Form 2b Individual Screener/Field Test

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

Attachment 2b
PATH Study Data Collection Instruments:
Individual Screener
July 23, 2012

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Individual Screener
Version 6.2

Section

Number of questions

Introductory Demographics

13

Tobacco Use

32

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Individual Screener
Version 6.2

Table of Contents
INTRODUCTORY DEMOGRAPHICS ................................................................................ 1
TOBACCO USE SECTION ................................................................................................. 6

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OMB Control Number: 0925-XXXX

Expiration Date:XX/XX/XXXX

Public reporting burden for this collection of information is estimated to average 6 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. 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. Send comments regarding this burden estimate or any other aspect
of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance
Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-XXXX). Do
not return the completed form to this address.

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INTRODUCTORY DEMOGRAPHICS
PATH ID:

AM0001

Screen ID:

What is your date of birth?
-8
-7

MM/DD/YYYY
DON’T KNOW
REFUSED

GO TO AM0004

ASK: All respondents
INTERVIEWER NOTE: Used to confirm 18+ years of age for eligibility.
PATH ID:

AM0002

Screen ID:

Can you tell me how old you are? Please enter age in years.
1
-8
-7

|__|__|__|
DON’T KNOW
REFUSED

GO TO AM0004

ASK: Respondents who refused to give or did not know their date of birth in AM0001
INTERVIEWER NOTE: Used to confirm 18+ years of age for eligibility
PATH ID:

AM0003

Screen ID:

Are you …
1
2
3
4
-8
-7

Less than 18 years old,
18 to 24 years old
25 to 29 years old
30 years old or older
DON’T KNOW
REFUSED

ASK: Respondents who refused to give or did not know date of birth (AM0001=DK,R) and age
(AM0002=DK,R)
PATH ID:

AM0004

Screen ID:

What is your sex?
1
2
-8
-7

Male
Female
DON’T KNOW
REFUSED

ASK: All respondents

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PATH ID:

AM0005

Screen ID:

Are you Hispanic, [Latino I Latina], or of Spanish origin? Choose all that apply.
1
2
3
4
5
-8
-7

No, not of Hispanic, Latino or Latina, or Spanish origin
Yes, Mexican, Mexican American, Chicano or Chicana
Yes, Puerto Rican
Yes, Cuban
Yes, Another Hispanic, Latino or Latina, or Spanish origin
DON’T KNOW
REFUSED

ASK: All respondents
PROGRAM: If male (AM0004=1), display “Latino”; if female (AM0004=2), display “Latina”
PATH ID:

AM0006

Screen ID:

What is your race? Choose all that apply.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
-8
-7

White
Black or African American
American Indian or Alaska Native
Asian Indian
Chinese
Filipino
Japanese
Korean
Vietnamese
Other Asian
Native Hawaiian
Guamanian or Chamorro
Samoan
Other Pacific Islander
DON’T KNOW
REFUSED

ASK: All respondents

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PATH ID:

AM0007

Screen ID:

Have you ever served on active duty in the U.S. Armed Forces, Military Reserves, or National
Guard? Note: Active duty for the Reserves or National Guard does not include the regular training for the
Reserves or Guard. It does include being activated for deployment, such as for the Iraq War.
1
2
4
5
-8
-7

Yes, now on active duty
Yes, on active duty in the past, but not now
No, training for Reserves or National Guard only
No, never served in the military
DON’T KNOW
REFUSED

GO TO AM0010
GO TO AC1003
GO TO AC1003
GO TO AC1003
GO TO AC1003

ASK: All respondents
PATH ID:

AM0008

Screen ID:

You said you are currently on active duty in the U.S. Armed Forces. Is that correct?
1
Yes
GO TO AM0009
2
No
GO BACK TO AM0007
-8
DON’T KNOW
GO TO AM0009
-7
REFUSED
GO TO AM0009
ASK: Respondents who are currently on active duty (AM0007=1)
PATH ID:

AM0009

Screen ID:

[DISPLAY IF RESPONDENT IS CURRENTLY ON ACTIVE DUTY (AM0008 <> NO)]
People who are currently on active duty in the U.S. Armed Forces are not eligible to be interviewed in this
study. We appreciate you taking the time to speak with us. Please give the computer back to the
interviewer.
ASK: Respondents who are currently on active duty (AM0007=1) and confirmed their response
(AM0008<>NO)

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PATH ID:

AM0010

Screen ID:

When did you serve on active duty in the U.S. Armed Forces? Choose all that apply, even if it was just for
part of the period.
1
September 2001 or later
2
August 1990 to August 2001 (including Persian Gulf War)
3
September 1980 to July 1990
4
May 1975 to August 1980
5
Vietnam era (August 1964 to April 1975)
6
March 1961 to July 1964
7
February 1955 to February 1961
8
Korean War (July 1950 to January 1955)
9
January 1947 to June 1950
10
World War II (December 1941 to December 1946)
11
November 1941 or earlier
-8
DON’T KNOW
-7
REFUSED
ASK: Respondents who have been on active duty, but are not currently on active duty (AM0007=2, 3)
BOX – DISPLAY INSTRUCTIONS
For AM0011, display a “Yes” and “No” column with options for each response category.
PATH ID:

AM0011

Screen ID:

In which branch or branches did you serve on active duty? Choose all that apply.
1
Army
2
Navy
3
Air Force
4
Marine Corps
5
Coast Guard
-8
DON’T KNOW
-7
REFUSED
ASK: Respondents who have been on active duty, but are not currently on active duty (AM0007=2, 3)

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PATH ID:

AM0012

Screen ID:

Have you ever been enrolled in VA health care?
1
Yes
2
No
-8
DON’T KNOW
-7
REFUSED
ASK: Respondents who have been on active duty, but are not currently on active duty (AM0007=2, 3)
PATH ID:

AM0013

Screen ID:

Have you used any VA health care benefits? Choose all that apply.
1
I have received services at the VA
2
VA has paid for some or all of my health care
3
I have not received any VA health care benefits
-8
DON’T KNOW
-7
REFUSED
ASK: Respondents who have been on active duty, but are not currently on active duty (AM0007=2, 3)

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TOBACCO USE SECTION
PATH ID:

AC1002

Screen ID:

Have you ever smoked a cigarette, even one or two puffs?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

GO TO BOX AE1
GO TO BOX AE1
GO TO BOX AE1

ASK: All respondents
PATH ID:

AC1003

Screen ID:

Do you now smoke cigarettes…
1
2
3
-8
-7

Every day
Some days
Not at all
DON’T KNOW
REFUSED

GO TO BOX AE1
GO TO BOX AE1

ASK: Respondents who have ever smoked a cigarette (AC1002 = 1)
PATH ID:

AC1004

Screen ID:

In the past 30 days, have you smoked a cigarette, even one or two puffs?
1
2
-8
-7

Yes
No
REFUSED
DON’T KNOW

ASK: Respondents who do not currently smoke every day or some days (AC1003=3, DK, RF)
Box AE1

Screen ID:

The next questions are about electronic cigarettes, often called e-cigarettes. E-cigarettes look like regular
cigarettes, but are battery-powered and produce vapor instead of smoke. There are many types of ecigarettes. Some common brands include Smoking Everywhere, NJOY, Blu and Vapor King.
SHOW GENERIC IMAGE OF E-CIGARETTES

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PATH ID:

AE1001

Screen ID:

Have you ever heard of an electronic cigarette or e-cigarette before this study?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

GO TO BOX AG1
GO TO BOX AG1
GO TO BOX AG1

ASK: All respondents
PATH ID:

AE1002

Screen ID:

Have you ever used an e-cigarette, such as Smoking Everywhere, NJOY, Blu or Vapor King, even one or
two times?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

GO TO BOX AG1
GO TO BOX AG1
GO TO BOX AG1

ASK: Respondents who have heard of e-cigarettes (AE1001=1)
PATH ID:

AE1003

Screen ID:

Do you now use e-cigarettes…
1
2
3
-8
-7

Every day
Some days
Not at all
DON’T KNOW
REFUSED

GO TO BOX AG1
GO TO BOX AG1

ASK: Respondents who have used an e-cigarette (AE1002=1)
PATH ID:

AE1004

Screen ID:

In the past 30 days, have you used an e-cigarette, even one or two times?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

ASK: Respondents who have used an e-cigarette (AE1002=1) AND do not currently use e-cigarettes every
day or some days (AE1003=3, DK, RF)

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BOX AG1A
Traditional cigars contain tightly rolled cured tobacco that is wrapped in a tobacco leaf. Some common
brands of cigars include Macanudo, Romeo y Julieta, and Arturo Fuente, but there are many others.
SHOW GENERIC IMAGE OF TRADITIONAL CIGARS

BOX AG1B
Cigarillos and filtered cigars are smaller than traditional cigars. They are usually brown. Some are the
same size as cigarettes, and some come with plastic or wood tips. Some common brands are Black and
Mild, Swisher Sweets, Dutch Masters, Phillies Blunts, Prime Time, and Winchester.
SHOW GENERIC IMAGES OF CIGARILLOS AND FILTERED CIGARS
PATH ID:

AG1001

Screen ID:

Have you ever heard of a cigar, cigarillo, or filtered cigar before this study?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

GO TO BOX APH1
GO TO BOX APH1
GO TO BOX APH1

ASK: All respondents
BOX – DISPLAY INSTRUCTIONS
For AG9002, display a “Yes” and “No” column with options for each response category.
PATH ID:

AG9002

Screen ID:

Which type of cigar have you heard of before this study? Choose all that apply.
1

Traditional cigars like Macanudo, Romeo y Julieta, Arturo Fuente, or
others

2

Cigarillos or filtered cigars like Black and Mild, Swisher Sweets, Dutch
Masters, Phillies Blunts, Prime Time, Winchester, or others

-8
-7

DON’T KNOW
REFUSED

GO TO BOX APH1
GO TO BOX APH1

ASK: Respondents who have heard of a cigar, cigarillo or filtered cigar (AG1001=1)
GO TO: If R has not heard of either type of cigar (AG9002 NOT IN (1, 2)), go to BOX APH1

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PATH ID:

AG9003

Screen ID:

Have you ever smoked a traditional cigar, even one or two puffs?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

ASK: Respondents who have heard of a traditional cigar (AG9002 IN TRADITIONAL CIGAR)
GO TO: If R has not heard of cigarillos or filtered cigars (AG9002 NOT IN “CIGARILLO OR FILTERED
CIGAR”), go to BOX APH1
PROGRAM: DISPLAY GENERIC IMAGE OF TRADITIONAL CIGARS
PATH ID:

AG9004

Screen ID:

Have you ever smoked a cigarillo or filtered cigar, even one or two puffs?
1
2

Yes
No

-8
-7

DON’T KNOW
REFUSED

GO TO [CIGARFILL] SERIES

ASK: Respondents who have heard of a cigarillo/FC (AG9002 IN “CIGARILLO OR FILTERED CIGAR”)
PROGRAM: DISPLAY GENERIC IMAGE OF CIGARILLOS AND FILTERED CIGARS
PATH ID:

AG9006

Screen ID:

Have you ever smoked a cigarillo or filtered cigar that has a wooden or plastic tip?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

ASK: Respondents who have smoked a cigarillo/FC (AG9004 IN “CIGARILLO OR FILTERED CIGAR”)
PROGRAM: DISPLAY GENERIC IMAGE OF CIGARILLOS WITH TIPS
PATH ID:

AG9007

Screen ID:

Have you ever smoked a cigarillo or filtered cigar that has a filter?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

ASK: Respondents who have smoked a cigarillo/FC (AG9004 IN “CIGARILLO OR FILTERED CIGAR”)
PROGRAM: DISPLAY GENERIC IMAGE OF FILTERED CIGARS

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PATH ID:

AG9008

Screen ID:

Have you ever smoked a cigarillo or filtered cigar that does not have a tip or filter?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

ASK: Respondents who have smoked a cigarillo/FC (AG9004 IN “CIGARILLO OR FILTERED CIGAR”)
PROGRAM: DISPLAY GENERIC IMAGE OF CIGARILLOS WITHOUT TIP OR FILTER
PROGRAM: [CIGARFILL] SERIES
Create [CIGARFILL] and repeat AG1003 and AG1004 for each product that the respondent has indicated
that he or she used in questions AG9003, AG9006, AG9007 and AG9008.
Create [CIGARFILL]. If AG9003=1, [CIGARFILL]=cigar. If AG9004=1 AND (AG9006=1 OR AG9008=1),
[CIGARFILL]=cigarillo. If AG9004=1 AND AG9007=1, [CIGARFILL]=filtered cigar.
Repeat the rest of the section once for each type of cigar the respondent has used (traditional cigars,
cigarillos, filtered cigars). Display text below as follows:
For respondents who have used traditional cigars, but have not used cigarillos or filtered cigars: No display.
For all other respondents, display the following text each time they repeat the rest of the section. Add the
last sentence only if they still have another CIGARFILL to answer questions about.
The next questions are about [CIGARFILL]. Please think only about your use of [CIGARFILLS] like those
shown below as you answer these questions. [SHOW GENERIC IMAGE FOR CIGARFILL]. [ONLY IF
THIS IS NOT THE LAST TIME THROUGH THE SECTION]. There will be a separate section later about
other kinds of cigars.
PATH ID:

AG1003

Screen ID:

Do you now smoke [CIGARFILL]s…
1
2
3
-8
-7

Every day
Some days
Not at all
DON’T KNOW
REFUSED

GO TO BOX APH1
GO TO BOX APH1

ASK: Respondents who have smoked at least one type of cigar (regular cigar (AG9003=1) and/or cigarillo
(AG9006=1) and/or FC (AG9007=1))

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PATH ID:

AG1004

Screen ID:

In the past 30 days, have you smoked a [CIGARFILL], even one or two puffs?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

ASK: Respondents who have smoked at least one type of cigar (regular cigar (AG9003=1) and/or cigarillo
(AG9006=1) and/or FC (AG9007=1)) and do not currently smoke every day or Some Days (AG1003=3, DK,
RF)
BOX APH1
The next questions are about smoking tobacco in pipes.
We first ask about smoking tobacco in a regular pipe. There are many different types of regular pipes.
They all have a bowl that holds the tobacco and a stem. The picture below shows a typical pipe.
[GENERIC IMAGES OF PIPES]
We next ask about smoking tobacco in a hookah, which is a type of water pipe used to smoke tobacco. It is
sometimes also called a “narghile” pipe. From now on, we will use “hookah” to refer to a water pipe or
narghile pipe that is used to smoke tobacco. There are many types of hookahs. People often smoke
tobacco in hookahs in groups at cafes or in hookah bars. The picture below shows a typical hookah.
[GENERIC IMAGES OF HOOKAH]
PATH ID:

AP1001

Screen ID:

Have you ever heard of a pipe before this study?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

GO TO AH1001
GO TO AH1001
GO TO AH1001

ASK: All respondents
PATH ID:

AP1002

Screen ID:

Have you ever smoked a pipe filled with tobacco, even one or two puffs?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

GO TO AH1001
GO TO AH1001
GO TO AH1001

ASK: Respondents who have heard of pipes (AP1001=1)

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PATH ID:

AP1003

Screen ID:

Do you now smoke a pipe filled with tobacco…
1
2
3
-8
-7

Every day
Some days
Not at all
DON’T KNOW
REFUSED

GO TO AH1001
GO TO AH1001

ASK: Respondents who have a smoked pipe filled with tobacco (AP1002=1)
PATH ID:

AP1004

Screen ID:

In the past 30 days, have you smoked a regular pipe filled with tobacco, even one or two puffs?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

ASK: Respondents who have smoked a pipe filled with tobacco (AP1002=1) AND do not currently smoke
pipes every day or Some Days (AP1003=3, DK, RF)
PATH ID:

AH1001

Screen ID:

Have you ever heard of a hookah before this study?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

GO TO BOX ASU1
GO TO BOX ASU1
GO TO BOX ASU1

ASK: All respondents
PATH ID:

AH1002

Screen ID:

Have you ever smoked tobacco in a hookah, even one or two puffs?
1
2
-8
-7

Yes
No
DON’T KNOW
REFUSED

GO TO BOX ASU1
GO TO BOX ASU1
GO TO BOX ASU1

ASK: Respondents who have heard of a hookah (AH1001=1)

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PATH ID:

AH1003

Screen ID:

Do you now smoke a hookah…
1
Every day
2
Some days
3
Not at all
-8
DON’T KNOW
-7
REFUSED
ASK: Respondents who have smoked a hookah (AH1002=1)
Box ASU1

Screen ID:

The next questions ask about smokeless tobacco which you put in your mouth. Frequently you chew,
suck or spit while using smokeless tobacco, although there is no need to do so for some types. Snus, for
instance, is a type of smokeless tobacco that comes in a small pouch that you put under your lip.
There are many kinds of smokeless tobacco, such as snus pouches, loose snusmoist snuff, dip, spit, and
chewing tobacco. Common brands include Redman, Levi Garrett, Beechnut, Skoal, Nordic Ice and
Copenhagen.
SHOW GENERIC IMAGES OF SMOKELESS TOBACCO
PATH ID:

AS1001

Screen ID:

Have you ever heard of smokeless tobacco, such as snus pouches, loose snus, moist snuff, dip, spit or
chewing tobacco, before this study?
1

Yes

2

No

-8

DON’T KNOW

-7

REFUSED

GO TO BOX AD1

ASK: All respondents
BOX – DISPLAY INSTRUCTIONS
For AS1002, display a “Yes” and “No” column with options for each response category.

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PATH ID:

AS1002

Screen ID:

Have you ever used any of the following smokeless tobacco products, even one or two times? Choose all
that apply.
1
2
-8
-7

Snus pouches
Loose snus, moist snuff, dip, spit, or chewing tobacco
DON’T KNOW
REFUSED

ASK: Respondents who have heard of smokeless tobacco (AS1001=1)
GO TO: If respondent has used snus pouches (AS1002 = 1 IN SNUS POUCHES), go to AU1003
Else if respondent has used loose snus, moist snuff, dip, spit or chewing tobacco AND has NOT used snus
pouches ((AS1002(1) NE 1 AND AS1002(2)=1)), go to BOX AS5
Else If respondent has NOT used any type of smokeless tobacco including snus pouches AND loose snus,
moist snuff, dip, spit or chewing tobacco ((AS1002(1, 2) NE 1)), go to BOX AD1
BOX AS4
DEFINE VARIABLE [OTHPOUCH] to capture names of types of smokeless tobacco pouches other than
snus pouches.
OTHPOUCH=”Skoal Bandits”
PATH ID:

AU1003

Screen ID:

You mentioned that you have used snus pouches. There are many brands of snus pouches. Did you use
the brand called “[OTHPOUCH]”?
1
2
3
-8
-7

Yes, I used only [OTHPOUCH]
Yes, I used both [OTHPOUCH] and other brands of snus pouches
No, I did not use [OTHPOUCH]
DON’T KNOW
REFUSED

ASK: Respondents who have used snus ((AS1002(1)=1 IN SNUS POUCHES))
BOX AS5
DEFINE: CREATE AN ARRAY SMKLSSTYPE WITH 2 ELEMENTS - ONE FOR EACH SMOKELESS
TOBACCO TYPE (SMOKELESS TOBACCO; SNUS) .
If respondent has ever used smokeless tobacco and has not used snus ((AS1002(1)=2 AND AS1002(2)=1))
then SMKLSSTYPE[1]=1;
If respondent has ever used snus (AS1002(1)=1) AND the snus was Skoal Bandits (AU1003=1 or 2), then
SMKLSSTYPE[1]=1;
If respondent has ever used snus (AS1002(1)=1) AND the snus was NOT exclusively Skoal Bandits
(AU1003=2 or 3), then SMKLSSTYPE[2]=2.

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Then do the following:
If SMKLSSTYPE[1]=1 and SMKLSSTYPE[2] <> 2, complete the rest of this section one time, filling
[SMKLSSFILL] with “smokeless tobacco”
If SMKLSSTYPE[1] <> 1 and SMKLSSTYPE[2]=2, complete the rest of this section one time, filling
[SMKLSSFILL] with “snus”
If SMKLSSTYPE[1]=1 and SMKLSSTYPE[2]=2, complete the rest of this section TWICE. The first time, fill
[SMKLSSFILL] with “snus”. The second time, fill [SMKLSSFILL] with “smokeless tobacco.”
BOX AS6
If SMKLSSTYPE[1]=1 and SMKLSSTYPE[2]=null (respondent uses smokeless tobacco, but not snus
pouches), GO TO AS1003.
If SMKLSSTYPE[1]=null and SMKLSSTYPE[2]=2 (respondent uses snus pouches, but not other forms of
smokeless), display the following text:
The next two questions are about snus pouches. Common brands of snus pouches include Camel snus,
General snus, Marlboro snus, and Nordic Ice, but there are many others.
Please think about your use of snus pouches as you answer these questions.
[SHOW GENERIC IMAGE OF SNUS TIN AND POUCHES]
If SMKLSSTYPE[1]=1 and SMKLSSTYPE[2]=2, (respondent uses snus pouches AND other forms of
smokeless) FIRST TIME THROUGH, display the following text:
The next questions are about snus. Please think about your use of snus pouches as you answer these
questions.
[SHOW GENERIC IMAGE OF SNUS TIN AND POUCHES]
If SMKLSSTYPE[1]=1 and SMKLSSTYPE[2]=2, SECOND TIME THROUGH, display the following text:
The next questions are about your use of other kinds of smokeless tobacco, not including snus pouches.
The questions will use the phrase “smokeless tobacco” to refer to these products.
[SHOW GENERIC IMAGE OF SMOKELESS PRODUCTS, EXCLUDING SNUS TIN AND POUCHES]

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PATH ID:

AS1003

Screen ID:

Do you now use [smokeless tobacco | snus pouches]…
1

Every day

GO TO BOX AD1

2

Some days

GO TO BOX AD1

3

Not at all

-8

DON’T KNOW

-7

REFUSED

ASK: Respondents who have used smokeless tobacco (AS1002=1)
PROGRAM: If SMKLSSTYPE[1]=1, display “smokeless tobacco”; if SMKLSSTYPE[2]=2, display “snus
pouches”.
PATH ID:

AS1004

Screen ID:

In the past 30 days have you used [smokeless tobacco | snus pouches], even one or two times?
1

Yes

2

No

-8

DON’T KNOW

-7

REFUSED

ASK: Respondents who have used smokeless tobacco (AS1002=1) AND do not currently use smokeless
tobacco every day or Some Days (AS1003=3, DK, RF)
PROGRAM: If SMKLSSTYPE[1]=1, display “smokeless tobacco”; if SMKLSSTYPE[2]=2, display “snus
pouches”.
BOX AD1
The next questions ask about another new type of tobacco called dissolvable tobacco. You don’t smoke
dissolvable tobacco products – they are made of finely ground flavored tobacco that dissolves in your
mouth.
Dissolvable tobacco products come in a variety of shapes, including small round pellets, thin sticks and flat
strips. Some common brands are Ariva, Stonewall, or Camel Orbs, Sticks or Strips.
SHOW GENERIC IMAGES OF DISSOLVABLES

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PATH ID:

AD1001

Screen ID:

Have you ever heard of dissolvable tobacco before this study?
1

Yes

2

GO TO BOX AX1

-8

No
DON’T KNOW

-7

REFUSED

GO TO BOX AX1

GO TO BOX AX1

ASK: All respondents
PATH ID:

AD1002

Screen ID:

Have you ever used dissolvable tobacco products, such as Ariva, Stonewall, or Camel Orbs, Sticks, or
Strips, even one or two times?
1

Yes

2

No

GO TO BOX AX1

-8

DON’T KNOW

GO TO BOX AX1

-7

REFUSED

GO TO BOX AX1

ASK: Respondents who have heard of dissolvable tobacco (AD1001=1)
PATH ID:

AD1003

Screen ID:

Do you now use dissolvable tobacco…
1

Every day

GO TO BOX AX1

2

Some days

GO TO BOX AX1

3
-8

Not at all

-7

REFUSED

DON’T KNOW

ASK: Respondents who have used dissolvable tobacco (AD1002=1)
PATH ID:

AD1004

Screen ID:

In the past 30 days, have you used dissolvable tobacco, even one or two times?
1

Yes

2

No

-8

DON’T KNOW

-7

REFUSED

ASK: Respondents who have used dissolvable tobacco AND do not currently use dissolvable tobacco every
day or some days (AD1003=3, DK, RF)

PATH
Individual Screener

17

PATH
Individual Screener
Version 6.2

BOX AX1
The second stage sampling algorithm will be run here. After the sampling algorithm is run, do the following:
DEFINE: EVER USER CIG = YES (1) IF AC1002=1; = NO (2) IF AC1002=2, DK/R.
For respondents that are ever users of cigarettes (EVER USER CIG = 1): go to cigarette section, then to
sections (in order) for the other products they use (if any), then to questions A*1027, A*1080, A*1081 for all
other products (in order) they have heard of but do not use (if any). Then for respondents who are dual or
poly users, go to polyuse section, for all others go to nicotine dependence section. Complete remaining
sections in order.
For respondents that have never used cigarettes (EVER USER CIG = 2): go to sections (in order) for the
product or products they use. Then for respondents who are dual or poly users, go to polyuse section, for
all others go to nicotine dependence section. Complete remaining sections in order.
Create a summary screen displaying responses to all questions used in the Phase 2 sampling algorithm
and/or in setting tobacco use-defined groups. Allow respondent either to 1) confirm in a master checkbox
that there are no changes (can mean either all correct or does not wish to answer any remaining missing
questions), or 2 ) check individual items for correction/filling any still-missing data.
For the master checkbox, label it as "Check here if you do not want to make any {more} changes."
[DISPLAY{more} IF RESPONDENT MAKES ANY CHANGES AND IS ROUTHED BACK TO THIS BOX
FOR CONFIRMATION AGAIN.
For any DK or RF response, display response as "Not answered".
For each item checkbox, label as "Check here to change" (if valid data) or "Check here to answer" (if
missing).
Route the questionnaire back to each checked question and allow respondent to change answer. Save
original answers in a history variable for each question. Apply the same missing probes or logic checks to
any revisited question as specified for the initial administration of the question, e.g., probe for DK or Ref, but
only once each.
After respondent has been routed through any checked items, display the summary screen again and allow
further iterations until the respondent checks the master box.
Do not run the Phase 2 sampling algorithm until the respondent checks the master approval box.

PATH
Individual Screener

18