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. 2010 Jul 5;20(4):339–345. doi: 10.2188/jea.JE20090127

Appendix. Primary questions addressing smoking, and their response options, in the student questionnaire.

1. Have you ever smoked even 1 cigarette? [No/Yes]
2. Have you ever smoked daily for 6 months or more? [No/Yes]
3. Do you currently smoke? [daily/sometimes/never]
4. (For those who answered “daily” or “sometimes” to Question 3) (1) Have you ever abstained from smoking? [No/Yes] (2) Do you currently wish to quit smoking? [No/Yes] (3) Have you been advised to quit smoking? [No/Yes] (4) Have you smoked during the past year in the buildings of the university? [No/Yes] (5) Have you smoked during the past year on the premises of the university? [No/Yes]
5. (To those who answered “daily” to Question 3) How many cigarettes do you smoke daily?
6. How many days have you experienced passive smoking over the past 7 days?
7. In view of your position as a medical student, do you think that you should not smoke? [No, I do not think it is a problem/Yes, I think I should not smoke/I don’t know]
8. What is your view on smoking by patients? [They should not smoke/There is no problem with them smoking/Patients may smoke at their discretion/I don’t know]
9. For the following questions, please answer “No” or “Yes” to express your opinion.
  1) We should make it a policy not to smoke in public. [No/Yes]
  2) A doctor should master the ability to be a non-smoker. [No/Yes]
  3) A doctor should be an example to patients with regard to cessation of smoking. [No/Yes]
  4) A doctor should advise patients not to smoke. [No/Yes]
  5) A doctor should provide patients with information related to non-smoking. [No/Yes]
  6) If a doctor quits smoking, his/her patients will find it easier to quit smoking. [No/Yes]
  7) A doctor is as free to smoke as people in other occupations. [No/Yes]
10. Did you learn about smoking at school? [No/Yes]
11. Does your father smoke? [He doesn’t smoke/He used to smoke/He smokes currently/I have no father]
12. Does your mother smoke? [She doesn’t smoke/She used to smoke/She smokes currently/I have no mother]
13. Do you have a brother who smokes? [They don’t smoke/They used to smoke/They smoke currently/I have no brothers]
14. Do you have a sister who smokes? [They don’t smoke/They used to smoke/They smoke currently/I have no sisters]