Lead Generation Solution

First Name *

Last Name *

Date of birth *

Email *

password *

Phone *

Are cigarettes the main nicotine product that you are using?

Yes

No

What would be your motivation towards switching from cigarettes today?

I am determined to switch completely from cigarettes to smoke free alternatives

I want to find a smoke free alternative to reduce my cigarette usage

I just want to find out more about IQOS

How do you prefer to be contacted?

Telephone

E-mail

Both telephone and e-mail

What time would you prefer to be contacted?

09.00-12.00 12.00-15.00 15.00-18.00

I agree to the , that I am an adult smoker user*

I would like to receive news and offers from IQOS**

**By subscribing you give consent to receive news and occasional promotions on non-tobacco products from Philip Morris via ordinary mail, e-mail, SMS and phone. You can unsubscribe at any time via our communication or on your profile. Read more in our privacy policy

CONTACT INFORMATION