Smoking History
Tick one box only. NOTE: Subject should be a lifetime non-smoker or an ex-smoker of >1 year duration with a <5 year pack history to be eligible to participate in this study.
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Former smoker
integer
Former smoker, date stopped
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Urine Cotinine Test
Date sample taken
date
If it's positive, EXCLUDE subject from the study
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Note the Initials
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