Form:	GLNE 007 General Information v9.1

CDE ID	CDE Description
* 421	EDRN Participant ID (Go To: 2176)
* 2176	Visit code (Go To: 423)
	Permissible Values (value): BLN1 (1)
	BLN2 (2)
* 423	EDRN Protocol ID (Go To: 422)
* 422	EDRN Site ID (Go To: 929)
* 929	EDRN Staff ID of the person who collected the data: (Go To: 1219)
* 1219	Date of contact (MM/DD/YYYY): (Go To: 1429)
* 1429	Year of birth (In what year were you born?) (Go To: 2995)
* 2995	Age at start: (Go To: 1322)
* 1322	Hispanic or Latino (Are you Hispanic or Latino?) (Go To: 1315)
	Permissible Values (value): No (0)
	Yes (1)
	Refused (88)
	Unknown (99)
* 1315	Race (What is your race? Check all that apply.) (Go To: 4221)
	Permissible Values (value): White (1)
	Black or African-American (2)
	American Indian or Alaska Native (3)
	Asian (4)
	Native Hawaiian or other Pacific Islander (7)
	Refused (88)
	Other, specify: (97) (Go To: 1294)
	Unknown (99)
* 1294	Race (Other, specify) (Go To: 4221)
* 4221	Height (value): (Go To: 4222)
* 4222	Height (unit): (Go To: 4223)
	Permissible Values (value): cm (centimeters) (1)
	inches (2)
* 4223	Weight (value): (Go To: 4224)
* 4224	Weight (unit): (Go To: 1300)
	Permissible Values (value): kg (kilograms) (1)
	lbs (pounds) (2)
* 1300	Ever smoke cigarettes regularly, at least one a day for a year or more? (Did you ever smoke cigarettes regularly, at least one a day for a year or more?) (Go To: 1328)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 1299)
	Refused (88)
	Unknown (99)
* 1299	Currently smoke at least one cigarette a day? (Do you currently smoke cigarettes regularly, at least one a day?) (Go To: 1297)
	Permissible Values (value): No (0) (Go To: 1298)
	Yes (1)
	Refused (88)
	Unknown (99)
* 1298	Age quit smoking cigarettes? (How old were you when you permanently quit smoking cigarettes?) (Go To: 1297)
* 1297	Age first began smoking cigarettes regularly, at least one a day? (How old were you when you began smoking cigarettes regularly, at least one a day?) (Go To: 1325)
* 1325	Average number of cigarettes smoked per day? (During the time you have smoked, on average, how many cigarettes did you smoke per day?) (Go To: 1301)
* 1301	Total number of years smoked? (How many years total have you smoked?) (Go To: 1715)
* 1715	Total number of pack years smoked. (Go To: 1328)
* 1328	Has participant ever had at least one drink of alcohol [beer, liquor, wine, or wine coolers] per month during a twelve-month period? (Have you ever had at least one drink of alcohol [beer, liquor, wine, or wine coolers] per month during a twelve-month period?) (Go To: 1320)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 1330)
	Refused (88)
	Unknown (99)
* 1330	On average, how many glasses/cans of beer do you drink? Count a twelve-ounce can as one beer. (Go To: 1329)
	Permissible Values (value): None (4)
	<1 per week (5)
	1-6 per week (6)
	1-2 per day (7)
	3-5 per day (8)
	6+ per day (9)
	Refused (88)
	Unknown (99)
* 1329	On average, how many glasses of wine do you drink? Count a four-ounce glass of wine as one drink. (Go To: 1331)
	Permissible Values (value): None (4)
	<1 per week (5)
	1-6 per week (6)
	1-2 per day (7)
	3-5 per day (8)
	6+ per day (9)
	Refused (88)
	Unknown (99)
* 1331	On average, how many shots of hard liquor or mixed drinks do you drink? Count one shot (1 1/2 ounces) or one mixed drink as one drink. (Go To: 1320)
	Permissible Values (value): None (4)
	<1 per week (5)
	1-6 per week (6)
	1-2 per day (7)
	3-5 per day (8)
	6+ per day (9)
	Refused (88)
	Unknown (99)
* 1320	Gender (What is your gender?) (Go To: 1097)
	Permissible Values (value): Male (1)
	Female (2) (Go To: 2594)
	Refused (88)
	Unknown (99)
* 2594	Currently pregnant? (Go To: 1347)
	Permissible Values (value): No (0)
	Yes (1)
	Refused (88)
	Unknown (99)
* 1347	Age of first menstrual period? (How old were you when you first started having menstrual periods?) (Go To: 1316)
* 1316	Have menstrual periods stopped due to natural menopause, hysterectomy, the removal of both ovaries, or radiation or chemotherapy treatment? (Have your menstrual periods stopped due to natural menopause, hysterectomy, the removal of both ovaries, or radiation or chemotherapy treatment?) (Go To: 1097)
	Permissible Values (value): No (0)
	Yes (1) (Go To: 1348)
	Refused (88)
	Unknown (99)
* 1348	Age when menstrual periods stopped (How old were you when your menstrual periods stopped?) (Go To: 1097)
1097	Comments (do not include any participant identifiers) (Go To: End of Form)