______ Per week ______ OR per month Taking the past year, can you tell me what the normal earnings of the household have been? ______ OR per year (RECORD ONLY ONE, NOT ALL 3) Refused 88 2. Lifestyle Factors Tobacco Use Now I am to ask you some questions about tobacco use. Question Response Code Do you currently any tobacco products, such as cigarettes? Yes 1 (USE SHOWCARD) No 2 If No, go to X Yes 1 Do you currently smoke tobacco products daily? No 2 Age (years) How old were you when you first started smoking? Don’t know 77 └─┴─┘ On average, how many cigarettes do you smoke each day Number of cigarettes └─┴─┘ per day Don’t Know 77 Yes 1 In the past, did you ever smoke daily? No 2 How old were you when you stopped smoking? Age (years) └─┴─┘ Alcohol Consumption The next questions ask about the consumption of alcohol. Have you ever consumed any alcohol such as beer, wine, spirits Yes 1 or [add other local examples]? No 2 If No, go to X (USE SHOWCARD OR SHOW EXAMPLES) Yes 1 If Yes, go to X Have you consumed any alcohol within the past 12 months? No 2 Have you stopped drinking due to health reasons, such as a Yes 1 X negative impact on your health or on the advice of your doctor or No X other health worker? Daily 1 During the past 12 months, how frequently have you had at least 5-6 days per week 2 one standard alcoholic drink? 3-4 days per week 3 (READ RESPONSES, USE SHOWCARD) 1-2 days per week 4
Taking the past year, can you tell me what the normal earnings of the household have been? (RECORD ONLY ONE, NOT ALL 3) Per week ______ OR per month ______ OR per year ______ Refused 88 2. Lifestyle Factors Tobacco Use Now I am to ask you some questions about tobacco use. Question Response Code Do you currently any tobacco products, such as cigarettes? (USE SHOWCARD) Yes 1 No 2 If No, go to X Do you currently smoke tobacco products daily? Yes 1 No 2 How old were you when you first started smoking? Age (years) └─┴─┘ Don’t know 77 On average, how many cigarettes do you smoke each day Don’t Know 77 Number of cigarettes per day └─┴─┘ In the past, did you ever smoke daily? Yes No 1 2 How old were you when you stopped smoking? Age (years) └─┴─┘ Alcohol Consumption The next questions ask about the consumption of alcohol. Have you ever consumed any alcohol such as beer, wine, spirits or [add other local examples]? (USE SHOWCARD OR SHOW EXAMPLES) Yes 1 No 2 If No, go to X Have you consumed any alcohol within the past 12 months? Yes 1 If Yes, go to X No 2 Have you stopped drinking due to health reasons, such as a negative impact on your health or on the advice of your doctor or other health worker? Yes 1 X No X During the past 12 months, how frequently have you had at least one standard alcoholic drink? (READ RESPONSES, USE SHOWCARD) Daily 1 5-6 days per week 2 3-4 days per week 3 1-2 days per week 4
MSF%20OCA%20Mweso%20DM%20protocol%20v%205%20%28ID%201542%29.docx