Survey Text

2012
2002
2000
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2012
Survey form view entire document:  text  image
QuestionID: ALT.300_00.000

Instrument Variable Name: AHB_LSTY Adult CAM
QuestionText:
? [F1] (book) CAM2 Please tell me which of these supplements you have taken DURING THE PAST 12 MONTHS? If you took more than one herb in a single supplement, select "combination herb pill."
*Enter all that apply, separate with commas.
01 Combination herb pill
02 Acai (pills, gelcaps)
03 Bee Pollen and other Bee products
04 Chondroitin
05 Co-enzyme Q10 (CoQ10)
06 Cranberry (pills or capsules)
07 Digestive Enzymes (lactaid)
08 Echinacea
09 Fish Oil or omega 3 or DHA fatty acid or EPA fatty acid supplements
10 Garlic supplements (pills, gelcaps)
11 Ginkgo Biloba
12 Ginseng
13 Glucosamine
14 Green tea pills (not brewed tea) or EGCG (pills)
15 Melatonin
16 Milk Thistle (silymarin)
17 MSM (Methylsulfonylmethane)
18 Probiotics or Prebiotics
19 SAM-e
20 Saw Palmetto
21 Valerian
22 Other herbs or non-vitamin supplements
97 Refused
99 Don't know
UniverseText: Sample adults 18+ who have taken herbs or other non-vitamin supplements in the past 12 months
SkipInstructions:

(1-22) [goto AHB_MON]
(R,D) [goto AHB_EVR1]

Survey form view entire document:  text  image
Question ID: CAL.300_00.000

Instrument Variable Name: CHB_LSTY
QuestionText:
? [F1] (book) CAM2
Please tell me which of these supplements [S.C. name] has taken DURING THE PAST 12 MONTHS? If [fill: he/she] took more than one herb in a single supplement, select "combination herb pill."
*Enter all that apply, separate with commas.
01 Combination herb pill
02 Acai (pills, gelcaps)
03 Bee Pollen and other Bee products
04 Chondroitin
05 Co-enzyme Q10 (CoQ10)
06 Cranberry (pills or capsules)
07 Digestive Enzymes (lactaid)
08 Echinacea
09 Fish Oil or omega 3 or DHA fatty acid or EPA fatty acid supplements
10 Garlic supplements (pills, gelcaps)
11 Ginkgo Biloba
12 Ginseng
13 Glucosamine
14 Green tea pills (not brewed tea) or EGCG (pills)
15 Melatonin
16 Milk Thistle (silymarin)
17 MSM (Methylsulfonylmethane)
18 Probiotics or Prebiotics
19 SAM-e
20 Saw Palmetto
21 Valerian
22 Other herbs or non-vitamin supplements
97 Refused
99 Don't know
UniverseText: Sample children 4+ who have taken herbs or other non-vitamin supplements in the past 12 months
SkipInstructions:
(1-22) [goto CHB_MON]
(R,D) [goto CHB_EVR1]

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2002
Survey form view entire document:  text  image
ALT.218

DURING THE PAST 12 MONTHS, did you use any of the following natural herbs for health reasons?

FR: MARK ALL THAT APPLY. ENTER (N) FOR NO MORE.

(1) Yes
(2) No
(7) Refused
(9) Don't know
HRBTAK01 (01) Bee pollen or royal jelly
HRBTAK02 (02) Black cohosh
HRBTAK03 (03) Bladder wrack/kelp
HRBTAK04 (04) Cascara sagrada
HRBTAK05 (05) Chaparral
HRBTAK06 (06) Chasteberry/vitex
HRBTAK07 (07) Comfrey
HRBTAK08 (08) Dong quai/don gui tong kuei
HRBTAK09 (09) Echinacea
HRBTAK10 (10) Evening primrose
HRBTAK11 (11) Feverfew
HRBTAK12 (12) Fish oils/omega fatty acids
HRBTAK13 (13) Garlic supplements
HRBTAK14 (14) Ginger supplements
HRBTAK15 (15) Gingko biloba
HRBTAK16 (16) Ginseng
HRBTAK17 (17) Glucosamine with or without chondroitin
HRBTAK18 (18) Guarana
HRBTAK19 (19) Hawthorn
HRBTAK20 (20) Kava kava
HRBTAK21 (21) Licorice
HRBTAK22 (22) Ma huang (ephedra)
HRBTAK23 (23) Melatonin
HRBTAK24 (24) Mexican yam cream
HRBTAK25 (25) Milk thistle
HRBTAK26 (26) Peppermint
HRBTAK27 (27) Progesterone cream
HRBTAK28 (28) Ragweed/chamomile
HRBTAK29 (29) SAM-e
HRBTAK30 (30) Saw palmetto
HRBTAK31 (31) Senna
HRBTAK32 (32) Soy supplements
HRBTAK33 (33) St. John's wort
HRBTAK34 (34) Valerian
HRBTAK35 (35) Yohimbe

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2000
Survey form view entire document:  text  image
NAC.330

These next questions are about herbal supplements.
During the PAST 12 MONTHS, did you take any MIXED or single herbal or botanical supplements.

FR: READ IF NECESSARY:

Include pills, capsules, liquid tinctures and extracts. Do NOT include teas or food. Do NOT include garlic or ginger used in cooking.
HERBSUPP
(1) Yes (NAC.340)
(2) No (NAC.370)
(7) Refused (NAC.370)
(9) Don't know (NAC.370)

NAC.340

FR: SHOW CARD CAN5.

Which ones?

FR: MARK ALL THAT APPLY. ENTER THE NUMBER OF EACH ITEM MENTIONED.
ENTER (N) FOR NO MORE.
Card CAN5
1. Aloe
2. Astragalus
3. Bilberry
4. Cascara Sagrada
5. Cat's Claw
6. Cayenne
7. Cranberry
8. Dong Quai
9. Echinacea
10. Evening primrose oil
11. Feverfew
12. Garlic pills
13. Ginger pills
14. Ginkgo (biloba)
15. Ginseng (Amer., Asian)
16. Ginseng (Siberian)
17. Goldenseal
18. Grapeseed extract
19. Kava Kava
20. Lecithin
21. Melatonin
22. Milk Thistle
23: Saw Palmetto
24. St. John's Wort
25. Valerian
26. Another herbal supplement
HERB_ALO (1) Aloe
HERB_AST (2) Astragalus
HERB_BIL (3) Bilberry
HERB_CAS (4) Cascara Sagrada
HERB_CAT (5) Cat's Claw
HERB_CAY (6) Cayenne
HERB_CRA (7) Cranberry
HERB_DON (8) Dong Quai
HERB_ECH (9) Echinacea
HERB_EVE (10) Evening primrose oil
HERB_FEV (11) Feverfew
HERB_GAR (12) Garlic pills
HERB_GIG (13) Ginger pills
HERB_GIK (14) Ginkgo (biloba)
HERB_GIA (15) Ginseng(Amer, Asian)
HERB_GIS (16) Ginseng (Siberian)
HERB_GOL (17) Goldenseal
HERB_GRA (18) Grapeseed extract
HERB_KAV (19) Kava Kava
HERB_LEC (20) Lecithin
HERB_MEL (21) Melatonin
HERB_MIL (22) Milk Thistle
HERB_SAW (23) Saw Palmetto
HERB_JOH (24) St. John's Wort
HERB_VAL (25) Valerian
HERB_OTH (26) Another herbal supplement
(97) Refused
(99) Don't know