Attitudes and Norms Regarding Smoking Questionnaire

Hello, my name is Kineret Sher. I am doing my BA in Nursing at the Academic College of Emek Yezreel.

I am doing a study for my degree comparing subjective norms and opinions about smoking tobacco cigarettes between people who were born in Israel and people who were born in North America (Canada and the USA).

The questionnaire is anonymous; no identifying information is required.

I would be very grateful if you would fill out the following questionnaire to help me complete my study.

If you have any questions, please feel free to contact me at 053-5272345.

Thank you for your help and cooperation.

Age (in years)

Gender

Male

Female

Country of birth

Israel

North America (USA or Canada)

Other

Age at time of immigration (in years)

Have you served in the IDF?

Yes

Partial service or National Service

What part of your education did you acquire in Israel?

Elementary school and onward

Junior high school and onward

Senior high school and onward

Vocational/academic education

Other

Do you smoke tobacco cigarettes?

Yes

I did in the past

How many cigarettes, on average, do/did you smoke a day?

At what age did you start smoking?

In the following questions you are asked to fill in the answer most fitting for you on a scale of 1-7, each number representing a different opinion. For example: Black cats for me are: Very scary 7 6 5 4 3 2 1 Very cute If you think black cats are very cute, fill in the number 1. If you think black cats are quite scary, fill in the number 6. If you think black cats are slightly cute, fill in the number 3. If you think black cats aren’t cute or scary, fill in the number 4. Please do not skip any questions and do not fill in more the one answer. Please remember that the questions are all regarding only smoking tobacco cigarettes.

Thank you for your help, time and cooperation.

מערכת השאלונים הוקמה על ידי IMK
תוכן השאלון נוצר על ידי בונה השאלון ואינו נתמך או מאושר באופן כלשהו על ידי IMK
אין למסור נתונים חסויים כגון מספרי כרטיסי אשראי

	1	2	3	4	5	6	7
Smoking helps me relax (1: Strongly agree 7: Strongly disagree)	1	2	3	4	5	6	7
Smoking is fun (1: Strongly agree 7: Strongly disagree)	1	2	3	4	5	6	7
Smoking provides me with opportunities for interactions with other people (1: Strongly agree 7: Strongly disagree)	1	2	3	4	5	6	7
Smoking is bad for my health (1: Strongly agree 7: Strongly disagree)	1	2	3	4	5	6	7
Smoking is disgusting (1: Strongly agree 7: Strongly disagree)	1	2	3	4	5	6	7
Not smoking for me is (1: Extremely good 7: Extremely bad)	1	2	3	4	5	6	7
Smoking is (1: Extremely meaningful 7: Insignificant)	1	2	3	4	5	6	7

	1	2	3	4	5	6	7
If I smoke, people around me (1: Support me 7: Object strongly)	1	2	3	4	5	6	7
Most people that are important to me think (1:I should smoke 7: I shouldn’t smoke)	1	2	3	4	5	6	7
Most people that are close to me (1: Extremely support smoking 7: Extremely object to smoking)	1	2	3	4	5	6	7
If I smoke, my friends (1: Extremely support me 7: Extremely object)	1	2	3	4	5	6	7
If I smoke, my friends (1: Get closer to me 7: Distance themselves from me)	1	2	3	4	5	6	7
If I smoke, my family (1: Extremely support me 7: Extremely object)	1	2	3	4	5	6	7
If I smoke, my family (1: Get closer to me 7: Distance themselves from me)	1	2	3	4	5	6	7