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This survey is not intended to separate anyone or target any group of individuals. The purpose is to simply understand everyone's viewpoint and the habits of smokers and nonsmokers. Sharing ideas allow us to better meet everyone's needs.

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 Human Resources.

Thank you very much for your time and support.
 
 
 
This survey is not intended to separate anyone or target any group of individuals. The purpose is to simply understand everyone's viewpoint and the habits of smokers and nonsmokers. Sharing ideas allow us to better meet everyone's needs.

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 Human Resources.

Thank you very much for your time and support.
 
 
 
Do you smoke cigarettes? 
 
Yes
 
No
 
 
 
* If you are a smoker, how many times a day do you take smoke breaks?
(skip to question 3 if you are not a smoker)
 
none
 
once a day
 
twice a day
 
three times a day
 
four or more times a day
 
N/A skip to question 3

 
 
 
* How often do you see smokers take breaks outside of their normal break times?
 
never noticed
 
once a day
 
twice a day
 
three times a day
 
four or more times a day
 
 
 
* When smoke breaks are taken more than twice (average break times), do you think this affects productivity?
 
Yes
 
No
 
 
 
* Do you think the company should become a smoke-free campus? (no smoking anywhere on the property)
 
Yes
 
No
 
 
 
Do you think it would be beneficial if the company offered a smoking cessation program?
 
Yes
 
No