Innovative Tobacco Research

Thank you for registering your interest in this new research on behalf of a Worldwide Tobacco Organisation.

This leading and innovative research will give you the opportunity to test a new type of tobacco product, similar in style to an e-cigarette, and we need your feedback!

The research is in the form of a 90 minute session and is taking place on Saturday 24th & Sunday 25th January 2015.

For just 90 minutes of your time we are offering £50 cash incentive!

Details as follows:

Date – Saturday 24th & Sunday 25th January
Duration – 90 mins
Location - London
Incentive - £50 cash incentive
Type of research - Product Testing

When completing the form please answer carefully and as honestly as possible, there are no right or wrong answers, all answers will be looked at individually when checking that you are applicable for the research.

If you do fit the profile of respondent that we are looking for, then one of our team will call you to book you in.

Your Details...

Please amend any details that may have changed since last registering for research (current members only)

Your Contact Details

This will be used as the location in which the research may take place (e.g group discussions), alternatively please select local research only and we will contact you for anything within your local area and telephone interviews.

Your Lifestyle

Do you smoke regularly?
FEMALES ONLY - For the purpose of the research are you currently pregnant or lactating?

Your Smoking

Have you been smoking this brand of cigarette for 8 weeks or longer?
Do you suffer from any serious health conditions, physically or mentally?
Do you have a persistent cough or phlegm?
Have you been instructed by your doctor to quit tobacco use?
During the study, you will be asked to test a new type of tobacco product (similar in style to an e-cigarette) Would you be willing to try this product?


This information will be held confidentially and securely by Take Part in Research Ltd in accordance with the Data Protection Act 1998 and Market Research Society Code of Conduct.

I understand that my information will only be used to provide me with the opportunity to participate in occasional paid research. I am aware that I am under no obligation to participate and I am entitled to have my data removed at any point.

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