Macro International, Inc. INTRODUCTION/SCREENER Fieldwork Subcontractor for INTRO1 Alcohol Research Group Hello, my name is ______. I am calling as a part of a research study funded by the National Institutes National Alcohol Research Center of Health. [IF AN ADDRESS WAS AVAILABLE TO SEND AN INTRODUCTORY LETTER SAY: We PUBLIC HEALTH INSTITUTE may have sent a letter to your household describing the study.] 6475 Christie Ave., Suite 400 Emeryville, CA 94608 It will take just a minute to see who in your household is eligible to participate.
(IF NECESSARY: This is a purely scientific study sponsored by the National Institute of Health with 2009-10 NATIONAL ALCOHOL SURVEY funding to the Public Health Institute. We are not trying to sell anything or conduct any sort of business (N12) MAIN QUESTIONNAIRE with you. Your opinions are very important to us.")
Is this (phone number) ? Work on this project was supported by Center Grant P30 AA05595 from the If "no," U.S. National Institute on Alcohol Abuse and Alcoholism Thank you very much, but I seem to have dialed the wrong number. It's possible that your to the Alcohol Research Group number may be called at a later time. STOP National Alcohol Research Center on the Epidemiology of Alcohol Problems 6475 Christie Ave., Suite 400, Emeryville CA 94608 USA HS1 Is this a private residence? Thomas K Greenfield, PI, [email protected] If "no," Karen Trocki, Study Director [email protected] Thank you very much, but we are only interviewing private residences. STOP Jason Bond, Senior Biostatistician [email protected] Yu Ye, Biostatistician [email protected] HS2 NOTES: Is this a cellular telephone? 1. This is a draft version of N12. Since the final version of N12 will be in a CATI format, we are using Read only if necessary: "By cellular telephone we mean a telephone that is mobile and usable this draft version for development. Skip pattern may need refinements.. outside of your neighborhood." 2. We have tried to maintain the same question numbers as N10. Where new items have been inserted, they will have a code like BN instead of B to indicate these are new variables. In addition, BC If "yes," or BNC would be a variable in the B series that has been changed in some way. This version of the Thank you very much, but we are only interviewing land line telephones and private residences. questionnaire is not always in alphabetic and numeric order because of rearranging some sections and STOP moving some items. ADULTS I need to randomly select one adult who lives in your household to be interviewed. How many members of your household, including yourself, are 18 years of age or older?
__ Number of adults
If "1," ONEADULT. Are you the adult?
If "yes," Then you are the person I need to speak with. Enter 1 man or 1 woman below (Ask gender if necessary). Go to "YOURTHE1".
If "no," GETADULT. May I speak with (him/her)? Go to "NEWADULT" on the next page.
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MEN ASK OF ALL How many of these adults are men? PMQA2 In what state, territory, or country were you born? __ Number of men 01 Gave Response WOMEN 02 Other Country (specify) How many of these adults are women? 97 Don’t Know 99 Refused __ Number of women ASK IF PMQA2=01
ASKFOR 01 Alabama 21 Louisiana 41 Oregon The person in your household that I need to speak with is . 02 Alaska 22 Maine 42 Pennsylvania If "you," go to "CONSENT"
03 American Samoa 23 Maryland 43 North Carolina NEWADULT: Hello, my name is ______. I am calling as a part of a research study funded by the National Institutes 04 Arizona 24 Massachusetts 44 Rhode Island of Health. My computer has randomly selected you from among the adult members of your household to participate in this study, we cannot substitute any other person. 05 Arkansas 25 Michigan 45 South Carolina
YOURTHE1: 06 California 26 Minnesota 46 South Dakota Participation in the study involves answering questions about health related issues such as the experience of injuries, violence, and some background questions such as your age and marital status. 07 Colorado 27 Mississippi 47 Tennessee We are also interested in your attitudes, opinions and use of alcohol and drugs even if you do not drink
alcoholic beverages or use drugs. Your participation provides important information for treatment and 08 Connecticut 28 Missouri 48 Texas policy on health-related issues. Participation is voluntary. If any questions make you uncomfortable just tell me and we can move on to the next one; you can postpone or end the interview at any time. 09 Delaware 29 Montana 49 Utah All of your answers to questions will be confidential. Your answers will be grouped with those of all the other participants. Any answers given cannot be linked with any personal identifying information.The 10 District of Columbia 30 Nebraska 50 Vermont survey takes about 20-45 minutes. Portions of this call may be monitored and recorded for quality control purposes. 11 Florida 31 Nevada 51 Virginia
12 Georgia 32 New Hampshire 52 Virgin Islands [if needed] If you have any questions, I can provide a telephone number for you to call to get more information. [if needed] You can verify the legitimacy of the study and learn more information at 13 Guam 33 New Jersey 53 Washington www.nationalstudy12.org.
14 Hawaii 34 New Mexico 54 West Virginia ASK OF ALL TIMING SECTION 1 15 Idaho 35 New York 55 Wisconsin
A1 16 Illinois 36 North Carolina 56 Wyoming A1 First, I’d like to ask you a few questions for background purposes. (RECORD R’S GENDER) 17 Indiana 37 North Dakota 95 OTHER COUNTRY-SPECIFY (IF NECESSARY, ASK: Are you male or female?) 18 Iowa 38 Northern Marianas Islands 97 DON’T KNOW 01 Male
02 Female 19 Kansas 39 Ohio 99 REFUSED 3 IF GENDER FROM A1 DOESN’T MATCH GENDER FROM SCREENER, INTERVIEWER MUST GO 4 BACK TO FIX THE INCONSISTENCY
Page Page 20 Kentucky 40 Oklahoma
ASK IF A4=03 OR 05, OR A5=04 ASK IF MQA2=95 A6 Which one of these groups best describes your own ethnic identification: MQA2O. ENTER OTHER MENTION 01 Puerto Rican (SKIP TO PH1) ______02 Cuban (SKIP TO PH1) (STATE/TERRITORY/COUNTRY) 03 Cuban American (SKIP TO PH1) 04 Mexican (SKIP TO PH1) ASK IF PMQA2=02 05 Mexican American (SKIP TO PH1) 06 Latin American (ASK A6o) A3 How many years have you lived in the United States? 07 Other Spanish-Hispanic (ASK A6o) 08 Anglo American (SKIP TO PH1) ______RANGE 0-105 09 South American (ASK A6o) (YEARS) 10 Central American (ASK A6o) 997 Don’t Know 95 Some other group? (ASK A6o) 999 Refused ASK IF A6=06, 07, 09, 10, OR 95 ASK OF ALL A4. Which one of these groups best describes your family origin: A6o. What country is that? (ALL RESPONSES SKIP TO PH1)
01 Asian (SKIP TO A8) 01 Antigua and Barbuda 14 El Salvador 27 Saint Kitts and Nevis 02 Black, not of Hispanic origin. (skip to A7) 03 Black of Hispanic origin (that is, Latino, Mexican, Central or South American, or any other 02 Argentina 15 Grenada 28 Saint Lucia Hispanic Origin.) (SKIP TO A6) 04 White, not of Hispanic origin. (SKIP TO PH1) 03 Barbados 16 Guatemala 29 Saint Vincent and the 05 White of Hispanic origin (that is, Latino, Mexican, Central or South American, or any other Grenadines Hispanic Origin.) (SKIP TO A6) 06 American Indian or Alaskan Native (SKIP TO PH1) 04 Belize 17 Guyana 30 Spain 07 Pacific Islander (SKIP TO PH1)
08 Other origin? (ASK A4o) 97 DON’T KNOW (SKIP TO PH1) 05 Bolivia 18 Haiti 31 Suriname 99 REFUSED (SKIP TO PH1) ASK IF A4=08 06 Brazil 19 Honduras 32 Trinidad and Tobago A4o. What origin is that? (SPECIFY) ______07 Chile 20 Jamaica 33 Uruguay ASK IF A4=08 A5. Which one of these racial and ethnic groups best describes most of your ancestors: 08 Costa Rica 21 Mexico 34 Venezuela
01 Asian (SKIP TO A8) 09 Cuba 22 Nicaragua 35 United States/American 02 Black (SKIP TO A7)
03 White (SKIP TO PH1) 10 Colombia 23 Panama 95 Other 04 Hispanic (ASK A6) 05 American Indian or Alaskan Native, or (SKIP TO PH1) 06 Pacific Islander (SKIP TO PH1) 11 Dominica 24 Paraguay 97 DON’T KNOW 97 DON’T KNOW (SKIP TO PH1) 99 REFUSED (SKIP TO PH1) 12 Dominican Republic 25 Peru 99 REFUSED
13 Ecuador 26 Portugal
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ASK IF A4=02 OR A5=02 11 Cambodian, (SKIP TO PH1)
12 A7 Which one of the following terms best fits how you would describe yourself: Burmese, or (SKIP TO PH1) 95 Some other group? (ASK A8o) 01 American, (SKIP TO PH1) 97 DON’T KNOW (SKIP TO PH1) 99 REFUSED 02 African-American, (SKIP TO PH1) (SKIP TO PH1) 03 African, (SKIP TO PH1) 04 Black, (SKIP TO PH1) ASK IF A8=95
05 Negro, (SKIP TO PH1) 06 Creole, (SKIP TO PH1) A8o. What country is that? [ALL RESPONSES SKIP TO PH1] 07 Colored, (SKIP TO PH1)
08 West Indian, or (SKIP TO PH1) 01 Mixture 02 Bangladesh 95 Some other group (ASK A7o) 03 Bhutan 97 DON’T KNOW (SKIP TO PH1) 04 Brunei 99 Refused (SKIP TO PH1) 05 Kazakhstan ASK IF A7=95 06 North Korea 07 South Korea A7o. IF NECESSARY: Which one of the following terms best fits how you would describe yourself: 08 Kyrgyzstan 09 Maldives 01 Mixture (SKIP TO PH1) 10 Mongolia 02 Caribbean (SKIP TO PH1) 11 Myanmar 95 12 Nepal Other (SKIP TO PH1) 13 Singapore 97 DON’T KNOW (SKIP TO PH1) 14 Sri Lanka 99 15 Taiwan REFUSED (SKIP TO PH1) 16 Tajikistan
ASK IF A4=01 OR A5=01 17 Turkmenistan 18 Uzbekistan A8. Which one of the following terms best describes your own ethnic identification: 97 DON’T KNOW 99 REFUSED 01 Chinese, (SKIP TO PH1) 02 Japanese, (SKIP TO PH1) 03 Korean, (SKIP TO PH1) 04 Filipino, (SKIP TO PH1) 05 Vietnamese, (SKIP TO PH1) 06 Asian Indian, (SKIP TO PH1) 07 Indonesian, (SKIP TO PH1) 08 Malaysian, (SKIP TO PH1) 09 Thai, (SKIP TO PH1) 7 8 10 Laotian, (SKIP TO PH1) Page Page
ASK OF ALL 03 Very few or no calls are received on a cell phone?
[DO NOT READ] PH1 Are there any other RESIDENTIAL phone numbers in addition to this one 04 DON’T HAVE A REGULAR LANDLINE PHONE (CELL ONLY) ((###)### - ####) in your household? 05 DON’T HAVE A CELL PHONE (LANDLINE ONLY) 06 DON’T HAVE ANY PHONE (NO PHONE) 97 DON’T KNOW/NOT SURE 01 YES 99 REFUSED
02 NO
97 DON’T KNOW ASK OF ALL
99 REFUSED In what month, day and year were you born?
PREA10. ASK IF PH1=01
01 GAVE ANSWER PH2 Altogether, how many RESIDENTIAL phone numbers does your household have
INCLUDING this one ((###) ### - ####)? 97 DON’T KNOW [IF NECESSARY: Do not include cell phones or numbers that are only used by a
computer or fax machine.] 99 REFUSED
ASK IF PREA10=01 # of phone numbers ______[RANGE: 2-6] A10. In what month, day and year were you born? (Have CATI system calculate the age 7=DK 9=RF “AGE1") / ASK OF ALL / (MONTH) (DAY) (YEAR) CELL_a. In addition to your residential landline telephone, do you also use one or more cell phone numbers? 01...... YES (DUAL USER) 02...... NO (LANDLINE ONLY) [SKIP b. and c.] 97..... DON’T KNOW/NOT SURE 99.. Refused
//ask if CELL_a = 01//
CELL_b. How many? [IF NEEDED: Cell phones do you use.] [6=6 OR MORE] ____NUMBER OF PHONES__[range 1-6]______97 DON’T KNOW/NOT SURE 99.... REFUSED
//ask if CELL_a = 01//
CELL_c. Of all the telephone calls that you receive , would you say …
[READ LIST] 9 01 All or almost all calls are received on a cell phone? 10 02 Some calls are received on a cell phone and some on a regular landline phone? Page Page
ASK IF PREA10=01 ASK OF ALL
A11a. So you are currently (YEARS) years old (This confirms the calculation is correct) ?
01 Yes (SKIP TO A12) A13. What is your religious preference? Are you: 02 No (RE-ASK A10) [INTERVIEWER: IF R ANSWERS BAPTIST, EPISCOPALIAN, LUTHERAN, 97 DK (RE-ASK A10) METHODIST, MORMON, PRESBYTERIAN, OR UNITED CHURCH OF CHRIST 99 Refused (ASK A11b) CODE AS 1 (PROTESTANT) AND CODE NEXT Q ACCORDINGLY)
ASK IF PREA10=97,99 OR A11a=99 01 Protestant, (SKIP TO A14)
A11b. How old were you on your most recent birthday? 02 Catholic, (SKIP TO A15) 03 Jewish, ______(18-110 YEARS) 95 Something else:, or (ASK A13a) 96 Do you not have a religious (SKIP TO A15) preference? AGE 1 (system variable): computed age 97 DON’T KNOW 99 REFUSED
ASK OF ALL ASK IF A13=95
A13a. What is your religious preference? A12. What was the highest grade or year in school that you completed ? 01 Christian 02 7th day Adventist 01 1st Grade 12 12 th Grade 03 Jehovah Witness 02 2nd Grade 22 GED 04 Community Churches 03 3rd Grade 23 Technical/Vocational Schooling 05 Church of God Beyond High School 06 Church of God in Christ th 04 4 Grade 13 1 Year College 07 Pentecostal th 05 5 Grade 14 2 Years College 08 Unitarian th 06 6 Grade 15 3 Years College 09 Hindu th 07 7 Grade 16 4 Year College Degree 10 Islam/Muslim th 08 8 Grade 17 Graduate/professional School 11 Buddhist beyond 4 year degree 12 Shinto 09 9th Grade 96 None 10 10 th Grade 97 DON’T KNOW 95 OTHER, SPECIFY ______11 11 th Grade 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF AGE1 <=29 OR IF AGE1=MISSING A12A Are you currently a full-time student? MQA13. (System variable): Religious reference (see codebook for detail) 01 Yes 02 No 97 Don’t Know 99 Refused
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ASK IF A13=01 ASK IF A13=01-03, 95, 97
A14. What denomination is that? A16. Does your religion discourage drinking of alcoholic beverages?
01 Yes 01 BAPTIST 02 No 97 Don’t Know 02 EPISCOPALIAN 99 Refused 03 LUTHERAN TIMING MARKER 1 04 METHODIST (SKIP TO A15) TIMING SECTION 2 05 MORMON/LATTER DAY SAINTS 06 PRESBYTERIAN ASK OF ALL
07 UNITED CHURCH OF CHRIST 08 NO DENOMINATION A17. Please stop me when I get to the category that describes your present work situation. Are you: 95 OTHER (ASK A14a) [INTERVIEWER: IF MULTIPLE ANSWERS GIVEN - SELECT THE LOWEST 97 DON’T KNOW (SKIP TO A15 NUMBER] 99 REFUSED 01 Employed or self-employed full-time, 35 hours or more per week, ASK IF A14=95 02 Employed or self-employed part-time, that is, less than 35 hours per week,
A14a. What denomination is that? 03 Have a job, but not at work because of temporary illness, family leave, maternity leave or other type of leave 01 Christian 02 7th day Adventist 04 Unemployed or laid off and looking for work 03 Jehovah Witness 05 Unemployed or laid off and not looking for work 04 Community Churches 06 In school 05 Church of God 07 Retired 06 Church of God in Christ 07 Pentecostal 08 Homemaker 08 Unitarian 09 Disabled 95 OTHER, SPECIFY 10 Never worked for pay, or ______95 Something else? (SPECIFY ______) 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK OF ALL ASK IF A17 = 4 or 5
A15. How important is religion in your life? Would you say: A17BN How long have you been unemployed?:
01 Very important 1 Less than one month 02 Somewhat important 2 Two to six months 03 Not really important, or 3 7 to 12 months 04 Not at all important? 4 More than one year 97 Don’t Know 97 DON’T KNOW 99 Refused 99 REFUSED
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ASK OF ALL 97 Don’t Know 99 Refused A18C. Please stop me when I get to the category that describes your total household income ASK OF ALL from all sources in (YEAR) before taxes . A19d. Have you driven a car or any other vehicle at any time in the last twelve months?
01 $10,000 or less 01 Yes 02 No 02 More than 10,000 to 15,000 97 Don’t Know 03 More than 15,000 to 20,000 99 Refused
04 More than 20,000 to 30,000 ASK OF ALL 05 More than 30,000 to 40,000 06 More than 40,000 to 60,000 pA20. What is your height in feet and inches (or in meters and centimeters) without shoes?
07 More than 60,000 to 80,000 01 answered in feet 08 More than 80,000 to 100,000 02 answered in meters and centimeters 97 don’t know 09 More than 100,000 to 120,000 99 refused 10 More than 120,000 97 DON’T KNOW 99 REFUSED A20F (record feet and inches)(range 4-7 feet) (range 0-11 inches)
A20M (record meters and centimeters)__ ASK OF ALL (range 1-2 meters) (range 0-99 centimeters)
A19a. Have you ever had times in your life when you considered yourself homeless? [IF 97 Don’t Know NECESSARY READ: By homeless, I mean when you did not have your own place to 99 Refused stay, so you stayed in a shelter for homeless people or you slept in public places like a park or on the street or in an abandoned building or in a parked vehicle?) [READ LIST] ASK OF ALL 01 More than once 02 Once PA21. What is your weight in pounds (or in kilograms) without shoes? 03 Never 97 Don’t Know 01 answered in pounds 99 Refused 02 answered in kilograms ASK OF ALL 97 don’t know 99 refused A19b. Have you ever had times in your life when you applied for public assistance programs? [READ ONLY IF NECESSARY] 01 More than once A21p Pounds (range 50-350) 02 Once A21k Kilograms (range 34-159) 03 Never 97 Don’t Know 97 Don’t Know 99 Refused 99 Refused ASK OF ALL
A19C. Were there ever times during your childhood, that is, before the age of 18, when your family suffered from economic difficulties?
[READ ONLY IF NECESSARY]
15 01 More than once 16 02 Once
Page 03 Never Page
ASK OF ALL ASK IF A25a=01, 02, OR 03.
A23. What kind(s) of health insurance do you have? (CODE ALL THAT APPLY). A25b. Are you [or your spouse/Is your spouse] now serving in the Armed Forces? [INTERVIEWER: IF RESPONDENT GIVES A SPECIFIC PLAN NAME NOT LISTED BELOW, PROBE “Who pays for the insurance: an employer, the government, or you?” [IF A25a= 01 or 03 ] 01 Yes (self) AND CODE ACCORDINGLY] [If A25a=02 or 03] 02 Yes (spouse) 05 No (to both/either) 97 Don’t know 01 Private health insurance through an employer (your own or a 99 Refused spouse's employer, past or present); ASK IF A25a = 1, 2, or 3 02 Medicare (an insurance plan funded by Social Security for people
who are disabled or are over age 65); A25c. Did you [or your spouse/ Did your spouse] ever serve in a combat or war zone? 03 Medicaid (for example MediCal-California, HCCCS-Arizona, MediKan-Kansas); [IF A25a= 01 or 03 ] 01 Yes (self) 04 Federal Health Plans such as Champus [If A25a=02 or 03] 02 Yes (spouse) (for military personnel and families) 05 No (to both/either) or the VA (Veterans Administration); or 97 Don’t know Private health insurance or Medicare supplemental insurance that 99 Refused 05 you pay for yourself TIMING MARKER 2 06 DON’T HAVE HEALTH INSURANCE TIMING SECTION 3 95 Some other insurer? (SPECIFY______) 97 DON’T KNOW ASK OF ALL RESPONDENTS 99 REFUSED B1C. The next questions ask about your own use of various types of alcoholic beverages, such as wine, beer and spirits. Thinking about the last 12 months, how often do you usually have wine or a ASK IF A23=06 punch containing wine or wine coolers? Is it: [IF NECESSARY, ASK: “If you had to average it over the last twelve months, how often would it be?] AN23B. How long have you been without health insurance? 01 Less than one month [IF NECESSARY PROBE: "Please do not include any alcohol consumption from small tastes, sips, 02 Two to six months baking, cooking or religious ceremonies"] 03 7 to 12 months [READ LIST] 04 More than one year 97 DON’T KNOW 02 More than once a day 99 REFUSED 03 Once a day 04 Nearly every day 05 Three or four times a week ASK OF ALL 06 Once or twice a week 07 Two or three times a month A25a. Did you or your spouse—if you have one—ever serve on active duty in the US Armed 08 About once a month Forces? [If yes, was that you, your spouse, or both of you?] 09 Less than once a month but at least once a year 10 Less than once a year, or 01 Yes – Self 11 Have you never had wine? 02 Yes – Spouse 97 Don’t Know 03 Yes – Both 99 Refused 05 No (to both/either) 97 Don’t Know 99 Refused REFERENCE VARIABLE: B1C in (2,3,4,5,6,7,8,9) = WINE DRINKER
B1C in (10,11) = NON-WINE DRINKER B1C IN ( 2) = 2+ WINE OCCASIONS PER DAY
17 18 ASK OF ALL
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B2c. And how often do you usually have beer or malt liquor? If B3C in (2,3,4,5,6,7,8,9) = SPIRITS DRINKER If B3C in (10,11) = NON-SPIRITS DRINKER [IF NECESSARY, ASK: IF YOU HAD TO AVERAGE IT OVER THE LAST TWELVE MONTHS, HOW If B3C in (2) = 2+ SPIRITS OCCASIONS PER DAY OFTEN WOULD IT BE?] [IF NECESSARY PROBE: "Please do not include any alcohol consumption from small tastes, sips, ASK OF ALL baking, cooking or religious ceremonies"] [READ ONLY IF NECESSARY] B4C. Now, thinking of your overall drinking in the last 12 months, how often do you usually have any kind of beverage containing alcohol -- whether it is wine, beer, whiskey, coolers, or any other 02 More than once a day drink? Is it: (IF NECESSARY, ASK: If you had to average it over the last twelve months, how 03 Once a day often would it be?) 04 Nearly every day 05 Three or Four times a week 02 More than once a day 06 Once or twice a week 03 Once a day 07 Two or three times a month 04 Nearly every day 08 About once a month 05 Three or Four times a week 09 Less than once a month but at least once a year 06 Once or twice a week 10 Less than once a year, or 07 Two or three times a month 11 Have you never had beer? 08 About once a month 97 Don’t Know 09 Less than once a month but at least once a year 99 Refused 10 Less than once a year, or 11 Have you never had any beverage containing alcohol? REFERENCE VARIABLE: 97 Don’t Know IF B2C in (2,3,4,5,6,7,8,9) = BEER DRINKER 99 Refused If B2C in (10,11) = NON-BEER DRINKER If B2C in (2) = 2+ BEER OCCASIONS PER DAY //CATI CHECK: IF B4C > B1C OR B2C OR B3C, GIVE CHECK SCREEN: B4C_CHK I’m sorry, but previously you said that you have ASK OF ALL wine - ( b1c) B3C. And h ow often do you usually have drinks containing whiskey or any other liquor , beer or malt liquor ( b2c) including scotch, bourbon, gin, vodka, rum, and so on? whiskey ( b3c)
[IF NECESSARY, ASK: IF YOU HAD TO AVERAGE IT OVER THE LAST TWELVE MONTHS, I've now just recorded that overall you usually have any kind of alcoholic beverage [ b4c]. HOW OFTEN WOULD IT BE?] I need to correct the inconsistency . [go back to b4c and correct [IF NECESSARY PROBE: "Please do not include any alcohol consumption from small tastes, sips, baking, cooking or religious ceremonies"] [READ LIST IF NECESSARY] REFERENCE VARIABLE: If B4C in (2,3,4,5,6,7,8) = CURRENT DRINKER 02 More than once a day If B4C in (11) = ABSTAINER 03 Once a day 04 Nearly every day //IF B4C = 9,10,97,99 ASK B5.// //CURRENT DRINKERS SKIP TO B6. 05 Three or Four times a week 06 Once or twice a week B5. Think back over the last year, since (CURRENT DATE LAST YEAR). Did you have a whole drink of any alcoholic beverage like wine, beer, liquor, or cooler in these last twelve months? 07 Two or three times a month 01 Yes 08 About once a month 09 Less than once a month but at least once a year 02 No 10 Less than once a year, or 97 Don’t Know 11 Have you never had whiskey or liquor? 99 Refused 97 Don’t Know 99 Refused //IF B4C=11 OR (B4C = 97, 99 AND B5=2,97,99) ASK B5A//
19 REFERENCE VARIABLE: 20 B5A. Have you never in your whole life had a drink of alcohol, or have you drunk any alcohol in the past but not in the past year or currently?
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ASK IF B1C=02-09 01 Never in your whole life had a drink of alcohol 02 In the past but not in the past year. B7. When you drink wine , how often do you have only three or four glasses: 97 Don’t Know [READ ONLY IF NECESSARY] 99 Refused
01 Nearly every time, REFERENCE VARIABLES: 02 More than half the time, DRINKSTAT=01 (CURRENT DRINKER): 03 Less than half the time, QB4C=2-8 OR 04 Once in awhile, or (QB4C=9,10,97,99 AND QB5=1) 05 Never? DRINKSTAT=03 (EX DRINKER): 97 DON’T KNOW (QB4C=10 AND QB5=2,97,99) OR 99 REFUSED (QB4C=11 AND QB5a=2) OR (QB4C=97,99 AND QB5=2 AND QB5a=2,97,99) ASK IF B1C=02-09
DRINKSTAT=04 (ABSTAINER) B8a. When you drink wine , how often do you have only one or two glasses: //(QB4C=11 AND QB5a=1,97,99) OR [READ ONLY IF NECESSARY] (QB4C-97,99 AND QB5a=1)
DRINKSTAT = 02 (“EX OR CURRENT” DRINKERS) 01 Nearly every time, (QB4C=9 AND QB5=2,97,99) OR (QB4C=97,99 AND QB5=97,99 AND QB5a=2,97,99) 02 More than half the time, 03 Less than half the time,
04 Once in awhile, or
ASK IF B1C=02-09 05 Never? 97 DON’T KNOW B6. Think of all the times you have had wine or coolers recently. When you drink wine, how often do 99 REFUSED you have as many as five or six glasses or more:
ASK IF B2C=02-09 01 Nearly every time, 02 More than half the time, B9. Think of all the times you have had beer or malt liquor or flavored malt beverages recently. When you drink beer, how often do you have as many as five or six glasses or twelve-ounce cans or 03 Less than half the time, bottles or more: 04 Once in awhile, or [READ ONLY IF NECESSARY]
05 Never?
97 DON’T KNOW 99 REFUSED 01 Nearly every time, 02 More than half the time, 03 Less than half the time, 04 Once in awhile, or 05 Never? 97 DON’T KNOW
99 REFUSED
21 22
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ASK IF B2C=02-09
B10. When you drink beer , how often do you have only three or four glasses or twelve-ounce cans or bottles: [READ ONLY IF NECESSARY]
01 Nearly every time, 02 More than half the time, 03 Less than half the time, 04 Once in awhile, or 05 Never? 97 DON’T KNOW 99 REFUSED ASK IF B2C=02-09
B11a. When you drink beer , how often do you have only one or two glasses or 12-ounce cans or bottles? Would you say.... [READ ONLY IF NECESSARY]
01 Nearly every time, 02 More than half the time, 03 Less than half the time, 04 Once in awhile, or 05 Never? 97 DON’T KNOW 99 REFUSED ASK IF B2C=02-09
B11b. When you drink beer , about how much of the time do you drink malt liquor? Malt liquor is higher strength beer, and includes products like Old English 800 and Colt 45, etc. [READ ONLY IF NECESSARY]
01 Nearly every time, 02 More than half the time, 03 Less than half the time, 04 Once in awhile, or 05 Never? 97 DON’T KNOW 99 REFUSED
REFERENCE VARIABLE:
23 24 If B11b in (1,2,3,4) = MALT LIQUOR DRINKER Page Page
ASK IF B2C=02-09 ASK IF BN11da=95
B11D. What one BRAND AND TYPE of beer have you drunk the most in the last 12 months? B11Db. [IF NECESSARY: “Here are some examples of brands and types of beer: Budweiser Premium, Budweiser Light, Keystone Beer Type Category Examples Ice, Samuel Adams Microbrew, Corona Extra, Colt 45 Malt Liquor, or any other brand and type.”] 22 Regular (Premium & Pabst, Milwaukee Best, Old Milwaukee, Keystone Popular) [IF RESPONDENT REPORTS THAT THE BRANDS AND TYPES ARE TOO NUMEROUS 23 Malt Liquor Steel Reserve, Colt 45, St. Ides, Schlitz, Olde English 800 TO NAME, PROMPT: "Please choose a brand and type that you feel is typical of the beer you drink?"] 24 Craft/Microbrew Alaskan IPA, New Belgium Fat Tire, Widmer Hefeweizen, Red Hook, Sierra Nevada [IF RESPONDENT REPORTS BRAND BUT NO TYPE, PROBE: "What TYPE of beer is that?"] 25 Light Amstel Light, Heineken Light, Labatt Blue Light, Rolling Rock Light
[IF RESPONDENT REPORTS TYPE BUT NO BRAND, PROBE: "What BRAND of beer have 26 Ice Natural Ice, Ice House, Keystone Ice, Busch Light you drunk most often?"] 27 Import Guiness, Heineken, Fosters, Modelo, Tecate, Molson, Stella Artois, Chimay B11Da. 95 Other Smirnoff Ice 97 DON’T KNOW 01 Budweiser (Bud) 99 REFUSED 02 Budweiser Light 03 Coors Light
04 Corona 05 Corona Light ASK IF B11b = 01-04 06 Miller Light BN11g. When you drink Malt Liquor what brand do you drink most often? 07 Miller Genuine Draft (Miller, MGD) 08 Heineken 09 Michelob 01 Steel Reserve 10 Samuel Adams 02 Colt 45 11 Busch 03 St. Ides 12 Michelob Light/Ultra 04 Schlitz 13 Yuengling 05 Olde English 800 95 Other 96 Other (Malt Liquor) 97 DON’T KNOW 07 Other (Not Malt Liquor-Other Beer Type -[from last table]) 99 REFUSED
25 26 Page Page
ASK IF B3C=02-09 ASK IF B3C=02-09 BN14d. What spirits-based drink have you drunk the most in the last 12 months? Here are some B12 Think of all the times you have had drinks containing whiskey, liquor, or spirits (if BN0=3: or pre- examples of spirits-based drinks: margarita, rum and coke, martini, cosmopolitan, daiquiri, manhattan, made cocktails) recently. When you drink them, how often do you have as many as five or six drinks or or any other mixed drink. [DO NOT READ] more: [READ ONLY IF NECESSARY] 01 STRONG COCKTAILS (OR THOSE WITH 3 OR MORE SPIRITS) (EX. MARTINI, MANHATTAN, LONG ISLAND ICE TEA)
02 MARGARITA (ANY VARIATIONS) 01 Nearly every time, 03 02 More than half the time, STRAIGHT SPIRITS (EX. SHOT OR SHOOTER OF WHISKEY, GIN, COGNAC, VODKA, TEQUILA) 03 Less than half the time, 04 SPIRITS WITH ICE AND/OR WATER (EX. VODKA ON THE ROCKS, WHISKEY WITH 04 Once in awhile, or WATER) 05 Never? 05 MIXED DRINK WITH SODA OR JUICE (EX. RUM & COKE, GIN & TONIC, VODKA & OJ) 97 DON’T KNOW 99 REFUSED 06 LIQUEURS, SCHNAPPS, OR MILK/CREAM BASED SPIRITS (EX. BAILEYS, PEACH SCHNAPPS, KAHLUA, EGG NOG) ASK IF B3C=02-09 07 OTHER MIXED DRINKS (COSMOPOLITAN, DAIQUIRI, BLOODY MARY, MOJITO) 97 DON’T KNOW
B13 When you drink drinks containing whiskey, liquor, or spirits how often do you have only three or 99 REFUSED four drinks: [READ ONLY IF NECESSARY] ASK IF B3C=02-09
01 Nearly every time, BNC14e. When pouring a drink, do you use a jigger, shot glass or other measuring device to 02 More than half the time, measure the spirits?
03 Less than half the time, 01 Yes (SKIPTO B15) 04 Once in awhile, or 02 No 03 Don’t make my own drinks (SKIPTO B15) 05 Never?
97 DON’T KNOW 97 Don’t Know 99 REFUSED 99 Refused
ASK IF BNC14e=02, 97, 99 AND B3C=02-09 ASK IF B3C=02-09 BNC14f. Do you pour your spirits into an empty glass, or over ice, or on top of a mixer? B14 When you drink drinks containing whiskey, liquor, or spirits how often do you have only one or two drinks: [READ ONLY IF NECESSARY]
01 Into empty glass 01 Nearly every time, 02 Over Ice 02 More than half the time, 03 Pour into or on top of mixer 03 Less than half the time, 95 Other 04 Once in awhile, or 97 DON’T KNOW 05
Never? 99 REFUSED 97 DON’T KNOW TIMING MARKER 3 27 99 REFUSED 28 TIMING SECTION 4
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12 drinks = 12 cans of beer 3 drinks = 3 cans of beer ASK IF CURRENT DRINKER 4-1/4 quarts of beer 1 quart of beer B15. Think of all kinds of alcoholic beverages combined , that is, any combination of bottles or cans of 2-1/2 regular-size bottles of 1/2 bottle of wine beer, glasses of wine, drinks containing liquor of any kind, or coolers, flavored malt beverages or pre- wine made cocktails. In this question, 1 drink is equal to a 12 ounce bottle or can of beer or cooler, a five 1/2 gallon of wine 1/3 of a pint of liquor ounce glass of wine, or a 1 shot of liquor (1.5 ounces) . During the last 12 months , what is the largest number of drinks you had on any single day? Was it: 3/4 of a regular bottle of liquor
01 24 or more drinks in a single day 02 12 to 23 drinks in a single day 8 drinks = 8 cans of beer 1 drink = 1 12oz. can or bottle of beer 03 At least 8, but less than 12 drinks 1 5oz. glass of wine 04 5, 6, or 7 drinks 3 quarts of beer 05 4 drinks 1-3/5 bottles of wine 1 mixed drink with 1 shot liquor 06 3 drinks 07 2 drinks 1/2 of a regular bottle of 08 1 drinks liquor 97 Don’t Know 99 Refused One 12 oz. bottle of wine cooler equals one drink. ASK IF ”EX OR CURRENT” DRINKERS
B15A. Think of all kinds of alcoholic beverages combined , that is, any combination of bottles or cans of REFERENCE VARIABLE FOR DEFINITION OF ”EX OR CURRENT” DRINKERS: beer, glasses of wine, drinks containing liquor of any kind, or coolers, flavored malt beverages or pre- made cocktails. In this question, 1 drink is equal to a 12 ounce bottle or can of beer or cooler, a five DRNKSTAT (System variable): FOR ALL ”EX OR CURRENT” DRINKERS ounce glass of wine, or a 1 shot of liquor (1.5 ounces) . During the last 12 months , what is the largest number of drinks you had on any single day? Was it: 1) IF (QB1C OR QB2C OR QB3C) = 2-8: ASSIGN CURRENT [If inconsistency between beverage specifics and “all beverages” have been solved, this could be a null category] 01 24 or more drinks in a single day 02 12 to 23 drinks in a single day 2) IF (QB15A) = 1-8: ASSIGN CURRENT 03 At least 8, but less than 12 drinks 04 5, 6, or 7 drinks 3) IF (QB1C AND QB2C AND QB3C) = 9-11,97,99 AND (QB15A) = 9, 97,99: ASSIGN EX DRINKER 05 4 drinks 06 3 drinks 07 2 drinks 08 1 drinks ASK IF B15=01 OR 02, 97, 99 or b15a=01 OR 02, 97, 99 09 Or have you never in the last 12 months had any beverage containing alcohol? B16. During the last 12 months, how often did you have 12 or more drinks of any kind of alcoholic 97 Don’t Know beverage (in a single day), (ASK ONLY FIRST TIME: that is, any combination of bottles or cans of beer 99 Refused or cooler, glasses of wine, drinks containing liquor of any kind? Was it: (READ LIST)
01 Every day or nearly every day 02 Three to four times a week 03 Once or twice a week DO NOT READ. FOR REFERENCE ONLY -Revised by WCK: 8-11-08 .) 04 Once to three times a month 05 Less than once a month QUANTITY OF DRINK EQUIVALENCES 06 Once in those 12 months 24 drinks = 24 cans of beer 5 drinks = 5 cans of beer 07 Never in those 12 months 97 DON’T KNOW 9 quarts of beer 1-3/4 quarts of beer 99 REFUSED
5 regular-size bottles of wine 1 bottle of wine 1-1/2 regular bottles of liquor 1/3 of a regular bottle of liquor 29 30 ASK IF B15=01-03, 97,99 or B15a=01-03, 97,99 ½ a pint of liquor Page Page
B17. During the last 12 months, how often did you have at least eight, but less than 12 drinks of any ASK IF B15=05-07, 97, 99 or B15a=05-07, 97, 99 kind of alcoholic beverage (in a single day), (READ ONLY FIRST TIME: that is, any combination of BC20a. During the last 12 months, how often did you have two drinks but no more than 2 drinks of any bottles or cans of beer or cooler, glasses of wine, or drinks containing liquor of any kind)? Was it: kind of alcoholic beverage (in a single day), (READ ONLY FIRST TIME: that is, any combination of [READ ONLY IF NECESSARY] bottles or cans of beer or cooler, glasses of wine, or drinks containing liquor of any kind)? Was it: [READ ONLY IF NECESSARY]
01 Every day or nearly every day 02 Three to four times a week 01 Every day or nearly every day 03 Once or twice a week 02 Three to four times a week 04 Once to three times a month 03 Once or twice a week 05 Less than once a month 04 Once to three times a month 06 Once in those 12 months 05 Less than once a month 07 Never in those 12 months 06 Once in those 12 months 97 DON’T KNOW 07 Never in those 12 months 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF B15=01-04, 97,99 OR B15a=01-04, 97,99 ASK IF B15=05-08, 97, 99 or B15a=05-08, 97, 99 B18. During the last 12 months, how often did you have five, six, or seven but no more than 7 drinks of any kind of alcoholic beverage (in a single day) (READ ONLY FIRST TIME: that is, any combination of BC20b. During the last 12 months, how often did you have one drink , but no more than one drink of bottles or cans of beer or cooler, glasses of wine, or drinks containing liquor of any kind)? Was it: any kind of alcoholic beverage (in a single day), (READ ONLY FIRST TIME: that is, a bottle or can of [READ ONLY IF NECESSARY] beer or cooler, glass of wine, or drink containing liquor of any kind)? Was it: [READ ONLY IF NECESSARY]
01 Every day or nearly every day 01 Every day or nearly every day 02 Three to four times a week 02 Three to four times a week 03 Once or twice a week 03 Once or twice a week 04 Once to three times a month 04 Once to three times a month 05 Less than once a month 05 Less than once a month 06 Once in those 12 months 06 Once in those 12 months 07 Never in those 12 months 07 Never in those 12 months 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF B15=01- 06, 97, 99 or B15a=01- 06, 97, 99 ASK IF B15=01-04 or B15a=01-04 B19. During the last 12 months, how often did you have either three drinks or four drinks but no more BC20c. During the last 12 months, how often did you have either one drink or two drinks , but no more than 4 drinks of any kind of alcoholic beverage (in a single day), (READ ONLY FIRST TIME: that is, any than 2 drinks of any kind of alcoholic beverage (in a single day)? (READ ONLY FIRST TIME: that is, combination of bottles or cans of beer or cooler, glasses of wine, or drinks containing liquor of any any combination of bottles or cans of beer or cooler, glasses of wine, or drinks containing liquor of any kind)? Was it: [READ ONLY IF NECESSARY] kind)? Was it: [READ ONLY IF NECESSARY]
01 Every day or nearly every day 01 Every day or nearly every day 02 Three to four times a week 02 Three to four times a week 03 Once or twice a week 03 Once or twice a week 04 Once to three times a month 04 Once to three times a month 05 Less than once a month 05 Less than once a month 06 Once in those 12 months 06 Once in those 12 months 07 Never in those 12 months 07 Never in those 12 months 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED 31 32 Page Page
ASK OF CURRENT DRINKER 97 DON’T KNOW 99 REFUSED BN20D_1 How many drinks of an alcoholic beverage did you have yesterday? [IF A19d = 01 AND CURRENT AND [ B15 = 1-7, 97,99 OR B15A = 1-7,97,99] ______[RANGE: 0-96]
97 DON’T KNOW 99 REFUSED B23. In the last twelve months, have you driven a car when you had drunk enough to be in trouble if the police had stopped you? ASK IF BN20D_1=97, 99 01 Yes BN20D_2. Was it: 02 No (SKIP TO B25) [IF NECESSARY: “How many drinks of an alcoholic beverage did you have 97 DON’T KNOW (SKIP TO B25) yesterday?”] 99 REFUSED (SKIP TO B25) 01 12 or more drinks 02 Between 8 and 11 drinks ASK IF B23=01 03 Between 5 and 7 drinks 04 Four drinks B24. How many times has that happened in the last twelve months? 05 Three drinks 06 Two drinks ______NUMBER OF TIMES (96= 96 OR MORE) 07 One drink [RANGE: 1-96] 96 None 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK OF CURRENT DRINKER AND [ B15 = 1-7, 97,99 OR B15A = 1-7,97,99] ASK IF A19d=01 AND CURRENT AND [ B15 = 1-7, 97,99 OR B15A = 1-7,97,99]
B21. How often in the last twelve months did you drink enough to feel drunk? (IF NEEDED, READ: Would you say:) B25. About how many drinks do you think you can have, over a two hour period, before your ability to drive becomes impaired? By impaired we mean you had too much to drink to drive safely.
01 EVERY DAY OR NEARLY EVERY DAY ______NUMBER OF DRINKS (96= 96 OR MORE) [RANGE: 1-96] 02 THREE TO FOUR TIMES A WEEK
03 ONCE OR TWICE A WEEK 97 DON’T KNOW 04 ONCE TO THREE TIMES A MONTH 99 REFUSED
05 SEVEN TO ELEVEN TIMES IN THE LAST 12 MONTHS ASK IF CURRENT DRINKER 06 THREE TO SIX TIMES IN THE LAST 12 MONTHS 07 TWICE IN THE LAST 12 MONTHS B26. Over the last 30 days, have you spent any money on beverages containing alcohol, either for yourself or for others? 08 ONCE IN THE LAST 12 MONTHS [IF NECESSARY: “This includes purchases made for yourself and others”] 09 NEVER IN THE LAST 12 MONTHS [INTERVIEWER: Round to nearest dollar. If cent amount is 0.49 or less round down, if cent 97 DON’T KNOW amount .50 or higher round up to nearest dollar.] 99 REFUSED 01 YES (ASK B26a) 02 NO (SKIP TO B27) ASK IF B21=01-08 97 DON’T KNOW (SKIP TO B27) B22. How many drinks does it take you to feel drunk? 99 REFUSED (SKIP TO B27)
33 ______NUMBER OF DRINKS [RANGE: 1-96] 34 [IF EX-DRINKER SKIP TO B27] Page Page
03 Half, ASK IF B26=01 04 Less than 1/2, or B26A. Over the last thirty days, what would you say was the total amount you spent on beer which you or others drank? Please include any purchases you may have made at beer, liquor, or 05 None or almost none? convenience stores; restaurants; bars; and sporting or cultural events. 97 DON’T KNOW
______DOLLARS [RANGE: 0-99996] 99 REFUSED
99997 DON’T KNOW ASK CURRENT AND EX DRINKERS 99999 REFUSED B31. About how old were you when you first started drinking alcoholic beverages, not including small ASK IF B26=01 tastes? B26B. How about on wine? ______AGE [RANGE: 0-96] ______DOLLARS [RANGE: 0-99996] 97 DON’T KNOW 99997 DON’T KNOW 99 REFUSED 99999 REFUSED ASK CURRENT AND EX DRINKERS ASK IF B26=01 DON’T B26C. How about on liquor? B30. What is the largest number of drinks you can recall ever drinking at any one time? (IF KNOW , ASK: Was it five or more?) ______DOLLARS [RANGE: 0-99996] ______NUMBER OF DRINKS [RANGE: 0-93] 99997 DON’T KNOW 99999 REFUSED 95 DON’T KNOW: FIVE OR MORE 94 DON’T KNOW: FOUR OR LESS ASK IF CURRENT OR EX-DRINKER 99 REFUSED
B27. (IF DRINKING STATUS IS EX-DRINKER, OR IF RESPONDENT ONLY REPORTED 1 ASK CURRENT AND EX DRINKERS AND DRINK ON 1 OCCASION IN THE PAST YEAR [B15=8 OR B15A=8 AND BC20B=6]USE PAST TENSE.) //ask if [Female (A1=2) and B30>1] OR [ Male (A1=1) and B30>2 If [B15=8 OR B15A=8 AND BC20B=6] insert “In the past, “ BN30B. We would like to know your ages at the beginning and end of the period in your life when On those days when you (drink/drank) wine, beer, or hard liquor, how many drinks (did/do) you usually you were drinking most heavily. have per day? About what age would you say you were when the period of heaviest drinking began?
[IF NECESSARY: “We are interested in the MOST RECENT drinking pattern.”] INTERVIEWER: If Necessary: When was the time period in your life when you were drinking relatively more drinks on each occasion than any other time period’ ______NUMBER OF DRINKS (96= 96 OR MORE) [RANGE: 1-96] ______AGE WHEN HEAVIEST BEGAN [RANGE: 10-96]
97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 98 UNDER 10 YEARS OLD 99 REFUSED ASK CURRENT AND EX DRINKERS AND ASK IF CURRENT OR EX-DRINKER //ask if [Female (A1=2) and B30>1] OR [ Male (A1=1) and B30>2//
B29. If [B15=8 OR B15A=8 AND BC20B=6] insert “In the past, “ BN30C. ... and about how old were you when it ended? Approximately how much of your drinking (occurs/occurred) during meals? Would you say:
[INTERVIEWER: IF HEAVIEST DRINKING PERIOD HAS NOT ENDED, ENTER CURRENT AGE]
35 01 All or almost all, 36 ______AGE WHEN HEAVIEST ENDED [RANGE: 10-96] 02 More than 1/2, Page Page
05 Never? 97 DON’T KNOW 97 DON’T KNOW 98 UNDER 10 YEARS OLD 99 REFUSED
99 REFUSED ASK IF (B31 ≤ 49 OR B31=97,99) AND ( 40 ≤ AGE1 ≤ 99 or missing) AND[ b30 = 5-93, 95,98,99 ]
B32D You said you were (AGE STARTED DRINKING) when you first started drinking alcoholic ASK IF B31 ≤ 19 OR B31=97,99 AND[b30 = 5-93, 95,98,99 ] beverages, not including small tastes. B32A You said you were (AGE STARTED DRINKING) when you first started drinking alcoholic How often (do/did) you have five or more drinks on one occasion during your [40’s]? : beverages, not including small tastes. [READ ONLY IF NECESSARY] How often (do/did) you have five or more drinks on one occasion during your [TEENS]? : Is it/Was it: Is it/Was it:
01 Every day or nearly every day, 01 Every day or nearly every day, 02 At least once a week, 02 At least once a week, 03 At least once a month [but less than 1/week] 03 At least once a month [but less than 1/week] 04 At least once a year [but less than 1/month] or, 04 At least once a year [but less than 1/month] or, 05 Never? 05 Never? 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF (B31 ≤ 29 OR B31=97,99) AND ( 20 ≤ AGE1 ≤ 99 or missing) AND[ b30 = 5-93, 95,98,99 ]
B32B You said you were (AGE STARTED DRINKING) when you first started drinking alcoholic beverages, not including small tastes. How often (do/did) you have five or more drinks on one occasion during your [20’s]? : [READ ONLY IF NECESSARY]
Is it/Was it:
01 Every day or nearly every day, 02 At least once a week, 03 At least once a month [but less than 1/week] 04 At least once a year [but less than 1/month] or, 05 Never? 97 DON’T KNOW 99 REFUSED
ASK IF (B31 ≤ 39 OR B31=97,99) AND ( 30 ≤ AGE1 ≤ 99 or missing) AND[ b30 = 5-93, 95,98,99
B32C You said you were (AGE STARTED DRINKING) when you first started drinking alcoholic beverages, not including small tastes. How often (do/did) you have five or more drinks on one occasion during your [30’s]? : [READ ONLY IF NECESSARY]
Is it/Was it:
01 Every day or nearly every day, 02 At least once a week, 37 03 At least once a month [but less than 1/week] 38 04 At least once a year [but less than 1/month] or, Page Page
IF D2A=01 and CURRENT DRINKER ASK ASK IF [(B15=01-06, 97.99) OR (B15A=01-06, 97.99)] AND ((B30>=05 or B30 = 95 ) AND A1=01) OR D2B. Was that during the last 12 months? ((B30>=04 or B30 = 95) AND a1=02)) 01 Yes 02 No 97 DON’T KNOW B34. During the last twelve months , how many times have you had (FOR WOMEN) four or more 99 REFUSED (FOR MEN) five or more drinks of any alcoholic beverages in one day? ______NUMBER OF TIMES [RANGE: 000-996] ASK CURRENT AND EX DRINKERS 997 DON’T KNOW D3A. (Thinking of your entire lifetime) Was there ever a time when you felt your drinking had… 999 REFUSED a harmful effect on your home life or marriage? 01 Yes ASK IF B34=997 02 No 97 DON’T KNOW B35C. Was it: ? 99 REFUSED
IF D3A=01 and CURRENT DRINKER ASK 0 Zero times, D3B. Was that during the last 12 months? 01 1 to 2 times, 01 Yes 02 3 to 11 times, 02 No 97 DON’T KNOW 03 12 to 50 times, or 99 REFUSED 04 More than 50 times? 97 DON’T KNOW ASK CURRENT AND EX DRINKERS 99 REFUSED D4A. (Thinking of your entire lifetime) Was there ever a time when you felt your drinking had a harmful effect on your financial position? TIMING MARKER 4 01 Yes TIMING SECTION 5 02 No 97 DON’T KNOW
99 REFUSED ASK CURRENT AND EX DRINKERS
D1A. Now thinking of your entire lifetime, was there ever a time when you felt your drinking had a IF D4A=01 and CURRENT DRINKER ASK harmful effect on your friendships and social life? D4B. Was that during the last 12 months? 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
IF D1A=01 and CURRENT DRINKER ASK ASK CURRENT AND EX DRINKERS D1B. Was that during the last 12 months? D5A. (Thinking of your entire lifetime) Was there ever a time when you felt your drinking had 01 Yes a harmful effect on your work and employment opportunities? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW
99 REFUSED ASK CURRENT AND EX DRINKERS
D2A. Thinking of your entire lifetime, was there ever a time when you felt your drinking had….. IF D5A=01 and CURRENT DRINKER ASK D5B. Was that during the last 12 months? a harmful effect on your outlook on life? 01 Yes
01 Yes 02 No 02 No 97 DON’T KNOW 39 97 DON’T KNOW 40 99 REFUSED 99 REFUSED
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ASK CURRENT AND EX DRINKERS ASK IF D8=01 D6A. (Thinking of your entire lifetime) Was there ever a time when you felt your drinking had D10C. About how much would you say this health problem [or these health problems, taken a harmful effect on your health? together] cost either you or an insurance company? Would you say: 01 Yes (IF NEEDED, SAY: Please think only about financial costs due to your own health problems .) 02 No 97 DON’T KNOW 01 Under $1,000 99 REFUSED 02 More than $1000 but less than $10,000 IF D6A=01 and CURRENT DRINKER ASK 03 D6B. Was that during the last 12 months? More than $10,000 but Under $50,000 01 Yes 04 More than $50,000 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF D6a=01
ASK IF D6A=01 D7C. What was the most serious or worrisome harmful effect on your health? (READ LIST) DN12. About what age were you when you think your drinking FIRST had a
harmful effect on your health? 01 Internal effects on your liver, gastro-intestinal system, heart, or blood; ___age 02 An accident or injury that happened while you were drinking or still feeling the effects; 997 DON’T KNOW 999 REFUSED 03 Being sick to your stomach or hungover during or after drinking;
04 Feeling depressed, anxious, or experiencing some other mental health problem; 05 Feeling bad physically, rundown, or often ill; ASK IF D6b=01
06 Having alertness or sleep problems; or D11. Do you think your health is still being affected? 07 Having migraines or serious headaches 01 Yes 95 Something else? 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF D6a=1 AND D11 ≠1 IF D7C=95 D13C. Thinking back, for about how long do you think your drinking had a harmful effect on your D7Co: (SPECIFY): ______health? (IF R MENTIONS A HARMFUL EFFECT AT DIFFERENT TIMES IN LIFE, SAY: Altogether,
for about how long?) ASK IF D6a=01
D8. Did you see a doctor or another health professional about the problem or problems? 01 10 years or more, 01 Yes 02 5 to 9 years, 02 No (SKIP TO PREDN12) 03 1 to 4 years, 97 DON’T KNOW (SKIP TO PREDN12) 99 REFUSED (SKIP TO PREDN12) 97 DON’T KNOW 99 REFUSED ASK IF D8=01 ASK OF ALL D9. About how many visits did you make?
______NUMBER OF VISITS [RANGE: 1-996] AN25. How would you describe your current level of exercise or physical activity?
997 DON’T KNOW 01 Vigorous or heavy such as running, swimming, hiking, or biking uphill 41 999 REFUSED 42 02 Moderate such as walking briskly, biking in level areas or weight lifting 03 Light such as walking or stretching, or light housework
Page Page 95 Other
97 DON’T KNOW ASK IF AN25=95 99 REFUSED AN25o. IF NECESSARY: How would you describe your current level of exercise or physical activity? 01 No exercise 02 Very little exercise 03 Disabled 95 Other 97 DON’T KNOW 99 REFUSED
ASK IF AN25=01-03OR AN25o=02, 95 AN26. How frequently do you engage in these activities for at least 30 minutes on an occasion? 01 Every day 02 5-6 times per week 03 3-4 times per week 04 1-2 times per week 05 1-3 times per month 06 Less than once a month or never 97 DON’T KNOW 99 REFUSED
ASK OF ALL AN26A. In the past 12 months have you taken multivitamin supplements on a regular basis, that is, every day or nearly every day? 01 Yes 02 No 97 DON’T KNOW 99 REFUSED
ASK OF ALL
AN27. Now I have some questions about your general health and how you feel most of the time. Would you say your health in general is excellent, very good, good, fair or poor?
01 Excellent 02 Very Good 03 Good 04 Fair 05 Poor 97 DON’T KNOW 99 REFUSED
ASK OF ALL AN30A. Have you ever been told by a doctor or other health professional that you had hypertension, also called high blood pressure ?
01 Yes 02 No
43 44 97 DON’T KNOW 99 REFUSED
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ASK OF ALL AN31A. At what age were you first told? AN30I. (Have you ever been told by a doctor or other health professional that) you had a stroke? ______AGE [RANGE 0-96] 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK OF ALL AN30E. (Have you ever been told by a doctor or other health professional that ) ASK IF AN30I=1 AN31I. At what age were you first told? you had any heart or coronary problem? 01 Yes ______AGE [RANGE 0-96] 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED ASK OF ALL ASK IF AN30E=1 AN30J. (Have you ever been told by a doctor or other health professional that) AN31E. At what age were you first told? you had cancer? 01 Yes ______AGE [RANGE 0-96] 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK OF ALL ASK IF AN30J=1 AN30G. (Have you ever been told by a doctor or other health professional that ) AN31J. At what age were you first told? you had diabetes? 01 Yes ______AGE [RANGE 0-96] 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED ASK OF ALL ASK IF AN30G=1 AN31G. At what age were you first told? READ TO ALL
______AGE [RANGE 0-96] PreD14. The next few questions concern your experiences with other people’s drinking problems. 97 DON’T KNOW D14. When you were growing up, that is, during your first 18 years, did you live with anyone who 99 REFUSED was a problem drinker or an alcoholic?
ASK OF ALL 01 Yes AN30H. (Have you ever been told by a doctor or other health professional that ) 02 No you had injuries from a serious accident? 97 DON’T KNOW 01 Yes 99 REFUSED 02 No 97 DON’T KNOW 99 REFUSED
ASK IF AN30H=1 AN31H. At what age were you first told?
______AGE [RANGE 0-96] 97 DON’T KNOW 45 99 REFUSED 46
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ASK IF D14=1 ASK OF ALL
DC20. D15. Who was this? (CODE ALL THAT APPLY) [IF D15-D17 QUESTIONS ASKED SAY: Not including those you may have already mentioned, [OTHERWISE, IF SKIPPED TO HERE SAY:] have any of your (other) blood relatives ever 01 MOTHER been a problem drinker or an alcoholic?
02 FATHER 01 Yes 03 SISTER 02 No 97 DON’T KNOW 04 BROTHER 99 REFUSED
05 GRANDMOTHER ASK IF DC20=01 06 GRANDFATHER D21. Which blood relatives have been problem drinkers or alcoholics? (CODE ALL THAT APPLY) 07 AUNT
08 UNCLE 01 BIOLOGICAL MOTHER
09 COUSIN 02 BIOLOGICAL FATHER
10 OTHER BLOOD RELATIVE 03 FULL SISTER
11 NON -RELATIVE 04 HALF SISTER 97 DON’T KNOW 99 REFUSED 05 FULL BROTHER ASK IF D15 = 01 06 HALF BROTHER
D16. Was the mother that you mentioned your: (CODE ALL THAT APPLY) 07 GRANDMOTHER 08 GRANDFATHER
01 Biological (natural) mother, 09 AUNT
02 Adoptive mother, 10 UNCLE
03 Step-mother, or your 11 COUSIN
04 Foster mother? 12 OTHER BLOOD RELATIVE 97 DON’T KNOW 99 REFUSED 97 DON’T KNOW ASK IF D15=02 99 REFUSED
D17. Was the father that you mentioned your: (CODE ALL THAT APPLY) ASK OF ALL D22A. Have you ever had family problems or marriage difficulties due to someone else’s drinking? 01 Biological (natural) father, 02 Adoptive father, 01 Yes 02 No 03 Step-father, or your 97 DON’T KNOW 99 REFUSED 04 Foster father? 97 DON’T KNOW 99 REFUSED
47 48 Page Page
ASK IF D22A=1 ASK IF D26A=1 D22B. Has that happened during the last twelve months? D26B. Has that happened during the last twelve months? 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED ASK OF ALL D23A. Have you ever been a passenger with a driver who had too much to drink? ASK OF ALL 01 Yes D27A. Have you ever had your property vandalized by someone who had been drinking? 02 No 97 DON’T KNOW 01 Yes 99 REFUSED 02 No ASK IF D23A=1 97 DON’T KNOW D23B. Has that happened during the last twelve months? 99 REFUSED 01 Yes ASK IF D26A=1 02 No D27B. Has that happened during the last twelve months? 97 DON’T KNOW 01 Yes 99 REFUSED 02 No 97 DON’T KNOW ASK OF ALL 99 REFUSED D24A. Have you ever been in a motor vehicle accident because of someone else’s drinking? ASK OF ALL 01 Yes D30NA. Have you ever been concerned that another person had an alcohol problem? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW ASK IF D24A=1 99 REFUSED D24B. Has that happened during the last twelve months? ASK IF D30NA=1 01 Yes D30NB. Has that happened during the last twelve months? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK OF ALL D25A. Have you ever been pushed, hit or assaulted by someone who had been drinking? 01 Yes ASK OF ALL 02 No D28A. Have you ever suggested that another person seek help for an alcohol problem? 97 DON’T KNOW 01 Yes 99 REFUSED 02 No ASK IF D25A=1 97 DON’T KNOW D25B. Has that happened during the last twelve months? 99 REFUSED 01 Yes ASK IF D28A=1 02 No D28B. Has that happened during the last twelve months? 97 DON’T KNOW 01 Yes 99 REFUSED 02 No 97 DON’T KNOW ASK OF ALL 99 REFUSED D26A. Have you ever had financial trouble because of someone else’s drinking? 01 Yes ASK OF ALL
02 No D29A. Have you assisted another person with getting help for an alcohol problem? 97 DON’T KNOW 01 Yes
49 99 REFUSED 50 02 No 97 DON’T KNOW
Page Page 99 REFUSED
ASK IF D29A=1 ASK IF CURRENT DRINKER AND (A17=01 OR 02) AND D32=1-365 D29B. Has that happened during the last twelve months? D33. How many of those (NUMBER FROM D32) days, when you were late for work, were due to 01 Yes your use of alcohol? 02 No ______NUMBER OF DAYS [RANGE 0-ANSWER TO D32] 97 DON’T KNOW 997 DON’T KNOW 99 REFUSED 999 REFUSED
ASK IF D30N=1 OR D28=1 OR D29=1 TIMING MARKER 5 D31NA Have you been to an Al-Anon meeting about another person's alcohol problem? TIMING SECTION 6 01 Yes 02 No ASK IF CURRENT OR EX-DRINKER 97 DON’T KNOW 99 REFUSED ETEXT Here are some experiences that many people have reported in connection with drinking. As I ASK IF D31NA=1 read each item, please tell me if this has ever happened to you. D31NB. Has that happened during the last twelve months? 01 Yes ASK IF CURRENT OR EX DRINKER 02 No E9a. I have gotten into a heated argument while drinking. Has this ever happened to you? 97 DON’T KNOW 01 Yes 99 REFUSED 02 No
97 DON’T KNOW ASK OF ALL 99 REFUSED D30. The next questions refer to things you normally do on a day-to-day basis, including your work and leisure activities. ASK IF E9A=1 AND CURRENT DRINKER How many days out of the last twelve months were you totally unable to work or carry out your normal E9B. Did this happen in the last twelve months? activities for any reason? 01 Yes 02 No ______NUMBER OF DAYS [RANGE 0-365] 97 DON’T KNOW 997 DON’T KNOW 99 REFUSED 999 REFUSED ASK IF CURRENT OR EX DRINKER ASK IF CURRENT DRINKER AND D30=1-365 E10a. I have gotten into a fight while drinking. Has this ever happened to you? D31. How many of those (NUMBER FROM D30) days, when you were totally unable to work or 01 Yes carry out your normal activities, were due to your use of alcohol? 02 No 97 DON’T KNOW 99 REFUSED ______NUMBER OF DAYS [RANGE 0-ANSWER TO D30] 997 DON’T KNOW ASK IF E10A=1 AND CURRENT DRINKER 999 REFUSED E10B. Did this happen in the last twelve months? 01 Yes ASK IF A17 = 01 OR 02 02 No 97 DON’T KNOW D32. How many days out of the last twelve months were you late more than an hour for work for 99 REFUSED any reason? ASK IF CURRENT OR EX DRINKER ______NUMBER OF DAYS [RANGE 0-365] E11a. A police officer questioned or warned me because of my drinking. (Has this ever happened 997 DON’T KNOW to you?) 999 REFUSED 01 Yes 02 No 97 DON’T KNOW 99 REFUSED 51 52 Page Page
ASK IF E11A=1 AND CURRENT DRINKER E11B. Did this happen in the last twelve months? 01 Yes DEFINITION OF LIGHT DRINKER: 02 No 97 DON’T KNOW SKIP to I1 if “LIGHT DRINKER”, if: //NEW DEFINITION 3/2409 99 REFUSED ASK IF CURRENT OR EX DRINKER B6 in (05,97.) AND B9 in (05, 97.) AND B12 in (05,97 .) AND E28a. I sometimes kept on drinking after I had promised myself not to. (Has this ever happened [(B15 in 05, 06, 07, 08, 97.) . AND (B15A in 05, 06, 07, 08, 09, 97.)] AND to you?) B27 in (01, 02, 03, 04,97) AND (B30 in (01, 02, 03, 04, 94) AND 01 Yes B32a in (05, 97.) AND B32b in (05,97 .) AND B32c in (05, 97.) AND B32d in (05,97 .) AND 02 No D1A = 02,97 AND D2A= 02, 97 AND D3A= 02,97 AND D4A= 02,97 AND D5A= 02, 97 AND D6A = 02, 97 DON’T KNOW 97 AND 99 REFUSED E9A= 02,97 AND E10A= 02, 97 AND E11A = 02, 97 AND E28A = 02, 97 AND F3A = 02, 97 AND F5A= 02,97 ASK IF E28A=1 AND CURRENT DRINKER E28B. Did this happen in the last twelve months? 01 Yes [At this point, if the individuals who met all the other criteria for the screen and have answered 02 to 02 No these above six items, then get skipped to I1. This will include the light and non-problematic current 97 DON’T KNOW and ex-drinkers. You can seamlessly continue everyone else] 99 REFUSED
ASK IF CURRENT OR EX DRINKER ASK IF CURRENT OR EX DRINKER NOT LABELED AS “LIGHT DRINKER” F3a. I was sick or vomited after drinking or the morning after drinking. (Has this ever happened to you?) E1a. I have skipped a number of regular meals while drinking . (Has this ever happened to you?) 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF F3A=1 AND CURRENT DRINKER ASK IF E1A=1 AND CURRENT DRINKER F3B. Did this happen in the last twelve months? E1B. Did this happen in the last twelve months? 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF CURRENT OR EX DRINKER ASK IF CURRENT OR EX DRINKER NOT LABELED AS “LIGHT DRINKER” F5a. I found that the same amount of drinking had much less effect than it used to . (Has this
ever happened to you?) E2a. I have often taken a drink the first thing when I got up in the morning. (Has this ever 01 Yes happened to you?) 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW
99 REFUSED ASK IF F5A=1 AND CURRENT DRINKER
F5B. Did this happen in the last twelve months? ASK IF E2A=1 AND CURRENT DRINKER 01 Yes E2B. Did this happen in the last twelve months? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED 53 54
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ASK IF CURRENT OR EX DRINKER NOT LABELED AS “LIGHT DRINKER” E3a. I have taken a strong drink in the morning to get over the effects of last night’s drinking. ASK IF E7A=1 AND CURRENT DRINKER (Has this ever happened to you?) E7B. Did this happen in the last twelve months? 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF E3A=1 AND CURRENT DRINKER ASK IF CURRENT OR EX DRINKER NOT LABELED AS “LIGHT DRINKER” E3B. Did this happen in the last twelve months? E8a. Sometimes I have awakened during the night or early morning sweating all over because 01 Yes of drinking. (Has this ever happened to you?) 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF CURRENT OR EX DRINKER NOT LABELED AS “LIGHT DRINKER” E4a. My hands shook a lot the morning after drinking. (Has this ever happened to you?) ASK IF E8A=1 AND CURRENT DRINKER 01 Yes E8B. Did this happen in the last twelve months? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF E4A=1 AND CURRENT DRINKER E4B. Did this happen in the last twelve months? ASK IF CURRENT OR EX DRINKER NOT LABELED AS “LIGHT DRINKER” 01 Yes E12a. My drinking contributed to getting involved in an accident in which someone else was 02 No hurt, or property, such as a car, was damaged. (Has this ever happened to you?) 97 DON’T KNOW 01 Yes 99 REFUSED 02 No 97 DON’T KNOW 99 REFUSED
ASK IF CURRENT OR EX DRINKER NOT LABELED AS “LIGHT DRINKER” ASK IF E12A=1 AND CURRENT DRINKER E6a. My drinking has interfered with my spare time activities or hobbies. (Has this ever E12B. Did this happen in the last twelve months? happened to you?) 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF E6A=1 AND CURRENT DRINKER E6B. Did this happen in the last twelve months? 01 Yes 02 No 97 DON’T KNOW 99 REFUSED
ASK IF CURRENT OR EX DRINKER NOT LABELED AS “LIGHT DRINKER” E7a. Sometimes I have needed a drink so badly that I couldn’t think of anything else. (Has this ever happened to you?)
01 Yes
55 02 No 56 97 DON’T KNOW
Page 99 REFUSED Page
ASK IF CURRENT OR EX DRINKER NOT LABELED AS “LIGHT DRINKER” ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” E13a. My drinking contributed to getting hurt in an accident in a car or elsewhere. (Has this ever happened to you?) E16a. I stayed intoxicated for several days at a time. (Has this ever happened to you?) 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF E13A=1 AND CURRENT DRINKER ASK IF E16A=1 AND CURRENT DRINKER E13B. Did this happen in the last twelve months? E16B. Did this happen in the last twelve months? 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” E14a. I had trouble with the law about drinking when driving was not involved. (Has this ever happened to you?) E17a. Once I started drinking it was difficult for me to stop before I became completely 01 Yes intoxicated. (Has this ever happened to you?) 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF E14A=1 AND CURRENT DRINKER E14B. Did this happen in the last twelve months? ASK IF E17A=1 AND CURRENT DRINKER 01 Yes E17B. Did this happen in the last twelve months? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED
ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER”
E15a. I have been arrested for driving after drinking. (Has this ever happened to you?) E18a. I had an illness connected with drinking which kept me from working on my regular 01 Yes activities for a week or more. (Has this ever happened to you?) 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF E15A=1 AND CURRENT DRINKER E15B. Did this happen in the last twelve months? ASK IF E18A=1 AND CURRENT DRINKER 01 Yes E18B. Did this happen in the last twelve months? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED
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ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER”
E19a. I felt that my drinking was becoming a serious threat to my physical health. (Has this ever E22a. People at work indicated that I should cut down on drinking. (Has this ever happened to happened to you?) you?) 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF E19A=1 AND CURRENT DRINKER ASK IF E22A=1 AND CURRENT DRINKER E19B. Did this happen in the last twelve months? E22B. Did this happen in the last twelve months? 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER”
E20a. A physician suggested I cut down on drinking. (Has this ever happened to you?) E23a. Drinking may have hurt my chances for promotion, or raises, or better jobs. (Has this ever 01 Yes happened to you?) 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF E20A=1 AND CURRENT DRINKER E20B. Did this happen in the last twelve months? ASK IF E23A=1 AND CURRENT DRINKER 01 Yes E23B. Did this happen in the last twelve months? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” E21a. I have lost a job, or nearly lost one, because of drinking. (Has this ever happened to you?) 01 Yes E24a. A spouse or someone I lived with got angry about my drinking or the way I behaved while 02 No drinking. (Has this ever happened to you?) 97 DON’T KNOW 01 Yes 99 REFUSED 02 No 97 DON’T KNOW ASK IF E21A=1 AND CURRENT DRINKER 99 REFUSED E21B. Did this happen in the last twelve months? 01 Yes ASK IF E24A=1 AND CURRENT DRINKER 02 No E24B. Did this happen in the last twelve months? 97 DON’T KNOW 01 Yes 99 REFUSED 02 No 97 DON’T KNOW 99 REFUSED
59 60 Page Page
ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER”
E25a. A spouse or someone I lived with threatened to leave me because of my drinking. (Has E29a. I deliberately tried to cut down or quit drinking, but I was unable to do so. (Has this ever this ever happened to you?) happened to you?) 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF E25A=1 AND CURRENT DRINKER ASK IF E29A=1 AND CURRENT DRINKER E25B. Did this happen in the last twelve months? E29B. Did this happen in the last twelve months? 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” E30a. Someone in the criminal justice system required me to seek treatment for a drinking E26a. I was afraid I might be an alcoholic. (Has this ever happened to you?) problem. (Has this ever happened to you?) 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF E26A=1 AND CURRENT DRINKER ASK IF E30A=1 AND CURRENT DRINKER E26B. Did this happen in the last twelve months? E30B. Did this happen in the last twelve months? 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK IF CURRENT OR EX DRINKER NOT LABELED AS “LIGHT DRINKER” E5a. I needed more alcohol than I used to, to get the same effect as before. (Has this ever E27a. I have awakened the next day not being able to remember some of the things I had done happened to you?) while drinking. (Has this ever happened to you?) 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED ASK IF E5A=1 AND CURRENT DRINKER ASK IF E27A=1 AND CURRENT DRINKER E5B. Did this happen in the last twelve months? E27B. Did this happen in the last twelve months? 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
TIMING MARKER 6 TIMING SECTION 7
61 62 ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER”
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F1a. I kept wanting to cut down or quit drinking. (Has this ever happened to you?) ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” 01 Yes 02 No F2a. I found that I needed a drink to keep from getting the shakes or becoming sick. (Has this 97 DON’T KNOW ever happened to you?) 99 REFUSED 01 Yes 02 No ASK IF F1A=1 AND CURRENT DRINKER 97 DON’T KNOW F1B. Did this happen in the last twelve months? 99 REFUSED 01 Yes 02 No ASK IF F2A=1 AND CURRENT DRINKER 97 DON’T KNOW F2B. Did this happen in the last twelve months? 99 REFUSED 01 Yes 02 No 97 DON’T KNOW 99 REFUSED
ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER”
F4a. I was depressed, irritable or nervous after drinking or the morning after drinking. (Has this ever happened to you?) 01 Yes 02 No 97 DON’T KNOW 99 REFUSED
ASK IF F4A=1 AND CURRENT DRINKER F4B. Did this happen in the last twelve months? 01 Yes 02 No 97 DON’T KNOW 99 REFUSED ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER”
F6a. I have given up or reduced important work or social activities for my drinking. (Has this ever happened to you?) 01 Yes 02 No 97 DON’T KNOW 99 REFUSED
ASK IF F6A=1 AND CURRENT DRINKER F6B. Did this happen in the last twelve months? 01 Yes 02 No 97 DON’T KNOW 99 REFUSED
63 64 Page Page
ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK OF CURRENT THAT ARE NOT LABELED AS “LIGHT DRINKER”
F7a. I spent a lot of my time on drinking or getting over the effects of drinking or doing things GN1a. During the last year have you had a feeling of guilt or remorse after drinking? to get alcohol. (Has this ever happened to you?) 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF F7A=1 AND CURRENT DRINKER ASK OF CURRENT THAT ARE NOT LABELED AS “LIGHT DRINKER” F7B. Did this happen in the last twelve months? 01 Yes GN2a. During the last year has a friend or a family member ever told you about things you said 02 No or did while you were drinking and didn’t remember? 97 DON’T KNOW 01 Yes 99 REFUSED 02 No ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” 97 DON’T KNOW 99 REFUSED F8a. I kept on drinking although I knew that I had a health problem caused by or made worse by my drinking. (Has this ever happened to you?) ASK OF CURRENT THAT ARE NOT LABELED AS “LIGHT DRINKER” 01 Yes 02 No 97 DON’T KNOW GN3a. During the last year have you failed to do what was normally expected of you because of 99 REFUSED drinking?
ASK IF F8A=1 AND CURRENT DRINKER 01 Yes F8B. Did this happen in the last twelve months? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” GTEXT Now I’m going to read you a list of some other people who might have liked you to drink F9a. I kept on drinking although I felt that my drinking was giving me psychological or less or to act differently when you drank. For each one, please tell me if that person ever felt this way. emotional problems. (Has this ever happened to you?) 01 Yes ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” 02 No 97 DON’T KNOW G8a. Did a spouse or someone you lived with ever feel this way? 99 REFUSED 01 Yes 02 No ASK IF F9A=1 AND CURRENT DRINKER 97 DON’T KNOW F9B. Did this happen in the last twelve months? 99 REFUSED 01 Yes 02 No 97 DON’T KNOW 99 REFUSED
TIMING MARKER 7 TIMING SECTION 8
65 66 Page Page
ASK IF G8A=1 AND CURRENT DRINKER ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” G8B. Did this happen in the last twelve months? 01 Yes G12a. Did anyone else you lived with ever feel this way? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK IF G12A=1 AND CURRENT DRINKER G9a. Did a parent ever feel this way? G12B. Did this happen in the last twelve months? 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF G9A=1 AND CURRENT DRINKER ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” G9B. Did this happen in the last twelve months? 01 Yes G13a. Did any other friend ever feel this way? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK IF G13A=1 AND CURRENT DRINKER G10a. Did any other relative ever feel this way? G13B. Did this happen in the last twelve months? 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF G10A=1 AND CURRENT DRINKER ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” G10B. Did this happen in the last twelve months? 01 Yes G14a. Did an employer, supervisor, or coworker ever feel this way? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK OF CURRENT OR EX-DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK IF G14A=1 AND CURRENT DRINKER G11a. Did a girlfriend or boyfriend ever feel this way? G14B. Did this happen in the last twelve months? 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF G11A=1 AND CURRENT DRINKER TIMING MARKER 8 G11B. Did this happen in the last twelve months? TIMING SECTION 9 01 Yes 02 No
97 DON’T KNOW 99 REFUSED 67 68 Page Page
ASK OF CURRENT AND EX DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” ASK IF H1=1,97 H9A. Did you ever talk to: A priest, minister or rabbi? H1. Have you ever talked about an alcohol problem of your own with anyone? 01 Yes 02 No 01 Yes 97 DON’T KNOW 02 No (SKIP TO H22) 99 REFUSED 97 DON’T KNOW 99 REFUSED (SKIP TO H22) IF H9A=1 ASK H9B. Did this happen in the last twelve months? ASK IF H1=1,97 01 Yes H2CA. Did you ever talk to: Your spouse, partner, close intimate or an “ex” (ex-spouse)? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF H1=1,97 H10A. Did you ever talk to: A doctor? IF H2CA=1 ASK 01 Yes H2CB. Did this happen in the last twelve months? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW 99 REFUSED IF H10A=1 ASK H10B. Did this happen in the last twelve months? ASK IF H1=1,97 01 Yes H4CA. Did you ever talk to: Another relative, friend or acquaintance? 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW ASK IF H1=1,97 99 REFUSED H11A. Did you ever talk to: anyone else? 01 Yes IF H4CA=1 ASK 02 No H4CB. Did this happen in the last twelve months? 97 DON’T KNOW 01 Yes 99 REFUSED 02 No 97 DON’T KNOW IF H11A=1 ASK 99 REFUSED H11B. Did this happen in the last twelve months? 01 Yes ASK IF H1=1,97 02 No H8A. Did you ever talk to: Your supervisor or a fellow worker? 97 DON’T KNOW 01 Yes 99 REFUSED 02 No 97 DON’T KNOW ASK OF CURRENT AND EX DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” AT 99 REFUSED SECTION E //AND H1=01 OR 97
IF H8A=1 ASK H12. Have you ever gone to anyone -- a physician, AA, a treatment agency, anyone at all - for a H8B. Did this happen in the last twelve months? problem related in any way to your drinking? 01 Yes 02 No 01 Yes 97 DON’T KNOW 02 No (SKIP TO H22) 99 REFUSED 97 DON’T KNOW 99 REFUSED (SKIP TO H22) 69 70 ASK IF H12=01,97 Page Page
IF HC18A=1 ASK PREHC13 I am going to read you a list of community agencies and professions. For each one, HC18B. How long ago was the last contact? please tell me if you have gone there about a drinking problem? ___101-199 NUMBER OF DAYS ASK IF H12=01,97 ___201-299 NUMBER OF WEEKS HC13A. A hospital, private physician, or any general health or mental health program. Have you ___301-399 NUMBER OF MONTHS ever gone there about your drinking problem? ___401-499 NUMBER OF YEARS 01 Yes 02 No 997 DON’T KNOW 97 DON’T KNOW 999 REFUSED 99 REFUSED ASK IF H12=01,97 IF HC13A=1 ASK HC13B. How long ago was the last contact? HC18aA. Any other self-help group for your drinking. (Have you ever gone there about your drinking problem?) ___101-199 NUMBER OF DAYS 01 Yes ___201-299 NUMBER OF WEEKS 02 No ___301-399 NUMBER OF MONTHS 97 DON’T KNOW ___401-499 NUMBER OF YEARS 99 REFUSED IF HC18aA=1 ASK 997 DON’T KNOW HC18aB. How long ago was the last contact? 999 REFUSED ASK IF H12=01,97 ___101-199 NUMBER OF DAYS ___201-299 NUMBER OF WEEKS HC17A. A social service agency or social welfare department. Have you ever gone there about ___301-399 NUMBER OF MONTHS your drinking problem? ___401-499 NUMBER OF YEARS 01 Yes 02 No 997 DON’T KNOW 97 DON’T KNOW 999 REFUSED 99 REFUSED IF HC17A=1 ASK ASK IF H12=01,97 HC17B. How long ago was the last contact? HC19A. An alcoholism or drug treatment program. (Have you ever gone there about your drinking ___101-199 NUMBER OF DAYS problem?) ___201-299 NUMBER OF WEEKS 01 Yes ___301-399 NUMBER OF MONTHS 02 No ___401-499 NUMBER OF YEARS 97 DON’T KNOW 99 REFUSED 997 DON’T KNOW IF HC19A=1 ASK 999 REFUSED HC19B. How long ago was the last contact? ASK IF H12=01,97 ___101-199 NUMBER OF DAYS HC18A. Alcoholics Anonymous meetings. (Have you ever gone there about your drinking ___201-299 NUMBER OF WEEKS problem?) ___301-399 NUMBER OF MONTHS 01 Yes ___401-499 NUMBER OF YEARS 02 No 97 DON’T KNOW 997 DON’T KNOW 99 REFUSED 999 REFUSED
71 72 Page Page
ASK IF H12=01,97 ASK IF H12=01,97
HC20A. An Employee Assistance Program, or EAP . (Have you ever gone there about your H21A. Some other agency or professional person. drinking problem?) (Have you ever gone there about your drinking problem?) 01 Yes 01 Yes 02 No 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED IF HC20A=1 ASK IF H21A=1 ASK HC20B. How long ago was the last contact? H21B. How long ago was the last contact?
___101-199 NUMBER OF DAYS ___101-199 NUMBER OF DAYS ___201-299 NUMBER OF WEEKS ___201-299 NUMBER OF WEEKS ___301-399 NUMBER OF MONTHS ___301-399 NUMBER OF MONTHS ___401-499 NUMBER OF YEARS ___401-499 NUMBER OF YEARS
997 DON’T KNOW 997 DON’T KNOW 999 REFUSED 999 REFUSED ASK IF H12=01,97 ASK OF CURRENT AND EX DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” AT HN21A. A DUI program. (Have you ever gone there about your drinking problem?) SECTION E //AND H12=01 OR 97 01 Yes 02 No HN33 Have you ever used the internet to get information related to drinking ? 97 DON’T KNOW 99 REFUSED 01 YES IF HN21A=1 ASK 02 NO (SKIP TO H22) HN21B. How long ago was the last contact? 97 DON’T KNOW (CONTINUE) 99 REFUSED (SKIP TO H22) ___101-199 NUMBER OF DAYS ___201-299 NUMBER OF WEEKS ASK IF HN33=01,97 ___301-399 NUMBER OF MONTHS ___401-499 NUMBER OF YEARS HN34 What types of help from the internet have you used?
997 DON’T KNOW ASK IF HN33=01,97 999 REFUSED HN34A. General information regarding alcohol or alcoholism ASK IF H12=01,97 01 Yes 02 No HN22A. A private therapist, such as a psychiatrist, psychologist or social worker . 97 DON’T KNOW (Have you ever gone there about your drinking problem?) 99 REFUSED 01 Yes 02 No ASK IF HN33=01,97 97 DON’T KNOW HN34B. Information regarding professional treatment options such as professional therapy, 99 REFUSED detoxification or pharmaceuticals? IF HN22A=1 ASK 01 Yes HN22B. How long ago was the last contact? 02 No 97 DON’T KNOW ___101-199 NUMBER OF DAYS 99 REFUSED ___201-299 NUMBER OF WEEKS ___301-399 NUMBER OF MONTHS ___401-499 NUMBER OF YEARS
73 74 997 DON’T KNOW 999 REFUSED Page Page
ASK IF HN33=01,97 ASK IF H22=01, 97, 99 OR H23=02, 97, 99 AND [ H12=02, 97, 99 or missing] HN34C. Information regarding self- or mutual-help groups (such as AA) in your area 01 Yes H25. I didn’t know how to pay for it. 02 No 01 Yes 97 DON’T KNOW 02 No 99 REFUSED 97 DON’T KNOW ASK IF HN33=01,97 99 REFUSED HN34D. On-line drinking assessments 01 Yes ASK IF H22=01, 97, 99 OR H23=02, 97, 99 AND [ H12=02, 97, 99 or missing] 02 No 97 DON’T KNOW H26. I didn’t know where to go for help. 99 REFUSED 01 Yes 02 No ASK IF HN33=01,97 97 DON’T KNOW HN34E. Alcohol-related internet forums, meetings, or chat rooms 99 REFUSED 01 Yes 02 No ASK IF H22=01, 97, 99 OR H23=02, 97, 99 AND [ H12=02, 97, 99 or missing] 97 DON’T KNOW 99 REFUSED H27. There were too many difficulties, such as child care or transportation. 01 Yes 02 No ASK OF CURRENT AND EX DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” 97 DON’T KNOW 99 REFUSED H22. People differ a lot in their feelings about getting help for alcohol problems. Have you ever considered going for help for such a problem? ASK IF H22=01, 97, 99 OR H23=02, 97, 99 AND [ H12=02, 97, 99 or missing] 01 Yes (SKIP TO H24) 02 No H28. I thought that there wouldn’t be anyone who understood or could help me. 97 DON’T KNOW (SKIP TO H24) 01 Yes 99 REFUSED (SKIP TO H24) 02 No 97 DON’T KNOW ASK IF H22=02 99 REFUSED ASK IF H22=01, 97, 99 OR H23=02, 97, 99 AND [ H12=02, 97, 99 or missing] H23. Is that because you didn’t think you had a problem, or was there another reason?
H29. I didn’t think there would be anyone who spoke my language. 01 Didn’t have a problem 01 Yes 02 Some other reason 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF H22=01, 97, 99 OR H23=02, 97, 99 AND [ H12=02, 97, 99 or missing] ASK IF H22=01, 97, 99 OR H23=02, 97, 99 AND [ H12=02, 97, 99 or missing] PREH24. What are some of the reasons you didn’t go for help? When I read each statement, just
answer ‘Yes’ or ‘No.’ H30. I didn’t think there would be anyone of my racial or ethnic background.
01 Yes ASK IF H22=01, 97, 99 OR H23=02, 97, 99 AND [H12=02, , 97, 99 or missing] 02 No
97 DON’T KNOW
99 REFUSED H24. I was too afraid of people finding out.
01 Yes 02 No 97 DON’T KNOW 99 REFUSED
75 76 Page Page
ASK IF H22=01, 97, 99 OR H23=02, 97, 99 AND [ H12=02, 97, 99 or missing] ASK ALL RESPONDENTS
HN30A. I wasn’t sure my problem was serious enough I1 How about Drinking is bad for your health ? Would you say that is a very important reason, 01 Yes a somewhat important reason, not an important reason, or not a reason at all for your abstaining from 02 No alcoholic beverages or being careful about how much you drink? 97 DON’T KNOW 99 REFUSED 01 Very Important Reason 02 Somewhat important reason ASK IF H22=01, 97, 99 OR H23=02, 97, 99 AND [ H12=02, 97, 99 or missing] 03 Not an important reason 04 Not a reason at all H31 Some other reason? 97 DON’T KNOW 01 Yes 99 REFUSED 02 No 97 DON’T KNOW ASK ALL RESPONDENTS 99 REFUSED I3 Your family or friends get upset when you drink ? [READ IF NECESSARY]Would you say ASK IF H31=1 that is a very important reason, a somewhat important reason, not an important reason, or not a reason H31o. What was the other reason you didn’t go for help? at all for your abstaining from alcoholic beverages or being careful about how much you drink? [DO NOT READ] 01 Very Important Reason 01 Stopped or reduced drinking 02 Somewhat important reason 03 Not an important reason 02 Did it on my own, didn’t need any help 04 Not a reason at all 03 Didn’t/don’t want to stop drinking 97 DON’T KNOW 04 Ashamed, embarrassed 99 REFUSED 95 Other 97 DON’T KNOW ASK ALL RESPONDENTS
99 REFUSED I5 It goes against your religion ? [READ IF NECESSARY] (Would you say that is a very
important reason, a somewhat important reason, not an important reason, or not a reason at all for your ASK OF CURRENT AND EX DRINKERS THAT ARE NOT LABELED AS “LIGHT DRINKER” AT abstaining from alcoholic beverages or being careful about how much you drink?) SECTION E
HN32. Whether or not you have ever talked to anyone or whether you have ever been treated, do 01 Very Important Reason you consider yourself to be in recovery from an alcohol problem? 02 Somewhat important reason
03 Not an important reason 01 Yes 04 Not a reason at all 02 No 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK ALL RESPONDENTS TIMING MARKER 9
TIMING SECTION 10 I6 You are afraid of becoming an alcoholic ? [READ IF NECESSARY] (Would you say that is
a very important reason, a somewhat important reason, not an important reason, or not a reason at all ASK ALL RESPONDENTS for your abstaining from alcoholic beverages or being careful about how much you drink?)
ITEXT How important to you are each of the following reasons for abstaining from alcoholic beverages 01 Very Important Reason or being careful about how much you drink? 02 Somewhat important reason 03 Not an important reason 04 Not a reason at all 97 DON’T KNOW 99 REFUSED 77 78 Page Page
ASK ALL RESPONDENTS 99 REFUSED
I7 Drinking often makes you do things you are sorry for later on. (Would you say that is a ASK IF CURRENT DRINKER OR EX-DRINKER very important reason, a somewhat important reason, not an important reason, or not a reason at all for your abstaining from alcoholic beverages or being careful about how much you drink?) MN24h I drink when I feel tense and nervous ? [READ IF NECESSARY] (Would you say that (is/was) a very important reason, a somewhat important reason, not an important reason, or not a 01 Very Important Reason reason for your own drinking?) 02 Somewhat important reason 03 Not an important reason 01 Very Important Reason 04 Not a reason at all 02 Somewhat important reason 97 DON’T KNOW 03 Not an important reason 99 REFUSED 04 Not a reason at all 97 DON’T KNOW ASK ALL RESPONDENTS 99 REFUSED
I10 Drinking leads to losing control over your life . (Would you say that is a very important ASK IF CURRENT DRINKER OR EX-DRINKER reason, a somewhat important reason, not an important reason, or not a reason at all for your abstaining from alcoholic beverages or being careful about how much you drink?) MN24i I drink to be sociable ? [READ IF NECESSARY] (Would you say that (is/was) a very important reason, a somewhat important reason, not an important reason, or not a reason for your own 01 Very Important Reason drinking?) 02 Somewhat important reason 03 Not an important reason 01 Very Important Reason 04 Not a reason at all 02 Somewhat important reason 97 DON’T KNOW 03 Not an important reason 99 REFUSED 04 Not a reason at all 97 DON’T KNOW ASK IF CURRENT DRINKER OR EX-DRINKER 99 REFUSED
PreM24 Now I want you to think about reasons in favor of drinking.. TIMING MARKER 10 TIMING SECTION 11 ASK IF CURRENT DRINKER OR EX-DRINKER ASK OF ALL MN24a How about Drinking is a good way to celebrate ? [READ IF NECESSARY]Would you say JTEXT Now, we have some questions about your use of various kinds of drugs during the last twelve that (is/was) a very important reason, a somewhat important reason, not an important reason, or not a months. reason at all for your own drinking? 01 Very Important Reason ASK OF ALL 02 Somewhat important reason JN0A. How often have you used Prescription drugs taken as prescribed (IF NEEDED READ: 03 Not an important reason “That you take following doctor’s orders.”] during the last twelve months? Was it every day or 04 Not a reason at all nearly every day, about once a week, once 97 DON’T KNOW every two or three weeks, once every month or two, less often than that, or never? 99 REFUSED 00 Every day or nearly every day ASK IF CURRENT DRINKER OR EX-DRINKER 01 About once a week 02 Once every 2 or 3 weeks MN24f Drinking helps me to forget about my worries and my problems ? [READ IF 03 Once every month or two NECESSARY] (Would you say that (is/was) a very important reason, a somewhat important reason, not 04 Less often than that an important reason, or not a reason for your own drinking?) 05 Never 97 DON’T KNOW 01 Very Important Reason 99 REFUSED 02 Somewhat important reason 03 Not an important reason 79 04 Not a reason at all 80 97 DON’T KNOW Page Page
ASK IF JN0A <5 AND CURRENT DRINKER ASK OF ALL J3CA. How often have you used Any other drugs, including prescription drugs NOT taken as JN0B. How often did you use alcohol at the same time as Prescription drugs taken as prescribed, recreational drugs or illegal drugs during the last twelve months? [READ IF prescribed? (IF NEEDED READ: “That you take following doctor’s orders.”] Was it usually, NECESSARY] Was it every day or nearly every day, about once a week, once sometimes or never? every two or three weeks, once every month or two, less often than that, or never? 01 Usually 02 Sometimes 00 Every day or nearly every day 03 Never 01 About once a week 97 DON’T KNOW 02 Once every 2 or 3 weeks 99 REFUSED 03 Once every month or two 04 Less often than that 05 Never (SKIP TO JN10AA) ASK OF ALL 97 DON’T KNOW J1A. How often have you used Marijuana, hash, pot, THC or “weed” during the last twelve 99 REFUSED months? [READ IF NECESSARY]Was it every day or nearly every day, about once a week, once every two or three weeks, once every month or two, less often than that, or never? ASK IF J3CA = 0,1,2,3,4,97,99 J4A. How often have you used Uppers such as speed, Ritalin, amphetamines, or 00 Every day or nearly every day methamphetamines during the last twelve months? [READ IF NECESSARY]Was it every day or 01 About once a week nearly every day, about once a week, once every two or three weeks, once every month or two, less 02 Once every 2 or 3 weeks often than that, or never? 03 Once every month or two 04 Less often than that 00 Every day or nearly every day 05 Never 01 About once a week 97 DON’T KNOW 02 Once every 2 or 3 weeks 99 REFUSED 03 Once every month or two 04 Less often than that ASK IF J1A <5 AND CURRENT DRINKER 05 Never (SKIP TO JN10AA) 97 DON’T KNOW J1B. How often did you use alcohol and Marijuana at the same time? Was it usually, sometimes or 99 REFUSED never? 01 Usually ASK IF J4A <5 AND CURRENT DRINKER 02 Sometimes 03 Never J4B. How often did you use alcohol and Uppers such as speed or methamphetamines at the 97 DON’T KNOW same time? Was it usually, sometimes or never? 99 REFUSED 01 Usually 02 Sometimes ASK IF J1A <5 AND STATE = ARIZONA OR CALIFORNIA 03 Never 97 DON’T KNOW J1C How often was the Marijuana medically prescribed? Was it always, sometimes, or Never? 99 REFUSED 01 Always 02 Sometimes ASK IF J4A <5 03 Never J4C How often was/were the Uppers medically prescribed? Was it always, sometimes, or Never? 97 DON’T KNOW 01 Always 99 REFUSED 02 Sometimes 03 Never 97 DON’T KNOW 99 REFUSED
81 82 Page Page
ASK IF J3CA = 0,1,2,3,4,97,99 J2BHow often did you use alcohol and Cocaine or crack cocaine at the same time? Was it usually, J5A. How often have you used Downers such as tranquilizers, Librium, Valium, sleeping pills, sometimes or never? and so on during the last twelve months? [READ IF NECESSARY]Was it every day or nearly every day, about once a week, once every two or three weeks, once every month or two, less often than that, 01 Usually or never? 02 Sometimes 03 Never 00 Every day or nearly every day 97 DON’T KNOW 01 About once a week 99 REFUSED 02 Once every 2 or 3 weeks 03 Once every month or two ASK IF J3CA = 0,1,2,3,4,97,99 04 Less often than that 05 Never (SKIP TO JN10AA) J3a How often have you used Ecstasy or MDMA during the last twelve months? [READ IF 97 DON’T KNOW NECESSARY] Was it every day or nearly every day, about once a week, once every two or three 99 REFUSED weeks, once every month or two, less often than that, or never?
ASK IF J5A <5 AND CURRENT DRINKER 00 Every day or nearly every day 01 About once a week J5B. How often did you use alcohol and Downers such as tranquilizers or sleeping pills at the 02 Once every 2 or 3 weeks same time? Was it usually, sometimes or never? 03 Once every month or two 01 Usually 04 Less often than that 02 Sometimes 05 Never 03 Never 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED ASK IF J3A<5 AND CURRENT DRINKER ASK IF J5A <5 J5C How often was/were the Downers medically prescribed? Was it always, sometimes, or J3BHow often did you use alcohol and Ecstasy at the same time? Was it usually, sometimes or Never? never? 01 Always 02 Sometimes 01 Usually 03 Never 02 Sometimes 97 DON’T KNOW 03 Never 99 REFUSED 97 DON’T KNOW 99 REFUSED
ASK IF J3CA = 0,1,2,3,4,97,99
ASK IF J3CA = 0,1,2,3,4,97,99 J6a How often have you used Heroin or Opium during the last twelve months? [READ IF NECESSARY]Was it every day or nearly every day, about once a week, once every two or three J2a How often have you used Cocaine or crack cocaine during the last twelve months? [READ IF weeks, once every month or two, less often than that, or never? NECESSARY]Was it every day or nearly every day, about once a week, once every two or three weeks, once every month or two, less often than that, or never? 00 Every day or nearly every day 01 About once a week 00 Every day or nearly every day 02 Once every 2 or 3 weeks 01 About once a week 03 Once every month or two 02 Once every 2 or 3 weeks 04 Less often than that 03 Once every month or two 05 Never 04 Less often than that 97 DON’T KNOW 05 Never 99 REFUSED
97 DON’T KNOW 99 REFUSED
83 84 ASK IF J2A<5 AND CURRENT DRINKER
Page Page
ASK IF J6A<5 AND CURRENT DRINKER ASK IF J3CA = 0,1,2,3,4,97,99
J6BHow often did you use alcohol and Heroin or Opium . at the same time? Was it usually, sometimes J8a How often have you used Hallucinogens such as LSD, mescaline, psilocybin, PCP, and so on or never? during the last twelve months? [READ IF NECESSARY]Was it every day or nearly every day, about once a week, once every two or three weeks, once every month or two, less often than that, or never? 01 Usually 02 Sometimes 00 Every day or nearly every day 03 Never 01 About once a week 97 DON’T KNOW 02 Once every 2 or 3 weeks 99 REFUSED 03 Once every month or two 04 Less often than that ASK IF J3CA = 0,1,2,3,4,97,99 05 Never 97 DON’T KNOW J7a How often have you used Painkillers or other opiates such as Codeine, darvon, Percodan, 99 REFUSED Vicodin, OxyContin and so on during the last twelve months? [READ IF NECESSARY]Was it every day or nearly every day, about once a week, once every two or three weeks, once every month or two, ASK IF J8A<5 AND CURRENT DRINKER less often than that, or never? J8BHow often did you use alcohol and Hallucinogens such as LSD at the same time? Was it usually, 00 Every day or nearly every day sometimes or never? 01 About once a week 02 Once every 2 or 3 weeks 01 Usually 03 Once every month or two 02 Sometimes 04 Less often than that 03 Never 05 Never 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED ASK IF J3CA = 0,1,2,3,4,97,99 ASK IF J7A<5 AND CURRENT DRINKER J9ca How often have you used Any other drugs you may take without a prescription for recreation J7BHow often did you use alcohol and Painkillers or other opiates at the same time? Was it usually, during the last twelve months? [READ IF NECESSARY]Was it every day or nearly every day, about sometimes or never? once a week, once every two or three weeks, once every month or two, less often than that, or never?
01 Usually 00 Every day or nearly every day 02 Sometimes 01 About once a week 03 Never 02 Once every 2 or 3 weeks 97 DON’T KNOW 03 Once every month or two 99 REFUSED 04 Less often than that 05 Never 97 DON’T KNOW ASK IF J7a<5 99 REFUSED
J7C How often (was/were) the Painkillers or other opiates medically prescribed? Was it always, ASK IF J9c<5 AND CURRENT DRINKER sometimes or never? J9cBHow often did you use alcohol and Any other drugs you take without a prescription at the 01 Always same time? Was it usually, sometimes or never? 02 Sometimes 03 Never 01 Usually 97 DON’T KNOW 02 Sometimes 99 REFUSED 03 Never
97 DON’T KNOW 99 REFUSED
85 86 Page Page
ASK IF JIa=05 ASK IF J11a=01 OR 03
JN10AA. Have you ever used marijuana at any time in your life? J11b1. On the days that you [smoke/smoked], how many cigarettes [do/did] you smoke each day on 01 YES average? INTERVIEWER: 1 PACK=20 CIGARETTES] 02 NO PROGRAMMER: INSERT PRESENT TENSE IF J10=1-3, PAST TENSE IF10=04- 97 DON’T KNOW 97] 99 REFUSED ______CIGARETTES PER DAY [RANGE: 1-180, VERIFY 61 OR MORE] ASK OF ALL 996 LESS THAN 1 PER DAY 997 DON’T KNOW JN10A. Have you ever smoked cigarettes or used any other kind of tobacco products on a regular 999 REFUSED basis in your life? 01 YES 02 NO (SKIP TOJ15) ASK IF JN10a=01 97 DON’T KNOW(SKIP TOJ15) 99 REFUSED(SKIP TOJ15) JN11C . At the time in your life that you smoked or used tobacco most heavily, how often did you use it? ASK IF JN10A=01 01 Daily or nearly daily JN10B. At about what age did you first smoke cigarettes or use tobacco on a regular 02 One to four days per week basis? 03 Once every two to three weeks 04 Once every month or so AGE______[RANGE 5-96] 05 Less often than that 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF JN10A=01 ASK IF JN10a=01 J10 How often have you smoked cigarettes or used any other kinds of tobacco in the past twelve months? JN11. How long ago was the last time you smoked cigarettes or used any other kinds of tobacco?
01 Daily or nearly daily ___101-199 MONTHS 02 One to four days per week ___201-299 YEARS 03 Once every two to three weeks 000 Today 04 Once every month or so 997 DON’T KNOW 05 Less often than that 999 REFUSED 06 Never in the past 12 months 97 DON’T KNOW ASK OF ALL 99 REFUSED J15. Did you ever receive treatment from a chemical dependency or substance abuse ASK IF JN10a=01 program for either alcohol or drugs?
J11A. When you [use/used] tobacco [is/was] that cigarettes, other kinds of tobacco or 01 YES both? 02 NO (SKIP TO K1) [PROGRAMMER: INSERT PRESENT TENSE IF J10=1-3, PAST TENSE IF10=04- 97 DON’T KNOW (SKIP TO K1) 97] 99 REFUSED (SKIP TO K1) 01 Cigarettes 02 Other tobacco 03 Both 97 DON’T KNOW
99 REFUSED
87 88 Page Page
ASK IF J15=01 ASK IF J15=01 J16. How long ago was the most recent time you received treatment? J21. Did you think it might help solve job problems?. ___ 101-199 DAYS 01 YES ___201-299 WEEKS 02 NO ___301-399 MONTHS 97 DON’T KNOW ___ 401-499 YEARS 99 REFUSED 997 DON’T KNOW ASK IF J15=01 999 REFUSED J22. (Did you think it might) …help solve legal problems? ASK IF J15=01 01 YES J17. Was this an alcoholism program or a drug program? (IF NECESSARY, SAY: 02 NO Answer for the most recent time you received treatment.) 97 DON’T KNOW 99 REFUSED 01 ALCOHOLISM 02 DRUG ASK IF J15=01 03 BOTH 97 DON’T KNOW J23. (Did you think it might…) improve your health? 99 REFUSED 01 YES ASK IF J15=01 02 NO J18. Was this treatment for a drinking problem, a drug problem or both? 97 DON’T KNOW (IF NECESSARY, SAY: Answer for the most recent time you received treatment.) 99 REFUSED
01 DRINKING PROBLEM ASK IF J15=01 02 DRUG PROBLEM 03 BOTH J24. (Did you think it might) improve your 97 DON’T KNOW mental well being? 99 REFUSED 01 YES 02 NO ASK IF J15=01 97 DON’T KNOW J19. Thinking about the place you went for your drinking or drug problem, overall, how satisfied are 99 REFUSED you with the services you received? Were you: (IF NECESSARY, SAY: Answer for the most recent time you received treatment.) ASK IF J15=01
01 VERY SATISFIED J25. (Did you think it might…) 02 MOSTLY SATISFIED improve your financial situation? 03 INDIFFERENT 01 YES 04 MILDLY DISSATISFIED 02 NO 05 VERY DISSATISFIED 97 DON’T KNOW 97 DON’T’ KNOW 99 REFUSED 99 REFUSED ASK IF J15=01 ASK IF J15=01 J27. (Did you think it might…) J20. Which of the following factors influenced you to get help? Did you think it might… help you quit drinking? …improve relationships with family or friends. 01 YES
02 NO 01 YES 97 DON’T KNOW
89 02 NO 90 99 REFUSED 97 DON’T KNOW
Page 99 REFUSED Page
ASK IF J15=01 ASK OF ALL
J28. (Did you think it might…) K1. Next I have some questions about any injuries and illnesses you may have had in the last help you cut down on drinking? twelve months. Let’s start with injuries. In the last twelve months, did you have any kind of injury for which you thought about getting treatment, whether or not 01 YES you actually did get treatment? 02 NO 97 DON’T KNOW 01 YES 99 REFUSED 02 NO (SKIP TO K9) 97 DON’T KNOW (SKIP TO K9) ASK IF J15=01 99 REFUSED (SKIP TO K9)
J26. Were you pressured to get help? ASK IF K1=01
01 YES AK1B. Thinking about your most recent injury, which of the following events describes the main 02 NO reason you were injured? 97 DON’T KNOW 99 REFUSED 01 Falling (SKIP TO K2) 02 Motor Vehicle Accident (SKIP TO K2) 03 Cutting myself or being cut (SKIP TO K2) ASK IF J26 = 1. 95 other (ASK AK1Bo) J29o. Were you court-ordered to get help? 97 DON’T KNOW (SKIP TO K2) 01 YES 99 REFUSED (SKIP TO K2) 02 NO 97 DON’T KNOW ASK IF AK1b=95 99 REFUSED AK1Bo. INTERVIEWER, IF NECESSARY: Thinking about your most recent injury, which of the following events describes the main reason you were injured? ASK IF MORE THAN ONE 01 RESPONSE BETWEEN J20-J29 //SHOW RESPONSE LIST FOR ALL WHERE J20-J29=01// 01 Back injury or other strain or sprain (from twisting or lifting something) 02 something fell or closed on you (doors, heavy object) J30. Of those you mentioned, what was the most important reason for getting help? 03 Interpersonal injury like a fight or partner violence 04 Playing sports or doing exercise 01 improve relationships with 05 Injury related to weakness from chronic disease (such as family or friends. diabetes or arthritis) 02 help solve job problems. 06 Injured by an animal (dog bite, allergic reaction from bee sting, 03 help solve legal problems. thrown by horse) 04 improve health. 07 Repetitive motion injury 05 improve 97 DON’T KNOW mental well being. 99 REFUSED 06 improve financial situation. 08 help quit drinking. 09 help cut down on drinking. ASK IF K1=01 AND CURRENT DRINKER 07 pressured to go. 10 Court-ordered K2. In the six hours before your most recent injury, did you drink any alcoholic beverage, even one TIMING MARKER 11 drink? This includes wine, beer, hard liquor, and any other beverages containing alcohol. TIMING SECTION 12 01 YES
02 NO (SKIP TO INSTRUCTION ABOVE K4) 97 DON’T KNOW (SKIP TO INSTRUCTION ABOVE K4)
91 92 99 REFUSED (SKIP TO INSTRUCTION ABOVE K4)
Page Page
ASK IF K2=01 ASK IF K7=01 and K6 in (.)
K3. Was this most recent injury in any way related to your drinking? K8. When you went for treatment for the most recent injury, where did you go first? Was it:
01 YES 01 To an emergency room 02 NO 02 To a private doctor or clinic 97 DON’T KNOW 03 To some other place? 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF K1=01 AND ANY JNO - J9C<5 IF CODED 1 DRUG [1], USE SINGULAR FORM; 2 OR MORE DRUGS [2], USE PLURAL FORM. IF THE ASK OF ALL ONLY DRUG USED WAS A LEGAL PRESCRIPTION DRUG (JN0A. = 0-4) THEN SAY DID YOU USE ANY PRESCRIPTION DRUGS). NOTE: DOES NOT INCLUDE CIGARETTE USE.) K9. In the last twelve months, did you have any kind of illness for which you thought about getting treatment, whether or not you actually did get treatment? K4. In the six hours before this injury, did you use (the drug/any of the drugs) you 01 YES mentioned earlier, not including tobacco products? 02 NO (SKIP TO LOGIC ABOVE K17) 97 DON’T KNOW (SKIP TO LOGIC ABOVE K17) 01 YES 99 REFUSED (SKIP TO LOGIC ABOVE K17) 02 NO 97 DON’T KNOW ASK IF K9=01 AND CURRENT DRINKER 99 REFUSED K10. In the six hours before you most recently got sick or noticed this problem, did you drink any ASK IF K1=01 alcoholic beverages - even one drink? This includes wine, beer, hard liquor and any other beverage containing alcohol. K5. Did you go for treatment for this injury? 01 YES 01 YES 02 NO (SKIP TO LOGIC ABOVE K12) 02 NO (SKIP TO K7) 97 DON’T KNOW (SKIP TO LOGIC ABOVE K12) 97 DON’T KNOW (SKIP TO K7) 99 REFUSED (SKIP TO LOGIC ABOVE K12) 99 REFUSED (SKIP TO K7) ASK IF K10=01 ASK IF K5=01 K11. Was this illness in any way related to your drinking? K6. When you went for treatment for this injury, where did you go first? Was it: 01 YES 01 To an emergency room, 02 NO 02 To a private doctor or clinic, or 97 DON’T KNOW 03 To some other place? 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF K9=01 AND ANY JNO - J9C<05 IF DRUG USE CODED NEVER USED, SKIP TO K13. IF CODED 1 DRUG [1], USE SINGULAR FORM; 2 ASK IF K1=01 and if K6 in (.) OR MORE DRUGS [2], USE PLURAL FORM. IF THE ONLY DRUG USED WAS A LEGAL PRESCRIPTION DRUG (JN0A. = 0-4) THEN SAY DID YOU USE ANY PRESCRIPTION DRUGS). NOTE: K7. In the last twelve months, were you treated for any kind of injury at all? DOES NOT INCLUDE CIGARETTE USE.) 01 YES 02 NO (SKIP TO K9) K12. In the six hours prior to this most recent illness, did you use (the drug/any of the drugs/any of 97 DON’T KNOW (SKIP TO K9) the prescription drugs) you mentioned earlier not including tobacco products? 99 REFUSED (SKIP TO K9) 01 YES
02 NO 97 DON’T KNOW
93 94 99 REFUSED
Page Page
ASK IF K9=01 ASK IF K5=01 OR K7=01 OR K13=01 OR K15A=01
K13. Did you go for treatment for this illness? KN18. In the last twelve months, how often have you used the ER?
01 YES ______NUMBER OF TIMES [ RANGE 0-95] 02 NO (SKIP TO K15) 96 96 OR MORE 97 DON’T KNOW (SKIP TO K15) 97 DON’T KNOW 99 REFUSED (SKIP TO K15) 99 REFUSED
ASK IF K13=01 ASK IF K5=01 OR K7=01 OR K13=01 OR K15A=01 K14. When you went for treatment for this illness, where did you go first? Was it KN19 In the past twelve months, how often have you made a primary care visit? 01 To an emergency room, 02 To a private doctor or clinic, or ______NUMBER OF TIMES [ RANGE 0-95] 03 To some other place? 96 97 OR MORE 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF K9=01 and if K14 in (.) ASK IF K5=01 OR K7=01 OR K13=01 OR K15A=01
K15A In the last twelve months, were you treated for any kind of illness at all? KN20 In the last twelve months how many days have you spent in the hospital as a patient? ______NUMBER OF TIMES [ RANGE 0-95] 01 YES 96 97 OR MORE 02 NO (SKIP TO LOGIC ABOVE K17) 97 DON’T KNOW 97 DON’T KNOW (SKIP TO LOGIC ABOVE K17) 99 REFUSED 99 REFUSED (SKIP TO LOGIC ABOVE K17)
TIMING MARKER 12 K15a=01 AND if K14 in (.) TIMING SECTION 13
K16. When you went for treatment for the most recent illness, where did you go first? Was it ASK IF CURRENT DRINKER 01 To an emergency room, 02 To a private doctor or clinic, or Now I’d like to ask you some questions about different kinds of social activities sometimes involving 03 To some other place? drinking. During the last twelve months, 97 DON’T KNOW 99 REFUSED ASK IF CURRENT DRINKER
ASK IF K5=01 OR K7=01 OR K13=01 OR K15a=01 L1C How often do you drink When out for an evening meal at a restaurant? Would you say every day or nearly every day, at least once a week, at least once a month K17. In the last twelve months, how often have you used any type of health service for an injury or (but less than once a week), at least once a year (but less than once a month), or never during the last illness? This includes the emergency room, a private doctor or clinic, or 12 months? some other place. 01 Every day or nearly every day, ______NUMBER OF TIMES [ RANGE 1-96] 02 At least once a week, 96 96 OR MORE 03 At least once a month [but less than 1/week] 97 DON’T KNOW 04 At least once a year [but less than 1/month] or, 99 REFUSED 05 Never? 97 DON’T KNOW 99 REFUSED
95 96 Page Page
ASK IF L1C<5 L7C. When you drink, how many drinks do you typically have when out for an evening meal at a ______NUMBER OF DRINKS [RANGE 01-96] restaurant? 97 DON’T KNOW [INTERVIEWER NOTE: MUST BE AT LEAST 1 DRINK TO QUALIFY. IF 99 REFUSED RESPONSE IF NOT 1 OR HIGHER -- SHIFT 6 BACK AND CODE NEVER.
______NUMBER OF DRINKS [RANGE 1-96] 97 DON’T KNOW 99 REFUSED
ASK IF CURRENT DRINKER
L2C How often do you drink at bars, taverns, or cocktail Lounges? [READ IF NECESSARY]Would you say every day or nearly every day, at least once a week, at least once a month (but less than once a week), at least once a year (but less than once a month), or never during the last 12 months?
01 Every day or nearly every day, 02 At least once a week, 03 At least once a month [but less than 1/week] 04 At least once a year [but less than 1/month] or, 05 Never? 97 DON’T KNOW 99 REFUSED
ASK IF L2C<5 L8C. When you drink, how many drinks do you typically have when you drink at a bar, tavern, or cocktail Lounge? [INTERVIEWER NOTE: MUST BE AT LEAST 1 DRINK TO QUALIFY. IF RESPONSE IF NOT 1 OR HIGHER -- SHIFT 6 BACK AND CODE NEVER.
______NUMBER OF DRINKS [RANGE 1-96] 97 DON’T KNOW 99 REFUSED
ASK IF CURRENT DRINKER
L3C How often do you drink At parties in someone else’s Home? [READ IF NECESSARY]Would you say every day or nearly every day, at least once a week, at least once a month (but less than once a week), at least once a year (but less than once a month), or never during the last 12 months? 01 Every day or nearly every day, 02 At least once a week, 03 At least once a month [but less than 1/week] 04 At least once a year [but less than 1/month] or, 05 Never? 97 DON’T KNOW 99 REFUSED
ASK IF L3C<5 L9C. When you drink, how many drinks do you typically have at parties in someone else’s Home. 97 [INTERVIEWER NOTE: MUST BE AT LEAST 1 DRINK TO QUALIFY. IF 98 RESPONSE IF NOT 1 OR HIGHER -- SHIFT 6 BACK AND CODE NEVER. Page Page
ASK IF CURRENT DRINKER ASK IF CURRENT DRINKER
L4C How often do you drink spending a quiet evening at home? [READ IF NECESSARY]Would you L6C How often do you drink Spending time with friends in a say every day or nearly every day, at least once a week, at least once a month (but less than once a public place, such as a park, street, or parking lot? [READ IF NECESSARY]Would you say every week), at least once a year (but less than once a month), or never during the last 12 months? day or nearly every day, at least once a week, at least once a month (but less than once a week), at least once a year (but less than once a month), or never during the last 12 months? 01 Every day or nearly every day, 02 At least once a week, 01 Every day or nearly every day, 03 At least once a month [but less than 1/week] 02 At least once a week, 04 At least once a year [but less than 1/month] or, 03 At least once a month [but less than 1/week] 05 Never? 04 At least once a year [but less than 1/month] or, 97 DON’T KNOW 05 Never? 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF L4C<5 L10C. When you drink, how many drinks do you typically have On a quiet evening at home ASK IF L6C<5 [INTERVIEWER NOTE: MUST BE AT LEAST 1 DRINK TO QUALIFY. IF L12C. When you drink, how many drinks do you typically have When with friends in a public place, RESPONSE IF NOT 1 OR HIGHER -- SHIFT 6 BACK AND CODE NEVER. such as a park or parking lot? [INTERVIEWER NOTE: MUST BE AT LEAST 1 DRINK TO QUALIFY. IF ______NUMBER OF DRINKS [RANGE 1-96] RESPONSE IF NOT 1 OR HIGHER -- SHIFT 6 BACK AND CODE NEVER. 97 DON’T KNOW 99 REFUSED ______NUMBER OF DRINKS [RANGE 1-96] 97 DON’T KNOW ASK IF CURRENT DRINKER 99 REFUSED
L5C How often do you drink When friends drop over and visit in your home. [READ IF NECESSARY]Would you say every day or nearly every day, at least once a ASK IF CURRENT DRINKER week, at least once a month (but less than once a week), at least once a year (but less than once a L15. Think about the occasion in the last twelve months that you had the most to drink. How many month), or never during the last 12 months? drinks did you have at that time? (By ‘drink’, we mean one can or bottle of beer, one bottle of wine 01 Every day or nearly every day, cooler, one glass of wine or a drink with a shot of hard liquor.) 02 At least once a week, 03 At least once a month [but less than 1/week] ______NUMBER OF DRINKS [RANGE 1-96] 04 At least once a year [but less than 1/month] or, 96 96 OR MORE 05 Never? 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED ASK IF CURRENT DRINKER ASK IF L5C<5 L11C. When you drink, how many drinks do you typically have When friends drop over and visit in L16. And over about how long did you drink that amount? (IF NEEDED: from when you began to your home? drink until the time you finished your last drink) [INTERVIEWER NOTE: MUST BE AT LEAST 1 DRINK TO QUALIFY. IF RESPONSE IF NOT 1 OR HIGHER -- SHIFT 6 BACK AND CODE NEVER. ______Record HOURS AND MINUTES [example: 30 minutes is coded as 30 60 minutes is coded as 100 ______NUMBER OF DRINKS [RANGE 1-96] 1 hour is coded as 100 97 DON’T KNOW 2 hours 30 minutes is coded as 230] 99 REFUSED 997 DON’T KNOW 998 10 HOURS OR MORE
999 REFUSED
99 100 Page Page
BASE FOR SECTION L17-L20 ASK L19 IF L15=5-96 and B18 = missing
L19. During the last twelve months, how often did you have five, six or seven drink (IF B15=03 OR B15A=03) AND L15=12-96, OR kind of alcoholic beverage in any single day (READ ONLY FIRST TIME: that is, any (IF B15=04 OR B15A=04) AND L15=8-96, OR combination of cans of beer, glasses of wine, or drinks containing liquor of any kind)? (IF NEEDED, (IF B15=05 OR B15A=05) AND L15=5-96, OR READ: Was it:) (IF B15=06 OR B15A=06) AND L15=4-96, OR (IF B15=07 OR B15A= 07) AND L15=3-96, OR 01 Every day or nearly every day, 02 Three or four times a week, (IF B15=08 OR B15A=08) AND L15=2-96 continue, otherwise go to M1 03 Once or twice a week,
04 Once to three times a month,
05 Seven to eleven times in the last 12 months, ASK L17 IF L15=12-96 06 Three to six times in the last 12 months,
07 Twice in the last 12 months, L17 During the last twelve months, how often did you have twelve or more drinks of any kind of 08 Once in the last 12 months, alcoholic beverage in a single day (READ ONLY FIRST TIME: that is, any combination of cans of beer, 09 Never in the last 12 months? glasses of wine, or drinks containing liquor of any kind)? Was it: 97 DON’T KNOW
99 REFUSED 01 Every day or nearly every day,
02 Three or four times a week, ASK L20 IF L15=3-96 and B19 =MISSING 03 Once or twice a week,
04 Once to three times a month, L20. During the last twelve months, how often did you have either three drinks or four drinks of any 05 Seven to eleven times in the last 12 months, kind of alcoholic beverage in a single day (READ ONLY FIRST TIME: that is, any combination of cans 06 Three to six times in the last 12 months, of beer, glasses of wine, or drinks containing liquor of any kind)? (IF NEEDED, READ: Was it:) 07 Twice in the last 12 months, 01 Every day or nearly every day, 08 Once in the last 12 months, 02 Three or four times a week, 09 Never in the last 12 months? 03 Once or twice a week, 97 DON’T KNOW 04 Once to three times a month, 99 REFUSED 05 Seven to eleven times in the last 12 months,
06 Three to six times in the last 12 months, ASK L18 IF L15=8-96 and B17 =missing 07 Twice in the last 12 months,
08 Once in the last 12 months, L18. During the last twelve months, how often did you have at least eight, but less than twelve 09 Never in the last 12 months? drinks of any kind of alcoholic beverage in a single day (READ ONLY FIRST TIME: that is, any 97 DON’T KNOW combination of cans of beer, glasses of wine, or drinks containing liquor of any kind)? (IF NEEDED, 99 REFUSED READ: Was it:)
ASK L21 IF L15=2-96 and ((BC20a AND BC20b=MISSING) OR (BC20c =MISSING 01 Every day or nearly every day, L21 During the last twelve months, how often did you have either one drink or two drinks of any 02 Three or four times a week, kind of alcoholic beverage in a single day (READ ONLY FIRST TIME: that is, any combination of cans 03 Once or twice a week, of beer, glasses of wine, or drinks containing liquor of any kind)? (IF NEEDED, READ: Was it:) 04 Once to three times a month,
05 Seven to eleven times in the last 12 months, 01 Every day or nearly every day, 06 Three to six times in the last 12 months, 02 Three or four times a week, 07 Twice in the last 12 months, 03 Once or twice a week, 08 Once in the last 12 months, 04 Once to three times a month, 09 Never in the last 12 months? 05 Seven to eleven times in the last 12 months, 97 DON’T KNOW 06 Three to six times in the last 12 months, 99 REFUSED 07 Twice in the last 12 months,
08 Once in the last 12 months,
09 Never in the last 12 months? 97 DON’T KNOW
101 102 99 REFUSED
Page Page TIMING MARKER 13
TIMING SECTION 14 ASK OF ALL
PREM1. Now I’ll describe situations that people sometimes find themselves in. For each one, please tell me how much a person in that situation should feel free to drink.
ASK OF ALL M1. At a party, at someone else’s home. Would you say…
01 NO DRINKING 02 1 OR 2 DRINKS 03 FEEL EFFECTS, BUT NOT DRUNK 04 GETTING DRUNK IS SOMETIMES ALRIGHT 97 DON’T KNOW 99 REFUSED
ASK OF ALL M4. For a man out at a bar with friends [READ IF NECESSARY] 01 NO DRINKING 02 1 OR 2 DRINKS 03 FEEL EFFECTS, BUT NOT DRUNK 04 GETTING DRUNK IS SOMETIMES ALRIGHT 97 DON’T KNOW 99 REFUSED
ASK OF ALL M5. For a woman out at a bar with friends [READ IF NECESSARY] 01 NO DRINKING 02 1 OR 2 DRINKS 03 FEEL EFFECTS, BUT NOT DRUNK 04 GETTING DRUNK IS SOMETIMES ALRIGHT 97 DON’T KNOW 99 REFUSED
ASK OF ALL M7. When with friends at home. [READ IF NECESSARY] 01 NO DRINKING 02 1 OR 2 DRINKS 03 FEEL EFFECTS, BUT NOT DRUNK 04 GETTING DRUNK IS SOMETIMES ALRIGHT 97 DON’T KNOW 99 REFUSED
103 104 Page Page
ASK OF ALL ASK OF ALL Please tell me whether you agree or disagree with each of these statements. MN26A. (Think of the people who are important to you.) How many of the people who are important to you would approve of you drinking alcohol? [READ IF NECESSARY]Would you say all or most M18. Having a drink is one of the pleasures of life. of them, about half of them, less than half of them, or none of them?
01 AGREE 01 ALL OR MOST 02 DISAGREE 02 ABOUT HALF 97 DON’T KNOW 03 LESS THAN HALF 99 REFUSED 04 NONE 97 DON’T KNOW ASK OF ALL 99 REFUSED M20. Having a drink with someone is a way of being friendly. ASK OF ALL 01 AGREE MN26B. (Think of the people who are important to you.) How many of the people who are important 02 DISAGREE to you would approve of you drinking one or two drinks regularly? [READ IF NECESSARY] 97 DON’T KNOW (Would you say all or most of them, about half of them, less than half of them, or none of them?) 99 REFUSED 01 ALL OR MOST 02 ABOUT HALF ASK OF ALL 03 LESS THAN HALF M10. There is nothing good to be said about drinking. 04 NONE 97 DON’T KNOW 01 AGREE 99 REFUSED 02 DISAGREE 97 DON’T KNOW 99 REFUSED ASK OF ALL MN26C. (Think of the people who are important to you.) How many of the people who are important ASK OF ALL to you would approve of you occasionally getting drunk? [READ IF NECESSARY] (Would you say MN25A. Think of the people who are important to you. How many of the people who are important all or most of them, about half of them, less than half of them, or none of them?) to you are regular drinkers? Would you say all or most of them, about half of them, less than half of them, or none of them? 01 ALL OR MOST 02 ABOUT HALF 01 ALL OR MOST 03 LESS THAN HALF 02 ABOUT HALF 04 NONE 03 LESS THAN HALF 97 DON’T KNOW 04 NONE 99 REFUSED 97 DON’T KNOW 99 REFUSED TIMING MARKER 14 TIMING SECTION 15 ASK OF ALL MN25B. (Think of the people who are important to you.) How many of the people who are important ASK OF ALL to you are heavy or problem drinkers? [READ IF NECESSARY]Would you say all or most of them, about half of them, less than half of them, or none of them? N1. Next I’m going to ask about legal problems you may have had in the past. Since age 18, have you ever been arrested, not including for things like parking tickets? 01 ALL OR MOST 01 YES 02 ABOUT HALF 02 NO 03 LESS THAN HALF 97 DON’T KNOW
04 NONE 99 REFUSED 97 DON’T KNOW 99 REFUSED
105 106 Page Page
ASK IF N1=01 ASK OF ALL
N2. Has this happened in the last twelve months? ON1A. In the past year, have you had two consecutive weeks or more during which you felt sad, blue, or depressed, or when you lost all interest or pleasure in things that you usually cared about or 01 YES enjoyed? 02 NO 01 YES 97 DON’T KNOW 02 NO 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF N1=01 ASK OF ALL N3. Since age 18, have you ever been convicted of a crime? AN28. How much distress are you currently experiencing in your life, would you say .. 01 YES 02 NO 01 A great deal 97 DON’T KNOW 02 Some 99 REFUSED 03 Not much, 04 None, ASK IF N3=01 97 DON’T KNOW 99 REFUSED N4. Has this happened in the last twelve months? 01 YES 02 NO ASK OF ALL 97 DON’T KNOW 99 REFUSED O1. I’m going to read you a list of some ways that people often feel or behave. Please tell me how often you felt this way during the last week . I was bothered by things that usually don’t bother me. Would you say rarely, none of the time, a ASK IF N1=01 little of the time, a moderate amount of the time, or most or all of the time?
N5. Did the most recent arrest have anything to do with drinking? 01 RARELY OR NONE OF THE TIME 02 A LITTLE OF THE TIME 01 YES 03 A MODERATE AMOUNT OF THE TIME 02 NO 04 MOST OR ALL OF THE TIME 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
TIMING MARKER 15 ASK OF ALL TIMING SECTION 16 O2. (During the last week…) ASK OF ALL I felt depressed. [READ IF NECESSARY]Would you say rarely, none of the time, a little of the time, a moderate amount of the time, or most or all of the time? ON1B. Have you had two years or more in your life when you felt depressed or sad most days even if you felt okay sometimes? 01 RARELY OR NONE OF THE TIME 02 A LITTLE OF THE TIME 01 YES 03 A MODERATE AMOUNT OF THE TIME 02 NO 04 MOST OR ALL OF THE TIME 97 DON’T KNOW 97 DON’T KNOW
99 REFUSED 99 REFUSED
107 108 Page Page
ASK OF ALL ASK OF ALL
O3. (During the last week.. .) O7. (During the last week…) I enjoyed life. [READ IF NECESSARY] (Would you say rarely, none of I felt hopeful about the future. [READ IF NECESSARY] (Would you say rarely, none of the time, a the time, a little of the time, a moderate amount of the time, or most or all of the time?) little of the time, a moderate amount of the time, or most or all of the time?) 01 RARELY OR NONE OF THE TIME 01 RARELY OR NONE OF THE TIME 02 A LITTLE OF THE TIME 02 A LITTLE OF THE TIME 03 A MODERATE AMOUNT OF THE TIME 03 A MODERATE AMOUNT OF THE TIME 04 MOST OR ALL OF THE TIME 04 MOST OR ALL OF THE TIME 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED ASK OF ALL ASK OF ALL O4. (During the last week.. .) My sleep was restless. [READ IF NECESSARY] (Would you say rarely, none of the time, a little of the O8. (During the last week…) time, a moderate amount of the time, or most or all of the time?) I felt sad. [READ IF NECESSARY] (Would you say rarely, none of the time, a little of the time, a moderate amount of the time, or most or all of the time?) 01 RARELY OR NONE OF THE TIME 02 A LITTLE OF THE TIME 01 RARELY OR NONE OF THE TIME 03 A MODERATE AMOUNT OF THE TIME 02 A LITTLE OF THE TIME 04 MOST OR ALL OF THE TIME 03 A MODERATE AMOUNT OF THE TIME 97 DON’T KNOW 04 MOST OR ALL OF THE TIME 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK OF ALL ASK OF ALL O5. (During the last week.. .) O9. How well do each of the following statements describe you? I often act on the spur-of-the- I was happy. [READ IF NECESSARY] (Would you say rarely, none of the time, a little of the time, a moment without stopping to think. Would you say that this describes you quite a lot, some, a little, or moderate amount of the time, or most or all of the time?) not at all?
01 RARELY OR NONE OF THE TIME 01 QUITE A LOT 02 A LITTLE OF THE TIME 02 SOME 03 A MODERATE AMOUNT OF THE TIME 03 A LITTLE 04 MOST OR ALL OF THE TIME 04 NOT AT ALL 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK OF ALL ASK OF ALL O10. I get a real kick out of doing things that are a little dangerous. [READ IF O6. (During the last week…) NECESSARY]Would you say that this describes you quite a lot, some, a little, or not at all? I felt lonely. [READ IF NECESSARY] (Would you say rarely, none of the time, a little of the time, a moderate amount of the time, or most or all of the time?) 01 QUITE A LOT 02 SOME 01 RARELY OR NONE OF THE TIME 03 A LITTLE 02 A LITTLE OF THE TIME 04 NOT AT ALL 03 A MODERATE AMOUNT OF THE TIME 97 DON’T KNOW 04 MOST OR ALL OF THE TIME 99 REFUSED
97 DON’T KNOW 99 REFUSED
109 110 Page Page
ASK OF ALL ASK OF ALL O11. I like to test myself every now and then by doing something a little chancy. [READ IF NECESSARY] (Would you say that this describes you quite a lot, some, a little, or not at all?) O34. I get the emotional help and support I need from my family. Would you say that this describes you quite a lot, somewhat, a little, or not at all? 01 QUITE A LOT 02 SOME 01 QUITE A LOT 03 A LITTLE 02 SOMEWHAT 04 NOT AT ALL 03 A LITTLE 97 DON’T KNOW 04 NOT AT ALL 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK OF ALL O13. I like to try new things just for the excitement. [READ IF NECESSARY] (Would you say ASK OF ALL that this describes you quite a lot, some, a little, or not at all?) O37. I can talk about my problems with my family. [READ IF NECESSARY]Would you say that 01 QUITE A LOT this describes you quite a lot, somewhat, a little, or not at all? 02 SOME 03 A LITTLE 01 QUITE A LOT 04 NOT AT ALL 02 SOMEWHAT 97 DON’T KNOW 03 A LITTLE 99 REFUSED 04 NOT AT ALL 97 DON’T KNOW ASK OF ALL 99 REFUSED O15. I like to experience new and different sensations. [READ IF NECESSARY] (Would you say that this describes you quite a lot, some, a little, or not at all?) ASK OF ALL
01 QUITE A LOT ON38. My family really tries to help me. [READ IF NECESSARY] (Would you say that this 02 SOME describes you quite a lot, somewhat, a little, or not at all?) 03 A LITTLE 04 NOT AT ALL 01 QUITE A LOT 97 DON’T KNOW 02 SOMEWHAT 99 REFUSED 03 A LITTLE 04 NOT AT ALL ASK OF ALL 97 DON’T KNOW O16. You might say I act impulsively. [READ IF NECESSARY] (Would you say that this 99 REFUSED describes you quite a lot, some, a little, or not at all?) ASK OF ALL 01 QUITE A LOT 02 SOME ON40. My family accepts me the way I am. [READ IF NECESSARY] (Would you say that this 03 A LITTLE describes you quite a lot, somewhat, a little, or not at all?) 04 NOT AT ALL 97 DON’T KNOW 01 QUITE A LOT 99 REFUSED 02 SOMEWHAT 03 A LITTLE ASK OF ALL 04 NOT AT ALL O18. I don’t let the risk of getting hurt a little stop me from having a good time. [READ IF 97 DON’T KNOW NECESSARY] (Would you say that this describes you quite a lot, some, a little, or not at all?) 99 REFUSED
01 QUITE A LOT 02 SOME 03 A LITTLE
111 04 NOT AT ALL 112 97 DON’T KNOW
Page 99 REFUSED Page
ASK OF ALL ASK OF ALL O28. For each of the following questions, please tell me how often these things happen to you. How often do you feel that you are treated unfairly? Would you say often, P1. Now I would like to ask you a few questions about your family situation. Please stop me when sometimes, seldom, or almost never? I get to the category that describes your current marital status. Are you:
01 OFTEN 01 Married and living with your spouse, 02 SOMETIMES 02 Living with someone as a couple, 03 SELDOM 03 Married and not living with your spouse, 04 ALMOST NEVER 04 Legally separated, 97 DON’T KNOW 05 Divorced, 99 REFUSED 06 Widowed, or 07 Have you never married? ASK OF ALL 97 DON’T KNOW O29. How often are you in situations where you don’t know what to do? [READ IF 99 REFUSED NECESSARY]Would you say often, sometimes, seldom, or almost never? ASK OF ALL 01 OFTEN P2A. 02 SOMETIMES how many children 17 years of age or younger live in your household for whom you 03 SELDOM have or share responsibility? (PROBE - in household half the time or more) 04 ALMOST NEVER 97 DON’T KNOW ______(NUMBER OF CHILDREN) [RANGE: 0-96, VERIFY >15] 99 REFUSED 97 DON’T KNOW ASK OF ALL 99 REFUSED O30. How often do you feel that ‘bad things always happen to you?’ [READ IF NECESSARY]Would you say often, sometimes, seldom, or almost never? ASK OF ALL
01 OFTEN P2BN What is your current housing situation? 02 SOMETIMES 03 SELDOM 01 Own my own home 04 ALMOST NEVER 02 Rent a home 97 DON’T KNOW 03 Rent an apartment or room 99 REFUSED 04 Living in someone else’s home 05 Staying at a shelter or otherwise homeless (living in a public place like a park or on the ASK OF ALL street in a car) O31. How often do you feel that things you do in your daily life have little meaning? [READ IF 97 DON’T KNOW NECESSARY]Would you say often, sometimes, seldom, or almost never? 99 REFUSED
01 OFTEN ASK OF ALL 02 SOMETIMES 03 SELDOM A18DN_2 Have you or another member of your household been negatively affected by the recent 04 ALMOST NEVER economic downturn or recession? That is, since January 2008. 97 DON’T KNOW 01 YES 99 REFUSED 02 NO 97 DON’T KNOW TIMING MARKER 16 99 REFUSED TIMING SECTION 17 ASK IF A18DN_2=01
A18EN_1A Since January 2008, did you or anyone in your household Have their hours or pay reduced at work? 01 YES
113 114 02 NO 97 DON’T KNOW
Page Page 99 REFUSED
ASK IF A18DN_2 = 1 ASK IF A18EN_1A=01 A18EN_1B Did this happen in the last twelve months? A18EN_5A Since January 2008, did you or anyone in your household: Lose retirement money or 01 YES savings? 02 NO 01 YES 97 DON’T KNOW 02 NO 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF A18EN_1A=01 A18EN_1C Did this happen to you or someone else in your household? ASK IF A18DN_2 = 1 01 Self 02 Someone else A18EN_6A Since January 2008, did you or anyone in your household: Go into bankruptcy? 03 Both self and someone else 97 DON’T KNOW 01 YES 99 REFUSED 02 NO 97 DON’T KNOW ASK IF A18DN_2 = 1 99 REFUSED
A18EN_2A Since January 2008, did you or anyone in your household: Lose a job? 01 YES INSERT NEW TIMING MARKER 17 02 NO TIMING SECTION 18 97 DON’T KNOW 99 REFUSED ASK IF A1=02 AND AGE 1<45 ASK IF A18EN_2A=01 A18EN_2B Did this happen in the last twelve months? PN3A. Have you been pregnant in the past 15 months? 01 YES 02 NO 97 DON’T KNOW 01 YES 99 REFUSED 02 NO 97 DON’T KNOW ASK IF A18EN_2A=01 99 REFUSED A18EN_2C Did this happen to you or someone else in your household? 01 Self ASK IF PN3A=01 02 Someone else P4. Are you currently pregnant? 03 Both self and someone else 01 YES 97 DON’T KNOW 02 NO 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF A18DN_2 = 1 A18EN_3A Since January 2008, did you or anyone in your household: Have trouble paying their PREG FLAG A IF P4=2 rent or mortgage? PREG FLAG B IF P4=1 01 YES 02 NO ASK IF PN3A=01 97 DON’T KNOW PN4A. About how many months were you pregnant, during the last 12 months? [Probe: If you were 99 REFUSED pregnant more than once, think about the most recent pregnancy]
ASK IF A18DN_12= 1 ______NUMBER OF MONTHS [RANGE 1-12] A18EN_4A Since January 2008, did you or anyone in your household: Lose their housing, either 96 LESS THAN 1
owned or rented? 97 DON’T KNOW 01 YES 99 REFUSED 02 NO
115 97 DON’T KNOW 116 99 REFUSED
Page Page
ASK IF PN3A=01 [if R is a lifetime abstainer skip to PN1] ASK IF CURRENT OR EX-DRINKER AND PN3A=1 PN4B. About how many weeks was it before you realized that you were pregnant? PBC30A. Once you knew you were pregnant, what was the largest number of drinks you had in a ______NUMBER OF WEEKS [RANGE 0-40] single day?
97 DON’T KNOW IF DON’T KNOW, ASK: Was it 5 or more or 4 or less drinks in any single day ): 99 REFUSED ______NUMBER OF DRINKS [RANGE 0-24] ASK OF CURRENT AND EX DRINKERS IF PN3A=01 AND PN4b>0 95 DON’T KNOW: FIVE OR MORE PBC30B. During the [insert response from PN4B] weeks before you realized you were pregnant, 94 DON’T KNOW: FOUR OR LESS what was the largest number of drinks you had on a single day? 97 DON’T KNOW (CANNOT DETERMINE) 99 REFUSED (IF DON’T KNOW, ASK: Was it 5 or more or 4 or less drinks in any single day):
______NUMBER OF DRINKS [RANGE 0-24] [IF RESPONDENT DID NOT DRINK ONCE SHE KNEW SHE WAS PREGNANT, SKIP TO PN1] [IF RESPONDENT NOT WINE DRINKER (B1C = 02-09) SKIP TO PBC30d.] 95 DON’T KNOW: FIVE OR MORE 94 DON’T KNOW: FOUR OR LESS ASK IF PBC30A>0 AND B1C=02-09 97 DON’T KNOW (CANNOT DETERMINE) 99 REFUSED PBC30C. [if Preg flag A say ... Still thinking about your recent pregnancy, ] ..once you knew you were pregnant, if you drank wine, what is the largest number of wine drinks you had on a single day? ASK IF PN3A=01 (IF DON’T KNOW, ASK: Was it 5 or more or 4 or less drinks in any single day): PN4D. Beginning from the time you knew you were pregnant, how often did you take multivitamin supplements? ______NUMBER OF DRINKS [RANGE 0-24]
01 Every day or nearly every day 95 DON’T KNOW: FIVE OR MORE 02 3-4 times per week 94 DON’T KNOW: FOUR OR LESS 03 1-2 times per week 97 DON’T KNOW (CANNOT DETERMINE) 04 Less than weekly 99 REFUSED 95 Never during pregnancy 97 DON’T KNOW [IF RESPONDENT NOT BEER DRINKER (B2C = 2-9) SKIP TO PBC30e.] 99 REFUSED ASK IF PBC30A>0 AND B2C=02-09
ASK IF PN3A=01 PBC30D [if Preg flag A say ... Still thinking about your recent pregnancy, ] ..once you knew you were pregnant, if you drank beer, what is the largest number of beer drinks you had on a single day? PN4C. Once you knew you were pregnant, did you have 2 consecutive weeks or more in which you felt sad or depressed? (IF DON’T KNOW, ASK: Was it 5 or more or 4 or less drinks in any single day):
01 YES ______NUMBER OF DRINKS [RANGE 0-24] 02 NO 97 DON’T KNOW 95 DON’T KNOW: FIVE OR MORE 99 REFUSED 94 DON’T KNOW: FOUR OR LESS 97 DON’T KNOW (CANNOT DETERMINE) 99 REFUSED
117 118 Page Page
[IF RESPONDENT NOT SPIRITS DRINKER (B3C = 2-9) SKIP TO PN4e.] ASK IF PBC30A>05 ASK IF PBC30A>0 AND B3C=2-9 PB18. Once you knew you were pregnant, how often did you have five, six, or seven but no more than 7 drinks of any kind of alcoholic beverage (in a single day) (READ ONLY FIRST TIME: that is, any PBC30E. And how about spirits, [if Preg flag A say ... Still thinking about your recent pregnancy] combination of bottles or cans of beer or cooler, glasses of wine, or drinks containing liquor of any ..once you knew you were pregnant, if you drank spirits, what is the kind)? [READ IF NECESSARY]Was it: largest number of spirits drinks you had on a single day? 01 Every day or nearly every day 02 Three to four times a week (IF DON’T KNOW, ASK: Was it 5 or more or 4 or less drinks in any single day): 03 Once or twice a week 04 Once to three times a month ______NUMBER OF DRINKS [RANGE 0-24] 05 Less than once a mo nth 06 Once since you knew you were pregnant 95 DON’T KNOW: FIVE OR MORE 07 Never since you knew you were pregnant 94 DON’T KNOW: FOUR OR LESS 97 DON’T KNOW 97 DON’T KNOW (CANNOT DETERMINE) 99 REFUSED 99 REFUSED ASK IF PBC30A>02 ASK IF PBC30A>11 PB19. Once you knew you were pregnant, how often did you have either three drinks or four drinks but PB16. Once you knew you were pregnant, how often did you have 12 or more drinks of any kind of no more than 4 of any kind of alcoholic beverage (in a single day), (READ ONLY FIRST TIME: that is, alcoholic beverage (in a single day), (READ ONLY FIRST TIME: that is, any combination of bottles or any combination of bottles or cans of beer or cooler, glasses of wine, or drinks containing liquor of any cans of beer or cooler, glasses of wine, drinks containing liquor of any kind? Was it: (READ LIST) kind)? [READ IF NECESSARY] Was it: 01 Every day or nearly every day 01 Every day or nearly every day 02 Three to four times a week 02 Three to four times a week 03 Once or twice a week 03 Once or twice a week 04 Once to three times a month 04 Once to three times a month 05 Less than once a mo nth 05 Less than once a mo nth 06 Once since you knew you were pregnant 06 Once since you knew you were pregnant 07 Never since you knew you were pregnant 07 Never since you knew you were pregnant 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
ASK IF PBC30A>07 ASK IF PBC30A>01 PB17. Once you knew you were pregnant, how often did you have at least eight, but less than 12, PB20a. Once you knew you were pregnant, how often did you have two drinks but no more than 2 of drinks of any kind of alcoholic beverage (in a single day), (READ ONLY FIRST TIME: that is, any any kind of alcoholic beverage (in a single day), (READ ONLY FIRST TIME: that is, any combination of combination of bottles or cans of beer or cooler, glasses of wine, or drinks containing liquor of any bottles or cans of beer or cooler, glasses of wine, or drinks containing liquor of any kind)? [READ IF kind)? [READ IF NECESSARY]Was it NECESSARY]Was it: 01 Every day or nearly every day 01 Every day or nearly every day 02 Three to four times a week 02 Three to four times a week 03 Once or twice a week 03 Once or twice a week 04 Once to three times a month 04 Once to three times a month 05 Less than once a mo nth 05 Less than once a mo nth 06 Once since you knew you were pregnant 06 Once since you knew you were pregnant 07 Never since you knew you were pregnant 07 Never since you knew you were pregnant 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
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ASK IF PBC30A>0 INSERT NEW TIMING MARKER18 PB20b. Once you knew you were pregnant, how often did you have one drink, but no more than one TIMING SECTION 19 drink of any kind of alcoholic beverage (in a single day), (READ ONLY FIRST TIME: : that is, a bottle or can of beer or cooler, glass of wine, or drink containing liquor of any kind)? [READ IF PN1T. NECESSARY]Was it In the next part of the interview, we ask about stressful events that might have happened in your life If any question upsets you, you don't have to answer it and your answers will be kept private. 01 Every day or nearly every day 02 Three to four times a week ASK OF ALL 03 Once or twice a week 04 Once to three times a month PN1. During your childhood and adolescence, that is, before age 18, did anyone ever hit you with 05 Less than once a mo nth something, beat you up, intentionally burn or scald you, or use a knife or gun on you or threaten to? 06 Once since you knew you were pregnant 01 YES 07 Never since you knew you were pregnant 02 NO 97 DON’T KNOW 97 DON’T KNOW 99 REFUSED 99 REFUSED
[ask PN4E only if R drank two or more beverage types in PBC30c-e, otherwise skip to PN4F] ASK IF PN1=01
PN4E. Once you knew you were pregnant, which of these beverages did you drink the most or is it about equal? PN1A_ Who did this to you? Please tell me all that apply. [INTERVIEWER CODE ALL THAT APPLY] 01 ( IF DRINKS WINE PBC30C>0) Mostly wine Mul response = 3 02 ( IF DRINKS BEER: PBC30D>0) Mostly beer READ LIST 03 ( IF DRINKS SPIRITS: PBC30E>E) Mostly spirits 04 About equal 01 A parent or person who raised you 97 DON’T KNOW 02 Some other family member 99 REFUSED 03 Someone other than a family member 97 Don’t Know ASK IF PBC30A>0 99 Refused
PN4F. Once you knew you were pregnant, approximately how much of your drinking occurred during meals? Would you say: ASK IF PN1A =01 01 All or almost all PN2_1. How old were you the first time this happened by a parent or person who raised you? 02 More than ½ 03 About half ______AGE (YEARS) [ RANGE 0-17] 04 Less than ½ 97 DON’T KNOW 05 Never or almost none? 99 REFUSED 97 DON’T KNOW 99 REFUSED ASK IF PN1A=02 PN2_2. How old were you the first time this happened by some other family member?
______AGE (YEARS) [ RANGE 0-17] 97 DON’T KNOW 99 REFUSED
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ASK IF PN1=01 ASK IF PN3AN=02 PN4_2 How old were you the first time this happened by some other family member?
ASK IF PN1A=03 ______AGE (YEARS) [ RANGE 0-17] PN2_3. How old were you the first time this happened by some other person? 97 DON’T KNOW 99 REFUSED ______AGE (YEARS) [ RANGE 0-17] 97 DON’T KNOW 99 REFUSED ASK IF PN3AN_=03 PN4_3 How old were you the first time this happened by someone other than a family member? ASK OF ALL ______AGE (YEARS) [ RANGE 0-17] PN3. During your childhood and adolescence (that is before age 18), did anyone ever force you to 97 DON’T KNOW have sex against your will? By sex, I mean their touching your sexual parts, your touching their sexual 99 REFUSED parts, or sexual intercourse. 01 YES ASK OF ALL 02 NO PN5. Since you turned (age) 18 did anyone ever throw something at you, push, grab, shove or slap 97 DON’T KNOW you? 99 REFUSED 01 YES ASK IF PN3=01 02 NO 97 DON’T KNOW PN3AN Who did this to you? Please tell me all that apply. 99 REFUSED [INTERVIEWER CODE ALL THAT APPLY] Mul response = 3 ASK IF PN5=01 READ LIST PN5A Who did this to you? Please tell me all that apply. 01 A parent or person who raised you [INTERVIEWER CODE ALL THAT APPLY] 02 Some other family member Mul response = 3 03 Someone other than a family member READ LIST 97 Don’t Know 01 An intimate partner/spouse or date 99 Refused 02 A family member other than a partner (not a young child) 03 Anyone else 97 Don’t Know 99 Refused
ASK IF PN3AN=01 PN4_1. How old were you the first time this happened by a parent or person who raised you? ASK IF PN5A=01 PN6_1 Did this happen by an intimate partner/spouse or date during the last 12 months? ______AGE (YEARS) [ RANGE 0-17] 97 DON’T KNOW 01 YES 99 REFUSED 02 NO 97 DON’T KNOW 99 REFUSED
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ASK IF PN5A=01 99 REFUSED PN6A_1 Did this happen by an intimate partner/spouse or date more than 12 months ago, but since you were 18? ASK IF PN7=01
01 YES PN7A Who did this to you? Please tell me all that apply. 02 NO [INTERVIEWER CODE ALL THAT APPLY] 97 DON’T KNOW Mul response = 3 99 REFUSED READ LIST 01 An intimate partner/spouse or date 02 A family member other than a partner (not a young child) ASK IF PN5A = 2 03 Anyone else PN6_2 Did this happen by a family member other than a partner (not a young child) 97 Don’t Know during the last 12 months? 99 Refused
01 YES 02 NO ASK IF PN7A=01 97 DON’T KNOW PN8_1 Did this happen by an intimate partner/spouse or date during the last 12 months? 99 REFUSED 01 YES ASK IF PN5A=02 02 NO PN6A_2 Did this happen by a family member other than a partner (not a young child) more than 12 97 DON’T KNOW months ago but since you were 18? 99 REFUSED
01 YES ASK IF PN7A=01 02 NO PN8A_1 Did this happen by an intimate partner/spouse or date more than 12 months ago but since you 97 DON’T KNOW were 18? 99 REFUSED 01 YES 02 NO ASK IF PN5A=03 97 DON’T KNOW PN6_3 Did this happen by anyone else during the last 12 months? 99 REFUSED
01 YES 02 NO 97 DON’T KNOW 99 REFUSED
ASK IF PN5A=03 PN6A_3 Did this happen by anyone else more than 12 months ago but since you were 18?
01 YES 02 NO 97 DON’T KNOW 99 REFUSED
ASK OF ALL
PN7. Since you turned (age) 18 did anyone ever kick or bite you, hit you with a fist, try to hit you with something, beat you up, threaten to use--or use--a knife or gun against you?
125 01 YES 126 02 NO
Page 97 DON’T KNOW Page
03 Anyone else 97 Don’t Know ASK IF PN7A=02 99 Refused PN8_2 Did this happen by a family member other than a partner (not a young child) during the last 12 months?
01 YES 02 NO ASK IF PN9A=01 97 DON’T KNOW PN10_1 Did this happen by an intimate partner/spouse or date during the last 12 months? 99 REFUSED 01 YES ASK IF PN7A=02 02 NO PN8A_2 Did this happen by a family member other than a partner (not a young child) more than 12 97 DON’T KNOW months ago but since you were 18? 99 REFUSED
01 YES ASK IF PN9A=01 02 NO PN10A_1 Did this happen by an intimate partner/spouse or date more than 12 months ago but 97 DON’T KNOW since you were 18? 99 REFUSED 01 YES 02 NO ASK IF PN7A=03 97 DON’T KNOW PN8_3 Did this happen by anyone else during the last 12 months? 99 REFUSED
01 YES 02 NO ASK IF PN9A=02 97 DON’T KNOW PN10_2 Did this happen by a family member other than a partner (not a young child) 99 REFUSED during the last 12 months?
ASK IF PN7A=03 01 YES PN8A_3 Did this happen by anyone else more than 12 months ago but since you were 18? 02 NO 97 DON’T KNOW 01 YES 99 REFUSED 02 NO 97 DON’T KNOW ASK IF PN9A=02 99 REFUSED PN10A_2 Did this happen by a family member other than a partner (not a young child) more than 12 months ago but since you were 18? ASK OF ALL 01 YES PN9. Since you turned (age) 18 did anyone ever force you to have sex against your will? By sex, I 02 NO mean their touching your sexual parts, your touching their sexual parts, or sexual intercourse? 97 DON’T KNOW 01 YES 99 REFUSED 02 NO 97 DON’T KNOW ASK IF PN9=01 99 REFUSED
ASK IF PN9=01 ASK IF PN9A=03 PN10_3 Did this happen by anyone else during the last 12 months?
PN9A Who did this to you? Please tell me all that apply. [INTERVIEWER CODE ALL THAT APPLY] 01 YES Mul response = 3 02 NO
127 READ LIST 128 97 DON’T KNOW 01 An intimate partner/spouse or date 99 REFUSED
Page 02 A family member other than a partner (not a young child) Page
ASK IF PN9A_3=01 call 1-800-656-HOPE (4673). Would you like me to repeat this number?” PN10A_3 Did this happen by anyone else more than 12 months ago but since you were 18? 2) To speak to a trained counselor about child abuse, please call 1-800-4-A-CHILD (1-800-422-4453). Would you like me to repeat this number? 01 YES 3) To speak to a trained counselor about domestic violence, please call 1-800-799-SAFE (7233). Would 02 NO you like me to repeat this number? 97 DON’T KNOW 99 REFUSED TIMING MARKER 19 [IF NO TO PN1 AND PN3 AND PN5 AND PN7 AND PN9 SKIP TO Q24.] TIMING SECTION 20
ASK IF PN1=1 OR PN3=1 OR PN5=1 OR PN7=1 OR PN9=1 ASK OF ALL
PN10B. Were you physically injured as a child or an adult as a result of [this incident/any of these Q24. Which of the following statements best describes your sexual orientation? Would you say: incidents], whether or not you sought medical care? 01 Heterosexual, that is, ‘straight,’ or prefer to have sex with 01 YES people of the opposite sex; 02 NO 02 Bisexual, that is, prefer to have sex with people of either sex; or 97 DON’T KNOW 03 Homosexual, that is, gay or lesbian, or prefer to have sex 99 REFUSED with people of your own sex? 97 DON’T KNOW ASK IF PN10B=01 AND (PN1 OR PN3=01) 99 REFUSED
PN10B_1 Did this injury happen when you were a child? 01 YES 02 NO 97 DON’T KNOW 99 REFUSED
ASK IF PN10B=01 AND (PN5 OR PN7 OR PN9=01)
PN10B_2 Did this injury happen as an adult but not in the past 12 months ? 01 YES 02 NO 97 DON’T KNOW 99 REFUSED
ASK IF PN10B=01 AND (PN6_1=01 OR pn6_2 = 01 PN6_3=01 OR PN8_1=01 or pn8_2 = 01 OR PN8_3 = 01 OR PN10_1 =01 or pn1_2 = 01 OR PN10_3=01)
PN10B_3 Did this injury happen in the past 12 months?
01 YES 02 NO 97 DON’T KNOW 99 REFUSED
[IF NO TO PN1 AND PN3 AND PN5 AND PN7 AND PN9 SKIP TO Q24.]
READ IF PN1=1 OR PN3=1 OR PN5=1 OR PN7=1 OR PN9=1
We realize that these topics may bring up past experiences that some people may wish to talk about. If
129 you wish, I can provide you with telephone numbers for more information. 130 [INTERVIEWER, IF NECESSARY:]
Page 1) If you or someone you know would like to talk to a trained counselor about sexual violence, please Page
ASK OF ALL 97 DON’T KNOW 99 REFUSED Q25. Thinking of the last five years, that is since (SEASON) of (YEAR), has the ASK OF ALL partner or partners in your sexual relationships been: R10. Do you think alcoholic beverages should have warning labels about possible health hazards? 01 Only men, 01 YES 02 Mostly men, 02 NO 03 About the same number of men and women, 97 DON’T KNOW 04 Mostly women, 99 REFUSED 05 Only women, or 06 Have you not had a sexual relationship in the last five years? ASK OF ALL 97 DON’T KNOW 99 REFUSED R16N. Do you think alcoholic beverages should have labels about nutrition, calories and serving sizes? TIMING MARKER 20 01 YES TIMING SECTION 21 02 NO 97 DON’T KNOW ASK OF ALL 99 REFUSED R1. The next questions ask about your ideas or opinions. Do you think taxes on alcoholic beverages should be increased, decreased or remain the same? TIMING MARKER 21 TIMING SECTION 22 01 INCREASED 02 DECREASED [IF NOT HISPANIC, SKIP TO SN11.] 03 REMAIN THE SAME 97 DON’T KNOW ASK IF (A4=03 OR A4=05 OR A5=04) AND LANGUAGE=ENGLISH 99 REFUSED S1. Now I have some questions about your experiences with your ethnic background. ASK OF ALL R6. Do you think alcohol education and prevention programs should be increased, Do you speak Spanish? decreased or remain the same? 01 YES (SKIP TO S3) 01 INCREASED 02 NO (SKIP TO SN11) 02 DECREASED 97 DON’T KNOW ( SKIP TO SN11) 03 REMAIN THE SAME 99 REFUSED (SKIP TO SN11) 97 DON’T KNOW 99 REFUSED ASK IF (A4=03 OR A4=05 OR A5=04) AND LANGUAGE=SPANISH ASK OF ALL S2. Now I have some questions about your experiences with your ethnic background. Do you R15. Do you think alcohol treatment programs should be covered in everyone’s health care speak English? insurance? 01 YES 01 YES 02 NO (SKIP TO SN11) 02 NO 97 DON’T KNOW (SKIP TO SN11) 97 DON’T KNOW 99 REFUSED (SKIP TO SN11) 99 REFUSED
ASK OF ALL R8. Do you think that where you live, it’s easy to buy alcoholic beverages during the evening. (IF ASK IF (S1=01 OR S2=01) AND P1=01-03 NECESSARY, SAY: S3. Do you speak mostly Spanish or mostly English with Your spouse or do you use both about
‘Around here’ refers to the area around where you live, such as your neighborhood if the same? you live in a city, or your town if you live somewhere smaller.) 01 MOSTLY SPANISH
131 01 YES 132 02 MOSTLY ENGLISH 02 NO 03 BOTH ABOUT THE SAME Page Page
97 DON’T KNOW ASK IF (S1=01 OR S2=01) 99 REFUSED S4. Do you speak mostly Spanish or mostly English with Your children or do you use both about the same?
01 MOSTLY SPANISH 02 MOSTLY ENGLISH 03 BOTH ABOUT THE SAME 97 DON’T KNOW 99 REFUSED
ASK IF (S1=01 OR S2=01) S5. How about Your brothers and sisters
01 MOSTLY SPANISH 02 MOSTLY ENGLISH 03 BOTH ABOUT THE SAME 97 DON’T KNOW 99 REFUSED
ASK IF (S1=01 OR S2=01) S6. How about Your parents 01 MOSTLY SPANISH 02 MOSTLY ENGLISH 03 BOTH ABOUT THE SAME 97 DON’T KNOW 99 REFUSED
ASK IF (S1=01 OR S2=01) S7. How about Other relatives
01 MOSTLY SPANISH 02 MOSTLY ENGLISH 03 BOTH ABOUT THE SAME 97 DON’T KNOW 99 REFUSED
ASK IF (S1=01 OR S2=01) S8. How about Your friends
01 MOSTLY SPANISH 02 MOSTLY ENGLISH 03 BOTH ABOUT THE SAME 97 DON’T KNOW 99 REFUSED
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ASK IF (S1=01 OR S2=01) ASK OF ALL
S9. How about Your neighbors SN11_C. Many people have a problem with viewing my racial or ethnic group as 01 MOSTLY SPANISH equal. [READ IF NECESSARY] Do you agree very much, agree somewhat, disagree somewhat, or 02 MOSTLY ENGLISH disagree very much? 03 BOTH ABOUT THE SAME 97 DON’T KNOW 01 AGREE VERY MUCH 99 REFUSED 02 AGREE SOMEWHAT 03 DISAGREE SOMEWHAT ASK IF (S1=01 OR S2=01) 04 DISAGREE VERY MUCH 97 DON’T KNOW S10. How about People at work 99 REFUSED 01 MOSTLY SPANISH 02 MOSTLY ENGLISH ASK OF ALL 03 BOTH ABOUT THE SAME 97 DON’T KNOW PRESN12. This next section is going to ask about how you and others like you are treated. I am 99 REFUSED going to read a list of situations you might have experienced. When I read each statement, just answer ‘Yes’ or ‘No.’ ASK OF ALL Have you ever experienced discrimination, been prevented from doing something, or been hassled or made to feel inferior because of your race, ethnicity or color: SN11_A. Now I’m going to read some statements and ask you whether you agree with them. People have lots of different feelings about these issues; we’re interested in your opinions and experiences. ASK OF ALL The first statement is Stereotypes about my race or ethnic group have affected me personally. Do you agree very much, agree somewhat, disagree somewhat, or disagree very much? SN12A. At school? 01 YES 01 AGREE VERY MUCH 02 NO 02 AGREE SOMEWHAT 97 DON’T KNOW 03 DISAGREE SOMEWHAT 99 REFUSED 04 DISAGREE VERY MUCH 97 DON’T KNOW ASK OF ALL 99 REFUSED SN12B. Getting hired or getting a job? ASK OF ALL 01 YES 02 NO SN11_B. My race or ethnic group influence how people act with me. Do you agree very much, 97 DON’T KNOW agree somewhat, disagree somewhat, or disagree very much? 99 REFUSED
01 AGREE VERY MUCH ASK OF ALL 02 AGREE SOMEWHAT 03 DISAGREE SOMEWHAT SN12C. At work? 04 DISAGREE VERY MUCH 01 YES 97 DON’T KNOW 02 NO 99 REFUSED 97 DON’T KNOW 99 REFUSED
ASK OF ALL
SN12d. Getting housing?
01 YES 02 NO 97 DON’T KNOW
135 136 99 REFUSED Page Page
ASK OF ALL ASK IF Y1=01
SN12e. Getting medical care? FNAME Let’s start with your first name. 01 YES 02 NO ASK IF Y1=01 97 DON’T KNOW 99 REFUSED MNAME May I please have your middle name. ASK OF ALL ASK IF Y1=01 SN12f. Getting service in a store or restaurant? 01 YES LMAME May I please have your last name. 02 NO 97 DON’T KNOW ASK IF Y1=01 99 REFUSED ASK OF ALL PADD May I please have your mailing address and phone number. Please begin with your street number and street name. SN12g. Getting credit, bank loans, or a mortgage? 01 Respondent agrees –GIVES INFO 01 YES 02 Respondent Refused 02 NO 97 DON’T KNOW ADD May I please have your mailing address and phone number. Please begin with your street 99 REFUSED number and street name. ASK OF ALL ASK IF PADD=01 SN12h. On the street or in a public setting? 01 YES APTNO What is the apartment number? 02 NO 97 DON’T KNOW ASK IF Y1=01 99 REFUSED PCITY What city do you live in? ASK OF ALL 01 Respondent agrees –GIVES INFO 02 Respondent Refused SN12i. From the police or in the courts? 01 YES 02 NO ASK IF PCITY=01 97 DON’T KNOW CITY What city do you live in? 99 REFUSED
ASK IF Y1=01 TIMING MARKER 22 TIMING SECTION 23 PSTATE In what state? 01 Respondent agrees –GIVES INFO Y1. We’re almost finished with the interview now. 02 Respondent Refused We may wish to talk to you again in the future to ask more questions about attitudes and opinions about alcohol, whether you drink alcoholic beverages or not. To find you then, we’ll need some locating ASK IF PSTATE=01 information. I also want to assure you that this information will be kept completely confidential in secure STATE In what state? and protected data files, and will be separate from the responses you’ve already provided in the interview. Even if you agree now, you may choose not to participate if you are contacted in the future. ASK IF Y1=01
01--Respondent agrees – continue PZIPCODE What is your zip code? 02--Respondent does not agree to provide this information. - SKIP TO GEOCODE 01 Respondent agrees –GIVES INFO 02 Respondent Refused
137 138 ASK IF PZIPCODE=01
Page Page ZIPCODE What is your zip code?
//ASK IF INET1=1//
ASK IF Y1=01 EMAIL1 Do you have an email address?
LLPHONE1 What is your landline telephone number. Please begin with the area code. 01 YES ASK IF Y1=01 02 NO
LLPHONE2 Is this phone listed in your name? 97 DON’T KNOW 01 YES 99 REFUSED 02 NO 97 DON’T KNOW //ASK IF EMAIL1=1// 99 REFUSED PEMAIL2 Can we have your email address? 01 GAVE RESPONSE IF LLPHONE2=02 02 NO/REFUSED In whose name is it listed? //ASK IF PEMAIL2=1// ASK IF Y1=01 EMAIL2 Can we have your email address?
[ENTER RESPONSE]______PCPHONE Do you also have a cell phone number you would be willing to provide?
(Cell number recorded here)
ASK IF Y1=02 OR PADD=02 ASK IF Y1=01
GEOCODE Although you don’t want to give us your address, for analysis purposes it would help if CONFIRM1 I would like to confirm the information I just recorded. (READ COMPLETE we had some general information on where you live. This information is simply to find which census INFORMATION TO R. CONFIRM SPELLING.) tract you live in.
IF Y1=01 01 WILL GIVE INFORMATION 02 REFUSED INET1 Do you have access to the internet, either at home or somewhere else? ASK IF GEOCODE=01 and PZIPCODE =MISSING 01 YES 02 NO GEOZIP What is your zip code 97 DON’T KNOW ENTER ZIP CODE_____ 99 REFUSED 77777 DON’T KNOW 99999 REFUSED
ASK IF GEOCODE=01 PGEOSTR We don't need to know your house address, just the name of the street you live on -- what is the name of your street? [INTERVIEWER: CONFIRM SPELLING] 01 GAVE STREET ______02 REFUSED
ASK IF PGEOST=01
GEOST1. ENTER STREET ADDRESS -- INTERVIEWER: ASK RESPONDENT TO SPELL STREET NAME IF NEEDED.
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ASK IF PGEOST=01 related issue or to find out about treatment programs in your area, you can call 1-800-662- HELP (which is 1-800-662-4357). Would you like me to repeat that number? Thank you for GEOST2. And what is the name of the street down the corner from you that crosses your street? your time and cooperation. ENTER STREET ADDRESS -- INTERVIEWER: ASK RESPONDENT TO SPELL STREET NAME IF NEEDED. TIMING MARKER 21
ASKOF ALL YRADDR How many years have you lived at your current address? ______Number of years [range 0-96] INTERVIEWER OBSERVATIONS. THIS SECTION IS TO BE COMPLETED AFTER YOU CONDUCT 0=Less than one year THE INTERVIEW AND AFTER YOU HAVE HUNG UP WITH THE RESPONDENT. 97 DON’T KNOW 99 REFUSED Z1 OVERALL, HOW COOPERATIVE WAS THE RESPONDENT DURING THIS INTERVIEW? 01 VERY COOPERATIVE ASK IF YRADDR = 97 02 SOMEWHAT COOPERATIVE 03 SOMEWHAT UNCOOPERATIVE YRADDR2. Would you say that you have lived at your current address less than one year, between 04 VERY UNCOOPERATIVE 1 and 5 years, or more than 5 years? 00 Less than one year Z2 OVERALL, HOW INTERESTED WAS THE RESPONDENT IN THIS INTERVIEW? 01 1-5 years 01 VERY INTERESTED 02 More than 5 years 02 SOMEWHAT INTERESTED 97 DON’T KNOW 03 SOMEWHAT DISINTERESTED 99 REFUSED 04 VERY DISINTERESTED
Z3 OVERALL, IS THIS INTERVIEW OF QUESTIONABLE QUALITY, GENERALLY ADEQUATE ASK IF Y1=01, OTHERWISE GO TO CLOSING OR OF HIGH QUALITY? 01 QUESTIONABLE QUALITY Y2. In case we are unable to get in touch with you, may I have the full name of a close relative or 02 GENERALLY ADEQUATE the names of a friend who does not live with you but who would be likely to know where you can be 03 HIGH QUALITY reached in the future. Remember, everything you tell us will be completely confidential. We would contact them only if we cannot reach you directly. Ask if z3=1 Z4 THIS INTERVIEW IS OF QUESTIONABLE QUALITY BECAUSE R WAS: (CODE ALL THAT APPLY) 01--Respondent agrees - continue 01. EVASIVE, SUSPICIOUS, RELUCTANT 01 02--Respondent does not agree to provide this information. - SKIP TO pnclose 02. BORED, UNINTERESTED 02 03 UNABLE TO CONCENTRATE OR REMEMBER 03 ASK IF Y2=01 04 . HOSTILE 04 05 EMBARRASSED 05 Y2P1FN May I please have the person’s first name. 95 . OTHER (SPECIFY): ______Y2P1LN May I please have the last name. Y2P1REL What is this person’s relationship to you? Z5 WAS THERE ANY INDICATION FROM R’S BEHAVIOR OR CIRCUMSTANCES Y2P1ADD May I please have (his/her) mailing address and phone number. Please begin with the SURROUNDING THE INTERVIEW THAT R WAS NOT GIVING TRUTHFUL ANSWERS? street number and street name. 01 YES Y2P1APT And what is (his/her) apartment number? 02 NO Y2P1C What city does (he/she) live in ? Y2P1S In what state? Ask if z5=1 Y2P1Z What is his/her zip code? Z6 WERE THESE INDICATIONS RELATED TO: (CODE ALL THAT APPLY) Y2P1T What is his/her telephone number? Please begin with the area code. And his/her phone 01 THE PRESENCE OF ANOTHER PERSON number? 02 INABILITY OF R TO UNDERSTAND THE QUESTIONS CONFIRM4. I would like to confirm the information I just recorded. (READ COMPLETE 03 SUSPICION OR HOSTILITY TOWARD THE INTERVIEWER
INFORMATION TO R. CONFIRM SPELLING.) 04 LACK OF INTEREST 05 INTERRUPTIONS 95 SOMETHING ELSE? (SPECIFY): ______141 PNCLOSE (All): 142 That was my last question. If you or someone you know would like to talk about an alcohol- Z7 WAS THERE ANYTHING UNUSUAL ABOUT THE RESPONDENT, THE INTERVIEWING Page Page
SITUATION OR THE INTERVIEW ITSELF THAT MIGHT HELP INTERPRETING THE DATA? 01 yes 02 no
Ask if z7=1 Z7o. What was unusual? 01 Respondent seemed to be giving rote responses or not thinking about them 02 Respondent’s responses seemed to be inconsistent 03 Distractions in background 04 Language problems 05 Elderly/problems with understanding 06 Respondent was/possibly disabled or sick 07 Respondent criticized the items thought they should be asked differently 08 Respondent didn’t like answer categories 09 Impatient, tried to hurry interviewer 10 Respondent was confused about answer options 95 OTHER
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