Canadian Community Health Survey (CCHS) - 2014

Proxy interview (GR) - Question identifier:GR_N01A

Who is providing the information for this person's component?

• 01: MEMBER1
• 02: MEMBER2
• 03: MEMBER3
• 04: MEMBER4
• 05: MEMBER5
• 06: MEMBER6
• 07: MEMBER7
• 08: MEMBER8
• 09: MEMBER9
• 10: MEMBER10
• 11: MEMBER11
• 12: MEMBER12
• 13: MEMBER13
• 14: MEMBER14
• 15: MEMBER15
• 16: MEMBER16
• 17: MEMBER17
• 18: MEMBER18
• 19: MEMBER19
• 20: MEMBER20

Proxy interview (GR) - Question identifier:GR_N01B

Do you want to complete this component by proxy?

• 1: Yes
• 2: No

Proxy interview (GR) - Question identifier:GR_N02

Record the reason why this component is being completed by proxy. Proxy interviews are to occur only if the mental or physical health of the selected member makes it impossible to complete the interview during the collection period. If the reason for the proxy interview is neither of these choices, please press <F10> to exit the application and assign an appropriate outcome code.

• 1: Physical health condition
• 2: Mental health condition

Proxy interview (GR) - Question identifier:GR_N03

Enter the condition.

Long Answer Length = 80

Age of respondent (ANC) - Question identifier:ANC_R01

For some of the questions I'll be asking, I need to know your exact date of birth.

Age of respondent (ANC) - Question identifier:ANC_N01A

Enter the day. If necessary, ask (What is the day?)

Min = 1; Max = 31

Age of respondent (ANC) - Question identifier:ANC_N01B

Enter the month. If necessary, ask (What is the month?)

• 01: January
• 02: February
• 03: March
• 04: April
• 05: May
• 06: June
• 07: July
• 08: August
• 09: September
• 10: October
• 11: November
• 12: December
• 98: RF
• 99: DK

Age of respondent (ANC) - Question identifier:ANC_N01C

Enter a four-digit year.
If necessary, ask (What is the year?)

Min = 0; Max = 0

Age of respondent (ANC) - Question identifier:ANC_Q02

So your age is [calculated age].
Is that correct?

• 1: Yes
• 2: No, return and correct date of birth
• 3: No, collect age

Age of respondent (ANC) - Question identifier:ANC_Q03

What is your age?

Min = 0; Max = 121

Age of respondent (ANC) - Question identifier:ANC_R04

Because you are less than 12 years old, you are not eligible to participate in the Canadian Community Health Survey.

General health (GEN) - Question identifier:GEN_R01

This survey deals with various aspects of your health. The following questions ask about physical activity, social relationships and health status. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.

General health (GEN) - Question identifier:GEN_Q01

In general, would you say your health is...?

• 1: Excellent
• 2: Very good
• 3: Good
• 4: Fair
• 5: Poor
• 8: RF
• 9: DK

General health (GEN) - Question identifier:GEN_Q02A

Compared to one year ago, how would you say your health is now? Is it...?

• 1: Much better now than 1 year ago
• 2: Somewhat better now (than 1 year ago)
• 3: About the same as 1 year ago
• 4: Somewhat worse now (than 1 year ago)
• 5: Much worse now (than 1 year ago)
• 8: RF
• 9: DK

General health (GEN) - Question identifier:GEN_Q02B

Using a scale of 0 to 10, where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel about your life as a whole right now?

• 00: Very dissatisfied
• 01: |
• 02: |
• 03: |
• 04: |
• 05: |
• 06: |
• 07: |
• 08: |
• 09: V
• 10: Very satisfied
• 98: RF
• 99: DK

General health (GEN) - Question identifier:GEN_Q02C

In general, would you say your mental health is...?

• 1: Excellent
• 2: Very good
• 3: Good
• 4: Fair
• 5: Poor
• 8: RF
• 9: DK

General health (GEN) - Question identifier:GEN_Q07

Thinking about the amount of stress in your life, would you say that most days are...?

• 1: Not at all stressful
• 2: Not very stressful
• 3: A bit stressful
• 4: Quite a bit stressful
• 5: Extremely stressful
• 8: RF
• 9: DK

General health (GEN) - Question identifier:GEN_Q08

Have you worked at a job or business at any time in the past 12 months?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

General health (GEN) - Question identifier:GEN_R09

The next question is about your main job or business in the past 12 months.

General health (GEN) - Question identifier:GEN_Q09

Would you say that most days at work were...?

• 1: Not at all stressful
• 2: Not very stressful
• 3: A bit stressful
• 4: Quite a bit stressful
• 5: Extremely stressful
• 8: RF
• 9: DK

General health (GEN) - Question identifier:GEN_Q10

How would you describe your sense of belonging to your local community? Would you say it is...?

• 1: Very strong
• 2: Somewhat strong
• 3: Somewhat weak
• 4: Very weak
• 8: RF
• 9: DK

Voluntary organizations - Participation (ORG) - Question identifier:ORG_Q1

Are you a member of any voluntary organizations or associations such as school groups, church social groups, community centres, ethnic associations or social, civic or fraternal clubs?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Voluntary organizations - Participation (ORG) - Question identifier:ORG_Q2

How often did you participate in meetings or activities of these groups in the past 12 months? If you belong to many, just think of the ones in which you are most active.

• 1: At least once a week
• 2: At least once a month
• 3: At least 3 or 4 times a year
• 4: At least once a year
• 5: Not at all
• 8: RF
• 9: DK

Sleep (SLP) - Question identifier:SLP_Q01

Now a few questions about sleep.
How long do you usually spend sleeping each night?

• 01: Under 2 hours
• 02: 2 hours to less than 3 hours
• 03: 3 hours to less than 4 hours
• 04: 4 hours to less than 5 hours
• 05: 5 hours to less than 6 hours
• 06: 6 hours to less than 7 hours
• 07: 7 hours to less than 8 hours
• 08: 8 hours to less than 9 hours
• 09: 9 hours to less than 10 hours
• 10: 10 hours to less than 11 hours
• 11: 11 hours to less than 12 hours
• 12: 12 hours or more
• 98: RF
• 99: DK

Sleep (SLP) - Question identifier:SLP_Q02

How often do you have trouble going to sleep or staying asleep?

• 1: None of the time
• 2: A little of the time
• 3: Some of the time
• 4: Most of the time
• 5: All of the time
• 8: RF
• 9: DK

Sleep (SLP) - Question identifier:SLP_Q03

How often do you find your sleep refreshing?

• 1: None of the time
• 2: A little of the time
• 3: Some of the time
• 4: Most of the time
• 5: All of the time
• 8: RF
• 9: DK

Sleep (SLP) - Question identifier:SLP_Q04

How often do you find it difficult to stay awake when you want to?

• 1: None of the time
• 2: A little of the time
• 3: Some of the time
• 4: Most of the time
• 5: All of the time
• 8: RF
• 9: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q1

Next, some questions about changes made to improve health.
In the past 12 months, did you do anything to improve your health? (For example, lost weight, quit smoking, increased exercise).

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q2

What is the single most important change you have made?

• 01: Increased exercise, sports / physical activity
• 02: Lost weight
• 03: Changed diet / improved eating habits
• 04: Quit smoking / reduced amount smoked
• 05: Drank less alcohol
• 06: Reduced stress level
• 07: Received medical treatment
• 08: Took vitamins
• 09: Other
• 98: RF
• 99: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q3

Do you think there is [anything else/anything] you should do to improve your physical health?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q4

What is the most important thing?

• 01: Start / Increase exercise, sports / physical activity
• 02: Lose weight
• 03: Change diet / improve eating habits
• 04: Quit smoking / reduce amount smoked
• 05: Drink less alcohol
• 06: Reduce stress level
• 07: Receive medical treatment
• 08: Take vitamins
• 09: Other
• 98: RF
• 99: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q5

Is there anything stopping you from making this improvement?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q6

What is that?

• 01: Lack of will power / self-discipline
• 02: Family responsibilities
• 03: Work schedule
• 04: Addiction to drugs / alcohol
• 05: Physical condition
• 06: Disability / health problem
• 07: Too stressed
• 08: Too costly / financial constraints
• 09: Not available - in area
• 10: Transportation problems
• 11: Weather problems
• 12: Other
• 98: RF
• 99: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q7

Is there anything you intend to do to improve your physical health in the next year?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Changes made to improve health (CIH) - Question identifier:CIH_Q8

What is that?

• 01: Start / Increase exercise, sports / physical activity
• 02: Lose weight
• 03: Change diet / improve eating habits
• 04: Quit smoking / reduce amount smoked
• 05: Drink less alcohol
• 06: Reduce stress level
• 07: Receive medical treatment
• 08: Take vitamins
• 09: Other
• 98: RF
• 99: DK

Oral health 1 (OH1) - Question identifier:OH1_R20

Next, some questions about the health of your teeth and mouth.

Oral health 1 (OH1) - Question identifier:OH1_Q20

In general, would you say the health of your teeth and mouth is:

• 1: Excellent
• 2: Very good
• 3: Good
• 4: Fair
• 5: Poor
• 8: RF
• 9: DK

Oral health 1 (OH1) - Question identifier:OH1_Q21A

Now a few questions about your ability to chew different foods, whether you eat them or not. Can you:

chew firm foods (e.g., meat)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 1 (OH1) - Question identifier:OH1_Q21B

(Can you:)

bite off and chew a piece of fresh apple?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 1 (OH1) - Question identifier:OH1_Q21C

(Can you:)

chew boiled vegetables?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 1 (OH1) - Question identifier:OH1_Q22

In the past month, how often have you had any pain or discomfort in your teeth or gums?

• 1: Often
• 2: Sometimes
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Health care system satisfaction (HCS) - Question identifier:HCS_Q1

Now, a few questions about health care services in [Newfoundland and Labrador/Prince Edward Island/Nova Scotia/New Brunswick/Quebec/Ontario/Manitoba/Saskatchewan/Alberta/British Columbia/Yukon/the Northwest Territories/Nunavut]. Overall, how would you rate the availability of health care services in [Newfoundland and Labrador/Prince Edward Island/Nova Scotia/New Brunswick/Quebec/Ontario/Manitoba/Saskatchewan/Alberta/British Columbia/Yukon/the Northwest Territories/Nunavut]?
Would you say it is...?

• 1: Excellent
• 2: Good
• 3: Fair
• 4: Poor
• 8: RF
• 9: DK

Health care system satisfaction (HCS) - Question identifier:HCS_Q2

Overall, how would you rate the quality of the health care services that are available in [Newfoundland and Labrador/Prince Edward Island/Nova Scotia/New Brunswick/Quebec/Ontario/Manitoba/Saskatchewan/Alberta/British Columbia/Yukon/the Northwest Territories/Nunavut]?

• 1: Excellent
• 2: Good
• 3: Fair
• 4: Poor
• 8: RF
• 9: DK

Health care system satisfaction (HCS) - Question identifier:HCS_Q3

Overall, how would you rate the availability of health care services in your community?

• 1: Excellent
• 2: Good
• 3: Fair
• 4: Poor
• 8: RF
• 9: DK

Health care system satisfaction (HCS) - Question identifier:HCS_Q4

Overall, how would you rate the quality of the health care services that are available in your community?

• 1: Excellent
• 2: Good
• 3: Fair
• 4: Poor
• 8: RF
• 9: DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_Q1

It is important to know when analyzing health whether or not the person is pregnant. Are you pregnant?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_Q2

The next questions are about height and weight. How tall are you without shoes on?

• 0: Less than 1' / 12" (less than 29.2 cm.)
• 1: 1'0" to 1'11" / 12" to 23" (29.2 to 59.6 cm.)
• 2: 2'0" to 2'11" / 24" to 35" (59.7 to 90.1 cm.)
• 3: 3'0" to 3'11" / 36" to 47" (90.2 to 120.6 cm.)
• 4: 4'0" to 4'11" / 48" to 59" (120.7 to 151.0 cm.)
• 5: 5'0" to 5'11" (151.1 to 181.5 cm.)
• 6: 6'0" to 6'11" (181.6 to 212.0 cm.)
• 7: 7'0" and over (212.1 cm. and over)
• 8: RF
• 9: DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_N2A

Select the exact height.

• 00: 1'0" / 12" (29.2 to 31.7 cm.)
• 01: 1'1" / 13" (31.8 to 34.2 cm.)
• 02: 1'2" / 14" (34.3 to 36.7 cm.)
• 03: 1'3" / 15" (36.8 to 39.3 cm.)
• 04: 1'4" / 16" (39.4 to 41.8 cm.)
• 05: 1'5" / 17" (41.9 to 44.4 cm.)
• 06: 1'6" / 18" (44.5 to 46.9 cm.)
• 07: 1'7" / 19" (47.0 to 49.4 cm.)
• 08: 1'8" / 20" (49.5 to 52.0 cm.)
• 09: 1'9" / 21" (52.1 to 54.5 cm.)
• 10: 1'10" / 22" (54.6 to 57.1 cm.)
• 11: 1'11" / 23" (57.2 to 59.6 cm.)
• 98: RF
• 99: DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_N2B

Select the exact height.

• 00: 2'0" / 24" (59.7 to 62.1 cm.)
• 01: 2'1" / 25" (62.2 to 64.7 cm.)
• 02: 2'2" / 26" (64.8 to 67.2 cm.)
• 03: 2'3" / 27" (67.3 to 69.8 cm.)
• 04: 2'4" / 28" (69.9 to 72.3 cm.)
• 05: 2'5" / 29" (72.4 to 74.8 cm.)
• 06: 2'6" / 30" (74.9 to 77.4 cm.)
• 07: 2'7" / 31" (77.5 to 79.9 cm.)
• 08: 2'8" / 32" (80.0 to 82.5 cm.)
• 09: 2'9" / 33" (82.6 to 85.0 cm.)
• 10: 2'10" / 34" (85.1 to 87.5 cm.)
• 11: 2'11" / 35" (87.6 to 90.1 cm.)
• 98: RF
• 99: DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_N2C

Select the exact height.

• 00: 3'0" / 36" (90.2 to 92.6 cm.)
• 01: 3'1" / 37" (92.7 to 95.2 cm.)
• 02: 3'2" / 38" (95.3 to 97.7 cm.)
• 03: 3'3" / 39" (97.8 to 100.2 cm.)
• 04: 3'4" / 40" (100.3 to 102.8 cm.)
• 05: 3'5" / 41" (102.9 to 105.3 cm.)
• 06: 3'6" / 42" (105.4 to 107.9 cm.)
• 07: 3'7" / 43" (108.0 to 110.4 cm.)
• 08: 3'8" / 44" (110.5 to 112.9 cm.)
• 09: 3'9" / 45" (113.0 to 115.5 cm.)
• 10: 3'10" / 46" (115.6 to 118.0 cm.)
• 11: 3'11" / 47" (118.1 to 120.6 cm.)
• 98: RF
• 99: DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_N2D

Select the exact height.

• 00: 4'0" / 48" (120.7 to 123.1 cm.)
• 01: 4'1" / 49" (123.2 to 125.6 cm.)
• 02: 4'2" / 50" (125.7 to 128.2 cm.)
• 03: 4'3" / 51" (128.3 to 130.7 cm.)
• 04: 4'4" / 52" (130.8 to 133.3 cm.)
• 05: 4'5" / 53" (133.4 to 135.8 cm.)
• 06: 4'6" / 54" (135.9 to 138.3 cm.)
• 07: 4'7" / 55" (138.4 to 140.9 cm.)
• 08: 4'8" / 56" (141.0 to 143.4 cm.)
• 09: 4'9" / 57" (143.5 to 146.0 cm.)
• 10: 4'10" / 58" (146.1 to 148.5 cm.)
• 11: 4'11" / 59" (148.6 to 151.0 cm.)
• 98: RF
• 99: DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_N2E

Select the exact height.

• 00: 5'0" (151.1 to 153.6 cm.)
• 01: 5'1" (153.7 to 156.1 cm.)
• 02: 5'2" (156.2 to 158.7 cm.)
• 03: 5'3" (158.8 to 161.2 cm.)
• 04: 5'4" (161.3 to 163.7 cm.)
• 05: 5'5" (163.8 to 166.3 cm.)
• 06: 5'6" (166.4 to 168.8 cm.)
• 07: 5'7" (168.9 to 171.4 cm.)
• 08: 5'8" (171.5 to 173.9 cm.)
• 09: 5'9" (174.0 to 176.4 cm.)
• 10: 5'10" (176.5 to 179.0 cm.)
• 11: 5'11" (179.1 to 181.5 cm.)
• 98: RF
• 99: DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_N2F

Select the exact height.

• 00: 6'0" (181.6 to 184.1 cm.)
• 01: 6'1" (184.2 to 186.6 cm.)
• 02: 6'2" (186.7 to 189.1 cm.)
• 03: 6'3" (189.2 to 191.7 cm.)
• 04: 6'4" (191.8 to 194.2 cm.)
• 05: 6'5" (194.3 to 196.8 cm.)
• 06: 6'6" (196.9 to 199.3 cm.)
• 07: 6'7" (199.4 to 201.8 cm.)
• 08: 6'8" (201.9 to 204.4 cm.)
• 09: 6'9" (204.5 to 206.9 cm.)
• 10: 6'10" (207.0 to 209.5 cm.)
• 11: 6'11" (209.6 to 212.0 cm.)
• 98: RF
• 99: DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_Q3

How much do you weigh?

Min = 1; Max = 575

Height and weight - Self-reported (HWT) - Question identifier:HWT_N4

Was that in pounds or kilograms?

• 1: Pounds
• 2: Kilograms

Height and weight - Self-reported (HWT) - Question identifier:HWT_Q4

Do you consider yourself:

• 1: Overweight
• 2: Underweight
• 3: Just about right
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_R011

Now I'd like to ask about certain long-term health conditions which you may have. We are interested in "long-term conditions" which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.

Chronic conditions (CCC) - Question identifier:CCC_Q031

Do you have asthma?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q035

Have you had any asthma symptoms or asthma attacks in the past 12 months?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q036

In the past 12 months, have you taken any medicine for asthma such as inhalers, nebulizers, pills, liquids or injections?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q051

Do you have arthritis, excluding fibromyalgia?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q061

Do you have back problems, excluding fibromyalgia and arthritis?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q071

Remember, we're interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.

Do you have high blood pressure?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q072

Have you ever been diagnosed with high blood pressure?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q073

In the past month, have you taken any medicine for high blood pressure?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q075

Were you pregnant when you were first diagnosed with high blood pressure?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q077

Other than during pregnancy, has a health professional ever told you that you have high blood pressure?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q081

Remember, we're interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.

Do you have migraine headaches?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q091

Do you have chronic bronchitis, emphysema or chronic obstructive pulmonary disease or COPD?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q101

(Remember, we're interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.)

Do you have diabetes?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q102

How old were you when this was first diagnosed?

Min = 1; Max = 121

Chronic conditions (CCC) - Question identifier:CCC_Q10A

Were you pregnant when you were first diagnosed with diabetes?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q10B

Other than during pregnancy, has a health professional ever told you that you have diabetes?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q10C

When you were first diagnosed with diabetes, how long was it before you were started on insulin?

• 1: Less than 1 month
• 2: 1 month to less than 2 months
• 3: 2 months to less than 6 months
• 4: 6 months to less than 1 year
• 5: 1 year or more
• 6: Never
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q105

Do you currently take insulin for your diabetes?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q106

In the past month, did you take pills to control your blood sugar?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q121

Do you have heart disease?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q131

(Do you have:)

cancer?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q132

Have you ever been diagnosed with cancer?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q141

Remember, we're interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.

Do you have intestinal or stomach ulcers?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q151

Do you suffer from the effects of a stroke?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q161

Do you have:

urinary incontinence?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q171

Do you have a bowel disorder such as Crohn's Disease, ulcerative colitis, Irritable Bowel Syndrome or bowel incontinence?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q172

What kind of bowel disease do you have?

• 1: Crohn's Disease
• 2: Ulcerative colitis
• 3: Irritable Bowel Syndrome
• 4: Bowel incontinence
• 5: Other
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q173

Have you been diagnosed with scoliosis?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q181

Do you have:

Alzheimer's Disease or any other dementia?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q280

Remember, we're interested in conditions diagnosed by a health professional and that are expected to last or have already lasted 6 months or more.

Do you have a mood disorder such as depression, bipolar disorder, mania or dysthymia?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic conditions (CCC) - Question identifier:CCC_Q290

Do you have an anxiety disorder such as a phobia, obsessive-compulsive disorder or a panic disorder?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Fibromyalgia - Sub-block (CC3) - Question identifier:CC3_Q01

Do you have fibromyalgia?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic fatigue syndrome and multiple chemical sensitivities - Sub block (CC4) - Question identifier:CC4_Q01

Do you have chronic fatigue syndrome?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Chronic fatigue syndrome and multiple chemical sensitivities - Sub block (CC4) - Question identifier:CC4_Q02

Do you suffer from multiple chemical sensitivities?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Diabetes care (DIA) - Question identifier:DIA_R01

It was reported earlier that you have diabetes. The following questions are about diabetes care.

Diabetes care (DIA) - Question identifier:DIA_Q01

In the past 12 months, has a health care professional tested you for haemoglobin "A- one-C"? (An "A-one-C" haemoglobin test measures the average level of blood sugar over a 3-month period.)

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Diabetes care (DIA) - Question identifier:DIA_Q02

How many times? (In the past 12 months, has a health care professional tested you for haemoglobin "A-one-C"?)

Min = 1; Max = 99

Diabetes care (DIA) - Question identifier:DIA_Q03

In the past 12 months, has a health care professional checked your feet for any sores or irritations?

• 1: Yes
• 2: No
• 3: No feet
• 8: RF
• 9: DK

Diabetes care (DIA) - Question identifier:DIA_Q04

How many times? (In the past 12 months, has a health care professional checked your feet for any sores or irritations?)

Min = 1; Max = 99

Diabetes care (DIA) - Question identifier:DIA_Q05

In the past 12 months, has a health care professional tested your urine for protein (i.e., Microalbumin)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Diabetes care (DIA) - Question identifier:DIA_Q06

Have you ever had an eye exam where the pupils of your eyes were dilated? (This procedure would have made you temporarily sensitive to light.)

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Diabetes care (DIA) - Question identifier:DIA_Q07

When was the last time?

• 1: Less than one month ago
• 2: 1 month to less than 1 year ago
• 3: 1 year to less than 2 years ago
• 4: 2 or more years ago
• 8: RF
• 9: DK

Diabetes care (DIA) - Question identifier:DIA_R08

Now some questions about diabetes care not provided by a health care professional.

Diabetes care (DIA) - Question identifier:DIA_Q08

How often do you usually have your blood checked for glucose or sugar by yourself or by a family member or friend?

• 1: Per day
• 2: Per week
• 3: Per month
• 4: Per year
• 5: Never
• 8: RF
• 9: DK

Diabetes care (DIA) - Question identifier:DIA_N08B

Enter number of times per day.

Min = 1; Max = 99

Diabetes care (DIA) - Question identifier:DIA_N08C

Enter number of times per week.

Min = 1; Max = 99

Diabetes care (DIA) - Question identifier:DIA_N08D

Enter number of times per month.

Min = 1; Max = 99

Diabetes care (DIA) - Question identifier:DIA_N08E

Enter number of times per year.

Min = 1; Max = 99

Diabetes care (DIA) - Question identifier:DIA_Q09

How often do you usually have your feet checked for any sores or irritations by yourself or by a family member or friend?

• 1: Per day
• 2: Per week
• 3: Per month
• 4: Per year
• 5: Never
• 8: RF
• 9: DK

Diabetes care (DIA) - Question identifier:DIA_N09B

Enter number of times per day.

Min = 1; Max = 99

Diabetes care (DIA) - Question identifier:DIA_N09C

Enter number of times per week.

Min = 1; Max = 99

Diabetes care (DIA) - Question identifier:DIA_N09D

Enter number of times per month.

Min = 1; Max = 99

Diabetes care (DIA) - Question identifier:DIA_N09E

Enter number of times per year.

Min = 1; Max = 99

Diabetes care (DIA) - Question identifier:DIA_R10

Now a few questions about medication.

Diabetes care (DIA) - Question identifier:DIA_Q10

In the past month, did you take aspirin or other ASA (acetylsalicylic acid) medication every day or every second day?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Diabetes care (DIA) - Question identifier:DIA_Q11

In the past month, did you take prescription medications such as Lipitor or Zocor to control your blood cholesterol levels?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_R01

The next set of questions asks about your day-to-day health.

You may feel that some of these questions do not apply to you, but it is important that we ask the same questions of everyone.

Health utilities index (HUI) - Question identifier:HUI_Q01

Are you usually able to see well enough to read ordinary newsprint without glasses or contact lenses?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q02

Are you usually able to see well enough to read ordinary newsprint with glasses or contact lenses?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q03

Are you able to see at all?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q04

Are you able to see well enough to recognize a friend on the other side
of the street without glasses or contact lenses?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q05

Are you usually able to see well enough to recognize a friend on the other side of the street with glasses or contact lenses?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q06

Are you usually able to hear what is said in a group conversation with at
least three other people without a hearing aid?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q07A

Are you usually able to hear what is said in a group conversation with at
least three other people with a hearing aid?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q07B

Are you able to hear at all?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q08

Are you usually able to hear what is said in a conversation with one
other person in a quiet room without a hearing aid?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q09

Are you usually able to hear what is said in a conversation with one
other person in a quiet room with a hearing aid?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q10

Are you usually able to be understood completely when speaking with
strangers in your own language?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q11

Are you able to be understood partially when speaking with strangers?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q12

Are you able to be understood completely when speaking with those
who know you well?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q13

Are you able to be understood partially when speaking with those who know you well?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q14

Are you usually able to walk around the neighbourhood without difficulty and without mechanical support such as braces, a cane or crutches?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q15

Are you able to walk at all?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q16

Do you require mechanical support such as braces, a cane or
crutches to be able to walk around the neighbourhood?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q17

Do you require the help of another person to be able to walk?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q18

Do you require a wheelchair to get around?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q19

How often do you use a wheelchair?

• 1: Always
• 2: Often
• 3: Sometimes
• 4: Never
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q20

Do you need the help of another person to get around in the wheelchair?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q21

Are you usually able to grasp and handle small objects such as a pencil or scissors?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q22

Do you require the help of another person because of limitations in the use of your hands or fingers?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q23

Do you require the help of another person with...?

• 1: Some tasks
• 2: Most tasks
• 3: Almost all tasks
• 4: All tasks
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q24

Do you require special equipment, for example, devices to assist in dressing, because of limitations in the use of your hands or fingers?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q25

Would you describe [^FNAME/yourself] as being usually...?

• 1: Happy and interested in life
• 2: Somewhat happy
• 3: Somewhat unhappy
• 4: Unhappy with little interest in life
• 5: So unhappy, that life is not worthwhile
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q26

How would you describe your usual ability to remember things?

• 1: Able to remember most things
• 2: Somewhat forgetful
• 3: Very forgetful
• 4: Unable to remember anything at all
• 8: RF
• 9: DK

Health utilities index (HUI) - Question identifier:HUI_Q27

How would you describe your usual ability to think and solve day-to-day problems?

• 1: Able to think clearly and solve problems
• 2: Having a little difficulty
• 3: Having some difficulty
• 4: Having a great deal of difficulty
• 5: Unable to think or solve problems
• 8: RF
• 9: DK

Pain and discomfort (HUP) - Question identifier:HUP_R1

The next set of questions asks about the level of pain or discomfort you usually experience. They are not about illnesses like colds that affect people for short periods of time.

Pain and discomfort (HUP) - Question identifier:HUP_Q28

Are you usually free of pain or discomfort?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Pain and discomfort (HUP) - Question identifier:HUP_Q29

How would you describe the usual intensity of your pain or discomfort?

• 1: Mild
• 2: Moderate
• 3: Severe
• 8: RF
• 9: DK

Pain and discomfort (HUP) - Question identifier:HUP_Q30

How many activities does your pain or discomfort prevent?

• 1: None
• 2: A few
• 3: Some
• 4: Most
• 8: RF
• 9: DK

Health care utilization (HCU) - Question identifier:HCU_Q10

Do you have a regular medical doctor?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health care utilization (HCU) - Question identifier:HCU_Q20

Why do you not have a regular medical doctor?

• 1: No medical doctors available in the area
• 2: Medical doctors in the area are not taking new patients
• 3: Have not tried to contact one
• 4: Had a medical doctor who left or retired
• 5: Other - Specify
• 8: RF
• 9: DK

Health care utilization (HCU) - Question identifier:HCU_Q30

Is there a place that you usually [goes/go] to when you are sick or need advice about your health?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Health care utilization (HCU) - Question identifier:HCU_Q40

What kind of place is it?

• 01: Doctor's office
• 02: Community health centre / CLSC
• 03: Walk-in clinic
• 04: Appointment clinic
• 05: Telephone health line (for example, HealthLinks, Telehealth Ontario, Health-Line, TeleCare, Info-Santé)
• 06: Hospital emergency room
• 07: Hospital outpatient clinic
• 08: Other - Specify
• 98: RF
• 99: DK

Health care utilization (HCU) - Question identifier:HCU_Q50

Do you and this doctor usually speak in English, in French, or in another language?

• 01: English
• 02: French
• 03: Arabic
• 04: Chinese
• 05: Cree
• 06: German
• 07: Greek
• 08: Hungarian
• 09: Italian
• 10: Korean
• 11: Persian (Farsi)
• 12: Polish
• 13: Portuguese
• 14: Punjabi
• 15: Spanish
• 16: Tagalog (Filipino)
• 17: Ukrainian
• 18: Vietnamese
• 19: Dutch
• 20: Hindi
• 21: Russian
• 22: Tamil
• 23: Other - Specify
• 98: RF
• 99: DK

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_R01

Now I'd like to ask about your contacts with various health professionals during the past 12 months, that is, from ^DATEONEYEARAGO to yesterday.

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q01

In the past 12 months, have you been a patient overnight in a hospital, nursing home or convalescent home?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q02

For how many nights in the past 12 months?

Min = 1; Max = 366

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q03

[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen, or talked to any of the following health professionals about your physical, emotional or mental health:

a family doctor, [pediatrician/null] or general practitioner?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q04

How many times (in the past 12 months)?

Min = 1; Max = 366

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q05

Where did the most recent contact take place?

• 01: Doctor's office
• 02: Hospital emergency room
• 03: Hospital outpatient clinic (e.g. day surgery, cancer)
• 04: Walk-in clinic
• 05: Appointment clinic
• 06: Community health centre / CLSC
• 07: At work
• 08: At school
• 09: At home
• 10: Telephone consultation only
• 11: Other - Specify
• 98: RF
• 99: DK

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q06

([Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen, or talked to:)

an eye specialist, such as an ophthalmologist or optometrist (about your physical, emotional or mental health)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q07

How many times (in the past 12 months)?

Min = 1; Max = 75

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q08

([Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen, or talked to:)

any other medical doctor or specialist such as a surgeon, allergist, orthopaedist, [urologist/gynaecologist] or psychiatrist (about your physical, emotional or mental health)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q09

How many times (in the past 12 months)?

Min = 1; Max = 300

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q10

Where did the most recent contact take place?

• 01: Doctor's office
• 02: Hospital emergency room
• 03: Hospital outpatient clinic (e.g. day surgery, cancer)
• 04: Walk-in clinic
• 05: Appointment clinic
• 06: Community health centre / CLSC
• 07: At work
• 08: At school
• 09: At home
• 10: Telephone consultation only
• 11: Other - Specify
• 98: RF
• 99: DK

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q11

[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen, or talked to:

a nurse for care or advice about your physical, emotional or mental health?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q12

How many times (in the past 12 months)?

Min = 1; Max = 366

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q13

Where did the most recent contact take place?

• 01: Doctor's office
• 02: Hospital emergency room
• 03: Hospital outpatient clinic (e.g. day surgery, cancer)
• 04: Walk-in clinic
• 05: Appointment clinic
• 06: Community health centre / CLSC
• 07: At work
• 08: At school
• 09: At home
• 10: Telephone consultation only
• 11: Other - Specify
• 98: RF
• 99: DK

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q14

([Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen, or talked to:)

a dentist, dental hygienist or orthodontist (about your physical, emotional or mental health)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Contacts with Health Professionals - Part 1 (CHP) - Question identifier:CHP_Q15

How many times (in the past 12 months)?

Min = 1; Max = 99

Contacts with Health Professionals - Part 2 (CP2) - Question identifier:CP2_Q16

[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen, or talked to:

a chiropractor about your physical, emotional or mental health?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Contacts with Health Professionals - Part 2 (CP2) - Question identifier:CP2_Q17

How many times(in the past 12 months)?

Min = 1; Max = 366

Contacts with Health Professionals - Part 2 (CP2) - Question identifier:CP2_Q18

[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen, or talked to:

a physiotherapist (about your physical, emotional or mental health)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Contacts with Health Professionals - Part 2 (CP2) - Question identifier:CP2_Q19

How many times(in the past 12 months)?

Min = 1; Max = 366

Contacts with Health Professionals - Part 2 (CP2) - Question identifier:CP2_Q20

[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen, or talked to:

a psychologist (about your physical, emotional or mental health)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Contacts with Health Professionals - Part 2 (CP2) - Question identifier:CP2_Q21

How many times(in the past 12 months)?

Min = 1; Max = 366

Contacts with Health Professionals - Part 2 (CP2) - Question identifier:CP2_Q22

[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen, or talked to:

a social worker or counsellor (about your physical, emotional or mental health)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Contacts with Health Professionals - Part 2 (CP2) - Question identifier:CP2_Q23

How many times(in the past 12 months)?

Min = 1; Max = 366

Contacts with Health Professionals - Part 2 (CP2) - Question identifier:CP2_Q24

[Not counting when you were an overnight patient, in the past 12 months/In the past 12 months], have you seen, or talked to:

an audiologist, a speech or occupational therapist (about your physical, emotional or mental health)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Contacts with Health Professionals - Part 2 (CP2) - Question identifier:CP2_Q25

How many times(in the past 12 months)?

Min = 1; Max = 200

Unmet health care needs (UCN) - Question identifier:UCN_Q010

[During the past 12 months, was there ever a time when you felt that you needed health care but you didn't receive it?/During the past 12 months, was there ever a time when you felt that you needed health care but you didn't receive it?/During the past 12 months, was there ever a time when you felt that you needed health care but you didn't receive it?]

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Unmet health care needs (UCN) - Question identifier:UCN_Q020

Thinking of the most recent time, why didn't you get care?

• 01: Not available - in the area
• 02: Not available - at time required (e.g. doctor on
  holidays, inconvenient hours)
• 03: Waiting time too long
• 04: Felt would be inadequate
• 05: Cost
• 06: Too busy
• 07: Didn't get around to it / didn't bother
• 08: Decided not to seek care
• 09: Doctor - didn't think it was necessary
• 10: Other - Specify
• 98: RF
• 99: DK

Unmet health care needs (UCN) - Question identifier:UCN_Q030

Again, thinking of the most recent time, what was the type of care that was needed?

• 1: Treatment of - a physical health problem
• 2: Treatment of - an emotional or mental health problem
• 3: A regular check-up (including regular pre-natal care)
• 4: Care of an injury
• 5: Other - Specify
• 8: RF
• 9: DK

Unmet health care needs (UCN) - Question identifier:UCN_Q040

Where did you try to get the service you were seeking?

• 1: Doctor's office
• 2: Community health centre / CLSC
• 3: Walk-in clinic
• 4: Appointment clinic
• 5: Hospital - emergency room
• 6: Hospital - outpatient clinic
• 7: Other - Specify
• 8: RF
• 9: DK

Home care services (HMC) - Question identifier:HMC_R09

Now some questions on home care services. These are health care, home maker or other support services received at home. People may receive home care due to a health problem or condition that affects their daily activities. Examples include: nursing care, personal care or help with bathing, housework, meal preparation, meal delivery and respite care.

Home care services (HMC) - Question identifier:HMC_Q09

Have you received any home care services in the past 12 months, with the cost being entirely or partially covered by government?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Home care services (HMC) - Question identifier:HMC_Q10

What type of services have you received?

• 01: Nursing care (e.g., dressing changes, preparing medications, V.O.N. visits)
• 02: Other health care services (e.g., physiotherapy, occupational or speech therapy, nutrition counselling)
• 03: Medical equipment or supplies
• 04: Personal care (e.g., bathing, foot care)
• 05: Housework (e.g., cleaning, laundry)
• 06: Meal preparation or delivery
• 07: Shopping
• 08: Respite care (i.e., caregiver relief)
• 09: Other - Specify
• 98: RF
• 99: DK

Home care services (HMC) - Question identifier:HMC_Q11

Have you received any [other home/home] care services in the past 12 months, with the cost not covered by government (for example: care provided by a private agency or by a spouse or friends)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Home care services (HMC) - Question identifier:HMC_Q12

Who provided these [other home/home] home care services?

• 1: Nurse from a private agency
• 2: Homemaker or other support services from a private agency
• 3: Physiotherapist or other therapist from a private agency
• 4: Neighbour or friend
• 5: Family member or spouse
• 6: Volunteer
• 7: Other - Specify
• 8: RF
• 9: DK

Home care services (HMC) - Question identifier:HMC_Q13

What type of home care services have you received?

• 01: Nursing care (e.g., dressing changes, preparing medications, V.O.N. visits)
• 02: Other health care services (e.g., physiotherapy, occupational or speech therapy,
  nutrition counselling)
• 03: Medical equipment or supplies
• 04: Personal care (e.g., bathing, foot care)
• 05: Housework (e.g., cleaning, laundry)
• 06: Meal preparation or delivery
• 07: Shopping
• 08: Respite care (i.e., caregiver relief)
• 09: Other - Specify
• 98: RF
• 99: DK

Home care services (HMC) - Question identifier:HMC_Q14

During the past 12 months, was there ever a time when you felt that you needed home care services but you didn't receive them?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Home care services (HMC) - Question identifier:HMC_Q15

Thinking of the most recent time, why didn't you get these services?

• 01: Not available - in the area
• 02: Not available - at time required (e.g., inconvenient hours)
• 03: Waiting time too long
• 04: Felt would be inadequate
• 05: Cost
• 06: Too busy
• 07: Didn't get around to it / didn't bother
• 08: Didn't know where to go / call
• 09: Language problems
• 10: Personal or family responsibilities
• 11: Decided not to seek services
• 12: Doctor - did not think it was necessary
• 13: Did not qualify / not eligible for home care
• 14: Still waiting for home care
• 15: Other - Specify
• 98: RF
• 99: DK

Home care services (HMC) - Question identifier:HMC_Q16

Again, thinking of the most recent time, what type of home care was needed?

• 01: Nursing care (e.g., dressing changes, preparing medications, V.O.N. visits)
• 02: Other health care services (e.g., physiotherapy, occupational or speech therapy,
  nutrition counselling)
• 03: Medical equipment or supplies
• 04: Personal care (e.g., bathing, foot care)
• 05: Housework (e.g., cleaning, laundry)
• 06: Meal preparation or delivery
• 07: Shopping
• 08: Respite care (i.e., caregiver relief)
• 09: Other - Specify
• 98: RF
• 99: DK

Home care services (HMC) - Question identifier:HMC_Q17

Where did you try to get this home care service?

• 1: A government sponsored program
• 2: A private agency
• 3: A family member, friend or neighbour
• 4: A volunteer organization
• 5: Other
• 8: RF
• 9: DK

Patient satisfaction - Health care services (PAS) - Question identifier:PAS_R11

Earlier, I asked about your use of health care services in the past 12 months. Now I'd like to get your opinion on the quality of the care you received.

Patient satisfaction - Health care services (PAS) - Question identifier:PAS_Q11

In the past 12 months, have you received any health care services?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Patient satisfaction - Health care services (PAS) - Question identifier:PAS_Q12

Overall, how would you rate the quality of the health care you received?
Would you say it was...?

• 1: Excellent
• 2: Good
• 3: Fair
• 4: Poor
• 8: RF
• 9: DK

Patient satisfaction - Health care services (PAS) - Question identifier:PAS_Q13

Overall, how satisfied were you with the way health care services were provided? Were you...?

• 1: Very satisfied
• 2: Somewhat satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Somewhat dissatisfied
• 5: Very dissatisfied
• 8: RF
• 9: DK

Patient satisfaction - Health care services (PAS) - Question identifier:PAS_Q21A

In the past 12 months, have you received any health care services at a hospital, for any diagnostic or day surgery service, overnight stay, or as an emergency room patient?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Patient satisfaction - Health care services (PAS) - Question identifier:PAS_Q21B

Thinking of your most recent hospital visit, were you...?

• 1: Admitted overnight or longer (an inpatient)
• 2: A patient at a diagnostic or day surgery clinic (an outpatient)
• 3: An emergency room patient
• 8: RF
• 9: DK

Patient satisfaction - Health care services (PAS) - Question identifier:PAS_Q22

(Thinking of this most recent hospital visit:)

how would you rate the quality of the care you received? Would you say it was...?

• 1: Excellent
• 2: Good
• 3: Fair
• 4: Poor
• 8: RF
• 9: DK

Patient satisfaction - Health care services (PAS) - Question identifier:PAS_Q23

(Thinking of this most recent hospital visit:)

how satisfied were you with the way hospital services were provided?
Were you...?

• 1: Very satisfied
• 2: Somewhat satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Somewhat dissatisfied
• 5: Very dissatisfied
• 8: RF
• 9: DK

Patient satisfaction - Health care services (PAS) - Question identifier:PAS_Q31A

In the past 12 months, not counting hospital visits, have you received any health care services from a family doctor or other physician?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Patient satisfaction - Health care services (PAS) - Question identifier:PAS_Q31B

Thinking of the most recent time, was care provided by...?

• 1: A family doctor (general practitioner)
• 2: A medical specialist
• 8: RF
• 9: DK

Patient satisfaction - Health care services (PAS) - Question identifier:PAS_Q32

(Thinking of this most recent care from a physician:)

how would you rate the quality of the care you received? Would you say it was...?

• 1: Excellent
• 2: Good
• 3: Fair
• 4: Poor
• 8: RF
• 9: DK

Patient satisfaction - Health care services (PAS) - Question identifier:PAS_Q33

(Thinking of this most recent care from a physician:)

how satisfied were you with the way physician care was provided? Were you...?

• 1: Very satisfied
• 2: Somewhat satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Somewhat dissatisfied
• 5: Very dissatisfied
• 8: RF
• 9: DK

Patient satisfaction - Community-based care (PSC) - Question identifier:PSC_R41

The next questions are about community-based health care which includes any health care received outside of a hospital or doctor's office.

Examples are: home nursing care, home-based counselling or therapy, personal care and community walk-in clinics.

Patient satisfaction - Community-based care (PSC) - Question identifier:PSC_Q41

In the past 12 months, have you received any community-based care?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Patient satisfaction - Community-based care (PSC) - Question identifier:PSC_Q42

Overall, how would you rate the quality of the community-based care you received? Would you say it was...?

• 1: Excellent
• 2: Good
• 3: Fair
• 4: Poor
• 8: RF
• 9: DK

Patient satisfaction - Community-based care (PSC) - Question identifier:PSC_Q43

Overall, how satisfied were you with the way community-based care was provided?
Were you...?

• 1: Very satisfied
• 2: Somewhat satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Somewhat dissatisfied
• 5: Very dissatisfied
• 8: RF
• 9: DK

Restriction of activities (RAC) - Question identifier:RAC_R1

The next few questions deal with any current limitations in your daily activities caused by a long-term health condition or problem. In these questions, a "long-term condition" refers to a condition that is expected to last or has already lasted 6 months or more.

Restriction of activities (RAC) - Question identifier:RAC_Q1

Do you have any difficulty hearing, seeing, communicating, walking, climbing stairs, bending, learning or doing any similar activities?

• 1: Sometimes
• 2: Often
• 3: Never
• 8: RF
• 9: DK

Restriction of activities (RAC) - Question identifier:RAC_Q2A

Does a long-term physical condition or mental condition or health problem, reduce the amount or the kind of activity you can do:

at home?

• 1: Sometimes
• 2: Often
• 3: Never
• 8: RF
• 9: DK

Restriction of activities (RAC) - Question identifier:RAC_Q2B_1

(Does a long-term physical condition or mental condition or health problem, reduce the amount or the kind of activity you can do:)

at school?

• 1: Sometimes
• 2: Often
• 3: Never
• 4: Does not attend school
• 8: RF
• 9: DK

Restriction of activities (RAC) - Question identifier:RAC_Q2B_2

(Does a long-term physical condition or mental condition or health problem, reduce the amount or the kind of activity you can do:)

at work?

• 1: Sometimes
• 2: Often
• 3: Never
• 4: Does not work at a job
• 8: RF
• 9: DK

Restriction of activities (RAC) - Question identifier:RAC_Q2C

(Does a long-term physical condition or mental condition or health problem, reduce the amount or the kind of activity you can do:)

in other activities, for example, transportation or leisure?

• 1: Sometimes
• 2: Often
• 3: Never
• 8: RF
• 9: DK

Restriction of activities (RAC) - Question identifier:RAC_R5

You reported that you have difficulty hearing, seeing, communicating, walking, climbing stairs, bending, learning or doing any similar activities.

Restriction of activities (RAC) - Question identifier:RAC_Q5

Which one of the following is the best description of the cause of this condition?

• 01: Accident at home
• 02: Motor vehicle accident
• 03: Accident at work
• 04: Other type of accident
• 05: Existed from birth or genetic
• 06: Work conditions
• 07: Disease or illness
• 08: Ageing
• 09: Emotional or mental health problem or condition
• 10: Use of alcohol or drugs
• 11: Other - Specify
• 98: RF
• 99: DK

Activities of Daily Living (ADL) - Question identifier:ADL_R01

The next few questions are about common daily activities. These questions may not apply to you, but we need to ask the same questions of everyone.

Activities of Daily Living (ADL) - Question identifier:ADL_Q01

Because of any physical condition or mental condition or health problem, do you need the help of another person:

with preparing meals?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Activities of Daily Living (ADL) - Question identifier:ADL_Q02

(Because of any physical condition or mental condition or health problem, do you need the help of another person:)

with getting to appointments and running errands such as shopping for groceries?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Activities of Daily Living (ADL) - Question identifier:ADL_Q03

(Because of any physical condition or mental condition or health problem, do you need the help of another person:)

with doing everyday housework?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Activities of Daily Living (ADL) - Question identifier:ADL_Q04

(Because of any physical condition or mental condition or health problem, do you need the help of another person:)

with personal care such as washing, dressing, eating or taking medication?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Activities of Daily Living (ADL) - Question identifier:ADL_Q05

(Because of any physical condition or mental condition or health problem, do you need the help of another person:)

with moving about inside the house?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Activities of Daily Living (ADL) - Question identifier:ADL_Q06

(Because of any physical condition or mental condition or health problem, do you need the help of another person:)

with looking after your personal finances such as making bank transactions or paying bills?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Flu shots (FLU) - Question identifier:FLU_R160

Now a few questions about your use of various health care services.

Flu shots (FLU) - Question identifier:FLU_Q160

Have you ever had a seasonal flu shot?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Flu shots (FLU) - Question identifier:FLU_Q162

When did you have your last seasonal flu shot?

• 1: Less than 1 year ago
• 2: 1 year to less than 2 years ago
• 3: 2 years ago or more
• 8: RF
• 9: DK

Flu shots (FLU) - Question identifier:FLU_Q164

In which month did you have your last seasonal flu shot?

• 01: January
• 02: February
• 03: March
• 04: April
• 05: May
• 06: June
• 07: July
• 08: August
• 09: September
• 10: October
• 11: November
• 12: December
• 98: RF
• 99: DK

Flu shots (FLU) - Question identifier:FLU_Q165

Was that this year or last year?

• 1: This year
• 2: Last year
• 8: RF
• 9: DK

Flu shots (FLU) - Question identifier:FLU_Q166

What are the reasons that you have not had a seasonal flu shot in the past year?

• 01: Have not gotten around to it
• 02: Respondent - did not think it was necessary
• 03: Doctor - did not think it was necessary
• 04: Personal or family responsibilities
• 05: Not available - at time required
• 06: Not available - at all in the area
• 07: Waiting time was too long
• 08: Transportation - problems
• 09: Language - problem
• 10: Cost
• 11: Did not know where to go / uninformed
• 12: Fear (e.g., painful, embarrassing, find something wrong)
• 13: Bad reaction to previous shot
• 14: Unable to leave the house because of a health problem
• 15: Other - Specify
• 98: RF
• 99: DK

Blood pressure check (BPC) - Question identifier:BPC_Q010

(Now blood pressure)
Have you ever had your blood pressure taken?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Blood pressure check (BPC) - Question identifier:BPC_Q012

When was the last time?

• 1: less than 6 months ago
• 2: 6 months to less than 1 year ago
• 3: 1 year to less than 2 years ago
• 4: 2 years to less than 5 years ago
• 5: 5 or more years ago
• 8: RF
• 9: DK

Blood pressure check (BPC) - Question identifier:BPC_Q013

Were you pregnant the last time your blood pressure was taken?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Blood pressure check (BPC) - Question identifier:BPC_Q016

What are the reasons that you have not had your blood pressure taken in the past 2 years?

• 01: Have not gotten around to it
• 02: Respondent - did not think it was necessary
• 03: Doctor - did not think it was necessary
• 04: Personal or family responsibilities
• 05: Not available - at time required
• 06: Not available - at all in the area
• 07: Waiting time was too long
• 08: Transportation - problems
• 09: Language - problem
• 10: Cost
• 11: Did not know where to go / uninformed
• 12: Fear (e.g., painful, embarrassing, find something wrong)
• 13: Unable to leave the house because of a health problem
• 14: Other
• 98: RF
• 99: DK

PAP smear test (PAP) - Question identifier:PAP_Q020

(Now PAP tests)
Have you ever had a PAP smear test?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

PAP smear test (PAP) - Question identifier:PAP_Q022

When was the last time?

• 1: Less than 6 months ago
• 2: 6 months to less than 1 year ago
• 3: 1 year to less than 3 years ago
• 4: 3 years to less than 5 years ago
• 5: 5 or more years ago
• 8: RF
• 9: DK

PAP smear test (PAP) - Question identifier:PAP_Q026

What are the reasons that you have not had a PAP smear test in the past 3 years?

• 01: Have not gotten around to it
• 02: Respondent - did not think it was necessary
• 03: Doctor - did not think it was necessary
• 04: Personal or family responsibilities
• 05: Not available - at time required
• 06: Not available - at all in the area
• 07: Waiting time was too long
• 08: Transportation - problems
• 09: Language - problem
• 10: Cost
• 11: Did not know where to go / uninformed
• 12: Fear (e.g., painful, embarrassing, find something wrong)
• 13: Have had a hysterectomy
• 14: Hate / dislike having one done
• 15: Unable to leave the house because of a health problem
• 16: Other
• 98: RF
• 99: DK

Mammography (MAM) - Question identifier:MAM_Q30

(Now Mammography)
Have you ever had a mammogram, that is, a breast x-ray?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Mammography (MAM) - Question identifier:MAM_Q31

Why did you have it?

• 01: Family history of breast cancer
• 02: Part of regular check-up / routine screening
• 03: Age
• 04: Previously detected lump
• 05: Follow-up of breast cancer treatment
• 06: On hormone replacement therapy
• 07: Breast problem
• 08: Other
• 98: RF
• 99: DK

Mammography (MAM) - Question identifier:MAM_Q32

When was the last time?

• 1: less than 6 months ago
• 2: 6 months to less than 1 year ago
• 3: 1 year to less than 2 years ago
• 4: 2 years to less than 5 years ago
• 5: 5 or more years ago
• 8: RF
• 9: DK

Mammography (MAM) - Question identifier:MAM_Q36

What are the reasons you have not had one in the past 2 years?

• 01: Have not gotten around to it
• 02: Respondent - did not think it was necessary
• 03: Doctor - did not think it was necessary
• 04: Personal or family responsibilities
• 05: Not available - at time required
• 06: Not available - at all in the area
• 07: Waiting time was too long
• 08: Transportation - problems
• 09: Language - problem
• 10: Cost
• 11: Did not know where to go / uninformed
• 12: Fear (e.g., painful, embarrassing, find something wrong)
• 13: Unable to leave the house because of a health problem
• 14: Breasts removed / Mastectomy
• 15: Other - Specify
• 98: RF
• 99: DK

Mammography (MAM) - Question identifier:MAM_Q38

Have you had a hysterectomy (in other words, has your uterus been removed)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Prostate cancer screening (PSA) - Question identifier:PSA_Q170

(Now Prostate tests)
Have you ever had a prostate specific antigen test for prostate cancer, that is, a
PSA blood test?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Prostate cancer screening (PSA) - Question identifier:PSA_Q172

When was the last time?

• 1: Less than 1 year ago
• 2: 1 year to less than 2 years ago
• 3: 2 years to less than 3 years ago
• 4: 3 years to less than 5 years ago
• 5: 5 or more years ago
• 8: RF
• 9: DK

Prostate cancer screening (PSA) - Question identifier:PSA_Q173

Why did you have it?

• 1: Family history of prostate cancer
• 2: Part of regular check-up / routine screening
• 3: Age
• 4: Race
• 5: Follow-up of problem
• 6: Follow-up of prostate cancer treatment
• 7: Other - Specify
• 8: RF
• 9: DK

Prostate cancer screening (PSA) - Question identifier:PSA_Q174

A Digital Rectal Exam is an exam in which a gloved finger is inserted into the rectum in order to feel the prostate gland.
Have you ever had this exam?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Prostate cancer screening (PSA) - Question identifier:PSA_Q175

When was the last time?

• 1: Less than 1 year ago
• 2: 1 year to less than 2 years ago
• 3: 2 years to less than 3 years ago
• 4: 3 years to less than 5 years ago
• 5: 5 or more years ago
• 8: RF
• 9: DK

Colorectal cancer screening (CCS) - Question identifier:CCS_Q180

Now a few questions about various colorectal exams.

An FOBT is a test to check for blood in your stool, where you have a bowel movement and use a stick to smear a small sample on a special card.

Have you ever had this test?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Colorectal cancer screening (CCS) - Question identifier:CCS_Q182

When was the last time?

• 1: Less than 1 year ago
• 2: 1 year to less than 2 years ago
• 3: 2 years to less than 3 years ago
• 4: 3 years to less than 5 years ago
• 5: 5 years to less than 10 years ago
• 6: 10 or more years ago
• 8: RF
• 9: DK

Colorectal cancer screening (CCS) - Question identifier:CCS_Q183

Why did you have it?

• 1: Family history of colorectal cancer
• 2: Part of regular check-up / routine screening
• 3: Age
• 4: Race
• 5: Follow-up of problem
• 6: Follow-up of colorectal cancer treatment
• 7: Other - Specify
• 8: RF
• 9: DK

Colorectal cancer screening (CCS) - Question identifier:CCS_Q184

A colonoscopy or sigmoidoscopy is when a tube is inserted into the rectum to view the bowel for early signs of cancer and other health problems. Have you ever had either of these exams?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Colorectal cancer screening (CCS) - Question identifier:CCS_Q185

When was the last time?

• 1: Less than 1 year ago
• 2: 1 year to less than 2 years ago
• 3: 2 years to less than 3 years ago
• 4: 3 years to less than 5 years ago
• 5: 5 years to less than 10 years ago
• 6: 10 or more years ago
• 8: RF
• 9: DK

Colorectal cancer screening (CCS) - Question identifier:CCS_Q186

Why did you have it?

• 1: Family history of colorectal cancer
• 2: Part of regular check-up / routine screening
• 3: Age
• 4: Race
• 5: Follow-up of problem
• 6: Follow-up of colorectal cancer treatment
• 7: Other - Specify
• 8: RF
• 9: DK

Colorectal cancer screening (CCS) - Question identifier:CCS_Q187

Was the colonoscopy or sigmoidoscopy a follow-up of the results of an FOBT?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Eye examinations (EYX) - Question identifier:EYX_Q140

(Now eye examinations)
It was reported earlier that you have "seen" or "talked to" an optometrist or ophthalmologist in the past 12 months. Did you actually visit one?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Eye examinations (EYX) - Question identifier:EYX_Q142

(Now eye examinations)
When did you last have an eye examination?

• 1: Less than 1 year ago
• 2: 1 year to less than 2 years ago
• 3: 2 years to less than 3 years ago
• 4: 3 or more years ago
• 5: Never
• 8: RF
• 9: DK

Eye examinations (EYX) - Question identifier:EYX_Q146

What are the reasons that you have not had an eye examination in the past 2 years?

• 01: Have not gotten around to it
• 02: Respondent - did not think it was necessary
• 03: Doctor - did not think it was necessary
• 04: Personal or family responsibilities
• 05: Not available - at time required
• 06: Not available - at all in the area
• 07: Waiting time was too long
• 08: Transportation - problems
• 09: Language - problem
• 10: Cost
• 11: Did not know where to go / uninformed
• 12: Fear (e.g., painful, embarrassing, find something wrong)
• 13: Unable to leave the house because of a health problem
• 14: Other
• 98: RF
• 99: DK

Dental visits (DEN) - Question identifier:DEN_R130

The following questions are about dental visits.

Dental visits (DEN) - Question identifier:DEN_Q130

It was reported earlier that you have "seen" or "talked to" a dentist in the past 12 months. Did you actually visit one?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Dental visits (DEN) - Question identifier:DEN_Q132

When was the last time that you went to a dentist?

• 1: Less than 1 year ago
• 2: 1 year to less than 2 years ago
• 3: 2 years to less than 3 years ago
• 4: 3 years to less than 4 years ago
• 5: 4 years to less than 5 years ago
• 6: 5 or more years ago
• 7: Never
• 8: RF
• 9: DK

Dental visits (DEN) - Question identifier:DEN_Q136

What are the reasons that you have not been to a dentist in the past 3 years?

• 01: Have not gotten around to it
• 02: Respondent - did not think it was necessary
• 03: Doctor - did not think it was necessary
• 04: Personal or family responsibilities
• 05: Not available - at time required
• 06: Not available - at all in the area
• 07: Waiting time was too long
• 08: Transportation - problems
• 09: Language - problem
• 10: Cost
• 11: Did not know where to go / uninformed
• 12: Fear (e.g., painful, embarrassing, find something wrong)
• 13: Wears dentures
• 14: Unable to leave the house because of a health problem
• 15: Other
• 98: RF
• 99: DK

Oral health 2 (OH2) - Question identifier:OH2_Q10

Do you usually visit the dentist...?

• 1: more than once a year for check-ups
• 2: about once a year for check-ups
• 3: less than once a year for check-ups
• 4: only for emergency care
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q11

Do you have insurance that covers all or part of your dental expenses?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q11A

Is it...?

• 1: a government-sponsored plan
• 2: an employer-sponsored plan
• 3: a private plan
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q12

In the past 12 months, have you had any teeth removed by a dentist?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q13

(In the past 12 months,) were any teeth removed because of decay or gum disease?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q20

Do you have one or more of your own teeth?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q21

Do you wear dentures or false teeth?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_R22

Now we have some additional questions about oral health, that is the health of your teeth and mouth.

Oral health 2 (OH2) - Question identifier:OH2_Q22

Because of the condition of your [teeth, mouth or dentures/teeth or mouth], do you have difficulty pronouncing any words or speaking clearly?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q23

In the past 12 months, how often have you avoided:

conversation or contact with other people, because of the condition of your [teeth, mouth or dentures/teeth or mouth]?

• 1: Often
• 2: Sometimes
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q24

(In the past 12 months, how often have you avoided:)

laughing or smiling, because of the condition of your [teeth, mouth or dentures/teeth or mouth]?

• 1: Often
• 2: Sometimes
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_R25

Now some questions about the health of your [mouth/teeth and mouth] during the past month.

Oral health 2 (OH2) - Question identifier:OH2_Q25A

In the past month, have you had:

a toothache?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q25B

In the past month, were your teeth:

sensitive to hot or cold food or drinks?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q25C

In the past month, have you had:

pain in or around the jaw joints?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q25D

(In the past month, have you had:)

other pain in the mouth or face?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q25E

(In the past month, have you had:)

bleeding gums?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q25F

(In the past month, have you had:)

dry mouth?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q25G

(In the past month, have you had:)

bad breath?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Oral health 2 (OH2) - Question identifier:OH2_Q30

How often do you brush your teeth?

• 1: More than twice a day
• 2: Twice a day
• 3: Once a day
• 4: Less than once a day but more than once a week
• 5: Once a week
• 6: Less than once a week
• 8: RF
• 9: DK

Food choices (FDC) - Question identifier:FDC_R1

Now, some questions about the foods you eat.

Food choices (FDC) - Question identifier:FDC_Q1A

Do you choose certain foods or avoid others:

because you are concerned about your body weight?

• 1: Yes (or sometimes)
• 2: No
• 8: RF
• 9: DK

Food choices (FDC) - Question identifier:FDC_Q1B

(Do you choose certain foods or avoid others:)

because you are concerned about heart disease?

• 1: Yes (or sometimes)
• 2: No
• 8: RF
• 9: DK

Food choices (FDC) - Question identifier:FDC_Q1C

(Do you choose certain foods or avoid others:)

because you are concerned about cancer?

• 1: Yes (or sometimes)
• 2: No
• 8: RF
• 9: DK

Food choices (FDC) - Question identifier:FDC_Q1D

(Do you choose certain foods or avoid others:)

because you are concerned about osteoporosis (brittle bones)?

• 1: Yes (or sometimes)
• 2: No
• 8: RF
• 9: DK

Food choices (FDC) - Question identifier:FDC_Q2A

Do you choose certain foods because of:

the lower fat content?

• 1: Yes (or sometimes)
• 2: No
• 8: RF
• 9: DK

Food choices (FDC) - Question identifier:FDC_Q2B

(Do you choose certain foods because of:)

the fibre content?

• 1: Yes (or sometimes)
• 2: No
• 8: RF
• 9: DK

Food choices (FDC) - Question identifier:FDC_Q2C

(Do you choose certain foods because of:)

the calcium content?

• 1: Yes (or sometimes)
• 2: No
• 8: RF
• 9: DK

Food choices (FDC) - Question identifier:FDC_Q3A

Do you avoid certain foods because of:

the fat content?

• 1: Yes (or sometimes)
• 2: No
• 8: RF
• 9: DK

Food choices (FDC) - Question identifier:FDC_Q3B

(Do you avoid certain foods because of:)

the type of fat they contain?

• 1: Yes (or sometimes)
• 2: No
• 8: RF
• 9: DK

Food choices (FDC) - Question identifier:FDC_Q3C

(Do you avoid certain foods because of:)

the salt content?

• 1: Yes (or sometimes)
• 2: No
• 8: RF
• 9: DK

Food choices (FDC) - Question identifier:FDC_Q3D

(Do you avoid certain foods because of:)

the cholesterol content?

• 1: Yes (or sometimes)
• 2: No
• 8: RF
• 9: DK

Food choices (FDC) - Question identifier:FDC_Q3E

(Do you avoid certain foods because of:)

the calorie content?

• 1: Yes (or sometimes)
• 2: No
• 8: RF
• 9: DK

Fruit and vegetable consumption (FVC) - Question identifier:FVC_R1

The next questions are about the foods you usually eat or drink. Think about all the foods you eat, both meals and snacks, at home and away from home.

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q1A

How often do you usually drink fruit juices such as orange, grapefruit or tomato? (For example: once a day, three times a week, twice a month)

• 1: Per day
• 2: Per week
• 3: Per month
• 4: Per year
• 5: Never
• 8: RF
• 9: DK

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N1B

Enter number of times per day.

Min = 1; Max = 20

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N1C

Enter number of times per week.

Min = 1; Max = 90

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N1D

Enter number of times per month.

Min = 1; Max = 200

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N1E

Enter number of times per year.

Min = 1; Max = 500

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q2A

Not counting juice, how often do you usually eat fruit?

• 1: Per day
• 2: Per week
• 3: Per month
• 4: Per year
• 5: Never
• 8: RF
• 9: DK

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N2B

Enter number of times per day.

Min = 1; Max = 20

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N2C

Enter number of times per week.

Min = 1; Max = 90

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N2D

Enter number of times per month.

Min = 1; Max = 200

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N2E

Enter number of times per year.

Min = 1; Max = 500

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q3A

How often do you (usually) eat green salad?

• 1: Per day
• 2: Per week
• 3: Per month
• 4: Per year
• 5: Never
• 8: RF
• 9: DK

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N3B

Enter number of times per day.

Min = 1; Max = 20

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N3C

Enter number of times per week.

Min = 1; Max = 90

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N3D

Enter number of times per month.

Min = 1; Max = 200

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N3E

Enter number of times per year.

Min = 1; Max = 500

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q4A

How often do you usually eat potatoes, not including french fries, fried potatoes, or potato chips?

• 1: Per day
• 2: Per week
• 3: Per month
• 4: Per year
• 5: Never
• 8: RF
• 9: DK

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N4B

Enter number of times per day.

Min = 1; Max = 20

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N4C

Enter number of times per week.

Min = 1; Max = 90

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N4D

Enter number of times per month.

Min = 1; Max = 200

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N4E

Enter number of times per year.

Min = 1; Max = 500

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q5A

How often do you (usually) eat carrots?

• 1: Per day
• 2: Per week
• 3: Per month
• 4: Per year
• 5: Never
• 8: RF
• 9: DK

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N5B

Enter number of times per day.

Min = 1; Max = 20

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N5C

Enter number of times per week.

Min = 1; Max = 90

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N5D

Enter number of times per month.

Min = 1; Max = 200

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N5E

Enter number of times per year.

Min = 1; Max = 500

Fruit and vegetable consumption (FVC) - Question identifier:FVC_Q6A

Not counting carrots, potatoes, or salad, how many servings of other vegetables do you usually eat?

• 1: Per day
• 2: Per week
• 3: Per month
• 4: Per year
• 5: Never
• 8: RF
• 9: DK

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N6B

Enter number of servings per day.

Min = 1; Max = 20

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N6C

Enter number of servings per week.

Min = 1; Max = 90

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N6D

Enter number of servings per month.

Min = 1; Max = 200

Fruit and vegetable consumption (FVC) - Question identifier:FVC_N6E

Enter number of servings per year.

Min = 1; Max = 500

Physical activities (PAC) - Question identifier:PAC_R1

Now I'd like to ask you about some of your physical activities. To begin with, I'll be dealing with physical activities not related to work, that is, leisure time activities.

Physical activities (PAC) - Question identifier:PAC_Q1

Have you done any of the following in the past 3 months, that is, from ^DATETHREEMONTHSAGO to yesterday?

• 01: Walking for exercise
• 02: Gardening or yard work
• 03: Swimming
• 04: Bicycling
• 05: Popular or social dance
• 06: Home exercises
• 07: Ice hockey
• 08: Ice skating
• 09: In-line skating or rollerblading
• 10: Jogging or running
• 11: Golfing
• 12: Exercise class or aerobics
• 13: Downhill skiing or snowboarding
• 14: Bowling
• 15: Baseball or softball
• 16: Tennis
• 17: Weight-training
• 18: Fishing
• 19: Volleyball
• 20: Basketball
• 21: Soccer
• 22: Any other
• 23: No physical activity
• 98: RF
• 99: DK

Physical activities (PAC) - Question identifier:PAC_Q1X

In the past 3 months, did you do any other physical activity for leisure?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Physical activities (PAC) - Question identifier:PAC_Q1Y

In the past 3 months, did you do any other physical activity for leisure?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Physical activities (PAC) - Question identifier:PAC_Q2

In the past 3 months, how many times did you participate in [Walking for exercise/Gardening or yard work/Swimming/Bicycling/Popular or social dance/Home exercises/Ice hockey/Ice skating/In-line skating or rollerblading/Jogging or running/Golfing/Exercise class or aerobics/Downhill skiing or snowboarding/Bowling/Baseball or softball/Tennis/Weight-training/Fishing/Volleyball/Basketball/Soccer/Any other]?

Min = 1; Max = 300

Physical activities (PAC) - Question identifier:PAC_Q3

About how much time did you spend on each occasion?

• 1: 1 to 15 minutes
• 2: 16 to 30 minutes
• 3: 31 to 60 minutes
• 4: More than one hour
• 8: RF
• 9: DK

Physical activities (PAC) - Question identifier:PAC_R7

The last questions were about leisure time activities. Next, some questions about walking and bicycling that you do only as a way of getting to and from work or school.

Physical activities (PAC) - Question identifier:PAC_Q7A

[Other than the (X) times you already reported walking for exercise was there any other time/Was there any time] in the past 3 months when you walked to and from work or school?

• 1: Yes
• 2: No
• 3: Does not work or go to school
• 8: RF
• 9: DK

Physical activities (PAC) - Question identifier:PAC_Q7B

How many times?

Min = 1; Max = 270

Physical activities (PAC) - Question identifier:PAC_Q7C

About how much time did you spend on each occasion?

• 1: 1 to 15 minutes
• 2: 16 to 30 minutes
• 3: 31 to 60 minutes
• 4: More than one hour
• 8: RF
• 9: DK

Physical activities (PAC) - Question identifier:PAC_Q8A

[Other than the (X) times you already reported bicycling was there any other time/Was there any time] in the past 3 months when you bicycled to and from work or school?

• 1: Yes
• 2: No
• 3: Does not work or go to school
• 8: RF
• 9: DK

Physical activities (PAC) - Question identifier:PAC_Q8B

How many times?

Min = 1; Max = 200

Physical activities (PAC) - Question identifier:PAC_Q8C

About how much time did you spend on each occasion?

• 1: 1 to 15 minutes
• 2: 16 to 30 minutes
• 3: 31 to 60 minutes
• 4: More than one hour
• 8: RF
• 9: DK

Physical activity - Stages of change (SCP) - Question identifier:SCP_Q01

Thinking about the level of physical activity you do every week, do you consider yourself to be...?

• 1: Very physically active
• 2: Moderately physically active
• 3: A bit physically active
• 4: Not at all physically active
• 8: RF
• 9: DK

Physical activity - Stages of change (SCP) - Question identifier:SCP_Q02

Did you increase your physical activity level in the last 6 months?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Physical activity - Stages of change (SCP) - Question identifier:SCP_Q03

Do you intend to increase your physical activity level in the next 30 days?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Physical activity - Stages of change (SCP) - Question identifier:SCP_Q04

Do you intend to increase your physical activity level in the next 6 months?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Sedentary activities (SAC) - Question identifier:SAC_R1

Now, a few additional questions about activities you do in your leisure time, that is, activities not at work or at school.

Sedentary activities (SAC) - Question identifier:SAC_Q1

In a typical week in the past 3 months, how many hours did you usually spend:

on a computer, including playing computer games and using the Internet?

Min = 0; Max = 70

Sedentary activities (SAC) - Question identifier:SAC_Q2

(In a typical week, in the past 3 months, how many hours did you usually spend:)

playing video games on a game console or on a hand-held electronic device?

Min = 0; Max = 70

Sedentary activities (SAC) - Question identifier:SAC_Q3

(In a typical week in the past 3 months, how many hours did you usually spend:)

watching television or videos?

Min = 0; Max = 70

Sedentary activities (SAC) - Question identifier:SAC_Q4

(In a typical week, in the past 3 months, how many hours did you usually spend:)

reading, not counting at work or at school?

Min = 0; Max = 70

Use of protective equipment (UPE) - Question identifier:UPE_R10

Now a few questions about precautions you take while participating in some physical activities.

Use of protective equipment (UPE) - Question identifier:UPE_Q1A

In the past 12 months, have you done any bicycling?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q1B

When riding a bicycle, how often do you wear a helmet?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q2A

In the past 12 months, have you done any in-line skating or rollerblading?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q2B

When in-line skating or rollerblading, how often do you wear a helmet?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q2C

How often do you wear wrist guards or wrist protectors?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q2D

How often do you wear elbow pads?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q2E

How often do you wear knee pads?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q3A

Earlier, you mentioned going downhill skiing or snowboarding in the past 3 months. Was that:?

• 1: downhill skiing only
• 2: snowboarding only
• 3: both
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q3B

In the past 12 months, did you do any downhill skiing or snowboarding?

• 1: Downhill skiing only
• 2: Snowboarding only
• 3: Both
• 4: Neither
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q4A

When downhill skiing, how often do you wear a helmet?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q5A

When snowboarding, how often do you wear a helmet?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q5B

How often do you wear wrist guards or wrist protectors?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q6A

In the past 12 months, have you done any skateboarding?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q6B

How often do you wear a helmet?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q6C

How often do you wear wrist guards or wrist protectors?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q6D

How often do you wear elbow pads?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q7A

In the past 12 months, have you played any ice hockey?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Use of protective equipment (UPE) - Question identifier:UPE_Q7B

When playing ice hockey, how often do you wear a mouth guard?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Sun safety behaviours (SSB) - Question identifier:SSB_R01

The next few questions are about exposure to the sun and sunburns. Sunburn is defined as any reddening or discomfort of the skin, that lasts longer than 12 hours after exposure to the sun or other UV sources, such as tanning beds or sun lamps.

Sun safety behaviours (SSB) - Question identifier:SSB_Q01

In the past 12 months, has any part of your body been sunburnt?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Sun safety behaviours (SSB) - Question identifier:SSB_Q02

Did any of your sunburns involve blistering?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Sun safety behaviours (SSB) - Question identifier:SSB_Q03

Did any of your sunburns involve pain or discomfort that lasted for more than 1 day?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Sun safety behaviours (SSB) - Question identifier:SSB_R06

For the next questions, think about a typical weekend, or day off from work or school in the summer months.

Sun safety behaviours (SSB) - Question identifier:SSB_Q06

About how much time each day do you spend in the sun between 11 am and 4 pm?

• 01: None
• 02: Less than 30 minutes
• 03: 30 to 59 minutes
• 04: 1 hour to less than 2 hours
• 05: 2 hours to less than 3 hours
• 06: 3 hours to less than 4 hours
• 07: 4 hours to less than 5 hours
• 08: 5 hours
• 98: RF
• 99: DK

Sun safety behaviours (SSB) - Question identifier:SSB_Q07

In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:

seek shade?

• 1: Always
• 2: Often
• 3: Sometimes
• 4: Rarely
• 5: Never
• 8: RF
• 9: DK

Sun safety behaviours (SSB) - Question identifier:SSB_Q08

(In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:)

wear a hat that shades your face, ears and neck?

• 1: Always
• 2: Often
• 3: Sometimes
• 4: Rarely
• 5: Never
• 8: RF
• 9: DK

Sun safety behaviours (SSB) - Question identifier:SSB_Q09A

(In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:)

wear long pants or a long skirt to protect your skin from the sun?

• 1: Always
• 2: Often
• 3: Sometimes
• 4: Rarely
• 5: Never
• 8: RF
• 9: DK

Sun safety behaviours (SSB) - Question identifier:SSB_Q09B

(In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:)

use sunscreen on your face?

• 1: Always
• 2: Often
• 3: Sometimes
• 4: Rarely
• 5: Never
• 8: RF
• 9: DK

Sun safety behaviours (SSB) - Question identifier:SSB_Q10

What Sun Protection factor (SPF) do you usually use?

• 1: Less than 15
• 2: 15 to 25
• 3: More than 25
• 8: RF
• 9: DK

Sun safety behaviours (SSB) - Question identifier:SSB_Q11

In the summer months, on a typical weekend or day off, when you are in the sun for 30 minutes or more, how often do you:

use sunscreen on your body?

• 1: Always
• 2: Often
• 3: Sometimes
• 4: Rarely
• 5: Never
• 8: RF
• 9: DK

Sun safety behaviours (SSB) - Question identifier:SSB_Q12

What Sun Protection factor (SPF) do you usually use?

• 1: Less than 15
• 2: 15 to 25
• 3: More than 25
• 8: RF
• 9: DK

Sun safety behaviours (SSB) - Question identifier:SSB_Q13

Do you have skin cancer?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Sun safety behaviours (SSB) - Question identifier:SSB_Q14

Have you ever been diagnosed with skin cancer?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Sun safety behaviours (SSB) - Question identifier:SSB_Q15

What type of skin cancer [do/did] you have?

• 1: Melanoma
• 2: Non-melanoma
• 8: RF
• 9: DK

Injuries (INJ) - Question identifier:INJ_R01

Now some questions about [other/null] injuries which occurred in the past 12 months, and were serious enough to limit your normal activities the day after the injury occurred. For example, a broken bone, a bad cut, a burn or a sprain.

Injuries (INJ) - Question identifier:INJ_Q01

[Not counting repetitive strain injuries or food poisoning,/Not counting food poisoning,] in the past 12 months, that is, from ^DATEONEYEARAGOE to yesterday, were you injured?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Injuries (INJ) - Question identifier:INJ_Q02

How many times were you injured?

Min = 1; Max = 30

Injuries (INJ) - Question identifier:INJ_Q03

[In which/Thinking about the most serious injury, in which] month did it happen?

• 01: January
• 02: February
• 03: March
• 04: April
• 05: May
• 06: June
• 07: July
• 08: August
• 09: September
• 10: October
• 11: November
• 12: December
• 98: RF
• 99: DK

Injuries (INJ) - Question identifier:INJ_Q04

Was that this year or last year?

• 1: This year
• 2: Last year
• 8: RF
• 9: DK

Injuries (INJ) - Question identifier:INJ_Q05

What type of injury did you have? For example, a broken bone or burn.

• 01: Multiple serious injuries (excluding multiple minor injuries)
• 02: Broken or fractured bones
• 03: Burn, scald, chemical burn
• 04: Dislocation
• 05: Sprain or strain (including torn ligaments and muscles)
• 06: Cut, puncture, animal or human bite (open wound)
• 07: Scrape(s), bruise(s), blister(s) (including multiple minor injuries)
• 08: Concussion or other brain injury
• 09: Poisoning (excluding food poisoning, poison ivy, other contact dermatitis, and allergies)
• 10: Injury to internal organs
• 11: Other - Specify
• 98: RF
• 99: DK

Injuries (INJ) - Question identifier:INJ_Q06

What part of the body was injured?

• 01: Multiple sites
• 02: Eyes (excluding fracture of facial bones around the eye)
• 03: Head (including facial bones)
• 04: Neck
• 05: Shoulder, upper arm
• 06: Elbow, lower arm
• 07: Wrist
• 08: Hand
• 09: Hip
• 10: Thigh
• 11: Knee, lower leg
• 12: Ankle, foot
• 13: Upper back or upper spine (excluding neck)
• 14: Lower back or lower spine
• 15: Chest (excluding back and spine)
• 16: Abdomen or pelvis (excluding back and spine)
• 98: RF
• 99: DK

Injuries (INJ) - Question identifier:INJ_Q07

What part of the body was injured?

• 1: Chest (within rib cage)
• 2: Abdomen or pelvis (below ribs)
• 3: Other - Specify
• 8: RF
• 9: DK

Injuries (INJ) - Question identifier:INJ_Q08

Where were you when you were injured?
For example, someone's house, an office building, construction site.

• 01: In a home or its surrounding area (including respondent's home or other homes)
• 02: Residential institution
• 03: School, college, university (exclude sports areas)
• 04: Sports or athletics area of school, college, university
• 05: Other sports or athletics area (exclude school sports areas)
• 06: Other institution (e.g., church, hospital, theatre, civic building)
• 07: Street, highway, sidewalk
• 08: Commercial area (e.g., store, restaurant, office building, transport terminal)
• 09: Industrial or construction area
• 10: Farm (exclude farmhouse and its surrounding area)
• 11: Countryside, forest, lake, ocean, mountains, prairie, etc.
• 12: Other - Specify
• 98: RF
• 99: DK

Injuries (INJ) - Question identifier:INJ_Q09

What were you doing when you were injured?

• 01: Sports or physical exercise (including school activities, and running)
• 02: Leisure or hobby (including volunteering)
• 03: Working at a job or business (excluding travel to and from work)
• 04: Household chores, outdoor yard maintenance, home renovations or
  other unpaid work
• 05: Sleeping, eating, personal care
• 06: Going up and down stairs
• 07: Driver or passenger in/on road motor vehicle (including motorcycles,
  trucks)
• 08: Driver or passenger in/on off-road motor vehicle (including boat, ATV, snowmobile)
• 09: Walking
• 10: Other - Specify
• 98: RF
• 99: DK

Injuries (INJ) - Question identifier:INJ_Q10

Was the injury the result of a fall?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Injuries (INJ) - Question identifier:INJ_Q11

How did you fall?

• 01: While skating, skiing or snowboarding
• 02: While engaged in other sport or physical exercise (including school activities and running)
• 03: Going up or down stairs / steps (icy or not)
• 04: Slip, trip, stumble or loss balance while walking on ice or snow
• 05: Slip, trip or stumble or loss balance while walking on any other surface
• 06: From furniture or while rising from furniture (e.g., bed, chair)
• 07: From elevated position (e.g., ladder, tree, scaffolding)
• 08: Due to health problems (e.g., faint, weakness, dizziness, hip/knee gave out, seizure)
• 09: Other - Specify
• 98: RF
• 99: DK

Injuries (INJ) - Question identifier:INJ_Q12A

What caused the injury?

• 01: Transportation accident
• 02: Accidentally bumped, pushed, bitten, etc. by person or animal
• 03: Accidentally struck or crushed by object(s)
• 04: Accidental contact with sharp object, tool or machine
• 05: Smoke, fire, flames
• 06: Accidental contact with hot object, liquid or gas
• 07: Extreme weather or natural disaster
• 08: Overexertion or strenuous movement
• 09: Physical assault
• 10: Other - Specify
• 98: RF
• 99: DK

Injuries (INJ) - Question identifier:INJ_Q12B

At what time of day did your injury occur?

• 1: Morning (06:00-11:59)
• 2: Afternoon (12:00-17:59)
• 3: Evening (18:00-23:59)
• 4: Night (00:00-05:59)
• 8: RF
• 9: DK

Injuries (INJ) - Question identifier:INJ_Q13

Did you receive any medical attention for the injury from a health professional in the 48 hours following the injury?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Injuries (INJ) - Question identifier:INJ_Q14

Where did you receive treatment in the 48 hours?

• 01: Doctor's office
• 02: Hospital emergency room
• 03: Hospital outpatient clinic (e.g. day surgery, cancer)
• 04: Other clinic (e.g. walk-in, appointment, sports)
• 05: Physiotherapist or massage therapist's office
• 06: Community health centre / CLSC
• 07: Chiropractor's office
• 08: Where the injury happened/on-site (workplace, school, sports field,
  hotel, ski hill)
• 09: Other
• 98: RF
• 99: DK

Injuries (INJ) - Question identifier:INJ_Q15A

Were you admitted to a hospital overnight?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Injuries (INJ) - Question identifier:INJ_Q15B

At the present time, are you getting follow-up care from a health professional because of this injury?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Injuries (INJ) - Question identifier:INJ_Q16

In the past 12 months, did you have any other injuries that were treated by a health professional, but did not limit your normal activities?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Injuries (INJ) - Question identifier:INJ_Q17

How many injuries?

Min = 1; Max = 30

Repetitive strain - Sub Block (REP) - Question identifier:REP_R1

This next section deals with repetitive strain injuries. By this we mean injuries to muscles, tendons or nerves caused by overuse or repeating the same movement over an extended period. For example, carpal tunnel syndrome, tennis elbow or tendonitis.

Repetitive strain - Sub Block (REP) - Question identifier:REP_Q1

In the past 12 months, did you have any injuries due to repetitive strain?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Repetitive strain - Sub Block (REP) - Question identifier:REP_Q2

Were these injuries serious enough to limit your normal activities?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Repetitive strain - Sub Block (REP) - Question identifier:REP_Q3A

Thinking about the most serious repetitive strain, what part of the body was affected?

• 01: Head
• 02: Neck
• 03: Shoulder, upper arm
• 04: Elbow, lower arm
• 05: Wrist
• 06: Hand
• 07: Hip
• 08: Thigh
• 09: Knee, lower leg
• 10: Ankle, foot
• 11: Upper back or upper spine (excluding neck)
• 12: Lower back or lower spine
• 13: Chest (excluding back and spine)
• 14: Abdomen or pelvis (excluding back and spine)
• 98: RF
• 99: DK

Repetitive strain - Sub Block (REP) - Question identifier:REP_Q3B

Do you know what type of activity caused this repetitive strain injury?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Repetitive strain - Sub Block (REP) - Question identifier:REP_Q4

Was the activity something you did while working at a job or business (excluding travel to or from work)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Repetitive strain - Sub Block (REP) - Question identifier:REP_Q5

What type of activity was this?

• 01: Walking
• 02: Sports or physical exercise (including school activities and running)
• 03: Leisure or hobby (include volunteering)
• 04: Household chores, outdoor yard maintenance,
  home renovations or other unpaid work
• 05: Computer use or typing
• 06: Driving a motor vehicle
• 07: Lifting or carrying an object or person
• 08: Other - Specify
• 98: RF
• 99: DK

Workplace Injury - Sub Block (INW) - Question identifier:INW_Q01

Did this injury occur in your current main job?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Workplace Injury - Sub Block (INW) - Question identifier:INW_Q02

What kind of business, industry or service were you working in when you were injured? (For example: cardboard box manufacturing, road maintenance, retail shoe store, secondary school, dairy farm, municipal government).

Long Answer Length = 50

Workplace Injury - Sub Block (INW) - Question identifier:INW_Q03

What kind of work were you doing? (For example: babysitting in own home, factory worker, forestry technician)

Long Answer Length = 50

Workplace Injury - Sub Block (INW) - Question identifier:INW_Q04

What were your most important activities or duties? (For example: caring for children, stamp press machine operator, forest examiner.

Long Answer Length = 50

Satisfaction with life (SWL) - Question identifier:SWL_R1

Now I'd like to ask about your satisfaction with various aspects of your life. For each question, please tell me whether you are very satisfied, satisfied, neither satisfied nor dissatisfied, dissatisfied, or very dissatisfied.

Satisfaction with life (SWL) - Question identifier:SWL_Q02

How satisfied are you with your job or main activity?

• 1: Very satisfied
• 2: Satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Dissatisfied
• 5: Very dissatisfied
• 8: RF
• 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q03

How satisfied are you with your leisure activities?

• 1: Very satisfied
• 2: Satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Dissatisfied
• 5: Very dissatisfied
• 8: RF
• 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q04

(How satisfied are you) with your financial situation?

• 1: Very satisfied
• 2: Satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Dissatisfied
• 5: Very dissatisfied
• 8: RF
• 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q05

How satisfied are you with yourself?

• 1: Very satisfied
• 2: Satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Dissatisfied
• 5: Very dissatisfied
• 8: RF
• 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q06

How satisfied are you with the way your body looks?

• 1: Very satisfied
• 2: Satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Dissatisfied
• 5: Very dissatisfied
• 8: RF
• 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q07

How satisfied are you with your relationships with family members?

• 1: Very satisfied
• 2: Satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Dissatisfied
• 5: Very dissatisfied
• 8: RF
• 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q08

(How satisfied are you) with your relationships with friends?

• 1: Very satisfied
• 2: Satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Dissatisfied
• 5: Very dissatisfied
• 8: RF
• 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q09

(How satisfied are you) with your housing?

• 1: Very satisfied
• 2: Satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Dissatisfied
• 5: Very dissatisfied
• 8: RF
• 9: DK

Satisfaction with life (SWL) - Question identifier:SWL_Q10

(How satisfied are you) with your neighbourhood?

• 1: Very satisfied
• 2: Satisfied
• 3: Neither satisfied nor dissatisfied
• 4: Dissatisfied
• 5: Very dissatisfied
• 8: RF
• 9: DK

Stress - Sources (STS) - Question identifier:STS_R1

Now a few questions about the stress in your life.

Stress - Sources (STS) - Question identifier:STS_Q1

In general, how would you rate your ability to handle unexpected and difficult problems, for example, a family or personal crisis? Would you say your ability is...?

• 1: Excellent
• 2: Good
• 3: Fair
• 4: Poor
• 8: RF
• 9: DK

Stress - Sources (STS) - Question identifier:STS_Q2

In general, how would you rate your ability to handle the day-to-day demands in your life, for example, handling work, family and volunteer responsibilities? Would you say your ability is...?

• 1: Excellent
• 2: Good
• 3: Fair
• 4: Poor
• 8: RF
• 9: DK

Stress - Sources (STS) - Question identifier:STS_Q3

Thinking about stress in your day-to-day life, what would you say is the most important thing contributing to feelings of stress you may have?

• 01: Time pressures / not enough time
• 02: Own physical health problem or condition
• 03: Own emotional or mental health problem or condition
• 04: Financial situation (e.g., not enough money, debt)
• 05: Own work situation (e.g., hours of work, working conditions)
• 06: School
• 07: Employment status (e.g., unemployment)
• 08: Caring for - own children
• 09: Caring for - others
• 10: Other personal or family responsibilities
• 11: Personal relationships
• 12: Discrimination
• 13: Personal and family's safety
• 14: Health of family members
• 15: Other - Specify
• 16: Nothing
• 98: RF
• 99: DK

Smoking (SMK) - Question identifier:SMK_R1

The next questions are about smoking.

Smoking (SMK) - Question identifier:SMK_Q201A

In your lifetime, have you smoked a total of 100 or more cigarettes (about 4 packs)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking (SMK) - Question identifier:SMK_Q201B

Have you ever smoked a whole cigarette?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking (SMK) - Question identifier:SMK_Q201C

At what age did you smoke your first whole cigarette?

Min = 5; Max = 121

Smoking (SMK) - Question identifier:SMK_Q202

At the present time, do you smoke cigarettes daily, occasionally or not at all?

• 1: Daily
• 2: Occasionally
• 3: Not at all
• 8: RF
• 9: DK

Smoking (SMK) - Question identifier:SMK_Q203

At what age did you begin to smoke cigarettes daily?

Min = 5; Max = 121

Smoking (SMK) - Question identifier:SMK_Q204

How many cigarettes do you smoke each day now?

Min = 1; Max = 99

Smoking (SMK) - Question identifier:SMK_Q205B

On the days that you do smoke, how many cigarettes do you usually smoke?

Min = 1; Max = 99

Smoking (SMK) - Question identifier:SMK_Q205C

In the past month, on how many days have you smoked 1 or more cigarettes?

Min = 0; Max = 30

Smoking (SMK) - Question identifier:SMK_Q205D

Have you ever smoked cigarettes daily?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking (SMK) - Question identifier:SMK_Q206A

When did you stop smoking? Was it...?

• 1: Less than one year ago
• 2: 1 year to less than 2 years ago
• 3: 2 years to less than 3 years ago
• 4: 3 or more years ago
• 8: RF
• 9: DK

Smoking (SMK) - Question identifier:SMK_Q206B

In what month did you stop?

• 01: January
• 02: February
• 03: March
• 04: April
• 05: May
• 06: June
• 07: July
• 08: August
• 09: September
• 10: October
• 11: November
• 12: December
• 98: RF
• 99: DK

Smoking (SMK) - Question identifier:SMK_Q206C

How many years ago was it?

Min = 3; Max = 121

Smoking (SMK) - Question identifier:SMK_Q207

At what age did you begin to smoke (cigarettes) daily?

Min = 5; Max = 121

Smoking (SMK) - Question identifier:SMK_Q208

How many cigarettes did you usually smoke each day?

Min = 1; Max = 99

Smoking (SMK) - Question identifier:SMK_Q209A

When did you stop smoking daily? Was it...?

• 1: Less than one year ago
• 2: 1 year to less than 2 years ago
• 3: 2 years to less than 3 years ago
• 4: 3 or more years ago
• 8: RF
• 9: DK

Smoking (SMK) - Question identifier:SMK_Q209B

In what month did you stop?

• 01: January
• 02: February
• 03: March
• 04: April
• 05: May
• 06: June
• 07: July
• 08: August
• 09: September
• 10: October
• 11: November
• 12: December
• 98: RF
• 99: DK

Smoking (SMK) - Question identifier:SMK_Q209C

How many years ago was it?

Min = 3; Max = 121

Smoking (SMK) - Question identifier:SMK_Q210A

Was that when you completely quit smoking?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking (SMK) - Question identifier:SMK_Q210B

When did you stop smoking completely? Was it...?

• 1: Less than one year ago
• 2: 1 year to less than 2 years ago
• 3: 2 years to less than 3 years ago
• 4: 3 or more years ago
• 8: RF
• 9: DK

Smoking (SMK) - Question identifier:SMK_Q210C

In what month did you stop?

• 01: January
• 02: February
• 03: March
• 04: April
• 05: May
• 06: June
• 07: July
• 08: August
• 09: September
• 10: October
• 11: November
• 12: December
• 98: RF
• 99: DK

Smoking (SMK) - Question identifier:SMK_Q210D

How many years ago was it?

Min = 3; Max = 121

Smoking - Stages of change (SCH) - Question identifier:SCH_Q1

Are you seriously considering quitting smoking within the next 6 months?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Stages of change (SCH) - Question identifier:SCH_Q2

Are you seriously considering quitting within the next 30 days?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Stages of change (SCH) - Question identifier:SCH_Q3

In the past 12 months, did you stop smoking for at least 24 hours because you were trying to quit?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Stages of change (SCH) - Question identifier:SCH_Q4

How many times? (in the past 12 months, did you stop smoking for at least 24 hours because you were trying to quit.)

Min = 1; Max = 95

Smoking cessation methods (SCA) - Question identifier:SCA_Q10A

In the past 12 months, did you try a nicotine patch to quit smoking?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q10B

How useful was that in helping you quit?

• 1: Very useful
• 2: Somewhat useful
• 3: Not very useful
• 4: Not useful at all
• 8: RF
• 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q11A

(In the past 12 months) did you try Nicorettes or other nicotine gum or candy to quit smoking?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q11B

How useful was that in helping you quit?

• 1: Very useful
• 2: Somewhat useful
• 3: Not very useful
• 4: Not useful at all
• 8: RF
• 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q12A

In the past 12 months, did you try medication such as Zyban, Prolev or Wellbutrin to quit smoking?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q12B

How useful was that in helping you quit?

• 1: Very useful
• 2: Somewhat useful
• 3: Not very useful
• 4: Not useful at all
• 8: RF
• 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q50

In the past 12 months, did you stop smoking for at least 24 hours because you were trying to quit?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q60

In the past 12 months, did you try any of the following to quit smoking:

a nicotine patch?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q61

(In the past 12 months, did you try any of the following to quit smoking:)

Nicorettes or other nicotine gum or candy?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking cessation methods (SCA) - Question identifier:SCA_Q62

(In the past 12 months, did you try any of the following to quit smoking:)

medication such as Zyban, Prolev or Wellbutrin?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Physician counselling (SPC) - Question identifier:SPC_Q10

Earlier, you mentioned having a regular medical doctor. In the past 12 months, did you go see this doctor?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Physician counselling (SPC) - Question identifier:SPC_Q11

Does your doctor know that you [smoke/smoked] cigarettes?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Physician counselling (SPC) - Question identifier:SPC_Q12

In the past 12 months, did your doctor advise you to quit smoking?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Physician counselling (SPC) - Question identifier:SPC_Q13

(In the past 12 months,) did your doctor give you any specific help or information to quit smoking?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Physician counselling (SPC) - Question identifier:SPC_Q14

What type of help did the doctor give?

• 1: Referral to a one-on-one cessation program
• 2: Referral to a group cessation program
• 3: Recommended use of nicotine patch or nicotine gum
• 4: Recommended Zyban or other medication
• 5: Provided self-help information (e.g., pamphlet, referral to website)
• 6: Own doctor offered counselling
• 7: Other
• 8: RF
• 9: DK

Smoking - Physician counselling (SPC) - Question identifier:SPC_Q20

Earlier, you mentioned having "seen or talked to" a dentist in the past 12 months. Did you actually go to the dentist?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Physician counselling (SPC) - Question identifier:SPC_Q21

Does your dentist or dental hygienist know that you [smoke/smoked] cigarettes?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Physician counselling (SPC) - Question identifier:SPC_Q22

In the past 12 months, did the dentist or hygienist advise you to quit smoking?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Youth smoking (YSM) - Question identifier:YSM_Q1

Where do you usually get your cigarettes?

• 01: Buy from - Vending machine
• 02: Buy from - Small grocery / corner store
• 03: Buy from - Supermarket
• 04: Buy from - Drug store
• 05: Buy from - Gas station
• 06: Buy from - Other store
• 07: Buy from - Friend or someone else
• 08: Given them by - Brother or sister
• 09: Given them by - Mother or father
• 10: Given them by - Friend or someone else
• 11: Take them from - Mother, father or sibling
• 12: Other
• 98: RF
• 99: DK

Smoking - Youth smoking (YSM) - Question identifier:YSM_Q2

In the past 12 months, have you bought cigarettes for yourself or for someone else?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Youth smoking (YSM) - Question identifier:YSM_Q3

In the past 12 months, have you been asked your age when buying cigarettes in a store?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Youth smoking (YSM) - Question identifier:YSM_Q4

In the past 12 months, has anyone in a store refused to sell you cigarettes?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Youth smoking (YSM) - Question identifier:YSM_Q5

In the past 12 months, have you asked a stranger to buy you cigarettes?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Exposure to second-hand smoke (ETS) - Question identifier:ETS_R01

The next questions are about exposure to second-hand smoke.

Exposure to second-hand smoke (ETS) - Question identifier:ETS_Q10

Including both household members and regular visitors, does anyone smoke inside your home, every day or almost every day?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Exposure to second-hand smoke (ETS) - Question identifier:ETS_Q11

How many people smoke inside your home every day or almost every day?

Min = 1; Max = 15

Exposure to second-hand smoke (ETS) - Question identifier:ETS_Q20A

In the past month, were you exposed to second-hand smoke, every day or almost every day, in a car or other private vehicle?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Exposure to second-hand smoke (ETS) - Question identifier:ETS_Q20B

(In the past month,) were you exposed to second-hand smoke, every day or almost every day, in public places (such as bars, restaurants, shopping malls, arenas, bingo halls, bowling alleys)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Exposure to second-hand smoke (ETS) - Question identifier:ETS_Q35

Is smoking allowed inside your home?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Exposure to second-hand smoke (ETS) - Question identifier:ETS_Q36

Is smoking inside your home restricted in anyway?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Exposure to second-hand smoke (ETS) - Question identifier:ETS_Q37

How is smoking restricted inside your home?

• 1: Allowed in certain rooms only
• 2: Restricted in the presence of young children
• 3: Allowed only if windows are open or with another type of ventilation
• 4: Other restriction(s)
• 8: RF
• 9: DK

Smoking - Other tobacco products (TAL) - Question identifier:TAL_Q1

Now I'd like to ask about your use of tobacco other than cigarettes.

In the past month, have you smoked cigars?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Other tobacco products (TAL) - Question identifier:TAL_Q2

(In the past month,) have you smoked a pipe?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Other tobacco products (TAL) - Question identifier:TAL_Q3

(In the past month,) have you used snuff?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Smoking - Other tobacco products (TAL) - Question identifier:TAL_Q4

(In the past month,) have you used chewing tobacco?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use (ALC) - Question identifier:ALC_R1

Now, some questions about your alcohol consumption.
When we use the word 'drink' it means:
- one bottle or can of beer or a glass of draft
- one glass of wine or a wine cooler
- one drink or cocktail with one and a half ounces of liquor.

Alcohol use (ALC) - Question identifier:ALC_Q1

During the past 12 months, that is, from [CURRENTDATE-1] to yesterday, have you had a drink of beer, wine, liquor or any other alcoholic beverage?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use (ALC) - Question identifier:ALC_Q2

During the past 12 months, how often did you drink alcoholic beverages?

• 1: Less than once a month
• 2: Once a month
• 3: 2 to 3 times a month
• 4: Once a week
• 5: 2 to 3 times a week
• 6: 4 to 6 times a week
• 7: Every day
• 8: RF
• 9: DK

Alcohol use (ALC) - Question identifier:ALC_Q3

How often in the past 12 months have you had [5/4] or more drinks on one occasion?

• 1: Never
• 2: Less than once a month
• 3: Once a month
• 4: 2 to 3 times a month
• 5: Once a week
• 6: More than once a week
• 8: RF
• 9: DK

Alcohol use during the past week (ALW) - Question identifier:ALW_Q5

Thinking back over the past week, that is, from last ^DAYLASTWEEKE to yesterday, did you have a drink of beer, wine, liquor or any other alcoholic beverage?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use during the past week (ALW) - Question identifier:ALW_Q5A_1

Starting with yesterday, that is [Sunday/Monday/Tuesday/Wednesday/Thursday/Friday/Saturday], how many drinks did you have?

Min = 0; Max = 99

Alcohol use during the past week (ALW) - Question identifier:ALW_Q5A_2

How many drinks did you have:

on [Saturday/Sunday/Monday/Tuesday/Wednesday/Thursday/Friday]?

Min = 0; Max = 99

Alcohol use during the past week (ALW) - Question identifier:ALW_Q5A_3

(How many drinks did you have:)

on [Friday/Saturday/Sunday/Monday/Tuesday/Wednesday/Thursday]?

Min = 0; Max = 99

Alcohol use during the past week (ALW) - Question identifier:ALW_Q5A_4

(How many drinks did you have:)

on [Thursday/Friday/Saturday/Sunday/Monday/Tuesday/Wednesday]?

Min = 0; Max = 99

Alcohol use during the past week (ALW) - Question identifier:ALW_Q5A_5

(How many drinks did you have:)

on [Wednesday/Thursday/Friday/Saturday/Sunday/Monday/Tuesday]?

Min = 0; Max = 99

Alcohol use during the past week (ALW) - Question identifier:ALW_Q5A_6

(How many drinks did you have:)

on [Tuesday/Wednesday/Thursday/Friday/Saturday/Sunday/Monday]?

Min = 0; Max = 99

Alcohol use during the past week (ALW) - Question identifier:ALW_Q5A_7

(How many drinks did you have:)

on [Monday/Tuesday/Wednesday/Thursday/Friday/Saturday/Sunday]?

Min = 0; Max = 99

Driving and safety (DRV) - Question identifier:DRV_R01

The next questions are about driving a motor vehicle. By motor vehicle, we mean a car, truck or van.

Driving and safety (DRV) - Question identifier:DRV_Q01A

In the past 12 months, have you driven a motor vehicle?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q01B

In the past 12 months, have you driven a motorcycle?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q02

How often do you fasten your seat belt when you drive a motor vehicle?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q03A

Excluding hands-free use, how often do you use a cell phone while you are driving a motor vehicle?

• 1: Often
• 2: Sometimes
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q03B

How often do you use a hands-free when talking on the cell phone while you are driving a motor vehicle?

• 1: Often
• 2: Sometimes
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q04

How often do you drive when you are feeling tired?

• 1: Often
• 2: Sometimes
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q05

Compared to other drivers, would you say you usually drive...?

• 1: Much faster
• 2: A little faster
• 3: About the same speed
• 4: A little slower
• 5: Much slower
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q06

(Compared to other drivers,) would you say you usually drive...?

• 1: Much more aggressively
• 2: A little more aggressively
• 3: About the same
• 4: A little less aggressively
• 5: Much less aggressively
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q07A

In the past 12 months, have you driven a motor vehicle after having 2 or more drinks in the hour before you drove?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q07B

How many times (in the past 12 months)?

Min = 1; Max = 95

Driving and safety (DRV) - Question identifier:DRV_R08

Now some questions about being a passenger in a motor vehicle.

Driving and safety (DRV) - Question identifier:DRV_Q08A

When you are a front seat passenger, how often do you fasten your seat belt?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 5: Do not ride in front seat
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q08B

When you are a back seat passenger, how often do you fasten your seat belt?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 5: Do not ride in back seat
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q09

When you are a passenger in a taxi, how often do you fasten your seat belt?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 5: Do not take taxis
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q10A

In the past 12 months, have you been a passenger with a driver who had 2 or more drinks in the hour before driving?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q10B

How many times (in the past 12 months)?

Min = 1; Max = 95

Driving and safety (DRV) - Question identifier:DRV_Q11A

In the past 12 months, have you been the driver of, or a passenger in, a snowmobile, motor boat or seadoo?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q11B

In the past 12 months, have you been the driver of, or a passenger in, an ATV (all terrain vehicle)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q12

How often do you wear a helmet when on an ATV?

• 1: Always
• 2: Most of the time
• 3: Rarely
• 4: Never
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q13A

In the past 12 months, have you been a passenger on [a snowmobile, motor boat, seadoo or ATV/a snowmobile, motor boat or seadoo/an ATV] with a driver who had 2 or more drinks in the hour before driving?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q13B

How many times (in the past 12 months)?

Min = 1; Max = 95

Driving and safety (DRV) - Question identifier:DRV_Q14A

In the past 12 months, have you driven [a snowmobile, motor boat, seadoo or ATV/a snowmobile, motor boat or seadoo/an ATV] after having 2 or more drinks in the hour before you drove?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Driving and safety (DRV) - Question identifier:DRV_Q14B

How many times (in the past 12 months)?

Min = 1; Max = 95

Alcohol use - Dependence (ALD) - Question identifier:ALD_R1

The next questions are about how drinking can affect people in their activities. We will be referring to the past 12 months, that is, from [date one year ago] to yesterday.

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q01

In the past 12 months, have you ever been drunk or hung-over while at work, school or while taking care of children?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q02

How many times? Was it:

• 1: Once or twice?
• 2: 3 to 5 times?
• 3: 6 to 10 times?
• 4: 11 to 20 times?
• 5: More than 20 times?
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q03

In the past 12 months, were you ever in a situation while drunk or hung-over which increased your chances of getting hurt? (For example, driving a boat, using guns, crossing against traffic, or during sports.)

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q04

(In the past 12 months,) have you had any emotional or psychological problems because of alcohol use, such as feeling uninterested in things, depressed or suspicious of people?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q05

(In the past 12 months,) have you had such a strong desire or urge to drink alcohol that you could not resist it or could not think of anything else?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q06

(In the past 12 months,) have you had a period of a month or more when you spent a great deal of time getting drunk or being hung-over?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q07

In the past 12 months, did you ever drink much more or for a longer period of time than you intended?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q08

How many times? Was it:

• 1: Once or twice?
• 2: 3 to 5 times?
• 3: 6 to 10 times?
• 4: 11 to 20 times?
• 5: More than 20 times?
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q09

In the past 12 months, did you ever find that you had to drink more alcohol than usual to get the same effect or that the same amount of alcohol had less effect on you than usual?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_R10

People who cut down their alcohol use or stop drinking altogether may not feel well if they have been drinking steadily for some time. These feelings are more intense and can last longer than the usual hangover.

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q10

In the past 12 months, did you ever have a period when you stopped, cut down, or went without alcohol and then experienced symptoms like fatigue, headaches, diarrhea, the shakes or emotional problems?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q11

(In the past 12 months,) did you ever have a period when you drank alcohol even though you promised yourself you wouldn't, or when you drank a lot more than you intended?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q12

(In the past 12 months,) did you ever have a period of several days or more when you spent so much time drinking alcohol or recovering from the effects that you had little time for anything else?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q13

(In the past 12 months,) did you ever have a period of a month or longer when you gave up or greatly reduced important activities because of your use of alcohol?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q14

(In the past 12 months,) did you ever continue to drink alcohol when you knew you had a serious physical or emotional problem that might have been caused by or made worse by your alcohol use?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Alcohol use - Dependence (ALD) - Question identifier:ALD_R15

Please tell me what number best describes how much your use of alcohol interfered with each of the following activities during the past 12 months. For each activity, answer with a number between 0 and 10; 0 means "no interference", while 10 means "very severe interference".

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q15A

In the past 12 months, how much did your alcohol use interfere with:

your home responsibilities, like cleaning, shopping and taking care of the house or apartment?

0 No interference
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 \/
10 Very severe interference

Min = 0; Max = 10

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q15B_1

(How much did it interfere with:)

your ability to attend school?

0 No interference
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 \/
10 Very severe interference

Min = 0; Max = 11

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q15B_2

(How much did it interfere with:)

your ability to work at a job?

0 No interference
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 \/
10 Very severe interference

Min = 0; Max = 11

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q15C

(In the past 12 months,) how much did your alcohol use interfere with your ability to form and maintain close relationships with other people? (Remember that 0 means "no interference" and 10 means "very severe interference".)

0 No interference
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 \/
10 Very severe interference

Min = 0; Max = 10

Alcohol use - Dependence (ALD) - Question identifier:ALD_Q15D

How much did it interfere with your social life?

0 No interference
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 \/
10 Very severe interference

Min = 0; Max = 10

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_R01

The next questions are for recent mothers.

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q01A

Have you given birth in the past 5 years?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q01B

In what year?

Min = 1900; Max = 2099

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q02

Did you take a vitamin supplement containing folic acid before your (last) pregnancy, that is, before you found out that you were pregnant?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q03

For your last baby, did you breastfeed or try to breastfeed your baby, even if only for a short time?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q04

What is the main reason that you did not breastfeed?

• 01: Bottle feeding easier
• 02: Formula as good as breast milk
• 03: Breastfeeding is unappealing / disgusting
• 04: Father / partner didn't want me to
• 05: Returned to work / school early
• 06: C-Section
• 07: Medical condition - mother
• 08: Medical condition - baby
• 09: Premature birth
• 10: Multiple births (e.g. twins)
• 11: Wanted to drink alcohol
• 12: Wanted to smoke
• 13: Other - Specify
• 98: RF
• 99: DK

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q05

Are you still breastfeeding?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q06A

How long did you breastfeed (your last baby)?

• 01: Less than 1 week
• 02: 1 to 2 weeks
• 03: 3 to 4 weeks
• 04: 5 to 8 weeks
• 05: 9 weeks to less than 12 weeks
• 06: 3 months (12 weeks to less than 16 weeks)
• 07: 4 months (16 weeks to less than 20 weeks)
• 08: 5 months (20 weeks to less than 24 weeks)
• 09: 6 months (24 weeks to less than 28 weeks)
• 10: 7 to 9 months
• 11: 10 to 12 months
• 12: More than 1 year
• 98: RF
• 99: DK

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q06B

Have other liquids such as milk, formula, water, juice, tea or herbal mixture been introduced to the baby's feeds?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q06C

How old was your (last) baby when other liquids [such as milk, formula, water, juice, tea or herbal mixture/null] were first added to the baby's feeds?

• 01: Less than 1 week
• 02: 1 to 2 weeks
• 03: 3 to 4 weeks
• 04: 5 to 8 weeks
• 05: 9 weeks to less than 12 weeks
• 06: 3 months (12 weeks to less than 16 weeks)
• 07: 4 months (16 weeks to less than 20 weeks)
• 08: 5 months (20 weeks to less than 24 weeks)
• 09: 6 months (24 weeks to less than 28 weeks)
• 10: 7 to 9 months
• 11: 10 to 12 months
• 12: More than 1 year
• 13: Have not added other liquids
• 98: RF
• 99: DK

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q08A

How old was your (last) baby when solid foods such as cereals, mashed up or pureed meat vegetables or fruits were first added to the baby's feeds?

• 01: Less than 1 week
• 02: 1 to 2 weeks
• 03: 3 to 4 weeks
• 04: 5 to 8 weeks
• 05: 9 weeks to less than 12 weeks
• 06: 3 months (12 weeks to less than 16 weeks)
• 07: 4 months (16 weeks to less than 20 weeks)
• 08: 5 months (20 weeks to less than 24 weeks)
• 09: 6 months (24 weeks to less than 28 weeks)
• 10: 7 to 9 months
• 11: 10 to 12 months
• 12: More than 1 year
• 13: Have not added solid foods
• 98: RF
• 99: DK

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q08B

What is the main reason [other liquids/other liquids and solid foods/solid foods] were first added to the baby's feeds?

• 01: Not enough breast milk
• 02: Baby was ready for solid foods
• 03: Inconvenience / fatigue due to breastfeeding
• 04: Difficulty with BF techniques (e.g., sore nipples, engorged breasts, mastitis)
• 05: Medical condition - mother
• 06: Medical condition - baby
• 07: Advice of doctor / health professional
• 08: Returned to work / school
• 09: Advice of partner / family / friends
• 10: Formula equally healthy for baby
• 11: Wanted to drink alcohol
• 12: Wanted to smoke
• 13: Other - Specify
• 98: RF
• 99: DK

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q09A

During the time when your (last) baby was less than one year old and fed breast milk, did you give the baby a vitamin supplement containing Vitamin D?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q09B

Overall, how often did you give the baby a supplement containing Vitamin D?

• 1: Every day
• 2: Almost every day
• 3: Once or twice a week
• 4: Less than once a week
• 8: RF
• 9: DK

Maternal experiences - Breastfeeding (MEX) - Question identifier:MEX_Q10

What is the main reason that you stopped breastfeeding?

• 01: Not enough breast milk
• 02: Baby was ready for solid foods
• 03: Inconvenience / fatigue due to breastfeeding
• 04: Difficulty with BF techniques (e.g., sore nipples, engorged breasts, mastitis)
• 05: Medical condition - mother
• 06: Medical condition - baby
• 07: Planned to stop at this time
• 08: Child weaned him / herself (e.g., baby biting, refusing breast)
• 09: Advice of doctor / health professional
• 10: Returned to work / school
• 11: Advice of partner / family / friends
• 12: Formula equally healthy for baby
• 13: Wanted to drink alcohol
• 14: Wanted to smoke
• 15: Other - Specify
• 98: RF
• 99: DK

Maternal experiences - Alcohol use during pregnancy (MXA) - Question identifier:MXA_Q30

Did you drink any alcohol during your last pregnancy?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Maternal experiences - Alcohol use during pregnancy (MXA) - Question identifier:MXA_Q31

How often did you drink?

• 1: Less than once a month
• 2: Once a month
• 3: 2 to 3 times a month
• 4: Once a week
• 5: 2 to 3 times a week
• 6: 4 to 6 times a week
• 7: Every day
• 8: RF
• 9: DK

Maternal experiences - Alcohol use during pregnancy (MXA) - Question identifier:MXA_Q32

Did you drink any alcohol while you were breastfeeding (your last baby)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Maternal experiences - Alcohol use during pregnancy (MXA) - Question identifier:MXA_Q33

How often did you drink?

• 1: Less than once a month
• 2: Once a month
• 3: 2 to 3 times a month
• 4: Once a week
• 5: 2 to 3 times a week
• 6: 4 to 6 times a week
• 7: Every day
• 8: RF
• 9: DK

Maternal experiences - Smoking during pregnancy (MXS) - Question identifier:MXS_Q20

During your last pregnancy, did you smoke daily, occasionally or not at all?

• 1: Daily
• 2: Occasionally
• 3: Not at all
• 8: RF
• 9: DK

Maternal experiences - Smoking during pregnancy (MXS) - Question identifier:MXS_Q21

How many cigarettes did you usually smoke each day?

Min = 1; Max = 99

Maternal experiences - Smoking during pregnancy (MXS) - Question identifier:MXS_Q22

On the days that you smoked, how many cigarettes did you usually smoke?

Min = 1; Max = 99

Maternal experiences - Smoking during pregnancy (MXS) - Question identifier:MXS_Q23

When you were breastfeeding (your last baby), did you smoke daily, occasionally or not at all?

• 1: Daily
• 2: Occasionally
• 3: Not at all
• 8: RF
• 9: DK

Maternal experiences - Smoking during pregnancy (MXS) - Question identifier:MXS_Q24

How many cigarettes did you usually smoke each day?

Min = 1; Max = 99

Maternal experiences - Smoking during pregnancy (MXS) - Question identifier:MXS_Q25

On the days that you smoked, how many cigarettes did you usually smoke?

Min = 1; Max = 99

Maternal experiences - Smoking during pregnancy (MXS) - Question identifier:MXS_Q26

Did anyone regularly smoke in your presence during or after the pregnancy (about 6 months after)?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_R01

I am going to ask some questions about drug use. Again, I would like to remind you that everything you say will remain strictly confidential.

Illicit drugs use (IDG) - Question identifier:IDG_Q01

Have you ever used or tried marijuana, cannabis or hashish?

• 1: Yes, just once
• 2: Yes, more than once
• 3: No
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q02

Have you used it in the past 12 months?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q03

How often (did you use marijuana, cannabis or hashish in the past 12 months)?

• 1: Less than once a month
• 2: 1 to 3 times a month
• 3: Once a week
• 4: More than once a week
• 5: Every day
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q04

Have you ever used or tried cocaine or crack?

• 1: Yes, just once
• 2: Yes, more than once
• 3: No
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q05

Have you used it in the past 12 months?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q06

How often (did you use cocaine or crack in the past 12 months)?

• 1: Less than once a month
• 2: 1 to 3 times a month
• 3: Once a week
• 4: More than once a week
• 5: Every day
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q07

Have you ever used or tried speed (amphetamines)?

• 1: Yes, just once
• 2: Yes, more than once
• 3: No
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q08

Have you used it in the past 12 months?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q09

How often (did you use speed (amphetamines) in the past 12 months)?

• 1: Less than once a month
• 2: 1 to 3 times a month
• 3: Once a week
• 4: More than once a week
• 5: Every day
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q10

Have you ever used or tried ecstasy (MDMA) or other similar drugs?

• 1: Yes, just once
• 2: Yes, more than once
• 3: No
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q11

Have you used it in the past 12 months?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q12

How often (did you use ecstasy or other similar drugs in the past 12 months)?

• 1: Less than once a month
• 2: 1 to 3 times a month
• 3: Once a week
• 4: More than once a week
• 5: Every day
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q13

Have you ever used or tried hallucinogens, PCP or LSD (acid)?

• 1: Yes, just once
• 2: Yes, more than once
• 3: No
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q14

Have you used it in the past 12 months?

• 1: Yes
• 2: No
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q15

How often (did you use hallucinogens, PCP or LSD in the past 12 months)?

• 1: Less than once a month
• 2: 1 to 3 times a month
• 3: Once a week
• 4: More than once a week
• 5: Every day
• 8: RF
• 9: DK

Illicit drugs use (IDG) - Question identifier:IDG_Q16

Did you ever sniff glue, gasoline or other solvents?

• 1: Yes, just once
• 2: Yes, more than once
• 3: No
• 8: RF
• 9: DK