Smoking Questionnaire

If you smoke cigarettes or cannabis, we would like your help in shaping the support services we provide for helping young people who wish to quit. Please complete this short questionnaire. Your responses will be anonymous (unless you choose to tell us your contact details at the end).

Do you smoke cigarettes?

Do you smoke cannabis?

Do you smoke tobacco with your cannabis?

Yes
No (I smoke cannabis on its own)
I do not smoke cannabis

Do you want to give up smoking (either cigarettes or cannabis)?

Yes
No
I do not smoke

If you answered no to the previous question, please tell us why you don't want to give it up? (You can then either skip the following questions or continue to answer them and help us shape the service for those who are interesting in quitting).

If you answered yes and would like to give up smoking, would you attend a service that helps you give up both?

Would you like a give up smoking service to be one-to-one or with a group?

One-to-one
Group

What would be the best times and days for this service to run?

2-3pm

4-5pm

6-7pm

8-9pm

Weekdays

Weekends

Would you attend a weekly workshop?

What would be the best way for young people to learn about such a service?

Flyers/posters

Where would the best place be to put these flyers and/or posters? (you can skip this box if you didn't tick "flyers/posters" above)

Websites

Which websites would be the best to advertise through? (you can skip this box if you didn't tick "websites" above)

Canvassing (directly contacting people and telling them about it)

Where would be the best place to canvass people? (you can skip this box if you didn't tick "canvassing" above)

Other - tell us about any other method of advertising the service you can think of.

What would help you to give up smoking?

Thank you!

If you would like us to contact you regarding helping you to quit smoking, then enter your email or contact phone number here. Otherwise, leave this blank for your responses to be sent anonymously.