Smoking History Survey
Smoking Cessation Medication
Smoking Cessation Counseling
Smokers Beliefs Questionnaire
Short Understanding of Substance Abuse Scale
Short Opiate Withdrawal Scale
This 10-item self-report scale is easy to understand and was found to provide a reliable and valid means of measuring the signs and symptoms of withdrawal among persons with opioid dependence (SOWS; Gossup, 1990). Symptoms assessed are: feeling sick, stomach cramps, muscle spasms/twitching, feelings of coldness, heart pounding, muscular tension, aches and pains, yawning, runny eyes, and insomnia/problems sleeping.
Short Inventory of Problems
SF-36 and SF-12 Health Status Questionnaire
The SF-36 is a multi-purpose, short-form health survey with only 36 questions. It yields an 8-scale profile of functional health and well-being scores, as well as psychometrically-based physical and mental health summary measures and a preference-based health utility index. It is a generic measure of perceived health status, as opposed to one that targets a specific age, disease, or treatment group. It is used to measure observable and tangible limitations due to poor health and/or bodily pain in physical, social, and role activities. Accordingly, the SF-36 has proven useful in surveys of general and specific populations, comparing the relative burden of diseases, and in differentiating the health benefits produced by a wide range of different treatments. Administration time is about 10-12 minutes. The SF-12 is an even shorter -- 1 page, 2 minute -- survey form that has been shown to yield summary physical and mental health outcome scores that are interchangeable with those from the SF-36.