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* 1. What is your gender?

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* 2. What is the mental illness diagnosis of your family member/friend/client?

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* 3. What suburb is the hospital your family member/friend/client goes for treatment located in?

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* 4. Does your family member/friend/client smoke and if so how many years have they been smoking for?

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* 5. Has your family member/client expressed a desire to quit smoking?

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* 6. Do you smoke?

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* 7. Have you ever encouraged your family member/client to quit smoking?

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* 8. Have you experienced the implementation of the smoking ban in NSW Health facilities (with all outdoor smoking areas eliminated)?

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* 9. Please only answer the following if you are aware that the hospital that your family member/patient has enforced a smoke-free policy on all grounds. Otherwise leave the remaining questions blank.

In which month and year did you find out that the hospital where your family member/client visits went smoke-free?

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* 10. Has your family member/client ever refused or expressed reluctance to visit their hospital for treatment due to the smoke-free policies?

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* 11. Has your family member/client ever left hospital grounds and failed to return during a smoke-break off hospital grounds?

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* 12. Has your family member/patient ever used advice or resources from hospital staff in an attempt to quit smoking?

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* 13. Do you have any other comments or observations you would like to make?

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