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Visit 1 Run-In Substance Use: Tobacco History NCT01117584

1 Formulär  
General Information
Beskrivning

General Information

Tobacco History
Beskrivning

Tobacco History

Datatyp

integer

For Former Tobacco User or Current Tobacco User, please specify quantity
Beskrivning

Specification of Quantity if Tobacco User

Datatyp

text

Name of Substance
Beskrivning

Tobacco Type

Datatyp

text

Substance Use Consumption
Beskrivning

Quantity

Datatyp

text

Consumption Units
Beskrivning

Units

Datatyp

text

Total Daily Consumption using SUDOSU
Beskrivning

Total Daily Consumption using SUDOSU

Datatyp

text

Category for Substance Use
Beskrivning

Category for Substance Use

Datatyp

text

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Visit 1 Run-In Substance Use: Tobacco History NCT01117584

1 Formulär
Name
Typ
Description | Question | Decode (Coded Value)
Datatyp
Alias
Item Group
General Information
Item
Tobacco History
integer
Tobacco History
Code List
Tobacco History
CL Item
Never used Tobacco (1)
CL Item
Former Tobacco User (2)
CL Item
Current Tobacco User (3)
Specification of Quantity if Tobacco User
Item
For Former Tobacco User or Current Tobacco User, please specify quantity
text
Tobacco Type
Item
Name of Substance
text
Quantity
Item
Substance Use Consumption
text
Item
Consumption Units
text
Units
Code List
Consumption Units
CL Item
Cigarettes (1)
CL Item
Cigars (2)
CL Item
Pipes(Bowls) (3)
CL Item
Chews (4)
Total Daily Consumption using SUDOSU
Item
Total Daily Consumption using SUDOSU
text
Category for Substance Use
Item
Category for Substance Use
text
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