11 Quick Questions: Carbal's TIS Survey
Complete our short online survey and go in to the draw to win a Carbal TIS merchandise pack!
Do you identify as having Aboriginal and/or Torres Strait Islander heritage?
*
Yes
No
What is your age?
*
What postcode do you currently reside in?
*
Would you currently describe yourself as being a smoker or a non-smoker?
*
Smoker
Non-Smoker
Are you an ex-smoker?
*
Yes
No
How many cigarettes or tobacco products would you have in an average day?
*
Do you vape?
*
Yes
No
How many vapes would you have in an average day?
*
Have you previously considered or tried to quit?
*
Yes
No
Do you know where to get help to quit?
*
Yes
No
Do you want Carbal's TIS team to contact you and help you to commence your quitting journey?
*
Yes
No
If so, can you please provide your mobile phone number:
eg: 0402123456
Submit
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