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Protocol - Substance Abuse and Dependence - Past Year - Tobacco

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Protocol Name from Source:

This section will be completed when reviewed by an Expert Review Panel.

Availability:

Publicly available

Description:

In a face-to-face interview, the respondent is asked several questions about nicotine dependence during the past 12 months. These responses correspond with criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (American Psychiatric Association, 1994). The questions encompass nicotine from any source (e.g., cigarettes, cigars, a pipe, snuff, or chewing tobacco).

Protocol:

Section 3A - Tobacco Use

Column a

Column b

8a. The next few questions are about experiences that many people have had with using tobacco, including cigarettes, cigars, a pipe, snuff, or chewing tobacco. As I read each experience, please tell me if it has EVER happened to you as a result of using ANY of these types of tobacco.

In your ENTIRE LIFE, did you EVER…(PAUSE)

(Repeat phrase frequently)

b. Did this happen in the last 12 months?

(1) More than once want to cut down on your tobacco use?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b1]

(2) Give up or cut down on activities that you were interested in or that gave you pleasure because tobacco use was not permitted at the activity?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b2]

(3) Give up or cut down on activities that were important to you — like associating with friends or relatives or attending social activities - because tobacco use was not permitted at the activity?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b3]

(4) Continue to use tobacco even though you knew it was causing you a health problem or making a health problem worse?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b4]

(5) Find yourself (chain smoking/using one pinch or plug of snuff or chewing tobacco right after another)?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b5]

(6) More than once try to stop or cut down on your tobacco use but found you couldn’t do it?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b6]

(7) Many people experience problems on occasions when they stop or cut down on their tobacco use.

After stopping or cutting down on your tobacco use, did you EVER…

(a) Feel depressed?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b7a]
(b) Have difficulty falling asleep or staying asleep?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b7b]
(c) Have difficulty concentrating?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b7c]
(d) Eat more than usual or gain weight?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b7d]
(e) Become easily irritated, angry, or frustrated?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b7e]
(f) Feel anxious or nervous?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b7f]
(g) Feel your heart beating more slowly than usual?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b7g]
(h) Feel more restless than usual?

1 [ ] Yes →

2 [ ] No - Go to Check
Item 3.4

1 [ ] Yes

2 [ ] No

[s3aq8b7h]

CHECK ITEM 3.4

Are at least 2 items marked "Yes" in column b, 7(a) - 7(h)?

1 [ ] Yes - Go to 7(i)

2 [ ] No - SKIP to (8)

(i) You just mentioned that you had some experiences after stopping or cutting down on your tobacco use in the last 12 months. Were any of these experiences very uncomfortable or upsetting to you or did they cause problems in your life — like at work or school or with family or friends?

1 [ ] Yes

2 [ ] No

[s3aq8b7i]
(j) Did you use tobacco in the last 12 months to keep from having any of these experiences?

1 [ ] Yes

2 [ ] No

[s3aq8b7j]

(8) Wake up in the middle of the night to use tobacco?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b8]

(9) Often use tobacco just after getting up or shortly after getting up in the morning?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b9]

(10) Find yourself using tobacco JUST AFTER being in a situation where tobacco use was not permitted - like after being on a plane, at a meeting, or shopping at the mall?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b10]

(11) Find that you had to use much more tobacco than you once did to get the effect you wanted?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b11]

(12) Increase your use of tobacco by at least 50 percent?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b12]

(13) Have a period when you often used tobacco more than you intended to?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b13]

(14) Continue to use tobacco even though it made you nervous, jittery, anxious, or depressed?

1 [ ] Yes →

2 [ ] No - Go to next experience

1 [ ] Yes

2 [ ] No

[s3aq8b14]

Scoring Procedure and Interpretation

The scoring algorithms were reverse-engineered and further validated by members of the Substance Abuse and Addiction Scientific Panel and Working Group, and the results from the algorithms were found to match* the nicotine dependence diagnoses reported in the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) (Saha et al., 2010; Muthen & Asparouhov, 2006).

The variable names used in the following SAS code for nicotine dependence diagnosis correspond to the variable names shown in blue from the protocol text. The algorithms are derived from published work by NESARC investigators (Grant et al., 2004), and they are provided to assist with derivation of estimates from NESARC.

The SAS code creates NESARC-compatible dichotomous variables (with values 0 = negative and 1 = positive) for past-year nicotine dependence diagnostic criteria (p12tolerance, p12withdrawal_v2, p12intend, p12quit, p12giveup, p12time, and p12problems) and past-year nicotine dependence diagnosis (dsm4depend_p12). The nicotine withdrawal algorithm, shown below as p12withdrawal_v2, may not directly relate to withdrawal based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (American Psychiatric Association, 1994). All other diagnostic criteria algorithms are directly based on DSM-IV. Nicotine withdrawal according to Criterion B of DSM-IV (American Psychiatric Association, 1994) may be captured by using p12withdrawal_dsm alone.

* For p12tolerance, a 1% difference was noted between the publication (Saha et al., 2010) and the reverse-engineered algorithm results.

SAS code

********************Dependence items******************;

p12tolerance = (s3aq8b11=1) or (s3aq8b12=1);

p12withdrawal_total = ((s3aq8b7a=1)+(s3aq8b7b=1)+(s3aq8b7c=1)+(s3aq8b7d=1)+(s3aq8b7e=1)+(s3aq8b7f=1)+(s3aq8b7g=1)+(s3aq8b7h=1));

p12withdrawal_v1=(p12withdrawal_total>3);

p12withdrawal_v2=(p12withdrawal_v1=1 or (s3aq8b7j=1 or s3aq8b8=1 or s3aq8b9=1 or s3aq8b10=1));

p12withdrawal_dsm=(p12withdrawal_v1=1 or s3aq8b7j=1);

p12intend = (s3aq8b13=1);

p12quit = (s3aq8b1=1 or s3aq8b6=1);

p12giveup = (s3aq8b2=1 or s3aq8b3=1);

p12time = (s3aq8b5=1);

p12problems = (s3aq8b4=1 or s3aq8b14=1);

***********Past 12-month dependence diagnosis***;

dsm4depend_total_p12=p12tolerance+p12withdrawal_v2+p12intend+p12quit+p12giveup+p12time+p12problems;

dsm4depend_p12 =(dsm4depend_total_p12 ge 3);

Personnel and Training Required

Interviewer must be trained and found to be competent to conduct personal interviews with individuals from the general population. Specifically, the 2-week AUDADIS training covers directed self-study, intensive classroom training, and practice interviewing. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.

Equipment Needs

Although the Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV) instrument was developed for administration by computer, the PhenX Working Group acknowledges that these questions can be administered in a noncomputerized format. Hasin et al. (1997) and Grant et al. (1995) used the AUDADIS in paper-and-pencil format; Grant et al. (2003) obtained data with the computerized format.

Requirements

Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualYes
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingYes

Mode of Administration

Self-administered

Life Stage:

Adult

Specific Instructions:

Questions concerning past 12-month nicotine experiences are found in Section 3A (questions 8-11) of the Alcohol Use Disorder and Associated Disabilities Interview Schedule - Fourth Edition Version (AUDADIS-IV). The questions and check items have not been renumbered, so the protocol text starts with question "8." Note that not all questions are administered to all respondents because of skip patterns in AUDADIS-IV. These questions are asked if a respondent had affirmatively answered the first question in the "Tobacco - Smoking Status" measure from the Alcohol, Tobacco and Other Substances domain, such that never smokers skip Section 3A entirely. Variable names, shown in blue, are used in the scoring algorithm for nicotine dependence diagnosis in the past 12 months.

The Substance Abuse and Addiction Working Group acknowledges that the following questions may gather sensitive information relating to the use of substances and/or illegal conduct. If the information is released, it might be damaging to an individual’s employability, lead to social stigmatization, or lead to other consequences.

Most researchers assure confidentiality as part of their informed consent process, as required by their institutional review boards. When assessing minors with these questions, it may be necessary to obtain informed consent from a parent of the adolescent. Further assurance of confidentiality may be obtained by applying to National Institutes of Health (NIH) for a Certificate of Confidentiality, which helps researchers protect the privacy of human research participants. The procedures for the Certificate of Confidentiality can be found at the Grants Policy website of the NIH: http://grants1.nih.gov/grants/policy/coc/index.htm.

Research Domain Information

Release Date:

June 7, 2012

Definition

Interviewer-administered questions to determine whether the respondent has experienced symptoms of alcohol abuse and dependence, nicotine dependence, or substance abuse and dependence in the past year (i.e., past 12 months).

Purpose

This measure uses the 12-month criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), to evaluate alcohol abuse and dependence, nicotine dependence, or substance abuse and dependence.

Selection Rationale

The Alcohol Use Disorder and Associated Disabilities Interview Schedule-Fourth Edition Version (AUDADIS-IV) is a fully structured diagnostic interview for alcohol and substance use disorders and their associated disabilities. AUDADIS-IV was designed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) to be administered by lay interviewers. Questions from the AUDADIS-IV were chosen because this protocol has been used in an established epidemiological study of adults with a wide age range and different races and ethnicities (National Epidemiologic Survey on Alcohol and Related Conditions, NESARC). AUDADIS-IV questions have been validated and psychometrically tested.

Language

English, Spanish

Standards

StandardNameIDSource
Common Data Elements (CDE)Substance Abuse Tobacco Use Past Year Questionnaire Assessment Description Text3466871CDE Browser

Process and Review

This section will be completed when reviewed by an Expert Review Panel.

Source

National Institute on Alcohol Abuse and Alcoholism (NIAAA) National Epidemiologic Survey on Alcohol and Related Conditions. Wave 1 (NESARC-WAVE 1). Alcohol Use Disorder and Associated Disabilities Interview Schedule-Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition Version (AUDADIS-IV). Section 3A Tobacco Use, Questions 8-11.

Grant, B. F., Dawson, D. A., Stinson, F. S., Chou, P. S., Kay, W., & Pickering, R. (2003) The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): Reliability of alcohol consumption, tobacco use, family history of depression and psychiatric diagnostic modules in a general population sample. Drug and Alcohol Dependence, 71(1), 7-16.

The reverse-engineering of the scoring algorithms reflects a collaborative effort, particularly between Dr. Arpana Agrawal (Washington University in St. Louis, Substance Abuse and Addiction Scientific Panel Member) and Alvaro Verges from the research group of Dr. Kenneth Sher (University of Missouri, Substance Abuse and Addiction Scientific Panel Chair).

General References

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC.

Canino, G., Bravo, M., Ramirez, R., Febo, V. E., Rubio-Stipec, M., Fernandez, R. L., & Hasin, D. (1999). The Spanish Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS): Reliability and concordance with clinical diagnoses in a Hispanic population. Journal of Studies on Alcohol, 60(6), 790-799.

Grant, B. F., Harford, T. C., Dawson, D. A., Chou, P. S., & Pickering, R. P. (1995). The Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS): Reliability of alcohol and drug modules in a general population sample. Drug and Alcohol Dependence, 39(1), 37-44.

Grant, B. F., Hasin, D. S., Chou, S. P., Stinson, F. S., & Dawson, D. A. (2004). Nicotine dependence and psychiatric disorders in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61(11), 1107-1115.

Grant, B. F., & Towle, L. (1990). Standardized diagnostic interviews for alcohol research. Alcohol Health and Research World, 14(4), 340-348.

Hasin, D., Carpenter, K. M., McCloud, S., Smith, M., & Grant, B. F. (1997). The Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS): Reliability of alcohol and drug modules in a clinical sample. Drug and Alcohol Dependence, 44(2-3), 133-141.

Muthen, B., & Asparouhov, T. (2006). Item response mixture modeling: Application to tobacco dependence criteria. Addictive Behaviors, 31(6), 1050-1066.

Saha, T. D., Compton, W. M., Pulay, A. J., Stinson, F. S., Ruan, W. J., & Grant, B. F. (2010). Dimensionality of DSM-IV nicotine dependence in a national sample: An item response theory application. Drug and Alcohol Dependence, 108(1-2), 21-28.

Ruan, W. J., Goldstein, R. B., Chou, S. P., Smith, S. M., Saha, T. D., Pickering, R. P., Dawson, D. A., Huang, B., Stinson, F. S., & Grant, B. F. (2008). The Alcohol Use Disorder and Associated Disabilities Interview Schedule-IV (AUDADIS-IV): Reliability of new psychiatric diagnostic modules and risk factors in a general population sample. Drug and Alcohol Dependence, 92(1-3), 27-36.

Protocol ID:

510403

Variables:

Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX510403_EntireLife_WantTo_CutDown_TobaccoUsePX510403010100In your ENTIRE LIFE, did you EVER¿¿¿ (PAUSE) More than once want to cut down on your tobacco use?4N/A
PX510403_WantTo_CutDown_TobaccoUse_Last12MonthsPX510403010200In your ENTIRE LIFE, did you EVER¿¿¿ (PAUSE) More than once want to cut down on your tobacco use? Did this happen in the last 12 months?4N/A
PX510403_EntireLife_CutDown_InterestingActivities_TobaccoUse_NotPermittedPX510403020100In your ENTIRE LIFE, did you EVER¿¿¿ (PAUSE) Give up or cut down on activities that you were interested in or that gave you pleasure because tobacco use was not permitted at the activity?4N/A
PX510403_CutDown_InterestingActivities_TobaccoUse_NotPermitted_Last12MonthsPX510403020200In your ENTIRE LIFE, did you EVER¿¿¿ (PAUSE) Give up or cut down on activities that you were interested in or that gave you pleasure because tobacco use was not permitted at the activity? Did this happen in the last 12 months?4N/A
PX510403_EntireLife_CutDown_ImportantActivities_TobaccoUse_NotPermittedPX510403030100In your ENTIRE LIFE, did you EVER¿¿¿ (PAUSE) Give up or cut down on activities that were important to you ¿¿¿ like associating with friends or relatives or attending social activities ¿¿¿ because tobacco use was not permitted at the activity?4N/A
PX510403_CutDown_ImportantActivities_TobaccoUse_NotPermitted_Last12MonthsPX510403030200In your ENTIRE LIFE, did you EVER¿¿¿ (PAUSE) Give up or cut down on activities that were important to you ¿¿¿ like associating with friends or relatives or attending social activities ¿¿¿ because tobacco use was not permitted at the activity? Did this happen in the last 12 months?4N/A
PX510403_EntireLife_Continue_Tobacco_HealthProblemsPX510403040100In your ENTIRE LIFE, did you EVER¿¿¿ (PAUSE) Continue to use tobacco even though you knew it was causing you a health problem or making a health problem worse?4N/A
PX510403_Continue_Tobacco_HealthProblems_Last12MonthsPX510403040200In your ENTIRE LIFE, did you EVER¿¿¿ (PAUSE) Continue to use tobacco even though you knew it was causing you a health problem or making a health problem worse? Did this happen in the last 12 months?4N/A
PX510403_EntireLife_Chain_SmokingPX510403050100In your ENTIRE LIFE, did you EVER¿¿¿ (PAUSE) Find yourself chain smoking/using one pinch or plug of snuff or chewing tobacco right after another.?4N/A
PX510403_Chain_Smoking_Last12MonthsPX510403050200In your ENTIRE LIFE, did you EVER¿¿¿ (PAUSE) Find yourself chain smoking/using one pinch or plug of snuff or chewing tobacco right after another.? Did this happen in the last 12 months?4N/A
PX510403_EntireLife_CouldNot_CutOut_TobaccoPX510403060100In your ENTIRE LIFE, did you EVER¿¿¿ (PAUSE) More than once try to stop or cut down on your tobacco use but found you couldn¿¿¿t do it?4Variable Mapping
PX510403_CouldNot_CutOut_Tobacco_Last12MonthsPX510403060200In your ENTIRE LIFE, did you EVER¿¿¿ (PAUSE) More than once try to stop or cut down on your tobacco use but found you couldn¿¿¿t do it? Did this happen in the last 12 months?4N/A
PX510403_After_Stopping_DepressedPX510403070101After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Feel depressed4N/A
PX510403_After_Stopping_Depressed_Last12MonthsPX510403070102After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Feel depressed Did this happen in the last 12 months?4N/A
PX510403_After_Stopping_SleeplessPX510403070201After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Have difficulty falling asleep or staying asleep?4N/A
PX510403_After_Stopping_Sleepless_Last12MonthsPX510403070202After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Have difficulty falling asleep or staying asleep? Did this happen in the last 12 months?4N/A
PX510403_After_Stopping_Difficulty_ConcentratingPX510403070301After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Have difficulty concentrating?4N/A
PX510403_After_Stopping_Difficulty_Concentrating_Last12MonthsPX510403070302After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Have difficulty concentrating? Did this happen in the last 12 months?4N/A
PX510403_After_Stopping_Gain_WeightPX510403070401After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Eat more than usual or gain weight?4N/A
PX510403_After_Stopping_Gain_Weight_Last12MonthsPX510403070402After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Eat more than usual or gain weight? Did this happen in the last 12 months?4N/A
PX510403_After_Stopping_Angry_FrustratedPX510403070501After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Become easily irritated, angry, or frustrated?4N/A
PX510403_After_Stopping_Angry_Frustrated_Last12MonthsPX510403070502After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Become easily irritated, angry, or frustrated? Did this happen in the last 12 months?4N/A
PX510403_After_Stopping_Anxious_NervousPX510403070601After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Feel anxious or nervous?4N/A
PX510403_After_Stopping_Anxious_Nervous_Last12MonthsPX510403070602After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Feel anxious or nervous? Did this happen in the last 12 months?4N/A
PX510403_After_Stopping_Slow_HeartbeatPX510403070701After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Feel your heart beating more slowly than usual?4N/A
PX510403_After_Stopping_Slow_Heartbeat_Last12MonthsPX510403070702After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Feel your heart beating more slowly than usual? Did this happen in the last 12 months?4N/A
PX510403_After_Stopping_RestlessPX510403070801After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Feel more restless than usual?4N/A
PX510403_After_Stopping_Restless_Last12MonthsPX510403070802After stopping or cutting down on your tobacco use, did you EVER¿¿¿ Feel more restless than usual? Did this happen in the last 12 months?4N/A
PX510403_Check_ItemPX510403070900CHECK ITEM 3.4: Are at least 2 items marked ¿¿¿Yes" in column b, 7 a. - 7 h.?4N/A
PX510403_Experiences_CauseProblems_WorkSchoolPX510403071001You just mentioned that you had some experiences after stopping or cutting down on your tobacco use in the last 12 months. Were any of these experiences very uncomfortable or upsetting to you or did they cause problems in your life ¿¿¿ like at work or school or with family or friends?4N/A
PX510403_Experiences_CauseProblems_WorkSchool_Last12MonthsPX510403071002You just mentioned that you had some experiences after stopping or cutting down on your tobacco use in the last 12 months. Were any of these experiences very uncomfortable or upsetting to you or did they cause problems in your life ¿¿¿ like at work or school or with family or friends? Did this happen in the last 12 months?4N/A
PX510403_Use_Tobacco_Prevent_ProblemsPX510403071101Did you use tobacco in the last 12 months to keep from having any of these experiences?4N/A
PX510403_Wake_Up_Use_TobaccoPX510403080100Wake up in the middle of the night to use tobacco?4N/A
PX510403_Wake_Up_Use_Tobacco_Last12MonthsPX510403080200Wake up in the middle of the night to use tobacco? Did this happen in the last 12 months?4N/A
PX510403_Use_Tobacco_Upon_WakingPX510403090100Often use tobacco just after getting up or shortly after getting up in the morning?4N/A
PX510403_Use_Tobacco_Upon_Waking_Last12MonthsPX510403090200Often use tobacco just after getting up or shortly after getting up in the morning? Did this happen in the last 12 months?4N/A
PX510403_Use_Tobacco_Just_AfterPX510403100100Find yourself using tobacco JUST AFTER being in a situation where tobacco use was not permitted ¿¿¿ like after being on a plane, at a meeting, or shopping at the mall?4N/A
PX510403_Use_Tobacco_Just_After_Last12MonthsPX510403100200Find yourself using tobacco JUST AFTER being in a situation where tobacco use was not permitted ¿¿¿ like after being on a plane, at a meeting, or shopping at the mall? Did this happen in the last 12 months?4N/A
PX510403_Use_More_Tobacco_EffectPX510403110100Find that you had to use much more tobacco than you once did to get the effect you wanted?4N/A
PX510403_Use_More_Tobacco_Effect_Last12MonthsPX510403110200Find that you had to use much more tobacco than you once did to get the effect you wanted? Did this happen in the last 12 months?4N/A
PX510403_Use_50Percent_More_TobaccoPX510403120100Increase your use of tobacco by at least 50 percent?4N/A
PX510403_Use_50Percent_More_Tobacco_Last12MonthsPX510403120200Increase your use of tobacco by at least 50 percent? Did this happen in the last 12 months?4N/A
PX510403_Use_More_Tobacco_ThanIntendedPX510403130100Have a period when you often used tobacco more than you intended to?4Variable Mapping
PX510403_Use_More_Tobacco_ThanIntended_Last12MonthsPX510403130200Have a period when you often used tobacco more than you intended to? Did this happen in the last 12 months?4N/A
PX510403_Continue_Tobacco_Made_NervousPX510403140100Continue to use tobacco even though it made you nervous, jittery, anxious, or depressed?4N/A
PX510403_Continue_Tobacco_Made_Nervous_Last12MonthsPX510403140200Continue to use tobacco even though it made you nervous, jittery, anxious, or depressed? Did this happen in the last 12 months?4N/A