Health Needs Assessment of the Marshall Islands - Page 7
Do you smoke cigarettes?
*
z
24.
[ ]
f ]
25.
Yes
No
(continue)
(skip to question #26)
How many cigarettes do you smoke each day?
f ]
Less than 1
{ ]
1/2 pack (5-14)
f }
{ }
[ ]
11/2 packs (25-34)
2 packs (35-44)
2 1/2 packs (45-54)
[] 1-4
[ ]
{ ]
26.
1 pack (15-24)
More than 2 1/2 packs (55 or more)
What do you normally drink when you get thirsty during the day?
IF RESPONDENT ANSWERS YES TO ANY OF THE RESPONSES BELOW, ASK HOW MANY?
Yes
No
C]
(]
[]}]
[C]
Coke/soda
{ }
[ J
Beer
[ ]
[ ]
Wine
[]
(]
Liquor
{}
(]
Other (specify)
{ ]
[ ]
Water
‘ Fresh coconut
If yes, how many a day?
27.
About how many people including yourself live in your house?
28.
About how many women who are able to have babies live in your house?
29.
About how old were you when you had your first pregnancy?
30.
About how many live babies were born to the women of your house during the
last year?
ASK FEMALE ONLY