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* 1. How old are you?

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* 2. What's your gender?

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* 3. If you are a smoker at what age did you start smoking?

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* 4. Do you have a respiratory problems?

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* 5. How often do you get dental appointment?

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* 6. Does your teeth hurt when you smoke?

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* 7. Do you have swollen gums?

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* 8. Does your gums bleed when you brush your teeth?

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* 9. Are you interested in enrolling in tobacco cessation program or receive information on Vaping?

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