FLORIDA YOUTH SURVEY 2018
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- Cameron Chandler
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1 SERIAL # PLEASE DO NO WRIE IN HIS AREA \\\\\\\\\\\\\\\\\\\\\\\\ FLORIDA YOUH SURVEY 2018
2 Florida Youh obacco Survey (FYS) 2018 Quesionnaire his survey is abou you and wha you do ha may affec your healh. he informaion you give us will be used o develop beer educaion programs for people like you. DO NO wrie your name on his survey. he answers you give will be kep privae. one will know wha you wrie. Remember, his is no a es. Answer he quesions based on wha you really do and know. Compleing he survey is volunary. Wheher or no you answer he quesions will no affec your grade in his class. If you are no comforable answering a quesion, jus leave i blank. he quesions ha ask abou your background will only be used o describe he ypes of sudens compleing his survey. he informaion will no be used o find ou who you are. names will ever be repored. Make sure o read every quesion. Fill in he circles on he survey bookle compleely. When you are finished, follow he insrucions of he person giving you he survey. hank You Very Much For Your Help.
3 DIRECIONS Make dark marks. Fill in a response like his: \\\\» A B C D o change your answer, erase compleely. INFORMAION ABOU YOU 1. Wha is your age? Wha is your sex? Female Male 3. Wha grade are you in? 6h 7h 8h 9h 10h 11h 12h \ j. \ k. \ l. \ m How do you bes describe yourself? (SELEC ONLY ONE RESPONSE) American Indian or Alaska Naive Asian Black or African American Naive Hawaiian or Oher Pacific Islander Whie Oher 5. Are you Hispanic or Laino? 6. In wha ype of house or building do you live? A sand-alone single-family home A railer or mobile home An aached home like a ownhouse or duplex A muli-sory building like a condominium or aparmen Oher Incorrec Marks \\\\ A B C D 7. During he pas 12 monhs, how would you describe your grades in school? Mosly A s Mosly B s Mosly C s Mosly D s 8. Are you an acive member of S.W.A.. (Sudens Working agains obacco)? 9. Have you ever ried cigaree smoking, even one or wo puffs? \ j. \ k. Mosly F s ne of hese grades sure here is no a S.W.A.. group in my school or communiy I am no sure 10. Wha age were you when you smoked a cigaree for he firs ime? I have never smoked a cigaree 8 or younger or older 11. Abou how many cigarees have you smoked in your enire life? ne 1 o 2 puffs, bu no a whole cigaree One cigaree 2 o 20 cigarees 21 o 99 cigarees 100 or more cigarees page 1
4 12. Have you ever smoked cigarees daily, ha is, a 19. How many imes, if any, have you ried o qui leas one cigaree every day for 30 days? smoking cigarees? I have never smoked cigarees ne 1 ime 13. During he pas 30 days, on how many days did 2 imes you smoke cigarees? 3 o 5 imes 0 days 10 o 19 days 6 o 9 imes 1 or 2 days 20 o 29 days 10 or more imes 3 o 5 days All 30 days 6 o 9 days 20. When you las ried o qui, how long did you say off cigarees? 14. During he pas 30 days, on he days you smoked, I have never smoked cigarees how many cigarees did you smoke per day? I smoke bu have never ried o qui 0 cigarees per day Less han 1 day Less han 1 cigaree per day 1 o 7 days 1 cigaree per day More han 7 days bu less han 30 days 2 o 5 cigarees per day More han 30 days bu less han 6 monhs 6 o 10 cigarees per day More han 6 monhs bu less han 1 year 11 o 20 cigarees per day More han 1 year More han 20 cigarees per day 21. How long can you go wihou smoking before 15. Are he cigarees you usually smoke menhol you feel like you need a cigaree? cigarees? I do no smoke cigarees I do no smoke cigarees Less han one hour 1 o 3 hours More han 3 hours bu less han a whole day A whole day Several days 16. During he pas 30 days, how did you usually ge A week or more your cigarees? (CHOOSE ONLY ONE ANSWER) I did no smoke during he pas 30 days 22. How soon afer you wake up do you usually I bough hem in a sore such as a convenience smoke your firs cigaree? sore, supermarke, or gas saion I gave someone else money o buy hem for me I don smoke now I borrowed (or bummed) hem from someone else Less han 15 minues I sole hem from a sore 15 o 30 minues I sole hem from someone I know More han 30 minues bu less han 60 minues I go hem from my parens 1 o 2 hours A person 18 years old or older gave hem o me More han 2 hours bu less han half a day I bough hem from anoher person (no in a sore) More han half a day \ j. I bough hem on he inerne \ k. I go hem some oher way 23. During he pas 12 monhs, did you do any of he following o help you sop smoking? 17. During he pas 30 days, did you smoke cigarees (SELEC ALL YOU HAVE RIED) on school propery? I did no smoke in he pas 12 monhs I do no smoke cigarees Aended a program in my school Aended a program in my communiy Called a help line or a qui line Used nicoine gum or nicoine pach Used any medicaions o help you sop 18. During he pas 12 monhs, did you ever ry o Used a qui line service on he inerne qui smoking cigarees? Used an elecronic vapor produc o help qui I did no smoke cigarees in he pas 12 monhs I have no done anyhing o qui page 2
5 24. Are you hinking abou quiing smoking? Would you say Wha age were you when you used an elecronic vapor produc for he firs ime? I do no smoke now, wihin he nex 30 days, wihin he nex 6 monhs, bu no wihin he nex 6 monhs, I am no hinking of quiing smoking for good sure Elecronic Vapor Producs HE NEX QUESIONS REFERENCE BAERY- POWERED DEVICES HA PRODUCE VAPOR INSEAD OF SMOKE AND USUALLY CONAIN NICOINE-BASED LIQUID HA IS INHALED. YOU MAY KNOW HEM AS E-CIGAREES, E-CIGARS, E-PIPES, VAPE PENS, E-HOOKAHS, OR VAPORIZERS MADE BY COMPANIES SUCH AS NJOY, BLU, VUSE, MARKEN, FINII, SARBUZZ, AND FANASIA. 25. Have you ever used an elecronic vapor produc? 26. Do you hink using elecronic vapor producs is harmful o your healh? sure 27. Do you hink breahing aerosol from elecronic vapor producs is harmful o your healh? sure I have never used an elecronic vapor produc 8 or younger days 1 or 2 days 3 o 5 days 6 o 9 days 28. Compared o cigaree smoking, using elecronic vapor producs is More harmful Equally harmful Less harmful sure \ j. \ k or older 30. During he pas 30 days, on how many days did you use an elecronic vapor produc? 10 o 19 days 20 o 29 days All 30 days 31. During he pas 30 days, did you use an elecronic vapor produc on school propery? 35. Have you ever used an elecronic vapor produc wih any of he following? (SELEC ALL HA APPLY) I have never used an elecronic vapor produc 32. When you use an elecronic vapor produc, is i usually flavored (for example: cherry, chocolae, or bubblegum)? I have never used an elecronic vapor produc 33. During he pas 30 days, how did you usually ge your elecronic vapor produc? (CHOOSE ONLY ONE ANSWER) \ j. \ k. I did no use an elecronic vapor produc during he pas 30 days I bough hem in a sore such as a convenience sore, supermarke, or gas saion I go hem from my parens I bough hem from anoher person I gave someone else money o buy hem for me I bough hem on he Inerne I borrowed (or bummed) hem from someone else I sole hem from a sore I sole hem from someone I know A person 18 years old or older gave hem o me I go hem in some oher way 34. Where do you usually use an elecronic vapor produc? (CHOOSE ONLY ONE ANSWER) I have never used an elecronic vapor produc A your home A anoher person s home A a resauran, bar, or elecronic vapor produc shop A a relaive s house A school In a car Ouside Somewhere else I have never used an elecronic vapor produc Nicoine Marijuana oil or hash oil Bah sals or flakka Spice or K2 I have no used any of hese drugs while vaping sure page 3
6 HE NEX QUESIONS INCLUDE CIGARS, CIGARILLOS, AND LILE CIGARS, SUCH AS SWISHER SWEES, BLACK & MILD, PHILLIES, GARCIA Y VEGA, MACANUDOS, OR KING Smokeless obacco HE NEX QUESIONS INCLUDE CHEWING OBAO, SNUFF, OR DIP, SUCH AS RED MAN, LEVI GARRE, BEECH-NU, SKOAL, SKOAL BANDIS, OR COPENHAGEN. EDWARD. 41. Have you ever used chewing obacco, snuff, 36. Have you ever ried smoking cigars, cigarillos, or dip? or lile cigars, even one or wo puffs? 42. Wha age were you when you used chewing 37. Wha age were you when you smoked a cigar, obacco, snuff, or dip for he firs ime? cigarillo, or lile cigar for he firs ime? I have never used smokeless 12 I have never smoked a cigar, 12 obacco 13 cigarillo, or lile cigar 13 8 or younger 14 8 or younger \ j \ j \ k. 17 or older 11 \ k. 17 or older 43. During he pas 30 days, on how many days did 38. During he pas 30 days, on how many days did you use chewing obacco, snuff, or dip? you smoke cigars, cigarillos, or lile cigars? 0 days 10 o 19 days 0 days 10 o 19 days 1 or 2 days 20 o 29 days 1 or 2 days 20 o 29 days 3 o 5 days All 30 days 3 o 5 days All 30 days 6 o 9 days 6 o 9 days 44. During he pas 30 days, did you use chewing 39. During he pas 30 days, did you smoke cigars, obacco, snuff, or dip on school propery? cigarillos, or lile cigars on school propery? I did no use chewing obacco, snuff, or dip I did no smoke a cigar, cigarillo, or lile cigar during he pas 30 days during he pas 30 days 45. During he pas 30 days, how did you usually 40. During he pas 30 days, how did you usually ge your chewing obacco, snuff, or dip? ge your cigars, cigarillos, or lile cigars? (CHOOSE ONLY ONE ANSWER) (CHOOSE ONLY ONE ANSWER) I did no smoke a cigar, cigarillo, or lile cigar during he pas 30 days I bough hem in a sore such as a convenience sore, supermarke, or gas saion I gave someone else money o buy hem for me I borrowed (or bummed) hem from someone else I sole hem from a sore I sole hem from someone I know I go hem from my parens A person 18 years old or older gave hem o me I bough hem from anoher person (no in a sore) \ j. \ j. I bough hem on he inerne \ k. \ k. I go hem some oher way page 4 I did no use chewing obacco, snuff, or dip during he pas 30 days I bough hem in a sore such as a convenience sore, supermarke, or gas saion I gave someone else money o buy hem for me I borrowed (or bummed) hem from someone else I sole hem from a sore I sole hem from someone I know I go hem from my parens A person 18 years old or older gave hem o me I bough hem from anoher person (no in a sore) I bough hem on he inerne I go hem some oher way
7 Flavored obacco/ HE NEX QUESIONS ARE ABOU HE FOLLOWING SPECIALIY OBAO PRODUCS: 1. FLAVORED CIGAREES, CIGARS, AND SMOKELESS OBAO MADE O ASE LIKE CHOCOLAE, CANDY, FRUI, AND OHER FLAVORS; 2. HOOKAH - A WAERPIPE USED FOR SMOKING OBAO. 46. Have you ever ried, even once: Smoking flavored cigarees? Smoking flavored cigars? Smoking hookah? Using flavored smokeless obacco? 47. During he pas 30 days, have you: Smoked flavored cigarees? Smoked flavored cigars? Smoked hookah? Used flavored smokeless obacco? 48. Where do you usually smoke obacco from a waerpipe/hookah? (CHOOSE ONLY ONE ANSWER) I have never smoked from a waerpipe/hookah A your home A a relaive s home A anoher person s home A a pary A a resauran, bar, or waerpipe/hookah café A school In a car Oher 49. Do you hink waerpipe/hookah smoking is harmful o your healh? sure 50. Compared o cigaree smoking, waerpipe/hookah smoking is... More harmful Equally harmful Marijuana Less harmful sure 51. Have you ever smoked par or all of a blun? I have never smoked a blun SOMEIMES PEOPLE AKE OBAO OU OF A CIGAR AND REPLACE I WIH MARIJUANA. HIS IS SOMEIMES CALLED A BLUN. 52. During he pas 30 days, on how many days did you smoke bluns? 0 days 1 or 2 days 3 o 5 days 6 o 9 days 10 o 19 days 20 o 29 days All 30 days HE NEX QUESIONS ASK ABOU OBAO EDUCAION. 53. During his school year, were you augh in any of your classes abou obacco use? sure 54. Does your school have any special groups or classes for sudens who wan o qui using obacco? sure 55. Have any of he following people alked o you abou he danger of obacco use in he pas 12 monhs? I have no been in pas 12 monhs Docor or someone in a docor s office Denis or someone in a denis s office Paren, guardian, or oher adul relaive HE NEX QUESIONS ASK ABOU OBAO USE ON SCHOOL PROPERY, INCLUDING FIELDS, BUILDINGS, PARKING LOS, OR A SCHOOL EVENS. 56. Is here a rule a your school ha no one is allowed o smoke cigarees, chew obacco, snuff or dip or use elecronic vapor producs on school propery including fields, buildings, parking los, or a any school evens? Sure Chewing obacco, snuff, or dip Elecronic Vapor Producs \b. a. \ page 5
8 57. During he pas 12 monhs, have you seen sudens 63. Do you hink people can ge addiced o: using he following producs on school propery? Sure Sure Chewing obacco, snuff, or dip Elecronic Vapor Producs \b. \c.?? Chewing obacco, snuff, or dip?? Elecronic Vapor Producs? 58. During he pas 12 monhs, have you seen eachers, saff, or oher aduls using he following producs on school propery? 64. Do you hink i would be easy o qui using: Sure Sure \? Chewing obacco, snuff, or dip a.? Elecronic Vapor Producs Chewing obacco, snuff, or dip?? Elecronic Vapor Producs? \ HE NEX QUESIONS ASK ABOU YOUR HOUGHS ABOU OBAO. 65. Do you hink smoke from oher people s producs 59. Do you hink ha you will ry any of hese are harmful o you? obacco producs soon? Sure Sure Chewing obacco, snuff, or dip Elecronic Vapor Producs Elecronic Vapor Producs 66. Do you hink young people who use he following producs have more friends? 60. Do you hink you will smoke or use any of hese Sure obacco producs a any ime during he nex year? Chewing obacco, snuff, or dip Elecronic Vapor Producs Sure Chewing obacco, snuff, or dip Elecronic Vapor Producs 67. Do you hink using he following producs makes young people look cool or fi in? 61. Do you hink you will smoke or use any of hese Sure obacco producs 5 years from now? Chewing obacco, snuff, or dip Elecronic Vapor Producs Sure Chewing obacco, snuff, or dip Elecronic Vapor Producs 68. Do you hink using he following producs helps people feel more comforable a paries or in 62. If one of your bes friends offered you any of oher social siuaions? hese producs, would you smoke or use i? Sure Chewing obacco, snuff, or dip Elecronic Vapor Producs Sure Chewing obacco, snuff, or dip Elecronic Vapor Producs page 6
9 69. Do you hink using he following producs helps people relieve sress? Sure Chewing obacco, snuff, or dip Elecronic Vapor Producs 70. Do you hink smoking cigarees helps people mainain or conrol body weigh? 71. Do you hink your friends view cigaree smoking among aduls as accepable? sure 72. Do you hink people in your neighborhood or communiy view cigaree smoking among aduls as accepable? sure HE NEX QUESIONS ASK ABOU EVENS YOU MAY HAVE AENDED OR WHA YOU HAVE SEEN ON V. 73. During he pas 12 monhs, have you paricipaed in any communiy evens o discourage people your age from using cigarees, chewing obacco, snuff, dip, or cigars? 74. During he pas 12 monhs, have you paricipaed in any school sponsored evens o discourage people your age from using any of he following producs? Chewing obacco, snuff, or dip Elecronic Vapor Producs 75. hink abou he movie, video, or show you las wached on V or he inerne. Did any characers use he following producs? Chewing obacco, snuff, or dip Elecronic Vapor Producs 76. During he pas 30 days, did you hear ani-smoking messages on he radio or seen hem on V, he inerne, billboards and oudoor signs, or in newspapers and magazines? 77. Were any of he ani-smoking messages ha you have seen or heard in he pas 30 days sponsored by obacco Free Florida? sure 78. he las ime you visied he following places, did you see obacco adverisemens, such as displays or posers? Convenience sore Gas saion Pharmacy/Drug sore Grocery sore Big box sore, such as Walmar or K-Mar Oher 79. Have you ever seen any flavored obacco producs (such as chocolae, candy, or frui flavors) or any adverising for hem? 80. During he pas 30 days, have you heard or seen adverising for Elecronic Vapor Producs in any of he following places? Commercials on he radio Commercials on V On he inerne On billboards or oudoor signs In magazines or newspapers 81. During he pas 30 days, were you in he same room wih someone who was using any of he following? (SELEC ALL HA APPLY) Elecronic Vapor Producs 82. During he pas 30 days, did you ride in a car wih someone smoking any of he following? (SELEC ALL HA APPLY) Elecronic Vapor Producs HE NEX QUESIONS ASK ABOU YOUR EXPOSURE O OBAO. 83. During he pas 30 days, when you were around someone who was smoking indoors, were you usually: I was no around anyone smoking in he pas 30 days A home A school A work In anoher public place like a mall A someone else s house In your paren s car In someone else s car A some oher place page 7
10 84. During he pas 30 days, when you were around someone who was smoking indoors, who was 90. Which saemen bes describes you? smoking? I do no use obacco producs I was no around someone smoking in he pas 30 days I use obacco producs and my parens don know One or boh of my parens abou i Anoher relaive I use obacco producs and my parens don like i One or more of my friends I use obacco producs and my parens don mind Someone I work wih Someone I don know 91. During he pas 30 days, which ype of obacco produc did you use mos? 85. During he pas 12 monhs, have you asked I did no use a obacco produc in he pas 30 days someone no o smoke around you? Chewing obacco, snuff, or dip 86. During he pas 12 monhs, have you asked Elecronic Vapor Producs someone who lives in your home o qui smoking? one in my home has smoked in he pas HE NEX QUESIONS ASK ABOU 12 monhs \ OBAO PURCHASING LAWS: b. \ OBAO INCLUDES ELECRONIC VAPOR c. PRODUCS AS WELL AS RADIIONAL OBAO. 87. Does anyone who lives in your home use any of he following producs? (Do no coun yourself) 92. When you bough or ried o buy obacco during he pas 30 days, were you asked o show proof of age? I did no ry o buy obacco in he pas 30 days Chewing obacco, snuff, or dip Elecronic Vapor Producs 93. During he pas 30 days, did anyone refuse o sell you obacco due o your age? 88. Is he use of any of he following allowed in. I did no ry o buy obacco in he pas 30 days (SELEC ALL HA APPLY) Any vehicles you or your household Your drive or ride in as home? a passenger? Neiher 94. When you bough or ried o buy obacco during he pas 30 days, did you use or ry o use a fake ID? Chewing obacco, I did no ry o buy obacco in he pas 30 days snuff, or dip Elecronic Vapor Produc 95. Wha is he younges a person can legally buy obacco in Florida? Less han 16 years old 21 years old 89. Have your parens ever offered you any of he 16 years old sure following obacco producs? 18 years old 96. Does Florida have a law ha punishes anyone Chewing obacco, snuff, or dip under age 18 who has obacco producs in heir possession? Elecronic Vapor Producs sure page 8
11 HE LAS QUESIONS ASK ABOU YOU 97. Which of hese saemens bes describes he food eaen in your home in he las 12 monhs: 101. During he pas 12 monhs, how many imes did you go o an emergency room or urgen care cener because of your ashma? Enough of he kinds of food we wan o ea Enough, bu no always he kinds of food we wan o ea Someimes no enough o ea Ofen no enough o ea sure 98. Has a docor or nurse ever old you ha you have ashma? I have never had ashma sure I have never had ashma 0 imes 1 o 3 imes 4 o 9 imes 10 o 12 imes 13 or more imes 103. During he pas 7 days, on how many days were you physically acive for a oal of a leas 60 minues per day? (Add up all he ime you spen in any kind of physical aciviy ha increased your hear rae and made you breahe hard some of he ime.) 99. Do you sill have ashma? I have never had ashma sure sure 100. During he pas 12 monhs, did you have an ashma aack? 102. Do you play organized spors? 0 days 1 day 2 days 3 days 4 days 5 days 6 days 7 days 104. How all are you wihou your shoes on? (Wrie your heigh in he blank boxes. Fill in he maching circle below each wrien number.) Example Heigh Heigh,,,,,, 57 \ 0 \ 0 \ 0 \ 0 \ 1 \ 1 \ 1 \ 1 \ 2 \ 2 \ 2 \ 2 \ 3 \ 3 \ 3 \ 3 \ 4 \ 4 \ 4 \ 4 \» 5 \ 5 \ 5 \ 5 \ 6 \ 6 \ 6 \ 6 \ 7»\ 7 \ 7 \ 7 \ 8 \ 8 \ 9 \ 9 \ 10 \ 10 \ 11 \ How much do you weigh wihou your shoes on? (Wrie your weigh in he blank boxes. Fill in he maching circle below each wrien number.) Example Weigh 152 \ 0 \ 0 \ 0 \» 1 \ 1 \ 1 \ 2 \ 2» \ 2 \ 3 \ 3 \ 3 \ 4 \ 4»\ 5 \ 5 \ 6 \ 6 \ 7 \ 7 \ 8 \ 8 \ 9 \ 9 Weigh \ 0 \ 0 \ 0 \ 1 \ 1 \ 1 \ 2 \ 2 \ 2 \ 3 \ 3 \ 3 \ 4 \ 4 \ 5 \ 5 \ 6 \ 6 \ 7 \ 7 \ 8 \ 8 \ 9 \ Which of he following are you rying o do abou your weigh? Lose weigh Gain weigh Say he same weigh I am no rying o do anyhing abou my weigh 107. How do you describe your weigh? Very underweigh Slighly underweigh Abou he righ weigh Slighly overweigh Very overweigh page 9
12 108. During he pas 30 days, did you ride in a car or oher vehicle driven by someone who had been drinking alcohol? 109. During he pas 30 days, did you NO go o school because you fel you would be unsafe a school or on your way o school? 110. During he pas 12 monhs, did you do somehing o purposely hur yourself wihou waning o die, such as cuing or burning yourself on purpose? 111. During he pas 12 monhs, did you ever feel so sad or hopeless for wo or more weeks in a row ha you sopped doing usual aciviies? HANK YOU FOR PARICIPAING IN HIS SURVEY. OpScan insigh EM : PLEASE DO NO WRIE IN HIS AREA page \\\\\\\\\\\\\\\\\\\\\\\\ SERIAL # 10 HR06
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