11 Quick Question - Carbal's TIS Survey

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?*

YesNo
What is your age?*
What postcode do you currently reside in?*
Would you currently describe yourself as being a smoker or a non-smoker?*

SmokerNon-Smoker
Are you an ex-smoker?*

YesNo
How many cigarettes or tobacco products would you have in an average day?*
Do you vape?*

YesNo
How many vapes would you have in an average day?*
Have you previously considered or tried to quit?*

YesNo
Do you know where to get help to quit?*

YesNo
Do you want Carbal's TIS team to contact you and help you to commence your quitting journey?*

YesNo
If so, can you please provide your mobile phone number:
eg: 0402123456
Should be Empty:

11 Quick Questions: Carbal's TIS Survey