CMS-P-0015A Nicotine Alcohol

2022 MCBS Community Questionnaire

Variable Name

MR Screen Name

Question Type

NAQ-NICOTINE AND ALCOHOL USE

Question Text/Description

Code List

Routing

NICOTINE AND ALCOHOL USE QUESTIONNAIRE SPECIFICATIONS
CRITERIA
INTTYPE=C001, C002, C003, C004, C005, C006
SPALIVE=1
SEASON=FALL
SPPROXY=SP or PROXY
Other: N/A
PLACEMENT
Administer after HFQ.

CIGINT

CIG100

NA1

no entry

These next questions are about cigarette smoking.

BOX NA1

routing

If SP previously reported smoking cigarettes (sample_person.P_CIG100=1), go to NA3-CIGNOW.
Else go to NA2-CIG100.

NA2

yes/no

[Have you/Has (SP)] smoked at least 100 cigarettes in [your/his/her] entire life?

(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED

(1) NA3-CIGNOW
(2) NA4-SMKLSINT
(-8) NA4-SMKLSINT
(-9) NA4-SMKLSINT

(1) EVERY DAY
(2) SOME DAYS
(3) NOT AT ALL
(-8) DON'T KNOW
(-9) REFUSED

NA4-SMKLSINT

CIGNOW

NA3

code one

[Do you/Does (SP)] now smoke cigarettes every day, some days, or not at all?

SMKLSINT

NA4

no entry

The next questions are about “smokeless” tobacco such as snuff, dip, chewing tobacco, or “snus.”

BOX NA2

routing

If SP previously reported using smokeless tobacco (sample_person.P_SMKLSONE=1), go to NA6-SMKLSNOW.
Else go to NA5-SMKLSONE.

SMKLSONE

NA5

yes/no

BOX NA1

[Have you/Has (SP)] ever used “smokeless” tobacco, even once?

BOX NA2

(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED

(1) NA6-SMKLSNOW
(2) NA7-CIGARINT
(-8) NA7-CIGARINT
(-9) NA7-CIGARINT

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2022 MCBS Community Questionnaire

Variable Name

MR Screen Name

Question Type

NAQ-NICOTINE AND ALCOHOL USE

Question Text/Description

Code List

Routing

(1) EVERY DAY
(2) SOME DAYS
(3) NOT AT ALL
(-8) DON'T KNOW
(-9) REFUSED

NA7-CIGARINT

SMKLSNOW

NA6

code one

[Do you/Does (SP)] now use smokeless tobacco every day, some days, or not at all?

CIGARINT

NA7

no entry

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.

routing

If SP never reported smoking cigars (sample_person.P_CIGARONE^=1), go to NA8-CIGARONE.
Else if SP previously reported smoking cigars (sample_person.P_CIGARONE=1) and smoked less than 50 cigars
(sample_person.P_CIGAR50^=1), go to NA9-CIGAR50.
Else if SP previously reported smoking cigars (sample_person.P_CIGARONE=1) and smoked more than 50 cigars
(sample_person.P_CIGAR50=1), go to NA10-CIGARNOW.

BOX NA3

CIGARONE

CIGAR50

NA8

NA9

yes/no

yes/no

BOX NA3

[Have you/Has (SP)] ever smoked a cigar EVEN ONE TIME?

(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED

(1) NA9-CIGAR50
(2) NA11-PIPEINT
(-8) NA11-PIPEINT
(-9) NA11-PIPEINT

[Have you/Has (SP)] smoked at least 50 cigars in [your/his/her] entire life?

(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED

NA10-CIGARNOW

(1) EVERY DAY
(2) SOME DAYS
(3) NOT AT ALL
(-8) DON'T KNOW
(-9) REFUSED

NA11-PIPEINT

CIGARNOW

NA10

yes/no

[Do you/Does (SP)] now smoke cigars every day, some days, or not at all?

PIPEINT

NA11

no entry

The next questions on tobacco products are about using a pipe to smoke tobacco.

BOX NA4

routing

If SP previously reported smoking tobacco in a pipe (sample_person.P_PIPEONE=1), go to NA13-PIPENOW.
Else go to NA12-PIPEONE.

BOX NA4

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2022 MCBS Community Questionnaire

Variable Name

PIPEONE

MR Screen Name

NA12

Question Type

yes/no

NAQ-NICOTINE AND ALCOHOL USE

Question Text/Description

Code List

Routing

[Have you/Has (SP)] ever smoked tobacco in a pipe, even once?

(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED

(1) NA13-PIPENOW
(2) NA14-ECIGINT
(-8) NA14-ECIGINT
(-9) NA14-ECIGINT

(1) EVERY DAY
(2) SOME DAYS
(3) NOT AT ALL
(-8) DON'T KNOW
(-9) REFUSED

NA14-ECIGINT

PIPENOW

NA13

code one

[Do you/Does (SP)] now smoke tobacco in a pipe every day, some days, or not at all?

ECIGINT

NA14

no entry

The next questions are about electronic cigarettes, often called e-cigarettes. E-cigarettes look like regular cigarettes,
but are battery-powered and produce vapor instead of smoke.

BOX NA5

routing

If SP previously reported using e-cigarettes (sample_person.P_ECIGONE=1), go to NA16-ECIGNOW.
Else go to NA15-ECIGONE.

ECIGONE

ECIGNOW

NA15

NA16

yes/no

code one

BOX NA5

[Have you/Has (SP)] ever used an e-cigarette, even once?

(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED

(1) NA16-ECIGNOW
(2) BOX NA5B
(-8) BOX NA5B
(-9) BOX NA5B

[Do you/Does (SP)] now use e-cigarettes every day, some days, or not at all?

(1) EVERY DAY
(2) SOME DAYS
(3) NOT AT ALL
(-8) DON'T KNOW
(-9) REFUSED

BOX NA5B

IF SP IS IN THE BASELINE INTERVIEW (sample_person.INTTYPE=3) AND [NA3-CIGNOW=(1) EVERY DAY OR
(2) SOME DAYS OR NA10-CIGARNOW=(1) EVERY DAY OR (2) SOME DAYS OR NA13-PIPENOW=(1) EVERY
DAY OR (2) SOME DAYS OR NA16-ECIGNOW=(1) EVERY DAY OR (2) SOME DAYS THEN GO TO NA25BDOCSMOK.
BOX NA5B

routing

ELSE IF P_DOCSMOK ^= 1 AND [NA3-CIGNOW=(1) EVERY DAY OR (2) SOME DAYS OR NA10CIGARNOW=(1) EVERY DAY OR (2) SOME DAYS OR NA13-PIPENOW=(1) EVERY DAY OR (2) SOME DAYS
OR NA16-ECIGNOW=(1) EVERY DAY OR (2) SOME DAYS, THEN GO TO NA26-CDOCSMOK.
ELSE GO TO NA17-ALCINT.

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2022 MCBS Community Questionnaire

Variable Name

BDOCSMOK

MR Screen Name

NA25

Question Type

NAQ-NICOTINE AND ALCOHOL USE

Question Text/Description

Code List

Routing

yes/no

Has a doctor or other health professional ever talked to [you/(SP)] about [your/his/her] smoking?

(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED

NA17-ALCINT

(1) YES
(2) NO
(-8) DON’T KNOW
(-9) REFUSED

NA17-ALCINT

CDOCSMOK

NA26

yes/no

Since (SAMPLE_PERSON.DATE_FALLRND) has a doctor or other health professional talked to [you/(SP)] about
[your/his/her] smoking?

ALCINT

NA17

no entry

The next questions are about drinking alcoholic beverages. Included are liquor (such as whiskey or gin), beer, wine,
wine coolers, and any other type of alcoholic beverage.

BOX NA7

routing

If SP reported having more than 12 alcoholic drinks in his/her lifetime (sample_person.P_ALCLIFE=1), go to NA20ALC12MN.
Else go to NA19-ALCLIFE.

ALCLIFE

NA19

yes/no

In [your/(SP)’s] entire life, [have you/has (he/she)] had at least 12 drinks of any type of alcoholic beverage?

BOX NA7

(1) YES
(2) NO
(-8) DON'T KNOW
(-9) REFUSED

(1) NA20-ALC12MN
(2) BOX ENDNAQ
(-8) BOX ENDNAQ
(-9) BOX ENDNAQ

(1) [continuous response]
(-8) DON'T KNOW
(-9) REFUSED
[996] NEVER / DOES NOT DRINK

NA20-ALC12MNU

In the past 12 months, how often did [you/(SP)] drink any type of alcoholic beverage?
[PROBE IF NECESSARY: How many days per week, per month, or per year did [you/(SP]) drink?]
ALC12MN

NA20

numeric

[ENTER QUANTITY AND UNIT.]
[FOR RESPONSES OF DON'T KNOW OR REFUSED, ENTER DON'T KNOW/REFUSED FOR BOTH QUANTITY
AND UNIT OF ALCOHOLIC BEVERAGES.]

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2022 MCBS Community Questionnaire

Variable Name

ALC12MNU

MR Screen Name

Question Type

NA20

quantity unit

BOX NA9

routing

NAQ-NICOTINE AND ALCOHOL USE

Question Text/Description

Code List

Routing

(1) WEEK
(2) MONTH
(3) YEAR
(-8) DON'T KNOW
(-9) REFUSED

BOX NA9

(1) [continuous response]
(-8) DON'T KNOW
(-9) REFUSED

NA22-ALCNDAY

If the SP didn't drink in the last 12 months (NA20 -ALC12MN = 996), go to NA23 - ALPERDAY.
Else go to NA21 - ALCDAY.

SHOWCARD NA1

ALCDAY

NA21

numeric

In the past 12 months, on those days that [you/(SP)] drank alcoholic beverages, on the average, how many drinks
did [you/he/she] have? (By a drink, I mean a 12 oz. beer, a 5 oz. glass of wine, or one and a half ounces of liquor.)
[ENTER NUMBER OF DRINKS.]
[ENTER '1' IF LESS THAN 1 DRINK.]
[ENTER '95' IF 95 OR MORE DRINKS.]

In the past 12 months, on how many days did [you/(SP)] have [5/4] or more drinks of any alcoholic beverage?

ALCNDAY

NA22

numeric

PROBE IF NECESSARY: How many days per week, per month, or per year did [you/(SP)] have [5/4] or more drinks
(1) [continuous response]
in a single day?
(-8) DON'T KNOW
(-9) REFUSED
[ENTER QUANTITY AND UNIT.]
[996] NONE

NA22-ALCNDAYU

[FOR RESPONSES OF DON'T KNOW OR REFUSED, ENTER DON'T KNOW/REFUSED FOR BOTH QUANTITY
AND UNIT OF ALCOHOLIC BEVERAGES.]

ALCNDAYU

NA22

quantity unit

(1) WEEK
(2) MONTH
(3) YEAR
(-8) DON'T KNOW
(-9) REFUSED

NA23-ALPERDAY

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2022 MCBS Community Questionnaire

Variable Name

ALPERDAY

MR Screen Name

NAQ-NICOTINE AND ALCOHOL USE

Question Type

Question Text/Description

Code List

Routing

NA23

yes/no

Was there ever a time or times in [your/(SP)'s] life when [you/he/she] drank [5/4] or more drinks of any kind of
alcoholic beverage almost every day?

(1) YES
(2) NO
(-8) DON'T KNOW
(-9) REFUSED

BOX NA8

BOX NA8

routing

If the SP didn't drink in the last 12 months (NA20 -ALC12MN = 996), go to BOX ENDNAQ.
Else go to NA24 - ALCTIME

(1) [continuous response]
(-8) DON'T KNOW
(-9) REFUSED

BOX ENDNAQ

Considering all types of alcoholic beverages, DURING THE PAST 30 DAYS, how many times did [you/SP] have [5
or more/4 or more] drinks on an occasion?
ALCTIME

NA24

numeric

BOX ENDNAQ

routing

[ENTER QUANTITY.]
[ENTER '0' FOR NEVER.]
[ENTER '95' IF 95 OR MORE TIMES.]

GO TO SCQ.

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