Survey Text

2012
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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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