Questionnaire

This survey is a part of a study. Please fill this form will full sincerity.

1. What is your gender?
Male Female

2. How old are you?
15 – 25 25 – 35 35 – 45 45 and above

3. Marital Status?
Single Married

4. Occupation
Student Doctor Engineer Others______________

5. Education
10 10 + 2 Under Graduate Graduate Ph. D

6. What is your monthly income?
5,000 – 10,000 10,000 – 15,000 15,000 – 25,000 25,000 and above

7. How long have you been smoking (years)? Less than 1 1–5 5 – 10 10 – 15 15 and more

8. Who/ what influenced you to smoke?
Friends Advertisements Celebrity (if others, pls specify)

9. Why did you start smoking?
To feel more confident To move with the trend to feel more powerful to spend leisure time

10. Which brand do you regularly smoke (please click only one)
Surya Classic Marlboro Regular Shikhar Regular 24ct Regular Lights Lights Menthol (Continue Page 2) 24ct Lights Regular Lights

How many cigarettes do you smoke per day? Less than 5 5 – 10 10 – 15 15 – 20 20 and above 12. b. pls specify)_____________________ 11. How long did you smoke the brand you used to smoke previously (years)? Less than 1 1–5 5 – 10 10 – 15 15 and more Thank You . Have ever switched your brand and types of cigarette? Yes No If Yes. a. WHY_____________________________________________________________ _________________________________________________ _________________________________________________ _________________________________________________ _________________________________________________ 12.LM Regular Khukuri Lights Yak (if others.