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I need to start my day with some sort of caffeinated product
 
Strongly Disagree
 
Disagree
 
Undecided
 
Agree
 
Strongly Agree
 
 
 
How often do you drink caffeine?
 
Never
 
Rarely
 
Occasionally
 
Sometimes
 
Always
 
 
 
I feel like I am dependent on caffeine for energy
 
Strongly Disagree
 
Disagree
 
Undecided
 
Agree
 
Strongly Agree
 
 
 
Why do you drink caffeinated beverages?
   
 
 
 
If you do not drink caffeinated drinks, what are the reasons? (choose all that apply)
 
Do not like the taste
 
Do not like carbonated drinks
 
I often feel very full and uncomfortable
 
My stomach can not handle it
 
Other
 

 
 
 
How many caffeinated beverages do you drink a day?
 
None
 
1-2
 
3-4
 
5+
 
 
 
Caffeine is just as habit forming as cigarettes and alcohol
 
Strongly Disagree
 
Disagree
 
Undecided
 
Agree
 
Strongly Agree
 
 
 
To what extent do you feel that caffeine affects sleeping patterns
 
Strongly Disagree
 
Disagree
 
Undecided
 
Agree
 
Strongly Agree
 
 
 
Are you male or female?
 
Male
 
Female
 
 
 
How old are you?