Tobacco Survey

This survey asks you questions about tobacco (cigarettes and smokeless tobacco). Maybe you don't know much about tobacco. Maybe you know someone who uses it. Just answer based on what you think. Answer as honestly as you can. If you do not want to answer a question, you can skip it. This survey is anonymous!

Part 1


1 Have you ever tried cigarette
smoking, even one or two puffs?
2 Have you ever used chewing tobacco, snuff, or dip?
3 How many of your four closest friends smoke cigarettes?





4 How many of your four closest friends use chewing tobacco, snuff, or dip?





5 If one of your best friends offered you a cigarette, would you smoke it?

6 Do you think it is safe to smoke for only a year or two, as long as you quit after that?

Part Two


1 Do you think most middle school students smoke?
2 Why do you think young people smoke cigarettes or use smokeless tobacco?
3 Have you ever felt pressured to use tobacco?

If you have ever felt pressured to use tobacco, what did you do?


4 Do you think there are health consequences with using tobacco?

If you think there are health consequences with using tobacco, what do you think they are?


5 Do you think it's easy or difficult for people to quit using tobacco?

Explain why you think it's easy or difficult to quit using tobacco:


6 How do you feel about hanging out with young people who use tobacco?


Explain why:



If you need to print this page, click "Print" before you click "Submit." Then, close the print window and click "Submit" to send your anonymous responses and see a final question.

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