Drinking Habits Self-Assessment

Your Drinking in General

1. Thank you for considering this survey on drinking habits. Your answers are confidential and used only for research on mindful drinking.

2. How often do you have a drink containing alcohol?

   Choose one:

   • Daily
   • Weekly
   • Monthly
   • Less than monthly
   • Never

3. Which kind of alcoholic drink do you have most often?

   Asked only when q_drink_frequency.outcome is not None and q_drink_frequency.outcome != 5

   Choose one from a list:

   • Beer
   • Wine
   • Spirits
   • Mixed drinks
   • Something else

4. Which drink is that?

   Asked only when q_drink_frequency.outcome is not None and q_drink_frequency.outcome != 5 and q_beverage_type.outcome == 5

   Open answer

When and How You Drink

Asked only when q_drink_frequency.outcome is not None and q_drink_frequency.outcome != 5

1. How much do you agree with this statement: most of my drinking happens when I am with other people.

   Choose one:

   • Strongly disagree
   • Disagree
   • Neither agree nor disagree
   • Agree
   • Strongly agree

2. Does each of these statements describe you?

   • I end up drinking more than I planned.
   • I feel guilty after drinking.
   • I have tried to drink less.

   For each row: choose one:

   • Yes
   • Not sure
   • No

Effects on Your Life

Asked only when q_drink_frequency.outcome is not None and q_drink_frequency.outcome != 5

1. Has your drinking affected any of these areas?

   Choose any that apply:

   • Work or study performance
   • Relationships
   • Physical health
   • Mental health
   • Trouble with the law
   • None of these

2. What do you plan to do about your drinking in the future?

   Choose one:

   • Drink more
   • Keep it about the same
   • Drink less
   • Stop completely
   • Not sure

3. If you are willing, describe how drinking has affected your life.

   Asked only when q_drinking_consequences.outcome is not None and q_drinking_consequences.outcome & 31 != 0

   Open answer