Tobacco Product Use History - TIG

This is an example of a CRF used to collect tobacco product use history.

"Tobacco Implementation Guide_Tobacco Usage History [TIG_TOB_USAGE_HIST]" Form Preview

Tobacco Implementation Guide_Tobacco Usage History

Tobacco Usage History

What is the object?

What was the age of the subject when they started smoking?

Did the subject have any tobacco cessation counseling?

No Yes

What is the longest duration of previous abstinence from tobacco use?

Tobacco Product Used

* What is the type of tobacco product used by the subject?

Smoked Tobacco Product Smokeless Tobacco Product

What was the brand name of the tobacco product?

Is this the subject's usual brand of tobacco product?

Usual Brand Not Usual Brand

What was the duration of use of the tobacco product ?

What is the unit?

Is the tobacco use ongoing?

No Yes

What is the end date?

01 Jan 2000

* Mandatory field

Package(s)
TIG_eCRF_Package_Tobacco_Product_Use_History