How soon after you wake do you smoke your first cigarette?
Within 5 minutes
6 to 30 minutes
31 to 60 minutes
After 60 minutes

Do you find it difficult to refrain from smoking in places where it is forbidden (for example, in church, at the library, at the movies)?
Yes
No

Which cigarette would you most hate to give up?
The first one in the morning
The afternoon break-time cigarette
The after-dinner smoke
The one smoked with friends in a bar

How many cigarettes per day do you smoke?
10 or less
11 to 20
21 to 30
31 or more

Do you smoke more frequently during the first hours after waking than during the rest of the day?
Yes
No

Do you smoke if you are so ill that you are in bed most of the day?
Yes
No