Alcohol Use |
Healthy Daily Living Form |
How often did you drink beer during the last 12 months?
How often did you drink hard liquor during the last 12 months?
How often did you drink wine during the last 12 months?
What was the usual amount of beer you had on any typical day when you drank beer during the past 12 months?
What was the usual amount of hard liquor you had on any typical day when you drank hard liquor during the past 12 months?
What was the usual amount of wine you had on any typical day when you drank wine during the past 12 months?
|
Frequency of Use |
Never
Several times
About once a month
Several times a month
1 to 2 days a week
3 to 4 days a week
5 to 6 days a week
Everyday
|
Beer Quantity Responses |
Did not drink beer
1-2 bottles or cans (12 oz.)
3-5 bottles or cans (12 oz.)
About 1 six-pack
About 2 six-packs
3 six-packs or more
|
Hard Liquor Quantity Responses |
Never drank liquor
1-2 drinks
3-4 drinks
5-7 drinks
8-10 drinks
About 12 drinks
About 1 pint
About 2 pints
3 pints or more
|
Wine Quantity Responses |
Never drank wine
1-3 glasses
4-5 glasses
About 6 glasses (one bottle)
About 9 glasses
About 2 bottles (12 glasses)
Three bottles or more
|
Drug Use |
Drug Use Frequency measure |
How often did you use the following drugs or medications during the past 12 months?: sedatives, hypnotics or tranquilizers; cannabis; stimulants; heroin; opioids; cocaine; PCP; hallucinogens; inhalants; others |
Never
Several times
About once a month
Several times a month
1 to 2 days a week
3 to 4 days a week
5 to 6 days a week
Everyday
|
Maternal Age of Alcohol and Drug Use Onset |
Life Course and Health Research Center Survey |
When I mention the following substances, please indicate the age when you first started using that substance: alcohol, sedatives, hypnotics or tranquilizers; cannabis; stimulants; heroin; opioids; cocaine; PCP; hallucinogens; inhalants; others |
n/a |
Age of Sexual Debut |
Life Course and Health Research Center Survey |
How old were you the first time you had vaginal sex?
How old were you the first time you had oral sex?
How old were you the first time you had anal sex?
|
n/a |
Number of Sexual Partners |
Life Course and Health Research Center Survey |
Thinking back over the past 12 months, with how many different people, including men and women, have you had sex (vaginal, anal or oral) even if only one time? |
n/a |
Substance Use Before or During Sex |
Life Course and Health Research Center Survey |
In the last 12 months, how often did you or your sexual partners drink alcohol before or during sex?
In the last 12 months, how often did you or your sexual partners use any drugs to get high or intoxicated before or during sex?
|
1 = Never
2 = Rarely
3 = Sometimes
4 = Usually
5 = Always
|
Participant and Sexual Partners Intoxication During Sex |
Life Course and Health Research Center Survey |
On average, how strongly were you affected by the alcohol?
On average how strongly was your sexual partner affected by the alcohol?
On average, how strongly were you affected by the drugs?
On average, how strongly was your sexual partner affected by the alcohol?
|
1 = Not at all
2 = Somewhat
3 = Very Strongly
|