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* 1. CRL ID #:

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* 2. Please provide gender:

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* 3. What is your age?

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* 4. Are you a smoker?

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* 5. How many cigarettes do you smoke a day?

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* 6. Are you willing to not smoke for 24-72 hours?

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* 7. Are you willing to wear patches every other day?

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* 8. Are you willing to not smoke every other day?

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* 9. Are you willing to wear a nicotine patch?

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* 10. Do you react to adhesive patches?

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* 11. Are you an active exerciser?

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* 12. Are you willing undergo elevated temperature and humidity exposure at the end of the study?

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* 13. Please provide any other information you'd like to let us know about your activity level and smoking habits.

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