Lead Generation Solution

Name *

Phone number *

E-mail *

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

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