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Cigarette Litter Survey

Thank you for taking the time to fill out our cigarette litter survey. Your responses to this survey help us create a more beautiful region. Thanks again for helping to keep Truckee Meadows beautiful! Once you fill out your email address and hit "submit" you will be entered to win a free 100% organic KTMB tote bag.

Survey

Please fill out our survey below:

1. Are you a smoker?:	Yes No
2. Does someone close to you smoke?	Yes No
3. Do you consider cigarette butts litter?	Yes No
4. When do you consider cigarette butts as litter?	Never When there is a receptacle that it could be put in Always Other
5. How much does cigarette litter in the community bother you?	Don't Care Bother's Me I Think It's a Health Hazard
6. Where do you notice most cigarette litter?
7. If more cigarette receptacles were placed in the areas you listed above, would you use them?	Never 25% of the time 50% of the time 75% of the time Always
8. Do you have a pocket ashtray (a portable container to put used cigarettes when there are no other cigarette receptacles)?	Yes No
9. If you do not have a pocket ashtray, would you use one?	Yes No
10. If you use or would use a pocket ashtray, how often would or do you use it?	Never 25% of the time 50% of the time 75% of the time Always
11. Would you encourage others to use pocket ashtrays?	Yes No
12. How important are the use of pocket ashtrays to keep down cigarette litter?	Not Important Kind of Important Extremely Important
13. How would you recommend spreading the word about "Being Responsible for Your Butt"?
Other Comments:
I would like to do more to prevent Cigarette Litter! Donate Now!	I Would Like to Volunteer, Please Contact Me I Would Like to Donate to Support this Program, Please Contact Me
Name:
Phone Number:
Email Address:

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