Students 2012 - 2014 National Youth Tobacco Surveys

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National Youth Tobacco Survey (NYTS) 2012 Questionnaire

Thank You Very Much for Your Help.

Directions

• Use a #2 pencil only

• M ake dark marks

• Fill in a response like this

• If you change your answer, erase your old answer completely.

The first five questions ask for some background information about you

1. How old are you?

   1. 9 years old

   2. 10 years old

   3. 11 years old

   4. 12 years old

   5. 13 years old

   6. 14 years old

   7. 15 years old

   8. 16 years old

   9. 17 years old

   10. 18 years old

   11. 19 years old or older

2. What is your sex?

   1. Female

   2. Male

3. What grade are you in?

   1. 6th

   2. 7th

   3. 8th

   4. 9th

   5. 10th

   6. 11th

   7. 12th

   8. Ungraded or other grade

4. Are you Hispanic or Latino?

   1. No

   2. Yes, I am Mexican, Mexican American, or Chicano

   3. Yes, I am Puerto Rican

   4. Yes, I am Cuban or Cuban American

   5. Yes, I am some other Hispanic or Latino not listed here

5. What race or races do you consider yourself to be? (CHOOSE ALL THAT APPLY)

   1. American Indian or Alaska Native

   2. Asian

   3. Black or African American

   4. Native Hawaiian or Other Pacific Islander

   5. White

T he next six sections ask about your use of different kinds of tobacco products

Cigarettes

6. Have you ever been curious about smoking a cigarette?

   1. Definitely yes

   2. Probably yes

   3. Probably not

   4. Definitely not

7. Have you ever tried cigarette smoking, even one or two puffs?

   1. Yes

   2. No

8. Do you think you will smoke a cigarette in the next year?

   1. Definitely yes

   2. Probably yes

   3. Probably not

   4. Definitely not

9. Do you think that you will try a cigarette soon?

   1. Definitely yes

   2. Probably yes

   3. Probably not

   4. Definitely not

10. If one of your best friends were to offer you a cigarette, would you smoke it?

    1. Definitely yes

    2. Probably yes

    3. Probably not

    4. Definitely not

11. How old were you when you first tried cigarette smoking, even one or two puffs?

    1. I have never smoked cigarettes, not even one or two puffs

    2. 8 years old or younger

    3. 9 years old

    4. 10 years old

    5. 11 years old

    6. 12 years old

    7. 13 years old

    8. 14 years old

    9. 15 years old

    10. 16 years old

    11. 17 years old

    12. 18 years old

    13. 19 years old or older

12. About how many cigarettes have you smoked in your entire life?

    1. I have never smoked cigarettes, not even one or two puffs

    2. 1 or more puffs but never a whole cigarette

    3. 1 cigarette

    4. 2 to 5 cigarettes

    5. 6 to 15 cigarettes (about 1/2 a pack total)

    6. 16 to 25 cigarettes (about 1 pack total)

    7. 26 to 99 cigarettes (more than 1 pack, but less than 5 packs)

    8. 100 or more cigarettes (5 or more packs)

13. During the past 30 days, on how many days did you smoke cigarettes?

    1. 0 days

    2. 1 or 2 days

    3. 3 to 5 days

    4. 6 to 9 days

    5. 10 to 19 days

    6. 20 to 29 days

    7. All 30 days

14. During the past 30 days, on the days you smoked, how many cigarettes did you smoke per day?

    1. I did not smoke cigarettes during the past 30 days

    2. Less than 1 cigarette per day

    3. 1 cigarette per day

    4. 2 to 5 cigarettes per day

    5. 6 to 10 cigarettes per day

    6. 11 to 20 cigarettes per day

    7. More than 20 cigarettes per day

15. When was the last time you smoked a cigarette, even one or two puffs? (PLEASE CHOOSE THE FIRST ANSWER THAT FITS)

    1. I have never smoked cigarettes, not even one or two puffs

    2. Earlier today

    3. Not today but sometime during the past 7 days

    4. Not during the past 7 days but sometime during the past 30 days

    5. Not during the past 30 days but sometime during the past 6 months

    6. Not during the past 6 months but sometime during the past year

    7. 1 to 4 years ago

    8. 5 or more years ago

16. D uring the past 30 days, what brand of cigarettes did you usually smoke? (CHOOSE ONLY ONE ANSWER)

    1. I did not smoke cigarettes during the past 30 days

    2. I did not smoke a usual brand

    3. American Spirit

    4. Camel

    5. GPC, Basic, or Doral

    6. Kool

    7. Lucky Strike

    8. Marlboro

    9. Newport

    10. Parliament

    11. Virginia Slims

    12. Some other brand not listed here

    13. Not sure

17. Menthol cigarettes are cigarettes that taste like mint. During the past 30 days, were the cigarettes that you usually smoked menthol?

    1. I did not smoke cigarettes during the past 30 days

    2. Yes

    3. No

    4. Not sure

18. How likely is it that you will try to purchase cigarettes within the next 30 days?

    1. I do not smoke cigarettes

    2. Very likely

    3. Somewhat likely

    4. Somewhat unlikely

    5. Very unlikely

19. During the past 30 days, how did you get your own cigarettes? (CHOOSE ALL THAT APPLY)

    1. I did not get cigarettes during the past 30 days

    2. I bought a pack of cigarettes myself

    3. I had someone else buy a pack of cigarettes for me

    4. I asked someone to give me a cigarette

    5. Someone offered me a cigarette

    6. I bought cigarettes from another person

    7. I took cigarettes from a store or another person

    8. I got cigarettes some other way

20. During the past 30 days, where did you buy your own cigarettes? (CHOOSE ALL THAT APPLY)

    1. I did not buy cigarettes during the past 30 days

    2. A gas station or convenience store

    3. A grocery store

    4. A drugstore

    5. A vending machine

    6. Over the Internet

    7. Through the mail

    8. Some other place not listed here

21. During the past 30 days, did anyone refuse to sell you cigarettes because of your age?

    1. I did not try to buy cigarettes during the past 30 days

    2. Yes

    3. No

Cigars, cigarillos, or little cigars, such as Black and Milds, Swisher Sweets, Dutch Masters, White Owl, or Phillies Blunts

22. Have you ever been curious about smoking a cigar, cigarillo, or little cigar, such as Black and Milds, Swisher Sweets, Dutch Masters, White Owl, or Phillies Blunts?

    1. Definitely yes

    2. Probably yes

    3. Probably not

    4. Definitely not

23. Have you ever tried smoking cigars, cigarillos, or little cigars, such as Black and Milds, Swisher Sweets, Dutch Masters, White Owl, or Phillies Blunts, even one or two puffs?

    1. Yes

    2. No

24. H ow old were you when you first tried smoking a cigar, cigarillo, or little cigar even one or two puffs?

    1. I have never smoked cigars, cigarillos, or little cigars, not even one or two puffs

    2. 8 years old or younger

    3. 9 years old

    4. 10 years old

    5. 11 years old

    6. 12 years old

    7. 13 years old

    8. 14 years old

    9. 15 years old

    10. 16 years old

    11. 17 years old

    12. 18 years old

    13. 19 years old or older

25. During the past 30 days, on how many days did you smoke cigars, cigarillos, or little cigars?

    1. 0 days

    2. 1 or 2 days

    3. 3 to 5 days

    4. 6 to 9 days

    5. 10 to 19 days

    6. 20 to 29 days

    7. All 30 days

26. During the past 30 days, how did you get your own cigars, cigarillos, or little cigars? (CHOOSE ALL THAT APPLY)

    1. I did not get cigars, cigarillos, or little cigars during the past 30 days

    2. I bought them myself

    3. I had someone else buy them for me

    4. I asked someone to give me one

    5. Someone offered it to me

    6. I bought them from another person

    7. I took them from a store or another person

    8. I got them some other way

27. During the past 30 days, where did you buy your own cigars, cigarillos, or little cigars? (CHOOSE ALL THAT APPLY)

    1. I did not buy cigars, cigarillos, or little cigars during the past 30 days

    2. A gas station or convenience store

    3. A grocery store

    4. A drugstore

    5. A vending machine

    6. Over the Internet

    7. Through the mail

    8. Some other place not listed here

Chewing tobacco, snuff, or dip, such as Redman, Levi Garrett, Beechnut, Skoal, Skoal Bandits, or Copenhagen

28. Have you ever been curious about using chewing tobacco, snuff, or dip, such as Redman, Levi Garrett, Beechnut, Skoal, Skoal Bandits, or Copenhagen?

    1. Definitely yes

    2. Probably yes

    3. Probably not

    4. Definitely not

29. Have you ever used chewing tobacco, snuff, or dip, such as Redman, Levi Garrett, Beechnut, Skoal, Skoal Bandits, or Copenhagen, even just a small amount?

    1. Yes

    2. No

30. How old were you when you used chewing tobacco, snuff, or dip for the first time?

    1. I have never used chewing tobacco, snuff, or dip

    2. 8 years old or younger

    3. 9 years old

    4. 10 years old

    5. 11 years old

    6. 12 years old

    7. 13 years old

    8. 14 years old

    9. 15 years old

    10. 16 years old

    11. 17 years old

    12. 18 years old

    13. 19 years old or older

31. D uring the past 30 days, on how many days did you use chewing tobacco, snuff, or dip?

    1. 0 days

    2. 1 or 2 days

    3. 3 to 5 days

    4. 6 to 9 days

    5. 10 to 19 days

    6. 20 to 29 days

    7. All 30 days

32. During the past 30 days, how did you get your own chewing tobacco, snuff, or dip? (CHOOSE ALL THAT APPLY)

    1. I did not get chewing tobacco, snuff, or dip during the past 30 days

    2. I bought it myself

    3. I had someone else buy it for me

    4. I asked someone to give me some

    5. Someone offered it to me

    6. I bought it from another person

    7. I took it from a store or another person

    8. I got it some other way

33. During the past 30 days, where did you buy your own chewing tobacco, snuff, or dip? (CHOOSE ALL THAT APPLY)

1. I did not buy chewing tobacco, snuff, or dip during the past 30 days

2. A gas station or convenience store

3. A grocery store

4. A drugstore

5. A vending machine

6. Over the Internet

7. Through the mail

8. Some other place not listed here

A Pipe. Do NOT include smoking tobacco in a waterpipe or hookah

34. Have you ever tried smoking tobacco in a pipe, even one or two puffs?

    1. Yes

    2. No

35. During the past 30 days, on how many days did you smoke tobacco in a pipe?

    1. 0 days

    2. 1 or 2 days

    3. 3 to 5 days

    4. 6 to 9 days

    5. 10 to 19 days

    6. 20 to 29 days

    7. All 30 days

Other tobacco products

36. Which of the following tobacco products have you ever heard of? (CHOOSE ALL THAT APPLY)

    1. Roll-your-own cigarettes

    2. Bidis (small brown cigarettes wrapped in a leaf)

    3. Clove cigarettes (kreteks)

    4. Smoking tobacco from a hookah or a waterpipe

    5. Snus, such as Camel or Marlboro Snus

    6. Dissolvable tobacco products, such as Ariva, Stonewall, Camel orbs, Camel sticks, Marlboro sticks, or Camel strips

    7. Electronic Cigarettes or E-cigarettes, such as Ruyan or NJOY

    8. Some other new tobacco product not listed here

    9. I have never heard of any of the products listed above or any new tobacco product

37. Which of the following tobacco products have you ever tried, even just one time? (CHOOSE ALL THAT APPLY)

    1. Roll-your-own cigarettes

    2. Bidis (small brown cigarettes wrapped in a leaf)

    3. Clove cigarettes (kreteks)

    4. Smoking tobacco from a hookah or a waterpipe

    5. Snus, such as Camel or Marlboro Snus

    6. Dissolvable tobacco products, such as Ariva, Stonewall, Camel orbs, Camel sticks, Marlboro sticks, or Camel strips

    7. Electronic Cigarettes or E-cigarettes, such as Ruyan or NJOY

    8. Some other new tobacco products not listed here

    9. I have never tried any of the products listed above or any new tobacco product

38. D uring the past 30 days, which of the following products have you used on at least one day? (CHOOSE ALL THAT APPLY)

    1. Roll-your-own cigarettes

    2. Bidis (small brown cigarettes wrapped in a leaf)

    3. Clove cigarettes (kreteks)

    4. Smoking tobacco from a hookah or a waterpipe

    5. Snus, such as Camel or Marlboro Snus

    6. Dissolvable tobacco products, such as Ariva, Stonewall, Camel orbs, Camel sticks, Marlboro sticks, or Camel strips

    7. Electronic Cigarettes or E-cigarettes, such as Ruyan or NJOY

    8. Some other new tobacco products not listed here

    9. I have not used any of the products listed above or any new tobacco product during the past 30 days

39. Were any of the tobacco products you used in the past 30 days flavored to taste like menthol (mint), clove, spice, alcohol (wine, cognac), candy, fruit, chocolate, or other sweets?

    1. I did not use any flavored tobacco products in the past 30 days

    2. Yes

    3. No

40. During the past 30 days, have you had a strong craving or felt like you really needed to use a tobacco product of any kind (such as smoking a cigarette or using chewing tobacco, snuff, dip, or snus)?

    1. Yes

    2. No

41. During the past 30 days, was there a time when you wanted to use a tobacco product so much that you found it difficult to think of anything else?

    1. Yes

    2. No

42. How soon after you wake up do you want to use a tobacco product?

    1. I do not use tobacco

    2. Within 5 minutes

    3. From 6 to 30 minutes

    4. From more than 30 minutes to 1 hour

    5. After more than 1 hour but less than 24 hours

    6. I rarely want to use tobacco

43. How true is this statement for you? I feel restless and irritable when I don’t use tobacco for a while.

    1. I do not use tobacco

    2. Not at all true

    3. Sometimes true

    4. Often true

    5. Always true

The next nine questions ask about about different issues related to tobacco.

44. How easy do you think it is for kids your age to buy tobacco products in a store?

    1. Easy

    2. Somewhat easy

    3. Not easy at all

45. When you are using the Internet, how often do you see any ads or promotions for cigarettes or other tobacco products?

    1. I do not use the Internet

    2. Never

    3. Rarely

    4. Sometimes

    5. Most of the time

    6. Always

46. When you read newspapers or magazines, how often do you see any ads or promotions for cigarettes or other tobacco products?

    1. I do not read newspapers or magazines

    2. Never

    3. Rarely

    4. Sometimes

    5. Most of the time

    6. Always

47. D uring the past 30 days, did you receive coupons from a tobacco company through… (CHOOSE ALL THAT APPLY)

    1. The mail

    2. E-mail

    3. The Internet

    4. Social Networks (such as Facebook and Twitter)

    5. A text message

    6. On a cigarette pack or other tobacco product

    7. I did not receive coupons from a tobacco company

48. During the past 30 days, did a tobacco company send you information (other than coupons) through… (CHOOSE ALL THAT APPLY)

    1. The mail

    2. E-mail

    3. A text message

    4. Some other way

    5. I did not receive any information from a tobacco company

49. When you go to a convenience store, supermarket, or gas station, how often do you see any ads or promotions for cigarettes or other tobacco products?

    1. I never go to a convenience store, supermarket, or gas station

    2. Never

    3. Rarely

    4. Sometimes

    5. Most of the time

    6. Always

50. During the past 30 days, how often did you see any ads or promotions for cigarettes or other tobacco products that were outdoors on a billboard or could be seen from outside a store?

    1. I did not see an ad for cigarettes or other tobacco products during the past 30 days

    2. Never

    3. Rarely

    4. Sometimes

    5. Most of the time

    6. Always

51. When you watch TV or go to the movies, how often do you see actors and actresses using cigarettes or other tobacco products?

    1. I do not watch TV or go to the movies

    2. Never

    3. Rarely

    4. Sometimes

    5. Most of the time

    6. Always

52. What is the name of the cigarette brand of your favorite cigarette ad? (CHOOSE ONLY ONE ANSWER)

    1. American Spirit

    2. Camel

    3. GPC, Basic, or Doral

    4. Kool

    5. Marlboro

    6. Newport

    7. Some other brand not listed here

    8. I don’t have a favorite cigarette ad

    9. Not sure

The next four questions ask about about different issues related to tobacco warning labels.

53. A warning label tells you if a product is harmful to you and can be either a picture or words. During the past 30 days, how often did you see a warning label on a cigarette pack?

    1. I did not see a cigarette pack during the past 30 days

    2. Never

    3. Rarely

    4. Sometimes

    5. Most of the time

    6. Always

54. During the past 30 days, to what extent did warning labels on cigarette packs make you think about the health risks of smoking?

    1. I did not see a warning label on a cigarette pack in the past 30 days.

    2. Not at all

    3. A little

    4. Somewhat

    5. A lot

55. D uring the past 30 days, how often did you see a warning label on a smokeless tobacco product, such as chewing tobacco, snuff, dip, or snus?

    1. I did not see a smokeless tobacco product during the past 30 days

    2. Never

    3. Rarely

    4. Sometimes

    5. Most of the time

    6. Always

56. During the past 30 days, to what extent did warning labels on smokeless tobacco products make you think about the health risks of smokeless tobacco, such as chewing tobacco, snuff, dip, or snus?

    1. I did not see a warning label on a smokeless tobacco product in the past 30 days

    2. Not at all

    3. A little

    4. Somewhat

    5. A lot

The next six questions are about quitting tobacco products.

57. Are you seriously thinking about quitting cigarettes?… (PLEASE CHOOSE THE FIRST ANSWER THAT FITS)

    1. I do not smoke cigarettes

    2. Yes, within the next 30 days

    3. Yes, within the next 6 months

    4. Yes, within the year

    5. Yes, but not within the year

    6. No, I am not thinking about quitting cigarettes

58. If you decided to quit cigarettes for good, how likely is it that you would succeed?

    1. I do not smoke cigarettes

    2. Very likely

    3. Somewhat likely

    4. Somewhat unlikely

    5. Very unlikely

59. During the past 12 months, how many times have you stopped smoking for one day or longer because you were trying to quit smoking cigarettes for good?

    1. I did not smoke during the past 12 months

    2. I did not try to quit during the past 12 months

    3. 1 time

    4. 2 times

    5. 3 to 5 times

    6. 6 to 9 times

    7. 10 or more times

60. When you last tried to quit for good, how long did you stay off cigarettes? (PLEASE CHOOSE THE FIRST ANSWER THAT FITS)

    1. I have never smoked cigarettes

    2. I have never tried to quit

    3. Less than a day

    4. 1 to 7 days

    5. More than 7 days but less than 30 days

    6. More than 30 days but less than 6 months

    7. More than 6 months but less than 1 year

    8. 1 year or more

61. Are you seriously thinking about quitting the use of all tobacco products?

    1. I do not use tobacco products

    2. Yes, within the next 30 days

    3. Yes, within the next 6 months

    4. Yes, within the year

    5. Yes, but not within the year

    6. No, I am not thinking about quitting the use of all tobacco products

62. During the past 12 months, how many times have you stopped using all tobacco products for one day or longer because you were trying to quit all tobacco products for good?

    1. I did not use tobacco products during the past 12 months

    2. I did not try to quit during the past 12 months

    3. 1 time

    4. 2 times

    5. 3 to 5 times

    6. 6 to 9 times

    7. 10 or more times

T he next thirteen questions ask about your thoughts on tobacco.

63. Do you think smoking cigarettes makes young people look cool or fit in?

1. Definitely yes

2. Probably yes

3. Probably not

4. Definitely not

64. Do you think young people who smoke cigarettes have more friends?

1. Definitely yes

2. Probably yes

3. Probably not

4. Definitely not

65. How long do you think someone has to smoke before it harms their health?

    1. Less than a year

    2. 1 year

    3. 5 years

    4. 10 years

    5. 20 years or more

66. How much do you think people harm themselves when they smoke a few cigarettes every day?

    1. No harm

    2. Little harm

    3. Some harm

    4. A lot of harm

67. How much do you think people harm themselves when they smoke cigarettes some days but not every day?

    1. No harm

    2. Little harm

    3. Some harm

    4. A lot of harm

68. How much do you think people harm themselves when they smoke 10 or more cigarettes every day?

    1. No harm

    2. Little harm

    3. Some harm

    4. A lot of harm

69. Do you believe that electronic cigarettes or e-cigarettes, such as Ruyan or NJOY, are (LESS HARMFUL, EQUALLY HARMFUL, or MORE HARMFUL) than regular cigarettes?

    1. Less harmful

    2. Equally harmful

    3. More harmful

    4. I have never heard of electronic cigarettes or e-cigarettes

    5. I don’t know enough about these products

70. How much do you think people harm themselves when they use smokeless tobacco, such as chewing tobacco, snuff, dip, or snus, every day?

    1. No harm

    2. Little harm

    3. Some harm

    4. A lot of harm

71. How much do you think people harm themselves when they use smokeless tobacco, such as chewing tobacco, snuff, dip, or snus, some days but not every day?

    1. No harm

    2. Little harm

    3. Some harm

    4. A lot of harm

72. Do you believe that dissolvable tobacco products, such as Ariva, Stonewall, Camel orbs, Camel sticks, Marlboro sticks, or Camel strips are (LESS HARMFUL, EQUALLY HARMFUL, or MORE HARMFUL) than other smokeless tobacco products, such as chewing tobacco, snuff, dip, or snus?

    1. Less harmful

    2. Equally harmful

    3. More harmful

    4. I have never heard of dissolvable tobacco products

    5. I don’t know enough about these products

73. How strongly do you agree with the statement ‘All tobacco products are dangerous’?

    1. Strongly agree

    2. Agree

    3. Disagree

    4. Strongly disagree

74. I n the past 30 days, how often have you thought about the harmful chemicals in tobacco products?

    1. Never

    2. Rarely

    3. Sometimes

    4. Often

    5. Very Often

75. Do you think that breathing smoke from other people's cigarettes or other tobacco products causes…

    1. No harm

    2. Little harm

    3. Some harm

    4. A lot of harm

The next two questions ask about smoking and other tobacco use by students in your grade.

76. Out of every 10 students in your grade at school, how many do you think smoke cigarettes?

1. 0

2. 1

3. 2

4. 3

5. 4

6. 5

7. 6

8. 7

9. 8

10. 9

11. 10

77. Out of every 10 students in your grade at school, how many do you think use tobacco products other than cigarettes?

1. 0

2. 1

3. 2

4. 3

5. 4

6. 5

7. 6

8. 7

9. 8

10. 9

11. 10

S ome tobacco companies make items like sports gear, T-shirts, lighters, hats, jackets, sunglasses or other items that people can buy or receive for free.

78. During the past 12 months, did you buy or receive anything such as a lighter, T-shirt, hat, sunglasses, that has a tobacco brand name, logo, or picture on it?

    1. Yes

    2. No

79. How likely is it that you would ever use or wear something--such as a lighter, T-shirt, hat, or sunglasses --that has a tobacco brand name, logo, or picture on it?

    1. Very likely

    2. Somewhat likely

    3. Somewhat unlikely

    4. Very unlikely

The next question asks about smoking and other tobacco use by your family.

80. Does anyone who lives with you now…? (CHOOSE ALL THAT APPLY).

    1. Smoke cigarettes

    2. Use smokeless tobacco, such as chewing tobacco, snuff, dip, or snus

    3. Smoke cigars, cigarillos, or little cigars

    4. Use any other form of tobacco

    5. No one who lives with me now uses any form of tobacco

The last question is about your experience at home.

81. During the past 12 months, have your parents or guardians talked with you, even once, about not using any type of tobacco product?

1. Yes

2. No

Thank you very much.