.
Survey about Smoking Habits Among Students
Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.
Start
Secured
Survio
Create a survey
1
How old were you when you started smoking?
Please select the age range when you started smoking.
Under 18
18-21
Over 21
2
Rate the impact of smoking on your health (10 being highly impactful)
Please rate the impact on a scale from 1 to 10.
3
What triggers you to smoke the most?
Please provide the main reason that triggers your smoking habit.
4
How many cigarettes do you smoke per day on average?
Please enter the approximate number of cigarettes smoked in a day.
5
Do you smoke more when you are stressed?
Please select yes or no.
Yes
No
6
Do you smoke more when you are stressed?
Please select yes or no.
Yes
No
7
Rate your willingness to quit smoking (10 being highly willing)
Please rate your willingness to quit on a scale from 1 to 10.
8
Do you think peer pressure influences your smoking habit?
Please select yes or no.
Yes
No
9
Have you tried to quit smoking before?
Please select yes or no.
Yes
No
10
How do you feel after smoking a cigarette?
Please select the option that best describes your feeling after smoking.
Relaxed
Stressed
No Change
11
Do you think smoking helps you concentrate?
Please select yes or no.
Yes
No
Continue
Create a survey
Submit
Create a survey