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Project ACCESS

Brief Pre-Screening Survey.

Please answer the questions below:


   

    

    
   
5. Are you currently in a smoking cessation program?
   
6. Do you currently use nicotine gum, the nicotine patch, spray, inhaler, lozenges, Wellbutrin (Zyban) or varenicline (Chantix)?
   

    

    

    
   
   
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Other