ATTACHMENT #1- 1-12-10:
2010-2011 Tobacco Use Supplement to the Current Population Survey
OMB #: 0925-0368 Expires: April 2013 (expected date)
Public reporting burden for this collection of information is estimated to average 9 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: NIH Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0368). Do not return the completed form to this address.
2010-2011 Tobacco Use Supplement to the Current Population Survey- [ Rv 1-12-10 updt mthol B2a ]
All skip paths should go to the next item unless otherwise instructed. All item questions accept don’t know and refused as response. All <D> and <R> pre-codes are to be blind coded. Use blind coded <L> to go to END.
Allow Proxy interviews on the 4th callback.
PRESUP This month we would also like to ask about your thoughts and experiences concerning tobacco use. I need to ask each individual, age 18 years old and older, these questions.
ENTER (P) TO PROCEED
ENTER (I) FOR IMPORTANCE OF RESPONDING
|__|
H_SUPP_I Your answers to the tobacco questions are very important. The National Institutes of Health, CDC, and other researchers will use this information to measure changes in tobacco use and to help with policy-making and services.
PRESS ENTER TO CONTINUE
NXTPR |
ENTER LINE NO: |__|__| FOR [fill name]
I (also) need to talk with [fill name/READ LIST OF NEEDED PERSONS]. Is he/she at home now/Are either of them at home now/Are any of them at home now)?
NO ONE ELIGIBLE, SKIP TO FIN (F10) IF ANSWERED, JUMP FORWARD (F3)
GET SELF RESPONSE ONLY. WHEN DONE, F10 FOR CALLBACKS CALLBACK #: [fill number]
(R) Respondent Refused for someone else
ENTER LINE NUMBER FOR INTERVIEW: |__|__| |
HOUSEHOLD ROSTER LN Q NEED NAME M AGE 01 (Person 1) 02 (Person 2) 03 (Person 3) |
NXTPR3 DO NOT ASK, INTERVIEWER CHECK ITEM
(ONLY TAKE A PROXY IF THIS IS THE 4TH CALLBACK, THE PERSON WILL NOT RETURN BEFORE CLOSEOUT OR THE HOUSEHOLD IS GETTING IRRITATED.)
Is this a Self or Proxy response?
(1) Self [GO TO A1]
(2) Proxy
|__|
EPROXY DO NOT ASK
POSSIBLE ERROR
You have picked PROXY for [fill name] even though [fill name] is the current respondent.
Are you currently talking to [fill name]?
(1) Yes, SELF interview [GO TO A1]
(2) No
|__|
NXTPER5 |
DO NOT ASK ENTER LINE NUMBER OF CURRENT RESPONDENT |__|__|
|
HOUSEHOLD ROSTER LN NAME 01 (Person 1) 02 (Person 2) 03 (Person 3) |
SECTION A. SCREENING FOR EVER/EVERYDAY/SOMEDAY SMOKING
A1 (Have/Has) (you/name) smoked at least 100 cigarettes in (your/his/her) entire life?
[FR NOTE: 100 CIGARETTES = APPROXIMATELY 5 PACKS]
(1) YES [GO TO A2]
(2) NO [GO TO SECTION J]
[ DON’T KNOW OR REFUSED: GO TO SECTION J]
A2 How old (were/was) (you/name) when (you/he/she) first started smoking cigarettes FAIRLY REGULARLY?
ENTER (X) IF NEVER SMOKED REGULARLY: [GO TO A2a]
ENTER AGE (01 – AGE): [GO TO A2b]
|__|__|
[Age >5: GO TO A2b ]
[AGE Less Than OR Equal 5: GO TO A2V]
[DON’T KNOW OR REFUSED: GO TO A2b]
A2V I have recorded that (you/name) (were/was) [fill entry A2] years old when (you/he/she) started smoking cigarettes fairly regularly. Is that correct?
Yes [GO TO A2b]
No [GO TO A2]
|__|
A2a You said that (you/name) never smoked regularly. How old (were/was) (you/name) the first time (you/he/she) smoked part or all of a cigarette?
ENTER AGE: [SKIP TO A2c]
|__|__|
[DON’T KNOW OR REFUSED: GO TO A2c]
A2b In what state or country did (you/name) live when (you/he/she) started to smoke cigarettes fairly regularly?
| (H)| Help [GIVES STATE/COUNTRY ABBREVIATIONS]
|__|__| ENTER STATE/COUNTRY ABBREVIATION GO TO A3
[DON’T KNOW OR REFUSED: GO TO A3]
A2c In what state or country did (you/name) live when (you/he/she) FIRST smoked part or all of a cigarette?
| (H)| Help [GIVES STATE ABBREVIATIONS]
|__|__| ENTER STATE ABBREVIATION GO TO A3
[DON’T KNOW OR REFUSED: GO TO A3]
A3 (Do/Does) (you/name) now smoke cigarettes every day, some days, or not at all?
(1) Every day
(2) Some days
(3) Not at all
|__|
BOX 1
IF SELF RESPONDENT AND:
A3 = (1) EVERY DAY SMOKERS GO TO SECTION B
A3 = (2) SOME-DAY SMOKERS GO TO SECTION C
A3 = (3) NOT-AT-ALL SMOKERS GO TO SECTION H
A3 = D, R GO TO SECTION J
IF PROXY RESPONDENT GO TO SECTION J
SECTION B. EVERY-DAY SMOKER HISTORY/CONSUMPTION SERIES
B1 On the average, about how many cigarettes do you now smoke each day?
(ONE PACK USUALLY EQUALS 20 CIGARETTES. IF CONVERTING PACKS TO CIGARETTES, ALWAYS VERIFY CALCULATION WITH RESPONDENT.)
ENTER NUMBER OF CIGARETTES PER DAY
(1-96)
|__||__|
BOX 2
IF B1 = D, R GO TO B1a
IF B1 > 40 GO TO B1v
ELSE GO TO B2
B1a Would you say that, on average, you now smoke more or less than 20 cigarettes each day?
(1) MORE
(2) LESS
(3) ABOUT 20 (ONE PACK)
|__|
[1, 2, OR 3: GO TO B2]
[Don’t Know OR Refused: GO TO B2]
B1v I have recorded that on the average, you now smoke [fill entry B1] cigarettes a day. Is that correct?
(1) Yes [GO TO B2]
(2) No [GO TO B1]
|__|
[Don’t Know OR Refused: GO TO B2]
B2 Do you usually smoke menthol or non-menthol cigarettes?
(1) Menthol
(2) Non-menthol
(3) NO USUAL TYPE
|__|
[1 or 2: GO TO B2a]
[ 3, Don’t Know OR Refused: GO TO B5a]
B2a For each of the following, please tell me whether it’s a reason you usually smoke menthol/non-menthol { fill menthol if B2 = 1; fill non-menthol if B2 = 2 } cigarettes? ----Please answer “yes” or “no” for each.
(1) Yes
(2) No
B2a@1 |__| (A) They are less harmful than non-menthol /menthol {{fill non-menthol if B2 = 1; fill menthol if B2 = 2—NOTE: Opposite of the fill in the question stem B2a} cigarettes
B2a@2 |__| (B) They are less harsh on your THROAT than non-menthol /menthol {{fill non-menthol if B2 = 1; fill menthol if B2 = 2—NOTE: Opposite of the fill in the question stem B2a} cigarettes
B2a@3 |__| (C) They have a better flavor than non-menthol /menthol {{fill non-menthol if B2 = 1; fill menthol if B2 = 2—NOTE: Opposite of the fill in the question stem B2a} cigarettes
B2a@4 |__| (D) They are less harsh on your CHEST than non-menthol/menthol { fill non-menthol if B2 = 1; fill menthol if B2 = 2 } cigarettes
B5a How soon after you wake up do you typically smoke your first cigarette of the day?
(IF NECESSARY, FR ASK FOR BEST ANSWER IN MINUTES OR HOURS)
ENTER (X) IF RESPONDENT INSISTS IT VARIES
B5a@NUM ENTER NUMBER (1 – 90 for minutes)
|__|__|
B5a@UNT ENTER UNIT REPORTED
|__| (1) Minutes (2) Hours
BOX 5
IF B5a = X, D, R GO TO B5b
ELSE GO TO B5c
B5b Would you say you smoke your first cigarette of the day within the first 30 minutes?
(1) Yes
(2) No
(3) Varies— DO NOT READ
|__|
[1, 2, OR 3: GO TO B5c]
[Don’t know OR Refused: GO TO B5c]
B5c Do you sometimes awaken at night to have a cigarette?
Yes
No
DO NOT READ
DON’T SLEEP AT NIGHT
USE SOME OTHER TOBACCO PRODUCT WHEN I AWAKEN DURING THE NIGHT
|__|
BA6a Do you USUALLY BUY your own cigarettes?
(1) Yes [GO TO B6a]
(2) No [GO TO B6e1]
|__|
[Don’t Know OR Refused: GO TO B6e1]
B6a Do you USUALLY buy your cigarettes by the pack or by the carton? [FR: A CARTON HAS 10 PACKS]
(1) Pack
(2) Carton
(3) Buy both packs and cartons
|__|
BOX 6
IF B6a = (1) OR (3) OR D, R GO TO B6b
IF B6a = (2) GO TO B6c
B6b What price did you pay for the LAST PACK of cigarettes you bought? Please report the cost after using discounts or coupons. [FR: PRICE PER PACK]
$___ ___ . ___ ___ [GO TO B6d]
[Don’t know OR Refused: GO TO B6d]
B6c What price did you pay for the LAST CARTON of cigarettes you bought? Please report the cost after using discounts or coupons. [FR: PRICE PER CARTON]
$__ __ __.__ __ GO TO B6d
[Don’t know OR Refused: GO TO B6d]
B6d Did you buy your LAST (fill appropriate term here from B6a responses (=1 or 3 or DK or R fill “pack”; =2 fill “carton”) of cigarettes in (fill respondent’s state of residence) or in some other state?
B6d1 (1) In respondent’s state of residence
(2) In some other state (including DC)
Enter (X) FOR BOUGHT SOME OTHER WAY (Internet, other country, ...)
|
BOX 7
IF B6d1 =1 ENTER AUTOMATICALLY RESPONDENT’S STATE OF RESIDENCE IN B6d2 GO TO B6d3
ELSE IF B6d = 2 GO TO B6d2
ELSE IF B6d=X GO TO B6dOTHR
ELSE GO TO B6e1
B6d2 In what other state did you buy your LAST (fill appropriate term here from B6a responses (=1, 3, DK or R fill “pack”; =2 fill “carton”) of cigarettes?
| (H) | Help [GIVES STATE ABBREVIATIONS]
|__|__| ENTER STATE ABBREVIATION GO TO B6d3
B6d3 Did you buy your LAST (fill appropriate term here from B6a responses (=1,
3, DK or R fill “pack”; =2 fill “carton”) of cigarettes from an Indian
reservation?
YES- GO TO B6e1
NO GO TO B6e1
[DON’T KNOW OR REFUSED, GO TO B6e1]
ALL GO TO B6e1
B6dOTHR Was the “Other Way” in which you purchased your LAST (fill appropriate term here from B6a responses (=1, 3, DK or R fill “pack”; =2 fill “carton”) of cigarettes:
READ the FIRST THREE CHOICES
(1) In a foreign country or a duty-free shop
(2) From an Indian reservation OR
(3) By mail-order, phone or internet
(4) Some other way (NOT READ)
|__|
If B6dOTHR = (4)--some other way, GO TO B6dSPC; ELSE GO TO B6e1
B6dSPC:_______________________________________________
B6e1 In the LAST 2 months, have you bought any SINGLE or INDIVIDUAL cigarettes? [FR: Respondent may refer to it as a “loosie” or “loose out of the pack”]
Yes
No GO TO B7a
|__|
[Don’t Know OR Refused: GO TO B7a]
B6e2 What price did you pay for the LAST “single or individual” cigarette you bought?
$ __ .__ __ ( FR: price per individual cigarette) [ IF A PRICE IS PROVIDED, or R or DK FOR THIS ITEM, GO TO B6e3]
ELSE IF RESPONDENT SAYS HE USED SOMETHING OTHER THAN MONEY, OR BARTERED OR EXCHANGED CIGARETEES FOR SOMETHING OTHER THAN MONEY, GO TO B6e2a and ASK RESPONDENT TO
B6e2a Please Specify what you exchanged for cigarettes _____________________________________________________________________
B6e3 Did you buy your LAST “single or individual” cigarette in (fill respondent’s state of residence) or in some other state or other country?
B6e31 (1) In respondent’s state of residence
(2) In some other state (including DC)
(3) In another country
Enter (X) FOR BOUGHT SOME OTHER WAY (Internet, etc.)
|__|
BOX 7B
IF B6e31 = 1, ENTER AUTOMATICALLY RESPONDENT’S STATE OF RESIDENCE IN B6e32 GO TO B7a
ELSE IF B6e31= 2, 3 GO TO B6e32
ELSE IF B6e31 = X GO TO B6e3SPC
ELSE GO TO B7a
B6e32 In what OTHER state/country did you buy your LAST SINGLE OR INDIVIDUAL cigarette?
| (H) | Help [GIVES STATE/COUNTRY ABBREVIATIONS]
|__|__| ENTER STATE /COUNTRY ABBREVIATION GO TO B7a
B6e3SPC SPECIFY Other way in which last single cigarette was purchased ____________________________________ GO TO B7a
B7a At what age did you first start to smoke cigarettes EVERY DAY?
ENTER AGE (01 – AGE)
|__|__|
[Age >5: GO TO B7b]
[AGE Less Than OR Equal 5: GO TO B7aV]
[DON’T KNOW OR REFUSED: GO TO B7c]
B7aV I have recorded that you were [fill entry B7a] years old when you started smoking cigarettes EVERY DAY. Is that correct?
Yes [GO TO B7b]
No [GO TO B7a]
|__|
B7b When you first started to smoke EVERY DAY, were you living in [fill state/country from A2b] or somewhere else?
in state/country from A2b
somewhere else, SPECIFY OTHER STATE /COUNTRY
| (H) | Help [GIVES STATE/COUNTRY ABBREVIATIONS]
|__|__| ENTER STATE /COUNTRY ABBREVIATION
B7c For how long have you smoked EVERY DAY – READ CHOICES 1-4
All or nearly all the years you have smoked
Most of the years you have smoked
Half of the years you have smoked, OR -
Less than half the years you have smoked
IF VOLUNTEERED: LESS THAN ONE YEAR
|__|
IF B2 = 1, GO TO B7c3; ELSE IF B2 =2, 3, R, OR DK, GO TO B7c2
B7c2 Have you EVER smoked MENTHOL cigarettes for 6 months or more?
(1) Yes
(2) No
|__|
IF B7c2 = 1, THEN GO TO B7c3, ELSE GO TO B7d.
B7c3 For how long have you smoked MENTHOL cigarettes – READ CHOICES 1-4
All or nearly all the years you have smoked
Most of the years you have smoked
Half of the years you have smoked, OR -
Less than half the years you have smoked
IF VOLUNTEERED: LESS THAN ONE YEAR
|__|
B7d Think of the time during your life when you SMOKED THE MOST. During that time, how many cigarettes did you smoke each day?
[ ONE PACK USUALLY EQUALS 20 CIGARETTES. IF CONVERTING PACKS TO CIGARETTES, ALWAYS VERIFY CALCULATION WITH RESPONDENT.]
ENTER NUMBER OF CIGARETTES PER DAY
(1-96)
|__|__| IF 40: GO TO B8
[If >40: GO TO B7dV]
[Don’t Know OR Refused: GO TO B8]
B7dV I have recorded that the time during your life when you SMOKED THE MOST, you smoked [fill entry B7d] cigarettes each day. Is that correct?
(1) Yes [GO TO B8]
(2) No [GO TO B7d]
|__|__|
[Don’t Know OR Refused: GO TO B8]
B8 Around this time 12 MONTHS AGO, were you smoking cigarettes every day, some days, or not at all?
(1) Every day IF B8=1 GO TO B9
(2) Some days IF B8=2 GO TO B10a
(3) Not at all IF B8 =3 GO TO D1R ( 3rd QUESTION IN QUIT ATTEMPT SECTION
|__|
IF B8=DK, R GO TO B11
B9 Around this time 12 MONTHS AGO, on the average, about how many cigarettes did you smoke each day?
(ONE PACK USUALLY EQUALS 20 CIGARETTES. IF CONVERTING PACKS TO CIGARETTES, ALWAYS VERIFY CALCULATION WITH RESPONDENT.)
ENTER NUMBER OF CIGARETTES PER DAY
(1-96)
|__||__|
BOX 7C
IF B9 = D, R GO TO B11
IF B9 > 40 GO TO B9v
ELSE GO TO B11
B9v I have recorded that on the average, you smoked [fill entry B9] cigarettes a day 12 months ago. Is that correct?
(1) Yes
(2) No GO TO B9
|__| IF B9v =1 OR B9v = D, R GO TO B11
B10a Around this time 12 MONTHS AGO, on how many of 30 days in the month did you smoke cigarettes?
ENTER (X) FOR NONE
|__|__| Range 1-30
BOX 7D
IF B10a = X OR 30 GO TO B10aV
ELSE GO TO B10b
B10aV You said that you smoked cigarettes some days. Is that correct?
(1) Yes
(2) No
|__|
BOX 7E
IF (B10aV = 1 AND B10a= 30 ), OR B10aV = DK, R GO TO B10b
IF B10aV = 1 AND B10a= X GO TO B11
IF B10aV = 2 GO TO B8
B10b On the average, on those [If B10a = 1-30 (Fill entry B10a days) If B10a=D, R (Fill days you smoked)], how many cigarettes did you usually smoke each day?
WE ARE STILL TALKING ABOUT “AROUND THIS TIME 12 MONTHS AGO”
|__|__| Range 1-96 IF 40 GO TO B11; ELSE IF B10b = D, RB11
B10bV I have recorded that on the average, when you smoked on those [fill entry B10a] days, you smoked [fill entry B10b] cigarettes a day. Is that correct?
(1) Yes
(2) No GO TO B10b
|__|
B11 Around this time 12 MONTHS AGO, were you usually smoking menthol or non-menthol cigarettes?
(1) Menthol
(2) Non-menthol
(3) NO USUAL TYPE
|__|
EVERY-DAY SMOKERS (A3=1) GO TO D1R ( 3rd QUESTION IN QUIT ATTEMPT SECTION)
SECTION C. SOME-DAY SMOKER SERIES
C1 On how many of the past 30 days did you smoke cigarettes?
ENTER (X) FOR NONE
|__|__|
BOX 9
IF C1 = X OR 30 GO TO C1v
ELSE IF C1=DK, R GO TO C1i
ELSE GO TO C1a
C1v You said that you smoked cigarettes some days. Is that correct?
(1) Yes
(2) No
|__|
BOX 10
IF C1v = 1 AND C1 = 30 GO TO C1a
IF C1v = 1 AND C1 = X GO TO C2
IF C1v = 2 GO TO A3
IF C1v = DK, R GO TO C1a
C1i Would you say you smoked on AT LEAST 12 DAYS in the past 30 days?
Yes
(2) No
|__|
C1a On the average, on those [C1] days, how many cigarettes did you usually smoke each day?
|__|__| IF 40 GO TO C2
[IF >40, GO TO C1aV]
[Don’t Know OR Refused: GO TO C2]
C1aV I have recorded that on the average, when you smoked on those [C1] days, you smoked [C1a] cigarettes a day. Is that correct?
(1) Yes [GO TO C2]
(2) No [GO TO C1a]
|__|
[Don’t Know OR Refused: GO TO C2]
C2 Do you usually smoke menthol or non-menthol cigarettes?
(1) Menthol
(2) Non-menthol
(3) NO USUAL TYPE
|__|
[1 or 2: GO TO C2a]
[ 3, Don’t Know OR Refused: GO TO C5a]
C2a For each of the following, please tell me whether it’s a reason you usually smoke menthol/non-menthol { fill menthol if C2 = 1; fill non-menthol if C2 = 2 } cigarettes ? ----Please answer “yes” or “no” for each.
(1) Yes
(2) No
C2a@1 |__| (A) They are less harmful than non-menthol /menthol {{fill non-menthol if C2 = 1; fill menthol if C2 = 2—NOTE: Opposite of the fill in the question stem C2a} cigarettes
C2a@2 |__| (B) They are less harsh on your THROAT than non-menthol /menthol {{fill non-menthol if C2 = 1; fill menthol if C2 = 2—NOTE: Opposite of the fill in the question stem C2a} cigarettes
C2a@3 |__| (C) They have a better flavor than non-menthol /menthol {{fill non-menthol if C2 = 1; fill menthol if C2 = 2—NOTE: Opposite of the fill in the question stem C2a} cigarettes
C2a@4 |__| (D) They are less harsh on your CHEST than non-menthol/menthol { fill non-menthol if C2 = 1; fill menthol if C2 = 2 — NOTE: Opposite of the fill in the question stem C2a} cigarettes
C5a On the days that you smoke, how soon after you wake up do you typically smoke your first cigarette of the day?
(IF NECESSARY, FR ASK FOR BEST ANSWER IN MINUTES OR HOURS)
ENTER (X) IF RESPONDENT INSISTS IT VARIES
C5a@NUM ENTER NUMBER (1 – 90 for minutes)
|__|__|
C5a@UNT ENTER UNIT REPORTED
|__| (1) Minutes (2) Hours
BOX 13
IF C5a = X, D, R GO TO C5b
ELSE GO TO C5c
C5b On the days that you smoke, would you say you smoke your first cigarette of the day within the first 30 minutes?
(1) Yes
(2) No
(3) Varies— DO NOT READ
|__|
[GO TO C5c]
C5c Do you sometimes awaken at night to have a cigarette?
(1) Yes
(2) No
DO NOT READ
DON’T SLEEP AT NIGHT
USE SOME OTHER TOBACCO PRODUCT WHEN I AWAKEN DURING THE NIGHT
|__|
*CA6a Do you USUALLY BUY your own cigarettes?
(1) Yes (GO TO C6a)
No (GO TO C6e1)
|__|
[Don’t Know OR Refused: GO TO C6e1]
C6a Do you USUALLY buy your cigarettes by the pack or by the carton? [FR: A CARTON HAS 10 PACKS]
(1) Pack
(2) Carton
(3) Buy both packs and cartons
|__|
BOX 14
IF C6a = (1) OR (3) OR DK, R GO TO C6b
IF C6a = (2) GO TO C6c
C6b What price did you pay for the LAST PACK of cigarettes you bought? Please report the cost after using discounts or coupons. [FR: PRICE PER PACK]
$___ ___.___ ___GO TO C6d
[Don’t Know OR Refused: GO TO C6d]
C6c What price did you pay for the LAST carton of cigarettes you bought? Please report the cost after using discounts or coupons. [FR: PRICE PER CARTON]
$__ __ __.__ __ GO TO C6d
[Don’t Know OR Refused: GO TO C6d]
C6d Did you buy your LAST (fill appropriate term here from C6a responses (=1, 3, DK or R fill “pack”; =2 fill “carton”) of cigarettes in [fill respondent’s state of residence] or in some other state?
C6d1 (1) In respondent’s state of residence
(2) In some other state (including DC)
Enter (X) FOR BOUGHT SOME OTHER WAY (Internet, other country, ...)
|__|
BOX 15
IF C6d1 =1, ENTER AUTOMATICALLY RESPONDENT’S STATE OF RESIDENCE IN C6d2 GO TO C6d3
ELSE IF C6d1 = 2 GO TO C6d2
ELSE IF C6d1 = X GO TO C6dOTHR
ELSE GO TO C6e1
C6d2 In what other state did you buy your LAST (fill appropriate term here: pack/carton) of cigarettes?
| (H) | Help [GIVES STATE ABBREVIATIONS]
|__|__| ENTER STATE ABBREVIATION GO TO C6d3
C6d3 Did you buy your LAST (fill appropriate term here from C6a responses (=1,
3, DK or R fill “pack”; = 2 fill “carton”) of cigarettes from an Indian reservation?
(1)YES- GO TO C6e1
(2)NO GO TO C6e1
[DON’T KNOW OR REFUSED, GO TO C6e1]
|
ALL GO TO C6e1
C6dOTHR Was the “Other Way” in which you purchased your LAST (fill appropriate term here from C6a responses (=1, 3, DK or R fill “pack”; =2 fill “carton”) of cigarettes:
READ the FIRST THREE CHOICES
(1) In a foreign country or a duty-free shop
(2) From an Indian reservation OR
(3) By mail-order, phone or internet
(4) Some other way (NOT READ)
|__|
If C6dOTHR = (4)--some other way, GO TO C6dSPC; ELSE GO TO C6e1
C6dSPC - Specify: ______________________________________
C6e1 In the LAST 2 months, have you bought any SINGLE or INDIVIDUAL cigarettes? [FR: Respondent may refer to it as a “loosie” or “loose out of the pack”]
Yes
(2) No GO TO C7a
[Don’t Know OR Refused: GO TO C7a]
C6e2 What price did you pay for the LAST “single or individual” cigarette you bought?
$__ .__ __ ( FR: price per “individual” cigarette) [ IF A PRICE IS PROVIDED, or R or DK FOR THIS ITEM,GO TO C6e3]
ELSE IF RESPONDENT SAYS HE USED SOMETHING OTHER THAN MONEY, OR BARTERED OR EXCHANGED CIGARETEES FOR SOMETHING OTHER THAN MONEY, GO TO B6e2a and ASK RESPONDENT TO
B6e2a Please Specify what you exchanged for cigarettes _____________________________________________________________________
[Don’t Know OR Refused: GO TO C6e3]
C6e3 Did you buy your LAST SINGLE or INDIVIDUAL cigarette in [fill respondent’s state of residence] or in some other state or other country?
C6e31 (1) In respondent’s state of residence
In some other state (including DC)
In another country
Enter (X) FOR BOUGHT SOME OTHER WAY (Internet, etc..)
|__|
BOX 15B
IF C6e31 =1, ENTER AUTOMATICALLY RESPONDENT’S STATE OF RESIDENCE IN C6e32 GO TO C7a
ELSE IF C6e31 = 2, 3 GO TO C6e32
ELSE IF C6e31 = X GO TO C6e3SPC
ELSE GO TO C7a
C6e32 In what OTHER state or other country did you buy your LAST SINGLE OR INDIVIDUAL cigarette?
| (H) | Help [GIVES STATE/COUNTRY ABBREVIATIONS]
|__|__| ENTER STATE/COUNTRY ABBREVIATION GO TO C7a
C6e3SPC SPECIFY Other way in which last single cigarette was purchased:
________________________________________________________
Past Smoking Behavior for Some-Day Smokers
C7a Have you EVER smoked cigarettes EVERY DAY for at least 6 months?
(1) Yes [GO TO C7a2]
(2) No [If C7a = 2 AND C2=1, GO TO C7d3; Else if C7a =2 AND C2=2, 3, DK, or R, Go to C7d2]
|__|
[If C7a = Don’t Know OR Refused AND If C2=1, GO TO C7d3; Else If C7a = DK or R AND C2=2, 3, DK, or R, GO TO C7d2]
C7a2 At what age did you first start to smoke cigarettes EVERY DAY?
ENTER AGE (01 – AGE)
|__|__|
[Age >5: GO TO C7a3]
[AGE Less Than OR Equal 5: GO TO C7a2V]
[DON’T KNOW OR REFUSED: GO TO C7d]
C7a2V I have recorded that you were [fill entry C7a2] years old when you started smoking cigarettes EVERY DAY. Is that correct?
(1)Yes [GO TO C7a3]
(2)No [GO TO C7a2]
|__|
C7a3 When you first started to smoke EVERY DAY, were you living in [fill state/country from A2b] or somewhere else?
in state/country from A2b
somewhere else, SPECIFY OTHER STATE /COUNTRY
| (H) | Help [GIVES STATE/COUNTRY ABBREVIATIONS]
|__|__| ENTER STATE /COUNTRY ABBREVIATION
C7d For how long have you smoked EVERY DAY – READ CHOICES 1-4
All or nearly all the years you have smoked
Most of the years you have smoked
Half of the years you have smoked, OR -
Less than half the years you have smoked
IF VOLUNTEERED: LESS THAN ONE YEAR
|__|
IF C2 = 1, GO TO C7d3; ELSE IF C2 =2, 3, R, OR DK, GO TO C7d2
C7d2 Have you EVER smoked MENTHOL cigarettes for 6 months or more?
(1) Yes
(2) No
IF C7d2 = 1, THEN GO TO C7d3; ELSE if C7a =2, R, or DK, GO TO C8; ELSE GO TO C7e
C7d3 For how long have you smoked MENTHOL cigarettes – READ CHOICES 1-4
All or nearly all the years you have smoked
Most of the years you have smoked
Half of the years you have smoked, OR -
Less than half the years you have smoked
IF VOLUNTEERED: LESS THAN ONE YEAR
|__|
IF C7a = 2, R, or DK, Go to C8; ELSE Go To C7e
C7e When you last smoked every day, on average how many cigarettes did you smoke each day?
ENTER NUMBER OF CIGARETTES EACH DAY
(1‑99)
|__|__| IF 40: GO TO C7f
[If >40: GO TO C7eV]
[Don’t Know OR Refused: GO TO C7f]
C7eV I have recorded that when you last smoked every day, on the average you smoked [fill entry C7e] cigarettes each day. Is that correct?
(1) Yes [GO TO C7f]
(2) No [GO TO C7e]
|__|__|
[Don’t Know OR Refused: GO TO C7f]
C7f Think of the time during your life when you SMOKED THE MOST. During that time, how many cigarettes did you smoke each day?
[ ONE PACK USUALLY EQUALS 20 CIGARETTES. IF CONVERTING PACKS TO CIGARETTES, ALWAYS VERIFY CALCULATION WITH RESPONDENT.)]
ENTER NUMBER OF CIGARETTES PER DAY
(1-96)
|__|__| IF 40: GO TO C8
[If >40: GO TO C7fV]
[Don’t Know OR Refused: GO TO C8]
C7fV I have recorded that the time during your life when you SMOKED THE MOST, you smoked [fill entry C7f] cigarettes each day. Is that correct?
(1) Yes [GO TO C8]
(2) No [GO TO C7f]
|__|__|
[Don’t Know OR Refused: GO TO C8]
C8 Around this time 12 MONTHS AGO, were you smoking cigarettes every day, some days, or not at all?
(1) Every day IF C8 = 1 GO TO C9
(2) Some days IF C8 = 2 GO TO C10a
(3) Not at all IF C8 =3 BOX 18
|__|
IF C8 = DK, R GO TO C11
C9 Around this time 12 MONTHS AGO, on the average, about how many cigarettes did you smoke each day?
(ONE PACK USUALLY EQUALS 20 CIGARETTES. IF CONVERTING PACKS TO CIGARETTES, ALWAYS VERIFY CALCULATION WITH RESPONDENT.)
ENTER NUMBER OF CIGARETTES PER DAY
(1-96)
|__||__|
BOX16B
IF C9 = D, R GO TO C11
IF C9 > 40 GO TO C9v
ELSE GO TO C11
C9v I have recorded that on the average, you smoked [fill entry C9] cigarettes a day 12 months ago. Is that correct?
(1) Yes GO TO C11
(2) No GO TO C9
|__|
C10a Around this time 12 MONTHS AGO, on how many of 30 days in the month did you smoke cigarettes?
ENTER (X) FOR NONE
|__|__|
BOX 16C
IF C10a = X OR 30 GO TO C10aV
If C10a=D, R, GO C10b
ELSE GO TO C10b
C10aV You said that you smoked cigarettes some days. Is that correct?
(1) Yes
(2) No
|__|
BOX 16D
IF (C10aV = 1 AND C10a= 30 ), OR C10aV = DK, R GO TO C10b
ELSE IF C10aV = 1 AND C10a= X GO TO C11
ELSE IF C10aV = 2 GO TO C8
C10b On the average, on those [fill entry C10a; If C10a=D, R (Fill “days you smoked”] days, how many cigarettes did you usually smoke each day?
WE ARE STILL TALKING ABOUT “AROUND THIS TIME 12 MONTHS AGO”
|__|__| Range 1-96 IF 40 GO TO C11; ELSE IF C10b = D, R GO TO C11
C10bV I have recorded that on the average, when you smoked on those [fill entry C10a] days, you smoked [fill entry C10b] cigarettes a day. Is that correct?
(1) Yes
(2) No GO TO C10b
|__|
C11 Around this time 12 MONTHS AGO, were you usually smoking menthol or non-menthol cigarettes?
(1) Menthol
(2) Non-menthol
(3) NO USUAL TYPE
|__|
BOX 18
IF ENTRY IN C1 12 DAYS IN THE PAST 30 DAYS, D1R (3rd question in Section D)
ELSE IF C1i = 1 (Yes) D1R (3rd question in Section D)
ELSE IF C1i = 2 (NO), OR C1i = DK, R Da
ELSE IF C1 < 12 Da
SECTION D. PAST 12-MONTH QUIT ATTEMPTS FOR CURRENT EVERY-DAY
AND SOME-DAY SMOKERS
PAST 12-MONTH QUIT ATTEMPTS FOR SOME-DAY SMOKERS SMOKING <12 DAYS IN THE PAST 30 DAYS
Da During the PAST 12 MONTHS, have you TRIED to QUIT smoking COMPLETELY?
(1) Yes [GO TO D3b]
(2) No [GO TO Db]
|__|
[Don’t Know OR Refused: GO TO Db]
Db Have you EVER TRIED to QUIT smoking COMPLETELY?
(1) Yes
(2) No
|__|
All responses GO TO F1a
PAST 12-MONTH QUIT ATTEMPTS FOR EVERY-DAY AND SOME-DAY SMOKERS (some day smokers smoking >=12 days during the past 30 days)
Quit attempts of 1 day or longer:
D1R During the PAST 12 MONTHS, have you stopped smoking for ONE DAY or longer BECAUSE YOU WERE TRYING TO QUIT SMOKING?
(1) Yes [GO TO D3]
(2) No [GO TO D7R]
|__|
[Don’t Know OR Refused: GO TO D7R]
D3 How many TIMES during the past 12 months have you stopped smoking for one day or longer BECAUSE YOU WERE TRYING TO QUIT SMOKING?
FR READ CHOICES
Once (1 time)
2-3 times
4 or more times
|_|
BOX 19
IF D3 = DK/REF GO TO D3b
ELSE GO TO D4
D3b Would you say that during the past 12 months it was MORE THAN 3 TIMES that you have stopped smoking for one day or longer BECAUSE YOU WERE TRYING TO QUIT SMOKING?
(1) Yes
(2) No
|__|
[GO TO D4]
D4 The LAST TIME you stopped smoking during the PAST 12 months because you were TRYING to quit, how long did you stop for?
D4@NUM ENTER NUMBER
(1 – 96)
|__|__|
D4@UNT ENTER UNIT REPORTED
(1) Days
(2) Weeks
(3) Months
(4) Years
|__|
IF D4@NUM AND/OR D4@UNT = DK/REF GO TO D4b
IF D4@NUM >18 AND D4@UNT = 2 GO TO D4V
IF D4@NUM > 12 AND D4@UNT =3 GO TO D4V
IF D4@NUM >2 AND D4@UNT = 4 GO TO D4V
ELSE GO TO D4c
D4v I have recorded that the LAST TIME you stopped smoking in the past 12 months BECAUSE YOU WERE TRYING TO QUIT SMOKING was [fill entry D4@NUM AND D4@UNT]? Is that correct?
(1) Yes GO TO D4c
(2) No GO TO D4
|
D4b Was it more or less than one week?
(1) More
(2) Less
(3) One week
|
D4c When was the approximate END date of this LAST QUIT ATTEMPT that lasted [fill response to D4@NUM, D4@UNT OR fill response to D4b—(more/less than) 1 week]?
Month: __ __ / Day: __ __ / Year: __ __ {FR- last two digits of the year}
D5 Was [fill entry D4 @NUM AND D4@UNT] the LONGEST you went without smoking in the past 12 months?
(1) Yes GO TO SECTION E
(2) No
|__|
D6 During the PAST 12 MONTHS, what is the [LENGTH / LONGEST length: If D3 = 1, fill with “LENGTH;” ELSE fill with “LONGEST Length”] of time you stopped smoking because you were TRYING to quit smoking? [FR NOTE: If quit attempt began more than 12 months ago BUT ended within the past 12 months, count all of it.]
D6@NUM ENTER NUMBER (1 - 96)
|__|__|
D6@UNT ENTER UNIT REPORTED
(1) Days
(2) Weeks
(3)Months
(4)Years
|__|
BOX 20
IF D6@NUM AND/OR D6@UNT = DK/REF GO TO D6b
IF D6@NUM >18 AND D6@UNT = 2 GO TO D6V
IF D6@NUM > 12 AND D6@UNT =3 GO TO D6V
IF D6@NUM >2 AND D6@UNT = 4 GO TO D6V
ELSE GO TO SECTION E
D6V I have recorded that the LONGEST length of time you stopped smoking in the past 12 months because you were TRYING to quit smoking was [fill entry D6@num and
D6@unt]? Is that correct?
(1) Yes [GO TO SECTION E, Box 21]
(2) No [GO TO D6@NUM]
|__|
[Don’t Know OR Refused: GO TO D6b]
D6b Was it more or less than one week?
(1) More
(2) Less
(3) One week
|__| [GO TO SECTION E, Box 21]
Quit attempts of less than a day (if no quit attempts lasting for one DAY or more):
D7R DURING THE PAST 12 MONTHS, have you made a serious attempt to stop smoking because you were TRYING to quit – even if you stopped for less than a day?
(1) Yes [GO TO SECTION E, Box 21]
(2) No [GO TO D8R]
|__|
[Don’t Know OR Refused: GO TO D8R]
D8R Have you EVER made a serious attempt to stop smoking because you were TRYING to quit – even if you stopped for less than a day?
(1) Yes [GO TO F1a]
(2) No [GO TO F1a]
|__|
[Don’t Know OR Refused: GO TO F1a]
SECTION E. METHODS USED DURING PAST (12-MONTH) QUIT ATTEMPTS (EVERY-DAY AND SOME-DAY SMOKERS)
BOX 21
IF D3 = 1, THEN FILL E1a, E1b, E1c AND E2 WITH “The TIME”
ELSE FILL E1a, E1b, E1c AND E2 WITH “The LAST TIME”
E1a Thinking back to the (LAST TIME/time) you tried to QUIT smoking in the past 12 months. Did you use ANY of the following PRODUCTS:
(1) Yes
(2) No
E1a@1 A nicotine patch |__|
E1a@2 A nicotine gum or nicotine lozenge |__|
E1a@3 A nicotine nasal spray or nicotine inhaler |__|
E1ab In total, during the LAST TIME/time you tried to QUIT smoking, how long did you use [fill with EACH E1a@ 1, 2, 3 = 1 (YES) OR IF all three are =1- YES, then fill with “ANY of these” ]
|__|__| @NUM [1-96]
|__|__| @UNT [1= DAYS, 2= WEEKS, 3= Months
E1a@7a A prescription pill, called Chantix or Varenicline ? |__|
E1a@7b A prescription pill, called Zyban, Bupropion, or Wellbutrin? |__|
E1a@7c Another prescription pill |__|
IF E1a@7c = YES, E1a7cSPC SPECIFY: __________________________
E1ac In total, during the LAST TIME/time you tried to QUIT smoking, how long did you use [fill with EACH E1a@7a,b,c =1 (YES) OR IF ALL @7a ,@7b , AND @7c are =1- YES, then fill with “ANY of these prescription PILLS” ]
|__|__| @NUM [1-96]
|__|__| @UNT [1= DAYS, 2= WEEKS, 3= Months
E1b Thinking back to the (LAST TIME/time) you tried to QUIT smoking in the past 12 months:
Did you use ANY of the following: [FR NOTE: FOR THIS QUESTION, RE-READ STEM PERIODICALLY]
(1) Yes
(2) No
E1b@1 |__| (A) A telephone help line or quit line
E1b@2 |__| (B) One-on-one counseling
E1b@3 |__| (C) A stop smoking clinic, class, or support group
E1b@4 |__| (D) Help or support from friends or family
E1b@5 |__| (E) Internet or web-based program
E1b@6 |__| (F) Books, pamphlets, videos, or other materials
E1b@7 |__| (G) Acupuncture or hypnosis
E1b@7a |__| [IF YES] Which - (1) Acupuncture (2) Hypnosis (3) Both
E1c The (LAST TIME / time) you tried to QUIT smoking in the past 12 months: Did you do ANY of the following: : [FR NOTE: FOR THIS QUESTION, RE-READ STEM PERIODICALLY]
(1) Yes
(2) No
E1c@1 |__| (A) Try to quit by GRADUALLY cutting back on cigarettes
E1c@2 |__| (B) Try to quit by SWITCHING to smokeless tobacco such as chewing
tobacco, snuff, or snus
E1c@2b |__| (B2) Try to quit by SWITCHING to regular cigars, cigarillos, little filtered
cigars or pipes filled with tobacco
E1c@3 |__| (C) Did you SWITCH to a “lighter” cigarette in order to TRY TO QUIT:
IF C2=2 (NON-MENTHOL), 3, DK, OR R, GO TO E1c@3b; ELSE IF C2=1, GO TO E1c@3c
E1c@3b |__| (C2) Did you SWITCH to menthol cigarettes in order to TRY TO QUIT----
HELP SCREEN: IF RESPONDENT SAYS THEY WERE ALREADY SMOKING 'MENTHOL CIGARETTES WHEN THEY TRIED TO QUIT-- THEN THE ANSWER IS "NO" THEY DIDN'T SWITCH TO TRY TO QUIT
IF C2=2 (NON-MENTHOL), THEN GO TO E1c@4; ELSE GO TO E1c@3c
E1c@3c |__| (C3) Did you switch to non-menthol cigarettes in order to TRY TO QUIT
HELP SCREEN: IF RESPONDENT SAYS THEY WERE ALREADY SMOKING ”NON-MENTHOL” CIGARETTES WHEN THEY TRIED TO QUIT-- THEN THE ANSWER IS "NO" THEY DIDN'T SWITCH TO TRY TO QUIT
E1c@4 |__| (D) Did you try to give up cigarettes ALL at ONCE
IF E1c@4 = 1 (YES), GO TO E1d; ELSE GO TO F1a
E1d Please tell me which one statement is true about this most recent quit attempt where you tried to give up cigarettes all at once: [IF NEEDED, We are still talking about the past 12 months.]
(1) I tried to quit as soon as I made the decision.
(2) I planned the quit for later the same day.
(3) I planned the quit for a date in the future.
(4) I decided to quit after having NOT smoked for some other reason
|__|
E1e When you tried to quit all at once, would you say you TRIED TO QUIT “cold turkey?
YES
NO
HELP SCREEN: “COLD TURKEY” IS STOPPING ALL AT ONCE WITHOUT ANY AIDS
|__|
(All responses GO TO F1a)
SECTION F. DOCTOR/DENTIST ADVICE TO STOP SMOKING --- CURRENT AND SOME-DAY SMOKERS
The F section has been re-written since the 2003 cycle.
F1a In the PAST 12 MONTHS have you SEEN a medical doctor?
(1) Yes GO TO F1b
(2) No GO TO F2a
|__|
[Don’t Know OR Refused: GO TO F2a]
F1b During the PAST 12 MONTHS, did any medical doctor ADVISE you to stop smoking?
(1) Yes GO TO F1c
(2) No GO TO F2a
|__|
[Don’t Know OR Refused: GO TO F2a]
F1c In the PAST 12 MONTHS, when a medical doctor advised you to quit smoking, did
the doctor also:
Yes
No
F1c@1 |__| (A) Suggest that you call or use a telephone help line or quit line?
F1c@2 |__| (B) Suggest that you use a smoking cessation class, program, or counseling?
F1c@3 |__| (C) Recommend or Prescribe a nicotine product such as patch, gum, lozenge, nasal
spray or inhaler
F1c@4 |__| (D) Prescribe a pill such as Chantiz, Varenicline, Zyban, Bupropion, Wellbutrin
F1c@5 |__| (E) Suggest that you set a specific date to stop smoking?
GO TO F2a
F2a In the PAST 12 MONTHS have you SEEN a dentist?
(1) Yes GO TO F2b
(2) No GO TO G1
|__|
[Don’t Know OR Refused: GO TO G1]
F2b
During the PAST 12 MONTHS,
did any dentist ADVISE you to stop smoking?
(1) Yes GO TO F2c
(2) No GO TO G1
|__|
[Don’t Know OR Refused: GO TO G1]
F2c In the PAST 12 MONTHS, when a dentist advised you to quit smoking, did
the dentist also:
Yes
No
F2c@1 |__| (A) Suggest that you call or use a telephone help line or quit line?
F2c@2 |__| (B) Suggest that you use a smoking cessation class, program, or counseling?
F2c@3 |__| (C) Recommend or Prescribe a nicotine product such as a patch, gum, lozenge,
nasal spray or inhaler
F2c@4 |__| (D) Prescribe a pill such as Chantiz, Varenicline, Zyban, Bupropion, Wellbutrin
F2c@5 |__| (E) Suggest that you set a specific date to stop smoking?
All responses GO TO G1
SECTION G. STAGES OF CHANGE – EVERY DAY/SOME-DAY SMOKERS
G1 Are you seriously considering quitting smoking within the next 6 months?
(1) Yes [GO TO G2]
(2) No [GO TO G3]
|__|
[Don’t Know OR Refused: GO TO G3]
G2 Are you planning to quit within the next 30 days?
(1) Yes
(2) No
|__| All responses GO TO G3
G3 Overall, on a scale from 1 to 10 where 1 is NOT AT ALL interested and 10 is EXTREMELY interested, how interested are you in quitting smoking?
|__| IF G3 = 1 GO TO SECTION J, ELSE GO TO G4
(1) Not at all
(2) A little likely
(3) Somewhat likely
(4) Very likely
|__|
ALL EVERY DAY/SOME DAY SMOKERS (A3=1, 2) GO TO SECTION J
SECTION H. FORMER SMOKER SECTION
H1 About how long has it been since you COMPLETELY quit smoking cigarettes?
H1@NUM ENTER NUMBER
(1‑96)
|__|__|
H1@UNT ENTER UNIT REPORTED
(1) Days
(2) Weeks
(3) Months
(4) Years
|__|
BOX 24
IF H1@NUM > 18 AND H1@UNT = 2GO TO H1V
IF H1@NUM > 30 AND H1@UNT = 3 GO TO H1V
IF H1@NUM >(AGE - [ENTRY A2]) AND H1@UNT = 4 GO TO H1ERR
ELSE GO TO H2
H1ERR *** DO NOT READ ***
It was reported (in item A2) that this person first started smoking [fill AGE ‑ (entry to A2)] years ago. Response of [fill entry H1] (in item H1) is inconsistent.
(B) Back to correct
|__| GO TO H1@NUM
H1v I have recorded that it has been about [fill entry H1@num and H1@unt] since you completely quit smoking cigarettes? Is that correct?
(1) Yes [GO TO H2]
(2) No [GO TO H1@NUM]
|__|
[Don’t Know OR Refused: GO TO H2]
H2 Have you EVER smoked cigarettes EVERY DAY for at least 6 months?
(1) Yes [GO TO H2a]
(2) No [GO TO BOX 26]
|__|
[Don’t Know OR Refused: GO TO BOX 26]
H2a At what age did you first start to smoke cigarettes EVERY DAY?
ENTER AGE (01 – AGE)
|__|__|
[Age >5: GO TO H2b]
[AGE Less Than OR Equal 5: GO TO H2aV]
[DON’T KNOW OR REFUSED: GO TO H5]
H2aV I have recorded that you were [fill entry H2a] years old when you started smoking cigarettes EVERY DAY. Is that correct?
(1)Yes [GO TO H2b]
(2)No [GO TO H2a]
|__|
H2b When you first started to smoke EVERY DAY, were you living in [fill state/country from A2b] or somewhere else?
in state/country from A2b
somewhere else, SPECIFY OTHER STATE /COUNTRY
| (H) | Help [GIVES STATE/COUNTRY ABBREVIATIONS]
|__|__| ENTER STATE /COUNTRY ABBREVIATION
H5 For how long did you smoke EVERY DAY – READ CHOICES 1-4
(1)All or nearly all the years you have smoked
(2)Most of the years you have smoked
(3)Half of the years you have smoked, OR -
(4)Less than half the years you have smoked
(5)IF VOLUNTEERED: LESS THAN ONE YEAR
|__|
H5a When you last smoked every day, on average how many cigarettes did you smoke each day?
ENTER NUMBER OF CIGARETTES EACH DAY
(1‑96)
|__|__| IF 40: GO TO H5b
[If >40: GO TO H5aV]
[Don’t Know OR Refused: H5b]
H5aV I have recorded that when you last smoked every day, on the average you smoked [fill entry H5a] cigarettes each day. Is that correct?
(1) Yes [GO TO H5b]
(2) No [GO TO H5a]
|__|__|
[Don’t Know OR Refused: H5b]
H5b Think of the time during your life when you SMOKED THE MOST. During that time, how many cigarettes did you smoke each day?
[ ONE PACK USUALLY EQUALS 20 CIGARETTES. IF CONVERTING PACKS TO CIGARETTES, ALWAYS VERIFY CALCULATION WITH RESPONDENT.)]
ENTER NUMBER OF CIGARETTES PER DAY
(1-96)
|__|__| IF 40: GO TO BOX 26
[If >40: GO TO H5bV]
[Don’t Know OR Refused: GO TO BOX 26]
H5bV I have recorded that the time during your life when you SMOKED THE MOST, you smoked [fill entry H5b] cigarettes each day. Is that correct?
(1) Yes [GO TO BOX 26]
(2) No [GO TO H5b]
|__|__|
[Don’t Know OR Refused: GO TO BOX 26]
BOX 26
IF H1 1 YEAR (12 MONTHS, 52 WEEKS, 96 DAYS) GO TO H6
IF H1 > 3YEARS (36 MONTHS, EQUIVALENT in WEEKS and in DAYS) GO TO H11
ELSE GO TO H6C2
H6 Around this time 12 MONTHS AGO, were you smoking cigarettes every day, some days, or not at all?
(1) Every day IF H6 = 1 GO TO H6A
(2) Some days IF H6 =2 GO TO H6B
(3) Not at all
|__|
[IF H6 = 3, GO TO H6C2; ELSE IF H6 = DK, R GO TO H6Ci]]
H6A Around this time 12 MONTHS AGO, on the average, about how many cigarettes did you smoke each day?
(ONE PACK USUALLY EQUALS 20 CIGARETTES. IF CONVERTING PACKS TO CIGARETTES, ALWAYS VERIFY CALCULATION WITH RESPONDENT.)
ENTER NUMBER OF CIGARETTES PER DAY
(1-96)
|__||__|
BOX26A
IF H6A = D, R GO TO H6Ci
IF H6A > 40 GO TO H6Av
ELSE GO TO H6Ci
H6Av I have recorded that on the average, you smoked [fill entry H6A] cigarettes a day 12 months ago. Is that correct?
(1) Yes GO TO H6Ci
|__|
H6B Around this time 12 MONTHS AGO, on how many of 30 days in the month did you smoke cigarettes?
ENTER (X) FOR NONE
|__|__|
BOX 26B
IF H6B = X OR 30 GO TO H6BV
ELSE GO TO H6C
H6BV You said that you smoked cigarettes some days. Is that correct?
(1) Yes
(2) No
|__|
BOX 26C
IF (H6BV = 1 AND H6B = 30 ), OR H6BV = DK, R GO TO H6C
ELSE IF H6BV = 1 AND H6B = X GO TO H6C2
ELSE IF H6BV = 2 GO TO H6
H6C On the average, on those [fill entry H6B] days, how many cigarettes did you usually smoke each day?
WE ARE STILL TALKING ABOUT “AROUND THIS TIME 12 MONTHS AGO”
|__|__| IF 40 GO TO H6Ci; ELSE IF H6C = D, R GO TO H6Ci
H6CV I have recorded that on the average, when you smoked on those [fill entry H6B] days, you smoked [fill entry H6C] cigarettes a day. Is that correct?
(1) Yes
(2) No GO TO H6C
|__|
(Don’t Know or Refused GO TO H6Ci)
H6Ci Around this time 12 MONTHS AGO, were you usually smoking menthol or non-menthol cigarettes?
(1) Menthol
(2) Non-menthol
(3) NO USUAL TYPE
|__|
[1 or 2: GO TO H6C3;]
[ 3, Don’t Know OR Refused: GO TO H6C4]
H6C2 Thinking back to the 12 MONTHS BEFORE YOU QUIT SMOKING CIGARETTES,
During that time, did you usually smoke menthol or non-menthol cigarettes?
(1) Menthol
(2) Non-menthol
(3) NO USUAL TYPE
|__|
[1 or 2: GO TO H6C3;]
[ 3, Don’t Know OR Refused: GO TO H6C4]
H6C3 For each of the following, please tell me whether it’s a reason you usually smoked menthol/non-menthol { fill menthol if H6Ci or H6C2 = 1; fill non-menthol if H6Ci or H6C2 = 2 } cigarettes ? ----Please answer “yes” or “no” for each.
(1) Yes
(2) No
H6C3@1 |__| (A) They were less harmful than non-menthol /menthol {{fill non-menthol if H6C2 = 1 or H6Ci = 1; fill menthol if H6C2 = 2 or H6Ci = 2—NOTE: Opposite of the fill in the question stem H6C3} cigarettes
H6C3@2 |__| (B) They were less harsh on your THROAT than non-menthol /menthol {{fill non-menthol if H6Ci =1 or H6C2 = 1; fill menthol if H6Ci = 2 or H6C2 = 2—NOTE: Opposite of the fill in the question stem H6C3} cigarettes
H6C3@3 |__| (C) They had a better flavor than non-menthol /menthol {{fill non-menthol if H6Ci = 1 or H6C2 = 1; fill menthol if H6Ci = 2 or H6C2 = 2—NOTE: Opposite of the fill in the question stem H6C3} cigarettes
H6C3@4 |__| (D) They were less harsh on your CHEST than non-menthol/menthol {fill non-menthol if H6Ci = 1 or H6C2 = 1; fill menthol if H6Ci = 2 or H6C2 = 2—NOTE: Opposite of the fill in the question stem H6C3} cigarettes
IF H6Ci or H6C2 = 1, GO TO H6C5; ELSE IF H6Ci or H6C2 =2, 3, R, or DK, GO TO H6C4
H6C4 Have you EVER smoked MENTHOL cigarettes for 6 months or more?
(1) Yes
(2) No
IF H6C4= 1, THEN GO TO H6C5, ELSE GO TO H6D
H6C5 For how long have you smoked MENTHOL cigarettes – READ CHOICES 1-4
(1) All or nearly all the years you have smoked
(2) Most of the years you have smoked
Half of the years you have smoked, OR -
Less than half the years you have smoked
IF VOLUNTEERED: LESS THAN ONE YEAR
|__|
H6D Now I would like to ask about HOW you went about completely quitting smoking. When you quit smoking completely, did you use ANY of the following PRODUCTS:
(1) Yes
(2) No
H6D@1 A nicotine patch |__|
H6D@2 A nicotine gum or nicotine lozenge |__|
H6D@3 A nicotine nasal spray or nicotine inhaler |__|
H6D In total, how long did you use [fill with EACH E1a@ 1, 2, 3 = 1 (YES) OR IF all three are =1- YES, then fill with “ANY of these” ] during your last quit attempt when you stopped smoking completely
|__|__| @NUM [1-96]
|__|__| @UNT [1= DAYS, 2= WEEKS, 3= Months
HDa When you quit smoking completely, did you use ANY of the following PRODUCTS:
(1) Yes
(2) No
H6D@7a A prescription pill, called Chantix or Varenicline ? |__|
H6D@7b A prescription pill, called Zyban, Bupropion, or Wellbutrin? |__|
H6D@7c Another prescription pill |__|
IF H6D@7c = YES, GO TO H6D7cSPC
H6D7cSPC --- SPECIFY: __________________________
H6D7d In total, how long did you use [fill with EACH H6D@7a,b,c =1 (YES) OR IF ALL@7a and @7b and @7c are =1- YES, then fill with “ANY of these prescription PILLS” ] during your last quit attempt when you stopped smoking completely
|__|__| @NUM [1-96]
|__|__| @UNT [1= DAYS, 2= WEEKS, 3= Months
H6E When you quit smoking completely, did you use ANY of the following: : [FR NOTE: FOR THIS QUESTION, RE-READ STEM PERIODICALLY]
(1) Yes
(2) No
H6E@1 |__| (A) A telephone help line or quit line
H6E@2 |__| (B) One-on-one counseling
H6E@3 |__| (C) A stop smoking clinic, class, or support group
H6E@4 |__| (D) Help or support from friends or family
H6E@5 |__| (E) Internet or web-based program
H6E@6 |__| (F) Books, pamphlets, videos, or other materials
H6E@7 |__| (G) Acupuncture or hypnosis
H6E@7a |__| [IF YES] Which - (1) Acupuncture (2) Hypnosis (3) Both
H6F When you quit smoking completely, did you do ANY of the following: Please mention ALL methods, whether or not you think they were effective: : [FR NOTE: FOR THIS QUESTION, RE-READ STEM PERIODICALLY]
(1) Yes
(2) No
H6F@1 |__| (A) Try to quit by GRADUALLY cutting back on cigarettes
H6F@2 |__| (B) Try to quit by SWITCHING to smokeless tobacco such as chewing
tobacco, snuff, or snus
H6F@2b |__| (B2) Try to quit by SWITCHING to regular cigars, cigarillos, little filtered
cigars or pipes filled with tobacco
H6F@3 |__| (C) Did you SWITCH to a “lighter” cigarette in order to TRY TO QUIT
IF H6Ci = 2 (NON-MENTHOL), 3, DK, R OR H6C2 =2 (NON-MENTHOL), 3, DK, R, GO TO H6f@3b; ELSE GO TO H6f@3c.
H6F@3b |__| (C2) Did you SWITCH to menthol cigarettes in order to TRY TO QUIT----
HELP SCREEN: IF RESPONDENT SAYS THEY WERE ALREADY SMOKING 'MENTHOL CIGARETTES WHEN THEY TRIED TO QUIT-- THEN THE ANSWER IS "NO" THEY DIDN'T SWITCH TO TRY TO QUIT
IF H2Ci = 2 (NON-MENTHOL) OR H6C2 = 2 (NON-MENTHOL), THEN GO TO H6f@4; ELSE GO TO H6f@3c.
H6F@3c |__| (C3) Did you SWITCH to non-menthol cigarettes in order to TRY TO QUIT
HELP SCREEN: IF RESPONDENT SAYS THEY WERE ALREADY SMOKING “NON-MENTHOL” CIGARETTES WHEN THEY TRIED TO QUIT-- THEN THE ANSWER IS "NO" THEY DIDN'T SWITCH TO TRY TO QUIT
H6F@4 |__| (D) Did you try to give up cigarettes all at once
IF H6F@4 = 1 (YES), GO TO H6F1; ELSE GO TO H6.1a
H6F1 Please tell me which is true about when you completely quit smoking by giving up
cigarettes all at once:
(1) I tried to quit as soon as I made the decision.
(2) I planned the quit for later the same day.
(3) I planned the quit for a date in the future.
(4) I decided to quit after having not smoked for some other reason
|__|
H6F2 When you completely stopped smoking by quitting ALL AT ONCE, would you say
you QUIT “COLD TURKEY?
YES
NO
HELP SCREEN: “COLD TURKEY” IS STOPPING ALL AT ONCE WITHOUT
ANY AIDS
|__|
H6.1a In the 12 MONTHS BEFORE you COMPLETELY quit smoking, did you SEE a medical doctor?
YES GO TO H6.1b
NO GO TO H6.2a
don’t know or refused --- GO TO H6.2a
|__|
H6.1b During the 12 MONTHS BEFORE you completely quit smoking, did any medical doctor ADVISE you to stop smoking?
YES GO TO H6.1c
NO GO TO H6.2a
don’t know or refused GO TO H6.2a
|__|
H6.1c In the 12 MONTHS BEFORE you quit smoking, when a medical doctor advised you to quit smoking, did the doctor also:
H6.1c@1 (A) Suggest that you call or use a telephone help line or quit line?
H6.1c@2 (B) Suggest that you use a smoking cessation class, program, or counseling?
H6.1c@3 (C) Recommend or prescribe a nicotine product such as patch, gum, lozenge,
nasal spray or inhaler
H6.1c@4 (D) Prescribe a pill such as Chantix, Varenicline, Zyban, Bupropion, or
Wellbutrin
H6.1c@5 (E ) Suggest that you set a specific date to stop smoking?
GO TO H6.2a
H6.2a In the 12 MONTHS BEFORE you COMPLETELY quit smoking, did you SEE a dentist?
YES GO TO H6.2b
NO GO TO H8a
[don’t know or refused GO TO H8a ]
H6.2b During the 12 MONTHS BEFORE you completely quit smoking, did any dentist ADVISE you to stop smoking?
YES GO TO H6.2c
NO GO TO H8a
[don’t know OR refused GO TO H8a]
H6.2c In the 12 MONTHS BEFORE you quit smoking, when a dentist advised you to quit smoking, did the dentist also:
H6.2c@1 |__| (A) Suggest that you call or use a telephone help line or quit line?
H6.2c@2 |__| (B) Suggest that you use a smoking cessation class, program, or
counseling?
H6.2c@3 |__| (C) Recommend or Prescribe a nicotine product such as patch, gum, lozenge, nasal spray or inhaler
H6.2c@4 |__| (D) Prescribe a pill such as Chantix, Varenicline, Zyban, Bupropion, Wellbutrin
H6.2c@5 |__| (E) Suggest that you set a specific date to stop smoking?
GO TO H8a
H8a During the 12 MONTHS before you quit smoking, how soon after you woke up did you typically smoke your first cigarette of the day?
(IF NECESSARY, ASK FOR BEST ANSWER IN MINUTES OR HOURS)
ENTER (X) IF RESPONDENT INSISTS IT VARIES
H8a@NUM ENTER NUMBER (1 – 90 for minutes)
|__|__|
H8a@UNT ENTER UNIT REPORTED
|__| (1) Minutes (2) Hours
BOX 29
IF H8a = X, D, R GO TO H8b
ELSE GO TO H8c
H8b During the 12 months before you quit smoking, would you say you smoked your first cigarette of the day within the first 30 minutes of awakening?
(1) Yes
(2) No
(3) Varies— DO NOT READ
|__|
H8c During the 12 months before you quit smoking did you sometimes awaken at night to have a cigarette?
Yes
No
DO NOT READ
DON’T SLEEP AT NIGHT
USE SOME OTHER TOBACCO PRODUCT WHEN I AWAKEN DURING THE NIGHT
|__|
[GO TO Section J]
[The menthol questions are repeated again below for those who stopped smoking greater than 3 years ago from Box 26. ]
H11 Thinking back to the 12 MONTHS BEFORE YOU COMPLETELY QUIT
SMOKING CIGARETTES, During that time, DID YOU USUALLY SMOKE menthol or non-menthol cigarettes?
MENTHOL
NON-MENTHOL
NO USUAL TYPE
|__|
[1, 2: GO TO H11b]
[3, Don’t Know OR Refused: GO TO H11c]
H11B For each of the following, please tell me whether it’s a reason you usually smoked menthol/non-menthol { fill menthol if H11 = 1; fill non-menthol if H11 = 2 } cigarettes ? ----Please answer “yes “or “no” for each.
(1) Yes
(2) No
H11B@1 |__| (A) They were less harmful than non-menthol /menthol {{ fill non-menthol if H11 = 1 ; fill menthol if H11 = 2 —NOTE: Opposite of the fill in the question stem H11B} cigarettes
H11B@2 |__| (B) They were less harsh on your THROAT than non-menthol /menthol {{ fill non-menthol if H11= 1; fill menthol if H11 = 2—NOTE: Opposite of the fill in the question stem H11B} cigarettes
H11B@3 |__| (C) They had a better flavor than non-menthol /menthol {{ fill non-menthol if H11 = 1; fill menthol if H11 = 2—NOTE: Opposite of the fill in the question stem H11B} cigarettes
H11B@4 |__| (D) They were less harsh on your CHEST than non-menthol/menthol { fill non-menthol if H11 = 1; fill menthol if H11 = 2 }—NOTE: Opposite of the fill in the question stem H11B} cigarettes
IF H11 = 1, GO TO H11D; ELSE IF H11 =2, 3, R, or DK, GO TO H11C
H11C Have you EVER smoked MENTHOL cigarettes for 6 months or more?
(1) Yes
(2) No
|__|
IF H11C= 1, THEN GO TO H11D; ELSE GO TO SECTION J
H11D For how long have you smoked MENTHOL cigarettes – READ CHOICES 1-4
(1) All or nearly all the years you have smoked
(2) Most of the years you have smoked
(3) Half of the years you have smoked, OR –
(4) Less than half the years you have smoked
IF VOLUNTEERED: LESS THAN ONE YEAR
|__|
[SKIP TO SECTION J]
(version SECTION J 7-23-09 cmpl rvcog test _4-7-09_2-5-09)
SECTION J. OTHER TOBACCO USE – ALL RESPONDENTS
J The next questions are about the use of tobacco other than in cigarettes.
PRESS ENTER TO PROCEED
J1a (Have/Has) (you/name) EVER used any of the following EVEN ONE TIME?
(1) Yes
(2) No
J1a@1 A regular cigar or cigarillo OR a little filtered cigar? |__|
HELP: Regular cigars are different from little filter cigars. They can be large cigars, or smaller in size such as cigarillos. They are usually sold individually or in packs of 5 or 8. Some common brands are Black and Mild’s, Swisher Sweets cigarillos, and Phillies Blunts, but there are others.
HELP: Little filtered cigars are different from regular cigars and cigarillos. They resemble cigarettes in size, and are often sold in packs of 20. They are usually brown in color and have a spongy filter like a cigarette. Some common brands are Prime Time little filter cigars and Winchester little filter cigars, but there are others.
J1a@2 A regular pipe filled with tobacco |__|
HELP: IF ASKED, “pipe smoking” ONLY INCLUDES PIPE TOBACCO. IT DOES NOT INCLUDE SMOKING HASHISH, MARIJUANA, CRACK, OR OTHER SUBSTANCES IN A PIPE. DO NOT INCLUDE WATER PIPES/HOOKAHS {who-kahs}OR OTHER NAMES: SHISHA/NARGHILE/ARGILEH, OR HUBBLE-BUBBLE
J2a@3 A water pipe or hookah {pronounced: who-kah} pipe filled with tobacco
HELP: IF ASKED, “water pipe or hookah {who-kah} pipe smoking” ONLY INCLUDES PIPE TOBACCO. IT DOES NOT INCLUDE SMOKING HASHISH, MARIJUANA, CRACK, OR OTHER SUBSTANCES IN A PIPE. A WATER PIPE OR HOOKAH {who-kah} PIPE IS ALSO REFERRED TO AS A SHISHA, NARGHILE, ARGILEH OR HUBBLE-BUBBLE.
The next question is about smokeless tobacco products which are used in the mouth --
J1a (Have/Has) (you/name) EVER used any of the following EVEN ONE TIME?
(1) Yes
(2) No
J1a@4 SMOKELESS tobacco, such as moist snuff, dip, spit, chew tobacco or snus.
HELP: Snuff or dip is commonly placed between the gum and lip and sold in round cans in --a loose form or a pouch that looks like a small tea-bag; common brands are Skoal, Copenhagen and Grizzley but there are others.
Chewing or spit tobacco (also twist, plug or scrap)) is usually placed in the side of your mouth and chewed and often sold in wallet-sized pouches;
common brands are Redman, Levi- Garret, and Beech-nut, but there are others.
Snus is a spitless tobacco product that may be sold in a tin or slidepak in a loose form or in small teabag-like pouches; common brands are Camel Snus, Marlboro Snus, and Skoal Snus.
BOX 31
IF ((J1a@1 THROUGH J1a@4 = NO, DK or R) AND:
IF PROXY RESPONDENT GO TO S78
IF SELF RESPONDENT GO TO BOX 34)
ELSE IF ANY J1a@1, 2, 3, 4 = YES (1) GO TO J2a FOR THOSE PRODUCTS
BOX 32
ASK J2a FOR EACH YES ENTRY IN J1a@1 THROUGH J1a@4
J2a (Do you/Does [name]) NOW (smoke/use) [fill entry in J1a] every day, some days or not at all?
(1) Every day
(2) Some days
(3) Not at all
|__|
IF (J2A@2 = 1 OR 2) AND (J2A@3 = 1 OR 2), THEN ASK J2A2-3V. ELSE GO TO BOX 33.
J2A2-3V Do you currently smoke BOTH regular pipes AND water pipes or hookah {who-kah} pipes?
YES
NO- GO TO J2A@ 2 and J2A@3 to correct and then proceed to BOX 33
|__|
GO TO BOX 33
BOX 33
IF J2a = 1 OR 3:
IF PROXY: IF LAST ENTRY FROM J1a GO TO S78
ELSE REPEAT J2a FOR NEXT YES ENTRY IN J1a@1 – 4
IF J2a=1:
IF SELF: IF J2a@4 (SMOKELESS) IS 1 (EVERY DAY) AND LAST ENTRY FROM J1a - GO TO JA
ELSE IF J2a@1 (CIGARS) IS 1 (EVERY DAY)AND LAST ENTRY FROM J1a - GO TO JB
ELSE LAST YES ENTRY FROM J1a@1-4 GO TO JD
ELSE REPEAT J2a FOR NEXT YES ENTRY IN J1a@1-4
IF J2A=3;
IF SELF: IF LAST ENTRY FROM J1a GO TO JD
ELSE REPEAT J2a FOR NEXT YES ENTRY IN J1a@1 – 4
FOR EACH ENTRY J2a@1-4 =3 (NOT AT ALL), ASK HOW LONG HAS IT BEEN SINCE YOU COMPLETELY STOPPED SMOKING//USING CIGARS/PIPES//SMOKELESS TOBACCOQ JD1/2
IF J2a = 2: (Someday Smokers)
IF PROXY: IF LAST YES ENTRY FROM J1a@ 1-4 GO TO S78
ELSE REPEAT J2a FOR NEXT YES ENTRY IN J1a@1 -4
IF SELF: GO TO J2b
IF J2a= DK/REF (-2 or -3):GO BACK TO J2a for next item (ie. cigars, etc.)
IF J2a= DK/REF (-2 or -3) AND IF LAST ENTRY FROM J1a@1-4 GO TO BOX 34
J2b On how many of the past 30 days did you (smoke/use) [fill entry J1a@]?
[ASK SEPARATELY FOR EACH “YES” ENTRY IN J1a@ WITH J2a = 2]
ENTER NUMBER OF DAYS
ENTER (X) FOR NONE
(1-30)
|__||__| IF [entry in J2b = X OR 30] GO TO J2bV; ELSE AFTER OBTAINING ALL RELEVANT RESPONSES TO THIS QUESTION, IF SMOKELESS CURRENT USE GO TO JA; ELSE IF CIGAR CURRENT USE GO TO JB,
J2bV You said that you (smoked/used) [fill entry J1a@] some days. Is that correct?
[ASK SEPARATELY FOR EACH “YES” ENTRY IN J1a WITH J2b = X (0) OR 30]
(1) Yes
(2) No [GO TO J2a]
|__|
NOTE: THE J2a, J2b, and J2Bv (as needed) SERIES IS REPEATED FOR EACH YES ENTRY IN J1a@1-4
AFTER OBTAINING ALL RELEVANT RESPONSES TO THIS QUESTION, IF SMOKELESS CURRENT USE GO TO JA; ELSE IF CIGAR CURRENT USE GO TO JB,
JA During the PAST 30 days, what BRAND of smokeless tobacco [IF necessary: moist snuff, dip, spit, chew or snus] did you use MOST OFTEN?
Allow for filling in coded brand name or code number, whichever is easier to program. |__|__| OR ENTER Brand NAME by clicking on it—
JA |__|__|
IF “Brand not on List” is chosen, ENTER “X” in JA, then enter under JASPC.
JASPC: Specify___________________
THE UNREAD CODES FOR INTERVIEWER ENTRY ARE:
BEECH-NUT
CAMEL SNUS
COPE
COPENHAGEN
COUGAR
GRIZZLY
HAWKEN
HUSKY
KAYAK
KODIAK
LEVI GARRETT
LONGHORN
MARLBORO SNUS
RED MAN
RED
SEAL
ROOSTER
SILVER CREEK
SKOAL
SKOAL SNUS
TAYLOR'S PRIDE
TIMBER
WOLF
Brand not on LIST
JASPC:_________________________
[NOTE:
THESE brands are 96% of the market share]
IF J2a@1 = 1 or 2 GO TO JB--- [ If ‘cigars” is NOW smoked every day or some days, ask JB and JC ]—ELSE GO TO JD3
JB During the PAST 30 days, what type of CIGAR did you use MOST OFTEN?
(1) Regular/large cigars
“Cigarillos”
Little, filtered cigars
UNREAD codes:
(4) none of the above;
(5) more than one of the above;
DK; R
JC During the PAST 30 days, what BRAND of CIGAR did you smoke MOST OFTEN?
________________ BRAND
NOTE: List of major brands for Coding SEE BELOW. IF indicates “ need to prompt with F/U question”, ask FU question JCPROMPT after asking main question JC It does this for certain brands that produce regular and little cigars.
THE UNREAD CODES FOR INTERVIEWER ENTRY ARE:
Al capone(makes regular and little/small cigars== prompt)
Backwoods (regular only)
Black & Milds (makes regular and little/small cigars with plastic hard filter (not spongy filter ===prompt)
Captain black (little only)
Dutch masters (regular/large cigar)
Dutch treats (little cigar)
Erik (little only)
Hav-a-tampa (makes regular and little/small cigars== prompt)
King edward(makes regular and little/small cigars== prompt)
Muriel (makes regular and little/small cigars== prompt)
Phillies (makes regular and little/small cigars== prompt)
Prime time (little only)
Smoker's choice (little only )
Swisher sweet* (makes regular and little/small cigars== prompt)
Other (prompt )
JCPROMPT—Is that a regular or little cigar? Little cigars are cigarette size with a filter.
(1) Regular cigar
(2) Little/small cigars
|__|
JCFLAVR—During the past 30 days, did you USUALLY smoke flavored cigars? By flavored we mean fruit, candy, alcohol, clove or any other flavorings
(1) Yes
(2) No
|__|
JD FOR EACH ENTRY J2A@1-4 = 3 (NOT AT ALL), GO TO JD1/2@1-4; ELSE GO TO JD3
JD1/2@1-4 About how long has it been since you COMPLETELY quit smoking//using --cigars/pipes/hookahs {houk-ahs}//smokeless tobacco?
JD1@1/2/3 /4 |__|__|| NUMBER (1-96)
JD2 @1/2/3 /4 |__| UNITS
(1) Days
(2) Weeks
(3) Months
(4) Years
JD3 ASK JD3 SEPARATELY FOR EACH J1A@1-4 = 1 (YES):
JD3 In total, about how many years have you smoked //used – cigars/pipes/smokeless tobacco (fill as appropriate from J1a @1-4)?
ENTER X FOR LESS THAN ONE YEAR
JD3@1, 2,3,4 |__|__| years
BOX 34
FOR PROXY RESPONDENT: GO TO S78
FOR SELF RESPONDENT:
IF CURRENT SMOKER OF CIGARETTES (A3=1 OR 2) GO TO SECTION JJ
ELSE IF J1a@1-4 = NO OR J2a = DK/Refused OR ANY COMBINATION OF THESE THREE STIPULATIONS FOR ALL FOUR
“OTHER” TOBACCO PRODUCTS FOR ALL ENTRIES GO TO SECTION JJ
Other tobacco time to first use:
BOX 39
IF ONLY ONE PRODUCT MENTIONED IN J2a IS NOW USED “EVERY DAY” OR “SOME DAYS [J2a =1 OR J2a =2]THAT PRODUCT IS USED FOR J3a.
IF > 1 PRODUCT MENTIONED IN J2a, ASK J3b IF J2a@1,2 indicates NOW SMOKES 2 OR MORE OF CIGARS AND PIPES (COMBINATIONS OF 1, 2, OR 3);
ASK J3C IF J2a@1-4 indicates NOW USES any other combination of two or more non-cigarette tobacco products (e.g., cigars and smokeless; pipes (regular or hookah)) and smokeless; or cigars, pipes (regular or hookah) and smokeless);
IF respondent insists it VARIES in response to ANY J3a-J3c, record an "X" for VARIES and ask J3d.
ELSE IF [(J2a=3 OR J1a = 2) FOR ALL J1a@1- 4] AND [JD1/2 LESS THAN OR EQUAL TO 1 YEAR, 12 MONTHS, 52 WEEKS, 96 DAYS (i.e., 1 YEAR EQUIVALENCE) FOR ONLY ONE “OTHER TOBACCO PRODUCT” J1a@1,2,OR 4] AND [ IF A3 =3 AND H1@NUM/@UNT > 1 YEAR, 12 MOS., 52 WEEKS, OR EQUIVALENCE ] THEN GO TO J3f.
_________________________________________________________
J3a How soon after you wake up do you typically [fill with appropriate stem and ending based on responses to J2a@1-4] smoke your first cigar // pipe -// - use smokeless tobacco?
(IF NECESSARY, FR ASK FOR BEST ANSWER IN MINUTES OR HOURS)
ENTER (X) in J3a@1 IF RESPONDENT INSISTS IT VARIES
J3a@1 ENTER NUMBER (1 - 90)
|__|__|
J3a@2 ENTER UNIT REPORTED
|__| (1) Minutes (2) Hours
J3b How soon after you wake up do you typically [fill with appropriate stem and ending based on responses to J2a@1,2] smoke your first --cigar or pipe
(IF NECESSARY, FR ASK FOR BEST ANSWER IN MINUTES OR HOURS)
ENTER (X) in J3b IF RESPONDENT INSISTS IT VARIES
J3b@1 ENTER NUMBER (1 - 90)
|__|__|
J3b@2 ENTER UNIT REPORTED
|__| (1) Minutes (2) Hours
J3c How soon after you wake up do you typically [fill with appropriate ending based on multiple responses to J2a@1,2,3-4] use any of your non-cigarette tobacco products -- for the first time?
(IF NECESSARY, FR ASK FOR BEST ANSWER IN MINUTES OR HOURS)
ENTER (X) in J3c IF RESPONDENT INSISTS IT VARIES
J3c @1 ENTER NUMBER (1 - 90)
|__|__|
J3c@2 ENTER UNIT REPORTED
|__| (1) Minutes (2) Hours
IF ANY J3a-c = X, D, or R, THEN GO TO CORRESPONDING J3d_a-c; ELSE GO TO J3e
J3d_a-c Would you say you first use cigars/ pipes/ smokeless tobacco// cigars or pipes //(other combination of ) non-cigarette tobacco products within the first 30 minutes of awakening?
(1) Yes
(2) No
(3) Varies— DO NOT READ
|__|
J3e Do you sometimes awaken at night to use tobacco?
(1)Yes
(2)No
(3)Don’t sleep at night (UNREAD)
GO TO BOX 39A
J3f In the 12 months BEFORE YOU COMPLETELY QUIT smoking …cigars/pipes..// using smokeless tobacco, how soon after you woke up did you typically [fill with appropriate stem and ending based on responses to J2a@1,2,4] smoke your first cigar ../ pipe -// - use smokeless tobacco?
(IF NECESSARY, FR ASK FOR BEST ANSWER IN MINUTES OR HOURS)
ENTER (X) in J3f@1 IF RESPONDENT INSISTS IT VARIES
J3f@1 ENTER NUMBER (1 - 90)
|__|__|
J3f@2 ENTER UNIT REPORTED
|__| (1) Minutes (2) Hours
IF J3f@1 = X, D or R, THEN GO TO J3g; ELSE GO TO J3h
J3g Would you say you first used cigars/ pipes/ smokeless tobacco// within the first 30 minutes of awakening?
(1) Yes
(2) No
(3) Varies— DO NOT READ
|__|
J3h During the 12 months BEFORE YOU COMPLETELY QUIT smoking …cigars/pipes..// using smokeless tobacco, DID you sometimes awaken at night to use tobacco?
(1)Yes
(2)No
DO NOT READ
(3)DON’T SLEEP AT NIGHT
(4)USE SOME OTHER TOBACCO PRODUCT WHEN I AWAKEN DURING THE NGHT
|__|
_______________BOX 39A _________________
IF A3 = 1 OR 2 (CURRENT CIGARETTE SMOKER) GO TO SECTION JJ- DO NOT ASK J4-J7
ELSE IF J2a@3 = 1 OR 2, THEN GO TO SECTION JJ (DO NOT ASK J4 – J7 FOR WATER PIPES (HOOKAHS)
ELSE IF ONLY ONE PRODUCT MENTIONED IN J2a (J2a @1,2,4) IS NOW USED “EVERY DAY” OR “SOME [J2a =1 OR J2a =2)]THAT PRODUCT IS USED FOR J4-J7—GO TO J4
ELSE IF > 1 PRODUCT MENTIONED IN J2a [J2a =1 OR J2a =2 ], GO TO SECTION JJ
ELSE IF [(J2a=3 OR J1a = 2) FOR ALL J1a@1- 4] AND [JD1/2 LESS THAN OR EQUAL TO 1 YEAR, 12 MONTHS, 52 WEEKS, 99 DAYS (i.e., 1 YEAR EQUIVALENCE) FOR ONLY ONE “OTHER TOBACCO PRODUCT” J1a@1,2,OR 4] AND [ IF A3 =3 AND H1@NUM/@UNT > 1 YEAR, 12 MOS., 52 WEEKS, OR EQUIVALENCE ] THEN GO TO J7a.
ELSE GO TO SECTION JJ
J4 During the PAST 12 MONTHS, have you stopped smoking/using [fill entry BOX 39A] for one day or longer BECAUSE YOU WERE TRYING TO QUIT?
(1) Yes è GO TO J5
(2) No GO TO SECTION JJ
IF J4 = D, R è GO TO SECTION JJ
J5 The LAST TIME you stopped smoking/using [fill entry Box 39A] in the Past 12 Months BECAUSE YOU WERE TRYING TO QUIT, how long did you stop for?
J5@NUM ENTER NUMBER
(1 - 99)
|__|__||
J5@UNT ENTER UNIT REPORTED
(1) Days
(2) Weeks
(3) Months
|__| IF (J5@UNT = 2 AND J5@NUM >18) OR (J5@NUM >12 AND J5@UNT = 3) ºGO TO J5V; D or R ºGO TO J7a; ELSE ºGO TO J6a
J5v I have recorded that the LAST TIME you stopped smoking/using [fill entry Box 39 A in the past 12 months because you were TRYING to quit was [fill entry J5@NUM/J5@UNT]? Is that correct?
(1) Yes
( 2) No ºGO TO J5@NUM
|__|
J6a Was [fill entry J5] the LONGEST you went without smoking/using [fill entry Box 39A] in the past 12 months?
(1) Yes ºGO TO J7
(2) No
|__|
J 6b During the past 12 MONTHS, what is the LONGEST length of time you stopped smoking/using [fill entry Box 39] because you were TRYING to quit?
J6b@NUM ENTER NUMBER
(1 -96)
|__|__||
J6b@UNT ENTER UNIT REPORTED
(1) Days
(2) Weeks
(3) Months
|__| IF (J6@NUM >18 AND J6b@UNT = 2) OR (J6b@NUM >12 AND J6b@UNT = 3) ºGO TO J6bV; ELSE ºGO TO J7a@1
J6bV I have recorded that the LONGEST length of time you stopped smoking/using [fill entry Box 39] in the past 12 months because you were TRYING to quit was [fill entry J6b@NUM/J6b@UNT]? Is that correct?
(1) Yes
(2) No ºGO TO J6b@NUM
|__|
J7a-- For J7a – J7c-- Use alternative wording for those who met criteria in BOX 39A for recent former users of one “other tobacco product” (: ELSE IF [(J2a=3 OR J1a = 2) FOR ALL J1a@1- 4] AND [JD1/2 LESS THAN OR EQUAL TO 1 YEAR, 12 MONTHS, 52 WEEKS, 96DAYS (i.e., 1 YEAR EQUIVALENCE) FOR ONLY ONE “OTHER TOBACCO PRODUCT” J1a@1,2,OR 4] AND [ IF A3 =3 AND H1@NUM/@UNT > 1 YEAR, 12 MOS., 52 WEEKS, OR EQUIVALENCE ] THEN GO TO J7a.)
Alternative wording: J7a “Now I would like to ask about HOW you went about completely quitting smoking…cigars/ pipes //using smokeless tobacco. When you COMPLETELY quit smoking cigars/pipes // using smokeless tobacco, did you use ANY of the following PRODUCTS?—For 7b and 7c alternative wording is: “When you COMPLETELY quit smoking cigars/pipes // using smokeless tobacco, did..............?
J 7a Thinking back about the last time you tried to quit [fill entry Box 39A] in the past 12 months // SUBSTITUTE ALTERNATIVE WORDING FOR RECENT FORMER USER OF OTHER TOBACCO PRODUCT-- CRITERIA FROM BOX 39aA//:
Did you use any of the following PRODUCTS:
(1) Yes
(2) No
J7a@1 A nicotine patch |__|
J7a@2 A nicotine gum or lozenge |__|
J7a@3 A nicotine nasal spray or inhaler |__|
J7a@7a A prescription pill called Chantix or Varenicline? |__|
J7a@7b A prescription pill, called Zyban, Bupropion, or Wellbutrin? |__|
J7a@7c Another prescription pill ? |__|
IF YES TO J7a@7c (J7a@7c=1) GO TO J7aSPC
J7aSPC -- SPECIFY: _________________________
J7b The LAST TIME you tried to quit [fill entry Box 39A], did you use ANY of the following//USE ALTERNTAIVE WORDING FOR RECENT FORMER USER OF OTHER TOBACCO PRODUCT//: : [FR NOTE: FOR THIS QUESTION, RE-READ STEM PERIODICALLY]
(1) Yes
(2) No
J7b@1 |__| (A) A telephone help line or quit line
J7b@2 |__| (B) One-on-one counseling
J7b@3 |__| (C) A stop smoking clinic, class, or support group
J7b@4 |__| (D) Help or support from friends or family
J7b@5 |__| (E) Internet or web-based program
J7b@6 |__| (F) Books, pamphlets, videos, or other materials
J7b@6b |__| (F2) Acupuncture or hypnosis
J7b@6c |__| [IF YES] Which - (1) Acupuncture (2) Hypnosis (3) Both
J7b@7 |__| (G) Advice from a medical doctor, dentist or other health professional
J7b@7a|__| [IF YES] Which ?- (1) Doctor (2) Dentist (3) Other Health professional (4) More than one of the previous choices
J7c The LAST TIME you tried to QUIT (fill entry Box 39A) in the past 12 months//, did you do ANY of the following : // USE ALTERNTAIVE WORDING FOR RECENT FORMER USER OF OTHER TOBACCO PRODUCT//
(1) Yes
(2) No
J7c@1 |__| (A) Stopping by gradually cutting back on (fill entry Box 39) in order to TRY TO
QUIT
J7c@2 |__| (B) Did you TRY GIVING IT UP ALL AT ONCE?
[IF YES TO J7c@2, ask J7c@2a]
J7c@2a|__| Would you say you TRIED TO QUIT “cold turkey?
HELP SCREEN: “COLD TURKEY” IS STOPPING ALL AT ONCE WITHOUT
ANY AIDS
(1) YES
(2) NO
|__|
SECTION JJ
NEW QUESTION REPLACES THE OLD HARM REDUCTION SECTION THAT HAD ABOUT 10 QUESTIONS
(ASK ALL CURRENT CIGARETTE SMOKERS, OR CURRENT USERS OF OTHER TOBACCO PRODUCTS, OR--- RECENT FORMER USERS OF ANY TOBACCO PRODUCT (CIGARETTES OR OTHER TOBACCO PRODUCTS)-- WHO STOPPED USING THAT PRODUCT WITHIN THE LAST THREE YEARS (H1@NUM/UNT OR JD1/2 <equal 3 years, 36months, 96 weeks, or 96 days –
JJ1 Tobacco companies are developing new smokeless tobacco products, in various shapes, such as a pellet, a toothpick size stick, and a film strip, made from finely ground flavored tobacco that dissolves. Some common brands are Camel Orbs, Strips and Sticks.
Have you tried any of these?
(1) YES
(2) NO
|__|
IF YES TO JJ1, ASK JJ2
JJ2 What did you try? SPECIFY ______________________________
GO TO SECTION K
SECTION K. WORKPLACE AND HOME BAN – ALL RESPONDENTS
BOX 41 -- CONTEXT FOR K1 same as always been:
IF NOT RETIRED AND HAVE BEEN WORKING FOR PAY OR EMPLOYED IN PAST WEEK AND ARE NOT SELF-EMPLOYED:
K1 The next questions are about your place of work. Which of these best describes the area in which you work MOST of the time?
[FR NOTE: If Respondent has more than 1 job, have them answer for their main job.]
K1a. Do you mainly work indoors or outdoors?
[FR NOTE: Do not read the first 2 categories unless necessary. Never read the remaining categories.]
(1) INDOORS [SKIP TO K1b]
(2) OUTDOORS [SKIP TO K3d]
(3) ABOUT EQUALLY INDOORS AND OUTDOORS [SKIP TO K1b2]
(4) WORKS MAINLY INDOORS IN A NON-TRADITIONAL ENVIRONMENT SUCH AS WAREHOUSE OR OTHER SIMILAR LARGE SEMI-STRUCTURED AREA --[SKIP TO K1b1]
(5) MAINLY TRAVEL AROUND TO DIFFERENT CLIENTS OR SITES OR MAINLY IN A MOTOR VEHICLE/BUS/TRAIN/BOAT/AIRPLANE/UNDERGROUND/IN A MINE, ETC. [SKIP TO K3d]
(V) VARIES (DO NOT READ) [SKIP TO K3d]
K1b Do you mainly work in an office building, in your own home, in someone else’s home, or in another indoor place?
(1)OFFICE BUILDING [SKIP TO Kb1]
(2)OWN HOME [SKIP TO K4]
(3)SOMEONE ELSE’S HOME [SKIP TO K4]
(4)ANOTHER INDOOR PLACE [SKIP TO K1b1]
don’t know or refused [SKIP TO K1b1]
K1b1 In which State (including DC), do you work?
| (H)| Help [GIVES STATE/COUNTRY ABBREVIATIONS]
|__|__| ENTER STATE/COUNTRY ABBREVIATION
GO TO K2a
K1b2. When you work INDOORS: Do you mainly work in an office building, in your own home, in someone else’s home, or in another indoor place?
(1)OFFICE BUILDING [SKIP TO K1c]
(2)OWN HOME [SKIP TO K4]
(3)SOMEONE ELSE’S HOME [SKIP TO K4]
(4)ANOTHER INDOOR PLACE [SKIP TO K1c]
don’t know OR refused [SKIP TO K1c]
K1c In which State (including DC), do you work on your main indoor job or business?
| (H)| Help [GIVES STATE/COUNTRY ABBREVIATIONS]
|__|__| ENTER STATE/COUNTRY ABBREVIATION ______________________________
K2a. Is smoking restricted in ANY WAY at your place of work?
[READ IF NECESSARY]: “By ‘restricted’, we mean any limitation on smoking , regardless of who is responsible for that restriction (including owner, employer, gov’t , union, etc.).
YES
NO [SKIP TO K3C]
Don’t KNOW OR refused [SKIP TO K3C]
K3a Which of these best describes the smoking policy at your place of work for INDOOR PUBLIC OR COMMON AREAS, such as lobbies, rest rooms, and lunch rooms?
(1) Not allowed in ANY public areas
(2) Allowed in SOME public areas
(3) Allowed in ALL public areas
ENTER (4) IF NOT APPLICABLE
K3b Which of these best describes the smoking policy at your place of work for INDOOR WORK AREAS?
(1) Not allowed in ANY work areas
(2) Allowed in SOME work areas
(3) Allowed in ALL work areas
ENTER (4) IF NOT APPLICABLE
K3c During the PAST TWO WEEKS, has anyone smoked in the area in which you work?
(1)YES
(2)NO
K3d Within the PAST 12 MONTHS, has your employer offered any stop smoking program or any other help to employees who want to quit smoking?
(1)YES
(2)NO
The final set of questions are about your home and other places.
K4 Which statement best describes the rules about smoking INSIDE YOUR HOME?
[READ IF NECESSARY]: “HOME” IS WHERE YOU LIVE. “RULES” INCLUDE ANY UNWRITTEN “RULES” AND PERTAIN TO ALL PEOPLE WHETHER OR NOT THEY RESIDE IN THE HOME OR ARE VISITORS, WORKMEN, ETC.
(1) No one is allowed to smoke anywhere INSIDE YOUR HOME
(2) Smoking is allowed in some places or at some times INSIDE YOUR HOME
(3) Smoking is permitted anywhere INSIDE YOUR HOME
K6c In bars, cocktail lounges, and clubs, do you THINK that smoking SHOULD be allowed in all areas, allowed in some areas, or not allowed at all?
(1)ALLOWED IN ALL AREAS
(2)ALLOWED IN SOME AREAS
NOT ALLOWED AT ALL
K6f On outdoor children’s playgrounds and outdoor children’s sports fields, do you THINK that smoking SHOULD be allowed in all areas, allowed in some areas, or not allowed at all?
(1)ALLOWED IN ALL AREAS
(2)ALLOWED IN SOME AREAS
(3)NOT ALLOWED AT ALL
K6g Inside casinos, do you THINK that smoking SHOULD be allowed in all areas, allowed in some areas, or not allowed at all?
(1)ALLOWED IN ALL AREAS
(2)ALLOWED IN SOME AREAS
(3)NOT ALLOWED AT ALL
K6h Inside a car, when there are other people present, do you THINK that smoking SHOULD…
Always be allowed,
Allowed under some conditions, or
Never be allowed? [SKIP TO KOTHQT]
K6h2 IF children are present inside the car, do you think that smoking SHOULD…
Always be allowed,
Allowed under some conditions,
Never be allowed?
Ask K7 if B2=1 OR C2 = 1 (menthol smoker); ELSE GO TO KSTRESH.
K7 If menthol cigarettes were no longer sold, which of the following would you MOST LIKELY do:
(1) Switch to non-menthol cigarettes
(2) Switch to some other tobacco product; or
(3) Quit smoking and not use any other tobacco product
DO NOT READ
(6) NONE OF THE ABOVE
KSTRESH—STATE Residential History for ALL Respondents
KSTRESHa: - In what state/country were you born?
| (H)| Help [GIVES STATE/COUNTRY ABBREVIATIONS]
|__|__| ENTER STATE/COUNTRY ABBREVIATION
(GO TO SINTTP)
S78 |
*** DO NOT READ ***
Enter line number of the person who answered the supplement questions for (NAME)
|__|__|
|
HOUSEHOLD ROSTER LN NAME 01 (Person 1) 02 (Person 2) 03 (Person 3) |
KSTRESH—STATE Residential History for ALL Respondents
KSTRESHa: - In what state/country were you born?
| (H)| Help [GIVES STATE/COUNTRY ABBREVIATIONS]
|__|__| ENTER STATE/COUNTRY ABBREVIATION
SINTTP *** DO NOT READ ***
In what language was the interview for this person conducted?
(1) English
(2) Spanish
(3) Chinese
(4) Korean
(5) Vietnamese
(6) Khmer
(7) Other Asian or Asian unspecified
(8) Other
|__|
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| File Type | application/msword |
| File Title | revised2003Cessation_0709.wpd |
| Last Modified By | NCI |
| File Modified | 2010-01-13 |
| File Created | 2010-01-13 |