0 ' BRIEN ASSOCIATES SHERROOD INC _ TKREE CITY CICARETTE STUDY 24 {7-16 #OCDSIDE AVENUE ATLANTA ROODSIDE 11377 NET YORK CHICAGO WOODBRIDGz SCREENZNG PAGz morning/afcernoon/evening Good My 13 nane :rom taikicg people -oday Research 2c wa [2 abouc 0p1:ions chelr 1rouc produccs and certaln like ask few you questions reading In che time Looking Past week Jave Of Ewo you 3pene ary Chrough or nagazine newspaper at nme (Asx Yes TERMINATE) Nc (THANK AND smoke cigafettes? Do filter You TERMINATE) Yes (ASK 0. 341 No (TAANK AND 3A . smoke Q. 3B) If Do Ycu usuafly menthol? Yes (ASK "No (THANK AND TZRMINATE 35 , Within the have cigarette survey Pasz mont-s or been interviewed 63 YJu on mall here at this Yes THANK AND TERMINATE) No (ASK Q. J8lowfegujao 1s cigarettes Wnat brand o brand smoke most tne often? You {RECORD SiOw BRAND LIST To DETERMINE MHICH VERSION AND NOMEER) Full Nare Number {BE SURZ THAT NAME AND NOMBER AGREE } IOII, (NOTE : BRAND HAS NC NUMBER NEXT THANX AND TERMINATE ) ing How long have {BRAND (DO NOT You been anox Iv READ LISI; monchs or iess 7-1 12 months (aboue} year ronzhs Over year years 11 morehs Over Years 1 52. Above how many you smoke packs Ceartons cigarettes do week? Or days (If How xould answer 10 aak many Packs Eha pe ir week? Packs Carcons
0 ' BRIEN SHERROOD ASSOCIATES {7-16 #OCDSIDE AVENUE ROODSIDE NET YORK 11377 INC _ TKREE CITY CICARETTE STUDY 24 ATLANTA CHICAGO WOODBRIDGz SCREENZNG PAGz Good morning/afcernoon/evening My nane 13 :rom Research 2c wa [2 taikicg people -oday abouc chelr 0p1:ions 1rouc certaln produccs and like ask you few questions In che Past week Of Ewo Jave you 3pene ary time Looking Chrough or reading nagazine newspaper at nme (Asx Yes (THANK AND TERMINATE) Nc Do You smoke filter cigafettes? (TAANK AND TERMINATE) Yes (ASK 0. 341 No 3A . Do Ycu usuafly smoke (ASK Q. 3B) If "No (THANK AND TZRMINATE menthol? Yes 35 , Within the Pasz mont-s or 63 have YJu been interviewed on here at this mall cigarette survey Yes THANK AND TERMINATE) No (ASK Q. Wnat 1s J8lowfegujao brand o cigarettes tne brand You smoke most often? {RECORD SiOw BRAND LIST To DETERMINE MHICH VERSION AND NOMEER) Full Nare Number {BE SURZ THAT NAME AND NOMBER AGREE } BRAND HAS NC NUMBER NEXT IOII, THANX AND TERMINATE ) (NOTE : How long have You been anox ing {BRAND Iv (DO NOT READ LISI; monchs or iess 7-1 12 months (aboue} year ronzhs Over year years 11 morehs Over Years 52. Above how many packs Or Ceartons cigarettes do you smoke week? (If answer 10 days aak How many Packs xould Eha pe ir week? 1 Packs Carcons