Survey of Missouri State Students
1 Have you ever smoked cigarettes?
Yes
No (Skip to Q4)
2 Have you ever drank alcohol?
3 Have you ever drank alcohol and smoked cigarettes together?
Yes (Skip to Q5)
No
4 Have you had opportunities to observe friends, family or other people when they drink and smoke?
Yes (Skip to Q9)
No (Skip to Q11)
5 When you drink, are you inclined to smoke more, the same or less than before you started drinking?
Smoke More
Smoke the Same (Skip to Q8)
Smoke Less (Skip to Q8)
6 Do you start smoking more cigarettes right away or after you have had a few drinks?
Right Away
After a few drinks
7 Do you smoke more when drinking in a social setting than when you drink when no one is around?
Social Setting
When no one is around
Both Equally
Neither
8 What makes you want a cigarette more, having a few drinks or being around someone else smoking?
Having a few drinks [Skip to Q11]
Being around someone else smoking [Skip to Q11]
Both Equally [Skip to Q11]
Neither [Skip to Q11]
9 When you have observed others drink, are they inclined to smoke more, the same or less than before they started drinking?
Smoke the Same (Skip to Q11)
Smoke Less (Skip to Q11)
10 Do they start smoking more cigarettes right away or after they have had a few drinks?
11 Please indicate your sex.
Male
Female
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To maintain the integrity of our random sample, please do not distribute this survey to anyone else. Thank you!