Houston Study - Vapor Products May 2018

Introduction Section

Plaza Research Houston is conducting a discussion with Males and Females 21-54 year old consumers on Vapor Products. You will make 2 visits to our office on May 7th or 8th and May 21 or 22, 2018. Each visit will last approximately 10-15 minutes. This will be a product testing study. You will receive $50 for your time (2 visits + free product usage for testing).

Please answer the questions below. If you look like a match, we will contact you by telephone.

**Due to the large response to our surveys, we are only able to contact those that look like a match. Please continue to answer future studies, as you may be a match to those.

Question Title

* 1. Please provide us with the following information. We will be contacting you by telephone if you seem like a match.

Name:

ZIP/Postal Code:

Email Address:

Phone Number:

Question Title

* 2. Alternate Contact number

Question Title

* 3. What is your age?

Question Title

* 4. What is your gender?

Question Title

* 5. Which of the following products do you use daily?

Coffee

Soft drinks

Tobacco Products (such as traditional cigarettes, e-cigarettes/vapor products, snus or moist snuff)

Mints

Chewing Gum

None of these