Questionnaire

Direction: Please answer the following questions completely. All information will be

used for academic purposes only. We assure you that your answers will be respected

and kept highly confidentially. Kindly choose the best answer and put a checkmark on

the provided parenthesis beside the item, which corresponds to your answer.

I. PROFILE OF THE RESPONDENTS :

Name (optional):

Gender: ( ) Male ( ) Female

Age: ( ) 15-19 yrs. Old ( ) 30-34 yrs. Old

( ) 20-24 yrs. Old ( ) 35-39 yrs. old

( ) 25-29 yrs. Old ( ) 40 and above

Civil Status: ( ) Single ( ) Widow

( ) Married ( ) Separated

Family income:

( ) Php 20 000 above ( ) Php 5 000-10 000

( ) Php 11 000- 15 000 ( ) Php 5 000 below

What kind of consumer are you?

( ) Smoker ( ) Liquor Drinker ( ) Smoker and Liquor Drinker

Campuses: Hilltop | MH del Pilar | Pallocan East | Pallocan West | Lipa

Telephone Numbers: +63 43 723 1446 | 980 0041
Website: www.ub.edu.ph
 II. EFECT OF SIN TAX LAW TO CONSUMPTION PATTERN

Directions: Please answer the following questions according to its degree by checking
the column that corresponds to your answer.

3). How often you consume cigarettes/alcohol before Sin Tax?

Liquor
Frequency Smoking Frequency Drinking

5-7 times per

1 pack per day
week
11-15 times per 3-5 times per
day week
5-10 times per
2 times per week
day

2-4 times per day Occasional

4). How do the implementation of sin tax law affect your consumption pattern?

Effect of Implementation Smoking Drinking liquor

of Sin Tax Law

Increased in Consumption

Remained the Consumption

Decreased in Consumption

Stopped in Consumption

Campuses: Hilltop | MH del Pilar | Pallocan East | Pallocan West | Lipa

Telephone Numbers: +63 43 723 1446 | 980 0041
Website: www.ub.edu.ph
Campuses: Hilltop | MH del Pilar | Pallocan East | Pallocan West | Lipa
Telephone Numbers: +63 43 723 1446 | 980 0041
Website: www.ub.edu.ph