2 PATH Study Data Collection Instruments

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

Attachment 2
Part B
PATH Study Data Collection Instruments

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

Table of Contents
Section

Page
IN4-5

Parent Questionnaire – New and Aged-Up Interview ..............

3

IN4-6

Parent Questionnaire – Extended Interview ..............................

69

IN4-7

Youth Questionnaire – New and Aged-Up Interview ..............

128

IN4-8

Youth Questionnaire – Extended Interview...............................

495

IN4-9

Adult and Youth Tobacco Use Form .........................................

839

IN4-10

Shadow Youth Only Screener ......................................................

841

IN4-11

Verification Task Wrapper............................................................

843

IN4-12

Telephone Validation Script .........................................................

879

IN4-13a

Continuing Adult Field Visit Validation Form ..........................

890

IN4-13b

Replenishment Sample Adult Field Visit Validation
Form.................................................................................................

900

IN4-13c

Household Screener Field Visit Validation Form .....................

909

IN4-14

Parent and Youth Field Visit Validation Form..........................

918

IN4-15

Blood Data Collection Form (English) .......................................

924

IN4-15

Blood Data Collection Form (Spanish) ......................................

926

IN4-16

Urine Data Collection Form (English) .......................................

928

IN4-16

Urine Data Collection Form (Spanish) .......................................

929

IN4-17

Adult Participant Information Form (English) .........................

930

IN4-17

Adult Participant Information Form (Spanish) .........................

934

IN4-18

Parent Participant Information Form (English) ........................

938

IN4-18

Parent Participant Information Form (Spanish) ........................

942

IN4-19

Parent of Youth Under Age 12 Participant
Information Form (English) .........................................................

946

IN4-19

Parent of Youth Under Age 12 Participant
Information Form (Spanish) ........................................................

950

Parent Questionnaire – New and Aged-Up Interview

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

Table of Contents
FAMILY COMPOSITION ..................................................................................................... 1
SCHOOL, HOME AND TOBACCO USE ........................................................................... 16
HEALTH ............................................................................................................................ 21
RESPONDENT CHARACTERISTICS .............................................................................. 39
CONTACT INFORMATION ............................................................................................... 49

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
SECTION

# OF QUESTIONS

Family Composition

32

School, Home and Tobacco Use
Health
Respondent Characteristics
Contact Information

9
48
19
33

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

POMBIntro

IF RESPONDENT ASKS ABOUT THE OFFICE OF MANAGEMENT AND BUDGET (OMB), READ THE
FOLLOWING PARAGRAPH ALOUD
OMB Control Number: 0925-0664
Expiration Date: XX/XX/XXXX
Public reporting burden for this collection of information is estimated to average 19 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 (0925-0664). Do not return the
completed form to this address.
PRESS 1 TO CONTINUE
1

CONTINUE

ASK: Parent/guardian of sampled youth.
DISPLAY: Display OMB statement text in grey. Display "IF RESPONDENT ASKS..." statement and
"PRESS 1 TO CONTINUE" in blue. Pending language selected in F2; display English OMB statement if
English is selected, display Spanish OMB statement if Spanish is selected. Default to English display.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

FAMILY COMPOSITION
BOX ID:

R04_PXV01

PROGRAM: LOAD THE FOLLOWING VARIABLES
R03_PT0001 = Wave 3 parent's relationship to youth SP
R03_PT0046 = ID of Wave 3 parent's spouse
R03_PT0047 = Wave 3 parent's marital status
R03_PARREPT_ADHD = Youth has been told that he/she has ADD/ADHD
R03_PARREPT_ASTHMA = Youth has been told that he/she has asthma
R03_PARREPT_DIABETES = Youth has been told that he/she has diabetes
R01_HM0014 = Are there twins/multiple births in household (Wave 1 HH Screener)
R04_HM0014 = Are there twins/multiple births in household (Wave 4 HH Screener)
R04_CONTACTFLAG = Adult SP or parent/guardian of youth SP has provided contact information.
R04_ADULT_COMPLETE_LD = Adult respondent has completed the adult questionnaire.
R04_PARENT_COMPLETE_LD = Parent/guardian of sampled youth has completed one or more
parent questionnaire(s).
R04_LINKED_ADDRESS = Best address from IMS
R04_VTBESTSPPHONE = Best phone number from IMS
R04_PHONE2 = Second phone number from IMS
PROGRAM - LOAD THE FOLLOWING VARIABLES FROM CONSENT WRAPPER:
R04_YOUTHTYPE
(1) ContinuingYouth = Youth completed a youth interview in a previous wave and will do a youth
interview this wave.
(2) NewBaselineYouth = Youth was a shadow youth in previous wave, but will do a youth interview this
wave.
(3) New Cohort Youth = Youth respondents who are new to the PATH Study as part of the
replenishment sample. This is their first interview in the Youth cohort and in the PATH Study.
(4) ContinuingShadowYouth = Youth was a shadow youth in previous wave and is still a shadow youth.
R04_LASTWVPARENTCOMP
For the parent associated with this youth:
(1) wave 1 = the last time this parent did a parent interview for this youth was in baseline.
(2) wave 2 = the last time this parent did a parent interview for this youth was in wave 2.
(3) wave 3 = the last time this parent did a parent interview for this youth was in wave 3.
(null) this parent has never done a parent interview for this youth.
R04_PARENTTYPE
(1) PriorParent = This parent has completed a parent interview for this youth in a previous wave.
(2) NewParent = This parent has not completed a parent interview for this youth in a previous wave.
R04_PARYTHAGE = age of youth at time of parent consent.
Program Note: In the following specifications, “!=” represents “not equal to”.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_PXR03

If the W4 parent/guardian is the same respondent as the W3 parent/guardian, and the W3 parent
relationship to youth was not "Other relative", "Non-relative" or Don't Know/Refused, go to
R04_PM0053.
Else, go to R04_PT0001.
PATH ID:

R04_PM0053

I have that you are {Child’s first name}'s {parent's relationship to sampled youth}? Is that correct?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO BOX R04_PTR01

GO TO BOX R04_PTR01

ASK: Parent/guardian of sampled youth who selected a relationship in R03_PT0001.
PATH ID:

R04_PT0001

What is your relationship to {Child’s first name}? In other words, you are {Child’s first name}'s...
[Would you say biological, adoptive or step mother / father?]
1

BIOLOGICAL MOTHER

2

BIOLOGICAL FATHER

3

ADOPTIVE MOTHER

4

ADOPTIVE FATHER

5

STEP MOTHER

6

STEP FATHER

7

FOSTER MOTHER

8

FOSTER FATHER

9

GRANDMOTHER

10

GRANDFATHER

11

AUNT

12

UNCLE

91

OTHER RELATIVE (SPECIFY)

92

NON RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: This item is asked when the W4 parent/guardian is not the same as the W3 parent/guardian; or
any respondent who reported OTHER/SPECIFY, DON'T KNOW, or REFUSED to this question in W3; or
any respondent who did not confirm relationship in R04_PM0053.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_PTR01

If parent/guardian of shadow youth, go to Contact Information section.
Else, if parent has already completed a parent interview for another youth and parent is
married and has provided a valid name for their spouse, go to R04_PT0002.
Else, if parent has already completed a parent interview for another youth and parent is not married or
has not provided a valid name for their spouse, go to R04_PM0057.
Else, go to R04_PT0047.
PATH ID:

R04_PT0047

What is your marital status? Are you currently married, widowed, divorced, separated or never married?
1

MARRIED

2

WIDOWED

3

DIVORCED

4

SEPARATED

5

NEVER MARRIED

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete a parent interview.
BOX ID:

R04_PTR03

Parents who were married at W3 and who are still married at W4, go to R04_PM0052.
Else, parents who are now married at W4, go to R04_PT0046.
Else, go to R04_PM0057.
PATH ID:

R04_PM0052

I have that your spouse is {Spouse's first name}, is that correct?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO R04_PT0045

GO TO R04_PM0057

ASK: Parent/guardian of sampled youth who is married at W3 and W4. If parent has already completed
a parent interview for another youth, do not re-ask this item.
DISPLAY: Fill {Spouse's first name} with name selected in R03_PT0046. Only display the first name.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0046

What is your spouse's name?
SELECT NAME AMONG THE LIST. READ NAMES IF NECESSARY. IF SPOUSE'S NAME IS NOT
LISTED, SELECT SPECIFY.
1

[First Name and age of person #1]

GO TO R04_PT0045

2

[First Name and age of person #2]

GO TO R04_PT0045

3

[First Name and age of person #3]

GO TO R04_PT0045

4

[First Name and age of person #4]

GO TO R04_PT0045

5

[First Name and age of person #5]

GO TO R04_PT0045

25

SPECIFY: [ENTER FIRST AND LAST NAME AND AGE OF
SPOUSE]

-8

DON'T KNOW

GO TO R04_PM0057

-7

REFUSED

GO TO R04_PM0057

ASK: Parent/guardian whose spouse's name was not confirmed in R04_PM0052, or parents who report
now being married in W4. If parent has already completed a parent interview for another youth, do not
re-ask this item.
DISPLAY: List first names of everyone in the grid who is aged 18 years old or older (and not deceased)
in the HH screener with their age, ordered by oldest to youngest and then new people that were added
earliest to most recent below. For response options, display one row for each person on the grid.
Display interviewer instructions in blue.
PATH ID:

R04_PT0046_OS_1

What is your spouse's first name?
ENTER THE SPOUSE'S FIRST NAME.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0045

-7

REFUSED

GO TO R04_PT0045

ASK: Parent/guardian of sampled youth who needs to specify the name of their spouse.
DISPLAY: Display interviewer instructions in blue.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0046_OS_2

What is your spouse's last name?
ENTER THE SPOUSE'S LAST NAME.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0045

-7

REFUSED

GO TO R04_PT0045

ASK: Parent/guardian of sampled youth who needs to specify the name of their spouse.
DISPLAY: Display interviewer instructions in blue.
PATH ID:

R04_PT0046_OS_3

What is your spouse's age?
ENTER THE SPOUSE'S AGE.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0045

-7

REFUSED

GO TO R04_PT0045

ASK: Parent/guardian of sampled youth who needs to specify the name of their spouse.
DISPLAY: Display interviewer instructions in blue.
PATH ID:

R04_PT0045

Does {Spouse's first name} live here?
[If your spouse or partner is deployed for military active duty, please consider them as living here.]
1

YES

2

NO

GO TO R04_PM0057

-8

DON'T KNOW

GO TO R04_PM0057

-7

REFUSED

GO TO R04_PM0057

ASK: Parent/guardian of sampled youth whose spouse is confirmed in R04_PM0052 or provided in
R04_PT0046. If parent has already completed a parent interview for another youth, do not re-ask this
item.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0002

What is {Spouse's first name}’s relationship to {Child’s first name}? In other words, {Spouse's first name}
is {Child’s first name}'s...
[Would you say biological, step, adoptive or foster mother / father?]
1

BIOLOGICAL MOTHER

2

BIOLOGICAL FATHER

3

ADOPTIVE MOTHER

4

ADOPTIVE FATHER

5

STEP MOTHER

6

STEP FATHER

7

FOSTER MOTHER

8

FOSTER FATHER

9

GRANDMOTHER

10

GRANDFATHER

11

AUNT

12

UNCLE

91

OTHER RELATIVE (SPECIFY)

92

NON RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth whose spouse is confirmed in R04_PM0052 or provided in
R04_PT0046_PID or R04_PT0046_OS_1.
DISPLAY: If R04_PM0052 = 1, fill {Spouse's first name} with R03_PT0046_PID. Else, fill {Spouse's first
name} with name selected/entered in R04_PT0046_PID or R04_PT0046_OS_1. Only display the first
name.
PATH ID:

R04_PM0057

Does {Childs' first name} have any other parental figures or guardians who live here?
[If the parental figure or guardian is deployed for military active duty, please consider them as living
here.]
1

YES

2

NO

GO TO R04_PT0003

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0058

What is the other parental figure or guardian's name?
IF NEEDED, CLARIFY THAT YOU ARE ASKING ABOUT THE PARENTAL FIGURE OR GUARDIAN
WHO LIVES IN THE HOME. READ NAMES IF NECESSARY. IF HOUSEHOLD MEMBER IS NOT
LISTED, SELECT SPECIFY.
1

[First Name and age of person #1]

GO TO R04_PM0059

2

[First Name and age of person #2]

GO TO R04_PM0059

3

[First Name and age of person #3]

GO TO R04_PM0059

4

[First Name and age of person #4]

GO TO R04_PM0059

5

[First Name and age of person #5]

GO TO R04_PM0059

25

SPECIFY: [ENTER FIRST AND LAST NAME AND AGE OF
PARENTAL FIGURE/GUARDIAN]

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who has another parental figure or guardian who lives in the
home.
DISPLAY: List first names of everyone in the grid who is aged 11 years old or older in the HH screener
with their age, ordered by oldest to youngest and then new people that were added earliest to most
recent below. For response options, display one row for each person on the grid who is age 11 or older.
Display "IF NEEDED,..." statement in blue.
PATH ID:

R04_PM0058_OS_1

What is the other parental figure or guardian's first name?
ENTER THE OTHER PARENTAL FIGURE OR GUARDIAN'S FIRST NAME.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who needs to specify the other parental figure or guardian who
lives in the home.
DISPLAY: Display interviewer instructions in blue.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0058_OS_2

What is the other parental figure or guardian's last name?
ENTER THE OTHER PARENTAL FIGURE OR GUARDIAN'S LAST NAME.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who needs to specify the other parental figure or guardian who
lives in the home.
DISPLAY: Display interviewer instructions in blue.
PATH ID:

R04_PM0058_OS_3

What is the other parental figure or guardian's age?
ENTER THE OTHER PARENTAL FIGURE OR GUARDIAN'S AGE.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who needs to specify the other parental figure or guardian who
lives in the home.
DISPLAY: Display interviewer instructions in blue.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0059

What is {Parental figure/guardian's first name}'s relationship to {Child’s first name}? In other words,
{Parental figure/guardian's first name} is {Child’s first name}'s...
[Would you say biological, adoptive or step mother / father?]
1

BIOLOGICAL MOTHER

2

BIOLOGICAL FATHER

3

ADOPTIVE MOTHER

4

ADOPTIVE FATHER

5

STEP MOTHER

6

STEP FATHER

7

FOSTER MOTHER

8

FOSTER FATHER

9

GRANDMOTHER

10

GRANDFATHER

11

AUNT

12

UNCLE

91

OTHER RELATIVE (SPECIFY)

92

NON RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian who report another parental figure or guardian in R04_PM0058 or
R04_PM0058_OS_1.
PATH ID:

R04_PM0060

Does {Childs' first name} have any other parental figures or guardians who live here?
[If the parental figure or guardian is deployed for military active duty, please consider them as living
here.]
1

YES

2

NO

GO TO R04_PT0003

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who has another parental figure or guardian who lives in the
home.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0061

What is the other parental figure or guardian's name?
IF NEEDED, CLARIFY THAT YOU ARE ASKING ABOUT THE PARENTAL FIGURE OR GUARDIAN
WHO LIVES IN THE HOME. READ NAMES IF NECESSARY. IF HOUSEHOLD MEMBER IS NOT
LISTED, SELECT SPECIFY.
1

[First Name and age of person #1]

GO TO R04_PM0062

2

[First Name and age of person #2]

GO TO R04_PM0062

3

[First Name and age of person #3]

GO TO R04_PM0062

4

[First Name and age of person #4]

GO TO R04_PM0062

5

[First Name and age of person #5]

GO TO R04_PM0062

25

SPECIFY: [ENTER FIRST AND LAST NAME AND AGE OF
PARENTAL FIGURE/GUARDIAN]

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who has a second other parental figure or guardian who lives in
the home.
DISPLAY: List first names of everyone in the grid who is aged 11 years old or older in the HH screener
with their age, ordered by oldest to youngest and then new people that were added earliest to most
recent below. For response options, display one row for each person on the grid who is age 11 or older.
Display "IF NEEDED,..." statement in blue.
PATH ID:

R04_PM0061_OS_1

What is the other parental figure or guardian's first name?
ENTER THE OTHER PARENTAL FIGURE OR GUARDIAN'S FIRST NAME.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who needs to specify the other parental figure or guardian who
lives in the home.
DISPLAY: Display interviewer instructions in blue.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0061_OS_2

What is the other parental figure or guardian's last name?
ENTER THE OTHER PARENTAL FIGURE OR GUARDIAN'S LAST NAME.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who needs to specify the other parental figure or guardian who
lives in the home.
DISPLAY: Display interviewer instructions in blue.
PATH ID:

R04_PM0061_OS_3

What is the other parental figure or guardian's age?
ENTER THE OTHER PARENTAL FIGURE OR GUARDIAN'S AGE.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who needs to specify the other parental figure or guardian who
lives in the home.
DISPLAY: Display interviewer instructions in blue.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0062

What is {Parental figure/guardian's first name}'s relationship to {Child’s first name}? In other words,
{Parental figure/guardian's first name} is {Child’s first name}'s...
[Would you say biological, adoptive or step mother / father?]
1

BIOLOGICAL MOTHER

2

BIOLOGICAL FATHER

3

ADOPTIVE MOTHER

4

ADOPTIVE FATHER

5

STEP MOTHER

6

STEP FATHER

7

FOSTER MOTHER

8

FOSTER FATHER

9

GRANDMOTHER

10

GRANDFATHER

11

AUNT

12

UNCLE

91

OTHER RELATIVE (SPECIFY)

92

NON RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian who reported another parental figure or guardian in R04_PM0061 or
R04_PM0061_OS_1.
PATH ID:

R04_PT0003

Does {Child’s first name} have another parent who lives somewhere else?
1

YES

2

NO

GO TO BOX R04_PXR01

-8

DON'T KNOW

GO TO BOX R04_PXR01

-7

REFUSED

GO TO BOX R04_PXR01

ASK: Parent/guardian of sampled youth.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0006

How often does {Child’s first name} stay there? Would you say never, less than half the time, about half
the time, or more than half the time?
1

NEVER

2

LESS THAN HALF THE TIME

3

ABOUT HALF THE TIME

4

MORE THAN HALF THE TIME

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth if sampled youth has another parental figure or guardian who
lives somewhere else.
BOX ID:

R04_PXR01

If new baseline youth is a twin or part of a multiple birth, as identified in the Household Screener, ask
twin items following skips appropriately.
Else, go to R04_PT0009.
PATH ID:

R04_PM0066_RS

What is {Child’s first name}’s date of birth?
1

|___|___|___|

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of new baseline youth.
PATH ID:

R04_PM0066_RS_LC1

I recorded that {Child’s first name}’s date of birth is {DOB2}. Is that correct?
1

Yes

2

No

ASK: Parent/guardian of new baseline youth.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PTWININTRO_NB

{CHILD’S FIRST NAME} WAS IDENTIFIED IN THE WAVE 1 HOUSEHOLD SCREENER AS PART OF
A SET OF TWINS OR MULTIPLE BIRTHS. THE NEXT SET OF QUESTIONS IS SPECIFIC TO THESE
TWINS OR MULTIPLE BIRTHS.
PRESS 1 TO CONTINUE.
1

CONTINUE

ASK: Parent/guardian of new baseline youth who is a twin or part of a multiple birth as identified in the
Household Screener.
DISPLAY: FILL {Child's first name} with first name of sampled youth that was identified as a twin or
multiple birth. Display {CHILD'S FIRST NAME} WAS IDENTIFIED..." statement in blue.
PATH ID:

R04_PM0016_NB

In an earlier interview, {Child’s first name] was identified as a twin or part of a multiple birth. Is that
correct?
PROBE, IF NEEDED: [Is {Child’s first name} a twin or a multiple?]
1

YES, TWIN

2

YES, PART OF MULTIPLE BIRTH

GO TO R04_PM0035_NB

3

NO

GO TO R04_PT0009

-8

DON'T KNOW

GO TO R04_PT0009

-7

REFUSED

GO TO R04_PT0009

ASK: Parent/guardian of new baseline youth who is a twin or part of a multiple birth as identified in the
HH Screener.
DISPLAY: Display QxQ words in bold/green. Display “PROBE, IF NEEDED” in blue.
PATH ID:

R04_PM0030_NB

What is the first name of the child that {Child’s first name} is a twin of?
1

Name: ______________________

-8

DON'T KNOW

GO TO R04_PT0009

-7

REFUSED

GO TO R04_PT0009

ASK: Parent/guardian of new baseline youth who is a twin.
DISPLAY: Display QxQ words in bold/green.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

14

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0017_NB

Are {Child’s first name} and {Twin’s first name from R04_PM0030_NB} identical twins?
1

YES

GO TO R04_PT0009

2

NO

GO TO R04_PT0009

-8

DON'T KNOW

GO TO R04_PT0009

-7

REFUSED

GO TO R04_PT0009

ASK: Parent/guardian of new baseline youth who is a twin.
DISPLAY: Fill “Twin’s first name” with the other twin’s name that was identified in R04_PM0030_NB.
Display QxQ words in bold/green.
PATH ID:

R04_PM0035_NB

What are the first names of the other children in the multiple birth with {Child’s first name}?
1

Names: ______________________

-8

DON'T KNOW

GO TO R04_PT0009

-7

REFUSED

GO TO R04_PT0009

ASK: Parent/guardian of new baseline youth who is part of a multiple birth.
DISPLAY: Display QxQ words in bold/green.
PATH ID:

R04_PM0019_NB

Are any of them identical to {Child’s first name}?
IF AT LEAST ONE PERSON IN THE MULTIPLE BIRTH IS IDENTICAL TO THE SP YOUTH, CODE
THIS QUESTION AS ‘YES’.
1

YES

2

NO

GO TO R04_PT0009

-8

DON'T KNOW

GO TO R04_PT0009

-7

REFUSED

GO TO R04_PT0009

ASK: Parent/guardian of new baseline youth who is part of a multiple birth.
DISPLAY: Display QxQ words in bold/green. Display "IF AT LEAST ONE PERSON..." statement in blue.
PATH ID:

R04_PM0021_NB

Who is identical to {Child’s first name}?
1

Names: _____________________

-8

DON'T KNOW

GO TO R04_PT0009

-7

REFUSED

GO TO R04_PT0009

ASK: Parent/guardian of new baseline youth who is part of an identical multiple birth.
DISPLAY: Display QxQ words in bold/green.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

15

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

SCHOOL, HOME AND TOBACCO USE
PATH ID:

R04_PT0009

The next series of questions ask about {Child’s first name}’s life at home and in school.
In general, does {Child’s first name} have a curfew or set time that {he/she} needs to be home on school
nights?
IF THE RESPONDENT IS UNSURE HOW TO ANSWER BECAUSE THE CURFEW VARIES BASED
ON THE SITUATION, CODE YES AS LONG AS THE PARENT IS THE ONE WHO SETS THE
CURFEW TIME.
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display "IF THE RESPONDENT IS..." statement in blue. Underline "school".
PATH ID:

R04_PT0011

In general, does {Child’s first name} have a curfew or set time that {he/she} needs to be home on
weekend nights?
IF THE RESPONDENT IS UNSURE HOW TO ANSWER BECAUSE THE CURFEW VARIES BASED
ON THE SITUATION, CODE YES AS LONG AS THE PARENT IS THE ONE WHO SETS THE
CURFEW TIME.
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display "IF THE RESPONDENT IS..." instructions in blue. Underline "weekend".

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

16

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0019

Please look at this list. How would you describe how {Child’s first name} has performed at school in the
past 12 months? Would you say {Child’s first name}’s grades are...
READ RESPONSE OPTIONS ALOUD.
1

Mostly A’s,

2

A’s and B’s,

3

Mostly B’s,

4

B’s and C’s,

5

Mostly C’s,

6

C’s and D’s,

7

Mostly D’s,

8

D’s and F’s,

9

Mostly F’s, or

10

Your child’s school is ungraded?

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display "READ RESPONSE OPTIONS ALOUD" in blue. Underline "past 12 months".
PATH ID:

R04_PT0021

As far as you know, has {Child’s first name} ever smoked a cigarette, used e-cigarettes or other
electronic nicotine products, smoked cigars, a pipe, a hookah, used snus or other smokeless
tobacco?
Please look at this list. Would you say…
READ RESPONSE OPTIONS ALOUD.
1

You know that {she/he} has,

2

You strongly suspect {she/he} has,

3

You don’t think {she/he} has, or

4

You are confident {she/he} has not?

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display "READ RESPONSE OPTIONS ALOUD" in blue. Display QxQ words in bold/green.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

17

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_PXR02

If parent has already completed an adult interview or a parent interview for another youth, GO TO
R04_PT0029.
Else, go to R04_PR1045.
PATH ID:

R04_PR1045

These next few questions ask about the rules of using tobacco inside your home. Please think about
everyone who might be in your home including children, adults, visitors, guests, or workers.
For tobacco products that are burned, such as cigarettes, cigars, pipes or hookah, which statement best
describes the rules about smoking these products inside your home?
Please look at this list. Would you say…
READ RESPONSE OPTIONS ALOUD.
1

It is not allowed anywhere or at any time inside my home,

2

It is allowed in some places or at some times inside my home, or

3

It is allowed anywhere and at any time inside my home?

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: Display "READ RESPONSE OPTIONS ALOUD" in blue. Underline "burned" and "inside".
PATH ID:

R04_PR1051

Now think about e-cigarettes and other electronic nicotine products.
Which statement best describes the rules about using these products inside your home?
Please look at this list. Would you say…
READ RESPONSE OPTIONS ALOUD.
1

It is not allowed anywhere or at any time inside my home,

2

It is allowed in some places or at some times inside my home, or

3

It is allowed anywhere and at any time inside my home?

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: Display "READ RESPONSE OPTIONS ALOUD" in blue. Underline "inside". Display QxQ
words in bold/green.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

18

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PR1050

Now think about other tobacco products that are not burned, like snus and other types of smokeless
tobacco.
Which statement best describes the rules about using these products inside your home?
Please look at this list. Would you say…
READ RESPONSE OPTIONS ALOUD.
1

It is not allowed anywhere or at any time inside my home,

2

It is allowed in some places or at some times inside my home, or

3

It is allowed anywhere and at any time inside my home?

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: Display "READ RESPONSE OPTIONS ALOUD" in blue. Underline "not" and "inside".
PATH ID:

R04_PT0029

Do you think any tobacco products or electronic nicotine products (such as e-cigarettes) might be
available to {Child’s first name} at your home?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display QxQ words in bold/green.
BOX ID:

R04_PTR04

If child spends time at another parent’s home, go to R04_PT0005.
Else, go to R04_PT0035.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

19

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0005

Do you think any tobacco products or electronic nicotine products (such as e-cigarettes) might be
available to {Child’s first name} when {he/she} is at the other parent’s home?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth where child spends time at another parent’s home.
DISPLAY: Display QxQ words in bold/green.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

20

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

HEALTH
PATH ID:

R04_PT0035

The next series of questions ask about {Child’s first name}’s health.
In general, would you say {Child’s first name}’s overall health is excellent, very good, good, fair, or
poor?
1

EXCELLENT

2

VERY GOOD

3

GOOD

4

FAIR

5

POOR

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display QxQ words in bold/green.
PATH ID:

R04_PT0007

About how tall is {Child’s first name} without shoes? Please answer in either feet and inches or meters.
1

I___I___I FEET

2

I___I___I INCHES

3

I__I__I.I__I__I METERS

-8

DON'T KNOW

GO TO R04_PT0008

-7

REFUSED

GO TO R04_PT0008

ASK: Parent/guardian of sampled youth.
DISPLAY: Display "FEET" and "INCHES", or "METERS" as a title.
PATH ID:

R04_PT0008

About how much does {Child’s first name} weigh without clothes or shoes? Please answer in either
pounds or kilograms.
1

I___I___I___I POUNDS

2

I___I___I___I KILOGRAMS

-8

DON'T KNOW

GO TO BOX R04_PXR04

-7

REFUSED

GO TO BOX R04_PXR04

ASK: Parent/guardian of sampled youth.
DISPLAY: Display "POUNDS" and "KILOGRAMS as title.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

21

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0008_LC1

I have that {CHILD'S FIRST NAME}'s current weight is [R04_PT0008] {pounds/kilograms}.
Is that correct?
YES: PRESS SUPPRESS TO GO TO THE NEXT QUESTION.
NO: PRESS GOTO TO CORRECT THE ANSWER.
1

GOTO

GO TO R04_PT0008

2

SUPPRESS

GO TO BOX R04_PXR04

ASK: IF R04_PT0008 > 450 OR R04_PT0008 < 75.
BOX ID:

R04_PXR04

If parent/guardian of new baseline youth, go to R04_PX0186_NB.
Else, if parent/guardian of continuing youth, go to R04_PT0050_12M.
PATH ID:

R04_PX0186_NB

The next set of questions is about limitations caused by any long-term physical, mental or emotional
problem or illness. Please do not include temporary conditions, such as a cold or broken limbs.
Does {Child’s first name} have serious difficulty walking or climbing stairs?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of new baseline youth.
PATH ID:

R04_PX0188_NB

Does {Child’s first name} have difficulty dressing or bathing?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of new baseline youth.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

22

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PX0191_NB

Is {Child’s first name} blind or does {he/she} have serious difficulty seeing, even when wearing glasses?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of new baseline youth.
PATH ID:

R04_PX0190_NB

Is {Child’s first name} deaf or does {he/she} have serious difficulty hearing?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of new baseline youth.
PATH ID:

R04_PX0189_NB

Because of a physical, mental, or emotional condition, does {Child’s first name} have serious difficulty
concentrating, remembering, or making decisions?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of new baseline youth.
BOX ID:

R04_PXR05

If new baseline youth is 15 years old or older, go to R04_PX0187_NB.
Else, go to R04_PT0050_NB.
PATH ID:

R04_PX0187_NB

Because of a physical, mental, or emotional condition, does {Child’s first name} have difficulty doing
errands alone such as visiting a doctor's office or shopping?
1

YES

GO TO R04_PT0050_NB

2

NO

GO TO R04_PT0050_NB

-8

DON'T KNOW

GO TO R04_PT0050_NB

-7

REFUSED

GO TO R04_PT0050_NB

ASK: Parent/guardian of new baseline youth who is 15 years old or older.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

23

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

PATH ID:

R04_PT0050_NB

Has {Child’s first name} ever been told by a doctor, nurse or other health professional that {he/she} has
high blood pressure?
1

YES

2

NO

GO TO R04_PT0051_NB

-8

DON'T KNOW

GO TO R04_PT0051_NB

-7

REFUSED

GO TO R04_PT0051_NB

ASK: Parent/guardian of new baseline youth.
DISPLAY: Underline "ever".
PATH ID:

R04_PT0041_NB

How old was {Child’s first name} when {he/she} was first told {he/she} had high blood pressure?
1

|___|___| YEARS OLD

-8

DON'T KNOW

GO TO R04_PT0253_NB

-7

REFUSED

GO TO R04_PT0253_NB

ASK: Parent/guardian of new baseline youth who has ever had high blood pressure.
DISPLAY: Display "YEARS OLD" as title.
PATH ID:

R04_PT0041_NB_LC1

I have that {CHILD'S FIRST NAME} was diagnosed with high blood pressure at age [R04_PT0041_NB].
That is older than {he/she} is now. Is that correct?
YES: PRESS SUPPRESS TO GO TO THE NEXT QUESTION.
NO: PRESS GOTO TO CORRECT THE ANSWER.
1

GOTO

GO TO R04_PT0041_NB

2

SUPPRESS

GO TO R04_PT0051_NB

ASK: IF R04_PT0041_NB > R04_R04_PARYTHAGE.
PATH ID:

R04_PT0253_NB

Was {Child’s first name} less than 12 years old, 12 to 14 years old, or 15 to 17 years old?
1

LESS THAN 12 YEARS OLD

GO TO R04_PT0051_NB

2

12 TO 14 YEARS OLD

GO TO R04_PT0051_NB

3

15 TO 17 YEARS OLD

GO TO R04_PT0051_NB

-8

DON’T KNOW

GO TO R04_PT0051_NB

-7

REFUSED

GO TO R04_PT0051_NB

ASK: Parent/guardian of new baseline youth who did not know or refused to give age when youth was
told they had high blood pressure.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

24

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

PATH ID:

R04_PT0051_NB

Has {Child’s first name} ever been told by a doctor, nurse or other health professional that {he/she} has
high cholesterol?
1

YES

2

NO

GO TO R04_PT0031_NB

-8

DON'T KNOW

GO TO R04_PT0031_NB

-7

REFUSED

GO TO R04_PT0031_NB

ASK: Parent/guardian of new baseline youth.
DISPLAY: Underline "ever".
PATH ID:

R04_PT0043_NB

How old was {Child’s first name} when {he/she} was first told {he/she} had high cholesterol?
1

|___|___|___| YEARS OLD

-8

DON'T KNOW

GO TO R04_PT0254_NB

-7

REFUSED

GO TO R04_PT0254_NB

ASK: Parent/guardian of new baseline youth who has ever had high cholesterol.
DISPLAY: Display "YEARS OLD" as title.
PATH ID:

R04_PT0043_NB_LC1

I have that {CHILD'S FIRST NAME} was diagnosed with high cholesterol at age [R04_PT0043_NB].
That is older than {he/she} is now. Is that correct?
YES: PRESS SUPPRESS TO GO TO THE NEXT QUESTION.
NO: PRESS GOTO TO CORRECT THE ANSWER.
1

GOTO

GO TO R04_PT0043_NB

2

SUPPRESS

GO TO R04_PT0031_NB

ASK: IF R04_PT0043_NB > R04_PARYTHAGE.
PATH ID:

R04_PT0254_NB

Was {Child’s first name} less than 12 years old, 12 to 14 years old, or 15 to 17 years old?
1

LESS THAN 12 YEARS OLD

GO TO R04_PT0031_NB

2

12 TO 14 YEARS OLD

GO TO R04_PT0031_NB

3

15 TO 17 YEARS OLD

GO TO R04_PT0031_NB

-8

DON’T KNOW

GO TO R04_PT0031_NB

-7

REFUSED

GO TO R04_PT0031_NB

ASK: Parent/guardian of new baseline youth who did not know or refused to give age when youth was
told they had high cholesterol.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

25

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

BOX ID:

R04_PTR06

If the parent of a continuing youth ever reported that youth has asthma, go to R04_PT0022.
If the continuing youth has never been told they have asthma, go to R04_PT0033.
PATH ID:

R04_PT0031_NB

Has {Child’s first name} ever been told by a doctor, nurse or other health professional that {he/she} has
asthma?
1

YES

2

NO

GO TO R04_PT0033

-8

DON'T KNOW

GO TO R04_PT0033

-7

REFUSED

GO TO R04_PT0033

ASK: Parent/guardian of new baseline youth.
DISPLAY: Display QxQ words in bold/green. Underline "ever".
PATH ID:

R04_PT0038_NB

How old was {Child’s first name} when {he/she} was first told {he/she} had asthma?
1

|___|___|___| YEARS OLD

-8

DON'T KNOW

GO TO R04_PT0260_NB

-7

REFUSED

GO TO R04_PT0260_NB

ASK: Parent/guardian of new baseline youth who ever had asthma.
DISPLAY: Display QxQ words in bold/green. Display "YEARS OLD" as title.
PATH ID:

R04_PT0038_NB_LC1

I have that {CHILD'S FIRST NAME} was diagnosed with asthma at age [R04_PT0038_NB]. That is
older than {he/she} is now. Is that correct?
YES: PRESS SUPPRESS TO GO TO THE NEXT QUESTION.
NO: PRESS GOTO TO CORRECT THE ANSWER.
1

GOTO

GO TO R04_PT0038_NB

2

SUPPRESS

GO TO R04_PT0022

ASK: IF R04_PT0038_NB > R04_PARYTHAGE.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

26

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0260_NB

Was {Child’s first name} less than 12 years old, 12 to 14 years old, or 15 to 17 years old?
1

LESS THAN 12 YEARS OLD

2

12 TO 14 YEARS OLD

3

15 TO 17 YEARS OLD

-8

DON’T KNOW

-7

REFUSED

ASK: Parent/guardian of new baseline youth who did not know or refused to give age when youth was
first told they had asthma.
PATH ID:

R04_PT0022

[In a previous interview, it was reported that {Child's first name} had asthma.
]In the past 12 months, has {Child’s first name} taken medications regularly for asthma?
[Taken regularly means according to a health care provider’s instructions.]
1

YES

2

NO

GO TO R04_PT0125

3

YOUTH SP HAS NEVER HAD ASTHMA

GO TO R04_PT0033

-8

DON'T KNOW

GO TO R04_PT0125

-7

REFUSED

GO TO R04_PT0125

ASK: Parent/guardian of sampled youth who has ever had asthma.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green.
IF R03_PARREPT_ASTHMA = 1 AND R04_PT0031_12M != 1, DISPLAY "In a previous interview, it
was reported that {Child's first name} had asthma." ELSE, DO NOT DISPLAY THIS TEXT.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

27

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0036

Please look at this list. In the past 12 months, which of the following medications did {Child’s first
name} regularly take for asthma? Choose all that apply.
READ TEXT BEFORE THE HYPHEN ALOUD.
1

Quick-relief inhaler - FOR EXAMPLE: ALBUTEROL (PROAIR, VENTOLIN,
XOPENEX), IPRATROPIUM (ATROVENT), OR A COMBINATION INHALER
(COMBIVENT)

2

Controller or long-acting inhaler including steroid inhaler – FOR EXAMPLE:
BECLOMETHASONE (QVAR), FLUTICASONE (FLOVENT), SALMETEROL
(SEREVENT), TIOTROPIUM (SPIRIVA), OR A COMBINATION INHALER
(ADVAIR)

3

Other controlling medication – FOR EXAMPLE: MONTELUKAST (SINGULAIR),
ZAFIRLUKAST (ACCOLATE), THEOPHYLLINE, ROFLUMILAST (DALIRESP)

4

Other asthma medication

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who regularly took medications for asthma.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green. Display "READ TEXT
BEFORE THE HYPHEN ALOUD." in blue.
PATH ID:

R04_PT0125

In the past 12 months, has {Child’s first name} had an asthma attack that required use of an oral or
injected steroid medication at the time of the attack?
[Examples of oral or injected steroid medications include prednisone, prednisolone (Orapred), and
dexamethasone (Decadron).]
1

YES

2

NO

GO TO R04_PT0127

-8

DON'T KNOW

GO TO R04_PT0127

-7

REFUSED

GO TO R04_PT0127

ASK: Parent/guardian of sampled youth who has ever had asthma.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

28

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0039

In the past 12 months, how many asthma attacks has {Child’s first name} had that required use of an
oral or injected steroid medication at the time of the attack?
1

|___|___|___|

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who had an asthma attack in the past 12 months that required
medication.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green. Allow 0-999.
PATH ID:

R04_PT0039_LC1

I have that in the past 12 months {CHILD'S FIRST NAME} had [R04_PT0039] asthma attacks that
required use of an oral or injected steroid medication at the time of the attack. Is that correct?
YES: PRESS SUPPRESS TO GO TO THE NEXT QUESTION.
NO: PRESS GOTO TO CORRECT THE ANSWER.
1

GOTO

GO TO R04_PT0039

2

SUPPRESS

GO TO R04_PT0127

ASK: IF R04_PT0039 > 20.
PATH ID:

R04_PT0127

In the past 12 months, has {Child’s first name} had to visit an emergency room or urgent care center
because of asthma?
1

YES

2

NO

GO TO R04_PT0033

-8

DON'T KNOW

GO TO R04_PT0033

-7

REFUSED

GO TO R04_PT0033

ASK: Parent/guardian of sampled youth who has ever had asthma.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green.
PATH ID:

R04_PT0282

In the past 12 months, how many times has {Child’s first name} had to visit an emergency room or
urgent care center because of asthma?
1

|___|___|___|

-8

DON'T KNOW

GO TO R04_PXR07

-7

REFUSED

GO TO R04_PXR07

ASK: Parent/guardian of sampled youth who had to go to emergency room for asthma.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green. Allow 0-999.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

29

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0282_LC1

I have that in the past 12 months {CHILD'S FIRST NAME} had to visit the emergency room or urgent
care center [R04_PT0282] times because of asthma. Is that correct?
YES: PRESS SUPPRESS TO GO TO THE NEXT QUESTION.
NO: PRESS GOTO TO CORRECT THE ANSWER.
1

GOTO

GO TO R04_PT0282

2

SUPPRESS

GO TO BOX R04_PXR07

ASK: IF R04_PT0282 > 10.
BOX ID:

R04_PXR07

Parent/guardian of sampled youth who has visited the emergency room or urgent care once in the past
12 months for asthma, go to R04_PX0692.
Parent/guardian of sampled youth who has visited the emergency room or urgent care more than once
in the past 12 months for asthma, go to R04_PX0720.
Else, go to R04_PT0033.
PATH ID:

R04_PX0692

Was that visit due to an asthma attack?
1

YES

GO TO R04_PT0033

2

NO

GO TO R04_PT0033

-8

DON'T KNOW

GO TO R04_PT0033

-7

REFUSED

GO TO R04_PT0033

ASK: Parent/guardian of sampled youth who had to go to emergency room for asthma once in the past
12 months.
PATH ID:

R04_PX0720

How many of those visits were due to an asthma attack?
1

|___|___|___|

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who had to go to emergency room for asthma multiple times in
the past 12 months.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

30

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PX0720_LC1

I have that in the past 12 months {CHILD'S FIRST NAME} had to visit the emergency room or urgent
care center [R04_PX0720] times because of an asthma attack. Is that correct?
YES: PRESS SUPPRESS TO GO TO THE NEXT QUESTION.
NO: PRESS GOTO TO CORRECT THE ANSWER.
1

GOTO

GO TO R04_PX0720

2

SUPPRESS

GO TO R04_PT0033

ASK: IF R04_PX0720 > R04_PT0282.
PATH ID:

R04_PT0033

In the past 12 months, has {Child’s first name} been told by a doctor, nurse or other health professional
that {he/she} has bronchitis, pneumonia, or chronic cough?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Underline "past 12 months".
BOX ID:

R04_PTR07

Parent/guardian of new baseline youth that have never been told they had bronchitis or said don't know,
go to R04_PT0040_NB.
Else, go to R04_PT0052_12M.
PATH ID:

R04_PT0040_NB

Has {Child’s first name} ever been told by a doctor, nurse or other health professional that {he/she} had
bronchitis, pneumonia, or chronic cough?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of new baseline youth who have not been told they had bronchitis in past 12
months.
DISPLAY: Underline "ever".

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

31

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0052_12M

In the past 12 months, has {Child’s first name} been told by a doctor, nurse or other health professional
that {he/she} has ADHD or ADD?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green.
BOX ID:

R04_PTR08

Parent/guardian of new baseline youth that has not been told they had ADD/ADHD in past year or said
don't know, go to R04_PT0052_NB.
Else, if youth has ever been told they have ADD/ADHD, go to R04_PT0048.
Else, go to R04_PT0049.
PATH ID:

R04_PT0052_NB

Has {Child’s first name} ever been told by a doctor, nurse or other health professional that {he/she} has
ADHD or ADD?
1

YES

2

NO

GO TO R04_PT0049

-8

DON'T KNOW

GO TO R04_PT0049

-7

REFUSED

GO TO R04_PT0049

ASK: Parent/guardian of new baseline youth that were not told they had ADD/ADHD in past year.
DISPLAY: Underline "ever". Display QxQ words in bold/green.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

32

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0048

[In a previous interview, it was reported that {Child's first name} had ADHD or ADD.
]In the past 12 months, has {Child’s first name} taken medications regularly for ADHD or ADD?
[Taken regularly means according to a health care provider’s instructions.]
1

YES

2

NO

3

YOUTH SP HAS NEVER HAD ADHD OR ADD

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of youth who have ever been told they had ADD/ADHD.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green.
IF R03_PARREPT_ADHD = 1 AND R04_PT0052_12M != 1, DISPLAY "In a previous interview, it was
reported that {Child's first name} had ADHD or ADD." ELSE, DO NOT DISPLAY THIS TEXT.
PATH ID:

R04_PT0049

In the past 12 months, has {Child’s first name} been told by a doctor, dentist or other health professional
that {he/she} has dental health issues, such as cavities, gum disease or dental stains?
[Dental health issues do NOT include orthodontia or braces.]
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Underline "past 12 months".
BOX ID:

R04_PTR09

Parent/guardian of new baseline youth that have not been told they had dental issues in past year or
said refused/dont' know, go to R04_PT0044_NB.
Else, parent/guardian of new baseline youth, go to R04_PT0281_NB.
Else, parent/guardian of continuing youth, go to R04_PT0281_12M.

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Parent Questionnaire – New and Aged-Up Interview

33

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0044_NB

Has {Child’s first name} ever been told by a doctor, dentist, or other health professional that {he/she}
has dental health issues, such as cavities, gum disease, or dental stains?
[Dental health issues do NOT include orthodontia or braces.]
1

YES

GO TO R04_PT0281_NB

2

NO

GO TO R04_PT0281_NB

-8

DON'T KNOW

GO TO R04_PT0281_NB

-7

REFUSED

GO TO R04_PT0281_NB

ASK: Parent/guardian of new baseline youth who were not told they had dental issues in past year.
DISPLAY: Underline "ever".
PATH ID:

R04_PT0281_NB

Has {Child’s first name} ever been told by a doctor, nurse or other health professional that {he/she} has
diabetes, sugar diabetes, high blood sugar, or borderline diabetes?
1

YES

2

NO

GO TO BOX R04_PTR10

-8

DON'T KNOW

GO TO BOX R04_PTR10

-7

REFUSED

GO TO BOX R04_PTR10

ASK: Parent/guardian of new baseline youth.
DISPLAY: Underline "ever".
PATH ID:

R04_PT0042_NB

How old was {Child’s first name} when {he/she} was first told {he/she} had diabetes, sugar diabetes,
high blood sugar, or borderline diabetes?
1

|___|___| YEARS OLD

-8

DON'T KNOW

GO TO R04_PT0263_NB

-7

REFUSED

GO TO R04_PT0263_NB

ASK: Parent/guardian of new baseline youth who ever had diabetes.
DISPLAY: Display "YEARS OLD" as title.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

34

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0042_NB_LC1

I have that {CHILD'S FIRST NAME} was diagnosed with diabetes, sugar diabetes, high blood sugar, or
borderline diabetes at age [R04_PT0042_NB] That is older than {he/she} is now. Is that correct?
YES: PRESS SUPPRESS TO GO TO THE NEXT QUESTION.
NO: PRESS GOTO TO CORRECT THE ANSWER.
1

GOTO

GO TO R04_PT0042_NB

2

SUPPRESS

GO TO BOX R04_PTR10

ASK: IF R04_PT0042_NB > R04_PARYTHAGE
PATH ID:

R04_PT0263_NB

Was {Child’s first name} less than 12 years old, 12 to 14 years old, or 15 to 17 years old?
1

LESS THAN 12 YEARS OLD

2

12 TO 14 YEARS OLD

3

15 TO 17 YEARS OLD

-8

DON’T KNOW

-7

REFUSED

ASK: Parent/guardian of new baseline youth who did not know or refused to give age when selected
youth was told he/she had diabetes.
BOX ID:

R04_PTR10

If a parent has ever reported that the youth had diabetes, go to R04_PX0721.
Else, go to R04_PX0756.
PATH ID:

R04_PX0721

[In a previous interview, it was reported that {Child's first name} had diabetes.
]Does [Child's first name] have Type 1 or Type 2 diabetes?
1

TYPE 1

2

TYPE 2

3

YOUTH SP HAS NEVER HAD DIABETES

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who have ever been told they have diabetes.
DISPLAY: If parent reported youth had diabetes in any previous wave, but not Wave 4
[R03_PARREPT_DIABETES = 1 AND R04_PT0281_12M != 1], display "In a previous interview, it was
reported that {Child's first name} had diabetes."
Else, do not display this transition text.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

35

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PX0756

Has {Child’s first name} ever been told by a doctor, therapist or other mental health professional that
{he/she} had schizophrenia, schizoaffective disorder or psychosis?
1

YES

2

NO

GO TO R04_PX0761

-8

DON'T KNOW

GO TO R04_PX0761

-7

REFUSED

GO TO R04_PX0761

ASK: Parent/guardian of sampled youth.
PATH ID:

R04_PX0757

How old was {Child’s first name} when {he/she} was first told by a doctor, therapist, or other mental
health professional that {he/she} had schizophrenia, schizoaffective disorder or psychosis?
1

|___|___| YEARS OLD

-8

DON'T KNOW

-7

REFUSED

GO TO R04_PX0221

ASK: Parent/guardian of youth who have schizophrenia/pscyhosis.
PATH ID:

R04_PX0758

Was {Child’s first name} less than 12 years old, 12 to 14 years old, or 15 to 17 years old?
1

LESS THAN 12 YEARS OLD

GO TO R04_PX0221

2

12 TO 14 YEARS OLD

GO TO R04_PX0221

3

15 TO 17 YEARS OLD

GO TO R04_PX0221

-8

DON'T KNOW

GO TO R04_PX0221

-7

REFUSED

GO TO R04_PX0221

ASK: Parent/guardian who did not know or refused to give age when sampled youth was told he/she
had schizophrenia/pscyhosis.
PATH ID:

R04_PX0761

Has {Child’s first name} ever been told by a doctor, therapist or other mental health professional that
{he/she} had a psychotic illness or episode?
1

YES

2

NO

GO TO R04_PX0221

-8

DON'T KNOW

GO TO R04_PX0221

-7

REFUSED

GO TO R04_PX0221

ASK: Parent/guardian of sampled youth who have not been diagnosed with schizophrenia,
schizoaffective disorder or psychosis.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

36

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PX0762

How old was {Child’s first name} when {he/she} was first told by a doctor, therapist, or other mental
health professional that {he/she} had a psychotic illness or episode?
1

|___|___| YEARS OLD

-8

DON'T KNOW

-7

REFUSED

GO TO R04_PX0221

ASK: Parent/guardian of youth who have schizophrenia/pscyhosis.
PATH ID:

R04_PX0772

Was {Child’s first name} less than 12 years old, 12 to 14 years old, or 15 to 17 years old?
1

LESS THAN 12 YEARS OLD

2

12 TO 14 YEARS OLD

3

15 TO 17 YEARS OLD

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian who did not know or refused to give age when sampled youth was told he/she
had a psychotic illness or episode.
PATH ID:

R04_PX0221

The next questions ask about {Child's first name}'s close biological or blood relatives, including {his|her}
father, mother, or brothers or sisters, both living and deceased.
Were any of {Child's first name}'s close biological or blood relatives ever told by a health professional
that they had high blood pressure?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
PATH ID:

R04_PX0222

Were any of {Child's first name}'s close biological or blood relatives ever told by a health professional
that they had high cholesterol?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

37

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PX0707

Have any of {Child's first name}'s close biological or blood relatives used any tobacco products? By this
we mean cigarettes, e-cigarettes or other electronic nicotine products, cigars, pipe, hookah, snus or
other types of smokeless tobacco (such as dip, spit or chew), and dissolvable tobacco.
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display QxQ words in bold/green.
PATH ID:

R04_PX0731

Have any of {Child's first name}'s close biological or blood relatives ever been an alcoholic or problem
drinker? By this we mean a person whose drinking causes problems with their physical or emotional
health, family or friends, work or school, or the police.
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
PATH ID:

R04_PX0732

Have any of {Child's first name}'s close biological or blood relatives ever had problems with drugs? By
this we mean a person whose drug use causes problems with their physical or emotional health, family
or friends, work or school, or the police.
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

38

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

RESPONDENT CHARACTERISTICS
BOX ID:

R04_PMR02

If parent has already completed a parent interview for another youth, go to R04_PL0030
Else, if the parent has already completed the adult interview, go to Box R04_PMR03.
Else, go to R04_PM0069.
PATH ID:

R04_PM0069

The next few questions are about you and your household.
Are you a citizen of the United States? Please look at this list. Would you say...
READ RESPONSE OPTIONS ALOUD.
1

Yes, born in the United States

2

Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or Northern Marianas

3

Yes, born abroad of U.S. citizen parent or parents

4

Yes, U.S. citizen by naturalization

5

No, not a U.S. citizen

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: Display interviewer instructions in blue.
PATH ID:

R04_PM0065

About how many years have you lived in the United States?
IF LESS THAN 1 YEAR, ENTER 1.
1

I___I___I___I Years

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: DISPLAY INTERVIEWER INSTRUCTIONS IN BLUE.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

39

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0066

How well do you speak English? Would you say very well, well, not well, or not at all?
1

VERY WELL

2

WELL

3

NOT WELL

4

NOT AT ALL

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
PATH ID:

R04_PM0070

How well do you read English? Would you say very well, well, not well, or not at all?
1

VERY WELL

2

WELL

3

NOT WELL

4

NOT AT ALL

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
PATH ID:

R04_PM0073

How well do you write in English? Would you say very well, well, not well, or not at all?
1

VERY WELL

2

WELL

3

NOT WELL

4

NOT AT ALL

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
PATH ID:

R04_PM0071

Do you speak a language other than English at home?
1

YES

2

NO

GO TO R04_PM0001

-8

DON'T KNOW

GO TO R04_PM0001

-7

REFUSED

GO TO R04_PM0001

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

40

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

PATH ID:

R04_PM0072

What other languages do you speak at home?
CODE ALL THAT APPLY.
1

SPANISH

2

CHINESE

3

TAGALOG

4

VIETNAMESE

5

FRENCH

6

KOREAN

7

GERMAN

8

ARABIC

9

RUSSIAN

10

SOME OTHER LANGUAGE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview and
speaks another language at home.
DISPLAY: DISPLAY INTERVIEWER INSTRUCTION IN BLUE.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

41

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0001

What is the highest grade or level of school that you have completed?
1

LESS THAN HIGH SCHOOL

2

SOME HIGH SCHOOL, NO DIPLOMA

3

GED

4

HIGH SCHOOL GRADUATE—DIPLOMA

5

SOME COLLEGE BUT NO DEGREE

6

ASSOCIATE DEGREE—OCCUPATIONAL/VOCATIONAL

7

ASSOCIATE DEGREE—ACADEMIC PROGRAM

8

BACHELOR’S DEGREE (EX: BA, AB, BS)

9

MASTER’S DEGREE (EX: MA, MS, MENG, MED, MSW)

10

PROFESSIONAL SCHOOL DEGREE (EX: MD, DDS, DVM, JD)

11

DOCTORATE DEGREE (EX: PHD, EDD)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: Underline "you".
BOX ID:

R04_PMR03

If parent/guardian of sampled youth reports having a spouse living in the household, go to
R04_PM0118.
Else, go to Box R04_PMR04.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

42

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0118

What is the highest grade or level of school that [Spouse/Guardian's First name] has completed?
1

LESS THAN HIGH SCHOOL

2

SOME HIGH SCHOOL, NO DIPLOMA

3

GED

4

HIGH SCHOOL GRADUATE—DIPLOMA

5

SOME COLLEGE BUT NO DEGREE

6

ASSOCIATE DEGREE—OCCUPATIONAL/VOCATIONAL

7

ASSOCIATE DEGREE—ACADEMIC PROGRAM

8

BACHELOR’S DEGREE (EX: BA, AB, BS)

9

MASTER’S DEGREE (EX: MA, MS, MENG, MED, MSW)

10

PROFESSIONAL SCHOOL DEGREE (EX: MD, DDS, DVM, JD)

11

DOCTORATE DEGREE (EX: PHD, EDD)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who reports having a spouse living in the household and did not
already complete a parent interview.
DISPLAY: FILL "{Spouse/Guardian's First name}" as follows:
If R04_PM0052=1, FILL with spouse name loaded from R03_PT0046. Else fill with name of spouse
selected or entered in R04_PT0046. If R04_PM0057=1 and R04_PM0059=1 or 2, FILL with name of
parental figure selected or entered in R04_PM0058.
BOX ID:

R04_PMR04

If the parent has already completed the adult interview, go to R04_PT0060.
Else, go to R04_PM0130.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

43

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0130

Please look at this list. Which of the following categories best describes your total household income in
the past 12 months?
This is the total income before taxes of all persons in your household combined. Please include money
from jobs, relatives, pensions, dividends, interest, social security payments or retirement benefits, net
income from business, farm or rent, and any other money received by household members.
1

LESS THAN $10,000

GO TO R04_PL0040

2

$10,000 TO $14,999

GO TO R04_PL0040

3

$15,000 TO $24,999

GO TO R04_PL0040

4

$25,000 TO $34,999

GO TO R04_PL0040

5

$35,000 TO $49,999

GO TO R04_PL0040

6

$50,000 TO $74,999

GO TO R04_PL0040

7

$75,000 TO $99,999

GO TO R04_PL0040

8

$100,000 TO $149,999

GO TO R04_PL0040

9

$150,000 TO $199,999

GO TO R04_PL0040

10

$200,000 OR MORE

GO TO R04_PL0040

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: Underline "total household income" and "all persons in your household combined".
PATH ID:

R04_PM0031

Is your total household income during the past 12 months above or below $50,000?
1

ABOVE $50,000

2

BELOW $50,000

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview and
did not know or refused to give total household income.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

44

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0040

Do you own or rent your home?
[IF NEEDED: Ownership includes having a mortgage or loan.]
1

OWN

2

RENT

3

OTHER

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
PATH ID:

R04_PX0691

Please look at this list. In what type of living space do you currently live?
1

SINGLE FAMILY HOME

2

DUPLEX

3

DOUBLE OR MULTI-FAMILY HOME

4

CONDOMINIUM

5

TOWNHOUSE

6

APARTMENT BUILDING

7

NONE OF THE ABOVE

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
BOX ID:

R04_PMD04

For R04_PN0335, display as a stem and leaf question. For each leaf, display a yes/no response. Show
all leaves at one time.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

45

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PN0335

Please look at this picture. In the past 30 days, have you used any of the following products, even one
or two times?
1

Cigarettes

2

Traditional cigars

3

Cigarillos

4

Filtered cigars

5

Pipe

6

Hookah

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
BOX ID:

R04_PMD05

For R04_PN0336, display as a stem and leaf question. For each leaf, display a yes/no response. Show
all leaves at one time.
PATH ID:

R04_PN0336

Please look at this picture. In the past 30 days, have you used any of the following products, even one
or two times?
1

Snus

2

Other types of smokeless tobacco such as moist snuff, dip, spit, or chewing tobacco

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
BOX ID:

R04_PMD06

For R04_PN0337, display as a stem and leaf question. For each leaf, display a yes/no response. Show
all leaves at one time.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

46

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PN0337

Please look at this picture. In the past 30 days, have you used any of the following products, even one
or two times?
1

E-cigarettes or other electronic nicotine products (IF NEEDED: Electronic nicotine
products include e-cigarettes, vape pens, personal vaporizers and mods, e-cigars, epipes, e-hookahs and hookah pens.)

2

Dissolvable tobacco

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: In response option 1, display words "IF NEEDED:" in blue.
PATH ID:

R04_PT0060

How much do you think people harm themselves when they smoke tobacco products that are burned
(such as cigarettes, cigars, pipes or hookah)?
Would you say no harm, a little harm, some harm, or a lot of harm?
1

NO HARM

2

A LITTLE HARM

3

SOME HARM

4

A LOT OF HARM

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete a parent interview.
PATH ID:

R04_PT0061

Now think about e-cigarettes and other electronic nicotine products. How much do you think people
harm themselves when they use these products?
Would you say no harm, a little harm, some harm, or a lot of harm?
1

NO HARM

2

A LITTLE HARM

3

SOME HARM

4

A LOT OF HARM

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete a parent interview.
DISPLAY: Display QxQ words in bold/green.

PATH – Wave 4
Parent Questionnaire – New and Aged-Up Interview

47

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0062

And finally, how much do you think people harm themselves when they use smokeless tobacco
products (products in which you chew, suck or spit such as snus pouches, loose snus, moist snuff, dip,
spit, and chewing tobacco)?
Would you say no harm, a little harm, some harm, or a lot of harm?
1

NO HARM

2

A LITTLE HARM

3

SOME HARM

4

A LOT OF HARM

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete a parent interview.

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Parent Questionnaire – New and Aged-Up Interview

48

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

CONTACT INFORMATION
BOX ID:

R04_PLV03

PROGRAM: Parent/guardian of sampled youth or shadow youth has completed one or more parent
questionnaire(s).
BOX ID:

R04_PLR01

ASK CONTACT INFORMATION 1 TIME FOR EACH PARENT RESPONDENT.
IF PARENT IS AN SP AND HAS ALREADY PROVIDED CONTACT INFORMATION AT THE END OF
THE ADULT INTERVIEW OR HAS PROVIDED CONTACT INFORMATION FOR ANOTHER SAMPLED
YOUTH OR SHADOW YOUTH DURING THEIR PARENT INTERVIEW, GO TO R04_PL0030.
ELSE, GO TO R04_PL0041
PATH ID:

R04_PL0041

Since your continued participation in the PATH Study is important to the study’s success, I’d like to take
a brief moment to confirm your contact information for my records. We’ll only use this information to
contact you about your participation in the study.
PRESS 1 TO CONTINUE.
1

CONTINUE

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.
DISPLAY: Display instructional text in blue.
BOX ID:

R04_PLR03

If parent/guardian of youth has a valid physical address on file, go to R04_PL0001.
Else, go to R04_PL0037.

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Parent Questionnaire – New and Aged-Up Interview

49

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0001

I have your address as…
READ ADDRESS ALOUD.
ADDRESS
APT #
CITY, STATE ZIP CODE
Is that correct?
1

YES

2

NO

GO TO R04_PL0002

ASK: Parent/guardian of sampled youth who has a valid W4 physical address (where
R04_LINKED_ADDRESS has any value, and never equal to NULL).
DISPLAY: Display address in an easy to read format. Display instructional text in blue.
PATH ID:

R04_PL0037

What is your address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

GO TO R04_PL0035

-7

REFUSED

GO TO R04_PL0035

ASK: Parent/guardian of sampled youth who needs to correct their physical address or who does not
have a valid Wave 4 physical address.
DISPLAY: Display instructional text in blue.
PATH ID:

R04_PL0002

Do you receive mail at this address?
1

YES

2

NO

GO TO R04_PL0035

-8

DON'T KNOW

GO TO R04_PL0035

-7

REFUSED

GO TO R04_PL0035

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

PATH ID:

R04_PL0003

Can I please have your mailing address?
VERIFY ALL SPELLING
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who does not receive mail at their physical address.
DISPLAY: Display instructional text in blue.
PATH ID:

R04_PL0035

Do you have a second home where you live during the year?
1

YES

2

NO

GO TO BOX R04_PLR05

-8

DON'T KNOW

GO TO BOX R04_PLR05

-7

REFUSED

GO TO BOX R04_PLR05

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.
PATH ID:

R04_PL0036

What is the address of the second home?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who has a second home.
DISPLAY: Display instructional text in blue.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_PLR05

If parent/guardian of youth has a valid telephone number on file, go to R04_PL0004_12M.
Else, go to R04_PL0004.
PATH ID:

R04_PL0004_12M

I have your telephone number as [(XXX) XXX-XXXX].
Is that correct?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO R04_PL0038

GO TO R04_PL0012

ASK: Parent/guardian of sampled youth who has a valid telephone number.
PATH ID:

R04_PL0004

What is the best telephone number to reach you?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

GO TO R04_PL0012

-7

REFUSED

GO TO R04_PL0012

ASK: Parent/guardian of sampled youth who needs to correct their telephone number, who doesn't
know if the telephone number provided is correct, or who does not have a valid Wave 4 telephone
number.
DISPLAY: Display instructional text in blue.
PATH ID:

R04_PL0038

Is this a cell phone number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO BOX R04_PLR04

ASK: Parent/guardian of sampled youth who provided a phone number in R04_PL0004.

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Parent Questionnaire – New and Aged-Up Interview

52

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0032

May we contact you by text message at this number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who said their telephone number is a cell phone or did not know
or refused to report whether it is a cell phone.
BOX ID:

R04_PLR04

If parent/guardian of youth has a valid second telephone number on file, go to R04_PL0005.
Else, go to R04_PL0006.
PATH ID:

R04_PL0005

I have your second telephone number as [(XXX) XXX-XXXX].
Is that correct?
1

YES

2

NO

GO TO R04_PL0039

-8

DON'T KNOW

GO TO R04_PL0012

-7

REFUSED

GO TO R04_PL0012

ASK: Parent/guardian of sampled youth who has a valid W4 second telephone number (where
R04_PHONE2 field has 10 digits, and never equal to NULL).
PATH ID:

R04_PL0006

What is a second telephone number where you can be reached?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

GO TO R04_PL0012

-7

REFUSED

GO TO R04_PL0012

ASK: Parent/guardian of sampled youth who needs to correct their second telehone number or who
does not have a valid Wave 4 second telephone number.
DISPLAY: Display instructional text in blue.

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Parent Questionnaire – New and Aged-Up Interview

53

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0039

Is this a cell phone number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO R04_PL0012

ASK: Parent/guardian of sampled youth who confirmed their phone number in R04_PL0005 or provided
a phone number in R04_PL0006.
PATH ID:

R04_PL0033

May we contact you by text message at this number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who said their second number is a cell phone or did not know or
refused to report whether it is a cell phone.
PATH ID:

R04_PL0012

Can you please give me your e-mail address?
VERIFY ALL SPELLING AND PUNCTUATION. RECORD TEXT BEFORE @ SYMBOL IN THE EMAIL
NAME FIELD. TEXT AFTER THE @ SYMBOL IS ENTERED IN THE EMAIL PROVIDER FIELD.
1

EMAIL NAME

2

EMAIL PROVIDER

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.
DISPLAY: Display instructional text in blue.
BOX ID:

R04_PLR09

If more than one mode of contact was provided, go to R04_PL0017.
Else, go to R04_PL0018.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0017

What is the best way to reach you?
1

PHONE

2

TEXT MESSAGE

3

E-MAIL

-8

DON’T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth R04_PL0017 if more than one contact information field are
entered.
PATH ID:

R04_PL0018

Do you anticipate moving or relocating either permanently or temporarily in the next 12 months?
1

YES

2

NO

3

MAYBE

GO TO R04_PL0030

-8

DON'T KNOW

GO TO R04_PL0030

-7

REFUSED

GO TO R04_PL0030

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.
PATH ID:

R04_PL0019

Can you tell me more about your plans to move?
[For example, your new street address or the city or state to which you plan to move?]
PROBE FOR AND RECORD ANY KNOWN INFORMATION.
1

[TEXT FIELD]

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who plans to move.
DISPLAY: Display instructional text in blue.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0030

Do you anticipate {Child’s first name} moving or relocating either permanently or temporarily in the next
12 months?
1

YES

2

NO

3

MAYBE

GO TO BOX R04_PLR02

-8

DON'T KNOW

GO TO BOX R04_PLR02

-7

REFUSED

GO TO BOX R04_PLR02

ASK: Parent/guardian of sampled youth, about each sampled youth and each sampled shadow youth.
PATH ID:

R04_PL0031

Can you tell me more about {Child’s first name}’s plans to move?
[For example, {Child’s first name}’s new street address or the city or state to which {Child’s first name}
plans to move?]
PROBE FOR AND RECORD ANY KNOWN INFORMATION.
1

[TEXT FIELD]

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth, about each sampled youth and each sample shadow youth,
who plans to move.
DISPLAY: Display instructional text in blue.
BOX ID:

R04_PLR02

IF PARENT HAS ALREADY PROVIDED CONTACT INFORMATION AT THE END OF THE ADULT
INTERVIEW OR HAS PROVIDED CONTACT INFORMATION FOR ANOTHER SAMPLED YOUTH OR
SHADOW YOUTH, GO TO R04_PL0034.
ELSE, CONTINUE WITH R04_PL0020.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0020

Since we would like to interview you again, it is important that we are able to contact you in about a
year. In case we cannot reach you, is there a relative or friend who does not live in this household, who
will know how to reach you?
[IF NEEDED: Rest assured, we will only use this information if we have lost contact with you.]
What is the person’s name?
VERIFY ALL SPELLING.
IF SP IS UNABLE TO PROVIDE A FIRST NAME MARK AS DON'T KNOW / REFUSED.
1

FIRST NAME

2

LAST NAME

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.
DISPLAY: Display instructional text in blue and bold FIRST NAME.
BOX ID:

R04_PLR10

If FIRST NAME is don’t know or refused, go to R04_PX0769.
Else, go to R04_PL0022.
PATH ID:

R04_PL0022

What is their address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who provided a name in R04_PL0020.
DISPLAY: Display instructional text in blue.

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Parent Questionnaire – New and Aged-Up Interview

57

PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0023

What is their telephone number?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian respondents who provided a name in R04_PL0020.
DISPLAY: Display instructional text in blue.
PATH ID:

R04_PL0021

How are they related to you?
1

HUSBAND/WIFE

2

FATHER/MOTHER (INCLUDING IN-LAWS)

3

GRANDPARENT

4

SON/DAUGHTER (INCLUDING IN-LAWS)

5

GRANDCHILD

6

BROTHER/SISTER (INCLUDING IN-LAWS)

7

FRIEND/NEIGHBOR

8

OTHER RELATIVE (SPECIFY)

9

OTHER NON-RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who provided a name in R04_PL0020.
PATH ID:

R04_PL0025

Could you provide me with the name of a second relative or friend who will know how to reach you?
VERIFY ALL SPELLING.
IF SP IS UNABLE TO PROVIDE A FIRST NAME MARK AS DON'T KNOW / REFUSED.
1

FIRST NAME

2

LAST NAME

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who provided a name in R04_PL0020.
DISPLAY: Display instructional text in blue and bold FIRST NAME.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_PLR11

If FIRST NAME is don’t know or refused, go to R04_PX0769.
Else, go to R04_PL0027.
PATH ID:

R04_PL0027

What is their address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who provided a name in R04_PL0025.
DISPLAY: Display instructional text in blue.
PATH ID:

R04_PL0028

What is their telephone number?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian respondents who provided a name in R04_PL0025.
DISPLAY: Display instructional text in blue.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0026

How are they related to you?
1

HUSBAND/WIFE

2

FATHER/MOTHER (INCLUDING IN-LAWS)

3

GRANDPARENT

4

SON/DAUGHTER (INCLUDING IN-LAWS)

5

GRANDCHILD

6

BROTHER/SISTER (INCLUDING IN-LAWS)

7

FRIEND/NEIGHBOR

8

OTHER RELATIVE (SPECIFY)

9

OTHER NON-RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who provided a name in R04_PL0025.
PATH ID:

R04_PX0769

In the future, the PATH questionnaire may be available to take online on your personal desktop, laptop,
or tablet. Due to its length, the questionnaire will not be available on smart phones.
You would be able to complete the questionnaire at your convenience, without an interviewer present.
The incentive would arrive in the mail a few days after the questionnaire is completed.
Would you be very interested, somewhat interested, or not at all interested in taking the PATH
questionnaire online on your personal desktop, laptop, or tablet?
1

VERY INTERESTED

GO TO R04_PL0034

2

SOMEWHAT INTERESTED

GO TO R04_PL0034

3

NOT AT ALL INTERESTED

4

UNSURE/DON'T KNOW

GO TO R04_PL0034

-8

DON'T KNOW

GO TO R04_PL0034

-7

REFUSED

GO TO R04_PL0034

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_PX0770

Why not?
CODE ALL RESPONSES THAT APPLY.
1

DO NOT HAVE INTERNET ACCESS ON DESKTOP/LAPTOP/TABLET

2

CONCERNED ABOUT TECHNICAL DIFFICULTIES

3

PREFER TO HAVE INTERVIEWER

4

CONCERNED ABOUT CONFIDENTIALITY

5

CONCERNED ABOUT NOT RECEIVING INCENTIVE

6

OTHER (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who would not be interested in doing PATH questionnaires
online in the future.
DISPLAY: Display interviewer instructions in blue.
PATH ID:

R04_PL0034

[THIS RESPONDENT HAS ALREADY PROVIDED CONTACT INFORMATION.]
If you do move or change your phone numbers please update your contact information on the PATH
Study website or by calling our toll free number. Each year you may receive a $5 thank you on your
debit card for updating your contact information.
Thank you for taking the time to answer these questions.
PRESS 1 TO CONTINUE.
1

CONTINUE

ASK: Parent/guardian of sampled youth.
DISPLAY: If the respondent has already provided contact information in another completed interview
(R04_CONTACTFLAG_LD =1), display: “THIS RESPONDENT HAS ALREADY PROVIDED CONTACT
INFORMATION”. Else, do not display this text.
Display instructional text in blue.
BOX ID:

R04_PLV02

PROGRAM: Contact information was provided by parent/guardian of youth SP, set
R04_CONTACTFLAG.

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Parent Questionnaire – New and Aged-Up Interview

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PATH
Parent Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_LCPT01

INTERVIEWER: IN WHAT LANGUAGE DID YOU MOSTLY CONDUCT THE CAPI PORTIONS OF
THIS INTERVIEW?
1

ENGLISH

END INTERVIEW AND RETURN TO IMS

2

SPANISH

END INTERVIEW AND RETURN TO IMS

ASK: Parent/guardian of sampled youth (asked of Interviewer).
DISPLAY: Display instructional text in blue.

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Parent Questionnaire – New and Aged-Up Interview

62

Parent Questionnaire – Extended Interview

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)

Table of Contents
FAMILY COMPOSITION ..................................................................................................... 1
SCHOOL, HOME AND TOBACCO USE ........................................................................... 14
HEALTH ............................................................................................................................ 19
RESPONDENT CHARACTERISTICS .............................................................................. 32
CONTACT INFORMATION ............................................................................................... 42

PATH – Wave 4
Parent Questionnaire – Extended Interview

ii

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
SECTION

# OF QUESTIONS

Family Composition
School, Home and Tobacco Use
Health
Respondent Characteristics
Contact Information

PATH – Wave 4
Parent Questionnaire – Extended Interview

24
9
31
19
33

iii

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

POMBIntro

IF RESPONDENT ASKS ABOUT THE OFFICE OF MANAGEMENT AND BUDGET (OMB), READ THE
FOLLOWING PARAGRAPH ALOUD
OMB Control Number: 0925-0664
Expiration Date: XX/XX/XXXX
Public reporting burden for this collection of information is estimated to average 16 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 (0925-0664). Do not return the
completed form to this address.
PRESS 1 TO CONTINUE
1

CONTINUE

ASK: Parent/guardian of sampled youth.
DISPLAY: Display OMB statement text in grey. Display "IF RESPONDENT ASKS..." statement and
"PRESS 1 TO CONTINUE" in blue. Pending language selected in F2; display English OMB statement if
English is selected, display Spanish OMB statement if Spanish is selected. Default to English display.

PATH – Wave 4
Parent Questionnaire – Extended Interview

iv

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)

FAMILY COMPOSITION
BOX ID:

R04_PXV01

PROGRAM: LOAD THE FOLLOWING VARIABLES
R03_PT0001 = Wave 3 parent's relationship to youth SP
R03_PT0046 = ID of Wave 3 parent's spouse
R03_PT0047 = Wave 3 parent's marital status
R03_PARREPT_ADHD = Youth has been told that he/she has ADD/ADHD
R03_PARREPT_ASTHMA = Youth has been told that he/she has asthma
R03_PARREPT_DIABETES = Youth has been told that he/she has diabetes
R01_HM0014 = Are there twins/multiple births in household (Wave 1 HH Screener)
R04_HM0014 = Are there twins/multiple births in household (Wave 4 HH Screener)
R04_CONTACTFLAG = Adult SP or parent/guardian of youth SP has provided contact information.
R04_ADULT_COMPLETE_LD = Adult respondent has completed the adult questionnaire.
R04_PARENT_COMPLETE_LD = Parent/guardian of sampled youth has completed one or more
parent questionnaire(s).
R04_LINKED_ADDRESS = Best address from IMS
R04_VTBESTSPPHONE = Best phone number from IMS
R04_PHONE2 = Second phone number from IMS
PROGRAM - LOAD THE FOLLOWING VARIABLES FROM CONSENT WRAPPER:
R04_YOUTHTYPE
(1) ContinuingYouth = Youth completed a youth interview in a previous wave and will do a youth
interview this wave.
(2) NewBaselineYouth = Youth was a shadow youth in previous wave, but will do a youth interview this
wave.
(3) New Cohort Youth = Youth respondents who are new to the PATH Study as part of the
replenishment sample. This is their first interview in the Youth cohort and in the PATH Study.
(4) ContinuingShadowYouth = Youth was a shadow youth in previous wave and is still a shadow youth.
R04_LASTWVPARENTCOMP
For the parent associated with this youth:
(1) wave 1 = the last time this parent did a parent interview for this youth was in baseline.
(2) wave 2 = the last time this parent did a parent interview for this youth was in wave 2.
(3) wave 3 = the last time this parent did a parent interview for this youth was in wave 3.
(null) this parent has never done a parent interview for this youth.
R04_PARENTTYPE
(1) PriorParent = This parent has completed a parent interview for this youth in a previous wave.
(2) NewParent = This parent has not completed a parent interview for this youth in a previous wave.
R04_PARYTHAGE = age of youth at time of parent consent.
Program Note: In the following specifications, “!=” represents “not equal to”.

PATH – Wave 4
Parent Questionnaire – Extended Interview

1

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_PXR03

If the W4 parent/guardian is the same respondent as the W3 parent/guardian, and the W3 parent
relationship to youth was not "Other relative", "Non-relative" or Don't Know/Refused, go to
R04_PM0053.
Else, go to R04_PT0001.
PATH ID:

R04_PM0053

I have that you are {Child’s first name}'s {parent's relationship to sampled youth}? Is that correct?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO BOX R04_PTR01

GO TO BOX R04_PTR01

ASK: Parent/guardian of sampled youth who selected a relationship in R03_PT0001.
PATH ID:

R04_PT0001

What is your relationship to {Child’s first name}? In other words, you are {Child’s first name}'s...
[Would you say biological, adoptive or step mother / father?]
1

BIOLOGICAL MOTHER

2

BIOLOGICAL FATHER

3

ADOPTIVE MOTHER

4

ADOPTIVE FATHER

5

STEP MOTHER

6

STEP FATHER

7

FOSTER MOTHER

8

FOSTER FATHER

9

GRANDMOTHER

10

GRANDFATHER

11

AUNT

12

UNCLE

91

OTHER RELATIVE (SPECIFY)

92

NON RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: This item is asked when the W4 parent/guardian is not the same as the W3 parent/guardian; or
any respondent who reported OTHER/SPECIFY, DON'T KNOW, or REFUSED to this question in W3; or
any respondent who did not confirm relationship in R04_PM0053.

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Parent Questionnaire – Extended Interview

2

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_PTR01

If parent/guardian of shadow youth, go to Contact Information section.
Else, if parent has already completed a parent interview for another youth and parent is
married and has provided a valid name for their spouse, go to R04_PT0002.
Else, if parent has already completed a parent interview for another youth and parent is not married or
has not provided a valid name for their spouse, go to R04_PM0057.
Else, go to R04_PT0047.
PATH ID:

R04_PT0047

What is your marital status? Are you currently married, widowed, divorced, separated or never married?
1

MARRIED

2

WIDOWED

3

DIVORCED

4

SEPARATED

5

NEVER MARRIED

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete a parent interview.
BOX ID:

R04_PTR03

Parents who were married at W3 and who are still married at W4, go to R04_PM0052.
Else, parents who are now married at W4, go to R04_PT0046.
Else, go to R04_PM0057.
PATH ID:

R04_PM0052

I have that your spouse is {Spouse's first name}, is that correct?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO R04_PT0045

GO TO R04_PM0057

ASK: Parent/guardian of sampled youth who is married at W3 and W4. If parent has already completed
a parent interview for another youth, do not re-ask this item.
DISPLAY: Fill {Spouse's first name} with name selected in R03_PT0046. Only display the first name.

PATH – Wave 4
Parent Questionnaire – Extended Interview

3

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0046

What is your spouse's name?
SELECT NAME AMONG THE LIST. READ NAMES IF NECESSARY. IF SPOUSE'S NAME IS NOT
LISTED, SELECT SPECIFY.
1

[First Name and age of person #1]

GO TO R04_PT0045

2

[First Name and age of person #2]

GO TO R04_PT0045

3

[First Name and age of person #3]

GO TO R04_PT0045

4

[First Name and age of person #4]

GO TO R04_PT0045

5

[First Name and age of person #5]

GO TO R04_PT0045

25

SPECIFY: [ENTER FIRST AND LAST NAME AND AGE OF
SPOUSE]

-8

DON'T KNOW

GO TO R04_PM0057

-7

REFUSED

GO TO R04_PM0057

ASK: Parent/guardian whose spouse's name was not confirmed in R04_PM0052, or parents who report
now being married in W4. If parent has already completed a parent interview for another youth, do not
re-ask this item.
DISPLAY: List first names of everyone in the grid who is aged 18 years old or older (and not deceased)
in the HH screener with their age, ordered by oldest to youngest and then new people that were added
earliest to most recent below. For response options, display one row for each person on the grid.
Display interviewer instructions in blue.
PATH ID:

R04_PT0046_OS_1

What is your spouse's first name?
ENTER THE SPOUSE'S FIRST NAME.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0045

-7

REFUSED

GO TO R04_PT0045

ASK: Parent/guardian of sampled youth who needs to specify the name of their spouse.
DISPLAY: Display interviewer instructions in blue.

PATH – Wave 4
Parent Questionnaire – Extended Interview

4

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0046_OS_2

What is your spouse's last name?
ENTER THE SPOUSE'S LAST NAME.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0045

-7

REFUSED

GO TO R04_PT0045

ASK: Parent/guardian of sampled youth who needs to specify the name of their spouse.
DISPLAY: Display interviewer instructions in blue.
PATH ID:

R04_PT0046_OS_3

What is your spouse's age?
ENTER THE SPOUSE'S AGE.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0045

-7

REFUSED

GO TO R04_PT0045

ASK: Parent/guardian of sampled youth who needs to specify the name of their spouse.
DISPLAY: Display interviewer instructions in blue.
PATH ID:

R04_PT0045

Does {Spouse's first name} live here?
[If your spouse or partner is deployed for military active duty, please consider them as living here.]
1

YES

2

NO

GO TO R04_PM0057

-8

DON'T KNOW

GO TO R04_PM0057

-7

REFUSED

GO TO R04_PM0057

ASK: Parent/guardian of sampled youth whose spouse is confirmed in R04_PM0052 or provided in
R04_PT0046. If parent has already completed a parent interview for another youth, do not re-ask this
item.

PATH – Wave 4
Parent Questionnaire – Extended Interview

5

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0002

What is {Spouse's first name}’s relationship to {Child’s first name}? In other words, {Spouse's first name}
is {Child’s first name}'s...
[Would you say biological, step, adoptive or foster mother / father?]
1

BIOLOGICAL MOTHER

2

BIOLOGICAL FATHER

3

ADOPTIVE MOTHER

4

ADOPTIVE FATHER

5

STEP MOTHER

6

STEP FATHER

7

FOSTER MOTHER

8

FOSTER FATHER

9

GRANDMOTHER

10

GRANDFATHER

11

AUNT

12

UNCLE

91

OTHER RELATIVE (SPECIFY)

92

NON RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth whose spouse is confirmed in R04_PM0052 or provided in
R04_PT0046_PID or R04_PT0046_OS_1.
DISPLAY: If R04_PM0052 = 1, fill {Spouse's first name} with R03_PT0046_PID. Else, fill {Spouse's first
name} with name selected/entered in R04_PT0046_PID or R04_PT0046_OS_1. Only display the first
name.
PATH ID:

R04_PM0057

Does {Childs' first name} have any other parental figures or guardians who live here?
[If the parental figure or guardian is deployed for military active duty, please consider them as living
here.]
1

YES

2

NO

GO TO R04_PT0003

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth.

PATH – Wave 4
Parent Questionnaire – Extended Interview

6

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0058

What is the other parental figure or guardian's name?
IF NEEDED, CLARIFY THAT YOU ARE ASKING ABOUT THE PARENTAL FIGURE OR GUARDIAN
WHO LIVES IN THE HOME. READ NAMES IF NECESSARY. IF HOUSEHOLD MEMBER IS NOT
LISTED, SELECT SPECIFY.
1

[First Name and age of person #1]

GO TO R04_PM0059

2

[First Name and age of person #2]

GO TO R04_PM0059

3

[First Name and age of person #3]

GO TO R04_PM0059

4

[First Name and age of person #4]

GO TO R04_PM0059

5

[First Name and age of person #5]

GO TO R04_PM0059

25

SPECIFY: [ENTER FIRST AND LAST NAME AND AGE OF
PARENTAL FIGURE/GUARDIAN]

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who has another parental figure or guardian who lives in the
home.
DISPLAY: List first names of everyone in the grid who is aged 11 years old or older in the HH screener
with their age, ordered by oldest to youngest and then new people that were added earliest to most
recent below. For response options, display one row for each person on the grid who is age 11 or older.
Display "IF NEEDED,..." statement in blue.
PATH ID:

R04_PM0058_OS_1

What is the other parental figure or guardian's first name?
ENTER THE OTHER PARENTAL FIGURE OR GUARDIAN'S FIRST NAME.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who needs to specify the other parental figure or guardian who
lives in the home.
DISPLAY: Display interviewer instructions in blue.

PATH – Wave 4
Parent Questionnaire – Extended Interview

7

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0058_OS_2

What is the other parental figure or guardian's last name?
ENTER THE OTHER PARENTAL FIGURE OR GUARDIAN'S LAST NAME.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who needs to specify the other parental figure or guardian who
lives in the home.
DISPLAY: Display interviewer instructions in blue.
PATH ID:

R04_PM0058_OS_3

What is the other parental figure or guardian's age?
ENTER THE OTHER PARENTAL FIGURE OR GUARDIAN'S AGE.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who needs to specify the other parental figure or guardian who
lives in the home.
DISPLAY: Display interviewer instructions in blue.

PATH – Wave 4
Parent Questionnaire – Extended Interview

8

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0059

What is {Parental figure/guardian's first name}'s relationship to {Child’s first name}? In other words,
{Parental figure/guardian's first name} is {Child’s first name}'s...
[Would you say biological, adoptive or step mother / father?]
1

BIOLOGICAL MOTHER

2

BIOLOGICAL FATHER

3

ADOPTIVE MOTHER

4

ADOPTIVE FATHER

5

STEP MOTHER

6

STEP FATHER

7

FOSTER MOTHER

8

FOSTER FATHER

9

GRANDMOTHER

10

GRANDFATHER

11

AUNT

12

UNCLE

91

OTHER RELATIVE (SPECIFY)

92

NON RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian who report another parental figure or guardian in R04_PM0058 or
R04_PM0058_OS_1.
PATH ID:

R04_PM0060

Does {Childs' first name} have any other parental figures or guardians who live here?
[If the parental figure or guardian is deployed for military active duty, please consider them as living
here.]
1

YES

2

NO

GO TO R04_PT0003

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who has another parental figure or guardian who lives in the
home.

PATH – Wave 4
Parent Questionnaire – Extended Interview

9

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0061

What is the other parental figure or guardian's name?
IF NEEDED, CLARIFY THAT YOU ARE ASKING ABOUT THE PARENTAL FIGURE OR GUARDIAN
WHO LIVES IN THE HOME. READ NAMES IF NECESSARY. IF HOUSEHOLD MEMBER IS NOT
LISTED, SELECT SPECIFY.
1

[First Name and age of person #1]

GO TO R04_PM0062

2

[First Name and age of person #2]

GO TO R04_PM0062

3

[First Name and age of person #3]

GO TO R04_PM0062

4

[First Name and age of person #4]

GO TO R04_PM0062

5

[First Name and age of person #5]

GO TO R04_PM0062

25

SPECIFY: [ENTER FIRST AND LAST NAME AND AGE OF
PARENTAL FIGURE/GUARDIAN]

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who has a second other parental figure or guardian who lives in
the home.
DISPLAY: List first names of everyone in the grid who is aged 11 years old or older in the HH screener
with their age, ordered by oldest to youngest and then new people that were added earliest to most
recent below. For response options, display one row for each person on the grid who is age 11 or older.
Display "IF NEEDED,..." statement in blue.
PATH ID:

R04_PM0061_OS_1

What is the other parental figure or guardian's first name?
ENTER THE OTHER PARENTAL FIGURE OR GUARDIAN'S FIRST NAME.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who needs to specify the other parental figure or guardian who
lives in the home.
DISPLAY: Display interviewer instructions in blue.

PATH – Wave 4
Parent Questionnaire – Extended Interview

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PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0061_OS_2

What is the other parental figure or guardian's last name?
ENTER THE OTHER PARENTAL FIGURE OR GUARDIAN'S LAST NAME.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who needs to specify the other parental figure or guardian who
lives in the home.
DISPLAY: Display interviewer instructions in blue.
PATH ID:

R04_PM0061_OS_3

What is the other parental figure or guardian's age?
ENTER THE OTHER PARENTAL FIGURE OR GUARDIAN'S AGE.
1

__________________

-8

DON'T KNOW

GO TO R04_PT0003

-7

REFUSED

GO TO R04_PT0003

ASK: Parent/guardian of sampled youth who needs to specify the other parental figure or guardian who
lives in the home.
DISPLAY: Display interviewer instructions in blue.

PATH – Wave 4
Parent Questionnaire – Extended Interview

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PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0062

What is {Parental figure/guardian's first name}'s relationship to {Child’s first name}? In other words,
{Parental figure/guardian's first name} is {Child’s first name}'s...
[Would you say biological, adoptive or step mother / father?]
1

BIOLOGICAL MOTHER

2

BIOLOGICAL FATHER

3

ADOPTIVE MOTHER

4

ADOPTIVE FATHER

5

STEP MOTHER

6

STEP FATHER

7

FOSTER MOTHER

8

FOSTER FATHER

9

GRANDMOTHER

10

GRANDFATHER

11

AUNT

12

UNCLE

91

OTHER RELATIVE (SPECIFY)

92

NON RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian who reported another parental figure or guardian in R04_PM0061 or
R04_PM0061_OS_1.
PATH ID:

R04_PT0003

Does {Child’s first name} have another parent who lives somewhere else?
1

YES

2

NO

GO TO BOX R04_PXR01

-8

DON'T KNOW

GO TO BOX R04_PXR01

-7

REFUSED

GO TO BOX R04_PXR01

ASK: Parent/guardian of sampled youth.

PATH – Wave 4
Parent Questionnaire – Extended Interview

12

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0006

How often does {Child’s first name} stay there? Would you say never, less than half the time, about half
the time, or more than half the time?
1

NEVER

2

LESS THAN HALF THE TIME

3

ABOUT HALF THE TIME

4

MORE THAN HALF THE TIME

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth if sampled youth has another parental figure or guardian who
lives somewhere else.
BOX ID:

R04_PXR01

If new baseline youth is a twin or part of a multiple birth, as identified in the Household Screener, ask
twin items following skips appropriately.
Else, go to R04_PT0009.

PATH – Wave 4
Parent Questionnaire – Extended Interview

13

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)

SCHOOL, HOME AND TOBACCO USE
PATH ID:

R04_PT0009

The next series of questions ask about {Child’s first name}’s life at home and in school.
In general, does {Child’s first name} have a curfew or set time that {he/she} needs to be home on school
nights?
IF THE RESPONDENT IS UNSURE HOW TO ANSWER BECAUSE THE CURFEW VARIES BASED
ON THE SITUATION, CODE YES AS LONG AS THE PARENT IS THE ONE WHO SETS THE
CURFEW TIME.
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display "IF THE RESPONDENT IS..." statement in blue. Underline "school".
PATH ID:

R04_PT0011

In general, does {Child’s first name} have a curfew or set time that {he/she} needs to be home on
weekend nights?
IF THE RESPONDENT IS UNSURE HOW TO ANSWER BECAUSE THE CURFEW VARIES BASED
ON THE SITUATION, CODE YES AS LONG AS THE PARENT IS THE ONE WHO SETS THE
CURFEW TIME.
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display "IF THE RESPONDENT IS..." instructions in blue. Underline "weekend".

PATH – Wave 4
Parent Questionnaire – Extended Interview

14

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0019

Please look at this list. How would you describe how {Child’s first name} has performed at school in the
past 12 months? Would you say {Child’s first name}’s grades are...
READ RESPONSE OPTIONS ALOUD.
1

Mostly A’s,

2

A’s and B’s,

3

Mostly B’s,

4

B’s and C’s,

5

Mostly C’s,

6

C’s and D’s,

7

Mostly D’s,

8

D’s and F’s,

9

Mostly F’s, or

10

Your child’s school is ungraded?

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display "READ RESPONSE OPTIONS ALOUD" in blue. Underline "past 12 months".
PATH ID:

R04_PT0021

As far as you know, has {Child’s first name} ever smoked a cigarette, used e-cigarettes or other
electronic nicotine products, smoked cigars, a pipe, a hookah, used snus or other smokeless
tobacco?
Please look at this list. Would you say…
READ RESPONSE OPTIONS ALOUD.
1

You know that {she/he} has,

2

You strongly suspect {she/he} has,

3

You don’t think {she/he} has, or

4

You are confident {she/he} has not?

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display "READ RESPONSE OPTIONS ALOUD" in blue. Display QxQ words in bold/green.

PATH – Wave 4
Parent Questionnaire – Extended Interview

15

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_PXR02

If parent has already completed an adult interview or a parent interview for another youth, GO TO
R04_PT0029.
Else, go to R04_PR1045.
PATH ID:

R04_PR1045

These next few questions ask about the rules of using tobacco inside your home. Please think about
everyone who might be in your home including children, adults, visitors, guests, or workers.
For tobacco products that are burned, such as cigarettes, cigars, pipes or hookah, which statement best
describes the rules about smoking these products inside your home?
Please look at this list. Would you say…
READ RESPONSE OPTIONS ALOUD.
1

It is not allowed anywhere or at any time inside my home,

2

It is allowed in some places or at some times inside my home, or

3

It is allowed anywhere and at any time inside my home?

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: Display "READ RESPONSE OPTIONS ALOUD" in blue. Underline "burned" and "inside".
PATH ID:

R04_PR1051

Now think about e-cigarettes and other electronic nicotine products.
Which statement best describes the rules about using these products inside your home?
Please look at this list. Would you say…
READ RESPONSE OPTIONS ALOUD.
1

It is not allowed anywhere or at any time inside my home,

2

It is allowed in some places or at some times inside my home, or

3

It is allowed anywhere and at any time inside my home?

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: Display "READ RESPONSE OPTIONS ALOUD" in blue. Underline "inside". Display QxQ
words in bold/green.

PATH – Wave 4
Parent Questionnaire – Extended Interview

16

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PR1050

Now think about other tobacco products that are not burned, like snus and other types of smokeless
tobacco.
Which statement best describes the rules about using these products inside your home?
Please look at this list. Would you say…
READ RESPONSE OPTIONS ALOUD.
1

It is not allowed anywhere or at any time inside my home,

2

It is allowed in some places or at some times inside my home, or

3

It is allowed anywhere and at any time inside my home?

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: Display "READ RESPONSE OPTIONS ALOUD" in blue. Underline "not" and "inside".
PATH ID:

R04_PT0029

Do you think any tobacco products or electronic nicotine products (such as e-cigarettes) might be
available to {Child’s first name} at your home?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display QxQ words in bold/green.
BOX ID:

R04_PTR04

If child spends time at another parent’s home, go to R04_PT0005.
Else, go to R04_PT0035.

PATH – Wave 4
Parent Questionnaire – Extended Interview

17

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0005

Do you think any tobacco products or electronic nicotine products (such as e-cigarettes) might be
available to {Child’s first name} when {he/she} is at the other parent’s home?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth where child spends time at another parent’s home.
DISPLAY: Display QxQ words in bold/green.

PATH – Wave 4
Parent Questionnaire – Extended Interview

18

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)

HEALTH
PATH ID:

R04_PT0035

The next series of questions ask about {Child’s first name}’s health.
In general, would you say {Child’s first name}’s overall health is excellent, very good, good, fair, or
poor?
1

EXCELLENT

2

VERY GOOD

3

GOOD

4

FAIR

5

POOR

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display QxQ words in bold/green.
PATH ID:

R04_PT0007

About how tall is {Child’s first name} without shoes? Please answer in either feet and inches or meters.
1

I___I___I FEET

2

I___I___I INCHES

3

I__I__I.I__I__I METERS

-8

DON'T KNOW

GO TO R04_PT0008

-7

REFUSED

GO TO R04_PT0008

ASK: Parent/guardian of sampled youth.
DISPLAY: Display "FEET" and "INCHES", or "METERS" as a title.
PATH ID:

R04_PT0008

About how much does {Child’s first name} weigh without clothes or shoes? Please answer in either
pounds or kilograms.
1

I___I___I___I POUNDS

2

I___I___I___I KILOGRAMS

-8

DON'T KNOW

GO TO BOX R04_PXR04

-7

REFUSED

GO TO BOX R04_PXR04

ASK: Parent/guardian of sampled youth.
DISPLAY: Display "POUNDS" and "KILOGRAMS as title.

PATH – Wave 4
Parent Questionnaire – Extended Interview

19

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0008_LC1

I have that {CHILD'S FIRST NAME}'s current weight is [R04_PT0008] {pounds/kilograms}.
Is that correct?
YES: PRESS SUPPRESS TO GO TO THE NEXT QUESTION.
NO: PRESS GOTO TO CORRECT THE ANSWER.
1

GOTO

GO TO R04_PT0008

2

SUPPRESS

GO TO BOX R04_PXR04

ASK: IF R04_PT0008 > 450 OR R04_PT0008 < 75.
BOX ID:

R04_PXR04

If parent/guardian of new baseline youth, go to R04_PX0186_NB.
Else, if parent/guardian of continuing youth, go to R04_PT0050_12M.
BOX ID:

R04_PXR05

If new baseline youth is 15 years old or older, go to R04_PX0187_NB.
Else, go to R04_PT0050_NB.
PATH ID:

R04_PT0050_12M

In the past 12 months, has {Child’s first name} been told by a doctor, nurse or other health professional
that {he/she} has high blood pressure?
1

YES

GO TO R04_PT0051_12M

2

NO

GO TO R04_PT0051_12M

-8

DON'T KNOW

GO TO R04_PT0051_12M

-7

REFUSED

GO TO R04_PT0051_12M

ASK: Parent/guardian of continuing youth.
DISPLAY: Underline "past 12 months".

PATH – Wave 4
Parent Questionnaire – Extended Interview

20

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0051_12M

In the past 12 months, has {Child’s first name} been told by a doctor, nurse or other health professional
that {he/she} has high cholesterol?
1

YES

GO TO R04_PT0031_12M

2

NO

GO TO R04_PT0031_12M

-8

DON'T KNOW

GO TO R04_PT0031_12M

-7

REFUSED

GO TO R04_PT0031_12M

ASK: Parent/guardian of continuing youth.
DISPLAY: Underline "past 12 months".
PATH ID:

R04_PT0031_12M

In the past 12 months, has {Child’s first name} been told by a doctor, nurse or other health professional
that {he/she} has asthma?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of continuing youth.
DISPLAY: Underline "In the past 12 months". Display QxQ words in bold/green.
BOX ID:

R04_PTR06

If the parent of a continuing youth ever reported that youth has asthma, go to R04_PT0022.
If the continuing youth has never been told they have asthma, go to R04_PT0033.

PATH – Wave 4
Parent Questionnaire – Extended Interview

21

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0022

[In a previous interview, it was reported that {Child's first name} had asthma.
]In the past 12 months, has {Child’s first name} taken medications regularly for asthma?
[Taken regularly means according to a health care provider’s instructions.]
1

YES

2

NO

GO TO R04_PT0125

3

YOUTH SP HAS NEVER HAD ASTHMA

GO TO R04_PT0033

-8

DON'T KNOW

GO TO R04_PT0125

-7

REFUSED

GO TO R04_PT0125

ASK: Parent/guardian of sampled youth who has ever had asthma.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green.
IF R03_PARREPT_ASTHMA = 1 AND R04_PT0031_12M != 1, DISPLAY "In a previous interview, it
was reported that {Child's first name} had asthma." ELSE, DO NOT DISPLAY THIS TEXT.
PATH ID:

R04_PT0036

Please look at this list. In the past 12 months, which of the following medications did {Child’s first
name} regularly take for asthma? Choose all that apply.
READ TEXT BEFORE THE HYPHEN ALOUD.
1

Quick-relief inhaler - FOR EXAMPLE: ALBUTEROL (PROAIR, VENTOLIN,
XOPENEX), IPRATROPIUM (ATROVENT), OR A COMBINATION INHALER
(COMBIVENT)

2

Controller or long-acting inhaler including steroid inhaler – FOR EXAMPLE:
BECLOMETHASONE (QVAR), FLUTICASONE (FLOVENT), SALMETEROL
(SEREVENT), TIOTROPIUM (SPIRIVA), OR A COMBINATION INHALER (ADVAIR)

3

Other controlling medication – FOR EXAMPLE: MONTELUKAST (SINGULAIR),
ZAFIRLUKAST (ACCOLATE), THEOPHYLLINE, ROFLUMILAST (DALIRESP)

4

Other asthma medication

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who regularly took medications for asthma.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green. Display "READ TEXT
BEFORE THE HYPHEN ALOUD." in blue.

PATH – Wave 4
Parent Questionnaire – Extended Interview

22

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0125

In the past 12 months, has {Child’s first name} had an asthma attack that required use of an oral or
injected steroid medication at the time of the attack?
[Examples of oral or injected steroid medications include prednisone, prednisolone (Orapred), and
dexamethasone (Decadron).]
1

YES

2

NO

GO TO R04_PT0127

-8

DON'T KNOW

GO TO R04_PT0127

-7

REFUSED

GO TO R04_PT0127

ASK: Parent/guardian of sampled youth who has ever had asthma.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green.
PATH ID:

R04_PT0039

In the past 12 months, how many asthma attacks has {Child’s first name} had that required use of an
oral or injected steroid medication at the time of the attack?
1

|___|___|___|

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who had an asthma attack in the past 12 months that required
medication.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green. Allow 0-999.
PATH ID:

R04_PT0039_LC1

I have that in the past 12 months {CHILD'S FIRST NAME} had [R04_PT0039] asthma attacks that
required use of an oral or injected steroid medication at the time of the attack. Is that correct?
YES: PRESS SUPPRESS TO GO TO THE NEXT QUESTION.
NO: PRESS GOTO TO CORRECT THE ANSWER.
1

GOTO

GO TO R04_PT0039

2

SUPPRESS

GO TO R04_PT0127

ASK: IF R04_PT0039 > 20.

PATH – Wave 4
Parent Questionnaire – Extended Interview

23

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0127

In the past 12 months, has {Child’s first name} had to visit an emergency room or urgent care center
because of asthma?
1

YES

2

NO

GO TO R04_PT0033

-8

DON'T KNOW

GO TO R04_PT0033

-7

REFUSED

GO TO R04_PT0033

ASK: Parent/guardian of sampled youth who has ever had asthma.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green.
PATH ID:

R04_PT0282

In the past 12 months, how many times has {Child’s first name} had to visit an emergency room or
urgent care center because of asthma?
1

|___|___|___|

-8

DON'T KNOW

GO TO R04_PXR07

-7

REFUSED

GO TO R04_PXR07

ASK: Parent/guardian of sampled youth who had to go to emergency room for asthma.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green. Allow 0-999.
PATH ID:

R04_PT0282_LC1

I have that in the past 12 months {CHILD'S FIRST NAME} had to visit the emergency room or urgent
care center [R04_PT0282] times because of asthma. Is that correct?
YES: PRESS SUPPRESS TO GO TO THE NEXT QUESTION.
NO: PRESS GOTO TO CORRECT THE ANSWER.
1

GOTO

GO TO R04_PT0282

2

SUPPRESS

GO TO BOX R04_PXR07

ASK: IF R04_PT0282 > 10.
BOX ID:

R04_PXR07

Parent/guardian of sampled youth who has visited the emergency room or urgent care once in the past
12 months for asthma, go to R04_PX0692.
Parent/guardian of sampled youth who has visited the emergency room or urgent care more than once
in the past 12 months for asthma, go to R04_PX0720.
Else, go to R04_PT0033.

PATH – Wave 4
Parent Questionnaire – Extended Interview

24

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PX0692

Was that visit due to an asthma attack?
1

YES

GO TO R04_PT0033

2

NO

GO TO R04_PT0033

-8

DON'T KNOW

GO TO R04_PT0033

-7

REFUSED

GO TO R04_PT0033

ASK: Parent/guardian of sampled youth who had to go to emergency room for asthma once in the past
12 months.
PATH ID:

R04_PX0720

How many of those visits were due to an asthma attack?
1

|___|___|___|

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who had to go to emergency room for asthma multiple times in
the past 12 months.
PATH ID:

R04_PX0720_LC1

I have that in the past 12 months {CHILD'S FIRST NAME} had to visit the emergency room or urgent
care center [R04_PX0720] times because of an asthma attack. Is that correct?
YES: PRESS SUPPRESS TO GO TO THE NEXT QUESTION.
NO: PRESS GOTO TO CORRECT THE ANSWER.
1

GOTO

GO TO R04_PX0720

2

SUPPRESS

GO TO R04_PT0033

ASK: IF R04_PX0720 > R04_PT0282.
PATH ID:

R04_PT0033

In the past 12 months, has {Child’s first name} been told by a doctor, nurse or other health professional
that {he/she} has bronchitis, pneumonia, or chronic cough?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Underline "past 12 months".

PATH – Wave 4
Parent Questionnaire – Extended Interview

25

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_PTR07

Parent/guardian of new baseline youth that have never been told they had bronchitis or said don't know,
go to R04_PT0040_NB.
Else, go to R04_PT0052_12M.
PATH ID:

R04_PT0052_12M

In the past 12 months, has {Child’s first name} been told by a doctor, nurse or other health professional
that {he/she} has ADHD or ADD?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green.
BOX ID:

R04_PTR08

Parent/guardian of new baseline youth that has not been told they had ADD/ADHD in past year or said
don't know, go to R04_PT0052_NB.
Else, if youth has ever been told they have ADD/ADHD, go to R04_PT0048.
Else, go to R04_PT0049.
PATH ID:

R04_PT0048

[In a previous interview, it was reported that {Child's first name} had ADHD or ADD.
]In the past 12 months, has {Child’s first name} taken medications regularly for ADHD or ADD?
[Taken regularly means according to a health care provider’s instructions.]
1

YES

2

NO

3

YOUTH SP HAS NEVER HAD ADHD OR ADD

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of youth who have ever been told they had ADD/ADHD.
DISPLAY: Underline "past 12 months". Display QxQ words in bold/green.
IF R03_PARREPT_ADHD = 1 AND R04_PT0052_12M != 1, DISPLAY "In a previous interview, it was
reported that {Child's first name} had ADHD or ADD." ELSE, DO NOT DISPLAY THIS TEXT.

PATH – Wave 4
Parent Questionnaire – Extended Interview

26

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0049

In the past 12 months, has {Child’s first name} been told by a doctor, dentist or other health professional
that {he/she} has dental health issues, such as cavities, gum disease or dental stains?
[Dental health issues do NOT include orthodontia or braces.]
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Underline "past 12 months".
BOX ID:

R04_PTR09

Parent/guardian of new baseline youth that have not been told they had dental issues in past year or
said refused/dont' know, go to R04_PT0044_NB.
Else, parent/guardian of new baseline youth, go to R04_PT0281_NB.
Else, parent/guardian of continuing youth, go to R04_PT0281_12M.
PATH ID:

R04_PT0281_12M

In the past 12 months, has {Child’s first name} been told by a doctor, nurse or other health professional
that {he/she} has diabetes, sugar diabetes, high blood sugar, or borderline diabetes?
1

YES

GO TO BOX R04_PTR10

2

NO

GO TO BOX R04_PTR10

-8

DON'T KNOW

GO TO BOX R04_PTR10

-7

REFUSED

GO TO BOX R04_PTR10

ASK: Parent/guardian of continuing youth.
DISPLAY: Underline "past 12 months".
BOX ID:

R04_PTR10

If a parent has ever reported that the youth had diabetes, go to R04_PX0721.
Else, go to R04_PX0756.

PATH – Wave 4
Parent Questionnaire – Extended Interview

27

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PX0721

[In a previous interview, it was reported that {Child's first name} had diabetes.
]Does [Child's first name] have Type 1 or Type 2 diabetes?
1

TYPE 1

2

TYPE 2

3

YOUTH SP HAS NEVER HAD DIABETES

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who have ever been told they have diabetes.
DISPLAY: If parent reported youth had diabetes in any previous wave, but not Wave 4
[R03_PARREPT_DIABETES = 1 AND R04_PT0281_12M != 1], display "In a previous interview, it was
reported that {Child's first name} had diabetes."
Else, do not display this transition text.
PATH ID:

R04_PX0756

Has {Child’s first name} ever been told by a doctor, therapist or other mental health professional that
{he/she} had schizophrenia, schizoaffective disorder or psychosis?
1

YES

2

NO

GO TO R04_PX0761

-8

DON'T KNOW

GO TO R04_PX0761

-7

REFUSED

GO TO R04_PX0761

ASK: Parent/guardian of sampled youth.
PATH ID:

R04_PX0757

How old was {Child’s first name} when {he/she} was first told by a doctor, therapist, or other mental
health professional that {he/she} had schizophrenia, schizoaffective disorder or psychosis?
1

|___|___| YEARS OLD

-8

DON'T KNOW

-7

REFUSED

GO TO R04_PX0221

ASK: Parent/guardian of youth who have schizophrenia/pscyhosis.

PATH – Wave 4
Parent Questionnaire – Extended Interview

28

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PX0758

Was {Child’s first name} less than 12 years old, 12 to 14 years old, or 15 to 17 years old?
1

LESS THAN 12 YEARS OLD

GO TO R04_PX0221

2

12 TO 14 YEARS OLD

GO TO R04_PX0221

3

15 TO 17 YEARS OLD

GO TO R04_PX0221

-8

DON'T KNOW

GO TO R04_PX0221

-7

REFUSED

GO TO R04_PX0221

ASK: Parent/guardian who did not know or refused to give age when sampled youth was told he/she
had schizophrenia/pscyhosis.
PATH ID:

R04_PX0761

Has {Child’s first name} ever been told by a doctor, therapist or other mental health professional that
{he/she} had a psychotic illness or episode?
1

YES

2

NO

GO TO R04_PX0221

-8

DON'T KNOW

GO TO R04_PX0221

-7

REFUSED

GO TO R04_PX0221

ASK: Parent/guardian of sampled youth who have not been diagnosed with schizophrenia,
schizoaffective disorder or psychosis.
PATH ID:

R04_PX0762

How old was {Child’s first name} when {he/she} was first told by a doctor, therapist, or other mental
health professional that {he/she} had a psychotic illness or episode?
1

|___|___| YEARS OLD

-8

DON'T KNOW

-7

REFUSED

GO TO R04_PX0221

ASK: Parent/guardian of youth who have schizophrenia/pscyhosis.
PATH ID:

R04_PX0772

Was {Child’s first name} less than 12 years old, 12 to 14 years old, or 15 to 17 years old?
1

LESS THAN 12 YEARS OLD

2

12 TO 14 YEARS OLD

3

15 TO 17 YEARS OLD

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian who did not know or refused to give age when sampled youth was told he/she
had a psychotic illness or episode.

PATH – Wave 4
Parent Questionnaire – Extended Interview

29

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PX0221

The next questions ask about {Child's first name}'s close biological or blood relatives, including {his|her}
father, mother, or brothers or sisters, both living and deceased.
Were any of {Child's first name}'s close biological or blood relatives ever told by a health professional
that they had high blood pressure?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
PATH ID:

R04_PX0222

Were any of {Child's first name}'s close biological or blood relatives ever told by a health professional
that they had high cholesterol?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
PATH ID:

R04_PX0707

Have any of {Child's first name}'s close biological or blood relatives used any tobacco products? By this
we mean cigarettes, e-cigarettes or other electronic nicotine products, cigars, pipe, hookah, snus or
other types of smokeless tobacco (such as dip, spit or chew), and dissolvable tobacco.
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
DISPLAY: Display QxQ words in bold/green.

PATH – Wave 4
Parent Questionnaire – Extended Interview

30

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PX0731

Have any of {Child's first name}'s close biological or blood relatives ever been an alcoholic or problem
drinker? By this we mean a person whose drinking causes problems with their physical or emotional
health, family or friends, work or school, or the police.
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.
PATH ID:

R04_PX0732

Have any of {Child's first name}'s close biological or blood relatives ever had problems with drugs? By
this we mean a person whose drug use causes problems with their physical or emotional health, family
or friends, work or school, or the police.
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth.

PATH – Wave 4
Parent Questionnaire – Extended Interview

31

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)

RESPONDENT CHARACTERISTICS
BOX ID:

R04_PMR02

If parent has already completed a parent interview for another youth, go to R04_PL0030
Else, if the parent has already completed the adult interview, go to Box R04_PMR03.
Else, go to R04_PM0069.
PATH ID:

R04_PM0069

The next few questions are about you and your household.
Are you a citizen of the United States? Please look at this list. Would you say...
READ RESPONSE OPTIONS ALOUD.
1

Yes, born in the United States

2

Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or Northern Marianas

3

Yes, born abroad of U.S. citizen parent or parents

4

Yes, U.S. citizen by naturalization

5

No, not a U.S. citizen

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: Display interviewer instructions in blue.
PATH ID:

R04_PM0065

About how many years have you lived in the United States?
IF LESS THAN 1 YEAR, ENTER 1.
1

I___I___I___I Years

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: DISPLAY INTERVIEWER INSTRUCTIONS IN BLUE.

PATH – Wave 4
Parent Questionnaire – Extended Interview

32

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0066

How well do you speak English? Would you say very well, well, not well, or not at all?
1

VERY WELL

2

WELL

3

NOT WELL

4

NOT AT ALL

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
PATH ID:

R04_PM0070

How well do you read English? Would you say very well, well, not well, or not at all?
1

VERY WELL

2

WELL

3

NOT WELL

4

NOT AT ALL

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
PATH ID:

R04_PM0073

How well do you write in English? Would you say very well, well, not well, or not at all?
1

VERY WELL

2

WELL

3

NOT WELL

4

NOT AT ALL

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
PATH ID:

R04_PM0071

Do you speak a language other than English at home?
1

YES

2

NO

GO TO R04_PM0001

-8

DON'T KNOW

GO TO R04_PM0001

-7

REFUSED

GO TO R04_PM0001

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.

PATH – Wave 4
Parent Questionnaire – Extended Interview

33

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)

PATH ID:

R04_PM0072

What other languages do you speak at home?
CODE ALL THAT APPLY.
1

SPANISH

2

CHINESE

3

TAGALOG

4

VIETNAMESE

5

FRENCH

6

KOREAN

7

GERMAN

8

ARABIC

9

RUSSIAN

10

SOME OTHER LANGUAGE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview and
speaks another language at home.
DISPLAY: DISPLAY INTERVIEWER INSTRUCTION IN BLUE.

PATH – Wave 4
Parent Questionnaire – Extended Interview

34

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0001

What is the highest grade or level of school that you have completed?
1

LESS THAN HIGH SCHOOL

2

SOME HIGH SCHOOL, NO DIPLOMA

3

GED

4

HIGH SCHOOL GRADUATE—DIPLOMA

5

SOME COLLEGE BUT NO DEGREE

6

ASSOCIATE DEGREE—OCCUPATIONAL/VOCATIONAL

7

ASSOCIATE DEGREE—ACADEMIC PROGRAM

8

BACHELOR’S DEGREE (EX: BA, AB, BS)

9

MASTER’S DEGREE (EX: MA, MS, MENG, MED, MSW)

10

PROFESSIONAL SCHOOL DEGREE (EX: MD, DDS, DVM, JD)

11

DOCTORATE DEGREE (EX: PHD, EDD)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: Underline "you".
BOX ID:

R04_PMR03

If parent/guardian of sampled youth reports having a spouse living in the household, go to
R04_PM0118.
Else, go to Box R04_PMR04.

PATH – Wave 4
Parent Questionnaire – Extended Interview

35

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0118

What is the highest grade or level of school that [Spouse/Guardian's First name] has completed?
1

LESS THAN HIGH SCHOOL

2

SOME HIGH SCHOOL, NO DIPLOMA

3

GED

4

HIGH SCHOOL GRADUATE—DIPLOMA

5

SOME COLLEGE BUT NO DEGREE

6

ASSOCIATE DEGREE—OCCUPATIONAL/VOCATIONAL

7

ASSOCIATE DEGREE—ACADEMIC PROGRAM

8

BACHELOR’S DEGREE (EX: BA, AB, BS)

9

MASTER’S DEGREE (EX: MA, MS, MENG, MED, MSW)

10

PROFESSIONAL SCHOOL DEGREE (EX: MD, DDS, DVM, JD)

11

DOCTORATE DEGREE (EX: PHD, EDD)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who reports having a spouse living in the household and did not
already complete a parent interview.
DISPLAY: FILL "{Spouse/Guardian's First name}" as follows:
If R04_PM0052=1, FILL with spouse name loaded from R03_PT0046. Else fill with name of spouse
selected or entered in R04_PT0046. If R04_PM0057=1 and R04_PM0059=1 or 2, FILL with name of
parental figure selected or entered in R04_PM0058.
BOX ID:

R04_PMR04

If the parent has already completed the adult interview, go to R04_PT0060.
Else, go to R04_PM0130.

PATH – Wave 4
Parent Questionnaire – Extended Interview

36

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PM0130

Please look at this list. Which of the following categories best describes your total household income in
the past 12 months?
This is the total income before taxes of all persons in your household combined. Please include money
from jobs, relatives, pensions, dividends, interest, social security payments or retirement benefits, net
income from business, farm or rent, and any other money received by household members.
1

LESS THAN $10,000

GO TO R04_PL0040

2

$10,000 TO $14,999

GO TO R04_PL0040

3

$15,000 TO $24,999

GO TO R04_PL0040

4

$25,000 TO $34,999

GO TO R04_PL0040

5

$35,000 TO $49,999

GO TO R04_PL0040

6

$50,000 TO $74,999

GO TO R04_PL0040

7

$75,000 TO $99,999

GO TO R04_PL0040

8

$100,000 TO $149,999

GO TO R04_PL0040

9

$150,000 TO $199,999

GO TO R04_PL0040

10

$200,000 OR MORE

GO TO R04_PL0040

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: Underline "total household income" and "all persons in your household combined".
PATH ID:

R04_PM0031

Is your total household income during the past 12 months above or below $50,000?
1

ABOVE $50,000

2

BELOW $50,000

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview and
did not know or refused to give total household income.

PATH – Wave 4
Parent Questionnaire – Extended Interview

37

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0040

Do you own or rent your home?
[IF NEEDED: Ownership includes having a mortgage or loan.]
1

OWN

2

RENT

3

OTHER

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
PATH ID:

R04_PX0691

Please look at this list. In what type of living space do you currently live?
1

SINGLE FAMILY HOME

2

DUPLEX

3

DOUBLE OR MULTI-FAMILY HOME

4

CONDOMINIUM

5

TOWNHOUSE

6

APARTMENT BUILDING

7

NONE OF THE ABOVE

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
BOX ID:

R04_PMD04

For R04_PN0335, display as a stem and leaf question. For each leaf, display a yes/no response. Show
all leaves at one time.

PATH – Wave 4
Parent Questionnaire – Extended Interview

38

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PN0335

Please look at this picture. In the past 30 days, have you used any of the following products, even one
or two times?
1

Cigarettes

2

Traditional cigars

3

Cigarillos

4

Filtered cigars

5

Pipe

6

Hookah

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
BOX ID:

R04_PMD05

For R04_PN0336, display as a stem and leaf question. For each leaf, display a yes/no response. Show
all leaves at one time.
PATH ID:

R04_PN0336

Please look at this picture. In the past 30 days, have you used any of the following products, even one
or two times?
1

Snus

2

Other types of smokeless tobacco such as moist snuff, dip, spit, or chewing tobacco

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
BOX ID:

R04_PMD06

For R04_PN0337, display as a stem and leaf question. For each leaf, display a yes/no response. Show
all leaves at one time.

PATH – Wave 4
Parent Questionnaire – Extended Interview

39

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PN0337

Please look at this picture. In the past 30 days, have you used any of the following products, even one
or two times?
1

E-cigarettes or other electronic nicotine products (IF NEEDED: Electronic nicotine
products include e-cigarettes, vape pens, personal vaporizers and mods, e-cigars, epipes, e-hookahs and hookah pens.)

2

Dissolvable tobacco

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete an adult or parent interview.
DISPLAY: In response option 1, display words "IF NEEDED:" in blue.
PATH ID:

R04_PT0060

How much do you think people harm themselves when they smoke tobacco products that are burned
(such as cigarettes, cigars, pipes or hookah)?
Would you say no harm, a little harm, some harm, or a lot of harm?
1

NO HARM

2

A LITTLE HARM

3

SOME HARM

4

A LOT OF HARM

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete a parent interview.
PATH ID:

R04_PT0061

Now think about e-cigarettes and other electronic nicotine products. How much do you think people
harm themselves when they use these products?
Would you say no harm, a little harm, some harm, or a lot of harm?
1

NO HARM

2

A LITTLE HARM

3

SOME HARM

4

A LOT OF HARM

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete a parent interview.
DISPLAY: Display QxQ words in bold/green.

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Parent Questionnaire – Extended Interview

40

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PT0062

And finally, how much do you think people harm themselves when they use smokeless tobacco
products (products in which you chew, suck or spit such as snus pouches, loose snus, moist snuff, dip,
spit, and chewing tobacco)?
Would you say no harm, a little harm, some harm, or a lot of harm?
1

NO HARM

2

A LITTLE HARM

3

SOME HARM

4

A LOT OF HARM

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who did not already complete a parent interview.

PATH – Wave 4
Parent Questionnaire – Extended Interview

41

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)

CONTACT INFORMATION
BOX ID:

R04_PLV03

PROGRAM: Parent/guardian of sampled youth or shadow youth has completed one or more parent
questionnaire(s).
BOX ID:

R04_PLR01

ASK CONTACT INFORMATION 1 TIME FOR EACH PARENT RESPONDENT.
IF PARENT IS AN SP AND HAS ALREADY PROVIDED CONTACT INFORMATION AT THE END OF
THE ADULT INTERVIEW OR HAS PROVIDED CONTACT INFORMATION FOR ANOTHER SAMPLED
YOUTH OR SHADOW YOUTH DURING THEIR PARENT INTERVIEW, GO TO R04_PL0030.
ELSE, GO TO R04_PL0041
PATH ID:

R04_PL0041

Since your continued participation in the PATH Study is important to the study’s success, I’d like to take
a brief moment to confirm your contact information for my records. We’ll only use this information to
contact you about your participation in the study.
PRESS 1 TO CONTINUE.
1

CONTINUE

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.
DISPLAY: Display instructional text in blue.
BOX ID:

R04_PLR03

If parent/guardian of youth has a valid physical address on file, go to R04_PL0001.
Else, go to R04_PL0037.

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Parent Questionnaire – Extended Interview

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PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0001

I have your address as…
READ ADDRESS ALOUD.
ADDRESS
APT #
CITY, STATE ZIP CODE
Is that correct?
1

YES

2

NO

GO TO R04_PL0002

ASK: Parent/guardian of sampled youth who has a valid W4 physical address (where
R04_LINKED_ADDRESS has any value, and never equal to NULL).
DISPLAY: Display address in an easy to read format. Display instructional text in blue.
PATH ID:

R04_PL0037

What is your address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

GO TO R04_PL0035

-7

REFUSED

GO TO R04_PL0035

ASK: Parent/guardian of sampled youth who needs to correct their physical address or who does not
have a valid Wave 4 physical address.
DISPLAY: Display instructional text in blue.
PATH ID:

R04_PL0002

Do you receive mail at this address?
1

YES

2

NO

GO TO R04_PL0035

-8

DON'T KNOW

GO TO R04_PL0035

-7

REFUSED

GO TO R04_PL0035

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.

PATH – Wave 4
Parent Questionnaire – Extended Interview

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PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)

PATH ID:

R04_PL0003

Can I please have your mailing address?
VERIFY ALL SPELLING
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who does not receive mail at their physical address.
DISPLAY: Display instructional text in blue.
PATH ID:

R04_PL0035

Do you have a second home where you live during the year?
1

YES

2

NO

GO TO BOX R04_PLR05

-8

DON'T KNOW

GO TO BOX R04_PLR05

-7

REFUSED

GO TO BOX R04_PLR05

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.
PATH ID:

R04_PL0036

What is the address of the second home?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who has a second home.
DISPLAY: Display instructional text in blue.

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Parent Questionnaire – Extended Interview

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PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_PLR05

If parent/guardian of youth has a valid telephone number on file, go to R04_PL0004_12M.
Else, go to R04_PL0004.
PATH ID:

R04_PL0004_12M

I have your telephone number as [(XXX) XXX-XXXX].
Is that correct?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO R04_PL0038

GO TO R04_PL0012

ASK: Parent/guardian of sampled youth who has a valid telephone number.
PATH ID:

R04_PL0004

What is the best telephone number to reach you?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

GO TO R04_PL0012

-7

REFUSED

GO TO R04_PL0012

ASK: Parent/guardian of sampled youth who needs to correct their telephone number, who doesn't
know if the telephone number provided is correct, or who does not have a valid Wave 4 telephone
number.
DISPLAY: Display instructional text in blue.
PATH ID:

R04_PL0038

Is this a cell phone number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO BOX R04_PLR04

ASK: Parent/guardian of sampled youth who provided a phone number in R04_PL0004.

PATH – Wave 4
Parent Questionnaire – Extended Interview

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PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0032

May we contact you by text message at this number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who said their telephone number is a cell phone or did not know
or refused to report whether it is a cell phone.
BOX ID:

R04_PLR04

If parent/guardian of youth has a valid second telephone number on file, go to R04_PL0005.
Else, go to R04_PL0006.
PATH ID:

R04_PL0005

I have your second telephone number as [(XXX) XXX-XXXX].
Is that correct?
1

YES

2

NO

GO TO R04_PL0039

-8

DON'T KNOW

GO TO R04_PL0012

-7

REFUSED

GO TO R04_PL0012

ASK: Parent/guardian of sampled youth who has a valid W4 second telephone number (where
R04_PHONE2 field has 10 digits, and never equal to NULL).
PATH ID:

R04_PL0006

What is a second telephone number where you can be reached?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

GO TO R04_PL0012

-7

REFUSED

GO TO R04_PL0012

ASK: Parent/guardian of sampled youth who needs to correct their second telehone number or who
does not have a valid Wave 4 second telephone number.
DISPLAY: Display instructional text in blue.

PATH – Wave 4
Parent Questionnaire – Extended Interview

46

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0039

Is this a cell phone number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO R04_PL0012

ASK: Parent/guardian of sampled youth who confirmed their phone number in R04_PL0005 or provided
a phone number in R04_PL0006.
PATH ID:

R04_PL0033

May we contact you by text message at this number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who said their second number is a cell phone or did not know or
refused to report whether it is a cell phone.
PATH ID:

R04_PL0012

Can you please give me your e-mail address?
VERIFY ALL SPELLING AND PUNCTUATION. RECORD TEXT BEFORE @ SYMBOL IN THE EMAIL
NAME FIELD. TEXT AFTER THE @ SYMBOL IS ENTERED IN THE EMAIL PROVIDER FIELD.
1

EMAIL NAME

2

EMAIL PROVIDER

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.
DISPLAY: Display instructional text in blue.
BOX ID:

R04_PLR09

If more than one mode of contact was provided, go to R04_PL0017.
Else, go to R04_PL0018.

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Parent Questionnaire – Extended Interview

47

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0017

What is the best way to reach you?
1

PHONE

2

TEXT MESSAGE

3

E-MAIL

-8

DON’T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth R04_PL0017 if more than one contact information field are
entered.
PATH ID:

R04_PL0018

Do you anticipate moving or relocating either permanently or temporarily in the next 12 months?
1

YES

2

NO

3

MAYBE

GO TO R04_PL0030

-8

DON'T KNOW

GO TO R04_PL0030

-7

REFUSED

GO TO R04_PL0030

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.
PATH ID:

R04_PL0019

Can you tell me more about your plans to move?
[For example, your new street address or the city or state to which you plan to move?]
PROBE FOR AND RECORD ANY KNOWN INFORMATION.
1

[TEXT FIELD]

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who plans to move.
DISPLAY: Display instructional text in blue.

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Parent Questionnaire – Extended Interview

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PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0030

Do you anticipate {Child’s first name} moving or relocating either permanently or temporarily in the next
12 months?
1

YES

2

NO

3

MAYBE

GO TO BOX R04_PLR02

-8

DON'T KNOW

GO TO BOX R04_PLR02

-7

REFUSED

GO TO BOX R04_PLR02

ASK: Parent/guardian of sampled youth, about each sampled youth and each sampled shadow youth.
PATH ID:

R04_PL0031

Can you tell me more about {Child’s first name}’s plans to move?
[For example, {Child’s first name}’s new street address or the city or state to which {Child’s first name}
plans to move?]
PROBE FOR AND RECORD ANY KNOWN INFORMATION.
1

[TEXT FIELD]

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth, about each sampled youth and each sample shadow youth,
who plans to move.
DISPLAY: Display instructional text in blue.
BOX ID:

R04_PLR02

IF PARENT HAS ALREADY PROVIDED CONTACT INFORMATION AT THE END OF THE ADULT
INTERVIEW OR HAS PROVIDED CONTACT INFORMATION FOR ANOTHER SAMPLED YOUTH OR
SHADOW YOUTH, GO TO R04_PL0034.
ELSE, CONTINUE WITH R04_PL0020.

PATH – Wave 4
Parent Questionnaire – Extended Interview

49

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0020

Since we would like to interview you again, it is important that we are able to contact you in about a
year. In case we cannot reach you, is there a relative or friend who does not live in this household, who
will know how to reach you?
[IF NEEDED: Rest assured, we will only use this information if we have lost contact with you.]
What is the person’s name?
VERIFY ALL SPELLING.
IF SP IS UNABLE TO PROVIDE A FIRST NAME MARK AS DON'T KNOW / REFUSED.
1

FIRST NAME

2

LAST NAME

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.
DISPLAY: Display instructional text in blue and bold FIRST NAME.
BOX ID:

R04_PLR10

If FIRST NAME is don’t know or refused, go to R04_PX0769.
Else, go to R04_PL0022.
PATH ID:

R04_PL0022

What is their address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who provided a name in R04_PL0020.
DISPLAY: Display instructional text in blue.

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Parent Questionnaire – Extended Interview

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PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0023

What is their telephone number?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian respondents who provided a name in R04_PL0020.
DISPLAY: Display instructional text in blue.
PATH ID:

R04_PL0021

How are they related to you?
1

HUSBAND/WIFE

2

FATHER/MOTHER (INCLUDING IN-LAWS)

3

GRANDPARENT

4

SON/DAUGHTER (INCLUDING IN-LAWS)

5

GRANDCHILD

6

BROTHER/SISTER (INCLUDING IN-LAWS)

7

FRIEND/NEIGHBOR

8

OTHER RELATIVE (SPECIFY)

9

OTHER NON-RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who provided a name in R04_PL0020.
PATH ID:

R04_PL0025

Could you provide me with the name of a second relative or friend who will know how to reach you?
VERIFY ALL SPELLING.
IF SP IS UNABLE TO PROVIDE A FIRST NAME MARK AS DON'T KNOW / REFUSED.
1

FIRST NAME

2

LAST NAME

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who provided a name in R04_PL0020.
DISPLAY: Display instructional text in blue and bold FIRST NAME.

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Parent Questionnaire – Extended Interview

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PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_PLR11

If FIRST NAME is don’t know or refused, go to R04_PX0769.
Else, go to R04_PL0027.
PATH ID:

R04_PL0027

What is their address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who provided a name in R04_PL0025.
DISPLAY: Display instructional text in blue.
PATH ID:

R04_PL0028

What is their telephone number?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian respondents who provided a name in R04_PL0025.
DISPLAY: Display instructional text in blue.

PATH – Wave 4
Parent Questionnaire – Extended Interview

52

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PL0026

How are they related to you?
1

HUSBAND/WIFE

2

FATHER/MOTHER (INCLUDING IN-LAWS)

3

GRANDPARENT

4

SON/DAUGHTER (INCLUDING IN-LAWS)

5

GRANDCHILD

6

BROTHER/SISTER (INCLUDING IN-LAWS)

7

FRIEND/NEIGHBOR

8

OTHER RELATIVE (SPECIFY)

9

OTHER NON-RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who provided a name in R04_PL0025.
PATH ID:

R04_PX0769

In the future, the PATH questionnaire may be available to take online on your personal desktop, laptop,
or tablet. Due to its length, the questionnaire will not be available on smart phones.
You would be able to complete the questionnaire at your convenience, without an interviewer present.
The incentive would arrive in the mail a few days after the questionnaire is completed.
Would you be very interested, somewhat interested, or not at all interested in taking the PATH
questionnaire online on your personal desktop, laptop, or tablet?
1

VERY INTERESTED

GO TO R04_PL0034

2

SOMEWHAT INTERESTED

GO TO R04_PL0034

3

NOT AT ALL INTERESTED

4

UNSURE/DON'T KNOW

GO TO R04_PL0034

-8

DON'T KNOW

GO TO R04_PL0034

-7

REFUSED

GO TO R04_PL0034

ASK: Parent/guardian of sampled youth who has not already provided contact information in another
completed interview.

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Parent Questionnaire – Extended Interview

53

PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_PX0770

Why not?
CODE ALL RESPONSES THAT APPLY.
1

DO NOT HAVE INTERNET ACCESS ON DESKTOP/LAPTOP/TABLET

2

CONCERNED ABOUT TECHNICAL DIFFICULTIES

3

PREFER TO HAVE INTERVIEWER

4

CONCERNED ABOUT CONFIDENTIALITY

5

CONCERNED ABOUT NOT RECEIVING INCENTIVE

6

OTHER (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Parent/guardian of sampled youth who would not be interested in doing PATH questionnaires
online in the future.
DISPLAY: Display interviewer instructions in blue.
PATH ID:

R04_PL0034

[THIS RESPONDENT HAS ALREADY PROVIDED CONTACT INFORMATION.]
If you do move or change your phone numbers please update your contact information on the PATH
Study website or by calling our toll free number. Each year you may receive a $5 thank you on your
debit card for updating your contact information.
Thank you for taking the time to answer these questions.
PRESS 1 TO CONTINUE.
1

CONTINUE

ASK: Parent/guardian of sampled youth.
DISPLAY: If the respondent has already provided contact information in another completed interview
(R04_CONTACTFLAG_LD =1), display: “THIS RESPONDENT HAS ALREADY PROVIDED CONTACT
INFORMATION”. Else, do not display this text.
Display instructional text in blue.
BOX ID:

R04_PLV02

PROGRAM: Contact information was provided by parent/guardian of youth SP, set
R04_CONTACTFLAG.

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PATH
Parent Questionnaire – Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_LCPT01

INTERVIEWER: IN WHAT LANGUAGE DID YOU MOSTLY CONDUCT THE CAPI PORTIONS OF
THIS INTERVIEW?
1

ENGLISH

END INTERVIEW AND RETURN TO IMS

2

SPANISH

END INTERVIEW AND RETURN TO IMS

ASK: Parent/guardian of sampled youth (asked of Interviewer).
DISPLAY: Display instructional text in blue.

PATH – Wave 4
Parent Questionnaire – Extended Interview

55

Youth Questionnaire – New and Aged-Up Interview

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

Table of Contents
INTRODUCTORY DEMOGRAPHICS ................................................................................. 1
CIGARETTE ........................................................................................................................ 8
ELECTRONIC NICOTINE PRODUCTS ............................................................................ 29
CIGAR ............................................................................................................................... 62
PIPE................................................................................................................................. 115
HOOKAH ......................................................................................................................... 123
SNUS ............................................................................................................................... 146
SMOKELESS TOBACCO................................................................................................ 167
DISSOLVABLE TOBACCO ............................................................................................. 187
BIDIS AND KRETEKS ..................................................................................................... 189
OTHER TOBACCO ......................................................................................................... 192
NEW PRODUCT - PLACEHOLDER ............................................................................... 193
FIRST TOBACCO PRODUCT......................................................................................... 195
NICOTINE DEPENDENCE AND CESSATION / QUITTER ............................................ 197
PACKAGING AND HEALTH WARNINGS ...................................................................... 214
PRODUCT REGULATION - MODIFIED RISK TOBACCO PRODUCTS ........................ 227
MEDIA USE .................................................................................................................... 248
SECONDHAND SMOKE EXPOSURE ............................................................................ 254
HEALTH .......................................................................................................................... 256
MARKETING, ADVERTISING AND PROMOTION ......................................................... 276
SOCIAL NORMS, PEER AND FAMILY INFLUENCES .................................................. 287
ACCESSIBILITY .............................................................................................................. 297
PSYCHOSOCIAL ............................................................................................................ 299
SUBSTANCE USE .......................................................................................................... 305
ADDITIONAL DEMOGRAPHICS .................................................................................... 325
CONTACT INFORMATION – EMANCIPATED YOUTH ................................................. 332
APPENDIX: USER GROUPS .......................................................................................... 342
APPENDIX: DERIVED VARIABLES ............................................................................... 359

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
SECTION

# OF QUESTIONS

Introductory Demographics
Cigarettes

10
46

Electronic Nicotine Products
Cigar
Pipe
Hookah
Snus
Smokeless Tobacco

72
92
14
57
49
48

Dissolvable Tobacco
Bidis and Kreteks
Other Tobacco
New Product - Placeholder
First Tobacco Product
Nicotine Dependence and Cessation/Quitter

4
4
1
5
1
39

Packaging and Health Warnings
Product Regulation - Modified Risk Tobacco Products
Media Use
Secondhand Smoke Exposure
Health
Marketing, Advertising and Promotion

31
56
11
2
49
19

Social Norms, Peer and Family Influences
Accessibility
Psychosocial
Substance Use
Additional Demographics
Contact Information – Emancipated Youth

26
5
15
33
16
27

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
OMB Control Number: 0925-0664

Expiration Date: XX/XX/XXXX

Public reporting burden for this collection of information is estimated to average 45 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 208927974, ATTN: PRA (0925-0664). Do not return the completed form to this address.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

INTRODUCTORY DEMOGRAPHICS
BOX ID:

R04_YMV01

PROGRAM: LOAD THE FOLLOWING DERIVED VARIABLES FROM PRELOAD FILE.
R03_EVER_NEVER_CIGS - Wave 3 ever or never user of cigarettes
R03_EVER_NEVER_EPRODS - Wave 3 ever or never user of e-products
R03_EVER_NEVER_GTRAD - Wave 3 ever or never user of traditional cigars
R03_EVER_NEVER_GRILLO - Wave 3 ever or never user of cigarillos
R03_EVER_NEVER_GFILTR - Wave 3 ever or never user of filtered cigars
R03_EVER_NEVER_BTRAD - Wave 3 ever or never user of traditional cigars as blunts
R03_EVER_NEVER_BRILLO - Wave 3 ever or never user of cigarillos as blunts
R03_EVER_NEVER_BFILTR - Wave 3 ever or never user of filtered cigars as blunts
R03_EVER_NEVER_PIPE - Wave 3 ever or never user of pipes
R03_EVER_NEVER_HOOK - Wave 3 ever or never user of hookah
R03_EVER_NEVER_SNUS - Wave 3 ever or never user of snus
R03_EVER_NEVER_SMKLS - Wave 3 ever or never user of smokeless tobacco
R03_EVER_NEVER_DISSBL - Wave 3 ever or never user of dissolvable tobacco
R03_EVER_NEVER_BIDI - Wave 3 ever or never user of bidis
R03_EVER_NEVER_KRETEK - Wave 3 ever or never user of kreteks
R03_NUMLIFE_CIGS - The respondent reported smoking 100+ cigarettes in their lifetime at any
previous wave.
R03_NUMLIFE_ECIG - The respondent reported using e-cigarettes 100+ times in their lifetime at any
previous wave.
R03_NUMLIFE_GTRAD - The respondent reported smoking 100+ traditional cigars in their lifetime at
any previous wave.
R03_NUMLIFE_GRILLO - The respondent reported smoking 100+ cigarillos in their lifetime at any
previous wave.
R03_NUMLIFE_GFILTR - The respondent reported smoking 100+ filtered cigars in their lifetime at any
previous wave.
R03_NUMLIFE_PIPE - The respondent reported smoking a pipe 100+ times in their lifetime at any
previous wave.
R03_NUMLIFE_HOOK - The respondent reported smoking hookah 100+ times in their lifetime at any
previous wave.
R03_NUMLIFE_SNUS - The respondent reported using 100+ snus pouches in their lifetime at any
previous wave.
R03_NUMLIFE_SMKLS - The respondent reported using smokeless tobacco 100+ times in their
lifetime at any previous wave.
R03_REGUSE_CIGS - The respondent reported smoking cigarettes fairly regularly at any previous
wave.
R03_REGUSE_ECIG - The respondent reported using e-cigarettes fairly regularly at any previous
wave.
R03_REGUSE_GTRAD - The respondent reported smoking traditional cigars fairly regularly at any
previous wave.
PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

1

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
R03_REGUSE_GRILLO - The respondent reported smoking cigarillos fairly regularly at any previous
wave.
R03_REGUSE_GFILTR - The respondent reported smoking filtered cigars fairly regularly at any
previous wave.
R03_REGUSE_PIPE - The respondent reported smoking a pipe fairly regularly at any previous wave.
R03_REGUSE_HOOK - The respondent reported smoking hookah fairly regularly at any previous wave.
R03_REGUSE_SNUS - The respondent reported using snus fairly regularly at any previous wave.
R03_REGUSE_SMKLS - The respondent reported using smokeless tobacco fairly regularly at any
previous wave.
R03_GENDER - Respondent reported gender
R03_ASTHMA - Respondent reported being diagnosed with asthma in any previous wave.
R03_EVER_USER_ALCOHOL - Respondent reported ever using alcohol in any previous wave.
R03_EVER_USER_MARIJUANA - Respondent reported ever using marijuana in any previous wave.
R03_EVER_USER_RITALIN - Respondent reported ever using ritalin in any previous wave.
R03_EVER_USER_PAINKILLERS - Respondent reported ever using painkillers in any previous wave.
R03_EVER_USER_COCAINE - Respondent reported ever using cocaine in any previous wave.
R03_EVER_USER_STIMULANTS - Respondent reported ever using stimulants in any previous wave.
R03_USCITIZEN – Respondent reported US citizenship in any previous wave.
R03_RACE - Respondent reported race as White in any previous wave.
R03_LGBT - Respondent identified as LGBT in any previous wave.
R04_LINKED_ADDRESS - Emancipated youth respondents' best address from IMS.
R04_VTBESTSPPHONE - Emancipated youth respondents' best phone number from IMS.
R04_PHONE2 - Emancipated youth respondents' second phone number from IMS.
R04_E_YOUTH_LD - Youth respondents that are emancipated.
R04_QUEXSAMPLE - Indicates a random sample of youth respondents.
BOX ID:

R04_YMV02

PROGRAM: DERIVE THE FOLLOWING VARIABLE (SEE APPENDIX).
R04_YOUTHAGE = Age verified by parent or age derived from emancipated youth's birthdate.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YMD04

Note - In the following specifications, “!=” represents “not equal to”.
Note - References to the various respondent types are as follows:
"New baseline youth respondents" = Youth respondents where this is their first interview in the Youth
cohort and in the PATH Study. Includes youth who have aged-up into the Youth cohort and youth who
are new to the PATH Study as part of the replenishment sample.
"Continuing youth respondents" = Youth respondents whose last completed interview in a previous
wave was in the Youth cohort, and they continue to be in the Youth cohort. This is not their first
interview in the Youth cohort or the PATH Study.
"Emancipated youth respondents" = Youth respondents who are emancipated.
"All youth respondents" = All youth respondents in the Youth cohort.
BOX ID:

R04_YMR03

New baseline youth respondents, go to R04_YM0004_NB.
Else, continuing youth respondents who did not report US citizenship in a previous wave, go to
R04_YM0069.
Else, go to R04_YM0065.
PATH ID:

R04_YM0004_NB

What is your sex?
1

Male

2

Female

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YM0005_NB

Are you Hispanic, [Latino/Latina/Latino or Latina], or of Spanish origin? Choose all that apply.
1

No, not of Hispanic, [Latino/Latina/Latino or Latina], or Spanish origin

2

Yes, Mexican, Mexican American, [Chicano/Chicana/Chicano or Chicana]

3

Yes, Puerto Rican

4

Yes, Cuban

5

Yes, Another Hispanic, [Latino/Latina/Latino or Latina], or Spanish origin

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents.
DISPLAY: IF R04_YM0004_NB = 1, DISPLAY “Latino” AND “Chicano”;
ELSE, IF R04_YM0004_NB = 2, DISPLAY “Latina” AND “Chicana”;
ELSE, IF R04_YM0004_NB= -8 OR -7, DISPLAY “Latino or Latina” AND “Chicano or Chicana”.
PATH ID:

R04_YM0006_NB

What is your race? Choose all that apply.
1

White

2

Black or African American

3

American Indian or Alaska Native

4

Asian Indian

5

Chinese

6

Filipino

7

Japanese

8

Korean

9

Vietnamese

10

Other Asian

11

Native Hawaiian

12

Guamanian or Chamorro

13

Samoan

14

Other Pacific Islander

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents.

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Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YM0069

Are you a citizen of the United States?
1

Yes, born in the United States

2

Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or Northern Marianas

3

Yes, born abroad of U.S. citizen parent or parents

4

Yes, U.S. citizen by naturalization

5

No, not a U.S. citizen

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents and continuing youth respondents who did not report US
citizenship in a previous wave.
PATH ID:

R04_YM0065

About how many years have you lived in the United States? (If you have lived in the United States for
less than a year, enter 1.)
1

I___I___I___I YEARS

-8

DON'T KNOW

GO TO R04_YMD03

-7

REFUSED

GO TO R04_YMD03

ASK: All youth respondents.
DISPLAY: DISPLAY "YEARS" AS TITLE.
PATH ID:

R04_YM0065_LC1

The computer recorded that you have lived in the United States for [R04_YM0065] years. That is older
than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YM0065

2

NEXT

GO TO BOX R04_YMD03

ASK: IF R04_YM0065 > R04_YOUTHAGE
BOX ID:

R04_YMD03

Display questions R04_YM0066 through R04_YM0073 using the expanded WVB stem-leaf screen. The
introduction text from R04_YM0066 is the stem. Show all leaves on the screen at once.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YM0066

How well do you...
speak English?
1

Very well

2

Well

3

Not well

4

Not at all

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YM0070

read English?
1

Very well

2

Well

3

Not well

4

Not at all

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YM0073

write in English?
1

Very well

2

Well

3

Not well

4

Not at all

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YM0071

Do you speak a language other than English at home?
1

Yes

2

No

GO TO BOX R04_YCT01

-8

DON'T KNOW

GO TO BOX R04_YCT01

-7

REFUSED

GO TO BOX R04_YCT01

ASK: All youth respondents.
PATH ID:

R04_YM0072

What other languages do you speak at home? Choose all that apply.
1

Spanish

2

Chinese

3

Tagalog

4

Vietnamese

5

French

6

Korean

7

German

8

Arabic

9

Russian

10

Some other language (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who speak another language at home.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

CIGARETTE
BOX ID:

R04_YCT01

The next questions are about your experience with cigarettes.
BOX ID:

R04_YCR02

New baseline youth respondents, go to R04_YC1002_NB.
Continuing youth respondents, go to R04_YC1002_12M.
PATH ID:

R04_YC1002_NB

Have you ever tried cigarette smoking, even one or two puffs?
1

Yes

GO TO BOX R04_YCV02

2

No

GO TO BOX R04_YCV02

-8

DON'T KNOW

GO TO BOX R04_YCV02

-7

REFUSED

GO TO BOX R04_YCV02

ASK: New baseline youth respondents.
BOX ID:

R04_YCV02

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_CIGS_YOUTH = 1 (Ever user) Youth respondents who have ever smoked a
cigarette.
R04_EVER_NEVER_CIGS_YOUTH = 2 (Never user) Youth respondents who have not ever smoked a
cigarette.
R04_INIT_CIGS_YOUTH = 1 (Initiator) Youth respondents who initiated cigarette use between Waves
or new baseline youth respondents who have ever smoked a cigarette.
BOX ID:

R04_YCR01

Youth respondents who have never smoked a cigarette, go to R04_YC1103.
Else, new baseline youth respondents who have ever smoked a cigarette, go to R04_YC1006_NB.
Else, continuing youth respondents who initiated cigarette smoking since the previous wave, go to
R04_YC1108.
Else, continuing youth respondents who had smoked 100 or more cigarettes in the previous wave, go to
Box R04_YCR21.
Else, go to R04_YC1005.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1103

Have you ever been curious about smoking a cigarette?
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have never smoked a cigarette.
PATH ID:

R04_YC1206

Do you think you will smoke a cigarette in the next year?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have never smoked a cigarette.
PATH ID:

R04_YC1104

Do you think that you will try a cigarette soon?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have never smoked a cigarette.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1105

If one of your best friends were to offer you a cigarette, would you smoke it?
1

Definitely yes

GO TO BOX R04_YVT01

2

Probably yes

GO TO BOX R04_YVT01

3

Probably not

GO TO BOX R04_YVT01

4

Definitely not

GO TO BOX R04_YVT01

-8

DON'T KNOW

GO TO BOX R04_YVT01

-7

REFUSED

GO TO BOX R04_YVT01

ASK: Youth respondents who have never smoked a cigarette.
PATH ID:

R04_YC1006_NB

How old were you when you first tried cigarette smoking, even one or two puffs?
1

|__|__| Years old

-8

DON'T KNOW

GO TO R04_YC1120_NB

-7

REFUSED

GO TO R04_YC1120_NB

ASK: New baseline youth respondents who have ever smoked a cigarette.
DISPLAY: DISPLAY “Years old” AS A TITLE.
PATH ID:

R04_YC1006_NB_LC1

The computer recorded that you first tried cigarette smoking at age [R04_YC1006_NB]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC1006_NB

2

NEXT

GO TO R04_YC1108

ASK: IF R04_YC1006_NB <= 5.
PATH ID:

R04_YC1006_NB_LC2

The computer recorded that you first tried cigarette smoking at age [R04_YC1006_NB]. That is older
than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC1006_NB

2

NEXT

GO TO R04_YC1108

ASK: IF R04_YC1006_NB > R04_YOUTHAGE.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1120_NB

When you first tried cigarette smoking, even one or two puffs, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON’T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever smoked a cigarette and did not know or refused
to report the age they first tried cigarette smoking.
PATH ID:

R04_YC1108

Was the first cigarette you smoked flavored to taste like menthol or mint?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have initiated cigarette use since the previous wave, and new
baseline youth respondents who have ever smoked a cigarette.
PATH ID:

R04_YC9104

How much did you experience pleasant sensations the first time you smoked a cigarette?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have initiated cigarette use since the previous wave, and new
baseline youth respondents who have ever smoked a cigarette.
DISPLAY: UNDERLINE "pleasant".

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC9105

How much did you experience unpleasant sensations the first time you smoked a cigarette?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have initiated cigarette use since the previous wave, and new
baseline youth respondents who have ever smoked a cigarette.
DISPLAY: UNDERLINE "unpleasant".
PATH ID:

R04_YC9106

How much did you feel sick to your stomach the first time you smoked a cigarette?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have initiated cigarette use since the previous wave, and new
baseline youth respondents who have ever smoked a cigarette.
PATH ID:

R04_YC1005

How many cigarettes have you smoked in your entire life? A pack usually has 20 cigarettes in it.
1

1 or more puffs but never a whole cigarette

2

1 cigarette

3

2 to 10 cigarettes (about ½ pack total)

4

11 to 20 cigarettes (about ½ pack to 1 pack)

5

21 to 50 cigarettes (more than 1 pack but less than 3 packs)

6

51 to 99 cigarettes (more than 2 ½ packs but less than 5 packs)

7

100 or more cigarettes (5 packs or more)

-8

DON'T KNOW

-7

REFUSED

ASK: Aged-up and continuing youth respondents who have ever smoked a cigarette and had not
smoked 100 or more cigarettes in the previous wave, and new cohort youth respondents who have ever
smoked a cigarette.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YCR21

Youth respondents who have ever smoked a cigarette and had never smoked cigarettes fairly regularly
in the previous wave, go to R04_YC1100.
Else, go to R04_YC9022.
PATH ID:

R04_YC1100

Have you ever smoked cigarettes fairly regularly?
1

Yes

2

No

GO TO R04_YC9022

-8

DON'T KNOW

GO TO R04_YC9022

-7

REFUSED

GO TO R04_YC9022

ASK: Youth respondents who have ever smoked a cigarette and had never smoked fairly regularly in
the previous wave.
PATH ID:

R04_YC1007

How old were you when you first started smoking cigarettes fairly regularly?
1

|__|__| Years old

-8

DON'T KNOW

GO TO R04_YC1121

-7

REFUSED

GO TO R04_YC1121

ASK: Youth respondents who have ever smoked cigarettes fairly regularly and did not smoke fairly
regularly in the previous wave.
DISPLAY: DISPLAY "Years old" AS A TITLE.
PATH ID:

R04_YC1007_LC1

The computer recorded that you started smoking cigarettes fairly regularly at age [R04_YC1007]. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC1007

2

NEXT

GO TO R04_YC9022

ASK: IF R04_YC1007 <= 5 OR R04_YC1007 < R04_YC1006_NB.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1007_LC2

The computer recorded that you started smoking cigarettes fairly regularly at age [R04_YC1007]. This is
older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC1007

2

NEXT

GO TO R04_YC9022

ASK: IF R04_YC1007 > R04_YOUTHAGE.
PATH ID:

R04_YC1121

When you first started smoking cigarettes fairly regularly, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked cigarettes fairly regularly and did not smoke fairly
regularly in a previous wave and who did not know or refused to report the age they started smoking.
PATH ID:

R04_YC9022

Do you consider yourself a smoker?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a cigarette.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1112

When was the last time you smoked a cigarette, even one or two puffs?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YCV01

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YCV01

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YCV01

6

1 to 4 years ago

GO TO BOX R04_YCV01

7

5 or more years ago

GO TO BOX R04_YCV01

-8

DON'T KNOW

GO TO BOX R04_YCV01

-7

REFUSED

GO TO BOX R04_YCV01

ASK: Youth respondents who have ever smoked a cigarette.
PATH ID:

R04_YC0100

When did you last smoke a cigarette?
1

In the past hour

GO TO R04_YC0103

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YCV01

-8

DON'T KNOW

GO TO BOX R04_YCV01

-7

REFUSED

GO TO BOX R04_YCV01

ASK: Youth respondents who smoked a cigarette in the past 7 days.
PATH ID:

R04_YC0102

When you last smoked a cigarette [FILL BASED ON R04_YC0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked a cigarette today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YC0100]: IF R04_YC0100 = 2, DISPLAY “today”; IF
R04_YC0100 = 3, DISPLAY "yesterday"; IF R04_YC0100 = 4, DISPLAY “the day before yesterday”.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC0103

How many cigarettes [have/did] you [smoked/smoke] [FILL BASED ON R04_YC0100]? A pack usually
has 20 cigarettes in it.
1

I__I__I Number of cigarettes

-8

DON'T KNOW

GO TO BOX R04_YCV01

-7

REFUSED

GO TO BOX R04_YCV01

ASK: Youth respondents who have smoked a cigarette in the past hour, sometime today, yesterday or
the day before yesterday.
DISPLAY: DISPLAY "Number of cigarettes" AS A TITLE.
IF R04_YC0100 = 1, 2, DISPLAY “have” AND “smoked”.
IF R04_YC0100 = 3, 4, DISPLAY, “did” AND “smoke”.
FOR [FILL BASED ON R04_YC0100]:
IF R04_YC0100 = 1, 2, DISPLAY “today”.
IF R04_YC0100 = 3, DISPLAY “yesterday”.
IF R04_YC0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YC0103_LC1

The computer recorded that you smoked [R04_YC0103] cigarettes [today/yesterday/the day before
yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC0103

2

NEXT

GO TO BOX R04_YCV01

ASK: IF R04_YC0103 > 60 OR R04_YC0103 = 11, 22, 33, 44, 55.
DISPLAY: IF R04_YC0100 = 1, 2, DISPLAY “today”.
IF R04_YC0100 = 3, DISPLAY “yesterday”.
IF R04_YC0100 = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YCV01

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PAST30DAY_CIGS = 1 (Past 30 day cigarette smoker) Youth respondents who have smoked a
cigarette in the past 30 days.
R04_PAST30DAY_CIGS_LEVEL = 1 (Past 30 day "Very Light" cigarette smokers) Youth
respondents who have smoked a cigarette in the past 30 days, and have smoked 10 or less cigarettes
in their lifetime.
R04_PAST30DAY_CIGS_LEVEL = 2 (Past 30 day "Not Light" cigarette smokers) Youth
respondents who have smoked a cigarette in the past 30 days, and have smoked more than 10
cigarettes in their lifetime.

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16

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YCR22

Past 30 day cigarette smokers, go to R04_YC1022.
Else, go to R04_YVT01.
PATH ID:

R04_YC1022

In the past 30 days, on how many days did you smoke cigarettes?
1

I__I__I DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.
DISPLAY: DISPLAY 'DAYS' AS A TITLE.
PATH ID:

R04_YC1023

In the past 30 days, on the days you smoked, how many cigarettes did you smoke per day? A pack
usually has 20 cigarettes in it.
1

Less than 1 cigarette per day

2

1 cigarette per day

3

2 to 5 cigarettes per day

4

6 to 10 cigarettes per day

5

11 to 20 cigarettes per day

6

More than 20 cigarettes per day

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.

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Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1150

After you finish smoking a cigarette, where do you throw away the cigarette butts? Choose all that
apply.
1

Ash tray or cigarette disposal

2

Trash or dumpster

3

Ground, bushes, or shrubbery

4

Sink or toilet

5

Out of a car window

6

Other (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YC1151

Where do you most often throw away empty cigarette packs?
1

Ash tray or cigarette disposal

2

Trash or dumpster

3

Ground, bushes, or shrubbery

4

Out of a car window

5

Other (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.
PATH ID:

R04_YC9048

In the past 30 days, did you smoke manufactured cigarettes or did you smoke roll-your-own cigarettes?
1

Manufactured cigarettes

2

Roll-your-own cigarettes

3

Both manufactured and roll-your-own cigarettes

4

I don't know

-8

DON'T KNOW

-7

REFUSED

GO TO BOX R04_YCR20

ASK: Past 30 day cigarette smokers.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1130

In the past 30 days, were any of the cigarettes you smoked flavored to taste like menthol or mint?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day manufactured cigarette smokers.
BOX ID:

R04_YCR20

Youth respondents who have smoked roll-your-own cigarettes in the past 30 days, go to R04_YC9045.
Else, go to R04_YC1142.
PATH ID:

R04_YC9045

In the past 30 days, was any of the roll-your-own tobacco you smoked flavored to taste like menthol or
mint?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day roll-your-own cigarette smokers.
PATH ID:

R04_YC1142

In the past 30 days, did anyone sell you cigarettes?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1123

In the past 30 days, did anyone refuse to sell you cigarettes because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.
PATH ID:

R04_YC1118

In the past 30 days, how did you usually get your own cigarettes?
1

I gave someone else money to buy cigarettes for me

2

I bought cigarettes myself from a store

3

I asked someone to give me a cigarette

4

Someone offered me a cigarette

5

I bought cigarettes from another person

6

I took cigarettes from a store or another person

7

I got cigarettes some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YCR03

Past 30 day cigarette smokers who usually buy cigarettes for themselves or give someone else money
to buy cigarettes for them, go to R04_YC1030.
Else, go to Box R04_YCR23.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

20

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1030

[When you give money to someone else, how do they/How do you] usually buy your cigarettes?
1

In person

2

From the internet

GO TO R04_YC1039

3

By telephone

GO TO R04_YC1039

-8

DON'T KNOW

GO TO R04_YC1039

-7

REFUSED

GO TO R04_YC1039

ASK: Past 30 day cigarette smokers (including "very light" smokers) who buy cigarettes for themselves
or someone else buys for them.
DISPLAY: IF R04_YC1118 = 1, DISPLAY “When you give money to someone else, how do they”; IF
R04_YC1118 = 2, DISPLAY “How do you”.
PATH ID:

R04_YC1032

Do [you/they] usually buy cigarettes...
1

In your own state

2

In another state

3

Outside the US

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers (including "very light" smokers) who buy cigarettes for themselves
or someone else buys for them in person.
DISPLAY: IF R04_YC1118 = 1, DISPLAY “they”; IF R04_YC1118 = 2, DISPLAY “you”.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

21

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1033

Where do [you/they] buy your cigarettes most of the time?
1

A convenience store or gas station

2

A supermarket, grocery store, or drug store

3

A warehouse club, such as Sam’s or Costco

4

A smoke shop, tobacco specialty store or tobacco outlet store

5

A duty free shop or military commissary

6

A bar, pub, restaurant or casino

7

A friend or relative

8

A swap meet or flea market

9

A store on an Indian reservation

10

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers (including "very light" smokers) who buy cigarettes for themselves
or someone else buys for them in person.
DISPLAY: IF R04_YC1118 = 1, DISPLAY “they”; IF R04_YC1118 = 2, DISPLAY “you”.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
BOX ID:

R04_YCR24

Past 30 day "not-light" cigarette smokers who usually buy cigarettes for themselves or give someone
else money to buy cigarettes for them, go to R04_YC1039.
Else, go to Box R04_YCR23.
PATH ID:

R04_YC1039

Think about the last time you [bought/gave money to someone else to buy you] cigarettes. Did you buy
them by the carton, pack, or as a single cigarette?
1

Carton

2

Pack

3

Single cigarette

-8

DON'T KNOW

GO TO BOX R04_YCR23

-7

REFUSED

GO TO BOX R04_YCR23

ASK: Past 30 day "not-light" cigarette smokers who buy cigarettes for themselves or someone else buys
for them.
DISPLAY: IF R04_YC1118 = 2, DISPLAY "bought". IF R04_YC1118 = 1, DISPLAY "gave money to
someone else to buy you".

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

22

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1034

How much did you pay for a [carton of cigarettes/pack of cigarettes/single cigarette]?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YCR23

-7

REFUSED

GO TO BOX R04_YCR23

ASK: Past 30 day "not-light" cigarette smokers who buy cigarettes for themselves or someone else buys
for them by the carton, pack or as singles.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
IF R04_YC1039 = 1, DISPLAY "carton of cigarettes"; IF R04_YC1039 = 2, DISPLAY "pack of
cigarettes"; IF R04_YC1039 = 3, DISPLAY "single cigarette".
PATH ID:

R04_YC1034_LC1

The computer recorded that you paid $[R04_YC1034] for a [carton of cigarettes/pack of
cigarettes/single cigarette]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

2

NEXT

GO TO R04_YC1034

ASK: IF ((R04_YC1034_D > 125 OR R04_YC1034_D < 25) AND R04_YC1039 = 1) OR
((R04_YC1034_D > 15 OR R04_YC1034_D < 4) AND R04_YC1039 = 2) OR ((R04_YC1034_D > 3 OR
(R04_YC1034_D = 0 AND R04_YC1034_C < 50)) AND R04_YC1039 = 3).
DISPLAY: IF R04_YC1039 = 1, DISPLAY "carton of cigarettes".
IF R04_YC1039 = 2, DISPLAY “pack of cigarettes”.
IF R04_YC1039 = 3, DISPLAY “single cigarette”.
BOX ID:

R04_YCR23

Past 30 day "not light" cigarette smokers, go to R04_YC1047.
Else, past 30 day cigarette smokers, go to R04_YC1945.
Else, go to Box R04_YVT01.
PATH ID:

R04_YC1047

Do you have a regular brand of cigarettes that you usually smoke?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

23

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1945

Do you know the name of the brand of cigarettes you [usually smoke/last smoked]?
1

Yes

2

No

GO TO BOX R04_YCR07

-8

DON'T KNOW

GO TO BOX R04_YCR07

-7

REFUSED

GO TO BOX R04_YCR07

ASK: Past 30 day cigarette smokers.
DISPLAY: IF R04_YC1047 = 1, DISPLAY “usually smoke”.
ELSE, DISPLAY “last smoked”.
UNDERLINE "name of the brand".
PATH ID:

R04_YC1048

What brand of cigarette [do/did] you [usually/last] smoke?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers who know the brand name.
DISPLAY: IF R04_YC1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[If multiple screens] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[If single screen OR last screen of multiple screens] DISPLAY: If you do not see it below, touch the box
marked “Something else”.
BOX ID:

R04_YCR04

If youth respondent selects brand in R04_YC1048_BRAND, go to R04_YC1070_PRODUCT.
Else, if youth respondent selects “Something else” in R04_YC1048_BRAND, go to R04_YC1049.
Else, go to Box R04_YCR07.
PATH ID:

R04_YC1049

You said that your brand was not listed. What is it?
1

__________________________

GO TO BOX R04_YCR07

-8

DON'T KNOW

GO TO BOX R04_YCR07

-7

REFUSED

GO TO BOX R04_YCR07

ASK: Past 30 day cigarette smokers that know the name of the brand they smoke who selected
"Something else" for their brand.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

24

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] [do/did] you [usually/last] smoke?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers that know the name of the brand they smoke who selected a brand
image.
DISPLAY: IF R04_YC1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[If multiple screens] Display: If you do not see it below, touch the button marked “NEXT”.
[If single screen OR last screen of multiple screens] Display: If you do not see it below, touch the box
marked “Something else”.
BOX ID:

R04_YCR05

If youth respondent selects "Something else" in R04_YC1070_PRODUCT, go to R04_YC1071.
Else, go to Box R04_YCR07.
PATH ID:

R04_YC1071

You said that the type of [BRANDFILL]s that you smoke was not listed. What type is it?
1

__________________________

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers that know the name of the brand they smoke who selected a brand
image, but selected "Something else" for their subbrand image.
BOX ID:

R04_YCR07

Past 30 day “not-light” cigarette smokers who have a regular brand, go to R04_YC1051.
Else, youth respondents who have smoked a cigarette today, yesterday or the day before yesterday;
and who selected a valid brand and product for the last cigarette smoked, go to R04_YC0104.
Else, go to Box R04_YVT01.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

25

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1051

About how long have you been smoking your regular brand of cigarettes?
1

I___I___I

DAYS

2

I___I___I

MONTHS

3

I___I___I YEARS

-8

DON'T KNOW

GO TO R04_YC9019

-7

REFUSED

GO TO R04_YC9019

ASK: Past 30 day "not-light" cigarette smokers who have a regular brand.
PATH ID:

R04_YC1051_LC1

The computer recorded that you have been smoking your regular brand for [R04_YC1051_NN]. That is
older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC1051

2

NEXT

GO TO R04_YC9019

ASK: IF (R04_YC1051_NN > R04_YOUTHAGE) AND R04_YC1051_UN = 3.
PATH ID:

R04_YC1051_LC2

The computer recorded "0" for how long you have been smoking your regular brand of cigarettes.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC1051

2

NEXT

GO TO R04_YC9019

ASK: IF R04_YC1051_NN = 0.
PATH ID:

R04_YC9019

Do you think the brand of cigarettes you usually smoke might be less harmful, no different, or more
harmful, compared to other cigarette brands?
1

Less harmful

2

No different

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers who have a regular brand.

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Youth Questionnaire – New and Aged-Up Interview

26

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YCD01

PROGRAM: Display questions R04_YC9010 and R04_YC9014 on one screen. Show the intro/transition
text from R04_YC9010 first, then show each item with a Yes/No response. As each item is answered,
show the next one.
PATH ID:

R04_YC9010

In choosing your regular brand of cigarettes, was part of your decision based on any of the following?
It is affordable.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers who have a regular brand.
PATH ID:

R04_YC9014

The taste.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers who have a regular brand.
BOX ID:

R04_YCR08

Youth respondents who have smoked a cigarette today, yesterday or the day before yesterday and
have selected a valid brand in R04_YC1048_BRAND and valid product in R04_YC1070_PRODUCT, go
to R04_YC0104.
Else, go to Box R04_YVT01.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

27

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC0104

We just have one more question about [your regular brand / the last brand] of cigarettes[ you smoked].
You said earlier that you smoked a cigarette [TIME OF LAST USE].
Think about the very last cigarette you smoked. Was the brand [NEQBRAND]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers who have smoked a cigarette in the past hour, sometime today,
yesterday or the day before yesterday AND who selected a valid brand AND valid product.
DISPLAY: UNDERLINE "your regular brand" AND "the last brand" IN THE QUESTION TEXT.
IF R04_YC1047 = 1, DISPLAY “your regular brand”.
ELSE, DISPLAY "the last brand" AND "you smoked".
IF R04_YC0100 = 1, FILL [TIME OF LAST USE] WITH “in the past hour”.
IF R04_YC0100 = 2, FILL [TIME OF LAST USE] WITH “sometime today”.
IF R04_YC0100 = 3, FILL [TIME OF LAST USE] WITH “yesterday”.
IF R04_YC0100 = 4, FILL [TIME OF LAST USE] WITH “the day before yesterday”.
FILL [NEQBRAND] WITH R04_YC1070_PRODUCT RESPONSE.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

28

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

ELECTRONIC NICOTINE PRODUCTS
BOX ID:

R04_YVT01

The next questions are about electronic nicotine products, such as e-cigarettes, vape pens, personal
vaporizers and mods, e-cigars, e-pipes, e-hookahs and hookah pens.
These products are battery-powered and produce vapor or aerosol instead of smoke. They contain
nicotine liquid, sometimes called “e-liquid” or “e-juice,” although the amount of nicotine can vary and
some may not contain any nicotine at all.
Some can be bought as one-time, disposable products, while others can be bought as re-usable kits
that are rechargeable. Some common brands include Vuse, Blu, Logic, MarkTen, NJOY, eGo, and
iTaste.
[SHOW GENERIC IMAGE OF E-PRODUCTS]
BOX ID:

R04_YVR03

New baseline youth respondents, go to R04_YV1001_NB.
Else, continuing youth respondents, go to R04_YV1002_12M.
PATH ID:

R04_YV1001_NB

Have you ever seen or heard of electronic nicotine products before this study? (Electronic nicotine
products include e-cigarettes, vape pens, personal vaporizers and mods, e-cigars, e-pipes, e-hookahs
and hookah pens.)
[SHOW GENERIC IMAGE OF E-PRODUCTS]
1

Yes

2

No

GO TO BOX R04_YVV02

-8

DON'T KNOW

GO TO BOX R04_YVV02

-7

REFUSED

GO TO BOX R04_YVV02

ASK: New baseline youth respondents.

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Youth Questionnaire – New and Aged-Up Interview

29

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1002_NB

Have you ever used an electronic nicotine product, even one or two times? (Electronic nicotine products
include e-cigarettes, vape pens, personal vaporizers and mods, e-cigars, e-pipes, e-hookahs and
hookah pens.)
[SHOW GENERIC IMAGE OF E-PRODUCTS]
1

Yes

GO TO BOX R04_YVV02

2

No

GO TO BOX R04_YVV02

-8

DON'T KNOW

GO TO BOX R04_YVV02

-7

REFUSED

GO TO BOX R04_YVV02

ASK: New baseline youth respondents who have heard of e-products.
BOX ID:

R04_YVV02

PROGRAM - CREATE THE FOLLOWING USER GROUPS AND DERIVED VARIABLES (SEE
APPENDIX):
R04_EVER_NEVER_EPRODS_YOUTH = 1 (Ever user) Youth respondents who have ever used an
electronic nicotine product.
R04_EVER_NEVER_EPRODS_YOUTH = 2 (Never user) Youth respondents who have not ever used
an electronic nicotine product.
R04_INIT_EPRODS_YOUTH = 1 (Initiator) Youth respondents who initiated electronic nicotine product
use between Waves or new baseline respondents who have ever used an e-product.
R04_EPRODCOUNT= The number of electronic nicotine products used.
BOX ID:

R04_YVR01

New baseline youth respondents who did not say they have heard of e-products, go to Box
R04_YGT01.
Else, continuing youth respondents who have never used e-products, and new baseline youth
respondents who have heard of but never used e-products, go to R04_YV1103.
Else, go to Box R04_YVR02.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

30

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1103

Have you ever been curious about using an electronic nicotine product? (Electronic nicotine products
include e-cigarettes, vape pens, personal vaporizers and mods, e-cigars, e-pipes, e-hookahs and
hookah pens.)
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have never used e-products, and new baseline youth
respondents who have heard of but never used e-products.
PATH ID:

R04_YV1206

Do you think you will try an electronic nicotine product in the next year?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used e-products.
PATH ID:

R04_YV1104

Do you think that you will try an electronic nicotine product soon?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used e-products.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

31

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1105

If one of your best friends were to offer you an electronic nicotine product, would you try it?
1

Definitely yes

GO TO R04_YV9041

2

Probably yes

GO TO R04_YV9041

3

Probably not

GO TO R04_YV9041

4

Definitely not

GO TO R04_YV9041

-8

DON'T KNOW

GO TO R04_YV9041

-7

REFUSED

GO TO R04_YV9041

ASK: Youth respondents who have heard of but never used e-products.
BOX ID:

R04_YVR02

New baseline youth respondents who have ever used e-products, go to R04_YV1006_NB.
Else, continuing youth respondents who initiated e-product since the previous wave, go to
R04_YV1011.
Else, continuing youth respondents who had used e-products 100 or more times in the previous wave,
go to Box R04_YVR37.
Else, go to R04_YV1005.
PATH ID:

R04_YV1006_NB

How old were you when you first tried an electronic nicotine product, even one or two times?
1

|___|___| Years old

-8

DON'T KNOW

GO TO R04_YV1120_NB

-7

REFUSED

GO TO R04_YV1120_NB

ASK: New baseline youth respondents who have ever used an e-product.
DISPLAY: DISPLAY “Years old” AS A TITLE.
PATH ID:

R04_YV1006_NB_LC1

The computer recorded that you first tried an electronic nicotine product at age [R04_YV1006_NB]. Is
that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1006_NB

2

NEXT

GO TO R04_YV1011

ASK: IF R04_YV1006_NB <= 5.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

32

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1006_NB_LC2

The computer recorded that you first tried an electronic nicotine product at age [R04_YV1006_NB]. That
is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1006_NB

2

NEXT

GO TO R04_YV1011

ASK: IF R04_YV1006_NB > R04_YOUTHAGE.
PATH ID:

R04_YV1120_NB

When you first tried an electronic nicotine product, even one or two times, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON’T KNOW

-7

REFUSED

ASK: New baseline youth respondents who did not know or refused to report the age they first tried an
e-product.
PATH ID:

R04_YV1011

When you first used an electronic nicotine product, which flavor did you use? Choose all that apply.
1

Tobacco-flavored

2

Menthol or mint

3

Clove or spice

4

Fruit

5

Chocolate

6

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

7

A non-alcoholic drink (such as coffee, soda, energy drinks, or other beverages)

8

Candy, desserts or other sweets

9

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have initiated e-product use since the previous wave, and new
baseline youth respondents who have ever used an e-product.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

33

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1005

How many times have you used an electronic nicotine product in your entire life?
1

1 time, even just a few puffs

2

2 to 10 times

3

11 to 20 times

4

21 to 50 times

5

51 to 99 times

6

100 or more times

-8

DON'T KNOW

-7

REFUSED

ASK: Aged-up and continuing youth respondents who have ever used an e-product and had not used
100 or more times in the previous wave, and new cohort youth respondents who have ever used an eproduct.
BOX ID:

R04_YVR37

Youth respondents who have ever used an e-product and had never used e-products fairly regularly in
the previous wave, go to R04_YV1100.
Else, go to R04_YV1112.
PATH ID:

R04_YV1100

Have you ever used electronic nicotine products fairly regularly?
1

Yes

2

No

GO TO R04_YV1112

-8

DON'T KNOW

GO TO R04_YV1112

-7

REFUSED

GO TO R04_YV1112

ASK: Youth respondents who have ever used an e-product and had never used fairly regularly in the
previous wave.
PATH ID:

R04_YV1007

How old were you when you first started using electronic nicotine products fairly regularly?
1

|__|__| Years old

-8

DON'T KNOW

GO TO R04_YV1121

-7

REFUSED

GO TO R04_YV1121

ASK: Youth respondents who have ever used e-products fairly regularly and did not use fairly regularly
in the previous wave.
DISPLAY: DISPLAY "Years old" AS A TITLE.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

34

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1007_LC1

The computer recorded that you started using electronic nicotine products fairly regularly at age
[R04_YV1007]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1007

2

NEXT

GO TO R04_YV1112

ASK: IF R04_YV1007 <= 5 OR (R04_YV1007 < R04_YV1006_NB).
PATH ID:

R04_YV1007_LC2

The computer recorded that you started using electronic nicotine products fairly regularly at age
[R04_YV1007]. That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1007

2

NEXT

GO TO R04_YV1112

ASK: IF R04_YV1007 > R04_YOUTHAGE.
PATH ID:

R04_YV1121

When you first started using electronic nicotine products fairly regularly, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who did not know or refused to report the age they started using e-products
fairly regularly.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

35

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1112

When was the last time you used an electronic nicotine product, even one or two times?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YVV01

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YVV01

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YVV01

6

1 to 4 years ago

GO TO BOX R04_YVV01

7

5 or more years ago

GO TO BOX R04_YVV01

-8

DON'T KNOW

GO TO BOX R04_YVV01

-7

REFUSED

GO TO BOX R04_YVV01

ASK: Youth respondents who have ever used an e-product.
PATH ID:

R04_YV0100

When did you last use an electronic nicotine product?
1

In the past hour

GO TO R04_YV0103

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YVV01

-8

DON'T KNOW

GO TO BOX R04_YVV01

-7

REFUSED

GO TO BOX R04_YVV01

ASK: Youth respondents who used e-products in the past 7 days.
PATH ID:

R04_YV0102

When you last used an electronic nicotine product [FILL BASED ON R04_YV0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used an e-product today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YV0100]:
IF R04_YV0100 = 2, DISPLAY “today”.
IF R04_YV0100 = 3, DISPLAY “yesterday”.
IF R04_YV0100 = 4, DISPLAY “the day before yesterday”.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

36

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV0103

How many puffs from an electronic nicotine product [have/did] you [taken/take] [FILL BASED ON
R04_YV0100]?
1

I__I__I

-8

DON'T KNOW

GO TO BOX R04_YVV01

-7

REFUSED

GO TO BOX R04_YVV01

ASK: Youth respondents who have used an e-product in the past hour, sometime today, yesterday or
the day before yesterday.
DISPLAY: IF R04_YV0100 = 1, 2, DISPLAY “have” AND “taken”.
IF R04_YV0100 = 3, 4, DISPLAY “did” AND “take”.
FOR [FILL BASED ON R04_YV0100]:
IF R04_YV0100 = 1, 2, DISPLAY “today”.
IF R04_YV0100 = 3, DISPLAY “yesterday”.
IF R04_YV0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YV0103_LC1

The computer recorded you took [R04_YV0103] puffs from an electronic nicotine product
[today/yesterday/the day before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is not correct, please press the BACK
button and re-enter.
1

BACK

GO TO R04_YV0103

2

NEXT

GO TO BOX R04_YVV01

ASK: IF R04_YV0103 > 200 OR R04_YV0103 = 11, 22, 33, 44, 55, 66, 77, 88, 99, 111.
DISPLAY: IF R04_YV0100 = 1, 2, DISPLAY “today”.
IF R04_YV0100 = 3, DISPLAY “yesterday”.
IF R04_YV0100 = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YVV01

PROGRAM - CREATE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PAST30DAY_EPRODS = 1 (Past 30 day e-product user) Youth respondents who have used an
electronic nicotine product in the past 30 days.
R04_PAST30DAY_EPRODS_LEVEL = 1 (Past 30 day "Very Light" e-product user) Youth
respondents who have used an electronic nicotine product in the past 30 days, and have used an
electronic nicotine product only once in their lifetime.
R04_PAST30DAY_EPRODS_LEVEL = 2 (Past 30 day "Not Light" e-product user) Youth
respondents who have used an electronic nicotine product in the past 30 days, and have used
electronic nicotine products more than once in their lifetime.

PATH – Wave 4
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37

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV9041

Not including yourself, does anyone living in your home own an e-cigarette or other electronic nicotine
product?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have seen, heard of, or ever used e-product, and continuing
youth respondents.
BOX ID:

R04_YVR54

Continuing youth respondents that have used an e-product in the past 12 months and new baseline
youth respondents that have ever used an e-product, go to R04_YV9035.
Else, go to Box R04_YVR04.
PATH ID:

R04_YV9035

Which of the following electronic nicotine products have you used? Choose all that apply.
[SHOW GENERIC IMAGE OF E-PRODUCTS BY SUBTYPE]
1

E-cigarette including a vape pen, personal vaporizer, or mod

2

E-cigar

3

E-pipe

4

E-hookah including a hookah pen

5

Something else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever used e-products, and continuing youth
respondents who have used e-products in the past 12 months.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YVR55

If the only device type selected is “Something else” or the respondent did not know or refused to report
which device types they have used, go to Box R04_YVR04.
Else, repeat R04_YV9060 and R04_YV9061 for each device type selected, except "Something else".
When all loops complete, go to Box R04_YVV04.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

38

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV9060

Do you use more than one kind of [FILL WITH DEVICE TYPE SELECTED IN R04_YV9035]?
1

Yes

2

No

GO TO BOX R04_YVR59

-8

DON'T KNOW

GO TO BOX R04_YVR59

-7

REFUSED

GO TO BOX R04_YVR59

ASK: New baseline youth respondents who have ever used e-products, and continuing youth
respondents who have used e-products in the past 12 months and selected a type of e-product.
DISPLAY: FOR R04_YV9060_01, DISPLAY "e-cigarette".
FOR R04_YV9060_02, DISPLAY "e-cigar".
FOR R04_YV9060_03, DISPLAY "e-pipe".
FOR R04_YV9060_04, DISPLAY "e-hookah".
PATH ID:

R04_YV9061

How many different kinds of [FILL WITH DEVICE TYPE IN R04_YV9035] have you used?
1

|__|__|

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever used e-products, and continuing youth
respondents who have used e-products in the past 12 months and selected a type of e-product and use
multiple e-products.
DISPLAY: FOR R04_YV9061_01, DISPLAY "e-cigarettes".
FOR R04_YV9061_02, DISPLAY "e-cigars".
FOR R04_YV9061_03, DISPLAY "e-pipes".
FOR R04_YV9061_04, DISPLAY "e-hookahs".
BOX ID:

R04_YVR59

If there are remaining device types, go back to Box R04_YVR55 and complete loop for all remaining
device types.
Else, if all loops are complete, go to Box R04_YVV04.
BOX ID:

R04_YVV04

PROGRAM - CREATE THE FOLLOWING DERIVED VARIABLE (SEE APPENDIX):
R04_EPRODCOUNT = Number of e-products used.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YVR56

If the respondent uses more than one type of electronic nicotine product, go to R04_YV9044.
Else, go to Box R04_YVR04.
PATH ID:

R04_YV9044

You mentioned that you have used more than one type of electronic nicotine product.
Which electronic nicotine product do you use most often?
1

E-cigarette including a vape pen, personal vaporizer, or mod

2

E-cigar

3

E-pipe

4

E-hookah including a hookah pen

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever used e-products, and continuing youth
respondents who have used e-products in the past 12 months and selected a type of e-product and
have used more than one e-product.
BOX ID:

R04_YVR04

Past 30 day e-product users (including "very light" users), go to R04_YV9140.
Else, go to Box R04_YVR58.
PATH ID:

R04_YV9140

Please look at this picture. Which group is most like the electronic nicotine product you use most often?
[SHOW GENERIC IMAGE OF 6 E-PRODUCT GROUPS]
1

Group 1

2

Group 2

3

Group 3

4

Group 4

5

Group 5

6

Group 6

7

None of the above

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users (including "very light" users).
DISPLAY: UNDERLINE "most often".

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

40

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YVR58

Past 30 day "not light" e-product users, go to Box R04_YVD04.
Else, past 30 day e-product users, go to Box R04_YVV03.
Else, go to R04_YV9042.
BOX ID:

R04_YVD04

Display questions R04_YV9005 through R04_YV9009 using the expanded WVB stem-leaf screen. For
each leaf, display a yes/no response. The introduction text from R04_YV9005 is the stem. Show all
leaves on the screen at once.
PATH ID:

R04_YV9005

For the following questions, please think about the electronic nicotine product you use most often.
Is it rechargeable?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not light" e-product users.
DISPLAY: BOLD AND UNDERLINE “most often”.
PATH ID:

R04_YV9038

Does it use a tank system?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not light" e-product users.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

41

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV9008

Does it use cartridges?
[IF EPRODTYPE1=e-cigarettes, SHOW GENERIC IMAGE OF E-CIGARETTE CARTRIDGES]
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not light" e-product users.
PATH ID:

R04_YV9009

Can you refill it with “e-liquid”?
1

Yes

2

No

GO TO BOX R04_YVV03

-8

DON'T KNOW

GO TO BOX R04_YVV03

-7

REFUSED

GO TO BOX R04_YVV03

ASK: Past 30 day "not light" e-product users.
PATH ID:

R04_YV9046

How often do you refill your electronic nicotine product with e-liquid?
1

At least once a day

2

Once every couple of days

3

Once a week

4

A few times a month

5

Once a month

6

A few times a year

7

Once a year

8

Never

-8

DON'T KNOW

-7

REFUSED

GO TO BOX R04_YVV03

ASK: Past 30 day "not light" e-product users that use refillable e-products.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

42

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV9036

Who refills it with e-liquid?
1

I refill it myself

2

I get it refilled at a vape shop or vapor lounge

3

I buy it already filled

4

I get it refilled some other way

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not light" e-product users that use refillable e-products and has refilled them before.
BOX ID:

R04_YVV03

PROGRAM - CREATE THE FOLLOWING DERIVED VARIABLES (SEE APPENDIX):
R04_EDEVICETYPE (E-Product device type):
R04_EDEVICETYPE = 1 (Disposable E-Product Users).
R04_EDEVICETYPE = 2 (Non-Refillable Cartridge E-Product Users).
R04_EDEVICETYPE = 3 (Refillable Cartridge E-Product Users).
R04_EDEVICETYPE = 4 (Refillable Tank System E-Product Users).
R04_EDEVICETYPE = 5 (Refillable Mod System E-Product Users).
R04_EDEVICETYPE = 6 (Unknown E-Product User Type).
BOX ID:

R04_YVT04

PROGRAM - CREATE [EPRODFILL1-3]:
EPRODFILL1:
IF R04_EDEVICETYPE = 1, 6 (Disposable/Unknown), EPRODFILL1 = "electronic nicotine products".
IF R04_EDEVICETYPE = 2 (Non-refillable Cartridges), EPRODFILL1 = "electronic nicotine cartridges".
IF R04_EDEVICETYPE = 3, 4, 5 (Refillable Cartridges/Tank/Mod), EPRODFILL1 = "milliliters of eliquid".
EPRODFILL2:
IF R04_EDEVICETYPE = 1, 6 (Disposable/Unknown), EPRODFILL2 = "electronic nicotine products".
IF R04_EDEVICETYPE = 2 (Non-refillable Cartridges), EPRODFILL2 = "electronic nicotine cartridges".
IF R04_EDEVICETYPE = 3, 4, 5 (Refillable Cartridges/Tank/Mod), EPRODFILL2 = "e-liquid".
EPRODFILL3:
IF R04_EDEVICETYPE = 1, 6 (Disposable/Unknown), EPRODFILL3 = "electronic nicotine product".
IF R04_EDEVICETYPE = 2 (Non-refillable Cartridges), EPRODFILL3 = "electronic nicotine cartridge".
IF R04_EDEVICETYPE = 3, 4, 5 (Refillable Cartridges/Tank/Mod), EPRODFILL3 = "e-liquid".

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

43

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV9010

Please think about the [EPRODFILL3] you use most often.
Does it contain nicotine?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: BOLD AND UNDERLINE “most often”.
PATH ID:

R04_YV1022

In the past 30 days, on how many days did you use an electronic nicotine product?
1

|___|___| DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: DISPLAY 'DAYS' AS A TITLE.
PATH ID:

R04_YV9040

In the past 30 days, on the days you used an electronic nicotine product, how many [EPRODFILL1] did
you use per day?
1

Less than 1 per day

2

I___I___I

GO TO R04_YV1131

-8

DON'T KNOW

GO TO R04_YV1131

-7

REFUSED

GO TO R04_YV1131

ASK: Past 30 day e-product users.
PATH ID:

R04_YV9040_LC1

The computer recorded that on the days you used in the past 30 days, you used [R04_YV9040]
[EPRODFILL1] a day.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV9040

2

NEXT

GO TO R04_YV1131

ASK: IF R04_YV9040 > 5.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

44

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

PATH ID:

R04_YV1131

Which flavors of [EPRODFILL2] have you used in the past 30 days? Choose all that apply.
1

Tobacco-flavored

2

Menthol or mint

3

Clove or spice

4

Fruit

5

Chocolate

6

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

7

A non-alcoholic drink (such as coffee, soda, energy drinks, or other beverages)

8

Candy, desserts or other sweets

9

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YVR38

Youth respondents who used menthol or mint flavored e-products in the past 30 days, go to
R04_YV1147.
Else, youth respondents who used flavored e-products (other than menthol/mint or tobacco-flavored) in
the past 30 days, go to R04_YV1157.
Else, go to R04_YV1142.
PATH ID:

R04_YV1147

In the past 30 days, on the days you used an electronic nicotine product, how often was it flavored to
taste like menthol or mint?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users that have used menthol or mint flavored e-products.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

45

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YVR40

Youth respondents who used flavored e-products (other than menthol/mint or tobacco-flavored) in the
past 30 days, go to R04_YV1157.
Else, go to R04_YV1142.
PATH ID:

R04_YV1157

In the past 30 days, on the days you used an electronic nicotine product, how often was it flavored to
taste like clove, spice, fruit, chocolate, alcoholic or non-alcoholic drinks, candy, desserts or other
sweets?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who used flavored e-products (other than menthol/mint or tobacco-flavored) in
the past 30 days.
PATH ID:

R04_YV1142

In the past 30 days, did anyone sell you [EPRODFILL2]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
PATH ID:

R04_YV1123

In the past 30 days, did anyone refuse to sell you [EPRODFILL2] because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

46

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1118

In the past 30 days, how did you usually get your own [EPRODFILL2]?
1

I gave someone else money to buy them for me

2

I bought them myself from a store (including a vape shop or vapor lounge)

3

I asked someone to give me one

4

Someone offered it to me

5

I bought them from another person

6

I took them from a store or another person

7

I got them some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YVR05

Past 30 day e-product users who usually buy e-products for themselves or give someone else money to
buy e-products for them, go to R04_YV1030.
Else, go to Box R04_YVR57.
PATH ID:

R04_YV1030

[When you give money to someone else, how do they/How do you] usually buy your [EPRODFILL2]?
1

In person

2

From the internet

GO TO BOX R04_YVR06

3

By telephone

GO TO BOX R04_YVR06

-8

DON'T KNOW

GO TO BOX R04_YVR06

-7

REFUSED

GO TO BOX R04_YVR06

ASK: Past 30 day e-product users (including "very light" users) who buy e-products for themselves or
someone else buys for them.
DISPLAY: IF R04_YV1118 = 1, DISPLAY “When you give money to someone else, how do they”;
IF R04_YV1118 = 2, DISPLAY “How do you”.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

47

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1033

Where do [you/they] buy your [EPRODFILL2] most of the time?
11

A vape shop or vapor lounge

1

A mall kiosk

2

A convenience store or gas station

3

A supermarket, grocery store, or drug store

4

A warehouse club, such as Sam’s or Costco

5

A smoke shop, tobacco specialty store or tobacco outlet store

6

A duty free shop or military commissary

7

A bar, pub, restaurant or casino

8

A friend or relative

9

A swap meet or flea market

10

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users (including "very light" users) who buy e-products for themselves or
someone else buys for them in person.
DISPLAY: IF R04_YV1118 = 1, DISPLAY “they”;
IF R04_YV1118 = 2, DISPLAY “you”.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
BOX ID:

R04_YVR06

Past 30 day "not-light" disposable e-product users and e-product users of undetermined types who buy
e-products for themselves or someone else buys for them, go to R04_YV1136.
Else, refillable cartridge, tank system, and mod system e-product users, go to R04_YV1041.
Else, non-refillable e-product users, go to R04_YV1039.
Else, go to Box R04_YVR57.
PATH ID:

R04_YV1136

Think about the last time you [bought/gave money to someone else to buy you] electronic nicotine
products. Did you buy them by the box or pack, or as single electronic nicotine products?
1

Box or pack

2

Single electronic nicotine products

GO TO R04_YV1034

-8

DON'T KNOW

GO TO R04_YV1034

-7

REFUSED

GO TO R04_YV1034

ASK: Past 30 day "not-light" disposable e-product users and e-product users of undetermined types
who buy e-products for themselves or someone else buys for them.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

48

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1137

How many electronic nicotine products came in the box or pack that you last bought?
1

I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" disposable e-product users and e-product users of undetermined types
who buy e-products for themselves or someone else buys for them who last bought e-products in a box
or pack.
PATH ID:

R04_YV1138

How much did you pay for a box or pack of electronic nicotine products?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YVR57

-7

REFUSED

GO TO BOX R04_YVR57

ASK: Past 30 day "not-light" disposable e-product users and e-product users of undetermined types
who buy e-products for themselves or someone else buys for them who last bought e-products in a box
or pack.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
PATH ID:

R04_YV1138_LC1

The computer recorded that you paid $[R04_YV1138_D] for a box or pack of electronic nicotine
products. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1138

2

NEXT

GO TO BOX R04_YVR57

ASK: IF R04_YV1138_D < 10 OR R04_YV1138_D > 75.
PATH ID:

R04_YV1034

How much did you pay for a single electronic nicotine product?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YVR57

-7

REFUSED

GO TO BOX R04_YVR57

ASK: Past 30 day "not-light" disposable e-product users and e-product users of undetermined types
who buy e-products for themselves or someone else buys for them who did not buy their last e-product
in box or pack.
DISPLAY: DISPLAY“$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.

PATH – Wave 4
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49

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1034_LC1

The computer recorded that you paid $[R04_YV1034_D] for a single electronic nicotine product. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1034

2

NEXT

GO TO BOX R04_YVR57

ASK: IF R04_YV1034_D > 50.
PATH ID:

R04_YV1041

Think about the last time you [bought/gave money to someone else to buy you] e-liquid.
How much did you pay for a bottle or container of e-liquid?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YVR57

-7

REFUSED

GO TO BOX R04_YVR57

ASK: Past 30 day "not-light" refillable cartridge, tank system, and mod system e-product users who buy
e-liquid for themselves or someone else buys for them.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
IF R04_YV1118 = 1, DISPLAY "gave money to someone else to buy you".
IF R04_YV1118 = 2, DISPLAY "bought".
PATH ID:

R04_YV1041_LC1

The computer recorded that you paid $[R04_YV1041_D] for a bottle or container of e-liquid. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1041

2

NEXT

GO TO BOX R04_YVR57

ASK: IF R04_YV1041_D > 50.

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Youth Questionnaire – New and Aged-Up Interview

50

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1039

Think about the last time you [bought/gave money to someone else to buy you] electronic nicotine
product cartridges.
Did you buy them by the box or pack, or as single cartridges?
1

Box or pack

2

Single cartridges

GO TO R04_YV1043

-8

DON'T KNOW

GO TO R04_YV1043

-7

REFUSED

GO TO R04_YV1043

ASK: Past 30 day "not-light" non-refillable cartridge e-product users who buy cartridges for themselves
or someone else buys for them.
DISPLAY: IF R04_YV1118 = 1, DISPLAY "gave money to someone else to buy you".
IF R04_YV1118 = 2, DISPLAY "bought".
PATH ID:

R04_YV1040

How many electronic nicotine product cartridges came in the box or pack that you last bought?
1

I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" non-refillable cartridge e-product users who buy cartridges for themselves
or someone else buys for them and last bought cartridges in a box or pack.
PATH ID:

R04_YV1042

How much did you pay for a box or pack of electronic nicotine product cartridges?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YVR57

-7

REFUSED

GO TO BOX R04_YVR57

ASK: Past 30 day "not-light" non-refillable cartridge e-product users who buy cartridges for themselves
or someone else buys for them and last bought cartridges in a box or pack.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

51

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1042_LC1

The computer recorded that you paid $[R04_YV1042_D] for a box or pack of [EPRODFILL1]. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1042

2

NEXT

GO TO BOX R04_YVR57

ASK: IF R04_YV1042_D > 50.
PATH ID:

R04_YV1043

How much did you pay for a single electronic nicotine product cartridge?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YVR57

-7

REFUSED

GO TO BOX R04_YVR57

ASK: Past 30 day "not-light" non-refillable cartridge e-product users who buy cartridges for themselves
or someone else buys for them and last bought single cartridges or did not know or refused to report
whether the non-refillable cartridge was in a box or pack or a single cartridge.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
PATH ID:

R04_YV1043_LC1

The computer recorded that you paid $[R04_YV1043_D] for a single [EPRODFILL3]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1043

2

NEXT

GO TO BOX R04_YVR57

ASK: IF R04_YV1043_D > 50.
BOX ID:

R04_YVR57

Past 30 day "not-light" e-product users, go to R04_YV1047.
Else, go to R04_YV1945.

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52

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1047

Do you have a regular brand of [EPRODFILL2] that you usually use?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" e-product users.
PATH ID:

R04_YV1945

Do you know the name of the brand of [EPRODFILL2] you [usually use/last used]?
1

Yes

2

No

GO TO BOX R04_YVD02

-8

DON'T KNOW

GO TO BOX R04_YVD02

-7

REFUSED

GO TO BOX R04_YVD02

ASK: Past 30 day e-product users.
DISPLAY: IF R04_YV1047 = 1, DISPLAY “usually use”.
ELSE, DISPLAY “last used”.
UNDERLINE "name of the brand".
PATH ID:

R04_YV1048

What brand of [EPRODFILL2] [do/did] you [usually/last] use?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else.”]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users who know the brand name.
DISPLAY: IF R04_YV1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[If multiple screens] Display: If you do not see it below, touch the button marked “NEXT”.
[If single screen OR last screen of multiple screens] Display: If you do not see it below, touch the box
marked “Something else”.

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Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YVR33

If youth respondent selects "Something else" in R04_YV1048_BRAND, go to R04_YV1049.
Else, past 30 day e-product users who have used an e-product today, yesterday or the day before
yesterday AND who selected a valid brand in R04_YV1048_BRAND, go to R04_YV0104.
Else, go to Box R04_YVD02.
PATH ID:

R04_YV1049

You said that your brand was not listed. What is it?
1

__________________________

GO TO R04_YVD02

-8

DON'T KNOW

GO TO R04_YVD02

-7

REFUSED

GO TO R04_YVD02

ASK: Past 30 day e-product users that know the name of the brand they use who selected "Something
else" for their brand.
PATH ID:

R04_YV0104

You said earlier that you last used an electronic nicotine product [TIME OF LAST USE].
Think about the very last puff you took. Was the brand [NEQBRAND]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users who have used an e-product in the past hour, sometime today,
yesterday or the day before yesterday and selected a valid brand.
DISPLAY: IF R04_YV0100 = 1, FILL [TIME OF LAST USE] WITH “in the past hour”.
IF R04_YV0100 = 2, FILL [TIME OF LAST USE] WITH “sometime today”.
IF R04_YV0100 = 3, FILL [TIME OF LAST USE] WITH “yesterday”.
IF R04_YV0100 = 4, FILL [TIME OF LAST USE] WITH “the day before yesterday”.
FILL [NEQBRAND] WITH SELECTION MADE IN R04_YV1048_BRAND.
BOX ID:

R04_YVD02

Display question R04_YV1060, R04_YV1085, R04_YV1062, R04_YV1075, R04_YV1063,
R04_YV1064, R04_YV1065, R04_YV1066, R04_YV1067 on one screen. Show the intro/transition text
from R04_YV1060 first, then show each item with a Yes/No response. As each item is answered, show
the next one.
PROGRAM: Randomize order of R04_YV1060 through R04_YV1067.

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Youth Questionnaire – New and Aged-Up Interview

54

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1060

The next questions are about the reasons people use electronic nicotine products. Please select which
reasons apply to you.
I use electronic nicotine products because…
They are affordable.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
PATH ID:

R04_YV1085

I can use electronic nicotine products at times when or in places where smoking cigarettes isn’t allowed.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
PATH ID:

R04_YV1062

They might be less harmful to me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
PATH ID:

R04_YV1075

They might be less harmful to people around me than cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

55

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1063

E-liquid comes in flavors I like.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
BOX ID:

R04_YVR13

Past 30 day e-product users who have also smoked cigarettes in the past year, go to R04_YV1064.
Else, go to R04_YV1065.
PATH ID:

R04_YV1064

Using electronic nicotine products helps people quit smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users who have also smoked cigarettes in the past year.
PATH ID:

R04_YV1065

Electronic nicotine products don't smell.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
PATH ID:

R04_YV1066

Using an electronic nicotine product feels like smoking a regular cigarette.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

56

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1067

Electronic nicotine products don’t bother non-tobacco users.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
BOX ID:

R04_YVR14

Past 30 day e-product users who have also smoked cigarettes in the past 30 days, go to R04_YV1086.
Else, past 30 day e-product users, go to R04_YV1139.
Else, go to R04_YV9042.
PATH ID:

R04_YV1086

In the past 30 days, have you used an electronic nicotine product at times when or in places where you
could not smoke regular cigarettes?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users who have also smoked cigarettes in the past 30 days.
PATH ID:

R04_YV1139

Please rate your level of agreement for each statement using the following scale: 1 = not true of me at
all to 4 = very true of me.
It is easier to talk and get along with other people when using an electronic nicotine product.
1

Not true of me at all

2
3
4

Very true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: DISPLAY SCALE FOR THE R04_YV1139-1141 SERIES.

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Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1140

While using an electronic nicotine product, I feel more confident with other people.
1

Not true of me at all

2
3
4

Very true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: DISPLAY SCALE FOR THE R04_YV1139-1141 SERIES.
PATH ID:

R04_YV1141

I use electronic nicotine products much more when I am with other people.
1

Not true of me at all

2
3
4

Very true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: DISPLAY SCALE FOR THE R04_YV1139-1141 SERIES.
PATH ID:

R04_YV9042

Have you ever used marijuana, marijuana concentrates, marijuana waxes, THC, or hash oils in an
electronic product such as an e-cigarette, vape, mod, personal vaporizer, e-hookah, or hookah pen?
(Remember all information you give to the PATH Study will be kept private.)
1

Yes

2

No

GO TO BOX R04_YVR10

-8

DON'T KNOW

GO TO BOX R04_YVR10

-7

REFUSED

GO TO BOX R04_YVR10

ASK: New baseline youth respondents who have seen, heard of, or ever used e-products, and
continuing youth respondents.
DISPLAY: UNDERLINE "electronic product".

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV9106

When you have used an electronic product, how often were you using it to smoke marijuana, marijuana
concentrates, marijuana waxes, THC, or hash oils?
1

Every time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used e-products to smoke marijuana.
PATH ID:

R04_YM0100

When did you last use marijuana, marijuana concentrates, marijuana waxes, THC, or hash oils in an
electronic product such as an e-cigarette, vape, mod, personal vaporizer, e-hookah, or hookah pen?
1

In the past hour

2

Sometime today

3

Yesterday

4

Day before yesterday

5

GO TO R04_YM0103

Three or more days ago

GO TO BOX R04_YVR10

-8

DON'T KNOW

GO TO BOX R04_YVR10

-7

REFUSED

GO TO BOX R04_YVR10

ASK: Youth respondents who have ever used marijuana in an e-product.
DISPLAY: UNDERLINE "electronic product".

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

59

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YM0102

When you last used marijuana, marijuana concentrates, marijuana waxes, THC, or hash oils in an
electronic product [FILL BASED ON R04_YM0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used marijuana in an e-product today, yesterday or the day before
yesterday.
DISPLAY: FOR [FILL BASED ON R04_YM0100]:
IF R04_YM0100 = 2, DISPLAY “today”.
IF R04_YM0100 = 3, DISPLAY “yesterday”.
IF R04_YM0100 = 4, DISPLAY “the day before yesterday”.
UNDERLINE "electronic product".
PATH ID:

R04_YM0103

How many puffs of marijuana, marijuana concentrates, marijuana waxes, THC, or hash oils from an
electronic product [have/did] you [taken/take] [FILL BASED ON R04_YM0100]?
1

I__I__I__I

-8

DON'T KNOW

GO TO BOX R04_YVR10

-7

REFUSED

GO TO BOX R04_YVR10

ASK: Youth respondents who have used marijuana in an e-product in the past hour, today, yesterday or
the day before yesterday.
DISPLAY: IF R04_YM0100 = 1, 2, DISPLAY “have” AND “taken”.
IF R04_YM0100 = 3, 4, DISPLAY “did” AND “take”.
FOR [FILL BASED ON R04_YM0100]:
IF R04_YM0100 = 1, 2, DISPLAY “today”.
IF R04_YM0100 = 3, DISPLAY “yesterday”.
IF R04_YM0100 = 4, DISPLAY “the day before yesterday”.
UNDERLINE "electronic product".

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

60

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YM0103_LC1

The computer recorded you took [R04_YM0103] puffs from an electronic nicotine product
[today/yesterday/the day before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is not correct, please press the BACK
button and re-enter.
1

BACK

GO TO R04_YM0103

2

NEXT

GO TO BOX R04_YVR10

ASK: IF R04_YM0103 > 200 OR R04_YM0103 = 11, 22, 33, 44, 55, 66, 77, 88, 99, 111.
DISPLAY: IF R04_YM0100 = 1, 2, DISPLAY “today”.
IF R04_YM0100 = 3, DISPLAY “yesterday”.
IF R04_YM0100 = 4, DISPLAY “the day before yesterday”.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

CIGAR
BOX ID:

R04_YGT01

The next questions are about traditional cigars, cigarillos, and filtered cigars. These products go by
lots of different names, so please use these descriptions and photos to understand what they are.
Traditional cigars contain tightly rolled tobacco that is wrapped in a tobacco leaf. Some common
brands of cigars include Macanudo, Romeo y Julieta, Arturo Fuente, and Cohiba, but there are many
others.
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
BOX ID:

R04_YGT02

Cigarillos and filtered cigars are smaller than traditional cigars. They are usually brown. Some are the
same size as cigarettes, and some come with filters or with plastic or wooden tips. Some common
brands are Black & Mild, Swisher Sweets, Dutch Masters, Phillies Blunts, Zig Zag, and Cheyenne.
[SHOW GENERIC IMAGES OF CIGARILLOS AND FILTERED CIGARS]
BOX ID:

R04_YGR03

New baseline youth respondents, go to R04_YG9101_NB.
Continuing youth respondents, go to R04_YG1002_12M.
PATH ID:

R04_YG9101_NB

Have you ever seen or heard of a traditional cigar, cigarillo, or filtered cigar before this study?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS, CIGARILLOS AND FILTERED CIGARS]
1

Yes

2

No

GO TO BOX R04_YGV04

-8

DON'T KNOW

GO TO BOX R04_YGV04

-7

REFUSED

GO TO BOX R04_YGV04

ASK: New baseline youth respondents.

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Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1002_NB

Have you ever smoked a traditional cigar, cigarillo, or filtered cigar, even one or two puffs?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS, CIGARILLOS AND FILTERED CIGARS]
1

Yes

2

No

GO TO BOX R04_YGV04

-8

DON'T KNOW

GO TO BOX R04_YGV04

-7

REFUSED

GO TO BOX R04_YGV04

ASK: New baseline youth respondents who have heard of traditional cigars, cigarillos, or filtered cigars.
BOX ID:

R04_YGD02

DISPLAY INSTRUCTIONS
For R04_YG9104_NB, display a “Yes” and “No” column with options for each response category.
PATH ID:

R04_YG9104_NB

Which type of cigar have you ever smoked?
1

Traditional cigars like Macanudo, Romeo y Julieta, Arturo Fuente, Cohiba, or others

2

Cigarillos or filtered cigars like Black & Mild, Swisher Sweets, Dutch Masters, Phillies
Blunts, Zig Zag, Cheyenne, or others

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever smoked a traditional cigar, cigarillo or filtered
cigar.
BOX ID:

R04_YGR19

New baseline youth respondents who have ever smoked a cigarillo or filtered cigar, go to
R04_YG9009_NB.
Else, go to Box R04_YGV04.

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Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9009_NB

Which of the following kinds of cigarillos or filtered cigars have you ever smoked? Choose all that apply.
The kind…
[SHOW GENERIC IMAGE OF CIGARILLOS WITH TIPS, FILTERED CIGARS, AND CIGARILLOS
WITHOUT TIPS]
1

With a plastic or wooden tip

GO TO BOX R04_YGV04

2

With a filter (like a cigarette filter)

GO TO BOX R04_YGV04

3

Without a tip or filter

GO TO BOX R04_YGV04

-8

DON'T KNOW

GO TO BOX R04_YGV04

-7

REFUSED

GO TO BOX R04_YGV04

ASK: New baseline youth respondents who have ever smoked a cigarillo or filtered cigar.
BOX ID:

R04_YGD05

DISPLAY INSTRUCTIONS
For R04_YG9104_12M, display a “Yes” and “No” column with options for each response category.
BOX ID:

R04_YGR20

Continuing youth respondents who have smoked a cigarillo or filtered cigar in the past 12 months, go to
R04_YG9009_12M.
Else, go to Box R04_YGV04.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

64

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YGV04

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_GTRAD_YOUTH = 1 (Ever user) Youth respondents who have ever smoked a
traditional cigar.
R04_EVER_NEVER_GTRAD_YOUTH = 2 (Never user) Youth respondents who have not ever smoked
a traditional cigar.
R04_INIT_GTRAD_YOUTH = 1 (Initiator) Youth respondents who initiated traditional cigar use
between Waves or new baseline youth respondents who have ever smoked a traditional cigar.
R04_EVER_NEVER_GRILLO_YOUTH = 1 (Ever user) Youth respondents who have ever smoked a
cigarillo.
R04_EVER_NEVER_GRILLO_YOUTH = 2 (Never user) Youth respondents who have not ever
smoked a cigarillo.
R04_INIT_GRILLO_YOUTH = 1 (Initiator) Youth respondents who initiated cigarillo use between
Waves or new baseline youth respondents who have ever smoked a cigarillo.
R04_EVER_NEVER_GFILTR_YOUTH = 1 (Ever user) Youth respondents who have ever smoked a
filtered cigar.
R04_EVER_NEVER_GFILTR_YOUTH = 2 (Never user) Youth respondents who have not ever smoked
a filtered cigar.
R04_INIT_GFILTR_YOUTH = 1 (Initiator) Youth respondents who initiated filtered cigar use between
Waves or new baseline youth respondents who have ever smoked a filtered cigar.
BOX ID:

R04_YGR04

Youth respondents who have never heard of traditional cigars, cigarillos, and filtered cigars, go to Box
R04_YPT01.
Else, youth respondents who have heard of cigars but never smoked a traditional cigar, go to
R04_YG9010.
Else, youth respondents who have heard of cigars but never smoked a cigarillo, go to R04_YG9011.
Else, youth respondents who have heard of cigars but never smoked a filtered cigar, go to
R04_YG9012.
Else, new baseline youth respondents who have heard of cigars, go to R04_YG9105_NB.
Else, continuing youth respondents, go to R04_YG9107.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

65

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9010

Have you ever been curious about smoking a traditional cigar?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a traditional cigar.
PATH ID:

R04_YG9020

Do you think you will smoke a traditional cigar in the next year?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a traditional cigar.
PATH ID:

R04_YG9013

Do you think that you will try a traditional cigar soon?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a traditional cigar.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9016

If one of your best friends were to offer you a traditional cigar, would you smoke it?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a traditional cigar.
BOX ID:

R04_YGR12

Youth respondents who have heard of cigars but never smoked a cigarillo, go to R04_YG9011.
Else, youth respondents who have heard of cigars but never smoked a filtered cigar, go to
R04_YG9012.
Else, new baseline youth respondents who have heard of cigars, go to R04_YG9105_NB.
Else, continuing youth respondents, go to R04_YG9107.
PATH ID:

R04_YG9011

Have you ever been curious about smoking a cigarillo?
[SHOW GENERIC IMAGE OF CIGARILLOS]
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a cigarillo.

PATH – Wave 4
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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9021

Do you think you will smoke a cigarillo in the next year?
[SHOW GENERIC IMAGE OF CIGARILLOS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a cigarillo.
PATH ID:

R04_YG9014

Do you think that you will try a cigarillo soon?
[SHOW GENERIC IMAGE OF CIGARILLOS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a cigarillo.
PATH ID:

R04_YG9017

If one of your best friends were to offer you a cigarillo, would you smoke it?
[SHOW GENERIC IMAGE OF CIGARILLOS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a cigarillo.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YGR13

Youth respondents who have heard of cigars but never smoked a filtered cigar, go to R04_YG9012.
Else, new baseline youth respondents who have heard of cigars, go to R04_YG9105_NB.
Else, continuing youth respondents, go to R04_YG9107.
PATH ID:

R04_YG9012

Have you ever been curious about smoking a filtered cigar?
[SHOW GENERIC IMAGE OF FILTERED CIGARS]
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a filtered cigar.
PATH ID:

R04_YG9022

Do you think you will smoke a filtered cigar in the next year?
[SHOW GENERIC IMAGE OF FILTERED CIGARS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a filtered cigar.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9015

Do you think that you will try a filtered cigar soon?
[SHOW GENERIC IMAGE OF FILTERED CIGARS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a filtered cigar.
PATH ID:

R04_YG9018

If one of your best friends were to offer you a filtered cigar, would you smoke it?
[SHOW GENERIC IMAGE OF FILTERED CIGARS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a filtered cigar.
BOX ID:

R04_YGR14

New baseline youth respondents who have heard of cigars, go to R04_YG9105_NB.
Else, go to R04_YG9107.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9105_NB

Sometimes people take tobacco out of a traditional cigar, cigarillo or filtered cigar and replace it with
marijuana. This is sometimes called a “blunt”.
Have you ever smoked part or all of a traditional cigar, cigarillo or filtered cigar with marijuana in it?
(Remember all information you give to the PATH Study will be kept private.)
1

Yes

2

No

GO TO BOX R04_YGV01

-8

DON'T KNOW

GO TO BOX R04_YGV01

-7

REFUSED

GO TO BOX R04_YGV01

ASK: New baseline youth respondents who have heard of cigars.
DISPLAY: UNDERLINE "ever".
PATH ID:

R04_YG9107

[Sometimes people take tobacco out of a traditional cigar, cigarillo or filtered cigar and replace it with
marijuana. This is sometimes called a “blunt”.
]In the past 12 months, have you smoked part or all of a traditional cigar, cigarillo or filtered cigar with
marijuana in it? [(Remember all information you give to the PATH Study will be kept private.)]
1

Yes

2

No

GO TO BOX R04_YGV01

-8

DON'T KNOW

GO TO BOX R04_YGV01

-7

REFUSED

GO TO BOX R04_YGV01

ASK: New baseline youth respondents who have ever smoked a blunt and all continuing youth
respondents.
DISPLAY: UNDERLINE "past 12 months".
IF R04_YOUTHTYPE = 1, DISPLAY "Sometimes people take tobacco out of a cigar, cigarillo or filtered
cigar and replace it with marijuana. This is sometimes called a “blunt”." AND "(Remember all the
information you give to the PATH Study will be kept private.)".
ELSE, DO NOT DISPLAY THIS TRANSITION TEXT.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1095

Which of the following looks like the type of cigar you usually smoke as a blunt? Choose all that apply.
[SHOW GENERIC IMAGE OF 3 CIGAR GROUPS]
1

Group 1

2

Group 2

3

Group 3

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked blunts in the past 12 months.
PATH ID:

R04_YG9106

Now think about the past 12 months when you smoked the type of cigar shown below.
In the past 12 months, how often was any of the tobacco replaced with marijuana?
[SHOW GENERIC IMAGE OF [YG1095CIGARTYPE]]
1

Every time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked blunts in the past 12 months. (This question is repeated for
every cigar type identified in R04_YG1095[_01/_02/_03].)

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YGV01

DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
BLUNT-ONLY USER GROUPS:
R04_12MBLUNT_ONLY_BTRAD = Youth respondents who smoke traditional cigars as blunts every
time when smoked in the past 12 months.
R04_12MBLUNT_ONLY_BRILLO = Youth respondents who smoke cigarillos as blunts every time
when smoked in the past 12 months.
R04_12MBLUNT_ONLY_BFILTR = Youth respondents who smoke filtered cigars as blunts every time
when smoked in the past 12 months.
R04_INIT_BLUNT_BTRAD_YOUTH = Youth respondents who initiated smoking traditional cigars as
blunts between Waves or new baseline youth respondents who have ever used traditional cigars as
blunts every time in the past 12 months.
R04_INIT_BLUNT_BRILLO_YOUTH = Youth respondents who initiated smoking cigarillos as blunts
between Waves or new baseline youth respondents who have ever used cigarillos as blunts every time
in the past 12 months.
R04_INIT_BLUNT_BFILTR_YOUTH = Youth respondents who initiated smoking filtered cigars as
blunts between Waves or new baseline youth respondents who have ever used filtered cigars as blunts
every time in the past 12 months.
DEFINE THE FOLLOWING DERIVED VARIABLES (SEE APPENDIX):
CIGAR LOOPS
Cigars as Non-Blunts:
GTRAD = Youth respondents who have ever smoked traditional cigars and have not smoked traditional
cigars as blunts every time when smoked in the past 12 months.
GRILLO = Youth respondents who have ever smoked cigarillos and have not smoked cigarillos as
blunts every time when smoked in the past 12 months.
GFILTR = Youth respondents who have ever smoked filtered cigars and have not smoked filtered cigars
as blunts every time when smoked in the past 12 months.
Cigars as Blunts-Only:
BTRAD = Youth respondents who smoke traditional cigars as blunts every time when smoked in the
past 12 months.
BRILLO = Youth respondents who smoke cigarillos as blunts every time when smoked in the past 12
months.
BFILTR = Youth respondents who smoke filtered cigars as blunts every time when smoked in the past
12 months.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YGR02

PROGRAM: CREATE LOOPS FOLLOWING ROUTING INSTRUCTIONS FOR VARIOUS CIGAR
TYPES:
Blunt/Cigar Loops
If the respondent has smoked cigars as blunts-only, R04_YJ1108[TC/CL/FC] through
R04_YJ1071[TC/CL/FC] are repeated in a loop for each cigar type as blunts. See Box R04_YJT04 for
transition text shown at the start of each loop.
After all blunt loops are complete, items from R04_YG1006_NB[TC/CL/FC] through
R04_YG1141[TC/CL/FC] are repeated once for each type of cigar the respondent has smoked,
following skips appropriately. See Box R04_YGT04 for transition text shown at the start of each loop.
If the respondent only smoked traditional cigars, cigarillos, or filtered cigars as blunts, go to Box
R04_YJT04.
Else, if the respondent has ever smoked traditional cigars, cigarillos, or filtered cigars, go to Box
R04_YGT04.
Else, if the respondent has not smoked traditional cigars, cigarillos, or filtered cigars as blunts, and has
never smoked traditional cigars, cigarillos, or filtered cigars, go to Box R04_YPT01.
[CIGARFILL]
If traditional cigar/blunt smoker, [CIGARFILL] = "traditional cigar".
If cigarillo/blunt smoker, [CIGARFILL] = "cigarillo".
If filtered cigar/blunt smoker, [CIGARFILL] = "filtered cigar".

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YJT04

PROGRAM - DISPLAY THE FOLLOWING TRANSITION TEXT AT THE START OF LOOPS:
IF LOOP=BTRAD Traditional Cigars (as blunts-only):
The next questions are about traditional cigars when smoked as blunts.
Traditional cigars contain tightly rolled tobacco that is wrapped in a tobacco leaf. Sometimes people
take tobacco out of a traditional cigar and replace it with marijuana. This is sometimes called a blunt. As
you answer these questions, please think only about your use of traditional cigars when smoked as
blunts like those shown below. [ONLY IF THIS IS NOT THE LAST TIME THROUGH THE SECTION:]
There will be a separate section later about other kinds of blunts.
[SHOW GENERIC IMAGE FOR TRADITIONAL CIGAR]
IF LOOP=BRILLO Cigarillos (as blunts-only):
The next questions are about cigarillos when smoked as blunts.
Cigarillos are medium-sized cigars and sometimes come with plastic or wood tips. [Sometimes people
take tobacco out of a cigarillo and replace it with marijuana. This is sometimes called a blunt.] As you
answer these questions, please think only about your use of cigarillos when smoked as blunts like those
shown below. [ONLY IF THIS IS NOT THE LAST TIME THROUGH THE SECTION:] There will be a
separate section later about other kinds of blunts.
[SHOW GENERIC IMAGE FOR CIGARILLO]
IF LOOP=BFILTR Filtered Cigars (as blunts-only):
The next questions are about filtered cigars when smoked as blunts.
Filtered cigars are usually brown and have a filter like a cigarette. [Sometimes people take tobacco out
of a filtered cigar and replace it with marijuana. This is sometimes called a blunt.] As you answer these
questions, please think only about your use of filtered cigars when smoked as blunts like those shown
below. [ONLY IF THIS IS NOT THE LAST TIME THROUGH THE SECTION:] There will be a separate
section later about other kinds of blunts.
[SHOW GENERIC IMAGE FOR FILTERED CIGAR]
BOX ID:

R04_YJR09

Continuing youth respondents who have initiated blunt use since the previous wave, and new baseline
youth respondents who have ever smoked a blunt, go to R04_YJ1108[TC/CL/FC].
Else, youth respondents who have smoked blunts in the past 12 months, go to R04_YJ1112[TC/CL/FC].

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ1108

Was the first [CIGARFILL] you smoked as a blunt flavored to taste like menthol, mint, clove, spice, fruit,
chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YJ1112[TC/CL/FC]

3

I don't know

GO TO R04_YJ1112[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YJ1112[TC/CL/FC]

-7

REFUSED

GO TO R04_YJ1112[TC/CL/FC]

ASK: Continuing youth respondents who have initiated blunt use since previous wave, and new baseline
youth respondents who have ever smoked blunts.
PATH ID:

R04_YJ1011

What flavor was that first [CIGARFILL] you smoked as a blunt? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents whose first blunt was flavored.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YJ1112

When was the last time you smoked a [CIGARFILL] as a blunt, even one or two puffs?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YJV02

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YJV02

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YJV02

-8

DON'T KNOW

GO TO BOX R04_YJV02

-7

REFUSED

GO TO BOX R04_YJV02

ASK: Youth respondents who have smoked blunts in the past 12 months.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ0100

When did you last smoke a [CIGARFILL] as a blunt?
1

In the past hour

2

Sometime today

GO TO R04_YJ0103[TC/CL/FC]

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YJV02

-8

DON'T KNOW

GO TO BOX R04_YJV02

-7

REFUSED

GO TO BOX R04_YJV02

ASK: Youth respondents who have smoked blunts in the past 7 days.
PATH ID:

R04_YJ0102

When you last smoked a [CIGARFILL] as a blunt [FILL BASED ON R04_YJ0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked a blunt today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YJ0100[TC/CL/FC]]: IF R04_YJ0100[TC/CL/FC] = 2, DISPLAY
“today”.
ELSE, IF R04_YJ0100[TC/CL/FC] = 3, DISPLAY “yesterday”.
ELSE, IF R04_YJ0100[TC/CL/FC] = 4, DISPLAY “the day before yesterday”.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ0103

How many [CIGARFILL]s [have/did] you [smoked/smoke] as a blunt [FILL BASED ON
R04_YJ0100[TC/CL/FC]]? (If less than 1, enter 1.)
1

I__I__I

-8

DON'T KNOW

GO TO BOX R04_YJV02[TC/CL/FC]

-7

REFUSED

GO TO BOX R04_YJV02[TC/CL/FC]

ASK: Youth respondents who have smoked a blunt in the past hour, today, yesterday or the day before
yesterday.
DISPLAY: IF R04_YJ0100[TC/CL/FC] = 1, 2, DISPLAY “have” AND “smoked”.
ELSE, IF R04_YJ0100[TC/CL/FC] = 3, 4, DISPLAY “did” AND “smoke”.
FOR [FILL BASED ON R04_YJ0100[TC/CL/FC]]:
IF R04_YJ0100[TC/CL/FC] = 1, 2, DISPLAY “today”.
ELSE, IF R04_YJ0100[TC/CL/FC] = 3, DISPLAY “yesterday”.
ELSE, IF R04_YJ0100[TC/CL/FC] = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YJ0103TC_LC1

The computer recorded that you smoked [R04_YJ0103TC] traditional cigars as blunts
[today/yesterday/the day before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ0103TC

2

NEXT

GO TO BOX R04_YJV02

ASK: IF R04_YJ0103TC > 15 OR R04_YJ0103TC = 11.
DISPLAY: IF R04_YJ0100TC = 1, 2, DISPLAY “today”.
ELSE, IF R04_YJ0100TC = 3, DISPLAY “yesterday”.
ELSE, IF R04_YJ0100TC = 4, DISPLAY “the day before yesterday”.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ0103CL_LC1

The computer recorded that you smoked [R04_YJ0103CL] cigarillos as blunts [today/yesterday/the day
before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ0103CL

2

NEXT

GO TO BOX R04_YJV02

ASK: IF R04_YJ0103CL > 15 OR R04_YJ0103CL = 11.
DISPLAY: IF R04_YJ0100CL = 1, 2, DISPLAY “today”.
ELSE, IF R04_YJ0100CL = 3, DISPLAY “yesterday”.
ELSE, IF R04_YJ0100CL = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YJ0103FC_LC1

The computer recorded that you smoked [R04_YJ0103FC] filtered cigars as blunts [today/yesterday/the
day before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ0103FC

2

NEXT

GO TO BOX R04_YJV02

ASK: IF R04_YJ0103FC > 15 OR R04_YJ0103FC = 11.
DISPLAY: IF R04_YJ0100FC = 1, 2, DISPLAY “today”.
ELSE, IF R04_YJ0100FC = 3, DISPLAY “yesterday”.
ELSE, IF R04_YJ0100FC = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YJV02

PROGRAM - CREATE THE FOLLOWING VARIABLES FOR EACH CIGAR TYPE (SEE APPENDIX):
R04_30DBLUNT_ONLY_BTRAD = Youth respondents who have smoked a traditional cigar as a blunt
in the past 30 days.
R04_30DBLUNT_ONLY_BRILLO = Youth respondents who have smoked a cigarillo as a blunt in the
past 30 days.
R04_30DBLUNT_ONLY_BFILTR = Youth respondents who have smoked a filtered cigar as a blunt in
the past 30 days.
BOX ID:

R04_YJR06

Past 30 day blunt-only smokers, go to R04_YJ1022[TC/CL/FC].
Else, go to R04_YJ1047[TC/CL/FC].

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ1022

In the past 30 days, on how many days did you smoke a [CIGARFILL] as a blunt?
1

|___|___| DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day blunt-only smokers.
DISPLAY: DISPLAY 'DAYS' AS TITLE.
PATH ID:

R04_YJ1023

In the past 30 days, on the days you smoked [CIGARFILL]s as blunts, how many [CIGARFILL]s did you
smoke as a blunt per day?
1

Less than 1 [CIGARFILL] per day

2

1 [CIGARFILL] per day

3

2 to 5 [CIGARFILL]s per day

4

6 to 10 [CIGARFILL]s per day

5

11 to 20 [CIGARFILL]s per day

6

More than 20 [CIGARFILL]s per day

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day blunt-only smokers.
PATH ID:

R04_YJ1130

In the past 30 days, were any of the [CIGARFILL]s that you smoked as a blunt flavored to taste like
menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YJ1142[TC/CL/FC]

3

I don't know

GO TO R04_YJ1142[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YJ1142[TC/CL/FC]

-7

REFUSED

GO TO R04_YJ1142[TC/CL/FC]

ASK: Past 30 day blunt-only smokers.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ1131

Which flavors have you smoked in the past 30 days? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored blunt-only smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YJ1147

On the days you smoked [CIGARFILL]s as blunts in the past 30 days, how often did you smoke flavored
[CIGARFILL]s?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored blunt-only smokers.
DISPLAY: Underline "flavored".
PATH ID:

R04_YJ1142

In the past 30 days, did anyone sell you [CIGARFILL]s?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day blunt-only smokers.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ1123

In the past 30 days, did anyone refuse to sell you [CIGARFILL]s because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day blunt-only smokers.
PATH ID:

R04_YJ1118

In the past 30 days, how did you usually get your own [CIGARFILL]s for when you smoke blunts?
1

I gave someone else money to buy them for me

2

I bought them myself from a store (including a cigar bar)

3

I asked someone to give me one

GO TO R04_YJ1047[TC/CL/FC]

4

Someone offered it to me

GO TO R04_YJ1047[TC/CL/FC]

5

I bought them from another person

GO TO R04_YJ1047[TC/CL/FC]

6

I took them from a store or another person

GO TO R04_YJ1047[TC/CL/FC]

7

I got them some other way (SPECIFY)

GO TO R04_YJ1047[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YJ1047[TC/CL/FC]

-7

REFUSED

GO TO R04_YJ1047[TC/CL/FC]

ASK: Past 30 day blunt-only smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YJ1030

How do [you/they] usually buy your [CIGARFILL]s for when you smoke blunts?
1

In person (such as at a store or cigar bar)

2

From the internet

GO TO R04_YJ1039[TC/CL/FC]

3

By telephone

GO TO R04_YJ1039[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YJ1039[TC/CL/FC]

-7

REFUSED

GO TO R04_YJ1039[TC/CL/FC]

ASK: Past 30 day traditional cigar/cigarillo/filtered cigar as a blunt-only smokers who buy traditional
cigars/cigarillos/filtered cigars for blunts for themselves or someone else buys for them.
DISPLAY: IF R04_YJ1118[TC/CL/FC] =1, DISPLAY “they”;
ELSE, IF R04_YJ1118[TC/CL/FC] =2, DISPLAY “you”.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ1033

Where do [you/they] buy your [CIGARFILL]s for blunts most of the time?
1

A cigar bar

2

A convenience store or gas station

3

A supermarket, grocery store, or drug store

4

A warehouse club, such as Sam’s or Costco

5

A smoke shop, tobacco specialty store or tobacco outlet store

6

A duty free shop or military commissary

7

A bar, pub, restaurant or casino

8

A friend or relative

9

A swap meet or flea market

10

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day blunt-only traditional cigar/cigarillo/filtered cigar smokers who buy traditional
cigars/cigarillos/filtered cigars for blunts for themselves or someone else buys for them in person.
DISPLAY: IF R04_YJ1118[TC/CL/FC] =1, DISPLAY “they”;
ELSE, IF R04_YJ1118[TC/CL/FC] =2, DISPLAY “you”.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
PATH ID:

R04_YJ1039

Think about the last time you [bought/gave money to someone else to buy you] [CIGARFILL]s for blunts.
Did you buy them by the [carton, ]box or pack, or as single [CIGARFILL]s?
3

Carton

(DISPLAY ONLY IF LOOP = BFILTR)

1

Box or pack

GO TO R04_YJ1040[TC/CL/FC]

2

Single [CIGARFILL]s

GO TO R04_YJ1034[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YJ1047[TC/CL/FC]

-7

REFUSED

GO TO R04_YJ1047[TC/CL/FC]

ASK: Past 30 day blunt-only smokers who buy blunts for themselves or someone else buys for them.
DISPLAY: IF R04_YJ1118[TC/CL/FC] =2, DISPLAY "bought".
ELSE, IF R04_YJ1118[TC/CL/FC] =1, DISPLAY "gave money to someone else to buy you".
IF LOOP = BFILTR, DISPLAY "carton, " AND RESPONSE OPTION 3.
ELSE, DO NOT DISPLAY THIS TEXT OR OPTION.

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Wave 4 (version 3.0)
PATH ID:

R04_YJ9056

How many boxes or packs of filtered cigars came in the carton you last bought for blunts?
1

I___I___I

-8

DON'T KNOW

GO TO R04_YJ9057

-7

REFUSED

GO TO R04_YJ9057

ASK: Past 30 day blunt-only filtered cigar smokers who last bought filtered cigars by the carton.
PATH ID:

R04_YJ9056_LC1

A carton of filtered cigars usually has 10 packs in it, but not always. The computer recorded that there
[is R04_YJ9056pack/are R04_YJ9056 packs] of filtered cigars in the carton you usually buy.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ9056

2

NEXT

GO TO R04_YJ9057

ASK: IF R04_YJ9056 != 10.
DISPLAY: IF R04_YJ9056FC = 1, DISPLAY "is [R04_YJ9056] pack".
ELSE, DISPLAY "are [R04_YJ9056] packs".
PATH ID:

R04_YJ9057

How much did you pay for a carton of filtered cigars for blunts?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO R04_YJ1047FC

-7

REFUSED

GO TO R04_YJ1047FC

ASK: Past 30 day blunt-only filtered cigar smokers who last bought filtered cigars by the carton
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
PATH ID:

R04_YJ9057_LC1

The computer recorded that you paid $[R04_YJ9057_D] for a carton of filtered cigars for blunts. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ9057

2

NEXT

GO TO R04_YJ1047FC

ASK: IF R04_YJ9057_D > 125 OR R04_YJ9057_D < 25 OR (R04_YJ9057_D = 125 AND
R04_YJ9057_C > 00).

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Wave 4 (version 3.0)
PATH ID:

R04_YJ1040

How many [CIGARFILL]s came in the box or pack that you last bought for blunts?
1

I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day blunt-only smokers who last bought cigars by the box or pack.
PATH ID:

R04_YJ1034

How much did you pay for a [[box or pack of [CIGARFILL]s/single [CIGARFILL]]?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO R04_YJ1047[TC/CL/FC]

-7

REFUSED

GO TO R04_YJ1047[TC/CL/FC]

ASK: Past 30 day traditional cigar/cigarillo/filtered cigar as blunts-only smokers who buy traditional
cigar/cigarillo/filtered cigar as blunts for themselves or someone else buys for them who last bought by
box or pack or as single traditional cigars/cigarillos/filtered cigars.
DISPLAY: DISPLAY AS QUANTITY/QUANTITY. DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents”
AS TITLES.
IF R04_YJ1039[TC/CL/FC] =1, DISPLAY "box or pack of [CIGARFILL]s";
ELSE, IF R04_YJ1039[TC/CL/FC] =2, DISPLAY "single [CIGARFILL]".
PATH ID:

R04_YJ1034TC_LC1

The computer recorded that you paid $[R04_YJ1034TC] for a [box or pack of traditional cigars for
blunts/single traditional cigar for blunts]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ1034TC

2

NEXT

GO TO R04_YJ1047TC

ASK: IF ((R04_YJ1034TC_D > 300 OR R04_YJ1034TC_D < 10) AND R04_YJ1039TC = 1 ), OR
((R04_YJ1034TC_D > 15 OR R04_YJ1034TC_D < 1) AND R04_YJ1039TC = 2).
DISPLAY: IF R04_YJ1039TC = 1, DISPLAY "box or pack of traditional cigars for blunts";
ELSE, IF R04_YJ1039TC = 2, DISPLAY "single traditional cigar for blunts".

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Wave 4 (version 3.0)
PATH ID:

R04_YJ1034CL_LC1

The computer recorded that you paid $[R04_YJ1034CL] for a [box or pack of cigarillos for blunts/single
cigarillo for blunts]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ1034CL

2

NEXT

GO TO R04_YJ1047CL

ASK: IF ((R04_YJ1034CL_D > 11 OR R04_YJ1034CL_D < 1) AND R04_YJ1039CL = 1), OR
((R04_YJ1034CL_D > 3 OR (R04_YG1034CL_D = 0 AND R04_YJ1034CL_C < 50)) AND
R04_YJ1039CL = 2).
DISPLAY: IF R04_YJ1039CL = 1, DISPLAY "box or pack of cigarillos for blunts";
ELSE, IF R04_YJ1039CL = 2, DISPLAY "single cigarillo for blunts".
PATH ID:

R04_YJ1034FC_LC1

The computer recorded that you paid $[R04_YJ1034FC] for a [box or pack of filtered cigars for
blunts/single filtered cigar for blunts]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ1034FC

2

NEXT

GO TO R04_YJ1047FC

ASK: IF ((R04_YJ1034FC_D > 100 OR R04_YJ1034FC_D < 1) AND R04_YJ1039FC = 1) OR
((R04_YJ1034FC_D > 3 OR (R04_YJ1034FC_D = 0 AND R04_YJ1034FC_C < 50)) AND
R04_YJ1039FC = 2).
DISPLAY: IF R04_YJ1039FC = 1, DISPLAY "box or pack of filtered cigars for blunts";
ELSE, IF R04_YJ1039FC = 2, DISPLAY "single filtered cigar for blunts".
PATH ID:

R04_YJ1047

Do you have a regular brand of [CIGARFILL]s that you usually smoke as blunts?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 12 month blunt-only smokers.

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Wave 4 (version 3.0)
PATH ID:

R04_YJ1945

Do you know the name of the brand of [CIGARFILL]s you [usually smoke/last smoked] as blunts?
1

Yes

2

No

GO TO BOX R04_YJR08

-8

DON'T KNOW

GO TO BOX R04_YJR08

-7

REFUSED

GO TO BOX R04_YJR08

ASK: Past 12 month blunt-only smokers.
DISPLAY: IF R04_YJ1047[TC/CL/FC] = 1, DISPLAY “usually smoke”.
ELSE, IF R04_YJ1047[TC/CL/FC] = 2, 3, -8, -7, DISPLAY “last smoked”.
UNDERLINE "name of the brand".
PATH ID:

R04_YJ1048

What brand of [CIGARFILL] [do/did] you [usually/last] smoke as a blunt?
Please select it from the choices below by touching the screen. If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”. ]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 12 month blunt-only smokers who know the brand name.
DISPLAY: IF R04_YJ1047[TC/CL/FC] =1, DISPLAY “do” AND “usually”.
ELSE, IF R04_YJ1047[TC/CL/FC] = 2, -8, -7, DISPLAY “did” AND “last”.
[IF MULTIPLE SCREENS] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS] DISPLAY: If you do not see it
below, touch the box marked “Something else”.
[SHOW PICTURES OF THE MAJOR BRANDS ON THE TOUCHSCREEN.]
BOX ID:

R04_YJR01

If youth respondent selects "Something else" in R04_YJ1048[TC/CL/FC]_BRAND, go to
R04_YJ1049[TC/CL/FC].
Else, if youth respondent selects brand in R04_YJ1048[TC/CL/FC]_BRAND, go to
R04_YJ1070[TC/CL/FC]_PRODUCT.
Else, go to Box R04_YJR08.

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Wave 4 (version 3.0)
PATH ID:

R04_YJ1049

You said that your brand was not listed. What is it?
__________________________

GO TO BOX R04_YJR08

-8

1

DON'T KNOW

GO TO BOX R04_YJR08

-7

REFUSED

GO TO BOX R04_YJR08

ASK: Past 12 month blunt-only smokers that know the name of the brand they smoke who selected
"Something else" for their brand.
PATH ID:

R04_YJ1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] [do/did] you [usually/last] smoke
as a blunt?
Please select it from the choices below by touching the screen. [ If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”. ]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 12 month blunt-only smokers that know the name of the brand they smoke who selected a
brand image.
DISPLAY: IF R04_YJ1047[TC/CL/FC] =1, DISPLAY “do” AND “usually”.
ELSE, IF R04_YJ1047[TC/CL/FC] =2, -8, -7, DISPLAY “did” AND “last”.
[IF MULTIPLE SCREENS] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS] DISPLAY: If you do not see it
below, touch the box marked “Something else”.
[SHOW PICTURES OR TEXT ON THE TOUCHSCREEN OF THE MAJOR PRODUCTS ASSOCIATED
WITH BRAND SELECTED IN R04_YJ1048[TC/CL/FC]]
BOX ID:

R04_YJR02

If youth respondent selects "Something else" in R04_YJ1070[TC/CL/FC]_PRODUCT, go to
R04_YJ1071[TC/CL/FC].
Else, go to Box R04_YJR08.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ1071

You said that the type of [BRANDFILL]s that you smoke as blunts was not listed. What type is it?
1

__________________________

-8

DON'T KNOW

-7

REFUSED

ASK: Past 12 month blunt-only smokers that know the name of the brand they smoke who selected a
brand image, but selected "Something else" for their subbrand image.
BOX ID:

R04_YJR08

END BLUNT LOOP:
If respondent has loops to complete for other blunt types, return to Box R04_YJT04 and loop through
subsection for any other blunt types.
Else, if respondent has loops to complete for non-blunt cigar types, go to Box R04_YGT04.
Else, if respondent has no more remaining loops to complete, go to Box R04_YPT01.

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Wave 4 (version 3.0)
BOX ID:

R04_YGT04

PROGRAM - DISPLAY THE FOLLOWING TRANSITION TEXT AT THE START OF LOOPS:
IF LOOP=GTRAD Traditional Cigars (non-blunts)
The next questions are about traditional cigars.
Traditional cigars contain tightly rolled tobacco that is wrapped in a tobacco leaf.
As you answer these questions, please think only about your use of traditional cigars like those shown
below. [ONLY IF THIS IS NOT THE LAST TIME THROUGH THE SECTION:] There will be a separate
section later about other kinds of cigars.
[SHOW GENERIC IMAGE FOR TRADITIONAL CIGAR]
IF LOOP=GRILLO Cigarillos (non-blunts)
The next questions are about cigarillos.
Cigarillos are medium-sized cigars and sometimes come with plastic or wood tips.
As you answer these questions, please think only about your use of cigarillos like those shown below.
[ONLY IF THIS IS NOT THE LAST TIME THROUGH THE SECTION:] There will be a separate section
later about other kinds of cigars.
[SHOW GENERIC IMAGE FOR CIGARILLO].
IF LOOP=GFILTR Filtered Cigars (non-blunts)
The next questions are about filtered cigars.
Filtered cigars are usually brown and have a filter like a cigarette. As you answer these questions,
please think only about your use of filtered cigars like those shown below. [ONLY IF THIS IS NOT THE
LAST TIME THROUGH THE SECTION:] There will be a separate section later about other kinds of
cigars.
[SHOW GENERIC IMAGE FOR FILTERED CIGAR].
BOX ID:

R04_YGR05

New baseline youth respondents who have ever smoked cigars, go to R04_YG1006[TC/CL/FC]_NB.
Else, continuing youth respondents who initiated cigar smoking since the previous wave, go to
R04_YG1108[TC/CL/FC].
Else, continuing youth respondents who had smoked 100 or more cigars in the previous wave, go to
R04_YG9040[TC/CL/FC].
Else, go to R04_YG1005[TC/CL/FC].

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1006_NB

How old were you when you first tried a [CIGARFILL], even one or two puffs?
1

|___|___| Years old

-8

DON'T KNOW

GO TO R04_YG1120[TC/CL/FC]_NB

-7

REFUSED

GO TO R04_YG1120[TC/CL/FC]_NB

ASK: New baseline youth respondents who have ever smoked cigars.
DISPLAY: DISPLAY “Years old” AS A TITLE.
PATH ID:

R04_YG1006TC_NB_LC1

The computer recorded that you first smoked a cigar at age [R04_YG1006TC_NB]. That is older than
you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1006TC_NB

2

NEXT

GO TO R04_YG1108TC

ASK: IF R04_YG1006TC_NB > R04_YOUTHAGE.
PATH ID:

R04_YG1006TC_NB_LC2

The computer recorded that you started smoking traditional cigars at age [R04_YG1006TC_NB]. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1006TC_NB

2

NEXT

GO TO R04_YG1108

ASK: IF R04_YG1006TC < 5.
PATH ID:

R04_YG1006CL_NB_LC1

The computer recorded that you first smoked a cigarillo at age [R04_YG1006CL_NB]. That is older than
you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1006CL_NB

2

NEXT

GO TO R04_YG1108CL

ASK: IF R04_YG1006CL_NB > R04_YOUTHAGE.

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Wave 4 (version 3.0)
PATH ID:

R04_YG1006CL_NB_LC2

The computer recorded that you started smoking cigarillos at age [R04_YG1006CL_NB]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1006CL_NB

2

NEXT

GO TO R04_YG1108CL

ASK: IF R04_YG1006CL < 5.
PATH ID:

R04_YG1006FC_NB_LC1

The computer recorded that you first smoked a filtered cigar at age [R04_YG1006FC_NB]. That is older
than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1006FC_NB

2

NEXT

GO TO R04_YG1108FC

ASK: IF R04_YG1006FC_NB > R04_YOUTHAGE.
PATH ID:

R04_YG1006FC_NB_LC2

The computer recorded that you started smoking filtered cigars at age [R04_YG1006FC_NB]. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1006FC_NB

2

NEXT

GO TO R04_YG1108FC

ASK: IF R04_YG1006FC < 5.
PATH ID:

R04_YG1120_NB

When you first tried a [CIGARFILL], even one or two puffs, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON’T KNOW

-7

REFUSED

ASK: New baseline youth respondents who did not know or refused to report the age when they first
smoked cigars.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1108

Was the first [CIGARFILL] you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate,
alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO BOX R04_YGR09

3

I don't know

GO TO BOX R04_YGR09

-8

DON'T KNOW

GO TO BOX R04_YGR09

-7

REFUSED

GO TO BOX R04_YGR09

ASK: Continuing youth respondents who have initiated cigar smoking since the previous wave, and new
baseline youth respondents who have ever smoked cigars.
PATH ID:

R04_YG1011

What flavor was that first [CIGARFILL] you smoked? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents whose first cigar was flavored.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YGR09

Continuing youth respondents who had smoked 100 or more cigars in the previous wave, go to
R04_YG9040[TC/CL/FC].
Else, go to R04_YG1005[TC/CL/FC].

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Wave 4 (version 3.0)
PATH ID:

R04_YG1005

How many [CIGARFILL]s have you smoked in your entire life?
1

1 or more puffs but never a whole one

2

1

3

2 to 10

4

11 to 20

5

21 to 50

6

51 to 99

7

100 or more

-8

DON'T KNOW

-7

REFUSED

ASK: Aged-up and continuing youth respondents who have ever smoked cigars and had not smoked
100 or more cigars in the previous wave, and new cohort youth respondents who have ever smoked
cigars.
PATH ID:

R04_YG9040

Please look at this picture. Which group is most like the [CIGARFILL] you usually smoke?
[SHOW GENERIC IMAGE OF 4 CIGAR GROUPS]
1

Group 1

2

Group 2

3

Group 3

4

Group 4

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a traditional cigar/cigarillo/filtered cigar.
BOX ID:

R04_YGR18

Continuing youth respondents who have ever smoked cigars and had never smoked fairly regularly in
the previous wave, and new baseline youth respondents who have ever smoked cigars, go to
R04_YG1100[TC/CL/FC].
Else, go to R04_YG1112[TC/CL/FC].

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1100

Have you ever smoked [CIGARFILL]s fairly regularly?
1

Yes

2

No

GO TO R04_YG1112[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YG1112[TC/CL/FC]

-7

REFUSED

GO TO R04_YG1112[TC/CL/FC]

ASK: Aged-up and continuing youth respondents who have ever smoked a cigar (and had never
smoked fairly regularly in the previous wave), and new cohort youth respondents who have ever
smoked cigars.
PATH ID:

R04_YG1007

How old were you when you first started smoking [CIGARFILL]s fairly regularly?
1

|__|__| Years old

-8

DON'T KNOW

GO TO R04_YG1121[TC/CL/FC]

-7

REFUSED

GO TO R04_YG1121[TC/CL/FC]

ASK: Youth respondents who have ever smoked cigars fairly regularly and did not smoke fairly regularly
in the previous wave.
DISPLAY: DISPLAY "Years old" AS A TITLE.
PATH ID:

R04_YG1007TC_LC1

The computer recorded that you started smoking cigars fairly regularly at age [R04_YG1007TC]. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1007TC

2

NEXT

GO TO R04_YG1112TC

ASK: IF R04_AG1007TC <= 12 OR R04_YG1007TC < R04_YG1006TC_NB.
PATH ID:

R04_YG1007TC_LC2

The computer recorded that you started smoking cigars fairly regularly at age [R04_YG1007TC]. That is
older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1007TC

2

NEXT

GO TO R04_YG1112TC

ASK: IF R04_YG1007TC > R04_YOUTHAGE.

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Wave 4 (version 3.0)
PATH ID:

R04_YG1007CL_LC1

The computer recorded that you started smoking cigarillos fairly regularly at age [R04_YG1007CL]. Is
that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1007CL

2

NEXT

GO TO R04_YG1112CL

ASK: IF R04_AG1007CL <= 5 OR R04_YG1007CL < R04_YG1006CL_NB.
PATH ID:

R04_YG1007CL_LC2

The computer recorded that you started smoking cigarillos fairly regularly at age [R04_YG1007CL]. That
is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1007CL

2

NEXT

GO TO R04_YG1112CL

ASK: IF R04_YG1007CL > R04_YOUTHAGE.
PATH ID:

R04_YG1007FC_LC1

The computer recorded that you started smoking filtered cigars fairly regularly at age [R04_YG1007FC].
Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1007FC

2

NEXT

GO TO R04_YG1112FC

ASK: IF R04_AG1007FC <= 10 OR R04_YG1007FC < R04_YG1006FC_NB.
PATH ID:

R04_YG1007FC_LC2

The computer recorded that you started smoking filtered cigars fairly regularly at age [R04_YG1007FC].
That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1007FC

2

NEXT

GO TO R04_YG1112FC

ASK: IF R04_YG1007FC > R04_YOUTHAGE.

PATH – Wave 4
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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1121

When you first started smoking [CIGARFILL]s fairly regularly, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who did not know or refused to report the age when they started smoking
cigars fairly regularly.
PATH ID:

R04_YG1112

When was the last time you smoked a [CIGARFILL], even one or two puffs?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YGV02

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YGV02

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YGV02

6

1 to 4 years ago

GO TO BOX R04_YGV02

7

5 or more years ago

GO TO BOX R04_YGV02

-8

DON'T KNOW

GO TO BOX R04_YGV02

-7

REFUSED

GO TO BOX R04_YGV02

ASK: Youth respondents who have ever smoked cigars.
PATH ID:

R04_YG0100

When did you last smoke a [CIGARFILL]?
1

In the past hour

GO TO R04_YG0103[TC/CL/FC]

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YGV02

-8

DON'T KNOW

GO TO BOX R04_YGV02

-7

REFUSED

GO TO BOX R04_YGV02

ASK: Youth respondents who have smoked cigars in the past 7 days.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG0102

When you last smoked a [CIGARFILL] [FILL BASED ON R04_YG0100[TC/CL/FC]], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked a cigar today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YG0100[TC/CL/FC]]:
IF R04_YG0100[TC/CL/FC] = 2, DISPLAY “today”.
ELSE, IF R04_YG0100[TC/CL/FC] = 3, DISPLAY "yesterday".
ELSE, IF R04_YG0100[TC/CL/FC] = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YG0103

How many [CIGARFILL]s [have/did] you [smoked/smoke] [FILL BASED ON R04_YG0100[TC/CL/FC]]?
(If less than 1, enter 1.)
1

I__I__I

-8

DON'T KNOW

GO TO BOX R04_YGV02

-7

REFUSED

GO TO BOX R04_YGV02

ASK: Youth respondents who have smoked a cigar in the past hour, sometime today, yesterday or the
day before yesterday.
DISPLAY: IF R04_YG0100[TC/CL/FC] = 1, 2, DISPLAY “have” AND “smoked”.
ELSE, IF R04_YG0100[TC/CL/FC] = 3, 4, DISPLAY “did” AND “smoke”.
FOR [FILL BASED ON R04_YG0100[TC/CL/FC]],
IF R04_YG0100[TC/CL/FC] = 1, 2, DISPLAY “today”.
ELSE, IF R04_YG0100[TC/CL/FC] = 3, DISPLAY "yesterday".
ELSE, IF R04_YG0100[TC/CL/FC] = 4, DISPLAY “the day before yesterday”.

PATH – Wave 4
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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG0103TC_LC1

The computer recorded that you smoked [R04_YG0103TC] traditional cigars [today/yesterday/the day
before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG0103TC

2

NEXT

GO TO BOX R04_YGV02

ASK: IF R04_YG0103TC > 15 OR R04_YG0103TC = 11.
DISPLAY: IF R04_YG0100TC = 1, 2, DISPLAY “today”.
ELSE, IF R04_YG0100TC = 3, DISPLAY “yesterday”.
ELSE, IF R04_YG0100TC = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YG0103CL_LC1

The computer recorded that you smoked [R04_YG0103CL] cigarillos [today/yesterday/the day before
yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG0103CL

2

NEXT

GO TO BOX R04_YGV02

ASK: IF R04_YG0103CL > 15 OR R04_YG0103CL = 11.
DISPLAY: IF R04_YG0100CL = 1, 2, DISPLAY “today”.
ELSE, IF R04_YG0100CL = 3, DISPLAY “yesterday”.
ELSE, IF R04_YG0100CL = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YG0103FC_LC1

The computer recorded that you smoked [R04_YG0103FC] filtered cigars [today/yesterday/the day
before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG0103FC

2

NEXT

GO TO BOX R04_YGV02

ASK: IF R04_YG0103FC > 15 OR R04_YG0103FC = 11.
DISPLAY: IF R04_YG0100FC = 1, 2, DISPLAY “today”.
ELSE, IF R04_YG0100FC = 3, DISPLAY “yesterday”.
ELSE, IF R04_YG0100FC = 4, DISPLAY “the day before yesterday”.

PATH – Wave 4
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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YGV02

PROGRAM - CREATE THE FOLLOWING VARIABLES FOR EACH CIGAR TYPE (SEE APPENDIX):
R04_PAST30DAY_GTRAD = 1 (Past 30 day smoker) Youth respondents who have smoked a
traditional cigar in the past 30 days.
R04_PAST30DAY_GTRAD_LEVEL = 1 (Past 30 day “Very Light” smoker) Youth respondents who
have smoked a traditional cigar in the past 30 days, and have smoked 10 or less traditional cigars in
their lifetime.
R04_PAST30DAY_GTRAD_LEVEL = 2 (Past 30 day “Not Light” smoker) Youth respondents who
have smoked a traditional cigar in the past 30 days, and have smoked more than 10 traditional cigars in
their lifetime.
R04_PAST30DAY_GRILLO = 1 (Past 30 day smoker) Youth respondents who have smoked a cigarillo
in the past 30 days.
R04_PAST30DAY_GRILLO_LEVEL = 1 (Past 30 day “Very Light” smoker) Youth respondents who
have smoked a cigarillo in the past 30 days, and have smoked 10 or less cigarillos in their lifetime.
R04_PAST30DAY_GRILLO_LEVEL = 2 (Past 30 day “Not Light” smoker) Youth respondents who
have smoked a cigarillo in the past 30 days, and have smoked more than 10 cigarillos in their lifetime.
R04_PAST30DAY_GFILTR = 1 (Past 30 day smoker) Youth respondents who have smoked a filtered
cigar in the past 30 days.
R04_PAST30DAY_GFILTR_LEVEL = 1 (Past 30 day “Very Light” smoker) Youth respondents who
have smoked a filtered cigar in the past 30 days, and have smoked 10 or less filtered cigars in their
lifetime.
R04_PAST30DAY_GFILTR_LEVEL = 2 (Past 30 day “Not Light” smoker) Youth respondents who
have smoked a filtered cigar in the past 30 days, and have smoked more than 10 filtered cigars in their
lifetime.
BOX ID:

R04_YGR06

Past 30 day cigar smokers, go to R04_YG1022[TC/CL/FC].
Else, go to Box R04_YGR16.
PATH ID:

R04_YG1022

In the past 30 days, on how many days did you smoke a [CIGARFILL]?
1

|___|___| DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
DISPLAY: DISPLAY 'DAYS' AS A TITLE.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1023

In the past 30 days, on the days you smoked a [CIGARFILL], how many [CIGARFILL]s did you smoke
per day?
1

Less than 1 [CIGARFILL] per day

2

1 [CIGARFILL] per day

3

2 to 5 [CIGARFILL]s per day

4

6 to 10 [CIGARFILL]s per day

5

11 to 20 [CIGARFILL]s per day

6

More than 20 [CIGARFILL]s per day

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
PATH ID:

R04_YG1130

In the past 30 days, were any of the [CIGARFILL]s that you smoked flavored to taste like menthol, mint,
clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YG1142[TC/CL/FC]

3

I don't know

GO TO R04_YG1142[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YG1142[TC/CL/FC]

-7

REFUSED

GO TO R04_YG1142[TC/CL/FC]

ASK: Past 30 day cigar smokers.
PATH ID:

R04_YG1131

Which flavors have you smoked in the past 30 days? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored cigar smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1147

On the days you smoked [CIGARFILL]s in the past 30 days, how often did you smoke flavored
[CIGARFILL]s?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored cigar smokers.
DISPLAY: UNDERLINE "flavored".
PATH ID:

R04_YG1142

In the past 30 days, did anyone sell you [CIGARFILL]s?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
PATH ID:

R04_YG1123

In the past 30 days, did anyone refuse to sell you [CIGARFILL]s because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.

PATH – Wave 4
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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1118

In the past 30 days, how did you usually get your own [CIGARFILL]s?
1

I gave someone else money to buy them for me

2

I bought them myself from a store (including a cigar bar)

3

I asked someone to give me one

4

Someone offered it to me

5

I bought them from another person

6

I took them from a store or another person

7

I got them some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YGR07

Past 30 day cigar smokers who usually buy cigars themselves or usually give someone else money to
buy cigars for them, go to R04_YG1030[TC/CL/FC].
Else, past 30 day "not-light" cigar smokers go to R04_YG1047[TC/CL/FC].
Else, past 30 day cigar smokers, go to R04_YG1945[TC/CL/FC]
Else, all other youth respondents, go to Box R04_YGR16.
PATH ID:

R04_YG1030

How do [you/they] usually buy your [CIGARFILL]s?
1

In person (such as at a store or cigar bar)

2

From the internet

GO TO R04_YG1039[TC/CL/FC]

3

By telephone

GO TO R04_YG1039[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YG1039[TC/CL/FC]

-7

REFUSED

GO TO R04_YG1039[TC/CL/FC]

ASK: Past 30 day traditional cigar/cigarillo/filtered cigar smokers (including "very light" smokers) who
buy traditional cigars/cigarillos/filtered cigars for themselves or someone else buys for them.
DISPLAY: IF R04_YG1118[TC/CL/FC] = 1, DISPLAY “they”.
ELSE, IF R04_YG1118[TC/CL/FC] = 2, DISPLAY “you”.

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103

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1033

Where do [you/they] buy your [CIGARFILL]s most of the time?
1

A cigar bar

2

A convenience store or gas station

3

A supermarket, grocery store, or drug store

4

A warehouse club, such as Sam’s or Costco

5

A smoke shop, tobacco specialty store or tobacco outlet store

6

A duty free shop or military commissary

7

A bar, pub, restaurant or casino

8

A friend or relative

9

A swap meet or flea market

10

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day traditional cigar/cigarillo/filtered cigar smokers (including "very light" smokers) who
buy traditional cigars/cigarillos/filtered cigars for themselves or someone else buys for them in person.
DISPLAY: IF R04_YG1118[TC/CL/FC] = 1, DISPLAY “they”.
ELSE, IF R04_YG1118[TC/CL/FC] = 2, DISPLAY “you”.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
BOX ID:

R04_YGR22

Past 30 day "not-light" cigar smokers who buy cigars for themselves or someone else buys for them, go
to R04_YG1039[TC/CL/FC].
Else, go to R04_YG1047[CG/CL/FC].

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1039

Think about the last time you [bought/gave money to someone else to buy you] [CIGARFILL]s. Did you
buy them by the [carton, ]box or pack, or as single [CIGARFILL]s?
3

Carton

DISPLAY ONLY IF LOOP = GFILTR

1

Box or pack

GO TO R04_YG1040[TC/CL/FC]

2

Single [CIGARFILL]s

GO TO R04_YG1034[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YG1047[TC/CL/FC]

-7

REFUSED

GO TO R04_YG1047[TC/CL/FC]

ASK: Past 30 day "not-light" cigar smokers who buy cigars for themselves or someone else buys for
them.
DISPLAY: IF R04_YG1118[TC/CL/FC] = 2, DISPLAY "bought".
ELSE, IF R04_YG1118[TC/CL/FC] = 1, DISPLAY "gave money to someone else to buy you".
IF LOOP = GFILTR, DISPLAY "carton, " AND RESPONSE OPTION 3.
ELSE, DO NOT DISPLAY THIS TEXT OR RESPONSE OPTION.
PATH ID:

R04_YG9056

How many boxes or packs of filtered cigars came in the carton you last bought?
1

I___I___I

-8

DON'T KNOW

GO TO R04_YG9057

-7

REFUSED

GO TO R04_YG9057

ASK: Past 30 day "not-light" filtered cigar smokers who last bought filtered cigars by the carton.
PATH ID:

R04_YG9056_LC1

A carton of filtered cigars usually has 10 packs in it, but not always. The computer recorded that there
[is R04_YG9056 pack/are R04_YG9056 packs] of filtered cigars in the carton you usually buy.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG9056

2

NEXT

GO TO R04_YG9057

ASK: IF R04_YG9056 != 10.
DISPLAY: IF R04_YG9056FC = 1, DISPLAY "is [R04_YG9056] pack". ELSE, DISPLAY "are
[R04_YG9056] packs".

PATH – Wave 4
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105

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9057

How much did you pay for a carton of filtered cigars?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO R04_YG1047FC

-7

REFUSED

GO TO R04_YG1047FC

ASK: Past 30 day "not-light" filtered cigar smokers who last bought filtered cigars by the carton.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
PATH ID:

R04_YG9057_LC1

The computer recorded that you paid $[R04_YG9057_D] for a carton of filtered cigars. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG9057

2

NEXT

GO TO R04_YG1047FC

ASK: IF R04_YG9057_D > 125 OR R04_YG9057_D < 25 OR (R04_YG9057_D = 125 AND
R04_YG9057_C > 00).
PATH ID:

R04_YG1040

How many [CIGARFILL]s came in the box or pack that you last bought?
1

I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigar smokers who last bought cigars by the box or pack.
PATH ID:

R04_YG1034

How much did you pay for a [[box or pack of [CIGARFILL]s/single [CIGARFILL]]?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO R04_YG1047[TC/CL/FC]

-7

REFUSED

GO TO R04_YG1047[TC/CL/FC]

ASK: Past 30 day "not-light" cigar smokers who last bought cigars by the box or pack or as single
cigars.
DISPLAY: DISPLAY AS QUANTITY/QUANTITY. DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents”
AS TITLES.
IF R04_YG1039[TC/CL/FC] = 1, DISPLAY "box or pack of [CIGARFILL]s".
ELSE, IF R04_YG1039[TC/CL/FC] = 2, DISPLAY "single [CIGARFILL]".

PATH – Wave 4
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106

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1034TC_LC1

The computer recorded that you paid $[R04_YG1034TC_D] for a [box or pack of traditional cigars/single
traditional cigar]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1034TC

2

NEXT

GO TO R04_YG1047TC

ASK: IF ((R04_YG1034TC_D > 300 OR R04_YG1034TC_D < 10) AND R04_YG1039TC = 1) OR
((R04_YG1034TC_D > 15 OR R04_YG1034TC_D < 1) AND R04_YG1039TC = 2).
DISPLAY: IF R04_YG1039TC = 1, DISPLAY " box or pack of traditional cigars ".
ELSE, IF R04_YG1039TC = 2, DISPLAY " single traditional cigar".
PATH ID:

R04_YG1034CL_LC1

The computer recorded that you paid $[R04_YG1034CL_D] for a [box or pack of cigarillos/single
cigarillo]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1034CL

2

NEXT

GO TO R04_YG1047CL

ASK: IF ((R04_YG1034CL_D > 11 OR R04_YG1034CL_D < 1) AND R04_YG1039CL = 1) OR
((R04_YG1034CL_D > 3 OR (R04_YG1034CL_D = 0 AND R04_YG1034CL_C < 50)) AND
R04_YG1039CL = 2).
DISPLAY: IF R04_YG1039CL = 1, DISPLAY "box or pack of cigarillos".
ELSE, IF R04_YG1039CL = 2, DISPLAY "single cigarillo".
PATH ID:

R04_YG1034FC_LC1

The computer recorded that you paid $[R04_YG1034FC_D] for a [box or pack of filtered cigars/single
filtered cigar]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1034FC

2

NEXT

GO TO R04_YG1047FC

ASK: IF ((R04_YG1034FC_D > 100 OR R04_YG1034FC_D < 1) AND R04_YG1039FC = 1) OR
((R04_YG1034FC_D > 3 OR (R04_YG1034FC_D = 0 AND R04_YG1034FC_C < 50)) AND
R04_YG1039FC = 2).
DISPLAY: IF R04_YG1039FC = 1, DISPLAY "box or pack of filtered cigars".
ELSE, IF R04_YG1039FC = 2, DISPLAY "single filtered cigar".

PATH – Wave 4
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107

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1047

Do you have a regular brand of [CIGARFILL]s that you usually smoke?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigar smokers.
PATH ID:

R04_YG1945

Do you know the name of the brand of [CIGARFILL]s you [usually smoke/last smoked]?
1

Yes

2

No

GO TO BOX R04_YGR11

-8

DON'T KNOW

GO TO BOX R04_YGR11

-7

REFUSED

GO TO BOX R04_YGR11

ASK: Past 30 day cigar smokers.
DISPLAY: IF R04_YG1047[TC/CL/FC] = 1, DISPLAY “usually smoke”.
ELSE, DISPLAY “last smoked”.
UNDERLINE "name of the brand".
PATH ID:

R04_YG1048

What brand of [CIGARFILL] [do/did] you [usually/last] smoke?
Please select it from the choices below by touching the screen. If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”. ]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers who know the brand name.
DISPLAY: IF R04_YG1047[TC/CL/FC] = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[IF MULTIPLE SCREENS] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS] DISPLAY: If you do not see it
below, touch the box marked “Something else”.
[SHOW PICTURES OF THE MAJOR BRANDS ON THE TOUCHSCREEN.]

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YGR10

If youth respondent selects "Something else" in R04_YG1048[TC/CL/FC]_BRAND, go to
R04_YG1049[TC/CL/FC].
Else, if youth respondent selects brand from images in R04_YG1048[TC/CL/FC]_BRAND, go to
R04_YG1070[TC/CL/FC]_PRODUCT.
Else, go to Box R04_YGR11.
PATH ID:

R04_YG1049

You said that your brand was not listed. What is it?
1

__________________________

GO TO BOX R04_YGR11

-8

DON'T KNOW

GO TO BOX R04_YGR11

-7

REFUSED

GO TO BOX R04_YGR11

ASK: Past 30 day traditional cigar/cigarillo/filtered cigar smokers that know the name of the brand they
smoke who selected "Something else" for their brand.
PATH ID:

R04_YG1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] [do/did] you [usually/last] smoke?
Please select it from the choices below by touching the screen. [ If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”. ]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers that know the name of the brand they smoke who selected a brand
image.
DISPLAY: IF R04_YG1047[TC/CL/FC] = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[IF MULTIPLE SCREENS] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS] DISPLAY: If you do not see it
below, touch the box marked “Something else”.
[SHOW PICTURES OR TEXT ON THE TOUCHSCREEN OF THE MAJOR PRODUCTS ASSOCIATED
WITH BRAND SELECTED IN R04_YG1048[TC/CL/FC]_BRAND]
BOX ID:

R04_YGR21

If youth respondent selects "Something else" in R04_YG1070[TC/CL/FC]_PRODUCT, go to
R04_YG1071[TC/CL/FC].
Else, go to Box R04_YGR11.

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PATH ID:

R04_YG1071

You said that the type of [BRANDFILL]s that you smoke was not listed. What type is it?
1

__________________________

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day traditional cigar/cigarillo/filtered cigar smokers that know the name of the brand they
smoke who selected a brand image, but selected "Something else" for their subbrand image.
BOX ID:

R04_YGR11

Youth respondents who have smoked a cigar today, yesterday or the day before yesterday AND who
selected a valid brand AND valid product, go to R04_YG0104[TC/CL/FC].
Else, go to Box R04_YGD04.
PATH ID:

R04_YG0104

You said earlier that you smoked a [CIGARFILL] [TIME OF LAST USE].
Think about the very last [CIGARFILL] you smoked. Was the brand [NEQBRAND]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked a cigar in the past hour, sometime today, yesterday or the
day before yesterday AND who selected a valid brand AND valid product.
DISPLAY: IF R04_YG0100[TC/CL/FC] = 1, FILL [TIME OF LAST USE] WITH “in the past hour”.
ELSE, IF R04_YG0100[TC/CL/FC] = 2, FILL [TIME OF LAST USE] WITH “sometime today”.
ELSE, IF R04_YG0100[TC/CL/FC] = 3, FILL [TIME OF LAST USE] WITH “yesterday”.
ELSE, IF R04_YG0100[TC/CL/FC] = 4, FILL [TIME OF LAST USE] WITH “the day before yesterday”.
FILL [NEQBRAND] WITH RESPONSE TO R04_YG1070[TC/CL/FC]_PRODUCT.
BOX ID:

R04_YGD04

Display question R04_YG1060[TC/CL/FC], R04_YG1085[TC/CL/FC], R04_YG1062[TC/CL/FC],
R04_YG1075[TC/CL/FC], R04_YG1063[TC/CL/FC], R04_YG1064[TC/CL/FC],
R04_YG1066[TC/CL/FC], on one screen. Show the intro/transition text from R04_YG1060[TC/CL/FC]
first, then show each item with a Yes/No response. As each item is answered, show the next one.
Randomize order of R04_YG1060[TC/CL/FC] through R04_YG1066[TC/CL/FC].

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PATH ID:

R04_YG1060

The next questions are about the reasons people smoke [CIGARFILL]s. Please select which reasons
apply to you.
I smoke [CIGARFILL]s because…
They are affordable.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
PATH ID:

R04_YG1085

I can smoke [CIGARFILL]s at times when or in places where smoking cigarettes isn’t allowed.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
PATH ID:

R04_YG1062

They might be less harmful to me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
PATH ID:

R04_YG1075

They might be less harmful to people around me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.

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PATH ID:

R04_YG1063

[CIGARFILL]s come in flavors I like.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
BOX ID:

R04_YGR15

Youth respondents who have smoked cigarettes in the past year, go to R04_YG1064[TC/CL/FC].
Else, go to R04_YG1066[TC/CL/FC].
PATH ID:

R04_YG1064

Smoking [CIGARFILL]s helps people quit smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers who have also smoked cigarettes in the past year.
PATH ID:

R04_YG1066

Smoking a [CIGARFILL] feels like smoking a regular cigarette.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.

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PATH ID:

R04_YG1139

Please rate your level of agreement for each statement using the following scale: 1 = not true of me at
all to 4 = very true of me.
It is easier to talk and get along with other people when smoking a [CIGARFILL].
1

Not true of me at all

2
3
4

Very true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
DISPLAY: DISPLAY SCALE FOR THE R04_YG1139[TC/CL/FC]-1141[TC/CL/FC] SERIES.
PATH ID:

R04_YG1140

While smoking a [CIGARFILL], I feel more confident with other people.
1

Not true of me at all

2
3
4

Very true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
DISPLAY: DISPLAY SCALE FOR THE R04_YG1139[TC/CL/FC]-1141[TC/CL/FC] SERIES.
PATH ID:

R04_YG1141

I smoke [CIGARFILL]s much more when I am with other people.
1

Not true of me at all

2
3
4

Very true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
DISPLAY: DISPLAY SCALE FOR THE R04_YG1139[TC/CL/FC]-1141[TC/CL/FC] SERIES.

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BOX ID:

R04_YGR16

If youth respondent has remaining loops to complete for non-blunt cigar types, return to R04_YGT04
and repeat section.
Else, if youth respondent has no more remaining loops to complete for cigars, go to Box R04_YPT01.

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PIPE
BOX ID:

R04_YPT01

The next questions are about smoking tobacco in a pipe.
Pipes come in many shapes and sizes. They all have a bowl that holds the tobacco and a stem. Pipe
tobacco is often sold loose in packages or tins. In the following section, we are only asking about
smoking pipes filled with tobacco. The picture below shows a typical pipe and some pipe tobacco.
[SHOW GENERIC IMAGE OF PIPE AND PIPE TOBACCO]
BOX ID:

R04_YPR02

New baseline youth respondents, go to R04_YP1001_NB.
Continuing youth respondents, go to R04_YP1002_12M.
PATH ID:

R04_YP1001_NB

Have you ever seen or heard of a pipe before this study?
[SHOW GENERIC IMAGE OF PIPE AND PIPE TOBACCO]
1

Yes

2

No

GO TO BOX R04_YPV01

-8

DON'T KNOW

GO TO BOX R04_YPV01

-7

REFUSED

GO TO BOX R04_YPV01

ASK: New baseline youth respondents.
PATH ID:

R04_YP1002_NB

Have you ever smoked a pipe filled with tobacco, even one or two puffs?
[SHOW GENERIC IMAGE OF PIPE AND PIPE TOBACCO]
1

Yes

GO TO BOX R04_YPV01

2

No

GO TO BOX R04_YPV01

-8

DON'T KNOW

GO TO BOX R04_YPV01

-7

REFUSED

GO TO BOX R04_YPV01

ASK: New baseline youth respondents who have heard of a pipe.

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BOX ID:

R04_YPV01

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_PIPE_YOUTH = 1 (Ever user) Youth respondents who have ever smoked pipe
tobacco.
R04_EVER_NEVER_PIPE_YOUTH = 2 (Never user) = Youth respondents who have not ever smoked
pipe tobacco.
R04_INIT_PIPE_YOUTH = 1 (Initiator) Youth respondents who initiated pipe use between Waves or
new baseline youth respondents who have ever smoked a pipe.
BOX ID:

R04_YPR01

Youth respondents who have ever smoked a pipe, go to R04_YP1112.
Else, go to Box R04_YHT01.
PATH ID:

R04_YP1112

When was the last time you smoked a pipe, even one or two puffs?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YPV02

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YPV02

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YPV02

6

1 to 4 years ago

GO TO BOX R04_YPV02

7

5 or more years ago

GO TO BOX R04_YPV02

-8

DON'T KNOW

GO TO BOX R04_YPV02

-7

REFUSED

GO TO BOX R04_YPV02

ASK: Youth respondents who have ever smoked a pipe.
PATH ID:

R04_YP0100

When did you last smoke a pipe filled with tobacco?
1

In the past hour

GO TO R04_YP0103

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YPV02

-8

DON'T KNOW

GO TO BOX R04_YPV02

-7

REFUSED

GO TO BOX R04_YPV02

ASK: Youth respondents who smoked a pipe earlier today or in the past 7 days.

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PATH ID:

R04_YP0102

When you last smoked a pipe filled with tobacco [FILL BASED ON R04_YP0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked a pipe today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YP0100]:
IF R04_YP0100 = 2, DISPLAY “today”.
ELSE, IF R04_YP0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YP0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YP0103

How many bowls filled with pipe tobacco [have/did] you [smoked/smoke] [FILL BASED ON
R04_YP0100]? (If less than 1, enter 1.)
1

I__I__I

-8

DON'T KNOW

GO TO BOX R04_YPV02

-7

REFUSED

GO TO BOX R04_YPV02

ASK: Youth respondents who have smoked a pipe in the past hour, today, yesterday or the day before
yesterday.
DISPLAY: IF R04_YP0100 = 1, 2, DISPLAY “have” AND “smoked”.
ELSE, IF R04_YP0100 = 3, 4, DISPLAY “did” AND “smoke”.
FOR [FILL BASED ON R04_YP0100]:
IF R04_YP0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YP0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YP0100 = 4, DISPLAY “the day before yesterday”.

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PATH ID:

R04_YP0103_LC1

The computer recorded that you smoked [R04_YP0103] bowls filled with pipe tobacco
[today/yesterday/the day before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YP0103

2

NEXT

GO TO BOX R04_YPV02

ASK: IF R04_YP0103 > 10.
DISPLAY: IF R04_YP0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YP0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YP0100 = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YPV02

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PAST30DAY_PIPE = 1 (Past 30 day pipe smokers) Youth respondents who have smoked a pipe
in the past 30 days.
BOX ID:

R04_YPR04

Past 30 day pipe smokers, go to R04_YP1022.
Else, go to Box R04_YHT01.
PATH ID:

R04_YP1022

In the past 30 days, on how many days did you smoke a pipe?
1

I__I__I DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day pipe smokers.
DISPLAY: DISPLAY "days" AS TITLE.

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PATH ID:

R04_YP1023

In the past 30 days, on the days you smoked a pipe, how many bowls filled with tobacco did you smoke
per day?
1

Less than 1 bowl per day

2

1 bowl per day

3

2 to 5 bowls per day

4

6 to 10 bowls per day

5

11 to 20 bowls per day

6

More than 20 bowls per day

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day pipe smokers.
PATH ID:

R04_YP1142

In the past 30 days, did anyone sell you pipe tobacco?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day pipe smokers.
PATH ID:

R04_YP1123

In the past 30 days, did anyone refuse to sell you pipe tobacco because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day pipe smokers.

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PATH ID:

R04_YP1118

In the past 30 days, how did you usually get your own pipe tobacco?
1

I gave someone else money to buy it for me

2

I bought it myself from a store

3

I asked someone to give me some

4

Someone offered it to me

5

I bought it from another person

6

I took it from a store or another person

7

I got it some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day pipe smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YPR03

Past 30 day pipe smokers who usually buy pipe tobacco themselves or give someone else money to
buy pipe tobacco for them, go to R04_YP1030.
Else, go to Box R04_YHT01.
PATH ID:

R04_YP1030

[When you give money to someone else, how do they/How do you] usually buy your pipe tobacco?
1

In person

2

From the internet

GO TO R04_YP1034

3

By telephone

GO TO R04_YP1034

-8

DON'T KNOW

GO TO R04_YP1034

-7

REFUSED

GO TO R04_YP1034

ASK: Past 30 day pipe smokers who buy pipe tobacco for themselves or someone else buys it for them.
DISPLAY: IF R04_YP1118 = 1, DISPLAY “When you give money to someone else, how do they”;
ELSE, IF R04_YP1118 = 2, DISPLAY “How do you”.

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PATH ID:

R04_YP1033

Where do [you/they] buy your pipe tobacco most of the time?
1

A convenience store or gas station

2

A supermarket, grocery store, or drug store

3

A warehouse club, such as Sam’s or Costco

4

A smoke shop, tobacco specialty store or tobacco outlet store

5

A duty free shop or military commissary

6

A bar, pub, restaurant or casino

7

A friend or relative

8

A swap meet or flea market

9

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 pipe smokers who buy pipe tobacco themselves or someone else buys for them in
person.
DISPLAY: IF R04_YP1118=1, DISPLAY “they”;
ELSE, IF R04_YP1118=2, DISPLAY "you”
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
PATH ID:

R04_YP1034

Think about the last time you [bought/gave money to someone else to buy you] pipe tobacco. How
much did you pay for it?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO R04_YHT01

-7

REFUSED

GO TO R04_YHT01

ASK: Past 30 day pipe smokers who buy pipe tobacco themselves or someone else buys for them.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
IF R04_YP1118 = 1, DISPLAY "gave money to someone else to buy you".
ELSE, IF R04_YP1118 = 2, DISPLAY "bought".

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PATH ID:

R04_YP1034_LC1

The computer recorded that you paid $[R04_YP1034] for a pouch of pipe tobacco. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YP1034

2

NEXT

GO TO BOX R04_YHT01

ASK: IF R04_YP1034_D > 50.

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HOOKAH
BOX ID:

R04_YHT01

The next questions are about smoking tobacco in a hookah, which is a type of water pipe. It is
sometimes also called a "narghile" pipe. From now on, we will use "hookah" to refer to a water pipe or
narghile pipe. There are many types of hookahs. People often smoke tobacco in hookahs in groups at
cafes or in hookah bars.
People smoke shisha or hookah tobacco in a hookah. Shisha comes in many different flavors. Some
types of shisha contain tobacco and some do not.
[SHOW GENERIC IMAGE OF HOOKAH AND SHISHA]
BOX ID:

R04_YHR01

New baseline youth respondents, go to R04_YH1001_NB.
Continuing youth respondents, go to R04_YH1002_12M.
PATH ID:

R04_YH1001_NB

Have you ever seen or heard of a hookah before this study?
[SHOW GENERIC IMAGE OF HOOKAH]
1

Yes

2

No

GO TO BOX R04_YHV01

-8

DON'T KNOW

GO TO BOX R04_YHV01

-7

REFUSED

GO TO BOX R04_YHV01

ASK: New baseline youth respondents.
PATH ID:

R04_YH1002_NB

Have you ever smoked tobacco in a hookah, even one or two puffs?
[SHOW GENERIC IMAGE OF HOOKAH]
1

Yes

GO TO BOX R04_YHV01

2

No

GO TO BOX R04_YHV01

-8

DON'T KNOW

GO TO BOX R04_YHV01

-7

REFUSED

GO TO BOX R04_YHV01

ASK: New baseline youth respondents who have heard of a hookah.

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BOX ID:

R04_YHV01

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_HOOK_YOUTH = 1 (Ever user) Youth respondents who have ever smoked
hookah.
R04_EVER_NEVER_HOOK_YOUTH = 2 (Never user) Youth respondents who have not ever smoked
hookah.
R04_INIT_HOOK_YOUTH = 1 (Initiator) Youth respondents who initiated hookah use between Waves
or new baseline youth respondents who have ever smoked a hookah.
BOX ID:

R04_YHR02

New baseline youth who have never heard of a hookah, go to Box R04_YUT01.
Else, continuing youth who have never smoked hookah, and new baseline youth respondents who have
heard of but never smoked hookah, go to R04_YH1103.
Else, new baseline youth respondents who have ever smoked hookah, go to R04_YH1006_NB.
Else, continuing youth respondents who initiated hookah smoking since the previous wave, go to
R04_YH1108.
Else, continuing youth respondents who have ever smoked hookah and had not smoked 100 or more
times in the previous wave, go to R04_YH1005
Else, continuing youth respondents who have ever smoked hookah and had never smoked fairly
regularly in the previous wave, go to Box R04_YH1100.
Else, go to Box R04_YHV02.
PATH ID:

R04_YH1103

Have you ever been curious about smoking tobacco in a hookah?
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of hookah but have never smoked hookah.

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PATH ID:

R04_YH1206

Do you think you will smoke tobacco in a hookah in the next year?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but have never smoked hookah.
PATH ID:

R04_YH1104

Do you think you will try smoking tobacco in a hookah soon?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but have never smoked hookah.
PATH ID:

R04_YH1105

If one of your best friends were to offer you a hookah, would you try it?
1

Definitely yes

GO TO R04_YH9041

2

Probably yes

GO TO R04_YH9041

3

Probably not

GO TO R04_YH9041

4

Definitely not

GO TO R04_YH9041

-8

DON'T KNOW

GO TO R04_YH9041

-7

REFUSED

GO TO R04_YH9041

ASK: Youth respondents who have heard of but have never smoked hookah.

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PATH ID:

R04_YH1006_NB

How old were you when you first tried smoking tobacco in a hookah, even one or two puffs?
1

|___|___| Years old

-8

DON'T KNOW

GO TO R04_YH1120_NB

-7

REFUSED

GO TO R04_YH1120_NB

ASK: New baseline youth respondents who have ever smoked hookah.
DISPLAY: DISPLAY “Years old” AS A TITLE.
PATH ID:

R04_YH1006_NB_LC1

The computer recorded that you first tried smoking tobacco in a hookah at age [R04_YH1006_NB]. Is
that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH1006_NB

2

NEXT

GO TO R04_YH1108

ASK: IF R04_YH1006_NB <=12.
PATH ID:

R04_YH1006_NB_LC2

The computer recorded that you first tried smoking tobacco in a hookah at age [R04_YH1006_NB]. That
is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH1006_NB

2

NEXT

GO TO R04_YH1108

ASK: IF R04_YH1006_NB > R04_YOUTHAGE.
PATH ID:

R04_YH1120_NB

When you first tried smoking tobacco in a hookah, even one or two puffs, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON’T KNOW

-7

REFUSED

ASK: New baseline youth respondents who did not know or refused to report the age when they first
smoked hookah.

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PATH ID:

R04_YH1108

Was the first shisha or hookah tobacco you smoked flavored to taste like menthol, mint, clove, spice,
fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO BOX R04_YHR13

3

I don't know

GO TO BOX R04_YHR13

-8

DON'T KNOW

GO TO BOX R04_YHR13

-7

REFUSED

GO TO BOX R04_YHR13

ASK: Continuing youth respondents who have initiated hookah smoking since the previous wave, and
new baseline youth respondents who have ever smoked hookah.
PATH ID:

R04_YH1011

What flavor was that first shisha or hookah tobacco you smoked? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who initiated smoking with flavored shisha.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YHR13

Aged-up and continuing youth respondents who have ever smoked hookah (and had not smoked 100 or
more times in the previous wave), and new cohort youth respondents who have ever smoked hookah,
go to R04_YH1005.
Else, go to Box R04_YHR10.

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Wave 4 (version 3.0)
PATH ID:

R04_YH1005

How many times have you smoked tobacco in a hookah in your entire life? Count each sitting or session
where you smoked tobacco in a hookah, whether alone or with others.
1

1

2

2 to 10

3

11 to 20

4

21 to 50

5

51 to 99

6

100 or more

-8

DON'T KNOW

-7

REFUSED

ASK: Aged-up and continuing youth respondents who have ever smoked hookah and had not smoked
100 or more times in the previous wave, and new cohort youth respondents who have ever smoked
hookah.
BOX ID:

R04_YHR10

Youth respondents who have ever smoked hookah and had never smoked hookah fairly regularly in the
previous wave, go to R04_YH1100.
Else, go to R04_YH1112.
PATH ID:

R04_YH1100

Have you ever smoked tobacco in a hookah fairly regularly?
1

Yes

2

No

GO TO R04_YH1112

-8

DON'T KNOW

GO TO R04_YH1112

-7

REFUSED

GO TO R04_YH1112

ASK: Youth respondents who have ever smoked hookah (and had never smoked fairly regularly in the
previous wave).
PATH ID:

R04_YH1007

How old were you when you first started smoking tobacco in a hookah fairly regularly?
1

|__|__| Years old

-8

DON'T KNOW

GO TO R04_YH1121

-7

REFUSED

GO TO R04_YH1121

ASK: Youth respondents who have ever smoked hookah fairly regularly and did not smoke fairly
regularly in the previous wave.
DISPLAY: DISPLAY "Years old" AS A TITLE.

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Wave 4 (version 3.0)
PATH ID:

R04_YH1007_LC1

The computer recorded that you first started smoking tobacco in a hookah fairly regularly at age
[R04_YH1007]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH1007

2

NEXT

GO TO R04_YH1112

ASK: IF R04_YH1007< =5 OR If R04_YH1007 < R04_YH1006_NB.
PATH ID:

R04_YH1007_LC2

The computer recorded that you first started smoking tobacco in a hookah fairly regularly at age
[R04_YH1007]. That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH1007

2

NEXT

GO TO R04_YH1112

ASK: IF R04_YH1007 > R04_YOUTHAGE.
PATH ID:

R04_YH1121

When you first started smoking tobacco in a hookah fairly regularly, were you...
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who did not know or refused to report the age they first started smoking
hookah fairly regularly.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH1112

When was the last time you smoked tobacco in a hookah, even one or two puffs?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

4

Not in the past 30 days but sometime in the past 6 months

5

Not in the past 6 months but sometime in the past year

6

1 to 4 years ago

7

5 or more years ago

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked hookah.
BOX ID:

R04_YHV02

PROGRAM - CREATE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PAST30DAY_HOOK = 1 (Past 30 day hookah smokers) Youth respondents who have smoked
hookah in the past 30 days.
BOX ID:

R04_YHR12

Youth respondents who have smoked hookah in the past 7 days, go to R04_YH0100.
Else, youth respondents who have smoked hookah in the past 12 months, go to R04_YH9003.
Else, youth respondents who have ever smoked hookah, go to R04_YH1090.
Else, go to R04_YH9041.
PATH ID:

R04_YH0100

When did you last smoke tobacco in a hookah?
1

In the past hour

2

Sometime today

GO TO R04_YH0103

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO R04_YH9003

-8

DON'T KNOW

GO TO R04_YH9003

-7

REFUSED

GO TO R04_YH9003

ASK: Youth respondents who have smoked hookah in the past 7 days.

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Wave 4 (version 3.0)
PATH ID:

R04_YH0102

When you last smoked tobacco in a hookah [FILL BASED ON R04_YH0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked hookah today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YH0100]:
IF R04_YH0100 = 2, DISPLAY “today”.
ELSE, IF R04_YH0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YH0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YH0103

How many puffs from a hookah [have/did] you [taken/take] [FILL BASED ON R04_YH0100]?
1

I__I__I

-8

DON'T KNOW

GO TO R04_YH9003

-7

REFUSED

GO TO R04_YH9003

ASK: Youth respondents who have smoked hookah in the past hour, sometime today, yesterday or the
day before yesterday.
DISPLAY: IF R04_YH0100 = 1, 2, DISPLAY “have” AND “taken”.
ELSE, IF R04_YH0100 = 3, 4, DISPLAY “did” AND “take”.
FOR [FILL BASED ON R04_YH0100]:
IF R04_YH0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YH0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YH0100 = 4, DISPLAY “the day before yesterday”.

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Wave 4 (version 3.0)
PATH ID:

R04_YH0103_LC1

The computer recorded that you took [R04_YH0103] puffs from a hookah [today/yesterday/the day
before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH0103

2

NEXT

GO TO R04_YH9003

ASK: IF R04_YH0103 > 50 OR R04_YH0103 = 11, 22, 33, 44.
DISPLAY: IF R04_YH0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YH0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YH0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YH9003

Which of the following choices best describes your hookah smoking? Usually I smoke hookah tobacco
in a hookah…
1

Every day

2

Weekly

GO TO R04_YH9005

3

Monthly

GO TO R04_YH9004

4

Every couple of months

GO TO R04_YH1090

5

About once a year

GO TO R04_YH1090

-8

DON'T KNOW

GO TO R04_YH1090

-7

REFUSED

GO TO R04_YH1090

ASK: Youth respondents who have smoked hookah in the past 12 months.
PATH ID:

R04_YH9006

On average, about how many times do you smoke tobacco in a hookah each day? Count each sitting or
session where you smoked tobacco in a hookah, whether alone or with others.
1

I___I___I

-8

DON'T KNOW

GO TO R04_YH1090

-7

REFUSED

GO TO R04_YH1090

ASK: Youth respondents who smoke hookah every day.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH9006_LC1

The computer recorded that, on average, you smoke tobacco in a hookah [R04_YH9006] times each
day. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH9006

2

NEXT

GO TO R04_YH1090

ASK: IF R04_YH9006 > 2.
PATH ID:

R04_YH9005

On average, about how many times do you smoke tobacco in a hookah in a week? Count each sitting or
session where you smoked tobacco in a hookah, whether alone or with others.
1

I___I___I

-8

DON'T KNOW

GO TO R04_YH1090

-7

REFUSED

GO TO R04_YH1090

ASK: Youth respondents who smoke hookah weekly.
PATH ID:

R04_YH9005_LC1

The computer recorded that, on average, you smoke tobacco in a hookah [R04_YH9005] times in a
week. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH9005

2

NEXT

GO TO R04_YH1090

ASK: IF R04_YH9005 > 15.
PATH ID:

R04_YH9004

On average, about how many times do you smoke tobacco in a hookah in a month? Count each sitting
or session where you smoked tobacco in a hookah, whether alone or with others.
1

I___I___I

-8

DON'T KNOW

GO TO R04_YH1090

-7

REFUSED

GO TO R04_YH1090

ASK: Youth respondents who smoke hookah monthly.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH9004_LC1

The computer recorded that, on average, you smoke tobacco in a hookah [R04_YH9004] times in a
month. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH9004

2

NEXT

GO TO R04_YH1090

ASK: IF R04_YH9004 > 50.
PATH ID:

R04_YH1090

Do you own a hookah?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked hookah.
PATH ID:

R04_YH9041

Does anyone [else] living in your home own a hookah?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have heard of hookah, and continuing youth respondents.
DISPLAY: IF R04_EVER_NEVER_HOOK_YOUTH = 1), DISPLAY " else".
ELSE, DO NOT DISPLAY THIS TEXT.
BOX ID:

R04_YHR03

Past 30 day hookah smokers, go to R04_YH9012.
Else, youth respondents who have ever smoked hookah, go to R04_YH9042.
Else, go to R04_YH9031.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH9012

Do you usually share a hookah with others when you smoke?
1

Yes

2

No

GO TO R04_YH9014

-8

DON'T KNOW

GO TO R04_YH9014

-7

REFUSED

GO TO R04_YH9014

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH9013

How many people do you usually share a hookah with?
1

1 other person

2

2 other people

3

3 other people

4

4 or more other people

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers who report sharing with others.
PATH ID:

R04_YH9014

On average, how long is one hookah session for you[ and the people you share it with]?
1

Less than 30 minutes

2

More than 30 minutes up to 1 hour

3

1 to 2 hours

4

More than 2 hours

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
DISPLAY: IF R04_YH9012=1, DISPLAY “ and the people you share it with”. ELSE, DO NOT DISPLAY
THIS TEXT.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH9015

On average, when you [smoke/share a] hookah, how many times is the hookah refilled with tobacco
during a session?
1

0 times

2

1 time

3

2 to 3 times

4

4 or more times

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
DISPLAY: IF R04_YH9012 = 1, DISPLAY “share a”. ELSE, DISPLAY "smoke".
PATH ID:

R04_YH9016

How often do you personally set up the hookah?
1

Every time

2

Most of the time

3

Some of the time

4

Rarely

5

Never, someone else always sets it up for me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH9011

Where do you usually smoke hookah? Choose all that apply.
1

In your home

2

In someone else's home

3

In a hookah bar or hookah café

4

In a dance club or lounge

5

Somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH1130

In the past 30 days, was any of the shisha or hookah tobacco you smoked flavored to taste like menthol,
mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YH1142

3

I don't know

GO TO R04_YH1142

-8

DON'T KNOW

GO TO R04_YH1142

-7

REFUSED

GO TO R04_YH1142

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1131

Which flavors have you smoked in the past 30 days? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored hookah smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YH1147

On the days you smoked shisha or hookah tobacco in the past 30 days, how often did you smoke
flavored shisha or hookah tobacco?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored hookah smokers.
DISPLAY: UNDERLINE "flavored".

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH1142

In the past 30 days, did anyone sell you shisha or hookah tobacco?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1123

In the past 30 days, did anyone refuse to sell you shisha or hookah tobacco because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1118

In the past 30 days, how did you usually get your own shisha or hookah tobacco?
1

I gave someone else money to buy it for me

2

I bought it myself from a store (including a hookah bar or cafe)

3

I asked someone to give me some

4

Someone offered it to me

5

I bought it from another person

6

I took it from a store or another person

7

I got it some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YHR04

Past 30 day hookah smokers who usually buy shisha or hookah tobacco themselves or usually give
someone else money to buy for them, go to R04_YH1030.
Else, go to R04_YH1047.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH1030

[When you give money to someone else, how do they/How do you] usually buy your shisha or hookah
tobacco?
1

In person (such as at a store or hookah bar)

2

From the internet

GO TO R04_YH1047

3

By telephone

GO TO R04_YH1047

-8

DON'T KNOW

GO TO R04_YH1047

-7

REFUSED

GO TO R04_YH1047

ASK: Past 30 day hookah smokers who buy shisha or hookah tobacco for themselves or someone else
buys for them.
DISPLAY: IF R04_YH1118 = 1, DISPLAY “When you give money to someone else, how do they”; IF
R04_YH1118 = 2, DISPLAY “How do you”.
PATH ID:

R04_YH1033

Where do [you/they] buy your shisha or hookah tobacco most of the time?
1

A hookah bar or cafe

2

A convenience store or gas station

3

A supermarket, grocery store, or drug store

4

A warehouse club, such as Sam’s or Costco

5

A smoke shop, tobacco specialty store or tobacco outlet store

6

A duty free shop or military commissary

7

A bar, pub, restaurant or casino

8

A friend or relative

9

A swap meet or flea market

10

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers who buy shisha or hookah tobacco for themselves or someone else
buys for them in person.
DISPLAY: IF R04_YH1118 = 2, DISPLAY “you”. ELSE, IF R04_YH1118 = 1, DISPLAY “they”.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH1047

Do you have a regular brand of shisha or hookah tobacco that you usually smoke?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1945

Do you know the name of the brand of shisha or hookah tobacco you [usually smoke/last smoked]?
1

Yes

2

No

GO TO BOX R04_YHD01

-8

DON'T KNOW

GO TO BOX R04_YHD01

-7

REFUSED

GO TO BOX R04_YHD01

ASK: Past 30 day hookah smokers.
DISPLAY: IF R04_YH1047 = 1, DISPLAY “usually smoke”. IF R04_YH1047 = 2, -8, -7, DISPLAY “last
smoked”. UNDERLINE "name of the brand".
PATH ID:

R04_YH1048

What brand of shisha or hookah tobacco [do/did] you [usually/last] smoke?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers who know the brand name.
DISPLAY: IF R04_YH1047 = 1, DISPLAY “do” AND “usually”. IF R04_YH1047 = 2, -8, -7, DISPLAY
“did” AND “last” .
IF MULTIPLE SCREENS, DISPLAY: “If you do not see it below, touch the button marked “NEXT”.
IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS DISPLAY: “If you do not see it
below, touch the box marked “Something else”.”
BOX ID:

R04_YHR05

If youth respondent selects brand in R04_YH1048_BRAND, go to R04_YH1070_PRODUCT.
Else, if youth respondent selects "Something else" in R04_YH1048_BRAND, go to R04_YH1049.
Else, go to Box R04_YHD01.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH1049

You said that your brand was not listed. What is it?
__________________________

GO TO R04_YH9108

-8

1

DON'T KNOW

GO TO BOX R04_YHD01

-7

REFUSED

GO TO BOX R04_YHD01

ASK: Past 30 day hookah smokers that know the name of the brand they smoke who selected
"Something else" for their brand.
PATH ID:

R04_YH1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] [do/did] you [usually/last] smoke?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers that know the name of the brand they smoke who selected a brand
image.
DISPLAY: IF R04_YH1047=1, DISPLAY “do” AND “usually”. IF R04_YH1047 = 2, -8, -7, DISPLAY “did”
AND “last”.
IF MULTIPLE SCREENS, DISPLAY: “If you do not see it below, touch the button marked “NEXT”.
IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS DISPLAY: “If you do not see it
below, touch the box marked “Something else”.”
BOX ID:

R04_YHR06

If youth respondent selects "Something else" in R04_YH1070_PRODUCT, go to R04_YH1071.
Else, go to R04_YH9108.
PATH ID:

R04_YH1071

You said that the type of [BRANDFILL]s that you smoke was not listed. What type is it?
1

__________________________

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers that know the name of the brand they smoke who selected a brand
image, but selected "Something else" for their subbrand image.

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Wave 4 (version 3.0)
PATH ID:

R04_YH9108

Does this brand of shisha contain tobacco?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers who selected a brand in R04_YH1048_BRAND or entered their
brand in R04_YH1049.
BOX ID:

R04_YHR08

Youth respondents who smoked hookah today, yesterday or the day before yesterday AND who
selected a valid brand in R04_YH1048_BRAND AND valid product in R04_YH1070_PRODUCT, go to
R04_YH0104.
Else, go to Box R04_YHD01.
PATH ID:

R04_YH0104

You said earlier that you last smoked hookah [TIME OF LAST USE].
Think about the very last puff you took. Was the brand [NEQBRAND]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who smoked hookah in the past hour, sometime today, yesterday or the day
before yesterday AND who selected a valid brand in R04_YH1048_BRAND AND valid product in
R04_YH1070_PRODUCT.
DISPLAY: IF R04_YH0100 = 1, FILL [TIME OF LAST USE] WITH “in the past hour”.
IF R04_YH0100 = 2, FILL [TIME OF LAST USE] WITH “sometime today”.
IF R04_YH0100 = 3, FILL [TIME OF LAST USE] WITH “yesterday”.
IF R04_YH0100 = 4, FILL [TIME OF LAST USE] WITH “the day before yesterday”.
FILL [NEQBRAND] WITH RESPONSE TO R04_YH1070_PRODUCT.

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Wave 4 (version 3.0)
BOX ID:

R04_YHD01

Display question R04_YH1060, R04_YH1085, R04_YH1062, R04_YH1075, R04_YH1063,
R04_YH1064, R04_YH1069, and R04_YH1073 on one screen. Show the intro/transition text from
R04_YH1060 first, then show each item with a Yes/No response. As each item is answered, show the
next one.
PROGRAM: Randomize order of R04_YH1060 through R04_YH1073.
PATH ID:

R04_YH1060

The next questions are about the reasons people smoke hookah. Please select which reasons apply to
you.
I smoke hookah because…
It is affordable.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1085

I can smoke hookah at times when or in places where smoking cigarettes isn’t allowed.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1062

It might be less harmful to me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.

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Wave 4 (version 3.0)
PATH ID:

R04_YH1075

It might be less harmful to people around me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1063

Shisha or hookah tobacco comes in flavors I like.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
BOX ID:

R04_YHR07

Youth respondents who have smoked cigarettes in the past year, go to R04_YH1064.
Else, go to R04_YH1069.
PATH ID:

R04_YH1064

Smoking hookah helps people quit smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers who have also smoked cigarettes in the past year.
PATH ID:

R04_YH1069

I like socializing while smoking hookah.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.

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Wave 4 (version 3.0)
PATH ID:

R04_YH1073

Smoking hookah is part of my cultural tradition.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH9042

Have you ever used another liquid besides water in the bowl of the hookah?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked hookah.
BOX ID:

R04_YHR09

New baseline youth respondents who have heard of hookah, and continuing youth respondents, go to
R04_YH9031.
Else, go to Box R04_YUT01.
PATH ID:

R04_YH9031

Have you ever smoked marijuana in a hookah? (Remember all information you give to the PATH Study
will be kept private.)
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have heard of hookah and continuing youth respondents.
PATH ID:

R04_YH9040

Have you ever smoked herbal or tobacco-free shisha in a hookah?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have heard of hookah, and continuing youth respondents.

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SNUS
BOX ID:

R04_YUT01

Smokeless tobacco is tobacco which you put in your mouth. Smokeless tobacco may be loose or it
may be packaged in small pouches that you place under your lip. Frequently you chew, suck, or spit
while using smokeless tobacco, although for some types you may not need to.
There are many different types of smokeless tobacco which go by lots of different names, so please use
these descriptions and photos to understand what they are.
[SHOW GENERIC IMAGE OF SNUS AND OTHER SMOKELESS TOBACCO]
BOX ID:

R04_YUT03

Snus is a type of smokeless tobacco. Snus usually comes in small pouches, although some snus may
be sold as loose snus. Typically, with most kinds of smokeless tobacco, you spit, but you do not need to
spit when using snus. Common brands of snus include Camel Snus, Marlboro Snus and General Snus.
Please think about your use of snus as you answer the following questions. There will be a separate
section later about other types of smokeless tobacco products (such as dip, spit, chewing tobacco and
smokeless tobacco pouches).
[SHOW GENERIC IMAGE OF SNUS - BOTH LOOSE AND POUCHES]
BOX ID:

R04_YUR14

New baseline youth respondents, go to R04_YU1001_NB.
Continuing youth respondents, go to R04_YU1002_12M.
PATH ID:

R04_YU1001_NB

Have you ever seen or heard of snus, before this study?
[SHOW GENERIC IMAGE OF SNUS - BOTH LOOSE AND POUCHES]
1

Yes

2

No

GO TO R04_YUV03

-8

DON'T KNOW

GO TO R04_YUV03

-7

REFUSED

GO TO R04_YUV03

ASK: New baseline youth respondents.

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PATH ID:

R04_YU1002_NB

Have you ever used snus, even one or two times?
[SHOW GENERIC IMAGE OF SNUS - BOTH LOOSE AND POUCHES]
1

Yes

2

No

GO TO BOX R04_YUV03

-8

DON'T KNOW

GO TO BOX R04_YUV03

-7

REFUSED

GO TO BOX R04_YUV03

ASK: New baseline youth respondents who have heard of snus.
BOX ID:

R04_YUV03

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_SNUS_YOUTH = 1 (Ever user) Youth respondents who have ever used snus.
R04_EVER_NEVER_SNUS_YOUTH = 2 (Never user) Youth respondents who have not ever used
snus.
R04_INIT_SNUS_YOUTH = 1 (Initiator) Youth respondents who initiated snus use between Waves or
new baseline youth respondents who have ever used snus.
BOX ID:

R04_YUR02

New baseline youth respondents who have never heard of snus, go to Box R04_YST01.
Else, continuing youth respondents who have never used snus and new baseline youth respondents
who have heard of snus but have never used it, go to R04_YU1103.
Else, new baseline youth respondents who have ever used snus, go to R04_YU1006_NB.
Else, continuing youth respondents who initiated snus use since the previous wave, go to R04_YU1108.
Else, go to Box R04_YUR16.
PATH ID:

R04_YU1103

Have you ever been curious about using snus?
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used snus.

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PATH ID:

R04_YU1206

Do you think you will try snus in the next year?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used snus.
PATH ID:

R04_YU1104

Do you think you will try snus soon?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used snus.
PATH ID:

R04_YU1105

If one of your best friends were to offer you snus, would you try it?
1

Definitely yes

GO TO BOX R04_YST01

2

Probably yes

GO TO BOX R04_YST01

3

Probably not

GO TO BOX R04_YST01

4

Definitely not

GO TO BOX R04_YST01

-8

DON'T KNOW

GO TO BOX R04_YST01

-7

REFUSED

GO TO BOX R04_YST01

ASK: Youth respondents who have heard of but never used snus.

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Wave 4 (version 3.0)
PATH ID:

R04_YU1006_NB

How old were you when you first tried snus, even one or two times?
1

|___|___| Years old

-8

DON'T KNOW

GO TO R04_YU1120_NB

-7

REFUSED

GO TO R04_YU1120_NB

ASK: New baseline youth respondents who have ever used snus.
DISPLAY: DISPLAY “Years old” AS A TITLE.
PATH ID:

R04_YU1006_NB_LC1

The computer recorded that you first used snus at age [R04_YU1006_NB]. That is older than you are
now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YU1006_NB

2

NEXT

GO TO R04_YU1108

ASK: IF R04_YU1006_NB > R04_YOUTHAGE.
PATH ID:

R04_YU1006_NB_LC2

The computer recorded that you first tried snus at age [R04_YU1006_NB]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YU1006_NB

2

NEXT

GO TO R04_YU1108

ASK: IF R04_YU1006_NB < 8.
PATH ID:

R04_YU1120_NB

When you first tried snus, even one or two times, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON’T KNOW

-7

REFUSED

ASK: New baseline youth respondents who did not know or refused to report the age they first tried
snus.

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PATH ID:

R04_YU1108

Was the first snus you used flavored to taste like menthol, mint, wintergreen, spearmint or frost, clove,
spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO BOX R04_YUR16

3

I don't know

GO TO BOX R04_YUR16

-8

DON'T KNOW

GO TO BOX R04_YUR16

-7

REFUSED

GO TO BOX R04_YUR16

ASK: Continuing youth respondents who have initiated snus use since the previous wave, and new
baseline youth respondents who have ever used snus.
PATH ID:

R04_YU1011

What flavor was that first snus you used? Choose all that apply.
1

Menthol or mint

2

Wintergreen, spearmint or frost

3

Clove or spice

4

Fruit

5

Chocolate

6

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

7

Candy or other sweets

8

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents whose first snus was flavored.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YUR16

Aged-up and continuing youth respondents who have ever used snus (and had not used 100 or more
times in the previous wave) and new cohort youth respondents who have ever used snus, go to
R04_YU1005.
Else, go to Box R04_YUR06.

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PATH ID:

R04_YU1005

How many times have you used snus in your entire life?
1

1

2

2 to 10

3

11 to 20

4

21 to 50

5

51 to 99

6

100 or more

-8

DON'T KNOW

-7

REFUSED

ASK: Aged-up and continuing youth respondents who have ever used snus and had not used 100 or
more times in the previous wave, and new cohort youth respondents who have ever used snus.
BOX ID:

R04_YUR06

Youth respondents who have ever used snus and had never used snus fairly regularly in the previous
wave, go to R04_YU1100.
Else, go to R04_YU1112.
PATH ID:

R04_YU1100

Have you ever used snus fairly regularly?
1

Yes

2

No

GO TO R04_YU1112

-8

DON'T KNOW

GO TO R04_YU1112

-7

REFUSED

GO TO R04_YU1112

ASK: Youth respondents who have ever used snus (and had never used fairly regularly in the previous
wave).
PATH ID:

R04_YU1007

How old were you when you first started using snus fairly regularly?
1

|__|__| Years old

-8

DON'T KNOW

GO TO R04_YU1121

-7

REFUSED

GO TO R04_YU1121

ASK: Youth respondents who have ever used snus fairly regularly and did not use fairly regularly in the
previous wave.
DISPLAY: DISPLAY "Years old" AS A TITLE.

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Wave 4 (version 3.0)
PATH ID:

R04_YU1007_LC1

The computer recorded that you started using snus fairly regularly at age [R04_YU1007]. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YU1007

2

NEXT

GO TO R04_YU1112

ASK: IF R04_YU1007< =8 OR R04_YU1007 < R04_YU1006_NB.
PATH ID:

R04_YU1007_LC2

The computer recorded that you started using snus fairly regularly at age [R04_YU1007]. That is older
than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YU1007

2

NEXT

GO TO R04_YU1112

ASK: IF R04_YU1007 > R04_YOUTHAGE.
PATH ID:

R04_YU1121

When you first started using snus fairly regularly, were you...
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who did not know or refused to report the age when they started using snus
fairly regularly.

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Wave 4 (version 3.0)
PATH ID:

R04_YU1112

When did you last use snus even one or two times?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YUV04

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YST01

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YST01

6

1 to 4 years ago

GO TO BOX R04_YST01

7

5 or more years ago

GO TO BOX R04_YST01

-8

DON'T KNOW

GO TO BOX R04_YST01

-7

REFUSED

GO TO BOX R04_YST01

ASK: Youth respondents who have ever used snus.
PATH ID:

R04_YU0100

When did you last use snus?
1

In the past hour

GO TO R04_YU0103

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YUV04

-8

DON'T KNOW

GO TO BOX R04_YUV04

-7

REFUSED

GO TO BOX R04_YUV04

ASK: Youth respondents who have used snus in the past 7 days.
PATH ID:

R04_YU0102

When you last used snus [FILL BASED ON R04_YU0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used snus today, yesterday, or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YU0100]: IF R04_YU0100 = 2, DISPLAY “today”.
ELSE, IF R04_YU0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YU0100 = 4, DISPLAY “the day before yesterday”.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YU0103

How many times [have/did] you [used/use] snus [FILL BASED ON R04_YU0100]?
1

I___I___I

-8

DON'T KNOW

GO TO BOX R04_YUV04

-7

REFUSED

GO TO BOX R04_YUV04

ASK: Youth respondents who have used snus in the past hour, sometime today, yesterday or the day
before yesterday.
DISPLAY: IF R04_YU0100 = 1, 2, DISPLAY “have” AND “used”.
ELSE, IF R04_YU0100 = 3, 4, DISPLAY “did” AND “use”.
FOR [FILL BASED ON R04_YU0100]:
IF R04_YU0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YU0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YU0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YU0103_LC1

The computer recorded that you used snus [R04_YU0103] times [today/yesterday/the day before
yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YU0103

2

NEXT

GO TO BOX R04_YUV04

ASK: IF R04_YU0103 > 20 OR R04_YU0103 = 11.
DISPLAY: IF R04_YU0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YU0100 = 3, DISPLAY "yesterday".
ELSE, IF R04_YU0100 = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YUV04

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PAST30DAY_SNUS = (Past 30 day snus users) Youth respondents who have used snus in the
past 30 days.
R04_PAST30DAY_SNUS_LEVEL = 1 (Past 30 day "Very Light" users) Youth respondents who have
used snus in the past 30 days, and have used snus 10 or fewer times in their lifetime.
R04_PAST30DAY_SNUS_LEVEL = 2 (Past 30 day "Not Light" users) Youth respondents who have
used snus in the past 30 days, and have used snus more than 10 times in their lifetime.

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Wave 4 (version 3.0)
PATH ID:

R04_YU1022

In the past 30 days, on how many days did you use snus?
1

|___|___| DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
DISPLAY: DISPLAY 'DAYS' AS A TITLE.
PATH ID:

R04_YU1023

In the past 30 days, on the days you used snus, how many times did you use snus per day?
1

|___|___|

-8

DON'T KNOW

GO TO R04_YU1130

-7

REFUSED

GO TO R04_YU1130

ASK: Past 30 day snus users.
PATH ID:

R04_YU1023_LC1

The computer recorded that on the days you used in the past 30 days, you used snus (R04_YU1023)
times a day, on average.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YU1023

2

NEXT

GO TO R04_YU1130

ASK: IF R04_YU1023 > 20.
PATH ID:

R04_YU1130

In the past 30 days, was any of the snus you used flavored to taste like menthol, mint, wintergreen,
spearmint or frost, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YU1142

3

I don't know

GO TO R04_YU1142

-8

DON'T KNOW

GO TO R04_YU1142

-7

REFUSED

GO TO R04_YU1142

ASK: Past 30 day snus users.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YU1131

Which flavors have you used in the past 30 days? Choose all that apply.
1

Menthol or mint

2

Wintergreen, spearmint or frost

3

Clove or spice

4

Fruit

5

Chocolate

6

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

7

Candy or other sweets

8

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored snus users.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YU1147

On the days you used snus in the past 30 days, how often did you use flavored snus?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored snus users.
DISPLAY: UNDERLINE "flavored".
PATH ID:

R04_YU1142

In the past 30 days, did anyone sell you snus?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YU1123

In the past 30 days, did anyone refuse to sell you snus because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
PATH ID:

R04_YU9041

What type of snus have you used?
[SHOW GENERIC IMAGE OF SNUS - BOTH LOOSE AND POUCHES]
1

Snus pouches

GO TO R04_YU1118

2

Loose snus

GO TO R04_YU1118

3

Both snus pouches and loose snus

-8

DON'T KNOW

GO TO R04_YU1118

-7

REFUSED

GO TO R04_YU1118

ASK: Past 30 day snus users.
PATH ID:

R04_YU9042

You mentioned you have used both loose snus and snus pouches. Which type of snus do you use most
often?
[SHOW GENERIC IMAGE OF SNUS - BOTH LOOSE AND POUCHES]
1

Snus pouches

2

Loose snus

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used both loose snus and snus pouches.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YU1118

[Please think of the type of snus you use most often when answering these questions.
]In the past 30 days, how did you usually get your own snus?
1

I gave someone else money to buy it for me

2

I bought it myself from a store

3

I asked someone to give me some

4

Someone offered it to me

5

I bought it from another person

6

I took it from a store or another person

7

I got it some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
DISPLAY: IF R04_YU9041 = 3, DISPLAY "Please think of the type of snus you use most often when
answering these questions.".
ELSE, DO NOT DISPLAY THIS TEXT.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
BOX ID:

R04_YUR04

Past 30 day snus users who usually buy themselves or who give someone else money to buy for them,
go to R04_YU1030.
Else, go to Box R04_YUR17.
PATH ID:

R04_YU1030

[When you give money to someone else, how do they/How do you] usually buy your snus?
1

In person

2

From the internet

GO TO R04_YU1034

3

By telephone

GO TO R04_YU1034

-8

DON'T KNOW

GO TO R04_YU1034

-7

REFUSED

GO TO R04_YU1034

ASK: Past 30 day snus users (including "very light" users) who usually buy snus pouches for
themselves or who gives someone else money to buy for them.
DISPLAY: IF R04_YU1118 = 1, DISPLAY “When you give money to someone else, how do they”.
ELSE, DISPLAY “How do you”.

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Wave 4 (version 3.0)
PATH ID:

R04_YU1033

Where do [you/they] buy your snus most of the time?
1

A convenience store or gas station

2

A supermarket, grocery store, or drug store

3

A warehouse club, such as Sam’s or Costco

4

A smoke shop, tobacco specialty store or tobacco outlet store

5

A duty free shop or military commissary

6

A bar, pub, restaurant or casino

7

A friend or relative

8

A swap meet or flea market

9

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users (including "very light" users) who buy snus for themselves or someone
else buys for them in person.
DISPLAY: IF R04_YU1118=1, DISPLAY “they”.
ELSE, IF R04_YU1118=2, display “you”.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
BOX ID:

R04_YUR20

Past 30 day "not-light" snus users who buy snus for themselves or someone else buys for them, go to
R04_YU1034.
Else, go to Box R04_YUR17.
PATH ID:

R04_YU1034

Think about the last time you [bought/gave money to someone else to buy you] snus. How much did you
pay for a container of snus?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YUR18

-7

REFUSED

GO TO BOX R04_YUR18

ASK: Past 30 day "not-light" snus users who buy snus for themselves or someone else buys for them.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
IF R04_YU1118 = 1, DISPLAY "gave money to someone else to buy you".
ELSE, IF YU1118 = 2, DISPLAY "bought".

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PATH ID:

R04_YU1034_LC1

The computer recorded that you paid $[R04_YU1034] for a container of snus. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YU1034

2

NEXT

GO TO BOX R04_YUR18

ASK: IF R04_YU1034_D > 6 OR R04_YU1034_D < 1.
BOX ID:

R04_YUR18

Past 30 day "not-light" users of pouched snus who buy for themselves or someone else buys for them,
go to R04_YU9001.
Else, go to Box R04_YUR17.
PATH ID:

R04_YU9001

How many pouches are in the container of snus that you usually buy?
1

I___I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" snus pouch users who buy snus pouches for themselves or someone else
buys for them.
BOX ID:

R04_YUR17

Past 30 day "not light" users, go to R04_YU1047.
Else, past 30 day users, go to R04_YU1945.
Else, go to Box R04_YUD02.
PATH ID:

R04_YU1047

Do you have a regular brand of snus that you usually use?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" snus users.

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PATH ID:

R04_YU1945

Do you know the name of the brand of snus you [usually use/last used]?
1

Yes

2

No

GO TO BOX R04_YUD02

-8

DON'T KNOW

GO TO BOX R04_YUD02

-7

REFUSED

GO TO BOX R04_YUD02

ASK: Past 30 day snus users.
DISPLAY: IF R04_YU1047 = 1, DISPLAY “usually use”.
ELSE, DISPLAY “last used”.
UNDERLINE "name of the brand".
PATH ID:

R04_YU1048

What brand of snus [do/did] you [usually/last] use?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users who know the brand name.
DISPLAY: IF R04_YU1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[If multiple screens] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[If single screen OR last screen of multiple screens] DISPLAY: If you do not see it below, touch the box
marked “Something else”.
BOX ID:

R04_YUR09

If youth respondent selects brand in R04_YU1048_BRAND, go to R04_YU1070_PRODUCT.
Else, if youth respondent selects "Something else" in R04_YU1048_BRAND, go to R04_YU1049.
Else, go to Box R04_YUD02.
PATH ID:

R04_YU1049

You said that your brand was not listed. What is it?
1

__________________________

GO TO BOX R04_YUD02

-8

DON'T KNOW

GO TO BOX R04_YUD02

-7

REFUSED

GO TO BOX R04_YUD02

ASK: Past 30 day snus users that know the name of the brand they use who selected "Something else"
for their brand.

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PATH ID:

R04_YU1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] [do/did] you [usually/last] use?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users that know the name of the brand they use who selected a brand image.
DISPLAY: IF R04_YU1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[If multiple screens] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[If single screen OR last screen of multiple screens] DISPLAY: If you do not see it below, touch the box
marked “Something else”.
BOX ID:

R04_YUR10

If youth respondent selects "Something else" in R04_YU1070_PRODUCT, go to R04_YU1071.
Else, youth respondents who have used snus today, yesterday, or the day before yesterday AND who
selected a valid brand AND valid product, go to R04_YU0104.
Else, go to Box R04_YUD02.
PATH ID:

R04_YU1071

You said that the type of [BRANDFILL]s that you use was not listed. What type is it?
1

__________________________

GO TO BOX R04_YUD02

-8

DON'T KNOW

GO TO BOX R04_YUD02

-7

REFUSED

GO TO BOX R04_YUD02

ASK: Past 30 day snus users that know the name of the brand they use who selected a brand image,
but selected "Something else" for their subbrand image.
BOX ID:

R04_YUR19

Youth respondents who used snus today, yesterday or the day before yesterday AND who selected a
valid brand in R04_YU1048_BRAND AND valid product in R04_YU1070_PRODUCT, go to
R04_YU0104.
Else, go to Box R04_YUD02.

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PATH ID:

R04_YU0104

You said earlier that you last used snus [TIME OF LAST USE].
Think about the very last time you used it. Was the brand [NEQBRAND]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used snus in the past hour, sometime today, yesterday, or the day
before yesterday AND who selected a valid brand AND valid product.
DISPLAY: IF R04_YU0100 = 1, FILL [TIME OF LAST USE] WITH “in the past hour”.
ELSE, IF R04_YU0100 = 2, FILL [TIME OF LAST USE] WITH “sometime today”.
ELSE, IF R04_YU0100 = 3, FILL [TIME OF LAST USE] WITH “yesterday”.
ELSE, IF R04_YU0100 = 4, FILL [TIME OF LAST USE] WITH “the day before yesterday”.
FILL [NEQBRAND] WITH RESPONSE TO R04_YU1070_PRODUCT.
BOX ID:

R04_YUD02

Display question R04_YU1060, R04_YU1085, R04_YU1062, R04_YU1075, R04_YU1063,
R04_YU1064, R04_YU1065, R04_YU1067, R04_YU1076, on one screen. Show the intro/transition text
from R04_YU1060 first, then show each item with a Yes/No response. As each item is answered, show
the next one.
PROGRAM: Randomize order of R04_YU1060 through R04_YU1076.
PATH ID:

R04_YU1060

The next questions are about the reasons people use snus. Please select which reasons apply to you.
I use snus because…
It is affordable.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.

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PATH ID:

R04_YU1085

I can use snus at times when or in places where smoking cigarettes isn’t allowed.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
PATH ID:

R04_YU1062

They might be less harmful to me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
PATH ID:

R04_YU1075

They might be less harmful to people around me than cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
PATH ID:

R04_YU1063

Snus comes in flavors I like.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
BOX ID:

R04_YUR11

Past 30 day snus users who have also smoked cigarettes in the past year, go to R04_YU1064.
Else, go to R04_YU1065.

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PATH ID:

R04_YU1064

Using snus helps people quit smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users who have also smoked cigarettes in the past year.
PATH ID:

R04_YU1065

Snus doesn’t smell.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
PATH ID:

R04_YU1067

Snus doesn’t bother non-tobacco users.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
PATH ID:

R04_YU1076

No one can tell when I am using snus.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
BOX ID:

R04_YUR12

Past 30 day snus users who have also smoked cigarettes in the past 30 days, go to R04_YU1086.
Else, go to Box R04_YST01.

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PATH ID:

R04_YU1086

In the past 30 days, have you used snus at times when or in places where you could not smoke
cigarettes?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users who have also smoked cigarettes in the past 30 days.

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SMOKELESS TOBACCO
BOX ID:

R04_YST01

The next questions are about smokeless tobacco other than snus.
Smokeless tobacco is a type of tobacco which you put in your mouth and chew, suck, or spit. It may be
loose or packaged in small pouches that you can place directly in your mouth. There are many kinds of
smokeless tobacco, such as dip, spit, moist snuff, pouches and chewing tobacco. Common brands
include Skoal, Copenhagen, Grizzly, Redman, and Levi Garrett.
The questions will use the phrase “smokeless tobacco” to refer to these products. Please think about
smokeless tobacco products, not including snus, as you answer these questions.
[SHOW GENERIC IMAGE OF SMOKELESS PRODUCTS, EXCLUDING SNUS]
BOX ID:

R04_YSR01

New baseline youth respondents, go to R04_YS1001_NB.
Continuing youth respondents, go to R04_YS1002_12M.
PATH ID:

R04_YS1001_NB

Have you ever seen or heard of smokeless tobacco, such as dip, spit, moist snuff, pouches or chewing
tobacco, before this study?
[SHOW GENERIC IMAGE OF SMOKELESS TOBACCO (EXCLUDING SNUS)]
1

Yes

2

No

GO TO BOX R04_YDT01

-8

DON'T KNOW

GO TO BOX R04_YDT01

-7

REFUSED

GO TO BOX R04_YDT01

ASK: New baseline youth respondents.
PATH ID:

R04_YS1002_NB

Have you ever used smokeless tobacco, such as dip, spit, moist snuff, pouches or chewing tobacco,
even one or two times?
[SHOW GENERIC IMAGE OF SMOKELESS TOBACCO (EXCLUDING SNUS)]
1

Yes

2

No

GO TO BOX R04_YSV03

-8

DON'T KNOW

GO TO BOX R04_YSV03

-7

REFUSED

GO TO BOX R04_YSV03

ASK: New baseline youth respondents who have heard of smokeless tobacco.
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BOX ID:

R04_YSV03

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_SMKLS_YOUTH = 1 (Ever user) Youth respondents who have ever used
smokeless tobacco.
R04_EVER_NEVER_SMKLS_YOUTH = 2 (Never user) Youth respondents who have not ever used
smokeless tobacco.
R04_INIT_SMKLS_YOUTH = 1 (Initiator) Youth respondents who initiated smokeless tobacco use
between Waves or new baseline youth respondents who have ever used smokeless tobacco.
BOX ID:

R04_YSR02

New baseline youth respondents who have never heard of smokeless tobacco, go to Box R04_YDT01.
Else, continuing youth respondents who have never used smokeless tobacco and new baseline youth
respondents who have heard of smokeless tobacco but have never used it, go to R04_YS1103.
Else, new baseline youth respondents who have ever used smokeless tobacco, go to R04_YS1006_NB.
Else, continuing youth respondents who initiated smokeless tobacco use since the previous wave, go to
R04_YS1108.
Else, go to Box R04_YSR13.
PATH ID:

R04_YS1103

Have you ever been curious about using smokeless tobacco?
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used smokeless tobacco.
PATH ID:

R04_YS1206

Do you think you will try smokeless tobacco in the next year?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used smokeless tobacco.

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PATH ID:

R04_YS1104

Do you think you will try smokeless tobacco soon?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used smokeless tobacco.
PATH ID:

R04_YS1105

If one of your best friends were to offer you smokeless tobacco, would you try it?
1

Definitely yes

GO TO BOX R04_YDT01

2

Probably yes

GO TO BOX R04_YDT01

3

Probably not

GO TO BOX R04_YDT01

4

Definitely not

GO TO BOX R04_YDT01

-8

DON'T KNOW

GO TO BOX R04_YDT01

-7

REFUSED

GO TO BOX R04_YDT01

ASK: Youth respondents who have heard of but never used smokeless tobacco.
PATH ID:

R04_YS1006_NB

How old were you when you first tried smokeless tobacco, even one or two times?
1

|___|___| Years old

-8

DON'T KNOW

GO TO R04_YS1120_NB

-7

REFUSED

GO TO R04_YS1120_NB

ASK: New baseline youth respondents who have ever used smokeless tobacco.
DISPLAY: DISPLAY “Years old” AS A TITLE.
PATH ID:

R04_YS1006_NB_LC1

The computer recorded that you first tried smokeless tobacco at age [R04_YS1006_NB]. That is older
than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YS1006_NB

2

NEXT

GO TO R04_YS1108

ASK: IF R04_YS1006_NB > R04_YOUTHAGE.
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PATH ID:

R04_YS1006_NB_LC2

The computer recorded that you first tried smokeless tobacco at age [R04_YS1006_NB]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YS1006_NB

2

NEXT

GO TO R04_YS1108

ASK: IF R04_YS1006_NB < 8.
PATH ID:

R04_YS1120_NB

When you first tried smokeless tobacco, even one or two times, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON’T KNOW

-7

REFUSED

ASK: New baseline youth respondents who did not know or refused to report the age they first tried
smokeless tobacco.
PATH ID:

R04_YS1108

Was the first smokeless tobacco product you used flavored to taste like menthol, mint, wintergreen,
spearmint or frost, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO BOX R04_YSR13

3

I don't know

GO TO BOX R04_YSR13

-8

DON'T KNOW

GO TO BOX R04_YSR13

-7

REFUSED

GO TO BOX R04_YSR13

ASK: Continuing youth respondents who have initiated use since the previous wave and new baseline
youth respondents who have ever used smokeless tobacco.

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PATH ID:

R04_YS1011

What flavor was that first smokeless tobacco product you used? Choose all that apply.
1

Menthol or mint

2

Wintergreen, spearmint or frost

3

Clove or spice

4

Fruit

5

Chocolate

6

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

7

Candy or other sweets

8

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents whose first smokeless tobacco was flavored.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YSR13

Aged-up and continuing youth respondents who have ever used smokeless tobacco (and had not used
100 or more times in the previous wave) and new cohort youth respondents who have ever used
smokeless tobacco, go to R04_YS1005.
Else, go to Box R04_YSR06.

PATH ID:

R04_YS1005

How many times have you used smokeless tobacco in your entire life?
1

1

2

2 to 10

3

11 to 20

4

21 to 50

5

51 to 99

6

100 or more

-8

DON'T KNOW

-7

REFUSED

ASK: Aged-up and continuing youth respondents who have ever used smokeless tobacco and had not
used 100 or more times in the previous wave, and new cohort youth respondents who have ever used
smokeless tobacco.

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BOX ID:

R04_YSR06

Youth respondents who have ever used smokeless tobacco and had never used smokeless tobacco
fairly regularly in the previous wave, go to R04_YS1100.
Else, go to R04_YS1112.
PATH ID:

R04_YS1100

Have you ever used smokeless tobacco fairly regularly?
1

Yes

2

No

GO TO R04_YS1112

-8

DON'T KNOW

GO TO R04_YS1112

-7

REFUSED

GO TO R04_YS1112

ASK: Youth respondents who have ever used smokeless tobacco (and had never used fairly regularly in
the previous wave).
PATH ID:

R04_YS1007

How old were you when you first started using smokeless tobacco fairly regularly?
1

|__|__| Years old

-8

DON'T KNOW

GO TO R04_YS1121

-7

REFUSED

GO TO R04_YS1121

ASK: Youth respondents who have ever used smokeless tobacco fairly regularly and did not use fairly
regularly in the previous wave.
DISPLAY: DISPLAY "Years old" AS A TITLE.
PATH ID:

R04_YS1007_LC1

The computer recorded that you started using smokeless tobacco fairly regularly at age [R04_YS1007].
Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YS1007

2

NEXT

GO TO R04_YS1112

ASK: IF R04_YS1007 < =8 OR R04_YS1007 < R04_YS1006_NB.

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PATH ID:

R04_YS1007_LC2

The computer recorded that you started using smokeless tobacco fairly regularly at age [R04_YS1007].
That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YS1007

2

NEXT

GO TO R04_YS1112

ASK: IF R04_YS1007 > R04_YOUTHAGE.
PATH ID:

R04_YS1121

When you first started using smokeless tobacco fairly regularly, were you...
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who did not know or refused to report the age when they started using
smokeless tobacco fairly regularly.
PATH ID:

R04_YS1112

When did you last use smokeless tobacco, even one or two times?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YSV04

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YDT01

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YDT01

6

1 to 4 years ago

GO TO BOX R04_YDT01

7

5 or more years ago

GO TO BOX R04_YDT01

-8

DON'T KNOW

GO TO BOX R04_YDT01

-7

REFUSED

GO TO BOX R04_YDT01

ASK: Youth respondents who have ever used smokeless tobacco.

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PATH ID:

R04_YS0100

When did you last use smokeless tobacco (not including snus)?
1

In the past hour

2

Sometime today

GO TO R04_YS0103

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YSV04

-8

DON'T KNOW

GO TO BOX R04_YSV04

-7

REFUSED

GO TO BOX R04_YSV04

ASK: Youth respondents who have used smokeless tobacco in the past 7 days.
PATH ID:

R04_YS0102

When you last used smokeless tobacco (not including snus) [FILL BASED ON R04_YS0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used smokeless tobacco today, yesterday, or the day before
yesterday.
DISPLAY: FOR [FILL BASED ON R04_YS0100]: IF R04_YS0100 = 2, DISPLAY “today”.
ELSE, IF R04_YS0100 = 3, DISPLAY "yesterday".
ELSE, IF R04_YS0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YS0103

How many times [have/did] you [used/use] smokeless tobacco (not including snus) [FILL BASED ON
R04_YS0100]?
1

I__I__I

-8

DON'T KNOW

GO TO BOX R04_YSV04

-7

REFUSED

GO TO BOX R04_YSV04

ASK: Youth respondents who have used smokeless tobacco in the past hour, sometime today,
yesterday or the day before yesterday.
DISPLAY: IF R04_YS0100 = 1, 2, DISPLAY “have” AND “used”.
ELSE, IF R04_YS0100 = 3, 4, DISPLAY “did” AND “use”.
FOR [FILL BASED ON R04_YS0100]: IF R04_YS0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YS0100 = 3, DISPLAY "yesterday".
ELSE, IF R04_YS0100 = 4, DISPLAY “the day before yesterday”.

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PATH ID:

R04_YS0103_LC1

The computer recorded that you used smokeless tobacco [R04_YS0103] times [today/yesterday/the day
before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YS0103

2

NEXT

GO TO BOX R04_YSV04

ASK: IF R04_YS0103 > 20 OR R04_YS0103 = 11.
DISPLAY: IF R04_YS0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YS0100 = 3, DISPLAY "yesterday".
ELSE, IF R04_YS0100 = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YSV04

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PAST30DAY_SMKLS = ("Past 30 day users") Youth respondents who have used smokeless
tobacco in the past 30 days.
R04_PAST30DAY_SMKLS_LEVEL = 1 (Past 30 day "Very Light" users) Youth respondents who
have used smokeless tobacco in the past 30 days, and have used 10 times or less in their lifetime.
R04_PAST30DAY_SMKLS_LEVEL = 2 (Past 30 day "Not Light" users) Youth respondents who have
used smokeless tobacco in the past 30 days, and have used more than 10 times in their lifetime.
PATH ID:

R04_YS1022

In the past 30 days, on how many days did you use smokeless tobacco?
1

|___|___| DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
DISPLAY: DISPLAY 'DAYS' AS A TITLE.
PATH ID:

R04_YS1023

In the past 30 days, on the days you used smokeless tobacco, how many times did you use smokeless
tobacco per day?
1

|___|___|

-8

DON'T KNOW

GO TO R04_YS1130

-7

REFUSED

GO TO R04_YS1130

ASK: Past 30 day smokeless tobacco users.

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Wave 4 (version 3.0)
PATH ID:

R04_YS1023_LC1

The computer recorded that on the days you used in the past 30 days, you used smokeless tobacco
(R04_YS1023) times a day, on average.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YS1023

2

NEXT

GO TO R04_YS1130

ASK: IF R04_YS1023 > 10.
PATH ID:

R04_YS1130

In the past 30 days, was any of the smokeless tobacco you used flavored to taste like menthol, mint,
wintergreen, spearmint or frost, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YS1142

3

I don't know

GO TO R04_YS1142

-8

DON'T KNOW

GO TO R04_YS1142

-7

REFUSED

GO TO R04_YS1142

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS1131

Which flavors have you used in the past 30 days? Choose all that apply.
1

Menthol or mint

2

Wintergreen, spearmint or frost

3

Clove or spice

4

Fruit

5

Chocolate

6

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

7

Candy or other sweets

8

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored smokeless tobacco users.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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Wave 4 (version 3.0)
PATH ID:

R04_YS1147

On the days you used smokeless tobacco in the past 30 days, how often did you use flavored
smokeless tobacco?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored smokeless tobacco users.
DISPLAY: UNDERLINE "flavored".
PATH ID:

R04_YS1142

In the past 30 days, did anyone sell you smokeless tobacco?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS1123

In the past 30 days, did anyone refuse to sell you smokeless tobacco because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.

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Wave 4 (version 3.0)
PATH ID:

R04_YS9041

What type of smokeless tobacco have you used?
[SHOW GENERIC IMAGE OF SMOKELESS TOBACCO (EXCLUDING SNUS)]
1

Loose smokeless tobacco (such as dip, spit or chewing tobacco)

GO TO R04_YS1118

2

Smokeless tobacco pouches (not including snus)

GO TO R04_YS1118

3

Both loose and pouched smokeless tobacco

-8

DON'T KNOW

GO TO R04_YS1118

-7

REFUSED

GO TO R04_YS1118

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS9042

You mentioned you have used both loose and pouched smokeless tobacco. Which type of smokeless
tobacco do you use most often?
[SHOW GENERIC IMAGE OF SMOKELESS TOBACCO - BOTH LOOSE AND POUCHES]
1

Loose smokeless tobacco (such as dip, spit or chewing tobacco)

2

Smokeless tobacco pouches (not including snus)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used both loose and pouched smokeless tobacco.
PATH ID:

R04_YS1118

In the past 30 days, how did you usually get your own smokeless tobacco?
1

I gave someone else money to buy it for me

2

I bought it myself from a store

3

I asked someone to give me some

4

Someone offered it to me

5

I bought it from another person

6

I took it from a store or another person

7

I got it some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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BOX ID:

R04_YSR04

Past 30 day users who usually buy smokeless tobacco themselves or give someone else money to buy
for them, go to R04_YS1030.
Else, go to Box R04_YSR16.
PATH ID:

R04_YS1030

[When you give money to someone else, how do they/How do you] usually buy your smokeless
tobacco?
1

In person

2

From the internet

GO TO R04_YS1034

3

By telephone

GO TO R04_YS1034

-8

DON'T KNOW

GO TO R04_YS1034

-7

REFUSED

GO TO R04_YS1034

ASK: Past 30 day smokeless tobacco users (including "very light" users) who buy smokeless tobacco
for themselves or someone else buys for them.
DISPLAY: IF R04_YS1118=1, DISPLAY “When you give money to someone else, how do they”.
ELSE, IF R04_YS1118=2, DISPLAY “How do you”.
PATH ID:

R04_YS1033

Where do [you/they] buy your smokeless tobacco most of the time?
1

A convenience store or gas station

2

A supermarket, grocery store, or drug store

3

A warehouse club, such as Sam’s or Costco

4

A smoke shop, tobacco specialty store or tobacco outlet store

5

A duty free shop or military commissary

6

A bar, pub, restaurant or casino

7

A friend or relative

8

A swap meet or flea market

9

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users (including "very light" users) who buy smokeless tobacco
for themselves or someone else buys for them in person.
DISPLAY: IF R04_YS1118=1, DISPLAY “they”.
ELSE, IF R04_YS1118=2, DISPLAY “you”
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”

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BOX ID:

R04_YSR20

Past 30 day "not-light" smokeless tobacco users who buy smokeless tobacco for themselves or
someone else buys for them, go to R04_YS1034.
Else, go to Box R04_YSR16.
PATH ID:

R04_YS1034

Think about the last time you [bought/gave money to someone else to buy you] smokeless tobacco.
How much did you pay for a container of smokeless tobacco?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YSR18

-7

REFUSED

GO TO BOX R04_YSR18

ASK: Past 30 day "not-light" smokeless tobacco users who buy smokeless tobacco for themselves or
someone else buys for them.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
IF R04_YS1118=1, DISPLAY "gave money to someone else to buy you".
ELSE, IF YS1118=2, DISPLAY "bought".
PATH ID:

R04_YS1034_LC1

The computer recorded that you paid $[R04_YS1034] for a container of smokeless tobacco. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YS1034

2

NEXT

GO TO BOX R04_YSR18

ASK: IF R04_YS1034_D > 6 OR R04_YS1034_D < 1.
BOX ID:

R04_YSR18

Past 30 day "not-light" users of pouched smokeless tobacco who buy for themselves or someone else
buys for them, go to R04_YS9001.
Else, go to Box R04_YSR16.
PATH ID:

R04_YS9001

How many pouches are in the container of smokeless tobacco that you usually buy?
1

I___I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" users of pouched smokeless tobacco who buy for themselves or someone
else buys for them.

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BOX ID:

R04_YSR16

Past 30 day "not light" users, go to R04_YS1047.
Else, past 30 day users, go to R04_YS1945.
Else, go to Box R04_YSD02.
PATH ID:

R04_YS1047

Do you have a regular brand of smokeless tobacco that you usually use?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" smokeless tobacco users.
PATH ID:

R04_YS1945

Do you know the name of the brand of smokeless tobacco you [usually use/last used]?
1

Yes

2

No

GO TO BOX R04_YSD02

-8

DON'T KNOW

GO TO BOX R04_YSD02

-7

REFUSED

GO TO BOX R04_YSD02

ASK: Past 30 day smokeless tobacco users.
DISPLAY: IF R04_YS1047 = 1, DISPLAY “usually use”.
ELSE, DISPLAY “last used”.
UNDERLINE "name of the brand".

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YS1048

What brand of smokeless tobacco [do/did] you [usually/last] use?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users who know the brand name.
DISPLAY: IF R04_YS1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[IF MULTIPLE SCREENS] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS] DISPLAY: If you do not see it
below, touch the box marked “Something else”.
BOX ID:

R04_YSR09

If respondent selects brand in R04_YS1048_BRAND, go to R04_YS1070_PRODUCT.
Else, if respondent selects "Something else" in R04_YS1048_BRAND, go to R04_YS1049.
Else, go to Box R04_YSD02.
PATH ID:

R04_YS1049

You said that your brand was not listed. What is it?
1

__________________________

GO TO BOX R04_YSD02

-8

DON'T KNOW

GO TO BOX R04_YSD02

-7

REFUSED

GO TO BOX R04_YSD02

ASK: Past 30 day smokeless tobacco users that know the name of the brand they use who selected
"Something else" for their brand.

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Wave 4 (version 3.0)
PATH ID:

R04_YS1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] [do/did] you [usually/last] use?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users that know the name of the brand they use who selected a
brand image.
DISPLAY: IF R04_YS1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[IF MULTIPLE SCREENS] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS] DISPLAY: If you do not see it
below, touch the box marked “Something else”.
BOX ID:

R04_YSR10

If youth respondent selects "Something else" in R04_YS1070_PRODUCT, go to R04_YS1071.
Else, youth respondents who have used smokeless tobacco today, yesterday, or the day before
yesterday AND who selected a valid brand AND valid product, go to R04_YS0104.
Else, go to Box R04_YSD02.
PATH ID:

R04_YS1071

You said that the type of [BRANDFILL]s that you use was not listed. What type is it?
1

__________________________

GO TO BOX R04_YSD02

-8

DON'T KNOW

GO TO BOX R04_YSD02

-7

REFUSED

GO TO BOX R04_YSD02

ASK: Past 30 day smokeless tobacco users that know the name of the brand they use who selected a
brand image, but selected "Something else" for their subbrand image.
BOX ID:

R04_YSR19

Youth respondents who used smokeless tobacco today, yesterday or the day before yesterday AND
who selected a valid brand in R04_YS1048_BRAND AND valid product in R04_YS1070_PRODUCT, go
to R04_YS0104.
Else, go to Box R04_YSD02.

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Wave 4 (version 3.0)
PATH ID:

R04_YS0104

You said earlier that you used smokeless tobacco [TIME OF LAST USE].
Think about the very last time you used it. Was the brand [NEQBRAND]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used smokeless tobacco in the past hour, sometime today,
yesterday or the day before yesterday AND who selected a product AND valid sub brand.
DISPLAY: IF R04_YS0100 = 1, FILL [TIME OF LAST USE] WITH “in the past hour”.
ELSE, IF R04_YS0100 = 2, FILL [TIME OF LAST USE] WITH “sometime today”.
ELSE, IF R04_YS0100 = 3, FILL [TIME OF LAST USE] WITH “yesterday”.
ELSE, IF R04_YS0100 = 4, FILL [TIME OF LAST USE] WITH “the day before yesterday”.
FILL [NEQBRAND] WITH RESPONSE TO R04_YS1070_PRODUCT.
BOX ID:

R04_YSD02

Display question R04_YS1060, R04_YS1085, R04_YS1062, R04_YS1075, R04_YS1063,
R04_YS1064, R04_YS1065, R04_YS1067 on one screen. Show the intro/transition text from
R04_YS1060 first, then show each item with a Yes/No response. As each item is answered, show the
next one.
PROGRAM: Randomize order of R04_YS1060 through R04_YS1067.
PATH ID:

R04_YS1060

The next questions are about the reasons people use smokeless tobacco. Please select which reasons
apply to you.
I use smokeless tobacco because…
It is affordable.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.

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Wave 4 (version 3.0)
PATH ID:

R04_YS1085

I can use smokeless tobacco at times when or in places where smoking cigarettes isn’t allowed.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS1062

It might be less harmful to me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS1075

It might be less harmful to people around me than cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS1063

Smokeless tobacco comes in flavors I like.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
BOX ID:

R04_YSR11

Past 30 day smokeless tobacco users who have also smoked cigarettes in the past year, go to
R04_YS1064.
Else, go to R04_YS1065.

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Wave 4 (version 3.0)
PATH ID:

R04_YS1064

Using smokeless tobacco helps people quit smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users who have also smoked cigarettes in the past year.
PATH ID:

R04_YS1065

Smokeless tobacco doesn’t smell.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS1067

Smokeless tobacco doesn’t bother non-tobacco users.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
BOX ID:

R04_YSR12

Past 30 day smokeless tobacco users who have also smoked cigarettes in the past 30 days, go to
R04_YS1086.
Else, go to Box R04_YDT01.
PATH ID:

R04_YS1086

In the past 30 days, have you used smokeless tobacco at times when or in places where you could not
smoke cigarettes?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users who have also smoked cigarettes in the past 30 days.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

DISSOLVABLE TOBACCO
BOX ID:

R04_YDT01

The next questions ask about another type of tobacco called dissolvable tobacco. You don’t smoke
dissolvable tobacco products – they are made of finely ground flavored tobacco that dissolves in your
mouth.
Dissolvable tobacco products come in a variety of shapes, including small round pellets, thin sticks and
flat strips. Some common brands are Ariva, Stonewall, or Camel Orbs, Sticks or Strips.
[SHOW GENERIC IMAGE OF DISSOLVABLES]
BOX ID:

R04_YDR01

New baseline youth respondents, go to R04_YD1001_NB.
Continuing youth respondents, go to R04_YD1002_12M.
PATH ID:

R04_YD1001_NB

Have you ever seen or heard of dissolvable tobacco before this study?
[SHOW GENERIC IMAGE OF DISSOLVABLES]
1

Yes

2

No

GO TO BOX R04_YDV01

-8

DON'T KNOW

GO TO BOX R04_YDV01

-7

REFUSED

GO TO BOX R04_YDV01

ASK: New baseline youth respondents.
PATH ID:

R04_YD1002_NB

Have you ever used dissolvable tobacco products, such as Ariva, Stonewall, or Camel Orbs, Sticks, or
Strips, even one or two times?
[SHOW GENERIC IMAGE OF DISSOLVABLES]
1

Yes

2

No

GO TO BOX R04_YDV01

-8

DON'T KNOW

GO TO BOX R04_YDV01

-7

REFUSED

GO TO BOX R04_YDV01

ASK: New baseline youth respondents who have heard of dissolvable tobacco.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YD1002_12M

In the past 12 months, have you used dissolvable tobacco products, such as Ariva, Stonewall, or Camel
Orbs, Sticks, or Strips, even one or two times?
[SHOW GENERIC IMAGE OF DISSOLVABLES]
1

Yes

2

No

GO TO BOX R04_YDV01

-8

DON'T KNOW

GO TO BOX R04_YDV01

-7

REFUSED

GO TO BOX R04_YDV01

ASK: Continuing youth respondents and new baseline youth respondents who have ever used
dissolvable tobacco.
PATH ID:

R04_YD1002_30D

In the past 30 days, have you used dissolvable tobacco products, such as Ariva, Stonewall, or Camel
Orbs, Sticks, or Strips, even one or two times?
[SHOW GENERIC IMAGE OF DISSOLVABLES]
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used dissolvable tobacco in the past 12 months.
BOX ID:

R04_YDV01

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_DISSBL_YOUTH = 1 (Ever user) Youth respondents who have ever used
dissolvable tobacco.
R04_EVER_NEVER_DISSBL_YOUTH = 2 (Never user) Youth respondents who have not ever used
dissolvable tobacco.
R04_INIT_DISSBL_YOUTH = 1 (Initiator) Youth respondents who initiated dissolvable tobacco use
between Waves new baseline youth respondents who have ever used dissolvable tobacco.
R04_PAST30DAY_DISS = 1 (Past 30 day dissolvable users) Youth respondents who used
dissolvable tobacco in the past 30 days.

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Wave 4 (version 3.0)

BIDIS AND KRETEKS
BOX ID:

R04_YBT01

The next questions are about bidis or kreteks. Bidis are small brown cigarettes wrapped in a leaf and
typically tied on one or both ends with string. Kreteks are clove cigarettes.
[SHOW GENERIC IMAGE OF BIDIS AND KRETEKS]
BOX ID:

R04_YBR01

New baseline youth respondents, go to R04_YB9101_NB.
Continuing youth respondents, go to Box R04_YBR03.
PATH ID:

R04_YB9101_NB

Which of the following tobacco products have you ever seen or heard of before this study? Choose all
that apply.
[SHOW GENERIC IMAGE OF BIDIS AND KRETEKS]
1

Bidis

2

Kreteks

3

Never seen or heard of either of these products

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents.
BOX ID:

R04_YBR02

New baseline youth respondents who have heard of bidis and/or kreteks, go to R04_YB9102_NB.
Else, go to Box R04_YBV01.

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Wave 4 (version 3.0)
PATH ID:

R04_YB9102_NB

Which of the following tobacco products have you ever tried, even one or two times? Choose all that
apply.
[SHOW GENERIC IMAGE OF BIDIS AND KRETEKS]
1

Bidis

2

Kreteks

3

I have never tried either of these products

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have heard of bidis and/or kreteks.
BOX ID:

R04_YBR03

Continuing youth respondents and new baseline youth respondents who have ever smoked bidis or
kreteks, go to R04_YB9102_12M.
Else, go to Box R04_YBV01.
PATH ID:

R04_YB9102_12M

In the past 12 months, which of the following tobacco products have you tried, even one or two times?
Choose all that apply.
[SHOW GENERIC IMAGE OF BIDIS AND KRETEKS]
1

Bidis

2

Kreteks

3

I have not tried either of these products

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents and new baseline youth respondents who have ever smoked bidis
and/or kreteks
BOX ID:

R04_YBR04

Youth respondents who have smoked bidis and/or kreteks in the past 12 months, go to
R04_YB9102_30D.
Else, go to Box R04_YBV01.

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Wave 4 (version 3.0)
PATH ID:

R04_YB9102_30D

In the past 30 days, which of the following tobacco products have you tried, even one or two times?
Choose all that apply.
[SHOW GENERIC IMAGE OF BIDIS AND KRETEKS]
1

Bidis

2

Kreteks

3

I have not tried either of these products

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked bidis and/or kreteks in the past 12 months.
BOX ID:

R04_YBV01

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_BIDI_YOUTH = 1 (Ever user) Youth respondents who have ever smoked a bidi.
R04_EVER_NEVER_BIDI_YOUTH = 2 (Never user) Youth respondents who have not ever smoked a
bidi.
R04_INIT_BIDI_YOUTH = 1 (Initiator) Youth respondents who initiated bidi use between Waves or new
baseline youth respondents who have ever smoked a bidi.
R04_PAST30DAY_BIDI = 1 Youth respondents who used bidis in the past 30 days.
R04_EVER_NEVER_KRETEK_YOUTH = 1 (Ever user) Youth respondents who have ever smoked a
kretek.
R04_EVER_NEVER_KRETEK_YOUTH = 2 (Never user) Youth respondents who have not ever
smoked a kretek.
R04_INIT_KRETEK_YOUTH = 1 (Initiator) Youth respondents who initiated kretek use between Waves
or new baseline youth respondents who have ever smoked a kretek.
R04_PAST30DAY_KRETEK = 1 Youth respondents who used kreteks in the past 30 days.

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OTHER TOBACCO
PATH ID:

R04_YZ1002

You were just asked questions about cigarettes, electronic nicotine products, traditional cigars,
cigarillos, filtered cigars, pipes, hookahs, snus, smokeless tobacco, dissolvable tobacco, bidis and
kreteks.
Besides these products, have you ever used any other tobacco products? Please do not include
products such as a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge, or pill.
1

Yes (SPECIFY)

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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NEW PRODUCT - PLACEHOLDER
BOX ID:

R04_YZV01

CREATE THE FOLLOWING VARIABLE AND SET = 2: R04_NEW_PRODUCT_SECTION.
BOX ID:

R04_YZR01

If R04_NEW_PRODUCT_SECTION = 1, continue with R04_YZ1005.
Else, go to Box R04_YVV01.
PATH ID:

R04_YZ1005

How many [units of tobacco product] have you [smoked/used] in your entire life?
1

1 or more [units] but never a whole one

2

1 to 10

3

11 to 20

4

21 to 50

5

51 to 99

6

100 or more

7

I have never [smoked/used] [tobacco product]

-8

DON'T KNOW

-7

REFUSED

GO TO BOX R04_YYV01

ASK: All youth respondents.
PATH ID:

R04_YZ1008

When you first started [smoking/using] [tobacco product], were they flavored to taste like menthol, mint,
clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YZ9029

3

I don't know

GO TO R04_YZ9029

-8

DON'T KNOW

GO TO R04_YZ9029

-7

REFUSED

GO TO R04_YZ9029

ASK: Youth respondents who have ever used [tobacco product].

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PATH ID:

R04_YZ1011

Which flavor did you first start using? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used flavored [tobacco product].
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YZ9029

About how long has it been since you last [smoked/used] a [tobacco product]?
1

I___I___I DAYS

2

I___I___I MONTHS

3

I___I___I YEARS

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used [tobacco product].
PATH ID:

R04_YZ1100

Have you ever [smoked/used] a [tobacco product] fairly regularly?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used a [tobacco product].

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FIRST TOBACCO PRODUCT
BOX ID:

R04_YYV01

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_USE_TOB = Youth respondents who have ever used any type of tobacco product(s) in
lifetime.
R04_EVER_USE_CIGSONLY = Youth respondents who have ever used only cigarettes, and no other
products, in lifetime.
R04_EVER_USE_DUAL = Youth respondents who have ever used cigarettes and at least one other
tobacco product in lifetime.
R04_EVER_USE_TOBXCIGS = Youth respondents who have ever used any tobacco products,
excluding cigarettes, in lifetime.
R04_PAST30DAY_TOB = Youth respondents who have used any tobacco product(s) in the past 30
days.
R04_PASTYEAR_TOB_USE = Youth respondents who have used any tobacco product(s) in the past
12 months.
BOX ID:

R04_YYR01

New baseline youth respondents who started using 2 or more products at the same age, go to
R04_YY0601.
Else, continuing youth respondents who had not used any tobacco products at previous wave and
initiated use of 2 or more products at the same age, go to R04_YY0601.
Else, go to the next section.

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PATH ID:

R04_YY0601

You mentioned that you started using [LIST OF ALL PRODUCTS INITIATED/USED AT EARLIEST
AGE] [in the past 12 months/at age {EARLIEST AGE}]. Which type of tobacco did you try first?
1

Cigarettes

2

E-cigarettes or other electronic nicotine products

3

Traditional cigars

4

Cigarillos

5

Filtered cigars

7

Shisha or hookah tobacco

9

Snus

8

Smokeless tobacco (other than snus)

14

Other (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who used 2 or more products at the age they first started using
any tobacco and continuing youth respondents who initiated two or more products since the previous
wave (not including pipe, dissolvable tobacco, bidis, and kreteks).
DISPLAY: LIST OF ALL PRODUCTS MAY ONLY INCLUDE CIGARETTES, E-PRODUCTS,
TRADITIONAL CIGARS, CIGARILLOS, FILTERED CIGARS, HOOKAH, SNUS, SMOKELESS
TOBACCO.
IF R04_YOUTHTYPE = 1, DISPLAY "in the past 12 months"; AND [LIST OF ALL PRODUCTS
INITIATED], FOR ALL PRODUCTS FOR WHICH R04_INIT_[PRODUCT]_YOUTH = 1.
(R04_INIT_CIGS_YOUTH, R04_INIT_EPRODS_YOUTH, R04_INIT_GTRAD_YOUTH,
R04_INIT_GRILLO_YOUTH, R04_INIT_GFILTR_YOUTH, R04_INIT_HOOK_YOUTH,
R04_INIT_SNUS_YOUTH, R04_INIT_SMKLS_YOUTH)
IF R04_YOUTHTYPE = 2, 3, DISPLAY "at age {EARLIEST AGE}" AND FILL {EARLIEST AGE} WITH
THE AGE THE RESPONDENT FIRST STARTED USING TOBACCO; FOR [LIST OF ALL PRODUCTS
USED AT EARLIEST AGE], LIST ALL THE PRODUCTS FOR WHICH R04_Y*1006_NB = EARLIEST
AGE OF TOBACCO USE. (R04_YC1006_NB, R04_YV1006_NB, R04_YG1006TC_NB,
R04_YC1006CL_NB, R04_YC1006FC_NB, R04_YH1006_NB, R04_YU1006_NB, R04_YS1006_NB)
IF [LIST OF ALL PRODUCTS INITIATED/USED AT EARLIEST AGE] HAS TWO PRODUCTS,
CONNECT THE PRODUCTS WITH "and".
IF [LIST OF ALL PRODUCTS INITIATED/USED AT EARLIEST AGE] HAS THREE OR MORE
PRODUCTS, CONNECT THE PRODUCTS WITH COMMAS AND INCLUDE "and" BEFORE THE
FINAL PRODUCT.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”

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Wave 4 (version 3.0)

NICOTINE DEPENDENCE AND CESSATION / QUITTER
BOX ID:

R04_YNR04E

Youth respondents who have used any e-products in the past 12 months, go to Box R04_YNT03.
Else, youth respondents who have used any other tobacco product(s) in the past 12 months, go to Box
R04_YNT02.
Else, go to Box R04_YRT01.
BOX ID:

R04_YNT03

IF R04_PASTYEAR_TOB_USE = 2, DISPLAY THE FOLLOWING TEXT:
The next questions ask about your experience with electronic nicotine products.
IF R04_PASTYEAR_TOB_USE = 3, DISPLAY THE FOLLOWING TEXT:
The next questions ask about your experience with electronic nicotine products. Please think only about
electronic nicotine products as you answer these questions. We will ask you questions about other
products later.
PATH ID:

R04_YN0703E

How soon after you wake up do you want to use electronic nicotine products?
1

Within 5 minutes

2

From 6 to 30 minutes

3

From more than 30 minutes to 1 hour

4

After more than 1 hour but less than 24 hours

5

I rarely want to use electronic nicotine products

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.
PATH ID:

R04_YN0704E

Do you ever have strong cravings to use electronic nicotine products?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.

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PATH ID:

R04_YN0705E

Have you ever felt like you really needed to use electronic nicotine products?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.
PATH ID:

R04_YN0055E

Please rate your level of agreement for each statement using the following scale: 1= not true of me at all
to 5=extremely true of me.
I find myself reaching for electronic nicotine products without thinking about it.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.
BOX ID:

R04_YND02E

PROGRAM: Randomize order of items R04_YN0025E - R04_YN0080E.
PATH ID:

R04_YN0025E

I frequently crave electronic nicotine products.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.

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PATH ID:

R04_YN0045E

My electronic nicotine product use is out of control.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.
PATH ID:

R04_YN0070E

Using electronic nicotine products really helps me feel better if I’ve been feeling down.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.
PATH ID:

R04_YN0075E

Using electronic nicotine products helps me think better.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.

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Wave 4 (version 3.0)
PATH ID:

R04_YN0080E

I would feel alone without my electronic nicotine products.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.
BOX ID:

R04_YNR03E

Youth respondents who reported that they rarely want to use e-products after waking up, go to Box
R04_YNR06.
Else, youth respondents who have used any e-products in the past 12 months, go to R04_YN0060E.
PATH ID:

R04_YN0060E

I usually want to use electronic nicotine products right after I wake up.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months and did not report that
they rarely want to use e-products after waking up.
BOX ID:

R04_YNR06

Youth respondents who are past 30 day “not light” users of any e-products, go to R04_YN0126E.
Else, youth respondents who have used any e-product and at least one other tobacco product in the
past 12 months, go to Box R04_YNT02.
Else, go to R04_YN0330_12M.

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PATH ID:

R04_YN0126E

Have you tried to completely stop using electronic nicotine products within the past 12 months?
1

Yes

2

No

GO TO R04_YN0127E

-8

DON'T KNOW

GO TO R04_YN0127E

-7

REFUSED

GO TO R04_YN0127E

ASK: Past 30 day "not-light" users of any e-products.
PATH ID:

R04_YN0120E

In the past 12 months, have you stopped using electronic nicotine products for one day or longer
because you were trying to quit for good?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" users of any e-products who have tried to quit using e-products in the past
12 months.
PATH ID:

R04_YN0127E

Are you seriously thinking about quitting electronic nicotine products?
1

Yes, within the next 30 days

2

Yes, within the next 6 months

3

Yes, within the year

4

Yes, but not within the year

5

No, I am not seriously thinking about quitting

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" users of any e-products.
BOX ID:

R04_YNR02E

Youth respondents who have used any e-product and at least one other tobacco product in the past 12
months, go to Box R04_YNT02.
Else, go to R04_YN0330_12M.
BOX ID:

R04_YNT02

You mentioned that you use [TOBACCO PRODUCT LIST]. Please think about [all of these
products/both of these products/this product] as you answer the following questions.

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Wave 4 (version 3.0)
PATH ID:

R04_YN0703

How soon after you wake up do you want to use tobacco?
1

Within 5 minutes

2

From 6 to 30 minutes

3

From more than 30 minutes to 1 hour

4

After more than 1 hour but less than 24 hours

5

I rarely want to use tobacco

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.
PATH ID:

R04_YN0704

Do you ever have strong cravings to use tobacco?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.
PATH ID:

R04_YN0705

Have you ever felt like you really needed to use tobacco?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.

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Wave 4 (version 3.0)
PATH ID:

R04_YN0055

Please rate your level of agreement for each statement using the following scale: 1= not true of me at all
to 5=extremely true of me.
I find myself reaching for a tobacco product without thinking about it.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.
BOX ID:

R04_YND04

PROGRAM: Randomize order of items R04_YN0025 - R04_YN0080.
PATH ID:

R04_YN0025

I frequently crave tobacco.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.

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Wave 4 (version 3.0)
PATH ID:

R04_YN0045

My tobacco use is out of control.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.
PATH ID:

R04_YN0070

Using tobacco really helps me feel better if I’ve been feeling down.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.
PATH ID:

R04_YN0075

Using tobacco helps me think better.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.

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Wave 4 (version 3.0)
PATH ID:

R04_YN0080

I would feel alone without my tobacco.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.
BOX ID:

R04_YNR03

Youth respondents who reported that they rarely want to use tobacco after waking up, go to Box
R04_YNR05.
Else, youth respondents who have used tobacco in the past 12 months, go to R04_YN0060.
PATH ID:

R04_YN0060

I usually want to use tobacco right after I wake up.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product, and did not report that they
rarely want to use tobacco after waking up.
BOX ID:

R04_YNR05

Youth respondents who have used any tobacco products in the past 30 days, excluding cigarette only
users and e-product only users, go to R04_YN0126.
Else, youth respondents who are past 30 day “not light” users of cigarettes, go to R04_YN0127.
Else, go to R04_YN0330_12M.

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Wave 4 (version 3.0)
PATH ID:

R04_YN0126

Have you tried to completely stop using all tobacco products within the past 12 months?
1

Yes

2

No

GO TO R04_YN0127

-8

DON'T KNOW

GO TO R04_YN0127

-7

REFUSED

GO TO R04_YN0127

ASK: Youth respondents who have used any tobacco products in the past 30 days, excluding cigarette
only users and e-product only users.
PATH ID:

R04_YN0120

In the past 12 months, have you stopped using all tobacco products for one day or longer because you
were trying to quit for good?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have tried to quit using all tobacco in the past 12 months, excluding
cigarette only users and e-product only users.

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Wave 4 (version 3.0)
PATH ID:

R04_YN0127

Are you seriously thinking about quitting [cigarettes/all tobacco products/cigarettes and tobacco
products]?
1

Yes, within the next 30 days

2

Yes, within the next 6 months

3

Yes, within the year

4

Yes, but not within the year

5

No, I am not seriously thinking about quitting

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco (excluding e-products) in the past 30 days.
DISPLAY: IF CIGARETTE SMOKER ONLY (R04_PAST30DAY_CIGS_LEVEL = 2 AND
(R04_PAST30DAY_GTRAD = 2 AND R04_PAST30DAY_GRILLO = 2 AND R04_PAST30DAY_GFILTR
= 2 AND R04_PAST30DAY_PIPE = 2 AND R04_PAST30DAY_HOOK = 2 AND
R04_PAST30DAY_SNUS = 2 AND R04_PAST30DAY_SMKLS = 2 AND R04_PAST30DAY_DISS = 2
AND R04_PAST30DAY_BIDI = 2 AND R04_PAST30DAY_KRETEK = 2)), DISPLAY “cigarettes”.
IF NON-CIGARETTE TOBACCO USER (R04_PAST30DAY_CIGS = 2 OR
R04_PAST30DAY_CIGS_LEVEL = 1) AND R04_PAST30DAY_TOB = 1, DISPLAY “ all tobacco
products”.
IF CIGARETTE AND OTHER TOBACCO PRODUCT USER (R04_PAST30DAY_CIGS_LEVEL = 2 AND
(R04_PAST30DAY_GTRAD_LEVEL = 2 OR R04_PAST30DAY_GRILLO_LEVEL = 2 OR
R04_PAST30DAY_GFILTR_LEVEL = 2 OR R04_PAST30DAY_PIPE = 1 OR
R04_PAST30DAY_HOOK = 1 OR R04_PAST30DAY_SNUS_LEVEL = 2 OR
R04_PAST30DAY_SMKLS_LEVEL = 2 OR R04_PAST30DAY_DISS = 1 OR R04_PAST30DAY_BIDI =
1 OR R04_PAST30DAY_KRETEK = 1)) DISPLAY “cigarettes and tobacco products”.
BOX ID:

R04_YNR02

Youth respondents who are past 30 day "not-light" cigarette smokers who have used any other tobacco
products (excluding e-products) in the past 30 days, go to Box R04_YNT05.
Else, youth respondents who are past 30 day “not-light” cigarette smokers and have not used any other
products, go to R04_YC1210.
Else, go to R04_YN0330_12M.
BOX ID:

R04_YNT05

The next questions ask about your experience with cigarettes. Please think only about cigarettes as you
answer these questions.

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Wave 4 (version 3.0)
PATH ID:

R04_YC1210

Do you want to completely stop smoking cigarettes?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers.
BOX ID:

R04_YNR01

Past 30 day "not-light" cigarette smokers who have not tried to quit using all tobacco in the past 12
months, go to R04_YC1215.
Else, past 30 day “not-light” cigarette smokers who tried to quit using all tobacco in the past 12 months,
go to R04_YC1220.
PATH ID:

R04_YC1215

In the past 12 months, have you tried to completely stop smoking cigarettes?
1

Yes

2

No

GO TO R04_YC1230

-8

DON'T KNOW

GO TO R04_YC1230

-7

REFUSED

GO TO R04_YC1230

ASK: Past 30 day "not-light" cigarette smokers who have not tried to quit using all tobacco in the past 12
months.
PATH ID:

R04_YC1220

In the past 12 months, how many times have you stopped smoking for one day or longer because you
were trying to quit smoking cigarettes for good?
1

I__I__I__I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers who have tried to quit smoking in the past 12 months.

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Wave 4 (version 3.0)
PATH ID:

R04_YC1220_LC1

The computer recorded that you stopped smoking for one day or longer [R04_YC1220] times in the past
12 months because you were trying to quit smoking cigarettes for good. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC1220

2

NEXT

GO TO R04_YC1225

ASK: IF R04_YC1220 > 100.
PATH ID:

R04_YC1225

When you last tried to quit for good, how long did you stay off cigarettes? Please choose the first
answer that fits.
1

Less than 1 day

2

1 to 7 days

3

More than 7 days but less than 30 days

4

More than 30 days but less than 6 months

5

More than 6 months but less than 1 year

6

1 year or more

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers who have tried to quit smoking in the past 12 months.
PATH ID:

R04_YC1230

If you decided to quit cigarettes for good, how likely is it that you would succeed?
1

Very likely

2

Somewhat likely

3

Somewhat unlikely

4

Very unlikely

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0330_12M

In the past 12 months, have you used a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal
spray, lozenge or pill?
1

Yes

2

No

GO TO R04_YN0331_12M

-8

DON'T KNOW

GO TO R04_YN0331_12M

-7

REFUSED

GO TO R04_YN0331_12M

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months.
PATH ID:

R04_YN0307

When did you last use a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or
pill?
1

In the past hour

GO TO R04_YN0309

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO R04_YN0331_12M

-8

DON'T KNOW

GO TO R04_YN0331_12M

-7

REFUSED

GO TO R04_YN0331_12M

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months, and
who has used NRT in the past 12 months.
PATH ID:

R04_YN0308

When you last used a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or pill
[FILL BASED ON R04_YN0307], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months, and
used NRT today, yesterday or the day before yesterday.
DISPLAY: [FILL BASED ON R04_YN0307]:
IF R04_YN0307 = 2, DISPLAY "sometime today".
IF R04_YN0307 = 3, DISPLAY "yesterday".
IF R04_YN0307 = 4, DISPLAY “the day before yesterday”.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0309

When you last used a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or pill
[FILL BASED ON R04_YN0307], how many did you use?
1

I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months, and
used NRT in the past hour, today, yesterday or the day before yesterday.
DISPLAY: IF R04_YN0307 = 1, 2, DISPLAY “today”.
IF R04_YN0307 = 3, DISPLAY "yesterday".
IF R04_YN0307 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YN0309_LC1

The computer recorded that [today/yesterday/the day before yesterday], you used a nicotine patch,
nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or pill [R04_YN0309] times.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YN0309

2

NEXT

GO TO R04_YN0331_12M

ASK: IF R04_YN0309 = 0 OR R04_YN0309 > 5.
DISPLAY: IF R04_YN0307 = 1, 2, DISPLAY “today”.
IF R04_YN0307 = 3, DISPLAY “yesterday”.
IF R04_YN0307 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YN0331_12M

In the past 12 months, have you used any of the following prescription drugs: Chantix, varenicline,
Wellbutrin, Zyban, or bupropion?
1

Yes

2

No

GO TO BOX R04_YRT01

-8

DON'T KNOW

GO TO BOX R04_YRT01

-7

REFUSED

GO TO BOX R04_YRT01

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months.

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Youth Questionnaire – New and Aged-Up Interview

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0327

When did you last use Chantix, varenicline, Wellbutrin, Zyban, or bupropion?
1

In the past hour

2

Sometime today

GO TO R04_YN0329

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YRT01

-8

DON'T KNOW

GO TO BOX R04_YRT01

-7

REFUSED

GO TO BOX R04_YRT01

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months, and
who have used a prescription drug in the past 12 months.
PATH ID:

R04_YN0328

When you last used Chantix, varenicline, Wellbutrin, Zyban, or bupropion [FILL BASED ON
R04_YN0327], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months, and
who have used a prescription drug today, yesterday or the day before yesterday.
DISPLAY: IF R04_YN0327 = 2, DISPLAY "today".
IF R04_YN0327 = 3, DISPLAY "yesterday".
IF R04_YN0327 = 4, DISPLAY “the day before yesterday”.
ELSE, DISPLAY TEXT AS SHOWN IN OPTIONS SELECTED IN R04_YN0327, MAKING FIRST
LETTER LOWERCASE.

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Youth Questionnaire – New and Aged-Up Interview

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0329

When you used Chantix, varenicline, Wellbutrin, Zyban, or bupropion [FILL BASED ON R04_YN0327],
how many did you take?
1

I___I___I

-8

DON'T KNOW

GO TO BOX R04_YRT01

-7

REFUSED

GO TO BOX R04_YRT01

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months, and
who have used a prescription drug in the past hour, today, yesterday or the day before yesterday.
DISPLAY: IF R04_YN0327 = 1, 2, DISPLAY “today”.
IF R04_YN0327 = 3, DISPLAY "yesterday"
IF R04_YN0327 = 4, DISPLAY “the day before yesterday”.
ELSE, DISPLAY TEXT AS SHOWN IN OPTIONS SELECTED IN R04_YN0327, MAKING FIRST
LETTER LOWERCASE.
PATH ID:

R04_YN0329_LC1

The computer recorded that [today/yesterday/the day before yesterday], you used Chantix, varenicline,
Wellbutrin, Zyban, or bupropion [R04_YN0329] times.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YN0329

2

NEXT

GO TO BOX R04_YRT01

ASK: IF R04_YN0329 = 0 OR IF R04_YN0329 > 5.
DISPLAY: IF R04_YN0327 = 1, 2, DISPLAY “today”.
IF R04_YN0327 = 3, DISPLAY “yesterday”.
IF R04_YN0327 = 4, DISPLAY “the day before yesterday”.

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Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

PACKAGING AND HEALTH WARNINGS
BOX ID:

R04_YRT01

The next questions ask about things you may have seen or read about tobacco products.
PATH ID:

R04_YR0142

In the past 12 months, how often have you thought about the chemicals contained in tobacco products?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YR0005

In the past 30 days, how often, if at all, have you noticed the health warnings on cigarette packs?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YRR01

If youth respondent has ever smoked cigarettes and has noticed health warnings in the past 30 days, go
to R04_YR0202.
Else, if youth respondent has never smoked cigarettes and has noticed health warnings in the past 30
days, go to R04_YR0055.
Else, go to R04_YR0110.

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Youth Questionnaire – New and Aged-Up Interview

214

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0202

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
cigarette packs?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a cigarette and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0010

In the past 30 days, how often, if at all, have the health warnings stopped you from having a cigarette
when you were about to smoke one?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a cigarette and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0015

In the past 30 days, have you tried to avoid looking at or thinking about the health warnings on cigarette
packs - such as covering them up, keeping them out of sight, using a cigarette case, avoiding certain
warnings, or any other means?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a cigarette and have noticed health warnings in the
past 30 days.

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Youth Questionnaire – New and Aged-Up Interview

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0025

How believable do you consider the health warnings on cigarette packs to be?
1

Not at all believable

2

A little believable

3

Somewhat believable

4

Very believable

5

Extremely believable

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a cigarette and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0035

To what extent, if at all, do the health warnings on cigarette packs make you think about the health risks
of smoking?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a cigarette and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0203

To what extent, if at all, do the health warnings on cigarette packs make you never want to smoke
again?
1

Not at all

GO TO R04_YR0110

2

A little

GO TO R04_YR0110

3

Somewhat

GO TO R04_YR0110

4

A lot

GO TO R04_YR0110

-8

DON'T KNOW

GO TO R04_YR0110

-7

REFUSED

GO TO R04_YR0110

ASK: Youth respondents who have ever smoked a cigarette and have noticed health warnings in the
past 30 days.

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Youth Questionnaire – New and Aged-Up Interview

216

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0055

To what extent, if at all, have the health warnings on cigarette packs made you less likely to start
smoking?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have never smoked a cigarette and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0110

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of ecigarettes, e-liquid or other electronic nicotine products?
[SHOW GENERIC IMAGE OF E-PRODUCTS BY SUBTYPE WITH ENP LABEL]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YRR16

If youth respondent has ever used e-products and has noticed health warnings in the past 30 days, go
to R04_YR0222.
Else, go to R04_YR0115.

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Youth Questionnaire – New and Aged-Up Interview

217

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0222

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
packages of e-cigarettes, e-liquid or other electronic nicotine products?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used e-products and have noticed health warnings in the past
30 days.
PATH ID:

R04_YR0226

To what extent, if at all, do the health warnings on packages of e-cigarettes, e-liquid or other electronic
nicotine products make you think about the health risks of using them?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used e-products and have noticed health warnings in the past
30 days.
PATH ID:

R04_YR0115

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of traditional
cigars?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

218

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YRR17

If youth respondent has ever smoked traditional cigars and has noticed health warnings in the past 30
days, go to R04_YR0229.
Else, go to R04_YR0120.
PATH ID:

R04_YR0229

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
packages of traditional cigars?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked traditional cigars and have noticed health warnings in
the past 30 days.
PATH ID:

R04_YR0233

To what extent, if at all, do the health warnings on packages of traditional cigars make you think about
the health risks of smoking?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked traditional cigars and have noticed health warnings in
the past 30 days.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

219

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0120

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of cigarillos?
[SHOW GENERIC IMAGE OF CIGARILLOS]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YRR18

If youth respondent has ever smoked cigarillos and has noticed health warnings in the past 30 days, go
to R04_YR0236.
Else, go to R04_YR0125.
PATH ID:

R04_YR0236

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
packages of cigarillos?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked cigarillos and have noticed health warnings in the past
30 days.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

220

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0240

To what extent, if at all, do the health warnings on packages of cigarillos make you think about the
health risks of smoking?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked cigarillos and have noticed health warnings in the past
30 days.
PATH ID:

R04_YR0125

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of filtered
cigars?
[SHOW GENERIC IMAGE OF FILTERED CIGARS]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YRR19

If youth respondent has ever smoked filtered cigars and has noticed health warnings in the past 30
days, go to R04_YR0243.
Else, go to R04_YR0130.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

221

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0243

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
packages of filtered cigars?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked filtered cigars and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0247

To what extent, if at all, do the health warnings on packages of filtered cigars make you think about the
health risks of smoking?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked filtered cigars and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0130

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of pipe
tobacco?
[SHOW GENERIC IMAGE OF PIPE AND PIPE TOBACCO]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

222

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0135

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of shisha or
hookah tobacco?
[SHOW GENERIC IMAGE OF HOOKAH AND SHISHA]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YRR20

If youth respondent has ever smoked hookah and has noticed health warnings in the past 30 days, go to
R04_YR0250.
Else, go to R04_YR0206.
PATH ID:

R04_YR0250

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
packages of shisha or hookah tobacco?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked hookah and have noticed health warnings in the past
30 days.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

223

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0254

To what extent, if at all, do the health warnings on packages of shisha or hookah tobacco make you
think about the health risks of smoking?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked hookah and have noticed health warnings in the past
30 days.
PATH ID:

R04_YR0206

In the past 30 days, how often, if at all, have you noticed the health warnings on snus containers?
[SHOW GENERIC IMAGE OF SNUS]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YRR15

If youth respondent has ever used snus and has noticed health warnings in the past 30 days, go to
R04_YR0207.
Else, go to R04_YR0060.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

224

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0207

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on snus
containers?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used snus and have noticed health warnings in the past 30
days.
PATH ID:

R04_YR0211

To what extent, if at all, do the health warnings on snus containers make you think about the health risks
of using snus?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used snus and have noticed health warnings in the past 30
days.
PATH ID:

R04_YR0060

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of other
smokeless tobacco products like dip, spit and chew?
[SHOW GENERIC IMAGE OF SMOKELESS PRODUCTS (EXCLUDING]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

225

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YRR04

If youth respondent has ever used smokeless tobacco and noticed health warnings in the past 30 days,
go to R04_YR0205.
Else, go to Box R04_YXT30.
PATH ID:

R04_YR0205

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
smokeless tobacco packages?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used smokeless tobacco and have noticed health warnings in
the past 30 days.
PATH ID:

R04_YR0085

To what extent, if at all, do the health warnings on packages of smokeless tobacco products make you
think about the health risks of using smokeless tobacco products?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used smokeless tobacco and have noticed health warnings in
the past 30 days.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

226

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

PRODUCT REGULATION - MODIFIED RISK TOBACCO PRODUCTS
BOX ID:

R04_YXT30

The next questions ask about your opinions on using tobacco, including e-cigarettes and other
electronic nicotine products.
PATH ID:

R04_YN0250

Do you believe nicotine is the main substance in tobacco that makes people want to use tobacco
products?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0667

Please tell me how much you agree or disagree with the following statement.
Some tobacco products are safer than others.
1

Strongly agree

2

Agree

3

Neither agree nor disagree

4

Disagree

5

Strongly disagree

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview

227

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0723

Do you think a tobacco product described as additive-free is less harmful, about the same, or more
harmful than a regular tobacco product?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "additive-free".
PATH ID:

R04_YX0724

Do you think a tobacco product described as organic is less harmful, about the same, or more harmful
than a regular tobacco product?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "organic".
PATH ID:

R04_YC9050

How harmful do you think cigarettes are to health?
1

Not at all harmful

2

Slightly harmful

3

Somewhat harmful

4

Very harmful

5

Extremely harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

228

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1149

How harmful do you think the nicotine in cigarettes is to health?
1

Not at all harmful

2

Slightly harmful

3

Somewhat harmful

4

Very harmful

5

Extremely harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "nicotine".
PATH ID:

R04_YC1125

How much do you think people harm themselves when they smoke cigarettes?
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YC1170

How much do you think people harm themselves when they smoke cigarettes some days but not every
day?
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1180

How long do you think someone has to smoke cigarettes before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YC9047

In your opinion, do you think that cigarettes with lower amounts of nicotine are less harmful, about the
same, or more harmful to a person's health than regular cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YC9040

Do you think cigarettes flavored like menthol or mint are less harmful, no different, or more harmful than
regular cigarettes?
1

Less harmful

2

No different

3

More harmful

4

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC9118

Do you think cigarettes flavored like menthol or mint are easier to smoke, about the same, or harder to
smoke than regular cigarettes?
1

Easier to smoke

2

About the same

3

Harder to smoke

4

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YC1124

How likely is someone to become addicted to cigarettes?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YC9043

How likely are you to become addicted to cigarettes?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "you".

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC9120

Do you believe nicotine is the chemical that causes most of the cancer caused by smoking cigarettes?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YV1125

How much do you think people harm themselves when they use e-cigarettes or other electronic nicotine
products?
[SHOW GENERIC IMAGE OF E-PRODUCTS BY SUBTYPE WITH ENP LABEL]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YV1149

How harmful do you think the nicotine in e-cigarettes or other electronic nicotine products is to health?
1

Not at all harmful

2

Slightly harmful

3

Somewhat harmful

4

Very harmful

5

Extremely harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "nicotine".

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1180

How long do you think someone has to use e-cigarettes or other electronic nicotine products before it
harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YV1099

Do you think using e-cigarettes or other electronic nicotine products is less harmful, about the same, or
more harmful than smoking cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "e-cigarettes or other electronic nicotine products" AND "cigarettes".
PATH ID:

R04_YV1153

Do you think flavored e-cigarettes (other than mint or menthol) are easier to use, about the same, or
harder to use than tobacco-flavored or unflavored e-cigarettes?
1

Easier to use

2

About the same

3

Harder to use

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "flavored", "other than mint or menthol","tobacco-flavored" AND "unflavored".

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Youth Questionnaire – New and Aged-Up Interview

233

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1148

Do you think using menthol or mint flavored e-cigarettes is less harmful, about the same, or more
harmful than using tobacco-flavored or unflavored e-cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "menthol", "mint", "tobacco-flavored" AND "unflavored".
PATH ID:

R04_YV1152

Do you think using flavored e-cigarettes (other than mint or menthol) is less harmful, about the same, or
more harmful than using tobacco-flavored or unflavored e-cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "flavored", "other than mint or menthol","tobacco-flavored" AND "unflavored".
PATH ID:

R04_YV1124

How likely is someone to become addicted to e-cigarettes or other electronic nicotine products?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview

234

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9025

How much do you think people harm themselves when they smoke traditional cigars?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG1180

How long do you think someone has to smoke traditional cigars before before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG9097

Do you think smoking traditional cigars is less harmful, about the same, or more harmful than smoking
cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "traditional cigars" AND "cigarettes".

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

235

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9026

How much do you think people harm themselves when they smoke cigarillos?
[SHOW GENERIC IMAGE OF CIGARILLOS]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG9047

How much do you think people harm themselves when they smoke cigarillos some days but not every
day?
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG9048

How long do you think someone has to smoke cigarillos before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

236

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9098

Do you think smoking cigarillos is less harmful, about the same, or more harmful than smoking
cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "cigarillos" AND "cigarettes".
PATH ID:

R04_YG9125

How likely is someone to become addicted to cigarillos?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG9027

How much do you think people harm themselves when they smoke filtered cigars?
[SHOW GENERIC IMAGE OF FILTERED CIGARS]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview

237

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9054

How much do you think people harm themselves when they smoke filtered cigars some days but not
every day?
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG9055

How long do you think someone has to smoke filtered cigars before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG9099

Do you think smoking filtered cigars is less harmful, about the same, or more harmful than smoking
cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "filtered cigars" AND "cigarettes".

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

238

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9126

How likely is someone to become addicted to filtered cigars?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YH1125

How much do you think people harm themselves when they smoke shisha or hookah tobacco?
[SHOW GENERIC IMAGE OF HOOKAH AND SHISHA]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YH9044

How harmful is it to be around people who are smoking shisha or hookah tobacco?
1

Not at all harmful

2

Slightly harmful

3

Somewhat harmful

4

Very harmful

5

Extremely harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

239

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH9110

Do you think shisha that does not contain tobacco is less harmful, about the same, or more harmful than
shisha that does contain tobacco?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "does not contain tobacco" AND "does contain tobacco".
PATH ID:

R04_YH1180

How long do you think someone has to smoke shisha or hookah tobacco before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YH1099

Do you think smoking hookah is less harmful, about the same, or more harmful than smoking
cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "hookah" AND "cigarettes".

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

240

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH1124

How likely is someone to become addicted to shisha or hookah tobacco?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YU1125

How much do you think people harm themselves when they use snus?
[SHOW GENERIC IMAGE OF SNUS]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YU1170

How much do you think people harm themselves when they use snus some days but not every day?
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

241

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YU1180

How long do you think someone has to use snus before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YU1099

Do you think using snus is less harmful, about the same, or more harmful than smoking cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "snus" AND "cigarettes".
PATH ID:

R04_YU1124

How likely is someone to become addicted to snus?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

242

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YS1125

How much do you think people harm themselves when they use smokeless tobacco? (Smokeless
tobacco includes dip, spit or chew.)
[SHOW GENERIC IMAGE OF SMOKELESS TOBACCO (EXCLUDING SNUS)]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YS1170

How much do you think people harm themselves when they use smokeless tobacco some days but not
every day?
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YS1180

How long do you think someone has to use smokeless tobacco before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

243

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YS1099

Do you think using smokeless tobacco is less harmful, about the same, or more harmful than smoking
cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "smokeless tobacco" AND "cigarettes".
PATH ID:

R04_YS1124

How likely is someone to become addicted to smokeless tobacco?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0759

Sometimes people who are trying to quit using tobacco use nicotine replacement products such as
nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge, or pill.
How harmful do you think the nicotine in these products is to health?
1

Not at all harmful

2

Slightly harmful

3

Somewhat harmful

4

Very harmful

5

Extremely harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "nicotine".

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

244

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YXV01

CREATE AN ARRAY USEPROD WITH 12 ELEMENTS - ONE FOR EACH TOBACCO TYPE THAT
IDENTIFIES WHETHER THE RESPONDENT IS A PAST 30 DAY USER OF THE SPECIFIC
TOBACCO TYPE.
USEPROD(1-12): Past 30 day users of: (1) cigarettes; (2) [e-cigarettes / electronic nicotine product /
electronic nicotine products]; (3) traditional cigars; (4) cigarillos; (5) filtered cigars; (6) pipe tobacco (7)
shisha or hookah tobacco; (8) snus (9) smokeless tobacco; (10) dissolvable tobacco; (11) bids; (12)
kreteks.
DISPLAY: If [USEPROD(1-12)] is a list and contains two products, connect the products with "and". If it
has three or more products, connect the products with commas and include "and" before the final
product in the list. Display all products bold with lowercase letters.
For USEPROD(2): If respondent is a current user of e-cigarettes and R04_EPRODCOUNT = 1, display
“e-cigarettes”. Else, if R04_EPRODCOUNT = 1, display “electronic nicotine product”. Else, display
“electronic nicotine products”.
BOX ID:

R04_YYR02

Youth respondents who have ever smoked cigarettes and are past 30 day users of any other product,
go to R04_YX0300.
Else, youth respondents who have ever used e-products and are past 30 day users of any other
product, go to R04_YX0301.
Else, youth respondents who are past 30 day users of any product, go to R04_YX0307.
Else, go to Box R04_YXT05.
PATH ID:

R04_YX0300

How much do you agree or disagree with this statement?
I have considered switching completely from using [USEPROD(2-12)] to smoking cigarettes.
1

Strongly agree

2

Agree

3

Neither agree nor disagree

4

Disagree

5

Strongly disagree

-8

DON'T KNOW

-7

REFUSED

ASK: Ever cigarette smokers who are past 30 days users of at least one non-cigarette tobacco product
[USEPROD(2-12) = 1]. (This question is asked one time about the product(s) the respondent has used
in the past 30 days (USEPROD list), excluding cigarettes, and asks about switching completely from
those product(s) to cigarettes.)
DISPLAY: UNDERLINE "completely".

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

245

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YXR11

Youth respondents who have ever used e-products and are past 30 day users of any other product, go
to R04_YX0301.
Else, go to Box R04_YXR10.
PATH ID:

R04_YX0301

How much do you agree or disagree with this statement?
I have considered switching completely from using [USEPROD(1, 3-12)] to using e-cigarettes or other
electronic nicotine products.
1

Strongly agree

2

Agree

3

Neither agree nor disagree

4

Disagree

5

Strongly disagree

-8

DON'T KNOW

-7

REFUSED

ASK: Ever e-product users who are past 30 days users of at least one tobacco product [USEPROD(1,
3-12) = 1]. (This question is asked one time about the product(s) the respondent has used in the past
30 days, excluding e-products, and asks about switching completely from those product(s) to eproducts.)
DISPLAY: UNDERLINE "completely".
BOX ID:

R04_YXR10

Youth respondents who are past 30 day users of any product, go to R04_YX0307.
Else, go to Box R04_YXT05.

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

246

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0307

Have you considered switching from [USEPROD(1-12)] to any of the following products? Choose all
that apply.
1

I have not considered switching to another product

2

Cigarettes

3

E-cigarettes or other electronic nicotine products

4

Traditional cigars

5

Cigarillos

6

Filtered cigars

10

Pipes

7

Hookahs

8

Snus

9

[Other smokeless/Smokeless] tobacco such as, moist snuff, dip, spit, or chewing tobacco

13

Dissolvable tobacco

11

Bidis

12

Kreteks

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day users of [USEPROD(1-12)]. (This question is repeated for each product the
respondent has used in the past 30 days. The response options are the products the respondent has
not used in the past 30 days. If the respondent has used every product in the past 30 days, resulting in
no options presented, this question is not asked.)
DISPLAY: UNDERLINE "switching". Bold [USEPROD(1-12)].
IF R04_PAST30DAY_SNUS = 1 AND R04_PAST30DAY_SMKLS != 1, DISPLAY option 9 as "Other
smokeless tobacco such as moist snuff, dip, spit, or chewing tobacco".
ELSE, IF R04_PAST30DAY_SMKLS != 1, DISPLAY "Smokeless tobacco such as moist snuff, dip, spit,
or chewing tobacco".

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

247

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

MEDIA USE
BOX ID:

R04_YXT05

The next questions ask about your TV, radio, internet and cell phone use.
PATH ID:

R04_YX0494

On an average weekday, about how much time do you spend watching television and streaming videos
that include commercials?
1

None

2

Half hour or less

3

About 1 hour

4

About 2 hours

5

About 3 hours

6

About 4 hours

7

About 5 hours

8

About 6 hours

9

7 hours or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "weekday".
PATH ID:

R04_YX0495

On an average weekend day, how much time do you spend watching television and streaming videos
that includes commercials?
1

None

2

Less than 1 hour

3

1 to 2 hours

4

3 to 4 hours

5

5 to 6 hours

6

7 to 8 hours

7

9 to 10 hours

8

11 hours or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "weekend".

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

248

PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0060

On an average weekday, how much time do you spend listening to the radio or online radio stations that
include commercials?
1

None

2

Half hour or less

3

About 1 hour

4

About 2 hours

5

About 3 hours

6

About 4 hours

7

About 5 hours

8

About 6 hours

9

7 hours or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "weekday".
PATH ID:

R04_YX0061

On an average weekend day, how much time do you spend listening to the radio or online radio stations
that include commercials?
1

None

2

Less than 1 hour

3

1 to 2 hours

4

3 to 4 hours

5

5 to 6 hours

6

7 to 8 hours

7

9 to 10 hours

8

11 hours or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "weekend".

PATH – Wave 4
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Wave 4 (version 3.0)
PATH ID:

R04_YX0763

On an average weekday, how many hours do you spend on the internet, not including time spent for
work or school? Include time spent on the internet from a computer, tablet, or smartphone.
1

None

2

Half hour or less

3

About 1 hour

4

About 2 hours

5

About 3 hours

6

About 4 hours

7

About 5 hours

8

About 6 hours

9

7 hours or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "weekday".
PATH ID:

R04_YX0771

On an average weekend day, how many hours do you spend on the internet, not including time spent
for work or school? Include time spent on the internet from a computer, tablet, or smartphone.
1

None

2

Less than 1 hour

3

1 to 2 hours

4

3 to 4 hours

5

5 to 6 hours

6

7 to 8 hours

7

9 to 10 hours

8

11 hours or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "weekend".

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Wave 4 (version 3.0)
PATH ID:

R04_YX0062

Sometimes people use the internet to connect with other people online through social networks like
Facebook, Google Plus, YouTube, LinkedIn, Twitter, Tumblr, Instagram, Pinterest, or Snapchat. This is
often called social media.
Do you have a social media account?
1

Yes

2

No

GO TO R04_YX0503

-8

DON'T KNOW

GO TO R04_YX0503

-7

REFUSED

GO TO R04_YX0503

ASK: All youth respondents.
PATH ID:

R04_YX0317

About how often do you visit your social media accounts?
1

More than once a day

2

About once a day

3

3-5 days a week

4

1-2 days a week

5

Every few weeks

6

Less often

7

Never

-8

DON'T KNOW

-7

REFUSED

GO TO R04_YX0503

ASK: Youth respondents who have a social media account.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0686

In the past 12 months, have you liked or followed any of the following tobacco product, e-cigarette, or
other electronic nicotine product brands on Facebook, Twitter or other social media sites? Choose all
that apply.
0

I have not liked or followed any brands on social media sites

1

Camel

2

Marlboro

3

Newport

4

American Spirit

5

Vuse

6

Blu

7

Logic

8

MarkTen

9

NJOY

10

eGo

11

iTaste

12

Black & Mild

13

Swisher Sweets

14

Dutch Masters

15

Phillies Blunts

16

Zig Zag

17

Skoal

18

Redman

19

Grizzly

20

Copenhagen

21

Some other brand (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have a social media account (excluding those who never visit their social
media account).
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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Wave 4 (version 3.0)
PATH ID:

R04_YX0503

Please indicate if you use any of the following. Choose all that apply.
1

Smartphone, such as an iPhone, Android, Blackberry, or Windows phone

2

Cell phone without internet

3

A handheld device made primarily for e-book reading, such as a Nook or Kindle ereader but NOT a Kindle Fire

4

A tablet computer like an iPad, Samsung Galaxy Tab, Google Nexus, or Kindle Fire

5

A desktop or laptop computer

6

A game console like Xbox or PlayStation

7

An iPod or other MP3 player

8

A portable gaming device like a PSP or Sega Genesis game player

9

I do not use any of these devices

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YXR12

New baseline youth respondents who have any device other than a cell phone without internet, go to
R04_YX0496_NB.
Else, go to Box R04_YXT02.
PATH ID:

R04_YX0496_NB

A Quick Response code is a white square with black dots in it, sometimes called a QR code.
[INSERT GENERIC IMAGE OF QR CODE FOR PATH WEBSITE]
Have you ever used a tablet or a smartphone to scan a QR code for a tobacco product or to enter a
sweepstakes or drawing from a tobacco company?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have any device other than a cell phone without internet.
DISPLAY: UNDERLINE "QR code".

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Wave 4 (version 3.0)

SECONDHAND SMOKE EXPOSURE
BOX ID:

R04_YXT02

The next questions ask about the rules of using tobacco inside your home.
PATH ID:

R04_YX0671

Not including yourself, does anyone who lives with you now do any of the following? Choose all that
apply.
1

Smoke cigarettes

2

Use e-cigarettes or other electronic nicotine products

3

Use snus

4

Use other types of smokeless tobacco such as dip, spit or chew

5

Smoke traditional cigars, cigarillos, or filtered cigars

6

Smoke hookah

7

Use any other form of tobacco

8

No one who lives with me now uses any form of tobacco

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "now".
PATH ID:

R04_YX0068

During the past seven days, about how many hours were you around others who were smoking[,
whether or not you were smoking yourself]? Include time in your home, in a car, at school, or outdoors.
1

I__I__I__I Number of hours

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "others".
IF R04_PAST30DAY_CIGS = 1 OR R04_PAST30DAY_GTRAD= 1 OR R04_PAST30DAY_GRILLO = 1
OR R04_PAST30DAY_GFILTR= 1 OR R04_PAST30DAY_PIPE = 1 OR R04_PAST30DAY_HOOK = 1
OR R04_PAST30DAY_BIDI = 1 OR R04_PAST30DAY_KRETEK = 1, DISPLAY, ", whether or not you
were smoking yourself".
DISPLAY "Number of hours" AS A TITLE.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0068_LC1

The computer recorded that, during the last seven days, you were in close contact with others while
they were smoking for [R04_YX0068] hours. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0068

2

NEXT

GO TO BOX R04_YXT01

ASK: IF R04_YX0068 > 120 OR R04_YX0068 = 11, 22, 33, 44, 55, 66, 77, 88, 99, 111.

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Wave 4 (version 3.0)

HEALTH
BOX ID:

R04_YXT01

The next questions ask about some basic medical information that is important for the study.
BOX ID:

R04_YMD06

Display questions R04_YX0090 through R04_YX0088 using the expanded WVB stem-leaf screen. The
introduction text from R04_YX0090 is the stem. Show all leaves on the screen at once.
PATH ID:

R04_YX0090

In general, how would you rate your...
physical health?
1

Excellent

2

Very good

3

Good

4

Fair

5

Poor

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0091

mental health, which includes stress, depression, and problems with emotions?
1

Excellent

2

Very good

3

Good

4

Fair

5

Poor

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0088

overall health?
1

Excellent

2

Very good

3

Good

4

Fair

5

Poor

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "overall".
BOX ID:

R04_YMD05

Display questions R04_YX0090_12M through R04_YX0088_12M using the expanded WVB stem-leaf
screen. The introduction text from R04_YX0090_12M is the stem. Show all leaves on the screen at
once.
PATH ID:

R04_YX0090_12M

Compared with 12 months ago, would you say...
your physical health is now...
1

Better

2

Worse

3

About the same

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0091_12M

your mental health is now...
1

Better

2

Worse

3

About the same

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0088_12M

your overall health is now...
1

Better

2

Worse

3

About the same

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0726

Overall, how would you rate the health of your teeth and gums?
1

Excellent

2

Very good

3

Good

4

Fair

5

Poor

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0310

The next questions ask about your height and weight. Do you want to answer these questions in…
1

Feet and pounds, or

2

Meters and kilograms

-8

DON'T KNOW

-7

REFUSED

GO TO R04_YX0311

ASK: All youth respondents.

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Wave 4 (version 3.0)
PATH ID:

R04_YT0007

About how tall are you without shoes?
1

I___I Feet

2

I__I__I Inches

-8

DON'T KNOW

GO TO R04_YT0008

-7

REFUSED

GO TO R04_YT0008

ASK: Youth respondents who prefer to answer height in feet and inches or did not choose a system of
measurement.
DISPLAY: DISPLAY “Feet” AND “Inches” AS TITLES.
PATH ID:

R04_YT0007_LC1

The computer recorded that you are [R04_YT0007_FT] feet [and R04_YT0007_IN inches] tall. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YT0007

2

NEXT

GO TO R04_YT0008

ASK: IF R04_YT0007_FT > 8 OR R04_YT0007_FT < 3.
PATH ID:

R04_YX0311

About how tall are you without shoes?
1

I__I__I.I__I__I Meters

-8

DON'T KNOW

GO TO R04_YX0312

-7

REFUSED

GO TO R04_YX0312

ASK: Youth respondents who prefer to answer height in meters.
DISPLAY: DISPLAY “Meters” AS A TITLE.
PATH ID:

R04_YX0311_LC1

The computer recorded that you are [R04_YX0311] meters tall. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0311

2

NEXT

GO TO R04_YX0312

ASK: IF R04_YX0311 > 2.7 OR R04_YX0311 < 0.9.

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Wave 4 (version 3.0)
PATH ID:

R04_YT0008

About how much do you weigh without clothes or shoes?
1

I___I___I___I Pounds

-8

DON'T KNOW

GO TO R04_YX0241

-7

REFUSED

GO TO R04_YX0241

ASK: Youth respondents who prefer to answer weight in pounds or did not choose a system of
measurement.
DISPLAY: DISPLAY “Pounds” AS A TITLE.
PATH ID:

R04_YT0008_LC1

The computer recorded that you weigh [R04_YT0008] pounds. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YT0008

2

NEXT

GO TO R04_YX0241

ASK: IF R04_YT0008 > 450 OR R04_YT0008 < 75.
PATH ID:

R04_YX0312

About how much do you weigh without clothes or shoes?
1

I___I___I___I Kilograms

-8

DON'T KNOW

GO TO R04_YX0241

-7

REFUSED

GO TO R04_YX0241

ASK: Youth respondents who prefer to answer weight in kilograms.
DISPLAY: DISPLAY “Kilograms” AS A TITLE.
PATH ID:

R04_YX0312_LC1

The computer recorded that you weigh [R04_YX0312] kilograms. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0312

2

NEXT

GO TO R04_YX0241

ASK: IF R04_YX0312 > 205 OR R04_YX0312 < 34.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0241

During the past 7 days, on how many days were you physically active for a total of at least 60 minutes
per day? (Add up all the time you spent in any kind of physical activity that increased your heart rate
and made you breathe hard some of the time.)
1

0 days

2

1 day

3

2 days

4

3 days

5

4 days

6

5 days

7

6 days

8

7 days

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "past 7 days"; BOLD "at least 60 minutes per day".
PATH ID:

R04_YX0242

On how many of the past 7 days did you exercise or participate in physical activity for at least 20
minutes that made you sweat and breathe hard, such as basketball, soccer, running, swimming laps,
fast bicycling, fast dancing, or similar aerobic activities?
1

0 days

2

1 day

3

2 days

4

3 days

5

4 days

6

5 days

7

6 days

8

7 days

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD "at least 20 minutes that made you sweat and breathe hard".

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Wave 4 (version 3.0)
PATH ID:

R04_YX0243

On how many of the past 7 days did you do exercises to strengthen or tone your muscles, such as
push-ups, sit-ups, or weight lifting?
1

0 days

2

1 day

3

2 days

4

3 days

5

4 days

6

5 days

7

6 days

8

7 days

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YXR43

New baseline youth respondents, go to R04_YX0046_NB.
Else,continuing youth respondents, go to R04_YX0047_12M.
PATH ID:

R04_YX0046_NB

Have you ever had wheezing or whistling in the chest at any time in the past?
1

Yes

2

No

GO TO R04_YX0052

-8

DON'T KNOW

GO TO R04_YX0052

-7

REFUSED

GO TO R04_YX0052

ASK: New baseline youth respondents.
DISPLAY: UNDERLINE "ever".
PATH ID:

R04_YX0047_12M

Have you had wheezing or whistling in the chest in the past 12 months?
1

Yes

2

No

GO TO R04_YX0052

-8

DON'T KNOW

GO TO R04_YX0052

-7

REFUSED

GO TO R04_YX0052

ASK: New baseline youth respondents who had wheezing or whistling in the chest at any time in the
past and continuing youth respondents.
DISPLAY: UNDERLINE "past 12 months".

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Wave 4 (version 3.0)
PATH ID:

R04_YX0048

How many attacks of wheezing have you had in the past 12 months?
1

None

2

1 to 3

3

4 to12

4

More than 12

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who had wheezing or whistling in the chest in the past 12 months.
PATH ID:

R04_YX0049

In the past 12 months how often, on average, has your sleep been disturbed due to wheezing?
1

Never woken with wheezing

2

Less than one night per week

3

One or more nights per week

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who had wheezing or whistling in the chest in the past 12 months.
PATH ID:

R04_YX0050

In the past 12 months, has wheezing ever been severe enough to limit your speech to only one or two
words between breaths?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who had wheezing or whistling in the chest in the past 12 months.
PATH ID:

R04_YX0052

In the past 12 months, has your chest sounded wheezy during or after exercise?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0053

A dry cough is a cough without phlegm or mucus. In the past 12 months, have you had a dry cough at
night?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YXR18

Continuing youth respondents, go to R04_YT0031_12M.
Else, go to R04_YT0031_NB.
PATH ID:

R04_YT0031_NB

Have you ever been told by a doctor, nurse or other health professional that you have asthma?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents.
BOX ID:

R04_YXV03

PROGRAM: CREATE DERIVED VARIABLE (SEE APPENDIX)
R04_YOUTH_ASTHMA = All youth respondents who have ever had asthma.
BOX ID:

R04_YXR09

New baseline youth respondents that have asthma, go to R04_YT0038_NB.
Else, continuing youth respondents that have asthma, go to R04_YX0227.
Else, go to Box R04_YXD06.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YT0038_NB

How old were you when you were first told you had asthma?
1

|___|___|___| Years old

-8

DON'T KNOW

GO TO R04_YT0260_NB

-7

REFUSED

GO TO R04_YT0260_NB

ASK: New baseline youth respondetns who have asthma.
DISPLAY: DISPLAY “Years old” AS A TITLE.
PATH ID:

R04_YT0038_NB_LC1

The computer recorded that you were [R04_YT0038_NB] years old when you were first told you had
asthma. That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YT0038_NB

2

NEXT

GO TO R04_YX0227

ASK: IF R04_YT0038_NB > R04_YOUTHAGE.
PATH ID:

R04_YT0260_NB

When you were first told you had asthma, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON’T KNOW

-7

REFUSED

ASK: New baseline youth respondents who did not know or refused to report age when they were first
told they had asthma.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0227

In the past 30 days, how much of the time did your asthma keep you from getting as much done at
work, school or at home?
1

All of the time

2

Most of the time

3

Some of the time

4

A little of the time

5

None of the time

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have asthma.
DISPLAY: UNDERLINE "past 30 days".
PATH ID:

R04_YX0228

In the past 30 days, how often have you had shortness of breath?
1

More than once a day

2

Once a day

3

3-6 times a week

4

Once or twice a week

5

None at all

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have asthma.
PATH ID:

R04_YX0229

In the past 30 days, how often did your asthma symptoms (such as wheezing, coughing, shortness of
breath, chest tightness or pain) wake you up at night or earlier than usual in the morning?
1

4 or more nights a week

2

2 or 3 nights

3

Once a week

4

Once or twice

5

Not at all

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have asthma.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YT0022

In the past 12 months, have you taken medications regularly for asthma?
(Taken regularly means according to a health care provider’s instructions.)
1

Yes

2

No

GO TO R04_YT0127

-8

DON'T KNOW

GO TO R04_YT0127

-7

REFUSED

GO TO R04_YT0127

ASK: Youth respondents who have asthma.
DISPLAY: UNDERLINE "past 12 months".
BOX ID:

R04_YMD01

DISPLAY INSTRUCTION:
For R04_YT0036, display as a stem and leaf question. For each leaf, display a yes/no response.
PATH ID:

R04_YT0036

In the past 12 months, which of the following medications did you regularly take for asthma?
1

Quick-relief inhaler - for example: albuterol (ProAir, Ventolin, Xopenex), ipratropium
(Atrovent), or a combination inhaler (Combivent)

2

Controller or long-acting inhaler including steroid inhaler – for example:
beclomethasone (Qvar), fluticasone (Flovent), salmeterol (Serevent), tiotropium
(Spiriva), or a combination inhaler (Advair)

3

Other controlling medication – for example: montelukast (Singulair), zafirlukast
(Accolate), theophylline, roflumilast (Daliresp)

4

Other asthma medication

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have asthma that have taken medications regularly in the past 12 months.
PATH ID:

R04_YT0125

In the past 12 months, have you had an asthma attack that required use of an oral or injected steroid
medication at the time of the attack? Examples of oral or injected steroid medications include
prednisone, prednisolone (Orapred), and dexamethasone (Decadron).
1

Yes

2

No

GO TO R04_YT0127

-8

DON'T KNOW

GO TO R04_YT0127

-7

REFUSED

GO TO R04_YT0127

ASK: Youth respondents who have asthma that have taken medications regularly in the past 12 months.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YT0039

In the past 12 months, how many asthma attacks have you had that required use of an oral or injected
steroid medication at the time of the attack?
1

|___|___|___|

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who had an asthma attack in the past 12 months that needed oral or injected
steroid medication.
PATH ID:

R04_YT0127

In the past 12 months, have you had to visit an emergency room or urgent care center because of
asthma?
1

Yes

2

No

GO TO R04_YX0230

-8

DON'T KNOW

GO TO R04_YX0230

-7

REFUSED

GO TO R04_YX0230

ASK: Youth respondents who have asthma.
PATH ID:

R04_YT0282

In the past 12 months, how many times have you had to visit an emergency room or urgent care center
because of asthma?
1

|___|___|___|

-8

DON'T KNOW

GO TO BOX R04_YXR42

-7

REFUSED

GO TO BOX R04_YXR42

ASK: Youth respondents who had to go to the emergency room for asthma in the past 12 months.
PATH ID:

R04_YT0282_LC1

The computer recorded that you have visited an emergency room or urgent care center [R04_YT0282]
times in the past 12 months because of asthma. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YT0282

2

NEXT

GO TO BOX R04_YXR42

ASK: IF R04_YT0282 > 20.

PATH – Wave 4
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Wave 4 (version 3.0)
BOX ID:

R04_YXR42

Youth respondents who had to go to the emergency room for asthma once in the past 12 months, go to
R04_YX0695.
Else, youth respondents who had to go to the emergency room for asthma multiple times in the past 12
months, go to R04_YX0720.
Else, youth respondents who have asthma, go to R04_YX0230.
PATH ID:

R04_YX0695

Was that visit due to an asthma attack?
1

Yes

GO TO R04_YX0230

2

No

GO TO R04_YX0230

-8

DON'T KNOW

GO TO R04_YX0230

-7

REFUSED

GO TO R04_YX0230

ASK: Youth respondents who had to go to the emergency room for asthma once in the past 12 months.
PATH ID:

R04_YX0720

How many of those visits were due to an asthma attack?
1

|___|___|___|

-8

DON'T KNOW

GO TO R04_YX0230

-7

REFUSED

GO TO R04_YX0230

ASK: Youth respondents who had to go to the emergency room for asthma multiple times in the past 12
months.
PATH ID:

R04_YX0720_LC1

The computer recorded that you have visited an emergency room or urgent care center [R04_YX0720]
times in the past 12 months because of an asthma attack. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0720

2

NEXT

GO TO R04_YX0230

ASK: IF R04_YX0720 > R04_YT0282.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0230

In the past 30 days, how often have you used a rescue inhaler, nebulizer treatment, or other controlling
medication (such as albuterol)?
1

3 or more times per day

2

1 or 2 times per day

3

2 or 3 times per week

4

Once a week or less

5

Not at all

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have asthma.
DISPLAY: UNDERLINE "past 30 days".
PATH ID:

R04_YX0231

How would you rate your asthma control during the past 30 days?
1

Not controlled at all

2

Poorly controlled

3

Somewhat controlled

4

Well controlled

5

Completely controlled

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have asthma.
BOX ID:

R04_YXD06

DISPLAY INSTRUCTION:
For R04_YX0158, display a ‘Yes’ and ‘No’ column with options for each response category. Show all
response categories on the screen at once.
PATH ID:

R04_YX0158

In the past 12 months, did you take any of the following medications, even once?
1

Ibuprofen (Motrin, Advil, Naprosyn, or Aleve)

2

Acetaminophen (Tylenol)

3

Aspirin

4

Cox-2 inhibitors (Celebrex)

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Wave 4 (version 3.0)

BOX ID:

R04_YXR50

If youth respondent has not used any tobacco or e-product in the past 12 months, go to
R04_YN0330_12MH.
Else, go to Box R04_YXR19.
PATH ID:

R04_YN0330_12MH

In the past 12 months, have you used a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal
spray, lozenge or pill?
1

Yes

2

No

GO TO R04_YN0331_12MH

-8

DON'T KNOW

GO TO R04_YN0331_12MH

-7

REFUSED

GO TO R04_YN0331_12MH

ASK: Youth respondents who have not used any tobacco or e-product in the past 12 months.
PATH ID:

R04_YN0307H

When did you last use a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or
pill?
1

In the past hour

GO TO R04_YN0309H

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO R04_YN0331_12MH

-8

DON'T KNOW

GO TO R04_YN0331_12MH

-7

REFUSED

GO TO R04_YN0331_12MH

ASK: Youth respondents who have used NRT in the past 12 months.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0308H

When you last used a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or pill
[FILL BASED ON R04_YN0307H], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used NRT today, yesterday or the day before yesterday.
DISPLAY: [FILL BASED ON R04_YN0307H]:
IF R04_YN0307H = 2, DISPLAY "sometime today".
IF R04_YN0307H = 3, DISPLAY "yesterday".
IF R04_YN0307H = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YN0309H

When you last used a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or pill
[FILL BASED ON R04_YN0307H], how many did you use?
1

I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Youth who have used NRT in the past hour, today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YN0307H]:
IF R04_YN0307H = 1, 2, DISPLAY “today”.
IF R04_YN0307H = 3, DISPLAY "yesterday".
IF R04_YN0307H = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YN0309H_LC1

The computer recorded that [today/yesterday/the day before yesterday], you used a nicotine patch,
nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or pill [R04_YN0309H] times.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YN0309H

2

NEXT

GO TO R04_YN0331_12MH

ASK: IF R04_YN0309H = 0 OR R04_YN0309H > 5.
DISPLAY: IF R04_YN0307H = 1, 2, DISPLAY “today”.
IF R04_YN0307H = 3, DISPLAY “yesterday”.
IF R04_YN0307H = 4, DISPLAY “the day before yesterday”.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0331_12MH

In the past 12 months, have you used any of the following prescription drugs: Chantix, varenicline,
Wellbutrin, Zyban, or bupropion?
1

Yes

2

No

GO TO BOX R04_YXR19

-8

DON'T KNOW

GO TO BOX R04_YXR19

-7

REFUSED

GO TO BOX R04_YXR19

ASK: Youth respondents who have not used any tobacco or e-product in the past 12 months.
PATH ID:

R04_YN0327H

When did you last use Chantix, varenicline, Wellbutrin, Zyban, or bupropion?
1

In the past hour

GO TO R04_YN0329H

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YXR19

-8

DON'T KNOW

GO TO BOX R04_YXR19

-7

REFUSED

GO TO BOX R04_YXR19

ASK: Youth respondents who have used a prescription drug in the past 12 months.
PATH ID:

R04_YN0328H

When you last used Chantix, varenicline, Wellbutrin, Zyban, or bupropion [FILL BASED ON
R04_YN0327H], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth who have used a prescription drug today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YN0327H]:
IF R04_YN0327H = 2, DISPLAY "today".
IF R04_YN0327H = 3, DISPLAY "yesterday".
IF R04_YN0327H = 4, DISPLAY “the day before yesterday”.
ELSE, DISPLAY TEXT AS SHOWN IN OPTIONS SELECTED IN R04_YN0327H, MAKING FIRST
LETTER LOWERCASE.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0329H

When you used Chantix, varenicline, Wellbutrin, Zyban, or bupropion [FILL BASED ON R04_YN0327H],
how many did you take?
1

I___I___I

-8

DON'T KNOW

GO TO BOX R04_YXR19

-7

REFUSED

GO TO BOX R04_YXR19

ASK: Youth respondents who have used a prescription drug in the past hour, today, yesterday or the
day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YN0327H]:
IF R04_YN0327H = 1, 2, DISPLAY “today”.
IF R04_YN0327H = 3, DISPLAY "yesterday"
IF R04_YN0327H = 4, DISPLAY “the day before yesterday”.
ELSE, DISPLAY TEXT AS SHOWN IN OPTIONS SELECTED IN R04_YN0327H, MAKING FIRST
LETTER LOWERCASE.
PATH ID:

R04_YN0329H_LC1

The computer recorded that [today/yesterday/the day before yesterday], you used Chantix, varenicline,
Wellbutrin, Zyban, or bupropion [R04_YN0329H] times.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

2

NEXT

GO TO R04_YN0329H

ASK: IF R04_YN0329H = 0 OR R04_YN0329H > 5.
DISPLAY: IF R04_YN0327H = 1, 2, DISPLAY “today”.
IF R04_YN0327H = 3, DISPLAY “yesterday”.
IF R04_YN0327H = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YXR19

Female youth respondents aged 15 or older, go to R04_YX0136.
Else, go to Box R04_YXT03.
PATH ID:

R04_YX0136

Are you currently pregnant?
1

Yes

2

No

GO TO BOX R04_YXT03

-8

DON'T KNOW

GO TO BOX R04_YXT03

-7

REFUSED

GO TO BOX R04_YXT03

ASK: Female youth respondents aged 15 years or older.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

PATH ID:

R04_YX0137

How many months or weeks pregnant are you? Please enter number of months or weeks.
1

I__I__I Months

2

I__I__I Weeks

-8

DON'T KNOW

-7

REFUSED

ASK: Female youth respondents aged 15 years or older who are currently pregnant.
PATH ID:

R04_YX0137_LC1

The computer recorded that you have been pregnant for [R04_YX0137_NN] [months/weeks]. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0137

2

NEXT

GO TO BOX R04_YXT03

ASK: IF (R04_YX0134_NN > 10 AND R04_YX0137_UN = 1) OR (R04_YX0134_NN > 42 AND
R04_YX0137_UN = 2).
DISPLAY: IF R04_YX0137_UN = 1, DISPLAY "months".
ELSE, IF R04_YX0137_UN = 2, DISPLAY "weeks".

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PATH
Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

MARKETING, ADVERTISING AND PROMOTION
BOX ID:

R04_YXT03

The next questions ask about tobacco advertising that you may have seen or received.
PATH ID:

R04_YX0708

In the past 12 months, have you received discounts or coupons for any of the following products?
Choose all that apply.
1

Cigarettes

2

E-cigarettes or other electronic nicotine products (including e-liquid)

3

Cigars

4

Shisha or hookah tobacco

5

Snus

6

Other types of smokeless tobacco (such as dip, spit or chew)

7

Some other type of tobacco product

8

None of the above

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0678

In the past 30 days, have you gotten a free sample of an e-cigarette or other electronic nicotine
product (including e-liquid)?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "e-cigarette or other electronic nicotine product".

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0182

In the past 30 days, how often did you visit a convenience store, small market, or liquor store?
1

Not at all

2

Once in the past 30 days

3

2-3 times in the past 30 days

4

Once a week

5

2-3 times per week

6

Almost every day

-8

DON'T KNOW

-7

REFUSED

GO TO R04_YX0203

ASK: All youth respondents.
PATH ID:

R04_YX0183

In the past 30 days, when you visited convenience stores, small markets, or liquor stores, how often did
you see ads for e-cigarettes or other electronic nicotine products?
1

Never

2

Rarely

3

Sometimes

4

Often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have visited a store or market in the past 30 days.
DISPLAY: BOLD AND UNDERLINE "e-cigarettes or other electronic nicotine products".

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0203

In the past 30 days, have you noticed e-cigarettes or other electronic nicotine products being
advertised in any of the following places? Choose all that apply.
1

I haven't seen any advertisements in the past 30 days

2

At gas stations, convenience stores, or other retail stores

3

On billboards

4

In newspapers or magazines

5

On radio

6

On television

7

At events such as fairs, festivals, or sporting events

8

At nightclubs, bars, or music concerts

9

On websites or social media sites

10

Somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "e-cigarettes or other electronic nicotine products".
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
PATH ID:

R04_YX0709

Do you have a favorite e-cigarette or electronic nicotine product advertisement?
1

Yes

2

No

GO TO R04_YX0481

-8

DON'T KNOW

GO TO R04_YX0481

-7

REFUSED

GO TO R04_YX0481

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0297

What is the brand of your favorite advertisement for an e-cigarette or electronic nicotine product?
Choose only one.
If you do not see the brand listed below, select “Something else”.
1

Blu

2

eSmoke

3

Fin

4

GreenSmoke

5

iTaste

6

Logic

7

MarkTen

8

NJOY

9

ProVape

10

Smoking Everywhere

11

Vapor King

12

Vuse

13

V2Cigs

14

Something else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have a favorite e-product advertisement.
DISPLAY: UNDERLINE "e-cigarette or other electronic nicotine product". IF OS FIELD SELECTED AND
ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT AND ADD THE FOLLOWING
TEXT: “Please type your answer using the computer keyboard.”
PATH ID:

R04_YX0481

In the past 30 days, have you gotten a free sample of a tobacco product (not including e-cigarettes
or electronic nicotine products)?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "tobacco product (not including e-cigarettes or electronic nicotine
products)"

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YXR24

Youth respondents who have visited a store or market in the past 30 days, go to R04_YX0178.
Else, go to R04_YX0677.
PATH ID:

R04_YX0178

In the past 30 days, when you visited convenience stores, small markets, or liquor stores, how often did
you see ads for cigarettes or other tobacco products (not including e-cigarettes or electronic nicotine
products)?
1

Never

2

Rarely

3

Sometimes

4

Often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have visited a store or market in the past 30 days.
DISPLAY: BOLD AND UNDERLINE "cigarettes or other tobacco products".
PATH ID:

R04_YX0677

In the past 30 days, have you noticed cigarettes or other tobacco products (not including e-cigarettes
or electronic nicotine products) being advertised in any of the following places? Choose all that apply.
1

I haven't seen any advertisements in the past 30 days

2

At gas stations, convenience stores, or other retail stores

3

On billboards

4

In newspapers or magazines

5

On radio

6

On television

7

At events such as fairs, festivals, or sporting events

8

At nightclubs, bars, or music concerts

9

On websites or social media sites

10

Somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "cigarettes or other tobacco products".
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0710

Do you have a favorite tobacco advertisement?
1

Yes

2

No

GO TO BOX R04_YXR44

-8

DON'T KNOW

GO TO BOX R04_YXR44

-7

REFUSED

GO TO BOX R04_YXR44

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0197

What is the brand of your favorite tobacco advertisement? Choose only one.
If you do not see the brand listed below, select “Something else”.
1

American Spirit

2

Basic

3

Benson & Hedges

4

Black & Mild

5

Camel

6

Capri

7

Copenhagen

8

Doral

9

Dutch Masters

10

Grizzly

11

Kool

12

Levi Garrett

13

Liggett Select

14

Marlboro

15

Maverick

16

Misty

17

Newport

18

Pall Mall

19

Parliament

20

Phillies Blunts

21

Redman

22

Salem

23

Skoal

24

Sonoma

25

Swisher Sweets

26

USA Gold

27

Virginia Slims

28

Winchester

29

Winston

30

Something else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have a favorite tobacco advertisement.
DISPLAY: UNDERLINE "tobacco". IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS
SHOWN, DISPLAY QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer

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Wave 4 (version 3.0)
using the computer keyboard.”
BOX ID:

R04_YXR44

Random sample of all youth respondents, go to R04_YX0234.
Else, go to Box R04_YXR45.
PATH ID:

R04_YX0234

In the past 12 months, have you seen or heard of any ads on television, the internet or radio with the
following slogan or theme?
"A Tip From a Former Smoker"
[DISPLAY IMAGE OF TIPS CAMPAIGN LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Random sample of all youth respondents.
DISPLAY: BOLD "A Tip From a Former Smoker".
PATH ID:

R04_YX0235

In the past 12 months, have you seen or heard of any ads on television, the internet or radio with the
following slogan or theme?
[DISPLAY IMAGE OF TRUTH 'FINISH IT' CAMPAIGN LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Random sample of all youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0728

In the past 12 months, have you seen or heard of any ads on television, the internet or radio with the
following slogan or theme?
"Know the real costs."
[DISPLAY IMAGE OF REAL COST CAMPAIGN LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Random sample of all youth respondents.
DISPLAY: BOLD "Know the real costs."
PATH ID:

R04_YX0674

In the past 12 months, have you seen or heard of any ads on television, the internet or radio with the
following slogan or theme?
"Cigarettes are Bullies. Don’t let tobacco control you."
[DISPLAY IMAGE OF REAL COST CAMPAIGN LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Random sample of all youth respondents.
DISPLAY: BOLD "Cigarettes are Bullies. Don’t let tobacco control you."

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0713

In the past 12 months, have you seen or heard of any ads on television, the internet or radio with the
following slogan or theme?
"Keep it Fresh. Live Tobacco-Free."
[DISPLAY IMAGE OF FRESH EMPIRE LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Random sample of all youth respondents.
DISPLAY: BOLD "Keep it Fresh. Live Tobacco-Free".
BOX ID:

R04_YXR45

Continuing youth respondents who identified as LGBT in any previous wave, and a random sample of
all youth respondents, go to R04_YX0764.
Else, go to Box R04_YXR51.
PATH ID:

R04_YX0764

In the past 12 months, have you seen or heard of any ads with the following slogan or theme?
LGBT campaign
[DISPLAY IMAGE OF CAMPAIGN LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who identify as LGBT in any previous wave, and a random sample
of all youth respondents.
BOX ID:

R04_YXR51

White male youth respondents who are both Hispanic and non-Hispanic, go to R04_YX0765.
Else, go to R04_YX0008.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0765

In the past 12 months, have you seen or heard of any ads on television, the internet or radio with the
following slogan or theme?
Rural smokeless campaign
[DISPLAY IMAGE OF CAMPAIGN LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: White male (Hispanic and non-Hispanic) youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

SOCIAL NORMS, PEER AND FAMILY INFLUENCES
PATH ID:

R04_YX0008

In general, do you think most people disapprove of smoking cigarettes?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD "cigarettes".
PATH ID:

R04_YX0012

In general, do you think most people disapprove of using e-cigarettes or other electronic nicotine
products?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD "e-cigarettes or other electronic nicotine products".
PATH ID:

R04_YX0071

Thinking about the people who are important to you, how would you describe their views on using
tobacco in general?
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "people who are important to you"; BOLD "tobacco in general".

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YXD89

Display questions R04_YC1143 through R04_YS1143 using the expanded WVB stem-leaf screen. The
introduction text from R04_YC1143 is the stem. Show all leaves on the screen at once.
PATH ID:

R04_YC1143

Thinking about the people who are important to you, how would you describe their views on the
following?
Smoking cigarettes
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "people who are important to you"; BOLD "their views".
PATH ID:

R04_YV1143

Using e-cigarettes or other electronic nicotine products
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Wave 4 (version 3.0)
PATH ID:

R04_YG1143

Smoking traditional cigars, cigarillos, or filtered cigars
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YH1143

Smoking shisha or hookah tobacco
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YU1143

Using snus
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Wave 4 (version 3.0)
PATH ID:

R04_YS1143

Using other types of smokeless tobacco (such as dip, spit, or chew)
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0741

Thinking about the people who are important to you, do any of them use any of the following products?
Choose all that apply.
1

Cigarettes

2

E-cigarettes or other electronic nicotine products

3

Traditional cigars

4

Cigarillos

5

Filtered cigars

6

Pipe tobacco

7

Shisha or hookah tobacco

8

Snus

9

Other types of smokeless tobacco (such as dip, spit or chew)

10

None of the above

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "people who are important to you".

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Wave 4 (version 3.0)
PATH ID:

R04_YX0680

How many of your best friends smoke cigarettes?
1

None

2

A few

3

Some

4

Most

5

All

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0681

How many of your best friends use e-cigarettes or other electronic nicotine products?
1

None

2

A few

3

Some

4

Most

5

All

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0683

How many of your best friends smoke cigarillos?
1

None

2

A few

3

Some

4

Most

5

All

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX9686

How many of your best friends smoke hookah?
1

None

2

A few

3

Some

4

Most

5

All

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0693

How many of your best friends use snus?
1

None

2

A few

3

Some

4

Most

5

All

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0685

How many of your best friends use other types of smokeless tobacco (such as dip, spit, or chew)?
1

None

2

A few

3

Some

4

Most

5

All

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1156

Out of every 10 people your age, how many do you think smoke cigarettes?
0

0

1

1

2

2

3

3

4

4

5

5

6

6

7

7

8

8

9

9

10

10

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YV1156

Out of every 10 people your age, how many do you think use e-cigarettes or other electronic nicotine
products?
0

0

1

1

2

2

3

3

4

4

5

5

6

6

7

7

8

8

9

9

10

10

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YS1156

Out of every 10 people your age, how many do you think use smokeless tobacco?
0

0

1

1

2

2

3

3

4

4

5

5

6

6

7

7

8

8

9

9

10

10

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YH1156

Out of every 10 people your age, how many do you think smoke hookah?
0

0

1

1

2

2

3

3

4

4

5

5

6

6

7

7

8

8

9

9

10

10

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Wave 4 (version 3.0)
BOX ID:

R04_YXV04

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PASTYEAR_TOB_USE_LEVEL = 2 (Past year "not light" tobacco users) Youth respondents
who are "not light" users of any tobacco product and have used in the past year.
R04_PASTYEAR_TOB_USE_LEVEL = 1 (Past year "very light" tobacco users) Youth respondents
who have used any tobacco product in the last year, and are not "not light" users of any product.
BOX ID:

R04_YXR40

Past year "not light" tobacco users, go to R04_YX0742.
Else, past year "very light" tobacco users, go to R04_YX0743.
Else, go to R04_YX0714.
PATH ID:

R04_YX0742

In the past 12 months, to what extent, if at all, has the disapproval of close friends and family led you to
think about quitting?
1

Not at all

GO TO R04_YX0714

2

Somewhat

GO TO R04_YX0714

3

Very much

GO TO R04_YX0714

-8

DON'T KNOW

GO TO R04_YX0714

-7

REFUSED

GO TO R04_YX0714

ASK: Past year "not light" tobacco users.
DISPLAY: UNDERLINE "close friends and family".
PATH ID:

R04_YX0743

In the past 12 months, to what extent, if at all, has the disapproval of close friends and family led you to
think about not using?
1

Not at all

2

Somewhat

3

Very much

-8

DON'T KNOW

-7

REFUSED

ASK: Past year "very light" tobacco users.
DISPLAY: UNDERLINE "close friends and family".

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0714

In the past 12 months, have your parents or guardians talked with you, even once, about not using ecigarettes or other electronic nicotine products?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0694

If your parents or guardians found you using e-cigarettes or other electronic nicotine products, how do
you think they would react? Would they…
1

Be very upset

2

Not be too upset

3

Have no reaction

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0500

In the past 12 months, have your parents or guardians talked with you, even once, about not using any
other type of tobacco product?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0200

If your parents or guardians found you using tobacco, how do you think they would react? Would they…
1

Be very upset

2

Not be too upset

3

Have no reaction

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

ACCESSIBILITY
PATH ID:

R04_YX0715

How easy do you think it is for people your age to buy e-cigarettes or other electronic nicotine products
in a store?
1

Very easy

2

Somewhat easy

3

Somewhat difficult

4

Very difficult

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0716

How likely is it that you will try to purchase an e-cigarette or other electronic nicotine products within the
next 30 days?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0499

How easy do you think it is for people your age to buy tobacco products in a store?
1

Very easy

2

Somewhat easy

3

Somewhat difficult

4

Very difficult

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0501

How likely is it that you will try to purchase cigarettes within the next 30 days?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0502

How likely is it that you will try to purchase tobacco products other than cigarettes within the next 30
days?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

PSYCHOSOCIAL
PATH ID:

R04_YX0488

The next questions are about common psychological, behavioral, and personal problems. These
problems are considered significant when you have them for two or more weeks, when they keep
coming back, when they keep you from meeting your responsibilities, or when they make you feel like
you can’t go on.
After each of the following questions, please tell us the last time, if ever, you had the problem, by
answering whether it was in the past month, 2-12 months ago, over a year ago, or never.
1

NEXT

ASK: All youth respondents.
DISPLAY: UNDERLINE "significant".
BOX ID:

R04_YXD07

Display questions R04_YX0161 through R04_YX0164 using the expanded WVB stem-leaf screen. The
introduction text from R04_YX0161 is the stem. As each question is answered, show the next one.
PATH ID:

R04_YX0161

When was the last time that you had significant problems with...
feeling very trapped, lonely, sad, blue, depressed, or hopeless about the future?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "significant problems".

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0162

sleep trouble, such as bad dreams, sleeping restlessly, or falling asleep during the day?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0163

feeling very anxious, nervous, tense, scared, panicked, or like something bad was going to happen?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0164

becoming very distressed and upset when something reminded you of the past?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YXD08

Display questions R04_YX0165 through R04_YX0251 using the expanded WVB stem-leaf screen. The
introduction text from R04_YX0165 is the stem. As each question is answered, show the next one.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0165

When was the last time that you did any of the following things two or more times...
lied or conned to get things you wanted or to avoid having to do something?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "two or more times".
PATH ID:

R04_YX0166

had a hard time paying attention at school, work, or home?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0167

had a hard time listening to instructions at school, work, or home?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0168

were a bully or threatened other people?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0169

started physical fights with other people?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0250

felt restless or the need to run around or climb on things?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0251

gave answers before the other person finished asking the question?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YXR34

If new baseline youth respondent, go to Box R04_YXD90.
Else, go to Box R04_YXR05.
BOX ID:

R04_YXD90

Display questions R04_YX0510_NB through R04_YX0520_NB using the expanded WVB stem-leaf
screen. The introduction text from R04_YX0510_NB is the stem. Show all leaves on the screen at once.
PATH ID:

R04_YX0510_NB

Please answer how much you agree or disagree with each of the following statements:
I like to do frightening things.
1

Strongly agree

2

Agree

3

Neither agree nor disagree

4

Disagree

5

Strongly disagree

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0515_NB

I like new and exciting experiences, even if I have to break the rules.
1

Strongly agree

2

Agree

3

Neither agree nor disagree

4

Disagree

5

Strongly disagree

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents.
PATH ID:

R04_YX0520_NB

I prefer friends who are exciting and unpredictable.
1

Strongly agree

2

Agree

3

Neither agree nor disagree

4

Disagree

5

Strongly disagree

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

SUBSTANCE USE
BOX ID:

R04_YXR05

Continuing youth respondents, go to R04_YX0084_12M.
New baseline youth respondents, go to R04_YX0084_NB.
PATH ID:

R04_YX0084_NB

The next questions ask about your use of alcohol and other drugs. Remember all information you give
to the PATH Study will be kept private.
Have you ever used alcohol at all, including sips of someone’s drink or your own drink?
1

Yes

2

No

GO TO BOX R04_YXR06

-8

DON'T KNOW

GO TO BOX R04_YXR06

-7

REFUSED

GO TO BOX R04_YXR06

ASK: New baseline youth respondents.
DISPLAY: UNDERLINE "at all".
PATH ID:

R04_YX0086_NB

About how old were you when you first drank alcohol at all, counting small tastes or sips?
1

|___|___| Years old

-8

DON'T KNOW

GO TO R04_YX0087_NB

-7

REFUSED

GO TO R04_YX0087_NB

ASK: New baseline youth respondents who have ever used alcohol.
DISPLAY: DISPLAY “Years old” AS A TITLE.
PATH ID:

R04_YX0086_NB_LC1

The computer recorded that you first drank alcohol including small tastes or sips at age
[R04_YX0086_NB]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0086_NB

2

NEXT

GO TO R04_YX0074_NB

ASK: IF R04_YX0086_NB <= 5.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0086_NB_LC2

The computer recorded that you first drank alcohol including small tastes or sips at age
[R04_YX0086_NB]. That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0086_NB

2

NEXT

GO TO R04_YX0074_NB

ASK: IF R04_YX0086_NB > R04_YOUTHAGE.
PATH ID:

R04_YX0087_NB

When you first drank alcohol at all, counting small tastes or sips, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who did not know or refused to report age they first used alcohol.
DISPLAY: UNDERLINE "at all".
PATH ID:

R04_YX0074_NB

About how old were you when you had your first alcoholic drink, other than small tastes or sips?
A drink is a can or bottle of beer; a wine cooler or a glass of wine, champagne, or sherry; a shot of liquor
or a mixed drink or cocktail.
-2
1

I have never had an alcoholic drink other than small tastes
or sips
I___I___I Years old

-8

DON'T KNOW

GO TO R04_YX0270_NB

-7

REFUSED

GO TO R04_YX0270_NB

ASK: New baseline youth respondents who have ever used alcohol.
DISPLAY: DISPLAY AS NUMERIC QUANTITY FIELD WITH BUTTON “I have never had an alcoholic
drink other than small tastes or sips” ON LEFT.
UNDERLINE "first alcoholic drink".
DISPLAY “Years old” AS A TITLE.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0074_NB_LC1

The computer recorded that you had your first alcoholic drink, other than small tastes or sips at age
[R04_YX0074_NB]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0074_NB

2

NEXT

GO TO BOX R04_YXR26

ASK: IF R04_YX0074_NB <= 10
PATH ID:

R04_YX0074_NB_LC2

The computer recorded that you had your first alcoholic drink, other than small tastes or sips at age
[R04_YX0074_NB]. That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0074_NB

2

NEXT

GO TO BOX R04_YXR26

ASK: IF R04_YX0074_NB > R04_YOUTHAGE.
PATH ID:

R04_YX0270_NB

When you had your first alcoholic drink, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON’T KNOW

-7

REFUSED

ASK: New baseline youth respondents who did not know or refused to report age they first used alcohol.
BOX ID:

R04_YXR26

If new baseline youth respondent has ever used any form of tobacco and reported valid age of first drink
and onset of tobacco use precedes onset of alcohol use, go to R04_YX0077_NB.
Else, go to R04_YX0084_12M.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0077_NB

When you first used alcohol when you were {AGE OF FIRST ALCOHOL USE} years old, did you also
[smoke cigarettes/use tobacco products/smoke cigarettes or use other tobacco products]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever used tobacco and alcohol, where age of onset of
tobacco use precedes onset of alcohol use.
DISPLAY: FILL {AGE OF ALCOHOL USE} WITH AGE REPORTED IN R04_YX0074_NB.
IF R04_EVER_USE_CIGSONLY = 1, DISPLAY “smoke cigarettes”.
ELSE, IF R04_EVER_USE_TOBXCIGS = 1, DISPLAY “use tobacco products”.
ELSE, IF R04_EVER_USE_DUAL = 1, DISPLAY “smoke cigarettes or use other tobacco products”.
PATH ID:

R04_YX0084_12M

[The next questions ask about your use of alcohol and other drugs. Remember all information you give
to the PATH Study will be kept private.
]In the past 12 months, have you used any alcohol, including small sips or tastes?
1

Yes

2

No

GO TO BOX R04_YXR06

-8

DON'T KNOW

GO TO BOX R04_YXR06

-7

REFUSED

GO TO BOX R04_YXR06

ASK: New baseline youth respondents who have ever used alcohol and continuing youth respondents.
DISPLAY: IF R04_YOUTHTYPE = 1, DISPLAY "The next questions ask about your use of alcohol and
other drugs. Remember all information you give to the PATH Study will be kept private."
ELSE, DO NOT DISPLAY THIS TEXT.
PATH ID:

R04_YX0673

Have you used alcohol in the past 30 days?
1

Yes

2

No

GO TO BOX R04_YXR06

-8

DON'T KNOW

GO TO BOX R04_YXR06

-7

REFUSED

GO TO BOX R04_YXR06

ASK: Youth respondents who have used alcohol in the past 12 months.
DISPLAY: UNDERLINE "past 30 days".

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Wave 4 (version 3.0)
PATH ID:

R04_YX0075

In the past 30 days, on how many days did you have one or more alcoholic drinks?
A drink is a can or bottle of beer; a wine cooler or a glass of wine, champagne, or sherry; a shot of liquor
or a mixed drink or cocktail.
1

|___|___| DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used alcohol in the past 30 days.
BOX ID:

R04_YXR46

Youth respondents who have used alcohol on none of the past 30 days or did not know or refused to
report on how many days they have used alcohol in the past 30 days, go to Box R04_YXR06.
Else, go to R04_YX0076.
PATH ID:

R04_YX0076

On average, on those days that you drank in the past 30 days, how many alcoholic drinks did you
usually have each day?
Count a drink as a can or bottle of beer; a wine cooler or a glass of wine, champagne, or sherry; a shot
of liquor or a mixed drink or cocktail.
1

|___|___|

-8

DON'T KNOW

GO TO BOX R04_YXR06

-7

REFUSED

GO TO BOX R04_YXR06

ASK: Youth respondents who have used alcohol one day or more in the past 30 days.
PATH ID:

R04_YX0076_LC1

The computer recorded that you usually drank [R04_YX0076] alcoholic beverages on the days that you
drank during the last 30 days. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0076

2

NEXT

GO TO BOX R04_YXR06

ASK: IF R04_YX0076 > 30.

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BOX ID:

R04_YXR06

New baseline youth respondents who have never smoked a blunt, smoked marijuana from a hookah, or
used marijuana in an e-product, go to R04_YX0085_NB.
Else, new baseline youth respondents who have ever smoked a blunt, smoked marijuana from a
hookah, or used marijuana in an e-product, go to R04_YX0079_NB.
Else, continuing youth respondents who have not smoked a blunt in the past 12 months, go to
R04_YX0085_12M.
Else, continuing youth respondents who have smoked a blunt in the past 30 days, go to Box
R04_YXR28.
Else, continuing youth respondents who have smoked a blunt in the past 12 months, go to
R04_YX0675.
PATH ID:

R04_YX0085_NB

Have you ever used marijuana, hash, THC, grass, pot or weed?
1

Yes

2

No

GO TO BOX R04_YXD02

-8

DON'T KNOW

GO TO BOX R04_YXD02

-7

REFUSED

GO TO BOX R04_YXD02

ASK: New baseline youth respondents who did not previously report ever smoking a blunt, smoking
marijuana from a hookah, or using marijuana in an e-product.
PATH ID:

R04_YX0079_NB

How old were you when you first used marijuana, hash, THC, grass, pot or weed?
1

|___|___| Years old

-8

DON'T KNOW

GO TO R04_YX0271_NB

-7

REFUSED

GO TO R04_YX0271_NB

ASK: New baseline youth respondents who have ever used marijuana.
DISPLAY: DISPLAY “Years old” AS A TITLE.
PATH ID:

R04_YX0079_NB_LC1

The computer recorded that you first started using marijuana, hash, THC, grass, pot or weed at age
[R04_YX0079_NB]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0079_NB

2

NEXT

GO TO BOX R04_YXR27

ASK: IF R04_YX0079_NB <= 10.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0079_NB_LC2

The computer recorded that you were [R04_YX0079_NB] years old when you first started using
marijuana, hash, THC, grass, pot or weed. That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0079_NB

2

NEXT

GO TO BOX R04_YXR27

ASK: IF R04_YX0079_NB > R04_YOUTHAGE.
PATH ID:

R04_YX0271_NB

When you first used marijuana, hash, THC, grass, pot, or weed, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON’T KNOW

-7

REFUSED

ASK: New baseline youth respondents who did not know or refused to report age they first used
marijuana.
BOX ID:

R04_YXR27

If new baseline youth respondent reported valid age of first marijuana use and has ever used any form
of tobacco, and onset of tobacco use precedes onset of marijuana use, go to R04_YX0080_NB.
Else, youth respondents who have smoked a blunt in the past 30 days, go to Box R04_YXR28.
Else, new baseline youth who have ever used marijuana, go to R04_YX0085_12M.
Else, go to Box R04_YXR41.

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PATH ID:

R04_YX0080_NB

When you first used marijuana when you were {AGE OF FIRST MARIJUANA USE} years old, did you
also [smoke cigarettes/use tobacco products/smoke cigarettes or use other tobacco products]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever used tobacco and marijuana, where age of onset
of tobacco use precedes onset of marijuana use.
DISPLAY: FILL {AGE OF FIRST MARIJUANA USE} WITH AGE REPORTED IN R04_YX0079_NB.
IF R04_EVER_USE_CIGSONLY = 1, DISPLAY “smoke cigarettes”.
IF R04_EVER_USE_TOBXCIGS = 1, DISPLAY “use tobacco products”.
IF R04_EVER_USE_DUAL = 1, DISPLAY “smoke cigarettes or use other tobacco products”.
BOX ID:

R04_YXR41

Youth respondents who have smoked a blunt in the past 30 days, go to Box R04_YXR28.
Else, youth respondents who have smoked a blunt in the past 12 months, go to R03_YX0675.
Else, go to R04_YX0085_12M.
PATH ID:

R04_YX0085_12M

In the past 12 months, have you used marijuana, hash, THC, grass, pot or weed?
1

Yes

2

No

GO TO BOX R04_YXR28

-8

DON'T KNOW

GO TO BOX R04_YXR28

-7

REFUSED

GO TO BOX R04_YXR28

ASK: Continuing youth respondents who did not previously report smoking a blunt in the past 12 months
and new baseline youth respondents who ever used marijuana and did not previously report smoking a
blunt in the past 12 months.
PATH ID:

R04_YX0675

Have you used marijuana, hash, THC, grass, pot or weed in the past 30 days?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used marijuana in the past 12 months and did not report smoking
blunts in the past 30 days.
DISPLAY: UNDERLINE "past 30 days".

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Wave 4 (version 3.0)
BOX ID:

R04_YXR28

New baseline youth respondents, go to Box R04_YXD02.
Continuing youth respondents, go to Box R04_YXD03.
BOX ID:

R04_YXD02

DISPLAY INSTRUCTION:
For R04_YX0089_NB and R04_YX0220_NB, display a “Yes” and “No” column with options for each
response category.
PATH ID:

R04_YX0089_NB

Have you ever used any of the following prescription drugs that were not prescribed for you or that you
took only for the experience or feeling they caused?
1

Ritalin® or Adderall®

2

Painkillers, sedatives, or tranquilizers

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents.
DISPLAY: UNDERLINE "not" AND "only".
PATH ID:

R04_YX0220_NB

Have you ever used any of the following substances?
1

Cocaine or crack

2

Stimulants like methamphetamine or speed

3

Any other drugs like heroin, inhalants, solvents, or hallucinogens

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents.
BOX ID:

R04_YXR07

PROGRAM: Items R04_YX0082_NB[_01/.../_05], R04_YX0272_NB[_01/.../_05],
R04_YX0083_NB[_01/.../_05], and R04_YX0676[_01/.../_05] are asked for each substance the
respondent uses in R04_YX0089_NB[_01/_02] and R04_YX0220_NB[_01/_02/_03]. If respondent uses
more than one substance, repeat items in a loop.
If no substances are selected in R04_YX0089_NB[_01/_02] or R04_YX0220_NB[_01/_02/_03], go to
Box R04_YXV02.

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Wave 4 (version 3.0)
BOX ID:

R04_YXD05

PROGRAM: CREATE [SUBSTANCEFILL] If R04_YX0089_NB_01 = 1, display "Ritalin® or Adderall®”.
If R04_YX0089_NB_02 = 1, display “painkillers, sedatives, or tranquilizers”.
If R04_YX0220_NB_01 = 1, display “cocaine or crack”.
If R04_YX0220_NB_02 = 1, display “stimulants like methamphetamine or speed”.
If R04_YX0220_NB_03 = 1, display “other drugs like heroin, inhalants, solvents, or hallucinogens”.
PATH ID:

R04_YX0082_NB

How old were you when you first used [SUBSTANCEFILL]?
1

|___|___| Years old

-8

DON'T KNOW

GO TO R04_YX0272_NB[_01/…/_05]

-7

REFUSED

GO TO R04_YX0272_NB[_01/…/_05]

ASK: New baseline youth respondents that have ever used a substance.
DISPLAY: FOR R04_YX0082_NB_01: If R04_YX0089_NB_01 = 1, display “Ritalin® or Adderall®”.
FOR R04_YX0082_NB_02: If R04_YX0089_NB_02 = 1, display “painkillers, sedatives, or tranquilizers”.
FOR R04_YX0082_NB_03: If R04_YX0220_NB_01 = 1, display “cocaine or crack”
FOR R04_YX0082_NB_04: If R04_YX0220_NB_02 = 1, display “stimulants like methamphetamine or
speed”
FOR R04_YX0082_NB_05: If R04_YX0220_NB_03 = 1, display “other drugs like heroin, inhalants,
solvents, or hallucinogens”
PATH ID:

R04_YX0082_NB_01_LC1

The computer recorded that you first started using Ritalin® or Adderall® at age [R04_YX0082_NB_01].
Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0082_NB_01

2

NEXT

GO TO BOX R04_YXR30

ASK: IF R04_YX0082_NB_01 <= 10.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0082_NB_01_LC2

The computer recorded that you were [R04_YX0082_NB_01] years old when you first started using
Ritalin® or Adderall®. That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0082_NB_01

2

NEXT

GO TO BOX R04_YXR30

ASK: IF R04_YX0082_NB_01 > R04_YOUTHAGE.
PATH ID:

R04_YX0082_NB_02_LC1

The computer recorded that you first started using painkillers, sedatives, or tranquilizers at age
[R04_YX0082_NB_02]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0082_NB_02

2

NEXT

GO TO BOX R04_YXR30

ASK: IF R04_YX0082_NB_02 <= 10.
PATH ID:

R04_YX0082_NB_02_LC2

The computer recorded that you were [R04_YX0082_NB_02] years old when you first started using
painkillers, sedatives, or tranquilizers. That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0082_NB_02

2

NEXT

GO TO BOX R04_YXR30

ASK: IF R04_YX0082_NB_02 > R04_YOUTHAGE.
PATH ID:

R04_YX0082_NB_03_LC1

The computer recorded that you first started using cocaine or crack at age [R04_YX0082_NB_03]. Is
that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0082_NB_03

2

NEXT

GO TO BOX R04_YXR30

ASK: IF R04_YX0082_NB_03 <= 10.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0082_NB_03_LC2

The computer recorded that you were [R04_YX0082_NB_03] years old when you first started using
cocaine or crack. That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0082_NB_03

2

NEXT

GO TO BOX R04_YXR30

ASK: IF R04_YX0082_NB_03 > R04_YOUTHAGE.
PATH ID:

R04_YX0082_NB_04_LC1

The computer recorded that you first started using stimulants like methamphetamine, or speed at age
[R04_YX0082_NB_04]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0082_NB_04

2

NEXT

GO TO BOX R04_YXR30

ASK: IF R04_YX0082_NB_04 <= 10.
PATH ID:

R04_YX0082_NB_04_LC2

The computer recorded that you were [R04_YX0082_NB_04] years old when you first started using
stimulants like methamphetamine or speed. That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0082_NB_04

2

NEXT

GO TO BOX R04_YXR30

ASK: IF R04_YX0082_NB_04 > R04_YOUTHAGE.
PATH ID:

R04_YX0082_NB_05_LC1

The computer recorded that you first started using any other drugs like heroin, inhalants, solvents, or
hallucinogens at age [R04_YX0082_NB_05]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0082_NB_05

2

NEXT

GO TO BOX R04_YXR30

ASK: IF R04_YX0082_NB_05 <= 10.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0082_NB_05_LC2

The computer recorded that you were [R04_YX0082_NB_05] years old when you first started using
other drugs like heroin, inhalants, solvents, or hallucinogens. That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0082_NB_05

2

NEXT

GO TO BOX R04_YXR30

ASK: IF R04_YX0082_NB_05 > R04_YOUTHAGE.
PATH ID:

R04_YX0272_NB

When you first used [SUBSTANCEFILL], were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON’T KNOW

-7

REFUSED

ASK: New baseline youth respondents who did not know or refused to report age they first used
substance.
BOX ID:

R04_YXR30

If new baseline youth respondent reported valid age of first use and has ever used any form of tobacco,
and onset of tobacco use precedes onset of substance use, go to R04_YX0083_NB.
Else, go to Box R04_YXR47.
PATH ID:

R04_YX0083_NB

When you first used [SUBSTANCEFILL] when you were {AGE OF FIRST SUBSTANCE USE} years old,
did you also [smoke cigarettes/use tobacco products/smoke cigarettes or use other tobacco products]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever used tobacco and substances, where age of
onset of tobacco use precedes onset of substance use.
DISPLAY: FILL {AGE OF FIRST SUBSTANCE USE} WITH AGE REPORTED IN R04_YX0082_NB.
IF R04_EVER_USE_CIGSONLY = 1, DISPLAY “smoke cigarettes”.
IF R04_EVER_USE_TOBXCIGS = 1, DISPLAY “use tobacco products”.
IF R04_EVER_USE_DUAL= 1, DISPLAY “smoke cigarettes or use other tobacco products”.

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Wave 4 (version 3.0)
BOX ID:

R04_YXR47

New baseline youth respondents who have remaining substance loops to complete, go back to
R04_YX0082_NB and repeat for remaining substances.
Else, if new baseline youth respondent has no remaining substance loops to complete, go to Box
R04_YXD03.
BOX ID:

R04_YXD03

DISPLAY INSTRUCTIONS
For R04_YX0089_12M and R04_YX0220_12M, display a “Yes” and “No” column with options for each
response category.
BOX ID:

R04_YXR48

New baseline youth respondents who have ever used Ritalin® or Adderall®, or painkillers, sedatives, or
tranquilizers and continuing youth respondents, go to R04_YX0089_12M.
Else, new baseline youth respondents who have ever used cocaine or crack, stimulants, or other drugs,
go to R04_YX0220_12M.
PATH ID:

R04_YX0089_12M

In the past 12 months, have you used any of the following prescription drugs that were not prescribed
for you or that you took only for the experience or feeling they caused?
1

Ritalin® or Adderall®

2

Painkillers, sedatives, or tranquilizers

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever used Ritalin® or Adderall®, or painkillers,
sedatives, or tranquilizers and continuing youth respondents.
DISPLAY: UNDERLINE "not" AND "only".
IF R04_YOUTHTYPE = 2, 3 AND R04_YX0089_NB_01 = 1, DISPLAY OPTION 1; ELSE, DO NOT
DISPLAY OPTION 1.
IF R04_YOUTHTYPE = 2, 3 AND R04_YX0089_NB_02 = 1, DISPLAY OPTION 2; ELSE, DO NOT
DISPLAY OPTION 2.
IF R04_YOUTHTYPE = 1, DISPLAY ALL RESPONSE OPTIONS.
BOX ID:

R04_YXR49

New baseline youth respondents who have ever used cocaine or crack, stimulants, or other drugs and
continuing youth respondents, go to R04_YX0220_12M.
Else, go to Box R04_YXR08.

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PATH ID:

R04_YX0220_12M

In the past 12 months, have you used any of the following substances?
1

Cocaine or crack

2

Stimulants like methamphetamine or speed

3

Any other drugs like heroin, inhalants, solvents, or hallucinogens

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever used cocaine or crack, stimulants, or other drugs
and continuing youth respondents.
DISPLAY: IF R04_YOUTHTYPE = 2, 3 AND R04_YX0220_NB_01 = 1, DISPLAY RESPONSE OPTION
1; ELSE, DO NOT DISPLAY OPTION 1.
IF R04_YOUTHTYPE = 2, 3 AND R04_YX0220_NB_02 = 1, DISPLAY RESPONSE OPTION 2; ELSE,
DO NOT DISPLAY OPTION 2.
IF R04_YOUTHTYPE = 2, 3 AND R04_YX0220_NB_03 = 1, DISPLAY RESPONSE OPTION 3; ELSE,
DO NOT DISPLAY OPTION 3.
IF R04_YOUTHTYPE = 1, DISPLAY ALL RESPONSE OPTIONS.
BOX ID:

R04_YXR08

PROGRAM: Repeat R04_YX0676[_01/.../_05] for each substance selected in
R04_YX0089_12M[_01/_02] and R04_YX0220_12M[_01/_02/_03].
If no substances are selected in R04_YX0089_12M[_01/_02] and R04_YX0220_12M[_01/_02/_03], go
to Box R04_YXV02.
PATH ID:

R04_YX0676

Have you used [SUBSTANCEFILL] in the past 30 days?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used a substance in the past 12 months.
DISPLAY: UNDERLINE "past 30 days".
BOX ID:

R04_YXR01

Youth respondents who have remaining substance loops to complete, go back to R04_YX0676 and
repeat for remaining substances.
Else, if youth respondent has no remaining substance loops to complete, go to Box R04_YXV02.

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Wave 4 (version 3.0)
BOX ID:

R04_YXV02

PROGRAM: CREATE THE FOLLOWING DERIVED VARIABLES (SEE APPENDIX):
R04_EVER_USER_ALC = Has ever used alcohol
R04_EVER_USER_MJ = Has ever used marijuana
R04_EVER_USER_RIT = Has ever used Ritalin® or Adderall®
R04_EVER_USER_PK = Has ever used painkillers, sedatives, or tranquilizers
R04_EVER_USER_COC = Has ever used cocaine or crack
R04_EVER_USER_STIM = Has ever used stimulants like methamphetamine or speed
R04_EVER_USER_OTH = Has ever used other drugs like heroin, inhalants, solvents, or hallucinogens
R04_SUBSTANCE_COUNT = Count of the number of substances ever used
BOX ID:

R04_YXR02

If youth respondent has used at least one substance, go to R04_YX0170.
Else, go to Box R04_YMT01.
PATH ID:

R04_YX0170

When was the last time that...
You used alcohol or other drugs weekly or more often?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.
BOX ID:

R04_YXR03

If youth respondent has used two or more substances and has used alcohol or drugs weekly or more
often, go to R04_YX0175.
Else, go to R04_YX0171.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0175

You mentioned that you used alcohol or drugs at least weekly sometime in the past. Which substances
did you use weekly or more often? Please do not include drugs that were prescribed for you. Choose all
that apply.
1

Alcohol

2

Marijuana, hash, THC, grass, pot, or weed

3

Ritalin® or Adderall®

4

Painkillers, sedatives, or tranquilizers

5

Cocaine or crack

6

Stimulants like methamphetamine or speed

7

Any other drugs like heroin, inhalants, solvents, or hallucinogens

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who used alcohol or other drugs weekly or more often AND report ever using
two or more substances.
PATH ID:

R04_YX0171

When was the last time that...
You spent a lot of time getting alcohol or other drugs?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0172

When was the last time that...
You kept using alcohol or other drugs even though it was causing social problems, leading to fights, or
getting you into trouble with other people?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.
PATH ID:

R04_YX0173

When was the last time that...
Your use of alcohol or other drugs reduced your involvement with activities at work, school, home, or
social events?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.
PATH ID:

R04_YX0193

When was the last time that...
You spent a lot of time using or recovering from alcohol or other drugs?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0174

When was the last time that...
You had withdrawal problems such as shaky hands, throwing up, having trouble sitting still or sleeping?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.
PATH ID:

R04_YX0194

When was the last time that...
You used any alcohol or other drugs to stop being sick or avoid withdrawal problems?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.
BOX ID:

R04_YXR31

Youth respondents who use two or more substances and who indicated alcohol or drugs caused
problems for them, go to R04_YX0176.
Else, go to Box R04_YMT01.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0176

You mentioned that alcohol or drugs caused some problems for you. Which substances caused these
problems? Please do not include drugs that were prescribed for you. Choose all that apply.
1

Alcohol

2

Marijuana, hash, THC, grass, pot, or weed

3

Ritalin® or Adderall®

4

Painkillers, sedatives, or tranquilizers

5

Cocaine or crack

6

Stimulants like methamphetamine or speed

7

Any other drugs like heroin, inhalants, solvents, or hallucinogens

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who use two or more substances and who indicated alcohol or drugs caused
problems for them.

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ADDITIONAL DEMOGRAPHICS
BOX ID:

R04_YMT01

Finally, we have a few additional questions to ask about you.
PATH ID:

R04_YM0019

Have you been going to school at any time during the past 12 months?
1

Yes

2

No

GO TO R04_YM0020

-8

DON'T KNOW

GO TO R04_YM0020

-7

REFUSED

GO TO R04_YM0020

ASK: All youth respondents.
PATH ID:

R04_YM0018

What grade are you in? If you are on a holiday or summer break, please select the grade or year you
will enter when you return to school.
1

4th grade or below

GO TO R04_YM0032

2

5th

GO TO R04_YM0032

3

6th

GO TO R04_YM0032

4

7th

GO TO R04_YM0032

5

8th

GO TO R04_YM0032

6

9th

GO TO R04_YM0032

7

10th

GO TO R04_YM0032

8

11th

GO TO R04_YM0032

9

12th grade

GO TO R04_YM0032

10

College, vocational or technical school

GO TO R04_YM0032

11

Not enrolled

GO TO R04_YM0032

12

I am home-schooled

GO TO R04_YM0032

13

My school is ungraded

GO TO R04_YM0032

-8

DON'T KNOW

GO TO R04_YM0032

-7

REFUSED

GO TO R04_YM0032

ASK: Youth respondents who went to school in the past 12 months.

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PATH ID:

R04_YM0020

What grade or year in school did you last complete?
1

4th grade or below

2

5th

3

6th

4

7th

5

8th

6

9th

7

10th

8

11th

9

12th grade

10

College, vocational or technical school

11

I am home-schooled

12

My school is ungraded

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who did not go to school in the past 12 months.
PATH ID:

R04_YM0032

In the past 30 days, did you work for pay for anyone outside your home? This includes both regular jobs
and things like baby-sitting or yard work.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH ID:

R04_YM0008

During an average week, how much money do you receive in total? Please include money from a job,
your family, an allowance, or any other sources.
1

None

2

Less than $1

3

$1 to $5

4

$6 to $10

5

$11 to $20

6

$21 to $50

7

$51 to $100

8

$101 to $150

9

$151 or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YMR04

Youth respondents aged 17 and older, go to R04_YM0007.
Else, youth respondents aged 14 and older, go to R04_YM0021.
Else, go to R04_YMR05.
PATH ID:

R04_YM0007

Have you ever served on active duty in the U.S. Armed Forces, Military Reserves, or National Guard?
Note: Active duty for the Military Reserves or National Guard does not include regular training for the
Military Reserves or National Guard. It does include being activated for deployment, such as for the
Iraq War.
1

Yes, now on active duty

2

Yes, on active duty in the past, but not now

3

No, training for Reserves or National Guard only

GO TO R04_YM0021

4

No, never served in the military

GO TO R04_YM0021

-8

DON'T KNOW

GO TO R04_YM0021

-7

REFUSED

GO TO R04_YM0021

ASK: Youth respondents aged 17 and older.

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Wave 4 (version 3.0)
PATH ID:

R04_YM0011

In which branch or branches [do/did] you serve on active duty? Choose all that apply.
1

Army

2

Navy

3

Air Force

4

Marine Corps

5

Coast Guard

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents aged 17 and older who have been on active duty, both currently or in the past.
DISPLAY: IF R04_YM0007 = 1, DISPLAY "do".
ELSE, IF R04_YM0007 = 2, DISPLAY "did".
PATH ID:

R04_YM0021

The next question asks about your level of sexual attraction to BOTH males and females.
Please consider the response choices carefully, as it is important that you understand them and are as
honest as you can be in your answer.
To whom have you felt sexually attracted, even if you did not take any action based on feeling
attracted?
1

Only to females, never to males

2

Mostly to females, and at least once to a male

3

About equally often to females and to males

4

Mostly to males, and at least once to a female

5

Only to males, never to females

6

I have never felt sexually attracted to anyone at all

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents aged 14 and older.
DISPLAY: FOR MALE RESPONDENTS, DISPLAY RESPONSE OPTIONS 1-5 IN THE SPECIFIED
ORDER. FOR FEMALE RESPONDENTS, DISPLAY RESPONSE OPTIONS 1-5 IN REVERSE
ORDER, WHERE RESPONSE OPTION 5 IS PRESENTED FIRST, OPTION 4 SECOND, ETC. IF SEX
IS UNKNOWN, DEFAULT TO ORDER SHOWN FOR MALE RESPONDENTS.

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Wave 4 (version 3.0)
PATH ID:

R04_YM0063

Do you consider yourself to be…
1

Straight

2

Lesbian or gay

3

Bisexual

4

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents aged 14 and older.
PATH ID:

R04_YM0061

Some people describe themselves as transgender when they experience a different gender identity from
their sex at birth. For example, a person born into a male body, but who feels female or lives as a
woman would be transgender.
Do you consider yourself to be transgender?
1

Yes

2

No

GO TO R04_YMR05

-8

DON'T KNOW

GO TO R04_YMR05

-7

REFUSED

GO TO R04_YMR05

ASK: Youth respondents aged 14 and older.
PATH ID:

R04_YM0062

Do you consider yourself to be male-to-female, female-to-male, or non-conforming?
1

Yes, Transgender, male to female

2

Yes, Transgender, female to male

3

Yes, Transgender, gender nonconforming

4

No

5

Not sure

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents aged 14 and older who are transgender.
BOX ID:

R04_YMR05

Random sample of all youth respondents, go to R04_YX0769.
Else, go to R04_YL3000.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0769

In the future, the PATH questionnaire may be available to take online on your personal desktop, laptop,
or tablet. Due to its length, the questionnaire will not be available on smart phones.
You would be able to complete the questionnaire at your convenience, without an interviewer present.
The incentive would arrive in the mail a few days after the questionnaire is completed.
How interested would you be in taking the PATH questionnaire online on your personal desktop, laptop,
or tablet?
1

Very interested

GO TO R04_YL3000

2

Somewhat interested

GO TO R04_YL3000

3

Not at all interested

4

Unsure

GO TO R04_YL3000

-8

DON'T KNOW

GO TO R04_YL3000

-7

REFUSED

GO TO R04_YL3000

ASK: Random sample of all youth respondents.
PATH ID:

R04_YX0770

Why not? Choose all that apply.
1

I do not have a personal desktop, laptop, or tablet with internet access

2

I am concerned about technical difficulties

3

I prefer to have an interviewer present

4

I am concerned about the confidentiality of my information

5

I am concerned that I might not receive my incentive

6

Other (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Subsampled youth respondents who would not be interested in doing PATH questionnaires online
in the future.
PATH ID:

R04_YL3000

You have finished[ this part of] the questionnaire. Please hand the computer to the interviewer.
1

CONTINUE

ASK: All youth respondents.
DISPLAY: IF R04_E_YOUTH_LD = 1, DISPLAY “this part of ”;
ELSE, DO NOT DISPLAY THIS TEXT.

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Wave 4 (version 3.0)
PATH ID:

R04_YL3001

The interviewer must now enter the Monitor Password into the computer.
1

I__I__I__I__I MONITOR PASSWORD

ASK: All youth respondents.
PATH ID:

R04_ERR_YL3001

The password you entered was incorrect.
Please press the BACK button and re-enter. Don’t forget to press the ERASE button before you re-enter
your answer.
1

BACK

GO TO R04_YL3001

ASK: If interviewer entered monitor password incorrectly.
BOX ID:

R04_YLR04

Emancipated youth respondents, go to R04_YL3002.
Else, go to R04_LCYS01.
PATH ID:

R04_YL3002

YOU MUST COLLECT CONTACT INFORMATION FROM THE RESPONDENT.
THE RESPONDENT IS AN EMANCIPATED YOUTH.
PRESS 1 TO CONTINUE
1

CONTINUE

ASK: Interviewers
DISPLAY: Display interviewer instructions in blue font.
BOX ID:

R04_YLR05

Emancipated youth, go to contact information section R04_YXT04.
Else, go to R04_LCYS01

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

CONTACT INFORMATION – EMANCIPATED YOUTH
BOX ID:

R04_YXT04

CONTACT INFORMATION SECTION IS ASKED OF EMANCIPATED YOUTH ONLY.
PATH ID:

R04_YL0041

Since your continued participation in the PATH Study is important to the study’s success, I’d like to take
a brief moment to confirm your contact information for my records. We’ll only use this information to
contact you about your participation in the study.
PRESS 1 TO CONTINUE.
1

CONTINUE

ASK: Emancipated youth respondents.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
BOX ID:

R04_YLR01

Emancipated youth respondents who have a valid Wave 4 physical address, go to R04_YL0001.
Else, go to R04_YL0037.
PATH ID:

R04_YL0037

What is your address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

GO TO R04_YL0035

-7

REFUSED

GO TO R04_YL0035

ASK: Emancipated youth respondents who need to correct their physical address or who do not have a
valid physical address on file.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.

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PATH ID:

R04_YL0002

Do you receive mail at this address?
1

YES

2

NO

GO TO R04_YL0035

-8

DON'T KNOW

GO TO R04_YL0035

-7

REFUSED

GO TO R04_YL0035

ASK: Emancipated youth respondents who confirmed or provided their physical address.
PATH ID:

R04_YL0003

Can I please have your mailing address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who do not receive mail at their physical address.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
PATH ID:

R04_YL0035

Do you have a second home where you live during the year?
1

YES

2

NO

GO TO BOX R04_YLR02

-8

DON'T KNOW

GO TO BOX R04_YLR02

-7

REFUSED

GO TO BOX R04_YLR02

ASK: Emancipated youth respondents.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YL0036

What is the address of the second home?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who have a second home.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
BOX ID:

R04_YLR02

Emancipated youth respondents who have a valid telephone number on file, go to R04_YL0004_12M.
Else, go to R04_YL0004.
PATH ID:

R04_YL0004

What is the best telephone number to reach you?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

GO TO R04_YL0012

-7

REFUSED

GO TO R04_YL0012

ASK: Emancipated youth respondents who need to correct their telephone number, who don't know if
the telephone number provided is correct, or who do not have a valid telephone number on file.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
PATH ID:

R04_YL0038

Is this a cell phone number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO BOX R04_YLR03

ASK: Emancipated youth respondents who confirmed or provided their telephone number.

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Wave 4 (version 3.0)
PATH ID:

R04_YL0032

May we contact you by text message at this number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who said their telephone number is a cell phone or did not know
or refused to report whether it is a cell phone.
BOX ID:

R04_YLR03

Emancipated youth respondents who have a valid second telephone number on file, go to R04_YL0005.
Else, go to R04_YL0006.
PATH ID:

R04_YL0005

I have your second telephone number as [(XXX) XXX-XXXX].
Is that correct?
IF SP DOES NOT WANT TO PROVIDE A SECOND PHONE NUMBER, ENTER REFUSED.
1

YES

2

NO

GO TO R04_YL0039

-8

DON'T KNOW

GO TO R04_YL0012

-7

REFUSED

GO TO R04_YL0012

ASK: Emancipated youth respondents who have a valid second telephone number on file.
PATH ID:

R04_YL0006

What is a second telephone number where you can be reached?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

GO TO R04_YL0012

-7

REFUSED

GO TO R04_YL0012

ASK: Emancipated youth respondents who need to correct their second telehone number or who do not
have a valid second telephone number on file.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.

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Wave 4 (version 3.0)
PATH ID:

R04_YL0039

Is this a cell phone number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO R04_YL0012

ASK: Emancipated youth respondents who confirmed their phone number in R04_YL0005 or provided a
phone number in R04_YL0006.
PATH ID:

R04_YL0033

May we contact you by text message at this number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who said their second number is a cell phone or did not know or
refused to report whether it is a cell phone.
PATH ID:

R04_YL0012

Can you please give me your e-mail address?
VERIFY ALL SPELLING AND PUNCTUATION. RECORD TEXT BEFORE @ SYMBOL IN THE EMAIL
NAME FIELD. TEXT AFTER THE @ SYMBOL IS ENTERED IN THE EMAIL PROVIDER FIELD.
1

EMAIL NAME

2

EMAIL PROVIDER

-8

DON'T KNOW

-7

REFUSE

ASK: Emancipated youth respondents.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
BOX ID:

R04_YLR09

Emancipated youth respondents who provided more than one mode of contact information, go to
R04_YL0017.
Else, go to R04_YL0018.

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PATH ID:

R04_YL0017

What is the best way to reach you?
1

PHONE

2

TEXT MESSAGE

3

E-MAIL

-8

DON’T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided more than one mode of contact information.
PATH ID:

R04_YL0018

Do you anticipate moving or relocating either permanently or temporarily in the next 12 months?
1

YES

2

NO

3

MAYBE

GO TO R04_YL0020

-8

DON'T KNOW

GO TO R04_YL0020

-7

REFUSED

GO TO R04_YL0020

ASK: Emancipated youth respondents.
PATH ID:

R04_YL0019

Can you tell me more about your plans to move?
[IF NEEDED: For example, your new street address or the city or state to which you plan to move?]
PROBE FOR AND RECORD ANY KNOWN INFORMATION.
1

[TEXT FIELD]

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who plan to move in the next 12 months.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.

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PATH ID:

R04_YL0020

Since we would like to interview you again, it is important that we are able to contact you in about a
year. In case we cannot reach you, is there a relative or friend who does not live in this household, who
will know how to reach you?
IF NEEDED: Rest assured, we will only use this information if we have lost contact with you.
What is the person’s name?
VERIFY ALL SPELLING.
IF SP IS UNABLE TO PROVIDE A FIRST NAME MARK AS DON'T KNOW / REFUSED.
1

FIRST NAME

2

LAST NAME

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE AND BOLD "FIRST NAME".
BOX ID:

R04_YLR10

If FIRST NAME is don’t know or refused, go to R04_YL3003.
Else, go to R04_YL0022.
PATH ID:

R04_YL0022

What is their address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided a first name for a proxy contact in R04_YL0020.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.

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PATH ID:

R04_YL0023

What is their telephone number?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided a first name for a proxy contact in R04_YL0020.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
PATH ID:

R04_YL0021

How are they related to you?
1

HUSBAND/WIFE

2

FATHER/MOTHER (INCLUDING IN-LAWS)

4

GRANDPARENT

8

BROTHER/SISTER (INCLUDING IN-LAWS)

13

FRIEND/NEIGHBOR

91

OTHER RELATIVE (SPECIFY)

92

OTHER NON-RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who who provided a first name for a proxy contact in
R04_YL0020.
PATH ID:

R04_YL0025

Could you provide me with the name of a second relative or friend who will know how to reach you?
VERIFY ALL SPELLING.
IF SP IS UNABLE TO PROVIDE A FIRST NAME MARK AS DON'T KNOW / REFUSED.
1

FIRST NAME

2

LAST NAME

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided a first name for a proxy contact in R04_YL0020.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE AND BOLD "FIRST NAME".

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
BOX ID:

R04_YLR11

If FIRST NAME is don’t know or refused, go to R04_YL3003.
Else, go to R04_YL0027
PATH ID:

R04_YL0027

What is their address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided a first name for a proxy contact in R04_YL0025.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
PATH ID:

R04_YL0028

What is their telephone number?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided a first name for a proxy contact in R04_YL0025.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
PATH ID:

R04_YL0026

How are they related to you?
1

HUSBAND/WIFE

2

FATHER/MOTHER (INCLUDING IN-LAWS)

4

GRANDPARENT

8

BROTHER/SISTER (INCLUDING IN-LAWS)

13

FRIEND/NEIGHBOR

91

OTHER RELATIVE (SPECIFY)

92

OTHER NON-RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided a first name for a proxy contact in R04_YL0025.
PATH ID:

R04_YL3003

If you do move or change your phone numbers please update your contact information on the PATH
Study website or by calling our toll free number. Each year you may receive a $5 thank you on your
debit card for updating your contact information.
Thank you for taking the time to answer these questions.
ENTER 1 TO CONTINUE.
1

CONTINUE

ASK: Emancipated youth respondents.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
PATH ID:

R04_LCYS01

INTERVIEWER: IN WHAT LANGUAGE DID YOU MOSTLY CONDUCT THE CAPI PORTIONS OF
THIS INTERVIEW?
1

ENGLISH

END INTERVIEW AND RETURN TO IMS

2

SPANISH

END INTERVIEW AND RETURN TO IMS

ASK: All youth respondents (asked of Interviewer).
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)

APPENDIX: USER GROUPS
User Group and Variable Name

User Group Description

User Group Definition

Ever or Never users - Cigarettes
R04_EVER_NEVER_CIGS_YOUTH

(1) Ever user = Youth respondents who have
ever smoked a cigarette.
(2) Never user = Youth respondents who have
not ever smoked a cigarette.

IF (R04_YC1002_NB = 1 OR
R04_YC1002_12M = 1 OR
R03_EVER_NEVER_CIGS = 1), THEN
R04_EVER_NEVER_CIGS_YOUTH = 1.
ELSE, IF R04_EVER_NEVER_CIGS_YOUTH
!= 1, THEN
R04_EVER_NEVER_CIGS_YOUTH = 2.

Initiators - Cigarettes
R04_INIT_CIGS_YOUTH

(1) Initiator = Youth respondents who initiated
cigarette use between Waves or new baseline
youth respondents who have ever smoked a
cigarette.
(2) Non-initiator = Youth respondents who did
not initiate cigarette use between Waves or
new baseline youth respondent who have not
ever smoked a cigarette.

IF R03_EVER_NEVER_CIGS ! = 1 AND
R04_EVER_NEVER_CIGS_YOUTH = 1, THEN
R04_INIT_CIGS_YOUTH = 1.
ELSE, R04_INIT_CIGS_YOUTH = 2.

Past 30 Day Users - Cigarettes
R04_PAST30DAY_CIGS

(1) Past 30 day user = Youth respondents who
have smoked a cigarette in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a cigarette
in the past 30 days.

IF R04_YC1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_CIGS = 1.
ELSE, R04_PAST30DAY_CIGS = 2.

Past 30 Day "Very Light" or "Not Light" Cigarettes
R04_PAST30DAY_CIGS_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have smoked a cigarette in
the past 30 days, and have smoked 10 or less
cigarettes in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have smoked a cigarette in
the past 30 days, and have smoked more than
10 cigarettes in their lifetime.
(8) Unknown / missing = Unknown or missing

IF (R04_YC1005 = 1 OR 2 OR 3 AND
R03_NUMLIFE_CIGS != 1) AND (R04_YC1112
= 1 OR 2 OR 3), THEN
R04_PAST30DAY_CIGS_LEVEL = 1.
ELSE, IF (R04_YC1005 > 3 OR R04_YC1005 =
-8, -7 OR R03_NUMLIFE_CIGS = 1) AND
(R04_YC1112 = 1 OR 2 OR 3), THEN
R04_PAST30DAY_CIGS_LEVEL= 2.
ELSE, R04_PAST30DAY_CIGS_LEVEL = 8.

Ever or Never Users - Electronic
Nicotine Products

(1) Ever user = Youth respondents who have
ever used an electronic nicotine product.

IF (R03_EVER_NEVER_EPRODS = 1 OR
(R04_YV1001_NB = 1 AND R04_YV1002_NB

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Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

R04_EVER_NEVER_EPRODS_YOUTH

(2) Never user = Youth respondents who have
not ever used an electronic nicotine product.

= 1) OR R04_YV1002_12M = 1), THEN
R04_EVER_NEVER_EPRODS_YOUTH = 1.
ELSE, IF
R04_EVER_NEVER_EPRODS_YOUTH != 1,
THEN R04_EVER_NEVER_EPRODS_YOUTH
= 2.

Initiators - E-Products
R04_INIT_EPRODS_YOUTH

(1) Initiator = Youth respondents who initiated
e-product use between Waves or new baseline
youth respondents who have ever used an eproduct.
(2) Non-initiator = Youth respondents who
have not initiated e-product use between
Waves or new baseline youth respondents
who have not ever used an e-product.

IF R03_EVER_NEVER_EPRODS != 1 AND
R04_EVER_NEVER_EPRODS = 1, THEN
R04_INIT_EPRODS_YOUTH = 1.
ELSE, R04_INIT_EPRODS_YOUTH = 2.

Past 30 Day Users - E-Products
R04_PAST30DAY_EPRODS

(1) Past 30 day user = Youth respondents who
have used an e-product in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not used an e-product
in the past 30 days.

IF R04_YV1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_EPRODS = 1.
ELSE, R04_PAST30DAY_EPRODS = 2.

Past 30 Day "Very Light" or "Not Light
Users - E-Products
R04_PAST30DAY_EPRODS_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have used an e-product in
the past 30 days, and have used an e-product
only once in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have used an e-product in
the past 30 days, and have used e-products
more than once in their lifetime.
(8) Unknown / missing = Unknown or missing

IF (R04_YV1005 = 1 AND
R03_NUMLIFE_EPRODS != 1) AND
(R04_YV1112 = 1 OR 2 OR 3), THEN
R04_PAST30DAY_EPRODS_LEVEL = 1.
ELSE, IF (R04_YV1005 > 1 OR R04_YV1005 =
-8, -7 OR R03_NUMLIFE_EPRODS = 1) AND
(R04_YV1112 = 1 OR 2 OR 3), THEN
R04_PAST30DAY_EPRODS_LEVEL= 2.
ELSE, R04_PAST30DAY_EPRODS_LEVEL =
8.

Ever or Never Smokers – Traditional
Cigars
R04_EVER_NEVER_GTRAD_YOUTH

(1) Ever user = Youth respondents who have
ever smoked a traditional cigar.
(2) Never user = Youth respondents who have
not ever smoked a traditional cigar.

IF (R04_YG9101_NB = 1 AND
R04_YG1002_NB = 1 AND
R04_YG9104_NB_01 = 1) OR
R04_YG9104_12M_01 = 1 OR
R03_EVER_NEVER_GTRAD = 1, THEN

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User Group and Variable Name

User Group Description

User Group Definition
R04_EVER_NEVER_GTRAD_YOUTH = 1.
ELSE, IF
R04_EVER_NEVER_GTRAD_YOUTH != 1,
THEN R04_EVER_NEVER_GTRAD_YOUTH =
2.

Initiators – Traditional Cigars
R04_INIT_GTRAD_YOUTH

(1) Initiator = Youth respondents who initiated
traditional cigar use between Waves or new
baseline youth respondents who have ever
smoked a traditional cigar.
(2) Non-initiator = Youth respondents who did
not initiate traditional cigar use between
Waves or new baseline youth respondents
who have not ever smoked a traditional cigar.

IF R03_EVER_NEVER_GTRAD != 1 AND
R04_EVER_NEVER_GTRAD_YOUTH = 1,
THEN R04_INIT_GTRAD_YOUTH = 1.
ELSE, R04_INIT_GTRAD_YOUTH = 2.

Past 30 Day Smokers - Traditional
Cigars
R04_PAST30DAY_GTRAD

(1) Past 30 day user = Youth respondents who
have smoked a traditional cigar in the past 30
days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a
traditional cigar in the past 30 days.

IF R04_YG1112TC = 1 OR 2 OR 3, THEN
R04_PAST30DAY_GTRAD = 1.
ELSE, R04_PAST30DAY_GTRAD = 2.

Past 30 Day "Very Light" or "Not Light"
Smokers - Traditional Cigars
R04_PAST30DAY_GTRAD_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have smoked a traditional
cigar in the past 30 days, and have smoked 10
or less traditional cigars in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have smoked a traditional
cigar in the past 30 days, and have smoked
more than 10 traditional cigars in their lifetime.
(8) Unknown / missing = Unknown or missing

IF (R04_YG1005TC = 1 OR 2 OR 3 AND
R03_NUMLIFE_GTRAD != 1) AND
(R04_YG1112TC = 1 OR 2 OR 3), THEN
R04_PAST30DAY_GTRAD_LEVEL = 1.
ELSE, IF (R04_YG1005TC > 3 OR
R04_YG1005TC = -8, -7 OR
R03_NUMLIFE_GTRAD = 1 AND
(R04_YG1112TC = 1 OR 2 OR 3), THEN
R04_PAST30DAY_GTRAD_LEVEL = 2.
ELSE, R04_PAST30DAY_GTRAD_LEVEL = 8.

Past 12 Month Blunt-Only Smokers –
Traditional Cigars
R04_12MBLUNT_ONLY_BTRAD

(1) Past 12 month blunt-only smoker = Youth
respondents who smoke traditional cigars as
blunts every time when smoked in the past 12
months.
(2) Not a blunt-only smoker = Youth

IF R04_YG9106_01 = 1 AND R04_YG1095_01
= 1, THEN R04_12MBLUNT_ONLY_BTRAD =
1.
ELSE, R04_12MBLUNT_ONLY_BTRAD = 2.

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Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

respondents who do not smoke traditional
cigars as blunts every time when smoked in
the past 12 months.
Past 30 Day Blunt-Only Smokers –
Traditional Cigars
R04_30DBLUNT_ONLY_BTRAD

(1) Past 30 day user = Youth respondents who
have smoked a traditional cigar as a blunt in
the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a
traditional cigar as a blunt in the past 30 days.

IF R04_12MBLUNT_ONLY_BTRAD = 1 AND
R04_YJ1112TC = 1 OR 2 OR 3, THEN
R04_30DBLUNT_ONLY_BTRAD = 1.
ELSE, R04_30DBLUNT_ONLY_BTRAD = 2.

Initiators – Traditional Cigars as Blunts
R04_INIT_BLUNT_BTRAD_YOUTH

(1) Initiator = Youth respondents who initiated
smoking traditional cigars as blunts between
Waves or new baseline youth respondents
who have ever used traditional cigars as blunts
every time in the past 12 months.
(2) Non-initiator = Youth respondents who did
not initiate smoking traditional cigars as blunts
between Waves or new baseline youth
respondents who have not ever used
traditional cigars as blunts.

IF R03_EVER_NEVER_BTRAD != 1 AND
R04_YG1095_01 = 1 AND R04_YG9106_01 =
1, THEN R04_INIT_BLUNT_BTRAD_YOUTH =
1.
ELSE, R04_INIT_BLUNT_BTRAD_YOUTH = 2.

Ever or Never Smokers – Cigarillos
R04_EVER_NEVER_GRILLO_YOUTH

(1) Ever user = Youth respondents who have
ever smoked a cigarillo.
(2) Never user = Youth respondents who have
not ever smoked a cigarillo.

IF (R04_YG9101_NB = 1 AND
R04_YG1002_NB = 1 AND
R04_YG9104_NB_02 = 1 AND
(R04_YG9009_NB_01= 1 OR
R04_YG9009_NB_03 = 1)) OR
R04_YG9009_12M_01 = 1 OR
R4_YG9009_12M_03 = 1 OR
R03_EVER_NEVER_GRILLO = 1, THEN
R04_EVER_NEVER_GRILLO_YOUTH = 1.
ELSE, IF
R04_EVER_NEVER_GRILLO_YOUTH != 1,
THEN R04_EVER_NEVER_GRILLO_YOUTH =
2.

Initiators – Cigarillos
R04_INIT_GRILLO_YOUTH

(1) Initiator = Youth respondents who initiated
cigarillo use between Waves or new baseline
youth respondents who have ever smoked a

IF R03_EVER_NEVER_GRILLO != 1 AND
R04_EVER_NEVER_GRILLO_YOUTH = 1,
THEN R04_INIT_GRILLO_YOUTH = 1.

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Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

cigarillo.
(2) Non-initiator = Youth respondents who did
not initiate cigarillo use between Waves or new
baseline youth respondents who have not ever
smoked a cigarillo.

ELSE, R04_INIT_GRILLO_YOUTH = 2.

Past 30 Day Smokers - Cigarillos
R04_PAST30DAY_GRILLO

(1) Past 30 day user = Youth respondents who
have smoked a cigarillo in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a cigarillo
in the past 30 days.

IF R04_YG1112CL = 1 OR 2 OR 3, THEN
R04_PAST30DAY_GRILLO = 1.
ELSE, R04_PAST30DAY_GRILLO = 2.

Past 30 Day "Very Light" or "Not Light"
Smokers - Cigarillos
R04_PAST30DAY_GRILLO_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have smoked a cigarillo in
the past 30 days, and have smoked 10 or less
cigarillos in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have smoked a cigarillo in
the past 30 days, and have smoked more than
10 cigarillos in their lifetime.
(8) Unknown / missing = Unknown or missing

IF (R04_YG1005CL = 1 OR 2 OR 3 AND
R03_NUMLIFE_GRILLO != 1) AND
(R04_YG1112CL = 1 OR 2 OR 3), THEN
R04_PAST30DAY_GRILLO_LEVEL = 1.
ELSE, IF (R04_YG1005CL > 3 OR
R04_YG1005CL = -8, -7 OR
R03_NUMLIFE_GRILLO = 1) AND
(R04_YG1112CL = 1 OR 2 OR 3), THEN
R04_PAST30DAY_GRILLO_LEVEL = 2.
ELSE, R04_PAST30DAY_GRILLO_LEVEL = 8.

Past 12 Month Blunt-Only Smokers –
Cigarillos
R04_12MBLUNT_ONLY_BRILLO

(1) Past 12 month blunt-only smoker = Youth
respondents who smoke cigarillos as blunts
every time when smoked in the past 12
months.
(2) Not a blunt-only smoker = Youth
respondents who do not smoke cigarillos as
blunts every time when smoked in the past 12
months.

IF R04_YG9106_02 = 1 AND R04_YG1095_02
= 1, THEN R04_12MBLUNT_ONLY_BRILLO =
1.
ELSE, R04_12MBLUNT_ONLY_BRILLO = 2.

Past 30 Day Blunt-Only Smokers –
Cigarillos
R04_30DBLUNT_ONLY_BRILLO

(1) Past 30 day user = Youth respondents who
have smoked a cigarillo as a blunt in the past
30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a cigarillo
as a blunt in the past 30 days.

IF R04_12MBLUNT_ONLY_BRILLO = 1 AND
R04_YJ1112CG = 1 OR 2 OR 3, THEN
R04_30DBLUNT_ONLY_BRILLO = 1.
ELSE, R04_30DBLUNT_ONLY_BRILLO = 2.

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Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

Initiators – Cigarillos as Blunts
R04_INIT_BLUNT_BRILLO_YOUTH

(1) Initiator = Youth respondents who initiated
smoking cigarillos as blunts between Waves or
new baseline youth respondents who have
ever used cigarillos as blunts every time in the
past 12 months.
(2) Non-initiator = Youth respondents who did
not initiate smoking cigarillos as blunts
between Waves or new baseline youth
respondents who have not ever used cigarillos
as blunts.

IF R03_EVER_NEVER_BRILLO != 1 AND
R04_YG1095_02 = 1 AND R04_YG9106_02 =
1, THEN R04_INIT_BLUNT_BRILLO_YOUTH =
1.
ELSE, R04_INIT_BLUNT_BRILLO_YOUTH =
2.

Ever or Never Smokers – Filtered
Cigars
R04_EVER_NEVER_GFILTR_YOUTH

(1) Ever user = Youth respondents who have
ever smoked a filtered cigar.
(2) Never user = Youth respondents who have
not ever smoked a filtered cigar.

IF (R04_YG9101_NB = 1 AND
R04_YG1002_NB = 1 AND
R04_YG9104_NB_02 = 1 AND
R04_YG9009_NB_02 = 1) OR
R04_YG9009_12M_02 = 1 OR
R03_EVER_NEVER_GFILTR = 1), THEN
R04_EVER_NEVER_GFILTR_YOUTH = 1.
ELSE, IF
R04_EVER_NEVER_GFILTR_YOUTH != 1,
THEN R04_EVER_NEVER_GFILTR_YOUTH =
2.

Initiators – Filtered Cigars
R04_INIT_GFILTR_YOUTH

(1) Initiator = Youth respondents who initiated
filtered cigar use between Waves or new
baseline youth respondents who ever smoked
a filtered cigar.
(2) Non-initiator = Youth respondents who did
not initiate filtered cigar use between Waves or
new baseline youth respondents who have not
ever smoked a filtered cigar.

IF R03_EVER_NEVER_GFILTR != 1 AND
R04_EVER_NEVER_GFILTR_YOUTH = 1,
THEN R04_INIT_GFILTR_YOUTH = 1.
ELSE, R04_INIT_GFILTR_YOUTH = 2.

Past 30 Day Users – Filtered Cigars
R04_PAST30DAY_GFILTR

(1) Past 30 day user = Youth respondents who
have smoked a filtered cigar in the past 30
days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a filtered
cigar in the past 30 days.

IF R04_YG1112FC = 1 OR 2 OR 3, THEN
R04_PAST30DAY_GFILTR = 1.
ELSE, R04_PAST30DAY_GFILTR = 2.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

Past 30 Day "Very Light" or "Not light"
Smokers - Filtered Cigars
R04_PAST30DAY_GFILTR_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have smoked a filtered cigar
in the past 30 days, and have smoked 10 or
less filtered cigars in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have smoked a filtered cigar
in the past 30 days, and have smoked more
than 10 filtered cigars in their lifetime.
(8) Unknown / missing = Unknown or missing

IF R04_YG1005FC = 1 OR 2 OR 3 AND
R03_NUMLIFE_GFILTR != 1) AND
(R04_YG1112FC = 1 OR 2 OR 3), THEN
R04_PAST30DAY_GFILTR_LEVEL = 1.
ELSE, IF (R04_YG1005FC > 3 OR
R04_YG1005FC = -8, -7 OR
R03_NUMLIFE_GFILTR = 1) AND
(R04_YG1112FC = 1 OR 2 OR 3), THEN
R04_PAST30DAY_GFILTR_LEVEL = 2.
ELSE, R04_PAST30DAY_GFILTR_LEVEL = 8.

Past 12 Month Blunt-Only Smokers –
Filtered Cigars
R04_12MBLUNT_ONLY_BFILTR

(1) Past 12 month blunt-only smoker = Youth
respondents who smoke filtered cigars as
blunts every time when smoked in the past 12
months.
(2) Not a blunt-only smoker = Youth
respondents who do not smoke filtered cigars
as blunts every time when smoked in the past
12 months.

IF R04_YG9106_03 = 1 AND R04_YG1095_03
= 1, THEN R04_12MBLUNT_ONLY_BFILTR =
1.
ELSE, R04_12MBLUNT_ONLY_BFILTR = 2.

Past 30 Day Blunt-Only Smokers –
Filtered Cigars
R04_30DBLUNT_ONLY_BFILTR

(1) Past 30 day user = Youth respondents who
have smoked a filtered cigar as a blunt in the
past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a filtered
cigar as a blunt in the past 30 days.

IF R04_12MBLUNT_ONLY_BFILTR = 1 AND
R04_YJ1112FC = 1 OR 2 OR 3, THEN
R04_30DBLUNT_ONLY_BFILTR = 1.
ELSE, R04_30DBLUNT_ONLY_BFILTR = 2.

Initiators – Filtered Cigars as Blunts
R04_INIT_BLUNT_BFILTR_YOUTH

(1) Initiator = Youth respondents who initiated
smoking filtered cigars as blunts between
Waves or new baseline youth respondents
who have ever used filtered cigars as blunts
every time in the past 12 months.
(2) Non-initiator = Youth respondents who did
not initiate smoking filtered cigars as blunts
between Waves or new baseline youth
respondents who have not ever used filtered
cigars as blunts.

IF R03_EVER_NEVER_BFILTR != 1 AND
R04_YG9106_03 = 1 AND R04_YG1095_03 =
1, THEN R04_INIT_BLUNT_BFILTR_YOUTH =
1.
ELSE, R04_INIT_BLUNT_BFILTR_YOUTH = 2.

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Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

Ever or Never Users - Pipe
R04_EVER_NEVER_PIPE_YOUTH

(1) Ever user = Youth respondents who have
ever smoked pipe tobacco.
(2) Never user = Youth respondents who have
not ever smoked pipe tobacco.

IF (R04_YP1001_NB = 1 AND
R04_YP1002_NB = 1) OR R04_YP1002_12M
= 1 OR R03_EVER_NEVER_PIPE = 1, THEN
R04_EVER_NEVER_PIPE_YOUTH = 1.
ELSE, IF R04_EVER_NEVER_PIPE_YOUTH
!= 1, THEN R04_EVER_NEVER_PIPE_YOUTH
= 2.

Initiator - Pipe
R04_INIT_PIPE_YOUTH

(1) Initiator = Youth respondents who initiated
pipe use between Waves or new baseline
youth respondents who have ever smoked a
pipe.
(2) Non-initiator = Youth respondents who did
not initiate pipe use between Waves or new
baseline youth respondents who have not ever
smoked a pipe.

IF R03_EVER_NEVER_PIPE != 1 AND
R04_EVER_NEVER_PIPE_YOUTH = 1, THEN
R04_INIT_PIPE_YOUTH = 1.
ELSE, R04_INIT_PIPE_YOUTH = 2.

Past 30 Day Users - Pipe
R04_PAST30DAY_PIPE

(1) Past 30 day user = Youth respondents who
have smoked a pipe in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a pipe in
the past 30 days.

IF R04_YP1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_PIPE = 1.
ELSE, R04_PAST30DAY_PIPE = 2.

Ever or Never Users - Hookah
R04_EVER_NEVER_HOOK_YOUTH

(1) Ever user = Youth respondents who have
ever smoked hookah.
(2) Never user = Youth respondents who have
not ever smoked hookah.

IF (R04_YH1001_NB = 1 AND
R04_YH1002_NB = 1) OR R04_YH1002_12M
= 1 OR R03_EVER_NEVER_HOOK = 1),
THEN R04_EVER_NEVER_HOOK_YOUTH =
1.
ELSE, IF R04_EVER_NEVER_HOOK_YOUTH
!= 1, THEN
R04_EVER_NEVER_HOOK_YOUTH = 2.

Initiator - Hookah
R04_INIT_HOOK_YOUTH

(1) Initiator = Youth respondents who initiated
hookah use between Waves or new baseline
youth respondents who have ever smoked a
hookah.
(2) Non-initiator = Youth respondents who
have did not initiate hookah use between

IF R03_EVER_NEVER_HOOK != 1 AND
R04_EVER_NEVER_HOOK_YOUTH = 1,
THEN R04_INIT_HOOK_YOUTH = 1.
ELSE, R04_INIT_HOOK_YOUTH = 2.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

Waves or new baseline youth respondents
who have not ever smoked a hookah.
Past 30 Day Users - Hookah
R04_PAST30DAY_HOOK

(1) Past 30 day user = Youth respondents who
have smoked hookah in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked hookah in
the past 30 days.

IF R04_YH1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_HOOK = 1.
ELSE, R04_PAST30DAY_HOOK = 2.

Ever or Never Users - Snus
R04_EVER_NEVER_SNUS_YOUTH

(1) Ever user = Youth respondents who have
ever used snus.
(2) Never user = Youth respondents who have
not ever used snus.

IF (R04_YU1001_NB = 1 AND
R04_YU1002_NB = 1) OR R04_YU1002_12M
= 1 OR R03_EVER_NEVER_SNUS = 1, THEN
R04_EVER_NEVER_SNUS_YOUTH = 1.
ELSE, IF R04_EVER_NEVER_SNUS_YOUTH
!= 1, THEN
R04_EVER_NEVER_SNUS_YOUTH = 2.

Initiator - Snus
R04_INIT_SNUS_YOUTH

(1) Initiator = Youth respondents who initiated
snus use between Waves or new baseline
youth respondents who have ever used snus.
(2) Non-initiator = Youth respondents who did
not initiate snus use between Waves or new
baseline youth respondents who have not ever
used snus.

IF R03_EVER_NEVER_SNUS != 1 AND
R04_EVER_NEVER_SNUS_YOUTH = 1,
THEN R04_INIT_SNUS_YOUTH = 1.
ELSE, R04_INIT_SNUS_YOUTH = 2.

Past 30 Day Users - Snus
R04_PAST30DAY_SNUS

(1) Past 30 day user = Youth respondents who
have used snus in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not used snus in the
past 30 days.

IF R04_YU1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_SNUS = 1.
ELSE, R04_PAST30DAY_SNUS = 2.

Past 30 Day "Very Light" or "Not Light"
Users - Snus
R04_PAST30DAY_SNUS_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have used snus in the past
30 days, and have used snus 10 or fewer
times in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have used snus in the past
30 days, and have used snus more than 10
times in their lifetime.

IF (R04_YU1005 = 1 OR 2) AND (R04_YU1112
= 1 OR 2 OR 3), THEN
R04_PAST30DAY_SNUS_LEVEL = 1.
ELSE, IF (R04_YU1005> 2 OR R04_YU1005 =
-8, -7 OR R03_NUMLIFE_SNUS = 1) AND
(R04_YU1112 = 1 OR 2 OR 3), THEN
R04_PAST30DAY_SNUS_LEVEL = 2.
ELSE, R04_PAST30DAY_SNUS_LEVEL = 8.

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Youth Questionnaire – New and Aged-Up Interview
Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

(8) Unknown / missing = Unknown or missing
Ever or Never Users - Smokeless
Tobacco
R04_EVER_NEVER_SMKLS_YOUTH

(1) Ever user = Youth respondents who have
ever used smokeless tobacco.
(2) Never user = Youth respondents who have
not ever used smokeless tobacco.

IF (R04_YS1001_NB = 1 AND
R04_YS1002_NB = 1) OR R04_YS1002_12M
= 1 OR R03_EVER_NEVER_SMKLS = 1,
THEN R04_EVER_NEVER_SMKLS_YOUTH =
1.
ELSE, IF
R04_EVER_NEVER_SMKLS_YOUTH != 1,
THEN R04_EVER_NEVER_SMKLS_YOUTH =
2.

Initiator - Smokeless Tobacco
R04_INIT_SMKLS_YOUTH

(1) Initiator = Youth respondents who initiated
smokeless tobacco use between Waves or
new baseline youth respondents who have
ever used smokeless tobacco.
(2) Non-initiator = Youth respondents who did
not initiate smokeless tobacco use between
Waves or new baseline youth respondents
who have not ever used smokeless tobacco.

IF R03_EVER_NEVER_SMKLS != 1 AND
R04_EVER_NEVER_SMKLS_YOUTH = 1,
THEN R04_INIT_SMKLS_YOUTH = 1.
ELSE, R04_INIT_SMKLS_YOUTH = 2.

Past 30 Day Users – Smokeless
Tobacco
R04_PAST30DAY_SMKLS

(1) Past 30 day user = Youth respondents who
have used smokeless tobacco in the past 30
days.
(2) Not a past 30 day user = Youth
respondents who have not used smokeless
tobacco in the past 30 days.

IF R04_YS1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_SMKLS = 1.
ELSE, R04_PAST30DAY_SMKLS = 2.

Past 30 Day "Very Light" or "Not Light"
Users - Smokeless Tobacco
R04_PAST30DAY_SMKLS_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have used smokeless
tobacco in the past 30 days, and have used 10
times or less in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have used smokeless
tobacco in the past 30 days, and have used
more than 10 times in their lifetime.
(8) Unknown / missing = Unknown or missing

IF (R04_YS1005 = 1 OR 2) AND (R04_YS1112
= 1 OR 2 OR 3), THEN
R04_PAST30DAY_SMKLS_LEVEL = 1.
ELSE, IF (R04_YS1005 > 2 OR R04_YS1005 =
-8, -7 OR R03_NUMLIFE_SMKLS = 1) AND
R04_YS1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_SMKLS_LEVEL = 2.
ELSE, R04_PAST30DAY_SMKLS_LEVEL = 8.

Ever or Never Users - Dissolvable

(1) Ever user = Youth respondents who have

IF (R04_YD1001_NB = 1 AND

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User Group and Variable Name

User Group Description

User Group Definition

Tobacco
R04_EVER_NEVER_DISSBL_YOUTH

ever used dissolvable tobacco.
(2) Never user = Youth respondents who have
not ever used dissolvable tobacco.

R04_YD1002_NB = 1) OR R04_YD1002_12M
= 1 OR R03_EVER_NEVER_DISSBL = 1,
THEN R04_EVER_NEVER_DISSBL_YOUTH =
1.
ELSE, IF
R04_EVER_NEVER_DISSBL_YOUTH != 1,
THEN R04_EVER_NEVER_DISSBL_YOUTH =
2.

Initiator - Dissolvable Tobacco
R04_INIT_DISSBL_YOUTH

(1) Initiator = Youth respondents who initiated
dissolvable tobacco use between Waves new
baseline youth respondents who have ever
used dissolvable tobacco.
(2) Non-initiator = Youth respondents who did
not initiate dissolvable tobacco use between
Waves or new baseline youth respondents
who have not ever used dissolvable tobacco.

IF R03_EVER_NEVER_DISSBL != 1 AND
R04_EVER_NEVER_DISSBL_YOUTH = 1,
THEN R04_INIT_DISSBL_YOUTH = 1.
ELSE, R04_INIT_DISSBL_YOUTH = 2.

Past 30 Day Users - Dissolvable
Tobacco
R04_PAST30DAY_DISS

(1) Past 30 day user = Youth respondents who
have used dissolvable tobacco in the past 30
days.
(2) Not a past 30 day user = Youth
respondents who have not used dissolvable
tobacco in the past 30 days.

IF R04_YD1002_30D = 1, THEN
R04_PAST30DAY_DISS = 1.
ELSE, R04_PAST30DAY_DISS = 2.

Ever or Never Users - Bidis
R04_EVER_NEVER_BIDI_YOUTH

(1) Ever user = Youth respondents who have
ever smoked a bidi.
(2) Never user = Youth respondents who have
not ever smoked a bidi.

IF (R04_YB9101_NB_01 = 1 AND
R04_YB9102_NB_01 = 1) OR
R04_YB9102_12M_01 = 1 OR
R03_EVER_NEVER_BIDI = 1, THEN
R04_EVER_NEVER_BIDI_YOUTH= 1.
ELSE, IF R04_EVER_NEVER_BIDI_YOUTH !=
1, THEN R04_EVER_NEVER_BIDI_YOUTH =
2.

Initiator - Bidis
R04_INIT_BIDI_YOUTH

(1) Initiator = Youth respondents who initiated
bidi use between Waves or new baseline youth
respondents who have ever smoked a bidi.
(2) Non-initiator = Youth respondents who did

IF R03_EVER_NEVER_BIDI != 1 AND
R04_EVER_NEVER_BIDI_YOUTH = 1, THEN
R04_INIT_BIDI_YOUTH = 1.
ELSE, R04_INIT_BIDI_YOUTH = 2.

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User Group and Variable Name

User Group Description

User Group Definition

not initiate bidi use between Waves or new
baseline youth respondents who have not ever
smoked a bidi.
Past 30 Day Users - Bidis
R04_PAST30DAY_BIDI

(1) Past 30 day user = Youth respondents who
have smoked a bidi in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have never smoked a bidi in
the past 30 days.

IF R04_YB9102_30D_01 = 1, THEN
R04_PAST30DAY_BIDI = 1.
ELSE, R04_PAST30DAY_BIDI = 2.

Ever or Never Users - Kreteks
R04_EVER_NEVER_KRETEK_YOUTH

(1) Ever user = Youth respondents who have
ever smoked a kretek.
(2) Never user = Youth respondents who have
not ever smoked a kretek.

IF (R04_YB101_NB_02 = 1 AND
R04_YB9102_NB_02 = 1) OR
R04_YB9102_12M_02 = 1 OR
R03_EVER_NEVER_KRETEK = 1, THEN
R04_EVER_NEVER_KRETEK_YOUTH = 1. .
ELSE, IF
R04_EVER_NEVER_KRETEK_YOUTH != 1,
THEN R04_EVER_NEVER_KRETEK_YOUTH
= 2.

Initiator - Kreteks
R04_INIT_KRETEK_YOUTH

(1) Initiator = Youth respondents who initiated
kretek use between Waves or new baseline
youth respondents who have ever smoked a
kretek.
(2) Non-initiator = Youth respondents who did
not initiate smokeless tobacco use between
Waves or new baseline youth respondents
who have not ever smoked a kretek.

IF R03_EVER_NEVER_KRETEK != 1 AND
R04_EVER_NEVER_KRETEK_YOUTH = 1,
THEN R04_INIT_KRETEK_YOUTH = 1.
ELSE, R04_INIT_KRETEK_YOUTH = 2.

Past 30 Day Users - Kreteks
R04_PAST30DAY_KRETEK

(1) Past 30 day user = Youth respondents who
have smoked a kretek in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have never smoked a kretek
in the past 30 days.

IF R04_YB9102_30D_02 = 1, THEN
R04_PAST30DAY_KRETEK = 1.
ELSE, R04_PAST30DAY_KRETEK = 2.

Ever Users - Tobacco
R04_EVER_USE_TOB

(1) Ever user = Youth respondents who have
ever used any type of tobacco product(s) in
lifetime.
(2) Never user = Youth respondents who have

IF R04_EVER_NEVER_CIGS_YOUTH = 1 OR
R04_EVER_NEVER_EPRODS_YOUTH = 1
OR (R04_EVER_NEVER_GTRAD_YOUTH = 1
AND R04_12MBLUNT_ONLY_BTRAD = 2) OR

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User Group and Variable Name

User Group Description

User Group Definition

not ever used any type of tobacco product(s) in
lifetime.

(R04_EVER_NEVER_GRILLO_YOUTH = 1
AND R04_12MBLUNT_ONLY_BRILLO = 2) OR
(R04_EVER_NEVER_GFILTR_YOUTH = 1
AND R04_12MBLUNT_ONLY_BFILTR = 2) OR
R04_EVER_NEVER_PIPE_YOUTH = 1 OR
R04_EVER_NEVER_HOOK_YOUTH = 1 OR
R04_EVER_NEVER_SMKLS_YOUTH = 1 OR
R04_EVER_NEVER_SNUS_YOUTH = 1 OR
R04_EVER_NEVER_DISSBL_YOUTH = 1 OR
R04_EVER_NEVER_BIDI_YOUTH = 1 OR
R04_EVER_NEVER_KRETEK_YOUTH = 1,
THEN R04_EVER_USE_TOB=1.
ELSE, R04_EVER_USE_TOB=2.

Ever Users – Cigarettes Only
R04_EVER_USE_CIGSONLY

(1) Ever user = Youth respondents who have
ever used only cigarettes, and no other
products, in lifetime.
(2) Never user = Youth respondents who have
not ever used only cigarettes, and no other
products, in lifetime.

IF R04_EVER_NEVER_CIGS_YOUTH = 1
AND R04_EVER_NEVER_EPRODS_YOUTH
!= 1 AND
R04_EVER_NEVER_GTRAD_YOUTH != 1
AND R04_EVER_NEVER_GRILLO_YOUTH !=
1 AND R04_EVER_NEVER_GFILTR_YOUTH
!= 1 AND R04_EVER_NEVER_PIPE_YOUTH
!= 1 AND R04_EVER_NEVER_HOOK_YOUTH
!= 1 AND
R04_EVER_NEVER_SMKLS_YOUTH != 1
AND R04_EVER_NEVER_SNUS_YOUTH != 1
AND R04_EVER_NEVER_DISSBL_YOUTH !=
1 AND R04_EVER_NEVER_BIDI_YOUTH != 1
AND R04_EVER_NEVER_KRETEK_YOUTH !=
1, THEN R04_EVER_USE_CIGSONLY= 1.
ELSE, R04_EVER_USE_CIGSONLY= 2.

Ever Users - Dual
R04_EVER_USE_DUAL

(1) Ever user = Youth respondents who have
ever used cigarettes and at least one other
tobacco product in lifetime.
(2) Never user = Youth respondents who have
not ever used cigarettes and at least one other
tobacco product in lifetime.

IF R04_EVER_NEVER_CIGS_YOUTH = 1
AND (R04_EVER_NEVER_EPRODS_YOUTH
= 1) OR
(R04_EVER_NEVER_GTRAD_YOUTH = 1
AND R04_12MBLUNT_ONLY_BTRAD = 2) OR
(R04_EVER_NEVER_GRILLO_YOUTH = 1

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User Group and Variable Name

User Group Description

User Group Definition
AND R04_12MBLUNT_ONLY_BRILLO = 2) OR
(R04_EVER_NEVER_GFILTR_YOUTH = 1
AND R04_12MBLUNT_ONLY_BFILTR = 2) OR
(R04_EVER_NEVER_PIPE_YOUTH = 1) OR
(R04_EVER_NEVER_HOOK_YOUTH = 1) OR
(R04_EVER_NEVER_SMKLS_YOUTH = 1) OR
(R04_EVER_NEVER_SNUS_YOUTH = 1) OR
(R04_EVER_NEVER_DISSBL_YOUTH = 1)
OR (R04_EVER_NEVER_BIDI_YOUTH = 1)
OR (R04_EVER_NEVER_KRETEK_YOUTH =
1), THEN R04_EVER_USE_DUAL= 1.
ELSE, R04_EVER_USE_DUAL= 2.

Ever Users – Tobacco (Excluding
Cigarettes)
R04_EVER_USE_TOBXCIGS

(1) Ever user = Youth respondents who have
ever used any tobacco products, excluding
cigarettes, in lifetime.
(2) Never user = Youth respondents who have
not ever used any tobacco products, excluding
cigarettes, in lifetime.

IF R04_EVER_NEVER_CIGS_YOUTH = 2
AND (R04_EVER_NEVER_EPRODS_YOUTH
= 1 OR (R04_EVER_NEVER_GTRAD_YOUTH
= 1 AND R04_12MBLUNT_ONLY_BTRAD = 2)
OR (R04_EVER_NEVER_GRILLO_YOUTH = 1
AND R04_12MBLUNT_ONLY_BRILLO = 2) OR
(R04_EVER_NEVER_GFILTR_YOUTH = 1
AND R04_12MBLUNT_ONLY_BFILTR = 2) OR
(R04_EVER_NEVER_PIPE_YOUTH = 1) OR
(R04_EVER_NEVER_HOOK_YOUTH = 1) OR
(R04_EVER_NEVER_SMKLS_YOUTH = 1) OR
(R04_EVER_NEVER_SNUS_YOUTH = 1) OR
(R04_EVER_NEVER_DISSBL_YOUTH = 1)
OR (R04_EVER_NEVER_BIDI_YOUTH = 1)
OR (R04_EVER_NEVER_KRETEK_YOUTH =
1), THEN R04_EVER_USE_TOBXCIGS = 1.
ELSE, R04_EVER_USE_TOBXCIGS = 2.

Past 30 Day Users - Tobacco
R04_PAST30DAY_TOB

(1) Past 30 day user = Youth respondents who
have used any tobacco product(s) in the past
30 days.
(2) Not past 30 day user = Youth respondents
who have not ever used any tobacco
product(s) in the past 30 days.

IF R04_PAST30DAY_CIGS = 1 OR
R04_PAST30DAY_EPRODS = 1 OR
R04_PAST30DAY_GTRAD = 1 OR
R04_PAST30DAY_GRILLO = 1 OR
R04_PAST30DAY_GFILTR = 1 OR
R04_PAST30DAY_PIPE = 1 OR

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User Group and Variable Name

User Group Description

User Group Definition
R04_PAST30DAY_HOOK = 1 OR
R04_PAST30DAY_SMKLS = 1 OR
R04_PAST30DAY_SNUS = 1
R04_PAST30DAY_DISS = 1
R04_PAST30DAY_BIDI = 1
R04_PAST30DAY_KRETEK = 1,
THEN R04_PAST30DAY_TOB = 1.
ELSE, R04_PAST30DAY_TOB = 2.

Past Year Level - Tobacco
R04_PASTYEAR_TOB_USE_LEVEL

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

(1) Very light = Youth respondents who have
used any tobacco product in the last year, and
are not "not light" users of any product.
(2) Not light = Youth respondents who are not
light users of any tobacco product and have
used in the past year.

356

IF R04_EVER_USE_TOB = 1 AND
(((R04_YC1005 = 1 OR 2 OR 3 AND
R03_NUMLIFE_CIGS != 1) AND (R04_YC1112
= 1, 2, 3, 4, OR 5)) OR ((R04_YV1005 = 1 AND
R03_NUMLIFE_ECIG != 1) AND (R04_YV1112
= 1, 2, 3, 4, OR 5)) OR ((R04_YG1005TC = 1
OR 2 OR 3 AND R03_NUMLIFE_GTRAD != 1)
AND (R04_YG1112TC = 1, 2, 3, 4, OR 5)) OR
((R04_YG1005CL = 1 OR 2 OR 3 AND
R03_NUMLIFE_GRILLO != 1) AND
(R04_YG1112CL = 1, 2, 3, 4, OR 5)) OR
((R04_YG1005FC = 1 OR 2 OR 3 AND
R03_NUMLIFE_GFILTR != 1) AND
(R04_YG1112FC = 1, 2, 3, 4, OR 5)) OR
(R04_YP1112 = 1, 2, 3, 4, OR 5) OR
(R04_YH1112 = 1, 2, 3, 4, OR 5) OR
((R04_YU1005 = 1 OR 2) AND (R04_YU1112 =
1, 2, 3, 4, OR 5)) AND ((R04_YS1005 = 1 OR
2) AND (R04_YS1112 = 1, 2, 3, 4, OR 5)) OR
R04_YD1002_12M = 1 OR R04_YB9102_01 =
1 OR R04_YB9102_02 = 1), THEN
R04_PASTYEAR_TOB_USE_LEVEL = 1.
IF ((R04_YC1005 > 3 OR R04_YC1005 = -8, -7
OR R03_NUMLIFE_CIGS = 1) AND
(R04_YC1112 = 1 OR 2 OR 3 OR 4 OR 5)) OR
((R04_YV1005 > 1 OR R04_YV1005 = -8, -7
OR R03_NUMLIFE_ECIG = 1) AND
(R04_YV1112 = 1, 2, 3, 4, OR 5)) OR

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User Group and Variable Name

User Group Description

User Group Definition
((R04_YG1005TC > 3 OR R04_YG1005TC = 8, -7 OR R03_NUMLIFE_GTRAD = 1) AND
(R04_YG1112TC = 1, 2, 3, 4, OR 5)) OR
((R04_YG1005CL > 3 OR R04_YG1005CL = 8, -7 OR R03_NUMLIFE_GRILLO = 1) AND
(R04_YG1112CL = 1, 2, 3, 4, OR 5)) OR
((R04_YG1005FC > 3 OR R04_YG1005FC = 8, -7 OR R03_NUMLIFE_GFILTR = 1) AND
(R04_YG1112FC = 1, 2, 3, 4, OR 5)) OR
((R04_YU1005 > 2 OR R04_YU1005 = -8, -7
OR R03_NUMLIFE_SNUS = 1) AND
(R04_YU1112 = 1, 2, 3, 4, OR 5)) OR
((R04_YS1005 > 2 OR R04_YS1005 = -8, -7
OR R03_NUMLIFE_SMKLS = 1) AND
(R04_YS1112 = 1, 2, 3, 4, OR 5)), THEN
R04_PASTYEAR_TOB_USE_LEVEL = 2.

Past Year Users - Tobacco
R04_PASTYEAR_TOB_USE

PATH – Wave 4
Youth Questionnaire – New and Aged-Up Interview

(1) Past year tobacco = (Past year users of
tobacco only) Youth respondents who have
used any tobacco product(s) in the past 12
months, but have not used any e-products in
the past 12 months.
(2) Past year e-product = (Past year users of
e-products only) Youth respondents who have
used any e-product in the past 12 months, but
have not used any other tobacco product(s) in
the past 12 months.
(3) Past year both = (Past year users of
tobacco and e-products) Youth respondents
who have used any e-product in the past 12
months and have used at least one other
tobacco product in the past 12 months.
(4) Past year non-user = (Past year non-users
of any tobacco or e-product) Youth
respondents who have not used any e-product
in the past 12 months and have not used any
other tobacco product in the past 12 months.
357

IF [R04_YV1112 != 1, 2, 3, 4 or 5] AND
[(R04_YC1112=1, 2, 3, 4 or 5) OR
(R04_YG1112TC = 1, 2, 3, 4, or 5) OR
(R04_YG1112CL =1, 2, 3, 4 or 5) OR
(R04_YG1112FC = 1, 2, 3, 4, or 5) OR
(R04_YP1112=1, 2, 3, 4 or 5) OR
(R04_YH1112=1, 2, 3, 4 or 5) OR
(R04_YU1112 = 1, 2, 3, 4, OR 5) OR
(R04_YS1112=1, 2, 3, 4 or 5) OR
R04_YB9102_12M_01 = 1 OR
R04_YB9102_12M_02 = 1 OR
R04_YD1002_12M = 1, THEN
R04_PASTYEAR_TOB_USE = 1.
ELSE, IF [R04_YV1112 = 1, 2, 3, 4 or 5] AND
[(R04_YC1112 != 1, 2, 3, 4 or 5) AND
(R04_YG1112TC != 1, 2, 3, 4, or 5) AND
(R04_YG1112CL !=1, 2, 3, 4 or 5) AND
(R04_YG1112FC != 1, 2, 3, 4, or 5) AND
(R04_YP1112 != 1, 2, 3, 4 or 5) AND
(R04_YH1112 != 1, 2, 3, 4 or 5) AND

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User Group and Variable Name

User Group Description

User Group Definition
(R04_YU1112 != 1, 2, 3, OR 4) AND
(R04_YS1112 != 1, 2, 3, 4 or 5) AND
R04_YB9102_12M_01 != 1 AND
R04_YB9102_12M_02 != 1 AND
R04_YD1002_12M != 1], THEN
R04_PASTYEAR_TOB_USE = 2.
ELSE, IF [R04_YV1112 = 1, 2, 3, 4 or 5] AND
[(R04_YC1112=1, 2, 3, 4 or 5) OR
(R04_YG1112TC = 1, 2, 3, 4, or 5) OR
(R04_YG1112CL =1, 2, 3, 4 or 5) OR
(R04_YG1112FC = 1, 2, 3, 4, or 5) OR
(R04_YP1112=1, 2, 3, 4 or 5) OR
(R04_YH1112=1, 2, 3, 4 or 5) OR
(R04_YU1112 = 1, 2, 3, 4, OR 5) OR
(R04_YS1112=1, 2, 3, 4 or 5) OR
R04_YB9102_12M_01 = 1 OR
R04_YB9102_12M_02 = 1 OR
R04_YD1002_12M = 1, THEN
R04_PASTYEAR_TOB_USE = 3.
ELSE, IF [R04_YV1112 != 1, 2, 3, 4 or 5] AND
[(R04_YC1112 != 1, 2, 3, 4 or 5) AND
(R04_YG1112TC != 1, 2, 3, 4, or 5) AND
(R04_YG1112CL !=1, 2, 3, 4 or 5) AND
(R04_YG1112FC != 1, 2, 3, 4, or 5) AND
(R04_YP1112 != 1, 2, 3, 4 or 5) AND
(R04_YH1112 != 1, 2, 3, 4 or 5) AND
(R04_YU1112 != 1, 2, 3, OR 4) AND
(R04_YS1112 != 1, 2, 3, 4 or 5) AND
R04_YB9102_12M_01 != 1 AND
R04_YB9102_12M_02 != 1 AND
R04_YD1002_12M != 1], THEN
R04_PASTYEAR_TOB_USE = 4.

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APPENDIX: DERIVED VARIABLES
Variable Name

Variable Description

Variable Definition

R04_YOUTHAGE

Youth respondent age.

IF R04_E_YOUTH_LD = 1, THEN
R04_YOUTHAGE = R04_CURRENT_AGE_LD.
ELSE, R04_YOUTHAGE = R04_PARYTHAGE.

R04_EPRODCOUNT

The number of different electronic nicotine
products used.

R04_EPRODCOUNT = 0 (RANGE = 0-99)
IF R04_YV9035_01 = 1, SET
R04_EPRODCOUNT = R04_EPRODCOUNT +
1;
IF R04_YV9035_02 = 1, SET
R04_EPRODCOUNT = R04_EPRODCOUNT +
1;
IF R04_YV9035_03 = 1, SET
R04_EPRODCOUNT = R04_EPRODCOUNT +
1;
IF R04_YV9035_04 = 1, SET
R04_EPRODCOUNT = R04_EPRODCOUNT +
1;
IF R04_YV9035_05 = 1, SET
R04_EPRODCOUNT = R04_EPRODCOUNT +
1;
IF R04_YV9061_01 != -1, -8, -7, SET
R04_EPRODCOUNT = R04_EPRODCOUNT +
R04_YV9061_01;
IF R04_Y9061_02 != -1, -8, -7, SET
R04_EPRODCOUNT = R04_EPRODCOUNT +
R04_YV9061_02;
IF R04_YV9061_03 != -1, -8, -7, SET
R04_EPRODCOUNT = R04_EPRODCOUNT +
R04_YV9061_03;
IF R04_YV9061_04 != -1, -8, -7, SET
R04_EPRODCOUNT = R04_EPRODCOUNT +

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Variable Name

Variable Description

Variable Definition
R04_YV9061_04;

R04_EDEVICETYPE

Electronic nicotine product device type.

IF R04_YV9005 = 2, -8 OR -7 AND
R04_YV9008 = 2, -8 OR -7 AND R04_YV9038
= 2, 3, -8 OR -7 AND R04_YV9009 = 2, -8 OR 7, THEN R04_EDEVICETYPE = 1
(Disposable).
ELSE, IF R04_YV9005 = 1 AND R04_YV9008
= 1 AND R04_YV9038 = 2, 3, -8 OR -7 AND
R04_YV9009 = 2, -8 OR -7, THEN
R04_EDEVICETYPE = 2 (Non-Refillable
Cartridge).
ELSE, IF R04_YV9005 = 1 AND R04_YV9008
= 1 AND R04_YV9038 != 1 AND R04_YV9009
= 1, THEN R04_EDEVICETYPE = 3 (Refillable
Cartridge).
ELSE, IF R04_YV9005 = 1 AND R04_YV9038
= 1 AND R04_YV9009 = 1, THEN
R04_EDEVICETYPE = 4 (Refillable Tank
System).
ELSE, IF R04_YV9005 = 1, 2, -8 OR -7 AND
R04_YV9008 = 2, -8 OR -7 AND R04_YV9038
= 2, 3, -8 OR -7 AND R04_YV9009 = 1, THEN
R04_EDEVICETYPE = 5 (Refillable Mod
System).
ELSE, R04_EDEVICETYPE = 6 (Unknown).

CIGARFILL

Fill to be shown in question text to indicate the
cigar type.
Fill with "traditional cigar" for traditional
cigar/blunt smokers
Fill with "cigarillo" for cigarillo/blunt smokers
Fill with "filtered cigar" for filtered cigar/blunt
smokers

IF R04_EVER_USER_GTRAD = 1 OR
R04_12MBLUNT_ONLY_GTRAD = 1, THEN
CIGARFILL = "traditional cigar".
IF R04_EVER_USER_GRILLO = 1 OR
R04_12MBLUNT_ONLY_GRILLO = 1, THEN
CIGARFILL = "cigarillo".
IF R04_EVER_USER_GFILTR = 1 OR
R04_12MBLUNT_ONLY_GFILTR = 1, THEN

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Variable Name

Variable Description

Variable Definition
CIGARFILL = "filtered cigar".

CIGARLOOP

Cigars as Non-Blunts:
GTRAD = Youth respondents who have ever
smoked traditional cigars and have not smoked
traditional cigars as blunts every time when
smoked in the past 12 months.
GRILLO = Youth respondents who have ever
smoked cigarillos and have not smoked
cigarillos as blunts every time when smoked in
the past 12 months.
GFILTR = Youth respondents who have ever
smoked filtered cigars and have not smoked
filtered cigars as blunts every time when
smoked in the past 12 months.
Cigars as Blunts-Only:
BTRAD = Youth respondents who smoke
traditional cigars as blunts every time when
smoked in the past 12 months.
BRILLO = Youth respondents who smoke
cigarillos as blunts every time when smoked in
the past 12 months.
BFILTR = Youth respondents who smoke
filtered cigars as blunts every time when
smoked in the past 12 months.

Cigars as Non-Blunts:
GTRAD: IF R04_EVER_USER_GTRAD = 1
AND R04_12MBLUNT_ONLY_BTRAD = 2,
THEN LOOP = GTRAD.
GRILLO: IF R04_EVER_USER_GRILLO = 1
AND R04_12MBLUNT_ONLY_BRILLO = 2,
THEN LOOP = GRILLO.
GFILTR: IF R04_EVER_USER_GFILTR = 1
AND R04_12MBLUNT_ONLY_BFILTR = 2,
THEN LOOP = GFILTR.
Cigars as Blunts-Only:
BTRAD: IF R04_12MBLUNT_ONLY_BTRAD =
1, THEN LOOP = BTRAD.
BRILLO: IF R04_12MBLUNT_ONLY_BRILLO =
1, THEN LOOP = BRILLO.
BFILTR: IF R04_12MBLUNT_ONLY_BFILTR =
1, THEN LOOP = BFILTR.

R04_YOUTH_ASTHMA

(1) Asthma = Youth respondent has ever had
asthma.
(2) No asthma = Youth respondent has never
had asthma.

IF R03_ASTHMA = 1 OR R04_YT0031_NB = 1
OR R04_YT0031_12M = 1, THEN
R04_YOUTH_ASTHMA = 1.
ELSE, R04_YOUTH_ASTHMA = 2.

R04_SUBSTANCE_COUNT

Number of substances the youth respondent
has ever used.

R04_SUBSTANCE_COUNT = 0;

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Variable Name

Variable Description

Variable Definition
IF R04_EVER_USER_ALC = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;
IF R04_EVER_USER_MJ = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;
IF R04_EVER_USER_RIT = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;
IF R04_EVER_USER_PK = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;
IF R04_EVER_USER_COC = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;
IF R04_EVER_USER_STIM = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;
IF R04_EVER_USER_OTH = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;

R04_EVER_USER_ALC

Youth respondent has ever used alcohol.

IF R03_EVER_USER_ALCOHOL = 1 OR
(VALID AGE REPORTED IN R04_YX0074_NB
OR R04_YX0270_NB > 0) OR
R04_YX0084_12M = 1, THEN
R04_EVER_USER_ALC = 1. ELSE
R04_EVER_USER_ALC = 2.

R04_EVER_USER_MJ

Youth respondent has ever used marijuana.

IF R03_EVER_USER_MARIJUANA OR
R04_YX0085_NB =1 OR R04_YG9105_NB = 1
OR R04_YH9031 = 1 OR R04_YV9042 = 1 OR
R04_YX0085_12M = 1 OR R04_YG9107 = 1,
THEN R04_EVER_USER_MJ = 1. ELSE,

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Variable Name

Variable Description

Variable Definition
R04_EVER_USER_MJ = 2.

R04_EVER_USER_RIT

Youth respondent has ever used Ritalin® or
Adderall®.

IF R03_EVER_USER_RITALIN = 1 OR
R04_YX0089_NB[1] = 1 OR
R04_YX0089_12M[1] = 1, THEN
R04_EVER_USER_RIT = 1. ELSE
R04_EVER_USER_RIT = 2.

R04_EVER_USER_PK

Youth respondent has ever used painkillers,
sedatives, or tranquilizers.

IF R03_EVER_USER_PAINKILLERS OR
R04_YX0089_NB[2] = 1 OR
R04_YX0089_12M[2] = 1 , THEN
R04_EVER_USER_PK = 1. ELSE
R04_EVER_USER_PK = 2.

R04_EVER_USER_COC

Youth respondent has ever used cocaine or
crack.

IF R03_EVER_USER_COCAINE = 1 OR
R04_YX0220_NB[1] = 1 OR
R04_YX0220_12M[1] = 1, THEN
R04_EVER_USER_COC = 1. ELSE,
R04_EVER_USER_COC = 2.

R04_EVER_USER_STIM

Youth respondent has ever used stimulants like
methamphetamine or speed.

IF R03_EVER_USER_STIMULANTS = 1 OR
R04_YX0220_NB[2] = 1R04_YX0220_12M[2] =
1, THEN R04_EVER_USER_STIM = 1. ELSE,
R04_EVER_USER_STIM = 2.

R04_EVER_USER_OTH

Youth respondent has ever used other drugs
like heroin, inhalants, solvents, or
hallucinogens.

IF R03_EVER_USER_OTHERDRUG = 1 OR
R04_YX0220_NB[3] = 1 OR
R04_YX0220_12M[3] = 1, THEN
R04_EVER_USER_OTH = 1. ELSE,
R04_EVER_USER_OTH = 2.

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Table of Contents
INTRODUCTORY DEMOGRAPHICS ....................................................................................... 1
CIGARETTE .............................................................................................................................. 7
ELECTRONIC NICOTINE PRODUCTS .................................................................................. 27
CIGAR ..................................................................................................................................... 59
PIPE ..................................................................................................................................... 109
HOOKAH .............................................................................................................................. 116
SNUS ..................................................................................................................................... 137
SMOKELESS TOBACCO...................................................................................................... 157
DISSOLVABLE TOBACCO ................................................................................................... 175
BIDIS AND KRETEKS ........................................................................................................... 177
OTHER TOBACCO ............................................................................................................... 179
NEW PRODUCT - PLACEHOLDER ..................................................................................... 180
FIRST TOBACCO PRODUCT............................................................................................... 182
NICOTINE DEPENDENCE AND CESSATION / QUITTER .................................................. 184
PACKAGING AND HEALTH WARNINGS ............................................................................ 201
PRODUCT REGULATION - MODIFIED RISK TOBACCO PRODUCTS .............................. 214
MEDIA USE .......................................................................................................................... 235
SECONDHAND SMOKE EXPOSURE .................................................................................. 241
HEALTH................................................................................................................................. 243
MARKETING, ADVERTISING AND PROMOTION ............................................................... 262
SOCIAL NORMS, PEER AND FAMILY INFLUENCES ........................................................ 273
ACCESSIBILITY .................................................................................................................... 283
PSYCHOSOCIAL .................................................................................................................. 285
SUBSTANCE USE ................................................................................................................ 290
ADDITIONAL DEMOGRAPHICS .......................................................................................... 301
CONTACT INFORMATION – EMANCIPATED YOUTH ....................................................... 308
APPENDIX: USER GROUPS ................................................................................................ 319
APPENDIX: DERIVED VARIABLES ..................................................................................... 336

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SECTION

# OF QUESTIONS

Introductory Demographics
Cigarettes

7
44

Electronic Nicotine Products
Cigar
Pipe
Hookah
Snus
Smokeless Tobacco

69
88
13
54
46
45

Dissolvable Tobacco
Bidis and Kreteks
Other Tobacco
New Product - Placeholder
First Tobacco Product
Nicotine Dependence and Cessation/Quitter

2
2
1
5
1
39

Packaging and Health Warnings
Product Regulation - Modified Risk Tobacco Products
Media Use
Secondhand Smoke Exposure
Health
Marketing, Advertising and Promotion

31
56
10
2
46
19

Social Norms, Peer and Family Influences
Accessibility
Psychosocial
Substance Use
Additional Demographics
Contact Information – Emancipated Youth

26
5
12
18
16
29

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OMB Control Number: 0925-0664

Expiration Date: XX/XX/XXXX

Public reporting burden for this collection of information is estimated to average 35 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 208927974, ATTN: PRA (0925-0664). Do not return the completed form to this address.

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INTRODUCTORY DEMOGRAPHICS
BOX ID:

R04_YMV01

PROGRAM: LOAD THE FOLLOWING DERIVED VARIABLES FROM PRELOAD FILE.
R03_EVER_NEVER_CIGS - Wave 3 ever or never user of cigarettes
R03_EVER_NEVER_EPRODS - Wave 3 ever or never user of e-products
R03_EVER_NEVER_GTRAD - Wave 3 ever or never user of traditional cigars
R03_EVER_NEVER_GRILLO - Wave 3 ever or never user of cigarillos
R03_EVER_NEVER_GFILTR - Wave 3 ever or never user of filtered cigars
R03_EVER_NEVER_BTRAD - Wave 3 ever or never user of traditional cigars as blunts
R03_EVER_NEVER_BRILLO - Wave 3 ever or never user of cigarillos as blunts
R03_EVER_NEVER_BFILTR - Wave 3 ever or never user of filtered cigars as blunts
R03_EVER_NEVER_PIPE - Wave 3 ever or never user of pipes
R03_EVER_NEVER_HOOK - Wave 3 ever or never user of hookah
R03_EVER_NEVER_SNUS - Wave 3 ever or never user of snus
R03_EVER_NEVER_SMKLS - Wave 3 ever or never user of smokeless tobacco
R03_EVER_NEVER_DISSBL - Wave 3 ever or never user of dissolvable tobacco
R03_EVER_NEVER_BIDI - Wave 3 ever or never user of bidis
R03_EVER_NEVER_KRETEK - Wave 3 ever or never user of kreteks
R03_NUMLIFE_CIGS - The respondent reported smoking 100+ cigarettes in their lifetime at any
previous wave.
R03_NUMLIFE_ECIG - The respondent reported using e-cigarettes 100+ times in their lifetime at any
previous wave.
R03_NUMLIFE_GTRAD - The respondent reported smoking 100+ traditional cigars in their lifetime at
any previous wave.
R03_NUMLIFE_GRILLO - The respondent reported smoking 100+ cigarillos in their lifetime at any
previous wave.
R03_NUMLIFE_GFILTR - The respondent reported smoking 100+ filtered cigars in their lifetime at any
previous wave.
R03_NUMLIFE_PIPE - The respondent reported smoking a pipe 100+ times in their lifetime at any
previous wave.
R03_NUMLIFE_HOOK - The respondent reported smoking hookah 100+ times in their lifetime at any
previous wave.
R03_NUMLIFE_SNUS - The respondent reported using 100+ snus pouches in their lifetime at any
previous wave.
R03_NUMLIFE_SMKLS - The respondent reported using smokeless tobacco 100+ times in their
lifetime at any previous wave.
R03_REGUSE_CIGS - The respondent reported smoking cigarettes fairly regularly at any previous
wave.
R03_REGUSE_ECIG - The respondent reported using e-cigarettes fairly regularly at any previous
wave.
R03_REGUSE_GTRAD - The respondent reported smoking traditional cigars fairly regularly at any
previous wave.
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R03_REGUSE_GRILLO - The respondent reported smoking cigarillos fairly regularly at any previous
wave.
R03_REGUSE_GFILTR - The respondent reported smoking filtered cigars fairly regularly at any
previous wave.
R03_REGUSE_PIPE - The respondent reported smoking a pipe fairly regularly at any previous wave.
R03_REGUSE_HOOK - The respondent reported smoking hookah fairly regularly at any previous wave.
R03_REGUSE_SNUS - The respondent reported using snus fairly regularly at any previous wave.
R03_REGUSE_SMKLS - The respondent reported using smokeless tobacco fairly regularly at any
previous wave.
R03_GENDER - Respondent reported gender
R03_ASTHMA - Respondent reported being diagnosed with asthma in any previous wave.
R03_EVER_USER_ALCOHOL - Respondent reported ever using alcohol in any previous wave.
R03_EVER_USER_MARIJUANA - Respondent reported ever using marijuana in any previous wave.
R03_EVER_USER_RITALIN - Respondent reported ever using ritalin in any previous wave.
R03_EVER_USER_PAINKILLERS - Respondent reported ever using painkillers in any previous wave.
R03_EVER_USER_COCAINE - Respondent reported ever using cocaine in any previous wave.
R03_EVER_USER_STIMULANTS - Respondent reported ever using stimulants in any previous wave.
R03_USCITIZEN – Respondent reported US citizenship in any previous wave.
R03_RACE - Respondent reported race as White in any previous wave.
R03_LGBT - Respondent identified as LGBT in any previous wave.
R04_LINKED_ADDRESS - Emancipated youth respondents' best address from IMS.
R04_VTBESTSPPHONE - Emancipated youth respondents' best phone number from IMS.
R04_PHONE2 - Emancipated youth respondents' second phone number from IMS.
R04_E_YOUTH_LD - Youth respondents that are emancipated.
R04_QUEXSAMPLE - Indicates a random sample of youth respondents.
BOX ID:

R04_YMV02

PROGRAM: DERIVE THE FOLLOWING VARIABLE (SEE APPENDIX).
R04_YOUTHAGE = Age verified by parent or age derived from emancipated youth's birthdate.

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BOX ID:

R04_YMD04

Note - In the following specifications, “!=” represents “not equal to”.
Note - References to the various respondent types are as follows:
"New baseline youth respondents" = Youth respondents where this is their first interview in the Youth
cohort and in the PATH Study. Includes youth who have aged-up into the Youth cohort and youth who
are new to the PATH Study as part of the replenishment sample.
"Continuing youth respondents" = Youth respondents whose last completed interview in a previous
wave was in the Youth cohort, and they continue to be in the Youth cohort. This is not their first
interview in the Youth cohort or the PATH Study.
"Emancipated youth respondents" = Youth respondents who are emancipated.
"All youth respondents" = All youth respondents in the Youth cohort.
BOX ID:

R04_YMR03

New baseline youth respondents, go to R04_YM0004_NB.
Else, continuing youth respondents who did not report US citizenship in a previous wave, go to
R04_YM0069.
Else, go to R04_YM0065.
PATH ID:

R04_YM0069

Are you a citizen of the United States?
1

Yes, born in the United States

2

Yes, born in Puerto Rico, Guam, the U.S. Virgin Islands, or Northern Marianas

3

Yes, born abroad of U.S. citizen parent or parents

4

Yes, U.S. citizen by naturalization

5

No, not a U.S. citizen

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents and continuing youth respondents who did not report US
citizenship in a previous wave.

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PATH ID:

R04_YM0065

About how many years have you lived in the United States? (If you have lived in the United States for
less than a year, enter 1.)
1

I___I___I___I YEARS

-8

DON'T KNOW

GO TO R04_YMD03

-7

REFUSED

GO TO R04_YMD03

ASK: All youth respondents.
DISPLAY: DISPLAY "YEARS" AS TITLE.
PATH ID:

R04_YM0065_LC1

The computer recorded that you have lived in the United States for [R04_YM0065] years. That is older
than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YM0065

2

NEXT

GO TO BOX R04_YMD03

ASK: IF R04_YM0065 > R04_YOUTHAGE
BOX ID:

R04_YMD03

Display questions R04_YM0066 through R04_YM0073 using the expanded WVB stem-leaf screen. The
introduction text from R04_YM0066 is the stem. Show all leaves on the screen at once.
PATH ID:

R04_YM0066

How well do you...
speak English?
1

Very well

2

Well

3

Not well

4

Not at all

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH ID:

R04_YM0070

read English?
1

Very well

2

Well

3

Not well

4

Not at all

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YM0073

write in English?
1

Very well

2

Well

3

Not well

4

Not at all

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YM0071

Do you speak a language other than English at home?
1

Yes

2

No

GO TO BOX R04_YCT01

-8

DON'T KNOW

GO TO BOX R04_YCT01

-7

REFUSED

GO TO BOX R04_YCT01

ASK: All youth respondents.

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PATH ID:

R04_YM0072

What other languages do you speak at home? Choose all that apply.
1

Spanish

2

Chinese

3

Tagalog

4

Vietnamese

5

French

6

Korean

7

German

8

Arabic

9

Russian

10

Some other language (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who speak another language at home.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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CIGARETTE
BOX ID:

R04_YCT01

The next questions are about your experience with cigarettes.
BOX ID:

R04_YCR02

New baseline youth respondents, go to R04_YC1002_NB.
Continuing youth respondents, go to R04_YC1002_12M.
PATH ID:

R04_YC1002_12M

In the past 12 months, have you smoked a cigarette, even one or two puffs?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents.
BOX ID:

R04_YCV02

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_CIGS_YOUTH = 1 (Ever user) Youth respondents who have ever smoked a
cigarette.
R04_EVER_NEVER_CIGS_YOUTH = 2 (Never user) Youth respondents who have not ever smoked a
cigarette.
R04_INIT_CIGS_YOUTH = 1 (Initiator) Youth respondents who initiated cigarette use between Waves
or new baseline youth respondents who have ever smoked a cigarette.
BOX ID:

R04_YCR01

Youth respondents who have never smoked a cigarette, go to R04_YC1103.
Else, new baseline youth respondents who have ever smoked a cigarette, go to R04_YC1006_NB.
Else, continuing youth respondents who initiated cigarette smoking since the previous wave, go to
R04_YC1108.
Else, continuing youth respondents who had smoked 100 or more cigarettes in the previous wave, go to
Box R04_YCR21.
Else, go to R04_YC1005.

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PATH ID:

R04_YC1103

Have you ever been curious about smoking a cigarette?
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have never smoked a cigarette.
PATH ID:

R04_YC1206

Do you think you will smoke a cigarette in the next year?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have never smoked a cigarette.
PATH ID:

R04_YC1104

Do you think that you will try a cigarette soon?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have never smoked a cigarette.

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PATH ID:

R04_YC1105

If one of your best friends were to offer you a cigarette, would you smoke it?
1

Definitely yes

GO TO BOX R04_YVT01

2

Probably yes

GO TO BOX R04_YVT01

3

Probably not

GO TO BOX R04_YVT01

4

Definitely not

GO TO BOX R04_YVT01

-8

DON'T KNOW

GO TO BOX R04_YVT01

-7

REFUSED

GO TO BOX R04_YVT01

ASK: Youth respondents who have never smoked a cigarette.
PATH ID:

R04_YC1108

Was the first cigarette you smoked flavored to taste like menthol or mint?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have initiated cigarette use since the previous wave, and new
baseline youth respondents who have ever smoked a cigarette.
PATH ID:

R04_YC9104

How much did you experience pleasant sensations the first time you smoked a cigarette?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have initiated cigarette use since the previous wave, and new
baseline youth respondents who have ever smoked a cigarette.
DISPLAY: UNDERLINE "pleasant".

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PATH ID:

R04_YC9105

How much did you experience unpleasant sensations the first time you smoked a cigarette?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have initiated cigarette use since the previous wave, and new
baseline youth respondents who have ever smoked a cigarette.
DISPLAY: UNDERLINE "unpleasant".
PATH ID:

R04_YC9106

How much did you feel sick to your stomach the first time you smoked a cigarette?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have initiated cigarette use since the previous wave, and new
baseline youth respondents who have ever smoked a cigarette.
PATH ID:

R04_YC1005

How many cigarettes have you smoked in your entire life? A pack usually has 20 cigarettes in it.
1

1 or more puffs but never a whole cigarette

2

1 cigarette

3

2 to 10 cigarettes (about ½ pack total)

4

11 to 20 cigarettes (about ½ pack to 1 pack)

5

21 to 50 cigarettes (more than 1 pack but less than 3 packs)

6

51 to 99 cigarettes (more than 2 ½ packs but less than 5 packs)

7

100 or more cigarettes (5 packs or more)

-8

DON'T KNOW

-7

REFUSED

ASK: Aged-up and continuing youth respondents who have ever smoked a cigarette and had not
smoked 100 or more cigarettes in the previous wave, and new cohort youth respondents who have ever
smoked a cigarette.

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BOX ID:

R04_YCR21

Youth respondents who have ever smoked a cigarette and had never smoked cigarettes fairly regularly
in the previous wave, go to R04_YC1100.
Else, go to R04_YC9022.
PATH ID:

R04_YC1100

Have you ever smoked cigarettes fairly regularly?
1

Yes

2

No

GO TO R04_YC9022

-8

DON'T KNOW

GO TO R04_YC9022

-7

REFUSED

GO TO R04_YC9022

ASK: Youth respondents who have ever smoked a cigarette and had never smoked fairly regularly in
the previous wave.
PATH ID:

R04_YC1007

How old were you when you first started smoking cigarettes fairly regularly?
1

|__|__| Years old

-8

DON'T KNOW

GO TO R04_YC1121

-7

REFUSED

GO TO R04_YC1121

ASK: Youth respondents who have ever smoked cigarettes fairly regularly and did not smoke fairly
regularly in the previous wave.
DISPLAY: DISPLAY "Years old" AS A TITLE.
PATH ID:

R04_YC1007_LC1

The computer recorded that you started smoking cigarettes fairly regularly at age [R04_YC1007]. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC1007

2

NEXT

GO TO R04_YC9022

ASK: IF R04_YC1007 <= 5 OR R04_YC1007 < R04_YC1006_NB.

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PATH ID:

R04_YC1007_LC2

The computer recorded that you started smoking cigarettes fairly regularly at age [R04_YC1007]. This is
older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC1007

2

NEXT

GO TO R04_YC9022

ASK: IF R04_YC1007 > R04_YOUTHAGE.
PATH ID:

R04_YC1121

When you first started smoking cigarettes fairly regularly, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked cigarettes fairly regularly and did not smoke fairly
regularly in a previous wave and who did not know or refused to report the age they started smoking.
PATH ID:

R04_YC9022

Do you consider yourself a smoker?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a cigarette.

PATH – Wave 4
Youth Questionnaire – Extended Interview

12

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1112

When was the last time you smoked a cigarette, even one or two puffs?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YCV01

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YCV01

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YCV01

6

1 to 4 years ago

GO TO BOX R04_YCV01

7

5 or more years ago

GO TO BOX R04_YCV01

-8

DON'T KNOW

GO TO BOX R04_YCV01

-7

REFUSED

GO TO BOX R04_YCV01

ASK: Youth respondents who have ever smoked a cigarette.
PATH ID:

R04_YC0100

When did you last smoke a cigarette?
1

In the past hour

GO TO R04_YC0103

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YCV01

-8

DON'T KNOW

GO TO BOX R04_YCV01

-7

REFUSED

GO TO BOX R04_YCV01

ASK: Youth respondents who smoked a cigarette in the past 7 days.
PATH ID:

R04_YC0102

When you last smoked a cigarette [FILL BASED ON R04_YC0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked a cigarette today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YC0100]: IF R04_YC0100 = 2, DISPLAY “today”; IF
R04_YC0100 = 3, DISPLAY "yesterday"; IF R04_YC0100 = 4, DISPLAY “the day before yesterday”.

PATH – Wave 4
Youth Questionnaire – Extended Interview

13

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC0103

How many cigarettes [have/did] you [smoked/smoke] [FILL BASED ON R04_YC0100]? A pack usually
has 20 cigarettes in it.
1

I__I__I Number of cigarettes

-8

DON'T KNOW

GO TO BOX R04_YCV01

-7

REFUSED

GO TO BOX R04_YCV01

ASK: Youth respondents who have smoked a cigarette in the past hour, sometime today, yesterday or
the day before yesterday.
DISPLAY: DISPLAY "Number of cigarettes" AS A TITLE.
IF R04_YC0100 = 1, 2, DISPLAY “have” AND “smoked”.
IF R04_YC0100 = 3, 4, DISPLAY, “did” AND “smoke”.
FOR [FILL BASED ON R04_YC0100]:
IF R04_YC0100 = 1, 2, DISPLAY “today”.
IF R04_YC0100 = 3, DISPLAY “yesterday”.
IF R04_YC0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YC0103_LC1

The computer recorded that you smoked [R04_YC0103] cigarettes [today/yesterday/the day before
yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC0103

2

NEXT

GO TO BOX R04_YCV01

ASK: IF R04_YC0103 > 60 OR R04_YC0103 = 11, 22, 33, 44, 55.
DISPLAY: IF R04_YC0100 = 1, 2, DISPLAY “today”.
IF R04_YC0100 = 3, DISPLAY “yesterday”.
IF R04_YC0100 = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YCV01

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PAST30DAY_CIGS = 1 (Past 30 day cigarette smoker) Youth respondents who have smoked a
cigarette in the past 30 days.
R04_PAST30DAY_CIGS_LEVEL = 1 (Past 30 day "Very Light" cigarette smokers) Youth
respondents who have smoked a cigarette in the past 30 days, and have smoked 10 or less cigarettes
in their lifetime.
R04_PAST30DAY_CIGS_LEVEL = 2 (Past 30 day "Not Light" cigarette smokers) Youth
respondents who have smoked a cigarette in the past 30 days, and have smoked more than 10
cigarettes in their lifetime.

PATH – Wave 4
Youth Questionnaire – Extended Interview

14

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_YCR22

Past 30 day cigarette smokers, go to R04_YC1022.
Else, go to R04_YVT01.
PATH ID:

R04_YC1022

In the past 30 days, on how many days did you smoke cigarettes?
1

I__I__I DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.
DISPLAY: DISPLAY 'DAYS' AS A TITLE.
PATH ID:

R04_YC1023

In the past 30 days, on the days you smoked, how many cigarettes did you smoke per day? A pack
usually has 20 cigarettes in it.
1

Less than 1 cigarette per day

2

1 cigarette per day

3

2 to 5 cigarettes per day

4

6 to 10 cigarettes per day

5

11 to 20 cigarettes per day

6

More than 20 cigarettes per day

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.

PATH – Wave 4
Youth Questionnaire – Extended Interview

15

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1150

After you finish smoking a cigarette, where do you throw away the cigarette butts? Choose all that
apply.
1

Ash tray or cigarette disposal

2

Trash or dumpster

3

Ground, bushes, or shrubbery

4

Sink or toilet

5

Out of a car window

6

Other (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YC1151

Where do you most often throw away empty cigarette packs?
1

Ash tray or cigarette disposal

2

Trash or dumpster

3

Ground, bushes, or shrubbery

4

Out of a car window

5

Other (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.
PATH ID:

R04_YC9048

In the past 30 days, did you smoke manufactured cigarettes or did you smoke roll-your-own cigarettes?
1

Manufactured cigarettes

2

Roll-your-own cigarettes

3

Both manufactured and roll-your-own cigarettes

4

I don't know

-8

DON'T KNOW

-7

REFUSED

GO TO BOX R04_YCR20

ASK: Past 30 day cigarette smokers.

PATH – Wave 4
Youth Questionnaire – Extended Interview

16

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1130

In the past 30 days, were any of the cigarettes you smoked flavored to taste like menthol or mint?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day manufactured cigarette smokers.
BOX ID:

R04_YCR20

Youth respondents who have smoked roll-your-own cigarettes in the past 30 days, go to R04_YC9045.
Else, go to R04_YC1142.
PATH ID:

R04_YC9045

In the past 30 days, was any of the roll-your-own tobacco you smoked flavored to taste like menthol or
mint?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day roll-your-own cigarette smokers.
PATH ID:

R04_YC1142

In the past 30 days, did anyone sell you cigarettes?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.

PATH – Wave 4
Youth Questionnaire – Extended Interview

17

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1123

In the past 30 days, did anyone refuse to sell you cigarettes because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.
PATH ID:

R04_YC1118

In the past 30 days, how did you usually get your own cigarettes?
1

I gave someone else money to buy cigarettes for me

2

I bought cigarettes myself from a store

3

I asked someone to give me a cigarette

4

Someone offered me a cigarette

5

I bought cigarettes from another person

6

I took cigarettes from a store or another person

7

I got cigarettes some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YCR03

Past 30 day cigarette smokers who usually buy cigarettes for themselves or give someone else money
to buy cigarettes for them, go to R04_YC1030.
Else, go to Box R04_YCR23.

PATH – Wave 4
Youth Questionnaire – Extended Interview

18

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1030

[When you give money to someone else, how do they/How do you] usually buy your cigarettes?
1

In person

2

From the internet

GO TO R04_YC1039

3

By telephone

GO TO R04_YC1039

-8

DON'T KNOW

GO TO R04_YC1039

-7

REFUSED

GO TO R04_YC1039

ASK: Past 30 day cigarette smokers (including "very light" smokers) who buy cigarettes for themselves
or someone else buys for them.
DISPLAY: IF R04_YC1118 = 1, DISPLAY “When you give money to someone else, how do they”; IF
R04_YC1118 = 2, DISPLAY “How do you”.
PATH ID:

R04_YC1032

Do [you/they] usually buy cigarettes...
1

In your own state

2

In another state

3

Outside the US

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers (including "very light" smokers) who buy cigarettes for themselves
or someone else buys for them in person.
DISPLAY: IF R04_YC1118 = 1, DISPLAY “they”; IF R04_YC1118 = 2, DISPLAY “you”.

PATH – Wave 4
Youth Questionnaire – Extended Interview

19

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1033

Where do [you/they] buy your cigarettes most of the time?
1

A convenience store or gas station

2

A supermarket, grocery store, or drug store

3

A warehouse club, such as Sam’s or Costco

4

A smoke shop, tobacco specialty store or tobacco outlet store

5

A duty free shop or military commissary

6

A bar, pub, restaurant or casino

7

A friend or relative

8

A swap meet or flea market

9

A store on an Indian reservation

10

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers (including "very light" smokers) who buy cigarettes for themselves
or someone else buys for them in person.
DISPLAY: IF R04_YC1118 = 1, DISPLAY “they”; IF R04_YC1118 = 2, DISPLAY “you”.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
BOX ID:

R04_YCR24

Past 30 day "not-light" cigarette smokers who usually buy cigarettes for themselves or give someone
else money to buy cigarettes for them, go to R04_YC1039.
Else, go to Box R04_YCR23.
PATH ID:

R04_YC1039

Think about the last time you [bought/gave money to someone else to buy you] cigarettes. Did you buy
them by the carton, pack, or as a single cigarette?
1

Carton

2

Pack

3

Single cigarette

-8

DON'T KNOW

GO TO BOX R04_YCR23

-7

REFUSED

GO TO BOX R04_YCR23

ASK: Past 30 day "not-light" cigarette smokers who buy cigarettes for themselves or someone else buys
for them.
DISPLAY: IF R04_YC1118 = 2, DISPLAY "bought". IF R04_YC1118 = 1, DISPLAY "gave money to
someone else to buy you".

PATH – Wave 4
Youth Questionnaire – Extended Interview

20

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1034

How much did you pay for a [carton of cigarettes/pack of cigarettes/single cigarette]?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YCR23

-7

REFUSED

GO TO BOX R04_YCR23

ASK: Past 30 day "not-light" cigarette smokers who buy cigarettes for themselves or someone else buys
for them by the carton, pack or as singles.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
IF R04_YC1039 = 1, DISPLAY "carton of cigarettes"; IF R04_YC1039 = 2, DISPLAY "pack of
cigarettes"; IF R04_YC1039 = 3, DISPLAY "single cigarette".
PATH ID:

R04_YC1034_LC1

The computer recorded that you paid $[R04_YC1034] for a [carton of cigarettes/pack of
cigarettes/single cigarette]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

2

NEXT

GO TO R04_YC1034

ASK: IF ((R04_YC1034_D > 125 OR R04_YC1034_D < 25) AND R04_YC1039 = 1) OR
((R04_YC1034_D > 15 OR R04_YC1034_D < 4) AND R04_YC1039 = 2) OR ((R04_YC1034_D > 3 OR
(R04_YC1034_D = 0 AND R04_YC1034_C < 50)) AND R04_YC1039 = 3).
DISPLAY: IF R04_YC1039 = 1, DISPLAY "carton of cigarettes".
IF R04_YC1039 = 2, DISPLAY “pack of cigarettes”.
IF R04_YC1039 = 3, DISPLAY “single cigarette”.
BOX ID:

R04_YCR23

Past 30 day "not light" cigarette smokers, go to R04_YC1047.
Else, past 30 day cigarette smokers, go to R04_YC1945.
Else, go to Box R04_YVT01.
PATH ID:

R04_YC1047

Do you have a regular brand of cigarettes that you usually smoke?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers.

PATH – Wave 4
Youth Questionnaire – Extended Interview

21

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1945

Do you know the name of the brand of cigarettes you [usually smoke/last smoked]?
1

Yes

2

No

GO TO BOX R04_YCR07

-8

DON'T KNOW

GO TO BOX R04_YCR07

-7

REFUSED

GO TO BOX R04_YCR07

ASK: Past 30 day cigarette smokers.
DISPLAY: IF R04_YC1047 = 1, DISPLAY “usually smoke”.
ELSE, DISPLAY “last smoked”.
UNDERLINE "name of the brand".
PATH ID:

R04_YC1048

What brand of cigarette [do/did] you [usually/last] smoke?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers who know the brand name.
DISPLAY: IF R04_YC1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[If multiple screens] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[If single screen OR last screen of multiple screens] DISPLAY: If you do not see it below, touch the box
marked “Something else”.
BOX ID:

R04_YCR04

If youth respondent selects brand in R04_YC1048_BRAND, go to R04_YC1070_PRODUCT.
Else, if youth respondent selects “Something else” in R04_YC1048_BRAND, go to R04_YC1049.
Else, go to Box R04_YCR07.
PATH ID:

R04_YC1049

You said that your brand was not listed. What is it?
1

__________________________

GO TO BOX R04_YCR07

-8

DON'T KNOW

GO TO BOX R04_YCR07

-7

REFUSED

GO TO BOX R04_YCR07

ASK: Past 30 day cigarette smokers that know the name of the brand they smoke who selected
"Something else" for their brand.

PATH – Wave 4
Youth Questionnaire – Extended Interview

22

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] [do/did] you [usually/last] smoke?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers that know the name of the brand they smoke who selected a brand
image.
DISPLAY: IF R04_YC1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[If multiple screens] Display: If you do not see it below, touch the button marked “NEXT”.
[If single screen OR last screen of multiple screens] Display: If you do not see it below, touch the box
marked “Something else”.
BOX ID:

R04_YCR05

If youth respondent selects "Something else" in R04_YC1070_PRODUCT, go to R04_YC1071.
Else, go to Box R04_YCR07.
PATH ID:

R04_YC1071

You said that the type of [BRANDFILL]s that you smoke was not listed. What type is it?
1

__________________________

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers that know the name of the brand they smoke who selected a brand
image, but selected "Something else" for their subbrand image.
BOX ID:

R04_YCR07

Past 30 day “not-light” cigarette smokers who have a regular brand, go to R04_YC1051.
Else, youth respondents who have smoked a cigarette today, yesterday or the day before yesterday;
and who selected a valid brand and product for the last cigarette smoked, go to R04_YC0104.
Else, go to Box R04_YVT01.

PATH – Wave 4
Youth Questionnaire – Extended Interview

23

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1051

About how long have you been smoking your regular brand of cigarettes?
1

I___I___I

DAYS

2

I___I___I

MONTHS

3

I___I___I YEARS

-8

DON'T KNOW

GO TO R04_YC9019

-7

REFUSED

GO TO R04_YC9019

ASK: Past 30 day "not-light" cigarette smokers who have a regular brand.
PATH ID:

R04_YC1051_LC1

The computer recorded that you have been smoking your regular brand for [R04_YC1051_NN]. That is
older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC1051

2

NEXT

GO TO R04_YC9019

ASK: IF (R04_YC1051_NN > R04_YOUTHAGE) AND R04_YC1051_UN = 3.
PATH ID:

R04_YC1051_LC2

The computer recorded "0" for how long you have been smoking your regular brand of cigarettes.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC1051

2

NEXT

GO TO R04_YC9019

ASK: IF R04_YC1051_NN = 0.
PATH ID:

R04_YC9019

Do you think the brand of cigarettes you usually smoke might be less harmful, no different, or more
harmful, compared to other cigarette brands?
1

Less harmful

2

No different

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers who have a regular brand.

PATH – Wave 4
Youth Questionnaire – Extended Interview

24

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_YCD01

PROGRAM: Display questions R04_YC9010 and R04_YC9014 on one screen. Show the intro/transition
text from R04_YC9010 first, then show each item with a Yes/No response. As each item is answered,
show the next one.
PATH ID:

R04_YC9010

In choosing your regular brand of cigarettes, was part of your decision based on any of the following?
It is affordable.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers who have a regular brand.
PATH ID:

R04_YC9014

The taste.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers who have a regular brand.
BOX ID:

R04_YCR08

Youth respondents who have smoked a cigarette today, yesterday or the day before yesterday and
have selected a valid brand in R04_YC1048_BRAND and valid product in R04_YC1070_PRODUCT, go
to R04_YC0104.
Else, go to Box R04_YVT01.

PATH – Wave 4
Youth Questionnaire – Extended Interview

25

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC0104

We just have one more question about [your regular brand / the last brand] of cigarettes[ you smoked].
You said earlier that you smoked a cigarette [TIME OF LAST USE].
Think about the very last cigarette you smoked. Was the brand [NEQBRAND]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigarette smokers who have smoked a cigarette in the past hour, sometime today,
yesterday or the day before yesterday AND who selected a valid brand AND valid product.
DISPLAY: UNDERLINE "your regular brand" AND "the last brand" IN THE QUESTION TEXT.
IF R04_YC1047 = 1, DISPLAY “your regular brand”.
ELSE, DISPLAY "the last brand" AND "you smoked".
IF R04_YC0100 = 1, FILL [TIME OF LAST USE] WITH “in the past hour”.
IF R04_YC0100 = 2, FILL [TIME OF LAST USE] WITH “sometime today”.
IF R04_YC0100 = 3, FILL [TIME OF LAST USE] WITH “yesterday”.
IF R04_YC0100 = 4, FILL [TIME OF LAST USE] WITH “the day before yesterday”.
FILL [NEQBRAND] WITH R04_YC1070_PRODUCT RESPONSE.

PATH – Wave 4
Youth Questionnaire – Extended Interview

26

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)

ELECTRONIC NICOTINE PRODUCTS
BOX ID:

R04_YVT01

The next questions are about electronic nicotine products, such as e-cigarettes, vape pens, personal
vaporizers and mods, e-cigars, e-pipes, e-hookahs and hookah pens.
These products are battery-powered and produce vapor or aerosol instead of smoke. They contain
nicotine liquid, sometimes called “e-liquid” or “e-juice,” although the amount of nicotine can vary and
some may not contain any nicotine at all.
Some can be bought as one-time, disposable products, while others can be bought as re-usable kits
that are rechargeable. Some common brands include Vuse, Blu, Logic, MarkTen, NJOY, eGo, and
iTaste.
[SHOW GENERIC IMAGE OF E-PRODUCTS]
BOX ID:

R04_YVR03

New baseline youth respondents, go to R04_YV1001_NB.
Else, continuing youth respondents, go to R04_YV1002_12M.
PATH ID:

R04_YV1002_12M

In the past 12 months, have you used an electronic nicotine product, even one or two times? (Electronic
nicotine products include e-cigarettes, vape pens, personal vaporizers and mods, e-cigars, e-pipes, ehookahs and hookah pens.)
[SHOW GENERIC IMAGE OF E-PRODUCTS]
1

Yes

2

No

GO TO BOX R04_YVV02

-8

DON'T KNOW

GO TO BOX R04_YVV02

-7

REFUSED

GO TO BOX R04_YVV02

ASK: Continuing youth respondents.

PATH – Wave 4
Youth Questionnaire – Extended Interview

27

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_YVV02

PROGRAM - CREATE THE FOLLOWING USER GROUPS AND DERIVED VARIABLES (SEE
APPENDIX):
R04_EVER_NEVER_EPRODS_YOUTH = 1 (Ever user) Youth respondents who have ever used an
electronic nicotine product.
R04_EVER_NEVER_EPRODS_YOUTH = 2 (Never user) Youth respondents who have not ever used
an electronic nicotine product.
R04_INIT_EPRODS_YOUTH = 1 (Initiator) Youth respondents who initiated electronic nicotine product
use between Waves or new baseline respondents who have ever used an e-product.
R04_EPRODCOUNT= The number of electronic nicotine products used.
BOX ID:

R04_YVR01

New baseline youth respondents who did not say they have heard of e-products, go to Box
R04_YGT01.
Else, continuing youth respondents who have never used e-products, and new baseline youth
respondents who have heard of but never used e-products, go to R04_YV1103.
Else, go to Box R04_YVR02.
PATH ID:

R04_YV1103

Have you ever been curious about using an electronic nicotine product? (Electronic nicotine products
include e-cigarettes, vape pens, personal vaporizers and mods, e-cigars, e-pipes, e-hookahs and
hookah pens.)
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have never used e-products, and new baseline youth
respondents who have heard of but never used e-products.
PATH ID:

R04_YV1206

Do you think you will try an electronic nicotine product in the next year?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used e-products.
PATH – Wave 4
Youth Questionnaire – Extended Interview

28

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)

PATH ID:

R04_YV1104

Do you think that you will try an electronic nicotine product soon?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used e-products.
PATH ID:

R04_YV1105

If one of your best friends were to offer you an electronic nicotine product, would you try it?
1

Definitely yes

GO TO R04_YV9041

2

Probably yes

GO TO R04_YV9041

3

Probably not

GO TO R04_YV9041

4

Definitely not

GO TO R04_YV9041

-8

DON'T KNOW

GO TO R04_YV9041

-7

REFUSED

GO TO R04_YV9041

ASK: Youth respondents who have heard of but never used e-products.
BOX ID:

R04_YVR02

New baseline youth respondents who have ever used e-products, go to R04_YV1006_NB.
Else, continuing youth respondents who initiated e-product since the previous wave, go to
R04_YV1011.
Else, continuing youth respondents who had used e-products 100 or more times in the previous wave,
go to Box R04_YVR37.
Else, go to R04_YV1005.

PATH – Wave 4
Youth Questionnaire – Extended Interview

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1011

When you first used an electronic nicotine product, which flavor did you use? Choose all that apply.
1

Tobacco-flavored

2

Menthol or mint

3

Clove or spice

4

Fruit

5

Chocolate

6

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

7

A non-alcoholic drink (such as coffee, soda, energy drinks, or other beverages)

8

Candy, desserts or other sweets

9

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have initiated e-product use since the previous wave, and new
baseline youth respondents who have ever used an e-product.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YV1005

How many times have you used an electronic nicotine product in your entire life?
1

1 time, even just a few puffs

2

2 to 10 times

3

11 to 20 times

4

21 to 50 times

5

51 to 99 times

6

100 or more times

-8

DON'T KNOW

-7

REFUSED

ASK: Aged-up and continuing youth respondents who have ever used an e-product and had not used
100 or more times in the previous wave, and new cohort youth respondents who have ever used an eproduct.
BOX ID:

R04_YVR37

Youth respondents who have ever used an e-product and had never used e-products fairly regularly in
the previous wave, go to R04_YV1100.
Else, go to R04_YV1112.

PATH – Wave 4
Youth Questionnaire – Extended Interview

30

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1100

Have you ever used electronic nicotine products fairly regularly?
1

Yes

2

No

GO TO R04_YV1112

-8

DON'T KNOW

GO TO R04_YV1112

-7

REFUSED

GO TO R04_YV1112

ASK: Youth respondents who have ever used an e-product and had never used fairly regularly in the
previous wave.
PATH ID:

R04_YV1007

How old were you when you first started using electronic nicotine products fairly regularly?
1

|__|__| Years old

-8

DON'T KNOW

GO TO R04_YV1121

-7

REFUSED

GO TO R04_YV1121

ASK: Youth respondents who have ever used e-products fairly regularly and did not use fairly regularly
in the previous wave.
DISPLAY: DISPLAY "Years old" AS A TITLE.
PATH ID:

R04_YV1007_LC1

The computer recorded that you started using electronic nicotine products fairly regularly at age
[R04_YV1007]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1007

2

NEXT

GO TO R04_YV1112

ASK: IF R04_YV1007 <= 5 OR (R04_YV1007 < R04_YV1006_NB).
PATH ID:

R04_YV1007_LC2

The computer recorded that you started using electronic nicotine products fairly regularly at age
[R04_YV1007]. That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1007

2

NEXT

GO TO R04_YV1112

ASK: IF R04_YV1007 > R04_YOUTHAGE.

PATH – Wave 4
Youth Questionnaire – Extended Interview

31

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1121

When you first started using electronic nicotine products fairly regularly, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who did not know or refused to report the age they started using e-products
fairly regularly.
PATH ID:

R04_YV1112

When was the last time you used an electronic nicotine product, even one or two times?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YVV01

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YVV01

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YVV01

6

1 to 4 years ago

GO TO BOX R04_YVV01

7

5 or more years ago

GO TO BOX R04_YVV01

-8

DON'T KNOW

GO TO BOX R04_YVV01

-7

REFUSED

GO TO BOX R04_YVV01

ASK: Youth respondents who have ever used an e-product.
PATH ID:

R04_YV0100

When did you last use an electronic nicotine product?
1

In the past hour

GO TO R04_YV0103

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YVV01

-8

DON'T KNOW

GO TO BOX R04_YVV01

-7

REFUSED

GO TO BOX R04_YVV01

ASK: Youth respondents who used e-products in the past 7 days.

PATH – Wave 4
Youth Questionnaire – Extended Interview

32

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV0102

When you last used an electronic nicotine product [FILL BASED ON R04_YV0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used an e-product today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YV0100]:
IF R04_YV0100 = 2, DISPLAY “today”.
IF R04_YV0100 = 3, DISPLAY “yesterday”.
IF R04_YV0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YV0103

How many puffs from an electronic nicotine product [have/did] you [taken/take] [FILL BASED ON
R04_YV0100]?
1

I__I__I

-8

DON'T KNOW

GO TO BOX R04_YVV01

-7

REFUSED

GO TO BOX R04_YVV01

ASK: Youth respondents who have used an e-product in the past hour, sometime today, yesterday or
the day before yesterday.
DISPLAY: IF R04_YV0100 = 1, 2, DISPLAY “have” AND “taken”.
IF R04_YV0100 = 3, 4, DISPLAY “did” AND “take”.
FOR [FILL BASED ON R04_YV0100]:
IF R04_YV0100 = 1, 2, DISPLAY “today”.
IF R04_YV0100 = 3, DISPLAY “yesterday”.
IF R04_YV0100 = 4, DISPLAY “the day before yesterday”.

PATH – Wave 4
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33

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV0103_LC1

The computer recorded you took [R04_YV0103] puffs from an electronic nicotine product
[today/yesterday/the day before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is not correct, please press the BACK
button and re-enter.
1

BACK

GO TO R04_YV0103

2

NEXT

GO TO BOX R04_YVV01

ASK: IF R04_YV0103 > 200 OR R04_YV0103 = 11, 22, 33, 44, 55, 66, 77, 88, 99, 111.
DISPLAY: IF R04_YV0100 = 1, 2, DISPLAY “today”.
IF R04_YV0100 = 3, DISPLAY “yesterday”.
IF R04_YV0100 = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YVV01

PROGRAM - CREATE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PAST30DAY_EPRODS = 1 (Past 30 day e-product user) Youth respondents who have used an
electronic nicotine product in the past 30 days.
R04_PAST30DAY_EPRODS_LEVEL = 1 (Past 30 day "Very Light" e-product user) Youth
respondents who have used an electronic nicotine product in the past 30 days, and have used an
electronic nicotine product only once in their lifetime.
R04_PAST30DAY_EPRODS_LEVEL = 2 (Past 30 day "Not Light" e-product user) Youth
respondents who have used an electronic nicotine product in the past 30 days, and have used
electronic nicotine products more than once in their lifetime.
PATH ID:

R04_YV9041

Not including yourself, does anyone living in your home own an e-cigarette or other electronic nicotine
product?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have seen, heard of, or ever used e-product, and continuing
youth respondents.
BOX ID:

R04_YVR54

Continuing youth respondents that have used an e-product in the past 12 months and new baseline
youth respondents that have ever used an e-product, go to R04_YV9035.
Else, go to Box R04_YVR04.

PATH – Wave 4
Youth Questionnaire – Extended Interview

34

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV9035

Which of the following electronic nicotine products have you used? Choose all that apply.
[SHOW GENERIC IMAGE OF E-PRODUCTS BY SUBTYPE]
1

E-cigarette including a vape pen, personal vaporizer, or mod

2

E-cigar

3

E-pipe

4

E-hookah including a hookah pen

5

Something else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever used e-products, and continuing youth
respondents who have used e-products in the past 12 months.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YVR55

If the only device type selected is “Something else” or the respondent did not know or refused to report
which device types they have used, go to Box R04_YVR04.
Else, repeat R04_YV9060 and R04_YV9061 for each device type selected, except "Something else".
When all loops complete, go to Box R04_YVV04.
PATH ID:

R04_YV9060

Do you use more than one kind of [FILL WITH DEVICE TYPE SELECTED IN R04_YV9035]?
1

Yes

2

No

GO TO BOX R04_YVR59

-8

DON'T KNOW

GO TO BOX R04_YVR59

-7

REFUSED

GO TO BOX R04_YVR59

ASK: New baseline youth respondents who have ever used e-products, and continuing youth
respondents who have used e-products in the past 12 months and selected a type of e-product.
DISPLAY: FOR R04_YV9060_01, DISPLAY "e-cigarette".
FOR R04_YV9060_02, DISPLAY "e-cigar".
FOR R04_YV9060_03, DISPLAY "e-pipe".
FOR R04_YV9060_04, DISPLAY "e-hookah".

PATH – Wave 4
Youth Questionnaire – Extended Interview

35

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV9061

How many different kinds of [FILL WITH DEVICE TYPE IN R04_YV9035] have you used?
1

|__|__|

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever used e-products, and continuing youth
respondents who have used e-products in the past 12 months and selected a type of e-product and use
multiple e-products.
DISPLAY: FOR R04_YV9061_01, DISPLAY "e-cigarettes".
FOR R04_YV9061_02, DISPLAY "e-cigars".
FOR R04_YV9061_03, DISPLAY "e-pipes".
FOR R04_YV9061_04, DISPLAY "e-hookahs".
BOX ID:

R04_YVR59

If there are remaining device types, go back to Box R04_YVR55 and complete loop for all remaining
device types.
Else, if all loops are complete, go to Box R04_YVV04.
BOX ID:

R04_YVV04

PROGRAM - CREATE THE FOLLOWING DERIVED VARIABLE (SEE APPENDIX):
R04_EPRODCOUNT = Number of e-products used.
BOX ID:

R04_YVR56

If the respondent uses more than one type of electronic nicotine product, go to R04_YV9044.
Else, go to Box R04_YVR04.

PATH – Wave 4
Youth Questionnaire – Extended Interview

36

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV9044

You mentioned that you have used more than one type of electronic nicotine product.
Which electronic nicotine product do you use most often?
1

E-cigarette including a vape pen, personal vaporizer, or mod

2

E-cigar

3

E-pipe

4

E-hookah including a hookah pen

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever used e-products, and continuing youth
respondents who have used e-products in the past 12 months and selected a type of e-product and
have used more than one e-product.
BOX ID:

R04_YVR04

Past 30 day e-product users (including "very light" users), go to R04_YV9140.
Else, go to Box R04_YVR58.
PATH ID:

R04_YV9140

Please look at this picture. Which group is most like the electronic nicotine product you use most often?
[SHOW GENERIC IMAGE OF 6 E-PRODUCT GROUPS]
1

Group 1

2

Group 2

3

Group 3

4

Group 4

5

Group 5

6

Group 6

7

None of the above

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users (including "very light" users).
DISPLAY: UNDERLINE "most often".
BOX ID:

R04_YVR58

Past 30 day "not light" e-product users, go to Box R04_YVD04.
Else, past 30 day e-product users, go to Box R04_YVV03.
Else, go to R04_YV9042.

PATH – Wave 4
Youth Questionnaire – Extended Interview

37

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_YVD04

Display questions R04_YV9005 through R04_YV9009 using the expanded WVB stem-leaf screen. For
each leaf, display a yes/no response. The introduction text from R04_YV9005 is the stem. Show all
leaves on the screen at once.
PATH ID:

R04_YV9005

For the following questions, please think about the electronic nicotine product you use most often.
Is it rechargeable?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not light" e-product users.
DISPLAY: BOLD AND UNDERLINE “most often”.
PATH ID:

R04_YV9038

Does it use a tank system?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not light" e-product users.
PATH ID:

R04_YV9008

Does it use cartridges?
[IF EPRODTYPE1=e-cigarettes, SHOW GENERIC IMAGE OF E-CIGARETTE CARTRIDGES]
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not light" e-product users.

PATH – Wave 4
Youth Questionnaire – Extended Interview

38

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV9009

Can you refill it with “e-liquid”?
1

Yes

2

No

GO TO BOX R04_YVV03

-8

DON'T KNOW

GO TO BOX R04_YVV03

-7

REFUSED

GO TO BOX R04_YVV03

ASK: Past 30 day "not light" e-product users.
PATH ID:

R04_YV9046

How often do you refill your electronic nicotine product with e-liquid?
1

At least once a day

2

Once every couple of days

3

Once a week

4

A few times a month

5

Once a month

6

A few times a year

7

Once a year

8

Never

-8

DON'T KNOW

-7

REFUSED

GO TO BOX R04_YVV03

ASK: Past 30 day "not light" e-product users that use refillable e-products.
PATH ID:

R04_YV9036

Who refills it with e-liquid?
1

I refill it myself

2

I get it refilled at a vape shop or vapor lounge

3

I buy it already filled

4

I get it refilled some other way

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not light" e-product users that use refillable e-products and has refilled them before.

PATH – Wave 4
Youth Questionnaire – Extended Interview

39

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_YVV03

PROGRAM - CREATE THE FOLLOWING DERIVED VARIABLES (SEE APPENDIX):
R04_EDEVICETYPE (E-Product device type):
R04_EDEVICETYPE = 1 (Disposable E-Product Users).
R04_EDEVICETYPE = 2 (Non-Refillable Cartridge E-Product Users).
R04_EDEVICETYPE = 3 (Refillable Cartridge E-Product Users).
R04_EDEVICETYPE = 4 (Refillable Tank System E-Product Users).
R04_EDEVICETYPE = 5 (Refillable Mod System E-Product Users).
R04_EDEVICETYPE = 6 (Unknown E-Product User Type).
BOX ID:

R04_YVT04

PROGRAM - CREATE [EPRODFILL1-3]:
EPRODFILL1:
IF R04_EDEVICETYPE = 1, 6 (Disposable/Unknown), EPRODFILL1 = "electronic nicotine products".
IF R04_EDEVICETYPE = 2 (Non-refillable Cartridges), EPRODFILL1 = "electronic nicotine cartridges".
IF R04_EDEVICETYPE = 3, 4, 5 (Refillable Cartridges/Tank/Mod), EPRODFILL1 = "milliliters of eliquid".
EPRODFILL2:
IF R04_EDEVICETYPE = 1, 6 (Disposable/Unknown), EPRODFILL2 = "electronic nicotine products".
IF R04_EDEVICETYPE = 2 (Non-refillable Cartridges), EPRODFILL2 = "electronic nicotine cartridges".
IF R04_EDEVICETYPE = 3, 4, 5 (Refillable Cartridges/Tank/Mod), EPRODFILL2 = "e-liquid".
EPRODFILL3:
IF R04_EDEVICETYPE = 1, 6 (Disposable/Unknown), EPRODFILL3 = "electronic nicotine product".
IF R04_EDEVICETYPE = 2 (Non-refillable Cartridges), EPRODFILL3 = "electronic nicotine cartridge".
IF R04_EDEVICETYPE = 3, 4, 5 (Refillable Cartridges/Tank/Mod), EPRODFILL3 = "e-liquid".

PATH – Wave 4
Youth Questionnaire – Extended Interview

40

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV9010

Please think about the [EPRODFILL3] you use most often.
Does it contain nicotine?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: BOLD AND UNDERLINE “most often”.
PATH ID:

R04_YV1022

In the past 30 days, on how many days did you use an electronic nicotine product?
1

|___|___| DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: DISPLAY 'DAYS' AS A TITLE.
PATH ID:

R04_YV9040

In the past 30 days, on the days you used an electronic nicotine product, how many [EPRODFILL1] did
you use per day?
1

Less than 1 per day

2

I___I___I

GO TO R04_YV1131

-8

DON'T KNOW

GO TO R04_YV1131

-7

REFUSED

GO TO R04_YV1131

ASK: Past 30 day e-product users.
PATH ID:

R04_YV9040_LC1

The computer recorded that on the days you used in the past 30 days, you used [R04_YV9040]
[EPRODFILL1] a day.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV9040

2

NEXT

GO TO R04_YV1131

ASK: IF R04_YV9040 > 5.

PATH – Wave 4
Youth Questionnaire – Extended Interview

41

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)

PATH ID:

R04_YV1131

Which flavors of [EPRODFILL2] have you used in the past 30 days? Choose all that apply.
1

Tobacco-flavored

2

Menthol or mint

3

Clove or spice

4

Fruit

5

Chocolate

6

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

7

A non-alcoholic drink (such as coffee, soda, energy drinks, or other beverages)

8

Candy, desserts or other sweets

9

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YVR38

Youth respondents who used menthol or mint flavored e-products in the past 30 days, go to
R04_YV1147.
Else, youth respondents who used flavored e-products (other than menthol/mint or tobacco-flavored) in
the past 30 days, go to R04_YV1157.
Else, go to R04_YV1142.
PATH ID:

R04_YV1147

In the past 30 days, on the days you used an electronic nicotine product, how often was it flavored to
taste like menthol or mint?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users that have used menthol or mint flavored e-products.

PATH – Wave 4
Youth Questionnaire – Extended Interview

42

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_YVR40

Youth respondents who used flavored e-products (other than menthol/mint or tobacco-flavored) in the
past 30 days, go to R04_YV1157.
Else, go to R04_YV1142.
PATH ID:

R04_YV1157

In the past 30 days, on the days you used an electronic nicotine product, how often was it flavored to
taste like clove, spice, fruit, chocolate, alcoholic or non-alcoholic drinks, candy, desserts or other
sweets?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who used flavored e-products (other than menthol/mint or tobacco-flavored) in
the past 30 days.
PATH ID:

R04_YV1142

In the past 30 days, did anyone sell you [EPRODFILL2]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
PATH ID:

R04_YV1123

In the past 30 days, did anyone refuse to sell you [EPRODFILL2] because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.

PATH – Wave 4
Youth Questionnaire – Extended Interview

43

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1118

In the past 30 days, how did you usually get your own [EPRODFILL2]?
1

I gave someone else money to buy them for me

2

I bought them myself from a store (including a vape shop or vapor lounge)

3

I asked someone to give me one

4

Someone offered it to me

5

I bought them from another person

6

I took them from a store or another person

7

I got them some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YVR05

Past 30 day e-product users who usually buy e-products for themselves or give someone else money to
buy e-products for them, go to R04_YV1030.
Else, go to Box R04_YVR57.
PATH ID:

R04_YV1030

[When you give money to someone else, how do they/How do you] usually buy your [EPRODFILL2]?
1

In person

2

From the internet

GO TO BOX R04_YVR06

3

By telephone

GO TO BOX R04_YVR06

-8

DON'T KNOW

GO TO BOX R04_YVR06

-7

REFUSED

GO TO BOX R04_YVR06

ASK: Past 30 day e-product users (including "very light" users) who buy e-products for themselves or
someone else buys for them.
DISPLAY: IF R04_YV1118 = 1, DISPLAY “When you give money to someone else, how do they”;
IF R04_YV1118 = 2, DISPLAY “How do you”.

PATH – Wave 4
Youth Questionnaire – Extended Interview

44

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1033

Where do [you/they] buy your [EPRODFILL2] most of the time?
11

A vape shop or vapor lounge

1

A mall kiosk

2

A convenience store or gas station

3

A supermarket, grocery store, or drug store

4

A warehouse club, such as Sam’s or Costco

5

A smoke shop, tobacco specialty store or tobacco outlet store

6

A duty free shop or military commissary

7

A bar, pub, restaurant or casino

8

A friend or relative

9

A swap meet or flea market

10

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users (including "very light" users) who buy e-products for themselves or
someone else buys for them in person.
DISPLAY: IF R04_YV1118 = 1, DISPLAY “they”;
IF R04_YV1118 = 2, DISPLAY “you”.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
BOX ID:

R04_YVR06

Past 30 day "not-light" disposable e-product users and e-product users of undetermined types who buy
e-products for themselves or someone else buys for them, go to R04_YV1136.
Else, refillable cartridge, tank system, and mod system e-product users, go to R04_YV1041.
Else, non-refillable e-product users, go to R04_YV1039.
Else, go to Box R04_YVR57.
PATH ID:

R04_YV1136

Think about the last time you [bought/gave money to someone else to buy you] electronic nicotine
products. Did you buy them by the box or pack, or as single electronic nicotine products?
1

Box or pack

2

Single electronic nicotine products

GO TO R04_YV1034

-8

DON'T KNOW

GO TO R04_YV1034

-7

REFUSED

GO TO R04_YV1034

ASK: Past 30 day "not-light" disposable e-product users and e-product users of undetermined types
who buy e-products for themselves or someone else buys for them.

PATH – Wave 4
Youth Questionnaire – Extended Interview

45

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1137

How many electronic nicotine products came in the box or pack that you last bought?
1

I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" disposable e-product users and e-product users of undetermined types
who buy e-products for themselves or someone else buys for them who last bought e-products in a box
or pack.
PATH ID:

R04_YV1138

How much did you pay for a box or pack of electronic nicotine products?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YVR57

-7

REFUSED

GO TO BOX R04_YVR57

ASK: Past 30 day "not-light" disposable e-product users and e-product users of undetermined types
who buy e-products for themselves or someone else buys for them who last bought e-products in a box
or pack.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
PATH ID:

R04_YV1138_LC1

The computer recorded that you paid $[R04_YV1138_D] for a box or pack of electronic nicotine
products. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1138

2

NEXT

GO TO BOX R04_YVR57

ASK: IF R04_YV1138_D < 10 OR R04_YV1138_D > 75.
PATH ID:

R04_YV1034

How much did you pay for a single electronic nicotine product?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YVR57

-7

REFUSED

GO TO BOX R04_YVR57

ASK: Past 30 day "not-light" disposable e-product users and e-product users of undetermined types
who buy e-products for themselves or someone else buys for them who did not buy their last e-product
in box or pack.
DISPLAY: DISPLAY“$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.

PATH – Wave 4
Youth Questionnaire – Extended Interview

46

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1034_LC1

The computer recorded that you paid $[R04_YV1034_D] for a single electronic nicotine product. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1034

2

NEXT

GO TO BOX R04_YVR57

ASK: IF R04_YV1034_D > 50.
PATH ID:

R04_YV1041

Think about the last time you [bought/gave money to someone else to buy you] e-liquid.
How much did you pay for a bottle or container of e-liquid?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YVR57

-7

REFUSED

GO TO BOX R04_YVR57

ASK: Past 30 day "not-light" refillable cartridge, tank system, and mod system e-product users who buy
e-liquid for themselves or someone else buys for them.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
IF R04_YV1118 = 1, DISPLAY "gave money to someone else to buy you".
IF R04_YV1118 = 2, DISPLAY "bought".
PATH ID:

R04_YV1041_LC1

The computer recorded that you paid $[R04_YV1041_D] for a bottle or container of e-liquid. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1041

2

NEXT

GO TO BOX R04_YVR57

ASK: IF R04_YV1041_D > 50.

PATH – Wave 4
Youth Questionnaire – Extended Interview

47

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1039

Think about the last time you [bought/gave money to someone else to buy you] electronic nicotine
product cartridges.
Did you buy them by the box or pack, or as single cartridges?
1

Box or pack

2

Single cartridges

GO TO R04_YV1043

-8

DON'T KNOW

GO TO R04_YV1043

-7

REFUSED

GO TO R04_YV1043

ASK: Past 30 day "not-light" non-refillable cartridge e-product users who buy cartridges for themselves
or someone else buys for them.
DISPLAY: IF R04_YV1118 = 1, DISPLAY "gave money to someone else to buy you".
IF R04_YV1118 = 2, DISPLAY "bought".
PATH ID:

R04_YV1040

How many electronic nicotine product cartridges came in the box or pack that you last bought?
1

I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" non-refillable cartridge e-product users who buy cartridges for themselves
or someone else buys for them and last bought cartridges in a box or pack.
PATH ID:

R04_YV1042

How much did you pay for a box or pack of electronic nicotine product cartridges?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YVR57

-7

REFUSED

GO TO BOX R04_YVR57

ASK: Past 30 day "not-light" non-refillable cartridge e-product users who buy cartridges for themselves
or someone else buys for them and last bought cartridges in a box or pack.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.

PATH – Wave 4
Youth Questionnaire – Extended Interview

48

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1042_LC1

The computer recorded that you paid $[R04_YV1042_D] for a box or pack of [EPRODFILL1]. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1042

2

NEXT

GO TO BOX R04_YVR57

ASK: IF R04_YV1042_D > 50.
PATH ID:

R04_YV1043

How much did you pay for a single electronic nicotine product cartridge?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YVR57

-7

REFUSED

GO TO BOX R04_YVR57

ASK: Past 30 day "not-light" non-refillable cartridge e-product users who buy cartridges for themselves
or someone else buys for them and last bought single cartridges or did not know or refused to report
whether the non-refillable cartridge was in a box or pack or a single cartridge.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
PATH ID:

R04_YV1043_LC1

The computer recorded that you paid $[R04_YV1043_D] for a single [EPRODFILL3]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YV1043

2

NEXT

GO TO BOX R04_YVR57

ASK: IF R04_YV1043_D > 50.
BOX ID:

R04_YVR57

Past 30 day "not-light" e-product users, go to R04_YV1047.
Else, go to R04_YV1945.

PATH – Wave 4
Youth Questionnaire – Extended Interview

49

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1047

Do you have a regular brand of [EPRODFILL2] that you usually use?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" e-product users.
PATH ID:

R04_YV1945

Do you know the name of the brand of [EPRODFILL2] you [usually use/last used]?
1

Yes

2

No

GO TO BOX R04_YVD02

-8

DON'T KNOW

GO TO BOX R04_YVD02

-7

REFUSED

GO TO BOX R04_YVD02

ASK: Past 30 day e-product users.
DISPLAY: IF R04_YV1047 = 1, DISPLAY “usually use”.
ELSE, DISPLAY “last used”.
UNDERLINE "name of the brand".
PATH ID:

R04_YV1048

What brand of [EPRODFILL2] [do/did] you [usually/last] use?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else.”]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users who know the brand name.
DISPLAY: IF R04_YV1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[If multiple screens] Display: If you do not see it below, touch the button marked “NEXT”.
[If single screen OR last screen of multiple screens] Display: If you do not see it below, touch the box
marked “Something else”.

PATH – Wave 4
Youth Questionnaire – Extended Interview

50

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_YVR33

If youth respondent selects "Something else" in R04_YV1048_BRAND, go to R04_YV1049.
Else, past 30 day e-product users who have used an e-product today, yesterday or the day before
yesterday AND who selected a valid brand in R04_YV1048_BRAND, go to R04_YV0104.
Else, go to Box R04_YVD02.
PATH ID:

R04_YV1049

You said that your brand was not listed. What is it?
1

__________________________

GO TO R04_YVD02

-8

DON'T KNOW

GO TO R04_YVD02

-7

REFUSED

GO TO R04_YVD02

ASK: Past 30 day e-product users that know the name of the brand they use who selected "Something
else" for their brand.
PATH ID:

R04_YV0104

You said earlier that you last used an electronic nicotine product [TIME OF LAST USE].
Think about the very last puff you took. Was the brand [NEQBRAND]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users who have used an e-product in the past hour, sometime today,
yesterday or the day before yesterday and selected a valid brand.
DISPLAY: IF R04_YV0100 = 1, FILL [TIME OF LAST USE] WITH “in the past hour”.
IF R04_YV0100 = 2, FILL [TIME OF LAST USE] WITH “sometime today”.
IF R04_YV0100 = 3, FILL [TIME OF LAST USE] WITH “yesterday”.
IF R04_YV0100 = 4, FILL [TIME OF LAST USE] WITH “the day before yesterday”.
FILL [NEQBRAND] WITH SELECTION MADE IN R04_YV1048_BRAND.
BOX ID:

R04_YVD02

Display question R04_YV1060, R04_YV1085, R04_YV1062, R04_YV1075, R04_YV1063,
R04_YV1064, R04_YV1065, R04_YV1066, R04_YV1067 on one screen. Show the intro/transition text
from R04_YV1060 first, then show each item with a Yes/No response. As each item is answered, show
the next one.
PROGRAM: Randomize order of R04_YV1060 through R04_YV1067.

PATH – Wave 4
Youth Questionnaire – Extended Interview

51

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1060

The next questions are about the reasons people use electronic nicotine products. Please select which
reasons apply to you.
I use electronic nicotine products because…
They are affordable.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
PATH ID:

R04_YV1085

I can use electronic nicotine products at times when or in places where smoking cigarettes isn’t allowed.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
PATH ID:

R04_YV1062

They might be less harmful to me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
PATH ID:

R04_YV1075

They might be less harmful to people around me than cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.

PATH – Wave 4
Youth Questionnaire – Extended Interview

52

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1063

E-liquid comes in flavors I like.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
BOX ID:

R04_YVR13

Past 30 day e-product users who have also smoked cigarettes in the past year, go to R04_YV1064.
Else, go to R04_YV1065.
PATH ID:

R04_YV1064

Using electronic nicotine products helps people quit smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users who have also smoked cigarettes in the past year.
PATH ID:

R04_YV1065

Electronic nicotine products don't smell.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
PATH ID:

R04_YV1066

Using an electronic nicotine product feels like smoking a regular cigarette.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.

PATH – Wave 4
Youth Questionnaire – Extended Interview

53

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1067

Electronic nicotine products don’t bother non-tobacco users.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
BOX ID:

R04_YVR14

Past 30 day e-product users who have also smoked cigarettes in the past 30 days, go to R04_YV1086.
Else, past 30 day e-product users, go to R04_YV1139.
Else, go to R04_YV9042.
PATH ID:

R04_YV1086

In the past 30 days, have you used an electronic nicotine product at times when or in places where you
could not smoke regular cigarettes?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users who have also smoked cigarettes in the past 30 days.
PATH ID:

R04_YV1139

Please rate your level of agreement for each statement using the following scale: 1 = not true of me at
all to 4 = very true of me.
It is easier to talk and get along with other people when using an electronic nicotine product.
1

Not true of me at all

2
3
4

Very true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: DISPLAY SCALE FOR THE R04_YV1139-1141 SERIES.

PATH – Wave 4
Youth Questionnaire – Extended Interview

54

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1140

While using an electronic nicotine product, I feel more confident with other people.
1

Not true of me at all

2
3
4

Very true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: DISPLAY SCALE FOR THE R04_YV1139-1141 SERIES.
PATH ID:

R04_YV1141

I use electronic nicotine products much more when I am with other people.
1

Not true of me at all

2
3
4

Very true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day e-product users.
DISPLAY: DISPLAY SCALE FOR THE R04_YV1139-1141 SERIES.
PATH ID:

R04_YV9042

Have you ever used marijuana, marijuana concentrates, marijuana waxes, THC, or hash oils in an
electronic product such as an e-cigarette, vape, mod, personal vaporizer, e-hookah, or hookah pen?
(Remember all information you give to the PATH Study will be kept private.)
1

Yes

2

No

GO TO BOX R04_YVR10

-8

DON'T KNOW

GO TO BOX R04_YVR10

-7

REFUSED

GO TO BOX R04_YVR10

ASK: New baseline youth respondents who have seen, heard of, or ever used e-products, and
continuing youth respondents.
DISPLAY: UNDERLINE "electronic product".

PATH – Wave 4
Youth Questionnaire – Extended Interview

55

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV9106

When you have used an electronic product, how often were you using it to smoke marijuana, marijuana
concentrates, marijuana waxes, THC, or hash oils?
1

Every time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used e-products to smoke marijuana.
PATH ID:

R04_YM0100

When did you last use marijuana, marijuana concentrates, marijuana waxes, THC, or hash oils in an
electronic product such as an e-cigarette, vape, mod, personal vaporizer, e-hookah, or hookah pen?
1

In the past hour

2

Sometime today

3

Yesterday

4

Day before yesterday

5

GO TO R04_YM0103

Three or more days ago

GO TO BOX R04_YVR10

-8

DON'T KNOW

GO TO BOX R04_YVR10

-7

REFUSED

GO TO BOX R04_YVR10

ASK: Youth respondents who have ever used marijuana in an e-product.
DISPLAY: UNDERLINE "electronic product".

PATH – Wave 4
Youth Questionnaire – Extended Interview

56

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YM0102

When you last used marijuana, marijuana concentrates, marijuana waxes, THC, or hash oils in an
electronic product [FILL BASED ON R04_YM0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used marijuana in an e-product today, yesterday or the day before
yesterday.
DISPLAY: FOR [FILL BASED ON R04_YM0100]:
IF R04_YM0100 = 2, DISPLAY “today”.
IF R04_YM0100 = 3, DISPLAY “yesterday”.
IF R04_YM0100 = 4, DISPLAY “the day before yesterday”.
UNDERLINE "electronic product".
PATH ID:

R04_YM0103

How many puffs of marijuana, marijuana concentrates, marijuana waxes, THC, or hash oils from an
electronic product [have/did] you [taken/take] [FILL BASED ON R04_YM0100]?
1

I__I__I__I

-8

DON'T KNOW

GO TO BOX R04_YVR10

-7

REFUSED

GO TO BOX R04_YVR10

ASK: Youth respondents who have used marijuana in an e-product in the past hour, today, yesterday or
the day before yesterday.
DISPLAY: IF R04_YM0100 = 1, 2, DISPLAY “have” AND “taken”.
IF R04_YM0100 = 3, 4, DISPLAY “did” AND “take”.
FOR [FILL BASED ON R04_YM0100]:
IF R04_YM0100 = 1, 2, DISPLAY “today”.
IF R04_YM0100 = 3, DISPLAY “yesterday”.
IF R04_YM0100 = 4, DISPLAY “the day before yesterday”.
UNDERLINE "electronic product".

PATH – Wave 4
Youth Questionnaire – Extended Interview

57

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YM0103_LC1

The computer recorded you took [R04_YM0103] puffs from an electronic nicotine product
[today/yesterday/the day before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is not correct, please press the BACK
button and re-enter.
1

BACK

GO TO R04_YM0103

2

NEXT

GO TO BOX R04_YVR10

ASK: IF R04_YM0103 > 200 OR R04_YM0103 = 11, 22, 33, 44, 55, 66, 77, 88, 99, 111.
DISPLAY: IF R04_YM0100 = 1, 2, DISPLAY “today”.
IF R04_YM0100 = 3, DISPLAY “yesterday”.
IF R04_YM0100 = 4, DISPLAY “the day before yesterday”.

PATH – Wave 4
Youth Questionnaire – Extended Interview

58

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)

CIGAR
BOX ID:

R04_YGT01

The next questions are about traditional cigars, cigarillos, and filtered cigars. These products go by
lots of different names, so please use these descriptions and photos to understand what they are.
Traditional cigars contain tightly rolled tobacco that is wrapped in a tobacco leaf. Some common
brands of cigars include Macanudo, Romeo y Julieta, Arturo Fuente, and Cohiba, but there are many
others.
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
BOX ID:

R04_YGT02

Cigarillos and filtered cigars are smaller than traditional cigars. They are usually brown. Some are the
same size as cigarettes, and some come with filters or with plastic or wooden tips. Some common
brands are Black & Mild, Swisher Sweets, Dutch Masters, Phillies Blunts, Zig Zag, and Cheyenne.
[SHOW GENERIC IMAGES OF CIGARILLOS AND FILTERED CIGARS]
BOX ID:

R04_YGR03

New baseline youth respondents, go to R04_YG9101_NB.
Continuing youth respondents, go to R04_YG1002_12M.
BOX ID:

R04_YGD02

DISPLAY INSTRUCTIONS
For R04_YG9104_NB, display a “Yes” and “No” column with options for each response category.
BOX ID:

R04_YGR19

New baseline youth respondents who have ever smoked a cigarillo or filtered cigar, go to
R04_YG9009_NB.
Else, go to Box R04_YGV04.

PATH – Wave 4
Youth Questionnaire – Extended Interview

59

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1002_12M

In the past 12 months, have you smoked a traditional cigar, cigarillo, or filtered cigar, even one or two
puffs?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS, CIGARILLOS AND FILTERED CIGARS]
1

Yes

2

No

GO TO BOX R04_YGV04

-8

DON'T KNOW

GO TO BOX R04_YGV04

-7

REFUSED

GO TO BOX R04_YGV04

ASK: Continuing youth respondents.
BOX ID:

R04_YGD05

DISPLAY INSTRUCTIONS
For R04_YG9104_12M, display a “Yes” and “No” column with options for each response category.
PATH ID:

R04_YG9104_12M

Which type of cigar have you smoked in the past 12 months?
1

Traditional cigars like Macanudo, Romeo y Julieta, Arturo Fuente, Cohiba, or others

2

Cigarillos or filtered cigars like Black & Mild, Swisher Sweets, Dutch Masters, Phillies
Blunts, Zig Zag, Cheyenne, or others

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have smoked a traditional cigar, cigarillo or filtered cigar in the
past 12 months.
BOX ID:

R04_YGR20

Continuing youth respondents who have smoked a cigarillo or filtered cigar in the past 12 months, go to
R04_YG9009_12M.
Else, go to Box R04_YGV04.

PATH – Wave 4
Youth Questionnaire – Extended Interview

60

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9009_12M

Which of the following kinds of cigarillos or filtered cigars have you smoked in the past 12 months?
Choose all that apply.
The kind…
[SHOW GENERIC IMAGE OF CIGARILLOS WITH TIPS, FILTERED CIGARS, AND CIGARILLOS
WITHOUT TIPS]
1

With a plastic or wooden tip

2

With a filter (like a cigarette filter)

3

Without a tip or filter

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who have smoked a cigarillo or filtered cigar in the past 12 months.
BOX ID:

R04_YGV04

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_GTRAD_YOUTH = 1 (Ever user) Youth respondents who have ever smoked a
traditional cigar.
R04_EVER_NEVER_GTRAD_YOUTH = 2 (Never user) Youth respondents who have not ever smoked
a traditional cigar.
R04_INIT_GTRAD_YOUTH = 1 (Initiator) Youth respondents who initiated traditional cigar use
between Waves or new baseline youth respondents who have ever smoked a traditional cigar.
R04_EVER_NEVER_GRILLO_YOUTH = 1 (Ever user) Youth respondents who have ever smoked a
cigarillo.
R04_EVER_NEVER_GRILLO_YOUTH = 2 (Never user) Youth respondents who have not ever
smoked a cigarillo.
R04_INIT_GRILLO_YOUTH = 1 (Initiator) Youth respondents who initiated cigarillo use between
Waves or new baseline youth respondents who have ever smoked a cigarillo.
R04_EVER_NEVER_GFILTR_YOUTH = 1 (Ever user) Youth respondents who have ever smoked a
filtered cigar.
R04_EVER_NEVER_GFILTR_YOUTH = 2 (Never user) Youth respondents who have not ever smoked
a filtered cigar.
R04_INIT_GFILTR_YOUTH = 1 (Initiator) Youth respondents who initiated filtered cigar use between
Waves or new baseline youth respondents who have ever smoked a filtered cigar.

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BOX ID:

R04_YGR04

Youth respondents who have never heard of traditional cigars, cigarillos, and filtered cigars, go to Box
R04_YPT01.
Else, youth respondents who have heard of cigars but never smoked a traditional cigar, go to
R04_YG9010.
Else, youth respondents who have heard of cigars but never smoked a cigarillo, go to R04_YG9011.
Else, youth respondents who have heard of cigars but never smoked a filtered cigar, go to
R04_YG9012.
Else, new baseline youth respondents who have heard of cigars, go to R04_YG9105_NB.
Else, continuing youth respondents, go to R04_YG9107.
PATH ID:

R04_YG9010

Have you ever been curious about smoking a traditional cigar?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a traditional cigar.
PATH ID:

R04_YG9020

Do you think you will smoke a traditional cigar in the next year?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a traditional cigar.

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PATH ID:

R04_YG9013

Do you think that you will try a traditional cigar soon?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a traditional cigar.
PATH ID:

R04_YG9016

If one of your best friends were to offer you a traditional cigar, would you smoke it?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a traditional cigar.
BOX ID:

R04_YGR12

Youth respondents who have heard of cigars but never smoked a cigarillo, go to R04_YG9011.
Else, youth respondents who have heard of cigars but never smoked a filtered cigar, go to
R04_YG9012.
Else, new baseline youth respondents who have heard of cigars, go to R04_YG9105_NB.
Else, continuing youth respondents, go to R04_YG9107.

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PATH ID:

R04_YG9011

Have you ever been curious about smoking a cigarillo?
[SHOW GENERIC IMAGE OF CIGARILLOS]
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a cigarillo.
PATH ID:

R04_YG9021

Do you think you will smoke a cigarillo in the next year?
[SHOW GENERIC IMAGE OF CIGARILLOS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a cigarillo.
PATH ID:

R04_YG9014

Do you think that you will try a cigarillo soon?
[SHOW GENERIC IMAGE OF CIGARILLOS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a cigarillo.

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PATH ID:

R04_YG9017

If one of your best friends were to offer you a cigarillo, would you smoke it?
[SHOW GENERIC IMAGE OF CIGARILLOS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a cigarillo.
BOX ID:

R04_YGR13

Youth respondents who have heard of cigars but never smoked a filtered cigar, go to R04_YG9012.
Else, new baseline youth respondents who have heard of cigars, go to R04_YG9105_NB.
Else, continuing youth respondents, go to R04_YG9107.
PATH ID:

R04_YG9012

Have you ever been curious about smoking a filtered cigar?
[SHOW GENERIC IMAGE OF FILTERED CIGARS]
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a filtered cigar.

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PATH ID:

R04_YG9022

Do you think you will smoke a filtered cigar in the next year?
[SHOW GENERIC IMAGE OF FILTERED CIGARS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a filtered cigar.
PATH ID:

R04_YG9015

Do you think that you will try a filtered cigar soon?
[SHOW GENERIC IMAGE OF FILTERED CIGARS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a filtered cigar.
PATH ID:

R04_YG9018

If one of your best friends were to offer you a filtered cigar, would you smoke it?
[SHOW GENERIC IMAGE OF FILTERED CIGARS]
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of cigars but have never smoked a filtered cigar.

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BOX ID:

R04_YGR14

New baseline youth respondents who have heard of cigars, go to R04_YG9105_NB.
Else, go to R04_YG9107.
PATH ID:

R04_YG9107

[Sometimes people take tobacco out of a traditional cigar, cigarillo or filtered cigar and replace it with
marijuana. This is sometimes called a “blunt”.
]In the past 12 months, have you smoked part or all of a traditional cigar, cigarillo or filtered cigar with
marijuana in it? [(Remember all information you give to the PATH Study will be kept private.)]
1

Yes

2

No

GO TO BOX R04_YGV01

-8

DON'T KNOW

GO TO BOX R04_YGV01

-7

REFUSED

GO TO BOX R04_YGV01

ASK: New baseline youth respondents who have ever smoked a blunt and all continuing youth
respondents.
DISPLAY: UNDERLINE "past 12 months".
IF R04_YOUTHTYPE = 1, DISPLAY "Sometimes people take tobacco out of a cigar, cigarillo or filtered
cigar and replace it with marijuana. This is sometimes called a “blunt”." AND "(Remember all the
information you give to the PATH Study will be kept private.)".
ELSE, DO NOT DISPLAY THIS TRANSITION TEXT.
PATH ID:

R04_YG1095

Which of the following looks like the type of cigar you usually smoke as a blunt? Choose all that apply.
[SHOW GENERIC IMAGE OF 3 CIGAR GROUPS]
1

Group 1

2

Group 2

3

Group 3

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked blunts in the past 12 months.

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PATH ID:

R04_YG9106

Now think about the past 12 months when you smoked the type of cigar shown below.
In the past 12 months, how often was any of the tobacco replaced with marijuana?
[SHOW GENERIC IMAGE OF [YG1095CIGARTYPE]]
1

Every time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked blunts in the past 12 months. (This question is repeated for
every cigar type identified in R04_YG1095[_01/_02/_03].)

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BOX ID:

R04_YGV01

DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
BLUNT-ONLY USER GROUPS:
R04_12MBLUNT_ONLY_BTRAD = Youth respondents who smoke traditional cigars as blunts every
time when smoked in the past 12 months.
R04_12MBLUNT_ONLY_BRILLO = Youth respondents who smoke cigarillos as blunts every time
when smoked in the past 12 months.
R04_12MBLUNT_ONLY_BFILTR = Youth respondents who smoke filtered cigars as blunts every time
when smoked in the past 12 months.
R04_INIT_BLUNT_BTRAD_YOUTH = Youth respondents who initiated smoking traditional cigars as
blunts between Waves or new baseline youth respondents who have ever used traditional cigars as
blunts every time in the past 12 months.
R04_INIT_BLUNT_BRILLO_YOUTH = Youth respondents who initiated smoking cigarillos as blunts
between Waves or new baseline youth respondents who have ever used cigarillos as blunts every time
in the past 12 months.
R04_INIT_BLUNT_BFILTR_YOUTH = Youth respondents who initiated smoking filtered cigars as
blunts between Waves or new baseline youth respondents who have ever used filtered cigars as blunts
every time in the past 12 months.
DEFINE THE FOLLOWING DERIVED VARIABLES (SEE APPENDIX):
CIGAR LOOPS
Cigars as Non-Blunts:
GTRAD = Youth respondents who have ever smoked traditional cigars and have not smoked traditional
cigars as blunts every time when smoked in the past 12 months.
GRILLO = Youth respondents who have ever smoked cigarillos and have not smoked cigarillos as
blunts every time when smoked in the past 12 months.
GFILTR = Youth respondents who have ever smoked filtered cigars and have not smoked filtered cigars
as blunts every time when smoked in the past 12 months.
Cigars as Blunts-Only:
BTRAD = Youth respondents who smoke traditional cigars as blunts every time when smoked in the
past 12 months.
BRILLO = Youth respondents who smoke cigarillos as blunts every time when smoked in the past 12
months.
BFILTR = Youth respondents who smoke filtered cigars as blunts every time when smoked in the past
12 months.

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BOX ID:

R04_YGR02

PROGRAM: CREATE LOOPS FOLLOWING ROUTING INSTRUCTIONS FOR VARIOUS CIGAR
TYPES:
Blunt/Cigar Loops
If the respondent has smoked cigars as blunts-only, R04_YJ1108[TC/CL/FC] through
R04_YJ1071[TC/CL/FC] are repeated in a loop for each cigar type as blunts. See Box R04_YJT04 for
transition text shown at the start of each loop.
After all blunt loops are complete, items from R04_YG1006_NB[TC/CL/FC] through
R04_YG1141[TC/CL/FC] are repeated once for each type of cigar the respondent has smoked,
following skips appropriately. See Box R04_YGT04 for transition text shown at the start of each loop.
If the respondent only smoked traditional cigars, cigarillos, or filtered cigars as blunts, go to Box
R04_YJT04.
Else, if the respondent has ever smoked traditional cigars, cigarillos, or filtered cigars, go to Box
R04_YGT04.
Else, if the respondent has not smoked traditional cigars, cigarillos, or filtered cigars as blunts, and has
never smoked traditional cigars, cigarillos, or filtered cigars, go to Box R04_YPT01.
[CIGARFILL]
If traditional cigar/blunt smoker, [CIGARFILL] = "traditional cigar".
If cigarillo/blunt smoker, [CIGARFILL] = "cigarillo".
If filtered cigar/blunt smoker, [CIGARFILL] = "filtered cigar".

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BOX ID:

R04_YJT04

PROGRAM - DISPLAY THE FOLLOWING TRANSITION TEXT AT THE START OF LOOPS:
IF LOOP=BTRAD Traditional Cigars (as blunts-only):
The next questions are about traditional cigars when smoked as blunts.
Traditional cigars contain tightly rolled tobacco that is wrapped in a tobacco leaf. Sometimes people
take tobacco out of a traditional cigar and replace it with marijuana. This is sometimes called a blunt. As
you answer these questions, please think only about your use of traditional cigars when smoked as
blunts like those shown below. [ONLY IF THIS IS NOT THE LAST TIME THROUGH THE SECTION:]
There will be a separate section later about other kinds of blunts.
[SHOW GENERIC IMAGE FOR TRADITIONAL CIGAR]
IF LOOP=BRILLO Cigarillos (as blunts-only):
The next questions are about cigarillos when smoked as blunts.
Cigarillos are medium-sized cigars and sometimes come with plastic or wood tips. [Sometimes people
take tobacco out of a cigarillo and replace it with marijuana. This is sometimes called a blunt.] As you
answer these questions, please think only about your use of cigarillos when smoked as blunts like those
shown below. [ONLY IF THIS IS NOT THE LAST TIME THROUGH THE SECTION:] There will be a
separate section later about other kinds of blunts.
[SHOW GENERIC IMAGE FOR CIGARILLO]
IF LOOP=BFILTR Filtered Cigars (as blunts-only):
The next questions are about filtered cigars when smoked as blunts.
Filtered cigars are usually brown and have a filter like a cigarette. [Sometimes people take tobacco out
of a filtered cigar and replace it with marijuana. This is sometimes called a blunt.] As you answer these
questions, please think only about your use of filtered cigars when smoked as blunts like those shown
below. [ONLY IF THIS IS NOT THE LAST TIME THROUGH THE SECTION:] There will be a separate
section later about other kinds of blunts.
[SHOW GENERIC IMAGE FOR FILTERED CIGAR]
BOX ID:

R04_YJR09

Continuing youth respondents who have initiated blunt use since the previous wave, and new baseline
youth respondents who have ever smoked a blunt, go to R04_YJ1108[TC/CL/FC].
Else, youth respondents who have smoked blunts in the past 12 months, go to R04_YJ1112[TC/CL/FC].

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PATH ID:

R04_YJ1108

Was the first [CIGARFILL] you smoked as a blunt flavored to taste like menthol, mint, clove, spice, fruit,
chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YJ1112[TC/CL/FC]

3

I don't know

GO TO R04_YJ1112[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YJ1112[TC/CL/FC]

-7

REFUSED

GO TO R04_YJ1112[TC/CL/FC]

ASK: Continuing youth respondents who have initiated blunt use since previous wave, and new baseline
youth respondents who have ever smoked blunts.
PATH ID:

R04_YJ1011

What flavor was that first [CIGARFILL] you smoked as a blunt? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents whose first blunt was flavored.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YJ1112

When was the last time you smoked a [CIGARFILL] as a blunt, even one or two puffs?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YJV02

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YJV02

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YJV02

-8

DON'T KNOW

GO TO BOX R04_YJV02

-7

REFUSED

GO TO BOX R04_YJV02

ASK: Youth respondents who have smoked blunts in the past 12 months.

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PATH ID:

R04_YJ0100

When did you last smoke a [CIGARFILL] as a blunt?
1

In the past hour

2

Sometime today

GO TO R04_YJ0103[TC/CL/FC]

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YJV02

-8

DON'T KNOW

GO TO BOX R04_YJV02

-7

REFUSED

GO TO BOX R04_YJV02

ASK: Youth respondents who have smoked blunts in the past 7 days.
PATH ID:

R04_YJ0102

When you last smoked a [CIGARFILL] as a blunt [FILL BASED ON R04_YJ0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked a blunt today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YJ0100[TC/CL/FC]]: IF R04_YJ0100[TC/CL/FC] = 2, DISPLAY
“today”.
ELSE, IF R04_YJ0100[TC/CL/FC] = 3, DISPLAY “yesterday”.
ELSE, IF R04_YJ0100[TC/CL/FC] = 4, DISPLAY “the day before yesterday”.

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PATH ID:

R04_YJ0103

How many [CIGARFILL]s [have/did] you [smoked/smoke] as a blunt [FILL BASED ON
R04_YJ0100[TC/CL/FC]]? (If less than 1, enter 1.)
1

I__I__I

-8

DON'T KNOW

GO TO BOX R04_YJV02[TC/CL/FC]

-7

REFUSED

GO TO BOX R04_YJV02[TC/CL/FC]

ASK: Youth respondents who have smoked a blunt in the past hour, today, yesterday or the day before
yesterday.
DISPLAY: IF R04_YJ0100[TC/CL/FC] = 1, 2, DISPLAY “have” AND “smoked”.
ELSE, IF R04_YJ0100[TC/CL/FC] = 3, 4, DISPLAY “did” AND “smoke”.
FOR [FILL BASED ON R04_YJ0100[TC/CL/FC]]:
IF R04_YJ0100[TC/CL/FC] = 1, 2, DISPLAY “today”.
ELSE, IF R04_YJ0100[TC/CL/FC] = 3, DISPLAY “yesterday”.
ELSE, IF R04_YJ0100[TC/CL/FC] = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YJ0103TC_LC1

The computer recorded that you smoked [R04_YJ0103TC] traditional cigars as blunts
[today/yesterday/the day before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ0103TC

2

NEXT

GO TO BOX R04_YJV02

ASK: IF R04_YJ0103TC > 15 OR R04_YJ0103TC = 11.
DISPLAY: IF R04_YJ0100TC = 1, 2, DISPLAY “today”.
ELSE, IF R04_YJ0100TC = 3, DISPLAY “yesterday”.
ELSE, IF R04_YJ0100TC = 4, DISPLAY “the day before yesterday”.

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PATH ID:

R04_YJ0103CL_LC1

The computer recorded that you smoked [R04_YJ0103CL] cigarillos as blunts [today/yesterday/the day
before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ0103CL

2

NEXT

GO TO BOX R04_YJV02

ASK: IF R04_YJ0103CL > 15 OR R04_YJ0103CL = 11.
DISPLAY: IF R04_YJ0100CL = 1, 2, DISPLAY “today”.
ELSE, IF R04_YJ0100CL = 3, DISPLAY “yesterday”.
ELSE, IF R04_YJ0100CL = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YJ0103FC_LC1

The computer recorded that you smoked [R04_YJ0103FC] filtered cigars as blunts [today/yesterday/the
day before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ0103FC

2

NEXT

GO TO BOX R04_YJV02

ASK: IF R04_YJ0103FC > 15 OR R04_YJ0103FC = 11.
DISPLAY: IF R04_YJ0100FC = 1, 2, DISPLAY “today”.
ELSE, IF R04_YJ0100FC = 3, DISPLAY “yesterday”.
ELSE, IF R04_YJ0100FC = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YJV02

PROGRAM - CREATE THE FOLLOWING VARIABLES FOR EACH CIGAR TYPE (SEE APPENDIX):
R04_30DBLUNT_ONLY_BTRAD = Youth respondents who have smoked a traditional cigar as a blunt
in the past 30 days.
R04_30DBLUNT_ONLY_BRILLO = Youth respondents who have smoked a cigarillo as a blunt in the
past 30 days.
R04_30DBLUNT_ONLY_BFILTR = Youth respondents who have smoked a filtered cigar as a blunt in
the past 30 days.
BOX ID:

R04_YJR06

Past 30 day blunt-only smokers, go to R04_YJ1022[TC/CL/FC].
Else, go to R04_YJ1047[TC/CL/FC].

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PATH ID:

R04_YJ1022

In the past 30 days, on how many days did you smoke a [CIGARFILL] as a blunt?
1

|___|___| DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day blunt-only smokers.
DISPLAY: DISPLAY 'DAYS' AS TITLE.
PATH ID:

R04_YJ1023

In the past 30 days, on the days you smoked [CIGARFILL]s as blunts, how many [CIGARFILL]s did you
smoke as a blunt per day?
1

Less than 1 [CIGARFILL] per day

2

1 [CIGARFILL] per day

3

2 to 5 [CIGARFILL]s per day

4

6 to 10 [CIGARFILL]s per day

5

11 to 20 [CIGARFILL]s per day

6

More than 20 [CIGARFILL]s per day

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day blunt-only smokers.
PATH ID:

R04_YJ1130

In the past 30 days, were any of the [CIGARFILL]s that you smoked as a blunt flavored to taste like
menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YJ1142[TC/CL/FC]

3

I don't know

GO TO R04_YJ1142[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YJ1142[TC/CL/FC]

-7

REFUSED

GO TO R04_YJ1142[TC/CL/FC]

ASK: Past 30 day blunt-only smokers.

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PATH ID:

R04_YJ1131

Which flavors have you smoked in the past 30 days? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored blunt-only smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YJ1147

On the days you smoked [CIGARFILL]s as blunts in the past 30 days, how often did you smoke flavored
[CIGARFILL]s?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored blunt-only smokers.
DISPLAY: Underline "flavored".
PATH ID:

R04_YJ1142

In the past 30 days, did anyone sell you [CIGARFILL]s?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day blunt-only smokers.

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ1123

In the past 30 days, did anyone refuse to sell you [CIGARFILL]s because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day blunt-only smokers.
PATH ID:

R04_YJ1118

In the past 30 days, how did you usually get your own [CIGARFILL]s for when you smoke blunts?
1

I gave someone else money to buy them for me

2

I bought them myself from a store (including a cigar bar)

3

I asked someone to give me one

GO TO R04_YJ1047[TC/CL/FC]

4

Someone offered it to me

GO TO R04_YJ1047[TC/CL/FC]

5

I bought them from another person

GO TO R04_YJ1047[TC/CL/FC]

6

I took them from a store or another person

GO TO R04_YJ1047[TC/CL/FC]

7

I got them some other way (SPECIFY)

GO TO R04_YJ1047[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YJ1047[TC/CL/FC]

-7

REFUSED

GO TO R04_YJ1047[TC/CL/FC]

ASK: Past 30 day blunt-only smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YJ1030

How do [you/they] usually buy your [CIGARFILL]s for when you smoke blunts?
1

In person (such as at a store or cigar bar)

2

From the internet

GO TO R04_YJ1039[TC/CL/FC]

3

By telephone

GO TO R04_YJ1039[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YJ1039[TC/CL/FC]

-7

REFUSED

GO TO R04_YJ1039[TC/CL/FC]

ASK: Past 30 day traditional cigar/cigarillo/filtered cigar as a blunt-only smokers who buy traditional
cigars/cigarillos/filtered cigars for blunts for themselves or someone else buys for them.
DISPLAY: IF R04_YJ1118[TC/CL/FC] =1, DISPLAY “they”;
ELSE, IF R04_YJ1118[TC/CL/FC] =2, DISPLAY “you”.

PATH – Wave 4
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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ1033

Where do [you/they] buy your [CIGARFILL]s for blunts most of the time?
1

A cigar bar

2

A convenience store or gas station

3

A supermarket, grocery store, or drug store

4

A warehouse club, such as Sam’s or Costco

5

A smoke shop, tobacco specialty store or tobacco outlet store

6

A duty free shop or military commissary

7

A bar, pub, restaurant or casino

8

A friend or relative

9

A swap meet or flea market

10

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day blunt-only traditional cigar/cigarillo/filtered cigar smokers who buy traditional
cigars/cigarillos/filtered cigars for blunts for themselves or someone else buys for them in person.
DISPLAY: IF R04_YJ1118[TC/CL/FC] =1, DISPLAY “they”;
ELSE, IF R04_YJ1118[TC/CL/FC] =2, DISPLAY “you”.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
PATH ID:

R04_YJ1039

Think about the last time you [bought/gave money to someone else to buy you] [CIGARFILL]s for blunts.
Did you buy them by the [carton, ]box or pack, or as single [CIGARFILL]s?
3

Carton

(DISPLAY ONLY IF LOOP = BFILTR)

1

Box or pack

GO TO R04_YJ1040[TC/CL/FC]

2

Single [CIGARFILL]s

GO TO R04_YJ1034[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YJ1047[TC/CL/FC]

-7

REFUSED

GO TO R04_YJ1047[TC/CL/FC]

ASK: Past 30 day blunt-only smokers who buy blunts for themselves or someone else buys for them.
DISPLAY: IF R04_YJ1118[TC/CL/FC] =2, DISPLAY "bought".
ELSE, IF R04_YJ1118[TC/CL/FC] =1, DISPLAY "gave money to someone else to buy you".
IF LOOP = BFILTR, DISPLAY "carton, " AND RESPONSE OPTION 3.
ELSE, DO NOT DISPLAY THIS TEXT OR OPTION.

PATH – Wave 4
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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ9056

How many boxes or packs of filtered cigars came in the carton you last bought for blunts?
1

I___I___I

-8

DON'T KNOW

GO TO R04_YJ9057

-7

REFUSED

GO TO R04_YJ9057

ASK: Past 30 day blunt-only filtered cigar smokers who last bought filtered cigars by the carton.
PATH ID:

R04_YJ9056_LC1

A carton of filtered cigars usually has 10 packs in it, but not always. The computer recorded that there
[is R04_YJ9056pack/are R04_YJ9056 packs] of filtered cigars in the carton you usually buy.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ9056

2

NEXT

GO TO R04_YJ9057

ASK: IF R04_YJ9056 != 10.
DISPLAY: IF R04_YJ9056FC = 1, DISPLAY "is [R04_YJ9056] pack".
ELSE, DISPLAY "are [R04_YJ9056] packs".
PATH ID:

R04_YJ9057

How much did you pay for a carton of filtered cigars for blunts?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO R04_YJ1047FC

-7

REFUSED

GO TO R04_YJ1047FC

ASK: Past 30 day blunt-only filtered cigar smokers who last bought filtered cigars by the carton
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
PATH ID:

R04_YJ9057_LC1

The computer recorded that you paid $[R04_YJ9057_D] for a carton of filtered cigars for blunts. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ9057

2

NEXT

GO TO R04_YJ1047FC

ASK: IF R04_YJ9057_D > 125 OR R04_YJ9057_D < 25 OR (R04_YJ9057_D = 125 AND
R04_YJ9057_C > 00).

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ1040

How many [CIGARFILL]s came in the box or pack that you last bought for blunts?
1

I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day blunt-only smokers who last bought cigars by the box or pack.
PATH ID:

R04_YJ1034

How much did you pay for a [[box or pack of [CIGARFILL]s/single [CIGARFILL]]?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO R04_YJ1047[TC/CL/FC]

-7

REFUSED

GO TO R04_YJ1047[TC/CL/FC]

ASK: Past 30 day traditional cigar/cigarillo/filtered cigar as blunts-only smokers who buy traditional
cigar/cigarillo/filtered cigar as blunts for themselves or someone else buys for them who last bought by
box or pack or as single traditional cigars/cigarillos/filtered cigars.
DISPLAY: DISPLAY AS QUANTITY/QUANTITY. DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents”
AS TITLES.
IF R04_YJ1039[TC/CL/FC] =1, DISPLAY "box or pack of [CIGARFILL]s";
ELSE, IF R04_YJ1039[TC/CL/FC] =2, DISPLAY "single [CIGARFILL]".
PATH ID:

R04_YJ1034TC_LC1

The computer recorded that you paid $[R04_YJ1034TC] for a [box or pack of traditional cigars for
blunts/single traditional cigar for blunts]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ1034TC

2

NEXT

GO TO R04_YJ1047TC

ASK: IF ((R04_YJ1034TC_D > 300 OR R04_YJ1034TC_D < 10) AND R04_YJ1039TC = 1 ), OR
((R04_YJ1034TC_D > 15 OR R04_YJ1034TC_D < 1) AND R04_YJ1039TC = 2).
DISPLAY: IF R04_YJ1039TC = 1, DISPLAY "box or pack of traditional cigars for blunts";
ELSE, IF R04_YJ1039TC = 2, DISPLAY "single traditional cigar for blunts".

PATH – Wave 4
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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ1034CL_LC1

The computer recorded that you paid $[R04_YJ1034CL] for a [box or pack of cigarillos for blunts/single
cigarillo for blunts]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ1034CL

2

NEXT

GO TO R04_YJ1047CL

ASK: IF ((R04_YJ1034CL_D > 11 OR R04_YJ1034CL_D < 1) AND R04_YJ1039CL = 1), OR
((R04_YJ1034CL_D > 3 OR (R04_YG1034CL_D = 0 AND R04_YJ1034CL_C < 50)) AND
R04_YJ1039CL = 2).
DISPLAY: IF R04_YJ1039CL = 1, DISPLAY "box or pack of cigarillos for blunts";
ELSE, IF R04_YJ1039CL = 2, DISPLAY "single cigarillo for blunts".
PATH ID:

R04_YJ1034FC_LC1

The computer recorded that you paid $[R04_YJ1034FC] for a [box or pack of filtered cigars for
blunts/single filtered cigar for blunts]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YJ1034FC

2

NEXT

GO TO R04_YJ1047FC

ASK: IF ((R04_YJ1034FC_D > 100 OR R04_YJ1034FC_D < 1) AND R04_YJ1039FC = 1) OR
((R04_YJ1034FC_D > 3 OR (R04_YJ1034FC_D = 0 AND R04_YJ1034FC_C < 50)) AND
R04_YJ1039FC = 2).
DISPLAY: IF R04_YJ1039FC = 1, DISPLAY "box or pack of filtered cigars for blunts";
ELSE, IF R04_YJ1039FC = 2, DISPLAY "single filtered cigar for blunts".
PATH ID:

R04_YJ1047

Do you have a regular brand of [CIGARFILL]s that you usually smoke as blunts?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 12 month blunt-only smokers.

PATH – Wave 4
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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ1945

Do you know the name of the brand of [CIGARFILL]s you [usually smoke/last smoked] as blunts?
1

Yes

2

No

GO TO BOX R04_YJR08

-8

DON'T KNOW

GO TO BOX R04_YJR08

-7

REFUSED

GO TO BOX R04_YJR08

ASK: Past 12 month blunt-only smokers.
DISPLAY: IF R04_YJ1047[TC/CL/FC] = 1, DISPLAY “usually smoke”.
ELSE, IF R04_YJ1047[TC/CL/FC] = 2, 3, -8, -7, DISPLAY “last smoked”.
UNDERLINE "name of the brand".
PATH ID:

R04_YJ1048

What brand of [CIGARFILL] [do/did] you [usually/last] smoke as a blunt?
Please select it from the choices below by touching the screen. If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”. ]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 12 month blunt-only smokers who know the brand name.
DISPLAY: IF R04_YJ1047[TC/CL/FC] =1, DISPLAY “do” AND “usually”.
ELSE, IF R04_YJ1047[TC/CL/FC] = 2, -8, -7, DISPLAY “did” AND “last”.
[IF MULTIPLE SCREENS] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS] DISPLAY: If you do not see it
below, touch the box marked “Something else”.
[SHOW PICTURES OF THE MAJOR BRANDS ON THE TOUCHSCREEN.]
BOX ID:

R04_YJR01

If youth respondent selects "Something else" in R04_YJ1048[TC/CL/FC]_BRAND, go to
R04_YJ1049[TC/CL/FC].
Else, if youth respondent selects brand in R04_YJ1048[TC/CL/FC]_BRAND, go to
R04_YJ1070[TC/CL/FC]_PRODUCT.
Else, go to Box R04_YJR08.

PATH – Wave 4
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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ1049

You said that your brand was not listed. What is it?
__________________________

GO TO BOX R04_YJR08

-8

1

DON'T KNOW

GO TO BOX R04_YJR08

-7

REFUSED

GO TO BOX R04_YJR08

ASK: Past 12 month blunt-only smokers that know the name of the brand they smoke who selected
"Something else" for their brand.
PATH ID:

R04_YJ1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] [do/did] you [usually/last] smoke
as a blunt?
Please select it from the choices below by touching the screen. [ If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”. ]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 12 month blunt-only smokers that know the name of the brand they smoke who selected a
brand image.
DISPLAY: IF R04_YJ1047[TC/CL/FC] =1, DISPLAY “do” AND “usually”.
ELSE, IF R04_YJ1047[TC/CL/FC] =2, -8, -7, DISPLAY “did” AND “last”.
[IF MULTIPLE SCREENS] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS] DISPLAY: If you do not see it
below, touch the box marked “Something else”.
[SHOW PICTURES OR TEXT ON THE TOUCHSCREEN OF THE MAJOR PRODUCTS ASSOCIATED
WITH BRAND SELECTED IN R04_YJ1048[TC/CL/FC]]
BOX ID:

R04_YJR02

If youth respondent selects "Something else" in R04_YJ1070[TC/CL/FC]_PRODUCT, go to
R04_YJ1071[TC/CL/FC].
Else, go to Box R04_YJR08.

PATH – Wave 4
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84

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YJ1071

You said that the type of [BRANDFILL]s that you smoke as blunts was not listed. What type is it?
1

__________________________

-8

DON'T KNOW

-7

REFUSED

ASK: Past 12 month blunt-only smokers that know the name of the brand they smoke who selected a
brand image, but selected "Something else" for their subbrand image.
BOX ID:

R04_YJR08

END BLUNT LOOP:
If respondent has loops to complete for other blunt types, return to Box R04_YJT04 and loop through
subsection for any other blunt types.
Else, if respondent has loops to complete for non-blunt cigar types, go to Box R04_YGT04.
Else, if respondent has no more remaining loops to complete, go to Box R04_YPT01.

PATH – Wave 4
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85

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_YGT04

PROGRAM - DISPLAY THE FOLLOWING TRANSITION TEXT AT THE START OF LOOPS:
IF LOOP=GTRAD Traditional Cigars (non-blunts)
The next questions are about traditional cigars.
Traditional cigars contain tightly rolled tobacco that is wrapped in a tobacco leaf.
As you answer these questions, please think only about your use of traditional cigars like those shown
below. [ONLY IF THIS IS NOT THE LAST TIME THROUGH THE SECTION:] There will be a separate
section later about other kinds of cigars.
[SHOW GENERIC IMAGE FOR TRADITIONAL CIGAR]
IF LOOP=GRILLO Cigarillos (non-blunts)
The next questions are about cigarillos.
Cigarillos are medium-sized cigars and sometimes come with plastic or wood tips.
As you answer these questions, please think only about your use of cigarillos like those shown below.
[ONLY IF THIS IS NOT THE LAST TIME THROUGH THE SECTION:] There will be a separate section
later about other kinds of cigars.
[SHOW GENERIC IMAGE FOR CIGARILLO].
IF LOOP=GFILTR Filtered Cigars (non-blunts)
The next questions are about filtered cigars.
Filtered cigars are usually brown and have a filter like a cigarette. As you answer these questions,
please think only about your use of filtered cigars like those shown below. [ONLY IF THIS IS NOT THE
LAST TIME THROUGH THE SECTION:] There will be a separate section later about other kinds of
cigars.
[SHOW GENERIC IMAGE FOR FILTERED CIGAR].
BOX ID:

R04_YGR05

New baseline youth respondents who have ever smoked cigars, go to R04_YG1006[TC/CL/FC]_NB.
Else, continuing youth respondents who initiated cigar smoking since the previous wave, go to
R04_YG1108[TC/CL/FC].
Else, continuing youth respondents who had smoked 100 or more cigars in the previous wave, go to
R04_YG9040[TC/CL/FC].
Else, go to R04_YG1005[TC/CL/FC].

PATH – Wave 4
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86

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1108

Was the first [CIGARFILL] you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate,
alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO BOX R04_YGR09

3

I don't know

GO TO BOX R04_YGR09

-8

DON'T KNOW

GO TO BOX R04_YGR09

-7

REFUSED

GO TO BOX R04_YGR09

ASK: Continuing youth respondents who have initiated cigar smoking since the previous wave, and new
baseline youth respondents who have ever smoked cigars.
PATH ID:

R04_YG1011

What flavor was that first [CIGARFILL] you smoked? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents whose first cigar was flavored.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YGR09

Continuing youth respondents who had smoked 100 or more cigars in the previous wave, go to
R04_YG9040[TC/CL/FC].
Else, go to R04_YG1005[TC/CL/FC].

PATH – Wave 4
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87

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1005

How many [CIGARFILL]s have you smoked in your entire life?
1

1 or more puffs but never a whole one

2

1

3

2 to 10

4

11 to 20

5

21 to 50

6

51 to 99

7

100 or more

-8

DON'T KNOW

-7

REFUSED

ASK: Aged-up and continuing youth respondents who have ever smoked cigars and had not smoked
100 or more cigars in the previous wave, and new cohort youth respondents who have ever smoked
cigars.
PATH ID:

R04_YG9040

Please look at this picture. Which group is most like the [CIGARFILL] you usually smoke?
[SHOW GENERIC IMAGE OF 4 CIGAR GROUPS]
1

Group 1

2

Group 2

3

Group 3

4

Group 4

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a traditional cigar/cigarillo/filtered cigar.
BOX ID:

R04_YGR18

Continuing youth respondents who have ever smoked cigars and had never smoked fairly regularly in
the previous wave, and new baseline youth respondents who have ever smoked cigars, go to
R04_YG1100[TC/CL/FC].
Else, go to R04_YG1112[TC/CL/FC].

PATH – Wave 4
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88

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1100

Have you ever smoked [CIGARFILL]s fairly regularly?
1

Yes

2

No

GO TO R04_YG1112[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YG1112[TC/CL/FC]

-7

REFUSED

GO TO R04_YG1112[TC/CL/FC]

ASK: Aged-up and continuing youth respondents who have ever smoked a cigar (and had never
smoked fairly regularly in the previous wave), and new cohort youth respondents who have ever
smoked cigars.
PATH ID:

R04_YG1007

How old were you when you first started smoking [CIGARFILL]s fairly regularly?
1

|__|__| Years old

-8

DON'T KNOW

GO TO R04_YG1121[TC/CL/FC]

-7

REFUSED

GO TO R04_YG1121[TC/CL/FC]

ASK: Youth respondents who have ever smoked cigars fairly regularly and did not smoke fairly regularly
in the previous wave.
DISPLAY: DISPLAY "Years old" AS A TITLE.
PATH ID:

R04_YG1007TC_LC1

The computer recorded that you started smoking cigars fairly regularly at age [R04_YG1007TC]. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1007TC

2

NEXT

GO TO R04_YG1112TC

ASK: IF R04_AG1007TC <= 12 OR R04_YG1007TC < R04_YG1006TC_NB.
PATH ID:

R04_YG1007TC_LC2

The computer recorded that you started smoking cigars fairly regularly at age [R04_YG1007TC]. That is
older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1007TC

2

NEXT

GO TO R04_YG1112TC

ASK: IF R04_YG1007TC > R04_YOUTHAGE.

PATH – Wave 4
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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1007CL_LC1

The computer recorded that you started smoking cigarillos fairly regularly at age [R04_YG1007CL]. Is
that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1007CL

2

NEXT

GO TO R04_YG1112CL

ASK: IF R04_AG1007CL <= 5 OR R04_YG1007CL < R04_YG1006CL_NB.
PATH ID:

R04_YG1007CL_LC2

The computer recorded that you started smoking cigarillos fairly regularly at age [R04_YG1007CL]. That
is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1007CL

2

NEXT

GO TO R04_YG1112CL

ASK: IF R04_YG1007CL > R04_YOUTHAGE.
PATH ID:

R04_YG1007FC_LC1

The computer recorded that you started smoking filtered cigars fairly regularly at age [R04_YG1007FC].
Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1007FC

2

NEXT

GO TO R04_YG1112FC

ASK: IF R04_AG1007FC <= 10 OR R04_YG1007FC < R04_YG1006FC_NB.
PATH ID:

R04_YG1007FC_LC2

The computer recorded that you started smoking filtered cigars fairly regularly at age [R04_YG1007FC].
That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1007FC

2

NEXT

GO TO R04_YG1112FC

ASK: IF R04_YG1007FC > R04_YOUTHAGE.

PATH – Wave 4
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90

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG1121

When you first started smoking [CIGARFILL]s fairly regularly, were you…
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who did not know or refused to report the age when they started smoking
cigars fairly regularly.
PATH ID:

R04_YG1112

When was the last time you smoked a [CIGARFILL], even one or two puffs?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YGV02

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YGV02

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YGV02

6

1 to 4 years ago

GO TO BOX R04_YGV02

7

5 or more years ago

GO TO BOX R04_YGV02

-8

DON'T KNOW

GO TO BOX R04_YGV02

-7

REFUSED

GO TO BOX R04_YGV02

ASK: Youth respondents who have ever smoked cigars.
PATH ID:

R04_YG0100

When did you last smoke a [CIGARFILL]?
1

In the past hour

GO TO R04_YG0103[TC/CL/FC]

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YGV02

-8

DON'T KNOW

GO TO BOX R04_YGV02

-7

REFUSED

GO TO BOX R04_YGV02

ASK: Youth respondents who have smoked cigars in the past 7 days.

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Wave 4 (version 3.0)
PATH ID:

R04_YG0102

When you last smoked a [CIGARFILL] [FILL BASED ON R04_YG0100[TC/CL/FC]], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked a cigar today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YG0100[TC/CL/FC]]:
IF R04_YG0100[TC/CL/FC] = 2, DISPLAY “today”.
ELSE, IF R04_YG0100[TC/CL/FC] = 3, DISPLAY "yesterday".
ELSE, IF R04_YG0100[TC/CL/FC] = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YG0103

How many [CIGARFILL]s [have/did] you [smoked/smoke] [FILL BASED ON R04_YG0100[TC/CL/FC]]?
(If less than 1, enter 1.)
1

I__I__I

-8

DON'T KNOW

GO TO BOX R04_YGV02

-7

REFUSED

GO TO BOX R04_YGV02

ASK: Youth respondents who have smoked a cigar in the past hour, sometime today, yesterday or the
day before yesterday.
DISPLAY: IF R04_YG0100[TC/CL/FC] = 1, 2, DISPLAY “have” AND “smoked”.
ELSE, IF R04_YG0100[TC/CL/FC] = 3, 4, DISPLAY “did” AND “smoke”.
FOR [FILL BASED ON R04_YG0100[TC/CL/FC]],
IF R04_YG0100[TC/CL/FC] = 1, 2, DISPLAY “today”.
ELSE, IF R04_YG0100[TC/CL/FC] = 3, DISPLAY "yesterday".
ELSE, IF R04_YG0100[TC/CL/FC] = 4, DISPLAY “the day before yesterday”.

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Wave 4 (version 3.0)
PATH ID:

R04_YG0103TC_LC1

The computer recorded that you smoked [R04_YG0103TC] traditional cigars [today/yesterday/the day
before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG0103TC

2

NEXT

GO TO BOX R04_YGV02

ASK: IF R04_YG0103TC > 15 OR R04_YG0103TC = 11.
DISPLAY: IF R04_YG0100TC = 1, 2, DISPLAY “today”.
ELSE, IF R04_YG0100TC = 3, DISPLAY “yesterday”.
ELSE, IF R04_YG0100TC = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YG0103CL_LC1

The computer recorded that you smoked [R04_YG0103CL] cigarillos [today/yesterday/the day before
yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG0103CL

2

NEXT

GO TO BOX R04_YGV02

ASK: IF R04_YG0103CL > 15 OR R04_YG0103CL = 11.
DISPLAY: IF R04_YG0100CL = 1, 2, DISPLAY “today”.
ELSE, IF R04_YG0100CL = 3, DISPLAY “yesterday”.
ELSE, IF R04_YG0100CL = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YG0103FC_LC1

The computer recorded that you smoked [R04_YG0103FC] filtered cigars [today/yesterday/the day
before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG0103FC

2

NEXT

GO TO BOX R04_YGV02

ASK: IF R04_YG0103FC > 15 OR R04_YG0103FC = 11.
DISPLAY: IF R04_YG0100FC = 1, 2, DISPLAY “today”.
ELSE, IF R04_YG0100FC = 3, DISPLAY “yesterday”.
ELSE, IF R04_YG0100FC = 4, DISPLAY “the day before yesterday”.

PATH – Wave 4
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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_YGV02

PROGRAM - CREATE THE FOLLOWING VARIABLES FOR EACH CIGAR TYPE (SEE APPENDIX):
R04_PAST30DAY_GTRAD = 1 (Past 30 day smoker) Youth respondents who have smoked a
traditional cigar in the past 30 days.
R04_PAST30DAY_GTRAD_LEVEL = 1 (Past 30 day “Very Light” smoker) Youth respondents who
have smoked a traditional cigar in the past 30 days, and have smoked 10 or less traditional cigars in
their lifetime.
R04_PAST30DAY_GTRAD_LEVEL = 2 (Past 30 day “Not Light” smoker) Youth respondents who
have smoked a traditional cigar in the past 30 days, and have smoked more than 10 traditional cigars in
their lifetime.
R04_PAST30DAY_GRILLO = 1 (Past 30 day smoker) Youth respondents who have smoked a cigarillo
in the past 30 days.
R04_PAST30DAY_GRILLO_LEVEL = 1 (Past 30 day “Very Light” smoker) Youth respondents who
have smoked a cigarillo in the past 30 days, and have smoked 10 or less cigarillos in their lifetime.
R04_PAST30DAY_GRILLO_LEVEL = 2 (Past 30 day “Not Light” smoker) Youth respondents who
have smoked a cigarillo in the past 30 days, and have smoked more than 10 cigarillos in their lifetime.
R04_PAST30DAY_GFILTR = 1 (Past 30 day smoker) Youth respondents who have smoked a filtered
cigar in the past 30 days.
R04_PAST30DAY_GFILTR_LEVEL = 1 (Past 30 day “Very Light” smoker) Youth respondents who
have smoked a filtered cigar in the past 30 days, and have smoked 10 or less filtered cigars in their
lifetime.
R04_PAST30DAY_GFILTR_LEVEL = 2 (Past 30 day “Not Light” smoker) Youth respondents who
have smoked a filtered cigar in the past 30 days, and have smoked more than 10 filtered cigars in their
lifetime.
BOX ID:

R04_YGR06

Past 30 day cigar smokers, go to R04_YG1022[TC/CL/FC].
Else, go to Box R04_YGR16.
PATH ID:

R04_YG1022

In the past 30 days, on how many days did you smoke a [CIGARFILL]?
1

|___|___| DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
DISPLAY: DISPLAY 'DAYS' AS A TITLE.

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Wave 4 (version 3.0)
PATH ID:

R04_YG1023

In the past 30 days, on the days you smoked a [CIGARFILL], how many [CIGARFILL]s did you smoke
per day?
1

Less than 1 [CIGARFILL] per day

2

1 [CIGARFILL] per day

3

2 to 5 [CIGARFILL]s per day

4

6 to 10 [CIGARFILL]s per day

5

11 to 20 [CIGARFILL]s per day

6

More than 20 [CIGARFILL]s per day

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
PATH ID:

R04_YG1130

In the past 30 days, were any of the [CIGARFILL]s that you smoked flavored to taste like menthol, mint,
clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YG1142[TC/CL/FC]

3

I don't know

GO TO R04_YG1142[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YG1142[TC/CL/FC]

-7

REFUSED

GO TO R04_YG1142[TC/CL/FC]

ASK: Past 30 day cigar smokers.
PATH ID:

R04_YG1131

Which flavors have you smoked in the past 30 days? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored cigar smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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Wave 4 (version 3.0)
PATH ID:

R04_YG1147

On the days you smoked [CIGARFILL]s in the past 30 days, how often did you smoke flavored
[CIGARFILL]s?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored cigar smokers.
DISPLAY: UNDERLINE "flavored".
PATH ID:

R04_YG1142

In the past 30 days, did anyone sell you [CIGARFILL]s?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
PATH ID:

R04_YG1123

In the past 30 days, did anyone refuse to sell you [CIGARFILL]s because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.

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Wave 4 (version 3.0)
PATH ID:

R04_YG1118

In the past 30 days, how did you usually get your own [CIGARFILL]s?
1

I gave someone else money to buy them for me

2

I bought them myself from a store (including a cigar bar)

3

I asked someone to give me one

4

Someone offered it to me

5

I bought them from another person

6

I took them from a store or another person

7

I got them some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YGR07

Past 30 day cigar smokers who usually buy cigars themselves or usually give someone else money to
buy cigars for them, go to R04_YG1030[TC/CL/FC].
Else, past 30 day "not-light" cigar smokers go to R04_YG1047[TC/CL/FC].
Else, past 30 day cigar smokers, go to R04_YG1945[TC/CL/FC]
Else, all other youth respondents, go to Box R04_YGR16.
PATH ID:

R04_YG1030

How do [you/they] usually buy your [CIGARFILL]s?
1

In person (such as at a store or cigar bar)

2

From the internet

GO TO R04_YG1039[TC/CL/FC]

3

By telephone

GO TO R04_YG1039[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YG1039[TC/CL/FC]

-7

REFUSED

GO TO R04_YG1039[TC/CL/FC]

ASK: Past 30 day traditional cigar/cigarillo/filtered cigar smokers (including "very light" smokers) who
buy traditional cigars/cigarillos/filtered cigars for themselves or someone else buys for them.
DISPLAY: IF R04_YG1118[TC/CL/FC] = 1, DISPLAY “they”.
ELSE, IF R04_YG1118[TC/CL/FC] = 2, DISPLAY “you”.

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Wave 4 (version 3.0)
PATH ID:

R04_YG1033

Where do [you/they] buy your [CIGARFILL]s most of the time?
1

A cigar bar

2

A convenience store or gas station

3

A supermarket, grocery store, or drug store

4

A warehouse club, such as Sam’s or Costco

5

A smoke shop, tobacco specialty store or tobacco outlet store

6

A duty free shop or military commissary

7

A bar, pub, restaurant or casino

8

A friend or relative

9

A swap meet or flea market

10

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day traditional cigar/cigarillo/filtered cigar smokers (including "very light" smokers) who
buy traditional cigars/cigarillos/filtered cigars for themselves or someone else buys for them in person.
DISPLAY: IF R04_YG1118[TC/CL/FC] = 1, DISPLAY “they”.
ELSE, IF R04_YG1118[TC/CL/FC] = 2, DISPLAY “you”.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
BOX ID:

R04_YGR22

Past 30 day "not-light" cigar smokers who buy cigars for themselves or someone else buys for them, go
to R04_YG1039[TC/CL/FC].
Else, go to R04_YG1047[CG/CL/FC].

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Wave 4 (version 3.0)
PATH ID:

R04_YG1039

Think about the last time you [bought/gave money to someone else to buy you] [CIGARFILL]s. Did you
buy them by the [carton, ]box or pack, or as single [CIGARFILL]s?
3

Carton

DISPLAY ONLY IF LOOP = GFILTR

1

Box or pack

GO TO R04_YG1040[TC/CL/FC]

2

Single [CIGARFILL]s

GO TO R04_YG1034[TC/CL/FC]

-8

DON'T KNOW

GO TO R04_YG1047[TC/CL/FC]

-7

REFUSED

GO TO R04_YG1047[TC/CL/FC]

ASK: Past 30 day "not-light" cigar smokers who buy cigars for themselves or someone else buys for
them.
DISPLAY: IF R04_YG1118[TC/CL/FC] = 2, DISPLAY "bought".
ELSE, IF R04_YG1118[TC/CL/FC] = 1, DISPLAY "gave money to someone else to buy you".
IF LOOP = GFILTR, DISPLAY "carton, " AND RESPONSE OPTION 3.
ELSE, DO NOT DISPLAY THIS TEXT OR RESPONSE OPTION.
PATH ID:

R04_YG9056

How many boxes or packs of filtered cigars came in the carton you last bought?
1

I___I___I

-8

DON'T KNOW

GO TO R04_YG9057

-7

REFUSED

GO TO R04_YG9057

ASK: Past 30 day "not-light" filtered cigar smokers who last bought filtered cigars by the carton.
PATH ID:

R04_YG9056_LC1

A carton of filtered cigars usually has 10 packs in it, but not always. The computer recorded that there
[is R04_YG9056 pack/are R04_YG9056 packs] of filtered cigars in the carton you usually buy.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG9056

2

NEXT

GO TO R04_YG9057

ASK: IF R04_YG9056 != 10.
DISPLAY: IF R04_YG9056FC = 1, DISPLAY "is [R04_YG9056] pack". ELSE, DISPLAY "are
[R04_YG9056] packs".

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Wave 4 (version 3.0)
PATH ID:

R04_YG9057

How much did you pay for a carton of filtered cigars?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO R04_YG1047FC

-7

REFUSED

GO TO R04_YG1047FC

ASK: Past 30 day "not-light" filtered cigar smokers who last bought filtered cigars by the carton.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
PATH ID:

R04_YG9057_LC1

The computer recorded that you paid $[R04_YG9057_D] for a carton of filtered cigars. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG9057

2

NEXT

GO TO R04_YG1047FC

ASK: IF R04_YG9057_D > 125 OR R04_YG9057_D < 25 OR (R04_YG9057_D = 125 AND
R04_YG9057_C > 00).
PATH ID:

R04_YG1040

How many [CIGARFILL]s came in the box or pack that you last bought?
1

I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigar smokers who last bought cigars by the box or pack.
PATH ID:

R04_YG1034

How much did you pay for a [[box or pack of [CIGARFILL]s/single [CIGARFILL]]?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO R04_YG1047[TC/CL/FC]

-7

REFUSED

GO TO R04_YG1047[TC/CL/FC]

ASK: Past 30 day "not-light" cigar smokers who last bought cigars by the box or pack or as single
cigars.
DISPLAY: DISPLAY AS QUANTITY/QUANTITY. DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents”
AS TITLES.
IF R04_YG1039[TC/CL/FC] = 1, DISPLAY "box or pack of [CIGARFILL]s".
ELSE, IF R04_YG1039[TC/CL/FC] = 2, DISPLAY "single [CIGARFILL]".

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Wave 4 (version 3.0)
PATH ID:

R04_YG1034TC_LC1

The computer recorded that you paid $[R04_YG1034TC_D] for a [box or pack of traditional cigars/single
traditional cigar]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1034TC

2

NEXT

GO TO R04_YG1047TC

ASK: IF ((R04_YG1034TC_D > 300 OR R04_YG1034TC_D < 10) AND R04_YG1039TC = 1) OR
((R04_YG1034TC_D > 15 OR R04_YG1034TC_D < 1) AND R04_YG1039TC = 2).
DISPLAY: IF R04_YG1039TC = 1, DISPLAY " box or pack of traditional cigars ".
ELSE, IF R04_YG1039TC = 2, DISPLAY " single traditional cigar".
PATH ID:

R04_YG1034CL_LC1

The computer recorded that you paid $[R04_YG1034CL_D] for a [box or pack of cigarillos/single
cigarillo]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1034CL

2

NEXT

GO TO R04_YG1047CL

ASK: IF ((R04_YG1034CL_D > 11 OR R04_YG1034CL_D < 1) AND R04_YG1039CL = 1) OR
((R04_YG1034CL_D > 3 OR (R04_YG1034CL_D = 0 AND R04_YG1034CL_C < 50)) AND
R04_YG1039CL = 2).
DISPLAY: IF R04_YG1039CL = 1, DISPLAY "box or pack of cigarillos".
ELSE, IF R04_YG1039CL = 2, DISPLAY "single cigarillo".
PATH ID:

R04_YG1034FC_LC1

The computer recorded that you paid $[R04_YG1034FC_D] for a [box or pack of filtered cigars/single
filtered cigar]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YG1034FC

2

NEXT

GO TO R04_YG1047FC

ASK: IF ((R04_YG1034FC_D > 100 OR R04_YG1034FC_D < 1) AND R04_YG1039FC = 1) OR
((R04_YG1034FC_D > 3 OR (R04_YG1034FC_D = 0 AND R04_YG1034FC_C < 50)) AND
R04_YG1039FC = 2).
DISPLAY: IF R04_YG1039FC = 1, DISPLAY "box or pack of filtered cigars".
ELSE, IF R04_YG1039FC = 2, DISPLAY "single filtered cigar".

PATH – Wave 4
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101

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Wave 4 (version 3.0)
PATH ID:

R04_YG1047

Do you have a regular brand of [CIGARFILL]s that you usually smoke?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigar smokers.
PATH ID:

R04_YG1945

Do you know the name of the brand of [CIGARFILL]s you [usually smoke/last smoked]?
1

Yes

2

No

GO TO BOX R04_YGR11

-8

DON'T KNOW

GO TO BOX R04_YGR11

-7

REFUSED

GO TO BOX R04_YGR11

ASK: Past 30 day cigar smokers.
DISPLAY: IF R04_YG1047[TC/CL/FC] = 1, DISPLAY “usually smoke”.
ELSE, DISPLAY “last smoked”.
UNDERLINE "name of the brand".
PATH ID:

R04_YG1048

What brand of [CIGARFILL] [do/did] you [usually/last] smoke?
Please select it from the choices below by touching the screen. If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”. ]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers who know the brand name.
DISPLAY: IF R04_YG1047[TC/CL/FC] = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[IF MULTIPLE SCREENS] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS] DISPLAY: If you do not see it
below, touch the box marked “Something else”.
[SHOW PICTURES OF THE MAJOR BRANDS ON THE TOUCHSCREEN.]

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Wave 4 (version 3.0)
BOX ID:

R04_YGR10

If youth respondent selects "Something else" in R04_YG1048[TC/CL/FC]_BRAND, go to
R04_YG1049[TC/CL/FC].
Else, if youth respondent selects brand from images in R04_YG1048[TC/CL/FC]_BRAND, go to
R04_YG1070[TC/CL/FC]_PRODUCT.
Else, go to Box R04_YGR11.
PATH ID:

R04_YG1049

You said that your brand was not listed. What is it?
1

__________________________

GO TO BOX R04_YGR11

-8

DON'T KNOW

GO TO BOX R04_YGR11

-7

REFUSED

GO TO BOX R04_YGR11

ASK: Past 30 day traditional cigar/cigarillo/filtered cigar smokers that know the name of the brand they
smoke who selected "Something else" for their brand.
PATH ID:

R04_YG1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] [do/did] you [usually/last] smoke?
Please select it from the choices below by touching the screen. [ If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”. ]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers that know the name of the brand they smoke who selected a brand
image.
DISPLAY: IF R04_YG1047[TC/CL/FC] = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[IF MULTIPLE SCREENS] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS] DISPLAY: If you do not see it
below, touch the box marked “Something else”.
[SHOW PICTURES OR TEXT ON THE TOUCHSCREEN OF THE MAJOR PRODUCTS ASSOCIATED
WITH BRAND SELECTED IN R04_YG1048[TC/CL/FC]_BRAND]
BOX ID:

R04_YGR21

If youth respondent selects "Something else" in R04_YG1070[TC/CL/FC]_PRODUCT, go to
R04_YG1071[TC/CL/FC].
Else, go to Box R04_YGR11.

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Wave 4 (version 3.0)
PATH ID:

R04_YG1071

You said that the type of [BRANDFILL]s that you smoke was not listed. What type is it?
1

__________________________

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day traditional cigar/cigarillo/filtered cigar smokers that know the name of the brand they
smoke who selected a brand image, but selected "Something else" for their subbrand image.
BOX ID:

R04_YGR11

Youth respondents who have smoked a cigar today, yesterday or the day before yesterday AND who
selected a valid brand AND valid product, go to R04_YG0104[TC/CL/FC].
Else, go to Box R04_YGD04.
PATH ID:

R04_YG0104

You said earlier that you smoked a [CIGARFILL] [TIME OF LAST USE].
Think about the very last [CIGARFILL] you smoked. Was the brand [NEQBRAND]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked a cigar in the past hour, sometime today, yesterday or the
day before yesterday AND who selected a valid brand AND valid product.
DISPLAY: IF R04_YG0100[TC/CL/FC] = 1, FILL [TIME OF LAST USE] WITH “in the past hour”.
ELSE, IF R04_YG0100[TC/CL/FC] = 2, FILL [TIME OF LAST USE] WITH “sometime today”.
ELSE, IF R04_YG0100[TC/CL/FC] = 3, FILL [TIME OF LAST USE] WITH “yesterday”.
ELSE, IF R04_YG0100[TC/CL/FC] = 4, FILL [TIME OF LAST USE] WITH “the day before yesterday”.
FILL [NEQBRAND] WITH RESPONSE TO R04_YG1070[TC/CL/FC]_PRODUCT.
BOX ID:

R04_YGD04

Display question R04_YG1060[TC/CL/FC], R04_YG1085[TC/CL/FC], R04_YG1062[TC/CL/FC],
R04_YG1075[TC/CL/FC], R04_YG1063[TC/CL/FC], R04_YG1064[TC/CL/FC],
R04_YG1066[TC/CL/FC], on one screen. Show the intro/transition text from R04_YG1060[TC/CL/FC]
first, then show each item with a Yes/No response. As each item is answered, show the next one.
Randomize order of R04_YG1060[TC/CL/FC] through R04_YG1066[TC/CL/FC].

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PATH ID:

R04_YG1060

The next questions are about the reasons people smoke [CIGARFILL]s. Please select which reasons
apply to you.
I smoke [CIGARFILL]s because…
They are affordable.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
PATH ID:

R04_YG1085

I can smoke [CIGARFILL]s at times when or in places where smoking cigarettes isn’t allowed.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
PATH ID:

R04_YG1062

They might be less harmful to me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
PATH ID:

R04_YG1075

They might be less harmful to people around me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.

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PATH ID:

R04_YG1063

[CIGARFILL]s come in flavors I like.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
BOX ID:

R04_YGR15

Youth respondents who have smoked cigarettes in the past year, go to R04_YG1064[TC/CL/FC].
Else, go to R04_YG1066[TC/CL/FC].
PATH ID:

R04_YG1064

Smoking [CIGARFILL]s helps people quit smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers who have also smoked cigarettes in the past year.
PATH ID:

R04_YG1066

Smoking a [CIGARFILL] feels like smoking a regular cigarette.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.

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PATH ID:

R04_YG1139

Please rate your level of agreement for each statement using the following scale: 1 = not true of me at
all to 4 = very true of me.
It is easier to talk and get along with other people when smoking a [CIGARFILL].
1

Not true of me at all

2
3
4

Very true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
DISPLAY: DISPLAY SCALE FOR THE R04_YG1139[TC/CL/FC]-1141[TC/CL/FC] SERIES.
PATH ID:

R04_YG1140

While smoking a [CIGARFILL], I feel more confident with other people.
1

Not true of me at all

2
3
4

Very true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
DISPLAY: DISPLAY SCALE FOR THE R04_YG1139[TC/CL/FC]-1141[TC/CL/FC] SERIES.
PATH ID:

R04_YG1141

I smoke [CIGARFILL]s much more when I am with other people.
1

Not true of me at all

2
3
4

Very true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day cigar smokers.
DISPLAY: DISPLAY SCALE FOR THE R04_YG1139[TC/CL/FC]-1141[TC/CL/FC] SERIES.

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BOX ID:

R04_YGR16

If youth respondent has remaining loops to complete for non-blunt cigar types, return to R04_YGT04
and repeat section.
Else, if youth respondent has no more remaining loops to complete for cigars, go to Box R04_YPT01.

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PIPE
BOX ID:

R04_YPT01

The next questions are about smoking tobacco in a pipe.
Pipes come in many shapes and sizes. They all have a bowl that holds the tobacco and a stem. Pipe
tobacco is often sold loose in packages or tins. In the following section, we are only asking about
smoking pipes filled with tobacco. The picture below shows a typical pipe and some pipe tobacco.
[SHOW GENERIC IMAGE OF PIPE AND PIPE TOBACCO]
BOX ID:

R04_YPR02

New baseline youth respondents, go to R04_YP1001_NB.
Continuing youth respondents, go to R04_YP1002_12M.
PATH ID:

R04_YP1002_12M

In the past 12 months, have you smoked a pipe filled with tobacco, even one or two puffs?
[SHOW GENERIC IMAGE OF PIPE AND PIPE TOBACCO]
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents.
BOX ID:

R04_YPV01

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_PIPE_YOUTH = 1 (Ever user) Youth respondents who have ever smoked pipe
tobacco.
R04_EVER_NEVER_PIPE_YOUTH = 2 (Never user) = Youth respondents who have not ever smoked
pipe tobacco.
R04_INIT_PIPE_YOUTH = 1 (Initiator) Youth respondents who initiated pipe use between Waves or
new baseline youth respondents who have ever smoked a pipe.
BOX ID:

R04_YPR01

Youth respondents who have ever smoked a pipe, go to R04_YP1112.
Else, go to Box R04_YHT01.

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PATH ID:

R04_YP1112

When was the last time you smoked a pipe, even one or two puffs?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YPV02

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YPV02

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YPV02

6

1 to 4 years ago

GO TO BOX R04_YPV02

7

5 or more years ago

GO TO BOX R04_YPV02

-8

DON'T KNOW

GO TO BOX R04_YPV02

-7

REFUSED

GO TO BOX R04_YPV02

ASK: Youth respondents who have ever smoked a pipe.
PATH ID:

R04_YP0100

When did you last smoke a pipe filled with tobacco?
1

In the past hour

GO TO R04_YP0103

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YPV02

-8

DON'T KNOW

GO TO BOX R04_YPV02

-7

REFUSED

GO TO BOX R04_YPV02

ASK: Youth respondents who smoked a pipe earlier today or in the past 7 days.
PATH ID:

R04_YP0102

When you last smoked a pipe filled with tobacco [FILL BASED ON R04_YP0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked a pipe today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YP0100]:
IF R04_YP0100 = 2, DISPLAY “today”.
ELSE, IF R04_YP0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YP0100 = 4, DISPLAY “the day before yesterday”.

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PATH ID:

R04_YP0103

How many bowls filled with pipe tobacco [have/did] you [smoked/smoke] [FILL BASED ON
R04_YP0100]? (If less than 1, enter 1.)
1

I__I__I

-8

DON'T KNOW

GO TO BOX R04_YPV02

-7

REFUSED

GO TO BOX R04_YPV02

ASK: Youth respondents who have smoked a pipe in the past hour, today, yesterday or the day before
yesterday.
DISPLAY: IF R04_YP0100 = 1, 2, DISPLAY “have” AND “smoked”.
ELSE, IF R04_YP0100 = 3, 4, DISPLAY “did” AND “smoke”.
FOR [FILL BASED ON R04_YP0100]:
IF R04_YP0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YP0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YP0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YP0103_LC1

The computer recorded that you smoked [R04_YP0103] bowls filled with pipe tobacco
[today/yesterday/the day before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YP0103

2

NEXT

GO TO BOX R04_YPV02

ASK: IF R04_YP0103 > 10.
DISPLAY: IF R04_YP0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YP0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YP0100 = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YPV02

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PAST30DAY_PIPE = 1 (Past 30 day pipe smokers) Youth respondents who have smoked a pipe
in the past 30 days.
BOX ID:

R04_YPR04

Past 30 day pipe smokers, go to R04_YP1022.
Else, go to Box R04_YHT01.

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PATH ID:

R04_YP1022

In the past 30 days, on how many days did you smoke a pipe?
1

I__I__I DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day pipe smokers.
DISPLAY: DISPLAY "days" AS TITLE.
PATH ID:

R04_YP1023

In the past 30 days, on the days you smoked a pipe, how many bowls filled with tobacco did you smoke
per day?
1

Less than 1 bowl per day

2

1 bowl per day

3

2 to 5 bowls per day

4

6 to 10 bowls per day

5

11 to 20 bowls per day

6

More than 20 bowls per day

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day pipe smokers.
PATH ID:

R04_YP1142

In the past 30 days, did anyone sell you pipe tobacco?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day pipe smokers.
PATH ID:

R04_YP1123

In the past 30 days, did anyone refuse to sell you pipe tobacco because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day pipe smokers.

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PATH ID:

R04_YP1118

In the past 30 days, how did you usually get your own pipe tobacco?
1

I gave someone else money to buy it for me

2

I bought it myself from a store

3

I asked someone to give me some

4

Someone offered it to me

5

I bought it from another person

6

I took it from a store or another person

7

I got it some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day pipe smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YPR03

Past 30 day pipe smokers who usually buy pipe tobacco themselves or give someone else money to
buy pipe tobacco for them, go to R04_YP1030.
Else, go to Box R04_YHT01.
PATH ID:

R04_YP1030

[When you give money to someone else, how do they/How do you] usually buy your pipe tobacco?
1

In person

2

From the internet

GO TO R04_YP1034

3

By telephone

GO TO R04_YP1034

-8

DON'T KNOW

GO TO R04_YP1034

-7

REFUSED

GO TO R04_YP1034

ASK: Past 30 day pipe smokers who buy pipe tobacco for themselves or someone else buys it for them.
DISPLAY: IF R04_YP1118 = 1, DISPLAY “When you give money to someone else, how do they”;
ELSE, IF R04_YP1118 = 2, DISPLAY “How do you”.

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PATH ID:

R04_YP1033

Where do [you/they] buy your pipe tobacco most of the time?
1

A convenience store or gas station

2

A supermarket, grocery store, or drug store

3

A warehouse club, such as Sam’s or Costco

4

A smoke shop, tobacco specialty store or tobacco outlet store

5

A duty free shop or military commissary

6

A bar, pub, restaurant or casino

7

A friend or relative

8

A swap meet or flea market

9

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 pipe smokers who buy pipe tobacco themselves or someone else buys for them in
person.
DISPLAY: IF R04_YP1118=1, DISPLAY “they”;
ELSE, IF R04_YP1118=2, DISPLAY "you”
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
PATH ID:

R04_YP1034

Think about the last time you [bought/gave money to someone else to buy you] pipe tobacco. How
much did you pay for it?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO R04_YHT01

-7

REFUSED

GO TO R04_YHT01

ASK: Past 30 day pipe smokers who buy pipe tobacco themselves or someone else buys for them.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
IF R04_YP1118 = 1, DISPLAY "gave money to someone else to buy you".
ELSE, IF R04_YP1118 = 2, DISPLAY "bought".

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PATH ID:

R04_YP1034_LC1

The computer recorded that you paid $[R04_YP1034] for a pouch of pipe tobacco. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YP1034

2

NEXT

GO TO BOX R04_YHT01

ASK: IF R04_YP1034_D > 50.

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HOOKAH
BOX ID:

R04_YHT01

The next questions are about smoking tobacco in a hookah, which is a type of water pipe. It is
sometimes also called a "narghile" pipe. From now on, we will use "hookah" to refer to a water pipe or
narghile pipe. There are many types of hookahs. People often smoke tobacco in hookahs in groups at
cafes or in hookah bars.
People smoke shisha or hookah tobacco in a hookah. Shisha comes in many different flavors. Some
types of shisha contain tobacco and some do not.
[SHOW GENERIC IMAGE OF HOOKAH AND SHISHA]
BOX ID:

R04_YHR01

New baseline youth respondents, go to R04_YH1001_NB.
Continuing youth respondents, go to R04_YH1002_12M.
PATH ID:

R04_YH1002_12M

In the past 12 months, have you smoked tobacco in a hookah, even one or two puffs?
[SHOW GENERIC IMAGE OF HOOKAH]
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents.
BOX ID:

R04_YHV01

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_HOOK_YOUTH = 1 (Ever user) Youth respondents who have ever smoked
hookah.
R04_EVER_NEVER_HOOK_YOUTH = 2 (Never user) Youth respondents who have not ever smoked
hookah.
R04_INIT_HOOK_YOUTH = 1 (Initiator) Youth respondents who initiated hookah use between Waves
or new baseline youth respondents who have ever smoked a hookah.

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BOX ID:

R04_YHR02

New baseline youth who have never heard of a hookah, go to Box R04_YUT01.
Else, continuing youth who have never smoked hookah, and new baseline youth respondents who have
heard of but never smoked hookah, go to R04_YH1103.
Else, new baseline youth respondents who have ever smoked hookah, go to R04_YH1006_NB.
Else, continuing youth respondents who initiated hookah smoking since the previous wave, go to
R04_YH1108.
Else, continuing youth respondents who have ever smoked hookah and had not smoked 100 or more
times in the previous wave, go to R04_YH1005
Else, continuing youth respondents who have ever smoked hookah and had never smoked fairly
regularly in the previous wave, go to Box R04_YH1100.
Else, go to Box R04_YHV02.
PATH ID:

R04_YH1103

Have you ever been curious about smoking tobacco in a hookah?
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of hookah but have never smoked hookah.
PATH ID:

R04_YH1206

Do you think you will smoke tobacco in a hookah in the next year?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but have never smoked hookah.

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PATH ID:

R04_YH1104

Do you think you will try smoking tobacco in a hookah soon?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but have never smoked hookah.
PATH ID:

R04_YH1105

If one of your best friends were to offer you a hookah, would you try it?
1

Definitely yes

GO TO R04_YH9041

2

Probably yes

GO TO R04_YH9041

3

Probably not

GO TO R04_YH9041

4

Definitely not

GO TO R04_YH9041

-8

DON'T KNOW

GO TO R04_YH9041

-7

REFUSED

GO TO R04_YH9041

ASK: Youth respondents who have heard of but have never smoked hookah.
PATH ID:

R04_YH1108

Was the first shisha or hookah tobacco you smoked flavored to taste like menthol, mint, clove, spice,
fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO BOX R04_YHR13

3

I don't know

GO TO BOX R04_YHR13

-8

DON'T KNOW

GO TO BOX R04_YHR13

-7

REFUSED

GO TO BOX R04_YHR13

ASK: Continuing youth respondents who have initiated hookah smoking since the previous wave, and
new baseline youth respondents who have ever smoked hookah.

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PATH ID:

R04_YH1011

What flavor was that first shisha or hookah tobacco you smoked? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who initiated smoking with flavored shisha.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YHR13

Aged-up and continuing youth respondents who have ever smoked hookah (and had not smoked 100 or
more times in the previous wave), and new cohort youth respondents who have ever smoked hookah,
go to R04_YH1005.
Else, go to Box R04_YHR10.
PATH ID:

R04_YH1005

How many times have you smoked tobacco in a hookah in your entire life? Count each sitting or session
where you smoked tobacco in a hookah, whether alone or with others.
1

1

2

2 to 10

3

11 to 20

4

21 to 50

5

51 to 99

6

100 or more

-8

DON'T KNOW

-7

REFUSED

ASK: Aged-up and continuing youth respondents who have ever smoked hookah and had not smoked
100 or more times in the previous wave, and new cohort youth respondents who have ever smoked
hookah.

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BOX ID:

R04_YHR10

Youth respondents who have ever smoked hookah and had never smoked hookah fairly regularly in the
previous wave, go to R04_YH1100.
Else, go to R04_YH1112.
PATH ID:

R04_YH1100

Have you ever smoked tobacco in a hookah fairly regularly?
1

Yes

2

No

GO TO R04_YH1112

-8

DON'T KNOW

GO TO R04_YH1112

-7

REFUSED

GO TO R04_YH1112

ASK: Youth respondents who have ever smoked hookah (and had never smoked fairly regularly in the
previous wave).
PATH ID:

R04_YH1007

How old were you when you first started smoking tobacco in a hookah fairly regularly?
1

|__|__| Years old

-8

DON'T KNOW

GO TO R04_YH1121

-7

REFUSED

GO TO R04_YH1121

ASK: Youth respondents who have ever smoked hookah fairly regularly and did not smoke fairly
regularly in the previous wave.
DISPLAY: DISPLAY "Years old" AS A TITLE.
PATH ID:

R04_YH1007_LC1

The computer recorded that you first started smoking tobacco in a hookah fairly regularly at age
[R04_YH1007]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH1007

2

NEXT

GO TO R04_YH1112

ASK: IF R04_YH1007< =5 OR If R04_YH1007 < R04_YH1006_NB.

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PATH ID:

R04_YH1007_LC2

The computer recorded that you first started smoking tobacco in a hookah fairly regularly at age
[R04_YH1007]. That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH1007

2

NEXT

GO TO R04_YH1112

ASK: IF R04_YH1007 > R04_YOUTHAGE.
PATH ID:

R04_YH1121

When you first started smoking tobacco in a hookah fairly regularly, were you...
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who did not know or refused to report the age they first started smoking
hookah fairly regularly.
PATH ID:

R04_YH1112

When was the last time you smoked tobacco in a hookah, even one or two puffs?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

4

Not in the past 30 days but sometime in the past 6 months

5

Not in the past 6 months but sometime in the past year

6

1 to 4 years ago

7

5 or more years ago

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked hookah.
BOX ID:

R04_YHV02

PROGRAM - CREATE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PAST30DAY_HOOK = 1 (Past 30 day hookah smokers) Youth respondents who have smoked
hookah in the past 30 days.

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BOX ID:

R04_YHR12

Youth respondents who have smoked hookah in the past 7 days, go to R04_YH0100.
Else, youth respondents who have smoked hookah in the past 12 months, go to R04_YH9003.
Else, youth respondents who have ever smoked hookah, go to R04_YH1090.
Else, go to R04_YH9041.
PATH ID:

R04_YH0100

When did you last smoke tobacco in a hookah?
1

In the past hour

GO TO R04_YH0103

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO R04_YH9003

-8

DON'T KNOW

GO TO R04_YH9003

-7

REFUSED

GO TO R04_YH9003

ASK: Youth respondents who have smoked hookah in the past 7 days.
PATH ID:

R04_YH0102

When you last smoked tobacco in a hookah [FILL BASED ON R04_YH0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked hookah today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YH0100]:
IF R04_YH0100 = 2, DISPLAY “today”.
ELSE, IF R04_YH0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YH0100 = 4, DISPLAY “the day before yesterday”.

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PATH ID:

R04_YH0103

How many puffs from a hookah [have/did] you [taken/take] [FILL BASED ON R04_YH0100]?
1

I__I__I

-8

DON'T KNOW

GO TO R04_YH9003

-7

REFUSED

GO TO R04_YH9003

ASK: Youth respondents who have smoked hookah in the past hour, sometime today, yesterday or the
day before yesterday.
DISPLAY: IF R04_YH0100 = 1, 2, DISPLAY “have” AND “taken”.
ELSE, IF R04_YH0100 = 3, 4, DISPLAY “did” AND “take”.
FOR [FILL BASED ON R04_YH0100]:
IF R04_YH0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YH0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YH0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YH0103_LC1

The computer recorded that you took [R04_YH0103] puffs from a hookah [today/yesterday/the day
before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH0103

2

NEXT

GO TO R04_YH9003

ASK: IF R04_YH0103 > 50 OR R04_YH0103 = 11, 22, 33, 44.
DISPLAY: IF R04_YH0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YH0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YH0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YH9003

Which of the following choices best describes your hookah smoking? Usually I smoke hookah tobacco
in a hookah…
1

Every day

2

Weekly

GO TO R04_YH9005

3

Monthly

GO TO R04_YH9004

4

Every couple of months

GO TO R04_YH1090

5

About once a year

GO TO R04_YH1090

-8

DON'T KNOW

GO TO R04_YH1090

-7

REFUSED

GO TO R04_YH1090

ASK: Youth respondents who have smoked hookah in the past 12 months.

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PATH ID:

R04_YH9006

On average, about how many times do you smoke tobacco in a hookah each day? Count each sitting or
session where you smoked tobacco in a hookah, whether alone or with others.
1

I___I___I

-8

DON'T KNOW

GO TO R04_YH1090

-7

REFUSED

GO TO R04_YH1090

ASK: Youth respondents who smoke hookah every day.
PATH ID:

R04_YH9006_LC1

The computer recorded that, on average, you smoke tobacco in a hookah [R04_YH9006] times each
day. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH9006

2

NEXT

GO TO R04_YH1090

ASK: IF R04_YH9006 > 2.
PATH ID:

R04_YH9005

On average, about how many times do you smoke tobacco in a hookah in a week? Count each sitting or
session where you smoked tobacco in a hookah, whether alone or with others.
1

I___I___I

-8

DON'T KNOW

GO TO R04_YH1090

-7

REFUSED

GO TO R04_YH1090

ASK: Youth respondents who smoke hookah weekly.
PATH ID:

R04_YH9005_LC1

The computer recorded that, on average, you smoke tobacco in a hookah [R04_YH9005] times in a
week. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH9005

2

NEXT

GO TO R04_YH1090

ASK: IF R04_YH9005 > 15.

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PATH ID:

R04_YH9004

On average, about how many times do you smoke tobacco in a hookah in a month? Count each sitting
or session where you smoked tobacco in a hookah, whether alone or with others.
1

I___I___I

-8

DON'T KNOW

GO TO R04_YH1090

-7

REFUSED

GO TO R04_YH1090

ASK: Youth respondents who smoke hookah monthly.
PATH ID:

R04_YH9004_LC1

The computer recorded that, on average, you smoke tobacco in a hookah [R04_YH9004] times in a
month. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YH9004

2

NEXT

GO TO R04_YH1090

ASK: IF R04_YH9004 > 50.
PATH ID:

R04_YH1090

Do you own a hookah?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked hookah.
PATH ID:

R04_YH9041

Does anyone [else] living in your home own a hookah?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have heard of hookah, and continuing youth respondents.
DISPLAY: IF R04_EVER_NEVER_HOOK_YOUTH = 1), DISPLAY " else".
ELSE, DO NOT DISPLAY THIS TEXT.

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BOX ID:

R04_YHR03

Past 30 day hookah smokers, go to R04_YH9012.
Else, youth respondents who have ever smoked hookah, go to R04_YH9042.
Else, go to R04_YH9031.
PATH ID:

R04_YH9012

Do you usually share a hookah with others when you smoke?
1

Yes

2

No

GO TO R04_YH9014

-8

DON'T KNOW

GO TO R04_YH9014

-7

REFUSED

GO TO R04_YH9014

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH9013

How many people do you usually share a hookah with?
1

1 other person

2

2 other people

3

3 other people

4

4 or more other people

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers who report sharing with others.
PATH ID:

R04_YH9014

On average, how long is one hookah session for you[ and the people you share it with]?
1

Less than 30 minutes

2

More than 30 minutes up to 1 hour

3

1 to 2 hours

4

More than 2 hours

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
DISPLAY: IF R04_YH9012=1, DISPLAY “ and the people you share it with”. ELSE, DO NOT DISPLAY
THIS TEXT.

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PATH ID:

R04_YH9015

On average, when you [smoke/share a] hookah, how many times is the hookah refilled with tobacco
during a session?
1

0 times

2

1 time

3

2 to 3 times

4

4 or more times

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
DISPLAY: IF R04_YH9012 = 1, DISPLAY “share a”. ELSE, DISPLAY "smoke".
PATH ID:

R04_YH9016

How often do you personally set up the hookah?
1

Every time

2

Most of the time

3

Some of the time

4

Rarely

5

Never, someone else always sets it up for me

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH9011

Where do you usually smoke hookah? Choose all that apply.
1

In your home

2

In someone else's home

3

In a hookah bar or hookah café

4

In a dance club or lounge

5

Somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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PATH ID:

R04_YH1130

In the past 30 days, was any of the shisha or hookah tobacco you smoked flavored to taste like menthol,
mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YH1142

3

I don't know

GO TO R04_YH1142

-8

DON'T KNOW

GO TO R04_YH1142

-7

REFUSED

GO TO R04_YH1142

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1131

Which flavors have you smoked in the past 30 days? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored hookah smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YH1147

On the days you smoked shisha or hookah tobacco in the past 30 days, how often did you smoke
flavored shisha or hookah tobacco?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored hookah smokers.
DISPLAY: UNDERLINE "flavored".

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PATH ID:

R04_YH1142

In the past 30 days, did anyone sell you shisha or hookah tobacco?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1123

In the past 30 days, did anyone refuse to sell you shisha or hookah tobacco because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1118

In the past 30 days, how did you usually get your own shisha or hookah tobacco?
1

I gave someone else money to buy it for me

2

I bought it myself from a store (including a hookah bar or cafe)

3

I asked someone to give me some

4

Someone offered it to me

5

I bought it from another person

6

I took it from a store or another person

7

I got it some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YHR04

Past 30 day hookah smokers who usually buy shisha or hookah tobacco themselves or usually give
someone else money to buy for them, go to R04_YH1030.
Else, go to R04_YH1047.

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PATH ID:

R04_YH1030

[When you give money to someone else, how do they/How do you] usually buy your shisha or hookah
tobacco?
1

In person (such as at a store or hookah bar)

2

From the internet

GO TO R04_YH1047

3

By telephone

GO TO R04_YH1047

-8

DON'T KNOW

GO TO R04_YH1047

-7

REFUSED

GO TO R04_YH1047

ASK: Past 30 day hookah smokers who buy shisha or hookah tobacco for themselves or someone else
buys for them.
DISPLAY: IF R04_YH1118 = 1, DISPLAY “When you give money to someone else, how do they”; IF
R04_YH1118 = 2, DISPLAY “How do you”.
PATH ID:

R04_YH1033

Where do [you/they] buy your shisha or hookah tobacco most of the time?
1

A hookah bar or cafe

2

A convenience store or gas station

3

A supermarket, grocery store, or drug store

4

A warehouse club, such as Sam’s or Costco

5

A smoke shop, tobacco specialty store or tobacco outlet store

6

A duty free shop or military commissary

7

A bar, pub, restaurant or casino

8

A friend or relative

9

A swap meet or flea market

10

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers who buy shisha or hookah tobacco for themselves or someone else
buys for them in person.
DISPLAY: IF R04_YH1118 = 2, DISPLAY “you”. ELSE, IF R04_YH1118 = 1, DISPLAY “they”.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”

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PATH ID:

R04_YH1047

Do you have a regular brand of shisha or hookah tobacco that you usually smoke?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1945

Do you know the name of the brand of shisha or hookah tobacco you [usually smoke/last smoked]?
1

Yes

2

No

GO TO BOX R04_YHD01

-8

DON'T KNOW

GO TO BOX R04_YHD01

-7

REFUSED

GO TO BOX R04_YHD01

ASK: Past 30 day hookah smokers.
DISPLAY: IF R04_YH1047 = 1, DISPLAY “usually smoke”. IF R04_YH1047 = 2, -8, -7, DISPLAY “last
smoked”. UNDERLINE "name of the brand".
PATH ID:

R04_YH1048

What brand of shisha or hookah tobacco [do/did] you [usually/last] smoke?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers who know the brand name.
DISPLAY: IF R04_YH1047 = 1, DISPLAY “do” AND “usually”. IF R04_YH1047 = 2, -8, -7, DISPLAY
“did” AND “last” .
IF MULTIPLE SCREENS, DISPLAY: “If you do not see it below, touch the button marked “NEXT”.
IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS DISPLAY: “If you do not see it
below, touch the box marked “Something else”.”
BOX ID:

R04_YHR05

If youth respondent selects brand in R04_YH1048_BRAND, go to R04_YH1070_PRODUCT.
Else, if youth respondent selects "Something else" in R04_YH1048_BRAND, go to R04_YH1049.
Else, go to Box R04_YHD01.

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PATH ID:

R04_YH1049

You said that your brand was not listed. What is it?
__________________________

GO TO R04_YH9108

-8

1

DON'T KNOW

GO TO BOX R04_YHD01

-7

REFUSED

GO TO BOX R04_YHD01

ASK: Past 30 day hookah smokers that know the name of the brand they smoke who selected
"Something else" for their brand.
PATH ID:

R04_YH1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] [do/did] you [usually/last] smoke?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers that know the name of the brand they smoke who selected a brand
image.
DISPLAY: IF R04_YH1047=1, DISPLAY “do” AND “usually”. IF R04_YH1047 = 2, -8, -7, DISPLAY “did”
AND “last”.
IF MULTIPLE SCREENS, DISPLAY: “If you do not see it below, touch the button marked “NEXT”.
IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS DISPLAY: “If you do not see it
below, touch the box marked “Something else”.”
BOX ID:

R04_YHR06

If youth respondent selects "Something else" in R04_YH1070_PRODUCT, go to R04_YH1071.
Else, go to R04_YH9108.
PATH ID:

R04_YH1071

You said that the type of [BRANDFILL]s that you smoke was not listed. What type is it?
1

__________________________

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers that know the name of the brand they smoke who selected a brand
image, but selected "Something else" for their subbrand image.

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PATH ID:

R04_YH9108

Does this brand of shisha contain tobacco?
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers who selected a brand in R04_YH1048_BRAND or entered their
brand in R04_YH1049.
BOX ID:

R04_YHR08

Youth respondents who smoked hookah today, yesterday or the day before yesterday AND who
selected a valid brand in R04_YH1048_BRAND AND valid product in R04_YH1070_PRODUCT, go to
R04_YH0104.
Else, go to Box R04_YHD01.
PATH ID:

R04_YH0104

You said earlier that you last smoked hookah [TIME OF LAST USE].
Think about the very last puff you took. Was the brand [NEQBRAND]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who smoked hookah in the past hour, sometime today, yesterday or the day
before yesterday AND who selected a valid brand in R04_YH1048_BRAND AND valid product in
R04_YH1070_PRODUCT.
DISPLAY: IF R04_YH0100 = 1, FILL [TIME OF LAST USE] WITH “in the past hour”.
IF R04_YH0100 = 2, FILL [TIME OF LAST USE] WITH “sometime today”.
IF R04_YH0100 = 3, FILL [TIME OF LAST USE] WITH “yesterday”.
IF R04_YH0100 = 4, FILL [TIME OF LAST USE] WITH “the day before yesterday”.
FILL [NEQBRAND] WITH RESPONSE TO R04_YH1070_PRODUCT.

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BOX ID:

R04_YHD01

Display question R04_YH1060, R04_YH1085, R04_YH1062, R04_YH1075, R04_YH1063,
R04_YH1064, R04_YH1069, and R04_YH1073 on one screen. Show the intro/transition text from
R04_YH1060 first, then show each item with a Yes/No response. As each item is answered, show the
next one.
PROGRAM: Randomize order of R04_YH1060 through R04_YH1073.
PATH ID:

R04_YH1060

The next questions are about the reasons people smoke hookah. Please select which reasons apply to
you.
I smoke hookah because…
It is affordable.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1085

I can smoke hookah at times when or in places where smoking cigarettes isn’t allowed.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1062

It might be less harmful to me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.

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PATH ID:

R04_YH1075

It might be less harmful to people around me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH1063

Shisha or hookah tobacco comes in flavors I like.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
BOX ID:

R04_YHR07

Youth respondents who have smoked cigarettes in the past year, go to R04_YH1064.
Else, go to R04_YH1069.
PATH ID:

R04_YH1064

Smoking hookah helps people quit smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers who have also smoked cigarettes in the past year.
PATH ID:

R04_YH1069

I like socializing while smoking hookah.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.

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PATH ID:

R04_YH1073

Smoking hookah is part of my cultural tradition.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day hookah smokers.
PATH ID:

R04_YH9042

Have you ever used another liquid besides water in the bowl of the hookah?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked hookah.
BOX ID:

R04_YHR09

New baseline youth respondents who have heard of hookah, and continuing youth respondents, go to
R04_YH9031.
Else, go to Box R04_YUT01.
PATH ID:

R04_YH9031

Have you ever smoked marijuana in a hookah? (Remember all information you give to the PATH Study
will be kept private.)
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have heard of hookah and continuing youth respondents.
PATH ID:

R04_YH9040

Have you ever smoked herbal or tobacco-free shisha in a hookah?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have heard of hookah, and continuing youth respondents.

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SNUS
BOX ID:

R04_YUT01

Smokeless tobacco is tobacco which you put in your mouth. Smokeless tobacco may be loose or it
may be packaged in small pouches that you place under your lip. Frequently you chew, suck, or spit
while using smokeless tobacco, although for some types you may not need to.
There are many different types of smokeless tobacco which go by lots of different names, so please use
these descriptions and photos to understand what they are.
[SHOW GENERIC IMAGE OF SNUS AND OTHER SMOKELESS TOBACCO]
BOX ID:

R04_YUT03

Snus is a type of smokeless tobacco. Snus usually comes in small pouches, although some snus may
be sold as loose snus. Typically, with most kinds of smokeless tobacco, you spit, but you do not need to
spit when using snus. Common brands of snus include Camel Snus, Marlboro Snus and General Snus.
Please think about your use of snus as you answer the following questions. There will be a separate
section later about other types of smokeless tobacco products (such as dip, spit, chewing tobacco and
smokeless tobacco pouches).
[SHOW GENERIC IMAGE OF SNUS - BOTH LOOSE AND POUCHES]
BOX ID:

R04_YUR14

New baseline youth respondents, go to R04_YU1001_NB.
Continuing youth respondents, go to R04_YU1002_12M.
PATH ID:

R04_YU1002_12M

In the past 12 months, have you used snus, even one or two times?
[SHOW GENERIC IMAGE OF SNUS - BOTH LOOSE AND POUCHES]
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents and new baseline youth respondents who have heard of snus.

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BOX ID:

R04_YUV03

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_SNUS_YOUTH = 1 (Ever user) Youth respondents who have ever used snus.
R04_EVER_NEVER_SNUS_YOUTH = 2 (Never user) Youth respondents who have not ever used
snus.
R04_INIT_SNUS_YOUTH = 1 (Initiator) Youth respondents who initiated snus use between Waves or
new baseline youth respondents who have ever used snus.
BOX ID:

R04_YUR02

New baseline youth respondents who have never heard of snus, go to Box R04_YST01.
Else, continuing youth respondents who have never used snus and new baseline youth respondents
who have heard of snus but have never used it, go to R04_YU1103.
Else, new baseline youth respondents who have ever used snus, go to R04_YU1006_NB.
Else, continuing youth respondents who initiated snus use since the previous wave, go to R04_YU1108.
Else, go to Box R04_YUR16.
PATH ID:

R04_YU1103

Have you ever been curious about using snus?
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used snus.
PATH ID:

R04_YU1206

Do you think you will try snus in the next year?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used snus.

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PATH ID:

R04_YU1104

Do you think you will try snus soon?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used snus.
PATH ID:

R04_YU1105

If one of your best friends were to offer you snus, would you try it?
1

Definitely yes

GO TO BOX R04_YST01

2

Probably yes

GO TO BOX R04_YST01

3

Probably not

GO TO BOX R04_YST01

4

Definitely not

GO TO BOX R04_YST01

-8

DON'T KNOW

GO TO BOX R04_YST01

-7

REFUSED

GO TO BOX R04_YST01

ASK: Youth respondents who have heard of but never used snus.
PATH ID:

R04_YU1108

Was the first snus you used flavored to taste like menthol, mint, wintergreen, spearmint or frost, clove,
spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO BOX R04_YUR16

3

I don't know

GO TO BOX R04_YUR16

-8

DON'T KNOW

GO TO BOX R04_YUR16

-7

REFUSED

GO TO BOX R04_YUR16

ASK: Continuing youth respondents who have initiated snus use since the previous wave, and new
baseline youth respondents who have ever used snus.

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PATH ID:

R04_YU1011

What flavor was that first snus you used? Choose all that apply.
1

Menthol or mint

2

Wintergreen, spearmint or frost

3

Clove or spice

4

Fruit

5

Chocolate

6

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

7

Candy or other sweets

8

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents whose first snus was flavored.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YUR16

Aged-up and continuing youth respondents who have ever used snus (and had not used 100 or more
times in the previous wave) and new cohort youth respondents who have ever used snus, go to
R04_YU1005.
Else, go to Box R04_YUR06.
PATH ID:

R04_YU1005

How many times have you used snus in your entire life?
1

1

2

2 to 10

3

11 to 20

4

21 to 50

5

51 to 99

6

100 or more

-8

DON'T KNOW

-7

REFUSED

ASK: Aged-up and continuing youth respondents who have ever used snus and had not used 100 or
more times in the previous wave, and new cohort youth respondents who have ever used snus.

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BOX ID:

R04_YUR06

Youth respondents who have ever used snus and had never used snus fairly regularly in the previous
wave, go to R04_YU1100.
Else, go to R04_YU1112.
PATH ID:

R04_YU1100

Have you ever used snus fairly regularly?
1

Yes

2

No

GO TO R04_YU1112

-8

DON'T KNOW

GO TO R04_YU1112

-7

REFUSED

GO TO R04_YU1112

ASK: Youth respondents who have ever used snus (and had never used fairly regularly in the previous
wave).
PATH ID:

R04_YU1007

How old were you when you first started using snus fairly regularly?
1

|__|__| Years old

-8

DON'T KNOW

GO TO R04_YU1121

-7

REFUSED

GO TO R04_YU1121

ASK: Youth respondents who have ever used snus fairly regularly and did not use fairly regularly in the
previous wave.
DISPLAY: DISPLAY "Years old" AS A TITLE.
PATH ID:

R04_YU1007_LC1

The computer recorded that you started using snus fairly regularly at age [R04_YU1007]. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YU1007

2

NEXT

GO TO R04_YU1112

ASK: IF R04_YU1007< =8 OR R04_YU1007 < R04_YU1006_NB.

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PATH ID:

R04_YU1007_LC2

The computer recorded that you started using snus fairly regularly at age [R04_YU1007]. That is older
than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YU1007

2

NEXT

GO TO R04_YU1112

ASK: IF R04_YU1007 > R04_YOUTHAGE.
PATH ID:

R04_YU1121

When you first started using snus fairly regularly, were you...
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who did not know or refused to report the age when they started using snus
fairly regularly.
PATH ID:

R04_YU1112

When did you last use snus even one or two times?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YUV04

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YST01

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YST01

6

1 to 4 years ago

GO TO BOX R04_YST01

7

5 or more years ago

GO TO BOX R04_YST01

-8

DON'T KNOW

GO TO BOX R04_YST01

-7

REFUSED

GO TO BOX R04_YST01

ASK: Youth respondents who have ever used snus.

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PATH ID:

R04_YU0100

When did you last use snus?
1

In the past hour

2

Sometime today

GO TO R04_YU0103

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YUV04

-8

DON'T KNOW

GO TO BOX R04_YUV04

-7

REFUSED

GO TO BOX R04_YUV04

ASK: Youth respondents who have used snus in the past 7 days.
PATH ID:

R04_YU0102

When you last used snus [FILL BASED ON R04_YU0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used snus today, yesterday, or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YU0100]: IF R04_YU0100 = 2, DISPLAY “today”.
ELSE, IF R04_YU0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YU0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YU0103

How many times [have/did] you [used/use] snus [FILL BASED ON R04_YU0100]?
1

I___I___I

-8

DON'T KNOW

GO TO BOX R04_YUV04

-7

REFUSED

GO TO BOX R04_YUV04

ASK: Youth respondents who have used snus in the past hour, sometime today, yesterday or the day
before yesterday.
DISPLAY: IF R04_YU0100 = 1, 2, DISPLAY “have” AND “used”.
ELSE, IF R04_YU0100 = 3, 4, DISPLAY “did” AND “use”.
FOR [FILL BASED ON R04_YU0100]:
IF R04_YU0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YU0100 = 3, DISPLAY “yesterday”.
ELSE, IF R04_YU0100 = 4, DISPLAY “the day before yesterday”.

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PATH ID:

R04_YU0103_LC1

The computer recorded that you used snus [R04_YU0103] times [today/yesterday/the day before
yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YU0103

2

NEXT

GO TO BOX R04_YUV04

ASK: IF R04_YU0103 > 20 OR R04_YU0103 = 11.
DISPLAY: IF R04_YU0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YU0100 = 3, DISPLAY "yesterday".
ELSE, IF R04_YU0100 = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YUV04

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PAST30DAY_SNUS = (Past 30 day snus users) Youth respondents who have used snus in the
past 30 days.
R04_PAST30DAY_SNUS_LEVEL = 1 (Past 30 day "Very Light" users) Youth respondents who have
used snus in the past 30 days, and have used snus 10 or fewer times in their lifetime.
R04_PAST30DAY_SNUS_LEVEL = 2 (Past 30 day "Not Light" users) Youth respondents who have
used snus in the past 30 days, and have used snus more than 10 times in their lifetime.
PATH ID:

R04_YU1022

In the past 30 days, on how many days did you use snus?
1

|___|___| DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
DISPLAY: DISPLAY 'DAYS' AS A TITLE.
PATH ID:

R04_YU1023

In the past 30 days, on the days you used snus, how many times did you use snus per day?
1

|___|___|

-8

DON'T KNOW

GO TO R04_YU1130

-7

REFUSED

GO TO R04_YU1130

ASK: Past 30 day snus users.

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PATH ID:

R04_YU1023_LC1

The computer recorded that on the days you used in the past 30 days, you used snus (R04_YU1023)
times a day, on average.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YU1023

2

NEXT

GO TO R04_YU1130

ASK: IF R04_YU1023 > 20.
PATH ID:

R04_YU1130

In the past 30 days, was any of the snus you used flavored to taste like menthol, mint, wintergreen,
spearmint or frost, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YU1142

3

I don't know

GO TO R04_YU1142

-8

DON'T KNOW

GO TO R04_YU1142

-7

REFUSED

GO TO R04_YU1142

ASK: Past 30 day snus users.
PATH ID:

R04_YU1131

Which flavors have you used in the past 30 days? Choose all that apply.
1

Menthol or mint

2

Wintergreen, spearmint or frost

3

Clove or spice

4

Fruit

5

Chocolate

6

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

7

Candy or other sweets

8

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored snus users.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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PATH ID:

R04_YU1147

On the days you used snus in the past 30 days, how often did you use flavored snus?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored snus users.
DISPLAY: UNDERLINE "flavored".
PATH ID:

R04_YU1142

In the past 30 days, did anyone sell you snus?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
PATH ID:

R04_YU1123

In the past 30 days, did anyone refuse to sell you snus because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.

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PATH ID:

R04_YU9041

What type of snus have you used?
[SHOW GENERIC IMAGE OF SNUS - BOTH LOOSE AND POUCHES]
1

Snus pouches

GO TO R04_YU1118

2

Loose snus

GO TO R04_YU1118

3

Both snus pouches and loose snus

-8

DON'T KNOW

GO TO R04_YU1118

-7

REFUSED

GO TO R04_YU1118

ASK: Past 30 day snus users.
PATH ID:

R04_YU9042

You mentioned you have used both loose snus and snus pouches. Which type of snus do you use most
often?
[SHOW GENERIC IMAGE OF SNUS - BOTH LOOSE AND POUCHES]
1

Snus pouches

2

Loose snus

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used both loose snus and snus pouches.

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PATH ID:

R04_YU1118

[Please think of the type of snus you use most often when answering these questions.
]In the past 30 days, how did you usually get your own snus?
1

I gave someone else money to buy it for me

2

I bought it myself from a store

3

I asked someone to give me some

4

Someone offered it to me

5

I bought it from another person

6

I took it from a store or another person

7

I got it some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
DISPLAY: IF R04_YU9041 = 3, DISPLAY "Please think of the type of snus you use most often when
answering these questions.".
ELSE, DO NOT DISPLAY THIS TEXT.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
BOX ID:

R04_YUR04

Past 30 day snus users who usually buy themselves or who give someone else money to buy for them,
go to R04_YU1030.
Else, go to Box R04_YUR17.
PATH ID:

R04_YU1030

[When you give money to someone else, how do they/How do you] usually buy your snus?
1

In person

2

From the internet

GO TO R04_YU1034

3

By telephone

GO TO R04_YU1034

-8

DON'T KNOW

GO TO R04_YU1034

-7

REFUSED

GO TO R04_YU1034

ASK: Past 30 day snus users (including "very light" users) who usually buy snus pouches for
themselves or who gives someone else money to buy for them.
DISPLAY: IF R04_YU1118 = 1, DISPLAY “When you give money to someone else, how do they”.
ELSE, DISPLAY “How do you”.

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PATH ID:

R04_YU1033

Where do [you/they] buy your snus most of the time?
1

A convenience store or gas station

2

A supermarket, grocery store, or drug store

3

A warehouse club, such as Sam’s or Costco

4

A smoke shop, tobacco specialty store or tobacco outlet store

5

A duty free shop or military commissary

6

A bar, pub, restaurant or casino

7

A friend or relative

8

A swap meet or flea market

9

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users (including "very light" users) who buy snus for themselves or someone
else buys for them in person.
DISPLAY: IF R04_YU1118=1, DISPLAY “they”.
ELSE, IF R04_YU1118=2, display “you”.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
BOX ID:

R04_YUR20

Past 30 day "not-light" snus users who buy snus for themselves or someone else buys for them, go to
R04_YU1034.
Else, go to Box R04_YUR17.
PATH ID:

R04_YU1034

Think about the last time you [bought/gave money to someone else to buy you] snus. How much did you
pay for a container of snus?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YUR18

-7

REFUSED

GO TO BOX R04_YUR18

ASK: Past 30 day "not-light" snus users who buy snus for themselves or someone else buys for them.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
IF R04_YU1118 = 1, DISPLAY "gave money to someone else to buy you".
ELSE, IF YU1118 = 2, DISPLAY "bought".

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PATH ID:

R04_YU1034_LC1

The computer recorded that you paid $[R04_YU1034] for a container of snus. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YU1034

2

NEXT

GO TO BOX R04_YUR18

ASK: IF R04_YU1034_D > 6 OR R04_YU1034_D < 1.
BOX ID:

R04_YUR18

Past 30 day "not-light" users of pouched snus who buy for themselves or someone else buys for them,
go to R04_YU9001.
Else, go to Box R04_YUR17.
PATH ID:

R04_YU9001

How many pouches are in the container of snus that you usually buy?
1

I___I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" snus pouch users who buy snus pouches for themselves or someone else
buys for them.
BOX ID:

R04_YUR17

Past 30 day "not light" users, go to R04_YU1047.
Else, past 30 day users, go to R04_YU1945.
Else, go to Box R04_YUD02.
PATH ID:

R04_YU1047

Do you have a regular brand of snus that you usually use?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" snus users.

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PATH ID:

R04_YU1945

Do you know the name of the brand of snus you [usually use/last used]?
1

Yes

2

No

GO TO BOX R04_YUD02

-8

DON'T KNOW

GO TO BOX R04_YUD02

-7

REFUSED

GO TO BOX R04_YUD02

ASK: Past 30 day snus users.
DISPLAY: IF R04_YU1047 = 1, DISPLAY “usually use”.
ELSE, DISPLAY “last used”.
UNDERLINE "name of the brand".
PATH ID:

R04_YU1048

What brand of snus [do/did] you [usually/last] use?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users who know the brand name.
DISPLAY: IF R04_YU1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[If multiple screens] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[If single screen OR last screen of multiple screens] DISPLAY: If you do not see it below, touch the box
marked “Something else”.
BOX ID:

R04_YUR09

If youth respondent selects brand in R04_YU1048_BRAND, go to R04_YU1070_PRODUCT.
Else, if youth respondent selects "Something else" in R04_YU1048_BRAND, go to R04_YU1049.
Else, go to Box R04_YUD02.
PATH ID:

R04_YU1049

You said that your brand was not listed. What is it?
1

__________________________

GO TO BOX R04_YUD02

-8

DON'T KNOW

GO TO BOX R04_YUD02

-7

REFUSED

GO TO BOX R04_YUD02

ASK: Past 30 day snus users that know the name of the brand they use who selected "Something else"
for their brand.

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PATH ID:

R04_YU1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] [do/did] you [usually/last] use?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users that know the name of the brand they use who selected a brand image.
DISPLAY: IF R04_YU1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[If multiple screens] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[If single screen OR last screen of multiple screens] DISPLAY: If you do not see it below, touch the box
marked “Something else”.
BOX ID:

R04_YUR10

If youth respondent selects "Something else" in R04_YU1070_PRODUCT, go to R04_YU1071.
Else, youth respondents who have used snus today, yesterday, or the day before yesterday AND who
selected a valid brand AND valid product, go to R04_YU0104.
Else, go to Box R04_YUD02.
PATH ID:

R04_YU1071

You said that the type of [BRANDFILL]s that you use was not listed. What type is it?
1

__________________________

GO TO BOX R04_YUD02

-8

DON'T KNOW

GO TO BOX R04_YUD02

-7

REFUSED

GO TO BOX R04_YUD02

ASK: Past 30 day snus users that know the name of the brand they use who selected a brand image,
but selected "Something else" for their subbrand image.
BOX ID:

R04_YUR19

Youth respondents who used snus today, yesterday or the day before yesterday AND who selected a
valid brand in R04_YU1048_BRAND AND valid product in R04_YU1070_PRODUCT, go to
R04_YU0104.
Else, go to Box R04_YUD02.

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PATH ID:

R04_YU0104

You said earlier that you last used snus [TIME OF LAST USE].
Think about the very last time you used it. Was the brand [NEQBRAND]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used snus in the past hour, sometime today, yesterday, or the day
before yesterday AND who selected a valid brand AND valid product.
DISPLAY: IF R04_YU0100 = 1, FILL [TIME OF LAST USE] WITH “in the past hour”.
ELSE, IF R04_YU0100 = 2, FILL [TIME OF LAST USE] WITH “sometime today”.
ELSE, IF R04_YU0100 = 3, FILL [TIME OF LAST USE] WITH “yesterday”.
ELSE, IF R04_YU0100 = 4, FILL [TIME OF LAST USE] WITH “the day before yesterday”.
FILL [NEQBRAND] WITH RESPONSE TO R04_YU1070_PRODUCT.
BOX ID:

R04_YUD02

Display question R04_YU1060, R04_YU1085, R04_YU1062, R04_YU1075, R04_YU1063,
R04_YU1064, R04_YU1065, R04_YU1067, R04_YU1076, on one screen. Show the intro/transition text
from R04_YU1060 first, then show each item with a Yes/No response. As each item is answered, show
the next one.
PROGRAM: Randomize order of R04_YU1060 through R04_YU1076.
PATH ID:

R04_YU1060

The next questions are about the reasons people use snus. Please select which reasons apply to you.
I use snus because…
It is affordable.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.

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PATH ID:

R04_YU1085

I can use snus at times when or in places where smoking cigarettes isn’t allowed.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
PATH ID:

R04_YU1062

They might be less harmful to me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
PATH ID:

R04_YU1075

They might be less harmful to people around me than cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
PATH ID:

R04_YU1063

Snus comes in flavors I like.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
BOX ID:

R04_YUR11

Past 30 day snus users who have also smoked cigarettes in the past year, go to R04_YU1064.
Else, go to R04_YU1065.

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PATH ID:

R04_YU1064

Using snus helps people quit smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users who have also smoked cigarettes in the past year.
PATH ID:

R04_YU1065

Snus doesn’t smell.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
PATH ID:

R04_YU1067

Snus doesn’t bother non-tobacco users.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
PATH ID:

R04_YU1076

No one can tell when I am using snus.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users.
BOX ID:

R04_YUR12

Past 30 day snus users who have also smoked cigarettes in the past 30 days, go to R04_YU1086.
Else, go to Box R04_YST01.

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PATH ID:

R04_YU1086

In the past 30 days, have you used snus at times when or in places where you could not smoke
cigarettes?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day snus users who have also smoked cigarettes in the past 30 days.

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SMOKELESS TOBACCO
BOX ID:

R04_YST01

The next questions are about smokeless tobacco other than snus.
Smokeless tobacco is a type of tobacco which you put in your mouth and chew, suck, or spit. It may be
loose or packaged in small pouches that you can place directly in your mouth. There are many kinds of
smokeless tobacco, such as dip, spit, moist snuff, pouches and chewing tobacco. Common brands
include Skoal, Copenhagen, Grizzly, Redman, and Levi Garrett.
The questions will use the phrase “smokeless tobacco” to refer to these products. Please think about
smokeless tobacco products, not including snus, as you answer these questions.
[SHOW GENERIC IMAGE OF SMOKELESS PRODUCTS, EXCLUDING SNUS]
BOX ID:

R04_YSR01

New baseline youth respondents, go to R04_YS1001_NB.
Continuing youth respondents, go to R04_YS1002_12M.
PATH ID:

R04_YS1002_12M

In the past 12 months, have you used smokeless tobacco, such as dip, spit, moist snuff, pouches or
chewing tobacco, even one or two times?
[SHOW GENERIC IMAGE OF SMOKELESS TOBACCO (EXCLUDING SNUS)]
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents and new baseline youth respondents who have ever heard of
smokeless tobacco.
BOX ID:

R04_YSV03

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_SMKLS_YOUTH = 1 (Ever user) Youth respondents who have ever used
smokeless tobacco.
R04_EVER_NEVER_SMKLS_YOUTH = 2 (Never user) Youth respondents who have not ever used
smokeless tobacco.
R04_INIT_SMKLS_YOUTH = 1 (Initiator) Youth respondents who initiated smokeless tobacco use
between Waves or new baseline youth respondents who have ever used smokeless tobacco.

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BOX ID:

R04_YSR02

New baseline youth respondents who have never heard of smokeless tobacco, go to Box R04_YDT01.
Else, continuing youth respondents who have never used smokeless tobacco and new baseline youth
respondents who have heard of smokeless tobacco but have never used it, go to R04_YS1103.
Else, new baseline youth respondents who have ever used smokeless tobacco, go to R04_YS1006_NB.
Else, continuing youth respondents who initiated smokeless tobacco use since the previous wave, go to
R04_YS1108.
Else, go to Box R04_YSR13.
PATH ID:

R04_YS1103

Have you ever been curious about using smokeless tobacco?
1

Very curious

2

Somewhat curious

3

A little curious

4

Not at all curious

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used smokeless tobacco.
PATH ID:

R04_YS1206

Do you think you will try smokeless tobacco in the next year?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used smokeless tobacco.
PATH ID:

R04_YS1104

Do you think you will try smokeless tobacco soon?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have heard of but never used smokeless tobacco.

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PATH ID:

R04_YS1105

If one of your best friends were to offer you smokeless tobacco, would you try it?
1

Definitely yes

GO TO BOX R04_YDT01

2

Probably yes

GO TO BOX R04_YDT01

3

Probably not

GO TO BOX R04_YDT01

4

Definitely not

GO TO BOX R04_YDT01

-8

DON'T KNOW

GO TO BOX R04_YDT01

-7

REFUSED

GO TO BOX R04_YDT01

ASK: Youth respondents who have heard of but never used smokeless tobacco.
PATH ID:

R04_YS1108

Was the first smokeless tobacco product you used flavored to taste like menthol, mint, wintergreen,
spearmint or frost, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO BOX R04_YSR13

3

I don't know

GO TO BOX R04_YSR13

-8

DON'T KNOW

GO TO BOX R04_YSR13

-7

REFUSED

GO TO BOX R04_YSR13

ASK: Continuing youth respondents who have initiated use since the previous wave and new baseline
youth respondents who have ever used smokeless tobacco.
PATH ID:

R04_YS1011

What flavor was that first smokeless tobacco product you used? Choose all that apply.
1

Menthol or mint

2

Wintergreen, spearmint or frost

3

Clove or spice

4

Fruit

5

Chocolate

6

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

7

Candy or other sweets

8

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents whose first smokeless tobacco was flavored.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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BOX ID:

R04_YSR13

Aged-up and continuing youth respondents who have ever used smokeless tobacco (and had not used
100 or more times in the previous wave) and new cohort youth respondents who have ever used
smokeless tobacco, go to R04_YS1005.
Else, go to Box R04_YSR06.

PATH ID:

R04_YS1005

How many times have you used smokeless tobacco in your entire life?
1

1

2

2 to 10

3

11 to 20

4

21 to 50

5

51 to 99

6

100 or more

-8

DON'T KNOW

-7

REFUSED

ASK: Aged-up and continuing youth respondents who have ever used smokeless tobacco and had not
used 100 or more times in the previous wave, and new cohort youth respondents who have ever used
smokeless tobacco.
BOX ID:

R04_YSR06

Youth respondents who have ever used smokeless tobacco and had never used smokeless tobacco
fairly regularly in the previous wave, go to R04_YS1100.
Else, go to R04_YS1112.
PATH ID:

R04_YS1100

Have you ever used smokeless tobacco fairly regularly?
1

Yes

2

No

GO TO R04_YS1112

-8

DON'T KNOW

GO TO R04_YS1112

-7

REFUSED

GO TO R04_YS1112

ASK: Youth respondents who have ever used smokeless tobacco (and had never used fairly regularly in
the previous wave).

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PATH ID:

R04_YS1007

How old were you when you first started using smokeless tobacco fairly regularly?
1

|__|__| Years old

-8

DON'T KNOW

GO TO R04_YS1121

-7

REFUSED

GO TO R04_YS1121

ASK: Youth respondents who have ever used smokeless tobacco fairly regularly and did not use fairly
regularly in the previous wave.
DISPLAY: DISPLAY "Years old" AS A TITLE.
PATH ID:

R04_YS1007_LC1

The computer recorded that you started using smokeless tobacco fairly regularly at age [R04_YS1007].
Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YS1007

2

NEXT

GO TO R04_YS1112

ASK: IF R04_YS1007 < =8 OR R04_YS1007 < R04_YS1006_NB.
PATH ID:

R04_YS1007_LC2

The computer recorded that you started using smokeless tobacco fairly regularly at age [R04_YS1007].
That is older than you are now.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YS1007

2

NEXT

GO TO R04_YS1112

ASK: IF R04_YS1007 > R04_YOUTHAGE.
PATH ID:

R04_YS1121

When you first started using smokeless tobacco fairly regularly, were you...
1

Less than 12 years old,

2

12 to 14 years old, or

3

15 to 17 years old?

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who did not know or refused to report the age when they started using
smokeless tobacco fairly regularly.

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PATH ID:

R04_YS1112

When did you last use smokeless tobacco, even one or two times?
1

Earlier today

2

Not today but sometime in the past 7 days

3

Not in the past 7 days but sometime in the past 30 days

GO TO BOX R04_YSV04

4

Not in the past 30 days but sometime in the past 6 months

GO TO BOX R04_YDT01

5

Not in the past 6 months but sometime in the past year

GO TO BOX R04_YDT01

6

1 to 4 years ago

GO TO BOX R04_YDT01

7

5 or more years ago

GO TO BOX R04_YDT01

-8

DON'T KNOW

GO TO BOX R04_YDT01

-7

REFUSED

GO TO BOX R04_YDT01

ASK: Youth respondents who have ever used smokeless tobacco.
PATH ID:

R04_YS0100

When did you last use smokeless tobacco (not including snus)?
1

In the past hour

GO TO R04_YS0103

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YSV04

-8

DON'T KNOW

GO TO BOX R04_YSV04

-7

REFUSED

GO TO BOX R04_YSV04

ASK: Youth respondents who have used smokeless tobacco in the past 7 days.
PATH ID:

R04_YS0102

When you last used smokeless tobacco (not including snus) [FILL BASED ON R04_YS0100], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used smokeless tobacco today, yesterday, or the day before
yesterday.
DISPLAY: FOR [FILL BASED ON R04_YS0100]: IF R04_YS0100 = 2, DISPLAY “today”.
ELSE, IF R04_YS0100 = 3, DISPLAY "yesterday".
ELSE, IF R04_YS0100 = 4, DISPLAY “the day before yesterday”.

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PATH ID:

R04_YS0103

How many times [have/did] you [used/use] smokeless tobacco (not including snus) [FILL BASED ON
R04_YS0100]?
1

I__I__I

-8

DON'T KNOW

GO TO BOX R04_YSV04

-7

REFUSED

GO TO BOX R04_YSV04

ASK: Youth respondents who have used smokeless tobacco in the past hour, sometime today,
yesterday or the day before yesterday.
DISPLAY: IF R04_YS0100 = 1, 2, DISPLAY “have” AND “used”.
ELSE, IF R04_YS0100 = 3, 4, DISPLAY “did” AND “use”.
FOR [FILL BASED ON R04_YS0100]: IF R04_YS0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YS0100 = 3, DISPLAY "yesterday".
ELSE, IF R04_YS0100 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YS0103_LC1

The computer recorded that you used smokeless tobacco [R04_YS0103] times [today/yesterday/the day
before yesterday]. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YS0103

2

NEXT

GO TO BOX R04_YSV04

ASK: IF R04_YS0103 > 20 OR R04_YS0103 = 11.
DISPLAY: IF R04_YS0100 = 1, 2, DISPLAY “today”.
ELSE, IF R04_YS0100 = 3, DISPLAY "yesterday".
ELSE, IF R04_YS0100 = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YSV04

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PAST30DAY_SMKLS = ("Past 30 day users") Youth respondents who have used smokeless
tobacco in the past 30 days.
R04_PAST30DAY_SMKLS_LEVEL = 1 (Past 30 day "Very Light" users) Youth respondents who
have used smokeless tobacco in the past 30 days, and have used 10 times or less in their lifetime.
R04_PAST30DAY_SMKLS_LEVEL = 2 (Past 30 day "Not Light" users) Youth respondents who have
used smokeless tobacco in the past 30 days, and have used more than 10 times in their lifetime.

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PATH ID:

R04_YS1022

In the past 30 days, on how many days did you use smokeless tobacco?
1

|___|___| DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
DISPLAY: DISPLAY 'DAYS' AS A TITLE.
PATH ID:

R04_YS1023

In the past 30 days, on the days you used smokeless tobacco, how many times did you use smokeless
tobacco per day?
1

|___|___|

-8

DON'T KNOW

GO TO R04_YS1130

-7

REFUSED

GO TO R04_YS1130

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS1023_LC1

The computer recorded that on the days you used in the past 30 days, you used smokeless tobacco
(R04_YS1023) times a day, on average.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YS1023

2

NEXT

GO TO R04_YS1130

ASK: IF R04_YS1023 > 10.
PATH ID:

R04_YS1130

In the past 30 days, was any of the smokeless tobacco you used flavored to taste like menthol, mint,
wintergreen, spearmint or frost, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YS1142

3

I don't know

GO TO R04_YS1142

-8

DON'T KNOW

GO TO R04_YS1142

-7

REFUSED

GO TO R04_YS1142

ASK: Past 30 day smokeless tobacco users.

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PATH ID:

R04_YS1131

Which flavors have you used in the past 30 days? Choose all that apply.
1

Menthol or mint

2

Wintergreen, spearmint or frost

3

Clove or spice

4

Fruit

5

Chocolate

6

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

7

Candy or other sweets

8

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored smokeless tobacco users.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YS1147

On the days you used smokeless tobacco in the past 30 days, how often did you use flavored
smokeless tobacco?
1

All of the time

2

Most of the time

3

Sometimes

4

Rarely

5

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day flavored smokeless tobacco users.
DISPLAY: UNDERLINE "flavored".
PATH ID:

R04_YS1142

In the past 30 days, did anyone sell you smokeless tobacco?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.

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PATH ID:

R04_YS1123

In the past 30 days, did anyone refuse to sell you smokeless tobacco because of your age?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS9041

What type of smokeless tobacco have you used?
[SHOW GENERIC IMAGE OF SMOKELESS TOBACCO (EXCLUDING SNUS)]
1

Loose smokeless tobacco (such as dip, spit or chewing tobacco)

GO TO R04_YS1118

2

Smokeless tobacco pouches (not including snus)

GO TO R04_YS1118

3

Both loose and pouched smokeless tobacco

-8

DON'T KNOW

GO TO R04_YS1118

-7

REFUSED

GO TO R04_YS1118

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS9042

You mentioned you have used both loose and pouched smokeless tobacco. Which type of smokeless
tobacco do you use most often?
[SHOW GENERIC IMAGE OF SMOKELESS TOBACCO - BOTH LOOSE AND POUCHES]
1

Loose smokeless tobacco (such as dip, spit or chewing tobacco)

2

Smokeless tobacco pouches (not including snus)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used both loose and pouched smokeless tobacco.

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PATH ID:

R04_YS1118

In the past 30 days, how did you usually get your own smokeless tobacco?
1

I gave someone else money to buy it for me

2

I bought it myself from a store

3

I asked someone to give me some

4

Someone offered it to me

5

I bought it from another person

6

I took it from a store or another person

7

I got it some other way (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
BOX ID:

R04_YSR04

Past 30 day users who usually buy smokeless tobacco themselves or give someone else money to buy
for them, go to R04_YS1030.
Else, go to Box R04_YSR16.
PATH ID:

R04_YS1030

[When you give money to someone else, how do they/How do you] usually buy your smokeless
tobacco?
1

In person

2

From the internet

GO TO R04_YS1034

3

By telephone

GO TO R04_YS1034

-8

DON'T KNOW

GO TO R04_YS1034

-7

REFUSED

GO TO R04_YS1034

ASK: Past 30 day smokeless tobacco users (including "very light" users) who buy smokeless tobacco
for themselves or someone else buys for them.
DISPLAY: IF R04_YS1118=1, DISPLAY “When you give money to someone else, how do they”.
ELSE, IF R04_YS1118=2, DISPLAY “How do you”.

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PATH ID:

R04_YS1033

Where do [you/they] buy your smokeless tobacco most of the time?
1

A convenience store or gas station

2

A supermarket, grocery store, or drug store

3

A warehouse club, such as Sam’s or Costco

4

A smoke shop, tobacco specialty store or tobacco outlet store

5

A duty free shop or military commissary

6

A bar, pub, restaurant or casino

7

A friend or relative

8

A swap meet or flea market

9

Or from somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users (including "very light" users) who buy smokeless tobacco
for themselves or someone else buys for them in person.
DISPLAY: IF R04_YS1118=1, DISPLAY “they”.
ELSE, IF R04_YS1118=2, DISPLAY “you”
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
BOX ID:

R04_YSR20

Past 30 day "not-light" smokeless tobacco users who buy smokeless tobacco for themselves or
someone else buys for them, go to R04_YS1034.
Else, go to Box R04_YSR16.
PATH ID:

R04_YS1034

Think about the last time you [bought/gave money to someone else to buy you] smokeless tobacco.
How much did you pay for a container of smokeless tobacco?
1

$ I___I___I___I . I___I___I Dollars/Cents

-8

DON'T KNOW

GO TO BOX R04_YSR18

-7

REFUSED

GO TO BOX R04_YSR18

ASK: Past 30 day "not-light" smokeless tobacco users who buy smokeless tobacco for themselves or
someone else buys for them.
DISPLAY: DISPLAY “$” AS LEFT LABEL; “Dollars” AND “Cents” AS TITLES.
IF R04_YS1118=1, DISPLAY "gave money to someone else to buy you".
ELSE, IF YS1118=2, DISPLAY "bought".

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PATH ID:

R04_YS1034_LC1

The computer recorded that you paid $[R04_YS1034] for a container of smokeless tobacco. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YS1034

2

NEXT

GO TO BOX R04_YSR18

ASK: IF R04_YS1034_D > 6 OR R04_YS1034_D < 1.
BOX ID:

R04_YSR18

Past 30 day "not-light" users of pouched smokeless tobacco who buy for themselves or someone else
buys for them, go to R04_YS9001.
Else, go to Box R04_YSR16.
PATH ID:

R04_YS9001

How many pouches are in the container of smokeless tobacco that you usually buy?
1

I___I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" users of pouched smokeless tobacco who buy for themselves or someone
else buys for them.
BOX ID:

R04_YSR16

Past 30 day "not light" users, go to R04_YS1047.
Else, past 30 day users, go to R04_YS1945.
Else, go to Box R04_YSD02.
PATH ID:

R04_YS1047

Do you have a regular brand of smokeless tobacco that you usually use?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" smokeless tobacco users.

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PATH ID:

R04_YS1945

Do you know the name of the brand of smokeless tobacco you [usually use/last used]?
1

Yes

2

No

GO TO BOX R04_YSD02

-8

DON'T KNOW

GO TO BOX R04_YSD02

-7

REFUSED

GO TO BOX R04_YSD02

ASK: Past 30 day smokeless tobacco users.
DISPLAY: IF R04_YS1047 = 1, DISPLAY “usually use”.
ELSE, DISPLAY “last used”.
UNDERLINE "name of the brand".
PATH ID:

R04_YS1048

What brand of smokeless tobacco [do/did] you [usually/last] use?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users who know the brand name.
DISPLAY: IF R04_YS1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[IF MULTIPLE SCREENS] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS] DISPLAY: If you do not see it
below, touch the box marked “Something else”.
BOX ID:

R04_YSR09

If respondent selects brand in R04_YS1048_BRAND, go to R04_YS1070_PRODUCT.
Else, if respondent selects "Something else" in R04_YS1048_BRAND, go to R04_YS1049.
Else, go to Box R04_YSD02.
PATH ID:

R04_YS1049

You said that your brand was not listed. What is it?
1

__________________________

GO TO BOX R04_YSD02

-8

DON'T KNOW

GO TO BOX R04_YSD02

-7

REFUSED

GO TO BOX R04_YSD02

ASK: Past 30 day smokeless tobacco users that know the name of the brand they use who selected
"Something else" for their brand.

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PATH ID:

R04_YS1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] [do/did] you [usually/last] use?
Please select it from the choices below by touching the screen. [If you do not see it below, touch the
button marked “NEXT”./If you do not see it below, touch the box marked “Something else”.]
1

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users that know the name of the brand they use who selected a
brand image.
DISPLAY: IF R04_YS1047 = 1, DISPLAY “do” AND “usually”.
ELSE, DISPLAY “did” AND “last”.
[IF MULTIPLE SCREENS] DISPLAY: If you do not see it below, touch the button marked “NEXT”.
[IF SINGLE SCREEN OR LAST SCREEN OF MULTIPLE SCREENS] DISPLAY: If you do not see it
below, touch the box marked “Something else”.
BOX ID:

R04_YSR10

If youth respondent selects "Something else" in R04_YS1070_PRODUCT, go to R04_YS1071.
Else, youth respondents who have used smokeless tobacco today, yesterday, or the day before
yesterday AND who selected a valid brand AND valid product, go to R04_YS0104.
Else, go to Box R04_YSD02.
PATH ID:

R04_YS1071

You said that the type of [BRANDFILL]s that you use was not listed. What type is it?
1

__________________________

GO TO BOX R04_YSD02

-8

DON'T KNOW

GO TO BOX R04_YSD02

-7

REFUSED

GO TO BOX R04_YSD02

ASK: Past 30 day smokeless tobacco users that know the name of the brand they use who selected a
brand image, but selected "Something else" for their subbrand image.
BOX ID:

R04_YSR19

Youth respondents who used smokeless tobacco today, yesterday or the day before yesterday AND
who selected a valid brand in R04_YS1048_BRAND AND valid product in R04_YS1070_PRODUCT, go
to R04_YS0104.
Else, go to Box R04_YSD02.

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PATH ID:

R04_YS0104

You said earlier that you used smokeless tobacco [TIME OF LAST USE].
Think about the very last time you used it. Was the brand [NEQBRAND]?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used smokeless tobacco in the past hour, sometime today,
yesterday or the day before yesterday AND who selected a product AND valid sub brand.
DISPLAY: IF R04_YS0100 = 1, FILL [TIME OF LAST USE] WITH “in the past hour”.
ELSE, IF R04_YS0100 = 2, FILL [TIME OF LAST USE] WITH “sometime today”.
ELSE, IF R04_YS0100 = 3, FILL [TIME OF LAST USE] WITH “yesterday”.
ELSE, IF R04_YS0100 = 4, FILL [TIME OF LAST USE] WITH “the day before yesterday”.
FILL [NEQBRAND] WITH RESPONSE TO R04_YS1070_PRODUCT.
BOX ID:

R04_YSD02

Display question R04_YS1060, R04_YS1085, R04_YS1062, R04_YS1075, R04_YS1063,
R04_YS1064, R04_YS1065, R04_YS1067 on one screen. Show the intro/transition text from
R04_YS1060 first, then show each item with a Yes/No response. As each item is answered, show the
next one.
PROGRAM: Randomize order of R04_YS1060 through R04_YS1067.
PATH ID:

R04_YS1060

The next questions are about the reasons people use smokeless tobacco. Please select which reasons
apply to you.
I use smokeless tobacco because…
It is affordable.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.

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PATH ID:

R04_YS1085

I can use smokeless tobacco at times when or in places where smoking cigarettes isn’t allowed.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS1062

It might be less harmful to me than smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS1075

It might be less harmful to people around me than cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS1063

Smokeless tobacco comes in flavors I like.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
BOX ID:

R04_YSR11

Past 30 day smokeless tobacco users who have also smoked cigarettes in the past year, go to
R04_YS1064.
Else, go to R04_YS1065.

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PATH ID:

R04_YS1064

Using smokeless tobacco helps people quit smoking cigarettes.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users who have also smoked cigarettes in the past year.
PATH ID:

R04_YS1065

Smokeless tobacco doesn’t smell.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
PATH ID:

R04_YS1067

Smokeless tobacco doesn’t bother non-tobacco users.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users.
BOX ID:

R04_YSR12

Past 30 day smokeless tobacco users who have also smoked cigarettes in the past 30 days, go to
R04_YS1086.
Else, go to Box R04_YDT01.
PATH ID:

R04_YS1086

In the past 30 days, have you used smokeless tobacco at times when or in places where you could not
smoke cigarettes?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day smokeless tobacco users who have also smoked cigarettes in the past 30 days.

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DISSOLVABLE TOBACCO
BOX ID:

R04_YDT01

The next questions ask about another type of tobacco called dissolvable tobacco. You don’t smoke
dissolvable tobacco products – they are made of finely ground flavored tobacco that dissolves in your
mouth.
Dissolvable tobacco products come in a variety of shapes, including small round pellets, thin sticks and
flat strips. Some common brands are Ariva, Stonewall, or Camel Orbs, Sticks or Strips.
[SHOW GENERIC IMAGE OF DISSOLVABLES]
BOX ID:

R04_YDR01

New baseline youth respondents, go to R04_YD1001_NB.
Continuing youth respondents, go to R04_YD1002_12M.
PATH ID:

R04_YD1002_12M

In the past 12 months, have you used dissolvable tobacco products, such as Ariva, Stonewall, or Camel
Orbs, Sticks, or Strips, even one or two times?
[SHOW GENERIC IMAGE OF DISSOLVABLES]
1

Yes

2

No

GO TO BOX R04_YDV01

-8

DON'T KNOW

GO TO BOX R04_YDV01

-7

REFUSED

GO TO BOX R04_YDV01

ASK: Continuing youth respondents and new baseline youth respondents who have ever used
dissolvable tobacco.
PATH ID:

R04_YD1002_30D

In the past 30 days, have you used dissolvable tobacco products, such as Ariva, Stonewall, or Camel
Orbs, Sticks, or Strips, even one or two times?
[SHOW GENERIC IMAGE OF DISSOLVABLES]
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used dissolvable tobacco in the past 12 months.

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BOX ID:

R04_YDV01

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_DISSBL_YOUTH = 1 (Ever user) Youth respondents who have ever used
dissolvable tobacco.
R04_EVER_NEVER_DISSBL_YOUTH = 2 (Never user) Youth respondents who have not ever used
dissolvable tobacco.
R04_INIT_DISSBL_YOUTH = 1 (Initiator) Youth respondents who initiated dissolvable tobacco use
between Waves new baseline youth respondents who have ever used dissolvable tobacco.
R04_PAST30DAY_DISS = 1 (Past 30 day dissolvable users) Youth respondents who used
dissolvable tobacco in the past 30 days.

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BIDIS AND KRETEKS
BOX ID:

R04_YBT01

The next questions are about bidis or kreteks. Bidis are small brown cigarettes wrapped in a leaf and
typically tied on one or both ends with string. Kreteks are clove cigarettes.
[SHOW GENERIC IMAGE OF BIDIS AND KRETEKS]
BOX ID:

R04_YBR01

New baseline youth respondents, go to R04_YB9101_NB.
Continuing youth respondents, go to Box R04_YBR03.
BOX ID:

R04_YBR02

New baseline youth respondents who have heard of bidis and/or kreteks, go to R04_YB9102_NB.
Else, go to Box R04_YBV01.
BOX ID:

R04_YBR03

Continuing youth respondents and new baseline youth respondents who have ever smoked bidis or
kreteks, go to R04_YB9102_12M.
Else, go to Box R04_YBV01.
PATH ID:

R04_YB9102_12M

In the past 12 months, which of the following tobacco products have you tried, even one or two times?
Choose all that apply.
[SHOW GENERIC IMAGE OF BIDIS AND KRETEKS]
1

Bidis

2

Kreteks

3

I have not tried either of these products

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents and new baseline youth respondents who have ever smoked bidis
and/or kreteks
BOX ID:

R04_YBR04

Youth respondents who have smoked bidis and/or kreteks in the past 12 months, go to
R04_YB9102_30D.
Else, go to Box R04_YBV01.

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PATH ID:

R04_YB9102_30D

In the past 30 days, which of the following tobacco products have you tried, even one or two times?
Choose all that apply.
[SHOW GENERIC IMAGE OF BIDIS AND KRETEKS]
1

Bidis

2

Kreteks

3

I have not tried either of these products

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have smoked bidis and/or kreteks in the past 12 months.
BOX ID:

R04_YBV01

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_NEVER_BIDI_YOUTH = 1 (Ever user) Youth respondents who have ever smoked a bidi.
R04_EVER_NEVER_BIDI_YOUTH = 2 (Never user) Youth respondents who have not ever smoked a
bidi.
R04_INIT_BIDI_YOUTH = 1 (Initiator) Youth respondents who initiated bidi use between Waves or new
baseline youth respondents who have ever smoked a bidi.
R04_PAST30DAY_BIDI = 1 Youth respondents who used bidis in the past 30 days.
R04_EVER_NEVER_KRETEK_YOUTH = 1 (Ever user) Youth respondents who have ever smoked a
kretek.
R04_EVER_NEVER_KRETEK_YOUTH = 2 (Never user) Youth respondents who have not ever
smoked a kretek.
R04_INIT_KRETEK_YOUTH = 1 (Initiator) Youth respondents who initiated kretek use between Waves
or new baseline youth respondents who have ever smoked a kretek.
R04_PAST30DAY_KRETEK = 1 Youth respondents who used kreteks in the past 30 days.

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OTHER TOBACCO
PATH ID:

R04_YZ1002

You were just asked questions about cigarettes, electronic nicotine products, traditional cigars,
cigarillos, filtered cigars, pipes, hookahs, snus, smokeless tobacco, dissolvable tobacco, bidis and
kreteks.
Besides these products, have you ever used any other tobacco products? Please do not include
products such as a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge, or pill.
1

Yes (SPECIFY)

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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NEW PRODUCT - PLACEHOLDER
BOX ID:

R04_YZV01

CREATE THE FOLLOWING VARIABLE AND SET = 2: R04_NEW_PRODUCT_SECTION.
BOX ID:

R04_YZR01

If R04_NEW_PRODUCT_SECTION = 1, continue with R04_YZ1005.
Else, go to Box R04_YVV01.
PATH ID:

R04_YZ1005

How many [units of tobacco product] have you [smoked/used] in your entire life?
1

1 or more [units] but never a whole one

2

1 to 10

3

11 to 20

4

21 to 50

5

51 to 99

6

100 or more

7

I have never [smoked/used] [tobacco product]

-8

DON'T KNOW

-7

REFUSED

GO TO BOX R04_YYV01

ASK: All youth respondents.
PATH ID:

R04_YZ1008

When you first started [smoking/using] [tobacco product], were they flavored to taste like menthol, mint,
clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?
1

Yes

2

No

GO TO R04_YZ9029

3

I don't know

GO TO R04_YZ9029

-8

DON'T KNOW

GO TO R04_YZ9029

-7

REFUSED

GO TO R04_YZ9029

ASK: Youth respondents who have ever used [tobacco product].

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PATH ID:

R04_YZ1011

Which flavor did you first start using? Choose all that apply.
1

Menthol or mint

2

Clove or spice

3

Fruit

4

Chocolate

5

An alcoholic drink (such as wine, cognac, margarita or other cocktails)

6

Candy or other sweets

7

Some other flavor (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used flavored [tobacco product].
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”
PATH ID:

R04_YZ9029

About how long has it been since you last [smoked/used] a [tobacco product]?
1

I___I___I DAYS

2

I___I___I MONTHS

3

I___I___I YEARS

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used [tobacco product].
PATH ID:

R04_YZ1100

Have you ever [smoked/used] a [tobacco product] fairly regularly?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used a [tobacco product].

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FIRST TOBACCO PRODUCT
BOX ID:

R04_YYV01

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_EVER_USE_TOB = Youth respondents who have ever used any type of tobacco product(s) in
lifetime.
R04_EVER_USE_CIGSONLY = Youth respondents who have ever used only cigarettes, and no other
products, in lifetime.
R04_EVER_USE_DUAL = Youth respondents who have ever used cigarettes and at least one other
tobacco product in lifetime.
R04_EVER_USE_TOBXCIGS = Youth respondents who have ever used any tobacco products,
excluding cigarettes, in lifetime.
R04_PAST30DAY_TOB = Youth respondents who have used any tobacco product(s) in the past 30
days.
R04_PASTYEAR_TOB_USE = Youth respondents who have used any tobacco product(s) in the past
12 months.
BOX ID:

R04_YYR01

New baseline youth respondents who started using 2 or more products at the same age, go to
R04_YY0601.
Else, continuing youth respondents who had not used any tobacco products at previous wave and
initiated use of 2 or more products at the same age, go to R04_YY0601.
Else, go to the next section.

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PATH ID:

R04_YY0601

You mentioned that you started using [LIST OF ALL PRODUCTS INITIATED/USED AT EARLIEST
AGE] [in the past 12 months/at age {EARLIEST AGE}]. Which type of tobacco did you try first?
1

Cigarettes

2

E-cigarettes or other electronic nicotine products

3

Traditional cigars

4

Cigarillos

5

Filtered cigars

7

Shisha or hookah tobacco

9

Snus

8

Smokeless tobacco (other than snus)

14

Other (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who used 2 or more products at the age they first started using
any tobacco and continuing youth respondents who initiated two or more products since the previous
wave (not including pipe, dissolvable tobacco, bidis, and kreteks).
DISPLAY: LIST OF ALL PRODUCTS MAY ONLY INCLUDE CIGARETTES, E-PRODUCTS,
TRADITIONAL CIGARS, CIGARILLOS, FILTERED CIGARS, HOOKAH, SNUS, SMOKELESS
TOBACCO.
IF R04_YOUTHTYPE = 1, DISPLAY "in the past 12 months"; AND [LIST OF ALL PRODUCTS
INITIATED], FOR ALL PRODUCTS FOR WHICH R04_INIT_[PRODUCT]_YOUTH = 1.
(R04_INIT_CIGS_YOUTH, R04_INIT_EPRODS_YOUTH, R04_INIT_GTRAD_YOUTH,
R04_INIT_GRILLO_YOUTH, R04_INIT_GFILTR_YOUTH, R04_INIT_HOOK_YOUTH,
R04_INIT_SNUS_YOUTH, R04_INIT_SMKLS_YOUTH)
IF R04_YOUTHTYPE = 2, 3, DISPLAY "at age {EARLIEST AGE}" AND FILL {EARLIEST AGE} WITH
THE AGE THE RESPONDENT FIRST STARTED USING TOBACCO; FOR [LIST OF ALL PRODUCTS
USED AT EARLIEST AGE], LIST ALL THE PRODUCTS FOR WHICH R04_Y*1006_NB = EARLIEST
AGE OF TOBACCO USE. (R04_YC1006_NB, R04_YV1006_NB, R04_YG1006TC_NB,
R04_YC1006CL_NB, R04_YC1006FC_NB, R04_YH1006_NB, R04_YU1006_NB, R04_YS1006_NB)
IF [LIST OF ALL PRODUCTS INITIATED/USED AT EARLIEST AGE] HAS TWO PRODUCTS,
CONNECT THE PRODUCTS WITH "and".
IF [LIST OF ALL PRODUCTS INITIATED/USED AT EARLIEST AGE] HAS THREE OR MORE
PRODUCTS, CONNECT THE PRODUCTS WITH COMMAS AND INCLUDE "and" BEFORE THE
FINAL PRODUCT.
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”

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NICOTINE DEPENDENCE AND CESSATION / QUITTER
BOX ID:

R04_YNR04E

Youth respondents who have used any e-products in the past 12 months, go to Box R04_YNT03.
Else, youth respondents who have used any other tobacco product(s) in the past 12 months, go to Box
R04_YNT02.
Else, go to Box R04_YRT01.
BOX ID:

R04_YNT03

IF R04_PASTYEAR_TOB_USE = 2, DISPLAY THE FOLLOWING TEXT:
The next questions ask about your experience with electronic nicotine products.
IF R04_PASTYEAR_TOB_USE = 3, DISPLAY THE FOLLOWING TEXT:
The next questions ask about your experience with electronic nicotine products. Please think only about
electronic nicotine products as you answer these questions. We will ask you questions about other
products later.
PATH ID:

R04_YN0703E

How soon after you wake up do you want to use electronic nicotine products?
1

Within 5 minutes

2

From 6 to 30 minutes

3

From more than 30 minutes to 1 hour

4

After more than 1 hour but less than 24 hours

5

I rarely want to use electronic nicotine products

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.
PATH ID:

R04_YN0704E

Do you ever have strong cravings to use electronic nicotine products?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.

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PATH ID:

R04_YN0705E

Have you ever felt like you really needed to use electronic nicotine products?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.
PATH ID:

R04_YN0055E

Please rate your level of agreement for each statement using the following scale: 1= not true of me at all
to 5=extremely true of me.
I find myself reaching for electronic nicotine products without thinking about it.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.
BOX ID:

R04_YND02E

PROGRAM: Randomize order of items R04_YN0025E - R04_YN0080E.
PATH ID:

R04_YN0025E

I frequently crave electronic nicotine products.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.

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PATH ID:

R04_YN0045E

My electronic nicotine product use is out of control.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.
PATH ID:

R04_YN0070E

Using electronic nicotine products really helps me feel better if I’ve been feeling down.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.
PATH ID:

R04_YN0075E

Using electronic nicotine products helps me think better.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.

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PATH ID:

R04_YN0080E

I would feel alone without my electronic nicotine products.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months.
BOX ID:

R04_YNR03E

Youth respondents who reported that they rarely want to use e-products after waking up, go to Box
R04_YNR06.
Else, youth respondents who have used any e-products in the past 12 months, go to R04_YN0060E.
PATH ID:

R04_YN0060E

I usually want to use electronic nicotine products right after I wake up.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any e-products in the past 12 months and did not report that
they rarely want to use e-products after waking up.
BOX ID:

R04_YNR06

Youth respondents who are past 30 day “not light” users of any e-products, go to R04_YN0126E.
Else, youth respondents who have used any e-product and at least one other tobacco product in the
past 12 months, go to Box R04_YNT02.
Else, go to R04_YN0330_12M.

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Youth Questionnaire – Extended Interview

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0126E

Have you tried to completely stop using electronic nicotine products within the past 12 months?
1

Yes

2

No

GO TO R04_YN0127E

-8

DON'T KNOW

GO TO R04_YN0127E

-7

REFUSED

GO TO R04_YN0127E

ASK: Past 30 day "not-light" users of any e-products.
PATH ID:

R04_YN0120E

In the past 12 months, have you stopped using electronic nicotine products for one day or longer
because you were trying to quit for good?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" users of any e-products who have tried to quit using e-products in the past
12 months.
PATH ID:

R04_YN0127E

Are you seriously thinking about quitting electronic nicotine products?
1

Yes, within the next 30 days

2

Yes, within the next 6 months

3

Yes, within the year

4

Yes, but not within the year

5

No, I am not seriously thinking about quitting

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" users of any e-products.
BOX ID:

R04_YNR02E

Youth respondents who have used any e-product and at least one other tobacco product in the past 12
months, go to Box R04_YNT02.
Else, go to R04_YN0330_12M.
BOX ID:

R04_YNT02

You mentioned that you use [TOBACCO PRODUCT LIST]. Please think about [all of these
products/both of these products/this product] as you answer the following questions.

PATH – Wave 4
Youth Questionnaire – Extended Interview

188

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0703

How soon after you wake up do you want to use tobacco?
1

Within 5 minutes

2

From 6 to 30 minutes

3

From more than 30 minutes to 1 hour

4

After more than 1 hour but less than 24 hours

5

I rarely want to use tobacco

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.
PATH ID:

R04_YN0704

Do you ever have strong cravings to use tobacco?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.
PATH ID:

R04_YN0705

Have you ever felt like you really needed to use tobacco?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.

PATH – Wave 4
Youth Questionnaire – Extended Interview

189

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0055

Please rate your level of agreement for each statement using the following scale: 1= not true of me at all
to 5=extremely true of me.
I find myself reaching for a tobacco product without thinking about it.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.
BOX ID:

R04_YND04

PROGRAM: Randomize order of items R04_YN0025 - R04_YN0080.
PATH ID:

R04_YN0025

I frequently crave tobacco.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.

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Youth Questionnaire – Extended Interview

190

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0045

My tobacco use is out of control.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.
PATH ID:

R04_YN0070

Using tobacco really helps me feel better if I’ve been feeling down.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.
PATH ID:

R04_YN0075

Using tobacco helps me think better.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.

PATH – Wave 4
Youth Questionnaire – Extended Interview

191

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0080

I would feel alone without my tobacco.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product.
BOX ID:

R04_YNR03

Youth respondents who reported that they rarely want to use tobacco after waking up, go to Box
R04_YNR05.
Else, youth respondents who have used tobacco in the past 12 months, go to R04_YN0060.
PATH ID:

R04_YN0060

I usually want to use tobacco right after I wake up.
1

Not true of me at all

2
3
4
5

Extremely true of me

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product(s) in the past 12 months, including
respondents who used e-products and at least one other tobacco product, and did not report that they
rarely want to use tobacco after waking up.
BOX ID:

R04_YNR05

Youth respondents who have used any tobacco products in the past 30 days, excluding cigarette only
users and e-product only users, go to R04_YN0126.
Else, youth respondents who are past 30 day “not light” users of cigarettes, go to R04_YN0127.
Else, go to R04_YN0330_12M.

PATH – Wave 4
Youth Questionnaire – Extended Interview

192

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0126

Have you tried to completely stop using all tobacco products within the past 12 months?
1

Yes

2

No

GO TO R04_YN0127

-8

DON'T KNOW

GO TO R04_YN0127

-7

REFUSED

GO TO R04_YN0127

ASK: Youth respondents who have used any tobacco products in the past 30 days, excluding cigarette
only users and e-product only users.
PATH ID:

R04_YN0120

In the past 12 months, have you stopped using all tobacco products for one day or longer because you
were trying to quit for good?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have tried to quit using all tobacco in the past 12 months, excluding
cigarette only users and e-product only users.

PATH – Wave 4
Youth Questionnaire – Extended Interview

193

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0127

Are you seriously thinking about quitting [cigarettes/all tobacco products/cigarettes and tobacco
products]?
1

Yes, within the next 30 days

2

Yes, within the next 6 months

3

Yes, within the year

4

Yes, but not within the year

5

No, I am not seriously thinking about quitting

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco (excluding e-products) in the past 30 days.
DISPLAY: IF CIGARETTE SMOKER ONLY (R04_PAST30DAY_CIGS_LEVEL = 2 AND
(R04_PAST30DAY_GTRAD = 2 AND R04_PAST30DAY_GRILLO = 2 AND R04_PAST30DAY_GFILTR
= 2 AND R04_PAST30DAY_PIPE = 2 AND R04_PAST30DAY_HOOK = 2 AND
R04_PAST30DAY_SNUS = 2 AND R04_PAST30DAY_SMKLS = 2 AND R04_PAST30DAY_DISS = 2
AND R04_PAST30DAY_BIDI = 2 AND R04_PAST30DAY_KRETEK = 2)), DISPLAY “cigarettes”.
IF NON-CIGARETTE TOBACCO USER (R04_PAST30DAY_CIGS = 2 OR
R04_PAST30DAY_CIGS_LEVEL = 1) AND R04_PAST30DAY_TOB = 1, DISPLAY “ all tobacco
products”.
IF CIGARETTE AND OTHER TOBACCO PRODUCT USER (R04_PAST30DAY_CIGS_LEVEL = 2 AND
(R04_PAST30DAY_GTRAD_LEVEL = 2 OR R04_PAST30DAY_GRILLO_LEVEL = 2 OR
R04_PAST30DAY_GFILTR_LEVEL = 2 OR R04_PAST30DAY_PIPE = 1 OR
R04_PAST30DAY_HOOK = 1 OR R04_PAST30DAY_SNUS_LEVEL = 2 OR
R04_PAST30DAY_SMKLS_LEVEL = 2 OR R04_PAST30DAY_DISS = 1 OR R04_PAST30DAY_BIDI =
1 OR R04_PAST30DAY_KRETEK = 1)) DISPLAY “cigarettes and tobacco products”.
BOX ID:

R04_YNR02

Youth respondents who are past 30 day "not-light" cigarette smokers who have used any other tobacco
products (excluding e-products) in the past 30 days, go to Box R04_YNT05.
Else, youth respondents who are past 30 day “not-light” cigarette smokers and have not used any other
products, go to R04_YC1210.
Else, go to R04_YN0330_12M.
BOX ID:

R04_YNT05

The next questions ask about your experience with cigarettes. Please think only about cigarettes as you
answer these questions.

PATH – Wave 4
Youth Questionnaire – Extended Interview

194

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1210

Do you want to completely stop smoking cigarettes?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers.
BOX ID:

R04_YNR01

Past 30 day "not-light" cigarette smokers who have not tried to quit using all tobacco in the past 12
months, go to R04_YC1215.
Else, past 30 day “not-light” cigarette smokers who tried to quit using all tobacco in the past 12 months,
go to R04_YC1220.
PATH ID:

R04_YC1215

In the past 12 months, have you tried to completely stop smoking cigarettes?
1

Yes

2

No

GO TO R04_YC1230

-8

DON'T KNOW

GO TO R04_YC1230

-7

REFUSED

GO TO R04_YC1230

ASK: Past 30 day "not-light" cigarette smokers who have not tried to quit using all tobacco in the past 12
months.
PATH ID:

R04_YC1220

In the past 12 months, how many times have you stopped smoking for one day or longer because you
were trying to quit smoking cigarettes for good?
1

I__I__I__I

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers who have tried to quit smoking in the past 12 months.

PATH – Wave 4
Youth Questionnaire – Extended Interview

195

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1220_LC1

The computer recorded that you stopped smoking for one day or longer [R04_YC1220] times in the past
12 months because you were trying to quit smoking cigarettes for good. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YC1220

2

NEXT

GO TO R04_YC1225

ASK: IF R04_YC1220 > 100.
PATH ID:

R04_YC1225

When you last tried to quit for good, how long did you stay off cigarettes? Please choose the first
answer that fits.
1

Less than 1 day

2

1 to 7 days

3

More than 7 days but less than 30 days

4

More than 30 days but less than 6 months

5

More than 6 months but less than 1 year

6

1 year or more

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers who have tried to quit smoking in the past 12 months.
PATH ID:

R04_YC1230

If you decided to quit cigarettes for good, how likely is it that you would succeed?
1

Very likely

2

Somewhat likely

3

Somewhat unlikely

4

Very unlikely

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day "not-light" cigarette smokers.

PATH – Wave 4
Youth Questionnaire – Extended Interview

196

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0330_12M

In the past 12 months, have you used a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal
spray, lozenge or pill?
1

Yes

2

No

GO TO R04_YN0331_12M

-8

DON'T KNOW

GO TO R04_YN0331_12M

-7

REFUSED

GO TO R04_YN0331_12M

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months.
PATH ID:

R04_YN0307

When did you last use a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or
pill?
1

In the past hour

GO TO R04_YN0309

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO R04_YN0331_12M

-8

DON'T KNOW

GO TO R04_YN0331_12M

-7

REFUSED

GO TO R04_YN0331_12M

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months, and
who has used NRT in the past 12 months.
PATH ID:

R04_YN0308

When you last used a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or pill
[FILL BASED ON R04_YN0307], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months, and
used NRT today, yesterday or the day before yesterday.
DISPLAY: [FILL BASED ON R04_YN0307]:
IF R04_YN0307 = 2, DISPLAY "sometime today".
IF R04_YN0307 = 3, DISPLAY "yesterday".
IF R04_YN0307 = 4, DISPLAY “the day before yesterday”.

PATH – Wave 4
Youth Questionnaire – Extended Interview

197

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0309

When you last used a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or pill
[FILL BASED ON R04_YN0307], how many did you use?
1

I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months, and
used NRT in the past hour, today, yesterday or the day before yesterday.
DISPLAY: IF R04_YN0307 = 1, 2, DISPLAY “today”.
IF R04_YN0307 = 3, DISPLAY "yesterday".
IF R04_YN0307 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YN0309_LC1

The computer recorded that [today/yesterday/the day before yesterday], you used a nicotine patch,
nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or pill [R04_YN0309] times.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YN0309

2

NEXT

GO TO R04_YN0331_12M

ASK: IF R04_YN0309 = 0 OR R04_YN0309 > 5.
DISPLAY: IF R04_YN0307 = 1, 2, DISPLAY “today”.
IF R04_YN0307 = 3, DISPLAY “yesterday”.
IF R04_YN0307 = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YN0331_12M

In the past 12 months, have you used any of the following prescription drugs: Chantix, varenicline,
Wellbutrin, Zyban, or bupropion?
1

Yes

2

No

GO TO BOX R04_YRT01

-8

DON'T KNOW

GO TO BOX R04_YRT01

-7

REFUSED

GO TO BOX R04_YRT01

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months.

PATH – Wave 4
Youth Questionnaire – Extended Interview

198

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0327

When did you last use Chantix, varenicline, Wellbutrin, Zyban, or bupropion?
1

In the past hour

2

Sometime today

GO TO R04_YN0329

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YRT01

-8

DON'T KNOW

GO TO BOX R04_YRT01

-7

REFUSED

GO TO BOX R04_YRT01

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months, and
who have used a prescription drug in the past 12 months.
PATH ID:

R04_YN0328

When you last used Chantix, varenicline, Wellbutrin, Zyban, or bupropion [FILL BASED ON
R04_YN0327], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months, and
who have used a prescription drug today, yesterday or the day before yesterday.
DISPLAY: IF R04_YN0327 = 2, DISPLAY "today".
IF R04_YN0327 = 3, DISPLAY "yesterday".
IF R04_YN0327 = 4, DISPLAY “the day before yesterday”.
ELSE, DISPLAY TEXT AS SHOWN IN OPTIONS SELECTED IN R04_YN0327, MAKING FIRST
LETTER LOWERCASE.

PATH – Wave 4
Youth Questionnaire – Extended Interview

199

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YN0329

When you used Chantix, varenicline, Wellbutrin, Zyban, or bupropion [FILL BASED ON R04_YN0327],
how many did you take?
1

I___I___I

-8

DON'T KNOW

GO TO BOX R04_YRT01

-7

REFUSED

GO TO BOX R04_YRT01

ASK: Youth respondents who have used any tobacco product or e-product in the past 12 months, and
who have used a prescription drug in the past hour, today, yesterday or the day before yesterday.
DISPLAY: IF R04_YN0327 = 1, 2, DISPLAY “today”.
IF R04_YN0327 = 3, DISPLAY "yesterday"
IF R04_YN0327 = 4, DISPLAY “the day before yesterday”.
ELSE, DISPLAY TEXT AS SHOWN IN OPTIONS SELECTED IN R04_YN0327, MAKING FIRST
LETTER LOWERCASE.
PATH ID:

R04_YN0329_LC1

The computer recorded that [today/yesterday/the day before yesterday], you used Chantix, varenicline,
Wellbutrin, Zyban, or bupropion [R04_YN0329] times.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YN0329

2

NEXT

GO TO BOX R04_YRT01

ASK: IF R04_YN0329 = 0 OR IF R04_YN0329 > 5.
DISPLAY: IF R04_YN0327 = 1, 2, DISPLAY “today”.
IF R04_YN0327 = 3, DISPLAY “yesterday”.
IF R04_YN0327 = 4, DISPLAY “the day before yesterday”.

PATH – Wave 4
Youth Questionnaire – Extended Interview

200

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)

PACKAGING AND HEALTH WARNINGS
BOX ID:

R04_YRT01

The next questions ask about things you may have seen or read about tobacco products.
PATH ID:

R04_YR0142

In the past 12 months, how often have you thought about the chemicals contained in tobacco products?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YR0005

In the past 30 days, how often, if at all, have you noticed the health warnings on cigarette packs?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YRR01

If youth respondent has ever smoked cigarettes and has noticed health warnings in the past 30 days, go
to R04_YR0202.
Else, if youth respondent has never smoked cigarettes and has noticed health warnings in the past 30
days, go to R04_YR0055.
Else, go to R04_YR0110.

PATH – Wave 4
Youth Questionnaire – Extended Interview

201

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0202

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
cigarette packs?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a cigarette and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0010

In the past 30 days, how often, if at all, have the health warnings stopped you from having a cigarette
when you were about to smoke one?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a cigarette and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0015

In the past 30 days, have you tried to avoid looking at or thinking about the health warnings on cigarette
packs - such as covering them up, keeping them out of sight, using a cigarette case, avoiding certain
warnings, or any other means?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a cigarette and have noticed health warnings in the
past 30 days.

PATH – Wave 4
Youth Questionnaire – Extended Interview

202

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0025

How believable do you consider the health warnings on cigarette packs to be?
1

Not at all believable

2

A little believable

3

Somewhat believable

4

Very believable

5

Extremely believable

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a cigarette and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0035

To what extent, if at all, do the health warnings on cigarette packs make you think about the health risks
of smoking?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked a cigarette and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0203

To what extent, if at all, do the health warnings on cigarette packs make you never want to smoke
again?
1

Not at all

GO TO R04_YR0110

2

A little

GO TO R04_YR0110

3

Somewhat

GO TO R04_YR0110

4

A lot

GO TO R04_YR0110

-8

DON'T KNOW

GO TO R04_YR0110

-7

REFUSED

GO TO R04_YR0110

ASK: Youth respondents who have ever smoked a cigarette and have noticed health warnings in the
past 30 days.

PATH – Wave 4
Youth Questionnaire – Extended Interview

203

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0055

To what extent, if at all, have the health warnings on cigarette packs made you less likely to start
smoking?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have never smoked a cigarette and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0110

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of ecigarettes, e-liquid or other electronic nicotine products?
[SHOW GENERIC IMAGE OF E-PRODUCTS BY SUBTYPE WITH ENP LABEL]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YRR16

If youth respondent has ever used e-products and has noticed health warnings in the past 30 days, go
to R04_YR0222.
Else, go to R04_YR0115.

PATH – Wave 4
Youth Questionnaire – Extended Interview

204

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0222

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
packages of e-cigarettes, e-liquid or other electronic nicotine products?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used e-products and have noticed health warnings in the past
30 days.
PATH ID:

R04_YR0226

To what extent, if at all, do the health warnings on packages of e-cigarettes, e-liquid or other electronic
nicotine products make you think about the health risks of using them?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used e-products and have noticed health warnings in the past
30 days.
PATH ID:

R04_YR0115

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of traditional
cigars?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire – Extended Interview

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_YRR17

If youth respondent has ever smoked traditional cigars and has noticed health warnings in the past 30
days, go to R04_YR0229.
Else, go to R04_YR0120.
PATH ID:

R04_YR0229

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
packages of traditional cigars?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked traditional cigars and have noticed health warnings in
the past 30 days.
PATH ID:

R04_YR0233

To what extent, if at all, do the health warnings on packages of traditional cigars make you think about
the health risks of smoking?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked traditional cigars and have noticed health warnings in
the past 30 days.

PATH – Wave 4
Youth Questionnaire – Extended Interview

206

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0120

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of cigarillos?
[SHOW GENERIC IMAGE OF CIGARILLOS]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YRR18

If youth respondent has ever smoked cigarillos and has noticed health warnings in the past 30 days, go
to R04_YR0236.
Else, go to R04_YR0125.
PATH ID:

R04_YR0236

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
packages of cigarillos?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked cigarillos and have noticed health warnings in the past
30 days.

PATH – Wave 4
Youth Questionnaire – Extended Interview

207

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0240

To what extent, if at all, do the health warnings on packages of cigarillos make you think about the
health risks of smoking?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked cigarillos and have noticed health warnings in the past
30 days.
PATH ID:

R04_YR0125

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of filtered
cigars?
[SHOW GENERIC IMAGE OF FILTERED CIGARS]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YRR19

If youth respondent has ever smoked filtered cigars and has noticed health warnings in the past 30
days, go to R04_YR0243.
Else, go to R04_YR0130.

PATH – Wave 4
Youth Questionnaire – Extended Interview

208

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0243

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
packages of filtered cigars?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked filtered cigars and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0247

To what extent, if at all, do the health warnings on packages of filtered cigars make you think about the
health risks of smoking?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked filtered cigars and have noticed health warnings in the
past 30 days.
PATH ID:

R04_YR0130

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of pipe
tobacco?
[SHOW GENERIC IMAGE OF PIPE AND PIPE TOBACCO]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – Extended Interview

209

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0135

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of shisha or
hookah tobacco?
[SHOW GENERIC IMAGE OF HOOKAH AND SHISHA]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YRR20

If youth respondent has ever smoked hookah and has noticed health warnings in the past 30 days, go to
R04_YR0250.
Else, go to R04_YR0206.
PATH ID:

R04_YR0250

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
packages of shisha or hookah tobacco?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked hookah and have noticed health warnings in the past
30 days.

PATH – Wave 4
Youth Questionnaire – Extended Interview

210

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0254

To what extent, if at all, do the health warnings on packages of shisha or hookah tobacco make you
think about the health risks of smoking?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever smoked hookah and have noticed health warnings in the past
30 days.
PATH ID:

R04_YR0206

In the past 30 days, how often, if at all, have you noticed the health warnings on snus containers?
[SHOW GENERIC IMAGE OF SNUS]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YRR15

If youth respondent has ever used snus and has noticed health warnings in the past 30 days, go to
R04_YR0207.
Else, go to R04_YR0060.

PATH – Wave 4
Youth Questionnaire – Extended Interview

211

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YR0207

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on snus
containers?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used snus and have noticed health warnings in the past 30
days.
PATH ID:

R04_YR0211

To what extent, if at all, do the health warnings on snus containers make you think about the health risks
of using snus?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used snus and have noticed health warnings in the past 30
days.
PATH ID:

R04_YR0060

In the past 30 days, how often, if at all, have you noticed the health warnings on packages of other
smokeless tobacco products like dip, spit and chew?
[SHOW GENERIC IMAGE OF SMOKELESS PRODUCTS (EXCLUDING]
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – Extended Interview

212

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
BOX ID:

R04_YRR04

If youth respondent has ever used smokeless tobacco and noticed health warnings in the past 30 days,
go to R04_YR0205.
Else, go to Box R04_YXT30.
PATH ID:

R04_YR0205

In the past 30 days, how often, if at all, have you read or looked closely at the health warnings on
smokeless tobacco packages?
1

Never

2

Rarely

3

Sometimes

4

Often

5

Very often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used smokeless tobacco and have noticed health warnings in
the past 30 days.
PATH ID:

R04_YR0085

To what extent, if at all, do the health warnings on packages of smokeless tobacco products make you
think about the health risks of using smokeless tobacco products?
1

Not at all

2

A little

3

Somewhat

4

A lot

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have ever used smokeless tobacco and have noticed health warnings in
the past 30 days.

PATH – Wave 4
Youth Questionnaire – Extended Interview

213

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)

PRODUCT REGULATION - MODIFIED RISK TOBACCO PRODUCTS
BOX ID:

R04_YXT30

The next questions ask about your opinions on using tobacco, including e-cigarettes and other
electronic nicotine products.
PATH ID:

R04_YN0250

Do you believe nicotine is the main substance in tobacco that makes people want to use tobacco
products?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0667

Please tell me how much you agree or disagree with the following statement.
Some tobacco products are safer than others.
1

Strongly agree

2

Agree

3

Neither agree nor disagree

4

Disagree

5

Strongly disagree

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – Extended Interview

214

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YX0723

Do you think a tobacco product described as additive-free is less harmful, about the same, or more
harmful than a regular tobacco product?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "additive-free".
PATH ID:

R04_YX0724

Do you think a tobacco product described as organic is less harmful, about the same, or more harmful
than a regular tobacco product?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "organic".
PATH ID:

R04_YC9050

How harmful do you think cigarettes are to health?
1

Not at all harmful

2

Slightly harmful

3

Somewhat harmful

4

Very harmful

5

Extremely harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – Extended Interview

215

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1149

How harmful do you think the nicotine in cigarettes is to health?
1

Not at all harmful

2

Slightly harmful

3

Somewhat harmful

4

Very harmful

5

Extremely harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "nicotine".
PATH ID:

R04_YC1125

How much do you think people harm themselves when they smoke cigarettes?
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YC1170

How much do you think people harm themselves when they smoke cigarettes some days but not every
day?
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – Extended Interview

216

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC1180

How long do you think someone has to smoke cigarettes before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YC9047

In your opinion, do you think that cigarettes with lower amounts of nicotine are less harmful, about the
same, or more harmful to a person's health than regular cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YC9040

Do you think cigarettes flavored like menthol or mint are less harmful, no different, or more harmful than
regular cigarettes?
1

Less harmful

2

No different

3

More harmful

4

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – Extended Interview

217

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC9118

Do you think cigarettes flavored like menthol or mint are easier to smoke, about the same, or harder to
smoke than regular cigarettes?
1

Easier to smoke

2

About the same

3

Harder to smoke

4

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YC1124

How likely is someone to become addicted to cigarettes?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YC9043

How likely are you to become addicted to cigarettes?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "you".

PATH – Wave 4
Youth Questionnaire – Extended Interview

218

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YC9120

Do you believe nicotine is the chemical that causes most of the cancer caused by smoking cigarettes?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YV1125

How much do you think people harm themselves when they use e-cigarettes or other electronic nicotine
products?
[SHOW GENERIC IMAGE OF E-PRODUCTS BY SUBTYPE WITH ENP LABEL]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YV1149

How harmful do you think the nicotine in e-cigarettes or other electronic nicotine products is to health?
1

Not at all harmful

2

Slightly harmful

3

Somewhat harmful

4

Very harmful

5

Extremely harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "nicotine".

PATH – Wave 4
Youth Questionnaire – Extended Interview

219

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1180

How long do you think someone has to use e-cigarettes or other electronic nicotine products before it
harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YV1099

Do you think using e-cigarettes or other electronic nicotine products is less harmful, about the same, or
more harmful than smoking cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "e-cigarettes or other electronic nicotine products" AND "cigarettes".
PATH ID:

R04_YV1153

Do you think flavored e-cigarettes (other than mint or menthol) are easier to use, about the same, or
harder to use than tobacco-flavored or unflavored e-cigarettes?
1

Easier to use

2

About the same

3

Harder to use

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "flavored", "other than mint or menthol","tobacco-flavored" AND "unflavored".

PATH – Wave 4
Youth Questionnaire – Extended Interview

220

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YV1148

Do you think using menthol or mint flavored e-cigarettes is less harmful, about the same, or more
harmful than using tobacco-flavored or unflavored e-cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "menthol", "mint", "tobacco-flavored" AND "unflavored".
PATH ID:

R04_YV1152

Do you think using flavored e-cigarettes (other than mint or menthol) is less harmful, about the same, or
more harmful than using tobacco-flavored or unflavored e-cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "flavored", "other than mint or menthol","tobacco-flavored" AND "unflavored".
PATH ID:

R04_YV1124

How likely is someone to become addicted to e-cigarettes or other electronic nicotine products?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – Extended Interview

221

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9025

How much do you think people harm themselves when they smoke traditional cigars?
[SHOW GENERIC IMAGE OF TRADITIONAL CIGARS]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG1180

How long do you think someone has to smoke traditional cigars before before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG9097

Do you think smoking traditional cigars is less harmful, about the same, or more harmful than smoking
cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "traditional cigars" AND "cigarettes".

PATH – Wave 4
Youth Questionnaire – Extended Interview

222

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9026

How much do you think people harm themselves when they smoke cigarillos?
[SHOW GENERIC IMAGE OF CIGARILLOS]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG9047

How much do you think people harm themselves when they smoke cigarillos some days but not every
day?
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG9048

How long do you think someone has to smoke cigarillos before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – Extended Interview

223

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9098

Do you think smoking cigarillos is less harmful, about the same, or more harmful than smoking
cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "cigarillos" AND "cigarettes".
PATH ID:

R04_YG9125

How likely is someone to become addicted to cigarillos?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG9027

How much do you think people harm themselves when they smoke filtered cigars?
[SHOW GENERIC IMAGE OF FILTERED CIGARS]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – Extended Interview

224

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9054

How much do you think people harm themselves when they smoke filtered cigars some days but not
every day?
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG9055

How long do you think someone has to smoke filtered cigars before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YG9099

Do you think smoking filtered cigars is less harmful, about the same, or more harmful than smoking
cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "filtered cigars" AND "cigarettes".

PATH – Wave 4
Youth Questionnaire – Extended Interview

225

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YG9126

How likely is someone to become addicted to filtered cigars?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YH1125

How much do you think people harm themselves when they smoke shisha or hookah tobacco?
[SHOW GENERIC IMAGE OF HOOKAH AND SHISHA]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YH9044

How harmful is it to be around people who are smoking shisha or hookah tobacco?
1

Not at all harmful

2

Slightly harmful

3

Somewhat harmful

4

Very harmful

5

Extremely harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

PATH – Wave 4
Youth Questionnaire – Extended Interview

226

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH9110

Do you think shisha that does not contain tobacco is less harmful, about the same, or more harmful than
shisha that does contain tobacco?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "does not contain tobacco" AND "does contain tobacco".
PATH ID:

R04_YH1180

How long do you think someone has to smoke shisha or hookah tobacco before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YH1099

Do you think smoking hookah is less harmful, about the same, or more harmful than smoking
cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "hookah" AND "cigarettes".

PATH – Wave 4
Youth Questionnaire – Extended Interview

227

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
PATH ID:

R04_YH1124

How likely is someone to become addicted to shisha or hookah tobacco?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YU1125

How much do you think people harm themselves when they use snus?
[SHOW GENERIC IMAGE OF SNUS]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YU1170

How much do you think people harm themselves when they use snus some days but not every day?
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH ID:

R04_YU1180

How long do you think someone has to use snus before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YU1099

Do you think using snus is less harmful, about the same, or more harmful than smoking cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "snus" AND "cigarettes".
PATH ID:

R04_YU1124

How likely is someone to become addicted to snus?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH ID:

R04_YS1125

How much do you think people harm themselves when they use smokeless tobacco? (Smokeless
tobacco includes dip, spit or chew.)
[SHOW GENERIC IMAGE OF SMOKELESS TOBACCO (EXCLUDING SNUS)]
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YS1170

How much do you think people harm themselves when they use smokeless tobacco some days but not
every day?
1

No harm

2

A little harm

3

Some harm

4

A lot of harm

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YS1180

How long do you think someone has to use smokeless tobacco before it harms their health?
1

It will never harm their health

2

Less than a year

3

1 year

4

5 years

5

10 years

6

20 years or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH ID:

R04_YS1099

Do you think using smokeless tobacco is less harmful, about the same, or more harmful than smoking
cigarettes?
1

Less harmful

2

About the same

3

More harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "smokeless tobacco" AND "cigarettes".
PATH ID:

R04_YS1124

How likely is someone to become addicted to smokeless tobacco?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0759

Sometimes people who are trying to quit using tobacco use nicotine replacement products such as
nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge, or pill.
How harmful do you think the nicotine in these products is to health?
1

Not at all harmful

2

Slightly harmful

3

Somewhat harmful

4

Very harmful

5

Extremely harmful

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "nicotine".

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BOX ID:

R04_YXV01

CREATE AN ARRAY USEPROD WITH 12 ELEMENTS - ONE FOR EACH TOBACCO TYPE THAT
IDENTIFIES WHETHER THE RESPONDENT IS A PAST 30 DAY USER OF THE SPECIFIC
TOBACCO TYPE.
USEPROD(1-12): Past 30 day users of: (1) cigarettes; (2) [e-cigarettes / electronic nicotine product /
electronic nicotine products]; (3) traditional cigars; (4) cigarillos; (5) filtered cigars; (6) pipe tobacco (7)
shisha or hookah tobacco; (8) snus (9) smokeless tobacco; (10) dissolvable tobacco; (11) bids; (12)
kreteks.
DISPLAY: If [USEPROD(1-12)] is a list and contains two products, connect the products with "and". If it
has three or more products, connect the products with commas and include "and" before the final
product in the list. Display all products bold with lowercase letters.
For USEPROD(2): If respondent is a current user of e-cigarettes and R04_EPRODCOUNT = 1, display
“e-cigarettes”. Else, if R04_EPRODCOUNT = 1, display “electronic nicotine product”. Else, display
“electronic nicotine products”.
BOX ID:

R04_YYR02

Youth respondents who have ever smoked cigarettes and are past 30 day users of any other product,
go to R04_YX0300.
Else, youth respondents who have ever used e-products and are past 30 day users of any other
product, go to R04_YX0301.
Else, youth respondents who are past 30 day users of any product, go to R04_YX0307.
Else, go to Box R04_YXT05.
PATH ID:

R04_YX0300

How much do you agree or disagree with this statement?
I have considered switching completely from using [USEPROD(2-12)] to smoking cigarettes.
1

Strongly agree

2

Agree

3

Neither agree nor disagree

4

Disagree

5

Strongly disagree

-8

DON'T KNOW

-7

REFUSED

ASK: Ever cigarette smokers who are past 30 days users of at least one non-cigarette tobacco product
[USEPROD(2-12) = 1]. (This question is asked one time about the product(s) the respondent has used
in the past 30 days (USEPROD list), excluding cigarettes, and asks about switching completely from
those product(s) to cigarettes.)
DISPLAY: UNDERLINE "completely".

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BOX ID:

R04_YXR11

Youth respondents who have ever used e-products and are past 30 day users of any other product, go
to R04_YX0301.
Else, go to Box R04_YXR10.
PATH ID:

R04_YX0301

How much do you agree or disagree with this statement?
I have considered switching completely from using [USEPROD(1, 3-12)] to using e-cigarettes or other
electronic nicotine products.
1

Strongly agree

2

Agree

3

Neither agree nor disagree

4

Disagree

5

Strongly disagree

-8

DON'T KNOW

-7

REFUSED

ASK: Ever e-product users who are past 30 days users of at least one tobacco product [USEPROD(1,
3-12) = 1]. (This question is asked one time about the product(s) the respondent has used in the past
30 days, excluding e-products, and asks about switching completely from those product(s) to eproducts.)
DISPLAY: UNDERLINE "completely".
BOX ID:

R04_YXR10

Youth respondents who are past 30 day users of any product, go to R04_YX0307.
Else, go to Box R04_YXT05.

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PATH ID:

R04_YX0307

Have you considered switching from [USEPROD(1-12)] to any of the following products? Choose all
that apply.
1

I have not considered switching to another product

2

Cigarettes

3

E-cigarettes or other electronic nicotine products

4

Traditional cigars

5

Cigarillos

6

Filtered cigars

10

Pipes

7

Hookahs

8

Snus

9

[Other smokeless/Smokeless] tobacco such as, moist snuff, dip, spit, or chewing tobacco

13

Dissolvable tobacco

11

Bidis

12

Kreteks

-8

DON'T KNOW

-7

REFUSED

ASK: Past 30 day users of [USEPROD(1-12)]. (This question is repeated for each product the
respondent has used in the past 30 days. The response options are the products the respondent has
not used in the past 30 days. If the respondent has used every product in the past 30 days, resulting in
no options presented, this question is not asked.)
DISPLAY: UNDERLINE "switching". Bold [USEPROD(1-12)].
IF R04_PAST30DAY_SNUS = 1 AND R04_PAST30DAY_SMKLS != 1, DISPLAY option 9 as "Other
smokeless tobacco such as moist snuff, dip, spit, or chewing tobacco".
ELSE, IF R04_PAST30DAY_SMKLS != 1, DISPLAY "Smokeless tobacco such as moist snuff, dip, spit,
or chewing tobacco".

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MEDIA USE
BOX ID:

R04_YXT05

The next questions ask about your TV, radio, internet and cell phone use.
PATH ID:

R04_YX0494

On an average weekday, about how much time do you spend watching television and streaming videos
that include commercials?
1

None

2

Half hour or less

3

About 1 hour

4

About 2 hours

5

About 3 hours

6

About 4 hours

7

About 5 hours

8

About 6 hours

9

7 hours or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "weekday".
PATH ID:

R04_YX0495

On an average weekend day, how much time do you spend watching television and streaming videos
that includes commercials?
1

None

2

Less than 1 hour

3

1 to 2 hours

4

3 to 4 hours

5

5 to 6 hours

6

7 to 8 hours

7

9 to 10 hours

8

11 hours or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "weekend".

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PATH ID:

R04_YX0060

On an average weekday, how much time do you spend listening to the radio or online radio stations that
include commercials?
1

None

2

Half hour or less

3

About 1 hour

4

About 2 hours

5

About 3 hours

6

About 4 hours

7

About 5 hours

8

About 6 hours

9

7 hours or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "weekday".
PATH ID:

R04_YX0061

On an average weekend day, how much time do you spend listening to the radio or online radio stations
that include commercials?
1

None

2

Less than 1 hour

3

1 to 2 hours

4

3 to 4 hours

5

5 to 6 hours

6

7 to 8 hours

7

9 to 10 hours

8

11 hours or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "weekend".

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PATH ID:

R04_YX0763

On an average weekday, how many hours do you spend on the internet, not including time spent for
work or school? Include time spent on the internet from a computer, tablet, or smartphone.
1

None

2

Half hour or less

3

About 1 hour

4

About 2 hours

5

About 3 hours

6

About 4 hours

7

About 5 hours

8

About 6 hours

9

7 hours or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "weekday".
PATH ID:

R04_YX0771

On an average weekend day, how many hours do you spend on the internet, not including time spent
for work or school? Include time spent on the internet from a computer, tablet, or smartphone.
1

None

2

Less than 1 hour

3

1 to 2 hours

4

3 to 4 hours

5

5 to 6 hours

6

7 to 8 hours

7

9 to 10 hours

8

11 hours or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "weekend".

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PATH ID:

R04_YX0062

Sometimes people use the internet to connect with other people online through social networks like
Facebook, Google Plus, YouTube, LinkedIn, Twitter, Tumblr, Instagram, Pinterest, or Snapchat. This is
often called social media.
Do you have a social media account?
1

Yes

2

No

GO TO R04_YX0503

-8

DON'T KNOW

GO TO R04_YX0503

-7

REFUSED

GO TO R04_YX0503

ASK: All youth respondents.
PATH ID:

R04_YX0317

About how often do you visit your social media accounts?
1

More than once a day

2

About once a day

3

3-5 days a week

4

1-2 days a week

5

Every few weeks

6

Less often

7

Never

-8

DON'T KNOW

-7

REFUSED

GO TO R04_YX0503

ASK: Youth respondents who have a social media account.

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PATH ID:

R04_YX0686

In the past 12 months, have you liked or followed any of the following tobacco product, e-cigarette, or
other electronic nicotine product brands on Facebook, Twitter or other social media sites? Choose all
that apply.
0

I have not liked or followed any brands on social media sites

1

Camel

2

Marlboro

3

Newport

4

American Spirit

5

Vuse

6

Blu

7

Logic

8

MarkTen

9

NJOY

10

eGo

11

iTaste

12

Black & Mild

13

Swisher Sweets

14

Dutch Masters

15

Phillies Blunts

16

Zig Zag

17

Skoal

18

Redman

19

Grizzly

20

Copenhagen

21

Some other brand (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have a social media account (excluding those who never visit their social
media account).
DISPLAY: IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY
QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer
keyboard.”

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PATH ID:

R04_YX0503

Please indicate if you use any of the following. Choose all that apply.
1

Smartphone, such as an iPhone, Android, Blackberry, or Windows phone

2

Cell phone without internet

3

A handheld device made primarily for e-book reading, such as a Nook or Kindle ereader but NOT a Kindle Fire

4

A tablet computer like an iPad, Samsung Galaxy Tab, Google Nexus, or Kindle Fire

5

A desktop or laptop computer

6

A game console like Xbox or PlayStation

7

An iPod or other MP3 player

8

A portable gaming device like a PSP or Sega Genesis game player

9

I do not use any of these devices

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YXR12

New baseline youth respondents who have any device other than a cell phone without internet, go to
R04_YX0496_NB.
Else, go to Box R04_YXT02.

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SECONDHAND SMOKE EXPOSURE
BOX ID:

R04_YXT02

The next questions ask about the rules of using tobacco inside your home.
PATH ID:

R04_YX0671

Not including yourself, does anyone who lives with you now do any of the following? Choose all that
apply.
1

Smoke cigarettes

2

Use e-cigarettes or other electronic nicotine products

3

Use snus

4

Use other types of smokeless tobacco such as dip, spit or chew

5

Smoke traditional cigars, cigarillos, or filtered cigars

6

Smoke hookah

7

Use any other form of tobacco

8

No one who lives with me now uses any form of tobacco

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "now".
PATH ID:

R04_YX0068

During the past seven days, about how many hours were you around others who were smoking[,
whether or not you were smoking yourself]? Include time in your home, in a car, at school, or outdoors.
1

I__I__I__I Number of hours

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "others".
IF R04_PAST30DAY_CIGS = 1 OR R04_PAST30DAY_GTRAD= 1 OR R04_PAST30DAY_GRILLO = 1
OR R04_PAST30DAY_GFILTR= 1 OR R04_PAST30DAY_PIPE = 1 OR R04_PAST30DAY_HOOK = 1
OR R04_PAST30DAY_BIDI = 1 OR R04_PAST30DAY_KRETEK = 1, DISPLAY, ", whether or not you
were smoking yourself".
DISPLAY "Number of hours" AS A TITLE.

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PATH ID:

R04_YX0068_LC1

The computer recorded that, during the last seven days, you were in close contact with others while
they were smoking for [R04_YX0068] hours. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0068

2

NEXT

GO TO BOX R04_YXT01

ASK: IF R04_YX0068 > 120 OR R04_YX0068 = 11, 22, 33, 44, 55, 66, 77, 88, 99, 111.

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HEALTH
BOX ID:

R04_YXT01

The next questions ask about some basic medical information that is important for the study.
BOX ID:

R04_YMD06

Display questions R04_YX0090 through R04_YX0088 using the expanded WVB stem-leaf screen. The
introduction text from R04_YX0090 is the stem. Show all leaves on the screen at once.
PATH ID:

R04_YX0090

In general, how would you rate your...
physical health?
1

Excellent

2

Very good

3

Good

4

Fair

5

Poor

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0091

mental health, which includes stress, depression, and problems with emotions?
1

Excellent

2

Very good

3

Good

4

Fair

5

Poor

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH ID:

R04_YX0088

overall health?
1

Excellent

2

Very good

3

Good

4

Fair

5

Poor

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "overall".
BOX ID:

R04_YMD05

Display questions R04_YX0090_12M through R04_YX0088_12M using the expanded WVB stem-leaf
screen. The introduction text from R04_YX0090_12M is the stem. Show all leaves on the screen at
once.
PATH ID:

R04_YX0090_12M

Compared with 12 months ago, would you say...
your physical health is now...
1

Better

2

Worse

3

About the same

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0091_12M

your mental health is now...
1

Better

2

Worse

3

About the same

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH ID:

R04_YX0088_12M

your overall health is now...
1

Better

2

Worse

3

About the same

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0726

Overall, how would you rate the health of your teeth and gums?
1

Excellent

2

Very good

3

Good

4

Fair

5

Poor

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0310

The next questions ask about your height and weight. Do you want to answer these questions in…
1

Feet and pounds, or

2

Meters and kilograms

-8

DON'T KNOW

-7

REFUSED

GO TO R04_YX0311

ASK: All youth respondents.

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PATH ID:

R04_YT0007

About how tall are you without shoes?
1

I___I Feet

2

I__I__I Inches

-8

DON'T KNOW

GO TO R04_YT0008

-7

REFUSED

GO TO R04_YT0008

ASK: Youth respondents who prefer to answer height in feet and inches or did not choose a system of
measurement.
DISPLAY: DISPLAY “Feet” AND “Inches” AS TITLES.
PATH ID:

R04_YT0007_LC1

The computer recorded that you are [R04_YT0007_FT] feet [and R04_YT0007_IN inches] tall. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YT0007

2

NEXT

GO TO R04_YT0008

ASK: IF R04_YT0007_FT > 8 OR R04_YT0007_FT < 3.
PATH ID:

R04_YX0311

About how tall are you without shoes?
1

I__I__I.I__I__I Meters

-8

DON'T KNOW

GO TO R04_YX0312

-7

REFUSED

GO TO R04_YX0312

ASK: Youth respondents who prefer to answer height in meters.
DISPLAY: DISPLAY “Meters” AS A TITLE.
PATH ID:

R04_YX0311_LC1

The computer recorded that you are [R04_YX0311] meters tall. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0311

2

NEXT

GO TO R04_YX0312

ASK: IF R04_YX0311 > 2.7 OR R04_YX0311 < 0.9.

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PATH ID:

R04_YT0008

About how much do you weigh without clothes or shoes?
1

I___I___I___I Pounds

-8

DON'T KNOW

GO TO R04_YX0241

-7

REFUSED

GO TO R04_YX0241

ASK: Youth respondents who prefer to answer weight in pounds or did not choose a system of
measurement.
DISPLAY: DISPLAY “Pounds” AS A TITLE.
PATH ID:

R04_YT0008_LC1

The computer recorded that you weigh [R04_YT0008] pounds. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YT0008

2

NEXT

GO TO R04_YX0241

ASK: IF R04_YT0008 > 450 OR R04_YT0008 < 75.
PATH ID:

R04_YX0312

About how much do you weigh without clothes or shoes?
1

I___I___I___I Kilograms

-8

DON'T KNOW

GO TO R04_YX0241

-7

REFUSED

GO TO R04_YX0241

ASK: Youth respondents who prefer to answer weight in kilograms.
DISPLAY: DISPLAY “Kilograms” AS A TITLE.
PATH ID:

R04_YX0312_LC1

The computer recorded that you weigh [R04_YX0312] kilograms. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0312

2

NEXT

GO TO R04_YX0241

ASK: IF R04_YX0312 > 205 OR R04_YX0312 < 34.

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PATH ID:

R04_YX0241

During the past 7 days, on how many days were you physically active for a total of at least 60 minutes
per day? (Add up all the time you spent in any kind of physical activity that increased your heart rate
and made you breathe hard some of the time.)
1

0 days

2

1 day

3

2 days

4

3 days

5

4 days

6

5 days

7

6 days

8

7 days

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "past 7 days"; BOLD "at least 60 minutes per day".
PATH ID:

R04_YX0242

On how many of the past 7 days did you exercise or participate in physical activity for at least 20
minutes that made you sweat and breathe hard, such as basketball, soccer, running, swimming laps,
fast bicycling, fast dancing, or similar aerobic activities?
1

0 days

2

1 day

3

2 days

4

3 days

5

4 days

6

5 days

7

6 days

8

7 days

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD "at least 20 minutes that made you sweat and breathe hard".

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PATH ID:

R04_YX0243

On how many of the past 7 days did you do exercises to strengthen or tone your muscles, such as
push-ups, sit-ups, or weight lifting?
1

0 days

2

1 day

3

2 days

4

3 days

5

4 days

6

5 days

7

6 days

8

7 days

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YXR43

New baseline youth respondents, go to R04_YX0046_NB.
Else,continuing youth respondents, go to R04_YX0047_12M.
PATH ID:

R04_YX0047_12M

Have you had wheezing or whistling in the chest in the past 12 months?
1

Yes

2

No

GO TO R04_YX0052

-8

DON'T KNOW

GO TO R04_YX0052

-7

REFUSED

GO TO R04_YX0052

ASK: New baseline youth respondents who had wheezing or whistling in the chest at any time in the
past and continuing youth respondents.
DISPLAY: UNDERLINE "past 12 months".
PATH ID:

R04_YX0048

How many attacks of wheezing have you had in the past 12 months?
1

None

2

1 to 3

3

4 to12

4

More than 12

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who had wheezing or whistling in the chest in the past 12 months.

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PATH ID:

R04_YX0049

In the past 12 months how often, on average, has your sleep been disturbed due to wheezing?
1

Never woken with wheezing

2

Less than one night per week

3

One or more nights per week

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who had wheezing or whistling in the chest in the past 12 months.
PATH ID:

R04_YX0050

In the past 12 months, has wheezing ever been severe enough to limit your speech to only one or two
words between breaths?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who had wheezing or whistling in the chest in the past 12 months.
PATH ID:

R04_YX0052

In the past 12 months, has your chest sounded wheezy during or after exercise?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0053

A dry cough is a cough without phlegm or mucus. In the past 12 months, have you had a dry cough at
night?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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BOX ID:

R04_YXR18

Continuing youth respondents, go to R04_YT0031_12M.
Else, go to R04_YT0031_NB.
PATH ID:

R04_YT0031_12M

In the past 12 months, have you been told by a doctor, nurse or other health professional that you have
asthma?
1

Yes

GO TO BOX R04_YXV03

2

No

GO TO BOX R04_YXV03

-8

DON'T KNOW

GO TO BOX R04_YXV03

-7

REFUSED

GO TO BOX R04_YXV03

ASK: Continuing youth respondents.
BOX ID:

R04_YXV03

PROGRAM: CREATE DERIVED VARIABLE (SEE APPENDIX)
R04_YOUTH_ASTHMA = All youth respondents who have ever had asthma.
BOX ID:

R04_YXR09

New baseline youth respondents that have asthma, go to R04_YT0038_NB.
Else, continuing youth respondents that have asthma, go to R04_YX0227.
Else, go to Box R04_YXD06.
PATH ID:

R04_YX0227

In the past 30 days, how much of the time did your asthma keep you from getting as much done at
work, school or at home?
1

All of the time

2

Most of the time

3

Some of the time

4

A little of the time

5

None of the time

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have asthma.
DISPLAY: UNDERLINE "past 30 days".

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PATH ID:

R04_YX0228

In the past 30 days, how often have you had shortness of breath?
1

More than once a day

2

Once a day

3

3-6 times a week

4

Once or twice a week

5

None at all

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have asthma.
PATH ID:

R04_YX0229

In the past 30 days, how often did your asthma symptoms (such as wheezing, coughing, shortness of
breath, chest tightness or pain) wake you up at night or earlier than usual in the morning?
1

4 or more nights a week

2

2 or 3 nights

3

Once a week

4

Once or twice

5

Not at all

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have asthma.
PATH ID:

R04_YT0022

In the past 12 months, have you taken medications regularly for asthma?
(Taken regularly means according to a health care provider’s instructions.)
1

Yes

2

No

GO TO R04_YT0127

-8

DON'T KNOW

GO TO R04_YT0127

-7

REFUSED

GO TO R04_YT0127

ASK: Youth respondents who have asthma.
DISPLAY: UNDERLINE "past 12 months".
BOX ID:

R04_YMD01

DISPLAY INSTRUCTION:
For R04_YT0036, display as a stem and leaf question. For each leaf, display a yes/no response.

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PATH ID:

R04_YT0036

In the past 12 months, which of the following medications did you regularly take for asthma?
1

Quick-relief inhaler - for example: albuterol (ProAir, Ventolin, Xopenex), ipratropium
(Atrovent), or a combination inhaler (Combivent)

2

Controller or long-acting inhaler including steroid inhaler – for example:
beclomethasone (Qvar), fluticasone (Flovent), salmeterol (Serevent), tiotropium
(Spiriva), or a combination inhaler (Advair)

3

Other controlling medication – for example: montelukast (Singulair), zafirlukast
(Accolate), theophylline, roflumilast (Daliresp)

4

Other asthma medication

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have asthma that have taken medications regularly in the past 12 months.
PATH ID:

R04_YT0125

In the past 12 months, have you had an asthma attack that required use of an oral or injected steroid
medication at the time of the attack? Examples of oral or injected steroid medications include
prednisone, prednisolone (Orapred), and dexamethasone (Decadron).
1

Yes

2

No

GO TO R04_YT0127

-8

DON'T KNOW

GO TO R04_YT0127

-7

REFUSED

GO TO R04_YT0127

ASK: Youth respondents who have asthma that have taken medications regularly in the past 12 months.
PATH ID:

R04_YT0039

In the past 12 months, how many asthma attacks have you had that required use of an oral or injected
steroid medication at the time of the attack?
1

|___|___|___|

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who had an asthma attack in the past 12 months that needed oral or injected
steroid medication.

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PATH ID:

R04_YT0127

In the past 12 months, have you had to visit an emergency room or urgent care center because of
asthma?
1

Yes

2

No

GO TO R04_YX0230

-8

DON'T KNOW

GO TO R04_YX0230

-7

REFUSED

GO TO R04_YX0230

ASK: Youth respondents who have asthma.
PATH ID:

R04_YT0282

In the past 12 months, how many times have you had to visit an emergency room or urgent care center
because of asthma?
1

|___|___|___|

-8

DON'T KNOW

GO TO BOX R04_YXR42

-7

REFUSED

GO TO BOX R04_YXR42

ASK: Youth respondents who had to go to the emergency room for asthma in the past 12 months.
PATH ID:

R04_YT0282_LC1

The computer recorded that you have visited an emergency room or urgent care center [R04_YT0282]
times in the past 12 months because of asthma. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YT0282

2

NEXT

GO TO BOX R04_YXR42

ASK: IF R04_YT0282 > 20.
BOX ID:

R04_YXR42

Youth respondents who had to go to the emergency room for asthma once in the past 12 months, go to
R04_YX0695.
Else, youth respondents who had to go to the emergency room for asthma multiple times in the past 12
months, go to R04_YX0720.
Else, youth respondents who have asthma, go to R04_YX0230.

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PATH ID:

R04_YX0695

Was that visit due to an asthma attack?
1

Yes

GO TO R04_YX0230

2

No

GO TO R04_YX0230

-8

DON'T KNOW

GO TO R04_YX0230

-7

REFUSED

GO TO R04_YX0230

ASK: Youth respondents who had to go to the emergency room for asthma once in the past 12 months.
PATH ID:

R04_YX0720

How many of those visits were due to an asthma attack?
1

|___|___|___|

-8

DON'T KNOW

GO TO R04_YX0230

-7

REFUSED

GO TO R04_YX0230

ASK: Youth respondents who had to go to the emergency room for asthma multiple times in the past 12
months.
PATH ID:

R04_YX0720_LC1

The computer recorded that you have visited an emergency room or urgent care center [R04_YX0720]
times in the past 12 months because of an asthma attack. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0720

2

NEXT

GO TO R04_YX0230

ASK: IF R04_YX0720 > R04_YT0282.

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PATH ID:

R04_YX0230

In the past 30 days, how often have you used a rescue inhaler, nebulizer treatment, or other controlling
medication (such as albuterol)?
1

3 or more times per day

2

1 or 2 times per day

3

2 or 3 times per week

4

Once a week or less

5

Not at all

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have asthma.
DISPLAY: UNDERLINE "past 30 days".
PATH ID:

R04_YX0231

How would you rate your asthma control during the past 30 days?
1

Not controlled at all

2

Poorly controlled

3

Somewhat controlled

4

Well controlled

5

Completely controlled

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have asthma.
BOX ID:

R04_YXD06

DISPLAY INSTRUCTION:
For R04_YX0158, display a ‘Yes’ and ‘No’ column with options for each response category. Show all
response categories on the screen at once.
PATH ID:

R04_YX0158

In the past 12 months, did you take any of the following medications, even once?
1

Ibuprofen (Motrin, Advil, Naprosyn, or Aleve)

2

Acetaminophen (Tylenol)

3

Aspirin

4

Cox-2 inhibitors (Celebrex)

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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BOX ID:

R04_YXR50

If youth respondent has not used any tobacco or e-product in the past 12 months, go to
R04_YN0330_12MH.
Else, go to Box R04_YXR19.
PATH ID:

R04_YN0330_12MH

In the past 12 months, have you used a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal
spray, lozenge or pill?
1

Yes

2

No

GO TO R04_YN0331_12MH

-8

DON'T KNOW

GO TO R04_YN0331_12MH

-7

REFUSED

GO TO R04_YN0331_12MH

ASK: Youth respondents who have not used any tobacco or e-product in the past 12 months.
PATH ID:

R04_YN0307H

When did you last use a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or
pill?
1

In the past hour

GO TO R04_YN0309H

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO R04_YN0331_12MH

-8

DON'T KNOW

GO TO R04_YN0331_12MH

-7

REFUSED

GO TO R04_YN0331_12MH

ASK: Youth respondents who have used NRT in the past 12 months.

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PATH ID:

R04_YN0308H

When you last used a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or pill
[FILL BASED ON R04_YN0307H], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used NRT today, yesterday or the day before yesterday.
DISPLAY: [FILL BASED ON R04_YN0307H]:
IF R04_YN0307H = 2, DISPLAY "sometime today".
IF R04_YN0307H = 3, DISPLAY "yesterday".
IF R04_YN0307H = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YN0309H

When you last used a nicotine patch, nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or pill
[FILL BASED ON R04_YN0307H], how many did you use?
1

I___I___I

-8

DON'T KNOW

-7

REFUSED

ASK: Youth who have used NRT in the past hour, today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YN0307H]:
IF R04_YN0307H = 1, 2, DISPLAY “today”.
IF R04_YN0307H = 3, DISPLAY "yesterday".
IF R04_YN0307H = 4, DISPLAY “the day before yesterday”.
PATH ID:

R04_YN0309H_LC1

The computer recorded that [today/yesterday/the day before yesterday], you used a nicotine patch,
nicotine gum, nicotine inhaler, nicotine nasal spray, lozenge or pill [R04_YN0309H] times.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YN0309H

2

NEXT

GO TO R04_YN0331_12MH

ASK: IF R04_YN0309H = 0 OR R04_YN0309H > 5.
DISPLAY: IF R04_YN0307H = 1, 2, DISPLAY “today”.
IF R04_YN0307H = 3, DISPLAY “yesterday”.
IF R04_YN0307H = 4, DISPLAY “the day before yesterday”.

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PATH ID:

R04_YN0331_12MH

In the past 12 months, have you used any of the following prescription drugs: Chantix, varenicline,
Wellbutrin, Zyban, or bupropion?
1

Yes

2

No

GO TO BOX R04_YXR19

-8

DON'T KNOW

GO TO BOX R04_YXR19

-7

REFUSED

GO TO BOX R04_YXR19

ASK: Youth respondents who have not used any tobacco or e-product in the past 12 months.
PATH ID:

R04_YN0327H

When did you last use Chantix, varenicline, Wellbutrin, Zyban, or bupropion?
1

In the past hour

GO TO R04_YN0329H

2

Sometime today

3

Yesterday

4

Day before yesterday

5

Three or more days ago

GO TO BOX R04_YXR19

-8

DON'T KNOW

GO TO BOX R04_YXR19

-7

REFUSED

GO TO BOX R04_YXR19

ASK: Youth respondents who have used a prescription drug in the past 12 months.
PATH ID:

R04_YN0328H

When you last used Chantix, varenicline, Wellbutrin, Zyban, or bupropion [FILL BASED ON
R04_YN0327H], was it…
1

Between midnight and 6AM

2

After 6AM but before noon

3

Between noon and 6PM

4

After 6PM but before midnight

-8

DON'T KNOW

-7

REFUSED

ASK: Youth who have used a prescription drug today, yesterday or the day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YN0327H]:
IF R04_YN0327H = 2, DISPLAY "today".
IF R04_YN0327H = 3, DISPLAY "yesterday".
IF R04_YN0327H = 4, DISPLAY “the day before yesterday”.
ELSE, DISPLAY TEXT AS SHOWN IN OPTIONS SELECTED IN R04_YN0327H, MAKING FIRST
LETTER LOWERCASE.

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PATH ID:

R04_YN0329H

When you used Chantix, varenicline, Wellbutrin, Zyban, or bupropion [FILL BASED ON R04_YN0327H],
how many did you take?
1

I___I___I

-8

DON'T KNOW

GO TO BOX R04_YXR19

-7

REFUSED

GO TO BOX R04_YXR19

ASK: Youth respondents who have used a prescription drug in the past hour, today, yesterday or the
day before yesterday.
DISPLAY: FOR [FILL BASED ON R04_YN0327H]:
IF R04_YN0327H = 1, 2, DISPLAY “today”.
IF R04_YN0327H = 3, DISPLAY "yesterday"
IF R04_YN0327H = 4, DISPLAY “the day before yesterday”.
ELSE, DISPLAY TEXT AS SHOWN IN OPTIONS SELECTED IN R04_YN0327H, MAKING FIRST
LETTER LOWERCASE.
PATH ID:

R04_YN0329H_LC1

The computer recorded that [today/yesterday/the day before yesterday], you used Chantix, varenicline,
Wellbutrin, Zyban, or bupropion [R04_YN0329H] times.
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

2

NEXT

GO TO R04_YN0329H

ASK: IF R04_YN0329H = 0 OR R04_YN0329H > 5.
DISPLAY: IF R04_YN0327H = 1, 2, DISPLAY “today”.
IF R04_YN0327H = 3, DISPLAY “yesterday”.
IF R04_YN0327H = 4, DISPLAY “the day before yesterday”.
BOX ID:

R04_YXR19

Female youth respondents aged 15 or older, go to R04_YX0136.
Else, go to Box R04_YXT03.
PATH ID:

R04_YX0136

Are you currently pregnant?
1

Yes

2

No

GO TO BOX R04_YXT03

-8

DON'T KNOW

GO TO BOX R04_YXT03

-7

REFUSED

GO TO BOX R04_YXT03

ASK: Female youth respondents aged 15 years or older.

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PATH ID:

R04_YX0137

How many months or weeks pregnant are you? Please enter number of months or weeks.
1

I__I__I Months

2

I__I__I Weeks

-8

DON'T KNOW

-7

REFUSED

ASK: Female youth respondents aged 15 years or older who are currently pregnant.
PATH ID:

R04_YX0137_LC1

The computer recorded that you have been pregnant for [R04_YX0137_NN] [months/weeks]. Is that
correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0137

2

NEXT

GO TO BOX R04_YXT03

ASK: IF (R04_YX0134_NN > 10 AND R04_YX0137_UN = 1) OR (R04_YX0134_NN > 42 AND
R04_YX0137_UN = 2).
DISPLAY: IF R04_YX0137_UN = 1, DISPLAY "months".
ELSE, IF R04_YX0137_UN = 2, DISPLAY "weeks".

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MARKETING, ADVERTISING AND PROMOTION
BOX ID:

R04_YXT03

The next questions ask about tobacco advertising that you may have seen or received.
PATH ID:

R04_YX0708

In the past 12 months, have you received discounts or coupons for any of the following products?
Choose all that apply.
1

Cigarettes

2

E-cigarettes or other electronic nicotine products (including e-liquid)

3

Cigars

4

Shisha or hookah tobacco

5

Snus

6

Other types of smokeless tobacco (such as dip, spit or chew)

7

Some other type of tobacco product

8

None of the above

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0678

In the past 30 days, have you gotten a free sample of an e-cigarette or other electronic nicotine
product (including e-liquid)?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "e-cigarette or other electronic nicotine product".

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PATH ID:

R04_YX0182

In the past 30 days, how often did you visit a convenience store, small market, or liquor store?
1

Not at all

2

Once in the past 30 days

3

2-3 times in the past 30 days

4

Once a week

5

2-3 times per week

6

Almost every day

-8

DON'T KNOW

-7

REFUSED

GO TO R04_YX0203

ASK: All youth respondents.
PATH ID:

R04_YX0183

In the past 30 days, when you visited convenience stores, small markets, or liquor stores, how often did
you see ads for e-cigarettes or other electronic nicotine products?
1

Never

2

Rarely

3

Sometimes

4

Often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have visited a store or market in the past 30 days.
DISPLAY: BOLD AND UNDERLINE "e-cigarettes or other electronic nicotine products".

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PATH ID:

R04_YX0203

In the past 30 days, have you noticed e-cigarettes or other electronic nicotine products being
advertised in any of the following places? Choose all that apply.
1

I haven't seen any advertisements in the past 30 days

2

At gas stations, convenience stores, or other retail stores

3

On billboards

4

In newspapers or magazines

5

On radio

6

On television

7

At events such as fairs, festivals, or sporting events

8

At nightclubs, bars, or music concerts

9

On websites or social media sites

10

Somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "e-cigarettes or other electronic nicotine products".
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”
PATH ID:

R04_YX0709

Do you have a favorite e-cigarette or electronic nicotine product advertisement?
1

Yes

2

No

GO TO R04_YX0481

-8

DON'T KNOW

GO TO R04_YX0481

-7

REFUSED

GO TO R04_YX0481

ASK: All youth respondents.

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PATH ID:

R04_YX0297

What is the brand of your favorite advertisement for an e-cigarette or electronic nicotine product?
Choose only one.
If you do not see the brand listed below, select “Something else”.
1

Blu

2

eSmoke

3

Fin

4

GreenSmoke

5

iTaste

6

Logic

7

MarkTen

8

NJOY

9

ProVape

10

Smoking Everywhere

11

Vapor King

12

Vuse

13

V2Cigs

14

Something else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have a favorite e-product advertisement.
DISPLAY: UNDERLINE "e-cigarette or other electronic nicotine product". IF OS FIELD SELECTED AND
ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT AND ADD THE FOLLOWING
TEXT: “Please type your answer using the computer keyboard.”
PATH ID:

R04_YX0481

In the past 30 days, have you gotten a free sample of a tobacco product (not including e-cigarettes
or electronic nicotine products)?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "tobacco product (not including e-cigarettes or electronic nicotine
products)"

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BOX ID:

R04_YXR24

Youth respondents who have visited a store or market in the past 30 days, go to R04_YX0178.
Else, go to R04_YX0677.
PATH ID:

R04_YX0178

In the past 30 days, when you visited convenience stores, small markets, or liquor stores, how often did
you see ads for cigarettes or other tobacco products (not including e-cigarettes or electronic nicotine
products)?
1

Never

2

Rarely

3

Sometimes

4

Often

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have visited a store or market in the past 30 days.
DISPLAY: BOLD AND UNDERLINE "cigarettes or other tobacco products".
PATH ID:

R04_YX0677

In the past 30 days, have you noticed cigarettes or other tobacco products (not including e-cigarettes
or electronic nicotine products) being advertised in any of the following places? Choose all that apply.
1

I haven't seen any advertisements in the past 30 days

2

At gas stations, convenience stores, or other retail stores

3

On billboards

4

In newspapers or magazines

5

On radio

6

On television

7

At events such as fairs, festivals, or sporting events

8

At nightclubs, bars, or music concerts

9

On websites or social media sites

10

Somewhere else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD AND UNDERLINE "cigarettes or other tobacco products".
IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS SHOWN, DISPLAY QUESTION TEXT
AND ADD THE FOLLOWING TEXT: “Please type your answer using the computer keyboard.”

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PATH ID:

R04_YX0710

Do you have a favorite tobacco advertisement?
1

Yes

2

No

GO TO BOX R04_YXR44

-8

DON'T KNOW

GO TO BOX R04_YXR44

-7

REFUSED

GO TO BOX R04_YXR44

ASK: All youth respondents.

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PATH ID:

R04_YX0197

What is the brand of your favorite tobacco advertisement? Choose only one.
If you do not see the brand listed below, select “Something else”.
1

American Spirit

2

Basic

3

Benson & Hedges

4

Black & Mild

5

Camel

6

Capri

7

Copenhagen

8

Doral

9

Dutch Masters

10

Grizzly

11

Kool

12

Levi Garrett

13

Liggett Select

14

Marlboro

15

Maverick

16

Misty

17

Newport

18

Pall Mall

19

Parliament

20

Phillies Blunts

21

Redman

22

Salem

23

Skoal

24

Sonoma

25

Swisher Sweets

26

USA Gold

27

Virginia Slims

28

Winchester

29

Winston

30

Something else (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have a favorite tobacco advertisement.
DISPLAY: UNDERLINE "tobacco". IF OS FIELD SELECTED AND ADDITIONAL OS SCREEN IS
SHOWN, DISPLAY QUESTION TEXT AND ADD THE FOLLOWING TEXT: “Please type your answer

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using the computer keyboard.”
BOX ID:

R04_YXR44

Random sample of all youth respondents, go to R04_YX0234.
Else, go to Box R04_YXR45.
PATH ID:

R04_YX0234

In the past 12 months, have you seen or heard of any ads on television, the internet or radio with the
following slogan or theme?
"A Tip From a Former Smoker"
[DISPLAY IMAGE OF TIPS CAMPAIGN LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Random sample of all youth respondents.
DISPLAY: BOLD "A Tip From a Former Smoker".
PATH ID:

R04_YX0235

In the past 12 months, have you seen or heard of any ads on television, the internet or radio with the
following slogan or theme?
[DISPLAY IMAGE OF TRUTH 'FINISH IT' CAMPAIGN LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Random sample of all youth respondents.

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PATH ID:

R04_YX0728

In the past 12 months, have you seen or heard of any ads on television, the internet or radio with the
following slogan or theme?
"Know the real costs."
[DISPLAY IMAGE OF REAL COST CAMPAIGN LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Random sample of all youth respondents.
DISPLAY: BOLD "Know the real costs."
PATH ID:

R04_YX0674

In the past 12 months, have you seen or heard of any ads on television, the internet or radio with the
following slogan or theme?
"Cigarettes are Bullies. Don’t let tobacco control you."
[DISPLAY IMAGE OF REAL COST CAMPAIGN LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Random sample of all youth respondents.
DISPLAY: BOLD "Cigarettes are Bullies. Don’t let tobacco control you."

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PATH ID:

R04_YX0713

In the past 12 months, have you seen or heard of any ads on television, the internet or radio with the
following slogan or theme?
"Keep it Fresh. Live Tobacco-Free."
[DISPLAY IMAGE OF FRESH EMPIRE LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Random sample of all youth respondents.
DISPLAY: BOLD "Keep it Fresh. Live Tobacco-Free".
BOX ID:

R04_YXR45

Continuing youth respondents who identified as LGBT in any previous wave, and a random sample of
all youth respondents, go to R04_YX0764.
Else, go to Box R04_YXR51.
PATH ID:

R04_YX0764

In the past 12 months, have you seen or heard of any ads with the following slogan or theme?
LGBT campaign
[DISPLAY IMAGE OF CAMPAIGN LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: Continuing youth respondents who identify as LGBT in any previous wave, and a random sample
of all youth respondents.
BOX ID:

R04_YXR51

White male youth respondents who are both Hispanic and non-Hispanic, go to R04_YX0765.
Else, go to R04_YX0008.

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PATH ID:

R04_YX0765

In the past 12 months, have you seen or heard of any ads on television, the internet or radio with the
following slogan or theme?
Rural smokeless campaign
[DISPLAY IMAGE OF CAMPAIGN LOGO]
1

Yes

2

No

3

I don't know

-8

DON'T KNOW

-7

REFUSED

ASK: White male (Hispanic and non-Hispanic) youth respondents.

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SOCIAL NORMS, PEER AND FAMILY INFLUENCES
PATH ID:

R04_YX0008

In general, do you think most people disapprove of smoking cigarettes?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD "cigarettes".
PATH ID:

R04_YX0012

In general, do you think most people disapprove of using e-cigarettes or other electronic nicotine
products?
1

Definitely yes

2

Probably yes

3

Probably not

4

Definitely not

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: BOLD "e-cigarettes or other electronic nicotine products".
PATH ID:

R04_YX0071

Thinking about the people who are important to you, how would you describe their views on using
tobacco in general?
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "people who are important to you"; BOLD "tobacco in general".

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BOX ID:

R04_YXD89

Display questions R04_YC1143 through R04_YS1143 using the expanded WVB stem-leaf screen. The
introduction text from R04_YC1143 is the stem. Show all leaves on the screen at once.
PATH ID:

R04_YC1143

Thinking about the people who are important to you, how would you describe their views on the
following?
Smoking cigarettes
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "people who are important to you"; BOLD "their views".
PATH ID:

R04_YV1143

Using e-cigarettes or other electronic nicotine products
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH ID:

R04_YG1143

Smoking traditional cigars, cigarillos, or filtered cigars
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YH1143

Smoking shisha or hookah tobacco
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YU1143

Using snus
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH ID:

R04_YS1143

Using other types of smokeless tobacco (such as dip, spit, or chew)
1

Very positive

2

Positive

3

Neither positive nor negative

4

Negative

5

Very negative

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0741

Thinking about the people who are important to you, do any of them use any of the following products?
Choose all that apply.
1

Cigarettes

2

E-cigarettes or other electronic nicotine products

3

Traditional cigars

4

Cigarillos

5

Filtered cigars

6

Pipe tobacco

7

Shisha or hookah tobacco

8

Snus

9

Other types of smokeless tobacco (such as dip, spit or chew)

10

None of the above

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "people who are important to you".

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PATH ID:

R04_YX0680

How many of your best friends smoke cigarettes?
1

None

2

A few

3

Some

4

Most

5

All

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0681

How many of your best friends use e-cigarettes or other electronic nicotine products?
1

None

2

A few

3

Some

4

Most

5

All

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0683

How many of your best friends smoke cigarillos?
1

None

2

A few

3

Some

4

Most

5

All

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Wave 4 (version 3.0)
PATH ID:

R04_YX9686

How many of your best friends smoke hookah?
1

None

2

A few

3

Some

4

Most

5

All

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0693

How many of your best friends use snus?
1

None

2

A few

3

Some

4

Most

5

All

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0685

How many of your best friends use other types of smokeless tobacco (such as dip, spit, or chew)?
1

None

2

A few

3

Some

4

Most

5

All

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH ID:

R04_YC1156

Out of every 10 people your age, how many do you think smoke cigarettes?
0

0

1

1

2

2

3

3

4

4

5

5

6

6

7

7

8

8

9

9

10

10

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YV1156

Out of every 10 people your age, how many do you think use e-cigarettes or other electronic nicotine
products?
0

0

1

1

2

2

3

3

4

4

5

5

6

6

7

7

8

8

9

9

10

10

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Wave 4 (version 3.0)
PATH ID:

R04_YS1156

Out of every 10 people your age, how many do you think use smokeless tobacco?
0

0

1

1

2

2

3

3

4

4

5

5

6

6

7

7

8

8

9

9

10

10

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YH1156

Out of every 10 people your age, how many do you think smoke hookah?
0

0

1

1

2

2

3

3

4

4

5

5

6

6

7

7

8

8

9

9

10

10

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Wave 4 (version 3.0)
BOX ID:

R04_YXV04

PROGRAM - DEFINE THE FOLLOWING USER GROUPS (SEE APPENDIX):
R04_PASTYEAR_TOB_USE_LEVEL = 2 (Past year "not light" tobacco users) Youth respondents
who are "not light" users of any tobacco product and have used in the past year.
R04_PASTYEAR_TOB_USE_LEVEL = 1 (Past year "very light" tobacco users) Youth respondents
who have used any tobacco product in the last year, and are not "not light" users of any product.
BOX ID:

R04_YXR40

Past year "not light" tobacco users, go to R04_YX0742.
Else, past year "very light" tobacco users, go to R04_YX0743.
Else, go to R04_YX0714.
PATH ID:

R04_YX0742

In the past 12 months, to what extent, if at all, has the disapproval of close friends and family led you to
think about quitting?
1

Not at all

GO TO R04_YX0714

2

Somewhat

GO TO R04_YX0714

3

Very much

GO TO R04_YX0714

-8

DON'T KNOW

GO TO R04_YX0714

-7

REFUSED

GO TO R04_YX0714

ASK: Past year "not light" tobacco users.
DISPLAY: UNDERLINE "close friends and family".
PATH ID:

R04_YX0743

In the past 12 months, to what extent, if at all, has the disapproval of close friends and family led you to
think about not using?
1

Not at all

2

Somewhat

3

Very much

-8

DON'T KNOW

-7

REFUSED

ASK: Past year "very light" tobacco users.
DISPLAY: UNDERLINE "close friends and family".

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PATH ID:

R04_YX0714

In the past 12 months, have your parents or guardians talked with you, even once, about not using ecigarettes or other electronic nicotine products?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0694

If your parents or guardians found you using e-cigarettes or other electronic nicotine products, how do
you think they would react? Would they…
1

Be very upset

2

Not be too upset

3

Have no reaction

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0500

In the past 12 months, have your parents or guardians talked with you, even once, about not using any
other type of tobacco product?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0200

If your parents or guardians found you using tobacco, how do you think they would react? Would they…
1

Be very upset

2

Not be too upset

3

Have no reaction

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Wave 4 (version 3.0)

ACCESSIBILITY
PATH ID:

R04_YX0715

How easy do you think it is for people your age to buy e-cigarettes or other electronic nicotine products
in a store?
1

Very easy

2

Somewhat easy

3

Somewhat difficult

4

Very difficult

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0716

How likely is it that you will try to purchase an e-cigarette or other electronic nicotine products within the
next 30 days?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0499

How easy do you think it is for people your age to buy tobacco products in a store?
1

Very easy

2

Somewhat easy

3

Somewhat difficult

4

Very difficult

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH ID:

R04_YX0501

How likely is it that you will try to purchase cigarettes within the next 30 days?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0502

How likely is it that you will try to purchase tobacco products other than cigarettes within the next 30
days?
1

Very unlikely

2

Somewhat unlikely

3

Neither likely nor unlikely

4

Somewhat likely

5

Very likely

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)

PSYCHOSOCIAL
PATH ID:

R04_YX0488

The next questions are about common psychological, behavioral, and personal problems. These
problems are considered significant when you have them for two or more weeks, when they keep
coming back, when they keep you from meeting your responsibilities, or when they make you feel like
you can’t go on.
After each of the following questions, please tell us the last time, if ever, you had the problem, by
answering whether it was in the past month, 2-12 months ago, over a year ago, or never.
1

NEXT

ASK: All youth respondents.
DISPLAY: UNDERLINE "significant".
BOX ID:

R04_YXD07

Display questions R04_YX0161 through R04_YX0164 using the expanded WVB stem-leaf screen. The
introduction text from R04_YX0161 is the stem. As each question is answered, show the next one.
PATH ID:

R04_YX0161

When was the last time that you had significant problems with...
feeling very trapped, lonely, sad, blue, depressed, or hopeless about the future?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "significant problems".

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PATH ID:

R04_YX0162

sleep trouble, such as bad dreams, sleeping restlessly, or falling asleep during the day?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0163

feeling very anxious, nervous, tense, scared, panicked, or like something bad was going to happen?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0164

becoming very distressed and upset when something reminded you of the past?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YXD08

Display questions R04_YX0165 through R04_YX0251 using the expanded WVB stem-leaf screen. The
introduction text from R04_YX0165 is the stem. As each question is answered, show the next one.

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PATH ID:

R04_YX0165

When was the last time that you did any of the following things two or more times...
lied or conned to get things you wanted or to avoid having to do something?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
DISPLAY: UNDERLINE "two or more times".
PATH ID:

R04_YX0166

had a hard time paying attention at school, work, or home?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0167

had a hard time listening to instructions at school, work, or home?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH ID:

R04_YX0168

were a bully or threatened other people?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0169

started physical fights with other people?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
PATH ID:

R04_YX0250

felt restless or the need to run around or climb on things?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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Wave 4 (version 3.0)
PATH ID:

R04_YX0251

gave answers before the other person finished asking the question?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YXR34

If new baseline youth respondent, go to Box R04_YXD90.
Else, go to Box R04_YXR05.
BOX ID:

R04_YXD90

Display questions R04_YX0510_NB through R04_YX0520_NB using the expanded WVB stem-leaf
screen. The introduction text from R04_YX0510_NB is the stem. Show all leaves on the screen at once.

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SUBSTANCE USE
BOX ID:

R04_YXR05

Continuing youth respondents, go to R04_YX0084_12M.
New baseline youth respondents, go to R04_YX0084_NB.
BOX ID:

R04_YXR26

If new baseline youth respondent has ever used any form of tobacco and reported valid age of first drink
and onset of tobacco use precedes onset of alcohol use, go to R04_YX0077_NB.
Else, go to R04_YX0084_12M.
PATH ID:

R04_YX0084_12M

[The next questions ask about your use of alcohol and other drugs. Remember all information you give
to the PATH Study will be kept private.
]In the past 12 months, have you used any alcohol, including small sips or tastes?
1

Yes

2

No

GO TO BOX R04_YXR06

-8

DON'T KNOW

GO TO BOX R04_YXR06

-7

REFUSED

GO TO BOX R04_YXR06

ASK: New baseline youth respondents who have ever used alcohol and continuing youth respondents.
DISPLAY: IF R04_YOUTHTYPE = 1, DISPLAY "The next questions ask about your use of alcohol and
other drugs. Remember all information you give to the PATH Study will be kept private."
ELSE, DO NOT DISPLAY THIS TEXT.
PATH ID:

R04_YX0673

Have you used alcohol in the past 30 days?
1

Yes

2

No

GO TO BOX R04_YXR06

-8

DON'T KNOW

GO TO BOX R04_YXR06

-7

REFUSED

GO TO BOX R04_YXR06

ASK: Youth respondents who have used alcohol in the past 12 months.
DISPLAY: UNDERLINE "past 30 days".

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Youth Questionnaire - Extended Interview
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PATH ID:

R04_YX0075

In the past 30 days, on how many days did you have one or more alcoholic drinks?
A drink is a can or bottle of beer; a wine cooler or a glass of wine, champagne, or sherry; a shot of liquor
or a mixed drink or cocktail.
1

|___|___| DAYS

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used alcohol in the past 30 days.
BOX ID:

R04_YXR46

Youth respondents who have used alcohol on none of the past 30 days or did not know or refused to
report on how many days they have used alcohol in the past 30 days, go to Box R04_YXR06.
Else, go to R04_YX0076.
PATH ID:

R04_YX0076

On average, on those days that you drank in the past 30 days, how many alcoholic drinks did you
usually have each day?
Count a drink as a can or bottle of beer; a wine cooler or a glass of wine, champagne, or sherry; a shot
of liquor or a mixed drink or cocktail.
1

|___|___|

-8

DON'T KNOW

GO TO BOX R04_YXR06

-7

REFUSED

GO TO BOX R04_YXR06

ASK: Youth respondents who have used alcohol one day or more in the past 30 days.
PATH ID:

R04_YX0076_LC1

The computer recorded that you usually drank [R04_YX0076] alcoholic beverages on the days that you
drank during the last 30 days. Is that correct?
If this is correct, please press the NEXT button to continue. If this is NOT correct, please press the
BACK button and re-enter.
1

BACK

GO TO R04_YX0076

2

NEXT

GO TO BOX R04_YXR06

ASK: IF R04_YX0076 > 30.

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BOX ID:

R04_YXR06

New baseline youth respondents who have never smoked a blunt, smoked marijuana from a hookah, or
used marijuana in an e-product, go to R04_YX0085_NB.
Else, new baseline youth respondents who have ever smoked a blunt, smoked marijuana from a
hookah, or used marijuana in an e-product, go to R04_YX0079_NB.
Else, continuing youth respondents who have not smoked a blunt in the past 12 months, go to
R04_YX0085_12M.
Else, continuing youth respondents who have smoked a blunt in the past 30 days, go to Box
R04_YXR28.
Else, continuing youth respondents who have smoked a blunt in the past 12 months, go to
R04_YX0675.
BOX ID:

R04_YXR27

If new baseline youth respondent reported valid age of first marijuana use and has ever used any form
of tobacco, and onset of tobacco use precedes onset of marijuana use, go to R04_YX0080_NB.
Else, youth respondents who have smoked a blunt in the past 30 days, go to Box R04_YXR28.
Else, new baseline youth who have ever used marijuana, go to R04_YX0085_12M.
Else, go to Box R04_YXR41.
BOX ID:

R04_YXR41

Youth respondents who have smoked a blunt in the past 30 days, go to Box R04_YXR28.
Else, youth respondents who have smoked a blunt in the past 12 months, go to R03_YX0675.
Else, go to R04_YX0085_12M.
PATH ID:

R04_YX0085_12M

In the past 12 months, have you used marijuana, hash, THC, grass, pot or weed?
1

Yes

2

No

GO TO BOX R04_YXR28

-8

DON'T KNOW

GO TO BOX R04_YXR28

-7

REFUSED

GO TO BOX R04_YXR28

ASK: Continuing youth respondents who did not previously report smoking a blunt in the past 12 months
and new baseline youth respondents who ever used marijuana and did not previously report smoking a
blunt in the past 12 months.

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PATH ID:

R04_YX0675

Have you used marijuana, hash, THC, grass, pot or weed in the past 30 days?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used marijuana in the past 12 months and did not report smoking
blunts in the past 30 days.
DISPLAY: UNDERLINE "past 30 days".
BOX ID:

R04_YXR28

New baseline youth respondents, go to Box R04_YXD02.
Continuing youth respondents, go to Box R04_YXD03.
BOX ID:

R04_YXD02

DISPLAY INSTRUCTION:
For R04_YX0089_NB and R04_YX0220_NB, display a “Yes” and “No” column with options for each
response category.
BOX ID:

R04_YXR07

PROGRAM: Items R04_YX0082_NB[_01/.../_05], R04_YX0272_NB[_01/.../_05],
R04_YX0083_NB[_01/.../_05], and R04_YX0676[_01/.../_05] are asked for each substance the
respondent uses in R04_YX0089_NB[_01/_02] and R04_YX0220_NB[_01/_02/_03]. If respondent uses
more than one substance, repeat items in a loop.
If no substances are selected in R04_YX0089_NB[_01/_02] or R04_YX0220_NB[_01/_02/_03], go to
Box R04_YXV02.
BOX ID:

R04_YXD05

PROGRAM: CREATE [SUBSTANCEFILL] If R04_YX0089_NB_01 = 1, display "Ritalin® or Adderall®”.
If R04_YX0089_NB_02 = 1, display “painkillers, sedatives, or tranquilizers”.
If R04_YX0220_NB_01 = 1, display “cocaine or crack”.
If R04_YX0220_NB_02 = 1, display “stimulants like methamphetamine or speed”.
If R04_YX0220_NB_03 = 1, display “other drugs like heroin, inhalants, solvents, or hallucinogens”.

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BOX ID:

R04_YXR30

If new baseline youth respondent reported valid age of first use and has ever used any form of tobacco,
and onset of tobacco use precedes onset of substance use, go to R04_YX0083_NB.
Else, go to Box R04_YXR47.
BOX ID:

R04_YXR47

New baseline youth respondents who have remaining substance loops to complete, go back to
R04_YX0082_NB and repeat for remaining substances.
Else, if new baseline youth respondent has no remaining substance loops to complete, go to Box
R04_YXD03.
BOX ID:

R04_YXD03

DISPLAY INSTRUCTIONS
For R04_YX0089_12M and R04_YX0220_12M, display a “Yes” and “No” column with options for each
response category.
BOX ID:

R04_YXR48

New baseline youth respondents who have ever used Ritalin® or Adderall®, or painkillers, sedatives, or
tranquilizers and continuing youth respondents, go to R04_YX0089_12M.
Else, new baseline youth respondents who have ever used cocaine or crack, stimulants, or other drugs,
go to R04_YX0220_12M.
PATH ID:

R04_YX0089_12M

In the past 12 months, have you used any of the following prescription drugs that were not prescribed
for you or that you took only for the experience or feeling they caused?
1

Ritalin® or Adderall®

2

Painkillers, sedatives, or tranquilizers

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever used Ritalin® or Adderall®, or painkillers,
sedatives, or tranquilizers and continuing youth respondents.
DISPLAY: UNDERLINE "not" AND "only".
IF R04_YOUTHTYPE = 2, 3 AND R04_YX0089_NB_01 = 1, DISPLAY OPTION 1; ELSE, DO NOT
DISPLAY OPTION 1.
IF R04_YOUTHTYPE = 2, 3 AND R04_YX0089_NB_02 = 1, DISPLAY OPTION 2; ELSE, DO NOT
DISPLAY OPTION 2.
IF R04_YOUTHTYPE = 1, DISPLAY ALL RESPONSE OPTIONS.

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BOX ID:

R04_YXR49

New baseline youth respondents who have ever used cocaine or crack, stimulants, or other drugs and
continuing youth respondents, go to R04_YX0220_12M.
Else, go to Box R04_YXR08.
PATH ID:

R04_YX0220_12M

In the past 12 months, have you used any of the following substances?
1

Cocaine or crack

2

Stimulants like methamphetamine or speed

3

Any other drugs like heroin, inhalants, solvents, or hallucinogens

-8

DON'T KNOW

-7

REFUSED

ASK: New baseline youth respondents who have ever used cocaine or crack, stimulants, or other drugs
and continuing youth respondents.
DISPLAY: IF R04_YOUTHTYPE = 2, 3 AND R04_YX0220_NB_01 = 1, DISPLAY RESPONSE OPTION
1; ELSE, DO NOT DISPLAY OPTION 1.
IF R04_YOUTHTYPE = 2, 3 AND R04_YX0220_NB_02 = 1, DISPLAY RESPONSE OPTION 2; ELSE,
DO NOT DISPLAY OPTION 2.
IF R04_YOUTHTYPE = 2, 3 AND R04_YX0220_NB_03 = 1, DISPLAY RESPONSE OPTION 3; ELSE,
DO NOT DISPLAY OPTION 3.
IF R04_YOUTHTYPE = 1, DISPLAY ALL RESPONSE OPTIONS.
BOX ID:

R04_YXR08

PROGRAM: Repeat R04_YX0676[_01/.../_05] for each substance selected in
R04_YX0089_12M[_01/_02] and R04_YX0220_12M[_01/_02/_03].
If no substances are selected in R04_YX0089_12M[_01/_02] and R04_YX0220_12M[_01/_02/_03], go
to Box R04_YXV02.
PATH ID:

R04_YX0676

Have you used [SUBSTANCEFILL] in the past 30 days?
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who have used a substance in the past 12 months.
DISPLAY: UNDERLINE "past 30 days".

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BOX ID:

R04_YXR01

Youth respondents who have remaining substance loops to complete, go back to R04_YX0676 and
repeat for remaining substances.
Else, if youth respondent has no remaining substance loops to complete, go to Box R04_YXV02.
BOX ID:

R04_YXV02

PROGRAM: CREATE THE FOLLOWING DERIVED VARIABLES (SEE APPENDIX):
R04_EVER_USER_ALC = Has ever used alcohol
R04_EVER_USER_MJ = Has ever used marijuana
R04_EVER_USER_RIT = Has ever used Ritalin® or Adderall®
R04_EVER_USER_PK = Has ever used painkillers, sedatives, or tranquilizers
R04_EVER_USER_COC = Has ever used cocaine or crack
R04_EVER_USER_STIM = Has ever used stimulants like methamphetamine or speed
R04_EVER_USER_OTH = Has ever used other drugs like heroin, inhalants, solvents, or hallucinogens
R04_SUBSTANCE_COUNT = Count of the number of substances ever used
BOX ID:

R04_YXR02

If youth respondent has used at least one substance, go to R04_YX0170.
Else, go to Box R04_YMT01.
PATH ID:

R04_YX0170

When was the last time that...
You used alcohol or other drugs weekly or more often?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.
BOX ID:

R04_YXR03

If youth respondent has used two or more substances and has used alcohol or drugs weekly or more
often, go to R04_YX0175.
Else, go to R04_YX0171.

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PATH ID:

R04_YX0175

You mentioned that you used alcohol or drugs at least weekly sometime in the past. Which substances
did you use weekly or more often? Please do not include drugs that were prescribed for you. Choose all
that apply.
1

Alcohol

2

Marijuana, hash, THC, grass, pot, or weed

3

Ritalin® or Adderall®

4

Painkillers, sedatives, or tranquilizers

5

Cocaine or crack

6

Stimulants like methamphetamine or speed

7

Any other drugs like heroin, inhalants, solvents, or hallucinogens

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who used alcohol or other drugs weekly or more often AND report ever using
two or more substances.
PATH ID:

R04_YX0171

When was the last time that...
You spent a lot of time getting alcohol or other drugs?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.

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PATH ID:

R04_YX0172

When was the last time that...
You kept using alcohol or other drugs even though it was causing social problems, leading to fights, or
getting you into trouble with other people?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.
PATH ID:

R04_YX0173

When was the last time that...
Your use of alcohol or other drugs reduced your involvement with activities at work, school, home, or
social events?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.
PATH ID:

R04_YX0193

When was the last time that...
You spent a lot of time using or recovering from alcohol or other drugs?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.

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PATH ID:

R04_YX0174

When was the last time that...
You had withdrawal problems such as shaky hands, throwing up, having trouble sitting still or sleeping?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.
PATH ID:

R04_YX0194

When was the last time that...
You used any alcohol or other drugs to stop being sick or avoid withdrawal problems?
1

Past month

2

2 to 12 months ago

3

Over a year ago

4

Never

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who report ever using alcohol or ever using drugs.
BOX ID:

R04_YXR31

Youth respondents who use two or more substances and who indicated alcohol or drugs caused
problems for them, go to R04_YX0176.
Else, go to Box R04_YMT01.

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PATH ID:

R04_YX0176

You mentioned that alcohol or drugs caused some problems for you. Which substances caused these
problems? Please do not include drugs that were prescribed for you. Choose all that apply.
1

Alcohol

2

Marijuana, hash, THC, grass, pot, or weed

3

Ritalin® or Adderall®

4

Painkillers, sedatives, or tranquilizers

5

Cocaine or crack

6

Stimulants like methamphetamine or speed

7

Any other drugs like heroin, inhalants, solvents, or hallucinogens

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who use two or more substances and who indicated alcohol or drugs caused
problems for them.

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ADDITIONAL DEMOGRAPHICS
BOX ID:

R04_YMT01

Finally, we have a few additional questions to ask about you.
PATH ID:

R04_YM0019

Have you been going to school at any time during the past 12 months?
1

Yes

2

No

GO TO R04_YM0020

-8

DON'T KNOW

GO TO R04_YM0020

-7

REFUSED

GO TO R04_YM0020

ASK: All youth respondents.
PATH ID:

R04_YM0018

What grade are you in? If you are on a holiday or summer break, please select the grade or year you
will enter when you return to school.
1

4th grade or below

GO TO R04_YM0032

2

5th

GO TO R04_YM0032

3

6th

GO TO R04_YM0032

4

7th

GO TO R04_YM0032

5

8th

GO TO R04_YM0032

6

9th

GO TO R04_YM0032

7

10th

GO TO R04_YM0032

8

11th

GO TO R04_YM0032

9

12th grade

GO TO R04_YM0032

10

College, vocational or technical school

GO TO R04_YM0032

11

Not enrolled

GO TO R04_YM0032

12

I am home-schooled

GO TO R04_YM0032

13

My school is ungraded

GO TO R04_YM0032

-8

DON'T KNOW

GO TO R04_YM0032

-7

REFUSED

GO TO R04_YM0032

ASK: Youth respondents who went to school in the past 12 months.

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PATH ID:

R04_YM0020

What grade or year in school did you last complete?
1

4th grade or below

2

5th

3

6th

4

7th

5

8th

6

9th

7

10th

8

11th

9

12th grade

10

College, vocational or technical school

11

I am home-schooled

12

My school is ungraded

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents who did not go to school in the past 12 months.
PATH ID:

R04_YM0032

In the past 30 days, did you work for pay for anyone outside your home? This includes both regular jobs
and things like baby-sitting or yard work.
1

Yes

2

No

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.

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PATH ID:

R04_YM0008

During an average week, how much money do you receive in total? Please include money from a job,
your family, an allowance, or any other sources.
1

None

2

Less than $1

3

$1 to $5

4

$6 to $10

5

$11 to $20

6

$21 to $50

7

$51 to $100

8

$101 to $150

9

$151 or more

-8

DON'T KNOW

-7

REFUSED

ASK: All youth respondents.
BOX ID:

R04_YMR04

Youth respondents aged 17 and older, go to R04_YM0007.
Else, youth respondents aged 14 and older, go to R04_YM0021.
Else, go to R04_YMR05.
PATH ID:

R04_YM0007

Have you ever served on active duty in the U.S. Armed Forces, Military Reserves, or National Guard?
Note: Active duty for the Military Reserves or National Guard does not include regular training for the
Military Reserves or National Guard. It does include being activated for deployment, such as for the
Iraq War.
1

Yes, now on active duty

2

Yes, on active duty in the past, but not now

3

No, training for Reserves or National Guard only

GO TO R04_YM0021

4

No, never served in the military

GO TO R04_YM0021

-8

DON'T KNOW

GO TO R04_YM0021

-7

REFUSED

GO TO R04_YM0021

ASK: Youth respondents aged 17 and older.

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PATH ID:

R04_YM0011

In which branch or branches [do/did] you serve on active duty? Choose all that apply.
1

Army

2

Navy

3

Air Force

4

Marine Corps

5

Coast Guard

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents aged 17 and older who have been on active duty, both currently or in the past.
DISPLAY: IF R04_YM0007 = 1, DISPLAY "do".
ELSE, IF R04_YM0007 = 2, DISPLAY "did".
PATH ID:

R04_YM0021

The next question asks about your level of sexual attraction to BOTH males and females.
Please consider the response choices carefully, as it is important that you understand them and are as
honest as you can be in your answer.
To whom have you felt sexually attracted, even if you did not take any action based on feeling
attracted?
1

Only to females, never to males

2

Mostly to females, and at least once to a male

3

About equally often to females and to males

4

Mostly to males, and at least once to a female

5

Only to males, never to females

6

I have never felt sexually attracted to anyone at all

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents aged 14 and older.
DISPLAY: FOR MALE RESPONDENTS, DISPLAY RESPONSE OPTIONS 1-5 IN THE SPECIFIED
ORDER. FOR FEMALE RESPONDENTS, DISPLAY RESPONSE OPTIONS 1-5 IN REVERSE
ORDER, WHERE RESPONSE OPTION 5 IS PRESENTED FIRST, OPTION 4 SECOND, ETC. IF SEX
IS UNKNOWN, DEFAULT TO ORDER SHOWN FOR MALE RESPONDENTS.

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PATH ID:

R04_YM0063

Do you consider yourself to be…
1

Straight

2

Lesbian or gay

3

Bisexual

4

Something else

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents aged 14 and older.
PATH ID:

R04_YM0061

Some people describe themselves as transgender when they experience a different gender identity from
their sex at birth. For example, a person born into a male body, but who feels female or lives as a
woman would be transgender.
Do you consider yourself to be transgender?
1

Yes

2

No

GO TO R04_YMR05

-8

DON'T KNOW

GO TO R04_YMR05

-7

REFUSED

GO TO R04_YMR05

ASK: Youth respondents aged 14 and older.
PATH ID:

R04_YM0062

Do you consider yourself to be male-to-female, female-to-male, or non-conforming?
1

Yes, Transgender, male to female

2

Yes, Transgender, female to male

3

Yes, Transgender, gender nonconforming

4

No

5

Not sure

-8

DON'T KNOW

-7

REFUSED

ASK: Youth respondents aged 14 and older who are transgender.
BOX ID:

R04_YMR05

Random sample of all youth respondents, go to R04_YX0769.
Else, go to R04_YL3000.

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PATH ID:

R04_YX0769

In the future, the PATH questionnaire may be available to take online on your personal desktop, laptop,
or tablet. Due to its length, the questionnaire will not be available on smart phones.
You would be able to complete the questionnaire at your convenience, without an interviewer present.
The incentive would arrive in the mail a few days after the questionnaire is completed.
How interested would you be in taking the PATH questionnaire online on your personal desktop, laptop,
or tablet?
1

Very interested

GO TO R04_YL3000

2

Somewhat interested

GO TO R04_YL3000

3

Not at all interested

4

Unsure

GO TO R04_YL3000

-8

DON'T KNOW

GO TO R04_YL3000

-7

REFUSED

GO TO R04_YL3000

ASK: Random sample of all youth respondents.
PATH ID:

R04_YX0770

Why not? Choose all that apply.
1

I do not have a personal desktop, laptop, or tablet with internet access

2

I am concerned about technical difficulties

3

I prefer to have an interviewer present

4

I am concerned about the confidentiality of my information

5

I am concerned that I might not receive my incentive

6

Other (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Subsampled youth respondents who would not be interested in doing PATH questionnaires online
in the future.
PATH ID:

R04_YL3000

You have finished[ this part of] the questionnaire. Please hand the computer to the interviewer.
1

CONTINUE

ASK: All youth respondents.
DISPLAY: IF R04_E_YOUTH_LD = 1, DISPLAY “this part of ”;
ELSE, DO NOT DISPLAY THIS TEXT.

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PATH ID:

R04_YL3001

The interviewer must now enter the Monitor Password into the computer.
1

I__I__I__I__I MONITOR PASSWORD

ASK: All youth respondents.
PATH ID:

R04_ERR_YL3001

The password you entered was incorrect.
Please press the BACK button and re-enter. Don’t forget to press the ERASE button before you re-enter
your answer.
1

BACK

GO TO R04_YL3001

ASK: If interviewer entered monitor password incorrectly.
BOX ID:

R04_YLR04

Emancipated youth respondents, go to R04_YL3002.
Else, go to R04_LCYS01.
PATH ID:

R04_YL3002

YOU MUST COLLECT CONTACT INFORMATION FROM THE RESPONDENT.
THE RESPONDENT IS AN EMANCIPATED YOUTH.
PRESS 1 TO CONTINUE
1

CONTINUE

ASK: Interviewers
DISPLAY: Display interviewer instructions in blue font.
BOX ID:

R04_YLR05

Emancipated youth, go to contact information section R04_YXT04.
Else, go to R04_LCYS01

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CONTACT INFORMATION – EMANCIPATED YOUTH
BOX ID:

R04_YXT04

CONTACT INFORMATION SECTION IS ASKED OF EMANCIPATED YOUTH ONLY.
PATH ID:

R04_YL0041

Since your continued participation in the PATH Study is important to the study’s success, I’d like to take
a brief moment to confirm your contact information for my records. We’ll only use this information to
contact you about your participation in the study.
PRESS 1 TO CONTINUE.
1

CONTINUE

ASK: Emancipated youth respondents.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
BOX ID:

R04_YLR01

Emancipated youth respondents who have a valid Wave 4 physical address, go to R04_YL0001.
Else, go to R04_YL0037.
PATH ID:

R04_YL0001

I have your address as…
READ ADDRESS ALOUD.
ADDRESS
APT #
CITY, STATE ZIP CODE
Is that correct?
1

YES

2

NO

GO TO R04_YL0002

ASK: Emancipated youth respondents who have a valid physical address on file.
DISPLAY: DISPLAY ADDRESS IN EASY TO READ FORMAT. DISPLAY INSTRUCTIONAL TEXT IN
BLUE.

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PATH ID:

R04_YL0037

What is your address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

GO TO R04_YL0035

-7

REFUSED

GO TO R04_YL0035

ASK: Emancipated youth respondents who need to correct their physical address or who do not have a
valid physical address on file.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
PATH ID:

R04_YL0002

Do you receive mail at this address?
1

YES

2

NO

GO TO R04_YL0035

-8

DON'T KNOW

GO TO R04_YL0035

-7

REFUSED

GO TO R04_YL0035

ASK: Emancipated youth respondents who confirmed or provided their physical address.
PATH ID:

R04_YL0003

Can I please have your mailing address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who do not receive mail at their physical address.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.

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PATH ID:

R04_YL0035

Do you have a second home where you live during the year?
1

YES

2

NO

GO TO BOX R04_YLR02

-8

DON'T KNOW

GO TO BOX R04_YLR02

-7

REFUSED

GO TO BOX R04_YLR02

ASK: Emancipated youth respondents.
PATH ID:

R04_YL0036

What is the address of the second home?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who have a second home.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
BOX ID:

R04_YLR02

Emancipated youth respondents who have a valid telephone number on file, go to R04_YL0004_12M.
Else, go to R04_YL0004.
PATH ID:

R04_YL0004_12M

I have your telephone number as [(XXX) XXX-XXXX].
Is that correct?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO R04_YL0038

GO TO R04_YL0012

ASK: Emancipated youth respondents who have a valid telephone number on file.

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PATH ID:

R04_YL0004

What is the best telephone number to reach you?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

GO TO R04_YL0012

-7

REFUSED

GO TO R04_YL0012

ASK: Emancipated youth respondents who need to correct their telephone number, who don't know if
the telephone number provided is correct, or who do not have a valid telephone number on file.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
PATH ID:

R04_YL0038

Is this a cell phone number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO BOX R04_YLR03

ASK: Emancipated youth respondents who confirmed or provided their telephone number.
PATH ID:

R04_YL0032

May we contact you by text message at this number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who said their telephone number is a cell phone or did not know
or refused to report whether it is a cell phone.
BOX ID:

R04_YLR03

Emancipated youth respondents who have a valid second telephone number on file, go to R04_YL0005.
Else, go to R04_YL0006.

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PATH ID:

R04_YL0005

I have your second telephone number as [(XXX) XXX-XXXX].
Is that correct?
IF SP DOES NOT WANT TO PROVIDE A SECOND PHONE NUMBER, ENTER REFUSED.
1

YES

2

NO

GO TO R04_YL0039

-8

DON'T KNOW

GO TO R04_YL0012

-7

REFUSED

GO TO R04_YL0012

ASK: Emancipated youth respondents who have a valid second telephone number on file.
PATH ID:

R04_YL0006

What is a second telephone number where you can be reached?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

GO TO R04_YL0012

-7

REFUSED

GO TO R04_YL0012

ASK: Emancipated youth respondents who need to correct their second telehone number or who do not
have a valid second telephone number on file.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
PATH ID:

R04_YL0039

Is this a cell phone number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

GO TO R04_YL0012

ASK: Emancipated youth respondents who confirmed their phone number in R04_YL0005 or provided a
phone number in R04_YL0006.

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PATH ID:

R04_YL0033

May we contact you by text message at this number?
1

YES

2

NO

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who said their second number is a cell phone or did not know or
refused to report whether it is a cell phone.
PATH ID:

R04_YL0012

Can you please give me your e-mail address?
VERIFY ALL SPELLING AND PUNCTUATION. RECORD TEXT BEFORE @ SYMBOL IN THE EMAIL
NAME FIELD. TEXT AFTER THE @ SYMBOL IS ENTERED IN THE EMAIL PROVIDER FIELD.
1

EMAIL NAME

2

EMAIL PROVIDER

-8

DON'T KNOW

-7

REFUSE

ASK: Emancipated youth respondents.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
BOX ID:

R04_YLR09

Emancipated youth respondents who provided more than one mode of contact information, go to
R04_YL0017.
Else, go to R04_YL0018.
PATH ID:

R04_YL0017

What is the best way to reach you?
1

PHONE

2

TEXT MESSAGE

3

E-MAIL

-8

DON’T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided more than one mode of contact information.

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PATH ID:

R04_YL0018

Do you anticipate moving or relocating either permanently or temporarily in the next 12 months?
1

YES

2

NO

3

MAYBE

GO TO R04_YL0020

-8

DON'T KNOW

GO TO R04_YL0020

-7

REFUSED

GO TO R04_YL0020

ASK: Emancipated youth respondents.
PATH ID:

R04_YL0019

Can you tell me more about your plans to move?
[IF NEEDED: For example, your new street address or the city or state to which you plan to move?]
PROBE FOR AND RECORD ANY KNOWN INFORMATION.
1

[TEXT FIELD]

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who plan to move in the next 12 months.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.

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PATH ID:

R04_YL0020

Since we would like to interview you again, it is important that we are able to contact you in about a
year. In case we cannot reach you, is there a relative or friend who does not live in this household, who
will know how to reach you?
IF NEEDED: Rest assured, we will only use this information if we have lost contact with you.
What is the person’s name?
VERIFY ALL SPELLING.
IF SP IS UNABLE TO PROVIDE A FIRST NAME MARK AS DON'T KNOW / REFUSED.
1

FIRST NAME

2

LAST NAME

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE AND BOLD "FIRST NAME".
BOX ID:

R04_YLR10

If FIRST NAME is don’t know or refused, go to R04_YL3003.
Else, go to R04_YL0022.
PATH ID:

R04_YL0022

What is their address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided a first name for a proxy contact in R04_YL0020.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.

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PATH ID:

R04_YL0023

What is their telephone number?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided a first name for a proxy contact in R04_YL0020.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
PATH ID:

R04_YL0021

How are they related to you?
1

HUSBAND/WIFE

2

FATHER/MOTHER (INCLUDING IN-LAWS)

4

GRANDPARENT

8

BROTHER/SISTER (INCLUDING IN-LAWS)

13

FRIEND/NEIGHBOR

91

OTHER RELATIVE (SPECIFY)

92

OTHER NON-RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who who provided a first name for a proxy contact in
R04_YL0020.
PATH ID:

R04_YL0025

Could you provide me with the name of a second relative or friend who will know how to reach you?
VERIFY ALL SPELLING.
IF SP IS UNABLE TO PROVIDE A FIRST NAME MARK AS DON'T KNOW / REFUSED.
1

FIRST NAME

2

LAST NAME

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided a first name for a proxy contact in R04_YL0020.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE AND BOLD "FIRST NAME".

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BOX ID:

R04_YLR11

If FIRST NAME is don’t know or refused, go to R04_YL3003.
Else, go to R04_YL0027
PATH ID:

R04_YL0027

What is their address?
VERIFY ALL SPELLING.
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided a first name for a proxy contact in R04_YL0025.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
PATH ID:

R04_YL0028

What is their telephone number?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided a first name for a proxy contact in R04_YL0025.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.

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PATH ID:

R04_YL0026

How are they related to you?
1

HUSBAND/WIFE

2

FATHER/MOTHER (INCLUDING IN-LAWS)

4

GRANDPARENT

8

BROTHER/SISTER (INCLUDING IN-LAWS)

13

FRIEND/NEIGHBOR

91

OTHER RELATIVE (SPECIFY)

92

OTHER NON-RELATIVE (SPECIFY)

-8

DON'T KNOW

-7

REFUSED

ASK: Emancipated youth respondents who provided a first name for a proxy contact in R04_YL0025.
PATH ID:

R04_YL3003

If you do move or change your phone numbers please update your contact information on the PATH
Study website or by calling our toll free number. Each year you may receive a $5 thank you on your
debit card for updating your contact information.
Thank you for taking the time to answer these questions.
ENTER 1 TO CONTINUE.
1

CONTINUE

ASK: Emancipated youth respondents.
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.
PATH ID:

R04_LCYS01

INTERVIEWER: IN WHAT LANGUAGE DID YOU MOSTLY CONDUCT THE CAPI PORTIONS OF
THIS INTERVIEW?
1

ENGLISH

END INTERVIEW AND RETURN TO IMS

2

SPANISH

END INTERVIEW AND RETURN TO IMS

ASK: All youth respondents (asked of Interviewer).
DISPLAY: DISPLAY INSTRUCTIONAL TEXT IN BLUE.

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APPENDIX: USER GROUPS
User Group and Variable Name

User Group Description

User Group Definition

Ever or Never users - Cigarettes
R04_EVER_NEVER_CIGS_YOUTH

(1) Ever user = Youth respondents who have
ever smoked a cigarette.
(2) Never user = Youth respondents who have
not ever smoked a cigarette.

IF (R04_YC1002_NB = 1 OR
R04_YC1002_12M = 1 OR
R03_EVER_NEVER_CIGS = 1), THEN
R04_EVER_NEVER_CIGS_YOUTH = 1.
ELSE, IF R04_EVER_NEVER_CIGS_YOUTH
!= 1, THEN
R04_EVER_NEVER_CIGS_YOUTH = 2.

Initiators - Cigarettes
R04_INIT_CIGS_YOUTH

(1) Initiator = Youth respondents who initiated
cigarette use between Waves or new baseline
youth respondents who have ever smoked a
cigarette.
(2) Non-initiator = Youth respondents who did
not initiate cigarette use between Waves or
new baseline youth respondent who have not
ever smoked a cigarette.

IF R03_EVER_NEVER_CIGS ! = 1 AND
R04_EVER_NEVER_CIGS_YOUTH = 1, THEN
R04_INIT_CIGS_YOUTH = 1.
ELSE, R04_INIT_CIGS_YOUTH = 2.

Past 30 Day Users - Cigarettes
R04_PAST30DAY_CIGS

(1) Past 30 day user = Youth respondents who
have smoked a cigarette in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a cigarette
in the past 30 days.

IF R04_YC1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_CIGS = 1.
ELSE, R04_PAST30DAY_CIGS = 2.

Past 30 Day "Very Light" or "Not Light" Cigarettes
R04_PAST30DAY_CIGS_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have smoked a cigarette in
the past 30 days, and have smoked 10 or less
cigarettes in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have smoked a cigarette in
the past 30 days, and have smoked more than
10 cigarettes in their lifetime.
(8) Unknown / missing = Unknown or missing

IF (R04_YC1005 = 1 OR 2 OR 3 AND
R03_NUMLIFE_CIGS != 1) AND (R04_YC1112
= 1 OR 2 OR 3), THEN
R04_PAST30DAY_CIGS_LEVEL = 1.
ELSE, IF (R04_YC1005 > 3 OR R04_YC1005 =
-8, -7 OR R03_NUMLIFE_CIGS = 1) AND
(R04_YC1112 = 1 OR 2 OR 3), THEN
R04_PAST30DAY_CIGS_LEVEL= 2.
ELSE, R04_PAST30DAY_CIGS_LEVEL = 8.

Ever or Never Users - Electronic

(1) Ever user = Youth respondents who have

IF (R03_EVER_NEVER_EPRODS = 1 OR

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User Group and Variable Name

User Group Description

User Group Definition

Nicotine Products
R04_EVER_NEVER_EPRODS_YOUTH

ever used an electronic nicotine product.
(2) Never user = Youth respondents who have
not ever used an electronic nicotine product.

(R04_YV1001_NB = 1 AND R04_YV1002_NB
= 1) OR R04_YV1002_12M = 1), THEN
R04_EVER_NEVER_EPRODS_YOUTH = 1.
ELSE, IF
R04_EVER_NEVER_EPRODS_YOUTH != 1,
THEN R04_EVER_NEVER_EPRODS_YOUTH
= 2.

Initiators - E-Products
R04_INIT_EPRODS_YOUTH

(1) Initiator = Youth respondents who initiated
e-product use between Waves or new baseline
youth respondents who have ever used an eproduct.
(2) Non-initiator = Youth respondents who
have not initiated e-product use between
Waves or new baseline youth respondents
who have not ever used an e-product.

IF R03_EVER_NEVER_EPRODS != 1 AND
R04_EVER_NEVER_EPRODS = 1, THEN
R04_INIT_EPRODS_YOUTH = 1.
ELSE, R04_INIT_EPRODS_YOUTH = 2.

Past 30 Day Users - E-Products
R04_PAST30DAY_EPRODS

(1) Past 30 day user = Youth respondents who
have used an e-product in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not used an e-product
in the past 30 days.

IF R04_YV1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_EPRODS = 1.
ELSE, R04_PAST30DAY_EPRODS = 2.

Past 30 Day "Very Light" or "Not Light
Users - E-Products
R04_PAST30DAY_EPRODS_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have used an e-product in
the past 30 days, and have used an e-product
only once in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have used an e-product in
the past 30 days, and have used e-products
more than once in their lifetime.
(8) Unknown / missing = Unknown or missing

IF (R04_YV1005 = 1 AND
R03_NUMLIFE_EPRODS != 1) AND
(R04_YV1112 = 1 OR 2 OR 3), THEN
R04_PAST30DAY_EPRODS_LEVEL = 1.
ELSE, IF (R04_YV1005 > 1 OR R04_YV1005 =
-8, -7 OR R03_NUMLIFE_EPRODS = 1) AND
(R04_YV1112 = 1 OR 2 OR 3), THEN
R04_PAST30DAY_EPRODS_LEVEL= 2.
ELSE, R04_PAST30DAY_EPRODS_LEVEL =
8.

Ever or Never Smokers – Traditional
Cigars
R04_EVER_NEVER_GTRAD_YOUTH

(1) Ever user = Youth respondents who have
ever smoked a traditional cigar.
(2) Never user = Youth respondents who have
not ever smoked a traditional cigar.

IF (R04_YG9101_NB = 1 AND
R04_YG1002_NB = 1 AND
R04_YG9104_NB_01 = 1) OR
R04_YG9104_12M_01 = 1 OR

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User Group and Variable Name

User Group Description

User Group Definition
R03_EVER_NEVER_GTRAD = 1, THEN
R04_EVER_NEVER_GTRAD_YOUTH = 1.
ELSE, IF
R04_EVER_NEVER_GTRAD_YOUTH != 1,
THEN R04_EVER_NEVER_GTRAD_YOUTH =
2.

Initiators – Traditional Cigars
R04_INIT_GTRAD_YOUTH

(1) Initiator = Youth respondents who initiated
traditional cigar use between Waves or new
baseline youth respondents who have ever
smoked a traditional cigar.
(2) Non-initiator = Youth respondents who did
not initiate traditional cigar use between
Waves or new baseline youth respondents
who have not ever smoked a traditional cigar.

IF R03_EVER_NEVER_GTRAD != 1 AND
R04_EVER_NEVER_GTRAD_YOUTH = 1,
THEN R04_INIT_GTRAD_YOUTH = 1.
ELSE, R04_INIT_GTRAD_YOUTH = 2.

Past 30 Day Smokers - Traditional
Cigars
R04_PAST30DAY_GTRAD

(1) Past 30 day user = Youth respondents who
have smoked a traditional cigar in the past 30
days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a
traditional cigar in the past 30 days.

IF R04_YG1112TC = 1 OR 2 OR 3, THEN
R04_PAST30DAY_GTRAD = 1.
ELSE, R04_PAST30DAY_GTRAD = 2.

Past 30 Day "Very Light" or "Not Light"
Smokers - Traditional Cigars
R04_PAST30DAY_GTRAD_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have smoked a traditional
cigar in the past 30 days, and have smoked 10
or less traditional cigars in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have smoked a traditional
cigar in the past 30 days, and have smoked
more than 10 traditional cigars in their lifetime.
(8) Unknown / missing = Unknown or missing

IF (R04_YG1005TC = 1 OR 2 OR 3 AND
R03_NUMLIFE_GTRAD != 1) AND
(R04_YG1112TC = 1 OR 2 OR 3), THEN
R04_PAST30DAY_GTRAD_LEVEL = 1.
ELSE, IF (R04_YG1005TC > 3 OR
R04_YG1005TC = -8, -7 OR
R03_NUMLIFE_GTRAD = 1 AND
(R04_YG1112TC = 1 OR 2 OR 3), THEN
R04_PAST30DAY_GTRAD_LEVEL = 2.
ELSE, R04_PAST30DAY_GTRAD_LEVEL = 8.

Past 12 Month Blunt-Only Smokers –
Traditional Cigars
R04_12MBLUNT_ONLY_BTRAD

(1) Past 12 month blunt-only smoker = Youth
respondents who smoke traditional cigars as
blunts everytime when smoked in the past 12
months.

IF R04_YG9106_01 = 1 AND R04_YG1095_01
= 1, THEN R04_12MBLUNT_ONLY_BTRAD =
1.
ELSE, R04_12MBLUNT_ONLY_BTRAD = 2.

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User Group and Variable Name

User Group Description

User Group Definition

(2) Not a blunt-only smoker = Youth
respondents who do not smoke traditional
cigars as blunts everytime when smoked in the
past 12 months.
Past 30 Day Blunt-Only Smokers –
Traditional Cigars
R04_30DBLUNT_ONLY_BTRAD

(1) Past 30 day user = Youth respondents who
have smoked a traditional cigar as a blunt in
the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a
traditional cigar as a blunt in the past 30 days.

IF R04_12MBLUNT_ONLY_BTRAD = 1 AND
R04_YJ1112TC = 1 OR 2 OR 3, THEN
R04_30DBLUNT_ONLY_BTRAD = 1.
ELSE, R04_30DBLUNT_ONLY_BTRAD = 2.

Initiators – Traditional Cigars as Blunts
R04_INIT_BLUNT_BTRAD_YOUTH

(1) Initiator = Youth respondents who initiated
smoking traditional cigars as blunts between
Waves or new baseline youth respondents
who have ever used traditional cigars as blunts
every time in the past 12 months.
(2) Non-initiator = Youth respondents who did
not initiate smoking traditional cigars as blunts
between Waves or new baseline youth
respondents who have not ever used
traditional cigars as blunts.

IF R03_EVER_NEVER_BTRAD != 1 AND
R04_YG1095_01 = 1 AND R04_YG9106_01 =
1, THEN R04_INIT_BLUNT_BTRAD_YOUTH =
1.
ELSE, R04_INIT_BLUNT_BTRAD_YOUTH = 2.

Ever or Never Smokers – Cigarillos
R04_EVER_NEVER_GRILLO_YOUTH

(1) Ever user = Youth respondents who have
ever smoked a cigarillo.
(2) Never user = Youth respondents who have
not ever smoked a cigarillo.

IF (R04_YG9101_NB = 1 AND
R04_YG1002_NB = 1 AND
R04_YG9104_NB_02 = 1 AND
(R04_YG9009_NB_01= 1 OR
R04_YG9009_NB_03 = 1)) OR
R04_YG9009_12M_01 = 1 OR
R4_YG9009_12M_03 = 1 OR
R03_EVER_NEVER_GRILLO = 1, THEN
R04_EVER_NEVER_GRILLO_YOUTH = 1.
ELSE, IF
R04_EVER_NEVER_GRILLO_YOUTH != 1,
THEN R04_EVER_NEVER_GRILLO_YOUTH =
2.

Initiators – Cigarillos

(1) Initiator = Youth respondents who initiated
cigarillo use between Waves or new baseline

IF R03_EVER_NEVER_GRILLO != 1 AND
R04_EVER_NEVER_GRILLO_YOUTH = 1,

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User Group and Variable Name

User Group Description

User Group Definition

R04_INIT_GRILLO_YOUTH

youth respondents who have ever smoked a
cigarillo.
(2) Non-initiator = Youth respondents who did
not initiate cigarillo use between Waves or new
baseline youth respondents who have not ever
smoked a cigarillo.

THEN R04_INIT_GRILLO_YOUTH = 1.
ELSE, R04_INIT_GRILLO_YOUTH = 2.

Past 30 Day Smokers - Cigarillos
R04_PAST30DAY_GRILLO

(1) Past 30 day user = Youth respondents who
have smoked a cigarillo in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a cigarillo
in the past 30 days.

IF R04_YG1112CL = 1 OR 2 OR 3, THEN
R04_PAST30DAY_GRILLO = 1.
ELSE, R04_PAST30DAY_GRILLO = 2.

Past 30 Day "Very Light" or "Not Light"
Smokers - Cigarillos
R04_PAST30DAY_GRILLO_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have smoked a cigarillo in
the past 30 days, and have smoked 10 or less
cigarillos in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have smoked a cigarillo in
the past 30 days, and have smoked more than
10 cigarillos in their lifetime.
(8) Unknown / missing = Unknown or missing

IF (R04_YG1005CL = 1 OR 2 OR 3 AND
R03_NUMLIFE_GRILLO != 1) AND
(R04_YG1112CL = 1 OR 2 OR 3), THEN
R04_PAST30DAY_GRILLO_LEVEL = 1.
ELSE, IF (R04_YG1005CL > 3 OR
R04_YG1005CL = -8, -7 OR
R03_NUMLIFE_GRILLO = 1) AND
(R04_YG1112CL = 1 OR 2 OR 3), THEN
R04_PAST30DAY_GRILLO_LEVEL = 2.
ELSE, R04_PAST30DAY_GRILLO_LEVEL = 8.

Past 12 Month Blunt-Only Smokers –
Cigarillos
R04_12MBLUNT_ONLY_BRILLO

(1) Past 12 month blunt-only smoker = Youth
respondents who smoke cigarillos as blunts
everytime when smoked in the past 12
months.
(2) Not a blunt-only smoker = Youth
respondents who do not smoke cigarillos as
blunts everytime when smoked in the past 12
months.

IF R04_YG9106_02 = 1 AND R04_YG1095_02
= 1, THEN R04_12MBLUNT_ONLY_BRILLO =
1.
ELSE, R04_12MBLUNT_ONLY_BRILLO = 2.

Past 30 Day Blunt-Only Smokers –
Cigarillos
R04_30DBLUNT_ONLY_BRILLO

(1) Past 30 day user = Youth respondents who
have smoked a cigarillo as a blunt in the past
30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a cigarillo
as a blunt in the past 30 days.

IF R04_12MBLUNT_ONLY_BRILLO = 1 AND
R04_YJ1112CG = 1 OR 2 OR 3, THEN
R04_30DBLUNT_ONLY_BRILLO = 1.
ELSE, R04_30DBLUNT_ONLY_BRILLO = 2.

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Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

Initiators – Cigarillos as Blunts
R04_INIT_BLUNT_BRILLO_YOUTH

(1) Initiator = Youth respondents who initiated
smoking cigarillos as blunts between Waves or
new baseline youth respondents who have
ever used cigarillos as blunts every time in the
past 12 months.
(2) Non-initiator = Youth respondents who did
not initiate smoking cigarillos as blunts
between Waves or new baseline youth
respondents who have not ever used cigarillos
as blunts.

IF R03_EVER_NEVER_BRILLO != 1 AND
R04_YG1095_02 = 1 AND R04_YG9106_02 =
1, THEN R04_INIT_BLUNT_BRILLO_YOUTH =
1.
ELSE, R04_INIT_BLUNT_BRILLO_YOUTH =
2.

Ever or Never Smokers – Filtered
Cigars
R04_EVER_NEVER_GFILTR_YOUTH

(1) Ever user = Youth respondents who have
ever smoked a filtered cigar.
(2) Never user = Youth respondents who have
not ever smoked a filtered cigar.

IF (R04_YG9101_NB = 1 AND
R04_YG1002_NB = 1 AND
R04_YG9104_NB_02 = 1 AND
R04_YG9009_NB_02 = 1) OR
R04_YG9009_12M_02 = 1 OR
R03_EVER_NEVER_GFILTR = 1), THEN
R04_EVER_NEVER_GFILTR_YOUTH = 1.
ELSE, IF
R04_EVER_NEVER_GFILTR_YOUTH != 1,
THEN R04_EVER_NEVER_GFILTR_YOUTH =
2.

Initiators – Filtered Cigars
R04_INIT_GFILTR_YOUTH

(1) Initiator = Youth respondents who initiated
filtered cigar use between Waves or new
baseline youth respondents who ever smoked
a filtered cigar.
(2) Non-initiator = Youth respondents who did
not initiate filtered cigar use between Waves or
new baseline youth respondents who have not
ever smoked a filtered cigar.

IF R03_EVER_NEVER_GFILTR != 1 AND
R04_EVER_NEVER_GFILTR_YOUTH = 1,
THEN R04_INIT_GFILTR_YOUTH = 1.
ELSE, R04_INIT_GFILTR_YOUTH = 2.

Past 30 Day Users – Filtered Cigars
R04_PAST30DAY_GFILTR

(1) Past 30 day user = Youth respondents who
have smoked a filtered cigar in the past 30
days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a filtered
cigar in the past 30 days.

IF R04_YG1112FC = 1 OR 2 OR 3, THEN
R04_PAST30DAY_GFILTR = 1.
ELSE, R04_PAST30DAY_GFILTR = 2.

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

Past 30 Day "Very Light" or "Not light"
Smokers - Filtered Cigars
R04_PAST30DAY_GFILTR_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have smoked a filtered cigar
in the past 30 days, and have smoked 10 or
less filtered cigars in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have smoked a filtered cigar
in the past 30 days, and have smoked more
than 10 filtered cigars in their lifetime.
(8) Unknown / missing = Unknown or missing

IF R04_YG1005FC = 1 OR 2 OR 3 AND
R03_NUMLIFE_GFILTR != 1) AND
(R04_YG1112FC = 1 OR 2 OR 3), THEN
R04_PAST30DAY_GFILTR_LEVEL = 1.
ELSE, IF (R04_YG1005FC > 3 OR
R04_YG1005FC = -8, -7 OR
R03_NUMLIFE_GFILTR = 1) AND
(R04_YG1112FC = 1 OR 2 OR 3), THEN
R04_PAST30DAY_GFILTR_LEVEL = 2.
ELSE, R04_PAST30DAY_GFILTR_LEVEL = 8.

Past 12 Month Blunt-Only Smokers –
Filtered Cigars
R04_12MBLUNT_ONLY_BFILTR

(1) Past 12 month blunt-only smoker = Youth
respondents who smoke filtered cigars as
blunts everytime when smoked in the past 12
months.
(2) Not a blunt-only smoker = Youth
respondents who do not smoke filtered cigars
as blunts everytime when smoked in the past
12 months.

IF R04_YG9106_03 = 1 AND R04_YG1095_03
= 1, THEN R04_12MBLUNT_ONLY_BFILTR =
1.
ELSE, R04_12MBLUNT_ONLY_BFILTR = 2.

Past 30 Day Blunt-Only Smokers –
Filtered Cigars
R04_30DBLUNT_ONLY_BFILTR

(1) Past 30 day user = Youth respondents who
have smoked a filtered cigar as a blunt in the
past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a filtered
cigar as a blunt in the past 30 days.

IF R04_12MBLUNT_ONLY_BFILTR = 1 AND
R04_YJ1112FC = 1 OR 2 OR 3, THEN
R04_30DBLUNT_ONLY_BFILTR = 1.
ELSE, R04_30DBLUNT_ONLY_BFILTR = 2.

Initiators – Filtered Cigars as Blunts
R04_INIT_BLUNT_BFILTR_YOUTH

(1) Initiator = Youth respondents who initiated
smoking filtered cigars as blunts between
Waves or new baseline youth respondents
who have ever used filtered cigars as blunts
every time in the past 12 months.
(2) Non-initiator = Youth respondents who did
not initiate smoking filtered cigars as blunts
between Waves or new baseline youth
respondents who have not ever used filtered
cigars as blunts.

IF R03_EVER_NEVER_BFILTR != 1 AND
R04_YG9106_03 = 1 AND R04_YG1095_03 =
1, THEN R04_INIT_BLUNT_BFILTR_YOUTH =
1.
ELSE, R04_INIT_BLUNT_BFILTR_YOUTH = 2.

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User Group and Variable Name

User Group Description

User Group Definition

Ever or Never Users - Pipe
R04_EVER_NEVER_PIPE_YOUTH

(1) Ever user = Youth respondents who have
ever smoked pipe tobacco.
(2) Never user = Youth respondents who have
not ever smoked pipe tobacco.

IF (R04_YP1001_NB = 1 AND
R04_YP1002_NB = 1) OR R04_YP1002_12M
= 1 OR R03_EVER_NEVER_PIPE = 1, THEN
R04_EVER_NEVER_PIPE_YOUTH = 1.
ELSE, IF R04_EVER_NEVER_PIPE_YOUTH
!= 1, THEN R04_EVER_NEVER_PIPE_YOUTH
= 2.

Initiator - Pipe
R04_INIT_PIPE_YOUTH

(1) Initiator = Youth respondents who initiated
pipe use between Waves or new baseline
youth respondents who have ever smoked a
pipe.
(2) Non-initiator = Youth respondents who did
not initiate pipe use between Waves or new
baseline youth respondents who have not ever
smoked a pipe.

IF R03_EVER_NEVER_PIPE != 1 AND
R04_EVER_NEVER_PIPE_YOUTH = 1, THEN
R04_INIT_PIPE_YOUTH = 1.
ELSE, R04_INIT_PIPE_YOUTH = 2.

Past 30 Day Users - Pipe
R04_PAST30DAY_PIPE

(1) Past 30 day user = Youth respondents who
have smoked a pipe in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked a pipe in
the past 30 days.

IF R04_YP1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_PIPE = 1.
ELSE, R04_PAST30DAY_PIPE = 2.

Ever or Never Users - Hookah
R04_EVER_NEVER_HOOK_YOUTH

(1) Ever user = Youth respondents who have
ever smoked hookah.
(2) Never user = Youth respondents who have
not ever smoked hookah.

IF (R04_YH1001_NB = 1 AND
R04_YH1002_NB = 1) OR R04_YH1002_12M
= 1 OR R03_EVER_NEVER_HOOK = 1),
THEN R04_EVER_NEVER_HOOK_YOUTH =
1.
ELSE, IF R04_EVER_NEVER_HOOK_YOUTH
!= 1, THEN
R04_EVER_NEVER_HOOK_YOUTH = 2.

Initiator - Hookah
R04_INIT_HOOK_YOUTH

(1) Initiator = Youth respondents who initiated
hookah use between Waves or new baseline
youth respondents who have ever smoked a
hookah.
(2) Non-initiator = Youth respondents who
have did not initiate hookah use between

IF R03_EVER_NEVER_HOOK != 1 AND
R04_EVER_NEVER_HOOK_YOUTH = 1,
THEN R04_INIT_HOOK_YOUTH = 1.
ELSE, R04_INIT_HOOK_YOUTH = 2.

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

Waves or new baseline youth respondents
who have not ever smoked a hookah.
Past 30 Day Users - Hookah
R04_PAST30DAY_HOOK

(1) Past 30 day user = Youth respondents who
have smoked hookah in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not smoked hookah in
the past 30 days.

IF R04_YH1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_HOOK = 1.
ELSE, R04_PAST30DAY_HOOK = 2.

Ever or Never Users - Snus
R04_EVER_NEVER_SNUS_YOUTH

(1) Ever user = Youth respondents who have
ever used snus.
(2) Never user = Youth respondents who have
not ever used snus.

IF (R04_YU1001_NB = 1 AND
R04_YU1002_NB = 1) OR R04_YU1002_12M
= 1 OR R03_EVER_NEVER_SNUS = 1, THEN
R04_EVER_NEVER_SNUS_YOUTH = 1.
ELSE, IF R04_EVER_NEVER_SNUS_YOUTH
!= 1, THEN
R04_EVER_NEVER_SNUS_YOUTH = 2.

Initiator - Snus
R04_INIT_SNUS_YOUTH

(1) Initiator = Youth respondents who initiated
snus use between Waves or new baseline
youth respondents who have ever used snus.
(2) Non-initiator = Youth respondents who did
not initiate snus use between Waves or new
baseline youth respondents who have not ever
used snus.

IF R03_EVER_NEVER_SNUS != 1 AND
R04_EVER_NEVER_SNUS_YOUTH = 1,
THEN R04_INIT_SNUS_YOUTH = 1.
ELSE, R04_INIT_SNUS_YOUTH = 2.

Past 30 Day Users - Snus
R04_PAST30DAY_SNUS

(1) Past 30 day user = Youth respondents who
have used snus in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have not used snus in the
past 30 days.

IF R04_YU1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_SNUS = 1.
ELSE, R04_PAST30DAY_SNUS = 2.

Past 30 Day "Very Light" or "Not Light"
Users - Snus
R04_PAST30DAY_SNUS_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have used snus in the past
30 days, and have used snus 10 or fewer
times in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have used snus in the past
30 days, and have used snus more than 10
times in their lifetime.

IF (R04_YU1005 = 1 OR 2) AND (R04_YU1112
= 1 OR 2 OR 3), THEN
R04_PAST30DAY_SNUS_LEVEL = 1.
ELSE, IF (R04_YU1005> 2 OR R04_YU1005 =
-8, -7 OR R03_NUMLIFE_SNUS = 1) AND
(R04_YU1112 = 1 OR 2 OR 3), THEN
R04_PAST30DAY_SNUS_LEVEL = 2.
ELSE, R04_PAST30DAY_SNUS_LEVEL = 8.

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Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

(8) Unknown / missing = Unknown or missing
Ever or Never Users - Smokeless
Tobacco
R04_EVER_NEVER_SMKLS_YOUTH

(1) Ever user = Youth respondents who have
ever used smokeless tobacco.
(2) Never user = Youth respondents who have
not ever used smokeless tobacco.

IF (R04_YS1001_NB = 1 AND
R04_YS1002_NB = 1) OR R04_YS1002_12M
= 1 OR R03_EVER_NEVER_SMKLS = 1,
THEN R04_EVER_NEVER_SMKLS_YOUTH =
1.
ELSE, IF
R04_EVER_NEVER_SMKLS_YOUTH != 1,
THEN R04_EVER_NEVER_SMKLS_YOUTH =
2.

Initiator - Smokeless Tobacco
R04_INIT_SMKLS_YOUTH

(1) Initiator = Youth respondents who initiated
smokeless tobacco use between Waves or
new baseline youth respondents who have
ever used smokeless tobacco.
(2) Non-initiator = Youth respondents who did
not initiate smokeless tobacco use between
Waves or new baseline youth respondents
who have not ever used smokeless tobacco.

IF R03_EVER_NEVER_SMKLS != 1 AND
R04_EVER_NEVER_SMKLS_YOUTH = 1,
THEN R04_INIT_SMKLS_YOUTH = 1.
ELSE, R04_INIT_SMKLS_YOUTH = 2.

Past 30 Day Users – Smokeless
Tobacco
R04_PAST30DAY_SMKLS

(1) Past 30 day user = Youth respondents who
have used smokeless tobacco in the past 30
days.
(2) Not a past 30 day user = Youth
respondents who have not used smokeless
tobacco in the past 30 days.

IF R04_YS1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_SMKLS = 1.
ELSE, R04_PAST30DAY_SMKLS = 2.

Past 30 Day "Very Light" or "Not Light"
Users - Smokeless Tobacco
R04_PAST30DAY_SMKLS_LEVEL

(1) Past 30 day "very light" user = Youth
respondents who have used smokeless
tobacco in the past 30 days, and have used 10
times or less in their lifetime.
(2) Past 30 day "not light" user = Youth
respondents who have used smokeless
tobacco in the past 30 days, and have used
more than 10 times in their lifetime.
(8) Unknown / missing = Unknown or missing

IF (R04_YS1005 = 1 OR 2) AND (R04_YS1112
= 1 OR 2 OR 3), THEN
R04_PAST30DAY_SMKLS_LEVEL = 1.
ELSE, IF (R04_YS1005 > 2 OR R04_YS1005 =
-8, -7 OR R03_NUMLIFE_SMKLS = 1) AND
R04_YS1112 = 1 OR 2 OR 3, THEN
R04_PAST30DAY_SMKLS_LEVEL = 2.
ELSE, R04_PAST30DAY_SMKLS_LEVEL = 8.

Ever or Never Users - Dissolvable

(1) Ever user = Youth respondents who have

IF (R04_YD1001_NB = 1 AND

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

Tobacco
R04_EVER_NEVER_DISSBL_YOUTH

ever used dissolvable tobacco.
(2) Never user = Youth respondents who have
not ever used dissolvable tobacco.

R04_YD1002_NB = 1) OR R04_YD1002_12M
= 1 OR R03_EVER_NEVER_DISSBL = 1,
THEN R04_EVER_NEVER_DISSBL_YOUTH =
1.
ELSE, IF
R04_EVER_NEVER_DISSBL_YOUTH != 1,
THEN R04_EVER_NEVER_DISSBL_YOUTH =
2.

Initiator - Dissolvable Tobacco
R04_INIT_DISSBL_YOUTH

(1) Initiator = Youth respondents who initiated
dissolvable tobacco use between Waves new
baseline youth respondents who have ever
used dissolvable tobacco.
(2) Non-initiator = Youth respondents who did
not initiate dissolvable tobacco use between
Waves or new baseline youth respondents
who have not ever used dissolvable tobacco.

IF R03_EVER_NEVER_DISSBL != 1 AND
R04_EVER_NEVER_DISSBL_YOUTH = 1,
THEN R04_INIT_DISSBL_YOUTH = 1.
ELSE, R04_INIT_DISSBL_YOUTH = 2.

Past 30 Day Users - Dissolvable
Tobacco
R04_PAST30DAY_DISS

(1) Past 30 day user = Youth respondents who
have used dissolvable tobacco in the past 30
days.
(2) Not a past 30 day user = Youth
respondents who have not used dissolvable
tobacco in the past 30 days.

IF R04_YD1002_30D = 1, THEN
R04_PAST30DAY_DISS = 1.
ELSE, R04_PAST30DAY_DISS = 2.

Ever or Never Users - Bidis
R04_EVER_NEVER_BIDI_YOUTH

(1) Ever user = Youth respondents who have
ever smoked a bidi.
(2) Never user = Youth respondents who have
not ever smoked a bidi.

IF (R04_YB9101_NB_01 = 1 AND
R04_YB9102_NB_01 = 1) OR
R04_YB9102_12M_01 = 1 OR
R03_EVER_NEVER_BIDI = 1, THEN
R04_EVER_NEVER_BIDI_YOUTH= 1.
ELSE, IF R04_EVER_NEVER_BIDI_YOUTH !=
1, THEN R04_EVER_NEVER_BIDI_YOUTH =
2.

Initiator - Bidis
R04_INIT_BIDI_YOUTH

(1) Initiator = Youth respondents who initiated
bidi use between Waves or new baseline youth
respondents who have ever smoked a bidi.
(2) Non-initiator = Youth respondents who did

IF R03_EVER_NEVER_BIDI != 1 AND
R04_EVER_NEVER_BIDI_YOUTH = 1, THEN
R04_INIT_BIDI_YOUTH = 1.
ELSE, R04_INIT_BIDI_YOUTH = 2.

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Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

not initiate bidi use between Waves or new
baseline youth respondents who have not ever
smoked a bidi.
Past 30 Day Users - Bidis
R04_PAST30DAY_BIDI

(1) Past 30 day user = Youth respondents who
have smoked a bidi in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have never smoked a bidi in
the past 30 days.

IF R04_YB9102_30D_01 = 1, THEN
R04_PAST30DAY_BIDI = 1.
ELSE, R04_PAST30DAY_BIDI = 2.

Ever or Never Users - Kreteks
R04_EVER_NEVER_KRETEK_YOUTH

(1) Ever user = Youth respondents who have
ever smoked a kretek.
(2) Never user = Youth respondents who have
not ever smoked a kretek.

IF (R04_YB101_NB_02 = 1 AND
R04_YB9102_NB_02 = 1) OR
R04_YB9102_12M_02 = 1 OR
R03_EVER_NEVER_KRETEK = 1, THEN
R04_EVER_NEVER_KRETEK_YOUTH = 1. .
ELSE, IF
R04_EVER_NEVER_KRETEK_YOUTH != 1,
THEN R04_EVER_NEVER_KRETEK_YOUTH
= 2.

Initiator - Kreteks
R04_INIT_KRETEK_YOUTH

(1) Initiator = Youth respondents who initiated
kretek use between Waves or new baseline
youth respondents who have ever smoked a
kretek.
(2) Non-initiator = Youth respondents who did
not initiate smokeless tobacco use between
Waves or new baseline youth respondents
who have not ever smoked a kretek.

IF R03_EVER_NEVER_KRETEK != 1 AND
R04_EVER_NEVER_KRETEK_YOUTH = 1,
THEN R04_INIT_KRETEK_YOUTH = 1.
ELSE, R04_INIT_KRETEK_YOUTH = 2.

Past 30 Day Users - Kreteks
R04_PAST30DAY_KRETEK

(1) Past 30 day user = Youth respondents who
have smoked a kretek in the past 30 days.
(2) Not a past 30 day user = Youth
respondents who have never smoked a kretek
in the past 30 days.

IF R04_YB9102_30D_02 = 1, THEN
R04_PAST30DAY_KRETEK = 1.
ELSE, R04_PAST30DAY_KRETEK = 2.

Ever Users - Tobacco
R04_EVER_USE_TOB

(1) Ever user = Youth respondents who have
ever used any type of tobacco product(s) in
lifetime.
(2) Never user = Youth respondents who have

IF R04_EVER_NEVER_CIGS_YOUTH = 1 OR
R04_EVER_NEVER_EPRODS_YOUTH = 1
OR (R04_EVER_NEVER_GTRAD_YOUTH = 1
AND R04_12MBLUNT_ONLY_BTRAD = 2) OR

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Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition

not ever used any type of tobacco product(s) in
lifetime.

(R04_EVER_NEVER_GRILLO_YOUTH = 1
AND R04_12MBLUNT_ONLY_BRILLO = 2) OR
(R04_EVER_NEVER_GFILTR_YOUTH = 1
AND R04_12MBLUNT_ONLY_BFILTR = 2) OR
R04_EVER_NEVER_PIPE_YOUTH = 1 OR
R04_EVER_NEVER_HOOK_YOUTH = 1 OR
R04_EVER_NEVER_SMKLS_YOUTH = 1 OR
R04_EVER_NEVER_SNUS_YOUTH = 1 OR
R04_EVER_NEVER_DISSBL_YOUTH = 1 OR
R04_EVER_NEVER_BIDI_YOUTH = 1 OR
R04_EVER_NEVER_KRETEK_YOUTH = 1,
THEN R04_EVER_USE_TOB=1.
ELSE, R04_EVER_USE_TOB=2.

Ever Users – Cigarettes Only
R04_EVER_USE_CIGSONLY

(1) Ever user = Youth respondents who have
ever used only cigarettes, and no other
products, in lifetime.
(2) Never user = Youth respondents who have
not ever used only cigarettes, and no other
products, in lifetime.

IF R04_EVER_NEVER_CIGS_YOUTH = 1
AND R04_EVER_NEVER_EPRODS_YOUTH
!= 1 AND
R04_EVER_NEVER_GTRAD_YOUTH != 1
AND R04_EVER_NEVER_GRILLO_YOUTH !=
1 AND R04_EVER_NEVER_GFILTR_YOUTH
!= 1 AND R04_EVER_NEVER_PIPE_YOUTH
!= 1 AND R04_EVER_NEVER_HOOK_YOUTH
!= 1 AND
R04_EVER_NEVER_SMKLS_YOUTH != 1
AND R04_EVER_NEVER_SNUS_YOUTH != 1
AND R04_EVER_NEVER_DISSBL_YOUTH !=
1 AND R04_EVER_NEVER_BIDI_YOUTH != 1
AND R04_EVER_NEVER_KRETEK_YOUTH !=
1, THEN R04_EVER_USE_CIGSONLY= 1.
ELSE, R04_EVER_USE_CIGSONLY= 2.

Ever Users - Dual
R04_EVER_USE_DUAL

(1) Ever user = Youth respondents who have
ever used cigarettes and at least one other
tobacco product in lifetime.
(2) Never user = Youth respondents who have
not ever used cigarettes and at least one other
tobacco product in lifetime.

IF R04_EVER_NEVER_CIGS_YOUTH = 1
AND (R04_EVER_NEVER_EPRODS_YOUTH
= 1) OR
(R04_EVER_NEVER_GTRAD_YOUTH = 1
AND R04_12MBLUNT_ONLY_BTRAD = 2) OR
(R04_EVER_NEVER_GRILLO_YOUTH = 1

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Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition
AND R04_12MBLUNT_ONLY_BRILLO = 2) OR
(R04_EVER_NEVER_GFILTR_YOUTH = 1
AND R04_12MBLUNT_ONLY_BFILTR = 2) OR
(R04_EVER_NEVER_PIPE_YOUTH = 1) OR
(R04_EVER_NEVER_HOOK_YOUTH = 1) OR
(R04_EVER_NEVER_SMKLS_YOUTH = 1) OR
(R04_EVER_NEVER_SNUS_YOUTH = 1) OR
(R04_EVER_NEVER_DISSBL_YOUTH = 1)
OR (R04_EVER_NEVER_BIDI_YOUTH = 1)
OR (R04_EVER_NEVER_KRETEK_YOUTH =
1), THEN R04_EVER_USE_DUAL= 1.
ELSE, R04_EVER_USE_DUAL= 2.

Ever Users – Tobacco (Excluding
Cigarettes)
R04_EVER_USE_TOBXCIGS

(1) Ever user = Youth respondents who have
ever used any tobacco products, excluding
cigarettes, in lifetime.
(2) Never user = Youth respondents who have
not ever used any tobacco products, excluding
cigarettes, in lifetime.

IF R04_EVER_NEVER_CIGS_YOUTH = 2
AND (R04_EVER_NEVER_EPRODS_YOUTH
= 1 OR (R04_EVER_NEVER_GTRAD_YOUTH
= 1 AND R04_12MBLUNT_ONLY_BTRAD = 2)
OR (R04_EVER_NEVER_GRILLO_YOUTH = 1
AND R04_12MBLUNT_ONLY_BRILLO = 2) OR
(R04_EVER_NEVER_GFILTR_YOUTH = 1
AND R04_12MBLUNT_ONLY_BFILTR = 2) OR
(R04_EVER_NEVER_PIPE_YOUTH = 1) OR
(R04_EVER_NEVER_HOOK_YOUTH = 1) OR
(R04_EVER_NEVER_SMKLS_YOUTH = 1) OR
(R04_EVER_NEVER_SNUS_YOUTH = 1) OR
(R04_EVER_NEVER_DISSBL_YOUTH = 1)
OR (R04_EVER_NEVER_BIDI_YOUTH = 1)
OR (R04_EVER_NEVER_KRETEK_YOUTH =
1), THEN R04_EVER_USE_TOBXCIGS = 1.
ELSE, R04_EVER_USE_TOBXCIGS = 2.

Past 30 Day Users - Tobacco
R04_PAST30DAY_TOB

(1) Past 30 day user = Youth respondents who
have used any tobacco product(s) in the past
30 days.
(2) Not past 30 day user = Youth respondents
who have not ever used any tobacco
product(s) in the past 30 days.

IF R04_PAST30DAY_CIGS = 1 OR
R04_PAST30DAY_EPRODS = 1 OR
R04_PAST30DAY_GTRAD = 1 OR
R04_PAST30DAY_GRILLO = 1 OR
R04_PAST30DAY_GFILTR = 1 OR
R04_PAST30DAY_PIPE = 1 OR

PATH – Wave 4
Youth Questionnaire – Extended Interview

332

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition
R04_PAST30DAY_HOOK = 1 OR
R04_PAST30DAY_SMKLS = 1 OR
R04_PAST30DAY_SNUS = 1
R04_PAST30DAY_DISS = 1
R04_PAST30DAY_BIDI = 1
R04_PAST30DAY_KRETEK = 1,
THEN R04_PAST30DAY_TOB = 1.
ELSE, R04_PAST30DAY_TOB = 2.

Past Year Level - Tobacco
R04_PASTYEAR_TOB_USE_LEVEL

PATH – Wave 4
Youth Questionnaire – Extended Interview

(1) Very light = Youth respondents who have
used any tobacco product in the last year, and
are not "not light" users of any product.
(2) Not light = Youth respondents who are not
light users of any tobacco product and have
used in the past year.

333

IF R04_EVER_USE_TOB = 1 AND
(((R04_YC1005 = 1 OR 2 OR 3 AND
R03_NUMLIFE_CIGS != 1) AND (R04_YC1112
= 1, 2, 3, 4, OR 5)) OR ((R04_YV1005 = 1 AND
R03_NUMLIFE_ECIG != 1) AND (R04_YV1112
= 1, 2, 3, 4, OR 5)) OR ((R04_YG1005TC = 1
OR 2 OR 3 AND R03_NUMLIFE_GTRAD != 1)
AND (R04_YG1112TC = 1, 2, 3, 4, OR 5)) OR
((R04_YG1005CL = 1 OR 2 OR 3 AND
R03_NUMLIFE_GRILLO != 1) AND
(R04_YG1112CL = 1, 2, 3, 4, OR 5)) OR
((R04_YG1005FC = 1 OR 2 OR 3 AND
R03_NUMLIFE_GFILTR != 1) AND
(R04_YG1112FC = 1, 2, 3, 4, OR 5)) OR
(R04_YP1112 = 1, 2, 3, 4, OR 5) OR
(R04_YH1112 = 1, 2, 3, 4, OR 5) OR
((R04_YU1005 = 1 OR 2) AND (R04_YU1112 =
1, 2, 3, 4, OR 5)) AND ((R04_YS1005 = 1 OR
2) AND (R04_YS1112 = 1, 2, 3, 4, OR 5)) OR
R04_YD1002_12M = 1 OR R04_YB9102_01 =
1 OR R04_YB9102_02 = 1), THEN
R04_PASTYEAR_TOB_USE_LEVEL = 1.
IF ((R04_YC1005 > 3 OR R04_YC1005 = -8, -7
OR R03_NUMLIFE_CIGS = 1) AND
(R04_YC1112 = 1 OR 2 OR 3 OR 4 OR 5)) OR
((R04_YV1005 > 1 OR R04_YV1005 = -8, -7
OR R03_NUMLIFE_ECIG = 1) AND
(R04_YV1112 = 1, 2, 3, 4, OR 5)) OR

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition
((R04_YG1005TC > 3 OR R04_YG1005TC = 8, -7 OR R03_NUMLIFE_GTRAD = 1) AND
(R04_YG1112TC = 1, 2, 3, 4, OR 5)) OR
((R04_YG1005CL > 3 OR R04_YG1005CL = 8, -7 OR R03_NUMLIFE_GRILLO = 1) AND
(R04_YG1112CL = 1, 2, 3, 4, OR 5)) OR
((R04_YG1005FC > 3 OR R04_YG1005FC = 8, -7 OR R03_NUMLIFE_GFILTR = 1) AND
(R04_YG1112FC = 1, 2, 3, 4, OR 5)) OR
((R04_YU1005 > 2 OR R04_YU1005 = -8, -7
OR R03_NUMLIFE_SNUS = 1) AND
(R04_YU1112 = 1, 2, 3, 4, OR 5)) OR
((R04_YS1005 > 2 OR R04_YS1005 = -8, -7
OR R03_NUMLIFE_SMKLS = 1) AND
(R04_YS1112 = 1, 2, 3, 4, OR 5)), THEN
R04_PASTYEAR_TOB_USE_LEVEL = 2.

Past Year Users - Tobacco
R04_PASTYEAR_TOB_USE

PATH – Wave 4
Youth Questionnaire – Extended Interview

(1) Past year tobacco = (Past year users of
tobacco only) Youth respondents who have
used any tobacco product(s) in the past 12
months, but have not used any e-products in
the past 12 months.
(2) Past year e-product = (Past year users of
e-products only) Youth respondents who have
used any e-product in the past 12 months, but
have not used any other tobacco product(s) in
the past 12 months.
(3) Past year both = (Past year users of
tobacco and e-products) Youth respondents
who have used any e-product in the past 12
months and have used at least one other
tobacco product in the past 12 months.
(4) Past year non-user = (Past year non-users
of any tobacco or e-product) Youth
respondents who have not used any e-product
in the past 12 months and have not used any
other tobacco product in the past 12 months.
334

IF [R04_YV1112 != 1, 2, 3, 4 or 5] AND
[(R04_YC1112=1, 2, 3, 4 or 5) OR
(R04_YG1112TC = 1, 2, 3, 4, or 5) OR
(R04_YG1112CL =1, 2, 3, 4 or 5) OR
(R04_YG1112FC = 1, 2, 3, 4, or 5) OR
(R04_YP1112=1, 2, 3, 4 or 5) OR
(R04_YH1112=1, 2, 3, 4 or 5) OR
(R04_YU1112 = 1, 2, 3, 4, OR 5) OR
(R04_YS1112=1, 2, 3, 4 or 5) OR
R04_YB9102_12M_01 = 1 OR
R04_YB9102_12M_02 = 1 OR
R04_YD1002_12M = 1, THEN
R04_PASTYEAR_TOB_USE = 1.
ELSE, IF [R04_YV1112 = 1, 2, 3, 4 or 5] AND
[(R04_YC1112 != 1, 2, 3, 4 or 5) AND
(R04_YG1112TC != 1, 2, 3, 4, or 5) AND
(R04_YG1112CL !=1, 2, 3, 4 or 5) AND
(R04_YG1112FC != 1, 2, 3, 4, or 5) AND
(R04_YP1112 != 1, 2, 3, 4 or 5) AND
(R04_YH1112 != 1, 2, 3, 4 or 5) AND

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
User Group and Variable Name

User Group Description

User Group Definition
(R04_YU1112 != 1, 2, 3, OR 4) AND
(R04_YS1112 != 1, 2, 3, 4 or 5) AND
R04_YB9102_12M_01 != 1 AND
R04_YB9102_12M_02 != 1 AND
R04_YD1002_12M != 1], THEN
R04_PASTYEAR_TOB_USE = 2.
ELSE, IF [R04_YV1112 = 1, 2, 3, 4 or 5] AND
[(R04_YC1112=1, 2, 3, 4 or 5) OR
(R04_YG1112TC = 1, 2, 3, 4, or 5) OR
(R04_YG1112CL =1, 2, 3, 4 or 5) OR
(R04_YG1112FC = 1, 2, 3, 4, or 5) OR
(R04_YP1112=1, 2, 3, 4 or 5) OR
(R04_YH1112=1, 2, 3, 4 or 5) OR
(R04_YU1112 = 1, 2, 3, 4, OR 5) OR
(R04_YS1112=1, 2, 3, 4 or 5) OR
R04_YB9102_12M_01 = 1 OR
R04_YB9102_12M_02 = 1 OR
R04_YD1002_12M = 1, THEN
R04_PASTYEAR_TOB_USE = 3.
ELSE, IF [R04_YV1112 != 1, 2, 3, 4 or 5] AND
[(R04_YC1112 != 1, 2, 3, 4 or 5) AND
(R04_YG1112TC != 1, 2, 3, 4, or 5) AND
(R04_YG1112CL !=1, 2, 3, 4 or 5) AND
(R04_YG1112FC != 1, 2, 3, 4, or 5) AND
(R04_YP1112 != 1, 2, 3, 4 or 5) AND
(R04_YH1112 != 1, 2, 3, 4 or 5) AND
(R04_YU1112 != 1, 2, 3, OR 4) AND
(R04_YS1112 != 1, 2, 3, 4 or 5) AND
R04_YB9102_12M_01 != 1 AND
R04_YB9102_12M_02 != 1 AND
R04_YD1002_12M != 1], THEN
R04_PASTYEAR_TOB_USE = 4.

PATH – Wave 4
Youth Questionnaire – Extended Interview

335

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)

APPENDIX: DERIVED VARIABLES
Variable Name

Variable Description

Variable Definition

R04_YOUTHAGE

Youth respondent age.

R04_EPRODCOUNT

The number of different electronic nicotine
products used.

R04_EPRODCOUNT = 0 (RANGE = 0-99)
IF R04_YV9035_01 = 1, SET
R04_EPRODCOUNT = R04_EPRODCOUNT + 1;
IF R04_YV9035_02 = 1, SET
R04_EPRODCOUNT = R04_EPRODCOUNT + 1;
IF R04_YV9035_03 = 1, SET
R04_EPRODCOUNT = R04_EPRODCOUNT + 1;
IF R04_YV9035_04 = 1, SET
R04_EPRODCOUNT = R04_EPRODCOUNT + 1;
IF R04_YV9035_05 = 1, SET
R04_EPRODCOUNT = R04_EPRODCOUNT + 1;
IF R04_YV9061_01 != -1, -8, -7, SET
R04_EPRODCOUNT = R04_EPRODCOUNT +
R04_YV9061_01;
IF R04_Y9061_02 != -1, -8, -7, SET
R04_EPRODCOUNT = R04_EPRODCOUNT +
R04_YV9061_02;
IF R04_YV9061_03 != -1, -8, -7, SET
R04_EPRODCOUNT = R04_EPRODCOUNT +
R04_YV9061_03;
IF R04_YV9061_04 != -1, -8, -7, SET
R04_EPRODCOUNT = R04_EPRODCOUNT +
R04_YV9061_04;

R04_EDEVICETYPE

Electronic nicotine product device type.

IF R04_YV9005 = 2, -8 OR -7 AND R04_YV9008
= 2, -8 OR -7 AND R04_YV9038 = 2, 3, -8 OR -7
AND R04_YV9009 = 2, -8 OR -7, THEN

PATH – Wave 4
Youth Questionnaire – Extended Interview

IF R04_E_YOUTH_LD = 1, THEN
R04_YOUTHAGE = R04_CURRENT_AGE_LD.
ELSE, R04_YOUTHAGE = R04_PARYTHAGE.

336

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
Variable Name

Variable Description

Variable Definition
R04_EDEVICETYPE = 1 (Disposable).
ELSE, IF R04_YV9005 = 1 AND R04_YV9008 = 1
AND R04_YV9038 = 2, 3, -8 OR -7 AND
R04_YV9009 = 2, -8 OR -7, THEN
R04_EDEVICETYPE = 2 (Non-Refillable
Cartridge).
ELSE, IF R04_YV9005 = 1 AND R04_YV9008 = 1
AND R04_YV9038 != 1 AND R04_YV9009 = 1,
THEN R04_EDEVICETYPE = 3 (Refillable
Cartridge).
ELSE, IF R04_YV9005 = 1 AND R04_YV9038 = 1
AND R04_YV9009 = 1, THEN
R04_EDEVICETYPE = 4 (Refillable Tank
System).
ELSE, IF R04_YV9005 = 1, 2, -8 OR -7 AND
R04_YV9008 = 2, -8 OR -7 AND R04_YV9038 =
2, 3, -8 OR -7 AND R04_YV9009 = 1, THEN
R04_EDEVICETYPE = 5 (Refillable Mod System).
ELSE, R04_EDEVICETYPE = 6 (Unknown).

PATH – Wave 4
Youth Questionnaire – Extended Interview

337

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
Variable Name

Variable Description

Variable Definition

CIGARFILL

Fill to be shown in question text to indicate the
cigar type.
Fill with "traditional cigar" for traditional
cigar/blunt smokers
Fill with "cigarillo" for cigarillo/blunt smokers
Fill with "filtered cigar" for filtered cigar/blunt
smokers

IF R04_EVER_USER_GTRAD = 1 OR
R04_12MBLUNT_ONLY_GTRAD = 1, THEN
CIGARFILL = "traditional cigar".
IF R04_EVER_USER_GRILLO = 1 OR
R04_12MBLUNT_ONLY_GRILLO = 1, THEN
CIGARFILL = "cigarillo".
IF R04_EVER_USER_GFILTR = 1 OR
R04_12MBLUNT_ONLY_GFILTR = 1, THEN
CIGARFILL = "filtered cigar".

CIGARLOOP

Cigars as Non-Blunts:
GTRAD = Youth respondents who have ever
smoked traditional cigars and have not
smoked traditional cigars as blunts every time
when smoked in the past 12 months.
GRILLO = Youth respondents who have ever
smoked cigarillos and have not smoked
cigarillos as blunts every time when smoked in
the past 12 months.
GFILTR = Youth respondents who have ever
smoked filtered cigars and have not smoked
filtered cigars as blunts every time when
smoked in the past 12 months.

Cigars as Non-Blunts:
GTRAD: IF R04_EVER_USER_GTRAD = 1 AND
R04_12MBLUNT_ONLY_BTRAD = 2, THEN
LOOP = GTRAD.
GRILLO: IF R04_EVER_USER_GRILLO = 1 AND
R04_12MBLUNT_ONLY_BRILLO = 2, THEN
LOOP = GRILLO.
GFILTR: IF R04_EVER_USER_GFILTR = 1 AND
R04_12MBLUNT_ONLY_BFILTR = 2, THEN
LOOP = GFILTR.

Cigars as Blunts-Only:
BTRAD = Youth respondents who smoke
traditional cigars as blunts every time when
smoked in the past 12 months.
BRILLO = Youth respondents who smoke
cigarillos as blunts every time when smoked in
the past 12 months.
BFILTR = Youth respondents who smoke
filtered cigars as blunts every time when
smoked in the past 12 months.
PATH – Wave 4
Youth Questionnaire – Extended Interview

338

Cigars as Blunts-Only:
BTRAD: IF R04_12MBLUNT_ONLY_BTRAD = 1,
THEN LOOP = BTRAD.
BRILLO: IF R04_12MBLUNT_ONLY_BRILLO = 1,
THEN LOOP = BRILLO.
BFILTR: IF R04_12MBLUNT_ONLY_BFILTR = 1,
THEN LOOP = BFILTR.

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
Variable Name

Variable Description

Variable Definition

R04_YOUTH_ASTHMA

(1) Asthma = Youth respondent has ever had
asthma.
(2) No asthma = Youth respondent has never
had asthma.

IF R03_ASTHMA = 1 OR R04_YT0031_NB = 1
OR R04_YT0031_12M = 1, THEN
R04_YOUTH_ASTHMA = 1.
ELSE, R04_YOUTH_ASTHMA = 2.

R04_SUBSTANCE_COUNT

Number of substances the youth respondent
has ever used.

R04_SUBSTANCE_COUNT = 0;
IF R04_EVER_USER_ALC = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;
IF R04_EVER_USER_MJ = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;
IF R04_EVER_USER_RIT = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;
IF R04_EVER_USER_PK = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;
IF R04_EVER_USER_COC = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;
IF R04_EVER_USER_STIM = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;
IF R04_EVER_USER_OTH = 1, SET
R04_SUBSTANCE_COUNT =
R04_SUBSTANCE_COUNT + 1;

R04_EVER_USER_ALC

PATH – Wave 4
Youth Questionnaire – Extended Interview

Youth respondent has ever used alcohol.

339

IF R03_EVER_USER_ALCOHOL = 1 OR (VALID
AGE REPORTED IN R04_YX0074_NB OR
R04_YX0270_NB > 0) OR R04_YX0084_12M = 1,
THEN R04_EVER_USER_ALC = 1. ELSE
R04_EVER_USER_ALC = 2.

PATH
Youth Questionnaire - Extended Interview
Wave 4 (version 3.0)
Variable Name

Variable Description

Variable Definition

R04_EVER_USER_MJ

Youth respondent has ever used marijuana.

IF R03_EVER_USER_MARIJUANA OR
R04_YX0085_NB =1 OR R04_YG9105_NB = 1
OR R04_YH9031 = 1 OR R04_YV9042 = 1 OR
R04_YX0085_12M = 1 OR R04_YG9107 = 1,
THEN R04_EVER_USER_MJ = 1. ELSE,
R04_EVER_USER_MJ = 2.

R04_EVER_USER_RIT

Youth respondent has ever used Ritalin® or
Adderall®.

IF R03_EVER_USER_RITALIN = 1 OR
R04_YX0089_NB[1] = 1 OR R04_YX0089_12M[1]
= 1, THEN R04_EVER_USER_RIT = 1. ELSE
R04_EVER_USER_RIT = 2.

R04_EVER_USER_PK

Youth respondent has ever used painkillers,
sedatives, or tranquilizers.

IF R03_EVER_USER_PAINKILLERS OR
R04_YX0089_NB[2] = 1 OR R04_YX0089_12M[2]
= 1 , THEN R04_EVER_USER_PK = 1. ELSE
R04_EVER_USER_PK = 2.

R04_EVER_USER_COC

Youth respondent has ever used cocaine or
crack.

IF R03_EVER_USER_COCAINE = 1 OR
R04_YX0220_NB[1] = 1 OR R04_YX0220_12M[1]
= 1, THEN R04_EVER_USER_COC = 1. ELSE,
R04_EVER_USER_COC = 2.

R04_EVER_USER_STIM

Youth respondent has ever used stimulants
like methamphetamine or speed.

IF R03_EVER_USER_STIMULANTS = 1 OR
R04_YX0220_NB[2] = 1R04_YX0220_12M[2] = 1,
THEN R04_EVER_USER_STIM = 1. ELSE,
R04_EVER_USER_STIM = 2.

R04_EVER_USER_OTH

Youth respondent has ever used other drugs
like heroin, inhalants, solvents, or
hallucinogens.

IF R03_EVER_USER_OTHERDRUG = 1 OR
R04_YX0220_NB[3] = 1 OR R04_YX0220_12M[3]
= 1, THEN R04_EVER_USER_OTH = 1. ELSE,
R04_EVER_USER_OTH = 2.

PATH – Wave 4
Youth Questionnaire – Extended Interview

340

PATH Study Tobacco Use Form

OMB Control Number:
0925-0664
Expiration Date:
XX/XX/20XX

All information you give to the PATH Study will be kept private, and will only be used for research purposes.
Have you used any of the following products today, yesterday, or the day before yesterday?
(If you don’t know an answer or don’t want to provide one, you may leave the question blank.)

1 Cigarettes

YES
NO

2 Electronic nicotine
products that
contain nicotine

YES

3 Traditional cigars

YES

NO

(such as e-cigarettes, e-hookahs,
e-cigars or e-pipes)

(including when smoked with
tobacco OR with marijuana
such as a “blunt”)

4 Cigarillos

(including when smoked with
tobacco OR with marijuana
such as a “blunt”)

5 Filtered cigars

(including when smoked with
tobacco OR with marijuana
such as a “blunt”)

6 Pipe filled with tobacco

NO

YES
NO

YES
NO

YES
NO

45658.0316.8954040201–RS18–V3

When did you last smoke a cigarette?
In the past hour
Sometime today
Yesterday
Day before yesterday
When did you last use an e-product?
In the past hour
Sometime today
Yesterday
Day before yesterday
When did you last smoke a cigar?
In the past hour
Sometime today
Yesterday
Day before yesterday
When did you last smoke a cigarillo?
In the past hour
Sometime today
Yesterday
Day before yesterday
When did you last smoke a filtered cigar?
In the past hour
Sometime today
Yesterday
Day before yesterday
When did you last smoke a pipe filled with tobacco?
In the past hour
Sometime today
Yesterday
Day before yesterday

What time of day did you last smoke a cigarette?
Between midnight and 6AM
After 6AM but before noon
Between noon and 6PM
After 6PM but before midnight
What time of day did you last use an e-product?
Between midnight and 6AM
After 6AM but before noon
Between noon and 6PM
After 6PM but before midnight
What time of day did you last smoke a cigar?
Between midnight and 6AM
After 6AM but before noon
Between noon and 6PM
After 6PM but before midnight
What time of day did you last smoke a cigarillo?
Between midnight and 6AM
After 6AM but before noon
Between noon and 6PM
After 6PM but before midnight
What time of day did you last smoke a filtered cigar?
Between midnight and 6AM
After 6AM but before noon
Between noon and 6PM
After 6PM but before midnight
What time of day did you last smoke a pipe
filled with tobacco?
Between midnight and 6AM
After 6AM but before noon
Between noon and 6PM
After 6PM but before midnight

During the day you last smoked
a cigarette, how many cigarettes
did you smoke?

During the day you last used
an e-product, how many puffs
did you take?

During the day you last smoked
a cigar, how many did you
smoke?

During the day you last smoked
a cigarillo, how many did you
smoke?

During the day you last smoked
a filtered cigar, how many did
you smoke?

During the day you last smoked
a pipe, how many bowls filled
with tobacco did you smoke?

Page 1 of 2

PATH Study Tobacco Use Form
All information you give to the PATH Study will be kept private, and will only be used for research purposes.
Have you used any of the following products today, yesterday, or the day before yesterday?
(If you don’t know an answer or don’t want to provide one, you may leave the question blank.)

7 Hookah filled with
tobacco

YES

8 Snus

YES

When did you last smoke hookah?
In the past hour
Sometime today
Yesterday
Day before yesterday

NO

9 Smokeless tobacco

What time of day did you last use snus?

When did you last use smokeless tobacco?

What time of day did you last use smokeless tobacco?

In the past hour
Sometime today
Yesterday
Day before yesterday

NO

10 Nicotine patch, nicotine
gum, nicotine inhaler,
nicotine nasal spray,
lozenge, or pill

YES

11 Chantix, varenicline,
Wellbutrin, Zyban,
or bupropion

YES

NO

NO

During the day you last smoked
hookah, how many puffs did
you take?

During the day you last used snus,
how many times did you use it?

Between midnight and 6AM
After 6AM but before noon
Between noon and 6PM
After 6PM but before midnight

In the past hour
Sometime today
Yesterday
Day before yesterday

YES

(such as moist snuff,
dip, spit, or chew)

Between midnight and 6AM
After 6AM but before noon
Between noon and 6PM
After 6PM but before midnight

When did you last use snus?

NO

What time of day did you last smoke hookah?

Between midnight and 6AM
After 6AM but before noon
Between noon and 6PM
After 6PM but before midnight

During the day you last used
smokeless tobacco, how many
times did you use it?

When did you last use a nicotine patch, nicotine gum,
nicotine inhaler, nicotine nasal spray, lozenge, or pill?
In the past hour
Sometime today
Yesterday
Day before yesterday

What time of day did you last use nicotine patch, nicotine
gum, nicotine inhaler, nicotine nasal spray, lozenge, or pill?
Between midnight and 6AM
After 6AM but before noon
Between noon and 6PM
After 6PM but before midnight

During the day you last used a
nicotine patch, nicotine gum,
nicotine inhaler, nicotine nasal
spray, lozenge, or pill, how many
did you use?

When did you last use Chantix, varenicline,
Wellbutrin, Zyban, or bupropion?
In the past hour
Sometime today
Yesterday
Day before yesterday

What time of day did you last use Chantix, varenicline,
Wellbutrin, Zyban, or bupropion?
Between midnight and 6AM
After 6AM but before noon
Between noon and 6PM
After 6PM but before midnight

During the day you last used
Chantix, varenicline, Wellbutrin,
Zyban, or bupropion, how many
did you take?

Public reporting burden for this collection of information is estimated to average 5 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 (0925-0664). Do not return the completed form to this address.

Date:
m

m

d

d

2

0

y

y

Time:
y

y

h

h

m

m

AM
PM

Participant ID:
Page 2 of 2

OMB Control Number: 0925-0664
Expiration Date: xx/xx/xxxx

Household Questionnaire
Who Should Complete This Form?
An adult household member, 18 years or older, who lives at this address should complete the form.

Instructions
—

Please use a black or blue pen to complete this form.

—

Please mark

—

Please return the completed form in the enclosed postage-paid envelope.

to indicate your answer. If you want to change your answer, darken the box
mark the correct answer.

1. In general, how would you rate your health?

and

4. W
 here do you usually get information about
health or medical topics? Mark all that apply.

Excellent

Very good

Family or friends

Good

Doctor or health care provider

Fair

Health website (e.g., WebMD.com)

Poor

Government website (e.g., FDA.gov)

Some other website

Books

Newspaper or magazine

2. O
 verall, how confident are you about your
ability to take good care of your health?

Completely confident

Some place else

Very confident

Somewhat confident

I never look for information about health or
medical topics

A little confident

Not confident at all

3. D
 uring the past month, did you participate
in any physical activities or exercises of at
least moderate intensity such as running,
brisk walking, swimming, or bicycling at a
regular pace?

Yes

No

5. In the past 12 months, have you done any of the
following on the internet? Mark all that apply.

Looked for medical information for myself or for
someone else

Participated in an online forum or support
group for people with a similar health
issue

Used a website or app to help with diet, weight,
or physical activity

Looked for a health care provider

Kept track of personal health information such
as care received, test results, or upcoming
medical appointments

None of the above
DEV

6.  How much would you agree or disagree with
the following statement?

9. Including yourself, are any of the people who
live at this address in the following age groups?

Tobacco products are safer to use now than
they were 5 years ago.

Yes No
7 or younger . . . . . . . . . . . . . . .

Strongly agree

Somewhat agree

Neither agree nor disagree

Somewhat disagree

Strongly disagree

7. T
 hinking about the people who are important
to you, how would you describe their opinion
on using tobacco?

Very positive

Positive

Neither positive or negative

Negative

Very negative

8 or 9 . . . . . . . . . . . . . . . . . . . .
10 or 11 . . . . . . . . . . . . . . . . . .
12 or 13 . . . . . . . . . . . . . . . . . .
14 to 17 . . . . . . . . . . . . . . . . . .
18 to 24 . . . . . . . . . . . . . . . . . .
25 or older . . . . . . . . . . . . . . . .
10. If your household is selected to participate
in the PATH Study, we would like to follow up
with you. What is your first name?

8.  In your opinion, how much do you think
warning labels on tobacco products
discourage tobacco use?

Very much

Somewhat

A little

Not at all

Public reporting burden for this collection of information is estimated to average 5 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 (0925-0664). Do not
return the completed form to this address.

DEV

Wave 4 Verification Task Wrapper

Wave 4 Verification Task Wrapper
Generated: 21-Jun-2016

OMB Control Number: 0925-0664 Expiration Date: XX/XX/XXXX
Public reporting burden for this collection of information is estimated to average 2 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
(0925-0664). Do not return the completed form to this address.

1

Wave 4 Verification Task Wrapper
No table of contents entries found.

PATH ID:

VOMBIntro

IF RESPONDENT ASKS ABOUT THE OFFICE OF MANAGEMENT AND BUDGET (OMB), READ THE
FOLLOWING PARAGRAPH ALOUD
OMB Control Number: 0925-0664 Expiration Date: XX/XX/XXXX
Public reporting burden for this collection of information is estimated to average 2 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
(0925-0664). Do not return the completed form to this address.
PRESS 1 TO CONTINUE
1

CONTINUE

ASK: All Respondents.
DISPLAY: Display OMB statement text in grey. Display "IF RESPONDENT ASKS..." statement and
"PRESS 1 TO CONTINUE" in blue. Pending language selected in F2; display English OMB statement if
English is selected, display Spanish OMB statement if Spanish is selected. Default to English display.

2

Wave 4 Verification Task Wrapper
BOX ID:

R04_VTASTART

START
Enable Task 401 for each Wave 4 case: a grouping of SPs eligible for W4 and associated with an
R04_FieldedAddress in HMS tbl.PathRptW4CaseDU. The questions below are asked of a household
informant age 18+ about all SPs associated with the R04_FieldedAddress (this variable houses all
address fields for the W4 case).
LOAD
Defined at Address Level:
R04_FieldedAddress (contains all address fields for the address object that defines the case)
R04_AddressType = {CurrentAddress or MovedAddress or NewVerify}
DUID
R04_NumofPeople_LD - number of people (inclusive of SPs and nonSPs) associated with the DUID
Defined at Person Level:
R04_ExpectedSPEventType_LD = {Adult or ExpectedAdult or Youth}
PID
FirstName
LastName
Gender
R04_BestPhoneNumber (new derivation based on items in HMS contact table)
R04_CURRENT_AGE_LD (calculated by IMS each time at launch)
R04_BESTYTHPARENT_LD (new derivation for Load)
CurrentSP_LD = {1,2}
W1Parent_LD = {1,2}
W2Parent_LD = {1,2}
W3Parent_LD = {1,2}
ActivityFlag_LD = {Active, Inactive, Deceased, Other}
R04_InterviewDate_LD
R04_SPWindowStartMonth
R04_SPWindowEndMonth
If R04_AddressType = NewVerify, load above plus:
R04_NewParentfromPreviousVT_LD {1 or 2} and associated PID(s)
R04_NewPersoninVT_LD {1,2} and associated PID(s)
R04_VTA20 (from previous VT)
GLOBAL NOTES:
Disable RF and DK hot keys throughout unless specifically stated/called out in specs.
Add break-off programming (F10) to all screens except Program Boxes and End/Exit screens. If break
off at or after R04_VTA05, display EROC screen. Else, do not display EROC screen in IMS. Never
display any SP Event or enable any SP level tasks. VT must be completed before displaying any SP
Event to user. If break-off, clear all data; when VT is started a subsequent time, begin anew at
R04_VTA00.

3

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA00

ARE YOU CONDUCTING THE VERIFICATION TASK BY TELEPHONE OR IN-PERSON?
1

TELEPHONE

GO TO R04_VTA000

7

IN-PERSON

GO TO R04_VTA000

ASK: All
DISPLAY: Display instructional text in blue.
PATH ID:

R04_VTA000

ARE YOU SPEAKING WITH AN ADULT RESIDENT?
1

YES

GO TO R04_VTABOXAAA_R

2

NO

GO TO R04_VTABOXAAB_R

ASK: All
DISPLAY: Display all instructional text in blue.
BOX ID:

R04_VTABOXAAB_R

If the case has only one object with CurrentSP_LD = 1, go to R04_VTA0000.
Else, go to R04_VTA000D.
PATH ID:

R04_VTA0000

ARE YOU SPEAKING WITH AN ADULT INFORMANT?
[AN INFORMANT IS A NON-HOUSEHOLD MEMBER, FOR EXAMPLE, A NEIGHBOR OR A TRACING
INFORMANT.]
1

YES

GO TO R04_VTA000A

2

NO

GO TO R04_VTA000D

ASK: IF R04_VTA000 = 1.
DISPLAY: Display instructional text in blue.

4

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA000A

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
THE NON-HOUSEHOLD MEMBER INFORMANT REPORTED THAT THE SP IS…
1

DECEASED

GO TO R04_VTA000B

2

TERMINALLY ILL

GO TO R04_VTA000B

3

MENTALLY/PHYSICALLY IMPAIRED

GO TO R04_VTA000B

4

INCARCERATED

GO TO R04_VTA000B

5

OTHER

GO TO R04_VTA000D

ASK: IF R04_VTA0000 = 1.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
Display instructional text in blue.
PATH ID:

R04_VTA000B

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
YOU’VE INDICATED THAT {NAME} IS {DECEASED/TERMINALLY ILL/MENTALLY/PHYSICALLY
IMPAIRED/INCARCERATED}.
PRESS 1 TO CONFIRM.
PRESS 7 TO GO BACK.
1

CONFIRM

GO TO R04_VTABOXAAC_R

7

GO BACK

GO TO R04_VTA000A

ASK: IF R04_VTA000A = (1,2,3,4).
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
Display instructional text in blue.
BOX ID:

R04_VTABOXAAC_R

If R04_VTA000A = (1,2) go to R04_VTA000C.
Else, go to R04_VTA01.

5

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA000C

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
I'm very sorry to hear that.
PRESS 1 TO CONTINUE.
1

CONTINUE

GO TO R04_ VTA01

ASK: IF R04_VTA000A = (1,2).
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
Display instructional text in blue.
PATH ID:

R04_VTA000D

THE VT MUST BE COMPLETED WITH AN ADULT RESIDENT.
PRESS 1 TO EXIT.
1

EXIT

END INTERVIEW AND RETURN TO IMS

ASK: IF R04_VTA0000 = 2 OR R04_VTA000A = 5.
DISPLAY: Display instructional text in blue.
BOX ID:

R04_VTABOXAAA_R

If {R04_AddressType = NewVerify (OR) MovedAddress} OR if R04_FieldedAddress fields = any one or
more of Address line 1, city, state or zip = Empty, GO TO R04_VTA00D.
ELSE, GO TO R04_VTABOXA_V.

6

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA00D

May I please {verify/have} your full address?
IF ADDRESS IS SHOWN, READ ADDRESS ALOUD. VERIFY ALL SPELLING.
IF ADDRESS INFORMATION IS NOT SHOWN, RECORD FULL UPDATED ADDRESS.
ENTER THE PHYSICAL ADDRESS. (DO NOT ENTER A P.O. BOX.)
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

ASK: If R04_AddressType in {NewVerify or MovedAddress}, or if R04_FieldedAddress address fields
contain any one or more address fields: Address line 1, City, State, Zip = Empty.
DISPLAY: Display {have} if all address fields are empty (e.g. there is no address data to pre-fill to any of
the fields). Else, display {verify}.
Display instructional text in blue. Underline "NOT".
BOX ID:

R04_VTABOXA_V

Define R04_LINKED_ADDRESS:
1. If R04_AddressType ! = MovedAddress (or) NewVerify, set R04_LINKED_ADDRESS =
R04_FieldedAddress.
(OR)
2. If R04_AddressType = MovedAddress (or) NewVerify, set R04_LINKED_ADDRESS = THE
ADDRESS CORRECTED/ENTERED AT R04_VTA00D.
(OR)
3. If R04_FieldedAddress fields = any one or more of Address line 1, city, state, or zip = Empty, set
R04_LINKED_ADDRESS = THE ADDRESS CORRECTED/ENTERED AT R03_VTA00D.

DEFINITION: R04_LINKED_ADDRESS is that address for which VT data are being collected in this
instrument.

7

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA01

SELECT THE VERIFICATION TASK RESPONDENT.
1

HOUSEHOLD MEMBER 18+ FIRST NAME/
AGE/GENDER

GO TO R04_VTABOXBA_R

2

HOUSEHOLD MEMBER 18+ FIRST NAME/
AGE/GENDER

GO TO R04_VTABOXBA_R

3

HOUSEHOLD MEMBER 18+ FIRST NAME/
AGE/GENDER

GO TO R04_VTABOXBA_R

4

HOUSEHOLD MEMBER 18+ FIRST NAME/
AGE/GENDER

GO TO R04_VTABOXBA_R

5

HOUSEHOLD MEMBER 18+ FIRST NAME
/AGE/GENDER

GO TO R04_VTABOXBA_R

6

HOUSEHOLD MEMBER 18+ FIRST NAME
/AGE/GENDER

GO TO R04_VTABOXBA_R

7

HOUSEHOLD MEMBER 18+ FIRST NAME
/AGE/GENDER

GO TO R04_VTABOXBA_R

8

HOUSEHOLD MEMBER 18+ FIRST NAME
/AGE/GENDER

GO TO R04_VTABOXBA_R

9

SPEAKING WITH SOMEONE ELSE

GO TO R04_VTA01B

ASK: Asked of any adult household informant at the R04_LINKED_ADDRESS.
DISPLAY: Display instructional text in blue.
BOX ID:

R04_VTABOXBA_R

If R04_ExpectedSPEventType = ExpectedAdult for person selected in R04_VTA01 and
R04_AddressType != NewVerify, GO TO R04_VTA01A.
Else, GO TO R04_VTABOXB_VR.
PATH ID:

R04_VTA01A

YOU HAVE INDICATED THAT YOU ARE SPEAKING TO AN AGED UP ADULT. BEFORE SPEAKING
TO AN AGED UP ADULT, YOU MUST SPEAK WITH A PARENT TO CONFIRM THAT THE AGED UP
ADULT IS INDEED 18 OR OLDER. IF NOT, DO THE VT WITH ANOTHER ADULT RESIDENT.
PRESS 1 TO EXIT.
1

EXIT

END INTERVIEW AND RETURN TO IMS

ASK: If respondent is a new adult (R04_ExpectedSPEventType = ExpectedAdult) and
R04_AddressType != NewVerify.
DISPLAY: Display instructional text in blue.

8

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA01B

ENTER FIRST AND LAST NAME OF THE VT RESPONDENT.
1

FIRST NAME

2

LAST NAME

GO TO R04_VTA01BB

ASK: If R04_VTA01 = 9.
Asked in instances when the FI needs to enter a new VT R (selected 'speaking with someone else' at
R04_VTA01).
DISPLAY: Display instructional text in blue.
PATH ID:

R04_VTA01BB

To get started, can you please confirm that you are at least 18 years old?
1

VT R IS 18+ YEARS OLD

GO TO R04_VTA01C

2

VT R IS LESS THAN 18 YEARS OLD

GO TO R04_VTA02

ASK: If R04_VTA01 = 9.
Asked in instances when the FI selects 'speaking with someone else' (R04_VTA01 = 9) and provided
the name of a new person as the VT R in R04_VTA01B.
DISPLAY: Display instructional text in blue.
PATH ID:

R04_VTA01C

What is the best telephone number to reach you?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

GO TO R04_VTABOXB_VR

-7

REFUSED

GO TO R04_VTABOXB_VR

-8

DON'T KNOW

GO TO R04_VTABOXB_VR

ASK: If R04_VTA01 = 9 (and) R04_VTA01BB = 1.
Asked when the FI needs to enter a new VT R (who must be 18+ years old).
DISPLAY: Display instructional text in blue.

9

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA02

YOU HAVE INDICATED THAT YOU ARE SPEAKING TO A VT RESPONDENT WHO IS UNDER 18
YEARS OF AGE.
THE VT RESPONDENT MUST BE AGE 18 OR OLDER.
PRESS 1 TO EXIT.
1

EXIT

END INTERVIEW AND RETURN TO IMS

ASK: If R04_VTA01BB = 2.
Asked in instances when the FI selects that the VT R is less than 18 years old in R04_VTA01BB.
DISPLAY: Display instructional text in blue. Display second sentence of instructional text (The VT
Respondent...) in blue bold.
BOX ID:

R04_VTABOXB_VR

Link Verification Task respondent selected in R04_VTA01 or entered in R04_VTA01B to the VT. Set
R04_VT_R = respondent PID. If R04_VT_R is not assigned a respondent PID, set flag
R04_NewPersoninVT = 1 and set R04_NewPersonTypeinVT = VT R. Upon exit of VT, IMS: assign all
NewPersoninVT = 1, a unique PID.
Set flag W4VTR to 1 for PID that has been identified as the VT respondent.
NAVIGATION:
If R04_VTA000A = (1,2,3), go to R04_VTABOX7_VR.
Else, if R04_VTA000A = 4, go to R04_VTA54.
Else, if the R04_LINKED_ADDRESS has only one object with CurrentSP_LD = 1, go to R04_VTA05.
Else, go to R04_VTA04.

10

Wave 4 Verification Task Wrapper
PATH ID: R04_VTA04
We would like your help in getting some updated contact information for {you and the other PATH Study
participant(s)/ each PATH Study participant}.
{ADULT/YOUTH/SHADOW
{ADULT/YOUTH/SHADOW
{ADULT/YOUTH/SHADOW
{ADULT/YOUTH/SHADOW
{ADULT/YOUTH/SHADOW
{ADULT/YOUTH/SHADOW

YOUTH} NAME/AGE/GENDER
YOUTH} NAME/AGE/GENDER
YOUTH} NAME/AGE/GENDER
YOUTH} NAME/AGE/GENDER
YOUTH} NAME/AGE/GENDER
YOUTH} NAME/AGE/GENDER

PRESS 1 TO CONTINUE.
1

CONTINUE

GO TO R04_VTASTARTLOOP_R

ASK: If R04_LINKED_ADDRESS has 2 or more objects with CurrentSP = 1.
DISPLAY: Display instructional text in blue.
If the VT R is one of the SPs (W4VTR = 1) and CurrentSP_LD=1, display “you and the other PATH
Study participant(s).” Else, display “each PATH Study participant.”
BOX ID:

R04_VTASTARTLOOP_R

PROGRAM: For each object where CurrentSP_LD=1, ask items R04_VTA05 through R04_VTA40B,
following skips as appropriate, then returning to R04_VTA05 for the next SP in list. While asking
questions in the route for one SP instance (defined as SP N), continue to display associated SP
name/age/gender on all screens along the route. Once instrument transitions to the next SP in list
(defined as SP, N+1), display SP name/age/gender for SP N+1. Ask questions about all SPs in the
same order as shown in the List Display in R04_VTA04: age descending where age =
R04_CURRENT_AGE_LD. Continue until data is obtained for all SP instances. Create response panel
with all persons in List Display in R04_VTA04; display one person’s data per row.
BOX ID:

R04_BOX2_V

If R04_AddressType = NewVerify and (R04_ExpectedSPEventType_LD = ExpectedAdult and
R04_VTA20 = 1) (from previous VT), Set R04_ExpectedSPEventType = Adult,
Else, Set R04_ExpectedSPEventType = R04_ExpectedSPEventType_LD.

11

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA05

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
{I’d like to update {your/SP Name’s} contact information for my records.}
{Are you/Is NAME} currently living at {INSERT R04_LINKED_ADDRESS}?
{[We will not contact anyone under the age of 18 without first speaking to an adult or parent.]}
1

YES

GO TO R04_VTABOX3_R

2

NO

GO TO R04_VTA10

ASK: Ask for each object for which CurrentSP_LD=1 and SP is associated with this
R04_LINKED_ADDRESS.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
If first loop through, display "I’d like to update {your/SP Name’s} contact information for my records." In
second and subsequent loop(s), blank.
If W4VTR=1, display “your” and “Are you”. Else, display "SP Name" and “Is NAME”.
If R04_CURRENT_AGE_LD < 18, display "[We will not contact anyone under the age of 18 without first
speaking to an adult or parent.]" Else, blank.
BOX ID:

R04_VTABOX3_R

Routing: If SP is R04_ExpectedSPEventType = Adult, go to R04_VTABOX6B_R. Else if
R04_ExpectedSPEventType = ExpectedAdult, go to R04_VTA20. Else, if R04_ExpectedSPEventType
= Youth, go to R04_VTABOX6A_R.
PATH ID:

R04_VTA10

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
Did {you/NAME} move or is there another reason why {you are/he is/she is} not currently at this
address?
1

MOVED TO ANOTHER ADDRESS

GO TO R04_VTABOX4_R

7

DECEASED

GO TO R04_VTA14

9

ANOTHER REASON (E.G. LIVING IN A MEDICAL
FACILITY, ON A MILITARY BASE, AWAY AT COLLEGE)

GO TO R04_VTA16

ASK: If R04_VTA05 = 2.
Any SPs reported to no longer be at the R04_LINKED_ADDRESS (R04_VTA05).
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.

12

Wave 4 Verification Task Wrapper
BOX ID:

R04_VTABOX4_R

If this is the first SP instance for which R04_VTA10 = 1 and W4VTR=1, go to R04_VTA12. Or, if this is
the first SP instance for which R04_VTA10 = 1 and this PID is in W4VTR=2, go to R04_VTA11.
If this is not the first SP instance (first SP in Loop) for which R04_VTA10 = 1, go to R04_VTA10X.
PATH ID:

R04_VTA10X

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
Did {NAME} also move to (READ POSSIBLE ADDRESSES)?
1

MOVED TO {INSERT R03_MOVEDADD01}

GO TO R04_VTABOX4B_VR

2

MOVED TO {INSERT R03_MOVEDADD02}

GO TO R04_VTABOX4B_VR

3

MOVED TO {INSERT R03_MOVEDADD03}

GO TO R04_VTABOX4B_VR

4

MOVED TO {INSERT R03_MOVEDADD04}

GO TO R04_VTABOX4B_VR

5

MOVED TO {INSERT R03_MOVEDADD05}

GO TO R04_VTABOX4B_VR

6

MOVED TO {INSERT R03_MOVEDADD06}

GO TO R04_VTABOX4B_VR

7

MOVED TO {INSERT R03_MOVEDADD07}

GO TO R04_VTABOX4B_VR

8

ENTER DIFFERENT ADDRESS

GO TO R04_VTA12

-8

DON'T KNOW

GO TO R04_VTA13

-7

REFUSED

GO TO R04_VTA13

ASK: Ask of subsequent SP instances (after the first SP in Loop has found to have moved) for which
R04_VTA10 = 1 (moved to another address).
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
Display name of SP being discussed in {NAME}.
Display instructional text in blue.

13

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA11

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
OBTAIN A NEW ADDRESS FOR {ADULT/YOUTH/SHADOW YOUTH NAME} ONLY IF THIS IS A
MOVE.
Do you know {SP NAME}’s current address?
{[Right now, I am just looking to update my records. We will not contact anyone under the age of 18
without first speaking to an adult.]}
1

YES

GO TO R04_VTA12

7

NO

GO TO R04_VTA13

-8

DON'T KNOW

GO TO R04_VTA13

-7

REFUSED

GO TO R04_VTA13

ASK: Ask the Verification Task respondent of all Wave 1 SPs displayed in the List Display in
R04_VTA04. Do not ask this question of the VT respondent (W4VTR=2).
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
Display instructional text in blue.
If asking about a Youth/Shadow Youth, display "{[Right now, I am just looking to update my records.
We will not contact anyone under the age of 18 without first speaking to an adult.]}". Else, blank.

14

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA12

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
OBTAIN A NEW ADDRESS FOR {ADULT/YOUTH/SHADOW YOUTH} NAME ONLY IF THIS IS A
PERMANENT MOVE.
What is {your/NAME}’s address?
{[Right now, I am just looking to update my records. We will not contact anyone under the age of 18
without first speaking to an adult.]}
1

ADDRESS LINE 1

2

ADDRESS LINE 2

3

CITY

4

STATE

5

ZIP CODE

ASK: If (from R04_VTABOX4_R) or (R04_VTA11 = 1).
Ask in instances when the VT R has self-reported a move or when the VT R has reported other W3 SPs
have moved and he/she knows the new address.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
If asking about a Youth/Shadow Youth, display "{[Right now, I am just looking to update my records.
We will not contact anyone under the age of 18 without first speaking to an adult.]}". Else, do not
display.
PATH ID:

R04_VTA13

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
Could you provide any information about where {NAME} is now living, such as the city or state?
PROBE FOR AS MUCH DETAIL AS POSSIBLE.
1

[TEXT RESPONSE]

ASK: If R04_VTA11 = 7 or DK/RF (or) R04_VTA10X = DK/RF.

Ask in instances when the VT R does not know or refuses to provide/confirm the SPs new address in
R04_VTA11 or R04_VTA10X.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text
Display instructional text in blue.

15

Wave 4 Verification Task Wrapper
BOX ID:

R04_VTABOX4B_VR

Retain new address collected in first (and all previous) SP instance(s) in R04_VTA12. Then, create/add
to array of moved addresses that is asked/displayed in subsequent SP instances (N+1).
Create a new variable for each new unique moved address obtained, up to 7:
R04_MOVEDADD01
R04_MOVEDADD02
R04_MOVEDADD03
R04_MOVEDADD04
R04_MOVEDADD05
R04_MOVEDADD06
R04_MOVEDADD07
NAVIGATION: Go to R04_VTA18.
PATH ID:

R04_VTA14

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
YOU’VE INDICATED THAT {NAME} IS DECEASED.
PRESS 1 TO CONFIRM.
PRESS 7 TO GO BACK.
1

CONFIRM

GO TO R04_VTA15

7

GO BACK

GO TO R04_VTA10

ASK: If R04_VTA10 = 7.
Ask in all instances when the VT R reports that the SP is deceased in R04_VTA10.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
Display instructional text in blue.

16

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA15

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
I'm very sorry to hear of your loss. I will update my records and will make sure we don’t follow-up about
{NAME} again.
PRESS 1 TO CONTINUE.
1

CONTINUE

GO TO R04_VTABOX7_VR

ASK: If R04_VTA14 = 1.
Ask in all instances when the VT R reports the SP is deceased.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
Display instructional text in blue.
PATH ID:

R04_VTA16

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
YOU’VE INDICATED THAT {NAME} DID NOT PERMANENTLY MOVE BUT IS AWAY FROM
{R04_LINKED_ADDRESS} FOR ANOTHER REASON.
PRESS 1 TO CONFIRM.
PRESS 7 TO GO BACK.
1

CONFIRM

GO TO R04_VTA16B

7

GO BACK

GO TO R04_VTA10

ASK: If R04_VTA10 = 9.
Ask in all instances when the VT R reports the SP is no longer at the R04_LINKED_ADDRESS for
another reason (besides having permanently moved).
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
Display instructional text in blue.

17

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA16B

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
IF RESPONDENT HAS STATED THE REASON THE SP IS AWAY FROM THE ADDRESS AND IT
MATCHES A RESPONSE OPTION, CODE WITHOUT ASKING. SELECT THE OPTION THAT BEST
APPLIES.
IF RESPONDENT HAS NOT YET STATED THE REASON THE SP IS AWAY FROM THE ADDRESS,
OR IF THE STATED REASON DOES NOT EXACTLY MATCH A RESPONSE OPTION, READ THE
QUESTION AND ALL RESPONSE OPTIONS. THEN SELECT THE OPTION THAT BEST APPLIES.
Which option best describes why {NAME is/you are} away from {R04_LINKED_ADDRESS}? Would you
say {NAME is/you are}....
{SELECT RESPONSE OPTION 3 WHEN THE SP IS IN A SKILLED NURSING FACILITY, SUCH AS A
NURSING HOME, ASSISTED LIVING, CONTINUING CARE, OR OTHER SENIOR CARE FACILITY
THAT HELPS SUPPORT THE SP'S ACTIVITIES OF DAILY LIVING.}
SELECT RESPONSE OPTION 5 WHEN THE SP IS IN ANY OTHER GROUP QUARTERS SETTING,
SUCH AS A RESIDENTIAL TREATMENT CENTER, WORKERS CAMP, RELIGIOUS GROUP
QUARTERS, OR GROUP HOME PROVIDING PSYCHIATRIC OR REHABILITATIVE CARE.
1

Away at college or boarding school

GO TO R04_VTA17

2

Living in a military facility (such as in a military barracks or
on a military base)

GO TO R04_VTA17

3

{Living in a nursing home (or other senior care facility)}

GO TO R04_VTA16C

4

Incarcerated (such as in jail or a detention facility)

GO TO R04_VTA17

5

Living in a different Group Quarters Setting?

GO TO R04_VTA17

6

OTHER (SPECIFY)

GO TO R04_VTA17

-8

DON'T KNOW

GO TO R04_VTABOX5_R

-7

REFUSED

GO TO R04_VTABOX5_R

ASK: If R04_VTA16 = 1.
Ask in all instances when the VT R reports the SP is no longer at the R04_LINKED_ADDRESS for
another reason (besides having permanently moved).
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text. If ExpectedSPEventType_LD = Adult, display response option 3 (Entered
into a nursing home...) and "SELECT RESPONSE OPTION 3 WHEN THE SP IS IN A SKILLED
NURSING FACILITY, SUCH AS A NURSING HOME, ASSISTED LIVING, CONTINUING CARE, OR
OTHER SENIOR CARE FACILITY THAT HELPS SUPPORT THE SP'S ACTIVITIES OF DAILY
LIVING", else do not display.
If ExpectedSPEventType_LD = ExpectedAdult or Youth, do not re-adjust response option labels,
displaying only options 1, 2, 4, 5, 6, -8, -7.

18

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA16C

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
Is the facility a nursing home, an assisted living facility, a combined nursing home and assisted living
facility, or some other type of senior care facility?
1

NURSING HOME

GO TO R04_VTA17

2

ASSISTED LIVING FACILITY

GO TO R04_VTA17

3

COMBINED NURSING HOME AND ASSISTED LIVING
FACILITY

GO TO R04_VTA17

4

OTHER (SPECIFY)

GO TO R04_VTA17

-8

DON'T KNOW

GO TO R04_VTABOX5_R

-7

REFUSED

GO TO R04_VTABOX5_R

ASK: If R04_VTA16B = 3 (and) R04_ExpectedSPEventType = Adult.
Ask in all instances when the VT R reports self or an Adult SP has entered into a nursing home or
similar senior care facility.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
PATH ID:

R04_VTA17

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
Can you provide any information about where {{NAME} is/you are} currently?
PROBE TO OBTAIN THE FOLLOWING INFORMATION:
- TYPE OF PLACE AND ANY ADDRESS INFORMATION WHERE SP CURRENTLY RESIDES;
- PHONE NUMBER, IF APPLICABLE;
- EXPECTED RETURN DATE/LENGTH OF TIME AWAY FROM HOUSEHOLD;
1

[TEXT RESPONSE]

ASK: If R04_VTA16B = {1, 2, 3, 4, 5, 6}.
Ask in all instances when the VT R reports self or an Adult SP is away at college or boarding school,
living in a military facility, entered into a nursing home or similar senior care facility, incarcerated, living
in a different Group Quarters setting, or away for another specified reason at R04_VTA16B.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
If SP is VT R, display “you are”. Else, display “{NAME} is”.
Display instructional text in blue.

19

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA18

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
Which option best describes why {NAME/you} moved? Would you say {NAME is/you are}....
READ RESPONSE OPTIONS ALOUD. SELECT THE OPTION THAT BEST APPLIES
{SELECT RESPONSE OPTION 3 WHEN THE SP IS IN A SKILLED NURSING FACILITY, SUCH AS A
NURSING HOME, ASSISTED LIVING, CONTINUING CARE, OR OTHER SENIOR CARE FACILITY
THAT HELPS SUPPORT THE SP'S ACTIVITIES OF DAILY LIVING.}
SELECT RESPONSE OPTION 5 WHEN THE SP IS IN ANY OTHER GROUP QUARTERS SETTING,
SUCH AS A RESIDENTIAL TREATMENT CENTER, WORKERS CAMP, RELIGIOUS GROUP
QUARTERS, OR GROUP HOME PROVIDING PSYCHIATRIC OR REHABILITATIVE CARE.
1

Away at college or boarding school

GO TO R04_VTABOX5_R

2

Living in a military facility (such as in a military barracks or
on a military base)

GO TO R04_VTABOX5_R

3

{Living in a nursing home (or other senior care facility)}

GO TO R04_VTA18B

4

Incarcerated (such as in jail or a detention facility)

GO TO R04_VTABOX5_R

5

Living in a different Group Quarters Setting?

GO TO R04_VTABOX5_R

6

OTHER (SPECIFY)

GO TO R04_VTABOX5_R

-8

DON'T KNOW

GO TO R04_VTABOX5_R

-7

REFUSED

GO TO R04_VTABOX5_R

ASK: Ask in all instances when the VT R reports the SP has permanently moved.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text. If ExpectedSPEventType_LD = Adult, display response option 3 (Entered
into a nursing home...) and "SELECT RESPONSE OPTION 2 WHEN THE SP IS IN A SKILLED
NURSING FACILITY, SUCH AS A NURSING HOME, ASSISTED LIVING, CONTINUING CARE, OR
OTHER SENIOR CARE FACILITY THAT HELPS SUPPORT THE SP'S ACTIVITIES OF DAILY
LIVING", else do not display.
If ExpectedSPEventType_LD = ExpectedAdult or Youth, do not re-adjust response option labels,
displaying only options 1, 2, 4, 5, 6, -8, -7.

20

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA18B

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
Is the facility a nursing home, an assisted living facility, a combined nursing home and assisted living
facility, or some other type of senior care facility?
1

NURSING HOME

GO TO R04_VTABOX5_R

2

ASSISTED LIVING FACILITY

GO TO R04_VTABOX5_R

3

COMBINED NURSING HOME AND ASSISTED LIVING
FACILITY

GO TO R04_VTABOX5_R

4

OTHER (SPECIFY)

GO TO R04_VTABOX5_R

-8

DON'T KNOW

GO TO R04_VTABOX5_R

-7

REFUSED

GO TO R04_VTABOX5_R

ASK: If R04_VTA16B = 3 (and) R04_ExpectedSPEventType = Adult.
Ask in all instances when the VT R reports self or an Adult SP has entered into a nursing home or other
senior care facility.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
BOX ID:

R04_VTABOX5_R

If (R04_ExpectedSPEventType = Adult) (or) (SP=VT R and R04_ExpectedSPEventType =
ExpectedAdult and R04_AddressType=NewVerify and R04_CURRENT_AGE_LD >= 18) , go to
R04_VTABOX6C_R.
Else if (R04_ExpectedSPEventType = ExpectedAdult) or (R04_ExpectedSPEventType = Youth and
R04_CURRENT_AGE_LD >=18), go to R04_VTA20.
Else if R04_ExpectedSPEventType = Youth, go to R04_VTABOX6A_R
PATH ID:

R04_VTA20

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
Our records indicate that {NAME} is now 18 or older. Is this correct?
1

YES, SP IS 18 OR OLDER

GO TO R04_VTABOX5A_LC

2

NO, SP IS 17 OR YOUNGER

GO TO R04_VTABOX5B_LC

-8

DON'T KNOW

GO TO R04_VTABOX6A_R

-7

REFUSED

GO TO R04_VTABOX6A_R

ASK: If R04_ExpectedSPEventType = ExpectedAdult. (Routing from R04_VTABOX3_R or
R04_VTABOX5_R).
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.

21

Wave 4 Verification Task Wrapper
BOX ID:

R04_VTABOX5A_LC

DISPLAY ERROR MESSAGE:
YOU HAVE INDICATED THE FORMER YOUTH SP IS NOW 18 YEARS OF AGE OR OLDER.
PRESS S IF YES.
PRESS G TO GO BACK AND EDIT ENTRY.
S SUPPRESS GO TO R04_VTA25
G GO BACK GO TO R04_VTA20
BOX ID:

R04_VTABOX5B_LC

DISPLAY ERROR MESSAGE:
YOU HAVE INDICATED THE YOUTH SP IS STILL 17 YEARS OF AGE OR YOUNGER.
PRESS S IF YES.
PRESS G TO GO BACK AND EDIT ENTRY.
S SUPPRESS GO TO R04_VTABOX6A_R
G GO BACK GO TO R04_VTA20

22

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA25

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
{We would like to get in touch with {SP NAME} to discuss the next steps in the PATH Study.} What is
the best phone number to reach {SP NAME}?
(Since {NAME} is now 18, for purposes of this study {he/she} is considered an adult.)
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

GO TO R04_VTABOX6D_R

-8

DON'T KNOW

GO TO R04_VTABOX6D_R

-7

REFUSED

GO TO R04_VTABOX6D_R

ASK: If R04_VTA20 = 1 or ExpectedAdult was previously confirmed as 18+.
Ask in all instances when VT R reported that the SP is now 18 years or older at R04_VTA20 (or) the SP
was previously confirmed as 18+.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
If R04_VTA00=1 (telephone), display "{We would like to get in touch with {NAME} to discuss the next
steps in the PATH Study.}" Else, blank.
BOX ID:

R04_VTABOX6A_R

Routing Description: If R04_BESTYTHPARENT_LD is not already confirmed as NOT living at the
R04_LINKED_ADDRESS, go to R04_VTA26 (which asks if R04_BESTYTHPARENT_LD is still the best
parent to contact). [Assume the Parent is still at this address, until we know otherwise.] If
R04_BESTYTHPARENT_LD has already been confirmed as NOT living at the
R04_LINKED_ADDRESS, go to R04_VTA27.

23

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA26

{YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
Last time we visited your household, we spoke with {PARENT NAME/you} about {YOUTH NAME}. {Is
this/Are you} still the best person, living with {YOUTH NAME}, to contact regarding {YOUTH NAME}’s
participation in the PATH Study?
THE PARENT MUST LIVE WITH {YOUTH/SHADOW YOUTH NAME}.
REMINDER: A PARENT OR GUARDIAN CAN BE A ROLE, RATHER THAN A RELATIONSHIP. THE
PARENT OR GUARDIAN MUST LIVE WITH THE CHILD, SHOULD BE KNOWLEDGEABLE ABOUT
THE YOUTH AND BE RESPONSIBLE FOR MAKING DECISIONS ON YOUTH’S ACTIVITIES, LIKE
SCHOOL PERMISSIONS, WHERE TO LIVE, ETC.
1

YES

GO TO R04_VTABOX6B_R

2

NO

GO TO R04_VTA27

ASK: Asked when R04_ExpectedSPEventType = Youth and the Parent & Youth have been confirmed
as living at the R04_LINKED_ADDRESS. Route to R04_VTA26 also in instances when the VT R =
W3(1) Parent even if the W3(1) Parent is not an SP.
DISPLAY: Display “{YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the screen, prior to
question text.
If VT R PID = R04_BESTYTHPARENT_LD, display "you" and "Are you". Else, display {FirstName
LastName associated with R04_BESTYTHPARENT_LD} and "Is this".
Display instructional text in blue. Bold "REMINDER" and "A ROLE".

24

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA27

{YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
Who would be the best person, living with {YOUTH NAME}, to contact regarding {NAME}’s continued
participation in the PATH Study?
THE PARENT MUST LIVE WITH {YOUTH/SHADOW YOUTH NAME}.
REMINDER: A PARENT OR GUARDIAN CAN BE A ROLE, RATHER THAN A RELATIONSHIP. THE
PARENT OR GUARDIAN MUST LIVE WITH THE CHILD AND SHOULD BE KNOWLEDGEABLE
ABOUT THE YOUTH AND BE RESPONSIBLE FOR MAKING DECISIONS ON YOUTH’S ACTIVITIES,
LIKE SCHOOL PERMISSIONS, WHERE TO LIVE, ETC.
1

NAME/AGE/GENDER

GO TO R04_VTABOX6B_R

2

NAME/AGE/GENDER

GO TO R04_VTABOX6B_R

3

NAME/AGE/GENDER

GO TO R04_VTABOX6B_R

4

NAME/AGE/GENDER

GO TO R04_VTABOX6B_R

5

NAME/AGE/GENDER

GO TO R04_VTABOX6B_R

6

NAME/AGE/GENDER

GO TO R04_VTABOX6B_R

7

NAME/AGE/GENDER

GO TO R04_VTABOX6B_R

8

NAME/AGE/GENDER

GO TO R04_VTABOX6B_R

9

(NAME OF VT R)

GO TO R04_VTABOX6B_R

10

(NAME OF POSSIBLE PARENT)

GO TO R04_VTABOX6B_R

11

(NAME OF POSSIBLE PARENT)

GO TO R04_VTABOX6B_R

12

(NAME OF POSSIBLE PARENT)

GO TO R04_VTABOX6B_R

98

NO PARENT LIVES WITH YOUTH

GO TO R04_VTA29B

99

NEW PARENT IDENTIFIED

GO TO R04_VTA28

ASK: (From R04_VTABOX6A_R) OR (R04_VTA26 = 2).
Asked of youth or expected adults confirmed to still be 17 and for which R04_BESTYTHPARENT_LD is
not the best person to contact regarding the youth’s continued participation in the study.
DISPLAY: Display “{YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the screen, prior to
question text.
Display instructional text as blue. Bold "REMINDER" and "A ROLE".
Display name/age/gender of all persons 18+ that are associated with this household.

25

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA28

{YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
ENTER FIRST AND LAST NAME OF NEW PARENT.
1

FIRST NAME

2

LAST NAME

GO TO R04_VTA29

ASK: If R04_VTA27 = 99.
Collect new Parent first and last name in instances when option of ‘New Parent Identified’ is selected in
R04_VTA27.
DISPLAY: Display “{YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the screen, prior to
question text.
Display instructional text in blue.
PATH ID:

R04_VTA29

{YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
What is their telephone number?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

GO TO R04_VTABOX6AA_VR

-8

DON'T KNOW

GO TO R04_VTABOX6AA_VR

-7

REFUSED

GO TO R04_VTABOX6AA_VR

ASK: If R04_VTA27 = 99.
Collect new Parent phone number in instances when option of ‘New Parent Identified’ is selected in
R04_VTA27.
DISPLAY: Display “{YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the screen, prior to
question text.
Display instructional text in blue.

26

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA29B

{YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
DOCUMENT ANY INFORMATION PROVIDED ABOUT SITUATION WHEN NO HOUSEHOLD
MEMBER FILLS PARENT ROLE.
1

[TEXT RESPONSE]

GO TO R04_VTABOX6D_R

ASK: R04_VTA27 = 98
Collect clarifying information in instances when there is no one that fits the Parent role in the household.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
Display instructional text in blue.
BOX ID:

R04_VTABOX6AA_VR

(From R04_VTA29):
If original VT results in a split so this VT is R04_AddressType = NewVerify and parent name response
option selected in this VT at R04_VTA27 Parent is a new parent identified from a previous VT, go to
R04_VTABOX6B_R.
Else, If New Parent identified in R04_VTA27 and named in R04_VTA28 is not yet assigned a
respondent PID, set flag R04_NewPersoninVT = 1 and set R04_NewPersonTypeinVT = Parent.
NAVIGATION: Go to R04_VTABOX6B_R
If R04_VTA26 = 1, Set R04_VTBestParent_FN to first name associated with
R04_BESTYTHPARENT_LD and R04_VTBestParent_LN to last name associated with
R04_BESTYTHPARENT_LD.
Else, if R04_VTA27 in (1,2,3,4,5,6,7,8,9), Set R04_VTBestParent_FN to FirstName associated with that
response item and R04_VTBestParent_LN to LastName associated with that response item.
Else, if R04_VTA28_FN is not null, Set R04_VTBestParent_FN = R04_VTA28_FN and
R04_VTBestParent_LN = R04_VTA28_LN.

27

Wave 4 Verification Task Wrapper
BOX ID:

R04_VTABOX6B_R

Routing: If R04_VTA26 = 1 and R04_BESTYTHPARENT_LD has already completed loop, go to
R04_VTABOX6D_R.
If R04_VTA27 = PID associated with VT R and R04_VTA01 = 9, go to R04_VTABOX6D_R.
If R04_VTA29 is not null, go to R04_VTABOX6D_R.
Else go to R04_VTABOX6C_R.
Routing Description: If the SP row/instance’s phone number was previously obtained, e.g. the unique
person’s telephone number was asked already because the person is an also an Adult SP or a Parent
of another Y/SY, go to R04_VTABOX6D_R. If the parent selected in R04_VTA27 is also the VT R:
R04_VTA01 = 9, R name provided in R04_VTA01B, and phone number obtained in R04_VTA01C, go to
R04_VTABOX6D_R. Else, go to R04_VTABOX6C_VR.
BOX ID:

R04_VTABOX6C_R

If W4VTR=1 and we have a phone number(R04_BestPhoneNumber !=NULL), go to R04_VTA30. If
W4VTR=1 and we do not have a phone number(R04_BestPhoneNumber = NULL), go to R04_VTA35. If
W4VTR=2 and we have a phone number (R04_BestPhoneNumber != NULL), go to R04_VTA40. If
W4VTR=2 and we do not have a phone number (R04_BestPhoneNumber = NULL), go to
R04_VTA40B.
PATH ID:

R04_VTA30

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
I have your best phone number as {(XXX) XXX-XXXX}. Is that correct?
1

YES

GO TO R04_VTABOX6D_R

2

NO

GO TO R04_VTA35

ASK: W4VTR=1 and R04_BestPhoneNumber not null.
Ask in all instances when we have a best phone number for the W4 VT R.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
Fill {(XXX) XXX-XXXX} with R04_BestPhoneNumber for VT R. Format phone number fill with
parentheses and hyphens, e.g. (301) 251-1500.

28

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA35

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
What is the best telephone number to reach you?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

GO TO R04_VTABOX6D_R

-8

DON'T KNOW

GO TO R04_VTABOX6D_R

-7

REFUSED

GO TO R04_VTABOX6D_R

ASK: R04_VTA30 = 2 or (W4VTR=1 and R04_BestPhoneNumber is null)
Ask in all instances when the W4 VT R reported that the best phone number we have is not correct in
R04_VTA30 (or) we do not have a best phone number for the W4 VT R.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
Display instructional text in blue.

29

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA40

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
I have the following phone numbers for {ADULT NAME/PARENT NAME/you}. Which is the best
number?
READ PHONE NUMBERS BELOW, STOPPING ONCE RESPONDENT IDENTIFIES BEST NUMBER.
SELECT 4 TO ENTER NEW PHONE NUMBER.
1

PHONE NUMBER

GO TO R04_VTABOX6D_R

2

PHONE NUMBER

GO TO R04_VTABOX6D_R

3

PHONE NUMBER

GO TO R04_VTABOX6D_R

4

ENTER NEW PHONE NUMBER

GO TO R04_VTA40B

9

{REFUSE/DO NOT CONTACT}

GO TO R04_VTABOX6D_R

-8

DON'T KNOW

GO TO R04_VTABOX6D_R

-7

REFUSED

GO TO R04_VTABOX6D_R

ASK: W4VTR=2 and R04_BestPhoneNumber not null. Also not previously obtained in any prior loop in
this instrument.
Ask in all instances when we have a best phone number for an Adult SP or Parent who is not the W4 VT
R.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
Display instructional text in blue.
If W4VTR=1, display "you”. Else, display "SP Name".
For R04_ExpectedSPEventType = Youth and parent is not VT R, display name of adult (parent)
identified in R04_VTA26-R04_VTA28. Else, display Adult SP name if instance (row) is for an Adult SP.

30

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA40B

{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
[We would like to contact {ADULT NAME/PARENT NAME} to schedule an appointment for an interview
{about {YOUTH NAME}}].
What is the best number?
ENTER THE NUMBERS ONLY. DO NOT ENTER HYPHENS OR OTHER SYMBOLS.
1

AREA CODE AND PHONE NUMBER

GO TO R04_VTABOX6D_R

-8

DON'T KNOW

GO TO R04_VTABOX6D_R

-7

REFUSED

GO TO R04_VTABOX6D_R

ASK: R04_VTA40 = 4 or (W4VTR=2 and R04_BestPhoneNumber is null)
Ask in all instances where we obtained a new best phone number for an Adult SP or Parent in
R04_VTA40 (or) we do not have a best phone number for an Adult SP or Parent who is not the W4 VT
R.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text
Display instructional text in blue. Display first sentence above only if (W4VTR = 2 and
R04_BestPhoneNumber = NULL), else do not display first sentence. Display final phrase in first
sentence above {about YOUTH NAME} only for the subset in (R04_ExpectedSPEventType = Youth +
W4VTR =2) and R04_BestPhoneNumber = NULL.
BOX ID:

R04_VTABOX6D_R

Routing: If R04_CURRENT_AGE_LD < 17 OR R04_VTA16B = 4 OR R04_VTA18 = 4, go to
R04_VTABOX7_VR. Else, go to R04_VTA45.
Routing Description: If the participant's age is less than 17 (all shadow youth and youth younger than 17
years of age) or the SP is incarcerated (as part of a temporary or permanent move), go to
R04_VTABOX7_VR. Else, for all adults and youth at least 17 years of age who are not incarcerated, go
to R04_VTA45.

31

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA45

{ADULT/YOUTH} NAME/AGE/GENDER
{Are you/Is NAME} currently serving on active duty in the U.S. Armed Forces, Military Reserves or
National Guard?
[Active duty for the Reserves or National Guard does not include the regular training for the Reserves or
Guard. It does include being activated for deployment such as for the Iraq War.]
1

YES

GO TO R04_VTABOX7_VR

2

NO

GO TO R04_VTABOX7_VR

-8

DON'T KNOW

GO TO R04_VTABOX7_VR

-7

REFUSED

GO TO R04_VTABOX7_VR

ASK: All households, about ADULT household member and youth household members aged 17 and
older.
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
If SP is VT R, display “Are you”. Else, display “Is {NAME}”.
BOX ID:

R04_VTABOX7_VR

END OF LOOP
For each SP, set R04_VTBESTSPPHONE:
If R04_VTA30 = 1, set R04_VTBESTSPPHONE = R04_BestPhoneNumber.
Else, if R04_VTA35 is not null and not DK or RF, set R04_VTBESTSPPHONE = R04_VTA35.
Else, if R04_VTA40 in (1,2,3), set R04_VTBESTSPPHONE = number linked to the value of
R04_VTA40.
Else, if R04_VTA40B is not null and not DK or RF, set R04_VTBESTSPPHONE = R04_VTA40B.
If data has been collected for each SP row instance, N, and updated address information was received
for any SP row instance, go to R04_VTA50. Else if data has been collected for each SP row instance N
and no updated address information has been received, go to R04_VTA55.
Else, go to R04_VTA05 for row instance (N+1).

32

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA50

Before we end, I’d like to summarize some of the updated address information you told me today. I
recorded that:
SP Name New Address Information
1

CONFIRM

GO TO R04_VTABOX9_R

7

EDIT

GO TO R04_VTABOX8_LC

ASK: Summary page with data that should be confirmed for each SP, only in instances when new
address information was obtained in R04_VTA12 (or) R04_VTA13, or other known information was
obtained in R04_VTA17.
DISPLAY: Display each SPs data in one row.
SP Name: display full name (FirstName/LastName) of each SP (Adult, Youth or Shadow Youth). Only
display SP instances for which some new or partial address information was obtained. (If the SP's
address did not change, omit them from R04_VTA50.)
Street Address: In instances of moves, display updated street address obtained in
R04_VTA10X/R04_VTA12, or other known information obtained in R04_VTA13, or in instances of SP is
away for another reason, display other known information obtained in R04_VTA17.
BOX ID:

R04_VTABOX8_LC

If R04_VTA50 = 7 for said SP instance, display the following logic check table – error message:
SELECT ANY ROW FROM THE LIST BELOW TO GO BACK AND EDIT THAT ITEM.
UPDATE INFORMATION WHERE NEEDED:
SP Name (Disable/disallow any edit name functionality)
New Address Information (Able to Edit and go to R04_VTA05 (or) R04_VTA10 (or) R04_VTA12/13 (or)
R04_VTA17.
Display R04_VTABOX8_LC with one SP's data at a time and only if R04_VTA50 = 7 for said SP. Allow
user to select row, then click to change the response given to one or more fields for the associated SP
row instance.
If any one value in any SP instance row is changed, always redisplay R04_VTA50 for the associated
SP. Allow for multiple loops to edit the fields. R04_VTA50 must be confirmed (response option = 1) for
each SP instance before continuing.
BOX ID:

R04_VTABOX9_R

Once data has been confirmed for each SP instance for which updated address information was
obtained, go to R04_VTA55, Else, return to R04_VTA50 for row instance (N+1).

33

Wave 4 Verification Task Wrapper
PATH ID:

R04_VTA54

ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER
Can you provide any information about where {NAME} is currently?
PROBE TO OBTAIN THE FOLLOWING INFORMATION:
- TYPE OF PLACE AND ANY ADDRESS INFORMATION WHERE SP IS INCARCERATED;
- PHONE NUMBER, IF APPLICABLE;
- EXPECTED RETURN DATE/LENGTH OF TIME AWAY FROM HOUSEHOLD;
1

[TEXT RESPONSE]

GO TO R04_VTA55

ASK: IF R04_VTA000A = 4
DISPLAY: Display “{ADULT/YOUTH/SHADOW YOUTH} NAME/AGE/GENDER” at the top of the
screen, prior to question text.
Display instructional text in blue.
PATH ID:

R04_VTA55

{TARGET WINDOW FOR {SP NAME} IS {MONTH-MONTH}.} {TRY TO SCHEDULE INTERVIEW
DURING THE WINDOW. DOCUMENT APPOINTMENT IN AN EROC / TRY TO TRANSITION
DIRECTLY TO SP LEVEL DATA COLLECTION TASKS, AS APPROPRIATE BASED ON TARGET
WINDOW.}
PRESS 1 TO RETURN TO IMS.
1

EXIT

END INTERVIEW AND RETURN TO IMS

ASK: From R04_VTABOX7_VR (or) R04_VTA50.
DESCRIPTION: When Loop for each SP instance has been completed (or) all fields for all SPs in
R04_VTA50 have been confirmed.
DISPLAY: Display instructional text in blue.
Display name of SP in {SP NAME}, and "R04_SPWindowStartMonth - R04_SPWindowEndMonth" for
{MONTH-MONTH} for each SP in household.

34

Wave 4 Verification Task Wrapper
BOX ID:

R04_VTAEND

Return to IMS and set the following:
(A) Set R04_NumofPeople - value for R04_NumofPeople is the count of people associated with the
R04_LINKED_ADDRESS, inclusive of count of PIDs where R04_NewPersoninVT = 1 +
R04_NewPersonTypeinVT = {VT R, Parent} and exclusive of PIDs who are no longer associated with
R04_LINKED_ADDRESS if in SP Loop R04_VTA10 = 1 + R04_VTA10X = {1, 2, 3, 4, 5, 6, 7, 8, -8, -7}
(B) Create SP-level tasks for all SPs confirmed to have been living at linked W4 address:
Set R04_EventType = Adult (and) IMS, create SP Event Type = Adult if R04_ExpectedSPEventType =
Adult.
OR
Set R04_EventType = Youth (and) IMS, create SP Event Type = Youth if R04_ExpectedSPEventType =
Youth.
OR
Set R04_EventType = Adult (and) IMS, create SP Event Type = Adult if R04_ExpectedSPEventType =
ExpectedAdult + R04_VTA20 = 1.
OR
Set R04_EventType = Youth (and) IMS, create SP Event Type = Youth if R04_ExpectedSPEventType =
ExpectedAdult AND R04_VTA20 != 1.
Else, for SPs confirmed to have moved from R04_LINKED_ADDRESS, IMS, do not create SP-level
tasks at this DUID, instead move and associate SPs with new DUID created by IMS; new DUID:
R04_AddressType= NewVerify. IMS, create & display newly created DU on Browse Case screen in
IMS.
Exception: If R04_AddressType = NewVerify and PID with R04_ExpectedSPEventType =
ExpectedAdult was confirmed as 18+ in previous VT, create R04_EventType = Adult.
(C) Universe of status codes set in VT and returned then propagated forward by IMS:
Set Task 401 = FVS if PID has W4VTR = 1 and {CurrentSP_LD = 1 (or) W1Parent_LD = 1 (or)
W2_Parent_LD = 1 (or) W3_Parent_LD = 1}. Else set Task 401 = FVO.
Exception: Set Task 401 = FVS if (R04_ExpectedSPEventType = ExpectedAdult +
R04_CURRENT_AGE_LD >=18 + R04_AddressType = NewVerify).
Set Task 401 = FVM if the R04_FieldedAddress ! = R04_LINKED_ADDRESS (and) a new address was
collected at R04_VTA00C, and defined as the R04_LINKED_ADDRESS in R04_VTABOXA. (Do not set
status = FVM if the W4_FieldedAddress was simply corrected in R04_VTA00D.)
Set Task 401 = ISP (Split) for R04_AddressType = NewVerify in instances when a subset of SPs
associated with the parent DUID have split from this R04_LINKED_ADDRESS.
Set Task 401 = IMV (Moved) for R04_AddressType = NewVerify in instances when a subset of SPs
associated with the parent (buddy) DUID have split from this R04_LINKED_ADDRESS and a full new
address is not known (R04_VTA12 address fields contain any one or more address fields: Address line
1, City, State, Zip = Empty). Retain association of SPs who have moved and for whom a full address is
not known until we know otherwise.

35

Wave 4 Verification Task Wrapper
Set Task 412 (Adult SP) or Task 431 (Youth/SY) = IAW (Away) in instances when the SP is found to be
temporarily away from the R04_LINKED_ADDRESS: R04_VTA16 = 1 (and) possible free text detail was
provided in R04_VTA17. Extract free text entered in R04_VTA17 and display in Comments in the
Activity Log, Blaise returns status to set SP (Task 412 (or) Task 431) = IAW.
Set Task 412 (Adult SP) or Task 431 (Youth/SY) = FDC (Deceased) in instances when the VT R reports
the SP as deceased: R04_VTA15 = 1 or R04_VTA000A = 1. Display deceased SP event in Browse
Person, but do not enable any SP level data collection tasks.
Set Task 412 (Adult SP) or Task 431 (Youth/SY) = IIL (Illness) in instances when the VT R reports the
SP as terminally ill: R04_VTA000A = 2, Blaise returns status to set SP (Task 412 (or) Task 431) = IIL.
Set Task 412 (Adult SP) or Task 431 (Youth/SY) = IPM (Physical/Mental Disability) in instances when
the VT R reports the SP has mental or physical impairment: R04_VTA000A = 3, Blaise returns status to
set SP (Task 412 (or) Task 431) = IPM.
Set Task 412 (Adult SP) or Task 431 (Youth/SY) = IIC (Incarcerated) in instances when the VT R
reports the SP as incarcerated: R04_VTA000A = 4 or R04_VTA16B = 4 or R04_VTA18 = 4 (and)
possible free text detail was provided in R04_VTA54 or R04_VTA17. Extract free text entered in
R04_VTA54 or R04_VTA17 and display in Comments in the Activity Log, Blaise returns status to set SP
(Task 412 (or) Task 431) = IIC.
Set Task 431 (Youth/SY) = IRW (Interim Review) in instances when the Youth SP is reported to have no
parent living with the Youth (R04_VTA27 = 98) (and) possible free text detail was provided in
R04_VTA29B. Extract free text entered in R04_VTA29B and display in Comments in the Activity Log.
Blaise returns status to set SP (Task 431) = IRW.
If Task 401 IN (FVM, ISP, IMV), Set DUCreationWave = "Wave 4".

36

PATH Study Wave 4: Script for Telephone Validation

OMB Control Number: xxxx-xxxx

Expiration Date: xx/xx/xxxx

Public reporting burden for this collection of information is estimated to average 4 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 (0925-0664). Do not return the completed form to this address.

1

IN4-12

PROGRAMMING INSTRUCTIONS:
Display color text by Validation Type:
Orange – Household Screener
Green – Adult Interview
Blue – Parent Interview

Intro_A.
Hello, my name is [VALIDATOR’S NAME] and I am calling on behalf of the Population Assessment of
Tobacco and Health (PATH) Study. May I please speak with [HH SCREENER RESP NAME/SP
NAME/PARENT NAME]?
•

(IF YOU ARE SPEAKING WITH THE RESPONDENT/SP/PARENT….CONTINUE TO INTRO
B)

•

(IF RESPONDENT/SP/PARENT IS CALLED TO THE PHONE….INTRODUCE YOURSELF
AGAIN AND CONTINUE TO INTRO B)

•

(IF RESPONDENT/SP/PARENT IS NOT AVAILABLE….GO TO END_B)

•

(IF NO SUCH PERSON AT PHONE NUMBER….GO TO END_A)

Intro_B.
Please tell me if you are currently driving a car or doing any activity that requires your full attention so I can
call you back at a later time. May I continue?
☐ CONTINUE .......................... 1

(GO TO Q1)

☐ CALL BACK ........................ 2

(GO TO END_C)

1. Just to confirm, am I speaking with [HH SCREENER RESP NAME/SP NAME/PARENT NAME]?
☐ YES ....................................... 1

(GO TO Q2)

☐ NO ........................................ 2

(GO TO END_B)

2. Recently one of our interviewers visited your address to conduct an interview [with your son or
daughter] as part of the Population Assessment of Tobacco and Health (PATH) Study. Do you
remember talking to him or her?
☐ YES ....................................... 1

(SKIP TO Q7)

☐ NO ........................................ 2

(CONTINUE TO BOX A)

2

IN4-12

Box A
Routing Instructions:
IF Validation Type = Household Screener, GO TO Q3A.
IF Validation Type = Adult Interview or Parent Interview, GO TO Q3B.

3A. The interviewer talked to you about the members of your household and their use of tobacco
products. Do you remember the visit now?
☐ YES ....................................... 1

(SKIP TO Q7)

☐ NO ........................................ 2

(GO TO Q4)

3B. During the interview, you were asked questions about your [health and tobacco use/son or daughter].
Do you remember the visit now?
☐ YES ....................................... 1

(SKIP TO Q7)

☐ NO ........................................ 2

(GO TO Q4)

4. On [HH SCREENER INTERVIEW DATE/ADULT INTERVIEW DATE/PARENT INTERVIEW
DATE] did you live at [ADDRESS]?
☐ YES ....................................... 1

(SKIP TO Q6)

☐ NO ........................................ 2

(GO TO Q5)

5. When did you move to this address?
___________________________________________________________________ (GO TO END_D)

6. Perhaps there is a mistake. I’d like to make sure that I dialed correctly. Is this [PHONE NUMBER]?
☐ YES ...................................... 1

(GO TO END_D)

☐ NO ........................................ 2

(GO TO END_A)

7. On all of our studies, we routinely re-contact some people who were interviewed to make sure our
interviewers are following procedures correctly. My questions today will take only a few minutes. Is
this a good time for you?
☐ YES ...................................... 1

(GO TO Q8)

☐ NO ........................................ 2

(GO TO END_C)

3

IN4-12

8. Please know that information from our call today will be kept private and used only for the PATH
Study.
(CONTINUE TO Q9)

9. During the visit, was the interviewer polite and courteous?
☐ YES ...................................... 1

(CONTINUE TO BOX B)

☐ SOMEWHAT ....................... 2

(CONTINUE TO BOX B)

☐ NO ........................................ 3

(CONTINUE TO BOX B)

☐ DON’T RECALL ................. -8

(CONTINUE TO BOX B)

☐ REFUSED............................. -7

(CONTINUE TO BOX B)

Box B
Routing Instructions:
IF Household Screener or Adult Interview, GO TO Q10.
IF Parent Interview, GO TO Q10b.

10. On the day of the interview, approximately how long would you say the visit lasted?
☐ LESS THAN 15 MINUTES. ...................................................

1

(CONTINUE TO BOX C)

☐ BETWEEN 15 MINUTES TO 30 MINUTES.........................

2

(CONTINUE TO BOX C)

☐ BETWEEN 31 MINUTES TO 60 MINUTES.........................

3

(CONTINUE TO BOX C)

☐ LONGER THAN ONE HOUR................................................

4

(CONTINUE TO BOX C)

☐ DON’T RECALL .................................................................... -8

(CONTINUE TO BOX C)

☐ REFUSED................................................................................ -7

(CONTINUE TO BOX C)

Box C
Routing Instructions:
IF Adult Interview, GO TO Q11.
IF Household Screener, GO TO Q23.

4

IN4-12

10b.On the day of the interview, approximately how long would you say the visit lasted?
[PROBE FOR PARENT INTERVIEW AND YOUTH INTERVIEW LENGTHS IN MINUTES]
PARENT INTERVIEW______________________________ MINUTES
YOUTH INTERVIEW ______________________________ MINUTES(GO TO Q11)
☐ DON’T RECALL ................. -8

(GO TO Q11)

☐ REFUSED............................. -7

(GO TO Q11)

11. Did the interviewer give you a copy of our consent document to read? This was a document that
included information about the PATH Study and discussed your consent [to allow your son or
daughter] to participate in an interview.
☐ YES ...................................... 1

(CONTINUE TO BOX D)

☐ NO ........................................ 2

(CONTINUE TO BOX D)

☐ DON’T RECALL ................. -8

(CONTINUE TO BOX D)

☐ REFUSED............................. -7

(CONTINUE TO BOX D)

Box D
Routing Instructions:
IF Adult Interview, GO TO Q12.
IF Parent Interview, GO TO Q17.

12. For part of the visit, did the interviewer turn the laptop towards you and ask you to read the
questions to yourself and enter your answers directly into the laptop?
☐ YES ...................................... 1

(CONTINUE)

☐ NO ........................................ 2

(CONTINUE)

☐ DON’T RECALL ................. -8

(CONTINUE)

☐ REFUSED............................. -7

(CONTINUE)

13. During the most recent visit, did the interviewer ask for your permission to collect a urine sample?
☐ YES ...................................... 1

(CONTINUE)

☐ NO ........................................ 2

(CONTINUE)

☐ DON’T RECALL ................. -8

(CONTINUE)

☐ REFUSED............................. -7

(CONTINUE)

5

IN4-12

14. Did you give a urine sample?
☐ YES ...................................... 1

(CONTINUE)

☐ NO ........................................ 2

(CONTINUE)

☐ DON’T RECALL ................. -8

(CONTINUE)

☐ REFUSED............................. -7

(CONTINUE)

15. During the most recent visit, did the interviewer ask for your permission to let a health professional
visit to collect blood?
☐ YES ...................................... 1

(CONTINUE TO BOX E)

☐ NO ........................................ 2

(CONTINUE TO BOX E)

☐ DON’T RECALL ................. -8

(CONTINUE TO BOX E)

☐ REFUSED............................. -7

(CONTINUE TO BOX E)

Box E
Routing Instructions:
IF Blood Collection visit was completed, GO TO Q16.
OTHERWISE, SKIP TO Q21.

16. During the visit by the health professional who collected the blood sample, was the health
professional polite and courteous?
☐ YES ................................................. 1

(GO TO Q21)

☐ SOMEWHAT .................................. 2

(GO TO Q21)

☐ NO ................................................... 3

(GO TO Q21)

☐ BLOOD DRAW NOT TAKEN....... 4

(GO TO Q21)

☐ DON’T RECALL ............................ -8

(GO TO Q21)

☐ REFUSED........................................ -7

(GO TO Q21)

17. Did the interviewer ask for your permission to allow your son or daughter to participate in the
interview?
☐ YES ...................................... 1

(CONTINUE)

☐ NO ........................................ 2

(CONTINUE)

☐ DON’T RECALL ................. -8

(CONTINUE)

☐ REFUSED............................. -7

(CONTINUE)

6

IN4-12

18. Did your son or daughter participate in the interview?
☐ YES ...................................... 1

(CONTINUE)

☐ NO ........................................ 2

(CONTINUE)

☐ DON’T RECALL ................. -8

(CONTINUE)

☐ REFUSED............................. -7

(CONTINUE)

19. Did the interviewer ask for your permission to allow your son or daughter to provide a urine sample?
☐ YES ...................................... 1

(CONTINUE)

☐ NO ........................................ 2

(CONTINUE)

☐ DON’T RECALL ................. -8

(CONTINUE)

☐ REFUSED............................. -7

(CONTINUE)

20. Did your son or daughter give a urine sample?
☐ YES ...................................... 1

(CONTINUE)

☐ NO ........................................ 2

(CONTINUE)

☐ DON’T RECALL ................. -8

(CONTINUE)

☐ REFUSED............................. -7

(CONTINUE)

21. Did [you/your son or daughter] receive a payment on a debit card to thank [you/him or her] for
[your/his or her] participation?
☐ YES ...................... ................ 1

(CONTINUE TO BOX F)

☐ NO ........................................ 2

(CONTINUE TO BOX F)

☐ DON’T RECALL ................. -8

(CONTINUE TO BOX F)

☐ REFUSED............................. -7

(CONTINUE TO BOX F)

Box F
Routing Instructions:
IF Adult Interview, GO TO Q28.
IF Parent Interview, AND Q21 = NO, GO TO Q22. Otherwise, GO TO Q28.

7

IN4-12

22. Did your son or daughter not receive a payment because you requested the payment be given to you?
☐ YES ...................................... 1

(GO TO Q28)

☐ NO ....................................... 2

(GO TO Q28)

☐ DON’T RECALL ................ -8

(GO TO Q28)

☐ REFUSED............................ -7

(GO TO Q28)

23. Did the interviewer enter your responses into a laptop?
☐ YES ...................................... 1

(CONTINUE)

☐ NO ........................................ 2

(CONTINUE)

☐ DON’T RECALL ................. -8

(CONTINUE)

☐ REFUSED............................. -7

(CONTINUE)

24. What was your age on the date of the interview?
ENTER NUMBER .................... 1 |__|__|
☐ DON’T RECALL ................. -8

(CONTINUE)
(CONTINUE)

☐ REFUSED............................. -7

(CONTINUE)

25. On the date of the interview, did you serve on active duty in the U.S. Armed Forces, Military
Reserves or National Guard?
☐ YES ...................................... 1

(CONTINUE)

☐ NO ........................................ 2

(CONTINUE)

☐ DON’T RECALL ................. -8

(CONTINUE)

☐ REFUSED............................. -7

(CONTINUE)

26. On the date of the interview, did you smoke cigarettes, cigars, or a pipe, every day, some days or not
at all? Do not include the time since the interview.
☐ EVERY DAY ...... ............... 1

(CONTINUE)

☐ SOME DAYS ...... ................ 2

(CONTINUE)

☐ NOT AT ALL ....................... 3

(CONTINUE)

☐ DON’T RECALL ................. -8

(CONTINUE)

☐ REFUSED............................. -7

(CONTINUE)

8

IN4-12

27. On the date of the interview, including yourself, how many people lived at this address? Do not
include anyone who had a usual place of residence elsewhere.
IF NEEDED: Household members include people who think of your address as their primary
residence. This includes people who usually stay at your address but are temporarily away on
business, vacation, in a hospital, or living at school in a dorm or fraternity or sorority.
IF NEEDED: Do not include college students living in off-campus housing as household members.
ENTER NUMBER .................... 1 |__|__|

(CONTINUE)

☐ DON’T RECALL ................. -8

(CONTINUE)

☐ REFUSED............................. -7

(CONTINUE)

28. Would you like to tell me anything else about the interviewer?
____________________________________________________________________________
______________________________________________________________(CONTINUE)

29. What is your current address?
[ADDRESS 1]_______________________________________________________
[ADDRESS 2]_______________________________________________________
[CITY/STATE/ZIP]_______________________________________ (CONTINUE)
☐ REFUSED............................. -7

(GO TO END_E)

30. VALIDATOR INSTRUCTIONS. DO NOT READ TO RESPONDENT.
WAS THE ADDRESS PROVIDED ON THE PREVIOUS QUESTION THE SAME ADDRESS AS
BELOW? CODE AS “YES” IF ADDRESS IS SIMILAR. DOES NOT HAVE TO BE AN EXACT
MATCH.
___________________________________
☐ YES ...................................... 1

(GO TO END_E)

☐ NO ........................................ 2

(CONTINUE TO Q31)

☐ NOT SURE .......................... 3

(GO TO END_E)

9

IN4-12

31. Did the interviewer visit you at this address to conduct the interview?
☐ YES ...................................... 1

(GO TO END_F)

☐ NO ........................................ 2

(CONTINUE TO Q32)

☐ DON’T RECALL ................. -8

(GO TO END_F)

☐ REFUSED............................. -7

(GO TO END_F)

32. At what address did the interviewer visit you to conduct the interview?
[ADDRESS 1]_______________________________________________________
[ADDRESS 2]_______________________________________________________
[CITY/STATE/ZIP]_______________________________________ (CONTINUE TO Q33)
☐ REFUSED............................. -7

(GO TO END_F)

33. VALIDATOR INSTRUCTIONS. DO NOT READ TO RESPONDENT.
WAS THE ADDRESS PROVIDED ON THE PREVIOUS QUESTION THE SAME ADDRESS AS
BELOW? CODE AS “YES” IF ADDRESS IS SIMILAR. DOES NOT HAVE TO BE AN EXACT
MATCH.
___________________________________
☐ YES ...................................... 1

(GO TO END_E)

☐ NO ........................................ 2

(GO TO END_F)

☐ NOT SURE .......................... 3

(GO TO END_E)

•

IF QUESTIONS ARE ASKED, PLEASE REFER SP TO THE PATH SUPPORT DESK AT 1-888-3111819.

•

GO TO END_E

10

IN4-12

END_A: I apologize. I have the wrong number. Thank you. Goodbye.

END_B: Thank you for your time. What is a good day and time to reach [HH SCREENER RESP
NAME/SP NAME/PARENT NAME]? What phone number is best to use? Is this is a cellphone
number?
DATE: _____________________
TIME: _________ am pm
PHONE NUMBER: _____________________
CELL PHONE NUMBER: YES or NO
☐ REFUSED FURTHER CONTACT
Thank you. Goodbye.

END_C: What is a good day and time to reach you again? Is this is a cellphone number?
DATE: _____________________
TIME: _________ am pm
PHONE NUMBER: _____________________
CELL PHONE NUMBER: YES or NO
☐ REFUSED FURTHER CONTACT
Thank you. Goodbye.

END_D: Thank you for your time. There seems to be a problem with some of our information. I
will check our records and someone may call you back.
Thank you. Goodbye.

END_E: Those are all the questions I have. Thank you so much for your time today. Goodbye.

END_F: Those are all the questions I have. Thank you so much for your time today. Goodbye.
PROGRAMMER NOTE: SET RESULT CODE TO VR (Validation Risk)
[PLEASE READ THE FOLLOWING MESSAGE INTO THE ANSWERING MACHINE.]
Hello, I’m calling on behalf of the Population Assessment of Tobacco and Health Study, PATH.
We’d like a few minutes of [HH SCREENER RESP NAME/SP NAME/PARENT NAME]’s time to
verify some information (he/she) provided. We will call back another time or you may call us at
1-877-709-5807.

11

IN4-12

OMB Control Number: xxxx-xxxx
Expiration Date: mm/dd/yyyy

PATH STUDY WAVE 4
CONTINUING SAMPLE ADULT FIELD VISIT VALIDATION FORM
INSTRUCTIONS:
1.

FILL OUT THE FIELDS BELOW WITH THE CASE INFORMATION YOU RECEIVE FROM YOUR FIELD SUPERVISOR (VIA
PHONE CALL OR BSM EMAIL). THROUGHOUT THE FORM, YOU WILL SEE THE FIELDS BELOW REFERENCED
WITHIN BRACKETS (FOR EXAMPLE ). YOU WILL USE THE INFORMATION IN THE FIELDS BELOW FOR
THESE REFERENCES. OTHER THAN THE DUID/SPID, DO NOT WRITE ANY OF THE DATA BELOW ON THE
REMAINING PAGES OF THIS FORM.

2.

PRINT CLEARLY THE DUID/SPID IN THE SPACE PROVIDED ON THE TOP RIGHT CORNER OF EVERY PAGE OF THE
SECTION USED.

3.

COMPLETE THE VALIDATION ASSIGNMENT BY DATE INDICATED BY YOUR SUPERVISOR. SPACE IS ALLOWED ON
PAGE 2 FOR RECORDING UP TO 5 CONTACT ATTEMPTS. IF THE SP REFUSES VALIDATION, DO NOT RECONTACT,
SPEAK TO YOUR SUPERVISOR. SEE EXAMPLE BELOW OF HOW TO FILL OUT THE VALIDATION LOG:

Validation
Contact

Date

Time

Validator name

Validator ID

Validation
Result
Unable to
Contact

1

9/26

4:30pm

Jane Smith

PATH1234

2

9/27

7:00pm

Jane Smith

PATH1234

Language
Problem

3

9/28

2:05pm

Jane Smith

PATH1234

Complete

Comments
Knocked 3 times, did not
answer door
Able to make contact, was able
to gather someone who speaks
English will be home at 2pm
tomorrow

4.

AFTER COMPLETING THE VALIDATION FORM, USING A BLACK MARKER, MARK THROUGH THE SP NAME BELOW
SO THE NAME NO LONGER APPEARS ON THE FORM.

5.

RETURN PAGES OF THE VALIDATION FORM TO YOUR FIELD MANAGER VIA FEDEX PRIORITY OVERNIGHT.

DUID/SPID:______________________________________

SP LANGUAGE: _________________________________

SP NAME: ______________________________________

INTERVIEWER NAME/ID: ___________________________

ADDRESS:________________________________________

ADULT INT STATUS: _____________________________

__________________________________________________

ADULT INT DATE: ____________________

__________________________________________________

BLOOD COLLECTION VISIT COMPLETE? ______________

Public reporting burden for this collection of information is estimated to average 4 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 (0925-0664). Do not return the completed form to this address.

VALIDATION RESULT
Complete – Successful contact or Verification of Non-Response
Refused Validation – Respondent refuses to participate in Validation
Unable to Contact – No contact made with SP
Break-off – Completed part of validation interview
Language Problem – e.g. Language issue
Validation
Contact

Date

Time

Validator name

Validator ID

Validation
Result

Comments

1

2

3

4

5

FINAL VALIDATION STATUS – FOR FIELD MANAGEMENT USE ONLY (CIRLE ONE)
ACCEPTABLE
UNACCEPTABLE

REFUSAL / BREAKOFF
UNABLE TO CONTACT

ROUTING INSTRUCTIONS
•

ADULT INTERVIEW NON-RESPONSE  USE SECTION A

•

ADULT INTERVIEW COMPLETE  USE SECTION B

2

SECTION A
Adult Interview Non-response
A1.

ORIGINAL REASON FOR ADULT SP FINAL NON-RESPONSE:
______________________________
ROUTING INSTRUCTIONS:

IF FINAL DISPOSITION CODE IS:
FDU - DU NO ACCESS/ENTRY, OR
FIG - INSTITUTIONALIZED/GROUP QUARTERS
CONTINUE WITH A2.
IF FINAL DISPOSITION CODE IS:
FNA - UNAVAILABLE DURING WINDOW,
FBO - BREAK-OFF,
FIL - ILLNESS,
FPM - PHYSICAL/MENTAL IMPAIRMENT, OR
FLP - LANGUAGE PROBLEM – NOT SPANISH
THEN SKIP TO A3.

A2:

CODE STATUS OF DWELLING UNIT (DU) BASED ON YOUR VISIT:
INSTITUTIONALIZED/GROUP QUARTERS..................... 1 (SKIP TO A15)
ADDRESS QUALIFIES AS DU ............................................ 2 (CONTINUE)

A3.

CODE STATUS BASED ON YOUR VISIT:
DU NO ACCESS/ENTRY ...................................................... 1 (SKIP TO A15)
VACANT ................................................................................ 2 (SKIP TO A15)
NOT VACANT ....................................................................... 3 (CONTINUE)

A4.

Hello, my name is from the Population Assessment of Tobacco and Health (PATH)
Study. May I please speak with ?
SP AVAILABLE ....................................................................
SP NOT AVAILABLE ...........................................................

A5.

1 (CONTINUE)
2 (SKIP TO A13)

ONCE SPEAKING WITH SP: [REINTRODUCE SELF IF NECESSARY]
On one of our interviewers may have visited this address in person to
conduct an interview with you. Do you remember talking to him or her in person?
YES ......................................................................................... 1 (SKIP TO A9)
NO ........................................................................................... 2 (CONTINUE)

3

A6.

The PATH Study is an ongoing national study on tobacco and health. The interviewer would have
asked for you by name since you participated last time and may have shown you a brochure like this
one about the study [HAND BROCHURE TO SP]. Do you remember the visit now?
YES .........................................................................................
NO ...........................................................................................

A7.

1 (SKIP TO A9)
2 (CONTINUE)

On did you live at this address?
YES ......................................................................................... 1 (SKIP TO A12)
NO ........................................................................................... 2 (CONTINUE)

A8.

When did you move to this address?
_______________________________________________ (SKIP TO A12)

A9.

On all of our studies, we routinely re-contact some people who were interviewed to make sure our
interviewers are following procedures correctly.
During the in person visit, was the interviewer polite and courteous? Would you say yes, somewhat,
or no?
YES .......................................................................................
SOMEWHAT ........................................................................
NO .........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

A10.

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

1
2
-8
-7

(SKIP TO A12)
(GO TO A11)
(SKIP TO A12)
(SKIP TO A12)

Did you complete an interview?
YES .......................................................................................
NO .........................................................................................
DON’T RECALL ..................................................................
REFUSED .............................................................................

A11.

1
2
3
-8
-7

FOR INTERVIEWER ONLY: PROBE FOR REASON WHY INTERVIEW WAS NOT COMPLETED
_______________________________________________ (CONTINUE)

A12.

What is the best telephone number we can use to reach you in case we have additional questions?
_______________________________________________ (GO TO A14)

4

A13.

What is the best telephone number we can use to reach or the best time to
return to speak with him/her?
_______________________________________________ (CONTINUE)

A14.

Is this a cell phone number?
YES ....................................................................................... 1 (CONTINUE)
NO ......................................................................................... 2 (CONTINUE)

A15.

(Thank you very much for your time.)
FOR INTERVIEWER ONLY: WHAT IS YOUR ASSESSMENT OF THE DWELLING UNIT OR
CONTACT PROBLEM FOR THIS SP?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

A_END: RECORD DETAILS IN SECTION C.
IF QUESTIONS ARE ASKED, REFER THEM TO THE PATH STUDY
SUPPORT DESK AT 1-888-311-1819.

5

SECTION B
Adult Interview Complete
B1.

Hello, my name is from the Population Assessment of Tobacco and Health (PATH)
Study. May I please speak with ?
[REINTRODUCE SELF IF NECESSARY]
On one of our interviewers visited this address in person to conduct
an interview with you as part of the PATH Study. Do you remember talking to him or her in person?
YES ....................................................................................... 1 (SKIP TO B5)
NO ......................................................................................... 2 (CONTINUE)

B2.

During the interview, you were asked questions about your health and tobacco use. Do you
remember the visit now?
YES ....................................................................................... 1 (SKIP TO B5)
NO ......................................................................................... 2 (CONTINUE)

B3.

On did you live at this address?
YES ......................................................................................... 1 (SKIP TO B_END)
NO ........................................................................................... 2 (CONTINUE)

B4.

When did you move to this address?
_______________________________________________ (SKIP TO B_END)

B5.

On all of our studies, we routinely re-contact some people who were interviewed to make sure our
interviewers are following procedures correctly. My questions today will take only a few minutes.
The information from my visit today will be kept private and used only for the PATH Study.
(CONTINUE)

B6.

On the day of the interview, approximately how long would you say the visit lasted?

LESS THAN 15 MINUTES ..................................................
15-30 MINUTES ...................................................................
31-60 MINUTES ...................................................................
LONGER THAN ONE HOUR .............................................
DON’T RECALL ..................................................................
REFUSED .............................................................................

6

1
2
3
4
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

B7.

During the visit, was the interviewer polite and courteous? Would you say yes, somewhat, or no?
YES .......................................................................................
SOMEWHAT ........................................................................
NO .........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

B8.

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

During the most recent visit, did the interviewer ask you for a urine sample?
YES ......................................................................................
NO ........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

B12.

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

Did the interviewer give you a debit card to thank you for your participation?
YES .......................................................................................
NO…….….. ..........................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

B11.

1
2
-8
-7

For part of the visit, did the interviewer turn the laptop towards you and ask you to read the
questions to yourself and enter your answers directly into the laptop?
YES .......................................................................................
NO .........................................................................................
DON’T RECALL ..................................................................
REFUSED .............................................................................

B10.

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

Did the interviewer give you a copy of our consent document to read? This was a document that
included information about the PATH Study and discussed your consent to participate in an
interview.
YES .......................................................................................
NO .........................................................................................
DON’T RECALL ..................................................................
REFUSED .............................................................................

B9.

1
2
3
-8
-7

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

Did you give a urine sample?
YES ......................................................................................
NO ........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

7

B13.

During the most recent visit, did the interviewer ask for your permission to let a health professional
visit to collect blood?
YES ......................................................................................
NO ........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

B14.

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

1
2
-8
-7

(CONTINUE)
(SKIP TO B18)
(CONTINUE)
(CONTINUE)

Did you consent to a health professional visit to collect blood?
YES ......................................................................................
NO ........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

B15.

1
2
-8
-7

Did a health professional come to your home to collect the blood sample?
YES ......................................................................................
NO ........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

1
2
-8
-7

(CONTINUE)
(SKIP TO B18)
(CONTINUE)
(CONTINUE)

IF BLOOD COLLECTION VISIT WAS COMPLETE, CONTINUE WITH B16.
OTHERWISE, SKIP TO B18 AND ASK ONLY ABOUT THE INTERVIEWER’S VISIT.

B16.

During the visit by the health professional who collected the blood sample, was the health
professional polite and courteous? Would you say yes, somewhat, or no?
YES .......................................................................................
SOMEWHAT ........................................................................
NO .........................................................................................
BLOOD DRAW NOT TAKEN ...........................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

B17.

1
2
3
4
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

Would you like to tell me anything else about the health professional?
____________________________________________________________________________
_____________________________________________________________(CONTINUE)

B18.

Would you like to tell me anything else about the interviewer?
____________________________________________________________________________
_____________________________________________________________(CONTINUE)

8

B19.

What is the best telephone number we can use to reach you?
___________________________________ (CONTINUE)

B20.

Is this a cell phone number?
YES ....................................................................................... 1
NO ......................................................................................... 2

B_END: Thank you very much for your time.
IF QUESTIONS ARE ASKED, REFER THEM TO THE PATH STUDY
SUPPORT DESK AT 1-888-311-1819.
RECORD DETAILS IN SECTION C.

9

SECTION C
Documentation of Validation Problem Situations
RECORD ANY DETAILS FROM THE ORIGINAL INTERVIEW OR THE VALIDATION THAT MIGHT BE
HELPFUL IN INTERPRETING THE VALIDATION RESULT:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________

10

OMB Control Number: xxxx-xxxx
Expiration Date: mm/dd/yyy

PATH STUDY WAVE 4
REPLENISHMENT SAMPLE ADULT FIELD VISIT VALIDATION FORM
INSTRUCTIONS:
1.

FILL OUT THE FIELDS BELOW WITH THE CASE INFORMATION YOU RECEIVE FROM YOUR FIELD SUPERVISOR (VIA
PHONE CALL OR BSM EMAIL). THROUGHOUT THE FORM, YOU WILL SEE THE FIELDS BELOW REFERENCED
WITHIN BRACKETS (FOR EXAMPLE ). YOU WILL USE THE INFORMATION IN THE FIELDS BELOW FOR
THESE REFERENCES. OTHER THAN THE DUID/SPID, DO NOT WRITE ANY OF THE DATA BELOW ON THE
REMAINING PAGES OF THIS FORM.

2.

PRINT CLEARLY THE DUID/SPID IN THE SPACE PROVIDED ON THE TOP RIGHT CORNER OF EVERY PAGE OF THE
SECTION USED.

3.

COMPLETE THE VALIDATION ASSIGNMENT BY DATE INDICATED BY YOUR SUPERVISOR. SPACE IS ALLOWED ON
PAGE 2 FOR RECORDING UP TO 5 CONTACT ATTEMPTS. IF THE SP REFUSES VALIDATION, DO NOT RECONTACT,
SPEAK TO YOUR SUPERVISOR. SEE EXAMPLE BELOW OF HOW TO FILL OUT THE VALIDATION LOG:

Validation
Contact

Date

Time

Validator name

Validator ID

Validation
Result
Unable to
Contact

1

9/26

4:30pm

Jane Smith

PATH1234

2

9/27

7:00pm

Jane Smith

PATH1234

Language
Problem

3

9/28

2:05pm

Jane Smith

PATH1234

Complete

Comments
Knocked 3 times, did not
answer door
Able to make contact, was able
to gather someone who speaks
English will be home at 2pm
tomorrow

4.

AFTER COMPLETING THE VALIDATION FORM, USING A BLACK MARKER, MARK THROUGH THE SP NAME BELOW
SO THE NAME NO LONGER APPEARS ON THE FORM.

5.

RETURN PAGES OF THE VALIDATION FORM TO YOUR FIELD MANAGER VIA FEDEX PRIORITY OVERNIGHT.

DUID/SPID:______________________________________

VALIDATION TYPE: ________________________________

SP NAME: ______________________________________

IS SP ALSO SCREENER RESP? ________________________

ADDRESS:________________________________________

ADULT INT STATUS: _____________________________

__________________________________________________

ADULT INT DATE: ____________________

__________________________________________________

BLOOD COLLECTION VISIT COMPLETE? ______________

SP LANGUAGE: _________________________________
INTERVIEWER NAME/ID: ___________________________

Public reporting burden for this collection of information is estimated to average 4 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 (0925-0664). Do not return the completed form to this address.

VALIDATION RESULT
Complete – Successful contact or Verification of Non-Response
Refused Validation – Respondent refuses to participate in Validation
Unable to Contact – No contact made with SP
Break-off – Completed part of validation interview
Language Problem – e.g. Language issue
Validation
Contact

Date

Time

Validator name

Validator ID

Validation
Result

Comments

1

2

3

4

5

FINAL VALIDATION STATUS – FOR FIELD MANAGEMENT USE ONLY (CIRLE ONE)
ACCEPTABLE
UNACCEPTABLE

REFUSAL / BREAKOFF
UNABLE TO CONTACT

ROUTING INSTRUCTIONS
•

If Adult Interview status is Non-response  USE SECTION A

•

If Adult Interview status is Complete  USE SECTION B

2

SECTION A
Adult Interview Non-Response
A1.

ORIGINAL REASON FOR FINAL NON-RESPONSE:
______________________________
ROUTING INSTRUCTIONS:

IF FINAL DISPOSITION CODE IS:
FDU - DU NO ACCESS/ENTRY,
FNE - ADDRESS DOES NOT EXIST,
THEN CONTINUE WITH A2.
IF FINAL DISPOSITION CODE IS:
FNA - UNAVAILABLE DURING WINDOW,
FBO - BREAK-OFF,
FIL - ILLNESS,
FPM - PHYSICAL/MENTAL IMPAIRMENT, OR
FLP - LANGUAGE PROBLEM – NOT SPANISH
THEN SKIP TO A4.

A2:

CODE STATUS OF DWELLING UNIT (DU) BASED ON YOUR VISIT:
ADDRESS QUALIFIES AS DU .............................................. 1 (CONTINUE)
ADDRESS DOES NOT QUALIFY AS DU ............................ 2 (SKIP TO A12)
DON’T KNOW ........................................................................ 3 (SKIP TO A12)

A3.

CODE STATUS BASED ON YOUR VISIT:
VACANT ................................................................................ 1 (SKIP TO A12)
NOT VACANT ....................................................................... 2 (SKIP TO A4)

A4.

ASK TO SPEAK TO ANY HOUSEHOLD MEMBER AGE 18 OR OVER:
Hello, my name is from the Population Assessment of Tobacco and Health (PATH)
Study. On one of our interviewers may have visited this address in
person to conduct an interview with either you or one of your household members. Do you remember
if anyone in your household talked to him or her in person?
YES ......................................................................................... 1 (SKIP TO A8)
NO ........................................................................................... 2 (CONTINUE)
DON’T KNOW ....................................................................... -8 (CONTINUE)

A5.

The PATH Study is an ongoing national study on tobacco and health. The interviewer would have
shown you a brochure like this one about the Study [HAND BROCHURE TO RESPONDENT]. Do
you remember the visit now?
YES .........................................................................................
NO ...........................................................................................

3

1 (SKIP TO A8)
2 (CONTINUE)

A6.

On did your household live at ?
YES ......................................................................................... 1 (SKIP TO A10)
NO ........................................................................................... 2 (CONTINUE)

A7.

When did you move to this address?
__________________________________________________________ (SKIP TO A10)

A8.

Did the interviewer enter your responses into a laptop?
YES .......................................................................................
NO .........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

A9.

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

During the in person visit, was the interviewer polite and courteous? Would you say yes, somewhat,
or no?
YES .......................................................................................
SOMEWHAT ........................................................................
NO .........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

A10.

1
2
-8
-7

1
2
3
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

What is the best telephone number we can use to reach you in case we have additional questions?
__________________________________________________________ (CONTINUE)

A11.

Is this a cell phone number?
YES ......................................................................................... 1 (CONTINUE)
NO ........................................................................................... 2 (CONTINUE)

A12.

(Thank you very much for your time.)
FOR INTERVIEWER ONLY: WHAT IS YOUR ASSESSMENT OF THE DWELLING UNIT OR
CONTACT PROBLEM?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
A_END: RECORD DETAILS IN SECTION C.
IF QUESTIONS ARE ASKED, REFER THEM TO THE PATH SUPPORT DESK
AT 1-888-311-1819.

4

SECTION B
Adult Interview Complete
B1.

Hello, my name is from the Population Assessment of Tobacco and Health (PATH)
Study. May I please speak with ?
[REINTRODUCE SELF IF NECESSARY]
On one of our interviewers visited this address in person to conduct
an interview with you as part of our PATH Study. Do you remember talking to him or her in person?
YES ....................................................................................... 1 (SKIP TO B5)
NO ......................................................................................... 2 (CONTINUE)

B2.

During the interview, you were asked questions about your health and tobacco use. Do you
remember the visit now?
YES ....................................................................................... 1 (SKIP TO B5)
NO ......................................................................................... 2 (CONTINUE)

B3.

On did your household live at ?
YES ......................................................................................... 1 (SKIP TO B_END)
NO ........................................................................................... 2 (CONTINUE)

B4.

When did you move to this address?
_______________________________________________ (SKIP TO B_END)

B5.

On all of our studies, we routinely re-contact some people who were interviewed to make sure our
interviewers are following procedures correctly. My questions today will take only a few minutes.
The information from my visit today will be kept private and used only for the PATH Study.
(CONTINUE)

B6.

On the day of the interview, after you were selected for the study and you consented to be
interviewed, approximately how long would you say the visit lasted?

LESS THAN 15 MINUTES ..................................................
15-30 MINUTES ...................................................................
31-60 MINUTES ...................................................................
LONGER THAN ONE HOUR .............................................
DON’T RECALL ..................................................................
REFUSED .............................................................................

5

1
2
3
4
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

B7.

During the visit, was the interviewer polite and courteous? Would you say yes, somewhat, or no?
YES .......................................................................................
SOMEWHAT ........................................................................
NO .........................................................................................
DON’T RECALL ..................................................................
REFUSED .............................................................................

B8.

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

For part of the visit, did the interviewer turn the laptop towards you and ask you to read the
questions to yourself and enter your answers directly into the laptop?
YES .......................................................................................
NO .........................................................................................
DON’T RECALL ..................................................................
REFUSED .............................................................................

B10.

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

Did the interviewer give you a consent document to read? This was a document that included
information about the PATH Study and asked for your consent to participate in an interview.
YES .......................................................................................
NO .........................................................................................
DON’T RECALL ..................................................................
REFUSED .............................................................................

B9.

1
2
3
-8
-7

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

Did the interviewer give you a debit card to thank you for your participation?
YES .......................................................................................
NO .........................................................................................
DON’T RECALL ..................................................................
REFUSED .............................................................................

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

IF Adult Screened out (CPX) - SKIP to B18 AND ONLY ASK ABOUT INTERVIEWER.
IF Adult Complete (CPE) – CONTINUE to B11.

B11.

Did the interviewer ask for your permission to collect a urine sample?
YES ......................................................................................
NO ........................................................................................
DON’T RECALL ..................................................................
REFUSED .............................................................................

B12.

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

Did you give a urine sample?
YES ......................................................................................
NO ........................................................................................
DON’T RECALL ..................................................................
REFUSED .............................................................................

6

B13.

Did the interviewer ask for your permission to let a health professional visit to collect blood?
YES ......................................................................................
NO ........................................................................................
DON’T RECALL ..................................................................
REFUSED .............................................................................

B14.

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

1
2
-8
-7

(CONTINUE)
(SKIP TO B18)
(CONTINUE)
(CONTINUE)

Did you consent to a health professional visit to collect blood?
YES ......................................................................................
NO ........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

B15.

1
2
-8
-7

Did a health professional come to your home to collect the blood sample?
YES ......................................................................................
NO ........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

1
2
-8
-7

(CONTINUE)
(SKIP TO B18)
(CONTINUE)
(CONTINUE)

IF BLOOD COLLECTION VISIT WAS COMPLETE, CONTINUE WITH B16.
OTHERWISE, SKIP TO B18 AND ASK ONLY ABOUT THE INTERVIEWER’S VISIT.

B16.

During the visit by the health professional who collected the blood sample, was the health
professional polite and courteous? Would you say yes, somewhat, or no?
YES .......................................................................................
SOMEWHAT ........................................................................
NO .........................................................................................
BLOOD DRAW NOT TAKEN ...........................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

B17.

1
2
3
4
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

Would you like to tell me anything else about the health professional?
____________________________________________________________________________
_____________________________________________________________(CONTINUE)

B18.

Would you like to tell me anything else about the interviewer?
____________________________________________________________________________
_____________________________________________________________(CONTINUE)

7

B19.

What is the best telephone number we can use to reach you?
___________________________________ (CONTINUE)

B20.

Is this a cell phone number?
YES ....................................................................................... 1
NO ......................................................................................... 2

B_END: Thank you very much for your time.
IF QUESTIONS ARE ASKED, REFER THEM TO THE PATH STUDY
SUPPORT DESK AT 1-888-311-1819.
RECORD DETAILS IN SECTION C.

8

SECTION C
Documentation of Validation Problem Situations
RECORD ANY DETAILS FROM THE ORIGINAL INTERVIEW OR THE VALIDATION THAT MIGHT BE
HELPFUL IN INTERPRETING THE VALIDATION RESULT:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________

9

OMB Control Number: xxxx-xxxx
Expiration Date: mm/dd/yyy

PATH STUDY WAVE 4
HOUSEHOLD SCREENER FIELD VISIT VALIDATION FORM
INSTRUCTIONS:
1.

FILL OUT THE FIELDS BELOW WITH THE CASE INFORMATION YOU RECEIVE FROM YOUR FIELD SUPERVISOR (VIA
PHONE CALL OR BSM EMAIL). THROUGHOUT THE FORM, YOU WILL SEE THE FIELDS BELOW REFERENCED
WITHIN BRACKETS (FOR EXAMPLE ). YOU WILL USE THE INFORMATION IN THE FIELDS BELOW FOR
THESE REFERENCES. OTHER THAN THE DUID/SPID, DO NOT WRITE ANY OF THE DATA BELOW ON THE
REMAINING PAGES OF THIS FORM.

2.

PRINT CLEARLY THE DUID/SPID IN THE SPACE PROVIDED ON THE TOP RIGHT CORNER OF EVERY PAGE OF THE
SECTION USED.

3.

COMPLETE THE VALIDATION ASSIGNMENT BY DATE INDICATED BY YOUR SUPERVISOR. SPACE IS ALLOWED ON
PAGE 2 FOR RECORDING UP TO 5 CONTACT ATTEMPTS. IF THE SP REFUSES VALIDATION, DO NOT RECONTACT,
SPEAK TO YOUR SUPERVISOR. SEE EXAMPLE BELOW OF HOW TO FILL OUT THE VALIDATION LOG:

Validation
Contact

Date

Time

Validator name

Validator ID

Validation
Result
Unable to
Contact

1

9/26

4:30pm

Jane Smith

PATH1234

2

9/27

7:00pm

Jane Smith

PATH1234

Language
Problem

3

9/28

2:05pm

Jane Smith

PATH1234

Complete

Comments
Knocked 3 times, did not
answer door
Able to make contact, was able
to gather someone who speaks
English will be home at 2pm
tomorrow

4.

AFTER COMPLETING THE VALIDATION FORM, USING A BLACK MARKER, MARK THROUGH THE SP NAME BELOW
SO THE NAME NO LONGER APPEARS ON THE FORM.

5.

RETURN PAGES OF THE VALIDATION FORM TO YOUR FIELD MANAGER VIA FEDEX PRIORITY OVERNIGHT.

DUID/SPID:______________________________________

INTERVIEWER NAME/ID: ___________________________

RESPONDENT NAME:_________________________________

VALIDATION TYPE: ________________________________

ADDRESS:________________________________________

IS SCREENER RESP ALSO SP? ________________________

__________________________________________________

HH SCREENER STATUS: _____________________________

__________________________________________________

HH SCREENER DATE: ____________________

RESPONDENT LANGUAGE: _____________________________

Public reporting burden for this collection of information is estimated to average 4 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 (0925-0664). Do not return the completed form to this address.

VALIDATION RESULT
Complete – Successful contact or Verification of Non-Response
Refused Validation – Respondent refuses to participate in Validation
Unable to Contact – No contact made with SP
Break-off – Completed part of validation interview
Language Problem – e.g. Language issue
Validation
Contact

Date

Time

Validator name

Validator ID

Validation
Result

Comments

1

2

3

4

5

FINAL VALIDATION STATUS – FOR FIELD MANAGEMENT USE ONLY (CIRLE ONE)
ACCEPTABLE
UNACCEPTABLE

REFUSAL / BREAKOFF
UNABLE TO CONTACT

ROUTING INSTRUCTIONS
•

If Household Screener status is non-response  USE SECTION A

•

If Household Screener status is Complete  USE SECTION B

2

SECTION A
Household Screener Non-Response
A1.

ORIGINAL REASON FOR FINAL NON-RESPONSE AT SAMPLED ADDRESS:
______________________________
ROUTING INSTRUCTIONS:

IF FINAL DISPOSITION CODE IS:
FVC - VACANT,
FDU - DU NO ACCESS/ENTRY,
FDE - DEMOLISHED/EMPTY LOT,
FSH - SEASONAL HOME,
FCT - CONSTRUCTION,
FNL - NOT ABLE TO LOCATE,
FNE - ADDRESS DOES NOT EXIST,
FEF - NOT ON FRAME,
FOS - OUT OF SEGMENT,
FBS - BUSINESS,
FIG - INSTITUTION/GROUP HOME/CORRECTIONAL FACILITY,
FMB - MILITARY BASE,
FDA - DUPLICATE ADDRESS,
FON - OTHER – NON RESPONSE, OR
FOT - OTHER: SPECIFY
THEN CONTINUE WITH A2.
IF FINAL DISPOSITION CODE IS:
FNA - UNAVAILABLE DURING WINDOW,
FBO - BREAK-OFF,
FIL - ILLNESS,
FPM - PHYSICAL/MENTAL IMPAIRMENT, OR
FLP - LANGUAGE PROBLEM – NOT SPANISH
THEN SKIP TO A4.

A2:

CODE STATUS OF DWELLING UNIT (DU) BASED ON YOUR VISIT:
ADDRESS QUALIFIES AS DU .............................................. 1 (CONTINUE)
ADDRESS DOES NOT QUALIFY AS DU ............................ 2 (SKIP TO A12)
DON’T KNOW ........................................................................ 3 (SKIP TO A12)

A3.

CODE STATUS BASED ON YOUR VISIT:
VACANT ................................................................................ 1 (SKIP TO A12)
NOT VACANT ....................................................................... 2 (SKIP TO A4)

3

A4.

ASK TO SPEAK TO ANY HOUSEHOLD MEMBER AGE 18 OR OVER:
Hello, my name is from the Population Assessment of Tobacco and Health (PATH)
Study. On one of our interviewers may have visited this address in
person to conduct an interview with either you or one of your household members. Do you remember
if anyone in your household talked to him or her in person?
YES ......................................................................................... 1 (SKIP TO A8)
NO ........................................................................................... 2 (CONTINUE)
DON’T KNOW ....................................................................... -8 (CONTINUE)

A5.

The PATH Study is an ongoing national study on tobacco and health. The interviewer would have
shown you a brochure like this one about the Study [HAND BROCHURE TO RESPONDENT]. Do
you remember the visit now?
YES .........................................................................................
NO ...........................................................................................

A6.

1 (SKIP TO A8)
2 (CONTINUE)

On did your household live at ?
YES ......................................................................................... 1 (SKIP TO A10)
NO ........................................................................................... 2 (CONTINUE)

A7.

When did you move to this address?
__________________________________________________________ (SKIP TO A10)

A8.

Did the interviewer enter your responses into a laptop?
YES .......................................................................................
NO .........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

A9.

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

During the in person visit, was the interviewer polite and courteous? Would you say yes, somewhat,
or no?
YES .......................................................................................
SOMEWHAT ........................................................................
NO .........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

4

1
2
3
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

A10.

What is the best telephone number we can use to reach you in case we have additional questions?
__________________________________________________________ (CONTINUE)

A11.

Is this a cell phone number?
YES ......................................................................................... 1 (CONTINUE)
NO ........................................................................................... 2 (CONTINUE)

A12.

(Thank you very much for your time.)
FOR INTERVIEWER ONLY: WHAT IS YOUR ASSESSMENT OF THE DWELLING UNIT OR
CONTACT PROBLEM?
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
A_END: RECORD DETAILS IN SECTION C.
IF QUESTIONS ARE ASKED, REFER THEM TO THE PATH SUPPORT DESK
AT 1-888-311-1819.

5

SECTION B
Household Screener Complete
B1.

Hello, my name is from the Population Assessment of Tobacco and Health (PATH)
Study. May I please speak with ?
[REINTRODUCE SELF IF NECESSARY]
Hello, my name is from the Population Assessment of Tobacco and Health (PATH)
Study. On one of our interviewers may have visited this address in
person to conduct an interview with either you or one of your household members. Do you
remember if anyone in your household talked to him or her in person?
YES ....................................................................................... 1 (SKIP TO B5)
NO ......................................................................................... 2 (GO TO INSTRUCTION BOX)
DON’T KNOW ..................................................................... 3 (GO TO INSTRUCTION BOX)

ASK TO SPEAK WITH ANOTHER ADULT MEMBER OF HOUSEHOLD WHO MAY HAVE
COMPLETED THE SCREENER

[REINTRODUCE SELF IF SPEAKING WITH NEW HH MEMBER.]

On one of our interviewers visited this address to conduct an
interview with you in person as part of our PATH Study. Do you remember talking to him or her in
person?
YES ....................................................................................... 1 (SKIP TO B5)
NO ......................................................................................... 2 (CONTINUE)

B2.

The interviewer talked to you about the members of your household and their use of tobacco
products. Do you remember the visit now?
YES ....................................................................................... 1 (SKIP TO B5)
NO ......................................................................................... 2 (CONTINUE)

B3.

On did your household live at ?
YES ......................................................................................... 1 (SKIP TO B_END)
NO ........................................................................................... 2 (CONTINUE)

B4.

When did you move to this address?
_______________________________________________ (SKIP TO B_END)

6

B5.

On all of our studies, we routinely re-contact some people who were interviewed to make sure our
interviewers are following procedures correctly. My questions today will take only a few minutes.
The information from my visit today will be kept private and used only for the PATH Study.
(CONTINUE)

B6.

During the in person visit, was the interviewer polite and courteous? Would you say yes, somewhat,
or no?
YES .......................................................................................
SOMEWHAT ........................................................................
NO .........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

B7.

1
2
3
4
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

Did the interviewer enter your responses into a laptop?
YES .......................................................................................
NO .........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

B9.

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

On the day of the interview, approximately how long would you say the visit lasted?
LESS THAN 15 MINUTES ..................................................
15-30 MINUTES ...................................................................
31-60 MINUTES ...................................................................
LONGER THAN ONE HOUR .............................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

B8.

1
2
3
-8
-7

What was your age on the date of the interview?
_____________________________________________ 1 (CONTINUE)
DON'T RECALL ................................................................... -8 (CONTINUE)
REFUSED ............................................................................. -7 (CONTINUE)

B10. On the date of the interview, did you serve on active duty in the U.S. Armed Forces, Military Reserves
or National Guard?
YES .......................................................................................
NO .........................................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

7

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

B11.

On the date of the interview, did you smoke cigarettes, cigars, or a pipe, every day, some days or not
at all? Do not include the time after interview.
EVERY DAY ........................................................................
SOME DAYS ........................................................................
NOT AT ALL ........................................................................
DON'T RECALL ...................................................................
REFUSED .............................................................................

B12.

1
2
3
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

On the date of the interview, including you, how many people lived at this address? Do not include
anyone who had a usual place of residence elsewhere.
IF NEEDED: Household members include people who think of your address as their primary
residence. It includes people who usually stay at your address but are temporarily away on business,
vacation, in a hospital, or living at school in a dorm or fraternity or sorority.
IF NEEDED: Do not include college students living in off-campus housing as household members.

ENTER NUMBER ........................................................ |__|__|
(CONTINUE)
DON'T RECALL ................................................................... -8 (CONTINUE)
REFUSED ............................................................................. -7 (CONTINUE)

B13.

Would you like to tell me anything about the interviewer?
____________________________________________________________________________
____________________________________________________________________________
_____________________________________________________________

B14.

What is the best telephone number we can use to reach you in case we have additional questions?
__________________________________________________________

B15.

(CONTINUE)

(CONTINUE)

Is this a cell phone number?
YES ......................................................................................... 1
NO ........................................................................................... 2

B_END: Thank you very much for your time.
IF QUESTIONS ARE ASKED, REFER THEM TO THE PATH SUPPORT DESK
AT 1-888-311-1819.
RECORD DETAILS IN SECTION C.

8

SECTION C
Documentation of Validation Problem Situations
RECORD ANY DETAILS FROM THE ORIGINAL INTERVIEW OR THE VALIDATION THAT MIGHT BE
HELPFUL IN INTERPRETING THE VALIDATION RESULT:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________

9

OMB Control Number: xxxx-xxxx
Expiration Date: mm/dd/yyyy

PATH STUDY WAVE 4
PARENT AND YOUTH FIELD VISIT VALIDATION FORM
INSTRUCTIONS:
1.

FILL OUT THE FIELDS BELOW WITH THE CASE INFORMATION YOU RECEIVE FROM YOUR FIELD SUPERVISOR (VIA
PHONE CALL OR BSM EMAIL). THROUGHOUT THE FORM, YOU WILL SEE THE FIELDS BELOW REFERENCED WITHIN
BRACKETS (FOR EXAMPLE ). YOU WILL USE THE INFORMATION IN THE FIELDS BELOW FOR THESE
REFERENCES. OTHER THAN THE DUID/SPID, DO NOT WRITE ANY OF THE DATA BELOW ON THE REMAINING PAGES
OF THIS FORM.

2.

PRINT CLEARLY THE DUID/SPID IN THE SPACE PROVIDED ON THE TOP RIGHT CORNER OF EVERY PAGE OF THE
SECTION USED.

3.

COMPLETE THE VALIDATION ASSIGNMENT BY DATE INDICATED BY YOUR SUPERVISOR. SPACE IS ALLOWED ON
PAGE 2 FOR RECORDING UP TO 5 CONTACT ATTEMPTS. IF THE SP REFUSES VALIDATION, DO NOT RECONTACT,
SPEAK TO YOUR SUPERVISOR. SEE EXAMPLE BELOW OF HOW TO FILL OUT THE VALIDATION LOG:

Validation
Contact

Date

Time

Validator name

Validator ID

Validation
Result
Unable to
Contact

1

9/26

4:30pm

Jane Smith

PATH1234

2

9/27

7:00pm

Jane Smith

PATH1234

Language
Problem

3

9/28

2:05pm

Jane Smith

PATH1234

Complete

Comments
Knocked 3 times, did not
answer door
Able to make contact, was able
to gather someone who speaks
English will be home at 2pm
tomorrow

4.

AFTER COMPLETING THE VALIDATION FORM, USING A BLACK MARKER, MARK THROUGH THE SP NAME BELOW SO
THE NAME NO LONGER APPEARS ON THE FORM.

5.

RETURN PAGES OF THE VALIDATION FORM TO YOUR FIELD MANAGER VIA FEDEX PRIORITY OVERNIGHT.

DUID/SPID: ______________________________________

INTERVIEWER NAME/ID: __________________________

YOUTH SP NAME: _________________________________

PARENT PID: _ ____________________________________

YOUTH INT STATUS: ______________________________

PARENT NAME: __ _________________________________

YOUTH INT DATE:_________________________________

PARENT INT STATUS:______________________________

YOUTH LANGUAGE: _____________________________

PARENT INT DATE: ________________________________

YOUTH PHONE NUMBER: _________________________

PARENT LANGUAGE: _____________________________

ADDRESS:________________________________________

# OF YOUTH SPs IN HH:_____________________________

__________________________________________________
__________________________________________________

Public reporting burden for this collection of information is estimated to average 4 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 208927974, ATTN: PRA (0925-0664). Do not return the completed form to this address.

VALIDATION RESULT
Complete – Successful contact or Verification of Non-Response
Refused Validation – Respondent refuses to participate in Validation
Unable to Contact – No contact made with SP
Break-off – Completed part of validation interview
Language Problem – e.g. Language issue
Validation
Contact

Date

Time

Validator name

Validator ID

Validation
Result

Comments

1

2

3

4

5

FINAL VALIDATION STATUS – FOR FIELD MANAGEMENT USE ONLY (CIRLE ONE)
ACCEPTABLE
UNACCEPTABLE

REFUSAL / BREAKOFF
UNABLE TO CONTACT

SECTION A
Parent and Youth Interview Complete
A1.

Hello, my name is from the Population Assessment of Tobacco and Health (PATH)
Study. May I please speak with ?
[REINTRODUCE SELF IF NECESSARY]
On one of our interviewers visited this address in person to conduct an
interview with your son or daughter as part of the PATH Study. Do you remember talking to him or
her in person?
YES ........................................................................................ 1 (SKIP TO A5)
NO .......................................................................................... 2 (CONTINUE)

A2.

During the interview, you were asked questions about your son or daughter. Do you remember the visit
now?
YES ........................................................................................ 1 (SKIP TO A5)
NO .......................................................................................... 2 (CONTINUE)

A3.

On did you live at this address?
YES ........................................................................................ 1 (SKIP TO A_END)
NO .......................................................................................... 2 (CONTINUE)

A4.

When did you move to this address?
________________________________________________ (SKIP TO A_END)

A5.

On all of our studies, we routinely re-contact some people who were interviewed to make sure our
interviewers are following procedures correctly. My questions today will take only a few minutes.
The information from my visit today will be kept private and used only for the PATH Study.
(CONTINUE)

A6.

On the day of the interview, approximately how long would you say the visit lasted?
[PROBE FOR PARENT INTERVIEW AND YOUTH INTERVIEW LENGTHS]
PARENT INTERVIEW ______________________________________
YOUTH INTERVIEW _______________________________________ (CONTINUE)

A7.

During the visit, was the interviewer polite and courteous? Would you say yes, somewhat, or no?
YES ........................................................................................
SOMEWHAT .........................................................................
NO ..........................................................................................
DON'T RECALL ...................................................................
REFUSED ..............................................................................

A8.

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

Did your son or daughter give a urine sample?
YES ........................................................................................
NO…….….. ...........................................................................
DON'T RECALL ...................................................................
REFUSED ..............................................................................

A12.

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

Did your son or daughter participate in the interview?
YES ........................................................................................
NO…….….. ...........................................................................
DON'T RECALL ...................................................................
REFUSED ..............................................................................

A11.

1
2
-8
-7

Another document discussed your consent to allow your son or daughter to provide a urine sample. Did
the interviewer give you a copy of this consent document to read?
YES ........................................................................................
NO ..........................................................................................
DON’T RECALL ...................................................................
REFUSED ..............................................................................

A10.

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

Did the interviewer give you a copy of our consent documents to read? One of these documents
included information about the PATH Study and discussed your consent to allow your son or daughter
to participate in an interview.
YES ........................................................................................
NO ..........................................................................................
DON’T RECALL ...................................................................
REFUSED ..............................................................................

A9.

1
2
3
-8
-7

Did your son or daughter receive a payment on a debit card to thank him or her for his or her
participation?
YES ........................................................................................
NO…….….. ...........................................................................
DON'T RECALL ...................................................................
REFUSED ..............................................................................

1
2
-8
-7

(SKIP TO A14)
(CONTINUE)
(SKIP TO A14)
(SKIP TO A14)

A13.
you?

If no: Did your son or daughter not receive a payment because you requested the payment be given to

YES ........................................................................................
NO…….….. ...........................................................................
DON'T RECALL ...................................................................
REFUSED ..............................................................................
A14.

1
2
-8
-7

(CONTINUE)
(CONTINUE)
(CONTINUE)
(CONTINUE)

Would you like to tell me anything else about the interviewer?
__________________________________________________________________________
_______________________________________________________________(CONTINUE)

A15.

What is/Is this the best telephone number to reach you?
_______________________________________________________________(CONTINUE)

A16.

Is this a cell phone number?
YES ........................................................................................ 1
NO .......................................................................................... 2

A_END: Thank you very much for your time.
IF QUESTIONS ARE ASKED, REFER THEM TO THE PATH SUPPORT DESK
AT 1-888-311-1819.
RECORD DETAILS IN SECTION B.

SECTION B
Documentation of Validation Problem Situations
RECORD ANY DETAILS FROM THE ORIGINAL INTERVIEW OR THE VALIDATION THAT MIGHT BE
HELPFUL IN INTERPRETING THE VALIDATION RESULT:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________

Population Assessment of Tobacco and Health (PATH) Study (NIDA)

Respondent ID (Text Readable Barcode)
DCN
OMB Control Number: 0925-0664
Expiration Date: xx/xx/20xx
IN4-15 v3

PATH Study Blood Data Collection Form

Health Professional-Administered

Part A: Administrative

1.

Part C: Blood Collection Status

Staff ID: Preprinted

2. Today’s Date:
| |__|/| | |/|__|
M

M

D

D

Y

| | |

Y

Y

Y

3. Blood Collection:
Agreed
Not Agreed (Go to Part C)
4. Blood Kit ID:
(Place Label Here)

1. Collection Status (Mark one):
Collected (End)
Not Collected
Attempted, Not Collected
2. Reason not collected (Mark one main reason):
Respondent refused, specify:
Respondent refused, unwilling to give reason
Safety exclusion
No time/busy
No show
Respondent ill/emergency
Defective/missing collection supplies
Physical limitations, specify:
Other, specify:

Part B: Blood Suitability Questions

1. Do you have hemophilia or any bleeding
disorder?
Yes (Go to Part C)
Refused (Go to Part C)
No
Don’t Know (Go to Part C)

2. Have you had cancer chemotherapy within the past 2
weeks?
Yes
No
Refused
Don’t Know

3. Have you had any problems with a blood draw in
the past?

4. What problems have you had with a blood draw in
the past? (Mark all that apply.)

Yes
No (Go to Part D)

Refused (Go to Part D)
Don’t Know (Go To Part D)

Fainting
Bruising

Light-headedness
Other, specify

Hematoma

Population Assessment of Tobacco and Health (PATH) Study (NIDA)
Part D: Blood Tube Status

Full draw
Full draw
Full draw
Full draw
Full draw
Full draw

Blue Top Tube (BL01)
Red Top Tube #1 (RD01)
Red Top Tube #2 (RD02)
Lavender Tube #1 (LV01)
Lavender Tube #2 (LV02)
PAXgene Tube (PX01)
Part E: Blood Collection Results

1. Collection Time:
| |

| : | | |

H

H

M M

a.m.

p.m.

3. Time specimen and TrekView
temperature monitor placed in shipping
container:
| | | : | |__|
H

H

M

a.m.

Short draw
Short draw
Short draw
Short draw
Short draw
Short draw

No draw
No draw
No draw
No draw
No draw
No draw

2. TrekView temperature monitor activated and included with
specimen in amber transport bag?
Yes
4. Problems with the blood draw? (Mark all that apply.)
No problems
Hematoma

Fainting
Bruising

Light-headedness
Other, specify

p.m.

M

Part F: Comments



GO TO TOP OF FORM AND COMPLETE PART C BLOOD COLLECTION STATUS

Public reporting burden for this collection of information is estimated to average 18 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 (0925-0664). Do not return the completed form to this address.

IN4-15 – Blood Data Collection Form
Respondent ID (Text Readable Barcode)
DCN
OMB Control Number: 0925-0664
Expiration Date:
Date Printed

Una colaboración entre los NIH y la FDA

PATH Study Blood Data Collection Form

Health Professional-Administered

Part A: Administrative

1.

Part C: Blood Collection Status

Staff ID: Preprinted

1. Collection Status (Mark one):
Collected (End)
Not Collected
Attempted, Not Collected
2. Reason not collected (Mark one main reason):
Respondent refused, specify: ______________________
Respondent refused, unwilling to give reason
Safety exclusion
No time/busy
No show
Respondent ill/emergency
Defective/missing collection supplies
Physical limitations, specify: ______________________
Other, specify: _________________________________

2. Today’s Date:
|__|__|/|__|__|/|__|__|__|__|
M

M

D

D

Y

Y

Y

Y

3. Blood Collection:
Agreed
Not Agreed (Go to Part C)
4. Blood Kit ID:
(Place Label Here)
Part B: Blood Suitability Questions

1. ¿Tiene hemofilia o algún problema de hemorragias o
sangrados?
Sí (Go to Part C)
Refused (Go to Part C)
No
Don’t Know (Go to Part C)

2. ¿Ha tenido quimioterapia para el cáncer en las últimas 2
semanas?
Sí
No
Refused
Don’t Know

3. ¿Ha tenido algún problema con una extracción de
sangre anteriormente?
Sí
Refused (Go to Part D)
No (Go to Part D)
Don’t Know (Go To Part D)

4. ¿Qué problemas ha tenido anteriormente con
extracciones de sangre? (Marque todo lo que corresponda.)
Desmayos
Sensación de mareos Hematomas
Moretones
Otro, especifique ___________________

Part D: Blood Tube Status

Blue Top Tube (BL01)
Red Top Tube #1 (RD01)
Red Top Tube #2 (RD02)
Lavender Tube #1 (LV01)
Lavender Tube #2 (LV02)
PAXgene Tube (PX01)

Full draw
Full draw
Full draw
Full draw
Full draw
Full draw

Short draw
Short draw
Short draw
Short draw
Short draw
Short draw

No draw
No draw
No draw
No draw
No draw
No draw

Part E: Blood Collection Results

1. Collection Time:
H

|__|__| : |__|__|
H

M

M

a.m.

p.m.

3. Time specimen and TrekView
temperature monitor placed in shipping
container:
|__|__| : |__|__|

a.m.

2. TrekView temperature monitor activated and included with
specimen in amber transport bag?
Yes
4. Problems with the blood draw? (Mark all that apply.)
No problems
Fainting
Light-headedness
Hematoma
Bruising
Other, specify ________________

p.m.

HHMM

Part F: Comments



GO TO TOP OF FORM AND COMPLETE PART C BLOOD COLLECTION STATUS

Se calcula que el tiempo para esta recolección de información es de 18 minutos por cuestionario, incluyendo el tiempo necesario para revisar las instrucciones, buscar
fuentes de datos existentes, reunir y mantener los datos necesarios y completar y revisar la recolección de información. Ninguna agencia puede realizar ni patrocinar una
recolección de información, y ninguna persona está obligada a responder a dicha recolección de información, a menos que esta muestre un número de control vigente
de la OMB. Envíe sus comentarios respecto a este cálculo de tiempo o a otro aspecto de esta recolección de información, incluyendo sugerencias de cómo reducir este
cálculo de tiempo a: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0664). No devuelva el
cuestionario contestado a esta dirección.

OMB Control Number: 0925-0664
Expiration Date: xx/xx/xxxx
IN4-16

PATH Study Urine Data Collection Form

Interviewer-Administered

Part A: Administrative

1.

Part C: Urine Collection Status

Staff ID: Preprinted

1. Collection Status (Mark one):
Collected (End)
Not Collected
Attempted, Not Collected

2. Today’s Date:
|__|__|/|__|__|/|__|__|__|__|
M

M

D

D

Y

Y

Y

Y

2. Reason not collected (Mark one main reason):
Respondent refused, specify: ______________________
Respondent refused, unwilling to give reason
Respondent ill/emergency
Unable to urinate
No time/busy
Uncomfortable with self-collection procedures
Defective/missing collection supplies
Physical limitation, specify: ______________________
Other, specify: _________________________________

3. Urine Collection:
Agreed
Not Agreed (Go to Part C)
4. Urine Kit ID:
(Place Label Here)

Part B: Urine Collection Questions

1. When was the last time you urinated?
Date: |__|__|/|__|__|/|__|__|__|__|
M

M

D

D

Y

Y

Time: |__|__| : |__|__|
H

Refused

H

M

M

Y

2. When was the last time you had anything to eat or drink
other than water?
Date: |__|__|/|__|__|/|__|__|__|__|

Y

a.m.

p.m.

Don’t Know

M

M

D

D

Y

Time: |__|__| : |__|__|
H

Refused

H

M

M

Y

Y

Y

a.m.

p.m.

Don’t Know

3. Have you had cancer chemotherapy within the past 2 weeks?
Yes
No
Refused
Don’t Know
Part D: Urine Collection Results

1. Collection time:
|__|__| : |__|__|
H

H

M M

a.m.

p.m.

2. Time specimen placed in shipping container:
|__|__| : |__|__|
H

H

M M

a.m.

p.m.

Part E: Comments



GO TO TOP OF FORM AND COMPLETE PART C URINE COLLECTION STATUS

Public reporting burden for this collection of information is estimated to average 10 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 (0925-0664). Do not return the completed form to this address.

IN4-16 –Urine Data Collection Form
OMB Control Number: 0925-0664
Expiration Date: xx/xx/xxxx
IN4-16

Una colaboración entre los NIH y la FDA

PATH Study Urine Data Collection Form

Interviewer-Administered

1. Staff ID: Preprinted

1. Collection Status (Mark one):
Collected (End)
Not Collected
Attempted, Not Collected

2. Today’s Date:
|__|__|/|__|__|/|__|__|__|__|
M

M

D

D

Y

Y

Y

Y

2. Reason not collected (Mark one main reason):
Respondent refused, specify: ______________________
Respondent refused, unwilling to give reason
Respondent ill/emergency
Unable to urinate
No time/busy
Uncomfortable with self-collection procedures
Defective/missing collection supplies
Physical limitation, specify: ________________________
Other, specify: __________________________________

3. Urine Collection:
Agreed
Not Agreed (Go to Part C)
4. Urine Kit ID:
(Place Label Here)

Part B: Urine Collection Questions

1. ¿Cuándo fue la última vez que orinó?
Date: |__|__|/|__|__|/|__|__|__|__|
M

M

D

D

Y

Y

Time: |__|__| : |__|__|
H

Refused

H

M

M

Y

2. ¿Cuándo fue la última vez que comió o bebió algo, aparte
de agua?
Date: |__|__|/|__|__|/|__|__|__|__|

Y

a.m.

p.m.

Don’t Know

M

M

D

D

Y

Time: |__|__| : |__|__|
H

Refused

H

M

M

Y

Y

Y

a.m.

p.m.

Don’t Know

3. ¿Ha tenido quimioterapia para el cáncer en las últimas 2 semanas?
Sí
No
Refused
Don’t Know
Part D: Urine Collection Results

1. Collection time:
|__|__| : |__|__|
H

H

a.m.

p.m.

M M

2. Time specimen placed in shipping container:
|__|__| : |__|__|
H

H

M M

a.m.

p.m.

Part E: Comments



GO TO TOP OF FORM AND COMPLETE PART C URINE COLLECTION STATUS

Se calcula que el tiempo para esta recolección de información es de 10 minutos por cuestionario, incluyendo el tiempo necesario para revisar las instrucciones, buscar
fuentes de datos existentes, reunir y mantener los datos necesarios y completar y revisar la recolección de información. Ninguna agencia puede realizar ni patrocinar una
recolección de información, y ninguna persona está obligada a responder a dicha recolección de información, a menos que esta muestre un número de control vigente
de la OMB. Envíe sus comentarios respecto a este cálculo de tiempo o a otro aspecto de esta recolección de información, incluyendo sugerencias de cómo reducir este
cálculo de tiempo a: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0664). No devuelva el
cuestionario contestado a esta dirección.

OMB Control Number: 0925-0664
Expiration Date: xx/xx/xxxx

If you’ve moved or any of your contact information has changed since you last participated in the
Population Assessment of Tobacco and Health (PATH) Study,* please give us your new contact
information by either:
(1)
(2)

Filling out this form and returning it using the enclosed postage-paid envelope; OR
Completing the form online by logging into www.pathstudyinfo.nih.gov. If you have a
smartphone, you can scan this QR code to visit the website.

www.pathstudyinfo.nih.gov

As a thank you for completing this form, an additional $5 will be added to your PATH Study debit
card (only once every 6 months). **
Please review the information requested on this form. If none of your contact information has
changed, simply check this box:

Current Name: First

MI

Last

UPDATE YOUR NAME IF NOT LISTED CORRECTLY ABOVE. (PLEASE PRINT CLEARLY.)
NAME: ____________________________________________________________________________
FIRST

MI

LAST

Current Address:

Street
Apt#
City
ST
ZIP
UPDATE YOUR STREET ADDRESS IF NOT LISTED CORRECTLY ABOVE. (PLEASE PRINT
CLEARLY.)

STREET ADDRESS:_________________________________________________________________
STREET

APT. #

___________________________________________________________________________________
CITY

STATE

ZIP

UPDATE YOUR MAILING ADDRESS. (If different from the street address. PLEASE PRINT CLEARLY.)
STREET ADDRESS:_________________________________________________________________
STREET

APT. #

___________________________________________________________________________________
CITY

STATE

ZIP

* This study is sponsored by the National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA).
**The funds should be on the card within five days after the date you mail this form. Also, after 2 months, if any money is still on the
card, a $3 fee will be deducted from it each month. Please contact us toll-free at 1-888-311-1819, if the card was misplaced.

<>

1

IN4-17

PLEASE PROVIDE YOUR TELEPHONE NUMBER(S). (PLEASE PRINT CLEARLY.)
HOME: |___|___|___|-|___|___|___|-|___|___|___|___|
CELL: |___|___|___|-|___|___|___|-|___|___|___|___|
PLEASE PROVIDE YOUR EMAIL ADDRESS(ES). (PLEASE PRINT CLEARLY.)
EMAIL: _____________________________________________________ @ ___________________________
EMAIL: _____________________________________________________ @ ____________________________
PLEASE PROVIDE CONTACT INFORMATION FOR SOMEONE WHO WILL ALWAYS
KNOW HOW TO LOCATE YOU, WHO IS NOT A HOUSEHOLD MEMBER. (PLEASE PRINT
CLEARLY.)

NAME: ____________________________________________________________________________
FIRST

MI

LAST

TELEPHONE NUMBER(S):
HOME: |___|___|___|-|___|___|___|-|___|___|___|___|
CELL: |___|___|___|-|___|___|___|-|___|___|___|___|
EMAIL ADDRESS: _____________________________________ @ __________________________

STREET ADDRESS: _______________________________________________________________________
STREET

APT#

_____________________________________________________________________________________
CITY

STATE

ZIP

In addition to mail, how can we contact you? (PLEASE SELECT ALL THAT APPLY.)
 HOME PHONE
 CELL PHONE (VOICE)



CELL PHONE (TEXTING)

 EMAIL

<>

2

IN4-17

Do you expect to move either permanently or temporarily in the next 6 to 12 months?


NO



YES

IF YES, WHEN WILL YOU MOVE? ___________________________________________________
MONTH

YEAR

IF YES, PLEASE PRINT YOUR NEW CONTACT INFORMATION.
STREET ADDRESS:_________________________________________________________________
STREET

APT. #

_____________________________________________________________________________________
CITY

STATE

ZIP

Please return the completed form using the enclosed postage-paid envelope. You can also
mail the form to us at:
PATH Study
1600 Research Boulevard
RB 4264F
Rockville, MD 20850
.

Thank you for your time.

Public reporting burden for this collection of information is estimated to average 8 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 (0925-0664). Do not return
the completed form to this address.

<>

3

IN4-17

This page left intentionally blank.

<>

4

IN4-17

Número de control de la OMB: 0925-0664
Fecha de vencimiento:

Si se ha mudado o su información de contacto ha cambiado desde la última vez que participó en
la Evaluación demográfica del tabaco y la salud o Estudio PATH*, por favor denos su nueva
información de contacto de alguna de las siguientes maneras:
(1)
(2)

llene este formulario para darnos la nueva información y devuélvanoslo en el sobre con
franqueo pagado adjunto; O
conteste el formulario en línea en www.pathstudyinfo.nih.gov. Si tiene un teléfono
inteligente (smartphone), puede escanear este código QR para ir a la página Web del estudio.

www.pathstudyinfo.nih.gov

Como agradecimiento por llenar este formulario, recibirá 5 dólares adicionales en su tarjeta de
débito del Estudio PATH (únicamente una vez cada 6 meses). **
Por favor mire la información que se solicita en este formulario. Si su información de contacto
no ha cambiado, marque este recuadro:

Nombre actual:

Primer

Inicial del segundo nombre

Apellidos

ACTUALICE SU NOMBRE SI ARRIBA NO ESTÁ BIEN ESCRITO. (ESCRIBA EN LETRA LEGIBLE)
NOMBRE:__________________________________________________________________________
PRIMER

INICIAL DEL SEGUNDO NOMBRE

Dirección actual: Calle
Ciudad

APT #
Estado

APELLIDOS

Código postal

ACTUALICE SU DIRECCIÓN SI ARRIBA NO ESTÁ BIEN ESCRITA. (ESCRIBA EN LETRA
LEGIBLE)

DIRECCIÓN:_______________________________________________________________________
CALLE

APT. #

___________________________________________________________________________________
CIUDAD

ESTADO

CÓDIGO POSTAL

ACTUALICE SU DIRECCIÓN POSTAL. (Si es diferente a la dirección de su domicilio. ESCRIBA EN LETRA
LEGIBLE)

DIRECCIÓN:_______________________________________________________________________
CALLE

APT. #

___________________________________________________________________________________
CIUDAD

ESTADO

CÓDIGO POSTAL

* Patrocinan este estudio los Institutos Nacionales de la Salud (NIH, por sus siglas en inglés) en colaboración con la Administración de
Alimentos y Medicamentos (FDA, por sus siglas en inglés).
**Los fondos aparecerán en su tarjeta en un plazo de cinco días a partir de la fecha en que envíe este formulario. Después de 2 meses, si
queda algún saldo en la tarjeta, se descontará un cargo mensual de 3 dólares. Llámenos a la línea directa y gratuita, 1-888-311-1819 si ha
perdido la tarjeta.

<>

1

IN4-17 v3

POR FAVOR ANOTE SUS NÚMEROS DE TELÉFONO. (ESCRIBA EN LETRA LEGIBLE).
CASA: |___|___|___|-|___|___|___|-|___|___|___|___|
CELULAR: |___|___|___|-|___|___|___|-|___|___|___|___|
POR FAVOR ANOTE SU CORREO ELECTRÓNICO. (ESCRIBA EN LETRA LEGIBLE).
CORREO ELECTRÓNICO: __________________________________ @ ___________________________
CORREO ELECTRÓNICO: __________________________________ @ ____________________________
POR FAVOR ANOTE LA INFORMACIÓN DE CONTACTO DE ALGUNA PERSONA QUE
SEPA SIEMPRE CÓMO UBICARLO Y QUE NO VIVA CON USTED. (ESCRIBA EN LETRA
LEGIBLE)

NOMBRE:__________________________________________________________________________
PRIMER

INICIAL DEL SEGUNDO NOMBRE

APELLIDOS

NÚMEROS DE TELÉFONO:
CASA: |___|___|___|-|___|___|___|-|___|___|___|___|
CELULAR: |___|___|___|-|___|___|___|-|___|___|___|___|
CORREO ELECTRÓNICO: ______________________________ @ __________________________

DIRECCIÓN: _________________________________________________________________________
CALLE

APT#

_____________________________________________________________________________________
CIUDAD

ESTADO

CÓDIGO POSTAL

Aparte de correo postal, ¿cómo podemos comunicarnos con usted? (ELIJA TODAS LAS OPCIONES QUE
CORRESPONDAN)

 TELÉFONO FIJO EN CASA
 CELULAR (VOZ)



CELULAR (TEXTO)

 CORREO ELECTRÓNICO

<>

2

IN4-17 v3

¿Tiene pensado mudarse de manera permanente o temporal en los próximos 6 a 12 meses?


NO



SÍ

SI CONTESTÓ SÍ, ¿CUÁNDO SE MUDARÁ? __________________________________________
MES

AÑO

SI CONTESTÓ SÍ, POR FAVOR PROPORCIONE SU NUEVA DIRECCIÓN
DIRECCIÓN:_______________________________________________________________________
CALLE

APT. #

_____________________________________________________________________________________
CIUDAD

ESTADO

CÓDIGO POSTAL

Por favor envíe el formulario contestado en el sobre con franqueo pagado adjunto.
También puede enviarnos el formulario a:
PATH Study
1600 Research Boulevard
RB 4264F
Rockville, MD 20850

Gracias por su colaboración.

Se calcula que el tiempo para esta recolección de información es de 8 minutos por cuestionario, incluyendo el tiempo necesario para revisar las
instrucciones, buscar fuentes de datos existentes, reunir y mantener los datos necesarios y completar y revisar la recolección de información. Ninguna
agencia puede realizar ni patrocinar una recolección de información, y ninguna persona está obligada a responder a dicha recolección de información, a
menos que esta muestre un número de control vigente de la OMB. Envíe sus comentarios respecto a este cálculo de tiempo o a otro aspecto de esta
recolección de información, incluyendo sugerencias de cómo reducir este cálculo de tiempo a: NIH, Project Clearance Branch, 6705 Rockledge Drive,
MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0664). No devuelva el cuestionario contestado a esta dirección.

<>

3

IN4-17 v3

Esta página se ha dejado en blanco de manera intencional.

<>

4

IN4-17 v3

OMB Control Number: 0925-0664
Expiration Date: xx/xx/xxxx

If you’ve moved or any of your contact information has changed since your child last participated in
the Population Assessment of Tobacco and Health (PATH) Study,* please give us your new contact
information by either:
(1)
(2)

Filling out this form and returning it using the enclosed postage-paid envelope; OR
Completing the form online by logging into www.pathstudyinfo.nih.gov. If you have a
smartphone, you can scan this QR code to visit the website.

www.pathstudyinfo.nih.gov

As a thank you for completing this form, an additional $5 will be added to your child’s PATH Study
debit card (only once every 6 months). **
Please review the information requested on this form. If none of your contact information has
changed, check this box:

Youth’s First Name: Fname

UPDATE YOUTH’S FIRST NAME IF NOT LISTED CORRECTLY ABOVE. (PLEASE

PRINT CLEARLY.)

_______________________________________________________________________
FIRST NAME

Name of Parent:

First Name

MI

Last Name

UPDATE PARENT NAME IF NOT LISTED CORRECTLY ABOVE. (PLEASE PRINT CLEARLY.)
___________________________________________________________________________________
FIRST

Current Parent Address:

MI

LAST NAME

Street
City

Apt #
ST

ZIP

UPDATE YOUR STREET ADDRESS IF NOT LISTED CORRECTLY ABOVE. (PLEASE PRINT
CLEARLY.)

___________________________________________________________________________________
STREET

APT. #

___________________________________________________________________________________
CITY

STATE

ZIP

* This study is sponsored by the National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA).
**The funds should be on the card within five days after the date you mail this form. Also, after 2 months, if any money is still on the
card, a $3 fee will be deducted from it each month. Please contact us toll-free at 1-888-311-1819, if the card was misplaced.

<>

1
IN4-18

UPDATE YOUR MAILING ADDRESS. (If different from the Street Address. PLEASE PRINT CLEARLY.)
___________________________________________________________________________________
STREET

APT. #

___________________________________________________________________________________
CITY

STATE

ZIP

PLEASE PROVIDE YOUR TELEPHONE NUMBER(S). (PLEASE PRINT CLEARLY.)
HOME: |___|___|___|-|___|___|___|-|___|___|___|___|
CELL: |___|___|___|-|___|___|___|-|___|___|___|___|
PLEASE PROVIDE YOUR EMAIL ADDRESS(ES). (PLEASE PRINT CLEARLY.)
EMAIL: __________________________________________________ @ _____________________________
EMAIL: __________________________________________________ @ ____________________________
PLEASE PROVIDE CONTACT INFORMATION FOR SOMEONE WHO WILL ALWAYS
KNOW HOW TO LOCATE YOU, WHO IS NOT A HOUSEHOLD MEMBER. (PLEASE PRINT
CLEARLY.)

NAME: ____________________________________________________________________________
FIRST

MI

LAST

TELEPHONE NUMBER(S):
HOME: |___|___|___|-|___|___|___|-|___|___|___|___|
CELL: |___|___|___|-|___|___|___|-|___|___|___|___|
EMAIL ADDRESS: __________________________________________ @ ___________________________
STREET ADDRESS:_________________________________________________________________
STREET

APT. #

_____________________________________________________________________________________
CITY

STATE

ZIP

In addition to mail, how can we contact you? (PLEASE SELECT ALL THAT APPLY.)


HOME PHONE



CELL PHONE (VOICE)



EMAIL



CELL PHONE (TEXTING)

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2
IN4-18

Do you expect to move either permanently or temporarily in the next 6 to 12 months?


NO



YES

IF YES, WHEN WILL YOU MOVE? ___________________________________________________
MONTH

YEAR

IF YES, PLEASE PROVIDE YOUR NEW CONTACT INFORMATION.
STREET ADDRESS:_________________________________________________________________
STREET

APT. #

___________________________________________________________________________________
CITY

STATE

ZIP

Do you expect your child to move either permanently or temporarily in the next 6 to 12 months?


NO



YES

IF YES, WHEN WILL YOUR CHILD MOVE? __________________________________________
MONTH

YEAR

IF YES, PLEASE PROVIDE YOUR CHILD’S NEW CONTACT INFORMATION.
STREET ADDRESS:_________________________________________________________________
STREET

APT. #

____________________________________________________________________________________
CITY

STATE

ZIP

Is your child currently attending or planning to attend a college or university in the next 6 to 12
months?


NO



YES

IF YES, PLEASE PRINT THE NAME AND LOCATION OF THE COLLEGE OR
UNIVERSITY.
____________________________________________________________________________________c
COLLEGE OR UNIVERSITY NAME

CITY

STATE

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3
IN4-18

Please return the completed form using the enclosed postage-paid envelope. You can also
mail the form to us at:
PATH Study
1600 Research Boulevard
RB 4264F
Rockville, MD 20850

Thank you for your time.

Public reporting burden for this collection of information is estimated to average 8 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 (0925-0664). Do not return
the completed form to this address.

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4
IN4-18

Número de control de la OMB: 0925-0664
Fecha de vencimiento:

Si se ha mudado o su información de contacto ha cambiado desde la última vez que su hijo(a)
participó en la Evaluación demográfica del tabaco y la salud o Estudio PATH*, por favor denos su
nueva información de contacto de alguna de las siguientes maneras:

(1)
(2)

llene este formulario para darnos la nueva información y devuélvanoslo en el sobre con
franqueo pagado adjunto; O
conteste el formulario en línea en www.pathstudyinfo.nih.gov. Si tiene un teléfono
inteligente (smartphone), puede escanear este código QR para ir a la página Web del estudio.

www.pathstudyinfo.nih.gov

Como agradecimiento por llenar este formulario, recibirá 5 dólares adicionales en la tarjeta de débito
del Estudio PATH de su hijo(a) (únicamente una vez cada 6 meses).**
Por favor mire la información que se solicita en este formulario. Si su información de contacto
no ha cambiado, marque este recuadro:


Primer nombre del joven: Fname
ACTUALICE EL PRIMER NOMBRE DEL JOVEN SI ARRIBA NO ESTÁ BIEN
ESCRITO. (ESCRIBA EN LETRA LEGIBLE)
_____________________________________________________________________________
PRIMER NOMBRE

Nombre del padre o la madre:

Primer

Inicial del segundo nombre

Apellidos

ACTUALICE EL NOMBRE DEL PADRE O LA MADRE SI ARRIBA NO ESTÁ BIEN
ESCRITO. (ESCRIBA EN LETRA LEGIBLE)
___________________________________________________________________________________
PRIMER

INICIAL DEL SEGUNDO NOMBRE

Dirección actual del padre o de la madre: Calle
Ciudad

Apt #
Estado

APELLIDOS

Código postal

ACTUALICE SU DIRECCIÓN SI ARRIBA NO ESTÁ BIEN ESCRITA. (ESCRIBA EN LETRA
LEGIBLE)

___________________________________________________________________________________
CALLE

APT. #

___________________________________________________________________________________
CIUDAD

ESTADO

CÓDIGO POSTAL

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1

IN4-18 v3

* Patrocinan este estudio los Institutos Nacionales de la Salud (NIH, por sus siglas en inglés) en colaboración con la
Administración de Alimentos y Medicamentos (FDA, por sus siglas en inglés).
**Los fondos aparecerán en su tarjeta en un plazo de cinco días a partir de la fecha en que envíe este formulario. Después
de 2 meses, si queda algún saldo en la tarjeta, se descontará un cargo mensual de 3 dólares. Llámenos a la línea directa y
gratuita, 1-888-311-1819, si ha perdido la tarjeta.

ACTUALICE SU DIRECCIÓN POSTAL. (Si es diferente a la dirección de su domicilio. ESCRIBA EN LETRA
LEGIBLE)

___________________________________________________________________________________
CALLE

APT. #

___________________________________________________________________________________
CIUDAD

ESTADO

CÓDIGO POSTAL

POR FAVOR ANOTE SUS NÚMEROS DE TELÉFONO. (ESCRIBA EN LETRA LEGIBLE).
CASA: |___|___|___|-|___|___|___|-|___|___|___|___|
CELULAR: |___|___|___|-|___|___|___|-|___|___|___|___|
POR FAVOR ANOTE SU CORREO ELECTRÓNICO. (ESCRIBA EN LETRA LEGIBLE).
CORREO ELECTRÓNICO: ________________________________ @ ________________________
CORREO ELECTRÓNICO: ________________________________ @ _______________________
POR FAVOR ANOTE LA INFORMACIÓN DE CONTACTO DE ALGUNA PERSONA QUE
SEPA SIEMPRE CÓMO UBICARLO Y QUE NO VIVA CON USTED. (ESCRIBA EN LETRA
LEGIBLE)

NOMBRE:__________________________________________________________________________
PRIMER

INICIAL DEL SEGUNDO NOMBRE

APELLIDOS

NÚMEROS DE TELÉFONO:
CASA: |___|___|___|-|___|___|___|-|___|___|___|___|
CELULAR: |___|___|___|-|___|___|___|-|___|___|___|___|
CORREO ELECTRÓNICO: __________________________________ @ ___________________________
DIRECCIÓN:_______________________________________________________________________
CALLE

APT. #

_____________________________________________________________________________________
CIUDAD

ESTADO

CÓDIGO POSTAL

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2

IN4-18 v3

Aparte de correo postal, ¿cómo podemos comunicarnos con usted? (ELIJA TODAS LAS OPCIONES QUE
CORRESPONDAN)



TELÉFONO FIJO EN CASA



CELULAR (VOZ)



CORREO ELECTRÓNICO



CELULAR (TEXTO)

¿Tiene pensado mudarse de manera permanente o temporal en los próximos 6 a 12 meses?


NO



SÍ

SI CONTESTÓ SÍ, ¿CUÁNDO SE MUDARÁ? __________________________________________
MES

AÑO

SI CONTESTÓ SÍ, POR FAVOR PROPORCIONE SU NUEVA INFORMACIÓN DE
CONTACTO.
DIRECCIÓN:_______________________________________________________________________
CALLE

APT. #

___________________________________________________________________________________
CIUDAD

ESTADO

CÓDIGO POSTAL

¿Tiene su hijo(a) pensado mudarse de manera permanente o temporal en los próximos 6 a 12
meses?


NO



SÍ

SI CONTESTÓ SÍ, ¿CUÁNDO SE MUDARÁ SU HIJO(A)?
__________________________________________
MES

AÑO

SI CONTESTÓ SÍ, POR FAVOR ANOTE LA NUEVA INFORMACIÓN DE CONTACTO DE
SU HIJO(A).
DIRECCIÓN:_________________________________________________________________
CALLE

APT. #

____________________________________________________________________________________
CIUDAD

ESTADO

CÓDIGO POSTAL

¿Asiste su hijo a una universidad actualmente o tiene planes de asistir a una universidad en los
próximos 6 a 12 meses?


NO



SÍ

SI CONTESTÓ SÍ, ESCRIBA POR FAVOR EL NOMBRE Y LA UBICACIÓN DE LA
UNIVERSIDAD.
____________________________________________________________________________________
NOMBRE DE LA UNIVERSIDAD

CIUDAD

ESTADO

<>

3

IN4-18 v3

Por favor envíe el formulario contestado en el sobre con franqueo pagado adjunto.
También puede enviarnos el formulario a:
PATH Study
1600 Research Boulevard
RB 4264F
Rockville, MD 20850

Gracias por su colaboración.

Se calcula que el tiempo para esta recolección de información es de 8 minutos por cuestionario, incluyendo el tiempo necesario para revisar las
instrucciones, buscar fuentes de datos existentes, reunir y mantener los datos necesarios y completar y revisar la recolección de información. Ninguna
agencia puede realizar ni patrocinar una recolección de información, y ninguna persona está obligada a responder a dicha recolección de información, a
menos que esta muestre un número de control vigente de la OMB. Envíe sus comentarios respecto a este cálculo de tiempo o a otro aspecto de esta
recolección de información, incluyendo sugerencias de cómo reducir este cálculo de tiempo a: NIH, Project Clearance Branch, 6705 Rockledge Drive,
MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0664). No devuelva el cuestionario contestado a esta dirección.

<>

4

IN4-18 v3

OMB Control Number: 0925-0664
Expiration Date: xx/xx/xxxx

If you’ve moved or any of your contact information has changed since we last contacted you about
the Population Assessment of Tobacco and Health (PATH) Study,* please give us your new contact
information by filling out this form and returning it using the enclosed postage-paid envelope.
As a thank you for completing this form, you will receive $5 in the mail (only once every 6 months).
Please review the information requested on this form. If none of your contact information has
changed check this box:

Child’s First Name: Fname
UPDATE CHILD’S FIRST NAME IF NOT LISTED CORRECTLY ABOVE. (PLEASE PRINT
CLEARLY.)

___________________________________________________________________________________________________________
FIRST NAME

Name of Parent :

First Name

MI

Last Name

UPDATE PARENT NAME IF NOT LISTED CORRECTLY ABOVE. (PLEASE PRINT CLEARLY.)
________________________________________________________________________________________________________________
FIRST
MI
LAST NAME

Current Address:

Street Address
City

Apt #
ZIP

ST

UPDATE YOUR STREET ADDRESS IF NOT LISTED CORRECTLY ABOVE. (PLEASE PRINT
CLEARLY.)

___________________________________________________________________________________
STREET

APT. #

___________________________________________________________________________________
CITY

STATE

ZIP

UPDATE YOUR MAILING ADDRESS. (If different from the Street Address. PLEASE PRINT CLEARLY.)
___________________________________________________________________________________
STREET

APT. #

___________________________________________________________________________________
CITY

STATE

ZIP

* This study is sponsored by the National Institutes of Health (NIH), in partnership with the Food and Drug Administration (FDA).
<>

1
IN4-19

PLEASE PROVIDE YOUR TELEPHONE NUMBER(S). (PLEASE PRINT CLEARLY.)
HOME: |__|__|__| - |__|__|__| - |__|__|__|__|
CELL: |__|__|__| - |__|__|__| - |__|__|__|__|
PLEASE PROVIDE YOUR EMAIL ADDRESS(ES) (PLEASE PRINT CLEARLY.)
EMAIL: _________________________________________________ @ ______________________________
EMAIL: _________________________________________________ @ ______________________________

PLEASE PROVIDE CONTACT INFORMATION FOR SOMEONE WHO WILL ALWAYS
KNOW HOW TO LOCATE YOU, WHO IS NOT A HOUSEHOLD MEMBER. (PLEASE PRINT
CLEARLY.)

NAME: ____________________________________________________________________________
FIRST

MI

LAST

TELEPHONE NUMBER(S):
HOME: |___|___|___|-|___|___|___|-|___|___|___|___|
CELL: |___|___|___|-|___|___|___|-|___|___|___|___|
EMAIL ADDRESS: ___________________________________________ @ __________________________
STREET ADDRESS:_________________________________________________________________
STREET

APT. #

___________________________________________________________________________________
CITY

STATE

ZIP

In addition to mail, how can we contact you? (PLEASE SELECT ALL THAT APPLY)


HOME PHONE



CELL PHONE (VOICE)



EMAIL



CELL PHONE (TEXTING)

<>

2
IN4-19

Do you expect to move either permanently or temporarily in the next 6 to 12 months?


NO



YES

IF YES, WHEN WILL YOU MOVE?____________________________________________________
MONTH

YEAR

IF YES, PLEASE PROVIDE YOUR NEW CONTACT INFORMATION.
STREET ADDRESS:_________________________________________________________________
STREET

APT. #

___________________________________________________________________________________
CITY

STATE

ZIP

Do you expect your child to move either permanently or temporarily in the next 6 to 12 months?


NO



YES

IF YES, WHEN WILL YOUR CHILD MOVE? __________________________________________
MONTH

YEAR

IF YES, PLEASE PROVIDE YOUR CHILD’S NEW CONTACT INFORMATION.
STREET ADDRESS:_________________________________________________________________
STREET

APT. #

___________________________________________________________________________________
CITY

STATE

ZIP

Please return the completed form using the enclosed postage-paid envelope. You can also
mail the form to us at:
PATH Study
1600 Research Boulevard
RB 4264F
Rockville, MD 20850

Thank you for your time.
Public reporting burden for this collection of information is estimated to average 8 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 (0925-0664). Do not return
the completed form to this address.

<>

3
IN4-19

This page left intentionally blank.

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4
IN4-19

Número de control de la OMB: 0925-0664
Fecha de vencimiento:

Si se ha mudado o si ha cambiado su información de contacto desde la última vez que nos
comunicamos con usted respecto a la Evaluación demográfica del tabaco y la salud o Estudio
PATH*, llene este formulario para darnos la nueva información de contacto y devuélvanoslo en el
sobre con franqueo pagado adjunto.
Como agradecimiento por llenar este formulario, recibirá 5 dólares en el correo (únicamente una vez
cada 6 meses).
Por favor mire la información que se solicita en este formulario. Si su información de contacto
no ha cambiado, marque este recuadro:


Primer nombre del niño o de la niña: Fname
ACTUALICE EL PRIMER NOMBRE DEL NIÑO O DE LA NIÑA SI NO ESTÁ BIEN
ESCRITO. (ESCRIBA EN LETRA LEGIBLE)
____________________________________________________________________________________________________________
PRIMER NOMBRE

Nombre del padre o la madre: Primer

Inicial del segundo nombre

Apellidos

ACTUALICE EL NOMBRE DEL PADRE O LA MADRE SI ARRIBA NO ESTÁ BIEN
ESCRITO. (ESCRIBA EN LETRA LEGIBLE)
___________________________________________________________________________________
PRIMER

Dirección actual: Calle
Ciudad

INICIAL DEL SEGUNDO NOMBRE

APELLIDOS

Apt #
Código postal

Estado

ACTUALICE SU DIRECCIÓN SI ARRIBA NO ESTÁ BIEN ESCRITA. (ESCRIBA EN LETRA
LEGIBLE)

___________________________________________________________________________________
CALLE

APT. #

___________________________________________________________________________________
CIUDAD

ESTADO

CÓDIGO POSTAL

* Patrocinan este estudio los Institutos Nacionales de la Salud (NIH, por sus siglas en inglés) en colaboración con la
Administración de Alimentos y Medicamentos (FDA, por sus siglas en inglés).

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1

IN4-19 v3

ACTUALICE SU DIRECCIÓN POSTAL. Si es diferente a la dirección de su domicilio. (ESCRIBA EN LETRA
LEGIBLE)

___________________________________________________________________________________
CALLE

APT. #

___________________________________________________________________________________
CIUDAD

ESTADO

CÓDIGO POSTAL

POR FAVOR ANOTE SUS NÚMEROS DE TELÉFONO. (ESCRIBA EN LETRA LEGIBLE)
CASA: |___|___|___|-|___|___|___|-|___|___|___|___|
CELULAR: |__|___|___|-|___|___|___|-|___|___|___|___|
POR FAVOR ANOTE SU CORREO ELECTRÓNICO. (ESCRIBA EN LETRA LEGIBLE)
CORREO ELECTRÓNICO: ___________________________ @ ______________________________
CORREO ELECTRÓNICO: _____________________________ @ ___________________________
POR FAVOR ANOTE LA INFORMACIÓN DE CONTACTO DE ALGUNA PERSONA QUE
SEPA SIEMPRE CÓMO UBICARLO Y QUE NO VIVA CON USTED. (ESCRIBA EN LETRA
LEGIBLE)

NOMBRE:__________________________________________________________________________
PRIMER

INICIAL DEL SEGUNDO NOMBRE

APELLIDOS

NÚMEROS DE TELÉFONO:
CASA: |___|___|___|-|___|___|___|-|___|___|___|___|
CELULAR: |___|___|___|-|___|___|___|-|___|___|___|___|
CORREO ELECTRÓNICO: __________________________________ @ __________________________
DIRECCIÓN:_______________________________________________________________________
CALLE

APT. #

___________________________________________________________________________________
CIUDAD

<>

ESTADO

2

CÓDIGO POSTAL

IN4-19 v3

Aparte de correo postal, ¿cómo podemos comunicarnos con usted? (ELIJA TODAS LAS OPCIONES QUE
CORRESPONDAN)



TELÉFONO FIJO EN CASA



CELULAR (VOZ)



CORREO ELECTRÓNICO



CELULAR (TEXTO)

¿Tiene pensado mudarse de manera permanente o temporal en los próximos 6 a 12 meses?


NO



SÍ

SI CONTESTÓ SÍ, ¿CUÁNDO SE MUDARÁ?__________________________________________
MES

AÑO

SI CONTESTÓ SÍ, POR FAVOR PROPORCIONE SU NUEVA INFORMACIÓN DE
CONTACTO.
DIRECCIÓN:_______________________________________________________________________
CALLE

APT. #

___________________________________________________________________________________
CIUDAD

ESTADO

CÓDIGO POSTAL

¿Tiene su hijo(a) pensado mudarse de manera permanente o temporal en los próximos 6 a 12
meses?


NO



SÍ

SI CONTESTÓ SÍ, ¿CUÁNDO SE MUDARÁ SU HIJO(A)? _______________________________
MES

AÑO

SI CONTESTÓ SÍ, POR FAVOR ANOTE LA NUEVA INFORMACIÓN DE CONTACTO DE
SU HIJO(A).
DIRECCIÓN:_______________________________________________________________________
CALLE

APT. #

___________________________________________________________________________________
CIUDAD

<>

ESTADO

3

CÓDIGO POSTAL

IN4-19 v3

Por favor envíe el formulario contestado en el sobre con franqueo pagado adjunto.
También puede enviarnos el formulario a:
PATH Study
1600 Research Boulevard
RB 4264F
Rockville, MD 20850

Gracias por su colaboración.

Se calcula que el tiempo para esta recolección de información es de 8 minutos por cuestionario, incluyendo el tiempo necesario para revisar las
instrucciones, buscar fuentes de datos existentes, reunir y mantener los datos necesarios y completar y revisar la recolección de información. Ninguna
agencia puede realizar ni patrocinar una recolección de información, y ninguna persona está obligada a responder a dicha recolección de información, a
menos que esta muestre un número de control vigente de la OMB. Envíe sus comentarios respecto a este cálculo de tiempo o a otro aspecto de esta
recolección de información, incluyendo sugerencias de cómo reducir este cálculo de tiempo a: NIH, Project Clearance Branch, 6705 Rockledge Drive,
MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0664). No devuelva el cuestionario contestado a esta dirección.

<>

4

IN4-19 v3