Questionnaire A few seconds after answering this questionnaire, you will receive a personal evaluation report based on your answers. This report will be tailored to your personal characteristics. It will motivate you to quit smoking and tell you how to do it. Come back in a few weeks and answer the questionnaire again. Participating in the follow-up will increase your chances of quitting smoking.
Participation is free of charge.
We would like to archive your answers in a computer file. This way, the next time you ask for a feedback report, we'll be able to tell you whether you have progressed in this program. If you do not want us to archive your answers, please say so when answering the last question. Health On the Net Foundation and the Institute for Social and Preventive Medicine will treat your personal details as completely confidential. We will not release them to another organisation and will not use them for commercial or mass-mailing purposes.