| Order | CDASH Variable | Question Text | Prompt | CRF Completion Instructions | Type | SDTMIG Target | SDTMIG Target Mapping | Controlled Terminology Code List Name | Permissible Values | Pre-Populated Value | Query Display | List Style | Hidden |
|---|
| 1 | CMCAT | What is the category for the medication? | Concomitant Medication Category |
| Text | CMCAT |
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| SMOKING CESSATION PRODUCT |
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| Yes |
| 2 | CMTRT | What was the smoking cessation product? | Smoking Cessation Product | Indicate the type of smoking cessation products previously used. For each product type previously used complete a new line. | Text | CMTRT |
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| NICOTINE PATCHES:; NICOTINE GUM; NICOTINE LOZENGE; NICOTINE INHALER; CHANTIXVARENICLINE; ZYBAN BUPROPION; OTHER |
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| 3 | CMTRTOT | What was the name of the other smoking cessation product used? | Smoking Cessation Product Other | Indicate the Other type of smoking cessation product previously used. | Text | CMTRT |
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| 4 | CMCRSDIS | Was the smoking cessation product discontinued due to a adverse event ? | Reason Smoking Cessation Product Discontinued | Indicate if the smoking cessation product was discontinued due to a Adverse Event | Text | CMRSDISC | If Yes then CMRSDISC = "ADVERSE EVENT" | (NY) | Yes; No |
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| 5 | CMENDTC | Was the product used in the last 14 days? |
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| CMENDTC |
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| Yes; No |
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