1. How did you hear about DeterminedToQuit.com?
A web search (Google, AOL, Yahoo)
Web banner advertisement
A link from another site
A family member or friend
An anti-tobacco event in my area
A support or community group
If other, how?
2. What brought you to this site today?
I was looking for information for myself
I was looking for information for someone else
I was just curious about the what the site offers
I was looking for educational materials
If other, what?
3. How often do you visit this website?
Less than once a month
Once or more a month
Once or more a week
4. What type of information were you looking for today?
Online support for quitting
Nicotine Replacement Therapy (Patch/Gum/Rx)
Local events and support groups
Health information and statistics
If other, what?
5. DeterminedToQuit.com's Quit Companion offers support messages to
those who are attempting to quit. How would you like to receive these messages?
(Check all that apply. This does not mean you will start receiving messages.)
6. Was there anything you were looking for but couldn't find?
If yes, what?
7. How can we improve this website?
Under 18 years of age
18-24 years old
25-34 years old
35-49 years old
50-64 years old
65+ years of age
3. Which of the following best describes your race/ethnicity?
Asian & Pacific Islander
Hispanic / Latino
Prefer Not to Answer
4. Highest level of education?
Some high school
High school diploma or GED
Technical or trade school diploma
Masters' Degree or some other post-professional degree
5. What is your annual household income?
Less than $24,999
$25,000 to $49,999
$50,000 to $74,999
$75,000 to $99,999
$100,000 to $149,999
$150,000 or more
6. Are you a resident of Pennsylvania?
If yes, in which county do you live?
7. Average time spent online each week for personal use, including email?
Less than 5 hours
20 or more hours
8. If you use tobacco products, which of the following statements best describe your current mindset?
I am thinking of quitting and looking for ways to start
I have quit in the past and am willing to try again
I wanted to research what I can expect when quitting
I am not ready to quit, but want to know my habits
I don't use tobacco products.
Oral tobacco products contain 28 carcinogens (cancer-causing agents).