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1. How soon after you awake do you smoke your first cigarette?

Don't Know After 30 minutes Within 30 minutes *

2. Do you find it difficult to refrain from smoking in places where it is forbidden, such as the library, theater, or doctors' office?

No Yes *

3. Which of all the cigarettes you smoke in a day is the most satisfying?

Don't Know Any other than the first one in the morning The first one in the morning *

4. How many cigarettes a day do you smoke?

1-15 16-25 More than 26 *

5. Do you smoke more during the morning than during the rest of the day?

No Yes *

6. Do you smoke when you are so ill that you are in bed most of the day?

No Yes *

7. Does the brand you smoke have a low, medium, or high nicotine content?

Low Medium High *

8. How often do you inhale the smoke from your cigarette?

Never Sometime Always *