smoking survey アンケートに回答お願いします

統計学のクラスで「タバコ吸われる方」のアンケートが必要です。週末中〜月曜朝までに回答出来ましたらどうかご協力御願いします。該当のない質問はとばして下さって結構です。宛先は：naoko1@hotmail.com　までお願いします。


This survey is anonymous. Please fill out this questionnaire to help us gain information on demographics of tobacco use.

1. Where do you live?

___ Manhattan ___ Brooklyn ___ Queens

___ Bronx ___ Staten Island ___ Outside of the 5 Borough

2. What is your ethnicity/race? ___ Native American ___ Caucasian

___ African-American ___ Hispanic

___ Asian/Pacific Islander ___ East Indian

___ Middle Eastern ___ Rather not say

3. What is the highest level of education you have completed?

___ Less than High School

___ High School /GED

___ Some College

___ 2-year College Degree (Associate) or Technical Training

___ 4-year Completed Degree (Bachelors)

___ Grad school or higher

4. Do you consider yourself a habitual or social smoker?

A. Habitual B. Social

5. Do you feel that drinking alcohol increases your likelihood to smoke a cigarette?

A. Yes B. No

6. Do you feel that a stressful situation increases your likelihood to smoke a cigarette?

A. Yes B. No

7. On average, how many cigarettes do you smoke in one day?

A. 1 or less B. 2-3 C. 4-5 D. 6 +

8. On average, how many packs of cigarettes a week do you smoke?

A. 1 or less B. 2-3 C. 4-5 D. 5 or more

9. On average, about how much money does cigarette smoking cost you per week?

___ Less than $10 a week

___ $10-20 a week

___ $30-40 a week

___ $40-50 a week

___ $50 or more a week

10. What is your gender?

A. Male B. Female

11. What is your age? (Please choose one)

___ Under 21 ___ 21 to 25 ___ 26 to 30 ___ 31 to 35 ___ 36 to 40 ___ 41 to 45 ___ 50 or older

Thank you so much for participating in our survey!

以上です。どうもありがとうございました。