Surveys 2015 March A Anti-Smoking Campaign

Anti-Smoking Campaign

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Exit Survey

Have you ever smoked tobacco?   Yes   No       If yes, how old were you when you first smoked?   8-13   14-17   18-20   21-24   25 or older   I've never smoked       Why did you start smoking? Please explain       When was the last time you smoked?   Never   Today   1-6 days ago   More than a week ago   1-5 months ago   6-11 months ago   More than a year ago       What is your preferred way of smoking?   Cigarettes   Pipes   Cigars   Other         If cigarettes, how many do you smoke per day?   None   1-2   3-5   6-10   11-16   17-19   20-30   31-40   More than 40       How much money do you spend buying tobacco per month?   None   Less than $5.00   $5.01-$7.00   $7.01-$10.00   $10.01-$20.00   $20.01-$40.00   More than $40.00       What brand of cigarette do you smoke? (Check all that apply)   None   Any   Marlboro   Camel   Newports   Virginia Slims   American Spirit   Pall Mall   Other         Have you ever tried to quit?   Yes   No   I never started       If yes, how many times?   None   One to two   Three to four   Five or more       What was the longest time you have gone without smoking?   I have never smoked   Less than a day   1 day   2 days to a week   2-3 weeks   1 month   2-5 months   6-11 months   1 year   1-2 years   3-5 years   More than 5 years       Did you use any anti-smoking aids in order to help you quit? (patches, gum, etc.)   Yes   No   I've never tried to quit       If yes, what did you use? (Check all that apply)   None   Gum   Patches   E-cigarettes   Friends/family help   Other         How helpful were these anti smoking aids? «Not helpful at all Extremely helpful» 0 1 2 3 4 5 6 7 8 9 10       Are you familiar with any of the following anti-smoking campaigns? (Check all that apply)   The Truth   The Real Cost   Tobacco Free Kids   Other         Did any television advertisements help convince you to quit? (If yes, please explain what happened in the advertisement.)   No   Yes         Are you aware of the risks of smoking?   Yes   No       Which of these risks are you MOST concerned about?   Yellow teeth   Tooth loss   Black lungs   Organ failure   Heart disease   Cancer   Other         Which of these risks are you LEAST concerned about?   Yellow teeth   Tooth loss   Black lungs   Organ failure   Heart disease   Cancer   Other         Gender?   Male   Female   Other       Are you currently enrolled at a university?   Yes   No       If yes, what university?       Age?   Less than 15   16-18   19-21   22-26   27 or older       Race/Ethnicity?   American Indian or Alaska Native   White   Black or African American   Native Hawaiian or Other Pacific Islander   Asian   Hispanic/Latino   Other