Protocol - Amount, Type, and Frequency of Recent Use of Nicotine Products
Description
The TLFB (Timeline Followback) protocol can be used to track use of single or multiple products. It traditionally tracks cigarette use for 30 days and has also been used for marijuana, alcohol and other drugs. The TLFB can be administered by an interviewer, self-administered, or administered by computer. It involves asking clients to retrospectively estimate their tobacco use 7 days to 2 years prior to the interview date. For cigarettes, individuals are asked to estimate the number of cigarettes smoked per day.
Specific Instructions
Select the appropriate calendar.
To assess use in every day and someday smokers in a range of 14-30 days, insert the number of days you wish to assess in the protocol.
Although this question only asks about the use of cigarettes, the Biobehavioral Working Group feels that these questions can be asked about other tobacco products. When asking about multiple products, this protocol can identify co-occurring use of tobacco products. Specify each product you are asking about, for example:
Cigarettes: Specify the number of cigarettes you smoked each day
Cigars: Specify the number of premium cigars, large cigars, cigarillos, and little filtered cigars you smoked each day
Pipes: Specify the number of bowls filled with pipe tobacco that were smoked each day
Hookah: Specify the number of sessions in which you smoked hookah each day
E-cigarettes: Specify the number of e-cigarettes, e-cigarette cartridges, or milliliters of e-liquid you used each day (add these up if you used more than one type of e-cigarette product in a given day)
Smokeless tobacco: Specify the number of chews of chewing tobacco, dips of loose snuff, snuff pouches, or snus pouches that you used each day
Dissolvables: Specify the number of pieces of dissolvable tobacco you used each day
Bidis: Specify the number of bidis you smoked each day
Kreteks: Specify the number of kreteks (clove cigarettes from Indonesia) you smoked each day
Oral Nicotine Products: Specify the number of oral nicotine products (e.g., oral nicotine pouches, lozenges, gum, gummies, etc.) you used each day
Heated Tobacco Products: Specify the number of heated tobacco products (e.g., IQOS HeatSticks) you used each day
Availability
Protocol
| ✓ Instructions for Filling Out the Timeline Cigarette Use Calendar |
To help us evaluate your cigarette use, we need to get an idea of what your smoking was like in the past ____ days. To do this, we would like you to fill out the attached calendar.
✓ Filling out the calendar is not hard!
✓ Try to be as accurate as possible.
✓ We recognize you won’t have perfect recall. That’s OKAY.
✓ WHAT TO FILL IN
•The idea is to record how many cigarettes you smoked for each day on the calendar.
•On days when you did not smoke cigarettes, not even one, you should write a "0."
It’s important that something is written for every day, even if it is a 0".
✓ YOUR BEST ESTIMATE
•We realize it isn’t easy to recall things with 100% accuracy.
•If you are not sure whether you smoked 15 or 16 cigarettes or whether you smoked on a Thursday or a Friday, give it your best guess! What is important is that 15 or 16 cigarettes is very different from 1 cigarette. The goal is to get a sense of how frequently you smoked, how much you smoked, and your patterns of smoking.
✓ HELPFUL HINTS
•If you have an appointment book you can use it to help you recall your use.
•Holidays such as Thanksgiving and Christmas are marked on the calendar to help you recall your smoking. Also, think about how much you smoked on personal holidays & events such as birthdays, vacations, or parties.
•If you have regular patterns to your smoking, you can use these to help you recall your use. For example, some people may only smoke during social situations.
✓ COMPLETING THE CALENDAR
•A blank calendar is attached. Write in the number of cigarettes you smoked on each day.
• The time period we are talking about on the calendar is
from ________________________ to _______________________.
•In estimating the number of cigarettes you smoked, be as accurate as possible.
•DOUBLE CHECK THAT ALL DAYS ARE FILLED IN BEFORE RETURNING THE CALENDAR.
• Before you start look at the SAMPLE CALENDAR.
✓ SAMPLE CALENDAR
| 2000 | SUN | MON | TUES | WED | THURS | FRI | SAT |
| S E P T | 1 20 | 2 0 | |||||
| 3 20 | 4 Labor Day 20 | 5 23 | 6 28 | 7 21 | 8 20 | 9 23 | |
| 10 20 | 11 20 | 12 20 | 13 28 | 14 25 | 15 0 | 16 24 | |
| 17 20 | 18 20 | 19 20 | 20 20 | 21 22 | 22 22 | 23 24 | |
| 24 21 | 25 22 | 26 26 | 27 24 | 28 23 | 29 0 | 30 22 |
Personnel and Training Required
None
Equipment Needs
Calendar
Requirements
| Requirement Category | Required |
|---|---|
| Major equipment | No |
| Specialized training | No |
| Specialized requirements for biospecimen collection | No |
| Average time of greater than 15 minutes in an unaffected individual | Yes |
Mode of Administration
Interviewer-administered questionnaire
Lifestage
Adolescent, Adult
Participants
Adults and adolescents 13 years and over
Selection Rationale
A timeline follow-back provides a validated way to assess an individual’s patterns of tobacco use over extended timeframes.
Language
English
Standards
| Standard | Name | ID | Source |
|---|---|---|---|
| Human Phenotype Ontology | Triggered by smoking | HP:0025223 | HPO |
| caDSR Form | PhenX PX720101 - Amount Type And Frequency Of Recent Cigarette Use | 6238453 | caDSR Form |
Derived Variables
None
Process and Review
The Tobacco Regulatory Research (TRR) Content Expert Panel (CEP) reviewed the measures in the Tobacco Regulatory Research collection in February 2024.
Guidance from the TRR CEP includes:
- Name changed to include all nicotine products rather than just cigarettes
- Updates to specific instructions, source references, and participant ages
Previous version in Toolkit archive (link)
Protocol Name from Source
The Timeline Followback (TLFB)
Source
Robinson SM, Carter Sobell L, Sobell MB, Leo GI. (2014). Reliability of the Timeline Followback for cocaine, cannabis, and cigarette use. Psychol Addict Behav, 28(1), 154-162. doi: 10.1037/a0030992
Lewis-Esquerre JM, Colby SM, OLeary Tevyaw T, Eaton CA, Kahler CW, Monti PM. (2005). Validation of the timeline follow-back in the assessment of adolescent smoking. Drug Alcohol Depend, 79(1), 33-43. doi: 10.1016/j.drugalcdep.2004.12.007
General References
NoneProtocol ID
720101
Variables
Export Variables| Variable Name | Variable ID | Variable Description | dbGaP Mapping | |
|---|---|---|---|---|
| PX720101_Cigarette_Use_Assessment_Amount | ||||
| PX720101200000 | Assessment of how much smoked, derived from more | Variable Mapping | ||
| PX720101_Cigarette_Use_Assessment_Frequency | ||||
| PX720101400000 | Assessment of how frequently smoked, derived more | Variable Mapping | ||
| PX720101_Cigarette_Use_Assessment_Period_Days | ||||
| PX720101100000 | To help us evaluate your cigarette use, we more | Variable Mapping | ||
| PX720101_Cigarette_Use_Assessment_Type | ||||
| PX720101300000 | Assessment of patterns of smoking, derived more | Variable Mapping | ||
Measure Name
Amount, Type, and Frequency of Recent Use of Nicotine Products
Release Date
February 20, 2015
Definition
The Timeline Follow-Back (TLFB) is a method to assess recent cigarette tobacco use.
Purpose
To measure patterns of a person’s cigarette use. It provides detailed information about frequency and intensity of use.
Keywords
Co-occurring use, timeline follow-back, cigarette use, calendar, patterns of use, smoking, multiple products, TLFB, timeline follow back, frequency, cigarette
Measure Protocols
| Protocol ID | Protocol Name |
|---|---|
| 720101 | Amount, Type, and Frequency of Recent Use of Nicotine Products |
Publications
Garcia-Cazarin, M.L., Mandal, R.J., Grana, R., Wanke, K.L., Meissner, H. (2020) Host-agent-vector-environment measures for electronic cigarette research used in NIH grants. Tobacco Control. 2020 January; 29(1). doi: 10.1136/tobaccocontrol-2017-054032
Conway, K. P., et al. (2018) Co-occurrence of tobacco product use, substance use, and mental health problems among youth: Findings from wave 1 (2013-2014) of the population assessment of tobacco and health (PATH) study. Addict Behav. 2018 January; 76: 208-217. doi: 10.1016/j.addbeh.2017.08.009