Bar Customer Survey- Sipango Lounge

Thank you for taking this survey. Answers are anonymous and it should not take more then 5 minutes of your time.

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1. Please read each statement below and select the box indicating how much you agree or disagree.

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
Secondhand smoke is a serious health hazard.	Secondhand smoke is a serious health hazard. Strongly Disagree	Secondhand smoke is a serious health hazard. Disagree	Secondhand smoke is a serious health hazard. Neutral	Secondhand smoke is a serious health hazard. Agree	Secondhand smoke is a serious health hazard. Strongly Agree
Secondhand smoke in a confined space, like a bar or nightclub, is harmful to me.	Secondhand smoke in a confined space, like a bar or nightclub, is harmful to me. Strongly Disagree	Secondhand smoke in a confined space, like a bar or nightclub, is harmful to me. Disagree	Secondhand smoke in a confined space, like a bar or nightclub, is harmful to me. Neutral	Secondhand smoke in a confined space, like a bar or nightclub, is harmful to me. Agree	Secondhand smoke in a confined space, like a bar or nightclub, is harmful to me. Strongly Agree
Bar owners and managers have the right to choose whether their venue allows smoking or not.	Bar owners and managers have the right to choose whether their venue allows smoking or not. Strongly Disagree	Bar owners and managers have the right to choose whether their venue allows smoking or not. Disagree	Bar owners and managers have the right to choose whether their venue allows smoking or not. Neutral	Bar owners and managers have the right to choose whether their venue allows smoking or not. Agree	Bar owners and managers have the right to choose whether their venue allows smoking or not. Strongly Agree
I prefer to go to smoke-free bars and clubs.	I prefer to go to smoke-free bars and clubs. Strongly Disagree	I prefer to go to smoke-free bars and clubs. Disagree	I prefer to go to smoke-free bars and clubs. Neutral	I prefer to go to smoke-free bars and clubs. Agree	I prefer to go to smoke-free bars and clubs. Strongly Agree

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2. If Sipango's went smoke-free, how often would you return?

Less than I do now

About the same as I do now

More than I do now

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3. Do you smoke?

Yes- regularly

Yes- socially

No- I do not smoke

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4. What is your age?

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5. What is your zip code?