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ZONNIC Pre-Sample Survey – Pharmilink Sampling Program

Thank you for participating in this survey. Your responses are anonymous and will be used to better understand healthcare professionals’ awareness and perceptions of nicotine replacement therapies (NRTs), including ZONNIC. Participation is entirely voluntary, and the survey should take approximately 5 minutes to complete.
1.How often do you discuss smoking cessation with patients who smoke, and how confident are you in counseling them on strategies including NRTs?
Never
Rarely
Sometimes
Often
Always
Frequency of discussion
Confidence
(1 = Not at all confident, 5 = Extremely confident)
2.How familiar are you with NRTs?
1 (Not at all familiar)
2
3
4
5 (Extremely familiar)
Familiarity
3.Which NRTs formats are you aware of?
(Select all that apply):
4.Prior to this survey, were you aware of ZONNIC nicotine pouches?·
(If Yes, continue to Q4–Q6; if No, skip to Q7)
5.Before receiving any samples or detailed information, how would you rate your understanding of the following aspects of ZONNIC?
1 Not good understanding
2
3
4
5 Very good understanding
N/A
General mechanism of action
Intended use and purpose
Perceived Benefits
Known risks or side effects
Appropriate patient population
Usage instructions
6.Before receiving samples, how likely were you to consider recommending ZONNIC to patients?
1 Very low likelihood/advocacy
2
3
4
5 Very high likelihood/advocacy
Likelihood to recommend
Advocacy
7.How valuable do you consider pharmaceutical samples to be in your practice for the following purposes?
1 Not valuable
2
3
4
5 Very valuable
Educating patients
Supporting trial or initiating therapy
Immediate relief
Increasing personal familiarity
8.If you were to receive ZONNIC samples through Pharmilink, how do you anticipate using them in your practice?
9.Please indicate the province in which you currently practice:
10.Please provide your College of Physicians & Surgeons Licence # (not your billing #):
(NB. This is required to ship the gift card for completing both the pre-sample and post-sample surveys, to you).