Form 2 (Core Questionnaire) of NATSC Cambodia consists of 11 sections. Eight of these sections contain GATS survey items that have been adapted for use in Cambodia. A general description of each section that contains GATS items is described below (the questionnaire is provided in Appendix A):
• Tobacco smoking: Patterns of use (daily consumption, less than daily consumption, not at all), former/past tobacco consumption, age of initiation of daily smoking, consumption of different tobacco products, (cigarettes, pipes, cigars and other smoked tobacco), nicotine dependence, frequency of quit attempts.
• Smokeless tobacco: Patterns of use (daily consumption, less than daily consumption, not at all), former/past use of smokeless tobacco, age of initiation of daily use of smokeless tobacco, consumption of different smokeless tobacco products (snuff, chewing tobacco, betel quid, etc.), nicotine dependence, frequency of quit attempts.
• Cessation: Advice to quit smoking by health care provider, method used to try to stop smoking. Similar information is asked for cessation on smokeless tobacco as well.
• Secondhand smoke: Smoking allowed in the home, exposure to secondhand smoke at home, indoor smoking policy at work place, exposure during the last 30 days in: work place, government buildings/offices, health care facilities, restaurants, public transportation.
• Economics: Type of tobacco product and quantity bought, cost of tobacco product(s), brand, type of product purchased, and source of tobacco products.
• Media: Exposure to advertisement (television, radio, billboards, posters, newspapers/magazines, cinema, internet, public transportation, public walls, others); exposure to sporting events connected with tobacco; exposure to music, theatre, art or fashion events connected with tobacco; exposure to tobacco promotion activities; reaction to health warning labels on cigarette packages; exposure to anti-tobacco advertising and information. Similar questions are included for smokeless tobacco as well. The reference period for the questions in this section is 30 days.
• Knowledge, attitudes and perceptions: Knowledge about health effects of both smoking and smokeless tobacco.
In sum, NATSC 2011 survey items were designed from several sources of input: 1) GAT items, 2) focus groups conducted on tobacco and health issues in rural and urban centers, 3) survey research done as part of the TCLT program, and 4) consultation with local nongovernmental organizations that had conducted provincial surveys on tobacco use. Since the multidisciplinary group who designed the survey included both English and Khmer speaking investigators, there was need for translation from a working English document. The written survey items were translated and back-translated to verify content, criteria and semantic equivalence by bilingual and monolingual experts who used the methods described by Flaherty et al. Pre-testing among subjects in urban and rural centers was also done and the findings were used to refine the final wording of the NATSC survey.