Protocol - Pregnancy Status and Tobacco Use
Description
Population Assessment of Tobacco and Health (PATH) questions that assess number of pregnancies, kinds of complications, pregnancy status, alcohol, average cigarettes per day during pregnancy (not by trimester), and other tobacco product use.
Specific Instructions
Tobacco product list for Item 8:
1. Cigarettes
2. E-cigarettes
3. Traditional cigars
4. Cigarillos
5. Filtered cigars
6. Pipe filled with tobacco
7. Hookah
8. Snus pouches
9. Smokeless tobacco (such as loose snus, moist snuff, dip, spit or chew)
10. Dissolvable tobacco
11. A nicotine patch, gum, inhaler, nasal spray, lozenge or pill
Chantix, varenicline, Wellbutrin, Zyban, or bupropion
Protocol
The next questions are about your pregnancy history.
1. Have you ever been pregnant? Please include current pregnancy, live births, miscarriages, abortions, ectopic or tubal pregnancies and stillbirths.
1[ ]Yes
2[ ]No
-8[ ]DON’T KNOW
-7[ ]REFUSED
2. How many of your pregnancies have resulted in a live birth?
1[ ]|___|___|
-8[ ]DON’T KNOW
-7[ ]REFUSED
3. For [that birth those FILL## births], did any of the following occur? Choose all that apply.
1[ ]Preterm birth (birth of baby less than 37 weeks gestational age)
2[ ]Baby with low birth weight (less than 5 pounds 8 ounces)
3[ ]Baby with birth defects
4[ ]Placenta Previa
5[ ]Placenta Abruption
6[ ]Pre-eclampsia
7[ ]None of the above
-8[ ]DON’T KNOW
-7[ ]REFUSED
4. Are you pregnant now?
1[ ]Yes
2[ ]No
-8[ ]DON’T KNOW
-7[ ]REFUSED
5. How many months or weeks pregnant are you? Please enter the number of months or weeks.
1[ ]|___|___| Months
2[ ]|___|___| Weeks
-8[ ]DON’T KNOW
-7[ ]REFUSED
6. During your [most recent / current] pregnancy, [did you smoke / have you smoked] any cigarettes?
1[ ]Yes
2[ ]No
-8[ ]DON’T KNOW
-7[ ]REFUSED
7. During your [most recent / current] pregnancy, how many cigarettes [did you smoke/have you smoked] on an average day? A pack usually has 20 cigarettes in it.
1[ ]Less than 1 cigarette a day
2[ ]1 to 5 cigarettes a day
3[ ]6 to 10 cigarettes a day
4[ ]11 to 20 cigarettes a day
5[ ]21 to 40 cigarettes a day
6[ ]41 cigarettes or more a day
-8[ ]DON’T KNOW
-7[ ]REFUSED
8. During your [most recent/current] pregnancy, [did/have] you [use/used] [TOBACCO PRODUCT LIST]?
1[ ]Yes
2[ ]No
-8[ ]DON’T KNOW
-7[ ]REFUSED
PROGRAM: [TOBACCO PRODUCT LIST] = A list of all tobacco products the respondent has ever used, excluding cigarettes.
Availability
Personnel and Training Required
None
Equipment Needs
None
Requirements
Requirement Category | Required |
---|---|
Major equipment | No |
Specialized training | No |
Specialized requirements for biospecimen collection | No |
Average time of greater than 15 minutes in an unaffected individual | No |
Mode of Administration
Interviewer-administered questionnaire
Lifestage
Participants
Women, age 18 and over who have ever given birth
Selection Rationale
The PATH study collects information on number of pregnancies, kinds of complications, pregnancy status, and alcohol and tobacco use. The protocol collects average cigarette use per day during pregnancy, but is not separated by trimester. It also includes a separate tobacco products use list.
Language
English
Standards
Standard | Name | ID | Source |
---|---|---|---|
caDSR Common Data Elements (CDE) | Tobacco Use Pregnancy Status Questionnaire Assessment Tex | 4719208 | CDE Browser |
Human Phenotype Ontology | Triggered by smoking | HP:0025223 | HPO |
Derived Variables
None
Process and Review
Not applicable.
Protocol Name from Source
Population Assessment of Tobacco and Health (PATH) Study, Baseline Adult Extended Interview
Source
Population Assessment of Tobacco and Health (PATH) Study, Baseline Adult Extended Interview, pp. 240-245.
www.reginfo.gov/public/do/PRAICList?ref_nbr=201307-0925-001
General References
None
Protocol ID
720801
Variables
Export VariablesVariable Name | Variable ID | Variable Description | dbGaP Mapping | |
---|---|---|---|---|
PX720801_Birth_Event | ||||
PX720801030000 | For [that birth those FILL## births], did more | N/A | ||
PX720801_Ever_Pregnant_Indicator | ||||
PX720801010000 | Have you ever been pregnant? Please include more | Variable Mapping | ||
PX720801_Month_Week_Pregnancy | ||||
PX720801050000 | How many months or weeks pregnant are you? more | N/A | ||
PX720801_Number_Live_Birth | ||||
PX720801020000 | How many of your pregnancies have resulted more | Variable Mapping | ||
PX720801_Pregnancy_Smoke_Cigarettes_Quantity | ||||
PX720801070000 | During your [most recent / current] more | N/A | ||
PX720801_Pregnancy_Smoke_Cigarette_Indicator | ||||
PX720801060000 | During your [most recent / current] more | Variable Mapping | ||
PX720801_Pregnancy_Tobacco_Product_Use | ||||
PX720801080000 | During your [most recent/ current] more | N/A | ||
PX720801_Pregnant_Now_Indicator | ||||
PX720801040000 | Are you pregnant now? | Variable Mapping |
Measure Name
Pregnancy Status and Tobacco Use
Release Date
February 20, 2015
Definition
These questions ask about pregnancy and tobacco use.
Purpose
To determine tobacco product use during pregnancy.
Keywords
pregnancy status and tobacco use, pregnancy, smoking, pregnancy complications, pregnancy status, fetal alcohol, cigarettes, pregnancy, CPD pregnancy, Population Assessment of Tobacco and Health, PATH, tobacco products
Measure Protocols
Protocol ID | Protocol Name |
---|---|
720801 | Pregnancy Status and Tobacco Use |