Survey - English
National Adult Tobacco Survey
H-3. NATS 2013-2014 Questionnaire-8-29-2013-English
National Adult Tobacco Survey - Landline
OMB: 0920-0828
Form Approved
OMB No. 0920-0828
Exp. Date 7/31/2015
National Adult Tobacco Survey Questionnaire, 2013-2014
Public reporting burden of this collection of information is estimated to average 20 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 CDC Reports Clearance Officer, 1600 Clifton Road, MS-74, Atlanta, GA 30333, ATTN: PRA (0920-0828).
Surveillance Team/ Epidemiology Branch/ Office on Smoking and Health/ National Center for Chronic Disease Prevention and Health Promotion/ Centers for Disease Control and Prevention
Office of Science/ Center for Tobacco Products/ Food and Drug Administration
Table of Contents
Knowledge/Attitudes/Perceptions 78
Appendix A. Landline Screener 90
Introduction
This document contains the questions on the 2013-2014 National Adult Tobacco Survey (NATS) conducted by the CDC’s Office on Smoking and Health (OSH), in partnership with the Food and Drug Administration’s Center for Tobacco Products (FDA-CTP).
In 1999, the CDC’s Office on Smoking and Health (OSH) created the National Tobacco Control Program (NTCP) to encourage coordinated, national efforts to reduce tobacco use and tobacco-related diseases and deaths. In 2009, Congress’ the Family Smoking Prevention and Tobacco Control Act (FSPTCA) gave the Food and Drug Administration (FDA) the authority to regulate tobacco products. These regulatory changes are expected to influence tobacco product use patterns and to reduce tobacco-related morbidity and mortality. Tracking patterns of tobacco use over time is a shared interest for both the Centers for Disease Control and Prevention’s Office on Smoking and Health (OSH) and the FDA’s Center for Tobacco Products (CTP). The National Adult Tobacco Survey is intended to provide surveillance and evaluation data critical for evaluating the impact of the CDC’s National Tobacco Control Program (NTCP) and the FDA’s regulatory efforts. So, this survey includes measures on key outcome indicators critical to evaluating and monitoring CDC’s NTCP and questions on new and emerging tobacco products, as well as measures relevant to the impact of FDA’s regulatory activities which ensure that its efforts are protecting the public’s health.
The purpose of this introduction is to provide the reader with information that will help in understanding and navigating the questionnaire.
The NATS is a stratified, random-digit dialed, telephone survey of non-institutionalized adults 18 years of age and older. It is designed to yield data that are representative and comparable at the national level.
The sections of the NATS questionnaire capture information used to monitor the impact of FDA activities. These sections are:
Cigarette use patterns – Cigarettes are by far the largest contributor to tobacco-related disease and death in the U.S., and the questions in this section assess current and past usage patterns. Many of these questions are consistent with those asked in the previous version of NATS.
Susceptibility (cigarettes) – These questions are asked among young adults to gauge non-smokers’ susceptibility to cigarette smoking initiation. These are a subset of questions used to assess susceptibility among youth in NYTS, based on research by John Pierce.
Other tobacco products – As cigarettes have become increasing regulated and with the potential for future marketing of modified risk tobacco products, FDA needs to monitor awareness, use, susceptibility, and risk perceptions of non-cigarette tobacco products.
Addiction (all tobacco) – The most significant driver of continued use and relapse, addiction will be important to monitor, specifically as tobacco product changes are implemented.
Cessation – Standard measures of intention to quit, quit attempts, and quitting success, both for cigarettes and all tobacco products.
Marketing/Public Education – The Tobacco Control Act gives FDA the authority to regulate the marketing of tobacco products and to educate the public about the harms of tobacco products. These questions measure exposure to different types of marketing and promotion and responses to health warnings on packages and advertisements.
Purchasing behavior (cigarettes) – Monitoring smokers’ purchasing patterns and use of price promotions will enable FDA to assess the impact of regulatory actions regarding the marketing and distribution of tobacco products, as well as identify emerging marketing practices.
Demographics – Important covariates to identify differential impacts of regulatory actions among subpopulations.
Knowledge/Attitudes/Perceptions – These questions measure short-term outcomes of efforts to inform the public of the health risks associated with tobacco products, which predict intentions and behaviors.
Secondhand smoke – A few questions were kept from the previous version of NATS to measure social norm changes and perceptions about the harmful effects of SHS to non-smokers, one of the warning statements on the cigarette graphic health warnings.
Main Body of Questionnaire
Note: The landline and cell phone screeners are in Appendices A and B after the main body of the questions.
Introductory Questions
Cigarette Smoking
Susceptibility—Cigarettes
suscept1 Rationale: To gauge young adult never-smokers’ susceptibility to taking up cigarette smoking. /Asked of respondents who are age 18-29 and (who have never tried cigarette smoking or don’t know if they have ever tried cigarette smoking or refused to say if they have ever tried cigarette smoking)/ /ASK IF Q2 AGE EQ (18-29) AND Q13 SMOKEVER EQ (2,7,9)/ 19. Have you ever been curious about smoking a cigarette? Would you say… 1. Definitely yes 2. Probably yes 3. Probably not 4. Definitely not
7. DON’T KNOW/NOT SURE 9. REFUSED
|
suscept2 Rationale: To gauge young adult never-smokers’ susceptibility to taking up cigarette smoking. /Asked of respondents who are age 18-29 and (have not smoked at least 100 cigarettes in their entire life or don’t know if they have smoked at least 100 cigarettes in their entire life or refused to say if they have smoked at least 100 cigarettes in their entire life) and (now smoke not at all or don’t know if they now smoke every day, some days or not at all or refused to say if they now smoke every day, some days or not at all)/ /ASK IF Q2 AGE EQ (18-29) AND Q3 SMOK100 EQ (2,7,9) AND Q4 SMOKNOW EQ (3,7,9)/ 20. Do you think you will smoke a cigarette soon? Would you say… 1. Definitely yes 2. Probably yes 3. Probably not 4. Definitely not
7. DON’T KNOW/NOT SURE 9. REFUSED
|
suscept3 Rationale: To gauge young adult never-smokers’ susceptibility to taking up cigarette smoking. /Asked of respondents who are age 18-29 and (have not smoked at least 100 cigarettes in their entire life or don’t know if they have smoked at least 100 cigarettes in their entire life or refused to say if they have smoked at least 100 cigarettes in their entire life) and (now smoke not at all or don’t know if they now smoke every day, some days or not at all or refused to say if they now smoke every day, some days or not at all)/ /ASK IF Q2 AGE EQ (18-29) AND Q3 SMOK100 EQ (2,7,9) AND Q4 SMOKNOW EQ (3,7,9)/ 21. Do you think you will smoke a cigarette in the next year? Would you say… 1. Definitely yes 2. Probably yes 3. Probably not 4. Definitely not
7. DON’T KNOW/NOT SURE 9. REFUSED
|
Other Tobacco Products
cigarPAST Rationale: To monitor use of non-cigarette combustible tobacco products. /ASK ALL/ 22. The next questions ask about tobacco products that you might smoke other than cigarettes, specifically cigars, cigarillos and little filtered cigars. “Cigarillos” are medium cigars that sometimes are sold with plastic or wooden tips. Some common brands are Black and Mild’s, Swisher Sweets, Dutch Masters and Phillies Blunts. Cigarillos are usually sold individually or in packs of 5 or 8. In contrast, little filtered cigars look like cigarettes and are usually brown in color. Like cigarettes, little filtered cigars have a spongy filter and are sold in packs of 20. Some common brands are Prime Time and Winchester little filtered cigars. Have you smoked cigars, cigarillos, or little filtered cigars at least 50 times in your entire life? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
cigarnow Rationale: To monitor use of non-cigarette combustible tobacco products. /Asked of respondents who [are age 18-29 and (have not smoked cigars, cigarillos, or little filtered cigars at least 50 times in their entire life or don’t know if they have smoked cigars, cigarillos, or little filtered cigars at least 50 times in their entire life)] or have smoked cigars, cigarillos, or little filtered cigars at least 50 times in their entire life/ /ASK IF (Q2 AGE EQ (18-29) AND Q22 CIGARPAST EQ (2,7)) OR Q22 CIGARPAST EQ 1/ 23. Do you now smoke cigars, cigarillos, or little filtered cigars every day, some days, rarely, or not at all? 1. Every day 2. some days 3. rarely 4. not at all
7. DON’T KNOW/NOT SURE 9. REFUSED
|
cigarTYPE Rationale: To monitor use of non-cigarette combustible tobacco products. /Asked of respondents who now smoke cigars, cigarillos, or little filtered cigars every day, some days, or rarely/ /ASK IF (Q23 CIGARNOW EQ (1,2,3)/ 24. Is the size of the cigars, cigarillos, or little filtered cigars that you usually smoke…? 1. Around the length of a cigarette 2. Around the length of a dollar bill 3. Somewhere in between the length of a cigarette and a dollar bill 4. I do not have a usual size of cigar that I smoke
7. Don’t know/not sure 9. Refused
|
CIGARFILT Rationale: To monitor use of non-cigarette combustible tobacco products. /Asked of respondents who now smoke cigars, cigarillos, or little filtered cigars every day, some days, or rarely and (who smoke cigars, cigarillos, or little filtered cigars that are around the length of a cigarette , around the length of a dollar bill, somewhere in between the length of a cigarette and a dollar bill, or don’t know or are not sure of the length of the cigars, cigarillos, or little filtered cigars that they usually smoke)/ /ASK IF (Q23 CIGARNOW EQ (1,2,3) AND Q24 CIGARTYPE EQ (1,2,3,7)/ 25. Do you usually smoke a cigar, cigarillo or little filtered cigar that has…. 1. A spongy filter 2. A plastic tip 3. A wooden tip 4. No filter or tip
7. Don’t know/not sure 9. Refused
|
CIGARBRAND Rationale: To monitor use of non-cigarette combustible tobacco products. /Asked of respondents who now smoke cigars, cigarillos, or little filtered cigars every day, some days, or rarely and (who smoke cigars, cigarillos, or little filtered cigars that are around the length of a cigarette , around the length of a dollar bill, somewhere in between the length of a cigarette and a dollar bill, or don’t know or are not sure of the length of the cigars, cigarillos, or little filtered cigars that they usually smoke) and (who usually smoke a cigar, cigarillo or little filtered cigar that has a spongy filter, a plastic tip, a wooden tip, no filter or tip,or don’t know or are not sure of the type of filter or type of the cigars, cigarillos, or little filtered cigars that they usually smoke/ /ASK IF (Q23 CIGARNOW EQ (1,2,3) AND Q24 CIGARTYPE EQ (1,2,3,7) AND Q25 CIGARFILT EQ (1,2,3,4,7)/ 26. What is the name brand of the cigar, cigarillo, or little filtered cigar that you usually smoke?
16. WHITE OWL 96. OTHER (SPECIFY) 66. Do NOT HAVE A USUAL BRaND 77. DON’T KNOW/NOT SURE 99. REFUSED
CIGARBRAND_OTH /ASK IF Q26 CIGARBRAND EQ 96/ 26_oth. ENTER OTHER/SPECIFY |
cigarFLAV Rationale: To monitor use of flavored tobacco products. /Asked of respondents who now smoke cigars, cigarillos, or little filtered cigars every day, some days, or rarely/ /ASK IF (Q23 CIGARNOW EQ (1,2,3)/ 27. In the past 30 days, were any of the cigars, cigarillos, or little filtered cigars that you smoked flavored to taste like menthol or mint, clove, spice, candy, fruit, chocolate or other sweets? 1. YES 2. NO 6. RESPONDENT DID NOT SMOKE ANY CIGARS IN THE PAST 30 DAYS
7. DON’T KNOW/NOT SURE 9. REFUSED
|
cigarFLAV2 Rationale: To monitor use of flavored tobacco products. /Asked of respondents who now smoked flavored cigars, cigarillos, or little filtered cigars/ /ASK IF (Q27 CIGARFLAV EQ 1/ 28. Was the cigar, cigarillo, or little filtered cigar [SELECT ALL THAT APPLY]: 1. Menthol or mint flavored 2. Clove, spice or herb flavored 3. Fruit flavored 4. Alcohol flavored 5. Candy, chocolate, or other sweet flavored 6. Other (specify)
7. DON’T KNOW/NOT SURE 9. REFUSED
28_OTH //ASK IF Q28 EQ 6// 28_oth. ENTER OTHER/SPECIFY
|
CIGARsuscept Rationale: To monitor susceptibility to initiating cigar smoking among young adults. Asked of respondents who are age 18-29 and (have not smoked cigars, cigarillos, or little filtered cigars at least 50 times in their entire life or don’t know if they have smoked cigars, cigarillos, or little filtered cigars at least 50 times in their entire life) and (now smoke cigars, cigarillos, or little filtered cigars not at all or don’t know if they now smoke cigars, cigarillos, or little filtered cigars every day, some days, rarely, or not at all) /ASK IF Q2 AGE EQ (18-29) AND Q22 CIGARPAST EQ (2,7) AND Q23 CIGARNOW EQ (4,7)/ 29. Do you think you will smoke a cigar, cigarillo or little filtered cigar within the next year? Would you say… 1. Definitely yes 2. Probably yes 3. Probably not 4. Definitely not
7. DON’T KNOW/NOT SURE 9. REFUSED
|
PIPEREGPAST Rationale: To monitor use of non-cigarette combustible tobacco products. /ASK ALL/ 30. Moving away from cigars, the next questions that I am going to ask concern smoking tobacco in pipes. The first set of questions asks about smoking tobacco in a regular pipe. The second set of questions asks about smoking tobacco in a hookah, which is a type of water pipe. Have you smoked a regular pipe filled with tobacco at least 50 times in your entire life? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
PIPEREGnow Rationale: To monitor use of non-cigarette combustible tobacco products. /Asked of respondents who [are age 18-29 and (have not smoked tobacco in a regular pipe at least 50 times in their entire life or don’t know if they have smoked tobacco in a regular pipe at least 50 times in their entire life)] or have smoked tobacco in a regular pipe at least 50 times in their entire life/ /ASK IF (Q2 AGE EQ (18-29) AND Q30 PIPEREGPAST EQ (2,7)) OR Q30 PIPEREGPAST EQ 1/ 31. Do you now smoke a regular pipe filled with tobacco every day, some days, rarely, or not at all? 1. Every day 2. some days 3. rarely 4. not at all
7. DON’T KNOW/NOT SURE 9. REFUSED
|
PIPEREGsuscept Rationale: To monitor susceptibility to initiating regular pipe use among young adults. Asked of respondents who are age 18-29 and (have not smoked tobacco in a regular pipe at least 50 times in their entire life or don’t know if they have ever smoked tobacco in a regular pipe at least 50 times in their life) and (now smoke tobacco in a regular pipe not at all or don’t know if they now smoke tobacco in a regular pipe) /ASK IF Q2 AGE EQ (18-29) AND Q30 PIPEREGPAST EQ (2,7) AND Q31 PIPEREGNOW EQ (4,7)/ 32. Do you think you will smoke a regular pipe filled with tobacco within the next year? Would you say… 1. Definitely yes 2. Probably yes 3. Probably not 4. Definitely not
7. DON’T KNOW/NOT SURE 9. REFUSED
|
pipewtREVER Rationale: To monitor use of non-cigarette combustible tobacco products. /ASK ALL/ 33. The next question asks you about smoking tobacco in a hookah. A hookah is a type of water pipe. Have you ever smoked tobacco in a hookah in your entire life? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
pipewtrTIMES Rationale: To monitor use of non-cigarette combustible tobacco products. /Asked of respondents who have ever smoked tobacco in a water pipe/ /ASK IF Q33 PIPEWTREVER EQ 1/ 34. How many times in total do you think you have smoked tobacco in a hookah during your lifetime? Would you say… 1. 1-5 2. 6-20 3. 21-50 4. Over 50 times
7. DON’T KNOW/NOT SURE 9. REFUSED
|
pipewtrnow Rationale: To monitor use of non-cigarette combustible tobacco products. /Asked of respondents who have ever smoked tobacco in a water pipe/ /ASK IF Q33 PIPEWTREVER EQ 1/ 35. Do you now smoke tobacco in a hookah every day, some days, rarely or not at all? 1. Every day 2. some days 3. rarely 4. not at all
7. DON’T KNOW/NOT SURE 9. REFUSED
|
PIPEWTRsuscept Rationale: To monitor susceptibility to initiating hookah use among young adults. Asked of respondents who are age 18-29 and (have never smoked tobacco in a water pipein their entire life or don’t know if they have ever smoked tobacco in a water pipe in their entire life or now smoke tobacco in a water pipe not at all or don’t know if they now smoke tobacco in a water pipe) /ASK IF Q2 AGE EQ (18-29) AND (Q33 PIPEWTREVER EQ (2,7) OR Q35 PIPEWTRNOW EQ (4,7))/ 36. Do you think you will smoke tobacco in a hookah within the next year? Would you say… 1. Definitely yes 2. Probably yes 3. Probably not 4. Definitely not
7. DON’T KNOW/NOT SURE 9. REFUSED
|
PIPEFLAV Rationale: To monitor use of flavored tobacco products. /Asked of respondents who (now smoke tobacco in a regular pipe every day, some days, or rarely) or (now smoke tobacco in a hookah every day, some days, or rarely)/ /ASK IF Q31 PIPREGNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3)/ 37. Was any of the tobacco that you smoked [FILL IF Q31 PIPREGNOW EQ (1,2,3) AND Q35 PIPEWTRNOW EQ (4,7,9): “in a regular pipe”/ELSE FILL IF Q31 PIPREGNOW EQ (4,7,9) AND Q35 PIPEWTRNOW EQ (1,2,3): “in a hookah”/ELSE FILL IF Q31 PIPREGNOW EQ (1,2,3) AND Q35 PIPEWTRNOW EQ (1,2,3): “either in a regular pipe or a hookah”] in the past 30 days flavored to taste like menthol or mint, clove, spice, candy, fruit, chocolate, or other sweets? 1. YES 2. NO 6. RESPONDENT DID NOT SMOKE ANY TOBACCO IN A PIPE IN THE PAST 30 DAYS
7. DON’T KNOW/NOT SURE 9. REFUSED
|
PIPEFLAV2 Rationale: To monitor use of flavored tobacco products. /Asked of respondents who smoked flavored tobacco in a pipe/ /ASK IF Q37 PIPEFLAV EQ 1/ 38. Was the tobacco [FILL IF Q31 PIPREGNOW EQ (1,2,3) AND Q35 PIPEWTRNOW EQ (4,7,9): “in a regular pipe”/ELSE FILL IF Q31 PIPREGNOW EQ (4,7,9) AND Q35 PIPEWTRNOW EQ (1,2,3): “in a hookah”/ELSE FILL IF Q31 PIPREGNOW EQ (1,2,3) AND Q35 PIPEWTRNOW EQ (1,2,3): “either in a regular pipe or a hookah”] [SELECT ALL THAT APPLY]: 1. Menthol or mint flavored 2. Clove, spice or herb flavored 3. Fruit flavored 4. Alcohol flavored 5. Candy, chocolate, or other sweet flavored 6. Other (specify)
7. DON’T KNOW/NOT SURE 9. REFUSED
38_OTH //ASK IF Q38 EQ 6// 38_oth. ENTER OTHER/SPECIFY |
ECIGHEARD Rationale: To monitor awareness of non-cigarette tobacco products. /ASK ALL/ 39. Moving away from cigars, the next set of questions that I am going to ask concern electronic cigarettes. Electronic cigarettes, or e-cigarettes as they are often called, are battery-operated devices that simulate smoking a cigarette, but do not involve the burning of tobacco. The heated vapor produced by an e-cigarette often contains nicotine. Before today, had you ever heard of electronic cigarettes or e-cigarettes? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
ECIGEVER Rationale: To monitor use of non-cigarette tobacco products. /Asked of respondents who have ever heard of electronic cigarettes or e-cigarettes/ /ASK IF Q39 ECIGHEARD EQ 1/ 40. Have you ever used an electronic cigarette, even just one time in your entire life? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
ECIGTIMES Rationale: To monitor use of non-cigarette tobacco products. /Asked of respondents who have ever used an electronic cigarette/ /ASK IF Q40 ECIGEVER EQ 1/ 41. How many times in total do you think you have used an electronic-cigarette during your lifetime? 1. 1-10 2. 11-20 3. 21-50 4. Over 50 times
7. DON’T KNOW/NOT SURE 9. REFUSED
|
ECIGNOW Rationale: To monitor use of non-cigarette tobacco products. /Asked of respondents who have ever used an electronic cigarette/ /ASK IF Q40 ECIGEVER EQ 1/ 42. Do you now use electronic cigarettes everyday, some days, rarely, or not at all? 1. Every day 2. some days 3. rarely 4. not at all
7. DON’T KNOW/NOT SURE 9. REFUSED
|
ECIGflav Rationale: To monitor use of flavored tobacco products. /Asked of respondents who now use electronic cigarettes every day, some days, or rarely/ /ASK IF Q42 ECIGNOW EQ (1,2,3)/ 43. Were any of the electronic cigarettes that you used in the past 30 days flavored to taste like menthol, mint, clove, spice, candy, fruit, chocolate, or other sweets? 1. YES 2. NO 6. RESPONDENT DID NOT USE ANY SMOKED TOBACCO PRODUCT OTHER THAN CIGARETTES IN THE PAST 30 DAYS
7. DON’T KNOW/NOT SURE 9. REFUSED
|
EcigFLAV2 Rationale: To monitor use of flavored tobacco products. /Asked of respondents who smoked flavored electronic cigarettes/ /ASK IF Q43 ECIGFLAV EQ 1/ 44. Were the electronic cigarettes [SELECT ALL THAT APPLY]: 1. Menthol or mint flavored 2. Clove, spice or herb flavored 3. Fruit flavored 4. Alcohol flavored 5. Candy, chocolate, or other sweet flavored 6. Other (specify)
7. DON’T KNOW/NOT SURE 9. REFUSED
44_OTH //ASK IF Q44 EQ 6// 44_oth. ENTER OTHER/SPECIFY |
ECIGSUSCEPT Rationale: To monitor susceptibility to non-cigarette tobacco products. /Asked of respondents who have never tried an electronic cigarette or don’t know if they have ever tried an electronic cigarette or now use electronic cigarettes not at all or don’t know if they now use electronic cigarettes every day, some days, rarely, or not at all/ /ASK IF Q40 ECIGEVER EQ (2,7) OR Q42 ECIGNOW EQ (4,7)/ 45. Do you think you will use an electronic cigarette or e-cigarette in the next year? Would you say… 1. Definitely yes 2. Probably yes 3. Probably not 4. Definitely not
7. DON’T KNOW/NOT SURE 9. REFUSED
|
smkothage Rationale: To monitor youth use and susceptibility to non-cigarette tobacco products. /Asked of respondents who (have smoked a cigar, cigarillo, or a little filtered cigar at least 50 times in their entire life) or (have ever smoked tobacco in a water pipe)or (have smoked tobacco in a regular pipe at least 50 times in their entire life) or (have ever used an electronic cigarette in their entire life)/ /ASK IF Q22 CIGARPAST EQ 1 OR Q33 PIPEWTREVER EQ 1 OR Q30 PIPEREGPAST EQ 1 OR Q40 ECIGEVER EQ 1 or Q46_VER=2/ /RANGE: 1-130,777,999. VERIFY IF (1-11,31-130). VERIFY IF > ANSWER FROM Q2 AGE. / 46. How old were you when you first smoked [FILL if Q22 CIGARPAST EQ 1: “a cigar, cigarillo, or little filtered cigar”/FILL IF Q30 PIPEREGPAST EQ 1 OR Q33 PIPEWTREVER EQ 1: “a regular pipe or a hookah”/FILL IF Q40 ECIGEVER EQ 1: “an electronic cigarette”]—even if only one or two puffs? Please do not include cigarettes in your answer. _ _ _. age in years
777. DON’T KNOW/NOT SURE 999. REFUSED
|
//ASK if Q46=1-11, 31-130, or if Q46 response > Q2 AGE response// Q46_VER I just want to verify that you said you were //insert response if Q46=1-11, 31-130; insert response if Q46 response > Q2 AGE// years old when you first smoked a //[FILL if Q22 CIGARPAST EQ 1: “cigar, cigarillo, or little filtered cigar”/FILL IF Q30 PIPEREGPAST EQ 1 OR Q33 PIPEWTREVER EQ 1: “a regular pipe or a hookah”/FILL IF Q40 ECIGEVER EQ 1: “an electronic cigarette”]—even if only one or two puffs, is that correct?
2. NO, NEED TO RE-ENTER RESPONSE 9. REFUSED |
CSDPAST Rationale: To monitor use of smokeless tobacco products. /ASK ALL/ interviewer: pronounce “levi” as lee-vie 47. Now we will ask you about smokeless tobacco products, specifically chewing tobacco, snuff, or dip. Some examples of these product brands are Skoal, Copenhagen, Grizzly, Levi Garrett, Red Man, or Day’s Work. Have you used chewing tobacco, snuff or dip at least 20 times in your entire life? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
csdnow Rationale: To monitor use of smokeless tobacco products. /Asked of respondents who [are age 18-29 and (have not used chewing tobacco, snuff or dip at least 20 times in their entire life or don’t know if they have used chewing tobacco, snuff or dip at least 20 times in their entire life)] or or have used chewing tobacco, snuff or dip at least 20 times in their entire life/ /ASK IF (Q2 AGE EQ (18-29) AND Q47 CSDPAST EQ (2,7)) OR Q47 CSDPAST EQ 1/ 48. Do you now use chewing tobacco, snuff, or dip every day, some days, rarely, or not at all? 1. Every day 2. some days 3. rarely 4. not at all
7. DON’T KNOW/NOT SURE 9. REFUSED
|
CSDsuscept Rationale: To monitor susceptibility to initiate use of chewing tobacco, snuff or dip among young adults. /Asked of respondents who are age 18-29 and [(have not used chewing tobacco, snuff or dip at least 20 times in their entire life) or (don’t know if they have used chewing tobacco, snuff or dip at least 20 times in their entire life) ]and [(now use chewing tobacco, snuff, or dip not at all) or (don’t know if they now use chewing tobacco, snuff, or dip)]. /ASK IF Q2 AGE EQ (18-29) AND Q47 CSDPAST EQ (2,7) AND Q48 CSDNOW EQ (4,7)/ 49. Do you think you will chew tobacco, or use snuff or dip within the next year? Would you say… 1. Definitely yes 2. Probably yes 3. Probably not 4. Definitely not
7. DON’T KNOW/NOT SURE 9. REFUSED
|
snusheard Rationale: To monitor awareness of novel smokeless tobacco products. /ASK ALL/ iNTERVIEWER: Pronounce “snus” to rhyme with goose.
50. Have you ever heard of snus, such as Camel Snus or Marlboro Snus? Snus is a moist, smokeless tobacco usually sold in individual or pre-packaged small pouches that are placed under the lip against the gum. 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
snusever Rationale: To monitor use of novel smokeless tobacco products. /Asked of respondents who have ever heard of snus/ /ASK IF Q50 SNUSHEARD EQ 1/ iNTERVIEWER: Pronounce “snus” to rhyme with goose. If respondent asks what snus is, read: “Snus” is moist, smokeless tobacco, usually sold in individual or pre-packaged small pouches that are placed under the lip against the gum.”
51. Have you ever tried snus, even just one time in your entire life? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
SNUSTIMES Rationale: To monitor use of novel smokeless tobacco products. /Asked of respondents who have ever tried snus/ /ASK IF Q51 SNUSEVER EQ 1/ INTERVIEWER: PRONOUNCE “SNUS” TO RHYME WITH GOOSE 52. How many times in total do you think you have used snus during your lifetime? 1. 1-10 2. 11-20 3. 21-50 4. Over 50 times
7. DON’T KNOW/NOT SURE 9. REFUSED
|
snusnow Rationale: To monitor use of novel smokeless tobacco products. /Asked of respondents who have ever tried snus/ /ASK IF Q51 SNUSEVER EQ 1/ 53. Do you now use snus every day, some days, rarely, or not at all? 1. Every day 2. some days 3. rarely 4. not at all
7. DON’T KNOW/NOT SURE 9. REFUSED
|
SNUSsuscept Rationale: To monitor susceptibility to initiate use of snus among all respondents who have never tried snus or don’t know if they have tried snus or . /Asked of respondents who have not tried snus even just one time in their entire life or don’t know if they have tried snus even just one time in their life or currently use snus not at all or don’t know if they currently use snus every day, some days, rarely, or not at all /ASK IF Q51 SNUSEVER EQ (2,7) OR Q53 SNUSNOW EQ (4,7)/ 54. Do you think you will use snus within the next year? Would you say… 1. Definitely yes 2. Probably yes 3. Probably not 4. Definitely not
7. DON’T KNOW/NOT SURE 9. REFUSED
|
dissheard Rationale: To monitor awareness of novel smokeless tobacco products. /ASK ALL/ 55. Have you ever heard of a dissolvable tobacco product? Some examples of these product names are Ariva, Stonewall, Camel orbs, Camel sticks, or Camel strips. These products contain finely ground tobacco that are placed in the mouth or on the tongue and readily dissolve. 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
dissEVER Rationale: To monitor use of novel smokeless tobacco products. /Asked of respondents who have ever heard of dissolvable tobacco products/ /ASK IF Q55 DISSHEARD EQ 1/ 56. Have you ever tried a dissolvable tobacco product, even just one time in your entire life? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
dissTIMES Rationale: To monitor use of novel smokeless tobacco products. /Asked of respondents who have ever tried a dissolvable tobacco product/ /ASK IF Q56 DISSEVER EQ 1/ 57. How many times in total do you think you have used a dissolvable tobacco product during your lifetime? 1. 1-10 2. 11-20 3. 21-50 4. Over 50 times
7. DON’T KNOW/NOT SURE 9. REFUSED
|
dissnow Rationale: To monitor use of novel smokeless tobacco products. /Asked of respondents who have ever tried any dissolvable tobacco product/ /ASK IF Q56 DISSEVER EQ 1/ 58. Do you now use dissolvable tobacco products every day, some days, rarely, or not at all? 1. EVERY DAY 2. SOME DAYS 3. RARELY 4. NOT AT ALL
7. DON’T KNOW/NOT SURE 9. REFUSED
|
DISsSuscept Rationale: To monitor susceptibility to initiate use of dissolvable tobacco products among all respondents who have never previously tried these products. /Asked of respondents who have not tried dissolvable tobacco even just one time in their entire life or don’t know if they have tried dissolvable tobacco even one time in their entire life or now use a dissolvable tobacco not at all or don’t know if they now use a dissolvable tobacco product/ /ASK IF Q56 DISSEVER EQ (2,7) OR Q58 DISSNOW EQ (4,7)/ 59. Do you think you will use a dissolvable tobacco product within the next year? Would you say… 1. Definitely yes 2. Probably yes 3. Probably not 4. Definitely not
7. DON’T KNOW/NOT SURE 9. REFUSED
|
smklsflav Rationale: To monitor use of flavored tobacco products. /Asked of respondents who now use chewing tobacco, snuff, dip, snus, or dissolvable tobacco every day, some days, or rarely/ /ASK IF Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3)/ CATI PROGRAMMER: SMKLSLIST = [a list of all smokeless tobacco products the respondent currently uses] 60. In the past 30 days, was any of the [FILL SMKLSLIST] that you used flavored to taste like menthol, mint, clove, spice, candy, fruit, chocolate, or other sweets? 1. YES 2. NO
6. RESPONDENT DID NOT USE ANY SMOKEless TOBACCO PRODUCTS IN THE PAST 30 DAYS
7. DON’T KNOW/NOT SURE 9. REFUSED
|
SMKLSFLAV2 Rationale: To monitor use of flavored tobacco products. /Asked of respondents who used flavored smokeless tobacco/ /ASK IF (Q60 SMKLSFLAV EQ 1/ 61. Was the [FILL SMKLSLIST] [SELECT ALL THAT APPLY]: 1. Menthol or mint flavored 2. Clove, spice or herb flavored 3. Fruit flavored 4. Alcohol flavored 5. Candy, chocolate, or other sweet flavored 6. Other (specify)
7. DON’T KNOW/NOT SURE 9. REFUSED
61_OTH //ASK IF Q61 EQ 6// 61_oth. ENTER OTHER/SPECIFY |
smklsage Rationale: To monitor susceptibility to use smokeless tobacco products. /Asked of respondents who have ever used chewing tobacco, snuff or dip every day or have ever tried snus or a dissolvable tobacco product/ /ASK IF Q47 CSDPAST EQ 1 OR Q51 SNUSEVER EQ 1 OR Q56 DISSEVER EQ 1 or Q62_VER=2/ /RANGE: 1-130,777,999. VERIFY IF (1-11,31-130). VERIFY IF > ANSWER FROM Q2 AGE./ 62. How old were you when you first tried /IF Q47 CSDPAST EQ 1, INSERT/ chewing tobacco, snuff, or dip /IF Q51 SNUSEVER EQ 1, INSERT/ snus /IF Q56 DISSEVER EQ 1, INSERT/dissolvable tobacco products?
_ _ _. age in years
777. DON’T KNOW/NOT SURE 999. REFUSED
|
//ASK if Q62=1-11, 31-130, or if Q62 response > Q2 AGE response// Q62_VER I just want to verify that you said you were //insert response if Q62=1-11, 31-130; insert response if Q46 response > Q2 AGE// years old when you first tried //[FILL SMKLSLIST]//, is that correct? 1. YES, CORRECT AS IS 2. NO, NEED TO RE-ENTER RESPONSE 9. REFUSED
|
tobacyrago Rationale: To estimate the proportion of respondents using any tobacco product in the past year /Asked of respondents who [(have never smoked cigarettes) or (have ever smoked cigarettes and were not smoking 12 months ago)] and have ever used at least one other tobacco product/ [/ASK IF (Q13 SMOKEVER EQ 2 OR Q18 SMOKYRAGO EQ 3) AND (Q22 CIGARPAST EQ 1 OR Q33 PIPEWTREVER EQ 1 OR Q30 PIPEREGPAST EQ 1 OR Q40 ECIGEVER EQ 1 OR Q47 CSDPAST EQ 1 OR Q51 SNUSEVER EQ 1 OR Q56 DISSEVER EQ 1)] OR [Q2 AGE EQ (18-29) AND (Q23 CIGARNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3))]/ 63. Around this time 12 months ago, were you using any kind of tobacco product? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
quitcom Rationale: To monitor cessation of combustible tobacco products. /Asked of respondents who have ever used cigarettes and another product but do not currently use the product/ /IF [(Q3 SMOK100 EQ 1 AND Q4 SMOKNOW EQ 3) OR Q13 SMOKEVER EQ 1] AND [(Q22 CIGARPAST EQ 1 AND Q23 CIGARNOW EQ 4) OR (Q30 PIPEREGPAST EQ 1 AND Q31 PIPEREGNOW EQ 4) OR (Q33 PIPEWTREVER EQ 1 AND Q35 PIPEWTRNOW EQ 4) OR (Q47 CSDPAST EQ 1 AND Q48 CSDNOW EQ 4) OR (Q51 SNUSEVER EQ 1 AND Q53 SNUSNOW EQ 4) OR (Q56 DISSEVER EQ 1 AND Q58 DISSNOW EQ 4) OR (Q40 ECIGEVER EQ 1 AND Q42 ECIGNOW EQ 4)]/ 64. Previously you told me that you have smoked cigarettes and have used /IF Q22 CIGARPAST EQ 1 AND Q23 CIGARNOW EQ 4, INSERT/ cigars /IF Q30 PIPEREGPAST EQ 1 AND Q31 PIPEREGNOW EQ 4, INSERT/ pipes /IF Q33 PIPEWTREVER EQ 1 AND Q35 PIPEWTRNOW EQ 4, INSERT/ hookahs /IF Q47 CSDPAST EQ 1 AND Q48 CSDNOW EQ 4, INSERT/ chewing tobacco, snuff, or dip /IF Q51 SNUSEVER AND Q53 SNUSNOW EQ 4, INSERT/ snus /IF Q56 DISSEVER AND Q58 DISSNOW EQ 4, INSERT/ dissolvables /IF Q40 ECIGEVER EQ 1 AND Q42 ECIGNOW EQ 4, INSERT/ e-cigarettes Have you completely quit using /IF 1 ADDITIONAL PRODUCT, INSERT/ both of these products? /IF >1 ADDITIONAL PRODUCT, INSERT/ all of these products? 1. YES 2. NO 7. DON’T KNOW/NOT SURE 9. REFUSED
|
QuitCOM1 Rationale: To monitor cessation of combustible tobacco products. /Asked of respondents who have completely quit using combustible tobacco products/ /ASK IF Q64 QUITCOM =1 or Q65d_VER=2; or Q65w_VER=2; or Q65m_VER=2; or Q65y_VER=2; or Q65a_VER=2// 65. About how long has it been since you quit using /IF 1 ADDITIONAL PRODUCT/ both of these products? /IF >1 ADDITIONAL PRODUCT/ all of these products?
6. DATE 8. TODAY 7. DON’T KNOW/NOT SURE 9. REFUSED
/IF Q65=1/ 65d. ENTER NUMBER OF DAYS [RANGE: 1-500. VERIFY IF (366-500)] _ _ _ /IF Q65=2/ 65w. ENTER NUMBER OF WEEKS [RANGE: 1-150. VERIFY IF (53-150)] _ _ _ /IF Q65=3/ 65m. ENTER NUMBER OF MONTHS [RANGE: 1-60. VERIFY IF (19-60)] _ _ /IF Q65=4/ 65y. ENTER NUMBER OF YEARS [RANGE: 1-90. VERIFY IF (51-90)] _ _ /if q65=5/ 65a. ENTER AGE [RANGE: 1-130. VERIFY IF (1-10)] /IF Q65=6/ 65d1. ENTER MONTH [RANGE: 1-12] /IF Q65=6/ 65d2. ENTER DAY [RANGE 1-31] /IF Q65=6/ 65d3. ENTER YEAR [RANGE 1923-2014] |
//ASK if Q65d=366-500// Q65d_VER I just want to verify that you said you quit using cigarettes, cigars pipes and/or hookah //insert response if Q65d=366-500//days ago, is that correct? 1. YES, CORRECT AS IS 2. NO, NEED TO RE-ENTER RESPONSE 9. REFUSED
//ASK if Q65w=53-150// Q65w_VER I just want to verify that you said you quit using cigarettes, cigars pipes and/or hookah //insert response if Q65w=53-150//weeks ago, is that correct? 1. YES, CORRECT AS IS 2. NO, NEED TO RE-ENTER RESPONSE 9. REFUSED
//ASK if Q65m=19-60// Q65m_VER I just want to verify that you said you quit using cigarettes, cigars pipes and/or hookah //insert response if Q65d=366-500//months ago, is that correct? 1. YES, CORRECT AS IS 2. NO, NEED TO RE-ENTER RESPONSE 9. REFUSED
//ASK if Q65y=51-90// Q65y_VER I just want to verify that you said you quit using cigarettes, cigars pipes and/or hookah //insert response if Q65y=366-500//years ago, is that correct? 1. YES, CORRECT AS IS 2. NO, NEED TO RE-ENTER RESPONSE 9. REFUSED
//ASK IF Q65a=1-10// Q65a_VER I just want to verify that you said you quit using /IF 1 ADDITIONAL PRODUCT/ both of these products? /IF >1 ADDITIONAL PRODUCT/ all of these products?
1. YES, CORRECT AS IS 2. NO, NEED TO RE-ENTER RESPONSE 9. REFUSED
|
Addiction |
DECISIONBOXPRE68 /ASK ALL/ EVERYDAYPRODUCTCOUNT= 0 +1 for every product the respondents use everyday [where SMOKNOW=1 / CIGARNOW=1 / PIPEWTRNOW= 1/ PIPEREGNOW= 1 / ECIGNOW= 1 / CSDNOW= 1 / SNUSNOW= 1/ DISSNOW= 1] Range= 0-8 SOMEDAYPRODUCTCOUNT= 0 +1 for every product the respondent uses somedays/rarely [where SMOKNOW=2 / CIGARNOW=2,3 / PIPEWTRNOW= 2,3/ PIPEREGNOW= 2,3 / ECIGNOW= 2,3 / CSDNOW= 2,3 / SNUSNOW= 2,3/ DISSNOW= 2,3] Range= 0-8 TOBACLIST= [a list of all tobacco products the respondent currently uses] |
SOMEDAYUSE /Asked of respondents who do not use any tobacco product every day and who use two or more tobacco products some days or rarely/ /ASK IF EVERYDAYPRODUCTCOUNT EQ 0 AND SOMEDAYPRODUCTCOUNT EQ (2-8) 68. Previously you mentioned that you used [INSERT TOBACLIST] on some days or rarely. Thinking about these products, are there some days when you do not use [FILL IF SOMEDAYPRODUCTCOUNT EQ 2: “either product?”/ELSE FILL IF SOMEDAYPRODUCTCOUNT EQ (3-8): “any of these products?”] 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
smokwake1, SMOKWAKE2 Rationale: To monitor levels of addiction to nicotine. /Asked of respondents who now use a tobacco product every day/ /ASK IF EVERYDAYPRODUCTCOUNT EQ (1-8) OR Q68 SOMEDAYUSE EQ 2/ 69. Thinking about [FILL TOBACLIST], on average, how soon after you wake up do you usually first use [FILL IF EVERYDAYPRODUCTCOUNT EQ (2-8): “one of these products?”/ELSE FILL IF SOMEDAYUSE EQ 1: “this product?”
7. don’t know/not sure 9. refused
/IF Q69=1/ 69m. ENTER NUMBER OF minutes [RANGE: 0-120. verify if (61-120)] /IF Q69=2/ 69h. ENTER NUMBER OF hours [RANGE: 1-24. verify if (3-24)] |
awaken Rationale: To monitor levels of addiction to nicotine. /Asked of respondents who now use any tobacco product/ /ASK IF Q4 SMOKNOW EQ (1,2) OR Q23 CIGARNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q42 ECIGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3)/ 70. Do you sometimes wake up at night in order to have a cigarette or other tobacco product? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
tobaccrave Rationale: To monitor levels of addiction to nicotine. /Asked of respondents who now use any tobacco product/ /ASK IF Q4 SMOKNOW EQ (1,2) OR Q23 CIGARNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q42 ECIGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3)/ 71. During the past 30 days, have you had a strong craving to use tobacco products of any kind? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
tobacneed Rationale: To monitor levels of addiction to nicotine. /Asked of respondents who now use any tobacco product/ /ASK IF Q4 SMOKNOW EQ (1,2) OR Q23 CIGARNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q42 ECIGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3)/ 72. During the past 30 days, did you ever feel like you really needed to use a tobacco product? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
tobacwant Rationale: To monitor levels of addiction to nicotine. /Asked of respondents who now use any tobacco product/ /ASK IF Q4 SMOKNOW EQ (1,2) OR Q23 CIGARNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q42 ECIGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3)/ 73. During the past 30 days, was there a time when you wanted to use a tobacco product so much that you found it difficult to think of anything else? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
tobacirrit Rationale: To monitor levels of addiction to nicotine. /Asked of respondents who now use any tobacco product/ /ASK IF Q4 SMOKNOW EQ (1,2) OR Q23 CIGARNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q42 ECIGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3)/ 74. How true is this statement for you? After not using tobacco for a while, I feel restless and irritable. Would you say… 1. Not at all true? 2. Sometimes true? 3. Often true? 4. Always true?
7. DON’T KNOW/NOT SURE 9. REFUSED
|
Cessation
quitATTEMPT Rationale: To monitor frequency of attempts to quit smoking. /Asked of respondents who now smoke cigarettes every day or some days/ /ASK IF Q4 SMOKNOW EQ (1,2)/ 75. During the past 12 months, have you stopped smoking for 24 hours or more because you were trying to quit? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
ECIGswitch Rationale: To monitor replacement of cigarettes with other tobacco products. /Asked of respondents who have quit smoking cigarettes in the past 12 months and have ever used e-cigarettes/ /ASK IF Q12D SMOKLAST LESS THAN OR EQUAL TO 365; IF Q12W LESS THAN OR EQUAL TO 52; IF Q12M LESS THAN OR EQUAL TO 12; IF Q12y=1; or Q12D1 and Q12D3 GREATER THAN TODAY’S DATE MINUS 1 YEAR AND Q40 ECIGEVER EQ 1/ 76. At any time during the past 12 months, did you completely switch from smoking traditional cigarettes to using electronic or e-cigarettes? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
smKlsswitch Rationale: To monitor replacement of cigarettes with other tobacco products. Asked of respondents who have quit smoking cigarettes in the past 12 months /ASK IF Q12D SMOKLAST LESS THAN OR EQUAL TO 365; IF Q12W LESS THAN OR EQUAL TO 52; IF Q12M LESS THAN OR EQUAL TO 12; IF Q12y=1; or Q12D1 and Q12D3 GREATER THAN TODAY’S DATE MINUS 1 YEAR 77. At any point during the past 12 months, did you completely switch from smoking cigarettes to using a smokeless tobacco product, such as chewing tobacco, dip, snuff, or snus? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
quitcigs Rationale: To monitor the proportion of smokers contemplating quitting smoking. /Asked of respondents who now smoke cigarettes every day or some days/ /ASK IF Q4 SMOKNOW EQ (1,2)/ 78. Are you thinking about quitting cigarettes for good? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
quitcigsOON Rationale: To monitor the proportion of smokers contemplating quitting smoking. /Asked of respondents who are thinking about quitting smoking for good/ /ASK IF Q78 QUITCIGS EQ 1/ 79. How soon are you likely to quit smoking? Would you say… 1. within the next 30 days 2. within the next 6 months 3. within the year 4. longer than a year
7. DON’T KNOW/NOT SURE 9. REFUSED
|
quitalltobac Rationale: To monitor the proportion of tobacco users contemplating quitting all tobacco use. /Asked of respondents [who are thinking about quitting cigarettes for good and now use at least one other tobacco product every day, some days, or rarely] or non-cigarette smokers who use any other tobacco product every day, some days, or rarely/ /ASK IF [Q78 QUITCIGS EQ 1 AND (Q23 CIGARNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q42 ECIGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3))] OR [Q4 SMOKNOW EQ (3,7,9) AND (Q23 CIGARNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q42 ECIGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3))]/ 80. Are you thinking about quitting the use of all tobacco products for good? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
quitalltobacSOON Rationale: To monitor the proportion of tobacco users contemplating quitting tobacco use. /Asked of respondents who are thinking about quitting all tobacco products/ /ASK IF Q80 QUITALLTOBAC EQ 1/ 81. How soon are you likely to quit using all tobacco products? Would you say… 1. within the next 30 days 2. within the next 6 months 3. within the year 4. longer than a year
7. DON’T KNOW/NOT SURE 9. REFUSED
|
quitpastyr Rationale: To estimate the number of tobacco users that made at least one attempt to quit all forms of tobacco use within the past year /Asked of respondents who now smoke cigarettes every day or some days or use any other tobacco product every day, some days, or rarely / /ASK IF Q4 SMOKNOW EQ (1,2) OR Q23 CIGARNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q42 ECIGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3)/ 82. During the past 12 months, did you stop using all kinds of tobacco products for more than one day because you were trying to quit using tobacco? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
Demographics
PRE83 /ASK ALL/ Now I would like to ask you some questions about yourself and your family. Please remember that your answers will be treated in a secure manner and that no one will be able to identify you from any published reports. 1-CONTINUE |
|
marital2 Rationale: Key covariate /ASK ALL/ Interviewer: if respondent answers “single,” please verify that s/he was never married. if respondent is unsure between “living with a partner” and any other response category, code as “living with a partner.” 83. Are you now…? 01. Married 02. Living with a partner 03. Divorced 04. Widowed 05. Separated 06. Single, that is, never married and not now living with a partner 96. Other (specify)
77. DON’T KNOW/NOT SURE 99. REFUSED
MARITAL2_OTH /ASK IF Q83 MARITAL2 EQ 96/ 83_oth. ENTER OTHER/SPECIFY
|
|
hispanic Rationale: Key covariate /ASK ALL/ 84. Are you Hispanic or Latino, or of Spanish origin? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
|
hispMULTI1, HISPMULTI_OTH Rationale: Key covariate /ASK IF Q84 HISPANIC EQ 1/ /LENGTH OF HISPMULTI_OTH=40/ INTERVIEWER: CODE “CUBAN-AMERICAN” AS “CUBAN”, CODE “PUERTO RICAN-AMERICAN” AS “PUERTO RICAN”. IF A RESPONDENT MENTIONS A COUNTRY IN CENTRAL OR SOUTH AMERICA, CODE “ANOTHER HISPANIC, LATINO, OR SPANISH ORIGIN” RECORD ALL ANSWERS GIVEN BY RESPONDENT, BUT DO NOT PROBE FURTHER. 85. Which one or more of the following describes your Hispanic origin or ancestry?
DO NOT READ: 6. SOME OTHER HISPANIC, LATINO, OR SPANISH ORIGIN, SPECIFY 7. DON’T KNOW/NOT SURE 9. REFUSED /ASK IF Q85=6/ Q85_OTH //ENTER RESPONSE// |
|
racemulti, RACEMULTI_OTH Rationale: Key covariate /ASK ALL/ INTERVIEWER: IF respondent volunteers information prior to your having read the response list or in the middle of you reading the response list, ok to code without reading full list. IF this happens, please probe with “in addition to “XXX” are there any other racial categories that describe you.” to see if more than one category is appropriate. RECORD ALL ANSWERS GIVEN BY RESPONDENT, BUT DO NOT PROBE FURTHER. 86. I’m going to read a list of racial categories. Which one or more of the following do you consider yourself to be?
DO NOT READ: 6. SOME OTHER RACIAL CATEGORY, SPECIFY 7. DON’T KNOW/NOT SURE 9. REFUSED
/ASK IF Q86=6/ Q86_OTH //ENTER RESPONSE// |
|
asianmulti, ASIANMULTI_OTH Rationale: Key covariate /ASK IF Q86 RACEMULTI3 EQ 6/ /LENGTH OF ASIANMULTI_OTH=40/ interviewer: RECORD ALL ANSWERS GIVEN BY RESPONDENT, BUT DO NOT PROBE FURTHER. 87. Which one or more of the following describes your Asian ancestry?
DO NOT READ: 96. SOME OTHER asian CATEGORY, SPECIFY 77. DON’T KNOW/NOT SURE 99. REFUSED
/ASK IF Q87=96/ Q87_OTH //ENTER RESPONSE// |
|
NHOPImulti, NHOPIMULTI_OTH Rationale: Key covariate /ASK IF Q86 RACEMULTI4 EQ 4/ /LENGTH OF NHOPIMULTI_OTH=40/ interviewer: RECORD ALL ANSWERS GIVEN BY RESPONDENT, BUT DO NOT PROBE FURTHER. 88. Which one or more of the following describes your Native Hawaiian or other Pacific Islander ancestry?
DO NOT READ: 6. SOME OTHER PACIFIC ISLANDER CATEGORY 7. DON’T KNOW/NOT SURE 9. REFUSED
/ASK IF Q88=6/ Q88_OTH //ENTER RESPONSE// |
|
educa2 Rationale: Key covariate /ASK ALL/ 89. What is the highest level of school you have completed or the highest degree you have received? INTERVIEWER: Read only if necessary. 01. 5TH GRADE OR LESS 02. 6TH GRADE 03. 7TH GRADE 04. 8TH GRADE 05. 9TH GRADE 06. 10TH GRADE 07. 11TH GRADE 08. 12TH GRADE, NO DIPLOMA 09. GED OR EQUIVALENT 10. HIGH SCHOOL DIPLOMA 11. SOME COLLEGE, NO DEGREE 12. CERTIFICATE, DIPLOMA, OR ASSOCIATE DEGREE: OCCUPATIONAL, TECHNICAL, OR VOCATIONAL PROGRAM 13. ASSOCIATE DEGREE: ACADEMIC PROGRAM 14. BACHELOR’S DEGREE 15. MASTER’S DEGREE 16. PROFESSIONAL SCHOOL DEGREE (EXAMPLES: MD, DDS, DVM, LLB, JD) 17. DOCTORAL DEGREE (EXAMPLES: PHD, EDD)
77. DON’T KNOW/NOT SURE 99. REFUSED
|
|
genderB Rationale: Key covariate /ASK ALL/ 90. What sex were you at birth? 1. MALE 2. FEMALE 9. REFUSED
|
|
gender Rationale: Key covariate /ASK ALL/ 91. Do you currently consider yourself to be: 1. MALE 2. FEMALE 9. REFUSED |
|
TELNOSGT1 Rationale: Needed for weighting. /ASK IF SAMPLE FILE TYPE EQ LANDLINE/ 92. Now I’m going to ask you about how many different telephone numbers your household has. Do not include numbers that are only used by a computer or fax machine. Also, do not include cell phone telephone numbers. Do you have more than one landline telephone number in your household? INTERVIEWER, READ ONLY IF NECESSARY: By landline telephone, we mean a “regular” telephone in your home that is connected to outside telephone lines through a cable or cord and is used for making or receiving calls. Please include landline phones used for both business and personal use. NOTE: TELEPHONE SERVICE OVER THE INTERNET COUNTS AS LANDLINE SERVICE. 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
|
telnosres Rationale: Needed for weighting. /ASK IF Q92 TELNOSGT1 EQ 1/ /RANGE: 1-6,7, 8,9/ 93. How many of these are residential numbers? INTERVIEWER: enter 6 if number of residential telephone numbers is 6 or more. _. Number of residential telephone numbers
8. NONE
7. DON’T KNOW/NOT SURE 9. REFUSED
|
|
cellpers Rationale: for data weighting on the combined cell and landline data /ASK IF SAMPLE FILE TYPE EQ LANDLINE/ 94. Do you have a cell phone for personal use? Please include cell phones used for both business and personal use. 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
|
cellpctsh Rationale: For data weighting purpose /Asked of respondents who have a cell phone for personal use or share a cell phone for personal use (at least one-third of the time) with other adults/ /ASK IF Q94 CELLPERS EQ 1/ /RANGE: 0-100,777,999/ INTERVIEWER, READ ONLY IF NECESSARY: By landline telephone, we mean a “regular” telephone in your home that is connected to outside telephone lines through a cable or cord and is used for making or receiving calls. Please include landline phones used for both business and personal use. NOTE: TELEPHONE SERVICE OVER THE INTERNET COUNTS AS LANDLINE SERVICE. 95. Thinking about all of the phone calls that you have received over the past 30 days on your landline and cell phone, what percent, between 0 and 100, are received on your cell phone? _ _ _. percent of incoming phone calls received on cell phone
777. DON’T KNOW/NOT SURE 999. REFUSED
|
|
statefips Rationale: Key covariate /ASK ALL/ /RANGE: 1-56,77,99/ 96. What state do you live in? _ _. state fips code
77. DON’T KNOW/NOT SURE 99. REFUSED
|
|
State FIPS Codes for Q96 STATEFIPS: 01 Alabama 02 Alaska 04 Arizona 05 Arkansas 06 California 08 Colorado 09 Connecticut 10 Delaware 11 District of Columbia 12 Florida 13 Georgia 15 Hawaii 16 Idaho 17 Illinois 18 Indiana 19 Iowa 20 Kansas 21 Kentucky 22 Louisiana 23 Maine 24 Maryland 25 Massachusetts 26 Michigan 27 Minnesota 28 Mississippi 29 Missouri 30 Montana 31 Nebraska
|
32 Nevada 33 New Hampshire 34 New Jersey 35 New Mexico 36 New York 37 North Carolina 38 North Dakota 39 Ohio 40 Oklahoma 41 Oregon 42 Pennsylvania 44 Rhode Island 45 South Carolina 46 South Dakota 47 Tennessee 48 Texas 49 Utah 50 Vermont 51 Virginia 53 Washington 54 West Virginia 55 Wisconsin 56 Wyoming 77 DON’T KNOW 99 REFUSED
|
zipcode Rationale: Key covariate /ASK ALL/ 97. What is your ZIP Code? [RANGE=00000-99999] _____. zip code
99997. DON’T KNOW/NOT SURE 99999. REFUSED
|
|
Employ2 /ASK ALL/ 98. Are you currently working for pay or are you self-employed, either part-time or full-time? 1. YES 2. NO
7. DON’T KNOW 9. REFUSED
|
|
HOUSingTYPE Rationale: This question allows for the evaluation of Key Outcome Indicators 2.7.3 and 2.7.5. With the increasing number of restrictions on smoking in public areas, the home has become a larger source of secondhand smoke exposure for many individuals, particularly children. Individuals who live in multiunit housing are particularly susceptible to SHS incursions from nearby units and shared areas. /ASK ALL/ 99. In what type of living space do you currently reside? INTERVIEWER: READ ONLY IF NECESSARY 1. A one-family house detached from any other house 2. A one-family house attached to one or more houses 3. A building with 2 apartments or living units 4. A building with 3 to 9 apartments or living units 5. A building with 10 to 49 apartments or living units 6. A building with 50 or more apartments or living units 7. A mobile home, boat, RV, or van 8. Some other type of living space 77. Don’t know 99. REFUSED
|
|
Marketing/Public Education
promo1-promo4 Rationale: To measure exposure to different types of prohibited tobacco marketing and promotion. /Asked of respondents who are age 18-29 or who now smoke cigarettes every day or some days or use any other tobacco product every day, some days, or rarely/ /ASK IF Q2 AGE EQ (18-29) OR Q4 SMOKNOW EQ (1,2) OR Q23 CIGARNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q42 ECIGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3)/ 100. (1. YES, 2. NO, 7. DON’T KNOW/NOT SURE, 9. REFUSED)
|
||||||||||||||||||||||||||||||||
RECVpromo1-2 Rationale: To measure exposure to direct mail and email tobacco marketing and promotion. /Asked of all respondents / 101. (1. YES, 2. NO, 7. DON’T KNOW/NOT SURE, 9. REFUSED)
|
||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||
WARNLOOKCIG Rationale: To monitor awareness of graphic health warnings /ASK ALL/ 102. How often, if at all, have you seen a health warning on cigarette packs in the past 30 days? Would you say… 1. Very often 2. Often 3. Sometimes 4. Rarely 5. Never
7. DON’T KNOW/NOT SURE 9. REFUSED
|
||||||||||||||||||||||||||||||||
WARNSTOPCIG Rationale: To monitor response to graphic health warnings /Asked of respondents who have very often, often, sometimes, or rarely seen health warnings on cigarette packs in the past 30 days/ /ASK IF Q102 WARNLOOKCIG EQ (1,2,3,4)/ 103. In the past 30 days, has a health warning on a cigarette pack stopped you from having a cigarette when you were about to smoke one? Would you say… 1. Many times 2. A few times 3. Once 4. Never 5. I did not have an urge to smoke a cigarette in the past 30 days.
7. DON’T KNOW/NOT SURE 9. REFUSED
|
||||||||||||||||||||||||||||||||
WARNAVDCIG Rationale: To monitor response to graphic health warnings /Asked of respondents who have very often, often, sometimes, or rarely seen health warnings on cigarette packs in the past 30 days/ /ASK IF Q102 WARNLOOKCIG EQ (1,2,3,4)/ 104. In the past 30 days, have you done anything to avoid seeing health warnings on cigarette packs? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
||||||||||||||||||||||||||||||||
WARNRISKCIG Rationale: To monitor response to graphic health warnings /Asked of respondents who have very often, often, sometimes, or rarely seen health warnings on cigarette packs in the past 30 days/ /ASK IF Q102 WARNLOOKCIG EQ (1,2,3,4)/ 105. How often, if at all, have you thought about the health risks of smoking cigarettes in the past 30 days? Would you say… 1. Very often 2. Often 3. Sometimes 4. Rarely 5. Never
7. DON’T KNOW/NOT SURE 9. REFUSED
|
||||||||||||||||||||||||||||||||
WARNLOOKSMKLS Rationale: To monitor awareness of health warnings /ASK ALL/ 106. How often, if at all, have you seen health warnings on smokeless tobacco packages in the past 30 days? Would you say… 1. Very often 2. Often 3. Sometimes 4. Rarely 5. Never
7. DON’T KNOW/NOT SURE 9. REFUSED
|
||||||||||||||||||||||||||||||||
WARNSTOPSMKLS Rationale: To monitor response to graphic health warnings /Asked of respondents who have very often, often, sometimes, or rarely seen health warnings on smokeless tobacco packages in the past 30 days/ /ASK IF Q106 WARNLOOKSMKLS EQ (1,2,3,4)/ 107. In the past 30 days, have the health warnings on smokeless tobacco packages stopped you from using smokeless tobacco when you were about to? Would you say… 1. Many times 2. A few times 3. Once 4. Never 5. I did not have an urge to use smokeless tobacco in the past 30 days.
7. DON’T KNOW/NOT SURE 9. REFUSED
|
||||||||||||||||||||||||||||||||
WARNRISKSMKLS Rationale: To monitor response to graphic health warnings /Asked of respondents who have very often, often, sometimes, or rarely seen health warnings on smokeless tobacco packages in the past 30 days/ /ASK IF Q106 WARNLOOKSMKLS EQ (1,2,3,4)/ 108. How often, if at all, have you thought about the health risks of using smokeless tobacco in the past 30 days? Would you say… 1. Very often 2. Often 3. Sometimes 4. Rarely 5. Never
7. DON’T KNOW/NOT SURE 9. REFUSED
|
||||||||||||||||||||||||||||||||
warnNOTICE Rationale: to measure exposure to health warnings on advertisements. /Asked of respondents who are age 18-29 or who now use any tobacco product/ /ASK IF Q2 AGE EQ (18-29) OR Q4 SMOKNOW EQ (1,2) OR Q23 CIGARNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q42 ECIGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3)/ 109. In the past 30 days, have you noticed any health warnings on tobacco advertisements in stores where tobacco products are sold? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
||||||||||||||||||||||||||||||||
CHEMSEEN Rationale: To monitor awareness and risk perceptions of constituents in tobacco products. /Asked of respondents who now use any tobacco product/ /ASK IF Q4 SMOKNOW EQ (1,2) OR Q23 CIGARNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q42 ECIGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3) 110. How often have you seen a list of the chemicals contained in tobacco products in the past twelve months? Would you say…? 1. Never 2. Rarely 3. Sometimes 4. Often
7. DON’T KNOW/NOT SURE 9. REFUSED
|
||||||||||||||||||||||||||||||||
Purchasing
bghtpast30d Rationale: To understand smokers’ purchasing patterns. /Asked of respondents who now smoke cigarettes every day or some days/ /ASK IF Q4 SMOKNOW EQ (1,2)/ 111. Have you bought any cigarettes for yourself in the past 30 days, that is, since [DATE FILL]? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
buyquant2 Rationale: To obtain information on the cost of cigarettes. Rationale: Screener for Q113 COSTPACK2 AND Q114 COSTCARTON2. /Asked of respondents who bought cigarettes for themselves in the past 30 days/ /ASK IF Q111 BGHTPAST30D EQ 1/ 112. The last time you bought cigarettes for yourself, did you buy them by the pack, by the carton, or as singles or loose cigarettes? 1. By the pack 2. By the carton 3. as singles OR loose cigarettes 4. OTHER (SPECIFY)
7. DON’T KNOW/NOT SURE 9. REFUSED
BUYQUANT2_OTH /ASK IF Q112 BUYQUANT2 EQ 4/ 112_oth. ENTER OTHER/SPECIFY
|
costpack2 Rationale: To obtain information on the cost of cigarettes. /Asked of respondents who last bought cigarettes for themselves by the pack/ /ASK IF Q112 BUYQUANT2 EQ 1 or Q96_VER=2/ /RANGE: $.01-$20.00,7777,9999. VERIFY IF (01-2.99,8.50-20.00)/ Interviewer: If respondent asks about discounts or coupons, READ: Please report the cost after discounts or coupons. 113. What price did you pay for the last pack of cigarettes you bought? _ _ _ _. Amount paid for last pack of cigarettes (in cents, 2 implied decimals)
7777. DON’T KNOW/NOT SURE 9999. REFUSED
|
//ASK IF Q113 =1.00-2.99, 9.50-20.00// Q113_VER I just want to verify, you said that you paid //insert response from Q113 if 01-2.99, 8.50-20.00// for the last pack of cigarettes that you bought, is that correct? 1. YES, CORRECT AS IS 2. NO, NEED TO RE-ENTER RESPONSE 9. REFUSED
|
costcarton2 Rationale: To obtain information on the cost of cigarettes. /Asked of respondents who last bought cigarettes for themselves by the carton/ /ASK IF Q112 BUYQUANT2 EQ 2 or Q97_VER=2/ /RANGE: $10.00-$90.00,7777,9999. VERIFY IF (10.00-18.50,69.00-90.00)</ Interviewer: If respondent asks about discounts or coupons, READ: Please report the cost after discounts or coupons. 114. What price did you pay for the last carton of cigarettes you bought?
_ _ _ _. Amount paid for last carton of cigarettes
7777. DON’T KNOW/NOT SURE 9999. REFUSED
|
//ASK IF Q114=10.00-18.50,69.00-90.00// Q114_VER I just want to verify, you said that you paid //insert response from Q114 if 10.00-18.50,69.00-90.00// for the last carton of cigarettes that you bought, is that correct? 1. YES, CORRECT AS IS 2. NO, NEED TO RE-ENTER RESPONSE 9. REFUSED
|
BUYWHERE Rationale: To obtain information on the purchasing habits of cigarette consumers. /Asked of respondents who bought cigarettes for themselves in the past 30 days/ /ASK IF Q111 BGHTPAST30D EQ 1/ 115. The last time you bought cigarettes for yourself, did you buy them... INTERVIEWER: PLEASE READ 1. At a convenience store or gas station 2. At a supermarket 3. At a liquor store 4. At a drug store 5. At a tobacco discount store 6. At another discount store, such as Wal-Mart or Costco 7. On an Indian reservation 8. From a vending machine 9. On the internet 10. From another person 11. other (specify)
77. DON’T KNOW/NOT SURE 99. REFUSED
buywhere_oth /ASK IF Q115 BUYWHERE EQ 11/ 115_oth. ENTER OTHER/SPECIFY
|
specoffers Rationale: To obtain information about industry marketing strategies. /Asked of respondents who bought cigarettes for themselves in the past 30 days/ /ASK IF Q111 BGHTPAST30D EQ 1/ 116. In the past 30 days, did you use coupons, rebates, buy 1 get 1 free, 2 for 1, or any other special promotions when you bought cigarettes? 1. YES 2. NO
7. DON’T KNOW/NOT SURE 9. REFUSED
|
BUYST Rationale: To obtain information on the purchasing habits of cigarette consumers and to obtain information on tax avoidance and evasion. /Asked of respondents who bought cigarettes for themselves in the past 30 days/ /ASK IF Q111 BGHTPAST30D EQ 1/ 117. Did you buy your LAST [FILL IF Q112 BUYQUANT2 EQ 1 “pack”/FILL IF Q112 BUYQUANT2 EQ 2 “carton”/FILL IF Q112 BUYQUANT2 EQ 3 “cigarette”/FILL IF Q112 BUYQUANT2 EQ 4 “fill other specify response from BUYQUANT2_OTH”] in your state of residence or somewhere else? 1. IN RESPONDENT’S STATE OF RESIDENCE 2. IN SOME OTHER STATE (INCLUDING DC) 3. IN SOME OTHER COUNTRY
7. DON’T KNOW/NOT SURE 9. REFUSED
|
buyst2 /Asked of respondents who bought their last cigarettes in a different state or country/ /ASK IF Q117 BGHTPAST30D EQ 2 OR 3/ Rationale: To obtain information on the purchasing habits of cigarette consumers and to obtain information on tax avoidance and evasion. 118. In what other [FILL IF Q117 BUYST EQ 2 “state”/ FILL IF Q117 BUYST EQ 3 “country” did you buy your last [FILL IF Q112 BUYQUANT2 EQ 1 “pack”/FILL IF Q112 BUYQUANT2 EQ 2 “carton”/FILL IF Q112 BUYQUANT2 EQ 3 “cigarette”/FILL IF Q112 BUYQUANT2 EQ 4 “fill other specify response”]?
77 DON’T KNOW 99 refused
|
buyres /Asked of respondents who bought cigarettes for themselves in the past 30 days/ /ASK IF Q111 BGHTPAST30D EQ 1/ Rationale: To obtain information on the purchasing habits of cigarette consumers and to obtain information on tax avoidance and evasion. INTERVIEWER IF NECESSARY: A federal Indian reservation is an area of land reserved for a tribe or tribes under treaty or other agreement, and where the federal government holds title to the land in trust on behalf of the tribe. 119. How often do you purchase cigarettes from an Indian reservation? 1. ALL THE TIME 2. SOMETIMES 3. RARELY 4. NEVER
7. DON’T KNOW/NOT SURE 9. REFUSED
|
buyst3 /Asked of respondents who bought cigarettes for themselves in the past 30 days/ /ASK IF Q111 BGHTPAST30D EQ 1/ Rationale: To obtain information on the purchasing habits of cigarette consumers and to obtain information on tax avoidance and evasion. INTERVIEWER IF NECESSARY: “state of residence is the state where you reside most of the time”. 120. How often do you purchase cigarettes from a state other than your state of residence? 1. ALL THE TIME 2. SOMETIMES 3. RARELY 4. NEVER
7. DON’T KNOW/NOT SURE 9. REFUSED
|
Knowledge/Attitudes/Perceptions
smkaddict Rationale: To monitor risk perceptions of cigarette smoking. /ASK ALL/ 121. Overall, would you say that cigarette smoking is—…? 1. Not at all addictive 2. Moderately addictive 3. Very addictive
7. DON’T KNOW/NOT SURE 9. REFUSED
|
CGRADDICT Rationale: To monitor risk perceptions of cigar smoking. /ASK ALL/ 122. Overall, would you say that cigar smoking is—…? 1. Not at all addictive 2. Moderately addictive 3. Very addictive
7. DON’T KNOW/NOT SURE 9. REFUSED
|
SMKLSADDICT Rationale: To monitor risk perceptions of smokeless tobacco use. /ASK ALL/ 123. Overall, would you say that smokeless tobacco use is—…? 1. Not at all addictive 2. Moderately addictive 3. Very addictive
7. DON’T KNOW/NOT SURE 9. REFUSED
|
harmCIG Rationale: To monitor risk perceptions of cigarette smoking. /ASK ALL/ 124. How harmful do you think cigarette smoking is to a person’s health? 1. Not at all harmful 2. Moderately harmful 3. Very harmful
7. DON’T KNOW/NOT SURE 9. REFUSED
|
harmCIGAR Rationale: To monitor risk perceptions of cigar smoking. /ASK ALL/ 125. How harmful do you think cigar smoking is to a person’s health? 1. Not at all harmful 2. Moderately harmful 3. Very harmful
7. DON’T KNOW/NOT SURE 9. REFUSED
|
harmSMKLS Rationale: To monitor risk perceptions of smokeless tobacco use. /ASK ALL/ 126. How harmful do you think using smokeless tobacco is to a person’s health? 1. Not at all harmful 2. Moderately harmful 3. Very harmful
7. DON’T KNOW/NOT SURE 9. REFUSED
|
harmECIG Rationale: Both dissolvable tobacco and e-cigarettes are new tobacco products, but e-cigarettes are gaining market share and gaining in popularity, while dissolvable tobacco products have experienced only limited uptake and sales are being discontinued in some test markets. /ASK ALL/ 127. How harmful do you think using electronic cigarettes are to a person’s health? 1. Not at all harmful 2. Moderately harmful 3. Very harmful
7. DON’T KNOW/NOT SURE 9. REFUSED
|
harmLONG Rationale: To monitor risk perceptions of cigarette smoking. /ASK ALL/ 128. How long do you think someone has to smoke before it harms their health? Would you say… 1. Less than a year 2. 1 year 3. 5 years 4. 10 years 5. 20 years or more
7. DON’T KNOW/NOT SURE 9. REFUSED
|
CIGHALF Rationale: To monitor risk perceptions of cigarette or cigar smoking. /Asked of respondents who now smoke every day or some days or who now smoke cigars every day some days, or rarely/ /ASK IF Q4 SMOKNOW EQ (1,2) OR Q23 CIGARNOW EQ (1,2,3)/ 129. How much do you think your risk of developing a tobacco-related disease would decrease if you cut the amount that you smoke in half? Would you say… 1. Not at all 2. A little 3. Somewhat 4. A lot
7. DON’T KNOW/NOT SURE 9. REFUSED
|
harmsome Rationale: To monitor risk perceptions of cigarette smoking among young adults or current smokers. /Asked of respondents who are age 18-29 or now smoke cigarettes every day or some days/ /ASK IF Q2 AGE EQ (18-29) OR Q4 SMOKENOW EQ (1,2)/ 130. How much do you think people harm themselves when they smoke cigarettes some days but not every day? Would you say… 1. Not at all 2. A little 3. Somewhat 4. A lot
7. DON’T KNOW/NOT SURE 9. REFUSED
|
SMKLSHALF Rationale: To monitor risk perceptions of smokeless tobacco products. /Asked of respondents who now use chewing tobacco, snuff, dip, snus, or dissolvable tobacco every day, some days, or rarely/ /ASK IF Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3)/ 131. How much do you think your risk of developing a smoking-related disease would decrease if you cut your smokeless tobacco use by half? Would you say… 1. Not at all 2. A little 3. Somewhat 4. A lot
7. DON’T KNOW/NOT SURE 9. REFUSED
|
chemTHINK Rationale: To monitor awareness and risk perceptions of constituents in tobacco products. /Asked of respondents who now use any tobacco product/ /ASK IF Q4 SMOKNOW EQ (1,2) OR Q23 CIGARNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q42 ECIGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3)/ 132. How often have you thought about the chemicals contained in tobacco products in the past twelve months? Would you say…? 1. Never 2. Rarely 3. Sometimes 4. Often
7. DON’T KNOW/NOT SURE 9. REFUSED
|
smokstart Rationale: to monitor risk perceptions of tobacco products. /Asked of respondents who now use any tobacco product/ /ASK IF Q4 SMOKNOW EQ (1,2) OR Q23 CIGARNOW EQ (1,2,3) OR Q35 PIPEWTRNOW EQ (1,2,3) OR Q31 PIPEREGNOW EQ (1,2,3) OR Q42 ECIGNOW EQ (1,2,3) OR Q48 CSDNOW EQ (1,2,3) OR Q53 SNUSNOW EQ (1,2,3) OR Q58 DISSNOW EQ (1,2,3)/ 133. If you had to do it over again, would you have started using tobacco? Would you say… 1. Definitely not 2. Probably not 3. Probably yes 4. Definitely yes
7. DON’T KNOW/NOT SURE 9. REFUSED
|
Secondhand Smoke
homerules2 Rationale: To monitor perceptions about the harmful effects of secondhand smoke, which is one of the warning statements appearing on the graphic health warnings. /ASK ALL/ 134. Not counting decks, porches, or garages, inside your home, is smoking …? 1. Always allowed 2. Allowed only at some times or in some places 3. Never allowed
7. DON’T KNOW/NOT SURE 9. REFUSED
|
Shsvehpol Rationale: To monitor perceptions about the harmful effects of secondhand smoke, which is one of the warning statements appearing on the graphic health warnings. /ASK ALL/ 135. Not counting motorcycles, in the vehicles that you or family members who live with you own or lease, is smoking 1. Always allowed 2. Sometimes allowed in at least one vehicle 3. Never allowed in any vehicle
8. RESPONDENT’S FAMILY DOES NOT OWN OR LEASE A VEHICLE 7. DON’T KNOW/NOT SURE 9. REFUSED
|
SMOKHOME7D2 Rationale (CDC): This question allows for the evaluation of Key Outcome Indicators 2.7.3, 2.7.5. With the increasing number of restrictions on smoking in public areas, private areas such as homes and vehicles are becoming larger sources of exposure. The home is the primary source of secondhand smoke exposure for children. /ASK ALL/ /RANGE: 01-07/ 136. Not counting decks, porches, or garages, during the past 7 days, that is, since last [TODAY’S DAY OF WEEK], on how many days did someone other than you smoke tobacco inside your home while you were at home? 0_. NUMBER OF DAYS 88. NONE 77. DON’T KNOW/NOT SURE 99. REFUSED
|
shsvehexp Rationale (CDC): This question allows for the evaluation of Key Outcome Indicators 2.7.3, 2.7.5. With the increasing number of restrictions on smoking in public areas, private areas such as homes and vehicles are becoming larger sources of exposure. /ASK ALL/ /RANGE: 01-07/ 137. During the past 7 days, that is, since last [TODAY’S DAY OF WEEK], on how many days did you ride in a vehicle where someone other than you was smoking tobacco? 0_. NUMBER OF DAYS 88. NONE 77. DON’T KNOW/NOT SURE 99. REFUSED
|
SHSEXPWORK Rationale (CDC): This question allows for the evaluation of Key Outcome Indicators 2.7.1, 2.7.5. Worksites represents an important source of secondhand exposure for adults, particularly in states and localities that have not enacted comprehensive smoke-free policies prohibiting smoking in indoor areas of worksites, restaurants, and bars. /Asked of respondents who are employed or self-employed/ /ASK IF Q98 EMPLOY2 EQ 1/ /RANGE: 01-07/ 138. Now I’m going to ask you about smoke you might have breathed at work because someone else was smoking, either indoors or outdoors. During the past 7 days, that is, since last [TODAY’S DAY OF WEEK], on how many days did you breathe the smoke at your workplace from someone other than you who was smoking tobacco? 0_. NUMBER OF DAYS 88. NONE 77. DON’T KNOW/NOT SURE 99. REFUSED
|
SHSWORKPOL Rationale: This question allows for the evaluation of Key Outcome Indicator 2.4.3. It combines two questions from the 2009-2010 NATS questionnaire that assessed worksites policies in outdoor and indoor areas separately. Worksites are an important source of secondhand exposure for individuals residing in states and localities without comprehensive smoke-free policies prohibiting smoking in indoor areas of worksites, restaurants, and bars. /Asked of respondents who are employed or self-employed/ /ASK IF Q98 EMPLOY2 EQ 1/ 139. At your workplace, is smoking…..? 1. Allowed in both indoor and outdoor areas 2. Allowed in outdoor areas, but never allowed in any indoor areas 3. Allowed in indoor areas, but never allowed in any outdoor areas 4. Never allowed in any indoor or outdoor area
77. DON’T KNOW 99. REFUSED
|
SHSMUHEXP Rationale: This question allows for the evaluation of Key Outcome Indicators 2.7.3 and 2.7.5. With the increasing number of restrictions on smoking in public areas, the home has become an important source of secondhand smoke exposure for many individuals, particularly children. Individuals who live in multiunit housing are particularly susceptible to SHS incursions from nearby units and shared areas. /Asked of respondents who live in multi-unit housing and do not allow smoking inside their home/ /ASK IF Q99 HOUSINGTYPE EQ (2-6) AND Q134 HOMERULES2 EQ (3)/ 140. How often does tobacco smoke enter your living space from somewhere else in or around the building? 1. Every day 2. A few times a week 3. A few times a month 4. Once a month or less 5. Never
7. Don’t know 9. REFUSED
|
Closing Questions
income2 Rationale: Key covariate /ASK ALL/ Note: 2006 median U.S. household income eq $48,201 141. Now I would like to ask about the combined income of everybody who lives with you. Combined income includes income from all sources for all persons in this household, including income from jobs, Social Security, retirement income, public assistance, and all other sources. Is your annual household income from all sources…?
04. Less than $50,000 If
"no," ask 05; if "yes," ask 03
03. Less than $40,000 If
"no," code 04; if "yes," ask 02
02. Less than $30,000 If
"no," code 03; if "yes," ask 01 01. Less than $20,000 If "no," code 02
05. Less than $70,000 If
"no," ask 06
06. Less than $100,000
If "no," ask 07
07. Less than $150,000
If "no," code 08 08. $150,000 or more
77. DON’T KNOW/NOT SURE 99. REFUSED
|
sexualorient1 Rationale: Key covariate /ASK ALL/ INTERVIEWER: AS THE QUESTION IS READ, READ ALOUD THE NUMBERS OF THE RESPONSES. THIS ALLOWS THE RESPONDENT TO REPLY WITH A NUMBER IF, FOR WHATEVER REASON, THEY ARE UNCOMFORTABLE SAYING THE WORDS. 142A. Do you think of yourself as…? CATI PROGRAMMER: IF Q91 GENDER EQ 1, SHOW RESPONSES AS:
1. Gay 2. Straight, that is, not gay 3. Bisexual 4. Something else
6. respondent Does not understand responses 7. DON’T KNOW/NOT SURE 9. REFUSED
CATI PROGRAMMER: IF Q91 GENDER EQ (2,7,9) SHOW RESPONSES AS:
1. Lesbian or gay 2. Straight, that is, not lesbian or gay 3. Bisexual 4. Something else
6. respondent Does not understand responses 7. DON’T KNOW/NOT SURE 9. REFUSED
|
SEXUALORIENT2 /ASK IF Q142A SEXUALORIENT1 EQ 4/ 142B. By something else, do you mean that … 1. You are not straight, but identify with another label such as queer, trisexual, omnisexual or pansexual. 2. You are transgender, transsexual or gender variant. 3. You have not figured out your sexuality or are in the process of figuring it out. 4. You do not think of yourself as having sexuality. 5. You do not use labels to identify yourself. 6. You made a mistake and did not mean to pick this answer. 7. You mean something else. 9. REFUSED
SEXUALORIENT3 /ASK IF Q142A SEXUALORIENT1 EQ 7/ 142C. You gave “Don’t know” as an answer. Is that because … 1. You don’t understand the words. 2. You understand the words, but you have not figured out your sexuality or you are in the process of figuring it out. 3. You mean something else. 9. REFUSED
SEXUALORIENT_OTH /LENGTH OF SEXUALORIENT_OTH=40/ /ASK IF Q142C EQ 3/ 142D. Please tell me what you mean by “something else”?
|
CLOSE /ASK ALL/ That’s my last question. Everyone’s answers will be combined to give us information about tobacco in the U.S. The information you have provided will be used to help improve the health of people all across the US. Thank you very much for your time and cooperation. 1-CONTINUE |
LANGUAGE INTERVIEWER: IN WHAT LANGUAGE WAS THE INTERVIEW CONDUCTED? IF MORE THAN ONE, INDICATE THE PREDOMINANT LANGUAGE USED. 1. ENGLISH 2. SPANISH |
Appendix A. Landline Screener
answering machine Message text: [TO BE LEFT ON 1ST, 4TH, AND 9TH ATTEMPT RESULTING IN AN ANSWERING MACHINE]: Hello, my name is _______. I am calling on behalf of the Centers for Disease Control and Prevention to gather information on health and tobacco. We will call again in the next few days to conduct the interview. If you have any questions, please call us at /// at your convenience. Thanks." Privacy Manager Message text: [TO BE LEFT ON 1ST, 4TH, AND 9TH ATTEMPT RESULTING IN A PRIVACY MANAGER]: “(NAME) Calling on behalf of the Centers for Disease Control and Prevention” |
LINTRO1 /IF SAMPTYPE=1 (LANDLINE)/ INTERVIEWER: PLEASE READ SLOWLY AND DISTINCTLY L1. Hello, my name is [NAME FILL]. I'm calling for the CDC, the Centers for Disease Control and Prevention. The CDC is a federal agency charged with protecting and improving the public's health. We're gathering information on health and tobacco from selected people across the United States. Your phone number has been chosen randomly from a list of all telephone numbers in the US. Are you a member of this household and at least 18 years old? 1. YES CONTINUE 2. Continue in Spanish 3. Terminate
|
LPHONEUSE /ASK IF L1 LINTRO1 EQ 1/ L2. Is this phone number used for… 1. Home use 2. Home and business use, or 3. Business use only
|
/ASK IF L2 LPHONEUSE EQ 3/ X1 I’m sorry, we’re not interviewing people on their business phone. Thank you.
/IF LPHONEUSE EQ 0 ASSIGN DISPO ??/ |
Additional Information: TRAINING: Don’t Know/Not sure and Refused are not allowed. If the person answering the phone doesn’t know the answers to the questions, attempt to get someone else to the phone and re-read the introductory text. If no one is available, schedule a callback. If the person answering the phone refuses to answer these questions or breaks off a call, code the Screener as a Refusal or other appropriate disposition. This is true throughout the Screener. Home use includes a phone which serves a house, apartment, or condominium. If the phone serves a residence such as barracks, dorm, or nursing home, code as business use only. |
lnoadult /ASK IF L2 LPHONEUSE EQ (1,2)/ [RANGE: 0-18] L3. The CDC uses the data collected by this study to develop more effective public health programs. Your household’s participation is voluntary and important to the success of this study. First, I need to randomly select one adult who lives in your household to be interviewed. How many members of your household, including yourself, are 18 years of age or older? [IF NEEDED: Do not include students living away at school. Include adults who think of this household as their primary place of residence. Include adults who usually stay in the household but are temporarily away on business, vacation, or in a hospital.] _ _. Number of adults
|
/ASK IF LNOADULT = 0/ X2 I’m sorry we are only interviewing adult residents who are 18 years of age or older. Thank you.”
/IF LNOADULT=0 ASSIGN DISPO 27/ |
/ASK IF LNOADULT = 1/ ONEADULT Are you the adult? 21 Yes and the respondent is Male 22 Yes and the respondent is Female 03 No
If "yes," Then you are the person I need to speak with.
|
/ASK IF ONEADULT=03/ ASKGENDR Is the adult a man or a woman? 21 Male 22 Female
|
/ASK IF ONEADULT=03/ GETADULT May I speak with [fill in (him/her) from previous question]? 1 Yes, Adult coming to the phone. 2 No, not here (interview will terminate) [INTERVIEWER SET APPOINTMENT FOR BEST TIME TO REACH ADULT]
|
/ASK IF LNOADULT >1// MEN How many of these adults are men __ Number of men [RANGE 0-18]
|
/ASK IF LNOADULT>1/ WOMEN … and how many are women? __ Number of women [RANGE 0-18]
|
/ASK IF SAMPTYPE=1 (LANDLINE)/ RANDOMLY SELECT ADULT; Assign selected value: 01 Oldest Female 02 2nd Oldest Female 03 3rd Oldest Female 04 4th Oldest Female 05 5th Oldest Female 06 6th Oldest Female 07 7th Oldest Female 08 8th Oldest Female 09 9th Oldest Female 11 Oldest Male 12 2nd Oldest Male 13 3rd Oldest Male 14 4th Oldest Male 15 5th Oldest Male 16 6th Oldest Male 17 7th Oldest Male 18 8th Oldest Male 19 9th Oldest Male 20 No respondent selected 21 One person HH - Male 22 One person HH – Female
|
/ASK IF LNOADULT > 1/ ASFKOR The person in your household that I need to speak with is the [INSERT SELECTED] INTERVIEWER: IF SPEAKING WITH SAME GENDER, ASK: Are you the person? INTERVIEWER: IF SPEAKING WITH OPPOSITE GENDER, ASK: May I speak with him or her? 1 Yes – Selected is on the line 2 Yes – Adult coming to the phone 3 No, not here [INTERVIEWER: SET APPOINTMENT TIME] 4 Go back to Adults question. Warning: A new respondent may be selected. (You need Supervisor's permission to use this option.)
|
TO THE CORRECT RESPONDENT: /IF ASKFOR=2 OR GETADULT = 1/ NEWADULT Hello, I'm calling for the CDC, the Centers for Disease Control and Prevention. The CDC is a federal agency charged with protecting and improving the public's health. We're gathering information on health and tobacco from selected people across the United States. Your phone number has been chosen randomly from a list of all telephone numbers in the US.
|
/ASK IF SAMPTYPE=1 (LANDLINE)/ YOURTHE1 You don’t have to answer any question you don’t want to, and you can end the interview at any time. I won't ask for your last name, address, or other personal information that can identify you. Any information you give me will be maintained in a secure manner. If you have any questions about this survey, I will provide a telephone number for you to call to get more information. This call may be monitored or recorded for quality assurance. INTERVIEWER IF NEEDED: The interview takes about 15 to 25 minutes to complete, depending on your situation. INTERVIEWER IF NEEDED: There are no known risks to you for taking part in this interview. There are no direct benefits to you for taking part in this interview, but your answers are important and will help the CDC better understand health issues and plan health programs. Your answers will be maintained in a secure manner. Any information that might identify you, such as your telephone number, will never be linked to your answers and will not appear in any written reports or publications. 001 Person Interested, continue. 002 Go back to Adults question. WARNING: A NEW RESPONDENT WILL BE SELECTED AND YOU NEED A SUPERVISOR’S PASSWORD TO CONTINUE
|
Appendix B. Cell Phone Screener
answering machine Message text: [TO BE LEFT ON 1ST, 4TH, AND 9TH ATTEMPT RESULTING IN AN ANSWERING MACHINE]: Hello, my name is _______. I am calling on behalf of the Centers for Disease Control and Prevention to gather information on health and tobacco. We will call again in the next few days to conduct the interview. If you have any questions, please call us at /// at your convenience. Thanks." |
TRAINING: Don’t Know/Not sure and Refused are not allowed. If the person answering the phone refuses to answer these questions or breaks off a call, or if the phone is not a cell phone, code the Screener as a Refusal or other appropriate disposition. This is true throughout the Screener. |
CPintro /ASK IF SAMPTYPE=2 (CELL)/ INTERVIEWER: PLEASE READ SLOWLY AND DISTINCTLY C1. Hello, my name is [NAME FILL]. I'm calling for the CDC, the Centers for Disease Control and Prevention. The CDC is a federal agency charged with protecting and improving the public's health. Please let me know if you are currently driving a car or doing any activity that requires your full attention, so I can call you back at a later time. [END CALL IMMEDIATELY IF R IS DRIVING OR DOING AN ACTIVITY AND SET APPOINTMENT.] We're gathering information on health and tobacco from selected cell phone users across the United States. Your phone number has been chosen randomly from a list of all cell phone numbers in the US. It will take about 2 minutes to see if you qualify for the study. Are you at least 18 years old? 1. YES CONTINUE 2. CONTINUE IN SPANISH 3. TERMINATE
|
CPpHONEUSE /ASK IF C1 CPINTRO EQ 1/ C2. Is this phone number used for… 1. Personal use 2. Personal and business use, or 3. Business use only THANK AND END CALL
|
|
/ASK IF C2 CPPHONEUSE EQ 3/ X1 I’m sorry, we’re not interviewing people on their business phone. Thank you.
/IF CPPHONEUSE EQ 3 ASSIGN DISPO ??/ |
CPlandline /ASK IF C2 CPPHONEUSE EQ (1,2) C3. In your home, is a cell phone the only way you can be reached by telephone? 1. YES 2. NO
|
ASK IF C3 CPLANDLINE EQ 2/ or /ASK IF C4 CPPRIVRES EQ 2/ X3 I’m sorry, we are only interviewing people who can be reached only by cell phone.
/IF CPLANDLINE EQ 2 ASSIGN DISPO ??/ /IF CPPRIVRES EQ 2 ASSIGN DISPO ??/ |
CPprivres /ASK IF C3 CPLANDLINE EQ 1/ C4. Do you live in a house, an apartment, a condominium, or other type of private residence? interviewer: if respondent is unsure about WHAT a “private residence” IS, read: Examples of places where people live that are not private residences are barracks, dormitories, and nursing homes. Is the place where you live more like a house, an apartment or condominium, or more like a barracks, a dormitory, or a nursing home? 1. YES 2. NO THANK AND END CALL
|
|
CPconfidential /ASK IF C4 CPprivres=1/ C5. You are eligible to be interviewed. You have been selected to participate in this interview. You don’t have to answer any question you don’t want to, and you can end the interview at any time. I won't ask for your last name, address, or other personal information that can identify you. The interview takes about 15 to 25 minutes to complete, depending on your situation. If you have any questions about this survey, I will provide a telephone number for you to call to get more information. This call may be monitored or recorded for quality assurance. INTERVIEWER IF NEEDED: There are no known risks to you for taking part in this interview. There are no direct benefits to you for taking part in this interview, but your answers are important and will help the CDC better understand health issues and plan health programs. Your answers will be maintained in a secure manner. Any information that might identify you, such as your telephone number, will never be linked to your answers and will not appear in any written reports or publications. Is respondent continuing with the interview? 1. YES
|
Appendix C. List of States and Countries for Q118 BUYST2
//IF Q118 BUYST2 EQ 1//
118ST.
01 Alabama
02 Alaska
04 Arizona
05 Arkansas
06 California
08 Colorado
09 Connecticut
10 Delaware
11 District of Columbia
12 Florida
13 Georgia
15 Hawaii
16 Idaho
17 Illinois
18 Indiana
19 Iowa
20 Kansas
21 Kentucky
22 Louisiana
23 Maine
24 Maryland
25 Massachusetts
26 Michigan
27 Minnesota
28 Mississippi
29 Missouri
30 Montana
31 Nebraska
32 Nevada
33 New Hampshire
34 New Jersey
35 New Mexico
36 New York
37 North Carolina
38 North Dakota
39 Ohio
40 Oklahoma
41 Oregon
42 Pennsylvania
44 Rhode Island
45 South Carolina
46 South Dakota
47 Tennessee
48 Texas
49 Utah
50 Vermont
51 Virginia
53 Washington
54 West Virginia
55 Wisconsin
56 Wyoming
57 Other (Specify)
77 DON’T KNOW
99 REFUSED
//ASK IF Q101ST=57
Q101ST_OTH
ENTER OTHER RESPONSE __________________
//IF Q118 BUYST2 EQ 2//
118CO.
01 Afghanistan
02 Albania
03 Algeria
04 Andorra
05 Angola
06 Antigua and Barbuda
07 Argentina
08 Armenia
09 Australia
10 Austria
11 Azerbaijan
12 Bahamas
13 Bahrain
14 Bangladesh
15 Barbados
16 Belarus
17 Belgium
18 Belize
19 Benin
20 Bhutan
21 Bolivia
22 Bosnia and Herzegovina
23 Botswana
24 Brazil
25 Brunei
26 Bulgaria
27 Burkina Faso
28 Burundi
29 Cambodia
30 Cameroon
31 Canada
32 Cape Verde
33 Central African Republic
34 Chad
35 Chile
36 China
37 Colombia
38 Comoros
39 Congo, Democratic Republic of the
40 Congo, Republic of the
41 Costa Rica
42 Côte d'Ivoire
43 Croatia
44 Cuba
45 Cyprus
46 Czech Republic
47 Denmark
48 Djibouti
49 Dominica
50 Dominican Republic
51 Ecuador
52 Egypt
53 El Salvador
54 Equatorial Guinea
55 Eritrea
56 Estonia
57 Ethiopia
58 Federated States of Micronesia
59 Fiji
60 Finland
61 France
62 Gabon
63 Gambia
64 Georgia
65 Germany
66 Ghana
67 Greece
68 Grenada
69 Guatemala
70 Guinea
71 Guinea-Bissau
72 Guyana
73 Haiti
74 Honduras
75 Hungary
76 Iceland
77 India
78 Indonesia
79 Iran
80 Iraq
81 Ireland
82 Israel
83 Italy
84 Jamaica
85 Japan
86 Jordan
87 Kazakhstan
88 Kenya
89 Kiribati
90 Kuwait
91 Kyrgyzstan
92 Laos
93 Latvia
94 Lebanon
95 Lesotho
96 Liberia
97 Libya
98 Liechtenstein
99 Lithuania
100 Luxembourg
101 Macedonia
102 Madagascar
103 Malawi
104 Malaysia
105 Maldives
106 Mali
107 Malta
108 Marshall Islands
109 Mauritania
110 Mauritius
111 Mexico
112 Moldova
113 Monaco
114 Mongolia
115 Montenegro
116 Morocco
117 Mozambique
118 Myanmar
119 Namibia
120 Nauru
121 Nepal
122 Netherlands
123 New Zealand
124 Nicaragua
125 Niger
126 Nigeria
127 North Korea
128 Norway
129 Oman
130 Pakistan
131 Palau
132 Panama
133 Papua New Guinea
134 Paraguay
135 Peru
136 Philippines
137 Poland
138 Portugal
139 Qatar
140 Romania
141 Russia
142 Rwanda
143 Saint Kitts and Nevis
144 Saint Lucia
145 Saint Vincent and the Grenadines
146 Samoa
147 San Marino
148 São Tomé and Príncipe
149 Saudi Arabia
150 Senegal
151 Serbia
152 Seychelles
153 Sierra Leone
154 Singapore
155 Slovakia
156 Slovenia
157 Solomon Islands
158 Somalia
159 South Africa
160 South Korea
161 South Sudan
162 Spain
163 Sri Lanka
164 Sudan
165 Suriname
166 Swaziland
167 Sweden
168 Switzerland
169 Syria
170 Taiwan
171 Tajikistan
172 Tanzania
173 Thailand
174 Timor-Leste
175 Togo
176 Tonga
177 Trinidad and Tobago
178 Tunisia
179 Turkey
180 Turkmenistan
181 Tuvalu
182 Uganda
183 Ukraine
184 United Arab Emirates
185 United Kingdom
186 United States
187 Uruguay
188 Uzbekistan
189 Vanuatu
190 Vatican City
191 Venezuela
192 Vietnam
193 Yemen
194 Zambia
195 Zimbabwe
196 Other
777 REFUSED
999 DON’T KNOW
//ASK IF Q118CO=196
Q118CO_OTH
ENTER OTHER RESPONSE __________________
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | National Adult Tobacco Survey Questionnaire, 2012-2013 |
| Author | mariolis_p |
| File Modified | 0000-00-00 |
| File Created | 2021-01-28 |
© 2024 OMB.report | Privacy Policy