Order | Question Text | Prompt | Case Report Form Completion Instructions | Type | Collection Variable | Tabulation Target | Mapping Instructions | Controlled Terminology CodeList Name | Permissible Values | Pre-Populated Value |
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6 | What is the category of the medication/product the subject used to attempt to reduce nicotine dependency? | Medication |
| Text | CMTRT | CMCAT |
| NICOTINE REPLACEMENT THERAPY: DRUG USED IN REDUCING NICOTINE DEPENDENCE OTHER THAN NRTS
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7 | What is the medication/product subcategory, if not pre-printed on the CRF. | Subcategory | Applicant Defined | Text | CMSCAT | CMSCAT |
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| LAST ATTEMPTED USE WITH THIS MEDICATION |
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8 | What was the name of the medication/product the subject used to reduce nicotine dependency?
| Medication | Record only one medication/product per line. Provide the full trade or proprietary name of the medication/product; otherwise, record the generic name. | Text | CMTRT | CMTRT |
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9 | What was the duration of the medication/product used to reduce nicotine dependency for the last attempt? | Collected Duration | Provide the duration of the medication/product used. | Text | CMCDUR | CMDUR |
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10 | What was the duration unit of the medication/product used to reduce nicotine dependency for the last attempt? | Collected Duration Unit | Select the appropriate duration unit of the medication/product used. | Text | CMCDURU | CMDUR |
| DAYS; MONTHS; YEARS |
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