| 1.
|
How often do you have a drink containing alcohol?
|
Never
|
| Monthly or less (1) |
| Two to four times a month (2) |
| Two to three times a week (3) |
|
Four or more times a week (4)
|
| 2.
|
How many drinks containing alcohol do you have on a typical day when you are drinking?
|
1 or 2 (0) |
| 3 or 4 (1) |
| 5 or 6 (2) |
| 7 to 9 (3) |
| 10 or more (4) |
| 3.
|
How often do you have six or more drinks on one occasion?
|
Never |
| Monthly or less (1) |
| Two to four times a month (2) |
| Two to three times a week (3) |
| Four or more times a week (4) |
| 4.
|
How often during the last year have you found that you were not able to stop drinking once you had started?
|
Never |
| Monthly or less (1) |
| Two to four times a month (2) |
| Two to three times a week (3) |
| Four or more times a week (4) |
| 5.
|
How often during the last year have you failed to do what was normally expected from you because of drinking?
|
Never |
| Monthly or less (1) |
| Two to four times a month (2) |
| Two to three times a week (3) |
| Four or more times a week (4) |
| 6.
|
How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?
|
Never |
| Monthly or less (1) |
| Two to four times a month (2) |
| Two to three times a week (3) |
| Four or more times a week (4) |
| 7.
|
How often during the last year have you had a feeling of guilt or remorse after drinking?
|
Never |
| Monthly or less (1) |
| Two to four times a month (2) |
| Two to three times a week (3) |
| Four or more times a week (4) |
| 8.
|
How often during the last year have you been unable to remember what happened the night before because you had been drinking?
|
Never |
| Monthly or less (1) |
| Two to four times a month (2) |
| Two to three times a week (3) |
| Four or more times a week (4) |
| 9.
|
Have you or someone else been injured as a result of your drinking?
|
No (0) |
| Yes, but not in last year (2) |
| Yes, during last year (4 |
| 10.
|
Has a relative or friend, or a doctor or other health worker been concerned about your drinking or suggested you cut down?
|
No
(0) |
| Yes,but not in last year (2) |
| Yes, during last year (4) |
|
|
|
Total |