Now I will read you some statements about your relationship with your current or most recent spouse, even if you are divorced or widowed: I like to let my wife/partner know that she isn’t the only wife/partner I could have

Did any of these acts take place in front of children?

Before I reached age 18, I saw or heard my mother being insulted, belittled or humiliated by my father or another male relative

Before I reached 18, I had sex with someone because I was threatened, frightened or forced

Before I reached age 18, someone touched my intimate parts when I did not want them to

Do you feel that you smoke too much?

Have you ever had a health problem related to your smoking?

Do you smoke?

Which drugs or intoxicants, if any, have you ever tried? Alcohol

Which drugs or intoxicants if any have you ever tried? Stimulants