Think back over your entire lifetime and try to remember whether you have EVER used any of the following substances. If so, what was your age the FIRST TIME you used the substance: Never 10 or 11 12 13 14 15 16 17 or Used Younger Older Cigarettes: Include Ever smoked part menthol and regular or all of a cigarettes and loose cigarette? tobacco rolled into cigarettes Other tobacco products: Ever used any Include any tobacco other tobacco product other than product? cigarettes such as snuff, chewing tobacco, and smoking tobacco from a pipe Alcoholic beverages: Ever had a drink Include beer, wine, wine of an alcoholic coolers, malt beverages, beverage? Do and liquor NOT include any time when you only had a sip or two from a drink. Marijuana or hashish: Ever used Also known as grass, marijuana or pot, hash, or hash oil hashish? Methamphetamine: A Ever used highly addictive stimulant, also known as meth, crystal, ice or speed Cocaine or crack cocaine: Ever used A highly addictive cocaine? stimulant, also known as coke, snow or smack (usually a white powder) Heroin: A highly Ever used heroin? addictive drug that relieves pain. (usually injected)
Think back over your entire lifetime and try to remember whether you have EVER used any of the following substances. If so, what was your age the FIRST TIME you used the substance: Never Used 10 or Younger 11 12 13 14 15 16 17 or Older Cigarettes: Include menthol and regular cigarettes and loose tobacco rolled into cigarettes Ever smoked part or all of a cigarette? Other tobacco products: Include any tobacco product other than cigarettes such as snuff, chewing tobacco, and smoking tobacco from a pipe Ever used any other tobacco product? Alcoholic beverages: Include beer, wine, wine coolers, malt beverages, and liquor Ever had a drink of an alcoholic beverage? Do NOT include any time when you only had a sip or two from a drink. Marijuana or hashish: Also known as grass, pot, hash, or hash oil Ever used marijuana or hashish? Methamphetamine: A highly addictive stimulant, also known as meth, crystal, ice or speed Ever used Cocaine or crack cocaine: A highly addictive stimulant, also known as coke, snow or smack (usually a white powder) Ever used cocaine? Heroin: A highly addictive drug that relieves pain. (usually injected) Ever used heroin?
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