Smoking

Have you ever tried smoking?

• Yes
• No

Where did you try it?

Please select all that apply.

• At a party
• Bought your own
• With your friends
• Other

Do you smoke at this present time? (If no skip to Q6)

• Yes
• No

How often do you smoke?

• 1-3 days a week
• 4-7 days a week
• Only socially

How long have you smoked for?

• 1 year or less
• 2-5 years
• 5-10 years
• 10-20 years
• More than 20 years

Do you know people who smoke?

• Yes
• No

Do you see any differences in people who smoke? (If no skip to Q9)

• Yes
• No

If yes, what are these changes?

Please select all that apply.

• Their personality
• You don't see them as much
• They emotions change
• Other

Does this affect you in any way? How?

Please select all that apply.

• Socially - they don't get out to many places
• Physically - Your health when around them
• Socially - place are limited where you can go due to no smoking areas
• Other

Do you mind being around smokers?

• Yes
• No
• It doesn't bother me

Do you think these people have/will influence you to smoke?

Please select all that apply.

• Yes
• No
• Maybe

How could they influence you?

Please select all that apply.

• Being around them
• Peer pressure
• Out of Habit