Form CAI Questionnaire CAI Questionnaire CAI Questionnaire

2017 National Survey on Drug Use and Health (NSDUH)

2017 NSDUH PDF 2 (ATT B)

Interview

OMB: 0930-0110

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0930-0110 can be found here:
2024-04-09 - No material or nonsubstantive change to a currently approved collection
2023-10-24 - No material or nonsubstantive change to a currently approved collection
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2017 NSDUH, Supporting Statement
Attachment B – CAI Questionnaire

2017 NATIONAL SURVEY ON DRUG
USE AND HEALTH (NSDUH): OMB
DRAFT CAI SPECIFICATIONS FOR
PROGRAMMING (ENGLISH VERSION)

Substance Abuse and Mental Health Services Administration
Center for Behavioral Health Statistics and Quality
Rockville, Maryland 20857
Last Revised: April 15, 2016

2017 NATIONAL SURVEY ON DRUG
USE AND HEALTH (NSDUH): OMB
DRAFT CAI SPECIFICATIONS FOR
PROGRAMMING (ENGLISH VERSION)
Contract No. HHSS283201300001C
RTI Project No. 0213986.004.102.001
RTI Authors:

RTI Project Director:

Emily Geisen
Gretchen McHenry
Larry Kroutil

David Hunter
SAMHSA Project Officer:
Peter Tice

For questions about this report, please email [email protected].
Prepared for Substance Abuse and Mental Health Services Administration,
Rockville, Maryland
Prepared by RTI International, Research Triangle Park, North Carolina
Last Revised: April 15, 2016
Recommended Citation: Center for Behavioral Health Statistics and Quality.
(2016). 2017 National Survey on Drug Use and Health (NSDUH): CAI
Specifications for Programming (English Version). Substance Abuse and
Mental Health Services Administration, Rockville, MD.

Acknowledgments
This publication was developed for the Substance Abuse and Mental Health Services
Administration (SAMHSA), Center for Behavioral Health Statistics and Quality
(CBHSQ), by RTI International, a trade name of Research Triangle Institute, Research
Triangle Park, North Carolina, under Contract No. HHSS283201000003C. Significant
other contributors to this document at RTI include Rebecca Granger and David Hunter,
who were reviewers. Contributors to this report from CBHSQ include Joel Kennet,
Rachel Lipari, Grace Medley, and Dicy Painter.

Content of 2017 NSDUH Instrument

*
**

#
1.
2.
3.

Module
Introduction
Core Demographics
Beginning ACASI Section

Mode of Administration
CAPI*
CAPI
FI reads description of keyboard
and helps respondent adjust
headphones.
Respondent completes computer
practice session with FI help.
ACASI**

4.

Tutorial

5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.

Calendar
(30-day and 12-month reference dates)
Tobacco
Alcohol
Marijuana
Cocaine
Crack
Heroin
Hallucinogens
Inhalants
Methamphetamine
Pain Relievers Screener
Tranquilizers Screener
Stimulants Screener
Sedatives Screener
Pain Relievers Main Module
Tranquilizers Main Module
Stimulants Main Module
Sedatives Main Module
Special Drugs
Risk/Availability Section
Blunts
Definitions for Use in the Drugs Module
Substance Dependence and Abuse
Special Topics
Prior Substance Use
Drug Treatment
Health
Adult Mental Health Service Utilization
Social Environment
Parenting Experiences

35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.

Youth Experiences
Mental Health
Adult Depression
Youth Mental Health Service Utilization
Adolescent Depression
Definitions for Use in Consumption of Alcohol Module
Consumption of Alcohol
Back End Demographics
Education
Employment
Household Roster

ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI
ACASI: 18+ year-olds only
ACASI: parents of 12-17-yearolds
ACASI: 12-17-year-olds only
ACASI: 18+ year-olds only
ACASI: 18+ year-olds only
ACASI: 12-17-year-olds only
ACASI: 12-17-year-olds only
ACASI
ACASI
ACASI
ACASI
ACASI
CAPI

46.
47.

Proxy Information
Health Insurance

CAPI
CAPI (Proxy allowed)

48.

Income

CAPI (Proxy allowed)

49.

Verification

FI & respondent complete form.

Required
Aids
None
Showcards 1-5
None

Page
1
3
13

None

15

None

19

None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None
None

21
55
71
83
95
107
119
173
189
201
209
213
219
223
275
309
353
389
397
403
411
413
469
477
535
563
583
595
597

None
None
None
None
None
None
None
None
None
None
Showcards
6&7
None
Showcards
8&9
Showcards 1012
Verification
Form

601
615
625
643
657
675
677
687
691
697
705

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

717
731
739
753

2017 NATIONAL SURVEY ON DRUG USE AND HEALTH
CAI INSTRUMENT REVISIONS
General CAI Issues
Module Specific
Introduction
•

Page 1: CAI version number and expiration date will be updated.

Core Demographics
•

Page 12: Updated response options in QD12 to be consistent with the formatting of other
interviewer administered response options.

Alcohol
•

Page 67: Edited the ALC30USE variable so that respondents who reported use of alcohol
on 0 days in the past month are not asked to report misuse of prescription drugs with
alcohol in the past 30 days. Moved ALC30USE from the Definitions for Use in
Consumption of Alcohol module to the Alchol module.

Pain Relievers Main Module
•

Page 263: Added text used in PRANYOTH to PRYOTH to remind respondents not to
include over the counter medications.

Stimulants Main Module
•

Page 341: Added text used in STANYOTH to STYOTH to remind respondents not to
include over the counter medications.

Sedatives Main Module
•

Page 377: Added text used in SVANYOTH to SVYOTH to remind respondents not to
include over the counter medications.

Definitions for Use in the Drugs Module
•

Page 411: Edited the definition of ALC12MON to correct a logic error.

Health
•

Pages 570–582: Edited range of acceptable response options on HLTH27, HLTH28a –
HLTH28cc, HLTH30, HLTH32 – HLTH37, HLTH39, and HLTH41 to include 1 as a
lower bound.
i

April 15, 2016

Definitions for Use in Consumption of Alcohol Module
•

Page 675: Deleted ALC30USE definition from this module. Added a note that
ALC30USE is now defined in the Alcohol module.

Education
•

Page 694-695: Added two new categorical follow-up questions, QD20DKRE and
QD21DKRE, to collect data from those who respond DK or REF to QD20 and QD21
respectively.

Health Insurance
•

Page 731-734: Medicaid and CHIP names will be updated to reflect annual state program
name changes. Acronyms for program names will be removed from parentheses.

Income
•
•
•

Page 739: Edited “persons” to “people” in QI01N to be consistent with similar questions
in the CAI.
Pages 741-743: TANF names will be updated to reflect annual state program name
changes. Acronyms for program names will be removed from parentheses.
Pages 746-747: Edited “persons” to “people” in the interview note in QI20N, QI21A, and
QI21B to be consistent with similar questions in the CAI.

Verification
•

Pages 753: Deleted brackets from interviewer instructions in TOALLR3I to be consistent
with the formatting of other interviewer instructions.

ii
April 15, 2016

2017 National Survey on Drug Use and Health:
Specifications for Programming
Blaise Version 4.8
Introduction
FIIDCON INTERVIEWER: THE FIELD INTERVIEWER ID NUMBER FOR THIS
LAPTOP IS [FIIDFILL]. IS THIS YOUR FI ID?
1
2

YES
NO

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

INTERVIEWER: SELECT THE LANGUAGE TO BE USED FOR THIS
INTERVIEW.
1
2

ENGLISH
SPANISH

NSDUH CAI Instrument
Version: 23.xx
OMB Control #: 0930-0110
Expiration Date: 08/31/17

1
April 15, 2016

2
April 15, 2016

Core Demographics
note1 FI: DO NOT READ ALOUD UNLESS RESPONDENT QUESTIONS THE
BURDEN (OR TIME) ASSOCIATED WITH THIS INTERVIEW.
NOTICE: Public reporting burden for this collection of information is estimated
to average 60 minutes per response, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. Send comments
regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden, to SAMHSA Reports
Clearance Officer, Paperwork Reduction Project (0930-0110); Center for
Behavioral Health Statistics and Quality; 5600 Fishers Lane; Room 15E57B;
Rockville, MD 20857. An agency may not conduct or sponsor, and a person is
not required to respond to, a collection of information unless it displays a
currently valid OMB control number. The OMB control number for this project
is 0930-0110.
PRESS [ENTER] TO CONTINUE.
remindfi INTERVIEWER: HAVE YOU READ THE “INTRO TO CAI” IN YOUR
SHOWCARD BOOKLET ALOUD TO THE RESPONDENT?
1
2
introcai

age1

YES
NO

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

What is your date of birth?
ENTER MM-DD-YYYY
DOB: ________________
DK/REF
DEFINE CALCAGE:
CALCAGE = AGE CALCULATED BY "SUBTRACTING" DATE OF BIRTH
FROM DATE OF INTERVIEW.

confdob

[IF AGE1 NE DK OR REF] I have entered your date of birth as [AGE1]. Is
this correct?
1

YES

3
April 15, 2016

2
NO
DK/REF
HARD ERROR: [IF CONFDOB=2] INTERVIEWER: PRESS [ENTER] TO GO
BACK AND CORRECT THE RESPONDENT’S DATE OF BIRTH.
[NOTE: DO NOT DEFINE CALCAGE UNTIL CONFDOB=YES]
confirm

[IF AGE1 NE DK/REF AND CONFDOB NE DK/REF] That would make
you [CALCAGE] years old. Is this correct?
1
YES
2
NO
DK/REF

HARD ERROR: [IF CONFIRM = 2] INTERVIEWER: PRESS [ENTER] TO GO
BACK AND CORRECT THE RESPONDENT’S DATE OF BIRTH.
under12 [IF CONFIRM = 1 OR DK/REF AND CALCAGE < 12] Since you are
[CALCAGE] years old, we cannot interview you for this study. Thank you
for your cooperation.
PRESS [ENTER] TO CONTINUE. PROGRAM SHOULD ROUTE TO
FIEXIT.
dkrefage [IF (CALCAGE IS 12 OR OLDER AND CONFIRM = DK/REF) OR AGE1
= DK/REF OR CONFDOB = DK/REF] I need your correct age so I can ask
you the right questions. What is your correct age?
AGE:
DK/REF

[RANGE: 1 - 110]

IF DKREFAGE NOT (BLANK OR DK/REF) THEN CALCAGE =
DKREFAGE
under12b [IF DKREFAGE < 12] Since you are [CALCAGE] years old, we cannot
interview you for this study. Thank you for your cooperation.
PRESS [ENTER] TO CONTINUE. PROGRAM SHOULD ROUTE TO
FIEXIT
lastchance [IF DKREFAGE = DK/REF] Since I am not certain what your age is, I
cannot interview you for this study. Thank you for your cooperation.
PRESS [ENTER] TO CONTINUE. PROGRAM SHOULD ROUTE TO
FIEXIT

4
April 15, 2016

DEFINE CURNTAGE:
IF CALCAGE > 11 AND CONFIRM = 1, CURNTAGE = CALCAGE
IF CALCAGE > 11 AND CONFIRM = DK/REF AND DKREFAGE >
11, CURNTAGE = DKREFAGE
IF AGE1= DK/REF AND DKREFAGE > 11, CURNTAGE =
DKREFAGE
ELSE RESPONDENT IS INELIGIBLE; ROUTE TO FIEXIT
FIPE1 INTERVIEWER: WERE 2 PERSONS SELECTED FOR AN INTERVIEW AT
THIS SDU?
1
2

YES
NO

FIPE2 [IF FIPE1 = 1 AND CURNTAGE = 18 OR OLDER] INTERVIEWER: WAS A
12 - 17 YEAR OLD CHILD SELECTED FOR AN INTERVIEW AT THIS
SDU?
1
2

YES
NO

FIPE3 [IF FIPE2 = 1] INTERVIEWER: IS THIS RESPONDENT THE PARENT OR
LEGAL GUARDIAN OF THE 12 - 17 YEAR OLD CHILD WHO WAS
SELECTED FOR AN INTERVIEW? (VERIFY THIS WITH THE
RESPONDENT IF YOU ARE UNSURE.)
1
2

YES
NO

NOTE: IF FIPE3 = 1, SET THE FLAG TO ADMINISTER THE
PARENTING EXPERIENCES MODULE DURING ACASI.
FIPE4 INTERVIEWER: IN WHAT STATE IS THIS SAMPLE DWELLING UNIT
(SDU) LOCATED?
1
2
3
4
5
6
7
8
9

ALABAMA
27
MONTANA
ALASKA
28
NEBRASKA
ARIZONA
29
NEVADA
ARKANSAS
30
NEW HAMPSHIRE
CALIFORNIA
31
NEW JERSEY
COLORADO
32
NEW MEXICO
CONNECTICUT
33
NEW YORK
DELAWARE
34
NORTH CAROLINA
THE DISTRICT OF COLUMBIA (WASHINGTON, DC)
35
NORTH DAKOTA

5
April 15, 2016

10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

FLORIDA
GEORGIA
HAWAII
IDAHO
ILLINOIS
INDIANA
IOWA
KANSAS
KENTUCKY
LOUISIANA
MAINE
MARYLAND
MASSACHUSETTS
MICHIGAN
MINNESOTA
MISSISSIPPI
MISSOURI

36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51

OHIO
OKLAHOMA
OREGON
PENNSYLVANIA
RHODE ISLAND
SOUTH CAROLINA
SOUTH DAKOTA
TENNESSEE
TEXAS
UTAH
VERMONT
VIRGINIA
WASHINGTON
WEST VIRGINIA
WISCONSIN
WYOMING

FIPE5 INTERVIEWER: THE STATE YOU ENTERED IS:
FIPE4 STATE NAME FILL

IS THIS CORRECT?
1
2

YES
NO

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

QD01 INTERVIEWER: RECORD RESPONDENT’S GENDER.
5
9

MALE
FEMALE

QD01a

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

4
6

YES
NO

QD03 The first few questions are for statistical purposes only, to help us analyze the
results of the study.

6
April 15, 2016

Are you of Hispanic, Latino, or Spanish origin or descent?
1
YES
2
NO
DK/REF
QD04 [IF QD03 = 1] HAND R SHOWCARD 1 Which of these Hispanic, Latino, or
Spanish groups best describes you? Just give me the number or numbers from the
card.
TO SELECT MORE THAN ONE CATEGORY, PRESS THE SPACE BAR
BETWEEN EACH CATEGORY YOU SELECT.
1
MEXICAN, MEXICAN AMERICAN, MEXICANO, OR CHICANO
2
PUERTO RICAN
3
CENTRAL OR SOUTH AMERICAN
4
CUBAN ORCUBAN AMERICAN
5
DOMINICAN (FROM DOMINICAN REPUBLIC)
6
SPANISH (FROM SPAIN)
7
OTHER (SPECIFY)
DK/REF
QD04othr [IF QD04 = 7] Please tell me which other Hispanic, Latino or Spanish group
best describes you.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN QD04othr.
QD05 HAND R SHOWCARD 2 Which of these groups describes you? Just give me
the number or numbers from the card.
TO SELECT MORE THAN ONE CATEGORY, PRESS THE SPACE BAR
BETWEEN EACH CATEGORY YOU SELECT.
RESPONDENTS WHO REPORT THEIR RACE AS NATIVE AMERICAN
SHOULD BE INCLUDED IN RESPONSE CATEGORY 3.
1
2
3

4
5

WHITE
BLACK OR AFRICAN AMERICAN
AMERICAN INDIAN OR ALASKA NATIVE (AMERICAN INDIAN
INCLUDES NORTH AMERICAN, CENTRAL AMERICAN, AND
SOUTH AMERICAN INDIANS)
NATIVE HAWAIIAN
GUAMANIAN OR CHAMORRO

7
April 15, 2016

6
7
8

SAMOAN
OTHER PACIFIC ISLANDER
ASIAN (INCLUDING: ASIAN INDIAN, CHINESE, FILIPINO,
JAPANESE, KOREAN, AND VIETNAMESE)
9
OTHER (SPECIFY)
DK/REF
QD05ASIA

[IF QD05 = 8] HAND R SHOWCARD 3 Which of these Asian groups
describes you? Just give me the number or numbers from the card.
TO SELECT MORE THAN ONE CATEGORY, PRESS THE SPACE
BAR BETWEEN EACH CATEGORY YOU SELECT.
1
ASIAN INDIAN
2
CHINESE
3
FILIPINO
4
JAPANESE
5
KOREAN
6
VIETNAMESE
7
OTHER (SPECIFY)
DK/REF

QD05OTHA [IF QD05ASIA = 7] Please tell me which other Asian group or groups
describes you.
OTHER ASIAN GROUP: _____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN QD05OTHA.
QD05OTHR [IF QD05 = 9] Please tell me which other racial group or groups describes
you.
OTHER RACIAL GROUP: _____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN QD05OTHR.
QD07 [IF CURNTAGE = 15 OR OLDER] Are you now married, widowed, divorced or
separated, or have you never married?
1
MARRIED
2
WIDOWED
3
DIVORCED OR SEPARATED
4
HAVE NEVER MARRIED
DK/REF

8
April 15, 2016

INTERVIEWER NOTE:
If the respondent is divorced but currently remarried, code
as married.
By “divorce” we mean a legal cancellation or annulment of
a marriage.
By “separated” we mean legally or informally separating
due to marital discord.
QD08 [IF QDO7 = 1 OR 2 OR 3] How many times have you been married?
NUMBER OF TIMES:
DK/REF
QD09

[RANGE: 1 - 9]

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

QD10

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

V2a

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

V2b

[IF QD10 = 2] Are you currently serving full-time in a Reserve
component? Full-time service does not include annual training for the
Reserves or National Guard.
1
YES
2
NO
DK/REF

9
April 15, 2016

MILTERM1 [IF QD10 = 1] I need to verify what I just entered into the computer. You
said you are currently on active duty in the armed forces. Is this correct?
1
YES
2
NO
DK/REF
HARD ERROR: [IF MILTERM1 = 2 OR DK/REF] INTERVIEWER: PRESS
[ENTER] TO GO BACK AND CORRECT THE RESPONDENT’S CURRENT
MILITARY STATUS.
MILTERM2 [IF MILTERM1 = 1] People who are currently on active duty in the armed
forces are not eligible to be interviewed in this study. I appreciate you
taking the time to speak with me. Thank you.
PRESS [ENTER] TO CONTINUE.
[ROUTE TO FIEXIT]
QD10a

[IF QD09 = 1 or DK/REF] Have you ever served on active duty in the
United States Armed Forces or Reserve components? Active duty does
not include training for the Reserves or National Guard, but does include
activation, for example, for a national emergency or military conflict.
1
YES
2
NO
DK/REF

QD10b1

[IF (QD10a=1)] HAND R SHOWCARD 4.
When did you serve on active duty in the United States Armed Forces or
Reserve components? Just give me the number or numbers from the card.
TO SELECT MORE THAN ONE CATEGORY, PRESS THE SPACE
BAR BETWEEN EACH CATEGORY YOU SELECT.
1
2
3
4
5
6
7
8
9

SEPTEMBER 2001 OR LATER
AUGUST 1990 TO AUGUST 2001 (INCLUDING PERSIAN
GULF WAR)
MAY 1975 TO JULY 1990
VIETNAM ERA (MARCH 1961 TO APRIL 1975)
FEBRUARY 1955 TO FEBRUARY 1961
KOREAN WAR (JULY 1950 TO JANUARY 1955)
JANUARY 1947 TO JUNE 1950
WORLD WAR II (DECEMBER 1941 TO DECEMBER 1946)
NOVEMBER 1941 OR EARLIER

10
April 15, 2016

QD10c

[IF QD10a=1] Did you ever serve on active duty in the United States
Armed Forces or Reserve components in a military combat zone or an area
where you drew imminent danger pay or hostile fire pay?
1
Yes
2
No
DK/REF

QD11 HAND R SHOWCARD 5. What is the highest grade or year of school you have
completed? Just give me the number from the card.
INCLUDE JUNIOR OR COMMUNITY COLLEGE ATTENDANCE; DO NOT
INCLUDE TECHNICAL SCHOOLS (BEAUTICIAN, MECHANIC, ETC.).
0
1
2
3
4
5
6
7
8
9
10
11

NO SCHOOLING COMPLETED
1ST GRADE COMPLETED
2ND GRADE COMPLETED
3RD GRADE COMPLETED
4TH GRADE COMPLETED
5TH GRADE COMPLETED
6TH GRADE COMPLETED
7TH GRADE COMPLETED
8TH GRADE COMPLETED
9TH GRADE COMPLETED
10TH GRADE COMPLETED
11TH GRADE COMPLETED

12
13

REGULAR HIGH SCHOOL DIPLOMA
12TH GRADE, NO DIPLOMA

14

GED CERTIFICATE OF HIGH SCHOOL COMPLETION

15
16
17

SOME COLLEGE CREDIT, BUT NO DEGREE
ASSOCIATE’S DEGREE (FOR EXAMPLE, AA, AS)
BACHELOR’S DEGREE (FOR EXAMPLE, BA, BS)

18

MASTER’S DEGREE (FOR EXAMPLE, MA, MS, MENG, M. ED,
MSW, MBA)
DOCTORATE DEGREE (FOR EXAMPLE, PHD, EDD)
PROFESSIONAL DEGREE BEYOND A BACHELOR’S DEGREE
(FOR EXAMPLE, MD, DDS, DVM, LLB, JD)
DK/REF

19
20

11
April 15, 2016

QD12

This question is about your overall health. Would you say your health in
general is excellent, very good, good, fair, or poor?
1
Excellent EXCELLENT
2
Very good VERY GOOD
3
Good GOOD
4
Fair FAIR
5
Poor POOR
DK/REF

12
April 15, 2016

Beginning ACASI Section
IntroAcasi1 You will do an important part of this interview on your own, using the
computer and headphones.
Before you start, we’ll go through a short practice session so you can learn
how to use this computer and our interview program. Let me quickly
point out the keys you will use. The computerized practice session that
follows will go through what each key does in greater detail.
MOVE COMPUTER SO RESPONDENT CAN SEE THE KEYBOARD
AND POINT OUT THE FOLLOWING:
[POINT TO THE ROW OF FUNCTION KEYS] First, these are the
function keys. The function keys and what they do are labeled for you.
[POINT TO F3] If you don’t know the answer to a question, press F3.
[POINT TO F4] If you don’t want to answer a question, press F4.
PRESS [ENTER] TO CONTINUE.
IntroAcasi3 These next items will help you enter your answers into the computer.
[POINT TO THE ROW OF NUMBER KEYS] These are the number
keys.
[POINT TO THE ENTER KEY] The Enter key is here,
[POINT TO THE SPACE BAR] the space bar is here,
[POINT TO THE BACKSPACE KEY] and the Backspace key is here.
[POINT TO THE BOTTOM OF THE SCREEN] The answers that you
enter will show up here at the bottom of the screen.
PRESS [ENTER] TO CONTINUE.
IntroAcasi4 There are a couple of computer features that you will not use.
[POINT TO ON/OFF SWITCH] This button up here turns the machine on
and off. Please do not press it! It will turn the machine off, and we’ll lose
the interview.
[POINT TO TOUCHPAD] Also, please do not touch this pad. This might
disrupt the interview.
PRESS [ENTER] TO CONTINUE.

13
April 15, 2016

IntroAcasi2 These headphones will allow you to listen while the computer voice reads
the interview questions.
HAND HEADPHONES TO RESPONDENT.
You can adjust the volume here [DEMONSTRATE VOLUME
ADJUSTMENT ON THE HEADPHONE CORD].
Please put on your headphones. When you are ready, let me know.
MOVE COMPUTER SO RESPONDENT CAN USE IT.
ONCE RESPONDENT HAS HEADPHONES ON, PRESS “1" AND
[ENTER] SO R CAN BEGIN PRACTICE SESSION.

HeadPhone

This screen will play while you adjust the volume in your headphones.
When you have adjusted the volume to a level that is comfortable to you,
press the large [ENTER] key on the right side of the keyboard to continue
with the practice session. The [ENTER] key is the one with the ↵ symbol
on it.

14
April 15, 2016

Tutorial
INTRO1 Welcome to RTI’s self-interviewing system, which lets you control the
interview and answer in complete privacy.
First, you will learn how to use the system and complete some practice
questions. You will learn how to enter answers and how to back-up if you
make a mistake and want to change an answer.
Press the large [ENTER] key on the right side of the keyboard to move to the
next screen. The [ENTER] key is the one that says ENTER and has a ↵
symbol on it.
INTRO2 In this system you can read the questions on the computer screen and hear
them read through the headphones. If you would like to just see the questions
on the screen, you can turn down the voice.
Press [ENTER] to continue.

GOTDOG You answer questions by putting in the number that is shown next to your
answer. The numbers are located in the second row of the keyboard.
To answer a question, you first press the correct number and then press
[ENTER].
Practice Question #1: Do you have a dog?
1
Yes
2
No
DK/REF
EYECOLOR The last question was a Yes-No question. Other questions will have more
answers to choose from, and you will pick your answer from a list.
Practice Question #2: What color are your eyes? Put in the number that
best fits you and press [ENTER].
1
Blue
2
Brown
3
Gray
4
Green
5
Some other color
DK/REF

15
April 15, 2016

ALLAPPLY Some questions will let you choose more than one answer. For these
questions, you will use the space bar to separate the answers you type in.
Practice this now.
Practice Question #3: What kinds of music do you listen to?
To select more than one kind of music from the list, press the space bar
between each number you type. When you have finished, press [ENTER]
to go to the next question.
1
Classical
2
Country
3
Hip Hop
4
Jazz
5
Latin American/Spanish
6
Folk/Traditional
7
Pop/Rock
8
Soul/R&B
9
Something Else
DK/REF
NOTUSED For some questions, you may want to answer that you have not done any
of the things listed. In these questions, the computer will instruct you to
enter ‘95’ to indicate that you have not done these things. Try this now.
Practice Question #4: In the past 12 months, which, if any, of these
musical instruments have you played?
1
Banjo
2
Tuba
3
Bagpipes
95
I have not played any of these musical instruments in the past 12
months.
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, OR 3.
NUMBER

Other questions will ask you to type in a number instead of choosing a
number from a list.
Practice Question #5: In the past 30 days, on how many days did you eat
breakfast? Type in the number of days you ate breakfast and press
[ENTER].
________________ [RANGE: 0 - 30]

16
April 15, 2016

DK/REF
BACKUP

If you want to change or see your answer to a previous question, you can
back up using the [F9] key. Each time you press the [F9] key, the
computer will go back one question.
You can tell the computer to repeat a question by pressing [F10]. Try this
now.
When you are finished, press [ENTER] to continue.

PLAYINFO In some questions, you can use the [F2] key to see and hear extra
information to help you answer a question.
First listen to the question.
Practice Question #6: In the past 30 days, on how many days did you eat
any kind of fried potatoes?
________________ [RANGE: 0 - 30]
DK/REF
Now press [F2] to see and hear
examples of fried potatoes.
• French fries
• Home fries
• Hash brown potatoes
Press [ENTER] to close this box.
Then, type in your response to the
question.
rangeerr

For some questions, the computer can only accept certain answers. For
example, in the question below, the only numbers the computer will
accept are 1 for YES or 2 for NO.
If you try to enter some other number, an instruction box will appear. To
correct your answer, you must press [ENTER] to make the box disappear.
You can then answer the question again.
Try this with the question below. Type a 3 as your answer. Press
[ENTER] to remove the instruction box, then type in a valid answer.
Practice Question #7: Do you have a cat?

17
April 15, 2016

1
Yes
2
No
DK/REF

18
April 15, 2016

Calendar
calendar Throughout the rest of this interview, the computer will ask you questions
about three time periods, the past 30 days, the past 12 months, and your
lifetime. To help you remember the first two time periods, the computer will
record the beginning dates for each one of them.
PROGRAMMER: 30 DAY CALENDAR WILL DISPLAY
Now please think about the past 30 days. According to the calendar
[DATEFILL] was 30 days ago. That will be your 30-day reference date, and
can be found in blue on the calendar. The entire 30-day period is highlighted
in yellow.
PROGRAMMER: Fill date on 30 day reference date field and highlight the
30-day reference date. CIRCLE DAY; HIGHLIGHT ENTIRE 30-DAY
PERIOD. MAKE TEXT THAT SAYS ‘BLUE’ BLUE IN COLOR.
Press [ENTER] to continue.

calendr2 A number of questions will ask about the past 12 months, that is since this
date last year. According to the calendar [DATEFILL] was 12 months ago.
That will be your 12-month reference date and can be found in red on the
calendar. Today’s date can be found in green.
PROGRAMMER: Fill date on 12 month reference date field and highlight the
12 month reference date. CIRCLE DAY. MAKE TEXT THAT SAYS
‘RED’ RED IN COLOR AND THE SAME FOR GREEN TEXT.

Press [ENTER] to continue.
calendr3 Please use the calendar as you go through the interview to help you remember
when different things happened. The calendars will pop up to remind you to
think about your 30-day reference date and your 12-month reference date
when you answer questions. You can also look at the calendar at any time by
pressing [F1]. Press [F1] again to close the calendar.
Press [ENTER] to continue.
ANYQUES

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

19
April 15, 2016

20
April 15, 2016

Tobacco
LEADCIG These questions are about your use of tobacco products. This includes
cigarettes, chewing tobacco, snuff, cigars, and pipe tobacco. The first
questions are about cigarettes only.
Press [ENTER] to continue.
CG01 Have you ever smoked part or all of a cigarette?
1
Yes
2
No
DK/REF
CGREF1 [IF CG01 = REF] The answers that people give us about their cigarette
smoking are important to this study’s success. We know that this information
is personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever smoked part
or all of a cigarette?
1
Yes
2
No
DK/REF
CG02 [IF CURNTAGE = 12 - 17 AND (CG01 = 2 OR CGREF1 = 2)] If one of your
best friends offered you a cigarette, would you smoke it?
1
Definitely yes
2
Probably yes
3
Probably not
4
Definitely not
DK/REF
CG03 [IF CURNTAGE = 12 - 17 AND (CG01 = 2 OR CGREF1 = 2)] At any time
during the next 12 months do you think you will smoke a cigarette?
1
Definitely yes
2
Probably yes
3
Probably not
4
Definitely not
DK/REF
CG04 [IF CG01 = 1 OR CGREF1 = 1] How old were you the first time you smoked
part or all of a cigarette?

21
April 15, 2016

AGE:
DK/REF

[(RANGE: 1 - 110]

DEFINE AGE1STCG:
IF CG04 NE (BLANK OR DK/REF) THEN AGE1STCG = CG04
ELSE AGE1STCG = BLANK
IF CURNTAGE < AGE1STCG
CGCC01 The computer recorded that you were [AGE1STCG] years old
when you first smoked part or all of a cigarette. Is this
correct?
4
Yes
6
No
DK/REF
CGCC02 [IF CGCC01 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
2

I am currently [CURNTAGE] years old
I was [AGE1STCG] years old the first time I smoked
part or all of a cigarette
3
Neither answer is correct
DK/REF

CGCC03 [IF CGCC02 = 2 OR CGCC02 = 3] Please answer this
question again. What is your current age?
AGE:
DK/REF

[RANGE: 1 - 110]

CGCC03a [IF CGCC03 < 12] Since you have
indicated that you are [CGCC03 AGE]
years old, we cannot interview you for this
study. Please tell your interviewer that you
have finished the survey. Thank you for your
cooperation. PROGRAM SHOULD ROUTE
PENTER1.
CGCC04 [IF CGCC02 = 1 OR CGCC02 = 3 OR CGCC01 = 6] Please
answer this question again. How old were you the first time
you smoked part or all of a cigarette?
AGE:
DK/REF

[RANGE: 1 - 110]

22
April 15, 2016

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

[RANGE: 1 - 110]

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

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

CG04b
[IF AGE1STCG = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first smoke part or all of a cigarette in [CURRENT YEAR - 2] or
[CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
CG04c [IF CGCC05 NE DK/RE AND CGCC06 NE DK/REF AND AGE1STCG =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first smoke part or all of a cigarette?
1

January

23
April 15, 2016

2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CG04c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CG04d

[IF CG04a = 1 OR 2 OR CG04b = 1 OR 2] In what month in [YEAR
FROM CG04a or CG04b] did you first smoke part or all of a cigarette?

1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CG04d > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STCG:
MYR1STCG = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (CG04a-d). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCG IS
BLANK.

24
April 15, 2016

IF MYR1STCG NE 0 AND NE AGE1STCG:
CGCC19 The computer recorded that you first smoked part or all of a
cigarette in [CG04a-d fill]. That would make you
[MYR1STCG] years old when you first smoked part or all of a
cigarette. Is this correct?
4
Yes
6
No
DK/REF
CGCC20 [IF CGCC19 = 4] Earlier, the computer recorded that you
were [AGE1STCG] years old when you first smoked part or all
of a cigarette. Which answer is correct?
1

I first smoked part or all of a cigarette in [CG04a-d fill]
when I was [MYR1STCG] years old
2
I was [AGE1STCG] years old the first time I smoked
part or all of a cigarette
3
Neither answer is correct
DK/REF

UPDATE: IF CGCC20 = 1, THEN AGE1STCG = MYR1STCG
CGCC21 [IF CGCC20=2 OR CGCC20=3 OR CGCC19=6] Please
answer this question again. Did you first smoke part or all of a
cigarette in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
CGCC21a [IF CGCC21 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [CGCC21] did you first
smoke part or all of a cigarette?
1
2
3
4
5
6
7
8
9

January
February
March
April
May
June
July
August
September

25
April 15, 2016

10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CGCC21a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF CGCC21a NE (0 OR DK/RE) THEN UPDATE MYR1STCG.
MYR1STCG = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (CGCC21 AND CGCC21a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCG IS BLANK.
IF MYR1STCG = AGE1STCG THEN MYR1STCG = BLANK
CGCC22 [IF CGCC20 NE 1 AND MYR1STCG NE 0 AND (CGCC21
AND CGCC21a NE CG04a-d)] The computer recorded that
you first smoked part or all of a cigarette in [CGCC21CGCC21a fill]. That would make you [MYR1STCG] years old
when you first smoked part or all of a cigarette. Is this
correct?
4
Yes
6
No
DK/REF
UPDATE: IF CGCC22 NE (6, BLANK OR DK/REF) AND (CGCC21 AND CGCC21a
NE CG04a-d) THEN AGE1STCG = MYR1STCG
CG05 [IF CG01 = 1 OR CGREF1 = 1] Now think about the past 30 days, that is, from
[DATEFILL] up to and including today. During the past 30 days, have you
smoked part or all of a cigarette?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG06 [IF CG05 = 2] How long has it been since you last smoked part or all of a
cigarette?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF

26
April 15, 2016

CG06DK [IF CG06 = DK] What is your best guess of how long it has been since you
last smoked part or all of a cigarette?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF
CG06RE [IF CG06 = REF] The answers that people give us about their cigarette
smoking are important to this study’s success. We know that this information
is personal, but remember your answers will be kept confidential.
Please think again about answering this question: How long has it been since
you last smoked part or all of a cigarette?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF
CG07 [IF CG05 = 1] During the past 30 days, that is, since [DATEFILL], on how
many days did you smoke part or all of a cigarette?
# OF DAYS:
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG07DKRE [IF CG07 = DK/REF] What is your best estimate of the number of days
you smoked part or all of a cigarette during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE CIGDKRE FILL:
IF CG07DKRE = 1, THEN CIGDKRE = “1 or 2 days”
IF CG07DKRE = 2, THEN CIGDKRE = “3 to 5 days”
IF CG07DKRE = 3, THEN CIGDKRE = “6 to 9 days”
IF CG07DKRE = 4, THEN CIGDKRE = “10 to 19 days”
IF CG07DKRE = 5, THEN CIGDKRE = “20 to 29 days”

27
April 15, 2016

IF CG07DKRE = 6, THEN CIGDKRE = “30 days”
CG08 [IF CG07 > 1 OR CG07DKRE = 1 - 6]) On the [CG07 days / CIGDKRE] you
smoked cigarettes during the past 30 days, how many cigarettes did you smoke
per day, on average?
1
Less than one cigarette per day
2
1 cigarette per day
3
2 to 5 cigarettes per day
4
6 to 15 cigarettes per day (about ½ pack)
5
16 to 25 cigarettes per day (about 1 pack)
6
26 to 35 cigarettes per day (about 1 ½ packs)
7
More than 35 cigarettes per day (about 2 packs or more)
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG10 [IF CG07 = 1] On the one day you smoked cigarettes during the past 30 days,
how many cigarettes did you smoke?
1
Less than one cigarette
2
1 cigarette
3
2 to 5 cigarettes
4
6 to 15 cigarettes (about ½ pack)
5
16 to 25 cigarettes (about 1 pack)
6
26 to 35 cigarettes (about 1 ½ packs)
7
More than 35 cigarettes (about 2 packs or more)
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG11 [IF CG05 = 1] The next questions are about the brand of cigarettes you smoke -the brand is the name that is on the pack. During the past 30 days, what brand of
cigarettes did you smoke most often?
1
2
3
4
5
6
7
8
9
10
11
12
13

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

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

28
April 15, 2016

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

DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG11a

[IF CG11 = 26] Please think again about the brand of cigarettes you
smoke. During the past 30 days, what brand of cigarettes did you smoke most
often?
1
2
3
4
5

Alpine
15
Magna
Barclay
16
Maverick
Belair
17
Max
Best Value
18
Montclair
Bristol
19
Now
list
6
Bugler (roll-your-own)20
Old Gold
7
Cambridge
21
Players
8
Century
22
Private Label
9
Chesterfield
23
Pyramid
10
Eve
24
Raleigh
11
Harley Davidson
25
Richland
12
Lark
26
Saratoga
13
L&M
27
Satin
14
Lucky Strike
28
State Express
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

29
30
31
32
33

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

CG12 [IF CG11a = 33] Please type in the name of the brand of cigarettes you smoked
most often during the past 30 days. If you’re not sure how to spell the brand, just
make your best guess.
BRAND SMOKED: _____________________
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
PROGRAMMER: DO NOT ALLOW BLANKS IN CG12.
CG13 [IF CG11 NE (DK/REF OR 26) OR CG11a NE (DK/REF OR 33)] The computer
recorded that during the past 30 days, the cigarette brand you smoked most often
was [CG11 OR CG11a FILL]. Is this correct?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
RCG11

[IF CG13 = 2] Please review this list again. During the past 30 days, what
brand of cigarettes did you smoke most often?

29
April 15, 2016

1
American Spirit
14
Misty
2
Basic
15
Monarch
3
Benson & Hedges
16
More
4
Camel
17
Newport
5
Capri
18
Pall Mall
6
Carlton
19
Parliament
7
Doral
20
Salem
8
GPC
21
USA Gold
9
Kent
22
Vantage
10
Kool
23
Viceroy
11
Liggett Select
24
Virginia Slims
12
Marlboro
25
Winston
13
Merit
26
A brand not on this list
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
RCG11a [IF RCG11 = 26] Please review this list [IF CG11a = BLANK] again. During
the past 30 days, what brand of cigarettes did you smoke most often?
1
2
3
4
5

Alpine
15
Magna
29
Barclay
16
Maverick
30
Belair
17
Max
31
Best Value
18
Montclair
32
Bristol
19
Now
33
list
6
Bugler (roll-your-own) 20
Old Gold
7
Cambridge
21
Players
8
Century
22
Private Label
9
Chesterfield
23
Pyramid
10
Eve
24
Raleigh
11
Harley Davidson 25
Richland
12
Lark
26
Saratoga
13
L&M
27
Satin
14
Lucky Strike
28
State Express
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
RCG12

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

30
April 15, 2016

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

PROGRAMMER: DO NOT ALLOW BLANKS IN RCG12.
RCG13

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

RRCG11 [IF RCG13 = 2] Please review this list again. During the past 30 days, what
brand of cigarettes did you smoke most often?
1
American Spirit
14
Misty
2
Basic
15
Monarch
3
Benson & Hedges
16
More
4
Camel
17
Newport
5
Capri
18
Pall Mall
6
Carlton
19
Parliament
7
Doral
20
Salem
8
GPC
21
USA Gold
9
Kent
22
Vantage
10
Kool
23
Viceroy
11
Liggett Select
24
Virginia Slims
12
Marlboro
25
Winston
13
Merit
26
A brand not on this list
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
RRCG11a [IF RRCG11 = 26] Please review this list [IF CG11a AND RCG11a =
BLANK] again. During the past 30 days, what brand of cigarettes did you
smoke most often?
1
2
3
4
5
6
7
8
9
10
11

Alpine
15
Barclay
16
Belair
17
Best Value
18
Bristol
19
list
Bugler (roll-your-own)
Cambridge
Century
Chesterfield
Eve
Harley Davidson

Magna
Maverick
Max
Montclair
Now
20
21
22
23
24
25

31
April 15, 2016

29
31
33

Old Gold
Players
Private Label
Pyramid
Raleigh
Richland

Sterling
30
Tareyton
Top (roll-your-own)
32
True
A brand not on this

12
Lark
26
Saratoga
13
L&M
27
Satin
14
Lucky Strike
28
State Express
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
RRCG12 [IF RRCG11a = 33] Please type in the name of the brand of cigarettes you
smoked most often during the past 30 days. If you’re not sure how to spell
the brand, just make your best guess.
BRAND SMOKED: __________________
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
PROGRAMMER: DO NOT ALLOW BLANKS IN RRCG12.
RRCG13 [IF RRCG11 NE (DK/REF OR 26) OR RRCG11a NE (DK/REF OR 33)]
The computer recorded that during the past 30 days, the cigarette brand you
smoked most often was [RRCG11 OR RRCG11a FILL]. Is this correct?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CGTAR1 [IF ( CG11 = 1 – 25 AND CG13 = 1) OR IF (RCG11 = 1 – 25 AND RCG13 =
1) OR IF (RRCG11 = 1 – 25 and RRCG13 = 1) OR IF (CG11a =1 – 32 AND
CG13 = 1) OR IF (RCG11a = 1 – 32 AND RCG13 = 1) OR IF (RRCG11a = 1
– 32 AND RRCG13 = 1)] During the past 30 days, what type of
[CG11/CG11a/RCG11/RCG11a/RRCG11/RRCG11a FILL] cigarettes did
you smoke most often?
1
Lights
2
Ultra Lights
3
Mediums
4
Full Flavor
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CGTAR2 [IF CG12 NE BLANK OR DK/REF OR IF RCG12 NE BLANK OR DK/REF
OR IF RRCG12 NE BLANK OR DK/REF] During the past 30 days, what
type of cigarettes did you smoke most often?
1
2
3

Lights
Ultra Lights
Mediums

32
April 15, 2016

4
Full Flavor
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CGMENTH1 [IF (CG11 = 1 – 25 AND CG13 = 1) OR IF (RCG11 = 1 – 25 AND
RCG13 = 1) OR IF (RRCG11 = 1 – 25 AND RRCG13 = 1) OR IF
(CG11a =1 – 32 AND CG13 = 1) OR IF (RCG11a = 1 – 32 AND RCG13
= 1) OR IF RRCG11a = 1 – 32 AND RRCG13 = 1)] Were the
[CG11/CG11a/RCG11/RCG11a/RRCG11/RRCG11a FILL] cigarettes
you smoked during the past 30 days menthol?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CGMENTH2 [IF CG12 NE BLANK OR DK/REF OR IF RCG12 NE BLANK OR
DK/REF OR IF RRCG12 NE BLANK OR DK/REF] Were the cigarettes
you smoked during the past 30 days menthol?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CGLNTH

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

CG14 [IF (CG11a NE 6 OR 31) AND (RCG11a NE 6 OR 31) AND (RRCG11a NE 6 or
31)] During the past 30 days, that is, since [DATEFILL], have you smoked part
or all of a roll-your-own tobacco cigarette?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG15 [IF CG05 = DK/REF OR (CG06 = 1-3 OR DK/REF) OR (CG06DK = 1-3 OR
DK/REF) OR (CG06RE = 1-3 OR DK/REF) OR (CG07 = 1 - 29 OR DK/REF)

33
April 15, 2016

OR (CG07DKRE = 1 - 5 OR DK/REF)] Has there ever been a period in your life
when you smoked cigarettes every day for at least 30 days?
1
Yes
2
No
DK/REF
CG16 [IF CG07 = 30 OR CG07DKRE = 6 OR CG15 = 1] How old were you when you
first started smoking cigarettes every day?
AGE:
DK/REF

[RANGE: 1-110]

DEFINE DAILYCIG:
DAILYCIG = CG16
IF DAILYCIG < AGE1STCG
CGCC07 The computer recorded that you were [DAILYCIG] years old
when you first started smoking cigarettes every day. Is this
correct?
4
Yes
6
No
DK/REF
CGCC08 [IF CGCC07 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1

I was [DAILYCIG] years old when I first started
smoking cigarettes every day
2
I was [AGE1STCG] years old the first time I smoked
part or all of a cigarette
3
Neither answer is correct
DK/REF
CGCC09 [IF CGCC08 = 1 OR CGCC08 = 3] Please answer this
question again. How old were you the first time you smoked
part or all of a cigarette?
AGE:
DK/REF

[RANGE: 1-110]

CGCC10 [IF CGCC08 = 2 OR CGCC08 = 3 OR CGCC07 = 6] Please
answer this question again. How old were you when you first
started smoking cigarettes every day?

34
April 15, 2016

AGE:
DK/REF

[RANGE: 1-110]

UPDATE: IF CGCC09 NOT (BLANK OR DK/REF) THEN AGE1STCG = CGCC09
UPDATE: IF CGCC10 NOT (BLANK OR DK/REF) THEN DAILYCIG = CGCC10
IF DAILYCIG > CURNTAGE:
CGCC11 The computer recorded that you were [DAILYCIG] years old
when you first started smoking cigarettes every day. Is this
correct?
4
Yes
6
No
DK/REF
CGCC12 [IF CGCC11 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
2

I am currently [CURNTAGE] years old
I was [DAILYCIG] years old when I first started
smoking cigarettes every day
3
Neither answer is correct
DK/REF
CGCC13 [IF CGCC12 = 2 OR CGCC12 = 3] Please answer this
question again. What is your current age?
AGE:
DK/REF

[RANGE: 1 - 110]

CGCC13a [IF CGCC13 < 12] Since you have indicated that you are
[CGCC13] years old, we cannot interview you for this study.
Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD
ROUTE TO PENTER1.
CGCC14 [IF CGCC11 = 6 OR CGCC12 = 1 OR CGCC12 = 3] Please
answer this question again. How old were you when you first
started smoking cigarettes every day?
AGE:
DK/REF

[RANGE: 1- 110]

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

35
April 15, 2016

CG16y1

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

CG16y2

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

CG16m1 [IF DAILYCIG = CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In
what month in [CURRENT YEAR] did you first start smoking cigarettes
every day?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CG16m1 > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CG16m2 [IF CG16y1 = 1 OR 2 OR CG16y2 = 1 OR 2] In what month in [YEAR
FROM CG16y1 or CG16y2] did you first start smoking cigarettes every
day?
1

January

36
April 15, 2016

2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CG16m2 > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STDC:
MYR1STDC = AGE AT FIRST DAILY USE CALCULATED BY
“SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR OF FIRST
USE (CG16y1-m2). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN
MYR1STCG IS BLANK.
IF MYR1STDC NE 0 AND NE DAILYCIG:
CGCC15 The computer recorded that you first started smoking
cigarettes every day in [CG16y1-m2 fill]. That would make
you [MYR1STDC] years old when you first started smoking
cigarettes every day. Is this correct?
4
Yes
6
No
DK/REF
CGCC16 [IF CGCC15 = 4] Earlier, the computer recorded that you
were [DAILYCIG] years old when you first started smoking
cigarettes every day. Which answer is correct?
1

I first started smoking cigarettes every day in [CG16y1m2 fill] when I was [MYR1STDC] years old
2
I was [DAILYCIG] years old the first time I started
smoking cigarettes every day
3
Neither answer is correct
DK/REF
UPDATE: IF CGCC16 = 1, THEN DAILYCIG = MYR1STDC

37
April 15, 2016

CGCC17 [IF CGCC16=2 OR CGCC16=3 OR CGCC15=6] Please
answer this question again. Did you first start smoking
cigarettes every day in [CURRENT YEAR -2], [CURRENT
YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
CGCC17a [IF CGCC17 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [CGCC17] did you first start
smoking cigarettes every day?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CGCC17a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF CGCC17a NE (0 OR DK/REF) THEN UPDATE MYR1STDC.
MYR1STDC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (CGCC17 AND CGCC17a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STDC IS BLANK. IF
MYR1STDC = DAILYCIG THEN MYR1STDC = BLANK
CGCC18 [IF CGCC16 NE 1 AND MYR1STDC NE 0 AND (CGCC17
AND CGCC17a NE CG16y1-CG16m2)] The computer
recorded that you first started smoking cigarettes every day in
[CGCC17-CGCC17a fill]. That would make you
[MYR1STDC] years old when you first started smoking
cigarettes every day. Is this correct?

38
April 15, 2016

4
Yes
6
No
DK/REF
UPDATE: IF CGCC18 NE (6, BLANK OR DK/REF) AND (CGCC17 AND CGCC17a
NE CG16y1-CG16m2) THEN DAILYCIG = MYR1STDC
CG16a

[IF (CG05 = 2 OR DK/REF) OR ((CG08 < 4) OR (CG08 = 4 AND CG07
<17) OR (CG08 = 5 AND CG07 <7) OR (CG08 = 6 AND CG07 <4) OR (CG08
= 7 AND CG07 <3 AND CG07DKRE NE BLANK)) Have you smoked at least
100 cigarettes in your entire life?
1
Yes
2
No
DK/REF

CG25 The next questions are about your use of “smokeless” tobacco such as snuff, dip,
chewing tobacco, or “snus.”
Have you ever used “smokeless” tobacco, even once?
1
Yes
2
No
DK/REF
CGREF3 [IF CG25 = REF] The answers that people give us about their use of
“smokeless” tobacco are important to this study’s success. We know that this
information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever used
“smokeless” tobacco, even once?
1
Yes
2
No
DK/REF
CG26 [IF CG25 = 1 OR CGREF3 = 1] How old were you the first time you used
“smokeless” tobacco?
YEARS OLD:
DK/REF

[RANGE: 1 - 110]

DEFINE SNUFFAGE:
IF CG26 NE (BLANK OR DK/REF) THEN SNUFFAGE = CG26
ELSE SNUFFAGE = BLANK

39
April 15, 2016

IF CURNTAGE < SNUFFAGE
CGSN01 The computer recorded that you were [SNUFFAGE] years old
when you first used “smokeless” tobacco. Is this correct?
4
Yes
6
No
DK/REF
CGSN02 [IF CGSN01 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
2

I am currently [CURNTAGE] years old
I was [SNUFFAGE] years old the first time I used
“smokeless” tobacco
3
Neither answer is correct
DK/REF

CGSN03 [IF CGSN02 = 2 OR CGSN02 = 3] Please answer this
question again. What is your current age?
AGE:
DK/REF

[RANGE: 1 - 110]

CGSN03a [IF CGSN03 < 12] Since you have indicated that you are
[CGSN03 AGE] years old, we cannot interview you for this
study. Please tell your interviewer that you have finished the
survey. Thank you for your cooperation. PROGRAM
SHOULD ROUTE TO PENTER1.
CGSN04 [IF CGSN02 = 1 OR CGSN02 = 3 OR CGSN01 = 6] Please
answer this question again. How old were you the first time
you used “smokeless” tobacco?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CGSN04 NOT(BLANK OR DK/REF) THEN SNUFFAGE = CGSN04
UPDATE: IF CGSN03 NOT(BLANK OR DK/REF) THEN CURNTAGE = CGSN03
IF SNUFFAGE = CURNTAGE OR SNUFFAGE < 10:
CGSN05 The computer recorded that you were [SNUFFAGE] years old
the first time you used “smokeless” tobacco. Is this correct?
4
6

Yes
No

40
April 15, 2016

DK/REF
CGSN06 [IF CGSN05 = 6] Please answer this question again. How old
were you the first time you used “smokeless” tobacco?
AGE:
DK/REF

[RANGE: 1 - 110]

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

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

CG26b
[IF SNUFFAGE = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first use “smokeless” tobacco in [CURRENT YEAR - 2] or
[CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
CG26c [IF CGSN05 NE DK/RE AND CGSN06 NE DK/REF AND SNUFFAGE =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first use “smokeless” tobacco?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CG26c > CURRENT MONTH] THE MONTH IN

41
April 15, 2016

[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CG26d
[IF CG26a = 1 - 2 OR CG26b = 1 - 2] In what month in [YEAR FROM
CG26a or CG26b] did you first use “smokeless” tobacco?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CG26d > CURRENT MONTH] THE MONTH IN [CURRENT
MONTH] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STSN:
MYR1STSN = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (CG26a-d). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STSN IS
BLANK.
IF MYR1STSN NE 0 AND NE SNUFFAGE:
CGSN07 The computer recorded that you first used “smokeless”
tobacco in [CG26a-d fill]. That would make you
[MYR1STSN] years old when you first used “smokeless”
tobacco. Is this correct?
4
Yes
6
No
DK/REF
CGSN08 [IF CGSN07 = 4] Earlier, the computer recorded that you
were [SNUFFAGE] years old when you first used
“smokeless” tobacco. Which answer is correct?

42
April 15, 2016

1

I first used “smokeless” tobacco in [CG26a-d fill] when
I was [MYR1STSN] years old
2
I was [SNUFFAGE] years old the first time I used
“smokeless” tobacco
3
Neither answer is correct
DK/REF

UPDATE: IF CGSN08 = 1, THEN SNUFFAGE = MYR1STSN.
CGSN09 [IF CGSN08=2 OR CGSN08=3 OR CGSN07=6] Please
answer this question again. Did you first use “smokeless”
tobacco in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
CGSN09a [IF CGSN09 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [CGSN09] did you first use
“smokeless” tobacco?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CGSN09a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF CGSN09a NE (0 OR DK/REF) THEN UPDATE MYR1STSN.
MYR1STSN = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (CGSN09 AND CGSN09a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STSN IS BLANK.

43
April 15, 2016

IF MYR1STSN = SNUFFAGE THEN MYR1STSN = BLANK.
CGSN10 [IF CGSN08 NE 1 AND MYR1STSN NE 0 AND (CGSN09
AND CGSN09a NE CG26a-d)] The computer recorded that
you first used “smokeless” tobacco in [CGSN09-CGSN09a
fill]. That would make you [MYR1STSN] years old when you
first used “smokeless” tobacco. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF CGSN10 NE (6, BLANK OR DK/REF) AND (CGSN09 AND CGSN09a
NE CG26a-d) THEN SNUFFAGE = MYR1STSN
CG27 [IF CG25 = 1 OR CGREF3 = 1] Now think about the past 30 days, that is, from
[DATEFILL] up to and including today. During the past 30 days, have you used
“smokeless” tobacco, even once?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG28 [IF CG27 = 2] How long has it been since you last used “smokeless” tobacco?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF
CG28DK [IF CG28 = DK] What is your best guess of how long it has been since you
last used “smokeless” tobacco?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF
CG28RE [IF CG28 = REF] The answers that people give us about their use of
“smokeless” tobacco are important to this study’s success. We know that this
information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: How long has it been since
you last used “smokeless” tobacco?

44
April 15, 2016

1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF
CG29 [IF CG27 = 1] During the past 30 days, that is, since [DATEFILL], on how
many days did you use “smokeless” tobacco?
# OF DAYS:
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG29DKRE [IF CG29 = DK/REF] What is your best estimate of the number of days
you used “smokeless” tobacco during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG34 The next questions are about smoking cigars. By cigars we mean any kind,
including big cigars, cigarillos, and even little cigars that look like cigarettes.
Have you ever smoked part or all of any type of cigar?
1
Yes
2
No
DK/REF
CGREF4 [IF CG34 = REF] The answers that people give us about their cigar smoking
are important to this study’s success. We know that this information is
personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever smoked part
or all of a cigar?
1
Yes
2
No
DK/REF
CG35 [IF CG34 = 1 OR CGREF4 = 1] How old were you the first time you smoked
part or all of any type of cigar?

45
April 15, 2016

AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE CIGARAGE:
IF CG35 NE (BLANK OR DK/REF) THEN CIGARAGE = CG35
ELSE CIGARAGE = BLANK
IF CURNTAGE < CIGARAGE
CGCR01 The computer recorded that you were [CIGARAGE] years old
when you first smoked part or all of a cigar. Is this correct?
4
Yes
6
No
DK/REF
CGCR02 [IF CGCR01=4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
2

I am currently [CURNTAGE] years old
I was [CIGARAGE] years old the first time I smoked
part or all of a cigar
3
Neither answer is correct
DK/REF

CGCR03 [IF CGCR02 = 2 OR CGCR02 = 3] Please answer this
question again. What is your current age?
AGE:
DK/REF

[RANGE: 1 - 110]

CGCR03a [IF CGCR03 < 12] Since you have indicated that you are
[CGCR03 AGE] years old, we cannot interview you for this
study. Please tell your interviewer that you have finished the
survey. Thank you for your cooperation. PROGRAM
SHOULD ROUTE TO PENTER1.
CGCR04 [IF CGCR02 = 1 OR CGCR02 = 3 OR CGCR01 = 6] Please
answer this question again. How old were you the first time
you smoked part or all of a cigar?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CGCR04 NOT(BLANK OR DK/REF) THEN CIGARAGE = CGCR04

46
April 15, 2016

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

[RANGE: 1 - 110]

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

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

CG35b
[IF CIGARAGE = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first smoke part or all of a cigar in [CURRENT YEAR - 2] or
[CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
CG35c [IF CGCR05 NE DK/RE AND CGCR06 NE DK/REF AND CIGARAGE =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first smoke part or all of a cigar?
1
2
3
4
5
6
7

January
February
March
April
May
June
July

47
April 15, 2016

8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CG35c > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CG35d
[IF CG35a = 1 - 2 OR CG35b = 1 - 2] In what month in [YEAR FROM
CG35a or CG35b] did you first smoke part or all of a cigar?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CG35d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STCR:
MYR1STCR = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (CG35a-d). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCR IS
BLANK.
IF MYR1STCR NE 0 AND NE CIGARAGE:
CGCR07 The computer recorded that you first smoked part or all of a
cigar in [CG35a-d fill]. That would make you [MYR1STCR]
years old when you first smoked part or all of a cigar. Is this
correct?

48
April 15, 2016

4
Yes
6
No
DK/REF
CGCR08 [IF CGCR07 = 4] Earlier, the computer recorded that you
were [CIGARAGE] years old when you first smoked part or all
of a cigar. Which answer is correct?
1

I first smoked part or all of a cigar in [CG35a-d fill]
when I was [MYR1STCR] years old
2
I was [CIGARAGE] years old the first time I smoked
part or all of a cigar
3
Neither answer is correct
DK/REF
UPDATE: IF CGCR08 = 1, THEN CIGARAGE = MYR1STCR.
CGCR09 [IF CGCR08=2 OR CGCR08=3 OR CGCR07=6] Please
answer this question again. Did you first smoke part or all of a
cigar in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
CGCR09a [IF CGCR09 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [CGCR09] did you first
smoke part or all of a cigar?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CGCR09a > CURRENT MONTH] THE MONTH IN

49
April 15, 2016

[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF CGCR09a NE (0 OR DK/REF) THEN UPDATE MYR1STCR.
MYR1STCR = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (CGCR09 AND CGCR09a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCR IS BLANK.
IF MYR1STCR = CIGARAGE THEN MYR1STCR = BLANK
CGCR10 [IF CGCR08 NE 1 AND MYR1STCR NE 0 AND (CGCR09
AND CGCR09a NE CG35a-d)] The computer recorded that
you first smoked part or all of a cigar in [CGCR09-CGCR09a
fill]. That would make you [MYR1STCR] years old when you
first smoked part or all of a cigar. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF CGCR10 NE (6, BLANK OR DK/REF) AND (CGCR09 AND CGCR09a
NE CG35a-d) THEN CIGARAGE = MYR1STCR
CG36 [IF CG34 = 1 OR CGREF4 = 1] Now think about the past 30 days, that is, from
[DATEFILL] up to and including today. During the past 30 days, have you
smoked part or all of any type of cigar?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG37 [IF CG36 = 2] How long has it been since you last smoked part or all of any type
of cigar?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF
CG37DK [IF CG37 = DK] What is your best guess of how long it has been since you
last smoked part or all of any type of cigar?
1
2
3

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

50
April 15, 2016

DK/REF
CG37RE [IF CG37 = REF] The answers that people give us about their cigar smoking
are important to this study’s success. We know that this information is
personal, but remember your answers will be kept confidential.
Please think again about answering this question: How long has it been since
you last smoked part or all of any type of cigar?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF
CG38 [IF CG36 = 1] During the past 30 days, that is, since [DATEFILL], on how
many days did you smoke part or all of a cigar?
# OF DAYS:
[RANGE: 1-30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG38DKRE [IF CG38 = DK OR REF] What is your best estimate of the number of
days you smoked part or all of a cigar during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG39 [IF CG36 = 1] During the past 30 days, what brand of cigars did you smoke most
often?
1
2
3
4
5
6
7
8

Al Capone
Antonio y Cleopatra
Smalls
Arturo Fuente
Backwoods
Black & Mild
this list
Blackstone
Captain Black
Cohiba

13
14

Havatampa
King Edward

25
26

Thompson
Tijuana

15
16
17

La Corona
Little Nippers
Macanudo

27
28
29

White Owl
Winchester
A brand not on

18
19
20

Montecristo
Muriel
Partagas

51
April 15, 2016

9
Cuesta-Rey
21
Phillies
10
Dutch Masters
22
Punch
11
El Producto
23
Romeo y Julieta
12
Garcia y Vega
24
Swisher Sweets
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG40 [IF CG39 = 29] Please type in the name of the brand of cigars you smoked most
often during the past 30 days. If you’re not sure how to spell the brand, just make
your best guess.
BRAND SMOKED: __________________
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
PROGRAMMER: DO NOT ALLOW BLANKS IN CG40.
CG41 [IF CG39 NE (DK/REF OR 29)] The computer recorded that during the past 30
days the cigar brand you smoked most often was [CG39 FILL]. Is this correct?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
RCG39
[IF CG41 = 2] Please review this list again. During the past 30 days, what
brand of cigars did you smoke most often?
1
2
3
4
5

Al Capone
13
Havatampa 25
Antonio y Cleopatra 14
King Edward 26
Arturo Fuente
15
La Corona
27
Backwoods
16
Little Nippers 28
Black & Mild
17
Macanudo
29
list
6
Blackstone
18
Montecristo
7
Captain Black
19
Muriel
8
Cohiba
20
Partagas
9
Cuesta-Rey
21
Phillies
10
Dutch Masters
22
Punch
11
El Producto
23
Romeo y Julieta
12
Garcia y Vega
24
Swisher Sweets
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

Thompson
Tijuana Smalls
White Owl
Winchester
A brand not on this

RCG40
[IF RCG39 = 29] Please type in the name of the brand of cigars you
smoked most often during the past 30 days. If you’re not sure how to spell the

52
April 15, 2016

brand, just make your best guess.
BRAND SMOKED: __________________
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
PROGRAMMER: DO NOT ALLOW BLANKS IN RCG40.
RCG41
[IF RCG39 NE (DK/REF OR 29)] The computer recorded that during the
past 30 days the cigar brand you smoked most often was [RCG39 FILL]. Is this
correct?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
RRCG39 [IF RCG41 = 2] Please review this list again. During the past 30 days, what
brand of cigars did you smoke most often?
1
2
3
4
5

Al Capone
13
Havatampa 25
Antonio y Cleopatra 14
King Edward 26
Arturo Fuente
15
La Corona
27
Backwoods
16
Little Nippers 28
Black & Mild
17
Macanudo
29
list
6
Blackstone
18
Montecristo
7
Captain Black
19
Muriel
8
Cohiba
20
Partagas
9
Cuesta-Rey
21
Phillies
10
Dutch Masters
22
Punch
11
El Producto
23
Romeo y Julieta
12
Garcia y Vega
24
Swisher Sweets
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

Thompson
Tijuana Smalls
White Owl
Winchester
A brand not on this

RRCG40 [IF RRCG39 = 29] Please type in the name of the brand of cigars you smoked
most often during the past 30 days. If you’re not sure how to spell the brand,
just make your best guess.
BRAND SMOKED: __________________
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
PROGRAMMER: DO NOT ALLOW BLANKS IN RRCG40.

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April 15, 2016

RRCG41 [IF RRCG39 NE (DK/REF OR 29)] The computer recorded that during the
past 30 days the cigar brand you smoked most often was [RRCG39 FILL].
Is this correct?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG42 The last questions on tobacco products are about using a pipe to smoke tobacco.
Have you ever smoked tobacco in a pipe, even once?
1
Yes
2
No
DK/REF
CGREF5 [IF CG42 = REF] The answers that people give us about their pipe smoking
are important to this study’s success. We know that this information is
personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever smoked
tobacco in a pipe?
1
Yes
2
No
DK/REF
CG43 [IF CG42 = 1 OR CGREF5 = 1] During the past 30 days, that is, since
[DATEFILL], have you smoked tobacco in a pipe, even once?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

54
April 15, 2016

Alcohol
ALCINTR1 The next questions are about alcoholic beverages, such as beer, wine,
brandy, and mixed drinks. Listed on the next screen are examples of the
types of beverages we are interested in.
Please review this list carefully before you answer these questions.
Press [ENTER] to continue.
CARD3a

Types of Alcoholic Beverages
Beer
Regular Beer
Lite or light beer
Low-alcohol (LA) beer

Malt liquor
Ale
Stout

Lager

Wine
Red, white, blush wine

Sherry

Fortified wines, such
as Cisco

Wine coolers
Champagne

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

Liquor
Bourbon

Scotch

Gin
Rum

Tequila
Vodka

Liqueurs, Cordials, and Brandy
Brandy
Drambuie
Cassis
Grand Marnier
Cognac
Kahlua
Creme de menthe
Port
Mixed Drinks and Cocktails
Bloody Mary
Manhattan
Bourbon and water Margarita
Daiquiri
Martini
Gin and tonic
Piña colada

Homemade liquor,
such as moonshine

Schnapps
Tia Maria
Triple sec
Vermouth

Rob Roy
Rum and cola
Scotch and soda
Whiskey sour

Press [ENTER] to continue.
ALCINTR2 These questions are about drinks of alcoholic beverages. Throughout

55
April 15, 2016

these questions, by a “drink,” we mean a can or bottle of beer, a glass of
wine or a wine cooler, a shot of liquor, or a mixed drink with liquor in it.
We are not asking about times when you only had a sip or two from a
drink.
Press [ENTER] to continue.
AL01 Have you ever, even once, had a drink of any type of alcoholic beverage? Please
do not include times when you only had a sip or two from a drink.
1
Yes
2
No
DK/REF
ALREF
[IF AL01 = REF] The answers that people give us about their use of
alcohol are important to this study’s success. We know that this information is
personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever, even once, had
a drink of any type of alcoholic beverage? Please do not include times when you
only had a sip or two from a drink.
1
Yes
2
No
DK/REF
AL02 [IF AL01 = 1 OR ALREF = 1] Think about the first time you had a drink of an
alcoholic beverage. How old were you the first time you had a drink of an
alcoholic beverage? Please do not include any time when you only had a sip or
two from a drink.
AGE:
DK/REF

[RANGE: 1 - 110]

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

56
April 15, 2016

ALCC02 [IF ALCC01 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
2

I am currently [CURNTAGE] years old
I was [AGE1STAL] years old the first time I drank an
alcoholic beverage
3
Neither answer is correct
DK/REF

ALCC03 [IF ALCC02=2 OR ALCC02=3] Please answer this question
again. What is your current age?
AGE:
DK/REF

[RANGE: 1 - 110]

ALCC03a [IF ALCC03 < 12] Since you have indicated that you are
[ALCC03] years old, we cannot interview you for this study.
Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD
ROUTE TO PENTER1.
ALCC04 [IF ALCC02=1 OR ALCC02=3 OR ALCC01=6] Please
answer this question again. Think about the first time you had
a drink of an alcoholic beverage. How old were you the first
time you had a drink of any alcoholic beverage? Please do not
include times when you only had a sip or two from a drink.
AGE:
DK/REF

[RANGE: 1 - 110]

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

57
April 15, 2016

alcoholic beverage? Please do not include times when you only
had a sip or two from a drink.
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF ALCC06 NOT (BLANK OR DK/REF) THEN AGE1STAL = ALCC06
AL02a [IF ALCC05 NE DK/RE AND ALCC06 NE DK/REF AND AGE1STAL =
CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STAL =
CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first have a
drink of an alcoholic beverage in [CURRENT YEAR - 1] or [CURRENT
YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
AL02b [IF AGE1STAL = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you first have a drink of an alcoholic beverage in [CURRENT YEAR - 2] or
[CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
AL02c IF ALCC05 NE DK/RE AND ALCC06 NE DK/REF AND AGE1STAL =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first have a drink of an alcoholic beverage?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF AL02c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX

58
April 15, 2016

DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
AL02d [IF AL02a = 1 OR 2 OR AL02b = 1 OR 2] In what month in [YEAR FROM
AL02a or AL02b] did you first have a drink of an alcoholic beverage?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF AL02d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STAL:
MYR1STAL = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (AL02a-d). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STAL IS
BLANK.
IF MYR1STAL NE 0 AND NE AGE1STAL:
ALCC31 The computer recorded that you first had a drink of an
alcoholic beverage in [AL02a-d fill]. That would make you
[MYR1STAL] years old when you first had a drink of an
alcoholic beverage. Is this correct?
4
Yes
6
No
DK/REF
ALCC32 [IF ALCC31 = 4] Earlier, the computer recorded that you
were [AGE1STAL] years old when you first had a drink of an
alcoholic beverage. Which answer is correct?
1

I first had a drink of an alcoholic beverage in [AL02a-d

59
April 15, 2016

fill] when I was [MYR1STAL] years old
2
I was [AGE1STAL] years old the first time I had a
drink of an alcoholic beverage
3
Neither answer is correct
DK/REF
UPDATE: IF ALCC32 = 1, THEN AGE1STAL = MYR1STAL.
ALCC33 [IF ALCC32=2 OR ALCC32=3 OR ALCC31=6] Please
answer this question again. Did you first have a drink of an
alcoholic beverage in [CURRENT YEAR-2], [CURRENT
YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
ALCC33a [IF ALCC33 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [ALCC33] did you first have
a drink of an alcoholic beverage?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF ALCC33a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF ALCC33a NE (0 OR DK/REF) THEN UPDATE MYR1STAL.
MYR1STAL = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (ALCC33 AND ALCC33a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STAL IS BLANK.
IF MYR1STAL = AGE1STAL THEN MYR1STAL = BLANK

60
April 15, 2016

ALCC34 [IF ALCC32 NE 1 AND MYR1STAL NE 0 AND (ALCC33 AND
ALCC33a NE AL02a-d)] The computer recorded that you first
had a drink of an alcoholic beverage in [ALCC33-ALCC33a
fill]. That would make you [MYR1STAL] years old when you
first had a drink of an alcoholic beverage. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF ALCC34 NE (6, BLANK OR DK/REF )AND (ALCC33 AND ALCC33a
NE AL02a-d) THEN AGE1STAL = MYR1STAL
ALLAST3

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

ALRECDK

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

ALRECRE

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

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April 15, 2016

ALFRAME3 [IF ALLAST3 = 1 OR 2 OR ALRECDK = 1 OR 2 OR ALRECRE = 1 OR
2] Now think about the past 12 months, from [DATEFILL] through
today. We want to know how many days you’ve had a drink of an
alcoholic beverage during the past 12 months.
What would be the easiest way for you to tell us how many days you
drank alcoholic beverages?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF
ALYRAVE

[IF ALFRAME3 = 3 OR DK/REF] On how many days in the past 12
months did you drink an alcoholic beverage?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ALMONAVE [IF ALFRAME3 = 2 OR ALYRAVE = DK/REF] On average, how many
days did you drink an alcoholic beverage each month during the past 12
months?
AVG # OF DAYS PER MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ALWKAVE [IF ALFRAME3 = 1 OR ALMONAVE = DK/REF] On average, how
many days did you drink an alcoholic beverage each week during the past
12 months?
AVG # OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DEFINE TOTDRINK:
IF ALYRAVE NOT (BLANK OR DK/REF) THEN TOTDRINK=ALYRAVE
ELSE IF ALMONAVE NOT(BLANK OR DK/REF) THEN
TOTDRINK=ALMONAVE*12
ELSE IF ALWKAVE NOT (BLANK OR DK/REF) THEN TOTDRINK =
ALWKAVE*52
ELSE TOTDRINK=DK/REF
DEFINE FILL1:

62
April 15, 2016

IF ALYRAVE > 1, THEN FILL1 = “[ALYRAVE] days”
ELSE IF ALYRAVE = 1, THEN FILL1 = “1 day”
ELSE IF ALMONAVE > 1, THEN FILL1 = “[ALMONAVE] days per month”
ELSE IF ALMONAVE = 1, THEN FILL1 = “1 day per month”
ELSE IF ALWKAVE > 1, THEN FILL1 = “[ALWKAVE] days per week”
ELSE IF ALWKAVE = 1, THEN FILL1 = “1 day per week”
DEFINE FILL1A:
IF FILL1 = “[ALMONAVE] day(s) per month” OR “[ALWKAVE] day(s) per
week” THEN FILL1A = “for a total of [TOTDRINK] days”
ELSE FILL1A = BLANK
AL06 [IF ALLAST3 = 1 OR ALRECDK = 1 OR ALRECRE = 1] Think specifically
about the past 30 days, from [DATEFILL], up to and including today. During
the past 30 days, on how many days did you drink one or more drinks of an
alcoholic beverage?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
AL06DKRE [IF AL06 = DK/REF] What is your best estimate of the number of days
you drank alcohol during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE ALC30DAY
ALC30DAY = AL06
DEFINE ALCEST30
ALCEST30 = AL06DKRE
DEFINE ESTIALC
IF ALCEST30 = 1, THEN ESTIALC = 1
IF ALCEST30 = 2, THEN ESTIALC = 3
IF ALCEST30 = 3, THEN ESTIALC = 6
IF ALCEST30 = 4, THEN ESTIALC = 10
IF ALCEST30 = 5, THEN ESTIALC = 20
IF ALCEST30 = 6, THEN ESTIALC = 30

63
April 15, 2016

ELSE ESTIALC = BLANK
DEFINE ALCESTFL
IF AL06DKRE = 1 ALCESTFL = “1 or 2"
IF AL06DKRE = 2 ALCESTFL = “3 to 5"
IF AL06DKRE = 3 ALCESTFL = “6 to 9"
IF AL06DKRE = 4 ALCESTFL = “10 to 19"
IF AL06DKRE = 5 ALCESTFL = “20 to 29"
IF AL06DKRE = 6 ALCESTFL = “all 30"
ELSE ALCESTFL FILL = BLANK
IF TOTDRINK NOT DK/REF AND (ALC30DAY > TOTDRINK OR ESTIALC
> TOTDRINK):
ALCC17a [IF ALC30DAY > TOTDRINK] For the last question, the
computer recorded that you drank one or more alcoholic
beverages on [ALC30DAY] of the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
ALCC17b [IF ESTIALC > TOTDRINK] For the last question, the
computer recorded that you drank one or more alcoholic
beverages on [ALCESTFL] of the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
ALCC18 [IF ALCC17a = 4 OR ALCC17b = 4] The answers for the last
question and an earlier question disagree. Which answer is
correct?
1

I drank alcohol on [FILL1] in the past 12 months
[FILL1A]
2
I drank alcohol on [ALC30DAY / ALCESTFL] days
in the past 30 days
3
Neither answer is correct
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ALCC19 [IF ALCC18 = 2 OR ALCC18 = 3] Please answer this

64
April 15, 2016

question again. Think about the past 12 months, from
[DATEFILL] through today. We want to know how many days
you’ve had a drink of an alcoholic beverage during the past 12
months.
What would be the easiest way for you to tell us how many
days you drank alcoholic beverages?
1

Average number of days per week during the past 12
months
2
Average number of days per month during the past 12
months
3
Total number of days during the past 12 months
DK/REF

ALCC20 [IF ALCC19 = 3] On how many days in the past 12 months did
you drink an alcoholic beverage?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ALCC21 [IF ALCC19 = 2] On average, how many days did you drink
an alcoholic beverage each month during the past 12 months?
# OF DAYS/MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ALCC22 [IF ALCC19 = 1] On average, how many days did you drink
an alcoholic beverage each week during the past 12 months?
# OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
UPDATE TOTDRINK:
IF ALCC20 NOT(BLANK OR DK/REF) THEN TOTDRINK = ALCC20
ELSE IF ALCC21 NOT(BLANK OR DK/REF) THEN TOTDRINK = ALCC21*12
ELSE IF ALCC22 NOT(BLANK OR DK/REF) THEN TOTDRINK = ALCC22*52
ELSE TOTDRINK=DK/REF
ALCC23a [IF (ALCC17a =6 OR ALCC18 = 1 OR ALCC18 =3) AND
ALC30DAY NE (BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. During the past 30

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April 15, 2016

days, on how many days did you drink one or more drinks of an
alcoholic beverage?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
ALCC23b [IF (ALCC17b =6 OR ALCC18 = 1 OR ALCC18 =3) AND
ALCEST30 NE (BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. What is your best
estimate of the number of days you drank alcohol during the
past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
UPDATE: IF ALCC23a NOT (BLANK OR DK/REF) THEN ALC30DAY = ALCC23a
UPDATE: IF ALCC23b NOT (BLANK OR DK/REF) THEN ALCEST30 = ALCC23b
UPDATE ESTIALC
IF ALCC23b = 1 THEN ESTIALC = 1
IF ALCC23b = 2 THEN ESTIALC = 3
IF ALCC23b = 3 THEN ESTIALC = 6
IF ALCC23b = 4 THEN ESTIALC = 10
IF ALCC23b = 5 THEN ESTIALC = 20
IF ALCC23b = 6 THEN ESTIALC = 30
ELSE ESTIALC = BLANK
DEFINE ESTIALC2
IF ESTIALC = 1 THEN ESTIALC2 = 2
IF ESTIALC = 3 THEN ESTIALC2 = 5
IF ESTIALC = 6 THEN ESTIALC2 = 9
IF ESTIALC = 10 THEN ESTIALC2 = 19
IF ESTIALC = 20 THEN ESTIALC2 = 29
IF ESTIALC = 30 THEN ESTIALC2 = 30
UPDATE ALCESTFL
IF ALCC23b = 1 THEN ALCESTFL = “1 or 2"

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April 15, 2016

IF ALCC23b = 2 THEN ALCESTFL = “3 to 5"
IF ALCC23b = 3 THEN ALCESTFL = “6 to 9"
IF ALCC23b = 4 THEN ALCESTFL = “10 to 19"
IF ALCC23b = 5 THEN ALCESTFL = “20 to 29"
IF ALCC23b = 6 THEN ALCESTFL = “all 30"
ELSE ALCESTFL = BLANK
IF ALC30DAY = 0:
ALCC24 The computer recorded that you drank alcoholic beverages on
0 days during the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
ALCC26 [IF ALCC24 = 6] Please answer this question again. During
the past 30 days, that is, since [DATEFILL], on how many
days did you drink one or more drinks of an alcoholic
beverage?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
UPDATE: IF ALCC26 NOT (BLANK OR DK/REF) THEN ALC30DAY = ALCC26
DEFINE ALC30USE:
IF (ALLAST3 = 1 OR ALRECDK = 1 OR ALRECRE = 1) AND (ALCC24 = EMPTY
OR ALCC26 > 0 OR ALCC26 = DK/REF) THEN ALC30USE = 1
ELSE ALC30USE = 2
AL07 [IF ALC30DAY = 2 - 30 OR ALCEST30 = 1 - 6] On the [ALC30DAY /
ALCESTFL] days that you drank during the past 30 days, how many drinks did
you usually have each day? Count as a drink a can or bottle of beer; a wine
cooler or a glass of wine, champagne, or sherry; a shot of liquor or a mixed drink
or cocktail.
[IF ALC30DAY = 1] On the 1 day that you drank during the past 30 days, how
many drinks did you have? Count as a drink a can or bottle of beer; a wine
cooler or a glass of wine, champagne, or sherry; a shot of liquor or a mixed drink
or cocktail.
[IF ALCEST30 = DK/REF] On the days that you drank during the past 30 days,
how many drinks did you usually have each day? Count as a drink a can or
bottle of beer; a wine cooler or a glass of wine, champagne, or sherry; a shot of

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April 15, 2016

liquor or a mixed drink or cocktail.
# OF DRINKS:
[RANGE: 1 - 90]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

AL08 [IF ALC30DAY = 1 – 30 OR ALCEST30 = (1 – 6, DK OR REF)] During the
past 30 days, that is, since [DATEFILL], on how many days did you have [IF
QD01=5 THEN FILL 5 IF QD01=9 THEN FILL 4] or more drinks on the same
occasion? By ‘occasion,’ we mean at the same time or within a couple of hours
of each other.
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE BINGEFLAG:
IF AL08 = 1-30 THEN BINGEFLAG = 1
ELSE BINGEFLAG=0
IF AL08 > ALC30DAY OR AL08 > ESTIALC2:
ALCC27 The computer recorded that in the past 30 days you drank [IF
QD01=5 THEN FILL 5 IF QD01=9 THEN FILL 4] or more
alcoholic beverages on [AL08] days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

ALCC28 [IF ALCC27 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1

I drank one or more alcoholic beverages on
[ALC30DAY / ALCESTFL] days in the past 30 days
2
I drank [IF QD01=5 THEN FILL 5 IF QD01=9 THEN
FILL 4]or more alcoholic beverages on [AL08] days in
the past 30 days
3
Neither answer is correct
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

ALCC29a [IF ALCC28 = 2 OR 3 AND ALC30DAY NE (BLANK OR

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April 15, 2016

DK/REF)] Please answer this question again. Think
specifically about the past 30 days, that is from [DATEFILL]
through today. During the past 30 days, on how many days did
you drink one or more drinks of an alcoholic beverage?
# OF DAYS:
[RANGE: 0 -30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
ALCC29b [IF ALCC28 = 2 OR 3 AND ALCEST30 NE (BLANK OR
DK/REF)] Please answer this question again. Think
specifically about the past 30 days, that is from [DATEFILL]
through today. What is your best estimate of the number of
days you drank alcohol during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
ALCC30 [(IF ALCC27 = 6 OR ALCC28 = 1 OR ALCC28 = 3) AND
ALCC29a NE DK/REF AND ALCC29b NE DK/REF] Please
answer this question again. During the past 30 days, on how
many days did you drink [IF QD01=5 THEN FILL 5 IF
QD01=9 THEN FILL 4]or more alcoholic beverages on the
same occasion? By ‘occasion’ we mean at the same time or
within a couple of hours of each other.
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
UPDATE BINGEFLAG:
IF ALCC30 = 1-30 THEN BINGEFLAG = 1
ELSE IF ALCC30=0 OR DK/REF THEN BINGEFLAG=0

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April 15, 2016

70
April 15, 2016

Marijuana
MRJINTRO The next questions are about marijuana and hashish. Marijuana is also
called pot or grass. Marijuana is usually smoked, either in cigarettes,
called joints, or in a pipe. It is sometimes cooked in food. Hashish is a
form of marijuana that is also called “hash.” It is usually smoked in a
pipe. Another form of hashish is hash oil.
Press [ENTER] to continue.
MJ01 Have you ever, even once, used marijuana or hashish?
1
Yes
2
No
DK/REF
MJREF

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

MJ02 [IF MJ01 =1 OR MJREF = 1] How old were you the first time you used
marijuana or hashish?
AGE:
DK/REF

[RANGE: 1 - 110]

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

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April 15, 2016

MJCC02 [IF MJCC01 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
2

I am currently [CURNTAGE] years old
I was [AGE1STMJ] years old the first time I used
marijuana or hashish
3
Neither answer is correct
DK/REF
MJCC03 [IF MJCC02=2 OR MJCC02=3] Please answer this question
again. What is your current age?
AGE:
DK/REF

[RANGE: 1 - 110]

MJCC03a [IF MJCC03 < 12] Since you have indicated that you are
[MJCC03] years old, we cannot interview you for this study.
Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD
ROUTE TO PENTER1.
MJCC04 [IF MJCC02=1 OR MJCC02=3 OR MJCC01=6] Please
answer this question again. Think about the first time you used
marijuana or hashish. How old were you the first time you
used marijuana or hashish?
AGE:
DK/REF

[RANGE: 1 - 110]

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

[RANGE: 1 - 110]

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April 15, 2016

DK/REF
UPDATE: IF MJCC06 NOT(BLANK OR DK/REF) THEN AGE1STMJ = MJCC06
MJ03a [IF MJCC05 NE DK/REF AND MJCC06 NE DK/REF AND AGE1STMJ =
CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STMJ =
CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first use
marijuana or hashish in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
MJ03b

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

MJ03c [IF MJCC05 NE DK/REF AND MJCC06 NE DK/REF AND AGE1STMJ =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first use marijuana or hashish?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF MJ03c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
MJ03d

[IF MJ03a = 1 - 2 OR MJO3b = 1 - 2] In what month in [YEAR FROM
MJ03a or MJ03b] did you first use marijuana or hashish?

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April 15, 2016

1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF MJ03d > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STMJ:
MYR1STMJ = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (MJ03a-d). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STMJ IS
BLANK.
IF MYR1STMJ NE 0 AND NE AGE1STMJ:
MJCC17 The computer recorded that you first used marijuana or
hashish in [MJ03a-d fill]. That would make you
[MYR1STMJ] years old when you first used marijuana or
hashish. Is this correct?
4
Yes
6
No
DK/REF
MJCC18 [IF MJCC17 = 4] Earlier, the computer recorded that you
were [AGE1STMJ] years old when you first used marijuana or
hashish. Which answer is correct?
1

I first used marijuana or hashish in [MJ03a-d fill]
when I was [MYR1STMJ] years old
2
I was [AGE1STMJ] years old the first time I used
marijuana or hashish
3
Neither answer is correct
DK/REF

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April 15, 2016

UPDATE: IF MJCC18 = 1, THEN AGE1STMJ = MYR1STMJ.
MJCC19 [IF MJCC18=2 OR MJCC18=3 OR MJCC17=6] Please
answer this question again. Did you first use marijuana or
hashish in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
MJCC19a [IF MJCC19 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [MJCC19] did you first use
marijuana or hashish?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF MJCC19a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN.
PRESS [ENTER] TO CONTINUE.
UPDATE: IF MJCC19a NE (0 OR DK/REF) THEN UPDATE MYR1STMJ.
MYR1STMJ = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (MJCC19 AND MJCC19a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STMJ IS BLANK.
IF MYR1STMJ = AGE1STMJ THEN MYR1STMJ = BLANK
MJCC20 [IF MJCC18 NE 1 AND MYR1STMJ NE 0 AND (MJCC19
AND MJCC19a NE MJ03a-d)] The computer recorded that

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April 15, 2016

you first used marijuana or hashish in [MJCC19-MJCC19a
fill]. That would make you [MYR1STMJ] years old when you
first used marijuana or hashish. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF MJCC20 NE (6, BLANK OR DK/REF) AND (MJCC19 AND MJCC19a
NE MJ03a-d) THEN AGE1STMJ = MYR1STMJ
MJLAST3

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

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

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

MJFRAME3 [IF MJLAST3 = 1 - 2 OR MJRECDK = 1 - 2 OR MJRECRE = 1 - 2]
Now think about the past 12 months, from [DATEFILL] through today.
We want to know how many days you’ve used marijuana or hashish

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April 15, 2016

during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve
used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF
MJYRAVE

[IF MJFRAME3 = 3 OR DK/REF] On how many days in the past 12
months did you use marijuana or hashish?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

MJMONAVE[IF MJFRAME3 = 2 OR MJYRAVE = DK/REF] On average, how many
days did you use marijuana or hashish each month during the past 12
months?
AVERAGE # OF DAYS PER MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
MJWKAVE [IF MJFRAME3 = 1 OR MJMONAVE = DK/REF] On average, how
many days did you use marijuana or hashish each week during the past 12
months?
AVERAGE # OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
MJ06 [IF MJLAST3=1 OR MJRECDK = 1 OR MJRECRE = 1] Think specifically
about the past 30 days, from [DATEFILL] up to and including today. During the
past 30 days, on how many days did you use marijuana or hashish?
NUMBER OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
MJ06DKRE [IF MJ06 = DK/REF] What is your best estimate of the number of days
you used marijuana or hashish during the past 30 days?
1
2

1 or 2 days
3 to 5 days

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April 15, 2016

3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE ESTIMJ
IF MJ06DKRE = 1, THEN ESTIMJ = 1
IF MJ06DKRE = 2, THEN ESTIMJ = 3
IF MJ06DKRE = 3, THEN ESTIMJ = 6
IF MJ06DKRE = 4, THEN ESTIMJ = 10
IF MJ06DKRE = 5, THEN ESTIMJ = 20
IF MJ06DKRE = 6, THEN ESTIMJ = 30
ELSE ESTIMJ = BLANK
DEFINE MJ30DAY
IF MJ06DKRE = 1, THEN MJ30DAY = “1 or 2"
IF MJ06DKRE = 2, THEN MJ30DAY = “3 to 5"
IF MJ06DKRE = 3, THEN MJ30DAY = “6 to 9"
IF MJ06DKRE = 4, THEN MJ30DAY = “10 to 19"
IF MJ06DKRE = 5, THEN MJ30DAY = “20 to 29"
IF MJ06DKRE = 6, THEN MJ30DAY = “all 30"
ELSE MJ30DAY = BLANK
DEFINE TOTMJ:
IF MJYRAVE NOT(BLANK OR DK/REF) THEN TOTMJ = MJYRAVE
ELSE IF MJMONAVE NOT(BLANK OR DK/REF) THEN TOTMJ =
MJMONAVE*12
ELSE IF MJWKAVE NOT (BLANK OR DK/REF) THEN TOTMJ =
MJWKAVE*52
ELSE TOTMJ = DK/REF
IF TOTMJ = DK/REF, SKIP TO COCINTRO
IF TOTMJ NOT DK/REF AND ((MJ06 NE DK/REF OR BLANK AND MJ06 >
TOTMJ) OR (MJ06 = DK/REF AND ESTIMJ > TOTMJ)):
MJCC07a [IF MJ06 > TOTMJ] For the last question, the computer
recorded that you used marijuana or hashish on [MJ06] of the
past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
MJCC07b [IF ESTIMJ > TOTMJ] For the last question, the computer

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April 15, 2016

recorded that you used marijuana or hashish on [MJ30DAY]
of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE FILLMJ:
IF MJYRAVE > 1, THEN FILLMJ = “[MJYRAVE] days”
ELSE IF MJYRAVE = 1, THEN FILLMJ = “1 day”
ELSE IF MJMONAVE > 1, THEN FILLMJ = “[MJMONAVE] days per month”
ELSE IF MJMONAVE = 1, THEN FILLMJ = “1 day per month”
ELSE IF MJWKAVE > 1, THEN FILLMJ = “[MJWKAVE] days per week”
ELSE IF MJWKAVE = 1, THEN FILLMJ = “1 day per week”
DEFINE FILLMJA:
IF FILLMJ = “[MJMONAVE] day(s) per month” OR “[MJWKAVE] day(s) per
week” FILLMJA = “for a total of [TOTMJ] days”
ELSE FILLMJA = BLANK
MJCC08 [IF MJCC07a = 4 OR MJCC07b = 4] The answers for the last
question and an earlier question disagree. Which answer is
correct?
1

I used marijuana or hashish on [FILLMJ] in the past
12 months [FILLMJA]
2
I used marijuana or hashish on [MJ06 / MJ30DAY]
days in the past 30 days
3
Neither answer is correct
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
MJCC09 [IF MJCC08 = 2 OR MJCC08 = 3] Please answer this
question again. Think about the past 12 months, from
[DATEFILL] through today. We want to know how many days
you’ve used marijuana or hashish during the past 12 months.
What would be the easiest way for you to tell us how many
days you’ve used it?
1
2
3

Average number of days per week during the past 12
months
Average number of days per month during the past 12
months
Total number of days during the past 12 months

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April 15, 2016

DK/REF
MJCC10 [IF MJCC09 = 3 ] On how many days in the past 12 months
did you use marijuana or hashish?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
MJCC11 [IF MJCC09 = 2] On average, how many days did you use
marijuana or hashish each month during the past 12 months?
# OF DAYS/MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
MJCC12 [IF MJCC09 = 1] On average, how many days did you use
marijuana or hashish each week during the past 12 months?
# OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
IF MJCC10 NOT(BLANK OR DK/REF) THEN TOTMJ = MJCC10
ELSE IF MJCC11 NOT(BLANK OR DK/REF) THEN TOTMJ = MJCC11*12
ELSE IF MJCC12 NOT(BLANK OR DK/REF) THEN TOTMJ = MJCC12*52
ELSE TOTMJ = DK/REF
MJCC13a [IF MJCC07a=6 OR ((MJCC08 = 1 OR MJCC08 = 3) AND
MJCC07a NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. During the past 30
days, on how many days did you use marijuana or hashish?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
MJCC13b [IF MJCC07b = 6 OR ((MJCC08 = 1 OR 3) AND MJCC07b
NE BLANK OR DK/REF)] Please answer this question again.
Think specifically about the past 30 days, from [DATEFILL]
up to and including today. What is your best estimate of the
number of days you used marijuana or hashish during the past
30 days?
1

1 or 2 days

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April 15, 2016

2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
IF MJ06 = 0:
MJCC14 The computer recorded that you used marijuana or hashish on
0 days during the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
MJCC16 [IF MJCC14 = 6] Please answer this question again. During
the past 30 days, that is, since [DATEFILL], on how many
days did you use marijuana or hashish?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

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April 15, 2016

Cocaine
COCINTRO These questions are about cocaine, including all the different forms of
cocaine such as powder, ‘crack,’ free base, and coca paste.
Press [ENTER] to continue.
CC01 Have you ever, even once, used any form of cocaine?
1
Yes
2
No
DK/REF
CCREF

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

CC02 [IF CC01 =1 OR CCREF = 1] How old were you the first time you used
cocaine, in any form?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STCC:
IF CC02 NE (BLANK OR DK/REF) THEN AGE1STCC = CC02
ELSE AGE1STCC = BLANK
IF CURNTAGE < AGE1STCC:
CCCC01 The computer recorded that you were [AGE1STCC] years old
when you first used cocaine. Is this correct?
4
Yes
6
No
DK/REF
CCCC02 [IF CCCC01 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1

I am currently [CURNTAGE] years old

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April 15, 2016

2

I was [AGE1STCC] years old the first time I used
cocaine
3
Neither answer is correct
DK/REF

CCCC03 [IF CCCC02=2 OR CCCC02=3] Please answer this question
again. What is your current age?
AGE:
DK/REF

[RANGE: 1 - 110]

CCCC03a [IF CCCC03 < 12] Since you have indicated that you are
[CCCC03 AGE] years old, we cannot interview you for this
study. Please tell your interviewer that you have finished the
survey. Thank you for your cooperation. PROGRAM
SHOULD ROUTE TO PENTER1.
CCCC04 [IF CCCC02=1 OR CCCC02=3 OR CCCC01=6] Please
answer this question again. Think about the first time you used
cocaine. How old were you the first time you used cocaine in
any form?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CCCC04 NOT(BLANK OR DK/REF) THEN AGE1STCC = CCCC04
UPDATE: IF CCCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = CCCC03
IF AGE1STCC=CURNTAGE OR AGE1STCC < 10:
CCCC05 The computer recorded that you were [AGE1STCC] years old
the first time you used cocaine. Is this correct?
4
Yes
6
No
DK/REF
CCCC06 [IF CCCC05=6] Please answer this question again. Think
about the first time you used cocaine. How old were you the
first time you used cocaine in any form?
AGE:
DK/REF

[RANGE: 1 - 110]

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

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April 15, 2016

CC03a [IF CCCC05 NE DK/RE AND CCCC06 NE DK/REF AND AGE1STCC =
CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STCC =
CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first use
cocaine in any form in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
CC03b

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

CC03c [IF CCCC05 NE DK/RE AND CCCC06 NE DK/REF AND AGE1STCC =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first use cocaine in any form?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CC03c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CC03d

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

January
February
March

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April 15, 2016

4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CC03d > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STCC:
MYR1STCC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (CC03a-d). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCC IS
BLANK.
IF MYR1STCC NE 0 AND NE AGE1STCC:
CCCC17 The computer recorded that you first used cocaine in any form
in [CC03a-d fill]. That would make you [MYR1STCC] years
old when you first used cocaine in any form. Is this correct?
4
Yes
6
No
DK/REF
CCCC18 [IF CCCC17 = 4] Earlier, the computer recorded that you
were [AGE1STCC] years old when you first used cocaine in
any form. Which answer is correct?
1

I first used cocaine in any form in [CC03a-d fill] when I
was [MYR1STCC] years old
2
I was [AGE1STCC] years old the first time I used
cocaine in any form.
3
Neither answer is correct
DK/REF

UPDATE: IF CCCC18 = 1, THEN AGE1STCC = MYR1STCC.
CCCC19 [IF CCCC18=2 OR CCCC18=3 OR CCCC17=6] Please
answer this question again. Did you first use cocaine in any

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April 15, 2016

form in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
CCCC19a [IF CCCC19 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [CCCC19] did you first use
cocaine in any form?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CCCC19a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF CCCC19a NE (0 OR DK/REF) THEN UPDATE MYR1STCC.
MYR1STCC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (CCCC19 AND CCCC19a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCC IS BLANK.
IF MYR1STCC = AGE1STCC THEN MYR1STCC = BLANK
CCCC20 [IF CCCC18 NE 1 AND MYR1STCC NE 0 AND (CCCC19
AND CCCC19a NE CC03a-d)] The computer recorded that
you first used cocaine in any form in [CCCC19-CCCC19a fill].
That would make you [MYR1STCC] years old when you first
used cocaine in any form. Is this correct?
4
Yes
6
No
DK/REF

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April 15, 2016

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

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

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

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

CCFRAME3 [IF CCLAST3 = 1 OR 2 OR CCRECDK = 1 OR 2 OR CCRECRE = 1 OR
2] Now think about the past 12 months, from [DATEFILL] through
today. We want to know how many days you’ve used cocaine during the
past 12 months.
What would be the easiest way for you to tell us how many days you’ve
used it?
1
2

Average number of days per week during the past 12 months
Average number of days per month during the past 12 months

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April 15, 2016

3
Total number of days during the past 12 months
DK/REF
CCYRAVE

[IF CCFRAME3 = 3 OR DK/REF] On how many days in the past 12
months did you use cocaine?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

CCMONAVE[IF CCFRAME3 = 2 OR CCYRAVE = DK/REF] On average, how many
days did you use cocaine each month during the past 12 months?
AVERAGE # OF DAYS PER MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CCWKAVE [IF CCFRAME3 = 1 OR CCMONAVE = DK/REF] On average, how
many days did you use cocaine each week during the past 12 months?
AVERAGE # OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CC06 [IF CCLAST3 =1 OR CCRECDK = 1 OR CCRECRE = 1] Think specifically
about the past 30 days, from [DATEFILL] up to and including today. During the
past 30 days, on how many days did you use cocaine?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CC06DKRE [IF CC06 = DK/REF] What is your best estimate of the number of days
you used cocaine during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE ESTICC:
IF CC06DKRE = 1, THEN ESTICC = 1

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April 15, 2016

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

90
April 15, 2016

ELSE IF CCYRAVE = 1, THEN FILLCN = “1 day”
ELSE IF CCMONAVE > 1, THEN FILLCN = “[CCMONAVE] days per month”
ELSE IF CCMONAVE = 1, THEN FILLCN = “1 day per month”
ELSE IF CCWKAVE > 1, THEN FILLCN = “[CCWKAVE] days per week”
ELSE IF CCWKAVE = 1, THEN FILLCN = “1 day per week”
DEFINE FILCNA:
IF FILLCN = “[CCMONAVE] day(s) per month” OR “[CCWKAVE] day(s) per
week” THEN FILLCNA = “for a total of [TOTCOKE] days”
ELSE FILLCNA = BLANK
CCCC08 [IF CCCC07a = 4 OR CCCC07b = 4] The answers for the
last question and an earlier question disagree. Which answer
is correct?
1

I used cocaine on [FILLCN] days in the past 12 months
[FILLCNA]
2
I used cocaine on [CC06 / COC30DAY] days in the
past 30 days
3
Neither answer is correct
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CCCC09 [IF CCCC08 = 2 OR CCCC08 = 3] Please answer this
question again. Think about the past 12 months, from
[DATEFILL] through today. We want to know how many days
you’ve used cocaine during the past 12 months.
What would be the easiest way for you to tell us how many
days you’ve used it?
1

Average number of days per week during the past 12
months
2
Average number of days per month during the past 12
months
3
Total number of days during the past 12 months
DK/REF

CCCC10 [IF CCCC09 = 3] On how many days in the past 12 months
did you use cocaine?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CCCC11 [IF CCCC9 = 2] On average, how many days did you use

91
April 15, 2016

cocaine each month during the past 12 months?
# OF DAYS/MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CCCC12 [IF CCCC09 = 1] On average, how many days did you use
cocaine each week during the past 12 months?
# OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
IF CCCC10 NOT(BLANK OR DK/REF) THEN TOTCOKE = CCCC10
ELSE IF CCCC11 NOT(BLANK OR DK/REF THEN TOTCOKE=CCCC11*12
ELSE IF CCC12 NOT(BLANK OR DK/REF) THEN TOTCOKE=CCCC12*52
ELSE TOTCOKE = DK/REF
CCCC13a [IF (CCCC07a=6 OR ((CCCC08 = 1 OR CCCC08 = 3) AND
CCCC07a NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. During the past 30
days, on how many days did you use cocaine?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CCCC13b [IF CCCC07b = 6 or ((CCCC08 = 1 OR 3) AND CCCC07b
NE BLANK OR DK/REF)] Please answer this question again.
Think specifically about the past 30 days, from [DATEFILL]
up to and including today. What is your best estimate of the
number of days you used cocaine during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
IF CC06 = 0:
CCCC14 The computer recorded that you used any form of cocaine on 0
days during the past 30 days. Is this correct?

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April 15, 2016

4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CCCC16 [IF CCCC14 = 6] Please answer this question again. During
the past 30 days, that is, since [DATEFILL], on how many
days did you use cocaine?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

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April 15, 2016

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April 15, 2016

Crack
CKINTRO [IF CC01 = 1 OR CCREF = 1] The next questions are about ‘crack’, that
is cocaine in rock or chunk form, and not the other forms of cocaine.
Press [ENTER] to continue.
CK01 [IF CC01 = 1 OR CCREF = 1] Have you ever, even once, used ‘crack’?
1
Yes
2
No
DK/REF
CKREF [IF CK01 = REF] The answers that people give us about their use of ‘crack’
are important to this study’s success. We know that this information is
personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever, even once,
used ‘crack’?
1
Yes
2
No
DK/REF
CK02 [IF CK01 = 1 OR CKREF = 1] How old were you the first time you used
‘crack’?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STCK:
IF CK02 NE (BLANK OR DK/REF) THEN AGE1STCK = CK02
ELSE AGE1STCK = BLANK
IF CURNTAGE < AGE1STCK:
CKCC01 The computer recorded that you were [AGE1STCK] years old
when you first used ‘crack’. Is this correct?
4
Yes
6
No
DK/REF
CKCC02 [IF CKCC01 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1

I am currently [CURNTAGE] years old

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April 15, 2016

2

I was [AGE1STCK] years old the first time I used
‘crack’
3
Neither answer is correct
DK/REF

CKCC03 [IF CKCC2=2 OR CKCC2=3] Please answer this question
again. What is your current age?
AGE:
DK/REF

[RANGE: 1 - 110]

CKCC03a [IF CKCC03 < 12] Since you have indicated that you are
[CCKCC03 AGE] years old, we cannot interview you for this
study. Please tell your interviewer that you have finished the
survey. Thank you for your cooperation. PROGRAM
SHOULD ROUTE TO PENTER1.
CKCC04 [IF CKCC02=1 OR CKCC02=3 OR CKCC01=6] Please
answer this question again. Think about the first time you used
‘crack’. How old were you the first time you used ‘crack’?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF CKCC04 NOT(BLANK OR DK/REF) THEN AGE1STCK = CKCC04
UPDATE: IF CKCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = CKCC03
IF AGE1STCK=CURNTAGE OR AGE1STCK < 10:
CKCC05 The computer recorded that you were [AGE1STCK] years old
the first time you used ‘crack’. Is this correct?
4
Yes
6
No
DK/REF
CKCC06 [IF CKCC05=6] Please answer this question again. Think
about the first time you used ‘crack’. How old were you the
first time you used ‘crack’?
AGE:
DK/REF

[RANGE: 1 - 110]

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

[IF CKCC05 NE DK/RE AND CKCC06 NE DK/REF AND AGE1STCK

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April 15, 2016

= CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STCK =
CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first use ‘crack’
in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
CK03b
[IF AGE1STCK = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first use ‘crack’ in [CURRENT YEAR - 2] or [CURRENT
YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
CK03c [IF CKCC05 NE DK/RE AND CKCC06 NE DK/REF AND AGE1STCK =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first use ‘crack’?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CK03c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CK03d
[IF CK03a = 1 OR 2 OR CK03b = 1 OR 2] In what month in [YEAR
FROM CK03a or CK03b] did you first use ‘crack’?
1
2
3
4

January
February
March
April

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April 15, 2016

5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CK03d > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STCK:
MYR1STCK = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (CK03a-d). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCK IS
BLANK.
IF MYR1STCK NE 0 AND NE AGE1STCK:
CKCC17 The computer recorded that you first used ‘crack’ in [CK03a-d
fill]. That would make you [MYR1STCK] years old when you
first used ‘crack’. Is this correct?
4
Yes
6
No
DK/REF
CKCC18 [IF CKCC17 = 4] Earlier, the computer recorded that you
were [AGE1STCK] years old when you first used ‘crack’.
Which answer is correct?
1

I first used ‘crack’ in [CK03a-d fill] when I was
[MYR1STCK] years old
2
I was [AGE1STCK] years old the first time I used
‘crack’
3
Neither answer is correct
DK/REF
UPDATE: IF CKCC18 = 1, THEN AGE1STCK = MYR1STCK.
CKCC19 [IF CKCC18=2 OR CKCC18=3 OR CKCC17=6] Please
answer this question again. Did you first use ‘crack’ in
[CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT

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April 15, 2016

YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
CKCC19a [IF CKCC19 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [CKCC19] did you first use
‘crack’?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CKCC19a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF CKCC19a NE (0 OR DK/REF) THEN UPDATE MYR1STCK.
MYR1STCK = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (CKCC19 AND CKCC19a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STCK IS BLANK.
IF MYR1STCK = AGE1STCK THEN MYR1STCK = BLANK
CKCC20 [IF CKCC18 NE 1 AND MYR1STCK NE 0 AND (CKCC19
AND CKCC19a NE CK03a-d)] The computer recorded that
you first used ‘crack’ in [CKCC19-CKCC19a fill]. That would
make you [MYR1STCK] years old when you first used ‘crack’.
Is this correct?
4
Yes
6
No
DK/REF

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April 15, 2016

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

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

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

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

CKFRAME3 [IF CKLAST3 = 1 OR 2 OR CKRECDK = 1 OR 2 OR CKRECRE = 1
OR 2] Now think about the past 12 months, from [DATEFILL] through
today. We want to know how many days you’ve used ‘crack’ during the
past 12 months.
What would be the easiest way for you to tell us how many days you’ve
used it?
1
2
3

Average number of days per week during the past 12 months
Average number of days per month during the past 12 months
Total number of days during the past 12 months

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April 15, 2016

DK/REF
CKYRAVE [IF CKFRAME3 = 3 OR DK/REF] On how many days in the past 12
months did you use ‘crack’?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CKMONAVE
[IF CKFRAME3 = 2 OR CKYRAVE = DK/REF] On average,
how many days did you use ‘crack’ each month during the past 12
months?
AVERAGE # OF DAYS PER MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CKWKAVE [IF CKFRAME3 = 1 OR CKMONAVE = DK/REF] On average, how
many days did you use ‘crack’ each week during the past 12 months?
AVERAGE # OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CK06 [IF CKLAST3=1 OR CKRECDK =1 OR CKRECRE = 1] Think specifically
about the past 30 days, from [DATEFILL] up to and including today. During the
past 30 days, on how many days did you use ‘crack’?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CK06DKRE [IF CK06 = DK/REF] What is your best estimate of the number of days
you used ‘crack’ during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE ESTICK:
IF CK06DKRE = 1, THEN ESTICK = 1

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

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IF CKYRAVE > 1, THEN FILLCK = “[CKYRAVE] days”
ELSE IF CKYRAVE = 1, THEN FILLCK = “1 day”
ELSE IF CKMONAVE > 1, THEN FILLCK = “[CKMONAVE] days per month”
ELSE IF CKMONAVE = 1, THEN FILLCK = “1 day per month”
ELSE IF CKWKAVE > 1, THEN FILLCK = “[CKWKAVE] days per week”
ELSE IF CKWKAVE = 1, THEN FILLCK = “1 day per week”
DEFINE FILLCKA:
IF FILLCK = “[CKMONAVE] day(s) per month” OR [CKWKAVE] day(s) per
week” THEN FILLCKA = “for a total of TOTCRACK] days”
ELSE FILLCKA = BLANK
CKCC08 [IF CKCC07a = 4 OR CKCC07b = 4] The answers for the
last question and an earlier question disagree. Which answer
is correct?
1

I used ‘crack’ on [FILLCK] days in the past 12 months
[FILLCKA]
2
I used ‘crack’ on [CK06 / CRK30DAY] days in the
past 30 days
3
Neither answer is correct
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CKCC09 [IF CKCC08 = 2 OR CKCC08 = 3] Please answer this
question again. Think about the past 12 months, from
[DATEFILL] through today. We want to know how many days
you’ve used ‘crack’ during the past 12 months.
What would be the easiest way for you to tell us how many
days you’ve used it?
1

Average number of days per week during the past 12
months
2
Average number of days per month during the past 12
months
3
Total number of days during the past 12 month
DK/REF
CKCC10 [IF CKCC09 = 3] On how many days in the past 12 months
did you use ‘crack’?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

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CKCC11 [IF CKCC09 = 2] On average, how many days did you use
‘crack’ each month during the past 12 months?
# OF DAYS/MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CKCC12 [IF CKCC09 = 1] On average, how many days did you use
‘crack’ each week during the past 12 months?
# OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
IF CKCC10 NOT(BLANK OR DK/REF) THEN TOTCRACK = CKCC10
IF CKCC11 NOT(BLANK OR DK/REF) THEN TOTCRACK= CKCC11*12
IF CKCC12 NOT(BLANK OR DK/REF) THEN TOTCRACK= CKCC12*52
ELSE TOTCRACK = DK/REF
CKCC13a [IF CKCC07a = 6 OR ((CKCC08 = 1 OR CKCC08 = 3) AND
CKCC07a NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. During the past 30
days, on how many days did you use ‘crack’?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CKCC13b [IF CKCC07b = 6 OR (CKCC08 = 1 OR CKCC08 = 3) AND
(CKCC07b NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. What is your best
estimate of the number of days you used ‘crack’ during the
past 30 days?
1
2
3
4
5
6

1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 daysPROGRAMMER: SHOW 30 DAY
CALENDAR

IF CK06 = 0:
CKCC14 The computer recorded that you used ’crack’ on 0 days during

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the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CKCC16 [IF CKCC14 = 6] Please answer this question again. During
the past 30 days, that is, since [DATEFILL], on how many
days did you use ‘crack’?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

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Heroin
HEINTRO

These next questions are about heroin.
Press [ENTER] to continue.

HE01 Have you ever, even once, used heroin?
1
Yes
2
No
DK/REF
HEREF

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

HE02 [IF HE01 = 1 OR HEREF = 1] How old were you the first time you used heroin?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STHR:
IF HE02 NE (BLANK OR DK/REF) THEN AGE1STHR = HE02
ELSE AGE1STHR = BLANK
IF CURNTAGE < AGE1STHR:
HECC01 The computer recorded that you were [AGE1STHR] years old
when you first used heroin. Is this correct?
4
Yes
6
No
DK/REF
HECC02 [IF HECC01 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
2

I am currently [CURNTAGE] years old
I was [AGE1STHR] years old the first time I used
heroin

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3
Neither answer is correct
DK/REF
HECC03 [IF HECC02=2 OR HECC02=3] Please answer this question
again. What is your current age?
AGE:
DK/REF

[RANGE: 1 - 110]

HECC03a [IF HECC03 < 12] Since you have indicated that you are
[HECC03 AGE] years old, we cannot interview you for this
study. Please tell your interviewer that you have finished the
survey. Thank you for your cooperation. PROGRAM
SHOULD ROUTE TO PENTER1.
HECC04 [IF HECC02=1 OR HECC02=3 OR HECC01=6] Please
answer this question again. Think about the first time you used
heroin. How old were you the first time you used heroin?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF HECC04 NOT(BLANK OR DK/REF) THEN AGE1STHR = HECC04
UPDATE: IF HECC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = HECC03
IF AGE1STHR = CURNTAGE OR AGE1STHR<10:
HECC05 The computer recorded that you were [AGE1STHR] years old
the first time you used heroin. Is this correct?
4
Yes
6
No
DK/REF
HECC06 [IF HECC05=6] Please answer this question again. Think
about the first time you used heroin. How old were you the
first time you used heroin?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF HECC06 NOT(BLANK OR DK/REF) THEN AGE1STHR = HECC06
HE03a [IF HECC05 NE DK/RE AND HECC06 NE DK/REF AND AGE1STHR =
CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STHR =
CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first use heroin
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in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
HE03b
[IF AGE1STHR = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first use heroin in [CURRENT YEAR - 2] or [CURRENT
YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
HE03c [IF HECC05 NE DK/RE AND HECC06 NE DK/REF AND AGE1STHR =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first use heroin?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF HE03c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
HE03d
[IF HE03a = 1 OR 2 OR HE03b = 1 OR 2] In what month in [YEAR
FROM HE03a or HE03b] did you first use heroin?
1
2
3
4
5
6

January
February
March
April
May
June

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7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF HE03d > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STHE:
MYR1STHE = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (HE03a-d). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STHE IS
BLANK.
IF MYR1STHE NE 0 AND NE AGE1STHR:
HECC17 The computer recorded that you first used heroin in [HE03a-d
fill]. That would make you [MYR1STHE] years old when you
first used heroin. Is this correct?
4
Yes
6
No
DK/REF
HECC18 [IF HECC17 = 4] Earlier, the computer recorded that you
were [AGE1STHR] years old when you first used heroin.
Which answer is correct?
1

I first used heroin in [HE03a-d fill] when I was
[MYR1STHE] years old
2
I was [AGE1STHR] years old the first time I used
heroin
3
Neither answer is correct
DK/REF

UPDATE: IF HECC18 = 1, THEN AGE1STHR = MYR1STHE
HECC19 [IF HECC18=2 OR HECC18=3 OR HECC17=6] Please
answer this question again. Did you first use heroin in
[CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?

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1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
HECC19a [IF HECC19 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [HECC19] did you first use
heroin?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF HECC19a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF HECC19a NE (0 OR DK/REF) THEN UPDATE MYR1STHE.
MYR1STHE = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (HECC19 AND HECC19a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STHE IS BLANK.
IF MYR1STHE = AGE1STHR THEN MYR1STHE = BLANK
HECC20 [IF HECC18 NE 1 AND MYR1STDHENE 0 AND (HECC19
AND HECC19a NE HE03a-d)] The computer recorded that
you first used heroin in [HECC19-HECC19a fill]. That would
make you [MYR1STHE] years old when you first used heroin.
Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF HECC20 NE (6, BLANK OR DK/REF) AND (HECC19 AND HECC19a
NE HE03a-d) THEN AGE1STHR = MYR1STHE

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HELAST3

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

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

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

HEFRAME3 [IF HELAST3 = 1 OR 2 OR HERECDK = 1 OR 2 OR HERECRE = 1 OR
2] Now think about the past 12 months, from [DATEFILL] through
today. We want to know how many days you’ve used heroin during the
past 12 months.
What would be the easiest way for you to tell us how many days you’ve
used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

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HEYRAVE

[IF HEFRAME3 = 3 OR DK/REF] On how many days in the past 12
months did you use heroin?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

HEMONAVE

[IF HEFRAME3 = 2 OR HEYRAVE = DK/REF] On average,
how many days did you use heroin each month during the past 12
months?
AVERAGE # OF DAYS PER MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

HEWKAVE [IF HEFRAME3 = 1 OR HEMONAVE = DK/REF] On average, how
many days did you use heroin each week during the past 12 months?
AVERAGE # OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
HE06 [IF HELAST3=1 OR HERECDK = 1 OR HERECRE = 1] Think specifically
about the past 30 days, from [DATEFILL] up to and including today. During the
past 30 days, on how many days did you use heroin?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
HE06DKRE [IF HE06 = DK/REF] What is your best estimate of the number of days
you used heroin during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE ESTIHE:
IF HE06DKRE = 1, THEN ESTIHE = 1
IF HE06DKRE = 2, THEN ESTIHE = 3
IF HE06DKRE = 3, THEN ESTIHE = 6

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

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ELSE IF HEMONAVE = 1, THEN FILLHE = “1 day per month”
ELSE IF HEWKAVE > 1, THEN FILLHE = “[HEWKAVE] days per week”
ELSE IF HEWKAVE = 1, THEN FILLHE = “1 day per week”
DEFINE FILLHERA:
IF FILLHER = “[HEMONAVE] day(s) per month” OR “[HEWKAVE] day(s) per
week” THEN FILLHERA = “for a total of TOTHERO days”
ELSE FILLHERA = BLANK
HECC08 [IF HECC07a = 4 OR HECC07b = 4] The answers for the
last question and an earlier question disagree. Which answer
is correct?
1

I used heroin on [FILLHER] days in the past 12
months [FILLHERA]
2
I used heroin on [HE06 /HER30DAY] days in the past
30 days
3
Neither answer is correct
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
HECC09 [IF HECC08 = 2 OR HECC08 = 3] Please answer this
question again. Think about the past 12 months, from
[DATEFILL] through today. We want to know how many days
you’ve used heroin during the past 12 months.
What would be the easiest way for you to tell us how many
days you’ve used it?
1

Average number of days per week during the past 12
months
2
Average number of days per month during the past 12
months
3
Total number of days during the past 12 months
DK/REF

HECC10 [IF HECC09 = 3] On how many days in the past 12 months
did you use heroin?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
HECC11 [IF HECC09 = 2] On average, how many days did you use
heroin each month during the past 12 months?

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# OF DAYS/MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
HECC12 [IF HECC09 = 1] On average, how many days did you use
heroin each week during the past 12 months?
# OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
IF HECC10 NOT(BLANK OR DK/REF) THEN TOTHERO = HECC10
ELSE IF HECC11 NOT(BLANK OR DK/REF) THEN TOTHERO = HECC11*12
ELSE IF HECC12 NOT(BLANK OR DK/REF0 THEN TOTHERO = HECC12*52
ELSE TOTHERO = DK/REF
HECC13a [IF HECC07a = 6 OR ((HECC08 = 1 OR 3) AND HECC07a
NE BLANK OR DK/REF)] Please answer this question again.
Think specifically about the past 30 days, from [DATEFILL],
up to and including today. During the past 30 days, on how
many days did you use heroin?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
HECC13b [IF HECC7b = 6 OR ((HECC08 = 1 OR 3) AND HECC07b
NE BLANK OR DK/REF)] Please answer this question again.
Think specifically about the past 30 days, from [DATEFILL]
up to and including today. What is your best estimate of the
number of days you used heroin during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
IF HE06 = 0:
HECC14 The computer recorded that you used heroin on 0 days during
the past 30 days. Is this correct?

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4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
HECC16 [IF HECC14 = 6] Please answer this question again. During
the past 30 days, that is, since [DATEFILL], on how many
days did you use heroin?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

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Hallucinogens

HALINTRO The next questions are about substances called hallucinogens. These drugs
often cause people to see or experience things that are not real.
A list of some common hallucinogens is shown below. These and many
other substances that people use as hallucinogens are often known by
street names, and we can’t list them all. Please take a moment to look at
the substances listed below so you know what kind of drugs the next
questions are about.
LSD, also called ‘acid’
PCP, also called ‘angel dust’ or phencyclidine
Peyote
Mescaline
Psilocybin
‘Ecstasy’ or ‘Molly’, also called MDMA
Ketamine, also called “Special K” or “Super K”
DMT, also called dimethyltryptamine
AMT, also called alpha-methyltryptamine
Foxy, also called 5-MeO-DIPT
Salvia divinorum
Press [ENTER] to continue.
LS01a Have you ever, even once, used LSD, also called “acid”?
1
Yes
2
No
DK/REF
LSREF1 [IF LS01a = REF] The answers that people give us about their use of LSD are
important to this study’s success. We know that this information is personal,
but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever, even once,
used LSD, also called ‘acid’?
1
Yes
2
No
DK/REF
LS01b Have you ever, even once, used PCP, also called ‘angel dust’ or phencyclidine?
1

Yes

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April 15, 2016

2
No
DK/REF
LSREF2 [IF LS01b = REF] The answers that people give us about their use of PCP are
important to this study’s success. We know that this information is personal,
but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever, even once,
used PCP, also called ‘angel dust’ or phencyclidine?
1
Yes
2
No
DK/REF
LS01c Have you ever, even once, used peyote?
1
Yes
2
No
DK/REF
LS01d Have you ever, even once, used mescaline?
1
Yes
2
No
DK/REF
LS01e Have you ever, even once, used psilocybin, found in mushrooms?
1
Yes
2
No
DK/REF
LS01f Have you ever, even once, used ‘Ecstasy’ or ‘Molly’, also known as MDMA?
1
Yes
2
No
DK/REF
LSREF3 [IF LS01f = REF] The answers that people give us about their use of ‘Ecstasy’
or ‘Molly’ are important to this study’s success. We know that this
information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever, even once,
used ‘Ecstasy’ or ‘Molly’, also known as MDMA?
1

Yes

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April 15, 2016

2
No
DK/REF
LS01i Have you ever, even once, used Ketamine, also called “Special K” or “Super
K”?
1
Yes
2
No
DK/REF

LS01j Have you ever, even once, used any of the following:
DMT, also called dimethyltryptamine
AMT, also called alpha-methyltryptamine, or
Foxy, also called 5-MeO-DIPT?

1
Yes
2
No
DK/REF

LS01k Have you ever, even once, used Salvia divinorum?
1
Yes
2
No
DK/REF

LS01h Have you ever, even once, used any other hallucinogens besides the ones that
have been listed?
1
Yes
2
No
DK/REF
LS01hs1 [IF LS01h = 1] Please type in the name of the other hallucinogens you have
used. If you’re not sure how to spell the name of the hallucinogen you used,
just make your best guess.
When you have finished, press the [ENTER] key to go to the next question.
Remember, you do not need to type in the names of any hallucinogens that
you already reported.
________________

121
April 15, 2016

DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN LS01hs1.
LS01hs2 [IF LS01HS1 NE (BLANK OR DK/REF)] Please type in the name of any
other hallucinogen you have used other than those you have already
mentioned. If you have not used any other hallucinogens, press the [ENTER]
key to go to the next question.
________________
DK/REF
LS01hs3 [IF LS01HS2 NE (BLANK OR DK/REF)] Please type in the name of any
other hallucinogen you have used other than those you have already
mentioned. If you have not used any other hallucinogens, press the [ENTER]
key to go to the next question.
________________
DK/REF
LS01hs4 [IF LS01HS3 NE (BLANK OR DK/REF)] Please type in the name of any
other hallucinogen you have used other than those you have already
mentioned. If you have not used any other hallucinogens, press the [ENTER]
key to go to the next question.
________________
DK/REF
LS01hs5 [IF LS01HS4 NE (BLANK OR DK/REF)] Please type in the name of any
other hallucinogen you have used other than those you have already
mentioned. If you have not used any other hallucinogens, press the [ENTER]
key to go to the next question.
________________
DK/REF
DEFINE LSFILL:
IF (LS01a = 1 OR LSREF1 = 1) AND ((LS01b = 2 OR LSREF2 = 2) AND
LS01c = 2 AND LS01d = 2 AND LS01e = 2 AND (LS01f = 2 OR LSREF3 = 2)
AND LS01h = 2 AND LS01i=2 AND LS01j=2 AND LS01k=2), LSFILL =
“LSD”

IF (LS01a = 1 OR LSREF1 = 1) AND ( LS01b NE 1 AND LSREF2 NE 1 AND
LS01c NE 1 AND LS01d NE 1 AND LS01e NE 1 AND LS01f NE 1 AND

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April 15, 2016

LSREF3 NE 1 AND LS01h NE 1 AND LS01i NE 1 AND LS01j NE 1 AND
LS01k NE 1) AND ( (LS01b = DK OR (LS01b = REF AND LSREF2 = DK/REF)
OR LS01c = DK/REF OR LS01d = DK/REF OR LS01e = DK/REF OR LS01f =
DK OR (LS01f = REF AND LSREF3 = DK/REF) OR LS01h = DK/REF OR
LS01i=DK/REF OR LS01j=DK/REF OR LS01k=DK/REF) ) LSFILL = "LSD or
any other hallucinogen"
IF (LS01b = 1 OR LSREF2 = 1) AND ((LS01a = 2 OR LSREF1 = 2) AND
LS01c = 2 AND LS01d = 2 AND LS01e = 2 AND (LS01f = 2 OR LSREF3 = 2)
AND LS01h = 2 AND LS01i=2 AND LS01j=2 AND LS01k=2), LSFILL =
“PCP”

IF (LS01b = 1 OR LSREF2 = 1) AND ( LS01a NE 1 AND LSREF1 NE 1 AND
LS01c NE 1 AND LS01d NE 1 AND LS01e NE 1 AND LS01f NE 1 AND
LSREF3 NE 1 AND LS01h NE 1 AND LS01i NE 1 AND LS01j NE 1 AND
LS01k NE 1) AND ( (LS01a = DK OR (LS01a = REF AND LSREF1 = DK/REF)
OR LS01c = DK/REF OR LS01d = DK/REF OR LS01e = DK/REF OR LS01f =
DK OR (LS01f = REF AND LSREF3 = DK/REF) OR LS01h = DK/REF OR
LS01i=DK/REF OR LS01j=DK/REF OR LS01k=DK/REF) ) LSFILL = "PCP or
any other hallucinogen"

IF (LS01f = 1 OR LSREF3 = 1) AND ((LS01a = 2 OR LSREF1 = 2) AND
(LS01b = 2 OR LSREF2 = 2) AND LS01c = 2 AND LS01d = 2 AND LS01e = 2
AND LS01h = 2 AND LS01i=2 AND LS01j=2 AND LS01k=2), LSFILL =
“‘Ecstasy’ or ‘Molly’”

IF (LS01f = 1 OR LSREF3 = 1) AND (LS01a NE 1 AND LSREF1 NE 1 AND
LS01b NE 1 AND LSREF2 NE 1 AND LS01c NE 1 AND LS01d NE 1 AND
LS01e NE 1 AND LS01h NE 1 AND LS01i NE 1 AND LS01j NE 1 AND LS01k
NE 1) AND ( LS01a=DK OR (LS01a=REF AND LSREF1=DK/REF) OR(LS01b
= DK OR (LS01b = REF AND LSREF2 = DK/REF) OR LS01c = DK/REF OR
LS01d = DK/REF OR LS01e = DK/REF OR LS01h = DK/REF OR
LS01i=DK/REF OR LS01j=DK/REF OR LS01k=DK/REF) ) LSFILL =
"”Ecstasy”, ‘Molly’, or any other hallucinogen"

IF (LS01i = 1) AND ((LS01a = 2 OR LSREF1 = 2) AND (LS01b = 2 OR
LSREF2 = 2) AND LS01c = 2 AND LS01d = 2 AND LS01e = 2 AND (LS01f=2
OR LSREF3=2) AND LS01h = 2 AND LS01j=2 AND LS01k=2), LSFILL =
“Ketamine”

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April 15, 2016

IF (LS01i = 1) AND (LS01a NE 1 AND LSREF1 NE 1 AND LS01b NE 1
AND LSREF2 NE 1 AND LS01c NE 1 AND LS01d NE 1 AND LS01e NE
1 AND LS01f NE 1 AND LSREF3 NE 1 AND LS01h NE 1 AND LS01j NE 1
AND LS01k NE 1) AND ( LS01a=DK OR (LS01a=REF AND
LSREF1=DK/REF) OR(LS01b = DK OR (LS01b = REF AND LSREF2 =
DK/REF) OR LS01c = DK/REF OR LS01d = DK/REF OR LS01e = DK/REF
OR LS01f = DK OR (LS01f = REF AND LSREF3 = DK/REF) OR LS01h =
DK/REF OR LS01j=DK/REF OR LS01k=DK/REF) ) LSFILL = "Ketamine or
any other hallucinogen"

IF (LS01j = 1) AND ((LS01a = 2 OR LSREF1 = 2) AND (LS01b = 2 OR
LSREF2 = 2) AND LS01c = 2 AND LS01d = 2 AND LS01e = 2 AND (LS01f=2
OR LSREF3=2) AND LS01h = 2 AND LS01i=2 AND LS01k=2), LSFILL =
“DMT, AMT, or Foxy”
IF (LS01j = 1) AND (LS01a NE 1 AND LSREF1 NE 1 AND LS01b NE 1
AND LSREF2 NE 1 AND LS01c NE 1 AND LS01d NE 1 AND LS01e NE
1 AND LS01f NE 1 AND LSREF3 NE 1 AND LS01h NE 1 AND LS01i NE 1
AND LS01k NE 1) AND ( LS01a=DK OR (LS01a=REF AND
LSREF1=DK/REF) OR(LS01b = DK OR (LS01b = REF AND LSREF2 =
DK/REF) OR LS01c = DK/REF OR LS01d = DK/REF OR LS01e = DK/REF
OR LS01f = DK OR (LS01f = REF AND LSREF3 = DK/REF) OR LS01h =
DK/REF OR LS01i=DK/REF OR LS01k=DK/REF) ) LSFILL = "DMT, AMT,
Foxy or any other hallucinogen"

IF (LS01k = 1) AND ((LS01a = 2 OR LSREF1 = 2) AND (LS01b = 2 OR
LSREF2 = 2) AND LS01c = 2 AND LS01d = 2 AND LS01e = 2 AND (LS01f=2
OR LSREF3=2) AND LS01h = 2 AND LS01i=2 AND LS01j=2), LSFILL =
“Salvia divinorum”
IF (LS01k = 1) AND (LS01a NE 1 AND LSREF1 NE 1 AND LS01b NE 1
AND LSREF2 NE 1 AND LS01c NE 1 AND LS01d NE 1 AND LS01e NE
1 AND LS01f NE 1 AND LSREF3 NE 1 AND LS01h NE 1 AND LS01i NE 1
AND LS01j NE 1) AND ( LS01a=DK OR (LS01a=REF AND
LSREF1=DK/REF) OR(LS01b = DK OR (LS01b = REF AND LSREF2 =
DK/REF) OR LS01c = DK/REF OR LS01d = DK/REF OR LS01e = DK/REF
OR LS01f = DK OR (LS01f = REF AND LSREF3 = DK/REF) OR LS01h =
DK/REF OR LS01i=DK/REF OR LS01j=DK/REF) ) LSFILL = "Salvia
divinorum or any other hallucinogen"

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April 15, 2016

ELSE, LSFILL = “any hallucinogen”
LS02 [IF ANY IN LS01a TO LS01f =1 OR LS01h = 1 OR LS01i=1 OR LS01j=1 OR
LS01k=1 OR LSREF1 = 1 OR LSREF2 = 1 OR LSREF3 = 1] How old were you
the first time you used [LSFILL]?
AGE:
DK/REF

[RANGE: 1 - 110]

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

[IF LSCC01 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
2

I am currently [CURNTAGE] years old
I was [AGE1STHA] years old the first time I used
[LSFILL]
3
Neither answer is correct
DK/REF
LSCC03

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

[RANGE: 1 - 110]

LSCC03a [IF LSCC03 < 12] Since you have indicated that you are
[LSCC03] years old, we cannot interview you for this study.
Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD
ROUTE TO PENTER1.
LSCC04

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

125
April 15, 2016

AGE:
DK/REF

[RANGE: 1 - 110]

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

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

[RANGE: 1 - 110]

UPDATE: IF LSCC06 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCC06
LS03a [IF LSCC05 NE DK/RE AND LSCC06 NE DK/REF AND AGE1STHA =
CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STHA =
CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first use
[LSFILL] in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LS03b [IF AGE1STHA = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you first use [LSFILL] in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LS03c [IF LSCC05 NE DK/RE AND LSCC06 NE DK/REF AND AGE1STHA =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first use [LSFILL]?
1

January

126
April 15, 2016

2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LS03c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LS03d [IF LS03a = 1 OR 2 OR LS03b = 1 OR 2] In what month in [YEAR FROM
LS03a or LS03b] did you first use [LSFILL]?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LS03d > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STHA:
MYR1STHA = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LS03a-d). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STHA IS
BLANK.

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April 15, 2016

IF MYR1STHA NE 0 AND NE AGE1STHA:
LSCC56 The computer recorded that you first used [LSFILL] in
[LS03a-d fill]. That would make you [MYR1STHA] years old
when you first used [LSFILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCC57

[IF LSCC56 = 4] Earlier, the computer recorded that you were
[AGE1STHA] years old when you first used [LSFILL]. Which
answer is correct?
1

I first used [LSFILL] in [LS03a-d fill] when I was
[MYR1STHA] years old
2
I was [AGE1STHA] years old the first time I used
[LSFILL]
3
Neither answer is correct
DK/REF
UPDATE: IF LSCC57 = 1, THEN AGE1STHA = MYR1STHA
LSCC58

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

LSCC58a [IF LSCC58 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LSCC58] did you first use
[LSFILL]?
1
2
3
4
5
6
7
8
9
10
11

January
February
March
April
May
June
July
August
September
October
November

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April 15, 2016

12
December
DK/REF
HARD ERROR: [IF LSCC58a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LSCC58a NE (0 OR DK/REF) THEN UPDATE MYR1STHA.
MYR1STHA = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LSCC58 AND LSCC58a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STHA IS BLANK.
IF MYR1STHA = AGE1STHA THEN MYR1STHA = BLANK
LSCC59

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

UPDATE: IF LSCC59 NE (6, BLANK OR DK/REF) AND (LSCC58 AND LSCC58a
NE LS03a-d) THEN AGE1STHA = MYR1STHA
LSLAST [IF LS01a = 1 OR LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR LS01c =
1 OR LS01d = 1 OR LS01e = 1 OR LSREF3 = 1 OR LS01f = 1 OR LS01h =
1 OR LS01i=1 OR LS01j=1 OR LS01k=1] How long has it been since you
last used [LSFILL]?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSRECDK [IF LSLAST = DK] What is your best guess of how long it has been since
you last used [LSFILL]?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

129
April 15, 2016

LSRECRE [IF LSLAST = REF] The answers that people give us about their use of
hallucinogens are important to this study’s success. We know that this
information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: How long has it been since
you last used [LSFILL]?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DEFINE HALLREC:
IF LSLAST = 1 OR LSRECDK = 1 OR LSRECRE = 1, THEN HALLREC = 1
IF LSLAST = 2 OR LSRECDK = 2 OR LSRECRE = 2, THEN HALLREC = 2
IF LSLAST = 3 OR LSRECDK = 3 OR LSRECRE = 3, THEN HALLREC = 3
ELSE HALLREC = BLANK
LSFRAME3 [IF HALLREC = 1 OR 2] Now think about the past 12 months, from
[DATEFILL] through today. We want to know how many days you’ve
used [LSFILL] during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve
used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF
LSYRAVE

[IF LSFRAME3 = 3 OR DK/REF] On how many days in the past 12
months did you use [LSFILL]?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

LSMONAVE [IF LSFRAME3 = 2 OR LSYRAVE = DK/REF] On average, how many
days did you use [LSFILL] each month during the past 12 months?
AVERAGE # OF DAYS PER MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

130
April 15, 2016

LSWKAVE [IF LSFRAME3 = 1 OR LSMONAVE = DK/REF] On average, how
many days did you use [LSFILL] each week during the past 12 months?
AVERAGE # OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LS04 [IF LSLAST=1 OR LSRECDK = 1 OR LSRECRE = 1] Think specifically about
the past 30 days, from [DATEFILL] up to and including today. During the past
30 days, on how many days did you use [LSFILL]?
NUMBER OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

LS04DKRE [IF LS04 = DK/REF] What is your best estimate of the number of days
you used [LSFILL] during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE ESTILS:
IF LS04DKRE = 1, THEN ESTILS = 1
IF LS04DKRE = 2, THEN ESTILS = 3
IF LS04DKRE = 3, THEN ESTILS = 6
IFLS04DKRE = 4, THEN ESTILS = 10
IF LS04DKRE =5, THEN ESTILS = 20
IF LS04DKRE = 6, THEN ESTILS = 30
ELSE ESTILS = BLANK
DEFINE HAL30DAY
IF LS04DKRE = 1, THEN HAL30DAY = “1 or 2"
IF LS04DKRE = 2, THEN HAL30DAY = “3 to 5"
IF LS04DKRE = 3, THEN HAL30DAY = “6 to 9"
IF LS04DKRE = 4, THEN HAL30DAY = “10 to 19"
IF LS04DKRE = 5, THEN HAL30DAY = “20 to 29"
IF LS04DKRE = 6, THEN HAL30DAY = “all 30"
ELSE HAL30DAY = BLANK

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April 15, 2016

DEFINE TOTHALL:
IF LSYRAVE NOT(BLANK OR DK/REF) THEN TOTHALL = LSYRAVE
ELSE IF LSMONAVE NOT(BLANK OR DK/REF) THEN TOTHALL =
LSMONAVE*12
ELSE IF LSWKAVE NOT(BLANK OR DK/REF) THEN TOTHALL =
LSWKAVE*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LS04 NE DK/REF OR BLANK AND LS04
> TOTHALL) OR (LS04 = DK/REF AND ESTILS > TOTHALL)):
LSCC07a [IF LS04 > TOTHALL] For the last question, the computer
recorded that you used [LSFILL] on [LS04] of the past 30
days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCC07b [IF ESTILS > TOTHALL] For the last question, the computer
recorded that you used [LSFILL] on [HAL30DAY] of the past
30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE FILLHAL:
IF LSYRAVE > 1, THEN FILLHAL = “[LSYRAVE] days”
ELSE IF LSYRAVE = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONAVE > 1, THEN FILLHAL = “[LSMONAVE] days per
month”
ELSE IF LSMONAVE = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKAVE > 1, THEN FILLHAL = “[LSWKAVE] days per week”
ELSE IF LSWKAVE = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONAVE] day(s) per month OR “[LSWKAVE] day(s) per
week” THEN FILLHALA = “for a total of TOTHALL days”
ELSE FILLHALA = BLANK
LSCC08

[IF LSCC07a = 4 OR LSCC07b = 4] The answers for the last
question and an earlier question disagree. Which answer is
correct?

132
April 15, 2016

1

I used [LSFILL] [FILLHAL] in the past 12 months
[FILLHALA]
2
I used [LSFILL] [LS04 / HAL30DAY] days in the past
30 days
3
Neither answer is correct
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCC09

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

Average number of days per week during the past 12
months
2
Average number of days per month during the past 12
months
3
Total number of days during the past 12 months
DK/REF

LSCC10

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

TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCC11

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

# OF DAYS/MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCC12

[IF LSCC09 = 1] On average, how many days did you use
[LSFILL] each week during the past 12 months?

# OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
IF LSCC10 NOT(BLANK OR DK/REF) THEN TOTHALL = LSCC10

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April 15, 2016

ELSE IF LSCC11 NOT(BLANK OR DK/REF) THEN TOTHALL=LSCC11*12
ELSE IF LSCC12 NOT(BLANK OR DK/REF) THENTOTHALL=LSCC12*52
ELSE TOTHALL = DK/REF
LSCC13a [IF LSCC07a = 6 OR ((LSCC08 = 1 OR LSCC8 = 3) AND
LSCC07a NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30
days, on how many days did you use [LSFILL]?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCC13b [IF LSCC07b = 6 OR ((LSCC08 = 1 OR LSCC08 = 3) AND
LSCC07b NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. What is your best
estimate of the number of days you used [LSFILL] during the
past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
IF LS04 = 0:
LSCC14

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

LSCC16

[IF LSCC14 = 6] Please answer this question again. During
the past 30 days, that is, since [DATEFILL], on how many
days did you use [LSFILL]?
# OF DAYS:
[RANGE: 0 - 30]
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR

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LS05 [IF (LS01a = 1 OR LSREF1 =1) AND (LS01b = 1 OR LSREF2 = 1 OR LS01c =
1 OR LS01d = 1 OR LS01e = 1 OR LSREF3 = 1 OR LS01f = 1 OR LS01h = 1
OR LS01i=1 OR LS01j=1 OR LS01k=1)] Now think only about LSD. How old
were you the first time you used LSD?
AGE:
DK/REF

[RANGE: 1 - 110]

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

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

LSCC19

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

[RANGE: 1 - 110]

LSCC19a [IF LSCC19 < 12] Since you have indicated that you are
[LSCC19] years old, we cannot interview you for this study.
Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD
ROUTE TO PENTER1.
LSCC20

[IF LSCC18 =1 OR LSCC18=3 OR LSCC17=6] Please
answer this question again. Think about the first time you used
LSD. How old were you the first time you used LSD?
AGE:
DK/REF

[RANGE: 1 - 110]

135
April 15, 2016

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

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

[RANGE: 1 - 110]

UPDATE: IF LSCC22 NOT(BLANK OR DK/REF) THEN AGE1STLS = LSCC22
IF AGE1STLS < AGE1STHA:
LSCC23 The answers for the last question and an earlier question
disagree. Which answer is correct?
1

I was [AGE1STHA] years old the first time I used
[LSFILL]
2
I was [AGE1STLS] years old the first time I used LSD
3
Neither answer is correct
DK/REF
LSCC24

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

LSCC25

[RANGE: 1 - 110]

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

[RANGE: 1 - 110]

136
April 15, 2016

UPDATE: IF LSCC24 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCC24
UPDATE: IF LSCC25 NOT(BLANK OR DK/REF) THEN AGE1STLS = LSCC25
LS06 [IF AGE1STLS = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF
AGE1STLS = CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you
first use LSD in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LS07 [IF AGE1STLS = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you first use LSD in [CURRENT YEAR - 2] OR [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LS08 [IF AGE1STLS = CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what
month in [CURRENT YEAR] did you first use LSD?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LS08 > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LS09 [IF LS06 = 1 OR 2 OR LS07 = 1 OR 2] In what month in [YEAR FROM LS06
or LS07] did you first use LSD?
1
2

January
February

137
April 15, 2016

3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LS09 > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STLS:
MYR1STLS = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LS06-09). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STLS IS
BLANK.
IF MYR1STLS NE 0 AND NE AGE1STLS:
LSCC60 The computer recorded that you first used LSD in [LS06-09
fill]. That would make you [MYR1STLS] years old when you
first used LSD. Is this correct?
4
Yes
6
No
DK/REF
LSCC61

[IF LSCC60 = 4] Earlier, the computer recorded that you were
[AGE1STLS] years old when you first used LSD. Which
answer is correct?
1

I first used LSD in [LS06-09 fill] when I was
[MYR1STLS] years old
2
I was [AGE1STLS] years old the first time I used LSD
3
Neither answer is correct
DK/REF
UPDATE: IF LSCC61 = 1, THEN AGE1STLS = MYR1STLS.
LSCC62

[IF LSCC61=2 OR LSCC61=3 OR LSCC60=6] Please answer
this question again. Did you first use LSD in [CURRENT

138
April 15, 2016

YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LSCC62a [IF LSCC62 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LSCC62] did you first use
LSD?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LSCC62a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LSCC62a NE (0 OR DK/REF) THEN UPDATE MYR1STLS.
MYR1STLS = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LSCC62 AND LSCC62a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STLS IS BLANK. IF
MYR1STLS = AGE1STLS THEN MYR1STLS = BLANK
LSCC63

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

139
April 15, 2016

UPDATE: IF LSCC63 NE (6, BLANK OR DK/REF) AND (LSCC62 AND LSCC62a
NE LS06-LS09) THEN AGE1STLS = MYR1STLS
LS10 [IF (LS01a =1 OR LSREF1 = 1) AND (LS01b = 1 OR LSREF2=1 OR LS01c = 1
OR LS01d = 1 OR LS01e = 1 OR LS01f = 1 OR LSREF3 = 1 OR LS01h = 1 OR
LS01i=1 OR LS01j=1 OR LS01k=1] How long has it been since you last used
LSD?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DEFINE LSDREC
IF LS10 NE (BLANK OR DK/REF) THEN LSDREC = LS10
ELSE LSDREC = BLANK
IF LSDREC < HALLREC:
LSCC26 The computer recorded that you last used LSD [LSDREC
FILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCC27

[IF LSCC26 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
I last used [LSFILL] [HALLREC FILL]
2
I last used LSD [LSDREC FILL]
3
Neither answer is correct
DK/REF

LSCC28

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

LSCC29

[IF LSCC26 =6 OR LSCC27 = 1 OR LSCC27 = 3] Please
answer this question again. Think only about LSD. How long
has it been since you last used LSD?

140
April 15, 2016

1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REFPROGRAMMER: SHOW 12 MONTH CALENDAR
UPDATE: IF LSCC28 NOT (BLANK OR DK/REF) THEN HALLREC = LSCC28
UPDATE: IF LSCC29 NOT (BLANK OR DK/REF) THEN LSDREC = LSCC29
DEFINE LSFILL2:
IF HALLREC = 1 OR 2, LSFILL2 = "[LSFILL]"
ELSE IF LSDREC = 1 OR 2, LSFILL2 = "LSD or any other hallucinogen"
LSFRAME4 [IF (HALLREC OR LSDREC = 1 OR 2) AND LSFRAME3 = BLANK]
Now think about the past 12 months, from [DATEFILL] through today.
We want to know how many days you’ve used [LSFILL2] during the past
12 months.
What would be the easiest way for you to tell us how many days you’ve
used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF
LSYRAV2

[IF LSFRAME4 = 3 OR DK/REF] On how many days in the past 12
months did you use [LSFILL2]?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

LSMONAV2 [IF LSFRAME4 = 2 OR LSYRAV2 = DK/REF] On average, how many
days did you use [LSFILL2] each month during the past 12 months?
AVERAGE # OF DAYS PER MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSWKAV2

[IF LSFRAME4 = 1 OR LSMONAV2 = DK/REF] On average, how
many days did you use [LSFILL2] each week during the past 12 months?
AVERAGE # OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

141
April 15, 2016

LS30 [IF HALLREC = 1 OR LSDREC = 1 AND LS04 = BLANK] Think specifically
about the past 30 days, from [DATEFILL] up to and including today. During the
past 30 days, on how many days did you use [LSFILL2]?
NUMBER OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LS30DKRE [IF LS30 = DK/REF] What is your best estimate of the number of days
you used [LSFILL2] during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE ESTILS:
IF LS30DKRE = 1, THEN
IF LS30DKRE = 2, THEN
IF LS30DKRE = 3, THEN
IF LS30DKRE = 4, THEN
IF LS30DKRE = 5, THEN
IF LS30DKRE = 6, THEN
ELSE ESTILS = BLANK

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

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

142
April 15, 2016

IF TOTHALL NOT DK/REF AND ((LS30 NE DK/REF OR BLANK AND LS30
> TOTHALL) OR (LS30 = DK/REF AND ESTILS > TOTHALL)):
LSCC72a [IF LS30 > TOTHALL] For the last question, the computer
recorded that you used [LSFILL2] on [LS30] of the past 30
days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCC72b [IF ESTILS > TOTHALL] For the last question, the computer
recorded that you used [LSFILL2] on [HAL30DAY] of the past
30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE FILLHAL:
IF LSYRAV2 > 1, THEN FILLHAL = “[LSYRAV2] days”
ELSE IF LSYRAV2 = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONAV2 > 1, THEN FILLHAL = “[LSMONAV2] days per month”
ELSE IF LSMONAV2 = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKAV2 > 1, THEN FILLHAL = “[LSWKAV2] days per week”
ELSE IF LSWKAV2 = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONAV2] day(s) per month OR “[LSWKAV2] day(s) per
week” THEN FILLHALA = “for a total of TOTHALL days”
ELSE FILLHALA = BLANK
LSCC73

[IF LSCC72a = 4 OR LSCC72b = 4] The answers for the last
question and an earlier question disagree. Which answer is
correct?
1

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

143
April 15, 2016

LSCC74

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

Average number of days per week during the past 12
months
2
Average number of days per month during the past 12
months
3
Total number of days during the past 12 months
DK/REF
LSCC75

[IF LSCC74 = 3] On how many days in the past 12 months
did you use [LSFILL2]?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REFPROGRAMMER: SHOW 12 MONTH CALENDAR

LSCC76

[IF LSCC74 = 2] On average, how many days did you use
[LSFILL2] each month during the past 12 months?
# OF DAYS/MONTH:
[RANGE: 1 - 31]
DK/REFPROGRAMMER: SHOW 12 MONTH CALENDAR

LSCC77

[IF LSCC74 = 1] On average, how many days did you use
[LSFILL2] each week during the past 12 months?
# OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REFPROGRAMMER: SHOW 12 MONTH CALENDAR

IF LSCC75 NOT (BLANK OR DK/REF) THEN TOTHALL = LSCC75
ELSE IF LSCC76 NOT (BLANK OR DK/REF) THEN TOTHALL=LSCC76*12
ELSE IF LSCC77 NOT (BLANK OR DK/REF) THENTOTHALL=LSCC77*52
ELSE TOTHALL = DK/REF
LSCC78a [IF LSCC72a = 6 OR ((LSCC73 = 1 OR LSCC73 = 3) AND
LSCC72a NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30
days, on how many days did you use [LSFILL2]?
# OF DAYS:
[RANGE: 0 - 30]
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR

144
April 15, 2016

LSCC78b [IF LSCC72b = 6 OR ((LSCC73 = 1 OR LSCC73 = 3) AND
LSCC72b NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. What is your best
estimate of the number of days you used [LSFILL2] during the
past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR
IF LS30 = 0:
LSCC79

The computer recorded that you used [LSFILL2] on 0 days
during the past 30 days. Is this correct?
4
Yes
6
No
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR

LSCC80

[IF LSCC79 = 6] Please answer this question again. During
the past 30 days, that is, since [DATEFILL], on how many
days did you use [LSFILL2]?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

LS11 [IF (LS01b = 1 OR LSREF2 =1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01c =
1 OR LS01d = 1 OR LS01e = 1 OR LSREF3 = 1 OR LS01f = 1 OR LS01h = 1
OR LS01i=1 OR LS01j=1 OR LS01k=1)] Now think only about PCP. How old
were you the first time you used PCP?
AGE:
DK/REF

[RANGE: 1 - 110]

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

145
April 15, 2016

LSCC30

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

LSCC31

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

LSCC32

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

[RANGE: 1 - 110]

LSCC32a [IF LSCC32 < 12] Since you have indicated that you are
[LSCC32] years old, we cannot interview you for this study.
Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD
ROUTE TO PENTER1.
LSCC33

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

[RANGE: 1 - 110]

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

146
April 15, 2016

LSCC35

[IF LSCC34 =6] Please answer this question again. Think
about the first time you used PCP. How old were you the first
time you used PCP?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC35 NOT (BLANK OR DK/REF) THEN AGE1STPC = LSCC35
IF AGE1STPC < AGE1STHA:
LSCC36 The answers for the last question and an earlier question
disagree. Which answer is correct?
1

I was [AGE1STHA] years old the first time I used
[LSFILL]
2
I was [AGE1STPC] years old the first time I used PCP
3
Neither answer is correct
DK/REF
LSCC37

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

LSCC38

[RANGE: 1 - 110]

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

[RANGE: 1 - 110]

UPDATE: IF LSCC37 NOT (BLANK OR DK/REF) THEN AGE1STHA = LSCC37
UPDATE: IF LSCC38 NOT (BLANK OR DK/REF) THEN AGE1STPC = LSCC38
LS12 [IF LSCC34 NE DK/RE AND LSCC35 NE DK/REF AND AGE1STPC =
CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STPC =
CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first use PCP in
[CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

147
April 15, 2016

LS13 [IF AGE1STPC = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you first use PCP in [CURRENT YEAR - 2] OR [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LS14 [IF LSCC34 NE DK/RE AND LSCC35 NE DK/REF AND AGE1STPC =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first use PCP?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LS14 > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LS15 [IF LS12 = 1 OR 2 OR LS13 = 1 OR 2] In what month in [YEAR FROM LS12
or LS13] did you first use PCP?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF

148
April 15, 2016

HARD ERROR: [IF LS15 > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STPC:
MYR1STPC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LS12-15). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STPC IS
BLANK.
IF MYR1STPC NE 0 AND NE AGE1STPC:
LSCC64 The computer recorded that you first used PCP in [LS12-15
fill]. That would make you [MYR1STPC] years old when you
first used PCP. Is this correct?
4
Yes
6
No
DK/REF
LSCC65

[IF LSCC64 = 4] Earlier, the computer recorded that you were
[AGE1STPC] years old when you first used PCP. Which
answer is correct?
1

I first used PCP in [LS12-15 fill] when I was
[MYR1STPC] years old
2
I was [AGE1STPC] years old the first time I used PCP
3
Neither answer is correct
DK/REF
UPDATE: IF LSCC65 = 1, THEN AGE1STPC = MYR1STPC
LSCC66

[IF LSCC65=2 OR LSCC65=3 OR LSCC64=6] Please answer
this question again. Did you first use PCP in [CURRENT
YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LSCC66a [IF LSCC66 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LSCC66] did you first use
PCP?

149
April 15, 2016

1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LSCC66a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LSCC66a NE (0 OR DK/REF) THEN UPDATE MYR1STPC.
MYR1STPC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LSCC66 AND LSCC66a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STPC IS BLANK.
IF MYR1STPC = AGE1STPC THEN MYR1STPC = BLANK
LSCC67

[IF LSCC65 NE 1 AND MYR1STPC NE 0 AND (LSCC66 AND
LSCC66 NE LS12-LS15)] The computer recorded that you first
used PCP in [LSCC66-LSCC66a fill]. That would make you
[MYR1STPC] years old when you first used PCP. Is this
correct?
4
Yes
6
No
DK/REF

UPDATE: IF LSCC67 NE (6, BLANK OR DK/REF) AND (LSCC66 AND LSCC66
NE LS12-LS15) THEN AGE1STPC = MYR1STPC
LS16 [IF (LS01b = 1 OR LSREF2 = 1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01c =
1 OR LS01d = 1 OR LS01e = 1 OR LS01f = 1 OR LSREF3 = 1 OR LS01h = 1
OR LS01i=1 OR LS01j=1 OR LS01k=1)] How long has it been since you last
used PCP?
1
2
3

Within the past 30 days – that is, since [DATEFILL]
More than 30 days ago but within the past 12 months
More than 12 months ago

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DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DEFINE PCPREC:
IF LS16 NE (BLANK OR DK/REF) THEN PCPREC = LS16
ELSE PCPREC = BLANK
IF PCPREC < HALLREC:
LSCC39 The computer recorded that you last used PCP [PCPREC
FILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCC40

[IF LSCC39 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
I last used [LSFILL] [HALLREC FILL]
2
I last used PCP [PCPREC FILL]
3
Neither answer is correct
DK/REF

LSCC41

[IF LSCC40 = 2 OR LSCC40 = 3] Please answer this question
again. How long has it been since you last used [LSFILL]?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REFPROGRAMMER: SHOW 12 MONTH CALENDAR

LSCC42

[IF LSCC39 =6 OR LSCC40 = 1 OR LSCC40 = 3] Please
answer this question again. Think only about PCP. How long
has it been since you last used PCP?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REFPROGRAMMER: SHOW 12 MONTH CALENDAR

UPDATE: IF LSCC41 NOT (BLANK OR DK/REF), THEN HALLREC = LSCC41
UPDATE: IF LSCC42 NOT (BLANK OR DK/REF), THEN PCPREC = LSCC42
DEFINE LSFILL3:
IF HALLREC = 1 OR 2 OR LSDREC = 1 OR 2, LSFILL3 = "[LSFILL]"

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ELSE IF PCPREC = 1 OR 2, LSFILL3 = "PCP or any other hallucinogen"
LSFRAME5 [IF (HALLREC OR PCPREC = 1 OR 2) AND LSFRAME3 = BLANK
AND LSFRAME4 = BLANK] Now think about the past 12 months, from
[DATEFILL] through today. We want to know how many days you’ve
used [LSFILL3] during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve
used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF
LSYRAV3

[IF LSFRAME5 = 3 OR DK/REF] On how many days in the past 12
months did you use [LSFILL3]?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

LSMONAV3 [IF LSFRAME5 = 2 OR LSYRAV3 = DK/REF] On average, how many
days did you use [LSFILL3] each month during the past 12 months?
AVERAGE # OF DAYS PER MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSWKAV3

[IF LSFRAME5 = 1 OR LSMONAV3 = DK/REF] On average, how
many days did you use [LSFILL3] each week during the past 12 months?
AVERAGE # OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

LS31 [IF HALLREC = 1 OR PCPREC = 1 AND LS04 = BLANK AND LS30 =
BLANK] Think specifically about the past 30 days, from [DATEFILL] up to and
including today. During the past 30 days, on how many days did you use
[LSFILL3]?
NUMBER OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LS31DKRE [IF LS31 = DK/REF] What is your best estimate of the number of days

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April 15, 2016

you used [LSFILL3] during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE ESTILS:
IF LS31DKRE = 1, THEN
IF LS31DKRE = 2, THEN
IF LS31DKRE = 3, THEN
IF LS31DKRE = 4, THEN
IF LS31DKRE = 5, THEN
IF LS31DKRE = 6, THEN
ELSE ESTILS = BLANK

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

DEFINE HAL30DAY
IF LS31DKRE = 1, THEN HAL30DAY = “1 or 2"
IF LS31DKRE = 2, THEN HAL30DAY = “3 to 5"
IF LS31DKRE = 3, THEN HAL30DAY = “6 to 9"
IF LS31DKRE = 4, THEN HAL30DAY = “10 to 19"
IF LS31DKRE = 5, THEN HAL30DAY = “20 to 29"
IF LS31DKRE = 6, THEN HAL30DAY = “all 30"
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRAV3 NOT (BLANK OR DK/REF) THEN TOTHALL = LSYRAV3
ELSE IF LSMONAV3 NOT (BLANK OR DK/REF) THEN TOTHALL =
LSMONAV3*12
ELSE IF LSWKAV3 NOT (BLANK OR DK/REF) THEN TOTHALL =
LSWKAV3*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LS31 NE DK/REF OR BLANK AND LS31
> TOTHALL) OR (LS31 = DK/REF AND ESTILS > TOTHALL)):
LSCC81a [IF LS31 > TOTHALL] For the last question, the computer
recorded that you used [LSFILL3] on [LS31] of the past 30
days. Is this correct?
4
6

Yes
No

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April 15, 2016

DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCC81b [IF ESTILS > TOTHALL] For the last question, the computer
recorded that you used [LSFILL3] on [HAL30DAY] of the past
30 days. Is this correct?
4
Yes6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE FILLHAL:
IF LSYRAV3 > 1, THEN FILLHAL = “[LSYRAV3] days”
ELSE IF LSYRAV3 = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONAV3 > 1, THEN FILLHAL = “[LSMONAV3] days per month”
ELSE IF LSMONAV3 = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKAV3 > 1, THEN FILLHAL = “[LSWKAV3] days per week”
ELSE IF LSWKAV3 = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONAV3] day(s) per month OR “[LSWKAV3] day(s) per
week” THEN FILLHALA = “for a total of TOTHALL days”
ELSE FILLHALA = BLANK
LSCC82

[IF LSCC81a = 4 OR LSCC81b = 4] The answers for the last
question and an earlier question disagree. Which answer is
correct?
1

I used [LSFILL3] [FILLHAL] in the past 12 months
[FILLHALA]
2
I used [LSFILL3] [LS31 / HAL30DAY] days in the past
30 days
3
Neither answer is correct
DK/REF
LSCC83

[IF LSCC82 = 2 OR LSCC82 = 3] Please answer this question
again. Think about the past 12 months, from [DATEFILL]
through today. We want to know how many days you’ve used
[LSFILL3] during the past 12 months.
What would be the easiest way for you to tell us how many
days you’ve used it?
1
2

Average number of days per week during the past 12
months
Average number of days per month during the past 12

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April 15, 2016

months
3
Total number of days during the past 12 months
DK/REF
LSCC84

[IF LSC83 = 3] On how many days in the past 12 months did
you use [LSFILL3]?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REFPROGRAMMER: SHOW 12 MONTH CALENDAR

LSCC85

[IF LSCC83 = 2] On average, how many days did you use
[LSFILL3] each month during the past 12 months?
# OF DAYS/MONTH:
[RANGE: 1 - 31]
DK/REFPROGRAMMER: SHOW 12 MONTH CALENDAR

LSCC86

[IF LSCC83 = 1] On average, how many days did you use
[LSFILL3] each week during the past 12 months?
# OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REFPROGRAMMER: SHOW 12 MONTH CALENDAR

IF LSCC84 NOT(BLANK OR DK/REF) THEN TOTHALL = LSCC84
ELSE IF LSCC85 NOT(BLANK OR DK/REF) THEN TOTHALL=LSCC85*12
ELSE IF LSCC86 NOT(BLANK OR DK/REF) THEN TOTHALL=LSCC86*52
ELSE TOTHALL = DK/REF
LSCC87a [IF LSCC81a = 6 OR ((LSCC82 = 1 OR LSCC82 = 3) AND
LSCC81a NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30
days, on how many days did you use [LSFILL3]?
# OF DAYS:
[RANGE: 0 - 30]
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR
LSCC87b [IF LSCC81b = 6 OR ((LSCC82 = 1 OR LSCC82 = 3) AND
LSCC81b NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. What is your best
estimate of the number of days you used [LSFILL3] during the
past 30 days?
1
2
3

1 or 2 days
3 to 5 days
6 to 9 days

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April 15, 2016

4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR
IF LS31 = 0:
LSCC88

The computer recorded that you used [LSFILL3] on 0 days
during the past 30 days. Is this correct?
4
Yes
6
No
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR

LSCC89

[IF LSCC88 = 6] Please answer this question again. During
the past 30 days, that is, since [DATEFILL], on how many
days did you use [LSFILL3]?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

LS17 [IF (LS01f = 1 OR LSREF3 =1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01b =
1 OR LSREF2 = 1 OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR LS01h = 1
OR LS01i=1 OR LS01j=1 OR LK01k=1)] Now think only about ‘Ecstasy’ or
‘Molly’. How old were you the first time you used ‘Ecstasy’ or ‘Molly’, also
known as MDMA?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STEC
IF LS17 NE (BLANK OR DK/REF) THEN AGE1STEC = LS17
ELSE AGE1STEC = BLANK
IF CURNTAGE < AGE1STEC:
LSCC43 The computer recorded that you were [AGE1STEC] years old
when you first used ‘Ecstasy’ or ‘Molly’. Is this correct?
4
Yes
6
No
DK/REF
LSCC44

[IF LSCC43 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1

I am currently [CURNTAGE] years old

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April 15, 2016

2

I was [AGE1STEC] years old the first time I used
‘Ecstasy’ or ‘Molly’
3
Neither answer is correct
DK/REF

LSCC45

[IF LSCC44=2 OR LSCC44=3] Please answer this question
again. What is your current age?
AGE:
DK/REF

[RANGE: 1 - 110]

LSCC45a [IF LSCC45 < 12] Since you have indicated that you are
[LSCC45] years old, we cannot interview you for this study.
Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD
ROUTE TO PENTER1.
LSCC46

[IF LSCC43 =6 OR LSCC44=1 OR LSCC44=3] Please
answer this question again. Think about the first time you used
‘Ecstasy’ or ‘Molly’. How old were you the first time you used
‘Ecstasy’ or ‘Molly’, also known as MDMA?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC46 NOT(BLANK OR DK/REF) THEN AGE1STEC = LSCC46
UPDATE: IF LSCC45 NOT(BLANK OR DK/REF) THEN CURNTAGE = LSCC45
IF AGE1STEC =CURNTAGE OR AGE1STEC <10:
LSCC47 The computer recorded that you were [AGE1STEC] years old
the first time you used ‘Ecstasy’ or ‘Molly’. Is this correct?
4
Yes
6
No
DK/REF
LSCC48

[IF LSCC47 =6] Please answer this question again. Think
about the first time you used ‘Ecstasy’ or ‘Molly’. How old
were you the first time you used ‘Ecstasy’ or ‘Molly’, also
known as MDMA?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC48 NOT(BLANK OR DK/REF) THEN AGE1STEC = LSCC48

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April 15, 2016

IF AGE1STEC < AGE1STHA:
LSCC49 The answers for the last question and an earlier question
disagree. Which answer is correct?
1

I was [AGE1STHA] years old the first time I used
[LSFILL]
2
I was [AGE1STEC] years old the first time I used
‘Ecstasy’ or ‘Molly’
3
Neither answer is correct
DK/REF
LSCC50

[IF LSCC49 =2 OR LSCC49 =3] Please answer this question
again. Think about the first time you used [LSFILL]. How old
were you the first time you used [LSFILL]?
AGE:
DK/REF

LSCC51

[RANGE: 1 - 110]

[IF LSCC49 = 1 OR LSCC49 = 3] Please answer this question
again. Think about the first time you used ‘Ecstasy’ or
‘Molly’. How old were you the first time you used ‘Ecstasy’ or
‘Molly’, also known as MDMA?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF LSCC50 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCC50
UPDATE: IF LSCC51 NOT (BLANK OR DK/REF) THEN AGE1STEC = LSCC51
LS18 [IF LSCC47 NE DK/RE AND LSCC48 NE DK/REF AND AGE1STEC =
CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STEC =
CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first use
‘Ecstasy’ or ‘Molly’ in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LS19 [IF AGE1STEC = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you first use ‘Ecstasy’ or ‘Molly’ in [CURRENT YEAR - 2] or [CURRENT
YEAR - 1]?
1
2

CURRENT YEAR - 2
CURRENT YEAR - 1

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April 15, 2016

DK/REF
LS20 [IF LSCC47 NE DK/RE AND LSCC48 NE DK/REF AND AGE1STEC =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first use ‘Ecstasy’ or ‘Molly’?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LS20 > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LS21 [IF LS18 = 1 OR 2 OR LS19 = 1 OR 2] In what month in [YEAR FROM LS18
or LS19] did you first use ‘Ecstasy’ or ‘Molly’?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LS21 > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.

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April 15, 2016

DEFINE MYR1STEC:
MYR1STEC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LS12-15). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STEC IS
BLANK.
IF MYR1STEC NE 0 AND NE AGE1STEC:
LSCC68 The computer recorded that you first used ‘Ecstasy’ or ‘Molly’
in [LS18-21 fill]. That would make you [MYR1STEC] years
old when you first used ‘Ecstasy’ or ‘Molly’. Is this correct?
4
Yes
6
No
DK/REF
LSCC69

[IF LSCC68 = 4] Earlier, the computer recorded that you were
[AGE1STEC] years old when you first used ‘Ecstasy’ or
‘Molly’. Which answer is correct?
1

I first used ‘Ecstasy’ or ‘Molly’ in [LS18-21 fill] when I
was [MYR1STEC] years old
2
I was [AGE1STEC] years old the first time I used
‘Ecstasy’ or ‘Molly’
3
Neither answer is correct
DK/REF
UPDATE: IF LSCC69 = 1, THEN AGE1STEC = MYR1STEC.
LSCC70

[IF LSCC69=2 OR LSCC69=3 OR LSCC68=6] Please answer
this question again. Did you first use ‘Ecstasy’ or ‘Molly’ in
[CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LSCC70a [IF LSCC70 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LSCC70] did you first use
‘Ecstasy’ or ‘Molly’?
1
2
3

January
February
March

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April 15, 2016

4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LSCC70a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LSCC70a NE (0 OR DK/REF) THEN UPDATE MYR1STEC.
MYR1STDC = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LSCC70 AND LSCC70a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STEC IS BLANK.
IF MYR1STEC = AGE1STEC THEN MYR1STEC = BLANK
LSCC71

[IF LSCC69 NE 1 AND MYR1STEC NE 0 AND (LSCC70 AND
LSCC70a NE LS18-LS21)] The computer recorded that you
first used ‘Ecstasy’ or ‘Molly’ in [LSCC70-LSCC70a fill].
That would make you [MYR1STEC] years old when you first
used ‘Ecstasy’ or ‘Molly’. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LSCC71 NE (6, BLANK OR DK/REF) AND (LSCC70 AND LSCC70a
NE LS18-LS21) THEN AGE1STEC = MYR1STEC
LS22 [IF (LS01f = 1 OR LSREF3 = 1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01b =
1 OR LSREF2 = 1 OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR LS01h = 1
OR LS01i=1 OR LS01j=1 OR LS01k=1)] How long has it been since you last
used ‘Ecstasy’ or ‘Molly’, also known as MDMA?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

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April 15, 2016

DEFINE ECSTREC:
IF LS22 NE (BLANK OR DK/REF) THEN ECSTREC = LS22
ELSE ECSTREC = BLANK
IF ECSTREC < HALLREC:
LSCC52 The computer recorded that you last used ‘Ecstasy’ or ‘Molly’
[ECSTREC FILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCC53

[IF LSCC52 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
I last used [LSFILL] [HALLREC FILL]
2
I last used ‘Ecstasy’ or ‘Molly’ [ECSTREC FILL]
3
Neither answer is correct
DK/REF

LSCC54

[IF LSCC53 = 2 OR LSCC53 = 3] Please answer this question
again. How long has it been since you last used [LSFILL]?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

LSCC55

[IF LSCC52 =6 OR LSCC54 = 1 OR LSCC54 = 3] Please
answer this question again. Think only about ‘Ecstasy’ or
‘Molly’. How long has it been since you last used ‘Ecstasy’ or
‘Molly’, also known as MDMA?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REFPROGRAMMER: SHOW 12 MONTH CALENDAR

UPDATE: IF LSCC54 NOT (BLANK OR DK/REF), THEN HALLREC = LSCC54
UPDATE: IF LSCC55 NOT (BLANK OR DK/REF), THEN ECSTREC = LSCC55
DEFINE LSFILL4:
IF HALLREC OR LSDREC OR PCPREC = 1 OR 2, LSFILL4 = "[LSFILL]"

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April 15, 2016

ELSE IF ECSTREC = 1 OR 2, LSFILL4 = "’Ecstasy’ or ‘Molly’’’ or any other
hallucinogen"
LSFRAME6 [IF (HALLREC OR ECSTREC = 1 OR 2) AND LSFRAME3 = BLANK
AND LSFRAME4 = BLANK AND LSFRAME5 = BLANK] Now think
about the past 12 months, from [DATEFILL] through today. We want to
know how many days you’ve used [LSFILL4] during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve
used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF
LSYRAV4

[IF LSFRAME6 = 3 OR DK/REF] On how many days in the past 12
months did you use [LSFILL4]?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

LSMONAV4 [IF LSFRAME6 = 2 OR LSYRAV4 = DK/REF] On average, how many
days did you use [LSFILL4] each month during the past 12 months?
AVERAGE # OF DAYS PER MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSWKAV4

[IF LSFRAME6 = 1 OR LSMONAV4 = DK/REF] On average, how
many days did you use [LSFILL4] each week during the past 12 months?
AVERAGE # OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

LS32 [IF HALLREC = 1 OR ECSTREC = 1 AND LS04 = BLANK AND LS30 =
BLANK AND LS31 = BLANK] Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30 days, on how many
days did you use [LSFILL4]?
NUMBER OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

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April 15, 2016

LS32DKRE [IF LS32 = DK/REF] What is your best estimate of the number of days
you used [LSFILL4] during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DEFINE ESTILS:
IF LS32DKRE = 1, THEN
IF LS32DKRE = 2, THEN
IF LS32DKRE = 3, THEN
IF LS32DKRE = 4, THEN
IF LS32DKRE = 5, THEN
IF LS32DKRE = 6, THEN
ELSE ESTILS = BLANK

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

DEFINE HAL30DAY
IF LS32DKRE = 1, THEN HAL30DAY = “1 or 2"
IF LS32DKRE = 2, THEN HAL30DAY = “3 to 5"
IF LS32DKRE = 3, THEN HAL30DAY = “6 to 9"
IF LS32DKRE = 4, THEN HAL30DAY = “10 to 19"
IF LS32DKRE = 5, THEN HAL30DAY = “20 to 29"
IF LS32DKRE = 6, THEN HAL30DAY = “all 30"
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRAV4 NOT(BLANK OR DK/REF) THEN TOTHALL = LSYRAV4
ELSE IF LSMONAV4 NOT(BLANK OR DK/REF) THEN TOTHALL =
LSMONAV4*12
ELSE IF LSWKAV4 NOT(BLANK OR DK/REF) THEN TOTHALL =
LSWKAV4*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LS32 NE DK/REF OR BLANK AND LS32
> TOTHALL) OR (LS32 = DK/REF AND ESTILS > TOTHALL)):
LSCC90a [IF LS32 > TOTHALL] For the last question, the computer
recorded that you used [LSFILL4] on [LS32] of the past 30
days. Is this correct?
4

Yes

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April 15, 2016

6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCC90b [IF ESTILS > TOTHALL] For the last question, the computer
recorded that you used [LSFILL4] on [HAL30DAY] of the past
30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE FILLHAL:
IF LSYRAV4 > 1, THEN FILLHAL = “[LSYRAV4] days”
ELSE IF LSYRAV4 = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONAV4 > 1, THEN FILLHAL = “[LSMONAV4] days per month”
ELSE IF LSMONAV4 = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKAV4 > 1, THEN FILLHAL = “[LSWKAV4] days per week”
ELSE IF LSWKAV4 = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONAV4] day(s) per month OR “[LSWKAV4] day(s) per
week” THEN FILLHALA = “for a total of TOTHALL days”
ELSE FILLHALA = BLANK
LSCC91

[IF LSCC90a = 4 OR LSCC90b = 4] The answers for the last
question and an earlier question disagree. Which answer is
correct?
1

I used [LSFILL4] [FILLHAL] in the past 12 months
[FILLHALA]
2
I used [LSFILL4] [LS32 / HAL30DAY] days in the past
30 days
3
Neither answer is correct
DK/REF
LSCC92

[IF LSCC91 = 2 OR LSCC91 = 3] Please answer this question
again. Think about the past 12 months, from [DATEFILL]
through today. We want to know how many days you’ve used
[LSFILL4] during the past 12 months.
What would be the easiest way for you to tell us how many
days you’ve used it?
1

Average number of days per week during the past 12

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months
2
Average number of days per month during the past 12
months
3
Total number of days during the past 12 months
DK/REF
LSCC93

[IF LSCC92 = 3] On how many days in the past 12 months
did you use [LSFILL4]?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
PROGRAMMER: SHOW 12 MONTH CALENDAR

DK/REF
LSCC94

[IF LSCC92 = 2] On average, how many days did you use
[LSFILL4] each month during the past 12 months?

# OF DAYS/MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCC95

[IF LSCC92 = 1] On average, how many days did you use
[LSFILL4] each week during the past 12 months?

# OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
IF LSCC93 NOT(BLANK OR DK/REF) THEN TOTHALL = LSCC93
ELSE IF LSCC94 NOT(BLANK OR DK/REF) THEN TOTHALL=LSCC94*12
ELSE IF LSCC95 NOT(BLANK OR DK/REF) THENTOTHALL=LSCC95*52
ELSE TOTHALL = DK/REF
LSCC96a [IF LSCC90a = 6 OR ((LSCC91 = 1 OR LSCC91 = 3) AND
LSCC90a NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. During the past 30
days, on how many days did you use [LSFILL4]?
# OF DAYS:
[RANGE: 0 - 30]
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR
LSCC96b [IF LSCC90b = 6 OR ((LSCC91 = 1 OR LSCC91 = 3) AND
LSCC90b NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL] up to and including today. What is your best
estimate of the number of days you used [LSFILL4] during the
past 30 days?

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1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR
IF LS32 = 0:
LSCC97

The computer recorded that you used [LSFILL4] on 0 days
during the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

LSCC98

[IF LSCC97 = 6] Please answer this question again. During
the past 30 days, that is, since [DATEFILL], on how many
days did you use [LSFILL4]?
# OF DAYS:
[RANGE: 0 - 30]
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR

LS33 [IF (LS01i =1) AND (LS01a=1 OR LSREF1=1) OR (LS01b = 1 OR LSREF2=1)
OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR (LS01f = 1 OR LSREF3 = 1)
OR LS01h = 1 OR LS01j=1 OR LS01k=1] How long has it been since you last
used Ketamine?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DEFINE KETREC:
IF LS33 NE (BLANK OR DK/REF) THEN KETREC = LS33
ELSE KETREC = BLANK
IF KETREC < HALLREC:
LSCC99 The computer recorded that you last used Ketamine [KETREC
FILL]. Is this correct?
4
6

Yes
No

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April 15, 2016

DK/REF
LSCC100 [IF LSCC99 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
I last used [LSFILL] [HALLREC FILL]
2
I last used Ketamine [KETREC FILL]
3
Neither answer is correct
DK/REF
LSCC101 [IF LSCC100 = 2 OR LSCC100 = 3] Please answer this
question again. How long has it been since you last used
[LSFILL]?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCC102 [IF LSCC99 =6 OR LSCC100 = 1 OR LSCC100 = 3] Please
answer this question again. Think only about Ketamine. How
long has it been since you last used Ketamine?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
UPDATE: IF LSCC101 NOT (BLANK OR DK/REF), THEN HALLREC = LSCC101
UPDATE: IF LSCC102 NOT (BLANK OR DK/REF), THEN KETREC = LSCC102

LS34 [IF (LS01j =1) AND (LS01a=1 OR LSREF1=1) OR (LS01b = 1 OR LSREF2=1)
OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR (LS01f = 1 OR LSREF3 = 1)
OR LS01h = 1 OR LS01i=1 OR LS01k=1]How long has it been since you last
used DMT, AMT, or Foxy?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

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April 15, 2016

DEFINE DMTREC:
IF LS34 NE (BLANK OR DK/REF) THEN DMTREC = LS34
ELSE DMTREC = BLANK
IF DMTREC < HALLREC:
LSCC103 The computer recorded that you last used DMT, AMT or Foxy
[DMTREC FILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCC104 [IF LSCC103 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
I last used [LSFILL] [HALLREC FILL]
2
I last used DMT, AMT or Foxy [DMTREC FILL]
3
Neither answer is correct
DK/REF
LSCC105 [IF LSCC104 = 2 OR LSCC104 = 3] Please answer this
question again. How long has it been since you last used
[LSFILL]?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCC106 [IF LSCC103 =6 OR LSCC105 = 1 OR LSCC105 = 3] Please
answer this question again. Think only about DMT, AMT, or
Foxy. How long has it been since you last used DMT, AMT, or
Foxy?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
UPDATE: IF LSCC105 NOT (BLANK OR DK/REF), THEN HALLREC = LSCC105
UPDATE: IF LSCC106 NOT (BLANK OR DK/REF), THEN DMTREC = LSCC106

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April 15, 2016

LS35 [IF (LS01k =1) AND (LS01a=1 OR LSREF1=1) OR (LS01b = 1 OR LSREF2=1)
OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR (LS01f = 1 OR LSREF3 = 1)
OR LS01h = 1 OR LS01i=1 OR LS01j=1]How long has it been since you last
used Salvia divinorum?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DEFINE SLVREC:
IF LS35 NE (BLANK OR DK/REF) THEN SLVREC = LS35
ELSE SLVREC = BLANK
IF SLVREC < HALLREC:
LSCC107 The computer recorded that you last used Salvia divinorum
[SLVREC FILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCC108 [IF LSCC107 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
I last used [LSFILL] [HALLREC FILL]
2
I last used Salvia divinorum [SLVREC FILL]
3
Neither answer is correct
DK/REF
LSCC109 [IF LSCC108 = 2 OR LSCC108 = 3] Please answer this
question again. How long has it been since you last used
[LSFILL]?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCC110 [IF LSCC107 =6 OR LSCC109 = 1 OR LSCC109 = 3] Please
answer this question again. Think only about Salvia
divinorum. How long has it been since you last used Salvia
divinorum?

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April 15, 2016

1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
UPDATE: IF LSCC109 NOT (BLANK OR DK/REF), THEN HALLREC = LSCC109
UPDATE: IF LSCC110 NOT (BLANK OR DK/REF), THEN SLVREC = LSCC110

171
April 15, 2016

172
April 15, 2016

Inhalants
INHINTRO These next questions are about liquids, sprays, and gases that people sniff
or inhale to get high or to make them feel good.
We are not interested in times when you inhaled a substance accidentally
— such as when painting, cleaning an oven, or filling a car with gasoline.
The questions use the word ‘inhalant’ to include all the things listed
below, as well as any other substances that people sniff or inhale for kicks
or to get high. Take a moment to look at the substances listed below so
you know what kinds of liquids, sprays, and gases these questions are
about.
Amyl nitrite, ‘poppers,’ locker room odorizers, or ‘rush’
Correction fluid, degreaser, or cleaning fluid
Gasoline or lighter fluid
Glue, shoe polish, or toluene
Halothane, ether, or other anesthetics
Lacquer thinner, or other paint solvents
Lighter gases, such as butane or propane
Nitrous oxide or ‘whippits’
Felt-tip pens, felt-tip markers, or magic markers
Spray paints
Computer keyboard cleaner, also known as air duster
Other aerosol sprays
Press [ENTER] to continue.
IN01a Have you ever, even once, inhaled amyl nitrite, ‘poppers,’ locker room
odorizers, or ‘rush’ for kicks or to get high?
1
Yes
2
No
DK/REF
IN01b Have you ever, even once, inhaled correction fluid, degreaser, or cleaning fluid
for kicks or to get high?
1
Yes
2
No
DK/REF
IN01c Have you ever, even once, inhaled gasoline or lighter fluid for kicks or to get
high?
1

Yes

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April 15, 2016

2
No
DK/REF
IN01d Have you ever, even once, inhaled glue, shoe polish, or toluene for kicks or to
get high?
1
Yes
2
No
DK/REF
IN01e Have you ever, even once, inhaled halothane, ether, or other anesthetics for
kicks or to get high?
1
Yes
2
No
DK/REF
IN01f Have you ever, even once, inhaled lacquer thinner or other paint solvents for
kicks or to get high?
1
Yes
2
No
DK/REF
IN01g Have you ever, even once, inhaled lighter gases, such as butane or propane for
kicks or to get high?
1
Yes
2
No
DK/REF
IN01h Have you ever, even once, inhaled nitrous oxide or ‘whippits’ for kicks or to get
high?
1
Yes
2
No
DK/REF
IN01h1
Have you ever, even once, inhaled felt-tip pens, felt-tip markers, or
magic markers for kicks or to get high?
1
Yes
2
No
DK/REF
IN01i Have you ever, even once, inhaled spray paints for kicks or to get high?

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April 15, 2016

1
Yes
2
No
DK/REF

IN01ii Have you ever, even once, inhaled computer keyboard cleaner, also known as
air duster, for kicks or to get high?
1
Yes
2
No
DK/REF

IN01j Have you ever, even once, inhaled some other aerosol spray for kicks or to get
high?
1
Yes
2
No
DK/REF
IN01l Have you ever, even once, used any other inhalants for kicks or to get high
besides the ones that have been listed?
1
Yes
2
No
DK/REF

IN01OTH1

[IF IN01l = 1] Please type in the name of one of the other inhalants you
have used. If you’re not sure how to spell the name of the inhalant you
used, just make your best guess.
When you have finished, press the [ENTER] key to go to the next
question. Remember, you do not need to type in the names of any
inhalants that you already reported.

______________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN IN01OTH1.
IN01OTH2

[IF IN01l = 1 AND IN01OTH1 NE DK/REF] Please type in the name of
any other inhalant you have used. If you have not used any other
inhalants, press [ENTER].

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April 15, 2016

______________
DK/REF
IN01OTH3

[IF IN01OTH2 NE (BLANK OR DK/REF)] Please type in the name of
any other inhalant you have used. If you have not used any other
inhalants, press [ENTER].
______________
DK/REF

IN01OTH4

[IF IN01OTH3 NE (BLANK OR DK/REF)] Please type in the name of
any other inhalant you have used. If you have not used any other
inhalants, press [ENTER].
______________
DK/REF

IN01OTH5

[IF IN01OTH4 NE (BLANK OR DK/REF)] Please type in the name of
any other inhalant you have used. If you have not used any other
inhalants, press [ENTER].
______________
DK/REF

INREF
[IF IN01a = REF AND IN01b = REF AND IN01c = REF AND IN01d =
REF AND IN01e = REF AND IN01f = REF AND IN01g = REF AND IN01h =
REF AND IN01h1 = REF AND IN01i = REF AND IN01ii = REF AND IN01j =
REF AND IN01l = REF] The answers people give about their use of inhalants
are important to this study’s success. We know that this information is personal,
but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever, even once, used
any type of inhalant for kicks or to get high?
1
Yes
2
No
DK/REF

IN02 [IF IN01a = 1 OR IN01b = 1 OR IN01c = 1 OR IN01d = 1 OR IN01e = 1 OR
IN01f = 1 OR IN01g = 1 OR IN01h = 1 OR IN01h1=1 OR IN01i = 1 OR IN01ii
= 1 OR IN01j = 1 OR IN01l = 1 OR INREF = 1] How old were you the first
time you used any inhalant for kicks or to get high?
AGE:

[RANGE: 1 - 110]

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April 15, 2016

DK/REF
DEFINE AGE1STIN:
IF IN02 NE (BLANK OR DK/REF) THEN AGE1STIN = IN02
ELSE AGE1STIN = BLANK
IF CURNTAGE < AGE1STIN:
INCC01 The computer recorded that you were [AGE1STIN] years old
when you first used an inhalant of any kind for kicks or to get
high. Is this correct?
4
Yes
6
No
DK/REF
INCC02

[IF INCC01 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
2

I am currently [CURNTAGE] years old
I was [AGE1STIN] years old the first time I used an
inhalant of any kind for kicks or to get high
3
Neither answer is correct
DK/REF

INCC03

[IF INCC02=2 OR INCC02=3] Please answer this question
again. What is your current age?
AGE:
DK/REF

[RANGE: 1 - 110]

INCC03a [IF INCC03 < 12] Since you have indicated that you are
[INCC03] years old, we cannot interview you for this study.
Please tell your interviewer that you have finished the survey.
Thank you for your cooperation. PROGRAM SHOULD
ROUTE TO PENTER1.
INCC04

[IF INCC02=1 OR INCC02=3 OR INCC01=6] Please answer
this question again. Think about the first time you used an
inhalant of any kind for kicks or to get high. How old were you
the first time you used an inhalant for kicks or to get high?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF INCC04 NOT(BLANK OR DK/REF) THEN AGE1STIN = INCC04

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April 15, 2016

UPDATE: IF INCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = INCC03
IF AGE1STIN = CURNTAGE OR AGE1STIN < 10:
INCC05 The computer recorded that you were [AGE1STIN] years old
the first time you used an inhalant of any kind for kicks or to
get high. Is this correct?
4
Yes
6
No
DK/REF
INCC06

[IF INCC05=6] Please answer this question again. Think
about the first time you used an inhalant of any kind for kicks
or to get high. How old were you the first time you used an
inhalant of any kind for kicks or to get high?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF IINCC06 NOT(BLANK OR DK/REF) THEN AGE1STIN = INCC06
IN03a [IF INCC05 NE DK/RE AND INCC06 NE DK/REF AND AGE1STIN =
CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STIN =
CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first use an
inhalant of any kind for kicks or to get high in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
IN03b [IF AGE1STIN = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you first use an inhalant of any kind for kicks or to get high in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
IN03c [IF INCC05 NE DK/RE AND INCC06 NE DK/REF AND AGE1STIN =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first use an inhalant of any kind for kicks or to get
high?
1
2

January
February

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April 15, 2016

3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF IN03c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
IN03d [IF IN03a = 1 OR 2 OR IN03b = 1 OR 2] In what month in [YEAR FROM
IN03a or IN03b] did you first use an inhalant of any kind for kicks or to get
high?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF IN03d > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STIN:
MYR1STIN = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (IN03a-d). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STIN IS
BLANK.

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April 15, 2016

IF MYR1STIN NE 0 AND NE AGE1STIN:
INCC17 The computer recorded that you first used an inhalant of any
kind for kicks or to get high in [IN03a-d fill]. That would make
you [MYR1STIN] years old when you first used an inhalant of
any kind for kicks or to get high. Is this correct?
4
Yes
6
No
DK/REF
INCC18

[IF INCC17 = 4] Earlier, the computer recorded that you were
[AGE1STIN] years old when you first used an inhalant of any
kind for kicks or to get high. Which answer is correct?
1

I first used an inhalant of any kind for kicks or to get
high in [IN03a-d fill] when I was [MYR1STIN] years
old
2
I was [AGE1STIN] years old the first time I used an
inhalant of any kind for kicks or to get high.
3
Neither answer is correct
DK/REF
UPDATE: IF INCC18 = 1, THEN AGE1STIN = MYR1STIN.
INCC19

[IF INCC18=2 OR INCC18=3 OR INCC17=6] Please answer
this question again. Did you first use an inhalant of any kind
for kicks or to get high in [CURRENT YEAR-2], [CURRENT
YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

INCC19a [IF INCC19 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [INCC19] did you first use
an inhalant of any kind for kicks or to get high?
1
2
3
4
5
6
7
8

January
February
March
April
May
June
July
August

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April 15, 2016

9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF INCC19a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF INCC19a NE (0 OR DK/REF) THEN UPDATE MYR1STIN.
MYR1STIN = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF
BIRTH FROM MONTH AND YEAR OF FIRST USE (INCC19 AND INCC19a). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STIN IS BLANK. IF
MYR1STIN = AGE1STIN THEN MYR1STIN = BLANK
INCC20

[IF INCC18 NE 1 AND MYR1STIN NE 0 AND (INCC19 AND
INCC19a NE IN03a-d)] The computer recorded that you first
used an inhalant of any kind for kicks or to get high in
[INCC19-INCC19a fill]. That would make you [MYR1STIN]
years old when you first used an inhalant of any kind for kicks
or to get high. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF INCC20 NE (6, BLANK OR DK/REF) AND (INCC19 AND INCC19a
NE IN03a-d) THEN AGE1STIN = MYR1STIN
INLAST

[IF IN01a = 1 OR IN01b = 1 OR IN01c = 1 OR IN01d = 1 OR IN01e = 1
OR IN01f = 1 OR IN01g = 1 OR IN01h = 1 OR IN01h1=1 OR IN01i = 1
OR IN01ii=1 OR IN01j = 1 OR IN01L = 1 OR INREF = 1] How long has
it been since you last used any inhalant for kicks or to get high?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but with the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

INRECDK

[IF INLAST = DK] What is your best guess of how long it has been since
you last used any inhalant for kicks or to get high?
1

Within the past 30 days — that is, since [DATEFILL]

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April 15, 2016

2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
INRECRE

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

INFRAME3 [IF INLAST = 1 OR 2 OR INRECDK = 1 OR 2 OR INRECRE = 1 OR 2]
Now think about the past 12 months, from [DATEFILL] through today.
We want to know how many days you’ve used an inhalant of any kind for
kicks or to get high during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve
done this?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF
INYRAVE

[IF INFRAME 3 = 3 OR DK/REF] On how many days in the past 12
months did you use an inhalant of any kind for kicks or to get high?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

INMONAVE [IF INFRAME3 = 2 OR INYRAVE = DK/REF] On average, how many
days did you use an inhalant of any kind for kicks or to get high each
month during the past 12 months?
AVERAGE # OF DAYS PER MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

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INWKAVE

[IF INFRAME3 = 1 OR INMONAVE = DK/REF] On average, how
many days did you use an inhalant of any kind for kicks or to get high
each week during the past 12 months?
AVERAGE # OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

IN06 [IF INLAST=1 OR INRECDK = 1 OR INRECRE = 1] Think specifically about
the past 30 days, from [DATEFILL] up to and including today. During the past
30 days, on how many days did you use any inhalant for kicks or to get high?
NUMBER OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
IN06DKRE

[IF IN06 = DK/REF] What is your best estimate of the number of days
you used any inhalant for kicks or to get high during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DEFINE ESTIIN:
IF IN06DKRE = 1, THEN ESTIIN = 1
IF IN06DKRE = 2, THEN ESTIIN = 3
IF IN06DKRE = 3, THEN ESTIIN = 6
IF IN06DKRE = 4, THEN ESTIIN = 10
IF IN06DKRE = 5, THEN ESTIIN = 20
IF IN06DKRE = 6, THEN ESTIIN = 30
ELSE ESTIIN = BLANK
DEFINE INH30DAY
IF IN06DKRE = 1, THEN INH30DAY = “1 or 2"
IF IN06DKRE = 2, THEN INH30DAY = “3 to 5"
IF IN06DKRE = 3, THEN INH30DAY = “6 to 9"
IF IN06DKRE = 4, THEN INH30DAY = “10 to 19"
IF IN06DKRE = 5, THEN INH30DAY = “20 to 29"
IF IN06DKRE = 6, THEN INH30DAY = “all 30"
ELSE INH30DAY = BLANK

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DEFINE TOTINHAL:
IF INYRAVE NOT(BLANK OR DK/REF) THEN TOTINHAL = INYRAVE
ELSE IF INMONAVE NOT(BLANK OR DK/REF) THEN
TOTINHAL=INMONAVE*12
ELSE IF INWKAVE NOT(BLANK OR DK/REF) THEN
TOTINHAL=INWKAVE*52
ELSE TOTINHAL = DK/REF
IF TOTINHAL NOT DK/REF AND ((IN06 NE DK/REF OR BLANK AND
IN06 > TOTINHAL)) OR (IN06 = DK/REF AND ESTIIN > TOTINHAL:
INCC07a [IF IN06 > TOTINHAL] For the last question, the computer
recorded that you used an inhalant for kicks or to get high on
[IN06] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
INCC07b [IF ESTIIN > TOTINHAL] For the last question, the computer
recorded that you used an inhalant for kicks or to get high on
[INH30DAY] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE FILLINH:
IF INYRAVE > 1, THEN FILLINH = “[INYRAVE] days”
ELSE IF INYRAVE = 1, THEN FILLINH = “1 day”
ELSE IF INMONAVE > 1, THEN FILLINH = “[INMONAVE] days per month”
ELSE IF INMONAVE = 1, THEN FILLINH = “1 day per month”
ELSE IF INWKAVE > 1, THEN FILLINH = “[INWKAVE] days per week”
ELSE IF INWKAVE = 1, THEN FILLINH = “1 day per week”
ELSE IF INMONAVE NOT (BLANK OR DK/REF), THEN FILLINH =
“[INMONAVE] days per month”
ELSE IF INWKAVE NOT (BLANK OR DK/REF), THEN FILLINH =
“[INWKAVE] days per week”
DEFINE FILLINHA:
IF FILLINH = “[INMONAVE] day(s) per month” OR “[INWKAVE] day(s) per
week” THEN FILLINHA = “for a total of [TOTINHAL] days”
ELSE FILLINHA = BLANK

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April 15, 2016

INCC08

[IF INCC07a = 4 OR INCC07b = 4] The answers for the last
question and an earlier question disagree. Which answer is
correct?
1

I used an inhalant for kicks or to get high on
[FILLINH] days in the past 12 months [FILLINHA]
2
I used an inhalant for kicks or to get high on [IN06 /
INH30DAY] days in the past 30 days
3
Neither answer is correct
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
INCC09

[IF INCC08 = 2 OR INCC08 = 3] Please answer this question
again. Think about the past 12 months, from [DATEFILL]
through today. We want to know how many days you’ve used
an inhalant of any kind for kicks or to get high during the past
12 months.
What would be the easiest way for you to tell us how many
days you’ve used it?
1

Average number of days per week during the past 12
months
2
Average number of days per month during the past 12
months
3
Total number of days during the past 12 months
DK/REF
INCC10

[IF INCC09 = 3] On how many days in the past 12 months did
you use an inhalant of any kind for kicks or to get high?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

INCC11

[IF INCC09 = 2] On average, how many days did you use an
inhalant of any kind for kicks or to get high each month during
the past 12 months?
# OF DAYS/MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

INCC12

[IF INCC09 = 1] On average, how many days did you use an
inhalant of any kind for kicks or to get high each week during

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the past 12 months?
# OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
IF INCC10 NOT(BLANK OR DK/REF) THEN TOTINHAL = INCC10
ELSE IF INCC11 NOT(BLANK OR DK/REF) THEN TOTINHAL= INCC11*12
ELSE IF INCC12 NOT(BLANK OR DK/REF) THEN TOTINHAL= INCC12*52
ELSE TOTINHAL = DK/REF
INCC13a [IF INCC07a = 6 OR ((INCC08 = 1 OR INCC08 = 3) AND
INCC07a NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. During the past 30
days, on how many days did you use any inhalant for kicks or
to get high?
# OF DAYS:
[RANGE: 0 - 30]
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR
INCC13b [IF INCC07b = 6 OR ((INCC08 = 1 OR 3) AND INCC07b NE
BLANK OR DK/REF)] Please answer this question again.
Think specifically about the past 30 days, from [DATEFILL]
up to and including today. What is your best estimate of the
number of days you used any inhalant for kicks or to get high
during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR
IF IN06 = 0:
INCC14

The computer recorded that you used an inhalant for kicks or
to get high on 0 days during the past 30 days. Is this correct?
4
Yes
6
No
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR

INCC16

[IF INCC14 = 6] Please answer this question again. During
the past 30 days, that is, since [DATEFILL], on how many

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April 15, 2016

days did you use an inhalant of any kind for kicks or to get
high?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

187
April 15, 2016

188
April 15, 2016

Methamphetamine
METHINTRO

Methamphetamine, also known as crank, ice, crystal meth, speed,
glass, and many other names, is a stimulant that usually comes in
crystal or powder forms. It can be smoked, “snorted,” swallowed or
injected.
Press [ENTER] to continue.

ME01 Have you ever, even once, used methamphetamine?
1
Yes
2
No
DK/REF

MEREF [IF ME01 = REF] The answers that people give about their use of
methamphetamine are important to this study’s success. We know that this
information is personal, but remember your answers will be kept confidential.
Please think again about answering this question: Have you ever, even once,
used methamphetamine?
1
Yes
2
No
DK/REF
ME02 [IF ME01 =1 OR MEREF = 1] How old were you the first time you used
methamphetamine?
AGE:
DK/REF

[RANGE: 1 - 110]

DEFINE AGE1STME:
IF ME02 NE (BLANK OR DK/REF) THEN AGE1STME = ME02
ELSE AGE1STME = BLANK
IF CURNTAGE < AGE1STME:
MECC01 The computer recorded that you were [AGE1STME] years old
when you first used methamphetamine. Is this correct?
4
Yes
6
No
DK/REF

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April 15, 2016

MECC02 [IF MECC01 = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
1
2

I am currently [CURNTAGE] years old
I was [AGE1STME] years old the first time I used
methamphetamine
3
Neither answer is correct
DK/REF

MECC03 [IF MECC02=2 OR MECC02=3] Please answer this question
again. What is your current age?
AGE:
DK/REF

[RANGE: 1 - 110]

MECC03a [IF MECC03 < 12] Since you have indicated that you are
[MECC03 AGE] years old, we cannot interview you for this
study. Please tell your interviewer that you have finished the
survey. Thank you for your cooperation. PROGRAM
SHOULD ROUTE TO PENTER1.
MECC04 [IF MECC02=1 OR MECC02=3 OR MECC01=6] Please
answer this question again. Think about the first time you used
methamphetamine. How old were you the first time you used
methamphetamine?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF MECC04 NOT(BLANK OR DK/REF) THEN AGE1STME = MECC04
UPDATE: IF MECC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = MECC03
IF AGE1STME=CURNTAGE OR AGE1STME < 10:
MECC05 The computer recorded that you were [AGE1STME] years old
the first time you used methamphetamine. Is this correct?
4
Yes
6
No
DK/REF
MECC06 [IF MECC05=6] Please answer this question again. Think
about the first time you used methamphetamine. How old were
you the first time you used methamphetamine?

190
April 15, 2016

AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF MECC06 NOT (BLANK OR DK/REF) THEN AGE1STME = MECC06
ME03a
[IF MECC05 NE DK/RE AND MECC06 NE DK/REF AND AGE1STME
= CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STME =
CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first use
methamphetamine in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
ME03b
[IF AGE1STME = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first use methamphetamine in [CURRENT YEAR - 2] or
[CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
ME03c
[IF MECC05 NE DK/RE AND MECC06 NE DK/REF AND AGE1STME
= CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first use methamphetamine?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF ME03c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
ME03d

[IF ME03a = 1 - 2 OR ME03b = 1 - 2] In what month in [YEAR FROM

191
April 15, 2016

ME03a or ME03b] did you first use methamphetamine?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF ME03d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STME:
MYR1STME = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (ME03a-d). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STME IS
BLANK.
IF MYR1STME NE 0 AND NE AGE1STME:
MECC17 The computer recorded that you first used methamphetamine in
[ME03a-d fill]. That would make you [MYR1STME] years
old when you first used methamphetamine. Is this correct?
4
Yes
6
No
DK/REF
MECC18 [IF MECC17 = 4] Earlier, the computer recorded that you
were [AGE1STME] years old when you first used
methamphetamine. Which answer is correct?
1

I first used methamphetamine in [ME03a-d fill] when I
was [MYR1STME] years old
2
I was [AGE1STME] years old the first time I used
methamphetamine.
3
Neither answer is correct
DK/REF

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April 15, 2016

UPDATE: IF MECC18 = 1, THEN AGE1STME = MYR1STME.
MECC19 [IF MECC18=2 OR MECC18=3 OR MECC17=6] Please
answer this question again. Did you first use
methamphetamine in [CURRENT YEAR-2], [CURRENT
YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
MECC19a

[IF MECC19 NE (BLANK OR DK/REF)] Please answer
this question again. In what month in [MEC19] did you first
use methamphetamine?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF

HARD ERROR: [IF MECC19a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF MECC19a NE (0 OR DK/REF) THEN UPDATE MYR1STME.
MYR1STME = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (MECC19 AND MECC19a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STME IS BLANK.
IF MYR1STME = AGE1STME THEN MYR1STME = BLANK
MECC20 [IF MECC18 NE 1 AND MYR1STME NE 0 AND (MECC19
AND MECC19a NE ME03a-d)] The computer recorded that
you first used methamphetamine in [MECC19-MECC19a fill].
That would make you [MYR1STME] years old when you first

193
April 15, 2016

used methamphetamine. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF MECC20 NE (6, BLANK OR DK/REF) AND (MECC19 AND MECC19a
NE ME03a-d) THEN AGE1STME = MYR1STME
MELAST3

[IF ME01 = 1 OR MEREF = 1] How long has it been since you last used
methamphetamine?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

MERECDK [IF MELAST3 = DK] What is your best guess of how long it has been
since you last used methamphetamine?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

MERECRE [IF MELAST3 = REF] The answers that people give us about their use of
methamphetamine are important to this study’s success. We know that
this information is personal, but remember your answers will be kept
confidential.
Please think again about answering this question: How long has it been
since you last used methamphetamine?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

MEFRAME3 [IF MELAST3 = 1 OR 2 OR MERECDK = 1 OR 2 OR MERECRE = 1
OR 2] Now think about the past 12 months, from [DATEFILL] through

194
April 15, 2016

today. We want to know how many days you’ve used methamphetamine
during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve
used it?
1
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF

MEYRAVE [IF MEFRAME3 = 3 OR DK/REF] On how many days in the past 12
months did you use methamphetamine?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

MEMONAVE
[IF MEFRAME3 = 2 OR MEYRAVE = DK/REF] On average,
how many days did you use methamphetamine each month during the
past 12 months?
AVERAGE # OF DAYS PER MONTH:
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

MEWKAVE [IF MEFRAME3 = 1 OR MEMONAVE = DK/REF] On average, how
many days did you use methamphetamine each week during the past 12
months?
AVERAGE # OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ME06 [IF MELAST3 =1 OR MERECDK = 1 OR MERECRE = 1] Think specifically
about the past 30 days, from [DATEFILL] up to and including today. During the
past 30 days, on how many days did you use methamphetamine?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
ME06DKRE [IF ME06 = DK/REF] What is your best estimate of the number of days

195
April 15, 2016

you used methamphetamine during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE ESTIME:
IF ME06DKRE = 1, THEN ESTIME = 1
IF ME06DKRE = 2, THEN ESTIME = 3
IF ME06DKRE = 3, THEN ESTIME = 6
IF ME06DKRE = 4, THEN ESTIME = 10
IF ME06DKRE = 5, THEN ESTIME = 20
IF ME06DKRE = 6, THEN ESTIME = 30
ELSE ESTIME = BLANK
DEFINE TOTMETH:
IF MEYRAVE NOT(BLANK OR DK/REF) THEN TOTMETH= MEYRAVE
IF MEMONAVE NOT(BLANK OR DK/REF) THEN
TOTMETH=MEMONAVE*12
IF MEWKAVE NOT(BLANK OR DK/REF) THEN
TOTMETH=MEWKAVE*52
ELSE TOTMETH = DK/REF
DEFINE METH30DAY
IF ME06DKRE = 1, THEN METH30DAY = “1 or 2"
IF ME06DKRE = 2, THEN METH30DAY = “3 to 5"
IF ME06DKRE = 3, THEN METH30DAY = “6 to 9"
IF ME06DKRE = 4, THEN METH30DAY = “10 to 19"
IF ME06DKRE = 5, THEN METH30DAY = “20 to 29"
IF ME06DKRE = 6, THEN METH30DAY = “all 30"
ELSE METH30DAY = BLANK
IF TOTMETH NOT DK/REF AND (ME06 NE BLANK OR DK/REF AND
ME06 > TOTMETH) OR (ME06 = DK/REF AND ESTIME > TOTMETH):
MECC07a [IF ME06 > TOTMETH] For the last question, the computer
recorded that you used methamphetamine on [ME06] of the
past 30 days. Is this correct?
4
Yes
6
No
DK/REF

196
April 15, 2016

PROGRAMMER: SHOW 30 DAY CALENDAR
MECC07b [IF ESTIME > TOTMETH] For the last question, the computer
recorded that you used methamphetamine on [METH30DAY]
of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE FILLME:
IF MEYRAVE > 1, THEN FILLME = “[MEYRAVE] days”
ELSE IF MEYRAVE = 1, THEN FILLME = “1 day”
ELSE IF MEMONAVE > 1, THEN FILLME = “[MEMONAVE] days per
month”
ELSE IF MEMONAVE = 1, THEN FILLME = “1 day per month”
ELSE IF MEWKAVE > 1, THEN FILLME = “[MEWKAVE] days per week”
ELSE IF MEWKAVE = 1, THEN FILLME = “1 day per week”
DEFINE FILMEA:
IF FILLMEA = “[MEMONAVE] day(s) per month” OR “[MEWKAVE] day(s)
per week” THEN FILLMEA = “for a total of [TOTMETH] days”
ELSE FILLMEA = BLANK
MECC08 [IF MECC07a = 4 OR MECC07b = 4] The answers for the
last question and an earlier question disagree. Which answer
is correct?
1

I used methamphetamine on [FILLME] days in the past
12 months [FILLMEA]
2
I used methamphetamine on [ME06 / METH30DAY]
days in the past 30 days
3
Neither answer is correct
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
MECC09 [IF MECC08 = 2 OR MECC08 = 3] Please answer this
question again. Think about the past 12 months, from
[DATEFILL] through today. We want to know how many days
you’ve used methamphetamine during the past 12 months.
What would be the easiest way for you to tell us how many
days you’ve used it?
1

Average number of days per week during the past 12

197
April 15, 2016

months
2
Average number of days per month during the past 12
months
3
Total number of days during the past 12 month
DK/REF
MECC10 [IF MECC09 = 3] On how many days in the past 12 months
did you use methamphetamine?
TOTAL # OF DAYS:
[RANGE: 1 - 366]
DK/REFPROGRAMMER: SHOW 12 MONTH CALENDAR
MECC11 [IF MECC9 = 2] On average, how many days did you use
methamphetamine each month during the past 12 months?
# OF DAYS/MONTH:
[RANGE: 1 - 31]
DK/REFPROGRAMMER: SHOW 12 MONTH CALENDAR
MECC12 [IF MECC09 = 1] On average, how many days did you use
methamphetamine each week during the past 12 months?
# OF DAYS PER WEEK:
[RANGE: 1 - 7]
DK/REFPROGRAMMER: SHOW 12 MONTH CALENDAR
IF MECC10 NOT(BLANK OR DK/REF) THEN TOTMETH = MECC10
ELSE IF MECC11 NOT(BLANK OR DK/REF THEN TOTMETH=MECC11*12
ELSE IF MECC12 NOT(BLANK OR DK/REF) THEN TOTMETH=MECC12*52
ELSE TOTMETH = DK/REF
MECC13a [IF (MECC07a=6 OR ((MECC08 = 1 OR MECC08 = 3) AND
MECC07a NE BLANK OR DK/REF)] Please answer this
question again. Think specifically about the past 30 days, from
[DATEFILL], up to and including today. During the past 30
days, on how many days did you use methamphetamine?
# OF DAYS:
[RANGE: 0 - 30]
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR
MECC13b [IF MECC07b = 6 or ((MECC08 = 1 OR 3) AND MECC07b
NE BLANK OR DK/REF)] Please answer this question again.
Think specifically about the past 30 days, from [DATEFILL]
up to and including today. What is your best estimate of the
number of days you used methamphetamine during the past 30
days?
1

1 or 2 days

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April 15, 2016

2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR
IF ME06 = 0:
MECC14 The computer recorded that you used any form of
methamphetamine on 0 days during the past 30 days. Is this
correct?
4
Yes
6
No
DK/REFPROGRAMMER: SHOW 30 DAY CALENDAR
MECC16 [IF MECC14 = 6] Please answer this question again. During
the past 30 days, that is, since [DATEFILL], on how many
days did you use methamphetamine?
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

199
April 15, 2016

200
April 15, 2016

Pain Relievers Screener
INTROPR

These next questions are about any use of prescription pain relievers.
Please do not include “over-the-counter” pain relievers such as aspirin,
Tylenol, Advil, or Aleve.
To indicate that you have not used any of the pain relievers asked about in
a question, enter 95.
Press [ENTER] to continue.

PR01

Please look at the names and pictures of the pain relievers shown below.
Please note that some forms of these pain relievers may look different
from the pictures, but you should include any form that you have used.
PROGRAMMER: DISPLAY PILLS HERE FOR VICODIN, LORTAB,
NORCO, ZOHYDRO ER, AND HYDROCODONE.
In the past 12 months, which, if any, of these pain relievers have you
used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Vicodin
2
Lortab
3
Norco
4
Zohydro ER
5
Hydrocodone (generic)
95
I have not used any of these pain relievers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, 3, 4, OR 5.

PR02

Please look at the names and pictures of the pain relievers shown below.
PROGRAMMER: DISPLAY PILLS HERE FOR OXYCONTIN,
PERCOCET, AND PERCODAN.
In the past 12 months, which, if any, of these pain relievers have you
used?

201
April 15, 2016

To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
OxyContin
2
Percocet
3
Percodan
95
I have not used any of these pain relievers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, OR 3.

PR03

Please look at the names and pictures of the pain relievers shown below.
PROGRAMMER: DISPLAY PILLS HERE FOR ROXICODONE, AND
OXYCODONE.
In the past 12 months, which, if any, of these pain relievers have you
used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Roxicodone
2
Oxycodone (generic)
95
I have not used any of these pain relievers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, OR 2.
PRCC01

[IF ((PR01 = 1 AND PR02 = 1 AND PR03 = 1) OR (PR01 =2 AND PR02
= 2 AND PR03 = 2)) AND (# of responses in PR01 = 1) AND (# of
responses in PR02 = 1) AND (# of responses in PR03 = 1)] The computer
recorded that you used the following pain relievers in the past 12 months:
[PR01 FILL]
[PR02 FILL]
and [PR03 FILL]
Are all of these correct?
4

Yes

202
April 15, 2016

6

No

HARD ERROR: [IF PRCC01 = 6] Remember, please enter 95 if you have not used
any of the pain relievers asked about in the past 12 months. Please
press the [ENTER] key to return to these questions so that you can
revise your answers.

PR04

Please look at the names and pictures of the pain relievers shown below.
Remember, some forms of these pain relievers may look different from
the pictures, but you should include any form that you have used.
PROGRAMMER: DISPLAY PILLS HERE FOR ULTRAM, ULTRAM
ER, ULTRACET, TRAMADOL, AND EXTENDED-RELEASE
TRAMADOL.
In the past 12 months, which, if any, of these pain relievers have you
used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Ultram
2
Ultram ER
3
Ultracet
4
Tramadol (generic)
5
Extended-release tramadol (generic)
95
I have not used any of these pain relievers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, 3, 4, OR 5.

PR05

Please look at the names and pictures of the pain relievers shown below.
PROGRAMMER: DISPLAY PILLS HERE FOR TYLENOL WITH
CODEINE 3 OR 4 AND CODEINE.
In the past 12 months, which, if any, of these pain relievers have you
used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

203
April 15, 2016

1
Tylenol with codeine 3 or 4 (NOT over-the-counter Tylenol)
2
Codeine pills (generic)
95
I have not used any of these pain relievers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1 OR 2.

PR06

Please look at the names and pictures of the pain relievers shown below.
Remember, some forms of these pain relievers may look different from
the pictures, but you should include any form that you have used.

PROGRAMMER: DISPLAY PILLS HERE FOR AVINZA, KADIAN,
MS CONTIN, MORPHINE, AND EXTENDED-RELEASE MORPHINE.
In the past 12 months, which, if any, of these pain relievers have you
used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Avinza
2
Kadian
3
MS Contin
4
Morphine (generic)
5
Extended-release morphine (generic)
95
I have not used any of these pain relievers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, 3, 4, OR 5.

PR07

Please look at the names and pictures of the pain relievers shown below.
Remember, some forms of these pain relievers may look different from
the pictures, but you should include any form that you have used.
PROGRAMMER: DISPLAY IMAGES HERE FOR DURAGESIC,
FENTORA, AND FENTANYL.
In the past 12 months, which, if any, of these pain relievers have you
used?

204
April 15, 2016

To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Duragesic
2
Fentora
3
Fentanyl (generic)
95
I have not used any of these pain relievers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, OR 3.
PR08

Please look at the names and pictures of the pain relievers shown below.
PROGRAMMER: DISPLAY PILLS HERE FOR SUBOXONE AND
BUPRENORPHINE.
In the past 12 months, which, if any, of these pain relievers have you
used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Suboxone
2
Buprenorphine (generic)
3
Buprenorphine plus naloxone (generic)
95
I have not used any of these pain relievers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, OR 3.

PR09

Please look at the names and pictures of the pain relievers shown below.
PROGRAMMER: DISPLAY PILLS HERE FOR OPANA, OPANA ER,
OXYMORPHONE, AND EXTENDED-RELEASE OXYMORPHONE.
In the past 12 months, which, if any, of these pain relievers have you
used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

205
April 15, 2016

1
Opana
2
Opana ER
3
Oxymorphone (generic)
4
Extended-release oxymorphone (generic)
95
I have not used any of these pain relievers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, 3, OR 4.

PR10

Please look at the names and pictures of the pain relievers shown below.
PROGRAMMER: DISPLAY PILLS HERE FOR DEMEROL,
DILAUDID OR HYDROMORPHONE, EXALGO OR EXTENDEDRELEASE HYDROMORPHONE, AND METHADONE.
In the past 12 months, which, if any, of these pain relievers have you
used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Demerol
2
Dilaudid or hydromorphone
3
Exalgo or extended-release hydromorphone
4
Methadone
95
I have not used any of these pain relievers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, 3, OR 4.

PRANYOTH

In the past 12 months, have you used any other prescription pain
reliever?
Remember, do not include “over-the-counter” pain relievers such
as aspirin, Tylenol, Advil, or Aleve.
SHOW 12-MONTH CALENDAR ON SCREEN.

206
April 15, 2016

1
Yes
2
No
DK/REF

DEFINE PR12MON:
IF (PR01 NE 95 OR DK/REF) OR (PR02 NE 95 OR DK/REF) OR (PR03 NE 95 OR
DK/REF) OR (PR04 NE 95 OR DK/REF) OR (PR05 NE 95 OR DK/REF) OR (PR06
NE 95 OR DK/REF) OR (PR07 NE 95 OR DK/REF) OR (PR08 NE 95 OR DK/REF)
OR (PR09 NE 95 OR DK/REF) OR (PR10 NE 95 OR DK/REF) OR (PRANYOTH = 1)
THEN PR12MON = 1.
ELSE PR12MON = 2.
DEFINE PRYRCOUNT:
INITIALIZE PRYRCOUNT TO 0.
ADD 1 TO PRYRCOUNT FOR EACH INDIVIDUAL DRUG SELECTED IN PR01PRANYOTH.
PRLANY

[IF PR12MON = 2] Have you ever, even once, used any prescription
pain reliever?
Remember, do not include “over-the-counter” pain relievers such as
aspirin, Tylenol, Advil, or Aleve.
1
Yes
2
No
DK/REF

207
April 15, 2016

208
April 15, 2016

Tranquilizers Screener
INTROTR

These next questions are about any use of prescription tranquilizers.
Tranquilizers are usually prescribed to relax people, to calm people down,
to relieve anxiety, or to relax muscle spasms. Some people call
tranquilizers “nerve pills.”
To indicate that you have not used any of the tranquilizers asked about in
a question, enter 95.
Press [ENTER] to continue.

TR01

Please look at the names and pictures of the tranquilizers shown below.
Please note that some forms of these tranquilizers may look different from
the pictures, but you should include any form that you have used.
PROGRAMMER: DISPLAY PILLS HERE FOR XANAX, XANAX XR,
ALPRAZOLAM, AND EXTENDED-RELEASE ALPRAZOLAM.
In the past 12 months, which, if any, of these tranquilizers have you
used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Xanax
2
Xanax XR
3
Alprazolam (generic)
4
Extended-release alprazolam (generic)
95
I have not used any of these tranquilizers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, 3, OR 4.

TR02

Please look at the names and pictures of the tranquilizers shown below.
PROGRAMMER: DISPLAY PILLS HERE FOR ATIVAN,
LORAZEPAM, KLONOPIN, AND CLONAZEPAM.
In the past 12 months, which, if any, of these tranquilizers have you
used?

209
April 15, 2016

To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Ativan
2
Klonopin
3
Lorazepam (generic)
4
Clonazepam (generic)
95
I have not used any of these tranquilizers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, 3, OR 4.
TR03

Please look at the names and pictures of the tranquilizers shown below.
PROGRAMMER: DISPLAY PILLS HERE FOR VALIUM AND
DIAZPEPAM.
In the past 12 months, which, if any, of these tranquilizers have you
used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Valium
2
Diazepam (generic)
95
I have not used any of these tranquilizers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1 OR 2.

TRCC01

[IF ((TR01 = 1 AND TR02 = 1 AND TR03 = 1) OR (TR01 =2 AND
TR02 = 2 AND TR03 = 2)) AND (# of responses in TR01 = 1) AND (# of
responses in TR02 = 1) AND (# of responses in TR03 = 1)] The computer
recorded that you used the following tranquilizers in the past 12 months:
[TR01 FILL]
[TR02 FILL]
and [TR03 FILL]
Are all of these correct?

210
April 15, 2016

4
6

Yes
No

HARD ERROR: [IF TRCC01 = 6] Remember, please enter 95 if you
have not used any of the tranquilizers asked about in the past 12
months. Please press the [ENTER] key to return to these questions so
that you can revise your answers.
TR04

Please look at the names and pictures of the tranquilizers shown below.
Remember, some forms of these tranquilizers may look different from the
pictures, but you should include any form that you have used.
PROGRAMMER: DISPLAY PILLS HERE FOR CYCLOBENZAPRINE
AND SOMA.
In the past 12 months, which, if any, of these tranquilizers have you
used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Cyclobenzaprine (generic), also known as Flexeril
2
Soma
95
I have not used any of these tranquilizers in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1 OR 2.

TRANYOTH

In the past 12 months, have you used any other prescription
tranquilizer?
SHOW 12-MONTH CALENDAR ON SCREEN.
1
Yes
2
No
DK/REF

DEFINE TR12MON:
IF (TR01 NE 95 OR DK/REF) OR (TR02 NE 95 OR DK/REF) OR (TR03 NE 95 OR
DK/REF) OR (TR04 NE 95 OR DK/REF) OR (TRANYOTH = 1) THEN TR12MON =
1.
ELSE TR12MON = 2.

211
April 15, 2016

DEFINE TRYRCOUNT:
INITIALIZE TRYRCOUNT TO 0.
ADD 1 TO TRYRCOUNT FOR EACH INDIVIDUAL DRUG SELECTED IN TR01TRANYOTH.
TRLANY

[IF TR12MON = 2] Have you ever, even once, used any prescription
tranquilizer?
1
Yes
2
No
DK/REF

212
April 15, 2016

Stimulants Screener
INTROST

These next questions are about any use of prescription stimulants.
People sometimes take these drugs for attention deficit disorders, to lose
weight, or to stay awake. Please do not include “over-the-counter”
stimulants such as Dexatrim, No-Doz, Hydroxycut, or 5-Hour Energy.
To indicate that you have not used any of the stimulants asked about in a
question, enter 95.
Press [ENTER] to continue.

ST01

Please look at the names and pictures of the stimulants shown below.
Please note that some forms of these stimulants may look different from
the pictures, but you should include any form that you have used.
PROGRAMMER: DISPLAY PILLS HERE FOR ADDERALL,
ADDERALL XR, AND DEXEDRINE.
In the past 12 months, which, if any, of these stimulants have you used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Adderall
2
Adderall XR
3
Dexedrine
95
I have not used any of these stimulants in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, OR 3.

ST02

Please look at the names and pictures of the stimulants shown below.
PROGRAMMER: DISPLAY PILLS HERE FOR
DEXTROAMPHETAMINE, AMPHETAMINEDEXTROAMPHETAMINE MIX, AND EXTENDED-RELEASE
AMPHETAMINE-DEXTROAMPHETAMINE MIX.
In the past 12 months, which, if any, of these stimulants have you used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

213
April 15, 2016

1
2

Dextroamphetamine (generic)
Mixed amphetamine-dextroamphetamine pills other than Adderall
(generic)
3
Extended-release amphetamine-dextroamphetamine pills other
than Adderall XR (generic)
95
I have not used any of these stimulants in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, OR 3.
ST03

Please look at the names and pictures of the stimulants shown below.
PROGRAMMER: DISPLAY IMAGES FOR RITALIN, RITALIN LA,
CONCERTA, AND DAYTRANA. (DAYTRANA IS A PATCH.)
In the past 12 months, which, if any, of these stimulants have you used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Ritalin
2
Ritalin LA
3
Concerta
4
Daytrana
95
I have not used any of these stimulants in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, 3, OR 4.
STCC01

[IF ((ST01 = 1 AND ST02 = 1 AND ST03 = 1) OR (ST01 =2 AND ST02
= 2 AND ST03 = 2)) AND (# of responses in ST01 = 1) AND (# of
responses in ST02 = 1) AND (# of responses in ST03 = 1)] The computer
recorded that you used the following stimulants in the past 12 months:
[ST01 FILL]
[ST02 FILL]
and [ST03 FILL]
Are all of these correct?
4

Yes

214
April 15, 2016

6

No

HARD ERROR: [IF STCC01 = 6] Remember, please enter 95 if you have not used
any of the stimulants asked about in the past 12 months. Please press the [ENTER]
key to return to these questions so that you can revise your answers.
ST04

Please look at the names and pictures of the stimulants shown below.
PROGRAMMER: DISPLAY PILLS FOR METADATE CD,
METADATE ER, METHYLPHENIDATE, AND EXTENDEDRELEASE METHYLPHENIDATE.
In the past 12 months, which, if any, of these stimulants have you used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Metadate CD
2
Metadate ER
3
Methylphenidate (generic)
4
Extended-release methylphenidate (generic)
95
I have not used any of these stimulants in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, 3, OR 4.

ST05

Please look at the names and pictures of the stimulants shown below.
PROGRAMMER: DISPLAY PILLS FOR FOCALIN, FOCALIN XR,
DEXMETHYLPHENIDATE, AND EXTENDED-RELEASE
DEXMETHYLPHENIDATE.
In the past 12 months, which, if any, of these stimulants have you used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
2
3
4
95

Focalin
Focalin XR
Dexmethylphenidate (generic)
Extended-release dexmethylphenidate (generic)
I have not used any of these stimulants in the past 12 months

215
April 15, 2016

DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, 3, OR 4.

ST06

Please look at the names and pictures of the stimulants shown below.
PROGRAMMER: DISPLAY PILLS FOR BENZPHETAMINE,
DIDREX, DIETHYLPROPION, PHENDIMETRAZINE, AND
PHENTERMINE.
In the past 12 months, which, if any, of these stimulants have you used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Benzphetamine
2
Didrex
3
Diethylpropion
4
Phendimetrazine
5
Phentermine
95
I have not used any of these stimulants in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, 3, 4, OR 5.
ST07

Please look at the names and pictures of the stimulants shown below.
PROGRAMMER: DISPLAY PILLS FOR PROVIGIL, TENUATE, AND
VYVANSE.
In the past 12 months, which, if any, of these stimulants have you used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Provigil
2
Tenuate
3
Vyvanse
95
I have not used any of these stimulants in the past 12 months
DK/REF

216
April 15, 2016

DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, OR 3.
STANYOTH

In the past 12 months, have you used any other prescription
stimulant?
Remember, do not include “over-the-counter” stimulants such as
Dexatrim, No-Doz, Hydroxycut, or 5-Hour Energy.
SHOW 12-MONTH CALENDAR ON SCREEN.

1
Yes
2
No
DK/REF
DEFINE ST12MON:
IF (ST01 NE 95 OR DK/REF) OR (ST02 NE 95 OR DK/REF) OR (ST03 NE 95 OR
DK/REF) OR (ST04 NE 95 OR DK/REF) OR (ST05 NE 95 OR DK/REF) OR (ST06 NE
95 OR DK/REF) OR (ST07 NE 95 OR DK/REF) OR (STANYOTH = 1) THEN
ST12MON = 1.
ELSE ST12MON = 2.
DEFINE STYRCOUNT:
INITIALIZE STYRCOUNT TO 0.
ADD 1 TO STYRCOUNT FOR EACH INDIVIDUAL DRUG SELECTED IN ST01STANYOTH.
STLANY

[IF ST12MON = 2] Have you ever, even once, used any prescription
stimulant?
Remember, do not include “over-the-counter” stimulants such as
Dexatrim, No-Doz, Hydroxycut, or 5-Hour Energy.
1
Yes
2
No
DK/REF

217
April 15, 2016

218
April 15, 2016

Sedatives Screener
INTROSV

These next questions ask about any use of prescription sedatives or
barbiturates. These drugs are also called “downers” or “sleeping pills.”
People take these drugs to help them relax or help them sleep. Please do
not include “over-the-counter” sedatives such as Sominex, Unisom, Nytol,
or Benadryl.
To indicate that you have not used any of the sedatives asked about in a
question, enter 95.
Press [ENTER] to continue.

SV01

Please look at the names and pictures of the sedatives shown below.
Please note that some forms of these sedatives may look different from
the pictures, but you should include any form that you have used.
PROGRAMMER: DISPLAY PILLS HERE FOR AMBIEN, AMBIEN
CR, ZOLPIDEM, AND EXTENDED-RELEASE ZOLPIDEM.
In the past 12 months, which, if any, of these sedatives have you used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Ambien
2
Ambien CR
3
Zolpidem (generic)
4
Extended-release zolpidem (generic)
95
I have not used any of these sedatives in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, 3, OR 4.

SV02

Please look at the names and pictures of the sedatives shown below.
PROGRAMMER: DISPLAY IMAGES FOR LUNESTA, SONATA,
AND ZALEPLON.
In the past 12 months, which, if any, of these sedatives have you used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

219
April 15, 2016

1
Lunesta or eszopiclone
2
Sonata or zaleplon
95
I have not used any of these sedatives in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1 OR 2.
SV03

Please look at the names and pictures of the sedatives shown below.
PROGRAMMER: DISPLAY PILLS FOR HALCION, RESTORIL,
FLURAZEPAM, TEMAZEPAM, AND TRIAZOLAM.
In the past 12 months, which, if any, of these sedatives have you used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Halcion
2
Restoril
3
Flurazepam (generic), also known as Dalmane
4
Temazepam (generic)
5
Triazolam (generic)
95
I have not used any of these sedatives in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, 3, 4, OR 5.

SVCC01

[IF ((SV01 = 1 AND SV02 = 1 AND SV03 = 1) OR (SV01 =2 AND
SV02 = 2 AND SV03 = 2)) AND (# of responses in SV01 = 1) AND (# of
responses in SV02 = 1) AND (# of responses in SV03 = 1)] The computer
recorded that you used the following sedatives in the past 12 months:
[SV01 FILL]
[SV02 FILL]
and [SV03 FILL]
Are all of these correct?
4
6

Yes
No

220
April 15, 2016

HARD ERROR: [IF SVCC01 = 6] Remember, please enter 95 if you
have not used any of the sedatives asked about in the past 12 months.
Please press the [ENTER] key to return to these questions so that you
can revise your answers.
SV04

Please look at the names and pictures of the sedatives shown below.
PROGRAMMER: DISPLAY PILLS FOR BUTISOL, SECONAL, AND
PHENOBARBITAL.
In the past 12 months, which, if any, of these sedatives have you used?
To select more than one drug from the list, press the space bar between
each number you have typed. When you have finished, press [ENTER].

1
Butisol
2
Seconal
3
Phenobarbital (generic)
95
I have not used any of these sedatives in the past 12 months
DK/REF
DO NOT ALLOW 95 IN COMBINATION WITH ANY RESPONSE OF
1, 2, OR 3.
SVANYOTH

In the past 12 months, have you used any other prescription
sedative?
Remember, do not include “over-the-counter” sedatives such as
Sominex, Unisom, Nytol, or Benadryl.
SHOW 12-MONTH CALENDAR ON SCREEN.

1
Yes
2
No
DK/REF
DEFINE SV12MON:
IF (SV01 NE 95 OR DK/REF) OR (SV02 NE 95 OR DK/REF) OR (SV03 NE 95 OR
DK/REF) OR (SV04 NE 95 OR DK/REF) OR (SVANYOTH = 1) THEN SV12MON =
1.
ELSE SV12MON = 2.

221
April 15, 2016

DEFINE SVYRCOUNT:
INITIALIZE SVYRCOUNT TO 0.
ADD 1 TO SVYRCOUNT FOR EACH INDIVIDUAL DRUG SELECTED IN SV01SVANYOTH.
SVLANY

[IF SV12MON = 2] Have you ever, even once, used any prescription
sedative?
Remember, do not include “over-the-counter” sedatives such as Sominex,
Unisom, Nytol, or Benadryl.
1
Yes
2
No
DK/REF

222
April 15, 2016

Pain Relievers Main Module

If no 12 month use of prescription pain relievers:
PRINTROLIF

[IF PRLANY = 1] The next question asks about using prescription
pain relievers in any way a doctor did not direct you to use them.
When you answer this question, please think only about your use of
the drug in any way a doctor did not direct you to use it, including:




Using it without a prescription of your own
Using it in greater amounts, more often, or longer than you were
told to take it
Using it in any other way a doctor did not direct you to use it

Press Enter to continue.
PRL01

[IF PRLANY=1] Have you ever, even once, used any prescription pain
reliever in any way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

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April 15, 2016

If any 12 month use of prescription pain relievers:
PRINTROYR1 [IF PR12MON = 1] Earlier you reported having used certain
prescription pain relievers during the past year. Now please think
about whether you used any of these pain relievers in any way a
doctor did not direct you to use them.
When you answer these questions, please think only about your use of
the drug in any way a doctor did not direct you to use it, including:




Using it without a prescription of your own
Using it in greater amounts, more often, or longer than you were
told to take it
Using it in any other way a doctor did not direct you to use it

Press Enter to continue.
DEFINE PRFILL:
PRFILL LISTS ALL INDIVIDUAL DRUGS SELECTED IN PR01, PR02, PR03, PR04,
PR05, PR06, PR07, PR08, PR09, AND PR10.
USE MULTIPLE COLUMNS AS NEEDED. PRECEDE LAST ITEM
WITH “and”. IF PRANYOTH=1 AND PRYRCOUNT > 1, THEN ADD
“another prescription pain reliever” TO THE FILL.
THE FOLLOWING DRUGS SHOULD NOT USE INITIAL CAPS WHEN FILLED IN
SENTENCE FORMAT:
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•

hydrocodone
oxycodone
propoxyphene
tramadol
extended-release tramadol
codeine pills
morphine
extended-release morphine
fentanyl
buprenorphine
oxymorphone
extended-release oxymorphone
hydromorphone
extended-release hydromorphone
methadone
buprenorphine plus naloxone

224
April 15, 2016

WHEN IMPLEMENTING PRFILL, IF 1, OR 2 DRUGS APPEAR IN LIST, FILL IN
SENTENCE FORMAT, SEPARATED WITH AN “and” BEFORE THE
LAST FILL.
IF >2 DRUGS APPEAR IN LIST, FILL IN LIST (IN COLUMNS IF NEEDED)
BELOW THE PREVIOUS SENTENCE.
DEFINE PRFIRSTFLAG:
PRFIRSTFLAG IDENTIFIES THE FIRST PAIN RELIEVER USED
NONMEDICALLY.
INITIALIZE PRFIRSTFLAG TO 0.
(PRFIRSTFLAG NEEDS TO BE DEFINED BEFORE THE ROUTING TO
PRINTROYR2 OR PRYOTH.)
PRINTROYR2 [IF PR12MON=1 AND (PRANYOTH NE 1 OR (PRANYOTH=1
AND PRYRCOUNT > 1))] Earlier, the computer recorded that, in the
past 12 months, you used [PRFILL].
Press Enter to continue.
PROGRAMMER: SHOW CALENDAR WITH 12-MONTH
REFERENCE DATE FOR THE INTRO SCREEN
NOTE TO PROGRAMMERS: LOOP THROUGH THE 12-MONTH MISUSE, AGE AT
FIRST MISUSE, AND YEAR AND MONTH OF FIRST MISUSE (IF APPLICABLE)
FOR EACH PRESCRIPTION PAIN RELIEVER REPORTED IN THE SCREENER
FOR THE PAST 12 MONTHS.
PRY01

[IF PR01=1] In the past 12 months, did you use Vicodin in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR VICODIN
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRY01=1 THEN PRFIRSTFLAG=1.
PRY01a

[IF PRFIRSTFLAG=1] Please think about the first time you ever used
Vicodin in a way a doctor did not direct you to use it.
[IF PRY01=1] How old were you when you first used Vicodin in a way a
doctor did not direct you to use it?

225
April 15, 2016

AGE:
DK/REF

[(RANGE: 1 - 110)]

PROGRAMMER: DISPLAY IN LOWER RIGHT:
Press [F2] if you want to see and hear these ways
again.
• Without a prescription of your own,
• In greater amounts, more often, or longer than
you were told to take it
• In any other way a doctor did not direct you to
use it
DEFINE AGE1STPR1:
IF PRY01a NE (BLANK OR DK/REF) THEN AGE1STPR1 = PRY01a
ELSE AGE1STPR1 = 0
HARD ERROR: [IF CURNTAGE < AGE1STPR1] The age you just entered is older
than your current age. Press [Enter] to answer the question again.
IF 1 <= AGE1STPR1 < 10:
PRCC05A1 The computer recorded that you were [AGE1STPR1] years
old the first time you used Vicodin in a way a doctor did not
direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF PRCC05A1= DK/REF THEN AGE1STPR1 = 0
PRCC06A1 [IF PRCC05A1=6] Please answer this question again.
Think about the first time you used Vicodin in a way a doctor
did not direct you to use it.
How old were you the first time you used Vicodin in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF PRCC06A1 NOT (BLANK OR DK/REF) THEN AGE1STPR1 =
PRCC06A1
226
April 15, 2016

ELSE IF PRCC06A1 = DK/REF THEN AGE1STPR1 = 0
DEFINE PRYRINIT1:
IF AGE1STPR1 = CURNTAGE THEN PRYRINIT1 = 1
ELSE PRYRINIT1 = 0
DEFINE PRYRDKRE1:
IF PRYRINIT1 = 0 AND (PRY01a = DK/REF OR PRCC05A1 = DK/REF OR
PRCC06A1 = DK/REF) THEN PRYRDKRE1 = 1
ELSE PRYRDKRE1= 0
DEFINE PR30INIT1:
PR30INIT1 = 0
IF AGE1STPR1 = CURNTAGE AND DATE OF INTERVIEW >= DOB AND
NUMBER OF DAYS BASED ON THE DIFFERENCE BETWEEN DATE OF
INTERVIEW AND DOB <= 30, THEN PR30INIT1 = 1
2.2.1

Year and Month of First Nonmedical Use

DEFINE PRYFU1:
PRYFU1 = 0
DEFINE PRMFU1:
PRMFU1 = 0
PRY01b

[AGE1STPR1 = CURNTAGE AND DATE OF INTERVIEW < DOB OR
IF AGE1STPR1 = CURNTAGE - 1 AND DATE OF INTERVIEW ≥
DOB] Did you first use Vicodin in a way a doctor did not direct you to
use it in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

PRY01c

[IF AGE1STPR1 = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first use Vicodin in a way a doctor did not direct you to
use it in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

227
April 15, 2016

UPDATE: IF PRY01B = 2 OR (AGE1STPR1 = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB) THEN PRYFU1 = CURRENT YEAR
IF PRY01B = 1 OR PRY01C = 2 THEN PRYFU1 = CURRENT YEAR - 1
IF PRY01C = 1 THEN PRYFU1 = CURRENT YEAR - 2
DEFINE PRJANFLAG1:
PRJANFLAG1 = 0
IF PRYFU1=CURRENT YEAR AND CURRENT MONTH = JANUARY THEN
PRJANFLAG1 = 1
IF PRYFU1=CURRENT YEAR-1 AND BIRTHDAY MONTH=JANUARY AND
DATE OF INTERVIEW ≥ DOB THEN PRJANFLAG1=1
IF PRJANFLAG1=1 THEN PRY01D=1
DEFINE PRDECFLAG1:
PRDECFLAG1 = 0
IF AGE1STPR1 = CURNTAGE AND PRYFU1=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN PRDECFLAG1 = 1
IF PRDECFLAG1=1 THEN PRY01D=12
DEFINE PR1MTHFLAG1:
PR1MTHFLAG1=0
IF (AGE1STPR1=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH) THEN
PR1MTHFLAG1=1
IF PR1MTHFLAG1=1 THEN PRY01D=CURRENT MONTH
PRY01d.
[IF PRYFU1 NE 0 AND PRJANFLAG1 = 0 AND PRDECFLAG1=0
AND PR1MTHFLAG1=0]
[IF PRYFU1 = CURRENT YEAR OR CURRENT YEAR -1] Earlier, you reported that
you first used Vicodin in a way a doctor did not direct you to use it when you were
[AGE1STPR1] years old. Based on your date of birth, you turned [AGE1STPR1] in
[FILL WITH MONTH/YEAR FOR AGE1STPR1 BASED ON DOB].
[IF PRYFU1 NE 0] In what month in [PRYFU1] did you first use Vicodin in a way a
doctor did not direct you to use it?
[IF DATE OF INTERVIEW < DOB AND AGE1STPR1=CURRENT AGE AND
PRYFU1=CURRENT YEAR THEN SHOW JANUARY THROUGH INTERVIEW
MONTH.]
IF AGE1STPR1 = CURNTAGE AND DATE OF INTERVIEW ≥ DOB THEN SHOW
MONTHS FROM BIRTH MONTH TO INTERVIEW MONTH.
IF ((AGE1STPR1 = CURNTAGE AND DATE OF INTERVIEW <= DOB) or
(AGE1STPR1 = CURNTAGE – 1 AND DATE OF INTERVIEW > DOB))
AND (PRYFU1 = CURRENT YEAR – 1), SHOW BIRTH MONTH TO DECEMBER

228
April 15, 2016

IF PRYFU1=CURRENT YEAR AND AGE1STPR1=CURRENT AGE-1 AND DATE
OF INTERVIEW > DOB THEN SHOW JANUARY THROUGH BIRTH MONTH.
IF PRYFU1 = CURRENT YEAR - 1 AND AGE1STPR1 = CURNTAGE - 1 AND
DATE OF INTERVIEW < DOB THEN SHOW JANUARY THROUGH BIRTH
MONTH.
ELSE SHOW ALL MONTHS.]
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF PRY01D = 1-12 THEN PRMFU1 = PRY01D
IF PRJANFLAG1 = 1 THEN PRMFU1 = 1.
IF PRDECFLAG1=1 THEN PRMFU1=12.
UPDATE: IF PRYRINIT1 NE 1 AND (PRYFU1 = CURRENT YEAR OR (PRYFU1 =
CURRENT YEAR - 1 AND PRMFU1 = 1-12 AND PRMFU1 >= CURRENT MONTH)
THEN PRYRINIT1 = 1
UPDATE: IF PRYRINIT1 NE 1 AND PRYRDKRE1 NE 1 AND [(PRY01b = DK/REF
OR PRY01c = DK/REF) OR (PRYFU1 = CURRENT YEAR-1 AND PRY01d =
DK/REF)] THEN PRYRDKRE1 = 1
UPDATE: IF PR30INIT1 NE 1 AND PRYFU1 = CURRENT YEAR AND PRMFU1 =
CURRENT MONTH THEN PR30INIT1 = 1
DEFINE MYR1STPR1:
MYR1STPR1 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (PRY01b-d).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STPR1 IS 0.
IF MYR1STPR1 NE 0 AND NE AGE1STPR1:

229
April 15, 2016

PRCC32A1
Earlier, the computer recorded that you were
[AGE1STPR1] years old when you first used Vicodin in a way
a doctor did not direct you to use it.
Which answer is correct?
1

I was [MYR1STPR1] years old in [PRY01B-D fill] the
first time I used Vicodin in a way not directed for me by
a doctor
2
I was [AGE1STPR1] years old the first time I used
Vicodin in a way not directed for me by a doctor
3
Neither answer is correct
DK/REF
UPDATE: IF PRCC32A1 = 1, THEN AGE1STPR1 = MYR1STPR1.
UPDATE: IF PRYRINIT1 NE 1 AND AGE1STPR1 = CURNTAGE THEN PRYRINIT1
=1
ELSE IF PRYRINIT1 = 1 AND AGE1STPR1 NE CURNTAGE AND PRCC32A1 =
DK/REF THEN PRYRINIT1 = 0
UPDATE: IF PRYRINIT1 NE 1 AND PRYRDKRE1 NE 1 AND PRCC32A1 = DK/REF
THEN PRYRDKRE1 = 1
UPDATE: IF PR30INIT1 NE 1 AND PRCC32A1 = 1 AND AGE1STPR1 IS WITHIN
30 DAYS OF INTERVIEW DATE THEN PR30INIT1 = 1
UPDATE: IF PRYFU1 NE 0 AND PRCC32A1 = DK/REF THEN PRYFU1 = 0
UPDATE: IF PRMFU1 = 1-12 AND PRCC32A1 = DK/REF THEN PRMFU1 = 0
PRCC33A1 [IF PRCC32A1=2 OR PRCC32A1=3] Please answer this
question again. Did you first use Vicodin in a way a doctor did
not direct you to use it in [CURRENT YEAR-2], [CURRENT
YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
UPDATE: IF PRYFU1 NE 0 AND PRCC33A1 = DK/REF THEN PRYFU1 = 0
IF PRCC33A1 = 1 THEN PRYFU1 = CURRENT YEAR - 2
IF PRCC33A1 = 2 THEN PRYFU1 = CURRENT YEAR - 1
IF PRCC33A1 = 3 THEN PRYFU1 = CURRENT YEAR

230
April 15, 2016

UPDATE: IF PRMFU1 = 1-12 AND PRCC33A1 = DK/REF THEN PRMFU1 = 0
PRCC33B1

[IF PRCC33A1 NE (BLANK OR DK/REF)] Please answer
this question again. In what month in [PRCC33A1] did
you first use Vicodin in a way a doctor did not direct you to
use it?

IF PRCC33A1 = 3 THEN DISPLAY ONLY UP TO THE INTERVIEW MONTH.
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF PRCC33B1 = 1-12 THEN PRMFU1 = PRCC33B1
IF PRCC33B1 = DK/REF THEN PRMFU1 = 0
UPDATE: IF PRCC33B1 NE (0 OR DK/REF) THEN UPDATE MYR1STPR1.
MYR1STPR1 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (PRCC33A1 AND
PRCC33B1). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STPR1
IS 0. IF MYR1STPR1 = AGE1STPR1 THEN MYR1STPR1 = 0
UPDATE: IF PRYRINIT1 = 1 AND AGE1STPR1 NE CURNTAGE AND PRCC32A1
NE 1 AND MYR1STPR1 NE 0 AND (PRCC33A1 AND PRCC33B1 = PRY01b-d)
THEN PRYRINIT1 = 0
UPDATE: IF PRYRINIT1 NE 1 AND PRYRDKRE1 NE 1 AND PRCC33A1 = DK/REF
THEN PRYRDKRE1 = 1
IF PRYRINIT1 NE 1 AND PRYRDKRE1 NE 1 AND PRYFU1 = CURRENT YEAR-1
AND PRCC33B1 = DK/REF THEN PRYRDKRE1 = 1
UPDATE: IF PR30INIT1 = 1 AND AGE1STPR1 NOT WITHIN 30 DAYS OF DATE
OF INTERVIEW AND PRCC32A1 NE 1 AND MYR1STPR1 NE 0 AND (PRCC33A1
AND PRCC33B1 = PRY01b-d) THEN PR30INIT1 = 0

231
April 15, 2016

PRCC34A1 [IF PRCC32A1 NE 1 AND MYR1STPR1 NE 0 AND
(PRCC33A1 AND PRCC33b1 NE PRY01b-d)] The computer
recorded that you first used Vicodin in a way a doctor did not
direct you to use it in [PRCC33A1-PRCC33B1 fill]. That
would make you [MYR1STPR1] years old when you first used
Vicodin in any way a doctor did not direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF PRCC34A1 NE (6, BLANK OR DK/REF) AND (PRCC33A1 AND
PRCC33B1 NE PRY01b-d) THEN AGE1STPR1 = MYR1STPR1
UPDATE: IF PRYRINIT1 NE 1 AND AGE1STPR1 = CURNTAGE OR (PRCC34A1 =
4 AND PRCC33A1 = 3 OR (PRCC33A1 = 2 AND PRCC33b1 NE DK/REF AND
PRCC33B1 >= CURRENT MONTH) ) THEN PRYRINIT1 = 1
ELSE IF PRYRINIT = 1 AND AGE1STPR1 NE CURNTAGE AND PRCC34A1 = (6
OR DK/REF) THEN PRYRINIT1 = 0
UPDATE: IF PRYRINIT1 NE 1 AND PRYRDKRE1 NE 1 AND MYR1STPR1=
CURNTAGE AND PRCC34A1 = (6 OR DK/REF) THEN PRYRDKRE1 = 1
IF PRYRINIT1 NE 1 AND PRYRDKRE1 NE 1 AND PRCC34A1 = BLANK AND
PRCC33A1 = 3 THEN PRYRDKRE1 = 1
IF PRYRINIT1 NE 1 AND PRYRDKRE1 NE 1 AND PRCC34A1 = BLANK AND
PRCC33A1 = 2 AND PRCC33B1 = 1-12 AND PRCC33B1 >= CURRENT MONTH
THEN PRYRDKRE1 = 1
UPDATE: IF PR30INIT1 NE 1 AND AGE1STPR1 WITHIN 30 DAYS OF
INTERVIEW DATE OR (PRCC34A1 = 4 AND PRCC33A1 = 3 AND PRCC33B1 =
CURRENT MONTH) THEN PR30INIT1 = 1
ELSE IF PR30INIT1 = 1 AND AGE1STPR1 NOT WITHIN 30 DAYS OF INTERVIEW
DATE AND PRCC34A1 = (6 OR DK/REF) THEN PR30INIT1 = 0
UPDATE: IF PRYFU1 NE BLANK AND PRCC34A1 = OR DK/REF THEN PRYFU1
=0
IF PRCC34A1 = BLANK AND (PRCC33A1 AND PRCC33B1 EQ PRY01b-d) THEN
PRYFU1 = 0
UPDATE: IF PRMFU1 = 1-12 AND PRCC34A1 = (6 OR DK/REF) THEN PRMFU1 =
0
IF PRCC34A1 = BLANK AND (PRCC33A1 AND PRCC33B1 EQ PRY01b-d) THEN
PRMFU1 = 0

232
April 15, 2016

PRY02

[IF PR01=2] In the past 12 months, did you use Lortab in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR LORTAB
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY02=1 THEN PRFIRSTFLAG=2.
PRY02a

[IF PRFIRSTFLAG=2] Please think about the first time you ever used
Lortab in a way a doctor did not direct you to use it.
[IF PRY02=1] How old were you when you first used Lortab in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

PROGRAMMER: DISPLAY IN LOWER RIGHT:
Press [F2] if you want to see and hear these ways
again.
• Without a prescription of your own,
• In greater amounts, more often, or longer than
you were told to take it
• In any other way a doctor did not direct you to
use it
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
DEFINE AGE1STPR2:
IF PRY02a NE (BLANK OR DK/REF) THEN AGE1STPR2 = PRY02a
ELSE AGE1STPR2 = 0
HARD ERROR: [IF CURNTAGE < AGE1STPR2] The age you just reported is older
than your current age. Press [Enter] to answer the question again.
IF 1 <= AGE1STPR2 < 10:
PRCC05A2

The computer recorded that you were [AGE1STPR2] years old the first
time you used Lortab in a way a doctor did not direct you to use it.

233
April 15, 2016

Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF PRCC05A2= DK/REF THEN AGE1STPR2 = 0
PRCC06A2

[IF PRCC05A2=6] Please answer this question again. Think about the
first time you used Lortab in a way a doctor did not direct you to use it.
How old were you the first time you used Lortab in a way a doctor did not
direct you to use it?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF PRCC06A2 NOT (BLANK OR DK/REF) THEN AGE1STPR2 =
PRCC06A2
ELSE IF PRCC06A2 = DK/REF THEN AGE1STPR2 = 0
DEFINE PRYRINIT2:
IF AGE1STPR2 = CURNTAGE THEN PRYRINIT2 = 1
ELSE PRYRINIT2 = 0
DEFINE PRYRDKRE2:
IF PRYRINIT2 = 0 AND (PRY02a = DK/REF OR PRCC05A2 = DK/REF OR
PRCC06A2 = DK/REF) THEN PRYRDKRE2 = 1
ELSE PRYRDKRE2= 0
DEFINE PR30INIT2:
PR30INIT2 = 0
IF AGE1STPR2 = CURNTAGE AND DATE OF INTERVIEW >= DOB AND
NUMBER OF DAYS BASED ON THE DIFFERENCE BETWEEN
DATE OF INTERVIEW AND DOB <= 30, THEN PR30INIT2 = 1
2.2.1

Year and Month of First Nonmedical Use

DEFINE PRYFU2:
PRYFU2 = 0
DEFINE PRMFU2:

234
April 15, 2016

PRMFU2 = 0
PRY02b

[AGE1STPR2 = CURNTAGE AND DATE OF INTERVIEW < DOB OR
IF AGE1STPR2 = CURNTAGE - 1 AND DATE OF INTERVIEW ≥
DOB] Did you first use Lortab in a way a doctor did not direct you to
use it in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

PRY02c

[IF AGE1STPR2 = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first use Lortab in a way a doctor did not direct you to
use it in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

UPDATE: IF PRY02B = 2 OR (AGE1STPR2 = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB) THEN PRYFU2 = CURRENT YEAR
IF PRY02B = 1 OR PRY02C = 2 THEN PRYFU2 = CURRENT YEAR - 1
IF PRY02C = 1 THEN PRYFU2 = CURRENT YEAR - 2
DEFINE PRJANFLAG2:
PRJANFLAG2 = 0
IF PRYFU2=CURRENT YEAR AND CURRENT MONTH = JANUARY THEN
PRJANFLAG2 = 1
IF PRYFU2=CURRENT YEAR-1 AND BIRTHDAY MONTH=JANUARY AND
DATE OF INTERVIEW ≥ DOB THEN PRJANFLAG2=1
IF PRJANFLAG2=1 THEN PRY02D=1
DEFINE PRDECFLAG2:
PRDECFLAG2 = 0
IF AGE1STPR2 = CURNTAGE AND PRYFU2=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN PRDECFLAG2 = 1
IF PRDECFLAG2=1 THEN PRY02D=12
DEFINE PR1MTHFLAG2:
PR1MTHFLAG2=0
IF (AGE1STPR2=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH) THEN
PR1MTHFLAG2=1
IF PR1MTHFLAG2=1 THEN PRY02D=CURRENT MONTH
PRY02d

[IF PRYFU2 NE 0 AND PRJANFLAG2 = 0 AND PRDECFLAG2=0
AND PR1MTHFLAG2=0]

235
April 15, 2016

[IF PRYFU2 = CURRENT YEAR OR CURRENT YEAR -1] Earlier,
you reported that you first used Lortab in a way a doctor did not direct
you to use it when you were [AGE1STPR2] years old. Based on your date
of birth, you turned [AGE1STPR2] in [FILL WITH MONTH/YEAR FOR
AGE1STPR2 BASED ON DOB].
[IF PRYFU2 NE 0] In what month in [PRYFU2] did you first use Lortab
in a way a doctor did not direct you to use it?
[IF DATE OF INTERVIEW < DOB AND AGE1STPR2=CURRENT AGE AND
PRYFU2=CURRENT YEAR THEN SHOW JANUARY THROUGH
INTERVIEW MONTH.]
IF AGE1STPR2 = CURNTAGE AND DATE OF INTERVIEW ≥ DOB THEN SHOW
MONTHS FROM BIRTH MONTH TO INTERVIEW MONTH.
IF ((AGE1STPR2 = CURNTAGE AND DATE OF INTERVIEW <= DOB) or
(AGE1STPR2 = CURNTAGE – 1 AND DATE OF INTERVIEW >
DOB))
AND (PRYFU2 = CURRENT YEAR – 1), SHOW BIRTH MONTH TO DECEMBER
IF PRYFU2=CURRENT YEAR AND AGE1STPR2=CURRENT AGE-1 AND DATE
OF INTERVIEW > DOB THEN SHOW JANUARY THROUGH BIRTH
MONTH.
IF PRYFU2 = CURRENT YEAR - 1 AND AGE1STPR2 = CURNTAGE - 1 AND
DATE OF INTERVIEW < DOB THEN SHOW JANUARY THROUGH
BIRTH MONTH.
ELSE SHOW ALL MONTHS.]
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF

236
April 15, 2016

UPDATE: IF PRY02D = 1-12 THEN PRMFU2 = PRY02D
IF PRJANFLAG2 = 1 THEN PRMFU2 = 1.
IF PRDECFLAG2=1 THEN PRMFU2=12.
UPDATE: IF PRYRINIT2 NE 1 AND (PRYFU2 = CURRENT YEAR OR (PRYFU2 =
CURRENT YEAR - 1 AND PRMFU2 = 1-12 AND PRMFU2 >=
CURRENT MONTH) THEN PRYRINIT2 = 1
UPDATE: IF PRYRINIT2 NE 1 AND PRYRDKRE2 NE 2 AND [(PRY02b = DK/REF
OR PRY02c = DK/REF) OR (PRYFU2 = CURRENT YEAR-1 AND
PRY02d = DK/REF)] THEN PRYRDKRE2 = 1
UPDATE: IF PR30INIT2 NE 1 AND PRYFU2 = CURRENT YEAR AND PRMFU2 =
CURRENT MONTH THEN PR30INIT2 = 1
DEFINE MYR1STPR2:
MYR1STPR2 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (PRY02B-D).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN
MYR1STPR2 IS 0.
IF MYR1STPR2 NE 0 AND NE AGE1STPR2:
PRCC32A2

Earlier, the computer recorded that you were [AGE1STPR2] years old
when you first used Lortab in a way a doctor did not direct you to use it.
Which answer is correct?
1

I was [MYR1STPR2] years old in [PRY02B-D fill] the first time I
used Lortab in a way not directed for me by a doctor
2
I was [AGE1STPR2] years old the first time I used Lortab in a
way not directed for me by a doctor
3
Neither answer is correct
DK/REF
UPDATE: IF PRCC32A2 = 1, THEN AGE1STPR2 = MYR1STPR2.
UPDATE: IF PRYRINIT2 NE 1 AND AGE1STPR2 = CURNTAGE THEN
PRYRINIT2= 1
ELSE IF PRYRINIT2 = 1 AND AGE1STPR2 NE CURNTAGE AND PRCC32A2 =
DK/REF THEN PRYRINIT2 = 0
UPDATE: IF PRYRINIT2 NE 1 AND PRYRDKRE2 NE 1 AND PRCC32A2 = DK/REF
THEN PRYRDKRE2 = 1

237
April 15, 2016

UPDATE: IF PR30INIT2 NE 1 AND PRCC32A2 = 1 AND AGE1STPR2 IS WITHIN
30 DAYS OF INTERVIEW DATE THEN PR30INIT2 = 1
UPDATE: IF PRYFU2 NE 0 AND PRCC32A2 = DK/REF THEN PRYFU2 = 0
UPDATE: IF PRMFU2 = 1-12 AND PRCC32A2 = DK/REF THEN PRMFU2 = 0
PRCC33A2

[IF PRCC32A2=2 OR PRCC32A2=3] Please answer this question again.
Did you first use Lortab in a way a doctor did not direct you to use it in
[CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

UPDATE: IF PRYFU2 NE 0 AND PRCC33A2 = DK/REF THEN PRYFU2 = 0
IF PRCC33A2 = 1 THEN PRYFU2 = CURRENT YEAR - 2
IF PRCC33A2 = 2 THEN PRYFU2 = CURRENT YEAR - 1
IF PRCC33A2 = 3 THEN PRYFU2 = CURRENT YEAR
UPDATE: IF PRMFU2 = 1-12 AND PRCC33A2 = DK/REF THEN PRMFU2 = 0
PRCC33B2

[IF PRCC33A2 NE (BLANK OR DK/REF)] Please answer this question
again. In what month in [PRCC33A2] did you first use Lortab in any way
a doctor did not direct you to use it?

IF PRCC33A2 = 3 THEN DISPLAY ONLY UP TO THE INTERVIEW MONTH.
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF PRCC33B2 = 1-12 THEN PRMFU2 = PRCC33B2
IF PRCC33B2 = DK/REF THEN PRMFU2 = 0

238
April 15, 2016

UPDATE: IF PRCC33B2 NE (0 OR DK/REF) THEN UPDATE MYR1STPR2.
MYR1STPR2 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (PRCC33A2
AND PRCC33B2). IF MONTH OF FIRST USE = MONTH OF BIRTH,
THEN MYR1STPR2 IS 0. IF MYR1STPR2 = AGE1STPR2 THEN
MYR1STPR2 = 0
UPDATE: IF PRYRINIT2 = 1 AND AGE1STPR2 NE CURNTAGE AND PRCC32A2
NE 1 AND MYR1STPR2 NE 0 AND (PRCC33A2 AND PRCC33B2 =
PRY02b-d) THEN PRYRINIT2 = 0
UPDATE: IF PRYRINIT2 NE 1 AND PRYRDKRE2 NE 1 AND PRCC33A2 = DK/REF
THEN PRYRDKRE2 = 1
IF PRYRINIT2 NE 1 AND PRYRDKRE2 NE 1 AND PRYFU2 = CURRENT YEAR-1
AND PRCC33B2 = DK/REF THEN PRYRDKRE2 = 1
UPDATE: IF PR30INIT2 = 1 AND AGE1STPR2 NOT WITHIN 30 DAYS OF DATE
OF INTERVIEW AND PRCC32A2 NE 1 AND MYR1STPR2 NE 0 AND
(PRCC33A2 AND PRCC33B2 = PRY02b-d) THEN PR30INIT2 = 0
PRCC34A2

[IF PRCC32A2 NE 1 AND MYR1STPR2 NE 0 AND (PRCC33A2 AND
PRCC33B2 NE PRY02b-d)] The computer recorded that you first used
Lortab in a way a doctor did not direct you to use it in [PRCC33A2PRCC33B2 fill]. That would make you [MYR1STPR2] years old when
you first used Lortab in any way a doctor did not direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF PRCC34A2 NE (6, BLANK OR DK/REF) AND (PRCC33A2 AND
PRCC33B2 NE PRY02b-d) THEN AGE1STPR2 = MYR1STPR2
UPDATE: IF PRYRINIT2 NE 1 AND AGE1STPR2 = CURNTAGE OR (PRCC34A2 =
4 AND PRCC33A2 = 3 OR (PRCC33A2 = 2 AND PRCC33B2 NE
DK/REF AND PRCC33B2 >= CURRENT MONTH) ) THEN
PRYRINIT2 = 1
ELSE IF PRYRINIT = 1 AND AGE1STPR2 NE CURNTAGE AND PRCC34A2 = (6
OR DK/REF) THEN PRYRINIT2 = 0
UPDATE: IF PRYRINIT2 NE 1 AND PRYRDKRE2 NE 1 AND MYR1STPR2=
CURNTAGE AND PRCC34A2 = (6 OR DK/REF) THEN PRYRDKRE2
=1

239
April 15, 2016

IF PRYRINIT2 NE 1 AND PRYRDKRE2 NE 1 AND PRCC34A2 = BLANK AND
PRCC33A2 = 3 THEN PRYRDKRE2 = 1
IF PRYRINIT2 NE 1 AND PRYRDKRE2 NE 1 AND PRCC34A2 = BLANK AND
PRCC33A2 = 2 AND PRCC33B2 = 1-12 AND PRCC33B2 >=
CURRENT MONTH THEN PRYRDKRE2 = 1
UPDATE: IF PR30INIT2 NE 1 AND AGE1STPR2 WITHIN 30 DAYS OF
INTERVIEW DATE OR (PRCC34A2 = 4 AND PRCC33A2 = 3 AND
PRCC33B2 = CURRENT MONTH) THEN PR30INIT2 = 1
ELSE IF PR30INIT2 = 1 AND AGE1STPR2 NOT WITHIN 30 DAYS OF INTERVIEW
DATE AND PRCC34A2 = (6 OR DK/REF) THEN PR30INIT2 = 0
UPDATE: IF PRYFU2 NE BLANK AND PRCC34A2 = OR DK/REF THEN PRYFU2
=0
IF PRCC34A2 = BLANK AND (PRCC33A2 AND PRCC33B2 EQ PRY02b-d) THEN
PRYFU2 = 0
UPDATE: IF PRMFU2 = 1-12 AND PRCC34A2 = (6 OR DK/REF) THEN PRMFU2 =
0
IF PRCC34A2 = BLANK AND (PRCC33A2 AND PRCC33B2 EQ PRY02b-d) THEN
PRMFU2 = 0
Continue asking the misuse and age at first misuse questions above about each pain
reliever reported.

PRY03

[IF PR01=3] In the past 12 months, did you use Norco in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR NORCO
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY03=1 THEN PRFIRSTFLAG=3.
PRY03a

[IF PRFIRSTFLAG=3] Please think about the first time you ever used
Norco in a way a doctor did not direct you to use it.
[IF PRY03=1] How old were you when you first used Norco in a way a
doctor did not direct you to use it?
AGE:

[(RANGE: 1 - 110)]

240
April 15, 2016

DK/REF
[DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY04

[IF PR01=4] In the past 12 months, did you use Zohydro ER in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR ZOHYDRO ER
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY04=1 THEN PRFIRSTFLAG=4.
PRY04a

[IF PRFIRSTFLAG=4] Please think about the first time you ever used
Zohydro ER in a way a doctor did not direct you to use it.
[IF PRY04=1] How old were you when you first used Zohydro ER in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY05

[IF PR01=5] In the past 12 months, did you use hydrocodone in any way a
doctor did not direct you to use it?
1

Yes

241
April 15, 2016

2
No
DK/REF
UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY05=1 THEN PRFIRSTFLAG=5.
PRY05a

[IF PRFIRSTFLAG=5] Please think about the first time you ever used
hydrocodone in a way a doctor did not direct you to use it.
[IF PRY05=1] How old were you when you first used hydrocodone in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]
[DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY06

[IF PR02=1] In the past 12 months, did you use OxyContin in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR OXYCONTIN
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY06=1 THEN PRFIRSTFLAG=6.
PRY06a

[IF PRFIRSTFLAG=6] Please think about the first time you ever used
OxyContin in a way a doctor did not direct you to use it.
[IF PRY06=1] How old were you when you first used OxyContin in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]

242
April 15, 2016

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY07

[IF PR02=2] In the past 12 months, did you use Percocet in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR PERCOCET
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY07=1 THEN PRFIRSTFLAG=7.
PRY07a

[IF PRFIRSTFLAG=7] Please think about the first time you ever used
Percocet in a way a doctor did not direct you to use it.
[IF PRY07=1] How old were you when you first used Percocet in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY08

[IF PR02=3] In the past 12 months, did you use Percodan in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR PERCODAN
1
Yes
2
No
DK/REF

243
April 15, 2016

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY08=1 THEN PRFIRSTFLAG=8.
PRY08a

[IF PRFIRSTFLAG=8] Please think about the first time you ever used
Percodan in a way a doctor did not direct you to use it.
[IF PRY08=1] How old were you when you first used Percodan in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.
PRY09

[IF PR03=1] In the past 12 months, did you use Roxicodone in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR ROXICODONE
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY09=1 THEN PRFIRSTFLAG=9.
PRY09a

[IF PRFIRSTFLAG=9] Please think about the first time you ever used
Roxicodone in a way a doctor did not direct you to use it.
[IF PRY09=1] How old were you when you first used Roxicodone in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES

244
April 15, 2016

PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY10

[IF PR03=2] In the past 12 months, did you use oxycodone in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR OXYCODONE
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY10=1 THEN PRFIRSTFLAG=10.
PRY10a

[IF PRFIRSTFLAG=10] Please think about the first time you ever used
oxycodone in a way a doctor did not direct you to use it.
[IF PRY10=1] How old were you when you first used oxycodone in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY11

[IF PR04=1] In the past 12 months, did you use Ultram in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR ULTRAM
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY11=1 THEN PRFIRSTFLAG=11.

245
April 15, 2016

PRY11a

[IF PRFIRSTFLAG=11] Please think about the first time you ever used
Ultram in a way a doctor did not direct you to use it.
[IF PRY11=1] How old were you when you first used Ultram in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.
PRY12

[IF PR04=2] In the past 12 months, did you use Ultram ER in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR ULTRAM ER
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND IF PRY12=1 THEN PRFIRSTFLAG=12.
PRY12a

[IF PRFIRSTFLAG=12] Please think about the first time you ever used
Ultram ER in a way a doctor did not direct you to use it.
[IF PRY12=1] How old were you when you first used Ultram ER in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

246
April 15, 2016

PRY13

[IF PR04=3] In the past 12 months, did you use Ultracet in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR ULTRACET
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND IF PRY13=1 THEN PRFIRSTFLAG=13.
PRY13a

[IF PRFIRSTFLAG=13] Please think about the first time you ever used
Ultracet in a way a doctor did not direct you to use it.
[IF PRY13=1] How old were you when you first used Ultracet in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.
PRY14

[IF PR04=4] In the past 12 months, did you use tramadol in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR TRAMADOL
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND IF PRY14=1 THEN PRFIRSTFLAG=14.
PRY14a

[IF PRFIRSTFLAG=14] Please think about the first time you ever used
tramadol in a way a doctor did not direct you to use it.

247
April 15, 2016

[IF PRY14=1] How old were you when you first used tramadol in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.
PRY15

[IF PR04=5] In the past 12 months, did you use extended-release tramadol
in any way a doctor did not direct you to use it?
DISPLAY IMAGE FOR EXTENDED-RELEASE TRAMADOL
(GENERIC)
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY15=1 THEN PRFIRSTFLAG=15.
PRY15a

[IF PRFIRSTFLAG=15.] Please think about the first time you ever used
extended-release tramadol in a way a doctor did not direct you to use it.
[IF PRY15=1] How old were you when you first used extended-release
tramadol in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

248
April 15, 2016

PRY16

[IF PR05=1] In the past 12 months, did you use Tylenol with codeine 3 or
4 in any way a doctor did not direct you to use it?
DISPLAY IMAGE FOR TYLENOL WITH CODEINE
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY16=1 THEN PRFIRSTFLAG=16.
PRY16a

[IF PRFIRSTFLAG=16] Please think about the first time you ever used
Tylenol with codeine 3 or 4 in a way a doctor did not direct you to use it.
[IF PRY16=1] How old were you when you first used Tylenol with
codeine 3 or 4 in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY17

[IF PR05=2] In the past 12 months, did you use codeine pills in any way a
doctor did not direct you to use them?
DISPLAY IMAGE FOR CODEINE
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY17=1 THEN PRFIRSTFLAG=17.
PRY17a

[IF PRFIRSTFLAG=17] Please think about the first time you ever used
codeine pills in a way a doctor did not direct you to use them.

249
April 15, 2016

[IF PRY17=1] How old were you when you first used codeine pills in a
way a doctor did not direct you to use them?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY18

[IF PR06=1] In the past 12 months, did you use Avinza in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR AVINZA
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY18=1 THEN PRFIRSTFLAG=18.
PRY18a

[IF PRFIRSTFLAG=18] Please think about the first time you ever used
Avinza in a way a doctor did not direct you to use it.
[IF PRY18=1] How old were you when you first used Avinza in any way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES

250
April 15, 2016

PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY19

[IF PR06=2] In the past 12 months, did you use Kadian in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR KADIAN
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY19=1 THEN PRFIRSTFLAG=19.
PRY19a

[IF PRFIRSTFLAG=19] Please think about the first time you ever used
Kadian in a way a doctor did not direct you to use it.
[IF PRY19=1] How old were you when you first used Kadian in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY20

[IF PR06=3] In the past 12 months, did you use MS Contin in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR MS CONTIN
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:

251
April 15, 2016

IF PRFIRSTFLAG=0 AND PRY20=1 THEN PRFIRSTFLAG=20.
PRY20a

[IF PRFIRSTFLAG=20] Please think about the first time you ever used
MS Contin in a way a doctor did not direct you to use it.
[IF PRY20=1] How old were you when you first used MS Contin in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.
PRY21

[IF PR06=4] In the past 12 months, did you use morphine in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR MORPHINE
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY21=1 THEN PRFIRSTFLAG=21.
PRY21a

[IF PRFIRSTFLAG=21] Please think about the first time you ever used
morphine in a way a doctor did not direct you to use it.
[IF PRY21=1] How old were you when you first used morphine in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]

252
April 15, 2016

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.
PRY22

[IF PR06=5] In the past 12 months, did you use extended-release
morphine in any way a doctor did not direct you to use it?
DISPLAY IMAGE FOR EXTENDED-RELEASE MORPHINE
(GENERIC)
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY22=1 THEN PRFIRSTFLAG=22.
PRY22a

[IF PRFIRSTFLAG=22] Please think about the first time you ever used
extended-release morphine in a way a doctor did not direct you to use it.
[IF PRY22=1] How old were you when you first used extended-release
morphine in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.
PRY23

[IF PR07=1] In the past 12 months, did you use Duragesic in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR DURAGESIC
1
Yes
2
No
DK/REF

253
April 15, 2016

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY23=1 THEN PRFIRSTFLAG=23.
PRY23a

[IF PRFIRSTFLAG=23] Please think about the first time you ever used
Duragesic in a way a doctor did not direct you to use it.
[IF PRY23=1] How old were you when you first used Duragesic in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY24

[IF PR07=2] In the past 12 months, did you use Fentora in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR FENTORA
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY24=1 THEN PRFIRSTFLAG=24.
PRY24a

[IF PRFIRSTFLAG=24] Please think about the first time you ever used
Fentora in a way a doctor did not direct you to use it.
[IF PRY24=1] How old were you when you first used Fentora in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

254
April 15, 2016

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY25

[IF PR07=3] In the past 12 months, did you use fentanyl in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR FENTANYL
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY25=1 THEN PRFIRSTFLAG=25.
PRY25a

[IF PRFIRSTFLAG=25] Please think about the first time you ever used
fentanyl in a way a doctor did not direct you to use it.
[IF PRY25=1] How old were you when you first used fentanyl in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY26

[IF PR08=1] In the past 12 months, did you use Suboxone in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR SUBOXONE

255
April 15, 2016

1
Yes
2
No
DK/REF
UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY26=1 THEN PRFIRSTFLAG=26.
PRY26a

[IF PRFIRSTFLAG=26] Please think about the first time you ever used
Suboxone in a way a doctor did not direct you to use it.
[IF PRY26=1] How old were you when you first used Suboxone in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.
PRY27

[IF PR08=2] In the past 12 months, did you use buprenorphine in any way
a doctor did not direct you to use it?
DISPLAY IMAGE FOR BUPRENORPHINE
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY27=1 THEN PRFIRSTFLAG=27.
PRY27a

[IF PRFIRSTFLAG=27] Please think about the first time you ever used
buprenorphine in a way a doctor did not direct you to use it.
[IF PRY27=1] How old were you when you first used buprenorphine in a
way a doctor did not direct you to use it?
AGE:

[(RANGE: 1 - 110)]

256
April 15, 2016

DK/REF

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.
PRY28

[IF PR08=3] In the past 12 months, did you use buprenorphine plus
naloxone in any way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY28=1 THEN PRFIRSTFLAG=28.
PRY28a

[IF PRFIRSTFLAG=28] Please think about the first time you ever used
buprenorphine plus naloxone in a way a doctor did not direct you to use it.
[IF PRY28=1] How old were you when you first used buprenorphine plus
naloxone in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY29

[IF PR09=1] In the past 12 months, did you use Opana in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR OPANA
1

Yes

257
April 15, 2016

2
No
DK/REF
UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY29=1 THEN PRFIRSTFLAG=29.
PRY29a

[IF PRFIRSTFLAG=29] Please think about the first time you ever used
Opana in a way a doctor did not direct you to use it.
[IF PRY29=1] How old were you when you first used Opana in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY30

[IF PR09=2] In the past 12 months, did you use Opana ER in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR OPANA ER
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY30=1 THEN PRFIRSTFLAG=30.
PRY30a

[IF PRFIRSTFLAG=30] Please think about the first time you ever used
Opana ER in a way a doctor did not direct you to use it.
[IF PRY30=1] How old were you when you first used Opana ER in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

258
April 15, 2016

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY31

[IF PR09=3] In the past 12 months, did you use oxymorphone in any way
a doctor did not direct you to use it?
DISPLAY IMAGE FOR OXYMORPHONE (GENERIC)
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY31=1 THEN PRFIRSTFLAG=31.
PRY31a

[IF PRFIRSTFLAG=31] Please think about the first time you ever used
oxymorphone in a way a doctor did not direct you to use it.
[IF PRY31=1] How old were you when you first used oxymorphone in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.
PRY32

[IF PR09=4] In the past 12 months, did you use extended-release
oxymorphone in any way a doctor did not direct you to use it?

259
April 15, 2016

DISPLAY IMAGE FOR EXTENDED-RELEASE OXYMORPHONE
(GENERIC)
1
Yes
2
No
DK/REF
UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY32=1 THEN PRFIRSTFLAG=32.
PRY32a

[IF PRFIRSTFLAG=32] Please think about the first time you ever used
extended-release oxymorphone in a way a doctor did not direct you to use
it.
[IF PRY32=1] How old were you when you first used extended-release
oxymorphone in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY33

[IF PR10=1] In the past 12 months, did you use Demerol in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR DEMEROL
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY33=1 THEN PRFIRSTFLAG=33.
PRY33a

[IF PRFIRSTFLAG=33] Please think about the first time you ever used
Demerol in a way a doctor did not direct you to use it.

260
April 15, 2016

[IF PRY33=1] How old were you when you first used Demerol in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY34

[IF PR10=2] In the past 12 months, did you use Dilaudid or
hydromorphone in any way a doctor did not direct you to use it?
DISPLAY IMAGE FOR DILAUDID OR HYDROMORPHONE
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY34=1 THEN PRFIRSTFLAG=34.
PRY34a

[IF PRFIRSTFLAG=34] Please think about the first time you ever used
Dilaudid or hydromorphone in a way a doctor did not direct you to use it.
[IF PRY34=1] How old were you when you first used Dilaudid or
hydromorphone in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES

261
April 15, 2016

PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY35

[IF PR10=3] In the past 12 months, did you use Exalgo or extendedrelease hydromorphone in any way a doctor did not direct you to use it?
DISPLAY IMAGE FOR EXALGO OR EXTENDED-RELEASE
HYDROMORPHONE
1
Yes
2
No
DK/REF

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY35=1 THEN PRFIRSTFLAG=35.
PRY35a

[IF PRFIRSTFLAG=35] Please think about the first time you ever used
Exalgo or extended-release hydromorphone in a way a doctor did not
direct you to use it.
[IF PRY35=1] How old were you when you first used Exalgo or extendedrelease hydromorphone in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRY36

[IF PR10=4] In the past 12 months, did you use methadone in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR METHADONE
1
Yes
2
No
DK/REF

262
April 15, 2016

UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRY36=1 THEN PRFIRSTFLAG=36.
PRY36a

[IF PRFIRSTFLAG=36] Please think about the first time you ever used
methadone in a way a doctor did not direct you to use it.
[IF PRY36=1] How old were you when you first used methadone in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

PRYOTH

[IF PRANYOTH=1] In the past 12 months, did you use any [IF
PRANYOTH=1 AND PRYRCOUNT > 1 FILL “other”] prescription pain
reliever in a way a doctor did not direct you to use it?
Remember, do not include “over-the-counter” pain relievers such as
aspirin, Tylenol, Advil, or Aleve.
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW CALENDAR WITH 12-MONTH
REFERENCE DATE

263
April 15, 2016

PRYOTHA1 [IF PRYOTH = 1] Please type in the name of one of the [IF
PRANYOTH=1 AND PRYRCOUNT > 1 FILL “other”] prescription pain
relievers you have used in the past 12 months in a way a doctor did not
direct you to use it. If you’re not sure how to spell the name of the pain
reliever, just make your best guess.
When you have finished, press [ENTER] to go to the next question.
Remember, you do not need to type in the names of any prescription pain
relievers you already reported.
______________
[NOTE: DON'T ALLOW BLANKS IN PRYOTHA1 IF PROTH = 1]
DK/REF
PRYOTHA2 [IF PRYOTH = 1 AND PRYOTHA1 NE DK/REF)] Please type in the
name of any other prescription pain reliever you used in the past 12
months in a way a doctor did not direct you to use it.
If you have not used any other prescription pain reliever in a way a doctor
did not direct you to use it, press [ENTER].
______________
DK/REF
PRYOTHA3 [IF PRYOTHA2 NE (BLANK OR DK/REF)] Please type in the name of
any other prescription pain reliever you used in the past 12 months in a
way a doctor did not direct you to use it.
If you have not used any other prescription pain reliever in a way a doctor
did not direct you to use it, press [ENTER].
______________
DK/REF
PRYOTHA4 [IF PRYOTHA3 NE (BLANK OR DK/REF)] Please type in the name of
any other prescription pain reliever you used in the past 12 months in a
way a doctor did not direct you to use it.
If you have not used any other prescription pain reliever in a way a doctor
did not direct you to use it, press [ENTER].

______________
DK/REF

264
April 15, 2016

PRYOTHA5 [IF PRYOTHA4 NE (BLANK OR DK/REF Please type in the name of
any other prescription pain reliever you used in the past 12 months in a
way a doctor did not direct you to use it.
If you have not used any other prescription pain reliever in a way a doctor
did not direct you to use it, press [ENTER].

______________
DK/REF
UPDATE PRFIRSTFLAG:
IF PRFIRSTFLAG=0 AND PRYOTH =1 THEN PRFIRSTFLAG=37.
PRYOTHa

[IF PRFIRSTFLAG=37] Please think about the first time you ever used
any [IF PRANYOTH=1 AND PRYRCOUNT > 1 FILL “other”]
prescription pain reliever in a way a doctor did not direct you to use it.
[IF PRYOTH =1] How old were you when you first used any [IF
PRANYOTH=1 AND PRYRCOUNT > 1 FILL “other”] prescription pain
reliever in a way a doctor did not direct you to use it?

AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

DEFINE PRMISCOUNT:
INITIALIZE PRMISCOUNT TO 0.
INCREMENT PRMISCOUNT BY 1 FOR EVERY RESPONSE OF YES IN PRY01PRYOTH.
DEFINE PRMISUSE12:
IF PRMISCOUNT > 0 THEN PRMISUSE12 = 1.
ELSE PRMISUSE12 = 2.

265
April 15, 2016

If no pain relievers misused in the past 12 months:
PRL02

[IF PR12MON=1 AND PRMISUSE12=2] Have you ever, even once, used
any prescription pain reliever in any way a doctor did not direct you
to use it?
1
Yes
2
No
DK/REF

If any pain relievers misused in past 12 months:
DEFINE PRDKREFCOUNT:
INITIALIZE PRDKREFCOUNT TO 0.
INCREMENT PRDKREFCOUNT BY 1 FOR EVERY RESPONSE OF DK/REF IN
PRY01- PRYOTH AND PR01-PRANYOTH.
DEFINE PRDKREFFLAG:
IF PRDKREFCOUNT > 1 THEN PRDKREFFLAG = 1.
ELSE PRDKREFFLAG = 2.
DEFINE PRNUMFILL:
IF PRMISCOUNT = 1 AND PRY17 NE 1 AND PRYOTH NE 1 THEN PRNUMFILL =
"it".
ELSE PRNUMFILL = "them".
DEFINE PR30ANYINIT:
IF ANY CODE OF 1 IN PR30INIT1-PR30INITOT THEN PR30ANYINIT = 1.
ELSE PR30ANYINIT = 2.
DEFINE PRFILL2:
IF PRMISCOUNT < 3 AND PRYOTH NE 1 AND PRDKREFFLAG =2 THEN
PRFILL2=”[DRUG NAMES FROM PRY01-PRY36]”.
ELSE IF PRMISCOUNT=1 AND PRYOTH NE 1 AND PRDKREFFLAG=1 THEN
PRFILL2 = “[DRUG NAMES FROM PRY01-PRY36] or any other prescription pain
reliever.” ELSE IF PRMISCOUNT=2 AND PRDKREFFLAG=2 AND PRYOTH =1
THEN PRFILL2=”[DRUG NAME FROM PRY01-PRY36] and some other prescription
pain reliever.”
ELSE IF PRMISCOUNT=2 AND PRDKREFFLAG=1 THEN PRFILL2=”[DRUG
NAMES FROM PRY01-PRY36]”. IF PRYOTH =1 THEN ADD “some other
prescription pain reliever” TO THE FILL. [INCLUDE DRUG NAMES FOR NEW PAIN
RELIEVERS.]
ELSE PRFILL2= “prescription pain relievers”

266
April 15, 2016

DEFINE PRNAMEFILL:
IF PRMISCOUNT =1 AND (PRYOTH = 2 OR PRYOTH = BLANK) AND
PRDKREFFLAG =2 THEN PRNAMEFILL=”[DRUG NAME FROM PRY01-PRY36]”
ELSE IF PRMISCOUNT=1 AND (PRYOTH NE 1) AND PRDKREFFLAG=1 THEN
PRNAMEFILL=”[DRUG NAME FROM PRY01-PRY36] or any other prescription pain
reliever]”
ELSE IF PRMISCOUNT >1 THEN PRNAMEFILL= “prescription pain relievers”
DEFINE PRYINICT:
INITIALIZE PRYINICT TO 0.
INCREMENT PRYINICT BY 1 FOR EVERY VALUE OF 1 IN PRYRINIT1PRYRINITOT.

DEFINE PRYRDKRECT:
INITIALIZE PRYRDKRECT TO 0.
INCREMENT PRYRDKRECT BY 1 FOR EVERY VALUE OF 1 IN PRYRDKRE1PRYRDKREOT.

DEFINE PRYINALL:
IF PRMISCOUNT > 0 AND PRMISCOUNT = PRYINICT + PRYRDKRECT THEN
PRYINALL = 1.
ELSE PRYINALL = 2.
PRL03

[IF PRYINALL=1] Earlier questions were about the past 12 months. This
question is about any time before then, that is, any time in your life before
[DATEFILL -12 MONTHS].
At any time before [DATEFILL -12 MONTHS], did you ever use any
prescription pain reliever in a way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

PRINTROYR3 [IF PRMISUSE12=1 AND PRMISCOUNT>1] Earlier the computer
recorded that in the past 12 months you used [IF PRMISUSE12=1
AND PRMISCOUNT > 2, ADD "these"] [PRFILL2] in a way a
doctor did not direct you to use [PRNUMFILL].
[IF PRMISUSE12=1 AND PRMISCOUNT>2 ] FILL WITH DRUG
NAMES FROM PRY01- PRYOTH BELOW. USE MULTIPLE
COLUMNS AS NEEDED. IF PRYOTH = 1, FILL WITH "Some other
prescription pain reliever".

267
April 15, 2016

[IF PRMISUSE12=1 AND PRMISCOUNT>1] The next questions refer to
these drugs as prescription pain relievers.
Press Enter to continue.
PRM01

[IF PRMISUSE12 = 1 AND PR30ANYINIT = 2] In the past 30 days,
that is, from [DATEFILL] up to and including today, did you use
[PRNAMEFILL] in any way a doctor did not direct you to use
[PRNUMFILL]?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30-DAY CALENDAR

DEFINE PRMISUSE30:
PRMISUSE30=1 IF PRM01=1 OR PR30ANYINIT = 1.
PRMISUSE30=2 IF PRMISUSE12 = 1 AND (PRM01=2, DK, OR REF).
PRM02

[IF PRMISUSE30=1] During the past 30 days, on how many days did
you use [PRNAMEFILL] in any way a doctor did not direct you to use
[PRNUMFILL]?
________________ [RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30-DAY CALENDAR

PRM02DKRE

[IF PRM02 = DK/REF] What is your best estimate of the number of
days you used [PRNAMEFILL] in any way a doctor did not direct
you to use [PRNUMFILL] during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

PRM03

[IF ALC30USE = 1 and PRMISUSE30 = 1)] During the past 30 days, did
you use [PRNAMEFILL] in any way a doctor did not direct you to use
[PRNUMFILL] while you were drinking alcohol or within a couple of
hours of drinking?

268
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
PRYWAYS [IF PRMISUSE12=1] Which of these statements describe your use of
[PRNAMEFILL] at any time in the past 12 months?
To select more than one statement, press the space bar between the
numbers. When you have finished, press [ENTER].
1
2

I used [PRNAMEFILL] without a prescription of my own.
I used [PRNAMEFILL] in greater amounts than [IF
PRNAMEFILL= “codeine pills” or PRNAMEFILL= “prescription
pain relievers” THEN FILL WITH “they were”; ELSE FILL
WITH “it was”] prescribed.
3
I used [PRNAMEFILL] more often than [IF PRNAMEFILL=
“codeine pills” or PRNAMEFILL= “prescription pain relievers”
THEN FILL WITH “they were”; ELSE FILL WITH “it was”]
prescribed.
4
I used [PRNAMEFILL] for longer than [IF PRNAMEFILL=
“codeine pills” or PRNAMEFILL= “prescription pain relievers”
THEN FILL WITH “they were”; ELSE FILL WITH “it was”]
prescribed.
5
I used [PRNAMEFILL] in some other way a doctor did not
direct me to use [PRNUMFILL]
DISPLAY 12-MONTH CALENDAR

PRYLAST

[IF PRMISCOUNT > 1 OR (PRMISCOUNT = 1 AND
PRDKREFFLAG=1)] Now think about the last time you used a
prescription pain reliever in any way a doctor did not direct you to use
it.
Which of these pain relievers did you use the last time? If you used more
than one pain reliever the last time, please choose one pain reliever as
your best answer.
(LIST DRUGS WHERE PRY01- PRYOTH =1. NUMBER RESPONSE
OPTIONS SEQUENTIALLY STARTING AT 1, BUT MAINTAIN
UNIQUE CODES FOR EACH DRUG. IF PRYOTH =1, DISPLAY
"Another prescription pain reliever" AS THE LAST CATEGORY. IF
PRMISCOUNT > 0 AND PRYOTH NE 1 AND PRDKREFFLAG=1,
DISPLAY "Any other prescription pain reliever" AS THE LAST
CATEGORY. ALLOW ONLY 1 RESPONSE.)

269
April 15, 2016

PROGRAMMER: IF PRMISUSE12 = 1 THEN CREATE A RECODED RPRYLAST
VARIABLE. ASSIGN A UNIQUE CODE TO A GIVEN DRUG ACCORDING TO
THE OVERALL ORDER IN WHICH THE DRUGS APPEAR IN THE SCREENER.
INITIALIZE RPRYLAST TO BLANK.
IF "Vicodin" CHOSEN IN PRYLAST OR (PRMISCOUNT=1 AND
PRDKREFFLAG=2 AND PRY01 = 1) THEN RPRYLAST = 1.
IF "Lortab" CHOSEN IN PRYLAST OR (PRMISCOUNT=1 AND PRDKREFFLAG=2
AND PRY02 = 1) THEN PRYLAST = 2.
IF "Norco" CHOSEN IN PRYLAST OR (PRMISCOUNT=1 AND PRDKREFFLAG=2
AND PRY03 = 1) THEN RPRYLAST = 3.
ETC.
IF "Methadone" CHOSEN IN PRYLAST OR (PRMISCOUNT=1 AND
PRDKREFFLAG=2 AND PRY36=1) THEN RPRYLAST=36.
IF "Another prescription pain reliever" OR "Any other prescription pain reliever"
CHOSEN IN PRYLAST OR (PRMISCOUNT =1 AND PRYOTH = 1 AND
PRDKREFFLAG =2) THEN RPRYLAST = 37.
IF PRYLAST = DK OR REF, THEN ASSIGN THE DK/REF CODE TO RPRYLAST.)
DEFINE PRLASTFILL:
IF RPRYLAST = 1-36, THEN FILL WITH THE DRUG NAME.
IF RPRYLAST = 37 THEN FILL "other pain reliever".
IF RPRYLAST = DK, REF, OR BLANK, THEN FILL "pain reliever".
DEFINE PRLASTFILL2:
IF RPRYLAST = 1-36, THEN FILL WITH THE DRUG NAME.
IF RPRYLAST = 37 THEN FILL "the other pain reliever".
IF RPRYLAST = DK, REF, OR BLANK, THEN FILL "a pain reliever".
DEFINE PRLASTFILL3:
IF PRLASTFILL NE "other pain reliever" THEN PRLASTFILL3 = PRLASTFILL.
ELSE IF PRLASTFILL = "other pain reliever" THEN PRLASTFILL3 = "pain reliever".
PRYMOTIV [IF PRMISUSE12=1]
Now think about the last time you used [PRLASTFILL2] in any way a
doctor did not direct you to use [FILL WITH ‘them” IF RPRYLAST =17.
ELSE FILL WITH “it”].
What were the reasons you used [PRLASTFILL2] the last time? To select
more than one reason from the list, press the space bar between each
number you have typed. When you have finished, press [ENTER].

270
April 15, 2016

1
2
3
4
5
6
7
8
9

To relieve physical pain
To relax or relieve tension
To experiment or to see what [IF RPRYLAST=17 THEN “they’re”
ELSE “it’s”] like
To feel good or get high
To help with my sleep
To help me with my feelings or emotions
To increase or decrease the effect(s) of some other drug
Because I am “hooked” or I have to have [IF RPRYLAST=17
THEN “them” ELSE “it”]
I used [IF RPRYLAST=17 THEN “them” ELSE “it”] for some
other reason

DK/REF

PRMOTOT [IF PRYMOTIV=9] Please type in the other reason you used
[PRLASTFILL2] the last time. When you have finished typing your
answer, press [ENTER] to go to the next question.
REASON
__________________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN
PRMOTOT.
PRYMOT1

[IF MORE THAN ONE RESPONSE 1-9 CHOSEN IN PRYMOTIV]
Which was the main reason you used [PRLASTFILL2] the last time?
PROGRAMMER: FILL AS RESPONSE OPTIONS ONLY THOSE
CHOSEN IN PRYMOTIV
1
To relieve physical pain
2
To relax or relieve tension
3
To experiment or to see what [IF RPRYLAST=17 THEN “they’re”
ELSE “it’s”] like
4
To feel good or get high
5
To help with my sleep
6
To help me with my feelings or emotions
7
To increase or decrease the effect(s) of some other drug
8
Because I am “hooked” or I have to have [IF RPRYLAST=17
THEN “them” ELSE “it”]
9
[IF PRYMOTIV=9] The other reason I reported

271
April 15, 2016

DK/REF
PRYGOT

[IF PRMISUSE12=1 AND PRMISCOUNT=1 AND
PRDKREFFLAG=2] Now think again about the last time you used
[PRLASTFILL2] in any way a doctor did not direct you to use [FILL
WITH “them” IF RPRYLAST=17. ELSE FILL WITH “it”].
[IF PRMISUSE12 = 1] How did you get the [PRLASTFILL]? If you got
the [PRLASTFILL] in more than one way, please choose one of these
ways as your best answer.
1
2

I got a prescription for the [PRLASTFILL] from just one doctor
I got prescriptions for the [PRLASTFILL] from more than one
doctor
3
I stole the [PRLASTFILL] from a doctor’s office, clinic, hospital,
or pharmacy
4
I got the [PRLASTFILL] from a friend or relative for free
5
I bought the [PRLASTFILL] from a friend or relative
6
I took the [PRLASTFILL] from a friend or relative without asking
7
I bought the [PRLASTFILL] from a drug dealer or other stranger
8
I got the [PRLASTFILL] in some other way
DK/REF
PRYGOTSP [IF PRYGOT = 8] Please type in the other way you got the
[PRLASTFILL3].
You do not need to give a detailed description — just a few words will be
okay. When you have finished typing your answer, press [ENTER] to go
to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN PRYGOTSP.
PRYFRL

[IF PRYGOT =4] You reported that you got the [PRLASTFILL] from a
friend or relative for free. How did your friend or relative get the
[PRLASTFILL]?
1
2
3
4

He or she got a prescription for the [PRLASTFILL] from just one
doctor
He or she got prescriptions for the [PRLASTFILL] from more than
one doctor
He or she stole the [PRLASTFILL] from a doctor’s office, clinic,
hospital, or pharmacy
He or she got the [PRLASTFILL] from another friend or relative
for free
272

April 15, 2016

5

He or she bought the [PRLASTFILL] from another friend or
relative
6
He or she took the [PRLASTFILL] from another friend or relative
without asking
7
He or she bought the [PRLASTFILL] from a drug dealer or other
stranger
8
He or she got the [PRLASTFILL] in some other way
DK/REF
PRYFRLSP [IF PRYFRL = 8] Please type in the other way your friend or relative got
the last [PRLASTFILL3] you used.
You do not need to give a detailed description — just a few words will be
okay. When you have finished typing your answer, press [ENTER] to go
to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN PRYFRLSP.

273
April 15, 2016

274
April 15, 2016

Tranquilizers Main Module
If no 12 month use of prescription tranquilizers:
TRINTROLIF

[IF TRLANY = 1] The next question asks about using prescription
tranquilizers in any way a doctor did not direct you to use them.
When you answer this question, please think only about your use of
the drug in any way a doctor did not direct you to use it, including:




Using it without a prescription of your own
Using it in greater amounts, more often, or longer than you were
told to take it
Using it in any other way a doctor did not direct you to use it

Press Enter to continue.
TRL01

[IF TRLANY =1] Have you ever, even once, used any prescription
tranquilizer in any way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

If any 12 month use of prescription tranquilizers:
TRINTROYR1 [IF TR12MON = 1] The next questions ask about using prescription
tranquilizers in any way a doctor did not direct you to use them.
When you answer these questions, please think only about your use of
the drug in any way a doctor did not direct you to use it, including:




Using it without a prescription of your own
Using it in greater amounts, more often, or longer than you were
told to take it
Using it in any other way a doctor did not direct you to use it

Press Enter to continue.
DEFINE TRFILL:
TRFILL LISTS ALL INDIVIDUAL DRUGS SELECTED IN TR01, TR02, TR03, AND
TR04.
USE MULTIPLE COLUMNS AS NEEDED. IF TRANYOTH =1 AND
TRYRCOUNT > 1, THEN ADD “another prescription tranquilizer” TO
THE FILL.

275
April 15, 2016

THE FOLLOWING DRUGS SHOULD NOT USE INITIAL CAPS WHEN FILLED IN
SENTENCE FORMAT:
•
•
•
•
•
•

alprazolam
extended-release alprazolam
lorazepam
clonazepam
diazepam
cyclobenzaprine, also known as Flexeril

WHEN IMPLEMENTING TRFILL, IF 1, OR 2 DRUGS APPEAR IN LIST, FILL IN
SENTENCE FORMAT, SEPARATED WITH AN “and” BEFORE THE
LAST FILL.
IF >2 DRUGS APPEAR IN LIST, FILL IN LIST (IN COLUMNS IF NEEDED)
BELOW THE PREVIOUS SENTENCE.
DEFINE TRFIRSTFLAG:
TRFIRSTFLAG IDENTIFIES THE FIRST SEDATIVE USED NONMEDICALLY.
INITIALIZE TRFIRSTFLAG TO 0.
(TRFIRSTFLAG NEEDS TO BE DEFINED BEFORE THE ROUTING TO
TRINTROYR2 OR TRY40.)
TRINTROYR2 [IF TR12MON=1 AND (TRANYOTH NE 1 OR (TRANYOTH =1
AND TRYRCOUNT > 1))] Earlier, the computer recorded that, in the
past 12 months, you used [TRFILL].
Press Enter to continue.
PROGRAMMER: SHOW CALENDAR WITH 12-MONTH
REFERENCE DATE FOR THE INTRO SCREEN
NOTE TO PROGRAMMERS: LOOP THROUGH THE 12-MONTH MISUSE, AGE AT
FIRST MISUSE, AND YEAR AND MONTH OF FIRST MISUSE (IF APPLICABLE)
FOR EACH PRESCRIPTION TRANQUILIZER REPORTED IN THE SCREENER
FOR THE PAST 12 MONTHS.
TRY01

[IF TR01=1] In the past 12 months, did you use Xanax in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR XANAX
1
Yes
2
No
DK/REF
276

April 15, 2016

UPDATE TRFIRSTFLAG:
IF TRY01=1 THEN TRFIRSTFLAG=1.
TRY01a

[IF TRFIRSTFLAG=1] Please think about the first time you ever used
Xanax in a way a doctor did not direct you to use it.
[IF TRY01=1] How old were you when you first used Xanax in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

PROGRAMMER: DISPLAY IN LOWER RIGHT:
Press [F2] if you want to see and hear these ways
again.
• Without a prescription of your own,
• In greater amounts, more often, or longer than
you were told to take it
• In any other way a doctor did not direct you to
use it
DEFINE AGE1STTR1:
IF TRY01a NE (BLANK OR DK/REF) THEN AGE1STTR1 = TRY01a
ELSE AGE1STTR1 = 0
HARD ERROR: [IF CURNTAGE < AGE1STTR1] The age you just entered is older
than your current age. Press [Enter] to answer the question again.
IF 1 <= AGE1STTR1 < 10:
TRCC05A1 The computer recorded that you were [AGE1STTR1] years
old the first time you used Xanax in a way a doctor did not
direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF TRCC05A1= DK/REF THEN AGE1STTR1 = 0
TRCC06A1 [IF TRCC05A1=6] Please answer this question again.
Think about the first time you used Xanax in a way a doctor
did not direct you to use it.
277
April 15, 2016

How old were you the first time you used Xanax in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF TRCC06A1 NOT (BLANK OR DK/REF) THEN AGE1STTR1 =
TRCC06A1
ELSE IF TRCC06A1 = DK/REF THEN AGE1STTR1 = 0
DEFINE TRYRINIT1:
IF AGE1STTR1 = CURNTAGE THEN TRYRINIT1 = 1
ELSE TRYRINIT1 = 0
DEFINE TRYRDKRE1:
IF TRYRINIT1 = 0 AND (TRY01a = DK/REF OR TRCC05A1 = DK/REF OR
TRCC06A1 = DK/REF) THEN TRYRDKRE1 = 1
ELSE TRYRDKRE1= 0
DEFINE TR30INIT1:
TR30INIT1 = 0
IF AGE1STTR1 = CURNTAGE AND DATE OF INTERVIEW >= DOB AND
NUMBER OF DAYS BASED ON THE DIFFERENCE BETWEEN DATE OF
INTERVIEW AND DOB <= 30, THEN TR30INIT1 = 1
2.2.1

Year and Month of First Nonmedical Use

DEFINE TRYFU1:
TRYFU1 = 0
DEFINE TRMFU1:
TRMFU1 = 0
TRY01b.

[AGE1STTR1 = CURNTAGE AND DATE OF INTERVIEW < DOB OR
IF AGE1STTR1 = CURNTAGE - 1 AND DATE OF INTERVIEW ≥
DOB] Did you first use Xanax in a way a doctor did not direct you to
use it in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

278
April 15, 2016

TRY01c.

[IF AGE1STTR1 = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first use Xanax in a way a doctor did not direct you to
use it in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

UPDATE: IF TRY01B = 2 OR (AGE1STTR1 = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB) THEN TRYFU1 = CURRENT YEAR
IF TRY01B = 1 OR TRY01C = 2 THEN TRYFU1 = CURRENT YEAR - 1
IF TRY01C = 1 THEN TRYFU1 = CURRENT YEAR - 2
DEFINE TRJANFLAG1:
TRJANFLAG1 = 0
IF TRYFU1=CURRENT YEAR AND CURRENT MONTH = JANUARY THEN
TRJANFLAG1 = 1
IF TRYFU1=CURRENT YEAR-1 AND BIRTHDAY MONTH=JANUARY AND
DATE OF INTERVIEW ≥ DOB THEN TRJANFLAG1=1
IF TRJANFLAG1=1 THEN TRY01D=1
DEFINE TRDECFLAG1:
TRDECFLAG1 = 0
IF AGE1STTR1 = CURNTAGE AND TRYFU1=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN TRDECFLAG1 = 1
IF TRDECFLAG1=1 THEN TRY01D=12
DEFINE TR1MTHFLAG1:
TR1MTHFLAG1=0
IF (AGE1STTR1=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH) THEN
TR1MTHFLAG1=1
IF TR1MTHFLAG1=1 THEN TRY01D=CURRENT MONTH
TRY01d.
[IF TRYFU1 NE 0 AND TRJANFLAG1 = 0 AND TRDECFLAG1=0
AND TR1MTHFLAG1=0]
[IF TRYFU1 = CURRENT YEAR OR CURRENT YEAR -1] Earlier, you reported that
you first used Xanax in a way a doctor did not direct you to use it when you were
[AGE1STTR1] years old. Based on your date of birth, you turned [AGE1STTR1] in
[FILL WITH MONTH/YEAR FOR AGE1STTR1 BASED ON DOB].
[IF TRYFU1 NE 0] In what month in [TRYFU1] did you first use Xanax in a way a
doctor did not direct you to use it?

279
April 15, 2016

[IF DATE OF INTERVIEW < DOB AND AGE1STTR1=CURRENT AGE AND
TRYFU1=CURRENT YEAR THEN SHOW JANUARY THROUGH INTERVIEW
MONTH.]
IF AGE1STTR1 = CURNTAGE AND DATE OF INTERVIEW ≥ DOB THEN SHOW
MONTHS FROM BIRTH MONTH TO INTERVIEW MONTH.
IF ((AGE1STTR1 = CURNTAGE AND DATE OF INTERVIEW <= DOB) or
(AGE1STTR1 = CURNTAGE – 1 AND DATE OF INTERVIEW > DOB))
AND (TRYFU1 = CURRENT YEAR – 1), SHOW BIRTH MONTH TO DECEMBER
IF TRYFU1=CURRENT YEAR AND AGE1STTR1=CURRENT AGE-1 AND DATE
OF INTERVIEW > DOB THEN SHOW JANUARY THROUGH BIRTH MONTH.
IF TRYFU1 = CURRENT YEAR - 1 AND AGE1STTR1 = CURNTAGE - 1 AND
DATE OF INTERVIEW < DOB THEN SHOW JANUARY THROUGH BIRTH
MONTH.
ELSE SHOW ALL MONTHS.]
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF TRY01D = 1-12 THEN TRMFU1 = TRY01D
IF TRJANFLAG1 = 1 THEN TRMFU1 = 1.
IF TRDECFLAG1=1 THEN TRMFU1=12.
UPDATE: IF TRYRINIT1 NE 1 AND (TRYFU1 = CURRENT YEAR OR (TRYFU1 =
CURRENT YEAR - 1 AND TRMFU1 = 1-12 AND TRMFU1 >= CURRENT MONTH)
THEN TRYRINIT1 = 1
UPDATE: IF TRYRINIT1 NE 1 AND TRYRDKRE1 NE 1 AND [(TRY01b = DK/REF
OR TRY01c = DK/REF) OR (TRYFU1 = CURRENT YEAR-1 AND TRY01d =
DK/REF)] THEN TRYRDKRE1 = 1

280
April 15, 2016

UPDATE: IF TR30INIT1 NE 1 AND TRYFU1 = CURRENT YEAR AND TRMFU1 =
CURRENT MONTH THEN TR30INIT1 = 1
DEFINE MYR1STTR1:
MYR1STTR1 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (TRY01b-d).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STTR1 IS 0.
IF MYR1STTR1 NE 0 AND NE AGE1STTR1:
TRCC32A1
Earlier, the computer recorded that you were
[AGE1STTR1] years old when you first used Xanax in a way a
doctor did not direct you to use it.
Which answer is correct?
1

I was [MYR1STTR1] years old in [TRY01B-D fill] the
first time I used Xanax in a way not directed for me by
a doctor
2
I was [AGE1STTR1] years old the first time I used
Xanax in a way not directed for me by a doctor
3
Neither answer is correct
DK/REF
UPDATE: IF TRCC32A1 = 1, THEN AGE1STTR1 = MYR1STTR1.
UPDATE: IF TRYRINIT1 NE 1 AND AGE1STTR1 = CURNTAGE THEN
TRYRINIT1 = 1
ELSE IF TRYRINIT1 = 1 AND AGE1STTR1 NE CURNTAGE AND TRCC32A1 =
DK/REF THEN TRYRINIT1 = 0
UPDATE: IF TRYRINIT1 NE 1 AND TRYRDKRE1 NE 1 AND TRCC32A1 =
DK/REF THEN TRYRDKRE1 = 1
UPDATE: IF TR30INIT1 NE 1 AND TRCC32A1 = 1 AND AGE1STTR1 IS WITHIN
30 DAYS OF INTERVIEW DATE THEN TR30INIT1 = 1
UPDATE: IF TRYFU1 NE 0 AND TRCC32A1 = DK/REF THEN TRYFU1 = 0
UPDATE: IF TRMFU1 = 1-12 AND TRCC32A1 = DK/REF THEN TRMFU1 = 0
TRCC33A1 [IF TRCC32A1=2 OR TRCC32A1=3] Please answer this
question again. Did you first use Xanax in a way a doctor did
not direct you to use it in [CURRENT YEAR-2], [CURRENT
YEAR-1], or [CURRENT YEAR]?

281
April 15, 2016

1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
UPDATE: IF TRYFU1 NE 0 AND TRCC33A1 = DK/REF THEN TRYFU1 = 0
IF TRCC33A1 = 1 THEN TRYFU1 = CURRENT YEAR - 2
IF TRCC33A1 = 2 THEN TRYFU1 = CURRENT YEAR - 1
IF TRCC33A1 = 3 THEN TRYFU1 = CURRENT YEAR
UPDATE: IF TRMFU1 = 1-12 AND TRCC33A1 = DK/REF THEN TRMFU1 = 0
TRCC33B1

[IF TRCC33A1 NE (BLANK OR DK/REF)] Please answer
this question again. In what month in [TRCC33A1] did
you first use Xanax in a way a doctor did not direct you to
use it?

IF TRCC33A1 = 3 THEN DISPLAY ONLY UP TO THE INTERVIEW MONTH.
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF TRCC33B1 = 1-12 THEN TRMFU1 = TRCC33B1
IF TRCC33B1 = DK/REF THEN TRMFU1 = 0
UPDATE: IF TRCC33B1 NE (0 OR DK/REF) THEN UPDATE MYR1STTR1.
MYR1STTR1 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (TRCC33A1 AND
TRCC33B1). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STTR1
IS 0. IF MYR1STTR1 = AGE1STTR1 THEN MYR1STTR1 = 0
UPDATE: IF TRYRINIT1 = 1 AND AGE1STTR1 NE CURNTAGE AND TRCC32A1
NE 1 AND MYR1STTR1 NE 0 AND (TRCC33A1 AND TRCC33B1 = TRY01b-d)
THEN TRYRINIT1 = 0

282
April 15, 2016

UPDATE: IF TRYRINIT1 NE 1 AND TRYRDKRE1 NE 1 AND TRCC33A1 =
DK/REF THEN TRYRDKRE1 = 1
IF TRYRINIT1 NE 1 AND TRYRDKRE1 NE 1 AND TRYFU1 = CURRENT YEAR-1
AND TRCC33B1 = DK/REF THEN TRYRDKRE1 = 1
UPDATE: IF TR30INIT1 = 1 AND AGE1STTR1 NOT WITHIN 30 DAYS OF DATE
OF INTERVIEW AND TRCC32A1 NE 1 AND MYR1STTR1 NE 0 AND (TRCC33A1
AND TRCC33B1 = TRY01b-d) THEN TR30INIT1 = 0
TRCC34A1 [IF TRCC32A1 NE 1 AND MYR1STTR1 NE 0 AND
(TRCC33A1 AND TRCC33b1 NE TRY01b-d)] The computer
recorded that you first used Xanax in a way a doctor did not
direct you to use it in [TRCC33A1-TRCC33B1 fill]. That
would make you [MYR1STTR1] years old when you first used
Xanax in any way a doctor did not direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF TRCC34A1 NE (6, BLANK OR DK/REF) AND (TRCC33A1 AND
TRCC33B1 NE TRY01b-d) THEN AGE1STTR1 = MYR1STTR1
UPDATE: IF TRYRINIT1 NE 1 AND AGE1STTR1 = CURNTAGE OR (TRCC34A1 =
4 AND TRCC33A1 = 3 OR (TRCC33A1 = 2 AND TRCC33b1 NE DK/REF AND
TRCC33B1 >= CURRENT MONTH) ) THEN TRYRINIT1 = 1
ELSE IF TRYRINIT = 1 AND AGE1STTR1 NE CURNTAGE AND TRCC34A1 = (6
OR DK/REF) THEN TRYRINIT1 = 0
UPDATE: IF TRYRINIT1 NE 1 AND TRYRDKRE1 NE 1 AND MYR1STTR1=
CURNTAGE AND TRCC34A1 = (6 OR DK/REF) THEN TRYRDKRE1 = 1
IF TRYRINIT1 NE 1 AND TRYRDKRE1 NE 1 AND TRCC34A1 = BLANK AND
TRCC33A1 = 3 THEN TRYRDKRE1 = 1
IF TRYRINIT1 NE 1 AND TRYRDKRE1 NE 1 AND TRCC34A1 = BLANK AND
TRCC33A1 = 2 AND TRCC33B1 = 1-12 AND TRCC33B1 >= CURRENT MONTH
THEN TRYRDKRE1 = 1
UPDATE: IF TR30INIT1 NE 1 AND AGE1STTR1 WITHIN 30 DAYS OF
INTERVIEW DATE OR (TRCC34A1 = 4 AND TRCC33A1 = 3 AND TRCC33B1 =
CURRENT MONTH) THEN TR30INIT1 = 1

283
April 15, 2016

ELSE IF TR30INIT1 = 1 AND AGE1STTR1 NOT WITHIN 30 DAYS OF
INTERVIEW DATE AND TRCC34A1 = (6 OR DK/REF) THEN TR30INIT1 = 0
UPDATE: IF TRYFU1 NE BLANK AND TRCC34A1 = OR DK/REF THEN TRYFU1
=0
IF TRCC34A1 = BLANK AND (TRCC33A1 AND TRCC33B1 EQ TRY01b-d) THEN
TRYFU1 = 0
UPDATE: IF TRMFU1 = 1-12 AND TRCC34A1 = (6 OR DK/REF) THEN TRMFU1 =
0
IF TRCC34A1 = BLANK AND (TRCC33A1 AND TRCC33B1 EQ TRY01b-d) THEN
TRMFU1 = 0
TRY02

[IF TR01=2] In the past 12 months, did you use Xanax XR in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR XANAX XR
1
Yes
2
No
DK/REF

UPDATE TRFIRSTFLAG:
IF TRFIRSTFLAG=0 AND TRY02=1 THEN TRFIRSTFLAG=2.
TRY02a

[IF TRFIRSTFLAG=2] Please think about the first time you ever used
Xanax XR in a way a doctor did not direct you to use it.
[IF TRY02=1] How old were you when you first used Xanax XR in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

PROGRAMMER: DISPLAY IN LOWER RIGHT:
Press [F2] if you want to see and hear these ways
again.
• Without a prescription of your own,
• In greater amounts, more often, or longer than
you were told to take it
• In any other way a doctor did not direct you to
use it
DEFINE AGE1STTR2:
IF TRY02a NE (BLANK OR DK/REF) THEN AGE1STTR2 = TRY02a
ELSE AGE1STTR2 = 0
284
April 15, 2016

HARD ERROR: [IF CURNTAGE < AGE1STTR2] The age you just reported is older
than your current age. Press [Enter] to answer the question again.
IF 1 <= AGE1STTR2 < 10:
TRCC05A2 The computer recorded that you were [AGE1STTR2] years
old the first time you used Xanax XR in a way a doctor did not
direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF TRCC05A2= DK/REF THEN AGE1STTR2 = 0
TRCC06A2 [IF TRCC05A2=6] Please answer this question again.
Think about the first time you used Xanax XR in a way a
doctor did not direct you to use it.
How old were you the first time you used Xanax XR in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF TRCC06A2 NOT (BLANK OR DK/REF) THEN AGE1STTR2 =
TRCC06A2
ELSE IF TRCC06A2 = DK/REF THEN AGE1STTR2 = 0
DEFINE TRYRINIT2:
IF AGE1STTR2 = CURNTAGE THEN TRYRINIT2 = 1
ELSE TRYRINIT2 = 0
DEFINE TRYRDKRE2:
IF TRYRINIT2 = 0 AND (TRY02a = DK/REF OR TRCC05A2 = DK/REF OR
TRCC06A2 = DK/REF) THEN TRYRDKRE2 = 1
ELSE TRYRDKRE2= 0

DEFINE TR30INIT2:

285
April 15, 2016

TR30INIT2 = 0
IF AGE1STTR2 = CURNTAGE AND DATE OF INTERVIEW >= DOB AND
NUMBER OF DAYS BASED ON THE DIFFERENCE BETWEEN DATE OF
INTERVIEW AND DOB <= 30, THEN TR30INIT2 = 1
2.2.1

Year and Month of First Nonmedical Use

DEFINE TRYFU2:
TRYFU2 = 0
DEFINE TRMFU2:
TRMFU2 = 0
TRY02b.

[AGE1STTR2 = CURNTAGE AND DATE OF INTERVIEW < DOB OR
IF AGE1STTR2 = CURNTAGE - 1 AND DATE OF INTERVIEW ≥
DOB] Did you first use Xanax XR in a way a doctor did not direct you
to use it in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

TRY02c.

[IF AGE1STTR2 = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first use Xanax XR in a way a doctor did not direct you
to use it in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

UPDATE: IF TRY02B = 2 OR (AGE1STTR2 = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB) THEN TRYFU2 = CURRENT YEAR
IF TRY02B = 1 OR TRY02C = 2 THEN TRYFU2 = CURRENT YEAR - 1
IF TRY02C = 1 THEN TRYFU2 = CURRENT YEAR - 2
DEFINE TRJANFLAG2:
TRJANFLAG2 = 0
IF TRYFU2=CURRENT YEAR AND CURRENT MONTH = JANUARY THEN
TRJANFLAG2 = 1
IF TRYFU2=CURRENT YEAR-1 AND BIRTHDAY MONTH=JANUARY AND
DATE OF INTERVIEW ≥ DOB THEN TRJANFLAG2=1
IF TRJANFLAG2=1 THEN TRY02D=1
DEFINE TRDECFLAG2:
TRDECFLAG2 = 0

286
April 15, 2016

IF AGE1STTR2 = CURNTAGE AND TRYFU2=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN TRDECFLAG2 = 1
IF TRDECFLAG2=1 THEN TRY02D=12
DEFINE TR1MTHFLAG2:
TR1MTHFLAG2=0
IF (AGE1STTR2=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH) THEN
TR1MTHFLAG2=1
IF TR1MTHFLAG2=1 THEN TRY02D=CURRENT MONTH
TRY02d.
[IF TRYFU2 NE 0 AND TRJANFLAG2 = 0 AND TRDECFLAG2=0
AND TR1MTHFLAG2=0]
[IF TRYFU2 = CURRENT YEAR OR CURRENT YEAR -1] Earlier, you reported that
you first used Xanax XR in a way a doctor did not direct you to use it when you were
[AGE1STTR2] years old. Based on your date of birth, you turned [AGE1STTR2] in
[FILL WITH MONTH/YEAR FOR AGE1STTR2 BASED ON DOB].
[IF TRYFU2 NE 0] In what month in [TRYFU2] did you first use Xanax XR in a way a
doctor did not direct you to use it?
[IF DATE OF INTERVIEW < DOB AND AGE1STTR2=CURRENT AGE AND
TRYFU2=CURRENT YEAR THEN SHOW JANUARY THROUGH INTERVIEW
MONTH.]
IF AGE1STTR2 = CURNTAGE AND DATE OF INTERVIEW ≥ DOB THEN SHOW
MONTHS FROM BIRTH MONTH TO INTERVIEW MONTH.
IF ((AGE1STTR2 = CURNTAGE AND DATE OF INTERVIEW <= DOB) or
(AGE1STTR2 = CURNTAGE – 1 AND DATE OF INTERVIEW > DOB))
AND (TRYFU2 = CURRENT YEAR – 1), SHOW BIRTH MONTH TO DECEMBER
IF TRYFU2=CURRENT YEAR AND AGE1STTR2=CURRENT AGE-1 AND DATE
OF INTERVIEW > DOB THEN SHOW JANUARY THROUGH BIRTH MONTH.
IF TRYFU2 = CURRENT YEAR - 1 AND AGE1STTR2 = CURNTAGE - 1 AND
DATE OF INTERVIEW < DOB THEN SHOW JANUARY THROUGH BIRTH
MONTH.
ELSE SHOW ALL MONTHS.]
1
2
3
4
5

January
February
March
April
May

287
April 15, 2016

6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF TRY02D = 1-12 THEN TRMFU2 = TRY02D
IF TRJANFLAG2 = 1 THEN TRMFU2 = 1.
IF TRDECFLAG2=1 THEN TRMFU2=12.
UPDATE: IF TRYRINIT2 NE 1 AND (TRYFU2 = CURRENT YEAR OR (TRYFU2 =
CURRENT YEAR - 1 AND TRMFU2 = 1-12 AND TRMFU2 >= CURRENT MONTH)
THEN TRYRINIT2 = 1
UPDATE: IF TRYRINIT2 NE 1 AND TRYRDKRE2 NE 1 AND [(TRY02b = DK/REF
OR TRY02c = DK/REF) OR (TRYFU2 = CURRENT YEAR-1 AND TRY02d =
DK/REF)] THEN TRYRDKRE2 = 1
UPDATE: IF TR30INIT2 NE 1 AND TRYFU2 = CURRENT YEAR AND TRMFU2 =
CURRENT MONTH THEN TR30INIT2 = 1
DEFINE MYR1STTR2:
MYR1STTR2 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (TRY02B-D).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STTR2 IS 0.
IF MYR1STTR2 NE 0 AND NE AGE1STTR2:
TRCC32A2
Earlier, the computer recorded that you were
[AGE1STTR2] years old when you first used Xanax XR in a
way a doctor did not direct you to use it.
Which answer is correct?
1

I was [MYR1STTR2] years old in [TRY02B-D fill] the
first time I used Xanax XR in a way not directed for me
by a doctor
2
I was [AGE1STTR2] years old the first time I used
Xanax XR in a way not directed for me by a doctor
3
Neither answer is correct
DK/REF
UPDATE: IF TRCC32A2 = 1, THEN AGE1STTR2 = MYR1STTR2.

288
April 15, 2016

UPDATE: IF TRYRINIT2 NE 1 AND AGE1STTR2 = CURNTAGE THEN
TRYRINIT2 = 1
ELSE IF TRYRINIT2 = 1 AND AGE1STTR2 NE CURNTAGE AND TRCC32A2 =
DK/REF THEN TRYRINIT2 = 0
UPDATE: IF TRYRINIT2 NE 1 AND TRYRDKRE2 NE 1 AND TRCC32A2 =
DK/REF THEN TRYRDKRE2 = 1
UPDATE: IF TR30INIT2 NE 1 AND TRCC32A2 = 1 AND AGE1STTR2 IS WITHIN
30 DAYS OF INTERVIEW DATE THEN TR30INIT2 = 1
UPDATE: IF TRYFU2 NE 0 AND TRCC32A2 = DK/REF THEN TRYFU2 = 0
UPDATE: IF TRMFU2 = 1-12 AND TRCC32A2 = DK/REF THEN TRMFU2 = 0
TRCC33A2 [IF TRCC32A2=2 OR TRCC32A2=3] Please answer this
question again. Did you first use Xanax XR in a way a doctor
did not direct you to use it in [CURRENT YEAR-2],
[CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
UPDATE: IF TRYFU2 NE 0 AND TRCC33A2 = DK/REF THEN TRYFU2 = 0
IF TRCC33A2 = 1 THEN TRYFU2 = CURRENT YEAR - 2
IF TRCC33A2 = 2 THEN TRYFU2 = CURRENT YEAR - 1
IF TRCC33A2 = 3 THEN TRYFU2 = CURRENT YEAR
UPDATE: IF TRMFU2 = 1-12 AND TRCC33A2 = DK/REF THEN TRMFU2 = 0
TRCC33B2

[IF TRCC33A2 NE (BLANK OR DK/REF)] Please answer
this question again. In what month in [TRCC33A2] did
you first use Xanax XR in any way a doctor did not direct
you to use it?

IF TRCC33A2 = 3 THEN DISPLAY ONLY UP TO THE INTERVIEW MONTH.
1
2
3
4
5
6

January
February
March
April
May
June

289
April 15, 2016

7
July
8
August
9
September
10
October
11
November
12
December
DK/REF

UPDATE: IF TRCC33B2 = 1-12 THEN TRMFU2 = TRCC33B2
IF TRCC33B2 = DK/REF THEN TRMFU2 = 0
UPDATE: IF TRCC33B2 NE (0 OR DK/REF) THEN UPDATE MYR1STTR2.
MYR1STTR2 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (TRCC33A2 AND
TRCC33B2). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STTR2
IS 0. IF MYR1STTR2 = AGE1STTR2 THEN MYR1STTR2 = 0
UPDATE: IF TRYRINIT2 = 1 AND AGE1STTR2 NE CURNTAGE AND TRCC32A2
NE 1 AND MYR1STTR2 NE 0 AND (TRCC33A2 AND TRCC33B2 = TRY02b-d)
THEN TRYRINIT2 = 0
UPDATE: IF TRYRINIT2 NE 1 AND TRYRDKRE2 NE 1 AND TRCC33A2 =
DK/REF THEN TRYRDKRE2 = 1
IF TRYRINIT2 NE 1 AND TRYRDKRE2 NE 1 AND TRYFU2 = CURRENT YEAR-1
AND TRCC33B2 = DK/REF THEN TRYRDKRE2 = 1
UPDATE: IF TR30INIT2 = 1 AND AGE1STTR2 NOT WITHIN 30 DAYS OF DATE
OF INTERVIEW AND TRCC32A2 NE 1 AND MYR1STTR2 NE 0 AND (TRCC33A2
AND TRCC33B2 = TRY02b-d) THEN TR30INIT2 = 0
TRCC34A2 [IF TRCC32A2 NE 1 AND MYR1STTR2 NE 0 AND
(TRCC33A2 AND TRCC33B2 NE TRY02b-d)] The computer
recorded that you first used Xanax XR in a way a doctor did
not direct you to use it in [TRCC33A2-TRCC33B2 fill]. That
would make you [MYR1STTR2] years old when you first used
Xanax XR in any way a doctor did not direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF TRCC34A2 NE (6, BLANK OR DK/REF) AND (TRCC33A2 AND
TRCC33B2 NE TRY02b-d) THEN AGE1STTR2 = MYR1STTR2

290
April 15, 2016

UPDATE: IF TRYRINIT2 NE 1 AND AGE1STTR2 = CURNTAGE OR (TRCC34A2 =
4 AND TRCC33A2 = 3 OR (TRCC33A2 = 2 AND TRCC33B2 NE DK/REF AND
TRCC33B2 >= CURRENT MONTH)) THEN TRYRINIT2 = 1
ELSE IF TRYRINIT = 1 AND AGE1STTR2 NE CURNTAGE AND TRCC34A2 = (6
OR DK/REF) THEN TRYRINIT2 = 0
UPDATE: IF TRYRINIT2 NE 1 AND TRYRDKRE2 NE 1 AND MYR1STTR2=
CURNTAGE AND TRCC34A2 = (6 OR DK/REF) THEN TRYRDKRE2 = 1
IF TRYRINIT2 NE 1 AND TRYRDKRE2 NE 1 AND TRCC34A2 = BLANK AND
TRCC33A2 = 3 THEN TRYRDKRE2 = 1
IF TRYRINIT2 NE 1 AND TRYRDKRE2 NE 1 AND TRCC34A2 = BLANK AND
TRCC33A2 = 2 AND TRCC33B2 = 1-12 AND TRCC33B2 >= CURRENT MONTH
THEN TRYRDKRE2 = 1
UPDATE: IF TR30INIT2 NE 1 AND AGE1STTR2 WITHIN 30 DAYS OF
INTERVIEW DATE OR (TRCC34A2 = 4 AND TRCC33A2 = 3 AND TRCC33B2 =
CURRENT MONTH) THEN TR30INIT2 = 1
ELSE IF TR30INIT2 = 1 AND AGE1STTR2 NOT WITHIN 30 DAYS OF
INTERVIEW DATE AND TRCC34A2 = (6 OR DK/REF) THEN TR30INIT2 = 0
UPDATE: IF TRYFU2 NE BLANK AND TRCC34A2 = OR DK/REF THEN TRYFU2
=0
IF TRCC34A2 = BLANK AND (TRCC33A2 AND TRCC33B2 EQ TRY02b-d) THEN
TRYFU2 = 0
UPDATE: IF TRMFU2 = 1-12 AND TRCC34A2 = (6 OR DK/REF) THEN TRMFU2 =
0
IF TRCC34A2 = BLANK AND (TRCC33A2 AND TRCC33B2 EQ TRY02b-d) THEN
TRMFU2 = 0
Continue asking the misuse and age at first misuse questions above about each
tranquilizer reported.
TRY03

[IF TR01=3] In the past 12 months, did you use alprazolam in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR ALPRAZOLAM
1
Yes
2
No
DK/REF

UPDATE TRFIRSTFLAG:

291
April 15, 2016

IF TRFIRSTFLAG=0 AND TRY03=1 THEN TRFIRSTFLAG=3.
TRY03a

[IF TRFIRSTFLAG=3] Please think about the first time you ever used
alprazolam in a way a doctor did not direct you to use it.
[IF TRY03=1] How old were you when you first used alprazolam in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.

TRY04

[IF TR01=4] In the past 12 months, did you use extended-release
alprazolam in any way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE TRFIRSTFLAG:
IF TRFIRSTFLAG=0 AND TRY04=1 THEN TRFIRSTFLAG=4.
TRY04a

[IF TRFIRSTFLAG=4] Please think about the first time you ever used
extended-release alprazolam in a way a doctor did not direct you to use it.
[IF TRY04=1] How old were you when you first used extended-release
alprazolam in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.

292
April 15, 2016

TRY05

[IF TR02=1] In the past 12 months, did you use Ativan in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR ATIVAN
1
Yes
2
No
DK/REF

UPDATE TRFIRSTFLAG:
IF TRFIRSTFLAG=0 AND TRY05=1 THEN TRFIRSTFLAG=5.
TRY05a

[IF TRFIRSTFLAG=5] Please think about the first time you ever used
Ativan in a way a doctor did not direct you to use it.
[IF TRY05=1] How old were you when you first used Ativan in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.

TRY06

[IF TR02=2] In the past 12 months, did you use Klonopin in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR KLONOPIN
1
Yes
2
No
DK/REF

UPDATE TRFIRSTFLAG:
IF TRFIRSTFLAG=0 AND TRY06=1 THEN TRFIRSTFLAG=6.

293
April 15, 2016

TRY06a

[IF TRFIRSTFLAG=6] Please think about the first time you ever used
Klonopin in a way a doctor did not direct you to use it.
[IF TRY06=1] How old were you when you first used Klonopin in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.

TRY07

[IF TR02=3] In the past 12 months, did you use lorazepam in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR LORAZEPAM
1
Yes
2
No
DK/REF

UPDATE TRFIRSTFLAG:
IF TRFIRSTFLAG=0 AND TRY07=1 THEN TRFIRSTFLAG=7.
TRY07a

[IF TRFIRSTFLAG=7] Please think about the first time you ever used
lorazepam in a way a doctor did not direct you to use it.
[IF TRY07=1] How old were you when you first used lorazepam in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.

294
April 15, 2016

TRY08

[IF TR02=4] In the past 12 months, did you use clonazepam in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR CLONAZEPAM
1
Yes
2
No
DK/REF

UPDATE TRFIRSTFLAG:
IF TRFIRSTFLAG=0 AND TRY08=1 THEN TRFIRSTFLAG=8.
TRY08a

[IF TRFIRSTFLAG=8] Please think about the first time you ever used
clonazepam in a way a doctor did not direct you to use it.
[IF TRY08=1] How old were you when you first used clonazepam in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.

TRY09

[IF TR03=1] In the past 12 months, did you use Valium in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR VALIUM
1
Yes
2
No
DK/REF

UPDATE TRFIRSTFLAG:
IF TRFIRSTFLAG=0 AND TRY09=1 THEN TRFIRSTFLAG=9.
TRY09a

[IF TRFIRSTFLAG=9] Please think about the first time you ever used
Valium in a way a doctor did not direct you to use it.

295
April 15, 2016

[IF TRY09=1] How old were you when you first used Valium in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.

TRY10

[IF TR03=2] In the past 12 months, did you use diazepam in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR DIAZEPAM
1
Yes
2
No
DK/REF

UPDATE TRFIRSTFLAG:
IF TRFIRSTFLAG=0 AND TRY10=1 THEN TRFIRSTFLAG=10.
TRY10a

[IF TRFIRSTFLAG=10] Please think about the first time you ever used
diazepam in a way a doctor did not direct you to use it.
[IF TRY10=1] How old were you when you first used diazepam in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.

296
April 15, 2016

TRY11

[IF TR04=1] In the past 12 months, did you use cyclobenzaprine, also
known as Flexeril, in any way a doctor did not direct you to use it?
DISPLAY IMAGE FOR CYCLOBENZAPRINE
1
Yes
2
No
DK/REF

UPDATE TRFIRSTFLAG:
IF TRFIRSTFLAG=0 AND TRY11=1 THEN TRFIRSTFLAG=11.
TRY11a

[IF TRFIRSTFLAG=11] Please think about the first time you ever used
cyclobenzaprine in a way a doctor did not direct you to use it.
[IF TRY11=1] How old were you when you first used cyclobenzaprine in
a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.

TRY12

[IF TR04=2] In the past 12 months, did you use Soma in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR SOMA
1
Yes
2
No
DK/REF

UPDATE TRFIRSTFLAG:
IF TRFIRSTFLAG=0 AND TRY12=1 THEN TRFIRSTFLAG=12.
TRY12a

[IF TRFIRSTFLAG=12] Please think about the first time you ever used
Soma in a way a doctor did not direct you to use it.

297
April 15, 2016

[IF TRY12=1] How old were you when you first used Soma in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.
TRYOTH

[IF TRANYOTH =1] In the past 12 months, did you use any [IF
TRANYOTH =1 AND TRYRCOUNT > 1 FILL “other”] prescription
tranquilizer in a way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW CALENDAR WITH 12-MONTH
REFERENCE DATE

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
TRYOTHA1

[IF TRYOTH = 1] Please type in the name of one of the [IF
TRANYOTH =1 AND TRYRCOUNT > 1 FILL “other”]
prescription tranquilizers you have used in the past 12 months in a
way a doctor did not direct you to use it. If you’re not sure how to
spell the name of the tranquilizer, just make your best guess.
When you have finished, press [ENTER] to go to the next
question. Remember, you do not need to type in the names of any
prescription tranquilizers you already reported.

______________
[NOTE: DON'T ALLOW BLANKS IN TRYOTHA1 IF TRYOTH
= 1]
DK/REF

298
April 15, 2016

TRYOTHA2

[IF TRYOTH = 1 AND TRYOTHA1 NE DK/REF)] Please type in
the name of any other prescription tranquilizer you used in the
past 12 months in a way a doctor did not direct you to use it.
If you have not used any other prescription tranquilizer in a way a
doctor did not direct you to use it, press [ENTER].

______________
DK/REF
TRYOTHA3

[IF TRYOTHA2 NE (BLANK OR DK/REF)] Please type in the
name of any other prescription tranquilizer you used in the past 12
months in a way a doctor did not direct you to use it.
If you have not used any other prescription tranquilizer in a way a
doctor did not direct you to use it, press [ENTER].

______________
DK/REF
TRYOTHA4

[IF TRYOTHA3 NE (BLANK OR DK/REF)] Please type in the
name of any other prescription tranquilizer you used in the past 12
months in a way a doctor did not direct you to use it.
If you have not used any other prescription tranquilizer in a way a
doctor did not direct you to use it, press [ENTER].

______________
DK/REF
TRYOTHA5

[IF TRYOTHA4 NE (BLANK OR DK/REF Please type in the
name of any other prescription tranquilizer you used in the past 12
months in a way a doctor did not direct you to use it.
If you have not used any other prescription tranquilizer in a way a
doctor did not direct you to use it, press [ENTER].

______________
DK/REF

299
April 15, 2016

UPDATE TRFIRSTFLAG:
IF TRFIRSTFLAG=0 AND TRYOTH=1 THEN TRFIRSTFLAG=16.
TRYOTHA

[IF TRFIRSTFLAG=16] Please think about the first time you ever
used any [IF TRANYOTH =1 AND TRYRCOUNT > 1 FILL
“other”] prescription tranquilizer in a way a doctor did not direct
you to use it.
[IF TRYOTH=1] How old were you when you first used any [IF
TRANYOTH =1 AND TRYRCOUNT > 1 FILL “other”]
prescription tranquilizer in a way a doctor did not direct you to
use it?

AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.

DEFINE TRMISCOUNT:
INITIALIZE TRMISCOUNT TO 0.
INCREMENT TRMISCOUNT BY 1 FOR EVERY RESPONSE OF YES IN TRY01TRYOTH.
DEFINE TRMISUSE12:
IF TRMISCOUNT > 0 THEN TRMISUSE12 = 1.
ELSE TRMISUSE12 = 2.
If no tranquilizers misused in the past 12 months:
TRL02

[IF TR12MON=1 AND TRMISUSE12=2] Have you ever, even once,
used any prescription tranquilizer in any way a doctor did not direct
you to use it?
1
Yes
2
No
DK/REF

300
April 15, 2016

If any tranquilizers misused in past 12 months:
DEFINE TRDKREFCOUNT:
INITIALIZE TRDKREFCOUNT TO 0.
INCREMENT TRDKREFCOUNT BY 1 FOR EVERY RESPONSE OF DK/REF IN
TRY01-TRYOTH AND TR01- TRANYOTH.
DEFINE TRDKREFFLAG:
IF TRDKREFCOUNT > 1 THEN TRDKREFFLAG = 1.
ELSE TRDKREFFLAG = 2.
DEFINE TRNUMFILL:
IF TRMISCOUNT = 1 AND TRYOTH NE 1 THEN TRNUMFILL = "it".
ELSE TRNUMFILL = "them".
DEFINE TR30ANYINIT:
IF ANY CODE OF 1 IN TR30INIT1-TR30INITOT THEN TR30ANYINIT = 1.
ELSE TR30ANYINIT = 2.
DEFINE TRFILL2:
IF TRMISCOUNT < 3 AND TRYOTH NE 1 AND TRDKREFFLAG =2 THEN
TRFILL2=”[DRUG NAMES FROM TRY01- TRY12]”.
ELSE IF TRMISCOUNT=1 AND TRYOTH NE 1 AND TRDKREFFLAG=1 THEN
TRFILL2 = “[DRUG NAMES FROM TRY01- TRY12] or any other prescription
tranquilizer.”
ELSE IF TRMISCOUNT=2 AND TRDKREFFLAG=2 AND TRYOTH =1 THEN
TRFILL2=”[DRUG NAME FROM TRY01- TRY12] and some other prescription
tranquilizer.”
ELSE IF TRMISCOUNT=2 AND TRDKREFFLAG=1 THEN TRFILL2=”[DRUG
NAMES FROM TRY01- TRY12]”. IF TRYOTH =1 THEN ADD “some other
prescription tranquilizer” TO THE FILL.
ELSE TRFILL2= “prescription tranquilizers”
DEFINE TRNAMEFILL:
IF TRMISCOUNT =1 AND (TRYOTH = 2 OR TRYOTH = BLANK) AND
TRDKREFFLAG =2 THEN TRNAMEFILL=”[DRUG NAME FROM TRY01TRY12]”
ELSE IF TRMISCOUNT=1 AND (TRYOTH NE 1) AND TRDKREFFLAG=1 THEN
TRNAMEFILL=”[DRUG NAME FROM TRY01- TRY12] or any other prescription
tranquilizer]”
ELSE IF TRMISCOUNT >1 THEN TRNAMEFILL= “prescription tranquilizers”
DEFINE TRYINICT:

301
April 15, 2016

INITIALIZE TRYINICT TO 0.
INCREMENT TRYINICT BY 1 FOR EVERY VALUE OF 1 IN TRYRINIT1TRYRINITOT.
DEFINE TRYRDKRECT:
INITIALIZE TRYRDKRECT TO 0.
INCREMENT TRYRDKRECT BY 1 FOR EVERY VALUE OF 1 IN TRYRDKRE1TRYRDKREOT.
DEFINE TRYINALL:
IF TRMISCOUNT > 0 AND TRMISCOUNT = TRYINICT + TRYRDKRECT THEN
TRYINALL = 1.
ELSE TRYINALL = 2.
TRL03

[IF TRYINALL=1] Earlier questions were about the past 12 months. This
question is about any time before then, that is, any time in your life before
[DATEFILL -12 MONTHS].
At any time before [DATEFILL -12 MONTHS], did you ever use any
prescription tranquilizer in a way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

TRINTROYR3 [IF TRMISUSE12=1 AND TRMISCOUNT>1] Earlier the computer
recorded that in the past 12 months you used [IF TRMISUSE12=1
AND TRMISCOUNT > 2, ADD "these"] [TRFILL2] in a way a
doctor did not direct you to use [TRNUMFILL].
[IF TRMISUSE12=1 AND TRMISCOUNT>2 ] FILL WITH DRUG
NAMES FROM TRY01- TRYOTH BELOW. USE MULTIPLE
COLUMNS AS NEEDED. IF TRYOTH = 1, FILL WITH "Some other
prescription tranquilizer".
[IF TRMISUSE12=1 AND TRMISCOUNT>1] The next questions refer
to these drugs as prescription tranquilizers.
Press Enter to continue.

TRM01

[IF TRMISUSE12 = 1 AND TR30ANYINIT = 2] In the past 30 days,
that is, from [DATEFILL] up to and including today, did you use
[TRNAMEFILL] in any way a doctor did not direct you to use
[TRNUMFILL]?
1

Yes

302
April 15, 2016

2
No
DK/REF
PROGRAMMER: SHOW 30-DAY CALENDAR

DEFINE TRMISUSE30:
TRMISUSE30=1 IF TRM01=1 OR TR30ANYINIT = 1.
TRMISUSE30=2 IF TRMISUSE12 = 1 AND (TRM01=2, DK, OR REF).
TRM02

[IF TRMISUSE30=1] During the past 30 days, on how many days did
you use [TRNAMEFILL] in any way a doctor did not direct you to use
[TRNUMFILL]?
________________ [RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30-DAY CALENDAR

TRM02DKRE

[IF TRM02 = DK/REF] What is your best estimate of the number of
days you used [TRNAMEFILL] in any way a doctor did not direct
you to use [TRNUMFILL] during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

TRM03

[IF ALC30USE = 1 and TRMISUSE30 = 1)] During the past 30 days, did
you use [TRNAMEFILL] in any way a doctor did not direct you to use
[TRNUMFILL] while you were drinking alcohol or within a couple of
hours of drinking?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

303
April 15, 2016

TRYWAYS

[IF TRMISUSE12=1] Which of these statements describe your
use of [TRNAMEFILL] at any time in the past 12 months?
To select more than one statement, press the space bar between the
numbers. When you have finished, press [ENTER].
1
2

I used [TRNAMEFILL] without a prescription of my own.
I used [TRNAMEFILL] in greater amounts than [IF
TRNAMEFILL= “prescription tranquilizers” THEN FILL
WITH “they were”; ELSE FILL WITH “it was”]
prescribed.
3
I used [TRNAMEFILL] more often than [IF
TRNAMEFILL= “prescription tranquilizers” THEN FILL
WITH “they were”; ELSE FILL WITH “it was”]
prescribed.
4
I used [TRNAMEFILL] for longer than [IF
TRNAMEFILL= “prescription tranquilizers” THEN FILL
WITH “they were”; ELSE FILL WITH “it was”]
prescribed.
5
I used [TRNAMEFILL] in some other way a doctor did
not direct me to use [TRNUMFILL]
DISPLAY 12-MONTH CALENDAR

TRYLAST

[IF TRMISCOUNT > 1 OR (TRMISCOUNT = 1 AND TRYOTH
NE 1 AND TRDKREFFLAG=1)] Now think about the last time
you used a prescription tranquilizer in any way a doctor did not
direct you to use it.
Which of these tranquilizers did you use the last time? If you used
more than one tranquilizer the last time, please choose one
tranquilizer as your best answer.
(LIST DRUGS WHERE TRY01- TRYOTH =1. NUMBER
RESPONSE OPTIONS SEQUENTIALLY STARTING AT 1,
BUT MAINTAIN UNIQUE CODES FOR EACH DRUG. IF
TRYOTH =1, DISPLAY "Another prescription tranquilizer" AS
THE LAST CATEGORY. IF TRMISCOUNT > 0 AND
TRYOTH NE 1 AND TRDKREFFLAG=1, DISPLAY "Any other
prescription tranquilizer" AS THE LAST CATEGORY. ALLOW
ONLY 1 RESPONSE.)

PROGRAMMER: IF TRMISUSE12 = 1 THEN CREATE A RECODED RTRYLAST
VARIABLE. ASSIGN A UNIQUE CODE TO A GIVEN DRUG ACCORDING TO
THE OVERALL ORDER IN WHICH THE DRUGS APPEAR IN THE SCREENER.

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April 15, 2016

INITIALIZE RTRYLAST TO BLANK.
IF "Xanax" CHOSEN IN TRYLAST OR (TRMISCOUNT=1 AND TRDKREFFLAG=2
AND TRY01 = 1) THEN RTRYLAST = 1.
IF "Xanax XR" CHOSEN IN TRYLAST OR (TRMISCOUNT=1 AND
TRDKREFFLAG=2 AND TRY02 = 1) THEN RTRYLAST = 2.
IF "alprazolam" CHOSEN IN TRYLAST OR (TRMISCOUNT=1 AND
TRDKREFFLAG=2 AND TRY03 = 1) THEN RTRYLAST = 3.
ETC.
IF "meprobamate" CHOSEN IN TRYLAST OR (TRMISCOUNT=1 AND
TRDKREFFLAG=2 AND TRY12 = 1) THEN RTRYLAST = 12.
IF "Another prescription tranquilizer" OR "Any other prescription tranquilizer" CHOSEN
IN TRYLAST OR (TRMISCOUNT =1 AND TRYOTH = 1 AND TRDKREFFLAG =2)
THEN RTRYLAST = 13.
IF TRYLAST = DK OR REF, THEN ASSIGN THE DK/REF CODE TO RTRYLAST.)
DEFINE TRLASTFILL:
IF RTRYLAST = 1-12, THEN FILL WITH THE DRUG NAME.
IF RTRYLAST = 13 THEN FILL "other tranquilizer".
IF RTRYLAST = DK, REF, OR BLANK, THEN FILL "tranquilizer".
DEFINE TRLASTFILL2:
IF RTRYLAST = 1-12, THEN FILL WITH THE DRUG NAME.
IF RTRYLAST = 13 THEN FILL "the other tranquilizer".
IF RTRYLAST = DK, REF, OR BLANK, THEN FILL "a tranquilizer".
DEFINE TRLASTFILL3:
IF TRLASTFILL NE "other tranquilizer" THEN TRLASTFILL3 = TRLASTFILL.
ELSE IF TRLASTFILL = "other tranquilizer" THEN TRLASTFILL3 = "tranquilizer".
TRYMOTIV [IF TRMISUSE12=1]
Now think about the last time you used [TRLASTFILL2] in any way a
doctor did not direct you to use it.
What were the reasons you used [TRLASTFILL2] the last time? To
select more than one reason from the list, press the space bar between each
number you have typed. When you have finished, press [ENTER].

1
2
3
4
5
6
7

To relax or relieve tension
To experiment or to see what it’s like
To feel good or get high
To help with my sleep
To help me with my feelings or emotions
To increase or decrease the effect(s) of some other drug
Because I am “hooked” or I have to have it
305

April 15, 2016

8

I used it for some other reason

DK/REF

TRMOTOT [IF TRYMOTIV=8] Please type in the other reason you used
[TRLASTFILL2] the last time. When you have finished typing your
answer, press [ENTER] to go to the next question.
REASON
__________________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN
TRMOTOT.
TRYMOT1

[IF MORE THAN ONE RESPONSE 1-8 CHOSEN IN TRYMOTIV]
Which was the main reason you used [TRLASTFILL2] the last time?
PROGRAMMER: FILL AS RESPONSE OPTIONS ONLY THOSE
CHOSEN IN TRYMOTIV.
1
To relax or relieve tension
2
To experiment or to see what it’s like
3
To feel good or get high
4
To help with my sleep
5
To help me with my feelings or emotions
6
To increase or decrease the effect(s) of some other drug
7
Because I am “hooked” or I have to have it
8
[IF TRMOTIV=8] The other reason I reported
DK/REF

TRYGOT

[IF TRMISUSE12=1 AND TRMISCOUNT=1 AND
TRDKREFFLAG=2] Now think again about the last time you
used [TRLASTFILL2] in any way a doctor did not direct you to
use [FILL WITH “them” IF RTRYLAST=13. ELSE FILL WITH
“it”].
[IF TRMISUSE12 = 1] How did you get the [TRLASTFILL]? If
you got the [TRLASTFILL] in more than one way, please choose
one of these ways as your best answer.
1
2

I got a prescription for the [TRLASTFILL] from just one
doctor
I got prescriptions for the [TRLASTFILL] from more than
one doctor
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April 15, 2016

3

I stole the [TRLASTFILL] from a doctor’s office, clinic,
hospital, or pharmacy
4
I got the [TRLASTFILL] from a friend or relative for free
5
I bought the [TRLASTFILL] from a friend or relative
6
I took the [TRLASTFILL] from a friend or relative without
asking
7
I bought the [TRLASTFILL] from a drug dealer or other
stranger
8
I got the [TRLASTFILL] in some other way
DK/REF

TRYGOTSP

[IF TRYGOT = 8] Please type in the other way you got the
[TRLASTFILL3].
You do not need to give a detailed description — just a few words
will be okay. When you have finished typing your answer, press
[ENTER] to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN
TRYGOTSP.

TRYFRL

[IF TRYGOT=4] You reported that you got the [TRLASTFILL]
from a friend or relative for free. How did your friend or relative
get the [TRLASTFILL]?
1

He or she got a prescription for the [TRLASTFILL] from just one
doctor
2
He or she got prescriptions for the [TRLASTFILL] from more than
one doctor
3
He or she stole the [TRLASTFILL] from a doctor’s office, clinic,
hospital, or pharmacy
4
He or she got the [TRLASTFILL] from another friend or relative
for free
5
He or she bought the [TRLASTFILL] from another friend or
relative
6
He or she took the [TRLASTFILL] from another friend or relative
without asking
7
He or she bought the [TRLASTFILL] from a drug dealer or other
stranger
8
He or she got the [TRLASTFILL] in some other way
DK/REF

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April 15, 2016

TRYFRLSP

[IF TRYFRL = 8] Please type in the other way your friend or
relative got the last [TRLASTFILL3] you used.
You do not need to give a detailed description — just a few words
will be okay. When you have finished typing your answer, press
[ENTER] to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN
TRYFRLSP.

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Stimulants Main Module
If no 12 month use of prescription stimulants:
STINTROLIF

[IF STLANY = 1] The next question asks about using prescription
stimulants in any way a doctor did not direct you to use them.
When you answer this question, please think only about your use of
the drug in any way a doctor did not direct you to use it, including:




Using it without a prescription of your own
Using it in greater amounts, more often, or longer than you were
told to take it
Using it in any other way a doctor did not direct you to use it

Press Enter to continue.
STL01

[IF STLANY =1] Have you ever, even once, used any prescription
stimulant in any way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

If any 12 month use of prescription stimulants:
STINTROYR1

[IF ST12MON = 1] The next questions ask about using prescription
stimulants in any way a doctor did not direct you to use them.
When you answer these questions, please think only about your use of
the drug in any way a doctor did not direct you to use it, including:




Using it without a prescription of your own
Using it in greater amounts, more often, or longer than you were
told to take it
Using it in any other way a doctor did not direct you to use it

Press Enter to continue.
DEFINE STFILL:
STFILL LISTS ALL INDIVIDUAL DRUGS SELECTED IN ST01, ST02, ST03, ST04,
ST05, ST06, AND ST07.
USE MULTIPLE COLUMNS AS NEEDED. IF STANYOTH =1 AND
STYRCOUNT > 1 THEN ADD “another prescription stimulant” TO THE
FILL.

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April 15, 2016

THE FOLLOWING DRUGS SHOULD NOT USE INITIAL CAPS WHEN FILLED IN
SENTENCE FORMAT:
•
•
•
•
•
•
•
•
•
•
•

dextroamphetamine
mixed amphetamine-dextroamphetamine pills
extended-release amphetamine-dextroamphetamine pills
methylphenidate
extended-release methylphenidate
dexmethylphenidate
extended-release dexmethylphenidate
benzphetamine
diethylpropion
phendimetrazine
phentermine

WHEN IMPLEMENTING STFILL, IF 1 OR 2 DRUGS APPEAR IN LIST, FILL IN
SENTENCE FORMAT, SEPARATED BY AN “and” BEFORE THE
LAST FILL.
IF >2 DRUGS APPEAR IN LIST, FILL IN LIST (IN COLUMNS IF NEEDED)
BELOW THE PREVIOUS SENTENCE.
DEFINE STFIRSTFLAG:
STFIRSTFLAG IDENTIFIES THE FIRST STIMULANT USED NONMEDICALLY.
INITIALIZE STFIRSTFLAG TO 0.
STINTROYR2

[IF ST12MON=1 AND STYRCOUNT > 0 AND (STANYOTH NE 1
OR (STANYOTH =1 AND STYRCOUNT > 1))] Earlier, the
computer recorded that, in the past 12 months, you used [STFILL].
Press Enter to continue.

PROGRAMMER: SHOW CALENDAR WITH 12-MONTH REFERENCE
DATE FOR THE INTRO SCREEN
NOTE TO PROGRAMMERS: LOOP THROUGH THE 12-MONTH MISUSE, AGE AT
FIRST MISUSE, AND YEAR AND MONTH OF FIRST MISUSE (IF APPLICABLE)
FOR EACH PRESCRIPTION STIMULANT REPORTED IN THE SCREENER FOR
THE PAST 12 MONTHS.
STY01

[IF ST01=1] In the past 12 months, did you use Adderall in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR ADDERALL
1

Yes
310

April 15, 2016

2
No
DK/REF
UPDATE STFIRSTFLAG:
IF STY01=1 THEN STFIRSTFLAG=1.
STY01a

[IF STFIRSTFLAG=1] Please think about the first time you ever used
Adderall in a way a doctor did not direct you to use it.
[IF STY01=1] How old were you when you first used Adderall in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

PROGRAMMER: DISPLAY IN LOWER RIGHT:
Press [F2] if you want to see and hear these ways
again.
• Without a prescription of your own,
• In greater amounts, more often, or longer than
you were told to take it
• In any other way a doctor did not direct you to
use it
DEFINE AGE1STST1:
IF STY01a NE (BLANK OR DK/REF) THEN AGE1STST1 = STY01a
ELSE AGE1STST1 = 0
HARD ERROR: [IF CURNTAGE < AGE1STST1] The age you just entered is older
than your current age. Press [Enter] to answer the question again.
IF 1 <= AGE1STST1 < 10:
STCC05A1 The computer recorded that you were [AGE1STST1] years
old the first time you used Adderall in a way a doctor did not
direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF

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April 15, 2016

UPDATE: IF STCC05A1= DK/REF THEN AGE1STST1 = 0
STCC06A1 [IF STCC05A1=6] Please answer this question again.
Think about the first time you used Adderall in any way a
doctor did not direct you to use it.
How old were you the first time you used Adderall in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF STCC06A1 NOT (BLANK OR DK/REF) THEN AGE1STST1 =
STCC06A1
ELSE IF STCC06A1 = DK/REF THEN AGE1STST1 = 0
DEFINE STYRINIT1:
IF AGE1STST1 = CURNTAGE THEN STYRINIT1 = 1
ELSE STYRINIT1 = 0
DEFINE STYRDKRE1:
IF STYRINIT1 = 0 AND (STY01a = DK/REF OR STCC05A1 = DK/REF OR
STCC06A1 = DK/REF) THEN STYRDKRE1 = 1
ELSE STYRDKRE1= 0
DEFINE ST30INIT1:
ST30INIT1 = 0
IF AGE1STST1 = CURNTAGE AND DATE OF INTERVIEW >= DOB AND
NUMBER OF DAYS BASED ON THE DIFFERENCE BETWEEN DATE OF
INTERVIEW AND DOB <= 30, THEN ST30INIT1 = 1
2.2.1

Year and Month of First Nonmedical Use

DEFINE STYFU1:
STYFU1 = 0
DEFINE STMFU1:
STMFU1 = 0
STY01b.

[AGE1STST1 = CURNTAGE AND DATE OF INTERVIEW < DOB OR
IF AGE1STST1 = CURNTAGE - 1 AND DATE OF INTERVIEW ≥
DOB] Did you first use Adderall in a way a doctor did not direct you to
use it in [CURRENT YEAR - 1] or [CURRENT YEAR]?

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April 15, 2016

1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

STY01c.

[IF AGE1STST1 = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first use Adderall in a way a doctor did not direct you to
use it in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

UPDATE: IF STY01b = 2 OR (AGE1STST1 = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB) THEN STYFU1 = CURRENT YEAR
IF STY01b = 1 OR STY01c = 2 THEN STYFU1 = CURRENT YEAR - 1
IF STY01c = 1 THEN STYFU1 = CURRENT YEAR - 2
DEFINE STJANFLAG1:
STJANFLAG1 = 0
IF STYFU1=CURRENT YEAR AND CURRENT MONTH = JANUARY THEN
STJANFLAG1 = 1
IF STYFU1=CURRENT YEAR-1 AND BIRTHDAY MONTH=JANUARY AND
DATE OF INTERVIEW ≥ DOB THEN STJANFLAG1=1
IF STJANFLAG1=1 THEN STY01d=1
DEFINE STDECFLAG1:
STDECFLAG1 = 0
IF AGE1STST1 = CURNTAGE AND STYFU1=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN STDECFLAG1 = 1
IF STDECFLAG1=1 THEN STY01d=12
DEFINE ST1MTHFLAG1:
ST1MTHFLAG1=0
IF (AGE1STST1=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH) THEN
ST1MTHFLAG1=1
IF ST1MTHFLAG1=1 THEN STY01d=CURRENT MONTH
STY01d [IF STYFU1 NE 0 AND STJANFLAG1 = 0 AND STDECFLAG1=0 AND
ST1MTHFLAG1=0]
[IF STYFU1 = CURRENT YEAR OR CURRENT YEAR -1] Earlier, you reported that
you first used Adderall in a way a doctor did not direct you to use it when you were

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April 15, 2016

[AGE1STST1] years old. Based on your date of birth, you turned [AGE1STST1] in
[FILL WITH MONTH/YEAR FOR AGE1STST1 BASED ON DOB].
[IF STYFU1 NE 0] In what month in [STYFU1] did you first use Adderall in a way a
doctor did not direct you to use it?
[IF DATE OF INTERVIEW < DOB AND AGE1STST1=CURRENT AGE AND
STYFU1=CURRENT YEAR THEN SHOW JANUARY THROUGH INTERVIEW
MONTH.]
IF AGE1STST1 = CURNTAGE AND DATE OF INTERVIEW ≥ DOB THEN SHOW
MONTHS FROM BIRTH MONTH TO INTERVIEW MONTH.
IF ((AGE1STST1 = CURNTAGE AND DATE OF INTERVIEW <= DOB) or
(AGE1STST1 = CURNTAGE – 1 AND DATE OF INTERVIEW > DOB))
AND (STYFU1 = CURRENT YEAR – 1), SHOW BIRTH MONTH TO DECEMBER
IF STYFU1=CURRENT YEAR AND AGE1STST1=CURRENT AGE-1 AND DATE
OF INTERVIEW > DOB THEN SHOW JANUARY THROUGH BIRTH MONTH.
IF STYFU1 = CURRENT YEAR - 1 AND AGE1STST1 = CURNTAGE - 1 AND
DATE OF INTERVIEW < DOB THEN SHOW JANUARY THROUGH BIRTH
MONTH.
ELSE SHOW ALL MONTHS.]
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF STY01D = 1-12 THEN STMFU1 = STY01D
IF STJANFLAG1 = 1 THEN STMFU1 = 1.
IF STDECFLAG1=1 THEN STMFU1=12.

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April 15, 2016

UPDATE: IF STYRINIT1 NE 1 AND (STYFU1 = CURRENT YEAR OR (STYFU1 =
CURRENT YEAR - 1 AND STMFU1 = 1-12 AND STMFU1 >= CURRENT MONTH)
THEN STYRINIT1 = 1
UPDATE: IF STYRINIT1 NE 1 AND STYRDKRE1 NE 1 AND [(STY01b = DK/REF
OR STY01c = DK/REF) OR (STYFU1 = CURRENT YEAR-1 AND STY01d =
DK/REF)] THEN STYRDKRE1 = 1
UPDATE: IF ST30INIT1 NE 1 AND STYFU1 = CURRENT YEAR AND STMFU1 =
CURRENT MONTH THEN ST30INIT1 = 1
DEFINE MYR1STST1:
MYR1STST1 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (STY01b-d).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STST1 IS 0.
IF MYR1STST1 NE 0 AND NE AGE1STST1:
STCC32A1
Earlier, the computer recorded that you were
[AGE1STST1] years old when you first used Adderall in a way
a doctor did not direct you to use it.
Which answer is correct?
1

I was [MYR1STST1] years old in [STY01b-d fill] the
first time I used Adderall in a way not directed for me
by a doctor
2
I was [AGE1STST] years old the first time I used
Adderall in a way not directed for me by a doctor
3
Neither answer is correct
DK/REF
UPDATE: IF STCC32A1 = 1, THEN AGE1STST1 = MYR1STST1.
UPDATE: IF STYRINIT1 NE 1 AND AGE1STST1 = CURNTAGE THEN STYRINIT1
=1
ELSE IF STYRINIT1 = 1 AND AGE1STST1 NE CURNTAGE AND STCC32A1 =
DK/REF THEN STYRINIT1 = 0
UPDATE: IF STYRINIT1 NE 1 AND STYRDKRE1 NE 1 AND STCC32A1 = DK/REF
THEN STYRDKRE1 = 1
UPDATE: IF ST30INIT1 NE 1 AND STCC32A1 = 1 AND AGE1STST1 IS WITHIN 30
DAYS OF INTERVIEW DATE THEN ST30INIT1 = 1
UPDATE: IF STYFU1 NE 0 AND STCC32A1 = DK/REF THEN STYFU1 = 0

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April 15, 2016

UPDATE: IF STMFU1 = 1-12 AND STCC32A1 = DK/REF THEN STMFU1 = 0
STCC33A1 [IF STCC32A1=2 OR STCC32A1=3] Please answer this
question again. Did you first use Adderall in a way a doctor
did not direct you to use it in [CURRENT YEAR-2],
[CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

UPDATE: IF STYFU1 NE 0 AND STCC33A1 = DK/REF THEN STYFU1 = 0
IF STCC33A1 = 1 THEN STYFU1 = CURRENT YEAR - 2
IF STCC33A1 = 2 THEN STYFU1 = CURRENT YEAR - 1
IF STCC33A1 = 3 THEN STYFU1 = CURRENT YEAR
UPDATE: IF STMFU1 = 1-12 AND STCC33A1 = DK/REF THEN STMFU1 = 0
STCC33B1

[IF STCC33A1 NE (BLANK OR DK/REF)] Please answer
this question again. In what month in [STCC33B1] did
you first use Adderall in a way a doctor did not direct you
to use it?

IF STCC33A1 = 3 THEN DISPLAY ONLY UP TO THE INTERVIEW MONTH.
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF STCC33B1 = 1-12 THEN STMFU1 = STCC33B1
IF STCC33B1 = DK/REF THEN STMFU1 = 0
UPDATE: IF STCC33B1 NE (0 OR DK/REF) THEN UPDATE MYR1STST1.

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April 15, 2016

MYR1STST1 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (STCC33A1 AND
STCC33B1). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STST1
IS 0. IF MYR1STST1 = AGE1STST1 THEN MYR1STST1 = 0
UPDATE: IF STYRINIT1 = 1 AND AGE1STST1 NE CURNTAGE AND STCC32A1
NE 1 AND MYR1STST1 NE 0 AND (STCC33A1 AND STCC33B1 = STY01b-d)
THEN STYRINIT1 = 0
UPDATE: IF STYRINIT1 NE 1 AND STYRDKRE1 NE 1 AND STCC33A1 = DK/REF
THEN STYRDKRE1 = 1
IF STYRINIT1 NE 1 AND STYRDKRE1 NE 1 AND STYFU1 = CURRENT YEAR-1
AND STCC33B1 = DK/REF THEN STYRDKRE1 = 1
UPDATE: IF ST30INIT1 = 1 AND AGE1STST1 NOT WITHIN 30 DAYS OF DATE
OF INTERVIEW AND STCC32A1 NE 1 AND MYR1STST1 NE 0 AND (STCC33A1
AND STCC33B1 = STY01b-d) THEN ST30INIT1 = 0
STCC34A1 [IF STCC32A1 NE 1 AND MYR1STST1 NE 0 AND
(STCC33A1 AND STCC33B1 NE STY01b-d)] The computer
recorded that you first used Adderall in a way a doctor did not
direct you to use it in [STCC33A1-STCC33B1 fill]. That
would make you [MYR1STST1] years old when you first used
Adderall in any way a doctor did not direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF STCC34A1 NE (6, BLANK OR DK/REF ) AND (STCC33A1 AND
STCC33B1 NE STY01b-d) THEN AGE1STST1 = MYR1STST1
UPDATE: IF STYRINIT1 NE 1 AND AGE1STST1 = CURNTAGE OR (STCC34A1 =
4 AND STCC33A1 = 3 OR (STCC33A1 = 2 AND STCC33B1 NE DK/REF AND
STCC33B1 >= CURRENT MONTH) ) THEN STYRINIT1 = 1
ELSE IF STYRINIT1 = 1 AND AGE1STST1 NE CURNTAGE AND STCC34A1 = (6
OR DK/REF) THEN STYRINIT1 = 0
UPDATE: IF STYRINIT1 NE 1 AND STYRDKRE1 NE 1 AND MYR1STST1=
CURNTAGE AND STCC34A1 = (6 OR DK/REF) THEN STYRDKRE1 = 1
IF STYRINIT1 NE 1 AND STYRDKRE1 NE 1 AND STCC34A1 = BLANK AND
STCC33A1 = 3 THEN STYRDKRE1 = 1

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April 15, 2016

IF STYRINIT1 NE 1 AND STYRDKRE1 NE 1 AND STCC34A1 = BLANK AND
STCC33A1 = 2 AND STCC33B1 = 1-12 AND STCC33B1 >= CURRENT MONTH
THEN STYRDKRE1 = 1
UPDATE: IF ST30INIT1 NE 1 AND AGE1STST1 WITHIN 30 DAYS OF
INTERVIEW DATE OR (STCC34A1 = 4 AND STCC33A1 = 3 AND STCC33B1 =
CURRENT MONTH) THEN ST30INIT1 = 1
ELSE IF ST30INIT1 = 1 AND AGE1STST1 NOT WITHIN 30 DAYS OF INTERVIEW
DATE AND STCC34A1 = (6 OR DK/REF) THEN ST30INIT1 = 0
UPDATE: IF STYFU1 NE BLANK AND STCC34A1 = OR DK/REF THEN STYFU1 =
0
IF STCC34A1 = BLANK AND (STCC33A1 AND STCC33B1 EQ STY01b-d) THEN
STYFU1 = 0
UPDATE: IF STMFU1 = 1-12 AND STCC34A1 = (6 OR DK/REF) THEN STMFU1 = 0
IF STCC34A1 = BLANK AND (STCC33A1 AND STCC33B1 EQ STY01b-d) THEN
STMFU1 = 0
STY02

[IF ST01=2] In the past 12 months, did you use Adderall XR in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY02=1 THEN STFIRSTFLAG=2.
STY02a

[IF STFIRSTFLAG=2] Please think about the first time you ever used
Adderall XR in a way a doctor did not direct you to use it.
[IF STY02=1] How old were you when you first used Adderall XR in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
DEFINE AGE1STST2:
IF STY02a NE (BLANK OR DK/REF) THEN AGE1STST2 = STY02a

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April 15, 2016

ELSE AGE1STST2 = 0
HARD ERROR: [IF CURNTAGE < AGE1STST2] The age you just reported is older
than your current age. Press [Enter] to answer the question again.
IF 1 <= AGE1STST2 < 10:
STCC05A2 The computer recorded that you were [AGE1STST2] years
old the first time you used Adderall XR in a way a doctor did
not direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF STCC05A2= DK/REF THEN AGE1STST2 = 0
STCC06A2 [IF STCC05A2=6] Please answer this question again.
Think about the first time you used Adderall XR in a way a
doctor did not direct you to use it.
How old were you the first time you used Adderall XR in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF STCC06A2 NOT (BLANK OR DK/REF) THEN AGE1STST2 =
STCC06A2
ELSE IF STCC06A2 = DK/REF THEN AGE1STST2 = 0
DEFINE STYRINIT2:
IF AGE1STST2 = CURNTAGE THEN STYRINIT2 = 1
ELSE STYRINIT2 = 0
DEFINE STYRDKRE2:
IF STYRINIT2 = 0 AND (STY02a = DK/REF OR STCC05A2 = DK/REF OR
STCC06A2 = DK/REF) THEN STYRDKRE2 = 1
ELSE STYRDKRE2= 0

DEFINE ST30INIT2:

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April 15, 2016

ST30INIT2 = 0
IF AGE1STST2 = CURNTAGE AND DATE OF INTERVIEW >= DOB AND
NUMBER OF DAYS BASED ON THE DIFFERENCE BETWEEN DATE OF
INTERVIEW AND DOB <= 30, THEN ST30INIT2 = 1
2.2.1

Year and Month of First Nonmedical Use

DEFINE STYFU2:
STYFU2 = 0
DEFINE STMFU2:
STMFU2 = 0
STY02b.

[AGE1STST2 = CURNTAGE AND DATE OF INTERVIEW < DOB OR
IF AGE1STST2 = CURNTAGE - 1 AND DATE OF INTERVIEW ≥
DOB] Did you first use Adderall XR in a way a doctor did not direct
you to use it in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

STY02c.

[IF AGE1STST2 = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first use Adderall XR in a way a doctor did not direct
you to use it in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

UPDATE: IF STY02B = 2 OR (AGE1STST2 = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB) THEN STYFU2 = CURRENT YEAR
IF STY02B = 1 OR STY02C = 2 THEN STYFU2 = CURRENT YEAR - 1
IF STY02C = 1 THEN STYFU2 = CURRENT YEAR - 2
DEFINE STJANFLAG2:
STJANFLAG2 = 0
IF STYFU2=CURRENT YEAR AND CURRENT MONTH = JANUARY THEN
STJANFLAG2 = 1
IF STYFU2=CURRENT YEAR-1 AND BIRTHDAY MONTH=JANUARY AND
DATE OF INTERVIEW ≥ DOB THEN STJANFLAG2=1
IF STJANFLAG2=1 THEN STY02D=1
DEFINE STDECFLAG2:
STDECFLAG2 = 0

320
April 15, 2016

IF AGE1STST2 = CURNTAGE AND STYFU2=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN STDECFLAG2 = 1
IF STDECFLAG2=1 THEN STY02D=12
DEFINE ST1MTHFLAG2:
ST1MTHFLAG2=0
IF (AGE1STST2=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH) THEN
ST1MTHFLAG2=1
IF ST1MTHFLAG2=1 THEN STY02D=CURRENT MONTH
STY02d.
[IF STYFU2 NE 0 AND STJANFLAG2 = 0 AND STDECFLAG2=0
AND ST1MTHFLAG2=0]
[IF STYFU2 = CURRENT YEAR OR CURRENT YEAR -1] Earlier, you reported that
you first used Adderall XR in a way a doctor did not direct you to use it when you
were [AGE1STST2] years old. Based on your date of birth, you turned [AGE1STST2] in
[FILL WITH MONTH/YEAR FOR AGE1STST2 BASED ON DOB].
[IF STYFU2 NE 0] In what month in [STYFU2] did you first use Adderall XR in a way
a doctor did not direct you to use it?
[IF DATE OF INTERVIEW < DOB AND AGE1STST2=CURRENT AGE AND
STYFU2=CURRENT YEAR THEN SHOW JANUARY THROUGH INTERVIEW
MONTH.]
IF AGE1STST2 = CURNTAGE AND DATE OF INTERVIEW ≥ DOB THEN SHOW
MONTHS FROM BIRTH MONTH TO INTERVIEW MONTH.
IF ((AGE1STST2 = CURNTAGE AND DATE OF INTERVIEW <= DOB) or
(AGE1STST2 = CURNTAGE – 1 AND DATE OF INTERVIEW > DOB))
AND (STYFU2 = CURRENT YEAR – 1), SHOW BIRTH MONTH TO DECEMBER
IF STYFU2=CURRENT YEAR AND AGE1STST2=CURRENT AGE-1 AND DATE
OF INTERVIEW > DOB THEN SHOW JANUARY THROUGH BIRTH MONTH.
IF STYFU2 = CURRENT YEAR - 1 AND AGE1STST2 = CURNTAGE - 1 AND
DATE OF INTERVIEW < DOB THEN SHOW JANUARY THROUGH BIRTH
MONTH.
ELSE SHOW ALL MONTHS.]
1
2
3
4
5

January
February
March
April
May

321
April 15, 2016

6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF STY02D = 1-12 THEN STMFU2 = STY02D
IF STJANFLAG2 = 1 THEN STMFU2 = 1.
IF STDECFLAG2=1 THEN STMFU2=12.
UPDATE: IF STYRINIT2 NE 1 AND (STYFU2 = CURRENT YEAR OR (STYFU2 =
CURRENT YEAR - 1 AND STMFU2 = 1-12 AND STMFU2 >= CURRENT MONTH)
THEN STYRINIT2 = 1
UPDATE: IF STYRINIT2 NE 1 AND STYRDKRE2 NE 1 AND [(STY02b = DK/REF
OR STY02c = DK/REF) OR (STYFU2 = CURRENT YEAR-1 AND STY02d =
DK/REF)] THEN STYRDKRE2 = 1
UPDATE: IF ST30INIT2 NE 1 AND STYFU2 = CURRENT YEAR AND STMFU2 =
CURRENT MONTH THEN ST30INIT2 = 1
DEFINE MYR1STST2:
MYR1STST2 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (STY02B-D).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STST2 IS 0.
IF MYR1STST2 NE 0 AND NE AGE1STST2:
STCC32A2
Earlier, the computer recorded that you were
[AGE1STST2] years old when you first used Adderall XR in a
way a doctor did not direct you to use it.
Which answer is correct?
1

I was [MYR1STST2] years old in [STY02B-D fill] the
first time I used Adderall XR in a way not directed for
me by a doctor
2
I was [AGE1STST2] years old the first time I used
Adderall XR in a way not directed for me by a doctor
3
Neither answer is correct
DK/REF
UPDATE: IF STCC32A2 = 1, THEN AGE1STST2 = MYR1STST2.

322
April 15, 2016

UPDATE: IF STYRINIT2 NE 1 AND AGE1STST2 = CURNTAGE THEN STYRINIT2
=1
ELSE IF STYRINIT2 = 1 AND AGE1STST2 NE CURNTAGE AND STCC32A2 =
DK/REF THEN STYRINIT2 = 0
UPDATE: IF STYRINIT2 NE 1 AND STYRDKRE2 NE 1 AND STCC32A2 = DK/REF
THEN STYRDKRE2 = 1
UPDATE: IF ST30INIT2 NE 1 AND STCC32A2 = 1 AND AGE1STST2 IS WITHIN 30
DAYS OF INTERVIEW DATE THEN ST30INIT2 = 1
UPDATE: IF STYFU2 NE 0 AND STCC32A2 = DK/REF THEN STYFU2 = 0
UPDATE: IF STMFU2 = 1-12 AND STCC32A2 = DK/REF THEN STMFU2 = 0
STCC33A2 [IF STCC32A2=2 OR STCC32A2=3] Please answer this
question again. Did you first use Adderall XR in a way a
doctor did not direct you to use it in [CURRENT YEAR-2],
[CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
UPDATE: IF STYFU2 NE 0 AND STCC33A2 = DK/REF THEN STYFU2 = 0
IF STCC33A2 = 1 THEN STYFU2 = CURRENT YEAR - 2
IF STCC33A2 = 2 THEN STYFU2 = CURRENT YEAR - 1
IF STCC33A2 = 3 THEN STYFU2 = CURRENT YEAR
UPDATE: IF STMFU2 = 1-12 AND STCC33A2 = DK/REF THEN STMFU2 = 0
STCC33B2

[IF STCC33A2 NE (BLANK OR DK/REF)] Please answer
this question again. In what month in [STCC33A2] did
you first use Adderall XR in any way a doctor did not direct
you to use it?

IF STCC33A2 = 3 THEN DISPLAY ONLY UP TO THE INTERVIEW MONTH.
1
2
3
4
5
6

January
February
March
April
May
June

323
April 15, 2016

7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF STCC33B2 = 1-12 THEN STMFU2 = STCC33B2
IF STCC33B2 = DK/REF THEN STMFU2 = 0
UPDATE: IF STCC33B2 NE (0 OR DK/REF) THEN UPDATE MYR1STST2.
MYR1STST2 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (STCC33A2 AND
STCC33B2). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STST2
IS 0. IF MYR1STST2 = AGE1STST2 THEN MYR1STST2 = 0
UPDATE: IF STYRINIT2 = 1 AND AGE1STST2 NE CURNTAGE AND STCC32A2
NE 1 AND MYR1STST2 NE 0 AND (STCC33A2 AND STCC33B2 = STY02b-d)
THEN STYRINIT2 = 0
UPDATE: IF STYRINIT2 NE 1 AND STYRDKRE2 NE 1 AND STCC33A2 = DK/REF
THEN STYRDKRE2 = 1
IF STYRINIT2 NE 1 AND STYRDKRE2 NE 1 AND STYFU2 = CURRENT YEAR-1
AND STCC33B2 = DK/REF THEN STYRDKRE2 = 1
UPDATE: IF ST30INIT2 = 1 AND AGE1STST2 NOT WITHIN 30 DAYS OF DATE
OF INTERVIEW AND STCC32A2 NE 1 AND MYR1STST2 NE 0 AND (STCC33A2
AND STCC33B2 = STY02b-d) THEN ST30INIT2 = 0
STCC34A2 [IF STCC32A2 NE 1 AND MYR1STST2 NE 0 AND
(STCC33A2 AND STCC33B2 NE STY02b-d)] The computer
recorded that you first used Adderall XR in a way a doctor did
not direct you to use it in [STCC33A2-STCC33B2 fill]. That
would make you [MYR1STST2] years old when you first used
Adderall XR in any way a doctor did not direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF STCC34A2 NE (6, BLANK OR DK/REF) AND (STCC33A2 AND
STCC33B2 NE STY02b-d) THEN AGE1STST2 = MYR1STST2

324
April 15, 2016

UPDATE: IF STYRINIT2 NE 1 AND AGE1STST2 = CURNTAGE OR (STCC34A2 =
4 AND STCC33A2 = 3 OR (STCC33A2 = 2 AND STCC33B2 NE DK/REF AND
STCC33B2 >= CURRENT MONTH) ) THEN STYRINIT2 = 1
ELSE IF STYRINIT = 1 AND AGE1STST2 NE CURNTAGE AND STCC34A2 = (6
OR DK/REF) THEN STYRINIT2 = 0
UPDATE: IF STYRINIT2 NE 1 AND STYRDKRE2 NE 1 AND MYR1STST2=
CURNTAGE AND STCC34A2 = (6 OR DK/REF) THEN STYRDKRE2 = 1
IF STYRINIT2 NE 1 AND STYRDKRE2 NE 1 AND STCC34A2 = BLANK AND
STCC33A2 = 3 THEN STYRDKRE2 = 1
IF STYRINIT2 NE 1 AND STYRDKRE2 NE 1 AND STCC34A2 = BLANK AND
STCC33A2 = 2 AND STCC33B2 = 1-12 AND STCC33B2 >= CURRENT MONTH
THEN STYRDKRE2 = 1
UPDATE: IF ST30INIT2 NE 1 AND AGE1STST2 WITHIN 30 DAYS OF
INTERVIEW DATE OR (STCC34A2 = 4 AND STCC33A2 = 3 AND STCC33B2 =
CURRENT MONTH) THEN ST30INIT2 = 1
ELSE IF ST30INIT2 = 1 AND AGE1STST2 NOT WITHIN 30 DAYS OF INTERVIEW
DATE AND STCC34A2 = (6 OR DK/REF) THEN ST30INIT2 = 0
UPDATE: IF STYFU2 NE BLANK AND STCC34A2 = OR DK/REF THEN STYFU2 =
0
IF STCC34A2 = BLANK AND (STCC33A2 AND STCC33B2 EQ STY02b-d) THEN
STYFU2 = 0
UPDATE: IF STMFU2 = 1-12 AND STCC34A2 = (6 OR DK/REF) THEN STMFU2 = 0
IF STCC34A2 = BLANK AND (STCC33A2 AND STCC33B2 EQ STY02b-d) THEN
STMFU2 = 0
Continue asking the misuse and age at first misuse questions above about each
tranquilizer reported.
STY03

[IF ST01=3] In the past 12 months, did you use Dexedrine in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY03=1 THEN STFIRSTFLAG=3.
STY03a

[IF STFIRSTFLAG=3] Please think about the first time you ever used
Dexedrine in a way a doctor did not direct you to use it.

325
April 15, 2016

[IF STY03=1] How old were you when you first used Dexedrine in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY04

[IF ST02=1] In the past 12 months, did you use dextroamphetamine in any
way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY04=1 THEN STFIRSTFLAG=4.
STY04a

[IF STFIRSTFLAG=4] Please think about the first time you ever used
dextroamphetamine in a way a doctor did not direct you to use it.
[IF STY04=1] How old were you when you first used dextroamphetamine
in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

326
April 15, 2016

STY05

[IF ST02=2] In the past 12 months, did you use mixed amphetaminedextroamphetamine pills in any way a doctor did not direct you to use
them?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY05=1 THEN STFIRSTFLAG=5.
STY05a

[IF STFIRSTFLAG=5] Please think about the first time you ever used
mixed amphetamine-dextroamphetamine pills in a way a doctor did not
direct you to use them.
[IF STY05=1] How old were you when you first used mixed
amphetamine-dextroamphetamine pills in a way a doctor did not direct
you to use them?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY06

[IF ST02=3] In the past 12 months, did you use extended-release
amphetamine-dextroamphetamine pills in any way a doctor did not
direct you to use them?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY06=1 THEN STFIRSTFLAG=6.

327
April 15, 2016

STY06a

[IF STFIRSTFLAG=6. Please think about the first time you ever used
extended-release amphetamine-dextroamphetamine pills in a way a doctor
did not direct you to use them.
[IF STY06=1] How old were you when you first used extended-release
amphetamine-dextroamphetamine pills in a way a doctor did not direct
you to use them?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY07

[IF ST03=1] In the past 12 months, did you use Ritalin in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY07=1 THEN STFIRSTFLAG=7.
STY07a

[IF STFIRSTFLAG=7] Please think about the first time you ever used
Ritalin in a way a doctor did not direct you to use it.
[IF STY07=1] How old were you when you first used Ritalin in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]

328
April 15, 2016

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.
STY08

[IF ST03=2] In the past 12 months, did you use Ritalin LA in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY08=1 THEN STFIRSTFLAG=8.
STY08a

[IF STFIRSTFLAG=8] Please think about the first time you ever used
Ritalin LA in a way a doctor did not direct you to use it.
[IF STY08=1] How old were you when you first used Ritalin LA in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.
STY09

[IF ST03=3] In the past 12 months, did you use Concerta in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY09=1 THEN STFIRSTFLAG=9.
STY09a

[IF STFIRSTFLAG=9] Please think about the first time you ever used
Concerta in a way a doctor did not direct you to use it.

329
April 15, 2016

[IF STY09=1] How old were you when you first used Concerta in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.
STY10

[IF ST03=4] In the past 12 months, did you use Daytrana in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY10=1 THEN STFIRSTFLAG=10.
STY10a

[IF STFIRSTFLAG=10] Please think about the first time you ever used
Daytrana in a way a doctor did not direct you to use it.
[IF STY10=1] How old were you when you first used Daytrana in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

330
April 15, 2016

STY11

[IF ST04=1] In the past 12 months, did you use Metadate CD in any way
a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY11=1 THEN STFIRSTFLAG=11.
STY11a

[IF STFIRSTFLAG=11] Please think about the first time you ever used
Metadate CD in a way a doctor did not direct you to use it.
[IF STY11=1] How old were you when you first used Metadate CD in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY12

[IF ST04=2] In the past 12 months, did you use Metadate ER in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY12=1 THEN STFIRSTFLAG=12.
STY12a

[IF STFIRSTFLAG=12] Please think about the first time you ever used
Metadate ER in a way a doctor did not direct you to use it.
[IF STY12=1] How old were you when you first used Metadate ER in a
way a doctor did not direct you to use it?

331
April 15, 2016

AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY13

[IF ST04=3] In the past 12 months, did you use methylphenidate in any
way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY13=1 THEN STFIRSTFLAG=13.
STY13a

[IF STFIRSTFLAG=13] Please think about the first time you ever used
methylphenidate in a way a doctor did not direct you to use it.
[IF STY13=1] How old were you when you first used methylphenidate in
a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY14

[IF ST04=4] In the past 12 months, did you use extended-release
methylphenidate in any way a doctor did not direct you to use it?

332
April 15, 2016

1
Yes
2
No
DK/REF
UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY14=1 THEN STFIRSTFLAG=14.
STY14a

[IF STFIRSTFLAG=14] Please think about the first time you ever used
extended-release methylphenidate in a way a doctor did not direct you to
use it.
[IF STY14=1] How old were you when you first used extended-release
methylphenidate in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY15

[IF ST05=1] In the past 12 months, did you use Focalin in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY15=1 THEN STFIRSTFLAG=15.
STY15a

[IF STFIRSTFLAG=15] Please think about the first time you ever used
Focalin in a way a doctor did not direct you to use it.
[IF STY15=1] How old were you when you first used Focalin in a way a
doctor did not direct you to use it?
AGE:

[(RANGE: 1 - 110)]

333
April 15, 2016

DK/REF

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.
STY16

[IF ST05=2] In the past 12 months, did you use Focalin XR in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY16=1 THEN STFIRSTFLAG=16.
STY16a

[IF STFIRSTFLAG=16] Please think about the first time you ever used
Focalin XR in a way a doctor did not direct you to use it.
[IF STY16=1] How old were you when you first used Focalin XR in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.
STY17

[IF ST05=3] In the past 12 months, did you use dexmethylphenidate in
any way a doctor did not direct you to use it?
1
2

Yes
No

334
April 15, 2016

DK/REF
UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY17=1 THEN STFIRSTFLAG=17.
STY17a

[IF STFIRSTFLAG=17] Please think about the first time you ever used
dexmethylphenidate in a way a doctor did not direct you to use it.
[IF STY17=1] How old were you when you first used dexmethylphenidate
in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.
STY18

[IF ST05=4] In the past 12 months, did you use extended-release
dexmethylphenidate in any way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY18=1 THEN STFIRSTFLAG=18.
STY18a

[IF STFIRSTFLAG=18] Please think about the first time you ever used
extended-release dexmethylphenidate in a way a doctor did not direct you
to use it.
[IF STY18=1] How old were you when you first used extended-release
dexmethylphenidate in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]

335
April 15, 2016

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY19

[IF ST06=1] In the past 12 months, did you use benzphetamine in any way
a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY19=1 THEN STFIRSTFLAG=19.
STY19a

[IF STFIRSTFLAG=19] Please think about the first time you ever used
benzphetamine in a way a doctor did not direct you to use it.
[IF STY19=1] How old were you when you first used benzphetamine in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY20

[IF ST06=2] In the past 12 months, did you use Didrex in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY20=1 THEN STFIRSTFLAG=20.

336
April 15, 2016

STY20a

[IF STFIRSTFLAG=20] Please think about the first time you ever used
Didrex in a way a doctor did not direct you to use it.
[IF STY20=1] How old were you when you first used Didrex in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY21

[IF ST06=3] In the past 12 months, did you use diethylpropion in any way
a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY21=1 THEN STFIRSTFLAG=21.
STY21a

[IF STFIRSTFLAG=21] Please think about the first time you ever used
diethylpropion in a way a doctor did not direct you to use it.
[IF STY21=1] How old were you when you first used diethylpropion in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES

337
April 15, 2016

PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY22

[IF ST06=4] In the past 12 months, did you use phendimetrazine in any
way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY22=1 THEN STFIRSTFLAG=22.
STY22a

[IF STFIRSTFLAG=22] Please think about the first time you ever used
phendimetrazine in a way a doctor did not direct you to use it.
[IF STY22=1] How old were you when you first used phendimetrazine in
a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY23

[IF ST06=5] In the past 12 months, did you use phentermine in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY23=1 THEN STFIRSTFLAG=23.

338
April 15, 2016

STY23a

[IF STFIRSTFLAG=23] Please think about the first time you ever used
phentermine in a way a doctor did not direct you to use it.
[IF STY23=1] How old were you when you first used phentermine in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY24

[IF ST07=1] In the past 12 months, did you use Provigil in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY24=1 THEN STFIRSTFLAG=24.
STY24a

[IF STFIRSTFLAG=24] Please think about the first time you ever used
Provigil in a way a doctor did not direct you to use it.
[IF STY24=1] How old were you when you first used Provigil in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

339
April 15, 2016

STY25

[IF ST07=2] In the past 12 months, did you use Tenuate in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY25=1 THEN STFIRSTFLAG=25.
STY25a

[IF STFIRSTFLAG=25] Please think about the first time you ever used
Tenuate in a way a doctor did not direct you to use it.
[IF STY25=1] How old were you when you first used Tenuate in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STY26

[IF ST07=3] In the past 12 months, did you use Vyvanse in any way a
doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE STFIRSTFLAG:
IF STFIRSTFLAG=0 AND STY26=1 THEN STFIRSTFLAG=26.
STY26a

[IF STFIRSTFLAG=26] Please think about the first time you ever used
Vyvanse in a way a doctor did not direct you to use it.

340
April 15, 2016

[IF STY26=1] How old were you when you first used Vyvanse in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

STYOTH

[IF STANYOTH =1] In the past 12 months, did you use any [IF
STANYOTH =1 AND STYRCOUNT > 1 FILL “other”] prescription
stimulant in a way a doctor did not direct you to use it?
Remember, do not include “over-the-counter” stimulants such as
Dexatrim, No-Doz, Hydroxycut, or 5-Hour Energy.
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW CALENDAR WITH 12-MONTH
REFERENCE DATE.

STYOTHA1 [IF STYOTH = 1] Please type in the name of one of the [IF STANYOTH
AND STYRCOUNT > 1 FILL “other”] prescription stimulants you have
used in the past 12 months in a way a doctor did not direct you to use it. If
you’re not sure how to spell the name of the stimulant, just make your best
guess
When you have finished, press [ENTER] to go to the next question.
Remember, you do not need to type in the names of any prescription
stimulants you already reported.

__________________
[NOTE: DON'T ALLOW BLANKS IN STYOTHA1 IF STYOTH = 1]
DK/REF

341
April 15, 2016

STYOTHA2 [IF STYOTH = 1 AND STYOTHA1 NE DK/REF)] Please type in the
name of any other prescription stimulant you used in the past 12 months
in a way a doctor did not direct you to use it .
If you have not used any other prescription stimulant in a way a doctor did
not direct you to use it, press [ENTER].

______________
DK/REF
STYOTHA3 [IF STYOTHA2 NE (BLANK OR DK/REF)] Please type in the name of
any other prescription stimulant you used in the past 12 months in a way a
doctor did not direct you to use it .
If you have not used any other prescription stimulant in a way a doctor did
not direct you to use it, press [ENTER].

______________
DK/REF
STYOTHA4 [IF STYOTHA3 NE (BLANK OR DK/REF)] Please type in the name of
any other prescription stimulant you used in the past 12 months in a way a
doctor did not direct you to use it .
If you have not used any other prescription stimulant in a way a doctor did
not direct you to use it, press [ENTER].

______________
DK/REF
STYOTHA5 [IF STYOTHA4 NE (BLANK OR DK/REF)] Please type in the name of
any other prescription stimulant you used in the past 12 months in a way a
doctor did not direct you to use it .
If you have not used any other prescription stimulant in a way a doctor did
not direct you to use it, press [ENTER].

______________
DK/REF
UPDATE STFIRSTFLAG:

342
April 15, 2016

IF STFIRSTFLAG=0 AND STYOTH=1 THEN STFIRSTFLAG=27.
STYOTHa [IF STFIRSTFLAG=27] Please think about the first time you ever used any
[IF STANYOTH=1 AND STYRCOUNT > 1 FILL “other”] prescription
stimulant in a way a doctor did not direct you to use it.
[IF STYOTH=1] How old were you when you first used any [IF
STANYOTH=1 AND STYRCOUNT > 1 FILL “other”] prescription
stimulant in a way a doctor did not direct you to use it?

AGE:
DK/REF

[(RANGE: 1 - 110)]

[DISPLAY “HELP” TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT]

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.
DEFINE STMISCOUNT:
INITIALIZE STMISCOUNT TO 0.
INCREMENT STMISCOUNT BY 1 FOR EVERY RESPONSE OF YES IN STY01STYOTH.
DEFINE STMISUSE12:
IF STMISCOUNT > 0 THEN STMISUSE12 = 1.
ELSE STMISUSE12 = 2.
If no stimulants misused in the past 12 months:
STL02

[IF ST12MON=1 AND STMISUSE12=2] Have you ever, even once, used
any prescription stimulant in any way a doctor did not direct you to
use it?
1
Yes
2
No
DK/REF

If any stimulants misused in past 12 months:

343
April 15, 2016

DEFINE STDKREFCOUNT:
INITIALIZE STDKREFCOUNT TO 0.
INCREMENT STDKREFCOUNT BY 1 FOR EVERY RESPONSE OF DK/REF IN
STY01-STYOTH AND ST01-STANYOTH.
DEFINE STDKREFFLAG:
IF STDKREFCOUNT > 1 THEN STDKREFFLAG = 1.
ELSE STDKREFFLAG = 2.
DEFINE STNUMFILL:
IF STMISCOUNT = 1 AND STY05 NE 1 AND STY06 NE 1 AND STYOTH NE 1
THEN STNUMFILL = "it".
ELSE STNUMFILL = "them".
DEFINE ST30ANYINIT:
IF ANY CODE OF 1 IN ST30INIT1-ST30INITOT THEN ST30ANYINIT = 1.
ELSE ST30ANYINIT = 2.
DEFINE STFILL2:
IF STMISCOUNT < 3 AND STYOTH NE 1 AND STDKREFFLAG =2 THEN
STFILL2=”[DRUG NAMES FROM STY01-STY26]”.
ELSE IF STMISCOUNT=1 AND STYOTH NE 1 AND STDKREFFLAG=1 THEN
STFILL2 = “[DRUG NAMES FROM STY01- STY26] or any other prescription
stimulant.”
ELSE IF STMISCOUNT=2 AND STDKREFFLAG=2 AND STYOTH=1 THEN
STFILL2=”[DRUG NAME FROM STY01-STY23] and some other prescription
stimulant.”
ELSE IF STMISCOUNT=2 AND STDKREFFLAG=1 THEN STFILL2=”[DRUG
NAMES FROM STY01-STY26]”. IF STYOTH=1 THEN ADD “some other
prescription stimulant” TO THE FILL.
ELSE STFILL2= “prescription stimulants”
DEFINE STNAMEFILL:
IF STMISCOUNT=1 AND (STYOTH=2 OR STYOTH=BLANK) AND
STDKREFFLAG=2 THEN STNAMEFILL= “[DRUG NAME FROM STY01-STY26]”
[INCLUDE DRUG NAMES FOR NEW STIMULANTS.]
ELSE IF STMISCOUNT=1 AND STYOTH NE 1 AND STDKREFFLAG=1 THEN
STNAMEFILL=”[DRUG NAME FROM STY01-STY26] or any other prescription
stimulant”
ELSE IF STMISCOUNT >1 THEN STNAMEFILL= “prescription stimulants”
DEFINE STYINICT:
INITIALIZE STYINICT TO 0.
INCREMENT STYINICT BY 1 FOR EVERY VALUE OF 1 IN STYRINIT1STYRINITOT.

344
April 15, 2016

DEFINE STYRDKRECT:
INITIALIZE STYRDKRECT TO 0.
INCREMENT STYRDKRECT BY 1 FOR EVERY VALUE OF 1 IN STYRDKRE1STYRDKREOT.
DEFINE STYINALL:
IF STMISCOUNT > 0 AND STMISCOUNT = STYINICT + STYRDKRECT THEN
STYINALL = 1.
ELSE STYINALL = 2.
STL03

[IF STYINALL=1] Earlier questions were about the past 12 months. This
question is about any time before then, that is, any time in your life before
[DATEFILL -12 MONTHS].
At any time before [DATEFILL -12 MONTHS], did you ever use any
prescription stimulant in a way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

STINTROYR3

[IF STMISUSE12=1 AND STMISCOUNT>1] Earlier the computer
recorded that in the past 12 months you used [IF STMISUSE12=1
AND STMISCOUNT > 2, ADD "these"] [STFILL2] in any way a
doctor did not direct you to use [STNUMFILL].

[IF STMISUSE12=1 AND STMISCOUNT>2, FILL WITH DRUG
NAMES FROM STY01-STYOTH BELOW. USE MULTIPLE
COLUMNS AS NEEDED. IF STYOTH = 1, FILL WITH "Some
other prescription stimulant".]
[IF STMISUSE12=1 STMISCOUNT>1] The next questions refer to
these drugs as prescription stimulants.
Press Enter to continue.

STM01

[IF STMISUSE12=1 AND ST30ANYINIT= 2] In the past 30 days, that
is, from [DATEFILL] up to and including today, did you use
[STNAMEFILL] in any way a doctor did not direct you to use
[STNUMFILL]?
1
Yes
2
No
DK/REF

345
April 15, 2016

PROGRAMMER: SHOW 30-DAY CALENDAR
DEFINE STMISUSE30:
STMISUSE30=1 IF STM01=1 OR ST30ANYINIT=1.
STMISUSE30=2 IF STMISUSE12 = 1 AND STM01=2, DK, OR REF.
STM02

[IF STMISUSE30=1] During the past 30 days, on how many days did
you use [STNAMEFILL’] in any way a doctor did not direct you to use
[STNUMFILL]?
________________ [RANGE: 1- 30]
DK/REF
PROGRAMMER: SHOW 30-DAY CALENDAR

STM02DKRE

[IF STM02 = DK/REF] What is your best estimate of the number of
days you used [STNAMEFILL] in any way a doctor did not direct
you to use [STNUMFILL] during the past 30 days?

1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30-DAY CALENDAR
STM03

[IF ALC30USE = 1 and (STMISUSE30=1)] During the past 30 days, did
you use [STNAMEFILL] in any way a doctor did not direct you to use
[STNUMFILL] while you were drinking alcohol or within a couple of
hours of drinking?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

STYWAYS

[IF STMISUSE12=1] Which of these statements describe your use of
[STNAMEFILL] at any time in the past 12 months?
To select more than one statement, press the space bar between the
numbers. When you have finished, press [ENTER].

346
April 15, 2016

1
2

I used [STNAMEFILL] without a prescription of my own.
I used [STNAMEFILL] in greater amounts than [IF
STNAMEFILL= “mixed amphetamine-dextroamphetamine pills”
OR STNAMEFILL= “prescription stimulants” THEN FILL WITH
“they were”; ELSE FILL WITH “it was”] prescribed.
3
I used [STNAMEFILL] more often than [IF STNAMEFILL=
“mixed amphetamine-dextroamphetamine pills” OR
STNAMEFILL= “prescription stimulants” THEN FILL WITH
“they were”; ELSE FILL WITH “it was”] prescribed.
4
I used [STNAMEFILL] for longer than [IF STNAMEFILL=
“mixed amphetamine-dextroamphetamine pills” OR
STNAMEFILL= “prescription stimulants” THEN FILL WITH
“they were”; ELSE FILL WITH “it was”] prescribed.
5
I used [STNAMEFILL] in some other way a doctor did not
direct me to use [STNUMFILL]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
STYNDL

[IF STMISUSE12=1] At any time in the past 12 months, did you ever
use a needle to inject [STNAMEFILL]?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

STYNDL30 [IF STYNDL = 1 AND STMISUSE30=1] How long has it been since you
last used a needle to inject [STNAMEFILL]?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
STYLAST

[IF STMISCOUNT > 1 OR (STMISCOUNT = 1 AND
STDKREFFLAG=1)] Now think about the last time you used a
prescription stimulant in any way a doctor did not direct you to use it.
Which of these stimulants did you use the last time? If you used more than
one stimulant the last time, please choose one stimulant as your best
answer.

347
April 15, 2016

(LIST DRUGS WHERE STY01-STYOTH=1. NUMBER RESPONSE
OPTIONS SEQUENTIALLY STARTING AT 1, BUT MAINTAIN
UNIQUE CODES FOR EACH DRUG. IF STYOTH=1, DISPLAY
"Another prescription stimulant” AS THE LAST CATEGORY. IF
STMISCOUNT > 0 AND STYOTH 4 NE 1 AND STDKREFFLAG=1,
DISPLAY "Any other prescription stimulant" AS THE LAST
CATEGORY. ALLOW ONLY 1 RESPONSE.)
PROGRAMMER: IF STMISUSE12 = 1 THEN CREATE A RECODED RSTYLAST
VARIABLE. ASSIGN A UNIQUE CODE TO A GIVEN DRUG ACCORDING TO
THE OVERALL ORDER IN WHICH THE DRUGS APPEAR IN THE SCREENER.
INITIALIZE RSTYLAST TO BLANK.
IF "Adderall" CHOSEN IN STYLAST OR (STNUMMISUSE = 1 AND STY01 = 1)
THEN RSTYLAST = 1.
IF "Adderall XR" CHOSEN IN STYLAST OR (STNUMMISUSE = 1 AND STY02 = 1)
THEN RSTYLAST = 2.
IF "Dexedrine" CHOSEN IN STYLAST OR (STNUMMISUSE = 1 AND STY03 = 1)
THEN RSTYLAST = 3.
ETC.
IF "Vyvanse " CHOSEN IN STYLAST OR (STNUMMISUSE = 1 AND STY26 = 1)
THEN RSTYLAST = 26.
IF "Another prescription stimulant " OR "Any other prescription stimulant " CHOSEN
IN STYLAST OR (STMISCOUNT =1 AND STYOTH = 1 AND STDKREFFLAG =2)
THEN RSTYLAST =27
IF STYLAST = DK OR REF, THEN ASSIGN THE DK/REF CODE TO RSTYLAST.)
DEFINE STLASTFILL:
IF RSTYLAST = 1-26, THEN FILL WITH THE DRUG NAME.
IF RSTYLAST = 27 THEN FILL "other stimulant".
IF RSTYLAST = DK, REF, OR BLANK, THEN FILL "stimulant".
DEFINE STLASTFILL2:
IF RSTYLAST = 1-26, THEN FILL WITH THE DRUG NAME.
IF RSTYLAST = 24 THEN FILL "the other stimulant ".
IF RSTYLAST = DK, REF, OR BLANK, THEN FILL "a stimulant ".
DEFINE STLASTFILL3:
IF STLASTFILL NE "other stimulant" THEN STLASTFILL3 = STLASTFILL.
ELSE IF STLASTFILL = "other stimulant" THEN STLASTFILL3 = "stimulant".
STYMOTIV [IF STMISUSE12=1] Now think about the last time you used
[STLASTFILL2] in any way a doctor did not direct you to use [FILL
WITH ‘them” IF RSTYLAST=5 OR 6. ELSE FILL WITH “it”]

348
April 15, 2016

What were the reasons you used [STLASTFILL2] the last time? To select
more than one reason from the list, press the space bar between each
number you have typed. When you have finished, press [ENTER].

1
2
3
4
5
6
7
8
9

To help me lose weight
To help me concentrate
To help me be alert or stay awake
To help me study
To experiment or to see what [IF RSTYLAST =5 OR 6 THEN
“they’re” ELSE “it’s”] like
To feel good or get high
To increase or decrease the effect(s) of some other drug
Because I am “hooked” or I have to have [IF RSTYLAST =5
OR 6 THEN “them” ELSE “it”]
I used [IF RSTYLAST=5 OR 6 THEN “them” ELSE “it”] for
some other reason
DK/REF

STMOTOT [IF STYMOTIV=9] Please type in the other reason you used
[STLASTFILL2] the last time. When you have finished typing your
answer, press [ENTER] to go to the next question.
REASON
__________________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN
STMOTOT.
STYMOT1

[IF MORE THAN ONE RESPONSE 1-9 CHOSEN IN STYMOTIV]
Which was the main reason you used [STLASTFILL2] the last time?
PROGRAMMER: FILL AS RESPONSE OPTIONS ONLY THOSE
CHOSEN IN STYMOTIV
1. To help me lose weight
2. To help me concentrate
3. To help me be alert or stay awake
4. To help me study
5. To experiment or to see what [IF RSTYLAST =5 OR 6 THEN
“they’re” ELSE “it’s”]like
6. To feel good or get high
7. To increase or decrease the effect(s) of some other drug
349

April 15, 2016

8. Because I am “hooked” or I have to have [IF RSTYLAST=5
OR 6 THEN “them” ELSE “it”]
9. [IF STYMOTIV=9] The other reason I reported

DK/REF

STYGOT

[IF STMISUSE12=1 AND STMISCOUNT=1 AND STDKREFFLAG=1]
Now think again about the last time you used [STLASTFILL2] in any
way a doctor did not direct you to use [FILL WITH “them” IF
RSTYLAST=5 OR 6. ELSE FILL WITH “it”].
[IF STMISUSE12 = 1] How did you get the [STLASTFILL]? If you got
the [STLASTFILL] in more than one way, please choose one of these
ways as your best answer.
1
2

I got a prescription for the [STLASTFILL] from just one doctor
I got prescriptions for the [STLASTFILL] from more than one
doctor
3
I stole the [STLASTFILL] from a doctor’s office, clinic, hospital,
or pharmacy
4
I got the [STLASTFILL] from a friend or relative for free
5
I bought the [STLASTFILL] from a friend or relative
6
I took the [STLASTFILL] from a friend or relative without asking
7
I bought the [STLASTFILL] from a drug dealer or other stranger
8
I got the [STLASTFILL] in some other way
DK/REF
STYGOTSP [IF STYGOT = 8] Please type in the other way you got the
[STLASTFILL3].
You do not need to give a detailed description — just a few words will be
okay. When you have finished typing your answer, press [ENTER] to go
to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN STYGOTSP.
STYFRL

[IF STYGOT=4] You reported that you got the [STLASTFILL] from a
friend or relative for free. How did your friend or relative get the
[STLASTFILL]?

350
April 15, 2016

1

He or she got a prescription for the [STLASTFILL] from just one
doctor
2
He or she got prescriptions for the [STLASTFILL] from more than
one doctor
3
He or she stole the [STLASTFILL] from a doctor’s office, clinic,
hospital, or pharmacy
4
He or she got the [STLASTFILL] from another friend or relative
for free
5
He or she bought the [STLASTFILL] from another friend or
relative
6
He or she took the [STLASTFILL] from another friend or relative
without asking
7
He or she bought the [STLASTFILL] from a drug dealer or other
stranger
8
He or she got the [STLASTFILL] in some other way
DK/REF
STYFRLSP [IF STYFRL = 8] Please type in the other way your friend or relative got
the last [STLASTFILL3] you used.
You do not need to give a detailed description — just a few words will be
okay. When you have finished typing your answer, press [ENTER] to go
to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN STYFRLSP.

351
April 15, 2016

352
April 15, 2016

Sedatives Main Module
If no 12 month use of prescription sedatives:
SVINTROLIF

[IF SVLANY = 1] The next question asks about using prescription
sedatives in any way a doctor did not direct you to use them.
When you answer this question, please think only about your use of
the drug in any way a doctor did not direct you to use it, including:




Using it without a prescription of your own
Using it in greater amounts, more often, or longer than you were
told to take it
Using it in any other way a doctor did not direct you to use it

Press Enter to continue.
SVL01

[IF SVLANY =1] Have you ever, even once, used any prescription
sedative in any way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

If any 12 month use of prescription sedatives:
SVINTROYR1

[IF SV12MON = 1] The next questions ask about using prescription
sedatives in any way a doctor did not direct you to use them.
When you answer these questions, please think only about your use of
the drug in any way a doctor did not direct you to use it, including:




Using it without a prescription of your own
Using it in greater amounts, more often, or longer than you were
told to take it
Using it in any other way a doctor did not direct you to use it

Press Enter to continue.
DEFINE SVFILL:
SVFILL LISTS ALL INDIVIDUAL DRUGS SELECTED IN SV01, SV02, SV03, AND
SV04.
USE MULTIPLE COLUMNS AS NEEDED. IF SVANYOTH =1 AND
SVYRCOUNT > 1, THEN ADD “another prescription sedative” TO THE
FILL.

353
April 15, 2016

THE FOLLOWING DRUGS SHOULD NOT USE INITIAL CAPS WHEN FILLED IN
SENTENCE FORMAT:
•
•
•
•
•
•
•
•

zolpidem
extended-release zolpidem
eszopiclone
zaleplon
flurazepam
triazolam
temazepam
phenobarbital

WHEN IMPLEMENTING SVFILL, IF 1, OR 2 DRUGS APPEAR IN LIST, FILL IN
SENTENCE FORMAT, SEPARATED WITH AN “and” BEFORE THE
LAST FILL.
IF >2 DRUGS APPEAR IN LIST, FILL IN LIST (IN COLUMNS IF NEEDED)
BELOW THE PREVIOUS SENTENCE.
DEFINE SVFIRSTFLAG:
SVFIRSTFLAG IDENTIFIES THE FIRST SEDATIVE USED NONMEDICALLY.
INITIALIZE SVFIRSTFLAG TO 0.
(SVFIRSTFLAG NEEDS TO BE DEFINED BEFORE THE ROUTING TO
SVINTROYR2 OR SVYOTH.)
SVINTROYR2 [IF SV12MON=1 AND (SVANYOTH NE 1 OR (SVANYOTH =1
AND SVYRCOUNT > 1))] Earlier, the computer recorded that, in the
past 12 months, you used [SVFILL].
Press Enter to continue.
PROGRAMMER: SHOW CALENDAR WITH 12-MONTH
REFERENCE DATE FOR THE INTRO SCREEN
NOTE TO PROGRAMMERS: LOOP THROUGH THE 12-MONTH MISUSE, AGE AT
FIRST MISUSE, AND YEAR AND MONTH OF FIRST MISUSE (IF APPLICABLE)
FOR EACH PRESCRIPTION SEDATIVE REPORTED IN THE SCREENER FOR
THE PAST 12 MONTHS.
SVY01

[IF SV01=1] In the past 12 months, did you use Ambien in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR AMBIEN
1

Yes
354

April 15, 2016

2
No
DK/REF
UPDATE SVFIRSTFLAG:
IF SVY01=1 THEN SVFIRSTFLAG=1.
SVY01a

[IF SVFIRSTFLAG=1] Please think about the first time you ever used
Ambien in a way a doctor did not direct you to use it.
[IF SVY01=1] How old were you when you first used Ambien in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

PROGRAMMER: DISPLAY IN LOWER RIGHT:
Press [F2] if you want to see and hear these ways
again.
• Without a prescription of your own,
• In greater amounts, more often, or longer than
you were told to take it
• In any other way a doctor did not direct you to
use it
DEFINE AGE1STSV1:
IF SVY01a NE (BLANK OR DK/REF) THEN AGE1STSV1 = SVY01a
ELSE AGE1STSV1 = 0
HARD ERROR: [IF CURNTAGE < AGE1STSV1] The age you just entered is older
than your current age. Press [Enter] to answer the question again.
IF 1 <= AGE1STSV1 < 10:
SVCC05A1 The computer recorded that you were [AGE1STSV1] years
old the first time you used Ambien in a way a doctor did not
direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF SVCC05A1= DK/REF THEN AGE1STSV1 = 0

355
April 15, 2016

SVCC06A1 [IF SVCC05A1=6] Please answer this question again.
Think about the first time you used Ambien in a way a doctor
did not direct you to use it.
How old were you the first time you used Ambien in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF SVCC06A1 NOT (BLANK OR DK/REF) THEN AGE1STSV1 =
SVCC06A1
ELSE IF SVCC06A1 = DK/REF THEN AGE1STSV1 = 0
DEFINE SVYRINIT1:
IF AGE1STSV1 = CURNTAGE THEN SVYRINIT1 = 1
ELSE SVYRINIT1 = 0
DEFINE SVYRDKRE1:
IF SVYRINIT1 = 0 AND (SVY01a = DK/REF OR SVCC05A1 = DK/REF OR
SVCC06A1 = DK/REF) THEN SVYRDKRE1 = 1
ELSE SVYRDKRE1= 0
DEFINE SV30INIT1:
SV30INIT1 = 0
IF AGE1STSV1 = CURNTAGE AND DATE OF INTERVIEW >= DOB AND
NUMBER OF DAYS BASED ON THE DIFFERENCE BETWEEN DATE OF
INTERVIEW AND DOB <= 30, THEN SV30INIT1 = 1
2.2.1

Year and Month of First Nonmedical Use

DEFINE SVYFU1:
SVYFU1 = 0
DEFINE SVMFU1:
SVMFU1 = 0
SVY01b.

[AGE1STSV1 = CURNTAGE AND DATE OF INTERVIEW < DOB OR
IF AGE1STSV1 = CURNTAGE - 1 AND DATE OF INTERVIEW ≥
DOB] Did you first use Ambien in a way a doctor did not direct you to
use it in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1

CURRENT YEAR - 1

356
April 15, 2016

2
CURRENT YEAR
DK/REF

SVY01c.

[IF AGE1STSV1 = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first use Ambien in a way a doctor did not direct you to
use it in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

UPDATE: IF SVY01B = 2 OR (AGE1STSV1 = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB) THEN SVYFU1 = CURRENT YEAR
IF SVY01B = 1 OR SVY01C = 2 THEN SVYFU1 = CURRENT YEAR - 1
IF SVY01C = 1 THEN SVYFU1 = CURRENT YEAR - 2
DEFINE SVJANFLAG1:
SVJANFLAG1 = 0
IF SVYFU1=CURRENT YEAR AND CURRENT MONTH = JANUARY THEN
SVJANFLAG1 = 1
IF SVYFU1=CURRENT YEAR-1 AND BIRTHDAY MONTH=JANUARY AND
DATE OF INTERVIEW ≥ DOB THEN SVJANFLAG1=1
IF SVJANFLAG1=1 THEN SVY01D=1
DEFINE SVDECFLAG1:
SVDECFLAG1 = 0
IF AGE1STSV1 = CURNTAGE AND SVYFU1=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN SVDECFLAG1 = 1
IF SVDECFLAG1=1 THEN SVY01D=12
DEFINE SV1MTHFLAG1:
SV1MTHFLAG1=0
IF (AGE1STSV1=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH) THEN
SV1MTHFLAG1=1
IF SV1MTHFLAG1=1 THEN SVY01D=CURRENT MONTH
SVY01d.

[IF SVYFU1 NE 0 AND SVJANFLAG1 = 0 AND SVDECFLAG1=0
AND SV1MTHFLAG1=0]
[IF SVYFU1 = CURRENT YEAR OR CURRENT YEAR -1] Earlier,
you reported that you first used Ambien in a way a doctor did not direct
you to use it when you were [AGE1STSV1] years old. Based on your date
of birth, you turned [AGE1STSV1] in [FILL WITH MONTH/YEAR FOR
AGE1STSV1 BASED ON DOB].

357
April 15, 2016

[IF SVYFU1 NE 0] In what month in [SVYFU1] did you first use
Ambien in a way a doctor did not direct you to use it?
[IF DATE OF INTERVIEW < DOB AND AGE1STSV1=CURRENT AGE AND
SVYFU1=CURRENT YEAR THEN SHOW JANUARY THROUGH INTERVIEW
MONTH.]
IF AGE1STSV1 = CURNTAGE AND DATE OF INTERVIEW ≥ DOB THEN SHOW
MONTHS FROM BIRTH MONTH TO INTERVIEW MONTH.
IF ((AGE1STSV1 = CURNTAGE AND DATE OF INTERVIEW <= DOB) or
(AGE1STSV1 = CURNTAGE – 1 AND DATE OF INTERVIEW > DOB))
AND (SVYFU1 = CURRENT YEAR – 1), SHOW BIRTH MONTH TO DECEMBER
IF SVYFU1=CURRENT YEAR AND AGE1STSV1=CURRENT AGE-1 AND DATE
OF INTERVIEW > DOB THEN SHOW JANUARY THROUGH BIRTH MONTH.
IF SVYFU1 = CURRENT YEAR - 1 AND AGE1STSV1 = CURNTAGE - 1 AND
DATE OF INTERVIEW < DOB THEN SHOW JANUARY THROUGH BIRTH
MONTH.
ELSE SHOW ALL MONTHS.]
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF SVY01D = 1-12 THEN SVMFU1 = SVY01D
IF SVJANFLAG1 = 1 THEN SVMFU1 = 1.
IF SVDECFLAG1=1 THEN SVMFU1=12.
UPDATE: IF SVYRINIT1 NE 1 AND (SVYFU1 = CURRENT YEAR OR (SVYFU1 =
CURRENT YEAR - 1 AND SVMFU1 = 1-12 AND SVMFU1 >= CURRENT MONTH)
THEN SVYRINIT1 = 1

358
April 15, 2016

UPDATE: IF SVYRINIT1 NE 1 AND SVYRDKRE1 NE 1 AND [(SVY01b = DK/REF
OR SVY01c = DK/REF) OR (SVYFU1 = CURRENT YEAR-1 AND SVY01d =
DK/REF)] THEN SVYRDKRE1 = 1
UPDATE: IF SV30INIT1 NE 1 AND SVYFU1 = CURRENT YEAR AND SVMFU1 =
CURRENT MONTH THEN SV30INIT1 = 1
DEFINE MYR1STSV1:
MYR1STSV1 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (SVY01b-d).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STSV1 IS 0.
IF MYR1STSV1 NE 0 AND NE AGE1STSV1:
SVCC32A1
Earlier, the computer recorded that you were
[AGE1STSV1] years old when you first used Ambien in a way
a doctor did not direct you to use it.
Which answer is correct?
1

I was [MYR1STSV1] years old in [SVY01B-D fill] the
first time I used Ambien in a way not directed for me by
a doctor
2
I was [AGE1STSV1] years old the first time I used
Ambien in a way not directed for me by a doctor
3
Neither answer is correct
DK/REF

UPDATE: IF SVCC32A1 = 1, THEN AGE1STSV1 = MYR1STSV1.
UPDATE: IF SVYRINIT1 NE 1 AND AGE1STSV1 = CURNTAGE THEN
SVYRINIT1 = 1
ELSE IF SVYRINIT1 = 1 AND AGE1STSV1 NE CURNTAGE AND SVCC32A1 =
DK/REF THEN SVYRINIT1 = 0
UPDATE: IF SVYRINIT1 NE 1 AND SVYRDKRE1 NE 1 AND SVCC32A1 =
DK/REF THEN SVYRDKRE1 = 1
UPDATE: IF SV30INIT1 NE 1 AND SVCC32A1 = 1 AND AGE1STSV1 IS WITHIN
30 DAYS OF INTERVIEW DATE THEN SV30INIT1 = 1
UPDATE: IF SVYFU1 NE 0 AND SVCC32A1 = DK/REF THEN SVYFU1 = 0
UPDATE: IF SVMFU1 = 1-12 AND SVCC32A1 = DK/REF THEN SVMFU1 = 0

359
April 15, 2016

SVCC33A1 [IF SVCC32A1=2 OR SVCC32A1=3] Please answer this
question again. Did you first use Ambien in a way a doctor did
not direct you to use it in [CURRENT YEAR-2], [CURRENT
YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
UPDATE: IF SVYFU1 NE 0 AND SVCC33A1 = DK/REF THEN SVYFU1 = 0
IF SVCC33A1 = 1 THEN SVYFU1 = CURRENT YEAR - 2
IF SVCC33A1 = 2 THEN SVYFU1 = CURRENT YEAR - 1
IF SVCC33A1 = 3 THEN SVYFU1 = CURRENT YEAR
UPDATE: IF SVMFU1 = 1-12 AND SVCC33A1 = DK/REF THEN SVMFU1 = 0
SVCC33B1

[IF SVCC33A1 NE (BLANK OR DK/REF)] Please answer
this question again. In what month in [SVCC33A1] did
you first use Ambien in a way a doctor did not direct you to
use it?

IF SVCC33A1 = 3 THEN DISPLAY ONLY UP TO THE INTERVIEW MONTH.
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF SVCC33B1 = 1-12 THEN SVMFU1 = SVCC33B1
IF SVCC33B1 = DK/REF THEN SVMFU1 = 0
UPDATE: IF SVCC33B1 NE (0 OR DK/REF) THEN UPDATE MYR1STSV1.
MYR1STSV1 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (SVCC33A1 AND
SVCC33B1). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STSV1
IS 0. IF MYR1STSV1 = AGE1STSV1 THEN MYR1STSV1 = 0

360
April 15, 2016

UPDATE: IF SVYRINIT1 = 1 AND AGE1STSV1 NE CURNTAGE AND SVCC32A1
NE 1 AND MYR1STSV1 NE 0 AND (SVCC33A1 AND SVCC33B1 = SVY01b-d)
THEN SVYRINIT1 = 0
UPDATE: IF SVYRINIT1 NE 1 AND SVYRDKRE1 NE 1 AND SVCC33A1 =
DK/REF THEN SVYRDKRE1 = 1
IF SVYRINIT1 NE 1 AND SVYRDKRE1 NE 1 AND SVYFU1 = CURRENT YEAR-1
AND SVCC33B1 = DK/REF THEN SVYRDKRE1 = 1
UPDATE: IF SV30INIT1 = 1 AND AGE1STSV1 NOT WITHIN 30 DAYS OF DATE
OF INTERVIEW AND SVCC32A1 NE 1 AND MYR1STSV1 NE 0 AND (SVCC33A1
AND SVCC33B1 = SVY01b-d) THEN SV30INIT1 = 0
SVCC34A1 [IF SVCC32A1 NE 1 AND MYR1STSV1 NE 0 AND
(SVCC33A1 AND SVCC33b1 NE SVY01b-d)] The computer
recorded that you first used Ambien in a way a doctor did not
direct you to use it in [SVCC33A1-SVCC33B1 fill]. That
would make you [MYR1STSV1] years old when you first used
Ambien in any way a doctor did not direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF SVCC34A1 NE (6, BLANK OR DK/REF) AND (SVCC33A1 AND
SVCC33B1 NE SVY01b-d) THEN AGE1STSV1 = MYR1STSV1
UPDATE: IF SVYRINIT1 NE 1 AND AGE1STSV1 = CURNTAGE OR (SVCC34A1 =
4 AND SVCC33A1 = 3 OR (SVCC33A1 = 2 AND SVCC33b1 NE DK/REF AND
SVCC33B1 >= CURRENT MONTH) ) THEN SVYRINIT1 = 1
ELSE IF SVYRINIT = 1 AND AGE1STSV1 NE CURNTAGE AND SVCC34A1 = (6
OR DK/REF) THEN SVYRINIT1 = 0
UPDATE: IF SVYRINIT1 NE 1 AND SVYRDKRE1 NE 1 AND MYR1STSV1=
CURNTAGE AND SVCC34A1 = (6 OR DK/REF) THEN SVYRDKRE1 = 1
IF SVYRINIT1 NE 1 AND SVYRDKRE1 NE 1 AND SVCC34A1 = BLANK AND
SVCC33A1 = 3 THEN SVYRDKRE1 = 1
IF SVYRINIT1 NE 1 AND SVYRDKRE1 NE 1 AND SVCC34A1 = BLANK AND
SVCC33A1 = 2 AND SVCC33B1 = 1-12 AND SVCC33B1 >= CURRENT MONTH
THEN SVYRDKRE1 = 1

361
April 15, 2016

UPDATE: IF SV30INIT1 NE 1 AND AGE1STSV1 WITHIN 30 DAYS OF
INTERVIEW DATE OR (SVCC34A1 = 4 AND SVCC33A1 = 3 AND SVCC33B1 =
CURRENT MONTH) THEN SV30INIT1 = 1
ELSE IF SV30INIT1 = 1 AND AGE1STSV1 NOT WITHIN 30 DAYS OF
INTERVIEW DATE AND SVCC34A1 = (6 OR DK/REF) THEN SV30INIT1 = 0
UPDATE: IF SVYFU1 NE BLANK AND SVCC34A1 = OR DK/REF THEN SVYFU1
=0
IF SVCC34A1 = BLANK AND (SVCC33A1 AND SVCC33B1 EQ SVY01b-d) THEN
SVYFU1 = 0
UPDATE: IF SVMFU1 = 1-12 AND SVCC34A1 = (6 OR DK/REF) THEN SVMFU1 =
0
IF SVCC34A1 = BLANK AND (SVCC33A1 AND SVCC33B1 EQ SVY01b-d) THEN
SVMFU1 = 0

SVY02

[IF SV01=2] In the past 12 months, did you use Ambien CR in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR AMBIEN CR
1
Yes
2
No
DK/REF

UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVY02=1 THEN SVFIRSTFLAG=2.
SVY02a

[IF SVFIRSTFLAG=2] Please think about the first time you ever used
Ambien CR in a way a doctor did not direct you to use it.
[IF SVY02=1] How old were you when you first used Ambien CR in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

PROGRAMMER: DISPLAY IN LOWER RIGHT:
Press [F2] if you want to see and hear these ways
again.
• Without a prescription of your own,
• In greater amounts, more often, or longer than
you were told to take it
• In any other way a doctor did not direct you to
use it
362
April 15, 2016

DEFINE AGE1STSV2:
IF SVY02a NE (BLANK OR DK/REF) THEN AGE1STSV2 = SVY02a
ELSE AGE1STSV2 = 0
HARD ERROR: [IF CURNTAGE < AGE1STSV2] The age you just reported is older
than your current age. Press [Enter] to answer the question again.
IF 1 <= AGE1STSV2 < 10:
SVCC05A2 The computer recorded that you were [AGE1STSV2] years
old the first time you used Ambien CR in a way a doctor did
not direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF SVCC05A2= DK/REF THEN AGE1STSV2 = 0
SVCC06A2 [IF SVCC05A2=6] Please answer this question again.
Think about the first time you used Ambien CR in a way a
doctor did not direct you to use it.
How old were you the first time you used Ambien CR in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF SVCC06A2 NOT (BLANK OR DK/REF) THEN AGE1STSV2 =
SVCC06A2
ELSE IF SVCC06A2 = DK/REF THEN AGE1STSV2 = 0
DEFINE SVYRINIT2:
IF AGE1STSV2 = CURNTAGE THEN SVYRINIT2 = 1
ELSE SVYRINIT2 = 0
DEFINE SVYRDKRE2:
IF SVYRINIT2 = 0 AND (SVY02a = DK/REF OR SVCC05A2 = DK/REF OR
SVCC06A2 = DK/REF) THEN SVYRDKRE2 = 1

363
April 15, 2016

ELSE SVYRDKRE2= 0

DEFINE SV30INIT2:
SV30INIT2 = 0
IF AGE1STSV2 = CURNTAGE AND DATE OF INTERVIEW >= DOB AND
NUMBER OF DAYS BASED ON THE DIFFERENCE BETWEEN DATE OF
INTERVIEW AND DOB <= 30, THEN SV30INIT2 = 1
2.2.1

Year and Month of First Nonmedical Use

DEFINE SVYFU2:
SVYFU2 = 0
DEFINE SVMFU2:
SVMFU2 = 0
SVY02b.

[AGE1STSV2 = CURNTAGE AND DATE OF INTERVIEW < DOB OR
IF AGE1STSV2 = CURNTAGE - 1 AND DATE OF INTERVIEW ≥
DOB] Did you first use Ambien CR in a way a doctor did not direct you
to use it in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

SVY02c.

[IF AGE1STSV2 = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first use Ambien CR in a way a doctor did not direct you
to use it in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

UPDATE: IF SVY02B = 2 OR (AGE1STSV2 = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB) THEN SVYFU2 = CURRENT YEAR
IF SVY02B = 1 OR SVY02C = 2 THEN SVYFU2 = CURRENT YEAR - 1
IF SVY02C = 1 THEN SVYFU2 = CURRENT YEAR - 2
DEFINE SVJANFLAG2:
SVJANFLAG2 = 0
IF SVYFU2=CURRENT YEAR AND CURRENT MONTH = JANUARY THEN
SVJANFLAG2 = 1
IF SVYFU2=CURRENT YEAR-1 AND BIRTHDAY MONTH=JANUARY AND
DATE OF INTERVIEW ≥ DOB THEN SVJANFLAG2=1

364
April 15, 2016

IF SVJANFLAG2=1 THEN SVY02D=1
DEFINE SVDECFLAG2:
SVDECFLAG2 = 0
IF AGE1STSV2 = CURNTAGE AND SVYFU2=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN SVDECFLAG2 = 1
IF SVDECFLAG2=1 THEN SVY02D=12
DEFINE SV1MTHFLAG2:
SV1MTHFLAG2=0
IF (AGE1STSV2=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH) THEN
SV1MTHFLAG2=1
IF SV1MTHFLAG2=1 THEN SVY02D=CURRENT MONTH
SVY02d.
[IF SVYFU2 NE 0 AND SVJANFLAG2 = 0 AND SVDECFLAG2=0
AND SV1MTHFLAG2=0]
[IF SVYFU2 = CURRENT YEAR OR CURRENT YEAR -1] Earlier, you reported that
you first used Ambien CR in a way a doctor did not direct you to use it when you were
[AGE1STSV2] years old. Based on your date of birth, you turned [AGE1STSV2] in
[FILL WITH MONTH/YEAR FOR AGE1STSV2 BASED ON DOB].
[IF SVYFU2 NE 0] In what month in [SVYFU2] did you first use Ambien CR in a way
a doctor did not direct you to use it?
[IF DATE OF INTERVIEW < DOB AND AGE1STSV2=CURRENT AGE AND
SVYFU2=CURRENT YEAR THEN SHOW JANUARY THROUGH INTERVIEW
MONTH.]
IF AGE1STSV2 = CURNTAGE AND DATE OF INTERVIEW ≥ DOB THEN SHOW
MONTHS FROM BIRTH MONTH TO INTERVIEW MONTH.
IF ((AGE1STSV2 = CURNTAGE AND DATE OF INTERVIEW <= DOB) or
(AGE1STSV2 = CURNTAGE – 1 AND DATE OF INTERVIEW > DOB))
AND (SVYFU2 = CURRENT YEAR – 1), SHOW BIRTH MONTH TO DECEMBER
IF SVYFU2=CURRENT YEAR AND AGE1STSV2=CURRENT AGE-1 AND DATE
OF INTERVIEW > DOB THEN SHOW JANUARY THROUGH BIRTH MONTH.
IF SVYFU2 = CURRENT YEAR - 1 AND AGE1STSV2 = CURNTAGE - 1 AND
DATE OF INTERVIEW < DOB THEN SHOW JANUARY THROUGH BIRTH
MONTH.
ELSE SHOW ALL MONTHS.]
1

January

365
April 15, 2016

2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF SVY02D = 1-12 THEN SVMFU2 = SVY02D
IF SVJANFLAG2 = 1 THEN SVMFU2 = 1.
IF SVDECFLAG2=1 THEN SVMFU2=12.
UPDATE: IF SVYRINIT2 NE 1 AND (SVYFU2 = CURRENT YEAR OR (SVYFU2 =
CURRENT YEAR - 1 AND SVMFU2 = 1-12 AND SVMFU2 >= CURRENT MONTH)
THEN SVYRINIT2 = 1
UPDATE: IF SVYRINIT2 NE 1 AND SVYRDKRE2 NE 1 AND [(SVY02b = DK/REF
OR SVY02c = DK/REF) OR (SVYFU2 = CURRENT YEAR-1 AND SVY02d =
DK/REF)] THEN SVYRDKRE2 = 1
UPDATE: IF SV30INIT2 NE 1 AND SVYFU2 = CURRENT YEAR AND SVMFU2 =
CURRENT MONTH THEN SV30INIT2 = 1
DEFINE MYR1STSV2:
MYR1STSV2 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (SVY02B-D).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STSV2 IS 0.
IF MYR1STSV2 NE 0 AND NE AGE1STSV2:
SVCC32A2
Earlier, the computer recorded that you were
[AGE1STSV2] years old when you first used Ambien CR in a
way a doctor did not direct you to use it.
Which answer is correct?
1

2

I was [MYR1STSV2] years old in [SVY02B-D fill] the
first time I used Ambien CR in a way not directed for
me by a doctor
I was [AGE1STSV2] years old the first time I used
Ambien CR in a way not directed for me by a doctor

366
April 15, 2016

3
Neither answer is correct
DK/REF
UPDATE: IF SVCC32A2 = 1, THEN AGE1STSV2 = MYR1STSV2.
UPDATE: IF SVYRINIT2 NE 1 AND AGE1STSV2 = CURNTAGE THEN
SVYRINIT2 = 1
ELSE IF SVYRINIT2 = 1 AND AGE1STSV2 NE CURNTAGE AND SVCC32A2 =
DK/REF THEN SVYRINIT2 = 0
UPDATE: IF SVYRINIT2 NE 1 AND SVYRDKRE2 NE 1 AND SVCC32A2 =
DK/REF THEN SVYRDKRE2 = 1
UPDATE: IF SV30INIT2 NE 1 AND SVCC32A2 = 1 AND AGE1STSV2 IS WITHIN
30 DAYS OF INTERVIEW DATE THEN SV30INIT2 = 1
UPDATE: IF SVYFU2 NE 0 AND SVCC32A2 = DK/REF THEN SVYFU2 = 0
UPDATE: IF SVMFU2 = 1-12 AND SVCC32A2 = DK/REF THEN SVMFU2 = 0
SVCC33A2 [IF SVCC32A2=2 OR SVCC32A2=3] Please answer this
question again. Did you first use Ambien CR in a way a doctor
did not direct you to use it in [CURRENT YEAR-2],
[CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
UPDATE: IF SVYFU2 NE 0 AND SVCC33A2 = DK/REF THEN SVYFU2 = 0
IF SVCC33A2 = 1 THEN SVYFU2 = CURRENT YEAR - 2
IF SVCC33A2 = 2 THEN SVYFU2 = CURRENT YEAR - 1
IF SVCC33A2 = 3 THEN SVYFU2 = CURRENT YEAR
UPDATE: IF SVMFU2 = 1-12 AND SVCC33A2 = DK/REF THEN SVMFU2 = 0
SVCC33B2

[IF SVCC33A2 NE (BLANK OR DK/REF)] Please answer
this question again. In what month in [SVCC33A2] did
you first use Ambien CR in any way a doctor did not direct
you to use it?

IF SVCC33A2 = 3 THEN DISPLAY ONLY UP TO THE INTERVIEW MONTH.
1
2

January
February

367
April 15, 2016

3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
UPDATE: IF SVCC33B2 = 1-12 THEN SVMFU2 = SVCC33B2
IF SVCC33B2 = DK/REF THEN SVMFU2 = 0
UPDATE: IF SVCC33B2 NE (0 OR DK/REF) THEN UPDATE MYR1STSV2.
MYR1STSV2 = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (SVCC33A2 AND
SVCC33B2). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STSV2
IS 0. IF MYR1STSV2 = AGE1STSV2 THEN MYR1STSV2 = 0
UPDATE: IF SVYRINIT2 = 1 AND AGE1STSV2 NE CURNTAGE AND SVCC32A2
NE 1 AND MYR1STSV2 NE 0 AND (SVCC33A2 AND SVCC33B2 = SVY02b-d)
THEN SVYRINIT2 = 0
UPDATE: IF SVYRINIT2 NE 1 AND SVYRDKRE2 NE 1 AND SVCC33A2 =
DK/REF THEN SVYRDKRE2 = 1
IF SVYRINIT2 NE 1 AND SVYRDKRE2 NE 1 AND SVYFU2 = CURRENT YEAR-1
AND SVCC33B2 = DK/REF THEN SVYRDKRE2 = 1
UPDATE: IF SV30INIT2 = 1 AND AGE1STSV2 NOT WITHIN 30 DAYS OF DATE
OF INTERVIEW AND SVCC32A2 NE 1 AND MYR1STSV2 NE 0 AND (SVCC33A2
AND SVCC33B2 = SVY02b-d) THEN SV30INIT2 = 0
SVCC34A2 [IF SVCC32A2 NE 1 AND MYR1STSV2 NE 0 AND
(SVCC33A2 AND SVCC33B2 NE SVY02b-d)] The computer
recorded that you first used Ambien CR in a way a doctor did
not direct you to use it in [SVCC33A2-SVCC33B2 fill]. That
would make you [MYR1STSV2] years old when you first used
Ambien CR in any way a doctor did not direct you to use it.
Is this correct?
4
Yes
6
No
DK/REF

368
April 15, 2016

UPDATE: IF SVCC34A2 NE (6, BLANK OR DK/REF) AND (SVCC33A2 AND
SVCC33B2 NE SVY02b-d) THEN AGE1STSV2 = MYR1STSV2
UPDATE: IF SVYRINIT2 NE 1 AND AGE1STSV2 = CURNTAGE OR (SVCC34A2 =
4 AND SVCC33A2 = 3 OR (SVCC33A2 = 2 AND SVCC33B2 NE DK/REF AND
SVCC33B2 >= CURRENT MONTH) ) THEN SVYRINIT2 = 1
ELSE IF SVYRINIT = 1 AND AGE1STSV2 NE CURNTAGE AND SVCC34A2 = (6
OR DK/REF) THEN SVYRINIT2 = 0
UPDATE: IF SVYRINIT2 NE 1 AND SVYRDKRE2 NE 1 AND MYR1STSV2=
CURNTAGE AND SVCC34A2 = (6 OR DK/REF) THEN SVYRDKRE2 = 1
IF SVYRINIT2 NE 1 AND SVYRDKRE2 NE 1 AND SVCC34A2 = BLANK AND
SVCC33A2 = 3 THEN SVYRDKRE2 = 1
IF SVYRINIT2 NE 1 AND SVYRDKRE2 NE 1 AND SVCC34A2 = BLANK AND
SVCC33A2 = 2 AND SVCC33B2 = 1-12 AND SVCC33B2 >= CURRENT MONTH
THEN SVYRDKRE2 = 1

UPDATE: IF SV30INIT2 NE 1 AND AGE1STSV2 WITHIN 30 DAYS OF
INTERVIEW DATE OR (SVCC34A2 = 4 AND SVCC33A2 = 3 AND SVCC33B2 =
CURRENT MONTH) THEN SV30INIT2 = 1
ELSE IF SV30INIT2 = 1 AND AGE1STSV2 NOT WITHIN 30 DAYS OF
INTERVIEW DATE AND SVCC34A2 = (6 OR DK/REF) THEN SV30INIT2 = 0
UPDATE: IF SVYFU2 NE BLANK AND SVCC34A2 = OR DK/REF THEN SVYFU2
=0
IF SVCC34A2 = BLANK AND (SVCC33A2 AND SVCC33B2 EQ SVY02b-d) THEN
SVYFU2 = 0
UPDATE: IF SVMFU2 = 1-12 AND SVCC34A2 = (6 OR DK/REF) THEN SVMFU2 =
0
IF SVCC34A2 = BLANK AND (SVCC33A2 AND SVCC33B2 EQ SVY02b-d) THEN
SVMFU2 = 0
Continue asking the misuse and age at first misuse questions above about each
tranquilizer reported.
SVY03

[IF SV01=3] In the past 12 months, did you use zolpidem in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR ZOLPIDEM
1

Yes

369
April 15, 2016

2
No
DK/REF

UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVY03=1 THEN SVFIRSTFLAG=3.
SVY03a

[IF SVFIRSTFLAG=3] Please think about the first time you ever used
zolpidem in a way a doctor did not direct you to use it.
[IF SVY03=1] How old were you when you first used zolpidem in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.

SVY04

[IF SV01=4] In the past 12 months, did you use extended-release
zolpidem in any way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVY04=1 THEN SVFIRSTFLAG=4.
SVY04a

[IF SVFIRSTFLAG=4] Please think about the first time you ever used
extended-release zolpidem in a way a doctor did not direct you to use it.
[IF SVY04=1] How old were you when you first used extended-release
zolpidem in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT

370
April 15, 2016

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.
SVY05

[IF SV02=1] In the past 12 months, did you use Lunesta or eszopiclone in
any way a doctor did not direct you to use it?
DISPLAY IMAGE FOR LUNESTA OR ESZOPICLONE
1
Yes
2
No
DK/REF

UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVY05=1 THEN SVFIRSTFLAG=5.
SVY05a

[IF SVFIRSTFLAG=5] Please think about the first time you ever used
Lunesta or eszopiclone in a way a doctor did not direct you to use it.
[IF SVY05=1] How old were you when you first used Lunesta or
eszopiclone in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.
SVY06

[IF SV02=2] In the past 12 months, did you use Sonata or zaleplon in any
way a doctor did not direct you to use it?
DISPLAY IMAGE FOR SONATA OR ZALEPLON
1
Yes
2
No
DK/REF

UPDATE SVFIRSTFLAG:

371
April 15, 2016

IF SVFIRSTFLAG=0 AND SVY06=1 THEN SVFIRSTFLAG=6.
SVY06a

[IF SVFIRSTFLAG=6] Please think about the first time you ever used
Sonata or zaleplon in a way a doctor did not direct you to use it.
[IF SVY06=1] How old were you when you first used Sonata or zaleplon
in a way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.
SVY07

[IF SV03=1] In the past 12 months, did you use Halcion in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR HALCION
1
Yes
2
No
DK/REF

UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVY07=1 THEN SVFIRSTFLAG=7.
SVY07a

[IF SVFIRSTFLAG=7] Please think about the first time you ever used
Halcion in a way a doctor did not direct you to use it.
[IF SVY07=1] How old were you when you first used Halcion in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES

372
April 15, 2016

PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.
SVY08

[IF SV03=2] In the past 12 months, did you use Restoril in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR RESTORIL
1
Yes
2
No
DK/REF

UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVY08=1 THEN SVFIRSTFLAG=8.
SVY08a

[IF SVFIRSTFLAG=8] Please think about the first time you ever used
Restoril in a way a doctor did not direct you to use it.
[IF SVY08=1] How old were you when you first used Restoril in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]
DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.
SVY09

[IF SV03=3] In the past 12 months, did you use flurazepam, also known
as Dalmane, in any way a doctor did not direct you to use it?
DISPLAY IMAGE FOR FLURAZEPAM
1
Yes
2
No
DK/REF

UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVY09=1 THEN SVFIRSTFLAG=9.
SVY09a

[IF SVFIRSTFLAG=9] Please think about the first time you ever used
flurazepam in a way a doctor did not direct you to use it.

373
April 15, 2016

[IF SVY09=1] How old were you when you first used flurazepam in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.
SVY10

[IF SV03=4] In the past 12 months, did you use temazepam in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR TEMAZEPAM
1
Yes
2
No
DK/REF

UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVY10=1 THEN SVFIRSTFLAG=10.
SVY10a

[IF SVFIRSTFLAG=10] Please think about the first time you ever used
temazepam in a way a doctor did not direct you to use it.
[IF SVY10=1] How old were you when you first used temazepam in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.
SVY11

[IF SV03=5] In the past 12 months, did you use triazolam in any way a
doctor did not direct you to use it?

374
April 15, 2016

DISPLAY IMAGE FOR TRIAZOLAM
1
Yes
2
No
DK/REF
UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVY11=1 THEN SVFIRSTFLAG=11.
SVY11a

[IF SVFIRSTFLAG=11] Please think about the first time you ever used
triazolam in a way a doctor did not direct you to use it.
[IF SVY11=1] How old were you when you first used triazolam in a way
a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.
SVY12

[IF SV04=1] In the past 12 months, did you use Butisol in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR BUTISOL
1
Yes
2
No
DK/REF

UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVY12=1 THEN SVFIRSTFLAG=12.
SVY12a

[IF SVFIRSTFLAG=12] Please think about the first time you ever used
Butisol in a way a doctor did not direct you to use it.
[IF SVY12=1] How old were you when you first used Butisol in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

375
April 15, 2016

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.
SVY13

[IF SV04=2] In the past 12 months, did you use Seconal in any way a
doctor did not direct you to use it?
DISPLAY IMAGE FOR SECONAL
1
Yes
2
No
DK/REF

UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVY13=1 THEN SVFIRSTFLAG=13.
SVY13a

[IF SVFIRSTFLAG=13] Please think about the first time you ever used
Seconal in a way a doctor did not direct you to use it.
[IF SVY13=1] How old were you when you first used Seconal in a way a
doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.
SVY14

[IF SV04=3] In the past 12 months, did you use phenobarbital in any way
a doctor did not direct you to use it?
DISPLAY IMAGE FOR PHENOBARBITAL
1
Yes
2
No
DK/REF

376
April 15, 2016

UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVY14=1 THEN SVFIRSTFLAG=14.
SVY14a

[IF SVFIRSTFLAG=14] Please think about the first time you ever used
phenobarbital in a way a doctor did not direct you to use it.
[IF SVY14=1] How old were you when you first used phenobarbital in a
way a doctor did not direct you to use it?
AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT
INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.

SVYOTH

[IF SVANYOTH =1] In the past 12 months, did you use any [IF
SVANYOTH =1 AND SVYRCOUNT > 1 FILL “other”] prescription
sedative in a way a doctor did not direct you to use it?
Remember, do not include “over-the-counter” sedatives such as Sominex,
Unisom, Nytol, or Benadryl.
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW CALENDAR WITH 12-MONTH
REFERENCE DATE

SVYOTHA1

[IF SVYOTH = 1] Please type in the name of one of the [IF
SVANYOTH =1 AND SVYRCOUNT > 1 FILL “other”]
prescription sedatives you have used in the past 12 months in a
way a doctor did not direct you to use it. If you’re not sure how to
spell the name of the sedative, just make your best guess.
When you have finished, press [ENTER] to go to the next
question. Remember, you do not need to type in the names of any
prescription sedatives you already reported.

377
April 15, 2016

______________
[NOTE: DON'T ALLOW BLANKS IN SVYOTHA1 IF SVYOTH = 1]
DK/REF
SVYOTHA2

[IF SVYOTH = 1 AND SVYOTHA1 NE DK/REF)] Please type in
the name of any other prescription sedative you used in the past 12
months in a way a doctor did not direct you to use it.
If you have not used any other prescription sedative in a way a
doctor did not direct you to use it, press [ENTER].
______________
DK/REF

SVYOTHA3

[IF SVYOTHA2 NE (BLANK OR DK/REF)] Please type in the
name of any other prescription sedative you used in the past 12
months in a way a doctor did not direct you to use it.
If you have not used any other prescription sedative in a way a
doctor did not direct you to use it, press [ENTER].
______________
DK/REF

SVYOTHA4

[IF SVYOTHA3 NE (BLANK OR DK/REF)] Please type in the
name of any other prescription sedative you used in the past 12
months in a way a doctor did not direct you to use it.
If you have not used any other prescription sedative in a way a
doctor did not direct you to use it, press [ENTER].

______________
DK/REF
SVYOTHA5

[IF SVYOTHA4 NE (BLANK OR DK/REF Please type in the
name of any other prescription sedative you used in the past 12
months in a way a doctor did not direct you to use it.
If you have not used any other prescription sedative in a way a
doctor did not direct you to use it, press [ENTER].

378
April 15, 2016

______________
DK/REF
UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVYOTH=1 THEN SVFIRSTFLAG=15.
SVYOTHA

[IF SVFIRSTFLAG=15] Please think about the first time you ever
used any [IF SVANYOTH =1 AND SVYRCOUNT > 1 FILL
“other”] prescription sedative in a way a doctor did not direct you
to use it.
[IF SVYOTH=1] How old were you when you first used any [IF
SVANYOTH =1 AND SVYRCOUNT > 1 FILL “other”]
prescription sedative in a way a doctor did not direct you to use
it?

AGE:
DK/REF

[(RANGE: 1 - 110)]

DISPLAY "HELP" TEXT FOR ANY WAY OF
MISUSE IN LOWER RIGHT

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.
DEFINE SVMISCOUNT:
INITIALIZE SVMISCOUNT TO 0.
INCREMENT SVMISCOUNT BY 1 FOR EVERY RESPONSE OF YES IN SVY01SVYOTH.
DEFINE SVMISUSE12:
IF SVMISCOUNT > 0 THEN SVMISUSE12 = 1.
ELSE SVMISUSE12 = 2.
If no sedatives misused in the past 12 months:
SVL02

[IF SV12MON=1 AND SVMISUSE12=2] Have you ever, even once,
used any prescription sedative in any way a doctor did not direct you
to use it?
1
2

Yes
No
379

April 15, 2016

DK/REF

If any sedatives misused in past 12 months:
DEFINE SVDKREFCOUNT:
INITIALIZE SVDKREFCOUNT TO 0.
INCREMENT SVDKREFCOUNT BY 1 FOR EVERY RESPONSE OF DK/REF IN
SVY01-SVYOTH AND SV01- SVANYOTH.
DEFINE SVDKREFFLAG:
IF SVDKREFCOUNT > 1 17THEN SVDKREFFLAG = 1.
ELSE SVDKREFFLAG = 2.
DEFINE SVNUMFILL:
IF SVMISCOUNT = 1 AND SVYOTH NE 1 THEN SVNUMFILL = "it".
ELSE SVNUMFILL = "them".
DEFINE SV30ANYINIT:
IF ANY CODE OF 1 IN SV30INIT1-SV30INITOT THEN SV30ANYINIT = 1.
ELSE SV30ANYINIT = 2.
DEFINE SVFILL2:
IF SVMISCOUNT < 3 AND SVYOTH NE 1 AND SVDKREFFLAG =2 THEN
SVFILL2=”[DRUG NAMES FROM SVY01-SVY14]”.
ELSE IF SVMISCOUNT=1 AND SVYOTH NE 1 AND SVDKREFFLAG=1 THEN
SVFILL2 = “[DRUG NAMES FROM SVY01-SVY14] or any other prescription
sedative.”
ELSE IF SVMISCOUNT=2 AND SVDKREFFLAG=2 AND SVYOTH=1 THEN
SVFILL2=”[DRUG NAME FROM SVY01-SVY14] and some other prescription
sedative.”
ELSE IF SVMISCOUNT=2 AND SVDKREFFLAG=1 THEN SVFILL2=”[DRUG
NAMES FROM SVY01-SVY14]”. IF SVYOTH=1 THEN ADD “some other
prescription sedative” TO THE FILL.
ELSE SVFILL2= “prescription sedatives”
DEFINE SVNAMEFILL:
IF SVMISCOUNT =1 AND (SVYOTH = 2 OR SVYOTH = BLANK) AND
SVDKREFFLAG =2 THEN SVNAMEFILL=”[DRUG NAME FROM SVY01-SVY14]”
ELSE IF SVMISCOUNT=1 AND (SVYOTH NE 1) AND SVDKREFFLAG=1 THEN
SVNAMEFILL=”[DRUG NAME FROM SVY01-SVY14] or any other prescription
sedative]”
ELSE IF SVMISCOUNT >1 THEN SVNAMEFILL= “prescription sedatives”
DEFINE SVYINICT:

380
April 15, 2016

INITIALIZE SVYINICT TO 0.
INCREMENT SVYINICT BY 1 FOR EVERY VALUE OF 1 IN SVYRINIT1SVYRINITOT.
DEFINE SVYRDKRECT:
INITIALIZE SVYRDKRECT TO 0.
INCREMENT SVYRDKRECT BY 1 FOR EVERY VALUE OF 1 IN SVYRDKRE1SVYRDKREOT.
DEFINE SVYINALL:
IF SVMISCOUNT > 0 AND SVMISCOUNT = SVYINICT + SVYRDKRECT THEN
SVYINALL = 1.
ELSE SVYINALL = 2.
SVL03

[IF SVYINALL=1] Earlier questions were about the past 12 months. This
question is about any time before then, that is, any time in your life before
[DATEFILL -12 MONTHS].
At any time before [DATEFILL -12 MONTHS], did you ever use any
prescription sedative in a way a doctor did not direct you to use it?
1
Yes
2
No
DK/REF

SVINTROYR3

[IF SVMISUSE12=1 AND SVMISCOUNT>1] Earlier the computer
recorded that in the past 12 months you used [IF SVMISUSE12=1
AND SVMISCOUNT > 2, ADD "these"] [SVFILL2] in a way a
doctor did not direct you to use [SVNUMFILL].

[IF SVMISUSE12=1 AND SVMISCOUNT>2 ] FILL WITH DRUG
NAMES FROM SVY01-SVYOTH BELOW. USE MULTIPLE
COLUMNS AS NEEDED. IF SVYOTH = 1, FILL WITH "Some other
prescription sedative".
[IF SVMISUSE12=1 AND SVMISCOUNT>1] The next questions refer
to these drugs as prescription sedatives.
Press Enter to continue.

SVM01

[IF SVMISUSE12 = 1 AND SV30ANYINIT = 2] In the past 30 days,
that is, from [DATEFILL] up to and including today, did you use
[SVNAMEFILL] in any way a doctor did not direct you to use
[SVNUMFILL]?

381
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30-DAY CALENDAR
DEFINE SVMISUSE30:
SVMISUSE30=1 IF SVM01=1 OR SV30ANYINIT = 1.
SVMISUSE30=2 IF SVMISUSE12 = 1 AND (SVM01=2, DK, OR REF).
SVM02

[IF SVMISUSE30=1] During the past 30 days, on how many days did
you use [SVNAMEFILL] in any way a doctor did not direct you to use
[SVNUMFILL]?
________________ [RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30-DAY CALENDAR

SVM02DKRE

[IF SVM02 = DK/REF] What is your best estimate of the number of
days you used [SVNAMEFILL] in any way a doctor did not direct
you to use [SVNUMFILL] during the past 30 days?
1
1 or 2 days
2
3 to 5 days
3
6 to 9 days
4
10 to 19 days
5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30-DAY CALENDAR

SVM03

[IF ALC30USE = 1 and SVMISUSE30 = 1)] During the past 30 days, did
you use [SVNAMEFILL] in any way a doctor did not direct you to use
[SVNUMFILL] while you were drinking alcohol or within a couple of
hours of drinking?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

SVYWAYS

[IF SVMISUSE12=1] Which of these statements describe your
use of [SVNAMEFILL] at any time in the past 12 months?

382
April 15, 2016

To select more than one statement, press the space bar between the
numbers. When you have finished, press [ENTER].
1
2

I used [SVNAMEFILL] without a prescription of my own.
I used [SVNAMEFILL] in greater amounts than [IF
SVNAMEFILL= “prescription sedatives” THEN FILL
WITH “they were”; ELSE FILL WITH “it was”]
prescribed.
3
I used [SVNAMEFILL] more often than [IF
SVNAMEFILL= “prescription sedatives” THEN FILL
WITH “they were”; ELSE FILL WITH “it was”]
prescribed.
4
I used [SVNAMEFILL] for longer than [IF
SVNAMEFILL= “prescription sedatives” THEN FILL
WITH “they were”; ELSE FILL WITH “it was”]
prescribed.
5
I used [SVNAMEFILL] in some other way a doctor did
not direct me to use [SVNUMFILL]
DISPLAY 12-MONTH CALENDAR

SVYLAST

[IF SVMISCOUNT > 1 OR (SVMISCOUNT=1 AND SVYOTH
NE 1 AND SVDKREFFLAG=1)] Now think about the last time
you used a prescription sedative in any way a doctor did not
direct you to use it.
Which of these sedatives did you use the last time? If you used
more than one sedative the last time, please choose one sedative as
your best answer.
(LIST DRUGS WHERE SVY01-SVYOTH=1. NUMBER
RESPONSE OPTIONS SEQUENTIALLY STARTING AT 1,
BUT MAINTAIN UNIQUE CODES FOR EACH DRUG. IF
SVYOTH=1, DISPLAY "Another prescription sedative" AS THE
LAST CATEGORY. IF SVMISCOUNT > 0 AND SVYOTH NE
1 AND SVDKREFFLAG=1, DISPLAY "Any other prescription
sedative" AS THE LAST CATEGORY. ALLOW ONLY 1
RESPONSE.)

PROGRAMMER: IF SVMISUSE12 = 1 THEN CREATE A RECODED RSVYLAST
VARIABLE. ASSIGN A UNIQUE CODE TO A GIVEN DRUG ACCORDING TO
THE OVERALL ORDER IN WHICH THE DRUGS APPEAR IN THE SCREENER.
INITIALIZE RSVYLAST TO BLANK.

383
April 15, 2016

IF "Ambien" CHOSEN IN SVYLAST OR (SVMISCOUNT=1 AND
SVDKREFFLAG=2 AND SVY01 = 1) THEN RSVYLAST = 1.
IF "Ambien CR" CHOSEN IN SVYLAST OR (SVMISCOUNT=1 AND
SVDKREFFLAG=2 AND SVY02 = 1) THEN RSVYLAST = 2.
IF "zolpidem" CHOSEN IN SVYLAST OR (SVMISCOUNT=1 AND
SVDKREFFLAG=2 AND SVY03 = 1) THEN RSVYLAST = 3.
ETC.
IF "Phenobarbital" CHOSEN IN SVYLAST OR (SVMISCOUNT=1 AND
SVDKREFFLAG=2 AND SVY14 = 1) THEN RSVYLAST = 14.
IF "Another prescription sedative" OR "Any other prescription sedative" CHOSEN IN
SVYLAST OR (SVMISCOUNT =1 AND SVYOTH = 1 AND SVDKREFFLAG =2)
THEN RSVYLAST = 15.
IF SVYLAST = DK OR REF, THEN ASSIGN THE DK/REF CODE TO RSVYLAST.)
DEFINE SVLASTFILL:
IF RSVYLAST = 1-14, THEN FILL WITH THE DRUG NAME.
IF RSVYLAST = 15 THEN FILL "other sedative".
IF RSVYLAST = DK, REF, OR BLANK, THEN FILL "sedative".
DEFINE SVLASTFILL2:
IF RSVYLAST = 1-14, THEN FILL WITH THE DRUG NAME.
IF RSVYLAST = 15 THEN FILL "the other sedative".
IF RSVYLAST = DK, REF, OR BLANK, THEN FILL "a sedative".
DEFINE SVLASTFILL3:
IF SVLASTFILL NE "other sedative" THEN SVLASTFILL3 = SVLASTFILL.
ELSE IF SVLASTFILL = "other sedative" THEN SVLASTFILL3 = "sedative".
SVYMOTIV [IF SVMISUSE12=1] Now think about the last time you used
[SVLASTFILL2] in any way a doctor did not direct you to use it.
What were the reasons you used [SVLASTFILL2] the last time? To
select more than one reason from the list, press the space bar between each
number you have typed. When you have finished, press [ENTER].

1
2
3
4
5
6
7

To relax or relieve tension
To experiment or to see what it’s like
To feel good or get high
To help with my sleep
To help me with my feelings or emotions
To increase or decrease the effect(s) of some other drug
Because I am “hooked” or I have to have it

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April 15, 2016

8

I used it for some other reason
DK/REF

SVMOTOT [IF SVYMOTIV=8] Please type in the other reason you used
[SVLASTFILL] the last time. When you have finished typing your
answer, press [ENTER] to go to the next question.
REASON
__________________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN
SVMOTOT.
SVYMOT1

[IF MORE THAN ONE RESPONSE 1-7 CHOSEN IN SVYMOTIV]
Which was the main reason you used [SVLASTFILL] the last time?
PROGRAMMER: FILL AS RESPONSE OPTIONS ONLY THOSE
CHOSEN IN SVYMOTIV
1
To relax or relieve tension
2
To experiment or to see what it’s like
3
To feel good or get high
4
To help with my sleep
5
To help me with my feelings or emotions
6
To increase or decrease the effect(s) of some other drug
7
Because I am “hooked” or I have to have it
8
[IF SVYMOTIV=8] The other reason I reported
DK/REF

SVYGOT

[IF SVMISUSE12=1 AND SVMISCOUNT=1 AND
SVDKREFFLAG=2] Now think again about the last time you
used [SVLASTFILL2] in any way a doctor did not direct you to
use [FILL WITH “them” IF RSVYLAST =15. ELSE FILL WITH
“it”].
[IF SVMISUSE12 = 1] How did you get the [SVLASTFILL]? If
you got the [SVLASTFILL] in more than one way, please choose
one of these ways as your best answer.
1
2

I got a prescription for the [SVLASTFILL] from just one
doctor
I got prescriptions for the [SVLASTFILL] from more than
one doctor
385

April 15, 2016

3

I stole the [SVLASTFILL] from a doctor’s office, clinic,
hospital, or pharmacy
4
I got the [SVLASTFILL] from a friend or relative for free
5
I bought the [SVLASTFILL] from a friend or relative
6
I took the [SVLASTFILL] from a friend or relative without
asking
7
I bought the [SVLASTFILL] from a drug dealer or other
stranger
8
I got the [SVLASTFILL] in some other way
DK/REF

SVYGOTSP

[IF SVYGOT = 8] Please type in the other way you got the
[SVLASTFILL3].
You do not need to give a detailed description — just a few words
will be okay. When you have finished typing your answer, press
[ENTER] to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN
SVYGOTSP.

SVYFRL

[IF SVYGOT=4] You reported that you got the [SVLASTFILL] from a
friend or relative for free. How did your friend or relative get the
[SVLASTFILL]?
1

He or she got a prescription for the [SVLASTFILL] from just one
doctor
2
He or she got prescriptions for the [SVLASTFILL] from more than
one doctor
3
He or she stole the [SVLASTFILL] from a doctor’s office, clinic,
hospital, or pharmacy
4
He or she got the [SVLASTFILL] from another friend or relative
for free
5
He or she bought the [SVLASTFILL] from another friend or
relative
6
He or she took the [SVLASTFILL] from another friend or relative
without asking
7
He or she bought the [SVLASTFILL] from a drug dealer or other
stranger
8
He or she got the [SVLASTFILL] in some other way
DK/REF

386
April 15, 2016

SVYFRLSP

[IF SVYFRL = 8] Please type in the other way your friend or
relative got the last [SVLASTFILL3] you used.
You do not need to give a detailed description — just a few words
will be okay. When you have finished typing your answer, press
[ENTER] to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN
SVYFRLSP.

387
April 15, 2016

388
April 15, 2016

Special Drugs
SD01

The last questions were about prescription drugs. The next question is
about non-prescription cough or cold medicines, also known as “overthe-counter” medicines. Have you ever, even once, taken a nonprescription cough or cold medicine just to get high?
1
Yes
2
No
DK/REF

SD02

[IF SD01 = 1] How long has it been since you last took one of these
cough or cold medicines to get high?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SD02a

[IF SD02 = 1 OR 2] Now think about the past 12 months, that is, since
[DATEFILL ]. Please type in the name of one of the cough or cold
medicines you used in the past 12 months just to get high. If you’re not
sure how to spell the name of the medicine you used, just make your best
guess.
When you have finished, press the [ENTER] key to go to the next
question.
______________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN SD02a.

SD02b

[IF SD02a NE (BLANK OR DK/REF)] Please type in the name of any
other cough or cold medicine you used in the past 12 months just to get
high. If you have not used any other cough or cold medicines, press the
[ENTER] key to go to the next question.
______________
DK/REF

SD02c

[IF SD02b NE (BLANK OR DK/REF)] Please type in the name of any
other cough or cold medicine you used in the past 12 months just to get
high. If you have not used any other cough or cold medicines, press the
[ENTER] key to go to the next question.

389
April 15, 2016

______________
DK/REF
SD02d

[IF SD02c NE (BLANK OR DK/REF)] Please type in the name of any
other cough or cold medicine you used in the past 12 months just to get
high. If you have not used any other cough or cold medicines, press the
[ENTER] key to go to the next question.
______________
DK/REF

SD02e

[IF SD02d NE (BLANK OR DK/REF)] Please type in the name of any
other cough or cold medicine you used in the past 12 months just to get
high. If you have not used any other cough or cold medicines, press the
[ENTER] key to go to the next question.
______________
DK/REF

SD03

The next question is about GHB, also called “G,” “Georgia Home Boy,”
“Grievous Bodily Harm,” “Liquid G,” or gamma hydroxybutyrate. Have
you ever, even once, used GHB?
1
Yes
2
No
DK/REF

SD04

[IF SD03 = 1] How long has it been since you last used GHB?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

INTROSD

[IF CC01=1 OR CCREF=1 OR HE01=1 OR HEREF=1 OR ME01=1 OR
MEREF=1]
The next questions are about the different ways that certain drugs can be
used.

Press [ENTER] to continue.
SD05

[IF CC01 = 1 OR CCREF = 1] Have you ever, even once, used a needle to
inject cocaine?

390
April 15, 2016

1
Yes
2
No
DK/REF
SD06

[IF SD05 = 1] How long has it been since you last used a needle to inject
cocaine?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SD07

[IF HE01 = 1 OR HEREF = 1] Have you ever, even once, smoked
heroin?
1
Yes
2
No
DK/REF

SD08

[IF SD07 = 1] How long has it been since you last smoked heroin?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SD09

[IF HE01 = 1 OR HEREF = 1] Have you ever, even once, sniffed or
‘snorted’ heroin powder through your nose?
1
Yes
2
No
DK/REF

SD10

[IF SD09 = 1] How long has it been since you last sniffed or ‘snorted’
heroin powder through your nose?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SD11

[IF HE01 = 1 OR HEREF = 1] Have you ever, even once, used a needle to

391
April 15, 2016

inject heroin?
1
Yes
2
No
DK/REF
SDHEUSE

[IF SD07 = 2 AND SD09 = 2 AND SD11 = 2] Earlier the computer
recorded that you had used heroin. In what way have you used heroin?
To select more than one way, press the space bar between each number
you type. When you have finished, press the [ENTER] key to go to the
next question.
1
You smoked heroin
2
You sniffed or "snorted" heroin powder
3
You injected heroin with a needle
4
You used heroin some other way
DK/REF

SDHEUSE2 [IF SDHEUSE = 4 ONLY -- NO OTHER CATEGORIES SELECTED]
Please type in the way you have used heroin. When you have finished
typing your answer, press the [ENTER] key to go to the next question.
________________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN SDHEUSE2.
SDHEUSE3 [IF SDHEUSE = 1] How long has it been since you last smoked heroin?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SDHEUSE4 [IF SDHEUSE = 2] How long has it been since you last sniffed or
‘snorted’ heroin powder through your nose?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SD12

[IF SD11 = 1 OR SDHEUSE = 3] How long has it been since you last
used a needle to inject heroin?

392
April 15, 2016

1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SD13

[IF ME01 = 1 OR MEREF = 1] Have you ever, even once, used a needle
to inject methamphetamine?
1
Yes
2
No
DK/REF

SD14

[IF SD13 = 1] How long has it been since you last used a needle to inject
methamphetamine?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SD15

[IF STYNDL =1 OR SD05 = 1 OR SD11 = 1 OR SD13 = 1 OR
SDHEUSE = 3] Have you ever, even once, used a needle to inject any
other drug that was not prescribed for you?
[IF STYNDL NE 1 AND SD05 NE 1 AND SD11 NE 1 AND SD13 NE 1
AND SDHEUSE NE 3] Have you ever, even once, used a needle to inject
any drug that was not prescribed for you?
1
Yes
2
No
DK/REF

SD15SP

[SD15=1]

[IF (STYNDL =1 OR SD05 = 1 OR SD11 = 1 OR SD13 = 1 OR
SDHEUSE = 3) AND SD15=1 “The computer recorded that you have
used a needle to inject another drug that was not prescribed for
you.”] Please type in the name of one of these drugs you have used a

393
April 15, 2016

needle to inject. If you’re not sure how to spell the name of the drug you
used a needle to inject, just make your best guess. When you have
finished, press the [ENTER] key to go to the next question.
________________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN SD15SP.
SD15a

[IF SD15 = 1] Please type in the name of any other drug you have used a
needle to inject when it was not prescribed for you.
If you have not used a needle to inject any other drugs, press [ENTER].
________________
DK/REF

SD15b

[IF SD15a NE (BLANK OR DK/REF)] Please type in the name of any
other drug you have used a needle to inject when it was not prescribed for
you.
If you have not used a needle to inject any other drugs, press [ENTER].
________________
DK/REF

SD15c

[IF SD15b NE (BLANK OR DK/REF)] Please type in the name of any
other drug you have used a needle to inject when it was not prescribed for
you.
If you have not used a needle to inject any other drugs, press [ENTER].
________________
DK/REF

SD15d

SD16

[IF SD15c NE (BLANK OR DK/REF)] Please type in the name of any
other drug you have used a needle to inject when it was not prescribed for
you.
If you have not used a needle to inject any other drugs, press [ENTER] .
________________
DK/REF
[IFSD15=1] How long has it been since you last used a needle to inject
[any other drug / any drug] that was not prescribed for you?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF

394
April 15, 2016

PROGRAMMER: SHOW 12 MONTH CALENDAR
DEFINE INJECTFILL, INJECTFILL2:
IF SD05 = 1 AND SD11 NE 1 AND SDHEUSE NE 3 AND SD13 NE 1 AND
SD15 NE 1 AND STYNDL NE 1 THEN
INJECTFILL = “cocaine”
INJECTFILL2 = “to inject cocaine”
ELSEIF SD05 NE 1 AND (SD11 = 1 OR SDHEUSE = 3) AND SD13 NE 1 AND
SD15 NE 1 AND STYNDL NE 1 THEN
INJECTFILL = “heroin”
INJECTFILL2 = “to inject heroin”
ELSEIF SD05 NE 1 AND SD11 NE 1 AND SDHEUSE NE 3 AND SD13 = 1
AND SD15 NE 1 AND STYNDL NE 1 THEN
INJECTFILL = “methamphetamine”
INJECTFILL2 = “to inject methamphetamine”
ELSEIF SD05 NE 1 AND SD11 NE 1 AND SDHEUSE NE 3 AND SD13 NE 1
AND SD15 NE 1 AND STYNDL = 1 THEN
INJECTFILL = “STNAMEFILL”
INJECTFILL2 = “to inject STNAMEFILL”
ELSE
INJECTFILL = “drugs”
INJECTFILL2 = “for injecting drugs”
SD17

[IF STYNDL =1 AND SD05 NE 1 AND SD11 NE 1 AND SD13 NE 1
AND SD15 NE 1 AND SD15 NE DK AND SD15 NE REF AND
SDHEUSE NE 3] Earlier the computer recorded that you used a needle for
injecting [STNAMEFILL].
[IF STYNDL = 1 OR SD11 = 1 OR SDHEUSE=3 OR SD13 = 1 OR
SD05 = 1 OR SD15 = 1] Think about the last time you used a needle for
injecting [INJECTFILL]. The last time you used a needle
[INJECTFILL2], were you reusing a needle that you had used before?

1
Yes
2
No
DK/REF
SD18

[IF STYNDL =1 OR SD11 = 1 OR SDHEUSE = 3 OR SD13 = 1 OR
SD05 = 1 OR SD15 = 1] The last time you used a needle for injecting
drugs, did you use a needle that you knew or suspected someone else had
used before?
1
Yes
2
No
DK/REF

395
April 15, 2016

SD19

[IF STYNDL =1 OR SD11 = 1 OR SDHEUSE = 3 OR SD13 = 1 OR
SD05 = 1 OR SD15 = 1] The last time you used a needle for injecting
drugs, did you use bleach to clean the needle before you used it?
1
Yes
2
No
DK/REF

SD20

[IF STYNDL =1 OR SD11 = 1 OR SDHEUSE = 3 OR SD13 = 1 OR
SD15 = 1 OR SD05 = 1] The last time you used a needle for injecting
drugs, did someone else use the needle after you?
1
Yes
2
No
DK/REF

SD21

[IF STYNDL =1 OR SD11 = 1 OR SDHEUSE = 3 OR SD13 = 1 OR
SD05 = 1 OR SD15 = 1] The last time you used a needle for injecting
drugs, how did you get the needle?
1
I bought the needle from a pharmacy
2
I got the needle from a needle exchange
3
I bought the needle on the street
4
I got the needle in a shooting gallery
5
I got the needle some other way
DK/REF

SD21SP

[IF SD21 = 5] Please type a description of how you got the needle you
used the last time you used a needle for injecting drugs. You do not need
to give a detailed description — just a few words will be sufficient. When
you have finished typing your answer, press the [ENTER] key to go to the
next question.
________________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN SD21SP.

396
April 15, 2016

Risk/Availability Section
RKQ1 We are interested in your opinion about the effects of using certain drugs and
other substances, about whether it’s difficult or easy to get drugs, and the extent to
which drugs are available in your neighborhood.
Please indicate how much you think people risk harming themselves physically
and in other ways when they do each of the following activities.
If you’re not sure, choose an answer for the amount of risk that comes closest to
what you think might be true for that activity.
Press [ENTER] to continue.
RK01a

How much do people risk harming themselves physically and in other
ways when they smoke one or more packs of cigarettes per day?
1
No risk
2
Slight risk
3
Moderate risk
4
Great risk
DK/REF

RK01b
How much do people risk harming themselves physically and in other
ways when they smoke marijuana once a month?
1
No risk
2
Slight risk
3
Moderate risk
4
Great risk
DK/REF
RK01c

How much do people risk harming themselves physically and in other
ways when they smoke marijuana once or twice a week?
1
No risk
2
Slight risk
3
Moderate risk
4
Great risk
DK/REF

RK01d
How much do people risk harming themselves physically and in other
ways when they try LSD once or twice?
1
2

No risk
Slight risk

397
April 15, 2016

3
Moderate risk
4
Great risk
DK/REF
RK01e

How much do people risk harming themselves physically and in other
ways when they use LSD once or twice a week?
1
No risk
2
Slight risk
3
Moderate risk
4
Great risk
DK/REF

RK01f

How much do people risk harming themselves physically and in other
ways when they try heroin once or twice?
1
No risk
2
Slight risk
3
Moderate risk
4
Great risk
DK/REF

RK01g

How much do people risk harming themselves physically and in other
ways when they use heroin once or twice a week?
1
No risk
2
Slight risk
3
Moderate risk
4
Great risk
DK/REF

RK01h
How much do people risk harming themselves physically and in other
ways when they use cocaine once a month?
1
No risk
2
Slight risk
3
Moderate risk
4
Great risk
DK/REF
RK01i

How much do people risk harming themselves physically and in other
ways when they use cocaine once or twice a week?
1
2
3

No risk
Slight risk
Moderate risk

398
April 15, 2016

4
Great risk
DK/REF
RK01j

How much do people risk harming themselves physically and in other
ways when they have four or five drinks of an alcoholic beverage nearly every
day?
1
No risk
2
Slight risk
3
Moderate risk
4
Great risk
DK/REF

RK01k
How much do people risk harming themselves physically and in other
ways when they have five or more drinks of an alcoholic beverage once or
twice a week?
1
No risk
2
Slight risk
3
Moderate risk
4
Great risk
DK/REF
RKQ2

The next questions ask how difficult you think it would be for you to get
each of the following types of drugs, if you wanted some.
Press [ENTER] to continue.

RK02a

How difficult or easy would it be for you to get some marijuana, if you
wanted some?
1
Probably impossible
2
Very difficult
3
Fairly difficult
4
Fairly easy
5
Very easy
DK/REF

RK02b
How difficult or easy would it be for you to get some LSD, if you wanted
some?
1
2
3
4
5

Probably impossible
Very difficult
Fairly difficult
Fairly easy
Very easy

399
April 15, 2016

DK/REF
RK02c

How difficult or easy would it be for you to get some cocaine, if you
wanted some?
1
Probably impossible
2
Very difficult
3
Fairly difficult
4
Fairly easy
5
Very easy
DK/REF

RK02d
How difficult or easy would it be for you to get some ‘crack’, if you
wanted some?
1
Probably impossible
2
Very difficult
3
Fairly difficult
4
Fairly easy
5
Very easy
DK/REF
RK02e

How difficult or easy would it be for you to get some heroin, if you
wanted some?
1
Probably impossible
2
Very difficult
3
Fairly difficult
4
Fairly easy
5
Very easy
DK/REF

RK03 In the past 30 days, has anyone approached you to sell you an illegal drug?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
RK04a

How often do you get a real kick out of doing things that are a little
dangerous?
1
2
3
4

Never
Seldom
Sometimes
Always

400
April 15, 2016

DK/REF
RK04b

How often do you like to test yourself by doing something a little risky?

1
Never
2
Seldom
3
Sometimes
4
Always
DK/REF
RK04c

How often do you wear a seatbelt when you ride in the front passenger
seat of a car?
1
Never
2
Seldom
3
Sometimes
4
Always
DK/REF

RK04d

How often do you wear a seatbelt when you drive a car?

1
Never
2
Seldom
3
Sometimes
4
Always
5
I don’t drive
DK/REF

401
April 15, 2016

402
April 15, 2016

Blunts
BL01 Sometimes people take tobacco out of a cigar and replace it with marijuana. This
is sometimes called a ‘blunt’.
Have you ever smoked part or all of a cigar with marijuana in it?
1
Yes
2
No
DK/REF
BL08 [IF BL01 = 1] How old were you the first time you smoked part or all of a cigar
with marijuana in it?
AGE:
DK/REF

[(RANGE: 1 - 110]

DEFINE AGE1STBL:
IF BL08 NE (BLANK OR DK/REF) THEN AGE1STBL = BL08
ELSE AGE1STBL = BLANK
IF AGE1STBL = CURNTAGE OR AGE1STBL < 10:
BLCC01 The computer recorded that you were [AGE1STBL] years old
the first time you smoked part or all of a cigar with marijuana
in it. Is this correct?
4
Yes
6
No
DK/REF
BLCC02 [IF BLCC01 = 6] Please answer this question again. How old
were you the first time you smoked part or all of a cigar with
marijuana in it?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF BLCC02 NOT(BLANK OR DK/REF) THEN AGE1STBL =
BLCC02
BL08a [IF BLCC01 NE DK/RE AND BLCC02 NE DK/REF AND AGE1STBL =
CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STBL =
CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first smoke part
or all of a cigar with marijuana in it in [CURRENT YEAR - 1] or [CURRENT
YEAR]?

403
April 15, 2016

1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
BL08b [IF AGE1STBL = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you first smoke part or all of a cigar with marijuana in it in [CURRENT YEAR 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
BL08c [IF BLCC01 NE DK/RE AND BLCC02 NE DK/REF AND AGE1STBL =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first smoke part or all of a cigar with marijuana in
it?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF BL08c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
BL08d [IF BL08a = 1 OR 2 OR BL08b = 1 OR 2] In what month in [YEAR FROM
BL08a or BL08b] did you first smoke part or all of a cigar with marijuana in it?
1
2
3
4
5
6
7

January
February
March
April
May
June
July

404
April 15, 2016

8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF BL08d > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STBL:
MYR1STBL = AGE AT FIRST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST USE (BL08a-d). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STBL IS
BLANK.
IF MYR1STBL NE 0 AND NE AGE1STBL:
BLCC03 The computer recorded that you first smoked part or all of a
cigar with marijuana in it in [BL08a-d fill]. That would make
you [MYR1STBL] years old when you first smoked part or all
of a cigar with marijuana in it. Is this correct?
4
Yes
6
No
DK/REF
BLCC04 [IF BLCC03 = 4] Earlier, the computer recorded that you
were [AGE1STBL] years old when you first smoked part or all
of a cigar with marijuana in it. Which answer is correct?
1

I first smoked part or all of a cigar with marijuana in it
in [BL08a-d fill] when I was [MYR1STBL] years old
2
I was [AGE1STBL] years old the first time I smoked
part or all of a cigar with marijuana in it
3
Neither answer is correct
DK/REF
UPDATE: IF BLCC04 = 1, THEN AGE1STBL = MYR1STBL
BLCC05 [IF BLCC04=2 OR BLCC04=3 OR BLCC03=6] Please
answer this question again. Did you first smoke part or all of a
cigar with marijuana in it in [CURRENT YEAR-2],
[CURRENT YEAR-1], or [CURRENT YEAR]?

405
April 15, 2016

1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
BLCC05a [IF BLCC05 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [BLCC05] did you first
smoke part or all of a cigar with marijuana in it?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF BLCC05a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF BLCC05a NE (0 OR DK/RE) THEN UPDATE MYR1STBL.
MYR1STBL = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (BLCC05 AND BLCC05a).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STBL IS BLANK.
IF MYR1STBL = AGE1STBL THEN MYR1STBL = BLANK
BLCC06 [IF BLCC04 NE 1 AND MYR1STBL NE 0 AND (BLCC05 AND
BLCC05a NE BL08a-d)] The computer recorded that you first
smoked part or all of a cigar with marijuana in it in [BLCC05BLCC05a fill]. That would make you [MYR1STBL] years old
when you first smoked part or all of a cigar with marijuana in
it. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF BLCC06 NE (6, BLANK OR DK/REF) AND (BLCC05 AND BLCC05a

406
April 15, 2016

NE BL08a-d) THEN AGE1STBL = MYR1STBL
BL02 [IF BL01 = 1] How long has it been since you last smoked part or all of a cigar
with marijuana in it?
1
Within the past 30 days — that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
BL02a [IF (MJLAST3 = 1 OR MJRECDK = 1 OR MJRECRE = 1) AND BL02 = 1] On
how many of the past 30 days, that is, since [DATEFILL], did you smoke part or
all of a cigar with marijuana in it?
# OF DAYS: ______________ [RANGE: 1-30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
BL03 [IF (MJ01 = 2 OR MJREF = 2) AND BL02=1] The answer to the last question
and an earlier question disagree. Which answer is correct?
1
I have never used marijuana or hashish
2
I smoked part or all of a cigar with marijuana in it during the past 30 days
DK/REF
BL03a [IF BL03 = 2] On how many of the past 30 days, that is, since [DATEFILL], did
you smoke part or all of a cigar with marijuana in it?
# OF DAYS: ______________ [RANGE: 1-30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
BL04 [IF (MJLAST3 =2 or 3 OR MJRECDK=2 OR 3 OR MJRECRE=2 OR 3) AND
BL02=1] The answer to the last question and an earlier question disagree. Which
answer is correct?
1
I last used marijuana or hashish [MJREC FILL]
2
I smoked part or all of a cigar with marijuana in it during the past 30 days
DK/REF
BL04a [IF BL04 = 2] On how many of the past 30 days, that is, since [DATEFILL], did
you smoke part or all of a cigar with marijuana in it?
# OF DAYS: ______________ [RANGE: 1-30]
DK/REF

407
April 15, 2016

PROGRAMMER: SHOW 30 DAY CALENDAR
BL05 [IF BL03 =2] Why did you report earlier that you had never used marijuana or
hashish?
1
2

I didn’t consider a ‘blunt’ to be marijuana or hashish
I made a mistake when I answered the earlier question about ever using
marijuana or hashish
3
Some other reason
DK/REF
BL05SP
[IF BL05 = 3] Please type in the other reason you reported earlier that you
had never used marijuana or hashish.
When you have finished, press the [ENTER] key to go to the next question.
______________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN BL05SP.
BL06 [IF BL04 =2] Why did you report earlier that you did not use marijuana or
hashish during the past 30 days?
1
I didn’t consider a ‘blunt’ to be marijuana or hashish
2
I made a mistake earlier when I answered how long ago I last used
marijuana or hashish
3
Some other reason
DK/REF
BL06SP
[IF BL06 = 3] Please type in the other reason you reported earlier that you
had not used marijuana or hashish during the past 30 days.
When you have finished, press the [ENTER] key to go to the next question.
______________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN BL06SP.
BL07 [IF CG36=1 AND (BL02 = 1 OR BL03 = 2 OR BL04 = 2)] Earlier, you reported
that you had smoked part or all of a cigar during the past 30 days. During the past
30 days, did you smoke any cigars that did not have marijuana in them?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

408
April 15, 2016

MJMM01 [IF ((MJLAST3 = 1 - 2 OR MJRECDK = 1 - 2 OR MJRECRE = 1 - 2) OR
((BL02=1 OR 2) AND (BL03 NE 1)) Earlier, you reported using marijuana in
the past year. Was any of your marijuana use in the past 12 months
recommended by a doctor or other health care professional?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
MJMM02 [IF MJMM01=1] Was all of your marijuana use in the past 12 months
recommended by a doctor or other health care professional?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

409
April 15, 2016

410
April 15, 2016

Definitions for Use in the Drugs Module
DEFINE CIG30DAY:
IF CG05 = 1 THEN CIG30DAY = 1
ELSE CIG30DAY = 2
DEFINE ALC12MON:
IF (ALLAST3 = 1 OR 2 OR ALRECDK = 1 OR 2 OR ALRECRE = 1 OR 2)
AND TOTDRINK = DK/REF, THEN ALC12MON = 1
ELSE TOTDRINK > 5, THEN ALC12MON = 2
ELSE ALCC30 > 5 OR ALCC29b = 3 - 6 OR ALCC29a > 5 OR (AL08 >5 AND
ALCC27 = 4) OR AL06 > 5 OR ESTIALC > 25, THEN ALC12MON = 3
ELSE, ALC12MON = 4
DEFINE MAR12MON:
IF (MJLAST3 = 1 OR 2 OR MJRECDK = 1 OR 2 OR MJRECRE = 1 OR 2)
AND TOTMJ = DK/REF, THEN MAR12MON = 1
ELSE TOTMJ > 5, THEN MAR12MON = 2
ELSE MJCC16 > 5 OR MJCC13a > 5 OR MJC13b = 3 - 6 OR (ME06 > 5 AND
MJCC07a = 4) OR (MJ06DKRE = 3 - 6 AND MJCC07b = 4), THEN
MAR12MON = 3
ELSE MAR12MON = 4
DEFINE COC12MON:
IF CCLAST3 = 1 OR 2 OR CCRECDK = 1 OR 2 OR CCRECRE = 1 OR 2 OR
SD06 = 1 OR 2, THEN COC12MON = 1
ELSE COC12MON = 2
DEFINE CRK12MON:
IF CKLAST3 = 1 OR 2 OR CKRECDK = 1 OR 2 OR CKRECRE = 1 OR 2,
THEN CRK12MON = 1
ELSE CRK12MON = 2
DEFINE HER12MON:
IF HELAST3 = 1 OR 2 OR HERECDK = 1 OR 2 OR HERECRE = 1 OR 2 OR
SD08 = 1 OR 2 OR SD10 = 1 OR 2 OR SD12 = 1 OR 2, THEN HER12MON = 1
ELSE HER12MON = 2
DEFINE HAL12MON:
IF HALLREC = 1 OR 2 OR LSDREC = 1 OR 2 OR PCPREC = 1 OR 2 OR
ECSTREC = 1 OR 2, OR LS33 = 1 OR2, OR LS34 = 1 OR, 2 OR LS35 = 1
OR2, THEN HAL12MON = 1
ELSE HAL12MON = 2
DEFINE INH12MON:
IF INLAST = 1 OR 2 OR INRECDK = 1 OR 2 OR INRECRE = 1 OR 2, THEN

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April 15, 2016

INH12MON = 1
ELSE INH12MON = 2
DEFINE MET12MON:
IF MELAST3 = 1 OR 2 OR MERECDK = 1 OR 2 OR MERECRE = 1 OR 2 OR
SD14=1 OR 2, THEN MET12MON = 1
ELSE MET12MON = 2
DEFINE PAI12MON:
IF PRY01 = 1 OR PRY02 = 1 OR PRY03 = 1 OR PRY04 = 1 OR PRY05 = 1 OR
PRY06 = 1 OR PRY07 =1 OR PRY08 = 1 OR PRY09 = 1 OR PRY10 = 1
OR PRY11 = 1 OR PRY12 = 1 OR PRY13 = 1 OR PRY14 =1 OR PRY15
= 1 OR PRY16 = 1 OR PRY17 = 1 OR PRY18 = 1 OR PRY19 = 1 OR
PRY20 = 1 OR PRY21 = 1 OR PRY22 = 1 OR PRY23 = 1 OR PRY24 =
1 OR PRY25 = 1 OR PRY26 = 1 OR PRY27 = 1 OR PRY28 = 1 OR
PRY29 = 1 OR PRY30 = 1 OR PRY31 = 1 OR PRY32 = 1 OR PRY33 =
1 OR PRY34 = 1 OR PRY35 = 1 OR PRY36 = 1 OR PRYOTH = 1,
THEN PAI12MON = 1
ELSE PAI12MON = 2
DEFINE TRA12MON:
IF TRY01 = 1 OR TRY02 = 1 OR TRY03 = 1 OR TRY04 = 1 OR TRY05 = 1
OR TRY06 = 1 OR TRY07 = 1 OR TRY08 = 1 OR TRY09 = 1 OR
TRY10 = 1 OR TRY11 = 1 OR TRY12 = 1 OR TRYOTH = 1, THEN
TRA12MON = 1
ELSE TRA12MON = 2
DEFINE STI12MON:
IF STY01 = 1 OR STY02 = 1 OR STY03 = 1 OR STY04 = 1 OR STY05 = 1 OR
STY06 = 1 OR STY07 = 1 OR STY08 = 1 OR STY09 = 1 OR STY10 = 1 OR
STY11 = 1 OR STY12 = 1 OR STY13 = 1 OR STY14 = 1 OR STY15 = 1 OR
STY16 = 1 OR STY17 = 1 OR STY18 = 1 OR STY19 = 1 OR STY20 = 1 OR
STY21 = 1 OR STY22 = 1 OR STY23 = 1 OR STY24 = 1 OR STY25 = 1 OR
STY26 = 1 OR STYOTH = 1, THEN STI12MON= 1
ELSE STI12MON = 2
DEFINE SED12MON
IF SVY01 = 1 OR SVY02 = 1 OR SVY03 = 1 OR SVY04 = 1 OR SVY05 = 1
OR SVY06 = 1 OR SVY07 = 1 OR SVY08 = 1 OR SVY09 = 1 OR SVY10 = 1
OR SVY11 = 1 OR SVY12 = 1 OR SVY13 = 1 OR SVY14 = 1 OR SVYOTH =
1, THEN SED12MON = 1
ELSE SED12MON = 2

412
April 15, 2016

Substance Dependence and Abuse
INTRODR

[IF CIG30DAY = 1 OR ALC12MON = 1 OR 2 OR 3 OR MAR12MON =
1 OR 2 OR 3 OR COC12MON = 1 OR CRK12MON = 1 OR
HER12MON = 1 OR HAL12MON = 1 OR INH12MON = 1 OR
MET12MON = 1 OR PAI12MON = 1 OR TRA12MON = 1 OR
STI12MON = 1 OR SED12MON = 1] Now we’d like for you to tell us
about your experiences with the
[CIG30DAY = 1 AND ALC12MON = 4 AND (MAR12MON = 4 AND
COC12MON = 2 AND CRK12MON = 2 AND HER12MON = 2 AND
HAL12MON = 2 AND INH12MON = 2 AND MET12MON = 2 AND
PAI12MON = 2 AND TRA12MON = 2 AND STI12MON = 2 AND
SED12MON = 2)] cigarettes you smoked.
[CIG30DAY = 1 AND ALC12MON = 1 OR 2 OR 3 AND (MAR12MON
= 4 AND COC12MON = 2 AND CRK12MON = 2 AND HER12MON =
2 AND HAL12MON = 2 AND INH12MON = 2 AND MET12MON = 2
AND PAI12MON = 2 AND TRA12MON = 2 AND STI12MON = 2 AND
SED12MON = 2)] cigarettes you smoked and the alcohol you drank.
[CIG30DAY = 2 AND ALC12MON =1 OR 2 OR 3 AND (MAR12MON
= 4 AND COC12MON = 2 AND CRK12MON = 2 AND HER12MON =
2 AND HAL12MON = 2 AND INH12MON = 2 AND MET12MON = 2
AND PAI12MON = 2 AND TRA12MON = 2 AND STI12MON = 2 AND
SED12MON = 2)] alcohol you drank.
[CIG30DAY = 1 AND ALC12MON = 4 AND (MAR12MON = 1 OR 2
OR 3 OR COC12MON = 1 OR CRK12MON =1 OR HER12MON = 1
OR HAL12MON = 1 OR INH12MON = 1 OR MET12MON = 1 OR
PAI12MON = 1 OR TRA12MON = 1 OR STI12MON = 1 OR
SED12MON = 1)] cigarettes you smoked and the other drugs that you
used.
[CIG30DAY = 2 AND ALC12MON = 1 OR 2 OR 3 OR AND
(MAR12MON = 1 OR 2 OR 3 OR COC12MON = 1 OR CRK12MON =1
OR HER12MON = 1 OR HAL12MON = 1 OR INH12MON = 1 OR
MET12MON = 1 OR PAI12MON = 1 OR TRA12MON = 1 OR
STI12MON = 1 OR SED12MON = 1)] alcohol you drank and the other
drugs that you used.
[CIG30DAY = 1 AND ALC12MON = 1 OR 2 OR 3 AND (MAR12MON
= 1 OR 2 OR 3 OR COC12MON = 1 OR CRK12MON =1 OR
HER12MON = 1 OR HAL12MON = 1 OR INH12MON = 1 OR
MET12MON = 1 OR PAI12MON = 1 OR TRA12MON = 1 OR
STI12MON = 1 OR SED12MON = 1)]cigarettes you smoked, the alcohol

413
April 15, 2016

you drank, and the other drugs that you used.
[CIG30DAY = 2 AND ALC12MON = 4 AND (MAR12MON = 1 OR 2
OR 3 OR COC12MON = 1 OR CRK12MON =1 OR HER12MON = 1
OR HAL12MON = 1 OR INH12MON = 1 OR MET12MON = 1 OR
PAI12MON = 1 OR TRA12MON = 1 OR STI12MON = 1 OR
SED12MON = 1)]drugs that you used.
Press [ENTER] to continue.
DRCIG

[IF CIG30DAY = 1] Think about your use of cigarettes during the past
30 days as you answer these next questions.
Press [ENTER] to continue.
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE01

[IF CIG30DAY=1] Please think about how true each statement is of you.
After not smoking for a while, you need to smoke in order to feel less
restless and irritable.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE02

[IF CIG30DAY=1] When you don’t smoke for a few hours, you start to
crave cigarettes.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE03

[IF CIG30DAY=1] You sometimes have strong cravings for a cigarette
where it feels like you’re in the grip of a force you can’t control.
1
2
3

Not at all true
Somewhat true
Moderately true

414
April 15, 2016

4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DRCGE04

[IF CIG30DAY=1] You feel a sense of control over your smoking — that
is, you can “take it or leave it” at any time.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE05

[IF CIG30DAY=1] You tend to avoid places that don’t allow smoking,
even if you would otherwise enjoy them.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE06a [IF CIG30DAY=1] Do you have any friends who do not smoke
cigarettes?
1
Yes
2
No
DK/REF
DRCGE06b [IF DRCGE06a = 1] Think about your use of cigarettes during the past
30 days as you answer these next questions. There are times when you
choose not to be around your friends who don’t smoke because they won’t
like it if you smoke.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

415
April 15, 2016

DRCGE07

[IF CIG30DAY=1]
[ADD IF DRCGE06b = BLANK] Think about your use of cigarettes
during the past 30 days as you answer these next questions.
Even if you’re traveling a long distance, you’d rather not travel by
airplane because you wouldn’t be allowed to smoke.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE08

[IF CIG30DAY=1] You sometimes worry that you will run out of
cigarettes.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE09

[IF CIG30DAY=1] You smoke cigarettes fairly regularly throughout the
day.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE10

[IF CIG30DAY=1] You smoke about the same amount on weekends as on
weekdays.
1
2
3
4
5

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

416
April 15, 2016

DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DRCGE11

[IF CIG30DAY=1] You smoke just about the same number of cigarettes
from day to day.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE12

[IF CIG30DAY=1] It’s hard to say how many cigarettes you smoke per
day because the number often changes.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE13

[IF CIG30DAY=1] It’s normal for you to smoke several cigarettes in an
hour, then not have another one until hours later.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE14

[IF CIG30DAY=1] The number of cigarettes you smoke per day is often
influenced by other things -- how you’re feeling, or what you’re doing, for
example.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF

417
April 15, 2016

PROGRAMMER: SHOW 30 DAY CALENDAR
DRCGE15

[IF CIG30DAY=1] Your smoking is not affected much by other things.
For example, you smoke about the same amount whether you’re relaxing
or working, happy or sad, alone or with others.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE16

[IF CIG30DAY=1] Since you started smoking, the amount you smoke has
increased.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE17

[IF CIG30DAY=1] Compared to when you first started smoking, you need
to smoke a lot more now in order to be satisfied.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE18

[IF CIG30DAY=1] Compared to when you first started smoking, you can
smoke much, much more now before you start to feel anything.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

418
April 15, 2016

DRCGE19a [IF CIG30DAY=1 AND (CG07=30 OR CG07DKRE = 6] How soon after
you wake up do you have your first cigarette?
1
Within the first 5 minutes after you wake up
2
Between 6 and 30 minutes after you wake up
3
Between 31 and 60 minutes after you wake up
4
More than 60 minutes after you wake up
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DRCGE19b [IF DRCGE19a = BLANK AND CIG30DAY=1 AND (CG07 = 1 - 29 OR
CG07DKRE - 1-5] On the days that you smoke, how soon after you
wake up do you have your first cigarette?
1
Within the first 5 minutes after you wake up
2
Between 6 and 30 minutes after you wake up
3
Between 31 and 60 minutes after you wake up
4
More than 60 minutes after you wake up
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DRALC

[IF ALC12MON = 1 - 3] Think about your use of alcohol during the past
12 months as you answer these next questions.
Press [ENTER] to continue.

DRALC01

[IF ALC12MON = 1 - 3] During the past 12 months, was there a month or
more when you spent a lot of your time getting or drinking alcohol?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DRALC02

[IF DRALC01 = 2 OR DK/REF] During the past 12 months, was there a
month or more when you spent a lot of time getting over the effects of the
alcohol you drank?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DRALC04

[IF ALC12MON = 1 - 3] During the past 12 months, did you try to set
limits on how often or how much alcohol you would drink?

419
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC05

[IF DRALC04 = 1] Were you able to keep to the limits you set, or did you
often drink more than you intended to?
1
Usually kept to the limits set
2
Often drank more than intended
DK/REF

DRALC06

[IF ALC12MON = 1 - 3] During the past 12 months, did you need to
drink more alcohol than you used to in order to get the effect you wanted?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DRALC07

[IF DRALCO6=2 OR DK/REF] During the past 12 months, did you
notice that drinking the same amount of alcohol had less effect on you
than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DRALC08

[IF ALC12MON = 1 - 3] During the past 12 months, did you want to or
try to cut down or stop drinking alcohol?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DRALC09

[IF DRALC08 = 1] During the past 12 months, were you able to cut down
or stop drinking alcohol every time you wanted to or tried to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

420
April 15, 2016

DRALC10

[IF DRALC08 = 2 OR DK/REF OR DRALC09 = 2 OR DK/REF] During
the past 12 months, did you cut down or stop drinking at least one time?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DRALC11

[IF DRALC09 = 1 OR DRALC10 = 1] Please look at the symptoms listed
below. During the past 12 months, did you have 2 or more of these
symptoms after you cut back or stopped drinking alcohol?
•
•
•
•
•
•
•
•

Sweating or feeling that your heart was beating fast
Having your hands tremble
Having trouble sleeping
Vomiting or feeling nauseous
Seeing, hearing, or feeling things that weren’t really there
Feeling like you couldn’t sit still
Feeling anxious
Having seizures or fits

1
Yes
2
No
DK/REF
DRALC12

[IF DRALC11 = 1] Please look at the symptoms listed below. During the
past 12 months, did you have 2 or more of these symptoms at the same
time that lasted for longer than a day after you cut back or stopped
drinking alcohol?
•
•
•
•
•
•
•
•

Sweating or feeling that your heart was beating fast
Having your hands tremble
Having trouble sleeping
Vomiting or feeling nauseous
Seeing, hearing, or feeling things that weren’t really there
Feeling like you couldn’t sit still
Feeling anxious
Having seizures or fits

1
Yes
2
No
DK/REF
DRALC13

[IF ALC12MON = 1 - 3] During the past 12 months, did you have any
problems with your emotions, nerves, or mental health that were probably
caused or made worse by drinking alcohol?

421
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRALC14

[IF DRALC13 = 1] Did you continue to drink alcohol even though you
thought drinking was causing you to have problems with your emotions,
nerves, or mental health?
1
Yes
2
No
DK/REF

DRALC15

[IF DRALC13 = 2 OR DK/REF OR DRALC14 = 2 OR DK/REF] During
the past 12 months, did you have any physical health problems that were
probably caused or made worse by drinking alcohol?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DRALC16

[IF DRALC15 = 1] Did you continue to drink alcohol even though you
thought drinking was causing you to have physical problems?
1
Yes
2
No
DK/REF

DRALC17

[IF ALC12MON = 1 - 3] This question is about important activities such
as working, going to school, taking care of children, doing fun things such
as hobbies and sports, and spending time with friends and family.
During the past 12 months, did drinking alcohol cause you to give up or
spend less time doing these types of important activities?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DRALC18

[IF ALC12MON = 1 - 3] Sometimes people who drink alcohol have
serious problems at home, work or school — such as:

422
April 15, 2016

•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did drinking alcohol cause you to have serious
problems like this either at home, work, or school?
1
Yes
2
No
DK/REF
DRALC19

[IF ALC12MON = 1 - 3] During the past 12 months, did you regularly
drink alcohol and then do something where being drunk might have put
you in physical danger?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DRALC20

[IF ALC12MON = 1 - 3] During the past 12 months, did drinking alcohol
cause you to do things that repeatedly got you in trouble with the law?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DRALC21

[IF ALC12MON = 1 - 3] During the past 12 months, did you have any
problems with family or friends that were probably caused by your
drinking?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DRALC22

[IF DRALC21 = 1] Did you continue to drink alcohol even though you
thought your drinking caused problems with family or friends?
1
Yes
2
No
DK/REF

DRMJ

[IF MAR12MON = 1 - 3] Think about your use of marijuana or hashish

423
April 15, 2016

during the past 12 months as you answer these next questions.
Press [ENTER] to continue.
DRMJ01 [IF MAR12MON= 1 - 3] During the past 12 months, was there a month or
more when you spent a lot of your time getting or using marijuana or
hashish?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ02 [IF DRMJ01 = 2 OR DK/REF] During the past 12 months, was there a month
or more when you spent a lot of your time getting over the effects of the
marijuana or hashish you used?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ04 [IF MAR12MON= 1 - 3] During the past 12 months, did you try to set limits
on how often or how much marijuana or hashish you would use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ05 [IF DRMJ04 = 1] Were you able to keep to the limits you set, or did you often
use marijuana or hashish more than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF
DRMJ06 [IF MAR12MON = 1 - 3] During the past 12 months, did you need to use
more marijuana or hashish than you used to in order to get the effect you
wanted?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

424
April 15, 2016

DRMJ07 [IF DRMJ06=2 OR DK/REF] During the past 12 months, did you notice that
using the same amount of marijuana or hashish had less effect on you than it
used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ08 [IF MAR12MON= 1 - 3] During the past 12 months, did you want to or try
to cut down or stop using marijuana or hashish?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ09 [IF DRMJ08 = 1] During the past 12 months, were you able to cut down or
stop using marijuana or hashish every time you wanted to or tried to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ13 [IF MAR12MON= 1 - 3] During the past 12 months, did you have any
problems with your emotions, nerves, or mental health that were probably
caused or made worse by your use of marijuana or hashish?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ14 [IF DRMJ13 = 1] Did you continue to use marijuana or hashish even though
you thought it was causing you to have problems with your emotions, nerves,
or mental health?
1
Yes
2
No
DK/REF
DRMJ15 [IF DRMJ13 = 2 OR DK/REF OR DRMJ14 = 2 OR DK/REF] During the past
12 months, did you have any physical health problems that were probably
caused or made worse by your use of marijuana or hashish?

425
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ16 [IF DRMJ15 = 1] Did you continue to use marijuana or hashish even though
you thought it was causing you to have physical problems?
1
Yes
2
No
DK/REF
DRMJ17 [IF MAR12MON= 1 - 3] This question is about important activities such as
working, going to school, taking care of children, doing fun things such as
hobbies and sports, and spending time with friends and family.
During the past 12 months, did using marijuana or hashish cause you to give
up or spend less time doing these types of important activities?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ18 [IF MAR12MON= 1 - 3] Sometimes people who use marijuana or hashish
have serious problems at home, work or school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using marijuana or hashish cause you to
have serious problems like this either at home, work, or school?
1
Yes
2
No
DK/REF
DRMJ19 [IF MAR12MON= 1 - 3] During the past 12 months, did you regularly use
marijuana or hashish and then do something where using marijuana or
hashish might have put you in physical danger?
1
Yes
2
No
DK/REF

426
April 15, 2016

PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ20 [IF MAR12MON= 1 - 3] During the past 12 months, did using marijuana or
hashish cause you to do things that repeatedly got you in trouble with the
law?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ21 [IF MAR12MON= 1 - 3] During the past 12 months, did you have any
problems with family or friends that were probably caused by your use of
marijuana or hashish?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRMJ22 [IF DRMJ21 = 1] Did you continue to use marijuana or hashish even though
you thought it caused problems with family or friends?
1
Yes
2
No
DK/REF

DRCC

[IF COC12MON = 1 OR CRK12MON = 1] Think about your use of cocaine
[IF CRK12MON = 1] , including the form of cocaine called ‘crack’ during
the past 12 months as you answer these next questions.
Press [ENTER] to continue.

DEFINE COKEFILL:
IF COC12MON = 1 AND CRK12MON NE 1, THEN COKEFILL = ‘cocaine’
IF COC12MON = 1 AND CRK12MON = 1 THEN COKEFILL = ‘cocaine or
‘crack’
IF COC12MON NE 1 AND CRK12MON = 1 THEN COKEFILL = ‘crack’
ELSE COKEFILL = BLANK
DRCC01 [IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, was
there a month or more when you spent a lot of your time getting or using
[COKEFILL]?
1

Yes

427
April 15, 2016

2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC02 [IF DRCC01 = 2 OR DK/REF] During the past 12 months, was there a month
or more when you spent a lot of your time getting over the effects of the
[COKEFILL] you used?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC04 [IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did
you try to set limits on how often or how much [COKEFILL] you would
use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC05 [IF DRCC04 = 1] Were you able to keep to the limits you set, or did you often
use [COKEFILL] more than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF
DRCC06 [IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did
you need to use more [COKEFILL] than you used to in order to get the effect
you wanted?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC07 [IF DRCC06=2 OR DK/REF] During the past 12 months, did you notice that
using the same amount of [COKEFILL] had less effect on you than it used
to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

428
April 15, 2016

DRCC08 [IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did
you want to or try to cut down or stop using [COKEFILL]?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC09 [IF DRCC08 = 1] During the past 12 months, were you able to cut down or
stop using [COKEFILL] every time you wanted to or tried to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC10 [IF DRCC8 = 2 OR DK/REF OR DRCC9 = 2 OR DK/REF] During the past
12 months, did you cut down or stop using [COKEFILL] at least one time?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC10a [IF DRCC09 = 1 OR DRCC10 = 1] During the past 12 months, have you felt
kind of blue or down when you cut down or stopped using [COKEFILL]?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC11 [IF DRCC10a = 1] Please look at the symptoms listed below. During the past
12 months, did you have 2 or more of these symptoms after you cut back or
stopped using [COKEFILL]?
•
•
•
•
•

Feeling tired or exhausted
Having bad dreams
Having trouble sleeping or sleeping more than you normally do
Feeling hungry more often
Feeling either very slowed down or like you couldn’t sit still

1
Yes
2
No
DK/REF

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April 15, 2016

DRCC12 [IF DRCC11 = 1] Please look at the symptoms listed below. During the past
12 months, did you have 2 or more of these symptoms at the same time that
lasted for longer than a day after you cut back or stopped using
[COKEFILL]?
•
•
•
•
•

Feeling tired or exhausted
Having bad dreams
Having trouble sleeping or sleeping more than you normally do
Feeling hungry more often
Feeling either very slowed down or like you couldn’t sit still

1
Yes
2
No
DK/REF
DRCC13 [IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did
you have any problems with your emotions, nerves, or mental health that were
probably caused or made worse by your use of [COKEFILL]?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC14 [IF DRCC13 = 1] Did you continue to use [COKEFILL] even though you
thought it was causing you to have problems with your emotions, nerves, or
mental health?
1
Yes
2
No
DK/REF
DRCC15 [IF DRCC13 = 2 OR DK/REF OR DRCC14 = 2 OR DK/REF] During the
past 12 months, did you have any physical health problems that were probably
caused or made worse by your use of [COKEFILL]?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC16 [IF DRCC15 = 1] Did you continue to use [COKEFILL] even though you

430
April 15, 2016

thought it was causing you to have physical problems?
1
Yes
2
No
DK/REF
DRCC17 [IF COC12MON = 1 OR CRK12MON = 1] This question is about important
activities such as working, going to school, taking care of children, doing fun
things such as hobbies and sports, and spending time with friends and family.
During the past 12 months, did using [COKEFILL] cause you to give up or
spend less time doing these types of important activities?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC18 [IF COC12MON = 1 OR CRK12MON = 1] Sometimes people who use
[COKEFILL] have serious problems at home, work or school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using [COKEFILL] cause you to have serious
problems like this either at home, work, or school?
1
Yes
2
No
DK/REF
DRCC19 [IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did
you regularly use [COKEFILL] and then do something where using
[COKEFILL] might have put you in physical danger?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC20 [IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did
using [COKEFILL] cause you to do things that repeatedly got you in trouble
with the law?

431
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC21 [IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months, did
you have any problems with family or friends that were probably caused by
your use of [COKEFILL]?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRCC22 [IF DRCC21 = 1] Did you continue to use [COKEFILL] even though you
thought it caused problems with family or friends?
1
Yes
2
No
DK/REF
DRHE

[IF HER12MON = 1] Think about your use of heroin during the past 12
months as you answer these next questions.
Press [ENTER] to continue.

DRHE01 [IF HER12MON = 1] During the past 12 months, was there a month or more
when you spent a lot of your time getting or using heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE02 [IF DRHE01 = 2 OR DK/REF] During the past 12 months, was there a month
or more when you spent a lot of your time getting over the effects of the
heroin you used?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE04 [IF HER12MON = 1] During the past 12 months, did you try to set limits on
how often or how much heroin you would use?

432
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE05 [IF DRHE04 = 1] Were you able to keep to the limits you set, or did you often
use heroin more than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

DRHE06 [IF HER12MON = 1] During the past 12 months, did you need to use more
heroin than you used to in order to get the effect you wanted?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE07 [IF DRHE06=2 OR DK/REF] During the past 12 months, did you notice that
using the same amount of heroin had less effect on you than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE08 [IF HER12MON = 1] During the past 12 months, did you want to or try to
cut down or stop using heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE09 [IF DRHE08 = 1] During the past 12 months, were you able to cut down or
stop using heroin every time you wanted to or tried to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE10 [IF DRHE08 = 2 OR DK/REF OR DRHE09 = 2 OR DK/REF] During the

433
April 15, 2016

past 12 months, did you cut down or stop using heroin at least one time?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE11 [IF DRHE09 = 1 OR DRHE10 = 1] Please look at the symptoms listed
below. During the past 12 months, did you have 3 or more of these
symptoms after you cut back or stopped using heroin?
•
•
•
•
•
•
•
•
•

Feeling kind of blue or down
Vomiting or feeling nauseous
Having cramps or muscle aches
Having teary eyes or a runny nose
Feeling sweaty, having enlarged eye pupils, or having body hair
standing up on your skin
Having diarrhea
Yawning
Having a fever
Having trouble sleeping

1
Yes
2
No
DK/REF
DRHE12 [IF DRHE11 = 1] Please look at the symptoms listed below. During the past
12 months, did you have 3 or more of these symptoms at the same time that
lasted for longer than a day after you cut back or stopped using heroin?
•
•
•
•
•
•
•
•
•

Feeling kind of blue or down
Vomiting or feeling nauseous
Having cramps or muscle aches
Having teary eyes or a runny nose
Feeling sweaty, having enlarged eye pupils, or having body hair
standing up on your skin
Having diarrhea
Yawning
Having a fever
Having trouble sleeping

1
Yes
2
No
DK/REF
DRHE13 [IF HER12MON = 1] During the past 12 months, did you have any problems

434
April 15, 2016

with your emotions, nerves, or mental health that were probably caused or
made worse by your use of heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE14 [IF DRHE13 = 1] Did you continue to use heroin even though you thought it
was causing you to have problems with your emotions, nerves, or mental
health?
1
Yes
2
No
DK/REF
DRHE15 [IF DRHE13 = 2 OR DK/REF OR DRHE14 = 2 OR DK/REF] During the
past 12 months, did you have any physical health problems that were probably
caused or made worse by your use of heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE16 [IF DRHE15 = 1] Did you continue to use heroin even though you thought it
was causing you to have physical problems?
1
Yes
2
No
DK/REF
DRHE17 [IF HER12MON = 1] This question is about important activities such as
working, going to school, taking care of children, doing fun things such as
hobbies and sports, and spending time with friends and family.
During the past 12 months, did using heroin cause you to give up or spend
less time doing these types of important activities?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE18 [IF HER12MON = 1] Sometimes people who use heroin have serious
problems at home, work or school — such as:

435
April 15, 2016

•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using heroin cause you to have serious
problems like this either at home, work, or school?
1
Yes
2
No
DK/REF
DRHE19 [IF HER12MON = 1] During the past 12 months, did you regularly use
heroin and then do something where using heroin might have put you in
physical danger?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE20 [IF HER12MON = 1] During the past 12 months, did using heroin cause you
to do things that repeatedly got you in trouble with the law?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE21 [IF HER12MON = 1] During the past 12 months, did you have any problems
with family or friends that were probably caused by your use of heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRHE22 [IF DRHE21 = 1] Did you continue to use heroin even though you thought it
caused problems with family or friends?
1
Yes
2
No
DK/REF
DRLS

[IF HAL12MON = 1] Think about your use of hallucinogens, such as LSD,

436
April 15, 2016

‘acid’, PCP, ‘Ecstasy’ or ‘Molly’, psilocybin or mushrooms, mescaline, or
peyote during the past 12 months as you answer these next questions.
Press [ENTER] to continue.
DRLS01 [IF HAL12MON = 1] During the past 12 months, was there a month or more
when you spent a lot of your time getting or using hallucinogens?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS02 [IF DRLS01 = 2 OR DK/REF] During the past 12 months, was there a month
or more when you spent a lot of your time getting over the effects of the
hallucinogens you used?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS04 [IF HAL12MON = 1] During the past 12 months, did you try to set limits on
how often or how much hallucinogens you would use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS05 [IF DRLS04 = 1] Were you able to keep to the limits you set, or did you often
use hallucinogens more than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

DRLS06 [IF HAL12MON = 1] During the past 12 months, did you need to use more
hallucinogens than you used to in order to get the effect you wanted?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

437
April 15, 2016

DRLS07 IF DRLS06=2 OR DK/REF] During the past 12 months, did you notice that
using the same amount of hallucinogens had less effect on you than it used
to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS08 [IF HAL12MON = 1] During the past 12 months, did you want to or try to
cut down or stop using hallucinogens?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS09 [IF DRLS08 = 1] During the past 12 months, were you able to cut down or
stop using hallucinogens every time you wanted to or tried to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS13 [IF HAL12MON = 1] During the past 12 months, did you have any problems
with your emotions, nerves, or mental health that were probably caused or
made worse by your use of hallucinogens?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS14 [IF DRLS13 = 1] Did you continue to use hallucinogens even though you
thought this was causing you to have problems with your emotions, nerves, or
mental health?
1
Yes
2
No
DK/REF
DRLS15 [IF DRLS13 = 2 OR DK/REF OR DRLS14 = 2 OR DK/REF] During the past
12 months, did you have any physical health problems that were probably
caused or made worse by your use of hallucinogens?

438
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS16 [IF DRLS15 = 1] Did you continue to use hallucinogens even though you
thought this was causing you to have physical problems?
1
Yes
2
No
DK/REF
DRLS17 [IF HAL12MON = 1] This question is about important activities such as
working, going to school, taking care of children, doing fun things such as
hobbies and sports, and spending time with friends and family.
During the past 12 months, did using hallucinogens cause you to give up or
spend less time doing these types of important activities?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS18 [IF HAL12MON = 1] Sometimes people who use hallucinogens have serious
problems at home, work or school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using hallucinogens cause you to have serious
problems like this either at home, work, or school?
1
Yes
2
No
DK/REF

DRLS19 [IF HAL12MON = 1] During the past 12 months, did you regularly use
hallucinogens and then do something where using hallucinogens put you in
physical danger?
1

Yes

439
April 15, 2016

2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS20 [IF HAL12MON = 1] During the past 12 months, did using hallucinogens
cause you to do things that repeatedly got you in trouble with the law?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS21 [IF HAL12MON = 1] During the past 12 months, did you have any problems
with family or friends that were probably caused by your use of
hallucinogens?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRLS22 [IF DRLS21 = 1] Did you continue to use hallucinogens even though you
thought this caused problems with family or friends?
1
Yes
2
No
DK/REF
DRIN

[IF INH12MON = 1] Think about your use of inhalants, such as amyl nitrite,
‘poppers,’ nitrous oxide, gasoline or lighter fluids, glue, spray paints, or
correction fluids during the past 12 months as you answer these next
questions.
Press [ENTER] to continue.
PROGRAMMER: SHOW 12 MONTH CALENDAR

DRIN01 [IF INH12MON = 1] During the past 12 months, was there a month or more
when you spent a lot of your time getting or using inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN02 [IF DRIN01 = 2 OR DK/REF] During the past 12 months, was there a month
or more when you spent a lot of your time getting over the effects of the

440
April 15, 2016

inhalants you used?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN04 [IF INH12MON = 1] During the past 12 months, did you try to set limits on
how often or how much inhalants you would use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN05 [IF DRIN04 = 1] Were you able to keep to the limits you set, or did you often
use inhalants more than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF
DRIN06 [IF INH12MON = 1] During the past 12 months, did you need to use more
inhalants than you used to in order to get the effect you wanted?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN07 [IF DRIN06=2 OR DK/REF] During the past 12 months, did you notice that
using the same amount of inhalants had less effect on you than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN08 [IF INH12MON = 1] During the past 12 months, did you want to or try to cut
down or stop using inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

441
April 15, 2016

DRIN09 [IF DRIN08 = 1] During the past 12 months, were you able to cut down or
stop using inhalants every time you wanted to or tried to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN13 [IF INH12MON = 1] During the past 12 months, did you have any problems
with your emotions, nerves, or mental health that were probably caused or
made worse by your use of inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN14 [IF DRIN13 = 1] Did you continue to use inhalants even though you thought
this was causing you to have problems with your emotions, nerves, or mental
health?
1
Yes
2
No
DK/REF
DRIN15 [IF DRIN13 = 2 OR DK/REF OR DRIN14 = 2 OR DK/REF] During the past
12 months, did you have any physical health problems that were probably
caused or made worse by your use of inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN16 [IF DRIN15 = 1] Did you continue to use inhalants even though you thought
this was causing you to have physical problems?
1
Yes
2
No
DK/REF
DRIN17 [IF INH12MON = 1] This question is about important activities such as
working, going to school, taking care of children, doing fun things such as
hobbies and sports, and spending time with friends and family.
During the past 12 months, did using inhalants cause you to give up or spend

442
April 15, 2016

less time doing these types of important activities?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN18 [IF INH12MON = 1] Sometimes people who use inhalants have serious
problems at home, work or school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using inhalants cause you to have serious
problems like this either at home, work, or school?
1
Yes
2
No
DK/REF

DRIN19 [IF INH12MON = 1] During the past 12 months, did you regularly use
inhalants and then do something where using inhalants might have put you
in physical danger?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN20 [IF INH12MON = 1] During the past 12 months, did using inhalants cause
you to do things that repeatedly got you in trouble with the law?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN21 [IF INH12MON = 1] During the past 12 months, did you have any problems
with family or friends that were probably caused by your use of inhalants?
1
Yes
2
No
DK/REF

443
April 15, 2016

PROGRAMMER: SHOW 12 MONTH CALENDAR
DRIN22 [IF DRIN21 = 1] Did you continue to use inhalants even though you thought
this caused problems with family or friends?
1
Yes
2
No
DK/REF
DRME

[IF MET12MON = 1] Think about your use of methamphetamine during the
past 12 months as you answer these next questions.
Press [ENTER] to continue.

DRME01 [IF MET12MON = 1] During the past 12 months, was there a month or more
when you spent a lot of your time getting or using methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME02 [IF DRME01 = 2 OR DK/REF] During the past 12 months, was there a month
or more when you spent a lot of your time getting over the effects of the
methamphetamine you used?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME04 [IF MET12MON= 1] During the past 12 months, did you try to set limits on
how often or how much methamphetamine you would use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME05 [IF DRME04 = 1] Were you able to keep to the limits you set, or did you
often use methamphetamine more than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

444
April 15, 2016

DRME06 [IF MET12MON = 1] During the past 12 months, did you need to use more
methamphetamine than you used to in order to get the effect you wanted?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME07 [IF DRME06=2 OR DK/REF] During the past 12 months, did you notice that
using the same amount of methamphetamine had less effect on you than it
used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME08 [IF MET12MON= 1] During the past 12 months, did you want to or try to
cut down or stop using methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME09 [IF DRME08 = 1] During the past 12 months, were you able to cut down or
stop using methamphetamine every time you wanted to or tried to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME10 [IF DRME08 = 2 OR DK/REF OR DRME09 = 2 OR DK/REF] During the
past 12 months, did you cut down or stop using methamphetamine at least
one time?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME10a [IF DRME09 = 1 OR DRME10 = 1] During the past 12 months, have you
felt kind of blue or down when you cut down or stopped using
methamphetamine?

445
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME11 [IF DRME10a = 1] Please look at the symptoms listed below. During the
past 12 months, did you have 2 or more of these symptoms after you cut back
or stopped using methamphetamine?
•
•
•
•
•

Feeling tired or exhausted
Having bad dreams
Having trouble sleeping or sleeping more than you normally do
Feeling hungry more often
Feeling either very slowed down or like you couldn’t sit still

1
Yes
2
No
DK/REF
DRME12 [IF DRME11 = 1] Please look at the symptoms listed below. During the past
12 months, did you have 2 or more of these symptoms at the same time that
lasted for longer than a day after you cut back or stopped using
methamphetamine?
•
•
•
•
•

Feeling tired or exhausted
Having bad dreams
Having trouble sleeping or sleeping more than you normally do
Feeling hungry more often
Feeling either very slowed down or like you couldn’t sit still

1
Yes
2
No
DK/REF

DRME13 [IF MET12MON= 1] During the past 12 months, did you have any problems
with your emotions, nerves, or mental health that were probably caused or
made worse by your use of methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME14 [IF DRME13 = 1] Did you continue to use methamphetamine even though

446
April 15, 2016

you thought it was causing you to have problems with your emotions, nerves,
or mental health?
1
Yes
2
No
DK/REF
DRME15 [IF DRME13 = 2 OR DK/REF OR DRME14 = 2 OR DK/REF] During the
past 12 months, did you have any physical health problems that were probably
caused or made worse by your use of methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME16 [IF DRME15 = 1] Did you continue to use methamphetamine even though
you thought it was causing you to have physical problems?
1
Yes
2
No
DK/REF
DRME17 [IF MET12MON= 1] This question is about important activities such as
working, going to school, taking care of children, doing fun things such as
hobbies and sports, and spending time with friends and family.
During the past 12 months, did using methamphetamine cause you to give
up or spend less time doing these types of important activities?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME18 [IF MET12MON= 1] Sometimes people who use methamphetamine have
serious problems at home, work or school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using methamphetamine cause you to have
serious problems like this either at home, work, or school?

447
April 15, 2016

1
Yes
2
No
DK/REF
DRME19 [IF MET12MON= 1] During the past 12 months, did you regularly use
methamphetamine and then do something where using methamphetamine
might have put you in physical danger?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME20 [IF MET12MON= 1] During the past 12 months, did using
methamphetamine cause you to do things that repeatedly got you in trouble
with the law?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME21 [IF MET12MON= 1] During the past 12 months, did you have any problems
with family or friends that were probably caused by your use of
methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRME22 [IF DRME21 = 1] Did you continue to use methamphetamine even though
you thought it caused problems with family or friends?
1
Yes
2
No
DK/REF
DRPR

[IF PAI12MON = 1] Think about your use of prescription pain relievers
during the past 12 months as you answer these next questions. Remember, we
are only interested in prescription pain relievers that you used in any way a
doctor did not direct you to.
Earlier the computer recorded that in the past 12 months you used [IF
PRMISCOUNT=1 FILL PRFILL2][IF PRMISCOUNT>=2 FILL WITH “the

448
April 15, 2016

pain relievers listed below” ] in a way a doctor did not direct you to use
[PRNUMFILL].
[IF PRMISCOUNT>=2 FILL WITH DRUG NAMES FROM PRY01-PRY36
BELOW. USE MULTIPLE COLUMNS AS NEEDED. IF PRYOTH = 1,
ADD "Some other prescription pain reliever".]
The next questions refer to [IF PRYOTH NE 1 AND PRMISCOUNT=1 FILL
PRFILL2 as a prescription pain reliever; IF PRYOTH = 1 AND
PRMISCOUNT=1 FILL WITH “this other prescription pain reliever”; IF
PRMISCOUNT>=2 FILL WITH “these as prescription pain relievers”].
Press [ENTER] to continue.

DRPR01 [IF PAI12MON = 1] During the past 12 months, was there a month or more
when you spent a lot of your time getting or using prescription pain
relievers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR02 [IF DRPR01 = 2 OR DK/REF] During the past 12 months, was there a month
or more when you spent a lot of your time getting over the effects of the
prescription pain relievers you used?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR04 [IF PAI12MON = 1] During the past 12 months, did you try to set limits on
how often or how much prescription pain relievers you would use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR05 [IF DRPR04 = 1] Were you able to keep to the limits you set, or did you often
use prescription pain relievers more than you intended to?

449
April 15, 2016

1
Usually kept to the limits set
2
Often used more than intended
DK/REF
DRPR06 [IF PAI12MON = 1] During the past 12 months, did you need to use more
prescription pain relievers than you used to in order to get the effect you
wanted?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR07 [IF DRPR06=2 OR DK/REF] During the past 12 months, did you notice that
using the same amount of prescription pain relievers had less effect on you
than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR08 [IF PAI12MON = 1] During the past 12 months, did you want to or try to cut
down or stop using prescription pain relievers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR09 [IF DRPR08 = 1] During the past 12 months, were you able to cut down or
stop using prescription pain relievers every time you wanted to or tried to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR10 [IF DRPR08 = 2 OR DK/REF OR DRPR09 = 2 OR DK/REF] During the past
12 months, did you cut down or stop using prescription pain relievers at
least one time?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

450
April 15, 2016

DRPR11 [IF DRPR09 = 1 OR DRPR10 = 1] Please look at the symptoms listed
below. During the past 12 months, did you have 3 or more of these
symptoms after you cut back or stopped using prescription pain relievers?
•
•
•
•
•
•
•
•
•

Feeling kind of blue or down
Vomiting or feeling nauseous
Having cramps or muscle aches
Having teary eyes or a runny nose
Feeling sweaty, having enlarged eye pupils, or having body hair
standing up on your skin
Having diarrhea
Yawning
Having a fever
Having trouble sleeping

1
Yes
2
No
DK/REF
DRPR12 [IF DRPR11 = 1] Please look at the symptoms listed below. During the past
12 months, did you have 3 or more of these symptoms at the same time that
lasted for longer than a day after you cut back or stopped using prescription
pain relievers?
•
•
•
•
•
•
•
•
•

Feeling kind of blue or down
Vomiting or feeling nauseous
Having cramps or muscle aches
Having teary eyes or a runny nose
Feeling sweaty, having enlarged eye pupils, or having body hair
standing up on your skin
Having diarrhea
Yawning
Having a fever
Having trouble sleeping

1
Yes
2
No
DK/REF
DRPR13 [IF PAI12MON = 1] During the past 12 months, did you have any problems
with your emotions, nerves, or mental health that were probably caused or
made worse by your use of prescription pain relievers?
1
2

Yes
No

451
April 15, 2016

DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR14 [IF DRPR13 = 1] Did you continue to use prescription pain relievers even
though you thought this was causing you to have problems with your
emotions, nerves, or mental health?
1
Yes
2
No
DK/REF
DRPR15 [IF DRPR13 = 2 OR DK/REF OR DRPR14 = 2 OR DK/REF] During the past
12 months, did you have any physical health problems that were probably
caused or made worse by your use of prescription pain relievers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR16 [IF DRPR15 = 1] Did you continue to use prescription pain relievers even
though you thought this was causing you to have physical problems?
1
Yes
2
No
DK/REF
DRPR17 [IF PAI12MON = 1] This question is about important activities such as
working, going to school, taking care of children, doing fun things such as
hobbies and sports, and spending time with friends and family.
During the past 12 months, did using prescription pain relievers cause you
to give up or spend less time doing these types of important activities?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR18 [IF PAI12MON = 1] Sometimes people who use prescription pain relievers
have serious problems at home, work or school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

452
April 15, 2016

During the past 12 months, did using prescription pain relievers cause you
to have serious problems like this either at home, work, or school?
1
Yes
2
No
DK/REF
DRPR19 [IF PAI12MON = 1] During the past 12 months, did you regularly use
prescription pain relievers and then do something where using prescription
pain relievers might have put you in physical danger?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR20 [IF PAI12MON = 1] During the past 12 months, did using prescription pain
relievers cause you to do things that repeatedly got you in trouble with the
law?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR21 [IF PAI12MON = 1] During the past 12 months, did you have any problems
with family or friends that were probably caused by your use of prescription
pain relievers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRPR22 [IF DRPR21 = 1] Did you continue to use prescription pain relievers even
though you thought this caused problems with family or friends?
1
Yes
2
No
DK/REF
DRTR

[IF TRA12MON = 1] Think about your use of prescription tranquilizers
during the past 12 months as you answer these next questions. Remember, we
are only interested in prescription tranquilizers that you used in any way a
doctor did not direct you to.

453
April 15, 2016

Earlier the computer recorded that in the past 12 months you used [IF
TRMISCOUNT=1 FILL TRFILL2][IF TRMISCOUNT>=2 FILL WITH “the
tranquilizers listed below” ] in a way a doctor did not direct you to use
[TRNUMFILL].
[IF TRMISCOUNT >=2 FILL WITH DRUG NAMES FROM TRY01TRY12 BELOW. USE MULTIPLE COLUMNS AS NEEDED. IF TRYOTH
= 1, ADD "Some other prescription tranquilizer".]
The next questions refer to [IF TRYOTH NE 1 AND TRMISCOUNT =1 FILL
TRFILL2 as a prescription tranquilizer; IF TRYOTH = 1 AND
TRMISCOUNT =1 FILL WITH “this other prescription tranquilizer”; IF
TRMISCOUNT >=2 FILL WITH “these as prescription tranquilizers”].
Press [ENTER] to continue.

DRTR01 [IF TRA12MON = 1] During the past 12 months, was there a month or more
when you spent a lot of your time getting or using prescription
tranquilizers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR02 [IF DRTR01 = 2 OR DK/REF] During the past 12 months, was there a month
or more when you spent a lot of your time getting over the effects of the
prescription tranquilizers you used?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR04 [IF TRA12MON = 1] During the past 12 months, did you try to set limits on
how often or how much prescription tranquilizers you would use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR05 [IF DRTR04 = 1] Were you able to keep to the limits you set, or did you often

454
April 15, 2016

use prescription tranquilizers more than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

DRTR06 [IF TRA12MON = 1] During the past 12 months, did you need to use more
prescription tranquilizers than you used to in order to get the effect you
wanted?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR07 [IF DRTR06=2 OR DK/REF] During the past 12 months, did you notice that
using the same amount of prescription tranquilizers had less effect on you
than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR08 [IF TRA12MON = 1] During the past 12 months, did you want to or try to
cut down or stop using prescription tranquilizers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR09 [IF DRTR08 = 1] During the past 12 months, were you able to cut down or
stop using prescription tranquilizers every time you wanted to or tried to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR13 [IF TRA12MON = 1] During the past 12 months, did you have any problems
with your emotions, nerves, or mental health that were probably caused or
made worse by your use of prescription tranquilizers?
1

Yes

455
April 15, 2016

2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR14 [IF DRTR13 = 1] Did you continue to use prescription tranquilizers even
though you thought this was causing you to have problems with your
emotions, nerves, or mental health?
1
Yes
2
No
DK/REF
DRTR15 [IF DRTR13 = 2 OR DK/REF OR DRTR14 = 2 OR DK/REF] During the past
12 months, did you have any physical health problems that were probably
caused or made worse by your use of prescription tranquilizers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR16 [IF DRTR15 = 1] Did you continue to use prescription tranquilizers even
though you thought this was causing you to have physical problems?
1
Yes
2
No
DK/REF
DRTR17 [IF TRA12MON = 1] This question is about important activities such as
working, going to school, taking care of children, doing fun things such as
hobbies and sports, and spending time with friends and family.
During the past 12 months, did using prescription tranquilizers cause you to
give up or spend less time doing these types of important activities?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR18 [IF TRA12MON = 1] Sometimes people who use prescription tranquilizers
have serious problems at home, work or school — such as:
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school

456
April 15, 2016

•

losing a job or dropping out of school

During the past 12 months, did using prescription tranquilizers cause you to
have serious problems like this either at home, work, or school?
1
Yes
2
No
DK/REF
DRTR19 [IF TRA12MON = 1] During the past 12 months, did you regularly use
prescription tranquilizers and then do something where using prescription
tranquilizers might have put you in physical danger?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR20 [IF TRA12MON = 1] During the past 12 months, did using prescription
tranquilizers cause you to do things that repeatedly got you in trouble with
the law?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR21 [IF TRA12MON = 1] During the past 12 months, did you have any problems
with family or friends that were probably caused by your use of prescription
tranquilizers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRTR22 [IF DRTR21 = 1] Did you continue to use prescription tranquilizers even
though you thought this caused problems with family or friends?
1
Yes
2
No
DK/REF
DRST

[IF ST12MON = 1] Think about your use of prescription stimulants during
the past 12 months as you answer these next questions. Remember, we are

457
April 15, 2016

only interested in prescription stimulants that you used in any way a doctor
did not direct you to.
Earlier the computer recorded that in the past 12 months you used [IF
STMISCOUNT =1 FILL STFILL2][IF STMISCOUNT >=2 FILL WITH “the
stimulants listed below” ] in a way a doctor did not direct you to use
[STNUMFILL].
[IF STMISCOUNT >=2 FILL WITH DRUG NAMES FROM STY01-STY26
BELOW. USE MULTIPLE COLUMNS AS NEEDED. IF STYOTH = 1,
ADD "Some other prescription stimulant".]
The next questions refer to [IF STYOTH NE 1 AND STMISCOUNT =1 FILL
STFILL2 as a prescription stimulant; IF STYOTH = 1 AND STMISCOUNT
=1 FILL WITH “this other prescription stimulant”; IF STMISCOUNT
>=2 FILL WITH “these as prescription stimulants”].
Press [ENTER] to continue.

DRST01 [IF STI12MON = 1] During the past 12 months, was there a month or more
when you spent a lot of your time getting or using prescription stimulants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST02 [IF DRST01 = 2 OR DK/REF] During the past 12 months, was there a month
or more when you spent a lot of your time getting over the effects of the
prescription stimulants you used?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST04 [IF STI12MON = 1] During the past 12 months, did you try to set limits on
how often or how much prescription stimulants you would use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

458
April 15, 2016

DRST05 [IF DRST04 = 1] Were you able to keep to the limits you set, or did you often
use prescription stimulants more than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF

DRST06 [IF STI12MON = 1] During the past 12 months, did you need to use more
prescription stimulants than you used to in order to get the effect you
wanted?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST07 [IF DRST06=2 OR DK/REF] During the past 12 months, did you notice that
using the same amount of prescription stimulants had less effect on you than
it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST08 [IF STI12MON = 1] During the past 12 months, did you want to or try to cut
down or stop using prescription stimulants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST09 [IF DRST08 = 1] During the past 12 months, were you able to cut down or
stop using prescription stimulants every time you wanted to or tried to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST10 [IF DRST08 = 2 OR DK/REF OR DRST09 = 2 OR DK/REF] During the past
12 months, did you cut down or stop using prescription stimulants at least
one time?

459
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST10a [IF DRST09 = 1 OR DRST10 = 1] During the past 12 months, have you felt
kind of blue or down when you cut down or stopped using prescription
stimulants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST11 [IF DRST10a = 1] Please look at the symptoms listed below. During the past
12 months, did you have 2 or more of these symptoms after you cut back or
stopped using prescription stimulants?
•
•
•
•
•

Feeling tired or exhausted
Having bad dreams
Having trouble sleeping or sleeping more than you normally do
Feeling hungry more often
Feeling either very slowed down or like you couldn’t sit still

1
Yes
2
No
DK/REF
DRST12 [IF DRST11 = 1] Please look at the symptoms listed below. During the past
12 months, did you have 2 or more of these symptoms at the same time that
lasted for longer than a day after you cut back or stopped using prescription
stimulants?
•
•
•
•
•

Feeling tired or exhausted
Having bad dreams
Having trouble sleeping or sleeping more than you normally do
Feeling hungry more often
Feeling either very slowed down or like you couldn’t sit still

1
Yes
2
No
DK/REF
DRST13 [IF STI12MON = 1] During the past 12 months, did you have any problems
with your emotions, nerves, or mental health that were probably caused or

460
April 15, 2016

made worse by your use of prescription stimulants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST14 [IF DRST13 = 1] Did you continue to use prescription stimulants even
though you thought this was causing you to have problems with your
emotions, nerves, or mental health?
1
Yes
2
No
DK/REF

DRST15 [IF DRST13 = 2 OR DK/REF OR DRST14 = 2 OR DK/REF] During the past
12 months, did you have any physical health problems that were probably
caused or made worse by your use of prescription stimulants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST16 [IF DRST15 = 1] Did you continue to use prescription stimulants even
though this was causing you to have physical problems?
1
Yes
2
No
DK/REF
DRST17 [IF STI12MON = 1] This question is about important activities such as
working, going to school, taking care of children, doing fun things such as
hobbies and sports, and spending time with friends and family.
During the past 12 months, did using prescription stimulants cause you to
give up or spend less time doing these types of important activities?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST18 [IF STI12MON = 1] Sometimes people who use prescription stimulants

461
April 15, 2016

have serious problems at home, work or school — such as:
•
•
•
•

neglecting their children
missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using prescription stimulants cause you to
have serious problems like this either at home, work, or school?
1
Yes
2
No
DK/REF
DRST19 [IF STI12MON = 1] During the past 12 months, did you regularly use
prescription stimulants and then do something where using prescription
stimulants might have put you in physical danger?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST20 [IF STI12MON = 1] During the past 12 months, did using prescription
stimulants cause you to do things that repeatedly got you in trouble with the
law?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST21 [IF STI12MON = 1] During the past 12 months, did you have any problems
with family or friends that were probably caused by your use of prescription
stimulants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRST22 [IF DRST21 = 1] Did you continue to use prescription stimulants even
though you thought this caused problems with family or friends?
1
2

Yes
No

462
April 15, 2016

DK/REF
DRSV

[IF SV12MON = 1] Think about your use of prescription sedatives during the
past 12 months as you answer these next questions. Remember, we are only
interested in prescription sedatives that you used in any way a doctor did not
direct you to.
Earlier the computer recorded that in the past 12 months you used [IF
SVMISCOUNT =1 FILL SVFILL2][IF SVMISCOUNT >=2 FILL WITH “the
sedatives listed below” ] in a way a doctor did not direct you to use
[SVNUMFILL].
[IF SVMISCOUNT >= 2 FILL WITH DRUG NAMES FROM SVY01SVY14 BELOW. USE MULTIPLE COLUMNS AS NEEDED. IF SVYOTH
= 1, ADD "Some other prescription sedative".]
The next questions refer to [IF SVYOTH NE 1 AND SVMISCOUNT =1 FILL
SVFILL2 as a prescription sedative; IF SVYOTH = 1 AND SVMISCOUNT
=1 FILL WITH “this other prescription sedative”; IF SVMISCOUNT
>=2 FILL WITH “these as prescription sedatives”].
Press [ENTER] to continue.

DRSV01 [IF SED12MON = 1] During the past 12 months, was there a month or more
when you spent a lot of your time getting or using prescription sedatives?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV02 [IF DRSV01 = 2 OR DK/REF] During the past 12 months, was there a month
or more when you spent a lot of your time getting over the effects of the
prescription sedatives you used?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV04 [IF SED12MON = 1] During the past 12 months, did you try to set limits on
how often or how much prescription sedatives you would use?

463
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV05 [IF DRSV04 = 1] Were you able to keep to the limits you set, or did you often
use prescription sedatives more than you intended to?
1
Usually kept to the limits set
2
Often used more than intended
DK/REF
DRSV06 [IF SED12MON = 1] During the past 12 months, did you need to use more
prescription sedatives than you used to in order to get the effect you wanted?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV07 [IF DRSV06=2 OR DK/REF] During the past 12 months, did you notice that
using the same amount of prescription sedatives had less effect on you than
it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV08 [IF SED12MON = 1] During the past 12 months, did you want to or try to
cut down or stop using prescription sedatives?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV09 [IF DRSV08 = 1] During the past 12 months, were you able to cut down or
stop using prescription sedatives every time you wanted to or tried to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV10 [IF DRSV08 = 2 OR DK/REF OR DRSV09 = 2 OR DK/REF] During the past

464
April 15, 2016

12 months, did you cut down or stop using prescription sedatives at least
one time?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV11 [IF DRSV09 = 1 OR DRSV10 = 1] Please look at the symptoms listed below.
During the past 12 months, did you have 2 or more of these symptoms after
you cut back or stopped using prescription sedatives?
•
•
•
•
•
•
•
•

Sweating or feeling that your heart was beating fast
Having your hands tremble
Having trouble sleeping or sleeping more than you normally do
Vomiting or feeling nauseous
Seeing, hearing, or feeling things that weren’t really there
Feeling like you couldn’t sit still
Feeling anxious
Having seizures or fits

1
Yes
2
No
DK/REF
DRSV12 [IF DRSV11 = 1] Please look at the symptoms listed below. During the past
12 months, did you have 2 or more of these symptoms at the same time that
lasted for longer than a day after you cut back or stopped using prescription
sedatives?
•
•
•
•
•
•
•
•

Sweating or feeling that your heart was beating fast
Having your hands tremble
Having trouble sleeping or sleeping more than you normally do
Vomiting or feeling nauseous
Seeing, hearing, or feeling things that weren’t really there
Feeling like you couldn’t sit still
Feeling anxious
Having seizures or fits

1
Yes
2
No
DK/REF
DRSV13 [IF SED12MON = 1] During the past 12 months, did you have any problems
with your emotions, nerves, or mental health that were probably caused or
made worse by your use of prescription sedatives?

465
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV14 [IF DRSV13 = 1] Did you continue to use prescription sedatives even
though you thought this was causing you to have problems with your
emotions, nerves, or mental health?
1
Yes
2
No
DK/REF
DRSV15 [IF DRSV13 = 2 OR DK/REF OR DRSV14 = 2 OR DK/REF] During the past
12 months, did you have any physical health problems that were probably
caused or made worse by your use of prescription sedatives?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV16 [IF DRSV15 = 1] Did you continue to use prescription sedatives even
though you thought this was causing you to have physical problems?
1
Yes
2
No
DK/REF

DRSV17 [IF SED12MON = 1] This question is about important activities such as
working, going to school, taking care of children, doing fun things such as
hobbies and sports, and spending time with friends and family.
During the past 12 months, did using prescription sedatives cause you to
give up or spend less time doing these types of important activities?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV18 [IF SED12MON = 1] Sometimes people who use prescription sedatives have
serious problems at home, work or school — such as:
•

neglecting their children

466
April 15, 2016

•
•
•

missing work or school
doing a poor job at work or school
losing a job or dropping out of school

During the past 12 months, did using prescription sedatives cause you to
have serious problems like this either at home, work, or school?
1
Yes
2
No
DK/REF

DRSV19 [IF SED12MON = 1] During the past 12 months, did you regularly use
prescription sedatives and then do something where using prescription
sedatives might have put you in physical danger?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV20 [IF SED12MON = 1] During the past 12 months, did using prescription
sedatives cause you to do things that repeatedly got you in trouble with the
law?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV21 [IF SED12MON = 1] During the past 12 months, did you have any problems
with family or friends that were probably caused by your use of prescription
sedatives?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DRSV22 [IF DRSV21 = 1] Did you continue to use prescription sedatives even
though you thought this caused problems with family or friends?
1
Yes
2
No
DK/REF

467
April 15, 2016

468
April 15, 2016

Special Topics
INTROSP

The next questions are about encounters with the police or the court
system.
Press [ENTER] to continue.

SP01 Not counting minor traffic violations, have you ever been arrested and booked for
breaking the law?
Being ‘booked’ means that you were taken into custody and processed by the
police or by someone connected with the courts, even if you were then released.
1
Yes
2
No
DK/REF
SP02 [IF SP01 = 1] Not counting minor traffic violations, how many times during the
past 12 months have you been arrested and booked for breaking a law?
__________ [RANGE: 0 - 99]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
INTROBK [IF SP02 = 1 - 99 OR DK/REF] The next questions are about offenses that
are against the law. As you read each question, please answer whether you
were arrested and booked for that offense during the past 12 months.
Press [ENTER] to continue.
SP03a [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for motor vehicle theft?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03b [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for larceny or theft? [IF SP03a = 1 OR DK/REF] Do not include motor
vehicle theft.
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

469
April 15, 2016

SP03c [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for burglary or breaking and entering?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03d [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for aggravated assault?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03e [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for other assault, such as simple assault or battery?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03f [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for robbery?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03g [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for forcible rape?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03h [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for murder, homicide, or nonnegligent manslaughter?
1
Yes
2
No
DK/REF

470
April 15, 2016

PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03i [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for arson?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03j [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for driving under the influence of alcohol or drugs?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03k [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for drunkenness or other liquor law violations?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03l [IF SP02 = 1 - 99 OR DK/REF AND CURNTAGE = 12 - 17] In the past 12
months, were you arrested and booked for possession of tobacco?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03m
[IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested
and booked for possession, manufacture, or sale of drugs?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03n [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for prostitution or commercialized sex?
1

Yes

471
April 15, 2016

2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03o [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for any other sexual offense, not including rape or prostitution?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03p [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for fraud, possessing stolen goods, or vandalism?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03q [IF SP02 = 1 - 99 OR DK/REF] In the past 12 months, were you arrested and
booked for some other offense besides these that have been named? Please do
not include minor traffic violations.
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP03qsp [IF SP03q = 1] Please type one of the offenses for which you were arrested
and booked during the past 12 months. For this question, do not include
minor traffic violations. When you have finished, press the [ENTER] key to
go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN SP03qsp.
SP03r [IF SP02 = 1-99 AND ALL SP03a THROUGH SP03q = 2 OR DK/REF] The
computer recorded that you were arrested and booked for breaking a law (1
time/[SP02 FILL] times) during the past 12 months. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

472
April 15, 2016

SP03rsp [IF SP03r=4] Please type one of the offenses for which you were arrested and
booked during the past 12 months. For this question, do not include minor
traffic violations. When you have finished, press the [ENTER] key to go to
the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN SP03rsp.
SP03s [IF SP03r = 6 or DK/REF] Please answer this question again. Not counting minor
traffic violations, how many times during the past 12 months have you been
arrested and booked for breaking a law?
___________ [RANGE: 0-99]
DK/REF
SP03ssp

[IF SP03s = or > 1] Please type one of the offenses for which you were
arrested and booked during the past 12 months. For this question, do not
include minor traffic violations. When you have finished, press the [ENTER]
key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN SP03ssp.

SP04 Were you on probation at any time during the past 12 months?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP05 Were you on parole, supervised release, or other conditional release from
prison at any time during the past 12 months?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SP06a

[IF ALLAST3 = 1 OR 2 OR ALRECDK = 1 OR 2 OR ALRECRE = 1 OR
2] During the past 12 months, have you driven a vehicle while you were
under the influence of alcohol?
1 Yes
2 No
DK/REF

473
April 15, 2016

PROGRAMMER: SHOW 12 MONTH CALENDAR
SP06b

[IF MJLAST3 = 1 OR 2 OR MJRECDK = 1 OR 2 OR MJRECRE = 1 OR
2] During the past 12 months, have you driven a vehicle while you were
under the influence of marijuana?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SP06c

[IF COC12MON = 1 OR CRK12MON = 1] During the past 12 months,
have you driven a vehicle while you were under the influence of
[COKEFILL]?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SP06d

[IF HER12MON=1] During the past 12 months, have you driven a
vehicle while you were under the influence of heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SP06e

[IF HAL12MON=1] During the past 12 months, have you driven a
vehicle while you were under the influence of [LSFILL]?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SP06f

[IF INH12MON=1] During the past 12 months, have you driven a
vehicle while you were under the influence of any inhalant?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SP06g

[IF MET12MON=1] During the past 12 months, have you driven a
vehicle while you were under the influence of methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

474
April 15, 2016

SP06h

[IF SP06a=1 AND (SP06b OR SP06c OR SP06d OR SP06e OR SP06f
OR SP06g)=1] During the past 12 months, have you driven a vehicle
while you were under the influence of alcohol only?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SP07 What is the maximum legal penalty in [STATE FILL FROM FIPE4] for first
offense possession of an ounce or less of marijuana for your own use?
1
A fine
2
Probation
3
Community service
4
A possible prison sentence
5
A mandatory prison sentence
6
No penalty
DK/REF
SP08 [IF SP07 NE DK/REF]
[IF SP07 = 1-5] How sure are you that [FILL ANSWER FROM SP07] is the
maximum legal penalty for first offense possession of an ounce or less of
marijuana in [STATE FILL FROM FIPE4]?
[IF SP07 = 6] How sure are you that there is no legal penalty for first offense
possession of an ounce or less of marijuana in [STATE FILL FROM FIPE4]?
1
Very sure
2
Somewhat sure
3
Not at all sure
DK/REF
SP09 In [STATE FILL FROM FIPE4], has marijuana been legally approved for
medical use?
1
Yes
2
No
DK/REF

475
April 15, 2016

476
April 15, 2016

Prior Substance Use
LU01 [IF MJ01=1 OR MJREF = 1] Earlier questions were about the past 12 months.
This question is about the year before that, that is, from [DATEFILL - 12
MONTHS] to [DATEFILL]. During that year, beginning [DATEFILL - 12
MONTHS] and ending [DATEFILL], did you use marijuana or hashish, even
once?
1
Yes
2
No
DK/REF
LU02 [[IF ((MJLAST3=2 OR 3) OR (MJRECDK=2 OR 3) OR (MJRECRE=2 OR 3))
AND BL04 NE 2] The computer recorded that you last used marijuana or hashish
[MJREC FILL]. How old were you the last time you used marijuana or
hashish?
AGE:_____[RANGE: 1-110]
DK/REF
DEFINE AGELSTMJ:
IF LU02 NE (BLANK OR DK/REF) THEN AGELSTMJ = LU02
ELSE AGELSTMJ = BLANK
IF AGELSTMJ < AGE1STMJ OR AGELSTMJ < 10 OR IF CURNTAGE <
AGELSTMJ
LUCC01 The computer recorded that you were [AGELSTMJ] years old
when you last used marijuana or hashish. Is this correct?
4
Yes
6
No
DK/REF
LUCC02 [IF LUCC01 = 6] Please answer this question again. Think
about the last time you used marijuana or hashish. How old
were you the last time you used marijuana or hashish?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC02 NOT (BLANK OR DK/REF) THEN AGELSTMJ = LUCC02
LU02a [IF LU02 NE DK/RE AND AGELSTMJ = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGELSTMJ = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last use marijuana or hashish in [CURRENT
YEAR - 1] or [CURRENT YEAR]?

477
April 15, 2016

1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LU02b [IF AGELSTMJ = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last use marijuana or hashish in [CURRENT YEAR - 2] or [CURRENT
YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU02c [IF LU02 NE DK/RE AND AGELSTMJ = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last use
marijuana or hashish?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU02c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU02d [IF LU02a = 1 - 2 OR LU02b = 1 - 2] In what month in [YEAR FROM LU02a
or LU02b] did you last use marijuana or hashish?
1
2
3
4
5
6
7

January
February
March
April
May
June
July

478
April 15, 2016

8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU02d > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTMJ:
MYRLSTMJ = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU02a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTMJ IS
BLANK.
IF MYRLSTMJ NE 0 AND NE AGELSTMJ:
LUMJ05 The computer recorded that you last used marijuana or
hashish in [LU02a-d fill]. That would make you
[MYRLSTMJ] years old when you last used marijuana or
hashish. Is this correct?
4
Yes
6
No
DK/REF
LUMJ06 [IF LUMJ05 = 4] Earlier, the computer recorded that you
were [AGELSTMJ] years old when you last used marijuana or
hashish. Which answer is correct?
1

I last used marijuana or hashish in [LU02a-d fill] when
I was [MYRLSTMJ] years old
2
I was [AGELSTMJ] years old the last time I used
marijuana or hashish
3
Neither answer is correct
DK/REF
UPDATE: IF LUMJ06 = 1, THEN AGELSTMJ = MYRLSTMJ
LUMJ07 [IF LUMJ06=2 OR LUMJ06=3 OR LUMJ05 = 6] Please
answer this question again. Did you last use marijuana or
hashish in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?

479
April 15, 2016

1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LUMJ07a [IF LUMJ07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LUMJ07] did you last use
marijuana or hashish?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LUMJ07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUMJ07a NE (0 OR DK/RE) THEN UPDATE MYRLSTMJ.
MYRLSTMJ = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF LAST USE (LUMJ07 AND LUMJ07a).
IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTMJ IS BLANK. IF
MYRLSTMJ = AGELSTMJ THEN MYRLSTMJ = BLANK
LUMJ08 [IF LUMJ06 NE 1 AND MYRLSTMJ NE 0 AND (LUMJ07
AND LUMJ07a NE LU02a-d)] The computer recorded that
you last used marijuana or hashish in [LUMJ07- LUMJ07a
fill]. That would make you [MYRLSTMJ] years old when you
last used marijuana or hashish. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF LUMJ08 NE (6, BLANK OR DK/REF) AND (LUMJ07 AND LUMJ07a
NE LU02a-d) THEN AGELSTMJ = MYRLSTMJ

480
April 15, 2016

LU03 [IF (CG06=1, 2 OR 3) OR (CG06DK=1, 2 OR 3) OR (CG06RE=1, 2 OR 3) AND
CG15 NE 1] This question is about your cigarette smoking history.
[IF (CG06=1, 2 OR 3) OR (CG06DK=1, 2 OR 3) OR (CG06RE=1, 2 OR 3) AND
CG15=1] These next two questions are about your cigarette smoking history.
[IF (CG06=1, 2 OR 3) OR (CG06DK=1, 2 OR 3) OR (CG06RE=1, 2 OR 3)]
Earlier the computer recorded that you last smoked part or all of a cigarette
[CG06]. How old were you the last time you smoked part or all of a cigarette?
AGE:_____[RANGE: 1-110]
DK/REF
DEFINE AGELSTCG:
IF LU03 NE (BLANK OR DK/REF) THEN AGELSTCG = LU03
ELSE AGELSTCG = BLANK
IF AGELSTCG < AGE1STCG OR AGELSTCG < 10 OR IF CURNTAGE <
AGELSTCG
LUCC05 The computer recorded that you were [AGELSTCG] years old
when you last smoked part or all of a cigarette. Is this correct?
4
Yes
6
No
DK/REF
LUCC06 [IF LUCC05 = 6] Please answer this question again. Think
about the last time you smoked part or all of a cigarette. How
old were you the last time you smoked part or all of a
cigarette?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC06 NOT (BLANK OR DK/REF) THEN AGELSTCG = LUCC06
LU03a [IF LU03 NE DK/RE AND AGELSTCG = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGELSTCG = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last smoke part or all of a cigarette in
[CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

481
April 15, 2016

LU03b [IF AGELSTCG = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last smoke part or all of a cigarette in [CURRENT YEAR - 2] or
[CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU03c [IF LU03 NE DK/RE AND AGELSTCG = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last
smoke part or all of a cigarette?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU03c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU03d [IF LU03a = 1 - 2 OR LU03b = 1 - 2] In what month in [YEAR FROM LU03a
or LU03b] did you last smoke part or all of a cigarette?
1
2
3
4
5
6
7
8
9
10
11
12

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

482
April 15, 2016

DK/REF
HARD ERROR: [IF LU03d > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTCG:
MYRLSTCG = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU03a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCG IS
BLANK.
IF MYRLSTCG NE 0 AND NE AGELSTCG:
LUCG05 The computer recorded that you last smoked part or all of a
cigarette in [LU03a-d fill]. That would make you
[MYRLSTCG] years old when you last smoked part or all of a
cigarette. Is this correct?
4
Yes
6
No
DK/REF
LUCG06 [IF LUCG05 = 4] Earlier, the computer recorded that you
were [AGELSTCG] years old when you last smoked part or all
of a cigarette. Which answer is correct?
1

I last smoked part or all of a cigarette in [LU03a-d fill]
when I was [MYRLSTCG] years old
2
I was [AGELSTCG] years old the last time I smoked
part or all of a cigarette
3
Neither answer is correct
DK/REF
UPDATE: IF LUCG06 = 1, THEN AGELSTCG = MYRLSTCG
LUCG07 [IF LUCG06=2 OR LUCG06=3 OR LUCG05 = 6] Please
answer this question again. Did you last smoke part or all of a
cigarette in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

483
April 15, 2016

LUCG07a [IF LUCG07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LUCG07] did you last
smoke part or all of a cigarette?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LUCG07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUCG07a NE (0 OR DK/RE) THEN UPDATE MYRLSTCG.
MYRLSTCG = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF LAST USE (LUCG07 AND LUCG07a).
IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCG IS BLANK.
IF MYRLSTCG = AGELSTCG THEN MYRLSTCG = BLANK
LUCG08 [IF LUCG06 NE 1 AND MYRLSTCG NE 0 AND (LUCG07
AND LUCG07a NE LU03a-d)] The computer recorded that
you last smoked part or all of a cigarette in [LUCG07LUCG07a fill]. That would make you [MYRLSTCG] years old
when you last smoked part or all of a cigarette. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF LUCG08 NE (6, BLANK OR DK/REF) AND (LUCG07 AND LUCG07a
NE LU03a-d) THEN AGELSTCG = MYRLSTCG
LU04 [IF CG15=1] Earlier the computer also recorded that there was a period in your
life when you smoked cigarettes every day for at least 30 days. How old were
you when you last smoked cigarettes daily?

484
April 15, 2016

AGE:_____[RANGE: 1-110]
DK/REF
DEFINE LST30DCG:
IF LU04 NE (BLANK OR DK/REF) THEN LST30DCG = LU04
ELSE LST30DCG = BLANK
IF LST30DCG < DAILYCIG OR LST30DCG < 10 OR IF CURNTAGE <
LST30DCG
LUCC09 The computer recorded that you were [LST30DCG] years old
when you last smoked cigarettes daily. Is this correct?
4
Yes
6
No
DK/REF
LUCC10 [IF LUCC09 = 6] Please answer this question again. How
old were you when you last smoked cigarettes daily?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC10 NOT (BLANK OR DK/REF) THEN LST30DCG = LUCC10
LU04a [IF LU04 NE DK/RE AND LST30DCG = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF LST30DCG = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last smoke cigarettes daily in [CURRENT
YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LU04b [IF LST30DCG = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last smoke cigarettes daily in [CURRENT YEAR - 2] or [CURRENT
YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU04c [IF LU04 NE DK/RE AND LST30DCG = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last
smoke cigarettes daily?
1

January

485
April 15, 2016

2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU04c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU04d [IF LU04a = 1 - 2 OR LU04b = 1 - 2] In what month in [YEAR FROM
LU04a or LU04b] did you last smoke cigarettes daily?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU04d > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTDC:
MYRLSTDC = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU04a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTDC IS
BLANK.

486
April 15, 2016

IF MYRLSTDC NE 0 AND NE LST30DCG:
LUDC05 The computer recorded that you last smoked cigarettes daily in
[LU04a-d fill]. That would make you [MYRLSTDC] years old
when you last smoked cigarettes daily. Is this correct?
4
Yes
6
No
DK/REF
LUDC06 [IF LUDC05 = 4] Earlier, the computer recorded that you
were [LST30DCG] years old when you last smoked cigarettes
daily. Which answer is correct?
1

I last smoked cigarettes daily in [LU04a-d fill] when I
was [MYRLSTDC] years old
2
I was [LST30DCG] years old the last time I smoked
cigarettes daily
3
Neither answer is correct
DK/REF
UPDATE: IF LUDC06 = 1, THEN LST30DCG = MYRLSTDC
LUDC07 [IF LUDC06=2 OR LUDC06=3 OR LUDC05 = 6] Please
answer this question again. Did you last smoke cigarettes
daily in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LUDC07a [IF LUDC07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LUDC07] did you last
smoke cigarettes daily?
1
2
3
4
5
6
7
8
9
10

January
February
March
April
May
June
July
August
September
October

487
April 15, 2016

11
November
12
December
DK/REF
HARD ERROR: [IF LUDC07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUDC07a NE (0 OR DK/RE) THEN UPDATE MYRLSTDC.
MYRLSTDC = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF LAST USE (LUDC07 AND LUDC07a).
IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTDC IS BLANK.
IF MYRLSTDC = LST30DCG THEN MYRLSTDC = BLANK
LUDC08 [IF LUDC06 NE 1 AND MYRLSTDC NE 0 AND (LUDC07
AND LUDC07a NE LU04a-d)] The computer recorded that
you last smoked cigarettes daily in [LUDC07 - LUDC07a fill].
That would make you [MYRLSTDC] years old when you last
smoked cigarettes daily. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF LUDC08 NE (6, BLANK OR DK/REF) AND (LUDC07 AND LUDC07a
NE LU04a-d) THEN LST30DCG = MYRLSTDC
LU05 [IF (CG28=1, 2 OR 3) OR (CG28DK=1, 2 OR 3) OR (CG28RE = 1, 2 OR 3)]
The computer recorded that you last used “smokeless” tobacco [CGSNREC
FILL]. How old were you the last time you used “smokeless” tobacco?
AGE:_____[RANGE: 1-110]
DK/REF
DEFINE AGELSTSN:
IF LU05 NE (BLANK OR DK/REF) THEN AGELSTSN = LU05
ELSE AGELSTSN = BLANK
IF AGELSTSN < SNUFFAGE OR AGELSTSN < 10 OR IF CURNTAGE <
AGELSTSN
LUCC11 The computer recorded that you were [AGELSTSN] years old
when you last used “smokeless” tobacco. Is this correct?
4
6

Yes
No

488
April 15, 2016

DK/REF
LUCC12 [IF LUCC11 = 6] Please answer this question again. Think
about the last time you used “smokeless” tobacco. How old
were you the last time you used “smokeless” tobacco?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC12 NOT (BLANK OR DK/REF) THEN AGELSTSN = LUCC12
LU05a [IF LU05 NE DK/RE AND AGELSTSN = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGELSTSN = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last use “smokeless” tobacco in [CURRENT
YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LU05b [IF AGELSTSN = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last use “smokeless” tobacco in [CURRENT YEAR - 2] or [CURRENT
YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU05c [IF LU05 NE DK/RE AND AGELSTSN = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last use
“smokeless” tobacco?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF

489
April 15, 2016

HARD ERROR: [IF LU05c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU05d [IF LU05a = 1 - 2 OR LU05b = 1 - 2] In what month in [YEAR FROM LU05a
or LU05b] did you last use “smokeless” tobacco?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU05d > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTSN:
MYRLSTSN = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU05a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTSN IS
BLANK.
IF MYRLSTSN NE 0 AND NE AGELSTSN:
LUSN05 The computer recorded that you last used “smokeless” tobacco
in [LU05a-d fill]. That would make you [MYRLSTSN] years
old when you last used “smokeless” tobacco. Is this correct?
4
Yes
6
No
DK/REF
LUSN06

[IF LUSN05 = 4] Earlier, the computer recorded that you
were [AGELSTSN] years old when you last used “smokeless”
tobacco. Which answer is correct?

490
April 15, 2016

1

I last used “smokeless” tobacco in [LU05a-d fill] when
I was [MYRLSTSN] years old
2
I was [AGELSTSN] years old the last time I used
“smokeless” tobacco
3
Neither answer is correct
DK/REF

UPDATE: IF LUSN06 = 1, THEN AGELSTSN = MYRLSTSN
LUSN07

[IF LUSN06=2 OR LUSN06=3 OR LUSN05 = 6] Please
answer this question again. Did you last use “smokeless”
tobacco in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUSN07a [IF LUSN07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LUSN07] did you last use
“smokeless” tobacco?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LUSN07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUSN07a NE (0 OR DK/RE) THEN UPDATE MYRLSTSN.
MYRLSTSN = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF LAST USE (LUSN07 AND LUSN07a).
IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTSN IS BLANK. IF

491
April 15, 2016

MYRLSTSN = AGELSTSN THEN MYRLSTSN = BLANK
LUSN08

[IF LUSN06 NE 1 AND MYRLSTSN NE 0 AND (LUSN07 AND
LUSN07a NE LU05a-d)] The computer recorded that you last
used “smokeless” tobacco in [LUSN07 - LUSN07a fill]. That
would make you [MYRLSTSN] years old when you last used
“smokeless” tobacco. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUSN08 NE (6, BLANK OR DK/REF) AND (LUSN07 AND LUSN07a
NE LU05a-d) THEN AGELSTSN = MYRLSTSN

LU07 [IF (CG37=1, 2 OR 3) OR (CG37DK=1, 2 OR 3) OR (CG37RE = 1, 2 OR 3)]
The computer recorded that you last smoked part or all of a cigar [CG37REC
FILL]. How old were you the last time you smoked part or all of a cigar?
AGE:_____[RANGE: 1-110]
DK/REF
DEFINE AGELSTCR:
IF LU07 NE (BLANK OR DK/REF) THEN AGELSTCR = LU07
ELSE AGELSTCR = BLANK
IF AGELSTCR < CIGARAGE OR AGELSTCR < 10 OR IF CURNTAGE <
AGELSTCR
LUCC15 The computer recorded that you were [AGELSTCR] years old
when you last smoked part or all of a cigar. Is this correct?
4
Yes
6
No
DK/REF
LUCC16 [IF LUCC15 = 6] Please answer this question again. Think
about the last time you smoked part or all of a cigar. How old
were you the last time you smoked part or all of a cigar?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC16 NOT (BLANK OR DK/REF) THEN AGELSTCR = LUCC16
LU07a [IF LU07 NE DK AND AGELSTCR = CURNTAGE AND DATE OF

492
April 15, 2016

INTERVIEW < DOB OR IF AGELSTCR = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last smoke part or all of a cigar in [CURRENT
YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LU07b [IF AGELSTCR = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last smoke part or all of a cigar in [CURRENT YEAR - 2] or [CURRENT
YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU07c [IF LU07 NE DK/RE AND AGELSTCR = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last
smoke part or all of a cigar?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU07c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU07d [IF LU07a = 1 - 2 OR LU07b = 1 - 2] In what month in [YEAR FROM LU07a
or LU07b] did you last smoke part or all of a cigar?
1
2
3
4

January
February
March
April

493
April 15, 2016

5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU07d > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTCR:
MYRLSTCR = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU07a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCR IS
BLANK.
IF MYRLSTCR NE 0 AND NE AGELSTCR:
LUCR05 The computer recorded that you last smoked part or all of a
cigar in [LU07a-d fill]. That would make you [MYRLSTCR]
years old when you last smoked part or all of a cigar. Is this
correct?
4
Yes
6
No
DK/REF
LUCR06 [IF LUCR05 = 4] Earlier, the computer recorded that you
were [AGELSTCR] years old when you last smoked part or all
of a cigar. Which answer is correct?
1

I last smoked part or all of a cigar in [LU07a-d fill]
when I was [MYRLSTCR] years old
2
I was [AGELSTCR] years old the last time I smoked
part or all of a cigar
3
Neither answer is correct
DK/REF
UPDATE: IF LUCR06 = 1, THEN AGELSTCR = MYRLSTCR
LUCR07 [IF LUCR06=2 OR LUCR06=3 OR LUCR05 = 6] Please
answer this question again. Did you last smoke part or all of a

494
April 15, 2016

cigar in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LUCR07a [IF LUCR07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LUCR07] did you last
smoke part or all of a cigar?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LUCR07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUCR07a NE (0 OR DK/RE) THEN UPDATE MYRLSTCR.
MYRLSTCR = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF LAST USE (LUCR07 AND LUCR07a).
IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCR IS BLANK.
IF MYRLSTCR = AGELSTCR THEN MYRLSTCR = BLANK
LUCR08 [IF LUCR06 NE 1 AND MYRLSTCR NE 0 AND (LUCR07
AND LUCR07a NE LU07a-d)] The computer recorded that
you last smoked part or all of a cigar in [LUCR07 - LUCR07a
fill]. That would make you [MYRLSTCR] years old when you
last smoked part or all of a cigar. Is this correct?
4
Yes
6
No
DK/REF

495
April 15, 2016

UPDATE: IF LUCR08 NE (6, BLANK OR DK/REF) AND (LUCR07 AND LUCR07a
NE LU07a-d) THEN AGELSTCR = MYRLSTCR
LU08 IF (ALLAST3=2 OR 3) OR (ALRECDK=2 OR 3) OR (ALRECRE = 2 OR 3)]
The computer recorded that you last drank an alcoholic beverage [ALLREC
FILL]. How old were you the last time you drank an alcoholic beverage?
AGE:_____[RANGE: 1-110]
DK/REF
DEFINE AGELSTAL:
IF LU08 NE (BLANK OR DK/REF) THEN AGELSTAL = LU08
ELSE AGELSTAL = BLANK
IF AGELSTAL < AGE1STAL OR AGELSTAL < 10 OR IF CURNTAGE <
AGELSTAL
LUCC17 The computer recorded that you were [AGELSTAL] years old
when you last drank an alcoholic beverage. Is this correct?
4
Yes
6
No
DK/REF
LUCC18 [IF LUCC17 = 6] Please answer this question again. Think
about the last time you drank an alcoholic beverage. How old
were you the last time you drank an alcoholic beverage?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC18 NOT (BLANK OR DK/REF) THEN AGELSTAL = LUCC18
LU08a [IF LU08 NE DK/RE AND AGELSTAL = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGELSTAL = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last drink an alcoholic beverage in [CURRENT
YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LU08b [IF AGELSTAL = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last drink an alcoholic beverage in [CURRENT YEAR - 2] or [CURRENT
YEAR - 1]?

496
April 15, 2016

1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU08c [IF LU08 NE DK/RE AND AGELSTAL = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last drink
an alcoholic beverage?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU08c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU08d

[IF LU08a = 1 - 2 OR LU08b = 1 - 2] In what month in [YEAR FROM
LU08a or LU08b] did you last drink an alcoholic beverage?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF

HARD ERROR : [IF LU08d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS

497
April 15, 2016

BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTAL:
MYRLSTAL = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU08a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTAL IS
BLANK.
IF MYRLSTAL NE 0 AND NE AGELSTAL:
LUAL05 The computer recorded that you last drank an alcoholic
beverage in [LU08a-d fill]. That would make you
[MYRLSTAL] years old when you last drank an alcoholic
beverage. Is this correct?
4
Yes
6
No
DK/REF
LUAL06

[IF LUAL05 = 4] Earlier, the computer recorded that you
were [AGELSTAL] years old when you last drank an alcoholic
beverage. Which answer is correct?
1

I last drank an alcoholic beverage in [LU08a-d fill]
when I was [MYRLSTAL] years old
2
I was [AGELSTAL] years old the last time I drank an
alcoholic beverage
3
Neither answer is correct
DK/REF
UPDATE: IF LUAL06 = 1, THEN AGELSTAL = MYRLSTAL
LUAL07

[IF LUAL06=2 OR LUAL06=3 OR LUAL05 = 6] Please
answer this question again. Did you last drink an alcoholic
beverage in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUAL07a [IF LUAL07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LUAL07] did you last drink
an alcoholic beverage?

498
April 15, 2016

1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LUAL07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUAL07a NE (0 OR DK/RE) THEN UPDATE MYRLSTAL.
MYRLSTAL = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF LAST USE (LUAL07 AND LUAL07a).
IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTAL IS BLANK.
IF MYRLSTAL = AGELSTAL THEN MYRLSTAL = BLANK
LUAL08

[IF LUAL06 NE 1 AND MYRLSTAL NE 0 AND (LUAL07 AND
LUAL07a NE LU08a-d)] The computer recorded that you last
drank an alcoholic beverage in [LUAL07 - LUAL07a fill].
That would make you [MYRLSTAL] years old when you last
drank an alcoholic beverage. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUAL08 NE (6, BLANK OR DK/REF) AND (LUAL07 AND LUAL07a
NE LU08a-d) THEN AGELSTAL = MYRLSTAL
LU09 [IF (CCLAST3=2 OR 3) OR (CCRECDK=2 OR 3) OR (CCRECRE = 2 OR 3)]
The computer recorded that you last used cocaine [CCREC FILL]. How old
were you the last time you used cocaine?
AGE:_____[RANGE: 1-110]
DK/REF
DEFINE AGELSTCC:

499
April 15, 2016

IF LU09 NE (BLANK OR DK/REF) THEN AGELSTCC = LU09
ELSE AGELSTCC = BLANK
IF AGELSTCC < AGE1STCC OR AGELSTCC < 10 OR IF CURNTAGE <
AGELSTCC
LUCC19 The computer recorded that you were [AGELSTCC] years old
when you last used cocaine. Is this correct?
4
Yes
6
No
DK/REF
LUCC20 [IF LUCC19 = 6] Please answer this question again. Think
about the last time you used cocaine. How old were you the
last time you used cocaine?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC20 NOT (BLANK OR DK/REF) THEN AGELSTCC = LUCC20
LU09a [IF LU09 NE DK/RE AND AGELSTCC = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGELSTCC = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last use cocaine in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LU09b [IF AGELSTCC = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last use cocaine in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU09c [IF LU09 NE DK/RE AND AGELSTCC = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last use
cocaine?
1
2
3
4
5

January
February
March
April
May

500
April 15, 2016

6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU09c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU09d [IF LU09a = 1 - 2 OR LU09b = 1 - 2] In what month in [YEAR FROM LU09a
or LU09b] did you last use cocaine?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR : [IF LU09d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTCC:
MYRLSTCC = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU09a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCC IS
BLANK.
IF MYRLSTCC NE 0 AND NE AGELSTCC:
LUCN05 The computer recorded that you last used cocaine in [LU09a-d
fill]. That would make you [MYRLSTCC] years old when you
last used cocaine. Is this correct?

501
April 15, 2016

4
Yes
6
No
DK/REF
LUCN06 [IF LUCN05 = 4] Earlier, the computer recorded that you
were [AGELSTCC] years old when you last used cocaine.
Which answer is correct?
1

I last used cocaine in [LU09a-d fill] when I was
[MYRLSTCC] years old
2
I was [AGELSTCC] years old the last time I used
cocaine
3
Neither answer is correct
DK/REF
UPDATE: IF LUCN06 = 1, THEN AGELSTCC = MYRLSTCC
LUCN07 [IF LUCN06=2 OR LUCN06=3 OR LUCN05 = 6] Please
answer this question again. Did you last use cocaine in
[CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LUCN07a [IF LUCN07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LUCN07] did you last use
cocaine?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF

502
April 15, 2016

HARD ERROR: [IF LUCN07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUCN07a NE (0 OR DK/RE) THEN UPDATE MYRLSTCC.
MYRLSTCC = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF LAST USE (LUCN07 AND LUCN07a).
IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCC IS BLANK.
IF MYRLSTCC = AGELSTCC THEN MYRLSTCC = BLANK
LUCN08 [IF LUCN06 NE 1 AND MYRLSTCC NE 0 AND (LUCN07
AND LUCN07a NE LU09a-d)] The computer recorded that
you last used cocaine in [LUCN07 - LUCN07a fill]. That
would make you [MYRLSTCC] years old when you last used
cocaine. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF LUCN08 NE (6, BLANK OR DK/REF) AND (LUCN07 AND LUCN07a
NE LU09a-d) THEN AGELSTCC = MYRLSTCC
LU10 [IF (CKLAST3=2 OR 3) OR (CKRECDK=2 OR 3) OR (CKRECRE = 2 OR 3)]
The computer recorded that you last used ‘crack’ [CKREC FILL]. How old
were you the last time you used ‘crack’?
AGE:_____[RANGE: 1-110]
DK/REF
DEFINE AGELSTCK:
IF LU10 NE (BLANK OR DK/REF) THEN AGELSTCK = LU10
ELSE AGELSTCK = BLANK
IF AGELSTCK < AGE1STCK OR AGELSTCK < 10 OR IF CURNTAGE <
AGELSTCK
LUCC21 The computer recorded that you were [AGELSTCK] years old
when you last used ‘crack’. Is this correct?
4
Yes
6
No
DK/REF
LUCC22 [IF LUCC21 = 6] Please answer this question again. Think
about the last time you used ‘crack’. How old were you the

503
April 15, 2016

last time you used ‘crack’?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC22 NOT (BLANK OR DK/REF) THEN AGELSTCK = LUCC22
LU10a [IF LU10 NE DK/RE AND AGELSTCK = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGELSTCK = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last use ‘crack’ in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LU10b [IF AGELSTCK = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last use ‘crack’ in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU10c [IF LU10 NE DK/RE AND AGELSTCK = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last use
‘crack’?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU10c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.

504
April 15, 2016

LU10d [IF LU10a = 1 - 2 OR LU10b = 1 - 2] In what month in [YEAR FROM LU10a
or LU10b] did you last use ‘crack’?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR : [IF LU10d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTCK:
MYRLSTCK = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU10a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCK IS
BLANK.
IF MYRLSTCK NE 0 AND NE AGELSTCK:
LUCK05 The computer recorded that you last used ‘crack’ in [LU10a-d
fill]. That would make you [MYRLSTCK] years old when you
last used ‘crack’. Is this correct?
4
Yes
6
No
DK/REF
LUCK06 [IF LUCK05 = 4] Earlier, the computer recorded that you
were [AGELSTCK] years old when you last used ‘crack’.
Which answer is correct?
1
2
3

I last used ‘crack’ in [LU10a-d fill] when I was
[MYRLSTCK] years old
I was [AGELSTCK] years old the last time I used
‘crack’
Neither answer is correct

505
April 15, 2016

DK/REF
UPDATE: IF LUCK06 = 1, THEN AGELSTCK = MYRLSTCK
LUCK07 [IF LUCK06=2 OR LUCK06=3 OR LUCK05 = 6] Please
answer this question again. Did you last use ‘crack’ in
[CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LUCK07a [IF LUCK07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LUCK07] did you last use
‘crack’?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LUCK07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUCK07a NE (0 OR DK/RE) THEN UPDATE MYRLSTCK.
MYRLSTCK = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF LAST USE (LUCK07 AND LUCK07a).
IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTCK IS BLANK.
IF MYRLSTCK = AGELSTCK THEN MYRLSTCK = BLANK
LUCK08 [IF LUCK06 NE 1 AND MYRLSTCK NE 0 AND (LUCK07
AND LUCK07a NE LU10a-d)] The computer recorded that
you last used ‘crack’ in [LUCK07 - LUCK07a fill]. That

506
April 15, 2016

would make you [MYRLSTCK] years old when you last used
‘crack’. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF LUCK08 NE (6, BLANK OR DK/REF) AND (LUCK07 AND LUCK07a
NE LU10a-d) THEN AGELSTCK = MYRLSTCK
LU11 [IF (HELAST3=2 OR 3) OR (HERECDK=2 OR 3) OR (HERECRE = 2 OR 3)]
The computer recorded that you last used heroin [HEREC FILL]. How old were
you the last time you used heroin?
AGE:_____[RANGE: 1-110]
DK/REF
DEFINE AGELSTHE:
IF LU11 NE (BLANK OR DK/REF) THEN AGELSTHE = LU11
ELSE AGELSTHE = BLANK
IF AGELSTHE < AGE1STHR OR AGELSTHE < 10 OR IF CURNTAGE <
AGELSTHE
LUCC23 The computer recorded that you were [AGELSTHE] years old
when you last used heroin. Is this correct?
4
Yes
6
No
DK/REF
LUCC24 [IF LUCC23 = 6] Please answer this question again. Think
about the last time you used heroin. How old were you the last
time you used heroin?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC24 NOT (BLANK OR DK/REF) THEN AGELSTHE = LUCC24
LU11a [IF LU11 NE DK/RE AND AGELSTHE = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGELSTHE = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last use heroin in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
2

CURRENT YEAR - 1
CURRENT YEAR

507
April 15, 2016

DK/REF
LU11b [IF AGELSTHE = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last use heroin in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU11c [IF LU11 NE DK/RE AND AGELSTHE = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last use
heroin?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU11c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU11d [IF LU11a = 1 - 2 OR LU11b = 1 - 2] In what month in [YEAR FROM LU11a
or LU11b] did you last use heroin?
1
2
3
4
5
6
7
8
9
10
11

January
February
March
April
May
June
July
August
September
October
November

508
April 15, 2016

12
December
DK/REF
HARD ERROR : [IF LU11d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTHE:
MYRLSTHE = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU11a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTHE IS
BLANK.
IF MYRLSTHE NE 0 AND NE AGELSTHE:
LUHE05 The computer recorded that you last used heroin in [LU11a-d
fill]. That would make you [MYRLSTHE] years old when you
last used heroin. Is this correct?
4
Yes
6
No
DK/REF
LUHE06 [IF LUHE05 = 4] Earlier, the computer recorded that you
were [AGELSTHE] years old when you last used heroin.
Which answer is correct?
1

I last used heroin in [LU11a-d fill] when I was
[MYRLSTHE] years old
2
I was [AGELSTHE] years old the last time I used
heroin
3
Neither answer is correct
DK/REF
UPDATE: IF LUHE06 = 1, THEN AGELSTHE = MYRLSTHE
LUHE07 [IF LUHE06=2 OR LUHE06=3 OR LUHE05 = 6] Please
answer this question again. Did you last use heroin in
[CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

509
April 15, 2016

LUHE07a [IF LUHE07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LUHE07] did you last use
heroin?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LUHE07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUHE07a NE (0 OR DK/RE) THEN UPDATE MYRLSTHE.
MYRLSTHE = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF LAST USE (LUHE07 AND LUHE07a).
IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTHE IS BLANK.
IF MYRLSTHE = AGELSTHE THEN MYRLSTHE = BLANK
LUHE08 [IF LUHE06 NE 1 AND MYRLSTHE NE 0 AND (LUHE07
AND LUHE07a NE LU11a-d)] The computer recorded that
you last used heroin in [LUHE07 - LUHE07a fill]. That
would make you [MYRLSTHE] years old when you last used
heroin. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF LUHE08 NE (6, BLANK OR DK/REF) AND (LUHE07 AND LUHE07a
NE LU11a-d) THEN AGELSTHE = MYRLSTHE
LU12 [IF HALLREC=2 OR 3] The computer recorded that you last used [LSFILL]
[HALLREC FILL]. How old were you the last time you used [LSFILL]?
AGE:_____[RANGE: 1-110]

510
April 15, 2016

DK/REF
DEFINE AGELSTHA:
IF LU12 NE (BLANK OR DK/REF) THEN AGELSTHA = LU12
ELSE AGELSTHA = BLANK
IF AGELSTHA < AGE1STHA OR AGELSTHA < 10 OR IF CURNTAGE <
AGELSTHA
LUCC25 The computer recorded that you were [AGELSTHA] years old
when you last used [LSFILL]. Is this correct?
4
Yes
6
No
DK/REF
LUCC26 [IF LUCC25 = 6] Please answer this question again. Think
about the last time you used [LSFILL]. How old were you the
last time you used [LSFILL]?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC26 NOT (BLANK OR DK/REF) THEN AGELSTHA = LUCC26
LU12a [IF LU12 NE DK/RE AND AGELSTHA = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGELSTHA = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last use [LSFILL] in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LU12b [IF AGELSTHA = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last use [LSFILL] in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU12c [IF LU12 NE DK/RE AND AGELSTHA = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last use
[LSFILL]?
1
2

January
February

511
April 15, 2016

3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU12c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU12d [IF LU12a = 1 - 2 OR LU12b = 1 - 2] In what month in [YEAR FROM LU12a
or LU12b] did you last use [LSFILL]?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR : [IF LU12d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTHA:
MYRLSTHA = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU12a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTHA IS
BLANK.
IF MYRLSTHA NE 0 AND NE AGELSTHA:

512
April 15, 2016

LUHA05 The computer recorded that you last used [LSFILL] in
[LU12a-d fill]. That would make you [MYRLSTHA] years old
when you last used [LSFILL]. Is this correct?
4
Yes
6
No
DK/REF
LUHA06 [IF LUHA05 = 4] Earlier, the computer recorded that you
were [AGELSTHA] years old when you last used [LSFILL].
Which answer is correct?
1

I last used [LSFILL] in [LU12a-d fill] when I was
[MYRLSTHA] years old
2
I was [AGELSTHA] years old the last time I used
[LSFILL]
3
Neither answer is correct
DK/REF
UPDATE: IF LUHA06 = 1, THEN AGELSTHA = MYRLSTHA
LUHA07 [IF LUHA06=2 OR LUHA06=3 OR LUHA05 = 6] Please
answer this question again. Did you last use [LSFILL] in
[CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LUHA07a [IF LUHA07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LUHA07] did you last use
[LSFILL]?
1
2
3
4
5
6
7
8
9
10
11

January
February
March
April
May
June
July
August
September
October
November

513
April 15, 2016

12
December
DK/REF
HARD ERROR: [IF LUHA07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUHA07a NE (0 OR DK/RE) THEN UPDATE MYRLSTHA.
MYRLSTHA = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF LAST USE (LUHA07 AND LUHA07a).
IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTHA IS BLANK.
IF MYRLSTHA = AGELSTHA THEN MYRLSTHA = BLANK
LUHA08 [IF LUHA06 NE 1 AND MYRLSTHA NE 0 AND (LUHA07
AND LUHA07a NE LU12a-d)] The computer recorded that
you last used [LSFILL] in [LUHA07 - LUHA07a fill]. That
would make you [MYRLSTHA] years old when you last used
[LSFILL]. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF LUHA08 NE (6, BLANK OR DK/REF) AND (LUHA07 AND LUHA07a
NE LU12a-d) THEN AGELSTHA = MYRLSTHA
LU13 [IF LSDREC=2 OR 3] The computer recorded that you last used LSD [LSDREC
FILL]. How old were you the last time you used LSD?
AGE:_____[RANGE: 1-110]
DK/REF
DEFINE AGELSTLS:
IF LU13 NE (BLANK OR DK/REF) THEN AGELSTLS = LU13
ELSE AGELSTLS = BLANK
IF AGELSTLS < AGE1STLS OR AGELSTLS < 10 OR IF CURNTAGE <
AGELSTLS
LUCC27 The computer recorded that you were [AGELSTLS] years old
when you last used LSD. Is this correct?
4
Yes
6
No
DK/REF

514
April 15, 2016

LUCC28 [IF LUCC27 = 6] Please answer this question again. Think
about the last time you used LSD. How old were you the last
time you used LSD?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC28 NOT (BLANK OR DK/REF) THEN AGELSTLS = LUCC28
LU13a [IF LU13 NE DK/RE AND AGELSTLS = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGELSTLS = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last use LSD in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LU13b [IF AGELSTLS = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last use LSD in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU13c [IF LU13 NE DK/RE AND AGELSTLS = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last use
LSD?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU13c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE

515
April 15, 2016

QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU13d [IF LU13a = 1 - 2 OR LU13b = 1 - 2] In what month in [YEAR FROM LU13a
or LU13b] did you last use LSD?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR : [IF LU13d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTLS:
MYRLSTLS = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU13a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTLS IS
BLANK.
IF MYRLSTLS NE 0 AND NE AGELSTLS:
LULS05 The computer recorded that you last used LSD in [LU13a-d
fill]. That would make you [MYRLSTLS] years old when you
last used LSD. Is this correct?
4
Yes
6
No
DK/REF
LULS06

[IF LULS05 = 4] Earlier, the computer recorded that you were
[AGELSTLS] years old when you last used LSD. Which
answer is correct?
1
2

I last used LSD in [LU13a-d fill] when I was
[MYRLSTLS] years old
I was [AGELSTLS] years old the last time I used LSD

516
April 15, 2016

3
Neither answer is correct
DK/REF
UPDATE: IF LULS06 = 1, THEN AGELSTLS = MYRLSTLS
LULS07

[IF LULS06=2 OR LULS06=3 OR LULS05 = 6] Please
answer this question again. Did you last use LSD in
[CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LULS07a [IF LULS07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LULS07] did you last use
LSD?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LULS07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LULS07a NE (0 OR DK/RE) THEN UPDATE MYRLSTLS.
MYRLSTLS = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF
BIRTH FROM MONTH AND YEAR OF LAST USE (LULS07 AND LULS07a). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTLS IS BLANK. IF
MYRLSTLS = AGELSTLS THEN MYRLSTLS = BLANK
LULS08

[IF LULS06 NE 1 AND MYRLSTLS NE 0 AND (LULS07 AND
LULS07a NE LU13a-d)] The computer recorded that you last

517
April 15, 2016

used LSD in [LULS07 - LULS07a fill]. That would make you
[MYRLSTLS] years old when you last used LSD. Is this
correct?
4
Yes
6
No
DK/REF
UPDATE: IF LULS08 NE (6, BLANK OR DK/REF) AND (LULS07 AND LULS07a
NE LU13a-d) THEN AGELSTLS = MYRLSTLS
LU14 [IF PCPREC=2 OR 3] The computer recorded that you last used PCP [PCPREC
FILL]. How old were you the last time you used PCP?
AGE:_____[RANGE: 1-110]
DK/REF
DEFINE AGELSTPC:
IF LU14 NE (BLANK OR DK/REF) THEN AGELSTPC = LU14
ELSE AGELSTPC = BLANK
IF AGELSTPC < AGE1STPC OR AGELSTPC < 10 OR IF CURNTAGE <
AGELSTPC
LUCC29 The computer recorded that you were [AGELSTPC] years old
when you last used PCP. Is this correct?
4
Yes
6
No
DK/REF
LUCC30 [IF LUCC29 = 6] Please answer this question again. Think
about the last time you used PCP. How old were you the last
time you used PCP?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC30 NOT (BLANK OR DK/REF) THEN AGELSTPC = LUCC30
LU14a [IF LU14 NE DK/RE AND AGELSTPC = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGELSTPC = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last use PCP in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
2

CURRENT YEAR - 1
CURRENT YEAR

518
April 15, 2016

DK/REF
LU14b [IF AGELSTPC = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last use PCP in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU14c [IF LU14 NE DK/RE AND AGELSTPC = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last use
PCP?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU14c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU14d [IF LU14a = 1 - 2 OR LU14b = 1 - 2] In what month in [YEAR FROM LU14a
or LU14b] did you last use PCP?
1
2
3
4
5
6
7
8
9
10
11

January
February
March
April
May
June
July
August
September
October
November

519
April 15, 2016

12
December
DK/REF
HARD ERROR : [IF LU14d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTPC:
MYRLSTPC = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU14a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTPC IS
BLANK.
IF MYRLSTPC NE 0 AND NE AGELSTPC:
LUPC05 The computer recorded that you last used PCP in [LU14a-d
fill]. That would make you [MYRLSTPC] years old when you
last used PCP. Is this correct?
4
Yes
6
No
DK/REF
LUPC06 [IF LUPC05 = 4] Earlier, the computer recorded that you
were [AGELSTPC] years old when you last used PCP. Which
answer is correct?
1

I last used PCP in [LU14a-d fill] when I was
[MYRLSTPC] years old
2
I was [AGELSTPC] years old the last time I used PCP
3
Neither answer is correct
DK/REF
UPDATE: IF LUPC06 = 1, THEN AGELSTPC = MYRLSTPC
LUPC07 [IF LUPC06=2 OR LUPC06=3 OR LUPC05 = 6] Please
answer this question again. Did you last use PCP in
[CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LUPC07a [IF LUPC07 NE (BLANK OR DK/REF)] Please answer this

520
April 15, 2016

question again. In what month in [LUPC07] did you last use
PCP?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LUPC07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUPC07a NE (0 OR DK/RE) THEN UPDATE MYRLSTPC.
MYRLSTPC = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF LAST USE (LUPC07 AND LUPC07a).
IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTPC IS BLANK. IF
MYRLSTPC = AGELSTPC THEN MYRLSTPC = BLANK
LUPC08 [IF LUPC06 NE 1 AND MYRLSTPC NE 0 AND (LUPC07
AND LUPC07a NE LU14a-d)] The computer recorded that
you last used PCP in [LUPC07 - LUPC07a fill]. That would
make you [MYRLSTPC] years old when you last used PCP. Is
this correct?
4
Yes
6
No
DK/REF
UPDATE: IF LUPC08 NE (6, BLANK OR DK/REF) AND (LUPC07 AND LUPC07a
NE LU14a-d) THEN AGELSTPC = MYRLSTPC
LU15 [IF ECSTREC=2 OR 3] The computer recorded that you last used ‘Ecstasy’ or
‘Molly’, also known as MDMA [ECSTREC FILL]. How old were you the last
time you used ‘Ecstasy’ or ‘Molly’?
AGE:_____[RANGE: 1-110]

521
April 15, 2016

DK/REF
DEFINE AGELSTEC:
IF LU15 NE (BLANK OR DK/REF) THEN AGELSTEC = LU15
ELSE AGELSTEC = BLANK
IF AGELSTEC < AGE1STEC OR AGELSTEC < 10 OR IF CURNTAGE <
AGELSTEC
LUCC31 The computer recorded that you were [AGELSTEC] years old
when you last used ‘Ecstasy’ or ‘Molly’. Is this correct?
4
Yes
6
No
DK/REF
LUCC32 [IF LUCC31 = 6] Please answer this question again. Think
about the last time you used ‘Ecstasy’ or ‘Molly’. How old
were you the last time you used ‘Ecstasy’ or ‘Molly’?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC32 NOT (BLANK OR DK/REF) THEN AGELSTPC = LUCC32
LU15a [IF LU15 NE DK/RE AND AGELSTEC = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGELSTEC = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last use ‘Ecstasy’ or ‘Molly’ in [CURRENT
YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LU15b [IF AGELSTEC = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last use ‘Ecstasy’ or ‘Molly’ in [CURRENT YEAR - 2] or [CURRENT
YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU15c [IF LU15 NE DK/RE AND AGELSTEC = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last use
‘Ecstasy’ or ‘Molly’?
1

January

522
April 15, 2016

2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU15c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU15d [IF LU15a = 1 - 2 OR LU15b = 1 - 2] In what month in [YEAR FROM LU15a
or LU15b] did you last use ‘Ecstasy’ or ‘Molly’?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR : [IF LU15d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTEC:
MYRLSTEC = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU15a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTEC IS
BLANK.

523
April 15, 2016

IF MYRLSTEC NE 0 AND NE AGELSTEC:
LUEC05 The computer recorded that you last used ‘Ecstasy’ or ‘Molly’
in [LU15a-d fill]. That would make you [MYRLSTEC] years
old when you last used ‘Ecstasy’ or ‘Molly’. Is this correct?
4
Yes
6
No
DK/REF
LUEC06 [IF LUEC05 = 4] Earlier, the computer recorded that you
were [AGELSTEC] years old when you last used ‘Ecstasy’ or
‘Molly’. Which answer is correct?
1

I last used ‘Ecstasy’ or ‘Molly’ in [LU15a-d fill] when I
was [MYRLSTEC] years old
2
I was [AGELSTEC] years old the last time I used
‘Ecstasy’ or ‘Molly’
3
Neither answer is correct
DK/REF

UPDATE: IF LUEC06 = 1, THEN AGELSTEC = MYRLSTEC
LUEC07 [IF LUEC06=2 OR LUEC06=3 OR LUEC05 = 6] Please
answer this question again. Did you last use ‘Ecstasy’ or
‘Molly’ in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LUEC07a [IF LUEC07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LUEC07] did you last use
‘Ecstasy’ or ‘Molly’?
1
2
3
4
5
6
7
8
9
10

January
February
March
April
May
June
July
August
September
October

524
April 15, 2016

11
November
12
December
DK/REF
HARD ERROR: [IF LUEC07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUEC07a NE (0 OR DK/RE) THEN UPDATE MYRLSTEC.
MYRLSTEC = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF LAST USE (LUEC07 AND LUEC07a).
IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTEC IS BLANK. IF
MYRLSTEC = AGELSTEC THEN MYRLSTEC = BLANK
LUEC08 [IF LUEC06 NE 1 AND MYRLSTEC NE 0 AND (LUEC07
AND LUEC07a NE LU15a-d)] The computer recorded that
you last used ‘Ecstasy’ or ‘Molly’ in [LUEC07 - LUEC07a
fill]. That would make you [MYRLSTEC] years old when you
last used ‘Ecstasy’ or ‘Molly’. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF LUEC08 NE (6, BLANK OR DK/REF) AND (LUEC07 AND LUEC07a
NE LU15a-d) THEN AGELSTEC = MYRLSTEC
LU16 [IF (INLAST=2 OR 3) OR (INRECDK=2 OR 3) OR (INRECRE=2 OR 3)] The
computer recorded that you last used any inhalants for kicks or to get high
[INREC FILL]. How old were you the last time you used any inhalants for
kicks or to get high?
AGE:_____[RANGE: 1-110]
DK/REF
DEFINE AGELSTIN:
IF LU16 NE (BLANK OR DK/REF) THEN AGELSTIN = LU16
ELSE AGELSTIN = BLANK
IF AGESLSTIN < AGE1STIN OR AGELSTIN < 10 OR IF CURNTAGE <
AGELSTIN
LUCC33 The computer recorded that you were [AGELSTIN] years old
when you last used an inhalant for kicks or to get high. Is this
correct?

525
April 15, 2016

4
Yes
6
No
DK/REF
LUCC34 [IF LUCC33 = 6] Please answer this question again. Think
about the last time you used an inhalant for kicks or to get
high. How old were you the last time you used an inhalant for
kicks or to get high?
AGE:_______[RANGE: 1-110]
DK/REF
UPDATE: IF LUCC34 NOT (BLANK OR DK/REF) THEN AGELSTIN = LUCC34
LU16a [IF LU16 NE DK/RE AND AGELSTIN = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGELSTIN = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last use an inhalant for kicks or to get high in
[CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LU16b [IF AGELSTIN = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last use an inhalant for kicks or to get high in [CURRENT YEAR - 2] or
[CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU16c [IF LU16 NE DK/RE AND AGELSTIN = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last use
an inhalant for kicks or to get high?
1
2
3
4
5
6
7
8
9
10
11

January
February
March
April
May
June
July
August
September
October
November

526
April 15, 2016

12
December
DK/REF
HARD ERROR: [IF LU16c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU16d [IF LU16a = 1 - 2 OR LU16b = 1 - 2] In what month in [YEAR FROM LU16a
or LU16b] did you last use an inhalant for kicks or to get high?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR : [IF LU16d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTIN:
MYRLSTIN = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU16a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTIN IS
BLANK.
IF MYRLSTIN NE 0 AND NE AGELSTIN:
LUIN05 The computer recorded that you last used an inhalant for kicks
or to get high in [LU16a-d fill]. That would make you
[MYRLSTIN] years old when you last used an inhalant for
kicks or to get high. Is this correct?
4
Yes
6
No
DK/REF

527
April 15, 2016

LUIN06

[IF LUIN05 = 4] Earlier, the computer recorded that you were
[AGELSTIN] years old when you last used an inhalant for
kicks or to get high. Which answer is correct?
1

I last used an inhalant for kicks or to get high in
[LU16a-d fill] when I was [MYRLSTIN] years old
2
I was [AGELSTIN] years old the last time I used an
inhalant for kicks or to get high
3
Neither answer is correct
DK/REF

UPDATE: IF LUIN06 = 1, THEN AGELSTIN = MYRLSTIN
LUIN07

[IF LUIN06=2 OR LUIN06=3 OR LUIN05 = 6] Please
answer this question again. Did you last use an inhalant for
kicks or to get high in [CURRENT YEAR-2], [CURRENT
YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF

LUIN07a [IF LUIN07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LUIN07] did you last use
an inhalant for kicks or to get high?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LUIN07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.

528
April 15, 2016

UPDATE: IF LUIN07a NE (0 OR DK/RE) THEN UPDATE MYRLSTIN.
MYRLSTIN = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE OF
BIRTH FROM MONTH AND YEAR OF LAST USE (LUIN07 AND LUIN07a). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTIN IS BLANK. IF
MYRLSTIN = AGELSTIN THEN MYRLSTIN = BLANK
LUIN08

[IF LUIN06 NE 1 AND MYRLSTIN NE 0 AND (LUIN07 AND
LUIN07a NE LU16a-d)] The computer recorded that you last
used an inhalant for kicks or to get high in [LUIN07 LUIN07a fill]. That would make you [MYRLSTIN] years old
when you last used an inhalant for kicks or to get high. Is this
correct?
4
Yes
6
No
DK/REF

UPDATE: IF LUIN08 NE (6, BLANK OR DK/REF) AND (LUIN07 AND LUIN07a
NE LU16a-d) THEN AGELSTIN = MYRLSTIN
LU17 [IF (MELAST3=2 OR 3) OR MERECDK=2 OR 3) OR (MERECRE=2 OR 3)]
The computer recorded that you last used methamphetamine [MEREC FILL].
How old were you the last time you used methamphetamine?
AGE:_____[RANGE: 1-110]
DK/REF
DEFINE AGELSTME:
IF LU17 NE (BLANK OR DK/REF) THEN AGELSTME = LU17
ELSE AGELSTME = BLANK
IF AGESLSTME < AGE1STME OR AGELSTME < 10 OR IF CURNTAGE <
AGELSTME
LUCC35 The computer recorded that you were [AGELSTME] years old
when you last used methamphetamine. Is this correct?
4
Yes
6
No
DK/REF
LUCC36 [IF LUCC35 = 6] Please answer this question again. Think
about the last time you used methamphetamine. How old were
you the last time you used methamphetamine?
AGE:_______[RANGE: 1-110]
DK/REF

529
April 15, 2016

UPDATE: IF LUCC36 NOT (BLANK OR DK/REF) THEN AGELSTME = LUCC36
LU17a [IF LU17 NE DK/RE AND AGELSTME = CURNTAGE AND DATE OF
INTERVIEW < DOB OR IF AGELSTME = CURNTAGE - 1 AND DATE OF
INTERVIEW ≥ DOB] Did you last use methamphetamine in [CURRENT
YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LU17b [IF AGELSTME = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you last use methamphetamine in [CURRENT YEAR - 2] or [CURRENT
YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LU17c [IF LU17 NE DK/RE AND AGELSTME = CURNTAGE AND DATE OF
INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you last use
methamphetamine?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LU17c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
LU17d [IF LU17a = 1 - 2 OR LU17b = 1 - 2] In what month in [YEAR FROM LU17a
or LU17b] did you last use methamphetamine?

530
April 15, 2016

1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR : [IF LU17d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYRLSTME:
MYRLSTME = AGE AT LAST USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF LAST USE (LU17a-d). IF
MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTME IS
BLANK.
IF MYRLSTME NE 0 AND NE AGELSTME:
LUME05 The computer recorded that you last used methamphetamine in
[LU17a-d fill]. That would make you [MYRLSTME] years old
when you last used methamphetamine. Is this correct?
4
Yes
6
No
DK/REF
LUME06 [IF LUME05 = 4] Earlier, the computer recorded that you
were [AGELSTME] years old when you last used
methamphetamine. Which answer is correct?
1

I last used methamphetamine in [LU17a-d fill] when I
was [MYRLSTME] years old
2
I was [AGELSTME] years old the last time I used
methamphetamine
3
Neither answer is correct
DK/REF
UPDATE: IF LUME06 = 1, THEN AGELSTME = MYRLSTME

531
April 15, 2016

LUME07 [IF LUME06=2 OR LUME06=3 OR LUME05 = 6] Please
answer this question again. Did you last use
methamphetamine [CURRENT YEAR-2], [CURRENT YEAR1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LUME07a [IF LUME07 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LUME07] did you last use
methamphetamine?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LUME07a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF LUME07a NE (0 OR DK/RE) THEN UPDATE MYRLSTME.
MYRLSTME = AGE AT LAST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF LAST USE (LUME07 AND LUME07a).
IF MONTH OF LAST USE = MONTH OF BIRTH, THEN MYRLSTME IS BLANK.
IF MYRLSTME = AGELSTME THEN MYRLSTME = BLANK
LUME08 [IF LUME06 NE 1 AND MYRLSTME NE 0 AND (LUME07
AND LUME07a NE LU17a-d)] The computer recorded that
you last used methamphetamine [LUME07 - LUME07a fill].
That would make you [MYRLSTME] years old when you last
used methamphetamine. Is this correct?

532
April 15, 2016

4
Yes
6
No
DK/REF
UPDATE: IF LUME08 NE (6, BLANK OR DK/REF) AND (LUME07 AND LUME07a
NE LU17a-d) THEN AGELSTME = MYRLSTME
LU37 [IF (CG01=1 OR CGREF = 1) AND CG06 NE 3 AND CG06DK NE 3 AND
CG06RE NE 3] Earlier questions were about the past 12 months. This question is
about the year before that, that is, from [DATEFILL - 12 MONTHS] to
[DATEFILL]. During that year, beginning [DATEFILL - 12 MONTHS] and
ending [DATEFILL], did you smoke part or all of a cigarette, even once?
1
Yes
2
No
DK/REF
LU38 [IF AL01=1 OR ALREF = 1] [IF LU37 = BLANK: Earlier questions were about
the past 12 months. This question is about the year before that, that is, from
[DATEFILL - 12 MONTHS] to [DATEFILL].] During that year, beginning
[DATEFILL - 12 MONTHS] and ending [DATEFILL], did you have a drink of
any type of alcoholic beverage, even once?
1
Yes
2
No
DK/REF
LU39 [IF CC01=1 OR CCREF = 1] [IF LU37 = BLANK AND LU38 = BLANK:
Earlier questions were about the past 12 months. This question is about the year
before that, that is, from [DATEFILL - 12 MONTHS] to [DATEFILL].]
During that year, beginning [DATEFILL - 12 MONTHS] and ending
[DATEFILL], did you use any form of cocaine, even once?
1
Yes
2
No
DK/REF

533
April 15, 2016

534
April 15, 2016

Drug Treatment
INTROTX [IF AL01 = 1 OR ALREF = 1 OR MJ01 = 1 OR MJREF = 1 OR CC01 =
1 OR CCREF = 1 OR CK01 = 1 OR CKREF = 1 OR HE01 = 1 OR HEREF = 1
OR LS01a = 1 OR LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR LS01c = 1
OR LS01d = 1 OR LS01e = 1 OR LS01f =1 OR LSREF3 = 1 OR LS01h = 1 OR
LS01i=1 OR LS01j=1 OR LS01k=1 OR IN01a =1 OR IN01b =1 OR IN01c = 1
OR IN01d = 1 OR IN01e = 1OR IN01f = 1 OR IN01g = 1 OR IN01h = 1 OR
IN01h1=1 OR IN01i = 1 OR IN01ii=1 OR IN01j = 1 OR IN01l = 1 OR INREF =
1 OR ME01=1 OR MEREF=1 OR PRMISUSE12=1 OR PRL01=1 OR PRL02=1
TRMISUSE12=1 OR TRL01=1 OR TRL02=1 OR STMISUSE12=1 OR
STL01=1 OR STL02=1 OR SVMISUSE12=1 OR SVL01=1 OR SVL02=1 ]
These next questions deal with treatment for alcohol and drug problems, not
including cigarettes. Please report treatment or counseling designed to help you
reduce or stop your alcohol or drug use. Please include detoxification and any
other treatment for medical problems associated with your alcohol or drug use.
Press [ENTER] to continue.
TX01 [IF AL01 = 1 OR ALREF = 1 OR MJ01 = 1 OR MJREF = 1 OR CC01 = 1 OR
CCREF = 1 OR CK01 = 1 OR CKREF = 1 OR HE01 = 1 OR HEREF = 1 OR
LS01a = 1 LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR LS01c = 1 OR
LS01d = 1 OR LS01e = 1 OR LS01f = 1 OR LSREF3 = 1 OR LS01h = 1 OR
LS01i=1 OR LS01j=1 OR LS01k=1 OR IN01a =1 OR IN01b =1 OR IN01c = 1
OR IN01d = 1 OR IN01e = 1OR IN01f = 1 OR IN01g = 1 OR IN01h = 1 OR
IN01h1=1 OR IN01i = 1 OR IN01ii=1 OR IN01j = 1 OR IN01l = 1 OR INREF =
1 OR ME01=1 OR MEREF=1 OR PRMISUSE12=1 OR PRL01=1 OR PRL02=1
OR TRMISUSE12=1 OR TRL01=1 OR TRL02=1 OR STMISUSE12=1 OR
STL01=1 OR STL02=1 OR SVMISUSE12=1 OR SVL01=1 OR SVL02=1 ]
Have you ever received treatment or counseling for your use of alcohol or any
drug, not counting cigarettes?
1
Yes
2
No
DK/REF

TX02 [IF TX01 = 1] During the past 12 months, that is, since [DATEFILL], have you
received treatment or counseling for your use of alcohol or any drug, not counting
cigarettes?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

535
April 15, 2016

TX03 [IF TX02 = 1] During the past 12 months when you received treatment, was the
treatment for alcohol use only, drug use only, or both alcohol and drug use?
1
Alcohol use only
2
Drug use only
3
Both alcohol and drug use
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DEFINE TXFILL1:
IF TX03 = 1, TXFILL1 = alcohol use
IF TX03 = 2, TXFILL1 = drug use
IF TX03 = 3 OR DK/REF, TXFILL1 = alcohol or drug use
ELSE, TXFILL1 = BLANK
TX04a [IF TX03 NE BLANK ] During the past 12 months, have you received treatment
for your [TXFILL1] in a hospital overnight as an inpatient?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04a1
[IF TX03 = 3 AND TX04a = 1] Was the treatment you received in a
hospital overnight as an inpatient for your alcohol use, your drug use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF

TX04b [IF TX03 NE BLANK] During the past 12 months, have you received treatment
for your [TXFILL1] in a residential drug or alcohol rehabilitation facility
where you stayed overnight?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04b1
[IF TX03 = 3 AND TX04b = 1] Was the treatment you received in a
residential drug or alcohol rehabilitation facility where you stayed overnight
for your alcohol use, your drug use, or both?
1
2

Alcohol use
Drug use
536

April 15, 2016

3
Both alcohol and drug use
DK/REF
TX04c [IF TX03 NE BLANK] During the past 12 months, have you received treatment
for your [TXFILL1] in a drug or alcohol rehabilitation facility as an
outpatient?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04c1
[IF TX03 = 3 AND TX04c = 1] Was the treatment you received in a drug
or alcohol rehabilitation facility as an outpatient for your alcohol use, your
drug use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX04d [IF TX03 NE BLANK] During the past 12 months, have you received treatment
for your [TXFILL1] in a mental health center or facility as an outpatient?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04d1
[IF TX03 = 3 AND TX04d = 1] Was the treatment you received in a
mental health center or facility as an outpatient for your alcohol use, your drug
use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX04e [IF TX03 NE BLANK] During the past 12 months, have you received treatment
for your [TXFILL1] in an emergency room?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04e1

[IF TX03 = 3 AND TX04e = 1] Was the treatment you received in an
537

April 15, 2016

emergency room for your alcohol use, your drug use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX04f [IF TX03 NE BLANK] During the past 12 months, have you received treatment
for your [TXFILL1] in a private doctor’s office?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04f1
[IF TX03 = 3 AND TX04f = 1] Was the treatment you received in a
private doctor’s office for your alcohol use, your drug use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX04g [IF TX03 NE BLANK] During the past 12 months, have you received treatment
for your [TXFILL1] in a prison or jail?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04g1
[IF TX03 = 3 AND TX04g = 1] Was the treatment you received in a
prison or jail for your alcohol use, your drug use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX04h [IF TX03 NE BLANK] During the past 12 months, have you received treatment
for your [TXFILL1] in a self-help group such as Alcoholics Anonymous or
Narcotics Anonymous?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
538
April 15, 2016

TX04h1
[IF TX03 = 3 AND TX04h = 1] Was the treatment you received in a selfhelp group for your alcohol use, your drug use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX04i [IF TX03 NE BLANK] During the past 12 months, have you received treatment
for your [TXFILL1] in some other place besides these that have been listed?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX04iSP
[IF TX04i = 1] Please type in a description of the place where you
received treatment or counseling for your [TXFILL1] other than the places just
mentioned. When you have finished typing your answer, press the [Enter] key to
go to the next question.
_______________

DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX04iSP.
TX04i1
[IF TX03 = 3 AND TX04i = 1] Was the treatment you received in this
other place for your alcohol use, your drug use, or both?
1
Alcohol use
2
Drug use
3
Both alcohol and drug use
DK/REF
TX05 [IF TX03 = 2 OR 3 AND (MJ01 = 1 OR MJREF = 1 OR CC01 = 1 OR CCREF =
1 OR CK01 = 1 OR CKREF = 1 OR HE01 = 1 OR HEREF = 1 OR LS01a = 1
OR LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR ME01 = 1 OR MEREF =
1)] During the past 12 months, that is, since [DATEFILL], did you visit a
hospital emergency room to receive treatment for your use of cocaine, heroin,
marijuana, PCP, LSD, or methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX06 [IF TX05 = 1] During the past 12 months, how many times did you visit a
539
April 15, 2016

hospital emergency room to receive treatment for your use of cocaine, heroin,
marijuana, PCP, LSD, or methamphetamine?
# OF TIMES:
[RANGE: 1 - 90]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX07 [IF TX02 = 1 OR DK/REF] Are you currently receiving treatment or counseling
for your [TXFILL1]?
1
Yes
2
No
DK/REF
TX08 [IF (TX01 = 2 OR DK/REF) OR ((TX02 =2 OR DK/REF) AND TX07 NE 1)]
During the past 12 months, did you need treatment or counseling for your alcohol
or drug use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX09 [IF TX02 = 1 AND TX07 NE 1] During the past 12 months, did you need
additional treatment or counseling for your alcohol or drug use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX10 [IF TX09 = 1] During the past 12 months, for which of the following drugs did
you need additional treatment or counseling?
Type the number of each drug for which you needed additional treatment or
counseling during the past 12 months. To select more than one drug from the list,
press the space bar between each number you type. When you have finished,
press [ENTER].
1.
2.
3.
4.
5.
6.
7.

Alcohol
Marijuana or hashish
Cocaine or ‘crack’
Heroin
Hallucinogens
Inhalants
Methamphetamine

540
April 15, 2016

8. Prescription pain relievers
9. Prescription tranquilizers
10. Prescription stimulants
11. Prescription sedatives
12. Some other drug
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX11 [IF (AL01 = 1 OR ALREF = 1) AND TX08 = 1] During the past 12 months, did
you need treatment or counseling for your use of alcohol?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX12 [IF (MJ01 = 1 OR MJREF = 1) AND TX08 = 1] During the past 12 months, did
you need treatment or counseling for your use of marijuana or hashish?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX13 [IF (CC01 = 1 OR CCREF = 1 OR CK01 =1 OR CKREF = 1) AND TX08 = 1]
During the past 12 months, did you need treatment or counseling for your use of
cocaine or ‘crack’?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX14 [IF (HE01 = 1 OR HEREF = 1) AND TX08 = 1] During the past 12 months, did
you need treatment or counseling for your use of heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX15 [IF (LS01a =1 OR LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR LS01c = 1
OR LS01d =1 OR LS01e = 1 OR LS01f =1 OR LSREF3 = 1 OR LS01h = 1 OR
LS01i=1 OR LS01j=1 OR LS01k=1) AND TX08 =1] During the past 12 months,
did you need treatment or counseling for your use of hallucinogens?

541
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX16 [IF (IN01a =1 OR IN01b =1 OR IN01c =1 OR IN01d = 1 OR IN01e = 1 OR
IN01f = 1 OR IN01g = 1 OR IN01h = 1 OR IN01h1=1 OR IN01i = 1 OR
IN01ii=1 OR IN01j = 1 OR IN01l = 1 OR INREF = 1) AND TX08 = 1] During
the past 12 months, did you need treatment or counseling for your use of
inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX16a [IF (ME01=1 OR ME01REF=1) AND TX08 = 1] During the past 12 months, did
you need treatment or counseling for your use of methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX17 [IF (PRMISUSE12=1 OR PRL01=1 OR PRL02=1) AND TX08 = 1] During the
past 12 months, did you need treatment or counseling for your use of
prescription pain relievers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX18 [IF (TRMISUSE12=1 OR TRL01=1 OR TRL02=1) AND TX08 = 1] During the
past 12 months, did you need treatment or counseling for your use of
prescription tranquilizers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX19 [IF STMISUSE12=1 OR STL01=1 OR STL02=1) AND TX08 = 1] During the
past 12 months, did you need treatment or counseling for your use of
prescription stimulants?
1

Yes

542
April 15, 2016

2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX20 [IF (SVMISUSE12=1 OR SVL01=1 OR SVL02=1) AND TX08 = 1] During the
past 12 months, did you need treatment or counseling for your use of
prescription sedatives?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX21 [IF TX08 = 1] During the past 12 months, did you need treatment or counseling
for your use of some other drug besides the ones just listed?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX21SP1 [IF TX21 = 1] Please type in the name of one of the other drugs you needed
treatment or counseling for during the past 12 months. If you’re not sure how
to spell the drug name, just make your best guess. When you have finished
typing your answer, press the [ENTER] key to go to the next question.
____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX21SP1.
TX21SP2 [IF TX21SP1 NE (BLANK OR DK/REF)] Please type in the name of any
other drug that you needed treatment or counseling for during the past 12
months other than those you have already mentioned. If you have not needed
treatment or counseling for your use of any other drugs, press the [ENTER]
key to go to the next question.
____________
DK/REF
TX21SP3 [IF TX21SP2 NE (BLANK OR DK/REF)] Please type in the name of any
other drug that you needed treatment or counseling for during the past 12
months other than those you have already mentioned. If you have not needed
treatment or counseling for your use of any other drugs, press the [ENTER]
key to go to the next question.
____________

543
April 15, 2016

DK/REF
TX21SP4 [IF TX21SP3 NE (BLANK OR DK/REF)] Please type in the name of any
other drug that you needed treatment or counseling for during the past 12
months other than those you have already mentioned. If you have not needed
treatment or counseling for your use of any other drugs, press the [ENTER]
key to go to the next question.
____________
DK/REF
TX21SP5 [IF TX21SP4 NE (BLANK OR DK/REF)] Please type in the name of any
other drug that you needed treatment or counseling for during the past 12
months other than those you have already mentioned. If you have not needed
treatment or counseling for your use of any other drugs, press the [ENTER]
key to go to the next question.
____________
DK/REF
DEFINE TXFILL2:
IF TX11 = 1 AND ALL OF TX12 - TX21 = 2 OR DK/REF, TXFILL2 = alcohol
IF TX11 = 2 OR DK/REF, AND ANY IN TX12 - TX21 = 1, TXFILL2 = any
drug
ELSE, TXFILL2 = alcohol or any other drug
TX22 [IF TX08 = 1] During the past 12 months, did you make an effort to get
treatment or counseling for your use of [TXFILL2]?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX22A
[IF TX22 IS NOT BLANK] Which of these statements explain why you
did not get the treatment or counseling you needed for your use of [TXFILL2]?
To select more than one reason from the list, press the space bar between each
number you type. When you have finished, press [ENTER].
1
2
3
4

You had no health care coverage, and you couldn’t afford the cost.
You did have health care coverage, but it didn’t cover treatment for
[TXFILL2], or didn’t cover the full cost.
You had no transportation to a program, or the programs were too far
away, or the hours were not convenient.
You didn’t find a program that offered the type of treatment or counseling

544
April 15, 2016

you wanted.
5
You were not ready to stop using [TXFILL2].
6
There were no openings in the programs.
7
You did not know where to go to get treatment.
8
You were concerned that getting treatment or counseling might cause your
neighbors or community to have a negative opinion of you.
9
You were concerned that getting treatment or counseling might have a
negative effect on your job.
10
Some other reason or reasons.
DK/REF
TX22B
[IF ANY ENTRY IN TX22A = 10] Which of these statements explain
why you did not get the treatment or counseling you needed for your use of
[TXFILL2]?
To select more than one reason from the list, press the space bar between each
number you type. When you have finished, press [ENTER].
1
You didn't think you needed treatment at the time.
2
You thought you could handle the problem without treatment.
3
You didn't think treatment would help.
4
You didn't have time (because of job, childcare, or other commitments).
5
You didn't want others to find out that you needed treatment.
6
Some other reason or reasons.
DK/REF
TX22SP [IF ANY ENTRY IN TX22B = 6 ] Please type in the most important other
reason you did not get the treatment you needed. When you have finished
typing your answer, press the [ENTER] key to go to the next question.
____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX22SP.
TX23 [IF TX09 = 1] During the past 12 months, did you make an effort to get
additional treatment or counseling for your use of alcohol or any other drug?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX23A
[IF TX23 IS NOT BLANK] Which of these statements explain why you
did not get the additional treatment or counseling you needed for your use of
alcohol or drugs?

545
April 15, 2016

To select more than one reason from the list, press the space bar between each
number you type. When you have finished, press [ENTER].
1
2

You had no health care coverage, and you couldn’t afford the cost.
You did have health care coverage, but it didn’t cover treatment for alcohol
or drugs, or didn’t cover the full cost.
3
You had no transportation to a program, or the programs were too far
away, or the hours were not convenient.
4
You didn’t find a program that offered the type of treatment or counseling
you wanted.
5
You were not ready to stop using alcohol or drugs.
6
There were no openings in the programs.
7
You did not know where to go to get treatment.
8
You were concerned that getting treatment or counseling might cause your
neighbors or community to have a negative opinion of you.
9
You were concerned that getting treatment or counseling might have a
negative effect on your job.
10
Some other reason or reasons.
DK/REF
TX23B
[IF ANY ENTRY IN TX23A = 10] Which of these statements explain
why you did not get the additional treatment or counseling you needed for your
use of alcohol or drugs?
To select more than one reason from the list, press the space bar between each
number you type. When you have finished, press [ENTER].
1
You didn't think you needed treatment at the time.
2
You thought you could handle the problem without treatment.
3
You didn't think treatment would help.
4
You didn't have time (because of job, childcare, or other commitments).
5
You didn't want others to find out that you needed treatment.
6
Some other reason or reasons.
DK/REF
TX23SP [IF ANY ENTRY IN TX23B = 6] Please type in the most important other
reason you did not get the treatment you needed. When you have finished
typing your answer, press the [ENTER] key to go to the next question.
____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX23SP.
TX24 [IF TX07 NE 1] How long has it been since you were last in treatment or
counseling for your alcohol or drug use, not counting cigarettes?

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1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX25 [IF TX01 = 1 AND TX07 NE 1 OR BLANK] What was the main place where
you received treatment the last time you started treatment for your alcohol or
other drug use, not counting cigarettes?
[IF TX01 = 1 AND TX07 = 1] What is the main place where you are currently
receiving treatment for your alcohol or other drug use, not counting cigarettes?
1
2
3

A hospital overnight as an inpatient
A residential drug or alcohol rehabilitation facility where you stay at night
A drug or alcohol rehabilitation facility as an outpatient where you do not
stay at night
4
A mental health center or facility as an outpatient
5
An emergency room
6
A private doctor’s office
7
A prison or jail
8
A self-help group
9
Some other place
DK/REF
TX25SP [IF TX01 = 1 AND TX07 NE BLANK AND TX25 = 9] Please type in a
description of the place where you received treatment or counseling for your
drug use other than the places just mentioned. When you have finished typing
your answer, press the [Enter] key to go to the next question.
____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX25SP.
TX26 [IF (AL01 = 1 OR ALREF = 1) AND TX01 = 1 AND TX07 NE 1 OR BLANK]
The last time you entered treatment, did you receive treatment or counseling for
your use of alcohol?
[IF (AL01 = 1 OR ALREF = 1) AND TX01 = 1 AND TX07 = 1] Are you
currently receiving treatment or counseling for your use of alcohol?
1
Yes
2
No
DK/REF
TX27 [IF (MJ01 =1 OR MJREF = 1) AND TX01 =1 AND TX07 NE 1 OR BLANK]

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April 15, 2016

The last time you entered treatment, did you receive treatment or counseling for
your use of marijuana or hashish?
[IF (MJ01 = 1 OR MJREF = 1) AND TX01 = 1 AND TX07 = 1] Are you
currently receiving treatment or counseling for your use of marijuana or
hashish?
1
Yes
2
No
DK/REF
TX28 [IF (CC01 =1 OR CCREF = 1 OR CK01 =1 OR CKREF = 1) AND TX01 = 1
AND TX07 NE 1 OR BLANK] The last time you entered treatment, did you
receive treatment or counseling for your use of cocaine or ‘crack’?
[IF (CC01 = 1 OR CCREF = 1 OR CK01 =1 OR CKREF = 1) AND TX01 = 1
AND TX07 = 1] Are you currently receiving treatment or counseling for your
use of cocaine or ‘crack’?
1
Yes
2
No
DK/REF
TX29 [IF (HE01 =1 OR HEREF = 1) AND TX01 =1 AND TX07 NE 1 OR BLANK]
The last time you entered treatment, did you receive treatment or counseling for
your use of heroin?
[IF (HE01 = 1 OR HEREF = 1) AND TX01 = 1 AND TX07 = 1] Are you
currently receiving treatment or counseling for your use of heroin?
1
Yes
2
No
DK/REF
TX30 [IF (LS01a =1 OR LSREF1 = 1 OR LS01b =1 OR LSREF2 = 1 OR LS01c =1 OR
LS01d =1 OR LS01e =1 OR LS01f = 1 OR LS01i=1 OR LS01j=1 OR LS01k=1
OR LSREF3 = 1 OR LS01h =1) AND TX01 =1 AND TX07 NE 1 OR BLANK]
The last time you entered treatment, did you receive treatment or counseling for
your use of hallucinogens?
[IF (LS01a =1 OR LSREF1 = 1 OR LS01b =1 OR LSREF2 = 1 OR LS01c =1 OR
LS01d = 1 OR LS01e = 1 OR LS01f = 1 OR LSREF3 = 1 OR LS01h =1 OR
LS01i=1 OR LS01j=1 OR LS01k=1) AND TX01 = 1 AND TX07 = 1] Are you
currently receiving treatment or counseling for your use of hallucinogens?
1

Yes

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April 15, 2016

2
No
DK/REF
TX31 [IF (IN01a =1 OR IN01b =1 OR IN01c =1 OR IN01d = 1 OR IN01e = 1 OR
IN01f = 1 OR IN01g = 1 OR IN01h = 1 OR IN01h1=1 OR IN01i = 1 OR
IN01ii=1 OR IN01j = 1 OR IN01l = 1 OR INREF = 1) AND TX01 =1 AND
TX07 NE 1 OR BLANK] The last time you entered treatment, did you receive
treatment or counseling for your use of inhalants?
[IF (IN01a = 1 OR IN01b =1 OR IN01c =1 OR IN01d =1 OR IN01e = 1 OR
IN01f =1 OR IN01g=1 OR IN01h =1 OR IN01h1=1 OR IN01i =1 OR IN01ii=1
OR IN01j =1 OR IN01l =1 OR INREF = 1) AND TX01 = 1 AND TX07 = 1] Are
you currently receiving treatment or counseling for your use of inhalants?
1
Yes
2
No
DK/REF
TX31a [IF (ME01 =1 OR MEREF = 1) AND TX01 =1 AND TX07 NE 1 OR BLANK]
The last time you entered treatment, did you receive treatment or counseling for
your use of methamphetamine?
[IF (ME01 = 1 OR MEREF = 1) AND TX01 = 1 AND TX07 = 1] Are you
currently receiving treatment or counseling for your use of methamphetamine?
1
Yes
2
No
DK/REF
TX32 [IF ( PRMISUSE12=1 OR PRL01=1 OR PRL02=1) AND TX01 = 1 AND TX07
NE 1 OR BLANK] The last time you entered treatment, did you receive
treatment or counseling for your use of prescription pain relievers?
[IF (PRMISUSE12=1 OR PRL01=1 OR PRL02=1) AND TX01 = 1 AND TX07
= 1] Are you currently receiving treatment or counseling for your use of
prescription pain relievers?
1
Yes
2
No
DK/REF
TX33 [IF (TRMISUSE12=1 OR TRL01=1 OR TRL02=1) AND TX01 =1 AND TX07
NE 1 OR BLANK] The last time you entered treatment, did you receive
treatment or counseling for your use of prescription tranquilizers?
[IF (TRMISUSE12=1 OR TRL01=1 OR TRL02=1) AND TX01 = 1 AND TX07

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April 15, 2016

= 1] Are you currently receiving treatment or counseling for your use of
prescription tranquilizers?
1
Yes
2
No
DK/REF
TX34 [IF (STMISUSE12=1 OR STL01=1 OR STL02=1) AND TX01 =1 AND TX07
NE 1 OR BLANK] The last time you entered treatment, did you receive
treatment or counseling for your use of prescription stimulants?
[IF (STMISUSE12=1 OR STL01=1 OR STL02=1)AND TX01 = 1 AND TX07 =
1] Are you currently receiving treatment or counseling for your use of
prescription stimulants?
1
Yes
2
No
DK/REF
TX35 [IF (SVMISUSE12=1 OR SVL01=1 OR SVL02=1)AND TX01 = 1 AND TX07
NE 1 OR BLANK] The last time you entered treatment, did you receive
treatment or counseling for your use of prescription sedatives?
[IF (SVMISUSE12=1 OR SVL01=1 OR SVL02=1)AND TX01 = 1 AND TX07 =
1] Are you currently receiving treatment or counseling for your use of
prescription sedatives?
1
Yes
2
No
DK/REF
TX36 [IF TX01 = 1 AND TX07 NE 1 OR BLANK] The last time you entered
treatment, did you receive treatment or counseling for your use of any other
drug?
[IF TX01 = 1 AND TX07 = 1] Are you currently receiving treatment or
counseling for your use of any other drug?
1
Yes
2
No
DK/REF
TX36SP1 [IF TX36 = 1 AND TX07 NE 1 OR BLANK] Please type in the name of one
of the drugs you received treatment for the last time. If you’re not sure how to
spell the name of the drug, just make your best guess.

550
April 15, 2016

When you have finished typing your answer, press the [ENTER] key to go to
the next question.
[IF TX36 = 1 AND TX07 = 1] Please type in the name of one of the drugs for
which you are currently being treated. If you’re not sure how to spell the
name of the drug, just make your best guess.
When you have finished typing your answer, press the [ENTER] key to go to
the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX36SP1.
TX36SP2 [IF TX36SP1 NE (BLANK OR DK/REF) AND TX07 NE 1 OR BLANK]
Please type in the name of any other drug you received treatment or
counseling for the last time you entered treatment for your drug use. If there
are no other drugs you received treatment or counseling for the last time, other
than those you already mentioned, press the [ENTER] key to go to the next
question.
[IF TX36SP1 NE (BLANK OR DK/REF) AND TX07 =1] Please type in the
name of any other drug for which you are currently receiving treatment or
counseling. If there are no other drugs you are currently receiving treatment
or counseling for, other than those you already mentioned, press the [ENTER]
key to go to the next question.
_____________
DK/REF
TX36SP3 [IF TX36SP2 NE (BLANK OR DK/REF) AND TX07 NE 1 OR BLANK]
Please type in the name of any other drug you received treatment or
counseling for the last time you entered treatment for your drug use. If there
are no other drugs you received treatment or counseling for the last time, other
than those you already mentioned, press the [ENTER] key to go to the next
question.
[IF TX36SP2 NE (BLANK OR DK/REF) AND TX07 =1] Please type in the
name of any other drug for which you are currently receiving treatment or
counseling. If there are no other drugs you are currently receiving treatment
or counseling for, other than those you already mentioned, press the [ENTER]
key to go to the next question.
_____________
DK/REF

551
April 15, 2016

TX36SP4 [IF TX36SP3 NE (BLANK OR DK/REF) AND TX07 NE 1 OR BLANK]
Please type in the name of any other drug you received treatment or
counseling for the last time you entered treatment for your drug use. If there
are no other drugs you received treatment or counseling for the last time, other
than those you already mentioned, press the [ENTER] key to go to the next
question.
[IF TX36SP3 NE (BLANK OR DK/REF) AND TX07 =1] Please type in the
name of any other drug for which you are currently receiving treatment or
counseling. If there are no other drugs you are currently receiving treatment
or counseling for, other than those you already mentioned, press the [ENTER]
key to go to the next question.
_____________
DK/REF
TX36SP5 [IF TX36SP4 NE (BLANK OR DK/REF) AND TX07 NE 1 OR BLANK]
Please type in the name of any other drug you received treatment or
counseling for the last time you entered treatment for your drug use. If there
are no other drugs you received treatment or counseling for the last time, other
than those you already mentioned, press the [ENTER] key to go to the next
question.
[IF TX36SP4 NE (BLANK OR DK/REF) AND TX07 =1] Please type in the
name of any other drug for which you are currently receiving treatment or
counseling. If there are no other drugs you are currently receiving treatment
or counseling for, other than those you already mentioned, press the [ENTER]
key to go to the next question.
_____________
DK/REF
TX37 [IF MORE THAN 1 ITEM IN THE TX26 - TX36 SERIES = 1 OR DK/REF
AND TX07 NE 1 OR BLANK] What was the main drug you entered treatment
for the last time you were treated?
[IF MORE THAN 1 ITEM IN THE TX26 - TX36 SERIES = 1 OR DK/REF
AND TX07 = 1] What is the main drug for which you are currently receiving
treatment or counseling?
1
2
3
4
5
6

Alcohol
Marijuana or hashish
Cocaine or ‘crack’
Heroin
Hallucinogens
Inhalants

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April 15, 2016

7
Methamphetamine
8
Prescription pain relievers
9
Prescription tranquilizers
10
Prescription stimulants
11
Prescription sedatives
12
Some other drug
DK/REF
TX38 [IF TX25 = 1 - 8 AND TX07 NE 1 OR BLANK] What was the outcome of the
treatment or counseling you last received at [FILL IN ANSWER FROM TX25]?
[IF TX25 = DK/REF OR TX25 = 9 AND TX07 NE 1 OR BLANK] What was the
outcome of the treatment or counseling you last received?
1
You are still in treatment
2
You successfully completed treatment
3
You left because you had a problem with the program
4
You left because you couldn’t afford to continue treatment
5
You left because your family needed you
6
You left because you began using drugs again
7
Your last treatment had some other outcome
DK/REF
TX38SP [IF TX38 = 7] Please type in a description of the outcome of your last
treatment or counseling for drug use. You do not need to give a detailed
description — just a few words will be sufficient.
When you have finished typing your answer, press the [ENTER] key to go to
the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX38SP.
TX39 [IF TX25 = 1- 8 AND TX38 = 2 - 7 OR DK/REF] How long did you stay in
treatment for your alcohol or drug use during your last treatment at [FILL IN
ANSWER FROM TX25]?
[IF (TX25 = 1 - 8 AND TX38 = 1) OR (TX07 = 1 AND TX25 = 1 - 8)] How long
have you been in treatment for your alcohol or drug use at [FILL IN ANSWER
FROM TX17]?
[IF TX25 = 9 OR DK/REF AND TX38 = 2 - 7 OR DK/REF] How long did you
stay in treatment for your alcohol or drug use during your last treatment?
[IF (TX25 = 9 OR DK/REF AND TX38 = 1) OR TX07 = 1 AND TX25 = 9)]

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April 15, 2016

How long have you been in treatment for your alcohol or drug use so far?
Please indicate whether you want to give your answer in days, months, or years.
1
Days
2
Months
3
Years
DK/REF
TX40DAY1 [IF (TX38 = 1 OR TX07 = 1) AND TX39 = 1 OR DK/REF] How many
days have you been in treatment for your alcohol or drug use so far?
# OF DAYS:
DK/REF

[RANGE: 1 - 366]

TX40DAY2 [IF TX38 = 2 - 7 OR DK/REF AND TX39 = 1 OR DK/REF] How many
days did you stay in treatment for your alcohol or drug use the last time?
# OF DAYS:
DK/REF

[RANGE: 1 - 366]

TX41MON1 [IF (TX38 = 1 OR TX07 = 1) AND TX39 = 2] How many months have
you been in treatment for your alcohol or drug use so far?
# OF MONTHS:
DK/REF

[RANGE: 1 - 400]

TX41MON2 [IF TX38 = 2 - 7 OR DK/REF AND TX39 = 2] How many months did
you stay in treatment for your alcohol or drug use the last time?
# OF MONTHS:
DK/REF
TX41YR1

[IF (TX38 = 1 OR TX07 = 1) AND TX39 = 3] How many years have you
been in treatment for your alcohol or drug use so far?
# OF YEARS:
DK/REF

TX41YR2

[RANGE: 1 - 60]

[IF TX38 = 2 - 7 OR DK/REF AND TX39 = 3] How many years did you
stay in treatment for your alcohol or drug use the last time?
# OF YEARS:
DK/REF

TX42A

[RANGE: 1 - 400]

[RANGE: 1 - 60]

[IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did private health

554
April 15, 2016

insurance pay for the last treatment you received, even if it paid only part of the
cost?
[IF TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will private health insurance pay
for the treatment you are currently receiving, even if it pays only part of the cost?
1
Yes
2
No
DK/REF
TX42B
[IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did Medicare pay for the
last treatment you received, even if it paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will Medicare pay for the
treatment you are currently receiving, even if it pays only part of the cost?
1
Yes
2
No
DK/REF
TX42C
[IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did Medicaid pay for the
last treatment you received, even if it paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will Medicaid pay for the
treatment you are currently receiving, even if it pays only part of the cost?
1
Yes
2
No
DK/REF
TX42D
[IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did a public assistance
program other than Medicaid pay for the last treatment you received, even if it
paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will a public assistance program
other than Medicaid pay for the treatment you are currently receiving, even if it
pays only part of the cost?
1
Yes
2
No
DK/REF
TX42E
[IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did you use your own
savings or earnings to pay for the last treatment you received, even if you paid
only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will you use your own savings or
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April 15, 2016

earnings to pay for the treatment you are currently receiving, even if you pay
only part of the cost?
1
Yes
2
No
DK/REF
TX42F
[IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did family members pay
for the last treatment you received, even if they paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will family members pay for the
treatment you are currently receiving, even if they pay only part of the cost?
1
Yes
2
No
DK/REF
TX42G
[IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did the courts pay for the
last treatment you received, even if it paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will the courts pay for the
treatment you are currently receiving, even if it pays only part of the cost?
1
Yes
2
No
DK/REF
TX42H
[IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did CHAMPUS or
TRICARE, CHAMPVA, the VA, or some other military health care pay for
the last treatment you received, even if it paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will CHAMPUS or TRICARE,
CHAMPVA, the VA, or some other military health care pay for the treatment
you are currently receiving, even if it pays only part of the cost?
1
Yes
2
No
DK/REF
TX42I [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Did your employer pay for the last
treatment you received, even if it paid only part of the cost?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will your employer pay for the
treatment you are currently receiving, even if it pays only part of the cost?
1
2

Yes
No
556

April 15, 2016

DK/REF
TX42J [IF TX01 = 1 AND TX07 NE 1 OR BLANK] Was your last treatment paid for by
some other source besides those that have been listed?
[IF (TX01 = 1 AND TX07 = 1) OR TX38 = 1] Will the treatment you are
currently receiving be paid for by some other source besides those that have been
listed?
1
Yes
2
No
DK/REF
TX42JSP [IF TX42J = 1 AND TX07 NE 1 OR BLANK] Please type in a description of
the source that paid for your last treatment or counseling for alcohol or drug
use. You do not need to give a detailed description — just a few words will
be sufficient. When you have finished typing your answer, press the
[ENTER] key to go to the next question.
[IF TX42J = 1 AND (TX07 = 1 OR TX38 = 1)] Please type in a description of
the source that will pay for your current treatment or counseling for alcohol or
drug use. You do not need to give a detailed description — just a few words
will be sufficient. When you have finished typing your answer, press the
[ENTER] key to go to the next question.
_____________

DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TX42JSP.
TX42K

[IF TX42A - TX42J = 2 AND TX07 NE 1 OR BLANK] Was the last
treatment you received free?
[IF TX42A - TX42J = 2 AND (TX07 = 1 OR TX38 = 1)] Is the treatment you
are currently receiving free?
1
Yes
2
No
DK/REF

TX43 [IF TX01 = 1] Were you enrolled in a treatment program for your alcohol or drug
use on October 1, [CURRENT YEAR – 1]?
For this question, please include only treatment you received at a hospital, drug
rehabilitation facility, or mental health center.
1
2

Yes
No
557

April 15, 2016

DK/REF
TX44 [IF TX03 NE BLANK] Think about all the treatment or counseling you received
for your [TXFILL1] during the past 12 months. Was detoxification the only
[TXFILL1] treatment you received during the past 12 months?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX45 [IF TX01=1 AND TX02=2 AND (AL01 = 1 OR ALREF = 1) AND MJ01 NE 1
AND MJREF NE 1 AND CC01 NE 1 AND CCREF NE 1 AND CK01 NE 1
AND CKREF NE 1 AND HE01 NE 1 AND HEREF NE 1 AND LS01a NE 1
AND LSREF1 NE 1 AND LS01b NE 1 AND LSREF2 NE 1 AND LS01c NE 1
AND LS01d NE 1 AND LS01e NE 1 AND LS01f NE1 AND LSREF3 NE 1
AND LS01h NE 1 AND LS01i NE 1 AND LS01j NE 1 AND LS01k NE 1 AND
IN01a NE1 AND IN01b NE1 AND IN01c NE 1 AND IN01d NE 1 AND IN01e
NE 1AND IN01f NE 1 AND IN01g NE 1 AND IN01h NE 1 AND IN01h1 NE 1
AND IN01i NE 1 AND IN01ii NE 1 AND IN01j NE 1 AND IN01l NE 1 AND
INREF NE 1 AND ME01 NE 1 AND MEREF NE 1 AND (PRMISUSE12 NE 1
OR PRL01 NE 1 OR PRL02 NE 1) AND (TRMISUSE12 NE 1 OR TRL01 NE 1
OR TRL02 NE 1) AND (STMISUSE12 NE 12 OR STL01 NE 1 OR STL02 NE
1) AND (SVMISUSE12 NE 1 OR SVL01 NE 1 OR SVL02 NE 1)] Earlier you
reported that at some time in your life you received treatment or counseling for
your use of alcohol or any drug, not counting cigarettes. Have you ever received
treatment for your alcohol use?
1
Yes
2
No
DK/REF
TX45a [IF TX45 = 1] How old were you when you first received treatment for your
alcohol use?
_____________[RANGE: 1-110]
DK/REF
TX46 [IF TX01=1 AND TX02=2 AND (AL01 NE 1 AND ALREF NE1) AND MJ01 =
1 OR MJREF = 1 OR CC01 = 1 OR CCREF = 1 OR CK01 = 1 OR CKREF = 1
OR HE01 = 1 OR HEREF = 1 OR LS01a = 1 OR LSREF1 = 1 OR LS01b = 1 OR
LSREF2 = 1 OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR LS01f =1 OR
LSREF3 = 1 OR LS01h = 1 OR LS01i=1 OR LS01j=1 OR LS01k=1 OR IN01a
=1 OR IN01b =1 OR IN01c = 1 OR IN01d = 1 OR IN01e = 1OR IN01f = 1 OR
IN01g = 1 OR IN01h = 1 OR IN01h1=1 OR IN01i = 1 OR IN01ii=1 OR IN01j =
1 OR IN01l = 1 OR INREF = 1 OR ME01=1 OR MEREF=1 OR
PRMISUSE12=1 OR PRL01=1 OR PRL02=1 OR TRMISUSE12=1 OR
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April 15, 2016

TRL01=1 OR TRL02=1 OR STMISUSE12=1 OR STL01=1 OR STL02=1 OR
SVMISUSE12=1 OR SVL01=1 OR SVL02=1] Earlier you reported that at some
time in your life you received treatment or counseling for your use of alcohol or
any drug, not counting cigarettes. Have you ever received treatment or
counseling for your drug use?
1
Yes
2
No
DK/REF
TX46a [IF TX46 = 1] How old were you when you first received treatment or counseling
for your drug use?
_____________[RANGE: 1-110]
DK/REF
TX47 [IF TX01=1 AND TX02=2 AND (AL01 = 1 OR ALREF = 1) AND (MJ01 = 1
OR MJREF = 1 OR CC01 = 1 OR CCREF = 1 OR CK01 = 1 OR CKREF = 1 OR
HE01 = 1 OR HEREF = 1 OR LS01a = 1 OR LSREF1 = 1 OR LS01b = 1 OR
LSREF2 = 1 OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR LS01f =1 OR
LSREF3 = 1 OR LS01h = 1 OR LS01i=1 OR LS01j=1 OR LS01k=1 OR IN01a
=1 OR IN01b =1 OR IN01c = 1 OR IN01d = 1 OR IN01e = 1OR IN01f = 1 OR
IN01g = 1 OR IN01h = 1 OR IN01h1=1 OR IN01i = 1 OR IN01ii=1 OR IN01j =
1 OR IN01l = 1 OR INREF = 1 OR ME01=1 OR MEREF=1 OR
PRMISUSE12=1 OR PRL01=1 OR PRL02=1 OR TRMISUSE12=1 OR
TRL01=1 OR TRL02=1 OR STMISUSE12=1 OR STL01=1 OR STL02=1 OR
SVMISUSE12=1 OR SVL01=1 OR SVL02=1)] Earlier you reported that at some
time in your life you received treatment or counseling for your use of alcohol or
any drug, not counting cigarettes. Have you ever received treatment or
counseling for your alcohol use?
1
Yes
2
No
DK/REF
TX47a [IF TX47 = 1] How old were you when you first received treatment or counseling
for your alcohol use?
_____________[RANGE: 1-110]
DK/REF
TX48 [IF TX01=1 AND TX02=2 AND (AL01 = 1 OR ALREF = 1) AND (MJ01 = 1
OR MJREF = 1 OR CC01 = 1 OR CCREF = 1 OR CK01 = 1 OR CKREF = 1 OR
HE01 = 1 OR HEREF = 1 OR LS01a = 1 OR LSREF1 = 1 OR LS01b = 1 OR
LSREF2 = 1 OR LS01c = 1 OR LS01d = 1 OR LS01e = 1 OR LS01f =1 OR
LSREF3 = 1 OR LS01h = 1 OR LS01i=1 OR LS01j=1 OR LS01k=1 OR IN01a

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April 15, 2016

=1 OR IN01b =1 OR IN01c = 1 OR IN01d = 1 OR IN01e = 1OR IN01f = 1 OR
IN01g = 1 OR IN01h = 1 OR IN01h1=1 OR IN01i = 1 OR IN01ii=1 OR IN01j =
1 OR IN01l = 1 OR INREF = 1 OR ME01=1 OR MEREF=1 OR
PRMISUSE12=1 OR PRL01=1 OR PRL02=1 OR TRMISUSE12=1 OR
TRL01=1 OR TRL02=1 OR STMISUSE12=1 OR STL01=1 OR STL02=1 OR
SVMISUSE12=1 OR SVL01=1 OR SVL02=1)] Have you ever received
treatment or counseling for your drug use?
1
Yes
2
No
DK/REF
TX48a [IF TX48 = 1] How old were you when you first received treatment or counseling
for your drug use?
_____________[RANGE: 1-110]
DK/REF
TX49 [IF TX03 = 1] Earlier you reported that you received treatment or counseling for
your use of alcohol during the past 12 months. How old were you when you first
received treatment or counseling for your alcohol use?
_____________[RANGE: 1-110]
DK/REF

TX49a [IF TX03 = 1 AND (MJ01 = 1 OR MJREF = 1 OR CC01 = 1 OR CCREF = 1 OR
CK01 = 1 OR CKREF = 1 OR HE01 = 1 OR HEREF = 1 OR LS01a = 1 OR
LSREF1 = 1 OR LS01b = 1 OR LSREF2 = 1 OR LS01c = 1 OR LS01d = 1 OR
LS01e = 1 OR LS01f =1 OR LSREF3 = 1 OR LS01h = 1 OR LS01i=1 OR
LS01j=1 OR LS01k=1 OR IN01a =1 OR IN01b =1 OR IN01c = 1 OR IN01d = 1
OR IN01e = 1OR IN01f = 1 OR IN01g = 1 OR IN01h = 1 OR IN01h1=1 OR
IN01i = 1 OR IN01ii=1 OR IN01j = 1 OR IN01l = 1 OR INREF = 1 OR ME01=1
OR MEREF=1 OR PRMISUSE12=1 OR PRL01=1 OR PRL02=1 OR
TRMISUSE12=1 OR TRL01=1 OR TRL02=1 OR STMISUSE12=1 OR
STL01=1 OR STL02=1 OR SVMISUSE12=1 OR SVL01=1 OR SVL02=1)]
Have you ever received treatment or counseling for your use of any drug, not
including cigarettes or alcohol?
1
Yes
2
No
DK/REF
TX49b [IF TX49a = 1] How old were you when you first received treatment or
counseling for your drug use?

560
April 15, 2016

_____________[RANGE: 1-110]
DK/REF
TX50 [IF TX03 = 2] Earlier you reported that you received treatment or counseling for
your drug use during the past 12 months. How old were you when you first
received treatment or counseling for your drug use?
_____________[RANGE: 1-110]
DK/REF
TX50a [IF TX03 = 2 AND (AL01 = 1 OR ALREF = 1)] Have you ever received
treatment or counseling for your alcohol use?
1
Yes
2
No
DK/REF
TX50b [IF TX50a = 1] How old were you when you first received treatment or
counseling for your alcohol use?
_____________[RANGE: 1-110]
DK/REF

TX51 [IF TX03=3] Earlier, you reported that you received treatment or counseling for
your drug and alcohol use during the past 12 months. How old were you when
you first received treatment or counseling for your use of alcohol?
_____________[RANGE: 1-110]
DK/REF

TX51a [IF TX03=3] How old were you when you first received treatment or counseling
for your drug use?
_____________[RANGE: 1-110]
DK/REF
TX52 [IF (TX01 NE BLANK) AND (TX04h NE 1)] The next question is about selfhelp groups. Some examples of self-help groups for alcohol or drug use are AA
or Alcoholics Anonymous, NA or Narcotics Anonymous, CA or Cocaine
Anonymous, and CMA or Crystal Meth Anonymous.
During the past 12 months, did you go to any self-help group meetings or 12-step
programs to receive help for your own use of alcohol or any drug, not counting
cigarettes?

561
April 15, 2016

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TX53 [IF TX52 = 1] Did you go to the self-help group because of your alcohol use only,
your drug use only, or because of both alcohol and drug use?
1
Alcohol use only
2
Drug use only
3
Both alcohol and drug use
DK/REF

562
April 15, 2016

Health
HLTHINT

These next questions are about your health and health care.

Press [ENTER] to continue.

HLTH02 [IF QD01 = 9 AND CURNTAGE = 12 - 44] Are you currently pregnant?
1
Yes
2
No
DK/REF
HLTH03 [IF HLTH02 = 1] How many months pregnant are you?
# OF MONTHS: ________ [RANGE: 1 - 9]
DK/REF
HLTH04

This question asks about your height.
To answer in feet and inches, press 1. To answer in meters and
centimeters, press 2. To answer in inches only, press 3. To answer
in centimeters only, press 4. Then press [ENTER] to continue.
1
I would rather answer in feet and inches
2
I would rather answer in meters and centimeters
3
I would rather answer only in inches
4
I would rather answer only in centimeters
DK/REF

HLTH05

[IF HLTH04=1] About how tall are you, without shoes? First,
please type in the number of feet, then press [ENTER].
______feet [RANGE: 2-8]
DK/REF

HLTH06a

[IF HLTH04 = 1 AND HLTH05 NE DK/RF] Please type in the
number of inches and then press [ENTER].

______inch(es) [RANGE: 0-11.]
DK/REF
HLTH06b

(IF HLTH04 = 3) About how tall are you, without shoes? Please
type in the number of inches and then press [ENTER].

563
April 15, 2016

______inch(es) [RANGE: 24-96]
DK/REF
HLTH07

[IF HLTH04=2] About how tall are you, without shoes? First,
please type in the number of meters, then press [ENTER].
_______ meters [RANGE: 0-2]
DK/REF

HLTH08a

[IF HLTH04 = 2 AND HLTH07 NE DK/REF] Please type in the
number of centimeters and then press [ENTER].

______centimeter(s) [RANGE: 0-99. ]
DK/REF
HLTH08b

(IF HLTH04 = 4) About how tall are you, without shoes? Please
type in the number of centimeters and then press [ENTER].
______centimeter(s) [RANGE: 60-250]
DK/REF

HLTH09

The next question asks about your weight.
To answer in pounds, press 1. To answer in kilograms, press 2.
Then press [ENTER] to continue.
1
I would rather answer in pounds
2
I would rather answer in kilograms
DK/REF

HLTH10

[IF HLTH09=1 AND HLTH02 NE 1] About how much do you
weigh? Please type in the number of pounds and then press
[ENTER].
________pounds [RANGE: 40-999]
DK/REF

HLTH12

[IF HLTH09=2 AND HLTH02 NE 1] About how much do you
weigh? Please type in the number of kilograms and then press
[ENTER].
_______ kilograms [RANGE: 18.00-999.00]
DK/REF

564
April 15, 2016

HLTH13

[IF HLTH02=1 AND HLTH09=1] About how much did you
weigh before you got pregnant? Please type in the number of
pounds and then press [ENTER].
________pounds [RANGE: 40-999]
DK/REF

HLTH14

[IF HLTH02=1 AND HLTH09 =2] About how much did you
weigh before you got pregnant? Please type in the number of
kilograms and then press [ENTER].
_______ kilograms [RANGE: 18.00-999.00]
DK/REF

HLTH16 During the past 12 months, that is, since [DATEFILL], how many different
times have you been treated in an emergency room for any reason?
# OF TIMES: ____________ [RANGE: 0 - 90]
DK/REF
SHOW 12-MONTH CALENDAR
HLTH17 During the past 12 months, have you stayed overnight or longer as an
inpatient in a hospital?
1
Yes
2
No
DK/REF
SHOW 12-MONTH CALENDAR
HLTH18 [IF HLTH17 = 1] During the past 12 months, how many nights were you an
inpatient in a hospital?
# OF NIGHTS:
DK/REF

[RANGE: 1 - 366]

SHOW 12-MONTH CALENDAR

HLTH19

During the past 12 months, how many times have you visited a doctor,
nurse, physician assistant or nurse practitioner about your own health at a
doctor’s office, a clinic, or some other place?

565
April 15, 2016

NUMBER OF VISITS:
DK/REF

[(RANGE: 0 - 366)]

SHOW 12-MONTH CALENDAR

HLTH19DK [IF HLTH19=DK/REF] What is your best guess of how many times you
have visited a doctor, nurse, physician assistant or nurse practitioner about
your own health at a doctor’s office, a clinic, or some other place in the
past 12 months?

0.
I have not visited a health care professional in the past 12 months
1.
1 time
2.
2-3 times
3.
4-5 times
4.
6-7 times
5.
8-9 times
6.
10-12 times
7.
13-15 times
8.
16 or more times
DK/REF
SHOW 12-MONTH CALENDAR
DEFINE VISITFILL:
IF HLTH16=1 THEN VISITFILL= “your visit to the Emergency Room”
IF HLTH16>1 THEN VISITFILL = “your visits to the Emergency Room”
IF HLTH17=1 THEN VISITFILL= “your hospitalization’
IF HLTH19=1 OR HLTH19DK=1 THEN VISITFILL = “the talk you had with a
doctor or other health care professional”
IF HLTH19>1 OR HLTH19DK>1 THEN VISITFILL = “the talks you had with a
doctor or other health care professional”
HLTH20

[IF HLTH16>0 OR HLTH17=1 OR HLTH19>0 OR HLTH19DK>0]
During the past 12 months, did any doctor or other health care
professional ask, either in person or on a form, if you:

a. Smoke cigarettes or use any other tobacco products?
DK/REF
b. Drink alcohol?
DK/REF
c. Use marijuana or other illegal drugs?
DK/REF

566
April 15, 2016

1. Yes 2. No
1. Yes 2. No
1. Yes 2. No

HLTH21

[(IF HLTH16>0 OR HLTH17=1 OR HLTH19>0 OR HLTH19DK>0)
AND (CG05 = 1 OR CG06=1 OR CG06DK=1 OR CG06RE=1 OR
CG27=1 OR CG28=1 OR CG28DK=1 OR CG28RE=1 OR CG36=1 OR
CG37=1 OR CG37DK=1 OR CG37RE=1 OR CG43=1)] During the past
12 months, did any doctor or other health care professional advise you to
quit smoking cigarettes or quit using any other tobacco products?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

HLTH22

[((IF HLTH16>=1 AND (HLTH17=1 OR HLTH19>=1 OR
HLTH19DK>=1)) OR (HLTH17=1 AND (HLTH16>=1 OR HLTH19>=1
OR HLTH19DK>=1)) OR ((HLTH19>=1 OR HLTH19DK>=1) AND
(HLTH16>=1 OR HLTH17=1))) AND (ALLAST3=1 OR 2 OR
ALRECDK=1 OR 2 OR ALRECRE=1 OR 2)] Please think about all of
the talks you have had with a doctor or other health care professional
during the past 12 months when you answer this question. Choose the
statement or statements below that describe any discussions you may have
had in person with a doctor or other health professional about your
alcohol use.
[((IF HLTH16>=1 AND HLTH17 NE 1 AND HLTH19<1 AND
HLTH19DK<1) OR (HLTH17 =1 AND HLTH16 = 0 AND HLTH19<1
AND HLTH19DK<1) OR ((HLTH19 >=1 OR HLTH19DK>=1) AND
HLTH16 = 0 AND HLTH17 NE 1)) AND (ALLAST3=1 OR 2 OR
ALRECDK=1 OR 2 OR ALRECRE=1 OR 2)] Please think about
[VISITFILL] during the past 12 months when you answer this question.
Choose the statement or statements below that describe any discussion you
may have had in person with a doctor or other health professional about
your alcohol use.
To select more than one statement, press the space bar between each
number you type. When you have finished, press [ENTER].
1.
2.
3.
4.
5.

The doctor asked how much I drink.
The doctor asked how often I drink.
The doctor asked if I have any problems because of my drinking.
The doctor advised me to cut down on my drinking.
The doctor offered to give me more information about alcohol use and
treatment for problems with alcohol use.
95 The doctor didn’t discuss my alcohol use with me in the past 12
months.
DK/REF

567
April 15, 2016

HARD ERROR: [IF 95 AND AT LEAST ONE IN (1-5) SELECTED]: You have entered
“The doctor didn’t discuss my alcohol use with me in the past 12 months,” but you have
also entered one or more statements from the list. Press [Enter] to answer the question
again.
HLTH23

HLTH24

[(IF HLTH16>0 OR HLTH17=1 OR HLTH19>0 OR
HLTH19DK>0) AND [(MJLAST3=1 OR 2 OR MJRECDK=1 OR
2 OR MJRECRE=1 OR 2) OR COC12MON=1 OR
CRK12MON=1 OR HER12MON=1 OR INH12MON = 1 OR
HAL12MON = 1 OR MET12MON=1] During the past 12 months,
did any doctor or other health care professional talk to you about
your use of [FILLMARIJUANA/COCAINE/CRACK/HEROIN/
INHALANTS / HALLUCINOGENS/METHAMPHETAMINE]?
PROGRAMMERS: SEPARATE MULTIPLE FILLS WITH AN
‘OR’
1
Yes
2
No
DK/REF
These next questions are about certain medical conditions.
During the past 12 months, did you have a sexually transmitted disease
such as chlamydia, gonorrhea, herpes or syphilis?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

HLTH25

Below is a list of health conditions that you may have had during your
lifetime.
Please read the list and type in the numbers of all of the conditions that a
doctor or other health care professional has ever told you that you had.
To select more than one condition, press the space bar between each
number you type. When you have finished, press [ENTER].
1. Any kind of heart condition or heart disease
2. Diabetes or sugar diabetes
3. Chronic bronchitis, emphysema, chronic obstructive pulmonary
disease, also called COPD
4. Cirrhosis of the liver
5. Hepatitis B or C
6. Kidney disease, not including bladder infection or incontinence

568
April 15, 2016

7. Asthma
8. HIV or AIDS
9. Cancer or a malignancy of any kind
10. Hypertension, also called high blood pressure
95 None of the above - I have never had any of these conditions
DK/REF
HARD ERROR: [IF 95 AND AT LEAST ONE IN (1-10) SELECTED]: You have
entered “I have never had any of these conditions,” but you have also entered one or
more health conditions from the list. Press [ENTER] to answer the question again.
DEFINE NONCACOUNT:
INITIALIZE NONCACOUNT TO 0.
ADD 1 TO NONCACOUNT FOR EVERY RESPONSE OF 1 TO 8 OR 10 IN HLTH25.
DEFINE NONCAFILL:
NONCAFILL LISTS SPECIFIC HEALTH CONDITIONS OTHER THAN CANCER
WHEN ONLY 1 OTHER CONDITION BESIDES CANCER WAS REPORTED.
IF HLTH25=9 AND HLTH25=1 AND NONCACOUNT=1 THEN NONCAFILL =
“your heart condition or heart disease”
ELSE IF HLTH25=9 AND HLTH25=2 AND NONCACOUNT=1 THEN NONCAFILL
= “your diabetes or sugar diabetes”
ELSE IF HLTH25=9 AND HLTH25=3 AND NONCACOUNT=1 THEN NONCAFILL
= “your chronic bronchitis, emphysema, or chronic obstructive pulmonary disease, also
called COPD”
ELSE IF HLTH25=9 AND HLTH25=4 AND NONCACOUNT=1 THEN NONCAFILL
= “your cirrhosis of the liver”
ELSE IF HLTH25=9 AND HLTH25=5 AND NONCACOUNT=1 THEN NONCAFILL
= “your hepatitis”
ELSE IF HLTH25=9 AND HLTH25=6 AND NONCACOUNT=1 THEN NONCAFILL
= “your kidney disease”
ELSE IF HLTH25=9 AND HLTH25=7 AND NONCACOUNT=1 THEN NONCAFILL
= “your asthma”
ELSE IF HLTH25=9 AND HLTH25=8 AND NONCACOUNT=1 THEN NONCAFILL
= “your HIV or AIDS”
ELSE IF HLTH25=9 AND HLTH25=10 AND NONCACOUNT=1 THEN NONCAFILL
= “your high blood pressure”
ELSE IF HLTH25=9 AND NONCACOUNT >1 THEN NONCAFILL = “the other
health conditions you reported”
HLTH26

[IF HLTH25=9] What kind of cancer was it? Enter all that apply.
To select more than one category, press the space bar between the
numbers. When you have finished, press [ENTER].

569
April 15, 2016

1. Bladder
2. Blood
3. Bone
4. Brain
5. Breast
6. [IF QD01 = 9] Cervix
7. Colon
8. Esophagus
9. Gallbladder
10. Kidney
11. Larynx/windpipe
12. Leukemia
13. Liver
14. Lung
15. Lymphoma
16. Melanoma
17. Mouth/tongue/lip
18. [IF QD01 = 9] Ovary
19. Pancreas
20. [IF QD01 = 5] Prostate
21. Rectum
22. Skin (not melanoma)
23. Skin (don’t know which kind)
24. Soft tissue (muscle or fat)
25. Stomach
26. [IF QD01 = 5] Testis
27. Throat/pharynx
28. Thyroid
29. [IF QD01 = 9] Uterus
30. Other
HLTH26othr [IF HLTH26=30] Please tell me which other kind of cancer you had.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN HTLH26othr.

HLTH27 [IF HLTH26=1] How old were you when your bladder cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]

570
April 15, 2016

DK/REF
HARD ERROR: [HLTH27 > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28a

[IF HLTH26=2] How old were you when your blood cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28a > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28b

[IF HLTH26=3] How old were you when your bone cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28b > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28c

[IF HLTH26=4] How old were you when your brain cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28c > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28d

[IF HLTH26=5] How old were you when your breast cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.

571
April 15, 2016

Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF
HARD ERROR: [HLTH28d > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28e

[IF HLTH26=6] How old were you when your cervical cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28e > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28f

[IF HLTH26=7] How old were you when your colon cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28f > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28g

[IF HLTH26=8] How old were you when your esophageal cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28g > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28h

[IF HLTH26=9] How old were you when your gallbladder cancer was first
diagnosed?

572
April 15, 2016

If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF
HARD ERROR: [HLTH28h > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28i

[IF HLTH26=10] How old were you when your kidney cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28i > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28j

[IF HLTH26=11] How old were you when your larynx/windpipe cancer
was first diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28j > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28k

[IF HLTH26=12] How old were you when your leukemia was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28k > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.

573
April 15, 2016

HLTH28l

[IF HLTH26=13] How old were you when your liver cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28l > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28m

[IF HLTH26=14] How old were you when your lung cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28m > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28n

[IF HLTH26=15] How old were you when your lymphoma was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28n > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28o

[IF HLTH26=16] How old were you when your melanoma was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

574
April 15, 2016

HARD ERROR: [HLTH28o > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28p

[IF HLTH26=17] How old were you when your mouth/tongue/lip cancer
was first diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28p > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28q

[IF HLTH26=18] How old were you when your ovarian cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28q > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28r

[IF HLTH26=19] How old were you when your pancreatic cancer was
first diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28r > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28s

[IF HLTH26=20] How old were you when your prostate cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]

575
April 15, 2016

DK/REF
HARD ERROR: [HLTH28s > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28t

[IF HLTH26=21] How old were you when your rectal cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28t > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28u

[IF HLTH26=22] How old were you when your skin [not melanoma]
cancer was first diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28u > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28v

[IF HLTH26=23] How old were you when your skin cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28v > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28w

[IF HLTH26=24] How old were you when your soft tissue cancer was
first diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.

576
April 15, 2016

Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF
HARD ERROR: [HLTH28w > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28x

[IF HLTH26=25] How old were you when your stomach cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28x > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28y

[IF HLTH26=26] How old were you when your testicular cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28y > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28z

[IF HLTH26=27] How old were you when your throat/pharynx cancer was
first diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28z > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28aa

[IF HLTH26=28] How old were you when your thyroid cancer was first
diagnosed?

577
April 15, 2016

If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF
HARD ERROR: [HLTH28aa > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28bb [IF HLTH26=29] How old were you when your uterine cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF
HARD ERROR: [HLTH28bb > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH28cc

[IF HLTH26=30] How old were you when the type of cancer listed below
was first diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
[FILL HLTH26othr]
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28cc > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH29

[IF HLTH25=9 AND HLTH27 AND HLTH28a AND HLTH28b AND
HLTH28c AND HLTH28c AND HLTH28d AND HLTH28e AND
HLTH28f AND HLTH28g AND HLTH28h AND HLTH28i AND
HLTH28j AND HLTH28k AND HLTH28l AND HLTH28m AND
HLTH28n AND HLTH28o AND HLTH28p AND HLTH28q AND
HLTH28r AND HLTH28s AND HLTH28t AND HLTH28u AND
HLTH28v AND HLTH28w AND HLTH28x AND HLTH28y AND
HLTH28z AND HLTH28aa AND HLTH28bb AND HLTH28cc NE
CALCAGE] Did you have cancer during the past 12 months?
1
Yes

578
April 15, 2016

2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
HLTHOTHint

[IF HLTH25=9 AND (NONCACOUNT > 1 OR (NONCACOUNT
= 1 AND (NONCAFILL = “your heart condition or heart disease”
OR NONCAFILL = “your asthma” OR NONCAFILL = “your
high blood pressure”))] The next questions are about
[NONCAFILL].

[IF HLTH25=9 AND NONCACOUNT = 1 AND NONCAFILL NE “your
heart condition or heart disease” AND NONCAFILL NE “your asthma”
AND NONCAFILL NE “your high blood pressure”] The next question is
about [NONCAFILL].
Press [ENTER] to continue.
HLTH30

[IF HLTH25=1] How old were you when your heart condition or heart
disease was first diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH30 > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH31

[IF HLTH25=1 AND HLTH30 NE CALCAGE] Did you have any kind of
heart condition or heart disease in the past 12 months?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

HLTH32

[IF HLTH25=2] How old were you when your diabetes or sugar diabetes
was first diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

579
April 15, 2016

HARD ERROR: [HLTH32 > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH33

[IF HLTH25=3] How old were you when your chronic bronchitis,
emphysema, or chronic obstructive pulmonary disease, also called COPD
were first diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH33 > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH34

[IF HLTH25=4] How old were you when your cirrhosis of the liver was
first diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH34 > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH35

[IF HLTH25=5] How old were you when your hepatitis was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH35 > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH36

[IF HLTH25=6] How old were you when your kidney disease was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.

580
April 15, 2016

Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF
HARD ERROR: [HLTH36 > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH37

[IF HLTH25=7] How old were you when your asthma was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH37 > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH38

[IF HLTH25=7] Do you still have asthma?
1 Yes
2 No
DK/REF

HLTH39

[IF HLTH25=8] How old were you when you found out you had
HIV/AIDS?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH39 > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.
HLTH40

[IF HLTH25=10] Are you currently taking prescription medicine for your
high blood pressure?
1 Yes
2 No
DK/REF

HLTH41 [IF HLTH40=1] How old were you when your high blood pressure was first
diagnosed?

581
April 15, 2016

If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ [RANGE: 1-CURNTAGE]
DK/REF
HARD ERROR: [HLTH41 > CURNTAGE] The age you entered when you were
first diagnosed is older than your current age. Press [Enter] to answer
the question again.

582
April 15, 2016

Adult Mental Health Service Utilization
(Questions Administered only to respondents 18 or older)
ADINTRO

[IF CURNTAGE = 18 OR OLDER] These next questions are about
treatment and counseling for problems with emotions, nerves or mental
health. [IF TX01 = 1 OR DK/REF] Please do not include treatment for
alcohol or drug use.
Press [ENTER] to continue.

ADMT01

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, have you
stayed overnight or longer in a hospital or other facility to receive
treatment or counseling for any problem you were having with your
emotions, nerves, or mental health? [IF TX01 = 1 OR DK/REF] Please do
not include treatment for alcohol or drug use.
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMTREF1 [IF ADMT01 = REF] The answers that people give us about mental health
treatment are important to this study’s success. We know that this
information is personal, but remember your answers will be kept
confidential.
Please think again about answering this question: During the past 12
months, have you stayed overnight or longer in a hospital or other
facility to receive treatment or counseling for any problem you were
having with your emotions, nerves, or mental health? [IF TX01 = 1 OR
DK/REF] Please do not include treatment for alcohol or drug use.
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT02

[IF ADMT01 = 1 OR ADMTREF1 = 1] Where did you stay overnight or
longer to receive mental health treatment or counseling during the past 12
months?
To select more than one place, press the space bar between each number
you type. When you have finished, press the [ENTER] key to go to the
next question.

583
April 15, 2016

1
A private or public psychiatric hospital
2
A psychiatric unit of a general hospital
3
A medical unit of a general hospital
4
Another type of hospital
5
A residential treatment center
6
Some other type of facility
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT04

[IF ADMT02 = 1] During the past 12 months, how many nights did you
spend in a private or public psychiatric hospital for mental health care?
# OF NIGHTS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT05

[IF ADMT02 = 2] During the past 12 months, how many nights did you
spend in the psychiatric unit of a general hospital for mental health care?
# OF NIGHTS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT06

[IF ADMT02 = 3] During the past 12 months, how many nights did you
spend in the medical unit of a general hospital for mental health care?
# OF NIGHTS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT07

[IF ADMT02 = 4] During the past 12 months, how many nights did you
spend in some other type of hospital for mental health care?
# OF NIGHTS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT08

[IF ADMT02 = 5] During the past 12 months, how many nights did you
spend in a residential treatment center for mental health care?
# OF NIGHTS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT09

[IF ADMT02 = 6] During the past 12 months, how many nights did you
spend in some other type of facility for mental health care?

584
April 15, 2016

# OF NIGHTS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT10

[IF ADMT02 NE BLANK] Who paid or will pay for the inpatient mental
health care you received during the past 12 months?
To select more than one answer, press the space bar between each number
you type. When you have finished, press the [ENTER] key to go to the
next question.
1
Self or a family member living with you
2
A family member who does not live with you
3
Private health insurance
4
Medicare
5
Medicaid
6
Rehabilitation program
7
Employer
8
VA or other military program
9
Other public source
10
Other private source
11
No one paid because the treatment was free
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT11

[IF MORE THAN 1 RESPONSE SELECTED IN ADMT10 AND
ADMT02 NE DK/REF] Who paid or will pay most of the cost for the
inpatient mental health care you received during the past 12 months?
Please select only one answer from those that are shown in blue below.
[NOTE TO PROGRAMMERS: RESPONSES CHOSEN IN ADMT10
SHOULD BE SHOWN IN BLUE. IMPLEMENT AN ERROR
MESSAGE IF THE RESPONDENT SELECTS ONE OF THE OTHER
RESPONSES.]
1
2
3
4
5
6
7
8
9
10

Self or a family member living with you
A family member who does not live with you
Private health insurance
Medicare
Medicaid
Rehabilitation program
Employer
VA or other military program
Other public source
Other private source

585
April 15, 2016

11
No one paid because the treatment was free
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT12

[IF ADMT10 = 1 AND ADMT02 NE DK/REF] How much did you or
your family pay for the inpatient mental health care you received during
the past 12 months? Do not count any money that has been or will be
reimbursed by insurance or any other source.
[IF ADMT10 = 2 AND NE 1 AND ADMT02 NE DK/REF] How much
did your family pay for the inpatient mental health care you received
during the past 12 months? Do not count any money that has been or will
be reimbursed by insurance or any other source.
1
Less than $100
2
$100 to $200
3
$201 to $500
4
$501 to $900
5
$901 to $1,500
6
$1,501 to $2,000
7
$2,001 to $5,000
8
$5,001 to $7,500
9
$7,501 to $10,000
10
More than $10,000
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT13

[IF CURNTAGE = 18 OR OLDER] The list below includes some of the
places where people can get outpatient treatment or counseling for
problems with their emotions, nerves, or mental health.
During the past 12 months, did you receive any outpatient treatment or
counseling for any problem you were having with your emotions, nerves,
or mental health at any of the places listed below? [IF TX01 = 1 OR
DK/REF] Please do not include treatment for alcohol or drug use.
•
•
•
•
•
•

An outpatient mental health clinic or center
The office of a private therapist, psychologist, psychiatrist, social
worker, or counselor that was not part of a clinic
A doctor’s office that was not part of a clinic
An outpatient medical clinic
A partial day hospital or day treatment program
Some other place

1
2

Yes
No

586
April 15, 2016

DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMTREF13
[IF ADMT13 = REF] The answers that people give us about
mental health treatment are important to this study’s success. We know
that this information is personal, but remember your answers will be kept
confidential.
Please think again about answering this question: During the past 12
months, did you receive any outpatient treatment or counseling for any
problem you were having with your emotions, nerves, or mental health at
any of the places listed below? [IF TX01 = 1 OR DK/REF] Please do not
include treatment for alcohol or drug use.
•
•
•
•
•
•

An outpatient mental health clinic or center
The office of a private therapist, psychologist, psychiatrist, social
worker, or counselor that was not part of a clinic
A doctor’s office that was not part of a clinic
An outpatient medical clinic
A partial day hospital or day treatment program
Some other place

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT14

[IF ADMT13 = 1 OR ADMTREF13 = 1] Where did you receive
outpatient mental health treatment or counseling during the past 12
months?
To select more than one place, press the space bar between each number
you type. When you have finished, press the [ENTER] key to go to the
next question.
1
2

An outpatient mental health clinic or center
The office of a private therapist, psychologist, psychiatrist, social
worker, or counselor that was not part of a clinic
3
A doctor’s office that was not part of a clinic
4
An outpatient medical clinic
5
A partial day hospital or day treatment program
6
Some other place
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT15

[IF ADMT14 = 6] Please type in a description of this other place where

587
April 15, 2016

you received outpatient mental health treatment or counseling. When you
have finished, press the [ENTER] key to go to the next question.
________________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN ADMT15.
ADMT16

[IF ADMT14 = 1] During the past 12 months, how many visits did you
make to an outpatient mental health clinic or center for mental health
care?
# OF VISITS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT17

[IF ADMT14 = 2] During the past 12 months, how many outpatient
visits did you make to a private therapist, psychologist, psychiatrist, social
worker, or counselor for mental health care?
# OF VISITS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT18

[IF ADMT14 = 3] During the past 12 months, how many outpatient
visits did you make to a doctor’s office for mental health care?
# OF VISITS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT19

[IF ADMT14 = 4] During the past 12 months, how many outpatient
visits did you make to an outpatient medical clinic for mental health care?
# OF VISITS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT20

[IF ADMT14 = 5] During the past 12 months, how many outpatient
visits did you make to a partial day hospital or day treatment program for
mental health care?
# OF VISITS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT21

[IF ADMT14 = 6] During the past 12 months, how many outpatient visits

588
April 15, 2016

did you make to some other type of facility for mental health care?
# OF VISITS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT22

[IF ADMT14 NE BLANK] Who paid or will pay for the outpatient
mental health care you received during the past 12 months?
To select more than one answer, press the space bar between each number
you type. When you have finished, press the [ENTER] key to go to the
next question.
1
Self or a family member living with you
2
A family member who does not live with you
3
Private health insurance
4
Medicare
5
Medicaid
6
Rehabilitation program
7
Employer
8
VA or other military program
9
Other public source
10
Other private source
11
No one paid because the treatment was free
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT23

[IF MORE THAN 1 RESPONSE SELECTED IN ADMT22 AND
ADMT14 NE DK/REF] Who paid or will pay most of the cost for the
outpatient mental health care you received during the past 12 months?
Please select only one answer from those that are shown in blue below.
[NOTE TO PROGRAMMERS: RESPONSES CHOSEN IN ADMT22
SHOULD BE SHOWN IN BLUE. IMPLEMENT AN ERROR
MESSAGE IF THE RESPONDENT SELECTS ONE OF THE OTHER
RESPONSES.]
1
2
3
4
5
6
7
8
9

Self or a family member living with you
A family member who does not live with you
Private health insurance
Medicare
Medicaid
Rehabilitation program
Employer
VA or other military program
Other public source

589
April 15, 2016

10
Other private source
11
No one paid because the treatment was free
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT24

[IF ADMT22 = 1 AND ADMT14 NE DK/REF] How much did you or
your family pay for the outpatient mental health care you received during
the past 12 months? Do not count any money that has been or will be
reimbursed by insurance or any other source.
[IF ADMT22 = 2 AND NE 1 AND ADMT14 NE DK/REF] How much
did your family pay for the outpatient mental health care you received
during the past 12 months? Do not count any money that has been or will
be reimbursed by insurance or any other source.
1
Less than $100
2
$100 to $200
3
$201 to $500
4
$501 to $900
5
$901 to $1,500
6
$1,501 to $2,000
7
$2,001 to $5,000
8
More than $5,000
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT25

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, did you
take any prescription medication that was prescribed for you to treat a
mental or emotional condition?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMTREF25
[IF ADMT25 = REF] The answers that people give us about their
use of prescription medications are important to this study’s success. We
know that this information is personal, but remember your answers will be
kept confidential.
Please think again about answering this question: During the past 12
months, did you take any prescription medication that was prescribed for
you to treat a mental or emotional condition?
1
2

Yes
No

590
April 15, 2016

DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT26

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, was there
any time when you needed mental health treatment or counseling for
yourself but didn’t get it?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT27

[IF ADMT26 = 1] Which of these statements explain why you did not get
the mental health treatment or counseling you needed?
To select more than one reason from the list, press the space bar between
each number you type. When you have finished, press [ENTER].
1
2

You couldn’t afford the cost.
You were concerned that getting mental health treatment or
counseling might cause your neighbors or community to have a
negative opinion of you.
3
You were concerned that getting mental health treatment or
counseling might have a negative effect on your job.
4
Your health insurance does not cover any mental health treatment
or counseling.
5
Your health insurance does not pay enough for mental health
treatment or counseling.
6
You did not know where to go to get services.
7
You were concerned that the information you gave the counselor
might not be kept confidential.
8
You were concerned that you might be committed to a psychiatric
hospital or might have to take medicine.
9
Some other reason or reasons.
DK/REF
ADMT27A

[IF ANY ENTRY IN ADMT27 = 9] Which of these statements explain
why you did not get the mental health treatment or counseling you
needed?
To select more than one reason from the list, press the space bar between
each number you type. When you have finished, press [ENTER].
1
2
3

You didn't think you needed treatment at the time.
You thought you could handle the problem without treatment.
You didn't think treatment would help.

591
April 15, 2016

4

You didn't have time (because of job, childcare, or other
commitments).
5
You didn't want others to find out that you needed treatment.
6
You had no transportation, or treatment was too far away, or the
hours were not convenient.
7
Some other reason or reasons.
DK/REF
ADMT27SP [IF ADMT27A = 7] Please type in the most important other reason you
did not get the mental health treatment or counseling you needed. When
you have finished, press the [ENTER] key to go to the next question.
__________________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN ADMT27SP.
ADMT29a

[IF CURNTAGE = 18 OR OLDER] Earlier, we asked whether you have
received prescription medicines, inpatient treatment or outpatient
treatment for your emotions, nerves or mental health. The list below
contains possible sources of treatment, counseling or support that were
not mentioned before.
Acupuncturist or acupressurist
Chiropractor
Herbalist
In-person support group or self-help group
Internet support group or chat room
Spiritual or religious advisor, such as a pastor, priest, rabbi
Telephone hotline
Massage therapist
Did you receive treatment, counseling or support from any other sources
such as these during the past 12 months?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

ADMT29b

[IF ADMT29a = 1] From what source did you receive other treatment,
counseling or support for problems with your emotions, nerves or mental
health in the past 12 months?
To select more than one source from the list, press the space bar between
each number you type. When you have finished, press [ENTER].

592
April 15, 2016

1
Acupuncturist or acupressurist
2
Chiropractor
3
Herbalist
4
In-person support group or self-help group
5
Internet support group or chat room
6
Spiritual or religious advisor, such as a pastor, priest, rabbi
7
Telephone hotline
8
Massage therapist
9
Other (specify)
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
ADMT29bSP [IF ADMT29b = 9] Please type in the source of the other treatment,
counseling or support you received. When you have finished, press the
[ENTER] key to go to the next question.
____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN ADMT29bSP.
ADMT30

[IF ADMT01 = 1 OR ADMTREF1 = 1 OR ADMT13 = 1 OR
ADMTREF13 = 1 OR ADMT25 = 1 OR ADMTREF25 = 1 OR
ADMT29a=1] Please think about the mental health treatment or
counseling you received during the past 12 months. Which of these
statements best describes how you were prompted to get treatment?
1
I decided on my own to get treatment
2
I got treatment mainly because someone else thought I should
3
I was ordered to get treatment
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

593
April 15, 2016

594
April 15, 2016

Social Environment
(Section Administered to 18 + Year Olds Only)
leadsen

[IF CURNTAGE = 18 OR OLDER] The next questions are about things you
might or might not have done recently.
Press [ENTER] to continue.

SEN12a

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, how many
times have you sold illegal drugs?
1
0 times
2
1 or 2 times
3
3 to 5 times
4
6 to 9 times
5
10 or more times
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

sen12b

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, how many
times have you stolen or tried to steal anything worth more than $50?
1
0 times
2
1 or 2 times
3
3 to 5 times
4
6 to 9 times
5
10 or more times
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

sen12c

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, how many
times have you attacked someone with the intent to seriously hurt them?
1
0 times
2
1 or 2 times
3
3 to 5 times
4
6 to 9 times
5
10 or more times
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

sen13b

[IF CURNTAGE = 18 OR OLDER] How do you feel about adults trying
marijuana or hashish once or twice?
1

Neither approve nor disapprove

595
April 15, 2016

2
Somewhat disapprove
3
Strongly disapprove
DK/REF
senrelat

[IF CURNTAGE = 18 OR OLDER] During the past 12 months, how many
times did you attend religious services? Please do not include special
occasions such as weddings, funerals, or other special events in your answer.
1
0 times
2
1 to 2 times
3
3 to 5 times
4
6 to 24 times
5
25 to 52 times
6
More than 52 times
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

senrebe1 [IF CURNTAGE = 18 OR OLDER] These next questions are about the role
that religious beliefs may play in your life. For each statement, please
indicate whether you strongly disagree, disagree, agree, or strongly agree.
Your religious beliefs are a very important part of your life.
1
Strongly disagree
2
Disagree
3
Agree
4
Strongly agree
DK/REF
senrebe2 [IF CURNTAGE = 18 OR OLDER] Your religious beliefs influence how you
make decisions in your life.
1
Strongly disagree
2
Disagree
3
Agree
4
Strongly agree
DK/REF
senrebe3 [IF CURNTAGE = 18 OR OLDER] It is important that your friends share
your religious beliefs.
1
Strongly disagree
2
Disagree
3
Agree
4
Strongly agree
DK/REF

596
April 15, 2016

Parenting Experiences
(IF FIPE3 =1 ADMINISTER THIS SECTION; ELSE SKIP TO YOUTH
EXPERIENCES IF RESPONDENT IS 12 -17 OR DIINTRO IF
RESPONDENT IS 18 OR OLDER)
leadpar

[IF FIPE3 = 1] These questions refer to your child who was also selected to
complete an interview. Please think about this child as you answer these
questions. If you’re not sure which child was selected, please ask your
interviewer.
Press [ENTER] to continue.

pe01

[IF FIPE3 = 1] What is the birth date of your child who was also selected to
complete an interview?
Enter your child’s birth date as numbers in the following form: (MM-DD-YYYY)
DOB: _____________
DK/REF

CALCULATE CHILD’S AGE FROM PE01.
HARD ERROR: [IF CALCULATED AGE FROM PE01 > 18]: THE BIRTH DATE
YOU HAVE ENTERED ([PE01]) INDICATES THAT YOUR CHILD IS OLDER
THAN 18. PLEASE VERIFY WITH YOUR INTERVIEWER THAT THIS IS
THE CHILD WHO WAS ALSO SELECTED TO BE INTERVIEWED AND
CHECK TO MAKE SURE THE DATE OF BIRTH YOU HAVE ENTERED IS
CORRECT.
PRESS [ENTER] TO CONTINUE.
HARD ERROR: [IF CALCULATED AGE FROM PE01 < 12]: THE BIRTH DATE
YOU HAVE ENTERED ([PE01]) INDICATES THAT YOUR CHILD IS
YOUNGER THAN 12. THIS CHILD WOULD NOT BE ELIGIBLE TO BE
INTERVIEWED. PLEASE CHECK TO MAKE SURE THE DATE OF BIRTH
YOU HAVE ENTERED IS CORRECT.
PRESS [ENTER] TO CONTINUE.
pe01a [IF PE01 NE DK/REF] The computer calculated that the child who was also
selected to complete an interview is [CALCULATED AGE FROM PE01]. Is
this correct?
1
2

Yes
No

597
April 15, 2016

DK/REF
pe01b [IF PE01 = DK/REF OR PE01a = 2] How old is the child who was also selected
to complete an interview?
AGE:
DK/REF
pe02

[RANGE: 12 - 18]

[IF PE01a = 1 OR PE01b = 12 - 18] Think about the past 12 months, that is, from
[DATEFILL] through today. Please indicate if you think your child has done
any of these things during the past 12 months.
In the past 12 months, do you think your child has smoked one or more cigarettes,
even once?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

pe02b [IF PE01a = 1 OR PE01b = 12 - 18] In the past 12 months, do you think your
child has used any “smokeless” tobacco, such as snuff, dip, chewing tobacco or
”snus”, even once?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
pe02c [IF PE01a = 1 OR PE01b = 12 - 18] In the past 12 months, do you think your
child has drunk any type of alcoholic beverage, even once?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
pe02d [IF PE01a = 1 OR PE01b = 12 - 18] In the past 12 months, do you think your
child has used any marijuana or hashish, even once?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
pe02e [IF PE01a = 1 OR PE01b = 12 - 18] In the past 12 months, do you think your

598
April 15, 2016

child has used any form of cocaine, such as powder, ‘crack,’ free base or coca
paste, even once?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
pe02f [IF PE01a = 1 OR PE01b = 12 - 18] In the past 12 months, do you think your
child has used any inhalant, such as nitrous oxide, glue, paint thinner or certain
aerosol sprays, even once?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
pe03

[IF PE01a = 1 OR PE01b = 12 - 18] During the past 12 months, how many
times have you talked with your child about the dangers or problems associated
with the use of tobacco, alcohol, or other drugs?
1
0 times
2
1 to 2 times
3
A few times
4
Many times
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

pe04

[IF PE03 = 2 OR 3 OR 4] Think about the most serious and thorough discussion
about drugs you had with your child during the past 12 months. About how
long did this discussion last?
1
Less than 10 minutes
2
10 to 30 minutes
3
31 to 60 minutes
4
More than 60 minutes
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

pe05a [IF PE01a = 1 OR PE01b = 12 - 18] For each of the next statements, please
indicate whether you strongly agree, agree, disagree, or strongly disagree.
I wish I knew better what to say to my child about drugs.
1
2

Strongly agree
Agree

599
April 15, 2016

3
Disagree
4
Strongly disagree
DK/REF
pe05b [IF PE01a = 1 OR PE01b = 12 - 18] What I say will have little influence on
whether my child uses drugs.
1
Strongly agree
2
Agree
3
Disagree
4
Strongly disagree
DK/REF
pe05c [IF PE01a = 1 OR PE01b = 12 - 18] Drug education is best handled by the
schools, not by parents.
1
Strongly agree
2
Agree
3
Disagree
4
Strongly disagree
DK/REF
pe05d [IF PE01a = 1 OR PE01b = 12 - 18] There are places in my community where I
can learn more about how to help prevent my child from using drugs.
1
Strongly agree
2
Agree
3
Disagree
4
Strongly disagree
DK/REF

600
April 15, 2016

Youth Experiences
(Section Administered to 12 - 17 Year Olds Only; Respondents 18 or Older
Skip to DIINTRO)
LEADSEN [IF CURNTAGE = 12 - 17] The next questions are about school and other
activities.
Press [Enter] to continue.

YE09 [IF CURNTAGE = 12 - 17] The next questions are about school. By “school,” we
mean elementary school, junior high or middle school, high school, or a college or
university. Please include home schooling as well.
Have you attended any type of school at any time during the past 12 months?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE09a [IF YE09 = 2 OR DK/REF] Some parents decide to educate their children at
home rather than send them to school. Have you been home-schooled at any time
during the past 12 months?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE10 [IF YE09 = 1] Which of the statements below best describes how you felt overall
about going to school during the past 12 months?
[IF YE09a = 1] Please think about your home-schooling as you answer these next
questions about “school.”
Which of the statements below best describes how you felt overall about going to
school during the past 12 months?
1
You liked going to school a lot
2
You kind of liked going to school
3
You didn’t like going to school very much
4
You hated going to school
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

601
April 15, 2016

YE11 [IF YE09 = 1 OR YE09a = 1] During the past 12 months, how often did you
feel that the school work you were assigned to do was meaningful and important?
1
Always
2
Sometimes
3
Seldom
4
Never
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE12 [IF YE09 = 1 OR YE09a = 1] How important do you think the things you have
learned in school during the past 12 months are going to be to you later in life?
1
Very important
2
Somewhat important
3
Somewhat unimportant
4
Very unimportant
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE13 [IF YE09 = 1 OR YE09a = 1] How interesting do you think most of your courses
at school during the past 12 months have been?
1
Very interesting
2
Somewhat interesting
3
Somewhat boring
4
Very boring
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE14 [IF YE09 = 1 OR YE09a = 1] During the past 12 months, how often did your
teachers at school let you know when you were doing a good job with your school
work?
1
Always
2
Sometimes
3
Seldom
4
Never
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE15 [IF YE09 = 1 OR YE09a = 1] What were your grades for the last semester or
grading period you completed?
1

An ‘A+’, ‘A’, or ‘A-minus’ average

602
April 15, 2016

2
A ‘B+’, ‘B’, or ‘B-minus’ average
3
A ‘C+’, ‘C’, or ‘C-minus’ average
4
A ‘D’ or less than a ‘D’ average
5
My school does not give these grades
DK/REF
YE16a [IF YE09 = 1] How many of the students in your grade at school would you say
smoke cigarettes?
[IF YE09a = 1] Please think about the school you would be attending if you were
not home-schooled, as you answer these next questions.
How many of the students in your grade at school would you say smoke
cigarettes?
1
None of them
2
A few of them
3
Most of them
4
All of them
DK/REF
YE16b [IF YE09 = 1 OR YE09a = 1] How many of the students in your grade at school
would you say use marijuana or hashish?
1
None of them
2
A few of them
3
Most of them
4
All of them
DK/REF
YE16c [IF YE09 = 1 OR YE09a = 1] How many of the students in your grade at school
would you say drink alcoholic beverages?
1
None of them
2
A few of them
3
Most of them
4
All of them
DK/REF
YE16d [IF YE09 = 1 OR YE09a = 1] How many of the students in your grade at school
would you say get drunk at least once a week?
1
2
3
4

None of them
A few of them
Most of them
All of them

603
April 15, 2016

DK/REF
YE06a [IF YE09 = 1 OR YE09a = 1] The next questions ask about your parents. By
parents, we mean either your biological parents, adoptive parents, stepparents, or
adult guardians who live in your household.
During the past 12 months, how often did your parents check on whether you
had done your homework?
1
Always
2
Sometimes
3
Seldom
4
Never
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE06b [IF YE09 = 1 OR YE09a = 1] During the past 12 months, how often did your
parents provide help with your homework when you needed it?
1
Always
2
Sometimes
3
Seldom
4
Never
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE06c [IF YE09 =2 OR DK/REF AND YE09a = 2 OR DK/REF ADD: The next
questions ask about your parents. By parents, we mean either your biological
parents, adoptive parents, stepparents, or adult guardians who live in your
household. OTHERWISE SIMPLY SHOW QUESTION AS IS.] During the
past 12 months, how often did your parents make you do chores around the
house?
1
Always
2
Sometimes
3
Seldom
4
Never
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE06d [IF CURNTAGE = 12 - 17] During the past 12 months, how often did your
parents limit the amount of time you watched TV?
1
2
3
4

Always
Sometimes
Seldom
Never

604
April 15, 2016

DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE06e [IF YE09=1 OR YE09a = 1] During the past 12 months, how often did your
parents limit the amount of time you went out with friends on school nights?
1
Always
2
Sometimes
3
Seldom
4
Never
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE06f [IF CURNTAGE = 12 - 17] During the past 12 months, how often did your
parents let you know when you’d done a good job?
1
Always
2
Sometimes
3
Seldom
4
Never
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE06g [IF CURNTAGE = 12 - 17] During the past 12 months, how often did your
parents tell you they were proud of you for something you had done?
1
Always
2
Sometimes
3
Seldom
4
Never
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE18a [IF CURNTAGE = 12 - 17] During the past 12 months, how many times have
you argued or had a fight with at least one of your parents?
1
0 times
2
1 or 2 times
3
3 to 5 times
4
6 to 9 times
5
10 or more times
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE18b [IF CURNTAGE = 12 - 17] During the past 12 months, how many times have
you gotten into a serious fight at school or work?

605
April 15, 2016

1
0 times
2
1 or 2 times
3
3 to 5 times
4
6 to 9 times
5
10 or more times
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE18c [IF CURNTAGE = 12 - 17] During the past 12 months, how many times have
you taken part in a fight where a group of your friends fought against another
group?
1
0 times
2
1 or 2 times
3
3 to 5 times
4
6 to 9 times
5
10 or more times
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE18d [IF CURNTAGE = 12 - 17] During the past 12 months, how many times have
you carried a handgun?
1
0 times
2
1 or 2 times
3
3 to 5 times
4
6 to 9 times
5
10 or more times
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE18e [IF CURNTAGE = 12 - 17] During the past 12 months, how many times have
you sold illegal drugs?
1
0 times
2
1 or 2 times
3
3 to 5 times
4
6 to 9 times
5
10 or more times
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE18f [IF CURNTAGE = 12 - 17] During the past 12 months, how many times have
you stolen or tried to steal anything worth more than $50?

606
April 15, 2016

1
0 times
2
1 or 2 times
3
3 to 5 times
4
6 to 9 times
5
10 or more times
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE18g [IF CURNTAGE = 12 - 17] During the past 12 months, how many times have
you attacked someone with the intent to seriously hurt them?
1
0 times
2
1 or 2 times
3
3 to 5 times
4
6 to 9 times
5
10 or more times
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE07a [IF CURNTAGE = 12 - 17] How do you think your parents would feel about you
smoking one or more packs of cigarettes per day?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE07b [IF CURNTAGE = 12 - 17] How do you think your parents would feel about you
trying marijuana or hashish once or twice?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE07b1
[IF CURNTAGE = 12 - 17] How do you think your parents would feel
about you using marijuana or hashish once a month or more?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE07c [IF CURNTAGE = 12 - 17] How do you think your parents would feel about you
having one or two drinks of an alcoholic beverage nearly every day?

607
April 15, 2016

1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE19a [IF CURNTAGE = 12 - 17] How do you feel about someone your age smoking
one or more packs of cigarettes a day?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE19b [IF CURNTAGE = 12 - 17] How do you feel about someone your age trying
marijuana or hashish once or twice?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE19b1 [IF CURNTAGE = 12 - 17] How do you feel about someone your age using
marijuana once a month or more?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE19c [IF CURNTAGE = 12 - 17] How do you feel about someone your age having
one or two drinks of an alcoholic beverage nearly every day?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE20a [IF CURNTAGE = 12 - 17] How do you think your close friends would feel
about you smoking one or more packs of cigarettes a day?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE20b [IF CURNTAGE = 12 - 17] How do you think your close friends would feel

608
April 15, 2016

about you trying marijuana or hashish once or twice?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE20b1
[IF CURNTAGE = 12 - 17] How do you think your close friends would
feel about you using marijuana or hashish once a month or more?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE20c [IF CURNTAGE = 12 - 17] How do you think your close friends would feel
about you having one or two drinks of an alcoholic beverage nearly every day?
1
Neither approve nor disapprove
2
Somewhat disapprove
3
Strongly disapprove
DK/REF
YE22 [IF CURNTAGE = 12 - 17] If you wanted to talk to someone about a serious
problem, which of the following people would you turn to?
To select more than one category, press the space bar between each category you
select.
1
There is nobody I can talk to about serious problems
2
My mother or father or guardian
3
My boyfriend or girlfriend
4
Some other adult
5
Some other person or persons
DK/REF
YE08 [IF CURNTAGE = 12 - 17] Now think about the past 12 months, that is, from
[DATEFILL] through today. During the past 12 months, have you talked with
at least one of your parents about the dangers of tobacco, alcohol, or drug use?
By parents, we mean either your biological parents, adoptive parents,
stepparents, or adult guardians -- whether or not they live with you.
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

609
April 15, 2016

YE23b [IF CURNTAGE = 12 - 17] During the past 12 months have you participated in
a problem solving, communication skills or self-esteem group?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE23c [IF CURNTAGE = 12 - 17] During the past 12 months have you participated in
a violence prevention program, where you learn ways to avoid fights and control
anger?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE23g [IF CURNTAGE = 12 - 17] During the past 12 months have you participated
in an alcohol, tobacco or drug prevention program outside of school, where you
learn about the dangers of using, and how to resist using, alcohol, tobacco, or
drugs?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE23j [IF CURNTAGE = 12 - 17] During the past 12 months have you participated in
a program or meeting to help you deal with drug or alcohol use by you or another
member of your family, such as Alcoholics Anonymous, Alateen, or individual or
group counseling?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE23o [IF CURNTAGE = 12 - 17] During the past 12 months have you participated in
pregnancy or sexually transmitted disease prevention programs?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

610
April 15, 2016

YE23p [IF CURNTAGE = 12 - 17] During the past 12 months, in how many different
kinds of school-based activities, such as team sports, cheerleading, choir, band,
student government, or clubs, have you participated?
0
None
1
One
2
Two
3
3 or more
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE23q [IF CURNTAGE = 12 - 17] During the past 12 months, in how many different
kinds of community-based activities, such as volunteer activities, sports, clubs, or
groups have you participated?
0
None
1
One
2
Two
3
3 or more
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE23r [IF CURNTAGE = 12 - 17] During the past 12 months, in how many different
kinds of church or faith-based activities, such as clubs, youth groups, Saturday or
Sunday school, prayer groups, youth trips, service or volunteer activities have you
participated?
0
None
1
One
2
Two
3
3 or more
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE23s [IF CURNTAGE = 12 - 17] During the past 12 months, in how many different
kinds of other activities, such as dance lessons, piano lessons, karate lessons, or
horseback riding lessons, have you participated?
0
None
1
One
2
Two
3
3 or more
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE24a [IF YE09 = 1 OR YE09a = 1] During the past 12 months have you had a

611
April 15, 2016

special class about drugs or alcohol in school?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE24b [IF YE09 = 1 OR YE09a = 1] During the past 12 months have you had films,
lectures, discussions, or printed information about drugs or alcohol in one of your
regular school classes such as health or physical education?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE24c [IF YE09 = 1 OR YE09a = 1] During the past 12 months have you had films,
lectures, discussions, or printed information about drugs or alcohol outside of one
of your regular classes such as in a special assembly?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YE25 [IF YE09 = 1 OR YE09a = 1] During the past 12 months have you seen or heard
any alcohol or drug prevention messages from sources outside school such as
posters, pamphlets, radio, or TV?
[IF YE09 = 2 OR DK/REF AND YE09a = 2 OR DK/REF] During the past 12
months have you seen or heard any alcohol or drug prevention messages from
sources such as posters, pamphlets, radio, or TV?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YERELATT [IF CURNTAGE = 12 - 17] During the past 12 months, how many times
did you attend religious services? Please do not include special occasions
such as weddings, funerals, or other special events in your answer.
1
2
3
4
5

0 times
1 to 2 times
3 to 5 times
6 to 24 times
25 to 52 times

612
April 15, 2016

6
More than 52 times
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YEREBEL1 [IF CURNTAGE = 12 - 17] These next questions are about the role that
religious beliefs may play in your life. For each statement, please indicate
whether you strongly disagree, disagree, agree, or strongly agree.
Your religious beliefs are a very important part of your life.
1
Strongly Disagree
2
Disagree
3
Agree
4
Strongly Agree
DK/REF
YEREBEL2 [IF CURNTAGE = 12 - 17] Your religious beliefs influence how you
make decisions in your life.
1
Strongly Disagree
2
Disagree
3
Agree
4
Strongly Agree
DK/REF
YEREBEL3 [IF CURNTAGE = 12 - 17] It is important that your friends share your
religious beliefs.
1
Strongly Disagree
2
Disagree
3
Agree
4
Strongly Agree
DK/REF

613
April 15, 2016

614
April 15, 2016

Mental Health
(Questions administered only to respondents 18 or older.)
DIINTRO

[IF CURNTAGE = 18 OR OLDER] These questions ask how you have
been feeling during the past 30 days.
Press [ENTER] to continue.

NERVE30

[IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel nervous?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

HOPE30

[IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel hopeless?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

FIDG30

[IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel restless or fidgety?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

NOCHR30

[IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel so sad or depressed that
nothing could cheer you up?

615
April 15, 2016

1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
EFFORT30 [IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel that everything was an
effort?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DOWN30

[IF CURNTAGE = 18 OR OLDER]
During the past 30 days, how often did you feel down on yourself, no
good or worthless?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

WORST30

The last questions asked about how you have been feeling during the past
30 days. Now think about the past 12 months. Was there a month in the
past 12 months when you felt more depressed, anxious, or emotionally
stressed than you felt during the past 30 days?
1
Yes
2
No
PROGRAMMER: SHOW 12 MONTH CALENDAR

DSNERV1

[IF CURNTAGE = 18 OR OLDER AND WORST30=1] Think of one
month in the past 12 months when you were the most depressed, anxious,
or emotionally stressed.
During that month, how often did you feel nervous?

616
April 15, 2016

1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DSHOPE

[IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that
same month when you were at your worst emotionally . . .
how often did you feel hopeless?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF

DSFIDG

[IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that
same month when you were at your worst emotionally . . .
how often did you feel restless or fidgety?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF

DSNOCHR [IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that
same month when you were at your worst emotionally . . .
how often did you feel so sad or depressed that nothing could cheer you
up?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF

617
April 15, 2016

DSEFFORT [IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that
same month when you were at your worst emotionally . . .
how often did you feel that everything was an effort?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF
DSDOWN

[IF CURNTAGE = 18 OR OLDER AND WORST30=1] During that
same month when you were at your worst emotionally . . .
how often did you feel down on yourself, no good, or worthless?
1
All of the time
2
Most of the time
3
Some of the time
4
A little of the time
5
None of the time
DK/REF

DEFINE DISTRESS:
IF NERVE30 = 1-4 OR HOPE30 = 1-4 OR FIDG30 = 1-4, OR NOCHR30 = 1-4
OR EFFORT30= 1-4 OR DOWN30 = 1-4, OR DSNERV1 = 1-4 OR
DSHOPE = 1-4 OR DSFIDG = 1-4 ORDSNOCHR = 1-4 OR
DSEFFORT= 1-4 OR DSDOWN = 1-4, THEN DISTRESS = 1
ELSE, DISTRESS = 2
LIKERT

[IF DISTRESS=1] The next questions are about how much your emotions,
nerves, or mental health caused you to have difficulties in daily activities.
In answering, think of the one month in the past 12 months when your
emotions, nerves, or mental health interfered most with your daily
activities.
Press [ENTER] to continue.

LIREMEM [IF DISTRESS =1] During that one month when your emotions, nerves or
mental health interfered most with your daily activities . . .
how much difficulty did you have remembering to do things you needed
618
April 15, 2016

to do?
1
No difficulty
2
Mild difficulty
3
Moderate difficulty
4
Severe difficulty
DK/REF
LICONCEN [IF DISTRESS =1] During that one month when your emotions, nerves or
mental health interfered most with your daily activities . . .
how much difficulty did you have concentrating on doing something
important when other things were going on around you?
1
No difficulty
2
Mild difficulty
3
Moderate difficulty
4
Severe difficulty
DK/REF

LIGOOUT1 [IF DISTRESS =1] During that one month when your emotions, nerves or
mental health interfered most with your daily activities . . .
how much difficulty did you have going out of the house and getting
around on your own?
1
No difficulty
2
Mild difficulty
3
Moderate difficulty
4
Severe difficulty
5
You didn’t leave the house on your own
DK/REF
LIGOOUT2 [IF LIGOOUT1 = 5] Did problems with your emotions, nerves, or mental
health keep you from leaving the house on your own?
1
Yes
2
No
DK/REF
LISTRAN1

[IF DISTRESS =1] During that one month when your emotions, nerves or
mental health interfered most with your daily activities . . .
how much difficulty did you have dealing with people you did not know
well?

619
April 15, 2016

1
No difficulty
2
Mild difficulty
3
Moderate difficulty
4
Severe difficulty
5
You didn’t deal with people you did not know well
DK/REF
LISTRAN2

[IF LISTRAN1 = 5] Did problems with your emotions, nerves, or mental
health keep you from dealing with people you did not know well?
1
Yes
2
No
DK/REF

LISOC1

[IF DISTRESS =1] During that one month when your emotions, nerves or
mental health interfered most with your daily activities . . .
how much difficulty did you have participating in social activities, like
visiting friends or going to parties?
1
No difficulty
2
Mild difficulty
3
Moderate difficulty
4
Severe difficulty
5
You didn’t participate in social activities
DK/REF

LISOC2

[IF LISOC1=5] Did problems with your emotions, nerves, or mental
health keep you from participating in social activities?
1
Yes
2
No
DK/REF

LIHHRES1 [IF DISTRESS =1] During that one month when your emotions, nerves or
mental health interfered most with your daily activities . . .
how much difficulty did you have taking care of household
responsibilities?
1
2
3
4

No difficulty
Mild difficulty
Moderate difficulty
Severe difficulty

620
April 15, 2016

5
You didn’t take care of household responsibilities
DK/REF
LIHHRES2 [IF LIHHRES1=5] Did problems with your emotions, nerves, or mental
health keep you from taking care of household responsibilities?
1
Yes
2
No
DK/REF

LIWKRES1 [IF DISTRESS =1] During that one month when your emotions, nerves or
mental health interfered most with your daily activities . . .
how much difficulty did you have taking care of your daily
responsibilities at work or school?
1
No difficulty
2
Mild difficulty
3
Moderate difficulty
4
Severe difficulty
5
You didn’t work or go to school
DK/REF
LIWKRES2 [IF LIWKRES1=5] Did problems with your emotions, nerves, or mental
health keep you from working or going to school?
1
Yes
2
No
DK/REF

LIWKQUIC [IF DISTRESS =1 AND LIWKRES1 NE 5] During that one month when
your emotions, nerves or mental health interfered most with your daily
activities . . .
how much difficulty did you have getting your daily work done as
quickly as needed?
1
No difficulty
2
Mild difficulty
3
Moderate difficulty
4
Severe difficulty
DK/REF
IMWEEK1

[IF LIREMEM = 2 - 4 OR LICONCEN = 2 - 4 OR LIGOOUT1 = 2 - 4

621
April 15, 2016

OR LIGOOUT2 = 1 OR LISTRAN1 = 2 - 4 OR LISTRAN2 = 1 OR
LISOC1 = 2 - 4 OR LISOC2 = 1 OR LIHHRES1 = 2 - 4 OR LIHHRES2
= 1 OR LIWKRES1 = 2 - 4 OR LIWKRES2 = 1 OR LIWKQUIC = 2 4] You mentioned having difficulty with or being unable to do such
things as [FILL WITH BOLDED TEXT FROM UP TO ALL ITEMS
WHERE LIREMEM = 2 - 4 OR LICONCEN = 2 - 4 OR LIGOOUT1
= 2 - 4 OR LISTRAN1 = 2 - 4 OR LISOC1 = 2 - 4 OR LIHHRES1 = 2
- 4 OR LIWKRES1 = 2 - 4 OR LIWKQUIC = 2 - 4].
[Note to Programmers: Bolded text fills should appear in bold lower
case and be separated by semicolons. The last fill should be preceded by
the word “and.”
IF LIREMEM = 2 – 4 THEN FILL = “remembering to do things you
needed to do”
IF LICONCEN = 2 – 4 THEN FILL = “concentrating on doing
something important when other things were going on around you”
IF LIGOOUT1 = 2 – 4 THEN FILL = “going out of the house and
getting around on your own”
IF LISTRAN1 = 2 – 4 THEN FILL = “dealing with people you did not
know well”
IF LISOC1 = 2 – 4 THEN FILL = “participating in social activities, like
visiting friends or going to parties”
IF LIHHRES1 = 2 – 4 THEN FILL = “taking care of your household
responsibilities”
IF LIWKRES1 = 2 – 4 THEN FILL = “taking care of your daily
responsibilities at work or school”
IF LIWKQUIC = 2 – 4 THEN FILL = “getting your daily work done as
quickly as needed”
Further IMWEEK1 Fill Specifications:
IF LIGOOUT2=1 USE FILL FOR LIGOOUT1.
IF LISTRAN2=1 USE FILL FOR LISTRAN1.
IF LISOC2=1 USE FILL FOR LISOC1.
IF LIHHRES2=1 USE FILL FOR LIHHRES1.
IF LIWKRES2=1 USE FILL FOR LIWKRES1.]
During the past 12 months, about how many weeks did you have any of
these difficulties because of your emotions, nerves, or mental health? If
you can’t remember the exact number, just give your best estimate.
# OF WEEKS:
[RANGE: 1 - 52]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CREATE IMWEEK1 FILL.

622
April 15, 2016

IMDAYS

[IF IMWEEK1 =1-52] During (that [IMWEEK1FILL] week/those
[IMWEEK1 FILL] weeks), did you have these kinds of difficulties every
day, most days, or only one or two days a week?
1
Every day
2
Most days
3
Only one or two days a week
DK/REF

LIAD68

[IF LIREMEM = 2 – 4, OR LICONCEN = 2 - 4, OR LIGOOUT1 = 2 - 4 ,
OR LIGOOUT2 = 1, OR LISTRAN1 = 2 – 4, OR LISTRAN2 = 1, OR
LISOC1 = 2 - 4, OR LISOC2 = 1, OR LIHHRES1 = 2 - 4, OR LIHHRES2
= 1, OR LIWKRES1 = 2 - 4, OR LIWKQUIC = 2 - 4] About how many
days out of 365 in the past 12 months were you totally unable to work or
carry out your normal activities because of your emotions, nerves or
mental health?
You can use any number between 0 and 365 to answer.
# OF DAYS:__________ [RANGE: 0-365]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SUI01 [IF CURNTAGE=18 OR OLDER] The next few questions are about thoughts of
suicide. At any time in the past 12 months, that is from [DATEFILL] up to and
including today, did you seriously think about trying to kill yourself?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SUI02 [IF SUI01=1] During the past 12 months, did you make any plans to kill yourself?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SUI03 [IF SUI01=1] During the past 12 months, did you try to kill yourself?
1 Yes
2 No
DK/REF

623
April 15, 2016

PROGRAMMER: SHOW 12 MONTH CALENDAR
SUI04 [IF SUI03=1] During the past 12 months, did you get medical attention from a doctor
or other health professional as a result of an attempt to kill yourself?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
SUI05 [IF SUI04=1] Did you stay in a hospital overnight or longer because you tried to kill
yourself?
1 Yes
2 No
DK/REF

624
April 15, 2016

Adult Depression
[Questions administered only to respondents 18 years of age and older]
ASC21

[IF CURNTAGE = 18 OR OLDER] Have you ever in your life had a
period of time lasting several days or longer when most of the day you felt sad,
empty or depressed?
1
Yes
2
No
DK/REF

ASC22

[IF ASC21 = 2 OR DK/REF] Have you ever had a period of time lasting
several days or longer when most of the day you were very discouraged about
how things were going in your life?
1
Yes
2
No
DK/REF

ASC23

[IF ASC22 = 2 or DK/REF] Have you ever had a period of time lasting
several days or longer when you lost interest in most things you usually enjoy
like work, hobbies, and personal relationships?
1
Yes
2
No
DK/REF

AD01 [IF ASC21 =1] During times when you felt sad, empty, or depressed most of the
day, did you ever feel discouraged about how things were going in your life?
1
Yes
2
No
DK/REF
AD01a [IF AD01 = 1] During the times when you felt sad, empty, or depressed, did you
ever lose interest in most things like work, hobbies, and other things you usually
enjoy?
1
Yes
2
No
DK/REF

625
April 15, 2016

AD01b

[IF AD01 = 2 OR DK/REF] During the times when you felt sad, empty, or
depressed, did you ever lose interest in most things like work, hobbies, and other
things you usually enjoy?
1
Yes
2
No
DK/REF

AD02 [IF ASC22 = 1] During times when you felt discouraged about how things were
going in your life, did you ever lose interest in most things like work, hobbies,
and other things you usually enjoy?
1
Yes
2
No
DK/REF
AD09 [IF ASC23= 1] Did you ever have a period of time like this that lasted most of
the day nearly every day for two weeks or longer?
1
Yes
2
No
DK/REF
DEFINE FEELFILL:
IF (AD01a = 1), THEN FEELFILL = “were sad, discouraged, or lost interest in most
things”
IF (AD01a = 2 OR DK/REF), THEN FEELFILL = “were sad or discouraged”
IF (AD01b = 1), THEN FEELFILL = “were sad or lost interest in most things”
IF (AD01b = 2 OR DK/REF) THEN FEELFILL = “were sad”
IF (AD02 = 1), THEN FEELFILL = “were discouraged or lost interest in most things”
IF (AD02 = 2 OR DK/REF), THEN FEELFILL = “were discouraged about the way
things were going in your life”
IF (AD09 = 1), THEN FEELFILL = “lost interest in most things”
ELSE, FEELFILL = BLANK
DEFINE FEELNOUN:
IF (AD01a = 1), THEN FEELNOUN = “sadness, discouragement, or lack of interest”
IF (AD01a = 2 OR DK/REF), THEN FEELNOUN = “sadness or discouragement”
IF (AD01b = 1), THEN FEELNOUN = “sadness or lack of interest”
IF (AD01b = 2 OR DK/REF), THEN FEELNOUN = “sadness”
IF (AD02 = 1), THEN FEELNOUN = “discouragement or lack of interest”
IF (AD02 = 2 OR DK/REF), THEN FEELNOUN = “discouragement”
IF (AD09 = 1), THEN FEELNOUN = “lack of interest in most things”
ELSE FEELNOUN = BLANK
DEFINE NUMPROBS

626
April 15, 2016

IF AD01a NE BLANK OR AD01b = 1 OR AD02 = 1, THEN NUMPROBS = “these
problems”
IF AD01b = (2 OR DK/REF) OR AD02 = (2 OR DK/REF) OR AD09 = 1, THEN
NUMPROBS = “this problem”
ELSE NUMPROBS = BLANK
DEFINE WASWERE:
IF AD01a NE BLANK OR AD01b = 1 OR AD02 = 1, THEN WASWERE = “were”
IF AD01b = (2 OR DK/REF) OR AD02 = (2 OR DK/REF) OR AD09 = 1, THEN
WASWERE = “was”
ELSE WASWERE = BLANK
AD12 [IF AD01a NE BLANK OR AD01b NE BLANK OR AD02 NE BLANK] Think
about the times when you [FEELFILL]. Did you ever have a period of time like
this that lasted most of the day, nearly every day, for two weeks or longer?
1
Yes
2
No
DK/REF
AD16 [IF AD09 = 1 OR AD12 = 1] Think of times lasting two weeks or longer when
[NUMPROBS] with your mood [WASWERE] most severe and frequent.
During those times, how long did your [FEELNOUN] usually last?
1
Less than 1 hour
2
At least 1 hour but no more than 3 hours
3
At least 3 hours but no more than 5 hours
4
5 hours or more
DK/REF
AD17 [IF AD16 = 2, 3, 4, OR DK/REF] Still thinking of times lasting two weeks or longer
when [NUMPROBS] with your mood [WASWERE] most severe and frequent,
how severe was your emotional distress during those times?
1
Mild
2
Moderate
3
Severe
4
Very severe
DK/REF
AD18 [IF AD16 = 2, 3, 4, OR DK/REF] Again, think of times lasting two weeks or
longer when [NUMPROBS] with your mood [WASWERE] most severe and
frequent.
How often, during those times, was your emotional distress so severe that nothing
could cheer you up?

627
April 15, 2016

1
Often
2
Sometimes
3
Rarely
4
Never
DK/REF
AD19 [IF AD16 = 2, 3, 4, OR DK/REF] Once again, please think of times lasting two
weeks or longer when [NUMPROBS] with your mood [WASWERE]most severe
and frequent.
How often, during those times, was your emotional distress so severe that you
could not carry out your daily activities?
1
Often
2
Sometimes
3
Rarely
4
Never
DK/REF
AD21 [IF AD16 = (2, 3, 4 OR DK/REF) AND NOT (AD17 = 1 AND AD18 = 4 AND
AD19 = 4) AND (ASC21=1 OR ASC22=1 OR ASC23=1) AND AD09 NE (2 OR
DK/REF)] People who have problems with their mood often have other problems
at the same time. These problems may include things like changes in:
•
•
•
•
•

sleep
appetite
energy
the ability to concentrate and remember
feelings of low self-worth

Did you ever have any of these problems during a period of time when you
[FEELFILL] for two weeks or longer?
1
Yes
2
No
DK/REF

AD22 [IF AD21 = 1] Think again about these other problems we just mentioned. They
include things like changes in
•
•
•
•

sleep
appetite
energy
the ability to concentrate and remember
628

April 15, 2016

•

feelings of low self-worth

Please think of a time when you [FEELFILL] for two weeks or longer and you
also had the largest number of these other problems at the same time.
Is there one particular time like this that stands out in your mind as the worst one
you ever had?
1
Yes
2
No
DK/REF
AD22a

[IF AD22 = 1] How old were you when that worst period of time started?
__________ YEARS OLD [RANGE: 1-110]
DK/REF

AD22c [IF AD22 = 2 OR DK/REF] Then think of the most recent time when you
[FEELFILL] for two weeks or longer and you also had the largest number of
these other problems at the same time.
How old were you when that time started?
__________ YEARS OLD
DK/REF
DEFINE TIMEFILL:
IF AD22a NE BLANK, THEN TIMEFILL = ‘worst’
IF AD22c NE BLANK, THEN TIMEFILL = ‘most recent’
AD24a

[IF AD22a NE BLANK] In answering the next questions, think about the
period of time when your [FEELNOUN] and other problems were the worst.
[IF AD22c NE BLANK] In answering the next questions, think about the most
recent period of time when you [FEELFILL] and had other problems at the same
time.
During that time, did you feel sad, empty, or depressed most of the day nearly
every day?
1
Yes
2
No
DK/REF

629
April 15, 2016

AD24c

[IF AD22a NE BLANK OR AD22c NE BLANK] During that
[TIMEFILL] period of time, did you feel discouraged about how things were
going in your life most of the day nearly every day?
1
Yes
2
No
DK/REF

AD24e [IF AD22a NE BLANK OR AD22c NE BLANK] During that [TIMEFILL]
period of time, did you lose interest in almost all things like work and hobbies and
things you like to do for fun?
1
Yes
2
No
DK/REF
AD24f

[IF AD22a NE BLANK OR AD22c NE BLANK] During that
[TIMEFILL] period of time, did you lose the ability to take pleasure in having
good things happen to you, like winning something or being praised or
complimented?
1
Yes
2
No
DK/REF

AD26a
[IF ANY AD24a – AD24f = 1] The next questions are about changes in
appetite and weight.
[IF AD22a NE BLANK] In answering the next questions, think about the period
of time when your [FEELNOUN] and other problems were the worst.
[IF AD22c NE BLANK] In answering the next questions, think about the most
recent period of time when you [FEELFILL] and had other problems at the same
time.
Did you have a much smaller appetite than usual nearly every day during that
time?
1
Yes
2
No
DK/REF
AD26b

[IF AD26a = 2 OR DK/REF] Did you have a much larger appetite than
usual nearly every day?

630
April 15, 2016

1
Yes
2
No
DK/REF
AD26c

[IF AD26a = 2 OR DK/REF] Did you gain weight without trying to during
that [TIMEFILL] period of time?
1
Yes
2
No
DK/REF

AD26c1
[IF AD26c = 1 AND (AD22a ≤ 21 OR AD22c ≤ 21)] Did you gain
weight without trying to because you were growing?
1
Yes
2
No
DK/REF
AD26c2
[IF AD26c = 1 AND AD26c1 NE YES AND QD01 = 9] Did you gain
weight without trying to because you were pregnant?
1
Yes
2
No
DK/REF
AD26d

[IF AD26c = 1 AND AD26c1 NE YES AND AD26c2 NE YES] How
many pounds did you gain?
Please enter your answer as a whole number.
# OF POUNDS:__________ [RANGE: 0-200]
DK/REF

AD26e

[IF (AD26a = 1 OR AD26c=(2 OR DK/REF)] Did you lose weight
without trying to?
1
Yes
2
No
DK/REF

AD26e1

1
2

[IF AD26e = 1] Did you lose weight without trying to because you were
sick or on a diet?
Yes
No

631
April 15, 2016

DK/REF
AD26f [IF AD26e1 = 2 OR DK/REF] How many pounds did you lose?
Please enter your answer as a whole number.
# OF POUNDS:__________ [RANGE: 0-200]
DK/REF
AD26g [IF AD26a NE BLANK]
[IF AD22a NE BLANK] Again, please think about the period of time when your
[FEELNOUN] and other problems were the worst.
[IF AD22c NE BLANK] Again, please think about the most recent period of
time when you [FEELFILL] and had other problems at the same time.
Did you have a lot more trouble than usual falling asleep, staying asleep, or
waking too early nearly every night during that [TIMEFILL] period of time?
1
Yes
2
No
DK/REF
AD26h

[IF AD26g = 2 OR DK/REF] During that [TIMEFILL] period of time,
did you sleep a lot more than usual nearly every night?
1
Yes
2
No
DK/REF

AD26j

[IF AD26a NE BLANK] During that [TIMEFILL] period of time, did
you feel tired or low in energy nearly every day, even when you had not been
working very hard?
1
Yes
2
No
DK/REF

AD26l [IF AD26a NE BLANK] Did you talk or move more slowly than is normal for
you nearly every day?
1
Yes
2
No
DK/REF

632
April 15, 2016

AD26m
slowly?

[IF AD26l = 1] Did anyone else notice that you were talking or moving

1
Yes
2
No
DK/REF
AD26n

[IF AD26l = 2 OR DK/REF] Were you so restless or jittery nearly every
day that you paced up and down or couldn't sit still?
1
Yes
2
No
DK/REF

AD26o [AD26n = 1] Did anyone else notice that you were restless?
1
Yes
2
No
DK/REF
AD26p

[IF AD26a NE BLANK] The next questions are about changes in your
ability to concentrate, and your feelings about yourself.
[IF AD22a NE BLANK] Again, in answering these questions, think about the
period of time when your [FEELNOUN] and other problems were the worst.
[IF AD22c NE BLANK] Again, in answering these questions, think about the
most recent period of time when you [FEELFILL] and had other problems at the
same time.
During that [TIMEFILL] time, did your thoughts come much more slowly than
usual or seem confused nearly every day?
1
Yes
2
No
DK/REF

AD26r [IF AD26a NE BLANK] Did you have a lot more trouble concentrating than
usual nearly every day?
1
Yes
2
No
DK/REF

633
April 15, 2016

AD26s [IF AD26a NE BLANK] Were you unable to make decisions about things you
ordinarily have no trouble deciding about?
1
Yes
2
No
DK/REF
AD26u

[IF AD26a NE BLANK] Did you feel that you were not as good as other
people nearly every day?
1
Yes
2
No
DK/REF

AD26v [IF AD26u = 1] Did you feel totally worthless nearly every day?
1
Yes
2
No
DK/REF
AD26aa [IF AD26a NE BLANK] The next questions are about thoughts of death or
suicide.
[IF AD22a NE BLANK] Again, in answering these questions, think about the
period of time when your [FEELNOUN] and other problems were the worst.
[IF AD22c NE BLANK] Again, in answering these questions, think about the
most recent period of time when you [FEELFILL] and had other problems at the
same time.
Did you often think a lot about death, either your own, someone else’s, or death in
general?
1
Yes
2
No
DK/REF
AD26bb

[IF AD26a NE BLANK] During that period, did you ever think that it
would be better if you were dead?

1
Yes
2
No
DK/REF
AD26cc

[IF AD26a NE BLANK] Did you think about committing suicide?

634
April 15, 2016

1
Yes
2
No
DK/REF
AD26dd

[IF AD26cc = 1] Did you make a suicide plan?

1
Yes
2
No
DK/REF
AD26ee

[IF AD26cc = 1] Did you make a suicide attempt?

1
Yes
2
No
DK/REF
DEFINE D_MDEA1:
IF AD24A = 1 OR AD24C = 1, THEN D_MDEA1= 1
ELSE IF AD24A = 2 AND AD24C = 2, THEN D_MDEA1= 2
ELSE IF AD24A = DK OR AD24C = DK, THEN D_MDEA1= DK
ELSE IF AD24A = REF OR AD24C = REF, THEN D_MDEA1= REF
ELSE D_MDEA1= BLANK
DEFINE D_MDEA2:
IF AD24E = 1 OR AD24F = 1, THEN D_MDEA2= 1
ELSE IF AD24E = 2 AND AD24F = 2, THEN D_MDEA2= 2
ELSE IF AD24E = DK OR AD24F = DK, THEN D_MDEA2= DK
ELSE IF AD24E = REF OR AD24F = REF, THEN D_MDEA2= REF
ELSE D_MDEA2= BLANK
DEFINE D_MDEA3:
IF AD26A = 1 OR AD26B = 1 OR AD26D ≥10 OR AD26F ≥10, THEN D_MDEA3= 1
ELSE IF AD26A = 2 AND AD26B = 2 AND ((AD26D < 10 OR AD26F < 10) OR
(AD26C = (2 OR BLANK) AND AD26E = (2 OR BLANK)) OR (AD26C = 1 AND
(AD26C1 = 1 OR AD26C2 = 1)) OR (AD26E = 1 AND AD26E1 = 1)), THEN
D_MDEA3= 2
ELSE IF AD26A = DK OR AD26B = DK OR AD26C = DK OR AD26D = DK OR
AD26E = DK OR AD26F = DK, THEN D_MDEA3= DK
ELSE IF AD26A = REF OR AD26B = REF OR AD26C = REF OR AD26D = REF OR
AD26E = REF OR AD26F = REF, THEN D_MDEA3= REF
ELSE D_MDEA3= BLANK
DEFINE D_MDEA4:
IF AD26G = 1 OR AD26H = 1, THEN D_MDEA4= 1
ELSE IF AD26G = 2 AND AD26H = 2, THEN D_MDEA4= 2
ELSE IF AD26G = DK OR AD26H = DK, THEN D_MDEA4= DK

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April 15, 2016

ELSE IF AD26G = REF OR AD26H = REF, THEN D_MDEA4= REF
ELSE D_MDEA4= BLANK
DEFINE D_MDEA5:
IF AD26M = 1 OR AD26O = 1, THEN D_MDEA5= 1
ELSE IF (AD26L = (2 OR DK/REF) AND (AD26N = (2 OR DK/REF) OR AD26O = 2))
OR AD26M = 2, THEN D_MDEA5= 2
ELSE IF AD26L = DK OR AD26M = DK OR AD26N = DK OR AD26O = DK, THEN
D_MDEA5= DK
ELSE IF AD26L = REF OR AD26M = REF OR AD26N = REF OR AD26O = REF,
THEN D_MDEA5= REF
ELSE D_MDEA5= BLANK
DEFINE D_MDEA6:
D_MDEA6= AD26J
DEFINE D_MDEA7:
IF AD26V = 1, THEN D_MDEA7= 1
ELSE IF AD26U = (2 OR DK/REF) OR AD26V = 2, THEN D_MDEA7= 2
ELSE D_MDEA7=AD26V
ELSE D_MDEA7= BLANK
DEFINE D_MDEA8:
IF AD26P = 1 OR AD26R = 1 OR AD26S = 1, THEN D_MDEA8= 1
ELSE IF AD26P = 2 AND AD26R = 2 AND AD26S = 2, THEN D_MDEA8= 2
ELSE IF AD26P = DK OR AD26R = DK OR AD26S = DK, THEN D_MDEA8= DK
ELSE IF AD26P = REF OR AD26R = REF OR AD26S = REF, THEN D_MDEA8=
REF
ELSE D_MDEA8= BLANK
DEFINE D_MDEA9:
IF AD26AA = 1 OR D26BB = 1 OR AD26CC = 1 OR AD26DD = 1 OR AD26EE = 1,
THEN D_MDEA9= 1
ELSE IF AD26AA = 2 AND AD26BB = 2 AND AD26CC = 2, THEN D_MDEA9= 2
ELSE IF AD26AA = DK OR AD26BB = DK OR AD26CC = DK OR AD26DD = DK
OR AD26EE = DK, THEN D_MDEA9= DK
ELSE IF AD26AA = REF OR AD26BB = REF OR AD26CC = REF OR AD26DD =
REF OR AD26EE = REF, THEN D_MDEA9= REF
ELSE D_MDEA9= BLANK
DEFINE DSMMDEA2:
IF SUM (D_MDEA1 = 1, D_MDEA2 = 1, D_MDEA3 = 1, D_MDEA4 = 1, D_MDEA5
= 1, D_MDEA6 = 1, D_MDEA7 = 1, D_MDEA8 = 1, D_MDEA9 = 1) ≥ 5, THEN
DSMMDEA2 = 1
ELSE IF SUM (D_MDEA1 = (1 OR DK/REF), D_MDEA2 = (1 OR DK/REF),
D_MDEA3 = (1 OR DK/REF), D_MDEA4 = (1 OR DK/REF), D_MDEA5 = (1 OR

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April 15, 2016

DK/REF), D_MDEA6 = (1 OR DK/REF), D_MDEA7 = (1 OR DK/REF), D_MDEA8 =
(1 OR DK/REF), D_MDEA9 = (1 OR DK/REF)) < 5 AND N(OF D_MDEA1D_MDEA9) > 0, THEN DSMMDEA2 = 2
ELSE IF D_MDEA1 = DK OR D_MDEA2 = DK OR D_MDEA3 = DK OR D_MDEA4
= DK OR D_MDEA5 = DK OR D_MDEA6 = DK OR D_MDEA7 = DK OR
D_MDEA8 = DK OR D_MDEA9 = DK, THEN DSMMDEA2 = DK
ELSE IF D_MDEA1 = REF OR D_MDEA2 = REF OR D_MDEA3 = REF OR
D_MDEA4 = REF OR D_MDEA5 = REF OR D_MDEA6 = REF OR D_MDEA7 = REF
OR D_MDEA8 = REF OR D_MDEA9 = REF, THEN DSMMDEA2 = REF
AD28 [IF D_MDEA9 = 1 OR DSMMDEA2 = 1] You mentioned having some of the
problems I just asked you about.
During that [TIMEFILL] period of time, how much did your [FEELNOUN]
and these other problems interfere with your work, your social life, or your
personal relationships?
1
Not at all
2
A little
3
Some
4
A lot
5
Extremely
DK/REF
AD28a [IF AD28 NE (BLANK OR 1)] During that [TIMEFILL] period of time, how
often were you unable to carry out your daily activities because of these problems
with your mood?
1
Often
2
Sometimes
3
Rarely
4
Never
DK/REF
AD37 [IF AD28 NE BLANK] Think of the very first period of time in your life lasting
two weeks or longer when you [FEELFILL] for most of the day nearly every
day and also had some of the other problems we just asked about.
Can you remember your exact age?
1
Yes
2
No
DK/REF
AD37a [IF AD37 = 1] How old were you?

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April 15, 2016

__________ YEARS OLD [RANGE: 1-110]
DK/REF
AD37b

[IF AD37 = 2 OR DK] About how old were you when you first had a period
of time like this?
AGE:__________ [RANGE: 1-110]
DK/REF

AD52 [IF AD28 NE BLANK] In your entire life, how many times did you feel
[FEELNOUN] for two weeks or longer while also having some of the other
problems we asked about?
If you are not sure of your answer, just make your best guess.
______________
DK/REF

NUMBER [RANGE: 1-1000]

AD38 [IF AD28 NE BLANK ] In the past 12 months, did you have a period of time
when you felt [FEELNOUN] for two weeks or longer while also having some of
the other problems we asked about?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
AD66a [IF AD38 = 1] Think about the time in the past 12 months when [NUMPROBS]
with your mood [WASWERE] most severe.
Using the 0 to 10 scale shown below, where 0 means no interference and 10
means very severe interference, select the number that describes how much
[NUMPROBS] interfered with your ability to do each of the following activities
during that period. You can use any number between 0 and 10 to answer.
How much did your [FEELNOUN] interfere with your ability to do home
management tasks, like cleaning, shopping, and working around the house,
apartment, or yard?

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April 15, 2016

No
Very Severe
Interference
Severe
│
0

Mild
Interference
│
1

2

Moderate

3

4

5

6

7

8

9

10
DK/REF
AD66b

[IF AD38 = 1] During that time in the past 12 months when your
[FEELNOUN] was most severe, how much did this interfere with your ability to
work?
You can use any number between 0 and 10 to answer.

No
Very Severe
Interference
Severe
│
0

Mild
Interference
│
1

2

Moderate

3

4

5

6

7

8

9

10
DK/REF

AD66c [IF AD38 = 1]How much did your [FEELNOUN] interfere with your ability to
form and maintain close relationships with other people during that period of
time?
You can use any number between 0 and 10 to answer.

No
Very Severe
Interference
Severe
│
0

Mild
Interference
│
1

2

Moderate

3

4

10
DK/REF

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April 15, 2016

5

6

7

8

9

AD66d
[IF AD38 = 1] How much did [NUMPROBS] interfere with your ability
to have a social life during that period of time?
You can use any number between 0 and 10 to answer.

No
Very Severe
Interference
Severe
│
0

Mild
Interference
│
1

2

Moderate

3

4

5

6

7

8

9

10
DK/REF
AD68 [IF ANY RESPONSES TO AD66a – AD66d = 1-10] About how many days out
of 365 in the past 12 months were you totally unable to work or carry out your
normal activities because of your [FEELNOUN]?
You can use any number between 0 and 365 to answer.
# OF DAYS:__________ [RANGE: 0-365]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
AD86 [IF AD38 NE BLANK] Here is a list of professionals some people talk to about
the problems we have been asking about:
General practitioner or family doctor
Other medical doctor like a cardiologist, gynecologist, urologist
Psychologist
Psychiatrist or psychotherapist
Social Worker
Counselor
Other mental health professional, like a mental health nurse
A nurse, occupational therapist, or other health professional
A religious or spiritual advisor like a minister, priest, or rabbi
Another healer, like an herbalist, chiropractor, acupuncturist, or massage therapist
At any time in the past 12 months, did you see or talk to a medical doctor or
other professional about your [FEELNOUN]?
1
Yes
2
No
DK/REF

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April 15, 2016

PROGRAMMER: SHOW 12 MONTH CALENDAR
AD86a [IF AD86 = 1] During the past 12 months, which professionals did you see or
talk to about [NUMPROBS] with your mood?
Select all that apply from the categories shown below. To select more than one
answer from the list, press the space bar between each number you type. When you
have finished, press the [ENTER] key to go to the next question.
1
General practitioner or family doctor
2
Other medical doctor like a cardiologist, gynecologist, urologist
3
Psychologist
4
Psychiatrist or psychotherapist
5
Social Worker
6
Counselor
7
Other mental health professional, like a mental health nurse
8
A nurse, occupational therapist, or other health professional
9
A religious or spiritual advisor like a minister, priest, or rabbi
10
An herbalist, chiropractor, acupuncturist, or massage therapist
11
Another type of helping professional
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
AD86aSP

[IF AD86a = 11]Please type in the other type of professional you saw or
talked to during the past 12 months about your [FEELNOUN]. When
you have finished typing in your answer, press the [ENTER] key to go to
the next question.
______________[RANGE: 50 CHARACTERS]
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN AD86aSP.

AD86b

[IF AD86 = 1] Are you currently receiving professional treatment or
counseling for [NUMPROBS] with your mood?
1
Yes
2
No
DK/REF

AD86c [IF AD38 NE BLANK] During the past 12 months, did you take prescription
medication that was prescribed for [NUMPROBS]?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

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April 15, 2016

AD86d

[IF AD86c = 1] Are you currently taking prescription medication that
was prescribed for [NUMPROBS]?
1
Yes
2
No
DK/REF

AD86e [IF AD86c = 1] During the past 12 months, how much has this prescription
medication helped you?
1
Not at all
2
A little
3
Some
4
A lot
5
Extremely
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
AD86f [IF AD86 = 1] During the past 12 months, how much has treatment or counseling
helped you?
1
Not at all
2
A little
3
Some
4
A lot
5
Extremely
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

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April 15, 2016

Youth Mental Health Service Utilization
(Section Administered to 12 - 17 Year Old Respondents Only)

INTROYSU [IF CURNTAGE = 12 - 17] These next questions are about treatment and
counseling for problems with your behaviors or emotions that were not
caused by alcohol or drugs.
Press [ENTER] to continue.
YSU01

[IF CURNTAGE = 12 - 17] During the past 12 months, have you stayed
overnight or longer in any type of hospital to receive treatment or
counseling for emotional or behavioral problems that were not caused by
alcohol or drugs?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU02

[IF YSU01 = 1] During the past 12 months, how many nights altogether did
you stay in a hospital to receive treatment or counseling for emotional or
behavioral problems that were not caused by alcohol or drugs?
# OF NIGHTS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU03

[IF YSU01 = 1] Think about the last time you stayed overnight or longer in
a hospital to receive treatment or counseling for emotional or behavioral
problems that were not caused by alcohol or drugs. What was the reason you
were admitted there?
To select more than one reason from the list, press the space bar between each
number you type. When you have finished, press the [ENTER] key to go to
the next question.
1
You thought about killing yourself or tried to kill yourself
2
You felt depressed
3
You felt very afraid and tense
4
You were breaking rules and “acting out”
5
You had eating problems
6
Some other reason
DK/REF

643
April 15, 2016

YSU03a

[IF ANY ENTRY IN YSU03 = 6] What was the other emotional or
behavioral problem for which you last stayed overnight in a hospital?
To select more than one reason from the list, press the space bar between
each number you type. When you have finished, press the [ENTER] key
to go to the next question.
1
You had trouble controlling your anger
2
You had gotten into physical fights
3
You had problems at home or in your family
4
You had problems with your friends
5
You had problems with people other than your friends or family
6
You had problems at school
7
Some other reason
DK/REF

YSU03SP [IF ANY ENTRY IN YSU03a = 7] Please type in the most important other
reason for your last overnight stay in a hospital to receive treatment or
counseling for emotional or behavioral problems that were not caused by
alcohol or drugs. You do not need to give a detailed description — just a few
words will be okay. When you have finished typing your answer, press the
[ENTER] key to go to the next question.
_______________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU03SP.
YSU04

[IF CURNTAGE = 12 - 17] During the past 12 months, did you stay
overnight or longer in a residential treatment center to receive treatment or
counseling for emotional or behavioral problems that were not caused by
alcohol or drugs?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU05

[IF YSU04=1] During the past 12 months, how many nights altogether did
you stay in a residential treatment center to receive treatment for emotional
or behavioral problems that were not caused by alcohol or drugs?
# OF NIGHTS: _________ [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU06

[IF YSU04=1] Think about the last time you stayed overnight or longer in a

644
April 15, 2016

residential treatment center to receive treatment for emotional or behavioral
problems that were not caused by alcohol or drugs. What was the reason you
were admitted there?
To select more than one reason from the list, press the space bar between each
number you type. When you have finished, press the [ENTER] key to go to
the next question.
1
You thought about killing yourself or tried to kill yourself.
2
You felt depressed
3
You felt very afraid and tense
4
You were breaking rules and “acting out”
5
You had eating problems
6
Some other reason
DK/REF
YSU06a

[IF ANY ENTRY IN YSU06 = 6] What was the other emotional or
behavioral problem for which you last stayed overnight in a residential
treatment center?
To select more than one reason from the list, press the space bar between
each number you type. When you have finished, press the [ENTER] key
to go to the next question.
1
You had trouble controlling your anger
2
You had gotten into physical fights
3
You had problems at home or in your family
4
You had problems with your friends
5
You had problems with people other than your friends or family
6
You had problems at school
7
Some other reason
DK/REF

YSU06SP [IF ANY ENTRY IN YSU06a=7] Please type in the most important other
reason for your last overnight stay in a residential treatment center to
receive treatment or counseling for emotional or behavioral problems that
were not caused by alcohol or drugs. You do not need to give a detailed
description — just a few words will be okay. When you have finished typing
your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU06SP.
YSU07

[IF CURNTAGE = 12 - 17] During the past 12 months, did you stay
overnight or longer in foster care or in a therapeutic foster care home

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April 15, 2016

because you had emotional or behavioral problems that were not caused by
alcohol or drugs?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU08

[IF YSU07 = 1] During the past 12 months, how many nights altogether did
you stay in foster care or in a therapeutic foster care home because you
had emotional or behavioral problems that were not caused by alcohol or
drugs?
# OF NIGHTS: _________ [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU09

[IF YSU07=1] Think about the last time you stayed overnight or longer in
foster care or in a therapeutic foster care home because you had emotional
or behavioral problems that were not caused by alcohol or drugs. What was
the reason you were placed there?
To select more than one reason from the list, press the space bar between each
number you type. When you have finished, press the [ENTER] key to go to
the next question.
1
You thought about killing yourself or tried to kill yourself.
2
You felt depressed
3
You felt very afraid and tense
4
You were breaking rules and “acting out”
5
You had eating problems
6
Some other reason
DK/REF

YSU09a

[IF ANY ENTRY IN YSU09 = 6] What was the other emotional or
behavioral problem for which you last stayed overnight or longer in foster
care or a therapeutic foster care home?
To select more than one reason from the list, press the space bar between
each number you type. When you have finished, press the [ENTER] key
to go to the next question.
1
2
3
4

You had trouble controlling your anger
You had gotten into physical fights
You had problems at home or in your family
You had problems with your friends

646
April 15, 2016

5
You had problems with people other than your friends or family
6
You had problems at school
7
Some other reason
DK/REF
YSU09SP [IF ANY ENTRY IN YSU09a =7] Please type in the most important other
reason for your last overnight stay in foster care or in a therapeutic foster
care home to receive treatment or counseling for emotional or behavioral
problems that were not caused by alcohol or drugs. You do not need to give a
detailed description — just a few words will be okay. When you have
finished typing your answer, press the [ENTER] key to go to the next
question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU09SP.
YSU10

[IF CURNTAGE = 12 - 17] During the past 12 months, did you receive
treatment or counseling at a partial day hospital or day treatment program
because you had problems with your behavior or emotions that were not
caused by alcohol or drugs?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU11

[IF YSU10 = 1] During the past 12 months, how many times did you visit a
partial day hospital or day treatment program because you had emotional
or behavioral problems that were not caused by alcohol or drugs?
# OF TIMES: _________ [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU12

[IF YSU10 =1] Think about the last time you visited a partial day hospital
or day treatment program because you had emotional or behavioral
problems that were not caused by alcohol or drugs. What was the reason for
your visit?
To select more than one reason from the list, press the space bar between each
number you type. When you have finished, press the [ENTER] key to go to
the next question.
1
2

You thought about killing yourself or tried to kill yourself.
You felt depressed

647
April 15, 2016

3
You felt very afraid and tense
4
You were breaking rules and “acting out”
5
You had eating problems
6
Some other reason
DK/REF
YSU12a

[IF ANY ENTRY IN YSU12 = 6] What was the other emotional or
behavioral problem for which you last visited a partial day hospital or
day treatment program?
To select more than one reason from the list, press the space bar between
each number you type. When you have finished, press the [ENTER] key
to go to the next question.
1
You had trouble controlling your anger
2
You had gotten into physical fights
3
You had problems at home or in your family
4
You had problems with your friends
5
You had problems with people other than your friends or family
6
You had problems at school
7
Some other reason
DK/REF

YSU12SP [IF ANY ENTRY IN YSU12a =7] Please type in the most important other
reason for your last visit to a partial day hospital or day treatment
program to receive treatment or counseling for emotional or behavioral
problems that were not caused by alcohol or drugs. You do not need to give a
detailed description — just a few words will be okay. When you have
finished typing your answer, press the [ENTER] key to go to the next
question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU12SP.
YSU13

[IF CURNTAGE = 12 - 17] During the past 12 months, did you receive
treatment or counseling at a mental health clinic or center because you had
problems with your behavior or emotions that were not caused by alcohol or
drugs?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU14

[IF YSU13 = 1] During the past 12 months, how many times did you visit a

648
April 15, 2016

mental health clinic or center to receive treatment or counseling because
you had emotional or behavioral problems that were not caused by alcohol or
drugs?
# OF TIMES: _________ [RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU15

[IF YSU13 =1] Think about the last time you visited a mental health clinic
or center to receive treatment or counseling for emotional or behavioral
problems that were not caused by alcohol or drugs. What was the reason for
your visit?
To select more than one reason from the list, press the space bar between each
number you type. When you have finished, press the [ENTER] key to go to
the next question.
1
You thought about killing yourself or tried to kill yourself.
2
You felt depressed
3
You felt very afraid and tense
4
You were breaking rules and “acting out”
5
You had eating problems
6
Some other reason
DK/REF

YSU15a

[IF ANY ENTRY IN YSU15 = 6] What was the other emotional or
behavioral problem for which you last visited a mental health clinic or
center?
To select more than one reason from the list, press the space bar between
each number you type. When you have finished, press the [ENTER] key
to go to the next question.
1
You had trouble controlling your anger
2
You had gotten into physical fights
3
You had problems at home or in your family
4
You had problems with your friends
5
You had problems with people other than your friends or family
6
You had problems at school
7
Some other reason
DK/REF

YSU15SP [IF ANY ENTRY IN YSU15a =7] Please type in the most important other
reason for your last visit to a mental health clinic or center to receive
treatment or counseling for emotional or behavioral problems that were not
caused by alcohol or drugs. You do not need to give a detailed description —

649
April 15, 2016

just a few words will be okay. When you have finished typing your answer,
press the [ENTER] key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YSU15SP.
YSU16

[IF CURNTAGE = 12 - 17] During the past 12 months, did you receive
treatment or counseling from a private therapist, psychologist, psychiatrist,
social worker, or counselor for emotional or behavioral problems that were
not caused by alcohol or drugs?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU17

[IF YSU16 = 1] During the past 12 months, how many times did you receive
treatment or counseling from a private therapist, psychologist, psychiatrist,
social worker, or counselor for emotional or behavioral problems that were
not caused by alcohol or drugs?
# OF TIMES:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU18

[IF YSU16 = 1] Think about the last time you visited a private therapist,
psychologist, psychiatrist, social worker, or counselor to receive treatment
or counseling for emotional or behavioral problems that were not caused by
alcohol or drugs. What was the reason for your visit?
To select more than one reason from the list, press the space bar between each
number you type. When you have finished, press the [ENTER] key to go to
the next question.
1
You thought about killing yourself or tried to kill yourself.
2
You felt depressed
3
You felt very afraid and tense
4
You were breaking rules and “acting out”
5
You had eating problems
6
Some other reason
DK/REF

YSU18a

[IF ANY ENTRY IN YSU18 = 6] What was the other emotional or
behavioral problem for which you last visited a private therapist,
psychologist, psychiatrist, social worker or counselor?

650
April 15, 2016

To select more than one reason from the list, press the space bar between
each number you type. When you have finished, press the [ENTER] key
to go to the next question.
1
You had trouble controlling your anger
2
You had gotten into physical fights
3
You had problems at home or in your family
4
You had problems with your friends
5
You had problems with people other than your friends or family
6
You had problems at school
7
Some other reason
DK/REF
YSU18SP [IF ANY ENTRY IN YSU18a =7] Please type in the most important other
reason for your last visit to a private therapist, psychologist, psychiatrist,
social worker, or counselor for emotional or behavioral problems that were
not caused by alcohol or drugs. You do not need to give a detailed
description — just a few words will be okay. When you have finished typing
your answer, press the [ENTER] key to go to the next question.
_____________
DK/REF

PROGRAMMER: DO NOT ALLOW BLANKS IN YSU18SP.
YSU19

[IF CURNTAGE = 12 -17] During the past 12 months, did you receive
treatment or counseling from an in-home therapist, counselor, or family
preservation worker for emotional or behavioral problems that were not
caused by alcohol or drugs?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU20

[IF YSU19 = 1] During the past 12 months, how many times did you receive
treatment or counseling from an in-home therapist, counselor, or family
preservation worker for emotional or behavioral problems that were not
caused by alcohol or drugs?
# OF TIMES:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU21

[IF YSU19 = 1] Think about the last time you saw an in-home therapist,
counselor, or family preservation worker to receive treatment or counseling
for emotional or behavioral problems that were not caused by alcohol or
651

April 15, 2016

drugs. What was the reason for this visit?
To select more than one reason from the list, press the space bar between each
number you type. When you have finished, press the [ENTER] key to go to
the next question.
1
You thought about killing yourself or tried to kill yourself.
2
You felt depressed
3
You felt very afraid and tense
4
You were breaking rules and “acting out”
5
You had eating problems
6
Some other reason
DK/REF
YSU21a

[IF ANY ENTRY IN YSU21 = 6] What was the other emotional or
behavioral problem for which you last saw an in-home therapist,
counselor, or family preservation worker?
To select more than one reason from the list, press the space bar between
each number you type. When you have finished, press the [ENTER] key
to go to the next question.
1
You had trouble controlling your anger
2
You had gotten into physical fights
3
You had problems at home or in your family
4
You had problems with your friends
5
You had problems with people other than your friends or family
6
You had problems at school
7
Some other reason
DK/REF

YSU21SP [IF ANY ENTRY IN YSU21a=7] Please type in the most important other
reason you last saw an in-home therapist, counselor, or family preservation
worker for emotional or behavioral problems that were not caused by alcohol
or drugs. You do not need to give a detailed description — just a few words
will be okay. When you have finished typing your answer, press the
[ENTER] key to go to the next question.
_____________
DK/REF

PROGRAMMER: DO NOT ALLOW BLANKS IN YSU21SP.
YSU22

[IF CURNTAGE = 12 -17] During the past 12 months, did you receive
treatment or counseling from a pediatrician or other family doctor for
emotional or behavioral problems that were not caused by alcohol or drugs?
1

Yes
652

April 15, 2016

2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU23

[IF YSU22 = 1] During the past 12 months, how many times did you receive
treatment or counseling from a pediatrician or other family doctor for
emotional or behavioral problems that were not caused by alcohol or drugs?
# OF TIMES:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU24

[IF YSU22 = 1] Think about the last time you visited a pediatrician or
other family doctor to receive treatment or counseling for emotional or
behavioral problems that were not caused by alcohol or drugs. What was the
reason for your visit?
To select more than one reason from the list, press the space bar between each
number you type. When you have finished, press the [ENTER] key to go to
the next question.
1
You thought about killing yourself or tried to kill yourself.
2
You felt depressed
3
You felt very afraid and tense
4
You were breaking rules and “acting out”
5
You had eating problems
6
Some other reason
DK/REF

YSU24a

[IF ANY ENTRY IN YSU24 = 6] What was the other emotional or
behavioral problem for which you last visited a pediatrician or other
family doctor?
To select more than one reason from the list, press the space bar between
each number you type. When you have finished, press the [ENTER] key
to go to the next question.
1
You had trouble controlling your anger
2
You had gotten into physical fights
3
You had problems at home or in your family
4
You had problems with your friends
5
You had problems with people other than your friends or family
6
You had problems at school
7
Some other reason
DK/REF

653
April 15, 2016

YSU24SP [IF ANY ENTRY IN YSU24a=7] Please type in the most important other
reason for your last visit to a pediatrician or other family doctor for
emotional or behavioral problems that were not caused by alcohol or drugs.
You do not need to give a detailed description — just a few words will be
okay. When you have finished typing your answer, press the [ENTER] key to
go to the next question.
_____________
DK/REF

PROGRAMMER: DO NOT ALLOW BLANKS IN YSU24SP.

YSU30

[IF CURNTAGE = 12 – 17 and YE09=1] Sometimes students get
treatment or counseling through the school system. This counseling is often
provided by school social workers, school psychologists or school counselors.
During the past 12 months, that is, since [DATEFILL], did you receive any
treatment or counseling from a school social worker, a school psychologist, or a
school counselor for emotional or behavioral problems that were not caused by
alcohol or drugs?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU31

[IF YSU30 = 1] Think about the last time you talked with a school social
worker, school psychologist, or school counselor about emotional or
behavioral problems that were not caused by alcohol or drugs. What was the
reason for your talk?
To select more than one reason from the list, press the space bar between each
number you type. When you have finished, press the [ENTER] key to go to
the next question.
1
You thought about killing yourself or tried to kill yourself.
2
You felt depressed
3
You felt very afraid and tense
4
You were breaking rules and “acting out”
5
You had eating problems
6
Some other reason
DK/REF

YSU31a

[IF ANY ENTRY IN YSU31 = 6] What was the other reason for your
last talk with a school social worker, school psychologist or school
counselor ?
654

April 15, 2016

To select more than one reason from the list, press the space bar between
each number you type. When you have finished, press the [ENTER] key
to go to the next question.
1
You had trouble controlling your anger
2
You had gotten into physical fights
3
You had problems at home or in your family
4
You had problems with your friends
5
You had problems with people other than your friends or family
6
You had problems at school
7
Some other reason
DK/REF
YSU31SP [IF ANY ENTRY IN YSU31a=7] Please type in the most important other
reason for your last talk with a school social worker, school psychologist
or school counselor. You do not need to give a detailed description — just a
few words will be okay. When you have finished typing your answer, press
the [ENTER] key to go to the next question.
_____________
DK/REF

PROGRAMMER: DO NOT ALLOW BLANKS IN YSU31SP.
YSU32

[IF CURNTAGE = 12 – 17 AND YE09=1] At any time during the past
12 months, that is since [DATEFILL], did you attend a school for students with
emotional or behavioral problems?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU33

[IF CURNTAGE = 12 – 17 and YSU32=2 or DK/ref] Regular schools
sometimes provide programs for students with emotional or behavioral problems.
At any time during the past 12 months, did you participate in a school program
that was just for students with emotional or behavioral problems?

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU34 [IF CURNTAGE = 12 – 17 ] These next questions are about experiences with
the justice system.
655
April 15, 2016

During the past 12 months, that is, since [DATEFILL], did you stay overnight or
longer in any type of juvenile detention center, sometimes called “juvie”,
prison, or jail?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSU35

[IF YSU34=1] During the past 12 months, how many nights altogether did
you stay in any type of juvenile detention center, prison or jail?
# OF NIGHTS:
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSU36

[IF YSU34 = 1] Sometimes, the court system provides treatment or
counseling in juvenile detention centers, prisons or jails. These services are
often provided by psychiatrists, psychologists, social workers or counselors
who work for the court system.
While you were in a juvenile detention center, prison or jail during the past
12 months, did you receive treatment or counseling for emotional or
behavioral problems that were not caused by alcohol or drugs?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

656
April 15, 2016

Adolescent Depression
YDS21

[IF CURNTAGE = 12-17] Have you ever in your life had a period of time
lasting several days or longer when most of the day you felt sad, empty, or
depressed?
1
Yes
2
No
DK/REF

YDS22

[IF YDS21 = 2 OR DK/REF] Have you ever had a period of time lasting
several days or longer when most of the day you felt very discouraged or
hopeless about how things were going in your life?
1
Yes
2
No
DK/REF

YDS23

[IF YDS22 = 2 OR DK/REF] Have you ever had a period of time lasting
several days or longer when you lost interest and became bored with most
things you usually enjoy, like work, hobbies, and personal relationships?
1
Yes
2
No
DK/REF

YD01 [IF YDS21 = 1] During times when you felt sad, empty, or depressed most of
the day, did you ever feel discouraged about how things were going in your life?
1
Yes
2
No
DK/REF
YD01a [IF YD01 = 1] During the times when you felt sad, empty, or depressed, did you
ever lose interest and become really bored with most things like school, work,
hobbies, and other things that are usually fun for you, like listening to music,
watching TV, movies, or sports, playing computer games, or going out with
friends?
1
Yes
2
No
DK/REF
YD01b

[YD01 = 2 OR DK/REF] During times when you felt sad, empty, or
depressed, did you ever lose interest and become really bored with most things

657
April 15, 2016

like school, work, hobbies, and other things that are usually fun for you, like
listening to music, watching TV, movies, or sports, playing computer games, or
going out with friends?
1
Yes
2
No
DK/REF

YD02 [IF YDS22 = 1] During times when you felt discouraged about how things were
going in your life, did you ever lose interest and become really bored with most
things like school, work, hobbies, and other things that are usually fun for you,
like listening to music, watching TV, movies, or sports, playing computer games,
or going out with friends?
1
Yes
2
No
DK/REF
YD09 [IF YDS23 = 1] Did you ever have a period of time like this that lasted most of
the day almost every day for two weeks or longer?

1
Yes
2
No
DK/REF
DEFINE FEELFILL:
IF (YD01a = 1), THEN FEELFILL = “were sad, discouraged, or really bored”
IF (YD01a = 2 OR DK/REF), THEN FEELFILL = “were sad or discouraged”
IF (YD01b = 1), THEN FEELFILL = “were sad or really bored”
IF (YD01b = 2 OR DK/REF) THEN FEELFILL = “were sad”
IF (YD02 = 1), THEN FEELFILL = “were discouraged or really bored”
IF (YD02 = 2 OR DK/REF), THEN FEELFILL = “were discouraged about the way
things were going in your life”
IF (YD09 = 1), THEN FEELFILL = “were really bored”
ELSE, FEELFILL = BLANK
DEFINE FEELNOUN:
IF (YD01a = 1), THEN FEELNOUN = “sadness, discouragement, or boredom”
IF (YD01a = 2 OR DK/REF), THEN FEELNOUN = “sadness or discouragement”
IF (YD01b = 1), THEN FEELNOUN = “sadness or boredom”
IF (YD01b = 2 OR DK/REF), THEN FEELNOUN = “sadness”
IF (YD02 = 1), THEN FEELNOUN = “discouragement or boredom”
IF (YD02 = 2 OR DK/REF), THEN FEELNOUN = “discouragement”
IF (YD09 = 1), THEN FEELNOUN = “boredom”

658
April 15, 2016

ELSE FEELNOUN = BLANK
DEFINE NUMPROBS
IF YD01a NE BLANK OR YD01b = 1 OR YD02 = 1, THEN NUMPROBS = these
problems
IF YD01b = (2 OR DK/REF) OR YD02 = (2 OR DK/REF) OR YD09 = 1, THEN
NUMPROBS = this problem
ELSE NUMPROBS = BLANK
DEFINE WASWERE:
IF YD01a NE BLANK OR YD01b = 1 OR YD02 = 1, THEN WASWERE = “were”
IF YD01b = (2 OR DK/REF) OR YD02 = (2 OR DK/REF) OR YD09 = 1, THEN
WASWERE = “was”
ELSE WASWERE = BLANK
YD12 [IF YD01a NE BLANK OR YD01b NE BLANK OR YD02 NE BLANK] Think
about the times when you [FEELFILL]. Did you ever have a period of time like
this that lasted most of the day, almost every day, for two weeks or longer?
1
Yes
2
No
DK/REF

YD16 [IF YD09 = 1 OR YD12 = 1] Think of times lasting two weeks or longer when
[NUMPROBS] with your mood [WASWERE] most severe and frequent. During
those times, how long did your [FEELNOUN] usually last?
1
Less than 1 hour
2
At least 1 hour but less than 3 hours
3
At least 3 hours but less than 5 hours
4
5 hours or more
DK/REF
YD17 [IF YD16 = 2, 3, 4, OR DK/REF] Still thinking of times lasting two weeks or longer
when [NUMPROBS] with your mood [WASWERE] most severe and frequent,
how strong were your bad feelings during those times?
1
Mild
2
Moderate
3
Severe
4
Very severe
DK/REF

659
April 15, 2016

YD18 [IF YD16 = 2, 3, 4, OR DK/REF] Again, think of times lasting two weeks or
longer when [NUMPROBS] with your mood [WASWERE] most severe and
frequent.
How often, during those times, did you feel so bad that nothing could cheer you
up?
1
Often
2
Sometimes
3
Not very often
4
Never
DK/REF
YD19 [IF YD16 = 2, 3, 4, OR DK/REF] Once again, please think of times lasting two
weeks or longer when [NUMPROBS] with your mood [WASWERE] most severe
and frequent.
How often, during those times, did you feel so bad that you could not carry out
your daily activities?
1
Often
2
Sometimes
3
Not very often
4
Never
DK/REF
YD21 [IF YD16 = (2, 3, 4 OR DK/REF) AND NOT (YD17 = 1 AND YD18 = 4 AND
YD19 = 4) AND (YDS21=1 OR YDS22=1 OR YDS23=1) AND YD09 NE (2
OR DK/REF)] People who have problems with their mood often have other
problems at the same time. These problems may include things like changes in:
•
•
•
•
•

sleep
eating
energy
the ability to keep their mind on things
feeling badly about themselves

Did you ever have any of these problems during a period of time when you
[FEELFILL] for two weeks or longer?
1
Yes
2
No
DK/REF
YD22 [IF YD21=1] Think again about these other problems we just mentioned. They
include things like changes in:
660
April 15, 2016

•
•
•
•
•

sleep
eating
energy
the ability to keep their mind on things
feeling badly about themselves

Can you think of the worst time when you [FEELFILL] for two weeks or longer
and also had these other problems at the same time?
1
Yes
2
No
DK/REF
YD22a [IF YD22 = 1] How old were you when that worst period of time started?
AGE: __________ [RANGE: 1-17]
DK/REF
YD22c [IF YD22 = 2 OR DK/REF] Then think of the most recent time you [FEELFILL]
for two weeks or longer and you had these other problems at the same time.
How old were you when that time started?
AGE: __________ [RANGE: 1-17]
DK/REF
DEFINE TIMEFILL:
IF YD22a NE BLANK, THEN TIMEFILL = ‘worst’
IF YD22c NE BLANK, THEN TIMEFILL = ‘most recent’
YD24a [IF YD22a NE BLANK] In answering the next questions, think about the period
of time when your [FEELNOUN] and other problems were the worst.
[IF YD22c NE BLANK] In answering the next questions, think about the most
recent period of time when you [FEELFILL] and had other problems at the same
time.
During that time, did you feel sad, empty, or depressed for most of the day nearly
every day?
1
Yes
2
No
DK/REF

661
April 15, 2016

YD24c [IF YD22a NE BLANK OR YD22c NE BLANK] During that [TIMEFILL]
period of time, did you feel discouraged about how things were going in your life
most of the day nearly every day?
1
Yes
2
No
DK/REF
YD24e [IF YD22a NE BLANK OR YD22c NE BLANK] During that [TIMEFILL]
period of time, did you become bored with almost everything like school, work,
hobbies, and things you like to do for fun?
1
Yes
2
No
DK/REF
YD24f [IF YD22a NE BLANK OR YD22c NE BLANK] During that [TIMEFILL]
period of time, did you feel like nothing was fun even when good things were
happening?
1
Yes
2
No
DK/REF
YD26a [IF ANY YD24a - YD24f = 1] The next questions are about changes in appetite
and weight.
[IF YD22a NE BLANK] In answering these questions, think about the period of
time when your [FEELNOUN] and other problems were the worst.
[IF YD22c NE BLANK] In answering these questions, think about the most
recent period of time when you [FEELFILL] and had other problems at the same
time.
Did you eat much less than usual almost every day during that time?
1
Yes
2
No
DK/REF
YD26b [IF YD26a = 2 OR DK/REF] Did you eat much more than usual almost every day?
1
Yes
2
No
DK/REF

662
April 15, 2016

YD26c

[IF YD26a = 2 OR DK/REF]Did you gain weight without trying to during
that [TIMEFILL] period of time?
1
Yes
2
No
DK/REF

YD26c1
[IF YD26c = 1] Did you gain weight without trying to because you were
growing?
1
Yes
2
No
DK/REF
YD26c2
[IF YD26c1 = (2 OR DK/REF) AND QD01 = 9] Did you gain weight
without trying to because you were pregnant?
1
Yes
2
No
DK/REF
YD26d [IF (YD26c1=(2 OR DK/REF) AND YD26c2=BLANK, 2 OR DK/REF] How
many pounds did you gain?
Please enter your answer as a whole number.
# OF POUNDS:__________ [RANGE: 0-200]
DK/REF
YD26e

[IF YD26a = 1 OR YD26c = (2 OR DK/REF)] Did you lose weight without
trying to?
1
Yes
2
No
DK/REF

YD26e1

[IF YD26e = 1] Did you lose weight without trying to because you were sick
or on a diet?

1
Yes
2
No
DK/REF
YD26f [IF YD26e1=2 OR DK/REF] How many pounds did you lose?
Please enter your answer as a whole number.

663
April 15, 2016

# OF POUNDS:__________ [RANGE: 0-200]
DK/REF
YD26g [IF YD26a NE BLANK]
[IF YD22a NE BLANK] Again, please think about the period of time when your
[FEELNOUN] and other problems were the worst.
[IF YD22c NE BLANK] Again, please think about the most recent period of
time when you [FEELFILL]and had other problems at the same time.
Did you have a lot more trouble than usual falling asleep or staying asleep most
nights or waking too early most mornings during that [TIMEFILL] time?
1
Yes
2
No
DK/REF
YD26h [IF YD26g=2 OR DK/REF]During that [TIMEFILL] period of time, did you sleep
a lot more than usual?
1
Yes
2
No
DK/REF
YD26j [IF YD26a NE BLANK] On most days during that [TIMEFILL] period of time,
did you feel that you didn’t have much energy?
1
Yes
2
No
DK/REF
YD26l [IF YD26a NE BLANK] Did you feel as though you were talking or moving more
slowly than usual on most days during that [TIMEFILL] period of time?
1
Yes
2
No
DK/REF
YD26m
[IF YD26l = 1] Did anyone else notice that you were talking or moving
more slowly than usual?
1
Yes
2
No
DK/REF

664
April 15, 2016

YD26n [IF YD26l = 2 OR DK/REF] Were you so restless or jittery that you walked up or
down or couldn't sit still?
1
Yes
2
No
DK/REF
YD26o [IF YD26n = 1] Did anyone else notice that you couldn’t sit still?
1
Yes
2
No
DK/REF
YD26p [IF YD26a NE BLANK] The next questions are about changes in your ability to
concentrate, and your feelings about yourself.
[IF YD22a NE BLANK] Again, in answering these questions, think about the
period of time when your [FEELNOUN] and other problems were the worst.
[IF YD22c NE BLANK] Again, in answering these questions, think about the
most recent period of time when you [FEELFILL] and had other problems at the
same time.
On most days during that [TIMEFILL] time, did your thinking seem slower than
usual or seem mixed up?
1
Yes
2
No
DK/REF
YD26r [IF YD26a NE BLANK] On most days, did you have a lot more trouble than usual
keeping your mind on things?
1
Yes
2
No
DK/REF
YD26s [IF YD26a NE BLANK] Were you unable to make up your mind about things you
ordinarily have no trouble deciding about?
1
Yes
2
No
DK/REF
YD26u

[IF YD26a NE BLANK] Did you feel that you were not as good as other
people nearly every day?

665
April 15, 2016

1 Yes
2
No
DK/REF
YD26v

[IF YD26u = 1] Did you feel totally worthless nearly every day?
1 Yes
2
No
DK/REF

YD26aa

[IF YD26a NE BLANK] The next questions are about thoughts of death
or suicide.
[IF YD22a NE BLANK] Again, in answering these questions, think about
the period of time when your [FEELNOUN] and other problems were the
worst.
[IF YD22c NE BLANK] Again, in answering these questions, think about
the most recent period of time when you [FEELFILL] and had other
problems at the same time.
Did you often think a lot about death, either your own, someone else’s, or
death in general?
1 Yes
2
No
DK/REF

YD26bb

[IF YD26a NE BLANK] During that time, did you ever think that it would
be better if you were dead?
1 Yes
2
No
DK/REF

YD26cc

[IF YD26a NE BLANK] Did you think about killing yourself?
1 Yes
2
No
DK/REF

YD26dd

[IF YD26cc = 1] Did you make a plan to kill yourself?
1 Yes
2
No

666
April 15, 2016

DK/REF
YD26ee

[IF YD26cc = 1] Did you make a suicide attempt or try to kill yourself?
1 Yes
2
No
DK/REF

DEFINE D_MDEA1Y:
IF YD24A = 1 OR YD24C = 1, THEN D_MDEA1Y= 1
ELSE IF YD24A = 2 AND YD24C = 2, THEN D_MDEA1Y= 2
ELSE IF YD24A = DK OR YD24C = DK, THEN D_MDEA1Y= DK
ELSE IF YD24A = REF OR YD24C = REF, THEN D_MDEA1Y= REF
ELSE D_MDEA1Y= BLANK
DEFINE D_MDEA2Y:
IF YD09 = 1 OR YD24E = 1 OR YD24F = 1 THEN D_MDEA2Y = 1
ELSE IF (YDS21 = 1 OR YDS22 = 1 OR YD09 = 2) AND YD24E = 2 AND YD24F = 2
THEN D_MDEA2Y = 2
ELSE IF YD09 = DK OR YD24E = DK OR YD24F = DK THEN D_MDEA2Y = DK
ELSE IF YD09 = REF OR YD24E = REF OR YD24F = REF THEN D_MDEA2Y =
REF
ELSE D_MDEA2Y=BLANK
DEFINE D_MDEA3Y:
IF YD26A = 1 OR YD26B = 1 OR YD26D ≥10 OR YD26F ≥10, THEN D_MDEA3Y=
1
ELSE IF YD26A = 2 AND YD26B = 2 AND ((YD26D < 10 OR YD26F < 10) OR
(YD26C = (2 OR BLANK) AND YD26E = (2 OR BLANK)) OR (YD26C = 1 AND (YD26C1
= 1 OR YD26C2 = 1)) OR (YD26E = 1 AND YD26E1 = 1)), THEN D_MDEA3Y= 2
ELSE IF YD26A = DK OR YD26B = DK OR YD26C = DK OR YD26D = DK OR
YD26E = DK OR YD26F = DK, THEN D_MDEA3Y= DK
ELSE IF YD26A = REF OR YD26B = REF OR YD26C = REF OR YD26D = REF OR
YD26E = REF OR YD26F = REF, THEN D_MDEA3Y= REF
ELSE D_MDEA3Y= BLANK
DEFINE D_MDEA4Y:
IF YD26G = 1 OR YD26H = 1, THEN D_MDEA4Y= 1
ELSE IF YD26G = 2 AND YD26H = 2, THEN D_MDEA4Y= 2
ELSE IF YD26G = DK OR YD26H = DK, THEN D_MDEA4Y= DK
ELSE IF YD26G = REF OR YD26H = REF, THEN D_MDEA4Y= REF
ELSE D_MDEA4Y= BLANK
DEFINE D_MDEA5Y:
IF YD26M = 1 OR YD26O = 1, THEN D_MDEA5Y= 1

667
April 15, 2016

ELSE IF (YD26L = (2 OR DK/REF) AND (YD26N = (2 OR DK/REF) OR YD26O = 2))
OR YD26M = 2, THEN D_MDEA5Y= 2
ELSE IF YD26L = DK OR YD26M = DK OR YD26N = DK OR YD26O = DK, THEN
D_MDEA5Y= DK
ELSE IF YD26L = REF OR YD26M = REF OR YD26N = REF OR YD26O = REF,
THEN D_MDEA5Y= REF
ELSE D_MDEA5Y= BLANK
DEFINE D_MDEA6Y:
D_MDEA6Y= YD26J
DEFINE D_MDEA7Y:
IF YD26V = 1, THEN D_MDEA7Y= 1
ELSE IF YD26U = (2 OR DK/REF) OR YD26V = 2, THEN D_MDEA7Y= 2
ELSE D_MDEA7Y=YD26V
ELSE D_MDEA7Y= BLANK
DEFINE D_MDEA8Y:
IF YD26P = 1 OR YD26R = 1 OR YD26S = 1, THEN D_MDEA8Y= 1
ELSE IF YD26P = 2 AND YD26R = 2 AND YD26S = 2, THEN D_MDEA8Y= 2
ELSE IF YD26P = DK OR YD26R = DK OR YD26S = DK, THEN D_MDEA8Y= DK
ELSE IF YD26P = REF OR YD26R = REF OR YD26S = REF, THEN D_MDEA8Y=
REF
ELSE D_MDEA8Y= BLANK
DEFINE D_MDEA9Y:
IF YD26AA = 1 OR D26BB = 1 OR YD26CC = 1 OR YD26DD = 1 OR YD26EE = 1,
THEN D_MDEA9Y= 1
ELSE IF YD26AA = 2 AND YD26BB = 2 AND YD26CC = 2, THEN D_MDEA9Y= 2
ELSE IF YD26AA = DK OR YD26BB = DK OR YD26CC = DK OR YD26DD = DK
OR YD26EE = DK, THEN D_MDEA9Y= DK
ELSE IF YD26AA = REF OR YD26BB = REF OR YD26CC = REF OR YD26DD =
REF OR YD26EE = REF, THEN D_MDEA9Y= REF
ELSE D_MDEA9Y= BLANK
DEFINE DSMMDEAY:
IF SUM (D_MDEA1Y = 1, D_MDEA2Y = 1, D_MDEA3Y = 1, D_MDEA4Y = 1,
D_MDEA5Y = 1, D_MDEA6Y = 1, D_MDEA7Y = 1, D_MDEA8Y = 1, D_MDEA9Y
= 1) ≥ 5, THEN DSMMDEAY = 1
ELSE IF SUM (D_MDEA1Y = (1 OR DK/REF), D_MDEA2Y = (1 OR DK/REF),
D_MDEA3Y = (1 OR DK/REF), D_MDEA4Y = (1 OR DK/REF), D_MDEA5Y = (1
OR DK/REF), D_MDEA6Y = (1 OR DK/REF), D_MDEA7Y = (1 OR DK/REF),
D_MDEA8Y = (1 OR DK/REF), D_MDEA9Y = (1 OR DK/REF)) < 5 AND N(OF
D_MDEA1Y-D_MDEA9Y) > 0, THEN DSMMDEAY = 2

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April 15, 2016

ELSE IF D_MDEA1Y = DK OR D_MDEA2Y = DK OR D_MDEA3Y = DK OR
D_MDEA4Y = DK OR D_MDEA5 = DK OR D_MDEA6Y = DK OR D_MDEA7Y =
DK OR D_MDEA8Y = DK OR D_MDEA9Y = DK, THEN DSMMDEAY = DK
ELSE IF D_MDEA1Y = REF OR D_MDEA2Y = REF OR D_MDEA3Y = REF OR
D_MDEA4Y = REF OR D_MDEA5Y = REF OR D_MDEA6Y = REF OR D_MDEA7Y
= REF OR D_MDEA8Y = REF OR D_MDEA9Y = REF, THEN DSMMDEAY = REF
YD28 [IF D_MDEA9Y = 1 OR DSMMDEAY = 1] You mentioned having some of the
problems I just asked you about.
During that [TIMEFILL] period of time, how much did your [FEELNOUN]
interfere or cause problems with your school work, your job, or your relationships
with family and friends?
1
2
3
4
5
DK/REF

Not at all
A little
Some
A lot
Extremely

YD28a [IF YD28 = 2, 3, 4, 5 OR DK/REF] During that [TIMEFILL] period of time, how
often were you unable to carry out your daily activities or to take care of yourself
because of these problems with your mood?
1
2
3
4
DK/REF

Often
Sometimes
Not very often
Never

YD37 [IF YD28 NE BLANK] Think of the very first period of time in your life lasting
two weeks or longer when you [FEELFILL] and also had some of the other
problems we just asked about.
Can you remember your exact age?
1
Yes
2
No
DK/REF

YD37a [IF YD37 = 1] How old were you?
AGE:__________ [RANGE: 1-17]
DK/REF

669
April 15, 2016

YD37b

[IF YD37 = 2 OR DK] About how old were you when you first had a period
of time like this?
AGE:__________ [RANGE: 1-17]
DK/REF

YD52 [IF YD28 NE BLANK] In your entire life, how many times did you feel
[FEELNOUN] for two weeks or longer while also having some of the other
problems we asked about?
If you are not sure of your answer, just make your best guess.
# OF EPISODES______________ [RANGE: 1-1000]
DK/REF
YD38 [IF YD28 NE BLANK] In the past 12 months, did you have a period of time when
you felt [FEELNOUN] for two weeks or longer while also having some of the other
problems we asked about?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YD66a [IF YD38 = 1] Think about the time in the past 12 months when [NUMPROBS]
with your mood [WASWERE] the worst.
Using the 0 to 10 scale shown below, where 0 means no problems and 10 means
very severe problems, select the number that describes how much your
[FEELNOUN] caused problems with your ability to do each of the following
activities during that time. You can use any number between 0 and 10 to answer.
How much did your [FEELNOUN] cause problems with your chores at home?
No
Severe
Problems
Problems
│
0

Very
Mild
│
1

2

Moderate

3

4

10
NUMBER: ______________[RANGE: 0-10]
DK/REF

670
April 15, 2016

5

Severe

6

7

8

9

YD66b

[IF YD38 = 1] During that time in the past 12 months when your
[FEELNOUN] was worst, how much did this cause problems with your ability to
do well at school or work?
You can use any number between 0 and 10 to answer.
No

Severe
Problems
Problems
│
0

Mild
│
1

2

Very

Moderate

3

4

5

Severe

6

7

8

9

10
NUMBER: ______________[RANGE: 0-10]
DK/REF
YD66c [IF YD38 = 1] How much did your [FEELNOUN] cause problems with your
ability to get along with your family during that time?
You can use any number between 0 and 10 to answer.

No
Severe
Problems
Problems
│
0

Very
Mild
│
1

2

Moderate

3

4

5

Severe

6

7

8

9

10
NUMBER: ______________[RANGE: 0-10]
DK/REF

YD66d

[IF YD38 = 1] How much did your [FEELNOUN] cause problems with
your ability to have a social life during that time?
You can use any number between 0 and 10 to answer.

No

Very

Severe

671
April 15, 2016

Problems
Problems
│
0

Mild
│
1

2

Moderate

3

4

5

Severe

6

7

8

9

10
NUMBER: ______________[RANGE: 0-10]
DK/REF
YD68 [IF ANY RESPONSES TO YD66a – YD66d = 1-10] About how many days out
of 365 in the past 12 months were you totally unable to go to school or work or
carry out your normal activities because of your [FEELNOUN]?
You can use any number between 0 and 365 to answer.
# OF DAYS:__________ [RANGE: 0-365]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YD86

[IF YD38 NE BLANK] Here is a list of professionals some people talk to
about the problems we have been asking about:
General practitioner or family doctor
Other medical doctor like a cardiologist, gynecologist, urologist
Psychologist
Psychiatrist or psychotherapist
Social Worker
Counselor
Other mental health professional, like a mental health nurse
A nurse, occupational therapist, or other health professional
A religious or spiritual advisor like a minister, priest, or rabbi
Another healer, like an herbalist, chiropractor, acupuncturist, or massage
therapist
At any time in the past 12 months, did you see or talk to a medical doctor
or other professional about your [FEELNOUN]?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YD86a [IF YD86 = 1] During the past 12 months, which professionals did you see or
talk to about [NUMPROBS] with your mood?

672
April 15, 2016

To select more than one professional from the list, press the space bar between
each number you type. When you have finished, press the [ENTER] key to go to
the next question.
1 General practitioner or family doctor
2 Other medical doctor like a cardiologist, gynecologist, urologist
3 Psychologist
4 Psychiatrist or psychotherapist
5 Social Worker
6 Counselor
7 Other mental health professional, like a mental health nurse
8 A nurse, occupational therapist, or other health professional
9 A religious or spiritual advisor like a minister, priest, or rabbi
10 An herbalist, chiropractor, acupuncturist, or massage therapist
11 Another type of helping professional
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YD86aSP [IF ANY RESPONSE IN YD86a =11] Please type in the type of other
professional you saw or talked to during the past 12 months about your
[FEELNOUN]. When you have finished typing your answer, press the
[ENTER] key to go to the next question.
_____________ [RANGE: 50 CHARACTERS]
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN YD86aSP.
YD86b

[IF YD86= 1] Are you currently receiving treatment or counseling for
[NUMPROBS] with your mood?
1
Yes
2
No
DK/REF

YD86c [IF YD38 NE BLANK] During the past 12 months, did you take prescription
medication that was prescribed for[NUMPROBS]?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YD86d

[IF YD86c = 1] Are you currently taking prescription medication that
was prescribed for [NUMPROBS]?
1

Yes

673
April 15, 2016

2
No
DK/REF
YD86e [IF YD86c = 1] During the past 12 months, how much has this prescription
medication helped you?
1
Not at all
2
A little
3
Some
4
A lot
5
Extremely
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YD86f [IF YD86 = 1] During the past 12 months, how much has treatment or counseling
helped you?
1
Not at all
2
A little
3
Some
4
A lot
5
Extremely
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

674
April 15, 2016

Definitions for Use in Consumption of Alcohol Module
DEFINE ALC30USE:
IF ALLAST3 = 1 OR ALRECDK = 1 OR ALRECRE = 1 THEN ALC30USE = 1
ELSE ALC30USE = 2
(ALC30USE IS DEFINED IN THE ALCOHOL MODULE)
DEFINE MAR30USE:
IF MJLAST3 = 1 OR MJRECDK = 1 OR MJRECRE = 1 THEN MAR30USE=1
ELSE MAR30USE = 2
DEFINE COC30USE:
IF CCLAST3 = 1 OR CCRECDK = 1 OR CCRECRE = 1 OR CKLAST3 = 1 OR
CKRECDK = 1 OR CKRECRE = 1 OR SD06 = 1 THEN COC30USE = 1
ELSE COC30USE = 2
DEFINE HER30USE:
IF HELAST3=1 OR HERECDK=1 OR HERECRE=1 OR SD08=1 OR SD10=1
OR SDHEUSE3=1 OR SDHEUSE4=1 OR SD12=1 THEN HER30USE = 1
ELSE HER30USE = 2
DEFINE HAL30USE:
IF HALLREC = 1 OR LSDREC = 1 OR PCPREC = 1 OR ECSTREC = 1 OR
KETREC=1 OR DMTREC=1 OR SLVREC=1 THEN HAL30USE = 1
ELSE HAL30USE = 2
DEFINE INH30USE:
IF INLAST = 1 OR INRECDK = 1 OR INRECRE = 1 THEN INH30USE = 1
ELSE INH30USE = 2
DEFINE MTH30USE:
IF MELAST3 = 1 OR MERECRE = 1 OR MERECDK = 1 OR SD14=1 THEN
MTH30USE = 1
ELSE MTH30USE = 2
(RX DRUG MISUSE IS DEFINED IN THE MODULES)
DEFINE DRUGFILL:
IF MAR30USE=1 AND COC30USE = 2 AND HER30USE = 2 AND
HAL30USE = 2 AND INH30USE = 2 AND MTH30USE = 2 THEN DRUGFILL
= ‘marijuana or hashish’
IF MAR30USE = 2 AND (CCLAST3 = 1 OR CCRECDK = 1 OR CCRECRE = 1
OR SD06 = 1) AND (CKLAST3 NE 1 AND CKRECDK NE 1 AND CKRECRE
NE 1) AND HER30USE = 2 AND HAL30USE = 2 AND INH30USE = 2 AND

675
April 15, 2016

MTH30USE = 2 THEN DRUGFILL = ‘‘cocaine’’
IF MAR30USE = 2 AND (CCLAST3=1 OR CCRECDK=1 OR CCRECRE=1
OR SD06=1) AND (CKLAST3=1 OR CKRECDK=1 OR CKRECRE=1) AND
HER30USE = 2 AND HAL30USE = 2 AND INH30USE = 2 AND MTH30USE
= 2 THEN DRUGFILL = ‘cocaine or ‘crack’’
IF MAR30USE = 2 AND (CCLAST3 NE 1 AND CCRECDK NE 1 AND
CCRECRE NE 1 AND SD06 NE 1) AND (CKLAST3 = 1 OR CKRECDK = 1
OR CKRECRE = 1) AND HER30USE = 2 AND HAL30USE = 2 AND
INH30USE = 2 AND MTH30USE = 2 THEN DRUGFILL = ‘‘’crack’’’
IF MAR30USE=2 AND COC30USE = 2 AND HER30USE = 1 AND
HAL30USE = 2 AND INH30USE = 2 AND MTH30USE = 2 THEN DRUGFILL
= ‘heroin’
IF MAR30USE=2 AND COC30USE = 2 AND HER30USE = 2 AND
HAL30USE = 1 AND INH30USE = 2 AND MTH30USE = 2 THEN DRUGFILL
= ‘hallucinogens’
IF MAR30USE=2 AND COC30USE = 2 AND HER30USE = 2 AND
HAL30USE = 2 AND INH30USE = 1 AND MTH30USE = 2 THEN DRUGFILL
= ‘inhalants’

IF MAR30USE=2 AND COC30USE = 2 AND HER30USE = 2 AND
HAL30USE = 2 AND INH30USE = 2 AND MTH30USE = 1 THEN DRUGFILL
= ‘methamphetamine’

IF (MORE THAN ONE IN (MAR30USE AND COC30USE AND HER30USE
AND HAL30USE AND INH30USE) = 1) THEN DRUGFILL = ‘any of these
drugs’

676
April 15, 2016

Consumption of Alcohol
CAINTR [IF AL01 = 1 OR ALREF = 1] Next, we return to the topic of alcohol.
Remember that by a “drink,” we mean a can or bottle of beer, a glass of wine
or a wine cooler, a shot of liquor, or a mixed drink with liquor in it. We are
not asking about times when you only had a sip or two from a drink.
Press [ENTER] to continue.
CA01

[IF ALC30USE = 1] Earlier, the computer recorded that you drank at least one
alcoholic beverage within the past 30 days, that is, since [FILLDATE].
Please think about the last time you drank any alcoholic beverage. How
many drinks did you have that time?
# OF DRINKS: __________ [1 - 90]
DK/REF

CA02a

[IF ALC30USE = 1 AND CALCAGE = 12-20] This last time you drank,
were you alone or were you with one or more other people?
1
I was alone the last time I drank
2
I was with one other person the last time I drank
3
I was with more than one other person the last time I drank
DK/REF

CA02b

[IF ALC30USE = 1 AND CALCAGE = 12 - 20] Where did you drink
alcoholic beverages this last time you drank?
To select more than one place from the list, press the space bar after each
number that you type. When you have finished, press [ENTER].
1
I drank in a car or other vehicle
2
I drank at my home
3
I drank at someone else’s home
4
I drank at a park, on a beach, or in a parking lot
5
I drank in a restaurant, bar or club
6
I drank at a concert or sports game
7
I drank at school
8
I drank at some other place
DK/REF

CA02SP [IF CA02b = 8] Please type in the other place you drank the last alcoholic
beverages that you drank. You do not need to give a detailed description —
just a few words will be okay. When you have finished typing your answer,

677
April 15, 2016

press the [ENTER] key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN CA02SP.
CA03

[IF ALC30USE = 1 AND CALCAGE = 12 - 20] Did you pay for the last
alcoholic beverage that you drank?
1 Yes
2 No
DK/REF

CA04

[IF CA03 = 1] Did you buy this last alcoholic beverage yourself, or did you
give money to someone else to buy it for you?
1 I bought it myself
2 I gave money to someone else who bought it for me
DK/REF

CA05

[IF CA04 = 1] People often buy alcoholic beverages at stores, restaurants,
bars, clubs, or events. Sometimes they buy alcohol from other people. Which
of these statements describes the way you bought the last alcoholic beverage
that you drank?
1 I bought it at a store, restaurant, bar, club or event
2 I bought it from another person.
DK/REF

CA05a

[IF CA05 = 1] At which of these places did you buy the last alcoholic
beverage that you drank?
1
I bought it at a liquor store, convenience store, grocery store, or gas station
2
I bought it at a restaurant, bar or club
3
I bought it at a concert, sports or other event
DK/REF

CA05b

[IF CA05 = 2] Did you buy this last alcoholic beverage from someone
who was under age 21, or were they 21 or older?
1
Under age 21
2
Age 21 or older
DK/REF

CA06

[IF CA04 = 2] Who bought the alcoholic beverage for you?

678
April 15, 2016

1 My parent or guardian bought it for me
2 Another family member who is 21 or older bought it for me
3 Someone not related to me who is 21 or older bought it for me
4 Someone under age 21 bought it for me
DK/REF

CA07

[IF CA03 = 2] How did you get the last alcoholic beverage that you drank?
1 My parent or guardian gave it to me
2 Another family member who is 21 or older gave it to me
3 Someone not related to me who is 21 or older gave it to me
4 Someone under age 21 gave it to me
5 I took it from home
6 I took it from someone else’s home
7 I got it some other way
DK/REF

CA07SP [IF CA07 = 7] Please type in the other way you got the last alcoholic
beverage that you drank. You do not need to give a detailed description —
just a few words will be okay. When you have finished typing your answer,
press the [ENTER] key to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN CA07SP.
[Note to Programmers regarding CA08: Create a vertical list of all drugs (not
including alcohol) for which *30USE = 1. The names used in this list should be taken
from the DRUGFILL list. The first letter of each line should be capitalized. For
example, if ALC30USE = 1, COC30USE = 1 (where CCLAST3=1 and CKLAST3=1)
and HER30USE = 1, then the list would include ‘Cocaine or ‘crack’’ and ‘Heroin.’]
CA08

[IF ALC30USE = 1 AND AT LEAST ONE IN (MAR30USE AND
COC30USE AND HER30USE AND HAL30USE AND INH30USE AND
MTH30USE=1]
[IF CA01 NE DK/REF] Think again about this last time you drank any
alcoholic beverages, when you had [CA01 FILL] [drink/drinks]. Did you
also use [DRUGFILL] while you were drinking or within a couple of hours
of drinking?
[IF CA01 = DK/REF] Think again about this last time you drank any
alcoholic beverages during the past 30 days. Did you also use [DRUGFILL]
while you were drinking or within a couple of hours of drinking?

679
April 15, 2016

[IF ALC30USE = 1 AND ((MORE THAN ONE IN (MAR30USE AND
COC30USE AND HER30USE AND HAL30USE AND INH30USE AND
MTH30USE ): DISPLAY LIST OF SUBSTANCES.]
1 Yes
2 No
DK/REF
[Note to Programmers regarding CA09: Only display the response options that
correspond to the list displayed in CA08. Audio files should be played only for the
displayed response options. Responses not displayed will be invalid for CA09; they will
trigger a hard error below.]
CA09

[IF CA08 = 1 AND MORE THAN ONE IN (MAR30USE AND COC30USE
AND HER30USE AND HAL30USE AND INH30USE AND MTH30USE) =
1] What other drug or drugs did you use while you were drinking or within a
couple of hours of drinking?
To select more than one drug from the list, press the space bar between each
number you type. When you have finished, press the [ENTER] key to go to
the next question.
1 Marijuana or hashish
2 Cocaine or ‘crack’
3 Heroin
4 Hallucinogens
5 Inhalants
6 Methamphetamine
DK/REF

HARD ERROR: [IF ANY RESPONSE (1-9) IS SELECTED THAT WAS NOT
DISPLAYED]: THIS IS NOT ONE OF YOUR CHOICES. TO MAKE
THIS BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN
ANSWER THE QUESTION AGAIN.
CA10 [IF ((AL01 = 1 OR ALREF = 1) AND ALC30USE = 2) OR (ALC30USE = 1
AND BINGEFLAG=0 AND ((CA01 NE 5-90 AND QD01=5) OR (CA01 NE 490 AND QD01=9)))]
[IF ALC30USE = 2: Earlier the computer recorded that you have had at least one
drink of an alcoholic beverage in your lifetime.] Have you ever had [IF QD01=5
THEN FILL 5 IF QD01=9 THEN FILL 4] or more drinks on the same occasion?
By ‘occasion,’ we mean at the same time or within a couple of hours of each
other.
1
2

Yes
No

680
April 15, 2016

DK/REF
CA11 [IF CA10 = 1 OR BINGEFLAG=1 OR (CA01 = 5-90 AND QD01=5) OR (CA01
= 4-90 AND QD01=9)]
[IF BINGEFLAG=1 OR (CA01 = 5-90 AND QD01=5) OR (CA01 = 4-90 AND
QD01=9): Earlier the computer recorded that you had [IF QD01=5 THEN FILL 5
IF QD01=9 THEN FILL 4] or more drinks on the same occasion in the past 30
days.] How old were you the first time you had [IF QD01=5 THEN FILL 5 IF
QD01=9 THEN FILL 4] or more drinks on the same occasion?
AGE: __________ [1 - 110]
DK/REF
DEFINE AGE1STBA:
IF CA11 NE (BLANK OR DK/REF) THEN AGE1STBA = CA11
ELSE AGE1STBA = BLANK
IF CURNTAGE < AGE1STBA OR AGE1STBA < 10 OR AGE1STBA <
AGE1STAL:
BACC01 The computer recorded that you were [AGE1STBA] years old
when you first had [IF QD01=5 THEN FILL 5 IF QD01=9
THEN FILL 4] or more drinks on the same occasion. Is this
correct?
4
Yes
6
No
DK/REF

BACC02 [IF BACC01=6] Please answer this question again. Think
about the first time you had [IF QD01=5 THEN FILL 5 IF
QD01=9 THEN FILL 4] or more drinks on the same occasion.
How old were you the first time you had [IF QD01=5 THEN
FILL 5 IF QD01=9 THEN FILL 4] or more drinks on the same
occasion?
AGE:
DK/REF

[RANGE: 1 - 110]

UPDATE: IF BACC02 NOT (BLANK OR DK/REF) THEN AGE1STBA = BACC02
CA11a [IF AGE1STBA = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF
AGE1STBA = CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you
first have [IF QD01=5 THEN FILL 5 IF QD01=9 THEN FILL 4] or more drinks
on the same occasion in [CURRENT YEAR - 1] or [CURRENT YEAR]?

681
April 15, 2016

1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
CA11b

[IF AGE1STBA = CURNTAGE - 1 AND DATE OF INTERVIEW <
DOB] Did you first have [IF QD01=5 THEN FILL 5 IF QD01=9 THEN FILL 4]
or more drinks on the same occasion in [CURRENT YEAR - 2] or [CURRENT
YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

CA11c IF AGE1STBA = CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what
month in [CURRENT YEAR] did you first have [IF QD01=5 THEN FILL 5 IF
QD01=9 THEN FILL 4] or more drinks on the same occasion?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CA11c > CURRENT MONTH] THE MONTH IN [CURRENT
YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS BOX
DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER THE
QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
CA11d

[IF CA11a = 1 OR 2 OR CA11b = 1 OR 2] In what month in [YEAR
FROM CA11a or CA11b] did you first have [IF QD01=5 THEN FILL 5 IF
QD01=9 THEN FILL 4] or more drinks on the same occasion?
1
2
3
4
5

January
February
March
April
May

682
April 15, 2016

6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF CA11d > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
DEFINE MYR1STBA:
MYR1STBA = AGE AT FIRST BINGE USE CALCULATED BY
“SUBTRACTING” DATE OF BIRTH FROM MONTH AND YEAR OF FIRST
BINGE USE (CA11a-d). IF MONTH OF FIRST BINGE USE = MONTH OF
BIRTH, THEN MYR1STBA IS BLANK.
IF MYR1STBA NE 0 AND NE AGE1STBA:
BACC03 The computer recorded that you first had [IF QD01=5 THEN
FILL 5 IF QD01=9 THEN FILL 4] or more drinks on the same
occasion in [CA11a-d fill]. That would make you
[MYR1STBA] years old when you first had [IF QD01=5
THEN FILL 5 IF QD01=9 THEN FILL 4] or more drinks on
the same occasion. Is this correct?
4
Yes
6
No
DK/REF
BACC04 [IF BACC03 = 4] Earlier, the computer recorded that you
were [AGE1STBA] years old when you first had [IF QD01=5
THEN FILL 5 IF QD01=9 THEN FILL 4] or more drinks on
the same occasion. Which answer is correct?
1

I first had [IF QD01=5 THEN FILL 5 IF QD01=9
THEN FILL 4] or more drinks on the same occasion in
[CA11a-d fill] when I was [MYR1STBA] years old
2
I was [AGE1STBA] years old the first time I had [IF
QD01=5 THEN FILL 5 IF QD01=9 THEN FILL 4] or
more drinks on the same occasion
3
Neither answer is correct
DK/REF

683
April 15, 2016

UPDATE: IF BACC04 = 1, THEN AGE1STBA = MYR1STBA.
BACC05 [IF BACC04=2 OR BACC04=3 OR BACC03=6] Please
answer this question again. Did you first have [IF QD01=5
THEN FILL 5 IF QD01=9 THEN FILL 4] or more drinks on
the same occasion in [CURRENT YEAR-2], [CURRENT
YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
BACC05a [IF BACC05 NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [BACC05] did you first have
[IF QD01=5 THEN FILL 5 IF QD01=9 THEN FILL 4] or
more drinks on the same occasion?
1
January
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF BACC05a > CURRENT MONTH] THE MONTH IN
[CURRENT YEAR] YOU ENTERED HAS NOT BEGUN YET. TO MAKE THIS
BOX DISAPPEAR, PRESS THE [ENTER] KEY. YOU CAN THEN ANSWER
THE QUESTION AGAIN. PRESS [ENTER] TO CONTINUE.
UPDATE: IF BACC05a NE (0 OR DK/REF) THEN UPDATE MYR1STBA.
MYR1STBA = AGE AT FIRST BINGE USE CALCULATED BY “SUBTRACTING”
DATE OF BIRTH FROM MONTH AND YEAR OF FIRST BINGE USE (BACC05
AND BACC05a). IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN
MYR1STBA IS BLANK. IF MYR1STBA = AGE1STBA THEN MYR1STBA =
BLANK
BACC06 [IF BACC04 NE 1 AND MYR1STBA NE 0 AND (BACC05
AND BACC05a NE CA11a-d)] The computer recorded that

684
April 15, 2016

you first had [IF QD01=5 THEN FILL 5 IF QD01=9 THEN
FILL 4] or more drinks on the same occasion in [BACC05BACC05a fill]. That would make you [MYR1STBA] years old
when you first had [IF QD01=5 THEN FILL 5 IF QD01=9
THEN FILL 4] or more drinks on the same occasion. Is this
correct?
4
Yes
6
No
DK/REF
UPDATE: IF BACC06 NE (6, BLANK OR DK/REF )AND (BACC05 AND BACC05a
NE CA11a-d) THEN AGE1STBA = MYR1STBA

685
April 15, 2016

686
April 15, 2016

Back End Demographics

QD13 How many times in the past 12 months have you moved? Please include moves
from one residence to another within the same city/town as well as those from one
city/town to another.

NUMBER OF TIMES:
[RANGE: 0 - 365]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
QD13a

[IF QD13 NE 0] In what state did you live on [FILL PAST 1 YEAR
DATE], that is, one year ago today?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26

Alabama
27
Alaska
28
Arizona
29
Arkansas
30
California
31
Colorado
32
Connecticut
33
Delaware
34
The District Of Columbia (Washington, Dc) 35
Florida
36
Georgia
37
Hawaii
38
Idaho
39
Illinois
40
Indiana
41
Iowa
42
Kansas
43
Kentucky
44
Louisiana
45
Maine
46
Maryland
47
Massachusetts
48
Michigan
49
Minnesota
50
Mississippi
51
Missouri
52
DK/REF

687
April 15, 2016

Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Outside Of U.S.

QD14 Were you born in the United States?
1
Yes
2
No
DK/REF
QD15 [IF QD14 = 2] In what country or U.S. territory were you born?
COUNTRY OR US TERRITORY: _________________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN QD15.
QD16a

[IF QD14 = 2 and (QD13 > 0 OR QD13 = DK/REF)] Have you lived in
the United States for at least one year?
1
2

Yes
No

DK/REF
QD16b
[IF QD16a = 1 OR (QD14=2 AND QD13=0 AND QD13 NE DK/REF)]
For how many years have you lived in the United States? Please estimate the
total number of years you have lived here over your lifetime.
NUMBER OF YEARS: ______________ [RANGE: 1-90]
DK/REF
QD16c [IF QD16a = 2] For how many months have you lived in the United States?
Please estimate the total number of months you have lived here over your
lifetime. If you have lived in the United States for less than one month, please
enter 0.

NUMBER OF MONTHS: ______________ [RANGE: 0-12]
DK/REF
QD62 [IF CURNTAGE = 18 OR OLDER] People are different in their sexual attraction
to other people. Which statement best describes your feelings?
[IF QD01=5]
1 I am only attracted to females
2 I am mostly attracted to females
3 I am equally attracted to females and males
4 I am mostly attracted to males
5 I am only attracted to males
6 I am not sure

688
April 15, 2016

DK/REF
[IF QD01=9]
1 I am only attracted to males
2 I am mostly attracted to males
3 I am equally attracted to males and females
4 I am mostly attracted to females
5 I am only attracted to females
6 I am not sure

QD63 [IF CURNTAGE = 18 OR OLDER] Which one of the following do you consider
yourself to be?
1
2
3

Heterosexual, that is, straight
[IF QD01=9 THEN “Lesbian or] Gay
Bisexual
DK/REF

QD55 How well do you speak English?
1
Very well
2
Well
3
Not well
4
Not at all
DK/REF
QD56 Are you deaf or do you have serious difficulty hearing?
1
Yes
2
No
DK/REF

QD57 Are you blind or do you have serious difficulty seeing, even when wearing
glasses?
1
Yes
2
No
DK/REF
QD58 Because of a physical, mental or emotional condition, do you have serious
difficulty concentrating, remembering, or making decisions?
1
Yes
2
No

689
April 15, 2016

DK/REF
QD59 Do you have serious difficulty walking or climbing stairs?
1
Yes
2
No
DK/REF
QD60 Do you have difficulty dressing or bathing?
1
Yes
2
No
DK/REF
QD61 [IF CURNTAGE >14] Because of a physical, mental or emotional condition, do
you have difficulty doing errands alone such as visiting a doctors’ office or
shopping?
1
Yes
2
No
DK/REF

690
April 15, 2016

Education
QD17 The next questions are about school. By “school,” we mean elementary school,
junior high or middle school, high school, or a college or university. Please
include home schooling as well. Do you go to school?
If you are on a holiday or break from school, such as spring break or summer
vacation, but plan to return when the break is over, please answer yes.
1
Yes
2
No
DK/REF

QD17a

[IF CURNTAGE=12-25 AND (QD17=2 OR DK/REF) AND QD11 = 1 16] Are you currently on a holiday or vacation break from school?
1
Yes
2
No
DK/REF

QD17b

[IF QD17a = 1] Do you plan to return to school when your holiday or
vacation is over?
1
Yes
2
No
DK/REF

QD18 [IF QD17 = 1] What grade or year of school are you now attending?
[IF QD17b = 1] What grade or year of school will you be attending when your
vacation is over?
1
2
3
4
5
6
7
8
9
10
11
12
13

1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
College or university/1st year

691
April 15, 2016

14
College or university/2nd year
15
College or university/3rd year
16
College or university/4th year
17
College or university/5th or higher year
DK/REF

QD18CC01

[IF (QD11=17 AND QD18<=16 AND QD17=1) OR
(QD11=12 AND QD18<=12 AND QD17=1) OR
(QD11=13 AND QD18<=11 AND QD17=1) OR
(QD11=14 AND QD18<=12 AND QD17=1) ] The
computer recorded that you are now attending [QD18]. Is
this correct?
[IF (QD11=17 AND QD18<=16 AND QD17b=1) OR
(QD11=12 AND QD18<=12 AND QD17b=1) OR
(QD11=13 AND QD18<=11 AND QD17b=1) OR
(QD11=14 AND QD18<=12 AND QD17b=1) ] The
computer recorded that you will be attending [QD18] when
your vacation is over. Is this correct?
4
Yes
6
No
DK/REF

QD18CC02

[IF QD18CC01=4] The answers for the last question and
an earlier question disagree. Which answer is correct?
1

2
3

[IF QD17=1]I am now attending [QD18]
[IF QD17b=1] I will be attending [QD18]
when my vacation is over
The highest grade or degree that I
completed is [QD11]
Neither answer is correct
DK/REF

QD18CC03 [IF QD18CC02=2 OR QD18CC02=3 OR QD18CC01=6]
Please answer this question again. [IF QD17 = 1] What
grade or year of school are you now attending?
[IF QD17b = 1] What grade or year of school will you be
attending when your vacation is over?
1
1st grade
2
2nd grade
3
3rd grade

692
April 15, 2016

4
4th grade
5
5th grade
6
6th grade
7
7th grade
8
8th grade
9
9th grade
10
10th grade
11
11th grade
12
12th grade
13
College or university/1st year
14
College or university/2nd year
15
College or university/3rd year
16
College or university/4th year
17
College or university/5th or higher year
DK/REF

QD18CC04

[IF QD18CC02=1 OR QD18CC02=3]
Please answer this question again. What is the highest
grade or year of school you have completed?
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

No schooling completed
1st grade completed
2nd grade completed
3rd grade completed
4th grade completed
5th grade completed
6th grade completed
7th grade completed
8th grade completed
9th grade completed
10th grade completed
11th grade completed
Regular high school diploma
12th grade, NO DIPLOMA
GED certificate of high school completion
Some college credit, but no degree
Associate’s degree (for example, AA, AS)
Bachelor’s degree (for example, BA, BS)
Master’s degree (for example, MA, MS, MEng, M.
Ed, MSW, MBA)
Doctorate degree (for example, PhD, EdD)
Professional degree beyond a bachelor’s degree
(for example, MD, DDS, DVM, LLB, JD)
DK/REF

693
April 15, 2016

QD19 [IF QD17 = 1] Are you a full-time student or a part-time student?
[IF QD17b = 1] Will you be a full-time student or a part-time student?
1
Full-time
2
Part-time
DK/REF
QD20 [IF QD19 = 1] During the past 30 days, that is, from [DATEFILL] up to and
including today, how many whole days of school did you miss because you were
sick or injured? Please do not include days you missed because you stayed home
with a sick child or other family member.
If school was not in session during the past 30 days, enter 90.
NUMBER OF DAYS:
[RANGE: 0-30, 90]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
QD20DKRE

[IF QD20 = DK/REF] What is your best estimate of the number
of whole days of school you missed because you were sick or
injured during the past 30 days?
1
0 days
2
1 day
3
2 days
4
3 to 5 days
5
6 or more days
6
School was not in session during the past 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

QD21 [IF QD19 = 1 AND QD20 NE 90] During the past 30 days, that is, since
[DATEFILL], how many whole days of school did you miss because you
skipped or “cut” or just didn’t want to be there? Please do not include days you
missed because you stayed home with a sick child or other family member.
NUMBER OF DAYS:
[RANGE: 0 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
QD21DKRE

[IF QD21 = DK/REF] What is your best estimate of the number
of whole days of school you missed because you skipped or “cut”
or just didn’t want to be there during the past 30 days?

694
April 15, 2016

1
0 days
2
1 day
3
2 days
4
3 to 5 days
5
6 or more days
6
School was not in session during the past 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
QD10d

For this question, please consider only the family members listed below,
whether or not they live with you.
• Your spouse
• Your unmarried partner
• Your mother
• Your father
• Your son or sons
• Your daughter or daughters
• Your brother or brothers
• Your sister or sisters
Please include only these family members, whether they are biological, step or
adoptive. Are any of these family members currently serving in the United
States military? Press F2 to see and hear a definition of “military.”

1 Yes
2 No
DK/REF
IF F2 IS PRESSED, PLEASE DISPLAY:
To serve in the military is to be employed as
a member of one of the branches of the
United States Armed Forces, Reserve
components or National Guard, including
the Coast Guard.
Press Enter to close this box. Then, type in
your response to the question.
QD10e [IF QD10d = 1] Which member or members of your family are currently in the
United States military?
To select more than one category, press the space bar between each category
you select.

695
April 15, 2016

1
2
3
4
5
6
7
8

Your spouse
Your unmarried partner
Your mother
Your father
Your son or sons
Your daughter or daughters
Your brother or brothers
Your sister or sisters

696
April 15, 2016

Employment
QD26 [IF CURNTAGE = 15 OR OLDER] The next questions are about working. Did
you work at a job or business at any time last week? By last week, I mean the
week beginning on Sunday, [STARTDATE] and ending on Saturday,
[ENDDATE].
Press F2 to see and hear information about unpaid work.
1
Yes
2
No
DK/REF

IF F2 IS PRESSED, PLEASE DISPLAY:
• Please include unpaid work in a family farm or
business if you usually work more than 15 hours
each week.
• If you are a student who is given a stipend do not
count that as working.
• If you do volunteer work do not count that as
working.
• If you provide personal labor in exchange for work
done for you, rather than for pay, please count that
as working.
Press Enter to close this box. Then, type in your
response to the question.
QD27 [IF QD26 = 2] Even though you did not work at any time last week, did
you have a job or business? Press F2 to see and hear information about unpaid
work.

1
Yes
2
No
DK/REF
IF F2 IS PRESSED, PLEASE DISPLAY:
• Please include unpaid work in a family farm or
business if you usually work more than 15 hours
each week.
• If you are a student who is given a stipend do not
count that as working.
• If you do volunteer work do not count that as
working.
• If you provide personal labor in exchange for work
697
April 15, 2016

done for you, rather than for pay, please count that
as working.
Press Enter to close this box. Then, type in your
response to the question.
QD28 [IF QD26 =1] How many hours did you work last week at all jobs or businesses?
# OF HOURS WORKED:
DK/REF

[RANGE: 1 - 120]

QD29 [IF (QD28 = 1 - 120 OR DK/REF) OR QD27 = 1] Do you usually work 35 hours
or more per week at all jobs or businesses?
1
Yes
2
No
DK/REF
QD30 [IF QD27 = 1] Which one of these reasons best describes why you did not work
last week?

1
On vacation/sick/furlough/strike/other temporary absence/maternity leave
2
On layoff and not looking for work
3
On layoff and looking for work
4
Waiting to report to a new job
5
Self-employed and did not have any business last week
6
Going to school/training
7
Some other reason
DK/REF
QD31 [IF QD27 = 2 OR DK/REF] Which one of these reasons best describes why you
did not have a job or business last week?
1
Looking for work
2
On layoff and not looking for work
3
Keeping house or caring for children full time
4
going to school/training
5
Retired
6
Disabled for work
7
Didn’t want a job
8
Some other reason
DK/REF
QD32 [IF QD31 = 1] During the past 30 days, did you make specific efforts to find
work? Include any contacts you made with anyone about a job, sending out

698
April 15, 2016

resumes or applications, placing or answering ads. Do not include only reading
job ads.
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
QD33 [IF QD26 = DK/REF OR QD27 = 2 OR DK/REF] Now, think about the past 12
months, from [DATEFILL] through today. Did you work at a job or business at
any time during the past 12 months?
1
Yes
2
No
DK/REF
DISPLAY 12 MONTH CALENDAR
QD34 [IF QD26 = 1 OR QD33 = 1 OR (QD27 = 1 AND QD30 NE 5). Have you been
self-employed at any time during the past 12 months?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
QD35 [IF QD34 = 1 OR QD30 = 5] How many different employers, including yourself,
have you had in the past 12 months?
# OF EMPLOYERS IN PAST 12 MONTHS:
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

[RANGE: 1 - 52]

QD36 [IF QD34 = 2 OR DK/REF OR (QD34 = BLANK AND QD35 = BLANK AND
(QD30 = 5))] How many different employers have you had in the past 12 months?
# OF EMPLOYERS IN PAST 12 MONTHS:
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

[RANGE: 1 - 52]

QD37 [IF QD26 = 1 OR QD27 = 1] During the past 12 months, was there ever a time
when you did not have at least one job or business?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

699
April 15, 2016

QD38 [IF QD37 = 1] In how many weeks during the past 12 months did you not have
at least one job or business?
# OF WEEKS WITHOUT A JOB OR BUSINESS:
52]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

[RANGE: 0 -

IF QD38=0 HARD ERROR TEXT SHOULD READ: If
less than 1 week, enter 1.

QD39a

[IF QD27 = 2 OR DK/REF] In what year did you last work at a job or
business? If you have never worked for pay, enter 9991.
PROGRAMMER: ADD “YYYY” NEXT TO THE ENTRY FIELD IN THE
TOOL BAR.
____________ YEAR LAST WORKED
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN QD39a.

[IF QD39a > SYSTEM YEAR] HARD ERROR: The year that the computer recorded is
[YEAR FROM QD39a]. Press [ENTER] to close this box and then enter the correct
year.
[IF QD39a < (SYSTEM YEAR - CURRENT AGE)] HARD ERROR: The year the
computer recorded is earlier than your birth date. Press [ENTER] to close this box and
then double-check the year.
QD39b
[IF QD39a = SYSTEM YEAR OR (SYSTEM YEAR – 1)] In what month
in [YEAR FROM QD39a] did you last work at a job or business?
1
2
3
4
5
6
7
8
9
10
11

January
February
March
April
May
June
July
August
September
October
November

700
April 15, 2016

12
December
DK/REF

QD40 [IF QD26 = 1 OR QD27 = 1] During the past 30 days, that is, from [DATEFILL]
up to and including today, how many whole days of work did you miss because
you were sick or injured? Please do not include days you missed because you
stayed home with a sick child or other family member.
# OF DAYS:
DK/REF

[RANGE: 0 - 30]

SHOW 30 DAY CALENDAR
QD41 [IF QD26 = 1 OR QD27 = 1] During the past 30 days, that is, from [DATEFILL]
up to and including today, how many whole days of work did you miss because
you just didn’t want to be there? Please do not include days you missed because
of a planned vacation or days that you stayed home with a sick child or other
family member.
# OF DAYS:
[RANGE: 0 - 30]
DK/REF
SHOW 30 DAY CALENDAR
QD43 [IF QD26 = 1 OR QD27 = 1] At your workplace, is there a written policy about
employee use of alcohol or drugs?
1
Yes
2
No
DK/REF
QD44 [IF QD43 = 1] Does this policy cover only alcohol, only drugs, or both alcohol
and drugs?
1
Only alcohol
2
Only drugs
3
Both alcohol and drugs
DK/REF
QD45 [IF QD44 = (1 - 3 OR DK/REF) OR QD43 = (2 OR DK/REF)] At your
workplace, have you ever been given any educational information regarding the
use of alcohol or drugs?
1
Yes
2
No
DK/REF

701
April 15, 2016

QD46 [IF QD45 = 1 - 3 OR DK/REF] Through your workplace, is there access to any
type of employee assistance program or other type of counseling program for
employees who have alcohol or drug-related problems?
1
Yes
2
No
DK/REF
QD47 [IF QD46 = 1 - 2 OR DK/REF] Does your workplace ever test its employees for
alcohol use?
1
Yes
2
No
DK/REF
QD48 [IF QD47 = 1 - 2 OR DK/REF] Does your workplace ever test its employees for
drug use?
1
Yes
2
No
DK/REF
QD49 [IF QD47 = 1 OR QD48 = 1] Does your workplace test its employees for drug or
alcohol use as part of the hiring process?
1
Yes
2
No
DK/REF
QD50 [IF QD49 = 1 OR 2 OR DK/REF] Does your workplace test its employees for
drug or alcohol use on a random basis?
1
Yes
2
No
DK/REF
QD51 [IF QD47 = 1 OR QD48 = 1] According to the policy at your workplace, what
happens to an employee the first time he or she tests positive for illicit drugs?
1
Handled on an individual basis / policy does not specify what happens
2
Employee is fired
3
Employee is referred for treatment or counseling
4
Nothing happens
5
Something else happens
DK/REF

702
April 15, 2016

QD52 [IF QD26 = 1 OR QD27 = 1] Would you be more or less likely to want to work
for an employer that tests its employees for drug use as part of the hiring process?
1
More likely
2
Less likely
3
Would make no difference
DK/REF
QD53 [IF QD52 = 1 - 3 OR DK/REF] Would you be more or less likely to want to work
for an employer that tests its employees for drug or alcohol use on a random
basis?
1
More likely
2
Less likely
3
Would make no difference
DK/REF
PENTER1

Thank you for your help with this part of the interview. When you leave
this screen, the responses you entered into the computer will be locked and
can no longer be seen by you, the interviewer, or anyone else who uses
this computer. When you are ready, please press 1 and [ENTER] to
complete this part of the interview and lock your responses.

[ONCE 1 IS ENTERED FOR PENTER1, NO ONE CAN RE-ENTER THE ACASI
PORTION OF THE INTERVIEW.]

ENDAUDIO Your responses have been locked. Please tell your interviewer that you
are finished.
INTERVIEWER: ENTER THE 3-LETTER CODE TO MOVE TO THE
NEXT SECTION.
DEFINE CALCAGE2:
CALCAGE2 = VALUE OF CALCAGE WHEN PENTER1 IS REACHED.

703
April 15, 2016

704
April 15, 2016

Household Roster
INTRODM2 For the next questions, I will read the question out loud, you can tell me
your answer, and I will enter it into the computer.
PRESS [ENTER] TO CONTINUE
QD54 Altogether, how many people live here now, including yourself? Please include
anyone who (has lived/will live) here for most of (January, February, and
March / April, May, and June / July, August, and September / October,
November, and December).
# IN HOUSEHOLD:
DK/REF

[RANGE: 1 - 25]

INTERVIEWER NOTE:
If you are interviewing in a transient shelter, enter “1".
If you are interviewing in a group quarters unit that was
listed by room, enter the number of people living in the
room.
IF QD54 = 1 OR DK/REF SKIP TO FIRST QUESTION FOLLOWING HH ROSTER,
OTHERWISE CONTINUE.
DEFINE GRID WITH ROWS EQUAL TO QD54. EACH COLUMN OF THE GRID IS
A QUESTION AS SPEC’D BELOW.
PERAGEYR [IF QD54 = 2 - 25] Now I need some additional information about each
person who lives here. Let’s start with the oldest. How old was he or she
on his or her last birthday? (WORDING FOR ADDITIONAL CYCLES:
How old was the next oldest person on his or her last birthday?)
INTERVIEWER: FOR CHILDREN LESS THAN 24 MONTHS (2
YEARS), ENTER ‘1.’ YOU WILL BE PROMPTED FOR THE AGE IN
MONTHS ON THE NEXT SCREEN.
AGE IN WHOLE YEARS:
DK/REF

[RANGE: 1 - 110]

CHAGEMON
[IF PERAGEYR = 1] ENTER THE AGE IN WHOLE MONTHS
FOR THIS HOUSEHOLD MEMBER. FOR BABIES UNDER 1
MONTH OLD, ENTER 1.
AGE IN MONTHS:
DK/REF

[RANGE: 1 - 23]

705
April 15, 2016

CHMONSEX [IF CHAGEMON = 1 - 23] Is the [CHAGEMON FILL]-month old child
a male or a female?
5
MALE
9
FEMALE
DK/REF
CHYRSEX

[IF CHAGEMON = DK/REF] Is this child a male or female?
5
MALE
9
FEMALE
DK/REF

PERYRSEX [IF PERAGEYR = 2 - 110 ] Is the [PERAGEYR FILL]-year old person
male or female?
5
MALE
9
FEMALE
DK/REF
PERSEX

[IF PERAGEYR = DK/REF] Is this person a male or a female?
5
MALE
9
FEMALE
DK/REF

MRELATON [IF CHMONSEX OR CHYRSEX OR PERYRSEX OR PERSEX = 5]
[IF QD01 = 5] IF IT IS CLEAR THAT RESPONDENT IS TALKING
ABOUT HIMSELF:
ASK “Is that you?” IF YES, ENTER “1” for “SELF”.
IF RESPONDENT NOT TALKING ABOUT SELF:
HAND R SHOWCARD 6. Please look at this card and tell me which
category best describes his relationship to you.
1
2
3
4
5
6
7
8
9
10

SELF
HUSBAND
SON (INCLUDES STEP, FOSTER, ADOPTIVE)
SON-IN LAW
BROTHER (INCLUDES HALF, STEP, FOSTER, ADOPTIVE)
BROTHER-IN-LAW
FATHER (INCLUDES STEP, FOSTER, ADOPTIVE)
FATHER-IN-LAW
UNCLE
NEPHEW

706
April 15, 2016

11
GRANDFATHER
12
GRANDSON
13
COUSIN
14
EX-HUSBAND
15
UNMARRIED PARTNER
16
HOUSEMATE OR ROOMMATE
17
TENANT, BOARDER, OR EXCHANGE STUDENT
18
OTHER RELATIVE
19
OTHER NON-RELATIVE
DK/REF
[R GENDER] IF MRELATON=1 AND QD01=9 DISPLAY ERROR BOX THAT
SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE RESPONDENT IS
MALE. EARLIER, YOU RECORDED THE RESPONDENT’S SEX AS FEMALE.
CONFIRM THE RESPONDENT’S SEX AND CORRECT THE ANSWER THAT WAS
ENTERED INCORRECTLY.
CREATE ERROR BOX SO IT ALLOWS R TO GO TO EITHER ANSWER TO FIX IT.
[R AGE] IF MRELATON=1 AND PERAGEYR DOES NOT EQUAL CURNTAGE,
DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED
THAT THE RESPONDENT IS [FILL PERAGEYR]. EARLIER, THE
RESPONDENT’S AGE WAS ENTERED AS [FILL CURNTAGE]. PLEASE
CONFIRM THE RESPONDENT’S AGE. IF YOU NEED TO CORRECT THE AGE
OR RELATIONSHIP GIVEN IN THE ROSTER, HIGHLIGHT THAT QUESTION
NUMBER AND PRESS [ENTER]. IF THE ANSWER YOU ENTERED IN THE
ROSTER IS CORRECT, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
[NOTE: FI SHOULD ONLY BE ALLOWED TO CHANGE PERAGEYR AND
MRELATON.]
SUPPMAGE [IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY YOU HAVE CHOSEN TO SUPPRESS THIS ERROR
ALLOW 200 CHARACTERS
[GRANDPARENT YOUNGER THAN R] IF MRELATON = 11 AND PERAGEYR
DOES NOT EQUAL DK OR REF AND IS = OR < CURNTAGE, DISPLAY ERROR
BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S GRANDFATHER IS THE SAME AGE AS OR YOUNGER THAN
THE RESPONDENT. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU
NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND
PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT
‘SUPPRESS’ AND PRESS [ENTER].

707
April 15, 2016

SUPPGDAD [IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS
[GRANDCHILD OLDER THAN R] IF MRELATON = 12 AND PERAGEYR DOES
NOT EQUAL DK OR REF AND IS = OR > CURNTAGE, DISPLAY ERROR BOX
THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S GRANDSON IS THE SAME AGE AS OR OLDER THAN THE
RESPONDENT. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU
NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND
PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT
‘SUPPRESS’ AND PRESS [ENTER].
SUPPGSON [IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS
[SPOUSE/PARTNER < 16] IF MRELATON = 2 OR 15 OR 14 AND PERAGEYR =
OR < 16, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE
RECORDED THAT THE RESPONDENT’S SPOUSE, EX-SPOUSE OR PARTNER IS
16 YEARS OLD OR YOUNGER. PLEASE VERIFY THIS WITH THE
RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT
QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT
AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPHUS

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[IN-LAW < 16] IF MRELATON = 8 OR 4 AND PERAGEYR = OR < 16, DISPLAY
ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S [MRELATON] IS 16 YEARS OLD OR YOUNGER. PLEASE
VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN
ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE
ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS
[ENTER].
SUPPMIL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR

708
April 15, 2016

WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS
[SON IN-LAW OLDER THAN R] IF MRELATON = 4 AND PERAGEYR DOES
NOT EQUAL DK OR REF AND IS = OR > CURNTAGE, DISPLAY ERROR BOX
THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S SON-IN-LAW IS THE SAME AGE AS OR OLDER THAN THE
RESPONDENT. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU
NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND
PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT
‘SUPPRESS’ AND PRESS [ENTER].
SUPPSIL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[FATHER IN-LAW YOUNGER THAN R] IF MRELATON = 8 AND PERAGEYR
DOES NOT EQUAL DK OR REF AND IS = OR < CURNTAGE, DISPLAY ERROR
BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S FATHER-IN-LAW IS THE SAME AGE AS OR YOUNGER THAN
THE RESPONDENT. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU
NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND
PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT
‘SUPPRESS’ AND PRESS [ENTER].
SUPPPIL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
____________________________ALLOW 200 CHARACTERS

BTWNTYPE [IF AGE1 = AGE OF THIS HOUSEHOLD MEMBER AND
MRELATON=5] Is he your identical twin, fraternal twin, or neither?
1
IDENTICAL TWIN
2
FRATERNAL TWIN
3
NEITHER
DK/REF
FRELATON [IF CHMONSEX OR CHYRSEX OR PERYRSEX OR PERSEX = 9]
[IF QD01 = 9] IF IT IS CLEAR THAT RESPONDENT IS TALKING
ABOUT HERSELF:

709
April 15, 2016

ASK “Is that you?” IF YES, ENTER “1” for “SELF”.
IF RESPONDENT NOT TALKING ABOUT SELF:
HAND R SHOWCARD 7. Please look at this card and tell me which
category best describes her relationship to you.
1
SELF
2
WIFE
3
DAUGHTER (INCLUDES STEP, FOSTER, ADOPTIVE)
4
DAUGHTER-IN-LAW
5
SISTER (INCLUDES HALF, STEP, FOSTER, ADOPTIVE)
6
SISTER-IN-LAW
7
MOTHER (INCLUDES STEP, FOSTER, ADOPTIVE)
8
MOTHER-IN-LAW
9
AUNT
10
NIECE
11
GRANDMOTHER
12
GRANDDAUGHTER
13
COUSIN
14
EX-WIFE
15
UNMARRIED PARTNER
16
HOUSEMATE OR ROOMMATE
17
TENANT, BOARDER, OR EXCHANGE STUDENT
18
OTHER RELATIVE
19
OTHER NON-RELATIVE
DK/REF

[R GENDER] IF FRELATON=1 AND QD01=5 DISPLAY ERROR BOX THAT
SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE RESPONDENT IS
FEMALE. EARLIER, YOU RECORDED THE RESPONDENT’S SEX AS MALE.
CONFIRM THE RESPONDENT’S SEX AND CORRECT THE ANSWER THAT WAS
ENTERED INCORRECTLY.
CREATE ERROR BOX SO IT ALLOWS R TO GO TO EITHER ANSWER TO FIX IT.
[R AGE] IF FRELATON=1 AND PERAGEYR DOES NOT EQUAL CURNTAGE,
DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED
THAT THE RESPONDENT IS [FILL PERAGEYR]. EARLIER, THE
RESPONDENT’S AGE WAS ENTERED AS [FILL CURNTAGE]. PLEASE
CONFIRM THE RESPONDENT’S AGE. IF YOU NEED TO CORRECT THE AGE
OR RELATIONSHIP GIVEN IN THE ROSTER, HIGHLIGHT THAT QUESTION
NUMBER AND PRESS [ENTER]. IF THE ANSWER YOU ENTERED IN THE
ROSTER IS CORRECT, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
[NOTE: FI SHOULD ONLY BE ALLOWED TO CHANGE PERAGEYR AND

710
April 15, 2016

FRELATON.]
SUPPFAGE [IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY YOU HAVE CHOSEN TO SUPPRESS THIS ERROR
ALLOW 200 CHARACTERS
[GRANDPARENT YOUNGER THAN R] IF FRELATON = 11 AND PERAGEYR
DOES NOT EQUAL DK OR REF AND IS = OR < CURNTAGE, DISPLAY ERROR
BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S GRANDMOTHER IS THE SAME AGE AS OR YOUNGER THAN
THE RESPONDENT. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU
NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND
PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT
‘SUPPRESS’ AND PRESS [ENTER].
SUPPGMOM

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[GRANDCHILD OLDER THAN R] IF FRELATON = 12 AND PERAGEYR DOES
NOT EQUAL DK OR REF AND IS = OR > CURNTAGE, DISPLAY ERROR BOX
THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S GRANDDAUGHTER IS THE SAME AGE AS OR OLDER THAN
THE RESPONDENT. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU
NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND
PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT
‘SUPPRESS’ AND PRESS [ENTER].
SUPPGDAU [IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS
[SPOUSE/PARTNER < 16] IF FRELATON = 2 OR 15 OR 14 AND PERAGEYR =
OR < 16, DISPLAY ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE
RECORDED THAT THE RESPONDENT’S SPOUSE, EX-SPOUSE OR PARTNER IS
16 YEARS OLD OR YOUNGER. PLEASE VERIFY THIS WITH THE
RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT
QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT
AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
SUPPWIF

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]

711
April 15, 2016

INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS
[IN-LAW < 16] IF FRELATON = 8 OR 4 AND PERAGEYR = OR < 16, DISPLAY
ERROR BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S [FRELATON] IS 16 YEARS OLD OR YOUNGER. PLEASE
VERIFY THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN
ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE
ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS
[ENTER].
SUPPFIL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[DAUGHTER IN-LAW OLDER THAN R] IF FRELATON = 4 AND PERAGEYR
DOES NOT EQUAL DK OR REF AND IS = OR > CURNTAGE, DISPLAY ERROR
BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S DAUGHTER-IN-LAW IS THE SAME AGE AS OR OLDER THAN
THE RESPONDENT. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU
NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND
PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT
‘SUPPRESS’ AND PRESS [ENTER].
SUPPDIL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[MOTHER IN-LAW YOUNGER THAN R] IF FRELATON = 8 AND PERAGEYR
DOES NOT EQUAL DK OR REF AND IS = OR < CURNTAGE, DISPLAY ERROR
BOX THAT SAYS: INTERVIEWER: YOU HAVE RECORDED THAT THE
RESPONDENT’S MOTHER-IN-LAW IS THE SAME AGE AS OR YOUNGER THAN
THE RESPONDENT. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU
NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND
PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT
‘SUPPRESS’ AND PRESS [ENTER].
SUPPGIL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.

712
April 15, 2016

_________________________ALLOW 200 CHARACTERS
FTWNTYPE [IF AGE1 = AGE OF THIS HOUSEHOLD MEMBER AND
FRELATON=5 ] Is she your identical twin, fraternal twin, or neither?
1
IDENTICAL TWIN
2
FRATERNAL TWIN
3
NEITHER
DK/REF
MBRSELCT [IF FIPE1 = 1 AND MRELATON NE 1 AND FRELATON NE 1 AND
PERAGEYR = (12 OR OLDER OR DK/REF) AND MBRSELCT NE 1
FOR A PREVIOUS ROSTER MEMBER] WAS THIS HOUSEHOLD
MEMBER ALSO SELECTED TO BE INTERVIEWED? (IF YOU ARE
UNSURE, ATTEMPT TO VERIFY WITH THIS RESPONDENT.)
1
YES
2
NO
DK/REF

RETURN TO PERAGEYR AND CYCLE THROUGH THE QUESTIONS FOR THE
NEXT HOUSEHOLD MEMBER. CONTINUE CYCLES UNTIL THE NUMBER OF
CYCLES = THE NUMBER REPORTED IN QD54.
[OTHER HH MEMBER SELECTED FOR INTERVIEW] IF FIPE1=1 AND
MBRSELCT = 2 FOR ALL HOUSEHOLD MEMBERS, DISPLAY ERROR BOX:
INTERVIEWER: EARLIER, YOU RECORDED THAT 2 PEOPLE WERE SELECTED
AT THIS HOUSEHOLD. THE HOUSEHOLD ROSTER DOES NOT SHOW
ANYONE LISTED AS THE SECOND RESPONDENT. PLEASE VERIFY THE
NUMBER OF PEOPLE SELECTED AT THIS HOUSEHOLD AND FIX THE
APPROPRIATE ANSWER. IF YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT
THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE ANSWERS ARE
CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS [ENTER].
PROGRAMMER – ONLY ALLOW EDITING OF MBRSELCT.

SUPPHHME [IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY YOU HAVE CHOSEN TO SUPPRESS THIS ERROR
ALLOW 200 CHARACTERS

713
April 15, 2016

[MORE THAN 1 SELF] NOTE TO PROGRAMMERS: ONCE MRELATON OR
FRELATON = 1, PLEASE IMPLEMENT A HARD-ERROR TO OCCUR IF THE FI
ATTEMPTS TO ENTER A “1" FOR EITHER OF THESE VARIABLES FOR
SUBSEQUENT HOUSEHOLD MEMBERS. THE MESSAGE BOX SHOULD READ:
INTERVIEWER: YOU HAVE ALREADY RECORDED “SELF” AS THE
RELATIONSHIP FOR ANOTHER MEMBER OF THIS HOUSEHOLD. “SELF” CAN
ONLY BE CODED FOR ONE MEMBER OF THIS HOUSEHOLD. REVIEW YOUR
ENTRIES AND CORRECT THE APPROPRIATE RELATIONSHIPS AS
NECESSARY.
[MORE THAN 1 SPOUSE/PARTNER] NOTE TO PROGRAMMERS: Once
MRELATON OR FRELATON = 2 OR 15, PLEASE IMPLEMENT A HARD-ERROR
TO OCCUR IF THE FI ATTEMPTS TO ENTER A “2" OR “15” FOR EITHER OF
THESE VARIABLES FOR SUBSEQUENT HOUSEHOLD MEMBERS. THE
MESSAGE BOX SHOULD READ: INTERVIEWER: YOU HAVE RECORDED THAT
THIS IS THE RESPONDENT’S [WIFE/HUSBAND/UNMARRIED PARTNER].
EARLIER, YOU ENTERED THAT THE RESPONDENT ALREADY HAS [A/AN]
[WIFE/HUSBAND/UNMARRIED PARTNER. IF YOU NEED TO CORRECT AN
ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE
ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS
[ENTER].
SUPPMULT [IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS
[16 YEAR OLD R MARRIED/COHABITATING] IF CURNTAGE = OR < 16, AND
ANY FRELATON OR MRELATON = 2 OR 14 OR 15, DISPLAY ERROR BOX:
INTERVIEWER: YOU HAVE ENTERED THAT THE [CURNTAGE] YEAR OLD
RESPONDENT HAS BEEN MARRIED OR COHABITATING. PLEASE VERIFY
THIS WITH THE RESPONDENT. IF YOU NEED TO CORRECT AN ENTRY,
HIGHLIGHT THAT QUESTION NUMBER AND PRESS [ENTER]. IF THE
ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’ AND PRESS
[ENTER].
SUPPRMC

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[16 YEAR OLD R HAS IN-LAW] IF CURNTAGE = OR < 16, AND ANY
FRELATON OR MRELATON= 8 OR 4, DISPLAY ERROR BOX: INTERVIEWER:
YOU HAVE ENTERED THAT THE [CURNTAGE] YEAR OLD RESPONDENT HAS

714
April 15, 2016

AN IN-LAW. PLEASE VERIFY THIS WITH THE RESPONDENT. IF YOU NEED
TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER AND PRESS
[ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT ‘SUPPRESS’
AND PRESS [ENTER].
SUPPRINL

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

[GRANDPARENT/GRANDCHILD AND R LESS THAN 30 YEARS APART] IF
FRELATON OR MRELATON = (12 OR 11) AND PERAGEYR NE DK/REF AND IS
0-29 YEARS > OR < CURNTAGE, DISPLAY ERROR BOX THAT SAYS:
INTERVIEWER: YOU HAVE RECORDED THAT THE RESPONDENT’S
[GRANDPARENT/GRANDCHILD] IS LESS THAN 30 YEARS [OLDER/YOUNGER]
THAN THE RESPONDENT. PLEASE VERIFY THIS WITH THE RESPONDENT. IF
YOU NEED TO CORRECT AN ENTRY, HIGHLIGHT THAT QUESTION NUMBER
AND PRESS [ENTER]. IF THE ANSWERS ARE CORRECT AS IS, HIGHLIGHT
‘SUPPRESS’ AND PRESS [ENTER].
SUPPGR30

[IF FI CHOOSES TO SUPPRESS THE HARD ERROR ABOVE]
INTERVIEWER: PLEASE PROVIDE A BRIEF EXPLANATION FOR
WHY THE ANSWERS YOU HAVE ENTERED ARE CORRECT AS IS.
ALLOW 200 CHARACTERS

715
April 15, 2016

716
April 15, 2016

Proxy Information
PROXYINT The next questions are about your health insurance coverage and the kinds
and amounts of income that you [IF FAMILY MEMBERS IN ROSTER
THEN FILL “and your family”] receive. This information will help in
planning health care services and finding ways to lower costs of care.
PRESS “1” AND [ENTER] TO CONTINUE.
FAMLY IF QD54 = 1 SKIP TO QHI01
IF MRELATON=16 OR MRELATON=17 OR MRELATON=19 OR
FRELATON=16 OR FRELATON=17 OR FRELATON=19 FOR ALL
PERSONS IN HOUSEHOLD SKIP TO QHI01.
DEFINE FAMILY RELATIONSHIP FILLS:
IF EXACTLY 1 IN ROSTER = (MRELATON = 2), FILL = “husband”
IF MORE THAN 1 IN ROSTER = (MRELATON = 2), FILL = “husbands”
IF EXACTLY 1 IN ROSTER = (MRELATON = 3), FILL = “son”
IF MORE THAN 1 IN ROSTER = (MRELATON = 3 AND), FILL = “sons”
IF EXACTLY 1 IN ROSTER = (MRELATON = 4), FILL = “son-in-law”
IF MORE THAN 1 IN ROSTER = (MRELATON = 4), FILL = “sons-in-law”
IF EXACTLY 1 IN ROSTER = (MRELATON = 5), FILL = “brother”
IF MORE THAN 1 IN ROSTER = (MRELATON = 5), FILL = “brothers”
IF EXACTLY 1 IN ROSTER = (MRELATON = 6), FILL = “brother-in-law”
IF MORE THAN 1 IN ROSTER = (MRELATON = 6), FILL = “brothers-inlaw”
IF EXACTLY 1 IN ROSTER = (MRELATON = 7), FILL = “father”
IF MORE THAN 1 IN ROSTER = (MRELATON = 7), FILL = “fathers”
IF EXACTLY 1 IN ROSTER = (MRELATON = 8), FILL = “father-in-law”
IF MORE THAN 1 IN ROSTER = (MRELATON = 8), FILL = “fathers-inlaw”
IF EXACTLY 1 IN ROSTER = (MRELATON = 9), FILL = “uncle”
IF MORE THAN 1 IN ROSTER = (MRELATON = 9), FILL = “uncles”
IF EXACTLY 1 IN ROSTER = (MRELATON = 10), FILL = “nephew”
IF MORE THAN 1 IN ROSTER = (MRELATON = 10), FILL = “nephews”

717
April 15, 2016

IF EXACTLY 1 IN ROSTER = (MRELATON = 11), FILL = “grandfather”
IF MORE THAN 1 IN ROSTER = (MRELATON = 11), FILL =
“grandfathers”
IF EXACTLY 1 IN ROSTER = (MRELATON = 12), FILL = “grandson”
IF MORE THAN 1 IN ROSTER = (MRELATON = 12), FILL = “grandsons”
IF EXACTLY 1 IN ROSTER = (MRELATON = 13), FILL = “male cousin”
IF MORE THAN 1 IN ROSTER = (MRELATON = 13), FILL = “male
cousins”
IF EXACTLY 1 IN ROSTER = (MRELATON = 14), FILL = “ex-husband”
IF MORE THAN 1 IN ROSTER = (MRELATON = 14), FILL = “exhusbands”
IF EXACTLY 1 IN ROSTER = (MRELATON = 15 OR FRELATON = 15),
FILL = “partner”
IF MORE THAN 1 IN ROSTER = (MRELATON = 15 OR FRELATON =
15), FILL = “partners”
IF EXACTLY 1 IN ROSTER = (MRELATON = 18), FILL = “other male
relative”
IF MORE THAN 1 IN ROSTER = (MRELATON = 18), FILL = “other male
relatives”
IF EXACTLY 1 IN ROSTER = (FRELATON = 2), FILL = “wife”
IF MORE THAN 1 IN ROSTER = (FRELATON = 2), FILL = “wives”
IF EXACTLY 1 IN ROSTER = (FRELATON = 3), FILL = “daughter”
IF MORE THAN 1 IN ROSTER = (FRELATON = 3), FILL = “daughters”
IF EXACTLY 1 IN ROSTER = (FRELATON = 4), FILL = “daughter-in-law”
IF MORE THAN 1 IN ROSTER = (FRELATON = 4), FILL = “daughters-inlaw”
IF EXACTLY 1 IN ROSTER = (FRELATON = 5), FILL = “sister”
IF MORE THAN 1 IN ROSTER = (FRELATON = 5), FILL = “sisters”
IF EXACTLY 1 IN ROSTER = (FRELATON = 6), FILL = “sister-in-law”
IF MORE THAN 1 IN ROSTER = (FRELATON = 6), FILL = “sisters-inlaw”
IF EXACTLY 1 IN ROSTER = (FRELATON = 7), FILL = “mother”
IF MORE THAN 1 IN ROSTER = (FRELATON = 7), FILL = “mothers”
IF EXACTLY 1 IN ROSTER = (FRELATON = 8), FILL = “mother-in-law”

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April 15, 2016

IF MORE THAN 1 IN ROSTER = (FRELATON = 8), FILL = “mothers-inlaw”
IF EXACTLY 1 IN ROSTER = (FRELATON = 9), FILL = “aunt”
IF MORE THAN 1 IN ROSTER = (FRELATON = 9), FILL = “aunts”
IF EXACTLY 1 IN ROSTER = (FRELATON = 10), FILL = “niece”
IF MORE THAN 1 IN ROSTER = (FRELATON = 10), FILL = “nieces”
IF EXACTLY 1 IN ROSTER = (FRELATON = 11), FILL = “grandmother”
IF MORE THAN 1 IN ROSTER = (FRELATON = 11), FILL =
“grandmothers”
IF EXACTLY 1 IN ROSTER = (FRELATON = 12), FILL = “granddaughter”
IF MORE THAN 1 IN ROSTER = (FRELATON = 12), FILL =
“granddaughters”
IF EXACTLY 1 IN ROSTER = (FRELATON = 13), FILL = “female cousin”
IF MORE THAN 1 IN ROSTER = (FRELATON = 13), FILL = “female
cousins”
IF EXACTLY 1 IN ROSTER = (FRELATON = 14), FILL = “ex-wife”
IF MORE THAN 1 IN ROSTER = (FRELATON = 14), FILL = “ex-wives”
IF EXACTLY 1 IN ROSTER = (FRELATON = 18), FILL = “other female
relative”
IF MORE THAN 1 IN ROSTER = (FRELATON = 18), FILL = “other female
relatives”
[Note to Programmers: FAMILY RELATIONSHIP FILLS should be taken
from the roster. They should appear in lower case and be separated by
commas. In QP01, INTROINC, and INTROFI1, the last FAMILY
RELATIONSHIP FILL should be preceded by the word “and.” In all other
situations, the last FAMILY RELATIONSHIP FILL should be preceded by
the word “or.” For example, if a respondent has a father and a husband listed
in the roster, INTROINC should read, “These next questions are about the
kinds and amounts of income received by your family living here, including
you, your father, and your husband.”]
QP01 [IF QD54 > 1 AND RESPONDENT IS ONLY FAMILY MEMBER 18 OR
OLDER AND ALL PERAGEYR NE DK/REF, SKIP TO QHI01]
[IF ROSTER HAS MORE THAN 1 ADULT FAMILY MEMBER LISTED AND
ALL PERAGEYR NE DK/REF ] {FILL ONLY ADULT FAMILY MEMBERS
(PERAGEYR > 17) IN THIS QUESTION} I have listed as adult family members
who live here: your [FAMILY RELATIONSHIP FILLS]. Do you think one of

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April 15, 2016

these people would be better able to give me the correct information about your
health insurance coverage and the kinds of income you and your family receive?

[IF ROSTER HAS ONLY 1 ADULT FAMILY MEMBER LISTED] {FILL
ONLY ADULT FAMILY MEMBERS (PERAGEYR > 17) IN THIS
QUESTION} Do you think your [FAMILY RELATIONSHIP FILL] would be
better able to give me the correct information about your health insurance
coverage and the kinds of income you and your family receive?
[IF ROSTER HAS NO FAMILY MEMBER OTHER THAN THE
RESPONDENT LISTED AS 18 OR OLDER, BUT THERE IS AT LEAST 1 DK
OR REF ENTERED FOR ANY PERAGEYR OR THERE IS MORE THAN 1
ADULT LISTED AND AT LEAST 1 DK/REF ENTERED FOR ANY
PERAGEYR.] Is there anyone else who lives here who is 18 or older who would
be better able to give me the correct information about your health insurance
coverage and the kinds of income you and your family receive?
1
2

YES
NO [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR REMAINING
QUESTIONS]
DK/REF [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR
REMAINING QUESTIONS]

QP02 [IF QP01=1 AND MORE THAN 1 ADULT FAMILY MEMBER IN ROSTER]
(Who is the person you think can help us get the correct information for these
questions?) ENTER RELATIONSHIP OF PERSON WHO CAN BETTER
ANSWER THESE QUESTIONS.
[IF QP01 = 1 AND ONLY 1 ADULT FAMILY MEMBER IN ROSTER]
INTERVIEWER: ENTER ‛1’.
[FILL 1-9 WITH AGES AND RELATIONSHIPS FROM THE FIRST NINE
ADULT FAMILY MEMBERS OF THE HOUSEHOLD ROSTER, I.E., “ father”.
FILL UNUSED LINES WITH “DO NOT USE” AND MAKE THEM INVALID.
IF PERAGEYR=DK/REF AND MRELATON=7, 8, OR 11 OR FRELATON=7,
8 OR 11, DISPLAY MRELATON/FRELATON IN QP02]
1
2
3
4
5
6
7
8
9

[ROSTER FILL]
[ROSTER FILL]
[ROSTER FILL]
[ROSTER FILL]
[ROSTER FILL]
[ROSTER FILL]
[ROSTER FILL]
[ROSTER FILL]
[ROSTER FILL]

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April 15, 2016

10

OTHER ADULT RELATIVE

DK/REF

QP03 [IF QP01=1 ] (Is your [QP02 FILL] available right now?)
1
2

Yes
No [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR REMAINING
QUESTIONS]

DK/REF [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR REMAINING
QUESTIONS]

QP04 [IF QP03=1] (Would you ask your [QP02 FILL] to join us to help with these last
questions about health insurance and income?)
1
2

YES
NO [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR REMAINING
QUESTIONS]
DK/REF [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR REMAINING
QUESTIONS]

HASJOIN

[IF QP04 = 1] HAS THE PERSON’S [QP02 FILL] JOINED R?
1

2

YES [ACTIVATE PROXYFILL AS “SAMPLE
MEMBER/SAMPLE MEMBER’S” FOR REMAINING
QUESTIONS]
No [ACTIVATE PROXYFILL AS “YOU/YOUR” FOR
REMAINING QUESTIONS]

IF HASJOIN = 1, GO TOPROXY.
IF HASJOIN NE 1, GO TO DEFINE SAMPLE MEMBER
QP03a

[IF (QP03 = 2 OR DK/REF OR QP04=2 OR DK/REF OR HASJOIN=2)
AND ADULTFAMRELCOUNT > 1] Is there any other adult family member
available who might be able to answer these questions?
1 YES
2 NO
DK/REF

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April 15, 2016

IF QP03a = YES THEN RETURN TO QP02
PROGRAMMER NOTE: IF QP01=2 OR DK/REF OR QP02=2 OR DR/REF OR
QP03=2 OR DK/REF OR QP04=2 OR DK/REF OR HASJOIN=2 OR QP03a=2 OR
DK/REF THEN ACTIVATE PROXYFILL AS “YOU/YOUR” FOR REMAINING
QUESTIONS.

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April 15, 2016

DEFINE SAMPLE MEMBER:
IF QD54 = 1 OR (MRELATON=16 OR MRELATON=17 OR MRELATON=19 OR
FRELATON=16 OR
FRELATON=17 OR FRELATON=19 FOR ALL PERSONS IN HOUSEHOLD) OR
HASJOIN = 2, SAMPLE
MEMBER = “you”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 2) OR
“wife” (FRELATON = 2), SAMPLE MEMBER = “your husband”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3) OR
“daughter” (FRELATON = 3), SAMPLE MEMBER = “your father”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 4) OR
“daughter-in-law” (FRELATON = 4), SAMPLE MEMBER = “your father-in-law”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 5) OR
“sister” (FRELATON = 5), SAMPLE MEMBER = “your brother”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “brother-in-law” (MRELATON = 6)
OR “sister-in-law” (FRELATON = 6), SAMPLE MEMBER = “your brother-in-law”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father” (MRELATON = 7) OR
“mother” (FRELATON = 7), SAMPLE MEMBER = “your son”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 8) OR
“mother-in-law” (FRELATON = 8), SAMPLE MEMBER = “your son-in-law”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “uncle” (MRELATON = 9) OR “aunt”
(FRELATON = 9), SAMPLE MEMBER = “your nephew”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “nephew” (MRELATON = 10) OR
“niece” (FRELATON = 10), SAMPLE MEMBER = “your uncle”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR
“grandmother” (FRELATON = 11), SAMPLE MEMBER = “your grandson”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 12) OR
“granddaughter” (FRELATON = 12), SAMPLE MEMBER = “your grandfather”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “cousin” (FRELATON = 13 or
MRELATON = 13), SAMPLE MEMBER = “your cousin”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “ex-husband” (MRELATON = 14) OR
“ex-wife” (FRELATON = 14), SAMPLE MEMBER = “your ex-husband”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 15 OR
FRELATON = 15), SAMPLE MEMBER = “your partner”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON =
18) OR “other female relative” (FRELATON = 18), SAMPLE MEMBER = “your
relative”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 2) OR
“wife” (FRELATON = 2), SAMPLE MEMBER = “your husband”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3) OR
“daughter” (FRELATON = 3), SAMPLE MEMBER = “your mother”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 4) OR
“daughter-in-law” (FRELATON = 4), SAMPLE MEMBER = “your mother-in-law”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 5) OR

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“sister” (FRELATON = 5), SAMPLE MEMBER = “your sister”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “brother-in-law” (MRELATON = 6)
OR “sister-in-law” (FRELATON = 6), SAMPLE MEMBER = “your sister-in-law”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father” (MRELATON = 7) OR
“mother” (FRELATON = 7), SAMPLE MEMBER = “your daughter”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 8) OR
“mother-in-law” (FRELATON = 8), SAMPLE MEMBER = “your daughter-in-law”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “uncle” (MRELATON = 9) OR “aunt”
(FRELATON = 9), SAMPLE MEMBER = “your niece”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “nephew” (MRELATON = 10) OR
“niece” (FRELATON = 10), SAMPLE MEMBER = “your aunt”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR
“grandmother” (FRELATON = 11), SAMPLE MEMBER = “your granddaughter”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 12) OR
“granddaughter” (FRELATON = 12), SAMPLE MEMBER = “your grandmother”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “cousin” (MRELATON = 13 or
FRELATON = 13), SAMPLE MEMBER = “your cousin”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “ex-husband” (MRELATON = 14) OR
“ex-wife” (FRELATON = 14), SAMPLE MEMBER = “your ex-wife”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 15 OR
FRELATON = 15), SAMPLE MEMBER = “your partner”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON =
18) OR “other female relative” (FRELATON = 18), SAMPLE MEMBER = “your
relative”
DEFINE SAMPLE MEMBER POSS
IF QD54 = 1 OR (MRELATON=16 OR MRELATON=17 OR MRELATON=19 OR
FRELATON=16 OR FRELATON=17 OR FRELATON=19 FOR ALL
PERSONS IN HOUSEHOLD) OR HASJOIN = 2, SAMPLE MEMBER
POSS = “your”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 2) OR
“wife” (FRELATON = 2), SAMPLE MEMBER POSS = “your husband’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3) OR
“daughter” (FRELATON = 3), SAMPLE MEMBER POSS = “your father’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 4) OR
“daughter-in-law” (FRELATON = 4), SAMPLE MEMBER POSS = “your father-inlaw’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 5) OR
“sister” (FRELATON = 5), SAMPLE MEMBER POSS = “your brother’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “brother-in-law” (MRELATON = 6)
OR “sister-in-law” (FRELATON = 6), SAMPLE MEMBER POSS = “your brother-inlaw’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father” (MRELATON = 7) OR
“mother” (FRELATON = 7), SAMPLE MEMBER POSS = “your son’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 8) OR

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April 15, 2016

“mother-in-law” (FRELATON = 8), SAMPLE MEMBER POSS = “your son-in-law’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “uncle” (MRELATON = 9) OR “aunt”
(FRELATON = 9), SAMPLE MEMBER POSS = “your nephew’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “nephew” (MRELATON = 10) OR
“niece” (FRELATON = 10), SAMPLE MEMBER POSS = “your uncle’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR
“grandmother” (FRELATON = 11), SAMPLE MEMBER POSS = “your grandson’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 12) OR
“granddaughter” (FRELATON = 12), SAMPLE MEMBER POSS = “your
grandfather’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “cousin” (FRELATON = 13 or
MRELATON = 13), SAMPLE MEMBER = “your cousin’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “ex-husband” (MRELATON = 14) OR
“ex-wife” (FRELATON = 14), SAMPLE MEMBER = “your ex-husband’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 15 OR
FRELATON = 15), SAMPLE MEMBER POSS = “your partner’s”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON =
18) OR “other female relative” (FRELATON = 18), SAMPLE MEMBER POSS = “your
relative’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 2) OR
“wife” (FRELATON = 2), SAMPLE MEMBER POSS = “your wife’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3) OR
“daughter” (FRELATON = 3), SAMPLE MEMBER POSS = “your mother’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 4) OR
“daughter-in-law” (FRELATON = 4), SAMPLE MEMBER POSS = “your mother-inlaw’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 5) OR
“sister” (FRELATON = 5), SAMPLE MEMBER POSS = “your sister’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “brother-in-law” (MRELATON = 6)
OR “sister-in-law” (FRELATON = 6), SAMPLE MEMBER POSS = “your sister-inlaw’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father” (MRELATON = 7) OR
“mother” (FRELATON = 7), SAMPLE MEMBER POSS = “your daughter’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 8) OR
“mother-in-law” (FRELATON = 8), SAMPLE MEMBER POSS = “your daughter-inlaw’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “uncle” (MRELATON = 9) OR “aunt”
(FRELATON = 9), SAMPLE MEMBER POSS = “your niece’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “nephew” (MRELATON = 10) OR
“niece” (FRELATON = 10), SAMPLE MEMBER POSS = “your aunt’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR
“grandmother” (FRELATON = 11), SAMPLE MEMBER POSS = “your
granddaughter’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 12) OR
“granddaughter” (FRELATON = 12), SAMPLE MEMBER POSS = “your

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April 15, 2016

grandmother’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “cousin” (MRELATON = 13 or
FRELATON = 13), SAMPLE MEMBER = “your cousin”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “ex-husband” (MRELATON = 14) OR
“ex-wife” (FRELATON = 14), SAMPLE MEMBER = “your ex-wife’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 15 OR
FRELATON = 15), SAMPLE MEMBER POSS = “your partner’s”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON =
18) OR “other female relative” (FRELATON = 18), SAMPLE MEMBER POSS = “your
relative’s”
DEFINE SAMPLE MEMBER A
IF QD54 = 1 OR (MRELATON=16 OR MRELATON=17 OR MRELATON=19 OR
FRELATON=16 OR
FRELATON=17 OR FRELATON=19 FOR ALL PERSONS IN HOUSEHOLD) OR
HASJOIN = 2, SAMPLE
MEMBER A = “Are you”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 2) OR
“wife” (FRELATON = 2), SAMPLE MEMBER A = “Is your husband”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3) OR
“daughter” (FRELATON = 3), SAMPLE MEMBER A = “Is your father”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 4) OR
“daughter-in-law” (FRELATON = 4), SAMPLE MEMBER A = “Is your father-in-law”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 5) OR
“sister” (FRELATON = 5), SAMPLE MEMBER A = “Is your brother”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “brother-in-law” (MRELATON = 6)
OR “sister-in-law” (FRELATON = 6), SAMPLE MEMBER A = “Is your brother-inlaw”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father” (MRELATON = 7) OR
“mother” (FRELATON = 7), SAMPLE MEMBER A = “Is your son”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 8) OR
“mother-in-law” (FRELATON = 8), SAMPLE MEMBER A = “Is your son-in-law”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “uncle” (MRELATON = 9) OR “aunt”
(FRELATON = 9, SAMPLE MEMBER A = “Is your nephew”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “nephew” (MRELATON = 10) OR
“niece” (FRELATON = 10), SAMPLE MEMBER A = “Is your uncle”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR
“grandmother” (FRELATON = 11), SAMPLE MEMBER A = “Is your grandson”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 12) OR
“granddaughter” (FRELATON = 12), SAMPLE MEMBER A = “Is your grandfather”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “cousin” (FRELATON = 13 or
MRELATON = 13), SAMPLE MEMBER = “Is your cousin”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “ex-husband” (MRELATON = 14) OR
“ex-wife” (FRELATON = 14), SAMPLE MEMBER = “Is your ex-husband”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 15 OR

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April 15, 2016

FRELATON = 15), SAMPLE MEMBER A = “Is your partner”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON =
18) OR “other female relative” (FRELATON = 18), SAMPLE MEMBER A = “Is your
relative”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 2) OR
“wife” (FRELATON = 2), SAMPLE MEMBER A = “Is your wife”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3) OR
“daughter” (FRELATON = 3), SAMPLE MEMBER A = “Is your mother”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 4) OR
“daughter-in-law” (FRELATON = 4), SAMPLE MEMBER A = “Is your mother-inlaw”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 5) OR
“sister” (FRELATON = 5), SAMPLE MEMBER A = “Is your sister”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “brother-in-law” (MRELATON = 6)
OR “sister-in-law” (FRELATON = 6), SAMPLE MEMBER A = “Is your sister-in-law”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father” (MRELATON = 7) OR
“mother” (FRELATON = 7), SAMPLE MEMBER A = “Is your daughter”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 8) OR
“mother-in-law” (FRELATON = 8), SAMPLE MEMBER A = “Is your daughter-inlaw”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “uncle” (MRELATON = 9) OR “aunt”
(FRELATON = 9), SAMPLE MEMBER A = “Is your niece”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “nephew” (MRELATON = 10) OR
“niece” (FRELATON = 10), SAMPLE MEMBER A = “Is your aunt”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR
“grandmother” (FRELATON = 11), SAMPLE MEMBER A = “Is your granddaughter”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 12) OR
“granddaughter” (FRELATON = 12), SAMPLE MEMBER A = “Is your grandmother”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “cousin” (MRELATON = 13 or
FRELATON = 13), SAMPLE MEMBER = “Is your cousin”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “ex-husband” (MRELATON = 14) OR
“ex-wife” (FRELATON = 14), SAMPLE MEMBER = “Is your ex-wife”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 15 OR
FRELATON = 15), SAMPLE MEMBER A = “Is your partner”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON =
18) OR “other female relative” (FRELATON = 18), SAMPLE MEMBER A = “Is your
relative”
DEFINE SAMPLE MEMBER B
IF QD54 = 1 OR (MRELATON=16 OR MRELATON=17 OR MRELATON=19 OR
FRELATON=16 OR
FRELATON=17 OR FRELATON=19 FOR ALL PERSONS IN
HOUSEHOLD) OR HASJOIN = 2, SAMPLE MEMBER B = “you are”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 2) OR

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“wife” (FRELATON = 2), SAMPLE MEMBER B = “your husband is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3) OR
“daughter” (FRELATON = 3), SAMPLE MEMBER B = “your father is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 4) OR
“daughter-in-law” (FRELATON = 4), SAMPLE MEMBER B = “your father-in-law is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 5) OR
“sister” (FRELATON = 5), SAMPLE MEMBER B = “your brother is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “brother-in-law” (MRELATON = 6)
OR “sister-in-law” (FRELATON = 6), SAMPLE MEMBER B = “your brother-in-law
is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father” (MRELATON = 7) OR
“mother” (FRELATON = 7), SAMPLE MEMBER B = “your son is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 8) OR
“mother-in-law” (FRELATON = 8), SAMPLE MEMBER B = “your son-in-law is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “uncle” (MRELATON = 9) OR “aunt”
(FRELATON = 9, SAMPLE MEMBER B = “your nephew is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “nephew” (MRELATON = 10) OR
“niece” (FRELATON = 10), SAMPLE MEMBER B = “your uncle is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR
“grandmother” (FRELATON = 11), SAMPLE MEMBER B = “your grandson is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 12) OR
“granddaughter” (FRELATON = 12), SAMPLE MEMBER B = “your grandfather is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “cousin” (FRELATON = 13 or
MRELATON = 13), SAMPLE MEMBER = “your cousin is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “ex-husband” (MRELATON = 14) OR
“ex-wife” (FRELATON = 14), SAMPLE MEMBER = “your ex-husband is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 15 OR
FRELATON = 15), SAMPLE MEMBER B = “your partner is”
IF QD01 = 5 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON =
18) OR “other female relative” (FRELATON = 18), SAMPLE MEMBER B = “your
relative is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “husband” (MRELATON = 2) OR
“wife” (FRELATON = 2), SAMPLE MEMBER B = “your wife is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son” (MRELATON = 3) OR
“daughter” (FRELATON = 3), SAMPLE MEMBER B = “your mother is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “son-in-law” (MRELATON = 4) OR
“daughter-in-law” (FRELATON = 4), SAMPLE MEMBER B = “your mother-in-law is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “brother” (MRELATON = 5) OR
“sister” (FRELATON = 5), SAMPLE MEMBER B = “your sister is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “brother-in-law” (MRELATON = 6)
OR “sister-in-law” (FRELATON = 6), SAMPLE MEMBER B = “your sister-in-law is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father” (MRELATON = 7) OR
“mother” (FRELATON = 7), SAMPLE MEMBER B = “your daughter is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “father-in-law” (MRELATON = 8) OR
“mother-in-law” (FRELATON = 8), SAMPLE MEMBER B = “your daughter-in-law

728
April 15, 2016

is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “uncle” (MRELATON = 9) OR “aunt”
(FRELATON = 9, SAMPLE MEMBER B = “your niece is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “nephew” (MRELATON = 10) OR
“niece” (FRELATON = 10), SAMPLE MEMBER B = “your aunt is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandfather” (MRELATON = 11) OR
“grandmother” (FRELATON = 11), SAMPLE MEMBER B = “your granddaughter is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “grandson” (MRELATON = 12) OR
“granddaughter” (FRELATON = 12), SAMPLE MEMBER B = “your grandmother is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “cousin” (MRELATON = 13 or
FRELATON = 13), SAMPLE MEMBER = “your cousin is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “ex-husband” (MRELATON = 14) OR
“ex-wife” (FRELATON = 14), SAMPLE MEMBER = “your ex-wife is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “partner” (MRELATON = 15 OR
FRELATON = 15), SAMPLE MEMBER B = “your partner is”
IF QD01 = 9 AND SELECTED FILL IN QP02 = “other male relative” (MRELATON =
18) OR “other female relative” (FRELATON = 18), SAMPLE MEMBER B = “your
relative is”

729
April 15, 2016

730
April 15, 2016

Health Insurance
TOPROXY

[IF HASJOIN = 1] WHEN [QP02 FILL] HAS JOINED YOU:
The next questions are about [SAMPLE MEMBER POSS] health
insurance coverage and the kinds and amounts of income that [SAMPLE
MEMBER] and other people in your family receive. This information will
help in planning health care services and finding ways to lower costs of
care.
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] WHEN
[QP02 FILL] HAS JOINED YOU
The next questions are about [SAMPLE MEMBER POSS] health
insurance coverage and the kinds and amounts of income that [SAMPLE
MEMBER] and you receive. This information will help in planning health
care services and finding ways to lower costs of care.
PRESS [ENTER] TO CONTINUE.

QHI01

[IF QP03 = 2 OR DK/REF OR QP04 = 2 OR DK/REF OR HASJOIN = 2
ADD THIS TEXT PRIOR TO THE QUESTION: Since your [QP02 FILL] is
not available, I’d like you to answer these next questions the best you can.]
Several government programs provide medical care or help pay medical bills.
Medicare is a health insurance program for people aged 65 and older and for
certain people with disabilities. [SAMPLE MEMBER A] covered by
Medicare?
1
YES
2
NO
DK/REF

QHI01v

[IF QHI01 = 1 AND CURNTAGE < 65] You have indicated that [SAMPLE
MEMBER B] covered by Medicare, which is a health insurance program for
people aged 65 and older and for certain people with disabilities. Is this
correct?
1
YES
2
NO
DK/REF

DEFINE MEDIFILL:
IF FIPE4 =1 THEN MEDIFILL = Patient 1st
IF FIPE4 =2 THEN MEDIFILL = NONE

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April 15, 2016

IF FIPE4 =3 THEN MEDIFILL = AHCCCS or Arizona Health Care Cost
Containment System
IF FIPE4 =4 THEN MEDIFILL = NONE
IF FIPE4 =5 THEN MEDIFILL = Medi-Cal
IF FIPE4 =6 THEN MEDIFILL = NONE
IF FIPE4 =7 THEN MEDIFILL = Husky Health
IF FIPE4 =8 THEN MEDIFILL = The Delaware Medical Assistance Program
IF FIPE4 =9 THEN MEDIFILL = NONE
IF FIPE4 =10 THEN MEDIFILL = NONE
IF FIPE4 =11 THEN MEDIFILL = NONE
IF FIPE4 =12 THEN MEDIFILL = Med-QUEST
IF FIPE4 =13 THEN MEDIFILL = NONE
IF FIPE4 =14 THEN MEDIFILL = NONE
IF FIPE4 =15 THEN MEDIFILL = NONE
IF FIPE4 =16 THEN MEDIFILL = NONE
IF FIPE4 =17 THEN MEDIFILL = KanCare
IF FIPE4 =18 THEN MEDIFILL = NONE
IF FIPE4 =19 THEN MEDIFILL = Bayou Health
IF FIPE4 =20 THEN MEDIFILL = MaineCare
IF FIPE4 =21 THEN MEDIFILL = NONE
IF FIPE4 =22 THEN MEDIFILL = MassHealth
IF FIPE4 =23 THEN MEDIFILL = NONE
IF FIPE4 =24 THEN MEDIFILL = MinnesotaCare
IF FIPE4 =25 THEN MEDIFILL = NONE
IF FIPE4 =26 THEN MEDIFILL = MO HealthNet
IF FIPE4 =27 THEN MEDIFILL = NONE
IF FIPE4 =28 THEN MEDIFILL = NONE
IF FIPE4 =29 THEN MEDIFILL = NONE
IF FIPE4 =30 THEN MEDIFILL = NONE
IF FIPE4 =31 THEN MEDIFILL = NJ Family Care
IF FIPE4 =32 THEN MEDIFILL = Centennial Care
IF FIPE4 =33 THEN MEDIFILL = NONE
IF FIPE4 =34 THEN MEDIFILL = Community Care of North Carolina/Carolina
ACCESS (CCNC/CA)
IF FIPE4 =35 THEN MEDIFILL = NONE
IF FIPE4 =36 THEN MEDIFILL = Ohio Medicaid or Healthy Families
IF FIPE4 =37 THEN MEDIFILL = SoonerCare
IF FIPE4 =38 THEN MEDIFILL = Oregon Health Plan or OHP
IF FIPE4 =39 THEN MEDIFILL = Medical Assistance or MA
IF FIPE4 =40 THEN MEDIFILL = NONE
IF FIPE4 =41 THEN MEDIFILL = Healthy Connections
IF FIPE4 =42 THEN MEDIFILL = NONE
IF FIPE4 =43 THEN MEDIFILL = TennCare
IF FIPE4 =44 THEN MEDIFILL = NONE
IF FIPE4 =45 THEN MEDIFILL = NONE
IF FIPE4 =46 THEN MEDIFILL = Green Mountain Care

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April 15, 2016

IF FIPE4 =47 THEN MEDIFILL = NONE
IF FIPE4 =48 THEN MEDIFILL = Washington Apple Health
IF FIPE4 =49 THEN MEDIFILL = NONE
IF FIPE4 =50 THEN MEDIFILL = BadgerCare Plus
IF FIPE4 =51 THEN MEDIFILL = NONE
ELSE MEDIFILL = BLANK
QHI02

Medicaid is a public assistance program that pays for medical care for people
with low income and people with disabilities. [IF MEDIFILL NE NONE]
The Medicaid program in [STATE FILL] is also called [MEDIFILL].
Medicaid may also be called Medical Assistance.
[SAMPLE MEMBER A] covered by Medicaid?
1
YES
2
NO
DK/REF

QHI02v

[IF QHI02 = 1 AND CURNTAGE = 65 OR OLDER] You have indicated that
[SAMPLE MEMBER B] covered by Medicaid, which is a public assistance
program that pays for medical care for people with low income and people
with disabilities. Is this correct?
1
YES
2
NO
DK/REF

DEFINE CHIPFILL
IF FIPE4 = 1 THEN CHIPFILL = ALL Kids
IF FIPE4 = 2 THEN CHIPFILL = Denali KidCare (DKC)
IF FIPE4 = 3 THEN CHIPFILL = KidsCare
IF FIPE4 = 4 THEN CHIPFILL = ARKids or ARKids B
IF FIPE4 = 5 THEN CHIPFILL = Healthy Families or Medi-Cal
IF FIPE4 = 6 THEN CHIPFILL = Child Health Plan Plus, or CHP+
IF FIPE4 = 7 THEN CHIPFILL = Husky Health Program
IF FIPE4 = 8 THEN CHIPFILL = The Delaware Healthy Children Program or
DHCP
IF FIPE4 = 9 THEN CHIPFILL = DC Healthy Families
IF FIPE4 = 10 THEN CHIPFILL = Florida KidCare or Healthy Kids or MediKids
IF FIPE4 = 11 THEN CHIPFILL = PeachCare for Kids
IF FIPE4 = 12 THEN CHIPFILL = QUEST
IF FIPE4 = 13 THEN CHIPFILL = Idaho's State Children's Health Insurance
Program (SCHIP)
IF FIPE4 = 14 THEN CHIPFILL = All Kids
IF FIPE4 = 15 THEN CHIPFILL = Children's Health Insurance Program (CHIP)

733
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IF FIPE4 = 16 THEN CHIPFILL = Healthy and Well Kids in Iowa or hawk-i
IF FIPE4 = 17 THEN CHIPFILL = HealthWave
IF FIPE4 = 18 THEN CHIPFILL = KCHIP or Kentucky Children’s Health
Insurance Program
IF FIPE4 = 19 THEN CHIPFILL = Bayou Health or LaCHIP or Louisiana
Children’s Health Insurance Program
IF FIPE4 = 20 THEN CHIPFILL = MaineCare
IF FIPE4 = 21 THEN CHIPFILL = Maryland Children’s Health Program or
MCHP
IF FIPE4 = 22 THEN CHIPFILL = MassHealth
IF FIPE4 = 23 THEN CHIPFILL = MIChild
IF FIPE4 = 24 THEN CHIPFILL = MinnesotaCare
IF FIPE4 = 25 THEN CHIPFILL = Children’s Health Insurance Program or CHIP
IF FIPE4 = 26 THEN CHIPFILL = MO HealthNet for Kids
IF FIPE4 = 27 THEN CHIPFILL = Healthy Montana Kids (HMK)
IF FIPE4 = 28 THEN CHIPFILL = Children’s Health Insurance Program or CHIP
IF FIPE4 = 29 THEN CHIPFILL = Nevada Check Up
IF FIPE4 = 30 THEN CHIPFILL = New Hampshire Medicaid
IF FIPE4 = 31 THEN CHIPFILL = NJ Family Care
IF FIPE4 = 32 THEN CHIPFILL = New MexiKids or New MexiTeens
IF FIPE4 = 33 THEN CHIPFILL = Child Health Plus
IF FIPE4 = 34 THEN CHIPFILL = North Carolina Health Choice for Children or
NCHC
IF FIPE4 = 35 THEN CHIPFILL = North Dakota Healthy Steps
IF FIPE4 = 36 THEN CHIPFILL = Healthy Start or SCHIP
IF FIPE4 = 37 THEN CHIPFILL = SoonerCare
IF FIPE4 = 38 THEN CHIPFILL = Healthy Kids
IF FIPE4 = 39 THEN CHIPFILL = CHIP or Children’s Health Insurance Program
IF FIPE4 = 40 THEN CHIPFILL = RIte Care
IF FIPE4 = 41 THEN CHIPFILL = Healthy Connections
IF FIPE4 = 42 THEN CHIPFILL = Children’s Health Insurance Program or CHIP
IF FIPE4 = 43 THEN CHIPFILL = CoverKids
IF FIPE4 = 44 THEN CHIPFILL = Children’s Health Insurance Program or CHIP
IF FIPE4 = 45 THEN CHIPFILL = Utah Children’s Health Insurance Program or
CHIP
IF FIPE4 = 46 THEN CHIPFILL = Dr. Dynasaur
IF FIPE4 = 47 THEN CHIPFILL = The Family Access to Medical Insurance
Security Plan or FAMIS
IF FIPE4 = 48 THEN CHIPFILL = Apple Health for Kids
IF FIPE4 = 49 THEN CHIPFILL = West Virginia Children’s Health Insurance
Program or WVCHIP
IF FIPE4 = 50 THEN CHIPFILL = BadgerCare Plus
IF FIPE4 = 51 THEN CHIPFILL = Kid Care CHIP
ELSE CHIPFILL = BLANK
QHI02A [IF CURNTAGE = 12-19] [CHIPFILL] is a program that covers children

734
April 15, 2016

from low-income families who do not have private health insurance and who
do not qualify for other Medicaid programs. [SAMPLE MEMBER A]
currently covered by [CHIPFILL]?
1
YES
2
NO
DK/REF
QHI03

There are certain programs that cover active duty and retired career military
personnel and their dependents and survivors and also disabled veterans and
their dependents and survivors.
[SAMPLE MEMBER A] currently covered by TRICARE, or CHAMPUS,
CHAMPVA, the VA, or military health care?

INTERVIEWER NOTE:
CHAMPUS stands for Civilian Health and
Medical Program of the Uniformed Services. It
provides health care in private facilities for
dependents of military personnel on active duty
or retired for reasons other than disability. In
some areas, this may be known as TRICARE.
CHAMPVA stands for Civilian Health and
Medical Program of the Department of Veterans
Affairs. It provides health care for the spouse,
dependents, or survivors of a veteran who has a
total, permanent service-connected disability.
The VA provides medical assistance to veterans
of the Armed Forces.
Military health care refers to health care
available to active duty personnel and their
dependents.

1
YES
2
NO
DK/REF
QHI06

Private health insurance can be obtained through work, such as through an
employer, union, or professional association, by paying premiums directly to a
health insurance company, or by purchasing a plan through the Health

735
April 15, 2016

Insurance Marketplace. It includes coverage by a health maintenance
organization or HMO, fee for service plans, and single service plans.
[SAMPLE MEMBER A] currently covered by private health insurance?
1
YES
2
NO
DK/REF

QHI07

[IF QHI06 = 1] Was [SAMPLE MEMBER POSS] private health insurance
obtained through work, such as through an employer, union, or professional
association? It can be through any family member’s employment, not just
[SAMPLE MEMBER POSS] employment.
1
YES
2
NO
DK/REF

QHI08

[IF QHI06 = 1] Does [SAMPLE MEMBER POSS] private health insurance
include coverage for treatment for any of the following conditions?
Alcohol abuse or alcoholism?
1
YES
2
NO
DK/REF

QHI09

[IF QHI06 = 1] Drug abuse?
1
YES
2
NO
DK/REF

QHI10

[IF QHI06 = 1] Mental or emotional problems?
1
YES
2
NO
DK/REF

QHI11

[IF (QHI01 = 2 OR QHI01v = 2) AND (QHI02 = 2 OR QHI02v = 2) AND
QHI03 = 2 AND QHI06 = 2 AND (IF CURNTAGE = 12 - 19: QHI02a =
2)] [SAMPLE MEMBER A] currently covered by any kind of health
insurance, that is, any policy or program that provides or pays for medical

736
April 15, 2016

care?
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
If the respondent reports Indian Health
Insurance, enter “1".

QHI13

[IF (QHI01 = 1 AND QHI01v NE 2) OR (QHI02 = 1 AND QHI02v NE 2)
OR QHI02a = 1 OR QHI03=1 OR QH106 = 1 OR QHI11 = 1] During the
past 12 months, that is from [DATE FILL] through today, was there any time
when [SAMPLE MEMBER] did not have any kind of health insurance or
coverage?

1
YES
2
NO
DK/REF
DEFINE WEREWAS:
IF QD54 = 1 OR HASJOIN = BLANK OR 2 THEN WEREWAS = 'were you'
ELSE WEREWAS = 'was SAMPLE MEMBER'
QHI14

[IF QHI13 = 1] During the past 12 months, that is from [DATE FILL]
through today, about how many months [FILL WEREWAS] without any
kind of health insurance or coverage?

INTERVIEWER NOTE:
If the respondent reports less than one month, enter “1".
# OF MONTHS:
DK/REF
QHI15

[RANGE: 1 - 12]

[IF (QHI01 = 2 OR QHI01v = 2) AND (QHI02 = 2 OR QHI02v = 2) AND
QHI03 = 2 AND QHI06 = 2 AND QHI11 = 2 AND (IF CURNTAGE = 12 19: QHI02a = 2)] About how long has it been since [SAMPLE MEMBER]
last had any kind of health care coverage?
1
2
3
4

WITHIN THE PAST 6 MONTHS
MORE THAN 6 MONTHS AGO, BUT WITHIN THE PAST YEAR
MORE THAN 1 YEAR AGO, BUT WITHIN THE PAST 3 YEARS
MORE THAN 3 YEARS AGO

737
April 15, 2016

5
NEVER HAD COVERAGE
DK/REF
QHI17

[IF QHI15 = 1 - 4 OR DK/REF] HAND R SHOWCARD 8 Which of the
reasons on this card is the main reason why [SAMPLE MEMBER] stopped
being covered by health insurance?
1

PERSON IN FAMILY WITH HEALTH INSURANCE LOST JOB
OR CHANGED EMPLOYERS
2
LOST MEDICAID OR MEDICAL ASSISTANCE COVERAGE
BECAUSE OF NEW JOB OR INCREASE IN INCOME
3
LOST MEDICAID OR MEDICAL ASSISTANCE COVERAGE FOR
SOME OTHER REASON
4
COST IS TOO HIGH/CAN’T AFFORD PREMIUMS
5
BECAME INELIGIBLE BECAUSE OF AGE OR LEAVING
SCHOOL
6
EMPLOYER DOES NOT OFFER COVERAGE, OR NOT
ELIGIBLE FOR COVERAGE
7
GOT DIVORCED OR SEPARATED FROM PERSON WITH
INSURANCE
8
DEATH OF SPOUSE OR PARENT
9
INSURANCE COMPANY REFUSED COVERAGE
10
DON’T NEED IT
11
RECEIVED MEDICAID OR MEDICAL INSURANCE ONLY
WHILE PREGNANT
12
SOME OTHER REASON
DK/REF
QHI18

[IF QHI15 = 5] HAND R SHOWCARD 9 Which of these reasons on this card
describe why [SAMPLE MEMBER] never had health insurance coverage?
TO SELECT MORE THAN ONE CATEGORY, PRESS THE SPACE BAR
BETWEEN EACH CATEGORY YOU SELECT.
1
2

COST IS TOO HIGH/CAN’T AFFORD PREMIUMS
EMPLOYER DOES NOT OFFER COVERAGE, OR NOT
ELIGIBLE FOR COVERAGE
3
INSURANCE COMPANY REFUSED COVERAGE
4
DON’T NEED IT
5
SOME OTHER REASON
DK/REF

738
April 15, 2016

Income
INTROINC [IF NO FAMILY MEMBERS IN ROSTER] These next questions are
about the kinds and amounts of income that you receive.
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1 ] These
next questions are about the kinds and amounts of income received by you
and your [FAMILY RELATIONSHIP FILL].
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] These
next questions are about the kinds and amounts of income received by
[SAMPLE MEMBER] and you.
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND
HASJOIN NE 1] These next questions are about the kinds and amounts of
income received by your family living here, including you, your
[FAMILY RELATIONSHIP FILLS].
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND
HASJOIN=1] These next questions are about the kinds and amounts of
income received by [SAMPLE MEMBER] and [IF QD01=5 FILL his,
QD01 = 9 FILL her] family living here, including you, [IF QD01=5 FILL
his, QD01 = 9 FILL her] [FAMILY RELATIONSHIP FILLS].
[PROGRAMMER NOTE: THE PROXY SHOULD NOT APPEAR IN
[FAMILY RELATIONSHIP FILLS]. ALSO, USE ‘other’ AS A
MODIFIER TO THE FAMILY RELATIONSHIP FILL WHEN THE
RELATIONSHIP TYPE IS EQUAL TO PROXY RELATIONSHIP
TYPE AND ONE OF THESE RELATIONSHIP TYPES IS STILL IN
THE LIST. PLEASE PRECEDE EACH RELATIONSHIP WITH
‘HIS/HER’. ]
[IF HASJOIN NE 1] These questions refer to the calendar year
[CURRENT YEAR - 1] rather than to the past 12 months that were
referred to in some earlier questions. The calendar year [CURRENT
YEAR - 1] would be from January 1st, [CURRENT YEAR - 1], through
December 31st, [CURRENT YEAR - 1].
PRESS [ENTER] TO CONTINUE.

QI01N

Social Security or Railroad Retirement payments are paid by the U.S.
Government to persons people who are retired, severely disabled, or are
dependents or survivors of workers.
[IF NO FAMILY MEMBERS IN ROSTER] In [CURRENT YEAR - 1], did
you receive Social Security or Railroad Retirement payments?

739
April 15, 2016

[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] In
[CURRENT YEAR – 1], did you or your [FAMILY RELATIONSHIP FILL]
receive Social Security or Railroad Retirement payments?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] In
[CURRENT YEAR – 1], did [SAMPLE MEMBER] or you receive Social
Security or Railroad Retirement payments?
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER] In [CURRENT
YEAR - 1], did [SAMPLE MEMBER] or any of these same family members
receive Social Security or Railroad Retirement payments?

1
YES
2
NO
DK/REF

QI03N

Supplemental Security Income or SSI is a program administered by a
government agency that makes assistance payments to people with low
income who are aged, blind, or disabled. This is not the same as Social
Security.
[IF NO FAMILY MEMBERS IN ROSTER] In [CURRENT YEAR - 1], did
you receive Supplemental Security Income or SSI?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] In
[CURRENT YEAR – 1], did you or your [FAMILY RELATIONSHIP FILL]
receive Supplemental Security Income or SSI?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] In
[CURRENT YEAR – 1], did [SAMPLE MEMBER] or you receive
Supplemental Security Income or SSI?
[IF AT LEAST TWO FAMILY MEMBER IN ROSTER] In [CURRENT
YEAR - 1], did [SAMPLE MEMBER] or any of these same family members
receive Supplemental Security Income or SSI?
1
YES
2
NO
DK/REF

QI07N

The Supplemental Nutrition Assistance Program, or SNAP, formerly known
as food stamps, provides assistance for buying food. A special card is issued
which can be used to buy food in grocery stores. SNAP does not include WIC

740
April 15, 2016

or free or reduced school lunches.
[IF NO FAMILY MEMBERS IN ROSTER] In [CURRENT YEAR - 1], did
you receive SNAP benefits?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] In
[CURRENT YEAR - 1], did you or your [FAMILY RELATIONSHIP FILL]
receive SNAP benefits?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] In
[CURRENT YEAR - 1], did [SAMPLE MEMBER] or you receive SNAP
benefits?
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER] In [CURRENT
YEAR - 1], did [SAMPLE MEMBER] or any of these same family members
receive SNAP benefits?
1
YES
2
NO
DK/REF
DEFINE TANFFILL:
IF FIPE4 = 1 THEN TANFFILL = the Family Assistance Program (FAP)
IF FIPE4 = 2 THEN TANFFILL = the Alaska Temporary Assistance Program
(ATAP)
IF FIPE4 = 3 THEN TANFFILL = Cash Assistance (CA)
IF FIPE4 = 4 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)
IF FIPE4 = 5 THEN TANFFILL = California Temporary Assistance for Needy
Families (TANF) or California CalWORKs
IF FIPE4 = 6 THEN TANFFILL = Colorado Works
IF FIPE4 = 7 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)
IF FIPE4 = 8 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)
IF FIPE4 = 9 THEN TANFFILL = Temporary Cash Assistance for Needy
Families (TANF)
IF FIPE4 = 10 THEN TANFFILL = Temporary Cash Assistance (TCA)
IF FIPE4 = 11 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)
IF FIPE4 = 12 THEN TANFFILL = Temporary Assistance to Needy Families
(TANF) or Temporary Assistance to Other Needy Families (TAONF)
IF FIPE4 = 13 THEN TANFFILL = Temporary Assistance for Families in Idaho
(TAFI)
IF FIPE4 = 14 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)

741
April 15, 2016

IF FIPE4 = 15 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)
IF FIPE4 = 16 THEN TANFFILL = the Family Investment Program (FIP)
IF FIPE4 = 17 THEN TANFFILL = Cash Assistance
IF FIPE4 = 18 THEN TANFFILL = the Kentucky Transitional Assistance
Program (K-TAP)
IF FIPE4 = 19 THEN TANFFILL = The Family Independence Temporary
Assistance Program (FITAP)
IF FIPE4 = 20 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF) or Additional Support for People in Retraining and Employment
(ASPIRE)
IF FIPE4 = 21 THEN TANFFILL = Temporary Cash Assistance (TCA)
IF FIPE4 = 22 THEN TANFFILL = Transitional Aid to Families with Dependent
Children (TAFDC)
IF FIPE4 = 23 THEN TANFFILL = the Family Independence Program (FIP)
IF FIPE4 = 24 THEN TANFFILL = the Minnesota Family Investment Program
(MFIP)
IF FIPE4 = 25 THEN TANFFILL = Temporary Assistance to Needy Families
(TANF)
IF FIPE4 = 26 THEN TANFFILL = Temporary Assistance
IF FIPE4 = 27 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)
IF FIPE4 = 28 THEN TANFFILL = Aid to Dependent Children (ADC)
IF FIPE4 = 29 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)
IF FIPE4 = 30 THEN TANFFILL = Financial Assistance to Needy Families
(FANF)
IF FIPE4 = 31 THEN TANFFILL = Work First New Jersey (WFNJ)
IF FIPE4 = 32 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF), or NMWorks
IF FIPE4 = 33 THEN TANFFILL = Family Assistance (FA)
IF FIPE4 = 34 THEN TANFFILL = Work First
IF FIPE4 = 35 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF) or Job Opportunities and Basic Skills (JOBS)
IF FIPE4 = 36 THEN TANFFILL = Ohio Works First (OWF) or Temporary
Assistance for Needy Families (TANF)
IF FIPE4 = 37 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)
IF FIPE4 = 38 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)
IF FIPE4 = 39 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF), Cash Assistance, or Moving to Independence
IF FIPE4 = 40 THEN TANFFILL = Rhode Island Works (RI Works)
IF FIPE4 = 41 THEN TANFFILL = Family Independence (FI)
IF FIPE4 = 42 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)

742
April 15, 2016

IF FIPE4 = 43 THEN TANFFILL = Families First
IF FIPE4 = 44 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)
IF FIPE4 =45 THEN TANFFILL = the Family Employment Program (FEP)
IF FIPE4 = 46 THEN TANFFILL = Reach Up
IF FIPE4 = 47 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)
IF FIPE4 = 48 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF) or WorkFirst
IF FIPE4 = 49 THEN TANFFILL = West Virginia Works (WV Works)
IF FIPE4 = 50 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)
IF FIPE4 = 51 THEN TANFFILL = Temporary Assistance for Needy Families
(TANF)
ELSE TANFFILL = BLANK
QI08N

[IF NO FAMILY MEMBERS IN ROSTER] At any time during [CURRENT
YEAR - 1], even for one month, did you receive any cash assistance from a
state or [IF FIPE4=2 THEN “borough”] [IF FIPE4=19 THEN “parish”] [IF
FIPE4 NE 2 OR 19 THEN “county”] welfare program such as [TANFFILL]?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1 ] At any
time during [CURRENT YEAR - 1], even for one month, did you or your
[FAMILY RELATIONSHIP FILL] receive any cash assistance from a state or
[IF FIPE4=2 THEN “borough”] [IF FIPE4=19 THEN “parish”] [IF FIPE4 NE
2 OR 19 THEN “county”] welfare program such as [TANFFILL]?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] At any time
during [CURRENT YEAR - 1], even for one month, did [SAMPLE
MEMBER] or you receive any cash assistance from a state or [IF FIPE4=2
THEN “borough”] [IF FIPE4=19 THEN “parish”] [IF FIPE4 NE 2 OR 19
THEN “county”] welfare program such as [TANFFILL]?
[IF AT LEAST TWO FAMILY MEMBER IN ROSTER] At any time during
[CURRENT YEAR - 1], even for one month, did [SAMPLE MEMBER] or
any of these same family members receive any cash assistance from a state or
[IF FIPE4=2 THEN “borough”] [IF FIPE4=19 THEN “parish”] [IF FIPE4 NE
2 OR 19 THEN “county”] welfare program such as [TANFFILL]?
1
YES
2
NO
DK/REF
INTERVIEWER NOTE:
If the respondent volunteers receiving welfare payments
from a program other than the one mentioned, or from

743
April 15, 2016

another state, record a "yes" response. Do not probe for
this information.
QI10N

[IF NO FAMILY MEMBERS IN ROSTER] In [CURRENT YEAR - 1],
because of low income, did you receive any other kind of non-monetary
welfare or public assistance, such as help with getting a job, placement in
education or job training programs, or help with transportation, child care, or
housing?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] In
[CURRENT YEAR - 1], because of low income, did you or your [FAMILY
RELATIONSHIP FILL] receive any other kind of non-monetary welfare or
public assistance, such as help with getting a job, placement in education or
job training programs, or help with transportation, child care, or housing?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] In
[CURRENT YEAR - 1], because of low income, did [SAMPLE MEMBER]
or you receive any other kind of non-monetary welfare or public assistance,
such as help with getting a job, placement in education or job training
programs, or help with transportation, child care, or housing?
[IF AT LEAST TWO FAMILY MEMBER IN ROSTER] In [CURRENT
YEAR - 1], because of low income, did [SAMPLE MEMBER] or any of these
same family members receive any other kind of non-monetary welfare or
public assistance, such as help with getting a job, placement in education or
job training programs, or help with transportation, child care, or housing?
1
YES
2
NO
DK/REF

QI12AN [IF (QI08N=1 OR QI10N=1) AND QI07N=2]
[IF NO FAMILY MEMBERS IN ROSTER] For how many months in
[CURRENT YEAR - 1] did you receive any type of welfare or public
assistance?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] For how
many months in [CURRENT YEAR - 1] did you or your [FAMILY
RELATIONSHIP FILL] receive any type of welfare or public assistance?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] For how
many months in [CURRENT YEAR - 1] did [SAMPLE MEMBER] or you
receive any type of welfare or public assistance?
[IF AT LEAST TWO FAMILY MEMBER IN ROSTER] For how many

744
April 15, 2016

months in [CURRENT YEAR - 1] did [SAMPLE MEMBER] or any other
family member living here receive any type of welfare or public assistance?
[ALL] Please include:
• Cash assistance from a state or [IF FIPE4=2 THEN “borough”] [IF
FIPE4=19 THEN “parish”] [IF FIPE4 NE 2 OR 19 THEN “county”]
welfare program such as [TANFFILL]
• Any other kind of non-monetary welfare or public assistance
# OF MONTHS RECEIVED ASSISTANCE:
DK/REF

[RANGE: 1 - 12]

QI12BN [IF (QI08N=1 OR QI10N=1) AND QI07N=(1, DK OR REF)]
[IF NO FAMILY MEMBERS IN ROSTER] For how many months in
[CURRENT YEAR - 1] did you receive any type of welfare or public
assistance, not including SNAP benefits?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] For how
many months in [CURRENT YEAR - 1] did you or your [FAMILY
RELATIONSHIP FILL] receive any type of welfare or public assistance, not
including SNAP benefits?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] For how
many months in [CURRENT YEAR - 1] did [SAMPLE MEMBER] or you
receive any type of welfare or public assistance, not including SNAP
benefits?
[IF AT LEAST TWO FAMILY MEMBER IN ROSTER] For how many
months in [CURRENT YEAR - 1] did [SAMPLE MEMBER] or any other
family member living here receive any type of welfare or public assistance,
not including SNAP benefits?
[ALL] Please include:
• Cash assistance from a state or [IF FIPE4=2 THEN “borough”] [IF
FIPE4=19 THEN “parish”] [IF FIPE4 NE 2 OR 19 THEN “county”]
welfare program such as [TANFFILL]
• Any other kind of non-monetary welfare or public assistance

# OF MONTHS RECEIVED ASSISTANCE:
DK/REF

[RANGE: 1 - 12]

INTRTINN HAND R SHOWCARD 10 Here is a list of some other sources of income.
When you answer the next questions, please consider these income sources as
well as those asked about in earlier questions.
745
April 15, 2016

INTERVIEWER: PLEASE READ THIS ALOUD TO THE RESPONDENT
AS HE/SHE FOLLOWS ALONG ON THE SHOWCARD.
Income earned at a job or business
Retirement, disability, or survivor pension
Unemployment or worker's compensation
Veteran's Administration payments
Child support
Alimony
Interest income
Dividends from stocks or mutual funds
Income from rental properties, royalties, estates or trusts
INTERVIEWER: CHILD SUPPORT SHOULD BE REPORTED UNDER
THE PARENT’S INCOME, NOT THE CHILD’S INCOME.
PRESS [ENTER] TO CONTINUE.
QI20N

[IF NO FAMILY MEMBERS IN ROSTER] Before taxes and other
deductions, was your total personal income from all sources during
[CURRENT YEAR - 1] more or less than 20,000 dollars?
[IF AT LEAST ONE FAMILY MEMBER IN ROSTER] Now I am going to
ask about [SAMPLE MEMBER POSS] own personal income. Before taxes
and other deductions, was [SAMPLE MEMBER POSS] total personal
income from all sources during [CURRENT YEAR – 1] more or less than
20,000 dollars?
(Income data are important in analyzing the health information we collect.
For example, the information helps us to learn whether persons people in one
income group use certain types of medical care services or have conditions
more or less often than those in another group.)
1
$20,000 OR MORE
2
LESS THAN $20,000
DK/REF

QI21A

[IF QI20N = 2] HAND R SHOWCARD 11 Of these income groups, which
category best represents [SAMPLE MEMBER POSS] total personal income
during [CURRENT YEAR - 1]?
(Income data are important in analyzing the health information we collect.
For example, the information helps us to learn whether persons people in one
income group use certain types of medical care services or have conditions
more or less often than those in another group.)
746

April 15, 2016

1
LESS THAN $1,000
2
$1,000 - $1,999
3
$2,000 - $2,999
4
$3,000 - $3,999
5
$4,000 - $4,999
6
$5,000 - $5,999
7
$6,000 - $6,999
8
$7,000 - $7,999
9
$8,000 - $8,999
10
$9,000 - $9,999
11
$10,000 - $10,999
12
$11,000 - $11,999
13
$12,000 - $12,999
14
$13,000 - $13,999
15
$14,000 - $14,999
16
$15,000 - $15,999
17
$16,000 - $16,999
18
$17,000 - $17,999
19
$18,000 - $18,999
20
$19,000 - $19,999
DK/REF
QI21B

[IF QI20N = 1] HAND R SHOWCARD 12 Of these income groups, which
category best represents [SAMPLE MEMBER POSS] total personal income
during [CURRENT YEAR - 1]?
(Income data are important in analyzing the health information we collect.
For example, the information helps us to learn whether persons people in one
income group use certain types of medical care services or have conditions
more or less often than those in another group.)

21
$20,000 - $24,999
22
$25,000 - $29,999
23
$30,000 - $34,999
24
$35,000 - $39,999
25
$40,000 - $44,999
26
$45,000 - $49,999
27
$50,000 - $74,999
28
$75,000 - $99,999
29
$100,000 - $149,999
30
$150,000 OR MORE
DK/REF

747
April 15, 2016

INTROFI1

[IF MORE THAN ONE FAMILY MEMBER IN ROSTER AND IF
QI21B NE 30]
Next, we would like to know about the total family income from all
sources during [CURRENT YEAR - 1] before taxes and other
deductions.
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1 ] We
would like you to combine everyone’s income – that is, yours and that of
your [FAMILY RELATIONSHIP FILL].
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] We
would like you to combine everyone’s income – that is, [SAMPLE
MEMBER POSS] and yours.
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND
HASJOIN NE 1] We would like you to combine everyone’s income – that
is, yours and that of your [FAMILY RELATIONSHIP FILLS].
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND
HASJOIN = 1] We would like you to combine everyone’s income — that
is, yours, [SAMPLE MEMBER POSS] and that of [IF QD01 = 5 FILL
his, QD = 9 FILL her] [FAMILY RELATIONSHIP FILLS] living here.
[PROGRAMMER NOTE: THE PROXY SHOULD NOT APPEAR IN
[FAMILY RELATIONSHIP FILLS]. ALSO, USE ‘other’ AS A
MODIFIER TO THE FAMILY RELATIONSHIP FILL WHEN THE
RELATIONSHIP TYPE IS EQUAL TO PROXY RELATIONSHIP
TYPE AND ONE OF THESE RELATIONSHIP TYPES IS STILL IN
THE LIST.]
Please include all of the sources of income that we just talked about.
PRESS [ENTER] TO CONTINUE

QI22

[IF MORE THAN ONE FAMILY MEMBER IN ROSTER AND (QI20N NE
1)] Before taxes and other deductions, was the total combined family
income during [CURRENT YEAR - 1] more or less than 20,000 dollars?

1
$20,000 OR MORE
2
LESS THAN $20,000
DK/REF
QI23A

[IF QI22=2]
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1 ] HAND R
SHOWCARD 11 Of these income groups, which category best represents

748
April 15, 2016

your total combined family income during [CURRENT YEAR – 1] – that is,
yours and that of your [FAMILY RELATIONSHIP FILL].
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] HAND R
SHOWCARD 11 Of these income groups, which category best represents
your total combined family income during [CURRENT YEAR – 1] – that is,
your [SAMPLE MEMBER POSS] and yours.
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN
NE 1] HAND R SHOWCARD 11 Of these income groups, which category
best represents your total combined family income during [CURRENT
YEAR – 1] – that is, yours and that of your [RELATIONSHIP FILLS].
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN
=1] HAND R SHOWCARD 11 Of these income groups, which category best
represents your total combined family income during [CURRENT YEAR 1]-- that is, yours, [SAMPLE MEMBER POSS], and that of [IF QD01 = 5
FILL his, QD01 = 9 FILL her] [FAMILY RELATIONSHIP FILLS] living
here? [PROGRAMMER NOTE: THE PROXY SHOULD NOT APPEAR IN
[FAMILY RELATIONSHIP FILLS]. ALSO, USE ‘other’ AS A MODIFIER
TO THE FAMILY RELATIONSHIP FILL WHEN THE RELATIONSHIP
TYPE IS EQUAL TO PROXY RELATIONSHIP TYPE AND ONE OF
THESE RELATIONSHIP TYPES IS STILL IN THE LIST.]

1
LESS THAN $1,000
2
$1,000 - $1,999
3
$2,000 - $2,999
4
$3,000 - $3,999
5
$4,000 - $4,999
6
$5,000 - $5,999
7
$6,000 - $6,999
8
$7,000 - $7,999
9
$8,000 - $8,999
10
$9,000 - $9,999
11
$10,000 - $10,999
12
$11,000 - $11,999
13
$12,000 - $12,999
14
$13,000 - $13,999
15
$14,000 - $14,999
16
$15,000 - $15,999
17
$16,000 - $16,999
18
$17,000 - $17,999
19
$18,000 - $18,999
20
$19,000 - $19,999
DK/REF

749
April 15, 2016

QI23B

[IF (QI22=1 OR QI20N = 1) AND QI21B NE 30]
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1 ] HAND R
SHOWCARD 12 Of these income groups, which category best represents
your total combined family income during [CURRENT YEAR – 1] – that is,
yours and that of your [FAMILY RELATIONSHIP FILL]?
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] HAND R
SHOWCARD 12 Of these income groups, which category best represents
your total combined family income during [CURRENT YEAR – 1] – that is,
[SAMPLE MEMBER POSS] and yours?
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN
NE 1] HAND R SHOWCARD 12 Of these income groups, which category
best represents your total combined family income during [CURRENT
YEAR – 1] – that is, yours and that of your [FAMILY RELATIONSHIP
FILLS]?
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN
=1] HAND R SHOWCARD 12 Of these income groups, which category best
represents your total combined family income during [CURRENT YEAR 1]-- that is, yours, [SAMPLE MEMBER POSS], and that of [IF QD01 = 5
FILL his, QD01 =9 FILL her] [FAMILY RELATIONSHIP FILLS] living
here? [PROGRAMMER NOTE: THE PROXY SHOULD NOT APPEAR IN
[FAMILY RELATIONSHIP FILLS]. ALSO, USE ‘other’ AS A MODIFIER
TO THE FAMILY RELATIONSHIP FILL WHEN THE RELATIONSHIP
TYPE IS EQUAL TO PROXY RELATIONSHIP TYPE AND ONE OF
THESE RELATIONSHIP TYPES IS STILL IN THE LIST.]

21 $20,000 - $24,999
22 $25,000 - $29,999
23 $30,000 - $34,999
24 $35,000 - $39,999
25 $40,000 - $44,999
26 $45,000 - $49,999
27 $50,000 - $74,999
28 $75,000 - $99,999
29 $100,000 - $149,999
30 $150,000 OR MORE
DK/REF
CELL2

Do you or anyone at this address have a cell phone that is currently
working?

750
April 15, 2016

INTERVIEWER NOTE: We are asking
whether you or anyone at this address has a
cell phone that currently works and can be
used to make or receive calls.
1
YES
2
NO
DK/REF
CELL1

ENDPROXY

Is there at least one telephone at this address that is not a cell phone?
1
YES
2
NO
DK/REF

[IF HASJOIN=1] Thank you for answering these questions.
IF RESPONDENT IS A MINOR: COMPLETE QC FORM WITH A
PARENT/GUARDIAN.
IF RESPONDENT IS AN ADULT: COMPLETE QC FORM WITH
RESPONDENT.
PRESS [ENTER] TO CONTINUE.

751
April 15, 2016

752
April 15, 2016

Verification
QCID

ENTER THE QC ID FROM THE QUALITY CONTROL FORM FOR
THIS INTERVIEW. THE QC ID IS LOCATED IN THE UPPER RIGHT
HAND CORNER OF THE QUALITY CONTROL FORM. THE
HYPHEN MUST BE INCLUDED.

CASEID ENTER THE CASE ID FOR THIS INTERVIEW.
BE SURE TO INCLUDE A OR B AT THE END OF THE CASE ID.
TOALLR3I It is important that I do my job correctly; therefore, my supervisors will be
checking on my work. Would you help me by printing your phone number
and current address on this form?
[GIVE QUALITY CONTROL FORM AND ENVELOPE TO
RESPONDENT (OR PARENT / GUARDIAN OF YOUTH RESPONDENT,
IF AVAILABLE)]
Then place it in the postage-paid envelope so that my supervisor can write or
call you in several weeks to confirm that I did my job. When you are finished,
please seal the envelope and return it to me. As you can see, this is kept
separate from the responses that were entered so they will still be completely
private.
PRESS [ENTER] TO CONTINUE.
INCENT01

HAND RESPONDENT $30 CASH.

MARK THE APPROPRIATE ‘CASH ACCEPTANCE’ BOX ON THE
INTERVIEW INCENTIVE RECEIPT.
SIGN AND DATE INTERVIEW INCENTIVE RECEIPT AND GIVE TOP
COPY TO RESPONDENT.
I have signed this form to indicate that I have given you $30 for this interview.
At the bottom of this form, we have included national hotline numbers that
you can call if you ever feel you need to talk to someone about mental health
or drug use issues.
IF NOT DONE EARLIER, GIVE ADULT RESPONDENT OR
PARENT/GUARDIAN OF YOUTH THE Q&A BROCHURE AND SAY:
For more details on the National Survey on Drug Use and Health, this
brochure includes answers to common questions, website addresses and other

753
April 15, 2016

information.
PRESS [ENTER] TO CONTINUE.
THANKR2 Thank you for your time.

[ALL CASES] BE SURE YOU HAVE YOUR SHOWCARD BOOKLET,
QC ENVELOPE W/ FORM AND INCENTIVE RECEIPT COPIES.
[ALL CASES] PRESS [ENTER] TO CONTINUE.
FIEXIT

END OF INTERVIEW REACHED.
PRESS 1 TO EXIT.

754
April 15, 2016
File Type	application/pdf
Author	gmchenry
File Modified	2016-05-27
File Created	2016-05-27