Question Provenance

Attachment 2: Provenance of Questions to be Cognitively Tested

The cannabis questions were compiled and developed by CDC’s Cannabis Strategy Unit, state and federal agencies contributing to the Behavioral Health Coordinating Committee (BHCC) report on the state of cannabis surveillance in the U.S., and the Council for State and Territorial Epidemiologists (CSTE) Cannabis Subcommittee.

The origin and rationale for each of the questions are described below:

Question 1: This question was modified from the Behavioral Risk Factor Surveillance System (BRFSS) and National Survey on Drug Use and Health (NSDUH) questions on past 30-day marijuana use, which have been cognitively tested previously. The goal of the question is to ascertain possible ways to segment hemp data from marijuana data and to collect basic data on hemp/CBD utilization. The question was revised after an initial round of evaluation by NCHS/CCQDER.

Question 2: This question was modified from the BRFSS marijuana mode of use question, which has been cognitively tested previously. The goal of the question is to understand the different ways that people use marijuana and CBD and if modes of use differ by product type. The question was revised after an initial round of evaluation by NCHS/CCQDER.

Question 3: This question was modified from NSDUH. The question was revised after an initial round of evaluation by NCHS/CCQDER.

Question 4: These questions were modified from the Youth Risk Behavioral Surveillance System (YRBSS) introductory language, which was cognitively tested in Spring 2020. The question was revised after an initial round of evaluation by NCHS/CCQDER.

Question 5: This question was modified from NSDUH and developed for the BHCC report in conjunction with SAMHSA colleagues. It was cognitively tested for NSDUH. The question goal is to assess whether point of access/purchase could be used as a proxy to understand if people are reporting hemp/CBD-only use. The question was revised after an initial round of evaluation by NCHS/CCQDER.

Question 6: This question was developed with state and federal agency input for the BHCC report. The question goal is to understand polysubstance use and substances that may be co-administered or used in close proximity to marijuana. The question was revised after an initial round of evaluation by NCHS/CCQDER.

Question 7: This question was developed with state and federal agency input for the BHCC report. The goal is to assess potential substitution across substances. The question was revised after an initial round of evaluation by NCHS/CCQDER.

Question 8: This question was modified from the Oregon BRFSS and includes modifications in probes from questions asked by other states in their BRFSS modules. The goal is to assess impaired driving. The question was revised after an initial round of evaluation by NCHS/CCQDER.

Questions 9-10: These questions were modified with input from states and CSTE from tobacco control questions. The goal is to assess health professional engagements related to marijuana. The question was revised after an initial round of evaluation by NCHS/CCQDER.

Question 11: This question resulted from the combination of two questions assessing behaviors related to reducing or stopping marijuana use evaluated by NCHS/CCQDER in an initial round of testing. The original questions were developed with input from states and CSTE from tobacco control questions. The question was revised after an initial round of evaluation by NCHS/CCQDER.

Question 12: This question was modified from a tobacco control question that was cognitively tested in youth in 2018-2019. The goal is to assess household exposure to marijuana.

Question 13: This question was modified from the Oregon BRFSS. The goal of the question is to assess exposure to industry advertising and marketing. The question was revised after an initial round of evaluation by NCHS/CCQDER.

Question 14: This question was developed in conjunction with CSTE and state agencies. The goal is to assess exposure to prevention messaging. The question was revised after an initial round of evaluation by NCHS/CCQDER.

Question 15: This question was developed for the International Cannabis Policy Study funded by the Canadian Institutes of Health Research and modified by NCIPC/DOP/CSU.

Question 16, versions 1 and 2: These questions were modified from state-based marijuana user surveys in states that have legalized adult nonmedical use. The goal is to assess changes to patterns of marijuana use since a state marijuana policy change. The questions were revised after an initial round of evaluation by NCHS/CCQDER.

Question 17: This question was developed for the International Cannabis Policy Study funded by the Canadian Institutes of Health Research. The goal of this question is to ascertain consumer knowledge of their product consumption, particularly CBD ratio. The question was revised after an initial round of evaluation by NCHS/CCQDER.