Smoking & Vaping Survey

Please provide your best answers for the questions below. If you have no response to offer, or if a question doesn’t apply to you, please enter NA for any such questions. Thank you so much for completing this survey!

1. Do you feel you are a considerate smoker?

2. If you answered “yes” to number one above: What makes you a considerate smoker?

3. Do you feel guilty when you smoke?

4. Who makes you feel the guiltiest for smoking? Why?

5. Why haven’t you quit smoking already?

6. What would make you want to quit smoking right now?

7. What pet peeves do you have of other smokers?

8. What pet peeves do you have of family or friends who nag you to quit smoking?

9. What methods to quit (cold turkey, meds, gum, etc.) have you tried, but failed at?

10. If you quit, but failed in the past, what caused you to start up again?

Thank you again for taking time out of your—no doubt busy—day to complete this survey. Your responses may be included in my smoking cessation books or programs, used in conjunction with other survey participants’ data, or may be used for marketing purposes. By submitting your responses to this survey, you give me permission to use your responses in any way for my smoking cessation program and business. I do not collect names, or other personal information, of survey participants, or add you to a mailing list.

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