Form CAI Questionnaire CAI Questionnaire CAI Questionnaire

Attachment B
CAI Questionnaire Content

2013 NATIONAL SURVEY ON
DRUG USE AND HEALTH
Draft CAI Specifications for
Programming
English Version
Contract No. HHSS283201000003C
Project No. 0212800

Prepared by:
Research Triangle Institute

Project Director:
Tom Virag

Prepared for:
Substance Abuse and Mental
Health Services Administration
Rockville, Maryland 20857

May 2012

2013 NATIONAL SURVEY ON
DRUG USE AND HEALTH
Draft CAI Specifications for
Programming
English Version
Contract No. HHSS283201000003C
RTI Project No. 0212800

Authors:
Patricia LeBaron
Brian Head

Project Director:
Tom Virag

Prepared for:

Substance Abuse and Mental Health Services Administration
Rockville, MD 20857

Prepared by:
RTI International

May 2012

Content of 2013 NSDUH Instrument
Module
Questionnaire Changes
Introduction
Core Demographics
Calendar
(30-day and 12-month reference dates)
Beginning ACASI Section
Tutorial
Tobacco
Alcohol
Marijuana
Cocaine
Crack
Heroin
Hallucinogens
Inhalants
Pain Relievers
Tranquilizers
Stimulants
Sedatives
Special Drugs
Risk/Availability
Blunts
Definitions for Use in the Drugs Module
Substance Dependence and Abuse
Special Topics
Market Information for Marijuana
Prior Substance Use
Drug Treatment
Health Care
Adult Mental Health Service Utilization
Social Environment
Parenting Experiences
Youth Experiences
Mental Health
Adult Depression
Youth Mental Health Service Utilization
Adolescent Depression
Definitions for Use in
Consumption of Alcohol Module
Consumption of Alcohol
Back-End Demographics:
Education
Employment
Household Roster
Proxy Information
Health Insurance
Income
Verification

Mode of Administration
CAPI*
CAPI

Required Aids
None
None
Showcards 1-5

Page
i
1
3

FI reads instructions and identifies reference dates.

Reference Date Calendar

9

FI reads description of keyboard and helps respondent adjust
headphones.
Respondent completes computer practice session with FI help.
ACASI**
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI: 18+ year-olds only
ACASI: parents of 12-17-year-olds
ACASI: 12-17-year-olds only
ACASI: 18+ year-olds only
ACASI: 18+ year-olds only
ACASI: 12-17-year-olds only
ACASI: 12-17-year-olds only

None

11

None
None
None
None
None
None
None
None
None
Pillcard A
Pillcard B
Pillcard C
Pillcard D
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None

13
15
45
55
63
71
79
87
117
127
139
147
159
167
177
181
185
187
217
221
233
293
311
317
325
327
331
339
349
361
371

ACASI

None

383

ACASI
CAPI
CAPI
CAPI
CAPI
CAPI
CAPI (Proxy allowed)
CAPI (Proxy allowed)
FI & respondent complete form.

None
None
Showcards 6 & 7
Showcards 8 - 13
Showcards 14 & 15
None
Showcards 16 & 17
Showcard 17a, 18 & 19
Verification Form
Follow-up Study
Description
None

385
395
399
403
411
421
427
433
441

Recruitment Screens

FI recruits into Follow-up study

FI Observation Questions

FI records own responses.

*
**

443
445

CAPI (computer-assisted personal interviewing): FI reads questions and records responses.
ACASI (audio computer-assisted self-interviewing): Respondent reads questions on screen or listens to questions through headphones and then records answers
into computer.

2013 NATIONAL SURVEY ON DRUG USE AND HEALTH
CAI INSTRUMENT REVISIONS
NOTE: Changes made to the CAI instrument from 2012 to 2013 are highlighted
in the Specifications for Programming. Deletions are shown using highlights and
strikeout; new content is highlighted.
Module Specific
Introduction
 The CAI instrument version was updated.
Core Demographics
 Added new questions to ask about serving in Reserve components in the
military. Edited current questions for consistency.


Added two response categories to the question about race. The response
options now include Guamanian or Chamorro, and Samoan.

Blunts
 Added two new questions about medical marijuana in the blunts module.
Health
 Added new questions to the health module that ask about height, weight, and
the discussions one has had with a doctor about substance use and abuse in
the past year.
Mental Health


Deleted the computation of Mental Health variables from this module. These
variables were used to select respondents into the Mental Health Surveillance
Survey.

Back End Demographics
 Edits were made to the wording and routing of existing questions to more
precisely introduce survey topics and to use more natural question wording.
Health Insurance and Income
 State program names for Medicaid, CHIP and TANF will be updated.


The definitions of the CHAMPUS and CHAMPVA programs were updated.



The wording to INTRTINN underwent a minor change.



Edited the wording of QI24.

Recruitment Screens
 The recruitment screens were deleted in response to the discontinuation of
the Mental Health Study.
Verification

May 23, 2012



Edited the wording of TOALLR3I to alleviate confusion experienced by
some college students—i.e., changed “home telephone” to “phone” and
inserted “current” before address to clarify interest in their current residence.



Edited the wording of INCENT01.
i

May 23, 2012

ii

2013 National Survey on Drug Use and Health:
Specifications for Programming
Blaise Version 4.8
Introduction
FIIDCON

INTERVIEWER: THE FIELD INTERVIEWER ID NUMBER FOR THIS LAPTOP IS [FIIDFILL]. IS THIS
YOUR FI ID?
1
2

FIIDENT

YES
NO

[IF FIIDCON=2] PLEASE ENTER YOUR 6-DIGIT FI ID BELOW.

____________
INTERVIEWER: SELECT THE LANGUAGE TO BE USED IN THIS INTERVIEW.

lang

1
2
3

ENGLISH
SPANISH
MULTIMEDIA LANGUAGE
NSDUH CAI Instrument Version: 16.xx
OMB Control #: 0930-0110
Expiration Date: 8/31/2014

HARD ERROR: [IF LANG=3] THE LANGUAGE YOU SELECTED (MULTIMEDIA LANGUAGE) IS USED ONLY
FOR PLAYING AUDIO AND IS NOT VALID AS A SURVEY LANGUAGE. PLEASE CHOOSE ANOTHER
LANGUAGE. PRESS [ENTER] TO CONTINUE.
note1

FI: DO NOT READ ALOUD UNLESS RESPONDENT QUESTIONS THE BURDEN (OR TIME) ASSOCIATED
WITH THIS INTERVIEW.
NOTICE: Public reporting burden for this collection of information is estimated to average 60 minutes per response,
including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or
any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports
Clearance Officer, Paperwork Reduction Project (0930-0110); Room 8-1099; 1 Choke Cherry Road; Rockville, MD
20857. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information
unless it displays a currently valid OMB control number. The OMB control number for this project is-0930-0110
PRESS [ENTER] TO CONTINUE.

remindfi

INTERVIEWER: HAVE YOU READ THE “INTRO TO CAI” IN YOUR SHOWCARD BOOKLET ALOUD
TO THE RESPONDENT?
1
2

introcai

May 23, 2012

YES
NO

[IF REMINDFI = 2] YOU MUST READ THE “INTRO TO CAI” IN YOUR SHOWCARD BOOKLET
ALOUD TO THE RESPONDENT BEFORE YOU CONTINUE WITH THE INTERVIEW! DO SO NOW.
WHEN YOU ARE FINISHED, PRESS “1" TO CONTINUE.

1

May 23, 2012

2

Core Demographics
age1

What is your date of birth?
ENTER MM-DD-YYYY
DOB: ________________
DK/REF
DEFINE CALCAGE:
CALCAGE = AGE CALCULATED BY "SUBTRACTING" DATE OF BIRTH FROM DATE OF INTERVIEW.
[IF AGE1 NE DK OR REF] I have entered your date of birth as [AGE1]. Is this correct?

confdob

1
YES
2
NO
DK/REF
HARD ERROR: [IF CONFDOB=2] INTERVIEWER: PRESS [ENTER] TO GO BACK AND CORRECT THE
RESPONDENT’S DATE OF BIRTH.
[NOTE: DO NOT DEFINE CALCAGE UNTIL CONFDOB=YES]
[IF AGE1 NE DK/REF AND CONFDOB NE DK/REF] That would make you [CALCAGE] years old. Is this
correct?

confirm

1
YES
2
NO
DK/REF
HARD ERROR: [IF CONFIRM = 2] INTERVIEWER: PRESS [ENTER] TO GO BACK AND CORRECT THE
RESPONDENT’S DATE OF BIRTH.
[IF CONFIRM = 1 OR DK/REF AND CALCAGE < 12] Since you are [CALCAGE] years old, we cannot
interview you for this study. Thank you for your cooperation.

under12

PRESS [ENTER] TO CONTINUE. PROGRAM SHOULD ROUTE TO FIEXIT.
[IF (CALCAGE IS 12 OR OLDER AND CONFIRM = DK/REF) OR AGE1 = DK/REF OR CONFDOB =
DK/REF] I need your correct age so I can ask you the right questions. What is your correct age?

dkrefage

AGE:
DK/REF

[RANGE: 1 - 110]

IF DKREFAGE NOT (BLANK OR DK/REF) THEN CALCAGE = DKREFAGE
under12b

[IF DKREFAGE < 12] Since you are [CALCAGE] years old, we cannot interview you for this study. Thank you
for your cooperation.
PRESS [ENTER] TO CONTINUE. PROGRAM SHOULD ROUTE TO FIEXIT

lastchance

[IF DKREFAGE = DK/REF] Since I am not certain what your age is, I cannot interview you for this study.
Thank you for your cooperation.
PRESS [ENTER] TO CONTINUE. PROGRAM SHOULD ROUTE TO FIEXIT
DEFINE CURNTAGE:
IF CALCAGE > 11 AND CONFIRM = 1, CURNTAGE = CALCAGE
IF CALCAGE > 11 AND CONFIRM = DK/REF AND DKREFAGE > 11, CURNTAGE = DKREFAGE
IF AGE1= DK/REF AND DKREFAGE > 11, CURNTAGE = DKREFAGE
ELSE RESPONDENT IS INELIGIBLE; ROUTE TO FIEXIT

FIPE1

INTERVIEWER: WERE 2 PERSONS SELECTED FOR AN INTERVIEW AT THIS SDU?
1

May 23, 2012

YES
3

2
FIPE2

[IF FIPE1 = 1 AND CURNTAGE = 18 OR OLDER] INTERVIEWER: WAS A 12 - 17 YEAR OLD CHILD
SELECTED FOR AN INTERVIEW AT THIS SDU?
1
2

FIPE3

NO

YES
NO

[IF FIPE2 = 1] INTERVIEWER: IS THIS RESPONDENT THE PARENT OR LEGAL GUARDIAN OF THE 12 - 17
YEAR OLD CHILD WHO WAS SELECTED FOR AN INTERVIEW? (VERIFY THIS WITH THE RESPONDENT
IF YOU ARE UNSURE.)
1
2

YES
NO

NOTE: IF FIPE3 = 1, SET THE FLAG TO ADMINISTER THE PARENTING EXPERIENCES MODULE
DURING ACASI.
FIPE4

INTERVIEWER: IN WHAT STATE IS THIS SAMPLE DWELLING UNIT (SDU) LOCATED?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

FIPE5

ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
THE DISTRICT OF COLUMBIA (WASHINGTON, DC)
FLORIDA
GEORGIA
HAWAII
IDAHO
ILLINOIS
INDIANA
IOWA
KANSAS
KENTUCKY
LOUISIANA
MAINE
MARYLAND
MASSACHUSETTS
MICHIGAN
MINNESOTA
MISSISSIPPI
MISSOURI

27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51

MONTANA
NEBRASKA
NEVADA
NEW HAMPSHIRE
NEW JERSEY
NEW MEXICO
NEW YORK
NORTH CAROLINA
NORTH DAKOTA
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
RHODE ISLAND
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
VERMONT
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING

INTERVIEWER: THE STATE YOU ENTERED IS:

FIPE4 STATE NAME FILL
IS THIS CORRECT?
1
2

YES
NO

HARD ERROR: [IF FIPE5 = 2] INTERVIEWER: PRESS [ENTER] TO GO BACK-AND CORRECT THE STATE
WHERE YOU ARE CONDUCTING THIS INTERVIEW.

May 23, 2012

4

QD01

The first few questions are for statistical purposes only, to help us analyze the results of the study.
INTERVIEWER: RECORD RESPONDENT’S GENDER.
5
9

QD01a

MALE
FEMALE

INTERVIEWER: YOU HAVE ENTERED THAT THE RESPONDENT IS [FILL QD01]. IS THIS CORRECT?
4
6

YES
NO

HARD ERROR: [IF QD01a = 6] INTERVIEWER: PRESS [ENTER] TO GO BACK AND CORRECT THE
RESPONDENT'S GENDER.
QD03

Are you of Hispanic, Latino, or Spanish origin or descent?
1
YES
2
NO
DK/REF

QD04

[IF QD03 = 1] HAND R SHOWCARD 1. Which of these Hispanic, Latino, or Spanish groups best describes you? Just
give me the number or numbers from the card.
TO SELECT MORE THAN ONE CATEGORY, PRESS THE SPACE BAR BETWEEN EACH CATEGORY YOU
SELECT.
1
2
3
4
5
6
7
DK/REF

QD04othr

MEXICAN / MEXICAN AMERICAN / MEXICANO / CHICANO
PUERTO RICAN
CENTRAL OR SOUTH AMERICAN
CUBAN / CUBAN AMERICAN
DOMINICAN (FROM DOMINICAN REPUBLIC)
SPANISH (FROM SPAIN)
OTHER (SPECIFY)

[IF QD04 = 7] Please tell me which other Hispanic, Latino or Spanish group best describes you.
_____________
DK/REF

QD05

HAND R SHOWCARD 2. Which of these groups describes you? Just give me the number or numbers from the card.
TO SELECT MORE THAN ONE CATEGORY, PRESS THE SPACE BAR BETWEEN EACH CATEGORY YOU
SELECT.
RESPONDENTS WHO REPORT THEIR RACE AS NATIVE AMERICAN SHOULD BE INCLUDED IN
RESPONSE CATEGORY 3.
1
2
3
4
5
6
7
8
9
DK/REF

QD05ASIA

May 23, 2012

WHITE
BLACK / AFRICAN AMERICAN
AMERICAN INDIAN OR ALASKA NATIVE (AMERICAN INDIAN INCLUDES NORTH AMERICAN,
CENTRAL AMERICAN, AND SOUTH AMERICAN INDIANS)
NATIVE HAWAIIAN
GUAMANIAN OR CHAMMORO
SAMOAN
OTHER PACIFIC ISLANDER
ASIAN (FOR EXAMPLE: ASIAN INDIAN, CHINESE, FILIPINO, JAPANESE, KOREAN, AND
VIETNAMESE)
OTHER (SPECIFY)
[IF QD05 = 6] HAND R SHOWCARD 3. Which of these Asian groups describes you? Just give me the
number or numbers from the card.

5

TO SELECT MORE THAN ONE CATEGORY, PRESS THE SPACE BAR BETWEEN EACH
CATEGORY YOU SELECT.
1
2
3
4
5
6
7
DK/REF
QD05OTHA

ASIAN INDIAN
CHINESE
FILIPINO
JAPANESE
KOREAN
VIETNAMESE
OTHER (SPECIFY)

[IF QD05ASIA = 7] Please tell me which other Asian group or groups describes you.
OTHER ASIAN GROUP: _____________
DK/REF

QD05OTHR

[IF QD05 = 7] Please tell me which other racial group or groups describes you.
OTHER RACIAL GROUP: _____________
DK/REF

QD07

[IF CURNTAGE = 15 OR OLDER] Are you now married, widowed, divorced or separated, or have you never
married?
1
2
3
4
DK/REF

MARRIED
WIDOWED
DIVORCED OR SEPARATED
HAVE NEVER MARRIED
INTERVIEWER NOTE:
If the respondent is divorced but currently remarried, code as married.
By “divorce” we mean a legal cancellation or annulment of a marriage.
By “separated” we mean legally or informally separating due to marital discord.

QD08

[IF QDO7 = 1 OR 2 OR 3] How many times have you been married?
NUMBER OF TIMES:
DK/REF

QD09

[RANGE: 1 - 9]

[IF CURNTAGE = 17 OR OLDER] Have you ever been in the United States’ Armed Forces?
1
YES
2
NO
DK/REF

QD10

[IF QD09 = 1 OR DK/REF] Are you currently on active duty in the United States Armed Forces, in a Reserves
component, or now separated or retired from either reserves or active duty?
1
ON ACTIVE DUTY IN THE ARMED FORCES
2
IN A RESERVES COMPONENT
3
NOW SEPARATED OR RETIRED FROM EITHER RESERVES OR ACTIVE DUTY
DK/REF

V2a

[IF QD10 = 1] Are you a member of a Reserve component currently serving full-time in an active duty
status?
1
YES
2
NO
DK/REF

V2b

May 23, 2012

[IF QD10 = 2] Are you currently serving full-time in a Reserve component? Full-time service does not
include annual training for the Reserves or National Guard.

6

1
YES
2
NO
DK/REF
MILTERM1

[IF QD10 = 1] I need to verify what I just entered into the computer. You said you are currently on active
duty in the armed forces. Is that correct?
1
YES
2
NO
DK/REF

HARD ERROR: [IF MILTERM1 = 2 OR DK/REF] INTERVIEWER: PRESS [ENTER] TO GO BACK AND
CORRECT THE RESPONDENT’S CURRENT MILITARY STATUS.
MILTERM2

[IF MILTERM1 = 1] People who are currently on active duty in the armed forces are not eligible to be
interviewed in this study. I appreciate you taking the time to speak with me. Thank you.
PRESS [ENTER] TO CONTINUE.
[ROUTE TO FIEXIT]
[If QD9=1] Have you ever served on active duty in the United States Armed Forces or Reserve
components?
Active duty does not include training for the Reserves or National Guard, but does include activation, for
example, for a national emergency or military conflict.

QD10a

1
YES
2
NO
DK/REF
[IF (QD10a=1)] HAND R SHOWCARD 4. When did you serve on active duty in the United States Armed
Forces or Reserve components? Just give me the number or numbers from the card.

QD10b

TO SELECT MORE THAN ONE CATEGORY, PRESS THE SPACE BAR BETWEEN EACH
CATEGORY YOU SELECT.
1
2
3
4
5
6
7
8
9

September 2001 or later
August 1990 to August 2001 (including Persian Gulf War)
May 1975 to July 1990
Vietnam era (August 1964 to April 1975)
February 1955 to July 1964
Korean War (July 1950 to January 1955)
January 1947 to June 1950
World War II (December 1941 to December 1946)
November 1941 or earlier

[IF QD10a=1] Did you ever serve on active duty in the United States Armed Forces or Reserve components
in a military combat zone or an area where you drew imminent danger pay or hostile fire pay?

QD10c

1
Yes
2
No
DK/REF

QD11

HAND R SHOWCARD 5. What is the highest grade or year of school you have completed?
Please tell me the number from the card.
INCLUDE JUNIOR OR COMMUNITY COLLEGE ATTENDANCE; DO NOT INCLUDE TECHNICAL SCHOOLS
(BEAUTICIAN, MECHANIC, ETC.).
0
1
2

May 23, 2012

NEVER ATTENDED SCHOOL
1ST GRADE COMPLETED
2ND GRADE COMPLETED
7

3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
DK/REF
QD12

3RD GRADE COMPLETED
4TH GRADE COMPLETED
5TH GRADE COMPLETED
6TH GRADE COMPLETED
7TH GRADE COMPLETED
8TH GRADE COMPLETED
9TH GRADE COMPLETED
10TH GRADE COMPLETED
11TH GRADE COMPLETED
12TH GRADE COMPLETED
COLLEGE OR UNIVERSITY / 1ST YEAR COMPLETED
COLLEGE OR UNIVERSITY / 2ND YEAR COMPLETED
COLLEGE OR UNIVERSITY / 3RD YEAR COMPLETED
COLLEGE OR UNIVERSITY / 4TH YEAR COMPLETED
COLLEGE OR UNIVERSITY / 5TH OR HIGHER YEAR COMPLETED

This question is about your overall health. Would you say your health in general is excellent, very good, good, fair, or
poor?
1
2
3
4
5
DK/REF

May 23, 2012

EXCELLENT
VERY GOOD
GOOD
FAIR
POOR

8

calendar

CALENDAR
Throughout the rest of this interview, the computer will ask you questions about three time periods, the past 30
days, the past 12 months, and your lifetime. To help you remember the first two time periods, let’s mark this
calendar with the beginning dates for each one of them.
SHOW CALENDAR TO RESPONDENT.
Now let’s think about the past 30 days. According to the calendar [DATEFILL] was 30 days ago. I’ll call that
your 30-day reference date, and I will write [DATEFILL] here on the calendar.
WRITE [DATEFILL] FOR 30-DAY REFERENCE DATE ON CALENDAR AND CIRCLE DAY;
UNDERLINE ENTIRE 30-DAY PERIOD FROM [DATEFILL] TO [CURRENT DATE].
PRESS [ENTER] TO CONTINUE.

calendr2

A number of questions will ask about the past 12 months, that is since this date last year. According to the
calendar [DATEFILL] was 12 months ago. I’ll call that your 12-month reference date.
WRITE [DATEFILL] FOR 12 MONTH REFERENCE DATE ON CALENDAR, AND CIRCLE DAY ON
CALENDAR.
PRESS [ENTER] TO CONTINUE.

calendr3

Please use this calendar as we go through the interview to help you remember when different things happened. I
will remind you to think about your 30-day reference date and your 12-month reference date when I ask you
questions.
GIVE THE CALENDAR TO THE RESPONDENT. PRESS [ENTER] TO CONTINUE.

May 23, 2012

9

May 23, 2012

10

Beginning ACASI Section
IntroAcasi1

You will do an important part of this interview on your own, using the computer and headphones. Before
you start, we’ll go through a short practice session so you can learn how to use this computer and our
interview program. Let me quickly point out the keys you will use. The computerized practice session that
follows will go through what each key does in greater detail.
MOVE COMPUTER SO RESPONDENT CAN SEE THE KEYBOARD AND POINT OUT THE
FOLLOWING:
[POINT TO THE ROW OF FUNCTION KEYS] First, these are the function keys. The function keys and
what they do are labeled for you.
[POINT TO F3] If you don’t know the answer to a question, press F3.
[POINT TO F4] If you don’t want to answer a question, press F4.
[POINT TO F7] If you want to turn the sound off, press F7. To turn it on again, press F7 again.
PRESS [ENTER] TO CONTINUE.

IntroAcasi3

These next items will help you enter your answers into the computer.
[POINT TO THE ROW OF NUMBER KEYS] These are the number keys.
[POINT TO THE ENTER KEY] The Enter key is here,
[POINT TO THE SPACE BAR] the space bar is here,
[POINT TO THE BACKSPACE KEY] and the Backspace key is here.
[POINT TO THE BOTTOM OF THE SCREEN] The answers that you enter will show up here at the bottom
of the screen.
PRESS [ENTER] TO CONTINUE.

IntroAcasi4

There are a couple of computer features that you will not use.
[POINT TO ON/OFF SWITCH] This button up here turns the machine on and off. Please do not press it! It
will turn the machine off, and we’ll lose the interview.
[POINT TO TOUCHPAD] Also, please do not touch this pad. This might disrupt the interview.
PRESS [ENTER] TO CONTINUE.

IntroAcasi0

At certain times, the computer will tell you to ask me for some cards. At that time, be sure to ask me to show
you these cards.
PRESS [ENTER] TO CONTINUE.

IntroAcasi2

Lastly, these headphones will allow you to listen to the interview questions.
HAND HEADPHONES TO RESPONDENT.
You can adjust the volume here [DEMONSTRATE VOLUME ADJUSTMENT ON THE HEADPHONE
CORD].
Please put on your headphones. When you are ready, let me know.
MOVE COMPUTER SO RESPONDENT CAN USE IT. [BREAK]
ONCE RESPONDENT HAS HEADPHONES ON, PRESS “1" AND [ENTER] SO R CAN BEGIN
PRACTICE SESSION.

HeadPhone

May 23, 2012

This screen will play while you adjust the volume in your headphones. When you have adjusted the volume
to a level that is comfortable to you, press the large [ENTER] key on the right side of the keyboard to
11

continue with the practice session. The [ENTER] key is the one with the 5 symbol on it.

May 23, 2012

12

Tutorial
INTRO1

Welcome to RTI’s self-interviewing system, which lets you control the interview and answer in complete privacy.
First, you will learn how to use the system and complete some practice questions. You will learn how to enter
answers and how to back-up if you make a mistake and want to change an answer.
Press the large [ENTER] key on the right side of the keyboard to move to the next screen. The [ENTER] key is
the one with the 5 symbol on it.

INTRO2

In this system you can read the questions on the computer screen and hear them read through the headphones. If
you would like to just see the questions on the screen, you can turn off the voice.
Press the [ENTER] key to continue.

GOTDOG

You answer questions by putting in the number that is shown next to your answer. The numbers are located in the
second row of the keyboard.
To answer a question, you first press the correct number and then press [ENTER].
Do you have a dog?
1
Yes
2
No
DK/REF

EYECOLOR

The last question was a Yes-No question. Other questions will have more answers to choose from, and you
will pick your answer from a list.
What color are your eyes? Put in the number that best fits you and press the [ENTER] key.
1
2
3
4
5
DK/REF

ALLAPPLY

Blue
Brown
Gray
Green
Some other color

Some questions will let you choose more than one answer. For these questions, you will use the space bar to
separate the answers you type in. Practice this now.
What kinds of music do you listen to?
To select more than one kind of music from the list, press the space bar between each number you type.
When you have finished, press [ENTER] to go to the next question.
1
2
3
4
5
6
7
8
9
DK/REF

NUMBER

Classical
Country
Hip Hop
Jazz
Latin American/Spanish
Folk/Traditional
Pop/Rock
Soul/R&B
Techno

Other questions will ask you to type in a number instead of choosing a number from a list.
In the past 30 days, on how many days did you eat breakfast? Type in the number of days you ate breakfast
and press [ENTER].
________________ [RANGE: 0 - 30]
DK/REF

May 23, 2012

13

STOPLIST

If you hear your answer before the end of the list, you can put in your answer while the list is being read.
Practice this now. Remember to press [ENTER].
When do you want to interrupt this list?
1
2
3
4
DK/REF

BACKUP

First answer
Second answer
Third answer
Fourth answer

If you want to change or see your answer to a previous question, you can back up using the [F9] key. Each
time you press the [F9] key, the computer will go back one question.
Press [ENTER] to continue.

DOAGAIN

You can tell the computer to repeat a question by pressing [F10]. Try this now.
How many times did you listen to this screen?
1
I have listened to this screen more than once.
2
I have only listened to this screen one time
DK/REF

rangeerr

For some questions, the computer can only accept certain answers. For example, in the question below, the
only numbers the computer will accept are 1 for YES or 2 for NO.
If you try to enter some other number, an instruction box will appear. To correct your answer, you must
press the [ENTER] key to make the box disappear. You can then answer the question again.
Try this with the question below. Type a 3 as your answer. Press the [ENTER] key to remove the
instruction box, then type in a valid answer.
Do you have a cat?
1
Yes
2
No
DK/REF

INCONSIS

At times the computer may ask you to think again about one of your answers. Other times, it may think two
of your answers disagree. It will ask you to tell which one is correct and then fix the wrong one.
Press [ENTER] to continue.

ANYQUES

If you have any questions, ask your interviewer now. If not, press [ENTER] to begin.

May 23, 2012

14

Tobacco
LEADCIG

These questions are about your use of tobacco products. This includes cigarettes, chewing tobacco, snuff, cigars,
and pipe tobacco. The first questions are about cigarettes only.
Press [ENTER] to continue.

CG01

Have you ever smoked part or all of a cigarette?
1
Yes
2
No
DK/REF

CGREF1

[IF CG01 = REF] The answers that people give us about their cigarette smoking are important to this study’s
success. We know that this information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever smoked part or all of a cigarette?
1
Yes
2
No
DK/REF

CG02

[IF CURNTAGE = 12 - 17 AND (CG01 = 2 OR CGREF1 = 2)] If one of your best friends offered you a cigarette,
would you smoke it?
1
2
3
4
DK/REF

CG03

[IF CURNTAGE = 12 - 17 AND (CG01 = 2 OR CGREF1 = 2)] At any time during the next 12 months do you think
you will smoke a cigarette?
1
2
3
4
DK/REF

CG04

Definitely yes
Probably yes
Probably not
Definitely not

Definitely yes
Probably yes
Probably not
Definitely not

[IF CG01 = 1 OR CGREF1 = 1] How old were you the first time you smoked part or all of a cigarette?
AGE:
DK/REF

[(RANGE: 1 - 110]

DEFINE AGE1STCG:
IF CG04 NE (BLANK OR DK/REF) THEN AGE1STCG = CG04
ELSE AGE1STCG = BLANK
IF CURNTAGE < AGE1STCG
CGCC01
The computer recorded that you were [AGE1STCG] years old when you first smoked part or
all of a cigarette. Is this correct?
4
Yes
6
No
DK/REF
CGCC02

[IF CGCC01 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [AGE1STCG] years old the first time I smoked part or all of a cigarette
3
Neither answer is correct
DK/REF

May 23, 2012

15

CGCC03

[IF CGCC02 = 2 OR CGCC02 = 3] Please answer this question again. What is your current
age?
AGE:
DK/REF

[RANGE: 1 - 110]

CGCC03a

CGCC04

[IF CGCC03 < 12] Since you have indicated that you are [CGCC03
AGE] years old, we cannot interview you for this study. Please tell
your interviewer that you have finished the survey. Thank you for
your cooperation. PROGRAM SHOULD ROUTE ENDAUDIO.

[IF CGCC02 = 1 OR CGCC02 = 3 OR CGCC01 = 6] Please answer this question again.
How old were you the first time you smoked part or all of a cigarette?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CGCC04 NOT(BLANK OR DK/REF) THEN AGE1STCG = CGCC04
UPDATE: IF CGCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = CGCC03
IF AGE1STCG = CURNTAGE OR AGE1STCG < 10:
CGCC05
The computer recorded that you were [AGE1STCG] years old the first time you smoked part
or all of a cigarette. Is this correct?
4
Yes
6
No
DK/REF
CGCC06

[IF CGCC05 = 6] Please answer this question again. How old were you the first time you
smoked part or all of a cigarette?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CGCC06 NOT(BLANK OR DK/REF) THEN AGE1STCG = CGCC06
CG04a

[IF CGCC05 NE DK/RE AND CGCC06 NE DK/REF AND AGE1STCG = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STCG = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first
smoke part or all of a cigarette in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

CG04b [IF AGE1STCG = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first smoke part or all of a
cigarette in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
CG04c

[IF CGCC05 NE DK/RE AND CGCC06 NE DK/REF AND AGE1STCG = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first smoke part or all of a cigarette?
1
2
3
4
5
6
7
8
9
10

May 23, 2012

January
February
March
April
May
June
July
August
September
October
16

11
November
12
December
DK/REF
HARD ERROR: [IF CG04c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CG04d [IF CG04a = 1 OR 2 OR CG04b = 1 OR 2] In what month in [YEAR FROM CG04a or CG04b] did you first smoke
part or all of a cigarette?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CG04d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STCG:
MYR1STCG = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (CG04a-d). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCG IS
BLANK.
IF MYR1STCG NE 0 AND NE AGE1STCG:
CGCC19
The computer recorded that you first smoked part or all of a cigarette in [CG04a-d fill]. That
would make you [MYR1STCG] years old when you first smoked part or all of a cigarette. Is
this correct?
4
Yes
6
No
DK/REF
CGCC20

[IF CGCC19 = 4] Earlier, the computer recorded that you were [AGE1STCG] years old
when you first smoked part or all of a cigarette. Which answer is correct?
1
2
3
DK/REF

I first smoked part or all of a cigarette in [CG04a-d fill] when I was [MYR1STCG]
years old
I was [AGE1STCG] years old the first time I smoked part or all of a cigarette
Neither answer is correct

UPDATE: IF CGCC20 = 1, THEN AGE1STCG = MYR1STCG
CGCC21

[IF CGCC20=2 OR CGCC20=3 OR CGCC19=6] Please answer this question again. Did
you first smoke part or all of a cigarette in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

CGCC21a

May 23, 2012

[IF CGCC21 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [CGCC21] did you first smoke part or all of a cigarette?
17

1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CGCC21a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF CGCC21a NE (0 OR DK/RE) THEN UPDATE MYR1STCG.
MYR1STCG = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (CGCC21 AND CGCC21a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCG IS
BLANK. IF MYR1STCG = AGE1STCG THEN MYR1STCG = BLANK
CGCC22

[IF CGCC20 NE 1 AND MYR1STCG NE 0 AND (CGCC21 AND CGCC21a NE CG04a-d)]
The computer recorded that you first smoked part or all of a cigarette in [CGCC21-CGCC21a
fill]. That would make you [MYR1STCG] years old when you first smoked part or all of a
cigarette. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF CGCC22 NE (6, BLANK OR DK/REF) AND (CGCC21 AND CGCC21a NE CG04a-d) THEN AGE1STCG =
MYR1STCG
CG05

[IF CG01 = 1 OR CGREF1 = 1] Now think about the past 30 days – that is, from [DATEFILL] up to and including
today. During the past 30 days, have you smoked part or all of a cigarette?
1
Yes
2
No
DK/REF

CG06

[IF CG05 = 2] How long has it been since you last smoked part or all of a cigarette?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF

CG06DK

[IF CG06 = DK] What is your best guess of how long it has been since you last smoked part or all of a cigarette?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF

CG06RE

[IF CG06 = REF] The answers that people give us about their cigarette smoking are important to this study’s
success. We know that this information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: How long has it been since you last smoked part or all of a
cigarette?
1
2

May 23, 2012

More than 30 days ago but within the past 12 months
More than 12 months ago but within the past 3 years
18

3
More than 3 years ago
DK/REF
CG07

[IF CG05 = 1] During the past 30 days, that is, since [DATEFILL], on how many days did you smoke part or all of a
cigarette?
# OF DAYS:
DK/REF

CG07DKRE

[RANGE: 1 - 30]

[IF CG07 = DK/REF] What is your best estimate of the number of days you smoked part or all of a cigarette
during the past 30 days?
1
2
3
4
5
6
DK/REF

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

DEFINE CIGDKRE FILL:
IF CG07DKRE = 1, THEN CIGDKRE = “1 or 2 days”
IF CG07DKRE = 2, THEN CIGDKRE = “3 to 5 days”
IF CG07DKRE = 3, THEN CIGDKRE = “6 to 9 days”
IF CG07DKRE = 4, THEN CIGDKRE = “10 to 19 days”
IF CG07DKRE = 5, THEN CIGDKRE = “20 to 29 days”
IF CG07DKRE = 6, THEN CIGDKRE = “30 days”
CG08

[IF CG07 > 1 OR CG07DKRE = 1 - 6]) On the [CG07 days / CIGDKRE] you smoked cigarettes during the past 30
days, how many cigarettes did you smoke per day, on average?
1
2
3
4
5
6
7
DK/REF

CG10

[IF CG07 = 1] On the one day you smoked cigarettes during the past 30 days, how many cigarettes did you smoke?
1
2
3
4
5
6
7
DK/REF

CG11

Less than one cigarette per day
1 cigarette per day
2 to 5 cigarettes per day
6 to 15 cigarettes per day (about ½ pack)
16 to 25 cigarettes per day (about 1 pack)
26 to 35 cigarettes per day (about 1 ½ packs)
More than 35 cigarettes per day (about 2 packs or more)

Less than one cigarette
1 cigarette
2 to 5 cigarettes
6 to 15 cigarettes (about ½ pack)
16 to 25 cigarettes (about 1 pack)
26 to 35 cigarettes (about 1 ½ packs)
More than 35 cigarettes (about 2 packs or more)

[IF CG05 = 1] The next questions are about the brand of cigarettes you smoke -- the brand is the name that is on the
pack. During the past 30 days, what brand of cigarettes did you smoke most often?
1
2
3
4
5
6
7
8
9
10
11

May 23, 2012

American Spirit
Basic
Benson & Hedges
Camel
Capri
Carlton
Doral
GPC
Kent
Kool
Liggett Select

14
15
16
17
18
19
20
21
22
23
24
19

Misty
Monarch
More
Newport
Pall Mall
Parliament
Salem
USA Gold
Vantage
Viceroy
Virginia Slims

12
Marlboro
13
Merit
DK/REF
CG11a

Winston
A brand not on this list

[IF CG11 = 26] Please think again about the brand of cigarettes you smoke. During the past 30 days, what brand of
cigarettes did you smoke most often?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
DK/REF

CG12

25
26

Alpine
Barclay
Belair
Best Value
Bristol
Bugler (roll-your-own)
Cambridge
Century
Chesterfield
Eve
Harley Davidson
Lark
L&M
Lucky Strike

15
16
17
18
19
20
21
22
23
24
25
26
27
28

Magna
Maverick
Max
Montclair
Now
Old Gold
Players
Private Label
Pyramid
Raleigh
Richland
Saratoga
Satin
State Express

29
30
31
32
33

Sterling
Tareyton
Top (roll-your-own)
True
A brand not on this list

[IF CG11a = 33] Please type in the name of the brand of cigarettes you smoked most often during the past 30 days. If
you’re not sure how to spell the brand, just make your best guess.
BRAND SMOKED: _____________________
DK/REF

CG13

[IF CG11 NE (DK/REF OR 26) OR CG11a NE (DK/REF OR 33)] The computer recorded that during the past 30
days, the cigarette brand you smoked most often was [CG11 OR CG11a FILL]. Is this correct?
1
Yes
2
No
DK/REF

RCG11

[IF CG13 = 2] Please review this list again. During the past 30 days, what brand of cigarettes did you smoke most
often?
1
2
3
4
5
6
7
8
9
10
11
12
13
DK/REF

RCG11a

14
15
16
17
18
19
20
21
22
23
24
25
26

Misty
Monarch
More
Newport
Pall Mall
Parliament
Salem
USA Gold
Vantage
Viceroy
Virginia Slims
Winston
A brand not on this list

[IF RCG11 = 26] Please review this list [IF CG11a = BLANK] again. During the past 30 days, what brand of
cigarettes did you smoke most often?
1
2
3
4
5
6
7
8

May 23, 2012

American Spirit
Basic
Benson & Hedges
Camel
Capri
Carlton
Doral
GPC
Kent
Kool
Liggett Select
Marlboro
Merit

Alpine
Barclay
Belair
Best Value
Bristol
Bugler (roll-your-own)
Cambridge
Century

15
16
17
18
19
20
21
22
20

Magna
Maverick
Max
Montclair
Now
Old Gold
Players
Private Label

29
30
31
32
33

Sterling
Tareyton
Top (roll-your-own)
True
A brand not on this list

9
10
11
12
13
14
DK/REF
RCG12

Chesterfield
Eve
Harley Davidson
Lark
L&M
Lucky Strike

23
24
25
26
27
28

Pyramid
Raleigh
Richland
Saratoga
Satin
State Express

[IF RCG11a = 33] Please type in the name of the brand of cigarettes you smoked most often during the past 30
days. If you’re not sure how to spell the brand, just make your best guess.
BRAND SMOKED: __________________
DK/REF

RCG13

[IF RCG11 NE (DK/REF OR 26) OR RCG11a NE (DK/REF OR 33)] The computer recorded that during the past
30 days, the cigarette brand you smoked most often was [RCG11 OR RCG11a FILL]. Is this correct?
1
Yes
2
No
DK/REF

RRCG11

[IF RCG13 = 2] Please review this list again. During the past 30 days, what brand of cigarettes did you smoke
most often?
1
2
3
4
5
6
7
8
9
10
11
12
13
DK/REF

RRCG11a

14
15
16
17
18
19
20
21
22
23
24
25
26

Misty
Monarch
More
Newport
Pall Mall
Parliament
Salem
USA Gold
Vantage
Viceroy
Virginia Slims
Winston
A brand not on this list

[IF RRCG11 = 26] Please review this list [IF CG11a AND RCG11a = BLANK] again. During the past 30 days,
what brand of cigarettes did you smoke most often?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
DK/REF

RRCG12

American Spirit
Basic
Benson & Hedges
Camel
Capri
Carlton
Doral
GPC
Kent
Kool
Liggett Select
Marlboro
Merit

Alpine
Barclay
Belair
Best Value
Bristol
Bugler (roll-your-own)
Cambridge
Century
Chesterfield
Eve
Harley Davidson
Lark
L&M
Lucky Strike

15
16
17
18
19
20
21
22
23
24
25
26
27
28

Magna
Maverick
Max
Montclair
Now
Old Gold
Players
Private Label
Pyramid
Raleigh
Richland
Saratoga
Satin
State Express

29
30
31
32
33

Sterling
Tareyton
Top (roll-your-own)
True
A brand not on this list

[IF RRCG11a = 33] Please type in the name of the brand of cigarettes you smoked most often during the past 30
days. If you’re not sure how to spell the brand, just make your best guess.
BRAND SMOKED: __________________
DK/REF

RRCG13
May 23, 2012

[IF RRCG11 NE (DK/REF OR 26) OR RRCG11a NE (DK/REF OR 33)] The computer recorded that during the
21

past 30 days, the cigarette brand you smoked most often was [RRCG11 OR RRCG11a FILL]. Is this correct?
1
Yes
2
No
DK/REF
CGTAR1

[IF ( CG11 = 1 – 25 AND CG13 = 1) OR IF (RCG11 = 1 – 25 AND RCG13 = 1) OR IF (RRCG11 = 1 – 25 and
RRCG13 = 1) OR IF (CG11a =1 – 32 AND CG13 = 1) OR IF (RCG11a = 1 – 32 AND RCG13 = 1) OR IF
(RRCG11a = 1 – 32 AND RRCG13 = 1)] During the past 30 days, what type of
[CG11/CG11a/RCG11/RCG11a/RRCG11/RRCG11a FILL] cigarettes did you smoke most often?
1
2
3
4
DK/REF

CGTAR2

[IF CG12 NE BLANK OR DK/REF OR IF RCG12 NE BLANK OR DK/REF OR IF RRCG12 NE BLANK OR
DK/REF] During the past 30 days, what type of cigarettes did you smoke most often?
1
2
3
4
DK/REF

CGMENTH1

Lights
Ultra Lights
Mediums
Full Flavor

Lights
Ultra Lights
Mediums
Full Flavor

[IF (CG11 = 1 – 25 AND CG13 = 1) OR IF (RCG11 = 1 – 25 AND RCG13 = 1) OR IF (RRCG11 = 1 – 25
AND RRCG13 = 1) OR IF (CG11a =1 – 32 AND CG13 = 1) OR IF (RCG11a = 1 – 32 AND RCG13 = 1)
OR IF RRCG11a = 1 – 32 AND RRCG13 = 1)] Were the
[CG11/CG11a/RCG11/RCG11a/RRCG11/RRCG11a FILL] cigarettes you smoked during the past 30
days menthol?
1
Yes
2
No
DK/REF

CGMENTH2

[IF CG12 NE BLANK OR DK/REF OR IF RCG12 NE BLANK OR DK/REF OR IF RRCG12 NE BLANK
OR DK/REF] Were the cigarettes you smoked during the past 30 days menthol?
1
Yes
2
No
DK/REF

CGLNTH

[IF (CG11 = 12 AND CG13 = 1) OR (RCG11 = 12 AND RCG13 = 1) OR (RRCG11 = 12 AND RRCG13 =
1)] What length were the Marlboro cigarettes you smoked most often during the past 30 days? Were they
shorts, regulars (also known as king-sized), or 100s?
1
2
3

CG14

Shorts
Regulars or king-sized
100s

[IF (CG11a NE 6 OR 31) AND (RCG11a NE 6 OR 31) AND (RRCG11a NE 6 or 31)] During the past 30 days, that is,
since [DATEFILL], have you smoked part or all of a roll-your-own tobacco cigarette?
1
Yes
2
No
DK/REF

CG15

[IF CG05 = DK/REF OR (CG06 = 1-3 OR DK/REF) OR (CG06DK = 1-3 OR DK/REF) OR (CG06RE = 1-3 OR
DK/REF) OR (CG07 = 1 - 29 OR DK/REF) OR (CG07DKRE = 1 - 5 OR DK/REF)] Has there ever been a period in
your life when you smoked cigarettes every day for at least 30 days?
1
2

May 23, 2012

Yes
No
22

DK/REF
CG16

[IF CG07 = 30 OR CG07DKRE = 6 OR CG15 = 1] How old were you when you first started smoking cigarettes every
day?
AGE:
DK/REF

[RANGE: 1-110]

DEFINE DAILYCIG:
DAILYCIG = CG16
IF DAILYCIG < AGE1STCG
CGCC07
The computer recorded that you were [DAILYCIG] years old when you first started smoking
cigarettes every day. Is this correct?
4
Yes
6
No
DK/REF
CGCC08

[IF CGCC07 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I was [DAILYCIG] years old when I first started smoking cigarettes every day
2
I was [AGE1STCG] years old the first time I smoked part or all of a cigarette
3
Neither answer is correct
DK/REF

CGCC09

[IF CGCC08 = 1 OR CGCC08 = 3] Please answer this question again. How old were you the
first time you smoked part or all of a cigarette?
AGE:
DK/REF

CGCC10

[RANGE: 1-110]

[IF CGCC08 = 2 OR CGCC08 = 3 OR CGCC07 = 6] Please answer this question again.
How old were you when you first started smoking cigarettes every day?
AGE:
DK/REF

[RANGE: 1-110]

UPDATE: IF CGCC09 NOT (BLANK OR DK/REF) THEN AGE1STCG = CGCC09
UPDATE: IF CGCC10 NOT (BLANK OR DK/REF) THEN DAILYCIG = CGCC10
IF DAILYCIG > CURNTAGE:
CGCC11
The computer recorded that you were [DAILYCIG] years old when you first started smoking
cigarettes every day. Is this correct?
4
Yes
6
No
DK/REF
CGCC12

[IF CGCC11 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [DAILYCIG] years old when I first started smoking cigarettes every day
3
Neither answer is correct
DK/REF

CGCC13

[IF CGCC12 = 2 OR CGCC12 = 3] Please answer this question again. What is your current
age?
AGE:
DK/REF

CGCC13a
May 23, 2012

[RANGE: 1 - 110]

[IF CGCC13 < 12] Since you have indicated that you are [CGCC13] years old, we cannot
23

interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.
CGCC14

[IF CGCC11 = 6 OR CGCC12 = 1 OR CGCC12 = 3] Please answer this question again.
How old were you when you first started smoking cigarettes every day?
AGE:
DK/REF

[RANGE: 1- 110]

UPDATE: IF CGCC13 NOT (BLANK OR DK/REF) THEN CURNTAGE = CGCC13
UPDATE: IF CGCC14 NOT (BLANK OR DK/REF) THEN DAILYCIG = CGCC14
CG16y1

[IF DAILYCIG = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF DAILYCIG = CURNTAGE - 1
AND DATE OF INTERVIEW $ DOB] Did you first start smoking cigarettes every day in [CURRENT YEAR
-1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

CG16y2

[IF DAILYCIG = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first start smoking cigarettes
every day in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

CG16m1

[IF DAILYCIG = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in [CURRENT YEAR]
did you first start smoking cigarettes every day?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CG16m1 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CG16m2

[IF CG16y1 = 1 OR 2 OR CG16y2 = 1 OR 2] In what month in [YEAR FROM CG16y1 or CG16y2] did you
first start smoking cigarettes every day?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

May 23, 2012

January
February
March
April
May
June
July
August
September
October
November
December

24

HARD ERROR: [IF CG16m2 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STDC:
MYR1STDC = AGE AT FIRST DAILY USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM
MONTH AND YEAR OF FIRST USE (CG16y1-m2). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN
MYR1STCG IS BLANK.
IF MYR1STDC NE 0 AND NE DAILYCIG:
CGCC15
The computer recorded that you first started smoking cigarettes every day in [CG16y1-m2
fill]. That would make you [MYR1STDC] years old when you first started smoking cigarettes
every day. Is this correct?
4
Yes
6
No
DK/REF
CGCC16

[IF CGCC15 = 4] Earlier, the computer recorded that you were [DAILYCIG] years old when
you first started smoking cigarettes every day. Which answer is correct?
1
2
3
DK/REF

I first started smoking cigarettes every day in [CG16y1-m2 fill] when I was
[MYR1STDC] years old
I was [DAILYCIG] years old the first time I started smoking cigarettes every day
Neither answer is correct

UPDATE: IF CGCC16 = 1, THEN DAILYCIG = MYR1STDC
CGCC17

[IF CGCC16=2 OR CGCC16=3 OR CGCC15=6] Please answer this question again. Did
you first start smoking cigarettes every day in [CURRENT YEAR -2], [CURRENT YEAR-1],
or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

CGCC17a

[IF CGCC17 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [CGCC17] did you first start smoking cigarettes every day?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CGCC17a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF CGCC17a NE (0 OR DK/REF) THEN UPDATE MYR1STDC.
MYR1STDC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (CGCC17 AND CGCC17a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STDC IS
BLANK. IF MYR1STDC = DAILYCIG THEN MYR1STDC = BLANK

May 23, 2012

25

CGCC18

[IF CGCC16 NE 1 AND MYR1STDC NE 0 AND (CGCC17 AND CGCC17a NE CG16y1CG16m2)] The computer recorded that you first started smoking cigarettes every day in
[CGCC17-CGCC17a fill]. That would make you [MYR1STDC] years old when you first
started smoking cigarettes every day. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF CGCC18 NE (6, BLANK OR DK/REF) AND (CGCC17 AND CGCC17a NE CG16y1-CG16m2) THEN
DAILYCIG = MYR1STDC
CG16a

CG25

[IF (CG05 = 2 OR DK/REF) OR ((CG08 < 4) OR (CG08 = 4 AND CG07 <17) OR (CG08 = 5 AND CG07 <7) OR
(CG08 = 6 AND CG07 <4) OR (CG08 = 7 AND CG07 <3 AND CG07DKRE NE BLANK)) Have you smoked at least
100 cigarettes in your entire life?
1
Yes
2
No
DK/REF
These next questions are about your use of snuff, sometimes called dip.
Snuff is a finely ground form of tobacco that usually comes in a container called a tin. You can use snuff by placing a
pinch or dip in your mouth between your lip and gum or between your cheek and gum. Snuff can also be inhaled
through the nose. Snuff is sold in both loose form and in ready-to-use packets.
Have you ever used snuff, even once?
1
Yes
2
No
DK/REF

CGREF3

[IF CG25 = REF] The answers that people give us about their use of snuff are important to this study’s success.
We know that this information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever used snuff, even once?
1
Yes
2
No
DK/REF

CG26

[IF CG25 = 1 OR CGREF3 = 1] How old were you the first time you used snuff?
YEARS OLD:
DK/REF

[RANGE: 1 - 110]

DEFINE SNUFFAGE:
IF CG26 NE (BLANK OR DK/REF) THEN SNUFFAGE = CG26
ELSE SNUFFAGE = BLANK
IF CURNTAGE < SNUFFAGE
CGSN01
The computer recorded that you were [SNUFFAGE] years old when you first used snuff. Is
this correct?
4
Yes
6
No
DK/REF
CGSN02

[IF CGSN01 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [SNUFFAGE] years old the first time I used snuff
3
Neither answer is correct
DK/REF

CGSN03
May 23, 2012

[IF CGSN02 = 2 OR CGSN02 = 3] Please answer this question again. What is your current
26

age?
AGE:
DK/REF

[RANGE: 1 - 110]

CGSN03a

[IF CGSN03 < 12] Since you have indicated that you are [CGSN03 AGE] years old, we
cannot interview you for this study. Please tell your interviewer that you have finished the
survey. Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

CGSN04

[IF CGSN02 = 1 OR CGSN02 = 3 OR CGSN01 = 6] Please answer this question again. How
old were you the first time you used snuff?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CGSN04 NOT(BLANK OR DK/REF) THEN SNUFFAGE = CGSN04
UPDATE: IF CGSN03 NOT(BLANK OR DK/REF) THEN CURNTAGE = CGSN03
IF SNUFFAGE = CURNTAGE OR SNUFFAGE < 10:
CGSN05
The computer recorded that you were [SNUFFAGE] years old the first time you used snuff.
Is this correct?
4
Yes
6
No
DK/REF
CGSN06

[IF CGSN05 = 6] Please answer this question again. How old were you the first time you
used snuff?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CGSN06 NOT(BLANK OR DK/REF) THEN SNUFFAGE = CGSN06
CG26a

[IF CGSN05 NE DK/RE AND CGSN06 NE DK/REF AND SNUFFAGE = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF SNUFFAGE = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use
snuff in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

CG26b [IF SNUFFAGE = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use snuff in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
CG26c

[IF CGSN05 NE DK/RE AND CGSN06 NE DK/REF AND SNUFFAGE = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use snuff?
1
2
3
4
5
6
7
8
9
10
11
12

May 23, 2012

January
February
March
April
May
June
July
August
September
October
November
December
27

DK/REF
HARD ERROR: [IF CG26c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CG26d [IF CG26a = 1 - 2 OR CG26b = 1 - 2] In what month in [YEAR FROM CG26a or CG26b] did you first use snuff?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CG26d > CURRENT MONTH] THE MONTH IN [CURRENT MONTH] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STSN:
MYR1STSN = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (CG26a-d). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STSN IS
BLANK.
IF MYR1STSN NE 0 AND NE SNUFFAGE:
CGSN07
The computer recorded that you first used snuff in [CG26a-d fill]. That would make you
[MYR1STSN] years old when you first used snuff. Is this correct?
4
Yes
6
No
DK/REF
CGSN08

[IF CGSN07 = 4] Earlier, the computer recorded that you were [SNUFFAGE] years old
when you first used snuff. Which answer is correct?
1
I first used snuff in [CG26a-d fill] when I was [MYR1STSN] years old
2
I was [SNUFFAGE] years old the first time I used snuff
3
Neither answer is correct
DK/REF

UPDATE: IF CGSN08 = 1, THEN SNUFFAGE = MYR1STSN.
CGSN09

[IF CGSN08=2 OR CGSN08=3 OR CGSN07=6] Please answer this question again. Did you
first use snuff in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

CGSN09a

[IF CGSN09 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [CGSN09] did you first use snuff?
1
2
3
4
5

May 23, 2012

January
February
March
April
May
28

6
7
8
9
10
11
12
DK/REF

June
July
August
September
October
November
December

HARD ERROR: [IF CGSN09a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF CGSN09a NE (0 OR DK/REF) THEN UPDATE MYR1STSN.
MYR1STSN = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (CGSN09 AND CGSN09a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STSN IS
BLANK. IF MYR1STSN = SNUFFAGE THEN MYR1STSN = BLANK.
CGSN10

[IF CGSN08 NE 1 AND MYR1STSN NE 0 AND (CGSN09 AND CGSN09a NE CG26a-d)] The
computer recorded that you first used snuff in [CGSN09-CGSN09a fill]. That would make
you [MYR1STSN] years old when you first used snuff. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF CGSN10 NE (6, BLANK OR DK/REF) AND (CGSN09 AND CGSN09a NE CG26a-d) THEN SNUFFAGE =
MYR1STSN
CG27

[IF CG25 = 1 OR CGREF3 = 1] Now think about the past 30 days, that is from [DATEFILL] up to and including
today. During the past 30 days, have you used snuff, even once?
1
Yes
2
No
DK/REF

CG28

[IF CG27 = 2] How long has it been since you last used snuff?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF
[IF CG28 = DK] What is your best guess of how long it has been since you last used snuff?

CG28DK

1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF
[IF CG28 = REF] The answers that people give us about their use of snuff are important to this study’s success.
We know that this information is personal, but remember your answers will be kept confidential.

CG28RE

Please think again about answering this question: How long has it been since you last used snuff?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF
CG29

[IF CG27 = 1] During the past 30 days, that is, since [DATEFILL], on how many days did you use snuff?
# OF DAYS:
DK/REF

May 23, 2012

[RANGE: 1 - 30]

29

[IF CG29 = DK/REF] What is your best estimate of the number of days you used snuff during the past 30
days?

CG29DKRE

1
2
3
4
5
6
DK/REF
CG30

[IF CG27 = 1] During the past 30 days, what brand of snuff did you use most often?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
DK/REF

CG31

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

Copenhagen
Cougar
Gold River
Grizzly
Happy Days
Hawken
Kodiak
Red Seal
Redwood
Rooster
Silver Creek
Skoal
Timber Wolf
A brand not on this list

[IF CG30 = 14] Please type in the name of the brand of snuff you used most often during the past 30 days. If you’re
not sure how to spell the brand, just make your best guess.
BRAND USED: __________________
DK/REF

CG32

[IF CG30 NE (DK/REF OR 14)] The computer recorded that during the past 30 days the brand of snuff you used most
often was [CG30 FILL]. Is this correct?
1
Yes
2
No
DK/REF

RCG30

[IF CG32 = 2] Please review this list again. During the past 30 days, what brand of snuff did you use most often?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
DK/REF

RCG31

Copenhagen
Cougar
Gold River
Grizzly
Happy Days
Hawken
Kodiak
Red Seal
Redwood
Rooster
Silver Creek
Skoal
Timber Wolf
A brand not on this list

[IF RCG30 = 14] Please type in the name of the brand of snuff you used most often during the past 30 days. If
you’re not sure how to spell the brand, just make your best guess.
BRAND USED: ___________________
DK/REF

May 23, 2012

30

[IF RCG30 NE (DK/REF OR 14)] The computer recorded that during the past 30 days the brand of snuff you used
most often was [RCG30 FILL]. Is this correct?

RCG32

1
Yes
2
No
DK/REF
[IF RCG32 = 2] Please review this list again. During the past 30 days, what brand of snuff did you use most
often?

RRCG30

1
2
3
4
5
6
7
8
9
10
11
12
13
14
DK/REF

Copenhagen
Cougar
Gold River
Grizzly
Happy Days
Hawken
Kodiak
Red Seal
Redwood
Rooster
Silver Creek
Skoal
Timber Wolf
A brand not on this list

[IF RRCG30 = 14] Please type in the name of the brand of snuff you used most often during the past 30 days. If
you’re not sure how to spell the brand, just make your best guess.

RRCG31

BRAND USED: ____________________
DK/REF
[IF RRCG30 NE (DK/REF OR 14)] The computer recorded that during the past 30 days the brand of snuff you
used most often was [RRCG30 FILL]. Is this correct?

RRCG32

1
Yes
2
No
DK/REF
CG17

The next questions are only about chewing tobacco. Chewing tobacco is coarsely shredded tobacco that is sold in
pouches of loose tobacco leaves or in a “plug” or “twist” form. To use chewing tobacco, you either chew it or hold it in
your cheek or inside your lower lip.
Have you ever used chewing tobacco, even once?
1
Yes
2
No
DK/REF

CGREF2

[IF CG17 = REF] The answers that people give us about their use of chewing tobacco are important to this study’s
success. We know that this information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever used chewing tobacco, even once?
1
Yes
2
No
DK/REF

CG18

[IF CG17 = 1 OR CGREF2 = 1] How old were you the first time you used chewing tobacco?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE CHEWAGE:
May 23, 2012

31

IF CG18 NE (BLANK OR DK/REF) THEN CHEWAGE = CG18
ELSE CHEWAGE = BLANK
IF CURNTAGE < CHEWAGE
CGCH01
The computer recorded that you were [CHEWAGE] years old when you first used chewing
tobacco. Is this correct?
4
Yes
6
No
DK/REF
CGCH02

[IF CGCH01 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [CHEWAGE] years old the first time I used chewing tobacco
3
Neither answer is correct
DK/REF

CGCH03

[IF CGCH02 = 2 OR CGCH02 = 3] Please answer this question again. What is your current
age?
AGE:
DK/REF

[RANGE: 1 - 110]

CGCH03a

[IF CGCH03 < 12] Since you have indicated that you are [CH03 AGE] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

CGCH04

[IF CGCH02 = 1 OR CGCH02 = 3 OR CGCH01 = 6] Please answer this question again.
How old were you the first time you used chewing tobacco?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CGCH04 NOT(BLANK OR DK/REF) THEN CHEWAGE = CGCH04
UPDATE: IF CGCH03 NOT(BLANK OR DK/REF) THEN CURNTAGE = CGCH03
IF CHEWAGE = CURNTAGE OR CHEWAGE < 10:
CGCH05
The computer recorded that you were [CHEWAGE] years old the first time you used chewing
tobacco. Is this correct?
4
Yes
6
No
DK/REF
CGCH06

[IF CGCH05 = 6] Please answer this question again. How old were you the first time you
used chewing tobacco?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CGCH06 NOT(BLANK OR DK/REF) THEN CHEWAGE = CGCH06
CG18a

[IF CGCH05 NE DK/RE AND CGCH06 NE DK/REF AND CHEWAGE = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF CHEWAGE = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use
chewing tobacco in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

CG18b [IF CHEWAGE = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use chewing tobacco in
[CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
May 23, 2012

32

1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
CG18c

[IF CGCH05 NE DK/RE AND CGCH06 NE DK/REF AND CHEWAGE = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use chewing tobacco?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CG18c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CG18d [IF CG18a = 1 - 2 OR CG18b = 1 - 2] In what month in [YEAR FROM CG18a or CG18b] did you first use chewing
tobacco?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CG18d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STCH:
MYR1STCH = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (CG18a-d). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCH IS
BLANK.
IF MYR1STCH NE 0 AND NE CHEWAGE:
CGCH07
The computer recorded that you first used chewing tobacco in [CG18a-d fill]. That would
make you [MYR1STCH] years old when you first used chewing tobacco. Is this correct?
4
Yes
6
No
DK/REF
CGCH08

[IF CGCH07 = 4] Earlier, the computer recorded that you were [CHEWAGE] years old
when you first used chewing tobacco. Which answer is correct?
1
2

May 23, 2012

I first used chewing tobacco in [CG18a-d fill] when I was [MYR1STCH] years old
I was [CHEWAGE] years old the first time I used chewing tobacco
33

3
Neither answer is correct
DK/REF
UPDATE: IF CGCH08 = 1, THEN CHEWAGE = MYR1STCH.
CGCH09

[IF CGCH08=2 OR CGCH08=3 OR CGCH07=6] Please answer this question again. Did
you first use chewing tobacco in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

CGCH09a

[IF CGCH09 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [CGCH09] did you first use chewing tobacco?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CGCH09a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF CGCH09a NE (0 OR DK/REF) THEN UPDATE MYR1STCH.
MYR1STCH = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (CGCH09 AND CGCH09a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCH IS
BLANK. IF MYR1STCH = CHEWAGE THEN MYR1STCH = BLANK
CGCH10

[IF CGCH08 NE 1 AND MYR1STCH NE 0 AND (CGCH09 AND CGCH09a NE CG18a-d)]
The computer recorded that you first used chewing tobacco in [CGCH09-CGCH09a fill].
That would make you [MYR1STCH] years old when you first used chewing tobacco. Is this
correct?
4
Yes
6
No
DK/REF

UPDATE: IF CGCH10 NE (6, BLANK OR DK/REF) AND (CGCH09 AND CGCH09a NE CG18a-d) THEN CHEWAGE =
MYR1STCH
CG19

[IF CG17 = 1 OR CGREF2 = 1] Now think about the past 30 days -- that is, from [DATEFILL] up to and including
today. During the past 30 days, have you used chewing tobacco, even once?
1
Yes
2
No
DK/REF

CG20

[IF CG19 = 2] How long has it been since you last used chewing tobacco?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF

May 23, 2012

34

[IF CG20 = DK] What is your best guess of how long it has been since you last used chewing tobacco?

CG20DK

1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF
[IF CG20 = REF] The answers that people give us about their use of chewing tobacco are important to this
study’s success. We know that this information is personal, but remember your answers will be kept confidential.

CG20RE

Please think again about answering this question: How long has it been since you last used chewing tobacco?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF
CG21

[IF CG19 = 1] During the past 30 days, that is, since [DATEFILL], on how many days did you use chewing tobacco?
# OF DAYS:
DK/REF

CG21DKRE

[IF CG21 = DK/REF] What is your best estimate of the number of days you used chewing tobacco during
the past 30 days?
1
2
3
4
5
6
DK/REF

CG22

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

[IF CG19 = 1] During the past 30 days, what brand of chewing tobacco did you use most often?
1
2
3
4
5
6
7
8
DK/REF

CG23

[RANGE: 1 - 30]

Beech-Nut
Chattanooga Chew
Day’s Work
Granger
H.B. Scott
Levi Garrett
Red Fox
Red Man

9
10
11
12

Taylor’s Pride
Totems
Work Horse
A brand not on this list

[IF CG22 = 12] Please type in the name of the brand of chewing tobacco you used most often during the past 30 days.
If you’re not sure how to spell the brand, just make your best guess.
BRAND USED: __________________
DK/REF

CG24

[IF CG22 NE (DK/REF OR 12)] The computer recorded that during the past 30 days the brand of chewing tobacco
you used most often was [CG22 FILL]. Is this correct?
1
Yes
2
No
DK/REF

RCG22 [IF CG24 = 2] Please review this list again. During the past 30 days, what brand of chewing tobacco did you use most
often?
1
2
3
May 23, 2012

Beech-Nut
Chattanooga Chew
Day’s Work

9
10
11
35

Taylor’s Pride
Totems
Work Horse

4
5
6
7
8
DK/REF

Granger
H.B. Scott
Levi Garrett
Red Fox
Red Man

12

A brand not on this list

RCG23 [IF RCG22 = 12] Please type in the name of the brand of chewing tobacco you used most often during the past 30
days. If you’re not sure how to spell the brand, just make your best guess.
BRAND USED:__________________
DK/REF
RCG24 [IF RCG22 NE (DK/REF OR 12)] The computer recorded that during the past 30 days the brand of chewing tobacco
you used most often was [RCG22 FILL]. Is this correct?
1
Yes
2
No
DK/REF
[IF RCG24 = 2] Please review this list again. During the past 30 days, what brand of chewing tobacco did you use
most often?

RRCG22

1
2
3
4
5
6
7
8
DK/REF

Beech-Nut
Chattanooga Chew
Day’s Work
Granger
H.B. Scott
Levi Garrett
Red Fox
Red Man

9
10
11
12

Taylor’s Pride
Totems
Work Horse
A brand not on this list

[IF RRCG22 = 12] Please type in the name of the brand of chewing tobacco you used most often during the past
30 days. If you’re not sure how to spell the brand, just make your best guess.

RRCG23

BRAND USED:________________
DK/REF
[IF RRCG22 NE (DK/REF OR 12)] The computer recorded that during the past 30 days the brand of chewing
tobacco you used most often was [RRCG22 FILL]. Is this correct?

RRCG24

1
Yes
2
No
DK/REF
CG33a

[IF (CG22/RCG22/RRCG22 = 1-11 AND CG24/RCG24/RRCG24 = 1) AND (CG30/RCG30/RRCG30 = 1-9 AND
CG32/RCG32/RRCG32 = 1)] The computer recorded that the chewing tobacco you used most often during the past 30
days was [CG22/RCG22/RRCG22 FILL] and that the snuff you used most often during the past 30 days was
[CG30/RCG30/RRCG30 FILL]. Which of these two brands did you use most often during the past 30 days?
1
[CG22/RCG22/RRCG22 FILL] brand of chewing tobacco
2
[CG30/RCG30/RRCG30 FILL] brand of snuff
DK/REF

CG33b [IF CG23/RCG23/RRCG23 NOT(BLANK OR DK/REF) AND (CG30/RCG30/RRCG30 = 1 - 9 AND
CG32/RCG32/RRCG32 = 1)] You typed the following name as the brand of chewing tobacco you used most often
during the past 30 days: [CG23/RCG23/RRCG23 FILL]. The computer also recorded that the snuff you used most
often during the past 30 days was [CG30/RCG30/RRCG30 FILL]. Which of these two brands did you use most
often during the past 30 days?
1
The brand of chewing tobacco you typed into the computer yourself — [CG23/RCG23/RRCG23 FILL]
2
[CG30/RCG30/RRCG30] brand of snuff
DK/REF

May 23, 2012

36

CG33c

[IF (CG22/RCG22/RRCG22 = 1 - 11 AND CG24/RCG24/RRCG24 = 1) AND CG31/RCG31/RRCG31 NOT(BLANK
OR DK/REF)] The computer recorded that the chewing tobacco you used most often during the past 30 days was
[CG22/RCG22/RRCG22 FILL]. You typed the following name as the brand of snuff you used most often during the
past 30 days: [CG31/RCG31/RRCG31 FILL]. Which of these two brands did you use most often during the past 30
days?
1
[CG22/RCG22/RRCG22] brand of chewing tobacco
2
The brand of snuff you typed into the computer yourself — [CG31/RCG31/RRCG31 FILL]
DK/REF

CG33d [IF CG23/RCG23/RRCG23 NOT(BLANK OR DK/REF) AND CG31/RCG31/RRCG31 NOT(BLANK OR DK/REF)]
You typed the following name as the brand of chewing tobacco you used most often during the past 30 days:
[CG23/RCG23/RRCG23 FILL]. You also typed the following name as the brand of snuff you used most often during
the past 30 days: [CG31/RCG31/RRCG31 FILL]. Which of these brands did you use most often during the past 30
days?
1
The brand of chewing tobacco you typed into the computer yourself — [CG23RCG23/RRCG23 FILL]
2
The brand of snuff you typed into the computer yourself — [CG31/RCG31/RRCG31 FILL]
DK/REF
The next questions are about smoking cigars. By cigars we mean any kind, including big cigars, cigarillos, and even
little cigars that look like cigarettes.

CG34

Have you ever smoked part or all of any type of cigar?
1
Yes
2
No
DK/REF
CGREF4

[IF CG34 = REF] The answers that people give us about their cigar smoking are important to this study’s success.
We know that this information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever smoked part or all of a cigar?
1
Yes
2
No
DK/REF

CG35

[IF CG34 = 1 OR CGREF4 = 1] How old were you the first time you smoked part or all of any type of cigar?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE CIGARAGE:
IF CG35 NE (BLANK OR DK/REF) THEN CIGARAGE = CG35
ELSE CIGARAGE = BLANK
IF CURNTAGE < CIGARAGE
CGCR01
The computer recorded that you were [CIGARAGE] years old when you first smoked part or
all of a cigar. Is this correct?
4
Yes
6
No
DK/REF
CGCR02

[IF CGCR01=4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [CIGARAGE] years old the first time I smoked part or all of a cigar
3
Neither answer is correct
DK/REF

CGCR03

May 23, 2012

[IF CGCR02 = 2 OR CGCR02 = 3] Please answer this question again. What is your current
age?
37

AGE:
DK/REF

[RANGE: 1 - 110]

CGCR03a

[IF CGCR03 < 12] Since you have indicated that you are [CGCR03 AGE] years old, we
cannot interview you for this study. Please tell your interviewer that you have finished the
survey. Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

CGCR04

[IF CGCR02 = 1 OR CGCR02 = 3 OR CGCR01 = 6] Please answer this question again.
How old were you the first time you smoked part or all of a cigar?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CGCR04 NOT(BLANK OR DK/REF) THEN CIGARAGE = CGCR04
UPDATE: IF CGCR03 NOT(BLANK OR DK/REF) THEN CURNTAGE = CGCR03
IF CIGARAGE = CURNTAGE OR CIGARAGE < 10:
CGCR05
The computer recorded that you were [CIGARAGE] years old when you first smoked part or
all of a cigar. Is this correct?
4
Yes
6
No
DK/REF
CGCR06

[IF CGCR05 = 6] Please answer this question again. How old were you the first time you
smoked part or all of a cigar?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CGCR06 NOT(BLANK OR DK/REF) THEN CIGARAGE = CGCR06
CG35a

[IF CGCR05 NE DK/RE AND CGCR06 NE DK/REF AND CIGARAGE = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF CIGARAGE = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first
smoke part or all of a cigar in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

CG35b [IF CIGARAGE = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first smoke part or all of a cigar
in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
CG35c

[IF CGCR05 NE DK/RE AND CGCR06 NE DK/REF AND CIGARAGE = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first smoke part or all of a cigar?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

May 23, 2012

January
February
March
April
May
June
July
August
September
October
November
December

38

HARD ERROR: [IF CG35c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CG35d [IF CG35a = 1 - 2 OR CG35b = 1 - 2] In what month in [YEAR FROM CG35a or CG35b] did you first smoke part
or all of a cigar?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CG35d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STCR:
MYR1STCR = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (CG35a-d). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCR IS
BLANK.
IF MYR1STCR NE 0 AND NE CIGARAGE:
CGCR07
The computer recorded that you first smoked part or all of a cigar in [CG35a-d fill]. That
would make you [MYR1STCR] years old when you first smoked part or all of a cigar. Is this
correct?
4
Yes
6
No
DK/REF
CGCR08

[IF CGCR07 = 4] Earlier, the computer recorded that you were [CIGARAGE] years old
when you first smoked part or all of a cigar. Which answer is correct?
1
2
3
DK/REF

I first smoked part or all of a cigar in [CG35a-d fill] when I was [MYR1STCR]
years old
I was [CIGARAGE] years old the first time I smoked part or all of a cigar
Neither answer is correct

UPDATE: IF CGCR08 = 1, THEN CIGARAGE = MYR1STCR.
CGCR09

[IF CGCR08=2 OR CGCR08=3 OR CGCR07=6] Please answer this question again. Did
you first smoke part or all of a cigar in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

CGCR09a

[IF CGCR09 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [CGCR09] did you first smoke part or all of a cigar?
1
2

May 23, 2012

January
February
39

3
4
5
6
7
8
9
10
11
12
DK/REF

March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CGCR09a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF CGCR09a NE (0 OR DK/REF) THEN UPDATE MYR1STCR.
MYR1STCR = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (CGCR09 AND CGCR09a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCR IS
BLANK. IF MYR1STCR = CIGARAGE THEN MYR1STCR = BLANK
CGCR10

[IF CGCR08 NE 1 AND MYR1STCR NE 0 AND (CGCR09 AND CGCR09a NE CG35a-d)]
The computer recorded that you first smoked part or all of a cigar in [CGCR09-CGCR09a
fill]. That would make you [MYR1STCR] years old when you first smoked part or all of a
cigar. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF CGCR10 NE (6, BLANK OR DK/REF) AND (CGCR09 AND CGCR09a NE CG35a-d) THEN CIGARAGE =
MYR1STCR
CG36

[IF CG34 = 1 OR CGREF4 = 1] Now think about the past 30 days – that is, from [DATEFILL] up to and including
today. During the past 30 days, have you smoked part or all of any type of cigar?
1
Yes
2
No
DK/REF

CG37

[IF CG36 = 2] How long has it been since you last smoked part or all of any type of cigar?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF

CG37DK

[IF CG37 = DK] What is your best guess of how long it has been since you last smoked part or all of any type of
cigar?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF

CG37RE

[IF CG37 = REF] The answers that people give us about their cigar smoking are important to this study’s success.
We know that this information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: How long has it been since you last smoked part or all of any
type of cigar?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF

May 23, 2012

40

CG38

[IF CG36 = 1] During the past 30 days, that is, since [DATEFILL], on how many days did you smoke part or all of a
cigar?
# OF DAYS:
DK/REF

CG38DKRE

[IF CG38 = DK OR REF] What is your best estimate of the number of days you smoked part or all of a
cigar during the past 30 days?
1
2
3
4
5
6
DK/REF

CG39

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

[IF CG36 = 1] During the past 30 days, what brand of cigars did you smoke most often?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

CG40

[RANGE: 1-30]

Al Capone
Antonio y Cleopatra
Arturo Fuente
Backwoods
Black & Mild
Blackstone
Captain Black
Cohiba
Cuesta-Rey
Dutch Masters
El Producto
Garcia y Vega

13
14
15
16
17
18
19
20
21
22
23
24

Havatampa
King Edward
La Corona
Little Nippers
Macanudos
Montecristo
Muriel
Partagas
Phillies
Punch
Romeo y Julieta
Swisher Sweets

25
26
27
28
29

Thompson
Tijuana Smalls
White Owl
Winchester
A brand not on this list

[IF CG39 = 29] Please type in the name of the brand of cigars you smoked most often during the past 30 days. If
you’re not sure how to spell the brand, just make your best guess.
BRAND SMOKED: __________________
DK/REF

CG41

[IF CG39 NE (DK/REF OR 29)] The computer recorded that during the past 30 days the cigar brand you smoked most
often was [CG39 FILL]. Is this correct?
1
Yes
2
No
DK/REF

RCG39 [IF CG41 = 2] Please review this list again. During the past 30 days, what brand of cigars did you smoke most often?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

Al Capone
Antonio y Cleopatra
Arturo Fuente
Backwoods
Black & Mild
Blackstone
Captain Black
Cohiba
Cuesta-Rey
Dutch Masters
El Producto
Garcia y Vega

13
14
15
16
17
18
19
20
21
22
23
24

Havatampa
King Edward
La Corona
Little Nippers
Macanudos
Montecristo
Muriel
Partagas
Phillies
Punch
Romeo y Julieta
Swisher Sweets

25
26
27
28
29

Thompson
Tijuana Smalls
White Owl
Winchester
A brand not on this
list

RCG40 [IF RCG39 = 29] Please type in the name of the brand of cigars you smoked most often during the past 30 days. If
you’re not sure how to spell the brand, just make your best guess.
May 23, 2012

41

BRAND SMOKED: __________________
DK/REF
RCG41 [IF RCG39 NE (DK/REF OR 29)] The computer recorded that during the past 30 days the cigar brand you smoked
most often was [RCG39 FILL]. Is this correct?
1
Yes
2
No
DK/REF
[IF RCG41 = 2] Please review this list again. During the past 30 days, what brand of cigars did you smoke most
often?

RRCG39

1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

Al Capone
Antonio y Cleopatra
Arturo Fuente
Backwoods
Black & Mild
Blackstone
Captain Black
Cohiba
Cuesta-Rey
Dutch Masters
El Producto
Garcia y Vega

13
14
15
16
17
18
19
20
21
22
23
24

Havatampa
King Edward
La Corona
Little Nippers
Macanudos
Montecristo
Muriel
Partagas
Phillies
Punch
Romeo y Julieta
Swisher Sweets

25
26
27
28
29

Thompson
Tijuana Smalls
White Owl
Winchester
A brand not on this
list

[IF RRCG39 = 29] Please type in the name of the brand of cigars you smoked most often during the past 30 days.
If you’re not sure how to spell the brand, just make your best guess.

RRCG40

BRAND SMOKED: __________________
DK/REF
[IF RRCG39 NE (DK/REF OR 29)] The computer recorded that during the past 30 days the cigar brand you
smoked most often was [RRCG39 FILL]. Is this correct?

RRCG41

1
Yes
2
No
DK/REF
CG42

The last questions on tobacco products are about using a pipe to smoke tobacco. Have you ever smoked tobacco in a
pipe, even once?
1
Yes
2
No
DK/REF

May 23, 2012

42

CGREF5

[IF CG42 = REF] The answers that people give us about their pipe smoking are important to this study’s success.
We know that this information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever smoked tobacco in a pipe?
1
Yes
2
No
DK/REF

CG43

[IF CG42 = 1 OR CGREF5 = 1] During the past 30 days, that is, since [DATEFILL], have you smoked tobacco in a
pipe, even once?
1
Yes
2
No
DK/REF

May 23, 2012

43

May 23, 2012

44

Alcohol
ALCINTR1

The next questions are about alcoholic beverages, such as beer, wine, brandy, and mixed drinks. Listed on
the next screen are examples of the types of beverages we are interested in.
Please review this list carefully before you answer these questions.
Press [ENTER] to continue.

CARD3a

Types of Alcoholic Beverages
Beer
Regular Beer
Lite or light beer
Low-alcohol (LA) beer
Wine
Red, white, blush wine
Wine coolers
Champagne

Liquor
Bourbon
Gin
Rum

Malt liquor
Ale
Stout

Lager

Sherry
Homemade wines,
such as muscadine,
scuppernong, or fruit
wines

Fortified wines, such as Cisco

Scotch
Tequila
Vodka

Homemade liquor, such as moonshine

Liqueurs, Cordials, and Brandy
Brandy
Drambuie
Cassis
Grand Marnier
Cognac
Kahlua
Creme de menthe
Port

Schnapps
Tia Maria
Triple sec
Vermouth

Mixed Drinks and Cocktails
Bloody Mary
Manhattan
Bourbon and water
Margarita
Daiquiri
Martini
Gin and tonic
Piña colada

Rob Roy
Rum and cola
Scotch and soda
Whiskey sour

Press [ENTER] to continue.
ALCINTR2

These questions are about drinks of alcoholic beverages. Throughout these questions, by a “drink,” we mean
a can or bottle of beer, a glass of wine or a wine cooler, a shot of liquor, or a mixed drink with liquor in it.
We are not asking about times when you only had a sip or two from a drink.
Press [ENTER] to continue.

AL01

Have you ever, even once, had a drink of any type of alcoholic beverage? Please do not include times when you only
had a sip or two from a drink.
1
Yes
2
No
DK/REF

ALREF [IF AL01 = REF] The answers that people give us about their use of alcohol are important to this study’s success. We
know that this information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever, even once, had a drink of any type of alcoholic
beverage? Please do not include times when you only had a sip or two from a drink.
1
Yes
2
No
DK/REF

May 23, 2012

45

AL02

[IF AL01 = 1 OR ALREF = 1] Think about the first time you had a drink of an alcoholic beverage. How old were
you the first time you had a drink of an alcoholic beverage? Please do not include any time when you only had a sip or
two from a drink.
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STAL:
IF AL02 NE (BLANK OR DK/REF) THEN AGE1STAL = AL02
ELSE AGE1STAL = BLANK
IF CURNTAGE < AGE1STAL:
ALCC01
The computer recorded that you were [AGE1STAL] years old when you first drank an
alcoholic beverage. Is this correct?
4
Yes
6
No
DK/REF
ALCC02

[IF ALCC01 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [AGE1STAL] years old the first time I drank an alcoholic beverage
3
Neither answer is correct
DK/REF

ALCC03

[IF ALCC02=2 OR ALCC02=3] Please answer this question again. What is your current
age?
AGE:
DK/REF

[RANGE: 1 - 110]

ALCC03a

[IF ALCC03 < 12] Since you have indicated that you are [ALCC03] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

ALCC04

[IF ALCC02=1 OR ALCC02=3 OR ALCC01=6] Please answer this question again. Think
about the first time you had a drink of an alcoholic beverage. How old were you the first time
you had a drink of any alcoholic beverage? Please do not include times when you only had a
sip or two from a drink.
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF ALCC04 NOT (BLANK OR DK/REF) THEN AGE1STAL = ALCC04
UPDATE: IF ALCC03 NOT (BLANK OR DK/REF) THEN CURNTAGE = ALCC03
IF AGE1STAL = CURNTAGE OR AGE1STAL < 10:
ALCC05
The computer recorded that you were [AGE1STAL] years old the first time you had a drink of
any alcoholic beverage. Is this correct?
4
Yes
6
No
DK/REF
ALCC06

[IF ALCC05=6] Please answer this question again. Think about the first time you had a
drink of an alcoholic beverage. How old were you the first time you had a drink of any
alcoholic beverage? Please do not include times when you only had a sip or two from a drink.
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF ALCC06 NOT (BLANK OR DK/REF) THEN AGE1STAL = ALCC06
May 23, 2012

46

AL02a

[IF ALCC05 NE DK/RE AND ALCC06 NE DK/REF AND AGE1STAL = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STAL = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first
have a drink of an alcoholic beverage in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

AL02b

[IF AGE1STAL = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first have a drink of an alcoholic
beverage in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

AL02c

IF ALCC05 NE DK/RE AND ALCC06 NE DK/REF AND AGE1STAL = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first have a drink of an alcoholic beverage?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF AL02c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
AL02d

[IF AL02a = 1 OR 2 OR AL02b = 1 OR 2] In what month in [YEAR FROM AL02a or AL02b] did you first have a
drink of an alcoholic beverage?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF AL02d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STAL:
MYR1STAL = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (AL02a-d). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STAL IS
BLANK.
IF MYR1STAL NE 0 AND NE AGE1STAL:
ALCC31
The computer recorded that you first had a drink of an alcoholic beverage in [AL02a-d fill].
May 23, 2012

47

That would make you [MYR1STAL] years old when you first had a drink of an alcoholic
beverage. Is this correct?
4
Yes
6
No
DK/REF
ALCC32

[IF ALCC31 = 4] Earlier, the computer recorded that you were [AGE1STAL] years old when
you first had a drink of an alcoholic beverage. Which answer is correct?
1
2
3
DK/REF

I first had a drink of an alcoholic beverage in [AL02a-d fill] when I was
[MYR1STAL] years old
I was [AGE1STAL] years old the first time I had a drink of an alcoholic beverage
Neither answer is correct

UPDATE: IF ALCC32 = 1, THEN AGE1STAL = MYR1STAL.
ALCC33

[IF ALCC32=2 OR ALCC32=3 OR ALCC31=6] Please answer this question again. Did you
first have a drink of an alcoholic beverage in [CURRENT YEAR-2], [CURRENT YEAR-1],
or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

ALCC33a

[IF ALCC33 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [ALCC33] did you first have a drink of an alcoholic beverage?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF ALCC33a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF ALCC33a NE (0 OR DK/REF) THEN UPDATE MYR1STAL.
MYR1STAL = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (ALCC33 AND ALCC33a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STAL IS
BLANK. IF MYR1STAL = AGE1STAL THEN MYR1STAL = BLANK
ALCC34

[IF ALCC32 NE 1 AND MYR1STAL NE 0 AND (ALCC33 AND ALCC33a NE AL02a-d)] The
computer recorded that you first had a drink of an alcoholic beverage in [ALCC33-ALCC33a
fill]. That would make you [MYR1STAL] years old when you first had a drink of an alcoholic
beverage. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF ALCC34 NE (6, BLANK OR DK/REF )AND (ALCC33 AND ALCC33a NE AL02a-d) THEN AGE1STAL =
MYR1STAL

May 23, 2012

48

ALLAST3

[IF AL01 = 1 OR ALREF = 1] How long has it been since you last drank an alcoholic beverage?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

ALRECDK

[IF ALLAST3 = DK] What is your best guess of how long it has been since you last drank an alcoholic
beverage?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

ALRECRE

[IF ALLAST3 = REF] The answers that people give us about their use of alcohol are important to this
study’s success. We know that this information is personal, but remember your answers will be kept
confidential.
Please think again about answering this question: How long has it been since you last drank an alcoholic
beverage?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

ALFRAME3

[IF ALLAST3 = 1 OR 2 OR ALRECDK = 1 OR 2 OR ALRECRE = 1 OR 2] Now think about the past 12
months, from [DATEFILL] through today. We want to know how many days you’ve had a drink of an
alcoholic beverage during the past 12 months.
What would be the easiest way for you to tell us how many days you drank alcoholic beverages?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

ALYRAVE

[IF ALFRAME3 = 3 OR DK/REF] On how many days in the past 12 months did you drink an alcoholic
beverage?
TOTAL # OF DAYS:
DK/REF

ALMONAVE

[RANGE: 1 - 366]

[IF ALFRAME3 = 2 OR ALYRAVE = DK/REF] On average, how many days did you drink an alcoholic
beverage each month during the past 12 months?
AVG # OF DAYS PER MONTH:
DK/REF

ALWKAVE

[RANGE: 1 - 31]

[IF ALFRAME3 = 1 OR ALMONAVE = DK/REF] On average, how many days did you drink an alcoholic
beverage each week during the past 12 months?
AVG # OF DAYS PER WEEK:
DK/REF

[RANGE: 1 - 7]

DEFINE TOTDRINK:
IF ALYRAVE NOT (BLANK OR DK/REF) THEN TOTDRINK=ALYRAVE
ELSE IF ALMONAVE NOT(BLANK OR DK/REF) THEN TOTDRINK=ALMONAVE*12
ELSE IF ALWKAVE NOT (BLANK OR DK/REF) THEN TOTDRINK = ALWKAVE*52
ELSE TOTDRINK=DK/REF
DEFINE FILL1:
IF ALYRAVE > 1, THEN FILL1 = “[ALYRAVE] days”
ELSE IF ALYRAVE = 1, THEN FILL1 = “1 day”
May 23, 2012

49

ELSE IF ALMONAVE > 1, THEN FILL1 = “[ALMONAVE] days per month”
ELSE IF ALMONAVE = 1, THEN FILL1 = “1 day per month”
ELSE IF ALWKAVE > 1, THEN FILL1 = “[ALWKAVE] days per week”
ELSE IF ALWKAVE = 1, THEN FILL1 = “1 day per week”
DEFINE FILL1A:
IF FILL1 = “[ALMONAVE] day(s) per month” OR “[ALWKAVE] day(s) per week” THEN FILL1A = “for a total of
[TOTDRINK] days”
ELSE FILL1A = BLANK
AL06

[IF ALLAST3 = 1 OR ALRECDK = 1 OR ALRECRE = 1] Think specifically about the past 30 days, from
[DATEFILL], up to and including today. During the past 30 days, on how many days did you drink one or more
drinks of an alcoholic beverage?
# OF DAYS:
DK/REF

AL06DKRE

[RANGE: 0 - 30]

[IF AL06 = DK/REF] What is your best estimate of the number of days you drank alcohol during the past
30 days?
1
2
3
4
5
6
DK/REF

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

DEFINE ALC30DAY
ALC30DAY = AL06
DEFINE ALCEST30
ALCEST30 = AL06DKRE
DEFINE ESTIALC
IF ALCEST30 = 1, THEN ESTIALC = 1
IF ALCEST30 = 2, THEN ESTIALC = 3
IF ALCEST30 = 3, THEN ESTIALC = 6
IF ALCEST30 = 4, THEN ESTIALC = 10
IF ALCEST30 = 5, THEN ESTIALC = 20
IF ALCEST30 = 6, THEN ESTIALC = 30
ELSE ESTIALC = BLANK
DEFINE ALCESTFL
IF AL06DKRE = 1 ALCESTFL = “1 or 2"
IF AL06DKRE = 2 ALCESTFL = “3 to 5"
IF AL06DKRE = 3 ALCESTFL = “6 to 9"
IF AL06DKRE = 4 ALCESTFL = “10 to 19"
IF AL06DKRE = 5 ALCESTFL = “20 to 29"
IF AL06DKRE = 6 ALCESTFL = “all 30"
ELSE ALCESTFL FILL = BLANK
IF TOTDRINK NOT DK/REF AND (ALC30DAY > TOTDRINK OR ESTIALC > TOTDRINK):
ALCC17a
[IF ALC30DAY > TOTDRINK] For the last question, the computer recorded that you drank
one or more alcoholic beverages on [ALC30DAY] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
ALCC17b

[IF ESTIALC > TOTDRINK] For the last question, the computer recorded that you drank one
or more alcoholic beverages on [ALCESTFL] of the past 30 days. Is this correct?
4
6

May 23, 2012

Yes
No
50

DK/REF
ALCC18

[IF ALCC17a = 4 OR ALCC17b = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
1
I drank alcohol on [FILL1] in the past 12 months [FILL1A]
2
I drank alcohol on [ALC30DAY / ALCESTFL] days in the past 30 days
3
Neither answer is correct
DK/REF

ALCC19

[IF ALCC18 = 2 OR ALCC18 = 3] Please answer this question again. Think about the past
12 months, from [DATEFILL] through today. We want to know how many days you’ve had a
drink of an alcoholic beverage during the past 12 months.
What would be the easiest way for you to tell us how many days you drank alcoholic
beverages?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

ALCC20

[IF ALCC19 = 3] On how many days in the past 12 months did you drink an alcoholic
beverage?
[RANGE: 1 - 366]

TOTAL # OF DAYS:
DK/REF
ALCC21

[IF ALCC19 = 2] On average, how many days did you drink an alcoholic beverage each
month during the past 12 months?
# OF DAYS/MONTH:
DK/REF

ALCC22

[RANGE: 1 - 31]

[IF ALCC19 = 1] On average, how many days did you drink an alcoholic beverage each week
during the past 12 months?
[RANGE: 1 - 7]

# OF DAYS PER WEEK:
DK/REF

UPDATE TOTDRINK:
IF ALCC20 NOT(BLANK OR DK/REF) THEN TOTDRINK = ALCC20
ELSE IF ALCC21 NOT(BLANK OR DK/REF) THEN TOTDRINK = ALCC21*12
ELSE IF ALCC22 NOT(BLANK OR DK/REF) THEN TOTDRINK = ALCC22*52
ELSE TOTDRINK=DK/REF
ALCC23a

[IF (ALCC17a =6 OR ALCC18 = 1 OR ALCC18 =3) AND ALC30DAY NE (BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. During the past 30 days, on how many days did you
drink one or more drinks of an alcoholic beverage?
# OF DAYS:
DK/REF

ALCC23b

[IF (ALCC17b =6 OR ALCC18 = 1 OR ALCC18 =3) AND ALCEST30 NE (BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. What is your best estimate of the number of days
you drank alcohol during the past 30 days?
1
2
3
4
5
6

May 23, 2012

[RANGE: 0 - 30]

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days
51

DK/REF
UPDATE: IF ALCC23a NOT (BLANK OR DK/REF) THEN ALC30DAY = ALCC23a
UPDATE: IF ALCC23b NOT (BLANK OR DK/REF) THEN ALCEST30 = ALCC23b
UPDATE ESTIALC
IF ALCC23b = 1 THEN ESTIALC = 1
IF ALCC23b = 2 THEN ESTIALC = 3
IF ALCC23b = 3 THEN ESTIALC = 6
IF ALCC23b = 4 THEN ESTIALC = 10
IF ALCC23b = 5 THEN ESTIALC = 20
IF ALCC23b = 6 THEN ESTIALC = 30
ELSE ESTIALC = BLANK
DEFINE ESTIALC2
IF ESTIALC = 1 THEN ESTIALC2 = 2
IF ESTIALC = 3 THEN ESTIALC2 = 5
IF ESTIALC = 6 THEN ESTIALC2 = 9
IF ESTIALC = 10 THEN ESTIALC2 = 19
IF ESTIALC = 20 THEN ESTIALC2 = 29
IF ESTIALC = 30 THEN ESTIALC2 = 30
UPDATE ALCESTFL
IF ALCC23b = 1 THEN ALCESTFL = “1 or 2"
IF ALCC23b = 2 THEN ALCESTFL = “3 to 5"
IF ALCC23b = 3 THEN ALCESTFL = “6 to 9"
IF ALCC23b = 4 THEN ALCESTFL = “10 to 19"
IF ALCC23b = 5 THEN ALCESTFL = “20 to 29"
IF ALCC23b = 6 THEN ALCESTFL = “all 30"
ELSE ALCESTFL = BLANK
IF ALC30DAY = 0:
ALCC24

The computer recorded that you drank alcoholic beverages on 0 days during the past 30 days.
Is this correct?
4
Yes
6
No
DK/REF

ALCC26

[IF ALCC24 = 6] Please answer this question again. During the past 30 days, that is, since
[DATEFILL], on how many days did you drink one or more drinks of an alcoholic beverage?
# OF DAYS:
DK/REF

[RANGE: 0 - 30]

UPDATE: IF ALCC26 NOT (BLANK OR DK/REF) THEN ALC30DAY = ALCC26
AL07

[IF ALC30DAY = 2 - 30 OR ALCEST30 = 1 - 6] On the [ALC30DAY / ALCESTFL] days that you drank during the
past 30 days, how many drinks did you usually have each day? Count as a drink a can or bottle of beer; a wine cooler
or a glass of wine, champagne, or sherry; a shot of liquor or a mixed drink or cocktail.
[IF ALC30DAY = 1] On the 1 day that you drank during the past 30 days, how many drinks did you have? Count as a
drink a can or bottle of beer; a wine cooler or a glass of wine, champagne, or sherry; a shot of liquor or a mixed drink
or cocktail.
[IF ALCEST30 = DK/REF] On the days that you drank during the past 30 days, how many drinks did you usually
have each day? Count as a drink a can or bottle of beer; a wine cooler or a glass of wine, champagne, or sherry; a shot
of liquor or a mixed drink or cocktail.
# OF DRINKS:
DK/REF

[RANGE: 1 - 90]

DEFINE FOURORMOREFLAG:
IF AL07 = 4 THEN FOURORMOREFLAG = 1
May 23, 2012

52

IF AL07 > 4 THEN FOURORMOREFLAG = 2
ELSE FOURORMOREFLAG = 0
AL08

[IF ALC30DAY = 1 – 30 OR ALCEST30 = (1 – 6, DK OR REF)] During the past 30 days, that is, since
[DATEFILL], on how many days did you have 5 or more drinks on the same occasion? By ‘occasion,’ we mean at
the same time or within a couple of hours of each other.
# OF DAYS:
DK/REF

[RANGE: 0 - 30]

UPDATE FOURORMOREFLAG:
IF AL08 = 1-30 THEN FOURORMOREFLAG = 2
IF AL08 = 0 AND AL07 NE 4 THEN FOURORMOREFLAG = 0
IF AL08 > ALC30DAY OR AL08 > ESTIALC2:
ALCC27
The computer recorded that in the past 30 days you drank 5 or more alcoholic beverages on
[AL08] days. Is this correct?
4
Yes
6
No
DK/REF
UPDATE FOURORMOREFLAG:
IF ALCC27 = 6 AND AL07 NE 4 THEN FOURORMOREFLAG = 0
IF ALCC27 = 6 AND AL07 = 4 THEN FOURORMOREFLAG = 1
IF ALCC27 = 4 THEN FOURORMOREFLAG = 2
ALCC28

[IF ALCC27 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1

I drank one or more alcoholic beverages on [ALC30DAY / ALCESTFL] days in the
past 30 days
I drank 5 or more alcoholic beverages on [AL08] days in the past 30 days
Neither answer is correct

2
3
DK/REF
UPDATE FOURORMOREFLAG:
IF (ALCC28 = 1 OR ALCC28 = 3) AND AL07 = 4 THEN FOURORMOREFLAG = 1
IF (ALCC28 = 1 OR ALCC28 = 3) AND AL07 NE 4 THEN FOURORMOREFLAG = 0
IF ALCC28 = 2 THEN FOURORMOREFLAG = 2
ALCC29a

[IF ALCC28 = 2 OR 3 AND ALC30DAY NE (BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, that is from [DATEFILL] through
today. During the past 30 days, on how many days did you drink one or more drinks of an
alcoholic beverage?
# OF DAYS:
DK/REF

ALCC29b

[IF ALCC28 = 2 OR 3 AND ALCEST30 NE (BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, that is from [DATEFILL] through
today. What is your best estimate of the number of days you drank alcohol during the past 30
days?
1
2
3
4
5
6
DK/REF

ALCC30

May 23, 2012

[RANGE: 0 -30]

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

[IF ALCC27 = 6 OR ALCC28 = 1 OR ALCC28 = 3] Please answer this question again.
During the past 30 days, on how many days did you drink 5 or more alcoholic beverages on
the same occasion? By ‘occasion’ we mean at the same time or within a couple of hours of
each other.
53

# OF DAYS:
DK/REF

[RANGE: 0 - 30]

UPDATE FOURORMOREFLAG:
IF ALCC30 > 0 THEN FOURORMOREFLAG = 2
IF ALCC30 = 0 AND AL07 NE 4 THEN FOURORMOREFLAG = 0

May 23, 2012

54

Marijuana
The next questions are about marijuana and hashish. Marijuana is also called pot or grass. Marijuana is
usually smoked, either in cigarettes, called joints, or in a pipe. It is sometimes cooked in food. Hashish is a
form of marijuana that is also called “hash.” It is usually smoked in a pipe. Another form of hashish is hash
oil.

MRJINTRO

Press [ENTER] to continue.
MJ01

Have you ever, even once, used marijuana or hashish?
1
Yes
2
No
DK/REF
[IF MJ01 = REF] The answers that people give us about their use of marijuana and hashish are important to this
study’s success. We know that this information is personal, but remember your answers will be kept confidential.

MJREF

Please think again about answering this question: Have you ever, even once, used marijuana or hashish?
1
Yes
2
No
DK/REF
MJ02

[IF MJ01 =1 OR MJREF = 1] How old were you the first time you used marijuana or hashish?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STMJ:
IF MJ02 NE (BLANK OR DK/REF) THEN AGE1STMJ = MJ02
ELSE AGE1STMJ = BLANK
IF CURNTAGE < AGE1STMJ:
MJCC01
The computer recorded that you were [AGE1STMJ] years old when you first used marijuana
or hashish. Is this correct?
4
Yes
6
No
DK/REF
MJCC02

[IF MJCC01 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [AGE1STMJ] years old the first time I used marijuana or hashish
3
Neither answer is correct
DK/REF

MJCC03

[IF MJCC02=2 OR MJCC02=3] Please answer this question again. What is your current
age?
AGE:
DK/REF

MJCC03a

[IF MJCC03 < 12] Since you have indicated that you are [MJCC03] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

MJCC04

[IF MJCC02=1 OR MJCC02=3 OR MJCC01=6] Please answer this question again. Think
about the first time you used marijuana or hashish. How old were you the first time you used
marijuana or hashish?
AGE:
DK/REF

May 23, 2012

[RANGE: 1 - 110]

[RANGE: 1 - 110]

55

UPDATE: IF MJCC04 NOT(BLANK OR DK/REF) THEN AGE1STMJ = MJCC04
UPDATE: IF MJCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = MJCC03
IF AGE1STMJ = CURNTAGE OR AGE1STMJ <10:
MJCC05
The computer recorded that you were [AGE1STMJ] years old the first time you used
marijuana or hashish. Is this correct?
4
Yes
6
No
DK/REF
MJCC06

[IF MJCC05=6] Please answer this question again. Think about the first time you used
marijuana or hashish. How old were you the first time you used marijuana or hashish?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF MJCC06 NOT(BLANK OR DK/REF) THEN AGE1STMJ = MJCC06
MJ03a

[IF MJCC05 NE DK/REF AND MJCC06 NE DK/REF AND AGE1STMJ = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STMJ = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use
marijuana or hashish in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

MJ03b [IF AGE1STMJ = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use marijuana or hashish in
[CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
MJ03c

[IF MJCC05 NE DK/REF AND MJCC06 NE DK/REF AND AGE1STMJ = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use marijuana or hashish?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF MJ03c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
MJ03d [IF MJ03a = 1 - 2 OR MJO3b = 1 - 2] In what month in [YEAR FROM MJ03a or MJ03b] did you first use
marijuana or hashish?
1
2
3
4
5
May 23, 2012

January
February
March
April
May
56

6
7
8
9
10
11
12
DK/REF

June
July
August
September
October
November
December

HARD ERROR: [IF MJ03d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STMJ:
MYR1STMJ = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (MJ03a-d). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STMJ IS
BLANK.
IF MYR1STMJ NE 0 AND NE AGE1STMJ:
MJCC17
The computer recorded that you first used marijuana or hashish in [MJ03a-d fill]. That
would make you [MYR1STMJ] years old when you first used marijuana or hashish. Is this
correct?
4
Yes
6
No
DK/REF
MJCC18

[IF MJCC17 = 4] Earlier, the computer recorded that you were [AGE1STMJ] years old
when you first used marijuana or hashish. Which answer is correct?
1
2
3
DK/REF

I first used marijuana or hashish in [MJ03a-d fill] when I was [MYR1STMJ] years
old
I was [AGE1STMJ] years old the first time I used marijuana or hashish
Neither answer is correct

UPDATE: IF MJCC18 = 1, THEN AGE1STMJ = MYR1STMJ.
MJCC19

[IF MJCC18=2 OR MJCC18=3 OR MJCC17=6] Please answer this question again. Did
you first use marijuana or hashish in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

MJCC19a

[IF MJCC19 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [MJCC19] did you first use marijuana or hashish?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF MJCC19a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
May 23, 2012

57

NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN.
PRESS [ENTER] TO CONTINUE.
UPDATE: IF MJCC19a NE (0 OR DK/REF) THEN UPDATE MYR1STMJ.
MYR1STMJ = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (MJCC19 AND MJCC19a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STMJ IS
BLANK. IF MYR1STMJ = AGE1STMJ THEN MYR1STMJ = BLANK
MJCC20

[IF MJCC18 NE 1 AND MYR1STMJ NE 0 AND (MJCC19 AND MJCC19a NE MJ03a-d)] The
computer recorded that you first used marijuana or hashish in [MJCC19-MJCC19a fill].
That would make you [MYR1STMJ] years old when you first used marijuana or hashish. Is
this correct?
4
Yes
6
No
DK/REF

UPDATE: IF MJCC20 NE (6, BLANK OR DK/REF) AND (MJCC19 AND MJCC19a NE MJ03a-d) THEN AGE1STMJ =
MYR1STMJ
MJLAST3

[IF MJ01 = 1 OR MJREF = 1] How long has it been since you last used marijuana or hashish?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

MJRECDK

[IF MJLAST3 = DK] What is your best guess of how long it has been since you last used marijuana or
hashish?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

MJRECRE

[IF MJLAST3 = REF] The answers that people give us about their use of marijuana and hashish are
important to this study’s success. We know that this information is personal, but remember your answers
will be kept confidential.
Please think again about answering this question: How long has it been since you last used marijuana or
hashish?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

MJFRAME3

[IF MJLAST3 = 1 - 2 OR MJRECDK = 1 - 2 OR MJRECRE = 1 - 2] Now think about the past 12 months,
from [DATEFILL] through today. We want to know how many days you’ve used marijuana or hashish
during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

MJYRAVE

[IF MJFRAME3 = 3 OR DK/REF] On how many days in the past 12 months did you use marijuana or
hashish?
TOTAL # OF DAYS:
DK/REF

May 23, 2012

[RANGE: 1 - 366]

58

MJMONAVE

[IF MJFRAME3 = 2 OR MJYRAVE = DK/REF] On average, how many days did you use marijuana or
hashish each month during the past 12 months?
AVERAGE # OF DAYS PER MONTH:
DK/REF

MJWKAVE

[RANGE: 1 - 31]

[IF MJFRAME3 = 1 OR MJMONAVE = DK/REF] On average, how many days did you use marijuana or
hashish each week during the past 12 months?
[RANGE: 1 - 7]

AVERAGE # OF DAYS PER WEEK:
DK/REF
MJ06

[IF MJLAST3=1 OR MJRECDK = 1 OR MJRECRE = 1] Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30 days, on how many days did you use marijuana or
hashish?
[RANGE: 0 - 30]

NUMBER OF DAYS:
DK/REF
MJ06DKRE

[IF MJ06 = DK/REF] What is your best estimate of the number of days you used marijuana or hashish
during the past 30 days?
1
2
3
4
5
6
DK/REF

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

DEFINE ESTIMJ
IF MJ06DKRE = 1, THEN ESTIMJ = 1
IF MJ06DKRE = 2, THEN ESTIMJ = 3
IF MJ06DKRE = 3, THEN ESTIMJ = 6
IF MJ06DKRE = 4, THEN ESTIMJ = 10
IF MJ06DKRE = 5, THEN ESTIMJ = 20
IF MJ06DKRE = 6, THEN ESTIMJ = 30
ELSE ESTIMJ = BLANK
DEFINE MJ30DAY
IF MJ06DKRE = 1, THEN MJ30DAY = “1 or 2"
IF MJ06DKRE = 2, THEN MJ30DAY = “3 to 5"
IF MJ06DKRE = 3, THEN MJ30DAY = “6 to 9"
IF MJ06DKRE = 4, THEN MJ30DAY = “10 to 19"
IF MJ06DKRE = 5, THEN MJ30DAY = “20 to 29"
IF MJ06DKRE = 6, THEN MJ30DAY = “all 30"
ELSE MJ30DAY = BLANK
DEFINE TOTMJ:
IF MJYRAVE NOT(BLANK OR DK/REF) THEN TOTMJ = MJYRAVE
ELSE IF MJMONAVE NOT(BLANK OR DK/REF) THEN TOTMJ = MJMONAVE*12
ELSE IF MJWKAVE NOT (BLANK OR DK/REF) THEN TOTMJ = MJWKAVE*52
ELSE TOTMJ = DK/REF
IF TOTMJ = DK/REF, SKIP TO COCINTRO
IF TOTMJ NOT DK/REF AND ((MJ06 NE DK/REF OR BLANK AND MJ06 > TOTMJ) OR (MJ06 = DK/REF AND
ESTIMJ > TOTMJ)):
MJCC07a
[IF MJ06 > TOTMJ] For the last question, the computer recorded that you used marijuana
or hashish on [MJ06] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF

May 23, 2012

59

MJCC07b

[IF ESTIMJ > TOTMJ] For the last question, the computer recorded that you used marijuana
or hashish on [MJ30DAY] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF

DEFINE FILLMJ:
IF MJYRAVE > 1, THEN FILLMJ = “[MJYRAVE] days”
ELSE IF MJYRAVE = 1, THEN FILLMJ = “1 day”
ELSE IF MJMONAVE > 1, THEN FILLMJ = “[MJMONAVE] days per month”
ELSE IF MJMONAVE = 1, THEN FILLMJ = “1 day per month”
ELSE IF MJWKAVE > 1, THEN FILLMJ = “[MJWKAVE] days per week”
ELSE IF MJWKAVE = 1, THEN FILLMJ = “1 day per week”
DEFINE FILLMJA:
IF FILLMJ = “[MJMONAVE] day(s) per month” OR “[MJWKAVE] day(s) per week” FILLMJA = “for a total of
[TOTMJ] days”
ELSE FILLMJA = BLANK
MJCC08

[IF MJCC07a = 4 OR MJCC07b = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
1
I used marijuana or hashish on [FILLMJ] in the past 12 months [FILLMJA]
2
I used marijuana or hashish on [MJ06 / MJ30DAY] days in the past 30 days
3
Neither answer is correct
DK/REF

MJCC09

[IF MJCC08 = 2 OR MJCC08 = 3] Please answer this question again. Think about the past
12 months, from [DATEFILL] through today. We want to know how many days you’ve used
marijuana or hashish during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

MJCC10

[IF MJCC09 = 3 ] On how many days in the past 12 months did you use marijuana or
hashish?
TOTAL # OF DAYS:
DK/REF

MJCC11

[RANGE: 1 - 366]

[IF MJCC09 = 2] On average, how many days did you use marijuana or hashish each month
during the past 12 months?
# OF DAYS/MONTH:
DK/REF

MJCC12

[RANGE: 1 - 31]

[IF MJCC09 = 1] On average, how many days did you use marijuana or hashish each week
during the past 12 months?
[RANGE: 1 - 7]

# OF DAYS PER WEEK:
DK/REF

IF MJCC10 NOT(BLANK OR DK/REF) THEN TOTMJ = MJCC10
ELSE IF MJCC11 NOT(BLANK OR DK/REF) THEN TOTMJ = MJCC11*12
ELSE IF MJCC12 NOT(BLANK OR DK/REF) THEN TOTMJ = MJCC12*52
ELSE TOTMJ = DK/REF
MJCC13a

May 23, 2012

[IF MJCC07a=6 OR ((MJCC08 = 1 OR MJCC08 = 3) AND MJCC07a NE BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. During the past 30 days, on how many days did you
60

use marijuana or hashish?
# OF DAYS:
DK/REF
MJCC13b

[RANGE: 0 - 30]

[IF MJCC07b = 6 OR ((MJCC08 = 1 OR 3) AND MJCC07b NE BLANK OR DK/REF)]
Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. What is your best estimate of the number of days
you used marijuana or hashish during the past 30 days?
1
2
3
4
5
6
DK/REF

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

IF MJ06 = 0:
MJCC14

The computer recorded that you used marijuana or hashish on 0 days during the past 30 days.
Is this correct?
4
Yes
6
No
DK/REF

MJCC16

[IF MJCC14 = 6] Please answer this question again. During the past 30 days, that is, since
[DATEFILL], on how many days did you use marijuana or hashish?
# OF DAYS:
DK/REF

May 23, 2012

[RANGE: 0 - 30]

61

May 23, 2012

62

Cocaine
These questions are about cocaine, including all the different forms of cocaine such as powder, ‘crack,’ free
base, and coca paste.

COCINTRO

Press [ENTER] to continue.
CC01

Have you ever, even once, used any form of cocaine?
1
Yes
2
No
DK/REF
[IF CC01 = REF] The answers that people give us about their use of cocaine are important to this study’s success.
We know that this information is personal, but remember your answers will be kept confidential.

CCREF

Please think again about answering this question: Have you ever, even once, used any form of cocaine?
1
Yes
2
No
DK/REF
CC02

[IF CC01 =1 OR CCREF = 1] How old were you the first time you used cocaine, in any form?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STCC:
IF CC02 NE (BLANK OR DK/REF) THEN AGE1STCC = CC02
ELSE AGE1STCC = BLANK
IF CURNTAGE < AGE1STCC:
CCCC01
The computer recorded that you were [AGE1STCC] years old when you first used cocaine. Is
this correct?
4
Yes
6
No
DK/REF
CCCC02

[IF CCCC01 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [AGE1STCC] years old the first time I used cocaine
3
Neither answer is correct
DK/REF

CCCC03

[IF CCCC02=2 OR CCCC02=3] Please answer this question again. What is your current
age?
AGE:
DK/REF

[RANGE: 1 - 110]

CCCC03a

[IF CCCC03 < 12] Since you have indicated that you are [CCCC03 AGE] years old, we
cannot interview you for this study. Please tell your interviewer that you have finished the
survey. Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

CCCC04

[IF CCCC02=1 OR CCCC02=3 OR CCCC01=6] Please answer this question again. Think
about the first time you used cocaine. How old were you the first time you used cocaine in
any form?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CCCC04 NOT(BLANK OR DK/REF) THEN AGE1STCC = CCCC04
May 23, 2012

63

UPDATE: IF CCCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = CCCC03
IF AGE1STCC=CURNTAGE OR AGE1STCC < 10:
CCCC05
The computer recorded that you were [AGE1STCC] years old the first time you used cocaine.
Is this correct?
4
Yes
6
No
DK/REF
CCCC06

[IF CCCC05=6] Please answer this question again. Think about the first time you used
cocaine. How old were you the first time you used cocaine in any form?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CCCC06 NOT (BLANK OR DK/REF) THEN AGE1STCC = CCCC06
CC03a

[IF CCCC05 NE DK/RE AND CCCC06 NE DK/REF AND AGE1STCC = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STCC = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use
cocaine in any form in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

CC03b

[IF AGE1STCC = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use cocaine in any form in
[CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

CC03c

[IF CCCC05 NE DK/RE AND CCCC06 NE DK/REF AND AGE1STCC = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use cocaine in any form?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CC03c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CC03d

[IF CC03a = 1 - 2 OR CC03b = 1 - 2] In what month in [YEAR FROM CC03a or CC03b] did you first use cocaine?
1
2
3
4
5
6
7
8

May 23, 2012

January
February
March
April
May
June
July
August
64

9
10
11
12
DK/REF

September
October
November
December

HARD ERROR: [IF CC03d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STCC:
MYR1STCC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (CC03a-d). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCC IS
BLANK.
IF MYR1STCC NE 0 AND NE AGE1STCC:
CCCC17
The computer recorded that you first used cocaine in any form in [CC03a-d fill]. That would
make you [MYR1STCC] years old when you first used cocaine in any form. Is this correct?
4
Yes
6
No
DK/REF
CCCC18

[IF CCCC17 = 4] Earlier, the computer recorded that you were [AGE1STCC] years old
when you first used cocaine in any form. Which answer is correct?
1
2
3
DK/REF

I first used cocaine in any form in [CC03a-d fill] when I was [MYR1STCC] years
old
I was [AGE1STCC] years old the first time I used cocaine in any form.
Neither answer is correct

UPDATE: IF CCCC18 = 1, THEN AGE1STCC = MYR1STCC.
CCCC19

[IF CCCC18=2 OR CCCC18=3 OR CCCC17=6] Please answer this question again. Did
you first use cocaine in any form in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

CCCC19a

[IF CCCC19 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [CCCC19] did you first use cocaine in any form?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CCCC19a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF CCCC19a NE (0 OR DK/REF) THEN UPDATE MYR1STCC.
May 23, 2012

65

MYR1STCC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (CCCC19 AND CCCC19a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCC IS
BLANK. IF MYR1STCC = AGE1STCC THEN MYR1STCC = BLANK
CCCC20

[IF CCCC18 NE 1 AND MYR1STCC NE 0 AND (CCCC19 AND CCCC19a NE CC03a-d)]
The computer recorded that you first used cocaine in any form in [CCCC19-CCCC19a fill].
That would make you [MYR1STCC] years old when you first used cocaine in any form. Is this
correct?
4
Yes
6
No
DK/REF

UPDATE: IF CCCC20 NE (6, BLANK OR DK/REF) AND (CCCC19 AND CCCC19a NE CC03a-d) THEN AGE1STCC =
MYR1STCC
CCLAST3

[IF CC01 = 1 OR CCREF = 1] How long has it been since you last used any form of cocaine?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

CCRECDK

[IF CCLAST3 = DK] What is your best guess of how long it has been since you last used cocaine?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

CCRECRE

[IF CCLAST3 = REF] The answers that people give us about their use of cocaine are important to this
study’s success. We know that this information is personal, but remember your answers will be kept
confidential.
Please think again about answering this question: How long has it been since you last used cocaine?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

CCFRAME3

[IF CCLAST3 = 1 OR 2 OR CCRECDK = 1 OR 2 OR CCRECRE = 1 OR 2] Now think about the past 12
months, from [DATEFILL] through today. We want to know how many days you’ve used cocaine during
the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

CCYRAVE

[IF CCFRAME3 = 3 OR DK/REF] On how many days in the past 12 months did you use cocaine?
TOTAL # OF DAYS:
DK/REF

CCMONAVE

[RANGE: 1 - 366]

[IF CCFRAME3 = 2 OR CCYRAVE = DK/REF] On average, how many days did you use cocaine each
month during the past 12 months?
AVERAGE # OF DAYS PER MONTH:
DK/REF

CCWKAVE

May 23, 2012

[RANGE: 1 - 31]

[IF CCFRAME3 = 1 OR CCMONAVE = DK/REF] On average, how many days did you use cocaine each
week during the past 12 months?
66

AVERAGE # OF DAYS PER WEEK:
DK/REF
CC06

[RANGE: 1 - 7]

[IF CCLAST3 =1 OR CCRECDK = 1 OR CCRECRE = 1] Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30 days, on how many days did you use cocaine?
[RANGE: 0 - 30]

# OF DAYS:
DK/REF
CC06DKRE

[IF CC06 = DK/REF] What is your best estimate of the number of days you used cocaine during the past 30
days?
1
2
3
4
5
6
DK/REF

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

DEFINE ESTICC:
IF CC06DKRE = 1, THEN ESTICC = 1
IF CC06DKRE = 2, THEN ESTICC = 3
IF CC06DKRE = 3, THEN ESTICC = 6
IF CC06DKRE = 4, THEN ESTICC = 10
IF CC06DKRE = 5, THEN ESTICC = 20
IF CC06DKRE = 6, THEN ESTICC = 30
ELSE ESTICC = BLANK
DEFINE TOTCOKE:
IF CCYRAVE NOT(BLANK OR DK/REF) THEN TOTCOKE= CCYRAVE
IF CCMONAVE NOT(BLANK OR DK/REF) THEN TOTCOKE=CCMONAVE*12
IF CCWKAVE NOT(BLANK OR DK/REF) THEN TOTCOKE=CCWKAVE*52
ELSE TOTCOKE = DK/REF
DEFINE COC30DAY
IF CC06DKRE = 1, THEN COC30DAY = “1 or 2"
IF CC06DKRE = 2, THEN COC30DAY = “3 to 5"
IF CC06DKRE = 3, THEN COC30DAY = “6 to 9"
IF CC06DKRE = 4, THEN COC30DAY = “10 to 19"
IF CC06DKRE = 5, THEN COC30DAY = “20 to 29"
IF CC06DKRE = 6, THEN COC30DAY = “all 30"
ELSE COC30DAY = BLANK
IF TOTCOKE NOT DK/REF AND (CC06 NE BLANK OR DK/REF AND CC06 > TOTCOKE) OR (CC06 =
DK/REF AND ESTICC > TOTCOKE):
CCCC07a
[IF CC06 > TOTCOKE] For the last question, the computer recorded that you used cocaine
on [CC06] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
CCCC07b

[IF ESTICC > TOTCOKE] For the last question, the computer recorded that you used
cocaine on [COC30DAY] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF

DEFINE FILLCN:
IF CCYRAVE > 1, THEN FILLCN = “[CCYRAVE] days”
ELSE IF CCYRAVE = 1, THEN FILLCN = “1 day”
ELSE IF CCMONAVE > 1, THEN FILLCN = “[CCMONAVE] days per month”
May 23, 2012

67

ELSE IF CCMONAVE = 1, THEN FILLCN = “1 day per month”
ELSE IF CCWKAVE > 1, THEN FILLCN = “[CCWKAVE] days per week”
ELSE IF CCWKAVE = 1, THEN FILLCN = “1 day per week”
DEFINE FILCNA:
IF FILLCN = “[CCMONAVE] day(s) per month” OR “[CCWKAVE] day(s) per week” THEN FILLCNA = “for a total
of [TOTCOKE] days”
ELSE FILLCNA = BLANK
CCCC08

[IF CCCC07a = 4 OR CCCC07b = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
1
I used cocaine on [FILLCN] days in the past 12 months [FILLCNA]
2
I used cocaine on [CC06 / COC30DAY] days in the past 30 days
3
Neither answer is correct
DK/REF

CCCC09

[IF CCCC08 = 2 OR CCCC08 = 3] Please answer this question again. Think about the past
12 months, from [DATEFILL] through today. We want to know how many days you’ve used
cocaine during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 month
DK/REF

CCCC10

[IF CCCC09 = 3] On how many days in the past 12 months did you use cocaine?
TOTAL # OF DAYS:
DK/REF

CCCC11

[RANGE: 1 - 366]

[IF CCCC9 = 2] On average, how many days did you use cocaine each month during the
past 12 months?
[RANGE: 1 - 31]

# OF DAYS/MONTH:
DK/REF
CCCC12

[IF CCCC09 = 1] On average, how many days did you use cocaine each week during the
past 12 months?
# OF DAYS PER WEEK:
DK/REF

[RANGE: 1 - 7]

IF CCCC10 NOT(BLANK OR DK/REF) THEN TOTCOKE = CCCC10
ELSE IF CCCC11 NOT(BLANK OR DK/REF THEN TOTCOKE=CCCC11*12
ELSE IF CCC12 NOT(BLANK OR DK/REF) THEN TOTCOKE=CCCC12*52
ELSE TOTCOKE = DK/REF
CCCC13a

[IF (CCCC07a=6 OR ((CCCC08 = 1 OR CCCC08 = 3) AND CCCC07a NE BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. During the past 30 days, on how many days did you
use cocaine?
# OF DAYS:
DK/REF

CCCC13b

[IF CCCC07b = 6 or ((CCCC08 = 1 OR 3) AND CCCC07b NE BLANK OR DK/REF)]
Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. What is your best estimate of the number of days
you used cocaine during the past 30 days?
1
2

May 23, 2012

[RANGE: 0 - 30]

1 or 2 days
3 to 5 days
68

3
4
5
6
DK/REF
IF CC06 = 0:
CCCC14

6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

The computer recorded that you used any form of cocaine on 0 days during the past 30 days.
Is this correct?
4
Yes
6
No
DK/REF

CCCC16

[IF CCCC14 = 6] Please answer this question again. During the past 30 days, that is, since
[DATEFILL], on how many days did you use cocaine?
# OF DAYS:
DK/REF

May 23, 2012

[RANGE: 0 - 30]

69

May 23, 2012

70

Crack
CKINTRO

[IF CC01 = 1 OR CCREF = 1] The next questions are about ‘crack’, that is cocaine in rock or chunk form, and not
the other forms of cocaine.
Press [ENTER] to continue.

CK01

[IF CC01 = 1 OR CCREF = 1] Have you ever, even once, used ‘crack’?
1
Yes
2
No
DK/REF
[IF CK01 = REF] The answers that people give us about their use of ‘crack’ are important to this study’s success.
We know that this information is personal, but remember your answers will be kept confidential.

CKREF

Please think again about answering this question: Have you ever, even once, used ‘crack’?
1
Yes
2
No
DK/REF
CK02

[IF CK01 = 1 OR CKREF = 1] How old were you the first time you used ‘crack’?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STCK:
IF CK02 NE (BLANK OR DK/REF) THEN AGE1STCK = CK02
ELSE AGE1STCK = BLANK
IF CURNTAGE < AGE1STCK:
CKCC01
The computer recorded that you were [AGE1STCK] years old when you first used ‘crack’. Is
this correct?
4
Yes
6
No
DK/REF
CKCC02

[IF CKCC01 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [AGE1STCK] years old the first time I used ‘crack’
3
Neither answer is correct
DK/REF

CKCC03

[IF CKCC2=2 OR CKCC2=3] Please answer this question again. What is your current age?
AGE:
DK/REF

[RANGE: 1 - 110]

CKCC03a

[IF CKCC03 < 12] Since you have indicated that you are [CCKCC03 AGE] years old, we
cannot interview you for this study. Please tell your interviewer that you have finished the
survey. Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

CKCC04

[IF CKCC02=1 OR CKCC02=3 OR CKCC01=6] Please answer this question again. Think
about the first time you used ‘crack’. How old were you the first time you used ‘crack’?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CKCC04 NOT(BLANK OR DK/REF) THEN AGE1STCK = CKCC04
UPDATE: IF CKCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = CKCC03
May 23, 2012

71

IF AGE1STCK=CURNTAGE OR AGE1STCK < 10:
CKCC05
The computer recorded that you were [AGE1STCK] years old the first time you used ‘crack’.
Is this correct?
4
Yes
6
No
DK/REF
CKCC06

[IF CKCC05=6] Please answer this question again. Think about the first time you used
‘crack’. How old were you the first time you used ‘crack’?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CKCC06 NOT(BLANK OR DK/REF) THEN AGE1STCK = CKCC06
CK03a

[IF CKCC05 NE DK/RE AND CKCC06 NE DK/REF AND AGE1STCK = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STCK = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use
‘crack’ in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

CK03b [IF AGE1STCK = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use ‘crack’ in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
CK03c

[IF CKCC05 NE DK/RE AND CKCC06 NE DK/REF AND AGE1STCK = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use ‘crack’?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CK03c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CK03d [IF CK03a = 1 OR 2 OR CK03b = 1 OR 2] In what month in [YEAR FROM CK03a or CK03b] did you first use
‘crack’?
1
2
3
4
5
6
7
8
9
May 23, 2012

January
February
March
April
May
June
July
August
September
72

10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CK03d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STCK:
MYR1STCK = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (CK03a-d). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCK IS
BLANK.
IF MYR1STCK NE 0 AND NE AGE1STCK:
CKCC17
The computer recorded that you first used ‘crack’ in [CK03a-d fill]. That would make you
[MYR1STCK] years old when you first used ‘crack’. Is this correct?
4
Yes
6
No
DK/REF
CKCC18

[IF CKCC17 = 4] Earlier, the computer recorded that you were [AGE1STCK] years old
when you first used ‘crack’. Which answer is correct?
1
I first used ‘crack’ in [CK03a-d fill] when I was [MYR1STCK] years old
2
I was [AGE1STCK] years old the first time I used ‘crack’
3
Neither answer is correct
DK/REF

UPDATE: IF CKCC18 = 1, THEN AGE1STCK = MYR1STCK.
CKCC19

[IF CKCC18=2 OR CKCC18=3 OR CKCC17=6] Please answer this question again. Did
you first use ‘crack’ in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

CKCC19a

[IF CKCC19 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [CKCC19] did you first use ‘crack’?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CKCC19a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF CKCC19a NE (0 OR DK/REF) THEN UPDATE MYR1STCK.
MYR1STCK = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (CKCC19 AND CKCC19a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCK IS
May 23, 2012

73

BLANK. IF MYR1STCK = AGE1STCK THEN MYR1STCK = BLANK
CKCC20

[IF CKCC18 NE 1 AND MYR1STCK NE 0 AND (CKCC19 AND CKCC19a NE CK03a-d)]
The computer recorded that you first used ‘crack’ in [CKCC19-CKCC19a fill]. That would
make you [MYR1STCK] years old when you first used ‘crack’. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF CKCC20 NE (6, BLANK OR DK/REF) AND (CKCC19 AND CKCC19a NE CK03a-d) THEN AGE1STCK =
MYR1STCK
CKLAST3

[IF CK01 = 1 OR CKREF = 1] How long has it been since you last used ‘crack’?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

CKRECDK

[IF CKLAST3 = DK] What is your best guess of how long it has been since you last used ‘crack’?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

CKRECRE

[IF CKLAST3 = REF] The answers that people give us about their use of ‘crack’ are important to this
study’s success. We know that this information is personal, but remember your answers will be kept
confidential.
Please think again about answering this question: How long has it been since you last used ‘crack’?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

CKFRAME3

[IF CKLAST3 = 1 OR 2 OR CKRECDK = 1 OR 2 OR CKRECRE = 1 OR 2] Now think about the past 12
months, from [DATEFILL] through today. We want to know how many days you’ve used ‘crack’ during the
past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

CKYRAVE

[IF CKFRAME3 = 3 OR DK/REF] On how many days in the past 12 months did you use ‘crack’?
TOTAL # OF DAYS:
DK/REF

CKMONAVE

[RANGE: 1 - 366]

[IF CKFRAME3 = 2 OR CKYRAVE = DK/REF] On average, how many days did you use ‘crack’ each
month during the past 12 months?
AVERAGE # OF DAYS PER MONTH:
DK/REF

CKWKAVE

[RANGE: 1 - 31]

[IF CKFRAME3 = 1 OR CKMONAVE = DK/REF] On average, how many days did you use ‘crack’ each
week during the past 12 months?
AVERAGE # OF DAYS PER WEEK:
DK/REF

May 23, 2012

[RANGE: 1 - 7]

74

CK06

[IF CKLAST3=1 OR CKRECDK =1 OR CKRECRE = 1] Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30 days, on how many days did you use ‘crack’?
# OF DAYS:
DK/REF

CK06DKRE

[RANGE: 0 - 30]

[IF CK06 = DK/REF] What is your best estimate of the number of days you used ‘crack’ during the past 30
days?
1
2
3
4
5
6
DK/REF

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

DEFINE ESTICK:
IF CK06DKRE = 1, THEN ESTICK = 1
IF CK06DKRE = 2, THEN ESTICK = 3
IF CK06DKRE = 3, THEN ESTICK = 6
IF CK06DKRE = 4, THEN ESTICK = 10
IF CK06DKRE = 5, THEN ESTICK = 20
IF CK06DKRE = 6, THEN ESTICK = 30
ELSE ESTICK = BLANK
DEFINE CRK30DAY
IF CK06DKRE = 1, THEN CRK30DAY = “1 or 2"
IF CK06DKRE = 2, THEN CRK30DAY = “3 to 5"
IF CK06DKRE = 3, THEN CRK30DAY = “6 to 9"
IF CK06DKRE = 4, THEN CRK30DAY = “10 to 19"
IF CK06DKRE = 5, THEN CRK30DAY = “20 to 29"
IF CK06DKRE = 6, THEN CRK30DAY = “all 30"
ELSE CRK30DAY = BLANK
DEFINE TOTCRACK:
IF CKYRAVE NOT(BLANK OR DK/REF) THEN TOTCRACK = CKYRAVE
ELSE IF CKMONAVE NOT(BLANK OR DK/REF) THEN TOTCRACK= CKMONAVE*12
ELSE IF CKWKAVE NOT(BLANK OR DK/REF) THEN TOTCRACK=CKWKAVE*52
ELSE TOTCRACK= DK/REF
IF TOTCRACK = DK/REF SKIP TO HEINTRO
IF TOTCRACK NOT DK/REF AND (CK06 NE DK/REF OR BLANK AND CK06 > TOTCRACK) OR CK06 =
DK/REF AND ESTICK > TOTCRACK:
CKCC07a
[IF CK06 >TOTCRACK] For the last question, the computer recorded that you used ‘crack’
on [CK06] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
CKCC07b

[IF ESTICK > TOTCRACK] For the last question, the computer recorded that you used
‘crack’ on [CRK30DAY] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF

DEFINE FILLCK:
IF CKYRAVE > 1, THEN FILLCK = “[CKYRAVE] days”
ELSE IF CKYRAVE = 1, THEN FILLCK = “1 day”
ELSE IF CKMONAVE > 1, THEN FILLCK = “[CKMONAVE] days per month”
ELSE IF CKMONAVE = 1, THEN FILLCK = “1 day per month”
ELSE IF CKWKAVE > 1, THEN FILLCK = “[CKWKAVE] days per week”
May 23, 2012

75

ELSE IF CKWKAVE = 1, THEN FILLCK = “1 day per week”
DEFINE FILLCKA:
IF FILLCK = “[CKMONAVE] day(s) per month” OR [CKWKAVE] day(s) per week” THEN FILLCKA = “for a total
of TOTCRACK] days”
ELSE FILLCKA = BLANK
CKCC08

[IF CKCC07a = 4 OR CKCC07b = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
1
I used ‘crack’ on [FILLCK] days in the past 12 months [FILLCKA]
2
I used ‘crack’ on [CK06 / CRK30DAY] days in the past 30 days
3
Neither answer is correct
DK/REF

CKCC09

[IF CKCC08 = 2 OR CKCC08 = 3] Please answer this question again. Think about the past
12 months, from [DATEFILL] through today. We want to know how many days you’ve used
‘crack’ during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 month
DK/REF

CKCC10

[IF CKCC09 = 3] On how many days in the past 12 months did you use ‘crack’?
TOTAL # OF DAYS:
DK/REF

CKCC11

[RANGE: 1 - 366]

[IF CKCC09 = 2] On average, how many days did you use ‘crack’ each month during the
past 12 months?
# OF DAYS/MONTH:
DK/REF

CKCC12

[RANGE: 1 - 31]

[IF CKCC09 = 1] On average, how many days did you use ‘crack’ each week during the past
12 months?
[RANGE: 1 - 7]

# OF DAYS PER WEEK:
DK/REF

IF CKCC10 NOT(BLANK OR DK/REF) THEN TOTCRACK = CKCC10
IF CKCC11 NOT(BLANK OR DK/REF) THEN TOTCRACK= CKCC11*12
IF CKCC12 NOT(BLANK OR DK/REF) THEN TOTCRACK= CKCC12*52
ELSE TOTCRACK = DK/REF
CKCC13a

[IF CKCC07a = 6 OR ((CKCC08 = 1 OR CKCC08 = 3) AND CKCC07a NE BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. During the past 30 days, on how many days did you
use ‘crack’?
# OF DAYS:
DK/REF

CKCC13b

[IF CKCC07b = 6 OR (CKCC08 = 1 OR CKCC08 = 3) AND (CKCC07b NE BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. What is your best estimate of the number of days
you used ‘crack’ during the past 30 days?
1
2
3
4

May 23, 2012

[RANGE: 0 - 30]

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
76

5
6
IF CK06 = 0:
CKCC14

20 to 29 days
All 30 days

The computer recorded that you used ’crack’ on 0 days during the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF

CKCC16

[IF CKCC14 = 6] Please answer this question again. During the past 30 days, that is, since
[DATEFILL], on how many days did you use ‘crack’?
# OF DAYS:
DK/REF

May 23, 2012

[RANGE: 0 - 30]

77

May 23, 2012

78

Heroin
These next questions are about heroin.

HEINTRO

Press [ENTER] to continue.
HE01

Have you ever, even once, used heroin?
1
Yes
2
No
DK/REF
[IF HE01 = REF] The answers that people give us about their use of heroin are important to this study’s success.
We know that this information is personal, but remember your answers will be kept confidential.

HEREF

Please think again about answering this question: Have you ever, even once, used heroin?
1
Yes
2
No
DK/REF
HE02

[IF HE01 = 1 OR HEREF = 1] How old were you the first time you used heroin?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STHR:
IF HE02 NE (BLANK OR DK/REF) THEN AGE1STHR = HE02
ELSE AGE1STHR = BLANK
IF CURNTAGE < AGE1STHR:
HECC01
The computer recorded that you were [AGE1STHR] years old when you first used heroin. Is
this correct?
4
Yes
6
No
DK/REF
HECC02

[IF HECC01 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [AGE1STHR] years old the first time I used heroin
3
Neither answer is correct
DK/REF

HECC03

[IF HECC02=2 OR HECC02=3] Please answer this question again. What is your current
age?
AGE:
DK/REF

[RANGE: 1 - 110]

HECC03a

[IF HECC03 < 12] Since you have indicated that you are [HECC03 AGE] years old, we
cannot interview you for this study. Please tell your interviewer that you have finished the
survey. Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

HECC04

[IF HECC02=1 OR HECC02=3 OR HECC01=6] Please answer this question again. Think
about the first time you used heroin. How old were you the first time you used heroin?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF HECC04 NOT(BLANK OR DK/REF) THEN AGE1STHR = HECC04
UPDATE: IF HECC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = HECC03
May 23, 2012

79

IF AGE1STHR = CURNTAGE OR AGE1STHR<10:
HECC05
The computer recorded that you were [AGE1STHR] years old the first time you used heroin.
Is this correct?
4
Yes
6
No
DK/REF
HECC06

[IF HECC05=6] Please answer this question again. Think about the first time you used
heroin. How old were you the first time you used heroin?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF HECC06 NOT(BLANK OR DK/REF) THEN AGE1STHR = HECC06
HE03a

[IF HECC05 NE DK/RE AND HECC06 NE DK/REF AND AGE1STHR = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STHR = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use
heroin in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

HE03b [IF AGE1STHR = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use heroin in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
HE03c

[IF HECC05 NE DK/RE AND HECC06 NE DK/REF AND AGE1STHR = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use heroin?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF HE03c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
HE03d [IF HE03a = 1 OR 2 OR HE03b = 1 OR 2] In what month in [YEAR FROM HE03a or HE03b] did you first use
heroin?
1
2
3
4
5
6
7
8
9
May 23, 2012

January
February
March
April
May
June
July
August
September
80

10
October
11
November
12
December
DK/REF
HARD ERROR: [IF HE03d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STHE:
MYR1STHE = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (HE03a-d). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STHE IS
BLANK.
IF MYR1STHE NE 0 AND NE AGE1STHR:
HECC17
The computer recorded that you first used heroin in [HE03a-d fill]. That would make you
[MYR1STHE] years old when you first used heroin. Is this correct?
4
Yes
6
No
DK/REF
HECC18

[IF HECC17 = 4] Earlier, the computer recorded that you were [AGE1STHR] years old
when you first used heroin. Which answer is correct?
1
I first used heroin in [HE03a-d fill] when I was [MYR1STHE] years old
2
I was [AGE1STHR] years old the first time I used heroin
3
Neither answer is correct
DK/REF

UPDATE: IF HECC18 = 1, THEN AGE1STHR = MYR1STHE
HECC19

[IF HECC18=2 OR HECC18=3 OR HECC17=6] Please answer this question again. Did
you first use heroin in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

HECC19a

[IF HECC19 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [HECC19] did you first use heroin?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF HECC19a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF HECC19a NE (0 OR DK/REF) THEN UPDATE MYR1STHE.
MYR1STHE = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (HECC19 AND HECC19a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STHE IS
May 23, 2012

81

BLANK. IF MYR1STHE = AGE1STHR THEN MYR1STHE = BLANK
HECC20

[IF HECC18 NE 1 AND MYR1STDHENE 0 AND (HECC19 AND HECC19a NE HE03a-d)]
The computer recorded that you first used heroin in [HECC19-HECC19a fill]. That would
make you [MYR1STHE] years old when you first used heroin. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF HECC20 NE (6, BLANK OR DK/REF) AND (HECC19 AND HECC19a NE HE03a-d) THEN AGE1STHR =
MYR1STHE
HELAST3

[IF HE01 = 1 OR HEREF = 1] How long has it been since you last used heroin?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

HERECDK

[IF HELAST3 = DK] What is your best guess of how long it has been since you last used heroin?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

HERECRE

[IF HELAST3 = REF] The answers that people give us about their use of heroin are important to this study’s
success. We know that this information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: How long has it been since you last used heroin?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

HEFRAME3

[IF HELAST3 = 1 OR 2 OR HERECDK = 1 OR 2 OR HERECRE = 1 OR 2] Now think about the past 12
months, from [DATEFILL] through today. We want to know how many days you’ve used heroin during the
past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

HEYRAVE

[IF HEFRAME3 = 3 OR DK/REF] On how many days in the past 12 months did you use heroin?
TOTAL # OF DAYS:
DK/REF

HEMONAVE

[RANGE: 1 - 366]

[IF HEFRAME3 = 2 OR HEYRAVE = DK/REF] On average, how many days did you use heroin each
month during the past 12 months?
AVERAGE # OF DAYS PER MONTH:
DK/REF

HEWKAVE

[RANGE: 1 - 31]

[IF HEFRAME3 = 1 OR HEMONAVE = DK/REF] On average, how many days did you use heroin each
week during the past 12 months?
AVERAGE # OF DAYS PER WEEK:
DK/REF

May 23, 2012

[RANGE: 1 - 7]

82

HE06

[IF HELAST3=1 OR HERECDK = 1 OR HERECRE = 1] Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30 days, on how many days did you use heroin?
# OF DAYS:
DK/REF

HE06DKRE

[RANGE: 0 - 30]

[IF HE06 = DK/REF] What is your best estimate of the number of days you used heroin during the past 30
days?
1
2
3
4
5
6
DK/REF

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

DEFINE ESTIHE:
IF HE06DKRE = 1, THEN ESTIHE = 1
IF HE06DKRE = 2, THEN ESTIHE = 3
IF HE06DKRE = 3, THEN ESTIHE = 6
IF HE06DKRE = 4, THEN ESTIHE = 10
IF HE06DKRE = 5, THEN ESTIHE = 20
IF HE06DKRE = 6, THEN ESTIHE = 30
ELSE ESTIHE = BLANK
DEFINE HER30DAY
IF HE06DKRE = 1, THEN HER30DAY = “1 or 2"
IF HE06DKRE = 1, THEN HER30DAY = “3 to 5"
IF HE06DKRE = 3, THEN HER30DAY = “6 to 9"
IF HE06DKRE = 4, THEN HER30DAY = “10 to 19"
IF HE06DKRE = 5, THEN HER30DAY = “20 to 29"
IF HE06DKRE = 6, THEN HER30DAY = “all 30"
ELSE HER30DAY = BLANK
DEFINE TOTHERO:
IF HEYRAVE NOT(BLANK OR DK/REF) THEN TOTHERO = HEYRAVE
ELSE IF HEMONAVE NOT(BLANK OR DK/REF) THEN TOTHERO = HEMONAVE*12
ELSE IF HEWKAVE NOT(BLANK OR DK/REF) THEN TOTHERO=HEWKAVE*52
ELSE TOTHERO = DK/REF
IF TOTHERO NOT DK/REF AND (HE06 NE BLANK OR DK/REF AND HE06 > TOTHERO) OR (HE06 =
DK/REF AND ESTIHE > TOTHERO:
HECC07a
[IF HE06 > TOTHERO] For the last question, the computer recorded that you used heroin
on [HE06] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
HECC07b

[IF ESTIHE > TOTHERO] For the last question, the computer recorded that you used heroin
on [HER30DAY] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF

DEFINE FILLHER:
IF HEYRAVE > 1, THEN FILLHER = “[HEYRAVE] days”
ELSE IF HEYRAVE = 1, THEN FILLHE = “1 day”
ELSE IF HEMONAVE > 1, THEN FILLHE = “[HEMONAVE] days per month”
ELSE IF HEMONAVE = 1, THEN FILLHE = “1 day per month”
ELSE IF HEWKAVE > 1, THEN FILLHE = “[HEWKAVE] days per week”
ELSE IF HEWKAVE = 1, THEN FILLHE = “1 day per week”

May 23, 2012

83

DEFINE FILLHERA:
IF FILLHER = “[HEMONAVE] day(s) per month” OR “[HEWKAVE] day(s) per week” THEN FILLHERA = “for a
total of TOTHERO days”
ELSE FILLHERA = BLANK
HECC08

[IF HECC07a = 4 OR HECC07b = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
1
I used heroin on [FILLHER] days in the past 12 months [FILLHERA]
2
I used heroin on [HE06 /HER30DAY] days in the past 30 days
3
Neither answer is correct
DK/REF

HECC09

[IF HECC08 = 2 OR HECC08 = 3] Please answer this question again. Think about the past
12 months, from [DATEFILL] through today. We want to know how many days you’ve used
heroin during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

HECC10

[IF HECC09 = 3] On how many days in the past 12 months did you use heroin?
TOTAL # OF DAYS:
DK/REF

HECC11

[RANGE: 1 - 366]

[IF HECC09 = 2] On average, how many days did you use heroin each month during the
past 12 months?
# OF DAYS/MONTH:
DK/REF

HECC12

[RANGE: 1 - 31]

[IF HECC09 = 1] On average, how many days did you use heroin each week during the past
12 months?
[RANGE: 1 - 7]

# OF DAYS PER WEEK:
DK/REF

IF HECC10 NOT(BLANK OR DK/REF) THEN TOTHERO = HECC10
ELSE IF HECC11 NOT(BLANK OR DK/REF) THEN TOTHERO = HECC11*12
ELSE IF HECC12 NOT(BLANK OR DK/REF0 THEN TOTHERO = HECC12*52
ELSE TOTHERO = DK/REF
HECC13a

[IF HECC07a = 6 OR ((HECC08 = 1 OR 3) AND HECC07a NE BLANK OR DK/REF)]
Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. During the past 30 days, on how many days did you
use heroin?
# OF DAYS:
DK/REF

HECC13b

[IF HECC7b = 6 OR ((HECC08 = 1 OR 3) AND HECC07b NE BLANK OR DK/REF)] Please
answer this question again. Think specifically about the past 30 days, from [DATEFILL] up
to and including today. What is your best estimate of the number of days you used heroin
during the past 30 days?
1
2
3
4
5
6

May 23, 2012

[RANGE: 0 - 30]

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days
84

DK/REF
IF HE06 = 0:
HECC14

The computer recorded that you used heroin on 0 days during the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF

HECC16

[IF HECC14 = 6] Please answer this question again. During the past 30 days, that is, since
[DATEFILL], on how many days did you use heroin?
# OF DAYS:
DK/REF

May 23, 2012

[RANGE: 0 - 30]

85

May 23, 2012

86

Hallucinogens
HALINTRO

The next questions are about substances called hallucinogens. These drugs often cause people to see or
experience things that are not real.
A list of some common hallucinogens is shown below. These and many other substances that people use as
hallucinogens are often known by street names, and we can’t list them all. Please take a moment to look at
the substances listed below so you know what kind of drugs the next questions are about.
LSD, also called ‘acid’
PCP, also called ‘angel dust’ or phencyclidine
Peyote
Mescaline
Psilocybin
‘Ecstasy’, also called MDMA
Press [ENTER] to continue.

LS01a

Have you ever, even once, used LSD, also called “acid”?
1
Yes
2
No
DK/REF
[IF LS01a = REF] The answers that people give us about their use of LSD are important to this study’s success.
We know that this information is personal, but remember your answers will be kept confidential.

LSREF1

Please think again about answering this question: Have you ever, even once, used LSD, also called ‘acid’?
1
Yes
2
No
DK/REF
LS01b

Have you ever, even once, used PCP, also called ‘angel dust’ or phencyclidine?
1
Yes
2
No
DK/REF
[IF LS01b = REF] The answers that people give us about their use of PCP are important to this study’s success.
We know that this information is personal, but remember your answers will be kept confidential.

LSREF2

Please think again about answering this question: Have you ever, even once, used PCP, also called ‘angel dust’
or phencyclidine?
1
Yes
2
No
DK/REF
LS01c

Have you ever, even once, used peyote?
1
Yes
2
No
DK/REF

LS01d

Have you ever, even once, used mescaline?
1
Yes
2
No
DK/REF

LS01e

Have you ever, even once, used psilocybin, found in mushrooms?
1
2

May 23, 2012

Yes
No
87

DK/REF
LS01f

Have you ever, even once, used ‘Ecstasy’, also known as MDMA?
1
Yes
2
No
DK/REF
[IF LS01f = REF] The answers that people give us about their use of ‘Ecstasy’ are important to this study’s
success. We know that this information is personal, but remember your answers will be kept confidential.

LSREF3

Please think again about answering this question: Have you ever, even once, used ‘Ecstasy’, also known as
MDMA?
1
Yes
2
No
DK/REF
LS01h

Have you ever, even once, used any other hallucinogens besides the ones that have been listed?
1
Yes
2
No
DK/REF

LS01hs1

[IF LS01h = 1] Please type in the name of the other hallucinogens you have used. If you’re not sure how to spell
the name of the hallucinogen you used, just make your best guess.
When you have finished, press the [ENTER] key to go to the next question. Remember, you do not need to type
in the names of any hallucinogens that you already reported.
________________
DK/REF

LS01hs2

[IF LS01HS1 NE (BLANK OR DK/REF)] Please type in the name of any other hallucinogen you have used
other than those you have already mentioned. If you have not used any other hallucinogens, press the [ENTER]
key to go to the next question.
________________
DK/REF

LS01hs3

[IF LS01HS2 NE (BLANK OR DK/REF)] Please type in the name of any other hallucinogen you have used
other than those you have already mentioned. If you have not used any other hallucinogens, press the [ENTER]
key to go to the next question.
________________
DK/REF

LS01hs4

[IF LS01HS3 NE (BLANK OR DK/REF)] Please type in the name of any other hallucinogen you have used
other than those you have already mentioned. If you have not used any other hallucinogens, press the [ENTER]
key to go to the next question.
________________
DK/REF

LS01hs5

[IF LS01HS4 NE (BLANK OR DK/REF)] Please type in the name of any other hallucinogen you have used
other than those you have already mentioned. If you have not used any other hallucinogens, press the [ENTER]
key to go to the next question.
________________
DK/REF

DEFINE LSFILL:
IF (LS01a = 1 OR LSREF1 = 1) AND ((LS01b = 2 OR LSREF2 = 2) AND LS01c = 2 AND LS01d = 2 AND LS01e =
2 AND (LS01f = 2 OR LSREF3 = 2) AND LS01h = 2), LSFILL = “LSD”

May 23, 2012

88

IF (LS01a = 1 OR LSREF1 = 1) AND ((LS01b = 2 OR DK/REF OR LSREF2 = 2 OR DK/REF) AND LS01c = 2 OR
DK/REF AND LS01d = 2 OR DK/REF AND LS01e = 2 OR DK/REF AND (LS01f = 2 OR DK/REF OR LSREF3 = 2
OR DK/REF) AND LS01h = 2 OR DK/REF) AND AT LEAST ONE OF LS01b, LSREF2, LS01c, LS01d, LS01e,
LS01f, LSREF3 OR LS01h = DK/REF WHERE (LS01b = DK OR (LS01b = REF AND LSREF2 = DK/REF) OR
(LS01f = DK OR (LS01f = REF AND LSREF3 = DK/REF)), LSFILL = "LSD or any other hallucinogen"
IF (LS01b = 1 OR LSREF2 = 1) AND ((LS01a = 2 OR LSREF1 = 2) AND LS01c = 2 AND LS01d = 2 AND LS01e =
2 AND (LS01f = 2 OR LSREF3 = 2) AND LS01h = 2), LSFILL = “PCP”
IF (LS01b = 1 OR LSREF2 = 1) AND ((LS01a = 2 OR DK/REF OR LSREF1 = 2 OR DK/REF) AND LS01c = 2 OR
DK/REF AND LS01d = 2 OR DK/REF AND LS01e = 2 OR DK/REF AND (LS01f = 2 OR DK/REF OR LSREF3 = 2
OR DK/REF) AND LS01h = 2 OR DK/REF) AND AT LEAST ONE OF (LS01a OR LSREF1, LS01c, LS01d, LS01e,
LS01f, LSREF3 OR LS01h = DK/REF WHERE (LS01a = DK OR (LS01a = REF AND LSREF1 = DK/REF) OR
(LS01f = DK OR (LS01f = REF AND LSREF3 = DK/REF)), LSFILL = "PCP or any other hallucinogen"
IF (LS01F = 1 OR LSREF3 = 1) AND ((LS01a = 2 OR LSREF1 = 2) AND (LS01b = 2 OR LSREF2 = 2) AND LS01c
= 2 AND LS01d = 2 AND LS01e = 2 AND LS01h = 2), LSFILL = “‘Ecstasy’”
IF (LS01f = 1 OR LSREF3 = 1) AND ((LS01a = 2 OR DK/REF OR LSREF1 = 2 OR DK/REF) AND (LS01b = 2 OR
DK/REF OR LSREF2 = 2 OR DK/REF) AND LS01c = 2 OR DK/REF AND LS01d = 2 OR DK/REF AND LS01e= 2
OR DK/REF AND LS01h = 2 OR DK/REF) AND AT LEAST ONE OF LS01a, LSREF1, LS01b, LSREF2, LS01c,
LS01d, LS01e, OR LS01h = DK/REF WHERE (LS01a = DK OR (LS01a = REF AND LSREF1 = DK/REF) OR
(LS01b = DK OR (LS01b = REF AND LSREF2 = DK/REF)), LSFILL = "‛Ecstasy’’' or any other hallucinogen"
ELSE, LSFILL = “any hallucinogen”
LS02

[IF ANY IN LS01a TO LS01f =1 OR LS01h = 1 OR LSREF1 = 1 OR LSREF2 = 1 OR LSREF3 = 1] How old were
you the first time you used [LSFILL]?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STHA:
IF LS02 NE (BLANK OR DK/REF) THEN AGE1STHA = LS02
ELSE AGE1STHA = BLANK
IF CURNTAGE < AGE1STHA:
LSCC01
The computer recorded that you were [AGE1STHA] years old when you first used [LSFILL].
Is this correct?
4
Yes
6
No
DK/REF
LSCC02

[IF LSCC01 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [AGE1STHA] years old the first time I used [LSFILL]
3
Neither answer is correct
DK/REF

LSCC03

[IF LSCC02=2 OR LSCC02=3] Please answer this question again. What is your current
age?
AGE:
DK/REF

May 23, 2012

[RANGE: 1 - 110]

LSCC03a

[IF LSCC03 < 12] Since you have indicated that you are [LSCC03] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

LSCC04

[IF LSCC02=1 OR LSCC02=3 OR LSCC01=6] Please answer this question again. Think
about the first time you used [LSFILL]. How old were you the first time you used [LSFILL]?

89

AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC04 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCC04
UPDATE: IF LSCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = LSCC03
IF AGE1STHA =CURNTAGE OR AGE1STHA <10:
LSCC05
The computer recorded that you were [AGE1STHA] years old the first time you used
[LSFILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCC06

[IF LSCC05=6] Please answer this question again. Think about the first time you used
[LSFILL]. How old were you the first time you used [LSFILL]?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC06 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCC06
LS03a

[IF LSCC05 NE DK/RE AND LSCC06 NE DK/REF AND AGE1STHA = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STHA = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use
[LSFILL] in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LS03b

[IF AGE1STHA = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use [LSFILL] in
[CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LS03c

[IF LSCC05 NE DK/RE AND LSCC06 NE DK/REF AND AGE1STHA = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use [LSFILL]?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LS03c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LS03d

[IF LS03a = 1 OR 2 OR LS03b = 1 OR 2] In what month in [YEAR FROM LS03a or LS03b] did you first use
[LSFILL]?
1
2
3

May 23, 2012

January
February
March
90

4
5
6
7
8
9
10
11
12
DK/REF

April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LS03d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STHA:
MYR1STHA = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (LS03a-d). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STHA IS
BLANK.
IF MYR1STHA NE 0 AND NE AGE1STHA:
LSCC56
The computer recorded that you first used [LSFILL] in [LS03a-d fill]. That would make you
[MYR1STHA] years old when you first used [LSFILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCC57

[IF LSCC56 = 4] Earlier, the computer recorded that you were [AGE1STHA] years old when
you first used [LSFILL]. Which answer is correct?
1
I first used [LSFILL] in [LS03a-d fill] when I was [MYR1STHA] years old
2
I was [AGE1STHA] years old the first time I used [LSFILL]
3
Neither answer is correct
DK/REF

UPDATE: IF LSCC57 = 1, THEN AGE1STHA = MYR1STHA
LSCC58

[IF LSCC57=2 OR LSCC57=3 OR LSCC56=6] Please answer this question again. Did you
first use [LSFILL] in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LSCC58a

[IF LSCC58 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[LSCC58] did you first use [LSFILL]?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LSCC58a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
May 23, 2012

91

THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LSCC58a NE (0 OR DK/REF) THEN UPDATE MYR1STHA.
MYR1STHA = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (LSCC58 AND LSCC58a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STHA IS
BLANK. IF MYR1STHA = AGE1STHA THEN MYR1STHA = BLANK
LSCC59

[IF LSCC57 NE 1 AND MYR1STHA NE 0 AND (LSCC58 AND LSCC58a NE LS03a-d)] The
computer recorded that you first used [LSFILL] in [LSCC59-LSCC59a fill]. That would
make you [MYR1STHA] years old when you first used [LSFILL]. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LSCC59 NE (6, BLANK OR DK/REF) AND (LSCC58 AND LSCC58a NE LS03a-d) THEN AGE1STHA =
MYR1STHA
LSLAST

[IF LS01a = 1 OR LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR
LSREF3 = 1 OR LS01f = 1 OR LS01h = 1] How long has it been since you last used [LSFILL] ?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

LSRECDK

[IF LSLAST = DK] What is your best guess of how long it has been since you last used [LSFILL]?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

LSRECRE

[IF LSLAST = REF] The answers that people give us about their use of hallucinogens are important to this
study’s success. We know that this information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: How long has it been since you last used [LSFILL]?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

DEFINE HALLREC:
IF LSLAST = 1 OR LSRECDK = 1 OR LSRECRE = 1, THEN HALLREC = 1
IF LSLAST = 2 OR LSRECDK = 2 OR LSRECRE = 2, THEN HALLREC = 2
IF LSLAST = 3 OR LSRECDK = 3 OR LSRECRE = 3, THEN HALLREC = 3
ELSE HALLREC = BLANK
LSFRAME3

[IF HALLREC = 1 OR 2] Now think about the past 12 months, from [DATEFILL] through today. We want
to know how many days you’ve used [LSFILL] during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

LSYRAVE

[IF LSFRAME3 = 3 OR DK/REF] On how many days in the past 12 months did you use [LSFILL]?
TOTAL # OF DAYS:
DK/REF

LSMONAVE
May 23, 2012

[RANGE: 1 - 366]

[IF LSFRAME3 = 2 OR LSYRAVE = DK/REF] On average, how many days did you use [LSFILL] each
92

month during the past 12 months?
AVERAGE # OF DAYS PER MONTH:
DK/REF
LSWKAVE

[RANGE: 1 - 31]

[IF LSFRAME3 = 1 OR LSMONAVE = DK/REF] On average, how many days did you use [LSFILL] each
week during the past 12 months?
[RANGE: 1 - 7]

AVERAGE # OF DAYS PER WEEK:
DK/REF
LS04

[IF LSLAST=1 OR LSRECDK = 1 OR LSRECRE = 1] Think specifically about the past 30 days, from [DATEFILL]
up to and including today. During the past 30 days, on how many days did you use [LSFILL]?
NUMBER OF DAYS:
DK/REF

LS04DKRE

[RANGE: 0 - 30]

[IF LS04 = DK/REF] What is your best estimate of the number of days you used [LSFILL] during the past
30 days?
1
2
3
4
5
6
DK/REF

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

DEFINE ESTILS:
IF LS04DKRE = 1, THEN ESTILS = 1
IF LS04DKRE = 2, THEN ESTILS = 3
IF LS04DKRE = 3, THEN ESTILS = 6
IFLS04DKRE = 4, THEN ESTILS = 10
IF LS04DKRE =5, THEN ESTILS = 20
IF LS04DKRE = 6, THEN ESTILS = 30
ELSE ESTILS = BLANK
DEFINE HAL30DAY
IF LS04DKRE = 1, THEN HAL30DAY = “1 or 2"
IF LS04DKRE = 2, THEN HAL30DAY = “3 to 5"
IF LS04DKRE = 3, THEN HAL30DAY = “6 to 9"
IF LS04DKRE = 4, THEN HAL30DAY = “10 to 19"
IF LS04DKRE = 5, THEN HAL30DAY = “20 to 29"
IF LS04DKRE = 6, THEN HAL30DAY = “all 30"
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRAVE NOT(BLANK OR DK/REF) THEN TOTHALL = LSYRAVE
ELSE IF LSMONAVE NOT(BLANK OR DK/REF) THEN TOTHALL = LSMONAVE*12
ELSE IF LSWKAVE NOT(BLANK OR DK/REF) THEN TOTHALL = LSWKAVE*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LS04 NE DK/REF OR BLANK AND LS04 > TOTHALL) OR (LS04 = DK/REF
AND ESTILS > TOTHALL)):
LSCC07a
[IF LS04 > TOTHALL] For the last question, the computer recorded that you used [LSFILL]
on [LS04] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
LSCC07b

[IF ESTILS > TOTHALL] For the last question, the computer recorded that you used
[LSFILL] on [HAL30DAY] of the past 30 days. Is this correct?
4

May 23, 2012

Yes
93

6
No
DK/REF
DEFINE FILLHAL:
IF LSYRAVE > 1, THEN FILLHAL = “[LSYRAVE] days”
ELSE IF LSYRAVE = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONAVE > 1, THEN FILLHAL = “[LSMONAVE] days per month”
ELSE IF LSMONAVE = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKAVE > 1, THEN FILLHAL = “[LSWKAVE] days per week”
ELSE IF LSWKAVE = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONAVE] day(s) per month OR “[LSWKAVE] day(s) per week” THEN FILLHALA = “for a
total of TOTHALL days”
ELSE FILLHALA = BLANK
LSCC08

[IF LSCC07a = 4 OR LSCC07b = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
1
I used [LSFILL] [FILLHAL] in the past 12 months [FILLHALA]
2
I used [LSFILL] [LS04 / HAL30DAY] days in the past 30 days
3
Neither answer is correct
DK/REF

LSCC09

[IF LSCC08 = 2 OR LSCC08 = 3] Please answer this question again. Think about the past
12 months, from [DATEFILL] through today. We want to know how many days you’ve used
[LSFILL] during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

LSCC10

[IF LSCC09 = 3] On how many days in the past 12 months did you use [LSFILL]?
[RANGE: 1 - 366]

TOTAL # OF DAYS:
DK/REF
LSCC11

[IF LSCC09 = 2] On average, how many days did you use [LSFILL] each month during the
past 12 months?
[RANGE: 1 - 31]

# OF DAYS/MONTH:
DK/REF
LSCC12

[IF LSCC09 = 1] On average, how many days did you use [LSFILL] each week during the
past 12 months?
# OF DAYS PER WEEK:
DK/REF

[RANGE: 1 - 7]

IF LSCC10 NOT(BLANK OR DK/REF) THEN TOTHALL = LSCC10
ELSE IF LSCC11 NOT(BLANK OR DK/REF) THEN TOTHALL=LSCC11*12
ELSE IF LSCC12 NOT(BLANK OR DK/REF) THENTOTHALL=LSCC12*52
ELSE TOTHALL = DK/REF
LSCC13a

[IF LSCC07a = 6 OR ((LSCC08 = 1 OR LSCC8 = 3) AND LSCC07a NE BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30 days, on how many days did you
use [LSFILL]?
# OF DAYS:
DK/REF

May 23, 2012

[RANGE: 0 - 30]

94

LSCC13b

[IF LSCC07b = 6 OR ((LSCC08 = 1 OR LSCC08 = 3) AND LSCC07b NE BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. What is your best estimate of the number of days
you used [LSFILL] during the past 30 days?
1
2
3
4
5
6
DK/REF

IF LS04 = 0:
LSCC14

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

The computer recorded that you used [LSFILL] on 0 days during the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF

LSCC16

[IF LSCC14 = 6] Please answer this question again. During the past 30 days, that is, since
[DATEFILL], on how many days did you use [LSFILL]?
# OF DAYS:
DK/REF

LS05

[RANGE: 0 - 30]

[IF (LS01a = 1 OR LSREF1 =1) AND (LS01b = 1 OR LSREF2 = 1 OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR
LSREF3 = 1 OR LS01f = 1 OR LS01h = 1)] Now think only about LSD. How old were you the first time you used
LSD?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STLS:
IF LS05 NE (BLANK OR DK/REF) THEN AGE1STLS = LS05
ELSE AGE1STLS = BLANK
IF CURNTAGE < AGE1STLS:
LSCC17
The computer recorded that you were [AGE1STLS] years old when you first used LSD. Is
this correct?
4
Yes
6
No
DK/REF
LSCC18

[IF LSCC17 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [AGE1STLS] years old the first time I used LSD
3
Neither answer is correct
DK/REF

LSCC19

[IF LSCC18=2 OR LSCC18=3] Please answer this question again. What is your current
age?
AGE:
DK/REF

May 23, 2012

[RANGE: 1 - 110]

LSCC19a

[IF LSCC19 < 12] Since you have indicated that you are [LSCC19] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

LSCC20

[IF LSCC18 =1 OR LSCC18=3 OR LSCC17=6] Please answer this question again. Think
95

about the first time you used LSD. How old were you the first time you used LSD?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC20 NOT(BLANK OR DK/REF) THEN AGE1STLS = LSCC20
UPDATE: IF LSCC19 NOT(BLANK OR DK/REF) THEN CURNTAGE = LSCC19
IF AGE1STLS =CURNTAGE OR AGE1STLS <10:
LSCC21
The computer recorded that you were [AGE1STLS] years old the first time you used LSD. Is
this correct?
4
Yes
6
No
DK/REF
LSCC22

[IF LSCC21 =6] Please answer this question again. Think about the first time you used LSD.
How old were you the first time you used LSD?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC22 NOT(BLANK OR DK/REF) THEN AGE1STLS = LSCC22
IF AGE1STLS < AGE1STHA:
LSCC23
The answers for the last question and an earlier question disagree. Which answer is correct?
1
I was [AGE1STHA] years old the first time I used [LSFILL]
2
I was [AGE1STLS] years old the first time I used LSD
3
Neither answer is correct
DK/REF
LSCC24

[IF LSCC23=2 OR LSCC23=3] Please answer this question again. Think about the first time
you used [LSFILL]. How old were you the first time you used [LSFILL]?
AGE:
DK/REF

LSCC25

[RANGE: 1 - 110]

[IF LSCC23 = 1 OR LSCC23 = 3] Please answer this question again. Think about the first
time you used LSD. How old were you the first time you used LSD?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC24 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCC24
UPDATE: IF LSCC25 NOT(BLANK OR DK/REF) THEN AGE1STLS = LSCC25
LS06

[IF AGE1STLS = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STLS = CURNTAGE - 1 AND
DATE OF INTERVIEW $ DOB] Did you first use LSD in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LS07

[IF AGE1STLS = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use LSD in [CURRENT
YEAR - 2] OR [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LS08

[IF AGE1STLS = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in [CURRENT YEAR] did
you first use LSD?

May 23, 2012

96

1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LS08 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LS09

[IF LS06 = 1 OR 2 OR LS07 = 1 OR 2] In what month in [YEAR FROM LS06 or LS07] did you first use LSD?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LS09 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STLS:
MYR1STLS = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (LS06-09). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STLS IS
BLANK.
IF MYR1STLS NE 0 AND NE AGE1STLS:
LSCC60
The computer recorded that you first used LSD in [LS06-09 fill]. That would make you
[MYR1STLS] years old when you first used LSD. Is this correct?
4
Yes
6
No
DK/REF
LSCC61

[IF LSCC60 = 4] Earlier, the computer recorded that you were [AGE1STLS] years old when
you first used LSD. Which answer is correct?
1
I first used LSD in [LS06-09 fill] when I was [MYR1STLS] years old
2
I was [AGE1STLS] years old the first time I used LSD
3
Neither answer is correct
DK/REF

UPDATE: IF LSCC61 = 1, THEN AGE1STLS = MYR1STLS.
LSCC62

May 23, 2012

[IF LSCC61=2 OR LSCC61=3 OR LSCC60=6] Please answer this question again. Did you
first use LSD in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?

97

1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LSCC62a

[IF LSCC62 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[LSCC62] did you first use LSD?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LSCC62a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LSCC62a NE (0 OR DK/REF) THEN UPDATE MYR1STLS.
MYR1STLS = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (LSCC62 AND LSCC62a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STLS IS
BLANK. IF MYR1STLS = AGE1STLS THEN MYR1STLS = BLANK
LSCC63

[IF LSCC61 NE 1 AND MYR1STLS NE 0 AND (LSCC62 AND LSCC62a NE LS06-LS09)] The
computer recorded that you first used LSD in [LSCC62-LSCC62a fill]. That would make you
[MYR1STLS] years old when you first used LSD. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LSCC63 NE (6, BLANK OR DK/REF) AND (LSCC62 AND LSCC62a NE LS06-LS09) THEN AGE1STLS =
MYR1STLS
LS10

[IF (LS01a =1 OR LSREF1 = 1) AND (LS01b = 1 OR LSREF2=1 OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR
LS01f = 1 OR LSREF3 = 1 OR LS01h = 1)] How long has it been since you last used LSD?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

DEFINE LSDREC
IF LS10 NE (BLANK OR DK/REF) THEN LSDREC = LS10
ELSE LSDREC = BLANK
IF LSDREC < HALLREC:
LSCC26
The computer recorded that you last used LSD [LSDREC FILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCC27

[IF LSCC26 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1

May 23, 2012

I last used [LSFILL] [HALLREC FILL]
98

2
I last used LSD [LSDREC FILL]
3
Neither answer is correct
DK/REF
LSCC28

[IF LSCC27 = 2 OR LSCC27 = 3] Please answer this question again. How long has it been
since you last used [LSFILL]?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

LSCC29

[IF LSCC26 =6 OR LSCC27 = 1 OR LSCC27 = 3] Please answer this question again. Think
only about LSD. How long has it been since you last used LSD?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

UPDATE: IF LSCC28 NOT (BLANK OR DK/REF) THEN HALLREC = LSCC28
UPDATE: IF LSCC29 NOT (BLANK OR DK/REF) THEN LSDREC = LSCC29
DEFINE LSFILL2:
IF HALLREC = 1 OR 2, LSFILL2 = "[LSFILL]"
ELSE IF LSDREC = 1 OR 2, LSFILL2 = "LSD or any other hallucinogen"
LSFRAME4

[IF (HALLREC OR LSDREC = 1 OR 2) AND LSFRAME3 = BLANK] Now think about the past 12
months, from [DATEFILL] through today. We want to know how many days you’ve used [LSFILL2]
during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

LSYRAV2

[IF LSFRAME4 = 3 OR DK/REF] On how many days in the past 12 months did you use [LSFILL2]?
TOTAL # OF DAYS:
DK/REF

LSMONAV2

[RANGE: 1 - 366]

[IF LSFRAME4 = 2 OR LSYRAV2 = DK/REF] On average, how many days did you use [LSFILL2] each
month during the past 12 months?
[RANGE: 1 - 31]

AVERAGE # OF DAYS PER MONTH:
DK/REF
LSWKAV2

[IF LSFRAME4 = 1 OR LSMONAV2 = DK/REF] On average, how many days did you use [LSFILL2]
each week during the past 12 months?
AVERAGE # OF DAYS PER WEEK:
DK/REF

LS30

[RANGE: 1 - 7]

[IF HALLREC = 1 OR LSDREC = 1 AND LS04 = BLANK] Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30 days, on how many days did you use [LSFILL2]?
NUMBER OF DAYS:
DK/REF

LS30DKRE

May 23, 2012

[RANGE: 0 - 30]

[IF LS30 = DK/REF] What is your best estimate of the number of days you used [LSFILL2] during the
past 30 days?

99

1
2
3
4
5
6
DK/REF

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

DEFINE ESTILS:
IF LS30DKRE = 1, THEN
IF LS30DKRE = 2, THEN
IF LS30DKRE = 3, THEN
IF LS30DKRE = 4, THEN
IF LS30DKRE = 5, THEN
IF LS30DKRE = 6, THEN
ELSE ESTILS = BLANK

ESTILS = 1
ESTILS = 3
ESTILS = 6
ESTILS = 10
ESTILS = 20
ESTILS = 30

DEFINE HAL30DAY
IF LS30DKRE = 1, THEN HAL30DAY = “1 or 2"
IF LS30DKRE = 2, THEN HAL30DAY = “3 to 5"
IF LS30DKRE = 3, THEN HAL30DAY = “6 to 9"
IF LS30DKRE = 4, THEN HAL30DAY = “10 to 19"
IF LS30DKRE = 5, THEN HAL30DAY = “20 to 29"
IF LS30DKRE = 6, THEN HAL30DAY = “all 30"
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRAV2 NOT(BLANK OR DK/REF) THEN TOTHALL = LSYRAV2
ELSE IF LSMONAV2 NOT(BLANK OR DK/REF) THEN TOTHALL = LSMONAV2*12
ELSE IF LSWKAV2 NOT(BLANK OR DK/REF) THEN TOTHALL = LSWKAV2*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LS30 NE DK/REF OR BLANK AND LS30 > TOTHALL) OR (LS30 = DK/REF
AND ESTILS > TOTHALL)):
LSCC72a

[IF LS30 > TOTHALL] For the last question, the computer recorded that you used
[LSFILL2] on [LS30] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF

LSCC72b

[IF ESTILS > TOTHALL] For the last question, the computer recorded that you used
[LSFILL2] on [HAL30DAY] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF

DEFINE FILLHAL:
IF LSYRAV2 > 1, THEN FILLHAL = “[LSYRAV2] days”
ELSE IF LSYRAV2 = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONAV2 > 1, THEN FILLHAL = “[LSMONAV2] days per month”
ELSE IF LSMONAV2 = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKAV2 > 1, THEN FILLHAL = “[LSWKAV2] days per week”
ELSE IF LSWKAV2 = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONAV2] day(s) per month OR “[LSWKAV2] day(s) per week” THEN FILLHALA = “for a
total of TOTHALL days”
ELSE FILLHALA = BLANK
LSCC73

May 23, 2012

[IF LSCC72a = 4 OR LSCC72b = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?

100

1
I used [LSFILL2] [FILLHAL] in the past 12 months [FILLHALA]
2
I used [LSFILL2] [LS30 / HAL30DAY] days in the past 30 days
3
Neither answer is correct
DK/REF
LSCC74

[IF LSCC73 = 2 OR LSCC73 = 3] Please answer this question again. Think about the past
12 months, from [DATEFILL] through today. We want to know how many days you’ve used
[LSFILL2] during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

LSCC75

[IF LSCC74 = 3] On how many days in the past 12 months did you use [LSFILL2]?
TOTAL # OF DAYS:
DK/REF

LSCC76

[RANGE: 1 - 366]

[IF LSCC74 = 2] On average, how many days did you use [LSFILL2] each month during the
past 12 months?
# OF DAYS/MONTH:
DK/REF

LSCC77

[RANGE: 1 - 31]

[IF LSCC74 = 1] On average, how many days did you use [LSFILL2] each week during the
past 12 months?
# OF DAYS PER WEEK:
DK/REF

[RANGE: 1 - 7]

IF LSCC75 NOT(BLANK OR DK/REF) THEN TOTHALL = LSCC75
ELSE IF LSCC76 NOT(BLANK OR DK/REF) THEN TOTHALL=LSCC76*12
ELSE IF LSCC77 NOT(BLANK OR DK/REF) THENTOTHALL=LSCC77*52
ELSE TOTHALL = DK/REF
LSCC78a

[IF LSCC72a = 6 OR ((LSCC73 = 1 OR LSCC73 = 3) AND LSCC72a NE BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30 days, on how many days did you
use [LSFILL2]?
# OF DAYS:
DK/REF

LSCC78b

[IF LSCC72b = 6 OR ((LSCC73 = 1 OR LSCC73 = 3) AND LSCC72b NE BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. What is your best estimate of the number of days
you used [LSFILL2] during the past 30 days?
1
2
3
4
5
6
DK/REF

IF LS30 = 0:
LSCC79

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

The computer recorded that you used [LSFILL2] on 0 days during the past 30 days. Is this
correct?
4
6

May 23, 2012

[RANGE: 0 - 30]

Yes
No
101

DK/REF
LSCC80

[IF LSCC79 = 6] Please answer this question again. During the past 30 days, that is, since
[DATEFILL], on how many days did you use [LSFILL2]?
# OF DAYS:
DK/REF

LS11

[RANGE: 0 - 30]

[IF (LS01b = 1 OR LSREF2 =1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR
LSREF3 = 1 OR LS01f = 1 OR LS01h = 1)] Now think only about PCP. How old were you the first time you used
PCP?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STPC
IF LS11 NE (BLANK OR DK/REF) THEN AGE1STPC = LS11
ELSE AGE1STPC = BLANK
IF CURNTAGE < AGE1STPC:
LSCC30

The computer recorded that you were [AGE1STPC] years old when you first used PCP. Is
this correct?
4
Yes
6
No
DK/REF

LSCC31

[IF LSCC30 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [AGE1STPC] years old the first time I used PCP
3
Neither answer is correct
DK/REF

LSCC32

[IF LSCC31=2 OR LSCC31=3] Please answer this question again. What is your current
age?
AGE:
DK/REF

[RANGE: 1 - 110]

LSCC32a

[IF LSCC32 < 12] Since you have indicated that you are [LSCC32] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

LSCC33

[IF LSCC30 =6 OR LSCC31=1 OR LSCC31=3] Please answer this question again. Think
about the first time you used PCP. How old were you the first time you used PCP?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC33 NOT(BLANK OR DK/REF) THEN AGE1STPC = LSCC33
UPDATE: IF LSCC32 NOT(BLANK OR DK/REF) THEN CURNTAGE = LSCC32
IF AGE1STPC =CURNTAGE OR AGE1STPC <10:
LSCC34
The computer recorded that you were [AGE1STPC] years old the first time you used PCP. Is
this correct?
4
Yes
6
No
DK/REF
LSCC35
May 23, 2012

[IF LSCC34 =6] Please answer this question again. Think about the first time you used PCP.
102

How old were you the first time you used PCP?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC35 NOT(BLANK OR DK/REF) THEN AGE1STPC = LSCC35
IF AGE1STPC < AGE1STHA:
LSCC36
The answers for the last question and an earlier question disagree. Which answer is correct?
1
I was [AGE1STHA] years old the first time I used [LSFILL]
2
I was [AGE1STPC] years old the first time I used PCP
3
Neither answer is correct
DK/REF
LSCC37

[IF LSCC36 =2 OR LSCC36 =3] Please answer this question again. Think about the first
time you used [LSFILL]. How old were you the first time you used [LSFILL]?
AGE:
DK/REF

LSCC38

[RANGE: 1 - 110]

[IF LSCC36 = 1 OR LSCC36 = 3] Please answer this question again. Think about the first
time you used PCP. How old were you the first time you used PCP?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC37 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCC37
UPDATE: IF LSCC38 NOT(BLANK OR DK/REF) THEN AGE1STPC = LSCC38
LS12

[IF LSCC34 NE DK/RE AND LSCC35 NE DK/REF AND AGE1STPC = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STPC = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use
PCP in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LS13

[IF AGE1STPC = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use PCP in [CURRENT
YEAR - 2] OR [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LS14

[IF LSCC34 NE DK/RE AND LSCC35 NE DK/REF AND AGE1STPC = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use PCP?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LS14 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
May 23, 2012

103

QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LS15

[IF LS12 = 1 OR 2 OR LS13 = 1 OR 2] In what month in [YEAR FROM LS12 or LS13] did you first use PCP?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LS15 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STPC:
MYR1STPC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (LS12-15). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STPC IS
BLANK.
IF MYR1STPC NE 0 AND NE AGE1STPC:
LSCC64
The computer recorded that you first used PCP in [LS12-15 fill]. That would make you
[MYR1STPC] years old when you first used PCP. Is this correct?
4
Yes
6
No
DK/REF
LSCC65

[IF LSCC64 = 4] Earlier, the computer recorded that you were [AGE1STPC] years old when
you first used PCP. Which answer is correct?
1
I first used PCP in [LS12-15 fill] when I was [MYR1STPC] years old
2
I was [AGE1STPC] years old the first time I used PCP
3
Neither answer is correct
DK/REF

UPDATE: IF LSCC65 = 1, THEN AGE1STPC = MYR1STPC
LSCC66

[IF LSCC65=2 OR LSCC65=3 OR LSCC64=6] Please answer this question again. Did you
first use PCP in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LSCC66a

[IF LSCC66 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[LSCC66] did you first use PCP?
1
2
3
4
5
6
7
8
9

May 23, 2012

January
February
March
April
May
June
July
August
September
104

10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LSCC66a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LSCC66a NE (0 OR DK/REF) THEN UPDATE MYR1STPC.
MYR1STPC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (LSCC66 AND LSCC66a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STPC IS
BLANK. IF MYR1STPC = AGE1STPC THEN MYR1STPC = BLANK
LSCC67

[IF LSCC65 NE 1 AND MYR1STPC NE 0 AND (LSCC66 AND LSCC66 NE LS12-LS15)] The
computer recorded that you first used PCP in [LSCC66-LSCC66a fill]. That would make you
[MYR1STPC] years old when you first used PCP. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LSCC67 NE (6, BLANK OR DK/REF) AND (LSCC66 AND LSCC66 NE LS12-LS15) THEN AGE1STPC =
MYR1STPC
LS16

[IF (LS01b = 1 OR LSREF2 = 1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR
LS01f = 1 OR LSREF3 = 1 OR LS01h = 1)] How long has it been since you last used PCP?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

DEFINE PCPREC:
IF LS16 NE (BLANK OR DK/REF) THEN PCPREC = LS16
ELSE PCPREC = BLANK
IF PCPREC < HALLREC:
LSCC39
The computer recorded that you last used PCP [PCPREC FILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCC40

[IF LSCC39 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I last used [LSFILL] [HALLREC FILL]
2
I last used PCP [PCPREC FILL]
3
Neither answer is correct
DK/REF

LSCC41

[IF LSCC40 = 2 OR LSCC40 = 3] Please answer this question again. How long has it been
since you last used [LSFILL]?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

LSCC42

[IF LSCC39 =6 OR LSCC40 = 1 OR LSCC40 = 3] Please answer this question again. Think
only about PCP. How long has it been since you last used PCP?
1
2

May 23, 2012

Within the past 30 days – that is, since [DATEFILL]
More than 30 days ago but within the past 12 months
105

3
More than 12 months ago
DK/REF
UPDATE: IF LSCC41 NOT (BLANK OR DK/REF), THEN HALLREC = LSCC41
UPDATE: IF LSCC42 NOT (BLANK OR DK/REF), THEN PCPREC = LSCC42
DEFINE LSFILL3:
IF HALLREC = 1 OR 2 OR LSDREC = 1 OR 2, LSFILL3 = "[LSFILL]"
ELSE IF PCPREC = 1 OR 2, LSFILL3 = "PCP or any other hallucinogen"
LSFRAME5

[IF (HALLREC OR PCPREC = 1 OR 2) AND LSFRAME3 = BLANK AND LSFRAME4 = BLANK] Now
think about the past 12 months, from [DATEFILL] through today. We want to know how many days you’ve
used [LSFILL3] during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

LSYRAV3

[IF LSFRAME5 = 3 OR DK/REF] On how many days in the past 12 months did you use [LSFILL3]?
TOTAL # OF DAYS:
DK/REF

LSMONAV3

[RANGE: 1 - 366]

[IF LSFRAME5 = 2 OR LSYRAV3 = DK/REF] On average, how many days did you use [LSFILL3] each
month during the past 12 months?
AVERAGE # OF DAYS PER MONTH:
DK/REF

LSWKAV3

[RANGE: 1 - 31]

[IF LSFRAME5 = 1 OR LSMONAV3 = DK/REF] On average, how many days did you use [LSFILL3]
each week during the past 12 months?
[RANGE: 1 - 7]

AVERAGE # OF DAYS PER WEEK:
DK/REF
LS31

[IF HALLREC = 1 OR PCPREC = 1 AND LS04 = BLANK AND LS30 = BLANK] Think specifically about the past
30 days, from [DATEFILL] up to and including today. During the past 30 days, on how many days did you use
[LSFILL3]?
NUMBER OF DAYS:
DK/REF

LS31DKRE

[IF LS31 = DK/REF] What is your best estimate of the number of days you used [LSFILL3] during the
past 30 days?
1
2
3
4
5
6
DK/REF

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

DEFINE ESTILS:
IF LS31DKRE = 1, THEN
IF LS31DKRE = 2, THEN
IF LS31DKRE = 3, THEN
IF LS31DKRE = 4, THEN
IF LS31DKRE = 5, THEN
IF LS31DKRE = 6, THEN
ELSE ESTILS = BLANK
May 23, 2012

[RANGE: 0 - 30]

ESTILS = 1
ESTILS = 3
ESTILS = 6
ESTILS = 10
ESTILS = 20
ESTILS = 30

106

DEFINE HAL30DAY
IF LS31DKRE = 1, THEN HAL30DAY = “1 or 2"
IF LS31DKRE = 2, THEN HAL30DAY = “3 to 5"
IF LS31DKRE = 3, THEN HAL30DAY = “6 to 9"
IF LS31DKRE = 4, THEN HAL30DAY = “10 to 19"
IF LS31DKRE = 5, THEN HAL30DAY = “20 to 29"
IF LS31DKRE = 6, THEN HAL30DAY = “all 30"
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRAV3 NOT(BLANK OR DK/REF) THEN TOTHALL = LSYRAV3
ELSE IF LSMONAV3 NOT(BLANK OR DK/REF) THEN TOTHALL = LSMONAV3*12
ELSE IF LSWKAV3 NOT(BLANK OR DK/REF) THEN TOTHALL = LSWKAV3*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LS31 NE DK/REF OR BLANK AND LS31 > TOTHALL) OR (LS31 = DK/REF
AND ESTILS > TOTHALL)):
LSCC81a

[IF LS31 > TOTHALL] For the last question, the computer recorded that you used
[LSFILL3] on [LS31] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF

LSCC81b

[IF ESTILS > TOTHALL] For the last question, the computer recorded that you used
[LSFILL3] on [HAL30DAY] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF

DEFINE FILLHAL:
IF LSYRAV3 > 1, THEN FILLHAL = “[LSYRAV3] days”
ELSE IF LSYRAV3 = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONAV3 > 1, THEN FILLHAL = “[LSMONAV3] days per month”
ELSE IF LSMONAV3 = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKAV3 > 1, THEN FILLHAL = “[LSWKAV3] days per week”
ELSE IF LSWKAV3 = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONAV3] day(s) per month OR “[LSWKAV3] day(s) per week” THEN FILLHALA = “for a
total of TOTHALL days”
ELSE FILLHALA = BLANK
LSCC82

[IF LSCC81a = 4 OR LSCC81b = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
1
I used [LSFILL3] [FILLHAL] in the past 12 months [FILLHALA]
2
I used [LSFILL3] [LS31 / HAL30DAY] days in the past 30 days
3
Neither answer is correct
DK/REF

LSCC83

[IF LSCC82 = 2 OR LSCC82 = 3] Please answer this question again. Think about the past
12 months, from [DATEFILL] through today. We want to know how many days you’ve used
[LSFILL3] during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

May 23, 2012

107

LSCC84

[IF LSC83 = 3] On how many days in the past 12 months did you use [LSFILL3]?
TOTAL # OF DAYS:
DK/REF

LSCC85

[RANGE: 1 - 366]

[IF LSCC83 = 2] On average, how many days did you use [LSFILL3] each month during the
past 12 months?
[RANGE: 1 - 31]

# OF DAYS/MONTH:
DK/REF
LSCC86

[IF LSCC83 = 1] On average, how many days did you use [LSFILL3] each week during the
past 12 months?
# OF DAYS PER WEEK:
DK/REF

[RANGE: 1 - 7]

IF LSCC84 NOT(BLANK OR DK/REF) THEN TOTHALL = LSCC84
ELSE IF LSCC85 NOT(BLANK OR DK/REF) THEN TOTHALL=LSCC85*12
ELSE IF LSCC86 NOT(BLANK OR DK/REF) THENTOTHALL=LSCC86*52
ELSE TOTHALL = DK/REF
LSCC87a

[IF LSCC81a = 6 OR ((LSCC82 = 1 OR LSCC82 = 3) AND LSCC81a NE BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30 days, on how many days did you
use [LSFILL3]?
# OF DAYS:
DK/REF

LSCC87b

[IF LSCC81b = 6 OR ((LSCC82 = 1 OR LSCC82 = 3) AND LSCC81b NE BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. What is your best estimate of the number of days
you used [LSFILL3] during the past 30 days?
1
2
3
4
5
6
DK/REF

IF LS31 = 0:
LSCC88

[RANGE: 0 - 30]

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

The computer recorded that you used [LSFILL3] on 0 days during the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF

LSCC89

[IF LSCC88 = 6] Please answer this question again. During the past 30 days, that is, since
[DATEFILL], on how many days did you use [LSFILL3]?
# OF DAYS:
DK/REF

LS17

[RANGE: 0 - 30]

[IF (LS01f = 1 OR LSREF3 =1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR LS01c = 1 OR
LS01d = 1 OR LS01e = 1 OR LS01h = 1)] Now think only about ‘Ecstasy’. How old were you the first time you used
‘Ecstasy’, also known as MDMA?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STEC
May 23, 2012

108

IF LS17 NE (BLANK OR DK/REF) THEN AGE1STEC = LS17
ELSE AGE1STEC = BLANK
IF CURNTAGE < AGE1STEC:
LSCC43
The computer recorded that you were [AGE1STEC] years old when you first used ‘Ecstasy’.
Is this correct?
4
Yes
6
No
DK/REF
LSCC44

[IF LSCC43 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [AGE1STEC] years old the first time I used ‘Ecstasy’
3
Neither answer is correct
DK/REF

LSCC45

[IF LSCC44=2 OR LSCC44=3] Please answer this question again. What is your current
age?
AGE:
DK/REF

[RANGE: 1 - 110]

LSCC45a

[IF LSCC45 < 12] Since you have indicated that you are [LSCC45] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

LSCC46

[IF LSCC43 =6 OR LSCC44=1 OR LSCC44=3] Please answer this question again. Think
about the first time you used ‘Ecstasy’. How old were you the first time you used ‘Ecstasy’,
also known as MDMA?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC46 NOT(BLANK OR DK/REF) THEN AGE1STEC = LSCC46
UPDATE: IF LSCC45 NOT(BLANK OR DK/REF) THEN CURNTAGE = LSCC45
IF AGE1STEC =CURNTAGE OR AGE1STEC <10:
LSCC47
The computer recorded that you were [AGE1STEC] years old the first time you used
‘Ecstasy’. Is this correct?
4
Yes
6
No
DK/REF
LSCC48

[IF LSCC47 =6] Please answer this question again. Think about the first time you used
‘Ecstasy’. How old were you the first time you used ‘Ecstasy’, also known as MDMA?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC48 NOT(BLANK OR DK/REF) THEN AGE1STEC = LSCC48
IF AGE1STEC < AGE1STHA:
LSCC49
The answers for the last question and an earlier question disagree. Which answer is correct?
1
I was [AGE1STHA] years old the first time I used [LSFILL]
2
I was [AGE1STEC] years old the first time I used ‘Ecstasy’
3
Neither answer is correct
DK/REF
LSCC50
May 23, 2012

[IF LSCC49 =2 OR LSCC49 =3] Please answer this question again. Think about the first
109

time you used [LSFILL]. How old were you the first time you used [LSFILL]?
AGE:
DK/REF
LSCC51

[RANGE: 1 - 110]

[IF LSCC49 = 1 OR LSCC49 = 3] Please answer this question again. Think about the first
time you used ‘Ecstasy’. How old were you the first time you used ‘Ecstasy’, also known as
MDMA?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC50 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCC50
UPDATE: IF LSCC51 NOT(BLANK OR DK/REF) THEN AGE1STEC = LSCC51
LS18

[IF LSCC47 NE DK/RE AND LSCC48 NE DK/REF AND AGE1STEC = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STEC = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use
‘Ecstasy’ in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LS19

[IF AGE1STEC = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use ‘Ecstasy’ in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LS20

[IF LSCC47 NE DK/RE AND LSCC48 NE DK/REF AND AGE1STEC = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use ‘Ecstasy’?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LS20 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LS21

[IF LS18 = 1 OR 2 OR LS19 = 1 OR 2] In what month in [YEAR FROM LS18 or LS19] did you first use ‘Ecstasy’?
1
2
3
4
5
6
7
8
9
10
11

May 23, 2012

January
February
March
April
May
June
July
August
September
October
November
110

12
December
DK/REF
HARD ERROR: [IF LS21 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STEC:
MYR1STEC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (LS12-15). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STEC IS
BLANK.
IF MYR1STEC NE 0 AND NE AGE1STEC:
LSCC68
The computer recorded that you first used ‘Ecstasy’ in [LS18-21 fill]. That would make you
[MYR1STEC] years old when you first used ‘Ecstasy’. Is this correct?
4
Yes
6
No
DK/REF
LSCC69

[IF LSCC68 = 4] Earlier, the computer recorded that you were [AGE1STEC] years old when
you first used ‘Ecstasy’. Which answer is correct?
1
I first used ‘Ecstasy’ in [LS18-21 fill] when I was [MYR1STEC] years old
2
I was [AGE1STEC] years old the first time I used ‘Ecstasy’
3
Neither answer is correct
DK/REF

UPDATE: IF LSCC69 = 1, THEN AGE1STEC = MYR1STEC.
LSCC70

[IF LSCC69=2 OR LSCC69=3 OR LSCC68=6] Please answer this question again. Did you
first use ‘Ecstasy’ in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LSCC70a

[IF LSCC70 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[LSCC70] did you first use ‘Ecstasy’?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LSCC70a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LSCC70a NE (0 OR DK/REF) THEN UPDATE MYR1STEC.
MYR1STDC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (LSCC70 AND LSCC70a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STEC IS
BLANK. IF MYR1STEC = AGE1STEC THEN MYR1STEC = BLANK
LSCC71
May 23, 2012

[IF LSCC69 NE 1 AND MYR1STEC NE 0 AND (LSCC70 AND LSCC70a NE LS18-LS21)]
111

The computer recorded that you first used ‘Ecstasy’ in [LSCC70-LSCC70a fill]. That would
make you [MYR1STEC] years old when you first used ‘Ecstasy’. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF LSCC71 NE (6, BLANK OR DK/REF) AND (LSCC70 AND LSCC70a NE LS18-LS21) THEN AGE1STEC =
MYR1STEC
LS22

[IF (LS01f = 1 OR LSREF3 = 1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR LS01c = 1
OR LS01d = 1 OR LS01e = 1 OR LS01h = 1)] How long has it been since you last used ‘Ecstasy’, also known as
MDMA?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

DEFINE ECSTREC:
IF LS22 NE (BLANK OR DK/REF) THEN ECSTREC = LS22
ELSE ECSTREC = BLANK
IF ECSTREC < HALLREC:
LSCC52
The computer recorded that you last used ‘Ecstasy’ [ECSTREC FILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCC53

[IF LSCC52 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
I last used [LSFILL] [HALLREC FILL]
2
I last used ‘Ecstasy’ [ECSTREC FILL]
3
Neither answer is correct
DK/REF

LSCC54

[IF LSCC53 = 2 OR LSCC53 = 3] Please answer this question again. How long has it been
since you last used [LSFILL]?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

LSCC55

[IF LSCC52 =6 OR LSCC54 = 1 OR LSCC54 = 3] Please answer this question again. Think
only about ‘Ecstasy’. How long has it been since you last used ‘Ecstasy’, also known as
MDMA?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

UPDATE: IF LSCC54 NOT (BLANK OR DK/REF), THEN HALLREC = LSCC54
UPDATE: IF LSCC55 NOT (BLANK OR DK/REF), THEN ECSTREC = LSCC55
DEFINE LSFILL4:
IF HALLREC OR LSDREC OR PCPREC = 1 OR 2, LSFILL4 = "[LSFILL]"
ELSE IF ECSTREC = 1 OR 2, LSFILL4 = "’Ecstasy’’’ or any other hallucinogen"
LSFRAME6

May 23, 2012

[IF (HALLREC OR ECSTREC = 1 OR 2) AND LSFRAME3 = BLANK AND LSFRAME4 = BLANK AND
LSFRAME5 = BLANK] Now think about the past 12 months, from [DATEFILL] through today. We want
112

to know how many days you’ve used [LSFILL4] during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF
LSYRAV4

[IF LSFRAME6 = 3 OR DK/REF] On how many days in the past 12 months did you use [LSFILL4]?
TOTAL # OF DAYS:
DK/REF

LSMONAV4

[RANGE: 1 - 366]

[IF LSFRAME6 = 2 OR LSYRAV4 = DK/REF] On average, how many days did you use [LSFILL4] each
month during the past 12 months?
AVERAGE # OF DAYS PER MONTH:
DK/REF

LSWKAV4

[RANGE: 1 - 31]

[IF LSFRAME6 = 1 OR LSMONAV4 = DK/REF] On average, how many days did you use [LSFILL4]
each week during the past 12 months?
[RANGE: 1 - 7]

AVERAGE # OF DAYS PER WEEK:
DK/REF
LS32

[IF HALLREC = 1 OR ECSTREC = 1 AND LS04 = BLANK AND LS30 = BLANK AND LS31 = BLANK] Think
specifically about the past 30 days, from [DATEFILL] up to and including today. During the past 30 days, on how
many days did you use [LSFILL4]?
NUMBER OF DAYS:
DK/REF

LS32DKRE

[RANGE: 0 - 30]

[IF LS32 = DK/REF] What is your best estimate of the number of days you used [LSFILL4] during the
past 30 days?
1
2
3
4
5
6
DK/REF

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

DEFINE ESTILS:
IF LS32DKRE = 1, THEN
IF LS32DKRE = 2, THEN
IF LS32DKRE = 3, THEN
IF LS32DKRE = 4, THEN
IF LS32DKRE = 5, THEN
IF LS32DKRE = 6, THEN
ELSE ESTILS = BLANK

ESTILS = 1
ESTILS = 3
ESTILS = 6
ESTILS = 10
ESTILS = 20
ESTILS = 30

DEFINE HAL30DAY
IF LS32DKRE = 1, THEN HAL30DAY = “1 or 2"
IF LS32DKRE = 2, THEN HAL30DAY = “3 to 5"
IF LS32DKRE = 3, THEN HAL30DAY = “6 to 9"
IF LS32DKRE = 4, THEN HAL30DAY = “10 to 19"
IF LS32DKRE = 5, THEN HAL30DAY = “20 to 29"
IF LS32DKRE = 6, THEN HAL30DAY = “all 30"
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRAV4 NOT(BLANK OR DK/REF) THEN TOTHALL = LSYRAV4
ELSE IF LSMONAV4 NOT(BLANK OR DK/REF) THEN TOTHALL = LSMONAV4*12
May 23, 2012

113

ELSE IF LSWKAV4 NOT(BLANK OR DK/REF) THEN TOTHALL = LSWKAV4*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LS32 NE DK/REF OR BLANK AND LS32 > TOTHALL) OR (LS32 = DK/REF
AND ESTILS > TOTHALL)):
LSCC90a

[IF LS32 > TOTHALL] For the last question, the computer recorded that you used
[LSFILL4] on [LS32] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF

LSCC90b

[IF ESTILS > TOTHALL] For the last question, the computer recorded that you used
[LSFILL4] on [HAL30DAY] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF

DEFINE FILLHAL:
IF LSYRAV4 > 1, THEN FILLHAL = “[LSYRAV4] days”
ELSE IF LSYRAV4 = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONAV4 > 1, THEN FILLHAL = “[LSMONAV4] days per month”
ELSE IF LSMONAV4 = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKAV4 > 1, THEN FILLHAL = “[LSWKAV4] days per week”
ELSE IF LSWKAV4 = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONAV4] day(s) per month OR “[LSWKAV4] day(s) per week” THEN FILLHALA = “for a
total of TOTHALL days”
ELSE FILLHALA = BLANK
LSCC91

[IF LSCC90a = 4 OR LSCC90b = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
1
I used [LSFILL4] [FILLHAL] in the past 12 months [FILLHALA]
2
I used [LSFILL4] [LS32 / HAL30DAY] days in the past 30 days
3
Neither answer is correct
DK/REF

LSCC92

[IF LSCC91 = 2 OR LSCC91 = 3] Please answer this question again. Think about the past
12 months, from [DATEFILL] through today. We want to know how many days you’ve used
[LSFILL4] during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

LSCC93

[IF LSCC92 = 3] On how many days in the past 12 months did you use [LSFILL4]?
TOTAL # OF DAYS:
DK/REF

LSCC94

[IF LSCC92 = 2] On average, how many days did you use [LSFILL4] each month during the
past 12 months?
# OF DAYS/MONTH:
DK/REF

LSCC95

May 23, 2012

[RANGE: 1 - 366]

[RANGE: 1 - 31]

[IF LSCC92 = 1] On average, how many days did you use [LSFILL4] each week during the
past 12 months?
114

# OF DAYS PER WEEK:
DK/REF

[RANGE: 1 - 7]

IF LSCC93 NOT(BLANK OR DK/REF) THEN TOTHALL = LSCC93
ELSE IF LSCC94 NOT(BLANK OR DK/REF) THEN TOTHALL=LSCC94*12
ELSE IF LSCC95 NOT(BLANK OR DK/REF) THENTOTHALL=LSCC95*52
ELSE TOTHALL = DK/REF
LSCC96a

[IF LSCC90a = 6 OR ((LSCC91 = 1 OR LSCC91 = 3) AND LSCC90a NE BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30 days, on how many days did you
use [LSFILL4]?
# OF DAYS:
DK/REF

LSCC96b

[IF LSCC90b = 6 OR ((LSCC91 = 1 OR LSCC91 = 3) AND LSCC90b NE BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. What is your best estimate of the number of days
you used [LSFILL4] during the past 30 days?
1
2
3
4
5
6
DK/REF

IF LS32 = 0:
LSCC97

[RANGE: 0 - 30]

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

The computer recorded that you used [LSFILL4] on 0 days during the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF

LSCC98

[IF LSCC97 = 6] Please answer this question again. During the past 30 days, that is, since
[DATEFILL], on how many days did you use [LSFILL4]?
# OF DAYS:
DK/REF

May 23, 2012

[RANGE: 0 - 30]

115

May 23, 2012

116

Inhalants
INHINTRO

These next questions are about liquids, sprays, and gases that people sniff or inhale to get high or to make
them feel good.
We are not interested in times when you inhaled a substance accidentally — such as when painting, cleaning
an oven, or filling a car with gasoline. The questions use the word ‘inhalant’ to include all the things listed
below, as well as any other substances that people sniff or inhale for kicks or to get high. Take a moment to
look at the substances listed below so you know what kinds of liquids, sprays, and gases these questions are
about.
Amyl nitrite, ‘poppers,’ locker room odorizers, or ‘rush’
Correction fluid, degreaser, or cleaning fluid
Gasoline or lighter fluid
Glue, shoe polish, or toluene
Halothane, ether, or other anesthetics
Lacquer thinner, or other paint solvents
Lighter gases, such as butane or propane
Nitrous oxide or ‘whippits’
Spray paints
Other aerosol sprays
Press [ENTER] to continue.

IN01a

Have you ever, even once, inhaled amyl nitrite, ‘poppers,’ locker room odorizers, or ‘rush’ for kicks or to get high?
1
Yes
2
No
DK/REF

IN01b

Have you ever, even once, inhaled correction fluid, degreaser, or cleaning fluid for kicks or to get high?
1
Yes
2
No
DK/REF

IN01c

Have you ever, even once, inhaled gasoline or lighter fluid for kicks or to get high?
1
Yes
2
No
DK/REF

IN01d

Have you ever, even once, inhaled glue, shoe polish, or toluene for kicks or to get high?
1
Yes
2
No
DK/REF

IN01e

Have you ever, even once, inhaled halothane, ether, or other anesthetics for kicks or to get high?
1
Yes
2
No
DK/REF

IN01f

Have you ever, even once, inhaled lacquer thinner or other paint solvents for kicks or to get high?
1
Yes
2
No
DK/REF

IN01g

Have you ever, even once, inhaled lighter gases, such as butane or propane for kicks or to get high?
1
Yes
2
No
DK/REF

May 23, 2012

117

IN01h

Have you ever, even once, inhaled nitrous oxide or ‘whippits’ for kicks or to get high?
1
Yes
2
No
DK/REF

IN01i

Have you ever, even once, inhaled spray paints for kicks or to get high?
1
Yes
2
No
DK/REF

IN01j

Have you ever, even once, inhaled some other aerosol spray for kicks or to get high?
1
Yes
2
No
DK/REF

IN01l

Have you ever, even once used any other inhalants for kicks or to get high besides the ones that have been listed?
1
Yes
2
No
DK/REF

IN01OTH1

[IF IN01l = 1] Please type in the name of one of the other inhalants you have used. If you’re not sure how to
spell the name of the inhalant you used, just make your best guess.
When you have finished, press the [ENTER] key to go to the next question. Remember, you do not need to
type in the names of any inhalants that you already reported.
______________
DK/REF

IN01OTH2

[IF IN01OTH1 NE (BLANK OR DK/REF)] Please type in the name of any other inhalant you have used
other than those you have already mentioned. If you have not used any other inhalants, press the [ENTER]
key to go to the next question.
______________
DK/REF

IN01OTH3

[IF IN01OTH2 NE (BLANK OR DK/REF)] Please type in the name of any other inhalant you have used
other than those you have already mentioned. If you have not used any other inhalants, press the [ENTER]
key to go to the next question.
______________
DK/REF

IN01OTH4

[IF IN01OTH3 NE (BLANK OR DK/REF)] Please type in the name of any other inhalant you have used
other than those you have already mentioned. If you have not used any other inhalants, press the [ENTER]
key to go to the next question.
______________
DK/REF

IN01OTH5

[IF IN01OTH4 NE (BLANK OR DK/REF)] Please type in the name of any other inhalant you have used
other than those you have already mentioned. If you have not used any other inhalants, press the [ENTER]
key to go to the next question.
______________
DK/REF

INREF

[IF IN01a = REF AND IN01b = REF AND IN01c = REF AND IN01d = REF AND IN01e = REF AND IN01f = REF
AND IN01g = REF AND IN01h = REF AND IN01i = REF AND IN01j = REF AND IN01l = REF] The answers that
people give us about their use of inhalants are important to this study’s success. We know that this information is

May 23, 2012

118

personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever, even once, used any type of inhalant for kicks or to
get high?
1
Yes
2
No
DK/REF
IN02

[IF IN01a = 1 OR IN01b = 1 OR IN01c = 1 OR IN01d = 1 OR IN01e = 1 OR IN01f = 1 OR IN01g = 1 OR IN01h = 1
OR IN01i = 1 OR IN01j = 1 OR IN01l = 1 OR INREF = 1] How old were you the first time you used any inhalant for
kicks or to get high?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STIN:
IF IN02 NE (BLANK OR DK/REF) THEN AGE1STIN = IN02
ELSE AGE1STIN = BLANK
IF CURNTAGE < AGE1STIN:
INCC01
The computer recorded that you were [AGE1STIN] years old when you first used an inhalant
of any kind for kicks or to get high. Is this correct?
4
Yes
6
No
DK/REF
INCC02

[IF INCC01 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
2
3
DK/REF

INCC03

I am currently [CURNTAGE] years old
I was [AGE1STIN] years old the first time I used an inhalant of any kind for kicks
or to get high
Neither answer is correct

[IF INCC02=2 OR INCC02=3] Please answer this question again. What is your current
age?
AGE:
DK/REF

[RANGE: 1 - 110]

INCC03a

[IF INCC03 < 12] Since you have indicated that you are [INCC03] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

INCC04

[IF INCC02=1 OR INCC02=3 OR INCC01=6] Please answer this question again. Think
about the first time you used an inhalant of any kind for kicks or to get high. How old were
you the first time you used an inhalant for kicks or to get high?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF INCC04 NOT(BLANK OR DK/REF) THEN AGE1STIN = INCC04
UPDATE: IF INCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = INCC03
IF AGE1STIN = CURNTAGE OR AGE1STIN < 10:
INCC05
The computer recorded that you were [AGE1STIN] years old the first time you used an
inhalant of any kind for kicks or to get high. Is this correct?
4
Yes
6
No
DK/REF
May 23, 2012

119

INCC06

[IF INCC05=6] Please answer this question again. Think about the first time you used an
inhalant of any kind for kicks or to get high. How old were you the first time you used an
inhalant of any kind for kicks or to get high?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF IINCC06 NOT(BLANK OR DK/REF) THEN AGE1STIN = INCC06
IN03a

[IF INCC05 NE DK/RE AND INCC06 NE DK/REF AND AGE1STIN = CURNTAGE AND DATE OF INTERVIEW
< DOB OR IF AGE1STIN = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use an inhalant of
any kind for kicks or to get high in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

IN03b

[IF AGE1STIN = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use an inhalant of any kind
for kicks or to get high in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

IN03c

[IF INCC05 NE DK/RE AND INCC06 NE DK/REF AND AGE1STIN = CURNTAGE AND DATE OF INTERVIEW
 DOB] In what month in [CURRENT YEAR] did you first use an inhalant of any kind for kicks or to get high?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF IN03c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
IN03d

[IF IN03a = 1 OR 2 OR IN03b = 1 OR 2] In what month in [YEAR FROM IN03a or IN03b] did you first use an
inhalant of any kind for kicks or to get high?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF IN03d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
May 23, 2012

120

QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STIN:
MYR1STIN = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (IN03a-d). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STIN IS
BLANK.
IF MYR1STIN NE 0 AND NE AGE1STIN:
INCC17
The computer recorded that you first used an inhalant of any kind for kicks or to get high in
[IN03a-d fill]. That would make you [MYR1STIN] years old when you first used an inhalant
of any kind for kicks or to get high. Is this correct?
4
Yes
6
No
DK/REF
INCC18

[IF INCC17 = 4] Earlier, the computer recorded that you were [AGE1STIN] years old when
you first used an inhalant of any kind for kicks or to get high. Which answer is correct?
1
2
3
DK/REF

I first used an inhalant of any kind for kicks or to get high in [IN03a-d fill] when I
was [MYR1STIN] years old
I was [AGE1STIN] years old the first time I used an inhalant of any kind for kicks
or to get high.
Neither answer is correct

UPDATE: IF INCC18 = 1, THEN AGE1STIN = MYR1STIN.
INCC19

[IF INCC18=2 OR INCC18=3 OR INCC17=6] Please answer this question again. Did you
first use an inhalant of any kind for kicks or to get high in [CURRENT YEAR-2], [CURRENT
YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

INCC19a

[IF INCC19 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[INCC19] did you first use an inhalant of any kind for kicks or to get high?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF INCC19a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF INCC19a NE (0 OR DK/REF) THEN UPDATE MYR1STIN.
MYR1STIN = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (INCC19 AND INCC19a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STIN IS
BLANK. IF MYR1STIN = AGE1STIN THEN MYR1STIN = BLANK
INCC20

May 23, 2012

[IF INCC18 NE 1 AND MYR1STIN NE 0 AND (INCC19 AND INCC19a NE IN03a-d)] The
computer recorded that you first used an inhalant of any kind for kicks or to get high in
121

[INCC19-INCC19a fill]. That would make you [MYR1STIN] years old when you first used
an inhalant of any kind for kicks or to get high. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF INCC20 NE (6, BLANK OR DK/REF) AND (INCC19 AND INCC19a NE IN03a-d) THEN AGE1STIN =
MYR1STIN
INLAST

[IF IN01a = 1 OR IN01b = 1 OR IN01c = 1 OR IN01d = 1 OR IN01e = 1 OR IN01f = 1 OR IN01g = 1 OR
IN01h = 1 OR IN01i = 1 OR IN01j = 1 OR IN01L = 1 OR INREF = 1] How long has it been since you last
used any inhalant for kicks or to get high?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but with the past 12 months
3
More than 12 months ago
DK/REF

INRECDK

[IF INLAST = DK] What is your best guess of how long it has been since you last used any inhalant for
kicks or to get high?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

INRECRE

[IF INLAST = REF] The answers that people give us about their use of inhalants are important to this
study’s success. We know that this information is personal, but remember your answers will be kept
confidential.
Please think again about answering this question: How long has it been since you last used any inhalant for
kicks or to get high?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

INFRAME3

[IF INLAST = 1 OR 2 OR INRECDK = 1 OR 2 OR INRECRE = 1 OR 2] Now think about the past 12
months, from [DATEFILL] through today. We want to know how many days you’ve used an inhalant of any
kind for kicks or to get high during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve done this?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

INYRAVE

[IF INFRAME 3 = 3 OR DK/REF] On how many days in the past 12 months did you use an inhalant of any
kind for kicks or to get high?
TOTAL # OF DAYS:
DK/REF

INMONAVE

[RANGE: 1 - 366]

[IF INFRAME3 = 2 OR INYRAVE = DK/REF] On average, how many days did you use an inhalant of any
kind for kicks or to get high each month during the past 12 months?
[RANGE: 1 - 31]

AVERAGE # OF DAYS PER MONTH:
DK/REF
INWKAVE

May 23, 2012

[IF INFRAME3 = 1 OR INMONAVE = DK/REF] On average, how many days did you use an inhalant of
any kind for kicks or to get high each week during the past 12 months?

122

AVERAGE # OF DAYS PER WEEK:
DK/REF
IN06

[RANGE: 1 - 7]

[IF INLAST=1 OR INRECDK = 1 OR INRECRE = 1] Think specifically about the past 30 days, from [DATEFILL]
up to and including today. During the past 30 days, on how many days did you use any inhalant for kicks or to get
high?
[RANGE: 0 - 30]

NUMBER OF DAYS:
DK/REF
IN06DKRE

[IF IN06 = DK/REF] What is your best estimate of the number of days you used any inhalant for kicks or to
get high during the past 30 days?
1
2
3
4
5
6
DK/REF

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

DEFINE ESTIIN:
IF IN06DKRE = 1, THEN ESTIIN = 1
IF IN06DKRE = 2, THEN ESTIIN = 3
IF IN06DKRE = 3, THEN ESTIIN = 6
IF IN06DKRE = 4, THEN ESTIIN = 10
IF IN06DKRE = 5, THEN ESTIIN = 20
IF IN06DKRE = 6, THEN ESTIIN = 30
ELSE ESTIIN = BLANK
DEFINE INH30DAY
IF IN06DKRE = 1, THEN INH30DAY = “1 or 2"
IF IN06DKRE = 2, THEN INH30DAY = “3 to 5"
IF IN06DKRE = 3, THEN INH30DAY = “6 to 9"
IF IN06DKRE = 4, THEN INH30DAY = “10 to 19"
IF IN06DKRE = 5, THEN INH30DAY = “20 to 29"
IF IN06DKRE = 6, THEN INH30DAY = “all 30"
ELSE INH30DAY = BLANK
DEFINE TOTINHAL:
IF INYRAVE NOT(BLANK OR DK/REF) THEN TOTINHAL = INYRAVE
ELSE IF INMONAVE NOT(BLANK OR DK/REF) THEN TOTINHAL=INMONAVE*12
ELSE IF INWKAVE NOT(BLANK OR DK/REF) THEN TOTINHAL=INWKAVE*52
ELSE TOTINHAL = DK/REF
IF TOTINHAL NOT DK/REF AND ((IN06 NE DK/REF OR BLANK AND IN06 > TOTINHAL)) OR (IN06 =
DK/REF AND ESTIIN > TOTINHAL:
INCC07a
[IF IN06 > TOTINHAL] For the last question, the computer recorded that you used an
inhalant for kicks or to get high on [IN06] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
INCC07b

[IF ESTIIN > TOTINHAL] For the last question, the computer recorded that you used an
inhalant for kicks or to get high on [INH30DAY] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF

DEFINE FILLINH:
IF INYRAVE > 1, THEN FILLINH = “[INYRAVE] days”
ELSE IF INYRAVE = 1, THEN FILLINH = “1 day”
ELSE IF INMONAVE > 1, THEN FILLINH = “[INMONAVE] days per month”
May 23, 2012

123

ELSE IF INMONAVE = 1, THEN FILLINH = “1 day per month”
ELSE IF INWKAVE > 1, THEN FILLINH = “[INWKAVE] days per week”
ELSE IF INWKAVE = 1, THEN FILLINH = “1 day per week”
ELSE IF INMONAVE NOT (BLANK OR DK/REF), THEN FILLINH = “[INMONAVE] days per month”
ELSE IF INWKAVE NOT (BLANK OR DK/REF), THEN FILLINH = “[INWKAVE] days per week”
DEFINE FILLINHA:
IF FILLINH = “[INMONAVE] day(s) per month” OR “[INWKAVE] day(s) per week” THEN FILLINHA = “for a
total of [TOTINHAL] days”
ELSE FILLINHA = BLANK
INCC08

[IF INCC07a = 4 OR INCC07b = 4] The answers for the last question and an earlier question
disagree. Which answer is correct?
1
2
3
DK/REF

INCC09

I used an inhalant for kicks or to get high on [FILLINH] days in the past 12 months
[FILLINHA]
I used an inhalant for kicks or to get high on [IN06 / INH30DAY] days in the past
30 days
Neither answer is correct

[IF INCC08 = 2 OR INCC08 = 3] Please answer this question again. Think about the past 12
months, from [DATEFILL] through today. We want to know how many days you’ve used an
inhalant of any kind for kicks or to get high during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

INCC10

[IF INCC09 = 3] On how many days in the past 12 months did you use an inhalant of any
kind for kicks or to get high?
[RANGE: 1 - 366]

TOTAL # OF DAYS:
DK/REF
INCC11

[IF INCC09 = 2] On average, how many days did you use an inhalant of any kind for kicks or
to get high each month during the past 12 months?
# OF DAYS/MONTH:
DK/REF

INCC12

[RANGE: 1 - 31]

[IF INCC09 = 1] On average, how many days did you use an inhalant of any kind for kicks or
to get high each week during the past 12 months?
# OF DAYS PER WEEK:
DK/REF

[RANGE: 1 - 7]

IF INCC10 NOT(BLANK OR DK/REF) THEN TOTINHAL = INCC10
ELSE IF INCC11 NOT(BLANK OR DK/REF) THEN TOTINHAL= INCC11*12
ELSE IF INCC12 NOT(BLANK OR DK/REF) THEN TOTINHAL= INCC12*52
ELSE TOTINHAL = DK/REF
INCC13a

[IF INCC07a = 6 OR ((INCC08 = 1 OR INCC08 = 3) AND INCC07a NE BLANK OR
DK/REF)] Please answer this question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. During the past 30 days, on how many days did you
use any inhalant for kicks or to get high?
# OF DAYS:
DK/REF

INCC13b
May 23, 2012

[RANGE: 0 - 30]

[IF INCC07b = 6 OR ((INCC08 = 1 OR 3) AND INCC07b NE BLANK OR DK/REF)] Please
124

answer this question again. Think specifically about the past 30 days, from [DATEFILL] up
to and including today. What is your best estimate of the number of days you used any
inhalant for kicks or to get high during the past 30 days?
1
2
3
4
5
6
DK/REF
IF IN06 = 0:
INCC14

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days

The computer recorded that you used an inhalant for kicks or to get high on 0 days during the
past 30 days. Is this correct?
4
Yes
6
No
DK/REF

INCC16

[IF INCC14 = 6] Please answer this question again. During the past 30 days, that is, since
[DATEFILL], on how many days did you use an inhalant of any kind for kicks or to get high?
# OF DAYS:
DK/REF

INTRPILL

[RANGE: 0 - 30]

Now we have some questions about drugs that people are supposed to take only if they have a prescription
from a doctor.
We are only interested in your use of a drug if:
• the drug was not prescribed for you, or
• you took the drug only for the experience or feeling it caused.
Press [ENTER] to continue.

May 23, 2012

125

May 23, 2012

126

Pain Relievers
INTROPR1

These questions are about the use of pain relievers. We are not interested in your use of “over-the-counter”
pain relievers such as aspirin, Tylenol, or Advil that can be bought in drug stores or grocery stores without a
doctor’s prescription.
Ask your interviewer to show you Card A.
Press [ENTER] to continue.

INTROPR2

Card A shows pictures of some different kinds of prescription pain relievers and lists the names of some
others. These pictures show only pills, but we are interested in your use of any form of prescription pain
relievers that were not prescribed for you or that you took only for the experience or feeling they caused.
Please look at Card A carefully as you answer the next questions.
Press [ENTER] to continue.

PR01

Please look at the pain relievers shown in Box 1 above the red line on Card A.
Have you ever, even once, used Darvocet, Darvon, or Tylenol with codeine that was not prescribed for you or that
you took only for the experience or feeling it caused?
1
Yes
2
No
DK/REF

PR02

Please look at the pain relievers shown in Box 2.
Have you ever, even once, used Percocet, Percodan, or Tylox that was not prescribed for you or that you took only
for the experience or feeling it caused?
1
Yes
2
No
DK/REF

PR03

Please look at the pain relievers shown in Box 3.
Have you ever, even once, used Vicodin, Lortab, or Lorcet that was not prescribed for you or that you took only for
the experience or feeling it caused?
1
Yes
2
No
DK/REF

PR04

Please look at the pain relievers shown below the red line on Card A.
Have you ever, even once, used any of these pain relievers when they were not prescribed for you or that you took only
for the experience or feeling they caused?
1
Yes
2
No
DK/REF

PR04a

[IF PR04 = 1] Which of the pain relievers shown below the red line on Card A have you used when they were not
prescribed for you or that you took only for the experience or feeling they caused?
To select more than one drug from the list, press the space bar between each number you type. When you have
finished, press [ENTER].
4
5
6
7
8

May 23, 2012

Codeine
Demerol
Dilaudid
Fioricet
Fiorinal
127

9
10
11
12
13
14
15
16
17
18
19
20
21
DK/REF
PR05

Hydrocodone
Methadone
Morphine
OxyContin
Phenaphen with Codeine
Propoxyphene
SK-65
Stadol
Talacen
Talwin
Talwin NX
Tramadol
Ultram

Have you ever, even once, used any other prescription pain reliever, besides the ones shown on Card A, when it was
not prescribed for you or that you took only for the experience or feeling it caused?
1
Yes
2
No
DK/REF

PR05a

[IF PR05 = 1] Please type in the name of one of the other prescription pain relievers you have used other than the
ones on Card A. If you’re not sure how to spell the name of the pain reliever you used, just make your best guess.
When you have finished, press the [ENTER] key to go to the next question. Remember, you do not need to type in the
names of any prescription pain relievers you already reported.
______________
DK/REF

PR05b

[IF PR05a NE (BLANK OR DK/REF)] Please type in the name of any other prescription pain reliever you have
used when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not
used any other prescription pain relievers, press the [ENTER] key to go to the next question.
______________
DK/REF

PR05c

[IF PR05b NE (BLANK OR DK/REF)] Please type in the name of any other prescription pain reliever you have
used when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not
used any other prescription pain relievers, press the [ENTER] key to go to the next question.
______________
DK/REF

PR05d

[IF PR05c NE (BLANK OR DK/REF)] Please type in the name of any other prescription pain reliever you have
used when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not
used any other prescription pain relievers, press the [ENTER] key to go to the next question.
______________
DK/REF

PR05e

[IF PR05d NE (BLANK OR DK/REF)] Please type in the name of any other prescription pain reliever you have
used when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not
used any other prescription pain relievers, press the [ENTER] key to go to the next question.
______________
DK/REF

PRREF [IF PR01 = REF AND PR02 = REF AND PR03 = REF AND PR04 = REF AND PR05 = REF] The answers that
people give us about their use of prescription pain relievers are important to this study’s success. We know that this
information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever, even once, used any type of prescription pain
reliever that was not prescribed for you or that you took only for the experience or feeling it caused?
May 23, 2012

128

1
Yes
2
No
DK/REF
PR06

[IF (PR04a = 12 AND (PR01 = 1 OR PR02 = 1 OR PR03 = 1 OR PR04a = (4-11, 13-21) OR PR05 = 1)) OR ((PR04a
NE 12) AND (PR01 = 1 OR PR02 = 1 OR PR03 = 1 OR PR04 = 1 OR PR05 = 1 OR PRREF = 1))] How old were you
the first time you used any prescription pain reliever that was not prescribed for you or that you took only for the
experience or feeling it caused?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STPR:
IF PR06 NE (BLANK OR DK/REF) THEN AGE1STPR = PR06
ELSE AGE1STPR = BLANK
IF CURNTAGE < AGE1STPR
PRCC01

The computer recorded that you were [AGE1STPR] years old when you first used any
prescription pain reliever that was not prescribed for you or that you took only for the
experience or feeling it caused. Is this correct?
4
Yes
6
No
DK/REF

PRCC02

[IF PRCC01 = 4]The answers for the last question and an earlier question disagree. Which
answer is correct?
1
2

3
DK/REF
PRCC03

I am currently [CURNTAGE] years old
I was [AGE1STPR] years old the first time I used any prescription pain reliever
that was not prescribed for me or that I took only for the experience or feeling it
caused
Neither answer is correct

[IF PRCC02=2 OR PRCC02=3] Please answer this question again. What is your current
age?
[RANGE: 1-110]

AGE:
DK/REF
PRCC03a

[IF PRCC03 < 12] Since you have indicated that you are [PRCC03] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

PRCC04

[IF PRCC02=1 OR PRCC02=3 OR PRCC01=6] Please answer this question again. Think
about the first time you used any prescription pain reliever that was not prescribed for you or
that you took only for the experience or feeling it caused. How old were you the first time you
used a prescription pain reliever in either of these ways?
[RANGE: 1 - 110]

AGE:
DK/REF

UPDATE: IF PRCC04 NOT(BLANK OR DK/REF) THEN AGE1STPR = PRCC04
UPDATE: IF PRCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = PRCC03
IF AGE1STPR = CURNTAGE OR AGE1STPR <10:
PRCC05
The computer recorded that you were [AGE1STPR] years old the first time you used any
prescription pain reliever that was not prescribed for you or that you took only for the
experience or feeling it caused. Is this correct?
4
6
May 23, 2012

Yes
No
129

DK/REF
PRCC06

[IF PRCC05=6] Please answer this question again. Think about the first time you used any
prescription pain reliever that was not prescribed for you or that you took only for the
experience or feeling it caused. How old were you the first time you used a prescription pain
reliever in either of these ways?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF PRCC06 NOT(BLANK OR DK/REF) THEN AGE1STPR = PRCC06
PR07a

[IF PRCC05 NE DK/RE AND PRCC06 NE DK/REF AND AGE1STPR = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STPR = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use
any prescription pain reliever that was not prescribed for you or that you took only for the experience or feeling it
caused in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

PR07b

[IF AGE1STPR = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use any prescription pain
reliever that was not prescribed for you or that you took only for the experience or feeling it caused in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

PR08a

[IF PRCC05 NE DK/RE AND PRCC06 NE DK/REF AND AGE1STPR = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use any prescription pain reliever that was
not prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF PR08a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
PR08b

[IF PR07a = 1 OR 2 OR PR07b = 1 OR 2] In what month in [YEAR FROM PR07a or PR07b] did you first use any
prescription pain reliever that was not prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11

May 23, 2012

January
February
March
April
May
June
July
August
September
October
November
130

12
December
DK/REF
HARD ERROR: [IF PR08b > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STPR:
MYR1STPR = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (PR07a-08b). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STPR
IS BLANK.
IF MYR1STPR NE 0 AND NE AGE1STPR:
PRCC07
The computer recorded that you first used any prescription pain reliever that was not
prescribed for you or that you took only for the experience or feeling it caused in [PR07a-08b
fill]. That would make you [MYR1STPR] years old when you first used a prescription pain
reliever in either of these ways. Is this correct?
4
Yes
6
No
DK/REF
PRCC08

[IF PRCC07 = 4] Earlier, the computer recorded that you were [AGE1STPR] years old when
you first used any prescription pain reliever that was not prescribed for you or that you took
only for the experience or feeling it caused. Which answer is correct?
1

2

3
DK/REF

I first used any prescription pain reliever that was not prescribed for me or that I
took only for the experience or feeling it caused in [PR07a-08b fill] when I was
[MYR1STPR] years old
I was [AGE1STPR] years old the first time I used any prescription pain reliever
that was not prescribed for me or that I took only for the experience or feeling it
caused
Neither answer is correct

UPDATE: IF PRCC08 = 1, THEN AGE1STPR = MYR1STPR
PRCC09

[IF PRCC08=2 OR PRCC08=3 OR PRCC07=6] Please answer this question again. Did you
first use any prescription pain reliever that was not prescribed for you or that you took only
for the experience or feeling it caused in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

PRCC09a

[IF PRCC09 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [PRCC09] did you first use any prescription pain reliever that was not prescribed for you
or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

May 23, 2012

January
February
March
April
May
June
July
August
September
October
November
December

131

HARD ERROR: [IF PRCC09a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF PRCC09a NE (0 OR DK/REF) THEN UPDATE MYR1STPR.
MYR1STPR = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (PRCC09 AND PRCC09a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STPR IS
BLANK. IF MYR1STPR = AGE1STPR THEN MYR1STPR = BLANK
PRCC10

[IF PRCC08 NE 1 AND MYR1STPR NE 0 AND (PRCC09 AND PRCC09a NE PR07aPR08b)] The computer recorded that you first used any prescription pain reliever that was not
prescribed for you or that you took only for the experience or feeling it caused in [PRCC09PRCC09a fill]. That would make you [MYR1STPR] years old when you first used any
prescription pain reliever in either of these ways. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF PRCC10 NE (6, BLANK OR DK/REF) AND (PRCC09 AND PRCC09a NE PR07a-PR08b) THEN AGE1STPR =
MYR1STPR
PR09

[IF (PR04a = 12 AND (PR01 = 1 OR PR02 = 1 OR PR03 = 1 OR PR04a = (4-11, 13-21) OR PR05 = 1)) OR ((PR04a
NE 12) AND (PR01 = 1 OR PR02 = 1 OR PR03 = 1 OR PR04 = 1 OR PR05 = 1 OR PRREF = 1))] How long has it
been since you last used any prescription pain reliever that was not prescribed for you or that you took only for the
experience or feeling it caused?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

PRRECDK

[IF PR09 = DK] What is your best guess of how long it has been since you last used any prescription pain
reliever that was not prescribed for you or that you took only for the experience or feeling it caused?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

PRRECRE

[IF PR09 = REF] The answers that people give us about their use of prescription pain relievers are important
to this study’s success. We know that this information is personal, but remember your answers will be kept
confidential.
Please think again about answering this question: How long has it been since you last used any prescription
pain reliever that was not prescribed for you or that you took only for the experience or feeling it caused?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

DEFINE PRREC:
IF PR09 = 1 OR PRRECDK = 1 OR PRRECRE = 1, THEN PRREC = 1
IF PR09 = 2 OR PRRECDK = 2 OR PRRECRE = 2, THEN PRREC = 2
IF PR09 = 3 OR PRRECDK = 3 OR PRRECRE = 3, THEN PRREC = 3
ELSE PRREC = BLANK
PR10

[IF PR09 = 1 OR 2 OR PRRECDK = 1 OR 2 OR PRRECRE = 1 OR 2] Now think about the past 12 months, from
[DATEFILL] through today. We want to know how many days you’ve used any prescription pain reliever that was
not prescribed for you or that you took only for the experience or feeling it caused during the past 12 months.
What would be the easiest way for you to tell us how many days you used a prescription pain reliever in either of these
ways?

May 23, 2012

132

1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF
PR11

[IF PR10 = 3 OR DK/REF] On how many days in the past 12 months did you use any prescription pain reliever that
was not prescribed for you or that you took only for the experience or feeling it caused?
TOTAL # OF DAYS:
DK/REF

PR12

[RANGE: 1 - 366]

[IF PR10 = 2 OR PR11 = DK/REF] On average, how many days each month during the past 12 months did you use
any prescription pain reliever that was not prescribed for you or that you took only for the experience or feeling it
caused?
[RANGE: 1 - 31]

AVG # OF DAYS PER MONTH:
DK/REF
PR13

[IF PR10 = 1 OR PR12 = DK/REF] On average, how many days each week during the past 12 months did you use any
prescription pain reliever that was not prescribed for you or that you took only for the experience or feeling it caused?
AVG # OF DAYS PER WEEK:
DK/REF

PR14

[RANGE: 1 - 7]

[IF PR04a = 12 AND (PR01 = 1 OR PR02 = 1 OR PR03 = 1 OR PR04a = (4-11 OR 13-21) OR PR05 = 1)] Now think
only about your use of OxyContin that was not prescribed for you or that you took only for the experience or feeling it
caused. How old were you the first time you used OxyContin in either of these ways?
[IF PR04a = 12 AND (PR01 = 2 OR DK/REF AND PR02 = 2 OR DK/REF AND PR03 =2 OR DK/REF AND PR04a
NE (4-11 AND 13-21) AND PR05 = 2 OR DK/REF)] How old were you the first time you used OxyContin that was
not prescribed for you or that you took only for the experience or feeling it caused?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STOX:
IF PR14 NE (BLANK OR DK/REF) THEN AGE1STOX = PR14
ELSE AGE1STOX = BLANK
IF CURNTAGE < AGE1STOX
PRCC11
The computer recorded that you were [AGE1STOX] years old when you first used OxyContin
that was not prescribed for you or that you took only for the experience or feeling it caused. Is
this correct?
4
Yes
6
No
DK/REF
PRCC12

[IF PRCC11 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
2
3
DK/REF

PRCC13

[IF PRCC12=2 OR PRCC12=3] Please answer this question again. What is your current
age?
AGE:
DK/REF

PRCC13a

May 23, 2012

I am currently [CURNTAGE] years old
I was [AGE1STOX] years old the first time I used OxyContin that was not
prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct

[RANGE: 1-110]

[IF PRCC13 < 12] Since you have indicated that you are [PRCC13] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
133

Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.
PRCC14

[IF PRCC12=1 OR PRCC12=3 OR PRCC11=6] Please answer this question again. Think
about the first time you used OxyContin that was not prescribed for you or that you took only
for the experience or feeling it caused. How old were you the first time you used OxyContin
in either of these ways?
[RANGE: 1 - 110]

AGE:
DK/REF

UPDATE: IF PRCC14 NOT(BLANK OR DK/REF) THEN AGE1STOX = PRCC14
UPDATE: IF PRCC13 NOT(BLANK OR DK/REF) THEN CURNTAGE = PRCC13
IF AGE1STOX= CURNTAGE OR AGE1STOX <10:
PRCC15
The computer recorded that you were [AGE1STOX] years old the first time you used
OxyContin that was not prescribed for you or that you took only for the experience or feeling
it caused. Is this correct?
4
Yes
6
No
DK/REF
PRCC16

[IF PRCC15=6] Please answer this question again. Think about the first time you used
OxyContin that was not prescribed for you or that you took only for the experience or feeling
it caused. How old were you the first time you used OxyContin in either of these ways?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF PRCC16 NOT(BLANK OR DK/REF) THEN AGE1STOX = PRCC16
IF AGE1STOX < AGE1STPR:
PRCC17
The answers for the last question and an earlier question disagree. Which answer is correct?
1

2
3
DK/REF
PRCC18

[IF PRCC17 = 2 OR PRCC17 = 3] Please answer this question again. Think about the first
time you used any prescription pain reliever that was not prescribed for you or that you took
only for the experience or feeling it caused. How old were you the first time you used a
prescription pain reliever in either of these ways?
AGE:
DK/REF

PRCC19

I was [AGE1STPR] years old the first time I used any prescription pain reliever
that was not prescribed for me or that I took only for the experience or feeling it
caused
I was [AGE1STOX] years old the first time I used OxyContin that was not
prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct

[RANGE: 1 - 110]

[IF PRCC17 =1 OR PRCC17 =3] Please answer this question again. Think about the first
time you used OxyContin that was not prescribed for you or that you took only for the
experience or feeling it caused. How old were you the first time you used OxyContin in either
of these ways?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF PRCC18 NOT (BLANK OR DK/REF) THEN AGE1STST = PRCC18
UPDATE: IF PRCC19 NOT (BLANK OR DK/REF) THEN AGE1STOX = PRCC19
PR15

[IF PRCC15 NE DK/RE AND PRCC16 NE DK/REF AND (AGE1STOX = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STOX = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB)] Did you first

May 23, 2012

134

use OxyContin that was not prescribed for you or that you took only for the experience or feeling it caused in
[CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
PR16

[IF AGE1STOX = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use OxyContin that was not
prescribed for you or that you took only for the experience or feeling it caused in [CURRENT YEAR - 2] OR
[CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

PR17

[IF PRCC15 NE DK/RE AND PRCC16 NE DK/REF AND AGE1STOX = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use OxyContin that was not prescribed for
you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF PR17 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
PR18

[IF PR15 = 1 OR 2 OR PR16 = 1 OR 2] In what month in [YEAR FROM PR15 or PR16] did you first use
OxyContin that was not prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF PR18 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STOX:
MYR1STOX = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (PR15-18). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STOX IS
BLANK.
IF MYR1STOX NE 0 AND NE AGE1STOX:
PRCC20
The computer recorded that you first used OxyContin that was not prescribed for you or that
May 23, 2012

135

you took only for the experience or feeling it caused in [PR15-18 fill]. That would make you
[MYR1STOX] years old when you first used OxyContin in either of these ways. Is this
correct?
4
Yes
6
No
DK/REF
PRCC21

[IF PRCC20 = 4] Earlier, the computer recorded that you were [AGE1STOX] years old when
you first used OxyContin that was not prescribed for you or that you took only for the
experience or feeling it caused. Which answer is correct?
1

2
3
DK/REF

I first used OxyContin that was not prescribed for me or that I took only for the
experience or feeling it caused in [PR15-18 fill] when I was [MYR1STOX] years
old
I was [AGE1STOX] years old the first time I used OxyContin that was not
prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct

UPDATE: IF PRCC21 = 1, THEN AGE1STOX = MYR1STOX.
PRCC22

[IF PRCC21=2 OR PRCC21=3 OR PRCC20=6] Please answer this question again. Did you
first use OxyContin that was not prescribed for you or that you took only for the experience or
feeling it caused in [CURRENT YEAR-2], [CURRENT YEAR-1] or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

PRCC22a

[IF PRCC22 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [PRCC22] did you first use OxyContin that was not prescribed for you or that you took only
for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF PRCC22a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF PRCC22a NE (0 OR DK/REF) THEN UPDATE MYR1STOX.
MYR1STOX = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (PRCC22 AND PRCC22a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STOX IS
BLANK. IF MYR1STOX = AGE1STOX THEN MYR1STOX = BLANK
PRCC23

[IF PRCC21 NE 1 AND MYR1STOX NE 0 AND (PRCC22 AND PRCC22a NE PR15-PR18)]
The computer recorded that you first used OxyContin that was not prescribed for you or that
you took only for the experience or feeling it caused in [PRCC22-PRCC22a fill]. That would
make you [MYR1STOX] years old when you first used OxyContin in either of these ways. Is
this correct?
4

May 23, 2012

Yes
136

6
No
DK/REF
UPDATE: IF PRCC23 NE (6, BLANK OR DK/REF) AND (PRCC22 AND PRCC22a NE PR15-PR18) THEN AGE1STOX =
MYR1STOX
PR19

[IF PR14 NE BLANK] How long has it been since you last used OxyContin that was not prescribed for you or that you
took only for the experience or feeling it caused?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

DEFINE OXYREC:
IF PR19 NE DK/REF, THEN OXYREC = PR19
ELSE, OXYREC = BLANK
IF OXYREC < PRREC:
PRCC24
The computer recorded that you last used OxyContin that was not prescribed for you or that
you took only for the experience or feeling it caused [OXYREC FILL]. Is this correct?
4
Yes
6
No
DK/REF
PRCC25

[IF PRCC24=4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1

2
3
DK/REF
PRCC26

I last used any prescription pain reliever that was not prescribed for me or that I
took only for the experience or feeling it caused [PR09/PRRECDK/PRRECRE
FILL]
I last used OxyContin that was not prescribed for me or that I took only for the
experience or feeling it caused [OXYREC FILL]
Neither answer is correct

[IF PRCC25 = 2 OR PRCC25 = 3] Please answer this question again. How long has it been
since you last used any prescription pain reliever that was not prescribed for you or that you
took only for the experience or feeling it caused?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

PRCC27

[IF PRCC24 =6 OR PRCC25 = 1 OR PRCC25 = 3] Please answer this question again.
Think only about OxyContin. How long has it been since you last used OxyContin that was
not prescribed for you or that you took only for the experience or feeling it caused?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

UPDATE: IF PRCC26 NOT (BLANK OR DK/REF) THEN PRREC = PRCC26
UPDATE: IF PRCC27 NOT (BLANK OR DK/REF) THEN OXYREC = PRCC27
PR10a

[IF PRREC NE BLANK AND OXYREC = 1 OR 2 AND PR10 = BLANK] Now think about the past 12 months, from
[DATEFILL] through today. We want to know how many days you’ve used any prescription pain reliever that was
not prescribed for you or that you took only for the experience or feeling it caused during the past 12 months.
What would be the easiest way for you to tell us how many days you used a prescription pain reliever in either of these
ways?

May 23, 2012

137

1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF
PR11a

[IF PR10a = 3 OR DK/REF] On how many days in the past 12 months did you use any prescription pain reliever that
was not prescribed for you or that you took only for the experience or feeling it caused?
TOTAL # OF DAYS:
DK/REF

PR12a

[RANGE: 1 - 366]

[IF PR10a = 2 OR PR11a = DK/REF] On average, how many days each month during the past 12 months did you use
any prescription pain reliever that was not prescribed for you or that you took only for the experience or feeling it
caused?
AVG # OF DAYS PER MONTH:
DK/REF

PR13a

[IF PR10a = 1 OR PR12a = DK/REF] On average, how many days each week during the past 12 months did you use
any prescription pain reliever that was not prescribed for you or that you took only for the experience or feeling it
caused?
[RANGE: 1 - 7]

AVG # OF DAYS PER WEEK:
DK/REF
PR20

[RANGE: 1 - 31]

[IF OXYREC = 1 OR 2] Now think about the past 12 months, from [DATEFILL] through today. We want to know
how many days you’ve used OxyContin that was not prescribed for you or that you took only for the experience or
feeling it caused during the past 12 months.
What would be the easiest way for you to tell us how many days you used OxyContin in either of these ways?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

PR21

[IF PR20 = 3 OR DK/REF] On how many days in the past 12 months did you use OxyContin that was not prescribed
for you or that you took only for the experience or feeling it caused?
TOTAL # OF DAYS:
DK/REF

PR22

[RANGE: 1 - 366]

[IF PR20 = 2 OR PR21 = DK/REF] On average, how many days each month during the past 12 months did you use
OxyContin that was not prescribed for you or that you took only for the experience or feeling it caused?
AVG # OF DAYS PER MONTH:
DK/REF

PR23

[RANGE: 1 - 31]

[IF PR20 = 1 OR PR22 = DK/REF] On average, how many days each week during the past 12 months did you use
OxyContin that was not prescribed for you or that you took only for the experience or feeling it caused?
AVG # OF DAYS PER WEEK:
DK/REF

May 23, 2012

[RANGE: 1 - 7]

138

Tranquilizers
INTROTR1

These next questions ask about the use of tranquilizers. Tranquilizers are usually prescribed to relax people,
to calm people down, to relieve anxiety, or to relax muscle spasms. Some people call tranquilizers ‘nerve
pills.’
Ask your interviewer to show you Card B.
Press [ENTER] to continue.

INTROTR2

Card B shows pictures of some different kinds of prescription tranquilizers. These pictures show only pills,
but we are interested in your use of any form of prescription tranquilizers that were not prescribed for you or
that you took only for the experience or feeling they caused.
Please look at Card B carefully as you answer the next questions.
Press [ENTER] to continue.

TR01

Please look at the tranquilizers shown in Box 1 above the red line on Card B.
Have you ever, even once, used Klonopin or Clonazepam that was not prescribed for you or that you took only for
the experience or feeling it caused?
1
Yes
2
No
DK/REF

TR02

Please look at the tranquilizers shown in Box 2.
Have you ever, even once, used Xanax, Alprazolam, Ativan, or Lorazepam that was not prescribed for you or that
you took only for the experience or feeling it caused?
1
Yes
2
No
DK/REF

TR03

Please look at the tranquilizers shown in Box 3.
Have you ever, even once, used Valium or Diazepam that was not prescribed for you or that you took only for the
experience or feeling it caused?
1
Yes
2
No
DK/REF

TR04

Please look at the tranquilizers shown below the red line on Card B.
Have you ever, even once, used any of these tranquilizers when they were not prescribed for you or that you took only
for the experience or feeling they caused?
1
Yes
2
No
DK/REF

TR04a

[IF TR04 = 1] Which of the tranquilizers shown below the red line on Card B have you used when they were not
prescribed for you or that you took only for the experience or feeling they caused?
To select more than one drug from the list, press the space bar between each number you type. When you have
finished, press [ENTER].
4
5
6
7
8

May 23, 2012

Atarax
BuSpar
Equanil
Flexeril
Librium
139

9
10
11
12
13
14
15
16
DK/REF
TR05

Limbitrol
Meprobamate
Miltown
Rohypnol
Serax
Soma
Tranxene
Vistaril

Have you ever, even once, used any other prescription tranquilizer, besides the ones shown on Card B, when it was
not prescribed for you or that you took only for the experience or feeling it caused?
1
Yes
2
No
DK/REF

TR05a

[IF TR05 = 1] Please type in the name of one of the other prescription tranquilizers you have used other than the ones
on Card B. If you’re not sure how to spell the name of the tranquilizer you used, just make your best guess.
When you have finished, press the [ENTER] key to go to the next question. Remember, you do not need to type in the
names of any prescription tranquilizers you already reported.
______________
DK/REF

TR05b

[IF TR05a NE (BLANK OR DK/REF)] Please type in the name of any other prescription tranquilizer you have used
when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not used
any other prescription tranquilizers, press the [ENTER] key to go to the next question.
______________
DK/REF

TR05c

[IF TR05b NE (BLANK OR DK/REF)] Please type in the name of any other prescription tranquilizer you have
used when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not
used any other prescription tranquilizers, press the [ENTER] key to go to the next question.
______________
DK/REF

TR05d

[IF TR05c NE (BLANK OR DK/REF)] Please type in the name of any other prescription tranquilizer you have
used when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not
used any other prescription tranquilizers, press the [ENTER] key to go to the next question.
______________
DK/REF

TR05e

[IF TR05d NE (BLANK OR DK/REF)] Please type in the name of any other prescription tranquilizer you have
used when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not
used any other prescription tranquilizers, press the [ENTER] key to go to the next question.
______________
DK/REF

TRREF [IF TR01 = REF AND TR02 = REF AND TR03 = REF AND TR04 = REF AND TR05 = REF] The answers that
people give us about their use of prescription tranquilizers are important to this study’s success. We know that this
information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever, even once, used any type of prescription
tranquilizer that was not prescribed for you or that you took only for the experience or feeling it caused?
1
Yes
2
No
DK/REF

May 23, 2012

140

TR06

[IF TR01 = 1 OR TR02 = 1 OR TR03 = 1 OR TR04 = 1 OR TR05 = 1 OR TRREF = 1] How old were you the first
time you used any prescription tranquilizer that was not prescribed for you or that you took only for the experience or
feeling it caused?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STTR:
IF TR06 NE (BLANK OR DK/REF) THEN AGE1STTR = TR06
ELSE AGE1STTR = BLANK
IF CURNTAGE < AGE1STTR
TRCC01
The computer recorded that you were [AGE1STTR] years old when you first used any
prescription tranquilizer that was not prescribed for you or that you took only for the
experience or feeling it caused. Is this correct?
4
Yes
6
No
DK/REF
TRCC02

[IF TRCC01 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
2
3
DK/REF

TRCC03

I am currently [CURNTAGE] years old
I was [AGE1STTR] years old the first time I used any prescription tranquilizer that
was not prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct

[IF TRCC02=2 OR TRCC02=3] Please answer this question again. What is your current
age?
AGE:
DK/REF

[RANGE: 1 - 110]

TRCC03a

[IF TRCC03 < 12] Since you have indicated that you are [TRCC03] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

TRCC04

[IF TRCC02=1 OR TRCC02=3 OR TRCC01=6] Please answer this question again. Think
about the first time you used any prescription tranquilizer that was not prescribed for you or
that you took only for the experience or feeling it caused. How old were you the first time you
used a prescription tranquilizer in either of these ways?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF TRCC04 NOT(BLANK OR DK/REF) THEN AGE1STTR = TRCC04
UPDATE: IF TRCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = TRCC03
IF AGE1STTR = CURNTAGE OR AGE1STTR <10:
TRCC05
The computer recorded that you were [AGE1STTR] years old the first time you used any
prescription tranquilizer that was not prescribed for you or that you took only for the
experience or feeling it caused. Is this correct?
4
Yes
6
No
DK/REF
TRCC06

May 23, 2012

[IF TRCC05=6] Please answer this question again. Think about the first time you used any
prescription tranquilizer that was not prescribed for you or that you took only for the
experience or feeling it caused. How old were you the first time you used a prescription
tranquilizer in either of these ways?

141

AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF TRCC6 NOT(BLANK OR DK/REF) THEN AGE1STTR = TRCC6
TR07a

[IF TRCC05 NE DK/RE AND TRCC06 NE DK/REF AND AGE1STTR = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STTR = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use
any prescription tranquilizer that was not prescribed for you or that you took only for the experience or feeling it caused
in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

TR07b

[IF AGE1STTR = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use any prescription
tranquilizer that was not prescribed for you or that you took only for the experience or feeling it caused in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

TR08a

[IF TRCC05 NE DK/RE AND TRCC06 NE DK/REF AND AGE1STTR = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use any prescription tranquilizer that was
not prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF TR08a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
TR08b

[IF TR07a = 1 OR 2 OR TR07b = 1 OR 2] In what month in [YEAR FROM TR07a or TR07b] did you first use any
prescription tranquilizer that was not prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF TR08b > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.

May 23, 2012

142

DEFINE MYR1STTR:
MYR1STTR = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (TR07a-08b). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STTR
IS BLANK.
IF MYR1STTR NE 0 AND NE AGE1STTR:
TRCC07
The computer recorded that you first used any prescription tranquilizer that was not
prescribed for you or that you took only for the experience or feeling it caused in [TR07a-08b
fill]. That would make you [MYR1STTR] years old when you first used a prescription
tranquilizer in either of these ways. Is this correct?
4
Yes
6
No
DK/REF
TRCC08

[IF TRCC07 = 4] Earlier, the computer recorded that you were [AGE1STTR] years old when
you first used any prescription tranquilizer that was not prescribed for you or that you took
only for the experience or feeling it caused. Which answer is correct?
1

2
3
DK/REF

I first used any prescription tranquilizer that was not prescribed for me or that I
took only for the experience or feeling it caused in [TR07a-08b fill] when I was
[MYR1STTR] years old
I was [AGE1STTR] years old the first time I used any prescription tranquilizer that
was not prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct

UPDATE: IF TRCC08 = 1, THEN AGE1STTR = MYR1STTR
TRCC09

[IF TRCC08=2 OR TRCC08=3 OR TRCC07=6] Please answer this question again. Did you
first use any prescription tranquilizer that was not prescribed for you or that you took only for
the experience or feeling it caused in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

TRCC09a

[IF TRCC09 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [TRCC09] did you first use any prescription tranquilizer that was not prescribed for you or
that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF TRCC09a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF TRCC09a NE (0 OR DK/REF) THEN UPDATE MYR1STTR.
MYR1STTR = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (TRCC09 AND TRCC09a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STTR IS
BLANK. IF MYR1STTR = AGE1STTR THEN MYR1STTR = BLANK
May 23, 2012

143

TRCC10

[IF TRCC08 NE 1 AND MYR1STTR NE 0 AND (TRCC09 AND TRCC09a NE TR07a-TR08b)]
The computer recorded that you first used any prescription tranquilizer that was not
prescribed for you or that you took only for the experience or feeling it caused in [PRCC09PRCC09a fill]. That would make you [MYR1STTR] years old when you first used any
prescription tranquilizer in either of these ways. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF TRCC10 NE (6, BLANK OR DK/REF) AND (TRCC09 AND TRCC09a NE TR07a-TR08b) THEN AGE1STTR
= MYR1STTR
TR09

[IF TR01 = 1 OR TR02 = 1 OR TR03 = 1 OR TR04 = 1 OR TR05 = 1 OR TRREF = 1] How long has it been since
you last used any prescription tranquilizer that was not prescribed for you or that you took only for the experience or
feeling it caused?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

TRRECDK

[IF TR09 = DK] What is your best guess of how long it has been since you last used any prescription
tranquilizer that was not prescribed for you or that you took only for the experience or feeling it caused?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

TRRECRE

[IF TR09 = REF] The answers that people give us about their use of prescription tranquilizers are important
to this study’s success. We know that this information is personal, but remember your answers will be kept
confidential.
Please think again about answering this question: How long has it been since you last used any prescription
tranquilizer that was not prescribed for you or that you took only for the experience or feeling it caused?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

TR10

[IF TR09 = 1 OR 2 OR TRRECDK = 1 OR 2 OR TRRECRE = 1 OR 2] Now think about the past 12 months, from
[DATEFILL] through today. We want to know how many days you’ve used any prescription tranquilizer that was not
prescribed for you or that you took only for the experience or feeling it caused during the past 12 months.
What would be the easiest way for you to tell us how many days you used a prescription tranquilizer in either of these
ways?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

TR11

[IF TR10 = 3 OR DK/REF] On how many days in the past 12 months did you use any prescription tranquilizer that
was not prescribed for you or that you took only for the experience or feeling it caused?
TOTAL # OF DAYS:
DK/REF

TR12

[RANGE: 1 - 366]

[IF TR10 = 2 OR TR11 = DK/REF] On average, how many days each month during the past 12 months did you use
any prescription tranquilizer that was not prescribed for you or that you took only for the experience or feeling it
caused?
AVG # OF DAYS PER MONTH:

May 23, 2012

[RANGE: 1 - 31]
144

DK/REF
TR13

[IF TR10 = 1 OR TR12 = DK/REF] On average, how many days each week during the past 12 months did you use
any prescription tranquilizer that was not prescribed for you or that you took only for the experience or feeling it
caused?
AVG # OF DAYS PER WEEK:
DK/REF

May 23, 2012

[RANGE: 1 - 7]

145

May 23, 2012

146

Stimulants
INTROST1

These next questions ask about the use of drugs such as amphetamines that are known as stimulants,
‘uppers,’ or ‘speed.’ People sometimes take these drugs to lose weight, to stay awake, or for attention deficit
disorders. We are not interested in the use of “over-the-counter” stimulants such as Dexatrim or No-Doz that
can be bought in drug stores or grocery stores without a doctor’s prescription.
Ask your interviewer to show you Card C.
Press [ENTER] to continue.

INTROST2

Card C shows pictures of some different kinds of prescription stimulants and lists the names of some others.
These pictures show only pills, but we are interested in your use of any form of prescription stimulants that
were not prescribed for you or that you took only for the experience or feeling they caused.
Please look at Card C carefully as you answer the next questions.
Press [ENTER] to continue.

ST01

Please look at the stimulants shown in Box 1 above the red line on Card C.
Have you ever, even once, used Methamphetamine, Desoxyn, or Methedrine that was not prescribed for you or that
you took only for the experience or feeling it caused? Methamphetamine is also known as crank, crystal, ice, or speed.
1
Yes
2
No
DK/REF
[IF ST01 = REF] The answers that people give us about their use of Methamphetamine, Desoxyn, and Methedrine
are important to this study’s success. We know that this information is personal, but remember your answers will
be kept confidential.

STREF1

Please think again about answering this question: Have you ever, even once, used Methamphetamine, Desoxyn,
or Methedrine that was not prescribed for you or that you took only for the experience or feeling it caused?
Methamphetamine is also known as crank, crystal, ice, or speed.
1
Yes
2
No
DK/REF
ST02

Please look at the stimulants shown in Box 2.
Have you ever, even once, used prescription diet pills, such as Amphetamines, Benzedrine, Biphetamine, Fastin,
or Phentermine, that were not prescribed for you or that you took only for the experience or feeling it caused?
1
Yes
2
No
DK/REF

ST03

Please look at the stimulants shown in Box 3.
Have you ever, even once, used Ritalin or Methylphenidate that was not prescribed for you or that you took only for
the experience or feeling it caused?
1
Yes
2
No
DK/REF

ST04

Please look at the stimulants shown below the red line on Card C.
Have you ever, even once, used any of these stimulants when they were not prescribed for you or that you took only for
the experience or feeling they caused?
1
2

May 23, 2012

Yes
No
147

DK/REF
ST04a

[IF ST04 = 1] Which of the stimulants shown below the red line on Card C have you used when they were not
prescribed for you or that you took only for the experience or feeling they caused?
To select more than one drug from the list, press the space bar between each number you type. When you have
finished, press [ENTER].
4
5
6
7
8
9
10
11
12
13
14
15
DK/REF

ST05

Cylert
Dexedrine
Dextroamphetamine
Didrex
Eskatrol
Ionamin
Mazanor
Obedrin - L.A.
Plegine
Preludin
Sanorex
Tenuate

Have you ever, even once, used any other prescription stimulant, besides the ones shown on Card C when it was not
prescribed for you or that you took only for the experience or feeling it caused?
1
Yes
2
No
DK/REF

ST05a

[IF ST05 = 1] Please type in the name of one of the other prescription stimulants you have used other than the ones on
Card C. If you’re not sure how to spell the name of the stimulant you used, just make your best guess.
When you have finished, press the [ENTER] key to go to the next question. Remember, you do not need to type in the
names of any prescription stimulants you already reported.
______________
DK/REF

ST05b

[IF ST05a NE (BLANK OR DK/REF)] Please type in the name of any other prescription stimulant you have used
when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not used
any other prescription stimulants, press the [ENTER] key to go to the next question.
______________
DK/REF

ST05c

[IF ST05b NE (BLANK OR DK/REF)] Please type in the name of any other prescription stimulant you have used
when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not used
any other prescription stimulants, press the [ENTER] key to go to the next question.
______________
DK/REF

ST05d

[IF ST05c NE (BLANK OR DK/REF)] Please type in the name of any other prescription stimulant you have used
when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not used
any other prescription stimulants, press the [ENTER] key to go to the next question.
______________
DK/REF

ST05e

[IF ST05d NE (BLANK OR DK/REF)] Please type in the name of any other prescription stimulant you have used
when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not used
any other prescription stimulants, press the [ENTER] key to go to the next question.
______________
DK/REF

May 23, 2012

148

[IF ST01 = REF AND STREF1 = REF AND ST02 = REF AND ST03 = REF AND ST04 = REF AND ST05 =
REF] The answers that people give us about their use of prescription stimulants are important to this study’s
success. We know that this information is personal, but remember your answers will be kept confidential.

STREF2

Please think again about answering this question: Have you ever, even once, used any type of prescription
stimulant that was not prescribed for you or that you took only for the experience or feeling it caused?
1
Yes
2
No
DK/REF
ST06

[IF ((ST01 = 1 OR STREF1 = 1) AND (ST02 = 1 OR ST03 = 1 OR ST04 = 1 OR ST05 = 1 OR STREF2 = 1)) OR
((ST01 NE 1 AND STREF1 NE 1) AND (ST02 = 1 OR ST03 = 1 OR ST04 = 1 OR ST05 = 1 OR STREF2 = 1))] How
old were you the first time you used any prescription stimulant that was not prescribed for you or that you took only
for the experience or feeling it caused?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STST:
IF ST06 NE (BLANK OR DK/REF) THEN AGE1STST = ST06
ELSE AGE1STST = BLANK
IF CURNTAGE < AGE1STST
STCC01
The computer recorded that you were [AGE1STST] years old when you first used any
prescription stimulant that was not prescribed for you or that you took only for the experience
or feeling it caused. Is this correct?
4
Yes
6
No
DK/REF
STCC02

[IF STCC01 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
2
3
DK/REF

STCC03

I am currently [CURNTAGE] years old
I was [AGE1STST] years old the first time I used any prescription stimulant that
was not prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct

[IF STCC02=2 OR STCC02=3] Please answer this question again. What is your current
age?
AGE: __________
DK/REF

STCC03a

[IF STCC03 < 12] Since you have indicated that you are [STCC03] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

STCC04

[IF STCC02=1 OR STCC02=3 OR STCC01=6] Please answer this question again. Think
about the first time you used any prescription stimulant that was not prescribed for you or that
you took only for the experience or feeling it caused. How old were you the first time you
used a prescription stimulant in either of these ways?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF STCC04 NOT(BLANK OR DK/REF) THEN AGE1STST = STCC04
UPDATE: IF STCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = STCC03
IF AGE1STST = CURNTAGE OR AGE1STST <10:
May 23, 2012

149

STCC05

The computer recorded that you were [AGE1STST] years old the first time you used any
prescription stimulant that was not prescribed for you or that you took only for the experience
or feeling it caused. Is this correct?
4
Yes
6
No
DK/REF

STCC06

[IF STCC05=6] Please answer this question again. Think about the first time you used any
prescription stimulant that was not prescribed for you or that you took only for the experience
or feeling it caused. How old were you the first time you used a prescription stimulant in
either of these ways?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF STCC06 NOT(BLANK OR DK/REF) THEN AGE1STST = STCC06
ST07a

[IF STCC05 NE DK/RE AND STCC06 NE DK/REF AND AGE1STST = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STST = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use
any prescription stimulant that was not prescribed for you or that you took only for the experience or feeling it caused
in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

ST07b

[IF AGE1STST = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use any prescription
stimulant that was not prescribed for you or that you took only for the experience or feeling it caused in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

ST08a

[IF STCC05 NE DK/RE AND STCC06 NE DK/REF AND AGE1STST = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use any prescription stimulant that was not
prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF ST08a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
ST08b

[IF ST07a = 1 OR 2 OR ST07b = 1 OR 2] In what month in [YEAR FROM ST07a or ST07b] did you first use any
prescription stimulant that was not prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5

May 23, 2012

January
February
March
April
May
150

6
7
8
9
10
11
12
DK/REF

June
July
August
September
October
November
December

HARD ERROR: [IF ST08b > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STST:
MYR1STST = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (ST07a-08b). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STST
IS BLANK.
IF MYR1STST NE 0 AND NE AGE1STST:
STCC20
The computer recorded that you first used any prescription stimulant that was not prescribed
for you or that you took only for the experience or feeling it caused in [ST07a-08b fill]. That
would make you [MYR1STST] years old when you first used a prescription stimulant in either
of these ways. Is this correct?
4
Yes
6
No
DK/REF
STCC21

[IF STCC20 = 4] Earlier, the computer recorded that you were [AGE1STST] years old when
you first used any prescription stimulant that was not prescribed for you or that you took only
for the experience or feeling it caused. Which answer is correct?
1

2
3
DK/REF

I first used any prescription stimulant that was not prescribed for me or that I took
only for the experience or feeling it caused in [ST07a-08b fill] when I was
[MYR1STST] years old
I was [AGE1STST] years old the first time I used any prescription stimulant that
was not prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct

UPDATE: IF STCC21 = 1, THEN AGE1STST = MYR1STST.
STCC22

[IF STCC21=2 OR STCC21=3 OR STCC20=6] Please answer this question again. Did you
first use any prescription stimulant that was not prescribed for you or that you took only for
the experience or feeling it caused in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

STCC22a

[IF STCC22 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[STCC22] did you first use any prescription stimulant that was not prescribed for you or that
you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9

May 23, 2012

January
February
March
April
May
June
July
August
September
151

10
October
11
November
12
December
DK/REF
HARD ERROR: [IF STCC22a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF STCC22a NE (0 OR DK/REF) THEN UPDATE MYR1STST
MYR1STST = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (STCC22 AND STCC22a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STST IS
BLANK. IF MYR1STST = AGE1STST THEN MYR1STST = BLANK
STCC23

[IF STCC21 NE 1 AND MYR1STST NE 0 AND (STCC22 AND STCC22a NE ST07a-ST08b)]
The computer recorded that you first used any prescription stimulant that was not prescribed
for you or that you took only for the experience or feeling it caused in [STCC22-STCC22a
fill]. That would make you [MYR1STST] years old when you first used any prescription
stimulant in either of these ways. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF STCC23 NE (6, BLANK OR DK/REF) AND (STCC22 AND STCC22a NE ST07a-ST08b) THEN AGE1STST =
MYR1STST
ST09

[IF ((ST01 = 1 OR STREF1 = 1) AND (ST02 = 1 OR ST03 = 1 OR ST04 = 1 OR ST05 = 1 OR STREF2 = 1)) OR
(ST01 NE 1 AND STREF1 NE 1 AND (ST02 = 1 OR ST03 = 1 OR ST04 = 1 OR ST05 = 1 OR STREF2 = 1))] How
long has it been since you last used any prescription stimulant that was not prescribed for you or that you took only for
the experience or feeling it caused?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

STRECDK

[IF ST09 = DK] What is your best guess of how long it has been since you last used any prescription
stimulant that was not prescribed for you or that you took only for the experience or feeling it caused?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

STRECRE

[IF ST09 = REF] The answers that people give us about their use of prescription stimulants are important to
this study’s success. We know that this information is personal, but remember your answers will be kept
confidential.
Please think again about answering this question: How long has it been since you last used any prescription
stimulant that was not prescribed for you or that you took only for the experience or feeling it caused?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

DEFINE STIMREC:
IF ST09 = 1 OR STRECDK = 1 OR STRECRE = 1, THEN STIMREC = 1
IF ST09 = 2 OR STRECDK = 2 OR STRECRE = 2, THEN STIMREC = 2
IF ST09 = 3 OR STRECDK = 3 OR STRECRE = 3, THEN STIMREC = 3
ELSE STIMREC = BLANK
ST10

[IF STIMREC = 1 OR 2] Now think about the past 12 months, from [DATEFILL] through today. We want to know
how many days you’ve used any prescription stimulant that was not prescribed for you or that you took only for the

May 23, 2012

152

experience or feeling it caused during the past 12 months.
What would be the easiest way for you to tell us how many days you used a prescription stimulant in either of these
ways?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF
ST11

[IF ST10 = 3 OR DK/REF] On how many days in the past 12 months did you use any prescription stimulant that was
not prescribed for you or that you took only for the experience or feeling it caused?
TOTAL # OF DAYS:
DK/REF

ST12

[RANGE: 1 - 366]

[IF ST10 = 2 OR ST11 = DK/REF] On average, how many days each month during the past 12 months did you use
any prescription stimulant that was not prescribed for you or that you took only for the experience or feeling it caused?
[RANGE: 1 - 31]

AVG # OF DAYS PER MONTH:
DK/REF
ST13

[IF ST10 = 1 OR ST12 = DK/REF] On average, how many days each week during the past 12 months did you use any
prescription stimulant that was not prescribed for you or that you took only for the experience or feeling it caused?
AVG # OF DAYS PER WEEK:
DK/REF

ST14

[RANGE: 1 - 7]

[IF (ST01 = 1 OR STREF1 = 1) AND (ST02 = 1 OR ST03 = 1 OR ST04 = 1 OR ST05 = 1 OR STREF2 = 1)] Now
think only about your use of Methamphetamine, Desoxyn, or Methedrine. How old were you the first time you used
Methamphetamine, Desoxyn, or Methedrine?
[IF (ST01 = 1 OR STREF1 = 1) AND ST02 = 2 OR DK/REF AND ST03 = 2 OR DK/REF AND ST04 = 2 OR
DK/REF AND ST05 = 2 OR DK/REF AND STREF2 = 2 OR DK/REF] How old were you the first time you used
Methamphetamine, Desoxyn, or Methedrine?
[RANGE: 1 - 110]

AGE:
DK/REF

DEFINE AGE1STME:
IF ST14 NE (BLANK OR DK/REF) THEN AGE1STME = ST14
ELSE AGE1STME = BLANK
IF CURNTAGE < AGE1STME
STCC07
The computer recorded that you were [AGE1STME] years old when you first used
Methamphetamine, Desoxyn, or Methedrine that was not prescribed for you or that you took
only for the experience or feeling it caused. Is this correct?
4
Yes
6
No
DK/REF
STCC08

[IF STCC07 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
2

3
DK/REF
STCC09

May 23, 2012

I am currently [CURNTAGE] years old
I was [AGE1STME] years old the first time I used Methamphetamine, Desoxyn, or
Methedrine that was not prescribed for me or that I took only for the experience or
feeling it caused
Neither answer is correct

[IF STCC08=2 OR STCC08=3] Please answer this question again. What is your current
age?

153

AGE:
DK/REF

[RANGE: 1-110]

STCC09a

[IF STCC09 < 12] Since you have indicated that you are [STCC03] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

STCC10

[IF STCC08=1 OR STCC08=3 OR STCC07=6] Please answer this question again. Think
about the first time you used Methamphetamine, Desoxyn, or Methedrine that was not
prescribed for you or that you took only for the experience or feeling it caused. How old were
you the first time you used Methamphetamine, Desoxyn, or Methedrine in either of these
ways?
[RANGE: 1 - 110]

AGE:
DK/REF

UPDATE: IF STCC10 NOT(BLANK OR DK/REF) THEN AGE1STME = STCC10
UPDATE: IF STCC09 NOT(BLANK OR DK/REF) THEN CURNTAGE = STCC09
IF AGE1STSME= CURNTAGE OR AGE1STME <10:
STCC11
The computer recorded that you were [AGE1STME] years old the first time you used
Methamphetamine, Desoxyn, or Methedrine that was not prescribed for you or that you took
only for the experience or feeling it caused. Is this correct?
4
Yes
6
No
DK/REF
STCC12

[IF STCC11=6] Please answer this question again. Think about the first time you used
Methamphetamine, Desoxyn, or Methedrine that was not prescribed for you or that you took
only for the experience or feeling it caused. How old were you the first time you used
Methamphetamine, Desoxyn, or Methedrine in either of these ways?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF STCC12 NOT(BLANK OR DK/REF) THEN AGE1STME = STCC12
IF AGE1STME < AGE1STST:
STCC13
The answers for the last question and an earlier question disagree. Which answer is correct?
1
2

3
DK/REF
STCC14

[IF STCC13 = 2 OR STCC13 = 3] Please answer this question again. Think about the first
time you used any prescription stimulant that was not prescribed for you or that you took only
for the experience or feeling it caused. How old were you the first time you used any
prescription stimulant in either of these ways?
AGE:
DK/REF

STCC15

[RANGE: 1 - 110]

[IF STCC13 =1 OR STCC13 =3] Please answer this question again. Think about the first
time you used Methamphetamine, Desoxyn, or Methedrine that was not prescribed for you or
that you took only for the experience or feeling it caused. How old were you the first time you
used Methamphetamine, Desoxyn, or Methedrine in either of these ways?
AGE:
DK/REF

May 23, 2012

I was [AGE1STST] years old the first time I used any prescription stimulant that
was not prescribed for me or that I took only for the experience or feeling it caused
I was [AGE1STME] years old the first time I used Methamphetamine, Desoxyn, or
Methedrine that was not prescribed for me or that I took only for the experience or
feeling it caused
Neither answer is correct

[RANGE: 1 - 110]

154

UPDATE: IF STCC14 NOT (BLANK OR DK/REF) THEN AGE1STST = STCC14
UPDATE: IF STCC15 NOT (BLANK OR DK/REF) THEN AGE1STME = STCC15
ST15

[IF STCC11 NE DK/RE AND STCC12 NE DK/REF AND (AGE1STME = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STME = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB)] Did you first
use Methamphetamine, Desoxyn, or Methedrine that was not prescribed for you or that you took only for the
experience or feeling it caused in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

ST16

[IF AGE1STME = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use Methamphetamine,
Desoxyn, or Methedrine that was not prescribed for you or that you took only for the experience or feeling it caused in
[CURRENT YEAR - 2] OR [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

ST17

[IF STCC11 NE DK/RE AND STCC12 NE DK/REF AND AGE1STME = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use Methamphetamine, Desoxyn, or
Methedrine that was not prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF ST17 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
ST18

[IF ST15 = 1 OR 2 OR ST16 = 1 OR 2] In what month in [YEAR FROM ST15 or ST16] did you first use
Methamphetamine, Desoxyn, or Methedrine that was not prescribed for you or that you took only for the experience or
feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF ST18 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
May 23, 2012

155

DEFINE MYR1STME:
MYR1STME = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (ST015-18). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STME
IS BLANK.
IF MYR1STME NE 0 AND NE AGE1STME:
STCC24
The computer recorded that you first used Methamphetamine, Desoxyn, or Methedrine that
was not prescribed for you or that you took only for the experience or feeling it caused in
[ST15-18 fill]. That would make you [MYR1STME] years old when you first used
Methamphetamine, Desoxyn, or Methedrine in either of these ways. Is this correct?
4
Yes
6
No
DK/REF
STCC25

[IF STCC24 = 4] Earlier, the computer recorded that you were [AGE1STME] years old when
you first used Methamphetamine, Desoxyn, or Methedrine that was not prescribed for you or
that you took only for the experience or feeling it caused. Which answer is correct?
1

2

3
DK/REF

I first used Methamphetamine, Desoxyn, or Methedrine that was not prescribed for
me or that I took only for the experience or feeling it caused in [ST15-18 fill] when I
was [MYR1STME] years old
I was [AGE1STME] years old the first time I used Methamphetamine, Desoxyn, or
Methedrine that was not prescribed for me or that I took only for the experience or
feeling it caused
Neither answer is correct

UPDATE: IF STCC25 = 1, THEN AGE1STME = MYR1STME.
STCC26

[IF STCC25=2 OR STCC25=3 OR STCC24=6] Please answer this question again. Did you
first use Methamphetamine, Desoxyn, or Methedrine that was not prescribed for you or that
you took only for the experience or feeling it caused in [CURRENT YEAR-2], [CURRENT
YEAR-1] or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

STCC26a

[IF STCC26 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[STCC26] did you first use Methamphetamine, Desoxyn, or Methedrine that was not
prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF STCC26a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF STC26a NE (0 OR DK/REF) THEN UPDATE MYR1STME.
MYR1STME = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND
May 23, 2012

156

YEAR OF FIRST USE (STCC26 AND STCC26a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STME
IS BLANK. IF MYR1STME = AGE1STME THEN MYR1STME = BLANK
STCC27

[IF STCC25 NE 1 AND MYR1STME NE 0 AND (STCC26 AND STCC26a NE ST15-ST18)]
The computer recorded that you first used Methamphetamine, Desoxyn, or Methedrine that
was not prescribed for you or that you took only for the experience or feeling it caused in
[STCC26-STCC26a fill]. That would make you [MYR1STME] years old when you first used
any Methamphetamine, Desoxyn, or Methedrine in either of these ways. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF STCC27 NE (6, BLANK OR DK/REF) AND (STCC26 AND STCC26a NE ST15-ST18) THEN AGE1STME =
MYR1STME
ST19

[IF ST14 NE BLANK] How long has it been since you last used Methamphetamine, Desoxyn, or Methedrine?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

DEFINE METHREC:
IF ST19 NE DK/REF, THEN METHREC = ST19
ELSE, METHREC = BLANK
IF METHREC < STIMREC:
STCC16
The computer recorded that you last used Methamphetamine, Desoxyn, or Methedrine
[METHREC FILL]. Is that correct?
4
Yes
6
No
DK/REF
STCC17

[IF STCC16=4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
2
3
DK/REF

STCC18

I last used any prescription stimulant that was not prescribed for me or that I took
only for the experience or feeling it caused [ST09/STRECDK/STRECRE FILL]
I last used Methamphetamine, Desoxyn, or Methedrine [METHREC FILL]
Neither answer is correct

[IF STCC17 = 2 OR STCC17 = 3] Please answer this question again. How long has it been
since you last used any prescription stimulant that was not prescribed for you or that you took
only for the experience or feeling it caused?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

STCC19

[IF STCC16 =6 OR STCC17 = 1 OR STCC17 = 3] Please answer this question again. Think
only about Methamphetamine, Desoxyn, and Methedrine. How long has it been since you last
used Methamphetamine, Desoxyn, or Methedrine?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

UPDATE: IF STCC18 NOT (BLANK OR DK/REF) THEN STIMREC = STCC18
UPDATE: IF STCC19 NOT (BLANK OR DK/REF) THEN METHREC = STCC19
May 23, 2012

157

ST10a

[IF STIMREC NE BLANK AND METHREC = 1 OR 2 AND ST10 = BLANK] Now think about the past 12 months,
from [DATEFILL] through today. We want to know how many days you’ve used any prescription stimulant that was
not prescribed for you or that you took only for the experience or feeling it caused during the past 12 months.
What would be the easiest way for you to tell us how many days you used a prescription stimulant in either of these
ways?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

ST11a

[IF ST10a = 3 OR DK/REF] On how many days in the past 12 months did you use any prescription stimulant that was
not prescribed for you or that you took only for the experience or feeling it caused?
TOTAL # OF DAYS:
DK/REF

ST12a

[RANGE: 1 - 366]

[IF ST10a = 2 OR ST11a = DK/REF] On average, how many days each month during the past 12 months did you use
any prescription stimulant that was not prescribed for you or that you took only for the experience or feeling it caused?
AVG # OF DAYS PER MONTH:
DK/REF

ST13a

[IF ST10a = 1 OR ST12a = DK/REF] On average, how many days each week during the past 12 months did you use
any prescription stimulant that was not prescribed for you or that you took only for the experience or feeling it caused?
AVG # OF DAYS PER WEEK:
DK/REF

ST20

[RANGE: 1 - 31]

[RANGE: 1 - 7]

[IF METHREC = 1 OR 2] Now think about the past 12 months, from [DATEFILL] through today. We want to know
how many days you’ve used Methamphetamine, Desoxyn, or Methedrine that was not prescribed for you or that you
took only for the experience or feeling it caused during the past 12 months.
What would be the easiest way for you to tell us how many days you used Methamphetamine, Desoxyn, or Methedrine
in either of these ways?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

ST21

[IF ST20 = 3 OR DK/REF] On how many days in the past 12 months did you use Methamphetamine, Desoxyn, or
Methedrine that was not prescribed for you or that you took only for the experience or feeling it caused?
TOTAL # OF DAYS:
DK/REF

ST22

[RANGE: 1 - 366]

[IF ST20 = 2 OR ST21 = DK/REF] On average, how many days each month during the past 12 months did you use
Methamphetamine, Desoxyn, or Methedrine that was not prescribed for you or that you took only for the experience or
feeling it caused?
AVG # OF DAYS PER MONTH:
DK/REF

ST23

[RANGE: 1 - 31]

[IF ST20 = 1 OR ST22 = DK/REF] On average, how many days each week during the past 12 months did you use
Methamphetamine, Desoxyn, or Methedrine that was not prescribed for you or that you took only for the experience or
feeling it caused?
AVG # OF DAYS PER WEEK:
DK/REF

May 23, 2012

[RANGE: 1 - 7]

158

Sedatives
INTROSV1

These next questions ask about the use of sedatives or barbiturates. These drugs are also called “downers”
or “sleeping pills.” People take these drugs to help them relax or to help them sleep. We are not interested in
the use of “over-the-counter” sedatives such as Sominex, Unisom, Nytol, or Benadryl that can be bought in
drug stores or grocery stores without a doctor’s prescription.
Ask your interviewer to show you Card D.
Press [ENTER] to continue.

INTROSV2

Card D shows pictures of some different kinds of prescription sedatives and lists the names of some others.
These pictures show only pills, but we are interested in your use of any prescription sedatives that were not
prescribed for you, or that you took only for the experience or feeling they caused.
Please look at Card D carefully as you answer the next questions.
Press [ENTER] to continue.

SV01

Please look at the sedatives shown in Box 1 above the red line on Card D.
Have you ever, even once, used Methaqualone, Sopor, or Quaalude that was not prescribed for you or that you took
only for the experience or feeling it caused?
1
Yes
2
No
DK/REF

SV02

Please look at the sedatives shown in Box 2.
Have you ever, even once, used barbiturates such as Nembutal, Pentobarbital, Seconal, Secobarbital, or
Butalbital that were not prescribed for you or that you took only for the experience or feeling they caused?
1
Yes
2
No
DK/REF

SV03

Please look at the sedatives shown in Box 3.
Have you ever, even once, used Restoril or Temazepam that was not prescribed for you or that you took only for the
experience or feeling it caused?
1
Yes
2
No
DK/REF

SV04

Please look at the sedatives shown below the red line on Card D.
Have you ever, even once, used any of these sedatives when they were not prescribed for you or that you took only for
the experience or feeling they caused?
1
Yes
2
No
DK/REF

SV04a

[IF SV04=1]Which of the sedatives shown below the red line on Card D have you used when they were not prescribed
for you or that you took only for the experience or feeling they caused?
To select more than one drug from the list, press the space bar between each number you type. When you have
finished, press [ENTER].
4
5
6
7

May 23, 2012

Amytal
Butisol
Chloral Hydrate
Dalmane
159

8
9
10
11
DK/REF
SV05

Halcion
Phenobarbital
Placidyl
Tuinal

Have you ever, even once, used any other prescription sedative, besides the ones shown on Card D, when it was not
prescribed for you or that you took only for the experience or feeling it caused?
1
Yes
2
No
DK/REF

SV05a

[IF SV05 = 1] Please type in the name of one of the other prescription sedatives you have used other than the ones on
Card D. If you’re not sure how to spell the name of the sedative you used, just make your best guess.
When you have finished, press the [ENTER] key to go to the next question. Remember, you do not need to type in the
names of any prescription sedatives you already reported.
________________
DK/REF

SV05b

[IF SV05a NE (BLANK OR DK/REF)] Please type in the name of any other prescription sedative you have used
when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not used
any other prescription sedatives, press the [ENTER] key to go to the next question.
________________
DK/REF

SV05c

[IF SV05b NE (BLANK OR DK/REF)] Please type in the name of any other prescription sedative you have used
when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not used
any other prescription sedatives, press the [ENTER] key to go to the next question.
________________
DK/REF

SV05d

[IF SV05c NE (BLANK OR DK/REF)] Please type in the name of any other prescription sedative you have used
when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not used
any other prescription sedatives, press the [ENTER] key to go to the next question.
________________
DK/REF

SV05e

[IF SV05d NE (BLANK OR DK/REF)] Please type in the name of any other prescription sedative you have used
when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not used
any other prescription sedatives, press the [ENTER] key to go to the next question.
________________
DK/REF

SVREF [IF SV01 = REF AND SV02 = REF AND SV03 = REF AND SV04 = REF AND SV05 = REF] The answers that
people give us about their use of prescription sedatives are important to this study’s success. We know that this
information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever, even once, used any type of prescription sedative
that was not prescribed for you or that you took only for the experience or feeling it caused?
1
Yes
2
No
DK/REF
SV06

[IF SV01 = 1 OR SV02 = 1 OR SV03 = 1 OR SV04 = 1 OR SV05 = 1 OR SVREF = 1] How old were you the first
time you used any prescription sedative that was not prescribed for you or that you took only for the experience or
feeling it caused?

May 23, 2012

160

AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STSV:
IF SV06 NE (BLANK OR DK/REF) THEN AGE1STSV = SV06
ELSE AGE1STSV = BLANK
IF CURNTAGE < AGE1STSV
SVCC01
The computer recorded that you were [AGE1STSV] years old when you first used any
prescription sedative that was not prescribed for you or that you took only for the experience
or feeling it caused. Is this correct?
4
Yes
6
No
DK/REF
SVCC02

[IF SVCC01 = 4] The answers for the last question and an earlier question disagree. Which
answer is correct?
1
2
3
DK/REF

SVCC03

I am currently [CURNTAGE] years old
I was [AGE1STSV] years old the first time I used any prescription sedative that was
not prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct

[IF SVCC02=2 OR SVCC02=3] Please answer this question again. What is your current
age?
AGE:
DK/REF

[RANGE: 1 - 110]

SVCC03a

[IF SVCC03 < 12] Since you have indicated that you are [SVCC03] years old, we cannot
interview you for this study. Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD ROUTE TO ENDAUDIO.

SVCC04

[IF SVCC02=1 OR SVCC02=3 OR SVCC01=6] Please answer this question again. Think
about the first time you used any prescription sedative that was not prescribed for you or that
you took only for the experience or feeling it caused. How old were you the first time you
used a prescription sedative in either of these ways?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF SVCC04 NOT(BLANK OR DK/REF) THEN AGE1STSV = SVCC04
UPDATE: IF SVCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = SVCC03
IF AGE1STSV = CURNTAGE OR AGE1STSV <10:
SVCC05
The computer recorded that you were [AGE1STSV] years old the first time you used any
prescription sedative that was not prescribed for you or that you took only for the experience
or feeling it caused. Is this correct?
4
Yes
6
No
DK/REF
SVCC06

[IF SVCC05=6] Please answer this question again. Think about the first time you used any
prescription sedative that was not prescribed for you or that you took only for the experience
or feeling it caused. How old were you the first time you used a prescription sedative in either
of these ways?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF SVCC06 NOT(BLANK OR DK/REF) THEN AGE1SVSV = SVCC06
May 23, 2012

161

SV07a

[IF SVCC05 NE DK/RE AND SVCC06 NE DK/REF AND AGE1STSV = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STSV = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first use
any prescription sedative that was not prescribed for you or that you took only for the experience or feeling it caused in
[CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

SV07b

[IF AGE1STSV = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use any prescription sedative
that was not prescribed for you or that you took only for the experience or feeling it caused in [CURRENT YEAR - 2]
or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

SV08a

[IF SVCC05 NE DK/RE AND SVCC06 NE DK/REF AND AGE1STSV = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first use any prescription sedative that was not
prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF SV08a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
SV08b

[IF SV07a = 1 OR 2 OR SV07b = 1 OR 2] In what month in [YEAR FROM SV07a or SV07b] did you first use any
prescription sedative that was not prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF SV08b > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STSV:
MYR1STSV = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (SV07a-08b). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STSV
IS BLANK.
May 23, 2012

162

IF MYR1STSV NE 0 AND NE AGE1STSV:
SVCC07
The computer recorded that you first used any prescription sedative that was not prescribed
for you or that you took only for the experience or feeling it caused in [SV07a-08b fill]. That
would make you [MYR1STSV] years old when you first used a prescription sedative in either
of these ways. Is this correct?
4
Yes
6
No
DK/REF
SVCC08

[IF SVCC07 = 4] Earlier, the computer recorded that you were [AGE1STSV] years old when
you first used any prescription sedative that was not prescribed for you or that you took only
for the experience or feeling it caused. Which answer is correct?
1

2
3
DK/REF

I first used any prescription sedative that was not prescribed for me or that I took
only for the experience or feeling it caused in [SV07a-08b fill] when I was
[MYR1STSV] years old
I was [AGE1STSV] years old the first time I used any prescription sedative that was
not prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct

UPDATE: IF SVCC08 = 1, THEN AGE1STSV = MYR1STSV
SVCC09

[IF SVCC08=2 OR SVCC08=3 OR SVCC07=6] Please answer this question again. Did you
first use any prescription sedative that was not prescribed for you or that you took only for the
experience or feeling it caused in [CURRENT YEAR-2], [CURRENT YEAR-1] or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

SVCC09a

[IF SVCC09 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[SVCC09] did you first use any prescription sedative that was not prescribed for you or that
you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF SVCC09a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF SVCC09a NE (0 OR DK/REF) THEN UPDATE MYR1STSV.
MYR1STSV = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (SVCC09 AND SVCC09a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STSV IS
BLANK. IF MYR1STSV = AGE1STSV THEN MYR1STSV = BLANK
SVCC10

May 23, 2012

[IF SVCC08 NE 1 AND MYR1STSV NE 0 AND (SVCC09 AND SVCC09a NE SV07a-SV08b)]
The computer recorded that you first used any prescription sedative that was not prescribed
for you or that you took only for the experience or feeling it caused in [SVCC09-SVCC09a
163

fill]. That would make you [MYR1STSV] years old when you first used any prescription
sedative in either of these ways. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF SVCC10 NE (6, BLANK OR DK/REF) AND (SVCC09 AND SVCC09a NE SV07a-SV08b) THEN AGE1STSV
= MYR1STSV
SV09

[IF SV01 = 1 OR SV02 = 1 OR SV03 = 1 OR SV04 = 1 OR SV05 = 1 OR SVREF = 1] How long has it
been since you last used any prescription sedative that was not prescribed for you or that you took only for
the experience or feeling it caused?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SVRECDK

[IF SV09 = DK] What is your best guess of how long it has been since you last used any
prescription sedative that was not prescribed for you or that you took only for the experience or
feeling it caused?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SVRECRE

[IF SV09 = REF] The answers that people give us about their use of prescription sedatives are
important to this study’s success. We know that this information is personal, but remember your
answers will be kept confidential.
Please think again about answering this question: How long has it been since you last used any
prescription sedative that was not prescribed for you or that you took only for the experience or
feeling it caused?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SV10

[IF SV09 = 1 OR 2 OR SVRECDK = 1 OR 2 OR SVRECRE = 1 OR 2] Now think about the past 12 months, from
[DATEFILL] through today. We want to know how many days you’ve used any prescription sedative that was not
prescribed for you or that you took only for the experience or feeling it caused during the past 12 months.
What would be the easiest way for you to tell us how many days you used a prescription sedative in either of these
ways?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

SV11

[IF SV10 = 3 OR DK/REF] On how many days in the past 12 months did you use any prescription sedative that was
not prescribed for you or that you took only for the experience or feeling it caused?
TOTAL # OF DAYS:
DK/REF

SV12

[RANGE: 1 - 366]

[IF SV10 = 2 OR SV11= DK/REF] On average, how many days each month during the past 12 months did you use
any prescription sedative that was not prescribed for you or that you took only for the experience or feeling it caused?
AVG # OF DAYS PER MONTH:
DK/REF

May 23, 2012

[RANGE: 1 - 31]

164

SV13

[IF SV10 = 1 OR SV12 = DK/REF] On average, how many days each week during the past 12 months did you use
any prescription sedative that was not prescribed for you or that you took only for the experience or feeling it caused?
AVG # OF DAYS PER WEEK:
DK/REF

May 23, 2012

[RANGE: 1 - 7]

165

May 23, 2012

166

Special Drugs
INTROSD

These next questions are about the different ways that certain drugs can be used.
Press [ENTER] to continue.

SD01

[IF HE01 = 1 OR HEREF = 1] Have you ever, even once, smoked heroin?
1
Yes
2
No
DK/REF

SD02

[IF SD01 = 1] How long has it been since you last smoked heroin?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SD03

[IF HE01 = 1 OR HEREF = 1] Have you ever, even once, sniffed or ‘snorted’ heroin powder through your nose?
1
Yes
2
No
DK/REF

SD04

[IF SD03 = 1] How long has it been since you last sniffed or ‘snorted’ heroin powder through your nose?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SD08

[IF HE01 = 1 OR HEREF = 1] Have you ever, even once, used a needle to inject heroin?
1
Yes
2
No
DK/REF

SDHEUSE

[IF SD01 = 2 AND SD03 = 2 AND SD08 = 2] Earlier the computer recorded that you had used heroin. In
what way have you used heroin?
To select more than one way, press the space bar between each number you type. When you have finished,
press the [ENTER] key to go to the next question.
1
2
3
4
DK/REF

SDHEUSE2

You smoked heroin
You sniffed or "snorted" heroin powder
You injected heroin with a needle
You used heroin some other way

[IF SDHEUSE = 4 ONLY -- NO OTHER CATEGORIES SELECTED] Please type in the way you have
used heroin. When you have finished typing your answer, press the [ENTER] key to go to the next question.
________________
DK/REF

SDHEUSE3

[IF SDHEUSE = 1] How long has it been since you last smoked heroin?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

May 23, 2012

167

SDHEUSE4

[IF SDHEUSE = 2] How long has it been since you last sniffed or ‘snorted’ heroin powder through your
nose?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SD09

[IF SD08 = 1 OR SDHEUSE = 3] How long has it been since you last used a needle to inject heroin?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SD10a

[IF ST01 = 1 OR STREF1 = 1] Have you ever, even once, used a needle to inject Methamphetamine, Desoxyn, or
Methedrine when it was not prescribed for you or that you took only for the experience or feeling it caused?
1
Yes
2
No
DK/REF

SD10b

[IF SD10a = 1] How long has it been since you last used a needle to inject Methamphetamine, Desoxyn, or
Methedrine when it was not prescribed for you or that you took only for the experience or feeling it caused?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SD17a

[IF ST01 = (2 OR DK) OR STREF1 = (2 OR DK)] Methamphetamine, also known as crank, ice, crystal meth, speed,
glass, and many other names, is a stimulant that usually comes in crystal or powder forms. It can be smoked,
“snorted,” swallowed or injected. Have you ever, even once, used Methamphetamine?
1
Yes
2
No
DK/REF

SD17b

[IF SD17a = 1] How long has it been since you last used Methamphetamine?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

DEFINE METHREC2:
IF SD17b NE (BLANK OR DK/REF) THEN METHREC2=SD17b
ELSE METHREC2 = BLANK
DEFINE METHFILL:
IF METHREC = 1, 2 OR 3, THEN METHFILL = “Methamphetamine, Desoxyn or Methedrine”
IF METHREC2 = 1, 2 OR 3, THEN METHFILL = “Methamphetamine”
ELSE, METHFILL = BLANK
SD18a

[IF SD17a = 1] Have you ever, even once, used a needle to inject Methamphetamine?
1
Yes
2
No
DK/REF

SD18b

[IF SD18a = 1] How long has it been since you last used a needle to inject Methamphetamine?
1
2
3

May 23, 2012

Within the past 30 days -- that is, since [DATEFILL]
More than 30 days ago but within the past 12 months
More than 12 months ago
168

DK/REF
SD17a1 [IF (ST01 = 2 OR STREF1 = 2) AND SD17b = 1-3] Earlier, the computer recorded that you have never used
Methamphetamine, Desoxyn or Methedrine. Which answer is correct?
1
I have never, even once, used Methamphetamine, Desoxyn or Methedrine
2
I last used Methamphetamine [SD17B FILL]
DK/REF
SD17ALT

[IF (ST01 = 2 OR STREF1 = 2) AND SD17a = 1 AND SD17b = DK/REF] Earlier, the computer recorded
that you have never used Methamphetamine, Desoxyn or Methedrine. Which answer is correct?

1
I have never, even once, used Methamphetamine, Desoxyn or Methedrine
2
I have used Methamphetamine
DK/REF
SD17a2 [IF SD17a1 = 2 OR SD17ALT = 2] Why did you report earlier that you had never used Methamphetamine?
1
2
3
DK/REF
SD17a2SP

The earlier question asked about prescription drugs, and I didn’t think of Methamphetamine as a prescription
drug
I made a mistake when I answered the earlier question about ever using Methamphetamine
Some other reason
[IF SD17a2 = 3] Please type in the other reason you reported earlier that you had never used
Methamphetamine. When you have finished typing your answer, press the [ENTER] key to go to the next
question.
________________
DK/REF

SDME01 [IF SD17a1 = 2 OR SD17ALT = 2] How old were you the first time you used Methamphetamine?
[RANGE: 1 - 110]

AGE:
DK/REF

DEFINE AGE1STME2:
IF SDME01 NE (BLANK OR DK/REF) THEN AGE1STME2 = SDME01
ELSE AGE1STME2 = BLANK
IF CURNTAGE < AGE1STME2 OR AGE1STME2 < 10
SDCC01
The computer recorded that you were [AGE1STME2] years old when you first used
Methamphetamine. Is this correct?
4
Yes
6
No
DK/REF
SDCC02

[IF SDCC01=6] Please answer this question again. How old were you the first time you used
Methamphetamine?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF SDCC02 NOT(BLANK OR DK/REF) THEN AGE1STME2 = SDCC02
SDME02 [IF SDME01 NE DK/RE AND (AGE1STME2 = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF
AGE1STME2 = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB)] Did you first use Methamphetamine in
[CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
SDME03 [IF AGE1STME2 = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first use Methamphetamine in
May 23, 2012

169

[CURRENT YEAR - 2] OR [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
SDME04 [IF SDME01 NE DK/RE AND AGE1STME2 = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month
in [CURRENT YEAR] did you first use Methamphetamine?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF SDME04 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
SDME05 [IF SDME02 = 1 OR 2 OR SDME03 = 1 OR 2] In what month in [YEAR FROM SDME02 or SDME03] did you
first use Methamphetamine?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF SDME05 > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STME2:
MYR1STME2 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (SDME02-SDME05). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN
MYR1STME2 IS BLANK.
IF MYR1STME2 NE 0 AND NE AGE1STME2:
SDCC03
The computer recorded that you first used Methamphetamine in [SDME02-05 fill]. That
would make you [MYR1STME] years old when you first used Methamphetamine. Is this
correct?
4
Yes
6
No
DK/REF
SDCC04

May 23, 2012

[IF SDCC03 = 4] Earlier, the computer recorded that you were [AGE1STME2] years old
when you first used Methamphetamine. Which answer is correct?

170

1
2
3
DK/REF

I first used Methamphetamine in [SDME02-05fill] when I was [MYR1STME2]
years old
I was [AGE1STME2] years old the first time I used Methamphetamine
Neither answer is correct

UPDATE: IF SDCC04 = 1, THEN AGE1STME2 = MYR1STME2.
SDCC05

[IF SDCC04=2 OR SDCC04=3 OR SDCC03=6] Please answer this question again. Did you
first use Methamphetamine in [CURRENT YEAR-2], [CURRENT YEAR-1] or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

SDCC05a

[IF SDCC05 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [SDCC05] did you first use Methamphetamine?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF SDCC05a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF SDCC05a NE (0 OR DK/REF) THEN UPDATE MYR1STME2.
MYR1STME2 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND
YEAR OF FIRST USE (SDCC05 AND SDCC05a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STME2
IS BLANK. IF MYR1STME2 = AGE1STME2 THEN MYR1STME2 = BLANK
SDCC06

[IF SDCC04 NE 1 AND MYR1STME2 NE 0 AND (SDCC05 AND SDCC05a NE SDME0205)] The computer recorded that you first used Methamphetamine in [SDCC05-SDCC05a
fill]. That would make you [MYR1STME2] years old when you first used any
Methamphetamine. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF SDCC06 NE (6, BLANK OR DK/REF) AND (SDCC05 AND SDCC05a NE SDME02-05) THEN AGE1STME2
= MYR1STME2
SDME06 [IF SD17b = 1 OR 2 OR SD18b = 1 OR 2 AND (SD17a1 NE 1 AND SD17ALT NE 1)] Now think about the past 12
months, from [DATEFILL] through today. We want to know how many days you’ve used Methamphetamine during
the past 12 months.
What would be the easiest way for you to tell us how many days you used Methamphetamine?
1
2
3
May 23, 2012

Average number of days per week during the past 12 months
Average number of days per month during the past 12 months
Total number of days during the past 12 months
171

DK/REF
SDME07 [IF SDME06 = 3 OR DK/REF] On how many days in the past 12 months did you use Methamphetamine?
TOTAL # OF DAYS:
DK/REF

[RANGE: 1 - 366]

SDME08 [IF SDME06 = 2 OR SDME07 = DK/REF] On average, how many days each month during the past 12 months did
you use Methamphetamine?
AVG # OF DAYS PER MONTH:
DK/REF

[RANGE: 1 - 31]

SDME09 [IF SDME06 = 1 OR SDME08 = DK/REF] On average, how many days each week during the past 12 months did you
use Methamphetamine?
AVG # OF DAYS PER WEEK:
DK/REF
SD10c

[RANGE: 1 - 7]

[IF ST01 = 1 OR STREF1 = 1 OR SD17a = 1 AND (ST02 = 1 OR ST03 = 1 OR ST04 = 1 OR ST05 = 1 OR STREF2
= 1)] Have you ever, even once, used a needle to inject any other stimulant when it was not prescribed for you or that
you took only for the experience or feeling it caused?
[IF ST01 = 2 OR DK/REF OR STREF1 = 2 OR DK/REF OR SD17a = 2 OR DK/REF AND (ST02 = 1 OR ST03 = 1
OR ST04 = 1 OR ST05 = 1 OR STREF2 = 1)] Have you ever, even once, used a needle to inject a stimulant when it
was not prescribed for you or that you took only for the experience or feeling it caused?
1
Yes
2
No
DK/REF

SD11

[IF SD10c = 1] How long has it been since you last used a needle to inject [any other stimulant / any stimulant]
when it was not prescribed for you or that you took only for the experience or feeling it caused?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SD06

[IF CC01 = 1 OR CCREF = 1] Have you ever, even once, used a needle to inject cocaine?
1
Yes
2
No
DK/REF

SD07

[IF SD06 = 1] How long has it been since you last used a needle to inject cocaine?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SD05

[IF SD06 = 1 OR SD08 = 1 OR SD10a = 1 OR SD10c = 1 OR SD18a = 1 OR SDHEUSE = 3] Have you ever, even
once, used a needle to inject any other drug that was not prescribed for you or that you took only for the experience or
feeling it caused?
[IF SD06 NE 1 AND SD08 NE 1 AND SD10a NE 1 AND SD10c NE 1 AND SD18a NE 1 AND SDHEUSE NE 3]
Have you ever, even once, used a needle to inject any drug that was not prescribed for you or that you took only for the
experience or feeling it caused?
1
Yes
2
No
DK/REF

SD05a

[IF SD05 = 1] Please type in the name of one of the drugs you have used a needle to inject. If you’re not sure how to

May 23, 2012

172

spell the name of the drug you used a needle to inject, just make your best guess.
When you have finished, press the [ENTER] key to go to the next question.
________________
DK/REF
SD05b

[IF SD05a NE (BLANK OR DK/REF)] Please type in the name of any other drug you have used a needle to inject
when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not used a
needle to inject any other drugs, press the [ENTER] key to go to the next question.
________________
DK/REF

SD05c

[IF SD05b NE (BLANK OR DK/REF)] Please type in the name of any other drug you have used a needle to inject
when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not used a
needle to inject any other drugs, press the [ENTER] key to go to the next question.
________________
DK/REF

SD05d

[IF SD05c NE (BLANK OR DK/REF)] Please type in the name of any other drug you have used a needle to inject
when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not used a
needle to inject any other drugs, press the [ENTER] key to go to the next question.
________________
DK/REF

SD05e

[IF SD05d NE (BLANK OR DK/REF)] Please type in the name of any other drug you have used a needle to inject
when it was not prescribed for you or that you took only for the experience or feeling it caused. If you have not used a
needle to inject any other drugs, press the [ENTER] key to go to the next question.
________________
DK/REF

SD12

[IF SD08 = 1 OR SDHEUSE = 3 OR SD10a = 1 OR SD10c = 1 OR SD06 = 1 OR SD05 = 1 OR SD18a = 1] Think
about the last time you used a needle for injecting drugs. The last time you used a needle for injecting drugs, were you
reusing a needle that you had used before?
1
Yes
2
No
DK/REF

SD13

[IF SD08 = 1 OR SDHEUSE = 3 OR SD10a = 1 OR SD10c = 1 OR SD06 = 1 OR SD05 = 1 OR SD18a = 1] The last
time you used a needle for injecting drugs, did you use a needle that you knew or suspected someone else had used
before?
1
Yes
2
No
DK/REF

SD14

[IF SD08 = 1 OR SDHEUSE = 3 OR SD10a = 1 OR SD10c = 1 OR SD06 = 1 OR SD05 = 1 OR SD18a = 1] The last
time you used a needle for injecting drugs, did you use bleach to clean the needle before you used it?
1
Yes
2
No
DK/REF

SD15

[IF SD08 = 1 OR SDHEUSE = 3 OR SD10a = 1 OR SD10c = 1 OR SD06 = 1 OR SD05 = 1 OR SD18a = 1 ] The last
time you used a needle for injecting drugs, did someone else use the needle after you?
1
Yes
2
No
DK/REF

May 23, 2012

173

SD16

[IF SD08 = 1 OR SDHEUSE = 3 OR SD10a = 1 OR SD10c = 1 OR SD06 = 1 OR SD05 = 1 OR SD18a = 1] The last
time you used a needle for injecting drugs, how did you get the needle?
1
2
3
4
5
DK/REF

bought the needle from a pharmacy
got the needle from a needle exchange
bought the needle on the street
got the needle in a shooting gallery
got the needle some other way

[IF SD16 = 5] Please type a description of how you got the needle you used the last time you used a needle for
injecting drugs. You do not need to give a detailed description — just a few words will be sufficient. When you
have finished typing your answer, press the [ENTER] key to go to the next question.

SD16SP

________________
DK/REF
The next question is about GHB, also called “G,” “Georgia Home Boy,” “Grievous Bodily Harm,” “Liquid
G,” or gamma hydroxybutyrate. Have you ever, even once, used GHB?

SD19

1
Yes
2
No
DK/REF
SD20

[DISPLAY IMAGE FILE] Adderall is a prescription stimulant that comes in tablet or capsule form. Adderall tablets
and capsules are shown below. Have you ever, even once, used Adderall that was not prescribed for you or that you
took only for the experience or feeling it caused?
1
Yes
2
No
DK/REF

SD21

[DISPLAY IMAGE FILE] Ambien is a prescription sedative or sleeping pill that comes in tablet form. Ambien
tablets are shown below. Have you ever, even once, used Ambien that was not prescribed for you or that you took
only for the experience or feeling it caused?
1
Yes
2
No
DK/REF

SD22a

The last two questions were about prescription drugs. The next question is about non-prescription cough or
cold medicines, also known as over the counter medicines. Have you ever, even once, taken a nonprescription cough or cold medicine just to get high?
1
Yes
2
No
DK/REF

SD23INTR

Earlier, the computer asked you questions about your use of hallucinogens. These drugs often cause people
to see or experience things that are not real. The next questions are about hallucinogens you were not
specifically asked about earlier.
Press [ENTER] to continue.

SD23a

Have you ever, even once, used Ketamine, also called “Special K” or “Super K”?
1
Yes
2
No
DK/REF

SD23b

Have you ever, even once, used any of the following:
DMT, also called dimethyltryptamine,
AMT, also called alpha-methyltryptamine, or
Foxy, also called 5-MeO-DIPT?

May 23, 2012

174

1
Yes
2
No
DK/REF
Have you ever, even once, used Salvia divinorum?

SD23c

1
Yes
2
No
DK/REF
SD24

[IF SD19 = 1] Earlier, the computer recorded that you have used GHB. How long has it been since you last used
GHB?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SD25

[IF SD20 = 1] Earlier, the computer recorded that you have used Adderall that was not prescribed for you or that you
took only for the experience or feeling it caused. How long has it been since you last used Adderall in either of these
ways?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SD26

[IF SD21 = 1] Earlier the computer recorded that you have used Ambien that was not prescribed for you or that you
took only for the experience or feeling it caused. How long has it been since you last used Ambien in either of these
ways?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SD27

[IF SD22a = 1] Earlier, the computer recorded that you have taken a non-prescription cough or cold medicine just to
get high. How long has it been since you last took one of these cough or cold medicines to get high?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SD27a

[IF SD27 = 1 OR 2] Now think about the past 12 months, that is, since [DATEFILL ]. Please type in the
name of one of the cough or cold medicines you used in the past 12 months just to get high. If you’re not
sure how to spell the name of the medicine you used, just make your best guess.
When you have finished, press the [ENTER] key to go to the next question.
______________
DK/REF

SD27b

[IF SD27a NE (BLANK OR DK/REF)] Please type in the name of any other cough or cold medicine you
used in the past 12 months just to get high. If you have not used any other cough or cold medicines, press the
[ENTER] key to go to the next question.
______________
DK/REF

SD27c

May 23, 2012

[IF SD27b NE (BLANK OR DK/REF)] Please type in the name of any other cough or cold medicine you
used in the past 12 months just to get high. If you have not used any other cough or cold medicines, press the
[ENTER] key to go to the next question.

175

______________
DK/REF
[IF SD27c NE (BLANK OR DK/REF)] Please type in the name of any other cough or cold medicine you
used in the past 12 months just to get high. If you have not used any other cough or cold medicines, press the
[ENTER] key to go to the next question.

SD27d

______________
DK/REF
[IF SD27d NE (BLANK OR DK/REF)] Please type in the name of any other cough or cold medicine you
used in the past 12 months just to get high. If you have not used any other cough or cold medicines, press the
[ENTER] key to go to the next question.

SD27e

______________
DK/REF
SD28

[IF SD23a = 1] Earlier, the computer recorded that you have used Ketamine. How long has it been since you last used
Ketamine?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SD29

[IF SD23b = 1] Earlier, the computer recorded that you have used DMT, AMT, or Foxy. How long has it been since
you last used any of these drugs?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

SD30

[IF SD23c = 1] Earlier, the computer recorded that you have used Salvia divinorum. How long has it been since you
last used Salvia divinorum?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

May 23, 2012

176

Risk/Availability Section
RKQ1

We are interested in your opinion about the effects of using certain drugs and other substances, about whether it’s
difficult or easy to get drugs, and the extent to which drugs are available in your neighborhood.
Please indicate how much you think people risk harming themselves physically and in other ways when they do each of
the following activities.
If you’re not sure, choose an answer for the amount of risk that comes closest to what you think might be true for that
activity.
Press [ENTER] to continue.

RK01a

How much do people risk harming themselves physically and in other ways when they smoke one or more packs of
cigarettes per day?
1
2
3
4
DK/REF

No risk
Slight risk
Moderate risk
Great risk

RK01b How much do people risk harming themselves physically and in other ways when they smoke marijuana once a
month?
1
2
3
4
DK/REF
RK01c

No risk
Slight risk
Moderate risk
Great risk

How much do people risk harming themselves physically and in other ways when they smoke marijuana once or
twice a week?
1
2
3
4
DK/REF

No risk
Slight risk
Moderate risk
Great risk

RK01d How much do people risk harming themselves physically and in other ways when they try LSD once or twice?
1
2
3
4
DK/REF
RK01e

How much do people risk harming themselves physically and in other ways when they use LSD once or twice a week?
1
2
3
4
DK/REF

RK01f

No risk
Slight risk
Moderate risk
Great risk

No risk
Slight risk
Moderate risk
Great risk

How much do people risk harming themselves physically and in other ways when they try heroin once or twice?
1
2
3
4
DK/REF

May 23, 2012

No risk
Slight risk
Moderate risk
Great risk

177

RK01g

How much do people risk harming themselves physically and in other ways when they use heroin once or twice a
week?
1
2
3
4
DK/REF

No risk
Slight risk
Moderate risk
Great risk

RK01h How much do people risk harming themselves physically and in other ways when they use cocaine once a month?
1
2
3
4
DK/REF
RK01i

How much do people risk harming themselves physically and in other ways when they use cocaine once or twice a
week?
1
2
3
4
DK/REF

RK01j

No risk
Slight risk
Moderate risk
Great risk

No risk
Slight risk
Moderate risk
Great risk

How much do people risk harming themselves physically and in other ways when they have four or five drinks of an
alcoholic beverage nearly every day?
1
2
3
4
DK/REF

No risk
Slight risk
Moderate risk
Great risk

RK01k How much do people risk harming themselves physically and in other ways when they have five or more drinks of an
alcoholic beverage once or twice a week?
1
2
3
4
DK/REF
RKQ2

No risk
Slight risk
Moderate risk
Great risk

The next questions ask how difficult you think it would be for you to get each of the following types of drugs, if you
wanted some.
Press [ENTER] to continue.

RK02a

How difficult or easy would it be for you to get some marijuana, if you wanted some?
1
2
3
4
5
DK/REF

Probably impossible
Very difficult
Fairly difficult
Fairly easy
Very easy

RK02b How difficult or easy would it be for you to get some LSD, if you wanted some?
1
2
3
4
5
May 23, 2012

Probably impossible
Very difficult
Fairly difficult
Fairly easy
Very easy
178

DK/REF
RK02c

How difficult or easy would it be for you to get some cocaine, if you wanted some?
1
2
3
4
5
DK/REF

Probably impossible
Very difficult
Fairly difficult
Fairly easy
Very easy

RK02d How difficult or easy would it be for you to get some ‘crack’, if you wanted some?
1
2
3
4
5
DK/REF
RK02e

How difficult or easy would it be for you to get some heroin, if you wanted some?
1
2
3
4
5
DK/REF

RK03

Probably impossible
Very difficult
Fairly difficult
Fairly easy
Very easy

Probably impossible
Very difficult
Fairly difficult
Fairly easy
Very easy

In the past 30 days, has anyone approached you to sell you an illegal drug?
1
Yes
2
No
DK/REF

RK04a

How often do you get a real kick out of doing things that are a little dangerous?
1
2
3
4
DK/REF

Never
Seldom
Sometimes
Always

RK04b How often do you like to test yourself by doing something a little risky?
1
2
3
4
DK/REF
RK04c

Never
Seldom
Sometimes
Always

How often do you wear a seatbelt when you ride in the front passenger seat of a car?
1
2
3
4
DK/REF

Never
Seldom
Sometimes
Always

RK04d How often do you wear a seatbelt when you drive a car?
1
2
3
4
May 23, 2012

Never
Seldom
Sometimes
Always
179

5
I don’t drive
DK/REF

May 23, 2012

180

Blunts
BL01

Sometimes people take tobacco out of a cigar and replace it with marijuana. This is sometimes called a ‘blunt’.
Have you ever smoked part or all of a cigar with marijuana in it?
1
Yes
2
No
DK/REF

BL08

[IF BL01 = 1] How old were you the first time you smoked part or all of a cigar with marijuana in it?
[(RANGE: 1 - 110]

AGE:
DK/REF

DEFINE AGE1STBL:
IF BL08 NE (BLANK OR DK/REF) THEN AGE1STBL = BL08
ELSE AGE1STBL = BLANK
IF AGE1STBL = CURNTAGE OR AGE1STBL < 10:
BLCC01
The computer recorded that you were [AGE1STBL] years old the first time you smoked part
or all of a cigar with marijuana in it. Is this correct?
4
Yes
6
No
DK/REF
BLCC02

[IF BLCC01 = 6] Please answer this question again. How old were you the first time you
smoked part or all of a cigar with marijuana in it?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF BLCC02 NOT(BLANK OR DK/REF) THEN AGE1STBL = BLCC02
BL08a

[IF BLCC01 NE DK/RE AND BLCC02 NE DK/REF AND AGE1STBL = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGE1STBL = CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you first
smoke part or all of a cigar with marijuana in it in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

BL08b

[IF AGE1STBL = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first smoke part or all of a cigar
with marijuana in it in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

BL08c

[IF BLCC01 NE DK/RE AND BLCC02 NE DK/REF AND AGE1STBL = CURNTAGE AND DATE OF
INTERVIEW $ DOB] In what month in [CURRENT YEAR] did you first smoke part or all of a cigar with marijuana
in it?
1
2
3
4
5
6
7
8
9
10
11

May 23, 2012

January
February
March
April
May
June
July
August
September
October
November
181

12
December
DK/REF
HARD ERROR: [IF BL08c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
BL08d

[IF BL08a = 1 OR 2 OR BL08b = 1 OR 2] In what month in [YEAR FROM BL08a or BL08b] did you first smoke
part or all of a cigar with marijuana in it?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF BL08d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STBL:
MYR1STBL = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST USE (BL08a-d). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STBL IS
BLANK.
IF MYR1STBL NE 0 AND NE AGE1STBL:
BLCC03
The computer recorded that you first smoked part or all of a cigar with marijuana in it in
[BL08a-d fill]. That would make you [MYR1STBL] years old when you first smoked part or
all of a cigar with marijuana in it. Is this correct?
4
Yes
6
No
DK/REF
BLCC04

[IF BLCC03 = 4] Earlier, the computer recorded that you were [AGE1STBL] years old when
you first smoked part or all of a cigar with marijuana in it. Which answer is correct?
1
2
3
DK/REF

I first smoked part or all of a cigar with marijuana in it in [BL08a-d fill] when I was
[MYR1STBL] years old
I was [AGE1STBL] years old the first time I smoked part or all of a cigar with
marijuana in it
Neither answer is correct

UPDATE: IF BLCC04 = 1, THEN AGE1STBL = MYR1STBL
BLCC05

[IF BLCC04=2 OR BLCC04=3 OR BLCC03=6] Please answer this question again. Did you
first smoke part or all of a cigar with marijuana in it in [CURRENT YEAR-2], [CURRENT
YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

BLCC05a

May 23, 2012

[IF BLCC05 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [BLCC05] did you first smoke part or all of a cigar with marijuana in it?
182

1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF BLCC05a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF BLCC05a NE (0 OR DK/RE) THEN UPDATE MYR1STBL.
MYR1STBL = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF FIRST USE (BLCC05 AND BLCC05a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STBL IS
BLANK. IF MYR1STBL = AGE1STBL THEN MYR1STBL = BLANK
BLCC06

[IF BLCC04 NE 1 AND MYR1STBL NE 0 AND (BLCC05 AND BLCC05a NE BL08a-d)] The
computer recorded that you first smoked part or all of a cigar with marijuana in it in
[BLCC05-BLCC05a fill]. That would make you [MYR1STBL] years old when you first
smoked part or all of a cigar with marijuana in it. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF BLCC06 NE (6, BLANK OR DK/REF) AND (BLCC05 AND BLCC05a NE BL08a-d) THEN AGE1STBL =
MYR1STBL
BL02

[IF BL01 = 1] How long has it been since you last smoked part or all of a cigar with marijuana in it?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

BL02a

[IF (MJLAST3 = 1 OR MJRECDK = 1 OR MJRECRE = 1) AND BL02 = 1] On how many of the past 30 days, that is,
since [DATEFILL], did you smoke part or all of a cigar with marijuana in it?
# OF DAYS: ______________ [RANGE: 1-30]
DK/REF

BL03

[IF (MJ01 = 2 OR MJREF = 2) AND BL02=1] The answer to the last question and an earlier question disagree.
Which answer is correct?
1
I have never used marijuana or hashish
2
I smoked part or all of a cigar with marijuana in it during the past 30 days
DK/REF

BL03a

[IF BL03 = 2] On how many of the past 30 days, that is, since [DATEFILL], did you smoke part or all of a cigar with
marijuana in it?
# OF DAYS: ______________ [RANGE: 1-30]
DK/REF

BL04

[IF (MJLAST3 =2 or 3 OR MJRECDK=2 OR 3 OR MJRECRE=2 OR 3) AND BL02=1] The answer to the last
question and an earlier question disagree. Which answer is correct?

May 23, 2012

183

1
I last used marijuana or hashish [MJREC FILL]
2
I smoked part or all of a cigar with marijuana in it during the past 30 days
DK/REF
BL04a

[IF BL04 = 2] On how many of the past 30 days, that is, since [DATEFILL], did you smoke part or all of a cigar with
marijuana in it?
# OF DAYS: ______________ [RANGE: 1-30]
DK/REF

BL05

[IF BL03 =2] Why did you report earlier that you had never used marijuana or hashish?
1
I didn’t consider a ‘blunt’ to be marijuana or hashish
2
I made a mistake when I answered the earlier question about ever using marijuana or hashish
3
Some other reason
DK/REF

BL05SP [IF BL05 = 3] Please type in the other reason you reported earlier that you had never used marijuana or hashish.
When you have finished, press the [ENTER] key to go to the next question.
______________
DK/REF
BL06

[IF BL04 =2] Why did you report earlier that you did not use marijuana or hashish during the past 30 days?
1
I didn’t consider a ‘blunt’ to be marijuana or hashish
2
I made a mistake earlier when I answered how long ago I last used marijuana or hashish
3
Some other reason
DK/REF

BL06SP [IF BL06 = 3] Please type in the other reason you reported earlier that you had not used marijuana or hashish during
the past 30 days.
When you have finished, press the [ENTER] key to go to the next question.
______________
DK/REF

BL07

[IF CG36=1 AND (BL02 = 1 OR BL03 = 2 OR BL04 = 2)] Earlier, you reported that you had smoked part or all of a
cigar during the past 30 days. During the past 30 days, did you smoke any cigars that did not have marijuana in them?
1
Yes
2
No
DK/REF

MJMM01

[IF MJLAST3 = 1 - 2 OR MJRECDK = 1 - 2 OR MJRECRE = 1 - 2] Earlier, you reported using marijuana
in the past year. Was any of your marijuana use in the past 12 months recommended by a doctor?
1
Yes
2
No
DK/REF

MJMM02

[IF MJMM01=1] Was all of your marijuana use in the past 12 months recommended by a doctor?
1
Yes
2
No
DK/REF

May 23, 2012

184

Definitions for Use in the Drugs Module
DEFINE CIG30DAY:
IF CG05 = 1 THEN CIG30DAY = 1
ELSE CIG30DAY = 2
DEFINE ALC12MON:
IF (ALLAST3 = 1 OR 2 OR ALRECDK = 1 OR 2 OR ALRECRE = 1 OR 2) AND TOTDRINK = DK/REF, THEN
ALC12MON = 1
ELSE TOTDRINK > 5, THEN ALC12MON = 2
ELSE ALCC30 > 5 OR ALCC29b = 3 - 6 OR ALCC29a > 5 OR (AL08 >5 AND ALCC27 = 4) OR AL06 > 5 OR
ESTIALC > 2, THEN ALC12MON = 3
ELSE, ALC12MON = 4
DEFINE MAR12MON:
IF (MJLAST3 = 1 OR 2 OR MJRECDK = 1 OR 2 OR MJRECRE = 1 OR 2) AND TOTMJ = DK/REF, THEN
MAR12MON = 1
ELSE TOTMJ > 5, THEN MAR12MON = 2
ELSE MJCC16 > 5 OR MJCC13a > 5 OR MJC13b = 3 - 6 OR (MJ06 > 5 AND MJCC07a = 4) OR (MJ06DKRE = 3 6 AND MJCC07b = 4), THEN MAR12MON = 3
ELSE MAR12MON = 4
DEFINE COC12MON:
IF CCLAST3 = 1 OR 2 OR CCRECDK = 1 OR 2 OR CCRECRE = 1 OR 2 OR SD07 = 1 OR 2, THEN COC12MON
=1
ELSE COC12MON = 2
DEFINE CRK12MON:
IF CKLAST3 = 1 OR 2 OR CKRECDK = 1 OR 2 OR CKRECRE = 1 OR 2, THEN CRK12MON = 1
ELSE CRK12MON = 2
DEFINE HER12MON:
IF HELAST3 = 1 OR 2 OR HERECDK = 1 OR 2 OR HERECRE = 1 OR 2 OR SD02 = 1 OR 2 OR SD04 = 1 OR 2
OR SD09 = 1 OR 2, THEN HER12MON = 1
ELSE HER12MON = 2
DEFINE HAL12MON:
IF HALLREC = 1 OR 2 OR LSDREC = 1 OR 2 OR PCPREC = 1 OR 2 OR ECSTREC = 1 OR 2, OR SD28 = 1 OR2,
OR SD29 = 1 OR, 2 OR SD30 = 1 OR2, THEN HAL12MON = 1
ELSE HAL12MON = 2
DEFINE INH12MON:
IF INLAST = 1 OR 2 OR INRECDK = 1 OR 2 OR INRECRE = 1 OR 2, THEN INH12MON = 1
ELSE INH12MON = 2
DEFINE PAI12MON:
IF PRREC = 1 OR 2 OR OXYREC = 1 OR 2, THEN PAI12MON = 1
ELSE PAI12MON = 2
DEFINE TRA12MON:
IF TR09 = 1 OR 2 OR TRRECDK = 1 OR 2 OR TRRECRE = 1 OR 2, THEN TRA12MON = 1
ELSE TRA12MON = 2
DEFINE STI12MON:
IF STIMREC = 1 OR 2 OR METHREC = 1 OR 2 OR SD10b = 1 OR 2 OR SD11 = 1 OR 2 OR (SD17b = (1 OR 2)
AND SD17a1 NE 1) OR SD18b = 1 OR 2, OR SD25 = 1 OR2, THEN STI12MON= 1
ELSE STI12MON = 2
DEFINE SED12MON
IF SV09 = 1 OR 2 OR SVRECDK = 1 OR 2 OR SVRECRE = 1 OR 2, OR SD26 = 1 OR2THEN SED12MON = 1
ELSE SED12MON = 2

May 23, 2012

185

May 23, 2012

186

Substance Dependence and Abuse
INTRODR

[IF CIG30DAY = 1 OR ALC12MON = 1 OR 2 OR 3 OR MAR12MON = 1 OR 2 OR 3 OR COC12MON =
1 OR CRK12MON = 1 OR HER12MON = 1 OR HAL12MON = 1 OR INH12MON = 1 OR PAI12MON = 1
OR TRA12MON = 1 OR STI12MON = 1 OR SED12MON = 1] Now we’d like for you to tell us about your
experiences with the
[CIG30DAY = 1 AND ALC12MON = 4 AND (MAR12MON = 4 AND COC12MON = 2 AND
CRK12MON = 2 AND HER12MON = 2 AND HAL12MON = 2 AND INH12MON = 2 AND PAI12MON =
2 AND TRA12MON = 2 AND STI12MON = 2 AND SED12MON = 2)] cigarettes you smoked.
[CIG30DAY = 1 AND ALC12MON = 1 OR 2 OR 3 AND (MAR12MON = 4 AND COC12MON = 2 AND
CRK12MON = 2 AND HER12MON = 2 AND HAL12MON = 2 AND INH12MON = 2 AND PAI12MON =
2 AND TRA12MON = 2 AND STI12MON = 2 AND SED12MON = 2)] cigarettes you smoked and the
alcohol you drank.
[CIG30DAY = 2 AND ALC12MON =1 OR 2 OR 3 AND (MAR12MON = 4 AND COC12MON = 2 AND
CRK12MON = 2 AND HER12MON = 2 AND HAL12MON = 2 AND INH12MON = 2 AND PAI12MON =
2 AND TRA12MON = 2 AND STI12MON = 2 AND SED12MON = 2)] alcohol you drank.
[CIG30DAY = 1 AND ALC12MON = 4 AND (MAR12MON = 1 OR 2 OR 3 OR COC12MON = 1 OR
CRK12MON =1 OR HER12MON = 1 OR HAL12MON = 1 OR INH12MON = 1 OR PAI12MON = 1 OR
TRA12MON = 1 OR STI12MON = 1 OR SED12MON = 1)] cigarettes you smoked and the other drugs that
you used.
[CIG30DAY = 2 AND ALC12MON = 1 OR 2 OR 3 OR AND (MAR12MON = 1 OR 2 OR 3 OR
COC12MON = 1 OR CRK12MON =1 OR HER12MON = 1 OR HAL12MON = 1 OR INH12MON = 1 OR
PAI12MON = 1 OR TRA12MON = 1 OR STI12MON = 1 OR SED12MON = 1)] alcohol you drank and the
other drugs that you used.
[CIG30DAY = 1 AND ALC12MON = 1 OR 2 OR 3 AND (MAR12MON = 1 OR 2 OR 3 OR COC12MON
= 1 OR CRK12MON =1 OR HER12MON = 1 OR HAL12MON = 1 OR INH12MON = 1 OR PAI12MON =
1 OR TRA12MON = 1 OR STI12MON = 1 OR SED12MON = 1)]cigarettes you smoked, the alcohol you
drank, and the other drugs that you used.
[CIG30DAY = 2 AND ALC12MON = 4 AND (MAR12MON = 1 OR 2 OR 3 OR COC12MON = 1 OR
CRK12MON =1 OR HER12MON = 1 OR HAL12MON = 1 OR INH12MON = 1 OR PAI12MON = 1 OR
TRA12MON = 1 OR STI12MON = 1 OR SED12MON = 1)]drugs that you used.
Press [ENTER] to continue.

DRCIG [IF CIG30DAY = 1] Think about your use of cigarettes during the past 30 days as you answer these next questions.
Press [ENTER] to continue.
DRCGE01

[IF CIG30DAY=1] Please think about how true each statement is of you.
After not smoking for a while, you need to smoke in order to feel less restless and irritable.
1
2
3
4
5
DK/REF

DRCGE02

[IF CIG30DAY=1] When you don’t smoke for a few hours, you start to crave cigarettes.
1
2
3
4
5
DK/REF

May 23, 2012

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

187

DRCGE03

[IF CIG30DAY=1] You sometimes have strong cravings for a cigarette where it feels like you’re in the grip
of a force you can’t control.
1
2
3
4
5
DK/REF

DRCGE04

[IF CIG30DAY=1] You feel a sense of control over your smoking — that is, you can “take it or leave it” at
any time.
1
2
3
4
5
DK/REF

DRCGE05

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

[IF CIG30DAY=1] You tend to avoid places that don’t allow smoking, even if you would otherwise enjoy
them.
1
2
3
4
5
DK/REF

DRCGE06a

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

[IF CIG30DAY=1] Do you have any friends who do not smoke cigarettes?
1
Yes
2
No
DK/REF

DRCGE06b

[IF CGE6A = 1] Think about your use of cigarettes during the past 30 days as you answer these next
questions. There are times when you choose not to be around your friends who don’t smoke because they
won’t like it if you smoke.
1
2
3
4
5
DK/REF

DRCGE07

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

[IF CIG30DAY=1]
[ADD IF DRCGE06b = BLANK] Think about your use of cigarettes during the past 30 days as you answer
these next questions.
Even if you’re traveling a long distance, you’d rather not travel by airplane because you wouldn’t be allowed
to smoke.
1
2
3
4
5
DK/REF

May 23, 2012

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

188

DRCGE08

[IF CIG30DAY=1] You sometimes worry that you will run out of cigarettes.
1
2
3
4
5
DK/REF

DRCGE09

[IF CIG30DAY=1] You smoke cigarettes fairly regularly throughout the day.
1
2
3
4
5
DK/REF

DRCGE10

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

[IF CIG30DAY=1] The number of cigarettes you smoke per day is often influenced by other things -- how
you’re feeling, or what you’re doing, for example.
1
2
3
4
5
DK/REF

May 23, 2012

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

[IF CIG30DAY=1] It’s normal for you to smoke several cigarettes in an hour, then not have another one until
hours later.
1
2
3
4
5
DK/REF

DRCGE14

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

[IF CIG30DAY=1] It’s hard to say how many cigarettes you smoke per day because the number often
changes.
1
2
3
4
5
DK/REF

DRCGE13

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

[IF CIG30DAY=1] You smoke just about the same number of cigarettes from day to day.
1
2
3
4
5
DK/REF

DRCGE12

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

[IF CIG30DAY=1] You smoke about the same amount on weekends as on weekdays.
1
2
3
4
5
DK/REF

DRCGE11

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

189

DRCGE15

[IF CIG30DAY=1] Your smoking is not affected much by other things. For example, you smoke about the
same amount whether you’re relaxing or working, happy or sad, alone or with others.
1
2
3
4
5
DK/REF

DRCGE16

[IF CIG30DAY=1] Since you started smoking, the amount you smoke has increased.
1
2
3
4
5
DK/REF

DRCGE17

Within the first 5 minutes after you wake up
Between 6 and 30 minutes after you wake up
Between 31 and 60 minutes after you wake up
More than 60 minutes after you wake up

[IF DRCGE19a = BLANK AND CIG30DAY=1 AND (CG07 = 1 - 29 OR CG07DKRE - 1-5] On the days
that you smoke, how soon after you wake up do you have your first cigarette?
1
2
3
4
DK/REF

DRALC

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

[IF CIG30DAY=1 AND (CG07=30 OR CG07DKRE = 6] How soon after you wake up do you have your
first cigarette?
1
2
3
4
DK/REF

DRCGE19b

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

[IF CIG30DAY=1] Compared to when you first started smoking, you can smoke much, much more now
before you start to feel anything.
1
2
3
4
5
DK/REF

DRCGE19a

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

[IF CIG30DAY=1] Compared to when you first started smoking, you need to smoke a lot more now in order
to be satisfied.
1
2
3
4
5
DK/REF

DRCGE18

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

Within the first 5 minutes after you wake up
Between 6 and 30 minutes after you wake up
Between 31 and 60 minutes after you wake up
More than 60 minutes after you wake up

[IF ALC12MON = 1 - 3] Think about your use of alcohol during the past 12 months as you answer these
next questions.
Press [ENTER] to continue.

DRALC01

May 23, 2012

[IF ALC12MON = 1 - 3] During the past 12 months, was there a month or more when you spent a lot of your
time getting or drinking alcohol?
190

1
Yes
2
No
DK/REF
DRALC02

[IF DRALC01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot
of time getting over the effects of the alcohol you drank?
1
Yes
2
No
DK/REF

DRALC04

[IF ALC12MON = 1 - 3] During the past 12 months, did you try to set limits on how often or how much
alcohol you would drink?
1
Yes
2
No
DK/REF

DRALC05

[IF DRALC04 = 1] Were you able to keep to the limits you set, or did you often drink more than you
intended to?
1
Usually kept to the limits set
2
Often drank more than intended
DK/REF

DRALC06

[IF ALC12MON = 1 - 3] During the past 12 months, did you need to drink more alcohol than you used to in
order to get the effect you wanted?
1
Yes
2
No
DK/REF

DRALC07

[IF DRALCO6=2 OR DK/REF] During the past 12 months, did you notice that drinking the same amount of
alcohol had less effect on you than it used to?
1
Yes
2
No
DK/REF

DRALC08

[IF ALC12MON = 1 - 3] During the past 12 months, did you want to or try to cut down or stop drinking
alcohol?
1
Yes
2
No
DK/REF

DRALC09

[IF DRALC08 = 1] During the past 12 months, were you able to cut down or stop drinking alcohol every
time you wanted to or tried to?
1
Yes
2
No
DK/REF

DRALC10

[IF DRALC08 = 2 OR DK/REF OR DRALC09 = 2 OR DK/REF] During the past 12 months, did you cut
down or stop drinking at least one time?
1
Yes
2
No
DK/REF

DRALC11

[IF DRALC09 = 1 OR DRALC10 = 1] Please look at the symptoms listed below. During the past 12
months, did you have 2 or more of these symptoms after you cut back or stopped drinking alcohol?
•

May 23, 2012

Sweating or feeling that your heart was beating fast
191

•
•
•
•
•
•
•

Having your hands tremble
Having trouble sleeping
Vomiting or feeling nauseous
Seeing, hearing, or feeling things that weren’t really there
Feeling like you couldn’t sit still
Feeling anxious
Having seizures or fits

1
Yes
2
No
DK/REF
DRALC12

[IF DRALC11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or
more of these symptoms at the same time that lasted for longer than a day after you cut back or stopped
drinking alcohol?
•
•
•
•
•
•
•
•

Sweating or feeling that your heart was beating fast
Having your hands tremble
Having trouble sleeping
Vomiting or feeling nauseous
Seeing, hearing, or feeling things that weren’t really there
Feeling like you couldn’t sit still
Feeling anxious
Having seizures or fits

1
Yes
2
No
DK/REF
DRALC13

[IF ALC12MON = 1 - 3] During the past 12 months, did you have any problems with your emotions, nerves,
or mental health that were probably caused or made worse by drinking alcohol?
1
Yes
2
No
DK/REF

DRALC14

[IF DRALC13 = 1] Did you continue to drink alcohol even though you thought drinking was causing you to
have problems with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF

DRALC15

[IF DRALC13 = 2 OR DK/REF OR DRALC14 = 2 OR DK/REF] During the past 12 months, did you have
any physical health problems that were probably caused or made worse by drinking alcohol?
1
Yes
2
No
DK/REF

DRALC16

[IF DRALC15 = 1] Did you continue to drink alcohol even though you thought drinking was causing you to
have physical problems?
1
Yes
2
No
DK/REF

DRALC17

[IF ALC12MON = 1 - 3] This question is about important activities such as working, going to school, taking
care of children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did drinking alcohol cause you to give up or spend less time doing these types of
important activities?
1
2

May 23, 2012

Yes
No
192

DK/REF
DRALC18

[IF ALC12MON = 1 - 3] Sometimes people who drink alcohol have serious problems at home, work or
school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did drinking alcohol cause you to have serious problems like this either at home,
work, or school?
1
Yes
2
No
DK/REF
DRALC19

[IF ALC12MON = 1 - 3] During the past 12 months, did you regularly drink alcohol and then do something
where being drunk might have put you in physical danger?
1
Yes
2
No
DK/REF

DRALC20

[IF ALC12MON = 1 - 3] During the past 12 months, did drinking alcohol cause you to do things that
repeatedly got you in trouble with the law?
1
Yes
2
No
DK/REF

DRALC21

[IF ALC12MON = 1 - 3] During the past 12 months, did you have any problems with family or friends that
were probably caused by your drinking?
1
Yes
2
No
DK/REF

DRALC22

[IF DRALC21 = 1] Did you continue to drink alcohol even though you thought your drinking caused
problems with family or friends?
1
Yes
2
No
DK/REF

DRMJ

[IF MAR12MON = 1 - 3] Think about your use of marijuana or hashish during the past 12 months as you
answer these next questions.
Press [ENTER] to continue.

DRMJ01

[IF MAR12MON= 1 - 3] During the past 12 months, was there a month or more when you spent a lot of your time
getting or using marijuana or hashish?
1
Yes
2
No
DK/REF

DRMJ02

[IF DRMJ01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of
your time getting over the effects of the marijuana or hashish you used?
1
Yes
2
No
DK/REF

DRMJ04
May 23, 2012

[IF MAR12MON= 1 - 3] During the past 12 months, did you try to set limits on how often or how much
193

marijuana or hashish you would use?
1
Yes
2
No
DK/REF
DRMJ05

[IF DRMJ04 = 1] Were you able to keep to the limits you set, or did you often use marijuana or hashish more
than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

DRMJ06

[IF MAR12MON = 1 - 3] During the past 12 months, did you need to use more marijuana or hashish than you
used to in order to get the effect you wanted?
1
Yes
2
No
DK/REF

DRMJ07

[IF DRMJ06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of
marijuana or hashish had less effect on you than it used to?
1
Yes
2
No
DK/REF

DRMJ08

[IF MAR12MON= 1 - 3] During the past 12 months, did you want to or try to cut down or stop using marijuana
or hashish?
1
Yes
2
No
DK/REF

DRMJ09

[IF DRMJ08 = 1] During the past 12 months, were you able to cut down or stop using marijuana or hashish
every time you wanted to or tried to?
1
Yes
2
No
DK/REF

DRMJ13

[IF MAR12MON= 1 - 3] During the past 12 months, did you have any problems with your emotions, nerves, or
mental health that were probably caused or made worse by your use of marijuana or hashish?
1
Yes
2
No
DK/REF

DRMJ14

[IF DRMJ13 = 1] Did you continue to use marijuana or hashish even though you thought it was causing you to
have problems with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF

DRMJ15

[IF DRMJ13 = 2 OR DK/REF OR DRMJ14 = 2 OR DK/REF] During the past 12 months, did you have any
physical health problems that were probably caused or made worse by your use of marijuana or hashish?
1
Yes
2
No
DK/REF

DRMJ16

May 23, 2012

[IF DRMJ15 = 1] Did you continue to use marijuana or hashish even though you thought it was causing you to
have physical problems?

194

1
Yes
2
No
DK/REF
DRMJ17

[IF MAR12MON= 1 - 3] This question is about important activities such as working, going to school, taking care
of children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using marijuana or hashish cause you to give up or spend less time doing these
types of important activities?
1
Yes
2
No
DK/REF

DRMJ18

[IF MAR12MON= 1 - 3] Sometimes people who use marijuana or hashish have serious problems at home, work
or school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using marijuana or hashish cause you to have serious problems like this either at
home, work, or school?
1
Yes
2
No
DK/REF
DRMJ19

[IF MAR12MON= 1 - 3] During the past 12 months, did you regularly use marijuana or hashish and then do
something where using marijuana or hashish might have put you in physical danger?
1
Yes
2
No
DK/REF

DRMJ20

[IF MAR12MON= 1 - 3] During the past 12 months, did using marijuana or hashish cause you to do things that
repeatedly got you in trouble with the law?
1
Yes
2
No
DK/REF

DRMJ21

[IF MAR12MON= 1 - 3] During the past 12 months, did you have any problems with family or friends that were
probably caused by your use of marijuana or hashish?
1
Yes
2
No
DK/REF

DRMJ22

[IF DRMJ21 = 1] Did you continue to use marijuana or hashish even though you thought it caused problems
with family or friends?
1
Yes
2
No
DK/REF

DRCC

[IF COC12MON = 1 OR CRK12MON = 1] Think about your use of cocaine [IF CRK12MON = 1] , including
the form of cocaine called ‘crack’ during the past 12 months as you answer these next questions.
Press [ENTER] to continue.

DEFINE COKEFILL:
IF COC12MON = 1 AND CRK12MON NE 1, THEN COKEFILL = ‘cocaine’
IF COC12MON = 1 AND CRK12MON = 1 THEN COKEFILL = ‘cocaine or ‘crack’
May 23, 2012

195

IF COC12MON NE 1 AND CRK12MON = 1 THEN COKEFILL = ‘crack’
ELSE COKEFILL = BLANK
DRCC01

[IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, was there a month or more when you
spent a lot of your time getting or using [COKEFILL]?
1
Yes
2
No
DK/REF

DRCC02

[IF DRCC01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of
your time getting over the effects of the [COKEFILL] you used?
1
Yes
2
No
DK/REF

DRCC04

[IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did you try to set limits on how often or
how much [COKEFILL] you would use?
1
Yes
2
No
DK/REF

DRCC05

[IF DRCC04 = 1] Were you able to keep to the limits you set, or did you often use [COKEFILL] more than you
intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

DRCC06

[IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did you need to use more [COKEFILL]
than you used to in order to get the effect you wanted?
1
Yes
2
No
DK/REF

DRCC07

[IF DRCC06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of
[COKEFILL] had less effect on you than it used to?
1
Yes
2
No
DK/REF

DRCC08

[IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did you want to or try to cut down or
stop using [COKEFILL]?
1
Yes
2
No
DK/REF

DRCC09

[IF DRCC08 = 1] During the past 12 months, were you able to cut down or stop using [COKEFILL] every time
you wanted to or tried to?
1
Yes
2
No
DK/REF

DRCC10

[IF DRCC8 = 2 OR DK/REF OR DRCC9 = 2 OR DK/REF] During the past 12 months, did you cut down or stop
using [COKEFILL] at least one time?
1
Yes
2
No
DK/REF

May 23, 2012

196

DRCC10a

[IF DRCC09 = 1 OR DRCC10 = 1] During the past 12 months, have you felt kind of blue or down when you cut
down or stopped using [COKEFILL]?
1
Yes
2
No
DK/REF

DRCC11

[IF DRCC10a = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more
of these symptoms after you cut back or stopped using [COKEFILL]?
•
•
•
•
•

Feeling tired or exhausted
Having bad dreams
Having trouble sleeping or sleeping more than you normally do
Feeling hungry more often
Feeling either very slowed down or like you couldn’t sit still

1
Yes
2
No
DK/REF
DRCC12

[IF DRCC11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more
of these symptoms at the same time that lasted for longer than a day after you cut back or stopped using
[COKEFILL]?
•
•
•
•
•

Feeling tired or exhausted
Having bad dreams
Having trouble sleeping or sleeping more than you normally do
Feeling hungry more often
Feeling either very slowed down or like you couldn’t sit still

1
Yes
2
No
DK/REF
DRCC13

[IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did you have any problems with your
emotions, nerves, or mental health that were probably caused or made worse by your use of [COKEFILL]?
1
Yes
2
No
DK/REF

DRCC14

[IF DRCC13 = 1] Did you continue to use [COKEFILL] even though you thought it was causing you to have
problems with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF

DRCC15

[IF DRCC13 = 2 OR DK/REF OR DRCC14 = 2 OR DK/REF] During the past 12 months, did you have any
physical health problems that were probably caused or made worse by your use of [COKEFILL]?
1
Yes
2
No
DK/REF

DRCC16

[IF DRCC15 = 1] Did you continue to use [COKEFILL] even though you thought it was causing you to have
physical problems?
1
Yes
2
No
DK/REF

DRCC17

May 23, 2012

[IF COC12MON = 1 OR CRK12MON = 1] This question is about important activities such as working, going to
school, taking care of children, doing fun things such as hobbies and sports, and spending time with friends and
197

family.
During the past 12 months, did using [COKEFILL] cause you to give up or spend less time doing these types of
important activities?
1
Yes
2
No
DK/REF
DRCC18

[IF COC12MON = 1 OR CRK12MON = 1] Sometimes people who use [COKEFILL] have serious problems at
home, work or school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using [COKEFILL] cause you to have serious problems like this either at home,
work, or school?
1
Yes
2
No
DK/REF
DRCC19

[IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did you regularly use [COKEFILL] and
then do something where using [COKEFILL] might have put you in physical danger?
1
Yes
2
No
DK/REF

DRCC20

[IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did using [COKEFILL] cause you to do
things that repeatedly got you in trouble with the law?
1
Yes
2
No
DK/REF

DRCC21

[IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did you have any problems with family or
friends that were probably caused by your use of [COKEFILL]?
1
Yes
2
No
DK/REF

DRCC22

[IF DRCC21 = 1] Did you continue to use [COKEFILL] even though you thought it caused problems with family
or friends?
1
Yes
2
No
DK/REF

DRHE

[IF HER12MON = 1] Think about your use of heroin during the past 12 months as you answer these next
questions.
Press [ENTER] to continue.

DRHE01

[IF HER12MON = 1] During the past 12 months, was there a month or more when you spent a lot of your time
getting or using heroin?
1
Yes
2
No
DK/REF

DRHE02
May 23, 2012

[IF DRHE01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of
198

your time getting over the effects of the heroin you used?
1
Yes
2
No
DK/REF
DRHE04

[IF HER12MON = 1] During the past 12 months, did you try to set limits on how often or how much heroin you
would use?
1
Yes
2
No
DK/REF

DRHE05

[IF DRHE04 = 1] Were you able to keep to the limits you set, or did you often use heroin more than you intended
to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

DRHE06

[IF HER12MON = 1] During the past 12 months, did you need to use more heroin than you used to in order to
get the effect you wanted?
1
Yes
2
No
DK/REF

DRHE07

[IF DRHE06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of heroin
had less effect on you than it used to?
1
Yes
2
No
DK/REF

DRHE08

[IF HER12MON = 1] During the past 12 months, did you want to or try to cut down or stop using heroin?
1
Yes
2
No
DK/REF

DRHE09

[IF DRHE08 = 1] During the past 12 months, were you able to cut down or stop using heroin every time you
wanted to or tried to?
1
Yes
2
No
DK/REF

DRHE10

[IF DRHE08 = 2 OR DK/REF OR DRHE09 = 2 OR DK/REF] During the past 12 months, did you cut down or
stop using heroin at least one time?
1
Yes
2
No
DK/REF

DRHE11

[IF DRHE09 = 1 OR DRHE10 = 1] Please look at the symptoms listed below. During the past 12 months, did
you have 3 or more of these symptoms after you cut back or stopped using heroin?
•
•
•
•
•
•
•
•

May 23, 2012

Feeling kind of blue or down
Vomiting or feeling nauseous
Having cramps or muscle aches
Having teary eyes or a runny nose
Feeling sweaty, having enlarged eye pupils, or having body hair standing up on your skin
Having diarrhea
Yawning
Having a fever
199

•

Having trouble sleeping

1
Yes
2
No
DK/REF
DRHE12

[IF DRHE11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 3 or more
of these symptoms at the same time that lasted for longer than a day after you cut back or stopped using heroin?
•
•
•
•
•
•
•
•
•

Feeling kind of blue or down
Vomiting or feeling nauseous
Having cramps or muscle aches
Having teary eyes or a runny nose
Feeling sweaty, having enlarged eye pupils, or having body hair standing up on your skin
Having diarrhea
Yawning
Having a fever
Having trouble sleeping

1
Yes
2
No
DK/REF
DRHE13

[IF HER12MON = 1] During the past 12 months, did you have any problems with your emotions, nerves, or
mental health that were probably caused or made worse by your use of heroin?
1
Yes
2
No
DK/REF

DRHE14

[IF DRHE13 = 1] Did you continue to use heroin even though you thought it was causing you to have problems
with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF

DRHE15

[IF DRHE13 = 2 OR DK/REF OR DRHE14 = 2 OR DK/REF] During the past 12 months, did you have any
physical health problems that were probably caused or made worse by your use of heroin?
1
Yes
2
No
DK/REF

DRHE16

[IF DRHE15 = 1] Did you continue to use heroin even though you thought it was causing you to have physical
problems?
1
Yes
2
No
DK/REF

DRHE17

[IF HER12MON = 1] This question is about important activities such as working, going to school, taking care of
children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using heroin cause you to give up or spend less time doing these types of
important activities?
1
Yes
2
No
DK/REF

DRHE18

[IF HER12MON = 1] Sometimes people who use heroin have serious problems at home, work or school — such
as:
•

May 23, 2012

neglecting their children
200

•
•
•

missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using heroin cause you to have serious problems like this either at home, work, or
school?
1
Yes
2
No
DK/REF
DRHE19

[IF HER12MON = 1] During the past 12 months, did you regularly use heroin and then do something where
using heroin might have put you in physical danger?
1
Yes
2
No
DK/REF

DRHE20

[IF HER12MON = 1] During the past 12 months, did using heroin cause you to do things that repeatedly got you
in trouble with the law?
1
Yes
2
No
DK/REF

DRHE21

[IF HER12MON = 1] During the past 12 months, did you have any problems with family or friends that were
probably caused by your use of heroin?
1
Yes
2
No
DK/REF

DRHE22

[IF DRHE21 = 1] Did you continue to use heroin even though you thought it caused problems with family or
friends?
1
Yes
2
No
DK/REF

DRLS

[IF HAL12MON = 1] Think about your use of hallucinogens, such as LSD, ‘acid’, PCP, ‘Ecstasy’, psilocybin or
mushrooms, mescaline, or peyote during the past 12 months as you answer these next questions.
Press [ENTER] to continue.

DRLS01

[IF HAL12MON = 1] During the past 12 months, was there a month or more when you spent a lot of your time
getting or using hallucinogens?
1
Yes
2
No
DK/REF

DRLS02

[IF DRLS01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of
your time getting over the effects of the hallucinogens you used?
1
Yes
2
No
DK/REF

DRLS04

[IF HAL12MON = 1] During the past 12 months, did you try to set limits on how often or how much
hallucinogens you would use?
1
Yes
2
No
DK/REF

May 23, 2012

201

DRLS05

[IF DRLS04 = 1] Were you able to keep to the limits you set, or did you often use hallucinogens more than you
intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

DRLS06

[IF HAL12MON = 1] During the past 12 months, did you need to use more hallucinogens than you used to in
order to get the effect you wanted?
1
Yes
2
No
DK/REF

DRLS07

IF DRLS06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of
hallucinogens had less effect on you than it used to?
1
Yes
2
No
DK/REF

DRLS08

[IF HAL12MON = 1] During the past 12 months, did you want to or try to cut down or stop using
hallucinogens?
1
Yes
2
No
DK/REF

DRLS09

[IF DRLS08 = 1] During the past 12 months, were you able to cut down or stop using hallucinogens every time
you wanted to or tried to?
1
Yes
2
No
DK/REF

DRLS13

[IF HAL12MON = 1] During the past 12 months, did you have any problems with your emotions, nerves, or
mental health that were probably caused or made worse by your use of hallucinogens?
1
Yes
2
No
DK/REF

DRLS14

[IF DRLS13 = 1] Did you continue to use hallucinogens even though you thought this was causing you to have
problems with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF

DRLS15

[IF DRLS13 = 2 OR DK/REF OR DRLS14 = 2 OR DK/REF] During the past 12 months, did you have any
physical health problems that were probably caused or made worse by your use of hallucinogens?
1
Yes
2
No
DK/REF

DRLS16

[IF DRLS15 = 1] Did you continue to use hallucinogens even though you thought this was causing you to have
physical problems?
1
Yes
2
No
DK/REF

May 23, 2012

202

DRLS17

[IF HAL12MON = 1] This question is about important activities such as working, going to school, taking care of
children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using hallucinogens cause you to give up or spend less time doing these types of
important activities?
1
Yes
2
No
DK/REF

DRLS18

[IF HAL12MON = 1] Sometimes people who use hallucinogens have serious problems at home, work or school
— such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using hallucinogens cause you to have serious problems like this either at home,
work, or school?
1
Yes
2
No
DK/REF
DRLS19

[IF HAL12MON = 1] During the past 12 months, did you regularly use hallucinogens and then do something
where using hallucinogens put you in physical danger?
1
Yes
2
No
DK/REF

DRLS20

[IF HAL12MON = 1] During the past 12 months, did using hallucinogens cause you to do things that repeatedly
got you in trouble with the law?
1
Yes
2
No
DK/REF

DRLS21

[IF HAL12MON = 1] During the past 12 months, did you have any problems with family or friends that were
probably caused by your use of hallucinogens?
1
Yes
2
No
DK/REF

DRLS22

[IF DRLS21 = 1] Did you continue to use hallucinogens even though you thought this caused problems with
family or friends?
1
Yes
2
No
DK/REF

DRIN

[IF INH12MON = 1] Think about your use of inhalants, such as amyl nitrite, ‘poppers,’ nitrous oxide, gasoline
or lighter fluids, glue, spray paints, or correction fluids during the past 12 months as you answer these next
questions.
Press [ENTER] to continue.

DRIN01

[IF INH12MON = 1] During the past 12 months, was there a month or more when you spent a lot of your time
getting or using inhalants?
1
Yes
2
No
DK/REF

May 23, 2012

203

DRIN02

[IF DRIN01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of
your time getting over the effects of the inhalants you used?
1
Yes
2
No
DK/REF

DRIN04

[IF INH12MON = 1] During the past 12 months, did you try to set limits on how often or how much inhalants
you would use?
1
Yes
2
No
DK/REF

DRIN05

[IF DRIN04 = 1] Were you able to keep to the limits you set, or did you often use inhalants more than you
intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

DRIN06

[IF INH12MON = 1] During the past 12 months, did you need to use more inhalants than you used to in order to
get the effect you wanted?
1
Yes
2
No
DK/REF

DRIN07

[IF DRIN06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of inhalants
had less effect on you than it used to?
1
Yes
2
No
DK/REF

DRIN08

[IF INH12MON = 1] During the past 12 months, did you want to or try to cut down or stop using inhalants?
1
Yes
2
No
DK/REF

DRIN09

[IF DRIN08 = 1] During the past 12 months, were you able to cut down or stop using inhalants every time you
wanted to or tried to?
1
Yes
2
No
DK/REF

DRIN13

[IF INH12MON = 1] During the past 12 months, did you have any problems with your emotions, nerves, or
mental health that were probably caused or made worse by your use of inhalants?
1
Yes
2
No
DK/REF

DRIN14

[IF DRIN13 = 1] Did you continue to use inhalants even though you thought this was causing you to have
problems with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF

May 23, 2012

204

DRIN15

[IF DRIN13 = 2 OR DK/REF OR DRIN14 = 2 OR DK/REF] During the past 12 months, did you have any
physical health problems that were probably caused or made worse by your use of inhalants?
1
Yes
2
No
DK/REF

DRIN16

[IF DRIN15 = 1] Did you continue to use inhalants even though you thought this was causing you to have
physical problems?
1
Yes
2
No
DK/REF

DRIN17

[IF INH12MON = 1] This question is about important activities such as working, going to school, taking care of
children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using inhalants cause you to give up or spend less time doing these types of
important activities?
1
Yes
2
No
DK/REF

DRIN18

[IF INH12MON = 1] Sometimes people who use inhalants have serious problems at home, work or school —
such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using inhalants cause you to have serious problems like this either at home, work,
or school?
1
Yes
2
No
DK/REF
DRIN19

[IF INH12MON = 1] During the past 12 months, did you regularly use inhalants and then do something where
using inhalants might have put you in physical danger?
1
Yes
2
No
DK/REF

DRIN20

[IF INH12MON = 1] During the past 12 months, did using inhalants cause you to do things that repeatedly got
you in trouble with the law?
1
Yes
2
No
DK/REF

DRIN21

[IF INH12MON = 1] During the past 12 months, did you have any problems with family or friends that were
probably caused by your use of inhalants?
1
Yes
2
No
DK/REF

DRIN22

[IF DRIN21 = 1] Did you continue to use inhalants even though you thought this caused problems with family or
friends?
1
2

May 23, 2012

Yes
No
205

DK/REF
DRPR

[IF PAI12MON = 1] Think about your use of prescription pain relievers during the past 12 months as you
answer these next questions. Remember, we are only interested in your use of prescription pain relievers that
were not prescribed for you or that you used only for the experience or feeling they caused.
Press [ENTER] to continue.

DRPR01

[IF PAI12MON = 1] During the past 12 months, was there a month or more when you spent a lot of your time
getting or using prescription pain relievers?
1
Yes
2
No
DK/REF

DRPR02

[IF DRPR01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of
your time getting over the effects of the prescription pain relievers you used?
1
Yes
2
No
DK/REF

DRPR04

[IF PAI12MON = 1] During the past 12 months, did you try to set limits on how often or how much prescription
pain relievers you would use?
1
Yes
2
No
DK/REF

DRPR05

[IF DRPR04 = 1] Were you able to keep to the limits you set, or did you often use prescription pain relievers
more than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

DRPR06

[IF PAI12MON = 1] During the past 12 months, did you need to use more prescription pain relievers than you
used to in order to get the effect you wanted?
1
Yes
2
No
DK/REF

DRPR07

[IF DRPR06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of
prescription pain relievers had less effect on you than it used to?
1
Yes
2
No
DK/REF

DRPR08

[IF PAI12MON = 1] During the past 12 months, did you want to or try to cut down or stop using prescription
pain relievers?
1
Yes
2
No
DK/REF

DRPR09

[IF DRPR08 = 1] During the past 12 months, were you able to cut down or stop using prescription pain
relievers every time you wanted to or tried to?
1
Yes
2
No
DK/REF

DRPR10
May 23, 2012

[IF DRPR08 = 2 OR DK/REF OR DRPR09 = 2 OR DK/REF] During the past 12 months, did you cut down or
206

stop using prescription pain relievers at least one time?
1
Yes
2
No
DK/REF
DRPR11

[IF DRPR09 = 1 OR DRPR10 = 1] Please look at the symptoms listed below. During the past 12 months, did
you have 3 or more of these symptoms after you cut back or stopped using prescription pain relievers?
•
•
•
•
•
•
•
•
•

Feeling kind of blue or down
Vomiting or feeling nauseous
Having cramps or muscle aches
Having teary eyes or a runny nose
Feeling sweaty, having enlarged eye pupils, or having body hair standing up on your skin
Having diarrhea
Yawning
Having a fever
Having trouble sleeping

1
Yes
2
No
DK/REF
DRPR12

[IF DRPR11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 3 or more
of these symptoms at the same time that lasted for longer than a day after you cut back or stopped using
prescription pain relievers?
•
•
•
•
•
•
•
•
•

Feeling kind of blue or down
Vomiting or feeling nauseous
Having cramps or muscle aches
Having teary eyes or a runny nose
Feeling sweaty, having enlarged eye pupils, or having body hair standing up on your skin
Having diarrhea
Yawning
Having a fever
Having trouble sleeping

1
Yes
2
No
DK/REF
DRPR13

[IF PAI12MON = 1] During the past 12 months, did you have any problems with your emotions, nerves, or mental
health that were probably caused or made worse by your use of prescription pain relievers?
1
Yes
2
No
DK/REF

DRPR14

[IF DRPR13 = 1] Did you continue to use prescription pain relievers even though you thought this was causing
you to have problems with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF

DRPR15

[IF DRPR13 = 2 OR DK/REF OR DRPR14 = 2 OR DK/REF] During the past 12 months, did you have any
physical health problems that were probably caused or made worse by your use of prescription pain relievers?
1
Yes
2
No
DK/REF

DRPR16

May 23, 2012

[IF DRPR15 = 1] Did you continue to use prescription pain relievers even though you thought this was causing
you to have physical problems?

207

1
Yes
2
No
DK/REF
DRPR17

[IF PAI12MON = 1] This question is about important activities such as working, going to school, taking care of
children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using prescription pain relievers cause you to give up or spend less time doing
these types of important activities?
1
Yes
2
No
DK/REF

DRPR18

[IF PAI12MON = 1] Sometimes people who use prescription pain relievers have serious problems at home,
work or school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using prescription pain relievers cause you to have serious problems like this
either at home, work, or school?
1
Yes
2
No
DK/REF
DRPR19

[IF PAI12MON = 1] During the past 12 months, did you regularly use prescription pain relievers and then do
something where using prescription pain relievers might have put you in physical danger?
1
Yes
2
No
DK/REF

DRPR20

[IF PAI12MON = 1] During the past 12 months, did using prescription pain relievers cause you to do things that
repeatedly got you in trouble with the law?
1
Yes
2
No
DK/REF

DRPR21

[IF PAI12MON = 1] During the past 12 months, did you have any problems with family or friends that were
probably caused by your use of prescription pain relievers?
1
Yes
2
No
DK/REF

DRPR22

[IF DRPR21 = 1] Did you continue to use prescription pain relievers even though you thought this caused
problems with family or friends?
1
Yes
2
No
DK/REF

DRTR

[IF TRA12MON = 1] Think about your use of prescription tranquilizers during the past 12 months as you
answer these next questions. Remember, we are only interested in your use of prescription tranquilizers that
were not prescribed for you or that you used only for the experience or feeling they caused.
Press [ENTER] to continue.

DRTR01

May 23, 2012

[IF TRA12MON = 1] During the past 12 months, was there a month or more when you spent a lot of your time
getting or using prescription tranquilizers?
208

1
Yes
2
No
DK/REF
DRTR02

[IF DRTR01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of
your time getting over the effects of the prescription tranquilizers you used?
1
Yes
2
No
DK/REF

DRTR04

[IF TRA12MON = 1] During the past 12 months, did you try to set limits on how often or how much prescription
tranquilizers you would use?
1
Yes
2
No
DK/REF

DRTR05

[IF DRTR04 = 1] Were you able to keep to the limits you set, or did you often use prescription tranquilizers
more than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

DRTR06

[IF TRA12MON = 1] During the past 12 months, did you need to use more prescription tranquilizers than you
used to in order to get the effect you wanted?
1
Yes
2
No
DK/REF

DRTR07

[IF DRTR06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of
prescription tranquilizers had less effect on you than it used to?
1
Yes
2
No
DK/REF

DRTR08

[IF TRA12MON = 1] During the past 12 months, did you want to or try to cut down or stop using prescription
tranquilizers?
1
Yes
2
No
DK/REF

DRTR09

[IF DRTR08 = 1] During the past 12 months, were you able to cut down or stop using prescription tranquilizers
every time you wanted to or tried to?
1
Yes
2
No
DK/REF

DRTR13

[IF TRA12MON = 1] During the past 12 months, did you have any problems with your emotions, nerves, or
mental health that were probably caused or made worse by your use of prescription tranquilizers?
1
Yes
2
No
DK/REF

DRTR14

[IF DRTR13 = 1] Did you continue to use prescription tranquilizers even though you thought this was causing
you to have problems with your emotions, nerves, or mental health?
1

May 23, 2012

Yes
209

2
No
DK/REF
DRTR15

[IF DRTR13 = 2 OR DK/REF OR DRTR14 = 2 OR DK/REF] During the past 12 months, did you have any
physical health problems that were probably caused or made worse by your use of prescription tranquilizers?
1
Yes
2
No
DK/REF

DRTR16

[IF DRTR15 = 1] Did you continue to use prescription tranquilizers even though you thought this was causing
you to have physical problems?
1
Yes
2
No
DK/REF

DRTR17

[IF TRA12MON = 1] This question is about important activities such as working, going to school, taking care of
children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using prescription tranquilizers cause you to give up or spend less time doing
these types of important activities?
1
Yes
2
No
DK/REF

DRTR18

[IF TRA12MON = 1] Sometimes people who use prescription tranquilizers have serious problems at home,
work or school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using prescription tranquilizers cause you to have serious problems like this
either at home, work, or school?
1
Yes
2
No
DK/REF
DRTR19

[IF TRA12MON = 1] During the past 12 months, did you regularly use prescription tranquilizers and then do
something where using prescription tranquilizers might have put you in physical danger?
1
Yes
2
No
DK/REF

DRTR20

[IF TRA12MON = 1] During the past 12 months, did using prescription tranquilizers cause you to do things that
repeatedly got you in trouble with the law?
1
Yes
2
No
DK/REF

DRTR21

[IF TRA12MON = 1] During the past 12 months, did you have any problems with family or friends that were
probably caused by your use of prescription tranquilizers?
1
Yes
2
No
DK/REF

DRTR22

May 23, 2012

[IF DRTR21 = 1] Did you continue to use prescription tranquilizers even though you thought this caused
problems with family or friends?
210

1
Yes
2
No
DK/REF
DRST

[IF STI12MON = 1] Think about your use of prescription stimulants during the past 12 months as you answer
these next questions. Remember, we are only interested in your use of prescription stimulants that were not
prescribed for you or that you used only for the experience or feeling they caused.
Press [ENTER] to continue.

DRST01

[IF STI12MON = 1] During the past 12 months, was there a month or more when you spent a lot of your time
getting or using prescription stimulants?
1
Yes
2
No
DK/REF

DRST02

[IF DRST01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of
your time getting over the effects of the prescription stimulants you used?
1
Yes
2
No
DK/REF

DRST04

[IF STI12MON = 1] During the past 12 months, did you try to set limits on how often or how much prescription
stimulants you would use?
1
Yes
2
No
DK/REF

DRST05

[IF DRST04 = 1] Were you able to keep to the limits you set, or did you often use prescription stimulants more
than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

DRST06

[IF STI12MON = 1] During the past 12 months, did you need to use more prescription stimulants than you used
to in order to get the effect you wanted?
1
Yes
2
No
DK/REF

DRST07

[IF DRST06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of
prescription stimulants had less effect on you than it used to?
1
Yes
2
No
DK/REF

DRST08

[IF STI12MON = 1] During the past 12 months, did you want to or try to cut down or stop using prescription
stimulants?
1
Yes
2
No
DK/REF

DRST09

[IF DRST08 = 1] During the past 12 months, were you able to cut down or stop using prescription stimulants
every time you wanted to or tried to?
1
2

May 23, 2012

Yes
No
211

DK/REF
DRST10

[IF DRST8 = 2 OR DK/REF OR DRST9 = 2 OR DK/REF] During the past 12 months, did you cut down or stop
using prescription stimulants at least one time?
1
Yes
2
No
DK/REF

DRST10a

[IF DRST09 = 1 OR DRST10 = 1] During the past 12 months, have you felt kind of blue or down when you cut
down or stopped using prescription stimulants?
1
Yes
2
No
DK/REF

DRST11

[IF DRST10a = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more
of these symptoms after you cut back or stopped using prescription stimulants?
•
•
•
•
•

Feeling tired or exhausted
Having bad dreams
Having trouble sleeping or sleeping more than you normally do
Feeling hungry more often
Feeling either very slowed down or like you couldn’t sit still

1
Yes
2
No
DK/REF
DRST12

[IF DRST11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 2 or more
of these symptoms at the same time that lasted for longer than a day after you cut back or stopped using
prescription stimulants?
•
•
•
•
•

Feeling tired or exhausted
Having bad dreams
Having trouble sleeping or sleeping more than you normally do
Feeling hungry more often
Feeling either very slowed down or like you couldn’t sit still

1
Yes
2
No
DK/REF
DRST13

[IF STI12MON = 1] During the past 12 months, did you have any problems with your emotions, nerves, or mental
health that were probably caused or made worse by your use of prescription stimulants?
1
Yes
2
No
DK/REF

DRST14

[IF DRST13 = 1] Did you continue to use prescription stimulants even though you thought this was causing you
to have problems with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF

DRST15

[IF DRST13 = 2 OR DK/REF OR DRST14 = 2 OR DK/REF] During the past 12 months, did you have any
physical health problems that were probably caused or made worse by your use of prescription stimulants?
1
Yes
2
No
DK/REF

DRST16
May 23, 2012

[IF DRST15 = 1] Did you continue to use prescription stimulants even though this was causing you to have
212

physical problems?
1
Yes
2
No
DK/REF
DRST17

[IF STI12MON = 1] This question is about important activities such as working, going to school, taking care of
children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using prescription stimulants cause you to give up or spend less time doing these
types of important activities?
1
Yes
2
No
DK/REF

DRST18

[IF STI12MON = 1] Sometimes people who use prescription stimulants have serious problems at home, work or
school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using prescription stimulants cause you to have serious problems like this either
at home, work, or school?
1
Yes
2
No
DK/REF
DRST19

[IF STI12MON = 1] During the past 12 months, did you regularly use prescription stimulants and then do
something where using prescription stimulants might have put you in physical danger?
1
Yes
2
No
DK/REF

DRST20

[IF STI12MON = 1] During the past 12 months, did using prescription stimulants cause you to do things that
repeatedly got you in trouble with the law?
1
Yes
2
No
DK/REF

DRST21

[IF STI12MON = 1] During the past 12 months, did you have any problems with family or friends that were
probably caused by your use of prescription stimulants?
1
Yes
2
No
DK/REF

DRST22

[IF DRST21 = 1] Did you continue to use prescription stimulants even though you thought this caused problems
with family or friends?
1
Yes
2
No
DK/REF

DRSV

[IF SED12MON = 1] Think about your use of prescription sedatives during the past 12 months as you answer
these next questions. Remember, we are only interested in your use of prescription sedatives that were not
prescribed for you or that you used only for the experience or feeling they caused.
Press [ENTER] to continue.

May 23, 2012

213

DRSV01

[IF SED12MON = 1] During the past 12 months, was there a month or more when you spent a lot of your time
getting or using prescription sedatives?
1
Yes
2
No
DK/REF

DRSV02

[IF DRSV01 = 2 OR DK/REF] During the past 12 months, was there a month or more when you spent a lot of
your time getting over the effects of the prescription sedatives you used?
1
Yes
2
No
DK/REF

DRSV04

[IF SED12MON = 1] During the past 12 months, did you try to set limits on how often or how much prescription
sedatives you would use?
1
Yes
2
No
DK/REF

DRSV05

[IF DRSV04 = 1] Were you able to keep to the limits you set, or did you often use prescription sedatives more
than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

DRSV06

[IF SED12MON = 1] During the past 12 months, did you need to use more prescription sedatives than you used
to in order to get the effect you wanted?
1
Yes
2
No
DK/REF

DRSV07

[IF DRSV06=2 OR DK/REF] During the past 12 months, did you notice that using the same amount of
prescription sedatives had less effect on you than it used to?
1
Yes
2
No
DK/REF

DRSV08

[IF SED12MON = 1] During the past 12 months, did you want to or try to cut down or stop using prescription
sedatives?
1
Yes
2
No
DK/REF

DRSV09

[IF DRSV08 = 1] During the past 12 months, were you able to cut down or stop using prescription sedatives
every time you wanted to or tried to?
1
Yes
2
No
DK/REF

DRSV10

[IF DRSV08 = 2 OR DK/REF OR DRSV09 = 2 OR DK/REF] During the past 12 months, did you cut down or
stop using prescription sedatives at least one time?
1
Yes
2
No
DK/REF

DRSV11

May 23, 2012

[IF DRSV09 = 1 OR DRSV10 = 1] Please look at the symptoms listed below. During the past 12 months, did
you have 1 or more of these symptoms after you cut back or stopped using prescription sedatives?
214

•
•
•
•
•
•
•
•

Sweating or feeling that your heart was beating fast
Having your hands tremble
Having trouble sleeping or sleeping more than you normally do
Vomiting or feeling nauseous
Seeing, hearing, or feeling things that weren’t really there
Feeling like you couldn’t sit still
Feeling anxious
Having seizures or fits

1
Yes
2
No
DK/REF
DRSV12

[IF DRSV11 = 1] Please look at the symptoms listed below. During the past 12 months, did you have 1 or more
of these symptoms at the same time that lasted for longer than a day after you cut back or stopped using
prescription sedatives?
•
•
•
•
•
•
•
•

Sweating or feeling that your heart was beating fast
Having your hands tremble
Having trouble sleeping or sleeping more than you normally do
Vomiting or feeling nauseous
Seeing, hearing, or feeling things that weren’t really there
Feeling like you couldn’t sit still
Feeling anxious
Having seizures or fits

1
Yes
2
No
DK/REF
DRSV13

[IF SED12MON = 1] During the past 12 months, did you have any problems with your emotions, nerves, or
mental health that were probably caused or made worse by your use of prescription sedatives?
1
Yes
2
No
DK/REF

DRSV14

[IF DRSV13 = 1] Did you continue to use prescription sedatives even though you thought this was causing you
to have problems with your emotions, nerves, or mental health?
1
Yes
2
No
DK/REF

DRSV15

[IF DRSV13 = 2 OR DK/REF OR DRSV14 = 2 OR DK/REF] During the past 12 months, did you have any
physical health problems that were probably caused or made worse by your use of prescription sedatives?
1
Yes
2
No
DK/REF

DRSV16

[IF DRSV15 = 1] Did you continue to use prescription sedatives even though you thought this was causing you
to have physical problems?
1
Yes
2
No
DK/REF

DRSV17

[IF SED12MON = 1] This question is about important activities such as working, going to school, taking care of
children, doing fun things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using prescription sedatives cause you to give up or spend less time doing these
types of important activities?
1

May 23, 2012

Yes
215

2
No
DK/REF
DRSV18

[IF SED12MON = 1] Sometimes people who use prescription sedatives have serious problems at home, work or
school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using prescription sedatives cause you to have serious problems like this either at
home, work, or school?
1
Yes
2
No
DK/REF
DRSV19

[IF SED12MON = 1] During the past 12 months, did you regularly use prescription sedatives and then do
something where using prescription sedatives might have put you in physical danger?
1
Yes
2
No
DK/REF

DRSV20

[IF SED12MON = 1] During the past 12 months, did using prescription sedatives cause you to do things that
repeatedly got you in trouble with the law?
1
Yes
2
No
DK/REF

DRSV21

[IF SED12MON = 1] During the past 12 months, did you have any problems with family or friends that were
probably caused by your use of prescription sedatives?
1
Yes
2
No
DK/REF

DRSV22

[IF DRSV21 = 1] Did you continue to use prescription sedatives even though you thought this caused problems
with family or friends?
1
Yes
2
No
DK/REF

May 23, 2012

216

Special Topics
INTROSP

The next questions are about encounters with the police or the court system.
Press [ENTER] to continue.

SP01

Not counting minor traffic violations, have you ever been arrested and booked for breaking the law?
Being ‘booked’ means that you were taken into custody and processed by the police or by someone connected with the
courts, even if you were then released.
1
Yes
2
No
DK/REF

SP02

[IF SP01 = 1] Not counting minor traffic violations, how many times during the past 12 months have you been
arrested and booked for breaking a law?
__________ [RANGE: 0 - 99]
DK/REF

INTROBK

[IF SP02 = 1 - 99 OR DK/REF] The next questions are about offenses that are against the law. As you read each
question, please answer whether you were arrested and booked for that offense during the past 12 months.
Press [ENTER] to continue.

SP03a

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for motor vehicle theft?
1
Yes
2
No
DK/REF

SP03b

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for larceny or theft? [IF
SP03a = 1 OR DK/REF] Do not include motor vehicle theft.
1
Yes
2
No
DK/REF

SP03c

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for burglary or breaking and
entering?
1
Yes
2
No
DK/REF

SP03d

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for aggravated assault?
1
Yes
2
No
DK/REF

SP03e

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for other assault, such as
simple assault or battery?
1
Yes
2
No
DK/REF

SP03f

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for robbery?
1
Yes
2
No
DK/REF

May 23, 2012

217

SP03g

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for forcible rape?
1
Yes
2
No
DK/REF

SP03h

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for murder, homicide, or
nonnegligent manslaughter?
1
Yes
2
No
DK/REF

SP03i

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for arson?
1
Yes
2
No
DK/REF

SP03j

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for driving under the
influence of alcohol or drugs?
1
Yes
2
No
DK/REF

SP03k

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for drunkenness or other
liquor law violations?
1
Yes
2
No
DK/REF

SP03l

[IF SP02 = 1 - 99 OR DK/REF AND CURNTAGE = 12 - 17] In the past 12 months, were you arrested and booked
for possession of tobacco?
1
Yes
2
No
DK/REF

SP03m

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for possession, manufacture,
or sale of drugs?
1
Yes
2
No
DK/REF

SP03n

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for prostitution or
commercialized sex?
1
Yes
2
No
DK/REF

SP03o

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for any other sexual offense,
not including rape or prostitution?
1
Yes
2
No
DK/REF

May 23, 2012

218

SP03p

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for fraud, possessing stolen
goods, or vandalism?
1
Yes
2
No
DK/REF

SP03q

[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and booked for some other offense besides
these that have been named? Please do not include minor traffic violations.
1
Yes
2
No
DK/REF
[IF SP03q = 1] Please type one of the offenses for which you were arrested and booked during the past 12 months.
For this question, do not include minor traffic violations. When you have finished, press the [ENTER] key to go
to the next question.

SP03qsp

_____________
DK/REF
SP03r

[IF SP02 = 1-99 AND ALL SP03a THROUGH SP03q = 2 OR DK/REF] The computer recorded that you were arrested
and booked for breaking a law (1 time/[SP02 FILL] times) during the past 12 months. Is that correct?
4
Yes
6
No
DK/REF
[IF SP03r=4] Please type one of the offenses for which you were arrested and booked during the past 12 months.
For this question, do not include minor traffic violations. When you have finished, press the [ENTER] key to go
to the next question.

SP03rsp

_____________
DK/REF
SP03s

[IF SP03r = 6 or DK/REF] Please answer this question again. Not counting minor traffic violations, how many times
during the past 12 months have you been arrested and booked for breaking a law?
___________ [RANGE: 0-99]
DK/REF
[IF SP03s = or > 1] Please type one of the offenses for which you were arrested and booked during the past 12
months. For this question, do not include minor traffic violations. When you have finished, press the [ENTER]
key to go to the next question.

SP03ssp

_____________
DK/REF
SP04

Were you on probation at any time during the past 12 months?
1
Yes
2
No
DK/REF

SP05

Were you on parole, supervised release, or other conditional release from prison at any time during the past 12
months?
1
Yes
2
No
DK/REF

SP06a

[IF (ALLAST3 = 1 OR 2 OR ALRECDK = 1 OR 2 OR ALRECRE = 1 OR 2) AND (MJLAST3 = 1 OR 2 OR
MJRECDK = 1 OR 2 OR MJRECRE = 1 OR 2 OR COC12MON = 1 OR CRK12MON = 1 OR HER12MON = 1 OR
HAL12MON = 1 OR INH12MON = 1 OR PAI12MON =1 OR TRA12MON = 1 OR STI12MON = 1 OR SED12MON
= 1)] During the past 12 months, have you driven a vehicle while you were under the influence of a combination of
alcohol and illegal drugs used together?

May 23, 2012

219

1
Yes
2
No
DK/REF
SP06b

[IF SP06a = BLANK AND (ALLAST3 = 1 OR 2 OR ALRECDK = 1 OR 2 OR ALRECRE = 1 OR 2) During the
past 12 months, have you driven a vehicle while you were under the influence of alcohol?
[IF SP06a NE BLANK] During the past 12 months, have you driven a vehicle while you were under the influence of
alcohol only?
1
Yes
2
No
DK/REF

SP06c

[IF SP06a = BLANK AND (MJLAST3 = 1 OR 2 OR MJRECDK = 1 OR 2 OR MJRECRE = 1 OR 2 OR COC12MON
= 1 OR CRK12MON = 1 OR HER12MON = 1 OR HAL12MON = 1 OR INH12MON = 1 OR PAI12MON =1 OR
TRA12MON = 1 OR STI12MON = 1 OR SED12MON = 1)] During the past 12 months, have you driven a vehicle
while you were under the influence of illegal drugs?
[IF SP06a NE BLANK] During the past 12 months, have you driven a vehicle while you were under the influence of
illegal drugs only?
1
Yes
2
No
DK/REF

SP07

What is the maximum legal penalty in [STATE FILL FROM FIPE4] for first offense possession of an ounce or less of
marijuana for your own use?
1
2
3
4
5
6
DK/REF

SP08

A fine
Probation
Community service
A possible prison sentence
A mandatory prison sentence
No penalty

[IF SP07 NE DK/REF]
[IF SP07 = 1-5] How sure are you that [FILL ANSWER FROM SP07] is the maximum legal penalty for first offense
possession of an ounce or less of marijuana in [STATE FILL FROM FIPE4]?
[IF SP07 = 6] How sure are you that there is no legal penalty for first offense possession of an ounce or less
of marijuana in [STATE FILL FROM FIPE4]?
1
Very sure
2
Somewhat sure
3
Not at all sure
DK/REF

SP09

In [STATE FILL FROM FIPE4], has marijuana been legally approved for medical use?
1
Yes
2
No
DK/REF

May 23, 2012

220

Market Information for Marijuana
MJE01 [IF MJLAST3 = 1 OR 2 OR MJRECDK = 1 OR 2 OR MJRECRE = 1 OR 2] Now think about the last time you used
marijuana. How did you get this marijuana?
1
2
3
4
DK/REF

You bought it
You traded something else for it
You got it for free or shared someone else’s
You grew it yourself

MJE02 [IF MJE01 = 1] How long has it been since you last bought any marijuana?
1
Within the past 30 days -- that is since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
MJE03 [IF MJE01 = 2 - 4 OR DK/REF] During the past 12 months, that is, since [DATEFILL], did you buy any marijuana?
1
Yes
2
No
DK/REF
MJE04 [IF MJE03 = 1] How long has it been since you last bought any marijuana?
1
Within the past 30 days -- that is since [DATEFILL]
2
More than 30 days ago but within the past 12 months
DK/REF
MJE05 [IF MJE02 = 1 OR MJE04 = 1] During the past 30 days, that is, since [DATEFILL], on how many days did you buy
marijuana?
# OF DAYS:
DK/REF

[RANGE: 1 - 30]

MJE06 [IF MJE02 = 1 - 3 OR MJE03 = 1] Think about the last time you bought marijuana. Did you buy marijuana that had
already been rolled into joints or did you buy the marijuana in loose form?
1
You bought joints
2
You bought the marijuana in loose form
DK/REF
MJE07 [IF MJE06 = 1] How many joints did you buy the last time you bought marijuana?
# OF JOINTS:
DK/REF

[RANGE: 1 - 500]

MJE08 [IF MJE07 > 1 OR DK/REF] How much did you pay for the joints you bought this last time?
[IF MJE07 = 1] How much did you pay for the joint you bought this last time?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF
May 23, 2012

less than $5.00
$5.00 to $10.99
$11.00 to $20.99
$21.00 to $50.99
$51.00 to $100.99
$101.00 to $150.99
$151.00 to $200.99
$201.00 to $250.99
$251.00 to $300.99
$301.00 to $500.99
$501.00 to $1000.99
More than $1000.99

221

MJE09 [IF MJE08 = 4 AND MJE07 > 1 OR DK/REF] More specifically, which of these categories includes the price you paid
for the joints you bought this last time?
[IF MJE08 = 4 AND MJE07 = 1] More specifically, which of these categories includes the price you paid for the joint
you bought this last time?
1
$21.00 to $30.99
2
$31.00 to $40.99
3
$41.00 to $50.99
DK/REF
MJE10 [IF MJE08 = 5 AND MJE07 > 1 OR DK/REF] More specifically, which of these categories includes the price you paid
for the joints you bought this last time?
[IF MJE08 = 5 AND MJE07 = 1] More specifically, which of these categories includes the price you paid for the joint
you bought this last time?
1
2
3
4
5
DK/REF

$51.00 to $60.99
$61.00 to $70.99
$71.00 to $80.99
$81.00 to $90.99
$91.00 to $100.99

MJE11 [IF MJE08 = 6 AND MJE07 > 1 OR DK/REF] More specifically, which of these categories includes the price you paid
for the joints you bought this last time?
[IF MJE08 = 6 AND MJE07 = 1] More specifically, which of these categories includes the price you paid for the joint
you bought this last time?
1
2
3
4
5
DK/REF

$101.00 to $110.99
$111.00 to $120.99
$121.00 to $130.99
$131.00 to $140.99
$141.00 to $150.99

MJE12 [IF MJE08 = 10 AND MJE07 > 1 OR DK/REF] More specifically, which of these categories includes the price you
paid for the joints you bought this last time?
[IF MJE08 = 10 AND MJE07 = 1] More specifically, which of these categories includes the price you paid for the joint
you bought this last time?
1
2
3
4
DK/REF

$301.00 to $350.99
$351.00 to $400.99
$401.00 to $450.99
$451.00 to $500.99

MJE13 [IF MJE08 = 11 AND MJE07 > 1 OR DK/REF] More specifically, which of these categories includes the price you
paid for the joints you bought this last time?
[IF MJE08 = 11 AND MJE07 = 1] More specifically, which of these categories includes the price you paid for the joint
you bought this last time?
1
2
3
4
5
6
7
8
9
May 23, 2012

$501.00 to $550.99
$551.00 to $600.99
$601.00 to $650.99
$651.00 to $700.99
$701.00 to $750.99
$751.00 to $800.99
$801.00 to $850.99
$851.00 to $900.99
$901.00 to $950.99
222

10
$951.00 to $1000.99
DK/REF
MJE14 [IF MJE06 = 2] Now we want to know how much marijuana you bought the last time you bought marijuana.
Do you want to give your answer in grams, ounces, or pounds?
1
Grams
2
Ounces
3
Pounds
DK/REF
DEFINE MJUNIT1A:
IF MJE14 = 1 THEN MJUNIT1A = “grams”
IF MJE14 = 2 THEN MJUNIT1A = “ounces”
IF MJE14 = 3 THEN MJUNIT1A = “pounds”
ELSE MJUNIT1A = BLANK
MJE15 [IF MJE14 NE DK/REF AND MJUNIT1A= “grams”] The last time you bought marijuana, how many grams did you
buy?
1
At least 1 but less than 5 grams
2
At least 5 but less than 10 grams
3
10 grams or more
DK/REF
MJE16 [IF MJE15 =3] How many grams of marijuana did you buy?
# OF GRAMS: __________ [RANGE 10 - 99]
DK/REF
MJE17 [IF MJE14 NE DK/REF AND MJUNIT1A= “ounces”] The last time you bought marijuana, how many ounces did you
buy?
1
2
3
4
5
6
7
DK/REF

At least 1/8, but less than 1/4 of an ounce
At least 1/4 but less than 1/3 of an ounce
At least 1/3 but less than ½ of an ounce
At least ½ but less than 1 ounce
At least 1 but less than 5 ounces
At least 5 but less than 10 ounces
At least 10 but less than 16 ounces

MJE18 [IF MJE14 NE DK/REF AND MJUNIT1A= “pounds”] The last time you bought marijuana, how many pounds did
you buy?
1
2
3
4
5
DK/REF

At least 1 but less than 2 pounds
At least 2 but less than 3 pounds
At least 3 but less than 4 pounds
At least 4 but less than 5 pounds
5 or more pounds

MJE19 [IF MJE18 = 5] How many pounds of marijuana did you buy?
# OF POUNDS:
DK/REF

[RANGE: 5 - 99]

MJE20 [IF MJE14 NE BLANK] How much did you pay for the marijuana you bought this last time?
1
2
3
4
5
May 23, 2012

less than $5.00
$5.00 to $10.99
$11.00 to $20.99
$21.00 to $50.99
$51.00 to $100.99
223

6
7
8
9
10
11
12
DK/REF

$101.00 to $150.99
$151.00 to $200.99
$201.00 to $250.99
$251.00 to $300.99
$301.00 to $500.99
$501.00 to $1000.99
More than $1000.99

MJE21 [IF MJE20 = 4] More specifically, which of these categories includes the price you paid for the marijuana you bought
this last time?
1
$21.00 to $30.99
2
$31.00 to $40.99
3
$41.00 to $50.99
DK/REF
MJE22 [IF MJE20 = 5 ] More specifically, which of these categories includes the price you paid for the marijuana you bought
this last time?
1
2
3
5
6
DK/REF

$51.00 to $60.99
$61.00 to $70.99
$71.00 to $80.99
$81.00 to $90.99
$91.00 to $100.99

MJE23 [IF MJE20 = 6] More specifically, which of these categories includes the price you paid for the marijuana you bought
this last time?
1
2
3
4
5
DK/REF

$101.00 to $110.99
$110.00 to $120.99
$121.00 to $130.99
$131.00 to $140.99
$141.00 to $150.99

MJE24 [IF MJE20 = 10] More specifically, which of these categories includes the price you paid for the marijuana you bought
this last time?
1
2
3
4
DK/REF

$301.00 to $350.99
$351.00 to $400.99
$401.00 to $450.99
$451.00 to $500.99

MJE25 [IF MJE20 = 11] More specifically, which of these categories includes the price you paid for the marijuana you bought
this last time?
1
2
3
4
5
6
7
8
9
10
DK/REF

May 23, 2012

$501.00 to $550.99
$551.00 to $600.99
$601.00 to $650.99
$651.00 to $700.99
$701.00 to $750.99
$751.00 to $800.99
$801.00 to $850.99
$851.00 to $900.99
$901.00 to $950.99
$951.00 to $1000.99

224

MJE26 [IF MJE02 = 1 - 3 OR MJE03 = 1] The last time you bought marijuana, who did you buy it from?
1
A friend
2
A relative or family member
3
Someone I had just met or didn’t know well
DK/REF
MJE27 [IF MJE02 = 1 - 3 OR MJE03 = 1] The last time you bought marijuana, where were you when you bought it?
1
2
3
4
5
6
DK/REF
MJE27SP

Inside a public building, such as a store, restaurant, sports arena, bar, or club
Inside a school building
Outside on school property
Inside a home, apartment, or dorm
Outside in a public area, such as a parking lot, street, or park
Some other place
[IF MJE27 = 6] Where were you when you last bought marijuana? When you have finished typing your
answer, press the [ENTER] key to go to the next question.
_______________
DK/REF

MJE28 [IF CURNTAGE = 15 OR OLDER AND (MJE02 = 1 - 3 OR MJE03 = 1)] The last time you bought marijuana were
you at work at your job or business?
1
Yes
2
No
3
Do not work at a job or business
DK/REF
MJE29 [IF MJE02 = 1 - 3 OR MJE03 = 1] The last time you bought marijuana, where did you buy it?
1
Near where you are now living
2
Somewhere else
DK/REF
MJE30 [IF MJE02 = 1 - 3 OR MJE03 = 1] Did you sell any of the marijuana you bought this last time?
1
Yes
2
No
DK/REF
MJE31 [IF MJE02 = 1 - 3 OR MJE03 = 1] Did you give away or share any of the marijuana you bought this last time?
1
Yes
2
No
DK/REF
MJE32 [IF MJE01 = (3 - 4 OR DK/REF) AND MJE03 = 2] During the past 12 months, that is, since [DATEFILL], did you
trade something for marijuana?
1
Yes
2
No
DK/REF
MJE33 [IF MJE32 = 1] During the past 30 days, that is, since [DATEFILL], did you trade something for marijuana?
1
Yes
2
No
DK/REF
MJE34 [IF MJE01 = 2 AND MJE03 = 2] How long has it been since you last traded something for marijuana?
1
May 23, 2012

Within the past 30 days -- that is since [DATEFILL]
225

2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
MJE35 [IF MJE33 = 1 OR MJE34 = 1] During the past 30 days, that is, since [DATEFILL], on how many days did you trade
something for marijuana?
# OF DAYS:
DK/REF

[RANGE: 1 - 30]

MJE36 [IF (MJE34 = 1 OR 2) OR MJE32 = 1] Think about the last time you traded something for marijuana. Did you get
marijuana that had already been rolled into joints or did you get the marijuana in loose form?
1
You got joints
2
You got the marijuana in loose form
DK/REF
MJE37 [IF MJE36 = 1] How many joints did you get the last time you traded something for marijuana?
# OF JOINTS:
DK/REF

[RANGE: 1 - 500]

MJE38 [IF MJE37 > 1 OR DK/REF] How much do you think the marijuana in these joints was worth?
[IF MJE37 = 1] How much do you think the marijuana in this joint was worth?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

less than $5.00
$5.00 to $10.99
$11.00 to $20.99
$21.00 to $50.99
$51.00 to $100.99
$101.00 to $150.99
$151.00 to $200.99
$201.00 to $250.99
$251.00 to $300.99
$301.00 to $500.99
$501.00 to $1000.99
More than $1000.99

MJE39 [IF MEJ38 = 4 AND MJE37 > 1 OR DK/REF] More specifically, which of these categories includes the price you
think the marijuana in these joints was worth?
[IF MJE38 = 4 AND MJE37 = 1] More specifically, which of these categories includes the price you think the
marijuana in this joint was worth?
1
$21.00 to $30.99
2
$31.00 to $40.99
3
$41.00 to $50.99
DK/REF
MJE40 [IF MJE38 = 5 AND MJE37 > 1 OR DK/REF] More specifically, which of these categories includes the price you
think the marijuana in these joints was worth?
[IF MJE38 = 5 AND MJE37 = 1] More specifically, which of these categories includes the price you think the
marijuana in this joint was worth?
1
2
3
5
6
DK/REF

$51.00 to $60.99
$61.00 to $70.99
$71.00 to $80.99
$81.00 to $90.99
$91.00 to $100.99

MJE41 [IF MJE38 = 6 AND MJE37 > 1 OR DK/REF] More specifically, which of these categories includes the price you
May 23, 2012

226

think the marijuana in these joints was worth?
[IF MJE38 = 6 AND MJE37 = 1] More specifically, which of these categories includes the price you think the
marijuana in this joint was worth?
1
2
3
4
5
DK/REF

$101.00 to $110.99
$111.00 to $120.99
$121.00 to $130.99
$131.00 to $140.99
$141.00 to $150.99

MJE42 [IF MEJ38 = 10 AND MJE37 > 1 OR DK/REF] More specifically, which of these categories includes the price you
think the marijuana in these joints was worth?
[IF MJE38 = 10 AND MJE37 = 1] More specifically, which of these categories includes the price you think the
marijuana in this joint was worth?
1
2
3
4
DK/REF

$301.00 to $350.99
$351.00 to $400.99
$401.00 to $450.99
$451.00 to $500.99

MJE43 [IF MEJ38 = 11 AND MJE37 > 1 OR DK/REF] More specifically, which of these categories includes the price you
think the marijuana in these joints was worth?
[IF MJE38 = 11 AND MJE37 = 1] More specifically, which of these categories includes the price you think the
marijuana in this joint was worth?
1
2
3
4
5
6
7
8
9
10
DK/REF

$501.00 to $550.99
$551.00 to $600.99
$601.00 to $650.99
$651.00 to $700.99
$701.00 to $750.99
$751.00 to $800.99
$801.00 to $850.99
$851.00 to $900.99
$901.00 to $950.99
$951.00 to $1000.99

MJE44 [IF MJE36 = 2] Now we want to know how much marijuana you got the last time you traded something for marijuana.
Do you want to give your answer in grams, ounces, or pounds?
1
Grams
2
Ounces
3
Pounds
DK/REF
DEFINE MJUNIT2A:
IF MJE44 = 1 THEN MJUNIT2A = “grams”
IF MJE44 = 2 THEN MJUNIT2A = “ounces”
IF MJE44 = 3 THEN MJUNIT2A = “pounds”
ELSE MJUNIT2A = BLANK
MJE45 [IF MJUNIT2A= “grams”] The last time you traded something for marijuana, how many grams did you get?
1
At least 1 but less than 5 grams
2
At least 5 but less than 10 grams
3
10 grams or more
DK/REF
MJE46 [IF MJE45=3] How many grams did you get?
May 23, 2012

227

# OF GRAMS: __________ [RANGE 10 - 99].
DK/REF
MJE47 [IF MJUNIT2A= “ounces”] The last time you traded something for marijuana, how many ounces did you get?
1
2
3
4
5
6
7
DK/REF

At least 1/8, but less than 1/4 of an ounce
At least 1/4 but less than 1/3 of an ounce
At least 1/3 but less than ½ of an ounce
At least ½ but less than 1 ounce
At least 1 but less than 5 ounces
At least 5 but less than 10 ounces
At least 10 but less than 16 ounces

MJE48 [IF MJUNIT2A= “pounds”] The last time you traded something for marijuana, how many pounds did you get?
1
2
3
4
5
DK/REF

At least 1 but less than 2 pounds
At least 2 but less than 3 pounds
At least 3 but less than 4 pounds
At least 4 but less than 5 pounds
5 or more pounds

MJE49 [IF MJE48 = 5] How many pounds of marijuana did you get?
# OF POUNDS:
DK/REF

[RANGE: 5 - 99]

MJE50 [IF MJE44 NE BLANK] How much do you think the marijuana you got this last time was worth?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

less than $5.00
$5.00 to $10.99
$11.00 to $20.99
$21.00 to $50.99
$51.00 to $100.99
$101.00 to $150.99
$151.00 to $200.99
$201.00 to $250.99
$251.00 to $300.99
$301.00 to $500.99
$501.00 to $1000.99
More than $1000.99

MJE51 [IF MJE50 = 4] More specifically, which of these categories includes the price you think the marijuana you got this last
time was worth?
1
$21.00 to $30.99
2
$31.00 to $40.99
3
$41.00 to $50.99
DK/REF
MJE52 [IF MJE50 = 5 ] More specifically, which of these categories includes the price you think the marijuana you got this
last time was worth?
1
2
3
4
5
DK/REF

$51.00 to $60.99
$61.00 to $70.99
$71.00 to $80.99
$81.00 to $90.99
$91.00 to $100.99

MJE53 [IF MJE50 = 6] More specifically, which of these categories includes the price you think the marijuana you got this last
time was worth?
May 23, 2012

228

1
2
3
4
5
DK/REF

$101.00 to $110.99
$111.00 to $120.99
$121.00 to $130.99
$131.00 to $140.99
$141.00 to $150.99

MJE54 [IF MJE50 = 10] More specifically, which of these categories includes the price you think the marijuana you got this
last time was worth?
1
2
3
4
DK/REF

$301.00 to $350.99
$351.00 to $400.99
$401.00 to $450.99
$451.00 to $500.99

MJE55 [IF MJE50 = 11] More specifically, which of these categories includes the price you think the marijuana you got this
last time was worth?
1
2
3
4
5
6
7
8
9
10
DK/REF

$501.00 to $550.99
$551.00 to $600.99
$601.00 to $650.99
$651.00 to $700.99
$701.00 to $750.99
$751.00 to $800.99
$801.00 to $850.99
$851.00 to $900.99
$901.00 to $950.99
$951.00 to $1000.99

MJE56 [IF (MJE01 = 2 AND MJE03 = 2) OR MJE32 = 1] The last time you traded something for marijuana, who did you get
it from?
1
A friend
2
A relative or family member
3
Someone I had just met or didn’t know well
DK/REF
MJE57 [IF (MJE01 = 2 AND MJE03 = 2) OR MJE32 = 1] The last time you traded something for marijuana, where were you
when you got it?
1
2
3
4
5
6
DK/REF
MJE57SP

Inside a public building, such as a store, restaurant, sports arena, bar, or club
Inside a school building
Outside on school property
Inside a home, apartment, or dorm
Outside in a public area, such as a parking lot, street, or park
Some other place
[IF MJE57 = 6] Where were you when you last traded something for marijuana? When you have finished
typing your answer, press the [ENTER] key to go to the next question.
_______________
DK/REF

MJE58 [IF (MJE01 = 2 AND MJE03 = 2) OR MJE32 = 1] The last time you traded something for marijuana, where did you
get it?
1
Near where you are now living
2
Somewhere else
DK/REF
MJE59 [IF (MJE01 = 2 AND MJE03 = 2) OR MJE32 = 1] The last time you traded something for marijuana, did you keep it
May 23, 2012

229

all for yourself?
1
Yes
2
No
DK/REF
MJE60 [IF MJE59 = 2] Did you sell any of the marijuana you got this last time?
1
Yes
2
No
DK/REF
MJE61 [IF MJE59 = 2] Did you give away any of the marijuana you got this last time?
1
Yes
2
No
DK/REF
MJE62 [IF MJE01 = 4 AND MJE03 = 2 AND MJE32 =2] The last time you grew marijuana, did you keep it all for yourself?
1
Yes
2
No
DK/REF
MJE63 [IF MJE62 = 2] Did you sell any of the marijuana you grew this last time?
1
Yes
2
No
DK/REF
MJE64 [IF MJE62 = 2] The last time you grew marijuana, did you give any of it away for free?
1
Yes
2
No
DK/REF
MJE65 [IF MJE01 =3 AND MJE03 = 2 AND MJE32 = 2] The last time you got marijuana for free, who did you get it from?
1
A friend
2
A relative or family member
3
Someone I had just met or didn’t know well
DK/REF
MJE66 [IF MJE01 = 3 AND MJE03 = 2 AND MJE32 = 2] The last time you got marijuana for free, where were you when you
got it?
1
2
3
4
5
6
DK/REF
MJE66SP

Inside a public building, such as a store, restaurant, sports arena, bar, or club
Inside a school building
Outside on school property
Inside a home, apartment, or dorm
Outside in a public area, such as a parking lot, street, or park
Some other place
[IF MJE66 = 6] Where were you when you last got marijuana for free? When you have finished typing your
answer, press the [ENTER] key to go to the next question.
_______________
DK/REF

MJE67 [IF MJE01 = 3 AND MJE03 = 2 AND MJE32 = 2] The last time you got marijuana for free, where did you get it?
1
Near where you are now living
2
Somewhere else
DK/REF
May 23, 2012

230

MJE68 [IF MJE01 = 3 AND MJE03 = 2 AND MJE32 = 2] The last time you got marijuana for free, did you keep it all for
yourself?
1
Yes
2
No
DK/REF
MJE69 [IF MJE68 = 2] Did you sell any of the marijuana you got this last time?
1
Yes
2
No
DK/REF
MJE70 [IF MJE68 = 2] Did you give away any of the marijuana you got this last time?
1
Yes
2
No
DK/REF

May 23, 2012

231

May 23, 2012

232

Prior Substance Use
LU01

[IF MJ01=1 OR MJREF = 1] Earlier questions were about the past 12 months. This question is about the year before
that, that is, from [DATEFILL - 12 MONTHS] to [DATEFILL]. During that year, beginning [DATEFILL - 12
MONTHS] and ending [DATEFILL], did you use marijuana or hashish, even once?
1
Yes
2
No
DK/REF

LU02

[IF (MJLAST3=2 OR 3) OR (MJRECDK=2 OR 3) OR (MJRECRE=2 OR 3)] The computer recorded that you last
used marijuana or hashish [MJREC FILL]. How old were you the last time you used marijuana or hashish?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTMJ:
IF LU02 NE (BLANK OR DK/REF) THEN AGELSTMJ = LU02
ELSE AGELSTMJ = BLANK
IF AGELSTMJ < AGE1STMJ OR AGELSTMJ < 10 OR IF CURNTAGE < AGELSTMJ
LUCC01
The computer recorded that you were [AGELSTMJ] years old when you last used marijuana
or hashish. Is this correct?
4
Yes
6
No
DK/REF
LUCC02

[IF LUCC01 = 6] Please answer this question again. Think about the last time you used
marijuana or hashish. How old were you the last time you used marijuana or hashish?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC02 NOT (BLANK OR DK/REF) THEN AGELSTMJ = LUCC02
LU02a

[IF LU02 NE DK/RE AND AGELSTMJ = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTMJ =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use marijuana or hashish in [CURRENT YEAR
- 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU02b

[IF AGELSTMJ = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use marijuana or hashish in
[CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU02c

[IF LU02 NE DK/RE AND AGELSTMJ = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use marijuana or hashish?
1
2
3
4
5
6
7
8
9
10
11

May 23, 2012

January
February
March
April
May
June
July
August
September
October
November
233

12
December
DK/REF
HARD ERROR: [IF LU02c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU02d

[IF LU02a = 1 - 2 OR LU02b = 1 - 2] In what month in [YEAR FROM LU02a or LU02b] did you last use
marijuana or hashish?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU02d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTMJ:
MYRLSTMJ = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU02a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTMJ IS
BLANK.
IF MYRLSTMJ NE 0 AND NE AGELSTMJ:
LUMJ05
The computer recorded that you last used marijuana or hashish in [LU02a-d fill]. That would
make you [MYRLSTMJ] years old when you last used marijuana or hashish. Is this correct?
4
Yes
6
No
DK/REF
LUMJ06

[IF LUMJ05 = 4] Earlier, the computer recorded that you were [AGELSTMJ] years old
when you last used marijuana or hashish. Which answer is correct?
1
2
3
DK/REF

I last used marijuana or hashish in [LU02a-d fill] when I was [MYRLSTMJ] years
old
I was [AGELSTMJ] years old the last time I used marijuana or hashish
Neither answer is correct

UPDATE: IF LUMJ06 = 1, THEN AGELSTMJ = MYRLSTMJ
LUMJ07

[IF LUMJ06=2 OR LUMJ06=3 OR LUMJ05 = 6] Please answer this question again. Did
you last use marijuana or hashish in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUMJ07a

[IF LUMJ07 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [LUMJ07] did you last use marijuana or hashish?
1

May 23, 2012

January
234

2
3
4
5
6
7
8
9
10
11
12
DK/REF

February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUMJ07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUMJ07a NE (0 OR DK/RE) THEN UPDATE MYRLSTMJ.
MYRLSTMJ = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUMJ07 AND LUMJ07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTMJ IS
BLANK. IF MYRLSTMJ = AGELSTMJ THEN MYRLSTMJ = BLANK
LUMJ08

[IF LUMJ06 NE 1 AND MYRLSTMJ NE 0 AND (LUMJ07 AND LUMJ07a NE LU02a-d)] The
computer recorded that you last used marijuana or hashish in [LUMJ07- LUMJ07a fill].
That would make you [MYRLSTMJ] years old when you last used marijuana or hashish. Is
this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUMJ08 NE (6, BLANK OR DK/REF) AND (LUMJ07 AND LUMJ07a NE LU02a-d) THEN AGELSTMJ =
MYRLSTMJ
LU03

[IF (CG06=1, 2 OR 3) OR (CG06DK=1, 2 OR 3) OR (CG06RE=1, 2 OR 3) AND CG15 NE 1] This question is about
your cigarette smoking history.
[IF (CG06=1, 2 OR 3) OR (CG06DK=1, 2 OR 3) OR (CG06RE=1, 2 OR 3) AND CG15=1] These next two questions
are about your cigarette smoking history.
[IF (CG06=1, 2 OR 3) OR (CG06DK=1, 2 OR 3) OR (CG06RE=1, 2 OR 3)] Earlier the computer recorded that you
last smoked part or all of a cigarette [CG06]. How old were you the last time you smoked part or all of a cigarette?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTCG:
IF LU03 NE (BLANK OR DK/REF) THEN AGELSTCG = LU03
ELSE AGELSTCG = BLANK
IF AGELSTCG < AGE1STCG OR AGELSTCG < 10 OR IF CURNTAGE < AGELSTCG
LUCC05
The computer recorded that you were [AGELSTCG] years old when you last smoked part or
all of a cigarette. Is this correct?
4
Yes
6
No
DK/REF
LUCC06

[IF LUCC05 = 6] Please answer this question again. Think about the last time you smoked
part or all of a cigarette. How old were you the last time you smoked part or all of a
cigarette?
AGE:_______[RANGE: 1-110]
DK/REF

May 23, 2012

235

UPDATE: IF LUCC06 NOT (BLANK OR DK/REF) THEN AGELSTCG = LUCC06
LU03a

[IF LU03 NE DK/RE AND AGELSTCG = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTCG =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last smoke part or all of a cigarette in [CURRENT
YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU03b

[IF AGELSTCG = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last smoke part or all of a
cigarette in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU03c

[IF LU03 NE DK/RE AND AGELSTCG = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last smoke part or all of a cigarette?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU03c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU03d

[IF LU03a = 1 - 2 OR LU03b = 1 - 2] In what month in [YEAR FROM LU03a or LU03b] did you last smoke part
or all of a cigarette?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU03d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTCG:
MYRLSTCG = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU03a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCG IS
BLANK.
IF MYRLSTCG NE 0 AND NE AGELSTCG:
May 23, 2012

236

LUCG05

The computer recorded that you last smoked part or all of a cigarette in [LU03a-d fill]. That
would make you [MYRLSTCG] years old when you last smoked part or all of a cigarette. Is
this correct?
4
Yes
6
No
DK/REF

LUCG06

[IF LUCG05 = 4] Earlier, the computer recorded that you were [AGELSTCG] years old
when you last smoked part or all of a cigarette. Which answer is correct?
1
2
3
DK/REF

I last smoked part or all of a cigarette in [LU03a-d fill] when I was [MYRLSTCG]
years old
I was [AGELSTCG] years old the last time I smoked part or all of a cigarette
Neither answer is correct

UPDATE: IF LUCG06 = 1, THEN AGELSTCG = MYRLSTCG
LUCG07

[IF LUCG06=2 OR LUCG06=3 OR LUCG05 = 6] Please answer this question again. Did
you last smoke part or all of a cigarette in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUCG07a

[IF LUCG07 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [LUCG07] did you last smoke part or all of a cigarette?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUCG07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUCG07a NE (0 OR DK/RE) THEN UPDATE MYRLSTCG.
MYRLSTCG = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUCG07 AND LUCG07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCG IS
BLANK. IF MYRLSTCG = AGELSTCG THEN MYRLSTCG = BLANK
LUCG08

[IF LUCG06 NE 1 AND MYRLSTCG NE 0 AND (LUCG07 AND LUCG07a NE LU03a-d)]
The computer recorded that you last smoked part or all of a cigarette in [LUCG07- LUCG07a
fill]. That would make you [MYRLSTCG] years old when you last smoked part or all of a
cigarette. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUCG08 NE (6, BLANK OR DK/REF) AND (LUCG07 AND LUCG07a NE LU03a-d) THEN AGELSTCG =
MYRLSTCG
May 23, 2012

237

LU04

[IF CG15=1] Earlier the computer also recorded that there was a period in your life when you smoked cigarettes every
day for at least 30 days. How old were you when you last smoked cigarettes daily?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE LST30DCG:
IF LU04 NE (BLANK OR DK/REF) THEN LST30DCG = LU04
ELSE LST30DCG = BLANK
IF LST30DCG < DAILYCIG OR LST30DCG < 10 OR IF CURNTAGE < LST30DCG
LUCC09
The computer recorded that you were [LST30DCG] years old when you last smoked
cigarettes daily. Is this correct?
4
Yes
6
No
DK/REF
LUCC10

[IF LUCC09 = 6] Please answer this question again. How old were you when you last
smoked cigarettes daily?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC10 NOT (BLANK OR DK/REF) THEN LST30DCG = LUCC10
LU04a

[IF LU04 NE DK/RE AND LST30DCG = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF LST30DCG =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last smoke cigarettes daily in [CURRENT YEAR 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU04b

[IF LST30DCG = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last smoke cigarettes daily in
[CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU04c

[IF LU04 NE DK/RE AND LST30DCG = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last smoke cigarettes daily?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU04c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU04d

[IF LU04a = 1 - 2 OR LU04b = 1 - 2] In what month in [YEAR FROM LU04a or LU04b] did you last smoke
cigarettes daily?

May 23, 2012

238

1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU04d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTDC:
MYRLSTDC = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU04a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTDC IS
BLANK.
IF MYRLSTDC NE 0 AND NE LST30DCG:
LUDC05
The computer recorded that you last smoked cigarettes daily in [LU04a-d fill]. That would
make you [MYRLSTDC] years old when you last smoked cigarettes daily. Is this correct?
4
Yes
6
No
DK/REF
LUDC06

[IF LUDC05 = 4] Earlier, the computer recorded that you were [LST30DCG] years old when
you last smoked cigarettes daily. Which answer is correct?
1
I last smoked cigarettes daily in [LU04a-d fill] when I was [MYRLSTDC] years old
2
I was [LST30DCG] years old the last time I smoked cigarettes daily
3
Neither answer is correct
DK/REF

UPDATE: IF LUDC06 = 1, THEN LST30DCG = MYRLSTDC
LUDC07

[IF LUDC06=2 OR LUDC06=3 OR LUDC05 = 6] Please answer this question again. Did
you last smoke cigarettes daily in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUDC07a

[IF LUDC07 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [LUDC07] did you last smoke cigarettes daily?
1
2
3
4
5
6
7
8
9
10
11

May 23, 2012

January
February
March
April
May
June
July
August
September
October
November
239

12
December
DK/REF
HARD ERROR: [IF LUDC07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUDC07a NE (0 OR DK/RE) THEN UPDATE MYRLSTDC.
MYRLSTDC = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUDC07 AND LUDC07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTDC IS
BLANK. IF MYRLSTDC = LST30DCG THEN MYRLSTDC = BLANK
LUDC08

[IF LUDC06 NE 1 AND MYRLSTDC NE 0 AND (LUDC07 AND LUDC07a NE LU04a-d)]
The computer recorded that you last smoked cigarettes daily in [LUDC07 - LUDC07a fill].
That would make you [MYRLSTDC] years old when you last smoked cigarettes daily. Is this
correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUDC08 NE (6, BLANK OR DK/REF) AND (LUDC07 AND LUDC07a NE LU04a-d) THEN LST30DCG =
MYRLSTDC
LU05

[IF (CG28=1, 2 OR 3) OR (CG28DK=1, 2 OR 3) OR (CG28RE = 1, 2 OR 3)] The computer recorded that you last
used snuff [CGSNREC FILL]. How old were you the last time you used snuff?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTSN:
IF LU05 NE (BLANK OR DK/REF) THEN AGELSTSN = LU05
ELSE AGELSTSN = BLANK
IF AGELSTSN < SNUFFAGE OR AGELSTSN < 10 OR IF CURNTAGE < AGELSTSN
LUCC11
The computer recorded that you were [AGELSTSN] years old when you last used snuff. Is
this correct?
4
Yes
6
No
DK/REF
LUCC12

[IF LUCC11 = 6] Please answer this question again. Think about the last time you used
snuff. How old were you the last time you used snuff?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC12 NOT (BLANK OR DK/REF) THEN AGELSTSN = LUCC12
LU05a

[IF LU05 NE DK/RE AND AGELSTSN = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTSN =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use snuff in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU05b

[IF AGELSTSN = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use snuff in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

May 23, 2012

240

LU05c

[IF LU05 NE DK/RE AND AGELSTSN = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use snuff?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU05c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU05d

[IF LU05a = 1 - 2 OR LU05b = 1 - 2] In what month in [YEAR FROM LU05a or LU05b] did you last use snuff?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU05d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTSN:
MYRLSTSN = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU05a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTSN IS
BLANK.
IF MYRLSTSN NE 0 AND NE AGELSTSN:
LUSN05
The computer recorded that you last used snuff in [LU05a-d fill]. That would make you
[MYRLSTSN] years old when you last used snuff. Is this correct?
4
Yes
6
No
DK/REF
LUSN06

[IF LUSN05 = 4] Earlier, the computer recorded that you were [AGELSTSN] years old when
you last used snuff. Which answer is correct?
1
I last used snuff in [LU05a-d fill] when I was [MYRLSTSN] years old
2
I was [AGELSTSN] years old the last time I used snuff
3
Neither answer is correct
DK/REF

UPDATE: IF LUSN06 = 1, THEN AGELSTSN = MYRLSTSN
LUSN07
May 23, 2012

[IF LUSN06=2 OR LUSN06=3 OR LUSN05 = 6] Please answer this question again. Did you
241

last use snuff in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LUSN07a

[IF LUSN07 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[LUSN07] did you last use snuff?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUSN07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUSN07a NE (0 OR DK/RE) THEN UPDATE MYRLSTSN.
MYRLSTSN = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUSN07 AND LUSN07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTSN IS
BLANK. IF MYRLSTSN = AGELSTSN THEN MYRLSTSN = BLANK
LUSN08

[IF LUSN06 NE 1 AND MYRLSTSN NE 0 AND (LUSN07 AND LUSN07a NE LU05a-d)] The
computer recorded that you last used snuff in [LUSN07 - LUSN07a fill]. That would make
you [MYRLSTSN] years old when you last used snuff. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUSN08 NE (6, BLANK OR DK/REF) AND (LUSN07 AND LUSN07a NE LU05a-d) THEN AGELSTSN =
MYRLSTSN
LU06

[IF (CG20=1, 2 OR 3) OR (CG20DK=1, 2 OR 3) OR (CG20RE =1, 2 OR 3)] The computer recorded that you last used
chewing tobacco [CG20REC FILL]. How old were you the last time you used chewing tobacco?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTCH:
IF LU06 NE (BLANK OR DK/REF) THEN AGELSTCH = LU06
ELSE AGELSTCH = BLANK
IF AGELSTCH < CHEWAGE OR AGELSTCH < 10 OR IF CURNTAGE < AGELSTCH
LUCC13
The computer recorded that you were [AGELSTCH] years old when you last used chewing
tobacco. Is this correct?
4
Yes
6
No
DK/REF
LUCC14

May 23, 2012

[IF LUCC13 = 6] Please answer this question again. Think about the last time you used
chewing tobacco. How old were you the last time you used chewing tobacco?

242

AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC14 NOT (BLANK OR DK/REF) THEN AGELSTCH = LUCC14
LU06a

[IF LU06 NE DK/RE AND DATE OF INTERVIEW < DOB OR IF AGELSTCH = CURNTAGE - 1 AND
DATE OF INTERVIEW $ DOB] Did you last use chewing tobacco in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU06b

[IF AGELSTCH = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use chewing
tobacco in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU06c

[IF LU06 NE DK/RE AND AGELSTCH = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what
month in [CURRENT YEAR] did you last use chewing tobacco?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU06c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER]
TO CONTINUE.
LU06d

[IF LU06a = 1 - 2 OR LU06b = 1 - 2] In what month in [YEAR FROM LU06a or LU06b] did you last
use chewing tobacco?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU06d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTCH:
MYRLSTCH = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
May 23, 2012

243

AND YEAR OF LAST USE (LU06a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCH IS
BLANK.
IF MYRLSTCH NE 0 AND NE AGELSTCH:
LUCH05
The computer recorded that you last used chewing tobacco in [LU06a-d fill]. That would
make you [MYRLSTCH] years old when you last used chewing tobacco. Is this correct?
4
Yes
6
No
DK/REF
LUCH06

[IF LUCH05 = 4] Earlier, the computer recorded that you were [AGELSTCH] years old
when you last used chewing tobacco. Which answer is correct?
1
I last used chewing tobacco in [LU06a-d fill] when I was [MYRLSTCH] years old
2
I was [AGELSTCH] years old the last time I used chewing tobacco
3
Neither answer is correct
DK/REF

UPDATE: IF LUCH06 = 1, THEN AGELSTCH = MYRLSTCH
LUCH07

[IF LUCH06=2 OR LUCH06=3 OR LUCH05 = 6] Please answer this question again. Did
you last use chewing tobacco in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUCH07a

[IF LUCH07 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [LUCH07] did you last use chewing tobacco?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUCH07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUCH07a NE (0 OR DK/RE) THEN UPDATE MYRLSTCH.
MYRLSTCH = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUCH07 AND LUCH07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCH IS
BLANK. IF MYRLSTCH = AGELSTCH THEN MYRLSTCH = BLANK
LUCH08

[IF LUCH06 NE 1 AND MYRLSTCH NE 0 AND (LUCH07 AND LUCH07a NE LU06a-d)]
The computer recorded that you last used chewing tobacco in [LUCH07 - LUCH07a fill].
That would make you [MYRLSTCH] years old when you last used chewing tobacco. Is this
correct?
4
Yes
6
No
DK/REF

May 23, 2012

244

UPDATE: IF LUCH08 NE (6, BLANK OR DK/REF) AND (LUCH07 AND LUCH07a NE LU06a-d) THEN AGELSTCH =
MYRLSTCH
LU07

[IF (CG37=1, 2 OR 3) OR (CG37DK=1, 2 OR 3) OR (CG37RE = 1, 2 OR 3)] The computer recorded that you last
smoked part or all of a cigar [CG37REC FILL]. How old were you the last time you smoked part or all of a cigar?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTCR:
IF LU07 NE (BLANK OR DK/REF) THEN AGELSTCR = LU07
ELSE AGELSTCR = BLANK
IF AGELSTCR < CIGARAGE OR AGELSTCR < 10 OR IF CURNTAGE < AGELSTCR
LUCC15
The computer recorded that you were [AGELSTCR] years old when you last smoked part or
all of a cigar. Is this correct?
4
Yes
6
No
DK/REF
LUCC16

[IF LUCC15 = 6] Please answer this question again. Think about the last time you smoked
part or all of a cigar. How old were you the last time you smoked part or all of a cigar?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC16 NOT (BLANK OR DK/REF) THEN AGELSTCR = LUCC16
LU07a

[IF LU07 NE DK AND AGELSTCR = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTCR =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last smoke part or all of a cigar in [CURRENT
YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU07b

[IF AGELSTCR = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last smoke part or all of a cigar in
[CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU07c

[IF LU07 NE DK/RE AND AGELSTCR = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last smoke part or all of a cigar?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU07c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.

May 23, 2012

245

LU07d

[IF LU07a = 1 - 2 OR LU07b = 1 - 2] In what month in [YEAR FROM LU07a or LU07b] did you last smoke part
or all of a cigar?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU07d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTCR:
MYRLSTCR = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU07a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCR IS
BLANK.
IF MYRLSTCR NE 0 AND NE AGELSTCR:
LUCR05
The computer recorded that you last smoked part or all of a cigar in [LU07a-d fill]. That
would make you [MYRLSTCR] years old when you last smoked part or all of a cigar. Is this
correct?
4
Yes
6
No
DK/REF
LUCR06

[IF LUCR05 = 4] Earlier, the computer recorded that you were [AGELSTCR] years old
when you last smoked part or all of a cigar. Which answer is correct?
1
2
3
DK/REF

I last smoked part or all of a cigar in [LU07a-d fill] when I was [MYRLSTCR]
years old
I was [AGELSTCR] years old the last time I smoked part or all of a cigar
Neither answer is correct

UPDATE: IF LUCR06 = 1, THEN AGELSTCR = MYRLSTCR
LUCR07

[IF LUCR06=2 OR LUCR06=3 OR LUCR05 = 6] Please answer this question again. Did
you last smoke part or all of a cigar in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUCR07a

[IF LUCR07 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [LUCR07] did you last smoke part or all of a cigar?
1
2
3
4
5
6
7

May 23, 2012

January
February
March
April
May
June
July
246

8
9
10
11
12
DK/REF

August
September
October
November
December

HARD ERROR: [IF LUCR07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUCR07a NE (0 OR DK/RE) THEN UPDATE MYRLSTCR.
MYRLSTCR = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUCR07 AND LUCR07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCR IS
BLANK. IF MYRLSTCR = AGELSTCR THEN MYRLSTCR = BLANK
LUCR08

[IF LUCR06 NE 1 AND MYRLSTCR NE 0 AND (LUCR07 AND LUCR07a NE LU07a-d)] The
computer recorded that you last smoked part or all of a cigar in [LUCR07 - LUCR07a fill].
That would make you [MYRLSTCR] years old when you last smoked part or all of a cigar. Is
this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUCR08 NE (6, BLANK OR DK/REF) AND (LUCR07 AND LUCR07a NE LU07a-d) THEN AGELSTCR =
MYRLSTCR
LU08

IF (ALLAST3=2 OR 3) OR (ALRECDK=2 OR 3) OR (ALRECRE = 2 OR 3)] The computer recorded that you last
drank an alcoholic beverage [ALLREC FILL]. How old were you the last time you drank an alcoholic beverage?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTAL:
IF LU08 NE (BLANK OR DK/REF) THEN AGELSTAL = LU08
ELSE AGELSTAL = BLANK
IF AGELSTAL < AGE1STAL OR AGELSTAL < 10 OR IF CURNTAGE < AGELSTAL
LUCC17
The computer recorded that you were [AGELSTAL] years old when you last drank an
alcoholic beverage. Is this correct?
4
Yes
6
No
DK/REF
LUCC18

[IF LUCC17 = 6] Please answer this question again. Think about the last time you drank an
alcoholic beverage. How old were you the last time you drank an alcoholic beverage?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC18 NOT (BLANK OR DK/REF) THEN AGELSTAL = LUCC18
LU08a

[IF LU08 NE DK/RE AND AGELSTAL = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTAL =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last drink an alcoholic beverage in [CURRENT
YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU08b

[IF AGELSTAL = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last drink an alcoholic beverage
in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?

May 23, 2012

247

1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU08c

[IF LU08 NE DK/RE AND AGELSTAL = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last drink an alcoholic beverage?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU08c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU08d

[IF LU08a = 1 - 2 OR LU08b = 1 - 2] In what month in [YEAR FROM LU08a or LU08b] did you last drink an
alcoholic beverage?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR : [IF LU08d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTAL:
MYRLSTAL = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU08a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTAL IS
BLANK.
IF MYRLSTAL NE 0 AND NE AGELSTAL:
LUAL05
The computer recorded that you last drank an alcoholic beverage in [LU08a-d fill]. That
would make you [MYRLSTAL] years old when you last drank an alcoholic beverage. Is this
correct?
4
Yes
6
No
DK/REF
LUAL06

[IF LUAL05 = 4] Earlier, the computer recorded that you were [AGELSTAL] years old when
you last drank an alcoholic beverage. Which answer is correct?
1

May 23, 2012

I last drank an alcoholic beverage in [LU08a-d fill] when I was [MYRLSTAL]
years old
248

2
I was [AGELSTAL] years old the last time I drank an alcoholic beverage
3
Neither answer is correct
DK/REF
UPDATE: IF LUAL06 = 1, THEN AGELSTAL = MYRLSTAL
LUAL07

[IF LUAL06=2 OR LUAL06=3 OR LUAL05 = 6] Please answer this question again. Did you
last drink an alcoholic beverage in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUAL07a

[IF LUAL07 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[LUAL07] did you last drink an alcoholic beverage?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUAL07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUAL07a NE (0 OR DK/RE) THEN UPDATE MYRLSTAL.
MYRLSTAL = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUAL07 AND LUAL07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTAL IS
BLANK. IF MYRLSTAL = AGELSTAL THEN MYRLSTAL = BLANK
LUAL08

[IF LUAL06 NE 1 AND MYRLSTAL NE 0 AND (LUAL07 AND LUAL07a NE LU08a-d)] The
computer recorded that you last drank an alcoholic beverage in [LUAL07 - LUAL07a fill].
That would make you [MYRLSTAL] years old when you last drank an alcoholic beverage. Is
this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUAL08 NE (6, BLANK OR DK/REF) AND (LUAL07 AND LUAL07a NE LU08a-d) THEN AGELSTAL =
MYRLSTAL
LU09

[IF (CCLAST3=2 OR 3) OR (CCRECDK=2 OR 3) OR (CCRECRE = 2 OR 3)] The computer recorded that you last
used cocaine [CCREC FILL]. How old were you the last time you used cocaine?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTCC:
IF LU09 NE (BLANK OR DK/REF) THEN AGELSTCC = LU09
ELSE AGELSTCC = BLANK
IF AGELSTCC < AGE1STCC OR AGELSTCC < 10 OR IF CURNTAGE < AGELSTCC
LUCC19
The computer recorded that you were [AGELSTCC] years old when you last used cocaine. Is
May 23, 2012

249

this correct?
4
Yes
6
No
DK/REF
LUCC20

[IF LUCC19 = 6] Please answer this question again. Think about the last time you used
cocaine. How old were you the last time you used cocaine?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC20 NOT (BLANK OR DK/REF) THEN AGELSTCC = LUCC20
LU09a

[IF LU09 NE DK/RE AND AGELSTCC = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTCC =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use cocaine in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU09b

[IF AGELSTCC = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use cocaine in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU09c

[IF LU09 NE DK/RE AND AGELSTCC = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use cocaine?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU09c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU09d

[IF LU09a = 1 - 2 OR LU09b = 1 - 2] In what month in [YEAR FROM LU09a or LU09b] did you last use cocaine?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

May 23, 2012

January
February
March
April
May
June
July
August
September
October
November
December

250

HARD ERROR : [IF LU09d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTCC:
MYRLSTCC = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU09a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCC IS
BLANK.
IF MYRLSTCC NE 0 AND NE AGELSTCC:
LUCN05
The computer recorded that you last used cocaine in [LU09a-d fill]. That would make you
[MYRLSTCC] years old when you last used cocaine. Is this correct?
4
Yes
6
No
DK/REF
LUCN06

[IF LUCN05 = 4] Earlier, the computer recorded that you were [AGELSTCC] years old
when you last used cocaine. Which answer is correct?
1
I last used cocaine in [LU09a-d fill] when I was [MYRLSTCC] years old
2
I was [AGELSTCC] years old the last time I used cocaine
3
Neither answer is correct
DK/REF

UPDATE: IF LUCN06 = 1, THEN AGELSTCC = MYRLSTCC
LUCN07

[IF LUCN06=2 OR LUCN06=3 OR LUCN05 = 6] Please answer this question again. Did
you last use cocaine in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUCN07a

[IF LUCN07 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [LUCN07] did you last use cocaine?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUCN07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUCN07a NE (0 OR DK/RE) THEN UPDATE MYRLSTCC.
MYRLSTCC = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUCN07 AND LUCN07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCC IS
BLANK. IF MYRLSTCC = AGELSTCC THEN MYRLSTCC = BLANK
LUCN08

May 23, 2012

[IF LUCN06 NE 1 AND MYRLSTCC NE 0 AND (LUCN07 AND LUCN07a NE LU09a-d)]
The computer recorded that you last used cocaine in [LUCN07 - LUCN07a fill]. That would
251

make you [MYRLSTCC] years old when you last used cocaine. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF LUCN08 NE (6, BLANK OR DK/REF) AND (LUCN07 AND LUCN07a NE LU09a-d) THEN AGELSTCC =
MYRLSTCC
LU10

[IF (CKLAST3=2 OR 3) OR (CKRECDK=2 OR 3) OR (CKRECRE = 2 OR 3)] The computer recorded that you last
used ‘crack’ [CKREC FILL]. How old were you the last time you used ‘crack’?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTCK:
IF LU10 NE (BLANK OR DK/REF) THEN AGELSTCK = LU10
ELSE AGELSTCK = BLANK
IF AGELSTCK < AGE1STCK OR AGELSTCK < 10 OR IF CURNTAGE < AGELSTCK
LUCC21
The computer recorded that you were [AGELSTCK] years old when you last used ‘crack’. Is
this correct?
4
Yes
6
No
DK/REF
LUCC22

[IF LUCC21 = 6] Please answer this question again. Think about the last time you used
‘crack’. How old were you the last time you used ‘crack’?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC22 NOT (BLANK OR DK/REF) THEN AGELSTCK = LUCC22
LU10a

[IF LU10 NE DK/RE AND AGELSTCK = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTCK =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use ‘crack’ in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU10b

[IF AGELSTCK = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use ‘crack’ in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU10c

[IF LU10 NE DK/RE AND AGELSTCK = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use ‘crack’?
1
2
3
4
5
6
7
8
9
10
11
12

May 23, 2012

January
February
March
April
May
June
July
August
September
October
November
December
252

DK/REF
HARD ERROR: [IF LU10c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU10d

[IF LU10a = 1 - 2 OR LU10b = 1 - 2] In what month in [YEAR FROM LU10a or LU10b] did you last use ‘crack’?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR : [IF LU10d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTCK:
MYRLSTCK = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU10a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCK IS
BLANK.
IF MYRLSTCK NE 0 AND NE AGELSTCK:
LUCK05
The computer recorded that you last used ‘crack’ in [LU10a-d fill]. That would make you
[MYRLSTCK] years old when you last used ‘crack’. Is this correct?
4
Yes
6
No
DK/REF
LUCK06

[IF LUCK05 = 4] Earlier, the computer recorded that you were [AGELSTCK] years old
when you last used ‘crack’. Which answer is correct?
1
I last used ‘crack’ in [LU10a-d fill] when I was [MYRLSTCK] years old
2
I was [AGELSTCK] years old the last time I used ‘crack’
3
Neither answer is correct
DK/REF

UPDATE: IF LUCK06 = 1, THEN AGELSTCK = MYRLSTCK
LUCK07

[IF LUCK06=2 OR LUCK06=3 OR LUCK05 = 6] Please answer this question again. Did
you last use ‘crack’ in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUCK07a

[IF LUCK07 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [LUCK07] did you last use ‘crack’?
1
2
3
4

May 23, 2012

January
February
March
April
253

5
6
7
8
9
10
11
12
DK/REF

May
June
July
August
September
October
November
December

HARD ERROR: [IF LUCK07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUCK07a NE (0 OR DK/RE) THEN UPDATE MYRLSTCK.
MYRLSTCK = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUCK07 AND LUCK07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCK IS
BLANK. IF MYRLSTCK = AGELSTCK THEN MYRLSTCK = BLANK
LUCK08

[IF LUCK06 NE 1 AND MYRLSTCK NE 0 AND (LUCK07 AND LUCK07a NE LU10a-d)]
The computer recorded that you last used ‘crack’ in [LUCK07 - LUCK07a fill]. That would
make you [MYRLSTCK] years old when you last used ‘crack’. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUCK08 NE (6, BLANK OR DK/REF) AND (LUCK07 AND LUCK07a NE LU10a-d) THEN AGELSTCK =
MYRLSTCK
LU11

[IF (HELAST3=2 OR 3) OR (HERECDK=2 OR 3) OR (HERECRE = 2 OR 3)] The computer recorded that you last
used heroin [HEREC FILL]. How old were you the last time you used heroin?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTHE:
IF LU11 NE (BLANK OR DK/REF) THEN AGELSTHE = LU11
ELSE AGELSTHE = BLANK
IF AGELSTHE < AGE1STHR OR AGELSTHE < 10 OR IF CURNTAGE < AGELSTHE
LUCC23
The computer recorded that you were [AGELSTHE] years old when you last used heroin. Is
this correct?
4
Yes
6
No
DK/REF
LUCC24

[IF LUCC23 = 6] Please answer this question again. Think about the last time you used
heroin. How old were you the last time you used heroin?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC24 NOT (BLANK OR DK/REF) THEN AGELSTHE = LUCC24
LU11a

[IF LU11 NE DK/RE AND AGELSTHE = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTHE =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use heroin in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU11b

[IF AGELSTHE = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use heroin in [CURRENT

May 23, 2012

254

YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU11c

[IF LU11 NE DK/RE AND AGELSTHE = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use heroin?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU11c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU11d

[IF LU11a = 1 - 2 OR LU11b = 1 - 2] In what month in [YEAR FROM LU11a or LU11b] did you last use heroin?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR : [IF LU11d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTHE:
MYRLSTHE = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU11a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTHE IS
BLANK.
IF MYRLSTHE NE 0 AND NE AGELSTHE:
LUHE05
The computer recorded that you last used heroin in [LU11a-d fill]. That would make you
[MYRLSTHE] years old when you last used heroin. Is this correct?
4
Yes
6
No
DK/REF
LUHE06

[IF LUHE05 = 4] Earlier, the computer recorded that you were [AGELSTHE] years old
when you last used heroin. Which answer is correct?
1
2

May 23, 2012

I last used heroin in [LU11a-d fill] when I was [MYRLSTHE] years old
I was [AGELSTHE] years old the last time I used heroin
255

3
Neither answer is correct
DK/REF
UPDATE: IF LUHE06 = 1, THEN AGELSTHE = MYRLSTHE
LUHE07

[IF LUHE06=2 OR LUHE06=3 OR LUHE05 = 6] Please answer this question again. Did
you last use heroin in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUHE07a

[IF LUHE07 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [LUHE07] did you last use heroin?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUHE07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUHE07a NE (0 OR DK/RE) THEN UPDATE MYRLSTHE.
MYRLSTHE = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUHE07 AND LUHE07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTHE IS
BLANK. IF MYRLSTHE = AGELSTHE THEN MYRLSTHE = BLANK
LUHE08

[IF LUHE06 NE 1 AND MYRLSTHE NE 0 AND (LUHE07 AND LUHE07a NE LU11a-d)]
The computer recorded that you last used heroin in [LUHE07 - LUHE07a fill]. That would
make you [MYRLSTHE] years old when you last used heroin. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUHE08 NE (6, BLANK OR DK/REF) AND (LUHE07 AND LUHE07a NE LU11a-d) THEN AGELSTHE =
MYRLSTHE
LU12

[IF HALLREC=2 OR 3] The computer recorded that you last used [LSFILL] [HALLREC FILL]. How old were you
the last time you used [LSFILL]?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTHA:
IF LU12 NE (BLANK OR DK/REF) THEN AGELSTHA = LU12
ELSE AGELSTHA = BLANK
IF AGELSTHA < AGE1STHA OR AGELSTHA < 10 OR IF CURNTAGE < AGELSTHA
LUCC25
The computer recorded that you were [AGELSTHA] years old when you last used [LSFILL].
Is this correct?
4
May 23, 2012

Yes
256

6
No
DK/REF
LUCC26

[IF LUCC25 = 6] Please answer this question again. Think about the last time you used
[LSFILL]. How old were you the last time you used [LSFILL]?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC26 NOT (BLANK OR DK/REF) THEN AGELSTHA = LUCC26
LU12a

[IF LU12 NE DK/RE AND AGELSTHA = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTHA
= CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use [LSFILL] in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU12b

[IF AGELSTHA = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use [LSFILL] in
[CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU12c

[IF LU12 NE DK/RE AND AGELSTHA = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use [LSFILL]?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU12c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU12d

[IF LU12a = 1 - 2 OR LU12b = 1 - 2] In what month in [YEAR FROM LU12a or LU12b] did you last use
[LSFILL]?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR : [IF LU12d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
May 23, 2012

257

BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTHA:
MYRLSTHA = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU12a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTHA IS
BLANK.
IF MYRLSTHA NE 0 AND NE AGELSTHA:
LUHA05
The computer recorded that you last used [LSFILL] in [LU12a-d fill]. That would make you
[MYRLSTHA] years old when you last used [LSFILL]. Is this correct?
4
Yes
6
No
DK/REF
LUHA06

[IF LUHA05 = 4] Earlier, the computer recorded that you were [AGELSTHA] years old
when you last used [LSFILL]. Which answer is correct?
1
I last used [LSFILL] in [LU12a-d fill] when I was [MYRLSTHA] years old
2
I was [AGELSTHA] years old the last time I used [LSFILL]
3
Neither answer is correct
DK/REF

UPDATE: IF LUHA06 = 1, THEN AGELSTHA = MYRLSTHA
LUHA07

[IF LUHA06=2 OR LUHA06=3 OR LUHA05 = 6] Please answer this question again. Did
you last use [LSFILL] in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUHA07a

[IF LUHA07 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [LUHA07] did you last use [LSFILL]?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUHA07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUHA07a NE (0 OR DK/RE) THEN UPDATE MYRLSTHA.
MYRLSTHA = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUHA07 AND LUHA07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTHA IS
BLANK. IF MYRLSTHA = AGELSTHA THEN MYRLSTHA = BLANK
LUHA08

May 23, 2012

[IF LUHA06 NE 1 AND MYRLSTHA NE 0 AND (LUHA07 AND LUHA07a NE LU12a-d)]
The computer recorded that you last used [LSFILL] in [LUHA07 - LUHA07a fill]. That
would make you [MYRLSTHA] years old when you last used [LSFILL]. Is this correct?

258

4
Yes
6
No
DK/REF
UPDATE: IF LUHA08 NE (6, BLANK OR DK/REF) AND (LUHA07 AND LUHA07a NE LU12a-d) THEN AGELSTHA =
MYRLSTHA
LU13

[IF LSDREC=2 OR 3] The computer recorded that you last used LSD [LSDREC FILL]. How old were you the last
time you used LSD?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTLS:
IF LU13 NE (BLANK OR DK/REF) THEN AGELSTLS = LU13
ELSE AGELSTLS = BLANK
IF AGELSTLS < AGE1STLS OR AGELSTLS < 10 OR IF CURNTAGE < AGELSTLS
LUCC27
The computer recorded that you were [AGELSTLS] years old when you last used LSD. Is
this correct?
4
Yes
6
No
DK/REF
LUCC28

[IF LUCC27 = 6] Please answer this question again. Think about the last time you used LSD.
How old were you the last time you used LSD?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC28 NOT (BLANK OR DK/REF) THEN AGELSTLS = LUCC28
LU13a

[IF LU13 NE DK/RE AND AGELSTLS = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTLS =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use LSD in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU13b

[IF AGELSTLS = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use LSD in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU13c

[IF LU13 NE DK/RE AND AGELSTLS = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use LSD?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

May 23, 2012

January
February
March
April
May
June
July
August
September
October
November
December

259

HARD ERROR: [IF LU13c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU13d

[IF LU13a = 1 - 2 OR LU13b = 1 - 2] In what month in [YEAR FROM LU13a or LU13b] did you last use LSD?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR : [IF LU13d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTLS:
MYRLSTLS = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU13a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTLS IS
BLANK.
IF MYRLSTLS NE 0 AND NE AGELSTLS:
LULS05
The computer recorded that you last used LSD in [LU13a-d fill]. That would make you
[MYRLSTLS] years old when you last used LSD. Is this correct?
4
Yes
6
No
DK/REF
LULS06

[IF LULS05 = 4] Earlier, the computer recorded that you were [AGELSTLS] years old when
you last used LSD. Which answer is correct?
1
I last used LSD in [LU13a-d fill] when I was [MYRLSTLS] years old
2
I was [AGELSTLS] years old the last time I used LSD
3
Neither answer is correct
DK/REF

UPDATE: IF LULS06 = 1, THEN AGELSTLS = MYRLSTLS
LULS07

[IF LULS06=2 OR LULS06=3 OR LULS05 = 6] Please answer this question again. Did you
last use LSD in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LULS07a

[IF LULS07 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[LULS07] did you last use LSD?
1
2
3
4
5
6
7

May 23, 2012

January
February
March
April
May
June
July
260

8
9
10
11
12
DK/REF

August
September
October
November
December

HARD ERROR: [IF LULS07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LULS07a NE (0 OR DK/RE) THEN UPDATE MYRLSTLS.
MYRLSTLS = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LULS07 AND LULS07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTLS IS
BLANK. IF MYRLSTLS = AGELSTLS THEN MYRLSTLS = BLANK
LULS08

[IF LULS06 NE 1 AND MYRLSTLS NE 0 AND (LULS07 AND LULS07a NE LU13a-d)] The
computer recorded that you last used LSD in [LULS07 - LULS07a fill]. That would make you
[MYRLSTLS] years old when you last used LSD. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LULS08 NE (6, BLANK OR DK/REF) AND (LULS07 AND LULS07a NE LU13a-d) THEN AGELSTLS =
MYRLSTLS
LU14

[IF PCPREC=2 OR 3] The computer recorded that you last used PCP [PCPREC FILL]. How old were you the last
time you used PCP?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTPC:
IF LU14 NE (BLANK OR DK/REF) THEN AGELSTPC = LU14
ELSE AGELSTPC = BLANK
IF AGELSTPC < AGE1STPC OR AGELSTPC < 10 OR IF CURNTAGE < AGELSTPC
LUCC29
The computer recorded that you were [AGELSTPC] years old when you last used PCP. Is
this correct?
4
Yes
6
No
DK/REF
LUCC30

[IF LUCC29 = 6] Please answer this question again. Think about the last time you used
PCP. How old were you the last time you used PCP?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC30 NOT (BLANK OR DK/REF) THEN AGELSTPC = LUCC30
LU14a

[IF LU14 NE DK/RE AND AGELSTPC = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTPC =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use PCP in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU14b

[IF AGELSTPC = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use PCP in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1

May 23, 2012

CURRENT YEAR - 2
261

2
CURRENT YEAR - 1
DK/REF
LU14c

[IF LU14 NE DK/RE AND AGELSTPC = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use PCP?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU14c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU14d

[IF LU14a = 1 - 2 OR LU14b = 1 - 2] In what month in [YEAR FROM LU14a or LU14b] did you last use PCP?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR : [IF LU14d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTPC:
MYRLSTPC = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU14a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTPC IS
BLANK.
IF MYRLSTPC NE 0 AND NE AGELSTPC:
LUPC05
The computer recorded that you last used PCP in [LU14a-d fill]. That would make you
[MYRLSTPC] years old when you last used PCP. Is this correct?
4
Yes
6
No
DK/REF
LUPC06

[IF LUPC05 = 4] Earlier, the computer recorded that you were [AGELSTPC] years old when
you last used PCP. Which answer is correct?
1
I last used PCP in [LU14a-d fill] when I was [MYRLSTPC] years old
2
I was [AGELSTPC] years old the last time I used PCP
3
Neither answer is correct
DK/REF

May 23, 2012

262

UPDATE: IF LUPC06 = 1, THEN AGELSTPC = MYRLSTPC
LUPC07

[IF LUPC06=2 OR LUPC06=3 OR LUPC05 = 6] Please answer this question again. Did
you last use PCP in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUPC07a

[IF LUPC07 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [LUPC07] did you last use PCP?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUPC07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUPC07a NE (0 OR DK/RE) THEN UPDATE MYRLSTPC.
MYRLSTPC = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUPC07 AND LUPC07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTPC IS
BLANK. IF MYRLSTPC = AGELSTPC THEN MYRLSTPC = BLANK
LUPC08

[IF LUPC06 NE 1 AND MYRLSTPC NE 0 AND (LUPC07 AND LUPC07a NE LU14a-d)] The
computer recorded that you last used PCP in [LUPC07 - LUPC07a fill]. That would make
you [MYRLSTPC] years old when you last used PCP. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUPC08 NE (6, BLANK OR DK/REF) AND (LUPC07 AND LUPC07a NE LU14a-d) THEN AGELSTPC =
MYRLSTPC
LU15

[IF ECSTREC=2 OR 3] The computer recorded that you last used ‘Ecstasy’ also known as MDMA [ECSTREC
FILL]. How old were you the last time you used ‘Ecstasy’?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTEC:
IF LU15 NE (BLANK OR DK/REF) THEN AGELSTEC = LU15
ELSE AGELSTEC = BLANK
IF AGELSTEC < AGE1STEC OR AGELSTEC < 10 OR IF CURNTAGE < AGELSTEC
LUCC31
The computer recorded that you were [AGELSTEC] years old when you last used ‘Ecstasy’.
Is this correct?
4
Yes
6
No
DK/REF

May 23, 2012

263

LUCC32

[IF LUCC31 = 6] Please answer this question again. Think about the last time you used
‘Ecstasy’. How old were you the last time you used ‘Ecstasy’?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC32 NOT (BLANK OR DK/REF) THEN AGELSTPC = LUCC32
LU15a

[IF LU15 NE DK/RE AND AGELSTEC = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTEC =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use ‘Ecstasy’ in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU15b

[IF AGELSTEC = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use ‘Ecstasy’ in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU15c

[IF LU15 NE DK/RE AND AGELSTEC = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use ‘Ecstasy’?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU15c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU15d

[IF LU15a = 1 - 2 OR LU15b = 1 - 2] In what month in [YEAR FROM LU15a or LU15b] did you last use
‘Ecstasy’?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR : [IF LU15d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.

May 23, 2012

264

DEFINE MYRLSTEC:
MYRLSTEC = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU15a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTEC IS
BLANK.
IF MYRLSTEC NE 0 AND NE AGELSTEC:
LUEC05
The computer recorded that you last used ‘Ecstasy’ in [LU15a-d fill]. That would make you
[MYRLSTEC] years old when you last used ‘Ecstasy’. Is this correct?
4
Yes
6
No
DK/REF
LUEC06

[IF LUEC05 = 4] Earlier, the computer recorded that you were [AGELSTEC] years old
when you last used ‘Ecstasy’. Which answer is correct?
1
I last used ‘Ecstasy’ in [LU15a-d fill] when I was [MYRLSTEC] years old
2
I was [AGELSTEC] years old the last time I used ‘Ecstasy’
3
Neither answer is correct
DK/REF

UPDATE: IF LUEC06 = 1, THEN AGELSTEC = MYRLSTEC
LUEC07

[IF LUEC06=2 OR LUEC06=3 OR LUEC05 = 6] Please answer this question again. Did
you last use ‘Ecstasy’ in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUEC07a

[IF LUEC07 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [LUEC07] did you last use ‘Ecstasy’?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUEC07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUEC07a NE (0 OR DK/RE) THEN UPDATE MYRLSTEC.
MYRLSTEC = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUEC07 AND LUEC07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTEC IS
BLANK. IF MYRLSTEC = AGELSTEC THEN MYRLSTEC = BLANK
LUEC08

[IF LUEC06 NE 1 AND MYRLSTEC NE 0 AND (LUEC07 AND LUEC07a NE LU15a-d)] The
computer recorded that you last used ‘Ecstasy’ in [LUEC07 - LUEC07a fill]. That would
make you [MYRLSTEC] years old when you last used ‘Ecstasy’. Is this correct?
4
Yes
6
No
DK/REF

May 23, 2012

265

UPDATE: IF LUEC08 NE (6, BLANK OR DK/REF) AND (LUEC07 AND LUEC07a NE LU15a-d) THEN AGELSTEC =
MYRLSTEC
LU16

[IF (INLAST=2 OR 3) OR (INRECDK=2 OR 3) OR (INRECRE=2 OR 3)] The computer recorded that you last used
any inhalants for kicks or to get high [INREC FILL]. How old were you the last time you used any inhalants for kicks
or to get high?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTIN:
IF LU16 NE (BLANK OR DK/REF) THEN AGELSTIN = LU16
ELSE AGELSTIN = BLANK
IF AGESLSTIN < AGE1STIN OR AGELSTIN < 10 OR IF CURNTAGE < AGELSTIN
LUCC33
The computer recorded that you were [AGELSTIN] years old when you last used an inhalant
for kicks or to get high. Is this correct?
4
Yes
6
No
DK/REF
LUCC34

[IF LUCC33 = 6] Please answer this question again. Think about the last time you used an
inhalant for kicks or to get high. How old were you the last time you used an inhalant for
kicks or to get high?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC34 NOT (BLANK OR DK/REF) THEN AGELSTIN = LUCC34
LU16a

[IF LU16 NE DK/RE AND AGELSTIN = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTIN =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use an inhalant for kicks or to get high in
[CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU16b

[IF AGELSTIN = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use an inhalant for kicks or to
get high in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU16c

[IF LU16 NE DK/RE AND AGELSTIN = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use an inhalant for kicks or to get high?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU16c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
May 23, 2012

266

BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU16d

[IF LU16a = 1 - 2 OR LU16b = 1 - 2] In what month in [YEAR FROM LU16a or LU16b] did you last use an
inhalant for kicks or to get high?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR : [IF LU16d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTIN:
MYRLSTIN = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU16a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTIN IS
BLANK.
IF MYRLSTIN NE 0 AND NE AGELSTIN:
LUIN05
The computer recorded that you last used an inhalant for kicks or to get high in [LU16a-d
fill]. That would make you [MYRLSTIN] years old when you last used an inhalant for kicks
or to get high. Is this correct?
4
Yes
6
No
DK/REF
LUIN06

[IF LUIN05 = 4] Earlier, the computer recorded that you were [AGELSTIN] years old when
you last used an inhalant for kicks or to get high. Which answer is correct?
1
2
3
DK/REF

I last used an inhalant for kicks or to get high in [LU16a-d fill] when I was
[MYRLSTIN] years old
I was [AGELSTIN] years old the last time I used an inhalant for kicks or to get high
Neither answer is correct

UPDATE: IF LUIN06 = 1, THEN AGELSTIN = MYRLSTIN
LUIN07

[IF LUIN06=2 OR LUIN06=3 OR LUIN05 = 6] Please answer this question again. Did you
last use an inhalant for kicks or to get high in [CURRENT YEAR-2], [CURRENT YEAR-1],
or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUIN07a

[IF LUIN07 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[LUIN07] did you last use an inhalant for kicks or to get high?
1
2
3
4

May 23, 2012

January
February
March
April
267

5
6
7
8
9
10
11
12
DK/REF

May
June
July
August
September
October
November
December

HARD ERROR: [IF LUIN07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUIN07a NE (0 OR DK/RE) THEN UPDATE MYRLSTIN.
MYRLSTIN = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUIN07 AND LUIN07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTIN IS
BLANK. IF MYRLSTIN = AGELSTIN THEN MYRLSTIN = BLANK
LUIN08

[IF LUIN06 NE 1 AND MYRLSTIN NE 0 AND (LUIN07 AND LUIN07a NE LU16a-d)] The
computer recorded that you last used an inhalant for kicks or to get high in [LUIN07 LUIN07a fill]. That would make you [MYRLSTIN] years old when you last used an inhalant
for kicks or to get high. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUIN08 NE (6, BLANK OR DK/REF) AND (LUIN07 AND LUIN07a NE LU16a-d) THEN AGELSTIN =
MYRLSTIN
LU17

[IF PRREC=2 OR 3] The computer recorded that you last used a prescription pain reliever that was not prescribed for
you or that you took only for the experience or feeling it caused [PRREC FILL]. How old were you the last time you
used any prescription pain reliever in either of these ways?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTPR:
IF LU17 NE (BLANK OR DK/REF) THEN AGELSTPR = LU17
ELSE AGELSTPR = BLANK
IF AGELSTPR < AGE1STPR OR AGELSTPR < 10 OR IF CURNTAGE < AGELSTPR
LUCC35
The computer recorded that you were [AGELSTPR] years old when you last used a
prescription pain reliever that was not prescribed for you or that you took only for the
experience or feeling it caused. Is this correct?
4
Yes
6
No
DK/REF
LUCC36

[IF LUCC35 = 6] Please answer this question again. Think about the last time you used a
prescription pain reliever that was not prescribed for you or that you took only for the
experience or feeling it caused. How old were you the last time you used any prescription
pain reliever in either of these ways?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC36 NOT (BLANK OR DK/REF) THEN AGELSTPR = LUCC36
LU17a

[IF LU17 NE DK/RE AND AGELSTPR = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTPR =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use any prescription pain reliever that was not
prescribed for you or that you took only for the experience or feeling it caused in [CURRENT YEAR - 1] or
[CURRENT YEAR]?

May 23, 2012

268

1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LU17b

[IF AGELSTPR = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use any prescription pain
reliever that was not prescribed for you or that you took only for the experience or feeling it caused in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU17c

[IF LU17 NE DK/RE AND AGELSTPR = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use a prescription pain reliever that was not prescribed for you or that you took only
for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU17c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU17d

[IF LU17a = 1 - 2 OR LU17b = 1 - 2] In what month in [YEAR FROM LU17a or LU17b] did you last use a
prescription pain reliever that was not prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR : [IF LU17d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTPR:
MYRLSTPR = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU17a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTPR IS
BLANK.
IF MYRLSTPR NE 0 AND NE AGELSTPR:
LUPR05
The computer recorded that you last used a prescription pain reliever that was not prescribed
for you or that you took only for the experience or feeling it caused in [LU17a-d fill]. That
would make you [MYRLSTPR] years old when you last used a prescription pain reliever in
May 23, 2012

269

either of these ways. Is this correct?
4
Yes
6
No
DK/REF
LUPR06

[IF LUPR05 = 4] Earlier, the computer recorded that you were [AGELSTPR] years old when
you last used a prescription pain reliever that was not prescribed for you or that you took only
for the experience or feeling it caused. Which answer is correct?
1

2
3
DK/REF

I last used a prescription pain reliever that was not prescribed for me or that I took
only for the experience or feeling it caused in [LU17a-d fill] when I was
[MYRLSTPR] years old
I was [AGELSTPR] years old the last time I used a prescription pain reliever that
was not prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct

UPDATE: IF LUPR06 = 1, THEN AGELSTPR = MYRLSTPR
LUPR07

[IF LUPR06=2 OR LUPR06=3 OR LUPR05 = 6] Please answer this question again. Did
you last use a prescription pain reliever that was not prescribed for you or that you took only
for the experience or feeling it caused in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUPR07a

[IF LUPR07 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[LUPR07] did you last use a prescription pain reliever that was not prescribed for you or that
you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUPR07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUPR07a NE (0 OR DK/RE) THEN UPDATE MYRLSTPR.
MYRLSTPR = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUPR07 AND LUPR07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTPR IS
BLANK. IF MYRLSTPR = AGELSTPR THEN MYRLSTPR = BLANK
LUPR08

[IF LUPR06 NE 1 AND MYRLSTPR NE 0 AND (LUPR07 AND LUPR07a NE LU17a-d)] The
computer recorded that you last used a prescription pain reliever that was not prescribed for
you or that you took only for the experience or feeling it caused in [LUPR07 - LUPR07a fill].
That would make you [MYRLSTPR] years old when you last used a prescription pain reliever
in either of these ways. Is this correct?
4
6

May 23, 2012

Yes
No
270

DK/REF
UPDATE: IF LUPR08 NE (6, BLANK OR DK/REF) AND (LUPR07 AND LUPR07a NE LU17a-d) THEN AGELSTPR =
MYRLSTPR
LU17e

[IF OXYREC=2 OR 3] The computer recorded that you last used OxyContin that was not prescribed for you or that
you took only for the experience or feeling it caused [OXYREC FILL]. How old were you the last time you used
OxyContin in either of these ways?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTOX:
IF LU17e NE (BLANK OR DK/REF) THEN AGELSTOX = LU17e
ELSE AGELSTOX = BLANK
IF AGELSTOX < AGE1STOX OR AGELSTOX < 10 OR IF CURNTAGE < AGELSTOX
LUCC35a
The computer recorded that you were [AGELSTOX] years old when you last used OxyContin
that was not prescribed for you or that you took only for the experience or feeling it caused. Is
this correct?
4
Yes
6
No
DK/REF
LUCC36a

[IF LUCC35a = 6] Please answer this question again. Think about the last time you used
OxyContin that was not prescribed for you or that you took only for the experience or feeling
it caused. How old were you the last time you used OxyContin in either of these ways?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC36a NOT (BLANK OR DK/REF) THEN AGELSTOX = LUCC36a
LU17f

[IF LU17e NE DK/RE AND AGELSTOX = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTOX
= CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use OxyContin that was not prescribed for you
or that you took only for the experience or feeling it caused in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU17g

[IF AGELSTOX = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use OxyContin that was not
prescribed for you or that you took only for the experience or feeling it caused in [CURRENT YEAR - 2] or
[CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU17h

[IF LU17e NE DK/RE AND AGELSTOX = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use OxyContin that was not prescribed for you or that you took only for the
experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11

May 23, 2012

January
February
March
April
May
June
July
August
September
October
November
271

12
December
DK/REF
HARD ERROR: [IF LU17h > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU17i

[IF LU17f = 1 - 2 OR LU17g = 1 - 2] In what month in [YEAR FROM LU17f or LU17g] did you last use
OxyContin that was not prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR : [IF LU17i > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTOX:
MYRLSTOX = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU17f-i). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTOX IS
BLANK.
IF MYRLSTOX NE 0 AND NE AGELSTOX:
LUOX05
The computer recorded that you last used OxyContin that was not prescribed for you or that
you took only for the experience or feeling it caused in [LU17f-i fill]. That would make you
[MYRLSTOX] years old when you last used OxyContin in either of these ways. Is this
correct?
4
Yes
6
No
DK/REF
LUOX06

[IF LUOX05 = 4] Earlier, the computer recorded that you were [AGELSTOX] years old
when you last used OxyContin that was not prescribed for you or that you took only for the
experience or feeling it caused. Which answer is correct?
1
2
3
DK/REF

I last used OxyContin that was not prescribed for me or that I took only for the
experience or feeling it caused in [LU17f-i fill] when I was [MYRLSTOX] years old
I was [AGELSTOX] years old the last time I used OxyContin that was not
prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct

UPDATE: IF LUOX06 = 1, THEN AGELSTOX = MYRLSTOX
LUOX07

[IF LUOX06=2 OR LUOX06=3 OR LUOX05 = 6] Please answer this question again. Did
you last use OxyContin that was not prescribed for you or that you took only for the
experience or feeling it caused in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

May 23, 2012

272

LUOX07a

[IF LUOX07 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [LUOX07] did you last use OxyContin that was not prescribed for you or that you took only
for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUOX07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUOX07a NE (0 OR DK/RE) THEN UPDATE MYRLSTOX.
MYRLSTOX = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUOX07 AND LUOX07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTOX IS
BLANK. IF MYRLSTOX = AGELSTOX THEN MYRLSTOX = BLANK
LUOX08

[IF LUOX06 NE 1 AND MYRLSTOX NE 0 AND (LUOX07 AND LUOX07a NE LU17f-i)] The
computer recorded that you last used OxyContin that was not prescribed for you or that you
took only for the experience or feeling it caused in [LUOX07 - LUOX07a fill]. That would
make you [MYRLSTOX] years old when you last used OxyContin in either of these ways. Is
this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUOX08 NE (6, BLANK OR DK/REF) AND (LUOX07 AND LUOX07a NE LU17f-i) THEN AGELSTOX =
MYRLSTOX
LU18

[IF (TR09=2 OR 3) OR (TRRECDK=2 OR 3) OR (TRRECRE=2 OR 3)] The computer recorded that you last used a
prescription tranquilizer that was not prescribed for you or that you took only for the experience or feeling it caused
[TRREC FILL]. How old were you the last time you used any prescription tranquilizer in either of those ways?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTTR:
IF LU18 NE (BLANK OR DK/REF) THEN AGELSTTR = LU18
ELSE AGELSTTR = BLANK
IF AGELSTTR < AGE1STTR OR AGELSTTR < 10 OR IF CURNTAGE < AGELSTTR
LUCC37
The computer recorded that you were [AGELSTTR] years old when you last used a
prescription tranquilizer that was not prescribed for you or that you took only for the
experience or feeling it caused. Is this correct?
4
Yes
6
No
DK/REF
LUCC38

May 23, 2012

[IF LUCC37 = 6] Please answer this question again. Think about the last time you used a
prescription tranquilizer that was not prescribed for you or that you took only for the
experience or feeling it caused How old were you the last time you used any prescription
tranquilizer in either of these ways?
273

AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC38 NOT (BLANK OR DK/REF) THEN AGELSTTR = LUCC38
LU18a

[IF LU18 NE DK/RE AND AGELSTTR = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTTR =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use any prescription tranquilizer that was not
prescribed for you or that you took only for the experience or feeling it caused in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU18b

[IF AGELSTTR = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use any prescription
tranquilizer that was not prescribed for you or that you took only for the experience or feeling it caused in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU18c

[IF LU18 NE DK/RE AND AGELSTTR = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use a prescription tranquilizer that was not prescribed for you or that you took only
for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU18c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU18d

[IF LU18a = 1 - 2 OR LU18b = 1 - 2] In what month in [YEAR FROM LU18a or LU18b] did you last use a
prescription tranquilizer that was not prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR : [IF LU18d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
May 23, 2012

274

DEFINE MYRLSTTR:
MYRLSTTR = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU18a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTTR IS
BLANK.
IF MYRLSTTR NE 0 AND NE AGELSTTR:
LUTR05
The computer recorded that you last used a prescription tranquilizer that was not prescribed
for you or that you took only for the experience or feeling it caused in [LU18a-d fill]. That
would make you [MYRLSTTR] years old when you last used a prescription tranquilizer in
either of these ways. Is this correct?
4
Yes
6
No
DK/REF
LUTR06

[IF LUTR05 = 4] Earlier, the computer recorded that you were [AGELSTTR] years old when
you last used a prescription tranquilizer that was not prescribed for you or that you took only
for the experience or feeling it caused. Which answer is correct?
1

2
3
DK/REF

I last used a prescription tranquilizer that was not prescribed for me or that I took
only for the experience or feeling it caused in [LU18a-d fill] when I was
[MYRLSTTR] years old
I was [AGELSTTR] years old the last time I used a prescription tranquilizer that
was not prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct

UPDATE: IF LUTR06 = 1, THEN AGELSTTR = MYRLSTTR
LUTR07

[IF LUTR06=2 OR LUTR06=3 OR LUTR05 = 6] Please answer this question again. Did you
last use a prescription tranquilizer that was not prescribed for you or that you took only for
the experience or feeling it caused in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUTR07a

[IF LUTR07 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[LUTR07] did you last use a prescription tranquilizer that was not prescribed for you or that
you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUTR07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUTR07a NE (0 OR DK/RE) THEN UPDATE MYRLSTTR.
MYRLSTTR = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUTR07 AND LUTR07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTTR IS
May 23, 2012

275

BLANK. IF MYRLSTTR = AGELSTTR THEN MYRLSTTR = BLANK
LUTR08

[IF LUTR06 NE 1 AND MYRLSTTR NE 0 AND (LUTR07 AND LUTR07a NE LU18a-d)] The
computer recorded that you last used a prescription tranquilizer that was not prescribed for
you or that you took only for the experience or feeling it caused in [LUTR07 - LUTR07a fill].
That would make you [MYRLSTTR] years old when you last used a prescription tranquilizer
in either of these ways. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUTR08 NE (6, BLANK OR DK/REF) AND (LUTR07 AND LUTR07a NE LU18a-d) THEN AGELSTTR =
MYRLSTTR
LU19

[IF (STIMREC=2 OR 3)] The computer recorded that you last used a prescription stimulant that was not prescribed for
you or that you took only for the experience or feeling it caused [STREC FILL]. How old were you the last time you
used any prescription stimulant in either of these ways?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTST:
IF LU19 NE (BLANK OR DK/REF) THEN AGELSTST = LU19
ELSE AGELSTST = BLANK
IF AGELSTST < AGE1STST OR AGELSTST < 10 OR IF CURNTAGE < AGELSTST
LUCC39
The computer recorded that you were [AGELSTST] years old when you last used a
prescription stimulant that was not prescribed for you or that you took only for the experience
or feeling it caused. Is this correct?
4
Yes
6
No
DK/REF
LUCC40

[IF LUCC39 = 6] Please answer this question again. Think about the last time you used a
prescription stimulant that was not prescribed for you or that you took only for the experience
or feeling it caused. How old were you the last time you used any prescription stimulant in
either of these ways?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC40 NOT (BLANK OR DK/REF) THEN AGELSTST = LUCC40
LU19a

[IF LU19 NE DK/RE AND AGELSTST = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTST =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use any prescription stimulant that was not
prescribed for you or that you took only for the experience or feeling it caused in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU19b

[IF AGELSTST = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use any prescription stimulant
that was not prescribed for you or that you took only for the experience or feeling it caused in [CURRENT YEAR - 2]
or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU19c

[IF LU19 NE DK/RE AND AGELSTST = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use a prescription stimulant that was not prescribed for you or that you took only for
the experience or feeling it caused?

May 23, 2012

276

1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU19c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU19d

[IF LU19a = 1 - 2 OR LU19b = 1 - 2] In what month in [YEAR FROM LU19a or LU19b] did you last use a
prescription stimulant that was not prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR : [IF LU19d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTST:
MYRLSTST = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU19a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTST IS
BLANK.
IF MYRLSTST NE 0 AND NE AGELSTST:
LUST05
The computer recorded that you last used a prescription stimulant that was not prescribed for
you or that you took only for the experience or feeling it caused in [LU19a-d fill]. That would
make you [MYRLSTST] years old when you last used a prescription stimulant in either of
these ways. Is this correct?
4
Yes
6
No
DK/REF
LUST06

[IF LUST05 = 4] Earlier, the computer recorded that you were [AGELSTST] years old when
you last used a prescription stimulant that was not prescribed for you or that you took only for
the experience or feeling it caused. Which answer is correct?
1

2
3
May 23, 2012

I last used a prescription stimulant that was not prescribed for me or that I took only
for the experience or feeling it caused in [LU19a-d fill] when I was [MYRLSTST]
years old
I was [AGELSTST] years old the last time I used a prescription stimulant that was
not prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct
277

DK/REF
UPDATE: IF LUST06 = 1, THEN AGELSTST = MYRLSTST
LUST07

[IF LUST06=2 OR LUST06=3 OR LUST05 = 6] Please answer this question again. Did you
last use a prescription stimulant that was not prescribed for you or that you took only for the
experience or feeling it caused in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUST07a

[IF LUST07 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[LUST07] did you last use a prescription stimulant that was not prescribed for you or that you
took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUST07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUST07a NE (0 OR DK/RE) THEN UPDATE MYRLSTST.
MYRLSTST = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUST07 AND LUST07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTST IS
BLANK. IF MYRLSTST = AGELSTST THEN MYRLSTST = BLANK
LUST08

[IF LUST06 NE 1 AND MYRLSTST NE 0 AND (LUST07 AND LUST07a NE LU19a-d)] The
computer recorded that you last used a prescription stimulant that was not prescribed for you
or that you took only for the experience or feeling it caused in [LUST07 - LUST07a fill].
That would make you [MYRLSTST] years old when you last used a prescription stimulant in
either of these ways. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUST08 NE (6, BLANK OR DK/REF) AND (LUST07 AND LUST07a NE LU19a-d) THEN AGELSTST =
MYRLSTST
LU20

[IF (METHREC=2 OR 3) OR (METHREC2 = 2 OR 3 AND SD17a1 NE 1)] The computer recorded that you last used
[METHFILL] [MEREC FILL]. How old were you the last time you used [METHFILL]?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTME:
IF LU20 NE (BLANK OR DK/REF) THEN AGELSTME = LU20
ELSE AGELSTME = BLANK
IF [AGELSTME < AGE1STME OR AGE1STME2] OR AGELSTME < 10 OR IF CURNTAGE < AGELSTME
May 23, 2012

278

LUCC41

The computer recorded that you were [AGELSTME] years old when you last used
[METHFILL]. Is this correct?
4
Yes
6
No
DK/REF

LUCC42

[IF LUCC41 = 6] Please answer this question again. Think about the last time you used
Methamphetamine[IF METHREC = 2 OR 3, ADD: , Desoxyn, or Methedrine]. How old were
you the last time you used [METHFILL]?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC42 NOT (BLANK OR DK/REF) THEN AGELSTME = LUCC42
LU20a

[IF LU20 NE DK/RE AND AGELSTME = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTME
= CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use [METHFILL] in [CURRENT YEAR - 1]
or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU20b

[IF AGELSTME = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use [METHFILL] in
[CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU20c

[IF LU20 NE DK/RE AND AGELSTME = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use [METHFILL]?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU20c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU20d

[IF LU20a = 1 - 2 OR LU20b = 1 - 2] In what month in [YEAR FROM LU20a or LU20b] did you last use
[METHFILL]?
1
2
3
4
5
6
7
8
9
10

May 23, 2012

January
February
March
April
May
June
July
August
September
October
279

11
November
12
December
DK/REF
HARD ERROR : [IF LU20d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTME:
MYRLSTME = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU20a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTME IS
BLANK.
IF MYRLSTME NE 0 AND NE AGELSTME:
LUME05
[IF METHREC = 2 OR 3] The computer recorded that you last used Methamphetamine,
Desoxyn or Methedrine that was not prescribed for you or that you took only for the
experience or feeling it caused in [LU20a-d fill]. That would make you [MYRLSTME] years
old when you last used Methamphetamine, Desoxyn or Methedrine in either of these ways. Is
this correct?
[IF METHREC2 = 2 OR 3] The computer recorded that you last used Methamphetamine in
[LU20a-d fill]. That would make you [MYRLSTME] years old when you last used
Methamphetamine. Is this correct?
4
Yes
6
No
DK/REF
LUME06

[IF LUME05 = 4]
[IF METHREC = 2 OR 3] Earlier, the computer recorded that you were [AGELSTME] years
old when you last used Methamphetamine, Desoxyn or Methedrine that was not prescribed for
you or that you took only for the experience or feeling it caused. Which answer is correct?
[IF METHREC2 = 2 OR 3] Earlier, the computer recorded that you were [AGELSTME]
years old when you last used Methamphetamine. Which answer is correct?
1

2

3
DK/REF

[IF METHREC = 2 OR 3] I last used Methamphetamine, Desoxyn or Methedrine
that was not prescribed for me or that I took only for the experience or feeling it
caused in [LU20a-d fill] when I was [MYRLSTME] years old
[IF METHREC2 = 2 OR 3] I last used Methamphetamine in [LU20a-d fill] when I
was [MYRLSTME] years old
[IF METHREC = 2 OR 3] I was [AGELSTME] years old the last time I used
Methamphetamine, Desoxyn or Methedrine that was not prescribed for me or that I
took only for the experience or feeling it caused
[IF METHREC2 = 2 OR 3] I was [AGELSTME] years old the last time I used
Methamphetamine
Neither answer is correct

UPDATE: IF LUME06 = 1, THEN AGELSTME = MYRLSTME
LUME07

[IF LUME06=2 OR LUME06=3 OR LUME05 = 6]
[IF METHREC = 2 OR 3] Please answer this question again. Did you last use
Methamphetamine, Desoxyn or Methedrine that was not prescribed for you or that you took
only for the experience or feeling it caused in [CURRENT YEAR-2], [CURRENT YEAR-1],
or [CURRENT YEAR]?
[IF METHREC2 = 2 OR 3] Please answer this question again. Did you last use
Methamphetamine in [CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?

1
2
May 23, 2012

CURRENT YEAR -2
CURRENT YEAR -1
280

3
CURRENT YEAR
DK/REF
LUME07a

[IF LUME07 NE (BLANK OR DK/REF)]
[IF METHREC = 2 OR 3] Please answer this question again. In what month in [LUME07]
did you last use Methamphetamine, Desoxyn or Methedrine that was not prescribed for you or
that you took only for the experience or feeling it caused?
[IF METHREC2 = 2 OR 3] Please answer this question again. In what month in [LUME07]
did you last use Methamphetamine?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LUME07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUME07a NE (0 OR DK/RE) THEN UPDATE MYRLSTME.
MYRLSTME = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUME07 AND LUME07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTME IS
BLANK. IF MYRLSTME = AGELSTME THEN MYRLSTME = BLANK
LUME08

[IF LUME06 NE 1 AND MYRLSTME NE 0 AND (LUME07 AND LUME07a NE LU20a-d)]
[IF METHREC = 2 OR 3] The computer recorded that you last used Methamphetamine,
Desoxyn or Methedrine that was not prescribed for you or that you took only for the
experience or feeling it caused in [LUME07 - LUME07a fill]. That would make you
[MYRLSTME] years old when you last used Methamphetamine, Desoxyn or Methedrine in
either of these ways. Is this correct?
[IF METHREC2 = 2 OR 3] The computer recorded that you last used Methamphetamine in
[LUME07 - LUME07a fill]. That would make you [MYRLSTME] years old when you last
used Methamphetamine. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUME08 NE (6, BLANK OR DK/REF) AND (LUME07 AND LUME07a NE LU20a-d) THEN AGELSTME =
MYRLSTME
LU21

[IF (SV09=2 OR 3) OR (SVRECDK=2 OR 3) OR (SVRECRE=2 OR 3)] The computer recorded that you last used a
prescription sedative that was not prescribed for you or that you took only for the experience or feeling it caused
[SVREC FILL]. How old were you the last time you used any prescription sedative in either of those ways?
AGE:_____[RANGE: 1-110]
DK/REF

DEFINE AGELSTSV:
IF LU20 NE (BLANK OR DK/REF) THEN AGELSTSV = LU21
ELSE AGELSTSV = BLANK
IF AGELSTSV < AGE1STSV OR AGELSTSV < 10 OR IF CURNTAGE < AGELSTSV
May 23, 2012

281

LUCC43

The computer recorded that you were [AGELSTSV] years old when you last used a
prescription sedative that was not prescribed for you or that you took only for the experience
or feeling it caused. Is this correct?
4
Yes
6
No
DK/REF

LUCC44

[IF LUCC43 = 6] Please answer this question again. Think about the last time you used a
prescription sedative that was not prescribed for you or that you took only for the experience
or feeling it caused. How old were you the last time you used any prescription sedative in
either of these ways?
AGE:_______[RANGE: 1-110]
DK/REF

UPDATE: IF LUCC44 NOT (BLANK OR DK/REF) THEN AGELSTSV = LUCC44
LU21a

[IF LU21 NE DK/RE AND AGELSTSV = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGELSTSV =
CURNTAGE - 1 AND DATE OF INTERVIEW $ DOB] Did you last use any prescription sedative that was not
prescribed for you or that you took only for the experience or feeling it caused in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

LU21b

[IF AGELSTSV = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you last use any prescription sedative
that was not prescribed for you or that you took only for the experience or feeling it caused in [CURRENT YEAR - 2]
or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

LU21c

[IF LU21 NE DK/RE AND AGELSTSV = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in
[CURRENT YEAR] did you last use a prescription sedative that was not prescribed for you or that you took only for
the experience or feeling it caused?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF LU21c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU21d

[IF LU21a = 1 - 2 OR LU21b = 1 - 2] In what month in [YEAR FROM LU21a or LU21b] did you last use a
prescription sedative that was not prescribed for you or that you took only for the experience or feeling it caused?
1
2
3
4
5

May 23, 2012

January
February
March
April
May
282

6
7
8
9
10
11
12
DK/REF

June
July
August
September
October
November
December

HARD ERROR : [IF LU21d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTSV:
MYRLSTSV = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF LAST USE (LU21a-d). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTSV IS
BLANK.
IF MYRLSTSV NE 0 AND NE AGELSTSV:
LUSV05
The computer recorded that you last used a prescription sedative that was not prescribed for
you or that you took only for the experience or feeling it caused in [LU21a-d fill]. That would
make you [MYRLSTSV] years old when you last used a prescription sedative in either of
these ways. Is this correct?
4
Yes
6
No
DK/REF
LUSV06

[IF LUSV05 = 4] Earlier, the computer recorded that you were [AGELSTSV] years old when
you last used a prescription sedative that was not prescribed for you or that you took only for
the experience or feeling it caused. Which answer is correct?
1

2
3
DK/REF

I last used a prescription sedative that was not prescribed for me or that I took only
for the experience or feeling it caused in [LU21a-d fill] when I was [MYRLSTSV]
years old
I was [AGELSTSV] years old the last time I used a prescription sedative that was
not prescribed for me or that I took only for the experience or feeling it caused
Neither answer is correct

UPDATE: IF LUSV06 = 1, THEN AGELSTSV = MYRLSTSV
LUSV07

[IF LUSV06=2 OR LUSV06=3 OR LUSV05 = 6] Please answer this question again. Did you
last use a prescription sedative that was not prescribed for you or that you took only for the
experience or feeling it caused in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUSV07a

[IF LUSV07 NE (BLANK OR DK/REF)] Please answer this question again. In what month in
[LUSV07] did you last use a prescription sedative that was not prescribed for you or that you
took only for the experience or feeling it caused?
1
2
3
4
5
6
7
8
9

May 23, 2012

January
February
March
April
May
June
July
August
September
283

10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LUSV07a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUSV07a NE (0 OR DK/RE) THEN UPDATE MYRLSTSV.
MYRLSTSV = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR
OF LAST USE (LUSV07 AND LUSV07a). IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTSV IS
BLANK. IF MYRLSTSV = AGELSTSV THEN MYRLSTSV = BLANK
LUSV08

[IF LUSV06 NE 1 AND MYRLSTSV NE 0 AND (LUSV07 AND LUSV07a NE LU21a-d)] The
computer recorded that you last used a prescription sedative that was not prescribed for you
or that you took only for the experience or feeling it caused in [LUSV07 - LUSV07a fill].
That would make you [MYRLSTSV] years old when you last used a prescription sedative in
either of these ways. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUSV08 NE (6, BLANK OR DK/REF) AND (LUSV07 AND LUSV07a NE LU21a-d) THEN AGELSTSV =
MYRLSTSV
LU22

[IF AGE1STCG = AGE1STAL NE AGE1STMJ] Earlier, the computer recorded that you started using alcohol and
cigarettes when you were [AFUFILL] years old. Which did you use first?
1
Alcohol
2
Cigarettes
DK/REF

LU23

[IF AGE1STCG = AGE1STMJ NE AGE1STAL] Earlier, the computer recorded that you started using marijuana and
cigarettes when you were [AFUFILL] years old. Which did you use first?
1
Marijuana
2
Cigarettes
DK/REF

LU24

[IF AGE1STAL = AGE1STMJ NE AGE1STCG] Earlier, the computer recorded that you started using alcohol and
marijuana when you were [AFUFILL] years old. Which did you use first?
1
Alcohol
2
Marijuana
DK/REF

LU25

[IF AGE1STCG = AGE1STAL = AGE1STMJ] Earlier, the computer recorded that you started using alcohol, cigarettes
and marijuana when you were [AFUFILL] years old. Which did you use first?
Alcohol
1
2
Cigarettes
3
Marijuana
DK/REF

LU26

[IF LU25 NE BLANK, DK OR REF] After first using [FILL LU25], which of these did you use next?
1
2

[IF LU25 = 1, FILL WITH ‘Cigarettes’
IF LU25 = 2, FILL WITH ‘Alcohol’]
[IF LU25 = 2, FILL WITH ‘Marijuana’
IF LU25 = 3, FILL WITH ‘Cigarettes’]

DK/REF
LU27

[IF PRREC = 1 OR OXYREC = 1] Earlier, the computer recorded that, during the past 30 days, you used prescription

May 23, 2012

284

pain relievers that were not prescribed for you or that you took only for the experience or feeling they caused. How
did you get these prescription pain relievers?
Please enter all of the ways that you got the prescription pain relievers you used in the past 30 days. To select more
than one answer from the list, press the space bar between each number you type. When you have finished, press
[ENTER].
1
2
3
4
5
6
7
8
9
10
DK/REF
LU27a

I got one or more prescriptions for pain relievers from just one doctor
I got prescriptions for pain relievers from more than one doctor
I wrote fake prescriptions for pain relievers
I stole the pain relievers from a doctor’s office, clinic, hospital, or pharmacy
I got the pain relievers from a friend or relative for free
I bought the pain relievers from a friend or relative
I took the pain relievers from a friend or relative without asking
I bought the pain relievers from a drug dealer or other stranger
I bought the pain relievers on the Internet
I got the pain relievers in some other way

[IF LU27 = 5] You reported that you got the prescription pain relievers you used in the past 30 days from a friend or
relative for free. How did your friend or relative get the prescription pain relievers that you used?
Please enter all of the ways that your friend or relative got the prescription pain relievers you used in the past 30 days.
To select more than one answer from the list, press the space bar between each number you type. When you have
finished, press [ENTER].
1
2
3
4
5
6
7
8
9
10
DK/REF

LU27aSP

He or she got one or more prescriptions for pain relievers from just one doctor
He or she got prescriptions for pain relievers from more than one doctor
He or she wrote fake prescriptions for pain relievers
He or she stole the pain relievers from a doctor’s office, clinic, hospital, or pharmacy
He or she got the pain relievers from another friend or relative for free
He or she bought the pain relievers from another friend or relative
He or she took the pain relievers from another friend or relative without asking
He or she bought the pain relievers from a drug dealer or other stranger
He or she bought the pain relievers on the Internet
He or she got the pain relievers in some other way

[IF ANY ENTRY IN LU27a = 10] Please type in the other way your friend or relative got the prescription pain
relievers you have used in the past 30 days. You do not need to give a detailed description — just a few words
will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
[IF ANY ENTRY IN LU27 = 10] Please type in the other way you got the prescription pain relievers you have
used in the past 30 days that were not prescribed for you or that you took only for the experience or feeling they
caused. You do not need to give a detailed description — just a few words will be okay. When you have finished
typing your answer, press the [ENTER] key to go to the next question.

LU27SP

_____________
DK/REF
LU28

[IF PRREC = 2 OR OXYREC = 2] Earlier, the computer recorded that, during the past 12 months, you used
prescription pain relievers that were not prescribed for you or that you took only for the experience or feeling they
caused.
[IF (MORE THAN ONE RESPONSE IN LU27) OR PRREC=2 OR OXYREC = 2] Now think about the last time you
used a prescription pain reliever that was not prescribed for you or that you took only for the experience or feeling it
caused. How did you get this prescription pain reliever?
1
2
3
4

May 23, 2012

I got a prescription for the pain reliever from just one doctor
I got prescriptions for the pain reliever from more than one doctor
I wrote a fake prescription for the pain reliever
I stole the pain reliever from a doctor’s office, clinic, hospital, or pharmacy
285

5
6
7
8
9
10
DK/REF
LU28a

I got the pain reliever from a friend or relative for free
I bought the pain reliever from a friend or relative
I took the pain reliever from a friend or relative without asking
I bought the pain reliever from a drug dealer or other stranger
I bought the pain reliever on the Internet
I got the pain reliever in some other way

[IF LU28 = 5] You reported that you got the prescription pain reliever you last used from a friend or relative for free.
How did your friend or relative get the last prescription pain reliever that you used?
1
2
3
4
5
6
7
8
9
10
DK/REF

LU28aSP

He or she got a prescription for the pain reliever from just one doctor
He or she got prescriptions for pain relievers from more than one doctor
He or she wrote a fake prescription for the pain reliever
He or she stole the pain reliever from a doctor’s office, clinic, hospital, or pharmacy
He or she got the pain reliever from another friend or relative for free
He or she bought the pain reliever from another friend or relative
He or she took the pain reliever from another friend or relative without asking
He or she bought the pain reliever from a drug dealer or other stranger
He or she bought the pain reliever on the Internet
He or she got the pain reliever in some other way

[IF ANY ENTRY IN LU28a = 10] Please type in the other way your friend or relative got the last prescription
pain reliever you used. You do not need to give a detailed description — just a few words will be okay. When
you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
[IF ANY ENTRY IN LU28 = 10] Please type in the other way you got the last prescription pain reliever you used
that was not prescribed for you or that you took only for the experience or feeling it caused. You do not need to
give a detailed description — just a few words will be okay. When you have finished typing your answer, press
the [ENTER] key to go to the next question.

LU28SP

_____________
DK/REF
LU29

[IF TR09=1 OR TRRECDK=1 OR TRRECRE=1] Earlier, the computer recorded that, during the past 30 days, you
used prescription tranquilizers that were not prescribed for you or that you took only for the experience or feeling
they caused. How did you get these prescription tranquilizers?
Please enter all of the ways that you got the prescription tranquilizers you used in the past 30 days. To select more than
one answer from the list, press the space bar between each number you type. When you have finished, press [ENTER].
1
2
3
4
5
6
7
8
9
10
DK/REF

LU29a

I got one or more prescriptions for tranquilizers from just one doctor
I got prescriptions for tranquilizers from more than one doctor
I wrote fake prescriptions for tranquilizers
I stole the tranquilizers from a doctor’s office, clinic, hospital, or pharmacy
I got the tranquilizers from a friend or relative for free
I bought the tranquilizers from a friend or relative
I took the tranquilizers from a friend or relative without asking
I bought the tranquilizers from a drug dealer or other stranger
I bought the tranquilizers on the Internet
I got the tranquilizers in some other way

[IF LU29 = 5] You reported that you got the prescription tranquilizers you used in the past 30 days from a friend or
relative for free. How did your friend or relative get the prescription tranquilizers that you used?
Please enter all of the ways that your friend or relative got the prescription tranquilizers you used in the past 30 days.
To select more than one answer from the list, press the space bar between each number you type. When you have
finished, press [ENTER].
1

May 23, 2012

He or she got one or more prescriptions for tranquilizers from just one doctor
286

2
3
4
5
6
7
8
9
10
DK/REF
LU29aSP

He or she got prescriptions for tranquilizers from more than one doctor
He or she wrote fake prescriptions for tranquilizers
He or she stole the tranquilizers from a doctor’s office, clinic, hospital, or pharmacy
He or she got the tranquilizers from another friend or relative for free
He or she bought the tranquilizers from another friend or relative
He or she took the tranquilizers from another friend or relative without asking
He or she bought the tranquilizers from a drug dealer or other stranger
He or she bought the tranquilizers on the Internet
He or she got the tranquilizers in some other way

[IF ANY ENTRY IN LU29a = 10] Please type in the other way your friend or relative got the prescription
tranquilizers you have used in the past 30 days. You do not need to give a detailed description — just a few words
will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
[IF ANY ENTRY IN LU29 = 10] Please type in the other way you got the prescription tranquilizers you have used
in the past 30 days that were not prescribed for you or that you took only for the experience or feeling they caused.
You do not need to give a detailed description — just a few words will be okay. When you have finished typing
your answer, press the [ENTER] key to go to the next question.

LU29SP

_____________
DK/REF
LU30

[IF TR09=2 OR TRRECDK=2 OR TRRECRE=2] Earlier, the computer recorded that, during the past 12 months, you
used prescription tranquilizers that were not prescribed for you or that you took only for the experience or feeling
they caused.
[IF (MORE THAN ONE RESPONSE IN LU29) OR (TR09=2 OR TRRECDK=2 OR TRRECRE=2)] Now think about
the last time you used a prescription tranquilizer that was not prescribed for you or that you took only for the
experience or feeling it caused. How did you get this prescription tranquilizer?
1
2
3
4
5
6
7
8
9
10
DK/REF

LU30a

I got a prescription for the tranquilizer from just one doctor
I got prescriptions for the tranquilizer from more than one doctor
I wrote a fake prescription for the tranquilizer
I stole the tranquilizer from a doctor’s office, clinic, hospital, or pharmacy
I got the tranquilizer from friend or relative for free
I bought the tranquilizer from a friend or relative
I took the tranquilizer from a friend or relative without asking
I bought the tranquilizer from a drug dealer or other stranger
I bought the tranquilizer on the Internet
I got the tranquilizer in some other way

[IF LU30 = 5] You reported that you got the prescription tranquilizer you last used from a friend or relative for free.
How did your friend or relative get the last prescription tranquilizer that you used?
1
2
3
4
5
6
7
8
9
10
DK/REF

LU30aSP

May 23, 2012

He or she got a prescription for the tranquilizer from just one doctor
He or she got prescriptions for tranquilizers from more than one doctor
He or she wrote a fake prescription for the tranquilizer
He or she stole the tranquilizer from a doctor’s office, clinic, hospital, or pharmacy
He or she got the tranquilizer from another friend or relative for free
He or she bought the tranquilizer from another friend or relative
He or she took the tranquilizer from another friend or relative without asking
He or she bought the tranquilizer from a drug dealer or other stranger
He or she bought the tranquilizer on the Internet
He or she got the tranquilizer in some other way

[IF ANY ENTRY IN LU30a = 10] Please type in the other way your friend or relative got the last prescription
tranquilizer you used. You do not need to give a detailed description — just a few words will be okay. When you
have finished typing your answer, press the [ENTER] key to go to the next question.

287

_____________
DK/REF
[IF ANY ENTRY IN LU30 = 10] Please type in the other way you got the last prescription tranquilizer you used
that was not prescribed for you or that you took only for the experience or feeling it caused. You do not need to
give a detailed description — just a few words will be okay. When you have finished typing your answer, press
the [ENTER] key to go to the next question.

LU30SP

_____________
DK/REF
LU31

[IF STIMREC=1] Earlier, the computer recorded that, during the past 30 days, you used prescription stimulants that
were not prescribed for you or that you took only for the experience or feeling they caused. How did you get these
prescription stimulants?
Please enter all of the ways that you got prescription stimulants you used in the past 30 days. To select more than one
answer from the list, press the space bar between each number you type. When you have finished, press [ENTER].
1
2
3
4
5
6
7
8
9
10
DK/REF

LU31a

I got one or more prescriptions for stimulants from just one doctor
I got prescriptions for stimulants from more than one doctor
I wrote fake prescriptions for stimulants
I stole the stimulants from a doctor’s office, clinic, hospital, or pharmacy
I got the stimulants from a friend or relative for free
I bought the stimulants from a friend or relative
I took the stimulants from a friend or relative without asking
I bought the stimulants from a drug dealer or other stranger
I bought the stimulants on the Internet
I got the stimulants in some other way

[IF LU31 = 5] You reported that you got the prescription stimulants you used in the past 30 days from a friend or
relative for free. How did your friend or relative get the prescription stimulants that you used?
Please enter all of the ways that your friend or relative got the prescription stimulants you used in the past 30 days. To
select more than one answer from the list, press the space bar between each number you type. When you have finished,
press [ENTER].
1
2
3
4
5
6
7
8
9
10
DK/REF

LU31aSP

He or she got one or more prescriptions for stimulants from just one doctor
He or she got prescriptions for stimulants from more than one doctor
He or she wrote fake prescriptions for stimulants
He or she stole the stimulants from a doctor’s office, clinic, hospital, or pharmacy
He or she got the stimulants from another friend or relative for free
He or she bought the stimulants from another friend or relative
He or she took the stimulants from another friend or relative without asking
He or she bought the stimulants from a drug dealer or other stranger
He or she bought the stimulants on the Internet
He or she got the stimulants in some other way

[IF ANY ENTRY IN LU31a = 10] Please type in the other way your friend or relative got the prescription
stimulants you have used in the past 30 days. You do not need to give a detailed description — just a few words
will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
[IF ANY ENTRY IN LU31 = 10] Please type in the other way you got the prescription stimulants you have used
in the past 30 days that were not prescribed for you or that you took only for the experience or feeling they caused.
You do not need to give a detailed description — just a few words will be okay. When you have finished typing
your answer, press the [ENTER] key to go to the next question.

LU31SP

_____________
DK/REF
LU32

[IF STIMREC = 2] Earlier, the computer recorded that, during the past 12 months, you used prescription stimulants

May 23, 2012

288

that were not prescribed for you or that you took only for the experience or feeling they caused.
[IF (MORE THAN ONE RESPONSE IN LU31) OR STIMREC=2] Now think about the last time you used a
prescription stimulant that was not prescribed for you or that you took only for the experience or feeling it caused.
How did you get this prescription stimulant?
1
2
3
4
5
6
7
8
9
10
DK/REF
LU32a

I got a prescription for the stimulant from just one doctor
I got prescriptions for the stimulant from more than one doctor
I wrote a fake prescription for the stimulant
I stole the stimulant from a doctor’s office, clinic, hospital, or pharmacy
I got the stimulant from a friend or relative for free
I bought the stimulant from a friend or relative
I took the stimulant from a friend or relative without asking
I bought the stimulant from a drug dealer or other stranger
I bought the stimulant on the Internet
I got the stimulant in some other way

[IF LU32 = 5] You reported that you got the prescription stimulant you last used from a friend or relative for free. How
did your friend or relative get the last prescription stimulant that you used?
1
2
3
4
5
6
7
8
9
10
DK/REF

LU32aSP

He or she got a prescription for the stimulant from just one doctor
He or she got prescriptions for stimulants from more than one doctor
He or she wrote a fake prescription for the stimulant
He or she stole the stimulant from a doctor’s office, clinic, hospital, or pharmacy
He or she got the stimulant from another friend or relative for free
He or she bought the stimulant from another friend or relative
He or she took the stimulant from another friend or relative without asking
He or she bought the stimulant from a drug dealer or other stranger
He or she bought the stimulant on the Internet
He or she got the stimulant in some other way

[IF ANY ENTRY IN LU32a = 10] Please type in the other way your friend or relative got the last prescription
stimulant you used. You do not need to give a detailed description — just a few words will be okay. When you
have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
[IF ANY ENTRY IN LU32 = 10] Please type in the other way you got the last prescription stimulant you used
that was not prescribed for you or that you took only for the experience or feeling it caused. You do not need to
give a detailed description — just a few words will be okay. When you have finished typing your answer, press
the [ENTER] key to go to the next question.

LU32SP

_____________
DK/REF
LU33

[IF METHREC=1 OR (SD17b = 1 AND SD17a1 NE 1)] Earlier, the computer recorded that, during the past 30 days,
you used Methamphetamine. How did you get this Methamphetamine?
Please enter all of the ways that you got the Methamphetamine you used in the past 30 days. To select more than one
answer from the list, press the space bar between each number you type. When you have finished, press [ENTER].
1
2
3
4
5
6
DK/REF

LU33a

I got the Methamphetamine from a friend or relative for free
I bought the Methamphetamine from a friend or relative
I took the Methamphetamine from a friend or relative without asking
I bought the Methamphetamine from a drug dealer or other stranger
I bought the Methamphetamine on the Internet
I got the Methamphetamine in some other way

[IF LU33 = 1] You reported that you got the Methamphetamine you used in the past 30 days from a friend or relative
for free. How did your friend or relative get the Methamphetamine that you used?

May 23, 2012

289

Please enter all of the ways that your friend or relative got the Methamphetamine you used in the past 30 days. To
select more than one answer from the list, press the space bar between each number you type. When you have finished,
press [ENTER].
1
2
3
4
5
6
DK/REF
LU33aSP

He or she got the Methamphetamine from another friend or relative for free
He or she bought the Methamphetamine from another friend or relative
He or she took the Methamphetamine from another friend or relative without asking
He or she bought the Methamphetamine from a drug dealer or other stranger
He or she bought the Methamphetamine on the Internet
He or she got the Methamphetamine in some other way

[IF ANY ENTRY IN LU33a = 6] Please type in the other way your friend or relative got the Methamphetamine
you have used in the past 30 days. You do not need to give a detailed description — just a few words will be
okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
[IF ANY ENTRY IN LU33 = 6] Please type in the other way you got the Methamphetamine you have used in the
past 30 days. You do not need to give a detailed description — just a few words will be okay. When you have
finished typing your answer, press the [ENTER] key to go to the next question.

LU33SP

_____________
DK/REF
LU34

[IF (METHREC=2 OR (SD17b = 2 AND SD17a1 NE 1))] Earlier, the computer recorded that, during the past 12
months, you used Methamphetamine.
[IF (MORE THAN ONE RESPONSE IN LU33) OR (METHREC=2 OR SD17b = 2)] Now think about the last time
you used Methamphetamine. How did you get this Methamphetamine?
1
2
3
4
5
6
DK/REF

LU34a

I got the Methamphetamine from a friend or relative for free
I bought the Methamphetamine from a friend or relative
I took the Methamphetamine from a friend or relative without asking
I bought the Methamphetamine from a drug dealer or other stranger
I bought the Methamphetamine on the Internet
I got the Methamphetamine in some other way

[IF LU34 = 1] You reported that you got the Methamphetamine you last used from a friend or relative for free. How
did your friend or relative get the last Methamphetamine that you used?
1
2
3
4
5
6
DK/REF

LU34aSP

He or she got the Methamphetamine from another friend or relative for free
He or she bought the Methamphetamine from another friend or relative
He or she took the Methamphetamine from another friend or relative without asking
He or she bought the Methamphetamine from a drug dealer or other stranger
He or she bought the Methamphetamine on the Internet
He or she got the Methamphetamine in some other way

[IF ANY ENTRY IN LU34a = 6] Please type in the other way your friend or relative got the last
Methamphetamine you used. You do not need to give a detailed description — just a few words will be okay.
When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF

LU34SP

[IF ANY ENTRY IN LU34 = 6] Please type in the other way you got the last Methamphetamine you used. You
do not need to give a detailed description — just a few words will be okay. When you have finished typing your
answer, press the [ENTER] key to go to the next question.
_____________
DK/REF

May 23, 2012

290

LU35

[IF SV09=1 OR SVRECDK=1 OR SVRECRE=1] Earlier, the computer recorded that, during the past 30 days, you
used prescription sedatives that were not prescribed for you or that you took only for the experience or feeling they
caused. How did you get these prescription sedatives?
Please enter all of the ways that you got the prescription sedatives you used in the past 30 days. To select more than
one answer from the list, press the space bar between each number you type. When you have finished, press [ENTER].
1
2
3
4
5
6
7
8
9
10
DK/REF

LU35a

I got one or more prescriptions for sedatives from just one doctor
I got prescriptions for sedatives from more than one doctor
I wrote fake prescriptions for sedatives
I stole the sedatives from a doctor’s office, clinic, hospital, or pharmacy
I got the sedatives from a friend or relative for free
I bought the sedatives from a friend or relative
I took the sedatives from a friend or relative without asking
I bought the sedatives from a drug dealer or other stranger
I bought the sedatives on the Internet
I got the sedatives in some other way

[IF LU35 = 5] You reported that you got the prescription sedatives you used in the past 30 days from a friend or
relative for free. How did your friend or relative get the prescription sedatives that you used?
Please enter all of the ways that your friend or relative got the prescription sedatives you used in the past 30 days. To
select more than one answer from the list, press the space bar between each number you type. When you have finished,
press [ENTER].
1
2
3
4
5
6
7
8
9
10
DK/REF

LU35aSP

He or she got one or more prescriptions for sedatives from just one doctor
He or she got prescriptions for sedatives from more than one doctor
He or she wrote fake prescriptions for sedatives
He or she stole the sedatives from a doctor’s office, clinic, hospital, or pharmacy
He or she got the sedatives from another friend or relative for free
He or she bought the sedatives from another friend or relative
He or she took the sedatives from another friend or relative without asking
He or she bought the sedatives from a drug dealer or other stranger
He or she bought the sedatives on the Internet
He or she got the sedatives in some other way

[IF ANY ENTRY IN LU35a = 10] Please type in the other way your friend or relative got the prescription
sedatives you have used in the past 30 days. You do not need to give a detailed description — just a few words
will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
[IF ANY ENTRY IN LU35 = 10] Please type in the other way you got the prescription sedatives you have used in
the past 30 days that were not prescribed for you or that you took only for the experience or feeling they caused.
You do not need to give a detailed description — just a few words will be okay. When you have finished typing
your answer, press the [ENTER] key to go to the next question.

LU35SP

_____________
DK/REF
LU36

[IF SV09=2 OR SVRECDK=2 OR SVRECRE=2] Earlier, the computer recorded that, during the past 12 months, you
used prescription sedatives that were not prescribed for you or that you took only for the experience or feeling they
caused.
[IF (MORE THAN ONE RESPONSE IN LU35) OR (SV09=2 OR SVRECDK=2 OR SVRECRE=2)] Now think about
the last time you used a prescription sedative that was not prescribed for you or that you took only for the experience
or feeling it caused. How did you get this prescription sedative?
1
2
3
4

May 23, 2012

I got a prescription for the sedative from just one doctor
I got prescriptions for the sedative from more than one doctor
I wrote a fake prescription for the sedative
I stole the sedative from a doctor’s office, clinic, hospital, or pharmacy
291

5
6
7
8
9
10
DK/REF
LU36a

I got the sedative from a friend or relative for free
I bought the sedative from a friend or relative
I took the sedative from a friend or relative without asking
I bought the sedative from a drug dealer or other stranger
I bought the sedative on the Internet
I got the sedative in some other way

[IF LU36 = 5] You reported that you got the prescription sedative you last used from a friend or relative for free. How
did your friend or relative get the last prescription sedative that you used?
1
2
3
4
5
6
7
8
9
10
DK/REF

LU36aSP

He or she got a prescription for the sedative from just one doctor
He or she got prescriptions for sedatives from more than one doctor
He or she wrote a fake prescription for the sedative
He or she stole the sedative from a doctor’s office, clinic, hospital, or pharmacy
He or she got the sedative from another friend or relative for free
He or she bought the sedative from another friend or relative
He or she took the sedative from another friend or relative without asking
He or she bought the sedative from a drug dealer or other stranger
He or she bought the sedative on the Internet
He or she got the sedative in some other way

[IF ANY ENTRY IN LU36a = 10] Please type in the other way your friend or relative got the last prescription
sedative you used. You do not need to give a detailed description — just a few words will be okay. When you
have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
[IF ANY ENTRY IN LU36 = 10] Please type in the other way you got the last prescription sedative you used that
was not prescribed for you or that you took only for the experience or feeling it caused. You do not need to give a
detailed description — just a few words will be okay. When you have finished typing your answer, press the
[ENTER] key to go to the next question.

LU36SP

_____________
DK/REF
LU37

[IF (CG01=1 OR CGREF = 1) AND CG06 NE 3 AND CG06DK NE 3 AND CG06RE NE 3] Earlier questions were
about the past 12 months. This question is about the year before that, that is, from [DATEFILL - 12 MONTHS] to
[DATEFILL]. During that year, beginning [DATEFILL - 12 MONTHS] and ending [DATEFILL], did you smoke
part or all of a cigarette, even once?
1
Yes
2
No
DK/REF

LU38

[IF AL01=1 OR ALREF = 1] [IF LU37 = BLANK: Earlier questions were about the past 12 months. This question is
about the year before that, that is, from [DATEFILL - 12 MONTHS] to [DATEFILL].] During that year, beginning
[DATEFILL - 12 MONTHS] and ending [DATEFILL], did you have a drink of any type of alcoholic beverage, even
once?
1
Yes
2
No
DK/REF

LU39

[IF CC01=1 OR CCREF = 1] [IF LU37 = BLANK AND LU38 = BLANK: Earlier questions were about the past 12
months. This question is about the year before that, that is, from [DATEFILL - 12 MONTHS] to [DATEFILL].]
During that year, beginning [DATEFILL - 12 MONTHS] and ending [DATEFILL], did you use any form of cocaine,
even once?
1
Yes
2
No
DK/REF

May 23, 2012

292

Drug Treatment
Introtx [IF AL01 = 1 OR ALREF = 1 OR MJ01 = 1 OR MJREF = 1 OR CC01 = 1 OR CCREF = 1 OR CK01 = 1 OR CKREF
= 1 OR HE01 = 1 OR HEREF = 1 OR LS01a = 1 OR LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR LS01c = 1 OR
LS01d = 1 OR LS01e = 1 OR LS01f =1 OR LSREF3 = 1 OR LS01h = 1 OR IN01a =1 OR IN01b =1 OR IN01c = 1
OR IN01d = 1 OR IN01e = 1OR IN01f = 1 OR IN01g = 1 OR IN01h = 1 OR IN01i = 1 OR IN01j = 1 OR IN01l = 1
OR INREF = 1 OR PR01 = 1 OR PR02 = 1 OR PR03 = 1 OR PR04 = 1 OR PR05 = 1 OR PRREF = 1 OR TR01 = 1
OR TR02 = 1 OR TR03 = 1 OR TR04 = 1 OR TR05 = 1 OR TRREF = 1 OR ST01 = 1 OR STREF1 = 1 OR ST02 = 1
OR ST03 = 1 OR ST04 = 1 OR ST05 = 1 OR STREF2 = 1 OR SV01 = 1 OR SV02 = 1 OR SV03 = 1 OR SV04 = 1
OR SV05 = 1 OR SVREF = 1 OR (SD17a = 1 AND SD17a1 NE 1 AND SD17ALT NE 1)] These next questions deal
with treatment for alcohol and drug problems, not including cigarettes. Please report treatment or counseling
designed to help you reduce or stop your alcohol or drug use. Please include detoxification and any other treatment for
medical problems associated with your alcohol or drug use.
Press [ENTER] to continue.
TX01

[IF AL01 = 1 OR ALREF = 1 OR MJ01 = 1 OR MJREF = 1 OR CC01 = 1 OR CCREF = 1 OR CK01 = 1 OR CKREF
= 1 OR HE01 = 1 OR HEREF = 1 OR LS01a = 1 LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR LS01c = 1 OR
LS01d = 1 OR LS01e = 1 OR LS01f = 1 OR LSREF3 = 1 OR LS01h = 1 OR IN01a =1 OR IN01b =1 OR IN01c = 1
OR IN01d = 1 OR IN01e = 1OR IN01f = 1 OR IN01g = 1 OR IN01h = 1 OR IN01i = 1 OR IN01j = 1 OR IN01l = 1
OR INREF = 1 OR PR01 = 1 OR PR02 = 1 OR PR03 = 1 OR PR04 = 1 OR PR05 = 1 OR PRREF = 1 OR TR01 = 1
OR TR02 = 1 OR TR03 = 1 OR TR04 = 1 OR TR05 = 1 OR TRREF = 1 OR ST01 = 1 OR STREF1 = 1 ST02 = 1 OR
ST03 = 1 OR ST04 = 1 OR ST05 = 1 OR STREF2 = 1 OR SV01 = 1 OR SV02 = 1 OR SV03 = 1 OR SV04 = 1 OR
SV05 = 1 OR SVREF = 1 OR (SD17a = 1 AND SD17a1 NE 1 AND SD17ALT NE 1)] Have you ever received
treatment or counseling for your use of alcohol or any drug, not counting cigarettes?
1
Yes
2
No
DK/REF

TX02

[IF TX01 = 1] During the past 12 months, that is, since [DATEFILL], have you received treatment or counseling for
your use of alcohol or any drug, not counting cigarettes?
1
Yes
2
No
DK/REF

TX03

[IF TX02 = 1] During the past 12 months when you received treatment, was the treatment for alcohol use only, drug
use only, or both alcohol and drug use?
1
Alcohol use only
2
Drug use only
3
Both alcohol and drug use
DK/REF

DEFINE TXFILL1:
IF TX03 = 1, TXFILL1 = alcohol use
IF TX03 = 2, TXFILL1 = drug use
IF TX03 = 3 OR DK/REF, TXFILL1 = alcohol or drug use
ELSE, TXFILL1 = BLANK
TX04a

[IF TX03 NE BLANK ] During the past 12 months, have you received treatment for your [TXFILL1] in a hospital
overnight as an inpatient?
1
Yes
2
No
DK/REF

TX04a1 [IF TX03 = 3 AND TX04a = 1] Was the treatment you received in a hospital overnight as an inpatient for your alcohol
use, your drug use, or both?
1
2
3
May 23, 2012

Alcohol use
Drug use
Both alcohol and drug use
293

DK/REF
TX04b

[IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in a residential
drug or alcohol rehabilitation facility where you stayed overnight?
1
Yes
2
No
DK/REF

TX04b1 [IF TX03 = 3 AND TX04b = 1] Was the treatment you received in a residential drug or alcohol rehabilitation facility
where you stayed overnight for your alcohol use, your drug use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX04c

[IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in a drug or
alcohol rehabilitation facility as an outpatient?
1
Yes
2
No
DK/REF

TX04c1 [IF TX03 = 3 AND TX04c = 1] Was the treatment you received in a drug or alcohol rehabilitation facility as an
outpatient for your alcohol use, your drug use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX04d

[IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in a mental
health center or facility as an outpatient?
1
Yes
2
No
DK/REF

TX04d1 [IF TX03 = 3 AND TX04d = 1] Was the treatment you received in a mental health center or facility as an outpatient
for your alcohol use, your drug use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX04e

[IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in an emergency
room?
1
Yes
2
No
DK/REF

TX04e1 [IF TX03 = 3 AND TX04e = 1] Was the treatment you received in an emergency room for your alcohol use, your drug
use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF

May 23, 2012

294

TX04f

[IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in a private
doctor’s office?
1
Yes
2
No
DK/REF

TX04f1 [IF TX03 = 3 AND TX04f = 1] Was the treatment you received in a private doctor’s office for your alcohol use, your
drug use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX04g

[IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in a prison or
jail?
1
Yes
2
No
DK/REF

TX04g1 [IF TX03 = 3 AND TX04g = 1] Was the treatment you received in a prison or jail for your alcohol use, your drug use,
or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX04h

[IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in a self-help
group such as Alcoholics Anonymous or Narcotics Anonymous?
1
Yes
2
No
DK/REF

TX04h1 [IF TX03 = 3 AND TX04h = 1] Was the treatment you received in a self-help group for your alcohol use, your drug
use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX04i

[IF TX03 NE BLANK] During the past 12 months, have you received treatment for your [TXFILL1] in some other
place besides these that have been listed?
1
Yes
2
No
DK/REF

TX04iSP [IF TX04i = 1] Please type in a description of the place where you received treatment or counseling for your
[TXFILL1] other than the places just mentioned. When you have finished typing your answer, press the [Enter] key to
go to the next question.
_______________
DK/REF

May 23, 2012

295

TX04i1 [IF TX03 = 3 AND TX04i = 1] Was the treatment you received in this other place for your alcohol use, your drug use,
or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX05

[IF TX03 = 2 OR 3 AND (MJ01 = 1 OR MJREF = 1 OR CC01 = 1 OR CCREF = 1 OR CK01 = 1 OR CKREF = 1 OR
HE01 = 1 OR HEREF = 1 OR LS01a = 1 OR LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR ST01 = 1 OR STREF1
= 1 OR (SD17a = 1 AND SD17a1 NE 1 AND SD17ALT NE 1))] During the past 12 months, that is, since
[DATEFILL], did you visit a hospital emergency room to receive treatment for your use of cocaine, heroin,
marijuana, PCP, LSD, or Methamphetamine?
1
Yes
2
No
DK/REF

TX06

[IF TX05 = 1] During the past 12 months, how many times did you visit a hospital emergency room to receive
treatment for your use of cocaine, heroin, marijuana, PCP, LSD, or Methamphetamine?
# OF TIMES:
DK/REF

TX07

[RANGE: 1 - 90]

[IF TX02 = 1 OR DK/REF] Are you currently receiving treatment or counseling for your [TXFILL1]?
1
Yes
2
No
DK/REF

TX08

[IF (TX01 = 2 OR DK/REF) OR ((TX02 =2 OR DK/REF) AND TX07 NE 1)] During the past 12 months, did you
need treatment or counseling for your alcohol or drug use?
1
Yes
2
No
DK/REF

TX09

[IF TX02 = 1 AND TX07 NE 1] During the past 12 months, did you need additional treatment or counseling for your
alcohol or drug use?
1
Yes
2
No
DK/REF

TX10

[IF TX09 = 1] During the past 12 months, for which of the following drugs did you need additional treatment or
counseling?
Type the number of each drug for which you needed additional treatment or counseling during the past 12 months. To
select more than one drug from the list, press the space bar between each number you type. When you have finished,
press [ENTER].
1
2
3
4
5
6
7
8
9
10
11
DK/REF

May 23, 2012

Alcohol
Marijuana or hashish
Cocaine or ‘crack’
Heroin
Hallucinogens
Inhalants
Prescription pain relievers
Prescription tranquilizers
Prescription stimulants
Prescription sedatives
Some other drug

296

TX11

[IF (AL01 = 1 OR ALREF = 1) AND TX08 = 1] During the past 12 months, did you need treatment or counseling for
your use of alcohol?
1
Yes
2
No
DK/REF

TX12

[IF (MJ01 = 1 OR MJREF = 1) AND TX08 = 1] During the past 12 months, did you need treatment or counseling for
your use of marijuana or hashish?
1
Yes
2
No
DK/REF

TX13

[IF (CC01 = 1 OR CCREF = 1 OR CK01 =1 OR CKREF = 1) AND TX08 = 1] During the past 12 months, did you
need treatment or counseling for your use of cocaine or ‘crack’?
1
Yes
2
No
DK/REF

TX14

[IF (HE01 = 1 OR HEREF = 1) AND TX08 = 1] During the past 12 months, did you need treatment or counseling for
your use of heroin?
1
Yes
2
No
DK/REF

TX15

[IF (LS01a =1 OR LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR LS01c = 1 OR LS01d =1 OR LS01e = 1 OR
LS01f =1 OR LSREF3 = 1 OR LS01h = 1) AND TX08 =1] During the past 12 months, did you need treatment or
counseling for your use of hallucinogens?
1
Yes
2
No
DK/REF

TX16

[IF (IN01a =1 OR IN01b =1 OR IN01c =1 OR IN01d = 1 OR IN01e = 1 OR IN01f = 1 OR IN01g = 1 OR IN01h = 1
OR IN01i = 1 OR IN01j = 1 OR IN01l = 1 OR INREF = 1) AND TX08 = 1] During the past 12 months, did you need
treatment or counseling for your use of inhalants?
1
Yes
2
No
DK/REF

TX17

[IF (PR01 = 1 OR PR02 = 1 OR PR03 = 1 OR PR04 = 1 OR PR05 = 1 OR PRREF = 1) AND TX08 = 1] During the
past 12 months, did you need treatment or counseling for your use of prescription pain relievers?
1
Yes
2
No
DK/REF

TX18

[IF (TR01 = 1 OR TR02 = 1 OR TR03 = 1 OR TR04 = 1 OR TR05 = 1 OR TRREF = 1) AND TX08 = 1] During the
past 12 months, did you need treatment or counseling for your use of prescription tranquilizers?
1
Yes
2
No
DK/REF

TX19

[IF (ST01 = 1 OR STREF1 = 1 OR ST02 = 1 OR ST03 = 1 OR ST04 = 1 OR ST05 = 1 OR STREF2 = 1) AND TX08
= 1] During the past 12 months, did you need treatment or counseling for your use of prescription stimulants?
1
Yes
2
No
DK/REF

May 23, 2012

297

TX20

[IF (SV01 = 1 OR SV02 = 1 OR SV03 = 1 OR SV04 = 1 OR SV05 = 1 OR SVREF = 1) AND TX08 = 1] During the
past 12 months, did you need treatment or counseling for your use of prescription sedatives?
1
Yes
2
No
DK/REF

TX21

[IF TX08 = 1] During the past 12 months, did you need treatment or counseling for your use of some other drug
besides the ones just listed?
1
Yes
2
No
DK/REF

TX21SP1

[IF TX21 = 1] Please type in the name of one of the other drugs you needed treatment or counseling for during the
past 12 months. If you’re not sure how to spell the drug name, just make your best guess. When you have
finished typing your answer, press the [ENTER] key to go to the next question.
____________
DK/REF

TX21SP2

[IF TX21SP1 NE (BLANK OR DK/REF)] Please type in the name of any other drug that you needed treatment
or counseling for during the past 12 months other than those you have already mentioned. If you have not needed
treatment or counseling for your use of any other drugs, press the [ENTER] key to go to the next question.
____________
DK/REF

TX21SP3

[IF TX21SP2 NE (BLANK OR DK/REF)] Please type in the name of any other drug that you needed treatment
or counseling for during the past 12 months other than those you have already mentioned. If you have not needed
treatment or counseling for your use of any other drugs, press the [ENTER] key to go to the next question.
____________
DK/REF

TX21SP4

[IF TX21SP3 NE (BLANK OR DK/REF)] Please type in the name of any other drug that you needed treatment
or counseling for during the past 12 months other than those you have already mentioned. If you have not needed
treatment or counseling for your use of any other drugs, press the [ENTER] key to go to the next question.
____________
DK/REF

TX21SP5

[IF TX21SP4 NE (BLANK OR DK/REF)] Please type in the name of any other drug that you needed treatment
or counseling for during the past 12 months other than those you have already mentioned. If you have not needed
treatment or counseling for your use of any other drugs, press the [ENTER] key to go to the next question.
____________
DK/REF

DEFINE TXFILL2:
IF TX11 = 1 AND ALL OF TX12 - TX21 = 2 OR DK/REF, TXFILL2 = alcohol
IF TX11 = 2 OR DK/REF, AND ANY IN TX12 - TX21 = 1, TXFILL2 = any drug
ELSE, TXFILL2 = alcohol or any other drug
TX22

[IF TX08 = 1] During the past 12 months, did you make an effort to get treatment or counseling for your use of
[TXFILL2]?
1
Yes
2
No
DK/REF

TX22A [IF TX22 IS NOT BLANK] Which of these statements explain why you did not get the treatment or counseling you
needed for your use of [TXFILL2]?
To select more than one reason from the list, press the space bar between each number you type. When you have
May 23, 2012

298

finished, press [ENTER].
1
2
3
4
5
6
7
8
9
10
DK/REF

You had no health care coverage, and you couldn’t afford the cost.
You did have health care coverage, but it didn’t cover treatment for [TXFILL2], or didn’t cover the full cost.
You had no transportation to a program, or the programs were too far away, or the hours were not convenient.
You didn’t find a program that offered the type of treatment or counseling you wanted.
You were not ready to stop using [TXFILL2].
There were no openings in the programs.
You did not know where to go to get treatment.
You were concerned that getting treatment or counseling might cause your neighbors or community to have a
negative opinion of you.
You were concerned that getting treatment or counseling might have a negative effect on your job.
Some other reason or reasons.

TX22B [IF ANY ENTRY IN TX22A = 10] Which of these statements explain why you did not get the treatment or counseling
you needed for your use of [TXFILL2]?
To select more than one reason from the list, press the space bar between each number you type. When you have
finished, press [ENTER].
1
2
3
4
5
6
DK/REF

You didn't think you needed treatment at the time.
You thought you could handle the problem without treatment.
You didn't think treatment would help.
You didn't have time (because of job, childcare, or other commitments).
You didn't want others to find out that you needed treatment.
Some other reason or reasons.

[IF ANY ENTRY IN TX22B = 6 ] Please type in the most important other reason you did not get the treatment
you needed. When you have finished typing your answer, press the [ENTER] key to go to the next question.

TX22SP

____________
DK/REF
TX23

[IF TX09 = 1] During the past 12 months, did you make an effort to get additional treatment or counseling for your
use of alcohol or any other drug?
1
Yes
2
No
DK/REF

TX23A [IF TX23 IS NOT BLANK] Which of these statements explain why you did not get the additional treatment or
counseling you needed for your use of alcohol or drugs?
To select more than one reason from the list, press the space bar between each number you type. When you have
finished, press [ENTER].
1
2
3
4
5
6
7
8
9
10
DK/REF

You had no health care coverage, and you couldn’t afford the cost.
You did have health care coverage, but it didn’t cover treatment for alcohol or drugs, or didn’t cover the full
cost.
You had no transportation to a program, or the programs were too far away, or the hours were not convenient.
You didn’t find a program that offered the type of treatment or counseling you wanted.
You were not ready to stop using alcohol or drugs.
There were no openings in the programs.
You did not know where to go to get treatment.
You were concerned that getting treatment or counseling might cause your neighbors or community to have a
negative opinion of you.
You were concerned that getting treatment or counseling might have a negative effect on your job.
Some other reason or reasons.

TX23B [IF ANY ENTRY IN TX23A = 10] Which of these statements explain why you did not get the additional treatment or
counseling you needed for your use of alcohol or drugs?

May 23, 2012

299

To select more than one reason from the list, press the space bar between each number you type. When you have
finished, press [ENTER].
1
2
3
4
5
6
DK/REF

You didn't think you needed treatment at the time.
You thought you could handle the problem without treatment.
You didn't think treatment would help.
You didn't have time (because of job, childcare, or other commitments).
You didn't want others to find out that you needed treatment.
Some other reason or reasons.

[IF ANY ENTRY IN TX23B = 6] Please type in the most important other reason you did not get the treatment
you needed. When you have finished typing your answer, press the [ENTER] key to go to the next question.

TX23SP

____________
DK/REF
TX24

[IF TX07 NE 1] How long has it been since you were last in treatment or counseling for your alcohol or drug use, not
counting cigarettes?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

TX25

[IF TX01 = 1 AND TX07 NE 1 OR BLANK] What was the main place where you received treatment the last time
you started treatment for your alcohol or other drug use, not counting cigarettes?
[IF TX01 = 1 AND TX07 = 1] What is the main place where you are currently receiving treatment for your alcohol or
other drug use, not counting cigarettes?
1
2
3
4
5
6
7
8
9
DK/REF

A hospital overnight as an inpatient
A residential drug or alcohol rehabilitation facility where you stay at night
A drug or alcohol rehabilitation facility as an outpatient where you do not stay at night
A mental health center or facility as an outpatient
An emergency room
A private doctor’s office
A prison or jail
A self-help group
Some other place

[IF TX01 = 1 AND TX07 NE BLANK AND TX25 = 9] Please type in a description of the place where you
received treatment or counseling for your drug use other than the places just mentioned. When you have finished
typing your answer, press the [Enter] key to go to the next question.

TX25SP

____________
DK/REF
TX26

[IF (AL01 = 1 OR ALREF = 1) AND TX01 = 1 AND TX07 NE 1 OR BLANK] The last time you entered treatment,
did you receive treatment or counseling for your use of alcohol?
[IF (AL01 = 1 OR ALREF = 1) AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling
for your use of alcohol?
1
Yes
2
No
DK/REF

TX27

[IF (MJ01 =1 OR MJREF = 1) AND TX01 =1 AND TX07 NE 1 OR BLANK] The last time you entered treatment,
did you receive treatment or counseling for your use of marijuana or hashish?
[IF (MJ01 = 1 OR MJREF = 1) AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling
for your use of marijuana or hashish?

May 23, 2012

300

1
Yes
2
No
DK/REF
TX28

[IF (CC01 =1 OR CCREF = 1 OR CK01 =1 OR CKREF = 1) AND TX01 = 1 AND TX07 NE 1 OR BLANK] The last
time you entered treatment, did you receive treatment or counseling for your use of cocaine or ‘crack’?
[IF (CC01 = 1 OR CCREF = 1 OR CK01 =1 OR CKREF = 1) AND TX01 = 1 AND TX07 = 1] Are you currently
receiving treatment or counseling for your use of cocaine or ‘crack’?
1
Yes
2
No
DK/REF

TX29

[IF (HE01 =1 OR HEREF = 1) AND TX01 =1 AND TX07 NE 1 OR BLANK] The last time you entered treatment,
did you receive treatment or counseling for your use of heroin?
[IF (HE01 = 1 OR HEREF = 1) AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling
for your use of heroin?
1
Yes
2
No
DK/REF

TX30

[IF (LS01a =1 OR LSREF1 = 1 OR LS01b =1 OR LSREF2 = 1 OR LS01c =1 OR LS01d =1 OR LS01e =1 OR LS01f
= 1 OR LSREF3 = 1 OR LS01h =1) AND TX01 =1 AND TX07 NE 1 OR BLANK] The last time you entered
treatment, did you receive treatment or counseling for your use of hallucinogens?
[IF (LS01a =1 OR LSREF1 = 1 OR LS01b =1 OR LSREF2 = 1 OR LS01c =1 OR LS01d = 1 OR LS01e = 1 OR LS01f
= 1 OR LSREF3 = 1 OR LS01h =1) AND TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or
counseling for your use of hallucinogens?
1
Yes
2
No
DK/REF

TX31

[IF (IN01a =1 OR IN01b =1 OR IN01c =1 OR IN01d = 1 OR IN01e = 1 OR IN01f = 1 OR IN01g = 1 OR IN01h = 1
OR IN01i = 1 OR IN01j = 1 OR IN01l = 1 OR INREF = 1) AND TX01 =1 AND TX07 NE 1 OR BLANK] The last
time you entered treatment, did you receive treatment or counseling for your use of inhalants?
[IF (IN01a = 1 OR IN01b =1 OR IN01c =1 OR IN01d =1 OR IN01e = 1 OR IN01f =1 OR IN01g=1 OR IN01h =1 OR
IN01i =1 OR IN01j =1 OR IN01l =1 OR INREF = 1) AND TX01 = 1 AND TX07 = 1] Are you currently receiving
treatment or counseling for your use of inhalants?
1
Yes
2
No
DK/REF

TX32

[IF (PR01 =1 OR PR02 =1 OR PR03 =1 OR PR04 = 1 OR PR05 = 1 OR PRREF = 1) AND TX01 = 1 AND TX07 NE
1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of
prescription pain relievers?
[IF (PR01 = 1 OR PR02 = 1 OR PR03 =1 OR PR04 = 1 OR PR05 =1 OR PRREF = 1) AND TX01 = 1 AND TX07 =
1] Are you currently receiving treatment or counseling for your use of prescription pain relievers?
1
Yes
2
No
DK/REF

TX33

[IF (TR01 =1 OR TR02 =1 OR TR03 =1 OR TR04 = 1 OR TR05 = 1 OR TRREF = 1) AND TX01 =1 AND TX07 NE
1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of
prescription tranquilizers?
[IF (TR01 = 1 OR TR02 = 1 OR TR03 =1 OR TR04 =1 OR TR05 =1 OR TRREF = 1) AND TX01 = 1 AND TX07 =
1] Are you currently receiving treatment or counseling for your use of prescription tranquilizers?

May 23, 2012

301

1
Yes
2
No
DK/REF
TX34

[IF ST01 =1 OR STREF1 = 1 OR ST02 =1 OR ST03 =1 OR ST04 = 1 OR ST05 = 1 OR STREF2 = 1 AND TX01 =1
AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your
use of prescription stimulants?
[IF (ST01 = 1 OR STREF1 = 1 OR ST02 = 1 OR ST03 =1 OR ST04 =1 OR ST05 =1 OR STREF2 = 1) AND TX01 =
1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of prescription stimulants?
1
Yes
2
No
DK/REF

TX35

[IF SV01 =1 OR SV02 =1 OR SV03 =1 OR SV04 = 1 OR SV05 = 1 OR SVREF = 1 AND TX01 = 1 AND TX07 NE 1
OR BLANK] The last time you entered treatment, did you receive treatment or counseling for your use of
prescription sedatives?
[IF (SV01 = 1 OR SV02 = 1 OR SV03 =1 OR SV04 =1 OR SV05 =1 OR SVREF = 1) AND TX01 = 1 AND TX07 =
1] Are you currently receiving treatment or counseling for your use of prescription sedatives?
1
Yes
2
No
DK/REF

TX36

[IF TX01 = 1 AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive treatment or
counseling for your use of any other drug?
[IF TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or counseling for your use of any other drug?
1
Yes
2
No
DK/REF

TX36SP1

[IF TX36 = 1 AND TX07 NE 1 OR BLANK] Please type in the name of one of the drugs you received treatment
for the last time. If you’re not sure how to spell the name of the drug, just make your best guess.
When you have finished typing your answer, press the [ENTER] key to go to the next question.
[IF TX36 = 1 AND TX07 = 1] Please type in the name of one of the drugs for which you are currently being
treated. If you’re not sure how to spell the name of the drug, just make your best guess.
When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF

TX36SP2

[IF TX36SP1 NE (BLANK OR DK/REF) AND TX07 NE 1 OR BLANK] Please type in the name of any other
drug you received treatment or counseling for the last time you entered treatment for your drug use. If there are
no other drugs you received treatment or counseling for the last time, other than those you already mentioned,
press the [ENTER] key to go to the next question.
[IF TX36SP1 NE (BLANK OR DK/REF) AND TX07 =1] Please type in the name of any other drug for which
you are currently receiving treatment or counseling. If there are no other drugs you are currently receiving
treatment or counseling for, other than those you already mentioned, press the [ENTER] key to go to the next
question.
_____________
DK/REF

TX36SP3

May 23, 2012

[IF TX36SP2 NE (BLANK OR DK/REF) AND TX07 NE 1 OR BLANK] Please type in the name of any other
drug you received treatment or counseling for the last time you entered treatment for your drug use. If there are
no other drugs you received treatment or counseling for the last time, other than those you already mentioned,
302

press the [ENTER] key to go to the next question.
[IF TX36SP2 NE (BLANK OR DK/REF) AND TX07 =1] Please type in the name of any other drug for which
you are currently receiving treatment or counseling. If there are no other drugs you are currently receiving
treatment or counseling for, other than those you already mentioned, press the [ENTER] key to go to the next
question.
_____________
DK/REF
TX36SP4

[IF TX36SP3 NE (BLANK OR DK/REF) AND TX07 NE 1 OR BLANK] Please type in the name of any other
drug you received treatment or counseling for the last time you entered treatment for your drug use. If there are
no other drugs you received treatment or counseling for the last time, other than those you already mentioned,
press the [ENTER] key to go to the next question.
[IF TX36SP3 NE (BLANK OR DK/REF) AND TX07 =1] Please type in the name of any other drug for which
you are currently receiving treatment or counseling. If there are no other drugs you are currently receiving
treatment or counseling for, other than those you already mentioned, press the [ENTER] key to go to the next
question.
_____________
DK/REF

TX36SP5

[IF TX36SP4 NE (BLANK OR DK/REF) AND TX07 NE 1 OR BLANK] Please type in the name of any other
drug you received treatment or counseling for the last time you entered treatment for your drug use. If there are
no other drugs you received treatment or counseling for the last time, other than those you already mentioned,
press the [ENTER] key to go to the next question.
[IF TX36SP4 NE (BLANK OR DK/REF) AND TX07 =1] Please type in the name of any other drug for which
you are currently receiving treatment or counseling. If there are no other drugs you are currently receiving
treatment or counseling for, other than those you already mentioned, press the [ENTER] key to go to the next
question.
_____________
DK/REF

TX37

[IF MORE THAN 1 ITEM IN THE TX26 - TX36 SERIES = 1 OR DK/REF AND TX07 NE 1 OR BLANK] What was
the main drug you entered treatment for the last time you were treated?
[IF MORE THAN 1 ITEM IN THE TX26 - TX36 SERIES = 1 OR DK/REF AND TX07 = 1] What is the main drug
for which you are currently receiving treatment or counseling?
1
2
3
4
5
6
7
8
9
10
11
DK/REF

TX38

Alcohol
Marijuana or hashish
Cocaine or ‘crack’
Heroin
Hallucinogens
Inhalants
Prescription pain relievers
Prescription tranquilizers
Prescription stimulants
Prescription sedatives
Some other drug

[IF TX25 = 1 - 8 AND TX07 NE 1 OR BLANK] What was the outcome of the treatment or counseling you last
received at [FILL IN ANSWER FROM TX25]?
[IF TX25 = DK/REF OR TX25 = 9 AND TX07 NE 1 OR BLANK] What was the outcome of the treatment or
counseling you last received?
1
2
3
4

May 23, 2012

You are still in treatment
You successfully completed treatment
You left because you had a problem with the program
You left because you couldn’t afford to continue treatment
303

5
You left because your family needed you
6
You left because you began using drugs again
7
Your last treatment had some other outcome
DK/REF
[IF TX38 = 7] Please type in a description of the outcome of your last treatment or counseling for drug use. You
do not need to give a detailed description — just a few words will be sufficient.

TX38SP

When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
TX39

[IF TX25 = 1- 8 AND TX38 = 2 - 7 OR DK/REF] How long did you stay in treatment for your alcohol or drug use
during your last treatment at [FILL IN ANSWER FROM TX25]?
[IF (TX25 = 1 - 8 AND TX38 = 1) OR (TX07 = 1 AND TX25 = 1 - 8)] How long have you been in treatment for your
alcohol or drug use at [FILL IN ANSWER FROM TX17]?
[IF TX25 = 9 OR DK/REF AND TX38 = 2 - 7 OR DK/REF] How long did you stay in treatment for your alcohol or
drug use during your last treatment?
[IF (TX25 = 9 OR DK/REF AND TX38 = 1) OR TX07 = 1 AND TX25 = 9)] How long have you been in treatment for
your alcohol or drug use so far?
Please indicate whether you want to give your answer in days, months, or years.
1
Days
2
Months
3
Years
DK/REF

TX40DAY1

[IF (TX38 = 1 OR TX07 = 1) AND TX39 = 1 OR DK/REF] How many days have you been in treatment for
your alcohol or drug use so far?
# OF DAYS:
DK/REF

TX40DAY2

[IF TX38 = 2 - 7 OR DK/REF AND TX39 = 1 OR DK/REF] How many days did you stay in treatment for
your alcohol or drug use the last time?
# OF DAYS:
DK/REF

TX41MON1

May 23, 2012

[RANGE: 1 - 400]

[IF (TX38 = 1 OR TX07 = 1) AND TX39 = 3] How many years have you been in treatment for your alcohol
or drug use so far?
# OF YEARS:
DK/REF

TX41YR2

[RANGE: 1 - 400]

[IF TX38 = 2 - 7 OR DK/REF AND TX39 = 2] How many months did you stay in treatment for your
alcohol or drug use the last time?
# OF MONTHS:
DK/REF

TX41YR1

[RANGE: 1 - 366]

[IF (TX38 = 1 OR TX07 = 1) AND TX39 = 2] How many months have you been in treatment for your
alcohol or drug use so far?
# OF MONTHS:
DK/REF

TX41MON2

[RANGE: 1 - 366]

[RANGE: 1 - 60]

[IF TX38 = 2 - 7 OR DK/REF AND TX39 = 3] How many years did you stay in treatment for your alcohol
or drug use the last time?

304

# OF YEARS:
DK/REF

[RANGE: 1 - 60]

TX42A [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did private health insurance pay for the last treatment you received,
even if it paid only part of the cost?
[IF TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will private health insurance pay for the treatment you are currently
receiving, even if it pays only part of the cost?
1
Yes
2
No
DK/REF
TX42B [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did Medicare pay for the last treatment you received, even if it paid
only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will Medicare pay for the treatment you are currently receiving, even if
it pays only part of the cost?
1
Yes
2
No
DK/REF
TX42C [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did Medicaid pay for the last treatment you received, even if it paid
only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will Medicaid pay for the treatment you are currently receiving, even if
it pays only part of the cost?
1
Yes
2
No
DK/REF
TX42D [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did a public assistance program other than Medicaid pay for the last
treatment you received, even if it paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will a public assistance program other than Medicaid pay for the
treatment you are currently receiving, even if it pays only part of the cost?
1
Yes
2
No
DK/REF
TX42E [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did you use your own savings or earnings to pay for the last treatment
you received, even if you paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will you use your own savings or earnings to pay for the treatment
you are currently receiving, even if you pay only part of the cost?
1
Yes
2
No
DK/REF
TX42F [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did family members pay for the last treatment you received, even if
they paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will family members pay for the treatment you are currently receiving,
even if they pay only part of the cost?
1
Yes
2
No
DK/REF
TX42G [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did the courts pay for the last treatment you received, even if it paid
only part of the cost?
May 23, 2012

305

[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will the courts pay for the treatment you are currently receiving, even
if it pays only part of the cost?
1
Yes
2
No
DK/REF
TX42H [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did CHAMPUS or TRICARE, CHAMPVA, the VA, or some other
military health care pay for the last treatment you received, even if it paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will CHAMPUS or TRICARE, CHAMPVA, the VA, or some other
military health care pay for the treatment you are currently receiving, even if it pays only part of the cost?
1
Yes
2
No
DK/REF
TX42I

[IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did your employer pay for the last treatment you received, even if it
paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will your employer pay for the treatment you are currently receiving,
even if it pays only part of the cost?
1
Yes
2
No
DK/REF

TX42J

[IF TX01 = 1 AND TX07 NE 1 OR BLANK] Was your last treatment paid for by some other source besides those
that have been listed?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will the treatment you are currently receiving be paid for by some
other source besides those that have been listed?
1
Yes
2
No
DK/REF

TX42JSP

[IF TX42J = 1 AND TX07 NE 1 OR BLANK] Please type in a description of the source that paid for your last
treatment or counseling for alcohol or drug use. You do not need to give a detailed description — just a few
words will be sufficient. When you have finished typing your answer, press the [ENTER] key to go to the next
question.
[IF TX42J = 1 AND (TX07 = 1 OR TX38 = 1)] Please type in a description of the source that will pay for your
current treatment or counseling for alcohol or drug use. You do not need to give a detailed description — just a
few words will be sufficient. When you have finished typing your answer, press the [ENTER] key to go to the
next question.
_____________
DK/REF
[IF TX42A - TX42J = 2 AND TX07 NE 1 OR BLANK] Was the last treatment you received free?

TX42K

[IF TX42A - TX42J = 2 AND (TX07 = 1 OR TX38 = 1)] Is the treatment you are currently receiving free?
1
Yes
2
No
DK/REF
TX43

[IF TX01 = 1] Were you enrolled in a treatment program for your alcohol or drug use on October 1, [CURRENT
YEAR – 1]?
For this question, please include only treatment you received at a hospital, drug rehabilitation facility, or mental health
center.

May 23, 2012

306

1
Yes
2
No
DK/REF
TX44

[IF TX03 NE BLANK] Think about all the treatment or counseling you received for your [TXFILL1] during the past
12 months. Was detoxification the only [TXFILL1] treatment you received during the past 12 months?
1
Yes
2
No
DK/REF

TX45

[IF TX01=1 AND TX02=2 AND (AL01 = 1 OR ALREF = 1) AND MJ01 NE 1 AND MJREF NE 1 AND CC01 NE 1
AND CCREF NE 1 AND CK01 NE 1 AND CKREF NE 1 AND HE01 NE 1 AND HEREF NE 1 AND LS01a NE 1
AND LSREF1 NE 1 AND LS01b NE 1 AND LSREF2 NE 1 AND LS01c NE 1 AND LS01d NE 1 AND LS01e NE 1
AND LS01f NE1 AND LSREF3 NE 1 AND LS01h NE 1 AND IN01a NE1 AND IN01b NE1 AND IN01c NE 1 AND
IN01d NE 1 AND IN01e NE 1AND IN01f NE 1 AND IN01g NE 1 AND IN01h NE 1 AND IN01i NE 1 AND IN01j
NE 1 AND IN01l NE 1 AND INREF NE 1 AND PR01 NE 1 AND PR02 NE 1 AND PR03 NE 1 AND PR04 NE 1
AND PR05 NE 1 AND PRREF NE 1 AND TR01 NE 1 AND TR02 NE 1 AND TR03 NE 1 AND TR04 NE 1 AND
TR05 NE 1 AND TRREF NE 1 AND ST01 NE 1 AND STREF1 NE 1 AND ST02 NE 1 AND ST03 NE 1 AND ST04
NE 1 AND ST05 NE 1 AND STREF2 NE 1 AND SV01 NE 1 AND SV02 NE 1 AND SV03 NE 1 AND SV04 NE 1
AND SV05 NE 1 AND SVREF NE 1 AND SD17a NE 1] Earlier you reported that at some time in your life you
received treatment or counseling for your use of alcohol or any drug, not counting cigarettes. Have you ever received
treatment for your alcohol use?
1
Yes
2
No
DK/REF

TX45a

[IF TX45 = 1] How old were you when you first received treatment for your alcohol use?
_____________[RANGE: 1-110]
DK/REF

TX46

[IF TX01=1 AND TX02=2 AND (AL01 NE 1 AND ALREF NE1) AND MJ01 = 1 OR MJREF = 1 OR CC01 = 1 OR
CCREF = 1 OR CK01 = 1 OR CKREF = 1 OR HE01 = 1 OR HEREF = 1 OR LS01a = 1 OR LSREF1 = 1 OR LS01b
= 1 OR LSREF2 = 1 OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR LS01f =1 OR LSREF3 = 1 OR LS01h = 1 OR
IN01a =1 OR IN01b =1 OR IN01c = 1 OR IN01d = 1 OR IN01e = 1OR IN01f = 1 OR IN01g = 1 OR IN01h = 1 OR
IN01i = 1 OR IN01j = 1 OR IN01l = 1 OR INREF = 1 OR PR01 = 1 OR PR02 = 1 OR PR03 = 1 OR PR04 = 1 OR
PR05 = 1 OR PRREF = 1 OR TR01 = 1 OR TR02 = 1 OR TR03 = 1 OR TR04 = 1 OR TR05 = 1 OR TRREF = 1 OR
ST01 = 1 OR STREF1 = 1 OR ST02 = 1 OR ST03 = 1 OR ST04 = 1 OR ST05 = 1 OR STREF2 = 1 OR SV01 = 1 OR
SV02 = 1 OR SV03 = 1 OR SV04 = 1 OR SV05 = 1 OR SVREF = 1 OR (SD17a = 1 AND SD17a1 NE 1 AND
SD17ALT NE 1)] Earlier you reported that at some time in your life you received treatment or counseling for your use
of alcohol or any drug, not counting cigarettes. Have you ever received treatment or counseling for your drug use?
1
Yes
2
No
DK/REF

TX46a

[IF TX46 = 1] How old were you when you first received treatment or counseling for your drug use?
_____________[RANGE: 1-110]
DK/REF

TX47

[IF TX01=1 AND TX02=2 AND (AL01 = 1 OR ALREF = 1) AND (MJ01 = 1 OR MJREF = 1 OR CC01 = 1 OR
CCREF = 1 OR CK01 = 1 OR CKREF = 1 OR HE01 = 1 OR HEREF = 1 OR LS01a = 1 OR LSREF1 = 1 OR LS01b
= 1 OR LSREF2 = 1 OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR LS01f =1 OR LSREF3 = 1 OR LS01h = 1 OR
IN01a =1 OR IN01b =1 OR IN01c = 1 OR IN01d = 1 OR IN01e = 1OR IN01f = 1 OR IN01g = 1 OR IN01h = 1 OR
IN01i = 1 OR IN01j = 1 OR IN01l = 1 OR INREF = 1 OR PR01 = 1 OR PR02 = 1 OR PR03 = 1 OR PR04 = 1 OR
PR05 = 1 OR PRREF = 1 OR TR01 = 1 OR TR02 = 1 OR TR03 = 1 OR TR04 = 1 OR TR05 = 1 OR TRREF = 1 OR
ST01 = 1 OR STREF1 = 1 OR ST02 = 1 OR ST03 = 1 OR ST04 = 1 OR ST05 = 1 OR STREF2 = 1 OR SV01 = 1 OR
SV02 = 1 OR SV03 = 1 OR SV04 = 1 OR SV05 = 1 OR SVREF = 1 OR (SD17a = 1 AND SD17a1 NE 1 AND
SD17ALT NE 1))] Earlier you reported that at some time in your life you received treatment or counseling for your use
of alcohol or any drug, not counting cigarettes. Have you ever received treatment or counseling for your alcohol use?
1

May 23, 2012

Yes
307

2
No
DK/REF
TX47a

[IF TX47 = 1] How old were you when you first received treatment or counseling for your alcohol use?
_____________[RANGE: 1-110]
DK/REF

TX48

[IF TX01=1 AND TX02=2 AND (AL01 = 1 OR ALREF = 1) AND (MJ01 = 1 OR MJREF = 1 OR CC01 = 1 OR
CCREF = 1 OR CK01 = 1 OR CKREF = 1 OR HE01 = 1 OR HEREF = 1 OR LS01a = 1 OR LSREF1 = 1 OR LS01b
= 1 OR LSREF2 = 1 OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR LS01f =1 OR LSREF3 = 1 OR LS01h = 1 OR
IN01a =1 OR IN01b =1 OR IN01c = 1 OR IN01d = 1 OR IN01e = 1OR IN01f = 1 OR IN01g = 1 OR IN01h = 1 OR
IN01i = 1 OR IN01j = 1 OR IN01l = 1 OR INREF = 1 OR PR01 = 1 OR PR02 = 1 OR PR03 = 1 OR PR04 = 1 OR
PR05 = 1 OR PRREF = 1 OR TR01 = 1 OR TR02 = 1 OR TR03 = 1 OR TR04 = 1 OR TR05 = 1 OR TRREF = 1 OR
ST01 = 1 OR STREF1 = 1 OR ST02 = 1 OR ST03 = 1 OR ST04 = 1 OR ST05 = 1 OR STREF2 = 1 OR SV01 = 1 OR
SV02 = 1 OR SV03 = 1 OR SV04 = 1 OR SV05 = 1 OR SVREF = 1 OR (SD17a = 1 AND SD17a1 NE 1 AND
SD17ALT NE 1))] Have you ever received treatment or counseling for your drug use?
1
Yes
2
No
DK/REF

TX48a

[IF TX48 = 1] How old were you when you first received treatment or counseling for your drug use?
_____________[RANGE: 1-110]
DK/REF

TX49

[IF TX03 = 1] Earlier you reported that you received treatment or counseling for your use of alcohol during the past 12
months. How old were you when you first received treatment or counseling for your alcohol use?
_____________[RANGE: 1-110]
DK/REF

TX49a

[IF TX03 = 1 AND (MJ01 = 1 OR MJREF = 1 OR CC01 = 1 OR CCREF = 1 OR CK01 = 1 OR CKREF = 1 OR HE01
= 1 OR HEREF = 1 OR LS01a = 1 OR LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR LS01c = 1 OR LS01d = 1
OR LS01e = 1 OR LS01f =1 OR LSREF3 = 1 OR LS01h = 1 OR IN01a =1 OR IN01b =1 OR IN01c = 1 OR IN01d =
1 OR IN01e = 1OR IN01f = 1 OR IN01g = 1 OR IN01h = 1 OR IN01i = 1 OR IN01j = 1 OR IN01l = 1 OR INREF = 1
OR PR01 = 1 OR PR02 = 1 OR PR03 = 1 OR PR04 = 1 OR PR05 = 1 OR PRREF = 1 OR TR01 = 1 OR TR02 = 1 OR
TR03 = 1 OR TR04 = 1 OR TR05 = 1 OR TRREF = 1 OR ST01 = 1 OR STREF1 = 1 OR ST02 = 1 OR ST03 = 1 OR
ST04 = 1 OR ST05 = 1 OR STREF2 = 1 OR SV01 = 1 OR SV02 = 1 OR SV03 = 1 OR SV04 = 1 OR SV05 = 1 OR
SVREF = 1 OR (SD17a = 1 AND SD17a1 NE 1 AND SD17ALT NE 1))] Have you ever received treatment or
counseling for your use of any drug, not including cigarettes or alcohol?
1
Yes
2
No
DK/REF

TX49b

[IF TX49a = 1] How old were you when you first received treatment or counseling for your drug use?
_____________[RANGE: 1-110]
DK/REF

TX50

[IF TX03 = 2] Earlier you reported that you received treatment or counseling for your drug use during the past 12
months. How old were you when you first received treatment or counseling for your drug use?
_____________[RANGE: 1-110]
DK/REF

TX50a

[IF TX03 = 2 AND (AL01 = 1 OR ALREF = 1)] Have you ever received treatment or counseling for your alcohol use?
1
Yes
2
No
DK/REF

May 23, 2012

308

TX50b

[IF TX50a = 1] How old were you when you first received treatment or counseling for your alcohol use?
_____________[RANGE: 1-110]
DK/REF

TX51

[IF TX03=3] Earlier, you reported that you received treatment or counseling for your drug and alcohol use during the
past 12 months. How old were you when you first received treatment or counseling for your use of alcohol?
_____________[RANGE: 1-110]
DK/REF

TX51a

[IF TX03=3] How old were you when you first received treatment or counseling for your drug use?
_____________[RANGE: 1-110]
DK/REF

TX52

[IF (TX01 NE BLANK) AND (TX04h NE 1)] The next question is about self-help groups. Some examples of self-help
groups for alcohol or drug use are AA or Alcoholics Anonymous, NA or Narcotics Anonymous, CA or Cocaine
Anonymous, and CMA or Crystal Meth Anonymous.
During the past 12 months, did you go to any self-help group meetings or 12-step programs to receive help for your
own use of alcohol or any drug, not counting cigarettes?
1
Yes
2
No
DK/REF

TX53

[IF TX52 = 1] Did you go to the self-help group because of your alcohol use only, your drug use only, or because of
both alcohol and drug use?
1
Alcohol use only
2
Drug use only
3
Both alcohol and drug use
DK/REF

May 23, 2012

309

May 23, 2012

310

Health Care
HLTHINT

These next questions are about your health and health care.
Press [ENTER] to continue.

HLTH01

[IF QD01 = 9 AND CURNTAGE = 12 - 44] Are you currently pregnant?
1
Yes
2
No
DK/REF

HLTH02

[IF HLTH01 = 1] How many months pregnant are you?
# OF MONTHS: ________ [RANGE: 1 - 9]
DK/REF

HLTH03

During the past 12 months, that is, since [DATEFILL], how many different times have you been treated in an
emergency room for any reason?
# OF TIMES: ____________ [RANGE: 0 - 90]
DK/REF

HLTH04

During the past 12 months, have you stayed overnight or longer as an inpatient in a hospital?
1
Yes
2
No
DK/REF

HLTH05

[IF HLTH04 = 1] During the past 12 months, how many nights were you an inpatient in a hospital?
# OF NIGHTS:

CHKLST

[RANGE: 1 - 366]

The following is a list of health conditions. Please read the list, and type in the numbers of any of these
conditions that a doctor or other medical professional has ever told you that you had.
Please type in the numbers of any that apply. To select more than one condition, press the space bar between
each number you type. For example, if a doctor has ever told you that you had asthma and ulcers, press
2[SPACE BAR]20.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
95
DK/REF

Anxiety disorder
Asthma
Bronchitis
Cirrhosis of the liver
Depression
Diabetes
Heart disease
Hepatitis
High blood pressure
HIV/AIDS
Lung cancer
Pancreatitis
Pneumonia
Sexually transmitted disease, such as chlamydia, gonorrhea, herpes or syphilis
Sinusitis
Sleep apnea
Stroke
Tinnitus
Tuberculosis
Ulcer or ulcers
None of the above - I have never had any of these conditions

HARD ERROR: [IF 95 AND AT LEAST ONE IN (1-20) SELECTED]: YOU HAVE ENTERED “I HAVE NEVER HAD
ANY OF THESE CONDITIONS,” BUT YOU HAVE ALSO ENTERED ONE OR MORE HEALTH CONDITIONS
May 23, 2012

311

FROM THE LIST. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN.
[NOTE REGARDING CHK12M: Only display response option 95, and the response options that correspond to the list displayed
in CHKLST. Audio files should be played only for the displayed response options. Responses not displayed will be invalid for
CHK12M; they will trigger a hard error below]
CHK12M

[IF ANY ANSWER IN CHKLST = 1-20] Which, if any, of these conditions did a doctor or other medical
professional tell you that you had in the past 12 months?
Please type in the numbers of any that apply. To select more than one condition, press the space bar between
each number you type.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
95
DK/REF

Anxiety disorder
Asthma
Bronchitis
Cirrhosis of the liver
Depression
Diabetes
Heart disease
Hepatitis
High blood pressure
HIV/AIDS
Lung cancer
Pancreatitis
Pneumonia
Sexually transmitted disease, such as chlamydia, gonorrhea, herpes or syphilis
Sinusitis
Sleep apnea
Stroke
Tinnitus
Tuberculosis
Ulcer or ulcers
None of the above - I have not had any of these conditions in the past 12 months

HARD ERROR: [IF 95 AND AT LEAST ONE IN (1-20) SELECTED]: YOU HAVE ENTERED “I HAVE NOT HAD
ANY OF THESE CONDITIONS IN THE PAST 12 MONTHS,” BUT YOU HAVE ALSO ENTERED ONE OR MORE
HEALTH CONDITIONS FROM THE LIST. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU
CAN THEN ANSWER THE QUESTION AGAIN.
HARD ERROR: [IF ANY RESPONSE (1-20) IS SELECTED THAT WAS NOT SELECTED IN CHKLST]: THIS IS
NOT ONE OF YOUR CHOICES. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN
THEN ANSWER THE QUESTION AGAIN.
HLTH06

This question asks about your height.
To answer in feet and inches, press 1. To answer in meters and centimeters, press 2. To answer in
inches only, press 3. To answer in centimeters only, press 4. Then press [ENTER] to continue.
1
2
3
4
DK/REF

HLTH07

I would rather answer in feet and inches
I would rather answer in meters and centimeters
I would rather answer only in inches
I would rather answer only in centimeters

[IF HLTH06=1] About how tall are you, without shoes? First, please type in the number of feet,
then press [ENTER].
______feet [RANGE: 0-8]
DK/REF

May 23, 2012

312

HLTH08

(IF HLTH06 = 1 OR 3 AND HLTH07 NE DK/RF) Please type in the number of inches and then
press [ENTER].

______inch(es) [RANGE: 0-110]
DK/REF
HLTH09

(IF HLTH06=2) About how tall are you, without shoes? First, please type in the number of meters,
then press [ENTER].
_______ meters [RANGE: 0-3]
DK/REF

HLTH10

[IF HLTH06 = 2 OR 4 AND HLTH09 NE DK/REF] Please type in the number of centimeters and
then press [ENTER].

______centimeter(s) [RANGE:0-300]
DK/REF
HLTH11

The next question asks about your weight.
To answer in pounds, press 1. To answer in kilograms, press 2. Then press [ENTER] to continue.
1
I would rather answer in pounds
2
I would rather answer in kilograms
DK/REF

HLTH12

[IF HLTH11=1 AND HLTH01 NE 1] About how much do you weigh? Please type in the number
of pounds and then press [ENTER].
________pounds [RANGE: 50-550]
DK/REF

HLTH13

(IF HLTH11=2 AND HLTH01 NE 1) About how much do you weigh? Please type in the number
of kilograms and then press [ENTER].
_______ kilograms [RANGE: 22.00-275.00]
DK/REF

HLTH14

[IF HLTH01=1 AND HLTH11=1] About how much did you weigh before you got pregnant?
Please type in the number of pounds and then press [ENTER].
________pounds [RANGE: 50-550]
DK/REF

HLTH15

(IF HLTH01=1 AND HLTH11 =2) About how much did you weigh before you got pregnant?
Please type in the number of kilograms and then press [ENTER].
_______ kilograms [RANGE: 22-275]
DK/REF

HLTH16

During the past 12 months, how many times have you visited a doctor, nurse, physician assistant or nurse
practitioner about your own health at a doctor’s office, a clinic, or some other place?
NUMBER OF VISITS:
DK/REF

May 23, 2012

[(RANGE: 0 - 366)]

313

HLTH16DK

[IF HLTH16=DK/REF] What is your best guess of how many times you have visited a doctor, nurse,
physician assistant or nurse practitioner about your own health at a doctor’s office, a clinic, or some other
place in the past 12 months?
0.
1.
2.
3.
4.
5.
6.
7.
8.
DK/REF

I have not visited a health care professional in the past 12 months
1 time
2-3 times
4-5 times
6-7 times
8-9 times
10-12 times
13-15 times
16 or more times

DEFINE VISITFILL:
IF HLTH03=1 THEN VISITFILL= “your visit to the Emergency Room”
IF HLTH03>1 THEN VISITFILL = “your visits to the Emergency Room”
IF HLTH04=1 THEN VISITFILL= “your hospitalization’
IF HLTH16=1 OR HLTH16DK=1 THEN VISITFILL = “the talk you had with a doctor or other health care
professional”
IF HLTH16>1 OR HLTH16DK>1 THEN VISITFILL = “the talks you had with a doctor or other health care
professional”
HLTH17

(IF HLTH03>0 OR HLTH04=1 OR HLTH16>0 OR HLTH16DK>0) During the past 12 months, did any
doctor or other health care professional ask, either in person or on a form, if you:
a. Smoke cigarettes or use any other tobacco products?
b. Drink alcohol?
c. Use illegal drugs?

HLTH18

1. Yes
1. Yes
1. Yes

2. No
2. No
2. No

DK/REF
DK/REF
DK/REF

[(IF HLTH03>0 OR HLTH04=1 OR HLTH16>0 OR HLTH16DK>0) AND (CG01 = 1 OR CGREF1 = 1 OR
CG17 = 1 OR CGREF2 = 1 OR CG25 = 1 OR CGREF3 = 1 OR CG34 = 1 OR CGREF4 = 1 OR CG42 = 1
OR CGREF5 = 1)] During the past 12 months, did any doctor or other health care professional advise you to
quit smoking cigarettes or quit using any other tobacco products?
1 Yes
2 No
DK/REF

HLTH19

[((IF HLTH03>=1 AND (HLTH04=1 OR HLTH16>=1 OR HLTH16DK >= 1)) OR (HLTH04=1 AND
(HLTH03>=1 OR HLTH16>=1 OR HLTH16DK>=1)) OR ((HLTH16>=1 OR HLTH16DK>=1) AND
(HLTH03>=1 OR HLTH04=1))) AND (ALLAST3=1 OR 2 OR ALRECDK=1 OR 2 OR ALRECRE=1 OR
2)] Please think about all of the talks you have had with a doctor or other health care professional during the
past 12 months when you answer this question. Choose the statement or statements below that describe any
discussions you may have had in person with a doctor or other health professional about your alcohol use.
[((IF HLTH03>=1 AND HLTH04 NE 1 AND HLTH16<1 AND HLTH16DK<1) OR (HLTH04 =1 AND
HLTH03 = 0 AND HLTH16<1 AND HLTH16DK<1) OR ((HLTH16 >=1 OR HLTH16DK>=1) AND
HLTH03 = 0 AND HLTH04 NE 1)) AND (ALLAST3=1 OR 2 OR ALRECDK=1 OR 2 OR ALRECRE=1
OR 2)] Please think about [VISITFILL] during the past 12 months when you answer this question. Choose
the statement or statements below that describe any discussion you may have had in person with a doctor or
other health professional about your alcohol use.
To select more than one statement, press the space bar between each number you type. When you have
finished, press [ENTER].
1.
2.
3.
4.
5.

May 23, 2012

The doctor asked how much I drink.
The doctor asked how often I drink.
The doctor asked if I have any problems because of my drinking.
The doctor advised me to cut down on my drinking.
The doctor offered to give me more information about alcohol use and treatment for problems with
alcohol use.
314

95 The doctor didn’t discuss my alcohol use with me in the past 12 months.
DK/REF
HARD ERROR: [IF 95 AND AT LEAST ONE IN (1-5) SELECTED]: You have entered “The doctor didn’t discuss my alcohol
use with me in the past 12 months,” but you have also entered one or more statements from the list. Press [Enter] to answer the
question again.
HLTH20

[(IF HLTH03>0 OR HLTH04=1 OR HLTH16>0 OR HLTH16DK>0) AND [MAR12MON=1 OR
COC12MON=1 OR CRK12MON=1 OR HER12MON=1 OR INH12MON = 1 OR HAL12MON =
1 OR ((METHREC=1 OR 2) OR (METHREC2=1 OR 2))] During the past 12 months, did any
doctor or other health care professional talk to you about your use of
[FILLMARIJUANA/COCAINE/CRACK/HEROIN/ INHALANTS /
HALLUCINOGENS/METHAMPHETAMINE]?
PROGRAMMERS: SEPARATE MULTIPLE FILLS WITH AN ‘OR’
1
Yes
2
No
DK/REF

May 23, 2012

315

May 23, 2012

316

Adult Mental Health Service Utilization
(Questions Administered only to respondents 18 or older)
ADINTRO

[IF CURNTAGE = 18 OR OLDER] These next questions are about treatment and counseling for problems
with emotions, nerves or mental health. [IF TX01 = 1 OR DK/REF] Please do not include treatment for
alcohol or drug use.
Press [ENTER] to continue.

ADMT01

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, have you stayed overnight or longer in a
hospital or other facility to receive treatment or counseling for any problem you were having with your
emotions, nerves, or mental health? [IF TX01 = 1 OR DK/REF] Please do not include treatment for alcohol
or drug use.
1
Yes
2
No
DK/REF

ADMTREF1

[IF ADMT01 = REF] The answers that people give us about mental health treatment are important to this
study’s success. We know that this information is personal, but remember your answers will be kept
confidential.
Please think again about answering this question: During the past 12 months, have you stayed overnight or
longer in a hospital or other facility to receive treatment or counseling for any problem you were having with
your emotions, nerves, or mental health? [IF TX01 = 1 OR DK/REF] Please do not include treatment for
alcohol or drug use.
1
Yes
2
No
DK/REF

ADMT02

[IF ADMT01 = 1 OR ADMTREF1 = 1] Where did you stay overnight or longer to receive mental health
treatment or counseling during the past 12 months?
To select more than one place, press the space bar between each number you type. When you have finished,
press the [ENTER] key to go to the next question.
1
2
3
4
5
6
DK/REF

ADMT04

A private or public psychiatric hospital
A psychiatric unit of a general hospital
A medical unit of a general hospital
Another type of hospital
A residential treatment center
Some other type of facility

[IF ADMT02 = 1] During the past 12 months, how many nights did you spend in a private or public
psychiatric hospital for mental health care?
# OF NIGHTS:
DK/REF

ADMT05

[IF ADMT02 = 2] During the past 12 months, how many nights did you spend in the psychiatric unit of a
general hospital for mental health care?
# OF NIGHTS:
DK/REF

ADMT06

May 23, 2012

[RANGE: 1 - 366]

[IF ADMT02 = 3] During the past 12 months, how many nights did you spend in the medical unit of a
general hospital for mental health care?
# OF NIGHTS:
DK/REF

ADMT07

[RANGE: 1 - 366]

[RANGE: 1 - 366]

[IF ADMT02 = 4] During the past 12 months, how many nights did you spend in some other type of
317

hospital for mental health care?
# OF NIGHTS:
DK/REF
ADMT08

[IF ADMT02 = 5] During the past 12 months, how many nights did you spend in a residential treatment
center for mental health care?
# OF NIGHTS:
DK/REF

ADMT09

[RANGE: 1 - 366]

[IF ADMT02 = 6] During the past 12 months, how many nights did you spend in some other type of facility
for mental health care?
# OF NIGHTS:
DK/REF

ADMT10

[RANGE: 1 - 366]

[RANGE: 1 - 366]

[IF ADMT02 NE BLANK] Who paid or will pay for the inpatient mental health care you received during
the past 12 months?
To select more than one answer, press the space bar between each number you type. When you have
finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
7
8
9
10
11
DK/REF

ADMT11

Self or a family member living with you
A family member who does not live with you
Private health insurance
Medicare
Medicaid
Rehabilitation program
Employer
VA or other military program
Other public source
Other private source
No one paid because the treatment was free

[IF MORE THAN 1 RESPONSE SELECTED IN ADMT10 AND ADMT02 NE DK/REF] Who paid or will
pay most of the cost for the inpatient mental health care you received during the past 12 months?
Please select only one answer from those that are shown in blue below.
[NOTE TO PROGRAMMERS: RESPONSES CHOSEN IN ADMT10 SHOULD BE SHOWN IN BLUE.
IMPLEMENT AN ERROR MESSAGE IF THE RESPONDENT SELECTS ONE OF THE OTHER
RESPONSES.]
1
2
3
4
5
6
7
8
9
10
11
DK/REF

ADMT12

Self or a family member living with you
A family member who does not live with you
Private health insurance
Medicare
Medicaid
Rehabilitation program
Employer
VA or other military program
Other public source
Other private source
No one paid because the treatment was free

[IF ADMT10 = 1 AND ADMT02 NE DK/REF] How much did you or your family pay for the inpatient
mental health care you received during the past 12 months? Do not count any money that has been or will be
reimbursed by insurance or any other source.
[IF ADMT10 = 2 AND NE 1 AND ADMT02 NE DK/REF] How much did your family pay for the
inpatient mental health care you received during the past 12 months? Do not count any money that has been
or will be reimbursed by insurance or any other source.

May 23, 2012

318

1
2
3
4
5
6
7
8
9
10
DK/REF
ADMT13

Less than $100
$100 to $200
$201 to $500
$501 to $900
$901 to $1,500
$1,501 to $2,000
$2,001 to $5,000
$5,001 to $7,500
$7,501 to $10,000
More than $10,000

[IF CURNTAGE = 18 OR OLDER] The list below includes some of the places where people can get
outpatient treatment or counseling for problems with their emotions, nerves, or mental health.
During the past 12 months, did you receive any outpatient treatment or counseling for any problem you were
having with your emotions, nerves, or mental health at any of the places listed below? [IF TX01 = 1 OR
DK/REF] Please do not include treatment for alcohol or drug use.
•
•
•
•
•
•

An outpatient mental health clinic or center
The office of a private therapist, psychologist, psychiatrist, social worker, or counselor that was not
part of a clinic
A doctor’s office that was not part of a clinic
An outpatient medical clinic
A partial day hospital or day treatment program
Some other place

1
Yes
2
No
DK/REF
ADMTREF13

[IF ADMT13 = REF] The answers that people give us about mental health treatment are important to this
study’s success. We know that this information is personal, but remember your answers will be kept
confidential.
Please think again about answering this question: During the past 12 months, did you receive any outpatient
treatment or counseling for any problem you were having with your emotions, nerves, or mental health at any
of the places listed below? [IF TX01 = 1 OR DK/REF] Please do not include treatment for alcohol or drug
use.
•
•
•
•
•
•

An outpatient mental health clinic or center
The office of a private therapist, psychologist, psychiatrist, social worker, or counselor that was not
part of a clinic
A doctor’s office that was not part of a clinic
An outpatient medical clinic
A partial day hospital or day treatment program
Some other place

1
Yes
2
No
DK/REF
ADMT14

[IF ADMT13 = 1 OR ADMTREF13 = 1] Where did you receive outpatient mental health treatment or
counseling during the past 12 months?
To select more than one place, press the space bar between each number you type. When you have finished,
press the [ENTER] key to go to the next question.
1
2
3
4
5
6

May 23, 2012

An outpatient mental health clinic or center
The office of a private therapist, psychologist, psychiatrist, social worker, or counselor that was not
part of a clinic
A doctor’s office that was not part of a clinic
An outpatient medical clinic
A partial day hospital or day treatment program
Some other place
319

DK/REF
ADMT15

[IF ADMT14 = 6] Please type in a description of this other place where you received outpatient mental health
treatment or counseling. When you have finished, press the [ENTER] key to go to the next question.
________________
DK/REF

ADMT16

[IF ADMT14 = 1] During the past 12 months, how many visits did you make to an outpatient mental health
clinic or center for mental health care?
# OF VISITS:
DK/REF

ADMT17

[IF ADMT14 = 2] During the past 12 months, how many outpatient visits did you make to a private
therapist, psychologist, psychiatrist, social worker, or counselor for mental health care?
# OF VISITS:
DK/REF

ADMT18

[RANGE: 1 - 366]

[IF ADMT14 = 6] During the past 12 months, how many outpatient visits did you make to some other type
of facility for mental health care?
# OF VISITS:
DK/REF

ADMT22

[RANGE: 1 - 366]

[IF ADMT14 = 5] During the past 12 months, how many outpatient visits did you make to a partial day
hospital or day treatment program for mental health care?
# OF VISITS:
DK/REF

ADMT21

[RANGE: 1 - 366]

[IF ADMT14 = 4] During the past 12 months, how many outpatient visits did you make to an outpatient
medical clinic for mental health care?
# OF VISITS:
DK/REF

ADMT20

[RANGE: 1 - 366]

[IF ADMT14 = 3] During the past 12 months, how many outpatient visits did you make to a doctor’s office
for mental health care?
# OF VISITS:
DK/REF

ADMT19

[RANGE: 1 - 366]

[RANGE: 1 - 366]

[IF ADMT14 NE BLANK] Who paid or will pay for the outpatient mental health care you received during
the past 12 months?
To select more than one answer, press the space bar between each number you type. When you have
finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
7
8
9
10
11
DK/REF

ADMT23

May 23, 2012

Self or a family member living with you
A family member who does not live with you
Private health insurance
Medicare
Medicaid
Rehabilitation program
Employer
VA or other military program
Other public source
Other private source
No one paid because the treatment was free

[IF MORE THAN 1 RESPONSE SELECTED IN ADMT22 AND ADMT14 NE DK/REF] Who paid or will
pay most of the cost for the outpatient mental health care you received during the past 12 months?
320

Please select only one answer from those that are shown in blue below.
[NOTE TO PROGRAMMERS: RESPONSES CHOSEN IN ADMT22 SHOULD BE SHOWN IN BLUE.
IMPLEMENT AN ERROR MESSAGE IF THE RESPONDENT SELECTS ONE OF THE OTHER
RESPONSES.]
1
2
3
4
5
6
7
8
9
10
11
DK/REF
ADMT24

Self or a family member living with you
A family member who does not live with you
Private health insurance
Medicare
Medicaid
Rehabilitation program
Employer
VA or other military program
Other public source
Other private source
No one paid because the treatment was free

[IF ADMT22 = 1 AND ADMT14 NE DK/REF] How much did you or your family pay for the outpatient
mental health care you received during the past 12 months? Do not count any money that has been or will be
reimbursed by insurance or any other source.
[IF ADMT22 = 2 AND NE 1 AND ADMT14 NE DK/REF] How much did your family pay for the
outpatient mental health care you received during the past 12 months? Do not count any money that has
been or will be reimbursed by insurance or any other source.
1
2
3
4
5
6
7
8
DK/REF

ADMT25

Less than $100
$100 to $200
$201 to $500
$501 to $900
$901 to $1,500
$1,501 to $2,000
$2,001 to $5,000
More than $5,000

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, did you take any prescription medication
that was prescribed for you to treat a mental or emotional condition?
1
Yes
2
No
DK/REF

ADMTREF25

[IF ADMT25 = REF] The answers that people give us about their use of prescription medications are
important to this study’s success. We know that this information is personal, but remember your answers
will be kept confidential.
Please think again about answering this question: During the past 12 months, did you take any prescription
medication that was prescribed for you to treat a mental or emotional condition?
1
Yes
2
No
DK/REF

ADMT26

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, was there any time when you needed
mental health treatment or counseling for yourself but didn’t get it?
1
Yes
2
No
DK/REF

ADMT27

May 23, 2012

[IF ADMT26 = 1] Which of these statements explain why you did not get the mental health treatment or
counseling you needed?

321

To select more than one reason from the list, press the space bar between each number you type. When you
have finished, press [ENTER].
1
2
3
4
5
6
7
8
9
DK/REF
ADMT27A

You couldn’t afford the cost.
You were concerned that getting mental health treatment or counseling might cause your neighbors
or community to have a negative opinion of you.
You were concerned that getting mental health treatment or counseling might have a negative effect
on your job.
Your health insurance does not cover any mental health treatment or counseling.
Your health insurance does not pay enough for mental health treatment or counseling.
You did not know where to go to get services.
You were concerned that the information you gave the counselor might not be kept confidential.
You were concerned that you might be committed to a psychiatric hospital or might have to take
medicine.
Some other reason or reasons.

[IF ANY ENTRY IN ADMT27 = 9] Which of these statements explain why you did not get the mental health
treatment or counseling you needed?
To select more than one reason from the list, press the space bar between each number you type. When you
have finished, press [ENTER].
1
2
3
4
5
6
7
DK/REF

ADMT27SP

You didn't think you needed treatment at the time.
You thought you could handle the problem without treatment.
You didn't think treatment would help.
You didn't have time (because of job, childcare, or other commitments).
You didn't want others to find out that you needed treatment.
You had no transportation, or treatment was too far away, or the hours were not convenient.
Some other reason or reasons.

[IF ADMT27A = 7] Please type in the most important other reason you did not get the mental health
treatment or counseling you needed. When you have finished, press the [ENTER] key to go to the next
question.
__________________
DK/REF

ADMT29a

[IF CURNTAGE = 18 OR OLDER] Earlier, we asked whether you have received prescription medicines,
inpatient treatment or outpatient treatment for your emotions, nerves or mental health. The list below
contains possible sources of treatment, counseling or support that were not mentioned before.
Acupuncturist or acupressurist
Chiropractor
Herbalist
In-person support group or self-help group
Internet support group or chat room
Spiritual or religious advisor, such as a pastor, priest, rabbi
Telephone hotline
Massage therapist
Did you receive treatment, counseling or support from any other sources such as these during the past 12
months?
1
Yes
2
No
DK/REF

ADMT29b

[IF ADMT29a = 1] From what source did you receive other treatment, counseling or support for problems
with your emotions, nerves or mental health in the past 12 months?
To select more than one source from the list, press the space bar between each number you type. When you
have finished, press [ENTER].

May 23, 2012

322

1
2
3
4
5
6
7
8
9
DK/REF
ADMT29bSP

Acupuncturist or acupressurist
Chiropractor
Herbalist
In-person support group or self-help group
Internet support group or chat room
Spiritual or religious advisor, such as a pastor, priest, rabbi
Telephone hotline
Massage therapist
Other (specify)

[IF ADMT29b = 9] Please type in the source of the other treatment, counseling or support you received.
When you have finished, press the [ENTER] key to go to the next question.
____________
DK/REF

ADMT30

[IF ADMT01 = 1 OR ADMTREF1 = 1 OR ADMT13 = 1 OR ADMTREF13 = 1 OR ADMT25 = 1 OR
ADMTREF25 = 1 OR ADMT29a=1] Please think about the mental health treatment or counseling you
received during the past 12 months. Which of these statements best describes how you were prompted to get
treatment?
1
I decided on my own to get treatment
2
I got treatment mainly because someone else thought I should
3
I was ordered to get treatment
DK/REF

May 23, 2012

323

May 23, 2012

324

Social Environment
(Section Administered to 18 + Year Olds Only)
leadsen

[IF CURNTAGE = 18 OR OLDER] The next questions are about things you might or might not have done
recently.
Press [ENTER] to continue.

sen04

[IF CURNTAGE = 18 OR OLDER] How many times have you moved in the past 5 years?
# TIMES MOVED:
DK/REF

SEN12a

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, how many times have you sold illegal drugs?
1
2
3
4
5
DK/REF

sen12b

0 times
1 or 2 times
3 to 5 times
6 to 9 times
10 or more times

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, how many times have you attacked someone
with the intent to seriously hurt them?
1
2
3
4
5
DK/REF

sen13b

0 times
1 or 2 times
3 to 5 times
6 to 9 times
10 or more times

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, how many times have you stolen or tried to
steal anything worth more than $50?
1
2
3
4
5
DK/REF

sen12c

[RANGE: 0 - 90]

0 times
1 or 2 times
3 to 5 times
6 to 9 times
10 or more times

[IF CURNTAGE = 18 OR OLDER] How do you feel about adults trying marijuana or hashish once or twice?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF

senrelat

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, how many times did you attend religious
services? Please do not include special occasions such as weddings, funerals, or other special events in your
answer.
1
2
3
4
5
6
DK/REF

senrebe1

May 23, 2012

0 times
1 to 2 times
3 to 5 times
6 to 24 times
25 to 52 times
More than 52 times

[IF CURNTAGE = 18 OR OLDER] These next questions are about the role that religious beliefs may play in your
life. For each statement, please indicate whether you strongly disagree, disagree, agree, or strongly agree.

325

Your religious beliefs are a very important part of your life.
1
2
3
4
DK/REF
senrebe2

[IF CURNTAGE = 18 OR OLDER] Your religious beliefs influence how you make decisions in your life.
1
2
3
4
DK/REF

senrebe3

Strongly disagree
Disagree
Agree
Strongly agree

[IF CURNTAGE = 18 OR OLDER] It is important that your friends share your religious beliefs.
1
2
3
4
DK/REF

May 23, 2012

Strongly disagree
Disagree
Agree
Strongly agree

Strongly disagree
Disagree
Agree
Strongly agree

326

Parenting Experiences
(IF FIPE3 =1 ADMINISTER THIS SECTION; ELSE SKIP TO YOUTH EXPERIENCES IF RESPONDENT
IS 12 -17 OR DIINTRO IF RESPONDENT IS 18 OR OLDER)
[IF FIPE3 = 1] These questions refer to your child who was also selected to complete an interview. Please think
about this child as you answer these questions. If you’re not sure which child was selected, please ask your
interviewer.

leadpar

Press [ENTER] to continue.
pe01

[IF FIPE3 = 1] What is the birth date of your child who was also selected to complete an interview?
Enter your child’s birth date as numbers in the following form: (MM-DD-YYYY)
DOB: _____________
DK/REF

CALCULATE CHILD’S AGE FROM PE01.
HARD ERROR: [IF CALCULATED AGE FROM PE01 > 18]: THE BIRTH DATE YOU HAVE ENTERED ([PE01])
INDICATES THAT YOUR CHILD IS OLDER THAN 18. PLEASE VERIFY WITH YOUR INTERVIEWER THAT
THIS IS THE CHILD WHO WAS ALSO SELECTED TO BE INTERVIEWED AND CHECK TO MAKE SURE THE
DATE OF BIRTH YOU HAVE ENTERED IS CORRECT.
PRESS [ENTER] TO CONTINUE.
HARD ERROR: [IF CALCULATED AGE FROM PE01 < 12]: THE BIRTH DATE YOU HAVE ENTERED ([PE01])
INDICATES THAT YOUR CHILD IS YOUNGER THAN 12. THIS CHILD WOULD NOT BE ELIGIBLE TO BE
INTERVIEWED. PLEASE CHECK TO MAKE SURE THE DATE OF BIRTH YOU HAVE ENTERED IS CORRECT.
PRESS [ENTER] TO CONTINUE.
pe01a

[IF PE01 NE DK/REF] The computer calculated that the child who was also selected to complete an interview is
[CALCULATED AGE FROM PE01]. Is this correct?
1
Yes
2
No
DK/REF

pe01b

[IF PE01 = DK/REF OR PE01a = 2] How old is the child who was also selected to complete an interview?
[RANGE: 12 - 18]

AGE:
DK/REF
pe02

[IF PE01a = 1 OR PE01b = 12 - 18] Think about the past 12 months, that is, from [DATEFILL] through today. Please
indicate if you think your child has done any of these things during the past 12 months.
In the past 12 months, do you think your child has smoked one or more cigarettes, even once?
1
Yes
2
No
DK/REF

pe02b

[IF PE01a = 1 OR PE01b = 12 - 18] In the past 12 months, do you think your child has used any chewing tobacco or
snuff, even once?
1
Yes
2
No
DK/REF

pe02c

[IF PE01a = 1 OR PE01b = 12 - 18] In the past 12 months, do you think your child has drunk any type of alcoholic
beverage, even once?
1

May 23, 2012

Yes
327

2
No
DK/REF
pe02d

[IF PE01a = 1 OR PE01b = 12 - 18] In the past 12 months, do you think your child has used any marijuana or hashish,
even once?
1
Yes
2
No
DK/REF

pe02e

[IF PE01a = 1 OR PE01b = 12 - 18] In the past 12 months, do you think your child has used any form of cocaine, such
as powder, ‘crack,’ free base or coca paste, even once?
1
Yes
2
No
DK/REF

pe02f

[IF PE01a = 1 OR PE01b = 12 - 18] In the past 12 months, do you think your child has used any inhalant, such as
nitrous oxide, glue, paint thinner or certain aerosol sprays, even once?
1
Yes
2
No
DK/REF

pe03

[IF PE01a = 1 OR PE01b = 12 - 18] During the past 12 months, how many times have you talked with your child
about the dangers or problems associated with the use of tobacco, alcohol, or other drugs?
1
2
3
4
DK/REF

pe04

[IF PE03 = 2 OR 3 OR 4] Think about the most serious and thorough discussion about drugs you had with your child
during the past 12 months. About how long did this discussion last?
1
2
3
4
DK/REF

pe05a

0 times
1 to 2 times
A few times
Many times

Less than 10 minutes
10 to 30 minutes
31 to 60 minutes
More than 60 minutes

[IF PE01a = 1 OR PE01b = 12 - 18] For each of the next statements, please indicate whether you strongly agree, agree,
disagree, or strongly disagree.
I wish I knew better what to say to my child about drugs.
1
2
3
4
DK/REF

pe05b

[IF PE01a = 1 OR PE01b = 12 - 18] What I say will have little influence on whether my child uses drugs.
1
2
3
4
DK/REF

pe05c

Strongly agree
Agree
Disagree
Strongly disagree

Strongly agree
Agree
Disagree
Strongly disagree

[IF PE01a = 1 OR PE01b = 12 - 18] Drug education is best handled by the schools, not by parents.
1
2

May 23, 2012

Strongly agree
Agree
328

3
Disagree
4
Strongly disagree
DK/REF
pe05d

[IF PE01a = 1 OR PE01b = 12 - 18] There are places in my community where I can learn more about how to help
prevent my child from using drugs.
1
2
3
4
DK/REF

May 23, 2012

Strongly agree
Agree
Disagree
Strongly disagree

329

May 23, 2012

330

Youth Experiences
(Section Administered to 12 - 17 Year Olds Only; Respondents 18 or Older Skip to DIINTRO)
LEADSEN

[IF CURNTAGE = 12 - 17] The next questions are about school and other activities.
Press [Enter] to continue.

YE04

[IF CURNTAGE = 12 - 17] How many times have you moved in the past 5 years?
# TIMES MOVED:
DK/REF

YE09

[RANGE: 0 - 90]

[IF CURNTAGE = 12 - 17] Have you attended any type of school at any time during the past 12 months?
1
Yes
2
No
DK/REF

YE09a

[IF YE09 = 2 OR DK/REF] Some parents decide to educate their children at home rather than send them to school.
Have you been home-schooled at any time during the past 12 months?
1
Yes
2
No
DK/REF

YE10

[IF YE09 = 1] Which of the statements below best describes how you felt overall about going to school during the
past 12 months?
[IF YE09a = 1] Please think about your home-schooling as you answer these next questions about “school.”
Which of the statements below best describes how you felt overall about going to school during the past 12 months?
1
2
3
4
DK/REF

YE11

[IF YE09 = 1 OR YE09a = 1] During the past 12 months, how often did you feel that the school work you were
assigned to do was meaningful and important?
1
2
3
4
DK/REF

YE12

Always
Sometimes
Seldom
Never

[IF YE09 = 1 OR YE09a = 1] How important do you think the things you have learned in school during the past 12
months are going to be to you later in life?
1
2
3
4
DK/REF

YE13

You liked going to school a lot
You kind of liked going to school
You didn’t like going to school very much
You hated going to school

Very important
Somewhat important
Somewhat unimportant
Very unimportant

[IF YE09 = 1 OR YE09a = 1] How interesting do you think most of your courses at school during the past 12 months
have been?
1
2
3
4
DK/REF

May 23, 2012

Very interesting
Somewhat interesting
Somewhat boring
Very boring

331

YE14

[IF YE09 = 1 OR YE09a = 1] During the past 12 months, how often did your teachers at school let you know when
you were doing a good job with your school work?
1
2
3
4
DK/REF

YE15

[IF YE09 = 1 OR YE09a = 1] What were your grades for the last semester or grading period you completed?
1
2
3
4
5
DK/REF

YE16a

Always
Sometimes
Seldom
Never

An ‘A+’, ‘A’, or ‘A-minus’ average
A ‘B+’, ‘B’, or ‘B-minus’ average
A ‘C+’, ‘C’, or ‘C-minus’ average
A ‘D’ or less than a ‘D’ average
My school does not give these grades

[IF YE09 = 1] How many of the students in your grade at school would you say smoke cigarettes?
[IF YE09a = 1] Please think about the school you would be attending if you were not home-schooled, as you answer
these next questions.
How many of the students in your grade at school would you say smoke cigarettes?
1
2
3
4
DK/REF

YE16b

[IF YE09 = 1 OR YE09a = 1] How many of the students in your grade at school would you say use marijuana or
hashish?
1
2
3
4
DK/REF

YE16c

None of them
A few of them
Most of them
All of them

[IF YE09 = 1 OR YE09a = 1] How many of the students in your grade at school would you say get drunk at least once
a week?
1
2
3
4
DK/REF

YE06a

None of them
A few of them
Most of them
All of them

[IF YE09 = 1 OR YE09a = 1] How many of the students in your grade at school would you say drink alcoholic
beverages?
1
2
3
4
DK/REF

YE16d

None of them
A few of them
Most of them
All of them

None of them
A few of them
Most of them
All of them

[IF YE09 = 1 OR YE09a = 1] The next questions ask about your parents. By parents, we mean either your biological
parents, adoptive parents, stepparents, or adult guardians who live in your household.
During the past 12 months, how often did your parents check on whether you had done your homework?
1
2

May 23, 2012

Always
Sometimes
332

3
Seldom
4
Never
DK/REF
YE06b

[IF YE09 = 1 OR YE09a = 1] During the past 12 months, how often did your parents provide help with your
homework when you needed it?
1
2
3
4
DK/REF

YE06c

[IF YE09 =2 OR DK/REF AND YE09a = 2 OR DK/REF ADD: The next questions ask about your parents. By
parents, we mean either your biological parents, adoptive parents, stepparents, or adult guardians who live in your
household. OTHERWISE SIMPLY SHOW QUESTION AS IS.] During the past 12 months, how often did your
parents make you do chores around the house?
1
2
3
4
DK/REF

YE06d

Always
Sometimes
Seldom
Never

[IF CURNTAGE = 12 - 17] During the past 12 months, how often did your parents tell you they were proud of you
for something you had done?
1
2
3
4
DK/REF

YE18a

Always
Sometimes
Seldom
Never

[IF CURNTAGE = 12 - 17] During the past 12 months, how often did your parents let you know when you’d done a
good job?
1
2
3
4
DK/REF

YE06g

Always
Sometimes
Seldom
Never

[IF YE09=1 OR YE09a = 1] During the past 12 months, how often did your parents limit the amount of time you
went out with friends on school nights?
1
2
3
4
DK/REF

YE06f

Always
Sometimes
Seldom
Never

[IF CURNTAGE = 12 - 17] During the past 12 months, how often did your parents limit the amount of time you
watched TV?
1
2
3
4
DK/REF

YE06e

Always
Sometimes
Seldom
Never

Always
Sometimes
Seldom
Never

[IF CURNTAGE = 12 - 17] During the past 12 months, how many times have you argued or had a fight with at least
one of your parents?
1
2

May 23, 2012

0 times
1 or 2 times
333

3
3 to 5 times
4
6 to 9 times
5
10 or more times
DK/REF
YE18b

[IF CURNTAGE = 12 - 17] During the past 12 months, how many times have you gotten into a serious fight at
school or work?
1
2
3
4
5
DK/REF

YE18c

[IF CURNTAGE = 12 - 17] During the past 12 months, how many times have you taken part in a fight where a
group of your friends fought against another group?
1
2
3
4
5
DK/REF

YE18d

0 times
1 or 2 times
3 to 5 times
6 to 9 times
10 or more times

[IF CURNTAGE = 12 - 17] During the past 12 months, how many times have you attacked someone with the intent
to seriously hurt them?
1
2
3
4
5
DK/REF

YE07a

0 times
1 or 2 times
3 to 5 times
6 to 9 times
10 or more times

[IF CURNTAGE = 12 - 17] During the past 12 months, how many times have you stolen or tried to steal anything
worth more than $50?
1
2
3
4
5
DK/REF

YE18g

0 times
1 or 2 times
3 to 5 times
6 to 9 times
10 or more times

[IF CURNTAGE = 12 - 17] During the past 12 months, how many times have you sold illegal drugs?
1
2
3
4
5
DK/REF

YE18f

0 times
1 or 2 times
3 to 5 times
6 to 9 times
10 or more times

[IF CURNTAGE = 12 - 17] During the past 12 months, how many times have you carried a handgun?
1
2
3
4
5
DK/REF

YE18e

0 times
1 or 2 times
3 to 5 times
6 to 9 times
10 or more times

0 times
1 or 2 times
3 to 5 times
6 to 9 times
10 or more times

[IF CURNTAGE = 12 - 17] How do you think your parents would feel about you smoking one or more packs of
cigarettes per day?

May 23, 2012

334

1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE07b

[IF CURNTAGE = 12 - 17] How do you think your parents would feel about you trying marijuana or hashish once or
twice?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF

YE07b1 [IF CURNTAGE = 12 - 17] How do you think your parents would feel about you using marijuana or hashish once a
month or more?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE07c

[IF CURNTAGE = 12 - 17] How do you think your parents would feel about you having one or two drinks of an
alcoholic beverage nearly every day?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF

YE19a

[IF CURNTAGE = 12 - 17] How do you feel about someone your age smoking one or more packs of cigarettes a day?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF

YE19b

[IF CURNTAGE = 12 - 17] How do you feel about someone your age trying marijuana or hashish once or twice?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF

YE19b1 [IF CURNTAGE = 12 - 17] How do you feel about someone your age using marijuana once a month or more?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE19c

[IF CURNTAGE = 12 - 17] How do you feel about someone your age having one or two drinks of an alcoholic
beverage nearly every day?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF

YE20a

[IF CURNTAGE = 12 - 17] How do you think your close friends would feel about you smoking one or more packs of
cigarettes a day?
1
2
3

May 23, 2012

Neither approve nor disapprove
Somewhat disapprove
Strongly disapprove
335

DK/REF
YE20b

[IF CURNTAGE = 12 - 17] How do you think your close friends would feel about you trying marijuana or hashish
once or twice?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF

YE20b1 [IF CURNTAGE = 12 - 17] How do you think your close friends would feel about you using marijuana or hashish
once a month or more?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE20c

[IF CURNTAGE = 12 - 17] How do you think your close friends would feel about you having one or two drinks of an
alcoholic beverage nearly every day?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF

YE22

[IF CURNTAGE = 12 - 17] If you wanted to talk to someone about a serious problem, which of the following people
would you turn to?
To select more than one category, press the space bar between each category you select.
1
2
3
4
5
DK/REF

YE08

There is nobody I can talk to about serious problems
My mother or father or guardian
My boyfriend or girlfriend
Some other adult
Some other person or persons

[IF CURNTAGE = 12 - 17] Now think about the past 12 months, that is, from [DATEFILL] through today. During
the past 12 months, have you talked with at least one of your parents about the dangers of tobacco, alcohol, or drug
use? By parents, we mean either your biological parents, adoptive parents, stepparents, or adult guardians -- whether
or not they live with you.
1
Yes
2
No
DK/REF

YE23b

[IF CURNTAGE = 12 - 17] During the past 12 months have you participated in a problem solving, communication
skills or self-esteem group?
1
Yes
2
No
DK/REF

YE23c

[IF CURNTAGE = 12 - 17] During the past 12 months have you participated in a violence prevention program,
where you learn ways to avoid fights and control anger?
1
Yes
2
No
DK/REF

YE23g

[IF CURNTAGE = 12 - 17] During the past 12 months have you participated in an alcohol, tobacco or drug
prevention program outside of school, where you learn about the dangers of using, and how to resist using, alcohol,
tobacco, or drugs?

May 23, 2012

336

1
Yes
2
No
DK/REF
YE23j

[IF CURNTAGE = 12 - 17] During the past 12 months have you participated in a program or meeting to help you
deal with drug or alcohol use by you or another member of your family, such as Alcoholics Anonymous, Alateen, or
individual or group counseling?
1
Yes
2
No
DK/REF

YE23o

[IF CURNTAGE = 12 - 17] During the past 12 months have you participated in pregnancy or sexually transmitted
disease prevention programs?
1
Yes
2
No
DK/REF

YE23p

[IF CURNTAGE = 12 - 17] During the past 12 months, in how many different kinds of school-based activities, such
as team sports, cheerleading, choir, band, student government, or clubs, have you participated?
0
1
2
3
DK/REF

YE23q

[IF CURNTAGE = 12 - 17] During the past 12 months, in how many different kinds of community-based activities,
such as volunteer activities, sports, clubs, or groups have you participated?
0
1
2
3
DK/REF

YE23r

None
One
Two
3 or more

[IF CURNTAGE = 12 - 17] During the past 12 months, in how many different kinds of other activities, such as dance
lessons, piano lessons, karate lessons, or horseback riding lessons, have you participated?
0
1
2
3
DK/REF

YE24a

None
One
Two
3 or more

[IF CURNTAGE = 12 - 17] During the past 12 months, in how many different kinds of church or faith-based
activities, such as clubs, youth groups, Saturday or Sunday school, prayer groups, youth trips, service or volunteer
activities have you participated?
0
1
2
3
DK/REF

YE23s

None
One
Two
3 or more

None
One
Two
3 or more

[IF YE09 = 1 OR YE09a = 1] During the past 12 months have you had a special class about drugs or alcohol in
school?
1
Yes
2
No
DK/REF

YE24b

[IF YE09 = 1 OR YE09a = 1] During the past 12 months have you had films, lectures, discussions, or printed
information about drugs or alcohol in one of your regular school classes such as health or physical education?

May 23, 2012

337

1
Yes
2
No
DK/REF
YE24c

[IF YE09 = 1 OR YE09a = 1] During the past 12 months have you had films, lectures, discussions, or printed
information about drugs or alcohol outside of one of your regular classes such as in a special assembly?
1
Yes
2
No
DK/REF

YE25

[IF YE09 = 1 OR YE09a = 1] During the past 12 months have you seen or heard any alcohol or drug prevention
messages from sources outside school such as posters, pamphlets, radio, or TV?
[IF YE09 = 2 OR DK/REF AND YE09a = 2 OR DK/REF] During the past 12 months have you seen or heard any
alcohol or drug prevention messages from sources such as posters, pamphlets, radio, or TV?
1
Yes
2
No
DK/REF

YERELATT

[IF CURNTAGE = 12 - 17] During the past 12 months, how many times did you attend religious services?
Please do not include special occasions such as weddings, funerals, or other special events in your answer.
1
2
3
4
5
6
DK/REF

YEREBEL1

0 times
1 to 2 times
3 to 5 times
6 to 24 times
25 to 52 times
More than 52 times

[IF CURNTAGE = 12 - 17] These next questions are about the role that religious beliefs may play in your
life. For each statement, please indicate whether you strongly disagree, disagree, agree, or strongly agree.
Your religious beliefs are a very important part of your life.
1
2
3
4
DK/REF

YEREBEL2

[IF CURNTAGE = 12 - 17] Your religious beliefs influence how you make decisions in your life.
1
2
3
4
DK/REF

YEREBEL3

Strongly Disagree
Disagree
Agree
Strongly Agree

[IF CURNTAGE = 12 - 17] It is important that your friends share your religious beliefs.
1
2
3
4
DK/REF

May 23, 2012

Strongly Disagree
Disagree
Agree
Strongly Agree

Strongly Disagree
Disagree
Agree
Strongly Agree

338

Mental Health
(Questions administered only to respondents 18 or older.)
DIINTRO

[IF CURNTAGE = 18 OR OLDER] These questions ask how you have been feeling during the past 30 days.
Press [ENTER] to continue.

NERVE30

[IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel nervous?
1
2
3
4
5
DK/REF

HOPE30

[IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel hopeless?
1
2
3
4
5
DK/REF

FIDG30

All of the time
Most of the time
Some of the time
A little of the time
None of the time

[IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel down on yourself, no good or worthless?
1
2
3
4

May 23, 2012

All of the time
Most of the time
Some of the time
A little of the time
None of the time

[IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel that everything was an effort?
1
2
3
4
5
DK/REF

DOWN30

All of the time
Most of the time
Some of the time
A little of the time
None of the time

[IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel so sad or depressed that nothing could cheer you up?
1
2
3
4
5
DK/REF

EFFORT30

All of the time
Most of the time
Some of the time
A little of the time
None of the time

[IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel restless or fidgety?
1
2
3
4
5
DK/REF

NOCHR30

All of the time
Most of the time
Some of the time
A little of the time
None of the time

All of the time
Most of the time
Some of the time
A little of the time
339

5
None of the time
DK/REF
WORST30

The last questions asked about how you have been feeling during the past 30 days. Now think about the past
12 months. Was there a month in the past 12 months when you felt more depressed, anxious, or emotionally
stressed than you felt during the past 30 days?
1
2

DSNERV1

Yes
No

[IF CURNTAGE = 18 OR OLDER AND WORST30=1] Think of one month in the past 12 months when you
were the most depressed, anxious, or emotionally stressed.
During that month, how often did you feel nervous?
1
2
3
4
5
DK/REF

DSHOPE

All of the time
Most of the time
Some of the time
A little of the time
None of the time

[IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that same month when you were at your
worst emotionally . . .
how often did you feel hopeless?
1
2
3
4
5
DK/REF

DSFIDG

All of the time
Most of the time
Some of the time
A little of the time
None of the time

[IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that same month when you were at your
worst emotionally . . .
how often did you feel restless or fidgety?
1
2
3
4
5
DK/REF

DSNOCHR

All of the time
Most of the time
Some of the time
A little of the time
None of the time

[IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that same month when you were at your
worst emotionally . . .
how often did you feel so sad or depressed that nothing could cheer you up?
1
2
3
4
5
DK/REF

DSEFFORT

All of the time
Most of the time
Some of the time
A little of the time
None of the time

[IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that same month when you were at your
worst emotionally . . .
how often did you feel that everything was an effort?
1

May 23, 2012

All of the time
340

2
3
4
5
DK/REF
DSDOWN

Most of the time
Some of the time
A little of the time
None of the time

[IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that same month when you were at your
worst emotionally . . .
how often did you feel down on yourself, no good, or worthless?
1
2
3
4
5
DK/REF

All of the time
Most of the time
Some of the time
A little of the time
None of the time

DEFINE DISTRESS:

IF NERVE30 = 1-4 OR HOPE30 = 1-4 OR FIDG30 = 1-4, OR NOCHR30 = 1-4 OR EFFORT30
= 1-4 OR DOWN30 = 1-4, OR DSNERV1 = 1-4 OR DSHOPE = 1-4 OR DSFIDG = 1-4 OR
DSNOCHR = 1-4 OR DSEFFORT = 1-4 OR DSDOWN = 1-4, THEN DISTRESS = 1
ELSE, DISTRESS = 2
LIKERT

[IF DISTRESS=1] The next questions are about how much your emotions, nerves, or mental health caused
you to have difficulties in daily activities.
In answering, think of the one month in the past 12 months when your emotions, nerves, or mental health
interfered most with your daily activities.
Press [ENTER] to continue.

LIREMEM

[IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most
with your daily activities . . .
how much difficulty did you have remembering to do things you needed to do?
1
2
3
4
DK/REF

LICONCEN

No difficulty
Mild difficulty
Moderate difficulty
Severe difficulty

[IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most
with your daily activities . . .
how much difficulty did you have concentrating on doing something important when other things were
going on around you?
1
2
3
4
DK/REF

LIGOOUT1

No difficulty
Mild difficulty
Moderate difficulty
Severe difficulty

[IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most
with your daily activities . . .
how much difficulty did you have going out of the house and getting around on your own?

May 23, 2012

341

1
2
3
4
5
DK/REF
LIGOOUT2

No difficulty
Mild difficulty
Moderate difficulty
Severe difficulty
You didn’t leave the house on your own

[IF LIGOOUT1 = 5] Did problems with your emotions, nerves, or mental health keep you from leaving the
house on your own?
1
Yes
2
No
DK/REF

LISTRAN1

[IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most
with your daily activities . . .
how much difficulty did you have dealing with people you did not know well?
1
2
3
4
5
DK/REF

LISTRAN2

No difficulty
Mild difficulty
Moderate difficulty
Severe difficulty
You didn’t deal with people you did not know well

[IF LISTRAN1 = 5] Did problems with your emotions, nerves, or mental health keep you from dealing with
people you did not know well?
1
Yes
2
No
DK/REF

LISOC1

[IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most with
your daily activities . . .
how much difficulty did you have participating in social activities, like visiting friends or going to
parties?
1
2
3
4
5
DK/REF

LISOC2

No difficulty
Mild difficulty
Moderate difficulty
Severe difficulty
You didn’t participate in social activities

[IF LISOC1=5] Did problems with your emotions, nerves, or mental health keep you from participating in
social activities?
1
Yes
2
No
DK/REF

LIHHRES1

[IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most with
your daily activities . . .
how much difficulty did you have taking care of household responsibilities?
1
2
3
4
5
DK/REF

May 23, 2012

No difficulty
Mild difficulty
Moderate difficulty
Severe difficulty
You didn’t take care of household responsibilities

342

LIHHRES2

[IF LIHHRES1=5] Did problems with your emotions, nerves, or mental health keep you from taking care of
household responsibilities?
1
Yes
2
No
DK/REF

LIWKRES1

[IF DISTRESS =1] During that one month when your emotions, nerves or mental health interfered most
with your daily activities . . .
how much difficulty did you have taking care of your daily responsibilities at work or school?
1
2
3
4
5
DK/REF

LIWKRES2

No difficulty
Mild difficulty
Moderate difficulty
Severe difficulty
You didn’t work or go to school

[IF LIWKRES1=5] Did problems with your emotions, nerves, or mental health keep you from working or
going to school?
1
Yes
2
No
DK/REF

LIWKQUIC

[IF DISTRESS =1 AND LIWKRES1 NE 5] During that one month when your emotions, nerves or mental
health interfered most with your daily activities . . .
how much difficulty did you have getting your daily work done as quickly as needed?
1
2
3
4
DK/REF

IMWEEK1

No difficulty
Mild difficulty
Moderate difficulty
Severe difficulty

[IF LIREMEM = 2 - 4 OR LICONCEN = 2 - 4 OR LIGOOUT1 = 2 - 4 OR LIGOOUT2 = 1 OR LISTRAN1
= 2 - 4 OR LISTRAN2 = 1 OR LISOC1 = 2 - 4 OR LISOC2 = 1 OR LIHHRES1 = 2 - 4 OR LIHHRES2 = 1
OR LIWKRES1 = 2 - 4 OR LIWKRES2 = 1 OR LIWKQUIC = 2 - 4] You mentioned having difficulty with
or being unable to do such things as [FILL WITH BOLDED TEXT FROM UP TO ALL ITEMS
WHERE LIREMEM = 2 - 4 OR LICONCEN = 2 - 4 OR LIGOOUT1 = 2 - 4 OR LISTRAN1 = 2 - 4
OR LISOC1 = 2 - 4 OR LIHHRES1 = 2 - 4 OR LIWKRES1 = 2 - 4 OR LIWKQUIC = 2 - 4].
[Note to Programmers: Bolded text fills should appear in bold lower case and be separated by semicolons.
The last fill should be preceded by the word “and.”
Further IMWEEK1 Fill Specifications:
IF LIGOOUT2=1 USE FILL FOR LIGOOUT1.
IF LISTRAN2=1 USE FILL FOR LISTRAN1.
IF LISOC2=1 USE FILL FOR LISOC1.
IF LIHHRES2=1 USE FILL FOR LIHHRES1.
During the past 12 months, about how many weeks did you have any of these difficulties because of your
emotions, nerves, or mental health? If you can’t remember the exact number, just give your best estimate.
# OF WEEKS:
DK/REF

[RANGE: 1 - 52]

CREATE IMWEEK1 FILL.
IMDAYS
May 23, 2012

[IF IMWEEK1 =1-52] During (that [IMWEEK1FILL] week/those [IMWEEK1 FILL] weeks), did you
343

have these kinds of difficulties every day, most days, or only one or two days a week?
1
Every day
2
Most days
3
Only one or two days a week
DK/REF
LIAD68 [IF LIREMEM = 2 – 4, OR LICONCEN = 2 - 4, OR LIGOOUT1 = 2 - 4 , OR LIGOOUT2 = 1, OR LISTRAN1 = 2 –
4, OR LISTRAN2 = 1, OR LISOC1 = 2 - 4, OR LISOC2 = 1, OR LIHHRES1 = 2 - 4, OR LIHHRES2 = 1, OR
LIWKRES1 = 2 - 4, OR LIWKQUIC = 2 - 4] About how many days out of 365 in the past 12 months were you totally
unable to work or carry out your normal activities because of your emotions, nerves or mental health?
You can use any number between 0 and 365 to answer.
# OF DAYS:__________ [RANGE: 0-365]
DK/REF

SUI01

[IF CURNTAGE=18 OR OLDER] The next few questions are about thoughts of suicide. At any time in the past 12
months, that is from [datefill] up to and including today, did you seriously think about trying to kill yourself?
1
Yes
2
No
DK/REF

SUI02

[IF SUI01=1] During the past 12 months, did you make any plans to kill yourself?
1
Yes
2
No
DK/REF

SUI03

[IF SUI01=1] During the past 12 months, did you try to kill yourself?
1
Yes
2
No
DK/REF

SUI04

[IF SUI03=1] During the past 12 months, did you get medical attention from a doctor or other health professional as a
result of an attempt to kill yourself?
1
Yes
2
No
DK/REF

SUI05

[IF SUI04=1] Did you stay in a hospital overnight or longer because you tried to kill yourself?
1
Yes
2
No
DK/REF

CREATE RWUSPD30:
if NERVE30=4 then NERVOUS30=1;
else if NERVE30=3 then NERVOUS30 =2;
else if NERVE30=2 then NERVOUS30 =3;
else if NERVE30=1 then NERVOUS30 =4;
else if NERVE30=5 then NERVOUS30 = 0
else NERVOUS30=BLANK
if HOPE30=4 then HOPELESS30=1;
else if HOPE30=3 then HOPELESS30=2;
else if HOPE30=2 then HOPELESS30 =3;
else if HOPE30=1 then HOPELESS30 =4;
else if HOPE30=5 then HOPELESS30 = 0
May 23, 2012

344

else HOPELESS30=BLANK;
if FIDG30=4 then RESTLESS30=1;
else if FIDG30=3 then RESTLESS30 =2;
else if FIDG30=2 then RESTLESS30 =3;
else if FIDG30=1 then RESTLESS30 =4;
else if FIDG30=5 then RESTLESS30 = 0
else RESTLESS30=BLANK;
if NOCHR30=4 then NOCHEER30=1;
else if NOCHR30=3 then NOCHEER30 =2;
else if NOCHR30=2 then NOCHEER30 =3;
else if NOCHR30=1 then NOCHEER30 =4;
else if NOCHR30=5 then NOCHEER30 = 0
else NOCHEER30=BLANK;
if EFFORT30=4 then EFF30=1;
else if EFFORT30=3 then EFF30=2;
else if EFFORT30=2 then EFF30=3;
else if EFFORT30=1 then EFF30=4;
else if EFFORT30=5 then EFF30 = 0
else EFF30=BLANK;
if DOWN30=4 then NOGOOD30=1;
else if DOWN30=3 then NOGOOD30=2;
else if DOWN30=2 then NOGOOD30=3;
else if DOWN30=1 then NOGOOD30=4;
else if DOWN30=5 then NOGOOD30 = 0
else NOGOOD30=BLANK;
if NERVOUS30, HOPELESS30, RESTLESS30, NOCHEER30, EFF30, NOGOOD30 ARE ALL BLANK THEN
RWUSPD30 = BLANK
else
RWUSPD30 = NERVOUS30 + HOPELESS30 + RESTLESS30 + NOCHEER30 + EFF30 + NOGOOD30
Check: RWUSPD30 should be between 0 and 24 or BLANK
CREATE RWUSPD12:
if DSNERV1=4 then NERVOUS=1;
else if DSNERV1=3 then NERVOUS =2;
else if DSNERV1=2 then NERVOUS =3;
else if DSNERV1=1 then NERVOUS =4;
else if DSNERV1=5 then NERVOUS = 0
else NERVOUS=BLANK;
if DSHOPE=4 then HOPELESS=1;
else if DSHOPE=3 then HOPELESS=2;
else if DSHOPE=2 then HOPELESS =3;
else if DSHOPE=1 then HOPELESS =4;
else if DSHOPE=5 then HOPELESS = 0
else HOPELESS=BLANK;
if DSFIDG=4 then RESTLESS=1;
else if DSFIDG=3 then RESTLESS =2;
else if DSFIDG=2 then RESTLESS =3;
else if DSFIDG=1 then RESTLESS =4;
else if DSFIDG=5 then RESTLESS = 0
else RESTLESS=BLANK;
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345

if DSNOCHR=4 then NOCHEER=1;
else if DSNOCHR=3 then NOCHEER =2;
else if DSNOCHR=2 then NOCHEER =3;
else if DSNOCHR=1 then NOCHEER =4;
else if DSNEOCHR=5 then NOCHEER = 0
else NOCHEER=BLANK;
if DSEFFORT=4 then EFFORT=1;
else if DSEFFORT=3 then EFFORT=2;
else if DSEFFORT=2 then EFFORT=3;
else if DSEFFORT=1 then EFFORT=4;
else if DSEFFORT=5 then EFFORT = 0
else EFFORT=BLANK;

if DSDOWN=4 then NOGOOD=1;
else if DSDOWN=3 then NOGOOD=2;
else if DSDOWN=2 then NOGOOD=3;
else if DSDOWN=1 then NOGOOD=4;
else if DSDOWN=5 then NOGOOD = 0
else NOGOOD=BLANK;

if NERVOUS, HOPELESS, RESTLESS, NOCHEER, EFFORT, NOGOOD ARE ALL BLANK THEN
RWUSPD12 = BLANK
else
RWUSPD12 = NERVOUS + HOPELESS + RESTLESS + NOCHEER + EFFORT + NOGOOD
Check: RWUSPD12 should be between 0 and 24 or BLANK
CREATE RWUSPDSC:
RWUSPDSC=MAX(RWUSPD30,RWUSPD12)

NOTE TO PROGRAMMERS: THESE RECODED VALUES ARE INTERMEDIATE, TO BE USED ONLY FOR
COMPUTING THE ‘WHODAS’ VARIABLE. THESE RECODED VALUES ARE NOT TO BE STORED IN THE
DATA FILE AND WILL NOT OVERRIDE THE ORIGINAL VALUES STORED IN THE CAI.
CREATE WHODAS:
RECODE LIREMEM (1=0) (2=1) (3=2) (4=3)
RECODE LICONCEN (1=0) (2=1) (3=2) (4=3)
RECODE LIGOOUT1 (1=0) (2=1) (3=2) (4=3)
LIGOOUT1=3 IF LIGOOUT1=5 AND LIGOOUT2=1
LIGOOUT1=0 IF LIGOOUT1=5 AND LIGOOUT2=2, DK OR REF
RECODE LISTRAN1 (1=0) (2=1) (3=2) (4=3)
LISTRAN1=3 IF LISTRAN1=5 AND LISTRAN2=1
LISTRAN1=0 IF LISTRAN1=5 AND LISTRAN2=2, DK OR REF
RECODE LISOC1 (1=0) (2=1) (3=2) (4=3)
LISOC1=3 IF LISOC1=5 AND LISOC2=1
LISOC1=0 IF LISOC1=5 AND LISOC2=2, DK OR REF
RECODE LIHHRES1 (1=0) (2=1) (3=2) (4=3)
LIHHRES1=3 IF LIHHRES1=5 AND LIHHRES2=1
LIHHRES1=0 IF LIHHRES1=5 AND LIHHRES2=2, DK OR REF

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RECODE LIWKRES1 (1=0) (2=1) (3=2) (4=3)
LIWKRES1=3 IF LIWKRES1=5 AND LIWKRES2=1
LIWKRES1=0 IF LIWKRES1=5 AND LIWKRES2=2, DK OR REF
RECODE LIWKQUIC (1=0) (2=1) (3=2) (4=3)
LIWKQUIC=3 IF LIWKRES1=5 AND LIWKRES2=1
LIWKQUIC=0 IF LIWKRES1=5 AND LIWKRES2=2, DK OR REF
IF LIREMEM = DK/REF
AND LICONCEN = DK/REF
AND (LIGOOUT1=DK/REF OR (LIGOOUT1=5 AND LIGOOUT2=DK/REF))
AND (LISTRAN1=DK/REF OR (LISTRAN1=5 AND LISTRAN12DK/REF))
AND (LISOC1=DK/REF OR (LISOC1=5 AND LISOC2=DK/REF))
AND (LIHHRES1=DK/REF OR (LIHHRES1=5 AND LIHHRES2=DK/REF))
AND (LIWKRES1=DK/REF OR (LIWKRES1=5 AND LIWKRES2=DK/REF))
AND LIWKQUIC = DK/REF,
THEN WHODAS = 50
IF (LIREMEM = DK/REF
OR LICONCEN = DK/REF
OR (LIGOOUT1=DK/REF OR (LIGOOUT1=5 AND LIGOOUT2=DK/REF))
OR (LISTRAN1=DK/REF OR (LISTRAN1=5 AND LISTRAN12DK/REF))
OR (LISOC1=DK/REF OR (LISOC1=5 AND LISOC2=DK/REF))
OR (LIHHRES1=DK/REF OR (LIHHRES1=5 AND LIHHRES2=DK/REF))
OR (LIWKRES1=DK/REF OR (LIWKRES1=5 AND LIWKRES2=DK/REF))
OR LIWKQUIC = DK/REF)
AND
IF (LIREMEM NE BLANK OR DK/REF OR LICONCEN NE BLANK OR DK/REF OR LIGOOUT1 = BLANK OR DK/REF
OR LISTRAN1 NE BLANK OR DK/REF OR LISOC1 NE BLANK OR DK/REF OR LIHHRES1 NE BLANK OR DK/REF
OR LIWKRES1 NE BLANK OR DK/REF OR LIWKQUIC NE BLANK OR DK/REF
OR (LIGOOUT1=5 AND LIGOOUT2 NE DK/REF)
OR (LISTRAN1=5 AND LISTRAN2 NE DK/REF)
OR (LISOC1=5 AND LISOC2 NE DK/REF)
OR (LIHHRES1=5 AND LIHHRES2 NE DK/REF)
OR (LIWKRES1=5 AND LIWKRES2 NE DK/REF))
THEN SET DK/REF = 0 FOR LIREMEM, LICONCEN,
WHODAS= SUM (LIREMEM, LICONCEN, LIGOOUT1, LISTRAN1, LISOC1, LIHHRES1, LIWKRES1, LIWKQUIC)

May 23, 2012

347

May 23, 2012

348

Adult Depression
[Questions administered only to respondents 18 years of age and older]
ASC21

[IF CURNTAGE = 18 OR OLDER] Have you ever in your life had a period of time lasting several days or longer when
most of the day you felt sad, empty or depressed?
1
Yes
2
No
DK/REF

ASC22

[IF ASC21 = 2 OR DK/REF] Have you ever had a period of time lasting several days or longer when most of the day
you were very discouraged about how things were going in your life?
1
Yes
2
No
DK/REF

ASC23

[IF ASC22 = 2 or DK/REF] Have you ever had a period of time lasting several days or longer when you lost interest in
most things you usually enjoy like work, hobbies, and personal relationships?
1
Yes
2
No
DK/REF

AD01

[IF ASC21 =1] During times when you felt sad, empty, or depressed most of the day, did you ever feel discouraged
about how things were going in your life?
1
Yes
2
No
DK/REF

AD01a

[IF AD01 = 1] During the times when you felt sad, empty, or depressed, did you ever lose interest in most things like
work, hobbies, and other things you usually enjoy?
1
Yes
2
No
DK/REF

AD01b

[IF AD01 = 2 OR DK/REF] During the times when you felt sad, empty, or depressed, did you ever lose interest in
most things like work, hobbies, and other things you usually enjoy?
1
Yes
2
No
DK/REF

AD02

[IF ASC22 = 1] During times when you felt discouraged about how things were going in your life, did you ever lose
interest in most things like work, hobbies, and other things you usually enjoy?
1
Yes
2
No
DK/REF

AD09

[IF ASC23= 1] Did you ever have a period of time like this that lasted most of the day nearly every day for two
weeks or longer?
1
Yes
2
No
DK/REF

DEFINE FEELFILL:
IF (AD01a = 1), THEN FEELFILL = “were sad, discouraged, or lost interest in most things”
IF (AD01a = 2 OR DK/REF), THEN FEELFILL = “were sad or discouraged”
IF (AD01b = 1), THEN FEELFILL = “were sad or lost interest in most things”
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349

IF (AD01b = 2 OR DK/REF) THEN FEELFILL = “were sad”
IF (AD02 = 1), THEN FEELFILL = “were discouraged or lost interest in most things”
IF (AD02 = 2 OR DK/REF), THEN FEELFILL = “were discouraged about the way things were going in your life”
IF (AD09 = 1), THEN FEELFILL = “lost interest in most things”
ELSE, FEELFILL = BLANK
DEFINE FEELNOUN:
IF (AD01a = 1), THEN FEELNOUN = “sadness, discouragement, or lack of interest”
IF (AD01a = 2 OR DK/REF), THEN FEELNOUN = “sadness or discouragement”
IF (AD01b = 1), THEN FEELNOUN = “sadness or lack of interest”
IF (AD01b = 2 OR DK/REF), THEN FEELNOUN = “sadness”
IF (AD02 = 1), THEN FEELNOUN = “discouragement or lack of interest”
IF (AD02 = 2 OR DK/REF), THEN FEELNOUN = “discouragement”
IF (AD09 = 1), THEN FEELNOUN = “lack of interest in most things”
ELSE FEELNOUN = BLANK
DEFINE NUMPROBS
IF AD01a NE BLANK OR AD01b = 1 OR AD02 = 1, THEN NUMPROBS = “these problems”
IF AD01b = (2 OR DK/REF) OR AD02 = (2 OR DK/REF) OR AD09 = 1, THEN NUMPROBS = “this problem”
ELSE NUMPROBS = BLANK
DEFINE WASWERE:
IF AD01a NE BLANK OR AD01b = 1 OR AD02 = 1, THEN WASWERE = “were”
IF AD01b = (2 OR DK/REF) OR AD02 = (2 OR DK/REF) OR AD09 = 1, THEN WASWERE = “was”
ELSE WASWERE = BLANK
AD12

[IF AD01a NE BLANK OR AD01b NE BLANK OR AD02 NE BLANK] Think about the times when you
[FEELFILL]. Did you ever have a period of time like this that lasted most of the day, nearly every day, for two
weeks or longer?
1
Yes
2
No
DK/REF

AD16

[IF AD09 = 1 OR AD12 = 1] Think of times lasting two weeks or longer when [NUMPROBS] with your mood
[WASWERE] most severe and frequent. During those times, how long did your [FEELNOUN] usually last?
1
2
3
4
DK/REF

AD17

[IF AD16 = 2, 3, 4, OR DK/REF] Still thinking of times lasting two weeks or longer when [NUMPROBS] with your
mood [WASWERE] most severe and frequent, how severe was your emotional distress during those times?
1
2
3
4
DK/REF

AD18

Less than 1 hour
At least 1 hour but no more than 3 hours
At least 3 hours but no more than 5 hours
5 hours or more

Mild
Moderate
Severe
Very severe

[IF AD16 = 2, 3, 4, OR DK/REF] Again, think of times lasting two weeks or longer when [NUMPROBS] with your
mood [WASWERE] most severe and frequent.
How often, during those times, was your emotional distress so severe that nothing could cheer you up?
1
2
3
4
DK/REF

AD19

Often
Sometimes
Rarely
Never

[IF AD16 = 2, 3, 4, OR DK/REF] Once again, please think of times lasting two weeks or longer when [NUMPROBS]
with your mood [WASWERE]most severe and frequent.

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350

How often, during those times, was your emotional distress so severe that you could not carry out your daily
activities?
1
2
3
4
DK/REF
AD21

Often
Sometimes
Rarely
Never

[IF AD16 = (2, 3, 4 OR DK/REF) AND NOT (AD17 = 1 AND AD18 = 4 AND AD19 = 4) AND (ASC21=1 OR
ASC22=1 OR ASC23=1) AND AD09 NE (2 OR DK/REF)] People who have problems with their mood often have
other problems at the same time. These problems may include things like changes in:






sleep
appetite
energy
the ability to concentrate and remember
feelings of low self-worth

Did you ever have any of these problems during a period of time when you [FEELFILL] for two weeks or longer?
1
Yes
2
No
DK/REF

AD22

[IF AD21 = 1] Think again about these other problems we just mentioned. They include things like changes in






sleep
appetite
energy
the ability to concentrate and remember
feelings of low self-worth

Please think of a time when you [FEELFILL] for two weeks or longer and you also had the largest number of these
other problems at the same time.
Is there one particular time like this that stands out in your mind as the worst one you ever had?
1
Yes
2
No
DK/REF
AD22a

[IF AD22 = 1] How old were you when that worst period of time started?
__________ YEARS OLD [RANGE: 1-110]
DK/REF

AD22c

[IF AD22 = 2 OR DK/REF] Then think of the most recent time when you [FEELFILL] for two weeks or longer and
you also had the largest number of these other problems at the same time.
How old were you when that time started?

__________ YEARS OLD
DK/REF
DEFINE TIMEFILL:
IF AD22a NE BLANK, THEN TIMEFILL = ‘worst’
IF AD22c NE BLANK, THEN TIMEFILL = ‘most recent’
AD24a

[IF AD22a NE BLANK] In answering the next questions, think about the period of time when your [FEELNOUN] and
other problems were the worst.

May 23, 2012

351

[IF AD22c NE BLANK] In answering the next questions, think about the most recent period of time when you
[FEELFILL] and had other problems at the same time.
During that time, did you feel sad, empty, or depressed most of the day nearly every day?
1
Yes
2
No
DK/REF
AD24c

[IF AD22a NE BLANK OR AD22c NE BLANK] During that [TIMEFILL] period of time, did you feel discouraged
about how things were going in your life most of the day nearly every day?
1
Yes
2
No
DK/REF

AD24e

[IF AD22a NE BLANK OR AD22c NE BLANK] During that [TIMEFILL] period of time, did you lose interest in
almost all things like work and hobbies and things you like to do for fun?
1
Yes
2
No
DK/REF

AD24f

[IF AD22a NE BLANK OR AD22c NE BLANK] During that [TIMEFILL] period of time, did you lose the ability to
take pleasure in having good things happen to you, like winning something or being praised or complimented?
1
Yes
2
No
DK/REF

AD26a

[IF ANY AD24a – AD24f = 1] The next questions are about changes in appetite and weight.
[IF AD22a NE BLANK] In answering the next questions, think about the period of time when your [FEELNOUN] and
other problems were the worst.
[IF AD22c NE BLANK] In answering the next questions, think about the most recent period of time when you
[FEELFILL] and had other problems at the same time.
Did you have a much smaller appetite than usual nearly every day during that time?
1
Yes
2
No
DK/REF

AD26b

[IF AD26a = 2 OR DK/REF] Did you have a much larger appetite than usual nearly every day?
1
Yes
2
No
DK/REF

AD26c

[IF AD26a = 2 OR DK/REF] Did you gain weight without trying to during that [TIMEFILL] period of time?
1
Yes
2
No
DK/REF

AD26c1 [IF AD26c = 1 AND (AD22a ≤ 21 OR AD22c ≤ 21)] Did you gain weight without trying to because you were
growing?
1
Yes
2
No
DK/REF

May 23, 2012

352

AD26c2 [IF AD26c = 1 AND AD26c1 NE YES AND QD01 = 9] Did you gain weight without trying to because you were
pregnant?
1
Yes
2
No
DK/REF
AD26d

[IF AD26c = 1 AND AD26c1 NE YES AND AD26c2 NE YES] How many pounds did you gain?
Please enter your answer as a whole number.
# OF POUNDS:__________ [RANGE: 0-200]
DK/REF

AD26e

[IF (AD26a = 1 OR AD26c=(2 OR DK/REF)] Did you lose weight without trying to?
1
Yes
2
No
DK/REF

AD26e1 [IF AD26e = 1] Did you lose weight without trying to because you were sick or on a diet?
1
Yes
2
No
DK/REF
AD26f

[IF AD26e1 = 2 OR DK/REF] How many pounds did you lose?
Please enter your answer as a whole number.
# OF POUNDS:__________ [RANGE: 0-200]
DK/REF

AD26g

[IF AD26a NE BLANK]
[IF AD22a NE BLANK] Again, please think about the period of time when your [FEELNOUN] and other problems
were the worst.
[IF AD22c NE BLANK] Again, please think about the most recent period of time when you [FEELFILL] and had
other problems at the same time.
Did you have a lot more trouble than usual falling asleep, staying asleep, or waking too early nearly every night during
that [TIMEFILL] period of time?
1
Yes
2
No
DK/REF

AD26h

[IF AD26g = 2 OR DK/REF] During that [TIMEFILL] period of time, did you sleep a lot more than usual nearly
every night?
1
Yes
2
No
DK/REF

AD26j

[IF AD26a NE BLANK] During that [TIMEFILL] period of time, did you feel tired or low in energy nearly every day,
even when you had not been working very hard?
1
Yes
2
No
DK/REF

AD26l

[IF AD26a NE BLANK] Did you talk or move more slowly than is normal for you nearly every day?

May 23, 2012

353

1
Yes
2
No
DK/REF
AD26m [IF AD26l = 1] Did anyone else notice that you were talking or moving slowly?
1
Yes
2
No
DK/REF
AD26n

[IF AD26l = 2 OR DK/REF] Were you so restless or jittery nearly every day that you paced up and down or couldn't sit
still?
1
Yes
2
No
DK/REF

AD26o

[AD26n = 1] Did anyone else notice that you were restless?
1
Yes
2
No
DK/REF

AD26p

[IF AD26a NE BLANK] The next questions are about changes in your ability to concentrate, and your feelings about
yourself.
[IF AD22a NE BLANK] Again, in answering these questions, think about the period of time when your [FEELNOUN]
and other problems were the worst.
[IF AD22c NE BLANK] Again, in answering these questions, think about the most recent period of time when you
[FEELFILL] and had other problems at the same time.
During that [TIMEFILL] time, did your thoughts come much more slowly than usual or seem confused nearly every
day?
1
Yes
2
No
DK/REF

AD26r

[IF AD26a NE BLANK] Did you have a lot more trouble concentrating than usual nearly every day?
1
Yes
2
No
DK/REF

AD26s

[IF AD26a NE BLANK] Were you unable to make decisions about things you ordinarily have no trouble deciding
about?
1
Yes
2
No
DK/REF

AD26u

[IF AD26a NE BLANK] Did you feel that you were not as good as other people nearly every day?
1
Yes
2
No
DK/REF

AD26v

[IF AD26u = 1] Did you feel totally worthless nearly every day?
1
Yes
2
No
DK/REF

May 23, 2012

354

AD26aa [IF AD26a NE BLANK] The next questions are about thoughts of death or suicide.
[IF AD22a NE BLANK] Again, in answering these questions, think about the period of time when your [FEELNOUN]
and other problems were the worst.
[IF AD22c NE BLANK] Again, in answering these questions, think about the most recent period of time when you
[FEELFILL] and had other problems at the same time.
Did you often think a lot about death, either your own, someone else’s, or death in general?
1
Yes
2
No
DK/REF
AD26bb [IF AD26a NE BLANK] During that period, did you ever think that it would be better if you were dead?
1
Yes
2
No
DK/REF
AD26cc [IF AD26a NE BLANK] Did you think about committing suicide?
1
Yes
2
No
DK/REF
AD26dd [IF AD26cc = 1] Did you make a suicide plan?
1
Yes
2
No
DK/REF
AD26ee [IF AD26cc = 1] Did you make a suicide attempt?
1
Yes
2
No
DK/REF
DEFINE D_MDEA1:
IF AD24A = 1 OR AD24C = 1, THEN D_MDEA1= 1
ELSE IF AD24A = 2 AND AD24C = 2, THEN D_MDEA1= 2
ELSE IF AD24A = DK OR AD24C = DK, THEN D_MDEA1= DK
ELSE IF AD24A = REF OR AD24C = REF, THEN D_MDEA1= REF
ELSE D_MDEA1= BLANK
DEFINE D_MDEA2:
IF AD24E = 1 OR AD24F = 1, THEN D_MDEA2= 1
ELSE IF AD24E = 2 AND AD24F = 2, THEN D_MDEA2= 2
ELSE IF AD24E = DK OR AD24F = DK, THEN D_MDEA2= DK
ELSE IF AD24E = REF OR AD24F = REF, THEN D_MDEA2= REF
ELSE D_MDEA2= BLANK
DEFINE D_MDEA3:
IF AD26A = 1 OR AD26B = 1 OR AD26D ≥10 OR AD26F ≥10, THEN D_MDEA3= 1
ELSE IF AD26A = 2 AND AD26B = 2 AND ((AD26D < 10 OR AD26F < 10) OR (AD26C = (2 OR BLANK) AND AD26E =
(2 OR BLANK)) OR (AD26C = 1 AND (AD26C1 = 1 OR AD26C2 = 1)) OR (AD26E = 1 AND AD26E1 = 1)),
THEN D_MDEA3= 2
ELSE IF AD26A = DK OR AD26B = DK OR AD26C = DK OR AD26D = DK OR AD26E = DK OR AD26F = DK, THEN
D_MDEA3= DK
ELSE IF AD26A = REF OR AD26B = REF OR AD26C = REF OR AD26D = REF OR AD26E = REF OR AD26F = REF,
THEN D_MDEA3= REF
ELSE D_MDEA3= BLANK
DEFINE D_MDEA4:
IF AD26G = 1 OR AD26H = 1, THEN D_MDEA4= 1
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355

ELSE IF AD26G = 2 AND AD26H = 2, THEN D_MDEA4= 2
ELSE IF AD26G = DK OR AD26H = DK, THEN D_MDEA4= DK
ELSE IF AD26G = REF OR AD26H = REF, THEN D_MDEA4= REF
ELSE D_MDEA4= BLANK
DEFINE D_MDEA5:
IF AD26M = 1 OR AD26O = 1, THEN D_MDEA5= 1
ELSE IF (AD26L = (2 OR DK/REF) AND (AD26N = (2 OR DK/REF) OR AD26O = 2)) OR AD26M = 2, THEN D_MDEA5=
2
ELSE IF AD26L = DK OR AD26M = DK OR AD26N = DK OR AD26O = DK, THEN D_MDEA5= DK
ELSE IF AD26L = REF OR AD26M = REF OR AD26N = REF OR AD26O = REF, THEN D_MDEA5= REF
ELSE D_MDEA5= BLANK
DEFINE D_MDEA6:
D_MDEA6= AD26J
DEFINE D_MDEA7:
IF AD26V = 1, THEN D_MDEA7= 1
ELSE IF AD26U = (2 OR DK/REF) OR AD26V = 2, THEN D_MDEA7= 2
ELSE D_MDEA7=AD26V
ELSE D_MDEA7= BLANK
DEFINE D_MDEA8:
IF AD26P = 1 OR AD26R = 1 OR AD26S = 1, THEN D_MDEA8= 1
ELSE IF AD26P = 2 AND AD26R = 2 AND AD26S = 2, THEN D_MDEA8= 2
ELSE IF AD26P = DK OR AD26R = DK OR AD26S = DK, THEN D_MDEA8= DK
ELSE IF AD26P = REF OR AD26R = REF OR AD26S = REF, THEN D_MDEA8= REF
ELSE D_MDEA8= BLANK
DEFINE D_MDEA9:
IF AD26AA = 1 OR D26BB = 1 OR AD26CC = 1 OR AD26DD = 1 OR AD26EE = 1, THEN D_MDEA9= 1
ELSE IF AD26AA = 2 AND AD26BB = 2 AND AD26CC = 2, THEN D_MDEA9= 2
ELSE IF AD26AA = DK OR AD26BB = DK OR AD26CC = DK OR AD26DD = DK OR AD26EE = DK, THEN D_MDEA9=
DK
ELSE IF AD26AA = REF OR AD26BB = REF OR AD26CC = REF OR AD26DD = REF OR AD26EE = REF, THEN
D_MDEA9= REF
ELSE D_MDEA9= BLANK
DEFINE DSMMDEA2:
IF SUM (D_MDEA1 = 1, D_MDEA2 = 1, D_MDEA3 = 1, D_MDEA4 = 1, D_MDEA5 = 1, D_MDEA6 = 1, D_MDEA7 = 1,
D_MDEA8 = 1, D_MDEA9 = 1) ≥ 5, THEN DSMMDEA2 = 1
ELSE IF SUM (D_MDEA1 = (1 OR DK/REF), D_MDEA2 = (1 OR DK/REF), D_MDEA3 = (1 OR DK/REF), D_MDEA4 = (1
OR DK/REF), D_MDEA5 = (1 OR DK/REF), D_MDEA6 = (1 OR DK/REF), D_MDEA7 = (1 OR DK/REF), D_MDEA8 = (1
OR DK/REF), D_MDEA9 = (1 OR DK/REF)) < 5 AND N(OF D_MDEA1-D_MDEA9) > 0, THEN DSMMDEA2 = 2
ELSE IF D_MDEA1 = DK OR D_MDEA2 = DK OR D_MDEA3 = DK OR D_MDEA4 = DK OR D_MDEA5 = DK OR
D_MDEA6 = DK OR D_MDEA7 = DK OR D_MDEA8 = DK OR D_MDEA9 = DK, THEN DSMMDEA2 = DK
ELSE IF D_MDEA1 = REF OR D_MDEA2 = REF OR D_MDEA3 = REF OR D_MDEA4 = REF OR D_MDEA5 = REF OR
D_MDEA6 = REF OR D_MDEA7 = REF OR D_MDEA8 = REF OR D_MDEA9 = REF, THEN DSMMDEA2 = REF
AD28

[IF D_MDEA9 = 1 OR DSMMDEA2 = 1] You mentioned having some of the problems I just asked you about.
During that [TIMEFILL] period of time, how much did your [FEELNOUN]
and these other problems interfere with your work, your social life, or your personal relationships?
1
2
3
4
5
DK/REF

AD28a

Not at all
A little
Some
A lot
Extremely

[IF AD28 NE (BLANK OR 1)] During that [TIMEFILL] period of time, how often were you unable to carry out your
daily activities because of these problems with your mood?
1

May 23, 2012

Often
356

2
Sometimes
3
Rarely
4
Never
DK/REF
AD37

[IF AD28 NE BLANK] Think of the very first period of time in your life lasting two weeks or longer when you
[FEELFILL] for most of the day nearly every day and also had some of the other problems we just asked about.
Can you remember your exact age?
1
Yes
2
No
DK/REF

AD37a

[IF AD37 = 1] How old were you?
__________ YEARS OLD [RANGE: 1-110]
DK/REF

AD37b

[IF AD37 = 2 OR DK] About how old were you when you first had a period of time like this?
AGE:__________ [RANGE: 1-110]
DK/REF

AD52

[IF AD28 NE BLANK] In your entire life, how many times did you feel [FEELNOUN] for two weeks or longer
while also having some of the other problems we asked about?
If you are not sure of your answer, just make your best guess.
______________
DK/REF

AD38

NUMBER [RANGE: 1-1000]

[IF AD28 NE BLANK ] In the past 12 months, did you have a period of time when you felt [FEELNOUN] for two
weeks or longer while also having some of the other problems we asked about?
1
Yes
2
No
DK/REF

AD66a

[IF AD38 = 1] Think about the time in the past 12 months when [NUMPROBS] with your mood [WASWERE] most
severe.
Using the 0 to 10 scale shown below, where 0 means no interference and 10 means very severe interference, select the
number that describes how much [NUMPROBS] interfered with your ability to do each of the following activities
during that period. You can use any number between 0 and 10 to answer.
How much did your [FEELNOUN] interfere with your ability to do home management tasks, like cleaning,
shopping, and working around the house, apartment, or yard?
No
Interference
│
0
DK/REF

AD66b

Mild
1

2

Moderate
3

4

5

Severe
6

7

8

Very Severe
Interference
│
9
10

[IF AD38 = 1] During that time in the past 12 months when your [FEELNOUN] was most severe, how much did this
interfere with your ability to work?
You can use any number between 0 and 10 to answer.
No
Interference
│

May 23, 2012

Mild

Moderate

357

Severe

Very Severe
Interference
│

0
DK/REF

AD66c

1

2

3

4

5

6

7

8

9

10

[IF AD38 = 1]How much did your [FEELNOUN] interfere with your ability to form and maintain close
relationships with other people during that period of time?
You can use any number between 0 and 10 to answer.
No
Interference
│
0
DK/REF

AD66d
time?

Mild
1

2

Moderate
3

4

5

Severe
6

7

8

Very Severe
Interference
│
9
10

[IF AD38 = 1] How much did [NUMPROBS] interfere with your ability to have a social life during that period of
You can use any number between 0 and 10 to answer.
No
Interference
│
0
DK/REF

AD68

Mild
1

2

Moderate
3

4

5

Severe
6

7

8

Very Severe
Interference
│
9
10

[IF ANY RESPONSES TO AD66a – AD66d = 1-10] About how many days out of 365 in the past 12 months were you
totally unable to work or carry out your normal activities because of your [FEELNOUN]?
You can use any number between 0 and 365 to answer.
# OF DAYS:__________ [RANGE: 0-365]
DK/REF

AD86

[IF AD38 NE BLANK] Here is a list of professionals some people talk to about the problems we have been asking
about:
General practitioner or family doctor
Other medical doctor like a cardiologist, gynecologist, urologist
Psychologist
Psychiatrist or psychotherapist
Social Worker
Counselor
Other mental health professional, like a mental health nurse
A nurse, occupational therapist, or other health professional
A religious or spiritual advisor like a minister, priest, or rabbi
Another healer, like an herbalist, chiropractor, acupuncturist, or massage therapist
At any time in the past 12 months, did you see or talk to a medical doctor or other professional about your
[FEELNOUN]?
1
Yes
2
No
DK/REF

AD86a

[IF AD86 = 1] During the past 12 months, which professionals did you see or talk to about [NUMPROBS] with your
mood?
Select all that apply from the categories shown below. To select more than one answer from the list, press the space bar
between each number you type. When you have finished, press the [ENTER] key to go to the next question.
1
2

May 23, 2012

General practitioner or family doctor
Other medical doctor like a cardiologist, gynecologist, urologist
358

3
4
5
6
7
8
9
10
11
DK/REF
AD86aSP

Psychologist
Psychiatrist or psychotherapist
Social Worker
Counselor
Other mental health professional, like a mental health nurse
A nurse, occupational therapist, or other health professional
A religious or spiritual advisor like a minister, priest, or rabbi
An herbalist, chiropractor, acupuncturist, or massage therapist
Another type of helping professional
[IF AD86a = 11]Please type in the other type of professional you saw or talked to during the past 12
months about your [FEELNOUN]. When you have finished typing in your answer, press the [ENTER] key
to go to the next question.
______________[RANGE: 50 CHARACTERS]
DK/REF

AD86b

[IF AD86 = 1] Are you currently receiving professional treatment or counseling for [NUMPROBS] with your mood?
1
Yes
2
No
DK/REF

AD86c

[IF AD38 NE BLANK] During the past 12 months, did you take prescription medication that was prescribed for
[NUMPROBS]?
1
Yes
2
No
DK/REF

AD86d

[IF AD86c = 1] Are you currently taking prescription medication that was prescribed for [NUMPROBS]?
1
Yes
2
No
DK/REF

AD86e

[IF AD86c = 1] During the past 12 months, how much has this prescription medication helped you?
1
2
3
4
5
DK/REF

AD86f

Not at all
A little
Some
A lot
Extremely

[IF AD86 = 1] During the past 12 months, how much has treatment or counseling helped you?
1
2
3
4
5
DK/REF

May 23, 2012

Not at all
A little
Some
A lot
Extremely

359

May 23, 2012

360

Youth Mental Health Service Utilization
(Section Administered to 12 - 17 Year Old Respondents Only)

INTROYSU

[IF CURNTAGE = 12 - 17] These next questions are about treatment and counseling for problems with your
behaviors or emotions that were not caused by alcohol or drugs.
Press [ENTER] to continue.

YSU01

[IF CURNTAGE = 12 - 17] During the past 12 months, have you stayed overnight or longer in any type of
hospital to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol
or drugs?
1
Yes
2
No
DK/REF

YSU02

[IF YSU01 = 1] During the past 12 months, how many nights altogether did you stay in a hospital to receive
treatment or counseling for emotional or behavioral problems that were not caused by alcohol or drugs?
# OF NIGHTS:
DK/REF

YSU03

[RANGE: 1 - 366]

[IF YSU01 = 1] Think about the last time you stayed overnight or longer in a hospital to receive treatment or
counseling for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason
you were admitted there?
To select more than one reason from the list, press the space bar between each number you type. When you have
finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
DK/REF

YSU03a

You thought about killing yourself or tried to kill yourself
You felt depressed
You felt very afraid and tense
You were breaking rules and “acting out”
You had eating problems
Some other reason

[IF ANY ENTRY IN YSU03 = 6] What was the other emotional or behavioral problem for which you last
stayed overnight in a hospital?
To select more than one reason from the list, press the space bar between each number you type. When you
have finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
7
DK/REF

YSU03SP

You had trouble controlling your anger
You had gotten into physical fights
You had problems at home or in your family
You had problems with your friends
You had problems with people other than your friends or family
You had problems at school
Some other reason

[IF ANY ENTRY IN YSU03a = 7] Please type in the most important other reason for your last overnight stay in
a hospital to receive treatment or counseling for emotional or behavioral problems that were not caused by
alcohol or drugs. You do not need to give a detailed description — just a few words will be okay. When you have
finished typing your answer, press the [ENTER] key to go to the next question.
_______________
DK/REF

YSU04

May 23, 2012

[IF CURNTAGE = 12 - 17] During the past 12 months, did you stay overnight or longer in a residential
treatment center to receive treatment or counseling for emotional or behavioral problems that were not caused by
361

alcohol or drugs?
1
Yes
2
No
DK/REF
YSU05

[IF YSU04=1] During the past 12 months, how many nights altogether did you stay in a residential treatment
center to receive treatment for emotional or behavioral problems that were not caused by alcohol or drugs?
# OF NIGHTS: _________ [RANGE: 1 - 366]
DK/REF

YSU06

[IF YSU04=1] Think about the last time you stayed overnight or longer in a residential treatment center to
receive treatment for emotional or behavioral problems that were not caused by alcohol or drugs. What was the
reason you were admitted there?
To select more than one reason from the list, press the space bar between each number you type. When you have
finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
DK/REF

YSU06a

You thought about killing yourself or tried to kill yourself.
You felt depressed
You felt very afraid and tense
You were breaking rules and “acting out”
You had eating problems
Some other reason

[IF ANY ENTRY IN YSU06 = 6] What was the other emotional or behavioral problem for which you last
stayed overnight in a residential treatment center?
To select more than one reason from the list, press the space bar between each number you type. When you
have finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
7
DK/REF

YSU06SP

You had trouble controlling your anger
You had gotten into physical fights
You had problems at home or in your family
You had problems with your friends
You had problems with people other than your friends or family
You had problems at school
Some other reason

[IF ANY ENTRY IN YSU06a=7] Please type in the most important other reason for your last overnight stay in a
residential treatment center to receive treatment or counseling for emotional or behavioral problems that were
not caused by alcohol or drugs. You do not need to give a detailed description — just a few words will be okay.
When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF

YSU07

[IF CURNTAGE = 12 - 17] During the past 12 months, did you stay overnight or longer in foster care or in a
therapeutic foster care home because you had emotional or behavioral problems that were not caused by alcohol
or drugs?
1
Yes
2
No
DK/REF

YSU08

[IF YSU07 = 1] During the past 12 months, how many nights altogether did you stay in foster care or in a
therapeutic foster care home because you had emotional or behavioral problems that were not caused by alcohol
or drugs?
# OF NIGHTS: _________ [RANGE: 1 - 366]
DK/REF

May 23, 2012

362

YSU09

[IF YSU07=1] Think about the last time you stayed overnight or longer in foster care or in a therapeutic
foster care home because you had emotional or behavioral problems that were not caused by alcohol or drugs.
What was the reason you were placed there?
To select more than one reason from the list, press the space bar between each number you type. When you have
finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
DK/REF

You thought about killing yourself or tried to kill yourself.
You felt depressed
You felt very afraid and tense
You were breaking rules and “acting out”
You had eating problems
Some other reason

[IF ANY ENTRY IN YSU09 = 6] What was the other emotional or behavioral problem for which you last
stayed overnight or longer in foster care or a therapeutic foster care home?

YSU09a

To select more than one reason from the list, press the space bar between each number you type. When you
have finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
7
DK/REF
YSU09SP

You had trouble controlling your anger
You had gotten into physical fights
You had problems at home or in your family
You had problems with your friends
You had problems with people other than your friends or family
You had problems at school
Some other reason

[IF ANY ENTRY IN YSU09a =7] Please type in the most important other reason for your last overnight stay in
foster care or in a therapeutic foster care home to receive treatment or counseling for emotional or behavioral
problems that were not caused by alcohol or drugs. You do not need to give a detailed description — just a few
words will be okay. When you have finished typing your answer, press the [ENTER] key to go to the next
question.
_____________
DK/REF

YSU10

[IF CURNTAGE = 12 - 17] During the past 12 months, did you receive treatment or counseling at a partial day
hospital or day treatment program because you had problems with your behavior or emotions that were not
caused by alcohol or drugs?
1
Yes
2
No
DK/REF

YSU11

[IF YSU10 = 1] During the past 12 months, how many times did you visit a partial day hospital or day
treatment program because you had emotional or behavioral problems that were not caused by alcohol or drugs?
# OF TIMES: _________ [RANGE: 1 - 366]
DK/REF

YSU12

[IF YSU10 =1] Think about the last time you visited a partial day hospital or day treatment program because
you had emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason for your
visit?
To select more than one reason from the list, press the space bar between each number you type. When you have
finished, press the [ENTER] key to go to the next question.
1
2
3
4
5

May 23, 2012

You thought about killing yourself or tried to kill yourself.
You felt depressed
You felt very afraid and tense
You were breaking rules and “acting out”
You had eating problems
363

6
Some other reason
DK/REF
YSU12a

[IF ANY ENTRY IN YSU12 = 6] What was the other emotional or behavioral problem for which you last
visited a partial day hospital or day treatment program?
To select more than one reason from the list, press the space bar between each number you type. When you
have finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
7
DK/REF

YSU12SP

You had trouble controlling your anger
You had gotten into physical fights
You had problems at home or in your family
You had problems with your friends
You had problems with people other than your friends or family
You had problems at school
Some other reason

[IF ANY ENTRY IN YSU12a =7] Please type in the most important other reason for your last visit to a partial
day hospital or day treatment program to receive treatment or counseling for emotional or behavioral problems
that were not caused by alcohol or drugs. You do not need to give a detailed description — just a few words will
be okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF

YSU13

[IF CURNTAGE = 12 - 17] During the past 12 months, did you receive treatment or counseling at a mental
health clinic or center because you had problems with your behavior or emotions that were not caused by alcohol
or drugs?
1
Yes
2
No
DK/REF

YSU14

[IF YSU13 = 1] During the past 12 months, how many times did you visit a mental health clinic or center to
receive treatment or counseling because you had emotional or behavioral problems that were not caused by
alcohol or drugs?
# OF TIMES: _________ [RANGE: 1 - 366]
DK/REF

YSU15

[IF YSU13 =1] Think about the last time you visited a mental health clinic or center to receive treatment or
counseling for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason
for your visit?
To select more than one reason from the list, press the space bar between each number you type. When you have
finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
DK/REF

YSU15a

You thought about killing yourself or tried to kill yourself.
You felt depressed
You felt very afraid and tense
You were breaking rules and “acting out”
You had eating problems
Some other reason

[IF ANY ENTRY IN YSU15 = 6] What was the other emotional or behavioral problem for which you last
visited a mental health clinic or center?
To select more than one reason from the list, press the space bar between each number you type. When you
have finished, press the [ENTER] key to go to the next question.
1
2
3

May 23, 2012

You had trouble controlling your anger
You had gotten into physical fights
You had problems at home or in your family
364

4
5
6
7
DK/REF
YSU15SP

You had problems with your friends
You had problems with people other than your friends or family
You had problems at school
Some other reason

[IF ANY ENTRY IN YSU15a =7] Please type in the most important other reason for your last visit to a mental
health clinic or center to receive treatment or counseling for emotional or behavioral problems that were not
caused by alcohol or drugs. You do not need to give a detailed description — just a few words will be okay.
When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF

YSU16

[IF CURNTAGE = 12 - 17] During the past 12 months, did you receive treatment or counseling from a private
therapist, psychologist, psychiatrist, social worker, or counselor for emotional or behavioral problems that
were not caused by alcohol or drugs?
1
Yes
2
No
DK/REF

YSU17

[IF YSU16 = 1] During the past 12 months, how many times did you receive treatment or counseling from a
private therapist, psychologist, psychiatrist, social worker, or counselor for emotional or behavioral problems
that were not caused by alcohol or drugs?
# OF TIMES:
DK/REF

YSU18

[RANGE: 1 - 366]

[IF YSU16 = 1] Think about the last time you visited a private therapist, psychologist, psychiatrist, social
worker, or counselor to receive treatment or counseling for emotional or behavioral problems that were not
caused by alcohol or drugs. What was the reason for your visit?
To select more than one reason from the list, press the space bar between each number you type. When you have
finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
DK/REF

YSU18a

You thought about killing yourself or tried to kill yourself.
You felt depressed
You felt very afraid and tense
You were breaking rules and “acting out”
You had eating problems
Some other reason

[IF ANY ENTRY IN YSU18 = 6] What was the other emotional or behavioral problem for which you last
visited a private therapist, psychologist, psychiatrist, social worker or counselor?
To select more than one reason from the list, press the space bar between each number you type. When you
have finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
7
DK/REF

YSU18SP

You had trouble controlling your anger
You had gotten into physical fights
You had problems at home or in your family
You had problems with your friends
You had problems with people other than your friends or family
You had problems at school
Some other reason

[IF ANY ENTRY IN YSU18a =7] Please type in the most important other reason for your last visit to a private
therapist, psychologist, psychiatrist, social worker, or counselor for emotional or behavioral problems that
were not caused by alcohol or drugs. You do not need to give a detailed description — just a few words will be
okay. When you have finished typing your answer, press the [ENTER] key to go to the next question.
_____________

May 23, 2012

365

DK/REF
YSU19

[IF CURNTAGE = 12 -17] During the past 12 months, did you receive treatment or counseling from an in-home
therapist, counselor, or family preservation worker for emotional or behavioral problems that were not caused
by alcohol or drugs?
1
Yes
2
No
DK/REF

YSU20

[IF YSU19 = 1] During the past 12 months, how many times did you receive treatment or counseling from an inhome therapist, counselor, or family preservation worker for emotional or behavioral problems that were not
caused by alcohol or drugs?
# OF TIMES:
DK/REF

YSU21

[RANGE: 1 - 366]

[IF YSU19 = 1] Think about the last time you saw an in-home therapist, counselor, or family preservation
worker to receive treatment or counseling for emotional or behavioral problems that were not caused by alcohol
or drugs. What was the reason for this visit?
To select more than one reason from the list, press the space bar between each number you type. When you have
finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
DK/REF

YSU21a

You thought about killing yourself or tried to kill yourself.
You felt depressed
You felt very afraid and tense
You were breaking rules and “acting out”
You had eating problems
Some other reason

[IF ANY ENTRY IN YSU21 = 6] What was the other emotional or behavioral problem for which you last
saw an in-home therapist, counselor, or family preservation worker?
To select more than one reason from the list, press the space bar between each number you type. When you
have finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
7
DK/REF

YSU21SP

You had trouble controlling your anger
You had gotten into physical fights
You had problems at home or in your family
You had problems with your friends
You had problems with people other than your friends or family
You had problems at school
Some other reason

[IF ANY ENTRY IN YSU21a=7] Please type in the most important other reason you last saw an in-home
therapist, counselor, or family preservation worker for emotional or behavioral problems that were not caused
by alcohol or drugs. You do not need to give a detailed description — just a few words will be okay. When you
have finished typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF

YSU22

[IF CURNTAGE = 12 -17] During the past 12 months, did you receive treatment or counseling from a
pediatrician or other family doctor for emotional or behavioral problems that were not caused by alcohol or
drugs?
1
Yes
2
No
DK/REF

YSU23

May 23, 2012

[IF YSU22 = 1] During the past 12 months, how many times did you receive treatment or counseling from a
pediatrician or other family doctor for emotional or behavioral problems that were not caused by alcohol or
366

drugs?
# OF TIMES:
DK/REF

[RANGE: 1 - 366]

[IF YSU22 = 1] Think about the last time you visited a pediatrician or other family doctor to receive treatment
or counseling for emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason
for your visit?

YSU24

To select more than one reason from the list, press the space bar between each number you type. When you have
finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
DK/REF

You thought about killing yourself or tried to kill yourself.
You felt depressed
You felt very afraid and tense
You were breaking rules and “acting out”
You had eating problems
Some other reason

[IF ANY ENTRY IN YSU24 = 6] What was the other emotional or behavioral problem for which you last
visited a pediatrician or other family doctor?

YSU24a

To select more than one reason from the list, press the space bar between each number you type. When you
have finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
7
DK/REF
YSU24SP

You had trouble controlling your anger
You had gotten into physical fights
You had problems at home or in your family
You had problems with your friends
You had problems with people other than your friends or family
You had problems at school
Some other reason

[IF ANY ENTRY IN YSU24a=7] Please type in the most important other reason for your last visit to a
pediatrician or other family doctor for emotional or behavioral problems that were not caused by alcohol or
drugs. You do not need to give a detailed description — just a few words will be okay. When you have finished
typing your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF

YSU30

[IF CURNTAGE = 12 – 17 and YE09=1] Sometimes students get treatment or counseling through the school system.
This counseling is often provided by school social workers, school psychologists or school counselors.
During the past 12 months, that is, since [DATEFILL], did you receive any treatment or counseling from a school
social worker, a school psychologist, or a school counselor for emotional or behavioral problems that were not caused
by alcohol or drugs?
1
Yes
2
No
DK/REF

YSU31

[IF YSU30 = 1] Think about the last time you talked with a school social worker, school psychologist, or school
counselor about emotional or behavioral problems that were not caused by alcohol or drugs. What was the reason
for your talk?
To select more than one reason from the list, press the space bar between each number you type. When you have
finished, press the [ENTER] key to go to the next question.
1
2

May 23, 2012

You thought about killing yourself or tried to kill yourself.
You felt depressed
367

3
4
5
6
DK/REF

You felt very afraid and tense
You were breaking rules and “acting out”
You had eating problems
Some other reason

[IF ANY ENTRY IN YSU31 = 6] What was the other reason for your last talk with a school social
worker, school psychologist or school counselor ?

YSU31a

To select more than one reason from the list, press the space bar between each number you type. When you
have finished, press the [ENTER] key to go to the next question.
1
2
3
4
5
6
7
DK/REF
YSU31SP

You had trouble controlling your anger
You had gotten into physical fights
You had problems at home or in your family
You had problems with your friends
You had problems with people other than your friends or family
You had problems at school
Some other reason

[IF ANY ENTRY IN YSU31a=7] Please type in the most important other reason for your last talk with a
school social worker, school psychologist or school counselor. You do not need to give a detailed description —
just a few words will be okay. When you have finished typing your answer, press the [ENTER] key to go to the
next question.
_____________
DK/REF

YSU32

[IF CURNTAGE = 12 – 17 AND YE09=1] At any time during the past 12 months, that is since [DATEFILL], did you
attend a school for students with emotional or behavioral problems?
1
Yes
2
No
DK/REF

YSU33

[IF CURNTAGE = 12 – 17 and YSU32=2 or DK/ref] Regular schools sometimes provide programs for students with
emotional or behavioral problems.
At any time during the past 12 months, did you participate in a school program that was just for students with
emotional or behavioral problems?
1
Yes
2
No
DK/REF

YSU34 [IF CURNTAGE = 12 – 17 ] These next questions are about experiences with the justice system.
During the past 12 months, that is, since [DATEFILL], did you stay overnight or longer in any type of juvenile
detention center, sometimes called “juvie”, prison, or jail?
1
Yes
2
No
DK/REF

YSU35

[IF YSU34=1] During the past 12 months, how many nights altogether did you stay in any type of juvenile detention
center, prison or jail?
# OF NIGHTS:
DK/REF

May 23, 2012

[RANGE: 1 - 366]

368

YSU36

[IF YSU34 = 1] Sometimes, the court system provides treatment or counseling in juvenile detention centers, prisons
or jails. These services are often provided by psychiatrists, psychologists, social workers or counselors who work
for the court system.
While you were in a juvenile detention center, prison or jail during the past 12 months, did you receive treatment or
counseling for emotional or behavioral problems that were not caused by alcohol or drugs?
1
Yes
2
No
DK/REF

May 23, 2012

369

May 23, 2012

370

Adolescent Depression
YDS21

[IF CURNTAGE = 12-17] Have you ever in your life had a period of time lasting several days or longer when most of
the day you felt sad, empty, or depressed?
1
Yes
2
No
DK/REF

YDS22

[IF YDS21 = 2 OR DK/REF] Have you ever had a period of time lasting several days or longer when most of the day
you felt very discouraged or hopeless about how things were going in your life?
1
Yes
2
No
DK/REF

YDS23

[IF YDS22 = 2 OR DK/REF] Have you ever had a period of time lasting several days or longer when you lost interest
and became bored with most things you usually enjoy, like work, hobbies, and personal relationships?
1
Yes
2
No
DK/REF

YD01

[IF YDS21 = 1] During times when you felt sad, empty, or depressed most of the day, did you ever feel discouraged
about how things were going in your life?
1
Yes
2
No
DK/REF

YD01a

[IF YD01 = 1] During the times when you felt sad, empty, or depressed, did you ever lose interest and become
really bored with most things like school, work, hobbies, and other things that are usually fun for you, like listening to
music, watching TV, movies, or sports, playing computer games, or going out with friends?
1
Yes
2
No
DK/REF

YD01b

[YD01 = 2 OR DK/REF] During times when you felt sad, empty, or depressed, did you ever lose interest and become
really bored with most things like school, work, hobbies, and other things that are usually fun for you, like listening to
music, watching TV, movies, or sports, playing computer games, or going out with friends?
1
Yes
2
No
DK/REF

YD02

[IF YDS22 = 1] During times when you felt discouraged about how things were going in your life, did you ever lose
interest and become really bored with most things like school, work, hobbies, and other things that are usually fun for
you, like listening to music, watching TV, movies, or sports, playing computer games, or going out with friends?
1
Yes
2
No
DK/REF

YD09

[IF YDS23 = 1] Did you ever have a period of time like this that lasted most of the day almost every day for two
weeks or longer?
1
Yes
2
No
DK/REF

DEFINE FEELFILL:
May 23, 2012

371

IF (YD01a = 1), THEN FEELFILL = “were sad, discouraged, or really bored”
IF (YD01a = 2 OR DK/REF), THEN FEELFILL = “were sad or discouraged”
IF (YD01b = 1), THEN FEELFILL = “were sad or really bored”
IF (YD01b = 2 OR DK/REF) THEN FEELFILL = “were sad”
IF (YD02 = 1), THEN FEELFILL = “were discouraged or really bored”
IF (YD02 = 2 OR DK/REF), THEN FEELFILL = “were discouraged about the way things were going in your life”
IF (YD09 = 1), THEN FEELFILL = “were really bored”
ELSE, FEELFILL = BLANK
DEFINE FEELNOUN:
IF (YD01a = 1), THEN FEELNOUN = “sadness, discouragement, or boredom”
IF (YD01a = 2 OR DK/REF), THEN FEELNOUN = “sadness or discouragement”
IF (YD01b = 1), THEN FEELNOUN = “sadness or boredom”
IF (YD01b = 2 OR DK/REF), THEN FEELNOUN = “sadness”
IF (YD02 = 1), THEN FEELNOUN = “discouragement or boredom”
IF (YD02 = 2 OR DK/REF), THEN FEELNOUN = “discouragement”
IF (YD09 = 1), THEN FEELNOUN = “boredom”
ELSE FEELNOUN = BLANK
DEFINE NUMPROBS
IF YD01a NE BLANK OR YD01b = 1 OR YD02 = 1, THEN NUMPROBS = these problems
IF YD01b = (2 OR DK/REF) OR YD02 = (2 OR DK/REF) OR YD09 = 1, THEN NUMPROBS = this problem
ELSE NUMPROBS = BLANK
DEFINE WASWERE:
IF YD01a NE BLANK OR YD01b = 1 OR YD02 = 1, THEN WASWERE = “were”
IF YD01b = (2 OR DK/REF) OR YD02 = (2 OR DK/REF) OR YD09 = 1, THEN WASWERE = “was”
ELSE WASWERE = BLANK
YD12

[IF YD01a NE BLANK OR YD01b NE BLANK OR YD02 NE BLANK] Think about the times when you
[FEELFILL]. Did you ever have a period of time like this that lasted most of the day, almost every day, for two
weeks or longer?
1
Yes
2
No
DK/REF

YD16

[IF YD09 = 1 OR YD12 = 1] Think of times lasting two weeks or longer when [NUMPROBS] with your mood
[WASWERE] most severe and frequent. During those times, how long did your [FEELNOUN] usually last?
1
Less than 1 hour
2
At least 1 hour but less than 3 hours
3
At least 3 hours but less than 5 hours
4
5 hours or more
DK/REF

YD17

[IF YD16 = 2, 3, 4, OR DK/REF] Still thinking of times lasting two weeks or longer when [NUMPROBS] with your
mood [WASWERE] most severe and frequent, how strong were your bad feelings during those times?
1
Mild
2
Moderate
3
Severe
4
Very severe
DK/REF

YD18

[IF YD16 = 2, 3, 4, OR DK/REF] Again, think of times lasting two weeks or longer when [NUMPROBS] with your
mood [WASWERE] most severe and frequent.
How often, during those times, did you feel so bad that nothing could cheer you up?
1
2
3
4

May 23, 2012

Often
Sometimes
Not very often
Never
372

DK/REF
YD19

[IF YD16 = 2, 3, 4, OR DK/REF] Once again, please think of times lasting two weeks or longer when [NUMPROBS]
with your mood [WASWERE] most severe and frequent.
How often, during those times, did you feel so bad that you could not carry out your daily activities?
1
Often
2
Sometimes
3
Not very often
4
Never
DK/REF

YD21

[IF YD16 = (2, 3, 4 OR DK/REF) AND NOT (YD17 = 1 AND YD18 = 4 AND YD19 = 4) AND (YDS21=1 OR
YDS22=1 OR YDS23=1) AND YD09 NE (2 OR DK/REF)] People who have problems with their mood often have
other problems at the same time. These problems may include things like changes in:






sleep
eating
energy
the ability to keep their mind on things
feeling badly about themselves

Did you ever have any of these problems during a period of time when you [FEELFILL] for two weeks or longer?
1
Yes
2
No
DK/REF
YD22

[IF YD21=1] Think again about these other problems we just mentioned. They include things like changes in:






sleep
eating
energy
the ability to keep their mind on things
feeling badly about themselves

Can you think of the worst time when you [FEELFILL] for two weeks or longer and also had these other problems at the
same time?
1
Yes
2
No
DK/REF
YD22a

[IF YD22 = 1] How old were you when that worst period of time started?
AGE: __________ [RANGE: 1-17]
DK/REF

YD22c

[IF YD22 = 2 OR DK/REF] Then think of the most recent time you [FEELFILL] for two weeks or longer and you
had these other problems at the same time.
How old were you when that time started?
AGE: __________ [RANGE: 1-17]
DK/REF

DEFINE TIMEFILL:
IF YD22a NE BLANK, THEN TIMEFILL = ‘worst’
IF YD22c NE BLANK, THEN TIMEFILL = ‘most recent’

May 23, 2012

373

YD24a

[IF YD22a NE BLANK] In answering the next questions, think about the period of time when your [FEELNOUN] and
other problems were the worst.
[IF YD22c NE BLANK] In answering the next questions, think about the most recent period of time when you
[FEELFILL] and had other problems at the same time.
During that time, did you feel sad, empty, or depressed for most of the day nearly every day?
1
Yes
2
No
DK/REF

YD24c

[IF YD22a NE BLANK OR YD22c NE BLANK] During that [TIMEFILL] period of time, did you feel discouraged
about how things were going in your life most of the day nearly every day?
1
Yes
2
No
DK/REF

YD24e

[IF YD22a NE BLANK OR YD22c NE BLANK] During that [TIMEFILL] period of time, did you become bored with
almost everything like school, work, hobbies, and things you like to do for fun?
1
Yes
2
No
DK/REF

YD24f

[IF YD22a NE BLANK OR YD22c NE BLANK] During that [TIMEFILL] period of time, did you feel like nothing
was fun even when good things were happening?
1
Yes
2
No
DK/REF

YD26a

[IF ANY YD24a - YD24f = 1] The next questions are about changes in appetite and weight.
[IF YD22a NE BLANK] In answering these questions, think about the period of time when your [FEELNOUN] and
other problems were the worst.
[IF YD22c NE BLANK] In answering these questions, think about the most recent period of time when you
[FEELFILL] and had other problems at the same time.
Did you eat much less than usual almost every day during that time?
1
Yes
2
No
DK/REF

YD26b

[IF YD26a = 2 OR DK/REF] Did you eat much more than usual almost every day?
1
Yes
2
No
DK/REF

YD26c

[IF YD26a = 2 OR DK/REF]Did you gain weight without trying to during that [TIMEFILL] period of time?
1
Yes
2
No
DK/REF

YD26c1 [IF YD26c = 1] Did you gain weight without trying to because you were growing?
1
Yes
2
No
DK/REF

May 23, 2012

374

YD26c2 [IF YD26c1 = (2 OR DK/REF) AND QD01 = 9] Did you gain weight without trying to because you were pregnant?
1
Yes
2
No
DK/REF
YD26d

[IF (YD26c1=(2 OR DK/REF) AND YD26c2=BLANK, 2 OR DK/REF] How many pounds did you gain?
Please enter your answer as a whole number.
# OF POUNDS:__________ [RANGE: 0-200]
DK/REF

YD26e

[IF YD26a = 1 OR YD26c = (2 OR DK/REF)] Did you lose weight without trying to?
1
Yes
2
No
DK/REF

YD26e1 [IF YD26e = 1] Did you lose weight without trying to because you were sick or on a diet?
1
Yes
2
No
DK/REF
YD26f

[IF YD26e1=2 OR DK/REF] How many pounds did you lose?
Please enter your answer as a whole number.
# OF POUNDS:__________ [RANGE: 0-200]
DK/REF

YD26g

[IF YD26a NE BLANK]
[IF YD22a NE BLANK] Again, please think about the period of time when your [FEELNOUN] and other problems
were the worst.
[IF YD22c NE BLANK] Again, please think about the most recent period of time when you [FEELFILL]and had
other problems at the same time.
Did you have a lot more trouble than usual falling asleep or staying asleep most nights or waking too early most mornings
during that [TIMEFILL] time?
1
Yes
2
No
DK/REF

YD26h

[IF YD26g=2 OR DK/REF]During that [TIMEFILL] period of time, did you sleep a lot more than usual?
1
Yes
2
No
DK/REF

YD26j [IF YD26a NE BLANK] On most days during that [TIMEFILL] period of time, did you feel that you
didn’t have much energy?
1
Yes
2
No
DK/REF
YD26l

[IF YD26a NE BLANK] Did you feel as though you were talking or moving more slowly than usual on most days during
that [TIMEFILL] period of time?
1
2

May 23, 2012

Yes
No
375

DK/REF
YD26m [IF YD26l = 1] Did anyone else notice that you were talking or moving more slowly than usual?
1
Yes
2
No
DK/REF
YD26n

[IF YD26l = 2 OR DK/REF] Were you so restless or jittery that you walked up or down or couldn't sit still?
1
Yes
2
No
DK/REF

YD26o

[IF YD26n = 1] Did anyone else notice that you couldn’t sit still?
1
Yes
2
No
DK/REF

YD26p

[IF YD26a NE BLANK] The next questions are about changes in your ability to concentrate, and your feelings about
yourself.
[IF YD22a NE BLANK] Again, in answering these questions, think about the period of time when your [FEELNOUN]
and other problems were the worst.
[IF YD22c NE BLANK] Again, in answering these questions, think about the most recent period of time when you
[FEELFILL] and had other problems at the same time.
On most days during that [TIMEFILL] time, did your thinking seem slower than usual or seem mixed up?
1
Yes
2
No
DK/REF

YD26r

[IF YD26a NE BLANK] On most days, did you have a lot more trouble than usual keeping your mind on things?
1
Yes
2
No
DK/REF

YD26s

[IF YD26a NE BLANK] Were you unable to make up your mind about things you ordinarily have no trouble deciding
about?
1
Yes
2
No
DK/REF

YD26u

[IF YD26a NE BLANK] Did you feel that you were not as good as other people nearly every day?
1
Yes
2
No
DK/REF

YD26v

[IF YD26u = 1] Did you feel totally worthless nearly every day?
1
Yes
2
No
DK/REF

YD26aa [IF YD26a NE BLANK] The next questions are about thoughts of death or suicide.
[IF YD22a NE BLANK] Again, in answering these questions, think about the period of time when your [FEELNOUN]
and other problems were the worst.

May 23, 2012

376

[IF YD22c NE BLANK] Again, in answering these questions, think about the most recent period of time when you
[FEELFILL]and had other problems at the same time.
Did you often think a lot about death, either your own, someone else’s, or death in general?
1
Yes
2
No
DK/REF
YD26bb [IF YD26a NE BLANK] During that time, did you ever think that it would be better if you were dead?
1
Yes
2
No
DK/REF
YD26cc

[IF YD26a NE BLANK] Did you think about killing yourself?
1
Yes
2
No
DK/REF

YD26dd [IF YD26cc = 1] Did you make a plan to kill yourself?
1
Yes
2
No
DK/REF
YD26ee

[IF YD26cc = 1] Did you make a suicide attempt or try to kill yourself?
1
Yes
2
No
DK/REF

DEFINE D_MDEA1Y:
IF YD24A = 1 OR YD24C = 1, THEN D_MDEA1Y= 1
ELSE IF YD24A = 2 AND YD24C = 2, THEN D_MDEA1Y= 2
ELSE IF YD24A = DK OR YD24C = DK, THEN D_MDEA1Y= DK
ELSE IF YD24A = REF OR YD24C = REF, THEN D_MDEA1Y= REF
ELSE D_MDEA1Y= BLANK
DEFINE D_MDEA2Y:
IF YD09 = 1 OR YD24E = 1 OR YD24F = 1 THEN D_MDEA2Y = 1
ELSE IF (YDS21 = 1 OR YDS22 = 1 OR YD09 = 2) AND YD24E = 2 AND YD24F = 2 THEN D_MDEA2Y = 2
ELSE IF YD09 = DK OR YD24E = DK OR YD24F = DK THEN D_MDEA2Y = DK
ELSE IF YD09 = REF OR YD24E = REF OR YD24F = REF THEN D_MDEA2Y = REF
ELSE D_MDEA2Y=BLANK
DEFINE D_MDEA3Y:
IF YD26A = 1 OR YD26B = 1 OR YD26D ≥10 OR YD26F ≥10, THEN D_MDEA3Y= 1
ELSE IF YD26A = 2 AND YD26B = 2 AND ((YD26D < 10 OR YD26F < 10) OR (YD26C = (2 OR BLANK) AND YD26E =
(2 OR BLANK)) OR (YD26C = 1 AND (YD26C1 = 1 OR YD26C2 = 1)) OR (YD26E = 1 AND YD26E1 = 1)),
THEN D_MDEA3Y= 2
ELSE IF YD26A = DK OR YD26B = DK OR YD26C = DK OR YD26D = DK OR YD26E = DK OR YD26F = DK, THEN
D_MDEA3Y= DK
ELSE IF YD26A = REF OR YD26B = REF OR YD26C = REF OR YD26D = REF OR YD26E = REF OR YD26F = REF,
THEN D_MDEA3Y= REF
ELSE D_MDEA3Y= BLANK
DEFINE D_MDEA4Y:
IF YD26G = 1 OR YD26H = 1, THEN D_MDEA4Y= 1
ELSE IF YD26G = 2 AND YD26H = 2, THEN D_MDEA4Y= 2
ELSE IF YD26G = DK OR YD26H = DK, THEN D_MDEA4Y= DK
ELSE IF YD26G = REF OR YD26H = REF, THEN D_MDEA4Y= REF
ELSE D_MDEA4Y= BLANK

May 23, 2012

377

DEFINE D_MDEA5Y:
IF YD26M = 1 OR YD26O = 1, THEN D_MDEA5Y= 1
ELSE IF (YD26L = (2 OR DK/REF) AND (YD26N = (2 OR DK/REF) OR YD26O = 2)) OR YD26M = 2, THEN
D_MDEA5Y= 2
ELSE IF YD26L = DK OR YD26M = DK OR YD26N = DK OR YD26O = DK, THEN D_MDEA5Y= DK
ELSE IF YD26L = REF OR YD26M = REF OR YD26N = REF OR YD26O = REF, THEN D_MDEA5Y= REF
ELSE D_MDEA5Y= BLANK
DEFINE D_MDEA6Y:
D_MDEA6Y= YD26J
DEFINE D_MDEA7Y:
IF YD26V = 1, THEN D_MDEA7Y= 1
ELSE IF YD26U = (2 OR DK/REF) OR YD26V = 2, THEN D_MDEA7Y= 2
ELSE D_MDEA7Y=YD26V
ELSE D_MDEA7Y= BLANK
DEFINE D_MDEA8Y:
IF YD26P = 1 OR YD26R = 1 OR YD26S = 1, THEN D_MDEA8Y= 1
ELSE IF YD26P = 2 AND YD26R = 2 AND YD26S = 2, THEN D_MDEA8Y= 2
ELSE IF YD26P = DK OR YD26R = DK OR YD26S = DK, THEN D_MDEA8Y= DK
ELSE IF YD26P = REF OR YD26R = REF OR YD26S = REF, THEN D_MDEA8Y= REF
ELSE D_MDEA8Y= BLANK
DEFINE D_MDEA9Y:
IF YD26AA = 1 OR D26BB = 1 OR YD26CC = 1 OR YD26DD = 1 OR YD26EE = 1, THEN D_MDEA9Y= 1
ELSE IF YD26AA = 2 AND YD26BB = 2 AND YD26CC = 2, THEN D_MDEA9Y= 2
ELSE IF YD26AA = DK OR YD26BB = DK OR YD26CC = DK OR YD26DD = DK OR YD26EE = DK, THEN
D_MDEA9Y= DK
ELSE IF YD26AA = REF OR YD26BB = REF OR YD26CC = REF OR YD26DD = REF OR YD26EE = REF, THEN
D_MDEA9Y= REF
ELSE D_MDEA9Y= BLANK
DEFINE DSMMDEAY:
IF SUM (D_MDEA1Y = 1, D_MDEA2Y = 1, D_MDEA3Y = 1, D_MDEA4Y = 1, D_MDEA5Y = 1, D_MDEA6Y = 1,
D_MDEA7Y = 1, D_MDEA8Y = 1, D_MDEA9Y = 1) ≥ 5, THEN DSMMDEAY = 1
ELSE IF SUM (D_MDEA1Y = (1 OR DK/REF), D_MDEA2Y = (1 OR DK/REF), D_MDEA3Y = (1 OR DK/REF),
D_MDEA4Y = (1 OR DK/REF), D_MDEA5Y = (1 OR DK/REF), D_MDEA6Y = (1 OR DK/REF), D_MDEA7Y = (1 OR
DK/REF), D_MDEA8Y = (1 OR DK/REF), D_MDEA9Y = (1 OR DK/REF)) < 5 AND N(OF D_MDEA1Y-D_MDEA9Y) > 0,
THEN DSMMDEAY = 2
ELSE IF D_MDEA1Y = DK OR D_MDEA2Y = DK OR D_MDEA3Y = DK OR D_MDEA4Y = DK OR D_MDEA5 = DK OR
D_MDEA6Y = DK OR D_MDEA7Y = DK OR D_MDEA8Y = DK OR D_MDEA9Y = DK, THEN DSMMDEAY = DK
ELSE IF D_MDEA1Y = REF OR D_MDEA2Y = REF OR D_MDEA3Y = REF OR D_MDEA4Y = REF OR D_MDEA5Y =
REF OR D_MDEA6Y = REF OR D_MDEA7Y = REF OR D_MDEA8Y = REF OR D_MDEA9Y = REF, THEN DSMMDEAY
= REF
YD28

[IF D_MDEA9Y = 1 OR DSMMDEAY = 1] You mentioned having some of the problems I just asked you about.
During that [TIMEFILL] period of time, how much did your [FEELNOUN]
interfere or cause problems with your school work, your job, or your relationships with family and friends?
1
2
3
4
5
DK/REF

YD28a

Not at all
A little
Some
A lot
Extremely

[IF YD28 = 2, 3, 4, 5 OR DK/REF] During that [TIMEFILL] period of time, how often were you unable to carry out your
daily activities or to take care of yourself because of these problems with your mood?
1
2
3
4

May 23, 2012

Often
Sometimes
Not very often
Never
378

DK/REF
[IF YD28 NE BLANK] Think of the very first period of time in your life lasting two weeks or longer when you
[FEELFILL] and also had some of the other problems we just asked about.

YD37

Can you remember your exact age?
1
Yes
2
No
DK/REF

YD37a

[IF YD37 = 1] How old were you?
AGE:__________ [RANGE: 1-17]
DK/REF

YD37b

[IF YD37 = 2 OR DK] About how old were you when you first had a period of time like this?
AGE:__________ [RANGE: 1-17]
DK/REF
[IF YD28 NE BLANK] In your entire life, how many times did you feel [FEELNOUN] for two weeks or longer while
also having some of the other problems we asked about?

YD52

If you are not sure of your answer, just make your best guess.
# OF EPISODES______________ [RANGE: 1-1000]
DK/REF
[IF YD28 NE BLANK] In the past 12 months, did you have a period of time when you felt [FEELNOUN] for two
weeks or longer while also having some of the other problems we asked about?

YD38

1
Yes
2
No
DK/REF
YD66a

[IF YD38 = 1] Think about the time in the past 12 months when [NUMPROBS] with your mood [WASWERE] the
worst.
Using the 0 to 10 scale shown below, where 0 means no problems and 10 means very severe problems, select the
number that describes how much your [FEELNOUN] caused problems with your ability to do each of the following
activities during that time. You can use any number between 0 and 10 to answer.
How much did your [FEELNOUN] cause problems with your chores at home?

No
Problems
│
0

Mild
1

2

Moderate
3

4

5

Severe
6

7

8

Very Severe
Problems
│
9
10

NUMBER: ______________[RANGE: 0-10]
DK/REF
YD66b

[IF YD38 = 1] During that time in the past 12 months when your [FEELNOUN] was worst, how much did this cause
problems with your ability to do well at school or work?

You can use any number between 0 and 10 to answer.
No
Problems
Mild
Moderate
│
0
1
2
3
4
5
NUMBER: ______________[RANGE: 0-10]
DK/REF
May 23, 2012

379

Severe
6

7

8

Very Severe
Problems
│
9
10

YD66c

[IF YD38 = 1] How much did your [FEELNOUN] cause problems with your ability to get along with your family
during that time?
You can use any number between 0 and 10 to answer.

No
Problems
│
0

Mild
1

2

Moderate
3

4

5

Severe
6

7

8

Very Severe
Problems
│
9
10

NUMBER: ______________[RANGE: 0-10]
DK/REF

YD66d

[IF YD38 = 1] How much did your [FEELNOUN] cause problems with your ability to have a social life during that
time?
You can use any number between 0 and 10 to answer.

No
Problems
│
0

Mild
1

2

Moderate
3

4

5

Severe
6

7

8

Very Severe
Problems
│
9
10

NUMBER: ______________[RANGE: 0-10]
DK/REF
YD68

[IF ANY RESPONSES TO YD66a – YD66d = 1-10] About how many days out of 365 in the past 12 months were you
totally unable to go to school or work or carry out your normal activities because of your [FEELNOUN]?
You can use any number between 0 and 365 to answer.
# OF DAYS:__________ [RANGE: 0-365]
DK/REF
[IF YD38 NE BLANK] Here is a list of professionals some people talk to about the problems we have been
asking about:

YD86

General practitioner or family doctor
Other medical doctor like a cardiologist, gynecologist, urologist
Psychologist
Psychiatrist or psychotherapist
Social Worker
Counselor
Other mental health professional, like a mental health nurse
A nurse, occupational therapist, or other health professional
A religious or spiritual advisor like a minister, priest, or rabbi
Another healer, like an herbalist, chiropractor, acupuncturist, or massage therapist
At any time in the past 12 months, did you see or talk to a medical doctor or other professional about your
[FEELNOUN]?

YD86a

1
Yes
2
No
DK/REF
[IF YD86 = 1] During the past 12 months, which professionals did you see or talk to about [NUMPROBS] with your
mood?
To select more than one professional from the list, press the space bar between each number you type. When you have
finished, press the [ENTER] key to go to the next question.
1

May 23, 2012

General practitioner or family doctor
380

2
Other medical doctor like a cardiologist, gynecologist, urologist
3
Psychologist
4
Psychiatrist or psychotherapist
5
Social Worker
6
Counselor
7
Other mental health professional, like a mental health nurse
8
A nurse, occupational therapist, or other health professional
9
A religious or spiritual advisor like a minister, priest, or rabbi
10 An herbalist, chiropractor, acupuncturist, or massage therapist
11 Another type of helping professional
DK/REF
YD86aSP

[IF ANY RESPONSE IN YD86a =11] Please type in the type of other professional you saw or talked to during
the past 12 months about your [FEELNOUN]. When you have finished typing your answer, press the [ENTER]
key to go to the next question.
_____________ [RANGE: 50 CHARACTERS]
DK/REF

YD86b

[IF YD86= 1] Are you currently receiving treatment or counseling for [NUMPROBS] with your mood?
1
Yes
2
No
DK/REF

YD86c

[IF YD38 NE BLANK] During the past 12 months, did you take prescription medication that was prescribed
for[NUMPROBS]?
1
Yes
2
No
DK/REF

YD86d

[IF YD86c = 1] Are you currently taking prescription medication that was prescribed for [NUMPROBS]?
1
Yes
2
No
DK/REF

YD86e

[IF YD86c = 1] During the past 12 months, how much has this prescription medication helped you?
1
2
3
4
5
DK/REF

YD86f

Not at all
A little
Some
A lot
Extremely

[IF YD86 = 1] During the past 12 months, how much has treatment or counseling helped you?
1
2
3
4
5
DK/REF

May 23, 2012

Not at all
A little
Some
A lot
Extremely

381

May 23, 2012

382

Definitions for Use in Consumption of Alcohol Module
DEFINE ALC30USE:
IF ALLAST3 = 1 OR ALRECDK = 1 OR ALRECRE = 1 THEN ALC30USE = 1
ELSE ALC30USE = 2
DEFINE MAR30USE:
IF MJLAST3 = 1 OR MJRECDK = 1 OR MJRECRE = 1 THEN MAR30USE=1
ELSE MAR30USE = 2
DEFINE COC30USE:
IF CCLAST3 = 1 OR CCRECDK = 1 OR CCRECRE = 1 OR CKLAST3 = 1 OR CKRECDK = 1 OR CKRECRE = 1
OR SD07 = 1 THEN COC30USE = 1
ELSE COC30USE = 2
DEFINE HER30USE:
IF HELAST3=1 OR HERECDK=1 OR HERECRE=1 OR SD02=1 OR SD04=1 OR SD09=1 THEN HER30USE = 1
ELSE HER30USE = 2
DEFINE HAL30USE:
IF HALLREC = 1 OR LSDREC = 1 OR PCPREC = 1 OR ECSTREC = 1 THEN HAL30USE = 1
ELSE HAL30USE = 2
DEFINE INH30USE:
IF INLAST = 1 OR INRECDK = 1 OR INRECRE = 1 THEN INH30USE = 1
ELSE INH30USE = 2
DEFINE PAI30USE:
IF PRREC = 1 OR OXYREC = 1 THEN PAI30USE = 1
ELSE PAI30USE = 2
DEFINE TRA30USE:
IF TR09 = 1 OR TRRECDK = 1 OR TRRECRE = 1 THEN TRA30USE = 1
ELSE TRA30USE = 2
DEFINE STI30USE:
IF STIMREC=1 OR SD11 = 1 THEN STI30USE =1
ELSE STI30USE = 2
DEFINE MTH30USE:
IF (METHREC = 1 OR SD10b = 1 OR SD17b = 1) AND SD17a1 NE 1 AND SD17ALT NE 1, THEN MTH30USE =
1
ELSE MTH30USE = 2
DEFINE SED30USE:
IF SV09 = 1 OR SVRECDK = 1 OR SVRECRE = 1 THEN SED30USE = 1
ELSE SED30USE = 2
DEFINE DRUGFILL:
IF MAR30USE = 1 AND COC30USE = 2 AND HER30USE = 2 AND HAL30USE = 2 AND INH30USE = 2 AND
PAI30USE = 2 AND TRA30USE = 2 AND STI30USE = 2 AND MTH30USE = 2 AND SED30USE = 2 THEN
DRUGFILL = ‘marijuana or hashish’
IF MAR30USE = 2 AND (CCLAST3=1 OR CCRECDK=1 OR CCRECRE=1 OR SD07 = 1) AND (CKLAST3 NE 1
AND CKRECDK NE 1 AND CKRECRE NE 1) AND HER30USE = 2 AND HAL30USE = 2 AND INH30USE = 2
AND PAI30USE = 2 AND TRA30USE = 2 AND STI30USE = 2 AND MTH30USE = 2 AND SED30USE = 2 THEN
DRUGFILL = ‘cocaine’
IF MAR30USE = 2 AND (CCLAST3=1 OR CCRECDK=1 OR CCRECRE=1 OR SD07 = 1) AND (CKLAST3=1 OR
CKRECDK=1 OR CKRECRE=1) AND HER30USE = 2 AND HAL30USE = 2 AND INH30USE = 2 AND
PAI30USE = 2 AND TRA30USE = 2 AND STI30USE = 2 AND MTH30USE = 2 AND SED30USE = 2 THEN
DRUGFILL = ‘cocaine or ‘crack’’
IF MAR30USE = 2 AND (CCLAST3 NE 1 AND CCRECDK NE 1 AND CCRECRE NE 1 AND SD07 NE 1) AND
(CKLAST3=1 OR CKRECDK=1 OR CKRECRE=1) AND HER30USE = 2 AND HAL30USE = 2 AND INH30USE =
May 23, 2012

383

2 AND PAI30USE = 2 AND TRA30USE = 2 AND STI30USE = 2 AND MTH30USE = 2 AND SED30USE = 2
THEN DRUGFILL = ‘‘crack’’
IF MAR30USE = 2 AND COC30USE = 2 AND HER30USE = 1 AND HAL30USE = 2 AND INH30USE = 2 AND
PAI30USE = 2 AND TRA30USE = 2 AND STI30USE = 2 AND MTH30USE = 2 AND SED30USE = 2 THEN
DRUGFILL = ‘heroin’
IF MAR30USE = 2 AND COC30USE = 2 AND HER30USE = 2 AND HAL30USE = 1 AND INH30USE = 2 AND
PAI30USE = 2 AND TRA30USE = 2 AND STI30USE = 2 AND MTH30USE = 2 AND SED30USE = 2 THEN
DRUGFILL = ‘hallucinogens’
IF MAR30USE = 2 AND COC30USE = 2 AND HER30USE = 2 AND HAL30USE = 2 AND INH30USE = 1 AND
PAI30USE = 2 AND TRA30USE = 2 AND STI30USE = 2 AND MTH30USE = 2 AND SED30USE = 2 THEN
DRUGFILL = ‘inhalants’
IF MAR30USE = 2 AND COC30USE = 2 AND HER30USE = 2 AND HAL30USE = 2 AND INH30USE = 2 AND
PAI30USE = 1 AND TRA30USE = 2 AND STI30USE = 2 AND MTH30USE = 2 AND SED30USE = 2 THEN
DRUGFILL = ‘prescription pain relievers’
IF MAR30USE = 2 AND COC30USE = 2 AND HER30USE = 2 AND HAL30USE = 2 AND INH30USE = 2 AND
PAI30USE = 2 AND TRA30USE = 1 AND STI30USE = 2 AND MTH30USE = 2 AND SED30USE = 2 THEN
DRUGFILL = ‘prescription tranquilizers’
IF MAR30USE = 2 AND COC30USE = 2 AND HER30USE = 2 AND HAL30USE = 2 AND INH30USE = 2 AND
PAI30USE = 2 AND TRA30USE = 2 AND ((STIMREC = 1 OR SD11 = 1) AND (METHREC NE 1 AND SD10b NE
1 AND SD17b NE 1 AND SD18b NE 1)) AND SED30USE = 2 THEN DRUGFILL = ‘prescription stimulants’
IF MAR30USE = 2 AND COC30USE = 2 AND HER30USE = 2 AND HAL30USE = 2 AND INH30USE = 2 AND
PAI30USE = 2 AND TRA30USE = 2 AND ((STIMREC NE 1 AND SD11 NE 1) AND (METHREC = 1 OR SD10b =
1 OR SD17b = 1 OR SD18b = 1)) AND SED30USE = 2 THEN DRUGFILL = ‘Methamphetamine’
IF MAR30USE = 2 AND COC30USE = 2 AND HER30USE = 2 AND HAL30USE = 2 AND INH30USE = 2 AND
PAI30USE = 2 AND TRA30USE = 2 AND STI30USE = 2 AND MTH30USE = 2 AND SED30USE = 1 THEN
DRUGFILL = ‘prescription sedatives’
IF (MORE THAN ONE IN (MAR30USE AND COC30USE AND HER30USE AND HAL30USE AND INH30USE
AND PAI30USE AND TRA30USE AND STI30USE AND MTH30USE AND SED30USE) = 1) OR IF ((STIMREC =
1 OR SD11 = 1) AND (METHREC = 1 OR SD10b = 1 OR SD17b = 1 OR SD18b = 1)) THEN DRUGFILL = ‘any of
these drugs’

May 23, 2012

384

Consumption of Alcohol
CAINTR

[IF AL01 = 1 OR ALREF = 1] The next few questions return to the topic of alcohol. Remember that by a “drink,”
we mean a can or bottle of beer, a glass of wine or a wine cooler, a shot of liquor, or a mixed drink with liquor in
it. We are not asking about times when you only had a sip or two from a drink.
Press [ENTER] to continue.

CA01

[IF ALC30USE = 1] Earlier, the computer recorded that you drank at least one alcoholic beverage within the past
30 days, that is, since [FILLDATE].
Please think about the last time you drank any alcoholic beverage. How many drinks did you have that time?
# OF DRINKS: __________ [1 - 90]
DK/REF

CA02a

[IF ALC30USE = 1 AND CALCAGE = 12-20] This last time you drank, were you alone or were you with one or
more other people?
1
2
3
DK/REF

CA02b

I was alone the last time I drank
I was with one other person the last time I drank
I was with more than one other person the last time I drank

[IF ALC30USE = 1 AND CALCAGE = 12 - 20] Where did you drink alcoholic beverages this last time you
drank?
To select more than one place from the list, press the space bar after each number that you type. When you have
finished, press [ENTER].
1
2
3
4
5
6
7
8
DK/REF

CA02SP

I drank in a car or other vehicle
I drank at my home
I drank at someone else’s home
I drank at a park, on a beach, or in a parking lot
I drank in a restaurant, bar or club
I drank at a concert or sports game
I drank at school
I drank at some other place

[IF CA02b = 8] Please type in the other place you drank the last alcoholic beverages that you drank. You do not
need to give a detailed description — just a few words will be okay. When you have finished typing your answer,
press the [ENTER] key to go to the next question.
_____________
DK/REF

CA03

[IF ALC30USE = 1 AND CALCAGE = 12 - 20] Did you pay for the last alcoholic beverage that you drank?
1
Yes
2
No
DK/REF

CA04

[IF CA03 = 1] Did you buy this last alcoholic beverage yourself, or did you give money to someone else to buy it
for you?
1
I bought it myself
2
I gave money to someone else who bought it for me
DK/REF

CA05

May 23, 2012

[IF CA04 = 1] People often buy alcoholic beverages at stores, restaurants, bars, clubs, or events. Sometimes they
buy alcohol from other people. Which of these statements describes the way you bought the last alcoholic
beverage that you drank?

385

1
I bought it at a store, restaurant, bar, club or event
2
I bought it from another person.
DK/REF
CA05a

[IF CA05 = 1] At which of these places did you buy the last alcoholic beverage that you drank?
1

I bought it at a liquor store, convenience store, grocery store, or gas station
I bought it at a restaurant, bar or club
I bought it at a concert, sports or other event

2
3
DK/REF
CA05b

[IF CA05 = 2] Did you buy this last alcoholic beverage from someone who was under age 21, or were they 21 or
older?
1
Under age 21
2
Age 21 or older
DK/REF

CA06

[IF CA04 = 2] Who bought the alcoholic beverage for you?
1
My parent or guardian bought it for me
2
Another family member who is 21 or older bought it for me
3
Someone not related to me who is 21 or older bought it for me
4
Someone under age 21 bought it for me
DK/REF

CA07

[IF CA03 = 2] How did you get the last alcoholic beverage that you drank?
1
My parent or guardian gave it to me
2
Another family member who is 21 or older gave it to me
3
Someone not related to me who is 21 or older gave it to me
4
Someone under age 21 gave it to me
5
I took it from home
6
I took it from someone else’s home
7
I got it some other way
DK/REF

CA07SP

[IF CA07 = 7] Please type in the other way you got the last alcoholic beverage that you drank. You do not need to
give a detailed description — just a few words will be okay. When you have finished typing your answer, press
the [ENTER] key to go to the next question.
_____________
DK/REF

[Note to Programmers regarding CA08: Create a vertical list of all drugs (not including alcohol) for which *30USE = 1. The
names used in this list should be taken from the DRUGFILL list. The first letter of each line should be capitalized. For example,
if ALC30USE = 1, COC30USE = 1 (where CCLAST3=1 and CKLAST3=1) and HER30USE = 1, then the list would include
‘Cocaine or ‘crack’’ and ‘Heroin.’]
CA08

[IF ALC30USE = 1 AND AT LEAST ONE IN (MAR30USE AND COC30USE AND HER30USE AND
HAL30USE AND INH30USE AND PAI30USE AND TRA30USE AND STI30USE AND MTH30USE AND
SED30USE) = 1]
[IF CA01 NE DK/REF] Think again about this last time you drank any alcoholic beverages, when you had [CA01
FILL] [drink/drinks]. Did you also use [DRUGFILL] while you were drinking or within a couple of hours of
drinking?
[IF CA01 = DK/REF] Think again about this last time you drank any alcoholic beverages during the past 30 days.
Did you also use [DRUGFILL] while you were drinking or within a couple of hours of drinking?
[IF ALC30USE = 1 AND ((MORE THAN ONE IN (MAR30USE AND COC30USE AND HER30USE AND
HAL30USE AND INH30USE AND PAI30USE AND TRA30USE AND STI30USE AND MTH30USE AND
SED30USE) = 1) OR ((STIMREC = 1 OR SD11 = 1) AND (METHREC = 1 OR SD10b = 1 OR SD17b = 1 OR

May 23, 2012

386

SD18b = 1))): DISPLAY LIST OF SUBSTANCES.]
1 Yes
2 No
DK/REF
[Note to Programmers regarding CA09: Only display the response options that correspond to the list displayed in CA08.
Audio files should be played only for the displayed response options. Responses not displayed will be invalid for CA09; they
will trigger a hard error below.]
[IF CA08 = 1 AND MORE THAN ONE IN (MAR30USE AND COC30USE AND HER30USE AND
HAL30USE AND INH30USE AND PAI30USE AND TRA30USE AND STI30USE AND MTH30USE AND
SED30USE) = 1] What other drug or drugs did you use while you were drinking or within a couple of hours of
drinking?

CA09

To select more than one drug from the list, press the space bar between each number you type. When you have
finished, press the [ENTER] key to go to the next question.
1
Marijuana or hashish
2
Cocaine or ‘crack’
3
Heroin
4
Hallucinogens
5
Inhalants
6
Prescription pain relievers
7
Prescription tranquilizers
8
Prescription stimulants
9
Methamphetamine
10 Prescription sedatives
DK/REF
HARD ERROR: [IF ANY RESPONSE (1-9) IS SELECTED THAT WAS NOT DISPLAYED]: THIS IS NOT ONE OF
YOUR CHOICES. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN
ANSWER THE QUESTION AGAIN.
CA10

[IF ((AL01 = 1 OR ALREF = 1) AND ALC30USE = 2) OR (ALC30USE = 1 AND FOURORMOREFLAG NE 2
AND CA01 NE 5-90)]
[IF ALC30USE = 2: Earlier the computer recorded that you have had at least one drink of an alcoholic beverage in
your lifetime.] Have you ever had 5 or more drinks on the same occasion? By ‘occasion,’ we mean at the same time or
within a couple of hours of each other.
1
Yes
2
No
DK/REF

CA11

[IF CA10 = 1 OR FOURORMOREFLAG = 2 OR CA01 = 5-90]
[IF FOURORMOREFLAG = 1 OR 2 OR CA01 = 5-90: Earlier the computer recorded that you had 5 or more drinks on
the same occasion in the past 30 days.] How old were you the first time you had 5 or more drinks on the same
occasion?
AGE: __________ [1 - 110]
DK/REF

DEFINE AGE1STBA:
IF CA11 NE (BLANK OR DK/REF) THEN AGE1STBA = CA11
ELSE AGE1STBA = BLANK
IF CURNTAGE < AGE1STBA OR AGE1STBA < 10 OR AGE1STBA < AGE1STAL:
BACC01
The computer recorded that you were [AGE1STBA] years old when you first had 5 or more
drinks on the same occasion. Is this correct?
4
Yes
6
No
DK/REF

May 23, 2012

387

BACC02

[IF BACC01=6] Please answer this question again. Think about the first time you had 5 or
more drinks on the same occasion. How old were you the first time you had 5 or more drinks
on the same occasion?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF BACC02 NOT (BLANK OR DK/REF) THEN AGE1STBA = BACC02
CA11a

[IF AGE1STBA = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STBA = CURNTAGE - 1 AND
DATE OF INTERVIEW $ DOB] Did you first have 5 or more drinks on the same occasion in [CURRENT YEAR 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

CA11b

[IF AGE1STBA = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first have 5 or more drinks on the
same occasion in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

CA11c

IF AGE1STBA = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in [CURRENT YEAR] did
you first have 5 or more drinks on the same occasion?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CA11c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CA11d

[IF CA11a = 1 OR 2 OR CA11b = 1 OR 2] In what month in [YEAR FROM CA11a or CA11b] did you first have 5
or more drinks on the same occasion?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CA11d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
May 23, 2012

388

QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STBA:
MYR1STBA = AGE AT FIRST BINGE USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM
MONTH AND YEAR OF FIRST BINGE USE (CA11a-d). IF MONTH OF FIRST BINGE USE = MONTH OF
BIRTH, THEN MYR1STBA IS BLANK.
IF MYR1STBA NE 0 AND NE AGE1STBA:
BACC03
The computer recorded that you first had 5 or more drinks on the same occasion in [CA11a-d
fill]. That would make you [MYR1STBA] years old when you first had 5 or more drinks on
the same occasion. Is this correct?
4
Yes
6
No
DK/REF
BACC04

[IF BACC03 = 4] Earlier, the computer recorded that you were [AGE1STBA] years old when
you first had 5 or more drinks on the same occasion. Which answer is correct?
1
2
3
DK/REF

I first had 5 or more drinks on the same occasion in [CA11a-d fill] when I was
[MYR1STBA] years old
I was [AGE1STBA] years old the first time I had 5 or more drinks on the same
occasion
Neither answer is correct

UPDATE: IF BACC04 = 1, THEN AGE1STBA = MYR1STBA.
BACC05

[IF BACC04=2 OR BACC04=3 OR BACC03=6] Please answer this question again. Did you
first have 5 or more drinks on the same occasion in [CURRENT YEAR-2], [CURRENT
YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

BACC05a

[IF BACC05 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [BACC05] did you first have 5 or more drinks on the same occasion?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF BACC05a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF BACC05a NE (0 OR DK/REF) THEN UPDATE MYR1STBA.
MYR1STBA = AGE AT FIRST BINGE USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM MONTH
AND YEAR OF FIRST BINGE USE (BACC05 AND BACC05a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN
MYR1STBA IS BLANK. IF MYR1STBA = AGE1STBA THEN MYR1STBA = BLANK
BACC06

May 23, 2012

[IF BACC04 NE 1 AND MYR1STBA NE 0 AND (BACC05 AND BACC05a NE CA11a-d)] The
computer recorded that you first had 5 or more drinks on the same occasion in [BACC05389

BACC05a fill]. That would make you [MYR1STBA] years old when you first had 5 or more
drinks on the same occasion. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF BACC06 NE (6, BLANK OR DK/REF )AND (BACC05 AND BACC05a NE CA11a-d) THEN AGE1STBA =
MYR1STBA
CA12

[IF (AL01 = 1 OR ALREF = 1) AND FOURORMOREFLAG NE 1 OR 2 AND CA10 NE 1 AND CA01 NE OR > 4
AND QD01=9] Have you ever had 4 or more drinks on the same occasion?
1
Yes
2
No
DK/REF

CA13

[IF (CA12 = 1 OR CA01 > = 4 OR CA10 = 1 OR FOURORMOREFLAG = 1 OR 2) AND ALC30USE = 1 AND
QD01 = 9] During the past 30 days, that is, since [DATEFILL], on how many days did you have 4 or more drinks on
the same occasion?
# OF DAYS:
DK/REF

[RANGE: 0 - 30]

CA14
[IF (CA12 = 1 OR CA01 >= 4 OR CA10 = 1 OR FOURORMOREFLAG = 1 OR 2) AND QD01 = 9] How old were
you the first time you had 4 or more drinks on the same occasion?
AGE: __________ [1- 110]
DK/REF
DEFINE AGE1WBA:
IF CA14 NE (BLANK OR DK/REF) THEN AGE1WBA = CA14
ELSE AGE1WBA = BLANK
IF CURNTAGE < AGE1WBA OR AGE1WBA < 10 OR AGE1WBA < AGE1STAL:
WBACC01
The computer recorded that you were [AGE1WBA] years old when you first had 4 or more
drinks on the same occasion. Is this correct?
4
Yes
6
No
DK/REF

WBACC02

[IF WBACC01=6] Please answer this question again. Think about the first time you had 4 or
more drinks on the same occasion. How old were you the first time you had 4 or more drinks
on the same occasion?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF WBACC02 NOT (BLANK OR DK/REF) THEN AGE1WBA = WBACC02
CA14a

[IF AGE1WBA = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1WBA = CURNTAGE - 1 AND
DATE OF INTERVIEW $ DOB] Did you first have 4 or more drinks on the same occasion in [CURRENT YEAR 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

CA14b

[IF AGE1WBA = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first have 4 or more drinks on the
same occasion in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
2

May 23, 2012

CURRENT YEAR - 2
CURRENT YEAR - 1
390

DK/REF
CA14c

IF AGE1WBA = CURNTAGE AND DATE OF INTERVIEW $ DOB] In what month in [CURRENT YEAR] did
you first have 4 or more drinks on the same occasion?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CA14c > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CA14d

[IF CA14a = 1 OR 2 OR CA14b = 1 OR 2] In what month in [YEAR FROM CA14a or CA14b] did you first have 4
or more drinks on the same occasion?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF CA14d > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS NOT
BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1WBA:
MYR1WBA = AGE AT FIRST BINGE USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM
MONTH AND YEAR OF FIRST BINGE USE (CA14a-d). IF MONTH OF FIRST BINGE USE = MONTH OF
BIRTH, THEN MYR1STBA IS BLANK.
IF MYR1WBA NE 0 AND NE AGE1WBA:
WBACC03
The computer recorded that you first had 4 or more drinks on the same occasion in [CA14a-d
fill]. That would make you [MYR1WBA] years old when you first had 4 or more drinks on
the same occasion. Is this correct?
4
Yes
6
No
DK/REF
WBACC04

[IF WBACC03 = 4] Earlier, the computer recorded that you were [AGE1WBA] years old
when you first had 4 or more drinks on the same occasion. Which answer is correct?
1
2

May 23, 2012

I first had 4 or more drinks on the same occasion in [CA14a-d fill] when I was
[MYR1WBA] years old
I was [AGE1WBA] years old the first time I had 4 or more drinks on the same
occasion
391

3
Neither answer is correct
DK/REF
UPDATE: IF WBACC04 = 1, THEN AGE1WBA = MYR1WBA.
WBACC05

[IF WBACC04=2 OR WBACC04=3 OR WBACC03=6] Please answer this question again.
Did you first have 4 or more drinks on the same occasion in [CURRENT YEAR-2],
[CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

WBACC05a

[IF WBACC05 NE (BLANK OR DK/REF)] Please answer this question again. In what month
in [WBACC05] did you first have 4 or more drinks on the same occasion?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

January
February
March
April
May
June
July
August
September
October
November
December

HARD ERROR: [IF WBACC05a > CURRENT MONTH] THE MONTH IN [CURRENT YEAR] YOU ENTERED HAS
NOT BEGUN YET. TO MAKE THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF WBACC05a NE (0 OR DK/REF) THEN UPDATE MYR1WBA.
MYR1WBA = AGE AT FIRST MODIFIED BINGE USE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM
MONTH AND YEAR OF FIRST MODIFIED BINGE USE (WBACC05 AND WBACC05a). IF MONTH OF FIRST
MODIFIED BINGE USE = MONTH OF BIRTH, THEN MYR1WBA IS BLANK. IF MYR1WBA = AGE1WBA THEN
MYR1WBA = BLANK
WBACC06

[IF WBACC04 NE 1 AND MYR1WBA NE 0 AND (WBACC05 AND WBACC05a NE CA14ad)] The computer recorded that you first had 4 or more drinks on the same occasion in
[WBACC05-WBACC05a fill]. That would make you [MYR1WBA] years old when you first
had 4 or more drinks on the same occasion. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF WBACC06 NE (6, BLANK OR DK/REF )AND (WBACC05 AND WBACC05a NE CA14a-d) THEN
AGE1WBA = MYR1WBA

May 23, 2012

392

ENDAUDIO

Thank you for your help with this part of the interview. Please tell your interviewer that you are finished.
INTERVIEWER: ENTER THE 3-LETTER CODE TO MOVE TO THE NEXT SECTION.
[Note: If the respondent reaches this screen because he/she has indicated he/she is younger than 12 at
CONFIRM, or UNDER12, or UNDER12,b or LASTCHANCE, or CGCC03a, or CGCC13a, or
CGSN03a, or CGCH03a, or CGCR03a, or ALCC03a, or MJCC03a, or CCCC03a, or CKCC03a, or
HECC03a, or LSCC03a, or LSCC19a or LSCC32a, or LSCC45a, or INCC03a, or PRCC03a, or
TRCC03a, or STCC03a, or STCC09a, or SVCC03a then after the interviewer enters the 3-letter code,
the program routes directly to FIEXIT. Otherwise, the program continues with INTRODM2]

[ONCE ENDAUDIO IS REACHED, THE PROGRAM SHOULD BE SET UP SO THAT NO ONE CAN RE-ENTER
THE ACASI PORTION OF THE INTERVIEW.]
DEFINE CALCAGE2:
CALCAGE2 = VALUE OF CALCAGE WHEN ENDAUDIO IS REACHED

May 23, 2012

393

May 23, 2012

394

Back-End Demographics
INTRODM2

For the next questions, I will read the question out loud, you can tell me your answer, and I will enter it into
the computer.
PRESS [ENTER] TO CONTINUE.

QD13

[IF YE04 >= 1 OR SEN04 >= 1] How many times in the past 12 months have you moved?
NUMBER OF TIMES:
DK/REF

[RANGE: 0 - 365]
INTERVIEWER NOTE:
The respondent should include moves from one residence to another within the same
city/town as well as those from one city/town to another.

QD13a

[IF QD13 NE 0] In what state did you live on [FILL PAST 1 YEAR DATE], that is, one year ago today?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
THE DISTRICT OF COLUMBIA (WASHINGTON, DC)
FLORIDA
GEORGIA
HAWAII
IDAHO
ILLINOIS
INDIANA
IOWA
KANSAS
KENTUCKY
LOUISIANA
MAINE
MARYLAND
MASSACHUSETTS
MICHIGAN
MINNESOTA
MISSISSIPPI
MISSOURI

27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51

MONTANA
NEBRASKA
NEVADA
NEW HAMPSHIRE
NEW JERSEY
NEW MEXICO
NEW YORK
NORTH CAROLINA
NORTH DAKOTA
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
RHODE ISLAND
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
VERMONT
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING

52

OUTSIDE OF U.S.

DK/REF
QD13b [IF SEN04 = OR > 1 OR YE04 = OR > 1] In what state did you live on [FILL 2 YEAR DATE], that is, two years ago
today?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
May 23, 2012

ALABAMA
ALASKA
ARIZONA
ARKANSAS
CALIFORNIA
COLORADO
CONNECTICUT
DELAWARE
THE DISTRICT OF COLUMBIA (WASHINGTON, DC)
FLORIDA
GEORGIA
HAWAII
IDAHO
ILLINOIS
395

27
28
29
30
31
32
33
34
35
36
37
38
39
40

MONTANA
NEBRASKA
NEVADA
NEW HAMPSHIRE
NEW JERSEY
NEW MEXICO
NEW YORK
NORTH CAROLINA
NORTH DAKOTA
OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
RHODE ISLAND

15
16
17
18
19
20
21
22
23
24
25
26

INDIANA
IOWA
KANSAS
KENTUCKY
LOUISIANA
MAINE
MARYLAND
MASSACHUSETTS
MICHIGAN
MINNESOTA
MISSISSIPPI
MISSOURI

41
42
43
44
45
46
47
48
49
50
51

SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
VERMONT
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING

52

OUTSIDE OF U.S.

DK/REF
QD13c

[IF (QD13a NE BLANK AND QD13a NE FIPE4) OR (QD13a = BLANK AND QD13b NE BLANK AND
QD13b NE FIPE4) OR (QD13a NE BLANK AND QD13a = FIPE4 AND QD13b NE BLANK AND
QD13b NE FIPE4)] In what month and year did you move to [FIPE4]?
IF QD13a NE BLANK AND QD13a NE FIPE4, FILL WITH RESPONSE OPTIONS BELOW:
1
2
3
4
5
6
7
8
9
10
11
12
13

[CURRENT MONTH, CURRENTYEAR – 12 MONTHS]
[CURRENT MONTH, CURRENT YEAR -11 MONTHS]
[CURRENT MONTH, CURRENT YEAR – 10 MONTHS]
[CURRENT MONTH, CURRENT YEAR -9 MONTHS]
[CURRENT MONTH, CURRENT YEAR -8 MONTHS]
[CURRENT MONTH, CURRENT YEAR -7 MONTHS]
[CURRENT MONTH, CURRENT YEAR – 6 MONTHS]
[CURRENT MONTH, CURRENT YEAR -5 MONTHS]
[CURRENT MONTH, CURRENT YEAR -4 MONTHS]
[CURRENT MONTH, CURRENT YEAR – 3 MONTHS]
[CURRENT MONTH, CURRENT YEAR – 2 MONTHS]
[CURRENT MONTH, CURRENT YEAR -1 MONTH]
[CURRENT MONTH, CURRENT YEAR]

ELSE, FILL WITH RESPONSE OPTIONS BELOW:
1
2
3
4
5
6
7
8
9
10
11
12
13

[CURRENT MONTH, CURRENTYEAR – 24 MONTHS]
[CURRENT MONTH, CURRENT YEAR -23 MONTHS]
[CURRENT MONTH, CURRENT YEAR -22 MONTHS]
[CURRENT MONTH, CURRENT YEAR -21 MONTHS]
[CURRENT MONTH, CURRENT YEAR -20 MONTHS]
[CURRENT MONTH, CURRENT YEAR -19 MONTHS]
[CURRENT MONTH, CURRENT YEAR -18 MONTHS]
[CURRENT MONTH, CURRENT YEAR -17 MONTHS]
[CURRENT MONTH, CURRENT YEAR -16 MONTHS]
[CURRENT MONTH, CURRENT YEAR -15 MONTHS]
[CURRENT MONTH, CURRENT YEAR -14 MONTHS]
[CURRENT MONTH, CURRENT YEAR -13 MONTHS]
[CURRENT MONTH, CURRENT YEAR-12 MONTHS]

DK/REF
QD14

Were you born in the United States?
1
YES
2
NO
DK/REF

QD15

[IF QD14 = 2] In what country or U.S. territory were you born?
COUNTRY OR US TERRITORY: _________________
DK/REF

May 23, 2012

396

QD16a

[IF QD14 = 2] Have you lived in the United States for at least one year?
1
YES
2
NO
DK/REF

QD16b [IF QD16a = 1] For how many years have you lived in the United States? Please estimate the total number of years
you have lived here over your lifetime.
NUMBER OF YEARS: ______________ [RANGE: 1-90]
DK/REF
QD16c

[IF QD16a = 2] For how many months have you lived in the United States? Please estimate the total number of months
you have lived here over your lifetime.
IF LESS THAN ONE MONTH, ENTER 0
NUMBER OF MONTHS: ______________ [RANGE: 0-12]
DK/REF

May 23, 2012

397

May 23, 2012

398

QD17

The next questions are about school. Are you now attending or are you currently enrolled in school? By “school,” we
mean an elementary school, a junior high or middle school, a high school, or a college or university. Please include
home schooling as well.
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
If the respondent is on a holiday or summer break from school, but plans to return when
the break is over, then he/she should be coded as currently enrolled in school.
Do not include vocational or technical schools.

QD17a

[IF CURNTAGE=12-25 AND (QD17=2 OR DK/REF) AND QD11 = 1 - 15] Are you currently on a holiday or
vacation break from school?
1
YES
2
NO
DK/REF

QD17b [IF QD17a = 1] Do you plan to return to school when your holiday or vacation is over?
1
YES
2
NO
DK/REF
QD18

[IF QD17 = 1] HAND R SHOWCARD 6. What grade or year of school are you now attending? Please tell me the
number from the card.
[IF QD17b = 1] HAND R SHOWCARD 6. What grade or year of school will you be attending when your vacation is
over? Please tell me the number from the card.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
DK/REF

1ST GRADE
2ND GRADE
3RD GRADE
4TH GRADE
5TH GRADE
6TH GRADE
7TH GRADE
8TH GRADE
9TH GRADE
10TH GRADE
11TH GRADE
12TH GRADE
COLLEGE OR UNIVERSITY/1ST YEAR
COLLEGE OR UNIVERSITY/2ND YEAR
COLLEGE OR UNIVERSITY/3RD YEAR
COLLEGE OR UNIVERSITY/4TH YEAR
COLLEGE OR UNIVERSITY/5TH OR HIGHER YEAR
INTERVIEWER NOTE:
If the respondent is on a holiday or summer break, select the category for the year or
grade he/she will enter when he/she returns to school.
If home schooled or other alternative, ask for grade equivalent.

HARD ERROR: IF QD18 < QD11, DISPLAY THE FOLLOWING ERROR BOX:
INTERVIEWER: THE ANSWER YOU HAVE ENTERED FOR THE RESPONDENT’S CURRENT GRADE
(QD18) IS LOWER THAN THE ANSWER YOU ENTERED EARLIER FOR THE RESPONDENT’S LAST GRADE
COMPLETED (QD11). PLEASE VERIFY THEM WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN
ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT
AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPRESS

May 23, 2012

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED FOR THE
399

RESPONDENT’S LAST GRADE COMPLETED AND HIS/HER CURRENT GRADE ARE CORRECT.
ALLOW 200 CHARACTERS.
QD19

[IF QD17 = 1] Are you a full-time student or a part-time student?
[IF QD17b = 1] Will you be a full-time student or a part-time student?
1
FULL-TIME
2
PART-TIME
DK/REF

QD20

[IF QD19 = 1] During the past 30 days, that is, from [DATEFILL] up to and including today, how many whole days
of school did you miss because you were sick or injured?
IF SCHOOL WAS NOT IN SESSION DURING THE PAST 30 DAYS, ENTER 90.
NUMBER OF DAYS:
DK/REF

[RANGE: 0-30, 90]
INTERVIEWER NOTE:
Days missed because the respondent stayed home with a sick child or other family
member should not be included.

QD21

[IF QD19 = 1 AND QD20 NE 90] During the past 30 days, that is, since [DATEFILL], how many whole days of
school did you miss because you skipped or “cut” or just didn’t want to be there?
NUMBER OF DAYS:
DK/REF

[RANGE: 0 - 30]
INTERVIEWER NOTE:
Days missed because the respondent stayed home with a sick child or other family
member should not be included.

QD22

[IF (QD11 = 1 - 12 OR DK/REF) AND CURNTAGE = 12 - 25 AND (QD17a = 2 OR DK/REF OR QD17b = 2)] Have
you received a high school diploma?
1
YES
2
NO
DK/REF

QD23

[IF QD22 = 2 OR DK/REF] Have you received a GED certificate of high school completion?
1
YES
2
NO
DK/REF

QD24

[IF QD23 = 1 OR 2 OR DK/REF] HAND R SHOWCARD 7. Please look at this card and tell me which one of these
reasons best describes why you left school before receiving a high school diploma. Just give me the number.
1
2
3
4
5
6
7
8
9
10
11
12
13
14

May 23, 2012

SCHOOL WAS BORING OR I DIDN’T WANT TO BE THERE
I GOT PREGNANT/I GOT SOMEONE PREGNANT
I GOT IN TROUBLE OR EXPELLED FOR SELLING DRUGS
I GOT IN TROUBLE OR EXPELLED FOR USING DRUGS
I GOT IN TROUBLE OR EXPELLED FOR SOME OTHER REASON
I OFTEN GOT INTO TROUBLE
I HAD TO GET A JOB (OR WORK MORE HOURS)
I WAS GETTING BAD GRADES
I WASN’T LEARNING ANYTHING
I GOT MARRIED OR MOVED IN WITH MY BOY/GIRLFRIEND
I MOVED HERE FROM ANOTHER COUNTRY AND DIDN’T ENROLL IN SCHOOL (OR DROPPED
OUT OF SCHOOL) BECAUSE OF LANGUAGE OR OTHER PROBLEMS
I WAS TREATED BADLY AT SCHOOL
I BECAME ILL OR INJURED
I WENT TO JAIL/PRISON
400

15
I HAD RESPONSIBILITIES AT HOME OR PERSONAL PROBLEMS
16
OTHER REASON
DK/REF
[IF QD24 = 16] What is the main reason you left school before receiving a high school diploma?

QD24SP

_____________
DK/REF
QD25

[IF QD24 = 1 - 16 OR DK/REF] How old were you when you stopped attending school?
AGE WHEN STOPPED ATTENDING SCHOOL:
DK/REF

[RANGE: 0-110]

HARD ERROR: IF QD25 < 10, PLEASE DISPLAY THE FOLLOWING ERROR BOX:
INTERVIEWER: YOU HAVE ENTERED THAT THE RESPONDENT WAS LESS THAN 10 YEARS OLD WHEN
HE OR SHE STOPPED ATTENDING SCHOOL. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU
NEED TO CORRECT THIS, PRESS [ENTER]. IF THE ANSWER IS CORRECT AS IS, HIGHLIGHT 'SUPPRESS'
AND PRESS [ENTER].
SUPPQD25

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE RESPONDENT STOPPED ATTENDING SCHOOL AT THAT
AGE.
ALLOW 200 CHARACTERS.

HARD ERROR IF QD25 > CURRENT AGE:
INTERVIEWER: YOU HAVE RECORDED THAT THE RESPONDENT STOPPED ATTENDING SCHOOL AT
[FILL QD25]. EARLIER, THE RESPONDENT'S AGE WAS ENTERED AS [CURNTAGE]. PLEASE CONFIRM
THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT THE AGE STOPPED ATTENDING SCHOOL,
PRESS [ENTER].
DEFINE STARTDATE:
IF INTERVIEW DAY = SUNDAY, STARTDATE = INTERVIEW DATE - 7
IF INTERVIEW DAY = MONDAY, STARTDATE = INTERVIEW DATE - 8
IF INTERVIEW DAY = TUESDAY, STARTDATE = INTERVIEW DATE - 9
IF INTERVIEW DAY = WEDNESDAY, STARTDATE = INTERVIEW DATE - 10
IF INTERVIEW DAY = THURSDAY, STARTDATE = INTERVIEW DATE - 11
IF INTERVIEW DAY = FRIDAY, STARTDATE = INTERVIEW DATE - 12
IF INTERVIEW DAY = SATURDAY, STARTDATE = INTERVIEW DATE - 13
DEFINE ENDDATE:
IF INTERVIEW DAY = SUNDAY, ENDDATE = INTERVIEW DATE - 1
IF INTERVIEW DAY = MONDAY, ENDDATE = INTERVIEW DATE - 2
IF INTERVIEW DAY = TUESDAY, ENDDATE = INTERVIEW DATE - 3
IF INTERVIEW DAY = WEDNESDAY, ENDDATE = INTERVIEW DATE - 4
IF INTERVIEW DAY = THURSDAY, ENDDATE = INTERVIEW DATE - 5
IF INTERVIEW DAY = FRIDAY, ENDDATE = INTERVIEW DATE - 6
IF INTERVIEW DAY = SATURDAY, ENDDATE = INTERVIEW DATE -7

May 23, 2012

401

May 23, 2012

402

QD26

[IF CURNTAGE = 15 OR OLDER] The next questions are about working. Did you work at a job or business at any
time last week? By last week, I mean the week beginning on Sunday, [STARTDATE] and ending on Saturday,
[ENDDATE].
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
If the respondent asks about unpaid work, tell him/her to include unpaid work in a family
farm or business if he/she usually works more than 15 hours each week.
A student who is given a stipend is not considered to be working.
Someone doing volunteer work is not considered to be working.
A person who provides personal labor in exchange for work done for them, rather than
for pay, is considered to be working.

QD27

[IF QD26 = 2] Even though you did not work at any time last week, did you have a job or business?
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
If the respondent asks about unpaid work, tell him/her to include unpaid work in a family
farm or business if he/she usually works more than 15 hours each week.
A student who is given a stipend is not considered to have a job or business.
Someone doing volunteer work is not considered to be have a job or business.
A person who provides personal labor in exchange for work done for them, rather than
for pay, is considered to have a job or business.

QD28

[IF QD26 =1] How many hours did you work last week at all jobs or businesses?
# OF HOURS WORKED:
DK/REF

QD29

[RANGE: 1 - 120]

[IF (QD28 = 1 - 120 OR DK/REF) OR QD27 = 1] Do you usually work 35 hours or more per week at all jobs or
businesses?
1
YES
2
NO
DK/REF

INOC01

[IF QD26 = 1 OR QD27 = 1] In what kind of business or industry do you work? That is, what product is made or
what service is offered?
______________ [ALLOW 100 CHARACTERS]
DK/REF
INTERVIEWER NOTE:
If the respondent has more than 1 job, he/she should tell you about only one of the jobs.
In these situations, the choice of which job to report is left to the respondent.
In order to accurately code a respondent’s occupation, our coders need complete
information. Examples include: Hospital, newspaper publishing, mail order house, auto
engine manufacturing, breakfast cereal manufacturing. Please probe thoroughly!
You may enter up to 100 characters.

INOC02

[IF QD26 =1 OR QD27=1 AND INOC01 NE DK/REF] HAND R SHOWCARD 8. Which of these categories
best describes the business or industry in which you work?
1
2
3
4

May 23, 2012

MANUFACTURING
WHOLESALE TRADE
RETAIL TRADE
AGRICULTURE
403

5
6
7
8
DK/REF
INOC02M

CONSTRUCTION
SERVICE
GOVERNMENT
OTHER

[IF INOC02 = 1] What do they make?
____________ [ALLOW 35 CHARACTERS]
DK/REF
INTERVIEWER NOTE:
You may enter up to 35 characters.

INOC02T

[IF INOC02 = 2 OR 3] What do they sell?
____________ [ALLOW 35 CHARACTERS]
DK/REF
INTERVIEWER NOTE:
You may enter up to 35 characters.

INOC03

[IF INOC02 = 8] Please describe the business or industry in which you work.
____________ [ALLOW 35 CHARACTERS]
DK/REF
INTERVIEWER NOTE:
You may enter up to 35 characters.

INOC04

[IF QD26 =1 OR QD27=1 AND INOC01 NE DK/REF] What kind of work do you do? That is, what is your
occupation?
_____________________ [ALLOW 50 CHARACTERS]
DK/REF
INTERVIEWER NOTE:
If the respondent has more than one job, he/she should tell you about only one of the
jobs. In these situations, the choice of which job to report is left to the respondent.
In order to accurately code a respondent’s occupation, our coders need complete
information. Examples include: Registered nurse, personnel manager, supervisor of
order department, gasoline engine assembler, grinder operator. Please probe thoroughly!
You may enter up to 50 characters.

INOC05

[IF QD26 = 1 OR QD27 = 1 AND INOC01 NE DK/REF] What are your most important activities or duties in
that job?
_____________________ [ALLOW 100 CHARACTERS]
DK/REF
INTERVIEWER NOTE:
If the respondent has more than one job, he/she should tell you about only one of the
jobs. In these situations, the choice of which job to report is left to the respondent.
In order to accurately code a respondent’s occupation, our coders need complete
information. Examples include: patient care, directing hiring practices, supervising order
clerks, assembling engines, operating grinding mill. Please probe thoroughly!
You may enter up to 100 characters.

May 23, 2012

404

[IF QD26 =1 OR QD27 = 1 AND INOC01 NE DK/REF] HAND R SHOWCARD 9. Which of these categories
best describes the business in which you work?

INOC06

1
2
3
4
5
6
7
8
9
DK/REF
QD30

PRIVATE FOR-PROFIT COMPANY OR BUSINESS
PRIVATE NOT-FOR-PROFIT COMPANY OR BUSINESS
LOCAL GOVERNMENT (CITY, COUNTY, ETC.)
STATE GOVERNMENT
FEDERAL GOVERNMENT
INTERNATIONAL OR FOREIGN GOVERNMENT
SELF-EMPLOYED IN AN INCORPORATED BUSINESS
SELF-EMPLOYED IN AN UNINCORPORATED BUSINESS
WORKING WITHOUT PAY IN A FAMILY BUSINESS OR FARM

[IF QD27 = 1] HAND R SHOWCARD 10. Please look at this card and tell me which one of these reasons best
describes why you did not work last week. Just give me the number.
INTERVIEWER NOTE:
If the respondent indicates that he/she was on maternity or family leave, enter “1”.
If the respondent indicates that his/her job is seasonal and this is the off-season, enter “7.”
1
2
3
4
5
6
7
DK/REF

QD31

[IF QD27 = 2 OR DK/REF] HAND R SHOWCARD 11. Please look at this card and tell me which one of these
reasons best describes why you did not have a job or business last week. Just give me the number.
1
2
3
4
5
6
7
8
DK/REF

QD32

ON VACATION/SICK/FURLOUGH/STRIKE/OTHER TEMPORARY ABSENCE
ON LAYOFF AND NOT LOOKING FOR WORK
ON LAYOFF AND LOOKING FOR WORK
WAITING TO REPORT TO A NEW JOB
SELF-EMPLOYED AND DID NOT HAVE ANY BUSINESS LAST WEEK
GOING TO SCHOOL/TRAINING
SOME OTHER REASON

LOOKING FOR WORK
ON LAYOFF AND NOT LOOKING FOR WORK
KEEPING HOUSE OR CARING FOR CHILDREN FULL TIME
GOING TO SCHOOL/TRAINING
RETIRED
DISABLED FOR WORK
DIDN’T WANT A JOB
SOME OTHER REASON

[IF QD31 = 1] During the past 30 days, did you make specific efforts to find work? Include any contacts you made
with anyone about a job, sending out resumes or applications, placing or answering ads. Do not include only reading
job ads.
1
YES
2
NO
DK/REF

QD33

[IF QD26 = DK/REF OR QD27 = 2 OR DK/REF] Now, think about the past 12 months, from [DATEFILL] through
today. Did you work at a job or business at any time during the past 12 months?
1
YES
2
NO
DK/REF

QD34

[IF QD30 = 5 OR INOC06 = 7-8, SKIP TO QD35.]
[IF QD26 = 1 OR QD33 = 1 OR (QD27 = 1 AND QD30 NE 5). Have you been self-employed at any time during the
past 12 months?
1

May 23, 2012

YES
405

2
NO
DK/REF
QD35

[IF QD34 = 1 OR QD30 = 5 OR INOC06 = 7-8] How many different employers, including yourself, have you had in
the past 12 months?
# OF EMPLOYERS IN PAST 12 MONTHS:
DK/REF

QD36

[RANGE: 1 - 52]

[IF QD34 = 2 OR DK/REF OR (QD34 = BLANK AND QD35 = BLANK AND (INOC06 = 7-8 OR QD30 = 5))] How
many different employers have you had in the past 12 months?
# OF EMPLOYERS IN PAST 12 MONTHS:
DK/REF

QD37

[RANGE: 1 - 52]

[IF QD26 = 1 OR QD27 = 1] During the past 12 months, was there ever a time when you did not have at least one job
or business?
1
YES
2
NO
DK/REF

QD38

[IF QD37 = 1] In how many weeks during the past 12 months did you not have at least one job or business?
[RANGE: 1 - 52]

# OF WEEKS WITHOUT A JOB OR BUSINESS:
DK/REF

INTERVIEWER NOTE:
If the respondent did not have at least one job or business for less than one week, enter “1”.
QD39a

[IF QD27 = 2 OR DK/REF] In what year did you last work at a job or business?
ENTER THE FOUR-DIGIT YEAR IN THE FOLLOWING FORMAT: YYYY.
IF THE RESPONDENT NEVER WORKED FOR PAY, ENTER 9991.
____________ YEAR LAST WORKED
DK/REF

[IF QD39a > SYSTEM YEAR] HARD ERROR: The year that the computer recorded is [YEAR FROM QD39a]. Press
[ENTER] to close this box and then enter the correct year.
[IF QD39a < (SYSTEM YEAR - CURRENT AGE)] HARD ERROR: The year the computer recorded is earlier than the
respondent's birth date. Press [ENTER] to close this box and then double-check the year with the respondent.
QD39b [IF QD39a = SYSTEM YEAR OR (SYSTEM YEAR – 1)] In what month in [YEAR FROM QD39a] did you last
work at a job or business?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

JANUARY
FEBRUARY
MARCH
APRIL
MAY
JUNE
JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER

HARD ERROR: [IF YEAR IN QD39A = CURRENT YEAR AND MONTH IN QD39B > CURRENT MONTH] The month
the computer recorded is later than the current month. Press [ENTER] to close this box and then enter the
correct month.
May 23, 2012

406

INOC07

[IF QD33 = 1 AND (QD39b AND QD39a NE DK/REF) ] When you last worked in [QD39b, QD39a FILL], in
what kind of business or industry did you work? That is, what product was made or what service was offered?
[IF QD33 = 1 AND (QD39b OR QD39a = DK/REF) ] When you last worked, in what kind of business or industry
did you work? That is, what product was made or what service was offered?
_____________________ [ALLOW 100 CHARACTERS]
DK/REF
INTERVIEWER NOTE:
If the respondent had more than 1 job, he/she should tell you about only one of the jobs.
In these situations, the choice of which job to report is left to the respondent.
In order to accurately code a respondent’s occupation, our coders need complete
information. Examples include: Hospital, newspaper publishing, mail order house, auto
engine manufacturing, breakfast cereal manufacturing. Please probe thoroughly!
You may enter up to 100 characters.

INOC08

INOC08M

[IF QD33 =1 AND INOC07 NE DK/REF] HAND R SHOWCARD 8. Which of these categories best describes
the business or industry in which you worked?
1
MANUFACTURING
2
WHOLESALE TRADE
3
RETAIL TRADE
4
AGRICULTURE
5
CONSTRUCTION
6
SERVICE
7
GOVERNMENT
8
OTHER
DK/REF
[IF INOC08 = 1] What did they make?
____________ [ALLOW 35 CHARACTERS]
DK/REF
INTERVIEWER NOTE:
You may enter up to 35 characters.

INOC08T

[IF INOC08 = 2 OR 3] What did they sell?
____________ [ALLOW 35 CHARACTERS]
DK/REF
INTERVIEWER NOTE:
You may enter up to 35 characters.

INOC09

[IF INOC08 = 8] Please describe the business or industry in which you worked.
____________ [ALLOW 35 CHARACTERS]
DK/REF
INTERVIEWER NOTE:
You may enter up to 35 characters.

INOC10

[IF QD33 =1 AND INOC07 NE DK/REF] What kind of work did you do? That is, what was your occupation?
_____________________ [ALLOW 50 CHARACTERS]
DK/REF

May 23, 2012

407

INTERVIEWER NOTE:
If the respondent had more than one job, he/she should tell you about only one of the
jobs. In these situations, the choice of which job to report is left to the respondent.
In order to accurately code a respondent’s occupation, our coders need complete
information. Examples include: Registered nurse, personnel manager, supervisor of
order department, gasoline engine assembler, grinder operator. Please probe thoroughly!
You may enter up to 50 characters.
[IF QD33 = 1 AND INOC07 NE DK/REF] What were your most important activities or duties in that job?

INOC11

_____________________ [ALLOW 100 CHARACTERS]
DK/REF
INTERVIEWER NOTE:
If the respondent had more than one job, he/she should tell you about only one of the
jobs. In these situations, the choice of which job to report is left to the respondent.
In order to accurately code a respondent’s occupation, our coders need complete
information. Examples include: patient care, directing hiring practices, supervising order
clerks, assembling engines, operating grinding mill. Please probe thoroughly!
You may enter up to 100 characters.
[IF QD33 =1 AND INOC07 NE DK/REF] HAND R SHOWCARD 9. Which of these categories best describes
the business in which you worked?

INOC12

1
2
3
4
5
6
7
8
9
DK/REF
QD40

PRIVATE FOR-PROFIT COMPANY OR BUSINESS
PRIVATE NOT-FOR-PROFIT COMPANY OR BUSINESS
LOCAL GOVERNMENT (CITY, COUNTY, ETC.)
STATE GOVERNMENT
FEDERAL GOVERNMENT
INTERNATIONAL OR FOREIGN GOVERNMENT
SELF-EMPLOYED IN AN INCORPORATED BUSINESS
SELF-EMPLOYED IN AN UNINCORPORATED BUSINESS
WORKING WITHOUT PAY IN A FAMILY BUSINESS OR FARM

[IF QD26 = 1 OR QD27 = 1] During the past 30 days, that is, from [DATEFILL] up to and including today, how
many whole days of work did you miss because you were sick or injured?
# OF DAYS:
DK/REF

[RANGE: 0 - 30]
INTERVIEWER NOTE:
Days missed because the respondent stayed home with a sick child or other family
member should not be included.

QD41

[IF QD26 = 1 OR QD27 = 1] During the past 30 days, that is, from [DATEFILL] up to and including today, how
many whole days of work did you miss because you just didn’t want to be there?
# OF DAYS:
DK/REF

[RANGE: 0 - 30]
INTERVIEWER NOTE:
Days missed because the respondent stayed home with a sick child or other family
member should not be included.
Days missed because of a planned vacation should not be included.

QD42

[IF QD26 = 1 OR QD27 = 1] HAND R SHOWCARD 12. Thinking about the location where you work, how many
people work for your employer out of this office, store, etc.?

May 23, 2012

408

1
2
3
4
5
DK/REF
QD43

LESS THAN 10 PEOPLE
10-24 PEOPLE
25-99 PEOPLE
100-499 PEOPLE
500 PEOPLE OR MORE

[IF QD42 = 1 - 5 OR DK/REF] At your workplace, is there a written policy about employee use of alcohol or drugs?
1
YES
2
NO
DK/REF

QD44

[IF QD43 = 1] Does this policy cover only alcohol, only drugs, or both alcohol and drugs?
1
ONLY ALCOHOL
2
ONLY DRUGS
3
BOTH ALCOHOL AND DRUGS
DK/REF

QD45

[IF QD44 = (1 - 3 OR DK/REF) OR QD43 = (2 OR DK/REF)] At your workplace, have you ever been given any
educational information regarding the use of alcohol or drugs?
1
YES
2
NO
3
DON’T REMEMBER
DK/REF

QD46

[IF QD45 = 1 - 3 OR DK/REF] Through your workplace, is there access to any type of employee assistance program
or other type of counseling program for employees who have alcohol or drug-related problems?
1
YES
2
NO
DK/REF

QD47

[IF QD46 = 1 - 2 OR DK/REF] Does your workplace ever test its employees for alcohol use?
1
YES
2
NO
DK/REF

QD48

[IF QD47 = 1 - 2 OR DK/REF] Does your workplace ever test its employees for drug use?
1
YES
2
NO
DK/REF

QD49

[IF Q47 = 1 OR Q48 = 1] Does your workplace test its employees for drug or alcohol use as part of the hiring process?
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
Testing as part of the hiring process refers to a test that must be conducted, and show no
presence of drugs in order for an applicant to be hired.

QD50

[IF Q49 = 1 OR 2 OR DK/REF] Does your workplace test its employees for drug or alcohol use on a random basis?
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
Testing on a random basis refers to a test conducted at unscheduled times with a random

May 23, 2012

409

group of a company’s employees.
QD51

[IF Q47 = 1 OR Q48 = 1] HAND R SHOWCARD 13. According to the policy at your workplace, what happens to an
employee the first time he or she tests positive for illicit drugs?
1
2
3
4
5
DK/REF

QD52

HANDLED ON AN INDIVIDUAL BASIS / POLICY DOES NOT SPECIFY WHAT HAPPENS
EMPLOYEE IS FIRED
EMPLOYEE IS REFERRED FOR TREATMENT OR COUNSELING
NOTHING HAPPENS
SOMETHING ELSE HAPPENS

[IF QD42 = 1 - 5 OR DK/REF] Would you be more or less likely to want to work for an employer that tests its
employees for drug use as part of the hiring process? Would you say more likely, less likely, or would it make no
difference to you?
1
MORE LIKELY
2
LESS LIKELY
3
WOULD MAKE NO DIFFERENCE
DK/REF

QD53

[IF QD52 = 1 - 3 OR DK/REF] Would you be more or less likely to want to work for an employer that tests its
employees for drug or alcohol use on a random basis? Would you say more likely, less likely, or would it make no
difference to you?
1
MORE LIKELY
2
LESS LIKELY
3
WOULD MAKE NO DIFFERENCE
DK/REF

May 23, 2012

410

QD54

Altogether, how many people live here now, including yourself? Please include anyone who (has lived/will live) here
for most of (January, February, and March / April, May, and June / July, August, and September / October,
November, and December).
# IN HOUSEHOLD:
DK/REF

[RANGE: 1 - 25]
INTERVIEWER NOTE:
If you are interviewing in a transient shelter, enter “1".
If you are interviewing in a group quarters unit that was listed by room, enter the number
of people living in the room.

IF QD54 = 1 OR DK/REF SKIP TO FIRST QUESTION FOLLOWING HH ROSTER, OTHERWISE CONTINUE.
DEFINE GRID WITH ROWS EQUAL TO QD54. EACH COLUMN OF THE GRID IS A QUESTION AS SPEC’D BELOW.
PERAGEYR

[IF QD54 = 2 - 25] Now I need some additional information about each person who lives here. Let’s start
with the oldest. How old was he or she on his or her last birthday? (WORDING FOR ADDITIONAL
CYCLES: How old was the next oldest person on his or her last birthday?)
INTERVIEWER: FOR CHILDREN LESS THAN 24 MONTHS (2 YEARS), ENTER ‘1.’ YOU WILL BE
PROMPTED FOR THE AGE IN MONTHS ON THE NEXT SCREEN.
AGE IN WHOLE YEARS:
DK/REF

CHAGEMON

[IF PERAGEYR = 1] ENTER THE AGE IN WHOLE MONTHS FOR THIS HOUSEHOLD MEMBER.
FOR BABIES UNDER 1 MONTH OLD, ENTER 1.
AGE IN MONTHS:
DK/REF

CHMONSEX

[RANGE: 1 - 110]

[RANGE: 1 - 23]

[IF CHAGEMON = 1 - 23] Is the [CHAGEMON FILL]-month old child a male or a female?
5
MALE
9
FEMALE
DK/REF

CHYRSEX

[IF CHAGEMON = DK/REF] Is this child a male or female?
5
MALE
9
FEMALE
DK/REF

PERYRSEX

[IF PERAGEYR = 2 - 110 ] Is the [PERAGEYR FILL]-year old person male or female?
5
MALE
9
FEMALE
DK/REF

PERSEX [IF PERAGEYR = DK/REF] Is this person a male or a female?
5
MALE
9
FEMALE
DK/REF
MRELATON

[IF CHMONSEX OR CHYRSEX OR PERYRSEX OR PERSEX = 5] HAND R SHOWCARD 14. Please
look at this card and tell me which category best describes his relationship to you.
INTERVIEWER NOTE:
If it is clear to you that the respondent is talking about/rostering themselves, you may say
“Is that you?”. If the answer is Yes, enter “1" for “SELF”.
Exchange families (exchange students or people who are hosting exchange students)
should be considered “other non-relatives.”

May 23, 2012

411

1
2
3
4
5
6
7
8
9
10
11
12
13
14
DK/REF

SELF
FATHER (INCLUDES STEP, FOSTER, ADOPTIVE)
SON (INCLUDES STEP, FOSTER, ADOPTIVE)
BROTHER (INCLUDES HALF, STEP, FOSTER, ADOPTIVE)
HUSBAND
UNMARRIED PARTNER
HOUSEMATE OR ROOMMATE
SON-IN-LAW
GRANDSON
FATHER-IN-LAW
GRANDFATHER
BOARDER OR ROOMER
OTHER RELATIVE
OTHER NON-RELATIVE

[R GENDER] IF MRELATON=1 AND QD01=9 DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE
RECORDED THAT THE RESPONDENT IS MALE. EARLIER, YOU RECORDED THE RESPONDENT’S SEX AS
FEMALE. CONFIRM THE RESPONDENT’S SEX AND CORRECT THE ANSWER THAT WAS ENTERED
INCORRECTLY.
CREATE ERROR BOX SO IT ALLOWS R TO GO TO EITHER ANSWER TO FIX IT.
[R AGE] IF MRELATON=1 AND PERAGEYR DOES NOT EQUAL CURNTAGE, DISPLAY ERROR BOX THAT SAYS:
INTERVIEWER: YOU HAVE RECORDED THAT THE RESPONDENT IS [FILL PERAGEYR]. EARLIER, THE
RESPONDENT’S AGE WAS ENTERED AS [FILL CURNTAGE]. PLEASE CONFIRM THE RESPONDENT’S AGE. IF
YOU NEED TO CORRECT THE AGE OR RELATIONSHIP GIVEN IN THE ROSTER, HIGHLIGHT THAT QUESTION
NUMBER AND PRESS [ENTER]. IF THE ANSWER YOU ENTERED IN THE ROSTER IS CORRECT, HIGHLIGHT
‘SUPPRESS’ AND PRESS [ENTER].
[NOTE: FI SHOULD ONLY BE ALLOWED TO CHANGE PERAGEYR AND MRELATON.]
SUPPMAGE

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY YOU HAVE CHOSEN TO SUPPRESS THIS ERROR
ALLOW 200 CHARACTERS

[GRANDPARENT YOUNGER THAN R] IF MRELATON = 11 AND PERAGEYR DOES NOT EQUAL DK OR REF AND
IS = OR < CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S GRANDFATHER IS THE SAME AGE AS OR YOUNGER THAN THE RESPONDENT. PLEASE
VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION
NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS
[ENTER].
SUPPGDAD

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[GRANDCHILD OLDER THAN R] IF MRELATON = 9 AND PERAGEYR DOES NOT EQUAL DK OR REF AND IS =
OR > CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S GRANDSON IS THE SAME AGE AS OR OLDER THAN THE RESPONDENT. PLEASE VERIFY THIS
WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND
PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPGSON

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[SPOUSE/PARTNER < 16] IF MRELATON = 5 OR 6 AND PERAGEYR = OR < 16, DISPLAY ERROR BOX THAT
SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE RESPONDENT’S SPOUSE OR PARTNER IS 16 YEARS
OLD OR YOUNGER. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY,
HIGHLIGHT THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS,
May 23, 2012

412

HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPHUS

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[IN-LAW < 16] IF MRELATON = 8 OR 10 AND PERAGEYR = OR < 16, DISPLAY ERROR BOX THAT SAYS:
INTERVIEWER: YOU HAVE RECORDED THAT THE RESPONDENT’S [MRELATON] IS 16 YEARS OLD OR
YOUNGER. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY,
HIGHLIGHT THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS,
HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPMIL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[SON IN-LAW OLDER THAN R] IF MRELATON = 8 AND PERAGEYR DOES NOT EQUAL DK OR REF AND IS = OR
> CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S SON-IN-LAW IS THE SAME AGE AS OR OLDER THAN THE RESPONDENT. PLEASE VERIFY THIS
WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND
PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPSIL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[FATHER IN-LAW YOUNGER THAN R] IF MRELATON = 10 AND PERAGEYR DOES NOT EQUAL DK OR REF AND
IS = OR < CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S FATHER-IN-LAW IS THE SAME AGE AS OR YOUNGER THAN THE RESPONDENT. PLEASE
VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION
NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS
[ENTER].
SUPPPIL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

FTHRTYPE

[IF MRELATON = 2] Is he your biological, step-, adoptive, or foster father?
1
2
3
4
DK/REF

BIOLOGICAL FATHER
STEP-FATHER
ADOPTIVE FATHER
FOSTER FATHER

[BIODAD YOUNGER THAN R] IF FTHRTYPE = 1 AND PERAGEYR DOES NOT EQUAL DK OR REF AND IS = OR <
CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S FATHER IS THE SAME AGE AS OR YOUNGER THAN THE RESPONDENT. PRESS [ENTER] TO
CLOSE THIS BOX AND GO BACK TO THE PERSON’S INFORMATION AND CORRECT IT.
[BIODAD AND R 0-12 YEARS APART] IF FTHRTYPE = 1 AND PERAGEYR DOES NOT EQUAL DK OR REF AND IS
0-12 YEARS OLDER THAN CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE
RECORDED THAT THE RESPONDENT'S FATHER IS LESS THAN 13 YEARS OLDER THAN THE RESPONDENT.
PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT
QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’
AND PRESS [ENTER].
SUPPFGAP
May 23, 2012

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
413

BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS
[NON-BIODAD YOUNGER THAN R] IF FTHRTYPE = 2-4 AND PERAGEYR DOES NOT EQUAL DK OR REF AND IS
= OR < CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S [FILL FTHRTYPE] IS THE SAME AGE AS OR YOUNGER THAN THE RESPONDENT. PLEASE
VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION
NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS
[ENTER].
SUPPFTYP

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

SONTYPE

[IF MRELATON = 3] Is he your biological, step-, adoptive, or foster son?
1
2
3
4
DK/REF

BIOLOGICAL SON
STEP-SON
ADOPTIVE SON
FOSTER SON

[BIOSON OLDER THAN R] IF SONTYPE = 1 AND PERAGEYR DOES NOT EQUAL DK OR REF AND IS = OR >
CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S SON IS THE SAME AGE AS OR OLDER THAN THE RESPONDENT. PRESS [ENTER] TO CLOSE
THIS BOX AND GO BACK TO THE PERSON’S INFORMATION AND CORRECT IT.
[BIOSON AND R 0-12 YEARS APART] IF SONTYPE = 1 AND PERAGEYR DOES NOT EQUAL DK OR REF AND IS 012 YEARS YOUNGER THAN CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE
RECORDED THAT THE RESPONDENT'S SON IS LESS THAN 13 YEARS YOUNGER THAN THE RESPONDENT.
PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT
QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’
AND PRESS [ENTER].
SUPPSGAP

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[NON-BIOSON OLDER THAN R] IF SONTYPE = 2-4 AND PERAGEYR DOES NOT EQUAL DK OR REF AND IS = OR
> CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S [FILL SONTYPE] IS THE SAME AGE AS OR OLDER THAN THE RESPONDENT. PLEASE VERIFY
THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER
AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPSTYP

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

BTHRTYPE

[IF MRELATON = 4] Is he your full, half, step-, adoptive, or foster brother?
1
2
3
4
5
DK/REF

May 23, 2012

FULL BROTHER
HALF BROTHER
STEP-BROTHER
ADOPTIVE BROTHER
FOSTER BROTHER

414

[BIOBRO AND R MORE THAN 25 YEARS APART] IF BTHRTYPE = 1 AND PERAGEYR DOES NOT EQUAL DK OR
REF AND IS (25 < OR >CURNTAGE) , DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED
THAT THERE IS A 25 YEAR OR MORE DIFFERENCE IN AGE BETWEEN THE RESPONDENT AND [HIS/HER]
BROTHER. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT
THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT
‘SUPPRESS’ AND PRESS [ENTER].
SUPPBRGP

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

BTWNTYPE

[IF AGE1 = AGE OF THIS HOUSEHOLD MEMBER AND BTHRTYPE = 1] Is he your identical twin,
fraternal twin, or neither?
1
IDENTICAL TWIN
2
FRATERNAL TWIN
3
NEITHER
DK/REF

FRELATON

[IF CHMONSEX OR CHYRSEX OR PERYRSEX OR PERSEX = 9] HAND R SHOWCARD 15. Please
look at this card and tell me which category best describes her relationship to you.
INTERVIEWER NOTE:
If it is clear to you that the respondent is talking about/rostering themselves, you may say
“Is that you?”. If the answer is Yes, enter “1" for “SELF”.
Exchange families (exchange students or people who are hosting exchange students)
should be considered “other non-relatives.”
1
2
3
4
5
6
7
8
9
10
11
12
13
14
DK/REF

SELF
MOTHER (INCLUDES STEP, FOSTER, ADOPTIVE)
DAUGHTER (INCLUDES STEP, FOSTER, ADOPTIVE)
SISTER (INCLUDES HALF, STEP, FOSTER, ADOPTIVE)
WIFE
UNMARRIED PARTNER
HOUSEMATE OR ROOMMATE
DAUGHTER-IN-LAW
GRANDDAUGHTER
MOTHER-IN-LAW
GRANDMOTHER
BOARDER OR ROOMER
OTHER RELATIVE
OTHER NON-RELATIVE

[R GENDER] IF FRELATON=1 AND QD01=5 DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE
RECORDED THAT THE RESPONDENT IS FEMALE. EARLIER, YOU RECORDED THE RESPONDENT’S SEX AS
MALE. CONFIRM THE RESPONDENT’S SEX AND CORRECT THE ANSWER THAT WAS ENTERED INCORRECTLY.
CREATE ERROR BOX SO IT ALLOWS R TO GO TO EITHER ANSWER TO FIX IT.
[R AGE] IF FRELATON=1 AND PERAGEYR DOES NOT EQUAL CURNTAGE, DISPLAY ERROR BOX THAT SAYS:
INTERVIEWER: YOU HAVE RECORDED THAT THE RESPONDENT IS [FILL PERAGEYR]. EARLIER, THE
RESPONDENT’S AGE WAS ENTERED AS [FILL CURNTAGE]. PLEASE CONFIRM THE RESPONDENT’S AGE. IF
YOU NEED TO CORRECT THE AGE OR RELATIONSHIP GIVEN IN THE ROSTER, HIGHLIGHT THAT QUESTION
NUMBER AND PRESS [ENTER]. IF THE ANSWER YOU ENTERED IN THE ROSTER IS CORRECT, HIGHLIGHT
‘SUPPRESS’ AND PRESS [ENTER].
[NOTE: FI SHOULD ONLY BE ALLOWED TO CHANGE PERAGEYR AND FRELATON.]
SUPPFAGE

May 23, 2012

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY YOU HAVE CHOSEN TO SUPPRESS THIS ERROR
415

ALLOW 200 CHARACTERS
[GRANDPARENT YOUNGER THAN R] IF FRELATON = 11 AND PERAGEYR DOES NOT EQUAL DK OR REF AND
IS = OR < CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S GRANDMOTHER IS THE SAME AGE AS OR YOUNGER THAN THE RESPONDENT. PLEASE
VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION
NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS
[ENTER].
SUPPGMOM

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[GRANDCHILD OLDER THAN R] IF FRELATON = 9 AND PERAGEYR DOES NOT EQUAL DK OR REF AND IS = OR
> CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S GRANDDAUGHTER IS THE SAME AGE AS OR OLDER THAN THE RESPONDENT. PLEASE
VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION
NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS
[ENTER].
SUPPGDAU

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[SPOUSE/PARTNER < 16] IF FRELATON = 5 OR 6 AND PERAGEYR = OR < 16, DISPLAY ERROR BOX THAT SAYS:
INTERVIEWER: YOU HAVE RECORDED THAT THE RESPONDENT’S SPOUSE OR PARTNER IS 16 YEARS OLD OR
YOUNGER. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY,
HIGHLIGHT THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS,
HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPWIF

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[IN-LAW < 16] IF FRELATON = 8 OR 10 AND PERAGEYR = OR < 16, DISPLAY ERROR BOX THAT SAYS:
INTERVIEWER: YOU HAVE RECORDED THAT THE RESPONDENT’S [FRELATON] IS 16 YEARS OLD OR
YOUNGER. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY,
HIGHLIGHT THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS,
HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPFIL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[DAUGHTER IN-LAW OLDER THAN R] IF FRELATON = 8 AND PERAGEYR DOES NOT EQUAL DK OR REF AND
IS = OR > CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S DAUGHTER-IN-LAW IS THE SAME AGE AS OR OLDER THAN THE RESPONDENT. PLEASE
VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION
NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS
[ENTER].
SUPPDIL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[MOTHER IN-LAW YOUNGER THAN R] IF FRELATON = 10 AND PERAGEYR DOES NOT EQUAL DK OR REF
AND IS = OR < CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT
THE RESPONDENT’S MOTHER-IN-LAW IS THE SAME AGE AS OR YOUNGER THAN THE RESPONDENT. PLEASE
VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION
NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS
May 23, 2012

416

[ENTER].
SUPPGIL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

MTHRTYPE

[IF FRELATON = 2] Is she your biological, step-, adoptive, or foster mother?
1
2
3
4
DK/REF

BIOLOGICAL MOTHER
STEP-MOTHER
ADOPTIVE MOTHER
FOSTER MOTHER

[BIOMOM YOUNGER THAN R] IF MTHRTYPE = 1 AND PERAGEYR DOES NOT EQUAL DK OR REF AND IS = OR
< CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S MOTHER IS THE SAME AGE AS OR YOUNGER THAN THE RESPONDENT. PRESS [ENTER] TO
CLOSE THIS BOX AND GO BACK TO THE PERSON’S INFORMATION AND CORRECT IT.
[BIOMOM AND R 0-12 YEARS APART] IF MTHRTYPE = 1 AND PERAGEYR DOES NOT EQUAL DK OR REF AND
IS 0-12 YEARS OLDER THAN CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE
RECORDED THAT THE RESPONDENT'S MOTHER IS LESS THAN 13 YEARS OLDER THAN THE RESPONDENT.
PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT
QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’
AND PRESS [ENTER].
SUPPMGAP

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[NON-BIOMOM YOUNGER THAN R] IF MTHRTYPE = 2-4 AND PERAGEYR DOES NOT EQUAL DK OR REF AND
IS = OR < CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S [FILL MTHRTYPE] IS THE SAME AGE AS OR YOUNGER THAN THE RESPONDENT. PLEASE
VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION
NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS
[ENTER].
SUPPMTYP

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

DAUTYPE

[IF FRELATON = 3] Is she your biological, step-, adoptive, or foster daughter?
1
2
3
4
DK/REF

BIOLOGICAL DAUGHTER
STEP-DAUGHTER
ADOPTIVE DAUGHTER
FOSTER DAUGHTER

[BIODAUGHTER OLDER THAN R] IF DAUTYPE = 1 AND PERAGEYR DOES NOT EQUAL DK OR REF AND IS =
OR > CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S DAUGHTER IS THE SAME AGE AS OR OLDER THAN THE RESPONDENT. PRESS [ENTER] TO
CLOSE THIS BOX AND GO BACK TO THE PERSON’S INFORMATION AND CORRECT IT.
[BIODAUGHTER AND R 0-12 YEARS APART] IF DAUTYPE = 1 AND PERAGEYR DOES NOT EQUAL DK OR REF
AND IS 0-12 YEARS YOUNGER THAN CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU
HAVE RECORDED THAT THE RESPONDENT'S DAUGHTER IS LESS THAN 13 YEARS YOUNGER THAN THE
RESPONDENT. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY,
HIGHLIGHT THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS,
May 23, 2012

417

HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPDGAP

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[NON-BIODAUGHTER OLDER THAN R] IF DAUTYPE = 2-4 AND PERAGEYR DOES NOT EQUAL DK OR REF AND
IS = OR > CURNTAGE, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S [FILL DAUTYPE] IS THE SAME AGE AS OR OLDER THAN THE RESPONDENT. PLEASE VERIFY
THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER
AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPDTYP

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

SISTYPE

[IF FRELATON = 4] Is she your full, half, step-, adoptive, or foster sister?
1
2
3
4
5
DK/REF

FULL SISTER
HALF SISTER
STEP-SISTER
ADOPTIVE SISTER
FOSTER SISTER

[BIOSIS AND R MORE THAN 25 YEARS APART] IF SISTYPE = 1 AND PERAGEYR DOES NOT EQUAL DK OR REF
AND IS (25 < OR >CURNTAGE), DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT
THERE IS A 25 YEAR OR MORE DIFFERENCE IN AGE BETWEEN THE RESPONDENT AND [HIS/HER] SISTER.
PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT
QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’
AND PRESS [ENTER].
SUPPSGP

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

FTWNTYPE

[IF AGE1 = AGE OF THIS HOUSEHOLD MEMBER AND SISTYPE = 1] Is she your identical twin,
fraternal twin, or neither?
1
IDENTICAL TWIN
2
FRATERNAL TWIN
3
NEITHER
DK/REF

MBRSELCT

[IF FIPE1 = 1 AND MRELATON NE 1 AND FRELATON NE 1 AND PERAGEYR = (12 OR OLDER OR
DK/REF)] WAS THIS HOUSEHOLD MEMBER ALSO SELECTED TO BE INTERVIEWED? (IF YOU
ARE UNSURE, ATTEMPT TO VERIFY WITH THIS RESPONDENT.)
1
YES
2
NO
DK/REF

RETURN TO PERAGEYR AND CYCLE THROUGH THE QUESTIONS FOR THE NEXT HOUSEHOLD MEMBER.
CONTINUE CYCLES UNTIL THE NUMBER OF CYCLES = THE NUMBER REPORTED IN QD54.
[OTHER HH MEMBER SELECTED FOR INTERVIEW] IF FIPE1=1 AND MBRSELCT = 2 FOR ALL HOUSEHOLD
MEMBERS, DISPLAY ERROR BOX: INTERVIEWER: EARLIER, YOU RECORDED THAT 2 PEOPLE WERE SELECTED
AT THIS HOUSEHOLD. THE HOUSEHOLD ROSTER DOES NOT SHOW ANYONE LISTED AS THE SECOND
May 23, 2012

418

RESPONDENT. PLEASE VERIFY THE NUMBER OF PEOPLE SELECTED AT THIS HOUSEHOLD AND FIX THE
APPROPRIATE ANSWER. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND
PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
PROGRAMMER – ONLY ALLOW EDITING OF MBRSELCT.

SUPPHHME

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY YOU HAVE CHOSEN TO SUPPRESS THIS ERROR
ALLOW 200 CHARACTERS

[MORE THAN ONE OTHER HH MEMBER SELECTED FOR INTERVIEW] IF MBRSELCT=1 FOR MORE THAN
ONE HOUSEHOLD MEMBER, DISPLAY ERROR BOX: INTERVIEWER: EARLIER YOU RECORDED THAT 2 PEOPLE
WERE SELECTED AT THIS HOUSEHOLD. HOWEVER, YOU HAVE DESIGNATED MORE THAN ONE HH MEMBER
AS THE OTHER SELECTED PERSON. PLEASE REVIEW YOUR ENTRIES IN THE HH ROSTER AND FIX THE
APPROPRIATE ANSWER.
[MORE THAN 1 SELF] NOTE TO PROGRAMMERS: ONCE MRELATON OR FRELATON = 1, PLEASE IMPLEMENT A
HARD-ERROR TO OCCUR IF THE FI ATTEMPTS TO ENTER A “1" FOR EITHER OF THESE VARIABLES FOR
SUBSEQUENT HOUSEHOLD MEMBERS. THE MESSAGE BOX SHOULD READ: INTERVIEWER: YOU HAVE
ALREADY RECORDED “SELF” AS THE RELATIONSHIP FOR ANOTHER MEMBER OF THIS HOUSEHOLD. “SELF”
CAN ONLY BE CODED FOR ONE MEMBER OF THIS HOUSEHOLD. REVIEW YOUR ENTRIES AND CORRECT THE
APPROPRIATE RELATIONSHIPS AS NECESSARY.
[MORE THAN 1 SPOUSE/PARTNER] NOTE TO PROGRAMMERS: Once MRELATON OR FRELATON = 5 OR 6,
PLEASE IMPLEMENT A HARD-ERROR TO OCCUR IF THE FI ATTEMPTS TO ENTER A “5" OR “6” FOR EITHER OF
THESE VARIABLES FOR SUBSEQUENT HOUSEHOLD MEMBERS. THE MESSAGE BOX SHOULD READ:
INTERVIEWER: YOU HAVE RECORDED THAT THIS IS THE RESPONDENT’S [WIFE/HUSBAND/UNMARRIED
PARTNER]. EARLIER, YOU ENTERED THAT THE RESPONDENT ALREADY HAS [A/AN]
[WIFE/HUSBAND/UNMARRIED PARTNER. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION
NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS
[ENTER].
SUPPMULT

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[16 YEAR OLD R MARRIED/COHABITATING] IF CURNTAGE = OR < 16, AND ANY FRELATON OR MRELATON =
5 OR 6, DISPLAY ERROR BOX: INTERVIEWER: YOU HAVE ENTERED THAT THE [CURNTAGE] YEAR OLD
RESPONDENT IS MARRIED OR COHABITATING. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU NEED
TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE
CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPRMC

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[16 YEAR OLD R HAS IN-LAW] IF CURNTAGE = OR < 16, AND ANY FRELATON OR MRELATON= 8 OR 10,
DISPLAY ERROR BOX: INTERVIEWER: YOU HAVE ENTERED THAT THE [CURNTAGE] YEAR OLD
RESPONDENT HAS AN IN-LAW. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT
AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS
IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPRINL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[GRANDPARENT/GRANDCHILD AND R LESS THAN 30 YEARS APART] IF FRELATON OR MRELATON = (9 OR
11) AND PERAGEYR NE DK/REF AND IS 0-29 YEARS > OR < CURNTAGE, DISPLAY ERROR BOX THAT SAYS:
INTERVIEWER: YOU HAVE RECORDED THAT THE RESPONDENT’S [GRANDPARENT/GRANDCHILD] IS LESS
May 23, 2012

419

THAN 30 YEARS [OLDER/YOUNGER] THAN THE RESPONDENT. PLEASE VERIFY THIS WITH THE RESPONDENT.
IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE
ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPGR30

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE] INTERVIEWER: PLEASE PROVIDE A
BRIEF EXPLANATION FOR WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

May 23, 2012

420

PROXYINT

PROXY INFORMATION
The next questions are about your health insurance coverage and the kinds and amounts of income that you
[IF FAMILY MEMBERS IN ROSTER THEN FILL: “and your family”] receive.
(This information will help in planning health care services and finding ways to lower costs of care.)
PRESS "1" TO CONTINUE.

FAMLY

IF QD54 = 1 SKIP TO QHI01
IF MRELATON=7 OR MRELATON=12 OR MRELATON=14 OR FRELATON=7 OR FRELATON=12 OR
FRELATON=14 FOR ALL PERSONS IN HOUSEHOLD SKIP TO QHI01.
DEFINE FAMILY RELATIONSHIP FILLS:
IF EXACTLY 1 IN ROSTER = (MRELATON = 2 AND FTHRTYPE NE 2), FILL = “father”
IF EXACTLY 1 IN ROSTER = (MRELATON = 2 AND FTHRTYPE = 2), FILL = “stepfather”
IF MORE THAN 1 IN ROSTER = (MRELATON = 2 AND FTHRTYPE NE 2), FILL = “fathers”
IF MORE THAN 1 IN ROSTER = (MRELATON = 2 AND FTHRTYPE = 2), FILL = “stepfathers”
IF EXACTLY 1 IN ROSTER = (MRELATON = 3 AND SONTYPE NE 2), FILL = “son”
IF EXACTLY 1 IN ROSTER = (MRELATON = 3 AND SONTYPE = 2), FILL = “stepson”
IF MORE THAN 1 IN ROSTER = (MRELATON = 3 AND SONTYPE NE 2), FILL = “sons”
IF MORE THAN 1 IN ROSTER = (MRELATON = 3 AND SONTYPE = 2), FILL = “stepsons”
IF EXACTLY 1 IN ROSTER = (MRELATON = 4 AND BTHRTYPE NE 3), FILL = “brother”
IF EXACTLY 1 IN ROSTER = (MRELATON = 4 AND BTHRTYPE = 3), FILL = “stepbrother”
IF MORE THAN 1 IN ROSTER = (MRELATON = 4 AND BTHRTYPE NE 3), FILL = “brothers”
IF MORE THAN 1 IN ROSTER = (MRELATON = 4 AND BTHRTYPE = 3), FILL = “stepbrothers”
IF EXACTLY 1 IN ROSTER = (MRELATON = 5), FILL = “husband”
IF MORE THAN 1 IN ROSTER = (MRELATON = 5), FILL = “husbands”
IF EXACTLY 1 IN ROSTER = (MRELATON = 6 OR FRELATON = 6), FILL = “partner”
IF MORE THAN 1 IN ROSTER = (MRELATON = 6 OR FRELATON = 6), FILL = “partners”
IF EXACTLY 1 IN ROSTER = (MRELATON = 8), FILL = “son-in-law”
IF MORE THAN 1 IN ROSTER = (MRELATON = 8), FILL = “sons-in-law”
IF EXACTLY 1 IN ROSTER = (MRELATON = 9), FILL = “grandson”
IF MORE THAN 1 IN ROSTER = (MRELATON = 9), FILL = “grandsons”
IF EXACTLY 1 IN ROSTER = (MRELATON = 10), FILL = “father-in-law”
IF MORE THAN 1 IN ROSTER = (MRELATON = 10), FILL = “fathers-in-law”
IF EXACTLY 1 IN ROSTER = (MRELATON = 11), FILL = “grandfather”
IF MORE THAN 1 IN ROSTER = (MRELATON = 11), FILL = “grandfathers”
IF EXACTLY 1 IN ROSTER = (MRELATON = 13), FILL = “other male relative”
IF MORE THAN 1 IN ROSTER = (MRELATON = 13), FILL = “other male relatives”
IF EXACTLY 1 IN ROSTER = (FRELATON = 2 AND MTHRTYPE NE 2), FILL = “mother”
IF EXACTLY 1 IN ROSTER = (FRELATON = 2 AND MTHRTYPE = 2), FILL = “stepmother”
IF MORE THAN 1 IN ROSTER = (FRELATON = 2 AND MTHRTYPE NE 2), FILL = “mothers”
IF MORE THAN 1 IN ROSTER = (FRELATON = 2 AND MTHRTYPE = 2), FILL = “stepmothers”
IF EXACTLY 1 IN ROSTER = (FRELATON = 3 AND DAUTYPE NE 2), FILL = “daughter”
IF EXACTLY 1 IN ROSTER = (FRELATON = 3 AND DAUTYPE = 2), FILL = “stepdaughter”
IF MORE THAN 1 IN ROSTER = (FRELATON = 3 AND DAUTYPE NE 2), FILL = “daughters”
IF MORE THAN 1 IN ROSTER = (FRELATON = 3 AND DAUTYPE = 2), FILL = “stepdaughters”
IF EXACTLY 1 IN ROSTER = (FRELATON = 4 AND SISTYPE NE 3), FILL = “sister”
IF EXACTLY 1 IN ROSTER = (FRELATON = 4 AND SISTYPE = 3), FILL = “stepsister”
IF MORE THAN 1 IN ROSTER = (FRELATON = 4 AND SISTYPE NE 3), FILL = “sisters”
IF MORE THAN 1 IN ROSTER = (FRELATON = 4 AND SISTYPE = 3), FILL = “stepsisters”

May 23, 2012

421

IF EXACTLY 1 IN ROSTER = (FRELATON = 5), FILL = “wife”
IF MORE THAN 1 IN ROSTER = (FRELATON = 5), FILL = “wives”
IF EXACTLY 1 IN ROSTER = (FRELATON = 8), FILL = “daughter-in-law”
IF MORE THAN 1 IN ROSTER = (FRELATON = 8), FILL = “daughters-in-law”
IF EXACTLY 1 IN ROSTER = (FRELATON = 9), FILL = “granddaughter”
IF MORE THAN 1 IN ROSTER = (FRELATON = 9), FILL = “granddaughters”
IF EXACTLY 1 IN ROSTER = (FRELATON = 10), FILL = “mother-in-law”
IF MORE THAN 1 IN ROSTER = (FRELATON = 10), FILL = “mothers-in-law”
IF EXACTLY 1 IN ROSTER = (FRELATON = 11), FILL = “grandmother”
IF MORE THAN 1 IN ROSTER = (FRELATON = 11), FILL = “grandmothers”
IF EXACTLY 1 IN ROSTER = (FRELATON = 13), FILL = “other female relative”
IF MORE THAN 1 IN ROSTER = (FRELATON = 13), FILL = “other female relatives”
[Note to Programmers: FAMILY RELATIONSHIP FILLS should be taken from the roster. They should appear
in lower case and be separated by commas. In QP01, INTROINC, INTROFI1, INTROFI2, and INTROFI3,
the last FAMILY RELATIONSHIP FILL should be preceded by the word “and.” In all other situations, the last
FAMILY RELATIONSHIP FILL should be preceded by the word “or.” For example, if a respondent has a father
and a husband listed in the roster, INTROINC should read, “These next questions are about the kinds and amounts
of income that you and your family – that is, your father and husband living here – receive.”]
QP01

[IF QD54 > 1 AND RESPONDENT IS ONLY FAMILY MEMBER 18 OR OLDER AND ALL PERAGEYR NE
DK/REF, SKIP TO QHI01]
[IF ROSTER HAS MORE THAN 1 ADULT FAMILY MEMBER LISTED AND ALL PERAGEYR NE DK/REF ]
{FILL ONLY ADULT FAMILY MEMBERS (PERAGEYR > 17) IN THIS QUESTION} I have listed as adult family
members who live here: your [FAMILY RELATIONSHIP FILLS]. Do you think one of these people would be better
able to give me the correct information about your health insurance coverage and the kinds of income you and your
family receive?
[IF ROSTER HAS ONLY 1 ADULT FAMILY MEMBER LISTED] {FILL ONLY ADULT FAMILY MEMBERS
(PERAGEYR > 17) IN THIS QUESTION} Do you think your [FAMILY RELATIONSHIP FILL] would be better
able to give me the correct information about your health insurance coverage and the kinds of income you and your
family receive?
[IF ROSTER HAS NO FAMILY MEMBER OTHER THAN THE RESPONDENT LISTED AS 18 OR OLDER, BUT
THERE IS AT LEAST 1 DK OR REF ENTERED FOR ANY PERAGEYR OR THERE IS MORE THAN 1 ADULT
LISTED AND AT LEAST 1 DK/REF ENTERED FOR ANY PERAGEYR.] Is there anyone else who lives here who
is 18 or older who would be better able to give me the correct information about your health insurance coverage and the
kinds of income you receive?
1
YES
2
NO [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR REMAINING QUESTIONS]
DK/REF [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR REMAINING QUESTIONS]

QP02

[IF QP01=1 AND MORE THAN 1 OTHER PERSON IN ROSTER] (Who is the person you think can help us get the
correct information for these questions?) ENTER RELATIONSHIP OF PERSON WHO CAN BETTER ANSWER
THESE QUESTIONS.
[IF QP01 = 1 AND ONLY 1 OTHER PERSON IN ROSTER] INTERVIEWER: ENTER ‛1’.
[FILL 1-9 WITH AGES AND RELATIONSHIPS FROM THE FIRST NINE ADULT FAMILY MEMBERS OF THE
HOUSEHOLD ROSTER, I.E., “ father”. FILL UNUSED LINES WITH “DO NOT USE” AND MAKE THEM
INVALID.]
1
2
3
4
5
6

May 23, 2012

[ROSTER FILL]
[ROSTER FILL]
[ROSTER FILL]
[ROSTER FILL]
[ROSTER FILL]
[ROSTER FILL]
422

7
8
9
10
DK/REF
QP03

[ROSTER FILL]
[ROSTER FILL]
[ROSTER FILL]
OTHER ADULT/RELATIVE

[IF QP02 NE DK/REF OR BLANK] (Is your [QP02 FILL] available right now?)
1
YES
2
NO [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR REMAINING QUESTIONS]
DK/REF [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR REMAINING QUESTIONS]

QP04

[IF QP03=1] (Would you ask your [QP02 FILL] to join us to help with these last questions about health insurance and
income?)
1
YES
2
NO [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR REMAINING QUESTIONS]
DK/REF [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR REMAINING QUESTIONS]

HASJOIN

[IF QP04 = 1] HAS THE PERSON’S [QP02 FILL] JOINED R?
1
2

YES [ACTIVATE PROXYFILL AS “SAMPLE MEMBER/SAMPLE MEMBER’S” FOR
REMAINING QUESTIONS]
NO [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR REMAINING QUESTIONS]

DEFINE SAMPLE MEMBER:
IF QD54 = 1 OR (MRELATON=7 OR MRELATON=12 OR MRELATON=14 OR FRELATON=7 OR
FRELATON=12 OR FRELATON=14 FOR ALL PERSONS IN HOUSEHOLD) OR HASJOIN = 2, SAMPLE
MEMBER = “you”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father” (MRELATON = 2 AND FTHRTYPE NE 2) OR “mother”
(FRELATON = 2 AND MTHRTYPE NE 2), SAMPLE MEMBER = “your son”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “stepfather” (MRELATON = 2 AND FTHRTYPE = 2) OR “stepmother”
(FRELATON = 2 AND MTHRTYPE = 2), SAMPLE MEMBER = “your stepson”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3 AND SONTYPE NE 2) OR “daughter” (FRELATON
= 3 AND DAUTYPE NE 2), SAMPLE MEMBER = “your father”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “stepson” (MRELATON = 3 AND SONTYPE = 2) OR “stepdaughter”
(FRELATON = 3 AND DAUTYPE = 2), SAMPLE MEMBER = “your stepfather”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 4 AND BTHRTYPE NE 3) OR “sister”
(FRELATON = 4 AND SISTYPE NE 3), SAMPLE MEMBER = “your brother”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “stepbrother” (MRELATON = 4 AND BTHRTYPE = 3) OR “stepsister”
(FRELATON = 4 AND SISTYPE = 3), SAMPLE MEMBER = “your stepbrother”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 5) OR “wife” (FRELATON = 5), SAMPLE
MEMBER = “your husband”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 6 OR FRELATON = 6), SAMPLE MEMBER =
“your partner”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 8) OR “daughter-in-law” (FRELATON = 8),
SAMPLE MEMBER = “your father-in-law”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 9) OR “granddaughter” (FRELATON = 9,
SAMPLE MEMBER = “your grandfather”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 10) OR “mother-in-law” (FRELATON = 10),
SAMPLE MEMBER = “your son-in-law”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR “grandmother” (FRELATON = 11),
SAMPLE MEMBER = “your grandson”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON = 13) OR “other female relative”
(FRELATON = 13), SAMPLE MEMBER = “SAMPLE MEMBER”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father” (MRELATON = 2 AND FTHRTYPE NE 2) OR “mother”
(FRELATON = 2 AND MTHRTYPE NE 2), SAMPLE MEMBER = “your daughter”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “stepfather” (MRELATON = 2 AND FTHRTYPE = 2) OR “stepmother”
(FRELATON = 2 AND MTHRTYPE = 2), SAMPLE MEMBER = “your stepdaughter”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3 AND SONTYPE NE 2) OR “daughter” (FRELATON
= 3 AND DAUTYPE NE 2), SAMPLE MEMBER = “your mother”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “stepson” (MRELATON = 3 AND SONTYPE = 2) OR “stepdaughter”
(FRELATON = 3 AND DAUTYPE = 2), SAMPLE MEMBER = “your stepmother”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 4 AND BTHRTYPE NE 3) OR “sister”
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(FRELATON = 4 AND SISTYPE NE 3), SAMPLE MEMBER = “your sister”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “stepbrother” (MRELATON = 4 AND BTHRTYPE = 3) OR “stepsister”
(FRELATON = 4 AND SISTYPE = 3), SAMPLE MEMBER = “your stepsister”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 5) OR “wife” (FRELATON = 5), SAMPLE
MEMBER = “your wife”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 6 OR FRELATON = 6), SAMPLE MEMBER =
“your partner”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 8) OR “daughter-in-law” (FRELATON = 8),
SAMPLE MEMBER = “your mother-in-law”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 9) OR “granddaughter” (FRELATON = 9,
SAMPLE MEMBER = “your grandmother”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 10) OR “mother-in-law” (FRELATON = 10),
SAMPLE MEMBER = “your daughter-in-law”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR “grandmother” (FRELATON = 11),
SAMPLE MEMBER = “your granddaughter”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON = 13) OR “other female relative”
(FRELATON = 13), SAMPLE MEMBER = “SAMPLE MEMBER”
DEFINE SAMPLE MEMBER POSS
IF QD54 = 1 OR (MRELATON=7 OR MRELATON=12 OR MRELATON=14 OR FRELATON=7 OR
FRELATON=12 OR FRELATON=14 FOR ALL PERSONS IN HOUSEHOLD) OR HASJOIN = 2, SAMPLE
MEMBER POSS = “your”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father” (MRELATON = 2 AND FTHRTYPE NE 2) OR “mother”
(FRELATON = 2 AND MTHRTYPE NE 2), SAMPLE MEMBER POSS = “your son’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “stepfather” (MRELATON = 2 AND FTHRTYPE = 2) OR “stepmother”
(FRELATON = 2 AND MTHRTYPE = 2), SAMPLE MEMBER POSS = “your stepson’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3 AND SONTYPE NE 2) OR “daughter” (FRELATON
= 3 AND DAUTYPE NE 2), SAMPLE MEMBER POSS = “your father’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “stepson” (MRELATON = 3 AND SONTYPE = 2) OR “stepdaughter”
(FRELATON = 3 AND DAUTYPE = 2), SAMPLE MEMBER POSS = “your stepfather’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 4 AND BTHRTYPE NE 3) OR “sister”
(FRELATON = 4 AND SISTYPE NE 3), SAMPLE MEMBER POSS = “your brother’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “stepbrother” (MRELATON = 4 AND BTHRTYPE = 3) OR “stepsister”
(FRELATON = 4 AND SISTYPE = 3), SAMPLE MEMBER POSS = “your stepbrother’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 5) OR “wife” (FRELATON = 5), SAMPLE
MEMBER POSS = “your husband’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 6 OR FRELATON = 6), SAMPLE MEMBER
POSS = “your partner’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 8) OR “daughter-in-law” (FRELATON = 8),
SAMPLE MEMBER POSS = “your father-in-law’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 9) OR “granddaughter” (FRELATON = 9,
SAMPLE MEMBER POSS = “your grandfather’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 10) OR “mother-in-law” (FRELATON = 10),
SAMPLE MEMBER POSS = “your son-in-law’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR “grandmother” (FRELATON = 11),
SAMPLE MEMBER POSS = “your grandson’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON = 13) OR “other female relative”
(FRELATON = 13), SAMPLE MEMBER POSS = “SAMPLE MEMBER’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father” (MRELATON = 2 AND FTHRTYPE NE 2) OR “mother”
(FRELATON = 2 AND MTHRTYPE NE 2), SAMPLE MEMBER POSS = “your daughter’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “stepfather” (MRELATON = 2 AND FTHRTYPE = 2) OR “stepmother”
(FRELATON = 2 AND MTHRTYPE = 2), SAMPLE MEMBER POSS = “your stepdaughter’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3 AND SONTYPE NE 2) OR “daughter” (FRELATON
= 3 AND DAUTYPE NE 2), SAMPLE MEMBER POSS = “your mother’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “stepson” (MRELATON = 3 AND SONTYPE = 2) OR “stepdaughter”
(FRELATON = 3 AND DAUTYPE = 2), SAMPLE MEMBER POSS = “your stepmother’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 4 AND BTHRTYPE NE 3) OR “sister”
(FRELATON = 4 AND SISTYPE NE 3), SAMPLE MEMBER POSS = “your sister’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “stepbrother” (MRELATON = 4 AND BTHRTYPE = 3) OR “stepsister”
(FRELATON = 4 AND SISTYPE = 3), SAMPLE MEMBER POSS = “your stepsister’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 5) OR “wife” (FRELATON = 5), SAMPLE
MEMBER POSS = “your wife’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 6 OR FRELATON = 6), SAMPLE MEMBER
POSS = “your partner’s”
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IF QD01 = 9 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 8) OR “daughter-in-law” (FRELATON = 8),
SAMPLE MEMBER POSS = “your mother-in-law’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 9) OR “granddaughter” (FRELATON = 9,
SAMPLE MEMBER POSS = “your grandmother’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 10) OR “mother-in-law” (FRELATON = 10),
SAMPLE MEMBER POSS = “your daughter-in-law’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR “grandmother” (FRELATON = 11),
SAMPLE MEMBER POSS = “your granddaughter’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON = 13) OR “other female relative”
(FRELATON = 13), SAMPLE MEMBER POSS = “SAMPLE MEMBER’s”
DEFINE SAMPLE MEMBER A
IF QD54 = 1 OR (MRELATON=7 OR MRELATON=12 OR MRELATON=14 OR FRELATON=7 OR
FRELATON=12 OR FRELATON=14 FOR ALL PERSONS IN HOUSEHOLD) OR HASJOIN = 2, SAMPLE
MEMBER A = “Are you”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father” (MRELATON = 2 AND FTHRTYPE NE 2) OR “mother”
(FRELATON = 2 AND MTHRTYPE NE 2), SAMPLE MEMBER A = “Is your son”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “stepfather” (MRELATON = 2 AND FTHRTYPE = 2) OR “stepmother”
(FRELATON = 2 AND MTHRTYPE = 2), SAMPLE MEMBER A = “Is your stepson”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3 AND SONTYPE NE 2) OR “daughter” (FRELATON
= 3 AND DAUTYPE NE 2), SAMPLE MEMBER A = “Is your father”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “stepson” (MRELATON = 3 AND SONTYPE = 2) OR “stepdaughter”
(FRELATON = 3 AND DAUTYPE = 2), SAMPLE MEMBER A = “Is your stepfather”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 4 AND BTHRTYPE NE 3) OR “sister”
(FRELATON = 4 AND SISTYPE NE 3), SAMPLE MEMBER A = “Is your brother”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “stepbrother” (MRELATON = 4 AND BTHRTYPE = 3) OR “stepsister”
(FRELATON = 4 AND SISTYPE = 3), SAMPLE MEMBER A = “Is your stepbrother”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 5) OR “wife” (FRELATON = 5), SAMPLE
MEMBER A = “Is your husband”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 6 OR FRELATON = 6), SAMPLE MEMBER A =
“Is your partner”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 8) OR “daughter-in-law” (FRELATON = 8),
SAMPLE MEMBER A = “Is your father-in-law”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 9) OR “granddaughter” (FRELATON = 9,
SAMPLE MEMBER A = “Is your grandfather”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 10) OR “mother-in-law” (FRELATON = 10),
SAMPLE MEMBER A = “Is your son-in-law”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR “grandmother” (FRELATON = 11),
SAMPLE MEMBER A = “Is your grandson”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON = 13) OR “other female relative”
(FRELATON = 13), SAMPLE MEMBER A = “Is SAMPLE MEMBER ”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father” (MRELATON = 2 AND FTHRTYPE NE 2) OR “mother”
(FRELATON = 2 AND MTHRTYPE NE 2), SAMPLE MEMBER A = “Is your daughter”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “stepfather” (MRELATON = 2 AND FTHRTYPE = 2) OR “stepmother”
(FRELATON = 2 AND MTHRTYPE = 2), SAMPLE MEMBER A = “Is your stepdaughter”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3 AND SONTYPE NE 2) OR “daughter” (FRELATON
= 3 AND DAUTYPE NE 2), SAMPLE MEMBER A = “Is your mother”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “stepson” (MRELATON = 3 AND SONTYPE = 2) OR “stepdaughter”
(FRELATON = 3 AND DAUTYPE = 2), SAMPLE MEMBER A = “Is your stepmother”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 4 AND BTHRTYPE NE 3) OR “sister”
(FRELATON = 4 AND SISTYPE NE 3), SAMPLE MEMBER A = “Is your sister”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “stepbrother” (MRELATON = 4 AND BTHRTYPE = 3) OR “stepsister”
(FRELATON = 4 AND SISTYPE = 3), SAMPLE MEMBER A = “Is your stepsister”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 5) OR “wife” (FRELATON = 5), SAMPLE
MEMBER A = “Is your wife”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 6 OR FRELATON = 6), SAMPLE MEMBER A =
“your partner”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 8) OR “daughter-in-law” (FRELATON = 8),
SAMPLE MEMBER A = “Is your mother-in-law”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 9) OR “granddaughter” (FRELATON = 9,
SAMPLE MEMBER A = “Is your grandmother”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 10) OR “mother-in-law” (FRELATON = 10),
SAMPLE MEMBER A = “Is your daughter-in-law”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR “grandmother” (FRELATON = 11),
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SAMPLE MEMBER A = “Is your granddaughter”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON = 13) OR “other female relative”
(FRELATON = 13), SAMPLE MEMBER A = “Is SAMPLE MEMBER”
DEFINE SAMPLE MEMBER B
IF QD54 = 1 OR (MRELATON=7 OR MRELATON=12 OR MRELATON=14 OR FRELATON=7 OR
FRELATON=12 OR FRELATON=14 FOR ALL PERSONS IN HOUSEHOLD) OR HASJOIN = 2, SAMPLE
MEMBER B = “you are”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father” (MRELATON = 2 AND FTHRTYPE NE 2) OR “mother”
(FRELATON = 2 AND MTHRTYPE NE 2), SAMPLE MEMBER B = “your son is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “stepfather” (MRELATON = 2 AND FTHRTYPE = 2) OR “stepmother”
(FRELATON = 2 AND MTHRTYPE = 2), SAMPLE MEMBER B = “your stepson is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3 AND SONTYPE NE 2) OR “daughter” (FRELATON
= 3 AND DAUTYPE NE 2), SAMPLE MEMBER B = “your father is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “stepson” (MRELATON = 3 AND SONTYPE = 2) OR “stepdaughter”
(FRELATON = 3 AND DAUTYPE = 2), SAMPLE MEMBER B = “your stepfather is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 4 AND BTHRTYPE NE 3) OR “sister”
(FRELATON = 4 AND SISTYPE NE 3), SAMPLE MEMBER B = “your brother is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “stepbrother” (MRELATON = 4 AND BTHRTYPE = 3) OR “stepsister”
(FRELATON = 4 AND SISTYPE = 3), SAMPLE MEMBER B = “your stepbrother is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 5) OR “wife” (FRELATON = 5), SAMPLE
MEMBER B = “your husband is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 6 OR FRELATON = 6), SAMPLE MEMBER B =
“your partner is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 8) OR “daughter-in-law” (FRELATON = 8),
SAMPLE MEMBER B = “your father-in-law is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 9) OR “granddaughter” (FRELATON = 9,
SAMPLE MEMBER B = “your grandfather is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 10) OR “mother-in-law” (FRELATON = 10),
SAMPLE MEMBER B = “your son-in-law is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR “grandmother” (FRELATON = 11),
SAMPLE MEMBER B = “your grandson is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON = 13) OR “other female relative”
(FRELATON = 13), SAMPLE MEMBER B = “SAMPLE MEMBER is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father” (MRELATON = 2 AND FTHRTYPE NE 2) OR “mother”
(FRELATON = 2 AND MTHRTYPE NE 2), SAMPLE MEMBER B = “your daughter is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “stepfather” (MRELATON = 2 AND FTHRTYPE = 2) OR “stepmother”
(FRELATON = 2 AND MTHRTYPE = 2), SAMPLE MEMBER B = “your stepdaughter is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3 AND SONTYPE NE 2) OR “daughter” (FRELATON
= 3 AND DAUTYPE NE 2), SAMPLE MEMBER B = “your mother is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “stepson” (MRELATON = 3 AND SONTYPE = 2) OR “stepdaughter”
(FRELATON = 3 AND DAUTYPE = 2), SAMPLE MEMBER B = “your stepmother is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 4 AND BTHRTYPE NE 3) OR “sister”
(FRELATON = 4 AND SISTYPE NE 3), SAMPLE MEMBER B = “your sister is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “stepbrother” (MRELATON = 4 AND BTHRTYPE = 3) OR “stepsister”
(FRELATON = 4 AND SISTYPE = 3), SAMPLE MEMBER B = “your stepsister is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 5) OR “wife” (FRELATON = 5), SAMPLE
MEMBER B = “your wife is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 6 OR FRELATON = 6), SAMPLE MEMBER B =
“your partner is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 8) OR “daughter-in-law” (FRELATON = 8),
SAMPLE MEMBER B = “your mother-in-law is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 9) OR “granddaughter” (FRELATON = 9,
SAMPLE MEMBER B = “your grandmother is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 10) OR “mother-in-law” (FRELATON = 10),
SAMPLE MEMBER B = “your daughter-in-law is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR “grandmother” (FRELATON = 11),
SAMPLE MEMBER B = “your granddaughter is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON = 13) OR “other female relative”
(FRELATON = 13), SAMPLE MEMBER B = “SAMPLE MEMBER is”

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TOPROXY

[IF HASJOIN = 1] WHEN [QP02 FILL] HAS JOINED YOU. The next questions are about [SAMPLE
MEMBER POSS] health insurance coverage and the kinds and amounts of income that [SAMPLE
MEMBER] and other people in your family receive.
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] WHEN [QP02 FILL] HAS JOINED YOU.
The next questions are about [SAMPLE MEMBER POSS] health insurance coverage and the kinds and
amounts of income that [SAMPLE MEMBER] and you receive.
(This information will help in planning health care services and finding ways to lower costs of care.)
PRESS [ENTER] TO CONTINUE.

QHI01

[IF QP03 = 2 OR DK/REF OR QP04 = 2 OR DK/REF OR HASJOIN = 2 OR DK/REF ADD THIS TEXT PRIOR
TO THE QUESTION: Since your [QP02 FILL] is not available, I’d like you to answer these next questions the
best you can.] Several government programs provide medical care or help pay medical bills.
Medicare is a health insurance program for persons aged 65 and older and for certain disabled persons.
[SAMPLE MEMBER A] covered by Medicare?
1
YES
2
NO
DK/REF

QHI01v

[IF QHI01 = 1 AND CURNTAGE < 65] You have indicated that [SAMPLE MEMBER B] covered by Medicare,
which is a health insurance program for persons aged 65 and older and for certain disabled persons. Is this
correct?

1
YES
2
NO
DK/REF
Note: Medicare Program Names will be updated in July.
DEFINE MEDIFILL:
IF FIPE4 =1 THEN MEDIFILL = Patient 1st, MLIF, or SOBRA
IF FIPE4 =2 THEN MEDIFILL = NONE
IF FIPE4 =3 THEN MEDIFILL = AHCCCS or Arizona Health Care Cost Containment System
IF FIPE4 =4 THEN MEDIFILL = NONE
IF FIPE4 =5 THEN MEDIFILL = Medi-Cal
IF FIPE4 =6 THEN MEDIFILL = NONE
IF FIPE4 =7 THEN MEDIFILL = Connecticut Medical Assistance Program
IF FIPE4 =8 THEN MEDIFILL = The Delaware Medical Assistance Program or the Diamond State Health Plan
IF FIPE4 =9 THEN MEDIFILL = DC Healthy Families
IF FIPE4 =10 THEN MEDIFILL = NONE
IF FIPE4 =11 THEN MEDIFILL = NONE
IF FIPE4 =12 THEN MEDIFILL = Hawaii QUEST, QUEST, or Medicaid Fee-For-Service Program
IF FIPE4 =13 THEN MEDIFILL = NONE
IF FIPE4 =14 THEN MEDIFILL = NONE
IF FIPE4 =15 THEN MEDIFILL = Hoosier Healthwise or Care Select
IF FIPE4 =16 THEN MEDIFILL = NONE
IF FIPE4 =17 THEN MEDIFILL = HealthWave
IF FIPE4 =18 THEN MEDIFILL = NONE
IF FIPE4 =19 THEN MEDIFILL = NONE
IF FIPE4 =20 THEN MEDIFILL = MaineCare
IF FIPE4 =21 THEN MEDIFILL = Maryland Medical Assistance
IF FIPE4 =22 THEN MEDIFILL = MassHealth
IF FIPE4 =23 THEN MEDIFILL = NONE
IF FIPE4 =24 THEN MEDIFILL = The Medical Assistance Program, MinnesotaCare, or General Assistance Medical
Care
IF FIPE4 =25 THEN MEDIFILL = NONE
IF FIPE4 =26 THEN MEDIFILL = MO HealthNet
IF FIPE4 =27 THEN MEDIFILL = NONE
IF FIPE4 =28 THEN MEDIFILL = NONE
IF FIPE4 =29 THEN MEDIFILL = NONE
IF FIPE4 =30 THEN MEDIFILL = NONE
IF FIPE4 =31 THEN MEDIFILL = NONE
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IF FIPE4 =32 THEN MEDIFILL = Salud!
IF FIPE4 =33 THEN MEDIFILL = NONE
IF FIPE4 =34 THEN MEDIFILL = North Carolina Medicaid
IF FIPE4 =35 THEN MEDIFILL = NONE
IF FIPE4 =36 THEN MEDIFILL = Ohio Medicaid or Healthy Families
IF FIPE4 =37 THEN MEDIFILL = SoonerCare
IF FIPE4 =38 THEN MEDIFILL = Oregon Health Plan or OHP
IF FIPE4 =39 THEN MEDIFILL = Medical Assistance or MA
IF FIPE4 =40 THEN MEDIFILL = RIteCare
IF FIPE4 =41 THEN MEDIFILL = Healthy Connections
IF FIPE4 =42 THEN MEDIFILL = NONE
IF FIPE4 =43 THEN MEDIFILL = TennCare
IF FIPE4 =44 THEN MEDIFILL = NONE
IF FIPE4 =45 THEN MEDIFILL = NONE
IF FIPE4 =46 THEN MEDIFILL = NONE
IF FIPE4 =47 THEN MEDIFILL = NONE
IF FIPE4 =48 THEN MEDIFILL = NONE
IF FIPE4 =49 THEN MEDIFILL = NONE
IF FIPE4 =50 THEN MEDIFILL = BadgerCare Plus
IF FIPE4 =51 THEN MEDIFILL = EqualityCare
ELSE MEDIFILL = BLANK
QHI02

Medicaid is a public assistance program that pays for medical care for low income and disabled persons. [IF
MEDIFILL NE NONE] The Medicaid program in [STATE FILL] is also called [MEDIFILL].
[SAMPLE MEMBER A]covered by Medicaid?
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
Medicaid refers to a medical assistance program that provides health care coverage to
low income and disabled persons. Most states refer to Medicaid as Medical Assistance.

QHI02v

[IF QHI02 = 1 AND CURNTAGE = 65 OR OLDER] You have indicated that [SAMPLE MEMBER B] covered
by Medicaid, which is a public assistance program that pays for medical care for low income and disabled
persons. Is this correct?

1
YES
2
NO
DK/REF
Note: CHIP Program Names will be updated in July.
DEFINE CHIPFILL
IF FIPE4 = 1 THEN CHIPFILL = ALL Kids
IF FIPE4 = 2 THEN CHIPFILL = Denali KidCare
IF FIPE4 = 3 THEN CHIPFILL = KidsCare
IF FIPE4 = 4 THEN CHIPFILL = ARKids First
IF FIPE4 = 5 THEN CHIPFILL = Healthy Families
IF FIPE4 = 6 THEN CHIPFILL = Child Health Plan Plus, or CHP+
IF FIPE4 = 7 THEN CHIPFILL = The HUSKY Plan, or HUSKY PLUS
IF FIPE4 = 8 THEN CHIPFILL = The Delaware Healthy Children Program or DHCP
IF FIPE4 = 9 THEN CHIPFILL = DC Healthy Families
IF FIPE4 = 10 THEN CHIPFILL = Florida KidCare
IF FIPE4 = 11 THEN CHIPFILL = PeachCare for Kids
IF FIPE4 = 12 THEN CHIPFILL = QUEST or QExA
IF FIPE4 = 13 THEN CHIPFILL = Idaho Health Plan for Children: Children Health Insurance Plan, or CHIP, or
Medicaid
IF FIPE4 = 14 THEN CHIPFILL = All Kids
IF FIPE4 = 15 THEN CHIPFILL = Hoosier Healthwise
IF FIPE4 = 16 THEN CHIPFILL = Healthy and Well Kids in Iowa or hawk-i
IF FIPE4 = 17 THEN CHIPFILL = HealthWave
IF FIPE4 = 18 THEN CHIPFILL = KCHIP or Kentucky Children’s Health Insurance Program
IF FIPE4 = 19 THEN CHIPFILL = LaCHIP or Louisiana Children’s Health Insurance Program
May 23, 2012

428

IF FIPE4 = 20 THEN CHIPFILL = Cub Care
IF FIPE4 = 21 THEN CHIPFILL = Maryland Children’s Health Program or MCHP
IF FIPE4 = 22 THEN CHIPFILL = MassHealth
IF FIPE4 = 23 THEN CHIPFILL = MIChild or Healthy Kids
IF FIPE4 = 24 THEN CHIPFILL = NONE
IF FIPE4 = 25 THEN CHIPFILL = Children’s Health Insurance Program or CHIP
IF FIPE4 = 26 THEN CHIPFILL = MO HealthNet for Kids
IF FIPE4 = 27 THEN CHIPFILL = Healthy Montana Kids
IF FIPE4 = 28 THEN CHIPFILL = Kids Connection
IF FIPE4 = 29 THEN CHIPFILL = Nevada Check Up
IF FIPE4 = 30 THEN CHIPFILL = NH Healthy Kids Gold or NH Healthy Kids Silver
IF FIPE4 = 31 THEN CHIPFILL = NJ Family Care
IF FIPE4 = 32 THEN CHIPFILL = New MexiKids or New MexiTeens
IF FIPE4 = 33 THEN CHIPFILL = Child Health Plus
IF FIPE4 = 34 THEN CHIPFILL = Health Check
IF FIPE4 = 35 THEN CHIPFILL = North Dakota Healthy Steps
IF FIPE4 = 36 THEN CHIPFILL = Healthy Start, SCHIP, or Healthchek
IF FIPE4 = 37 THEN CHIPFILL = SoonerCare
IF FIPE4 = 38 THEN CHIPFILL = Oregon Health Plan Plus or OHP Plus
IF FIPE4 = 39 THEN CHIPFILL = CHIP or Children’s Health Insurance Program
IF FIPE4 = 40 THEN CHIPFILL = RIte Care
IF FIPE4 = 41 THEN CHIPFILL = Partners for Healthy Children (PHC)
IF FIPE4 = 42 THEN CHIPFILL = Children’s Health Insurance Program or CHIP
IF FIPE4 = 43 THEN CHIPFILL = CoverKids
IF FIPE4 = 44 THEN CHIPFILL = Children’s Health Insurance Program or CHIP
IF FIPE4 = 45 THEN CHIPFILL = Utah Children’s Health Insurance Program
IF FIPE4 = 46 THEN CHIPFILL = Dr. Dynasaur
IF FIPE4 = 47 THEN CHIPFILL = The Family Access to Medical Insurance Security Plan or FAMIS
IF FIPE4 = 48 THEN CHIPFILL = Apple Health for Kids
IF FIPE4 = 49 THEN CHIPFILL = West Virginia Children’s Health Insurance Program or WVCHIP
IF FIPE4 = 50 THEN CHIPFILL = BadgerCare Plus
IF FIPE4 = 51 THEN CHIPFILL = Kid Care CHIP
ELSE CHIPFILL = BLANK
QHI02A

[IF CURNTAGE = 12-19] [SAMPLE MEMBER A] currently covered by [CHIPFILL]?
1
Yes
2
No
DK/REF
INTERVIEWER NOTE:
These programs cover children from low-income families who do not have private health
insurance and who do not qualify for other Medicaid programs.

QHI03

[SAMPLE MEMBER A] currently covered by TRICARE, or CHAMPUS, CHAMPVA, the VA, or military health
care?
(These programs cover active duty and retired career military personnel and their dependents and survivors and
also disabled veterans and their dependents and survivors.)
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
CHAMPUS stands for Civilian Comprehensive Health and Medical Program Plan of for
the Uniformed Services. It provides health care in private facilities for dependents of
military personnel on active duty or retired for reasons other than disability. In some
areas, this may be known as TRICARE.
CHAMPVA stands for Civilian Comprehensive Health and Medical Program Plan of the
Department of Veterans Affairs Administration. It provides health care for the spouse,
dependents, or survivors of a veteran who has a total, permanent service-connected
disability.

May 23, 2012

429

Military health care refers to health care available to active duty personnel and their
dependents; in addition, the VA provides medical assistance to veterans of the Armed
Forces, particularly those with service-connected ailments.
QHI06

Private health insurance can be obtained through work, such as through an employer, union, or professional
association, or by paying premiums directly to a health insurance company.
[SAMPLE MEMBER A] currently covered by private health insurance?
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
Private health insurance refers to any type of health insurance other than Medicare,
Medicaid and coverage provided to military personnel and their dependents. It includes
coverage by a health maintenance organization (HMO), fee for service plans, and single
service plans.

QHI07

[IF QHI06 = 1] Was[SAMPLE MEMBER POSS] private health insurance obtained through work, such as
through an employer, union, or professional association?
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
This health insurance could be obtained through any family member’s employment, not
just the respondent’s employment.

QHI08

[IF QHI06 = 1] Does [SAMPLE MEMBER POSS] private health insurance include coverage for treatment for
any of the following conditions?
Alcohol abuse or alcoholism?
1
YES
2
NO
DK/REF

QHI09

[IF QHI06 = 1] Drug abuse?
1
YES
2
NO
DK/REF

QHI10

[IF QHI06 = 1] Mental or emotional problems?
1
YES
2
NO
DK/REF

QHI11

[IF (QHI01 = 2 OR QHI01v = 2) AND (QHI02 = 2 OR QHI02v = 2) AND QHI03 = 2 AND QHI06 = 2 AND (IF
CURNTAGE = 12 - 19: QHI02a = 2)] [SAMPLE MEMBER A] currently covered by any kind of health
insurance, that is, any policy or program that provides or pays for medical care?
INTERVIEWER NOTE:
If the respondent reports Indian Health Insurance, enter “1".
1
YES
2
NO
DK/REF

QHI13

May 23, 2012

[IF (QHI01 = 1 AND QHI01v NE 2) OR (QHI02 = 1 AND QHI02v NE 2) OR QHI02a = 1 OR QHI03=1 OR
QH106 = 1 OR QHI11 = 1] During the past 12 months, was there any time when [SAMPLE MEMBER] did not
have any kind of health insurance or coverage?

430

1
YES
2
NO
DK/REF
DEFINE WEREWAS:
IF QD54 = 1 OR HASJOIN = BLANK OR 2 THEN WEREWAS = 'were you'
ELSE WEREWAS = 'was SAMPLE MEMBER'
QHI14

[IF QHI13 = 1] During the past 12 months, about how many months were [FILL WEREWAS] without any kind
of health insurance or coverage?
# OF MONTHS:
DK/REF

[RANGE: 1 - 12]
INTERVIEWER NOTE:
If the respondent reports less than one month, enter “1".

QHI15

[IF (QHI01 = 2 OR QHI01v = 2) AND (QHI02 = 2 OR QHI02v = 2) AND QHI03 = 2 AND QHI06 = 2 AND
QHI11 = 2 AND (IF CURNTAGE = 12 - 19: QHI02a = 2)] About how long has it been since [SAMPLE
MEMBER] last had any kind of health care coverage?
1
2
3
4
5
DK/REF

QHI17

[IF QHI15 = 1 - 4 OR DK/REF] HAND R SHOWCARD 16. Which of the reasons on this card is the main reason
why [SAMPLE MEMBER] stopped being covered by health insurance?
1
2
3
4
5
6
7
8
9
10
11
12
DK/REF

QHI18

WITHIN THE PAST 6 MONTHS
MORE THAN 6 MONTHS AGO, BUT WITHIN THE PAST YEAR
MORE THAN 1 YEAR AGO, BUT WITHIN THE PAST 3 YEARS
MORE THAN 3 YEARS AGO
NEVER HAD COVERAGE

PERSON IN FAMILY WITH HEALTH INSURANCE LOST JOB OR CHANGED EMPLOYERS
LOST MEDICAID OR MEDICAL ASSISTANCE COVERAGE BECAUSE OF NEW JOB OR
INCREASE IN INCOME
LOST MEDICAID OR MEDICAL ASSISTANCE COVERAGE FOR SOME OTHER REASON
COST IS TOO HIGH/CAN’T AFFORD PREMIUMS
BECAME INELIGIBLE BECAUSE OF AGE OR LEAVING SCHOOL
EMPLOYER DOES NOT OFFER COVERAGE, OR NOT ELIGIBLE FOR COVERAGE
GOT DIVORCED OR SEPARATED FROM PERSON WITH INSURANCE
DEATH OF SPOUSE OR PARENT
INSURANCE COMPANY REFUSED COVERAGE
DON’T NEED IT
RECEIVED MEDICAID OR MEDICAL INSURANCE ONLY WHILE PREGNANT
SOME OTHER REASON

[IF QHI15 = 5] HAND R SHOWCARD 17. Which of the reasons on this card describe why [SAMPLE
MEMBER] never had health insurance coverage?
TO SELECT MORE THAN ONE CATEGORY, PRESS THE SPACE BAR BETWEEN EACH CATEGORY
YOU SELECT.
1
2
3
4
5
DK/REF

May 23, 2012

COST IS TOO HIGH/CAN’T AFFORD PREMIUMS
EMPLOYER DOES NOT OFFER COVERAGE, OR NOT ELIGIBLE FOR COVERAGE
INSURANCE COMPANY REFUSED COVERAGE
DON’T NEED IT
SOME OTHER REASON

431

May 23, 2012

432

INTROINC
[IF NO FAMILY MEMBERS IN ROSTER] These next questions are about the kinds and amounts of
income that you receive.
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1 ] These next questions are about the kinds
and amounts of income that you and your [FAMILY RELATIONSHIP FILL] receive.
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] These next questions are about the kinds and
amounts of income that [SAMPLE MEMBER] and you receive.
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN NE 1] These next questions are
about the kinds and amounts of income that you, your [FAMILY RELATIONSHIP FILLS] living here
receive.
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN=1] These next questions are
about the kinds and amounts of income that [SAMPLE MEMBER] and [IF QD01=5 FILL his, QD01 = 9
FILL her] family – that is, you, [IF QD01=5 FILL his, QD01 = 9 FILL her] [FAMILY RELATIONSHIP
FILLS] living here – receive.
PROGRAMMER NOTE: DO NOT INCLUDE IN FAMILY RELATIONSIP FILL WHERE FAMILY
RELATIONSHIP = QP02.
[IF HASJOIN NE 1] These questions refer to the calendar year [CURRENT YEAR - 1] rather than to the
past 12 months that were referred to in some earlier questions. The calendar year [CURRENT YEAR - 1]
would be from January 1st, [CURRENT YEAR - 1], through December 31st, [CURRENT YEAR - 1].
PRESS [ENTER] TO CONTINUE

QI01N

[IF NO FAMILY MEMBERS IN ROSTER] In [CURRENT YEAR - 1], did you receive Social Security or
Railroad Retirement payments?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] In [CURRENT YEAR – 1], did you or your
[FAMILY RELATIONSHIP FILL] receive Social Security or Railroad Retirement payments?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] In [CURRENT YEAR – 1], did [SAMPLE
MEMBER] or you receive Social Security or Railroad Retirement payments?
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER] In [CURRENT YEAR - 1], did [SAMPLE MEMBER]
or any of these same family members receive Social Security or Railroad Retirement payments?
(Social Security checks are either automatically deposited in the bank or mailed to arrive on about the 3rd of every
month. If mailed, they are sent in a gold envelope.)
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
Social Security or Railroad Retirement payments are paid by the U.S. Government to
persons who are retired, severely disabled, or are dependents or survivors of workers.

QI05N

[IF NO FAMILY MEMBERS IN ROSTER] In [CURRENT YEAR - 1], did you receive income from wages or
pay earned while working at a job or business?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] In [CURRENT YEAR – 1], did you or your
[FAMILY RELATIONSHIP FILL] receive income from wages or pay earned while working at a job or business?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] In [CURRENT YEAR – 1], did [SAMPLE
MEMBER] or you receive income from wages or pay earned while working at a job or business?
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER] In [CURRENT YEAR - 1], did [SAMPLE MEMBER]
or any of these same family members receive income from wages or pay earned while working at a job or
business?

May 23, 2012

433

1
YES
2
NO
DK/REF
QI03N

[IF NO FAMILY MEMBERS IN ROSTER] In [CURRENT YEAR - 1], did you receive Supplemental Security
Income or SSI?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] In [CURRENT YEAR – 1], did you or your
[FAMILY RELATIONSHIP FILL] receive Supplemental Security Income or SSI?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] In [CURRENT YEAR – 1], did [SAMPLE
MEMBER] or you receive Supplemental Security Income or SSI?
[IF AT LEAST TWO FAMILY MEMBER IN ROSTER] In [CURRENT YEAR - 1], did [SAMPLE MEMBER]
or any of these same family members receive Supplemental Security Income or SSI?
(Federal SSI checks are either automatically deposited in the bank or mailed to arrive on the first of every month.
If mailed, they are sent in a blue envelope.)
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
Supplemental Security Income or SSI is a program administered by the Social Security
Administration that makes assistance payments to low income, aged, blind, and disabled
persons. Some states also have their own SSI programs. Include these also if reported.

QI07N

[IF NO FAMILY MEMBERS IN ROSTER] In [CURRENT YEAR - 1], did you receive food stamps?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] In [CURRENT YEAR - 1], did you or your
[FAMILY RELATIONSHIP FILL] receive food stamps?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] In [CURRENT YEAR - 1], did [SAMPLE
MEMBER] or you receive food stamps?
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER] In [CURRENT YEAR - 1], did [SAMPLE MEMBER]
or any of these same family members receive food stamps?
1
YES
2
NO
DK/REF

INTERVIEWER NOTE:
Food stamps are government-issued coupons that can be used to purchase food. Instead
of coupons, some states issue a special card that can be used like a credit card to purchase
food in grocery stores. The food stamp program is a joint federal-state program which is
administered by State and Local governments.
Do not include WIC or free/reduced school lunches.
Note: TANF Program Names will be updated in July.
DEFINE TANFFILL:
IF FIPE4 = 1 THEN TANFFILL = the Family Assistance Program (FAP)
IF FIPE4 = 2 THEN TANFFILL = the Alaska Temporary Assistance Program (ATAP)
IF FIPE4 = 3 THEN TANFFILL = Cash Assistance (CA) IF FIPE4 = 4 THEN TANFFILL = the Transitional
Employment Assistance Program (TEA)
IF FIPE4 = 5 THEN TANFFILL = California Work Opportunity and Responsibility to Kids (CalWorks)
IF FIPE4 = 6 THEN TANFFILL = Colorado Works
IF FIPE4 = 7 THEN TANFFILL = Temporary Family Assistance (TFA)
IF FIPE4 = 8 THEN TANFFILL = Temporary Assistance for Needy Families (TANF)
IF FIPE4 = 9 THEN TANFFILL = Temporary Cash Assistance for Needy Families (TANF)
IF FIPE4 = 10 THEN TANFFILL = Temporary Cash Assistance (TCA)
IF FIPE4 = 11 THEN TANFFILL = Temporary Assistance for Needy Families (TANF)
May 23, 2012

434

IF FIPE4 = 12 THEN TANFFILL = Temporary Assistance to Needy Families (TANF) or Temporary Assistance to
Other Needy Families (TAONF)
IF FIPE4 = 13 THEN TANFFILL = Temporary Assistance for Families in Idaho (TAFI)
IF FIPE4 = 14 THEN TANFFILL = Temporary Assistance for Needy Families (TANF)
IF FIPE4 = 15 THEN TANFFILL = Temporary Assistance for Needy Families (TANF)
IF FIPE4 = 16 THEN TANFFILL = the Family Investment Program (FIP)
IF FIPE4 = 17 THEN TANFFILL = Cash Assistance or Temporary Assistance for Families
IF FIPE4 = 18 THEN TANFFILL = the Kentucky Transitional Assistance Program (K-TAP)
IF FIPE4 = 19 THEN TANFFILL = The Family Independence Temporary Assistance Program (FITAP), Kinship Care
Subsidy Program (KCSP), and the Strategies to Empower People (STEP) Program
IF FIPE4 = 20 THEN TANFFILL = Temporary Assistance for Needy Families (TANF) or Additional Support for
People in Retraining and Employment (ASPIRE)
IF FIPE4 = 21 THEN TANFFILL = The Family Investment Program (FIP) or Temporary Cash Assistance (TCA)
IF FIPE4 = 22 THEN TANFFILL = Transitional Aid to Families with Dependent Children (TAFDC)
IF FIPE4 = 23 THEN TANFFILL = the Family Independence Program (FIP)
IF FIPE4 = 24 THEN TANFFILL = the Minnesota Family Investment Program (MFIP)
IF FIPE4 = 25 THEN TANFFILL = Temporary Assistance to Needy Families (TANF)
IF FIPE4 = 26 THEN TANFFILL = Temporary Assistance
IF FIPE4 = 27 THEN TANFFILL = Temporary Assistance for Needy Families (TANF)
IF FIPE4 = 28 THEN TANFFILL = Aid to Dependent Children (ADC)
IF FIPE4 = 29 THEN TANFFILL = Temporary Assistance for Needy Families (TANF)
IF FIPE4 = 30 THEN TANFFILL = Financial Assistance to Needy Families
IF FIPE4 = 31 THEN TANFFILL = Work First New Jersey (WFNJ)
IF FIPE4 = 32 THEN TANFFILL = Temporary Assistance for Needy Families (TANF), or NMWorks
IF FIPE4 = 33 THEN TANFFILL = Family Assistance (FA)
IF FIPE4 = 34 THEN TANFFILL = Work First
IF FIPE4 = 35 THEN TANFFILL = Temporary Assistance for Needy Families (TANF) or Jobs Opportunities and
Basic Skills (JOBS)
IF FIPE4 = 36 THEN TANFFILL = Ohio Works First (OWF), or Temporary Assistance for Needy Families (TANF)
IF FIPE4 = 37 THEN TANFFILL = Temporary Assistance for Needy Families (TANF)
IF FIPE4 = 38 THEN TANFFILL = Temporary Assistance for Needy Families (TANF)
IF FIPE4 = 39 THEN TANFFILL = Temporary Assistance for Needy Families (TANF), or Cash Assistance
IF FIPE4 = 40 THEN TANFFILL = Rhode Island Works (RI Works)
IF FIPE4 = 41 THEN TANFFILL = the Family Independence (FI)
IF FIPE4 = 42 THEN TANFFILL = Temporary Assistance for Needy Families (TANF)
IF FIPE4 = 43 THEN TANFFILL = Families First
IF FIPE4 = 44 THEN TANFFILL = Temporary Assistance for Needy Families (TANF)
IF FIPE4 =45 THEN TANFFILL = the Family Employment Program (FEP)
IF FIPE4 = 46 THEN TANFFILL = Reach Up
IF FIPE4 = 47 THEN TANFFILL = Temporary Assistance for Needy Families (TANF)
IF FIPE4 = 48 THEN TANFFILL = WorkFirst
IF FIPE4 = 49 THEN TANFFILL = West Virginia Works (WV Works)
IF FIPE4 = 50 THEN TANFFILL = Wisconsin Works (W-2)
IF FIPE4 = 51 THEN TANFFILL = Temporary Assistance for Needy Families (TANF)
ELSE TANFFILL = BLANK
QI08N

[IF NO FAMILY MEMBERS IN ROSTER] At any time during [CURRENT YEAR - 1], even for one month, did
you receive any cash assistance from a state or county welfare program such as [TANFFILL]?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1 ] At any time during [CURRENT YEAR - 1],
even for one month, did you or your [FAMILY RELATIONSHIP FILL] receive any cash assistance from a state
or county welfare program such as [TANFFILL]?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] At any time during [CURRENT YEAR - 1], even
for one month, did [SAMPLE MEMBER] or you receive any cash assistance from a state or county welfare
program such as [TANFFILL]?
[IF AT LEAST TWO FAMILY MEMBER IN ROSTER] At any time during [CURRENT YEAR - 1], even for
one month, did [SAMPLE MEMBER] or any of these same family members receive any cash assistance from a
state or county welfare program such as [TANFFILL]?
1
YES
2
NO
DK/REF

May 23, 2012

435

INTERVIEWER NOTE:
If the respondent volunteers receiving welfare payments from a program other than the
one mentioned, or from another state, record a "yes" response. Do not probe for this
information.

QI10N

[IF NO FAMILY MEMBERS IN ROSTER] In [CURRENT YEAR - 1], because of low income, did you receive
any other kind of welfare or public assistance, such as help with getting a job, placement in education or job
training programs, or help with transportation, child care, or housing?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] In [CURRENT YEAR - 1], because of low
income, did you or your [FAMILY RELATIONSHIP FILL] receive any other kind of welfare or public
assistance, such as help with getting a job, placement in education or job training programs, or help with
transportation, child care, or housing?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] ] In [CURRENT YEAR - 1], because of low
income, did [SAMLE MEMBER] or you receive any other kind of welfare or public assistance, such as help with
getting a job, placement in education or job training programs, or help with transportation, child care, or housing?
[IF AT LEAST TWO FAMILY MEMBER IN ROSTER] In [CURRENT YEAR - 1], because of low income, did
[SAMPLE MEMBER] or any of these same family members receive any other kind of welfare or public
assistance, such as help with getting a job, placement in education or job training programs, or help with
transportation, child care, or housing?
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
Only non-monetary types of assistance should be included for this question.

QI12AN

[IF (QI08N=1 OR QI10N=1) AND QI07N=2]
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] For how many months in [CURRENT YEAR
- 1] did you or your [FAMILY RELATIONSHIP FILL] receive any type of welfare or public assistance?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] For how many months in [CURRENT YEAR 1] did [SAMPLE MEMBER] or you receive any type of welfare or public assistance?
[IF AT LEAST TWO FAMILY MEMBER IN ROSTER] For how many months in [CURRENT YEAR - 1] did
[SAMPLE MEMBER] or any other family member living here receive any type of welfare or public assistance?
[RANGE: 1 - 12]

# OF MONTHS RECEIVED ASSISTANCE:
DK/REF
QI12BN

[IF (QI08N=1 OR QI10N=1) AND QI07N=(1, DK OR REF)]
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] For how many months in [CURRENT YEAR
- 1] did you or your [FAMILY RELATIONSHIP FILL] receive any type of welfare or public assistance, not
including food stamps?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] For how many months in [CURRENT YEAR 1] did [SAMPLE MEMBER] or you receive any type of welfare or public assistance, not including food stamps?
[IF AT LEAST TWO FAMILY MEMBER IN ROSTER] For how many months in [CURRENT YEAR - 1] did
[SAMPLE MEMBER] or any other family member living here receive any type of welfare or public assistance,
not including food stamps?
[RANGE: 1 - 12]

# OF MONTHS RECEIVED ASSISTANCE:
DK/REF

INTRTINN

May 23, 2012

HAND R SHOWCARD 17a. Here is a list of some other sources of income. When I ask you the next few
questions, you answer the next questions, please consider these as well as the other sources that we just talked
436

about.
INTERVIEWER: PLEASE READ THIS ALOUD TO THE RESPONDENT AS HE/SHE FOLLOWS ALONG
ON THE SHOWCARD.
Veteran’s Administration payments
Other disability, retirement or survivor pension
Unemployment or worker’s compensation
Interest income
Dividends from stocks or mutual funds
Income from rental properties, royalties, estates or trusts
Alimony
Child support
PRESS [ENTER] TO CONTINUE.
QI20N

[IF NO FAMILY MEMBERS IN ROSTER] Before taxes and other deductions, was your total personal
income from all sources during [CURRENT YEAR - 1] more or less than 20,000 dollars?
[IF AT LEAST ONE FAMILY MEMBER IN ROSTER] Now I am going to ask about [SAMPLE MEMBER
POSS] own personal income. Before taxes and other deductions, was [SAMPLE MEMBER POSS] total
personal income from all sources during [CURRENT YEAR – 1] more or less than 20,000 dollars?
(Income data are important in analyzing the health information we collect. For example, the information helps us
to learn whether persons in one income group use certain types of medical care services or have conditions more
or less often than those in another group.)
1
$20,000 OR MORE
2
LESS THAN $20,000
DK/REF
INTERVIEWER NOTE:
Do not include money received from loans or tax refunds.

HAND18a

[IF QI20N = 2] HAND R SHOWCARD 18.
PRESS [ENTER] TO CONTINUE.

HAND18b

[IF QI20N = 1] HAND R SHOWCARD 19.
PRESS [ENTER] TO CONTINUE.

INTROTPI

[IF QI20N NE DK/REF] Of these income groups, which category best represents [SAMPLE MEMBER POSS]
total personal income during [CURRENT YEAR - 1]?
(Income data are important in analyzing the health information we collect. For example, the information helps us
to learn whether persons in one income group use certain types of medical care services or have conditions more
or less often than those in another group.)
PRESS [ENTER] TO CONTINUE.

QI21A

[IF QI20N = 2] ENTER NUMBER THAT BEST REPRESENTS (R’S/SAMPLE MEMBER’S TOTAL
PERSONAL INCOME DURING [CURRENT YEAR - 1].
1
2
3
4
5
6
7
8
9
10
11

May 23, 2012

LESS THAN $1,000 (INCLUDING LOSS)
$1,000 - $1,999
$2,000 - $2,999
$3,000 - $3,999
$4,000 - $4,999
$5,000 - $5,999
$6,000 - $6,999
$7,000 - $7,999
$8,000 - $8,999
$9,000 - $9,999
$10,000 - $10,999
437

12
13
14
15
16
17
18
19
20
DK/REF
QI21B

[IF QI20N = 1] ENTER NUMBER THAT BEST REPRESENTS (R’S/SAMPLE MEMBER’S) TOTAL
PERSONAL INCOME DURING [CURRENT YEAR - 1].
21
22
23
24
25
26
27
28
29
DK/REF

INTROFI1

$11,000 - $11,999
$12,000 - $12,999
$13,000 - $13,999
$14,000 - $14,999
$15,000 - $15,999
$16,000 - $16,999
$17,000 - $17,999
$18,000 - $18,999
$19,000 - $19,999

$20,000 - $24,999
$25,000 - $29,999
$30,000 - $34,999
$35,000 - $39,999
$40,000 - $44,999
$45,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000 OR MORE

[IF MORE THAN ONE FAMILY MEMBER IN ROSTER AND IF QI21B NE 30]
Next, we would like to know about the total family income from all sources during [CURRENT YEAR - 1]
before taxes and other deductions.
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1 ] We would like you to combine everyone’s
income – that is, yours and that of your [FAMILY RELATIONSHIP FILL].
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] We would like you to combine everyone’s
income – that is, [SAMPLE MEMBER POSS] and yours.
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN NE 1] We would like you to combine
everyone’s income – that is, yours and that of your [FAMILY RELATIONSHIP FILLS].
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN = 1] We would like you to combine
everyone’s income — that is, yours, [SAMPLE MEMBER POSS] and that of [IF QD01=5 FILL his, QD01 = 9
FILL her] and that of SAMPLE MEMBER POSS][FAMILY RELATIONSHIP FILLS] living here.
[PROGRAMMER NOTE: THE PROXY SHOULD NOT APPEAR IN [FAMILY RELATIONSHIP FILLS].
ALSO, USE ‘other’ AS A MODIFIER TO THE FAMILY RELATIONSHIP FILL WHEN THE
RELATIONSHIP TYPE IS EQUAL TO PROXY RELATIONSHIP TYPE AND ONE OF THESE
RELATIONSHIP TYPES IS STILL IN THE LIST.]
Please include all of the sources of income that we just talked about.

QI22

[IF MORE THAN ONE FAMILY MEMBER IN ROSTER AND (QI20N NE 1)] Before taxes and other
deductions, was the total combined family income during [CURRENT YEAR - 1] more or less than 20,000
dollars?
(Income data are important in analyzing the health information we collect. For example, the information helps us
to learn whether persons in one income group use certain types of medical care services or have conditions more
or less often than those in another group.)
1
$20,000 OR MORE
2
LESS THAN $20,000
DK/REF
INTERVIEWER NOTE:
Do not include money received from loans or tax refunds.

May 23, 2012

438

HAND19a

[IF QI22=2] HAND R SHOWCARD 18.
PRESS [ENTER] TO CONTINUE.

HAND19b

[IF (QI22=1 OR QI20N = 1) AND Q121B NE 29] HAND R SHOWCARD 19.
PRESS [ENTER] TO CONTINUE.

INTROFI2

[IF QI22 = 2]
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1 ] Of these income groups, which category best
represents your total combined family income during [CURRENT YEAR – 1] – that is, yours and that of your
[FAMILY RELATIONSHIP FILL].
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] Of these income groups, which category best
represents your total combined family income during [CURRENT YEAR – 1] – that is, your [SAMPLE
MEMBER POSS] and yours.
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN NE 1] Of these income groups, which
category best represents your total combined family income during [CURRENT YEAR – 1] – that is, yours and
that of your [RELATIONSHIP FILLS].
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN =1] Of these income groups, which
category best represents your total combined family income during [CURRENT YEAR - 1]-- that is, yours,
[SAMPLE MEMBER POSS] and that of [IF QD01 = 5 FILL his, QD = 9 FILL her]SAMPLE MEMBER
POSS][FAMILY RELATIONSHIP FILLS] living here? [PROGRAMMER NOTE: THE PROXY SHOULD NOT
APPEAR IN [FAMILY RELATIONSHIP FILLS]. ALSO, USE ‘other’ AS A MODIFIER TO THE FAMILY
RELATIONSHIP FILL WHEN THE RELATIONSHIP TYPE IS EQUAL TO PROXY RELATIONSHIP TYPE
AND ONE OF THESE RELATIONSHIP TYPES IS STILL IN THE LIST.]
(Income data are important in analyzing the health information we collect. For example, the information helps us
to learn whether persons in one income group use certain types of medical care services or have conditions more
or less often than those in another group.)
PRESS [ENTER] TO CONTINUE.

INTROFI3

[IF (QI22 = 1 OR QI20N = 1) AND Q121B NE 29]
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1 ] Of these income groups, which category best
represents your total combined family income during [CURRENT YEAR – 1] – that is, yours and that of your
[FAMILY RELATIONSHIP FILL]?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] Of these income groups, which category best
represents your total combined family income during [CURRENT YEAR – 1] – that is, [SAMPLE MEMBER
POSS] and yours?
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN NE 1] Of these income groups, which
category best represents your total combined family income during [CURRENT YEAR – 1] – that is, yours and
that of your [FAMILY RELATIONSHIP FILLS]?
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN =1] Of these income groups, which
category best represents your total combined family income during [CURRENT YEAR - 1]-- that is, yours,
[SAMPLE MEMBER POSS] and that of [IF QD01 = 5 FILL his, QD = 9 FILL her]SAMPLE MEMBER
POSS][FAMILY RELATIONSHIP FILLS] living here? [PROGRAMMER NOTE: THE PROXY SHOULD NOT
APPEAR IN [FAMILY RELATIONSHIP FILLS]. ALSO, USE ‘other’ AS A MODIFIER TO THE FAMILY
RELATIONSHIP FILL WHEN THE RELATIONSHIP TYPE IS EQUAL TO PROXY RELATIONSHIP TYPE
AND ONE OF THESE RELATIONSHIP TYPES IS STILL IN THE LIST.]
(Income data are important in analyzing the health information we collect. For example, the information helps us
to learn whether persons in one income group use certain types of medical care services or have conditions more
or less often than those in another group.)
PRESS [ENTER] TO CONTINUE.

QI23A
May 23, 2012

[IF QI22=2] ENTER NUMBER THAT BEST REPRESENTS THE TOTAL COMBINED FAMILY INCOME
439

IN [CURRENT YEAR - 1].
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
DK/REF
QI23B

[IF (QI22=1 OR QI20N = 1) AND Q121B NE 29] ENTER NUMBER THAT BEST REPRESENTS THE
TOTAL COMBINED FAMILY INCOME IN [CURRENT YEAR - 1].
21
22
23
24
25
26
27
28
29
DK/REF

QI24

LESS THAN $1,000 (INCLUDING LOSS)
$1,000 - $1,999
$2,000 - $2,999
$3,000 - $3,999
$4,000 - $4,999
$5,000 - $5,999
$6,000 - $6,999
$7,000 - $7,999
$8,000 - $8,999
$9,000 - $9,999
$10,000 - $10,999
$11,000 - $11,999
$12,000 - $12,999
$13,000 - $13,999
$14,000 - $14,999
$15,000 - $15,999
$16,000 - $16,999
$17,000 - $17,999
$18,000 - $18,999
$19,000 - $19,999

$20,000 - $24,999
$25,000 - $29,999
$30,000 - $34,999
$35,000 - $39,999
$40,000 - $44,999
$45,000 - $49,999
$50,000 - $74,999
$75,000 - $99,999
$100,000 OR MORE

The next last question has to do with telephones in your household. How many different telephone numbers do
you have in this household? Please don’t include cellular phones in your answer. Also, don’t count business
numbers or extensions with the same number.
INTERVIEWER NOTE:
Do not include phone lines that are used only for fax machines and/or Internet access.
# OF TELEPHONE NUMBERS:
DK/REF

May 23, 2012

[RANGE: 0 - 20]

440

QCID

CASEID

ENTER THE QC ID FROM THE QUALITY CONTROL FORM FOR THIS INTERVIEW. THE QC ID IS
LOCATED IN THE UPPER RIGHT HAND CORNER OF THE QUALITY CONTROL FORM. THE
HYPHEN MUST BE INCLUDED.
ENTER THE CASE ID FOR THIS INTERVIEW.
BE SURE TO INCLUDE A OR B AT THE END OF THE CASE ID.

TOALLR3I It is important that I do my job correctly; therefore, my supervisors will be checking on my work. Would you help
me by printing your home telephone number and current address on this form?
[GIVE QUALITY CONTROL FORM AND ENVELOPE TO RESPONDENT]
Then place it in the postage-paid envelope so that my supervisor can write or call you in several weeks to confirm
that I did my job. When you are finished, please seal the envelope and return it to me. Please seal the envelope
when you are finished. As you can see, this is kept separate from your answers so they will still be completely
private.
PRESS [ENTER] TO CONTINUE.
INCENT01

PAY HAND RESPONDENT $30 CASH.
MARK THE APPROPRIATE ‘CASH ACCEPTANCE’ BOX ON THE INTERVIEW INCENTIVE RECEIPT
SIGN INTERVIEW INCENTIVE PAYMENT RECEIPT FORM AND GIVE TOP COPY TO RESPONDENT
I have signed this form to indicate that I have given paid you the $30 for this interview. At the bottom of this
form, we have included national hotline numbers that you can call if you ever feel you need to talk to someone
about mental health or drug use issues. [IF THE RESPONDENT WILL NOT ACCEPT THE CASH
INCENTIVE, MARK THE APPROPRIATE BOX ON THE INTERVIEW INCENTIVE PAYMENT RECEIPT
FORM.]
IF NOT DONE EARLIER, GIVE ADULT RESPONDENT OR PARENT/GUARDIAN OF YOUTH THE Q&A
BROCHURE AND SAY
(For more details on the National Survey on Drug Use and Health, this brochure includes answers to common
questions, website addresses and other information.)
[IF NOT ELIGIBLE FOR MENTAL HEALTH FOLLOW-UP STUDY]: Now I will finish some questions to
show that I did the interview.
Thank you very much for your help.
PRESS [ENTER] TO CONTINUE.

May 23, 2012

441

May 23, 2012

442

RECRUIT1 [IF ELIGIBLE FOR MENTAL HEALTH FOLLOW-UP STUDY] You have been randomly selected to
participate in one additional study for the U. S. Public Health Service. This interview will ask questions about
mental health issues. It will be conducted over the telephone and will take about an hour. Participation in this
interview is voluntary and all of your answers will be kept confidential.
HAND FOLLOW-UP STUDY DESCRIPTION TO RESPONDENT. Please read this statement. It describes the
survey and the legislation that assures the confidentiality of any information you provide.
If you agree to participate, I will pay you an additional $30 today. Within the next two weeks, a different
interviewer will call you to explain more about the interview and to schedule a convenient time to complete it. If
you wish, you may complete the full interview when the interviewer calls.
IF ASKED “WHY WAS I SELECTED?” (You have been randomly chosen for this special study for the National
Survey on Drug Use and Health. This study, sponsored by the U.S. Public Health Service, will ask questions
about various mental health issues. Knowledge gained from this study will improve our ability to describe and
understand mental health issues in the United States.)
1

2
3
RECRT4WK

[IF RECRUIT1=3] To accommodate your schedule, an interviewer will be available to call you about this study
and schedule a convenient time to complete the interview within the next four weeks.
1

2
3
REFFEAS

RESPONDENT AGREES TO RECONTACT
RESPONDENT DOES NOT AGREE TO RECONTACT
RESPONDENT IS NOT AVAILABLE DURING THE SPECIFIED TIME PERIOD

RESPONDENT AGREES TO RECONTACT
RESPONDENT DOES NOT AGREE TO RECONTACT
RESPONDENT IS NOT AVAILABLE DURING THE SPECIFIED TIME PERIOD

[IF RECRUIT1=2 OR RECRT4WK=2] Since this additional study is designed to help us improve future NSDUH
surveys, it is important to understand why people might not want to participate. Would you please tell me why
you do not want to participate?
[ALLOW 100]
DK/REF

RECRUIT2 [IF RECRUIT1=1 OR RECRT4WK=1] Since another interviewer will be completing the second interview, may I
have your first name and phone number so the interviewer can call you?
ENTER FIRST NAME ONLY AND PHONE NUMBER.
To check that I entered the number correctly, please repeat the phone number.
CONFIRM NUMBER. AS NEEDED, READ THE CONTACT INFORMATION ENTERED TO THE
RESPONDENT AND CONFIRM IT IS CORRECT.
Is there another number where the telephone interviewer could contact you about the second interview?
IF YES: RECORD PHONE NUMBER AND TYPE (CELL, WORK, ETC) IN THE NOTES FIELD.
REPEAT ABOVE STEPS TO CONFIRM THE NUMBER. YOU MAY ENTER UP TO 50 CHARACTERS.
IF NO: CONTINUE.
PRESS [ENTER] TO CONTINUE.
FIRST NAME:
PHONE NUMBER:
NOTES:
DK/REF

May 23, 2012

[ALLOW 20]
[ALLOW 10]
[ALLOW 50]

443

RECRUIT3 [IF RECRUIT1=1 OR RECRT4WK=1] Please also let me know the best days and times when you will be
available in the next [two weeks / four weeks]. I will give this information to the interviewer, and he or she will
try to contact you during one of these times.

ENTER BEST DAYS/TIMES. AS NEEDED, PROBE FOR ADDITIONAL BEST DAYS/TIMES.
READ THE INFORMATION ENTERED TO THE RESPONDENT AND CONFIRM IT IS CORRECT.

COMPLETE A REMINDER CARD AND HAND TO THE RESPONDENT.
I have entered these days and times in the computer and recorded them on this card. Please note the
interviewer may try to reach you at other times as well.
INTERVIEWER NOTE: ADDITIONAL INFORMATION REGARDING THE BEST DAYS OR TIMES
PROVIDED BY THE RESPONDENT SHOULD BE ENTERED IN THE NOTES FIELD. YOU MAY ENTER
UP TO 50 CHARACTERS.
TELEPHONE INTERVIEWERS ARE AVAILABLE EVENINGS AND WEEKENDS.
BEST DAYS
BEST TIMES
NOTES:
DK/REF

[ALLOW 50]
[ALLOW 50]
[ALLOW 50]

PRESS [ENTER] TO CONTINUE.

INCENTMH [IF RECRUIT1=1 OR RECRT4WK=1] PAY RESPONDENT $30 CASH.
SIGN FOLLOW-UP INTERVIEW PAYMENT RECEIPT FORM AND GIVE TOP COPY TO RESPONDENT.
I have signed this form to indicate that I have paid you the $30 for the telephone interview.
[IF THE RESPONDENT WILL NOT ACCEPT THE CASH INCENTIVE, MARK THE APPROPRIATE BOX
ON THE FOLLOW-UP INTERVIEW PAYMENT RECEIPT FORM.]
PRESS [ENTER] TO CONTINUE.
THANKR2 [IF RECRUIT1=1 OR 2 OR 3] Thank you for your time. I just need to finish a few questions on my own to show
that I did the interview. This will only take a few minutes.
[ALL CASES] BE SURE YOU HAVE YOUR SHOWCARD BOOKLET, CALENDAR, QC ENVELOPE W/
FORM AND PAYMENT RECEIPT COPIES.
[ALL CASES] PRESS [ENTER] TO CONTINUE.

May 23, 2012

444

FIDBFINTR DO NOT READ THIS TO R.
These questions are for you to answer without input from the respondent. DO NOT READ ANY OF THESE
QUESTIONS OUT LOUD. Use your own impressions of the interview to answer these questions — not the
respondent’s.
PRESS [ENTER] TO CONTINUE.

FIDBF01

Did you conduct this interview at the respondent’s home — either inside or outside?
1
2

FIDBF02

[IF FIDBF01 = 2] Where did you conduct this interview?
1
2
3
4
5
6

FIDBF02S

YES
NO

AT THE RESPONDENT’S WORKPLACE
AT THE HOME OF THE RESPONDENT’S RELATIVE OR FRIEND
IN SOME TYPE OF CONFERENCE ROOM IN A RESIDENCE HALL, SCHOOL OR APARTMENT
COMPLEX
AT A LIBRARY
IN SOME TYPE OF COMMON AREA, SUCH AS A LOBBY, HALLWAY, STAIRWELL, OR
LAUNDRY ROOM
SOME OTHER PLACE

[IF FIDBF02=6] Where did the interview take place?
________________ [ALLOW 75 CHARACTERS]

FIDBF04C

Please estimate for how much of the ACASI interview the respondent had their headphones on.
0
1
2
3
4

FIDBF05

Estimate the respondent’s understanding of the interview.
1
2
3
4

FIDBF06

2
3
4
5

May 23, 2012

VERY COOPERATIVE
FAIRLY COOPERATIVE
NOT VERY COOPERATIVE
OPENLY HOSTILE

Indicate on this scale of 1 through 5 how private the interview was. Please do not count yourself as another person
in the room.
1

FIDBF08

NO DIFFICULTY --- NO LANGUAGE OR READING PROBLEM
JUST A LITTLE DIFFICULTY — ALMOST NO LANGUAGE OR READING PROBLEM
A FAIR AMOUNT OF DIFFICULTY — SOME LANGUAGE OR READING PROBLEM
A LOT OF DIFFICULTY — CONSIDERABLE LANGUAGE OR READING PROBLEM

How cooperative has the respondent been?
1
2
3
4

FIDBF07

NONE/R TOOK HEADPHONES OFF IMMEDIATELY
LESS THAN HALF OF THE ACASI INTERVIEW
ABOUT HALF OF THE ACASI INTERVIEW
MORE THAN HALF OF THE ACASI INTERVIEW
ALL OF THE ACASI INTERVIEW

COMPLETELY PRIVATE — NO ONE WAS IN THE ROOM OR COULD OVERHEAR ANY PART
OF THE INTERVIEW
MINOR DISTRACTIONS - PERSON(S) IN THE ROOM OR LISTENING LESS THAN 1/3 OF THE
TIME
PERSON(S) IN THE ROOM OR LISTENING ABOUT 1/3 OF THE TIME
SERIOUS INTERRUPTIONS OF PRIVACY MORE THAN HALF THE TIME
CONSTANT PRESENCE OF OTHER PERSON(S)

[IF FIDBF07 NE 1] Not including yourself, other people present or listening to the interview were . . .

445

TO SELECT MORE THAN ONE CATEGORY, PRESS THE SPACE BAR BETWEEN EACH CATEGORY
YOU SELECT.
1
2
3
4
5
6
7
FIDBF09

PARENT(S)
SPOUSE
LIVE-IN PARTNER/BOYFRIEND/GIRLFRIEND
OTHER ADULT RELATIVE(S)
OTHER ADULT(S)
CHILD(REN) UNDER 15
OTHER

[IF FIDBF08 = 7] You have indicated that there was some other person present or listening to the interview.
Please use the keyboard to type a description of the other person.
____________ [ALLOW 50 CHARACTERS]

FIDBF11

How often did this respondent let you know what his or her answers were as he or she completed the ACASI
portion of the interview?
1
2
3
4
5

FIDBF12

NONE OF THE TIME — I DO NOT KNOW WHAT ANY OF THE ANSWERS ARE
A LITTLE OF THE TIME — I KNOW WHAT A FEW OF THE ANSWERS ARE
SOME OF THE TIME — I KNOW WHAT SOME OF THE ANSWERS ARE
A LOT OF THE TIME — I KNOW WHAT A LOT OF THE ANSWERS ARE
ALL OF THE TIME — I KNOW WHAT ALL OF THE ANSWERS ARE

Please note anything else you think would be helpful for the interpretation and understanding of this interview.
If there is nothing you wish to note, simply press [ENTER] to continue.
____________ [ALLOW 250 CHARACTERS]

FIEXIT

End of interview reached.
PRESS 1 TO EXIT.

May 23, 2012

446

Changes to NSDUH
Questionnaire for 2013

Introduction

Core Demographics

Calendar (30-day and 12month reference dates)

Beginning ACASI Section

Tutorial

Tobacco

Alcohol

Marijuana

Cocaine

Crack

Heroin

Hallucinogens

Inhalants

Pain Relievers

Tranquilizers

Stimulants

Sedatives

Special Drugs

Risk / Availability

Blunts

Definitions for Use in the
Drugs Module

Substance Dependence and
Abuse

Special Topics

Market Information for
Marijuana

Prior Substance Use

Drug Treatment

Health Care

Adult Mental Health Service
Utilization

Social Environment

Parenting Experiences

Youth Experiences

Mental Health

Adult Depression

Youth Mental Health Service
Utilization

Adolescent Depression

Definitions for Alcohol
Consumption Module

Consumption of Alcohol

Back-End Demographics

Education

Employment

Household Roster

Proxy Information

Health Insurance

Income

Verification

Recruitment Screens

FI Observation Questions