This is an example CRF ued to collect tobacco use history. This example does not include tobacco products that are being used as a medically acceptable therapy for smoke cessation
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| title | CDASH FA/SU Metadata Specifications |
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| Metadataspec |
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Section 1 | Order | Question Text | Prompt | CRF Completion Instructions | Type | Collection Variable | Tabulation Target | Mapping Instuctions | Controlled Terminology Code List Name | Permissible Values | Pre-Populated Value |
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| 1 | What is the object? |
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| Text | FAOBJ | FAOBJ |
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| TOBACCO | | 2 | What was the age of the subject when they started smoking? | Age Started Smoking | Record the Age Category when the subject started smoking | Text | AGESTSMK__FAORRES | FAORRES | FAORRES WHERE FATESTCD = "AGESTSMK" and FAOBJ = "TOBACCO" |
| 16-24 years; 25-34 years; 45–64 years; 65 years and older |
| | 3 | Did the subject have any tobacco cessation counseling? | Tobacco Cessation Counseling | Indicate whether the subject had previous tobacco cessation counseling | Text | TBCESSCO__FAORRES | FAORRES | FAORRES WHERE FATESTCD = "TBCESSCO" and FAOBJ = "TOBACCO" | (NY) | No;Yes |
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| | 4 | What is the longest duration of previous abstinence from tobacco use? | Longest Duration of Abstinence | Record the longest duration of tobacco abstinence | Text | LDURABS__FAORRES | FAORRES | FAORRES WHERE FATESTCD = "LDURABS" and FAOBJ = "TOBACCO" |
| ≤7 days; 8–28 days;1–6 months; >6 months |
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Section 2 | Order | Question Text | Prompt | CRF Completion Instructions | Type | Collection Variable | Tabulation Target | Mapping Instuctions | Controlled Terminology Code List Name | Permissible Values | Pre-Populated Value |
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| 5 | What is the type of tobacco product used by the subject? | Substance Use Category | Record the type of tobacco product used. | Text | SUCAT | SUCAT |
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| SMOKED TOBACCO PRODUCT; SMOKELESS TOBACCO PRODUCT (e.g., CHEWING TOBACCO, SNUFF, DIP, SNUS, or DISSOLVABLE TOBACCO PRODUCT) |
| | 6 | What was the brand name of the tobacco product?
| Substance Treatment Product Name | Record the brand name of the tobacco product used. | Text | SUTRT | SUTRT |
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| | 7 | Is this the subject's usual brand of tobacco product? | Substance Use Subcategory | Indicate if this is the subject's usual brand of tobacco product used | Text | SUSCAT | SUSCAT |
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| USUAL BRAND; NOT USUAL BRAND |
| | 9 | What was the duration of use of the tobacco product ? | Duration | Provide the duration for the product used | Text | SUCDUR | SUDUR |
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| | 9 | What was the unit of duration of use of the tobacco product? | Unit | Select the appropriate duration unit for the product used | Text | SUCDURU | SUDUR |
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| DAYS; MONTHS; YEARS; |
| | 10 | Is the tobacco use ongoing? | Ongoing | Record the product used as ongoing if the subject has not stopped taking the product used at the time of data collection. The end date should be left blank. | Text | SUONGO | SUENRF; SUENRTPT | SUENRF or SUENRTPT | (NY) | No;Yes |
| | 11 | What was the end date? | End Date | Record the date the product used was stopped using this format (DD-MON-YYYY). If the subject has not stopped taking the product used leave this field blank. | Date | SUENDAT | SUENDTC |
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