National Youth Tobacco Survey (2020 version)

National Youth Tobacco Surveys (NYTS) 2020

Attachment_I-1_National_Youth_Tobacco_Survey_2020_Questionnaire (OMB_0920-0621)_2

National Youth Tobacco Survey (NYTS) 2020 Questionnaire

OMB: 0920-0621

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National Youth Tobacco Survey (NYTS)

2020 Questionnaire

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This survey is about tobacco. We would like to know about you and things you do that may affect your health. Your answers will be used for programs for young people like yourself.

The answers you give will be kept private.

NO one will know what you answered. Answer the questions based on what you really do and know.

Completing the survey is voluntary. Whether or not you answer the questions will not affect your grade in this class. Try to answer all the questions. If you do not want to answer a question, just leave it blank. There are no wrong answers.

The questions that ask about your background will only be used to describe the types of students completing this survey. The information will not be used to find out your name. No names will ever be reported.

Please read every question. Try to answer all the questions. Select the squares next to the response you choose. When you are finished, follow the instructions of the person giving you the survey.

Public reporting burden for this collection of information is estimated to average 45 minutes per survey, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: CDC Reports Clearance Officer, 1600 Clifton Road, NE, MS D-74, Atlanta, GA 30329, ATTN: PRA (0920-0621).




























Thank You Very Much For Your Help.













Instruction Universe: all students


INSTRUCT_1. The first five questions ask some background information about you.

Question Universe: all students


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


Question Universe: all students


2. What is your sex?

  1. Male

  2. Female

Question Universe: all students


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


Question Universe: all students


4. Are you Hispanic, Latino, Latina, or of Spanish origin? (Select one or more)

  1. No, not of Hispanic, Latino, Latina, or Spanish origin [EXCLUSIVE]

  2. Yes, Mexican, Mexican American, Chicano, or Chicana

  3. Yes, Puerto Rican

  4. Yes, Cuban

  5. Yes, Another Hispanic, Latino, Latina, or Spanish origin

Question Universe: all students


5. What race or races do you consider yourself to be? (Select one or more)

  1. American Indian or Alaska Native

  2. Asian

  3. Black or African American

  4. Native Hawaiian or Other Pacific Islander

  5. White

Instruction Universe: all students


INSTRUCT_2. The next seven sections of questions ask about your use of particular kinds of tobacco products, such as e-cigarettes, cigarettes, cigars, smokeless tobacco, hookahs, roll-your own-cigarettes, pipes, snus, dissolvable tobacco, bidis, and heated tobacco products.

Instruction Universe: all students


INSTRUCT_3. The next several questions are about electronic cigarettes or e-cigarettes, such as JUUL, Vuse, blu, and Logic.

E-cigarettes are battery powered devices that usually contain a nicotine-based liquid that is vaporized and inhaled. You may also know them as e-cigs, vape-pens, e-hookahs, vapes, or mods.


Question Universe: all students


6. Have you ever used an e-cigarette, even once or twice?

  1. Yes

  2. No [SKIP TO Q17]

[IF Q6 EQ (NA) – SOFT VALIDATION]

[IF Q6 EQ (NA) SKIP TO Q9]

Question Universe: ever e-cigarette users [known]


7. How old were you when you first used an e-cigarette, even once or twice?

  1. 8 years old or younger

  2. 9 years old

  3. 10 years old

  4. 11 years old

  5. 12 years old

  6. 13 years old

  7. 14 years old

  8. 15 years old

  9. 16 years old

  10. 17 years old

  11. 18 years old

  12. 19 years old or older

Question Universe: ever e-cigarette users [known]


8. In total, on how many days have you used e-cigarettes in your entire life?

  1. 1 day

  2. 2 to 10 days

  3. 11 to 20 days

  4. 21 to 50 days

  5. 51 to 100 days

  6. Over 100 days

Question Universe: ever e-cigarette users [or unknown]


9. During the past 30 days, on how many days did you use e-cigarettes?


Specify: |__|__| (Range 0 – 30)


[PROGRAMMING: RANGE (0 – 30) ALLOWED]


IF Q9 EQ (NA) – SOFT VALIDATION


[IF Q6 EQ (NA) AND Q9 EQ (NA) SKIP TO Q21]

[IF Q6 EQ (NA) AND Q9 EQ (0) SKIP TO Q21]

[IF Q6 EQ (1) AND Q9 EQ (NA) CONTINUE TO Q10]

[IF Q6 EQ (NA) AND Q9 EQ (1-30) CONTINUE TO Q10]

[IF Q6 EQ (1) AND Q9 EQ (0-30) CONTINUE TO Q10]

Question Universe: ever/current e-cigarette users [known]


10. When was the last time you used an e-cigarette, even one or two times? (Please choose the first answer that fits)

  1. Earlier today

  2. Not today, but sometime during the past 7 days

  3. Not during the past 7 days, but sometime during the past 30 days

  4. Not during the past 30 days, but sometime during the past 6 months

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

  6. 1 to 4 years ago

  7. 5 or more years ago


[IF Q9 EQ (NA) SKIP TO Q16]

[IF Q9 EQ (0) SKIP TO Q16]

[ELSE IF Q9 EQ (1-30) CONTINUE TO Q11]

Question Universe: past 30-day e-cigarette user [known]


11. Which of the following best describes the type of e-cigarette you have used in the past 30 days? If you have used more than one type, please think about the one you use most often.

  1. A disposable e-cigarette

  2. An e-cigarette that uses pre-filled pods or cartridges (e.g. JUUL)

  3. An e-cigarette with a tank that you refill with liquids

  4. A mod system (an e-cigarette that can be customized by the user with their own combination of batteries or other parts)

  5. I don’t know the type

Question Universe: past 30-day e-cigarette user [known]


12. During the past 30 days, what e-cigarette brands did you use? (Select one or more)

  1. blu

  2. JUUL

  3. Logic

  4. NJOY

  5. SMOK

  6. Suorin

  7. Vuse

  8. Some other brand(s) not listed here (specify): ______________________________

  9. I don’t know the brand


[IF >1 OPTION SELECTED CONTINUE TO Q13]

[IF 1 OPTION SELECTED SKIP TO Q14]

Question Universe: past 30-day e-cigarette user reporting >1 brand [known]

13. During the past 30 days, what brand of e-cigarettes did you usually use? (Choose only one answer)

  1. I did not use a usual brand

  2. blu

  3. JUUL

  4. Logic

  5. NJOY

  6. SMOK

  7. Suorin

  8. Vuse

  9. Some other brand not listed here (specify): ____________________________

  10. I don’t know the brand

Question Universe: past 30-day e-cigarette users [known]


14. Did any of the e-cigarettes that you used in the past 30 days contain nicotine?

A. Yes

B. No

C. Don’t know

Question Universe: past 30-day e-cigarette user [known]


15. During the past 30 days, where did you get or buy the e-cigarettes that you have used? (Select one or more)

  1. A gas station or convenience store

  2. A grocery store

  3. A drugstore

  4. A mall or shopping center kiosk/stand

  5. On the Internet

  6. A vape shop or other store that only sells e-cigarettes

  7. Some other place not listed here (Specify: _______________________)

  8. From a family member

  9. From a friend

  10. From some other person that is not a family member or a friend

Question Universe: ever/current e-cigarette users [known]


16. What are the reasons that you have used e-cigarettes? (Select one or more)

  1. A friend used them

  2. A family member used

  3. To try to quit using other tobacco products, such as cigarettes

  4. They cost less than other tobacco products, such as cigarettes

  5. They are easier to get than other tobacco products, such as cigarettes

  6. I’ve seen people on TV, online, or in movies use them

  7. They are less harmful than other forms of tobacco, such as cigarettes

  8. They are available in flavors, such as mint, candy, fruit, or chocolate

  9. I can use them unnoticed at home or at school

  10. I can use them to do tricks

  11. I was curious about them

  12. I used them for some other reason (specify: _____________________)


[ALL RESPONSES SKIP TO Q21]

[IF Q16 EQ (NA) SKIP TO Q21]


Question Universe: never e-cigarette users [known]


17. Have you ever been curious about using an e-cigarette?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

Question Universe: never e-cigarette users [known]


18. Do you think that you will try an e-cigarette soon?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

Question Universe: never e-cigarette users [known]


19. Do you think you will use an e-cigarette in the next year?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not


Question Universe: never e-cigarette users [known]


20. If one of your best friends were to offer you an e-cigarette, would you use it?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

Question Universe: all students


21. Have you ever vaped marijuana or cannabis (including concentrates, waxes, or hash oils)?

  1. Yes

  2. No

  3. Don’t Know

Instruction Universe: all students


INSTRUCT_4. The next several questions are about smoking cigarettes (ones that have to be lit and burned).

Question Universe: all students


22. Have you ever smoked a cigarette, even one or two puffs?

  1. Yes

  2. No [SKIP TO Q31]

IF Q22 EQ (NA) [Not Answered] –SOFT VALIDATION

IF Q22 EQ (NA) SKIP TO Q25

Question Universe: ever cigarette smokers [known]


23. How old were you when you first smoked a cigarette, even one or two puffs?

  1. 8 years old or younger

  2. 9 years old

  3. 10 years old

  4. 11 years old

  5. 12 years old

  6. 13 years old

  7. 14 years old

  8. 15 years old

  9. 16 years old

  10. 17 years old

  11. 18 years old

  12. 19 years old or older

Question Universe: ever cigarette smokers [known]


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

  1. 1 or more puffs but never a whole cigarette

  2. 1 cigarette

  3. 2 to 5 cigarettes

  4. 6 to 15 cigarettes (about 1/2 a pack total)

  5. 16 to 25 cigarettes (about 1 pack total)

  6. 26 to 99 cigarettes (more than 1 pack, but less than 5 packs)

  7. 100 or more cigarettes (5 or more packs)

Question Universe: ever cigarette smokers [or unknown]


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


Specify: |__|__| (Range: 0 – 30)


[PROGRAMMING: RANGE (0 – 30) ALLOWED]


IF Q25 EQ (NA) –SOFT VALIDATION


[IF Q22 EQ (NA) AND Q25 EQ (NA) SKIP TO INSTRUCT_5]

[IF Q22 EQ (NA) AND Q25 EQ (0) SKIP TO INSTRUCT_5]

[IF Q22 EQ (NA) AND Q25 EQ (1-30) CONTINUE TO Q26]

[IF Q22 EQ (1) AND Q25 EQ (NA) CONTINUE TO Q26]

[ELSE, IF Q22 EQ (1) AND Q25 EQ (0-30) CONTINUE TO Q26]

Question Universe: ever/current cigarette smokers [known]


26. When was the last time you smoked a cigarette, even one or two puffs? (Please choose the first answer that fits)

  1. Earlier today

  2. Not today but sometime during the past 7 days

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

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

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

  6. 1 to 4 years ago

  7. 5 or more years ago


[IF Q25 EQ (NA) GO TO INSTRUCT_5]

[IF Q25 EQ (0) GO TO INSTRUCT_5]

[ELSE IF Q25 EQ (1-30) CONTINUE TO Q27]

Question Universe: past 30-day cigarette smokers [known]


27. During the past 30 days, on the days you smoked, about how many cigarettes did you smoke per day? A pack usually has 20 cigarettes in it.

  1. Less than 1 cigarette per day

  2. 1 cigarette per day

  3. 2 to 5 cigarettes per day

  4. 6 to 10 cigarettes per day

  5. 11 to 20 cigarettes per day

  6. More than 20 cigarettes per day

Question Universe: past 30-day cigarette smokers [known]


28. During the past 30 days, what brands of cigarettes did you smoke? (Select one or more)

  1. American Spirit

  2. Camel

  3. GPC, Basic, or Doral

  4. Kool

  5. Marlboro

  6. Maverick

  7. Newport

  8. L&M

  9. Pall Mall

  10. Parliament

  11. Winston

  12. Some other brand not listed here (Please specify: _____________________)

  13. Not sure


[IF >1 OPTION SELECTED CONTINUE TO Q29]

[IF 1 OPTION SELECTED SKIP TO Q30]

Question Universe: past 30-day cigarette smokers reporting more than 1 brand [known]


29. During the past 30 days, what brand of cigarettes did you usually smoke? (Choose only one answer)

  1. I did not smoke a usual brand

  2. American Spirit

  3. Camel

  4. GPC, Basic, or Doral

  5. Kool

  6. Marlboro

  7. Maverick

  8. Newport

  9. L&M

  10. Pall Mall

  11. Parliament

  12. Winston

  13. Some other brand not listed here (Please specify: _____________________)

  14. Not sure

Question Universe: past 30-day cigarette smokers [known]


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

  1. Yes

  2. No

  3. Not sure


[ALL RESPONSES SKIP TO INSTRUCT_5]

[IF Q30 EQ (NA) SKIP TO INSTRUCT_5]

Question Universe: never cigarette smokers [known]


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

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

Question Universe: never cigarette smokers [known]


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

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

Question Universe: never cigarette smokers [known]


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

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not


Question Universe: never cigarette smokers [known]


34. 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

Instruction Universe: all students


INSTRUCT_5. The next several questions are about the use of cigars, cigarillos, or little cigars such as Swisher Sweets, Black and Mild, Garcia y Vega, Cheyenne, White Owl, or Dutch Masters.

Question Universe: all students


35. Have you ever smoked a cigar, cigarillo, or little cigar, even one or two puffs?

  1. Yes

  2. No [SKIP TO Q40]


IF Q35 EQ (NA) – SOFT VALIDATION

IF Q35 EQ (NA) SKIP TO Q37.

Question Universe: ever cigar smokers [known]


36. How old were you when you first smoked a cigar, cigarillo, or little cigar, even one or two puffs?

  1. 8 years old or younger

  2. 9 years old

  3. 10 years old

  4. 11 years old

  5. 12 years old

  6. 13 years old

  7. 14 years old

  8. 15 years old

  9. 16 years old

  10. 17 years old

  11. 18 years old

  12. 19 years old or older

Question Universe: ever cigar smokers [or unknown]


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


Specify: |__|__| (Range 0 – 30)


[PROGRAMMING: RANGE (0 – 30) ALLOWED]


IF Q37 EQ (NA) – SOFT VALIDATION


[IF Q35 EQ (1) AND Q37 EQ (0) SKIP TO INSTRUCT_6]

[IF Q35 EQ (NA) AND Q37 EQ (NA) SKIP TO INSTRUCT_6]

[IF Q35 EQ (NA) AND Q37 EQ (0) SKIP TO INSTRUCT_6]

[IF Q35 EQ (NA) AND Q37 EQ (1-30) CONTINUE TO Q38]

[IF Q35 EQ (1) AND Q37 EQ (1-30) CONTINUE TO Q38]

[IF Q35 EQ (1) AND Q37 EQ (NA) SKIP TO INSTRUCT_6]

Question Universe: past 30-day cigar smokers [known]


38. During the past 30 days, on the days that you smoked, about how many cigars, cigarillos, or little cigars did you smoke per day?

  1. Less than 1 cigar, cigarillo, or little cigar per day

  2. 1 per day

  3. 2 to 5 per day

  4. 6 to 10 per day

  5. 11 to 20 per day

  6. More than 20 per day

Question Universe: past 30-day cigar smokers [known]


39. During the past 30 days, which of the following types of cigars have you smoked? (Select one or more)

  1. Regular cigars

  2. Cigarillos

  3. Little Cigars

  4. Don’t Know [EXCLUSIVE]


[ALL RESPONSES SKIP TO INSTRUCT_6]

[IF Q39 EQ (NA) SKIP TO INSTRUCT_6]

Question Universe: never cigar smokers [known]


40. Have you ever been curious about smoking a cigar, cigarillo, or little cigar?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

Question Universe: never cigar smokers [known]


41. Do you think you will try a cigar, cigarillo, or little cigar soon?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

Question Universe: never cigar smokers [known]


42. Do you think you will smoke a cigar, cigarillo, or little cigar in the next year?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

Question Universe: never cigar smokers [known]


43. If one of your best friends were to offer you a cigar, cigarillo, or little cigar, would you smoke it?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not


Instruction Universe: all students


INSTRUCT_6. The next several questions are about the use of chewing tobacco, snuff, or dip, such as Copenhagen, Grizzly, Skoal, or Longhorn. Do not think about snus or dissolvable tobacco products when you answer these questions.


Question Universe: all students


44. Have you ever used chewing tobacco, snuff, or dip, even just a small amount?

  1. Yes

  2. No [SKIP TO Q47]

[IF Q44 EQ (NA) – SOFT VALIDATION]

[IF Q44 EQ (NA) SKIP TO Q46]

Question Universe: ever smokeless tobacco users [known]


45. How old were you when you first used chewing tobacco, snuff, or dip, even just a small amount?

  1. 8 years old or younger

  2. 9 years old

  3. 10 years old

  4. 11 years old

  5. 12 years old

  6. 13 years old

  7. 14 years old

  8. 15 years old

  9. 16 years old

  10. 17 years old

  11. 18 years old

  12. 19 years old or older

Question Universe: ever smokeless tobacco users [or unknown]


46. During the past 30 days, on how many days did you use chewing tobacco, snuff, or dip?


Specify: |__|__| (Range 0 – 30)


[PROGRAMMING: RANGE (0 – 30) ALLOWED]


IF Q46 EQ (NA) – SOFT VALIDATION


[ALL RESPONSES SKIP TO INSTRUCT_7]

[IF Q46 EQ (NA) SKIP TO INSTRUCT_7]

Question Universe: never smokeless tobacco product users [known]


47. Have you ever been curious about using chewing tobacco, snuff, or dip?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

Instruction Universe: all students


INSTRUCT_7. The next several questions are about smoking tobacco in a hookah, which is a type of waterpipe. Shisha (or hookah tobacco) is smoked in a hookah.


Question Universe: all students


48. Have you ever smoked tobacco in a hookah or waterpipe, even one or two puffs?

  1. Yes

  2. No [SKIP TO Q52]

[IF Q48 EQ (NA) – SOFT VALIDATION]

[IF Q48 EQ (NA) SKIP TO Q50]

Question Universe: ever hookah users [known]


49. How old were you when you first smoked tobacco in a hookah or waterpipe, even one or two puffs?

  1. 8 years old or younger

  2. 9 years old

  3. 10 years old

  4. 11 years old

  5. 12 years old

  6. 13 years old

  7. 14 years old

  8. 15 years old

  9. 16 years old

  10. 17 years old

  11. 18 years old

  12. 19 years old or older

Question Universe: ever hookah users [or unknown]


50. During the past 30 days, on how many days did you smoke tobacco in a hookah or waterpipe?


Specify: |__|__| (Range 0 – 30)


[PROGRAMMING: RANGE (0 – 30) ALLOWED]


IF Q50 EQ (NA) – SOFT VALIDATION


[IF Q48 EQ (1) AND Q50 EQ (0) SKIP TO INSTRUCT_8]

[IF Q48 EQ (NA) AND Q50 EQ (NA) SKIP TO INSTRUCT_8]

[IF Q48 EQ (1) AND Q50 EQ (NA) SKIP TO INSTRUCT_8]

[IF Q48 EQ (NA) AND Q50 EQ (0) SKIP TO INSTRUCT_8]

[IF Q48 EQ (NA) AND Q50 EQ (1-30) CONTINUE TO Q51]

[IF Q48 EQ (1) AND Q50 EQ (1-30) CONTINUE TO Q51]

Question Universe: past 30-day hookah users [known]


51. During the past 30 days, where did you smoke tobacco in a hookah or waterpipe? (Select one or more)

  1. At my house

  2. At a friend’s house

  3. At a family member’s house, other than my house

  4. At a hookah bar

  5. At a café or restaurant

  6. Some other place not listed here


ALL RESPONSES SKIP TO INSTRUCT_8

[IF Q51 EQ (NA) SKIP TO INSTRUCT_8]

Question Universe: never hookah users [known]


52. Have you ever been curious about smoking tobacco in a hookah or waterpipe?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

Instruction Universe: all students


INSTRUCT_8. The next section is about the use of other tobacco products, not described in the previous sections.

Question Universe: all students


53. Which of the following tobacco products have you ever used, even just one time? (Select one or more)

  1. Roll-your-own cigarettes

  2. Pipes filled with tobacco (not hookah or waterpipe)

  3. Snus, such as Camel, Marlboro, or General Snus

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

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

  6. I have never tried any of the products listed above [EXCLUSIVE] [SKIP TO INSTRUCT_9]


IF Q53A EQ (NA) AND Q53B EQ (NA) AND Q53C EQ (NA) AND Q53D EQ (NA) AND Q53E EQ (NA) AND Q53F EQ (NA) SOFT VALIDATION


[IF Q53A EQ (1) OR Q53B EQ (1) OR Q53C EQ (1) OR Q53D EQ (1) OR Q53E EQ (1) CONTINUE TO Q54]

[IF Q53A EQ (NA) AND Q53B EQ (NA) AND Q53C EQ (NA) AND Q53D EQ (NA) AND Q53E EQ (NA) AND Q53F EQ (NA) CONTINUE TO Q54]


Question Universe: ever users of other tobacco products [or unknown]


54. In the past 30 days, which of the following products have you used on at least one day? (Select one or more)

  1. Roll-your-own cigarettes

  2. Pipes filled with tobacco (not hookah or waterpipe)

  3. Snus, such as Camel, Marlboro, or General Snus

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

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

  6. I have not used any of the products listed above in the past 30 days [EXCLUSIVE]


IF Q53A EQ (NA) AND Q53B EQ (NA) AND Q53C EQ (NA) AND Q53D EQ (NA) AND Q53E EQ (NA) AND Q53F EQ (NA) –SOFT VALIDATION

[ALL RESPONSES CONTINUE TO INSTRUCT_9]

Instruction Universe: all students


INSTRUCT_9. The next section is about “heated tobacco products”. Some people refer to these products as “heat-not-burn” tobacco products. “Heated tobacco products” heat tobacco sticks or capsules to produce a vapor. They are different from e-cigarettes, which heat a liquid to produce a vapor. Some brands of “heated tobacco products” include iQOS, glo, and Eclipse.


Question Universe: all students


55. Before today, have you heard of “heated tobacco products”?

  1. Yes

  2. No

  3. Don’t know/Not Sure


[ALL RESPONSES CONTINUE TO Q56]

Question Universe: all students


56. Have you ever used a “heated tobacco product”, even just one time?

  1. Yes [CONTINUE TO Q57]

  2. No [SKIP TO INSTRUCT_10]

  3. Don’t Know/Not Sure [CONTINUE TO Q57]


IF Q56 EQ (NA) –SOFT VALIDATION

[IF Q56 EQ (NA) CONTINUE TO Q57]

Question Universe: ever heated tobacco product user [or unknown/don’t know]


57. During the past 30 days, on how many days did you use a heated tobacco product?


Specify: |__|__| (Range 0 – 30)


[PROGRAMMING: RANGE (0 – 30) ALLOWED]


IF Q57 EQ (NA) – SOFT VALIDATION


ALL RESPONSES CONTINUE TO INSTRUCT_10

Programming Universe: all students


INSTRUCT_10. Programming note, only.


CONDITION #1: “current tobacco product user”


IF { [Q9=1-30] OR [Q25=1-30] OR [Q37=1-30] OR [Q46=1-30] OR [Q50=1-30] OR [(Q54A=1 OR Q54B=1 OR Q54C=1 OR Q54D=1 OR Q54E=1)] OR [Q57=1-30] } CONTINUE TO INSTRUCT_11


[CONDITION #2: never tobacco product user; former user of at least one product].

ELSE SKIP TO INSTUCT_16

Instruction Universe: current (past 30-day) tobacco product user (any product) [known]


INSTRUCT_11. Now think about your responses to the questions about past 30 day use of e-cigarettes, cigarettes, cigars, smokeless tobacco, hookahs, roll-your-own cigarettes, pipes, snus, dissolvable tobacco, bidis, and heated tobacco products.

Question Universe: current (past 30-day) tobacco product user (any product) [known]


58. During the past 30 days, on how many days did you use any tobacco product(s)?

Specify: |__|__| (Range 1 – 30)


[PROGRAMMING: RANGE (1 – 30) ALLOWED]


  • ALL RESPONSES CONTINUE TO INSTRUCT_12

Instruction Universe: current (past 30-day) tobacco product user (any product)


INSTRUCT_12. The next few questions ask about flavors in tobacco products.

Question Universe: past 30-day user of each tobacco product [cigars; smokeless tobacco; e-cigarettes; hookah; pipe tobacco; snus; dissolvable tobacco; bidis; roll-your-own cigarettes; heated tobacco], respectively


[EXCLUSIVE CIGARETTE SMOKERS SKIP TO INSTRUCT_13]

IF {[Q25=(1-30)] AND [(Q9=0 OR Q9=NA) AND (Q37=0 OR Q37=NA) AND (Q46=0 OR Q46=NA) AND (Q50=0 OR Q50=NA) AND [Q54F=1 OR (Q54A=NA AND Q54B=NA AND Q54C=NA AND Q54D=NA AND Q54E=NA AND Q54F=NA)] AND (Q58=0 OR Q58=NA)]} SKIP TO INSTRUCT_13


[ELSE LOOP through question for each tobacco product used in past 30 days]:

IF [Q9 EQ (1-30)] ASK Q59A (tobname = “e-cigarettes”)

IF [Q37 EQ (1-30)] ASK Q59B (tobname = “cigars, cigarillos, or little cigars”)

IF [Q46 EQ (1-30)] ASK Q59C (tobname = “chewing tobacco, snuff, or dip”)

IF [Q50 EQ (1-30)] ASK Q59D (tobname = ‘tobacco in a hookah or waterpipe”)

IF [Q54B EQ (1)] ASK Q59E (tobname = “pipe tobacco (not waterpipe)”)

IF [Q54C EQ (1)] ASK Q59F (tobname = “snus”)

IF [Q54D EQ (1)] ASK Q59G (tobname = “dissolvable tobacco products”)

IF [Q54E EQ (1)] ASK Q59H (tobname = “bidis”)

IF [Q54A EQ (1)] ASK Q59I (tobname = “roll-your-own cigarettes”)

IF [Q57 EQ (1-30)] ASK Q59J (tobname = “heated tobacco products”)


59 [A—J]. Were any of the [tobname] that you used in the past 30 days flavored to taste like menthol (mint), clove or spice, alcohol (wine, cognac), candy, fruit, chocolate, or any other flavor?

  1. Yes

  2. No

  3. Don’t Know


IF [Q59A=1 OR Q59B=1 OR Q59C=1 OR Q59D=1 OR Q59E=1 OR Q59F=1 OR Q59G=1 OR Q59H=1 OR Q59I=1 OR Q59J=1] CONTINUE TO Q60.


ELSE SKIP TO INSTRUCT_13.

Question Universe: past 30-day users of flavored [cigars; smokeless tobacco; e-cigarettes; hookah; pipe tobacco; snus; dissolvable tobacco; bidis; roll-your-own cigarettes; heated tobacco], respectively


LOOP through question for each flavored tobacco product used in past 30 days]:

IF [QN59A=1] ASK Q60A (tobname1 = “e-cigarettes”)

IF [QN59B=1] ASK Q60B (tobname1 = “cigars, cigarillos, or little cigars”)

IF [QN59C=1] ASK Q60C (tobname1 = “chewing tobacco, snuff, or dip”)

IF [QN59D=1] ASK Q60D (tobname1 = ‘tobacco in a hookah or waterpipe”)

IF [QN59E=1] ASK Q60E (tobname1 = “pipe tobacco (not waterpipe)”)

IF [QN59F=1] ASK Q60F (tobname1 = “snus”)

IF [QN59G=1] ASK Q60G (tobname1 = “dissolvable tobacco products”)

IF [QN59H=1] ASK Q60H (tobname1 = “bidis”)

IF [QN59I=1] ASK Q60I (tobname1 = “roll-your-own cigarettes”)

IF [QN59J=1] ASK Q60J (tobname1 = “heated tobacco products”)


60 [A—J]. What flavors were the [tobname1] that you have used in the past 30 days? (Select one or more)

  1. Menthol or mint

  2. Clove or spice

  3. Fruit

  4. Chocolate

  5. Alcoholic drinks (such as wine, cognac, margarita, or other cocktails)

  6. Candy, desserts, or other sweets

  7. Some other flavor not listed here (Specify: _____________________________)


[ALL RESPONSES CONTINUE TO INSTRUCT_13]

Instruction Universe: past 30-day users of any tobacco product [known]


INSTRUCT_13. The next two questions are about urges to use tobacco products.

Question Universe: past 30-day users of any tobacco product [known]


61. 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?

  1. Yes

  2. No

Question Universe: past 30-day users of any tobacco product [known]


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

  1. I do not want to use tobacco products

  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 products


[ALL RESPONSES CONTINUE TO INSTRUCT_14]

Instruction Universe: past 30-day tobacco product users (any product) [known]


INSTRUCT_14. The next few questions are about quitting tobacco products.

Question Universe: past 30-day tobacco product users (any product) [known]


63. Are you seriously thinking about quitting the use of all tobacco products? (Please choose the first answer that fits)

  1. Yes, during the next 30 days

  2. Yes, during the next 6 months

  3. Yes, during the next 12 months

  4. Yes, but not during the next 12 months

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


Question Universe: past 30-day tobacco product users (any product) [known]


64. 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 try to quit all tobacco products during the past 12 months

  2. 1 time

  3. 2 times

  4. 3 to 5 times

  5. 6 to 9 times

  6. 10 or more times


[IF Q25 EQ (1-30) CONTINUE TO Q65] (CURRENT CIGARETTE SMOKERS)

[ELSE IF Q9 EQ (1-30) SKIP TO Q67] (CURRENT E-CIGARETTE USERS)

[ELSE IF Q64 EQ (NA) SKIP TO INSTRUCT_15]

[ELSE SKIP TO INSTRUCT_15]


Question Universe: past 30-day users of cigarettes [known]


65. Are you seriously thinking about quitting cigarettes? (Please choose the first answer that fits)

  1. Yes, during the next 30 days

  2. Yes, during the next 6 months

  3. Yes, during the next 12 months

  4. Yes, but not during the next 12 months

  5. No, I am not thinking about quitting cigarettes

Question Universe: past 30-day users of cigarettes [known]


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

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

  2. 1 time

  3. 2 times

  4. 3 to 5 times

  5. 6 to 9 times

  6. 10 or more times


[IF Q9 EQ (1-30) CONTINUE TO Q67]

[ELSE SKIP TO INSTRUCT_15]

Question Universe: past 30-day users of e-cigarettes [known]


67. Are you seriously thinking about quitting e-cigarettes? (Please choose the first answer that fits)

  1. Yes, during the next 30 days

  2. Yes, during the next 6 months

  3. Yes, during the next 12 months

  4. Yes, but not during the next 12 months

  5. No, I am not thinking about quitting e-cigarettes

Question Universe: past 30-day users of e-cigarettes [known]


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

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

  2. 1 time

  3. 2 times

  4. 3 to 5 times

  5. 6 to 9 times

  6. 10 or more times


ALL RESPONSES CONTINUE TO INSTRUCT_15

Instruction Universe: past 30-day tobacco product users (any product) [known]


INSTRUCT_15. The next few questions are about getting tobacco products.

Question Universe: past 30-day users of [cigarettes; cigars; smokeless tobacco; e-cigarettes; hookah; pipe tobacco; snus; dissolvable tobacco; bidis; roll-your-own cigarettes; heated tobacco], respectively


[LOOP through for each product currently used (each time the skip above is satisfied)]

IF [QN9 EQ (1-30)] ASK Q69A (tobname = “e-cigarettes”)

IF [QN25 EQ (1-30)] ASK Q69B ( then tobname = “cigarettes”)

IF [QN37 EQ (1-30)] ASK Q69C ( then tobname = “cigars, cigarillos, or little cigars”)

IF [QN46 EQ (1-30)] ASK Q69D (then tobname = “chewing tobacco, snuff, or dip”)

IF [QN50 EQ (1-30)] ASK Q69E (then tobname = ‘tobacco in a hookah or waterpipe”)

IF [QN54B EQ (1)] ASK Q69F (then tobname = “pipe tobacco (not waterpipe)”)

IF [QN54C EQ (1)] ASK Q69G (then tobname = “snus”)

IF [QN54D EQ (1)] ASK Q69H (then tobname = “dissolvable tobacco products”)

IF [QN54E EQ (1)] ASK Q69I (then tobname = “bidis”)

IF [QN54A EQ (1)] ASK Q69J (then tobname = “roll-your-own cigarettes”)

IF [QN57 EQ (1-30)] ASK Q69K (then tobname = “heated tobacco products”)


69. During the past 30 days, how did you get your [tobname]? (Select one or more)

  1. I bought them myself

  2. I had someone else buy them for me

  3. I asked someone to give me some

  4. Someone offered them to me

  5. I bought them from another person

  6. I took them from a store or another person

  7. I got them in some other way (specify: ______________________________________)


[ALL RESPONSES CONTINUE TO Q70]

Question Universe: past 30-day users of [cigarettes; cigars; smokeless tobacco; e-cigarettes; hookah; pipe tobacco; snus; dissolvable tobacco; bidis; roll-your-own cigarettes; heated tobacco], respectively

[LOOP through for each product currently used (each time the skip above is satisfied)]

IF [QN9 EQ (1-30)] ASK Q70A (tobname = “e-cigarettes”)

IF [QN25 EQ (1-30)] ASK Q70B ( then tobname = “cigarettes”)

IF [QN37 EQ (1-30)] ASK Q70C ( then tobname = “cigars, cigarillos, or little cigars”)

IF [QN46 EQ (1-30)] ASK Q70D (then tobname = “chewing tobacco, snuff, or dip”)

IF [QN50 EQ (1-30)] ASK Q70E (then tobname = ‘tobacco in a hookah or waterpipe”)

IF [QN54B EQ (1)] ASK Q70F (then tobname = “pipe tobacco (not waterpipe)”)

IF [QN54C EQ (1)] ASK Q70G (then tobname = “snus”)

IF [QN54D EQ (1)] ASK Q70H (then tobname = “dissolvable tobacco products”)

IF [QN54E EQ (1)] ASK Q70I (then tobname = “bidis”)

IF [QN54A EQ (1)] ASK Q70J (then tobname = “roll-your-own cigarettes”)

IF [QN57 EQ (1-30)] ASK Q70K (then tobname = “heated tobacco products”)


70. During the past 30 days, where did you buy your [tobname]? (Select one or more)

  1. I did not buy tobacco products during the past 30 days EXCLUSIVE RESPONSE

  2. A gas station or convenience store

  3. A grocery store

  4. A drugstore

  5. A vending machine

  6. On the Internet

  7. Through the mail

  8. A vape shop or tobacco shop

  9. Some other place not listed here (specify): ___________________________________

Question Universe: past 30-day tobacco product users (any product) [known]


71. During the past 30 days, did anyone refuse to sell you any tobacco products because of your age?

  1. I did not try to buy any tobacco products during the past 30 days

  2. Yes

  3. No


[ALL RESPONSES SKIP TO Q72]

IF Q71 EQ (NA) SKIP TO Q72]

Instruction Universe: never, former users of any tobacco product [known/unknown]


INSTRUCT_16. The next two questions ask your thoughts about getting tobacco products.


Question Universe: all students


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

  1. Easy

  2. Somewhat easy

  3. Not easy at all

Question Universe: all students


73. How easy do you think it is for people your age to buy tobacco products online?

  1. Easy

  2. Somewhat easy

  3. Not easy at all


Instruction Universe: all students


INSTRUCT_17. The next four questions are about visits to a doctor, dentist, nurse, or other health professional.


When answering these questions, consider “any tobacco product” to include e-cigarettes, cigarettes, cigars, smokeless tobacco, hookahs, roll-your-own cigarettes, pipe tobacco, snus, dissolvable tobacco, bidis, or heated tobacco products.

Question Universe: all students


74. Think about when you have visited a doctor, dentist, or nurse in the past 12 months. During any of these visits, were you asked if you used any tobacco product?

A. I did not see a doctor, dentist, or nurse during the past 12 months.

B. Yes

C. No

Question Universe: all students


75. Think about when you have visited a doctor, dentist, or nurse in the past 12 months. During any of these visits, were you given advice not to use any tobacco products?

A. I did not see a doctor, dentist, or nurse during the past 12 months.

B. Yes

C. No

Question Universe: all students


76. Think about when you have visited a doctor, dentist, or nurse in the past 12 months. During any of these visits, were you asked if you used e-cigarettes?

A. I did not see a doctor, dentist, or nurse during the past 12 months.

B. Yes

C. No

Question Universe: all students


77. Think about when you have visited a doctor, dentist, or nurse in the past 12 months. During any of these visits, were you given advice not to use e-cigarettes?

A. I did not see a doctor, dentist, or nurse during the past 12 months.

B. Yes

C. No

Instruction Universe: all students


INSTRUCT_18. The next five questions are about different topics related to tobacco. A warning label tells you if a product is harmful to you and can be either a picture or words.

Question Universe: all students


78. During the past 30 days, how often did you see a warning label on a cigarette package?

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

  2. Never

  3. Rarely

  4. Sometimes

  5. Most of the time

  6. Always

Question Universe: all students


79. During the past 30 days, how often did you see a warning label on a cigar, cigarillo, or little cigar package?

  1. I did not see a cigar, cigarillo, or little cigar package during the past 30 days

  2. Never

  3. Rarely

  4. Sometimes

  5. Most of the time

  6. Always

Question Universe: all students


80. During the past 30 days, how often did you see a warning label on an e-cigarette package?

  1. I did not see an e-cigarette package during the past 30 days

  2. Never

  3. Rarely

  4. Sometimes

  5. Most of the time

  6. Always

Question Universe: all students


81. During the past 30 days, how often did you see a warning label on a package of hookah tobacco?

  1. I did not see a package of hookah tobacco during the past 30 days

  2. Never

  3. Rarely

  4. Sometimes

  5. Most of the time

  6. Always

Question Universe: all students


82. In the past 12 months, have you seen or heard The Real Cost, on television, the internet, social media, or radio as part of ads about tobacco?

  1. Yes

  2. No

  3. Not sure

Instruction Universe: all students


INSTRUCT_19. The next 15 questions ask about your thoughts on tobacco products.

Question Universe: all students


83. 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

Question Universe: all students


84. How much do you think people harm themselves when they smoke cigars, cigarillos, or little cigars, some days but not every day?

  1. No harm

  2. Little harm

  3. Some harm

  4. A lot of harm

Question Universe: all students


85. Do you believe that cigars, cigarillos, or little cigars are (LESS ADDICTIVE, EQUALLY ADDICTIVE, or MORE ADDICTIVE) than cigarettes?

  1. Less addictive

  2. Equally addictive

  3. More addictive

  4. I have never heard of cigars, cigarillos, or little cigars

  1. I don’t know enough about these products

Question Universe: all students


86. How much do you think people harm themselves when they use chewing tobacco, snuff, dip, snus, or dissolvable tobacco products, some days but not every day?

    1. No harm

    2. Little harm

    3. Some harm

    4. A lot of harm


Question Universe: all students


87. Do you believe that chewing tobacco, snuff, dip, snus, or dissolvable tobacco products are (LESS ADDICTIVE, EQUALLY ADDICTIVE, or MORE ADDICTIVE) than cigarettes?

  1. Less addictive

  2. Equally addictive

  3. More addictive

  4. I have never heard of chewing tobacco, snuff, dip, snus, or dissolvable tobacco products

  5. I don’t know enough about these products

Question Universe: all students


88. How much do you think people harm themselves when they use e-cigarettes some days but not every day?

  1. No harm

  2. Little harm

  3. Some harm

  4. A lot of harm

Question Universe: all students


89. Do you believe that e-cigarettes are (LESS ADDICTIVE, EQUALLY ADDICTIVE, or MORE ADDICTIVE) than cigarettes?

  1. Less addictive

  2. Equally addictive

  3. More addictive

  4. I have never heard of e-cigarettes

  5. I don’t know enough about these products

Question Universe: all students


90. How much do you think people harm themselves when they smoke tobacco in a hookah or waterpipe some days but not every day?

  1. No harm

  2. Little harm

  3. Some harm

  4. A lot of harm

Question Universe: all students


91. Do you believe that smoking tobacco in a hookah or waterpipe is (LESS ADDICTIVE, EQUALLY ADDICTIVE, or MORE ADDICTIVE) than cigarettes?

  1. Less addictive

  2. Equally addictive

  3. More addictive

  4. I have never heard of smoking tobacco in a hookah or waterpipe

  5. I don’t know enough about these products

Question Universe: all students


92. Compared to a typical cigarette, would you think that a cigarette advertised as low nicotine would be…

  1. Much less harmful

  2. Slightly less harmful

  3. Equally harmful

  4. Slightly more harmful

  5. Much more harmful

Question Universe: all students


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

  1. Strongly agree

  2. Agree

  3. Disagree

  4. Strongly disagree

Question Universe: all students


94. Not including the vapor from e-cigarettes, 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

Question Universe: all students


95. Do you think that breathing the vapor from other people’s e-cigarettes causes…

  1. No harm

  2. Little harm

  3. Some harm

  4. A lot of harm

Question Universe: all students


96. 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

Question Universe: all students


97. Out of every 10 students in your grade at school, how many do you think use e-cigarettes?

  1. 0

  2. 1

  3. 2

  4. 3

  5. 4

  6. 5

  7. 6

  8. 7

  9. 8

  10. 9

  11. 10

Instruction Universe: all students


INSTRUCT_20. The next four questions ask about advertisements for tobacco products such as cigarettes, cigars, smokeless tobacco, hookahs, roll-your-own cigarettes, pipes, snus, dissolvable tobacco, and bidis. Do not think of electronic cigarettes, or e-cigarettes.

Question Universe: all students


98. When you are using the Internet, how often do you see 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


Question Universe: all students


99. When you read newspapers or magazines, how often do you see 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


Question Universe: all students


100. When you go to a convenience store, supermarket, or gas station, how often do you see 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


Question Universe: all students


101. When you watch TV or streaming services (such as Netflix, Hulu, or Amazon Prime), or go to the movies, how often do you see ads or promotions for cigarettes or other tobacco products?

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

  2. Never

  3. Rarely

  4. Sometimes

  5. Most of the time

  6. Always


Instruction Universe: all students


INSTRUCT_21. The next five questions ask about e-cigarette advertisements. Do not think about cigarettes or other tobacco products.

Question Universe: all students


102. When you are using the Internet, how often do you see ads or promotions for e-cigarettes?

  1. I do not use the Internet

  2. Never

  3. Rarely

  4. Sometimes

  5. Most of the time

  6. Always


Question Universe: all students


103. When you read newspapers or magazines, how often do you see ads or promotions for e-cigarettes?

  1. I do not read newspapers or magazines

  2. Never

  3. Rarely

  4. Sometimes

  5. Most of the time

  6. Always


Question Universe: all students


104. When you go to a convenience store, supermarket, or gas station, how often do you see ads or promotions for e-cigarettes?

  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


Question Universe: all students


105. When you watch TV or streaming services (such as Netflix, Hulu, or Amazon Prime), or go to the movies, how often do you see ads or promotions for e-cigarettes?

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

  2. Never

  3. Rarely

  4. Sometimes

  5. Most of the time

  6. Always

Question Universe: all students


106. How often do you see posts related to e-cigarettes when you go on social media (such as YouTube, Instagram, Snapchat, Twitter, or Facebook)?

  1. I do not go on social media

  2. Never

  3. Rarely

  4. Sometimes

  5. Most of the time

  6. Always

Instruction Universe: all students


INSTRUCT_22. The next four questions ask about you being around other people’s tobacco smoke. Do not include exposure to vapor from e-cigarettes.

Question Universe: all students


107. During the past 7 days, on how many days did someone smoke tobacco products in your home while you were there?

  1. 0 days

  2. 1 day

  3. 2 days

  4. 3 days

  5. 4 days

  6. 5 days

  7. 6 days

  8. 7 days

Question Universe: all students


108. During the past 7 days, on how many days did you ride in a vehicle when someone was smoking a tobacco product?

  1. 0 days

  2. 1 day

  3. 2 days

  4. 3 days

  5. 4 days

  6. 5 days

  7. 6 days

  8. 7 days


Question Universe: all students


109. During the past 30 days, on how many days did you breathe the smoke from someone who was smoking tobacco products in an indoor public place? Examples of indoor public places are school buildings, stores, restaurants, and sports arenas.

  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

Question Universe: all students


110. During the past 30 days, on how many days did you breathe the smoke from someone who was smoking tobacco products in an outdoor public place? Examples of outdoor public places are school grounds, parking lots, stadiums, and parks.

  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

Instruction Universe: all students


INSTRUCT_23. The next three questions ask about being around other people’s e-cigarette vapor. Do not include exposure to smoke from cigarettes or other tobacco products.

Question Universe: all students


111. During the past 30 days, on how many days did you breathe the vapor from someone who was using an e-cigarette in an indoor public place? Examples of indoor public places are school buildings, stores, restaurants, and sports arenas.


  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


Question Universe: all students


112. During the past 30 days, on how many days did you breathe the vapor from someone who was using an e-cigarette in an outdoor public place? Examples of outdoor public places are school grounds, parking lots, stadiums, and parks.


  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


Question Universe: all students


113. Have you ever seen anyone using an e-cigarette, such as JUUL, Vuse, or blu in any locations in or around your school? (Select one or more)

  1. No [EXCLUSIVE]

  2. Yes, inside a school bathroom or locker room

  3. Yes, inside a classroom

  4. Yes, inside some other area of the school (hallway, cafeteria)

  5. Yes, outside of the school, such as in the parking lot, sidewalk, sports fields, or other school grounds

  6. Yes, somewhere else not listed here [SPECIFY: _____________________________________]


Instruction Universe: all students


INSTRUCT_24. The last four questions ask about your experiences at home and at school.

Question Universe: all students


114. Does anyone who lives with you now…? (Select one or more)

  1. Smoke cigarettes

  2. Smoke cigars, cigarillos, or little cigars

  3. Use chewing tobacco, snuff, or dip

  4. Use e-cigarettes

  5. Smoke tobacco in a hookah or waterpipe

  6. Smoke pipes filled with tobacco (not hookah or waterpipes)

  7. Use snus

  8. Use dissolvable tobacco products

  9. Smoke bidis (small brown cigarettes wrapped in a leaf)

  10. Use heated tobacco products

  11. No one who lives with me now uses any form of tobacco [EXCLUSIVE]

Question Universe: all students


115. Do you speak a language other than English at home?

  1. Yes

  2. No

Question Universe: all students


116. Which of the following best describes you?

  1. Heterosexual (straight)

  2. Gay or Lesbian

  3. Bisexual

  4. Not Sure

Question Universe: all students


117. Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions?

  1. Yes

  2. No



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorGentzke, Andrea (CDC/DDNID/NCCDPHP/OSH)
File Modified0000-00-00
File Created2021-01-14
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