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* 1. Do you know any women who in your opinion drink too much wine?

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* 2. If yes, how old are these women? Tick one or more boxes.

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* 3. If you had to guess, how many glasses of wine do they drink per week?

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* 4. Do they drink to

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* 5. Do you worry about the adverse health effects that wine has on these women?

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* 6. Do any of them talk about any of these issues being a cause for drinking too much? Tick one or more boxes

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* 7. Have you ever been asked to help out - tick one or more

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* 8. Do you worry about the effect their drinking has on their children and family?

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* 9. Do any of these women talk about wanting to stop drinking?

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* 10. Do you know any women who have sought counselling or treatment because of drinking? If Yes, how many?

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