Q1. Which of the following best describes you?

A contented smoker
A smoker who would like to stop
A social smoker i.e. very infrequently
A non-smoker

Q2. How many cigarettes do you smoke each day?

More than 20?
Between 11 and 20?
Between 1 and 10?
None

Q3. After you wake, when do you smoke your first cigarette?

Within five minutes?
Within half an hour?
Within an hour?
I don't

Q4. Do you find it difficult not to smoke in places like cinemas, buses or restaurants?

Yes, I do
Sometimes I do
Not at all

Q5. If you are ill in bed, would you still smoke?

Yes, just as normal
Yes, but not as much as normal
No