The 1st Screening Survey for Integrated smoking cessation and breastfeeding program
Instructions:
Thanks for your interest in our research.
1. This is a screening survey for an academic research study on smoking and pregnancy conducted by the Maternal and Child Health Program, Division of Behavioral Medicine, Department of Pediatrics, State University of New York at Buffalo (“University at Buffalo”).
2. Please read each question carefully and answer them based on your best knowledge. Try to answer ALL of the questions. Non-sense, conflicting, and incomplete answers may impact your eligibility for this study.
3. Depending on your responses to the questions, this screening survey may take up to 10 minutes.
4. You may be contacted via text-message, E-mail, or phone if you are eligible for our research study.