Languages: English (oral: Dzongkha)

Bhutan W1 Mixed Survey Code: BT1-M Languages: English (oral: Dzongkha) Mode: Face to Face Interview i

TABLE OF CONTENTS Smoking Behavior: Questions for All Respondents 001 Brand Choice for Factory-made Cigarettes 016 Last tobacco purchase: Single portions 025 Last tobacco purchase: Packs 028 Where Purchased 038 AVAILABILITY 042 Ban Effects on Availability Recall questions 057 KNOWLEDGE AND THOUGHTS 064 WARNING LABELS 067 ANTI-TOBACCO CAMPAIGNS 073 TOBACCO PROMOTION 076 ENVIRONMENTAL TOBACCO SMOKE 100 PSYCHOSOCIAL: BELIEFS ABOUT SMOKING 119 PERCEIVED RISK 120 RELATIVE RISKS 125 MODERATORS 131 MARIJUANA USE 140 DEMOGRAPHICS 149 ii

Bhutan W1 Mixed Q# VarName BT1-M 000a uniqid 000c BI64240 Gender: 000d Age 001a FR64225 001b FR64216 001c FR64226 001d FR64236 002a FR64019 Smoking Behavior: Questions for All Respondents Circle appropriate number in USAGE Column 3 (0 = Not used, 1 = Less than Weekly, 2 = Weekly, 3 = Daily). We are going to read out a list of tobacco products and would like to know how often you use each of these products. Do you smoke/ use [product] daily, at least weekly, less than weekly, or not at all? a. Manufactured cigarettes? 0 Not used 1 Less than Weekly 2 Weekly 3 Daily For smoked: How many do you smoke per day/week/month? (use appropriate interval) For smokeless: How long a pack or tin lasts and record in appropriate column. If response=0, go to 002a/FR019. How many do you smoke per day? Enter number per day: Go to 002a/FR019. How many do you smoke per week? Enter number per week: How many do you smoke per month? Enter number per month: Circle appropriate number in USAGE Column 3 (0 = Not used, 1 = Less than Weekly, 2 = Weekly, 3 = Daily). We are going to read out a list of tobacco products and would like to know how often you use each of these products. Do you smoke/ use [product] daily, at least weekly, less than weekly, or not at all? b. Hand-rolled cigarettes 0 Not used 1 Less than Weekly 2 Weekly 3 Daily For smoked: How many do you smoke per day/week/month? (use appropriate interval) For smokeless: How long a pack or tin lasts and record in appropriate column. If response=0, go to 003a/TF029. 3

002b FR64021 002c FR64023 002d FR64025 003a TF64029 003b TF64021 003c TF64023 003d TF64025 004a TF64129 004b TF64129o 004c TF64121 How many do you smoke per day? Enter number per day: Go to 003a/TF029. How many do you smoke per week? Enter number per week: How many do you smoke per month? Enter number per month: Circle appropriate number in USAGE Column 3 (0 = Not used, 1 = Less than Weekly, 2 = Weekly, 3 = Daily). We are going to read out a list of tobacco products and would like to know how often you use each of these products. Do you smoke/ use [product] daily, at least weekly, less than weekly, or not at all? c. Bidis? 0 Not used 1 Less than Weekly 2 Weekly 3 Daily For smoked: How many do you smoke per day/week/month? (use appropriate interval) For smokeless: How long a pack or tin lasts and record in appropriate column. If response=0, go to 004a/TF129. How many do you smoke per day? Enter number per day: Go to 004a/TF129. How many do you smoke per week? Enter number per week: How many do you smoke per month? Enter number per month: Circle appropriate number in USAGE Column 3 (0 = Not used, 1 = Less than Weekly, 2 = Weekly, 3 = Daily). We are going to read out a list of tobacco products and would like to know how often you use each of these products. Do you smoke/ use [product] daily, at least weekly, less than weekly, or not at all? Other smoked tobacco products (specify). 0 Not used 1 Less than Weekly 2 Weekly 3 Daily For smoked: How many do you smoke per day/week/month? (use appropriate interval) For smokeless: How long a pack or tin lasts and record in appropriate column. If response=0, go to 005a/TF379. Specify other smoked products: How many do you smoke per day? Enter number per day: Go to 005a/TF379. 4

004d TF64123 004e TF64125 005a TF64379 005b TF64371 005c TF64373 005d TF64375 006a TF64429 006b TF64421 006c TF64423 006d TF64425 How many do you smoke per week? Enter number per week: How many do you smoke per month? Enter number per month: Circle appropriate number in USAGE Column 3 (0 = Not used, 1 = Less than Weekly, 2 = Weekly, 3 = Daily). We are going to read out a list of tobacco products and would like to know how often you use each of these products. Do you smoke/ use [product] daily, at least weekly, less than weekly, or not at all? Khaini/surti 0 Not used 1 Less than Weekly 2 Weekly 3 Daily For smoked: How many do you smoke per day/week/month? (use appropriate interval) For smokeless: How long a pack or tin lasts and record in appropriate column. If response=0, go to 006a/TF429. How many days does a packet/ tin last? Enter days per packet/ tin: Go to 006a/TF429. How many weeks does a packet/tin last? Enter weeks per packet/tin: How many months does a packet/tin last? Enter months per packet/tin: Circle appropriate number in USAGE Column 3 (0 = Not used, 1 = Less than Weekly, 2 = Weekly, 3 = Daily). We are going to read out a list of tobacco products and would like to know how often you use each of these products. Do you smoke/ use [product] daily, at least weekly, less than weekly, or not at all? Zarda. 0 Not used 1 Less than Weekly 2 Weekly 3 Daily For smoked: How many do you smoke per day/week/month? (use appropriate interval) For smokeless: How long a pack or tin lasts and record in appropriate column. If response=0, go to 007a/SL245. How many days does a packet/ tin last? Enter days per packet/ tin: Go to 007a/SL245. How many weeks does a packet/tin last? Enter weeks per packet/tin: How many months does a packet/tin last? Enter months per packet/tin: 5

007a SL64245 007b SL64251 007c SL64253 007d SL64255 008a TF64529 008b TF64529o 008c TF64521 008d TF64523 008e TF64525 Circle appropriate number in USAGE Column 3 (0 = Not used, 1 = Less than Weekly, 2 = Weekly, 3 = Daily). We are going to read out a list of tobacco products and would like to know how often you use each of these products. Do you smoke/ use [product] daily, at least weekly, less than weekly, or not at all? Snuff. 0 Not used 1 Less than Weekly 2 Weekly 3 Daily For smoked: How many do you smoke per day/week/month? (use appropriate interval) For smokeless: How long a pack or tin lasts and record in appropriate column. If response=0, go to 008a/TF529. How many days does a packet/ tin last? Enter days per packet/ tin: Go to 008a/TF529. How many weeks does a packet/tin last? Enter weeks per packet/tin: How many months does a packet/tin last? Enter months per packet/tin: Circle appropriate number in USAGE Column 3 (0 = Not used, 1 = Less than Weekly, 2 = Weekly, 3 = Daily). We are going to read out a list of tobacco products and would like to know how often you use each of these products. Do you smoke/ use [product] daily, at least weekly, less than weekly, or not at all? Other smokeless. 0 Not used 1 Less than Weekly 2 Weekly 3 Daily For smoked: How many do you smoke per day/week/month? (use appropriate interval) For smokeless: How long a pack or tin lasts and record in appropriate column. If response=0, go to 009a/FR560. Other smokeless (specify) How many days does a packet/ tin last? Enter days per packet/ tin: Go to 009a/FR560. How many weeks does a packet/tin last? Enter weeks per packet/tin: How many months does a packet/tin last? Enter months per packet/tin: 6

009a FR64560 009b FR64560o Ask if respondent uses more than one product in table above. Is the main reason you use a variety of products because you like the variety or because you use what is available, or is it for some other reason? 1 Variety 2 Availability 3 Both, or 4 Some other reason (specify) If any daily use in 001a/FR225-008a/TF529 Go to 012/SB982, else continue. For some other reason (specify) 010 TF64821 Ask if no per-day answers to above question, else Go to 012/SB982. On average, how many days each week do you use tobacco? If response=7, go to 012/SB982. 011 HI64932 Ask if 010/TF821<7 (if not daily). In the past, have you used tobacco on a daily basis? Go to 014a/HI444. 012 SB64982 Ask if any tobacco products are used per day, else: Go to 014a/HI444. How soon after waking do you first use tobacco? 1 5 min or less 2 6-30 min 3 31-60 min 4 More than 60 min 5 No specific time - none of the above (Don't read out) 013 SB64987 How hard is it to go without using tobacco for a whole day? 1 Not at all hard 2 Somewhat hard 3 Very hard 4 Extremely hard or impossible 5 Can t say 7

014a HI64444 014b HI64446 015a HI64744 015b HI64746 Ask all. At what age did you start smoking tobacco at least once a month? Age At what age did you start smoking tobacco at least once a month? Year At what age did you start using smokeless tobacco at least once a month? Age At what age did you start using smokeless tobacco at least once a month? Year 016a BR64310 016b BR64311 016c BR64311m 016d BR64311o Brand Choice for Factory-made Cigarettes Now I am going to ask you some questions about cigarettes only. Earlier you said you smoked factory made cigarettes. Do you have a regular brand of cigarettes, one that you usually smoke? If response=2, 88, or 99, go to Last Purchase 020a/LP901. If has a regular brand: What is the name of your regular cigarette brand? 01 Wills Navy cut 02 Wills Flake 03 Wills Classic 04 Classic 05 Gold Flake 06 Marlboro 07 Triple Five 08 Camel 96 Multiple brands (specify) (Don't read) 97 Other brand (specify) (Don't read) 98 No Brand (Don't read) Specify multiple regular brands. Specify other regular brand. 8

017 BR64502 How long have you been smoking this brand of cigarettes? 1 Less than 1 year 2 1-5 years 3 More than 5 years 018a BR64626 In choosing this brand of cigarettes, was part of your decision based on any of the following? The price? 018b BR64624 Their availability? 018c BR64616 That they are less harmful than other brands? 019 BR64661 How frequently do you smoke other cigarette brands? 1 Never 2 Rarely 3 Sometimes 4 Often 020a LP64901 I am going to be asking you about buying tobacco. The last time you bought tobacco, which product or products did you buy? 1 Factory made cigarette 2 Hand-rolled tobacco 3 Bidis 4 Khaini/surti 5 Zarda 6 Snuff 7 Other (specify) 91 Never bought tobacco (Don't read) 97 Multiple products (specify) (Don't read) 98 No brand (Don't read) 99 Don't Know (Don't read) Prompt if necessary. If response=88, 99 or 98, go to 022/LP920. If response=91, go to Availability, 042a/TS891. 020b LP64901o Other (specify): 020c LP64902o Specify multiple products: 9

021a BR64712 021b BR64712o Ask if respondent's last purchase of tobacco was factory-made cigarettes (020a/LP901=1). Prompt with appropriate product categories. What brand was it? 01 Wills Navy cut 02 Wills Flake 03 Wills Classic 04 Classic 05 Gold Flake 06 Marlboro 07 Triple Five 08 Camel 09 Other cigarette brand (specify) (Don't read) Specify other. 021c LP64212 Ask if respondent's last purchase of tobacco was bidis (020a/LP901=3). What brand was it? 11 Mira Bidi 12 Mangla Bidi 13 Other Bidi (specify) (Don't read) 021d LP64612 Ask if respondent's last purchase of tobacco was smokeless tobacco (020a/LP901=4-6). 21 Baba 22 Raja Chap 23 Surti 24 Golden Khaini 25 Chaini 26 Snuff 27 Other smokeless (specify) (Don't read) 021e LP64914o Ask if respondent last purchased multiple products (020a/LP901=97). Specify multiple products: 97 Multiple products (specify) (Don't read) 98 No Brand (Don't read) 99 Don t Know (Don't read) 10

022 LP64920 The last time you bought tobacco, did you (mainly) buy it by the pack (or tin), as single pieces or sticks, or as loose tobacco? 1 Pack 2 Single piece, stick, or quid 3 Loose tobacco 4 Some combination (including packs) If response=1 or 4, go to Pack section, 028/LP935. If response=2, go to Single Portion section, 025/LP925. If response=3, go to 023a/PU551a. If response=88 or 99, go to Where Purchased section, 038a/LP961. 023a PU64551a Ask if 022/LP920=3 (Loose tobacco) Use only one, days or hours, not both. If loose tobacco: How long does the amount you bought last you for? days 023b PU64551b hours 024a PU64532 How much did you pay for that? 024b PU64533 Price How much did you pay for that? Currency 8 Refused (Don't read) 9 Don't Know (Don't read) Go to Where Purchased section, 038a/LP961. Last tobacco purchase: Single portions 025 LP64925 Ask if respondent last purchased single piece or stick (022/LP920=2). Based on your last purchase: How many <sticks of cigarettes/bidis><quids of smokeless> did you buy? sticks/ pieces 11

026a LP64927 026b LP64928 How much did each one cost? Interviewer Note: If gives total price for all units, record it here and compute per piece price later How much did each one cost? 027a LP64972 027b LP64972o Currency (If not Ngultrums) Interviewer Note: If gives total price for multiple packs, record it here and compute per pack price later Do you usually buy tobacco this way, or do you usually buy packs? 1 Usually single cigarettes 2 Usually packs 3 Both about equally often 4 Other (specify) Go to Where Purchased section, 038a/LP961. Specify other. Last tobacco purchase: Packs 028 LP64935 Ask if 022/LP920=1 or 4. When you bought the last pack: How many packs of tobacco did you buy? If response=88 or 99, go to AQN/031/LP976. 029 LP64974 Were these all for you or did you buy some for other people as well? 1 All for self 2 Some for self, some for others 3 All for others 030a LP64939 How much did each pack cost? Interviewer Note: If gives total price for multiple packs, record it here and compute per pack price later 030b LP64940 How much did each pack cost? Currency (If not Ngultrums) 12

031 LP64976 Does the price you pay for your preferred type of tobacco vary? If response=2, 88 or 99, go to 033/LP950. 032a LP64977 In the last 6 months: What is the lowest price you paid per pack? 032b LP64978 In the last 6 months: What is the highest price you paid per pack? 033 LP64950 Can you show me a pack (one of the brand) that you last purchased, one that you are currently smoking or one that you have at home? We will give it back, we just want to get some information off it., shown, not shown If response=2, 88 or 99, go to Where Purchased, 038a/LP961. 034a LP64951 034a/LP951 037a/LP960 interviewer to record information off pack. Record Pack size: No. of sticks per pack 034b LP64952 Weight per pack 999 Weight not specified (Don't read) 035a LP64753 034a/LP951 037a/LP960 interviewer to record information off pack. What product is the pack for? 1 Cigarettes 2 Bidis 3 Other (specify) 035b LP64753o Specify other. 036a LP64955 036b LP64957o 034a/LP951 037a/LP960 interviewer to record information off pack. Is an excise tax stamp visible on the pack?, the pack displays an excise tax, specify country 2 Yes, the pack displays a fraction of the tax stamp or minutely visible fragments of a tax stamp 3 No, there is no excise tax stamp, nor are there any signs to indicate that a stamp was ever present Specify country 13

037a LP64960 034a/LP951 037a/LP960 interviewer to record information off pack. 037b LP64960o Is a health warning label on the pack? 1 No, a health warning label is not visible on the pack 2 Yes, Thai graphic 3 Yes, standard Indian 4 Yes, other (specify) Specify other health-warning label. 038a LP64961 038b LP64962 038c LP64963 038d LP64964 Where Purchased [Interviewer Note: If it is outside the country, probe to see if it is India (option 3) and specify the town. If it is outside the country but not India (option 4) probe to specify country. Where did you buy this tobacco product? Was it in your neighborhood, elsewhere in Bhutan, or outside the country? 1 Neighborhood 2 Elsewhere in Bhutan (specify town) 3 Outside country: India (specify town) 4 Outside country: Other (specify country) 5 Friend brought them from outside country 6 Other (specify) 99 Don't Remember (Don't read) If response=3, go to 040/TS788. If response=4, 5, 6, 88 or 99, go to 041a/TS881. Specify town in Bhutan. Specify town in India. Specify other country. 038e LP64964o Other; specify Go to 041a/TS881. 039a LP64966 If inside Bhutan (038a/LP961=1 or 2): From what sort of a place did you buy it? 1 Shops 2 Vegetable market 3 Private house 4 Other (specify) If response=88 or 99, go to Availability section, 042a/TS891. 039b LP64966o Ask if other (039a/LP966=4). Specify other place. 14

040 TS64788 Is this where you usually buy tobacco? 3 Don t have a usual purchase place If response=1, 3, 88 or 99, go to Availability section, 042a/TS891. 041a TS64881 Ask if 040/TS788=2. Read out response options. Where do you usually buy it (tobacco)? Shops 041b TS64882 Vegetable market 041c TS64883 041d TS64889 041e TS64889o 041f TS64884 Private house Other (specify below). Specify other place. Read out response options. Outside country 042a TS64891 042b TS64892 042c TS64893 042d TS64898 042e TS64899 042f TS64899o AVAILABILITY Read out response options. What (other) sorts of places can you buy tobacco inside Bhutan? Shops Vegetable market Private house Nowhere Other (specify): Specify other place. 15

043 TS64907 Have you seen tobacco on open display in any of the shops in Bhutan? 044 TS64922 Is tobacco available all the time in the village or town where you live? 1 Available all the time 2 Nearly always 3 Mostly 4 Sometimes 5 Rarely 6 Never 045 TS64917 Are both smoked and smokeless forms of tobacco equally available? 1 Smokeless more available, 2 Smoked more available 3 No difference (equally available) 046a TS64322 [Interviewer Note: Read out response options. Mark as many as apply.] When you can't get your usual product to smoke, what do you do? Use a smokeless tobacco product 046b TS64323 Use a different smoked tobacco product 046c TS64324 046d TS64325 046e TS64326 Do without any tobacco. Travel to an area where your product is available Other 047 TS64122 How often are cigarettes available in your area? 1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 16

048 TS64522 How often is smokeless tobacco available in your area? 1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 049 TS64124 How often are bidis available in your area? 1 Always 2 Most of the time 3 Sometimes 4 Rarely 5 Never 050 TS64933 On the whole, is smoked tobacco cheaper or more expensive than smokeless tobacco, or is it about the same? 1 Smoked cheaper 2 About the same 3 More expensive 4 Don t compare as very different 051 TS64851 As far as you know, does anybody grow tobacco in Bhutan? If response=2, 88 or 99, go to 053/LP988. 052 TS64866 Do you ever use it?, often 2 Yes, sometimes 3 No 053 LP64988 Now a question on the impact of tobacco on your budget: In the last 6 months, has there been a time when the money you spent on tobacco resulted in not having enough money for household essentials like food? 17

054 TS64955 Now I want to ask some questions about importing tobacco into Bhutan: In the last six months, how often, (if at all,) have you imported tobacco products from outside Bhutan? 1 Never 2 Only once 3 2 or 3 times 4 4 to 10 times 5 More than 10 times 055 TS64960 In your opinion, should the present tobacco import quota be stopped since there is a ban of sale of tobacco products? 056 TS64963 The present import quota is 200 cigarettes, 150 gms of pipe tobacco and 50 gms of chewing tobacco for personal consumption. Do you think the present quota is 1 Too low 2 Too high 3 Just right Ban Effects on Availability Recall questions 057 TS64803 Now I want you to think back to when the national ban on the sale of tobacco products came into force in 2004. First, I need to know, were you using tobacco before the nationwide tobacco sales ban in 2004? If response=2, 88, or 99, go to next section (Knowledge and Thoughts), 064a/SB803. 058 TS64805 Did you make any attempt to quit using tobacco within the year after the ban was introduced in 2004? 059 TS64809 After the ban on selling came in, did it suddenly become harder to get tobacco, did it gradually become harder, or did it NOT make much difference to how easy it was to get tobacco? 1 Suddenly harder 2 Gradually harder 3 No real effect 99 Cannot remember (Don t Know) (Don't read) 18

060 TS64811 Compared with those early months, is tobacco more available now, less available now, or has availability not changed much? 1 More available 2 Less available 3 No change in availability 7 Not sure (Don't read) 061 TS64815 Was there ever a time when there was no tobacco available in this area? 062 TS64741 Has the ban on selling tobacco products in Bhutan had any effects on what tobacco products you use? If response=2, 88, or 99, go to next section (Knowledge and Thoughts), 064a/SB803. 063a TS64162 If Yes to 062/TS741: What products would you use more of, if they were readily available? Manufactured Cigarettes 1 Mentioned t mentioned 063b TS64165 Bidis. 063c TS64168 063d TS64171 063e TS64262 063f TS64265 063g TS64251 063h TS64864 063i TS64864o Cigars. Loose tobacco (for pipe or RYO) Khaini/surti Zarda. Snuff. Other; specify Specify other. KNOWLEDGE AND THOUGHTS 19

064a SB64803 Now I am going to ask you some questions about your thoughts on tobacco and smoking. 064b SB64804 064c SB64811 064d SB64805 064e SB64893 065a KT64421 065b KT64423 065c KT64432 065d KT64460 065e KT64477 066a KT64723 066b KT64724 In the last month, how often, if at all, did you... Think about how much you enjoy smoking? 1 Never 2 Sometimes 3 Often Think about the harm your smoking might be doing to you? Seriously consider quitting smoking tobacco? Think about the cost of smoking tobacco? Think about where you might be able to get tobacco? Interviewer Note: Repeat the question if necessary. I am going to read you a list of health effects and diseases that may or may not be caused by smoking tobacco. Based on what you know or believe, does smoking tobacco cause the following...? Lung cancer in smokers? Mouth cancer in smokers? Problems breathing or getting enough breath (Bronchitis or Emphysema)? Lung cancer in non-smokers from secondhand smoke? Asthma (breathing problems) in children from secondhand smoke? Now some health effects and diseases that may or may not be caused by smokeless tobacco use. Based on what you know or believe, does smokeless tobacco cause the following... Mouth cancer? Gum disease? WARNING LABELS 20

067 WL64201 Ask all. In the last month, how often, if at all, have you NOTICED health warnings on any of the cigarette packages you have seen? 1 Once in a while 2 Often 3 Never Interviewer Note: If respondent asks, this refers to packs you have seen within Bhutan. If response=3, 88 or 99, go to Anti-Tobacco Campaigns, AQN/073a/AC711. 068 WL64121 Ask if 067/WL201=1 (once in a while) or 2 (Often): Read out response options. Select all that apply. Which of the following sorts of warnings have you noticed? 1 Text only 2 Graphic warnings only 3 Both Graphic pictures and text-only 4 No warning 069 WL64211 In the last month, how often, if at all, have you read or looked closely at the warning labels on cigarette packages? 1 Never 2 Once in a while 3 Often 070 WL64221 In the last month, have the warning labels stopped you from having a cigarette when you were about to smoke one? 1 Never 2 Once in a while 3 Many times 071 WL64411 The next 2 questions may sound similar to you but in actual fact, the questions are asking about completely different things. To what extent, if at all, do the health warnings on cigarette packs make you more likely to think about the health risks (health danger) of smoking cigarettes? 1 Not at all 2 A little 3 A lot 21

072 WL64421 To what extent, if at all, do the health warnings on cigarette packs make you more likely to quit smoking cigarettes? 1 Not at all 2 A little 3 A lot 073a AC64711 073b AC64716 073c AC64715 073d AC64725 073e AC64731 073f AC64714 073g AC64717 ANTI-TOBACCO CAMPAIGNS In the last 6 months, have you noticed advertising or information that talks about the dangers of smoking tobacco, or encourages quitting, in any of the following places? Television. Radio. Group education sessions (including village meetings) Posters. Newspapers or magazines. In the workplace? Public transportation vehicles or stations. 073h AC64720 Cigarette packs. If No to all (073a/AC711-073h/AC720=2), go to 075/AC800. 074 AC64771 Has this advertising made you think about quitting smoking tobacco? 3 Made no difference 075 AC64800 Now, thinking about smokeless tobacco, have you seen any information about the harms of smokeless tobacco (other than cigarettes)? TOBACCO PROMOTION 22

076a TA64905 076b TA64907 076c TA64912 076d TA64929 Interviewer Note: Repeat the question if necessary. In the last 6 months, have you seen or heard cigarettes or other tobacco products being advertised in any of the following places? Television. Radio. Posters. Newspapers or magazines. 077 TA64935 Have you seen anybody with clothing or other items that has a tobacco (smoked-tobacco?) brand or logo on it? 078 TA64382 In the last 6 months, about how often have you seen people smoking tobacco in the entertainment media like movies, TV, Magazines, Etc.? 1 Never 2 Once in a while 3 Often 079 AQ64361 Have you ever made a serious attempt to stop smoking tobacco? [Interviewer Note: This means all types of smoked tobacco are included in quit attempt.] If response=2, 88, or 99, go to 083/CH801. 080 AQ64365 When did this / your last quit attempt end? 1 Less than 1 month ago 2 1-3 months ago 3 3 to 6 months ago 4 6 months to 1 year ago 5 1-3 years ago 6 More than 3 years ago 23

081 AQ64368 On this last quit attempt, how long did you go without smoking any tobacco? 1 Less than a day 2 At least a day, but less than a week 3 At least a week, but less than a month 4 1-3 months 5 6 months to 1 year 6 1-3 years 7 More than 3 years 082 AQ64662 Did this also involve trying to quit using smokeless tobacco as well? 083 CH64801 In the last year, have you visited a doctor or other health professional, for any reason? If response=2, 88, or 99, go to 086a/AQ422. 084 AQ64401 During any visit to the doctor or other health professional in the last 6 months, did you receive... Advice to quit smoking tobacco? If response=2, 88, or 99, go to 086a/AQ422. 085 AQ64402 Did this make you think about quitting smoking? 086a AQ64422 Read each item. During the past 12 months, did you use any of the following to try to stop smoking tobacco? Medicines? Specify 086b AQ64422o Specify medicines. 24

087 AQ64425 Read each item. During the past 12 months, did you use any of the following to try to stop smoking tobacco? Blessing from a Lama? 088 AQ64428 Read each item. During the past 12 months, did you use any of the following to try to stop smoking tobacco? Using smokeless tobacco instead? 089a AQ64429 Read each item. During the past 12 months, did you use any of the following to try to stop smoking tobacco? Anything else? Specify: 089b AQ64429o Specify, anything else. 090 TQ64933 Now we would like to ask you some questions on any thoughts you have about quitting tobacco use. Interviewer Note: Respondent does not need to be intending to quit to respond. Emphasize IF in wording. IF you decided to give up USING tobacco completely in the next 6 months, how sure are you that you would succeed? 1 Not at all sure 2 Slightly sure 3 Sure 4 Very sure 091 TQ64935 How hard would it be for you to quit using tobacco if you wanted to? 1 Very easy 2 Somewhat easy 3 Neither easy nor hard 4 Somewhat hard 5 Very hard 25

092 TQ64941 One year from now, how much do you expect to be using tobacco, compared to now: More than now, the same amount, less than now, or not smoking at all? 1 A lot more than now 2 A little more than now 3 The same amount as now 4 A little less than now 5 A lot less than now, or 6 Not smoking at all 093 TQ64444 Are you planning to quit smoking tobacco 1 Within the next month 2 Within the next 6 months 3 Sometime in the future, beyond 6 months 4 No plans to quit? If response=2 or 3, go to 096a/TQ450. If response=4, go to 095/TQ448. If response=88 or 99, go to 097a/TQ310. 094 TQ64446 Ask if 093/TQ444=1 (within next month). Have you set a firm date for quitting smoking tobacco? Go to 097a/TQ310. 095 TQ64448 Ask if 093/TQ444=4 (no plans to quit). Do you want to quit smoking tobacco? If response=2, 88, or 99, go to 097a/TQ310. 096a TQ64450 Ask if 093/TQ444=2-3 (plan to quit) or 095/TQ448=1 (want to quit). How much do you want to quit smoking tobacco? 1 A little 2 Somewhat 3 A lot 26

096b TQ64739 097a TQ64310 097b TQ64312 097c TQ64316 097d TQ64318 097e TQ64320 097f TQ64322 097g TQ64326 097h TQ64340 097i BQ64227 097j TQ64346 097k TQ64330 097l TQ64348 Do you also want to quit using smokeless tobacco? Have any of the following reasons led you to think about quitting smoking in the last month. Concern for your personal health? Concern about the effect of your tobacco smoke on non-smokers? That Bhutanese society disapproves of smoking? The price of tobacco? The law banning the sale of tobacco in Bhutan? The difficulty in getting tobacco? Rules banning smoking in public places? Advertisements or information about the health risks of smoking? Warning labels on cigarette packages? Setting a bad example for children? That close friends and family disapprove of your smoking? Your religious affiliation? 098 TQ64453 How much do you think you would benefit from health and other gains if you were to quit smoking tobacco permanently in the next 6 months? 1 Not at all 2 Slightly 3 Moderately 4 Very much 099 TQ64455 Still thinking about quitting permanently within the next 6 months: If you were to quit smoking tobacco, would your ability to enjoy life be improved, made worse, or stay the same? 1 Improved a lot 2 Improved a little 3 Stay the same 4 Made a little worse 5 Made much worse 27

ENVIRONMENTAL TOBACCO SMOKE 100 TP64101 Are you aware that smoke free areas are designated in Bhutan? If response=2, 88 or 99, go to 104/TP310. 101 TP64146 Has the smoke-free policy made you cut down on the amount of tobacco you smoke? 102 TP64121 Based on your observation, since the smoke-free policy came into effect, do you think more people or less people are smoking in smoke-free places, or has there been no change? 1 More 2 Less 3 No change 103 TP64125 In your opinion, how well is the smoke-free policy in Bhutan enforced? 1 Well enforced 2 Somehwat enforced 3 Poorly enforced 104 TP64310 Which of the following best describes smoking tobacco INSIDE your home? 1 Smoking tobacco is not allowed in any indoor room inside my home 2 Smoking tobacco is allowed only in some rooms inside my home 3 No rules or restrictions 105 TP64341 How concerned are you that smoking tobacco in the presence of your children will hurt your children s health? 1 Not concerned 2 A little concerned 3 Moderately concerned 4 Very concerned 5 No children in my household/no children 6 I do not smoke in the presence of my children 28

106 TP64345 Interviewer Note: Accept Don t know without pressing for an answer. How much, if at all, do you try to minimize the amount that non-smokers are exposed to your tobacco smoke? 1 A lot 2 Somewhat 3 Not at all 107 ET64233 In the last 6 months, have you visited a restaurant? If response=2, 88 or 99, go to 110/ET431. 108 TP64530 If visited: The last time you visited, were people smoking inside the restaurant? 109 TP64535 (The last time you visited a restaurant,) did you smoke indoors? 110 ET64431 In the last 6 months, have you visited a bar? If response=2, 88 or 99, go to 113/ET542. 111 TP64630 If visited: The last time you visited, were people smoking inside the bar? 112 TP64635 The last time you visited a bar, did you smoke indoors? 29

113 ET64542 In the past 6 months, have you ridden on buses/ taxis? If response=2, 88 or 99, go to 115/ET601. 114 TP64730 If ridden: The last time you rode on buses, were people smoking inside them? 115 ET64601 Are you currently employed outside the home? If response=2, 88 or 99, go to NEXT SECTION Psychosocial beliefs 119a/PS401. 116 ET64603 Do you usually work inside or outside a building? 1 Inside 2 Outside 3 Both inside and outside a building (do not read) If response=2, 88 or 99, go to NEXT SECTION Psychosocial beliefs 119a/PS401. 117 TP64830 In the last month, have people smoked tobacco in indoor areas where you work? 118 TP64835 In the last month, have you smoked tobacco in indoor areas at work? PSYCHOSOCIAL: BELIEFS ABOUT SMOKING 30

119a PS64401 119b OT64301 119c OT64501 119d OT64315 119e OT64320 119f OT64330 119g OT64335 119h OT64340 119i OT64360 119j OT64560 119k OT64365 119l IN64509 119m OT64385 119n OT64725 Interviewer note: Repeat response options if necessary. Now I want to ask you some questions about your thoughts about tobacco use, some questions are about cigarettes, others about all smoked tobacco and others about smokeless. Listen carefully to the type of tobacco we are asking about Do you think that smoking cigarettes is a sign of sophistication/ smartness? Is it acceptable for females to smoke tobacco? Is it acceptable for females to use smokeless tobacco? Is tobacco smoke dangerous to nonsmokers? Knowing what you know now, would you have started smoking tobacco? Do you think that your family and friends do not want you to smoke? Do you enjoy smoking tobacco a lot? Does smoking calm you down when you are worried? Does Bhutanese society disapprove of smoking tobacco? Does Bhutanese society disapprove of smokeless tobacco? Do you believe that smoking causes less harm than what doctors say? Should the government do more to tackle the harm done by smoking tobacco? Are you worried that your smoking tobacco will influence the children around you to start or continue smoking? Do you spend too much money on tobacco (of all kinds)? PERCEIVED RISK 120 PR64951 To what extent, if at all, has using tobacco damaged your health? 1 Not at all 2 A little 3 A lot 121 PR64953 How worried are you, if at all, that using tobacco WILL damage your health in the future? 1 Not at all worried 2 A little worried 3 Moderately worried 4 Very worried 31

122 PR64961 To what extent, if at all, has using tobacco lowered your quality of life? 1 Not at all 2 Just a little 3 A fair amount 4 A great deal 123 PR64963 How worried are you, if at all, that using tobacco will lower your quality of life in the future? 1 Not at all worried 2 A little worried 3 Moderately worried 4 Very worried 124 OT64710 In your opinion, does tobacco use increase or decrease gross national happiness? Does it 1 Increase a lot 2 Increase a little 3 No effect 4 Decrease a little 5 Decrease a lot 125 SB64150 Do you think smoking tobacco is? 1 Good for your health 2 Neither good nor bad 3 Bad, or 4 Very bad for your health 126 SB64160 Do you think smokeless tobacco use is 1 Good for your health 2 Neither good nor bad 3 Bad, or 4 Very bad for your health RELATIVE RISKS 32

127 SL64305 Compared to smoking tobacco, do you think smokeless tobacco products are less harmful, more harmful or no different for health? 1 Smokeless are a lot less harmful 2 Smokeless are a little less harmful 3 Smokeless are a little more harmful 4 Smokeless are a lot more harmful 5 No difference 128 RH64405 The next questions are about smoked tobacco products only. Do you think that some types of smoked tobacco COULD be less harmful than other types, or are all types of smoked tobacco equally harmful? 1 Some less harmful 2 All equally harmful If response=2, 88 or 99, go to next section (Moderators) 131/DI211. 129 RH64407 What types are most harmful? 130 RH64409 What types are least harmful? MODERATORS 131 DI64211 How would you best respond to this statement: Do you often think about how what you do today will affect your life in the future. 132a DI64503 During the LAST MONTH, have you been disinterested in doing things? 132b DI64504 During the LAST MONTH, have you been unhappy most of the time? 33

133 PR64101 Now a question about your overall health. In general, how would you describe your health? Is it... 1 Poor 2 Average 3 Good 4 Excellent 134 DI64500 In general, how would you describe your level of happiness? Is it... 1 Poor 2 Average 3 Good 4 Excellent 135 DI64280 Interviewer Note: Record number between 0 and 5. Of the five closest friends or acquaintances that you spend time with on a regular basis, how many of them smoke? 0 No friends smoke If response=0, 88 or 99, go to 137/PS601. 136 DI64281 Interviewer Note: Record a number that is smaller than or equal to above answer. In the last year, how many of them have talked about wanting to quit smoking tobacco? 137 PS64601 If you were to go to the local market and gather a group of 10 strangers, on average, how many of the 10 would you expect to be tobacco smokers? 138 DI64303 Is smoking tobacco? 1 Very good 2 Good 3 Neither good nor bad 4 Bad 5 Very bad 34

139 DI64305 Is use of smokeless tobacco? 1 Very good 2 Good 3 Neither good nor bad 4 Bad 5 Very bad MARIJUANA USE 140 DI64800 Have you ever used marijuana? If response=2, 88 or 99, go to next section: Alcohol, 145/DI700. 141 DI64801 In the last 12 months, how often, if at all, have you used marijuana? 1 Very often 2 Often 3 Sometimes 4 Rarely 5 Never 142 DI64812 Have you ever used marijuana as a substitute to cigarettes? If response=2, 88 or 99, go to 144a/DI804. 143 DI64813 In the last 12 months, how often, if at all, have you used marijuana as a substitute to cigarettes? 1 Very often 2 Often 3 Sometimes 4 Rarely 5 Never 35

144a DI64804 144b DI64804o How do you usually smoke marijuana? 1 (Smoked) by itself 2 (Smoked) mixed with tobacco 3 Other (specify) (Don t read out) Specify other. ALCOHOL 145 DI64700 Do you drink alcohol? If response=2, 88 or 99, go to next section Demographics, 149/DE111. 146 DI64712 How often do you drink alcoholic drinks? 1 Every day or nearly every day 2 Most days 3 2 or 3 days a week 4 About once a week 5 Less than once a week 147a DI64704 When you drink alcohol, how many cups or glasses would you drink? 1 1 cup 2 2-3 cups 3 4-6 cups 4 7 cups 5 More than 7 cups cups/glasses 147b DI64704o Specify, more than 7 cups: 148 DI64705 How often would you drink more than [4 (females)/ 6 (males)] drinks in one session? 1 Every day or nearly every day 2 Most days 3 2 or 3 days a week 4 About once a week 5 Less than once a week 6 Never 36

149 DE64111 Interviewer note: DO NOT read out response options. What is your marital status? 1 Married 2 Divorced or separated 3 Widowed 4 Single 150a DE64662 Interviewer note: DO NOT read out response options. What is your religion? 1 Buddhist 2 Hindu 3 Other (Specify) 150b DE64662o Specify other religion. DEMOGRAPHICS 151 PS64513 In your day-to-day life, how often do you refer to or use your religious beliefs and values to guide your actions? 1 Never 2 Rarely 3 Sometimes 4 All the time 5 I am not religious (Don't read out) if response=5, go to 155a/DE311. 152 PS64511 As far as you know, does your religion discourage use of tobacco? 153 PS64507 In the last year, have you been told (in a sermon) by a religious leader a lama or senior monk of a temple -- that you should try to quit smoking? 37

154 PS64505 If a lama advised you to quit using tobacco, would you quit? 3 Maybe 155a DE64311 What is your highest level of education? 1 No education 2 Attended school, but no grade completed 3 Highest school grade completed 5 University completed 6 Post-graduate degree completed 7 NFE completed 8 Monastic school completed 155b DE64311o Highest school grade completed 156 DE64236 Which of the following best describes your main work status over the past 12 months? 01 Government employee 0n-government employee 03 Self-employed 04 Student 05 Farmer 06 Housewife 07 Retired 08 Unemployed, able to work 09 Unemployed, unable to work 157 AI64101 Thank you for your time and cooperation. We hope that we will be able to talk to you again in our follow-up survey in one year's time. 158 AI64543 Interviewer Note: This question is for you. Interviewers' overall judgment about the interview. 1 Reliable 2 Somewhat reliable 3 With some errors/ misunderstanding 4 With a lot of errors 38