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Questionnaire shown in Appendix 3 was abstracted from the Right from the Start Baseline Questionnaire (Section C, Health Behaviors, pp. 9-13), as prepared by Savitz (co- Principal Investigator) and colleagues at the Department of Epidemiology, The University of North Carolina at Chapel Hill (CATI Version 2, October 25, 2001. Text updated to match CATI on December 16, 2002).

The next questions are about caffeine intake. I will ask you about how much coffee, tea, and soda you usually drink per day.

Ca. For the questions about caffeine intake, please think about what you drank over the past week when answering what you currently drink in a typical day. Try to answer these questions about your usual habits even if some days you drank a different amount than on other days.

Was this past week a typical week for you, meaning that you weren’t on vacation or there wasn’t anything unusual that would affect your coffee, tea or soda use?

Yes

No then, for all the following questions please think about a different week that you would consider a more typical week for you.

Caffeinated coffee

[interviewer notes: include hot and/or cold coffee]

C1a. Currently, how many cups of caffeinated coffee do you usually drink per day?

____ # per day ____<1 per day skip to C1c. none skip to C1c. ____ don’t know/refused skip to C1c.

C1asize. Are those cups usually small like a tea cup, about 4-10 oz; medium like a coffee mug, about 12-14oz; or large like an travel mug or oversized coffee mug, about 16-24oz?

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C1b. Do you usually drink instant or brewed coffee?[brewed includes espresso] brewed instant both [only if 50/50] don’t know/refused C1c. In the past 4 months, since [date], have you changed the amount of

caffeinated coffee you drink?

yes no skip to C2a. don’t know/refused skip to C2a. C1d. When did you change the amount of caffeinated coffee you drink?

month: ____ day: ______ [if doesn’t remember day ask C1e.] year: ___ doesn’t remember/refused

C1e. Do you remember what week in [month] that was, the first, second, third, fourth, or fifth?

___1st ____2nd ___ 3rd ____ 4th ___ 5th doesn’t remember/refused

C1f. Before you changed, how many cups of caffeinated coffee did you usually drink per day?

______ # per day ____<1 per day none

C1g. Were those cups usually small like a tea cup, about 4-10 oz; medium like a coffee mug, about 12-14oz; or large like an travel mug or oversized coffee mug, about 16-24oz?

Sm Med Lg Other: specify _______ don’t know/refused

Hot caffeinated tea

Now I’m going to ask you about caffeinated tea.

C2a. Currently, how many cups of hot caffeinated tea do you usually drink per day? ____ # per day ____<1 per day skip to C2b. none skip to C2b. Don’t know/refused skip to C2b.

C2asize. Are those cups usually small like a tea cup, about 4-10 oz; medium like a coffee mug, about 12-14oz; or large like an travel mug or oversized coffee mug, about 16-24oz?

Sm Med Lg Other: specify _______ don’t know/refused

C2b. In the past four months, have you changed the amount of hot caffeinated tea you drink?

yes no skip to C3a. don’t know/refused skip to C3a.

C2c. When did you change the amount of hot caffeinated tea you drink? month: ____ day: ______ [if doesn’t remember day ask C2d.] year: ___ doesn’t remember/refused

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C2d. Do you remember what week in [month] that was, the first, second, third, fourth, or fifth?

___1st ____2nd ___ 3rd ____ 4th ___ 5th doesn’t remember/refused

C2e. Before you changed, how many cups of hot caffeinated tea did you usually drink per day?

______ # per day ____<1 per day none

C2f. Were those cups usually small like a tea cup, about 4-10 oz; medium like a coffee mug, about 12-14oz; or large like an travel mug or oversized coffee mug, about 16- 24oz?

Sm Med Lg Other: specify _______ don’t know/refused

Iced caffeinated tea

[interviewer notes: both brewed and instant]

C3a. Currently, how many glasses of iced caffeinated tea do you usually drink per day? ____ # per day ____<1 per day skip to C3b. none skip to C3b.

Don’t know/refused skip to C3b.

C3asize. Are those glasses usually small like a juice glass, about 4-10oz; medium like a water glass, about 12-20; or large like a giant size drink at the movies/Fast food, about 22-34oz?

Sm Med Lg Other: specify _______ don’t know/refused

C3b. In the past four months, have you changed the amount of iced caffeinated tea you drink?

yes no skip to C4a. don’t know/refused skip to C4a.

C3c. When did you change the amount of iced caffeinated tea you drink? month: ____ day: ______ [if doesn’t remember day ask C3d.] year: ___ doesn’t remember/refused

C3d. Do you remember what week in [month] that was, the first, second, third, fourth, or fifth?

___1st ____2nd ___ 3rd ____ 4th ___ 5th doesn’t remember/refused

C3e. Before you changed, how many glasses of caffeinated tea did you usually drink per day?

______ # per day ____<1 per day none

C3f. Were those glasses usually small like a juice glass, about 4-10oz; medium like a water glass, about 12-20; or large like a giant size drink at the movies/Fast food, about 22-34oz?

151 Decaffeinated drinks

[interviewer notes: for both C4a and C4b. include hot or cold drinks]

C4a. Currently, how many cups of decaffeinated coffee do you usually drink per day? ____ # per day ____<1 per dayskip to C4b. noneskip to C4b.

Don’t know/refusedskip to C4b.

C4asize. Are those cups usually small like a tea cup, about 4-10 oz; medium like a coffee mug, about 12-14oz; or large like an travel mug or oversized coffee mug, about 16-24oz?

Sm Med Lg Other: specify _______ don’t know/refused C4b. Currently, how many cups of decaffeinated tea do you usually drink per day?

____ # per day ____<1 per day skip to C5a. noneskip to C5a. don’t know/refusedskip to C5a.

C4bsize. Are those cups usually small like a tea cup, about 4-10 oz; medium like a coffee mug, about 12-14oz; or large like an travel mug or oversized coffee mug, about 16-24oz?

Sm Med Lg Other: specify _______ don’t know/refused

Sodas/soft drinks

The next questions are about sodas and soft drinks.

C5a. Currently, do you drink one or more cans, bottles or glasses of soda or soft drinks per day, including tonic water, club soda, soda water, seltzer and caffeinated water?

yes no skip to C5g. don’t know/refused skip to C5g.

C5b. What brand or type of soda do you drink most often? Anything else [Up to 4 brands, those she usually/regularly drinks. If store brand, include name of store and type of soda, ie. cola.]

_____________ _____________ _______________ _____________ C5c. Is (brand) diet? [for each of up to 4 types/brands she drinks ask C5c.]

yes no don’t know/refused

C5d. Is (brand) caffeine free?[for each of up to 4 types/brands she drinks ask C5d.]

Yesif yes for all sodas skip to C5g No Don’t know/refused

[for each type/brand she drinks that is caffeinated or if she doesn’t know if it’s caffeinated, ask C5e-C5f.]

C5e. How many cans, bottles or glasses of ______ do you usually drink per day? ____ # per day ____<1 per day skip to C5g.

C5f. Are those usually small like a can of soda, about 8-12oz, medium like a small soda bottle about 14-22oz or large like a giant drink at the movies or fast food, about 24- 34oz?

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[Ask C5g-C5j about caffeinated drinks as a whole, not for each individual brand.]

C5g. The next questions are only about caffeinated sodas. In the past 4 months, have you changed the amount of caffeinated soft drinks/sodas you usually drink?

yes no skip to C6a. don’t know/refused skip to C6a. C5h. When did you change the amount of caffeinated soft drinks/sodas you drink?

month: ____ day: ______ [if doesn’t remember day ask C5i.] year: ___ doesn’t remember/refused

C5i. Do you remember what week in [month] that was, the first, second, third, fourth, or fifth?

___1st ____2nd ___ 3rd ____ 4th ___ 5th doesn’t remember/refused

C5j. Before you changed, how many cans, bottles or glasses of caffeinated soda or soft drinks did you usually drink per day?

______ # per day ____<1 per day skip to C6a. none skip to C6a.

C5k. Were those usually small like a can of soda, about 8-12oz, medium like a small soda bottle about 14-22oz or large like a giant drink at the movies or fast food, about 24- 34oz?

sm med lg Other _______ don’t

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