New Mexico Community Survey
2015 Codebook--Paper
SITE ID: _____ SITE
Location: ____________LOCATION
Surveyor initials:________ INITIALS
Survey #:__________PID
Date: ___________ Date
Time: ___________Time
English (this variable is in data entry templates only)
If the survey is in English, enter 1, else 0.
1
18 to 20
2
21 to 25
3
26 to 30
4
31 to 40
5
41 to 50
6
51 to 60
7
61 to 70
8
71 or older
0
Male 1
Female Q02
_____________________________________
4. How long have you lived in New Mexico? Q04
Less than 1 year
1 – 5 years
More than 5 years
I don’t live in NM
5. Which one or more of the following would you say is
your race or ethnicity? (Check all that apply.)
For each item enter 1 if selected. If not selected,
leave it blank.
Q05_1
Q05_2
Q05_3
Q05_4
Q05_5
Q05_6
Q05_7
Q05_8
White
Hispanic or Latino
Black or African American
American Indian
Native Hawaiian or Other Pacific Islander
Asian
Alaska Native
Other [Please write in your race/ethnicity]
Q05oth______________________________
6. Are you on active duty in the U.S. Armed Forces,
military Reserves, or National Guard or a veteran of
the U.S. Armed Forces? Q06
1
Yes
0
Less than high school
High school graduate or GED
Some college or technical school
College graduate, graduate or professional
school graduate
8. Do you identify as Lesbian, Gay, Bisexual, or
Transgender? Q08
1
1
2
3
3. What city or town or village do you live in? Q03
1
2
3
888
1
2
3
4
Yes
0
No
9. Do you now smoke cigarettes every day, some days,
or not at all? Q09
1. How old are you? Q01
2. Are you:
7. What is the highest grade or year of school you
completed to date? Q07
No
New Mexico Community Survey 2015
Page 1 of 4
Every day
Some days
Not at all
10. Do you currently use chewing tobacco or snuff, every
day, some days, or not at all? Q10
1 Every day
2 Some days
3 Not at all
11. In the past year, have you purchased or otherwise
provided tobacco (cigarettes, chew, snuff) for
someone under 18, even if it was for your own child?
(not including tobacco used for religious purposes)
Q11
1
Yes
0
No
999
Don’t know
12. Have you ever used an electronic vapor product? Q12
1 Yes 0 No
13. During the past 30 days, on how many days did you
use an electronic vapor product? Q13
0
1
2
3
4
5
6
0 days
1 or 2 days
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days
14. How easy do you think it is for teens in your
community to get alcohol? Q14
1
2
3
Very easy
Somewhat easy
Somewhat difficult
4
999
Very difficult
Don’t know
15. How easy do you think it is for teens in your
community to get alcohol from stores and
restaurants? Q15
1
2
3
Very easy
Somewhat easy
Somewhat difficult
4
999
Very difficult
Don’t know
16. In your opinion, how likely are police in your
community to break up parties where teens are
drinking? Q16
1
2
3
Very likely
4
Somewhat likely 999
Not very likely
Not at all likely
Don’t know
17. How likely are police in your community to arrest an
adult for giving alcohol to someone under 21? Q17
1 Very likely
4 Not at all likely
2 Somewhat likely 999 Don’t know
3 Not very likely
18. In your opinion, if someone was caught selling
alcohol to a drunk or intoxicated person in your
community, how likely is it that he/she would be
arrested? Q18
1 Very likely
4 Not at all likely
2 Somewhat likely 999 Don’t know
3 Not very likely
19. In your opinion, if you were driving after you had too
much to drink, how likely is it you would be stopped
by police? Q19
1
2
3
Very likely
4
Somewhat likely 999
Not very likely
Not at all likely
Don’t know
20. If you were driving after you had too much to drink
and were stopped and charged with DWI, how likely
is it you would be convicted?Q20
1
2
3
Very likely
4
Somewhat likely 999
Not very likely
Not at all likely
Don’t know
21. In general, how many alcoholic drinks do you
typically consume in a week (including weekends)?
Q21
0 None
________ Drinks a week (1 or more)
22. Think specifically about the past 30 days. During the
past 30 days, on how many days did you drink one or
more drinks of an alcoholic beverage (if any)? Q22
0
1
0 days
1 or 2 days
New Mexico Community Survey 2015
2
3
4
5
6
3 to 5 days
6 to 9 days
10 to 19 days
20 to 29 days
All 30 days
23. Considering all types of alcoholic beverages, how
many times during the past 30 days did you have 5 or
more drinks on an occasion (if any)? Q23
0 None
_________ Times in past 30 days
24. During the past 30 days, how many times have you
driven when you’ve had perhaps too much to drink?
Q24
0 None
__________ Times in past 30 days
25. During the past 30 days, have you driven a vehicle
after drinking 5 or more alcoholic beverages? Q25
1
Yes
0
No
26. If you are 18 to 20 years old, please answer this
question: During the past 30 days, how did you get
your alcohol? (Check all that apply.)
For each item enter 1 if selected. If not selected,
leave it blank.
Q26_1
Q26_2
Q26_4
I have not drunk alcohol in the past 30 days.
Adult family member who is 21 or older gave it
or bought it for me.
Someone not related to me who is 21 or older
gave it or bought it for me.
I got it at a party.
Q26_5
My parent or guardian gave it or bought it for me.
Q26_6
I took it from my home or someone else’s home.
Q26_7
I bought it at a store, restaurant, bar or public
place
Q26_8
Someone under age 21 bought or gave it to me.
Q26_3
Q26_9
I got it some other way. [Please describe]:
Q26oth___________________________________
27. In your opinion, when is it okay for someone to
provide alcohol to minors (i.e., under 21) (not for
religious purposes). Check all that apply.
For each item enter 1 if selected. If not selected,
leave it blank.
Never Q27_1
If parents give their permission Q27_2
If they are supervised by an adult Q27_3
Page 2 of 4
If they are drinking at home Q27_4
If they are responsible (mature for their age, a
good student, etc.) Q27_5
If there is a celebration (e.g., wedding,
quinceañera, graduation) Q27_6
34. If you took painkillers in the last 30 days, why did
you take them? (Check all that apply.)
For each item enter 1 if selected. If not selected,
leave it blank.
To treat pain that my doctor or dentist identified
(for example, injury, surgery, tooth extraction,
illness)Q34_1
As long as they are not driving and are safe
Q27_7
For pain not identified by my physician (e.g.,
minor injury) Q34_2
If they are in the military Q27_8
Other Q27_9 [Please describe]:
Q27oth_____________________________
To have fun with a friend or friend(s) socially
Q34_3
To help me sleep Q34_4
28. In the past year, have you purchased or otherwise
provided alcohol (beer, wine, liquor) for someone
under 21, even if it was for your own child? (not
including alcohol used for religious purposes) Q28
1
Yes
0
No
999
Yes
0
No
30. How much do you think people risk harming
themselves (physically or in other ways) using
prescription pain killers for a non-medical
reason?Q30
1
2
3
4
Q34oth________________________
35. If you used painkillers in the last 30 days for any
reason, where did you get them? (Check all that
apply.)
For each item enter 1 if selected. If not selected,
leave it blank.
A doctor or doctors prescribed or gave them to
me Q35_1
A family member shared them Q35_2
A friend shared them Q35_3
They were bought from somebody (e.g., friend,
dealer, family member) Q35_4
They were taken from someone (including
friends or relatives) without asking Q35_5
0 times
1 or 2 times
3 to 9 times
3
4
5
10 to 19 times
20 to 39 times
40 or more times
32. In the last 30 days, did you use prescription pain
killers for any reason (even if you were not prescribed
them)? Q32
1
Another reason Q34_7 [Please describe]:
No risk
Slight risk
Moderate risk
Great risk
31. During the past 30 days, how many times did you use
a pain killer to get high, like Vicodin, OxyContin
(also called Oxy or OC), or Percocet (also called
Percs)? Q31
0
1
2
To cope with anxiety or stress Q34_6
Don’t know
29. In the past year, were you prescribed painkillers by a
medical professional (even if you did not take them)?
Q29
1
To get high, messed up or stoned Q34_5
Yes
0
No – If you answer no, please skip
to question 36.
33. If you’ve taken prescription painkillers in the last 30
days, on how many days did you take them? Q33
____ days in the last 30 days (1-30)
New Mexico Community Survey 2015
Page 3 of 4
Other place Q35_6 (e.g., Mexico, internet):
Q35oth______________________________
36. In the past year, have you given or otherwise shared
any prescription drugs with someone that was not
prescribed them (even if that person was a close
friend or family member)? Q36
1
Yes
0
No
37. Are all your prescription painkillers stored in a locked
cabinet or box so that others cannot get to them
(including youth and family)? Q37
1 Yes
0
No
888 I do not have any prescription painkillers
38. During the past 4 weeks (28 days), how much of the
time did you feel … (Circle the best response)
a) …so sad
nothing could
cheer you up?
Q38_1
b) …nervous?
Q38_2
All of
the
time
1
Most
of the
time
2
Some
of the
time
3
A
little
of the
time
4
None
of the
time
5
1
2
3
4
5
d) …hopeless?
Q38_4
1
e) … that
everything was
an effort?
Q38_5
1
f) …worthless?
Q38_6
1
g)…anxiety?
Q38_7
1
2
3
4
Wake Up Now Q43_7
2
2
3
3
4
4
5
2
3
4
5
Q44_1
Q44_2
2
3
4
5
0
No
0
0
No
42. During the past year, have you had difficulty
accessing treatment for a mental health or substance
abuse problem? Q42
Yes
0
No
New Mexico Community Survey 2015
Q44_3
Q44_4
Q44_5
Q44_6
Page 4 of 4
Stay in school if you want to be successful.
Prescription drugs can be dangerous if not used
as intended.
Reality is harsh, but medication can help.
Daily exercise is good for your health.
Take your medication as directed by your
doctor.
Vaccinate your kids.
45. Would you support a 25 cents per drink tax on
alcohol to reduce underage drinking and provide
more health care? Q45
1
No
41. In the past year, have you ever sought help from
someone other than your friends or family for your
emotions, nerves, mental health, or your use of
alcohol or drugs? Q41
1
44. What do you think is the main prevention message of
the campaign “A Dose of Reality”? Check only one
option.
If there are one or more items selected, enter 1 for the
selected questions. If not selected, leave it blank.
Yes
Yes
I’ve never heard of any of these. Q43_8
5
40. At any time in the past 12 months, did you seriously
think about trying to kill yourself? Q40
1
Up and Away and Out of Sight Q43_6
5
39. In the past year, was there any time when you thought
you had a mental health, nervous, emotional, drug or
alcohol problem? Q39
1
Parents Who Host Lose the Most Q43_4
A Dose of Reality Q43_5
1
Yes
For each item enter 1 if selected. If not selected,
leave it blank.
Be the Solution Q43_1
Suck It Up! Q43_2
Good Drugs Gone Bad Q43_3
c) …restless or
fidgety?
Q38_3
1
43. The following is a list of different drug prevention
media campaigns. Please check the box next to those
you recognize or have heard of:
Yes
0
No
999
Not Sure
46. Is there anything else you’d like to tell us or add about
the issues we have asked about today? [Please write your
comments in the box below.] Q46