Smoking Survey For Smokers

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Questions 1-5
1. This survey is for smokers only. Please check all that apply in the boxes below.
2. How old were you when you smoked your first cigarette?
3. What was the first drug you tried or experimented with? If it's not on the list, please list it in the comment box. Feel free to make any additional comments.
4. Please check all that apply regarding your behavior when smoking and secondhand smoke.
5. Please indicate the level of importance that you believe each scenario had in your decision to smoke your first cigarette.
Extremely importantSomewhat importantSlightly importantNot important at allNot applicable
Your parents smoke/smoked.
Your parents or other close relatives encouraged you to try it.
Many of your friends smoke/smoked.
Many of your friends encouraged you to try it.
You knew someone that smoked that you looked up to and respected (i.e. teacher, sports star, neighbor, someone at church, etc.).
Television/Movie advertising.
Advertising in stores, windows, sidewalk signs, etc.
The rebellious side of you.
You believe smoking is a sign of maturity.
You have/had many problems in your life, and at the time you started smoking, you didn't care if it might hurt or kill you.
You started as a dare or on a bet from a friend or acquaintance.
You liked the smell of cigarettes and thought the taste would be a pleasant experience.
You were able to buy or obtain cigarettes easily as a minor.
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