Quit Tea Initial Survey
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1. Default Section

1. Do you currently smoke cigarettes and are interested in quitting?

Do you currently smoke cigarettes and are interested in quitting? Yes

Not interested in quitting at this time

2. If yes, how long have you been smoking?

If yes, how long have you been smoking? # years of smoking

3. How many cigarettes do you smoke per day, on average?

How many cigarettes do you smoke per day, on average? # cigarettes per day

4. Have you tried to quit smoking before?

Have you tried to quit smoking before? Yes

5. If yes, how many times?

If yes, how many times? # of attempts

6. If yes, which of the following products have you tried?

If yes, which of the following products have you tried? Nicorette Gum

NicoDerm CQ

Commit Lozenges

Zyban

Chantix

Electronic Cigarettes

Other

Other (please specify)

7. Do you currently drink some type of tea, black, green, herbal or other?

Do you currently drink some type of tea, black, green, herbal or other? Yes

8. Have you used any types of herbal remedies for any indication (echinacea for immune support, ginseng for stress, or even multi-vitamins) or would you be willing to try?

Have you used any types of herbal remedies for any indication (echinacea for immune support, ginseng for stress, or even multi-vitamins) or would you be willing to try? Yes

Maybe

9. Would you be willing to try Quit Tea to help you quit smoking?

Would you be willing to try Quit Tea to help you quit smoking? Yes