Questionnaire
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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.
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Come back in a few weeks and answer the questionnaire
again. You will obtain a follow-up report that will tell you if you have
made any progress in a series of key determinants of smoking cessation (intention
to quit, attitudes towards smoking, self-efficacy, the use of self-change
strategies, etc.). Participating in the follow-up will increase your chances
of quitting smoking.
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Participation is free of charge.
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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. Archived data will also be used for organizing the follow-up of
participants and for statistical analyses (in an anonymous format).
If you do not want us to archive your answers, please say so when answering the last question.
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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.
This program is intended for:
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