1) Do you currently smoke?

Yes
No

2) Are you aware of the $25 fine for smoking in the car with a child under age 14?

Yes
No

3) What is your preferred method of receiving health-related information?

TV
Radio
Internet
Billboard
Social Media (i.e., Facebook, Twitter, etc.)

4) Would you consider calling the Arkansas Tobacco Quit Line (1-800-QUIT NOW) for quitting assistance?

Yes
No

5) Would you consider calling the Arkansas Tobacco Quit Line (1-800-QUIT NOW) to refer a friend/ family member?

Yes
No

6) Are you aware that UAPB is a tobacco-free campus?

Yes
No

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