1. Multiple Sclerosis Survey

Thank you for taking part in this survey. It has been designed to study factors associated with multiple sclerosis as part of a college dissertation project.

All information gathered by this survey will be remain confedential and anoymous. If you have any queries, please contact me at nickclarke86@googlemail.com.

* 1. What is your age?

* 2. What is your gender?

* 3. What is your country of residence?

* 4. Have you ever been diagnosed with Multiple Sclerosis (MS)?

* 5. What sub-type of MS have you been diagnosed with most recently?

* 6. Do any of your blood relations suffer from MS? If yes, plese state their relationship to you.

* 7. Which statement best describes your smoking habits?
(If you choose option 3, stating that you have never been a smoker, please proceed to the end of the questionnaire and submit your answers).

* 8. At what age did you begin smoking regularly?

* 9. Approximately how many years have you smoked on a regular basis for?

* 10. On average, how many cigarettes have you smoked a day since you began smoking? If you no longer smoke, please state how many cigarttes you used to smoke a day on average.