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Smoker Offers - Sign up to become eligible for coupons & special offers. Limited to eligible smokers 21 or older.
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Once you are verified as a smoker 21 or older, you may be eligible to receive coupons, special offers and information delivered right to your door via U.S. Mail.
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First Name *
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Last Name *
Address *
City *
State *
Zip Code *
Date of Birth *
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Phone Number
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E-Mail Address  
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During the past 2 years, have you lived at another address? *
  Yes No
Please select exactly what you ask for when buying your regular brand - that is, when buying the brand you smoke most often. Please select the brand name and specific type. *
 
Is your regular brand...? *
 
Has this always been your regular brand? *
 
What would you do if you went to the store and your regular brand was not available?
Would you....? *
  Go to another store to buy your regular brand
Buy another type or length of your regular brand
Wait until the store has your regular brand
Buy a different brand entirely
How much do you agree or disagree with the following statements? *
  Strongly Disagree Somewhat Disagree Neither Agree or Disagree Somewhat Agree Strongly Agree
I'll buy a different brand of cigarettes, other than my regular brand, if it's on sale or if I have a coupon.
I'll buy a bonus product offer, like Buy-2-Get-1-Free, for a brand other than my regular brand.
I typically look for special offers and discounts on all brands when I'm buying cigarettes.
Which one of the following brands would you be most interested in receiving mail from? *
 
Electronic Signature:

Pursuant to the Federal Electronic Signatures in Global and National Commerce Act and applicable state laws, I consent to use and reliance on my electronic signature to verify the information that I have provided herein.  I certify that I am 21 years of age or older and that all of the information I provided in this survey is correct.   I further certify that I smoke cigarettes and would like to receive US Mail and/or e-mail communications from companies that market tobacco products.

Enter your first and last name below to indicate agreement—make sure you enter them exactly as you entered them above.
First Name *
Last Name *

By clicking on the "SUBMIT" button you consent to
sharing your information with the offer sponsor.