Date of interview |
|
State |
Alabama/Arizona/Florida/Vermont |
Tobacco use in last 30 days |
Yes/No/Don’t know |
Type of tobacco use |
Cigarettes/Cigars/Pipe/Chewing/Other |
Frequency of use |
Everyday/some days/not at all/don’t know (quantified for each type of tobacco by uses per day and any-use days in the last 30 days) |
Cigarette smoking upon waking |
Ordinal, range from “within 5 minutes” to “more than 60 minutes” |
Intention to quit within next 30 days |
Yes/No/Don’t know (for each type of tobacco use) |
Since registering has participant stopped use for ≥24 hours |
Yes/No/Don’t know |
Cessation product/medication use since registering |
Yes/No/Don’t know If yes → type |
Other cessation assistance |
Advice/Website/Telephone/Counseling/Self-help/Something else |
|
With write-in field to specify |
Time spent on phone/web with quitline staff |
Ordinal, range from < 1 min. to > 30 min |
Number of counseling sessions or times visited website |
Ordinal, range from 1 to > 5 |
Satisfaction with services |
Ordinal, range from “Very Satisfied” to “Not At All Satisfied” |
Extent quitline met participant’s needs |
Ordinal, range from “Almost all…” to “None…” |
If seeking help again, will participant contact quitline? |
Ordinal, range from “Yes, Definitely” to “No Definitely Not” (write in for “Why Not”) |
Would recommend quitline to a friend |
Ordinal, range from “Yes, Definitely” to “No Definitely Not” (write in for “Why Not”) |
Does participant go online? |
Yes/No/Don’t know |
Select where participant uses internet |
Home/Work/School/Public Library/Community Center / Someone Else’s House / Some Other Place |
Type of internet access |
Telephone/Cable/DSL |
Frequency of accessing internet |
Ordinal, range from “Several Time A Day” to “Less Than Once Per Week” |
Use of internet-based cessation activities |
Social Networking Site/Read Blog/Posted Comments on a Blog/Used Search Engine To Find Information About Cessation |
Type of telephone services used |
Landline/Mobile/Mobile With Internet/Mobile Internet Search Engine Used To Find Information About Cessation |
Frequency of communication or socialization with friends on a landline/send text messages/talk on mobile phone/instant messages/social networking site messages |
Ordinal, range from “Everyday” to “Never” |
Others who smoke in household |
Yes/No/Don’t know |
Marital Status |
Standard Responses |
Occupational Status |
Standard Responses |
Highest level of education |
Standard Responses |
Race |
Standard Responses |