something else (specify):........7
(VOL) Don’t know............................8
(VOL) Refused........................9
Q17e. Have you read or seen anything on the internet or your mobile phone about a special effort by police to reduce driving under the influence or drunk driving?
Yes.............1
No.................2 SKIP TO Q18a
(VOL)Don’t know......8 SKIP TO Q18a
(VOL)Refused.........9 SKIP TO Q18a
Q17f. Was the message you read or saw on the internet or your phone a…(Read List – Multiple Response)
News story..............1
Internet Ad.........2
Internet game.........3
Social network message like Facebook or
Twitter .........4
Internet video from something like YouTube.........5
Something else (specify):......7
(VOL) Don’t know.................8
(VOL) Refused.................9
Q18a. In the past 30 days, have you seen or heard anything about police setting up checkpoints or other enforcement efforts to catch drivers who were driving while under the influence of alcohol or driving drunk?
Yes..................1
No.....................2 SKIP TO Q19a
(VOL) Don’t know.....8 SKIP TO Q19a
(VOL) Refused..........9 SKIP TO Q19a
Q18b. Are you speaking about checkpoints only, other enforcement efforts only or both checkpoints and other enforcement efforts?
Checkpoints only...............1
Other enforcement efforts only.........2
Both .......................3
(VOL)Don’t know..........8
(VOL)Refused...............9
Q18c. In the past 30 days, did you personally drive past, or drive through a police checkpoint set up to catch drivers who were driving while under the influence of alcohol or driving drunk?
Yes..................1
No.......................2
(VOL) Don’t know.....8
(VOL) Refused............9
Q19a. Do you know the name or slogan of any enforcement program(s) that prevent driving under the influence or drunk driving in ________ [identify State]?
Yes..........1
No..............2 SKIP TO Q19c
(VOL)Don't know...8 SKIP TO Q19c
(VOL)Refused......9 SKIP TO Q19c
Q19b. What was the slogan or program called? [MULTIPLE MENTION][DO NOT READ]
1. Friends don't let friends drive drunk.....(“1”)
2. You Drink and Drive. You Lose.............(“2”)
3. Get the keys..............................(“3”)
4. Drunk Driving. Over The Limit. Under Arrest(“4”)
5. Recovery Month............................(“5”)
6. Buzzed Driving Is Drunk Driving ..........(“6”)
7. MADD/Mothers Against Drunk Driving........(“7”)
8. DARE/Drug Abuse Resistance Education......(“8”)
9. SADD/Students Against Drunk Driving.......(“9”)
Step away from your vehicle..............(“10”)
11. Don’t drink and drive.....................(“11”)
97. Other, specify _____________________..97
98. (VOL) Don't know..........................98
99. (VOL) Refused.........................99
Q19c. I'd like to find out if you recall seeing a particular ad in the past two weeks. “The ad starts by showing an automobile swerving on the road. The automobile is filled with liquid sloshing around the driver. Shown next is a motorcyclist looking through a helmet shield filled with liquid. Both the automobile driver and motorcyclist are stopped by police, and the liquid spills out.” Do you recall seeing this ad in the past two weeks?
Yes..........1
No..............2 SKIP TO Q20
(VOL)Don't know...8 SKIP TO Q20
(VOL)Refused..........9 SKIP TO Q20
Q19d. What was the slogan or logo used at the end of this ad?
[DO NOT READ – MULTIPLE RECORD]
Drunk Driving. Over The Limit. Under Arrest..1
Other (SPECIFY)........................2
Don’t drink and drive...............3
(VOL)Can’t recall...........................8
(VOL)Refused..............................9
Q20. Do you recall hearing or seeing the following slogans in the past 30 days? [ROTATE]
Yes No DK Ref
1. Friends don't let friends drive drunk..... 1 2 8 9
2. You Drink and Drive. You Lose............. 1 2 8 9
3. Get the keys.............................. 1 2 8 9
4. Drunk Driving. Over The limit. Under Arrest 1 2 8 9
5. Recovery Month............................. 1 2 8 9
6. Buzzed Driving Is Drunk Driving............ 1 2 8 9
7. Click It or Ticket... ..................... 1 2 8 9
8. Step away from your vehicle................ 1 2 8 9
Q21. Thinking about everything you have heard, how important do you think it is for [STATE] to enforce the drinking and driving laws more strictly . . . . very important, fairly important, just somewhat important, or not that important?
Very important....................1
Fairly important.....................2
Just somewhat important...........3
Not that important...................4
(VOL)Don’t know........................8
(VOL)Refused.......................9
Q22. During the past 30 days, have you driven a motorcycle?
Yes..........1 SKIP TO Q24
No..............2
(VOL)Don't know...8
(VOL)Refused..........9
Q23. Have you driven a motorcycle in the past year?
Yes..........1
No..............2
(VOL)Don't know...8
(VOL)Refused..........9
Q24. Do you favor or oppose mandatory helmet use laws for motorcyclists?
Yes..........1
No..............2
(VOL)Don't know...8
(VOL)Refused..........9
SKIP TO Q26 If Q23 IS 2, 8, OR 9
Q25. During the past 12 months, have you driven a motorcycle after drinking alcoholic beverages?
Yes..........1
No..............2
(VOL)Don't know...8
(VOL)Refused..........9
Q26. During the past 12 months, have you ridden as a passenger on a motorcycle?
Yes..........1
No..............2
(VOL)Don't know...8
(VOL)Refused..........9
DEMOGRAPHICS
Now I need some information about you.
D1. (NOTE: SELECT GENDER BY OBSERVATION - ASK ONLY IF NECESSARY.)
Are you Male or Female?
Male..........1
Female..........2
D2a. What is your age?
_________________ AGE REFUSED = 99 Skip to D2b
(INTERVIEWER: If respondent refuses, use the question below to attempt to get their age.)
D2b. Okay, if you would prefer not to provide your exact age, please stop me when I get to the category that includes your age? (INTERVIEWER: READ LIST UNTIL RESPONDENT STOPS YOU.)
18 to 24.......1
25 to 34.....2
35 to 44.......3
45 to 54.....4
55 to 64.......5
65 to 74.....6
75 or older....7
(VOL) Refused.......9
D3. Do you consider yourself to be Hispanic or Latino?
Yes.......................1
No.............................2 SKIP TO D4
(VOL) Not sure..........3
(VOL) Refused................9
D3b. Do you speak Spanish at home?
Yes.......................1
No.............................2 SKIP TO D4
(VOL)Refused.......9
D3c. In general, would you say you speak Spanish 100% of the time, 75% of the time, 50% of the time, or 25% of the time?
100%..............1
75%...............2
50%...............3
25%...............4
(VOL)Other: Specify ..7__________
(VOL)Don’t know......8
(VOL)Refused.........9
D4. Which of the following racial categories describes you? You may select more than one. [READ LIST--MULTIPLE RECORD]
American Indian or Alaska Native.............1
Asian.............................................2
Black or African American.........................3
Native Hawaiian or other Pacific Islander.........4
White.............................................5
[DO NOT READ] Other (Specify)...................7____________
(VOL)Refused................................9
D5. What is the highest grade or year of school you completed?
[DO NOT READ LIST]
8th grade or less.....................1
9th grade.................................2
10th grade............................3
11th grade................................4
12th grade/GED........................5
Some college..............................6
College graduate or higher............7
(VOL) Refused...........................9
D6. Please stop me when I reach the category that includes your household’s total annual income for last year, that is, 2009: (READ LIST UNTIL RESPONDENT STOPS YOU TO SELECT A CATEGORY.)
Under $15,000....................1
From $15,000 to less than $30,000.......2
From $30,000 to less than $50,000....3
From $50,000 to less than $75,000......4
From $75,000 to less than $100,000.......5
From $100,000 to less than $125,000.......6
$125,000 or more....................7
(VOL) Don’t know........................8
(VOL) Refused...........................9
Ask D7a Through D7e If Landline Sample
D7a. How many landline telephone numbers do you have in your household? Please do not count numbers for cell phones, or phone lines that are used exclusively for business purposes, computers or fax machines.
One.........1
Two..............2
Three.......3
Four or more.....4
(VOL) Don’t know...8 SKIP TO D7c
(VOL) Refused .....9 SKIP TO D7c
D7b. (TO CONFIRM, READ AFTER RESPONDENT HAS GIVEN ANSWER:)
So, you have [number] landline phone numbers that are not used exclusively for business, computers, fax machines or cell phones?
Yes.........1
No..............2 BACK TO D7a
(VOL) Don’t know...8
(VOL) Refused .....9
D7c. Do you personally use a cell phone?
Yes.........1
No..............2 SKIP TO END
(VOL) Don’t know...8 SKIP TO END
(VOL) Refused .....9 SKIP TO END
D7d. How many cell phones do you use?
_____ Enter Number
(VOL) Don’t know...97
(VOL) Refused .....99
D7e. Of all the telephone calls that you receive, are.....
All or almost all calls received on cell phones..............1
Some received on cell phones and some on regular phones,.....2
Or
Very few or none on cell phones..............................3 (VOL) Don’t know...8
(VOL) Refused .....9
Those are all of the questions that I have. If you have any questions about vehicle safety issues or just want some additional information, visit the National Highway Traffic Safety Administration’s website at www.nhtsa.dot.gov. Thank you for your time today.
Ask D8a Through D8d If Cell Sample
D8a. How many cell phones do you use?
_____ Enter Number
(VOL) Don’t know...97
(VOL) Refused .....99
D8b. Do you have a landline telephone in your home that is used to make and receive calls?
Yes.........1
No..............2 SKIP TO END
(VOL) Don’t know...8 SKIP TO END
(VOL) Refused .....9 SKIP TO END
D8c. Not including business or work numbers, how many landline telephone lines do you have in your home?
_____ Enter Number
(VOL) Don’t know...97
(VOL) Refused .....99
D8d. Of all the telephone calls that you receive, are.....
All or almost all calls received on cell phones..............1
Some received on cell phones and some on regular phones,.....2
Or
Very few or none on cell phones..............................3 (VOL) Don’t know...8
(VOL) Refused .....9
Those are all of the questions that I have. If you have any questions about vehicle safety issues or just want some additional information, visit the National Highway Traffic Safety Administration’s website at www.nhtsa.dot.gov. Thank you for your time today.
NHTSA Form 1011
| File Type | application/msword |
| File Title | ATTACHMENT C |
| Author | MLevy |
| Last Modified By | walter.culbreath |
| File Modified | 2011-05-02 |
| File Created | 2011-05-02 |