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Form Id: FRM-DRUGALCOHOL

ENGLISH  FRANÇAIS  PORTUGUÊS  ITALIANO

How often do you have a drink containing alcohol?:	NeverMonthly or less2 to 4 times a month2 to 3 times a week4 or More Times a Week
How often do you smoke?:	Never smokedFormer cigarette smokerCurrent some day smokerCurrent light tobacco smokerCurrent heavy tobacco smokerUnknown if ever smoked
How often do you use drugs?:	NeverMonthly or less2 to 4 times a month2 to 3 times a week4 or More Times a Week

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