Altogether, have you smoked at least 100 or more cigarettes in your entire lifetime?
How long have you smoked (cumulatively)?
Do you now smoke cigarettes every day, some days or not at all?
On average, how many cigarettes do you now smoke a day (1 pack = 20 cigarettes)?
How soon after you wake up do you smoke your first cigarette?
In the past 30 days, what tobacco products OTHER THAN cigarettes have you used (check all that apply)?
How often do you have a drink containing alcohol?
How many drinks containing alcohol do you have on a typical day when you are drinking?
How often do you have six or more drinks on one occasion?
How often during the last year have you found that you were not able to stop drinking once you had started?
How often during the last year have you failed to do what was normally expected from you because of drinking?
How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?
How often during the last year have you had a feeling of guilt or remorse after drinking?
How often during the last year have you been unable to remember what happened the night before because you had been drinking?
Have you or someone else been injured as a result of your drinking?
Has a relative or friend or a doctor or another health worker been concerned about your drinking or suggested you cut down?
Have you used any cannabis over the past 6 months?
How often do you use cannabis?
How many hours were you ‘stoned’ on
a typical day when you had been using
How often during the past six months did you find that you were not able to stop using cannabis once you had started?
How often during the past six months did you fail to do what was normally expected from you because of using cannabis?
How often in the past six months have you devoted a great deal of your time to getting, using, or recovering from cannabis?
How often in the past six months have you had a problem with your memory or concentration after using cannabis?
How often do you use cannabis in situations that could be physically hazardous, such as driving, operating machinery, or caring for children?
Have you ever thought about cutting down, or stopping, your use of cannabis?
Have you used drugs other than those required for medical reasons?
Do you abuse more than one drug at a time?
Are you always able to stop using drugs when you want to? (If never use
drugs, answer “Yes.” )
Have you had "blackouts" or "flashbacks" as a result of drug use?
Do you ever feel bad or guilty about your drug use? If never use drugs,
Does your spouse (or parents) ever complain about your involvement
Have you neglected your family because of your use of drugs?
Have you engaged in illegal activities in order to obtain drugs?
Have you ever experienced withdrawal symptoms (felt sick) when you
stopped taking drugs?
Have you had medical problems as a result of your drug use (e.g.,
memory loss, hepatitis, convulsions, bleeding, etc.)?