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Smoke-Free Northstate Survey

3.Thank you for participating in the Smoke-Free North State survey!

Smoke-Free North State advocates for smoke-free entryways in the cities of Orland and Chico. Smoke-free entryways benefit businesses, employees and customers by maintaining a healthy, clean, and professional atmosphere. Your participation in this survey will help us design our campaign so that it best represents YOU. Thank you for your input!
1.How did you hear about the Smoke-Free North State campaign?
2.Do you live in Chico or Orland?(Required.)
3.Do you work in Chico or Orland?(Required.)
4.Do you own or operate a business in Chico or Orland?(Required.)
5.Are you an adult of at least 18 years?(Required.)
6.Do you use tobacco products?(Required.)
7.Does secondhand smoke bother you - even a little?
8.Does cigarette butt litter bother you?
9.Are there any businesses in Chico or Orland that you would like us to recognize because they don't allow smoking (or butt litter) near doors or windows?
10.Are there any businesses in Chico or Orland where you have noticed a lot of smoking or butt litter around the entryway(s)?
11.You can help create a Smoke-Free North State! We are actively recruiting supporters and volunteers - all training and materials is provided. Please check any of the following activities you have an interest in or add your own!
12.If you checked "Sign program endorsement", please click on the following and provide your name and email or telephone number. This is a digital signature of our program endorsement form. We thank you!
13.Finally, if you checked any of the items in # 11, please provide your name and contact information so we can reach you. Thank you!
14.THANK YOU for participating in the Smoke-Free North State survey. Your opinion is important to us. We'd like to thank you for your time so we are randomly picking a survey every month and sending the lucky recipient a $ 10 giftcard to a store of their choice.(Required.)