| Question | Response |
|---|---|
| Date collected | |
| Category | Tobacco Alcohol Caffeine Other |
| Type | Tobacco products Cigars Cigarettes Beer Wine Spirits Caffeinated beverages |
| Use | Never Current Former |
| Quantity | |
| Quantity Unit | |
| Frequency | Daily Weekly Monthly Occasional Other |
| Duration | |
| Duration Unit | Days Weeks Months |