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Step 1 of 2
1. What best describes your pattern of smoking?
I have at least one cigarette a day
I only smoke occasionally
I recently quit smoking
2. When was your last cigarette?
Less than 24 hours
More than 24 hours
3. How many cigarettes do you or did you smoke per day?
Select
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100+
4. How many years have you smoked?
Select
0
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75+
5. How soon after you wake up do you or did you have your first cigarette?
Within 5 minutes
6-30 minutes
31-60 minutes
After 60 minutes
6. How many times have you tried to quit in the past, and lasted 24 hours or more?
Select
0
1
2
3
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9
10+
7. How many other smokers do you live with?
Select
0
1
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9
10+
8. What's your date of birth?
Year
After 1993
1993
1992
1991
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Month
January
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April
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Day
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9. You are:
Female
Male
10. About how much does a pack of cigarettes cost you?
$
€
£
[Example: 6.50]
11. In some countries, packs contain different amounts of cigarettes. About how many cigarettes are in the packs you bought?
Select
10
15
20
25
30