E Cigarettes

What gender are you

Male

Female

What age group are you in

What age did you start smoking

Do you smoke cigarettes, e-cigarettes or both

When did you start using E Cigarettes?

A year or more

Less than a year

Does your employer permit using e cigarette at work

Do you know what chemicals are in the fluid?

How much liquid or how many e cigarettes do you use each day

Have you ever spilt the liquid on your skin?

Yes

No

Did you get a reaction needing medical attention

Yes

No

n/a