Gen Z Smoking Study Qualification

Full Name

Email Address

Phone Number

Date of Birth

Format: Month/Day/Year (e.g., 01/15/2000)

Address Line 1

Address Line 2 (Optional)

City and State

ZIP Code

Do you currently live in the United States or a U.S. territory?

Yes No

If you had to choose, how would you describe where you live?

Suburban Urban Rural

Please indicate your gender

Have you ever used any of the following products, even just a few puffs/tries?

Have you used E-cigarettes or vapes that contain nicotine once in the past year?

Yes No

For how long have you been using E-cigarettes or vapes that contain nicotine at least monthly?

For less than 3 months For 3-6 months For 6-12 months For 13-18 months For 19-24 months For about 2 years For more than 24 months I don't use E-cigarettes or vapes that contain nicotine monthly

When was the first time you used E-cigarettes or vapes that contain nicotine?

Sometime in the last 3 months Sometime in the last 3-6 months Sometime in the last 6-12 months About a year ago Sometime in the last 13-18 months More than 18 months ago Not applicable

Have you used Cigarettes once in the past year?

Yes No

For how long have you been using Cigarettes at least monthly?

For less than 3 months For 3-6 months For 6-12 months For 13-18 months For 19-24 months For about 2 years For more than 24 months I don't use Cigarettes monthly

Have you used Cigars once in the past year?

Yes No

For how long have you been using Cigars at least monthly?

For less than 3 months For 3-6 months For 6-12 months For 13-18 months For 19-24 months For about 2 years For more than 24 months I don't use Cigars monthly

Have you used Cigarillos or little cigars once in the past year?

Yes No

For how long have you been using Cigarillos or little cigars at least monthly?

For less than 3 months For 3-6 months For 6-12 months For 13-18 months For 19-24 months For about 2 years For more than 24 months I don't use Cigarillos or little cigars monthly

Have you used Smokeless tobacco like dip and chew once in the past year?

Yes No

For how long have you been using Smokeless tobacco like dip and chew at least monthly?

For less than 3 months For 3-6 months For 6-12 months For 13-18 months For 19-24 months For about 2 years For more than 24 months I don't use Smokeless tobacco like dip and chew monthly

Have you used Nicotine pouches, like Zyn once in the past year?

Yes No

For how long have you been using Nicotine pouches, like Zyn at least monthly?

For less than 3 months For 3-6 months For 6-12 months For 13-18 months For 19-24 months For about 2 years For more than 24 months I don't use Nicotine pouches, like Zyn monthly

When was the first time you used Nicotine pouches, like Zyn?

Sometime in the last 3 months Sometime in the last 3-6 months Sometime in the last 6-12 months About a year ago Sometime in the last 13-18 months More than 18 months ago Not applicable

Have you used Hookah (also called waterpipes) once in the past year?

Yes No

For how long have you been using Hookah (also called waterpipes) at least monthly?

For less than 3 months For 3-6 months For 6-12 months For 13-18 months For 19-24 months For about 2 years For more than 24 months I don't use Hookah (also called waterpipes) monthly

Have you used Pipe tobacco once in the past year?

Yes No

For how long have you been using Pipe tobacco at least monthly?

For less than 3 months For 3-6 months For 6-12 months For 13-18 months For 19-24 months For about 2 years For more than 24 months I don't use Pipe tobacco monthly

Have you used Heated tobacco products, like IQOS once in the past year?

Yes No

For how long have you been using Heated tobacco products, like IQOS at least monthly?

For less than 3 months For 3-6 months For 6-12 months For 13-18 months For 19-24 months For about 2 years For more than 24 months I don't use Heated tobacco products, like IQOS monthly

Have you used Other type of tobacco product once in the past year?

Yes No

For how long have you been using Other type of tobacco product at least monthly?

For less than 3 months For 3-6 months For 6-12 months For 13-18 months For 19-24 months For about 2 years For more than 24 months I don't use Other type of tobacco product monthly

On average, how many fruits and vegetables do you eat in a day?

None 1-2 3-4 5 or more

On average, how many hours of sleep do you get in a 24-hour period?

Less than 5 hours 5 hours 6 hours 7 hours 8 hours 9 hours 10 hours More than 10 hours

Have you ever tried alcohol, even one or two sips?

Yes No

Have you ever used marijuana (also known as pot, hash, or THC)?

Yes No

Are you willing to participate in all elements of this study?

Yes No

Do you have access to an electronic device that has a working video camera and microphone?

Yes No

Do you own a smartphone?

Yes No

How would you prefer to be contacted?

Email Phone Text No preference

Where did you hear about the study?

Instagram Facebook Ad TikTok Facebook Group Support Group Google Provider Facebook

If you are not eligible for this study, would you like to give us permission to contact you about other studies or future opportunities that you may qualify for?

Yes, I give permission to be contacted about other studies or future research opportunities. No, I do not wish to be contacted for future research opportunities.