Your Personal Information

Are you a health care professional or a researcher? Please note that use of this program is for your personal, non-professional use.

Yes

Your First Name:
(to protect your privacy please only use your first name or a nickname)

You are:

male

female

Your date of birth:

What country do you live in?

About Your Smoking

On average, about how many cigarettes do you smoke per day?

How much does a pack of cigarettes cost you? (example: 8.55)

In some countries, packs contain different amounts of cigarettes. About how many cigarettes are in the packs you bought?

Please Note: By clicking "Next Page" you acknowledge that this test is for educational puposes only and is not to be used as a substitute for a consultation or visit with your family physician or other healthcare provider.

Statistical data collected throughout the site is used for research purposes only. Individual statistics are not collected or distributed and we do not collect or distribute email addresses or any other personal information. Please read this important legal information.

Please check this box to acknowledge that your anonymous information will be used for purposes of improving this questionnaire. Your use of this program is subject to your data being used for research purposes. We do not collect or analyze individual statistics and no one will contact you at any time.