.:. www.Estebyan.com .:.

Posted by: miney
Send a message to this member
Title: Effects Of Smoking
 
Question 1: You are?
 Male
 Female
Question 2: Your age?
 < 20 years ( less than 20)
 20-29 years
 30–39 years
 40- 49years
 50 and over years
Question 3: Are you a smoker?
 Yes
 No
Question 4: Have you ever been curious about smoking a cigarette?
 Yes
 No
Question 5: Have you ever tried cigarette smoking, even just a few puffs?
 Yes
 No
Question 6: Have you ever seriously thought about trying cigarette smoking?
 I have already tried smoking
 Yes
 No
 I already smoke.
Question 7: Do you think in the future you might try smoking cigarettes?
 I have already tried smoking
 Definitely Yes
 Definitely No
 Probably not
 Definitely not
Question 8: If one of your best friends was to offer you a cigarette would you smoke it?
 Definitely Yes
 Probably yes
 Probably not
 Definitely not
Question 9: How many of your closest friends smoke cigarettes?
 None
 1
 2
 3
 4
 5
 6
 more than 6
Question 10: Do you think you will try a cigarette soon?
 Definitely Yes
 Probably yes
 Probably not
 Definitely not
Question 11: How old were you when you smoked your first cigarette?
 Less than 11 years old.
 Between 11 and 15 years old
 Between 16 and 19 years old.
 Between 20 and 25 years old.
 Over 26 years old.
 I have never smoked a cigarette.
 I do not know
Question 12: On average, how many cigarettes per day do you currently smoke?
 Less than 10 cigarettes
 10 –19 cigarettes
 20 or more cigarettes
 I have never smoke cigarette
Question 13: What kind of smoking you used ( you can choose more than one answer)
 Shisha
 Cigarette
 Nargila
 Others
Question 14: Which of the following people smoke? Please tick all that apply.
 Best friend
 Other close friends
 Father
 Mother
 Grandparents
 A teacher at school
 Other caregiver (e.g., stepfather or stepmother)
 Older brother(s)
 Older sister(s)
 None of the above
Question 15: Have you ever made an attempt to stop smoking?
 Yes
 No
Question 16: How many times have you ever tried to stop smoking?
 1 times
 2 times
 3 times
 4 times
 5 times
 6 times and over
Question 17: Do you smoke now because it is really hard to quit?
 Yes
 No
 Don't know/unsure
 Refused
Question 18: Do you think cigarette smoking is harmful to your health?
 Definitely not
 Probably
 not Probably
 yes Definitely
 yes
Question 19: Do you think the smoke from other people’s cigarettes is harmful to you?
 Definitely not
 Probably
 not Probably
 yes Definitely
 Yes
Question 20: If you smoke, please check all that apply regarding your behaviour when smoking and second-hand smoke. If you don't smoke, we'd still like your opinion on several of the statements below
 I always consider others around me when smoking and don't smoke in front of children or non-smokers, unless they say it's okay.
 I abide by the law of the land, if it's legal to smoke, I do. If it's illegal to smoke, I don't.
 If a non-smoker gets on my nerves, I will intentionally blow smoke toward them
 It's my right to smoke most anywhere I want, if others don't like it, they have the right to leave.
 I am conscious not to let some people know that I smoke (parents, teachers, boss).
 I do not hide the fact that I smoke from anyone.
 I do not believe second-hand smoke hurts anyone in any way.
 • I have placed smoking limits on myself (don't smoke in my car, home, workplace)
 I believe that businesses should decide if they want to allow smoking, and it's strictly up to each individual business.
 Other (please specify)
Please enter the word inside the image below: