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Do you know anyone who smokes?
 
Yes
 
No
 
 
 
Has their health gone down?
 
Yes
 
No
 
 
 
Have you ever thought of smoking because of them?
 
Yes
 
No
 
 
 
Have you ever smoked?
 
Yes
 
No
 
 
 
If yes, how often
 
Hourly
 
Daily
 
Weekly
 
Monthly
 
 
 
Do you think that people who smoke look cool?
 
Yes
 
No
 
 
 
Will you ever smoke in the future?
 
Yes
 
No
 
 
 
Do you know anyone who has died from smoking?
 
Yes
 
No
 
 
 
Have you ever thought of helping someone who smokes?
 
Yes
 
No
 
 
 
Do people you know influence you to smoke?
 
Yes
 
No
 
Sometimes
 
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