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Surveys
2015
January
E
E Cigarettes
E Cigarettes
0%
Exit Survey
What gender are you
Male
Female
What age group are you in
Under 20
21-25
26-30
31-35
36-40
41-45
46-50
51-55
56-60
61-65
Over 65
Please tick one
What age did you start smoking
Do you smoke cigarettes, e-cigarettes or both
Cigarettes
E-Cigarettes
Both
Please tick one or more
When did you start using E Cigarettes?
A year or more
Less than a year
Does your employer permit using e cigarette at work
Yes
No
Don't know
Please tick one
Do you know what chemicals are in the fluid?
How much liquid or how many e cigarettes do you use each day
Have you ever spilt the liquid on your skin?
Yes
No
Did you get a reaction needing medical attention
Yes
No
n/a
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