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1. What is your gender?
 
Male
 
Female
 
 
 
2. What is your age?
 
18 to 24
 
25 to 34
 
35 to 44
 
45 to 54
 
 
 
3. Have you ever consumed an alcoholic drink?
 
Yes
 
No
 
 
 
4. Have you had an alcoholic drink in the past year?
 
Yes
 
No
 
 
 
6. During the past month, on how many occasions did you have at least one alcoholic drink?
 
none
 
once
 
2 to 5
 
6 to 10
 
11 to 30
 
 
 
7. In the past month, when you drank alcohol, on average, how many standard alcoholic drinks did you have during one drinking occasion?
 
none
 
one
 
2 to 5
 
6 to 10
 
11-30
 
 
 
8. In the past month, what was the largest number of alcoholic drinks you had on a single occasion?
 
none
 
one
 
2 to 5
 
6 to 10
 
11 to 30
 
 
 
9. During the past month, how many times did you have fiveĀ or more drinks ( four for women) in a single drinking occasion?
 
none
 
one
 
2 to 5
 
6 to 10
 
11 to 30
 
 
 
10. In a typical week, how many days do you participate in moderate intensity physical activity?
 
I don't regularly exercise
 
Once a week
 
2 to 4 times a week
 
5 to 7 times a week
 
 
 
11. On average, how much time do you spend exercising during each session?
 
0 to 30 minutes
 
30 minutes to 1 hour
 
1 hour to 1 hour 30 min
 
More than 2 hours
 
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