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Tobacco Usage History
SUCAT
Pre-populated
TOBACCO
Record the type of tobacco product usedWhat is the type of tobacco product used by the subject?
SUSCAT
SUTRT
_________________
Provide the duration of the tobacco product usedDuration
SUDUR SUDOSFRQ
Select the appropriate duration unit of the tobacco product usedUnit
SUCDURU SUDUR
Frequency
SUDOSFRQ Not Submitted
<FREQ codelist>
Record the tobacco product used as ongoing if the subject has not stopped taking the tobacco product used at the time of data collection and the end date should be left blank.Is the medication ongoing?
SUONGO SUENRF or SUENRTPT
<NY codelist>
Record the date the tobacco product used was stopped using this format (DD-MON-YYYY). If the subject has not stopped taking the tobacco product used leave this field blank.
SUENDAT SUENDTC
_ _ / _ _ _ / _ _ _ _
CDASH VariableOrderQuestion TextPromptCRF Completion InstructionsTypeSDTMIG Target VariableSDTMIG Target MappingControlled Terminology Code List NamePermissible ValuesPre-Populated ValueQuery DisplayList StyleHidden
SUCAT1What is the category for the substance?Substance Use Category
TextSUCAT


TOBACCO 


SUSCAT1What is the type of tobacco product  used by the subject? Substance Use SubcategoryRecord the type of tobacco product usedTextSUSCAT

Smoked tobacco products;

Chewed tobacco products;

Smokeless tobacco (e.g., chewing tobacco, snuff, dip, snus, or dissolvable tobacco)  







SUTRT4What was the name of the tobacco product? 



TextSUTRT






SUDUR6What was the duration of the tobacco product used?  DurationProvide the duration of the tobacco product usedTextSUDOSFRQ

QD; EVERY WEEK; QM; PA
Prompt

SUCDURU7What was the unit of duration of tobacco product used?UnitSelect the appropriate duration unit of the  tobacco product usedTextSUDUR

DAYS; MONTHS; YEARS
Prompt

SUDOSFRQ8What was the frequency of  the  tobacco product used ? Frequency



(FREQ)QD; EVERY WEEK; QM; PA
Prompt

SUONGO9Is the medication ongoing?OngoingRecord the tobacco product used as ongoing if the subject has not stopped taking the tobacco product used at the time of data collection and the end date should be left blank.TextSUENRF;  SUENRTPTSUENRF or SUENRTPT(NY)Yes

checkbox
SUENDAT10What was the end date?End DateRecord the date the tobacco product used was stopped using this format (DD-MON-YYYY). If the subject has not stopped taking the tobacco product used leave this field blank.DateSUENDTC



prompt

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