ID

5614

Beschrijving

Gynecologic Oncology Group Smoking History Questionnaire (Form SHQ) Radiation Therapy With or Without Chemotherapy in Patients With Stage I or Stage II Cervical Cancer Who Previously Underwent Surgery Source Form: NCI FormBuilder: https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=572CCDFB-3AD6-1370-E044-0003BA3F9857

Link

https://formbuilder.nci.nih.gov/FormBuilder/formDetailsAction.do?method=getFormDetails&formIdSeq=572CCDFB-3AD6-1370-E044-0003BA3F9857

Trefwoorden

Versies (3)
  1. 27-08-12 27-08-12 -
  2. 11-08-14 11-08-14 - Martin Dugas
  3. 09-01-15 09-01-15 - Martin Dugas
Geüploaded op

11 augustus 2014

DOI

Voor een aanvraag inloggen.

Licentie

Creative Commons BY-NC 3.0 Legacy
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Cervical Cancer NCT01101451 Quality of Life - Gynecologic Oncology Group Smoking History Questionnaire (Form SHQ) - 2785914v1.0

Engels

No Instruction available.

1 Formulieren  
  1. StudyEvent: Gynecologic Oncology Group Smoking History Questionnaire (Form SHQ)
    1. No Instruction available.
Header Module
Beschrijving

Header Module

Date form originally completed (m d y)
Beschrijving

FormOriginalCompleteDate

Datatype

date

Alias
NCI Thesaurus ObjectClass
C19464
UMLS 2011AA ObjectClass
C0376315
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property
C25604
UMLS 2011AA Property
C0205313
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain
C25367
Date form amended (m d y)
Beschrijving

FormAmendedCompleteDate

Datatype

date

Alias
NCI Thesaurus ObjectClass
C19464
UMLS 2011AA ObjectClass
C0376315
NCI Thesaurus Property
C25250
UMLS 2011AA Property
C0205197
NCI Thesaurus Property
C25416
UMLS 2011AA Property
C1691222
NCI Thesaurus ValueDomain
C25164
UMLS 2011AA ValueDomain
C0011008
NCI Thesaurus ValueDomain
C25367
Person amending form, last name
Beschrijving

ResponsiblePersonReportingChangeLastName

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
Patient Name, Last
Beschrijving

PatientLastName

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C25551
UMLS 2011AA Property
C1517741
Patient Name, First
Beschrijving

PatientFirstName

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C25509
UMLS 2011AA Property
C1279901
Patient Study ID
Beschrijving

PatientGynecologicOncologyGroupIdentifierNumber

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25337
UMLS 2011AA ValueDomain
C0237753
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C25521
UMLS 2011AA Property
C1512288
Person Completing Form, Last Name
Beschrijving

ResponsiblePersonLastName

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus ObjectClass
C25657
UMLS 2011AA ObjectClass
C1273518
NCI Thesaurus Property
C25364
UMLS 2011AA Property
C0600091
NCI Thesaurus Property
C25551
UMLS 2011AA Property
C1517741
NCI Thesaurus ValueDomain
C25191
UMLS 2011AA ValueDomain
C1547383
Smoking History Questionnaire
Beschrijving

Smoking History Questionnaire

Have you ever smoked tobacco products?
Beschrijving

TobaccoSmokingHistoryIndicator

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS 2011AA ValueDomain
C1522602
NCI Thesaurus ObjectClass
C17934
UMLS 2011AA ObjectClass
C0453996
NCI Thesaurus Property
C18772
UMLS 2011AA Property
C0262926
Personal Smoking Section
Beschrijving

Personal Smoking Section

Have you smoked at least 100 cigarette during your lifetime
Beschrijving

Smoking history

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25180
UMLS CUI-1
C1519384
NCI Thesaurus Property
C20989
NCI Thesaurus ObjectClass
C29719
Are you currently using nicotine skin patches or gum
Beschrijving

SmokingCessationNicotinePatchNicotineGumUseInd-2

Datatype

text

Alias
NCI Thesaurus ObjectClass
C17427
UMLS 2011AA ObjectClass
C0085134
NCI Thesaurus Property
C25340
UMLS 2011AA Property
C0457083
NCI Thesaurus Property
C17955
UMLS 2011AA Property
C0358855
NCI Thesaurus Property
C15663
UMLS 2011AA Property
C0068722
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
How old were you when you smoked your first cigarette
Beschrijving

PatientInitialCigaretteSmokingAgeYearCount

Datatype

double

Alias
NCI Thesaurus ObjectClass
C16960
UMLS 2011AA ObjectClass
C0030705
NCI Thesaurus Property
C25536
UMLS 2011AA Property
C1555582
NCI Thesaurus Property
C18270
UMLS 2011AA Property
C0700219
NCI Thesaurus ValueDomain
C29848
UMLS 2011AA ValueDomain
C0439234
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
On average, how many cigarettes do/did you smoke per day
Beschrijving

CigaretteAverageDailyUseCount

Datatype

double

Alias
NCI Thesaurus ObjectClass
C1802
UMLS 2011AA ObjectClass
C0677453
NCI Thesaurus Property
C25473
UMLS 2011AA Property
C0332173
NCI Thesaurus Property
C37917
UMLS 2011AA Property
C1510992
NCI Thesaurus Property
C25340
UMLS 2011AA Property
C0457083
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Are you still smoking at least one cigarette per week
Beschrijving

PersonCigaretteWeekCurrentUseSmokingHistoryInd-2

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus Property
C1802
UMLS 2011AA Property
C0677453
NCI Thesaurus Property
C29844
UMLS 2011AA Property
C0439230
NCI Thesaurus Property
C29719
UMLS 2011AA Property
C1519384
NCI Thesaurus Property
C25340
UMLS 2011AA Property
C0457083
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
If you are no longer smoking, how old were you when you stopped smoking (years old)
Beschrijving

PersonCigaretteSmokingCessationAgeYearCount

Datatype

double

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C1802
UMLS 2011AA Property
C0677453
NCI Thesaurus Property
C17427
UMLS 2011AA Property
C0085134
NCI Thesaurus Property
C25150
UMLS 2011AA Property
C0001779
NCI Thesaurus ValueDomain
C29848
UMLS 2011AA ValueDomain
C0439234
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Household Smoking Section
Beschrijving

Household Smoking Section

Have you ever lived for at least a year in the same household with someone who smoked cigarettes regularly
Beschrijving

PersonHouseholdYearPassiveSmokeExposureInd-2

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C29848
UMLS 2011AA Property
C0439234
NCI Thesaurus Property
C41194
UMLS 2011AA Property
C0020052
NCI Thesaurus Property
C17140
UMLS 2011AA Property
C0037370
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
For about how many years, in total, have you lived with someone who smoked cigarettes regularly at the time (years)
Beschrijving

PersonHouseholdYearPassiveSmokeExposureYearCount

Datatype

double

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C29848
UMLS 2011AA Property
C0439234
NCI Thesaurus Property
C41194
UMLS 2011AA Property
C0020052
NCI Thesaurus Property
C17140
UMLS 2011AA Property
C0037370
NCI Thesaurus ValueDomain
C29848
UMLS 2011AA ValueDomain
C0439234
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Do you now live in the same household with someone who smokes cigarettes regularly
Beschrijving

PersonCurrentHouseholdCigarettePassiveSmokeExposureInd-2

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus Property
C1802
UMLS 2011AA Property
C0677453
NCI Thesaurus Property
C41194
UMLS 2011AA Property
C0020052
NCI Thesaurus Property
C17140
UMLS 2011AA Property
C0037370
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
On average, how many cigarettes per day are smoked by other people while you are at home (cigarettes/day)
Beschrijving

PersonCurrentHouseholdCigarettePassiveSmokeExposureDayCount

Datatype

double

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus Property
C1802
UMLS 2011AA Property
C0677453
NCI Thesaurus Property
C41194
UMLS 2011AA Property
C0020052
NCI Thesaurus Property
C17140
UMLS 2011AA Property
C0037370
NCI Thesaurus ValueDomain
C25301
UMLS 2011AA ValueDomain
C0439228
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Second Hand Smoking Section
Beschrijving

Second Hand Smoking Section

Are you exposed to smoke from another person's cigarettes at least once per week when you are outside of your household
Beschrijving

PersonCurrentExternalHouseholdCigarettePassiveSmokeExposureInd-2

Datatype

text

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus Property
C1802
UMLS 2011AA Property
C0677453
NCI Thesaurus Property
C44280
UMLS 2011AA Property
C0205101
NCI Thesaurus Property
C41194
UMLS 2011AA Property
C0020052
NCI Thesaurus Property
C17140
UMLS 2011AA Property
C0037370
NCI Thesaurus ValueDomain
C38147
UMLS 2011AA ValueDomain
C1512698
On average, how many hours per week are you exposed to smoke from other person's cigarettes outside of your household (hours/week)
Beschrijving

PersonCurrentExternalHouseholdCigaretteHourWeekPassiveSmokeExposureCount

Datatype

double

Alias
NCI Thesaurus ObjectClass
C25190
UMLS 2011AA ObjectClass
C0027361
NCI Thesaurus Property
C25471
UMLS 2011AA Property
C0521116
NCI Thesaurus Property
C1802
UMLS 2011AA Property
C0677453
NCI Thesaurus Property
C44280
UMLS 2011AA Property
C0205101
NCI Thesaurus Property
C25529
UMLS 2011AA Property
C0439227
NCI Thesaurus Property
C29844
UMLS 2011AA Property
C0439230
NCI Thesaurus Property
C41194
UMLS 2011AA Property
C0020052
NCI Thesaurus Property
C17140
UMLS 2011AA Property
C0037370
NCI Thesaurus ValueDomain
C25463
UMLS 2011AA ValueDomain
C0750480
Comments
Beschrijving

Comments

COMMENTS
Beschrijving

ResearchCommentsText

Datatype

text

Alias
NCI Thesaurus ValueDomain
C25704
UMLS 2011AA ValueDomain
C1527021
NCI Thesaurus ObjectClass
C15319
NCI Thesaurus Property
C25393
UMLS 2011AA Property
C0282411
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No Instruction available.

1 Formulieren
  1. StudyEvent: Gynecologic Oncology Group Smoking History Questionnaire (Form SHQ)
    1. No Instruction available.
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Header Module
FormOriginalCompleteDate
Item
Date form originally completed (m d y)
date
C19464 (NCI Thesaurus ObjectClass)
C0376315 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25604 (NCI Thesaurus Property)
C0205313 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
FormAmendedCompleteDate
Item
Date form amended (m d y)
date
C19464 (NCI Thesaurus ObjectClass)
C0376315 (UMLS 2011AA ObjectClass)
C25250 (NCI Thesaurus Property)
C0205197 (UMLS 2011AA Property)
C25416 (NCI Thesaurus Property)
C1691222 (UMLS 2011AA Property)
C25164 (NCI Thesaurus ValueDomain)
C0011008 (UMLS 2011AA ValueDomain)
C25367 (NCI Thesaurus ValueDomain)
ResponsiblePersonReportingChangeLastName
Item
Person amending form, last name
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
PatientLastName
Item
Patient Name, Last
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25551 (NCI Thesaurus Property)
C1517741 (UMLS 2011AA Property)
PatientFirstName
Item
Patient Name, First
text
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25509 (NCI Thesaurus Property)
C1279901 (UMLS 2011AA Property)
PatientGynecologicOncologyGroupIdentifierNumber
Item
Patient Study ID
text
C25337 (NCI Thesaurus ValueDomain)
C0237753 (UMLS 2011AA ValueDomain)
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25521 (NCI Thesaurus Property)
C1512288 (UMLS 2011AA Property)
ResponsiblePersonLastName
Item
Person Completing Form, Last Name
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25657 (NCI Thesaurus ObjectClass)
C1273518 (UMLS 2011AA ObjectClass)
C25364 (NCI Thesaurus Property)
C0600091 (UMLS 2011AA Property)
C25551 (NCI Thesaurus Property)
C1517741 (UMLS 2011AA Property)
C25191 (NCI Thesaurus ValueDomain)
C1547383 (UMLS 2011AA ValueDomain)
Item Group
Smoking History Questionnaire
Item
Have you ever smoked tobacco products?
text
C25180 (NCI Thesaurus ValueDomain)
C1522602 (UMLS 2011AA ValueDomain)
C17934 (NCI Thesaurus ObjectClass)
C0453996 (UMLS 2011AA ObjectClass)
C18772 (NCI Thesaurus Property)
C0262926 (UMLS 2011AA Property)
CL.1
Code List
Have you ever smoked tobacco products?
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
Item Group
Personal Smoking Section
Item
Have you smoked at least 100 cigarette during your lifetime
text
C25180 (NCI Thesaurus ValueDomain)
C1519384 (UMLS CUI-1)
C20989 (NCI Thesaurus Property)
C29719 (NCI Thesaurus ObjectClass)
CL.2
Code List
Have you smoked at least 100 cigarette during your lifetime
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes, But Quit (Yes, but quit)
CL Item
Yes, Currently Smoke (Yes, currently smoke)
Item
Are you currently using nicotine skin patches or gum
text
C17427 (NCI Thesaurus ObjectClass)
C0085134 (UMLS 2011AA ObjectClass)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C17955 (NCI Thesaurus Property)
C0358855 (UMLS 2011AA Property)
C15663 (NCI Thesaurus Property)
C0068722 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.3
Code List
Are you currently using nicotine skin patches or gum
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PatientInitialCigaretteSmokingAgeYearCount
Item
How old were you when you smoked your first cigarette
double
C16960 (NCI Thesaurus ObjectClass)
C0030705 (UMLS 2011AA ObjectClass)
C25536 (NCI Thesaurus Property)
C1555582 (UMLS 2011AA Property)
C18270 (NCI Thesaurus Property)
C0700219 (UMLS 2011AA Property)
C29848 (NCI Thesaurus ValueDomain)
C0439234 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
CigaretteAverageDailyUseCount
Item
On average, how many cigarettes do/did you smoke per day
double
C1802 (NCI Thesaurus ObjectClass)
C0677453 (UMLS 2011AA ObjectClass)
C25473 (NCI Thesaurus Property)
C0332173 (UMLS 2011AA Property)
C37917 (NCI Thesaurus Property)
C1510992 (UMLS 2011AA Property)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Item
Are you still smoking at least one cigarette per week
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C1802 (NCI Thesaurus Property)
C0677453 (UMLS 2011AA Property)
C29844 (NCI Thesaurus Property)
C0439230 (UMLS 2011AA Property)
C29719 (NCI Thesaurus Property)
C1519384 (UMLS 2011AA Property)
C25340 (NCI Thesaurus Property)
C0457083 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.4
Code List
Are you still smoking at least one cigarette per week
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PersonCigaretteSmokingCessationAgeYearCount
Item
If you are no longer smoking, how old were you when you stopped smoking (years old)
double
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C1802 (NCI Thesaurus Property)
C0677453 (UMLS 2011AA Property)
C17427 (NCI Thesaurus Property)
C0085134 (UMLS 2011AA Property)
C25150 (NCI Thesaurus Property)
C0001779 (UMLS 2011AA Property)
C29848 (NCI Thesaurus ValueDomain)
C0439234 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Item Group
Household Smoking Section
Item
Have you ever lived for at least a year in the same household with someone who smoked cigarettes regularly
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C29848 (NCI Thesaurus Property)
C0439234 (UMLS 2011AA Property)
C41194 (NCI Thesaurus Property)
C0020052 (UMLS 2011AA Property)
C17140 (NCI Thesaurus Property)
C0037370 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.5
Code List
Have you ever lived for at least a year in the same household with someone who smoked cigarettes regularly
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PersonHouseholdYearPassiveSmokeExposureYearCount
Item
For about how many years, in total, have you lived with someone who smoked cigarettes regularly at the time (years)
double
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C29848 (NCI Thesaurus Property)
C0439234 (UMLS 2011AA Property)
C41194 (NCI Thesaurus Property)
C0020052 (UMLS 2011AA Property)
C17140 (NCI Thesaurus Property)
C0037370 (UMLS 2011AA Property)
C29848 (NCI Thesaurus ValueDomain)
C0439234 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Item
Do you now live in the same household with someone who smokes cigarettes regularly
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C1802 (NCI Thesaurus Property)
C0677453 (UMLS 2011AA Property)
C41194 (NCI Thesaurus Property)
C0020052 (UMLS 2011AA Property)
C17140 (NCI Thesaurus Property)
C0037370 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.6
Code List
Do you now live in the same household with someone who smokes cigarettes regularly
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PersonCurrentHouseholdCigarettePassiveSmokeExposureDayCount
Item
On average, how many cigarettes per day are smoked by other people while you are at home (cigarettes/day)
double
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C1802 (NCI Thesaurus Property)
C0677453 (UMLS 2011AA Property)
C41194 (NCI Thesaurus Property)
C0020052 (UMLS 2011AA Property)
C17140 (NCI Thesaurus Property)
C0037370 (UMLS 2011AA Property)
C25301 (NCI Thesaurus ValueDomain)
C0439228 (UMLS 2011AA ValueDomain)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Item Group
Second Hand Smoking Section
Item
Are you exposed to smoke from another person's cigarettes at least once per week when you are outside of your household
text
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C1802 (NCI Thesaurus Property)
C0677453 (UMLS 2011AA Property)
C44280 (NCI Thesaurus Property)
C0205101 (UMLS 2011AA Property)
C41194 (NCI Thesaurus Property)
C0020052 (UMLS 2011AA Property)
C17140 (NCI Thesaurus Property)
C0037370 (UMLS 2011AA Property)
C38147 (NCI Thesaurus ValueDomain)
C1512698 (UMLS 2011AA ValueDomain)
CL.7
Code List
Are you exposed to smoke from another person's cigarettes at least once per week when you are outside of your household
CL Item
No (No)
C49487 (NCI Thesaurus)
C1298908 (UMLS 2011AA)
CL Item
Yes (Yes)
C49488 (NCI Thesaurus)
C1705108 (UMLS 2011AA)
PersonCurrentExternalHouseholdCigaretteHourWeekPassiveSmokeExposureCount
Item
On average, how many hours per week are you exposed to smoke from other person's cigarettes outside of your household (hours/week)
double
C25190 (NCI Thesaurus ObjectClass)
C0027361 (UMLS 2011AA ObjectClass)
C25471 (NCI Thesaurus Property)
C0521116 (UMLS 2011AA Property)
C1802 (NCI Thesaurus Property)
C0677453 (UMLS 2011AA Property)
C44280 (NCI Thesaurus Property)
C0205101 (UMLS 2011AA Property)
C25529 (NCI Thesaurus Property)
C0439227 (UMLS 2011AA Property)
C29844 (NCI Thesaurus Property)
C0439230 (UMLS 2011AA Property)
C41194 (NCI Thesaurus Property)
C0020052 (UMLS 2011AA Property)
C17140 (NCI Thesaurus Property)
C0037370 (UMLS 2011AA Property)
C25463 (NCI Thesaurus ValueDomain)
C0750480 (UMLS 2011AA ValueDomain)
Item Group
Comments
ResearchCommentsText
Item
COMMENTS
text
C25704 (NCI Thesaurus ValueDomain)
C1527021 (UMLS 2011AA ValueDomain)
C15319 (NCI Thesaurus ObjectClass)
C25393 (NCI Thesaurus Property)
C0282411 (UMLS 2011AA Property)
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