Cigarette Smoking Paper Printable Survey Template

Looking for a paper-based survey solution for your organization? Take a look at this cigarette smoking paper printable survey template for your next research project.

Our templates come with well-designed questions that can be machine-read to recognize the checkmarks using optical mark recognition (OMR) technologies. Open text areas recognized with handwriting recognition (HWR) technologies allowing you to handwrite the text and automatically convert to a digitized form.

Questions in this survey: 19, Language: English

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List of questions in this template

  1. What do you prefer to smoke?
    • Cigarettes
    • Cigarillos
    • Cigars
    • Pipe
    • Water pipe
    • Electronic cigarettes
  2. I enjoy smoking
  3. There should not be smoking in restaurants
  4. Have you tried smoking an electronic cigarette?
    • Yes
    • No
  5. It calms me down
  6. There should not be smoking at bus/ tram stops etc.
  7. How many cigarettes do you smoke per day?
    • 0
    • 1 - 5
    • 5 - 10
    • 10 - 20
    • 20 - 30
    • More than 30
  8. It's expensive
  9. There should not be smoking in all public places
  10. It's a part of my life
  11. There should not be smoking in the workplace
  12. It's unhealthy
  13. There should not be smoking in restaurants
  14. I am planning to quit
  15. There should not be smoking at bus/ tram stops etc.
  16. Do you want to quit smoking?
    • Yes
    • No
  17. I am planning to quit
  18. There should not be smoking in all public places
  19. There should not be smoking in the workplace


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