Secondhand smoke, as defined by the Centers for Disease Control and Prevention (CDC), is the combination of smoke from the burning end of a tobacco product and the smoke breathed out by the user.

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* 1. In what ZIP code do you live? (enter 5-digit ZIP code; for example, 00544 or 94305)

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* 2. What is your gender?

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* 3. What is your age?

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* 5. Mark only one oval

  Strongly Agree Agree Neither Agree or Disagree Disagree Strongly Disagree
There is no risk-free level of secondhand smoke exposure; even brief exposure can be harmful to health
Exposure to secondhand smoke has immediate adverse effects on the cardiovascular system and can cause coronary heart disease and stroke.
Secondhand smoke can lead to health issues in adults who have never smoked, such as cardiovascular disease and lung cancer
Secondhand smoke can lead to cancer

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* 6. Would you say that breathing secondhand smoke is:

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* 7. In children, secondhand smoke can cause (Choose all that apply)

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* 8. Parents can help protect their children from secondhand smoke by taking the following actions (choose all that apply)

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* 9. Mark only one oval

  Strongly Agree Agree Neither Agree or Disagree Disagree Strongly Disagree
Breathing secondhand smoke can have immediate adverse effects on your blood and blood vessels, increasing the risk of having a heart attack
Eliminating smoking in indoor spaces is the only way to fully protect nonsmokers from secondhand smoke exposure
Separating smokers from nonsmokers within the same air space, cleaning the air, opening windows, and ventilating buildings does not eliminate secondhand smoke exposure
People who already have heart disease are at especially high risk of suffering adverse effects from breathing secondhand smoke and should take special precautions to avoid even brief exposures

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* 10. What form of media do you use most often? Please specify the type or station.

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