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Question 1
1
How old are you?
This question is required.
*
Select one that applies.
Key
A
Under 21
Key
B
21-29
Key
C
30-39
Key
D
40-49
Key
E
50-59
Key
F
60-69
Key
G
70-79
Key
H
80+
Question 2
2
Have you smoked more than 100 cigarettes (5 packs) ever in your life?
This question is required.
*
Select one that applies.
Key
A
Yes
Key
B
No
