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This is an example CRF used to collect information on prior use of smoking cessation products. The reason why a product was discontinued and any use in the last 14 days was of interest. 

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For each product previously taken record the appropriate details below.

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NICOTINE PATCH;  NICOTINE GUM;  NICOTINE LOZENGE; NICOTINE INHALER; VARENICLINE; BUPROPION;  OTHER

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What was the name of the other smoking cessation product used? 

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This is the SDTM date for the date collected above.  

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