Tobacco Implementation Guide -Recreational Product Usage
Any Recreational Products Used
Substance Use Category
*
Were any recreational products used?
No
Yes
Not Done
What was the reason the recreational product usage was not done?
Recreational Products Used
What was the recreational product used?
Does the subject currently use or formerly use recreational product?
Formerly
Current
What was the amount of theĀ recreational product used?
What was the dose unit?
What was the frequency of recreational product use?
Choose
Occasional
Intermitent
Daily
PRN
Unknown
*
Mandatory field