OMB #: 0925-0368 Expires: _________
2014-2015 Tobacco Use Supplement to the Current Population Survey
Public reporting burden for this collection of information is estimated to average 6 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.
2014-2015 Tobacco Use Supplement to the Current Population Survey
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 for any selected self-respondent. Allow proxy response for ALL OTHER eligible NON-selected self respondents AFTER interviewing or ATTEMPTING to interview selected SELF respondents first.
HHCPS-R ENTER LINE NUMBER FOR THE PERSON WHO IS REPORTING CPS INFO FOR ALL HH MEMBERS
|__|__|
RANDOM_INDICATORS FOR SELF-RESPONSE SELECTION
PRESUP This month we would also like to ask about your thoughts and experiences
concerning tobacco use.
If household has only 1 or 2 persons 18 years or older state:
"I need to ask each individual, age 18 years old and older, these questions."
If household has more than 2 persons age 18 years or older state:
"Two or three persons in this household, age 18 years and older, have been selected at random to answer these questions personally, that is, themselves."
ENTER (1) 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, FDA, 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]
(CNTRL-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 FOR THE SELF-RESPONDENT OR THE PERSON WILL NOT RETURN BEFORE CLOSEOUT. FOR ELIGIBLE NON-SELECTED SELF-RESPONDENTS TAKE A PROXY/PROXY SHORT VERSION AFTER INTERVIEWING ALL SELF-SELECTED RESPONDENTS BY SELF.)
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/EVERY DAY/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?
FR: “FAIRLY REGULARLY’ OR “REGULARLY” REFERS TO AGE WHEN STARTED SMOKING CIGARETTES ON A ROUTINE BASIS AS OPPOSED TO AGE WHEN TRIED FIRST CIGARETTE.”
ENTER (0) 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 (01 – AGE): [SKIP TO A2c]
|__|__|
[[Age >5: GO TO A2c ]
[AGE Less Than OR Equal 5: GO TO A2av]
DON’T KNOW OR REFUSED: GO TO A2c]
A2av I have recorded that (you/name) (were/was) [fill entry A2a years old) when your first smoked part or all of a cigarette. Is that correct?
Yes [GO TO A2c]
No [GO TO A2a]
|__|
A2b In what state or country did (you/name) live when (you/he/she) started to smoke cigarettes fairly regularly?
FR: Spell out the state or country name entering a text of at most 40 characters
__________ ENTER STATE/COUNTRY NAME 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?
FR: Spell out the state or country name entering a text of at most 40 characters
__________ ENTER STATE/COUNTRY NAME 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, THENGO TO SECTION B
A3 = (2) SOME-DAY SMOKERS, THEN GO TO SECTION C
A3 = (3) NOT-AT-ALL SMOKERS, THEN GO TO SECTION H
A3 = D, R, THEN GO TO SECTION J
IF PROXY RESPONDENT, THEN 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
(1-99)
|__||__|
BOX 2
IF B1 = D, R, THEN GO TO B1a
IF B1 > 40, THEN GO TO B1v
ELSE, THENGO 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 B5a]
[ 3, Don’t Know OR Refused: GO TO B5a]
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 (0) IF RESPONDENT INSISTS IT VARIES
B5anum ENTER NUMBER (0 – 90)
|__|__|
B5aunt ENTER UNIT REPORTED
|__| (1) Minutes (2) Hours
BOX 5
IF B5a = 0, D, R, THEN GO TO B5b
ELSE, THEN GO TO BA6a
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 BA6a]
[Don’t know OR Refused: GO TO BA6a]
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, THENGO TO B6b
IF B6a = (2), THEN GO TO B6c
B6b/B6b2 What price did you pay for the LAST PACK of cigarettes you bought? Please report the cost after using discounts or coupons.
[FR: Enter “dollars” per pack on the first screen (B6b) and enter “cents” per pack on the next screen (B6b2)]
B6b $___ __ ( 0-99 )
B6b2 . ___ ___ (0-99)
[GO TO B6c3]
[Don’t know OR Refused: GO TO B6c3]
B6c/B6c2 What price did you pay for the LAST CARTON of cigarettes you bought? Please report the cost after using discounts or coupons.
[FR: Enter “dollars” per carton on the first screen (B6c) and enter “cents” per carton on the next screen (B6c2)]
B6c $___ __ ___ ( 0-999 )
B6c2 . ___ ___ (0-99)
[GO TO B6c3]
[Don’t know OR Refused: GO TO B6c3]
B6c3 Did you use coupons, rebates, or any other special promotions when you
bought your LAST (fill appropriate term here from B6a responses…=1 or 3 or DK or R, fill “PACK”; =2, fill “CARTON”) of cigarettes?
(1) Yes
(2) No
|__|
[GO TO B6d]
[Don’t know OR Refused: GO TO B6d]
B6d/B6d1 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?
(1) In respondent’s state of residence
(2) In some other state (including DC)
(3) BOUGHT SOME OTHER WAY (Internet, other country, Indian reservation.)
|
BOX 7
IF B6d1 =1 ENTER AUTOMATICALLY RESPONDENT’S STATE OF RESIDENCE IN B6d2, THEN GO TO B6d3
ELSE IF B6d = 2, THEN GO TO B6d2
ELSE IF B6d=3 GO TO B6dOTH
ELSE, THEN 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?
|__|__| ENTER STATE ABBREVIATION –TEXT OF AT MOST 2 CHARACTERS - 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]
B6d OTH 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)
|__|
GO TO B6e1
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, bought –GO TO B6e31
No , did not buy-- GO TO B7c
|__|
[Don’t Know OR Refused: GO TO B7c]
B6e31 Did you buy your LAST “single or individual” cigarette in (fill respondent’s state of residence) or in some other state or other country?
(1) In respondent’s state of residence
(2) In some other state (including DC)
(3) In another country
(4) BOUGHT SOME OTHER WAY (Internet, etc.)
|__|
BOX 7B
IF B6e31 = 1, ENTER AUTOMATICALLY RESPONDENT’S STATE OF RESIDENCE IN B6e32, THEN GO TO B7c
ELSE IF B6e31= 2, 3, THEN GO TO B6e32
ELSE, THEN GO TO B7c
B6e32 In what OTHER state or country did you buy your LAST SINGLE OR INDIVIDUAL cigarette?
_______________________ [FR: SPELL OUT THE STATE OR COUNTRY NAME. ENTER A TEXT OF AT MOST 40 CHARACTERS. ]
GO TO B7c
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 AND USE THE APPROPRIATE FILL IN B7c3 (“…did you smoke…..”), ELSE GO TO B8.
B7c3 For how long [fill “have you smoked” for those with a B2 = 1/ “did you smoke” for B7c2 = 1] 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
|__|
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 D1R ( 3rd QUESTION IN QUIT ATTEMPT SECTION)
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
(1-99)
|__||__|
BOX 7C
IF B9 = D, R, THEN GO TO D1R (3rd QUESTION IN QUIT ATTEMPT SECTION)
IF B9 > 40, THEN GO TO B9v
ELSE, THEN GO TO D1R (3rd QUESTION IN QUIT ATTEMPT SECTION)
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 D1R (3rd QUESTION IN QUIT ATTEMPT SECTION)
B10a Around this time 12 MONTHS AGO, on how many of the 30 days in the month did you smoke cigarettes?
ENTER (0) FOR NONE
|__|__| Range 0-30
BOX 7D
IF B10a = 0 OR 30, THEN GO TO B10av
ELSE, THEN 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, THEN GO TO B10b
IF B10av = 1 AND B10a= 0, THEN GO TO D1R ( 3rd QUESTION IN QUIT ATTEMPT SECTION)
IF B10av = 2, THEN 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”
|__|__| ( 1-99 ) IF > (GREATER THAN) 40, THEN GO TO D1R ( 3rd QUESTION IN QUIT ATTEMPT SECTION);
ELSE IF B10b = D, RD1R (3rd QUESTION IN QUIT ATTEMPT SECTION)
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
|__|
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 (0) FOR NONE
|__|__| (0-30)
BOX 9
IF C1 = 0 OR 30, THEN GO TO C1v
ELSE IF C1=DK, R, THENGO 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, THEN GO TO C1a
IF C1v = 1 AND C1 = 0, THEN GO TO C2
IF C1v = 2, THEN GO TO A3
IF C1v = DK, R, THEN 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 IF entry for C1 NE D/R, OR “AT LEAST 12 days” IF C1i = 1 YES] days, how many cigarettes did you usually smoke each day?
|__|__| IF < = (LESS THAN OR EQUAL TO) 40, THEN 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 / AT LEAST 12] 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 C5a_num/unt]
[ 3, Don’t Know OR Refused: GO TO C5a_num/unt]
C5anum/unt 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 (0) IF RESPONDENT INSISTS IT VARIES
C5anum ENTER NUMBER (0 – 90)
|__|__|
C5aunt ENTER UNIT REPORTED
|__| (1) Minutes (2) Hours
BOX 13
IF C5a = 0, D, R, THEN GO TO C5b
ELSE GO TO CA6a
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 CA6a]
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, THEN GO TO C6b
IF C6a = (2), THEN GO TO C6c
C6b/C6b2 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]
$___ ___ C6b (0-99) ENTER DOLLARS PORTION OF THE PRICE PER PACK
.___ ___ C6b2 (0-99) ENTER THE CENTS PORTION OF THE PRICE PER PACK
GO TO C6c3
[Don’t Know OR Refused: GO TO C6c3]
C6c/C6c2 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]
$__ __ __ C6c (0-999) ENTER THE DOLLARS PORTION OF THE PRICE PER CARTON
.__ __ C6c (0-99) ENTER THE CENTS PORTION OF THE PRICE PER CARTON
GO TO C6c3
[Don’t Know OR Refused: GO TO C6c3]
C6c3 Did you use coupons, rebates, or any other special promotions when you
bought your LAST (fill appropriate term here from B6a responses…=1 or 3 or DK or R, fill “PACK”; =2, fill “CARTON”) of cigarettes?
(1) Yes
(2) No
|__|
GO TO C6d1
[Don’t Know OR Refused: GO TO C6d1]
C6d1 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?
(1) In respondent’s state of residence
(2) In some other state (including DC)
(3) BOUGHT SOME OTHER WAY (Internet, other country, Indian reservation...)
|__|
BOX 15
IF C6d1 =1, ENTER AUTOMATICALLY RESPONDENT’S STATE OF RESIDENCE IN C6d2, THEN GO TO C6d3
ELSE IF C6d1 = 2, THEN GO TO C6d2
ELSE IF C6d1 = 3, THEN GO TO C6dOTH
ELSE, THEN GO TO C6e1
C6d2 In what other state did you buy your LAST (fill appropriate term here: pack/carton from C6a responses … =1, 3, DK or R, fill “pack”; =2, fill “carton”) of cigarettes?
|__|__| ENTER 2 CHARACTER 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
C6d OTH 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)
|__|
GO TO C6e1
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, bought GO TO C6e31
No, did not buy GO TO C7a
[Don’t Know OR Refused: GO TO C7a]
C6e31 Did you buy your LAST SINGLE or INDIVIDUAL cigarette in [fill respondent’s state of residence] or in some other state or other country?
In respondent’s state of residence
In some other state (including DC)
In another country
(4) BOUGHT SOME OTHER WAY (Internet, etc..)
|__|
BOX 15B
IF C6e31 =1, ENTER AUTOMATICALLY RESPONDENT’S STATE OF RESIDENCE IN C6e32, THEN GO TO C7a
ELSE IF C6e31 = 2, 3, THEN GO TO C6e32
ELSE, THEN GO TO C7a
C6e32 In what OTHER state or other country did you buy your LAST SINGLE OR INDIVIDUAL cigarette?
------------------------------------- [FR: SPELL OUT THE STATE OR COUNTRY NAME. ENTER A TEXT OF AT MOST 40 CHARACTERS]
GO TO C7a
Past Smoking Behavior for Some-Day Smokers
C7a Have you EVER smoked cigarettes EVERY DAY for at least 6 months?
(1) Yes [GO TO C7d]
(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 = DK OR R, AND IF C2=1, GO TO C7d3; ELSE IF C7a = DK OR R, AND
C2= 2, 3, DK, OR R, GO TO C7d2]
C7d For how long did you smoke 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 and fill C7d3 with “did you smoke”; ELSE if C7a =2, R, or DK, GO TO C8; ELSE GO TO C7e
C7d3 For how long [fill “have you smoked” for C2 = 1 / fill “did you smoke” for C7d2 = 1] 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 C8
[If >40: GO TO C7ev]
[Don’t Know OR Refused: GO TO C8]
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 C8]
(2) No [GO TO C7e]
|__|__|
[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, GO TO BOX 18
|__|
IF C8 = DK, R GO TO BOX 18
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
(1-99)
|__||__|
BOX16B
IF C9 = D, R, THEN GO TO BOX 18
IF C9 > 40, THEN GO TO C9v
ELSE, THENGO TO BOX 18
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 BOX 18
(2) No GO TO C9
|__|
DK, R GO TO BOX 18
C10a Around this time 12 MONTHS AGO, on how many of the 30 days in the month did you smoke cigarettes?
ENTER (0) FOR NONE
|__|__| (0 – 30)
BOX 16C
IF C10a = 0 OR 30, THEN GO TO C10av
If C10a=D, R, THEN GO TO C10b
ELSE, THEN 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, THENGO TO C10b
ELSE IF C10av = 1 AND C10a= 0, THEN GO TO BOX 18
ELSE IF C10av = 2, THENGO TO C8 AND CORRECT
ELSE GO TO C10b
C10b On the average, on those [fill entry C10a days; If C10a=D, R, then fill with “days you smoked”], how many cigarettes did you usually smoke each day?
We are still talking about “around this time 12 months ago.”
|__|__| (1-99) IF < = 40, THEN GO TO BOX 18;
ELSE IF C10b = D, R GO TO BOX 18; IF C10b > 40, GO TO C10bv
C10bv I have recorded that on the average, when you smoked on those [fill entry C10a days; If C10a=D, R, then fill with “days you smoked”], you smoked [fill entry C10b] cigarettes a day. Is that correct?
(1) Yes
(2) No GO TO C10b AND CORRECT
|__|
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, THEN GO TO D3b
ELSE IF D3 = 1, GO TO D6
ELSE IF D3 = 2, 3, GO TO D6c
D3b Would you say that during the past 12 months it was MORE THAN 3 TIMES that you …… [fill “have stopped smoking for one day or longer BECAUSE YOU WERE TRYING TO QUIT SMOKING?” IF D3 = D, R; fill “TRIED to QUIT smoking COMPLETELY?” IF Da= 1]
(1) Yes
(2) No
|__|
[GO TO D6c]
D6 During the PAST 12 MONTHS, what is the LENGTH of time of this single quit attempt where 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.]
D6num ENTER NUMBER (1 - 99)
|__|__|
D6unt ENTER UNIT REPORTED
(1) Days
(2) Weeks
(3) Months
(4)Years
|__|
BOX 20
IF D6num AND/OR D6unt = DK/REF, THEN GO TO D6b
IF D6num >18 AND D6unt = 2, THEN GO TO D6v
IF D6num > 12 AND D6unt=3, THEN GO TO D6v
IF D6num >2 AND D6unt = 4, THEN GO TO D6v
ELSE, THEN GO TO SECTION E
D6v I have recorded that the length of time of this single quit attempt where you stopped smoking in the past 12 months because you were TRYING to quit smoking was [fill entry D6num and D6unt]? Is that correct?
(1) Yes GO TO SECTION E BOX 21.
(2) No [GO TO D6num]
|__|
[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
D6c Thinking of those attempts during the past 12 months, what was the length of time of the ONE attempt that lasted the longest?
[FR NOTE: IF QUIT ATTEMPT BEGAN MORE THAN 12 MONTHS AGO BUT ENDED WITHIN THE PAST 12 MONTHS, COUNT ALL OF IT.]
D6cnum ENTER NUMBER (1 - 99)
|__|__|
D6cunt ENTER UNIT REPORTED
(1) Days
(2) Weeks
(3) Months
(4)Years
|__|
BOX 20B
IF D6cnum AND/OR D6cunt = DK/REF, GO TO D6c2
IF D6cnum >18 AND D6cunt = 2, GO TO D6cv
IF D6cnum > 12 AND D6cunt = 3, GO TO D6cv
IF D6cnum >2 AND D6cunt = 4, GO TO D6cv
ELSE, GO TO SECTION E, BOX 21
D6cv I have recorded that the length of time of your LONGEST single quit attempt where you stopped smoking in the past 12 months because you were TRYING to quit smoking was [fill entry D6cnum and
D6cunt]? Is that correct?
(1) Yes GO TO SECTION E BOX 21.
(2) No [GO TO D6cnum]
|__|
[Don’t Know OR Refused: GO TO D6c2]
D6c2 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 ALL OF E1b, E1c SERIES WITH “The TIME,” ELSE FILL ALL OF E1b, E1c SERIES WITH “The LAST TIME.”
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:
(1) Yes
(2) No
E1b1 |__| A telephone help line or quit line
E1b5 |__| Internet or web-based program or tool
[FR NOTE: IF ASKED, “INTERNET OR WEB-BASED PROGRAM OR TOOL” INCLUDES ANY APPS, SMARTPHONES, OR OTHER RELATED DEVICES.]
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
E1c2 |__| Try to quit by SWITCHING to smokeless tobacco such as chewing
tobacco, snuff, or snus { snus is pronounced as / |snu :s / }?
E1c2b |__| Try to quit by SWITCHING to regular cigars, cigarillos, little
filtered cigars or ANY pipes filled with tobacco?
[FR NOTE: IF ASKED “ANY PIPES FILLED WITH TOBACCO” INCLUDES EITHER OR BOTH “REGULAR/TRADITIONAL” PIPES AND “WATER OR HOOKAH” PIPES --AS LONG AS THEY ARE FILLED WITH TOBACCO.]
IF E1c2b = 2 (No), D, R, GO TO E1c2c; ELSE GO TO E1c2d.
E1c2c |__| Try to quit by SWITCHING to electronic or E-cigarettes?
[FR: E-CIGARETTES CAN ALSO BE CALLED VAPE-PENS, HOOKAH-PENS, E-HOOKAHS, E-VAPORIZERS, E-CIGARS, OR E-PIPES]
GO TO F1a
E1c2d Did you switch to……..?
Yes
No
E1c2d1 |__| Cigars, cigarillos, little filtered cigars
E1c2d2 |__| Regular pipes filled with tobacco
E1c2d3 |__| Water or hookah {pronounced who-kah} pipes filled with
tobacco
E1c2cAlt The (LAST TIME/ time) you tried to quit smoking in the
past 12 months, did you try to quit by SWITCHING to
electronic or E-cigarettes?
Yes
No
|__|
[FR: E-CIGARETTES CAN ALSO BE CALLED VAPE-PENS, HOOKAH-PENS, E-HOOKAHS, E-VAPORIZERS, E-CIGARS, OR E-PIPES]
(All responses GO TO F1a)
SECTION F. DOCTOR/DENTIST ADVICE TO STOP SMOKING --- CURRENT AND SOME-DAY SMOKERS
.
F1a In the PAST 12 MONTHS have you SEEN a medical doctor? [FR NOTE: RESPONDENTS SHOULD ANSWER “YES” IF THEY VISITED THEIR DOCTOR/DENTIST FOR ANY MEDICAL/DENTAL REASON (NOT ONLY FOR SMOKING RELATED REASONS).]
(1) Yes GO TO F1b
(2) No GO TO G1
|__|
[Don’t Know OR Refused: GO TO G1]
F1b During the PAST 12 MONTHS, did any medical doctor ADVISE you to stop smoking?
(1) Yes GO TO G1
(2) No GO TO G1
|__|
[Don’t Know OR Refused: 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, THEN 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
H1NUM/UNT About how long has it been since you COMPLETELY quit smoking cigarettes?
H1NUM ENTER NUMBER
(1‑99)
|__|__|
H1UNT ENTER UNIT REPORTED
(1) Days
(2) Weeks
(3) Months
(4) Years
|__|
BOX 24
IF H1NUM> 18 AND H1UNT= 2, GO TO H1v
IF H1NUM > 30 AND H1UNT = 3, GO TO H1v
IF H1NUM >(AGE - [ENTRY A2]) AND H1UNT= 4, THENGO TO H1ERR
ELSE IF H1NUM/UNT IS LESS THAN 5 MONTHS (OR EQUIVALENT), GO TO H1B; ELSE GO TO H2
H1ERR *** DO NOT READ ***
It was reported (in item A2) that this person first started smoking greater than [fill AGE ‑ (entry to A2)] years ago. Response of [fill entry H1NUM/UNT] (in item H1NUM/UNT) is inconsistent.
(B) Back to correct
|__| GO TO H1NUM
H1v I have recorded that it has been about [fill entry H1NUM and H1UNT] since you completely quit smoking cigarettes? Is that correct?
(1) Yes [IF H1NUM/UNT IS LESS THAN 5 MONTHS (OR EQUIVALENT), GO TO H1B; ELSE GO TO H2]
(2) No [GO TO H1NUM]
|__|
[Don’t Know OR Refused: GO TO H2]
H1B In the PAST 12 months, was [enter duration from H1NUM/UNT] the
longest time you stopped smoking cigarettes because you were trying to
quit?
Yes
No
|__|
[Don’t Know OR Refused: GO TO H2]
IF H1B = 2, GO TO H1C; ELSE GO TO H2.
H1C During the PAST 12 MONTHS, what WAS the 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.]
H1Cnum ENTER NUMBER (1 - 99)
|__|__|
H1Cunt ENTER UNIT REPORTED
(1) Days
(2) Weeks
(3) Months
(4)Years
|__|
BOX 25
IF H1Cnum AND/OR H1Cunt = DK/REF, GO TO H2
IF H1Cnum >18 AND H1Cunt = 2, GO TO H1Cv
IF H1Cnum > 12 AND H1Cunt=3, GO TO H1Cv
IF H1Cnum >2 AND H1Cunt = 4, GO TO H1Cv
ELSE, GO TO H2
H1Cv 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 H1C num and
H1Cunt]? Is that correct?
(1) Yes
(2) No [GO TO H1Cnum]
|__|
[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 H5]
(2) No [GO TO BOX 26]
|__|
[Don’t Know OR Refused: GO TO BOX 26]
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
(1‑99)
|__|__| IF < = 40: GO TO BOX 26
[If >40: GO TO H5av]
[Don’t Know OR Refused: BOX 26]
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 BOX 26]
(2) No [GO TO H5a]
|__|__|
[Don’t Know OR Refused: BOX 26]
BOX 26
IF H1 (LESS THAN OR EQUAL TO) 1 YEAR (12 MONTHS, 52 WEEKS, 99 DAYS), GO TO H6
IF H1 > 3YEARS (36 MONTHS, EQUIVALENT in WEEKS and in DAYS), GO TO H11a
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 H6C2
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
(1-99)
|__||__|
BOX26A
IF H6A = D, R , GO TO H6C2
IF H6A > 40, GO TO H6Av
ELSE, GO TO H6C2
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 H6C2
(2) No GO TO H6A to CORRECT
|__|
H6B Around this time 12 MONTHS AGO, on how many of 30 days in the month did you smoke cigarettes?
ENTER (0) FOR NONE
|__|__| (0-30)
BOX 26B
IF H6B = 0 OR 30, THEN 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 =0, 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 H6C2; ELSE IF H6C = D, R GO TO H6C2;
ELSE GO TO H6Cv
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 TOH6C2)
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
|__|
IF H6C2 =1, GO TO H6C5; ELSE IF H6C2 = 2, 3, R, 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 H6e1
H6C5 For how long did you smoke 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
|__|
H6e1 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:
(1) Yes
(2) No
H6e1 |__| A telephone help line or quit line
H6e5 |__| The Internet or a web-based program or tool
[FR NOTE: IF ASKED, “THE INTERNET OR A WEB-BASED PROGRAM OR TOOL” INCLUDES ANY APPS, SMARTPHONES, OR OTHER RELATED DEVICES.]
H6F When you quit smoking completely, did you do ANY of the following, whether or not you think they were effective:
[FR: FOR THIS QUESTION, RE-READ STEM PERIODICALLY]
(1) Yes
(2) No
H6Fa2 |__| Try to quit by SWITCHING to smokeless tobacco such as chewing
tobacco, snuff, or snus { snus is pronounced as / |snu :s / } ?
H6Fa2b |__| Try to quit by SWITCHING to regular cigars, cigarillos, little filtered
cigars or ANY pipes filled with tobacco?
[FR NOTE: IF ASKED “ANY PIPES FILLED WITH TOBACCO” INCLUDES EITHER OR BOTH “REGULAR/TRADITIONAL” PIPES AND “WATER OR HOOKAH” PIPES --AS LONG AS THEY ARE FILLED WITH TOBACCO.]
IF H6Fa2b = 2 (No), D, R, GO TO H6Fa2c; ELSE GO TO H6Fa2d.
H6Fa2c |__| Try to quit by SWITCHING to electronic or E-cigarettes?
[FR: E-CIGARETTES CAN ALSO BE CALLED VAPE-PENS, HOOKAH-PENS, E-HOOKAHS, E-VAPORIZERS, E-CIGARS, OR E-PIPES]
GO TO H61a
H6Fa2d Did you switch to………..?
Yes
No
H6Fa2d1 |__| Cigars, cigarillos, little filtered cigars
H6Fa2d2 |__| Regular pipes filled with tobacco
H6Fa2d3 |__| Water or hookah {pronounced who-kah} pipes filled with
tobacco
H6Fa2cAlt When you quit smoking completely, did you try to quit
by SWITCHING to electronic or E-cigarettes?
Yes
No
[FR: E-CIGARETTES CAN ALSO BE CALLED VAPE-PENS, HOOKAH-PENS, E-HOOKAHS, E-VAPORIZERS, E-CIGARS, OR E-PIPES]
|__| GO TO H61a
H61a In the 12 MONTHS BEFORE you COMPLETELY quit smoking, did you SEE a medical doctor?
[FR NOTE: RESPONDENTS SHOULD ANSWER “YES” IF THEY VISITED THEIR DOCTOR/DENTIST FOR ANY MEDICAL/ DENTAL REASON (NOT ONLY FOR SMOKING RELATED REASONS).]
Yes GO TO H61b
NO GO TO H8a
don’t know or refused --- GO TO H8a
|__|
H61b During the 12 MONTHS BEFORE you completely quit smoking, did any medical doctor ADVISE you to stop smoking?
(1) YES
(2) NO
|__|
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 (0) IF RESPONDENT INSISTS IT VARIES
H8aNUM ENTER NUMBER (1 – 90)
|__|__|
H8aUNT ENTER UNIT REPORTED
|__| (1) Minutes (2) Hours
BOX 29
IF H8aNUM = 0, D, R, GO TO H8b
ELSE GO TO Section J
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
|__|
[GO TO Section J]
[The menthol questions are repeated again below for those who stopped smoking greater than 3 years ago from Box 26. ]
H11a 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
|__|
IF H11a = 1, GO TO H11d; ELSE IF H11a =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 did you smoke 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]
SECTION J. OTHER TOBACCO USE – ALL RESPONDENTS
J The next questions are about the use of tobacco other than in cigarettes.
PRESS 1 TO CONTINUE
J1a (Have/Has) (you/name) EVER used any of the following EVEN ONE TIME?
(1) Yes
(2) No
IF E1c2d1 OR H6Fa2d1 = 1 (YES TO SWITCHING TO CIGARS, CIGARILLOS, LITTLE FILTERED CIGARS), FILL J1a1 = 1 (YES) AND DON’T ASK J1a1 AND GO TO BOX JSW; ELSE ASK J1a1
J1a1 A regular cigar or cigarillo (in Spanish use “medium size cigar” instead of the word “cigarillo”) OR a little filtered cigar?
|__|
FR: Regular cigars are different from little filtered cigars. They can be large cigars, or smaller in size such as cigarillos (in Spanish use “medium size cigars” instead of the word “cigarillos” here.) 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.
FR: Little filtered cigars are different from regular cigars and cigarillos (in Spanish use “medium size cigars” instead of word “cigarillos” here). 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.
___________________________________________________________________________
BOX JSW: IF E1c2d2 OR H6Fa2d2= 2 (YES TO SWITCHING TO REGULAR PIPES FILLED WITH TOBACCO), FILL J1a2 = 1 (YES) AND DON’T ASK J1a2 AND GO TO BOX JSW2; ELSE ASK J1a2.
J1a2 A regular pipe filled with tobacco
|__|
FR: 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
_________________________________________________________
BOX JSW2: IF E1c2d3 OR H6Fa2d3= 1 (YES TO SWITCHING TO WATER/HOOKAH PIPES FILLED WITH TOBACCO), FILL J1a3 = 1 (YES) AND DON’T ASK J1a3 AND GO TO BOX JSW3; ELSE ASK J1a3.
J1a3 A water pipe or hookah {pronounced: who-kah} pipe filled with tobacco?
|__|
FR: 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.
____________________________________________________________________________________
BOX JSW3: IF E1c2c OR E1c2cAlt OR H6Fa2c OR H6Fa2cAlt= 1 (YES TO SWITCHING TO E-CIGARETTES), FILL J1a3.5 = 1 (YES) AND DON’T ASK J1a3.5 AND GO TO BOX JSW4; ELSE ASK J1a3.5 INTRO AND J1a3.5.
J1A3.5 INTRO: The next question is about electronic or e-cigarettes. You may also know them as vape-pens, hookah-pens, e-hookahs, or e-vaporizers. Some look like cigarettes, and others look like pens or small pipes. These are battery-powered, usually contain liquid nicotine, and produce vapor instead of smoke.
J1a3.5 (Have/Has)(you/name) EVER used E-cigarettes EVEN ONE TIME?
(1) Yes
(2) No
|__|
FR: E-CIGARETTES AND SIMILAR PRODUCTS CAN BE BOUGHT AS ONE-TIME, DISPOSABLE PRODUCTS, AS RE-USABLE KITS WITH A CARTRIDGE, OR WITH REFILLABLE CHAMBERS. THESE ITEMS CONTAIN A NICOTINE AND/OR FLAVORED LIQUID, OFTEN CALLED “E-LIQUIDS” OR “E-JUICE.” SOME OF THESE PRODUCTS LOOK LIKE REGULAR CIGARETTES OR PENS, AND SOME MORE CLOSELY RESEMBLE A SMALL PIPE OR CIGAR. POPULAR BRANDS INCLUDE “NJOY,” “BLU,” “LOGIC,” and “VUSE.”
______________________________________________________________________
BOX JSW4: IF E1c2= 1 OR H6Fa2 = 1 (YES TO SWITCHING TO SMOKELESS TOBACCO), FILL J1a4= 1 AND DON’T ASK J1a4 AND GO TO INTRO BEFORE J1a5; ELSE ASK J1a4 INTRO AND J1a4.
J1a4 INTRO The next question is about smokeless tobacco products which are used in the mouth --
J1a4 (Have/Has) (you/name) EVER used any of the following EVEN ONE TIME?
(1) Yes
(2) No
J1a4 SMOKELESS tobacco, such as moist snuff, dip, spit, chew tobacco or snus { snus is pronounced as / |snu :s / } ?
|__|
FR: 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 THE 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.
J1a5 INTRO: The next question is about another type of tobacco called dissolvable tobacco. You don’t smoke dissolvable tobacco products--they are made of finely ground tobacco often flavored that dissolves in your mouth.
J1a5 (Have/Has)(you/name) EVER used dissolvable tobacco EVEN ONE TIME?
(1) Yes
(2) No
|__|
BOX 31
IF ((J1a1 THROUGH J1a5 = NO, DK or R) AND:
IF PROXY RESPONDENT, GO TO S78
IF SELF RESPONDENT, GO TO BOX 34)
ELSE IF ANY J1a1, 2, 3, 3.5, 4, 5 = YES (1) GO TO J2a1-5 FOR THOSE PRODUCTS
BOX 32
ASK J2a FOR EACH YES ENTRY IN J1a1 THROUGH J1a5
J2a/J2a1-5 (Do you/Does [name]) NOW (smoke/use) [fill entry in J1a = 1] every day,
some days or not at all? [J1a1-5 entries: smoke regular cigars, or cigarillos
or little filtered cigars…./ smoke a regular pipe filled with tobacco…/
smoke a water pipe or hookah pipe filled with tobacco…./ use an
E- cigarette / use smokeless tobacco such as moist snuff, dip, spit, chew
tobacco or snus { snus is pronounced as / |snu :s / } / use dissolvable tobacco…. ]
(1) Every day
(2) Some days
(3) Not at all
|__|
IF (J2a2 = 1 OR 2) AND (J2a3 = 1 OR 2), THEN ASK J2a3v. ELSE GO TO BOX 33.
J2a3v Do you currently smoke BOTH regular pipes AND water pipes or hookah {who-kah} pipes?
YES
NO- GO TO J2a2 and J2a3 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 J1a1 – 5
IF J2a=1:
IF SELF: IF J2a4 (SMOKELESS) IS 1 (EVERY DAY) AND LAST ENTRY FROM J1a GO TO Ja
ELSE IF J2a1 (CIGARS) IS 1 (EVERY DAY) AND LAST ENTRY FROM J1a GO TO Jb
ELSE LAST YES ENTRY FROM J1a1-5, THEN GO TO JNflavr
ELSE REPEAT J2a FOR NEXT YES ENTRY IN J1a1-5
IF J2a=3;
IF SELF: IF LAST ENTRY FROM J1a, THENGO TO Jd
ELSE REPEAT J2a FOR NEXT YES ENTRY IN J1a1 – 5
FOR EACH ENTRY J2a1-5=3 (NOT AT ALL), ASK HOW LONG HAS IT BEEN SINCE YOU COMPLETELY STOPPED SMOKING // USING … CIGARS / PIPES // E-cigarettes / SMOKELESS TOBACCO / DISSOLVABLE TOBACCO Q Jd1/2
IF J2a = 2: (Someday Smokers)
IF PROXY: IF LAST YES ENTRY FROM J1a 1- 5, THENGO TO S78
ELSE REPEAT J2a FOR NEXT YES ENTRY IN J1a1 – 5
IF SELF: GO TO J2b
IF J2a= DK/REF (-2 or -3),: GO BACK TO J2a for next item (ie. pipes, etc.)
IF J2a= DK/REF (-2 or -3) AND IF LAST ENTRY FROM J1a1-5, THEN GO TO BOX 34
J2b/J2b1-4 On how many of the past 30 days did you (smoke/use) [fill entry J1a1-5]?
[ASK SEPARATELY FOR EACH “YES” ENTRY IN J1a and WITH J2a = 2]
ENTER NUMBER OF DAYS
ENTER (0) FOR NONE
(0-30)
|__||__| IF [entry in J2b = 0 OR 30], GO TO J2b1-5v; ELSE AFTER OBTAINING ALL RELEVANT RESPONSES TO THIS QUESTION, IF SMOKELESS CURRENT USE, GO TO Ja; ELSE IF CIGAR CURRENT USE, GO TO Jb; ELSE IF REGULAR OR HOOKAH PIPE FILLED WITH TOBACCO CURRENT USE OR E-CIGARETTE CURRENT USE OR DISSOLVABLE TOBACCO CURRENT USE, GO TO JNflavr.
J2b1-5v 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 RELEVANT J2a1-5 AND CORRECT]
|__|
NOTE: THE J2a, J2b, and J2bv (as needed) SERIES IS REPEATED FOR EACH YES ENTRY IN J1a1-5 AS APPROPRIATE
AFTER OBTAINING ALL RELEVANT RESPONSES TO THESE QUESTIONS (J2a, 2b, 2bv as appropriate), IF SMOKELESS CURRENT USE, THENGO TO Ja; ELSE IF CIGAR CURRENT USE, THEN GO TO Jb; ELSE IF REGULAR OR HOOKAH PIPE FILLED WITH TOBACCO CURRENT USE OR E-CIGARETTE CURRENT USE OR DISSOLVABLE TOBACCO CURRENT USE, GO TO JNflavr.
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 OR ENTER Brand NAME by clicking on it—
Ja |__|__| (1-21)
IF BRAND IS NOT ON THE LIST, ENTER “21” for OTHER in Ja.
THE UNREAD CODES FOR INTERVIEWER ENTRY ARE:
1 BEECH-NUT
2 CAMEL SNUS
3 COPE
4 COPENHAGEN
5 GENERAL SNUS
6 GRIZZLY
7 HUSKY
8 KAYAK
9 KODIAK
10 LEVI GARRETT
11 LONGHORN
12 MARLBORO SNUS
13 RED MAN
14 RED MAN GOLDEN BLEND
15 RED SEAL
16 SKOAL
17 SKOAL SNUS
18 SKOAL X-TRA
19 STOKER'S
20 TIMBER WOLF
21 OTHER
IF Ja = 21, GO TO Jaspc; ELSE IF J2a1 = 1 or 2, THEN GO TO Jb--- [ If “cigars” are NOW smoked every day or some days, ask Jb and Jc,…. ]—ELSE GO TO JNflavr.
Jaspc Please specify the other brand: ___________________ FR: ENTER A TEXT OF AT MOST 20 CHARACTERS.
IF J2a1 = 1 or 2, GO TO Jb--- [ If “cigars” are NOW smoked every day or some days, ask Jb and Jc, …… ]—ELSE GO TO JNflavr
Jb During the PAST 30 days, what type of CIGAR did you use MOST OFTEN?
READ the 3 CHOICES
Regular/large cigars
“Cigarillos”(in Spanish use “medium size cigars” instead of the word “cigarillos here”)
Little filtered cigars
|__|
Jc During the PAST 30 days, what BRAND of CIGAR did you smoke MOST OFTEN?
|__| ENTER CODE FOR BRAND (1-20).
ENTER 20 for OTHER BRAND NOT ON THE LIST
NOTE: List of major brands for coding SEE BELOW.
THE UNREAD CODES FOR INTERVIEWER ENTRY ARE:
1 305'S
2 AL CAPONE
3 ANTONIO Y CLEOPATRA
4 BACKWOODS
5 BLACK & MILD
6 CHEYENNE
7 DJARUM
8 DUTCH MASTERS
9 GARCIA Y VEGA
10 GOOD TIMES
11 HAV-A-TAMPA
12 PHILLIES
13 PRIME TIME
14 SANTA FE
15 SMOKER'S CHOICE
16 SWISHER SWEETS
17 WHITE CAT
18 WHITE OWL
19 ZIG ZAG
20 OTHER
IF Jc = 20, GO TO Jcspc;
Jcspc Please specify the other brand: ___________________ FR: ENTER A TEXT OF AT MOST 20 CHARACTERS.
FOR EACH NON-CIGARETTE TOBACCO PRODUCT OR E-CIGARETTE PRODUCT CURRENTLY USED, J2a1-5 = 1 OR 2, ASK JNflavr SEPARATELY AFTER READING THE JNflavr INTRO ONLY ONCE IF THERE ARE ANY J2a1-5 = 1 or 2.
JNflavr INTRO-- Some tobacco products come in flavors such as menthol or mint, clove, spice, candy, fruit, chocolate, alcohol, or other flavors.
JNflavr1-5 When you ….[fill as appropriate entry J2a1-5 – smoke a cigar /smoke a regular pipe filled with tobacco/ smoke a water/hookah pipe
filled with tobacco/ use an E-cigarette / use smokeless tobacco /
use dissolvable tobacco] is it usually flavored?
Yes
No
|__|
IF E-CIGARETTES ARE CURRENTLY USED (J2a3.5 = 1 OR 2) ASK JECIGREA; ELSE GO TO BOX Jd
JECIGREAa-d The next questions are about the reasons people use e-cigarettes. Please select which reasons apply to you.
[FR: E-CIGARETTES CAN ALSO BE CALLED VAPE-PENS, HOOKAH-PENS, E-HOOKAHS, E-VAPORIZERS, E-CIGARS, OR E-PIPES]
(1) Yes
(2) No
|__| (a) I can use e-cigarettes at times when or in places where smoking cigarettes
isn’t allowed.
|__| (b)They might be less harmful to me than cigarettes.
|__| ( c )They might be less harmful to people around me than cigarettes.
|__| (d) Using e-cigarettes helps people to quit smoking cigarettes.
BOX Jd
FOR EACH ENTRY J2a1-5 = 3 (NOT AT ALL), GO TO Jd1/2_1-5; ELSE GO TO Jd3.
Jd1/2_1-5 About how long has it been since you COMPLETELY quit smoking//using --cigars, cigarillos, or little filtered cigars /a regular pipe filled with tobacco / a water pipe or hookah {who-kah} pipe filled with tobacco // E-cigarettes /smokeless tobacco / dissolvable tobacco?
Jd11/2/3/3.5 /4/5 |__|__| NUMBER (1-99)
Jd2 1/2/3/3.5/4/5 |__| UNITS
(1) Days
(2) Weeks
(3) Months
(4) Years
Jd3 ASK Jd3 SEPARATELY FOR EACH.. J1a1-5 = 1 (YES): AND J2a1-5 = 1, 2, or 3
Jd3 In total, how many years [fill “have you smoked/used” when J2a1-5 = 1 or 2 / “did you smoke/use” when J2a1-5 = 3] cigars or cigarillos or little filtered cigars / a regular pipe filled with tobacco / a water pipe or hookah pipe filled with tobacco // E-cigarettes /smokeless tobacco / dissolvable tobacco (fill as appropriate from J1a1-5)?
ENTER 0 FOR LESS THAN ONE YEAR
Jd3 1,2,3,3.5,4,5 |__|__| (0-99) years
ASK JFECIGREAa-d FOR THOSE WITH J2a3.5 = 3; ELSE GO TO BOX 34
JFECIGREAa-d The next questions are about the reasons people use e-cigarettes. Please select which reasons applied to you when you used to use e-cigarettes.
(1) Yes
(2) No
|__| (a) I could use e-cigarettes at times when or in places where smoking cigarettes wasn’t allowed.
|__| ( b) They might have been less harmful to me than cigarettes.
|__| ( c) They might have been less harmful to people around me than cigarettes.
|__| (d) Using e-cigarettes helps people to quit smoking cigarettes.
BOX 34
FOR PROXY RESPONDENT, GO TO S78
FOR SELF RESPONDENT:
IF J1a1-5= NO OR J2a = DK/Refused OR ANY COMBINATION OF THESE THREE STIPULATIONS FOR ALL SIX “OTHER” TOBACCO PRODUCTS FOR ALL ENTRIES GO TO SECTION K
Other tobacco time to first use:
BOX 39
IF ONLY ONE PRODUCT MENTIONED IN J2a IS NOW USED “EVERY DAY” OR “SOME DAYS” [J2a@1-5 =1 OR 2], THAT PRODUCT IS USED FOR J3a.
If J2a1=1 or 2, fill with ‘smoke your first cigar’
If J2a2-3=1 or 2, fill with ‘smoke your first regular or hookah
pipe filled with tobacco’
If J2a3.5 =1 or 2, fill with ‘use your first e-cigarette’
If J2a4=1 or 2, fill with ‘first use smokeless tobacco’
If J2a5=1 or 2, fill with ‘first use dissolvables’
ELSE IF > 1 PRODUCT MENTIONED IN J2a IS NOW USED “EVERY DAY” OR “SOME DAYS [ANY J2a@1-5=1 OR 2] FILL J3a WITH THOSE PRODUCTS,” LIST ALL PRODUCTS NOW USED.
ELSE IF [(J2a=3 OR J1a = 2) FOR ALL J1a1- 5 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” J1a1- 5] AND [ ( IF A3 =3 AND H1NUM/UNT > (GREATER THAN) 1 YEAR, 12 MOS., 52 WEEKS, OR EQUIVALENCE) OR (IF A1=2, DK, R) ] THEN GO TO J3f;
ELSE IF [(J2a=3 OR J1a = 2) FOR ALL J1a1- 5 AND [Jd1/2 LESS THAN OR EQUAL TO 1 YEAR, 12 MONTHS, 52 WEEKS, 99 DAYS (i.e., 1 YEAR EQUIVALENCE) FOR ANY “OTHER TOBACCO PRODUCT” J1a1, 2, 3, 3.5, 4, OR 5] AND [ ( IF A3 =3 AND H1NUM/UNT LESS THAN OR EQUAL TO 1 YEAR, 12 MOS., 52 WEEKS, 99 DAYS (i.e., 1 YEAR 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 J2a1-5—SEE Box 39 ABOVE]?
(IF NECESSARY, FR ASK FOR BEST ANSWER IN MINUTES OR HOURS)
[FR NOTE: If respondents use both kinds of pipes, they should be thinking of both kinds and answer the earliest time after awakening they smoke the first of the two types of pipes.]
ENTER (0) in J3a1 IF RESPONDENT INSISTS IT VARIES
J3a1 ENTER NUMBER (0 - 90)
|__|__|
J3a2 ENTER UNIT REPORTED
|__| (1) Minutes (2) Hours
IF J3a = 0, D, or R, THEN GO TO J3d; ELSE GO TO BOX 39A
J3d Would you say you first .. [FILL WITH APPROPRIATE STEM AND ENDING BASED ON RESPONSES IN J2a1-5 SIMILAR TO J3a….smoke a cigar/ pipe// use … an e-cigarette/ smokeless tobacco / dissolvable tobacco// ….other appropriate combinations… within the first 30 minutes of awakening?
(1) Yes
(2) No
(3) Varies— DO NOT READ
|__|
GO TO BOX 39A
J3f1/2 In the 12 months BEFORE YOU COMPLETELY QUIT smoking… (…cigars/pipes).// using… (E- cigarettes/smokeless tobacco/dissolvable tobacco), how soon after you woke up did you typically [fill with appropriate stem and ending based on responses to J2a1-5] smoke your first ….cigar ./ pipe-// - use your first e-cigarette // first use ….. smokeless tobacco / dissolvable tobacco?
(IF NECESSARY, FR ASK FOR BEST ANSWER IN MINUTES OR HOURS)
[FR NOTE: If respondents used both kinds of pipes, they should be thinking of both kinds and answer the earliest time after awakening they smoked the first of the two types of pipes.]
ENTER (0) in J3f1 IF RESPONDENT INSISTS IT VARIES
J3f1 ENTER NUMBER (0 - 90)
|__|__|
J3f2 ENTER UNIT REPORTED
|__| (1) Minutes (2) Hours
IF J3f1 = 0, D or R, THEN GO TO J3g; ELSE GO TO BOX 39A
J3g Would you say you first used cigars/ pipes/ e-cigarettes/ smokeless tobacco/ dissolvable tobacco// within the first 30 minutes of awakening?
(1) Yes
(2) No
(3) Varies— DO NOT READ
|__|
_______________BOX 39A _________________
IF A3 = 1 OR 2 (CURRENT CIGARETTE SMOKER) GO TO SECTION K DO NOT ASK J4-J7
ELSE IF ONLY ONE PRODUCT MENTIONED IN J2a (J2a 1-5) IS NOW USED “EVERY DAY” OR “SOME DAYS” GREATER THAN OR EQUAL TO 12 DAYS” [J2a =1 OR (J2a =2 AND J2b ≥ 12 days)], 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 K
ELSE IF [(J2a=3 OR J1a = 2) FOR ALL J1a1-5] 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” J1a1-5] AND [ (IF A3 =3 AND H1NUM/UNT > 1 YEAR, 12 MOS., 52 WEEKS, OR OTHER EQUIVALENCE) OR (IF A1=2, D, R) ] , THEN GO TO J7a.
ELSE, THENGO TO SECTION K
J4 During the PAST 12 MONTHS, have you stopped smoking // using [fill entry based on BOX 39A—cigars / pipes // e-cigarettes / smokeless tobacco / dissolvable tobacco] for one day or longer BECAUSE YOU WERE TRYING TO QUIT?
(1) Yes è GO TO J6b
(2) No èGO TO SECTION K
IF J4 = D, R è GO TO SECTION K
J 6b Thinking of ANY attempts to stop smoking …// using … [fill entry same as J4 fill – cigars/pipes // E-cigarettes/ smokeless tobacco / dissolvable tobacco] because you were trying to quit, during the past 12 months, what was the length of time of the ONE attempt that lasted the longest?
[FR NOTE: IF QUIT ATTEMPT BEGAN MORE THAN 12 MONTHS AGO BUT ENDED WITHIN THE PAST 12 MONTHS, COUNT ALL OF IT.]
J6bnum ENTER NUMBER (1 -96)
|__|__|
J6bunt ENTER UNIT REPORTED
(1) Days
(2) Weeks
(3) Months
|__| IF (J6num >18 AND J6bunt = 2) OR (J6bnum >12 AND J6bunt = 3) è GO TO J6bv; ELSE è GO TO J7a1
J6bv I have recorded that the LONGEST length of time you stopped smoking//using [fill entry same fill as J4—cigars/ pipes//e-cigarettes/ smokeless tobacco/ dissolvable tobacco] in the past 12 months because you were TRYING to quit was [fill entry J6bnum/J6bunt]? Is that correct?
(1) Yes
(2) Noè GO TO J6bnum/unt TO CORRECT
|__|
BOX J7b-- For J7b– 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 J1a1- 5 AND [Jd1/2 LESS THAN OR EQUAL TO 1 YEAR, 12 MONTHS, 52 WEEKS, 99DAYS (i.e., 1 YEAR EQUIVALENCE) FOR ONLY ONE “OTHER TOBACCO PRODUCT” J1a1-5] AND [ ( IF A3 =3 AND H1NUM/UNT > 1 YEAR, 12 MOS., 52 WEEKS, OR EQUIVALENCE) OR (IF A1=2, D, R) ] THEN GO TO J7b.)
Alternative wording: J7b-c “Now I would like to ask about HOW you went about completely quitting smoking…cigars / pipes // using … e-cigarettes / smokeless tobacco / dissolvable tobacco. When you COMPLETELY quit smoking … cigars/pipes // using… e-cigarettes / smokeless tobacco / dissolvable tobacco, did ……
J7b Thinking back about the last time you tried to quit [fill entry Box 39A—smoking cigars/ smoking pipes/ using e-cigarettes / using smokeless tobacco/ using dissolvable tobacco] in the past 12 months …..// SUBSTITUTE ALTERNATIVE WORDING FOR RECENT FORMER USER OF OTHER TOBACCO PRODUCT-- CRITERIA FROM BOX 39A/ BOX J7b-- above//……:
J7b1 did you use ANY of the following://USE ALTERNTAIVE WORDING FOR RECENT FORMER USER OF OTHER TOBACCO PRODUCT//:
(1) Yes
(2) No
J7b1 |__| A telephone help line or quit line?
J7b5 |__| The Internet or web-based program or tool?
[FR NOTE: IF ASKED, “THE INTERNET OR A WEB-BASED PROGRAM OR TOOL” INCLUDES ANY APPS, SMARTPHONES, OR OTHER RELATED DEVICES.]
GO TO J7c.
J7c The LAST TIME you tried to QUIT (fill entry Box 39A/J7a—smoking cigars /smoking pipes/using e-cigarettes/ using smokeless tobacco/ using dissolvable tobacco) 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
IF PRODUCT ASKING ABOUT IS CIGARS OR PIPES, ASK J7c3 and J7c4; ELSE IF PRODUCT ASKING ABOUT IS SMOKELESS OR DISSOLVABLE TOBACCO, ASK J7c4 ; ELSE IF PRODUCT ASKING ABOUT IS E-CIGARETTES, ASK J7c3 , THEN GO TO SECTION K.
J7c3 |__| Try to quit by switching to any type of smokeless tobacco ?
J7c4 |__| Try to quit by switching to e-cigarettes ?
GO TO SECTION K
SECTION K. WORKPLACE POLICY, HOME RULES, PUBLIC OPINION ABOUT SMOKING IN PUBLIC VENUES
– ALL SELF RESPONDENTS
BOX41 -- CONTEXT FOR K1- K3 SERIES:
IF NOT RETIRED AND HAVE BEEN WORKING FOR PAY OR EMPLOYED IN PAST WEEK AND ARE NOT SELF-EMPLOYED:
K1a The next questions are about your place of work.
[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]
(6) Varies [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 K1b1]
(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?
|__|__| FR: ENTER 2 LETTER ABBREVIATION FOR THE STATE.
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?
|__|__| ENTER 2 LETTER STATE 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 K3d ]
Don’t KNOW OR refused [SKIP TO K3d ]
|___|
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?
READ THE FIRST 3 ANSWER CATEGIES ONLY
(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?
READ THE FIRST 3 ANSWER CATEGIES ONLY
(1) Not allowed in ANY work areas
(2) Allowed in SOME work areas
(3) Allowed in ALL work areas
ENTER (4) IF NOT APPLICABLE
|__|
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
|__|
K4 The final set of questions are about your home and other places.
K4 Which statement best describes the rules about smoking INSIDE YOUR HOME?
[FR 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. “SMOKING” INCLUDES CIGARS, REGULAR AND HOOKAH PIPES, AS WELL AS CIGARETTES.
(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
|__|
K5a. In buildings with multiple apartments or living areas, do you THINK that smoking should be… allowed INSIDE ALL apartments or living areas, allowed inside some apartments …., or NOT allowed at all inside apartments?
1. Allowed INSIDE ALL apartments or living areas
2. ALLOWED inside SOME apartments
3. NOT allowed at ALL inside apartments
|__|
K5b. Now think about INDOOR PUBLIC OR COMMON areas in buildings with MULTIPLE apartments, such as halls, stairs, lobbies, and recreation areas. Do you THINK that smoking should be allowed in ALL such INSIDE COMMON areas, allowed in SOME INSIDE COMMON areas, or NOT allowed at ALL in ANY INDOOR COMMON areas?
1. Allowed in ALL INDOOR COMMON areas
2. Allowed in SOME INDOOR COMMON areas
3. NOT allowed at ALL in ANY INDOOR COMMON areas
|__|
K6 (In/Inside/On ….. READ PLACE LISTED BELOW), do you THINK that smoking SHOULD be allowed in ALL areas, allowed in SOME areas, or NOT allowed at ALL.
(FR: READ SENTENCE SUBSTITUTING EACH PLACE LISTED BELOW, DROPPING THE STEM AS NECESSARY AFTER THE FIRST FEW TIMES.)
(1) Allowed in ALL areas
(2) Allowed in SOME areas
(3) NOT Allowed at ALL
K6b In Indoor work areas. . . . . . . . . ===>|__|
K6c Inside Bars, cocktail lounges, and clubs . . . ===>|__|
K6g Inside casinos ……………….. === > |__|
K6ga On Outdoor children’s playgrounds and outdoor children’s
sports fields, ……=== >|__|
GO TO K6h;
K6h Inside a car, when there are other people present, do you THINK that smoking SHOULD…
Always be allowed, GO TO K6h2
Be allowed under some conditions, or GO TO K6h2
Never be allowed? GO TO SINTTP
|__|
DON’T KNOW OR REFUSED GO TO K6h2
K6h2 IF children are present inside the car, do you think that smoking SHOULD…
Always be allowed,
Be allowed under some conditions, or
Never be allowed?
|
(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) …………. ……………. |
GO TO SINTTP
SINTTP *** DO NOT READ ***
In what language was the interview conducted for this person?
(1) English
(2) Spanish
(3) Chinese
(4) Korean
(5) Vietnamese
(6) Thai -Khmer
(7) Other Asian or Asian unspecified
(8) Other
|__|
|
|
|
April 2, 2014
| File Type | application/msword |
| File Title | revised2003Cessation_0709.wpd |
| Author | Noory, Laila (FDA) |
| Last Modified By | abdelmot |
| File Modified | 2014-04-23 |
| File Created | 2014-04-23 |