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Questions marked with an * are required Exit Survey
 
 
* Are you male/female?
 
Male
 
Female
 
 
 
* How old are you?
 
17yrs or less
 
18-24
 
25-34
 
35-44
 
45-54
 
55-64
 
65+
 
 
 
* Which would you consider your ethnicity/race?
 
 
White (Caucasian)
 
Black (African Black, Caribbean Black, other Black)
 
Asian (Chinese, Indian, Pakistani, Banglasheshi, Other asian)
 
Arab
 
Hispanic/Latino
 
Other
 
 
 
 
What is your profession?
 
Student
 
(Skilled) Manual Worker
 
Office Worker
 
Driver
 
Professional (e.g. doctor, dentist, teacher, lawyer etc)
 
Healthcare
 
Retail
 
Unemployed
 
Retired
 
Other
 
 
 
 
* Do you have any health probs
 
Yes
 
No
 
Details
 
 
 
 
How many cigs/day?
 
1-10
 
11-20
 
21-30
 
31-40
 
41+