[p.206]
Section O -- Alcohol
Section O1 -- Alcohol Screening And Abstainer
These next questions are about drinking alcoholic beverages. Included are liquor, such as whiskey, rum, gin, or vodka, beer, wine, or any other type of alcoholic beverage.
1a. In your entire life, have you had at least 12 drinks of any kind of alcoholic beverage?
2[] No (2)
b. In the past 12 months did you have at least 12 drinks of any kind of alcoholic beverage?
2[] No
c. In any one year of your entire life did you have least 12 drinks of any kind of alcoholic beverage?
2[] No (Section O2, page 71)
Hand Card O1, read list if telephone interview.
Card O1
02. Don't care for it or dislike it
03. Am an alcoholic
04. Thought I might become an alcoholic
05. Had problems with my drinking
06. Have a responsibility to my family
07. Family member an alcoholic or problem drinker
08. Medical or health reasons
09. Religious or moral reasons
10. Brought up not to drink
11. Makes me sick
12. Can't control my drinking
13. Costs too much or can't afford it
14. Dieting or too fattening
88. Other
2a. (Please look at this list and tell me) What are your favorite reasons for not drinking?
Anything else?
Mark all mentioned.
02[] Don't care for it or dislike it
03[] Am an alcoholic
04[] Thought I might became on alcoholic
05[] Had problems with my drinking
06[] Have a responsibility to my family
07[] Family member an alcoholic or problem drinker
08[] Medical or health reasons
09[] Religious or moral reasons
10[] Brought up not to drink
11[] Makes me sick
12[] Can't control my drinking
13[] Costs too much or can't afford it
14[] Dieting or too fatting
88[] Other
99[] DK
If only one reason in 2a, mark box without asking; otherwise, ask:
b. Of the reasons you have just told me, which of these is your most important reason for not drinking?
02[] Don't care for it or dislike it
03[] Am an alcoholic
04[] Thought I might became on alcoholic
05[] Had problems with my drinking
06[] Have a responsibility to my family
07[] Family member an alcoholic or problem drinker
08[] Medical or health reasons
09[] Religious or moral reasons
10[] Brought up not to drink
11[] Makes me sick
12[] Can't control my drinking
13[] Costs too much or can't afford it
14[] Dieting or too fatting
88[] Other
99[] DK
People have different opinions about heavy, moderate and light drinking. We would like to know how often and how much you think a person must drink in order to be considered a heavy, moderate or light drinker.
3a. In your opinion, how often must a person drink in order to be considered a heavy drinker?
Days per ____
2[] Month
3[] Year
b. On those days, how many drinks must a person have in order to be considered a heavy drinker?
99[] DK
4a. In your opinion, how often must a person drink in order to be considered a moderate drinker?
Days per ____
2[] Month
3[] Year
b. On those days, how many drinks must a person have in order to be considered a moderate drinker?
99[] DK
5a. In your opinion, how often must a person drink in order to be considered a light drinker?
Days per ____
2[] Month
3[] Year
b. On those days, how many drinks must a person have in order to be considered a light drinker?
99[] DK
[p.208]
Section O1 -- Alcohol Screening and Abstainer -- Continued
6a. When you were growing up, that is, during your first 18 years, did you live with anyone who was a problem drinker or alcoholic?
2[] No (7)
8[] DK (7)
b. Who was this?
Anyone else?
If parent, ask: Was this your biological (natural), adoptive, step, or foster (mother/father)?
If brother/sister, ask Was this your full, half, adoptive, step, or foster (brother/sister)?
Record up to first 5 mentioned.
2[] ____
3[] ____
4[] ____
5[] ____
Ask 6c for each person in 6b.
c. For how long did you live with (person in 6b) while (person in 6b) was a problem drinker or alcoholic?
[option for 5 entries in original document not presented here]
2[] Weeks ____
3[] Months ____
4[] Years ____
7a. Have any of your (other) blood relatives ever been a problem drinker or alcoholic?
2[] No (8)
9[] DK (8)
b. Who was this?
Anyone else?
Mark all mentioned.
If necessary, probe as indicated in 6b.
2[] Biological father
1[] Biological brother(s)
2[] Biological sister(s)
1[] Half brother(s)
2[] Half sister(s)
1[] Biological son(s)
2[] Biological daughter(s)
1[] Grandmother(s)
2[] Grandfather(s)
1[] Aunt(s)
2[] Uncle(s)
1[] Niece(s)
2[] Nephew(s)
1[] Cousin(s)
2[] Other blood relative(s)
1[] DK
8. Have you ever been married to, or lived with someone as if you were married, who was a problem drinker or alcoholic?
2[] No
[p.209]
Section O1 -- Alcohol Screening and Abstainer -- Continued
Refer to table B on the Cover Page and ask for each person listed except the sample person.
If personal interview -- hand Card O2 and read first alternative wording.
Card O2
2. Moderate
3. Light
4. Very light or occasional
5. Quit drinking
6. Never drank
If telephone interview -- read second alternative wording and the list of answer categories.
9a. Please look at this card and tell me which number best describes -- drinking during the past year. Or I am going to read a list of different drinking categories, please tell me which one best describes -- drinking in the past year.
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
b. What about -- drinking?
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
c. What about -- drinking?
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
d. What about -- drinking?
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
e. What about -- drinking?
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
f. What about -- drinking?
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
10. Tell me whether or not you have ever had any of the following conditions even if you have mentioned them before --
2[] No
2[] No
2[] No
2[] No
2[] No
2[] No
2[] No
Check Item 1
Mark one box, then go to next supplement.
2[] Child(ren) present during interview
3[] Other adult(s) present during interview
4[] Child(ren) and other adult(s) present during interview
5[] Telephone interview
[p.210]
Section O2 -- Lifetime Infrequent Drinker
1. Not counting small tastes, how old were you when you started drinking alcoholic beverages?
99[] DK
2. In the past 12 months about how many drinks of any kind of alcoholic beverage did you have?
Drinks ____
99[] DK
3. When did you have your last drink of any kind of alcoholic beverage?
Year 19____
9999[] DK
4. What type of alcoholic beverage (do/did) you prefer to drink -- beer, win, or liquor?
Mark only once box.
2[] Wine
3[] Liquor
4[] No preference
9[] DK
5. When you (drink/drank) who (do/did) you usually drink with -- friends, relatives, people from work, other people, or by yourself?
Mark only one box.
2[] Relatives
3[] People from work
4[] Other people
5[] Self
9[] DK
Hand Card O1, read list if telephone interview.
Card O1
02. Don't care for it or dislike it
03. Am an alcoholic
04. Thought I might become an alcoholic
05. Had problems with my drinking
06. Have a responsibility to my family
07. Family member an alcoholic or problem drinker
08. Medical or health reasons
09. Religious or moral reasons
10. Brought up not to drink
11. Makes me sick
12. Can't control my drinking
13. Costs too much or can't afford it
14. Dieting or too fattening
88. Other
6a. (Please look at this list and tell me) What are your reasons for not drinking very much?
Anything else?
Mark all mentioned.
02[] Don't care for it or dislike it
03[] Am an alcoholic
04[] Thought I might become an alcoholic
05[] Had problems with my drinking
06[] Have a responsibility to my family
07[] Family member an alcoholic or problem drinker
08[] Medical or health reasons
09[] Religious or moral reasons
10[] Brought up not to drink
11[] Makes me sick
12[] Can't control my drinking
13[] Costs too much or can't afford it
14[] Dieting or too fattening
88[] Other
99[] DK
If only one reason in 6a mark box without asking; otherwise, ask:
b. Of the reasons you have told me, which of these is your most important reason for not drinking very much?
Mark all mentioned.
02[] Don't care for it or dislike it
03[] Am an alcoholic
04[] Thought I might become an alcoholic
05[] Had problems with my drinking
06[] Have a responsibility to my family
07[] Family member an alcoholic or problem drinker
08[] Medical or health reasons
09[] Religious or moral reasons
10[] Brought up not to drink
11[] Makes me sick
12[] Can't control my drinking
13[] Costs too much or can't afford it
14[] Dieting or too fattening
88[] Other
99[] DK
[p.211]
Section O2 -- Lifetime Infrequent Drinker -- Continued
People have different opinions about heavy, moderate and light drinking. We would like to know how often and how much you think a person must drink in order to be considered a heavy, moderate or light drinker.
7a. In your opinion, how often must a person drink in order to be considered a heavy drinker?
Days per ____
2[] Month
3[] Year
b. On those days, how many drinks must a person have in order to be considered a heavy drinker?
99[] DK
8a. In your opinion, how often must a person drink in order to be considered a moderate drinker?
Days per ____
2[] Month
3[] Year
b. On those days, how many drinks must a person have in order to be considered a moderate drinker?
99[] DK
9a. In your opinion, how often must a person drink in order to be considered a light drinker?
Days per ____
2[] Month
3[] Year
b. On those days, how many drinks must a person have in order to be considered a light drinker?
99[] DK
10a. When you were growing up, that is, during your first 18 years, did you live with anyone who was a problem drinker or alcoholic?
2[] No (11)
9[] DK (11)
b. Who was this?
Anyone else?
If parent, ask: Was this your biological (natural), adoptive, step, or foster (mother/father)?
If brother/sister, ask: Was this your full, half, adoptive, step, or foster (brother/sister)?
Record up to first 5 mentioned.
2[] ____
3[] ____
4[] ____
5[] ____
Ask 10c for each person in 10b.
c. For how long did you live with (person in 10b) while (person in 10b) was a problem drinker or alcoholic?
[option for 5 entries in original document not presented here]
2[] Weeks ____
3[] Months ____
4[] Years ____
[p. 212]
Section O2 -- Lifetime Infrequent Drinker -- Continued
11a. Have any of your (other) blood relatives ever been problem drinkers or alcoholics?
2[] No (12)
9[] DK (12)
b. Who was this?
Anyone else?
Mark all mentioned.
If necessary, probe as indicated in 10b.
2[] Biological father
1[] Biological brother(s)
2[] Biological sister(s)
1[] Half brother(s)
2[] Half sister(s)
1[] Biological son(s)
2[] Biological daughter(s)
1[] Grandmother(s)
2[] Grandfather(s)
1[] Aunt(s)
2[] Uncle(s)
1[] Niece(s)
2[] Nephew(s)
1[] Cousin(s)
2[] Other blood relative(s)
1[] DK
12. Have you ever been married to, or lived with someone as if you were married, who was a problem drinker or alcoholic?
2[] No
Refer to Table B on the Cover Page and ask for each person listed except the sample person.
If personal interview -- Hand Card O2 and read first alternative wording.
Card O2
2. Moderate
3. Light
4. Very light or occasional
5. Quit drinking
6. Never drank
If telephone interview -- read second alternative wording and the list of answer categories.
13a. Please look at this card and tell me which number best describes --drinking during the past year. Or I am going to read a list of different drinking categories, please tell me which one best describes -- drinking in the past year.
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
b. What about -- drinking?
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
c. What about -- drinking?
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
d. What about -- drinking?
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
e. What about -- drinking?
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
f. What about -- drinking?
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
[p. 213]
Section O2 -- Lifetime Infrequent Drinker -- Continued
14. Tell me whether or not you have ever had any of the following conditions even if you have mentioned them before --
2[] No
2[] No
2[] No
2[] No
2[] No
2[] No
2[] No
Check Item 2
Mark one box, then go to next supplement.
2[] Child(ren) present during interview
3[] Other adult(s) present during interview
4[] Child(ren) and other adult(s) present during interview
5[] Telephone interview
[p.214]
Section O3 -- Current Drinker
1. Not counting small tastes, how old were you when you started drinking alcoholic beverages?
99[] DK
2a. On the average, how often do you drink any alcoholic beverages?
Days per ____
2[] month
3[] year
b. On the average, on the days that you drink alcohol, how many drinks do you have a day?
99[] DK
Hand calendar.
3a. Did you have a drink during the 2-week period (outlined on that calendar/beginning Monday, (date) and ending Sunday(date))?
2[] No (3c)
b. During that period, when did you last have a drink?
Date ____
Year 19____ (4)
c. When was your last drink prior to that 2-week period?
Date ____
Year 19____ (10)
4a. During that 2-week period, on how many days did you drink any beer?
Days ____
b. On the day(s) when you drank beer, about how many beers did you drink a day?
99[] DK
c. About how many ounces were in a typical can or bottle or glass of beer that you drank during that period?
99.99[] DK
5a. During that 2-week period, on how many days did you drink any wine?
Days ____
b. On the day(s) when you drank wine, about how many glasses of wine did you drink a day?
99[] DK
c. About how many ounces of wine were in a typical glass that you drank during that period?
99.99[] DK
6a. During that 2-week period, on how many days did you drink any liquor, such as whiskey, rum, gin, or vodka?
Days ____
b. On the day(s) when you drank liquor, about how many drinks did you have a day?
99[] DK
c. About how many ounces of liquor were in a typical drink that you had during that period?
99.99[] DK
Check Item 3
Refer to 4a, 5a, and 6a. Mark first appropriate box.
2[] Only one beverage type (8) (Do not read intro above q. 8)
3[] 14 days in 4a, 5a, or 6a (Intro above q. 8)
8[] Other (7)
I have asked you about beer, wine, and liquor separately. Now I want you to think about them combined.
7. During the 2-week period (outlined on that calendar/beginning Monday, (date) and ending Sunday (date)), on how many days altogether did you drink alcoholic beverages, that is, beer, or wine, or liquor?
01[] One day only (9)
[p.215]
Section O3 -- Current Drinker -- Continued
Intro: I have asked you about beer, wine, and liquor separately. Now I want you to think about them combined.
Refer to questions 4b, 5b, and 6b
8a. During that 2-week period, did you have more than (largest number in 4b, 5b, or 6b) drink(s) on a single day?
2[] No (9)
b. On how many days did you have more than (largest number in 4b, 5b, or 6b) drink(s) of beer, or wine, or liquor?
01[] one day only (8e)
c. What was the largest number of drinks you had on any one of those days?
d. On how many days during that 2-week period did you have (number in 8c) drinks?
e. How many drinks did you have on that day?
9a. Was the amount of your drinking during that 2-week period typical of your drinking during the past 12 months?
2[] No
b. Was the amount of your drinking during that 2-week period more or less than your drinking during the past 12 months?
2[] Less (16)
c. For how many years has this been typical of your drinking?
00[] Less than one (16)
Let's talk about the 2-week period ending the day you had your last drink. Please include that last day.
10a. During that 2-week period, on how many days did you drink any beer?
00[] None or never (11)
b. On the day(s) when you drank beer, about how many beers did you drink a day?
00[] DK
c. About how many ounces were in a typical can or bottle or glass of beer that you drank during that period?
99.99[] DK
11a. During that 2-week period, on how many days did you drink any wine?
00[] None or never (12)
b. On the day(s) when you drank wine, about how many glasses of wine did you drink a day?
99[] DK
c. About how many ounces of wine were in a typical glass that you drank during that period?
99.99[] DK
12a. During that 2-week period, on how many days did you drink any liquor, such as whiskey, rum, gin, or vodka?
00[] None or never (Check item 4)
b. On the day(s) when you drank liquor, about how many drinks did you have a day?
99[] DK
c. About how many ounces of liquor were in a typical drink that you had during that period?
99.99[] DK
Check Item 4
Refer to 10a, 11a, and 12a. Mark first appropriate box.
2[] 14 days in 10a, 11a, or 12a (14)
8[] Other (13)
Section O3 -- Current Drinker -- Continued
I have asked you about beer, wine and liquor separately. Now I want you to think about them combined.
13. Still thinking about the same 2-week period, on how many days altogether did you drink alcoholic beverages, that is, beer, wine, or liquor?
Days ____
14a. Was the amount of your drinking during that 2-week period typical of your drinking during the previous 12 months?
2[] No
b. During that 2-week period, did you drink more or less than usual?
2[] Less (15)
c. For how many years has this been typical of your drinking?
Years ____
Hand Card O1, read list if telephone interview.
Card O1
02. Don't care for it or dislike it
03. Am an alcoholic
04. Thought I might become an alcoholic
05. Had problems with my drinking
06. Have a responsibility to my family
07. Family member an alcoholic or problem drinker
08. Medical or health reasons
09. Religious or moral reasons
10. Brought up not to drink
11. Makes me sick
12. Can't control my drinking
13. Costs too much or can't afford it
14. Dieting or too fattening
88. Other
15a. (Please look at this list and tell me) What are your reasons for not drinking since (date in 3c)?
Anything else?
Mark all mentioned.
02[] Don't care for it/dislike it
03[] Am an alcoholic
04[] Thought I might become an alcoholic
05[] Had problems with my drinking
06[] Have a responsibility to my family
07[] Family member an alcoholic or problem drinker
08[] Medical or health reasons
09[] Religious or moral reasons
10[] Brought up not to drink
11[] Makes me sick
12[] Can't control my drinking
13[] Costs too much or can't afford it
14[] Dieting or too fattening
88[] Other
99[] DK
If only one reason in 15a, mark box without asking; otherwise ask:
b. Of the reasons you have told me, which of these is your most important reason for not drinking since (date in 3c)?
02[] Don't care for it/dislike it
03[] Am an alcoholic
04[] Thought I might become an alcoholic
05[] Had problems with my drinking
06[] Have a responsibility to my family
07[] Family member an alcoholic or problem drinker
08[] Medical or health reasons
09[] Religious or moral reasons
10[] Brought up not to drink
11[] Makes me sick
12[] Can't control my drinking
13[] Costs too much or can't afford it
14[] Dieting or too fattening
88[] Other
99[] DK
c. Do you think you will probably drink again or have you stopped drinking permanently?
2[] Stopped permanently
8[] Other
9[] DK
16a. (Thinking about the 12 months before your last drink) Did you have at least one drink in every month (last year/of that year)?
2[] No
b. In how many months did you have at least one drink?
00[] None (18)
17a. During (that month/those months), on how many days did you have 9 or more drinks of any alcoholic beverage?
000[] None
b. During (that month/those months), on how many days did you have 5 or more drinks of any alcoholic beverage?
(include the (number in 17a) days you had 9 or more drinks.)
000[] None
[p. 217]
Section O3 - Current Drinker -- Continued
18. Do you now consider yourself to be a heavy, moderate, light, very light or occasional drinker?
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
19a. In your entire life, when you drank the most, about how often did you drink?
Days per ____
2[] Month
3[] Year
b. On these days, about how many drinks did you have a day?
99[] DK
c. For how long of a period did you drink this amount?
Days per ____
2[] Month
3[] Year
20. (Before you stopped drinking) What type of alcoholic beverage (do/did) you prefer to drink -- beer, wine, or liquor?
Mark only one box.
2[] Wine
3[] Liquor
4[] No preference
9[] DK
21. (Before you stopped drinking) When you drink who (did/do) you usually drink with -- friends, relatives, people from work, other people, or by yourself?
Mark only one box.
2[] Relatives
3[] People from work
4[] Other people
5[] Self
9[] DK
People have different opinions about heavy, moderate and light drinking. We would like to know how often and how much you think a person must drink in order to be considered a heavy, moderate or light drinker.
22a. In your opinion, how often must a person drink in order to be considered a heavy drinker?
Days per ____
2[] Month
3[] Year
b. On those days, how many drinks must a person have in order to be considered a heavy drinker?
99[] DK
23a. In your opinion, how often must a person drink in order to be considered a moderate drinker?
Days per ____
2[] Month
3[] Year
b. On those days, how many drinks must a person have in order to be considered a moderate drinker?
99[] DK
24a. In your opinion, how often must a person drink in order to be considered a light drinker?
Days per ____
2[] Month
3[] Year
b. On those days, how many drinks must a person have in order to be considered a light drinker?
99[] DK
[p.218]
Section O3 -- Current Drinker -- Continued
25a. When you were growing up, that is, during your first 18 years, did you live with anyone who was a problem drinker or alcoholic?
2[] No (26)
9[] DK (26)
b. Who was this?
Anyone else?
If parents, ask: Was this your biological (natural), adoptive, step, or foster (mother/father)?
If brother/sister, ask: Was this your full, half, adoptive, step, or foster (brother/sister)?
Record up to first 5 mentioned.
2[] ____
3[] ____
4[] ____
5[] ____
Ask 25c for each person in 25b.
c. For how long did you live with (person in 25b) while (person in 25b) was a problem drinker or alcoholic?
[option for 5 entries in the original document not presented here]
2[] Weeks ____
3[] Months ____
4[] Years ____
26a. Have any of your (other) blood relatives ever been a problem drinker or alcoholic?
2[] No (27)
3[] DK (27)
b. Who was this?
Anyone else?
Mark all mentioned.
If necessary, probe as indicated in 25b.
2[] Biological father
1[] Biological brother(s)
2[] Biological sister(s)
1[] Half brother(s)
2[] Half sister(s)
1[] Biological son(s)
2[] Biological daughter(s)
1[] Grandmother(s)
2[] Grandfather(s)
1[] Aunt(s)
2[] Uncle(s)
1[] Niece(s)
2[] Nephew(s)
1[] Cousin(s)
2[] Other blood relative(s)
1[] DK
27. Have you ever been married to, or lived with someone as if you were married, who was a problem drinker or alcoholic?
2[] No
[p.219]
Section O3 -- Current Drinker -- Continued
Refer to Table B on the Cover Page and ask for each person listed except the sample person.
If personal interview -- hand Card O2 and read first alternative wording.
Card O2
2. Moderate
3. Light
4. Very light or occasional
5. Quit drinking
6. Never drank
If telephone interview -- read second alternative wording and the list of answer categories.
28a. Please look at this card and tell me which number best describes -- drinking during the past year.
I am going to read a list of different drinking categories, please tell me which best describes -- drinking in the past year.
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
b. What about -- drinking?
[option for 5 entries [b-f], for different sample adults in the household/family, in the original document not presented here]
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
29. Tell me whether or not you have ever had any of the following conditions even if you have mentioned them before --
a. Hypertension or high blood pressure (excluding during pregnancy)?
2[] No
2[] No
2[] No
2[] No
e. An ulcer, not including skin ulcers?
2[] No
2[] No
g. Any disease of the liver, such as yellow jaundice, hepatitis, or cirrhosis?
2[] No
h. Cancer, other than skin cancer?
2[] No
2[] No
Check Item 5
Mark one box, then read "Intro" for HIS-2, Alcohol Questionnaire.
2[] Child(ren) present during interview
3[] Other adult(s) present during interview
4[] Child(ren) and other adult(s) present during interview
5[] Telephone interview
Intro: (Hand questionnaire and read to respondent) These next questions are about things that happen to people when they are drinking or after they have been drinking. We would like to know if any of these things have ever happened to you. (I can read the questions to you or you can fill out the form yourself. Which would you prefer?)
Method of Interview
2[] Self-administered (Instructions)
3[] Telephone interview (HIS-2)
4[] Refused HIS-2 (next Supplement)
Instructions -- In column 1, please circle the answer that best describes the number of times each of these things has happened to you in the past 12 months. Complete column 1 for each question first. Then go back and in column 2, circle "yes" or "no" if any of these things have or have not ever happened to you in your entire life. If you need any help ask me for assistance.
[p. 220]
Section O4 -- Former Drinker
1. Not counting small tastes, how old were you when you started drinking alcoholic beverages?
99[] DK
2. In the past 12 months about how many drinks of any kind of alcoholic beverage did you have?
Drinks ____
99[] DK
3. When did you have your last drink of any kind of alcoholic beverage?
Year 19____
9999[] DK
4a. In your entire life, when you drank the most, about how often did you drink?
Days per ____
2[] Month
3[] Year
b. On those days, about how many drinks did you have a day?
Drinks ____
99[] DK
c. For how long of a period did you drink this amount?
2[] Weeks ____
3[] Months ____
4[] Years ____
9999[] DK
5. What type of alcoholic beverage (do/did) you prefer to drink -- beer, wine, or liquor?
Mark only one box
2[] Wine
3[] Liquor
4[] No preference
9[] DK
6. When you (drink/drank) who (do/did) you usually drink with -- friends, relatives, people from work, other people, or by yourself?
Mark only one box.
2[] Relatives
3[] People from work
4[] Other people
5[] Self
9[] DK
Hand card O1, read list if telephone interview.
Card O1
02. Don't care for it or dislike it
03. Am an alcoholic
04. Thought I might become an alcoholic
05. Had problems with my drinking
06. Have a responsibility to my family
07. Family member an alcoholic or problem drinker
08. Medical or health reasons
09. Religious or moral reasons
10. Brought up not to drink
11. Makes me sick
12. Can't control my drinking
13. Costs too much or can't afford it
14. Dieting or too fattening
88. Other
7a. (please look at this list and tell me) What are your reasons for drinking less than 12 drinks in the past year?
Anything else?
Mark all mentioned.
02[] Don't care for it or dislike it
03[] Am an alcoholic
04[] Thought I might become an alcoholic
05[] Had problems with my drinking
06[] Have a responsibility to my family
07[] Family member an alcoholic or problem drinker
08[] Medical or health reasons
09[] Religious or moral reasons
10[] Brought up not to drink
11[] Makes me sick
12[] Can't control my drinking
13[] Costs too much or can't afford it
14[] Dieting or too fattening
88[] Other
99[] DK
If only one reason in 7a, mark box without asking; otherwise, ask:
b. Of the reasons you have told me, which of these is your most important reason for drinking less than 12 drinks in the past year?
02[] Don't care for it or dislike it
03[] Am an alcoholic
04[] Thought I might become an alcoholic
05[] Had problems with my drinking
06[] Have a responsibility to my family
07[] Family member an alcoholic or problem drinker
08[] Medical or health reasons
09[] Religious or moral reasons
10[] Brought up not to drink
11[] Makes me sick
12[] Can't control my drinking
13[] Costs too much or can't afford it
14[] Dieting or too fattening
88[] Other
99[] DK
[p.221]
Section O4 -- Former Drinker
People have different opinions about heavy, moderate and light drinking. We would like to know how often and how much you think a person must drink in order to be considered a heavy, moderate or light drinker.
8a. In your opinion, how often must a person drink in order to be considered a heavy drinker?
Days per ____
2[] Month
3[] Year
b. On those days, how many drinks must a person have in order to be considered a heavy drinker?
99[] DK
9a. In your opinion, how often must a person drink in order to be considered a moderate drinker?
Days per ____
2[] Month
3[] Year
b. On those days, how many drinks must a person have in order to be considered a moderate drinker?
99[] DK
10a. In your opinion, how often must a person drink in order to be considered a light drinker?
Days per ____
2[] Month
3[] Year
b. On those days, how many drinks must a person have in order to be considered a light drinker?
99[] DK
11a. When you were growing up, that is, during your first 18 years, did you live with anyone who was a problem drinker or alcoholic?
2[] No (12)
3[] DK (12)
b. Who was this?
Anyone else?
If parent, ask: Was this your biological (natural), adoptive, step, or foster (mother/father)?
If brother/sister, ask: Was this your full, half, adoptive, step, or foster (brother/sister)?
Record up to first 5 mentioned.
2[] ____
3[] ____
4[] ____
5[] ____
Ask 11c for each person in 11b.
c. For how long did you live with (person in 11b) while (person in 11b) was a problem drinker or alcoholic?
[option for 5 entries in the original document not presented here]
2[] Weeks ____
3[] Months ____
4[] Years ____
[p.222]
Section O4 -- Former Drinker -- Continued
12a. Have any of your (other) blood relatives ever been problem drinkers or alcoholics?
2[] No (13)
9[] DK (13)
b. Who was this?
Anyone else?
Mark all mentioned.
If necessary, probe as indicated in 11b.
2[] Biological father
1[] Biological brother(s)
2[] Biological sister(s)
1[] Half brother(s)
2[] Half sister(s)
1[] Biological son(s)
2[] Biological daughter(s)
1[] Grandmother(s)
2[] Grandfather(s)
1[] Aunt(s)
2[] Uncle(s)
1[] Niece(s)
2[] Nephew(s)
1[] Cousin(s)
2[] Other blood relative(s)
1[] DK
13. Have you ever been married to, or lived with someone as if you were married, who was a problem drinker or alcoholic?
2[] No
Refer to table B on the Cover Page and ask for each person listed except the sample person.
If personal interview -- hand Card O2 and read first alternative wording.
Card O2
2. Moderate
3. Light
4. Very light or occasional
5. Quit drinking
6. Never drank
If telephone interview -- read second alternative wording and the list of answer categories.
14a. Please look at this card and tell me which number best describes -- drinking during the past year.
I am going to read a list of different drinking categories, please tell me which one best describes -- drinking in the past year.
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
b. What about -- drinking?
[option for 6 entries, (b-f) for different household/family member, in the original document not presented here]
1[] Heavy
2[] Moderate
3[] Light
4[] Very light or occasional
5[] Quit drinking
6[] Never drank
9[] DK
[p.223]
Section O4 -- Former Drinker -- Continued
15. Tell me whether or not you have ever had any of the following conditions even if you have mentioned them before --
2[] No
2[] No
2[] No
2[] No
2[] No
2[] No
2[] No
Check Item 6
Mark one box, then read "Intro" for HIS-3, Alcohol Questionnaire.
2[] Child(ren) present during interview
3[] Other adult(s) present during interview
4[] Child(ren) and other adult(s) present during interview
5[] Telephone interview
Intro: (Hand questionnaire and read to respondent) These next questions are about things that happen to people when they are drinking or after they have been drinking. We would like to know if any of these things have ever happened to you. (I can read the questions to you or you can fill out the form yourself. Which would you prefer?)
Method of Interview
2[] Self-administered (Instructions)
3[] Telephone interview (HIS-3)
4[] Refused HIS-3 (next Supplement)
Instructions -- Please circle "Yes" or "No" if any of these things have or have not ever happened to you in your entire life. If you need any help ask me for assistance.
[p.223]
ALCOHOL QUESTIONNAIRE
Segment ____
Serial ____
INSTRUCTIONS- Please circle "Yes" or "No" if any of these things have or have not ever happened to you IN YOUR ENTIRE LIFE. If you need any help ask me for assistance.
In your entire life have you ever....
1. Had a strong desire or urge to drink?
2[] No
2. Started drinking even though you hadn't intended to?
2[] No
3. Ended up drinking much more than you intended to?
2[] No
4. Found it difficult to stop drinking once you had started?
2[] No
5. Driven a car after having had too much to drink?
2[] No
6. Been sick or vomited after drinking, or the morning after?
2[] No
7. Done things when drinking that could have caused you to be hurt?
2[] No
8. Felt the effects of alcohol sooner than you used to?
2[] No
9. Kept on drinking for a longer period of time than you intended to?
2[] No
10. Found that the same amount of alcohol had less effect than before?
2[] No
11. Felt depresses, irritable, or nervous after drinking, or the morning after?
2[] No
12. Felt powerless over you drinking?
2[] No
13. Sought help from family, friends, professionals or self help groups about your drinking?
2[] No
14. Had a spouse or someone you lived with threaten to leave you because of your drinking?
2[] No
15. Gone on benders or binges that lasted two or more days?
2[] No
16. Tried to cut down or stop drinking and found you couldn't do it?
2[] No
17. Found yourself sweating heavily or shaking after drinking, or the morning after?
2[] No
18. Given up or cut down on activities or interests like sports or associations with friends, in order to drink?
2[] No
19. Been unable to remember some of the things you did while drinking?
2[] No
20. Needed a drink so badly you couldn't think of anything else?
2[] No
21. Found that you had to drink more than you once did to get the same effect?
2[] No
[p.224]
22. Stayed away from work or gone to work late because of drinking or a hangover?
2[] No
23. Spent money on drinks that was needed for essentials like food, or bills?
2[] No
24. Lost ties with or drifted apart from a family member or friend because of your drinking?
2[] No
25. Gotten drunk instead of doing the things you were supposed to do?
2[] No
26. Had a doctor suggest that you cut down or stop drinking alcohol?
2[] No
27. Continued to drink alcohol even though it was a threat to your health?
2[] No
28. Lost a job, or nearly lost one, because of drinking?
2[] No
29. Had family, friends, or co-workers suggest that you stop or cut down on your drinking?
2[] No
30. Done things when drinking that could have caused someone else to be hurt?
2[] No
31. Felt uneasy if alcohol was not around in case you wanted a drink?
2[] No
32. Spent a lot of time drinking, or getting over the effects of drinking?
2[] No
33. Been so hungover that it interfered with doing things you were supposed to do?
2[] No
34. Kept drinking even though it caused you emotional problems?
2[] No
35. Had you chances for promotion, raises, or better jobs hurt by your drinking?
2[] No
36. Heard or seen things that weren't really there after drinking, or the morning after?
2[] No
37. Taken a drink to keep yourself from shaking or feeling sick either after drinking, or the morning after?
2[] No
38. Kept drinking even though it caused you problems at home, work or school?
2[] No
39. Attended a meeting of Alcoholics Anonymous (AA) because of your drinking?
2[] No
40. Been arrested or had trouble with the police because of your drinking?
2[] No
41. Wanted to cut down or stop your drinking and found you couldn't do it?
2[] No
[p. 225]
ALCOHOL QUESTIONNAIRE
Segment ____
Serial ____
Instructions - In COLUMN 1, please circle the answer that best describes the number of times each of these things has happened to you IN THE PAST 12 MONTHS. Complete column 1 for each question first. Then go back and in COLUMN 2, circle "Yes" or "No" if any of these things have or have not ever happened to you IN YOUR ENTIRE LIFE. If you need any help ask me for assistance.
Column 1: In the past 12 months how many times have you .....
1. Had a strong desire or urge to drink?
[] 1
[] 2-3
[] 4 or more
2. Started drinking even though you hadn't intended to?
[] 1
[] 2-3
[] 4 or more
3. Ended up drinking much more that you intended to?
[] 1
[] 2-3
[] 4 or more
4. Found it difficult to stop drinking once you had started?
[] 1
[] 2-3
[] 4 or more
5. Driven a car after having had too much to drink?
[] 1
[] 2-3
[] 4 or more
6. Been sick or vomited after drinking, or the morning after?
[] 1
[] 2-3
[] 4 or more
7. Done things when drinking that could have caused you to be hurt?
[] 1
[] 2-3
[] 4 or more
8. Felt the effects of alcohol sooner than you used to?
[] 1
[] 2-3
[] 4 or more
9. Kept on drinking for a longer period of time than you intended to?
[] 1
[] 2-3
[] 4 or more
10. Found that the same amount of alcohol had less effect than before?
[] 1
[] 2-3
[] 4 or more
11. Felt depressed, irritable, or nervous after drinking, or the morning after?
[] 1
[] 2-3
[] 4 or more
12. Felt powerless over your drinking?
[] 1
[] 2-3
[] 4 or more
13. Sought help from family, friends, professionals or self-help groups about your drinking?
[] 1
[] 2-3
[] 4 or more
14. Had a spouse or someone you lived with threaten to leave you because of your drinking?
[] 1
[] 2-3
[] 4 or more
15. Gone on benders or binges that lasted two or more days?
[] 1
[] 2-3
[] 4 or more
16. Tried to cut down or stop drinking and found you couldn't do it?
[] 1
[] 2-3
[] 4 or more
17. Found yourself sweating heavily or shaking after drinking, or the morning after?
[] 1
[] 2-3
[] 4 or more
18. Given up or cut down on activities or interests like sports or associations with friends, in order to drink?
[] 1
[] 2-3
[] 4 or more
19. Been unable to remember some of the things you did while drinking?
[] 1
[] 2-3
[] 4 or more
20. Needed a drink so badly you couldn't think of anything else?
[] 1
[] 2-3
[] 4 or more
21. Found that you had to drink more than you once did to get the same effect?
[] 1
[] 2-3
[] 4 or more
22. Stayed away from work or gone to work late because of drinking or a hangover?
[] 1
[] 2-3
[] 4 or more
23. Spent money on drinks that was needed for essentials like food, or bills?
[] 1
[] 2-3
[] 4 or more
24. Lost ties with or drifted apart from a family member or friend because of your drinking?
[] 1
[] 2-3
[] 4 or more
25. Gotten drunk instead of doing the things you were supposed to do?
[] 1
[] 2-3
[] 4 or more
26. Had a doctor suggest that you cut down or stop drinking alcohol?
[] 1
[] 2-3
[] 4 or more
27. Continued to drink alcohol even though it was a threat to your health?
[] 1
[] 2-3
[] 4 or more
28. Lost a job, or nearly lost one, because of drinking?
[] 1
[] 2-3
[] 4 or more
29. Had family, friends, or co-workers suggest that you stop or cut down on your drinking?
[] 1
[] 2-3
[] 4 or more
30. Done things when drinking that could have caused someone else to be hurt?
[] 1
[] 2-3
[] 4 or more
31. Felt uneasy if alcohol was not around in case you wanted a drink?
[] 1
[] 2-3
[] 4 or more
32. Spent a lot of time drinking, or getting over the effects of drinking?
[] 1
[] 2-3
[] 4 or more
33. Been so hungover that it interfered with doing things you were supposed to do?
[] 1
[] 2-3
[] 4 or more
34. Kept drinking even though it caused you emotional problems?
[] 1
[] 2-3
[] 4 or more
35. Had your chances for promotion, raises, or better jobs hurt by your drinking?
[] 1
[] 2-3
[] 4 or more
36. Heard or seen things that weren't really there after drinking, or the morning after?
[] 1
[] 2-3
[] 4 or more
37. Taken a drink to keep yourself from shaking or feeling sick either after drinking, or the morning after?
[] 1
[] 2-3
[] 4 or more
38. Kept drinking even though it caused you problems at home, work, or school?
[] 1
[] 2-3
[] 4 or more
39. Attended a meeting of Alcoholics Anonymous (AA) because of your drinking?
[] 1
[] 2-3
[] 4 or more
40. Been arrested or had trouble with the police because of your drinking?
[] 1
[] 2-3
[] 4 or more
41. Wanted to cut down or stop your drinking and found you couldn't do it?
[] 1
[] 2-3
[] 4 or more
[p.225]
Column 2: In you Entire Life have you ever.....
1. Had a strong desire or urge to drink?
2[] No
2. Started drinking even though you hadn't intended to?
2[] No
3. Ended up drinking much more than you intended to?
2[] No
4. Found it difficult to stop drinking once you had started?
2[] No
5. Driven a car after having had too much to drink?
2[] No
6. Been sick or vomited after drinking, or the morning after?
2[] No
7. Done things when drinking that could have caused you to be hurt?
2[] No
8. Felt the effects of alcohol sooner than you used to?
2[] No
9. Kept on drinking for a longer period of time than you intended to?
2[] No
10. Found that the same amount of alcohol had less effect than before?
2[] No
11. Felt depresses, irritable, or nervous after drinking, or the morning after?
2[] No
12. Felt powerless over you drinking?
2[] No
13. Sought help from family, friends, professionals or self help groups about your drinking?
2[] No
14. Had a spouse or someone you lived with threaten to leave you because of your drinking?
2[] No
15. Gone on benders or binges that lasted two or more days?
2[] No
16. Tried to cut down or stop drinking and found you couldn't do it?
2[] No
17. Found yourself sweating heavily or shaking after drinking, or the morning after?
2[] No
18. Given up or cut down on activities or interests like sports or associations with friends, in order to drink?
2[] No
19. Been unable to remember some of the things you did while drinking?
2[] No
20. Needed a drink so badly you couldn't think of anything else?
2[] No
21. Found that you had to drink more than you once did to get the same effect?
2[] No
[p.226]
22. Stayed away from work or gone to work late because of drinking or a hangover?
2[] No
23. Spent money on drinks that was needed for essentials like food, or bills?
2[] No
24. Lost ties with or drifted apart from a family member or friend because of your drinking?
2[] No
25. Gotten drunk instead of doing the things you were supposed to do?
2[] No
26. Had a doctor suggest that you cut down or stop drinking alcohol?
2[] No
27. Continued to drink alcohol even though it was a threat to your health?
2[] No
28. Lost a job, or nearly lost one, because of drinking?
2[] No
29. Had family, friends, or co-workers suggest that you stop or cut down on your drinking?
2[] No
30. Done things when drinking that could have caused someone else to be hurt?
2[] No
31. Felt uneasy if alcohol was not around in case you wanted a drink?
2[] No
32. Spent a lot of time drinking, or getting over the effects of drinking?
2[] No
33. Been so hungover that it interfered with doing things you were supposed to do?
2[] No
34. Kept drinking even though it caused you emotional problems?
2[] No
35. Had you chances for promotion, raises, or better jobs hurt by your drinking?
2[] No
36. Heard or seen things that weren't really there after drinking, or the morning after?
2[] No
37. Taken a drink to keep yourself from shaking or feeling sick either after drinking, or the morning after?
2[] No
38. Kept drinking even though it caused you problems at home, work or school?
2[] No
39. Attended a meeting of Alcoholics Anonymous (AA) because of your drinking?
2[] No
40. Been arrested or had trouble with the police because of your drinking?
2[] No
41. Wanted to cut down or stop your drinking and found you couldn't do it?
2[] No
[p.223]
ALCOHOL QUESTIONNAIRE
Segment ____
Serial ____
INSTRUCTIONS- Please circle "Yes" or "No" if any of these things have or have not ever happened to you IN YOUR ENTIRE LIFE. If you need any help ask me for assistance.
In your entire life have you ever....
1. Had a strong desire or urge to drink?
2[] No
2. Started drinking even though you hadn't intended to?
2[] No
3. Ended up drinking much more than you intended to?
2[] No
4. Found it difficult to stop drinking once you had started?
2[] No
5. Driven a car after having had too much to drink?
2[] No
6. Been sick or vomited after drinking, or the morning after?
2[] No
7. Done things when drinking that could have caused you to be hurt?
2[] No
8. Felt the effects of alcohol sooner than you used to?
2[] No
9. Kept on drinking for a longer period of time than you intended to?
2[] No
10. Found that the same amount of alcohol had less effect than before?
2[] No
11. Felt depresses, irritable, or nervous after drinking, or the morning after?
2[] No
12. Felt powerless over you drinking?
2[] No
13. Sought help from family, friends, professionals or self help groups about your drinking?
2[] No
14. Had a spouse or someone you lived with threaten to leave you because of your drinking?
2[] No
15. Gone on benders or binges that lasted two or more days?
2[] No
16. Tried to cut down or stop drinking and found you couldn't do it?
2[] No
17. Found yourself sweating heavily or shaking after drinking, or the morning after?
2[] No
18. Given up or cut down on activities or interests like sports or associations with friends, in order to drink?
2[] No
19. Been unable to remember some of the things you did while drinking?
2[] No
20. Needed a drink so badly you couldn't think of anything else?
2[] No
21. Found that you had to drink more than you once did to get the same effect?
2[] No
[p.224]
22. Stayed away from work or gone to work late because of drinking or a hangover?
2[] No
23. Spent money on drinks that was needed for essentials like food, or bills?
2[] No
24. Lost ties with or drifted apart from a family member or friend because of your drinking?
2[] No
25. Gotten drunk instead of doing the things you were supposed to do?
2[] No
26. Had a doctor suggest that you cut down or stop drinking alcohol?
2[] No
27. Continued to drink alcohol even though it was a threat to your health?
2[] No
28. Lost a job, or nearly lost one, because of drinking?
2[] No
29. Had family, friends, or co-workers suggest that you stop or cut down on your drinking?
2[] No
30. Done things when drinking that could have caused someone else to be hurt?
2[] No
31. Felt uneasy if alcohol was not around in case you wanted a drink?
2[] No
32. Spent a lot of time drinking, or getting over the effects of drinking?
2[] No
33. Been so hungover that it interfered with doing things you were supposed to do?
2[] No
34. Kept drinking even though it caused you emotional problems?
2[] No
35. Had you chances for promotion, raises, or better jobs hurt by your drinking?
2[] No
36. Heard or seen things that weren't really there after drinking, or the morning after?
2[] No
37. Taken a drink to keep yourself from shaking or feeling sick either after drinking, or the morning after?
2[] No
38. Kept drinking even though it caused you problems at home, work or school?
2[] No
39. Attended a meeting of Alcoholics Anonymous (AA) because of your drinking?
2[] No
40. Been arrested or had trouble with the police because of your drinking?
2[] No
41. Wanted to cut down or stop your drinking and found you couldn't do it?
2[] No
[p. 225]
ALCOHOL QUESTIONNAIRE
Segment ____
Serial ____
Instructions - In COLUMN 1, please circle the answer that best describes the number of times each of these things has happened to you IN THE PAST 12 MONTHS. Complete column 1 for each question first. Then go back and in COLUMN 2, circle "Yes" or "No" if any of these things have or have not ever happened to you IN YOUR ENTIRE LIFE. If you need any help ask me for assistance.
Column 1: In the past 12 months how many times have you .....
1. Had a strong desire or urge to drink?
[] 1
[] 2-3
[] 4 or more
2. Started drinking even though you hadn't intended to?
[] 1
[] 2-3
[] 4 or more
3. Ended up drinking much more that you intended to?
[] 1
[] 2-3
[] 4 or more
4. Found it difficult to stop drinking once you had started?
[] 1
[] 2-3
[] 4 or more
5. Driven a car after having had too much to drink?
[] 1
[] 2-3
[] 4 or more
6. Been sick or vomited after drinking, or the morning after?
[] 1
[] 2-3
[] 4 or more
7. Done things when drinking that could have caused you to be hurt?
[] 1
[] 2-3
[] 4 or more
8. Felt the effects of alcohol sooner than you used to?
[] 1
[] 2-3
[] 4 or more
9. Kept on drinking for a longer period of time than you intended to?
[] 1
[] 2-3
[] 4 or more
10. Found that the same amount of alcohol had less effect than before?
[] 1
[] 2-3
[] 4 or more
11. Felt depressed, irritable, or nervous after drinking, or the morning after?
[] 1
[] 2-3
[] 4 or more
12. Felt powerless over your drinking?
[] 1
[] 2-3
[] 4 or more
13. Sought help from family, friends, professionals or self-help groups about your drinking?
[] 1
[] 2-3
[] 4 or more
14. Had a spouse or someone you lived with threaten to leave you because of your drinking?
[] 1
[] 2-3
[] 4 or more
15. Gone on benders or binges that lasted two or more days?
[] 1
[] 2-3
[] 4 or more
16. Tried to cut down or stop drinking and found you couldn't do it?
[] 1
[] 2-3
[] 4 or more
17. Found yourself sweating heavily or shaking after drinking, or the morning after?
[] 1
[] 2-3
[] 4 or more
18. Given up or cut down on activities or interests like sports or associations with friends, in order to drink?
[] 1
[] 2-3
[] 4 or more
19. Been unable to remember some of the things you did while drinking?
[] 1
[] 2-3
[] 4 or more
20. Needed a drink so badly you couldn't think of anything else?
[] 1
[] 2-3
[] 4 or more
21. Found that you had to drink more than you once did to get the same effect?
[] 1
[] 2-3
[] 4 or more
22. Stayed away from work or gone to work late because of drinking or a hangover?
[] 1
[] 2-3
[] 4 or more
23. Spent money on drinks that was needed for essentials like food, or bills?
[] 1
[] 2-3
[] 4 or more
24. Lost ties with or drifted apart from a family member or friend because of your drinking?
[] 1
[] 2-3
[] 4 or more
25. Gotten drunk instead of doing the things you were supposed to do?
[] 1
[] 2-3
[] 4 or more
26. Had a doctor suggest that you cut down or stop drinking alcohol?
[] 1
[] 2-3
[] 4 or more
27. Continued to drink alcohol even though it was a threat to your health?
[] 1
[] 2-3
[] 4 or more
28. Lost a job, or nearly lost one, because of drinking?
[] 1
[] 2-3
[] 4 or more
29. Had family, friends, or co-workers suggest that you stop or cut down on your drinking?
[] 1
[] 2-3
[] 4 or more
30. Done things when drinking that could have caused someone else to be hurt?
[] 1
[] 2-3
[] 4 or more
31. Felt uneasy if alcohol was not around in case you wanted a drink?
[] 1
[] 2-3
[] 4 or more
32. Spent a lot of time drinking, or getting over the effects of drinking?
[] 1
[] 2-3
[] 4 or more
33. Been so hungover that it interfered with doing things you were supposed to do?
[] 1
[] 2-3
[] 4 or more
34. Kept drinking even though it caused you emotional problems?
[] 1
[] 2-3
[] 4 or more
35. Had your chances for promotion, raises, or better jobs hurt by your drinking?
[] 1
[] 2-3
[] 4 or more
36. Heard or seen things that weren't really there after drinking, or the morning after?
[] 1
[] 2-3
[] 4 or more
37. Taken a drink to keep yourself from shaking or feeling sick either after drinking, or the morning after?
[] 1
[] 2-3
[] 4 or more
38. Kept drinking even though it caused you problems at home, work, or school?
[] 1
[] 2-3
[] 4 or more
39. Attended a meeting of Alcoholics Anonymous (AA) because of your drinking?
[] 1
[] 2-3
[] 4 or more
40. Been arrested or had trouble with the police because of your drinking?
[] 1
[] 2-3
[] 4 or more
41. Wanted to cut down or stop your drinking and found you couldn't do it?
[] 1
[] 2-3
[] 4 or more
[p.225]
Column 2: In your Entire Life have you ever.....
1. Had a strong desire or urge to drink?
2[] No
2. Started drinking even though you hadn't intended to?
2[] No
3. Ended up drinking much more than you intended to?
2[] No
4. Found it difficult to stop drinking once you had started?
2[] No
5. Driven a car after having had too much to drink?
2[] No
6. Been sick or vomited after drinking, or the morning after?
2[] No
7. Done things when drinking that could have caused you to be hurt?
2[] No
8. Felt the effects of alcohol sooner than you used to?
2[] No
9. Kept on drinking for a longer period of time than you intended to?
2[] No
10. Found that the same amount of alcohol had less effect than before?
2[] No
11. Felt depresses, irritable, or nervous after drinking, or the morning after?
2[] No
12. Felt powerless over you drinking?
2[] No
13. Sought help from family, friends, professionals or self help groups about your drinking?
2[] No
14. Had a spouse or someone you lived with threaten to leave you because of your drinking?
2[] No
15. Gone on benders or binges that lasted two or more days?
2[] No
16. Tried to cut down or stop drinking and found you couldn't do it?
2[] No
17. Found yourself sweating heavily or shaking after drinking, or the morning after?
2[] No
18. Given up or cut down on activities or interests like sports or associations with friends, in order to drink?
2[] No
19. Been unable to remember some of the things you did while drinking?
2[] No
20. Needed a drink so badly you couldn't think of anything else?
2[] No
21. Found that you had to drink more than you once did to get the same effect?
2[] No
[p.226]
22. Stayed away from work or gone to work late because of drinking or a hangover?
2[] No
23. Spent money on drinks that was needed for essentials like food, or bills?
2[] No
24. Lost ties with or drifted apart from a family member or friend because of your drinking?
2[] No
25. Gotten drunk instead of doing the things you were supposed to do?
2[] No
26. Had a doctor suggest that you cut down or stop drinking alcohol?
2[] No
27. Continued to drink alcohol even though it was a threat to your health?
2[] No
28. Lost a job, or nearly lost one, because of drinking?
2[] No
29. Had family, friends, or co-workers suggest that you stop or cut down on your drinking?
2[] No
30. Done things when drinking that could have caused someone else to be hurt?
2[] No
31. Felt uneasy if alcohol was not around in case you wanted a drink?
2[] No
32. Spent a lot of time drinking, or getting over the effects of drinking?
2[] No
33. Been so hungover that it interfered with doing things you were supposed to do?
2[] No
34. Kept drinking even though it caused you emotional problems?
2[] No
35. Had you chances for promotion, raises, or better jobs hurt by your drinking?
2[] No
36. Heard or seen things that weren't really there after drinking, or the morning after?
2[] No
37. Taken a drink to keep yourself from shaking or feeling sick either after drinking, or the morning after?
2[] No
38. Kept drinking even though it caused you problems at home, work or school?
2[] No
39. Attended a meeting of Alcoholics Anonymous (AA) because of your drinking?
2[] No
40. Been arrested or had trouble with the police because of your drinking?
2[] No
41. Wanted to cut down or stop your drinking and found you couldn't do it?
2[] No