Collectively, the two-part survey will give you insight into your students’ experience with tobacco and nicotine, their perceptions about tobacco and nicotine use, and their prior knowledge of the facts.
 
Since the survey asks students about their personal experience with tobacco and nicotine, it should be done independently and anonymously. Assure students that no personally identifying information will be included in the survey they email to you.

Before distributing the activity, explain to your class that they are going to take a survey about tobacco and nicotine. Instruct them that they will also learn facts about tobacco and nicotine use and tips for coping with peer pressure in this unit.

Then, direct your students to the online survey on the website by clicking the link below. We recommend emailing the link to them, posting it on a class webpage, projecting it on an interactive whiteboard, and/or writing it on a chalkboard. Remind students that their answers will be anonymous.

Encourage students to answer the questions as honestly as they can. Let them know that the first eight questions ask them about their experience with tobacco and nicotine and are only going to be used by you to get a sense of what they have experienced.

Inform them that once they are done with the survey, you will share some information with them related to Part Two. Explain that being informed is an important element in making the right decisions. Encourage students to volunteer answers if they feel comfortable.

Once the survey is complete, share with your students the facts listed in the answer key part of the “Wrapping Up” section to help dispel misperceptions they may have about tobacco and nicotine use.

Answers, part one

Answers will vary. Review the answers students provided for questions 1. This will give you a sense of your students’ experience with tobacco and nicotine but should not be shared with the students.

Answers, part two

1. Explain to students that most young people do not smoke or vape. Only about 1 of every 100 middle school students (1.0%) reported that they had smoked cigarettes in the past 30 days, and 1 out of every 30 middle school students (3.3%) reported that they had used electronic cigarettes (vapes) in the past 30 days.¹ Point out to students that the younger people are when they start smoking, the more likely they are to become addicted.³   

4. Ask students if they want to volunteer answers about why young people smoke or vape. Note their answers on the board. Explain to students that some of the reasons young people try or start to use tobacco and nicotine include: ^2,3

• They don’t feel good about themselves (low self-esteem and self-image).
• They don’t know about the health consequences of smokeless tobacco.
• They think lots of people smoke (overestimating the number of people who smoke/vape).
• They don’t realize that they can become addicted (not understanding the addictive potential of nicotine).  

5. Ask students if they want to volunteer answers about why they think young people choose to be tobacco and nicotine free. Explain that some people may choose to be tobacco and nicotine free because:^3,4 

• Their friends don’t use tobacco or nicotine.
• They know about the health consequences.
• They want to be tobacco and nicotine free. 

6. Explain to students that some young people try tobacco because of a “clack of self-efficacy in the ability to refuse offers to use tobacco,”³  or they don’t know how to tell their friends they don’t want to try it. 

Explain to students that people their age are sometimes pressured to use tobacco or nicotine products, and that pressure can be difficult to handle. Let them know that in this unit, they are going to learn some ways to say “no” and cope with peer pressure so they can be tobacco and nicotine free. 

If students volunteer stories, remind them not to use names. Listen to their concerns and explain to students that feeling pressure from friends happens, but that they will learn some ways to deal with the pressure.

8. Explain to students that there are health consequences related to tobacco and nicotine use and they will learn more about them in Activities Two and Three. If students want to volunteer answers, write them on the board and then revisit the list when you read Activity Three to see which ones are listed. 

9. Students might have heard that quitting tobacco and nicotine is difficult, but they may not know why. To illustrate the difficulty of quitting, offer this CDC statistic: “Most students who use tobacco products want to quit and have attempted to do so. This includes e-cigarettes. In 2020, nearly 2 in 3 middle and high school students who used e-cigarettes reported wanting to quit. Similarly, about 2 in 3 reported trying to quit in the last year.”³ Tell students that they will learn about nicotine’s addictive nature in detail later in the unit. 

10. Answers will vary. However, explain to your students that most teens strongly dislike being around smokers.² For additional information on factors that influence young people to use tobacco and nicotine and for reasons most of them abstain, review the Overview Booklet. 

To end the lesson, display the “Tobacco and Nicotine: Myth or Reality?” poster in the “Materials” section and review the content with your students. The poster will reinforce the message that most young people are tobacco free.

To assist you with evaluating your students’ anonymous responses to this survey, we have created a data collection spreadsheet that will allow you to input and view quantitative and qualitative measures. Click here to access the downloadable survey-response spreadsheet.

¹CDC. Smoking & Tobacco Use. Fact Sheet Youth and Tobacco Use: Current Estimates of Youth Tobacco Use. Referenced 2023. www.cdc.gov/tobacco/data_statistics/fact_sheets/youth_data/tobacco_use/index.htm

²https://www.ncbi.nlm.nih.gov/books/NBK99236/#ch4.s1

³ U.S. Department of Health and Human Services. Preventing Tobacco Use Among Youth and Young Adults: A Report of theSurgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; Washington, D.C., 2012. Referenced 2023. www.surgeongeneral.gov/library/reports/preventing-youth-tobacco-use/full-report.pdf

⁴ https://e-cigarettes.surgeongeneral.gov/knowtherisks.html#:~:text=Youth%20and%20young%20adults%20are,permanent%20lowering%20of%20impulse%20control.

⁵ CDC. Morbidity and Mortality Weekly Report, Quitting Smoking Among Adults — United States, 2001—2010, November 11, 2011.Vol. 47, No. 19. Referenced 2023. www.cdc.gov/mmwr/preview/mmwrhtml/mm6044a2.html