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| Q.1 |
How much do you pay for a pack
of cigarettes? |
R
|
| |
| Q.2 |
How many cigarettes are you smoking each
day? |
|
| |
| Q.3 |
When did you start smoking? (day
| month
| year) |
| |
|
|
|
| |
| |
Cost per day: |
R
|
| |
Cost per week: |
R
|
|
Cost per month: |
R
|
| |
Cost per year: |
R
|
| |
Cost if you continue smoking for
years |
R
|
| A. |
Total cost to date: |
R
|
| |
| |
|
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|
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