Feedback

1. How did you hear about DeterminedToQuit.com? Select... A web search (Google, AOL, Yahoo) Television Radio Web banner advertisement A link from another site A family member or friend An anti-tobacco event in my area A support or community group Other If other, how?

2. What brought you to this site today? Select... I was looking for information for myself I was looking for information for someone else I was just curious about the what the site offers I was looking for educational materials Other If other, what?

3. How often do you visit this website?  First time
 Less than once a month
 Once or more a month
 Once or more a week
 Daily

4. What type of information were you looking for today? Select... Quit methods Online support for quitting Nicotine Replacement Therapy (Patch/Gum/Rx) Local events and support groups Health information and statistics Success Stories Other If other, what?

5. DeterminedToQuit.com's Quit Companion offers support messages to those who are attempting to quit. How would you like to receive these messages?
(Check all that apply. This does not mean you will start receiving messages.)  EMail
 Text Message
 Phone Call
 None

6. Was there anything you were looking for but couldn't find?  Yes
 No If yes, what?

7. How can we improve this website?

1. Age?  Under 18 years of age
 18-24 years old
 25-34 years old
 35-49 years old
 50-64 years old
 65+ years of age

2. Gender?  Male
 Female

3. Which of the following best describes your race/ethnicity?  Asian & Pacific Islander
 Black
 Hispanic / Latino
 White
 Prefer Not to Answer

4. Highest level of education? Select... Some high school High school diploma or GED Technical or trade school diploma Some college Associate degree Bachelors' degree Masters' Degree or some other post-professional degree

5. What is your annual household income? Select... Less than $24,999 $25,000 to $49,999 $50,000 to $74,999 $75,000 to $99,999 $100,000 to $149,999 $150,000 or more

6. Are you a resident of Pennsylvania?  Yes
 No If yes, in which county do you live? Select... AdamsAlleghenyArmstrongBeaverBedfordBerksBlairBradfordBucksButlerCambriaCameronCarbonCentreChesterClarionClearfieldClintonColumbiaCrawfordCumberlandDauphinDelawareElkErieFayetteForestFranklinFultonGreeneHuntingdonIndianaJeffersonJuniataLackawannaLancasterLawrenceLebanonLehighLuzerneLycomingMckeanMercerMifflinMonroeMontgomeryMontourNorthamptonNorthumberlandPerryPhiladelphiaPikePotterSchuykillSnyderSomersetSullivanSusquehannaTiogaUnionVenangoWarrenWashingtonWayneWestmorelandWyomingYork

7. Average time spent online each week for personal use, including email? Select... Less than 5 hours 5-10 hours 10-20 hours 20 or more hours

8. If you use tobacco products, which of the following statements best describe your current mindset? Select... I am thinking of quitting and looking for ways to start I have quit in the past and am willing to try again I wanted to research what I can expect when quitting I am not ready to quit, but want to know my habits I don't use tobacco products.