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Hello: You are invited to participate in our survey [Tobacco Products Here]. In this survey, approximately [15-25] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [5] minutes to complete the questionnaire. Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions. Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [America Cancer Research Center] at [1-800-222-STOP] or by email at the email address specified below. Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.
 
 
 
We are interested in your valuable opinion on Tobacco use. How familiar are you with the product?
 
Very Familiar
 
Familiar
 
Neutral
 
Unfamiliar
 
Very Familiar

 
 
 
During the past year, have you notice any of the following types of promotion for tobacco products?
 
Billboard
 
Commercial
 
Magazine
 
Television
 
 
 
During the past year, have you notice any of the following types of promotion for tobacco products?
 
Billboard
 
Commercial
 
Magazine
 
Television
 
 
 
Have you seen advertisements for tobacco promotions? 
 
Yes
 
No
 
 
 
Have you ever read the health warning on tobacco products (i.e. cigarette package)?
 
Yes
 
No
 
 
 
Do you receive free samples on tobacco products in the mail?
 
Yes
 
No
 
 
 
How often do you conduct surveys?
 
Weekly
 
Monthly
 
Quarterly
 
Annually
 
 
 
Do you see advertisements for coupons, or sales of tobacco products?
 
Yes
 
No
 
 
 
Are you aware of all the diseases you can get from tobacco use? 
 
Yes
 
No
 
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