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Colchester Youth Survey 2019
This survey has been approved by the Colchester Board of Education and is sponsored by YouthFIRST,
Colchester's Local Prevention Council. The survey is open to youth in grades 6 through 12 attending
school in Colchester. We are conducting the survey to learn about your experiences and feelings regarding
tobacco, alcohol, drugs, and various activities. This is NOT a test. There are no right or wrong answers.
We encourage you to answer truthfully. Your answers cannot be traced back to you, so you can be
completely honest. This is your chance to be heard.
If you are taking this survey later in the cycle, you may have heard classmates talking about the questions
or answers they gave. We are relying on your independent spirit and integrity to give answers based on
your OWN opinions and experiences, regardless of what you may have heard.
Please work as quickly as you can. If you don't find an answer that fits exactly, choose the one that comes
closest. You should not compare or discuss your answers with other students while you are taking the
survey, but you may ask your teacher or survey administrator if you do not understand a question.
Until you click Done>> at the end, you may back up and change answers. To discontinue taking the
survey, click the Exit Survey box. If you exit, you are all finished, and cannot return to the survey later.
When you have completed the survey, click Done>> and wait for instructions from your teacher.
Colchester Youth Survey 2019
* 1. What grade are you in now?
6 9 12
7 10
8 11
2. What is your gender?
Female Male I prefer not to answer
3. How do you describe yourself? (Mark all that apply)
White or Caucasian Asian or Pacific Islander Hispanic or Latino
Black or African American Native American
Other (please specify)
Colchester Youth Survey 2019
4. On a regular weekday,how many hours do you usually spend after school without an adult
present?
None 1 To 2 Hours More Than 4 Hours
Less Than 1 Hour Up To 4 Hours
5. Please choose how true the following statements are for you:
Definitely Mostly Mostly Definitely
NOT True NOT True True True
I try hard to do good work at school.
I feel safe at school.
Teachers/Staff at my school encourage and
support me to do my best.
When I am away from home, my
parent/guardian(s) know where I am and who I
am with.
I share my thoughts and feelings with my
parent/guardian(s).
My parent/guardian(s) participates in activities
at my school, including attendance at school
events.
I feel very close to my parent/guardian(s).
I feel loved and valued by my family.
If I break one of my parent/guardian(s) rules, I
am usually disciplined.
Colchester Youth Survey 2019
6. Please choose how true this statement is for you:
My family has clear rules discouraging me from the following:
Definitely Mostly Mostly Definitely
NOT True NOT True True True
Smoking cigarettes or using tobacco.
Using electronic cigarettes (e-cigs, vapes,
juuls).
Drinking alcoholic beverages.
Using marijuana.
Using a prescription drug that is not prescribed
to me.
Gambling (scratch tickets, online, sports,
casino, etc).
7. Do either of your parents/guardians:
NO YES
Smoke cigarettes?
Use electronic cigarettes (e-cigs, vapes, juuls)?
Drink alcoholic beverages?
Use marijuana?
Gamble (scratch tickets, online, sports, casino,
etc)?
8. Has anyone in your family (such as a parent, brother or sister, not including you) ever used
alcohol so that it created problems at home, at work, or with friends?
NO YES
Colchester Youth Survey 2019
9. Think back over the past 30 days. On how many days, if any, did you use an energy drink (like
Red Bull, Monster, Amp or Rock Star)?
I have Occasionally Almost every day
NEVER used. (1 - 5 days) (21 days or more)
Not in the Frequently
past 30 days (6 - 20 days)
Colchester Youth Survey 2019
10. What was your age (in years) when you FIRST used an energy drink (like Red Bull, Monster,
Amp or Rock Star)?
10 yrs or 14 - 15
younger
16 or older
11 - 13
11. Think back over the past 30 days. On how many days, if any, did you use an energy drink
containing alcohol?
I have Occasionally Almost every day
NEVER used. (1 - 5 days) (21 days or more)
Not in the Frequently
past 30 days (6 - 20 days)
Colchester Youth Survey 2019
12. What was your age (in years) when you FIRST used an energy drink containing alcohol?
10 yrs or 14 - 15
younger
16 or older
11 - 13
13. Think back over the past 30 days. On how many days, if any, did you use electronic cigarettes
(e-cigs, vapes, juuls)?
I have Occasionally Almost every day
NEVER used. (1 - 5 days) (21 days or more)
Not in the Frequently
past 30 days (6 - 20 days)
Colchester Youth Survey 2019
14. What was your age (in years) when you FIRST used electronic cigarettes (e-cigs, vapes, juuls)?
10 yrs or 14 - 15
younger
16 or older
11 - 13
15. Have you ever used electronic cigarettes (e-cigs, vapes, juuls) to vape the following
substances?
No, never Yes, but not in the past 30 days. Yes, in the past 30 days.
Nicotine
Marijuana / THC
Other
16. When you first used electronic cigarettes, what influenced you the most to use?
Friends/Peer Pressure
Boredom
Curiosity
Advertisements/Media
Family Tradition
Easy to get
Angry/Upset with someone
Stress/To Feel Better
17. What influences you most to continue using electronic cigarettes ?
I am not currently using
Friends/Peer Pressure
Boredom
Curiosity
Advertisements/Media
Family Tradition
Easy to get
Angry/Upset with someone
Stress/To Feel Better
18. Think back over the past 30 days. On how many days, if any, did you use cigarettes?
I have Occasionally Almost every day
NEVER used. (1 - 5 days) (21 days or more)
Not in the Frequently
past 30 days (6 - 20 days)
Colchester Youth Survey 2019
19. What was your age (in years) when you FIRST used cigarettes?
10 yrs or 14 - 15
younger
16 or older
11 - 13
20. When you first used cigarettes, what influenced you the most to use?
Friends/Peer Pressure
Boredom
Curiosity
Advertisements/Media
Family Tradition
Easy to get
Angry/Upset with someone
Stress/To Feel Better
21. What influences you most to continue using cigarettes ?
I am not currently using
Friends/Peer Pressure
Boredom
Curiosity
Advertisements/Media
Family Tradition
Easy to get
Angry/Upset with someone
Stress/To Feel Better
22. How often do you get cigarettes from:
Never Sometimes Often
Your parents, with their
permission?
Your parents, without
their permission?
Your brother(s) or
sister(s)?
Your friends?
A store (you buy
them)?
Colchester Youth Survey 2019
23. Think back over the past 30 days. On how many days, if any, did you use other tobacco
products (like cigars, snuff, chewing tobacco, smoking tobacco from a pipe)?
I have Occasionally Almost every day
NEVER used. (1 - 5 days) (21 days or more)
Not in the Frequently
past 30 days (6 - 20 days)
Colchester Youth Survey 2019
24. What was your age (in years) when you FIRST used other tobacco products (like cigars, snuff,
chewing tobacco, smoking tobacco from a pipe)?
10 yrs or 14 - 15
younger
16 or older
11 - 13
25. When you first used other tobacco products what influenced you the most to use?
Friends/Peer Pressure
Boredom
Curiosity
Advertisements/Media
Family Tradition
Easy to get
Angry/Upset with someone
Stress/To Feel Better
26. What influences you most to continue using other tobacco products?
I am not currently using
Friends/Peer Pressure
Boredom
Curiosity
Advertisements/Media
Family Tradition
Easy to get
Angry/Upset with someone
Stress/To Feel Better
27. How often do you get other tobacco products from:
Never Sometimes Often
Your parents, with their
permission?
Your parents, without
their permission?
Your brother(s) or
sister(s)?
Your friends?
A store (you buy
them)?
Colchester Youth Survey 2019
28. Think back over the past 30 days. On how many days, if any, did you use marijuana or hashish?
I have Occasionally Almost every day
NEVER used. (1 - 5 days) (21 days or more)
Not in the Frequently
past 30 days (6 - 20 days)
Colchester Youth Survey 2019
29. What was your age (in years) when you FIRST used marijuana or hashish?
10 yrs or 14 - 15
younger
16 or older
11 - 13
30. When you first used marijuana, what influenced you the most to use?
Friends/Peer Pressure
Boredom
Curiosity
Advertisements/Media
Family Tradition
Easy to get
Angry/Upset with someone
Stress/To Feel Better
31. What influences you most to continue using marijuana?
I am not currently using
Friends/Peer Pressure
Boredom
Curiosity
Advertisements/Media
Family Tradition
Easy to get
Angry/Upset with someone
Stress/To Feel Better
32. How often do you get marijuana from:
Never Sometimes Often
Your parents, with their
permission?
Your parents, without
their permission?
Your brother(s) or
sister(s)?
Your friends?
Colchester Youth Survey 2019
* 33. During the past 30 days, on how many days (if any) did you drink one or more drinks of an
alcoholic beverage (more than a sip, and NOT including religious activities)?
I have NEVER used. Occasionally (1 - 5 days) Almost every day (21 days or more)
Not in the past 30 days Frequently (6 - 20 days)
Colchester Youth Survey 2019
34. In the past 30 days, did you drink alcoholic beverages in any of the following places:
Never Sometimes Often
At your home?
On the street, in the
woods, or in parks or
fields?
At the homes of other
people?
At school activities, like
dances or sporting
events?
While you were driving
a car, truck, or
motorcycle?
At a party with an adult
(21 or older) present?
At a party without an
adult (21 or older)
present?
35. During the past 30 days have you been under the influence of alcohol while you were at school?
NO YES
Colchester Youth Survey 2019
36. What was your age (in years) when you FIRST used alcoholic beverages (more than a sip, and
NOT including religious activities)?
10 yrs or 14 - 15
younger
16 or older
11 - 13
37. When you first used alcohol, what influenced you the most to use?
Friends/Peer Pressure
Boredom
Curiosity
Advertisements/Media
Family Tradition
Easy to get
Angry/Upset with someone
Stress/To Feel Better
38. What influences you most to continue using alcohol?
I am not currently using
Friends/Peer Pressure
Boredom
Curiosity
Advertisements/Media
Family Tradition
Easy to get
Angry/Upset with someone
Stress/To Feel Better
39. How often do you get alcohol from:
Never Sometimes Often
Your parents, with their
permission?
Your parents, without
their permission?
Your friends?
Your brother(s) or
sister(s)?
Other people who buy
it for you?
A party with an adult's
permission?
A store or bar (you buy
it)?
A restaurant ?
40. How often have you drank 4 or more alcoholic drinks (beer, wine, wine coolers, mixed drinks,
hard liquor etc.) during a single occasion?
I have NEVER drank 4 or more Occasionally (1 - 5 days) Almost every day (21 days or more)
drinks in a single occasion.
Frequently (6 - 20 days)
Not in the past 30 days
Colchester Youth Survey 2019
41. How important do you think the following are in preventing kids from drinking alcoholic
beverages?
Very Somewhat Not I Don't
Important Important Important Know.
Having driver's license suspended for drinking
Checking ID's in stores or bars
Fear of addiction
Friends who disapprove of drinking
High price
Breathalyzer tests
Parental strictness about drinking
Alcohol education in school
Being fined about $200 for drinking
Advertisement that show the problems
associated with drinking
Alcohol-free activities (like dances, concerts, or
sporting events)
Friends who don't drink
42. If you wanted to, how easy would it be for you to get:
Very Easy Sort Of Easy Sort Of Hard Very Hard
Beer, wine, wine
coolers, or hard
liquor?
Cigarettes?
Electronic cigarettes
(e-cigs, vapes, juuls)?
Marijuana?
A gun?
Illicit drugs like
cocaine, heroin, LSD,
or amphetamines?
A prescription drug
without your own
prescription (such as
OxyContin, Vicodin, or
Ritalin)?
Colchester Youth Survey 2019
43. How much do people risk harming themselves physically or in other ways when they do the
following:
No Slight Moderate Great
Risk Risk Risk Risk I Don't Know.
Smoke cigarettes, 1 or more packs a day?
Use electronic cigarettes (e-cigs, vapes, juuls)?
Drink alcoholic beverages, 5 or more once or
twice a week?
Take 1 or 2 drinks of an alcoholic beverage
nearly every day?
Use marijuana 1 or 2 times a week?
Use prescription drugs that are not prescribed
to them?
44. How wrong do your parents feel it would be for you to do the following:
Not At A Little
All Wrong Bit Wrong Wrong Very Wrong
Smoke tobacco?
Use electronic cigarettes (e-cigs, vapes, juuls)?
Drink one or two alcoholic beverages (beer,
wine, or liquor) nearly everyday?
Smoke marijuana?
Use prescription drugs not prescribed to you?
Gamble (scratch tickets, online, sports, casino,
etc)?
45. How wrong do your friends feel it would be for you to do the following:
Not At A Little
All wrong Bit Wrong Wrong Very Wrong
Smoke tobacco?
Use electronic cigarettes (e-cigs, vapes, juuls)?
Drink one or two alcoholic beverages (beer,
wine, or liquor) nearly everyday?
Smoke marijuana?
Use prescription drugs not prescribed to you?
Gamble (scratch tickets, online, sports, casino,
etc)?
46. How do you feel about someone your age having one or two drinks of an alcoholic beverage
nearly everyday?
Neither Approve or Disapprove Strongly Disapprove
Somewhat Disapprove Don't Know or Can't Say
Colchester Youth Survey 2019
47. Have you EVER used any of these drugs?
YES, But NOT in the YES, In the
NO, Never past 30 days past 30 days
Inhalants (things you sniff or inhale to get high
such as glue, paint, whippets, or sprays)
Cocaine
Crack cocaine (rock)
Allovites (vites)
Ecstasy (MDMA, Molly)
Hallucinogens (LSD, acid or mushrooms, PCP
or Angel Dust)
Heroin
Salvia
Ketamine (Special K)
GHB
Methamphetamine (Meth)
Synthetic marijuana (Spice, K2, K3)
Bath Salts (Ivorywave, Red Dove)
48. Have you ever used any of these drug(s) on your own,without your own prescription or a
doctor or dentist telling you to?
Yes, But NOT in the Yes, In the
NO, Never past 30 days past 30 days
Pain medication (OxyContin, Vicodin,
Percodan, Codeine, or Dilaudid)
Steroids (juice, roids)
Downers (barbiturates, sleeping pills,
sedatives, Quaaludes)
Tranquilizers (Valium, Xanax, or Librium)
Uppers (Ritalin, Adderall, Amphetamines, or
Speed)
Over the counter medications to get "high"
(cough medicine, mouthwash)
49. During the past 30 days, have you been intentionally high under the influence of drugs while
you were at school?
NO YES
Colchester Youth Survey 2019
50. Please choose how true the following statement are for you.
Definitely NOT
True Mostly NOT True Mostly True Definitely True
My community is a safe place.
In my community, kids are often teased or
taunted so much their feelings are hurt.
A lot of drugs are sold in my community.
There are lots of things for young people to do
in my community.
A lot of kids in my community are into using
marijuana and other drugs.
Adults in my town see teenagers as valuable
and important members of the community.
51. In the past year did you:
No Yes
Steal something less than $100?
Cheat on a test at school?
Sell illegal drugs?
Bring a knife, gun, or other weapon to school?
Bully someone with the idea of hurting their feelings?
Ride as a passenger with a driver under the influence of
drugs or alcohol?
Drive while under the influence of drugs or alcohol?
Gamble (scratch tickets, online, sports, casino, etc)?
52. How much do you disagree or agree with the following:
Strongly Strongly
Disagree Disagree Agree Agree
I feel lonely.
I am good at making decisions.
I feel sad most of the time.
I have so much energy I don't know what to do
with it.
I have a number of good qualities.
I have trouble concentrating.
I stand up for what I believe in.
I believe that my life is going in a positive
direction.
53. When you have a problem that bothers you, how often do you:
Never or Always or
Almost Never Sometimes Often Almost Always
Talk about it with your parent(s) or guardian(s)?
Talk about it with a teacher?
Talk about it with a friend?
Keep it to yourself?
54. There is at least one adult AT SCHOOL who I can talk to if I have a problem.
Yes
No
55. In the past 12 months, have you experienced any of the following?
Yes No
I have had thoughts about hurting myself.
I have hurt myself on purpose.
I have had a boyfriend/girlfriend hit, slap, or physically hurt me on
purpose.
I have felt sad or hopeless almost every day for 2 weeks or more so that
it stopped me from doing my usual activities.
I have seriously considered attempting suicide.
Colchester Youth Survey 2019
Gambling is risking money or something of value on an activity that has an uncertain outcome. This can include
things like bingo, scratch tickets, raffles, online gambling, sports betting and casino gambling.
56. How often do you gamble for money or possesions (such as poker, lottery, sports betting,
online bets)?
Daily Monthly Never
Weekly Less than monthly
Colchester Youth Survey 2019
57. Please choose a response for each question below:
Yes, but not in the past 12
Yes, in the past 12 months months Never
Have you ever tried to
cut back on your
gambling?
Has a family member
ever expressed
concern about the
amount of time you
gamble or the amount
of money you spend
gambling?
Have you ever missed
work, school or other
important social
activities because you
were gambling?
Do you think you have
a gambling problem?
58. Has anyone in your family (such as a parent or sibling, not you) ever gambled so that it created
problems at home, at work or with friends?
No Yes
Thank you for taking the time to complete this survey.