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Questionnaire


The following questionnaire aims at getting a better understanding of  
peoples smoking and drinking habits. I am student of the American  
University in Dubai and the questionnaire is a part of a research project I  
am doing therefore accurate information is highly appreciated. Thank you  
for taking time and providing your input.


* Required



Q1. Do you smoke? *

Yes (Please continue to the next question)
No (Please proceed to question no. 6)



Q2. You smoke when you

Are Stressed
Are Free
Need to Relax
Other



Q3. Has your smoking habit changed over the last few months?

Yes, I smoke more often
Yes, I smoke less
No



Q4. On average, how often do you smoke each day?

1-4 Cigarettes
5-9 Cigarettes
One whole Pack
More than One Pack



Q5. Without Smoking for 1 Day

I find it very hard to work
I can survive
I cannot exist



Q6. Do you drink? *

Tea
Coffee
Both
None



Q7. You drink Tea/Coffee

To Relax
When Free
To take a Break from Work
When Stressed



Q8. On average, how many cups of Tea/Coffee do you drink on a day

1-3 Cups
4-7 Cups
8 or More



Q9. Without a cup of Tea/Coffee for 1 Day

Must drink at least 1 or 2 cups to function
You can live with it
You are incomplete



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