QUESTIONNAIRE
This questionnaire is part of a research project investigating smoking patterns and
associated health risks among university students in Birmingham. Your responses will remain
confidential and anonymous. Participation is voluntary.
Note: This questionnaire is intended only for individuals aged 18 years and above. Please do
not proceed if you are under 18
What are the patterns, motivations, and perceived health risks associated with smoking
among Ulster University students in Birmingham, and how can this knowledge inform
targeted health interventions within university settings?
Instructions
Please read each question carefully and click a box to indicate your answer or by writing in
the spaces provided.
The questionnaire has 6 sections with 26 items to complete and will take no longer than 10
minutes.
Once you have finished, please take a minute to check if you have answered all the questions
required.
Once you have completed the questionnaire, please submit it. If you do not wish to complete
the questionnaire, please submit blank form.
Remember, you do not have to answer any of the questions if you do not wish to do so.
Completion of the questionnaire is voluntary and implies your consent to take part. All
information given is confidential.
Section 1: Demographic Information
1. What is your age?
☐ 18–20
☐ 21–24
☐ 25–29
☐ 30 1, 2, 3, 4
2. What is your gender?
☐ Male
☐ Female
☐ Non-binary
☐ Prefer not to say 3, 2, 1, 0
3. What is your current level of study?
☐ Undergraduate
☐ Postgraduate (Master’s)
☐ Doctorate (PhD)
☐ Other: ………………. 1, 2, 3, 4
4. Which faculty are you in?
☐ Life and Health Sciences
☐ Arts, Humanities and Social Sciences
☐ Computing, Engineering and the Built Environment
☐ Business School
Other: ………………. 1, 2, 3, 4, 5
Section 2: Smoking Behaviour
5. Have you ever smoked a cigarette (even one puff)?
☐ Yes
☐ No → SKIP TO SECTION 6 1, 0
6. Do you currently smoke cigarettes?
☐ Yes, regularly (daily or almost daily)
☐ Yes, occasionally (less than once a day)
☐ No, I have quit
☐ No, I only tried it once or twice 4, 3, 2, 1
7. At what age did you start smoking regularly (if applicable)?
☐ Under 15
☐ 15–17
☐ 18–20
☐ 21+ 1, 2, 3, 4
8. How many cigarettes do you smoke per day on average?
☐ 1–5
☐ 6–10
☐ 11–15
☐ 16+ 1, 2, 3, -
9. What type of smoking product do you mainly use?
☐ Traditional cigarettes
☐ E-cigarettes / vapes
☐ Hookah / shisha
Other: ……………… 1, 2, 3, 4
10. Where do you usually smoke? (multiple selections allowed)
☐ At home
☐ In designated smoking areas on campus
☐ At social events (parties, clubs)
☐ In public places (parks, streets)
Other: ……………….
Section 3: Motivation and Influences
11. What are the main reasons you smoke? (multiple selections allowed)
☐ To relieve stress
☐ Peer pressure / social influence
☐ Out of habit / addiction
☐ For relaxation
☐ Boredom
☐ To stay alert / focused
Other: ………………….
12. How often do you feel the urge to smoke when stressed?
☐ Never
☐ Sometimes
☐ Often
☐ Always 1, 2, 3, 4
13. Have any of your close friends or family members smoked?
☐ Yes
☐ No
☐ Not sure 2, 1, 0
14. Have you ever tried to quit smoking?
☐ Yes
☐ No
☐ I don’t want to quit 2, 1, 0
15. If yes, what method did you use to try quitting? (multiple selections allowed)
☐ Cold turkey
☐ Nicotine patches/gum
☐ Smoking cessation program
☐ Support from friends/family
Other: ………………
Section 4: Health Impacts
16. Do you experience any of the following health issues? (multiple selections allowed)
☐ Shortness of breath
☐ Persistent cough
☐ Fatigue
☐ Anxiety or stress
☐ Chest pain
☐ Difficulty sleeping
☐ None of the above
17. Have you visited a healthcare provider due to smoking-related symptoms?
☐ Yes
☐ No
18. On a scale of 1 to 5, how concerned are you about the health effects of smoking?
Linear scale:
Very unconcerned Unconcerned Neutral Concerned Very concerned
1 2 3 4 5
Section 5: Awareness and Attitudes
19. Are you aware of the health campaigns or support services provided by the university
regarding smoking cessation?
☐ Yes
☐ No 1, 0
20. Would you be interested in participating in a campus-based smoking cessation program?
☐ Yes
☐ No
☐ Maybe 2, 1, 0
21. Do you believe smoking is a major health issue among university students?
☐ Yes ☐ No ☐ Not sure 2, 1, 0
22. In your opinion, what would be the most effective way to reduce smoking among students
(multiple selections allowed)
☐ Awareness campaigns
☐ Peer support groups
☐ Free access to quitting aids (patches/gum)
☐ Counselling services
☐ Stricter campus policies
Other: ……………………………