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Exit Survey
 
 
Do you or did you previously smoke cigarettes?
 
Yes
 
No
 
 
 
Before the use of the vapor pen, did you smoke cigarettes?
 
Yes
 
No
 
 
 
Do you still smoke cigarettes?
 
Yes
 
No
 
 
 
If you still smoke cigarettes, how many do you consume a day?
 
1/3 of a pack a day (around 6)
 
½ of a pack a day (10)
 
¾ of a pack a day (15)
 
A pack a day
 
More than a pack a day
 
Less than or equal to 5 a day
 
Not applicable
 
 
 
How long did or have you been smoking cigarettes? (please indicate in number of: days, weeks, months, or years)
   
 
 
 
How long have you been using the vapor pen? (please indicate in number of: days, weeks, months, or years)
   
 
 
 
What nicotine level did you start out on when you first stated using the vapor pen?
 
0mg
 
6mg
 
12mg
 
18mg
 
24mg
 
 
 
What nicotine level are you currently on now?
 
0mg
 
6mg
 
12mg
 
18mg
 
24mg
 
 
 
Did the use of the vapor pen help you stop smoking cigarettes?
 
Yes
 
No
 
 
 
How strongly do you feel that vapor pens help people quite smoking cigarettes?
 
Strongly agree
 
Agree
 
Somewhat agree
 
Somewhat disagree
 
Disagree
 
Strongly disagree
 
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