Questions

Please click the response option that best describes your answer to each question. Follow all instructions between questions, and complete ALL questions to compute your score.

Thank you for agreeing to take part in this brief questionnaire about alcohol and tobacco. This questionnaire contains some questions about your experience of using these substances across your lifetime and in the last three months.



In your life, which of the following substances have you ever used?
(NON-MEDICAL USE ONLY)
Poll Completed
NO YES
Tobacco products (cigarettes, chewing tobacco, cigars, etc.)
Alcoholic beverages (beer, wine, spirits, etc.)