Copy of Tobacco Retailer Density Survey Question Title * 1. Your age? 17 or younger 18-20 21-29 30-39 40-49 50-59 60 or older OK Question Title * 2. Have you taken this survey in the past 2 months? Yes No OK Question Title * 3. How would you describe yourself? Female Male Prefer not to answer Other (please specify) OK Question Title * 4. Which of the following would you say is your race? (check all that apply) White Black or African-American American Indian or Alaska Native Asian Native Hawaiian or Pacific Islander Prefer not to answer Other (please specify) OK Question Title * 5. Are you Hispanic, Latino/a or Spanish origin? Yes No Prefer not to answer OK NEXT