Protect Your Home, Make it a Smoke-free Zone EOI

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* 1. Details

Name:

Address:

Email:

Ph:

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* 2. Are you:

Aboriginal

Torres Strait Islander

South Sea Islander

Other

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* 3. How many people live in your home?

Adults:

Kids:

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* 4. How many are smokers?

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* 5. What steps would you take to deter family members and visitors from smoking in your home?

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* 6. In 25 words or less what is your understanding o f the health effects of second hand smoke within the home?

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* 7. How would you promote Solid Mob's key tobacco message of 'protecting your home and making it a smoke free zone?