Fighting For Our Lives: No Menthol Survey Question Title * 1. What is your age? 18 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 or older Question Title * 2. What is your zip code? Question Title * 3. Do you currently smoke cigarettes, or not? Yes, I do No, I do not Question Title * 4. What is your gender? Female Male Question Title * 5. What is your race or ethnicity? Asian Black or African American Hispanic or Latino Middle Eastern or North African Multiracial or Multiethnic Native American or Alaska Native Native Hawaiian or other Pacific Islander White Other Question Title * 6. At what age did you start smoking cigarettes? Question Title * 7. Do any of your family members smoke cigarettes/cigars/milds/etc? Yes No Question Title * 8. Which of the following have you experienced in the last month? (choose all that apply) I have been upset because of something that happened unexpectedly. I felt that I was unable to control the important things in my life. I have felt nervous and “stressed”. I felt that things were going my way. I found that I could not cope with all the things that I had to do. I have often been able to control irritations in my life. I felt that I was on top of things. I have been angered because of things that were outside of my control. I felt difficulties were piling up so high that I could not overcome them. Question Title * 9. Which of the following applies to you? I am interested in quitting smoking/want to quit smoking. I need help to quit smoking. I want to quit smoking. I use cigarettes/cigars/milds/pipe as a coping mechanism for stress. One or more family members who smoke or used to smoke have smoking related diseases. I have been diagnosed with a mental health disorder. None of the above Question Title * 10. How would you rate the degree of crime where you most often purchase cigarettes? High Somewhat high Somewhat low Low Done