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2014
August
D
dependence on stimulants
dependence on stimulants
0%
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Hello:
You are invited to participate in our survey [Dependence on stimulants ]. In this survey, approximately [Approximate Respondents] people will be asked to complete a survey that asks questions about [General Survey Process]. It will take approximately [ 3 ] minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential.
Thank you very much for your time and support. Please start with the survey now by clicking on the
Continue
button below.
I Agree
Do you Drink Tea
Yes
No
How many cups of tea do you drink in a day
1
2
3
More than 3
Not applicable
Do you get stimulated or feel fresh after drinking tea
Yes
No
Not applicable
Do you smoke (cigarette ,bedi cigar etc )
Yes
No
How many cigarettes you smoke in a day
Less than 5
Less than 10
Lees than 15
More than 15
Not applicable
Do you feel fresh or get stimulated after smoking
Yes
No
Not applicable
When do feel more fresh or stimulated
After having a tea
After smoking
Not applicable
Do you simultaneously ( at a same time ) smoke and drink tea
Yes
No
Not applicable
Do you feel fresh or stimulated More after simultaneously smoking and having tea
No
Same as that after Having tea OR smoking
More that that after Having tea OR smoking
Not applicable
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