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OrderCDASH Variable Name Question TextPromptCRF Completion InstructionsSDTMIG Target VariableSDTM Target MappingControlled Terminology Code List NamePermissible ValuesPre-Populated Value
1CMCATWhat is the category for the medication?Concomitant Medication Category
CMCAT


SMOKING CESSATION PRODUCT
2CMOCCURWere any smoking cessation products  taken?Any Smoking Cessation Products Taken Indicate if the subject took any smoking cessation products  If Yes, include the appropriate details where indicated on the CRF.CMOCCURCMOCCUR;CMPRESP(NY)Yes; No
3CMTRTWhat was the smoking cessation product used?Smoking Cessation ProductSelect the smoking cessation product.CMTRTCMTRT; CMPRESP;  If CMTRT="OTHER" Then CMTRT and CMPRESP are NULL.    

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


4CMOCCUR

Was the  smoking cessation product  used? 

Smoking Cessation Product UsedFor each  product  indicate if the product was used.CMOCCURCMOCCUR
Yes;No
5CMTRTOT

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

Smoking Cessation Product OtherIndicate the Other type of product  previously used. CMTRT



6CMCRSDISWas the smoking cessation product discontinued due to a  adverse experience?   Reason Smoking Cessation Product DiscontinuedIndicate if the product was discontinued due to a Adverse ExperienceCMRSDISCIf Yes then CMRSDISC = "ADVERSE Experience"(NY)Yes; No
7CMENDAT What was the last date the product was used? Last Date Smoking Cessation Product Used Indicate the last date the product was used. If  the product was used with the last 14 days, a complete  date must be recorded. Otherwise partial dates can be recorded. CMENDTC



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