You are on page 1of 2

Directions: Hi beloved Participants Please rate the following statements according to your desired

points, you can either rate it as Strongly Agree(5), Agree(4), Undecided(3), Disagree(2), or Strongly
Disagree(1). Just check(/) the box according with all your heart and honesty Good luck!

A.CAUSES OF CIGARETTE SMOKING

Causes of Cigarette Smoking Strongly Agree Undecided Disagree Strongly


Agree Disagree
I used cigarette besause of the
following causes: (5) (4) (3) (2) (1)

1. Peer influence

2. No disciplinary action from


parents

3. Curiosity

4. Family problems

5. Family influence

6. To relieve stress

7. For pleasure

8. To tell the people that I am an


adult

9. To show people that I am a


real man

10. To drive away insects


B. IMPORTANCE OF PREVENTING CIGARETTE SMOKING

Importance of Preventing Strongly Agree Undecided Disagree Strongly


Cigarette Smoking Agree Disagree

(5) (4) (3) (2) (1)

1. My life will be
prolonged.

2. Reduce the risk of


cardiovascular diseases.

3. Reduce the risk of


developing a variety of
other conditions.

4. I can feel healthier.

5. Look and feel better.

6. Improve my sense of
taste and smell.

7. I can save money.

8. I can focus intensively


to my study.

9. Reduce the risk of


mental illneses.

10. Approachable to
others.

You might also like