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* 1.
What gender are you?

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* 2. Do you smoke cigarettes?

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* 3. If yes, please indicate what type of smoker you would classify yourself as?

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* 4. In regards to quitting which of the following stages would fit your circumstance? (Please answer even if you are not a smoker)

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* 5. If you have tried to quit smoking cigarettes within the last year, what smoking alternatives have you used to help? (Please answer even if you are not a smoker)

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* 6. As a student, what would be your reasons for quitting cigarettes?

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