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.

Question Title

* 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	Frequency of discussion Never	Frequency of discussion Rarely	Frequency of discussion Sometimes	Frequency of discussion Often	Frequency of discussion Always
Confidence (1 = Not at all confident, 5 = Extremely confident)	Confidence (1 = Not at all confident, 5 = Extremely confident) Never	Confidence (1 = Not at all confident, 5 = Extremely confident) Rarely	Confidence (1 = Not at all confident, 5 = Extremely confident) Sometimes	Confidence (1 = Not at all confident, 5 = Extremely confident) Often	Confidence (1 = Not at all confident, 5 = Extremely confident) Always

Question Title

* 2. How familiar are you with NRTs?

	1 (Not at all familiar)	2	3	4	5 (Extremely familiar)
Familiarity	Familiarity 1 (Not at all familiar)	Familiarity 2	Familiarity 3	Familiarity 4	Familiarity 5 (Extremely familiar)

Question Title

* 3. Which NRTs formats are you aware of?
(Select all that apply):

Patches

Gum

Lozenge

Inhaler

Nasal Spray

Pouch

Other (please specify)

Question Title

* 4. Prior to this survey, were you aware of ZONNIC nicotine pouches?·
(If Yes, continue to Q4–Q6; if No, skip to Q7)

Yes

Question Title

* 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	General mechanism of action 1 Not good understanding	General mechanism of action 2	General mechanism of action 3	General mechanism of action 4	General mechanism of action 5 Very good understanding	General mechanism of action N/A
Intended use and purpose	Intended use and purpose 1 Not good understanding	Intended use and purpose 2	Intended use and purpose 3	Intended use and purpose 4	Intended use and purpose 5 Very good understanding	Intended use and purpose N/A
Perceived Benefits	Perceived Benefits 1 Not good understanding	Perceived Benefits 2	Perceived Benefits 3	Perceived Benefits 4	Perceived Benefits 5 Very good understanding	Perceived Benefits N/A
Known risks or side effects	Known risks or side effects 1 Not good understanding	Known risks or side effects 2	Known risks or side effects 3	Known risks or side effects 4	Known risks or side effects 5 Very good understanding	Known risks or side effects N/A
Appropriate patient population	Appropriate patient population 1 Not good understanding	Appropriate patient population 2	Appropriate patient population 3	Appropriate patient population 4	Appropriate patient population 5 Very good understanding	Appropriate patient population N/A
Usage instructions	Usage instructions 1 Not good understanding	Usage instructions 2	Usage instructions 3	Usage instructions 4	Usage instructions 5 Very good understanding	Usage instructions N/A

Question Title

* 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	Likelihood to recommend 1 Very low likelihood/advocacy	Likelihood to recommend 2	Likelihood to recommend 3	Likelihood to recommend 4	Likelihood to recommend 5 Very high likelihood/advocacy
Advocacy	Advocacy 1 Very low likelihood/advocacy	Advocacy 2	Advocacy 3	Advocacy 4	Advocacy 5 Very high likelihood/advocacy

Question Title

* 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	Educating patients 1 Not valuable	Educating patients 2	Educating patients 3	Educating patients 4	Educating patients 5 Very valuable
Supporting trial or initiating therapy	Supporting trial or initiating therapy 1 Not valuable	Supporting trial or initiating therapy 2	Supporting trial or initiating therapy 3	Supporting trial or initiating therapy 4	Supporting trial or initiating therapy 5 Very valuable
Immediate relief	Immediate relief 1 Not valuable	Immediate relief 2	Immediate relief 3	Immediate relief 4	Immediate relief 5 Very valuable
Increasing personal familiarity	Increasing personal familiarity 1 Not valuable	Increasing personal familiarity 2	Increasing personal familiarity 3	Increasing personal familiarity 4	Increasing personal familiarity 5 Very valuable

Question Title

* 8. If you were to receive ZONNIC samples through Pharmilink, how do you anticipate using them in your practice?

Provide to eligible patients

Show product

Facilitate discussion

Personal understanding

Help patients afford NRTs

Would not use

Other

Question Title

* 9. Please indicate the province in which you currently practice:

Question Title

* 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).

ZONNIC Pre-Sample Survey – Pharmilink Sampling Program

Question Title

* 1. How often do you discuss smoking cessation with patients who smoke, and how confident are you in counseling them on strategies including NRTs?

Question Title

* 2. How familiar are you with NRTs?

Question Title

* 3. Which NRTs formats are you aware of?(Select all that apply):

Question Title

* 4. Prior to this survey, were you aware of ZONNIC nicotine pouches?· (If Yes, continue to Q4–Q6; if No, skip to Q7)

Question Title

* 5. Before receiving any samples or detailed information, how would you rate your understanding of the following aspects of ZONNIC?

Question Title

* 6. Before receiving samples, how likely were you to consider recommending ZONNIC to patients?

Question Title

* 7. How valuable do you consider pharmaceutical samples to be in your practice for the following purposes?

Question Title

* 8. If you were to receive ZONNIC samples through Pharmilink, how do you anticipate using them in your practice?

Question Title

* 9. Please indicate the province in which you currently practice:

Question Title

* 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).

* 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)

* 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).