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Social support questionnaire There is a special person who is around when you are in need.

1=Strongly agree 2=Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree There is a special person with whom you can share joys and sorrows. 1=Strongly agree 2= Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree Your family really tries to help you. 1=Strongly agree 2=Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree You get the emotional help and support you need from your family. 1=Strongly agree 2=Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree You have a special person who is a real source of comfort to you. 1=Strongly agree 2=Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree Your friends really try to help you. 1=Strongly agree 2=Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree

You can count on your friends when things go wrong. 1=Strongly agree 2=Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree You can really talk about your problems with your family. 1=Strongly agree 2=Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree You have friends with whom you can share your joys and sorrows. 1=Strongly agree 2= Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree There is a special person in your life who cares about your feelings. 1=Strongly agree 2=Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree Your family is willing to help you make decisions. 1=Strongly agree 2=Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree You can talk about your problems with your friends. 1=Strongly agree 2=Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree Your spouse/partner supports (or would support) your efforts not to smoke.

1=Strongly agree 2=Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree 9= Not applicable You have some family or friends who help you (or would help you) not to smoke. 1=Strongly agree 2=Agree 3=Slightly agree 4=Slightly disagree 5=Disagree 6=Strongly disagree ______________________________________________________________

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