Tobacco Control Strategies Survey

The Institute for Disability Studies creates newsletters, brochures, posters, public service announcements and online interviews promoting tobacco prevention and cessation for people with disabilities, mental illness and substance use disorder. These resource materials are promoted through an email group, social media, on two websites, online interviews and more. This survey will help to us discover how these prepared materials have been learned about, obtained, and used to promote cessation.

TCS Email List membership *

TCS Email List membership Join me up! No Thanks I'm already on the list

TCS Email List membership means you'll receive about four emails per year with information on TCS activities and resources.
Do you want to be entered into the Backpack giveaway? *

Do you want to be entered into the Backpack giveaway? Yes No

To be eligible to receive a backpack, please check "Yes" on this question and fill in all contact and mailing information.
Email *
Name Name * First Last
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone * - ### - ### ####
1. Which of our materials have you seen? *

1. Which of our materials have you seen? TCS News newsletters Posters YouTube Video Public Service Annoucements (PSAs) Television PSAs Chit Chat Thursday with Taylor YouTube Interviews IDS (https://usmids.org/home/tobacco-control-strategies/) MS Leadership Academy (https://msleadership.org) Brochures Sorry, Haven't seen a thing

(Please check all that apply.)
2. How did you learn about the materials?

2. How did you learn about the materials? Email Newsletter Conference display Facebook This is the first I've heard of the materials Other Other
3. How have you used the materials? (Please check all that apply.)

3. How have you used the materials? (Please check all that apply.) Printed and handed out paper materials Emailed electronic materials Shared social media Shared internet links Sorry, Haven't shared them yet Other Other
4. Check all that apply *

4. Check all that apply I smoke cigarettes I don't use tobacco I use smokeless tobacco I vape I use tobacco in another form. Enter which form below.
5. If you are a former tobacco user, why did you quit?

5. If you are a former tobacco user, why did you quit? Health concerns Expensive Tired of having to go outside Other Other
6. If you are a current tobacco user, what made you start?

6. If you are a current tobacco user, what made you start? Peer pressure Helped with nerves Had too much money in my pocket Curbed my appetite Other Other
7. Are you currently, or have your been, exposed to secondhand smoke in your home?

7. Are you currently, or have your been, exposed to secondhand smoke in your home? Yes No
8. Would you want your children or parents to start using tobacco?

8. Would you want your children or parents to start using tobacco? Yes No
9. Does anyone in your household use tobacco?

9. Does anyone in your household use tobacco? Yes No
10. Do you have a diagnosed disability?

10. Do you have a diagnosed disability? Yes No
11. Does anyone in your household have a diagnosed disability? *

11. Does anyone in your household have a diagnosed disability? Yes No
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