MPH718_Alemu_Brook

S1. Have you smoked at least 100 cigarettes,cigars or pipefuls in your lifetime?

Yes

No (Go to question #S8)

Uncertain (Go to question #S8)

S2. Have you ever smoked almost every day for at least one year?

Yes

No (Go to question #S8)

Uncertain (Go to question #S8)

S3. Do you know smoke?

Yes, daily ( Go to question #S5)

Yes, occasionallya

Not at all

S4. When did you stop smoking daily? (If you have quite smoking several times, give the time when you you last stopped smoking daily?)

Today or yesterday

2 day - 6 days ago

1 week - less than 1 month ago

1 month- less than 1 year ago

1- 5 years

More than 5 years ago

S5. On average, how many cigarettes, cigars, pipefuls of tobacco etc. do you smoke per day?

------- ---------- -----------

S6. which of the products do you smoke?

Manufactured cigarettes: Yes No

Self-rolled cigarettes: Yes No

Pipe: Yes No

Cigars: Yes No

S7. Have you during the past years (12 months) been advised by a health professional to stop smoking?

Yes

No

I have not smoked during the past 12 months

S8. Are you exposed to indoor tobacco smoke at home?

Yes

No

S9. About how many hours per day are you exposed to indoor tobacco smoke at your workplace?

I do not work outside the home

Almost never

Less than one hour a day

1-5 hours a day

More than 5 hours a day