We would like to know what you think about keeping outdoor places in your area free from smoking and vaping.  
Participation is Voluntary & you can opt out of the survey at any time.

The survey will take TWO minutes to complete and is anonymous

Please clearly tick/circle the box that represents your answer.



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* 1. What is your gender?

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* 2. Do you or any member of your family smoke?

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* 3.       Age

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* 4. Do you support No Smoking in the following places at your organisation?

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
Outdoor Spaces
Parks
Playgrounds
Outdoor Sports Grounds
Beaches
Public Events

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* 5. Do you support No Vaping in the following places at your organisation?

  Strongly agree Agree Neither agree nor disagree Disagree Strongly disagree
Outdoor Spaces
Parks
Playgrounds
Outdoor Sports Grounds
Beaches
Public Events

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* 6. Where do you see people smoke and/or vape around your organisation? (Tick all that apply)

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* 7. How do you feel about this statement " I want my organisation to be a smoke/vape free space"?

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