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Hello:
You are invited to participate in our survey for Social Cognitive class. In this survey, approximately 40 people will be asked to complete a survey that asks questions about smokers. It will take approximately 5 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. If you have questions at any time about the survey or the procedures, you may contact by email at the email address specified below.

[email protected]

Thank you very much for your time and support. Please start with the survey now by clicking on the Continue button below.

 
 
 
 
How often do you smoke in a month?
 
0
 
3-5
 
10-29
 
30
 
 
 
Are you trying to quit smoking completely?
 
Yes, I'm trying to quit completely
 
No, I'm not trying
 
 
 
Do you see youself smoking 1 year from now?
 
Yes
 
No
 
 
 
On a scale of 1-7 select the rank of a word that is closest to your opinion about how you perceive smoking and your attitudes towards it. The number represent the degree of your opinion.

1 = Left adjectives, 7 = Right adjectives
(E.g. If you think smokers are very stupid, choose 1. If you think that they are mildly stupid choose 2 or 3. If you think they are mildly clever, choose 5-6)
 
 
I think smoker tend to be
1 2 3 4 5 6 7
Stupid_____________________Clever
Boring_____________________Fun
Don’t take risk_______________Risk takers
Unhealthy___________________Healthy
Introverted__________________Extraverted
Immature___________________Mature
Dull________________________Exciting
Unpopular___________________Popular
Unhappy____________________Happy
Follow others________________Make up own mind
1 2 3 4 5 6 7
Unfriendly___________________Friendly
Uncool______________________Cool
Poor________________________Rich
Uncaring____________________Caring
Unimportant__________________Important
Insecure____________________Secure
Shy________________________Confident
Mean _______________________Kind
Uncooperative________________Co-operative
Not generous_________________Generous
1 2 3 4 5 6 7
Impulsive____________________Cautious
Not successful________________Successful
Superficial thinker_____________Deep thinker
Low achiever_________________High achiever
Bad_________________________Good
Weak_______________________Strong
Not likeable__________________Likeable
Unreliable___________________Reliable
Incapable___________________Capable
Lonely______________________Not lonely
1 2 3 4 5 6 7
Unfashionable________________Fashionable
Not respected by people________Respected by people
Drive fast____________________Don’t drive fast
Bad at sports_________________Good at sports
Like gambling_________________Don’t like gambling
Don’t like partying_____________Like partying
Don’t care about environment_______Care about the Environment
Unattractive to opposite sex_________Attractive to opposite sex
 
 
 
Demographic Information (Please circle the answer that applies to you)
 
 
 
Nationality
 
Thai
 
Non-Thai
 
 
 
Sex
 
Male
 
Female
 
 
 
Occupation
   
Age
   
 
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