Web-based CAI Ques Web-based CAI Questionnaire

2025 National Household Survey on
Behavioral Health (NHSBH): Final Web
Specifications for Programming (English
Version)

Substance Abuse and Mental Health Services Administration
Center for Behavioral Health Statistics and Quality
Rockville, Maryland
Last Revised: July 30, 2024

2025 National Household Survey on Behavioral Health
(NHSBH): Final Web Specifications for Programming (English
Version)
Acknowledgments
This report was prepared for the Substance Abuse and Mental Health Services Administration
(SAMHSA), U.S. Department of Health and Human Services (HHS), under Contract No.
75S20322C00001 with RTI International. Marlon Daniel served as the government project
officer and as the contracting officer representative.
Public Domain Notice
All material appearing in this report is in the public domain and may be reproduced or copied
without permission from SAMHSA. Citation of the source is appreciated. However, this
publication may not be reproduced or distributed for a fee without the specific, written
authorization of the Office of Communications, SAMHSA, HHS.
Electronic Access
This publication may be downloaded at https://www.samhsa.gov/data/.
Recommended Citation
Center for Behavioral Health Statistics and Quality. (2024). 2025 National Household Survey on
Behavioral Health (NHSBH): Final web specifications for programming (English version).
Substance Abuse and Mental Health Services Administration.
Originating Office
Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health
Services Administration, 5600 Fishers Lane, Room 15-E09D, Rockville, MD 20857. For
questions about this report, please email [email protected].
Nondiscrimination Notice/Aviso de no discriminación
SAMHSA complies with applicable federal civil rights laws and does not discriminate on the
basis of race, color, national origin, age, disability, or sex. SAMHSA cumple con las leyes
federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad,
edad, discapacidad o sexo.
U.S. Department of Health and Human Services
Substance Abuse and Mental Health Services Administration
Center for Behavioral Health Statistics and Quality
Populations Survey Branch
Last Revised: July 30, 2024

ii

Content of 2025 NHSBH Instrument
#
1.
2.
3.
4.
5.

Module
Error! Not a valid result for table.
Core Demographics
Calendar (30-day and 12-month reference dates)
Front End Demographics
Front End Demographics

Mode of Administration
Web
Web
Web
Web
Web

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

QD03

Are you of Hispanic, Latino, or
Spanish origin or descent?
1
Yes
2
No
DK/REF
QD04 [IF QD03 = 1] Which of these
Hispanic, Latino, or Spanish groups
best describes you? Select all that
apply.
1

Mexican, Mexican American,
Mexicano, or Chicano
2
Puerto Rican
3
Central or South American
4
Cuban or Cuban American
5
Dominican (from Dominican
Republic)
6
Spanish (from Spain)
7
Other
DK/REF
QD04othr [IF QD04 = 7] Which other
Hispanic, Latino or Spanish group
best describes you?
_____________
DK/REF
PROGRAMMER: DO NOT
ALLOW BLANKS IN QD04othr.

iii

Required Aids
None
None
None
None
None

Page
1
7
11
13
17

QD05 Which of these groups describes you?
Select all that apply.
1

2

3
4

5

American Indian or Alaska
Native, including North
American, Central American,
and South American Indians
Asian, including Asian Indian,
Chinese, Filipino, Japanese,
Korean, and Vietnamese
Black or African American
Native Hawaiian or Other
Pacific Islander, including
Guamanian, Chamorro, and
Samoan
White

DK/REF

QD05PI

[IF QD05 = 4] Which of these
Pacific Islander groups
describes you? Select all that
apply.
1
Guamanian or
Chamorro
2
Native Hawaiian
3
Samoan
4
Other Pacific Islander
DK/REF

QD05PIO
[IF QD05PI = 4] Which other
Pacific Islander group or groups
describes you?
OTHER PACIFIC ISLANDER
GROUP: _____________
DK/REF
PROGRAMMER: DO NOT
ALLOW BLANKS IN
QD05PIO
QD05ASIA

[IF QD05 = 2] Which of these
Asian groups describes you?

iv

Select all that apply.
1
Asian Indian
2
Chinese
3
Filipino
4
Japanese
5
Korean
6
Vietnamese
7
Other Asian
DK/REF
QD05OTHA [IF QD05ASIA = 7] Which
other Asian group or groups
describes you?
OTHER ASIAN GROUP:
_____________
DK/REF
PROGRAMMER: DO NOT
ALLOW BLANKS IN
QD05OTHA.
QD05OTHR [IF QD05 = DK] 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

v

QD08 [IF QD07 = 1 OR 2 OR 3] How many
times have you been married?
NUMBER OF TIMES:
times
[RANGE: 1 - 9]
DK/REF
QD01 What sex were you assigned at birth,
on your original birth certificate?
5
9
GI01

Male
Female
What is your current gender?
Select all that apply.
1
2
3
4

GIOTH

Male
Female
Transgender
I use a different term
DK/REF

[IF GI01= 4] What term do you
use to describe your gender?
DK/REF

PROGRAMMER: DO NOT
ALLOW BLANKS IN GIOTH.
DEFINE SABFILL:
IF QD01 = 5, THEN SABFILL =
“male”
IF QD01 = 9, THEN SABFILL =
“female”
DEFINE GIFILL
IF GI01 = 1, THEN GIFILL = “male”
IF GI01 = 2, THEN GIFILL =
“female”
IF GI01 = 3, THEN GIFILL =
“transgender”
IF GI01 = 4 AND GIOTH NE
BLANK, THEN GIFILL = [FILL FROM
GIOTH]

vi

IF (GI01 = 4 AND GIOTH BLANK)
OR (GI01 = DK) OR (GI01 = REF), THEN
GIFILL = “unreported”
[Note to Programmers: GIFILL should
appear in lower case and, if GI01 has more
than response, be separated by commas and
the last GIFILL should be preceded by the
word “and”.]
CONFGI

Just to confirm, you reported
you were assigned [SABFILL]
at birth and your current gender
is [GIFILL]. Is that correct?
1
2

GICC01

Yes
No
[IF CONFGI = 2] Which
answer is correct?
1 I was assigned
[SABFILL] at birth
2 My current gender is
[GIFILL]
3 Neither answer is
correct
DK/REF

GICC02

[IF GICC01 = 2 OR 3]
What sex were you assigned
at birth, on your original
birth certificate?
5
9

GICC03

Male
Female

[IF GICC01 = 1 OR 3]
What is your current
gender?
To select more than one
gender from the list, press
the space bar between each
number you type. When you
have finished, press

vii

[ENTER].
1 Male
2 Female
3 Transgender
4 I use a different term
DK/REF
GICC04
[IF GICC03 = 4] What
term do you use to describe your
gender?
_____________
DK/REF
DEFINE RSEX:
IF CONFGI = 1, RSEX =
QD01
IF CONFGI = 2 AND
GICC02 = 5 OR 9, RSEX =
GICC02
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
2
Very Good
3
Good
4
Fair
5
Poor
DK/REF

Nicotine
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

Alcohol
Marijuana
Cocaine
Crack
Heroin
Hallucinogens
Error! Not a valid result for table.
Methamphetamine
Pain Relievers Screener
Tranquilizers Screener

Web
Web
Web
Web
Web
Web
Web
Web

None
None
None
None
None
None
None
None

51
67
81
91
101
113
165
179

Web
Web

None
None

191
199

viii

16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.

Error! Not a valid result for table.
Sedatives Screener
Pain Relievers Main Module
Tranquilizers Main Module
Error! Not a valid result for table.
Sedatives Main Module
Special Drugs
Risk/Availability Section
Blunts
Definitions for Use in the Substance Use Disorder
Module
Substance Use Disorder
Special Topics

Web
Web
Web
Web
Web
Web
Web
Web
Web
Web

None
None
None
None
None
None
None
None
None
None

203
209
213
265
299
343
377
385
391
397

Web
Web

None
None

399
463

Alcohol and Drug Treatment
Health
Mental Health Services Utilization
Social Environment

Web
Web
Web
Web: 18+ year-olds only
Web: parents of 12-17-year-olds

None
None
None
None
None

527
541
563
569
571

Web: 12-17-year-olds only
Web: 18+ year-olds only
Web: 18+ year-olds only

None
None
None

575
591
603

Web: 12-17-year-olds only
Web
Web
Web
Web
Web
Web
Web
Web
Web
Web (Proxy allowed)
Web (Proxy allowed)
Web

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

621
639
641
649
653
659
663
669
675
679
685
693
705

Parenting Experiences
Youth Experiences
Mental Health
Adult Depression
Error! Not a valid result for table.
Definitions for Use in Consumption of Alcohol Module
Consumption of Alcohol
Emerging Issues
Market Information for Marijuana
Back End Demographics
Education
Employment
Error! Not a valid result for table.
Proxy Information
Health Insurance
Error! Not a valid result for table.
IncentiveEnd of Interview

ix

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x

2025 National Household Survey on Behavioral Health
Web Instrument Revisions
Introduction
•

The computer-assisted interviewing (CAI) version number will be updated when the
programmed instrument is finalized.

•

Revised “Substance Abuse and Mental Health Services Treatment Referral Helpline” to
SAMHSA’s National Helpline in ACON2 and YCON2 to be consistent with other
helpfine refences in the questionnaire and materials.

Hallucinogens
•

This module has been updated to include followup questions for each hallucinogen.
Refusal conversion questions are now asked of each hallucinogen where the respondent
refuses an answer to the lifetime use question. Age of first use, recency, number of days
in the past 12 months, and number of days in the past 30 days are now asked of each
hallucinogen as well.

Risk/Availability Section
• RKQ1 through RK01k were revised to be asked only of adult participants.
Prior Substance Use
• This module has been deleted.
Special Topics
•

Questions on experiences with the criminal justice system not involving substance use
(SP03a-i, SP03l, SP03n-ssp, SP07-SP09) were removed.

Health
• The series of questions measuring height were simplified by eliminating the option to
choose to report height in meters and centimeters (HLTH04, HLTH07, HLTH08a, and
HLTH08b). The introductory text from HLTH04 was moved to HLTH05. The option to
report weight in kilograms (HLTH09, HLTH12, and HLTH14) was removed.
•
•

Questions measuring sleep disorders (SLPFALL, SLPSTAY, and SLPMED) were added
for adult respodnents only.
Questions measuring chronic pain (PAINP3M and PAINLIM) were added for adult
respondents only.

Parenting Experiences
•

Questions asking for parental perception of youth respondent’s drug use (PE04, PE05a,
PE05c) have been removed.

xi

Youth Experiences
•

Questions asking for respondent’s perception on school, their classmates’ possible
substance use, smoking, and how their parents would feel about them smoking, drinking
or using marijuana (YE11-YE13, CG02, CG03, YE16a-d, YE07a-c) were removed.

•

Questions measuring non-suicidial self-harm (SFHRMPY and SFHRMNUM) were
added.

Market Information for Marijuana
•

Questions about how much respondent paid for marijuana the last time they bought it,
marijuana bought in loose form, and joints (MJE04-MJE04R2, MJE08-MJE19) were
removed.

Employment
•

Questions about workplace drug and alcohol testing (QD47, QD48 and QD53) were
removed.

Health Insurance
•

Questions about the respondent’s substance use/mental health coverage in their health
insurance policy (QHI08, QHI09, QHI10) were removed.

Verification and Mental Illness Calibration Study Recruitment Screens
•

On INCENT01 “hotline” was revised to “helpline” for accuracy.

•

Recruitment screens for the Mental Illness Calibration Study were removed.

xii

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xiii

2025 National Household Survey on Behavioral Health:
Web Specifications for Programming
NHSBH Web Instrument Version: xx.xx
OMB Control #: 0930-0110
Expiration Date: XX/XX/XXXX
PROGRAMMER NOTES:
• All response options have been changed to sentence case but not marked as a change.
• Include a Next and Back navigation button at the bottom of every screen.
• If respondent clicks Next without entering a response, the screen will reload with a soft
error and DK/REF response options visible. A response must be selected to move to the
next screen.
SCREENER PRELOADS:
• Respondent age

–

•

Number of selected respondents in household

–

•

DEFINE RESAGE
IF RESPONDENT AGE FROM SCREENER ≥ 18, THEN RESAGE = 1,
ELSE RESAGE = 2

DEFINE FIPE1
IF TWO PERSONS SELECTED FOR AN INTERVIEW AT THIS SDU, THEN
FIPE1 = 1,
ELSE FIPE1 = 2

Youth selected

–

DEFINE YOUTH_SELECTED
IF NO PERSON 12-17 YEARS OLD SELECTED FOR INTERVIEW, THEN
YOUTH SELECTED = 0,
IF ONE PERSON 12-17 YEARS OLD SELECTED FOR INTERVIEW, THEN
YOUTH_SELECTED = 1,
ELSE YOUTH_SELECTED = 2

xiv

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xv

Introduction
LANG

Would you like to complete this interview in English or Spanish?
English
Spanish

ACON1

[IF RESAGE = 1] If you are using a mobile device, turn your device horizontally
for best display.
Before you begin, please ensure you are at home in a private location where no
one else can see your responses. It is recommended you complete the entire
interview in one sitting, which takes about an hour, depending on your answers.
This year, about 70,000 people across the nation will complete this interview.
You have been randomly chosen to take part. You may choose not to take part in
this study, but no one else can take your place. When you finish the interview,
you will receive a $30 gift card.
This study asks about tobacco, alcohol, and drug use or non-use, knowledge and
attitudes about drugs, mental health, and other health issues. The data you provide
are confidential. Only the combined responses from all study participants will be
reported, not just one person’s answers.
If you would like additional information about this study, please review the Study
Description available by clicking on this link: [INSERT LINK TO STUDY
DESCRIPTION]
While the interview has some personal questions, federal law keeps your answers
private. Your participation is voluntary. You can quit the interview at any time by
closing your browser window and you can refuse to answer any questions.
If you have to stop the interview, after 15 minutes you will be logged out
automatically and will need your Participant Code and PIN, that you will create,
to resume the interview at the point where you exited. However, if you stop the
interview and do not resume within 4 weeks from the day you initially began, all
of your answers will be removed for security purposes to protect your privacy –
you will still be able to complete the interview and receive a $30 gift card but you
will need to start over.

ACON2

You may consider some of the questions to be sensitive in nature and some
questions may also make you feel certain emotions, such as sadness. For example,
the interview asks questions about criminal history, depression, suicide and other
topics. Remember, you can refuse to answer any questions and you can stop the
interview at any time. If you become upset during the interview and wish to speak

1

to a mental health professional about how you are feeling, you can call the tollfree helpline number below.
The 988 Suicide & Crisis Lifeline
[IF FIPE4 = 1-51 OR 53] 988 (call or text)
http://988lifeline.org
[IF FIPE4 = 52] 1-800-981-0023
https://lineapas.assmca.pr.gov
If you feel you need to talk to someone about drug use issues, you can call the
Substance Abuse and Mental Health Services Administration’s National Helpline.

SAMHSA’s National Helpline (24-hour service for local treatment options)
1-800-662-HELP (4357)
1-800-487-4889 (TTY)
http://findtreatment.samhsa.gov
If you have any questions about the study, call 1-800-848-4079. If you have
questions about your rights as a study participant, call RTI’s Office of Research
Protection at 1-866-214-2043 (a toll-free number).
To start the interview, please check the acceptance box below to indicate you:
• are 18 years old or older,
• are a current resident of the selected household,
• are at home in a private location, and
• have read and understand the information provided to you about your
participation.
Then click “Next” to begin the interview.
If you do not wish to proceed with the interview, exit this screen by closing your
browser window.
[CHECK BOX] I’ve read the information above and agree to proceed with the
interview.
YCON1

[IF RESAGE = 2] If you are using a mobile device, turn your device horizontally
for best display.
Before you begin, please ensure you are at home in a private location where no
one else can see your responses. It is recommended you complete the entire
interview in one sitting, which takes about an hour, depending on your answers.
This year, about 70,000 people across the nation will complete this interview.
You have been randomly chosen to take part. You may choose not to take part in

2

this study, but no one else can take your place. When you finish the interview,
you will receive a $30 gift card.
This study asks about tobacco, alcohol, and drug use or non-use, knowledge and
attitudes about drugs, mental health, and other health issues. The data you provide
are confidential. Only the combined responses from all study participants will be
reported, not just one person’s answers.
If you would like additional information about this study, please review the Study
Description available by clicking on this link: [INSERT LINK TO STUDY
DESCRIPTION]
While the interview has some personal questions, federal law keeps your answers
private. Your participation is voluntary. You can quit the interview at any time by
closing your browser window and you can refuse to answer any questions.
Click Next to continue.
YCON2

[IF RESAGE = 2] If you have to stop the interview, after 15 minutes you will be
logged out automatically and will need your Participant Code and PIN, that you
will create, to resume the interview at the point where you exited. However, if
you stop the interview and do not resume within 4 weeks from the day you
initially began, all of your answers will be removed for security purposes to
protect your privacy – you will still be able to complete the interview and receive
a $30 gift card but you will need to start over.
You may consider some of the questions to be sensitive in nature and some
questions may also make you feel certain emotions, such as sadness. For example,
the interview asks questions about criminal history, depression, suicide and other
topics. Remember, you can refuse to answer any questions and you can stop the
interview at any time.
If you become upset during the interview and wish to speak to a mental health
professional about how you are feeling, you can call the toll-free helpline number
below.
The 988 Suicide & Crisis Lifeline
[IF FIPE4 = 1-51 OR 53] 988 (call or text)
http://988lifeline.org
[IF FIPE4 = 52] 1-800-981-0023
https://lineapas.assmca.pr.gov
If you feel you need to talk to someone about drug use issues, you can call the
Substance Abuse and Mental Health Services Administration’s National Helpline.

3

SAMHSA’s National Helpline (24-hour service for local treatment options)
1-800-662 HELP (4357)
1-800-487-4889 (TTY)
http://findtreatment.samhsa.gov
If you have any questions about the study, call 1-800-848-4079. If you have
questions about your rights as a study participant, call RTI’s Office of Research
Protection at 1-866-214-2043 (a toll-free number).
To start the interview, please check the acceptance box below to indicate you
have read and understand the information provided to you about your
participation.
Then click “Next” to begin the interview.
If you do not wish to proceed with the interview, exit this screen by closing your
browser window.
[CHECK BOX] I’ve read the information above and agree to proceed with the
interview.
YRESIDE

[IF RESAGE = 2] Are you a current resident of this household?
1
2

YNORES

Yes
No

[IF YRESIDE = 2] Since you are not a resident of this household, you are not
eligible to complete this interview. Please click Next to exit this interview.

PROGRAMMER: IF YNORES = NEXT, EXIT INTERVIEW
YPARENT

[IF RESAGE = 2] Is your parent or guardian at home?
1
Yes
2
No

YNOPAR

[IF YPARENT = 2] Please wait to complete this interview until your parent or
guardian is at home.
Click on Exit to exit the interview.

YPRIV

[IF RESAGE = 2] Are you at home in a private location?
1
2

Yes
No

4

YNOPRIV

[IF YPRIV = 2] Please move to a private location before beginning this interview.
Click next to continue when you are in a private location.

CREATED_PIN

[IF (ACON2 OR YCON2 = NEXT) AND NO PIN PREVIOUSLY
CREATED]
If you leave the survey for any reason, you will need your Participant
Code and PIN to reenter the survey. Please create a secret four-digit PIN.
This PIN will help keep your answers private.
Enter the PIN you wish to create. (4-digit number, not all zeros):
____ [ALLOW FOUR DIGITS, NOT ALL ZEROS]
Re-enter the PIN:
____ [ALLOW FOUR DIGITS, NOT ALL ZEROS]

HARD ERROR: [IF CREATED_PIN IS INVALID] Invalid PIN, please try again.
HARD ERROR: [IF PINS DO NOT MATCH] PINs do not match. Please try again.
PROGRAMMER NOTE: ENTERED_PIN WILL APPEAR IF A RESPONDENT BREAKSOFF
AND TRIES TO REENTER THE SURVEY AFTER A VALID PIN HAS BEEN CREATED.
ENTERED_PIN

[IF SURVEY RESUMED AFTER A VALID PIN WAS CREATED]
Please enter your PIN to resume the survey.
____ [ALLOW FOUR DIGITS, NOT ALL ZEROS]

HARD ERROR: [IF INCORRECT PIN IS ENTERED] Please enter your 4-digit PIN to resume
where you left off.

5

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6

Core Demographics
age1

What is your date of birth?
DOB: ________________
DK/REF
DEFINE CALCAGE:
CALCAGE = AGE CALCULATED BY “SUBTRACTING” DATE OF BIRTH FROM
DATE OF INTERVIEW.

HARD ERROR: [IF YEAR OF BIRTH ENTERED IS 2020]: Please check to make sure the date
of birth you have entered is correct.
HARD ERROR: [IF CALCAGE > 120]: Your age ([CALCAGE]) is greater than the maximum
age allowed. Please check to make sure the date of birth you have entered is correct.
AGEREF [IF AGE1 = DK OR REF] The interview cannot be completed without your age.
Please back up to enter your date of birth or click Next to exit the survey.
confirm

[IF AGE1 NE DK/REF] That would make you [CALCAGE] years old. Is this
correct?
1
Yes
2
No
DK/REF

AGEREF2

[IF CONFIRM = DK OR REF] The interview cannot be completed without your
age. Please back up to confirm your date of birth or click Next to exit the survey.

SCRAGE

[IF RESAGE = 1 AND CALCAGE < 18] This age does not match the age of the
person who was selected for this interview. If you are not AGE-FILL years old,
click Back to correct your date of birth. If you are AGE-FILL years old, click Exit
to exit the interview.

HARD ERROR: [IF CONFIRM = 2] Please go back to the previous question and correct your
date of birth. If your age is now correct, select Yes.
[IF CONFIRM = 2, GO BACK TO AGE1]
under12 [IF CONFIRM = 1 OR DK/REF AND CALCAGE < 12] Since you are [CALCAGE]
years old, you cannot complete the interview. Thank you for your time.
PROGRAM SHOULD ROUTE TO FIEXIT.

7

DEFINE CURNTAGE:
IF CALCAGE > 11 AND CONFIRM = 1, CURNTAGE = CALCAGE
ELSE RESPONDENT IS INELIGIBLE; ROUTE TO FIEXIT
FIPE4 In which state do you live?
________ [DROP DOWN WITH 50 STATES ,WASHINGTON D.C., PUERTO RICO,
AND U.S. VIRGIN ISLANDS]
QD09 [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
MILTERM1 [IF QD10 = 1] To verify, you are currently on active duty in the armed forces. Is
this correct?
1
Yes
2
No
DK/REF
MILTERM2 [IF MILTERM1 = 1] People who are currently on active duty in the armed forces
are not eligible to be interviewed in this study. Thank you for your time.
[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

8

QD10b1

[IF (QD10a=1)] When did you serve on active duty in the United States Armed
Forces or Reserve components? Select all that apply.
1
2
3
4
5
6
7
8
9

September 2001 or later
August 1990 to August 2001. including the 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

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

QD10c

1
Yes
2
No
DK/REF
QD11 What is the highest grade or year of school you have completed?
Please include junior or community college attendance. Do not include technical school
attendance.
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19

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 (AA, AS)
Bachelor’s Degree (BA, BS)
Master’s Degree (MA, MS, MEng, M. Ed, MSW, MBA)
Doctorate Degree (PhD, EdD)

9

20

Professional Degree Beyond a Bachelor’s Degree (MD, DDS, DVM, LLB, JD)
DK/REF

PROGRAMMER: DROP DOWN BOX FOR MOBILE

10

Calendar
calendar Throughout the rest of this interview, you will be asked 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, a calendar can be displayed in a new tab with the
beginning dates for each one of them.
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.
PROGRAMMER: Fill date on 30 day reference date field and highlight the 30-day
reference date. MAKE TEXT THAT SAYS ‘BLUE’ BLUE IN COLOR.
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.
calendr3 Please use the calendar as you go through the interview to help you remember when
different things happened.
To view the calendar, click on the calendar icon on the right.
PLAYINFO In some questions, you can click on a help button at the bottom left to see extra
information to help you answer a question.
PROGRAMMER: DISPLAY IN LOWER LEFT: [Help]
Extra information to help you answer a question will appear here.
Click [Help] again to close this message.

11

This page intentionally left blank.

12

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

QD03

Are you of Hispanic, Latino, or Spanish origin or descent?
1
Yes
2
No
DK/REF
QD04 [IF QD03 = 1] Which of these Hispanic, Latino, or Spanish groups best describes you?
Select all that apply.
1
Mexican, Mexican American, Mexicano, or Chicano
2
Puerto Rican
3
Central or South American
4
Cuban or Cuban American
5
Dominican (from Dominican Republic)
6
Spanish (from Spain)
7
Other
DK/REF
QD04othr [IF QD04 = 7] Which other Hispanic, Latino or Spanish group best describes you?
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN QD04othr.
QD05 Which of these groups describes you? Select all that apply.
1
2
3
4
5

American Indian or Alaska Native, including North American, Central American,
and South American Indians
Asian, including Asian Indian, Chinese, Filipino, Japanese, Korean, and
Vietnamese
Black or African American
Native Hawaiian or Other Pacific Islander, including Guamanian, Chamorro, and
Samoan
White

DK/REF

QD05PI

[IF QD05 = 4] Which of these Pacific Islander groups describes you? Select all
that apply.

13

3
Guamanian or Chamorro
4
Native Hawaiian
3
Samoan
4
Other Pacific Islander
DK/REF

QD05PIO

[IF QD05PI = 4] Which other Pacific Islander group or groups
describes you?
OTHER PACIFIC ISLANDER GROUP: _____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN QD05PIO

QD05ASIA

[IF QD05 = 2] Which of these Asian groups describes you? Select all that apply.
1
Asian Indian
2
Chinese
3
Filipino
4
Japanese
5
Korean
6
Vietnamese
7
Other Asian
DK/REF

QD05OTHA [IF QD05ASIA = 7] Which other Asian group or groups describes you?
OTHER ASIAN GROUP: _____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN QD05OTHA.
QD05OTHR [IF QD05 = DK] 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
2
3
4

Married
Widowed
Divorced or Separated
Have Never Married

14

DK/REF
QD08 [IF QD07 = 1 OR 2 OR 3] How many times have you been married?
NUMBER OF TIMES:
[RANGE: 1 - 9]
DK/REF

times

QD01 What sex were you assigned at birth, on your original birth certificate?
5
9
GI01

Male
Female
What is your current gender? Select all that apply.
5
6
7
8

GIOTH

Male
Female
Transgender
I use a different term
DK/REF

[IF GI01= 4] What term do you use to describe your gender?
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN GIOTH.

DEFINE SABFILL:
IF QD01 = 5, THEN SABFILL = “male”
IF QD01 = 9, THEN SABFILL = “female”
DEFINE GIFILL
IF GI01 = 1, THEN GIFILL = “male”
IF GI01 = 2, THEN GIFILL = “female”
IF GI01 = 3, THEN GIFILL = “transgender”
IF GI01 = 4 AND GIOTH NE BLANK, THEN GIFILL = [FILL FROM GIOTH]
IF (GI01 = 4 AND GIOTH BLANK) OR (GI01 = DK) OR (GI01 = REF), THEN
GIFILL = “unreported”
[Note to Programmers: GIFILL should appear in lower case and, if GI01 has more than
response, be separated by commas and the last GIFILL should be preceded by the word “and”.]
CONFGI

Just to confirm, you reported you were assigned [SABFILL] at birth and your
current gender is [GIFILL]. Is that correct?
3

Yes

15

4
GICC01

No
[IF CONFGI = 2] Which answer is correct?
1 I was assigned [SABFILL] at birth
2 My current gender is [GIFILL]
3 Neither answer is correct
DK/REF

GICC02

[IF GICC01 = 2 OR 3] What sex were you assigned at birth, on your original
birth certificate?
5
9

GICC03

Male
Female

[IF GICC01 = 1 OR 3] What is your current gender?
To select more than one gender from the list, press the space bar between
each number you type. When you have finished, press [ENTER].
1 Male
2 Female
3 Transgender
4 I use a different term
DK/REF

GICC04

[IF GICC03 = 4] What term do you use to describe your gender?

_____________
DK/REF
DEFINE RSEX:
IF CONFGI = 1, RSEX = QD01
IF CONFGI = 2 AND GICC02 = 5 OR 9, RSEX = GICC02
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
2
Very Good
3
Good
4
Fair
5
Poor
DK/REF

16

Nicotine
LEADCIG

These questions are about cigarette smoking.
Click Next 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
CG04 [IF CG01 = 1 OR CGREF1 = 1] How old were you the first time you smoked part or all
of a cigarette?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STCG:
IF CG04 NE (BLANK OR DK/REF) THEN AGE1STCG = CG04
ELSE AGE1STCG = BLANK
IF CURNTAGE < AGE1STCG
CGCC01 You were [AGE1STCG] years old when you first smoked part or all of
a cigarette. Is this correct?
4
Yes
6
No
DK/REF

17

CGCC02 [IF CGCC01 = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
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

1
2

CGCC03 [IF CGCC02 = 2 OR CGCC02 = 3] Please answer this question
again. What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
CGCC03a [IF CGCC03 < 12] Since you have indicated that
you are [CGCC03 AGE] years old, we cannot
interview you for this study. Thank you for your
cooperation. PROGRAM SHOULD ROUTE TO
FIEXIT.
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:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF CGCC04 NOT(BLANK OR DK/REF) THEN AGE1STCG = CGCC04
UPDATE: IF CGCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = CGCC03
IF AGE1STCG < 10:
CGCC05 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:
years old
[RANGE: 1 - 110]
DK/REF
18

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
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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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?

19

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 CG02a = 2 AND CG04d > CURRENT MONTH] The month in
[CURRENT YEAR] you entered has not begun yet. Please answer this question again, then
click Next to continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
DEFINE MYR1STCG:
MYR1STCG = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (CG04a-d). IF MONTH OF
FIRST USE = MONTH OF BIRTH, THEN MYR1STCG IS BLANK.
IF MYR1STCG NE 0 AND NE AGE1STCG:
CGCC19 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, you reported that you were [AGE1STCG]
years old when you first smoked part or all of a cigarette. Which
answer is correct?
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

1

20

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
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 CGCC21a > CURRENT MONTH] The month in [CURRENT YEAR]
you entered has not begun yet. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] You first smoked part or all of a cigarette in
[CGCC21-CGCC21a fill]. That would make you [MYR1STCG] years
old when you first smoked part or all of a cigarette. Is this correct?
4
Yes
6
No
DK/REF
21

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
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

days in the past 30 days

22

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”
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
23

CGMENTH1 [IF CG05 = 1] Were the cigarettes you smoked most often during the past 30
days menthol?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
CG14 [IF CG05 = 1] 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) 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:
years old
[RANGE: 1-110]
DK/REF
DEFINE DAILYCIG:
DAILYCIG = CG16
IF DAILYCIG < AGE1STCG
CGCC07 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?

24

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
1

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:
[RANGE: 1-110]
DK/REF

years old

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?
AGE:
years old
[RANGE: 1-110]
DK/REF
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 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?

25

AGE:
years old
[RANGE: 1 - 110]
DK/REF
CGCC13a [IF CGCC13 < 12] Since you have indicated that you are [CGCC13]
years old, we cannot interview you for this study. Thank you for your
cooperation.
PROGRAM SHOULD ROUTE TO FIEXIT.
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:
years old
[RANGE: 1- 110]
DK/REF
UPDATE: IF CGCC13 NOT (BLANK OR DK/REF) THEN CURNTAGE = CGCC13
UPDATE: IF CGCC14 NOT (BLANK OR DK/REF) THEN DAILYCIG = CGCC14
CG16y1

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

CG16y2

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

CG16m1 [IF DAILYCIG = CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what
month in [CURRENT YEAR] did you first start smoking cigarettes every day?
1
2
3
4

January
February
March
April

26

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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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
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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 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?
27

4
Yes
6
No
DK/REF
CGCC16 [IF CGCC15 = 4] Earlier, you reported that you were [DAILYCIG]
years old when you first started smoking cigarettes every day. Which
answer is correct?
I first started smoking cigarettes every day in [CG16y1-m2 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

1

UPDATE: IF CGCC16 = 1, THEN DAILYCIG = MYR1STDC
CGCC17 [IF CGCC16=2 OR CGCC16=3 OR CGCC15=6] Please answer this
question again. Did you first start smoking cigarettes every day in
[CURRENT YEAR -2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
CGCC17a [IF CGCC17 NE (BLANK OR DK/REF)] Please answer this question
again. In what month in [CGCC17] did you first start smoking
cigarettes every day?
1
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

28

HARD ERROR: [IF CGCC17a > CURRENT MONTH] The month in [CURRENT YEAR]
you entered has not begun yet. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] You first started smoking cigarettes
every day in [CGCC17-CGCC17a fill]. That would make you
[MYR1STDC] years old when you first started smoking cigarettes
every day. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF CGCC18 NE (6, BLANK OR DK/REF) AND (CGCC17 AND CGCC17a NE
CG16y1-CG16m2) THEN DAILYCIG = MYR1STDC
CG16a [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
VPINTRO The next questions are about vaping nicotine with e-cigarettes or other vaping
devices. These devices might also be called vapes, vape pens, or mods. When
answering, please include any device that heats a liquid containing nicotine into a
vapor.
Click Next to continue.
VPLIF [PROGRAMMER, SHOW IN GRAY FONT: The next questions are about vaping
nicotine with e-cigarettes or other vaping devices. These devices might also be called
vapes, vape pens, or mods. When answering, please include any device that heats a
liquid containing nicotine into a vapor.]

29

Have you ever, even once, vaped nicotine with an e-cigarette or other vaping device?
1
Yes
2
No
DK/REF
VPLIFREF [IF VPLIF = REF] The answers that people give us about vaping nicotine with ecigarettes or other vaping devices 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, vaped
nicotine with an e-cigarette or other vaping device?
1
Yes
2
No
DK/REF
VPFT [IF VPLIF = 1 OR VPLIFREF = 1] How old were you the first time you vaped nicotine
with an e-cigarette or other vaping device?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE ENNICAGE:
IF VPFT NE (BLANK OR DK/REF) THEN ENNICAGE = VPFT
ELSE ENNICAGE = BLANK
IF CURNTAGE < ENNICAGE
CGEN01 You were [ENNICAGE] years old when you first vaped nicotine with
an e-cigarette or other vaping device. Is this correct?
4
Yes
6
No
DK/REF
CGEN02 [IF CGEN01=4] The answers for the last question and an earlier
question disagree. Which answer is correct?
I am currently [CURNTAGE] years old
I was [ENNICAGE] years old the first time I vaped nicotine
with an e-cigarette or other vaping device
3
Neither answer is correct
DK/REF

1
2

30

CGEN03 [IF CGEN02 = 2 OR CGEN02 = 3] Please answer this question
again. What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
CGEN03a [IF CGEN03 < 12] Since you have indicated that you are [CGEN03
AGE] years old, we cannot interview you for this study. Thank you for
your cooperation. PROGRAM SHOULD ROUTE TO PENTER1.
CGEN04 [IF CGEN02 = 1 OR CGEN 02 = 3 OR CGEN 01 = 6] Please answer
this question again. How old were you the first time you vaped
nicotine with an e-cigarette or other vaping device?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF CGEN04 NOT (BLANK OR DK/REF) THEN ENNICAGE = CGEN04
UPDATE: IF CGEN03 NOT (BLANK OR DK/REF) THEN CURNTAGE = CGEN03
IF ENNICAGE < 10:
CGEN05 You were [ENNICAGE] years old when you first vaped nicotine with
an e-cigarette or other vaping device. Is this correct?
4
Yes
6
No
DK/REF
CGEN06 [IF CGEN05 = 6] Please answer this question again. How old were
you the first time you vaped nicotine with an e-cigarette or other
vaping device?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF CGEN06 NOT (BLANK OR DK/REF) THEN ENNICAGE = CGEN06
VPFTYRa [IF CGEN05 NE DK/RE AND CGEN06 NE DK/REF AND ENNICAGE =
CURNTAGE AND DATE OF INTERVIEW < DOB OR IF ENNICAGE =
CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first vape
nicotine with an e-cigarette or other vaping device in [CURRENT YEAR - 1] or
[CURRENT YEAR]?

31

1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
VPFTYRb [IF ENNICAGE = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you first vape nicotine with an e-cigarette or other vaping device in [CURRENT
YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
VPFTMOa

[IF CGEN05 NE DK/RE AND CGEN06 NE DK/REF AND ENNICAGE =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in
[CURRENT YEAR] did you first vape nicotine with an e-cigarette or other
vaping device?
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 VPFTMOa > CURRENT MONTH]
The month in [CURRENT YEAR] you entered has not begun yet. Please answer this
question again, then click Next to continue.
VPFTMOb

[IF (VPFTYRa = 1 OR 2) OR (VPFTYRb = 1 OR 2)] In what month in [YEAR
FROM VPFTYRa or VPFTYRb] did you first vape nicotine with an e-cigarette
or other vaping device?
1
2
3
4
5
6

January
February
March
April
May
June

32

7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF VPFTYRa = 2 AND VPFTMOb > CURRENT MONTH] The month
in [CURRENT YEAR] you entered has not begun yet. Please answer this question again,
then click Next to continue.
DEFINE MYR1STEN:
MYR1STEN = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (VPFTYRa-VPFTMOb). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STEN IS BLANK.
IF MYR1STEN NE 0 AND NE ENNICAGE:
CGEN07 You first vaped nicotine with an e-cigarette or other vaping device in
[VPFTYRa-VPFTMOb fill]. That would make you [MYR1STEN]
years old when you first vaped nicotine with an e-cigarette or other
vaping device. Is this correct?
4
Yes
6
No
DK/REF
CGEN08 [IF CGEN07 = 4] Earlier, you reported that you were [ENNICAGE]
years old when you first vaped nicotine with an e-cigarette or other
vaping device. Which answer is correct?
1

I first vaped nicotine with an e-cigarette or other vaping device
in [VPFTYRa-VPFTMOb fill] when I was [MYR1STEN]
years old
2
I was [ENNICAGE] years old the first time I vaped nicotine
with an e-cigarette or other vaping device
3
Neither answer is correct
DK/REF

UPDATE: IF CGEN08 = 1, THEN ENNICAGE = MYR1STEN.
CGEN09 [IF CGEN08=2 OR CGEN08=3 OR CGEN07=6] Please answer this
question again. Did you first vape nicotine with an e-cigarette or other
vaping device in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?

33

1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
CGEN09a [IF CGEN09 NE (BLANK OR DK/REF)] Please answer this question
again. In what month in [CGEN09] did you first vape nicotine with an
e-cigarette or other vaping device?
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 CGEN09 = 3 AND CGEN09a > CURRENT MONTH]
The month in [CURRENT YEAR] you entered has not begun yet. Please answer this
question again, then click Next to continue.
UPDATE: IF CGEN09a NE (BLANK OR DK/REF) THEN UPDATE MYR1STEN.
MYR1STEN = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF
BIRTH FROM MONTH AND YEAR OF FIRST USE (CGEN09 AND CGEN09a). IF MONTH
OF FIRST USE = MONTH OF BIRTH, THEN MYR1STEN IS BLANK. IF MYR1STEN =
ENNICAGE THEN MYR1STEN = 0
CGEN10 [IF CGEN08 NE 1 AND MYR1STEN NE 0 AND (YEAR FROM
CGEN09 NE YEAR FROM VPFTYRa OR VPFTYRb AND MONTH
FROM CGEN09a NE MONTH FROM VPFTMOa OR VPFTMOb)]
You first vaped nicotine with an e-cigarette or other vaping device in
[CGEN09-CGEN09a fill]. That would make you [MYR1STEN] years
old when you first vaped nicotine with an e-cigarette or other vaping
device. Is this correct?
4
Yes
6
No
DK/REF

34

UPDATE: IF CGEN10 NE (6, BLANK OR DK/REF) AND ((CGEN09 NE VPFTYRa AND
VPFTYRa NE (BLANK OR DK/REF)) OR (CGEN09 NE VPFTYRb AND VPFTYRb NE
(BLANK OR DK/REF)) OR (CGEN09a NE VPFTMOa AND VPFTMOa NE (BLANK OR
DK/REF)) OR (CGEN09a NE VPFTMOb AND VPFTMOb NE (BLANK OR DK/REF)))
THEN ENNICAGE = MYR1STEN
VPPM [IF VPLIF = 1 OR VPLIFREF = 1] Now think about the past 30 days, that is, from
[DATEFILL] up to and including today. During the past 30 days, have you vaped
nicotine with an e-cigarette or other vaping device?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
VPREC [IF VPPM = 2] How long has it been since you last vaped nicotine with an e-cigarette
or other vaping device?
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
VPRECDK [IF VPREC = DK] What is your best guess of how long it has been since you last
vaped nicotine with an e-cigarette or other vaping device?
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
VPRECREF [IF VPREC = REF] The answers that people give us about vaping nicotine with ecigarettes and other vaping devices 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 vaped nicotine with an e-cigarette or other vaping device?
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
VPPMNUM [IF VPPM = 1] During the past 30 days, that is, since [DATEFILL], on how
many days did you vape nicotine with an e-cigarette or other vaping device?
# OF DAYS:

days in the past 30 days

35

[RANGE: 1-30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
VPPMNUNR [IF VPPMNUM = DK OR REF] What is your best estimate of the number of
days you vaped nicotine with an e-cigarette or other vaping device 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
SMINTRO

The next questions are about your use of smokeless tobacco such as snuff, dip,
chewing tobacco, or snus.
Click Next to continue.

CG25 [PROGRAMMER, SHOW IN GRAY FONT: The next questions are about your use of
smokeless tobacco such as snuff, dip, chewing tobacco, or snus.]
Have you ever, even once, used smokeless tobacco?
1
Yes
2
No
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click [Help] if you want
to see how to say snus.
Snus [snooz]
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, even once, used
smokeless tobacco?
1
Yes
2
No
DK/REF

36

CG26 [IF CG25 = 1 OR CGREF3 = 1] How old were you the first time you used smokeless
tobacco?
YEARS OLD:
[RANGE: 1 - 110]
DK/REF

years old

DEFINE SNUFFAGE:
IF CG26 NE (BLANK OR DK/REF) THEN SNUFFAGE = CG26
ELSE SNUFFAGE = BLANK
IF CURNTAGE < SNUFFAGE
CGSN01 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?
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

1
2

CGSN03 [IF CGSN02 = 2 OR CGSN02 = 3] Please answer this question again.
What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
CGSN03a [IF CGSN03 < 12] Since you have indicated that you are [CGSN03
AGE] years old, we cannot interview you for this study. Thank you for
your cooperation.
PROGRAM SHOULD ROUTE TO FIEXIT.
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:
years old
[RANGE: 1 - 110]
DK/REF
37

UPDATE: IF CGSN04 NOT(BLANK OR DK/REF) THEN SNUFFAGE = CGSN04
UPDATE: IF CGSN03 NOT(BLANK OR DK/REF) THEN CURNTAGE = CGSN03
IF SNUFFAGE < 10:
CGSN05 You were [SNUFFAGE] years old the first time you used smokeless
tobacco. Is this correct?
4
Yes
6
No
DK/REF
CGSN06 [IF CGSN05 = 6] Please answer this question again. How old were
you the first time you used smokeless tobacco?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
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
2
3
4

January
February
March
April

38

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 [CURRENT YEAR]
you entered has not begun yet. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 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?

39

4
Yes
6
No
DK/REF
CGSN08 [IF CGSN07 = 4] Earlier, you reported that you were [SNUFFAGE]
years old when you first used smokeless tobacco. Which answer is
correct?
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
1

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. Please answer this question again, then click Next to
continue.
40

PROGRAMMER: DROP DOWN BOX FOR MOBILE
UPDATE: IF CGSN09a NE (0 OR DK/REF) THEN UPDATE MYR1STSN.
MYR1STSN = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF
BIRTH FROM MONTH AND YEAR OF FIRST USE (CGSN09 AND CGSN09a). IF MONTH
OF FIRST USE = MONTH OF BIRTH, THEN MYR1STSN IS BLANK. IF MYR1STSN =
SNUFFAGE THEN MYR1STSN = BLANK.
CGSN10 [IF CGSN08 NE 1 AND MYR1STSN NE 0 AND (CGSN09 AND
CGSN09a NE CG26a-d)] 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

41

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?
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:
days in the past 30 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
CRINTRO

The next questions are about smoking cigars made only of tobacco, such as
cigarillos, big cigars, and little cigars that look like cigarettes.
Click Next to continue.

CG34 [PROGRAMMER, SHOW IN GRAY FONT: The next questions are about smoking
cigars, made only of tobacco, such as cigarillos, big cigars, and little cigars that look like
cigarettes.]
Have you ever, even once, smoked part or all of a cigar or cigarillo?
1
Yes
2
No
DK/REF

42

CGREF4 [IF CG34 = REF] The answers that people give us about their cigar or cigarillo
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, even once, smoked
part or all of a cigar or cigarillo?
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 a cigar or cigarillo?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE CIGARAGE:
IF CG35 NE (BLANK OR DK/REF) THEN CIGARAGE = CG35
ELSE CIGARAGE = BLANK
IF CURNTAGE < CIGARAGE
CGCR01 You were [CIGARAGE] years old when you first smoked part or all of
a cigar or cigarillo. 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?
I am currently [CURNTAGE] years old
I was [CIGARAGE] years old the first time I smoked part or
all of a cigar or cigarillo
3
Neither answer is correct
DK/REF

1
2

CGCR03 [IF CGCR02 = 2 OR CGCR02 = 3] Please answer this question
again. What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF

43

CGCR03a [IF CGCR03 < 12] Since you have indicated that you are [CGCR03
AGE] years old, we cannot interview you for this study. Thank you for
your cooperation.
PROGRAM SHOULD ROUTE TO FIEXIT.
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 or cigarillo?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF CGCR04 NOT(BLANK OR DK/REF) THEN CIGARAGE = CGCR04
UPDATE: IF CGCR03 NOT(BLANK OR DK/REF) THEN CURNTAGE = CGCR03
IF CIGARAGE < 10:
CGCR05 You were [CIGARAGE] years old when you first smoked part or all of
a cigar or cigarillo. 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 or cigarillo?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
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 or cigarillo in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF

44

CG35b [IF CIGARAGE = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you
first smoke part or all of a cigar or cigarillo 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 or cigarillo?
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 CG35c > CURRENT MONTH] The month in [CURRENT YEAR]
you entered has not begun yet. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 or cigarillo?
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
45

HARD ERROR: [IF CG35d > CURRENT MONTH] The month in [CURRENT YEAR]
you entered has not begun yet. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 You first smoked part or all of a cigar or cigarillo in [CG35a-d fill].
That would make you [MYR1STCR] years old when you first smoked
part or all of a cigar or cigarillo. Is this correct?
4
Yes
6
No
DK/REF
CGCR08 [IF CGCR07 = 4] Earlier, you reported that you were [CIGARAGE]
years old when you first smoked part or all of a cigar or cigarillo.
Which answer is correct?
I first smoked part or all of a cigar or cigarillo 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 or cigarillo
3
Neither answer is correct
DK/REF

1

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 or cigarillo
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 or cigarillo?

46

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 [CURRENT YEAR]
you entered has not begun yet. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] You first smoked part or all of a cigar or
cigarillo in [CGCR09-CGCR09a fill]. That would make you
[MYR1STCR] years old when you first smoked part or all of a cigar
or cigarillo. 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 a cigar or cigarillo?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
47

CG37 [IF CG36 = 2] How long has it been since you last smoked part or all of a cigar or
cigarillo?
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 a cigar or cigarillo?
1
More than 30 days ago but within the past 12 months
2
More than 12 months ago but within the past 3 years
3
More than 3 years ago
DK/REF
CG37RE [IF CG37 = REF] The answers that people give us about their cigar or cigarillo
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 cigar or cigarillo?
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 or cigarillo?
# OF DAYS:
days in the past 30 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 or cigarillo 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

48

PROGRAMMER: SHOW 30 DAY CALENDAR
CG42 The last questions on tobacco products are about using a pipe to smoke tobacco. Have
you ever, even once, smoked tobacco in a pipe?
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, even once, 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

49

This page intentionally left blank.

50

Alcohol
ALCINTR1 For these questions, a “drink” means a can or bottle of beer or hard seltzer, a glass
of wine or a wine cooler, a shot of liquor, or a drink with liquor in it.
PROGRAMMER: DISPLAY IN LOWER LEFT: Click [Help] to
see examples of alcoholic beverages.
Beer and Seltzers
Regular beer, lite or light beer, hard cider,
hard seltzer, or malt liquor.
Wine
Red or white wine, rosé, Champagne,
fortified wines, or wine coolers.
Liquor
Bourbon, Scotch, Gin, Tequila, Rum, or
Vodka.
Liqueurs, Cordials, and Brandy
Brandy, Schnapps, Kahlua, or Triple sec.
Mixed Drinks and Cocktails
Bloody Mary, Irish coffee, Margarita
Daiquiri, Martini or canned cocktail.

Click Next 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.

51

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:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STAL:
IF AL02 NE (BLANK OR DK/REF) THEN AGE1STAL = AL02
ELSE AGE1STAL = BLANK
IF CURNTAGE < AGE1STAL:
ALCC01 You were [AGE1STAL] years old when you first drank an alcoholic
beverage. Is this correct?
4
Yes
6
No
DK/REF
ALCC02 [IF ALCC01 = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
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

1
2

ALCC03 [IF ALCC02=2 OR ALCC02=3] Please answer this question again.
What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
ALCC03a [IF ALCC03 < 12] Since you have indicated that you are [ALCC03]
years old, we cannot interview you for this study. Thank you for your
cooperation.
PROGRAM SHOULD ROUTE TO FIEXIT.

52

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:
years old
[RANGE: 1 - 110]
DK/REF
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 You were [AGE1STAL] years old the first time you had a drink of any
alcoholic beverage. Is this correct?
4
Yes
6
No
DK/REF
ALCC06 [IF ALCC05=6] Please answer this question again. Think about the
first time you had a drink of an alcoholic beverage. How old were you
the first time you had a drink of any alcoholic beverage? Please do
not include times when you only had a sip or two from a drink.
AGE:
years old
[RANGE: 1 - 110]
DK/REF
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]?

53

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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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. Please answer this question again, then click Next to
54

continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 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, you reported that you were [AGE1STAL]
years old when you first had a drink of an alcoholic beverage. Which
answer is correct?
I first had a drink of an alcoholic beverage in [AL02a-d 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
1

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

55

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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
UPDATE: IF ALCC33a NE (0 OR DK/REF) THEN UPDATE MYR1STAL.
MYR1STAL = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF
BIRTH FROM MONTH AND YEAR OF FIRST USE (ALCC33 AND ALCC33a). IF MONTH
OF FIRST USE = MONTH OF BIRTH, THEN MYR1STAL IS BLANK. IF MYR1STAL =
AGE1STAL THEN MYR1STAL = BLANK
ALCC34 [IF ALCC32 NE 1 AND MYR1STAL NE 0 AND (ALCC33 AND
ALCC33a NE AL02a-d)] 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

56

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

57

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:
days in the past 12 months
[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:
days per month, on average
[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:
days per week, on average
[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:

58

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:
days in the past 30 days
[RANGE: 1 - 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
ELSE ESTIALC = BLANK
59

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, you reported
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, you reported 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?
I drank alcohol on [FILL1] in the past 12 months [FILL1A]
I drank alcohol on [ALC30DAY / ALCESTFL] days in the
past 30 days
3
Neither answer is correct
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
1
2

ALCC19 [IF ALCC18 = 2 OR ALCC18 = 3] Please answer this question again.
Think about the past 12 months, from [DATEFILL] through today.
We want to know how many days you’ve had a drink of an alcoholic
beverage during the past 12 months.
What would be the easiest way for you to tell us how many days you
drank alcoholic beverages?
60

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:
days in the past 12 months
[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:
days per month, on average
[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:
days per week, on average
[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 days, on how many days
did you drink one or more drinks of an alcoholic beverage?
# OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

61

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”
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

62

UPDATE: IF ALCC26 NOT (BLANK OR DK/REF) THEN ALC30DAY = ALCC26
DEFINE ALC30USE:
IF (ALLAST3 = 1 OR ALRECDK = 1 OR ALRECRE = 1) 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 or hard seltzer, a glass of wine or a
wine cooler, a shot of liquor, or a drink with liquor in it.
[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 or hard seltzer, a glass of
wine or a wine cooler, a shot of liquor, or a drink with liquor in it.
[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 or
hard seltzer, a glass of wine or a wine cooler, a shot of liquor, or a drink with liquor in it.
# OF DRINKS:
drinks each day in the past 30 days
[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 RSEX=5 THEN
FILL 5 IF RSEX=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:
days in the past 30 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 In the past 30 days you drank [IF RSEX=5 THEN FILL 5 IF RSEX=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

63

ALCC28 [IF ALCC27 = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
I drank one or more alcoholic beverages on [ALC30DAY /
ALCESTFL] days in the past 30 days
2
I drank [IF RSEX=5 THEN FILL 5 IF RSEX=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
1

ALCC29a [IF ALCC28 = 2 OR 3 AND ALC30DAY NE (BLANK OR DK/REF)]
Please answer this question again. Think specifically about the past 30
days, that is from [DATEFILL] through today. During the past 30
days, on how many days did you drink one or more drinks of an
alcoholic beverage?
# OF DAYS:
days in the past 30 days
[RANGE: 1 -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 RSEX=5 THEN FILL 5 IF RSEX=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:

days in the past 30 days

64

[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
UPDATE BINGEFLAG:
IF ALCC30 = 1-30 THEN BINGEFLAG = 1
ELSE IF DK/REF THEN BINGEFLAG=0

65

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66

Marijuana
CBDINTRO The next questions are about CBD or hemp products made from hemp plants.
CBD and hemp products have no or small amounts of THC and are not intended
to cause a “high.” They come in many forms including oils, lotions, edibles, and
isolate. People sometimes use them to relieve pain, to reduce anxiety, or to help
them sleep.
Click Next to continue.
CBDLIF

[PROGRAMMER, SHOW IN GRAY FONT: The next questions are about CBD
or hemp products made from hemp plants. CBD and hemp products have no or
small amounts of THC and are not intended to cause a “high.” They come in
many forms including oils, lotions, edibles, and isolate. People sometimes use
them to relieve pain, to reduce anxiety, or to help them sleep.]
Have you ever, even once, used any CBD or hemp products?
1
Yes
2
No
DK/REF

CBDLAST

[IF CBDLIF=1] How long has it been since you last used any form of CBD or
hemp product?
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 but within the past 3 years
4
More than 3 years ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

MRJINTRO The next questions are about marijuana and cannabis products, sometimes called
pot, weed, hashish, or concentrates. Some of the ways these products can be used
are smoking (such as in joints, pipes, bongs, blunts, or hookahs), vaping (using
vape pens, dab pens, tabletop vaporizers, or portable vaporizers), dabbing, eating
or drinking, or applying as a lotion.
[IF CBDLIF=1, DK/REF: Please exclude your use of CBD or hemp products
when answering these questions.] Any cannabis product
Click Next to continue.
MJ01

[PROGRAMMER, SHOW IN GRAY FONT: The next questions are about
marijuana and cannabis products, sometimes called pot, weed, hashish, or

67

concentrates. Some of the ways these products can be used are smoking (such as
in joints, pipes, bongs, blunts, or hookahs), vaping (using vape pens, dab pens,
tabletop vaporizers, or portable vaporizers), dabbing, eating or drinking, or
applying as a lotion.]
[IF CBDLIF=1, DK/REF: Please exclude your use of CBD or hemp products
when answering these questions.]
Have you ever, even once, used marijuana or any cannabis product?
1
Yes
2
No
DK/REF
MJREF

[IF MJ01 = REF] The answers that people give us about their use of marijuana or any
cannabis product 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 any cannabis product?
1
Yes
2
No
DK/REF

MJ02 [IF MJ01 =1 OR MJREF = 1] How old were you the first time you used marijuana or
any cannabis product?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STMJ:
IF MJ02 NE (BLANK OR DK/REF) THEN AGE1STMJ = MJ02
ELSE AGE1STMJ = BLANK
IF CURNTAGE < AGE1STMJ:
MJCC01 You were [AGE1STMJ] years old when you first used marijuana or
any cannabis product. Is this correct?
4
Yes
6
No
DK/REF
MJCC02 [IF MJCC01 = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?

68

I am currently [CURNTAGE] years old
I was [AGE1STMJ] years old the first time I used marijuana
or any cannabis product
3
Neither answer is correct
DK/REF

1
2

MJCC03 [IF MJCC02=2 OR MJCC02=3] Please answer this question again.
What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
MJCC03a [IF MJCC03 < 12] Since you have indicated that you are [MJCC03]
years old, we cannot interview you for this study. Thank you for your
cooperation.
PROGRAM SHOULD ROUTE TO FIEXIT.
MJCC04 [IF MJCC02=1 OR MJCC02=3 OR MJCC01=6] Please answer this
question again. Think about the first time you used marijuana or any
cannabis product. How old were you the first time you used marijuana
or any cannabis product?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF MJCC04 NOT(BLANK OR DK/REF) THEN AGE1STMJ = MJCC04
UPDATE: IF MJCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = MJCC03
IF AGE1STMJ <10:
MJCC05 You were [AGE1STMJ] years old the first time you used marijuana or
any cannabis product. 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 any cannabis product. How old were
you the first time you used marijuana or any cannabis product?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
69

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 any cannabis
product 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 any cannabis product 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 any cannabis product?
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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
MJ03d [IF MJ03a = 1 - 2 OR MJO3b = 1 - 2] In what month in [YEAR FROM MJ03a or
MJ03b] did you first use marijuana or any cannabis product?

70

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 MJ03a = 2 AND MJ03d > CURRENT MONTH] The month in
[CURRENT YEAR] you entered has not begun yet. Please answer this question again, then
click Next to continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 You first used marijuana or any cannabis product in [MJ03a-d fill].
That would make you [MYR1STMJ] years old when you first used
marijuana or any cannabis product. Is this correct?
4
Yes
6
No
DK/REF
MJCC18 [IF MJCC17 = 4] Earlier, you reported that you were [AGE1STMJ]
years old when you first used marijuana or any cannabis product.
Which answer is correct?
I first used marijuana or any cannabis product in [MJ03a-d
fill] when I was [MYR1STMJ] years old
2
I was [AGE1STMJ] years old the first time I used marijuana
or any cannabis product
3
Neither answer is correct
DK/REF
1

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

71

MJCC19 [IF MJCC18=2 OR MJCC18=3 OR MJCC17=6] Please answer this
question again. Did you first use marijuana or any cannabis product
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 any
cannabis product?
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 MJCC19 = 3 AND MJCC19a > CURRENT MONTH] The month in
[CURRENT YEAR] you entered has not begun yet. Please answer this question again, then
click Next to continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] You first used marijuana or any cannabis
product in [MJCC19-MJCC19a fill]. That would make you
[MYR1STMJ] years old when you first used marijuana or any
cannabis product. Is this correct?

72

4
Yes
6
No
DK/REF
UPDATE: IF MJCC20 NE (6, BLANK OR DK/REF) AND ((MJCC19 NE MJ03a AND MJ03a
NE (BLANK OR DK/REF)) OR (MJCC19 NE MJ03b AND MJ03b NE (BLANK OR DK/REF)
OR (MJCC19a NE MJ03c AND MJ03c NE (BLANK OR DK/REF) OR (MJCC19a NE MJ03d
AND MJ03d NE (BLANK OR DK/REF)) THEN AGE1STMJ = MYR1STMJ
MJLAST3

[IF MJ01 = 1 OR MJREF = 1] How long has it been since you last used
marijuana or any cannabis product?
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 any cannabis product?
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 or any cannabis product 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 any cannabis product?
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 any cannabis product during the past 12
months.

73

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 any cannabis product?
TOTAL # OF DAYS:
days in the past 12 months
[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 any cannabis product each month during the past 12
months?
AVERAGE # OF DAYS PER MONTH:
days per month, on average
[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 any cannabis product each week during the past 12
months?
AVERAGE # OF DAYS PER WEEK:
days per week, on average
[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 any cannabis product?
NUMBER OF DAYS:
days in the past 30 days
[RANGE: 1 - 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 any cannabis product during the past 30 days?

74

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 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, you reported that you used
marijuana or any cannabis product on [MJ06] of the past 30 days. Is
this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

75

MJCC07b [IF ESTIMJ > TOTMJ] For the last question, you reported that you
used marijuana or any cannabis product 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?
I used marijuana or any cannabis product on [FILLMJ] in the
past 12 months [FILLMJA]
2
I used marijuana or any cannabis product on [MJ06 /
MJ30DAY] days in the past 30 days
3
Neither answer is correct
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
1

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 any
cannabis product 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

76

MJCC10 [IF MJCC09 = 3 ] On how many days in the past 12 months did you
use marijuana or any cannabis product?
TOTAL # OF DAYS:
days in the past 12 months
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
MJCC11 [IF MJCC09 = 2] On average, how many days did you use marijuana
or any cannabis product each month during the past 12 months?
# OF DAYS/MONTH:
days per month, on average
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
MJCC12 [IF MJCC09 = 1] On average, how many days did you use marijuana
or any cannabis product each week during the past 12 months?
# OF DAYS PER WEEK:
days per week, on average
[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 any cannabis product?
# OF DAYS:
days in the past 30 days
[RANGE: 1 - 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 any cannabis product during the past 30 days?

77

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
MJMODEPY [IF MJLAST3 = (1 OR 2) OR MJRECDK = (1 OR 2) OR MJRECRE = (1 OR 2)]
During the past 12 months, that is, since [DATEFILL], in which of the
following ways did you use marijuana or any cannabis product?
Select all that apply.
1
2
3
4
5

Smoking
Vaping
Dabbing waxes, shatter, or concentrates
Eating or drinking
Putting drops, strips, lozenges, or sprays in your mouth or under your
tongue
6
Applying lotion, cream, or patches to your skin
7
Taking pills
8
Some other way
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

MJMDPYOa [IF MJMODEPY = 8] Please type in one or more of the other ways you used
marijuana or any cannabis product during the past 12 months.
[PROGRAMMER: PROVIDE 5 ROWS.]
____________________________________________________________
MJMODEPM [IF MJLAST3=1 OR MJRECDK = 1 OR MJRECRE = 1] During the past 30
days, that is, since [DATEFILL], in which of the following ways did you use
marijuana or any cannabis product?
Select all that apply.
1
2
3
4
5
6
7
8

Smoking
Vaping
Dabbing waxes, shatter, or concentrates
Eating or drinking
Putting drops, strips, lozenges, or sprays in your mouth or under your
tongue
Applying lotion, cream, or patches to your skin
Taking pills
Some other way
78

DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
MJMDPMOa [IF MJMODEPM = 8] Please type in one or more of the other ways you used
marijuana or any cannabis product during the past 30 days.
[PROGRAMMER: PROVIDE 5 ROWS.]
VPMJLIF

[IF MJMODEPY NE 2 AND MJMODEPM NE 2] The next questions are about
vaping marijuana. This question is about vaping marijuana with e-cigarettes or
other vaping devices. These devices might also be called vapes, vape pens, or
mods. When answering, please include any device that heats a liquid containing
marijuana into a vapor.
Have you ever, even once, vaped marijuana with a vaping device?
1
Yes
2
No
DK/REF

MJMM01 [IF (MJLAST3 = 1 - 2 OR MJRECDK = 1 - 2 OR MJRECRE = 1 - 2) Earlier, you
reported using marijuana or any cannabis product in the past year. Was any of your
marijuana or cannabis product 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 or cannabis product 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

79

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80

Cocaine
COCINTRO These questions are about cocaine, including all the different forms of cocaine
such as powder, ‘crack,’ free base, and coca paste.
Click Next to continue.
CC01 [PROGRAMMER, SHOW IN GRAY FONT: These questions are about cocaine,
including all the different forms of cocaine such as powder, ‘crack,’ free base, and coca
paste.]
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 any form of
cocaine?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STCC:
IF CC02 NE (BLANK OR DK/REF) THEN AGE1STCC = CC02
ELSE AGE1STCC = BLANK
IF CURNTAGE < AGE1STCC:
CCCC01 You were [AGE1STCC] years old when you first used cocaine. Is this
correct?
4
Yes
6
No
DK/REF

81

CCCC02 [IF CCCC01 = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [AGE1STCC] years old the first time I used cocaine
3
Neither answer is correct
DK/REF
CCCC03 [IF CCCC02=2 OR CCCC02=3] Please answer this question again.
What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
CCCC03a [IF CCCC03 < 12] Since you have indicated that you are [CCCC03
AGE] years old, we cannot interview you for this study. Thank you for
your cooperation.
PROGRAM SHOULD ROUTE TO FIEXIT.
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 any form of cocaine?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
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 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
any form of cocaine?
AGE:

years old

82

[RANGE: 1 - 110]
DK/REF
UPDATE: IF CCCC06 NOT (BLANK OR DK/REF) THEN AGE1STCC = CCCC06
CC03a [IF CCCC05 NE DK/RE AND CCCC06 NE DK/REF AND AGE1STCC = CURNTAGE
AND DATE OF INTERVIEW < DOB OR IF AGE1STCC = CURNTAGE - 1 AND
DATE OF INTERVIEW ≥ DOB] Did you first use any form of cocaine 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 any form of cocaine 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 any form of 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 CC03c > CURRENT MONTH] The month in [CURRENT YEAR]
you entered has not begun yet. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
CC03d [IF CC03a = 1 - 2 OR CC03b = 1 - 2] In what month in [YEAR FROM CC03a or
CC03b] did you first use cocaine?
83

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 CC03d > CURRENT MONTH] The month in [CURRENT YEAR]
you entered has not begun yet. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 You first used any form of cocaine in [CC03a-d fill]. That would make
you [MYR1STCC] years old when you first used any form of cocaine.
Is this correct?
4
Yes
6
No
DK/REF
CCCC18 [IF CCCC17 = 4] Earlier, you reported that you were [AGE1STCC]
years old when you first used any form of cocaine. Which answer is
correct?
I first used any form of cocaine in [CC03a-d fill] when I was
[MYR1STCC] years old
2
I was [AGE1STCC] years old the first time I used any form of
cocaine.
3
Neither answer is correct
DK/REF
1

84

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 any form of cocaine 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 any form of
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 CCCC19a > CURRENT MONTH] The month in [CURRENT YEAR]
you entered has not begun yet. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] You first used any form of cocaine in
[CCCC19-CCCC19a fill]. That would make you [MYR1STCC] years
old when you first used any form of cocaine. Is this correct?
4

Yes
85

6
No
DK/REF
UPDATE: IF CCCC20 NE (6, BLANK OR DK/REF) AND (CCCC19 AND CCCC19a NE
CC03a-d) THEN AGE1STCC = MYR1STCC
CCLAST3

[IF CC01 = 1 OR CCREF = 1] How long has it been since you last used any form
of cocaine?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
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
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
86

CCYRAVE

[IF CCFRAME3 = 3 OR DK/REF] On how many days in the past 12 months did
you use cocaine?
TOTAL # OF DAYS:
days in the past 12 months
[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:
days per month, on average
[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:
days per week, on average
[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:
days in the past 30 days
[RANGE: 1 - 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

87

DEFINE ESTICC:
IF CC06DKRE = 1, THEN ESTICC = 1
IF CC06DKRE = 2, THEN ESTICC = 3
IF CC06DKRE = 3, THEN ESTICC = 6
IF CC06DKRE = 4, THEN ESTICC = 10
IF CC06DKRE = 5, THEN ESTICC = 20
IF CC06DKRE = 6, THEN ESTICC = 30
ELSE ESTICC = BLANK
DEFINE TOTCOKE:
IF CCYRAVE NOT(BLANK OR DK/REF) THEN TOTCOKE= CCYRAVE
IF CCMONAVE NOT(BLANK OR DK/REF) THEN TOTCOKE=CCMONAVE*12
IF CCWKAVE NOT(BLANK OR DK/REF) THEN TOTCOKE=CCWKAVE*52
ELSE TOTCOKE = DK/REF
DEFINE COC30DAY
IF CC06DKRE = 1, THEN COC30DAY = “1 or 2”
IF CC06DKRE = 2, THEN COC30DAY = “3 to 5”
IF CC06DKRE = 3, THEN COC30DAY = “6 to 9”
IF CC06DKRE = 4, THEN COC30DAY = “10 to 19”
IF CC06DKRE = 5, THEN COC30DAY = “20 to 29”
IF CC06DKRE = 6, THEN COC30DAY = “all 30”
ELSE COC30DAY = BLANK
IF TOTCOKE NOT DK/REF AND (CC06 NE BLANK OR DK/REF AND CC06 >
TOTCOKE) OR (CC06 = DK/REF AND ESTICC > TOTCOKE):
CCCC07a [IF CC06 > TOTCOKE] For the last question, you reported 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, you reported 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”
ELSE IF CCYRAVE = 1, THEN FILLCN = “1 day”
ELSE IF CCMONAVE > 1, THEN FILLCN = “[CCMONAVE] days per month”

88

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?
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

1

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:
days in the past 12 months
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CCCC11 [IF CCCC9 = 2] On average, how many days did you use cocaine
each month during the past 12 months?
# OF DAYS/MONTH:
[RANGE: 1 - 31]

89

days per month, on average

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:
days per week, on average
[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:
days in the past 30 days
[RANGE: 1 - 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

90

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.
Click Next to continue.
CK01 [IF CC01 = 1 OR CCREF = 1] [PROGRAMMER, SHOW IN GRAY FONT: The next
questions are about ‘crack’, that is cocaine in rock or chunk form, and not the other forms
of cocaine.]
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:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STCK:
IF CK02 NE (BLANK OR DK/REF) THEN AGE1STCK = CK02
ELSE AGE1STCK = BLANK
IF CURNTAGE < AGE1STCK:
CKCC01 You were [AGE1STCK] years old when you first used ‘crack’. Is this
correct?
4
Yes
6
No
DK/REF

91

CKCC02 [IF CKCC01 = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
1
I am currently [CURNTAGE] years old
2
I was [AGE1STCK] years old the first time I used ‘crack’
3
Neither answer is correct
DK/REF
CKCC03 [IF CKCC2=2 OR CKCC2=3] Please answer this question again.
What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
CKCC03a [IF CKCC03 < 12] Since you have indicated that you are [CCKCC03
AGE] years old, we cannot interview you for this study. Thank you for
your cooperation.
PROGRAM SHOULD ROUTE TO FIEXIT.
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:
years old
[RANGE: 1 - 110]
DK/REF
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 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:

years old

92

[RANGE: 1 - 110]
DK/REF
UPDATE: IF CKCC06 NOT(BLANK OR DK/REF) THEN AGE1STCK = CKCC06
CK03a [IF CKCC05 NE DK/RE AND CKCC06 NE DK/REF AND AGE1STCK =
CURNTAGE AND DATE OF INTERVIEW < DOB OR IF AGE1STCK =
CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first use ‘crack’ in
[CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
CK03b [IF AGE1STCK = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you
first use ‘crack’ in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
CK03c [IF CKCC05 NE DK/RE AND CKCC06 NE DK/REF AND AGE1STCK =
CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what month in [CURRENT
YEAR] did you first use ‘crack’?
1
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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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’?
93

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 CK03d > CURRENT MONTH] The month in [CURRENT YEAR]
you entered has not begun yet. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 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, you reported that you were [AGE1STCK]
years old when you first used ‘crack’. Which answer is correct?
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
1

UPDATE: IF CKCC18 = 1, THEN AGE1STCK = MYR1STCK.
CKCC19 [IF CKCC18=2 OR CKCC18=3 OR CKCC17=6] Please answer this

94

question again. Did you first use ‘crack’ in [CURRENT YEAR-2],
[CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
CKCC19a [IF CKCC19 NE (BLANK OR DK/REF)] Please answer this question
again. In what month in [CKCC19] did you first use ‘crack’?
1
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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] You first used ‘crack’ in [CKCC19CKCC19a fill]. That would make you [MYR1STCK] years old when
you first used ‘crack’. Is this correct?
4
Yes
6
No
DK/REF

95

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
Average number of days per week during the past 12 months
2
Average number of days per month during the past 12 months
3
Total number of days during the past 12 months
DK/REF
CKYRAVE [IF CKFRAME3 = 3 OR DK/REF] On how many days in the past 12 months did
you use ‘crack’?

96

TOTAL # OF DAYS:
days in the past 12 months
[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:
days per month, on average
[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:
days per week, on average
[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:
days in the past 30 days
[RANGE: 1 - 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
IF CK06DKRE = 2, THEN ESTICK = 3

97

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, you reported 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, you reported 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:
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”

98

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?
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

1

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:
days in the past 12 months
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
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]

99

days per month, on average

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:
days per week, on average
[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:
days in the past 30 days
[RANGE: 1 - 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
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
PROGRAMMER: SHOW 30 DAY CALENDAR

100

Heroin
HEINTRO

These next questions are about any form of heroin, such as powder or tar. Heroin
can be smoked, snorted, or injected.
Click Next to continue.

HE01 [PROGRAMMER, SHOW IN GRAY FONT: These next questions are about any form of
heroin, such as powder or tar. Heroin can be smoked, snorted, or injected.]
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:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STHR:
IF HE02 NE (BLANK OR DK/REF) THEN AGE1STHR = HE02
ELSE AGE1STHR = BLANK
IF CURNTAGE < AGE1STHR:
HECC01 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?

101

1
I am currently [CURNTAGE] years old
2
I was [AGE1STHR] years old the first time I used heroin
3
Neither answer is correct
DK/REF
HECC03 [IF HECC02=2 OR HECC02=3] Please answer this question again.
What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
HECC03a [IF HECC03 < 12] Since you have indicated that you are [HECC03
AGE] years old, we cannot interview you for this study. Thank you for
your cooperation.
PROGRAM SHOULD ROUTE TO FIEXIT.
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:
years old
[RANGE: 1 - 110]
DK/REF
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 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:
years old
[RANGE: 1 - 110]
DK/REF

102

UPDATE: IF HECC06 NOT(BLANK OR DK/REF) THEN AGE1STHR = HECC06
HE03a [IF HECC05 NE DK/RE AND HECC06 NE DK/REF AND AGE1STHR = CURNTAGE
AND DATE OF INTERVIEW < DOB OR IF AGE1STHR = CURNTAGE - 1 AND
DATE OF INTERVIEW ≥ DOB] Did you first use heroin in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
HE03b [IF AGE1STHR = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you
first use heroin in [CURRENT YEAR - 2] or [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
HE03c [IF HECC05 NE DK/RE AND HECC06 NE DK/REF AND AGE1STHR = CURNTAGE
AND DATE OF INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you
first use heroin?
1
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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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

January

103

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 HE03d > CURRENT MONTH] The month in [CURRENT YEAR]
you entered has not begun yet. Please answer this question again, then click Next 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 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, you reported that you were [AGE1STHR]
years old when you first used heroin. Which answer is correct?
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
1

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

CURRENT YEAR -2

104

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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] You first used heroin in [HECC19HECC19a fill]. That would make you [MYR1STHE] years old when
you first used heroin. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF HECC20 NE (6, BLANK OR DK/REF) AND (HECC19 AND HECC19a NE
HE03a-d) THEN AGE1STHR = MYR1STHE
HELAST3

[IF HE01 = 1 OR HEREF = 1] How long has it been since you last used heroin?

105

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
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

days in the past 12 months

106

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:
days per month, on average
[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:
days per week, on average
[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:
days in the past 30 days
[RANGE: 1 - 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
IF HE06DKRE = 4, THEN ESTIHE = 10
IF HE06DKRE = 5, THEN ESTIHE = 20
IF HE06DKRE = 6, THEN ESTIHE = 30

107

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, you reported 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, you reported 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”
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”

108

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?
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
1

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:
days in the past 12 months
[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?
# OF DAYS/MONTH:
days per month, on average
[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]
109

days per week, on average

DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

110

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:
days in the past 30 days
[RANGE: 1 - 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

111

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112

Hallucinogens
HALINTRO The next questions are about substances called hallucinogens. These drugs often
cause people to have rapid, intense emotional swings or to see images, hear
sounds, and feel sensations that seem real but are not.

Click Next to continue.
PROGRAMMER: DISPLAY IN LOWER LEFT: Click [Help] if you want
to see how to say these drugs.
Hallucinogens [huh-LOOS-en-uh-jens]
LSD [el-ess-dee]
PCP, also called ‘angel dust’ or phencyclidine [pee-see-pee, fen-sike-luhdeen]
Peyote [pay-oh-tee]
Mescaline [mess-ka-lin]
Psilocybin [sill-i-sigh-bin]
‘Ecstasy’ or ‘Molly’, also called MDMA [ek-stuh-see, molly, em-dee-emay]
Ketamine, also called “Special K” or “Super K” [ket-uh-meen]
DMT, also called dimethyltryptamine [dee-em-tee, die-meth-ill-trip-tuhmeen]
AMT, also called alpha-methyltryptamine [ay-em-tee, al-fa-meth-ill-triptuh-meen]
Foxy, also called 5-MeO-DIPT [fox-ee, five-me-oh-dee-eye-pee-tee]
Salvia divinorum [salv-ee-uh div-i-nor-um]
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

113

LS01b Have you ever, even once, used PCP, also called ‘angel dust’ or phencyclidine?
1
Yes
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
LSREFPE [IF LS01c = REF] The answers that people give us about their use of peyote 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
peyote?
1
Yes
2
No
DK/REF
LS01d Have you ever, even once, used mescaline?
1
Yes
2
No
DK/REF
LSREFMES [IF LS01d = REF] The answers that people give us about their use of mescaline
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

114

mescaline?
1
Yes
2
No
DK/REF
LS01e Have you ever, even once, used psilocybin, found in mushrooms?
1
Yes
2
No
DK/REF
LSREFPSI [IF LS01e = REF] The answers that people give us about their use of psilocybin,
found in mushrooms, 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
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
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

115

LSREFKET [IF LS01i = REF] The answers that people give us about their use of “Special K”
or “Super K” 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
“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
LSREFDMT [IF LS01j = REF] The answers that people give us about their use of DMT, also
called dimethyltryptamine, AMT, also called alpha-methyltryptamine, or
Foxy, also called 5-MeO-DIPT, 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
DMT, also called dimethyltryptamine, AMT, also called alphamethyltryptamine, 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
LSREFSLV [IF LS01k = REF] The answers that people give us about their use of Salvia
divinorum 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
Salvia divinorum?
116

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
LSREFOH [IF LS01h = REF] The answers that people give us about their use of other
halucinogens 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
other hallucinogens?
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, click Next to go to the next question. Remember, you do not
need to type in the names of any hallucinogens that you already reported.
________________
DK/REF
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, click Next 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, click Next to go to the next question.
________________
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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, click Next 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, click Next 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
OR LSREFPE = 2) AND (LS01d = 2 OR LSREFMES = 2) AND (LS01e = 2 OR
LSREFPSI = 2) AND (LS01f = 2 OR LSREF3 = 2) AND (LS01h = 2 OR LSREFOH =
2) AND (LS01i=2 OR LSREFKET = 2) AND (LS01j=2 OR LSREFDMT = 2) AND
(LS01k=2 OR LSREFSLV = 2)), LSFILL = “LSD”

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

118

LS01e NE 1 AND LSREFPSI NE 1 AND LS01f NE 1 AND LSREF3 NE 1 AND LS01h
NE 1 AND LSREFOH NE 1 AND LS01i NE 1 AND LSREFKET NE 1 AND LS01j
AND LSREFDMT NE 1 NE 1 AND LS01k NE 1 AND LSREFSLV NE 1) AND (
(LS01a = DK OR (LS01a = REF AND LSREF1 = DK/REF) OR (LS01c = DK OR
(LS01c = REF AND LSREFPE = DK/REF) OR (LS01d = DK OR (LS01d = REF AND
LSREFMES = DK/REF) OR (LS01e = DK OR (LS01c = REF AND LSREFPE =
DK/REF) OR (LS01f = DK OR (LS01f = REF AND LSREF3 = DK/REF) OR (LS01h =
DK OR (LS01h = REF AND LSREFOH = DK/REF) OR (LS01i=DK OR (LS01i = REF
AND LSREFKET = DK/REF) OR (LS01j=DK OR (LS01j = REF AND LSREFDMT =
DK/REF) OR (LS01k=DK OR (LS01k = REF AND LSREFSLV = DK/REF) ) LSFILL
= “PCP or any other hallucinogen”
IF (LS01c = 1 OR LSREFPE = 1) AND ((LS01a = 2 OR LSREF1- 2) AND (LS01b = 2
OR LSREF2 = 2) AND (LS01d = 2 OR LSREFMES = 2) AND (LS01e = 2 OR
LSREFPSI = 2) AND (LS01f = 2 OR LSREF3 = 2) AND (LS01h = 2 OR LSREFOH =
2) AND (LS01i=2 OR LSREFKET = 2) AND (LS01j=2 OR LSREFDMT = 2) AND
(LS01k=2 OR LSREFSLV = 2), LSFILL = “peyote”
IF (LS01c = 1 OR LSREFPE = 1) AND (LS01a NE 1 AND LS01REF1 NE1 AND
LS01b NE 1 AND LSREF2 NE 1 AND LS01d NE 1 AND LSREFMES NE 1 AND
LS01e NE 1 AND LSREFPSI NE 1 AND LS01f NE 1 AND LSREF3 NE 1 AND LS01h
NE 1 AND LSREFOH NE 1 AND LS01i NE 1 AND LSREFKET NE 1 AND LS01j NE
1 AND LSREFDMT NE 1 AND LS01k NE 1 AND LSREFSLV NE 1) AND ( (LS01c =
DK OR (LS01c = REF AND LSREFPE = DK/REF) OR (LS01a = DK OR (LS01a =
REF AND LSREF1 = DK/REF) OR (LS01b = DK OR (LS01b = REF AND LSREF2 =
DK/REF) OR (LS01d = DK OR (LS01d = REF AND LSREFMES = DK/REF) OR
(LS01e = DK OR (LS01e = REF AND LSREFPSI = DK/REF) OR (LS01f = DK OR
(LS01f = REF AND LSREF3 = DK/REF) OR (LS01h = DK OR (LS01h = REF AND
LSREFOH = DK/REF) OR (LS01i=DK OR (LS01i = REF AND LSREFKET =
DK/REF) OR (LS01j=DK OR (LS01j = REF AND LSREFDMT = DK/REF) OR
(LS01k=DK OR (LS01k = REF AND LSREFSLV = DK/REF) ) LSFILL = "peyote or
any other hallucinogen"
IF (LS01d = 1 OR LSREFMES = 1) AND ((LS01a = 2 OR LSREF1= 2) AND (LS01b =
2 OR LSREF2 = 2) AND (LS01c = 2 OR LSREFPE = 2) AND (LS01e = 2 OR
LSREFPSI = 2) AND (LS01f = 2 OR LSREF3 = 2) AND (LS01h = 2 OR LSREFOH =
2) AND (LS01i=2 OR LSREFKET = 2) AND (LS01j=2 OR LSREFDMT = 2) AND
(LS01k=2 OR LSREFSLV = 2), LSFILL = “mescaline”
IF (LS01d = 1 OR LSREFMES = 1) AND (LS01a NE 1 AND LS01REF1 NE1 AND
LS01b NE 1 AND LSREF2 NE 1 AND LS01c NE 1 AND LSREFPE NE 1 AND LS01e
NE 1 AND LSREFPSI NE 1 AND LS01f NE 1 AND LSREF3 NE 1 AND LS01h NE 1
AND LSREFOH NE 1 AND LS01i NE 1 AND LSREFKET NE 1 AND LS01j NE 1
AND LSREFDMT NE 1 AND LS01k NE 1 AND LSREFSLV NE 1) AND ( (LS01d =
DK OR (LS01d = REF AND LSREFMES = DK/REF) OR (LS01a = DK OR (LS01a =
REF AND LSREF1 = DK/REF) OR (LS01b = DK OR (LS01b = REF AND LSREF2 =

119

DK/REF) OR (LS01c = DK OR (LS01c = REF AND LSREFPE = DK/REF) OR (LS01e
= DK OR (LS01e = REF AND LSREFPSI = DK/REF) OR (LS01f = DK OR (LS01f =
REF AND LSREF3 = DK/REF) OR (LS01h = DK OR (LS01h = REF AND LSREFOH
= DK/REF) OR (LS01i=DK OR (LS01i = REF AND LSREFKET = DK/REF)
OR (LS01j=DK OR (LS01j = REF AND LSREFDMT = DK/REF) OR (LS01k=DK OR
(LS01k = REF AND LSREFSLV = DK/REF) ) LSFILL = "mescaline or any other
hallucinogen"
IF (LS01e = 1 OR LSREFPSI = 1) AND ((LS01a = 2 OR LSREF1= 2) AND (LS01b = 2
OR LSREF2 = 2) AND (LS01c = 2 OR LSREFPE = 2) AND (LS01d = 2 OR
LSREFMES = 2) AND (LS01f = 2 OR LSREF3 = 2) AND (LS01h = 2 OR LSREFOH =
2) AND (LS01i=2 OR LSREFKET = 2) AND (LS01j=2 OR LSREFDMT = 2) AND
(LS01k=2 OR LSREFSLV = 2), LSFILL = “psilocybin”
I IF (LS01e = 1 OR LSREFPSI = 1) AND (LS01a NE 1 AND LS01REF1 NE1 AND
LS01b NE 1 AND LSREF2 NE 1 AND LS01c NE 1 AND LSREFPE NE 1 AND LS01d
NE 1 AND LSREFMES NE 1 AND LS01f NE 1 AND LSREF3 NE 1 AND LS01h NE 1
AND LSREFOH NE 1 AND LS01i NE 1 AND LSREFKET NE 1 AND LS01j NE 1
AND LSREFDMT NE 1 AND LS01k NE 1 AND LSREFSLV NE 1) AND ( (LS01e =
DK OR (LS01e = REF AND LSREFPSI = DK/REF) OR ((LS01a = DK OR (LS01a =
REF AND LSREF1 = DK/REF) OR (LS01b = DK OR (LS01b = REF AND LSREF2 =
DK/REF) OR (LS01c = DK OR (LS01c = REF AND LSREFPE = DK/REF) OR (LS01d
= DK OR (LS01d = REF AND LSREFMES = DK/REF) OR (LS01f = DK OR (LS01f =
REF AND LSREF3 = DK/REF) OR (LS01h = DK OR (LS01h = REF AND LSREFOH
= DK/REF) OR (LS01i=DK OR (LS01i = REF AND LSREFKET = DK/REF)
OR (LS01j=DK OR (LS01j = REF AND LSREFDMT = DK/REF) OR (LS01k=DK OR
(LS01k = REF AND LSREFSLV = DK/REF) ) LSFILL = "psilocybin 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 OR LSREFPE = 2) AND (LS01d = 2 OR
LSREFMES = 2) AND (LS01e = 2 OR LSREFPSI = 2) AND (LS01h = 2 OR LSREFOH
= 2) AND (LS01i=2 OR LSREFKET = 2) AND (LS01j=2 OR LSREFDMT = 2) AND
(LS01k=2 OR LSREFSLV = 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 LSREFPE NE 1 AND LS01d NE
1 AND LSREFMES NE 1 AND LS01e NE 1 AND LSREFPSI NE 1 AND LS01h NE 1
AND LSREFOH NE 1 AND LS01i NE 1 AND LSREFKET NE 1 AND LS01j NE 1
AND LSREFDMT NE 1 AND LS01k NE 1 AND LSREFSLV 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 OR (LS01c=REF AND LSREFPE=DK/REF) OR
(LS01d = DK OR (LS01d=REF AND LSREFMES=DK/REF) OR (LS01e = DK OR
(LS01e=REF AND LSREFPSI=DK/REF) OR (LS01h = DK OR (LS01h=REF AND
LSREFOH=DK/REF) OR (LS01i=DK OR (LS01i=REF AND LSREFKET=DK/REF)
OR (LS01j=DK OR (LS01j=REF AND LSREFDMT=DK/REF) OR (LS01k=DKOR

120

(LS01k=REF AND LSREFSLV=DK/REF)) LSFILL = ““Ecstasy”, ‘Molly’, or any other
hallucinogen”
IF (LS01i = 1 OR LSREFKET = 1)) AND ((LS01a = 2 OR LSREF1 = 2) AND (LS01b =
2 OR LSREF2 = 2) AND (LS01c = 2 OR LSREFPE = 2) AND (LS01d = 2 OR
LSREFMES = 2) AND (LS01e = 2 OR LSREFPSI = 2) AND (LS01f=2 OR LSREF3=2)
AND (LS01h = 2 OR LSREFOH = 2) AND (LS01j=2 OR LSREFDMT = 2) AND
(LS01k=2 OR LSREFSLV = 2)), LSFILL = “Ketamine”

IF (LS01i = 1 OR LSREFKET = 1) AND (LS01a NE 1 AND LSREF1 NE 1 AND LS01b
NE 1 AND LSREF2 NE 1 AND LS01c NE 1 AND LSREFPE NE 1 AND LS01d NE
1 AND LSREFMES NE 1 AND LS01e NE 1 AND LSREFPSI NE 1 AND LS01f NE 1
AND LSREF3 NE 1 AND LS01h NE 1 AND LSREFOH NE 1 AND LS01j NE 1 AND
LSREFDMT NE 1 AND LS01k NE 1 AND LSREFSLV 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 OR LSREFDMT = 1) AND ((LS01a = 2 OR LSREF1 = 2) AND (LS01b =
2 OR LSREF2 = 2) AND (LS01c = 2 OR LSREFPE = 2) AND (LS01d = 2 OR
LSREFMES = 2) AND (LS01e = 2 OR LSREFPSI = 2) AND (LS01f=2 OR LSREF3=2)
AND (LS01h = 2 OR LSREFOH = 2) AND (LS01i=2 OR LSREFKET = 2) AND
(LS01k=2 OR LSREFSLV = 2)), LSFILL = “DMT, AMT, or Foxy”
IF (LS01j = 1 OR LSREFDMT = 1) AND (LS01a NE 1 AND LSREF1 NE 1 AND
LS01b NE 1 AND LSREF2 NE 1 AND LS01c NE 1 AND LSREFPE NE 1 AND
LS01d NE 1 AND LSREFMES NE 1 AND LS01e NE 1 AND LSREFPSI NE 1 AND
LS01f NE 1 AND LSREF3 NE 1 AND LS01h NE 1 AND LSREFOH NE 1 AND LS01i
NE 1 AND LSREFKET NE 1 AND LS01k NE 1 AND LSREFSLV 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/ OR (LS01c=REF AND
LSREFPE=DK/REF)) OR (LS01d = DK OR (LS01d=REF AND
LSREFMES=DK/REF)) OR (LS01e = DK/ OR (LS01e=REF AND
LSREFPSI=DK/REF)) OR (LS01f = DK OR (LS01f = REF AND LSREF3 = DK/REF)
OR (LS01h = DK/ OR (LS01h=REF AND LSREFOH=DK/REF)) OR (LS01i=DK/ OR
(LS01i=REF AND LSREFKET=DK/REF)) OR (LS01k=DK/ OR (LS01k=REF AND
LSREFSLV=DK/REF))) ) LSFILL = “DMT, AMT, Foxy or any other hallucinogen”
IF (LS01k = 1 OR LSREFSLV = 1)) AND ((LS01a = 2 OR LSREF1 = 2) AND (LS01b =
2 OR LSREF2 = 2) AND (LS01c = 2 OR LSREFPE = 2) AND (LS01d = 2 OR
LSREFPE = 2) AND (LS01e = 2 OR LSREFPSI = 2) AND (LS01f=2 OR LSREF3=2)
AND (LS01h = 2 OR LSREFOH = 2) AND (LS01i=2 OR LSREFKET = 2) AND
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(LS01j=2 OR LSREFDMT = 2)), LSFILL = “Salvia divinorum”
IF (LS01k = 1 OR LSREFSLV = 1) AND (LS01a NE 1 AND LSREF1 NE 1 AND
LS01b NE 1 AND LSREF2 NE 1 AND LS01c NE 1 AND LSREFPE NE 1 AND
LS01d NE 1 AND LSREFMES NE 1 AND LS01e NE 1 AND LSREFPSI NE 1 AND
LS01f NE 1 AND LSREF3 NE 1 AND LS01h NE 1 AND LSREFOH NE 1 AND LS01i
NE 1 AND LSREFKET NE 1 AND LS01j NE 1 AND LSREFDMT 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/ OR (LS01c=REF AND
LSREFPE=DK/REF)) OR (LS01d = DK/ OR (LS01e=REF AND
LSREFMES=DK/REF)) OR (LS01e = DK/ OR (LS01e=REF AND
LSREFPSI=DK/REF)) OR (LS01f = DK OR (LS01f = REF AND LSREF3 = DK/REF)
OR (LS01h = DK/ OR (LS01h=REF AND LSREFOH=DK/REF)) OR (LS01i=DK/ OR
(LS01i=REF AND LSREFKET=DK/REF)) OR (LS01j=DK OR (LS01j=REF AND
LSREFSLV=DK/REF) ) LSFILL = “Salvia divinorum or any other hallucinogen”

ELSE, LSFILL = “any hallucinogen”
LS02 [IF ANY IN LS01a THROUGH LS01REFOH = 1] How old were you the first time you
used [LSFILL]?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STHA:
IF LS02 NE (BLANK OR DK/REF) THEN AGE1STHA = LS02
ELSE AGE1STHA = BLANK
IF CURNTAGE < AGE1STHA:
LSCC01 You were [AGE1STHA] years old when you first used [LSFILL]. Is
this correct?
4
Yes
6
No
DK/REF
LSCC02

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

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LSCC03

[IF LSCC02=2 OR LSCC02=3] Please answer this question again.
What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF

LSCC03a [IF LSCC03 < 12] Since you have indicated that you are [LSCC03]
years old, we cannot interview you for this study. Thank you for your
cooperation.
PROGRAM SHOULD ROUTE TO FIEXIT.
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]?
AGE:
years old
[RANGE: 1 - 110]
DK/REF

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 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:
years old
[RANGE: 1 - 110]
DK/REF

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]?
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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
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. Please answer this question again, then click Next to continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
LS03d [IF LS03a = 1 OR 2 OR LS03b = 1 OR 2] In what month in [YEAR FROM LS03a or
LS03b] did you first use [LSFILL]?
1
2
3
4
5
6
7
8
9

January
February
March
April
May
June
July
August
September
124

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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
DEFINE MYR1STHA:
MYR1STHA = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LS03a-d). IF MONTH OF
FIRST USE = MONTH OF BIRTH, THEN MYR1STHA IS BLANK.
IF MYR1STHA NE 0 AND NE AGE1STHA:
LSCC56 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, you reported that you were [AGE1STHA]
years old when you first used [LSFILL]. Which answer is correct?
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
1

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

125

again. In what month in [LSCC58] 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 LSCC58a > CURRENT MONTH] The month in [CURRENT YEAR]
you entered has not begun yet. Please answer this question, then click Next to continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] You first used [LSFILL] in [LSCC59LSCC59a 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 ANY LS01a = 1 THROUGH LSREFOH = 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

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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
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]

days in the past 12 months

127

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:
days per month, on average
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
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:
days per week, on average
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LS04 [IF HALLREC = 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:
days in the past 30 days
[RANGE: 1 - 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
128

ELSE ESTILS = BLANK
DEFINE HAL30DAY
IF LS04DKRE = 1, THEN HAL30DAY = “1 or 2”
IF LS04DKRE = 2, THEN HAL30DAY = “3 to 5”
IF LS04DKRE = 3, THEN HAL30DAY = “6 to 9”
IF LS04DKRE = 4, THEN HAL30DAY = “10 to 19”
IF LS04DKRE = 5, THEN HAL30DAY = “20 to 29”
IF LS04DKRE = 6, THEN HAL30DAY = “all 30”
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRAVE NOT(BLANK OR DK/REF) THEN TOTHALL = LSYRAVE
ELSE IF LSMONAVE NOT(BLANK OR DK/REF) THEN TOTHALL =
LSMONAVE*12
ELSE IF LSWKAVE NOT(BLANK OR DK/REF) THEN TOTHALL = LSWKAVE*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LS04 NE DK/REF OR BLANK AND LS04 >
TOTHALL) OR (LS04 = DK/REF AND ESTILS > TOTHALL)):
LSCC07a [IF LS04 > TOTHALL] For the last question, you reported 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, you reported 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”
129

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?
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
1

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:
days in the past 12 months
[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:
days per month, on average
[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

130

days per week, on average

PROGRAMMER: SHOW 12 MONTH CALENDAR
IF LSCC10 NOT(BLANK OR DK/REF) THEN TOTHALL = LSCC10
ELSE IF LSCC11 NOT(BLANK OR DK/REF) THEN TOTHALL=LSCC11*12
ELSE IF LSCC12 NOT(BLANK OR DK/REF) THENTOTHALL=LSCC12*52
ELSE TOTHALL = DK/REF
LSCC13a [IF LSCC07a = 6 OR ((LSCC08 = 1 OR LSCC8 = 3) AND LSCC07a
NE BLANK OR DK/REF)] Please answer this question again. Think
specifically about the past 30 days, from [DATEFILL] up to and
including today. During the past 30 days, on how many days did you
use [LSFILL]?
# OF DAYS:
days in the past 30 days
[RANGE: 1 - 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
LS05 [IF (LS01a = 1 OR LSREF1 =1) AND (LS01b = 1 OR LSREF2 = 1 OR LS01c = 1 OR
LSREFPE = 1 OR LS01d = 1 OR LSREFMES = 1 OR LS01e = 1 OR LSREFPSI = 1 OR
LSREF3 = 1 OR LS01f = 1 OR LS01h = 1 OR LSREFOH = 1 OR LS01i=1 OR
LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k=1 OR LSREFSLV = 1)]
Now think only about LSD. How old were you the first time you used LSD?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STLS:
IF LS05 NE (BLANK OR DK/REF) THEN AGE1STLS = LS05
ELSE AGE1STLS = BLANK

131

IF CURNTAGE < AGE1STLS:
LSCC17 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:
years old
[RANGE: 1 - 110]
DK/REF

LSCC19a [IF LSCC19 < 12] Since you have indicated that you are [LSCC19]
years old, we cannot interview you for this study. Thank you for your
cooperation.
PROGRAM SHOULD ROUTE TO FIEXIT.
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:
years old
[RANGE: 1 - 110]
DK/REF

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 You were [AGE1STLS] years old the first time you used LSD. Is this
correct?

132

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:
years old
[RANGE: 1 - 110]
DK/REF

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:
years old
[RANGE: 1 - 110]
DK/REF

LSCC25

[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:
years old
[RANGE: 1 - 110]
DK/REF

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]?

133

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]?

134

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. Please answer this question again, then click Next to continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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
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 LS09 > CURRENT MONTH] The month in [CURRENT YEAR] you
entered has not begun yet. Please answer this question again, then click Next to continue.

135

PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 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, you reported that you were [AGE1STLS]
years old when you first used LSD. Which answer is correct?
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

1

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 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
2
3
4
5
6
7
8

January
February
March
April
May
June
July
August

136

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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] You first used LSD in [LSCC62-LSCC62a
fill]. That would make you [MYR1STLS] years old when you first used
LSD. Is this correct?
4
Yes
6
No
DK/REF

UPDATE: IF LSCC63 NE (6, BLANK OR DK/REF) AND (LSCC62 AND LSCC62a NE LS06LS09) THEN AGE1STLS = MYR1STLS
LS10 [IF (LS01a =1 OR LSREF1 = 1) AND (LS01b = 1 OR LSREF2=1 OR LS01c = 1 OR
LSREFPE = 1 OR LS01d = 1 OR LSREFMES = 1 OR LS01e = 1 OR LSREFPSI = 1 OR
LS01f = 1 OR LSREF3 = 1 OR LS01h = 1 OR LSREFOH = 1 OR LS01i=1 OR
LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k=1 OR LSREFSLV = 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

137

IF LSDREC < HALLREC:
LSCC26 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/REF
PROGRAMMER: 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?
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 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?
138

139

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:
days in the past 12 months
[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:
days per month, on average
[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:
days per week, on average
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

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:
days in the past 30 days
[RANGE: 1 - 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
2
3
4
5

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

140

6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE ESTILS:
IF LS30DKRE = 1, THEN ESTILS = 1
IF LS30DKRE = 2, THEN ESTILS = 3
IF LS30DKRE = 3, THEN ESTILS = 6
IF LS30DKRE = 4, THEN ESTILS = 10
IF LS30DKRE = 5, THEN ESTILS = 20
IF LS30DKRE = 6, THEN ESTILS = 30
ELSE ESTILS = BLANK
DEFINE HAL30DAY
IF LS30DKRE = 1, THEN HAL30DAY = “1 or 2”
IF LS30DKRE = 2, THEN HAL30DAY = “3 to 5”
IF LS30DKRE = 3, THEN HAL30DAY = “6 to 9”
IF LS30DKRE = 4, THEN HAL30DAY = “10 to 19”
IF LS30DKRE = 5, THEN HAL30DAY = “20 to 29”
IF LS30DKRE = 6, THEN HAL30DAY = “all 30”
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRAV2 NOT (BLANK OR DK/REF) THEN TOTHALL = LSYRAV2
ELSE IF LSMONAV2 NOT (BLANK OR DK/REF) THEN TOTHALL =
LSMONAV2*12
ELSE IF LSWKAV2 NOT (BLANK OR DK/REF) THEN TOTHALL = LSWKAV2*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LS30 NE DK/REF OR BLANK AND LS30 >
TOTHALL) OR (LS30 = DK/REF AND ESTILS > TOTHALL)):
LSCC72a [IF LS30 > TOTHALL] For the last question, you reported 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, you reported that you
used [LSFILL2] on [HAL30DAY] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF

141

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?
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
1

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:
days in the past 12 months
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

LSCC76

[IF LSCC74 = 2] On average, how many days did you use [LSFILL2]
each month during the past 12 months?
142

# OF DAYS/MONTH:
days per month, on average
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: 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:
days per week, on average
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: 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:
days in the past 30 days
[RANGE: 01 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
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/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

143

LS11 [IF (LS01b = 1 OR LSREF2 =1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01c = 1 OR
LSREFPE = 1 OR LS01d = 1 OR LSREFMES = 1 OR LS01e = 1 OR LSREFPSI = 1 OR
LSREF3 = 1 OR LS01f = 1 OR LS01h = 1 OR LSREFOH = 1 OR LS01i=1 OR
LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k=1 OR LSREFSLV = 1)]
Now think only about PCP. How old were you the first time you used PCP?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STPC
IF LS11 NE (BLANK OR DK/REF) THEN AGE1STPC = LS11
ELSE AGE1STPC = BLANK
IF CURNTAGE < AGE1STPC:
LSCC30

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:
years old
[RANGE: 1 - 110]
DK/REF

LSCC32a [IF LSCC32 < 12] Since you have indicated that you are [LSCC32]
years old, we cannot interview you for this study. Thank you for your
cooperation.
PROGRAM SHOULD ROUTE TO FIEXIT.
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
144

were you the first time you used PCP?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
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 You were [AGE1STPC] years old the first time you used PCP. Is this
correct?
4
Yes
6
No
DK/REF
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:
years old
[RANGE: 1 - 110]
DK/REF

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:
years old
[RANGE: 1 - 110]
DK/REF

LSCC38

[IF LSCC36 = 1 OR LSCC36 = 3] Please answer this question again.

145

Think about the first time you used PCP. How old were you the first
time you used PCP?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCC37 NOT (BLANK OR DK/REF) THEN AGE1STHA = LSCC37
UPDATE: IF LSCC38 NOT (BLANK OR DK/REF) THEN AGE1STPC = LSCC38
LS12 [IF LSCC34 NE DK/RE AND LSCC35 NE DK/REF AND AGE1STPC = CURNTAGE
AND DATE OF INTERVIEW < DOB OR IF AGE1STPC = CURNTAGE - 1 AND
DATE OF INTERVIEW ≥ DOB] Did you first use PCP in [CURRENT YEAR - 1] or
[CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LS13 [IF AGE1STPC = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did you first
use PCP in [CURRENT YEAR - 2] OR [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LS14 [IF LSCC34 NE DK/RE AND LSCC35 NE DK/REF AND AGE1STPC = CURNTAGE
AND DATE OF INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you
first use PCP?
1
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

146

entered has not begun yet. Please answer this question again, then click Next to continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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
HARD ERROR: [IF LS15 > CURRENT MONTH] The month in [CURRENT YEAR] you
entered has not begun yet. Please answer this question again, then click Next to continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 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, you reported that you were [AGE1STPC]
years old when you first used PCP. Which answer is correct?
1
2
3

I first used PCP in [LS12-15 fill] when I was [MYR1STPC]
years old
I was [AGE1STPC] years old the first time I used PCP
Neither answer is correct

147

DK/REF
UPDATE: IF LSCC65 = 1, THEN AGE1STPC = MYR1STPC
LSCC66

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

LSCC66a [IF LSCC66 NE (BLANK OR DK/REF)] Please answer this question
again. In what month in [LSCC66] did you first use PCP?
1
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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] You first used PCP in [LSCC66-LSCC66a
fill]. That would make you [MYR1STPC] years old when you first
used PCP. Is this correct?

148

4
Yes
6
No
DK/REF
UPDATE: IF LSCC67 NE (6, BLANK OR DK/REF) AND (LSCC66 AND LSCC66 NE LS12LS15) THEN AGE1STPC = MYR1STPC
LS16 [IF (LS01b = 1 OR LSREF2 = 1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01c = 1 OR
LSREFPE = 1 OR LS01d = 1 OR LSREFMES = 1 OR LS01e = 1 OR LSREFPSI = 1 OR
LS01f = 1 OR LSREF3 = 1 OR LS01h = 1 OR LSREFOH = 1 OR LS01i=1 OR
LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k=1 OR LSREFSLV = 1)]
How long has it been since you last used PCP?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DEFINE PCPREC:
IF LS16 NE (BLANK OR DK/REF) THEN PCPREC = LS16
ELSE PCPREC = BLANK
IF PCPREC < HALLREC:
LSCC39 You last used PCP [PCPREC FILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCC40

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

LSCC41

[IF LSCC40 = 2 OR LSCC40 = 3] Please answer this question again.
How long has it been since you last used [LSFILL]?
1
Within the past 30 days – that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
149

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/REF
PROGRAMMER: 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]”
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:
days in the past 12 months
[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:
days per month, on average
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

150

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:
days per week, on average
[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:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LS31DKRE [IF LS31 = DK/REF] What is your best estimate of the number of days 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 ESTILS = 1
IF LS31DKRE = 2, THEN ESTILS = 3
IF LS31DKRE = 3, THEN ESTILS = 6
IF LS31DKRE = 4, THEN ESTILS = 10
IF LS31DKRE = 5, THEN ESTILS = 20
IF LS31DKRE = 6, THEN ESTILS = 30
ELSE ESTILS = BLANK
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

151

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, you reported that you
used [LSFILL3] on [LS31] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCC81b [IF ESTILS > TOTHALL] For the last question, you reported that you
used [LSFILL3] on [HAL30DAY] of the past 30 days. Is this correct?
4
Yes
6
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
2
3

I used [LSFILL3] [FILLHAL] in the past 12 months
[FILLHALA]
I used [LSFILL3] [LS31 / HAL30DAY] days in the past 30
days
Neither answer is correct
152

DK/REF
LSCC83

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

LSCC84

[IF LSC83 = 3] On how many days in the past 12 months did you use
[LSFILL3]?
TOTAL # OF DAYS:
days in the past 12 months
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: 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:
days per month, on average
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: 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:
days per week, on average
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: 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

153

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:
days in the last 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: 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
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
LSAFUPE [IF (LS01c = 1 OR LSREFPE =1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01b
= 1 OR LSREF2 = 1 OR OR LS01d = 1 OR LSREFMES = 1 OR LS01e = 1 OR
LSREFPSI = 1 OR LSREF3 = 1 OR LS01f = 1 OR LS01h = 1 OR LSREFOH = 1 OR
LS01i=1 OR LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k=1 OR
LSREFSLV = 1] Now think only about peyote. How old were you the first time you
used peyote?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STPE:
IF LSAFUPE NE (BLANK OR DK/REF) THEN AGE1STPE = LSAFUPE
ELSE AGE1STPE = BLANK
IF CURNTAGE < AGE1STPE:
LSCCAPE You were [AGE1STPE] years old when you first used peyote. Is this
correct?
4
Yes
6
No
DK/REF

154

LSCCWPE [IF LSCCAPE = 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 [AGE1STPE] years old the first time I used peyote
3
Neither answer is correct
DK/REF
LSCCPEC [IF LSCCWPE =2 OR LSCCWPE =3] Please answer this question
again. What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
LSCCPEI [IF LSCCPEC < 12] Since you have indicated that you are
[LSCCPEC] years old, we cannot interview you for this study.Thank
you for your cooperation. PROGRAM SHOULD ROUTE TO
PENTER1.
LSCCPEA [IF LSCCWPE =1 OR LSCCWPE =3 OR LSCCAPE =6] Please
answer this question again. Think about the first time you used peyote.
How old were you the first time you used peyote?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCPEA NOT(BLANK OR DK/REF) THEN AGE1STPE = LSCCPEA
UPDATE: IF LSCCPEC NOT(BLANK OR DK/REF) THEN CURNTAGE = LSCCPEC
IF AGE1STPE =CURNTAGE OR AGE1STPE <10:
LSCCPE10 You were [AGE1STPE] years old the first time you used peyote. Is
this correct?
4
Yes
6
No
DK/REF
LSCCPEA2 [IF LSCCPE10=6] Please answer this question again. Think about
the first time you used peyote. How old were you the first time you
used peyote?
AGE:

years old

155

[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCPEA2 NOT(BLANK OR DK/REF) THEN AGE1STPE = LSCCPEA2
IF AGE1STPE < AGE1STHA:
LSCCWPE3 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 [AGE1STPE] years old the first time I used peyote
3
Neither answer is correct
DK/REF
LSCCAHA3 [IF LSCCWPE3=2 OR LSCCWPE3=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:
years old
[RANGE: 1 - 110]
DK/REF
LSCCPEA3 [IF LSCCWPE3= 1 OR LSCCWPE3= 3] Please answer this
question again. Think about the first time you used peyote. How old
were you the first time you used peyote?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCAHA3 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCCAHA3
UPDATE: IF LSCCPEA3 NOT(BLANK OR DK/REF) THEN AGE1STPE = LSCCPEA3
LSPECYR [IF AGE1STPE = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF
AGE1STPE = CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first use
peyote in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LSPEPYR [IF AGE1STPE = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you first use peyote in [CURRENT YEAR - 2] OR [CURRENT YEAR - 1]?
1
2

CURRENT YEAR - 2
CURRENT YEAR - 1

156

DK/REF
LSPECMO [IF AGE1STPE = CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what
month in [CURRENT YEAR] did you first use peyote?
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 LSPECMO > 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.
LSPEPMO [IF LSPECYR = 1 OR 2 OR LSPEPYR = 1 OR 2] In what month in [YEAR
FROM LSPECYR OR LSPEPYR] did you first use peyote?
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 LSPEPMO > 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.

157

DEFINE MYR1STPE:
MYR1STPE = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LSPECYR - LSPEPMO). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STPE IS BLANK.
IF MYR1STPE NE 0 AND NE AGE1STPE:
LSCCPEMY You first used peyote in [LSPECYR - LSPEPMO fill]. That would
make you [MYR1STPE] years old when you first used peyote. Is this
correct?
4
Yes
6
No
DK/REF
LSCCWHP [IF LSCCPEMY = 4] Earlier, you reported that you were
[AGE1STPE] years old when you first used peyote. Which answer is
correct?
I first used peyote in [LSPECYR - LSPEPMO fill] when I was
[MYR1STPE] years old
2
I was [AGE1STPE] years old the first time I used peyote
3
Neither answer is correct
DK/REF
1

UPDATE: IF LSCCWHP = 1, THEN AGE1STPE = MYR1STPE.
LSCCPEY [IF LSCCWHP =2 OR LSCCWHP =3 OR LSCCPEMY =6] Please
answer this question again. Did you first use peyote in [CURRENT
YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LSCCPEM [IF LSCCPEY NE (BLANK OR DK/REF)] Please answer this question
again. In what month in [LSCCPEY] did you first use peyote?
1
2
3
4
5
6
7
8
9

January
February
March
April
May
June
July
August
September

158

10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LSCCPEM > 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 LSCCPEM NE (0 OR DK/REF) THEN UPDATE MYR1STPE.
MYR1STPE = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF
BIRTH FROM MONTH AND YEAR OF FIRST USE (LSCCPEY AND LSCCPEM). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STPE IS BLANK. IF
MYR1STPE = AGE1STPE THEN MYR1STPE = BLANK
LSCCPEYN [IF LSCCWHP NE 1 AND MYR1STPE NE 0 AND (LSCCPEY
AND LSCCPEM NE LS06-LS09)] You first used peyote in [LSCCPEY
- LSCCPEM fill]. That would make you [MYR1STPE] years old when
you first used peyote. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF LSCCPEYN NE (6, BLANK OR DK/REF) AND (LSCCPEY AND LSCCPEM
NE LSPECYR - LSPEPMO) THEN AGE1STPE = MYR1STPE
LSPEYREC [IF (LS01a =1 OR LSREF1 = 1) AND (LS01b = 1 OR LSREF2=1 OR LS01c = 1
OR LSREFPE = 1 OR LS01d = 1 OR LSREFMES = 1 OR LS01e = 1 OR LSREFPSI = 1
OR LS01f = 1 OR LSREF3 = 1 OR LS01h = 1 OR LSREFOH = 1 OR LS01i=1 OR
LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k=1 OR LSREFSLV = 1)]
How long has it been since you last used peyote?
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 PEYREC
IF LSPEYREC NE (BLANK OR DK/REF) THEN PEYREC = LSPEYREC
ELSE PEYREC = BLANK
IF PEYREC < HALLREC:
LSCCPER You last used peyote [PEYREC FILL]. Is this correct?

159

4
Yes
6
No
DK/REF
LSCCWHAR [IF LSCCPER = 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 peyote [PEYREC FILL]
3
Neither answer is correct
DK/REF
LSCCHAR3 [IF LSCCWHAR = 2 OR LSCCWHAR = 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
LSCCPER3 [IF LSCCPER =6 OR LSCCWHAR = 1 OR LSCCWHAR = 3]
Please answer this question again. Think only about peyote. How long
has it been since you last used peyote?
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 LSCCHAR3 NOT (BLANK OR DK/REF) THEN HALLREC = LSCCHAR3
UPDATE: IF LSCCPER3 NOT (BLANK OR DK/REF) THEN PEYREC = LSCCPER3
DEFINE LSFILLPE:
IF HALLREC = 1 OR 2, LSFILLPE = "[LSFILL]"
ELSE IF PEYREC = 1 OR 2, LSFILLPE = "peyote or any other hallucinogen"
LSFRPE

[IF (HALLREC OR PEYREC = 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 [LSFILLPE] 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

160

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

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

LSMONPE

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

LSWKPE

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

LSPE30
[IF HALLREC = 1 OR PEYREC = 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 [LSFILLPE]?
NUMBER OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSPE30DR

[IF LSPE30 = DK/REF] What is your best estimate of the number of days you
used [LSFILLPE] 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 days

161

DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE ESTIPE:
IF LSPE30DR = 1, THEN
IF LSPE30DR = 2, THEN
IF LSPE30DR = 3, THEN
IF LSPE30DR = 4, THEN
IF LSPE30DR = 5, THEN
IF LSPE30DR = 6, THEN
ELSE ESTIPE = BLANK

ESTIPE = 1
ESTIPE = 3
ESTIPE = 6
ESTIPE = 10
ESTIPE = 20
ESTIPE = 30

DEFINE HAL30DAY
IF LSPE30DR = 1, THEN HAL30DAY = “1 or 2”
IF LSPE30DR = 2, THEN HAL30DAY = “3 to 5”
IF LSPE30DR = 3, THEN HAL30DAY = “6 to 9”
IF LSPE30DR = 4, THEN HAL30DAY = “10 to 19”
IF LSPE30DR = 5, THEN HAL30DAY = “20 to 29”
IF LSPE30DR = 6, THEN HAL30DAY = “all 30”
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRPE NOT (BLANK OR DK/REF) THEN TOTHALL = LSYRPE
ELSE IF LSMONPE NOT (BLANK OR DK/REF) THEN TOTHALL = LSMONPE*12
ELSE IF LSWKPE NOT (BLANK OR DK/REF) THEN TOTHALL = LSWKPE*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LSPE30 NE DK/REF OR BLANK AND LSPE30
> TOTHALL) OR (LSPE30 = DK/REF AND ESTILS > TOTHALL)):
LSCCPEa [IF LSPE30 > TOTHALL] You reported that you used [LSFILLPE] on
[LSPE30] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCCPEb [IF ESTIPE > TOTHALL] You reported that you used [LSFILLPE] on
[HAL30DAY] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE FILLHAL:

162

IF LSYRPE > 1, THEN FILLHAL = “[LSYRPE] days”
ELSE IF LSYRPE = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONPE > 1, THEN FILLHAL = “[LSMONPE] days per month”
ELSE IF LSMONPE = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKPE > 1, THEN FILLHAL = “[LSWKPE] days per week”
ELSE IF LSWKPE = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONPE] day(s) per month OR “[LSWKPE] day(s) per week”
THEN FILLHALA = “for a total of TOTHALL days”
ELSE FILLHALA = BLANK
LSCCHA12 [IF LSCCPEa = 4 OR LSCCPEb = 4] The answers for the last
question and an earlier question disagree. Which answer is correct?
I used [LSFILLPE] [FILLHAL] in the past 12 months
[FILLHALA]
2
I used [LSFILLPE] [LSPE30 / HAL30DAY] days in the past
30 days
3
Neither answer is correct
DK/REF
1

LSCCHAFR [IF LSCCHA12 = 2 OR LSCCHA12 = 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
[LSFILLPE] 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
LSCCHAYR [IF LSCCHAFR = 3] On how many days in the past 12 months did
you use [LSFILLPE]?
TOTAL # OF DAYS:
days in the past 12 months
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCCHAMO [IF LSCCHAFR = 2] On average, how many days did you use
[LSFILLPE] each month during the past 12 months?
# OF DAYS/MONTH:
[RANGE: 1 - 31]

163

days per month, on average

DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCCHAWK [IF LSCCHAFR = 1] On average, how many days did you use
[LSFILLPE] each week during the past 12 months?
# OF DAYS PER WEEK:
days per week, on average
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
IF LSCCHAYR NOT (BLANK OR DK/REF) THEN TOTHALL = LSCCHAYR
ELSE IF LSCCHAMO NOT (BLANK OR DK/REF) THEN TOTHALL=LSCCHAMO*12
ELSE IF LSCCHAWK NOT (BLANK OR DK/REF) THENTOTHALL=LSCCHAWK*52
ELSE TOTHALL = DK/REF
LSCCHAa [IF LSCCPEa = 6 OR ((LSCCHA12 = 1 OR LSCCHA12 = 3) AND
LSCCPEa 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 [LSFILLPE]?
# OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCCHAb [IF LSCCPEb = 6 OR ((LSCCHA12 = 1 OR LSCCHA12 = 3) AND
LSCCPEb 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 [LSFILLPE] 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
LSAFUMES [IF (LS01d = 1 OR LSREFMES =1) AND (LS01a = 1 OR LSREF1 = 1 OR
LS01b = 1 OR LSREF2 = 1 OR OR LS01c = 1 OR LSREFPE = 1 OR LS01e = 1 OR
LSREFPSI = 1 OR LSREF3 = 1 OR LS01f = 1 OR LS01h = 1 OR LSREFOH = 1 OR
LS01i=1 OR LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k=1 OR
LSREFSLV = 1] Now think only about mescaline. How old were you the first time you
used mescaline?
164

AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STMES:
IF LSAFUMES NE (BLANK OR DK/REF) THEN AGE1STMES = LSAFUMES
ELSE AGE1STMES = BLANK
IF CURNTAGE < AGE1STMES:
LSCCAMS You were [AGE1STMES] years old when you first used mescaline. Is
this correct?
4
Yes
6
No
DK/REF
LSCCWMS [IF LSCCAMS = 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 [AGE1STMES] years old the first time I used mescaline
3
Neither answer is correct
DK/REF
LSCCMSC [IF LSCCWMS =2 OR LSCCWMS =3] Please answer this question
again. What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
LSCCMSI [IF LSCCMSC < 12] Since you have indicated that you are
[LSCCMSC] years old, we cannot interview you for this study. Thank
you for your cooperation. PROGRAM SHOULD ROUTE TO
PENTER1.
LSCCMSA [IF LSCCWMS =1 OR LSCCWMS =3 OR LSCCAMS =6] Please
answer this question again. Think about the first time you used
mescaline. How old were you the first time you used mescaline?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCMSA NOT(BLANK OR DK/REF) THEN AGE1STMES = LSCCMSA

165

UPDATE: IF LSCCMSC NOT(BLANK OR DK/REF) THEN CURNTAGE = LSCCMSC
IF AGE1STMES =CURNTAGE OR AGE1STMES <10:
LSCCMS10 You were [AGE1STMES] years old the first time you used
mescaline. Is this correct?
4
Yes
6
No
DK/REF
LSCCPMSA2 [IF LSCCMS10=6] Please answer this question again. Think
about the first time you used mescaline. How old were you the first
time you used mescaline?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCMSA2 NOT(BLANK OR DK/REF) THEN AGE1STMES = LSCCMSA2
IF AGE1STMES < AGE1STHA:
LSCCWMS3 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 [AGE1STMES] years old the first time I used mescaline
3
Neither answer is correct
DK/REF
LSCCAHA4 [IF LSCCWMS3=2 OR LSCCWMS3=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:
years old
[RANGE: 1 - 110]
DK/REF
LSCCMSA3 [IF LSCCWMS3= 1 OR LSCCWMS3= 3] Please answer this
question again. Think about the first time you used mescaline. How
old were you the first time you used mescaline?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCAHA4 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCCAHA4

166

UPDATE: IF LSCCMSA3 NOT(BLANK OR DK/REF) THEN AGE1STMES = LSCCMSA3
LSMSCYR [IF AGE1STMES = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF
AGE1STMES = CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first
use mescaline in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LSMSPYR [IF AGE1STMES = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB]
Did you first use mescaline in [CURRENT YEAR - 2] OR [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LSMSCMO [IF AGE1STMES = CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In
what month in [CURRENT YEAR] did you first use mescaline?
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 LSMSCMO > 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.
LSMSPMO [IF LSMSCYR = 1 OR 2 OR LSMSPYR = 1 OR 2] In what month in [YEAR
FROM LSMSCYR OR LSMSPYR] did you first use mescaline?
1
2
3
4

January
February
March
April

167

5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LSMSPMO > 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 MYR1STMES:
MYR1STMES = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LSMSCYR - LSMSPMO).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STMES IS BLANK.
IF MYR1STMES NE 0 AND NE AGE1STMES:
LSCCMSMY You first used mescaline in [LSMSCYR - LSMSPMO fill]. That
would make you [MYR1STMES] years old when you first used
mescaline. Is this correct?
4
Yes
6
No
DK/REF
LSCCWHM [IF LSCCMSMY = 4] Earlier, you reported that you were
[AGE1STMES] years old when you first used mescaline. Which
answer is correct?
I first used MESCALINE in [LSMSCYR - LSMSPMO fill]
when I was [MYR1STMES] years old
2
I was [AGE1STMES] years old the first time I used mescaline
3
Neither answer is correct
DK/REF
1

UPDATE: IF LSCCWHM = 1, THEN AGE1STMES = MYR1STMES.
LSCCMSY [IF LSCCWHM =2 OR LSCCWHM =3 OR LSCCMSMY =6] Please
answer this question again. Did you first use mescaline in [CURRENT
YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
2

CURRENT YEAR -2
CURRENT YEAR -1
168

3
CURRENT YEAR
DK/REF
LSCCMSM [IF LSCCMSY NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LSCCMSY] did you first use
mescaline?
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 LSCCMSM > 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 LSCCMSM NE (0 OR DK/REF) THEN UPDATE MYR1STMES.
MYR1STMES = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF
BIRTH FROM MONTH AND YEAR OF FIRST USE (LSCCMSY AND LSCCMSM). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STMES IS BLANK. IF
MYR1STMES = AGE1STMES THEN MYR1STMES = BLANK
LSCCMSYN [IF LSCCWHM NE 1 AND MYR1STMES NE 0 AND (LSCCMSY
AND LSCCMSM NE LSMSCYR - LSMSPYR)] You first used
mescaline in [LSCCMSY - LSCCMSM fill]. That would make you
[MYR1STMES] years old when you first used mescaline. Is this
correct?
4
Yes
6
No
DK/REF
UPDATE: IF LSCCMSYN NE (6, BLANK OR DK/REF) AND (LSCCMSY AND LSCCMSM
NE LSMSCYR - LSMSPYR) THEN AGE1STMES = MYR1STMES
LSMESREC [IF (LS01d =1 OR LSREFMES = 1) AND (LS01a = 1 OR LSREF1=1 OR LS01b
= 1 OR LSREF2=1 OR LS01c = 1 OR LSREFPE = 1 OR LS01e = 1 OR LSREFPSI = 1

169

OR LS01f = 1 OR LSREF3 = 1 OR LS01h = 1 OR LSREFOH = 1 OR LS01i=1 OR
LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k=1 OR LSREFSLV = 1)]
How long has it been since you last used mescaline?
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 MESREC
IF LSMESREC NE (BLANK OR DK/REF) THEN MESREC = LSMESREC
ELSE MESREC = BLANK
IF MESREC < HALLREC:
LSCCMSR
You last used mescaline [MESREC FILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCCWHMR [IF LSCCMSR = 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 mescaline [MESREC FILL]
3
Neither answer is correct
DK/REF
LSCCHAR4 [IF LSCCWHMR = 2 OR LSCCWHMR = 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
LSCCMSR4 [IF LSCCMSR =6 OR LSCCWHMR = 1 OR LSCCWHMR = 3]
Please answer this question again. Think only about mescaline. How
long has it been since you last used mescaline?
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
170

UPDATE: IF LSCCHAR4 NOT (BLANK OR DK/REF) THEN HALLREC = LSCCHAR4
UPDATE: IF LSCCMSR4 NOT (BLANK OR DK/REF) THEN MESREC = LSCCMSR4
DEFINE LSFILLMS:
IF HALLREC = 1 OR 2, LSFILLMS = "[LSFILL]"
ELSE IF MESREC = 1 OR 2, LSFILLMS = "mescaline or any other hallucinogen"
LSFRMS

[IF (HALLREC OR MESREC = 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 [LSFILLMS] 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

LSYRMS

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

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

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

LSMS30
[IF HALLREC = 1 OR MESREC = 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 [LSFILLMS]?

171

NUMBER OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSMS30DR [IF LSMS30 = DK/REF] What is your best estimate of the number of days you
used [LSFILLMS] 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 ESTIMES:
IF LSMS30DR = 1, THEN ESTIMES = 1
IF LSMS30DR = 2, THEN ESTIMES = 3
IF LSMS30DR = 3, THEN ESTIMES = 6
IF LSMS30DR = 4, THEN ESTIMES = 10
IF LSMS30DR = 5, THEN ESTIMES = 20
IF LSMS30DR = 6, THEN ESTIMES = 30
ELSE ESTIMES = BLANK
DEFINE HAL30DAY
IF LSMS30DR = 1, THEN HAL30DAY = “1 or 2”
IF LSMS30DR = 2, THEN HAL30DAY = “3 to 5”
IF LSMS30DR = 3, THEN HAL30DAY = “6 to 9”
IF LSMS30DR = 4, THEN HAL30DAY = “10 to 19”
IF LSMS30DR = 5, THEN HAL30DAY = “20 to 29”
IF LSMS30DR = 6, THEN HAL30DAY = “all 30”
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRMS NOT (BLANK OR DK/REF) THEN TOTHALL = LSYRMS
ELSE IF LSMONMS NOT (BLANK OR DK/REF) THEN TOTHALL =
LSMONMS*12
ELSE IF LSWKMS NOT (BLANK OR DK/REF) THEN TOTHALL = LSWKMS*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LSMS30 NE DK/REF OR BLANK AND LSMS30
> TOTHALL) OR (LS30 = DK/REF AND ESTIMES > TOTHALL)):

172

LSCCPEa [IF LSMS30 > TOTHALL] For the last question, you reported that
you used [LSFILLMS] on [LSMS30] of the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCCPEb [IF ESTIMES > TOTHALL] For the last question, you reported that
you used [LSFILLMS] on [HAL30DAY] of the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE FILLHAL:
IF LSYRMS > 1, THEN FILLHAL = “[LSYRMS] days”
ELSE IF LSYRMS = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONMS > 1, THEN FILLHAL = “[LSMONPE] days per month”
ELSE IF LSMONMS = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKMS > 1, THEN FILLHAL = “[LSWKPE] days per week”
ELSE IF LSWKMS = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONMS] day(s) per month OR “[LSWKMS] day(s) per week”
THEN FILLHALA = “for a total of TOTHALL days”
ELSE FILLHALA = BLANK
LSCCHM12 [IF LSCCMSa = 4 OR LSCCMSb = 4] The answers for the last
question and an earlier question disagree. Which answer is correct?
I used [LSFILLMS] [FILLHAL] in the past 12 months
[FILLHALA]
2
I used [LSFILLMS] [LSMS30 / HAL30DAY] days in the past
30 days
3
Neither answer is correct
DK/REF
1

LSCCHMFR [IF LSCCHM12 = 2 OR LSCCHM12 = 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
[LSFILLMS] during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve
used it?

173

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
LSCCHMYR [IF LSCCHMFR = 3] On how many days in the past 12 months
did you use [LSFILLMS]?
TOTAL # OF DAYS:
days in the past 12 months
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCCHMMO [IF LSCCHMFR = 2] On average, how many days did you use
[LSFILLMS] each month during the past 12 months?
# OF DAYS/MONTH:
days per month, on average
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCCHMWK [IF LSCCHMFR = 1] On average, how many days did you use
[LSFILLMS] each week during the past 12 months?
# OF DAYS PER WEEK:
days per week, on average
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
IF LSCCHMYR NOT (BLANK OR DK/REF) THEN TOTHALL = LSCCHMYR
ELSE IF LSCCHMMO NOT (BLANK OR DK/REF) THEN TOTHALL=LSCCHMMO*12
ELSE IF LSCCHMWK NOT (BLANK OR DK/REF) THEN TOTHALL=LSCCHMWK*52
ELSE TOTHALL = DK/REF
LSCCHMa [IF LSCCMSa = 6 OR ((LSCCHM12 = 1 OR LSCCHM12 = 3) AND
LSCCMSa 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 [LSFILLMS]?
# OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCCHMb [IF LSCCMSb = 6 OR ((LSCCHM12 = 1 OR LSCCHM12 = 3) AND
LSCCMSb NE BLANK OR DK/REF)] Please answer this question

174

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 [LSFILLMS] 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
LSAFUPSI [IF (LS01e = 1 OR LSREFPSI =1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01b =
1 OR LSREF2 = 1 OR LS01c = 1 OR LSREFPE = 1 OR LS01d = 1 OR LSREFMES =
1 OR LSREF3 = 1 OR LS01f = 1 OR LS01h = 1 OR LSREFOH = 1 OR LS01i=1 OR
LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k=1 OR LSREFSLV = 1]
Now think only about psilocybin. How old were you the first time you used psilocybin?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STPSI:
IF LSAFUPSI NE (BLANK OR DK/REF) THEN AGE1STPSI = LSAFUPSI
ELSE AGE1STPSI = BLANK
IF CURNTAGE < AGE1STPSI:
LSCCAPS You were [AGE1STPSI] years old when you first used psilocybin. Is
this correct?
4
Yes
6
No
DK/REF
LSCCWPS [IF LSCCAPS = 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 [AGE1STPSI] years old the first time I used psilocybin
3
Neither answer is correct
DK/REF
LSCCPSC [IF LSCCWPS =2 OR LSCCWPS =3] Please answer this question
again. What is your current age?
AGE:

years old
175

[RANGE: 1 - 110]
DK/REF
LSCCPSI [IF LSCCPSC < 12] Since you have indicated that you are
[LSCCPSC] years old, we cannot interview you for this study.Thank
you for your cooperation. PROGRAM SHOULD ROUTE TO
PENTER1.
LSCCPSA [IF LSCCWPS =1 OR LSCCWPS =3 OR LSCCAPS =6] Please
Please answer this question again. Think about the first time you used
psilocybin. How old were you the first time you used psilocybin?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCPSA NOT(BLANK OR DK/REF) THEN AGE1STPSI = LSCCPSA
UPDATE: IF LSCCPSC NOT(BLANK OR DK/REF) THEN CURNTAGE = LSCCPSC
IF AGE1STPSI =CURNTAGE OR AGE1STPSI <10:
LSCCPS10 You were [AGE1STPSI] years old the first time you used
psilocybin. Is this correct?
4
Yes
6
No
DK/REF
LSCCPSA2 [IF LSCCPS10=6] Please answer this question again. Think about
the first time you used psilocybin. How old were you the first time you
used psilocybin?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCPSA2 NOT(BLANK OR DK/REF) THEN AGE1STPSI = LSCCPSA2
IF AGE1STPSI < AGE1STHA:
LSCCWPS3 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 [AGE1STPSI] years old the first time I used psilocybin
3
Neither answer is correct
DK/REF

176

LSCCAHP5 [IF LSCCWPS3=2 OR LSCCWPS3=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:
years old
[RANGE: 1 - 110]
DK/REF
LSCCPSA3 [IF LSCCWPS3= 1 OR LSCCWPS3= 3] Please answer this
question again. Think about the first time you used psilocybin. How
old were you the first time you used psilocybin?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCAHP5 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCCAHP5
UPDATE: IF LSCCPSA3NOT(BLANK OR DK/REF) THEN AGE1STPSI = LSCCPSA3
LSPSCYR [IF AGE1STPSI = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF
AGE1STPSI = CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first
use psilocybin in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LSPSPYR
[IF AGE1STPSI = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you first use psilocybin in [CURRENT YEAR - 2] OR [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LSPSCMO [IF AGE1STPSI = CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In what
month in [CURRENT YEAR] did you first use psilocybin?
1
2
3
4
5
6
7
8

January
February
March
April
May
June
July
August

177

9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LSPSCMO > 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.
LSPSPMO [IF LSPSCYR = 1 OR 2 OR LSPSPYR = 1 OR 2] In what month in [YEAR
FROM LSPSCYR OR LSPSPYR] did you first use psilocybin?
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 LSPSPMO > 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 MYR1STPSI:
MYR1STPSI = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LSPSCYR - LSPSPMO). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STPSI IS BLANK.
IF MYR1STPSI NE 0 AND NE AGE1STPSI:
LSCCPSMY You first used psilocybin in [LSPSCYR - LSPSPMO fill]. That
would make you [MYR1STPSI] years old when you first used
psilocybin. Is this correct?
4
Yes
6
No
DK/REF

178

LSCCWHPS [IF LSCCPSMY = 4] Earlier, you reported that you were
[AGE1STPSI] years old when you first used psilocybin. Which answer
is correct?
I first used psilocybin in [LSPSCYR - LSPSPMO fill] when I
was [MYR1STPSI] years old
2
I was [AGE1STPSI] years old the first time I used psilocybin
3
Neither answer is correct
DK/REF
1

UPDATE: IF LSCCWHPS = 1, THEN AGE1STPSI = MYR1STPSI.
LSCCPSY [IF LSCCWHPS =2 OR LSCCWHPS =3 OR LSCCPSMY =6] Please
answer this question again. Did you first use psilocybin in
[CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LSCCPSM [IF LSCCPSY NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LSCCPSY] did you first use
psilocybin?
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 LSCCPSM > 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 LSCCPSM NE (0 OR DK/REF) THEN UPDATE MYR1STPSI.

179

MYR1STPSI = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF
BIRTH FROM MONTH AND YEAR OF FIRST USE (LSCCPSY AND LSCCPSM). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STPSI IS BLANK. IF
MYR1STPSI = AGE1STPSI THEN MYR1STPSI = BLANK
LSCCPSYN [IF LSCCWHPS NE 1 AND MYR1STPE NE 0 AND (LSCCPSY
AND LSCCPSM NE LSPSCYR - LSPSPYR)] You first used psilocybin
in [LSPSCYR - LSPSPYR fill]. That would make you [MYR1STPSI]
years old when you first used psilocybin. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF LSCCPSYN NE (6, BLANK OR DK/REF) AND (LSCCPSY AND LSCCPSM
NE LSPSCYR - LSPSPYR)) THEN AGE1STPSI = MYR1STPSI
LS36 [IF (LS01e = 1 OR LSREFPSI = 1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01b = 1
OR LSREF2 = 1 OR LS01c = 1 OR LSREFPE = 1 OR LS01d = 1 OR LSREFMES = 1
OR LS01f = 1 OR LSREF3 = 1 OR LS01h = 1 OR LSREFOH = 1 OR LS01i=1 OR
LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k=1 OR LSREFSLV = 1))]
How long has it been since you last used psilocybin?
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 PSIREC:
IF LS36 NE (BLANK OR DK/REF) THEN PSIREC = LS36
ELSE PSIREC = BLANK
IF PSIREC < HALLREC:
LSCC111 You last used psilocybin [PSIREC FILL]. Is this correct?
4
Yes
6
No
DK/REF
LSCC112 [IF LSCC111 = 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 psilocybin [PSIREC FILL]
3
Neither answer is correct
DK/REF
180

LSCC113 [IF LSCC112 = 2 OR LSCC112 = 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
LSCC114 [IF LSCC111 =6 OR LSCC113 = 1 OR LSCC113 = 3] Please answer
this question again. Think only about psilocybin. How long has it been
since you last used psilocybin?
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 LSCC113 NOT (BLANK OR DK/REF), THEN HALLREC = LSCC113
UPDATE: IF LSCC114 NOT (BLANK OR DK/REF), THEN PSIREC = LSCC114
DEFINE LSFILLPS:
IF HALLREC = 1 OR 2, LSFILLPS = "[LSFILL]"
ELSE IF PSIREC = 1 OR 2, LSFILLPS = "psilocybin or any other hallucinogen"
LSFRPS

[IF (HALLREC OR PSIREC = 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 [LSFILLPS] 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

LSYRPS

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

181

LSMONPS

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

LSWKPS

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

LSPS30
[IF HALLREC = 1 OR PSIREC = 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 [LSFILLPS]?
NUMBER OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSPS30DR

[IF LSPS30 = DK/REF] What is your best estimate of the number of days you
used [LSFILLPS] 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 ESTIPSI:
IF LSPS30DR = 1, THEN
IF LSPS30DR = 2, THEN
IF LSPS30DR = 3, THEN
IF LSPS30DR = 4, THEN
IF LSPS30DR = 5, THEN
IF LSPS30DR = 6, THEN
ELSE ESTIPSI = BLANK

ESTIPSI = 1
ESTIPSI = 3
ESTIPSI = 6
ESTIPSI = 10
ESTIPSI = 20
ESTIPSI = 30

182

DEFINE HAL30DAY
IF LSPS30DR = 1, THEN HAL30DAY = “1 or 2”
IF LSPS30DR = 2, THEN HAL30DAY = “3 to 5”
IF LSPS30DR = 3, THEN HAL30DAY = “6 to 9”
IF LSPS30DR = 4, THEN HAL30DAY = “10 to 19”
IF LSPS30DR = 5, THEN HAL30DAY = “20 to 29”
IF LSPS30DR = 6, THEN HAL30DAY = “all 30”
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRPS NOT (BLANK OR DK/REF) THEN TOTHALL = LSYRPS
ELSE IF LSMONPS NOT (BLANK OR DK/REF) THEN TOTHALL = LSMONPS*12
ELSE IF LSWKPS NOT (BLANK OR DK/REF) THEN TOTHALL = LSWKPS*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LSPS30 NE DK/REF OR BLANK AND LSPS30 >
TOTHALL) OR (LSPS30 = DK/REF AND ESTIPSI > TOTHALL)):
LSCCPSa [IF LSPS30 > TOTHALL] For the last question, you reported that you
used [LSFILLPS] on [LSPS30] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCCPSb [IF ESTIPSI > TOTHALL] For the last question, you reported that
you used [LSFILLPS] on [HAL30DAY] of the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE FILLHAL:
IF LSYRPS > 1, THEN FILLHAL = “[LSYRPS] days”
ELSE IF LSYRPS = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONPS > 1, THEN FILLHAL = “[LSMONPS] days per month”
ELSE IF LSMONPS = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKPS > 1, THEN FILLHAL = “[LSWKPS] days per week”
ELSE IF LSWKPS = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONPS] day(s) per month OR “[LSWKPS] day(s) per week”
THEN FILLHALA = “for a total of TOTHALL days”

183

ELSE FILLHALA = BLANK
LSCCHP12 [IF LSCCPSa = 4 OR LSCCPSb = 4] The answers for the last
question and an earlier question disagree. Which answer is correct?
I used [LSFILLPS] [FILLHAL] in the past 12 months
[FILLHALA]
2
I used [LSFILLPS] [LSPS30 / HAL30DAY] days in the past
30 days
3
Neither answer is correct
DK/REF
1

LSCCHPFR [IF LSCCHP12= 2 OR LSCCHP12= 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
[LSFILLPS] 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
LSCCHPYR [IF LSCCHPFR = 3] On how many days in the past 12 months did
you use [LSFILLPS]?
TOTAL # OF DAYS:
days in the past 12 months
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCCHPMO [IF LSCCHPFR = 2] On average, how many days did you use
[LSFILLPS] each month during the past 12 months?
# OF DAYS/MONTH:
days per month, on average
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCCHPWK [IF LSCCHPFR = 1] On average, how many days did you use
[LSFILLPS] each week during the past 12 months?
# OF DAYS PER WEEK:
days per week, on average
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

184

IF LSCCHPYR NOT (BLANK OR DK/REF) THEN TOTHALL = LSCCHPYR
ELSE IF LSCCHPMO NOT (BLANK OR DK/REF) THEN TOTHALL= LSCCHPMO*12
ELSE IF LSCCHPWK NOT (BLANK OR DK/REF) THENTOTHALL= LSCCHPWK*52
ELSE TOTHALL = DK/REF
LSCCHPa [IF LSCCPSa = 6 OR ((LSCCHP12 = 1 OR LSCCHP12 = 3) AND
LSCCPSa 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 [LSFILLPS]?
# OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCCHPb [IF LSCCPSb = 6 OR ((LSCCHP12 = 1 OR LSCCHP12 = 3) AND
LSCCPSb 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 [LSFILLPS] 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

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:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STEC
IF LS17 NE (BLANK OR DK/REF) THEN AGE1STEC = LS17
ELSE AGE1STEC = BLANK
IF CURNTAGE < AGE1STEC:

185

LSCC43

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

1
2

LSCC45

[IF LSCC44=2 OR LSCC44=3] Please answer this question again.
What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF

LSCC45a [IF LSCC45 < 12] Since you have indicated that you are [LSCC45]
years old, we cannot interview you for this study. Thank you for your
cooperation.
PROGRAM SHOULD ROUTE TO FIEXIT.
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:
years old
[RANGE: 1 - 110]
DK/REF

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 You were [AGE1STEC] years old the first time you used ‘Ecstasy’ or
‘Molly’. Is this correct?

186

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:
years old
[RANGE: 1 - 110]
DK/REF

UPDATE: IF LSCC48 NOT(BLANK OR DK/REF) THEN AGE1STEC = LSCC48
IF AGE1STEC < AGE1STHA:
LSCC49 The answers for the last question and an earlier question disagree.
Which answer is correct?
I was [AGE1STHA] years old the first time I used [LSFILL]
I was [AGE1STEC] years old the first time I used ‘Ecstasy’ or
‘Molly’
3
Neither answer is correct
DK/REF

1
2

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:
years old
[RANGE: 1 - 110]
DK/REF

LSCC51

[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:
years old
[RANGE: 1 - 110]
DK/REF

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

187

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
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LS20 [IF LSCC47 NE DK/RE AND LSCC48 NE DK/REF AND AGE1STEC = CURNTAGE
AND DATE OF INTERVIEW ≥ DOB] In what month in [CURRENT YEAR] did you
first use ‘Ecstasy’ 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. Please answer this question again, then click Next to continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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
2
3
4
5

January
February
March
April
May

188

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. Please answer this question again, then click Next to continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 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, you reported that you were [AGE1STEC]
years old when you first used ‘Ecstasy’ or ‘Molly’. Which answer is
correct?
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
1

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

189

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
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 LSCC70a > CURRENT MONTH] The month in [CURRENT YEAR]
you entered has not begun yet. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] 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 LS18LS21) THEN AGE1STEC = MYR1STEC

190

LS22 [IF (LS01f = 1 OR LSREF3 = 1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01b = 1 OR
LSREF2 = 1 OR LS01c = 1 OR LSREFPE = 1 OR LS01d = 1 OR LSREFMES = 1 OR
LS01e = 1 OR LSREFPSI = 1 OR LS01h = 1 OR LSREFOH = 1 OR LS01i=1 OR
LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k=1 OR LSREFSLV = 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

DEFINE ECSTREC:
IF LS22 NE (BLANK OR DK/REF) THEN ECSTREC = LS22
ELSE ECSTREC = BLANK
IF ECSTREC < HALLREC:
LSCC52 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]

191

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 LSCC54 NOT (BLANK OR DK/REF), THEN HALLREC = LSCC54
UPDATE: IF LSCC55 NOT (BLANK OR DK/REF), THEN ECSTREC = LSCC55
DEFINE LSFILL4:
IF HALLREC OR LSDREC OR PCPREC = 1 OR 2, LSFILL4 = “[LSFILL]”
ELSE IF ECSTREC = 1 OR 2, LSFILL4 = “‘Ecstasy’ or ‘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:
days in the past 12 months
[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:
days per month, on average
[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:

192

days per week, on average

[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:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
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 ESTILS = 1
IF LS32DKRE = 2, THEN ESTILS = 3
IF LS32DKRE = 3, THEN ESTILS = 6
IF LS32DKRE = 4, THEN ESTILS = 10
IF LS32DKRE = 5, THEN ESTILS = 20
IF LS32DKRE = 6, THEN ESTILS = 30
ELSE ESTILS = BLANK
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

193

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, you reported that you
used [LSFILL4] on [LS32] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCC90b [IF ESTILS > TOTHALL] For the last question, you reported 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?
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
1

194

LSCC92

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

LSCC93

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

LSCC94

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

# OF DAYS/MONTH:
days per month, on average
[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:
days per week, on average
[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

195

use [LSFILL4]?
# OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: 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?
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
LSAFUKET [IF (LS01i = 1 OR LSREFKET =1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01b
= 1 OR LSREF2 = 1 OR LS01c=1 OR LSREFPE = 1 OR LS01d = 1 OR LSREFMES =
1 OR LS01e = 1 OR LSREFPSI = 1 OR LSREF3 = 1 OR LS01f = 1 OR LS01h = 1 OR
LSREFOH = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k=1 OR LSREFSLV = 1Now
think only about Ketamine. How old were you the first time you used Ketamine?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STKET:
IF LSAFUKET NE (BLANK OR DK/REF) THEN AGE1STKET = LSAFUKET
ELSE AGE1STKET = BLANK
IF CURNTAGE < AGE1STKET:
LSCCAKT You were [AGE1STKET] years old when you first used Ketamine. Is
this correct?
4
Yes
6
No
DK/REF
LSCCWKT [IF LSCCAKT = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?

196

1
I am currently [CURNTAGE] years old
2
I was [AGE1STKET] years old the first time I used Ketamine
3
Neither answer is correct
DK/REF
LSCCKTC [IF LSCCWKT =2 OR LSCCWKT =3] Please answer this question
again. What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
LSCCKTI [IF LSCCKTC < 12] Since you have indicated that you are
[LSCCKTC] years old, we cannot interview you for this study. Thank
you for your cooperation. PROGRAM SHOULD ROUTE TO
PENTER1.
LSCCKTA [IF LSCCWKT =1 OR LSCCWKT =3 OR LSCCAKT =6] Please
answer this question again. Think about the first time you used
Ketamine. How old were you the first time you used Ketamine?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCKTA NOT(BLANK OR DK/REF) THEN AGE1STKET = LSCCKTA
UPDATE: IF LSCCKTC NOT(BLANK OR DK/REF) THEN CURNTAGE = LSCCKTC
IF AGE1STKET =CURNTAGE OR AGE1STKET <10:
LSCCKT10 You were [AGE1STKET] years old the first time you used
Ketamine. Is this correct?
4
Yes
6
No
DK/REF
LSCCKTA2 [IF LSCCKT10=6] Please answer this question again. Think about
the first time you used Ketamine. How old were you the first time you
used Ketamine?
AGE:
years old
[RANGE: 1 - 110]
DK/REF

197

UPDATE: IF LSCCKTA2 NOT(BLANK OR DK/REF) THEN AGE1STKET = LSCCKTA2
IF AGE1STKET < AGE1STHA:
LSCCWKT3 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 [AGE1STKET] years old the first time I used Ketamine
3
Neither answer is correct
DK/REF
LSCCAHA7 [IF LSCCWKT3=2 OR LSCCWKT3=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:
years old
[RANGE: 1 - 110]
DK/REF
LSCCKTA3 [IF LSCCWKT3= 1 OR LSCCWKT3= 3] Please answer this
question again. Think about the first time you used Ketamine. How old
were you the first time you used Ketamine?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCAHA7 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCCAHA7
UPDATE: IF LSCCKTA3 NOT(BLANK OR DK/REF) THEN AGE1STKET = LSCCKTA3
LSKTCYR [IF AGE1STKET = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF
AGE1STKET = CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first
use Ketamine in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LSKTPYR [IF AGE1STKET = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you first use Ketamine in [CURRENT YEAR - 2] OR [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LSKTCMO [IF AGE1STKET = CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In

198

what month in [CURRENT YEAR] did you first use Ketamine?
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 LSPECMO > 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.
LSKTPMO [IF LSKTCYR = 1 OR 2 OR LSKTPYR = 1 OR 2] In what month in [YEAR
FROM LSKTCYR OR LSKTPYR] did you first use Ketamine?
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 LSKTPMO > 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 MYR1STKET:
MYR1STKET = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LSKTCYR – LSKTPMO) IF

199

MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STKET IS BLANK.
IF MYR1STKET NE 0 AND NE AGE1STKET:
LSCCKTMY You first used Ketamine in [LSKTCYR - LSKTPMO fill]. That
would make you [MYR1STKET] years old when you first used
Ketamine. Is this correct?
4
Yes
6
No
DK/REF
LSCCWHK [IF LSCCKTMY = 4] Earlier, you reported that you were
[AGE1STKET] years old when you first used Ketamine. Which
answer is correct?
I first used Ketamine in [LSKTCYR - LSKTPMO fill] when I
was [MYR1STKET] years old
2
I was [AGE1STKET] years old the first time I used Ketamine
3
Neither answer is correct
DK/REF
1

UPDATE: IF LSCCWHK = 1, THEN AGE1STKET = MYR1STKET.
LSCCKTY [IF LSCCWHK =2 OR LSCCWHK =3 OR LSCCKTMY =6] Please
answer this question again. Did you first use Ketamine in [CURRENT
YEAR-2], [CURRENT YEAR-1], or [CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LSCCKTM [IF LSCCKTY NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LSCCKTY] did you first use
Ketamine?
1
2
3
4
5
6
7
8
9
10
11

January
February
March
April
May
June
July
August
September
October
November

200

12
December
DK/REF
HARD ERROR: [IF LSCCKTM > 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 LSCCKTM NE (0 OR DK/REF) THEN UPDATE MYR1STKET.
MYR1STKET = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF
BIRTH FROM MONTH AND YEAR OF FIRST USE (LSCCKTY AND LSCCKTM). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STKET IS BLANK. IF
MYR1STKET = AGE1STKET THEN MYR1STKET = BLANK
LSCCKTYN [IF LSCCWHK NE 1 AND MYR1STKET NE 0 AND (LSCCKTY
AND LSCCKTM NE LSKTCYR - LSKTPYR)] You first used Ketamine
in [LSCCKTY - LSCCKTM fill]. That would make you
[MYR1STKET] years old when you first used Ketamine. Is this
correct?
4
Yes
6
No
DK/REF
UPDATE: IF LSCCKTYN NE (6, BLANK OR DK/REF) AND (LSCCKTY AND LSCCKTM
NE LSKTCYR - LSKTPYR) THEN AGE1STKET = MYR1STKET
LS33 [IF (LS01i =1 OR LSREFKET = 1) AND (LS01a=1 OR LSREF1=1) OR (LS01b = 1 OR
LSREF2=1) OR LS01c = 1 OR LSREFPE = 1 OR LS01d = 1 OR LSREFMES = 1 OR
LS01e = 1 OR LSREFPSI = 1 OR (LS01f = 1 OR LSREF3 = 1) OR LS01h = 1 OR
LSREFOH = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k=1 OR LSREFSLV = 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 You last used Ketamine [KETREC FILL]. Is this correct?
4

Yes
201

6
No
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
DEFINE LSFILLKT:
IF HALLREC = 1 OR 2, LSFILLKT = "[LSFILL]"
ELSE IF KETREC = 1 OR 2, LSFILLKT = "Ketamine or any other hallucinogen"
LSFRKT

[IF (HALLREC OR KETREC = 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 [LSFILLKT] 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

202

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

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

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

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

LSKT30
[IF HALLREC = 1 OR KETREC = 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 [LSFILLKT]?
NUMBER OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSKT30DR [IF LSKT30 = DK/REF] What is your best estimate of the number of days you
used [LSFILLKT] 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

203

PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE ESTIKET:
IF LSKT30DR = 1, THEN ESTIKET = 1
IF LSKT30DR = 2, THEN ESTIKET = 3
IF LSKT30DR = 3, THEN ESTIKET = 6
IF LSKT30DR = 4, THEN ESTIKET = 10
IF LSKT30DR = 5, THEN ESTIKET = 20
IF LSKT30DR = 6, THEN ESTIKET = 30
ELSE ESTIKET = BLANK
DEFINE HAL30DAY
IF LSKT30DR = 1, THEN HAL30DAY = “1 or 2”
IF LSKT30DR = 2, THEN HAL30DAY = “3 to 5”
IF LSKT30DR = 3, THEN HAL30DAY = “6 to 9”
IF LSKT30DR = 4, THEN HAL30DAY = “10 to 19”
IF LSKT30DR = 5, THEN HAL30DAY = “20 to 29”
IF LSKT30DR = 6, THEN HAL30DAY = “all 30”
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRKT NOT (BLANK OR DK/REF) THEN TOTHALL = LSYRKT
ELSE IF LSMONKT NOT (BLANK OR DK/REF) THEN TOTHALL = LSMONKT*12
ELSE IF LSWKKT NOT (BLANK OR DK/REF) THEN TOTHALL = LSWKKT*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LS30 NE DK/REF OR BLANK AND LSKT30 >
TOTHALL) OR (LSKT30 = DK/REF AND ESTIKET > TOTHALL)):
LSCCKTa [IF LSKT30 > TOTHALL] For the last question, you reported that you
used [LSFILLKT] on [LSKT30] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCCKTb [IF ESTIKET > TOTHALL] For the last question, you reported that
you used [LSFILLKT] on [HAL30DAY] of the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE FILLHAL:

204

IF LSYRKT > 1, THEN FILLHAL = “[LSYRKT] days”
ELSE IF LSYRKT = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONKT > 1, THEN FILLHAL = “[LSMONKT] days per month”
ELSE IF LSMONKT = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKKT> 1, THEN FILLHAL = “[LSWKKT] days per week”
ELSE IF LSWKKT = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONKT] day(s) per month OR “[LSWKKT] day(s) per week”
THEN FILLHALA = “for a total of TOTHALL days”
ELSE FILLHALA = BLANK
LSCCHK12 [IF LSCCKTa = 4 OR LSCCKTb = 4] The answers for the last
question and an earlier question disagree. Which answer is correct?
I used [LSFILLKT] [FILLHAL] in the past 12 months
[FILLHALA]
2
I used [LSFILLKT] [LSKT30 / HAL30DAY] days in the past
30 days
3
Neither answer is correct
DK/REF

1

LSCCHKFR [IF LSCCHK12= 2 OR LSCCHK12= 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
[LSFILLKT] 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
LSCCHKYR [IF LSCCHKFR = 3] On how many days in the past 12 months did
you use [LSFILLKT]?
TOTAL # OF DAYS:
days in the past 12 months
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCCHKMO [IF LSCCHKFR = 2] On average, how many days did you use
[LSFILLKT] each month during the past 12 months?
# OF DAYS/MONTH:
[RANGE: 1 - 31]

205

days per month, on average

DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCCHKWK [IF LSCCHKFR = 1] On average, how many days did you use
[LSFILLKT] each week during the past 12 months?
# OF DAYS PER WEEK:
days per week, on average
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
IF LSCCHKYR NOT (BLANK OR DK/REF) THEN TOTHALL = LSCCHKYR
ELSE IF LSCCHKMO NOT (BLANK OR DK/REF) THEN TOTHALL= LSCCHKMO*12
ELSE IF LSCCHKWK NOT (BLANK OR DK/REF) THENTOTHALL= LSCCHKWK*52
ELSE TOTHALL = DK/REF
LSCCHKa [IF LSCCKTa = 6 OR ((LSCCHK12 = 1 OR LSCCHK12 = 3) AND
LSCCKTa 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 [LSFILLKT]?
# OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCCHKb [IF LSCCKTb = 6 OR ((LSCCHK12 = 1 OR LSCCHK12 = 3) AND
LSCCKTb 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 [LSFILLKT] 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
LSAFUDMT [[IF (LS01j = 1 OR LSREFDMT =1) AND (LS01a = 1 OR LSREF1 = 1 OR
LS01b = 1 OR LSREF2 = 1 OR LS01c=1 OR LSREFPE = 1 OR LS01d = 1 OR
LSREFMES = 1 OR LS01e = 1 OR LSREFPSI = 1 OR LSREF3 = 1 OR LS01f = 1 OR
LS01h = 1 OR LSREFOH = 1 OR LS01i=1 OR LSREFKET = 1 OR LS01k=1 OR
LSREFSLV = 1Now think only about DMT, AMT or Foxy. How old were you the first
time you used DMT, AMT or Foxy?
206

AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STDMT:
IF LSAFUDMT NE (BLANK OR DK/REF) THEN AGE1STDMT = LSAFUDMT
ELSE AGE1STDMT = BLANK
IF CURNTAGE < AGE1STDMT:
LSCCADM You were [AGE1STDMT] years old when you first used DMT,
AMT or Foxy. Is this correct?
4
Yes
6
No
DK/REF
LSCCWDM [IF LSCCADM = 4] The answers for the last question and an
earlier question disagree. Which answer is correct?
I am currently [CURNTAGE] years old
I was [AGE1STDMT] years old the first time I used DMT,
AMT or Foxy
3
Neither answer is correct
DK/REF

1
2

LSCCDMC [IF LSCCWDM =2 OR LSCCWDM =3] Please answer this
question again. What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
LSCCDMI [IF LSCCDMC < 12] Since you have indicated that you are
[LSCCDMC] years old, we cannot interview you for this study. Thank
you for your cooperation. PROGRAM SHOULD ROUTE TO
PENTER1.
LSCCDMA [IF LSCCWDM =1 OR LSCCWDM =3 OR LSCCADM =6] Please
answer this question again. Think about the first time you used DMT,
AMT or Foxy. How old were you the first time you used DMT, AMT or
Foxy?
AGE:
years old
[RANGE: 1 - 110]
DK/REF

207

UPDATE: IF LSCCDMA NOT(BLANK OR DK/REF) THEN AGE1STDMT = LSCCDMA
UPDATE: IF LSCCDMC NOT(BLANK OR DK/REF) THEN CURNTAGE = LSCCDMC
IF AGE1STDMT =CURNTAGE OR AGE1STDMT <10:
LSCCDM10 You were [AGE1STDMT] years old the first time you used DMT,
AMT or Foxy. Is this correct?
4
Yes
6
No
DK/REF
LSCCDMA2 [IF LSCCDM10=6] Please answer this question again. Think
about the first time you used DMT, AMT or Foxy. How old were you
the first time you used DMT, AMT or Foxy?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCDMA2 NOT(BLANK OR DK/REF) THEN AGE1STDMT = LSCCDMA2
IF AGE1STDMT < AGE1STHA:
LSCCWDM3 The answers for the last question and an earlier question disagree.
Which answer is correct?
I was [AGE1STHA] years old the first time I used [LSFILL]
I was [AGE1STDMT] years old the first time I used DMT,
AMT or Foxy
3
Neither answer is correct
DK/REF

1
2

LSCCAHA8 [IF LSCCWDM3=2 OR LSCCWDM3=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:
years old
[RANGE: 1 - 110]
DK/REF
LSCCDMA3 [IF LSCCWDM3= 1 OR LSCCWDM3= 3] Please answer this
question again. Think about the first time you used DMT, AMT or
Foxy. How old were you the first time you used DMT, AMT or Foxy?
AGE:
years old
[RANGE: 1 - 110]
208

DK/REF
UPDATE: IF LSCCAHA8 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCCAHA8
UPDATE: IF LSCCDMA3 NOT(BLANK OR DK/REF) THEN AGE1STDMT = LSCCDMA3
LSDMCYR [IF AGE1STDMT = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF
AGE1STDMT = CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first
use DMT, AMT or Foxy in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LSDMPYR [IF AGE1STDMT = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB]
Did you first use DMT, AMT or Foxy in [CURRENT YEAR - 2] OR [CURRENT
YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF
LSDMCMO [IF AGE1STDMT = CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In
what month in [CURRENT YEAR] did you first use DMT, AMT or Foxy?
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 LSDMCMO > 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.
LSDMPMO [IF LSDMCYR = 1 OR 2 OR LSDMPYR = 1 OR 2] In what month in [YEAR
FROM LSDMCYR OR LSDMPYR] did you first use DMT, AMT or Foxy?

209

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 LSDMPMO > 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 MYR1STDMT:
MYR1STDMT = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LSDMCYR - LSDMPMO).
IF MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STDMT IS BLANK.
IF MYR1STDMT NE 0 AND NE AGE1STDMT:
LSCCDMMY You first used DMT, AMT or Foxy in [LSDMCYR- LSDMPMO
fill]. That would make you [MYR1STDMT] years old when you first
used DMT, AMT or Foxy. Is this correct?
4
Yes
6
No
DK/REF
LSCCWHD [IF LSCCDMMY = 4] Earlier, you reported that you were
[AGE1STDMT] years old when you first used DMT, AMT or Foxy.
Which answer is correct?
I first used DMT, AMT or Foxy in [LSDMCYR- LSDMPMO
fill] when I was [MYR1STDMT] years old
2
I was [AGE1STDMT] years old the first time I used DMT,
AMT or Foxy
3
Neither answer is correct
DK/REF

1

UPDATE: IF LSCCWHD = 1, THEN AGE1STDMT = MYR1STDMT.

210

LSCCDMY [IF LSCCWHD =2 OR LSCCWHD =3 OR LSCCDMMY =6]
Please answer this question again. Did you first use DMT, AMT or
Foxy in [CURRENT YEAR-2], [CURRENT YEAR-1], or
[CURRENT YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LSCCDMM [IF LSCCDMY NE (BLANK OR DK/REF)] Please answer this
question again. In what month in [LSCCDMY] did you first use DMT,
AMT or Foxy?
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 LSCCDMM > 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 LSCCDMM NE (0 OR DK/REF) THEN UPDATE MYR1STDMT.
MYR1STDMT = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF
BIRTH FROM MONTH AND YEAR OF FIRST USE (LSCCDMY AND LSCCDMM). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STDMT IS BLANK. IF
MYR1STDMT = AGE1STDMT THEN MYR1STDMT = BLANK
LSCCDMYN [IF LSCCWHD NE 1 AND MYR1STDMT NE 0 AND (LSCCDMY
AND LSCCDMM NE LSDMCYR - LSDMPYR)] You first used DMT,
AMT or Foxy in [LSCCDMY - LSCCDMM fill]. That would make you
[MYR1STDMT] years old when you first used DMT, AMT or Foxy. Is
this correct?
4
6

Yes
No

211

DK/REF
UPDATE: IF LSCCDMYN NE (6, BLANK OR DK/REF) AND (LSCCDMY AND
LSCCDMM NE LSDMCYR - LSDMPYR THEN AGE1STDMT = MYR1STDMT
LS34 [IF (LS01j =1 OR LSREFDMT=1) AND (LS01a=1 OR LSREF1=1) OR (LS01b = 1 OR
LSREF2=1) OR LS01c = 1 OR LSREFPE=1 OR LS01d = 1 OR LSREFMES=1 OR
LS01e = 1 OR LSREFPSI=1 OR (LS01f = 1 OR LSREF3 = 1) OR LS01h = 1 OR
LSREFOH=1 OR LS01i=1 OR LSREFKET=1 OR LS01k=1 OR LSREFSLV=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
DEFINE DMTREC:
IF LS34 NE (BLANK OR DK/REF) THEN DMTREC = LS34
ELSE DMTREC = BLANK
IF DMTREC < HALLREC:
LSCC103 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

212

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
DEFINE LSFILLDM:
IF HALLREC = 1 OR 2, LSFILLDM = "[LSFILL]"
ELSE IF DMTREC = 1 OR 2, LSFILLDM = "DMT, AMT or Foxy or any other
hallucinogen"
LSFRDM

[IF (HALLREC OR DMTREC = 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 [LSFILLDM] 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

LSYRDM

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

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

[IF LSYRDM = 1 OR LSMONDM = DK/REF] On average, how many days did
you use [LSFILLDM] each week during the past 12 months?

213

AVERAGE # OF DAYS PER WEEK:
days per week, on average
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSDM30
[IF HALLREC = 1 OR DMTREC = 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 [LSFILLDM]?
NUMBER OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSDM30DR [IF LSDM30 = DK/REF] What is your best estimate of the number of days you
used [LSFILLDM] 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 ESTIDMT:
IF LSDM30DR = 1, THEN ESTIDMT = 1
IF LSDM30DR = 2, THEN ESTIDMT = 3
IF LSDM30DR = 3, THEN ESTIDMT = 6
IF LSDM30DR = 4, THEN ESTIDMT = 10
IF LSDM30DR = 5, THEN ESTIDMT = 20
IF LSDM30DR = 6, THEN ESTIDMT = 30
ELSE ESTIDMT = BLANK
DEFINE HAL30DAY
IF LSDM30DR = 1, THEN HAL30DAY = “1 or 2”
IF LSDM30DR = 2, THEN HAL30DAY = “3 to 5”
IF LSDM30DR = 3, THEN HAL30DAY = “6 to 9”
IF LSDM30DR = 4, THEN HAL30DAY = “10 to 19”
IF LSDM30DR = 5, THEN HAL30DAY = “20 to 29”
IF LSDM30DR = 6, THEN HAL30DAY = “all 30”
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRDM NOT (BLANK OR DK/REF) THEN TOTHALL = LSYRDM

214

ELSE IF LSMONDM NOT (BLANK OR DK/REF) THEN TOTHALL =
LSMONDM*12
ELSE IF LSWKDM NOT (BLANK OR DK/REF) THEN TOTHALL = LSWKDM*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LSDM30 NE DK/REF OR BLANK AND
LSDM30 > TOTHALL) OR (LSDM30 = DK/REF AND ESTIDMT > TOTHALL)):
LSCCDMa [IF LSDM30 > TOTHALL] For the last question, you reported that
you used [LSFILDM2] on [LSDM30] of the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCCDMb [IF ESTIDMT > TOTHALL] For the last question, you reported that
you used [LSFILLDM] on [HAL30DAY] of the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE FILLHAL:
IF LSYRDM > 1, THEN FILLHAL = “[LSYRAV2] days”
ELSE IF LSYRDM = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONDM > 1, THEN FILLHAL = “[LSMONDM] days per month”
ELSE IF LSMONDM = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKDM > 1, THEN FILLHAL = “[LSWKDM] days per week”
ELSE IF LSWKDM = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONDM] day(s) per month OR “[LSWKDM] day(s) per week”
THEN FILLHALA = “for a total of TOTHALL days”
ELSE FILLHALA = BLANK
LSCCHD12 [IF LSCCDMa = 4 OR LSCCDMb = 4] The answers for the last
question and an earlier question disagree. Which answer is correct?
I used [LSFILLDM] [FILLHAL] in the past 12 months
[FILLHALA]
2
I used [LSFILLDM] [LSDM30 / HAL30DAY] days in the past
30 days
3
Neither answer is correct
DK/REF
1

215

LSCCHDFR [IF LSCCHD12= 2 OR LSCCHD12= 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
[LSFILLDM] 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
LSCCHDYR [IF LSCCHDFR = 3] On how many days in the past 12 months did
you use [LSFILLDM]?
TOTAL # OF DAYS:
days in the past 12 months
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCCHDMO [IF LSCCHDFR = 2] On average, how many days did you use
[LSFILLDM] each month during the past 12 months?
# OF DAYS/MONTH:
days per month, on average
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCCHDWK [IF LSCCHDFR = 1] On average, how many days did you use
[LSFILLDM] each week during the past 12 months?
# OF DAYS PER WEEK:
days per week, on average
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
IF LSCCHDYR NOT (BLANK OR DK/REF) THEN TOTHALL = LSCCHDYR
ELSE IF LSCCHDMO NOT (BLANK OR DK/REF) THEN TOTHALL= LSCCHDMO*12
ELSE IF LSCCHDWK NOT (BLANK OR DK/REF) THENTOTHALL= LSCCHDWK*52
ELSE TOTHALL = DK/REF
LSCCHDa [IF LSCCDMa = 6 OR ((LSCCHD12 = 1 OR LSCCHD12 = 3) AND
LSCCDMa 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 [LSFILLDM]?

216

# OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCCHDb [IF LSCCDMb = 6 OR ((LSCCHD12 = 1 OR LSCCHD12 = 3) AND
LSCCDMb 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 [LSFILLDM] 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
LSAFUSLV [IF (LS01k = 1 OR LSREFSLV =1) AND (LS01a = 1 OR LSREF1 = 1 OR LS01b
= 1 OR LSREF2 = 1 OR LS01c = 1 OR LSREFPE = 1 OR LS01d = 1 OR LSREFMES =
1 OR LS01e = 1 OR LSREFPSI = 1 OR LSREF3 = 1 OR LS01f = 1 OR LS01h = 1 OR
LSREFOH = 1 OR LS01i=1 OR LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 1
Now think only about Salvia divinorum. How old were you the first time you used
Salvia divinorum?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STSLV:
IF LSAFUSLV NE (BLANK OR DK/REF) THEN AGE1STSLV = LSAFUSLV
ELSE AGE1STSLV = BLANK
IF CURNTAGE < AGE1STSLV:
LSCCASL You were [AGE1STSLV] years old when you first used Salvia
divinorum. Is this correct?
4
Yes
6
No
DK/REF
LSCCWSL [IF LSCCASL = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?

217

I am currently [CURNTAGE] years old
I was [AGE1STSLV] years old the first time I used Salvia
divinorum
3
Neither answer is correct
DK/REF

1
2

LSCCSLC [IF LSCCWSL =2 OR LSCCWSL =3] Please answer this question
again. What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
LSCCSLI [IF LSCCSLC < 12] Since you have indicated that you are
[LSCCSLC] years old, we cannot interview you for this study. Thank
you for your cooperation. PROGRAM SHOULD ROUTE TO
PENTER1.
LSCCSLA [IF LSCCWSL =1 OR LSCCWSL =3 OR LSCCASL =6]] Please
answer this question again. Think about the first time you used Salvia
divinorum. How old were you the first time you used Salvia
divinorum?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCSLA NOT(BLANK OR DK/REF) THEN AGE1STSLV = LSCCSLA
UPDATE: IF LSCCSLC NOT(BLANK OR DK/REF) THEN CURNTAGE = LSCCSLC
IF AGE1STSLV = CURNTAGE OR AGE1STSLV <10:
LSCCSL10 You were [AGE1STSLV] years old the first time you used Salvia
divinorum. Is this correct?
4
Yes
6
No
DK/REF
LSCCSLA2 [IF LSCCSL10 =6] Please answer this question again. Think
about the first time you used Salvia divinorum. How old were you the
first time you used Salvia divinorum?
AGE:
years old
[RANGE: 1 - 110]
DK/REF

218

UPDATE: IF LSCCSLA2 NOT(BLANK OR DK/REF) THEN AGE1STSLV = LSCCSLA2
IF AGE1STSLV < AGE1STHA:
LSCCWSL3 The answers for the last question and an earlier question disagree.
Which answer is correct?
I was [AGE1STHA] years old the first time I used [LSFILL]
I was [AGE1STSLV] years old the first time I used Salvia
divinorum
3
Neither answer is correct
DK/REF

1
2

LSCCAHA9 [IF LSCCWSL3=2 OR LSCCWSL3=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:
years old
[RANGE: 1 - 110]
DK/REF
LSCCPSL3 [IF LSCCWSL3= 1 OR LSCCWSL3= 3] Please answer this
question again. Think about the first time you used Salvia divinorum.
How old were you the first time you used Salvia divinorum?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF LSCCAHA9 NOT(BLANK OR DK/REF) THEN AGE1STHA = LSCCAHA9
UPDATE: IF LSCCSLA3 NOT(BLANK OR DK/REF) THEN AGE1STSLV = LSCCSLA3
LSSLCYR [IF AGE1STSLV = CURNTAGE AND DATE OF INTERVIEW < DOB OR IF
AGE1STSLV = CURNTAGE - 1 AND DATE OF INTERVIEW ≥ DOB] Did you first
use Salvia divinorum in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
LSSLPYR [IF AGE1STSLV = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you first use Salvia divinorum in [CURRENT YEAR - 2] OR [CURRENT YEAR - 1]?
1
CURRENT YEAR - 2
2
CURRENT YEAR - 1
DK/REF

219

LSSLCMO [IF AGE1STSLV = CURNTAGE AND DATE OF INTERVIEW ≥ DOB] In
what month in [CURRENT YEAR] did you first use Salvia divinorum?
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 LSSLCMO > 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.
LSSLPMO [IF LSSLCYR = 1 OR 2 OR LSSLPYR = 1 OR 2] In what month in [YEAR
FROM LSSLCYR OR LSSLPYR] did you first use Salvia divinorum?
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 LSSLPMO > 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 MYR1STSLV:

220

MYR1STSLV = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE
OF BIRTH FROM MONTH AND YEAR OF FIRST USE (LSSLCYR - LSSLPMO). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STSLV IS BLANK.
IF MYR1STSLV NE 0 AND NE AGE1STSLV:
LSCCSLMY You first used Salvia divinorum in [LSSLCYR - LSSLPMO fill].
That would make you [MYR1STSLV] years old when you first used
Salvia divinorum. Is this correct?
4
Yes
6
No
DK/REF
LSCCWHS [IF LSCCSLMY = 4] Earlier, you reported that you were
[AGE1STSLV] years old when you first used Salvia divinorum. Which
answer is correct?
I first used Salvia divinorum in [LSSLCYR - LSSLPMO fill]
when I was [MYR1STSLV] years old
2
I was [AGE1STSLV] years old the first time I used Salvia
divinorum
3
Neither answer is correct
DK/REF

1

UPDATE: IF LSCCWHS = 1, THEN AGE1STSLV = MYR1STSLV.
LSCCSLY [IF LSCCWHS =2 OR LSCCWHS =3 OR LSCCSLMY =6] Please
answer this question again. Did you first use Salvia divinorum in
[CURRENT YEAR-2], [CURRENT YEAR-1], or [CURRENT
YEAR]?
1
CURRENT YEAR -2
2
CURRENT YEAR -1
3
CURRENT YEAR
DK/REF
LSCCSLM [IF LSCCSLY NE (BLANK OR DK/REF)] Please answer this question
again. In what month in [LSCCSLY] did you first use Salvia
divinorum?
1
2
3
4
5
6
7

January
February
March
April
May
June
July

221

8
August
9
September
10
October
11
November
12
December
DK/REF
HARD ERROR: [IF LSCCSLM > 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 LSCCSLM NE (0 OR DK/REF) THEN UPDATE MYR1STSLV.
MYR1STSLV = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF
BIRTH FROM MONTH AND YEAR OF FIRST USE (LSCCPEY AND LSCCPEM). IF
MONTH OF FIRST USE = MONTH OF BIRTH, THEN MYR1STSLV IS BLANK. IF
MYR1STSLV = AGE1STSLV THEN MYR1STSLV = BLANK
LSCCSLYN [IF LSCCWHS NE 1 AND MYR1STSLV NE 0 AND (LSCCSLY
AND LSCCSLM NE LSSLCYR - LSSLPYR)] You first used Salvia
divinorum in [LSCCSLY - LSCCSLM fill]. That would make you
[MYR1STSLV] years old when you first used Salvia divinorum. Is this
correct?
4
Yes
6
No
DK/REF
UPDATE: IF LSCCSLYN NE (6, BLANK OR DK/REF) AND (LSCCSLY AND LSCCSLM
NE LSSLCYR - LSSLPYR THEN AGE1STSLV = MYR1STSLV
LS35 [IF (LS01k =1 OR LSREFSLV = 1) AND (LS01a=1 OR LSREF1=1) OR (LS01b = 1
OR LSREF2=1) OR LS01c = 1 OR LSREFPE = 1 OR LS01d = 1 OR LSREFMES = 1
OR LS01e = 1 OR LSREFPSI = 1 OR (LS01f = 1 OR LSREF3 = 1) OR LS01h = 1 OR
LSREFOH = 1 OR LS01i=1 OR LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 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

222

IF SLVREC < HALLREC:
LSCC107 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?
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
DEFINE LSFILLSL:
IF HALLREC = 1 OR 2, LSFILLSL = "[LSFILL]"
ELSE IF SLVREC = 1 OR 2, LSFILLSL = "Salvia divinorum or any other hallucinogen"
LSFRSL

[IF (HALLREC OR SLVREC = 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 [LSFILLSL] during the past 12 months.
What would be the easiest way for you to tell us how many days you’ve used it?
223

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
LSYRSL

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

LSMONSL

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

LSWKSL

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

LSSL30
[IF HALLREC = 1 OR SLVREC = 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 [LSFILLSL]?
NUMBER OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSSL30DR

[IF LSSL30 = DK/REF] What is your best estimate of the number of days you
used [LSFILLSL] during the past 30 days?
1
2
3
4

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

224

5
20 to 29 days
6
All 30 days
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE ESTISLV:
IF LSSL30DR = 1, THEN ESTISLV = 1
IF LSSL30DR = 2, THEN ESTISLV = 3
IF LSSL30DR = 3, THEN ESTISLV = 6
IF LSSL30DR = 4, THEN ESTISLV = 10
IF LSSL30DR = 5, THEN ESTISLV = 20
IF LSSL30DR = 6, THEN ESTISLV = 30
ELSE ESTISLV = BLANK
DEFINE HAL30DAY
IF LSSL30DR = 1, THEN HAL30DAY = “1 or 2”
IF LSSL30DR = 2, THEN HAL30DAY = “3 to 5”
IF LSSL30DR = 3, THEN HAL30DAY = “6 to 9”
IF LSSL30DR = 4, THEN HAL30DAY = “10 to 19”
IF LSSL30DR = 5, THEN HAL30DAY = “20 to 29”
IF LSSL30DR = 6, THEN HAL30DAY = “all 30”
ELSE HAL30DAY = BLANK
DEFINE TOTHALL:
IF LSYRSL NOT (BLANK OR DK/REF) THEN TOTHALL = LSYRSL
ELSE IF LSMONSL NOT (BLANK OR DK/REF) THEN TOTHALL = LSMONSL*12
ELSE IF LSWKSL NOT (BLANK OR DK/REF) THEN TOTHALL = LSWKSL*52
ELSE TOTHALL = DK/REF
IF TOTHALL NOT DK/REF AND ((LSSL30 NE DK/REF OR BLANK AND LSSL30
> TOTHALL) OR (LSSL30 = DK/REF AND ESTISLV > TOTHALL)):
LSCCSLa [IF LSSL30 > TOTHALL] For the last question, you reported that you
used [LSFILLSL] on [LS30] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCCSLb [IF ESTISLV > TOTHALL] For the last question, you reported that
you used [LSFILLSL] on [HAL30DAY] of the past 30 days. Is this
correct?
4
Yes
6
No
DK/REF

225

PROGRAMMER: SHOW 30 DAY CALENDAR
DEFINE FILLHAL:
IF LSYRSL > 1, THEN FILLHAL = “[LSYRSL] days”
ELSE IF LSYRSL = 1, THEN FILLHAL = “1 day”
ELSE IF LSMONSL > 1, THEN FILLHAL = “[LSMONSL] days per month”
ELSE IF LSMONASL = 1, THEN FILLHAL = “1 day per month”
ELSE IF LSWKSL > 1, THEN FILLHAL = “[LSWKSL] days per week”
ELSE IF LSWKSL = 1, THEN FILLHAL = “1 day per week”
DEFINE FILLHALA
IF FILLHAL = “[LSMONSL] day(s) per month OR “[LSWKSL] day(s) per week”
THEN FILLHALA = “for a total of TOTHALL days”
ELSE FILLHALA = BLANK
LSCCHS12 [IF LSCCSLa = 4 OR LSCCSLb = 4] The answers for the last
question and an earlier question disagree. Which answer is correct?
I used [LSFILLSL] [FILLHAL] in the past 12 months
[FILLHALA]
2
I used [LSFILLSL] [LSSL30 / HAL30DAY] days in the past 30
days
3
Neither answer is correct
DK/REF

1

LSCCHSFR [IF LSCCHS12 = 2 OR LSCCHS12 = 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
[LSFILLSL] 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
LSCCHSYR [IF LSCCHSFR= 3] On how many days in the past 12 months did
you use [LSFILLSL]?
TOTAL # OF DAYS:
days in the past 12 months
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCCHSMO [IF LSCCHSFR= 2] On average, how many days did you use
[LSFILLSL] each month during the past 12 months?

226

# OF DAYS/MONTH:
days per month, on average
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
LSCCHSWK [IF LSCCHSFR= 1] On average, how many days did you use
[LSFILLSL] each week during the past 12 months?
# OF DAYS PER WEEK:
days per week, on average
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
IF LSCCHSYR NOT (BLANK OR DK/REF) THEN TOTHALL = LSCCHSYR
ELSE IF LSCCHSMO NOT (BLANK OR DK/REF) THEN TOTHALL=LSCCHSMO*12
ELSE IF LSCCHSWK NOT (BLANK OR DK/REF) THENTOTHALL=LSCCHSWK*52
ELSE TOTHALL = DK/REF
LSCCHSa [IF LSCCSLa = 6 OR ((LSCCHS12 = 1 OR LSCCHS12 = 3) AND
LSCCSLa 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 [LSFILLSL]?
# OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
LSCCHSb [IF LSCCSLb = 6 OR ((LSCCHS12 = 1 OR LSCCHS12 = 3) AND
LSCCSLb 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 [LSFILLSL] 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

227

Inhalants
INHINTRO These next questions are about inhalants. Inhalants are liquids, sprays, and gases
that people sniff, huff, or inhale for fun or to get high.
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.
Click Next to continue.
PROGRAMMER: DISPLAY IN LOWER LEFT: Click [Help] if you want
to see how to say some of these inhalants.
Amyl nitrite, ‘poppers,’ locker room odorizers, or ‘rush’ [am-ill-NY-trite]
Glue, shoe polish, or toluene [TAWL-you-een]
Halothane, ether, or other anesthetics [hal-oh-thane, ann-uh-STHET-icks]
Lacquer thinner, or other paint solvents [lack-er]
Lighter gases, such as butane or propane [byoo-tane or pro-pain]
Nitrous oxide or ‘whippits’ [ny-truss OCK-side]
IN01a Have you ever, even once, inhaled amyl nitrite, ‘poppers,’ locker room odorizers, or
‘rush’ for fun or to get high?
1
Yes
2
No
DK/REF
IN01b Have you ever, even once, inhaled correction fluid, degreaser, or cleaning fluid for fun
or to get high?
1
Yes
2
No
DK/REF
IN01c Have you ever, even once, inhaled gasoline or lighter fluid for fun or to get high?
1
Yes
2
No
DK/REF
IN01d Have you ever, even once, inhaled glue, shoe polish, or toluene for fun or to get high?
1
Yes
2
No
DK/REF

228

IN01e Have you ever, even once, inhaled halothane, ether, or other anesthetics for fun or to
get high?
1
Yes
2
No
DK/REF
IN01f Have you ever, even once, inhaled lacquer thinner or other paint solvents for fun 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 fun or
to get high?
1
Yes
2
No
DK/REF
IN01h Have you ever, even once, inhaled nitrous oxide or ‘whippits’ for fun 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 fun or to get high?
1
Yes
2
No
DK/REF
IN01i Have you ever, even once, inhaled spray paints for fun or to get high?
1
Yes
2
No
DK/REF

IN01ii Have you ever, even once, inhaled computer keyboard cleaner, also known as air
duster, for fun or to get high?
1
2

Yes
No

229

DK/REF

IN01j Have you ever, even once, inhaled some other aerosol spray for fun or to get high?
1
Yes
2
No
DK/REF
IN01l Have you ever, even once, used any other inhalants for fun 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, click Next 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, click
Next.
______________
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, click Next.
______________
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, click Next.
______________
DK/REF

230

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, click Next.
______________
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 fun 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
fun or to get high?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STIN:
IF IN02 NE (BLANK OR DK/REF) THEN AGE1STIN = IN02
ELSE AGE1STIN = BLANK
IF CURNTAGE < AGE1STIN:
INCC01 You were [AGE1STIN] years old when you first used an inhalant of
any kind for fun 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

231

of any kind for fun 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:
years old
[RANGE: 1 - 110]
DK/REF

INCC03a [IF INCC03 < 12] Since you have indicated that you are [INCC03]
years old, we cannot interview you for this study. Thank you for your
cooperation.
PROGRAM SHOULD ROUTE TO FIEXIT.
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 fun or to get high. How old were you the first time you used
an inhalant for fun or to get high?
AGE:
years old
[RANGE: 1 - 110]
DK/REF

UPDATE: IF INCC04 NOT(BLANK OR DK/REF) THEN AGE1STIN = INCC04
UPDATE: IF INCC03 NOT(BLANK OR DK/REF) THEN CURNTAGE = INCC03
IF AGE1STIN = CURNTAGE OR AGE1STIN < 10:
INCC05 You were [AGE1STIN] years old the first time you used an inhalant of
any kind for fun 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 fun or to get high. How
old were you the first time you used an inhalant of any kind for fun or
to get high?
AGE:
years old
[RANGE: 1 - 110]
DK/REF

232

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 fun 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 fun 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 fun 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 IN03c > CURRENT MONTH] The month in [CURRENT YEAR] you
entered has not begun yet. Please answer this question again, then click Next to continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 fun or to get high?
1

January

233

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. Please answer this question again, then click Next to continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
DEFINE MYR1STIN:
MYR1STIN = AGE AT FIRST USE CALCULATED BY “SUBTRACTING” DATE OF
BIRTH FROM MONTH AND YEAR OF FIRST USE (IN03a-d). IF MONTH OF
FIRST USE = MONTH OF BIRTH, THEN MYR1STIN IS BLANK.
IF MYR1STIN NE 0 AND NE AGE1STIN:
INCC17 You first used an inhalant of any kind for fun or to get high in [IN03ad fill]. That would make you [MYR1STIN] years old when you first
used an inhalant of any kind for fun or to get high. Is this correct?
4
Yes
6
No
DK/REF
INCC18

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

I first used an inhalant of any kind for fun 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 fun 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 fun or to

234

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 fun 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

235

HARD ERROR: [IF INCC19a > CURRENT MONTH] The month in [current year] you
entered has not begun yet. Please answer this question again, then click NEXT to continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] You first used an inhalant of any kind for fun
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
fun 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 IN03ad) 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 fun 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 fun 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

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.
236

Please think again about answering this question: How long has it been since you
last used any inhalant for fun 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 fun 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 fun or to get high?
TOTAL # OF DAYS:
days in the past 12 months
[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 fun or to get high each month during the past
12 months?
AVERAGE # OF DAYS PER MONTH:
days per month, on average
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
INWKAVE

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

237

days per week, on average

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 fun or to get high?
NUMBER OF DAYS:
days in the past 30 days
[RANGE: 1 - 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 fun 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
DEFINE TOTINHAL:
IF INYRAVE NOT(BLANK OR DK/REF) THEN TOTINHAL = INYRAVE
ELSE IF INMONAVE NOT(BLANK OR DK/REF) THEN
TOTINHAL=INMONAVE*12

238

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, you reported that you
used an inhalant for fun 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, you reported that
you used an inhalant for fun 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
INCC08

[IF INCC07a = 4 OR INCC07b = 4] The answers for the last question
and an earlier question disagree. Which answer is correct?
1
2

I used an inhalant for fun or to get high on [FILLINH] days in
the past 12 months [FILLINHA]
I used an inhalant for fun or to get high on [IN06 /
INH30DAY] days in the past 30 days
239

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
fun 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

INCC10

[IF INCC09 = 3] On how many days in the past 12 months did you use
an inhalant of any kind for fun or to get high?
TOTAL # OF DAYS:
days in the past 12 months
[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 fun or to get high each month during the past 12
months?
# OF DAYS/MONTH:
days per month, on average
[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 fun or to get high each week during the past 12
months?
# OF DAYS PER WEEK:
days per week, on average
[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
240

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 fun or to get high?
# OF DAYS:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: 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 fun 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

241

Methamphetamine
METHINTRO

These questions are about methamphetamine, also known as meth, crank, ice,
crystal meth, or glass. It can be smoked, snorted, swallowed or injected.
Click Next to continue.
PROGRAMMER: DISPLAY IN LOWER LEFT: Click [Help] if you want
to see how to say these drugs.
Methamphetamine [Meth-am-FET-uh-meen]
Stimulant [stim-U-lent]

ME01 [PROGRAMMER, SHOW IN GRAY FONT: These questions are about
methamphetamine, also known as meth, crank, ice, crystal meth, or glass. It can be
smoked, snorted, swallowed or injected.]
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:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STME:
IF ME02 NE (BLANK OR DK/REF) THEN AGE1STME = ME02
ELSE AGE1STME = BLANK
IF CURNTAGE < AGE1STME:

242

MECC01 You were [AGE1STME] years old when you first used
methamphetamine. Is this correct?
4
Yes
6
No
DK/REF
MECC02 [IF MECC01 = 4] The answers for the last question and an earlier
question disagree. Which answer is correct?
I am currently [CURNTAGE] years old
I was [AGE1STME] years old the first time I used
methamphetamine
3
Neither answer is correct
DK/REF

1
2

MECC03 [IF MECC02=2 OR MECC02=3] Please answer this question again.
What is your current age?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
MECC03a [IF MECC03 < 12] Since you have indicated that you are [MECC03
AGE] years old, we cannot interview you for this study. Thank you for
your cooperation. PROGRAM SHOULD ROUTE TO FIEXIT.
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:
years old
[RANGE: 1 - 110]
DK/REF
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 You were [AGE1STME] years old the first time you used
methamphetamine. Is this correct?
4
Yes
6
No
DK/REF

243

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?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
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. Please answer this question again, then click Next to

244

continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
ME03d [IF ME03a = 1 - 2 OR ME03b = 1 - 2] In what month in [YEAR FROM 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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 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, you reported 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

245

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

2

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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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

246

MECC20 [IF MECC18 NE 1 AND MYR1STME NE 0 AND (MECC19 AND
MECC19a NE ME03a-d)] You first used methamphetamine in
[MECC19-MECC19a fill]. That would make you [MYR1STME]
years old when you first 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 today. We want
to know how many days you’ve used methamphetamine during the past 12

247

months.
What would be the easiest way for you to tell us how many days you’ve used it?

248

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:
days in the past 12 months
[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:
days per month, on average
[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:
days per week, on average
[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:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
ME06DKRE [IF ME06 = DK/REF] What is your best estimate of the number of days you used
methamphetamine during the past 30 days?
1
2
3
4
5

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

249

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, you reported that you
used methamphetamine on [ME06] of the past 30 days. Is this correct?
4
Yes
6
No
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
MECC07b [IF ESTIME > TOTMETH] For the last question, you reported 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

250

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?
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
1

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 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:
days in the past 12 months
[RANGE: 1 - 366]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

251

MECC11 [IF MECC9 = 2] On average, how many days did you use
methamphetamine each month during the past 12 months?
# OF DAYS/MONTH:
days per month, on average
[RANGE: 1 - 31]
DK/REF
PROGRAMMER: 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:
days per week, on average
[RANGE: 1 - 7]
DK/REF
PROGRAMMER: 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:
days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: 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
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

252

253

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, click 95.
Click Next to continue.
PROGRAMMER: DISPLAY IN LOWER LEFT: Click [Help] if you want
to see how to say these drugs.
Prescription pain relievers [pree-skrip-shun pane ree-LEE-vers]
Tylenol [TIE-len-all]
Advil [ADD-vill]
Aleve [uh-LEEV]

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?
Select all that apply.

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.

254

In the past 12 months, which, if any, of these pain relievers have you used?
Select all that apply.
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?
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)] 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
6
No
DK/REF

255

HARD ERROR: [IF PRCC01 = 6] Remember, please click 95 if you have not used any of
the pain relievers asked about in the past 12 months. Please click Back 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?
Select all that apply.
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?
Select all that apply.
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.

256

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?
Select all that apply.
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?
Select all that apply.
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?

257

Select all that apply.
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?
Select all that apply.
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 EXTENDED-RELEASE
HYDROMORPHONE, AND METHADONE.
In the past 12 months, which, if any, of these pain relievers have you used?
Select all that apply.
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

258

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.
1
Yes
2
No
DK/REF

PRAOTHA1 [IF PRANYOTH = 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. 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 PRAOTHA1 IF PRANYOTH = 1]
DK/REF
PRAOTHA2 [IF PRANYOTH = 1 AND PRAOTHA1 NE DK/REF)] Please type in the name
of any other prescription pain reliever you used in the past 12 months.
If you have not used any other prescription pain reliever, press [ENTER].
______________
DK/REF
PRAOTHA3 [IF PRAOTHA2 NE (BLANK OR DK/REF)] Please type in the name of any
other prescription pain reliever you used in the past 12 months.
If you have not used any other prescription pain reliever, press [ENTER].
______________
DK/REF

259

PRAOTHA4 [IF PRAOTHA3 NE (BLANK OR DK/REF)] Please type in the name of any
other prescription pain reliever you used in the past 12 months.
If you have not used any other prescription pain reliever, press [ENTER].

______________
DK/REF
PRAOTHA5 [IF PRAOTHA4 NE (BLANK OR DK/REF Please type in the name of any other
prescription pain reliever you used in the past 12 months.
If you have not used any other prescription pain reliever, press [ENTER].
______________
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

260

This page intentionally left blank.

261

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, click 95.
Click Next to continue.
PROGRAMMER: DISPLAY IN LOWER LEFT: Click [Help] if you want
to see how to say tranquilizers.
Tranquilizers [tran-kwill-eye-zers]

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?
Select all that apply.
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, KLONOPIN,
LORAZEPAM, AND CLONAZEPAM.
In the past 12 months, which, if any, of these tranquilizers have you used?

262

Select all that apply.
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?
Select all that apply.
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)] You used the following
tranquilizers in the past 12 months:
[TR01 FILL]
[TR02 FILL]
and [TR03 FILL]
Are all of these correct?
4
Yes
6
No
DK/REF
HARD ERROR: [IF TRCC01 = 6] Remember, please click 95 if you have not
used any of the tranquilizers asked about in the past 12 months. Please click
Back to return to these questions so that you can revise your answers.

263

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?
Select all that apply.
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.
In the past 12 months, have you used any other prescription tranquilizer?

TRANYOTH

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.
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

264

This page intentionally left blank.

265

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, click 95.
Click Next to continue.
PROGRAMMER: DISPLAY IN LOWER LEFT: Click [Help] if you want
to see how to say these drugs.
Stimulants [stim-U-lents]
Dexatrim [DECKS-uh-trim]
No-Doz [No doze]
Hydroxycut [hi-drocks-ee-cut]

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?
Select all that apply.
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,
AMPHETAMINE-DEXTROAMPHETAMINE MIX, AND EXTENDEDRELEASE AMPHETAMINE-DEXTROAMPHETAMINE MIX.

266

In the past 12 months, which, if any, of these stimulants have you used?
Select all that apply.
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?
Select all that apply.
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)] You used the following stimulants
in the past 12 months:
[ST01 FILL]
[ST02 FILL]
and [ST03 FILL]
Are all of these correct?
4
Yes
6
No
DK/REF

267

HARD ERROR: [IF STCC01 = 6] Remember, please click 95 if you have not used any of
the stimulants asked about in the past 12 months. Please click Back 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 EXTENDED-RELEASE
METHYLPHENIDATE.
In the past 12 months, which, if any, of these stimulants have you used?
Select all that apply.
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?
Select all that apply.
1
Focalin
2
Focalin XR
3
Dexmethylphenidate (generic)
4
Extended-release dexmethylphenidate (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.

268

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?
Select all that apply.
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?
Select all that apply.
1
Provigil
2
Tenuate
3
Vyvanse
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.

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.

269

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, NoDoz, Hydroxycut, or 5-Hour Energy.
1
Yes
2
No
DK/REF

270

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271

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,
click 95.
Click Next to continue.
PROGRAMMER: DISPLAY IN LOWER LEFT: Click [Help] if you want
to see how to say these drugs.
Sedatives [SED-uh-tivs]
Sominex [SOM-in-ex]
Unisom [U-ni-som]
Nytol [NIE-tall]
Benadryl [ben-UH-drill]

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?
Select all that apply.
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.

272

In the past 12 months, which, if any, of these sedatives have you used?
Select all that apply.
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?
Select all that apply.
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)] 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
DK/REF

273

HARD ERROR: [IF SVCC01 = 6] Remember, please click 95 if you have not
used any of the sedatives asked about in the past 12 months. Please click
Back 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?
Select all that apply.
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.
DEFINE SVYRCOUNT:
INITIALIZE SVYRCOUNT TO 0.
ADD 1 TO SVYRCOUNT FOR EACH INDIVIDUAL DRUG SELECTED IN SV01SVANYOTH.

274

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

275

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

Click Next 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

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

Click Next to continue.
DEFINE PRFILL:
PRFILL LISTS ALL INDIVIDUAL DRUGS SELECTED IN PR01, PR02, PR03, PR04, PR05,
PR06, PR07, PR08, PR09, AND PR10.

276

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

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, you reported that, in the past 12 months, you
used [PRFILL].
Click Next to continue.

277

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?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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. Please answer this question again.

278

IF 1 <= AGE1STPR1 < 10:
PRCC05A1 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:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF PRCC06A1 NOT (BLANK OR DK/REF) THEN AGE1STPR1 = PRCC06A1
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

279

ELSE IF (AGE1STPR1 = CURNTAGE) AND (PRYFU1 = CURRENT YEAR-1) AND (LAST
BIRTHDAY IN CURRENT YEAR-1) AND (# OF DAYS BETWEEN LAST YEAR’S
BIRTHDAY AND INTERVIEW DATE <= 30), THEN PR30INIT1 = 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

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 PRJANFLAG1=1 THEN PRMFU1=1
DEFINE PRDECFLAG1:
PRDECFLAG1 = 0
IF AGE1STPR1 = CURNTAGE AND PRYFU1=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN PRDECFLAG1 = 1
IF PRDECFLAG1=1 THEN PRMFU1=12

280

IF (PRAGEFT=CURNTAGE AND BIRTHDAY MONTH=INTERVIEW MONTH AND
DATE OF INTERVIEW ≥ DOB) THEN PRMFU1=CURRENT MONTH
PRY01d.

[IF PRYFU1 NE 0 AND PRMFU1=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
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
PROGRAMMER: DROP DOWN BOX FOR MOBILE

281

UPDATE: IF PRY01D = 1-12 THEN PRMFU1 = PRY01D
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:
PRCC32A1
Earlier, you reported 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?
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
1

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

282

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
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
PROGRAMMER: DROP DOWN BOX FOR MOBILE
UPDATE: IF PRCC33B1 = 1-12 THEN PRMFU1 = PRCC33B1
IF PRCC33B1 = DK/REF THEN PRMFU1 = 0

283

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
PRCC34A1 [IF PRCC32A1 NE 1 AND MYR1STPR1 NE 0 AND (PRCC33A1
AND PRCC33b1 NE PRY01b-d)] 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

284

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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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

285

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. Please answer this question again.
IF 1 <= AGE1STPR2 < 10:
PRCC05A2

You were [AGE1STPR2] years old the first time you used Lortab in a way a
doctor did not direct you to use it.
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:
years old
[RANGE: 1 - 110]
DK/REF

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

286

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
ELSE IF (AGE1STPR2 = CURNTAGE) AND (PRYFU2 = CURRENT YEAR-1) AND (LAST
BIRTHDAY IN CURRENT YEAR-1) AND (# OF DAYS BETWEEN LAST YEAR’S
BIRTHDAY AND INTERVIEW DATE <= 30), THEN PR30INIT2 = 1
Year and Month of First Nonmedical Use
DEFINE PRYFU2:
PRYFU2 = 0
DEFINE PRMFU2:
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

287

IF PRJANFLAG2=1 THEN PRMFU2=1
DEFINE PRDECFLAG2:
PRDECFLAG2 = 0
IF AGE1STPR2 = CURNTAGE AND PRYFU2=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN PRDECFLAG2 = 1
IF PRDECFLAG2=1 THEN TSMFU2=12
IF (AGE1STPR2=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH AND DATE of
INTERVIEW > OR = DOB) THEN PRMFU2=CURRENT MONTH
PRY02d

[IF PRYFU2 NE 0 AND PRMF2=0]
[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
2
3
4
5

January
February
March
April
May

288

6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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, you reported 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?
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
1

UPDATE: IF PRCC32A2 = 1, THEN AGE1STPR2 = MYR1STPR2.

289

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
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
2
3
4
5
6
7
8
9

January
February
March
April
May
June
July
August
September

290

10
October
11
November
12
December
DK/REF
PROGRAMMER: DROP DOWN BOX FOR MOBILE
UPDATE: IF PRCC33B2 = 1-12 THEN PRMFU2 = PRCC33B2
IF PRCC33B2 = DK/REF THEN PRMFU2 = 0
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)] You first used Lortab in a way a doctor did not
direct you to use it in [PRCC33A2-PRCC33B2 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

291

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
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.

292

[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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
293

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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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

294

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF

295

PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

296

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.

297

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see these ways again.

298

•
•
•

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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.
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?

299

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.

300

[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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
301

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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
302

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.
[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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF
303

PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

304

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:
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.

305

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF

306

PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

307

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.

308

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see these ways again.

309

•
•
•

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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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?

310

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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
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.

311

[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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
312

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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?
DISPLAY IMAGE FOR EXTENDED-RELEASE OXYMORPHONE
(GENERIC)

313

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.
[IF PRY33=1] How old were you when you first used Demerol in a way a doctor
did not direct you to use it?

314

AGE:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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

315

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.
PRY35

[IF PR10=3] In the past 12 months, did you use Exalgo or extended-release
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 extended-release
hydromorphone in a way a doctor did not direct you to use it?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS PRY01.

316

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

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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

317

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, click Next to go to the next question. Remember, you do
not need to type in the names of any prescription pain relievers you already
reported.
______________
DK/REF
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, click Next.
______________
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, click Next.
______________
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, click Next.
______________
DK/REF

318

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, click Next.
______________
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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 PRY01- PRYOTH.
DEFINE PRMISUSE12:
IF PRMISCOUNT > 0 THEN PRMISUSE12 = 1.
ELSE PRMISUSE12 = 2.

319

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 PRY01PRYOTH 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].”
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”
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]”

320

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 PRYRINIT1-PRYRINITOT.
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 you reported 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”.
[IF PRMISUSE12=1 AND PRMISCOUNT>1] The next questions refer to these
drugs as prescription pain relievers.
Click Next 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
2

Yes
No

321

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]?
________________ days in the past 30 days
[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?
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?
Select all that apply.
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.
322

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.)

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.

323

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?
Select all that apply.
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, click Next 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?

324

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
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
3

I got a prescription for the [PRLASTFILL] from just one doctor
I got prescriptions for the [PRLASTFILL] from more than one doctor
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, click Next to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN PRYGOTSP.

325

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

They got a prescription for the [PRLASTFILL] from just one doctor
They got prescriptions for the [PRLASTFILL] from more than one doctor
They stole the [PRLASTFILL] from a doctor’s office, clinic, hospital, or
pharmacy
4
They got the [PRLASTFILL] from another friend or relative for free
5
They bought the [PRLASTFILL] from another friend or relative
6
They took the [PRLASTFILL] from another friend or relative without
asking
7
They bought the [PRLASTFILL] from a drug dealer or other stranger
8
They 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, click Next to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN PRYFRLSP.

326

This page intentionally left blank.

327

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

Click Next 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

Click Next 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.

328

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, you reported that, in the past 12 months, you
used [TRFILL].
Click Next 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

329

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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. Please answer this question again.
IF 1 <= AGE1STTR1 < 10:
TRCC05A1 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.

330

How old were you the first time you used Xanax in a way a doctor did
not direct you to use it?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
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
ELSE IF (AGE1STTR1 = CURNTAGE) AND (TRYFU1 = CURRENT YEAR-1) AND (LAST
BIRTHDAY IN CURRENT YEAR-1) AND (# OF DAYS BETWEEN LAST YEAR’S
BIRTHDAY AND INTERVIEW DATE <= 30), THEN TR30INIT1 = 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
331

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 TRJANFLAG1=1 THEN TRMFU1=1
DEFINE TRDECFLAG1:
TRDECFLAG1 = 0
IF AGE1STTR1 = CURNTAGE AND TRYFU1=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN TRDECFLAG1 = 1
IF TRDECFLAG1=1 THEN TRMFU1=12
IF (TSAGEFT=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH AND DATE OF
INTERVIEW ≥ DOB) THEN TRMFU1=CURRENT MONTH
TRY01d.

[IF TRYFU1 NE 0 AND TRMFU1=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?
[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.

332

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
PROGRAMMER: DROP DOWN BOX FOR MOBILE
UPDATE: IF TRY01D = 1-12 THEN TRMFU1 = TRY01D
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
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.

333

IF MYR1STTR1 NE 0 AND NE AGE1STTR1:
TRCC32A1
Earlier, you reported 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?
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
1

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]?
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

334

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
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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
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

335

TRCC34A1 [IF TRCC32A1 NE 1 AND MYR1STTR1 NE 0 AND (TRCC33A1
AND TRCC33b1 NE TRY01b-d)] 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
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

336

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
HARD ERROR: [IF CURNTAGE < AGE1STTR2] The age you just reported is older than your
current age. Please answer this question again.
IF 1 <= AGE1STTR2 < 10:
TRCC05A2 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

337

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:
years old
[RANGE: 1 - 110]
DK/REF
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:
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
ELSE IF (AGE1STTR2 = CURNTAGE) AND (TRYFU2 = CURRENT YEAR-1) AND (LAST
BIRTHDAY IN CURRENT YEAR-1) AND (# OF DAYS BETWEEN LAST YEAR’S
BIRTHDAY AND INTERVIEW DATE <= 30), THEN TR30INIT2 = 1
Year and Month of First Nonmedical Use
DEFINE TRYFU2:
TRYFU2 = 0
DEFINE TRMFU2:
TRMFU2 = 0

338

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 TRJANFLAG2=1 THEN TRMFU2=1
DEFINE TRDECFLAG2:
TRDECFLAG2 = 0
IF AGE1STTR2 = CURNTAGE AND TRYFU2=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN TRDECFLAG2 = 1
IF TRDECFLAG2=1 THEN TRMFU2=12
IF (AGE1STTR2=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH AND DATE
OF INTERVIEW ≥ DOB) THEN TRMFU2=CURRENT MONTH
TRY02d.

[IF TRYFU2 NE 0 AND TRMFU2=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?

339

[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
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
PROGRAMMER: DROP DOWN BOX FOR MOBILE
UPDATE: IF TRY02D = 1-12 THEN TRMFU2 = TRY02D
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

340

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, you reported 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?
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
1

UPDATE: IF TRCC32A2 = 1, THEN AGE1STTR2 = MYR1STTR2.
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

341

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
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

PROGRAMMER: DROP DOWN BOX FOR MOBILE
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

342

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)] 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
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

343

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:
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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?

344

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 extendedrelease 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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.
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.

345

[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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
346

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.
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?

347

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.

348

[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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
349

INSERT YEAR AND MONTH OF FIRST USE FOR CURRENT AGE AND AGE-1
INITIATES
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS TRY01.
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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?

350

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.
[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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
351

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, click Next to go to the next question. Remember,
you do not need to type in the names of any prescription tranquilizers you
already reported.
______________
DK/REF

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, click Next.
______________
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, click Next.
______________
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, click Next.
______________
DK/REF

352

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, click Next.
______________
DK/REF

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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 TRY01-TRYOTH.
DEFINE TRMISUSE12:
IF TRMISCOUNT > 0 THEN TRMISUSE12 = 1.
ELSE TRMISUSE12 = 2.
If no tranquilizers misused in the past 12 months:

353

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

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 TRY01TRYOTH 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].”
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 TRY01- TRY12]”
ELSE IF TRMISCOUNT=1 AND (TRYOTH NE 1) AND TRDKREFFLAG=1 THEN
TRNAMEFILL=“[DRUG NAME FROM TRY01- TRY12] or any other prescription
tranquilizer]”

354

ELSE IF TRMISCOUNT >1 THEN TRNAMEFILL= “prescription tranquilizers”
DEFINE TRYINICT:
INITIALIZE TRYINICT TO 0.
INCREMENT TRYINICT BY 1 FOR EVERY VALUE OF 1 IN TRYRINIT1-TRYRINITOT.
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 you reported 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.
Click Next 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]?

355

1
Yes
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]?
________________ days in the past 30 days
[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

TRYWAYS

[IF TRMISUSE12=1] Which of these statements describe your use of
[TRNAMEFILL] at any time in the past 12 months?
Select all that apply.

356

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.
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.

357

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?
Select all that apply.

1
2
3
4
5
6
7
8

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
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, click Next to go to the
next question.
REASON

__________________

358

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
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

359

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, click Next 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

They got a prescription for the [TRLASTFILL] from just one
doctor
2
They got prescriptions for the [TRLASTFILL] from more than one
doctor
3
They stole the [TRLASTFILL] from a doctor’s office, clinic,
hospital, or pharmacy
4
They got the [TRLASTFILL] from another friend or relative for
free
5
They bought the [TRLASTFILL] from another friend or relative
6
They took the [TRLASTFILL] from another friend or relative
without asking
7
They bought the [TRLASTFILL] from a drug dealer or other
stranger
8
They got the [TRLASTFILL] in some other way
DK/REF

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, click Next to go to the
next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN TRYFRLSP.

360

This page intentionally left blank.

361

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

Click Next 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

Click Next 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.

362

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, you reported that, in the
past 12 months, you used [STFILL].
Click Next 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?

363

DISPLAY IMAGE FOR ADDERALL
1
Yes
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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. Please answer this question again.
IF 1 <= AGE1STST1 < 10:
STCC05A1 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
UPDATE: IF STCC05A1= DK/REF THEN AGE1STST1 = 0

364

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:
years old
[RANGE: 1 - 110]
DK/REF
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
ELSE IF (AGE1STST1 = CURNTAGE) AND (STYFU1 = CURRENT YEAR-1) AND (LAST
BIRTHDAY IN CURRENT YEAR-1) AND (# OF DAYS BETWEEN LAST YEAR’S
BIRTHDAY AND INTERVIEW DATE <= 30), THEN ST30INIT1 = 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

365

first use Adderall 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
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 STJANFLAG1=1 THEN STMFU1=1
DEFINE STDECFLAG1:
STDECFLAG1 = 0
IF AGE1STST1 = CURNTAGE AND STYFU1=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN STDECFLAG1 = 1
IF STDECFLAG1=1 THEN STMFU1=12
IF (STAGEFT=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH AND DATE OF
INTERVIEW ≥ DOB) THEN STMFU1=CURRENT MONTH
STY01d [IF STYFU1 NE 0 AND STMFU1=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 [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?

366

[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
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:

367

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, you reported 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?
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
1

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
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

368

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
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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.
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

369

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)] 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
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

370

IF STCC34A1 = BLANK AND (STCC33A1 AND STCC33B1 EQ STY01b-d) THEN STMFU1
=0
[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?

STY02

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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 AGE1STST2:
IF STY02a NE (BLANK OR DK/REF) THEN AGE1STST2 = STY02a
ELSE AGE1STST2 = 0
HARD ERROR: [IF CURNTAGE < AGE1STST2] The age you just reported is older than your
current age. Please answer this question again.
IF 1 <= AGE1STST2 < 10:
STCC05A2 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
371

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:
years old
[RANGE: 1 - 110]
DK/REF
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:
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
ELSE IF (AGE1STST2 = CURNTAGE) AND (STYFU2 = CURRENT YEAR-1) AND (LAST
BIRTHDAY IN CURRENT YEAR-1) AND (# OF DAYS BETWEEN LAST YEAR’S
BIRTHDAY AND INTERVIEW DATE <= 30), THEN ST30INIT2 = 1
Year and Month of First Nonmedical Use
DEFINE STYFU2:
STYFU2 = 0
DEFINE STMFU2:
STMFU2 = 0

372

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 STJANFLAG2=1 THEN STMFU2=1
DEFINE STDECFLAG2:
STDECFLAG2 = 0
IF AGE1STST2 = CURNTAGE AND STYFU2=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN STDECFLAG2 = 1
IF STDECFLAG2=1 THEN STMFU2=12
IF (AGE1STST2=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH AND DATE
OF INTERVIEW ≥ DOB) THEN STMFU2=CURRENT MONTH
STY02d.

[IF STYFU2 NE 0 STMFU2=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?

373

[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
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
PROGRAMMER: DROP DOWN BOX FOR MOBILE
UPDATE: IF STY02D = 1-12 THEN STMFU2 = STY02D
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

374

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, you reported 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?
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

1

UPDATE: IF STCC32A2 = 1, THEN AGE1STST2 = MYR1STST2.
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]?

375

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
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
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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

376

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)] 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
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

377

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.
[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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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?

378

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.
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 amphetaminedextroamphetamine pills in a way a doctor did not direct you to use them?

379

AGE:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.
STY06

[IF ST02=3] In the past 12 months, did you use extended-release 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 STY06=1 THEN STFIRSTFLAG=6.
STY06a

[IF STFIRSTFLAG=6. Please think about the first time you ever used extendedrelease 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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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

380

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.

381

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.
[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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see these ways again.
• Without a prescription of your own,

382

•
•

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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.
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
383

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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?
AGE:
years old
[RANGE: 1 - 110]
DK/REF

384

PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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?

385

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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?

386

AGE:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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

387

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
Yes
2
No
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.

388

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see these ways again.
• Without a prescription of your own,

389

•
•

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
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.
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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
390

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF

391

PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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?

392

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.
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:

years old

393

[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.
[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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

394

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, NoDoz, 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, click Next to go to the next question. Remember, you do
not need to type in the names of any prescription stimulants you already reported.
__________________
DK/REF
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, click Next.
______________
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, click Next.
______________
DK/REF

395

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, click Next.
______________
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, click Next.
______________
DK/REF
UPDATE STFIRSTFLAG:
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS STY01.

396

DEFINE STMISCOUNT:
INITIALIZE STMISCOUNT TO 0.
INCREMENT STMISCOUNT BY 1 FOR EVERY RESPONSE OF YES IN STY01- STYOTH.
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:
DEFINE STDKREFCOUNT:
INITIALIZE STDKREFCOUNT TO 0.
INCREMENT STDKREFCOUNT BY 1 FOR EVERY RESPONSE OF DK/REF IN STY01STYOTH 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].”
ELSE IF STMISCOUNT=2 AND STDKREFFLAG=2 AND STYOTH=1 THEN
STFILL2=“[DRUG NAME FROM STY01-STY23] and some other prescription stimulant.”

397

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 STYRINIT1-STYRINITOT.
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 you reported 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

398

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.
Click Next 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
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]?
________________ days in the past 30 days
[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?

399

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?
Select all that apply.
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

400

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.
(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.”

401

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”]
What were the reasons you used [STLASTFILL2] the last time?
Select all that apply.
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, click Next 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

402

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
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
3

I got a prescription for the [STLASTFILL] from just one doctor
I got prescriptions for the [STLASTFILL] from more than one doctor
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, click Next to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN STYGOTSP.

403

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]?
1
2
3

They got a prescription for the [STLASTFILL] from just one doctor
They got prescriptions for the [STLASTFILL] from more than one doctor
They stole the [STLASTFILL] from a doctor’s office, clinic, hospital, or
pharmacy
4
They got the [STLASTFILL] from another friend or relative for free
5
They bought the [STLASTFILL] from another friend or relative
6
They took the [STLASTFILL] from another friend or relative without
asking
7
They bought the [STLASTFILL] from a drug dealer or other stranger
8
They 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, click Next to go to the next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN STYFRLSP.

404

This page intentionally left blank.

405

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

Click Next 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

Click Next 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.
THE FOLLOWING DRUGS SHOULD NOT USE INITIAL CAPS WHEN FILLED IN
SENTENCE FORMAT:

406

•
•
•
•
•
•
•
•

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, you reported that, in the past 12 months, you
used [SVFILL].
Click Next 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
2
No
DK/REF

407

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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. Please answer this question again.
IF 1 <= AGE1STSV1 < 10:
SVCC05A1 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
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.

408

How old were you the first time you used Ambien in a way a doctor
did not direct you to use it?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
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
ELSE IF (AGE1STSV1 = CURNTAGE) AND (SVYFU1 = CURRENT YEAR-1) AND (LAST
BIRTHDAY IN CURRENT YEAR-1) AND (# OF DAYS BETWEEN LAST YEAR’S
BIRTHDAY AND INTERVIEW DATE <= 30), THEN SV30INIT1 = 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
2
CURRENT YEAR
DK/REF
409

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 SVJANFLAG1=1 THEN SVMFU1=1
DEFINE SVDECFLAG1:
SVDECFLAG1 = 0
IF AGE1STSV1 = CURNTAGE AND SVYFU1=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN SVDECFLAG1 = 1
IF SVDECFLAG1=1 THEN SVMFU1=12
IF (SVAGEFT=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH AND DATE OF
INTERVIEW ≥ DOB) THEN SVMFU1=CURRENT MONTH
SVY01d.

[IF SVYFU1 NE 0 SVMFU1=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].
[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.

410

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
PROGRAMMER: DROP DOWN BOX FOR MOBILE
UPDATE: IF SVY01D = 1-12 THEN SVMFU1 = SVY01D
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
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.

411

IF MYR1STSV1 NE 0 AND NE AGE1STSV1:
SVCC32A1
Earlier, you reported 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?
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
1

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
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

412

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
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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
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

413

SVCC34A1 [IF SVCC32A1 NE 1 AND MYR1STSV1 NE 0 AND (SVCC33A1
AND SVCC33b1 NE SVY01b-d)] 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
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

414

[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?

SVY02

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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 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. Please answer this question again.
IF 1 <= AGE1STSV2 < 10:
SVCC05A2 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

415

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:
years old
[RANGE: 1 - 110]
DK/REF
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
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
ELSE IF (AGE1STSV2 = CURNTAGE) AND (SVYFU2 = CURRENT YEAR-1) AND (LAST
BIRTHDAY IN CURRENT YEAR-1) AND (# OF DAYS BETWEEN LAST YEAR’S
BIRTHDAY AND INTERVIEW DATE <= 30), THEN SV30INIT2 = 1
Year and Month of First Nonmedical Use
DEFINE SVYFU2:
SVYFU2 = 0
DEFINE SVMFU2:
SVMFU2 = 0

416

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 SVJANFLAG2=1 THEN SVMFU2=1
DEFINE SVDECFLAG2:
SVDECFLAG2 = 0
IF AGE1STSV2 = CURNTAGE AND SVYFU2=CURRENT YEAR-1 AND BIRTH
MONTH=12 THEN SVDECFLAG2 = 1
IF SVDECFLAG2=1 THEN SVMFU2=12
IF (AGE1STTR2=CURNTAGE AND BIRTH MONTH=INTERVIEW MONTH AND DATE
OF INTERVIEW ≥ DOB) THEN SVMFU2=CURRENT MONTH
SVY02d.

[IF SVYFU2 NE 0 SVMFU2=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?

417

[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
2
February
3
March
4
April
5
May
6
June
7
July
8
August
9
September
10
October
11
November
12
December
DK/REF
PROGRAMMER: DROP DOWN BOX FOR MOBILE
UPDATE: IF SVY02D = 1-12 THEN SVMFU2 = SVY02D
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

418

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, you reported 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?
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
2
I was [AGE1STSV2] years old the first time I used Ambien CR
in a way not directed for me by a doctor
3
Neither answer is correct
DK/REF
1

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
419

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
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
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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
420

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)]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
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

421

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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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
422

UPDATE SVFIRSTFLAG:
IF SVFIRSTFLAG=0 AND SVY04=1 THEN SVFIRSTFLAG=4.
SVY04a

[IF SVFIRSTFLAG=4] Please think about the first time you ever used extendedrelease 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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF
423

PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
PLACEHOLDERS FOR CONSISTENCY CHECK. FULL CONSISTENCY CHECK
FOLLOWS SVY01.

424

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.

425

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.
[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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see these ways again.
• Without a prescription of your own,

426

•
•

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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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?

427

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.

428

[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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
429

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

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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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.

430

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, click Next to go to the next question. Remember,
you do not need to type in the names of any prescription sedatives you
already reported.
______________
DK/REF

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, click Next.
______________
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, click Next.
______________
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.

431

If you have not used any other prescription sedative in a way a doctor did
not direct you to use it, click Next.
______________
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, click Next.
______________
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:
years old
[RANGE: 1 - 110]
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click
[Help] if you want to see 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
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 SVY01-SVYOTH.

432

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
Yes
2
No
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 SVY01SVYOTH 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].”
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”

433

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:
INITIALIZE SVYINICT TO 0.
INCREMENT SVYINICT BY 1 FOR EVERY VALUE OF 1 IN SVYRINIT1-SVYRINITOT.
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 you reported 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.
Click Next to continue.

434

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]?
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]?
________________ days in the past 30 days
[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

435

SVYWAYS

[IF SVMISUSE12=1] Which of these statements describe your use of
[SVNAMEFILL] at any time in the past 12 months?
Select all that apply.
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.
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.

436

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?
Select all that apply.
1
2
3
4
5
6
7
8

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
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, click Next to go to the
next question.
REASON

__________________

437

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
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

438

[IF SVYGOT = 8] Please type in the other way you got the
[SVLASTFILL3].

SVYGOTSP

You do not need to give a detailed description — just a few words will be
okay. When you have finished typing your answer, click Next 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
2
3

They got a prescription for the [SVLASTFILL] from just one doctor
They got prescriptions for the [SVLASTFILL] from more than one doctor
They stole the [SVLASTFILL] from a doctor’s office, clinic, hospital, or
pharmacy
4
They got the [SVLASTFILL] from another friend or relative for free
5
They bought the [SVLASTFILL] from another friend or relative
6
They took the [SVLASTFILL] from another friend or relative without
asking
7
They bought the [SVLASTFILL] from a drug dealer or other stranger
8
They got the [SVLASTFILL] in some other way
DK/REF

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, click Next to go to the
next question.
_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN SVYFRLSP.

439

Special Drugs
SD01

The last questions were about prescription drugs. The next question is about nonprescription cough or cold medicines, also known as “over-the-counter”
medicines. Have you ever, even once, taken a non-prescription cough or cold
medicine just to get high?
1
Yes
2
No
DK/REF
PROGRAMMER: DISPLAY IN LOWER LEFT: Click [Help] if you want
to see how to say non-prescription.
Non-prescription [NON pree-skrip-shun]

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, click Next 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, click Next 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

440

have not used any other cough or cold medicines, click Next to go to the next
question.
______________
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, click Next 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, click Next 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
PROGRAMMER: DISPLAY IN LOWER LEFT: Click [Help] if you want
to see how to say GHB.
GHB or gamma hydroxybutyrate [Gee-aytch-bee or gam-uh hi-DROCKsee-byoo-ti-rate]

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]

441

The next questions are about the different ways that certain drugs can be used.
Click Next to continue.
SD05

[IF CC01 = 1 OR CCREF = 1] Have you ever, even once, used a needle to inject
cocaine?
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
2

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

442

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 inject
heroin?
1
Yes
2
No
DK/REF

SDHEUSE

[IF SD07 = 2 AND SD09 = 2 AND SD11 = 2] Earlier you reported that you had
used heroin. In what way have you used heroin?
Select all that apply.
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, click Next 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

443

SD12

[IF SD11 = 1 OR SDHEUSE = 3] How long has it been since you last used a
needle to inject heroin?
1
Within the past 30 days -- that is, since [DATEFILL]
2
More than 30 days ago but within the past 12 months
3
More than 12 months ago
DK/REF
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 “You reported 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 needle to inject. If you’re not sure how to spell the name of the

444

drug you used a needle to inject, just make your best guess. When you have
finished, click Next 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, click Next.
________________
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, click Next.
________________
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, click Next.
________________
DK/REF

SD15d

[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, click Next.
________________
DK/REF

SD16

[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
PROGRAMMER: SHOW 12 MONTH CALENDAR

445

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 you reported 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

446

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 okay. When you have finished typing your
answer, click Next to go to the next question.
________________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN SD21SP.

447

Risk/Availability Section
RKQ1 [IF CURNTAGE = 12 - 17] 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.
Click Next to continue.
RK01a

[IF CURNTAGE = 12 - 17] 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

[IF CURNTAGE = 12 - 17] 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

[IF CURNTAGE = 12 - 17] 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

[IF CURNTAGE = 12 - 17] How much do people risk harming themselves
physically and in other ways when they try LSD once or twice?
1

No risk

448

2
Slight risk
3
Moderate risk
4
Great risk
DK/REF
RK01e

[IF CURNTAGE = 12 - 17] 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

[IF CURNTAGE = 12 - 17] 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

[IF CURNTAGE = 12 - 17] 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

[IF CURNTAGE = 12 - 17] 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

[IF CURNTAGE = 12 - 17] How much do people risk harming themselves
physically and in other ways when they use cocaine once or twice a week?
1
2

No risk
Slight risk

449

3
Moderate risk
4
Great risk
DK/REF
[IF CURNTAGE = 12 - 17] 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?

RK01j

1
No risk
2
Slight risk
3
Moderate risk
4
Great risk
DK/REF
RK01k

[IF CURNTAGE = 12 - 17] 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.
Click Next 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

450

DK/REF
How difficult or easy would it be for you to get some cocaine, if you wanted
some?

RK02c

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
Never
2
Seldom
3
Sometimes
4
Always
DK/REF

451

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

452

This page intentionally left blank.

453

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:
years old
[RANGE: 1 - 110]
DK/REF
DEFINE AGE1STBL:
IF BL08 NE (BLANK OR DK/REF) THEN AGE1STBL = BL08
ELSE AGE1STBL = BLANK
IF AGE1STBL = CURNTAGE OR AGE1STBL < 10:
BLCC01 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:
years old
[RANGE: 1 - 110]
DK/REF
UPDATE: IF BLCC02 NOT(BLANK OR DK/REF) THEN AGE1STBL = BLCC02
BL08a [IF BLCC01 NE DK/RE AND BLCC02 NE DK/REF AND AGE1STBL = CURNTAGE
AND DATE OF INTERVIEW < DOB OR IF AGE1STBL = CURNTAGE - 1 AND
DATE OF INTERVIEW ≥ DOB] Did you first smoke part or all of a cigar with
marijuana in it in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1

CURRENT YEAR - 1

454

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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
BL08d [IF BL08a = 1 OR 2 OR BL08b = 1 OR 2] In what month in [YEAR FROM BL08a or
BL08b] did you first smoke part or all of a cigar with marijuana in it?
1
2
3
4
5
6
7
8

January
February
March
April
May
June
July
August

455

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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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 You first smoked part or all of a cigar with marijuana in it in [BL08ad 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, you reported 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]?
1
2

CURRENT YEAR -2
CURRENT YEAR -1

456

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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] You first smoked part or all of a cigar with
marijuana in it in [BLCC05-BLCC05a fill]. That would make you
[MYR1STBL] years old when you first smoked part or all of a cigar
with marijuana in it. Is this correct?
4
Yes
6
No
DK/REF
UPDATE: IF BLCC06 NE (6, BLANK OR DK/REF) AND (BLCC05 AND BLCC05a NE
BL08a-d) THEN AGE1STBL = MYR1STBL

457

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: ______________ days in the past 30 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 any cannabis product
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: ______________ days in the past 30 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 any cannabis product [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: ______________ days in the past 30 days
[RANGE: 1-30]
DK/REF

458

PROGRAMMER: SHOW 30 DAY CALENDAR
BL05 [IF BL03 =2] Why did you report earlier that you had never used marijuana or any
cannabis product?
1
2

I didn’t consider a ‘blunt’ to be marijuana or any cannabis product
I made a mistake when I answered the earlier question about ever using marijuana
or any cannabis product
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 any cannabis product.
When you have finished, click Next 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 any cannabis
product during the past 30 days?
1
I didn’t consider a ‘blunt’ to be marijuana or any cannabis product
2
I made a mistake earlier when I answered how long ago I last used marijuana or
any cannabis product
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 any cannabis product during the past 30 days.
When you have finished, click Next to go to the next question.
______________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN BL06SP.
BL07 [IF CG36=1 AND (BL02 = 1 AND (BL03 = 2 OR BLANK) AND (BL04 = 2 OR
BLANK)] 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
459

Definitions for Use in the Substance Use Disorder 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 > 5, 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 MJCC13a > 5 OR MJC13b = 3 - 6 OR (MJ06 > 5 AND MJCC07a = 4) OR
(MJ06DKRE = 3 - 6 AND MJCC07b = 4), THEN MAR12MON = 3
ELSE MAR12MON = 4
DEFINE COC12MON:
IF CCLAST3 = 1 OR 2 OR CCRECDK = 1 OR 2 OR CCRECRE = 1 OR 2 OR 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 PSIREC = 1 OR 2 OR KETREC = 1 OR2, OR DMTREC = 1 OR, 2 OR
SLVREC = 1 OR2, THEN HAL12MON = 1
ELSE HAL12MON = 2
DEFINE INH12MON:
IF INLAST = 1 OR 2 OR INRECDK = 1 OR 2 OR INRECRE = 1 OR 2, THEN
INH12MON = 1
ELSE INH12MON = 2
460

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
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

461

Substance Use Disorder
DPINTRO

[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 PR12MON = 1
OR TR12MON = 1 OR ST12MON = 1 OR SV12MON = 1] Now we’d like for
you to tell us about your experiences with the
[CIG30DAY = 1 AND ALC12MON = 2 4 AND (MAR12MON = 2 4 AND
COC12MON = 2 AND CRK12MON = 2 AND HER12MON = 2 AND
HAL12MON = 2 AND INH12MON = 2 AND MET12MON = 2 AND
PR12MON = 2 AND TR12MON = 2 AND ST12MON = 2 AND SV12MON =
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
PR12MON = 2 AND TR12MON = 2 AND ST12MON = 2 AND SV12MON =
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
PR12MON = 2 AND TR12MON = 2 AND ST12MON = 2 AND SV12MON =
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 PR12MON = 1 OR TR12MON
= 1 OR ST12MON = 1 OR SV12MON = 1)] cigarettes you smoked and the other
drugs that you used.
[CIG30DAY = 2 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 PR12MON = 1
OR TR12MON = 1 OR ST12MON = 1 OR SV12MON = 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 PR12MON = 1
OR TR12MON = 1 OR ST12MON = 1 OR SV12MON = 1)]cigarettes you
smoked, the alcohol you drank, and the other drugs that you used.
[CIG30DAY = 2 AND ALC12MON = 4 AND ( MAR12MON = 1 OR 2 OR 3
OR COC12MON = 1 OR CRK12MON =1 OR HER12MON = 1 OR

462

HAL12MON = 1 OR INH12MON = 1 OR MET12MON = 1 OR PR12MON = 1
OR TR12MON = 1 OR ST12MON = 1 OR SV12MON = 1)]drugs that you used.
Click Next to continue.
DRCIG

Think about your use of cigarettes during the past 30 days as you answer these
next questions.
Click Next to continue.
PROGRAMMER: SHOW 30 DAY CALENDAR

(IF CIG30DAY NE 1, SKIP TO DPMJINT)
DRCGE01

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

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

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
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

463

DRCGE04

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

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 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
DRCGE07

[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.

464

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

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

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

You smoke about the same amount on weekends as on weekdays.
1
Not at all true
2
Somewhat true
3
Moderately true
4
Very true
5
Extremely true
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE11

You smoke just about the same number of cigarettes from day to day.
1
2
3
4
5

Not at all true
Somewhat true
Moderately true
Very true
Extremely true

465

DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
DRCGE12

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

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

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
PROGRAMMER: SHOW 30 DAY CALENDAR

DRCGE15

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
466

DRCGE16

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

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

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

DRCGE19a [IF 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?

467

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
DPALINT

[IF ALC12MON= 1 OR 2 OR 3] Think about your use of alcohol during the past
12 months as you answer these next questions.
Click Next to continue.

(IF ALC12MON= 4 = 2 OR BLANK, SKIP TO DPMJINT)
DPALFEEL During the past 12 months, did you spend a great deal of your time drinking
alcohol, feeling its effects, or getting over the effects of drinking?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALGET

[IF DPALFEEL=2 OR DK/REF] During the past 12 months, did you spend a
great deal of your time getting or trying to get alcohol?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPALLRGR During the past 12 months, were there many times when you ended up drinking
alcohol in larger amounts or for a longer time than you meant to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALBDLY During the past 12 months, were there times when you wanted to drink alcohol so
badly that you couldn’t think of anything else?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

468

DPALURGE [IF DPALBDLY = 2 OR DK/REF] During the past 12 months, were there times
when you had a strong urge to drink alcohol?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALMORE Do you need to drink a lot more alcohol than you used to in order to get the
feeling you want?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALLESS [IF DPALMORE = 2 OR DK/REF] Does drinking the same amount of alcohol
have much less effect on you than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALSTOP During the past 12 months, did you try to cut down or try to stop drinking
alcohol?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALCANT [IF DPALSTOP=1] Some people who drink alcohol try to cut down or stop but
find they can’t. Was there more than one time in the past 12 months when you
tried but were unable to cut down or stop drinking alcohol?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALWISH [IF DPALSTOP=2 OR DK/REF] In the past 12 months, did you often wish that
you could cut down or stop drinking alcohol?
1
2

Yes
No

469

DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALPHYS During the past 12 months, did you have any long-lasting or repeated physical
health problems that were caused or made worse by drinking alcohol?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALPCNT [IF DPALPHYS = 1]: Did you continue to drink alcohol even though it was
causing long-lasting or repeated physical health problems or making your
physical health problems worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALMNTL [IF DPALPHYS = 2 OR DK/REF OR DPALPCNT = 2 OR DK/REF] During the
past 12 months, did you have any long-lasting or repeated problems with
emotions or mental health that were caused or made worse by drinking alcohol?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALMCNT [IF DPALMNTL = 1]: Did you continue to drink alcohol even though it was
causing long-lasting or repeated problems with your emotions or mental health or
making your emotions or mental health worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALBLCK [IF (DPALPHYS = 2 OR DK/REF OR DPALPCNT = 2 OR DK/REF) AND
(DPALMNTL=2 OR DK/REF OR DPALMCNT = 2 OR DK/REF)] A blackout is
lack of memory. That is, you were awake, but you have no recall of the things you
did or that were done to you.
During the past 12 months, did you repeatedly have blackouts while drinking or
after drinking alcohol?

470

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALBCNT [IF DPALBLCK = 1] Did you continue to drink alcohol even though drinking
gave you repeated blackouts?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALACTV This question is about important activities such as:





Spending time with friends and family
Attending special events at work or school
Participating in hobbies and sports
Attending religious services and events

During the past 12 months, did you give up or spend a lot less time doing any of
these types of important activities because of your alcohol use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALSERI Sometimes people who drink alcohol have serious problems at work, school, or
home—such as:






missing a lot of work or school
getting demoted, having your hours cut, or losing a job
not being able to get a job or keep a job
getting suspended, expelled, or dropping out of school
failing to take care of family

During the past 12 months, did you have any serious problems like these at work,
school, or home because of your alcohol use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

471

DPALARGU During the past 12 months, did you often have arguments or other problems with
family or friends that were caused or made worse by your alcohol use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALACNT [IF DPALARGU = 1]: Did you continue to drink alcohol even though it often
caused arguments or problems with family or friends?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALHURT During the past 12 months, did you repeatedly get into situations where drinking
alcohol increased your chances of getting physically hurt?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALWD

People may experience withdrawal symptoms when they drink less or stop
drinking alcohol. Withdrawal symptoms are stronger and last longer than a
hangover.
During the past 12 months, did you have the following withdrawal symptoms
after you drank less or stopped drinking alcohol for a while?

DPALWD_1 Sweating or feeling that your heart
was beating fast
DPALWD _2 Having your hands tremble
DPALWD _3 Having trouble sleeping
DPALWD _4 Vomiting or having an upset stomach
DPALWD _5 Seeing, hearing, or feeling things that
weren’t really there
DPALWD _6 Feeling like you couldn’t sit still
DPALWD _7 Feeling anxious
DPALWD _8 Having seizures or fits
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

472

Yes

No

⃝1

⃝2

⃝1
⃝1
⃝1

⃝2
⃝2
⃝2

⃝1

⃝2

⃝1
⃝1
⃝1

⃝2
⃝2
⃝2

DPALOVER During the past 12 months, did you use alcohol or another drug to get over or
avoid having alcohol withdrawal symptoms?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
PROGRAMMER: DISPLAY IN LOWER RIGHT:
Click Help to see these symptoms again.
DPALUSE

[IF DPALOVER=1]Which of the following did you use to get over or avoid
having alcohol withdrawal symptoms during the past 12 months?

DPALUSE _1 Alcohol
DPALUSE _2 Prescription sedatives, tranquilizers,
sleeping pills, or downers
DPALUSE _3 Something else
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPALOTH

Yes
⃝1

No
⃝2

⃝1

⃝2

⃝1

⃝2

[IF DPALUSE_3=1] You indicated that you took something else to get over or
avoid having alcohol withdrawal symptoms during the past 12 months. What did
you take?
______________________________________
DK/REF

DPALLAW 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
DPMJINT

[IF MAR12MON = 1 OR 2 OR 3] Think about your use of marijuana or any
cannabis product during the past 12 months as you answer these next questions.
Click Next to continue.

(IF MAR12MON = 4 OR BLANK, SKIP TO DPCCINT)
DPMJFEEL During the past 12 months, did you spend a great deal of your time using
marijuana or any cannabis product, feeling its effects, or getting over the
effects of marijuana or any cannabis product?

473

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJGET

[IF DPMJFEEL=2 OR DK/REF] During the past 12 months, did you spend a
great deal of your time getting or trying to get marijuana or any cannabis
product?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPMJLRGR During the past 12 months, were there many times when you ended up using
marijuana or any cannabis product in larger amounts or for a longer time than
you meant to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJBDLY During the past 12 months, were there times when you wanted to use marijuana
or any cannabis product so badly that you couldn’t think of anything else?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJURGE [IF DPMJBDLY = 2 OR DK/REF] During the past 12 months, were there times
when you had a strong urge to use marijuana or any cannabis product?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJMORE Do you need to use a lot more marijuana or any cannabis product than you
used to in order to get the feeling you want?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

474

DPMJLESS [IF DPMJMORE = 2 OR DK/REF] Does using the same amount of marijuana or
any cannabis product have much less effect on you than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJSTOP During the past 12 months, did you try to cut down or try to stop using
marijuana or any cannabis product?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJCANT [IF DPMJSTOP = 1] Some people who use marijuana or any cannabis product try
to cut down or stop but find they can’t. Was there more than one time in the past
12 months when you tried but were unable to cut down or stop using marijuana
or any cannabis product?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJWISH [IF DPMJSTOP=2 OR DK/REF] In the past 12 months, did you often wish that
you could cut down or stop using marijuana or any cannabis product?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJPHYS During the past 12 months, did you have any long-lasting or repeated physical
health problems that were caused or made worse by using marijuana or any
cannabis product?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJPCNT [IF DPMJPHYS = 1]: Did you continue to use marijuana or any cannabis
product even though it was causing long-lasting or repeated physical health
problems or making your physical health problems worse?
475

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJMNTL [IF DPMJPHYS = 2 OR DK/REF OR DPMJPCNT = 2 OR DK/REF] During the
past 12 months, did you have any long-lasting or repeated problems with
emotions or mental health that were caused or made worse by using marijuana
or any cannabis product?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJMCNT [IF DPMJMNTL = 1]: Did you continue to use marijuana or any cannabis
product even though it was causing long-lasting or repeated problems with your
emotions or mental health or making your emotions or mental health worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJACTV This question is about important activities such as:





Spending time with friends and family
Attending special events at work or school
Participating in hobbies and sports
Attending religious services and events

During the past 12 months, did you give up or spend a lot less time doing any of
these types of important activities because of your use of marijuana or any
cannabis product?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJSERI Sometimes people who use marijuana or any cannabis product have serious
problems at work, school, or home—such as:



missing a lot of work or school
getting demoted, having your hours cut, or losing a job

476





not being able to get a job or keep a job
getting suspended, expelled, or dropping out of school
failing to take care of family

During the past 12 months, did you have any serious problems like these at work,
school, or home because of your use of marijuana or any cannabis product?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJARGU During the past 12 months, did you often have arguments or other problems with
family or friends that were caused or made worse by your use of marijuana or
any cannabis product?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJACNT [IF DPMJARGU = 1]: Did you continue to use marijuana or any cannabis
product even though it often caused arguments or problems with family or
friends?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJHURT During the past 12 months, did you repeatedly get into situations where using
marijuana or any cannabis product increased your chances of getting
physically hurt?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJWDa

People may experience withdrawal symptoms when they use less or stop using
marijuana or any cannabis product.
During the past 12 months, did you have the following withdrawal symptoms
after you used less or stopped using marijuana or any cannabis product for a
while?

477

DPMJWD1 Feeling irritable or angry
DPMJWD2 Feeling anxious or nervous
DPMJWD3 Having trouble sleeping
DPMJWD4 Losing your appetite or losing weight
without trying to
DPMJWD5 Feeling like you couldn’t sit still
DPMJWD6 Feeling depressed
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

Yes
⃝1
⃝1
⃝1

No
⃝2
⃝2
⃝2

⃝1

⃝2

⃝1
⃝1

⃝2
⃝2

DPMJWDb During the past 12 months, did you have the following withdrawal symptoms
after you used less or stopped using marijuana or any cannabis product for a
while?
Yes
No
DPMJWD7 Stomach ache
⃝1
⃝2
DPMJWD8 Shaking or tremors
⃝1
⃝2
DPMJWD9 Sweating
⃝1
⃝2
DPMJWD10 Fever
⃝1
⃝2
DPMJWD11 Chills
⃝1
⃝2
DPMJWD12 Headache
⃝1
⃝2
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMJOVER During the past 12 months, did you use marijuana, any cannabis product, or
another drug to get over or avoid having marijuana or any cannabis product
withdrawal symptoms?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
PROGRAMMER: DISPLAY IN LOWER RIGHT:
Click Help to see these symptoms again.
DPMJUSE [IF DPMJOVER=1] Which of the following did you use to get over or avoid having
marijuana or any cannabis product withdrawal symptoms during the past 12
months?
Yes
No
DPMJUSE_1 Marijuana or any cannabis product
⃝1
⃝2
DPMJUSE_2 Something else
⃝1
⃝2
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

478

DPMJOTH

[IF DPMJUSE_2=1] You indicated that you took something else to get over or
avoid having marijuana or any cannabis product withdrawal symptoms during
the past 12 months. What did you take?
______________________________________
DK/REF

DPMJLAW During the past 12 months, did using marijuana or any cannabis product 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
DPCCINT

[IF COC12MON = 1 OR CRK12MON = 1] Think about your use of cocaine,
including the form of cocaine called ‘crack,’ during the past 12 months as you
answer these next questions.
Click Next to continue.

(IF COC12MON = 2 AND CRK12MON = 2, SKIP TO DPHEINT)
DPCCFEEL During the past 12 months, did you spend a great deal of your time using
cocaine, feeling its effects, or getting over the effects of cocaine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCGET

[IF DPCCFEEL=2 OR DK/REF] During the past 12 months, did you spend a
great deal of your time getting or trying to get cocaine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPCCLRGR During the past 12 months, were there many times when you ended up using
cocaine in larger amounts or for a longer time than you meant to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

479

DPCCBDLY During the past 12 months, were there times when you wanted to use cocaine so
badly that you couldn’t think of anything else?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCURGE [IF DPCCBDLY = 2 OR DK/REF] During the past 12 months, were there times
when you had a strong urge to use cocaine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCMORE Do you need to use a lot more cocaine than you used to in order to get the feeling
you want?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCLESS [IF DPCCMORE = 2 OR DK/REF] Does using the same amount of cocaine have
much less effect on you than it used to ?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCSTOP During the past 12 months, did you try to cut down or try to stop using cocaine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCCANT [IF DPCCSTOP = 1] Some people who use cocaine try to cut down or stop but
find they can’t. Was there more than one time in the past 12 months when you
tried but were unable to cut down or stop using cocaine?
1
Yes
2
No
DK/REF

480

PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCWISH [IF DPCCSTOP=2 OR DK/REF] In the past 12 months, did you often wish that
you could cut down or stop using cocaine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCPHYS During the past 12 months, did you have any long-lasting or repeated physical
health problems that were caused or made worse by using cocaine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCPCNT [IF DPCCPHYS = 1]: Did you continue to use cocaine even though it was causing
long-lasting or repeated physical health problems or making your physical health
problems worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCMNTL [IF DPCCPHYS = 2 OR DK/REF OR DPCCPCNT = 2 OR DK/REF] During the
past 12 months, did you have any long-lasting or repeated problems with
emotions or mental health that were caused or made worse by using cocaine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCMCNT [IF DPCCMNTL = 1]: Did you continue to use cocaine even though it was
causing long-lasting or repeated problems with your emotions or mental health or
making your emotions or mental health worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

481

DPCCACTV This question is about important activities such as:





Spending time with friends and family
Attending special events at work or school
Participating in hobbies and sports
Attending religious services and events

During the past 12 months, did you give up or spend a lot less time doing any of
these types of important activities because of your use of cocaine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCSERI Sometimes people who use cocaine have serious problems at work, school, or
home—such as:






missing a lot of work or school
getting demoted, having your hours cut, or losing a job
not being able to get a job or keep a job
getting suspended, expelled, or dropping out of school
failing to take care of family

During the past 12 months, did you have any serious problems like these at work,
school, or home because of your use of cocaine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCARGU During the past 12 months, did you often have arguments or other problems with
family or friends that were caused or made worse by your use of cocaine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCACNT [IF DPCCARGU = 1]: Did you continue to use cocaine even though it often
caused arguments or problems with family or friends?
1
Yes
2
No
DK/REF

482

PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCHURT During the past 12 months, did you repeatedly get into situations where using
cocaine increased your chances of getting physically hurt?
1
Yes
2
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCBLUE People may experience withdrawal symptoms when they use less or stop using
cocaine.
During the past 12 months, have you felt kind of blue or down after you used less
or stopped using cocaine for a while?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPCCWD

[IF DPCCBLUE = 1] During the past 12 months, did you have the following
withdrawal symptoms after you used less or stopped using cocaine for a while?
Yes
No
DPCCWD_1 Feeling tired or exhausted
⃝1
⃝2
DPCCWD_2 Having bad dreams
⃝1
⃝2
DPCCWD_3 Having trouble sleeping or sleeping
⃝1
⃝2
more than you normally do
DPCCWD_4 Feeling hungry more often
⃝1
⃝2
DPCCWD_5 Feeling either very slowed down or
⃝1
⃝2
like you couldn’t sit still
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPCCOVER During the past 12 months, did you use cocaine or another drug to get over or
avoid having cocaine withdrawal symptoms?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
PROGRAMMER: DISPLAY IN LOWER RIGHT:
Click Help to see these symptoms again.

483

DPCCUSE

[IF DPCCOVER=1] Which of the following did you use to get over or avoid
having cocaine withdrawal symptoms during the past 12 months?
Yes
No
DPCCUSE_1 Cocaine
⃝1
⃝2
DPCCUSE_2 Methamphetamine
⃝1
⃝2
DPCCUSE_3 Prescription stimulants or uppers
⃝1
⃝2
DPCCUSE_4 Something else
⃝1
⃝2
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPCCOTH

[IF DPCCUSE_4=1] You indicated that you took something else to get over or
avoid having cocaine withdrawal symptoms during the past 12 months. What did
you take?
______________________________________
DK/REF

DPCCLAW During the past 12 months, did using cocaine 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
DPHEINT

[IF HER12MON = 1] Think about your use of heroin during the past 12 months
as you answer these next questions.
Click Next to continue.

(IF HER12MON = 2, SKIP TO DPHAINT)
DPHEFEEL During the past 12 months, did you spend a great deal of your time using
heroin, feeling its effects, or getting over the effects of heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHEGET

[IF DPHEFEEL=2 OR DK/REF] During the past 12 months, did you spend a
great deal of your time getting or trying to get heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

484

DPHELRGR During the past 12 months, were there many times when you ended up using
heroin in larger amounts or for a longer time than you meant to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHEBDLY During the past 12 months, were there times when you wanted to use heroin so
badly that you couldn’t think of anything else?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHEURGE [IF DPHEBDLY = 2 OR DK/REF] During the past 12 months, were there times
when you had a strong urge to use heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHEMORE Do you need to use a lot more heroin than you used to in order to get the feeling
you want?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHELESS [IF DPHEMORE = 2 OR DK/REF] Does using the same amount of heroin have
much less effect on you than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHESTOP During the past 12 months, did you try to cut down or try to stop using heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

485

DPHECANT [IF DPHESTOP = 1] Some people who use heroin try to cut down or stop but find
they can’t. Was there more than one time in the past 12 months when you tried
but were unable to cut down or stop using heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHEWISH [IF DPHESTOP=2 OR DK/REF] In the past 12 months, did you often wish that
you could cut down or stop using heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHEPHYS During the past 12 months, did you have any long-lasting or repeated physical
health problems that were caused or made worse by using heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHEPCNT [IF DPHEPHYS = 1]: Did you continue to use heroin even though it was causing
long-lasting or repeated physical health problems or making your physical health
problems worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHEMNTL [IF DPHEPHYS = 2 OR DK/REF OR DPHEPCNT = 2 OR DK/REF] During the
past 12 months, did you have any long-lasting or repeated problems with
emotions or mental health that were caused or made worse by using heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHEMCNT [IF DPHEMNTL = 1]: Did you continue to use heroin even though it was
causing long-lasting or repeated problems with your emotions or mental health or
making your emotions or mental health worse?

486

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHEACTV This question is about important activities such as:





Spending time with friends and family
Attending special events at work or school
Participating in hobbies and sports
Attending religious services and events

During the past 12 months, did you give up or spend a lot less time doing any of
these types of important activities because of your use of heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHESERI Sometimes people who use heroin have serious problems at work, school, or
home—such as:






missing a lot of work or school
getting demoted, having your hours cut, or losing a job
not being able to get a job or keep a job
getting suspended, expelled, or dropping out of school
failing to take care of family

During the past 12 months, did you have any serious problems like these at work,
school, or home because of your use of heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHEARGU During the past 12 months, did you often have arguments or other problems with
family or friends that were caused or made worse by your use of heroin?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

487

DPHEACNT [IF DPHEARGU = 1]: Did you continue to use heroin even though it often
caused arguments or problems with family or friends?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHEHURT During the past 12 months, did you repeatedly get into situations where using
heroin increased your chances of getting physically hurt?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHEWD

People may experience withdrawal symptoms when they use less or stop using
heroin.
During the past 12 months, did you have the following withdrawal symptoms
after you used less or stopped using heroin for a while?
Yes
No
DPHEWD_1 Feeling kind of blue or down
⃝1
⃝2
DPHEWD_2 Vomiting or feeling nauseous
⃝1
⃝2
DPHEWD_3 Having cramps or muscle aches
⃝1
⃝2
DPHEWD_4 Having teary eyes or a runny nose
⃝1
⃝2
DPHEWD_5 Feeling sweaty, having enlarged eye
⃝1
⃝2
pupils, or having body hair standing up on your skin
DPHEWD_6 Having diarrhea
⃝1
⃝2
DPHEWD_7 Yawning
⃝1
⃝2
DPHEWD_8 Having a fever
⃝1
⃝2
DPHEWD_9 Having trouble sleeping
⃝1
⃝2
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPHEOVER During the past 12 months, did you use heroin or another drug to get over or avoid
having heroin withdrawal symptoms?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
PROGRAMMER: DISPLAY IN LOWER RIGHT:
Click Help to see these symptoms again.

488

DPHEUSE

[IF DPHEOVER=1] Which of the following did you use to get over or avoid
having heroin withdrawal symptoms during the past 12 months?
Yes
No
DPHEUSE_1 Heroin
⃝1
⃝2
DPHEUSE_2 Prescription pain relievers
⃝1
⃝2
DPHEUSE_3 Something else
⃝1
⃝2
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPHEOTH [IF DPHEUSE_3=1] You indicated that you took something else to get over or
avoid having heroin withdrawal symptoms during the past 12 months. What did
you take?
______________________________________
DK/REF
DPHELAW 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

DPHAINT

[IF HAL12MON = 1] Think about your use of hallucinogens, such as LSD,
‘acid,’ PCP, ‘Ecstasy’ or ‘Molly,’ psilocybin or mushrooms, mescaline, or peyote,
during the past 12 months as you answer these next questions.
Click Next to continue.

(IF HAL12MON = 2, SKIP TO DPININT)
DPHAFEEL During the past 12 months, did you spend a great deal of your time using
hallucinogens, feeling their effects, or getting over the effects of hallucinogens?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHAGET

[IF DPHAFEEL=2 OR DK/REF] During the past 12 months, did you spend a
great deal of your time getting or trying to get hallucinogens?
1
Yes
2
No
DK/REF

489

PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHALRGR During the past 12 months, were there many times when you ended up using
hallucinogens in larger amounts or for a longer time than you meant to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHABDLY During the past 12 months, were there times when you wanted to use
hallucinogens so badly that you couldn’t think of anything else?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHAURGE [IF DPHABDLY = 2 OR DK/REF] During the past 12 months, were there times
when you had a strong urge to use hallucinogens?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHAMORE Do you need to use a lot more hallucinogens than you used to in order to get the
feeling you want?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHALESS [IF DPHAMORE = 2 OR DK/REF] Does using the same amount of
hallucinogens have much less effect on you than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

490

DPHASTOP During the past 12 months, did you try to cut down or try to stop using
hallucinogens?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHACANT [IF DPHASTOP = 1] Some people who use hallucinogens try to cut down or stop
but find they can’t. Was there more than one time in the past 12 months when
you tried but were unable to cut down or stop using hallucinogens?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHAWISH [IF DPHASTOP=2 OR DK/REF] In the past 12 months, did you often wish that
you could cut down or stop using hallucinogens?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHAPHYS During the past 12 months, did you have any long-lasting or repeated physical
health problems that were caused or made worse by using hallucinogens?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHAPCNT [IF DPHAPHYS = 1]: Did you continue to use hallucinogens even though they
were causing long-lasting or repeated physical health problems or making your
physical health problems worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHAMNTL [IF DPHAPHYS = 2 OR DK/REF OR DPHAPCNT = 2 OR DK/REF] During the
past 12 months, did you have any long-lasting or repeated problems with
emotions or mental health that were caused or made worse by using
hallucinogens?

491

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHAMCNT [IF DPHAMNTL = 1]: Did you continue to use hallucinogens even though they
were causing long-lasting or repeated problems with your emotions or mental
health or making your emotions or mental health worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHAACTV This question is about important activities such as:





Spending time with friends and family
Attending special events at work or school
Participating in hobbies and sports
Attending religious services and events

During the past 12 months, did you give up or spend a lot less time doing any of
these types of important activities because of your use of hallucinogens?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHASERI Sometimes people who use hallucinogens have serious problems at work, school,
or home—such as:






missing a lot of work or school
getting demoted, having your hours cut, or losing a job
not being able to get a job or keep a job
getting suspended, expelled, or dropping out of school
failing to take care of family

During the past 12 months, did you have any serious problems like these at work,
school, or home because of your use of hallucinogens?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

492

DPHAARGU During the past 12 months, did you often have arguments or other problems with
family or friends that were caused or made worse by your use of hallucinogens?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHAACNT [IF DPHAARGU = 1]: Did you continue to use hallucinogens even though they
often caused arguments or problems with family or friends?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHAHURT During the past 12 months, did you repeatedly get into situations where using
hallucinogens increased your chances of getting physically hurt?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPHALAW 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
DPININT [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.
Click Next to continue.
(IF INH12MON = 2, SKIP TO DPMEINT)
DPINFEEL During the past 12 months, did you spend a great deal of your time using
inhalants, feeling their effects, or getting over the effects of inhalants?
1
Yes
2
No
DK/REF
493

PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINGET

[IF DPINFEEL=2 OR DK/REF] During the past 12 months, did you spend a
great deal of your time getting or trying to get inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPINLRGR During the past 12 months, were there many times when you ended up using
inhalants in larger amounts or for a longer time than you meant to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINBDLY During the past 12 months, were there times when you wanted to use inhalants so
badly that you couldn’t think of anything else?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINURGE [IF DPINBDLY = 2 OR DK/REF] During the past 12 months, were there times
when you had a strong urge to use inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINMORE Do you need to use a lot more inhalants than you used to in order to get the
feeling you want?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

494

DPINLESS

[IF DPINMORE = 2 OR DK/REF] Does using the same amount of inhalants
have much less effect on you than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPINSTOP During the past 12 months, did you try to cut down or try to stop using
inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINCANT [IF DPINSTOP = 1] Some people who use inhalants try to cut down or stop but
find they can’t. Was there more than one time in the past 12 months when you
tried but were unable to cut down or stop using inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINWISH [IF DPINSTOP=2 OR DK/REF] In the past 12 months, did you often wish that
you could cut down or stop using inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINPHYS During the past 12 months, did you have any long-lasting or repeated physical
health problems that were caused or made worse by using inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

495

DPINPCNT [IF DPINPHYS = 1]: Did you continue to use inhalants even though they were
causing long-lasting or repeated physical health problems or making your
physical health problems worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINMNTL [IF DPINPHYS = 2 OR DK/REF OR DPINPCNT = 2 OR DK/REF] During the
past 12 months, did you have any long-lasting or repeated problems with
emotions or mental health that were caused or made worse by using inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINMCNT [IF DPINMNTL = 1]: Did you continue to use inhalants even though they were
causing long-lasting or repeated problems with your emotions or mental health or
making your emotions or mental health worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINACTV This question is about important activities such as:





Spending time with friends and family
Attending special events at work or school
Participating in hobbies and sports
Attending religious services and events

During the past 12 months, did you give up or spend a lot less time doing any of
these types of important activities because of your use of inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINSERI

Sometimes people who use inhalants have serious problems at work, school, or
home—such as:

496







missing a lot of work or school
getting demoted, having your hours cut, or losing a job
not being able to get a job or keep a job
getting suspended, expelled, or dropping out of school
failing to take care of family

During the past 12 months, did you have any serious problems like these at work,
school, or home because of your use of inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINARGU During the past 12 months, did you often have arguments or other problems with
family or friends that were caused or made worse by your use of inhalants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINACNT [IF DPINARGU = 1]: Did you continue to use inhalants even though they often
caused arguments or problems with family or friends?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINHURT During the past 12 months, did you repeatedly get into situations where using
inhalants increased your chances of getting physically hurt?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPINLAW

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

497

PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEINT

[IF MET12MON = 1] Think about your use of methamphetamine during the
past 12 months as you answer these next questions.
Click Next to continue.

(IF MET12MON = 2, SKIP TO DPPRINT)
DPMEFEEL During the past 12 months, did you spend a great deal of your time using
methamphetamine, feeling its effects, or getting over the effects of
methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEGET [IF DPMEFEEL=2 OR DK/REF] During the past 12 months, did you spend a
great deal of your time getting or trying to get methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMELRGR During the past 12 months, were there many times when you ended up using
methamphetamine in larger amounts or for a longer time than you meant to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEBDLY During the past 12 months, were there times when you wanted to use
methamphetamine so badly that you couldn’t think of anything else?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

498

DPMEURGE [IF DPMEBDLY = 2 OR DK/REF] During the past 12 months, were there times
when you had a strong urge to use methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEMORE Do you need to use a lot more methamphetamine than you used to in order to
get the feeling you want?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMELESS [IF DPMEMORE = 2 OR DK/REF] Does using the same amount of
methamphetamine have much less effect on you than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMESTOP During the past 12 months, did you try to cut down or try to stop using
methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMECANT [IF DPMESTOP=1] Some people who use methamphetamine try to cut down or
stop but find they can’t. Was there more than one time in the past 12 months
when you tried but were unable to cut down or stop using methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEWISH [IF DPMESTOP=2 OR DK/REF] In the past 12 months, did you often wish that
you could cut down or stop using methamphetamine?
1
2

Yes
No

499

DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEPHYS During the past 12 months, did you have any long-lasting or repeated physical
health problems that were caused or made worse by using methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEPCNT [IF DPMEPHYS = 1]: Did you continue to use methamphetamine even though it
was causing long-lasting or repeated physical health problems or making your
physical health problems worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEMNTL [IF DPMEPHYS = 2 OR DK/REF OR DPMEPCNT = 2 OR DK/REF] During
the past 12 months, did you have any long-lasting or repeated problems with
emotions or mental health that were caused or made worse by using
methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEMCNT [IF DPMEMNTL = 1]: Did you continue to use methamphetamine even though
it was causing long-lasting or repeated problems with your emotions or mental
health or making your emotions or mental health worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEACTV This question is about important activities such as:





Spending time with friends and family
Attending special events at work or school
Participating in hobbies and sports
Attending religious services and events

500

During the past 12 months, did you give up or spend a lot less time doing any of
these types of important activities because of your use of methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMESERI Sometimes people who use methamphetamine have serious problems at work,
school, or home—such as:






missing a lot of work or school
getting demoted, having your hours cut, or losing a job
not being able to get a job or keep a job
getting suspended, expelled, or dropping out of school
failing to take care of family

During the past 12 months, did you have any serious problems like these at work,
school, or home because of your use of methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEARGU During the past 12 months, did you often have arguments or other problems with
family or friends that were caused or made worse by your use of
methamphetamine?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEACNT [IF DPMEARGU = 1]: Did you continue to use methamphetamine even though
it often caused arguments or problems with family or friends?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEHURT During the past 12 months, did you repeatedly get into situations where using
methamphetamine increased your chances of getting physically hurt?
1
2

Yes
No
501

DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEBLUE People may experience withdrawal symptoms when they use less or stop using
methamphetamine.
During the past 12 months, have you felt kind of blue or down after you used less
or stopped using methamphetamine for a while?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEWD

[IF DPMEBLUE=1] During the past 12 months, did you have the following
withdrawal symptoms after you used less or stopped using methamphetamine
for a while?
Yes
No
DPMEWD_1 Feeling tired or exhausted
⃝1
⃝2
DPMEWD_2 Having bad dreams
⃝1
⃝2
DPMEWD_3 Having trouble sleeping or sleeping
⃝1
⃝2
more than you normally do
DPMEWD_4 Feeling hungry more often
⃝1
⃝2
DPMEWD_5 Feeling either very slowed down or
⃝1
⃝2
like you couldn’t sit still
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPMEOVER During the past 12 months, did you use methamphetamine or another drug to get
over or avoid having methamphetamine withdrawal symptoms?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
PROGRAMMER: DISPLAY IN LOWER RIGHT:
Click Help to see these symptoms again.
DPMEUSE

[IF DPMEOVER=1] Which of the following did you use to get over or avoid
having methamphetamine withdrawal symptoms during the past 12 months?
Yes
No
DPMEUSE_1 Methamphetamine
⃝1
⃝2
DPMEUSE_2 Cocaine or crack
⃝1
⃝2
DPMEUSE_3 Prescription stimulants or uppers
⃝1
⃝2
DPMEUSE_4 Something else
⃝1
⃝2
DK/REF

502

PROGRAMMER: SHOW 12 MONTH CALENDAR
DPMEOTH [IF DPMEUSE_4=1] You indicated that you took something else to get over or
avoid having methamphetamine withdrawal symptoms during the past 12
months. What did you take?
______________________________________
DK/REF
DPMELAW 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
DPPRINT

[IF PR12MON = 1] Think about your use of prescription pain relievers during
the past 12 months as you answer these next questions.
Earlier you reported that in the past 12 months you used [IF PRYRCOUNT=1
FILL PRFILL][IF PRYRCOUNT >=2 FILL WITH “the pain relievers listed
below” ].
[IF PRYRCOUNT >=2 FILL WITH THE INDIVIDUAL DRUGS SELECTED
FROM PR01-PR10 BELOW. USE MULTIPLE COLUMNS AS NEEDED. IF
PRYANYOTH = 1, ADD “some other prescription pain reliever.”]
The next questions refer to [IF PRYANYOTH NE 1 AND PRYRCOUNT =1
FILL PRFILL as a prescription pain reliever; IF PRYANYOTH = 1 AND
PRYRCOUNT =1 FILL WITH “this other prescription pain reliever”; IF
PRYRCOUNT >=2 FILL WITH “these as prescription pain relievers”].
Click Next to continue.

(IF PR12MON = 2, SKIP TO DPTRINT)
DPPRFEEL During the past 12 months, did you spend a great deal of your time using any
prescription pain relievers, feeling their effects, or getting over the effects of
any prescription pain relievers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRGET

[IF DPPRFEEL=2 OR DK/REF] During the past 12 months, did you spend a
great deal of your time getting or trying to get any prescription pain relievers?
503

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRLRGR During the past 12 months, were there many times when you ended up using any
prescription pain relievers in larger amounts or for a longer time than you meant
to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRBDLY During the past 12 months, were there times when you wanted to use any
prescription pain relievers so badly that you couldn’t think of anything else?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRURGE [IF DPPRBDLY = 2 OR DK/REF] During the past 12 months, were there times
when you had a strong urge to use any prescription pain relievers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRMORE Do you need to use a lot more of any prescription pain relievers than you used
to in order to get the feeling you want?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRLESS [IF DPPRMORE = 2 OR DK/REF] Does using the same amount of any
prescription pain relievers have much less effect on you than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

504

DPPRSTOP During the past 12 months, did you try to cut down or try to stop using any
prescription pain relievers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRCANT [IF DPPRSTOP=1] Some people who use prescription pain relievers try to cut
down or stop but find they can’t. Was there more than one time in the past 12
months when you tried but were unable to cut down or stop using any
prescription pain relievers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRWISH [IF DPPRSTOP=2 OR DK/REF] In the past 12 months, did you often wish that
you could cut down or stop using any prescription pain relievers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRPHYS During the past 12 months, did you have any long-lasting or repeated physical
health problems that were caused or made worse by using a prescription pain
reliever?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRPCNT [IF DPPRPHYS = 1]: Did you continue to use any prescription pain relievers
even though they were causing long-lasting or repeated physical health problems
or making your physical health problems worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

505

DPPRMNTL [IF DPPRPHYS = 2 OR DK/REF OR DPPRPCNT = 2 OR DK/REF] During the
past 12 months, did you have any long-lasting or repeated problems with
emotions or mental health that were caused or made worse by using a
prescription pain reliever?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRMCNT [IF DPPRMNTL = 1]: Did you continue to use any prescription pain relievers
even though they were causing long-lasting or repeated problems with your
emotions or mental health or making your emotions or mental health worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRACTV This question is about important activities such as:





Spending time with friends and family
Attending special events at work or school
Participating in hobbies and sports
Attending religious services and events

During the past 12 months, did you give up or spend a lot less time doing any of
these types of important activities because of your use of any prescription pain
relievers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRSERI

Sometimes people who use prescription pain relievers have serious problems at
work, school, or home—such as:






missing a lot of work or school
getting demoted, having your hours cut, or losing a job
not being able to get a job or keep a job
getting suspended, expelled, or dropping out of school
failing to take care of family

During the past 12 months, did you have any serious problems like these at work,
school, or home because of your use of any prescription pain relievers?

506

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRARGU During the past 12 months, did you often have arguments or other problems with
family or friends that were caused or made worse by your use of a prescription
pain reliever?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRACNT [IF DPPRARGU = 1]: Did you continue to use any prescription pain relievers
even though they often caused arguments or problems with family or friends?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRHURT During the past 12 months, did you repeatedly get into situations where using a
prescription pain reliever increased your chances of getting physically hurt?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPRWD

People may experience withdrawal symptoms when they use less or stop using
prescription pain relievers.
During the past 12 months, did you have the following withdrawal symptoms
after you used less or stopped using any prescription pain relievers for a while?
Yes
No
DPPRWD_1 Feeling kind of blue or down
⃝1
⃝2
DPPRWD_2 Vomiting or feeling nauseous
⃝1
⃝2
DPPRWD_3 Having cramps or muscle aches
⃝1
⃝2
DPPRWD_4 Having teary eyes or a runny nose
⃝1
⃝2
DPPRWD_5 Feeling sweaty, having enlarged eye
⃝1
⃝2
pupils, or having body hair standing up on your skin
DPPRWD_6 Having diarrhea
⃝1
⃝2
DPPRWD_7 Yawning
⃝1
⃝2
DPPRWD_8 Having a fever
⃝1
⃝2
DPPRWD_9 Having trouble sleeping
⃝1
⃝2
507

DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPPROVER During the past 12 months, did you use any prescription pain relievers or other
drugs to get over or avoid having prescription pain reliever withdrawal
symptoms?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
PROGRAMMER: DISPLAY IN LOWER RIGHT:
Click Help to see these symptoms again.
DPPRUSE

[IF DPPROVER=1] Which of the following did you use to get over or avoid
having prescription pain reliever withdrawal symptoms during the past 12
months?
Yes
No
DPPRUSE_1 Prescription pain relievers
⃝1
⃝2
DPPRUSE_2 Heroin
⃝1
⃝2
DPPRUSE_3 Something else
⃝1
⃝2
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPPROTH

[IF DPPRUSE_3=1] You indicated that you took something else to get over or
avoid having prescription pain reliever withdrawal symptoms during the past 12
months. What did you take?
______________________________________
DK/REF

DPPRLAW 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
DPTRINT [IF TR12MON = 1] Think about your use of prescription tranquilizers during the
past 12 months as you answer these next questions.
Earlier you reported that in the past 12 months you used [IF TRYRCOUNT=1 FILL
TRFILL][IF TRYRCOUNT >=2 FILL WITH “the tranquilizers listed below” ].

508

[IF TRYRCOUNT >=2 FILL WITH THE INDIVIDUAL DRUGS SELECTED
FROM TR01-TR04 BELOW. USE MULTIPLE COLUMNS AS NEEDED. IF
TRYOTH = 1, ADD “some other prescription tranquilizer.”]
The next questions refer to [IF TRYANYOTH NE 1 AND TRYRCOUNT =1 FILL
TRFILL as a prescription tranquilizer; IF TRYANYOTH = 1 AND TRYRCOUNT =1
FILL WITH “this other prescription tranquilizer”; IF TRYRCOUNT >=2 FILL WITH
“these as prescription tranquilizers”].
Click Next to continue.
(IF TR12MON = 2, SKIP TO DPSTINT)
DPTRFEEL During the past 12 months, did you spend a great deal of your time using any
prescription tranquilizers, feeling their effects, or getting over the effects of any
prescription tranquilizers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRGET

[IF DPTRFEEL=2 OR DK/REF] During the past 12 months, did you spend a
great deal of your time getting or trying to get any prescription tranquilizers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPTRLRGR During the past 12 months, were there many times when you ended up using any
prescription tranquilizers in larger amounts or for a longer time than you meant
to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRBDLY During the past 12 months, were there times when you wanted to use any
prescription tranquilizers so badly that you couldn’t think of anything else?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

509

DPTRURGE [IF DPTRBDLY = 2 OR DK/REF] During the past 12 months, were there times
when you had a strong urge to use any prescription tranquilizers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRMORE Do you need to use a lot more of any prescription tranquilizers than you used to
in order to get the feeling you want?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRLESS [IF DPTRMORE= 2 OR DK/REF] Does using the same amount of any
prescription tranquilizers have much less effect on you than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRSTOP During the past 12 months, did you try to cut down or try to stop using any
prescription tranquilizers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRCANT [IF DPTRSTOP=1] Some people who use prescription tranquilizers try to cut
down or stop but find they can’t. Was there more than one time in the past 12
months when you tried but were unable to cut down or stop using any
prescription tranquilizers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRWISH [IF DPTRSTOP=2 OR DK/REF] In the past 12 months, did you often wish that
you could cut down or stop using any prescription tranquilizers?

510

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRPHYS During the past 12 months, did you have any long-lasting or repeated physical
health problems that were caused or made worse by using a prescription
tranquilizer?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRPCNT [IF DPTRPHYS = 1]: Did you continue to use any prescription tranquilizers
even though they were causing long-lasting or repeated physical health problems
or making your physical health problems worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRMNTL [IF DPTRPHYS = 2 OR DK/REF OR DPTRPCNT = 2 OR DK/REF] During the
past 12 months, did you have any long-lasting or repeated problems with
emotions or mental health that were caused or made worse by using a
prescription tranquilizer?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRMCNT [IF DPTRMNTL = 1]: Did you continue to use any prescription tranquilizers
even though they were causing long-lasting or repeated problems with your
emotions or mental health or making your emotions or mental health worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRACTV This question is about important activities such as:





Spending time with friends and family
Attending special events at work or school
Participating in hobbies and sports
Attending religious services and events
511

During the past 12 months, did you give up or spend a lot less time doing any of
these types of important activities because of your use of any prescription
tranquilizers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRSERI Sometimes people who use prescription tranquilizers have serious problems at
work, school, or home—such as:






missing a lot of work or school
getting demoted, having your hours cut, or losing a job
not being able to get a job or keep a job
getting suspended, expelled, or dropping out of school
failing to take care of family

During the past 12 months, did you have any serious problems like these at work,
school, or home because of your use of any prescription tranquilizers?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRARGU During the past 12 months, did you often have arguments or other problems with
family or friends that were caused or made worse by your use of a prescription
tranquilizer?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRACNT [IF DPTRARGU = 1]: Did you continue to use any prescription tranquilizers
even though they often caused arguments or problems with family or friends?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRHURT During the past 12 months, did you repeatedly get into situations where using a
prescription tranquilizer increased your chances of getting physically hurt?

512

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTRWD

People may experience withdrawal symptoms when they use less or stop using
prescription tranquilizers.
During the past 12 months, did you have the following withdrawal symptoms
after you used less or stopped using any prescription tranquilizers for a while?
Yes
No
DPTRWD_1 Sweating or feeling that your heart
⃝1
⃝2
was beating fast
DPTRWD_2 Having your hands tremble
⃝1
⃝2
DPTRWD_3 Having trouble sleeping
⃝1
⃝2
DPTRWD_4 Vomiting or having an upset stomach
⃝1
⃝2
DPTRWD_5 Seeing, hearing, or feeling things that
⃝1
⃝2
weren’t really there
DPTRWD_6 Feeling like you couldn’t sit still
⃝1
⃝2
DPTRWD_7 Feeling anxious
⃝1
⃝2
DPTRWD_8 Having seizures or fits
⃝1
⃝2
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPTROVER During the past 12 months, did you use any prescription tranquilizers or other
drugs to get over or avoid having prescription tranquilizer withdrawal
symptoms?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
PROGRAMMER: DISPLAY IN LOWER RIGHT:
Click Help to see these symptoms again.
DPTRUSE

[IF DPTROVER=1] Which of the following did you use to get over or avoid
having prescription tranquilizer withdrawal symptoms during the past 12
months?
Yes
No
DPTRUSE_1 Prescription tranquilizers, sedatives,
⃝1
⃝2
downers, or sleeping pills
DPTRUSE_2 Alcohol
⃝1
⃝2
DPTRUSE_3 Something else
⃝1
⃝2
DK/REF

513

PROGRAMMER: SHOW 12 MONTH CALENDAR
DPTROTH

[IF DPTRUSE_3=1] You indicated that you took something else to get over or
avoid having prescription tranquilizer withdrawal symptoms during the past 12
months. What did you take?
______________________________________
DK/REF

DPTRLAW 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
DPSTINT [IF ST12MON = 1] Think about your use of prescription stimulants during the past
12 months as you answer these next questions.
Earlier you reported that in the past 12 months you used [IF STYRCOUNT =1 FILL
STFILL][IF STYRCOUNT >=2 FILL WITH “the stimulants listed below” ].
[IF STYRCOUNT >=2 FILL WITH THE INDIVIDUAL DRUGS SELECTED
FROM ST01- ST07 BELOW. USE MULTIPLE COLUMNS AS NEEDED. IF
STANYOTH = 1, ADD “some other prescription stimulant.”]
The next questions refer to [IF STANYOTH NE 1 AND STYRCOUNT =1 FILL
STFILL as a prescription stimulant; IF STANYOTH = 1 AND STYRCOUNT =1
FILL WITH “this other prescription stimulant”; IF STYRCOUNT >=2 FILL WITH
“these as prescription stimulants”].
Click Next to continue.
(IF ST12MON = 2, SKIP TO DPSVINT)
DPSTFEEL During the past 12 months, did you spend a great deal of your time using any
prescription stimulants, feeling their effects, or getting over the effects of any
prescription stimulants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTGET

[IF DPSTFEEL=2 OR DK/REF] During the past 12 months, did you spend a
great deal of your time getting or trying to get any prescription stimulants?

514

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTLRGR During the past 12 months, were there many times when you ended up using any
prescription stimulants in larger amounts or for a longer time than you meant
to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTBDLY During the past 12 months, were there times when you wanted to use any
prescription stimulants so badly that you couldn’t think of anything else?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTURGE [IF DPSTBDLY = 2 OR DK/REF] During the past 12 months, were there times
when you had a strong urge to use any prescription stimulants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTMORE Do you need to use a lot more of any prescription stimulants than you used to in
order to get the feeling you want?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTLESS [IF DPSTMORE = 2 OR DK/REF] Does using the same amount of any
prescription stimulants have much less effect on you than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

515

DPSTSTOP During the past 12 months, did you try to cut down or try to stop using any
prescription stimulants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTCANT [IF DPSTSTOP=1] Some people who use prescription stimulants try to cut down
or stop but find they can’t. Was there more than one time in the past 12 months
when you tried but were unable to cut down or stop using any prescription
stimulants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTWISH [IF DPSTSTOP=2 OR DK/REF] In the past 12 months, did you often wish that
you could cut down or stop using any prescription stimulants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTPHYS During the past 12 months, did you have any long-lasting or repeated physical
health problems that were caused or made worse by using a prescription
stimulant?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTPCNT [IF DPSTPHYS = 1]: Did you continue to use any prescription stimulants even
though they were causing long-lasting or repeated physical health problems or
making your physical health problems worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTMNTL [IF DPSTPHYS = 2 OR DK/REF OR DPSTPCNT = 2 OR DK/REF] During the
past 12 months, did you have any long-lasting or repeated problems with

516

emotions or mental health that were caused or made worse by using a
prescription stimulant?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTMCNT [IF DPSTMNTL = 1]: Did you continue to use any prescription stimulants even
though they were causing long-lasting or repeated problems with your emotions
or mental health or making your emotions or mental health worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTACTV This question is about important activities such as:





Spending time with friends and family
Attending special events at work or school
Participating in hobbies and sports
Attending religious services and events

During the past 12 months, did you give up or spend a lot less time doing any of
these types of important activities because of your use of any prescription
stimulants?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTSERI

Sometimes people who use prescription stimulants have serious problems at
work, school, or home—such as:






missing a lot of work or school
getting demoted, having your hours cut, or losing a job
not being able to get a job or keep a job
getting suspended, expelled, or dropping out of school
failing to take care of family

During the past 12 months, did you have any serious problems like these at work,
school, or home because of your use of any prescription stimulants?
1
2

Yes
No

517

DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTARGU During the past 12 months, did you often have arguments or other problems with
family or friends that were caused or made worse by your use of a prescription
stimulant?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTACNT [IF DPSTARGU = 1]: Did you continue to use any prescription stimulants even
though they often caused arguments or problems with family or friends?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTHURT During the past 12 months, did you repeatedly get into situations where using a
prescription stimulant increased your chances of getting physically hurt?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSTBLUE People may experience withdrawal symptoms when they use less or stop using
prescription stimulants.
During the past 12 months, have you felt kind of blue or down after you used less
or stopped using any prescription stimulants for a while?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

518

DPSTWD

[IF DPSTBLUE=1] During the past 12 months, did you have the following
withdrawal symptoms after you used less or stopped using prescription
stimulants for a while?
Yes
No
DPSTWD_1 Feeling tired or exhausted
⃝1
⃝2
DPSTWD_2 Having bad dreams
⃝1
⃝2
DPSTWD_3 Having trouble sleeping or sleeping
⃝1
⃝2
more than you normally do
DPSTWD_4 Feeling hungry more often
⃝1
⃝2
DPSTWD_5 Feeling either very slowed down or
⃝1
⃝2
like you couldn’t sit still
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPSTOVER During the past 12 months, did you use any prescription stimulants or other drugs
to get over or avoid having prescription stimulant withdrawal symptoms?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
PROGRAMMER: DISPLAY IN LOWER RIGHT:
Click Help to see these symptoms again.
DPSTUSE

[IF DPSTOVER=1] Which of the following did you use to get over or avoid
having prescription stimulant withdrawal symptoms during the past 12 months?
Yes
No
DPSTUSE_1 Prescription stimulants or uppers
⃝1
⃝2
DPSTUSE_2 Cocaine or crack
⃝1
⃝2
DPSTUSE_3 Methamphetamine
⃝1
⃝2
DPSTUSE_4 Something else
⃝1
⃝2
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPSTOTH

[IF DPSTUSE_4=1] You indicated that you took something else to get over or
avoid having prescription stimulant withdrawal symptoms during the past 12
months. What did you take?
______________________________________
DK/REF

DPSTLAW

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

519

PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVINT [IF SV12MON = 1] Think about your use of prescription sedatives during the past
12 months as you answer these next questions.
Earlier you reported that in the past 12 months you used [IF SVYRCOUNT =1 FILL
SVFILL][IF SVYRCOUNT >=2 FILL WITH “the sedatives listed below” ].
[IF SVYRCOUNT >= 2 FILL WITH THE INDIVIDUAL DRUGS SELECTED
FROM SV01-SV04 BELOW. USE MULTIPLE COLUMNS AS NEEDED. IF
SVANYOTH = 1, ADD “some other prescription sedative”.]
The next questions refer to [IF SVANYOTH NE 1 AND SVYRCOUNT =1 FILL
SVFILL as a prescription sedative; IF SVANYOTH = 1 AND SVYRCOUNT =1
FILL WITH “this other prescription sedative”; IF SVYRCOUNT >=2 FILL WITH
“these as prescription sedatives”].
Click Next to continue.
(IF SV12MON = 2, SKIP TO INTROSP)
DPSVFEEL During the past 12 months, did you spend a great deal of your time using any
prescription sedatives, feeling their effects, or getting over the effects of any
prescription sedatives?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVGET

[IF DPSVFEEL=2 OR DK/REF] During the past 12 months, did you spend a
great deal of your time getting or trying to get any prescription sedatives?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPSVLRGR During the past 12 months, were there many times when you ended up using any
prescription sedatives in larger amounts or for a longer time than you meant to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

520

DPSVBDLY During the past 12 months, were there times when you wanted to use any
prescription sedatives so badly that you couldn’t think of anything else?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVURGE [IF DPSVBDLY = 2 OR DK/REF] During the past 12 months, were there times
when you had a strong urge to use any prescription sedatives?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVMORE Do you need to use a lot more of any prescription sedatives than you used to in
order to get the feeling you want?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVLESS [IF DPSVMORE = 2 OR DK/REF] Does using the same amount of any
prescription sedatives have much less effect on you than it used to?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVSTOP During the past 12 months, did you try to cut down or try to stop using any
prescription sedatives?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVCANT [IF DPSVSTOP=1] Some people who use prescription sedatives try to cut down or
stop but find they can’t. Was there more than one time in the past 12 months
when you tried but were unable to cut down or stop using any prescription
sedatives?

521

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVWISH [IF DPSVSTOP=2 OR DK/REF] In the past 12 months, did you often wish that
you could cut down or stop using any prescription sedatives?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVPHYS During the past 12 months, did you have any long-lasting or repeated physical
health problems that were caused or made worse by using a prescription
sedative?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVPCNT [IF DPSVPHYS = 1]: Did you continue to use any prescription sedatives even
though they were causing long-lasting or repeated physical health problems or
making your physical health problems worse?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVMNTL [IF DPSVPHYS = 2 OR DK/REF OR DPSVPCNT = 2 OR DK/REF] During the
past 12 months, did you have any long-lasting or repeated problems with
emotions or mental health that were caused or made worse by using a
prescription sedative?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVMCNT [IF DPSVMNTL = 1]: Did you continue to use any prescription sedatives even
though they were causing long-lasting or repeated problems with your emotions
or mental health or making your emotions or mental health worse?

522

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVACTV This question is about important activities such as:





Spending time with friends and family
Attending special events at work or school
Participating in hobbies and sports
Attending religious services and events

During the past 12 months, did you give up or spend a lot less time doing any of
these types of important activities because of your use of any prescription
sedatives?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVSERI

Sometimes people who use prescription sedatives have serious problems at
work, school, or home—such as:






missing a lot of work or school
getting demoted, having your hours cut, or losing a job
not being able to get a job or keep a job
getting suspended, expelled, or dropping out of school
failing to take care of family

During the past 12 months, did you have any serious problems like these at work,
school, or home because of your use of any prescription sedatives?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVARGU During the past 12 months, did you often have arguments or other problems with
family or friends that were caused or made worse by your use of a prescription
sedative?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

523

DPSVACNT [IF DPSVARGU = 1]: Did you continue to use any prescription sedatives even
though they often caused arguments or problems with family or friends?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVHURT During the past 12 months, did you repeatedly get into situations where using a
prescription sedative increased your chances of getting physically hurt?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
DPSVWD

People may experience withdrawal symptoms when they use less or stop using
prescription sedatives.
During the past 12 months, did you have the following withdrawal symptoms
after you used less or stopped using any prescription sedatives for a while?
Yes
No
DPSVWD_1 Sweating or feeling that your heart
⃝1
⃝2
was beating fast
DPSVWD_2 Having your hands tremble
⃝1
⃝2
DPSVWD_3 Having trouble sleeping
⃝1
⃝2
DPSVWD_4 Vomiting or having an upset stomach
⃝1
⃝2
DPSVWD_5 Seeing, hearing, or feeling things that
⃝1
⃝2
weren’t really there
DPSVWD_6 Feeling like you couldn’t sit still
⃝1
⃝2
DPSVWD_7 Feeling anxious
⃝1
⃝2
DPSVWD_8 Having seizures or fits
⃝1
⃝2
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPSVOVER During the past 12 months, did you use any prescription sedatives or other drugs
to get over or avoid having prescription sedative withdrawal symptoms?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
PROGRAMMER: DISPLAY IN LOWER RIGHT:
Click Help to see these symptoms again.

524

DPSVUSE

[IF DPSVOVER=1] Which of the following did you use to get over or avoid
having prescription sedative withdrawal symptoms during the past 12 months?
Yes
No
DPSVUSE_1 Prescription sedatives, tranquilizers,
⃝1
⃝2
sleeping pills, or downers
DPSVUSE_2 Alcohol
⃝1
⃝2
DPSVUSE_3 Something else
⃝1
⃝2
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

DPSVOTH

[IF DPSVUSE_3=1] You indicated that you took something else to get over or
avoid having prescription sedative withdrawal symptoms during the past 12
months. What did you take?
______________________________________
DK/REF

DPSVLAW

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

525

Special Topics
INTROSP

The next questions are about encounters with the police or the court system.
Click Next 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?
__________ times in the past 12 months
[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.
Click Next to continue.

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

526

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

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
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

527

528

This page intentionally left blank.

529

530

Alcohol and Drug Treatment
/*lifetime inhalant use*/
DEFINE INLIF
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, THEN INLIF = 1
ELSE, INLIF = 2
/*lifetime hallucinogen use*/
DEFINE HALIF
IF (LS01a=1 OR LSREF1=1) OR (LS01b = 1 OR LSREF2=1) OR LS01c = 1 OR
LSREFPE = 1 OR LS01d = 1 OR LSREFMES = 1 OR LS01e = 1 OR LSREFPSI = 1 OR
(LS01f = 1 OR LSREF3 = 1) OR LS01h = 1 OR LSREFOH = 1 OR LS01i=1 OR
LSREFKET = 1 OR LS01j=1 OR LSREFDMT = 1 OR LS01k =1 OR LSREFSLV = 1,
THEN HALIF = 1
ELSE, HALIF = 2
/*lifetime drug use*/
DEFINE SUBUSE
IF MJ01 = 1 OR MJREF = 1 OR
CC01 = 1 OR CCREF = 1 OR CK01 = 1 OR CKREF = 1 OR
HE01 = 1 OR HEREF = 1 OR
HALIF= 1 OR
INLIF=1 OR
ME01=1 OR MEREF=1 OR
PR12MON = 1 OR PRLANY=1 OR
ST12MON=1 OR STLANY=1 OR
TR12MON=1 OR TRLANY=1 OR
SV12MON=1 OR SVLANY=1, THEN SUBUSE=1;
ELSE, SUBUSE = 2
/*lifetime alcohol use */
DEFINE ALCUSE
IF AL01 = 1 OR ALREF = 1 then ALCUSE=1; else ALCUSE=2;
/*different combinations of alcohol or drug use */
DEFINE SUBUSE2
If SUBUSE=1 or ALCUSE=1 then SUBUSE2=1
TXSBINTa

[IF SUBUSE2 = 1] The next questions ask about help you may have received for
your alcohol or drug use, not including nicotine or tobacco.
Click Next to continue.

TXSBSUPP [IF SUBUSE2 = 1] During the past 12 months, have you participated in a support

531

group for your alcohol or drug use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXSBER

[IF SUBUSE2 = 1] During the past 12 months, were you seen in an emergency
room or emergency department for your alcohol or drug use?
1
Yes
2
No
PROGRAMMER: SHOW 12 MONTH CALENDAR

TXSBHEL

[IF (TXSBSUPP=1 OR TXSBER=1) AND ALCUSE=1 AND SUBUSE=1]
When you received the following help in the past 12 months, was it for your
alcohol use only, your drug use only, or for both your alcohol and drug use?
For both
For Alcohol For Drug use Alcohol and
use only
only
Drug use

Help Received
TXSBHELa [If TXSBSUPP=1] Support
groups
TXSBHELb [If TXSBER=1] Emergency
room or emergency department

TXSBINTB [IF SUBUSE2 = 1] The next questions ask about professional counseling,
medication, or other treatment you may have received for your alcohol or drug
use where you stayed overnight or longer. This is sometimes called inpatient or
residential treatment.
Click Next to continue.
TXSBIPT

[IF SUBUSE2 = 1] During the past 12 months, have you stayed overnight or
longer in any of the locations below for your alcohol or drug use?
LOCATION
TXSBIPTa A hospital as an inpatient for alcohol or drug
treatment?
TXSBIPTb A residential drug or alcohol rehab or
treatment center?
TXSBIPTc A residential mental health treatment center for
alcohol or drug treatment?
TXSBIPTd Some other place where you stayed overnight
for alcohol or drug treatment?
DK/REF
PROGRAMMER SHOW 12 MONTH CALENDAR

532

Yes
1

No
2

1

2

1

2

1

2

PROGRAMMER: USE STATIC GRID
TXSBIPdO [IF TXSBIPTd = 1] Please describe the other place where you stayed overnight or
longer to received treatment for your alcohol or drug use in the past 12 months.
Then, click Next to continue.
_______________ [ALLOW 30 CHARACTERS]
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS
DEFINE INFILL2
IF IN01a = 1, THEN INFILL2 = amyl nitrites. poppers, locker room odorizers, or rush
IF IN01b = 1, THEN INFILL2 = correction fluid, degreaser, or cleaning fluid
IF IN01c = 1, THEN INFILL2 = gasoline or lighter fluid
IF IN01d = 1, THEN INFILL2 = glue, shoe polish, or toluene
IF IN01e = 1, THEN INFILL2 = halothane, ether, or other anesthetics
IF IN01f = 1, THEN INFILL2 = lacquer thinner or other paint solvents
IF IN01g = 1, THEN INFILL2 = butane or propane
IF IN01h = 1, THEN INFILL2 = nitrous or whippits
IF IN01h1=1, THEN INFILL2 = felt-tip pens, felt-tip markers, or magic markers
IF IN01i = 1, THEN INFILL2 = spray paints
IF IN01ii = 1, THEN INFILL2 = computer keyboard cleaner, or air duster
IF IN01j = 1, THEN INFILL2 = other aerosol sprays
IF IN01l = 1, THEN INFILL2 = other inhalants
DEFINE HALLFILL2
IF LS01a = 1, THEN HALLFILL2 = LSD or acid
IF LS01b = 1, THEN HALLFILL2 = PCP, angel dust, or phencyclidine
IF LS01c = 1, THEN HALLFILL2 = peyote
IF LS01d = 1, THEN HALLFILL2 = mescaline
IF LS01e = 1, THEN HALLFILL2 = psilocybin, found in mushrooms
IF LS01f = 1, THEN HALLFILL2 = Ecstasy, Molly, or MDMA
IF LS01i = 1, THEN HALLFILL2 = Ketamine, “Special K”, or “Super K”
IF LS01j = 1, THEN HALLFILL2 = DMT, AMT, or Foxy
IF LS01k = 1, THEN HALLFILL2 = Salvia divinorum
IF LS01h = 1, THEN HALLFILL2 = other hallucinogens

PROGRAMMER: INCLUDE ONLY FIRST 2 INHALANTS AND HALLUCINOGENS
ENDORSED WITH “or” BETWEEN FILLS
IF # OF SUBSTANCES ENDORSED >= 2 THEN
INFILL2/HALLFILL2 = “such as” + FIRST_SUBSTANCE, or SECOND_SUBSTANCE
ELSEIF # OF SUBSTANCES ENDORSED = 1 THEN
INFILL2/HALLFILL2 = “such as” + FIRST_SUBSTANCE
ELSE
INFILL2/HALLFILL2 = BLANK

533

TXSBSUI [IF (TXSBIPTa OR TXSBIPTb OR TXSBIPTc OR TXSBIPTd = 1)] For which of
the following substances did you stay overnight or longer to receive treatment in the
past 12 months?
Substance
TXSBSUIa [IF AL01=1 OR ALREF=1] Alcohol?
TXSBSUIb [IF MJ01=1 OR MJREF=1]Marijuana or
cannabis products?
TXSBSUIc [INLIF=1] Inhalants such as [INFILL2]?
TXSBSUId [HALIF=1] Hallucinogens such as
[HALLFILL2]?
TXSBSUIe [CC01 = 1 OR CCREF = 1 OR CK01 = 1 OR
CKREF = 1] Cocaine or “crack”?
TXSBSUIf [HE01 = 1 OR HEREF = 1] Heroin?
TXSBSUIg [ME01= OR MEREF=1] Methamphetamine
also known as crank, ice, crystal meth, speed, or glass?
TXSBSUIh [PR12MON=1 OR PRLANY=1] Prescription
pain relievers such as [PRFILL2]?
TXSBSUIi [ST12MON=1 OR STLANY=1] Prescription
stimulants such as [STFILL2]?
TXSBSUIj [TR12MON=1 OR TRLANY=1] Prescription
tranquilizers such as [TRFILL2]?
TXSBSUIk [SV12MON=1 OR SVLANY=1] Prescription
sedatives such as [SVFILL2]?
TXSBSUIl Some other drug?
DK/REF
PROGRAMMER: USE STATIC GRID

Yes
1
1

No
2
2

1
1

2
2

1

2

1
1

2
2

1

2

1

2

1

2

1

2

1

2

TXSBIPSP [IF TXSBSUIl = 1] Please type in the name of the other drug for which you received
treatment in the past 12 months. Then, click Next to continue.
_______________ [ALLOW 30 CHARACTERS]
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS
TXSBIPSE

[IF TXSBSUIa – TXSBSUIl NE 1] For what substance or substances did you
stay overnight or longer to receive treatment in the past 12 months?
If you did not stay overnight or longer to receive treatment in the past 12 months,
enter NONE.
____________ [ALLOW 100 CHARACTERS]
DK/REF
PROGRAMMER NOTE: DO NOT ALLOW BLANKS

TXSBINTC [IF SUBUSE2 = 1] Professional counseling, medication or other treatment can

534

also be provided without needing to stay overnight. This type of care is called
outpatient treatment.
Click Next to continue
TXSBOPT

[IF SUBUSE2 = 1] During the past 12 months, have you received outpatient
professional counseling, medication, or other treatment in any of the locations
below for your alcohol or drug use?

LOCATION
Yes
TXSBOPTa A drug or alcohol rehab or
1
treatment center as an outpatient?
TXSBOPTb A mental health treatment center
1
as an outpatient for alcohol or drug treatment?
TXSBOPTc The office of a therapist,
1
psychologist, psychiatrist, or other substance
use treatment professional for alcohol or drug
treatment?
TXSBOPTd A general medical clinic or
1
doctor’s office for alcohol or drug treatment?
TXSBOPTe A hospital as an outpatient for
1
alcohol or drug treatment?
TXSBOPTf Your school’s health or
1
counseling center for alcohol or drug
treatment?
TXSBOPTg Some other place as an
1
outpatient for alcohol or drug treatment?
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
PROGRAMMER: USE STATIC GRID

No
2
2
2

2
2
2

2

TXSBOPgO [IF TXSBOPTg = 1] Please describe the other place where you received outpatient
treatment for your alcohol or drug use in the past 12 months. Then, click Next to
continue.
_______________ [ALLOW 30 CHARACTERS]
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS
TXSBSUO [IF (TXSBOPTa=1 or TXSBOPTb=1 or TXSBOPTc=1 or TXSBOPTd=1 or
TXSBOPTe=1 or TXSBOPTf=1 or TXSBOPTg=1)] For which of the following
substances did you receive outpatient treatment in the past 12 months?
Substance
TXSBSUOa [IF AL01=1 OR ALREF=1] Alcohol?
TXSBSUOb [IF MJ01=1 OR MJREF=1]Marijuana or

535

Yes
1
1

No
2
2

cannabis products?
TXSBSUOc [INLIF=1] Inhalants such as [INFILL2]?
TXSBSUOd [HALIF=1] Hallucinogens such as
[HALLFILL2]?
TXSBSUOe [CC01 = 1 OR CCREF = 1 OR CK01 = 1
OR CKREF = 1] Cocaine or “crack”?
TXSBSUOf [HE01 = 1 OR HEREF = 1] Heroin?
TXSBSUOg [ME01= OR MEREF=1] Methamphetamine
also known as crank, ice, crystal meth, speed, or glass?
TXSBSUOh [PR12MON=1 OR PRLANY=1]
Prescription pain relievers such as [PRFILL2]?
TXSBSUOi [ST12MON=1 OR STLANY=1] Prescription
stimulants such as [STFILL2]?
TXSBSUOj [TR12MON=1 OR TRLANY=1]
Prescription tranquilizers such as [TRFILL2]?
TXSBSUOk [SV12MON=1 OR SVLANY=1]
Prescription sedatives such as [SVFILL2]?
TXSBSUOl Some other drug?
DK/REF
PROGRAMMER: USE STATIC GRID

1
1

2
2

1

2

1
1

2
2

1

2

1

2

1

2

1

2

1

2

TXSBOPSP [IF TXSBSUOl = 1] Please type in the name of the other drug for which you
received treatment in the past 12 months. Then, click Next to continue.
_______________ [ALLOW 30 CHARACTERS]
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS
TXSBOPSE [IF TXSBSUOa – TXSBSUOl NE 1] For what substance or substances did you
receive outpatient treatment for in the past 12 months?
If you did not receive outpatient treatment in the past 12 months, enter NONE.
____________ [ALLOW 100 CHARACTERS]
DK/REF
PROGRAMMER NOTE: DO NOT ALLOW BLANKS
TXALRX [IF AL01 = 1 OR ALREF = 1] The next questions are about prescription medication
you may have used to cut back or stop your alcohol use. These medications are
different from medications given to stop an overdose.
Some examples of these medications include:
•
•
•
•

Acamprosate, also known as Campral
Disulfiram, also known as Antabuse,
Naltrexone pills, also known as ReVia or Trexan
Injectable naltrexone, also known as Vivitrol

536

During the past 12 months, did you use medication prescribed to you to help cut back
or stop your alcohol use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXDRRX [IF (HE01 =1 OR HEREF =1) OR (PR12MON = 1 OR PRLANY = 1)] The next
questions are about prescription medication you may have used to cut back or stop
your drug use. These medications are different from medications given to stop an
overdose.

537

Some examples of these medications include:
•
•
•
•
•
•

Methadone
Buprenorphine or buprenorphine-naloxone pills or film taken by mouth, also
known as Suboxone, Zubsolv, Bunavail, or Subutex
Injectable buprenorphine, also known as Sublocade
Buprenorphine implant placed under the skin, also known as Probuphine
Naltrexone pills, also known as ReVia or Trexan
Injectable naltrexone, also known as Vivitrol

During the past 12 months, did you use medication prescribed to you to help cut back or
stop your drug use?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
NARCANPY [IF SUBUSE=1] If someone appears to be overdosing on opioids, they might be
treated with an overdose reversal medicine, such as Narcan or naloxone.
During the past 12 months, have you been treated with an overdose reversal
medicine?
1
Yes
2
No
DK/REF

TXSBTELE [IF SUBUSE2= 1] During the past 12 months, have you received any professional
counseling, medication or treatment for your alcohol or drug use from a
therapist or other healthcare professional over the phone, or through video?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXSBJAIL

[IF SUBUSE2 = 1] During the past 12 months, did you receive any professional
counseling, medication, or other treatment for your alcohol or drug use while you
were in a prison, jail or juvenile detention center?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

538

TXSBDTOX [IF (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 PR12MON = 1 OR ST12MON = 1 OR
TR12MON = 1 OR SV12MON] During the past 12 months, have you received
detoxification services, or detox, from a health care professional to manage symptoms of
withdrawal from your alcohol or drug use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXSBPEER [IF SUBUSE2 = 1] During the past 12 months, have you received help from a
peer support specialist or recovery coach who works with a substance use
treatment program or other treatment provider?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXSBSRV

IF (TXSBTELE=1 OR TXSBJAIL=1 OR TXSBDTOX=1 OR TXSBPEER)
AND ALCUSE=1 AND SUBUSE=1] When you received the following treatment
services in the past 12 months, was it for your alcohol use only, your drug use
only, or both your alcohol and drug use?

Treatment services received
TXSBSRVa [If TXSBTELE=1] Professional treatment
over the phone, or through video
TXSBSRVb [If TXSBJAIL=1] Treatment while you
were in a prison, jail or juvenile detention center
TXSBSRVc [If TXSBDTOX=1] Detoxification
services, or detox for symptoms of withdrawal
TXSBSRVd [If TXSBPEER=1] Peer support specialist
or recovery coach
TXSBSEK

For Alcohol
use only

For Drug
use only

For both
Alcohol and
Drug use

[IF (IF SUBUSE2 = 1) AND [(TXSBSUPP AND TXSBPEER AND TXSBER
AND TXSBDTOX NE 1) AND (TXSBIPTa AND TXSBIPTb AND TXSBIPTc
AND TXSBIPTd NE 1) AND (TXSBOPTa AND TXSBOPTb AND TXSBOPTc
AND TXSBOPTd AND TXSBOPTe AND TXSBOPTf AND TXSBOPTg NE 1)
AND (TXSBJAIL NE 1) AND (TXALRX NE 1) AND (TXDRRX NE 1) AND
(TXSBTELE NE 1)]] During the past 12 months, did you seek professional
counseling, medication, or other treatment for your alcohol or drug use?
1

Yes

539

2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXSBSEK2 [IF (IF SUBUSE2 = 1) AND (TXSBSUPP=1 OR TXSBPEER=1 OR TXSBER=1
OR TXSBDTOX=1) AND TXSBIPTa AND TXSBIPTb AND TXSBIPTc AND
TXSBIPTd NE 1 AND TXSBOPTa AND TXSBOPTb AND TXSBOPTc AND
TXSBOPTd AND TXSBOPTe AND TXSBOPTf AND TXSBOPTg NE 1 AND
TXSBJAIL NE 1 AND TXSBRX NE 1 AND TXDRRX NE 1 AND TXSBTELE
NE 1] Other than the help you already reported receiving, did you seek additional
professional counseling, medication, or other treatment for your alcohol or drug
use in the past 12 months?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXSEKTYP [IF TXSBSEK =1 or TXSBSEK2=1] During the past 12 months when you
sought [if TXSBSEK2=1, FILL: additional] professional treatment, was it 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
TXSBGET

[IF TXSBSEK = NO, DK/REF] During the past 12 months, did you think you
should get professional counseling, medication, or other treatment for your
alcohol or drug use?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

TXSBGET2 [IF TXSBSEK2=NO, DK/REF] Other than the help you already reported receiving,
did you think you should get additional professional counseling, medication or
other treatment for your alcohol or drug use in the past 12 months?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXGETTYP [IF TXSBGET =1 or TXSBGET2=1] During the past 12 months when you
540

thought you should get [if TXSBGET2=1, FILL: additional] professional
treatment, was it 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
TXSBNONE [IF (TXSBGET OR TXSBGET2 OR TXSBSEK OR TXSBSEK2) = 1] There may
be many reasons you did not get (IF TXSBGET2=1 OR TXSBSEK2= 1, FILL:
additional) treatments during the past 12 months.
For each statement, please mark whether or not it was one of the reasons why you
did not get (IF TXSBGET2=1 OR TXSBSEK2= 1, FILL: additional) professional
counseling, medication, or other treatment for your alcohol or drug use.

TXSBNOa You thought it would cost too much.
TXSBNOb You did not have health insurance
coverage for alcohol or drug use treatment.
TXSBNOc Your health insurance would not pay
enough of the costs for treatment.
DK/REF
PROGRAMMER: ONE ROW AT A TIME

One of the
reasons
1
1

NOT one of
the reasons
2
2

1

2

TXSBNONE [IF (TXSBGET OR TXSBGET2 OR TXSBSEK OR TXSBSEK2) = 1] For each
statement, please mark whether or not it was one of the reasons why you did not
get (IF TXSBGET2=1 OR TXSBSEK2= 1, FILL: additional) professional
counseling, medication, or other treatment for your alcohol or drug use.

TXSBNOd You did not know how or where to get
treatment.
TXSBNOe You could not find a treatment program or
health care professional you wanted to go to.
TXSBNOf There were no openings in the treatment
program or with the health care professional you
wanted to go to.
TXSBNOg You had problems with things like
transportation, childcare, or getting appointments at
times that worked for you.

541

One of the
reasons
1

NOT one of
the reasons
2

1

2

1

2

1

2

TXSBNOh You didn’t have enough time for
treatment.
TXSBNOi You were worried that your information
would not be kept private.
DK/REF
PROGRAMMER: ONE ROW AT A TIME

542

1

2

1

2

TXSBNONE [IF (TXSBGET OR TXSBGET2 OR TXSBSEK OR TXSBSEK2) = 1] For each
statement, please mark whether or not it was one of the reasons why you did not
get (IF TXSBGET2=1 OR TXSBSEK2= 1, FILL: additional) professional
counseling, medication, or other treatment for your alcohol or drug use.

TXSBNOj You were worried about what people would
think or say if you got treatment.
TXSBNOk You thought that if people knew you were
in treatment bad things would happen, like losing your
job, home, or children.
TXSBNOl You were not ready to start treatment.
TXSBNOm You were not ready to stop or cut back
using alcohol or drugs.
TXSBNOn You thought you should have been able to
handle your alcohol or drug use on your own.
TXSBNOo You thought your family, friends, or
religious group wouldn’t like it if you got treatment.
TXSBNOp You thought you would be forced to stay
in rehab or treatment against your will.
TXSBNOq You didn’t think treatment would help
you.
TXSBNOr You thought no one would care if you got
better.
DK/REF
PROGRAMMER: ONE ROW AT A TIME

543

One of the
reasons
1

NOT one of
the reasons
2

1

2

1
1

2
2

1

2

1

2

1

2

1

2

1

2

This page intentionally left blank.

544

Health
HLTHINT

These next questions are about your health and health care.
Click Next to continue.

HLTH02 [IF RSEX = 9 AND CURNTAGE = 12 - 50] Are you currently pregnant?
1
Yes
2
No
DK/REF
HLTH03 [IF HLTH02 = 1] How many weeks pregnant are you?
# OF WEEKS: ________ weeks
[RANGE: 1 - 44]
DK/REF
HLTH04

This question asks about your height.
To answer in feet and inches, click 1. TTo answer in inches only, click 2..
Then click Next to continue.
1
I would rather answer in feet and inches
2
I would rather answer only in inches
DK/REF

HLTH05

[IF HLTH04=1] About how tall are you, without shoes? First, please type
in the number of feet.
______feet
[RANGE: 2-8]
DK/REF

HLTH06a

[IF HLTH04 = 1 AND HLTH05 NE DK/RF] Please type in the number of
inches and then click Next.
______ inch(es)
[RANGE: 0-11]
DK/REF

HLTH06b

[IF HLTH04 = 2] About how tall are you, without shoes? Please type in
the number of inches and then click Next.
______inch(es)
[RANGE: 24-96]

545

DK/REF

The next question asks about your weight.

HLTH10

About how much do you weigh? Please type in the number of pounds and
click Next.
________pounds
[RANGE: 40-999]
DK/REF

HLTH13

[IF HLTH02=1] About how much did you weigh before you got pregnant?
Please type in the number of pounds and then click Next.
________pounds
[RANGE: 40-999]
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: ____________ times in the past 12 months
[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:
nights as an inpatient
[RANGE: 1 - 366]
DK/REF

546

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?
NUMBER OF VISITS:
[RANGE: 0 - 366)]
DK/REF

visits in the past 12 months

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
HLTHTELE During the past 12 months, have you talked to a doctor, physician assistant, or
nurse practitioner about your own health over the phone, or through video
instead of going to an in-person appointment?
1
Yes
2
No
DK/REF
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) AND (HLTHTELE NE YES)]
OR [(HLTH19 = 0 OR (HLTH19DK = 0 OR DK/REF)) AND (HLTHTELE = YES)]
THEN VISITFILL = “the talk you had with a doctor or other health care professional”

547

IF HLTH19>1 OR HLTH19DK>1 OR (HLTH19 = 1 AND HLTHTELE = 1) OR
(HLTH19DK = 1 AND HLTHTELE = 1THEN 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 OR
HLTHTELE = 1] During the past 12 months, did any doctor or other health care
professional ask, either in person or on a form, if you:

a. Smoke cigarettes or use any other tobacco products?
b. Drink alcohol?
c. Use marijuana or other illegal drugs?
HLTH21

1. Yes 2. No DK/REF
1. Yes 2. No DK/REF
1. Yes 2. No DK/REF

[(IF HLTH16>0 OR HLTH17=1 OR HLTH19>0 OR HLTH19DK>0 OR
HLTHTELE = 1) 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
HLTHTELE = 1)) OR (HLTH17=1 AND (HLTH16>=1 OR HLTH19>=1 OR
HLTH19DK>=1 OR HLTHTELE = 1)) OR ((HLTH19>=1 OR HLTH19DK>=1)
AND (HLTH16>=1 OR HLTH17=1 OR HLTHTELE = 1)) OR (HLTHTELE = 1
AND (HLTH16>=1 OR HLTH17=1 OR HLTH19>=1 OR HLTH19DK>=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
AND HLTHTELE NE 1) OR (HLTH17 =1 AND HLTH16 = 0 AND HLTH19<1
AND HLTH19DK<1 AND HLTHTELE NE 1) OR ((HLTH19 >=1 OR
HLTH19DK>=1) AND HLTH16 = 0 AND HLTH17 NE 1 AND HLTHTELE NE
1) OR (HLTHTELE = 1 AND HLTH16 NE 1 AND HLTH17 NE 1 AND
HLTH19 < 1 AND HLTH19DK < 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.

548

Select all that apply.
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

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. Please answer this question again.
HLTH23

HLTH25

[(IF HLTH16>0 OR HLTH17=1 OR HLTH19>0 OR HLTH19DK>0 OR
HLTHTELE = 1) 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

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.
Select all that apply.
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
7. Asthma
8. HIV or AIDS

549

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
PROGRAMMER: DISPLAY IN LOWER LEFT: Click [Help] if you want
to see how to say these conditions.
Diabetes or sugar diabetes [die-uh-BEE-tees]
Chronic bronchitis, emphysema, chronic obstructive pulmonary disease,
also called COPD [bron-KI-tis, em-fuh-SEE-muh, kroon-ick, ob-struk-tiv
pul-muh-nair-ee, see-oh-pee-dee]
Cirrhosis of the liver [si-ROH-sis]
Hepatitis B or C [hep-uh-TIE-tus]
Asthma [AZ-muh]
HIV or AIDS [aytch-eye-vee or ayds]
Cancer or a malignancy of any kind [kan-ser or muh-LIG-nun-see]
Hypertension, also called high blood pressure [hie-per-TEN-shun]
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. Please answer this question again.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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”

550

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?
Select all that apply.
1. Bladder
2. Blood
3. Bone
4. Brain
5. Breast
6. [IF RSEX = 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 RSEX = 9] Ovary
19. Pancreas
20. [IF RSEX = 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 RSEX = 5] Testis
27. Throat/pharynx
28. Thyroid
29. [IF RSEX = 9] Uterus
30. Other

HLTH26othr [IF HLTH26=30] Please type in which other kind of cancer you had.
_____________

551

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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF
HARD ERROR: [HLTH27 > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28a > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28b > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

552

HARD ERROR: [HLTH28c > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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.
Age: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28d > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28e > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28f > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old

553

[RANGE: 1-CURNTAGE]
DK/REF
HARD ERROR: [HLTH28g > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this question
again.
HLTH28h

[IF HLTH26=9] How old were you when your gallbladder cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28h > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28i > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this question
again.

554

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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28j > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28k > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this question
again.
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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28l > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

555

HARD ERROR: [HLTH28m > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28n > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28o > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28p > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this question
again.

556

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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28q > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28r > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28s > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

557

HARD ERROR: [HLTH28t > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28u > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28v > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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.
Age: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28w > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this question
again.

558

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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28x > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28y > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28z > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this question
again.
HLTH28aa

[IF HLTH26=28] How old were you when your thyroid cancer was first
diagnosed?
If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

559

HARD ERROR: [HLTH28aa > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF
HARD ERROR: [HLTH28bb > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH28cc > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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 CURNTAGE] Did you have cancer during the past 12 months?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

560

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].
Click Next 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH30 > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this question
again.
HLTH31

[IF HLTH25=1 AND HLTH30 NE CURNTAGE] 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH32 > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this question
again.

561

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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH33 > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH34 > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH35 > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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.
Age: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF
562

HARD ERROR: [HLTH36 > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH37 > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this 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: _____________________ year old
[RANGE: 1-CURNTAGE]
DK/REF

HARD ERROR: [HLTH39 > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this question
again.
HLTH40

[IF HLTH25=10] Are you currently taking prescription medicine for your high
blood pressure?
1
Yes
2
No
DK/REF

563

[IF HLTH40=1] How old were you when your high blood pressure was first
diagnosed?

HLTH41

If you were first diagnosed before you were 1 year old, please enter 1.
Age: _____________________ years old
[RANGE: 1-CURNTAGE]
DK/REF
HARD ERROR: [HLTH41 > CURNTAGE] The age you entered when you were first
diagnosed is older than your current age. Please answer this question
again.

SLPFALL [IF CURNTAGE = 18 OR OLDER] During the past 30 days, how often did you
have trouble falling asleep?
1

Never

2

Some days

3

Most days

4 Every day
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

SLPSTAY [IF CURNTAGE = 18 OR OLDER] During the past 30 days, how often did you
have trouble staying asleep?
1

Never

2

Some days

3

Most days

4 Every day
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

SLPMED [IF CURNTAGE = 18 OR OLDER] During the past 30 days, how often did you
take any medication to help you fall asleep or stay asleep? Include both prescribed and “overthe-counter” medications.

564

1

Never

2

Some days

3

Most days

4 Every day
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR

PAINP3M [IF CURNTAGE = 18 OR OLDER] The next questions are about pain you may have
had in the past 3 months. In the past 3 months, how often did you have pain?
1

Never

2

Some days

3

Most days

4

Every day

DK/REF

PAINLIM [IF CURNTAGE = 18 OR OLDER] In the past 3 months, how often did your pain
limit your life or work activities?
1

Never

2

Some days

3

Most days

4

Every day

DK/REF

565

This page intentionally left blank.

566

Mental Health Services Utilization
TXMHINT

These next questions ask about help you may have received for your mental
health, emotions, or behavior.
Click Next to continue

TXMHSUPP During the past 12 months, have you participated in a support group to help you
with your mental health, emotions, or behavior?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXMHER

During the past 12 months, were you seen in an emergency room or emergency
department for your mental health, emotions, or behavior?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

TXMHINTb The next questions ask about professional counseling, medication, or other
treatment you may have received for your mental health, emotions, or behavior
where you stayed overnight or longer. This is sometimes called inpatient or
residential treatment.
Click Next to continue
TXMHIPT

During the past 12 months, have you stayed overnight or longer in any of the
locations below for your mental health, emotions, or behavior?

LOCATION
TXMHIPTa A hospital as an inpatient for mental health,
emotions, or behavior?
TXMHIPTb A residential mental health treatment center?
TXMHIPTc A residential drug or alcohol rehab or treatment
center for mental health, emotions, or behavior?
TXMHIPTd Some other place where you stayed overnight
for mental health, emotions, or behavior?
DK/REF
PROGRAMMER SHOW 12 MONTH CALENDAR
PROGRAMMER: USE STATIC GRID

Yes
1

No
2

1
1

2
2

1

2

TXMHIPdO [IF TXMHIPTd = 1] Please describe the other place where you received treatment

567

overnight or longer for your mental health, emotions, or behavior in the past 12
months. When you have finished typing your answer, click Next to continue.
_______________ [ALLOW 30 CHARACTERS]
DK/REF
TXMHINTC Professional counseling, medication or other treatment can also be provided
without needing to stay overnight. This type of care is called outpatient
treatment.
Click Next to continue
TXMHOPT During the past 12 months, have you received outpatient professional
counseling, medication, or other treatment in any of the locations below for
your mental health, emotions, or behavior?
LOCATION
TXMHOPTa A mental health treatment center as an
outpatient?
TXMHOPTb A drug or alcohol treatment or rehab center
as an outpatient for mental health, emotions, or behavior?
TXMHOPTc The office of a therapist, psychologist,
psychiatrist, or mental health professional for mental
health, emotions, or behavior?
TXMHOPTd A general medical clinic or doctor’s office
for mental health, emotions, or behavior?
TXMHOPTe A hospital as an outpatient for mental
health, emotions, or behavior?
TXMHOPTf Your school’s health or counseling center
for mental health, emotions, or behavior?
TXMHOPTg Some other place as an outpatient for mental
health, emotions, or behavior?
DKRE
PROGRAMMER: USE STATIC GRID
PROGRAMMER: SHOW 12 MONTH CALENDAR

Yes
1

No
2

1

2

1

2

1

2

1

2

1

2

1

2

TXMHOPgO [IF TXMHOPTg = 1] Please describe the other place where you received
outpatient treatment for your mental health, emotions, or behavior in the past 12
months. Then, click Next to continue.
_______________ [ALLOW 30 CHARACTERS]
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS
TXMHRX

During the past 12 months, did you take any medication that was prescribed to
you to help with your mental health, emotions, or behavior?

568

1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXMHTELE During the past 12 months have you received any professional counseling,
medication or treatment for your mental health, emotions, or behavior from a
therapist or other healthcare professional over the phone, or through video?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXMHJAIL During the past 12 months, did you receive any professional counseling,
medication, or other treatment for your mental health, emotions, or behavior while
you were in a prison, jail or juvenile detention center?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXMHPEER During the past 12 months, have you received help from a peer support specialist
or recovery coach who works with a mental health treatment program or other
treatment provider?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXMHSEK [IF (TXMHSUPP NE 1 AND TXMHPEER NE 1 AND TXMHER NE 1) AND
(TXMHIPTa AND TXMHIPTb AND TXMHIPTc AND TXMHIPTd NE 1)
AND (TXMHOPTa AND TXMHOPTb AND TXMHOPTc AND TXMHOPTd
AND TXMHOPTe AND TXMHOPTf AND TXMHOPTg NE 1) AND
(TXMHJAIL NE 1) AND (TXMHRX NE 1) AND (TXMHTELE NE 1)] During
the past 12 months, did you seek professional counseling, medication, or other
treatment for your mental health, emotions, or behavior?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

569

TXMHSEK2 [IF (TXMHSUPP=1 OR TXMHPEER=1 OR TXMHER=1) AND (TXMHIPTa
AND TXMHIPTb AND TXMHIPTc AND TXMHIPTd NE 1) AND
(TXMHOPTa AND TXMHOPTb AND TXMHOPTc AND TXMHOPTd AND
TXMHOPTe AND TXMHOPTf AND TXMHOPTg NE 1) AND (TXMHJAIL
NE 1) AND (TXMHRX NE 1) AND (TXMHTELE NE 1)] Other than the help
you already reported, did you seek additional professional counseling,
medication, or other treatment for your mental health, emotions, or behavior in
the past 12 months?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXMHGET [IF TXMHSEK = NO, DK/REF] During the past 12 months, did you think you
should get professional counseling, medication, or other treatment for your
mental health, emotions, or behavior?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXMHGET2 [IF TXMHSEK2=NO, DK/REF] Other than the help you already reported, did
you think you should get additional professional counseling, medication or other
treatment for your mental health, emotions, or behavior in the past 12 months?
1
Yes
2
No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
TXMHNONE [IF (TXMHGET OR TXMHGET2 OR TXMHSEK OR TXMHSEK2) = 1] There
may be many reasons you did not get (IF TXMHGET2=1 OR TXMHSEK2= 1, FILL:
additional) treatments during the past 12 months.
For each statement, please mark whether or not it was one of the reasons why you did
not get (IF TXMHGET2=1 OR TXMHSEK2= 1, FILL: additional) professional
counseling, medication or other treatment for your mental health, emotions, or
behavior.

570

One of the reasons
TXMHNOa You thought it
1
would cost too much.
TXMHNOb You did not
1
have health insurance
coverage for mental health
treatment.
TXMHNOc Your health
1
insurance would not pay
enough of the costs for
treatment.
DK/REF
PROGRAMMER: ONE ROW AT A TIME

NOT one of the reasons
2
2

2

TXMHNONE [IF (TXMHGET OR TXMHGET2 OR TXMHSEK OR TXMHSEK2) = 1] For
each statement, please mark whether or not it was one of the reasons why you did not get (IF
TXMHGET2=1 OR TXMHSEK2= 1, FILL: additional) professional counseling, medication or
other treatment for your mental health, emotions, or behavior.
One of the reasons
1

NOT one of the reasons
2

1

2

1

2

1

2

1

2

1

2

TXMHNOd You did not
know how or where to get
treatment.
TXMHNOe You could not
find a treatment program or
health care professional you
wanted to go to.
TXMHNOf There were no
openings in the treatment
program or with the health
care professional you wanted
to go to.
TXMHNOg You had
problems with things like
transportation, childcare, or
getting appointments at times
that worked for you.
TXMHNOh You didn’t have
enough time for treatment.
TXMHNOi You were
worried that your information
would not be kept private.
DK/REF
PROGRAMMER: ONE ROW AT A TIME

571

TXMHNONE [IF (TXMHGET OR TXMHGET2 OR TXMHSEK OR TXMHSEK2) = 1] For
each statement, please mark whether or not it was one of the reasons why you did not get (IF
TXMHGET2=1 OR TXMHSEK2= 1, FILL: additional) professional counseling, medication or
other treatment for your mental health, emotions, or behavior.
One of the reasons
1

NOT one of the reasons
2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

1

2

TXMHNOj You were
worried about what people
would think or say if you got
treatment.
TXMHNOk You thought that
if people knew you were in
treatment bad things would
happen, like losing your job,
home, or children.
TXMHNOl You were not
ready to start treatment.
TXMHNOm You thought
you should have been able to
handle your mental health,
emotions, or behavior on your
own.
TXMHNOn You thought
your family, friends, or
religious group wouldn’t like
it if you got treatment.
TXMHNOo You were afraid
of being committed to a
hospital or forced into
treatment against your will.
TXMHNOp You thought you
would be told you needed to
take medication.
TXMHNOq You didn’t think
treatment would help you.
TXMHNOr You thought no
one would care if you got
better.
DK/REF
PROGRAMMER: ONE ROW AT A TIME

572

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.
Click Next 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 any cannabis product once or twice?

573

1
Strongly disapprove
2
Somewhat disapprove
3
Neither approve nor disapprove
4
Somewhat approve
5
Strongly approve
DK/REF

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

574

Parenting Experiences
(IF (RESAGE = 1 AND FIPE1 = 1 AND YOUTH_SELECTED = 1) ADMINISTER
THIS SECTION; ELSE SKIP TO YOUTH EXPERIENCES IF RESPONDENT IS
12 -17 OR DIINTRO IF RESPONDENT IS 18 OR OLDER)
FIPE3b

[IF RESAGE = 1 AND FIPE1 = 1 AND YOUTH_SELECTED = 1] Are you the
parent or legal guardian of the 12-17 year old in this household who was also
selected for an interview?
4

Yes

5 No
DK/REF

leadpar

[IF FIPE3b = 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.
Click Next to continue.

pe01

[IF FIPE3b = 1] What is the birth date of your child who was also selected to complete an
interview?

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 answer this question
again, then click Next 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 answer this question again, then click Next to continue.
pe01a [IF PE01 NE DK/REF] The child who was also selected to complete an interview is
[CALCULATED AGE FROM PE01]. Is this correct?
1
Yes
2
No
DK/REF
pe01b [IF PE01 = DK/REF OR PE01a = 2] How old is the child who was also selected to
complete an interview?

575

AGE:
years old
[RANGE: 12 - 18]
DK/REF
pe02

[IF PE01a = 1 OR PE01b = 12 - 18] Think about the past 12 months, that is, from
[DATEFILL] through today. Please indicate if you think your child has done any of
these things during the past 12 months.
In the past 12 months, do you think your child has smoked one or more cigarettes, even
once?
1
Yes
2
No
DK/REF
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 any cannabis product, 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 child has
used any form of cocaine, such as powder, ‘crack,’ free base or coca paste, even once?
1
Yes
2
No
DK/REF

576

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

577

pe05b [IF PE01a = 1 OR PE01b = 12 - 18] For the next two statements, please indicate whether
you strongly agree, agree, disagree or strongly disagree.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

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

578

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.
Click Next 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

579

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
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

580

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 your time with television, tablets, smartphones, computers, or video games?
1
Always
2
Sometimes
3
Seldom
4
Never
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

581

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?
1
2
3

0 times
1 or 2 times
3 to 5 times

582

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

583

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?
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
YE19a [IF CURNTAGE = 12 - 17] The next questions are about how you feel about someone
your age doing certain things.
How do you feel about someone your age smoking one or more packs of cigarettes a
cigarettes every day?
1
Strongly disapprove
2
Somewhat disapprove
3
Neither approve nor disapprove
4
Somewhat approve
5
Strongly approve
DK/REF

584

YE19b [IF CURNTAGE = 12 - 17] How do you feel about someone your age trying marijuana
or any cannabis product once or twice?
1
Strongly disapprove
2
Somewhat disapprove
3
Neither approve nor disapprove
4
Somewhat approve
5
Strongly approve
DK/REF
YE19b1 [IF CURNTAGE = 12 - 17] How do you feel about someone your age using marijuana
or any cannabis product once a month or more?
1
Strongly disapprove
2
Somewhat disapprove
3
Neither approve nor disapprove
4
Somewhat approve
5
Strongly approve
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
Strongly disapprove
2
Somewhat disapprove
3
Neither approve nor disapprove
4
Somewhat approve
5
Strongly approve
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?
Select all that apply.
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

585

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

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
1
2
3

None
One
Two
3 or more

586

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 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?

587

1
Yes
2
No
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
YGAD1

[IF CURNTAGE = 12-17] Over the last 2 weeks, how often have you been
bothered by feeling nervous, anxious, or on edge?
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF

588

YGAD2

[IF CURNTAGE = 12-17] Over the last 2 weeks, how often have you been
bothered by not being able to stop or control worrying?
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF

YGAD3

[IF CURNTAGE = 12-17] Over the last 2 weeks, how often have you been
bothered by worrying to much about different things?
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF

YGAD4

[IF CURNTAGE = 12-17] Over the last 2 weeks, how often have you been
bothered by having trouble relaxing?
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF

YGAD5

[IF CURNTAGE = 12-17] Over the last 2 weeks, how often have you been
bothered by being so restless that it is hard to sit still?
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF

YGAD6

[IF CURNTAGE = 12-17] Over the last 2 weeks, how often have you been
bothered by becoming easily annoyed or irritable?
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF

YGAD7

[IF CURNTAGE = 12-17] Over the last 2 weeks, how often have you been
bothered by feeling afraid as if something awful might happen?
589

1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF
YSUINT

[IF CURNTAGE = 12-17] The next few questions are about thoughts of suicide. You
can answer “I’m not sure” or “I don’t want to answer” to any question.
Click Next to continue.

YSUI01[IF CURNTAGE = 12 – 17] 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
3 I’m not sure
4 I don’t want to answer
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSUI02 [IF CURNTAGE = 12 – 17] During the past 12 months, did you make any plans to kill
yourself?
1 Yes
2 No
3 I’m not sure
4 I don’t want to answer
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

YSUI03 [IF CURNTAGE = 12 – 17] During the past 12 months, did you try to kill yourself?
1 Yes
2 No
3 I’m not sure
4 I don’t want to answer
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

590

YSUI04 [IF YSUI03=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
3 I’m not sure
4 I don’t want to answer
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
YSUI05 [IF YSUI04=1] Did you stay in a hospital overnight or longer because you tried to kill
yourself?
1 Yes
2 No
3 I’m not sure
4 I don’t want to answer
DK/REF
SFHRMPY [IF CURNTAGE = 12-17] During the past 12 months, did you do something to hurt
yourself on purpose without trying to kill yourself, such as cutting, burning, or
bruising yourself?
1
2
3
4

Yes
No
I’m not sure
I don’t want to answer
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SFHRMNUM [IF SFHRMPY = 1] On how many days in the past 12 months did you do
something to hurt yourself on purpose without trying to kill yourself?
1
1 day
2
2 to 4 days
3
5 to 9 days
4
10 to 19 days
5
20 or more days
6
I’m not sure
7
I don’t want to answer
PROGRAMMER: SHOW 12 MONTH CALENDAR

YHELP [IF YSUI01 OR YSUI02 OR YSUI03 OR SFHRMPY = 1] If you ever feel that you
need to talk to someone about mental health issues, you can call or text the 988 Suicide

591

& Crisis Lifeline. Counselors are available to talk at any time of the day or night and
they can give you information about services in your area.

[IF FIPE4 = 1-51 OR 53] Please write down these numbers and website address. Then
click Next to continue.
988 (call or text)
http://988lifeline.org
[IF FIPE4 = 52] Please write down this number and website address. Then click Next to
continue.
1-800-981-0023
https://lineapas.assmca.pr.gov

592

This page intentionally left blank.

593

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.
Click Next 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?

594

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?

595

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
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?

596

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.
Click Next to continue.

LIREMEM [IF DISTRESS =1] During that one month when your emotions, nerves or mental
health interfered most with your daily activities . . .
how much difficulty did you have remembering to do things you needed to do?
1
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 . . .

597

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?
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

598

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
No difficulty
2
Mild difficulty
3
Moderate difficulty
4
Severe difficulty
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
2

No difficulty
Mild difficulty

599

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 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”

600

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:
weeks in the past 12 months
[RANGE: 1 - 52]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR
CREATE IMWEEK1 FILL.
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:__________ days in the past 12 months
[RANGE: 0-365]
DK/REF

601

PROGRAMMER: SHOW 12 MONTH CALENDAR
AGAD1

[IF CURNTAGE=18 OR OLDER] Over the last 2 weeks, how often have you
been bothered by feeling nervous, anxious, or on edge?
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF

AGAD2

[IF CURNTAGE=18 OR OLDER] Over the last 2 weeks, how often have you
been bothered by not being able to stop or control worrying?
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF

AGAD3

[IF CURNTAGE=18 OR OLDER] Over the last 2 weeks, how often have you
been bothered by worrying to much about different things?
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF

AGAD4

[IF CURNTAGE=18 OR OLDER] Over the last 2 weeks, how often have you
been bothered by having trouble relaxing?
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF

AGAD5

[IF CURNTAGE=18 OR OLDER] Over the last 2 weeks, how often have you
been bothered by being so restless that it is hard to sit still?
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF

602

AGAD6

[IF CURNTAGE=18 OR OLDER]Over the last 2 weeks, how often have you
been bothered by becoming easily annoyed or irritable?
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF

AGAD7

[IF CURNTAGE=18 OR OLDER] Over the last 2 weeks, how often have you
been bothered by feeling afraid as if something awful might happen?
1 Not at all
2 Several days
3 More than half the days
4 Nearly every day
DK/REF

SUI01 [IF CURNTAGE=18 OR OLDER] The next few questions are about thoughts of suicide. At
any time in the past 12 months, that is from [DATEFILL] up to and including today, did
you seriously think about trying to kill yourself?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

SUI02 [IF CURNTAGE=18 OR OLDER] 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 CURNTAGE=18 OR OLDER] During the past 12 months, did you try to kill yourself?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

603

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
AHELP [IF SUI01 OR SUI02 OR SUI03 = 1] If you ever feel that you need to talk to someone
about mental health issues, you can call or text the 988 Suicide & Crisis Lifeline.
Counselors are available to talk at any time of the day or night and they can give you
information about services in your area.
[IF FIPE4 = 1-51 OR 53] Please write down these numbers and website address. Then
click Next to continue.
988 (call or text)
http://988lifeline.org
[IF FIPE4 = 52] Please write down this number and website address. Then click Next to
continue.
1-800-981-0023
https://lineapas.assmca.pr.gov

604

This page intentionally left blank.

605

Adult Depression
[Questions administered only to respondents 18 years of age and older]
ASC21 [IF CURNTAGE = 18 OR OLDER] Have you ever in your life had a period of time
lasting several days or longer when most of the day you felt sad, empty or depressed?
1
Yes
2
No
DK/REF
ASC22 [IF ASC21 = 2 OR DK/REF] Have you ever had a period of time lasting several days or
longer when most of the day you were very discouraged about how things were going
in your life?
1
Yes
2
No
DK/REF
ASC23 [IF ASC22 = 2 or DK/REF] Have you ever had a period of time lasting several days or
longer when you lost interest in most things you usually enjoy like work, hobbies, and
personal relationships?
1
Yes
2
No
DK/REF
AD01 [IF ASC21 =1] During times when you felt sad, empty, or depressed most of the day,
did you ever feel discouraged about how things were going in your life?
1
Yes
2
No
DK/REF
AD01a [IF AD01 = 1] During the times when you felt sad, empty, or depressed, did you ever
lose interest in most things like work, hobbies, and other things you usually enjoy?
1
Yes
2
No
DK/REF
AD01b [IF AD01 = 2 OR DK/REF] During the times when you felt sad, empty, or depressed,
did you ever lose interest in most things like work, hobbies, and other things you
usually enjoy?
1
Yes
2
No
DK/REF

606

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
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”

607

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?
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.

608

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 just mentioned. They include
things like changes in
•
•
•
•
•

sleep
appetite
energy
the ability to concentrate and remember
feelings of low self-worth

Please think of a time when you [FEELFILL] for two weeks or longer and you also had
the largest number of these other problems at the same time.
Is there one particular time like this that stands out in your mind as the worst one you
ever had?
1
Yes
2
No
DK/REF

609

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
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
610

AD24f [IF AD22a NE BLANK OR AD22c NE BLANK] During that [TIMEFILL] period of
time, did you lose the ability to take pleasure in having good things happen to you, like
winning something or being praised or complimented?
1
Yes
2
No
DK/REF
AD26a [IF ANY AD24a – AD24f = 1] The next questions are about changes in appetite and
weight.
[IF AD22a NE BLANK] In answering the next questions, think about the period of time
when your [FEELNOUN] and other problems were the worst.
[IF AD22c NE BLANK] In answering the next questions, think about the most recent
period of time when you [FEELFILL] and had other problems at the same time.
Did you have a much smaller appetite than usual nearly every day during that time?
1
Yes
2
No
DK/REF
AD26b [IF AD26a = 2 OR DK/REF] Did you have a much larger appetite than usual nearly
every day?
1
Yes
2
No
DK/REF
AD26c [IF AD26a = 2 OR DK/REF] Did you gain weight without trying to during that
[TIMEFILL] period of time?
1
Yes
2
No
DK/REF
AD26c1 [IF AD26c = 1 AND (AD22a ≤ 21 OR AD22c ≤ 21)] Did you gain weight without
trying to because you were growing?
1
Yes
2
No
DK/REF

611

AD26c2 [IF AD26c = 1 AND AD26c1 NE YES AND RSEX = 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:__________ pounds
[RANGE: 0-200]
DK/REF
AD26e [IF (AD26a = 1 OR AD26c=(2 OR DK/REF)] Did you lose weight without trying to?
1
Yes
2
No
DK/REF
AD26e1 [IF AD26e = 1] Did you lose weight without trying to because you were sick or on a
diet?
1
Yes
2
No
DK/REF
AD26f [IF AD26e1 = 2 OR DK/REF] How many pounds did you lose?
Please enter your answer as a whole number.
# OF POUNDS:__________ 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.

612

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
AD26m [IF AD26l = 1] Did anyone else notice that you were talking or moving slowly?
1
Yes
2
No
DK/REF
AD26n [IF AD26l = 2 OR DK/REF] Were you so restless or jittery nearly every day that you
paced up and down or couldn’t sit still?
1
Yes
2
No
DK/REF
AD26o [AD26n = 1] Did anyone else notice that you were restless?
1
Yes
2
No
DK/REF

613

AD26p [IF AD26a NE BLANK] The next questions are about changes in your ability to
concentrate, and your feelings about yourself.
[IF AD22a NE BLANK] Again, in answering these questions, think about the period of
time when your [FEELNOUN] and other problems were the worst.
[IF AD22c NE BLANK] Again, in answering these questions, think about the most
recent period of time when you [FEELFILL] and had other problems at the same time.
During that [TIMEFILL] time, did your thoughts come much more slowly than usual or
seem confused nearly every day?
1
Yes
2
No
DK/REF
AD26r [IF AD26a NE BLANK] Did you have a lot more trouble concentrating than usual nearly
every day?
1
Yes
2
No
DK/REF
AD26s [IF AD26a NE BLANK] Were you unable to make decisions about things you ordinarily
have no trouble deciding about?
1
Yes
2
No
DK/REF
AD26u [IF AD26a NE BLANK] Did you feel that you were not as good as other people nearly
every day?
1
Yes
2
No
DK/REF
AD26v [IF AD26u = 1] Did you feel totally worthless nearly every day?
1
Yes
2
No
DK/REF
AD26aa [IF AD26a NE BLANK] The next questions are about thoughts of death or suicide.

614

[IF AD22a NE BLANK] Again, in answering these questions, think about the period of
time when your [FEELNOUN] and other problems were the worst.
[IF AD22c NE BLANK] Again, in answering these questions, think about the most
recent period of time when you [FEELFILL] and had other problems at the same time.
Did you often think a lot about death, either your own, someone else’s, or death in
general?
1
Yes
2
No
DK/REF
AD26bb

[IF AD26a NE BLANK] During that period, did you ever think that it would be
better if you were dead?
1
Yes
2
No
DK/REF

AD26cc

[IF AD26a NE BLANK] Did you think about committing suicide?
1
Yes
2
No
DK/REF

AD26dd

[IF AD26cc = 1] Did you make a suicide plan?
1
Yes
2
No
DK/REF

AD26ee

[IF AD26cc = 1] Did you make a suicide attempt?
1
Yes
2
No
DK/REF

DEFINE D_MDEA1:
IF AD24A = 1 OR AD24C = 1, THEN D_MDEA1= 1
ELSE IF AD24A = 2 AND AD24C = 2, THEN D_MDEA1= 2
ELSE IF AD24A = DK OR AD24C = DK, THEN D_MDEA1= DK
ELSE IF AD24A = REF OR AD24C = REF, THEN D_MDEA1= REF
ELSE D_MDEA1= BLANK

615

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
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

616

ELSE IF AD26P = 2 AND AD26R = 2 AND AD26S = 2, THEN D_MDEA8= 2
ELSE IF AD26P = DK OR AD26R = DK OR AD26S = DK, THEN D_MDEA8= DK
ELSE IF AD26P = REF OR AD26R = REF OR AD26S = REF, THEN D_MDEA8= REF
ELSE D_MDEA8= BLANK
DEFINE D_MDEA9:
IF AD26AA = 1 OR D26BB = 1 OR AD26CC = 1 OR AD26DD = 1 OR AD26EE = 1, THEN
D_MDEA9= 1
ELSE IF AD26AA = 2 AND AD26BB = 2 AND AD26CC = 2, THEN D_MDEA9= 2
ELSE IF AD26AA = DK OR AD26BB = DK OR AD26CC = DK OR AD26DD = DK OR
AD26EE = DK, THEN D_MDEA9= DK
ELSE IF AD26AA = REF OR AD26BB = REF OR AD26CC = REF OR AD26DD = REF OR
AD26EE = REF, THEN D_MDEA9= REF
ELSE D_MDEA9= BLANK
DEFINE DSMMDEA2:
IF SUM (D_MDEA1 = 1, D_MDEA2 = 1, D_MDEA3 = 1, D_MDEA4 = 1, D_MDEA5 = 1,
D_MDEA6 = 1, D_MDEA7 = 1, D_MDEA8 = 1, D_MDEA9 = 1) ≥ 5, THEN DSMMDEA2 = 1
ELSE IF SUM (D_MDEA1 = (1 OR DK/REF), D_MDEA2 = (1 OR DK/REF), D_MDEA3 = (1
OR DK/REF), D_MDEA4 = (1 OR DK/REF), D_MDEA5 = (1 OR DK/REF), D_MDEA6 = (1
OR DK/REF), D_MDEA7 = (1 OR DK/REF), D_MDEA8 = (1 OR DK/REF), D_MDEA9 = (1
OR DK/REF)) < 5 AND N(OF D_MDEA1-D_MDEA9) > 0, THEN DSMMDEA2 = 2
ELSE IF D_MDEA1 = DK OR D_MDEA2 = DK OR D_MDEA3 = DK OR D_MDEA4 = DK
OR D_MDEA5 = DK OR D_MDEA6 = DK OR D_MDEA7 = DK OR D_MDEA8 = DK OR
D_MDEA9 = DK, THEN DSMMDEA2 = DK
ELSE IF D_MDEA1 = REF OR D_MDEA2 = REF OR D_MDEA3 = REF OR D_MDEA4 =
REF OR D_MDEA5 = REF OR D_MDEA6 = REF OR D_MDEA7 = REF OR D_MDEA8 =
REF OR D_MDEA9 = REF, THEN DSMMDEA2 = REF
AD28 [IF D_MDEA9 = 1 OR DSMMDEA2 = 1] You mentioned having some of the problems
you were just asked 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?

617

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?
__________ 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:__________ years old
[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.
______________ times
[RANGE: 1-1000]
DK/REF
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

618

AD66a [IF AD38 = 1] Think about the time in the past 12 months when [NUMPROBS] with
your mood [WASWERE] most severe.
Using the 0 to 10 scale shown below, where 0 means no interference and 10 means very
severe interference, select the number that describes how much [NUMPROBS] interfered
with your ability to do each of the following activities during that period. You can use
any number between 0 and 10 to answer.
How much did your [FEELNOUN] interfere with your ability to do home management
tasks, like cleaning, shopping, and working around the house, apartment, or yard?
No
Interference

│
0
DK/REF

Mild

1

2

Moderate

3

4

5

Severe

6

7

8

Very Severe
Interference

9

│
10

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
Interference

│
0
DK/REF

Mild

1

2

Moderate

3

4

5

Severe

6

7

8

Very Severe
Interference

9

│
10

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
Interference

│
0
DK/REF

Mild

1

2

Moderate

3

4

5

Severe

6

7

8

Very Severe
Interference

9

│
10

AD66d [IF AD38 = 1] How much did [NUMPROBS] interfere with your ability to have a
social life during that period of time?

619

You can use any number between 0 and 10 to answer.
No
Interference

│
0
DK/REF

Mild

1

2

Moderate

3

4

5

Severe

6

7

8

Very Severe
Interference

9

│
10

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:__________ days in the past 12 months
[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
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

620

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, click Next 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
AD86d [IF AD86c = 1] Are you currently taking prescription medication that was prescribed
for [NUMPROBS]?
1
Yes
2
No
DK/REF

621

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

622

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623

Adolescent Depression
INTROYD

[IF CURNTAGE = 12-17] The next questions are about your mental health,
emotions, and behavior. Please make sure you’re in a private location when you
answer these questions.
If you don’t want to answer these questions, you can select “Don’t Know” or
“Rather Not Answer” to any question.
Click Next to continue.

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?

624

1
Yes
2
No
DK/REF
YD01b [YD01 = 2 OR DK/REF] During times when you felt sad, empty, or depressed, did you
ever lose interest and become really bored with most things like school, work,
hobbies, and other things that are usually fun for you, like listening to music, watching
TV, movies, or sports, playing computer games, or going out with friends?
1
Yes
2
No
DK/REF
YD02 [IF YDS22 = 1] During times when you felt discouraged about how things were going in
your life, did you ever lose interest and become really bored with most things like
school, work, hobbies, and other things that are usually fun for you, like listening to
music, watching TV, movies, or sports, playing computer games, or going out with
friends?
1
Yes
2
No
DK/REF
YD09 [IF YDS23 = 1] Did you ever have a period of time like this that lasted most of the day
almost every day for two weeks or longer?
1
Yes
2
No
DK/REF
DEFINE FEELFILL:
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”

625

IF (YD02 = 1), THEN FEELNOUN = “discouragement or boredom”
IF (YD02 = 2 OR DK/REF), THEN FEELNOUN = “discouragement”
IF (YD09 = 1), THEN FEELNOUN = “boredom”
ELSE FEELNOUN = BLANK
DEFINE NUMPROBS
IF YD01a NE BLANK OR YD01b = 1 OR YD02 = 1, THEN NUMPROBS = these problems
IF YD01b = (2 OR DK/REF) OR YD02 = (2 OR DK/REF) OR YD09 = 1, THEN NUMPROBS
= this problem
ELSE NUMPROBS = BLANK
DEFINE WASWERE:
IF YD01a NE BLANK OR YD01b = 1 OR YD02 = 1, THEN WASWERE = “were”
IF YD01b = (2 OR DK/REF) OR YD02 = (2 OR DK/REF) OR YD09 = 1, THEN WASWERE =
“was”
ELSE WASWERE = BLANK
YD12 [IF YD01a NE BLANK OR YD01b NE BLANK OR YD02 NE BLANK] Think about
the times when you [FEELFILL]. Did you ever have a period of time like this that lasted
most of the day, almost every day, for two weeks or longer?
1
Yes
2
No
DK/REF
YD16 [IF YD09 = 1 OR YD12 = 1] Think of times lasting two weeks or longer when
[NUMPROBS] with your mood [WASWERE] most severe and frequent. During those
times, how long did your [FEELNOUN] usually last?
1
Less than 1 hour
2
At least 1 hour but less than 3 hours
3
At least 3 hours but less than 5 hours
4
5 hours or more
DK/REF
YD17 [IF YD16 = 2, 3, 4, OR DK/REF] Still thinking of times lasting two weeks or longer when
[NUMPROBS] with your mood [WASWERE] most severe and frequent, how strong were
your bad feelings during those times?
1
Mild
2
Moderate
3
Severe
4
Very severe
DK/REF

626

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 just mentioned. They include
things like changes in:
•
•

sleep
eating

627

•
•
•

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: __________ years old
[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: __________ years old
[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
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?

628

1
Yes
2
No
DK/REF
YD24e [IF YD22a NE BLANK OR YD22c NE BLANK] During that [TIMEFILL] period of
time, did you become bored with almost everything like school, work, hobbies, and things
you like to do for fun?
1
Yes
2
No
DK/REF
YD24f [IF YD22a NE BLANK OR YD22c NE BLANK] During that [TIMEFILL] period of
time, did you feel like nothing was fun even when good things were happening?
1
Yes
2
No
DK/REF
YD26a [IF ANY YD24a - YD24f = 1] The next questions are about changes in appetite and
weight.
[IF YD22a NE BLANK] In answering these questions, think about the period of time when your
[FEELNOUN] and other problems were the worst.
[IF YD22c NE BLANK] In answering these questions, think about the most recent period of
time when you [FEELFILL] and had other problems at the same time.
Did you eat much less than usual almost every day during that time?
1
Yes
2
No
DK/REF
YD26b [IF YD26a = 2 OR DK/REF] Did you eat much more than usual almost every day?
1
Yes
2
No
DK/REF
YD26c

[IF YD26a = 2 OR DK/REF]Did you gain weight without trying to during that
[TIMEFILL] period of time?
1
Yes
2
No
DK/REF
629

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 RSEX = 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:__________ pounds
[RANGE: 0-200]
DK/REF
YD26e [IF YD26a = 1 OR YD26c = (2 OR DK/REF)] Did you lose weight without trying to?
1
Yes
2
No
DK/REF
YD26e1 [IF YD26e = 1] Did you lose weight without trying to because you were sick or on a diet?
1
Yes
2
No
DK/REF
YD26f [IF YD26e1=2 OR DK/REF] How many pounds did you lose?
Please enter your answer as a whole number.
# OF POUNDS:__________ pounds
[RANGE: 0-200]
DK/REF

630

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
YD26n [IF YD26l = 2 OR DK/REF] Were you so restless or jittery that you walked up or down or
couldn’t sit still?

631

1
Yes
2
No
DK/REF
YD26o [IF YD26n = 1] Did anyone else notice that you couldn’t sit still?
1
Yes
2
No
DK/REF
YD26p [IF YD26a NE BLANK] The next questions are about changes in your ability to
concentrate, and your feelings about yourself.
[IF YD22a NE BLANK] Again, in answering these questions, think about the period of time
when your [FEELNOUN] and other problems were the worst.
[IF YD22c NE BLANK] Again, in answering these questions, think about the most recent
period of time when you [FEELFILL] and had other problems at the same time.
On most days during that [TIMEFILL] time, did your thinking seem slower than usual or
seem mixed up?
1
Yes
2
No
DK/REF
YD26r [IF YD26a NE BLANK] On most days, did you have a lot more trouble than usual keeping
your mind on things?
1
Yes
2
No
DK/REF
YD26s [IF YD26a NE BLANK] Were you unable to make up your mind about things you
ordinarily have no trouble deciding about?
1
Yes
2
No
DK/REF
YD26u [IF YD26a NE BLANK] Did you feel that you were not as good as other people nearly
every day?
1
Yes
2
No
DK/REF
YD26v [IF YD26u = 1] Did you feel totally worthless nearly every day?

632

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
DK/REF

YD26ee

[IF YD26cc = 1] Did you make a suicide attempt or try to kill yourself?
1 Yes
2
No
DK/REF

633

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
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:

634

IF YD26V = 1, THEN D_MDEA7Y= 1
ELSE IF YD26U = (2 OR DK/REF) OR YD26V = 2, THEN D_MDEA7Y= 2
ELSE D_MDEA7Y=YD26V
ELSE D_MDEA7Y= BLANK
DEFINE D_MDEA8Y:
IF YD26P = 1 OR YD26R = 1 OR YD26S = 1, THEN D_MDEA8Y= 1
ELSE IF YD26P = 2 AND YD26R = 2 AND YD26S = 2, THEN D_MDEA8Y= 2
ELSE IF YD26P = DK OR YD26R = DK OR YD26S = DK, THEN D_MDEA8Y= DK
ELSE IF YD26P = REF OR YD26R = REF OR YD26S = REF, THEN D_MDEA8Y= REF
ELSE D_MDEA8Y= BLANK
DEFINE D_MDEA9Y:
IF YD26AA = 1 OR D26BB = 1 OR YD26CC = 1 OR YD26DD = 1 OR YD26EE = 1, THEN
D_MDEA9Y= 1
ELSE IF YD26AA = 2 AND YD26BB = 2 AND YD26CC = 2, THEN D_MDEA9Y= 2
ELSE IF YD26AA = DK OR YD26BB = DK OR YD26CC = DK OR YD26DD = DK OR
YD26EE = DK, THEN D_MDEA9Y= DK
ELSE IF YD26AA = REF OR YD26BB = REF OR YD26CC = REF OR YD26DD = REF OR
YD26EE = REF, THEN D_MDEA9Y= REF
ELSE D_MDEA9Y= BLANK
DEFINE DSMMDEAY:
IF SUM (D_MDEA1Y = 1, D_MDEA2Y = 1, D_MDEA3Y = 1, D_MDEA4Y = 1,
D_MDEA5Y = 1, D_MDEA6Y = 1, D_MDEA7Y = 1, D_MDEA8Y = 1, D_MDEA9Y = 1) ≥ 5,
THEN DSMMDEAY = 1
ELSE IF SUM (D_MDEA1Y = (1 OR DK/REF), D_MDEA2Y = (1 OR DK/REF),
D_MDEA3Y = (1 OR DK/REF), D_MDEA4Y = (1 OR DK/REF), D_MDEA5Y = (1 OR
DK/REF), D_MDEA6Y = (1 OR DK/REF), D_MDEA7Y = (1 OR DK/REF), D_MDEA8Y = (1
OR DK/REF), D_MDEA9Y = (1 OR DK/REF)) < 5 AND N(OF D_MDEA1Y-D_MDEA9Y) >
0, THEN DSMMDEAY = 2
ELSE IF D_MDEA1Y = DK OR D_MDEA2Y = DK OR D_MDEA3Y = DK OR D_MDEA4Y
= DK OR D_MDEA5 = DK OR D_MDEA6Y = DK OR D_MDEA7Y = DK OR D_MDEA8Y =
DK OR D_MDEA9Y = DK, THEN DSMMDEAY = DK
ELSE IF D_MDEA1Y = REF OR D_MDEA2Y = REF OR D_MDEA3Y = REF OR
D_MDEA4Y = REF OR D_MDEA5Y = REF OR D_MDEA6Y = REF OR D_MDEA7Y = REF
OR D_MDEA8Y = REF OR D_MDEA9Y = REF, THEN DSMMDEAY = REF
YD28 [IF D_MDEA9Y = 1 OR DSMMDEAY = 1] You mentioned having some of the
problems you were just asked 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

Not at all
A little

635

3
4
5
DK/REF

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:__________ years old
[RANGE: 1-17]
DK/REF
YD37b [IF YD37 = 2 OR DK] About how old were you when you first had a period of time like
this?
AGE:__________ years old
[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______________ times
[RANGE: 1-1000]
DK/REF

636

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
Problems
│
0
1

Mild
2

Moderate
3

4

5

Severe
6

7

8

Very Severe
Problems
│
9
10

NUMBER: ______________
[RANGE: 0-10]
DK/REF
YD66b [IF YD38 = 1] During that time in the past 12 months when your [FEELNOUN] was
worst, how much did this cause problems with your ability to do well at school or
work?
You can use any number between 0 and 10 to answer.
No
Problems
Mild
Moderate
│
0
1
2
3
4
5
6
7

Severe
8

Very Severe
Problems
│
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.
637

No
Problems
│
0
1

Mild
2

Moderate
3

4

5

Severe
6

7

8

Very Severe
Problems
│
9
10

NUMBER: ______________
[RANGE: 0-10]
DK/REF

YD66d [IF YD38 = 1] How much did your [FEELNOUN] cause problems with your ability to
have a social life during that time?
You can use any number between 0 and 10 to answer.
No
Problems
│
0
1

Mild
2

Moderate
3

4

5

Severe
6

7

8

Very Severe
Problems
│
9
10

NUMBER: ______________
[RANGE: 0-10]
DK/REF
YD68 [IF ANY RESPONSES TO YD66a – YD66d = 1-10] About how many days out of 365
in the past 12 months were you totally unable to go to school or work or carry out your
normal activities because of your [FEELNOUN]?
You can use any number between 0 and 365 to answer.
# OF DAYS:__________ days in the past 12 months
[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

638

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?
Select all that apply.
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, click Next 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]?

639

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
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

640

This page intentionally left blank.

641

Definitions for Use in Consumption of Alcohol Module
(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 PSIREC =
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 any
cannabis product’
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 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

642

= 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’

643

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 or hard seltzer, a glass of wine or a wine
cooler, a shot of liquor, or a drink with liquor in it. We are not asking about times
when you only had a sip or two from a drink.
Click Next to continue.
CA01

[IF ALC30USE = 1] Earlier, you reported 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: __________ # of drinks
[1 - 90]
DK/REF

CA02a

[IF ALC30USE = 1 AND CURNTAGE = 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 CURNTAGE = 12 - 20] Where did you drink alcoholic
beverages this last time you drank?
Select all that apply.
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, click Next to go to the
next question.

644

_____________
DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN CA02SP.
CA03

[IF ALC30USE = 1 AND CURNTAGE = 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?
1
2

My parent or guardian bought it for me
Another family member who is 21 or older bought it for me

645

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, click Next 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?
[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
646

[Note to Programmers regarding CA09: Only display the response options that correspond to
the list displayed in CA08. 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?
Select all that apply.
1 Marijuana or any cannabis product
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. Please answer this question again.
CA10 [IF ((AL01 = 1 OR ALREF = 1) AND ALC30USE = 2) OR (ALC30USE = 1 AND
BINGEFLAG=0 AND ((CA01 NE 5-90 AND RSEX=5) OR (CA01 NE 4-90 AND
RSEX=9)))]
[IF ALC30USE = 2: Earlier you reported that you have had at least one drink of an
alcoholic beverage in your lifetime.] Have you ever had [IF RSEX=5 THEN FILL 5 IF
RSEX=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
Yes
2
No
DK/REF
CA11 [IF CA10 = 1 OR BINGEFLAG=1 OR (CA01 = 5-90 AND RSEX=5) OR (CA01 = 4-90
AND RSEX=9)]
[IF BINGEFLAG=1 OR (CA01 = 5-90 AND RSEX=5) OR (CA01 = 4-90 AND
RSEX=9): Earlier you reported that you had [IF RSEX=5 THEN FILL 5 IF RSEX=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 RSEX=5 THEN FILL 5 IF RSEX=9 THEN FILL 4] or
more drinks on the same occasion?
AGE: __________ [1 - 110]
DK/REF

647

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 You were [AGE1STBA] years old when you first had [IF RSEX=5
THEN FILL 5 IF RSEX=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 RSEX=5 THEN FILL 5 IF RSEX=9 THEN
FILL 4] or more drinks on the same occasion. How old were you the
first time you had [IF RSEX=5 THEN FILL 5 IF RSEX=9 THEN
FILL 4] or more drinks on the same occasion?
AGE:
years old
[RANGE: 1 - 110]
DK/REF
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 RSEX=5 THEN FILL 5 IF RSEX=9 THEN FILL 4] or more drinks on the same
occasion in [CURRENT YEAR - 1] or [CURRENT YEAR]?
1
CURRENT YEAR - 1
2
CURRENT YEAR
DK/REF
CA11b [IF AGE1STBA = CURNTAGE - 1 AND DATE OF INTERVIEW < DOB] Did
you first have [IF RSEX=5 THEN FILL 5 IF RSEX=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 RSEX=5 THEN FILL 5 IF RSEX=9

648

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. Please answer this question again, then click Next 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 RSEX=5 THEN FILL 5 IF RSEX=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 CA11d > CURRENT MONTH] The month in [CURRENT YEAR]
you entered has not begun yet. Please answer this question again, then click Next 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.
649

IF MYR1STBA NE 0 AND NE AGE1STBA:
BACC03 You first had [IF RSEX=5 THEN FILL 5 IF RSEX=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 RSEX=5
THEN FILL 5 IF RSEX=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, you reported that you were [AGE1STBA]
years old when you first had [IF RSEX=5 THEN FILL 5 IF RSEX=9
THEN FILL 4] or more drinks on the same occasion. Which answer is
correct?
I first had [IF RSEX=5 THEN FILL 5 IF RSEX=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 RSEX=5
THEN FILL 5 IF RSEX=9 THEN FILL 4] or more drinks on
the same occasion
3
Neither answer is correct
DK/REF
1

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 RSEX=5 THEN FILL 5 IF
RSEX=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 RSEX=5
THEN FILL 5 IF RSEX=9 THEN FILL 4] or more drinks on the same
occasion?

650

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. Please answer this question again, then click Next to
continue.
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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)] You first had [IF RSEX=5 THEN FILL 5 IF
RSEX=9 THEN FILL 4] or more drinks on the same occasion in
[BACC05-BACC05a fill]. That would make you [MYR1STBA] years
old when you first had [IF RSEX=5 THEN FILL 5 IF RSEX=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

651

Emerging Issues
CA15 [IF CURNTAGE = 18 OR OLDER] Do you think you ever had a problem with your own
drug or alcohol use?
1
Yes
2
No
DK/REF
CA16 [IF CA15=1] At this time do you consider yourself to be in recovery or recovered from
your own problem with drugs or alcohol use?
1
Yes
2
No
DK/REF
CA17 [IF CURNTAGE = 18 OR OLDER] Do you think you ever had a problem with your own
mental health?
1
Yes
2
No
DK/REF
CA18 [IF CA17=1] At this time do you consider yourself to be in recovery or recovered from
your own mental health problem?
1
Yes
2
No
DK/REF
KAINTRO

This next question is about kratom, which can come in forms such as powder,
pills, or leaf.
Click Next to continue.

KA01

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

KALAST3

[IF KA01=1] How long has it been since you last used kratom?
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

652

DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

VPFLLIF

The next questions are about vaping flavoring.
Have you ever, even once, vaped only flavoring without nicotine or other
substances added?
1 Yes
2 No
DK/REF
PROGRAMMER: SHOW PAST 12 MONTH CALENDAR

VPFLRECa [IF VPFLLIF=1]
How long has it been since you last vaped only flavoring?
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
SMLIF

The next question is about synthetic marijuana or fake weed, also called K2 or Spice.
Have you ever, even once, used synthetic marijuana or fake weed?
• Yes
• No
DK/REF

SMREC [IF SMLIF=1] How long has it been since you last used synthetic marijuana or fake
weed?
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

653

SSLIF

The next question is about synthetic stimulants that people use to get high, also called
“bath salts” or flakka.
Have you ever, even once, used these synthetic stimulants?
1 Yes
2 No
DK/REF

SSREC

[IF SSLIF=1] How long has it been since you last used these synthetic stimulants,
also called “bath salts” or flakka?
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

IFLIF

Earlier, you were asked whether you had used prescription fentanyl, also known as
Duragesic or Fentora, in the past 12 months.
This next question is about illegally made fentanyl, which is fentanyl that people
can’t get from a doctor or pharmacy. Illegally made fentanyl can come in forms such
as powder, pills, or blotter paper. It can also be mixed with heroin or other drugs.
Have you ever, even once, used illegally made fentanyl?
1 Yes
2 No
DK/REF

IFREC

[IF IFLIF = 1] How long has it been since you last used illegally made fentanyl?
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

IFNDLLIF [IF IFLIF = 1] Have you ever, even once, used a needle to inject illegally made
fentanyl?
1 Yes
2 No
DK/REF

654

IFNDRECa [IF IFNDLLIF = 1 AND (IFREC = 1 OR IFREC = DK or REF)] How long has it
been since you last used a needle to inject illegally made fentanyl?
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
IFNDRECb [IF IFNDLLIF = 1 AND IFREC = 2] How long has it been since you last used a
needle to inject illegally made fentanyl?
1 More than 30 days ago but within the past 12 months
2 More than 12 months ago
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

655

Market Information for Marijuana
[IF MJLAST3 = 1 OR 2 OR MJRECDK = 1 OR 2 OR MJRECRE = 1 OR 2]
Now we return to the topic of marijuana and cannabis products. [IF CBDLAST =
1 OR 2] Please do not include CBD or hemp products when answering these
questions.

MJE01

During the past 12 months, how did you get marijuana or cannabis products?
MJE01a I paid for or bought it
MJE01b I traded something else for it
MJE01c I got it from someone for free or shared someone else’s
MJE01d I grew it myself
MJE01e I got it some other way
DK/REF
PROGRAMMER: USE STATIC GRID
PROGRAMMER: SHOW 12 MONTH CALENDAR

Yes
1
1
1
1
1

No
2
2
2
2
2

MJE01e2 [IF MJE01e = 1] In what other way did you get marijuana or cannabis products?
PROGRAMMER: PROVIDE 5 ROWS
___________________________________________________ [ALLOW 80
CHARACTERS]
DK/REF
[IF MJE01a = 1] How long has it been since you last paid for or bought
marijuana or cannabis products?

MJE02

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
[IF MJE02 = 1] During the past 30 days, that is, since [DATEFILL], on how
many days did you pay for or buy marijuana or cannabis products?

MJE03

# DAYS___________ days in the past 30 days
[RANGE: 1 - 30]
DK/REF
PROGRAMMER: SHOW 30 DAY CALENDAR
MJE06

[IF MJE01a = 1] The last time you bought marijuana or cannabis products, did you
buy it from either a store or dispensary?
1

Yes

656

2 No
DK/REF
MJE07

[ [IF MJE01a = 1] AND [MJE06 = 2 or DK/REF] ] The last time you paid for or
bought marijuana or cannabis products, how well did you know the person you got it
from?
1
Very well
2
Somewhat well
3
Not at all well
DK/REF

MJE05

[IF MJE01a = 1] The last time you paid for or bought marijuana, what forms of
marijuana or cannabis products did you buy?

Did you buy…
MJE05a Pre-rolled joints?
MJE05b Marijuana in loose form?
MJE05c Vaping cartridges, vaping oils, or pre-filled vape pens?
MJE05d Waxes, shatter, or concentrates, for dabbing?
MJE05e Edibles, for eating or drinking?
MJE05f Drops, strips, lozenges, sprays?
MJE05g Lotion, cream, patches?
MJE05h Pills?
MJE05i Some other form or forms?
DK/REF
PROGRAMMER: USE STATIC GRID

MJE21

Yes
1
1
1
1
1
1
1
1
1

No
2
2
2
2
2
2
2
2
2

[IF MJLAST3 = 1 OR 2 OR MJRECDK = 1 OR 2 OR MJRECRE = 1 OR 2]
During the past 12 months, did you sell any marijuana or cannabis products?
1
Yes
2
N0
DK/REF

657

This page intentionally left blank.

658

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:
times in the past 12 months
[RANGE: 0 - 365]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

QD14 Were you born in the United States or a U.S. territory, including American Samoa,
Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands?
1
Yes
2
No
DK/REF
QD14a [IF QD14 = 1] In which state or U.S. territory were you born?
Drop down list with 50 states and Washington, D.C. listed alphabetically followed by five
U.S. territories listed alphabetically
DK/REF
QD15 [IF QD14 = 2] In what country were you born?
COUNTRY: _________________
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 or a U.S. territory for at least one year?
1
Yes
2
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 or a U.S. territory? Please estimate the total
number of years you have lived here over your lifetime.
NUMBER OF YEARS: ______________ years
[RANGE: 1-90]
DK/REF
QD16c [IF QD16a = 2] For how many months have you lived in the United States or a U.S.

659

territory? Please estimate the total number of months you have lived here over your
lifetime. If you have lived in the United States or a U.S. territory for less than one month,
please enter 0.
NUMBER OF MONTHS: ______________ months
[RANGE: 0-12]
DK/REF
QD62 People are different in their sexual attraction to other people. Which statement best
describes your feelings?
[IF RSEX=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
DK/REF
[IF RSEX=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 Which one of the following do you consider yourself to be?
1
Heterosexual, that is, straight
2
Gay or lesbian
3
Bisexual
4 I use a different term
5 I am not sure about my sexual orientation
6 I do not know what this question is asking
DK/REF
QD63OTH

[IF QD63 = 4] What term do you use to describe your sexual identity?

_____________[ALLOW 50 CHARACTERS]
DK/REF

QD55 How well do you speak English?
1

Very well

660

2
Well
3
Not well
4
Not at all
DK/REF
SEE

Do you have difficulty seeing, even when wearing glasses or contact lenses?
1
No difficulty
2
Some difficulty
3
A lot of difficulty
4
Cannot do at all
DK/REF

HEAR

Do you have difficulty hearing, even when using hearing aids?
1
No difficulty
2
Some difficulty
3
A lot of difficulty
4
Cannot do at all
DK/REF

WALK

Do you have difficulty walking or climbing steps?
1
No difficulty
2
Some difficulty
3
A lot of difficulty
4
Cannot do at all
DK/REF

MEM

Do you have difficulty remembering or concentrating?
1
No difficulty
2
Some difficulty
3
A lot of difficulty
4
Cannot do at all
DK/REF

CARE

Do you have difficulty with self-care, such as washing all over or dressing?
1
No difficulty
2
Some difficulty
3
A lot of difficulty
4
Cannot do at all
DK/REF

COMM

Using your usual language, do you have difficulty communicating, for example
understanding or being understood?

661

1
No difficulty
2
Some difficulty
3
A lot of difficulty
4
Cannot do at all
DK/REF

662

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
[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?

QD17a

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
14

1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade
7th grade
8th grade
9th grade
10th grade
11th grade
12th grade
College or university/1st year
College or university/2nd year

663

15
College or university/3rd year
16
College or university/4th year
17
College or university/5th or higher year
DK/REF
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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) ] 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) ] 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
2
3
4
5
6

1st grade
2nd grade
3rd grade
4th grade
5th grade
6th grade

664

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
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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

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)
19
Doctorate degree (for example, PhD, EdD)
20
Professional degree beyond a bachelor’s degree (for
example, MD, DDS, DVM, LLB, JD)
DK/REF
PROGRAMMER: DROP DOWN BOX FOR MOBILE

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?

665

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:
days of school missed
[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 AND QD20DKRE NE 6] 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:
days in the past 30 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?
1
2

0 days
1 day

666

3
2 days
4
3 to 5 days
5
6 or more 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? Click Help to see a definition of “military.”
1 Yes
2 No
DK/REF
IF Help IS CLICKED, 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.

QD10e [IF QD10d = 1] Which member or members of your family are currently in the United
States military?
Select all that apply.
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

667

This page intentionally left blank.

668

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].
Click Help to see information about unpaid work.
1
Yes
2
No
DK/REF
IF HELP IS CLICKED, 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.
QD27 [IF QD26 = 2] Even though you did not work at any time last week, did you have
a job or business? Click Help to see information about unpaid work.
1
Yes
2
No
DK/REF
IF HELP IS CLICKED, 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.
QD28 [IF QD26 =1] How many hours did you work last week at all jobs or businesses?
# OF HOURS WORKED:
[RANGE: 1 - 120]
DK/REF

hours

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
669

QD30 [IF QD27 = 1] Which one of these reasons best describes why you did not work last
week?
1
On vacation/sick/furlough/strike/maternity or family 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 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 selfemployed at any time during the past 12 months?

670

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:
[RANGE: 1 - 52]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

different employers

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:
[RANGE: 1 - 52]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

different employers

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
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:
[RANGE: 0 - 52]
DK/REF
PROGRAMMER: SHOW 12 MONTH CALENDAR

weeks

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
____________ year last worked

671

DK/REF
PROGRAMMER: DO NOT ALLOW BLANKS IN QD39a.
[IF QD39a > SYSTEM YEAR] HARD ERROR: The year that you reported is [YEAR FROM
QD39a]. Please enter the correct year.
[IF QD39a < (SYSTEM YEAR - CURRENT AGE)] HARD ERROR: The year you reported is
earlier than your birth date. Please 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
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
PROGRAMMER: DROP DOWN BOX FOR MOBILE
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:
[RANGE: 0 - 30]
DK/REF

days in the past 30 days

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:
days in the past 30 days
[RANGE: 0 - 30]
DK/REF
SHOW 30 DAY CALENDAR

672

DEFINE CALCAGE2:
CALCAGE2 = VALUE OF CALCAGE WHEN PENTER1 IS REACHED.

673

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674

Household Roster
INTRODM2 The next questions will ask you about yourself and the people who live with you.
Click Next to continue.
QD54 Including yourself, how many people live here now? 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:
[RANGE: 1 - 25]
DK/REF

number of persons in household

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 AND FIRST GRID ROW] How old are you?
[IF QD54 = 2 – 25 AND SUBSEQUENT GRID ROWS] Now we need some
additional information about the other people who live here. Let’s start with the
oldest. How old are they? (WORDING FOR ADDITIONAL CYCLES: How old
is the next oldest person?)
For children less than 24 months, enter ‘1’. You will be prompted for the age in
months on the next screen.
years old
[RANGE: 1 - 110]
DK/REF
CHAGEMON
[IF PERAGEYR = 1] Enter the child’s age in whole months. For babies
under 1 month old, enter 1.
months old
[RANGE: 1 - 23]
DK/REF
CHMONSEX [IF CHAGEMON = 1 - 23] What sex was the [CHAGEMON FILL]-month old
child assigned at birth, on their original birth certificate?
5
Male
9
Female
DK/REF
675

CHYRSEX

[IF CHAGEMON = DK/REF] What sex was this child assigned at birth, on their
original birth certificate?
5
Male
9
Female
DK/REF

PERYRSEX [IF PERAGEYR = 2 - 110 AND SUBSEQUENT GRID ROWS] What sex was
the [PERAGEYR FILL]-year old person assigned at birth, on their original birth
certificate?
5
Male
9
Female
DK/REF
PERSEX

[IF PERAGEYR = DK/REF AND SUBSEQUENT GRID ROWS] What sex was
this person assigned at birth, on their original birth certificate?
5
Male
9
Female
DK/REF

RELATON

PROGRAMMER; IF FIRST GRID ROW, CODE 1: SELF AND GO TO NEXT
QUESTION
[IF SUBSEQUENT GRID ROWS:] Which category best describes their
relationship to you.
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18

Spouse
Child (Includes step, foster, and adoptive)
Child-in-law
Sibling (Includes half, step, foster, and adoptive)
Sibling-in-law
Parent (Includes step, foster, and adoptive)
Parent-in-law
Aunt or Uncle
Niece or Nephew
Grandparent
Grandchild
Cousin
Ex-spouse
Unmarried partner
Housemate or roommate
Tenant, boarder, or exchange student
Other relative

676

19
Other non-relative
DK/REF

PROGRAMMER: DROP DOWN BOX FOR MOBILE

MBRSELCT [IF FIPE1 = 1 AND RELATON 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?
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.

677

This page intentionally left blank.

678

Proxy Information
PENTER1

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.
Enter 1 and click Next to continue.

[ONCE 1 IS ENTERED FOR PENTER1, NO ONE CAN RE-ENTER PREVIOUS
INTERVIEW SCREENS.]
FAMLY IF QD54 = 1 SKIP TO QHI01
IF RELATON=16 OR RELATON=17 OR RELATON=19 FOR ALL PERSONS IN
HOUSEHOLD SKIP TO QHI01.
DEFINE FAMILY RELATIONSHIP FILLS:
IF EXACTLY 1 IN ROSTER = (RELATON = 2), FILL = “spouse”
IF MORE THAN 1 IN ROSTER = (RELATON = 2), FILL = “spouses”
IF EXACTLY 1 IN ROSTER = (RELATON = 3), FILL = “child”
IF MORE THAN 1 IN ROSTER = (RELATON = 3 AND), FILL = “children”
IF EXACTLY 1 IN ROSTER = (RELATON = 4), FILL = “child-in-law”
IF MORE THAN 1 IN ROSTER = (RELATON = 4), FILL = “children-in-law”
IF EXACTLY 1 IN ROSTER = (RELATON = 5), FILL = “sibling”
IF MORE THAN 1 IN ROSTER = (RELATON = 5), FILL = “siblings”
IF EXACTLY 1 IN ROSTER = (RELATON = 6), FILL = “sibling-in-law”
IF MORE THAN 1 IN ROSTER = (RELATON = 6), FILL = “siblings-in-law”
IF EXACTLY 1 IN ROSTER = (RELATON = 7), FILL = “parent”
IF MORE THAN 1 IN ROSTER = (RELATON = 7), FILL = “parents”
IF EXACTLY 1 IN ROSTER = (RELATON = 8), FILL = “parent-in-law”
IF MORE THAN 1 IN ROSTER = (RELATON = 8), FILL = “parents-in-law”
IF EXACTLY 1 IN ROSTER = (RELATON = 9), FILL = “aunt or uncle”
IF MORE THAN 1 IN ROSTER = (RELATON = 9), FILL = “aunts or uncles”
IF EXACTLY 1 IN ROSTER = (RELATON = 10), FILL = “niece or nephew”
IF MORE THAN 1 IN ROSTER = (RELATON = 10), FILL = “nieces or nephews”
IF EXACTLY 1 IN ROSTER = (RELATON = 11), FILL = “grandparent”

679

IF MORE THAN 1 IN ROSTER = (RELATON = 11), FILL = “grandparents”
IF EXACTLY 1 IN ROSTER = (RELATON = 12), FILL = “grandchild”
IF MORE THAN 1 IN ROSTER = (RELATON = 12), FILL = “grandchildren”
IF EXACTLY 1 IN ROSTER = (RELATON = 13), FILL = “cousin”
IF MORE THAN 1 IN ROSTER = (RELATON = 13), FILL = “cousins”
IF EXACTLY 1 IN ROSTER = (RELATON = 14), FILL = “ex-spouse”
IF MORE THAN 1 IN ROSTER = (RELATON = 14), FILL = “ex-spouses”
IF EXACTLY 1 IN ROSTER = (RELATON = 15), FILL = “partner”
IF MORE THAN 1 IN ROSTER = (RELATON = 15), FILL = “partners”
IF EXACTLY 1 IN ROSTER = (RELATON = 18), FILL = “other relative”
IF MORE THAN 1 IN ROSTER = (RELATON = 18), FILL = “other 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 parent and a spouse 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 parent, and your spouse.”]
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} Adult family members who live here are your [FAMILY
RELATIONSHIP FILLS]. Do you think one of these people would be better able to give
the correct information about your health insurance coverage and the kinds of income
you and your family receive?
If someone else answers these questions, they will not be able to go back to see your
answers to earlier questions.
[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 the correct
information about your health insurance coverage and the kinds of income you and your
family receive?
If your [FAMILY RELATION FILL] answers these questions, they will not be able to go

680

back to see your answers to earlier questions.
[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 the correct information about
your health insurance coverage and the kinds of income you and your family receive?
If someone else answers these questions, they will not be able to go back to see your
answers to earlier questions.
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 give the correct information for these questions?
[FILL 1-9 WITH AGES AND RELATIONSHIPS FROM THE FIRST NINE ADULT
FAMILY MEMBERS OF THE HOUSEHOLD ROSTER, I.E., “parent”. FILL UNUSED
LINES WITH “DO NOT USE” AND MAKE THEM INVALID. IF
PERAGEYR=DK/REF AND RELATON=7, 8, OR 11, DISPLAY MRELATON IN
QP02]
1
[ROSTER FILL]
2
[ROSTER FILL]
3
[ROSTER FILL]
4
[ROSTER FILL]
5
[ROSTER FILL]
6
[ROSTER FILL]
7
[ROSTER FILL]
8
[ROSTER FILL]
9
[ROSTER FILL]
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]

681

QP04 [IF QP03=1] Would you ask your [QP02 FILL] 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] Are you the respondent’s [QP02 FILL]?
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
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.
DEFINE SAMPLE MEMBER
IF QD54 = 1 OR (RELATON=16 OR RELATON=17 OR RELATON=19 FOR ALL PERSONS
IN HOUSEHOLD) OR HASJOIN = 2, SAMPLE
MEMBER = “you”
IF RELATON = 2, SAMPLE MEMBER = “your spouse”
IF RELATON = 3, SAMPLE MEMBER = “your parent”
IF RELATON = 4, SAMPLE MEMBER = “your parent-in-law”
IF RELATON = 5, SAMPLE MEMBER = “your sibling”
IF RELATON = 6, SAMPLE MEMBER = “your sibling-in-law”
IF RELATON = 7, SAMPLE MEMBER = “your child”
IF RELATON = 8, SAMPLE MEMBER = “your child-in-law”
IF RELATON = , SAMPLE MEMBER = “your niece or nephew”

682

IF RELATON = 10 SAMPLE MEMBER = “your aunt or uncle”
IF RELATON = 11, SAMPLE MEMBER = “your grandchild”
IF RELATON = 12, SAMPLE MEMBER = “your grandparent”
IF RELATON = 13, SAMPLE MEMBER = “your cousin”
IF RELATON = 14, SAMPLE MEMBER = “your ex-spouse”
IF RELATON = 15, SAMPLE MEMBER = “your partner”
IF RELATON = 18, SAMPLE MEMBER = “your relative”

DEFINE SAMPLE MEMBER POSS
IF QD54 = 1 OR (RELATON=16 OR RELATON=17 OR RELATON=19 OR FOR ALL
PERSONS IN HOUSEHOLD) OR HASJOIN = 2, SAMPLE MEMBER POSS =
“your”
IF RELATON = 2, SAMPLE MEMBER POSS = “your spouse’s”
IF MRELATON = 3, SAMPLE MEMBER POSS = “your parent’s”
IF MRELATON = 4, SAMPLE MEMBER POSS = “your parent-in-law’s”
IF MRELATON = 5, SAMPLE MEMBER POSS = “your sibling’s”
IF RELATON = 6, SAMPLE MEMBER POSS = “your sibling-in-law’s”
IF RELATON = 7, SAMPLE MEMBER POSS = “your child’s”
IF RELATON = 8, SAMPLE MEMBER POSS = “your child-in-law’s”
IF RELATON = 9, SAMPLE MEMBER POSS = “your niece’s or nephew’s”
IF RELATON = 10, SAMPLE MEMBER POSS = “your aunt’s or uncle’s”
IF RELATON = 11, SAMPLE MEMBER POSS = “your grandchild’s”
IF RELATON = 12, SAMPLE MEMBER POSS = “your grandparent’s”
IF RELATON = 13, SAMPLE MEMBER = “your cousin’s”
IF RELATON = 14, SAMPLE MEMBER = “your ex-spouse’s”
IF RELATON = 15, SAMPLE MEMBER POSS = “your partner’s”
IF RELATON = 18, SAMPLE MEMBER POSS = “your relative’s”

DEFINE SAMPLE MEMBER A
IF QD54 = 1 OR (RELATON=16 OR RELATON=17 OR RELATON=19 FOR ALL PERSONS
IN HOUSEHOLD) OR HASJOIN = 2, SAMPLE
MEMBER A = “Are you”
IF RELATON = 2, SAMPLE MEMBER A = “Is your spouse”
IF RELATON = 3, SAMPLE MEMBER A = “Is your parent”
IF RELATON = 4, SAMPLE MEMBER A = “Is your parent-in-law”
IF RELATON = 5, SAMPLE MEMBER A = “Is your sibling”
IF RELATON = 6, SAMPLE MEMBER A = “Is your sibling-in-law”
IF RELATON = 7, SAMPLE MEMBER A = “Is your child”
IF RELATON = 8, SAMPLE MEMBER A = “Is your child-in-law”
IF RELATON = 9, SAMPLE MEMBER A = “Is your niece or nephew”

683

IF RELATON = 10, SAMPLE MEMBER A = “Is your aunt or uncle”
IF RELATON = 11, SAMPLE MEMBER A = “Is your grandchild”
IF RELATON = 12, SAMPLE MEMBER A = “Is your grandparent”
IF RELATON = 13, SAMPLE MEMBER = “Is your cousin”
IF RELATON = 14, SAMPLE MEMBER = “Is your ex-spouse”
IF RELATON = 15, SAMPLE MEMBER A = “Is your partner”
IF RELATON = 18, SAMPLE MEMBER A = “Is your relative”

DEFINE SAMPLE MEMBER B
IF QD54 = 1 OR (RELATON=16 OR RELATON=17 OR RELATON=19 FOR ALL PERSONS
IN HOUSEHOLD) OR HASJOIN = 2, SAMPLE MEMBER B = “you are”
IF RELATON = 2, SAMPLE MEMBER B = “your spouse is”
IF RELATON = 3, SAMPLE MEMBER B = “your parent is”
IF RELATON = 4, SAMPLE MEMBER B = “your parent-in-law is”
IF RELATON = 5, SAMPLE MEMBER B = “your sibling is”
IF RELATON = 6, SAMPLE MEMBER B = “your sibling-in-law is”
IF RELATON = 7, SAMPLE MEMBER B = “your child is”
IF RELATON = 8, SAMPLE MEMBER B = “your child-in-law is”
IF RELATON = 9, SAMPLE MEMBER B = “your niece or nephew is”
IF RELATON = 10, SAMPLE MEMBER B = “your aunt or uncle is”
IF RELATON = 11, SAMPLE MEMBER B = “your grandchild is”
IF RELATON = 12, SAMPLE MEMBER B = “your grandparent is”
IF RELATON = 13, SAMPLE MEMBER = “your cousin is”
IF RELATON = 14SAMPLE MEMBER = “your ex-spouse is”
IF RELATON = 15, SAMPLE MEMBER B = “your partner is”
IF RELATON = 18, SAMPLE MEMBER B = “your relative is”

684

Health Insurance
TOPROXY [IF HASJOIN = 1] 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. Click Next
to continue.
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] 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. Click Next 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, please
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 = NONE
IF FIPE4 =2 THEN MEDIFILL = DenaliCare
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 = Health First Colorado
IF FIPE4 =7 THEN MEDIFILL = HUSKY Health
IF FIPE4 =8 THEN MEDIFILL = Diamond State Health Plan
IF FIPE4 =9 THEN MEDIFILL = DC Healthy Families
IF FIPE4 =10 THEN MEDIFILL = Statewide Medicaid Managed Care

685

IF FIPE4 =11 THEN MEDIFILL = Georgia Families or Peach State Health Plan
IF FIPE4 =12 THEN MEDIFILL = Med-QUEST or Hawai’I Medicaid State Plan
IF FIPE4 =13 THEN MEDIFILL = NONE
IF FIPE4 =14 THEN MEDIFILL = Idaho Medicaid Health Plan
IF FIPE4 =15 THEN MEDIFILL = Healthy Indiana Plan
IF FIPE4 =16 THEN MEDIFILL = IA Health Link, Medicaid Fee-for-Service, or FFS
IF FIPE4 =17 THEN MEDIFILL = KanCare
IF FIPE4 =18 THEN MEDIFILL = Kynect
IF FIPE9 THEN MEDIFILL = Healthy Louisiana
IF FIPE4 =20 THEN MEDIFILL = MaineCare
IF FIPE4 =21 THEN MEDIFILL = Maryland Health Connection
IF FIPE4 =22 THEN MEDIFILL = MassHealth
IF FIPE4 =23 THEN MEDIFILL = Healthy Michigan Plan
IF FIPE4 =24 THEN MEDIFILL = Medical Assistance or MA
IF FIPE4 =25 THEN MEDIFILL = Mississippi Coordinated Access Network or
MississippiCAN
IF FIPE4 =26 THEN MEDIFILL = MO HealthNet
IF FIPE4 =27 THEN MEDIFILL = Montana Medicaid, or HMK Plus
IF FIPE4 =28 THEN MEDIFILL = Heritage Health
IF FIPE4 =29 THEN MEDIFILL = Nevada check Up
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 = NY State of Health
IF FIPE4 =34 THEN MEDIFILL = North Carolina Medicaid Managed Care or North
Carolina Medicaid Direct
IF FIPE4 =35 THEN MEDIFILL = NONE
IF FIPE4 =36 THEN MEDIFILL = NONEIF FIPE4 =37 THEN MEDIFILL =
SoonerCare
IF FIPE4 =38 THEN MEDIFILL = Oregon Health Plan or OHP
IF FIPE4 =39 THEN MEDIFILL = HealthChoices
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 = STAR
IF FIPE4 =45 THEN MEDIFILL = PRISM
IF FIPE4 =46 THEN MEDIFILL = Dr Dynasaur
IF FIPE4 =47 THEN MEDIFILL = Cardinal Care
IF FIPE4 =48 THEN MEDIFILL = Apple Health
IF FIPE4 =49 THEN MEDIFILL = NONE
IF FIPE4 =50 THEN MEDIFILL = BadgerCare Plus
IF FIPE4 =51 THEN MEDIFILL = NONE
IF FIPE4 =52 THEN MEDIFILL = the Government Health Plan or Plan Vital
IF FIPE4 =53 THEN MEDIFILL = NONE
ELSE MEDIFILL = BLANK

686

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.

QHI02

[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 or DKC
IF FIPE4 = 3 THEN CHIPFILL = KidsCare
IF FIPE4 = 4 THEN CHIPFILL = ARKids First
IF FIPE4 = 5 THEN CHIPFILL = Medi-Cal
IF FIPE4 = 6 THEN CHIPFILL = Child Health Plan Plus, or CHP+
IF FIPE4 = 7 THEN CHIPFILL = Husky Health
IF FIPE4 = 8 THEN CHIPFILL = The Delaware Healthy Children Program or DHCP
IF FIPE4 = 9 THEN CHIPFILL = DC Healthy Families
IF FIPE4 = 10 THEN CHIPFILL = Florida KidCare
IF FIPE4 = 11 THEN CHIPFILL = PeachCare for Kids
IF FIPE4 = 12 THEN CHIPFILL = Children’s Health Insurance Program or CHIP
IF FIPE4 = 13 THEN CHIPFILL = Medicaid for Children
IF FIPE4 = 14 THEN CHIPFILL = All Kids
IF FIPE4 = 15 THEN CHIPFILL = Hoosier Healthwise, Children’s Health Insurance
Program, or CHIP
IF FIPE4 = 16 THEN CHIPFILL = Healthy and Well Kids in Iowa or Hawki
IF FIPE4 = 17 THEN CHIPFILL = Healthy Kansas Kids
IF FIPE4 = 18 THEN CHIPFILL = KCHIP or Kentucky Children’s Health Insurance
Program
IF FIPE4 = 19 THEN CHIPFILL = Louisiana Children’s Health Insurance Program or
LaCHIP
IF FIPE4 = 20 THEN CHIPFILL = Maine Children’s Health Insurance Program
IF FIPE4 = 21 THEN CHIPFILL = Maryland Children’s Health Program or MCHP
IF FIPE4 = 22 THEN CHIPFILL = MassHealth

687

IF FIPE4 = 23 THEN CHIPFILL = MIChild
IF FIPE4 = 24 THEN CHIPFILL = MinnesotaCare
IF FIPE4 = 25 THEN CHIPFILL = Mississippi Children’s Health Insurance Program or
CHIP
IF FIPE4 = 26 THEN CHIPFILL = MO HealthNet for Kids
IF FIPE4 = 27 THEN CHIPFILL = Healthy Montana Kids or HMK
IF FIPE4 = 28 THEN CHIPFILL = Children’s Health Insurance Program or CHIP
IF FIPE4 = 29 THEN CHIPFILL = Nevada Check Up or SCHIP
IF FIPE4 = 30 THEN CHIPFILL = Children’s Medicaid or CM
IF FIPE4 = 31 THEN CHIPFILL = NJ Family Care
IF FIPE4 = 32 THEN CHIPFILL = Centennial Care, Children’s Health Insurance
Program, or CHIP
IF FIPE4 = 33 THEN CHIPFILL = Child Health Plus
IF FIPE4 = 34 THEN CHIPFILL = NC Health Choice for Children
IF FIPE4 = 35 THEN CHIPFILL = Children’s Health Insurance Program or CHIP
IF FIPE4 = 36 THEN CHIPFILL = Healthy Start or SCHIP
IF FIPE4 = 37 THEN CHIPFILL = SoonerCare
IF FIPE4 = 38 THEN CHIPFILL = Oregon Health Plan or OHP
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 = 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
IF FIPE4 = 52 THEN CHIPFILL = Children's Health Insurance Program or CHIP
IF FIPEF4 = 53 THEN CHIPFILL = Children's Health Insurance Program or CHIP
ELSE CHIPFILL = BLANK
QHI02A [IF CURNTAGE = 12-19] [CHIPFILL] is a program that covers children from lowincome 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

688

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?
Click Help to see more information on TRICARE, CHAMPUS, CHAMPVA, the VA
and military health care.
PROGRAMMER: INCLUDE THE DEFINITIONS
BELOW WHEN THE R CLICKS HELPCHAMPUS
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 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

689

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

QHI11

[IF (QHI01 = 2 OR QHI01v = 2) AND (QHI02 = 2 OR QHI02v = 2) AND QHI03 =
2 AND QHI06 = 2 AND (IF CURNTAGE = 12 - 19: QHI02a = 2)] [SAMPLE
MEMBER A] currently covered by any kind of health insurance, that is, any policy or
program that provides or pays for medical care?
For Indian Health Insurance, please click “Yes”.
1
Yes
2
No
DK/REF

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?
If less than one month, please enter “1”.
# OF MONTHS:
[RANGE: 1 - 12]
DK/REF

QHI15

months in the past 12 months

[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?
690

1
Within the past 6 months
2
More than 6 months ago, but within the past year
3
More than 1 year ago, but within the past 3 years
4
More than 3 years ago
5
Never had coverage
DK/REF
QHI17

[IF QHI15 = 1 - 4 OR DK/REF] Which of the reasons below is the main reason why
[SAMPLE MEMBER] stopped being covered by health insurance?
1
2

Person in family with health insurance lost job or changed employers
Lost medicaid or medical assistance coverage because of new job or increase
in income
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

PROGRAMMER: DROP DOWN BOX FOR MOBILE
QHI18

[IF QHI15 = 5] Which of these reasons on this card describe why [SAMPLE
MEMBER] never had health insurance coverage?
Select all that apply.
1
Cost is too high/can’t afford premiums
2
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

691

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 their family living here, including you, their
[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].
Click Next to continue.
QI01N

Social Security or Railroad Retirement payments are paid by the U.S. Government to
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?
[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?

692

[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

[IF FIPE4 = 1 -51 OR 53] 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 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?

693

[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
IF FIPE4 = 2 THEN TANFFILL = the Alaska Temporary Assistance Program or ATAP
IF FIPE4 = 3 THEN TANFFILL = Cash Assistance
IF FIPE4 = 4 THEN TANFFILL = Transitional Employment Assistance or TEA
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 Family Assistance or TFA
IF FIPE4 = 8 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 9 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 10 THEN TANFFILL = Temporary Cash Assistance or TCA
IF FIPE4 = 11 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 12 THEN TANFFILL = Temporary Assistance for Needy Families, TANF,
Temporary Assistance to Other Needy Families or TAONF
IF FIPE4 = 13 THEN TANFFILL = Temporary Assistance for Families in Idaho or TAFI
IF FIPE4 = 14 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 15 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 16 THEN TANFFILL = the Family Investment Program or FIP
IF FIPE4 = 17 THEN TANFFILL = the Successful Families Program
IF FIPE4 = 18 THEN TANFFILL = the Kentucky Transitional Assistance Program or KTAP
IF FIPE4 = 19 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 20 THEN TANFFILL = Temporary Assistance for Needy Families, TANF,
Alternative Aid, or AA
IF FIPE4 = 21 THEN TANFFILL = Temporary Cash Assistance or TCA
IF FIPE4 = 22 THEN TANFFILL = Transitional Aid to Families with Dependent
Children or TAFDC or Emergency Aid to the Elderly, Disabled, and Children or EAEDC
IF FIPE4 = 23 THEN TANFFILL = Cash Assistance
IF FIPE4 = 24 THEN TANFFILL = the Minnesota Family Investment Program or MFIP
IF FIPE4 = 25 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 26 THEN TANFFILL = Temporary Assistance or TA
IF FIPE4 = 27 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 28 THEN TANFFILL = Aid to Dependent Children or ADC
IF FIPE4 = 29 THEN TANFFILL = Temporary Assistance for Needy Families or TANF

694

IF FIPE4 = 30 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 31 THEN TANFFILL = WorkFirst New Jersey or WFNJ
IF FIPE4 = 32 THEN TANFFILL = Temporary Assistance for Needy Families, TANF,
or NMWorks
IF FIPE4 = 33 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 34 THEN TANFFILL = Work First or WF
IF FIPE4 = 35 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 36 THEN TANFFILL = Ohio Works First, OWF, or Temporary Assistance
for Needy Families, or TANF
IF FIPE4 = 37 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 38 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 39 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 40 THEN TANFFILL = Cash Assistance, Rhode Island Works, RI Works, or
RIW
IF FIPE4 = 41 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 42 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 43 THEN TANFFILL = Families First
IF FIPE4 = 44 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 =45 THEN TANFFILL = Temporary Cash Assistance for Needy Families
IF FIPE4 = 46 THEN TANFFILL = Reach Up
IF FIPE4 = 47 THEN TANFFILL = Temporary Assistance for Needy Families or TANF,
or Virginia Initiative for Education and Work (VIEW)
IF FIPE4 = 48 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
or WorkFirst
IF FIPE4 = 49 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 50 THEN TANFFILL = Wisconsin Works, Temporary Assistance for Needy
Families, or TANF
IF FIPE4 = 51 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 52 THEN TANFFILL = Temporary Assistance for Needy Families or TANF
IF FIPE4 = 53 THEN TANFFILL = Temporary Assistance to Needy Families or 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=52 THEN
“municipality”] [IF FIPE4 NE 2 OR 19 OR 52 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=52 THEN
“municipality”] [IF FIPE4 NE 2 OR 19 OR 52 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

695

receive any cash assistance from a state or [IF FIPE4=2 THEN “borough”] [IF
FIPE4=19 THEN “parish”] [IF FIPE4=52 THEN “municipality”] [IF FIPE4 NE 2 OR
19 OR 52 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=52 THEN
“municipality”] [IF FIPE4 NE 2 OR 19 OR 52 THEN “county”] welfare program
such as [TANFFILL]?
1
Yes
2
No
DK/REF
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

696

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 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=52 THEN “municipality”] [IF FIPE4 NE 2 OR 19
OR 52 THEN “county”]welfare program such as [TANFFILL]
• Any other kind of non-monetary welfare or public assistance
# OF MONTHS RECEIVED ASSISTANCE:
YEAR – 1]
[RANGE: 1 - 12]
DK/REF

months in [CURRENT

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?

697

[ALL] Please include:
• Cash assistance from a state or [IF FIPE4=2 THEN “borough”] [IF FIPE4=19
THEN “parish”] [IF FIPE4=52 THEN “municipality”] [IF FIPE4 NE 2 OR 19
OR 52 THEN “county”] welfare program such as [TANFFILL]
• Any other kind of non-monetary welfare or public assistance
# OF MONTHS RECEIVED ASSISTANCE:
YEAR – 1]
[RANGE: 1 - 12]
DK/REF

months in [CURRENT

INTRTINN Below 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.
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
Click Next 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] This question is 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 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

698

QI21A

[IF QI20N = 2] Which of these income groups 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 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
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

PROGRAMMER: DROP DOWN BOX FOR MOBILE
QI21B

[IF QI20N = 1] Which of these income groups 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 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
22
23
24
25
26
27

$20,000 - $24,999
$25,000 - $29,999
$30,000 - $34,999
$35,000 - $39,999
$40,000 - $44,999
$45,000 - $49,999
$50,000 - $74,999

699

28
$75,000 - $99,999
29
$100,000 - $149,999
30
$150,000 or more
DK/REF
INTROFI1

[IF MORE THAN ONE FAMILY MEMBER IN ROSTER AND IF QI21B NE
30]
The next question is 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 ] Please
combine everyone’s income – that is, yours and that of your [FAMILY
RELATIONSHIP FILL].
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] Please combine
everyone’s income – that is, [SAMPLE MEMBER POSS] and yours.
[IF AT LEAST TWO FAMILY MEMBERS IN ROSTER AND HASJOIN NE 1]
Please 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]
Please combine everyone’s income — that is, yours, [SAMPLE MEMBER
POSS] and that of their [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 listed earlier.
Click Next 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 ore more
2
Less than $20,000
DK/REF

QI23A

[IF QI22=2]
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1] Which of
these income groups represents your total combined family income during

700

[CURRENT YEAR – 1] – that is, yours and that of your [FAMILY
RELATIONSHIP FILL].
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN=1] Which of these
income groups 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]
Which of these income groups 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]
Which of these income groups best represents your total combined family income
during [CURRENT YEAR - 1]-- that is, yours, [SAMPLE MEMBER POSS], and
that of their [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
PROGRAMMER: DROP DOWN BOX FOR MOBILE

701

QI23B

[IF (QI22=1 OR QI20N = 1) AND QI21B NE 30]
[IF ONE FAMILY MEMBER IN ROSTER AND HASJOIN NE 1 ] Which of these
income groups 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] Which of these
income groups 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]
Which of these income groups 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]
Which of these income groups best represents your total combined family income
during [CURRENT YEAR - 1]-- that is, yours, [SAMPLE MEMBER POSS], and
that of their [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

702

CELL2

Do you or anyone at this address have a cell phone that is currently working?
Click Help for more information about this question.
PROGRAMMER: INCLUDE THE FOLLOWING
WHEN THE R CLICKS HELP: 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

Is there at least one telephone at this address that is not a cell phone?
1
Yes
2
No
DK/REF

ENDPROXY [IF HASJOIN=1] Thank you for answering these questions.
Click Next to continue.

703

IncentiveEnd of Interview
INCENTTYPE

Thank you for participating in the National Household Survey on
Behavioral Health! To show our appreciation for completing this
interview, we would like to send you $30, by either electronic pre-paid or
physical Visa or MasterCard gift card. Please indicate how you would like
to receive your $30.
On the next screen enter your contact information. [IF CURNTAGE < 18]
If you choose an electronic gift card, we will ask for your parent or
guardian’s email. This information will be kept separate from the answers
to this survey, and will only be used for the purpose of sending your gift
card.
1. Electronic Visa Gift Card (Delivered by email within two business
days, can only be used for online purchases, and can only be used for
purchases of equal or lesser value )
2. Electronic MasterCard Gift Card (Delivered by email within two
business days, can only be used for online purchases, and can only be
used for purchases of equal or lesser value )
3. Physical Visa Gift Card (Delivered by mail within 4-6 weeks and can
be used in stores and online)
4. Physical MasterCard Gift Card (Delivered by mail within 4-6 weeks
and can be used in stores and online)
5. No, thanks. I decline the $30

DEFINE EMAILFILL
IF CURNTAGE ≥ 18 THEN, EMAILFILL = “your”
ELSE EMAILFILL = “your parent or guardian’s”
EADDRESS [IF INCENTTYPE = 1 OR 2]
The email message will be from [email protected] and the subject line
will say “How to Redeem Your $30 [Visa OR MasterCard] Card.” If you’d like a
physical gift card instead, click Back to change your selection.
Please enter [EMAILFILL] email address to receive the electronic gift card.
[EMAILADD]
Please re-enter [EMAILFILL] email address
[EMAILADD2]
ERROR MESSAGE: IF EMAILADD NE EMAILADD2: The email addresses do
not match. Please re-enter them.

704

MAILINCENT

[IF INCENTTYPE = 3 OR 4] Please enter the address you want us to mail
the gift card to. If you’d like an electronic gift card instead, click Back to
change your selection.
Street address 1: [MADDRESS]
Street address 2: [MADDRESS2]
Please enter your city.
City: [MCITY]
Please enter your state [IF FIPE4 = 52], including Puerto Rico.
State: [MSTATE]
Please enter your zip code.
Zip: [MZIP]

INCENTCON [IF INCENTTYPE = 3 OR 4] Your gift card will be delivered to you in a RTI
standard business sized envelope. Since we do not have your name, the letter will
be directed to you using your age.
Is this information correct?
FILL:
ADDRESS/PO BOX: [MADDRESS]
[MADDRESS2]
CITY: [MCITY]
STATE: [MSTATE]
ZIP: [MZIP]
1. Yes
2. No
IF NO IS ENTERED: Please click Back to go back one screen and enter the correct
information.

FIEXIT
That is all the questions we have for you. Thank you for participating in the National Household
Survey on Behavioral Health.

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706