TOBACCO USE QUESTIONS, YOUTH
Behavior (19 questions)
Have you ever tried cigarette smoking, even one or two puffs?
SOURCE: Wisconsin Youth Risk Behavior Survey High School Questionnaire, 2001
How old were you when you smoked a whole cigarette for the first time?
a. I have never smoked a whole cigarette
b. 8 years old or younger
c. 9 or 10 years old
d. 11 or 12 years old
e. 13 or 14 years old
f. 15 or 16 years old
g. 17 years old or older
SOURCE: Wisconsin Youth Risk Behavior Survey High School Questionnaire, 2001
Have you ever smoked cigarettes daily, that is, at least one cigarette every day for 30 days?
a. Yes
b. No
SOURCE: Wisconsin Youth Risk Behavior Survey High School Questionnaire, 2001
During the past 30 days, on how many days did you smoke cigarettes?
a. 0 days
b. 1 or 2 days
c. 3 to 5 days
d. 6 to 9 days
e. 10 to 19 days
f. 20 to 29 days
g. All 30 days
SOURCE: Wisconsin Youth Risk Behavior Survey High School Questionnaire, 2001
During the past 30 days, on the days you smoked, how many cigarettes did you smoke per day?
a. I did not smoke cigarettes during the past 30 days
b. Less than 1 cigarette per day
c. 1 cigarette per day
d. 2 to 5 cigarettes per day
e. 6 to 10 cigarettes per day
f. 11 to 20 cigarettes per day
g. More than 20 cigarettes per day
SOURCE: Wisconsin Youth Risk Behavior Survey High School Questionnaire, 2001
During the past 30 days, how did you usually get your own cigarettes? (Select only one response.)
a. I did not smoke cigarettes during the past 30 days
b. I bought them in a store such as a convenience store, supermarket, discount store, or gas station
c. I bought them from a vending machine
d. I gave someone else money to buy them for me
e. I borrowed (or bummed) them from someone else
f. A person 18 years old or older gave them to me
g. I took them from a store or family member
h. I got them some other way
SOURCE: Wisconsin Youth Risk Behavior Survey High School Questionnaire, 2001
During the past 30 days, on how many days did you smoke cigarettes on school property?
a. 0 days
b. 1 or 2 days
c. 3 to 5 days
d. 6 to 9 days
e. 10 to 19 days
f. 20 to 29 days
g. All 30 days
SOURCE: Wisconsin Youth Risk Behavior Survey High School Questionnaire, 2001
Have you ever used chewing tobacco, snuff, or dip, such as Redman, Levi Garrett, Beechnut, Skoal, Skoal Bandits, or Copenhagen?
SOURCE: Wisconsin Youth Risk Behavior Survey High School Questionnaire, 2001
During the past 30 days, on how many days did you use chewing tobacco, snuff, or dip such as Redman, Levi Garrett, Beechnut, Skoal, Skoal Bandits, or Copenhagen?
a. 0 days
b. 1 or 2 days
c. 3 to 5 days
d. 6 to 9 days
e. 10 to 19 days
f. 20 to 29 days
g. All 30 days
SOURCE: Wisconsin Youth Risk Behavior Survey High School Questionnaire, 2001
Have you ever tried smoking cigars, cigarillos, or little cigars, even one or two puffs?
SOURCE: Wisconsin Youth Risk Behavior Survey High School Questionnaire, 2001
During the past 30 days, on how many days did you smoke cigars, cigarillos, or little cigars?
a. 0 days
b. 1 or 2 days
c. 3 to 5 days
d. 6 to 9 days
e. 10 to 19 days
f. 20 to 29 days
g. All 30 days
SOURCE: Wisconsin Youth Risk Behavior Survey High School Questionnaire, 2001
Is there anyone (else) living in your household who smokes cigarettes, cigars or pipes?
1. Yes
2. No
7. Don't know/Not sure
9. Refused
Source: Oregon 1997, Texas 1998
Is there anyone [other than yourself], living in your household who currently smokes cigarettes, cigars, or tobacco in a pipe? Include occasional smokers.
1. Yes
2. No
7. Don’t Know/Not Sure
9. Refuse
Source: Minnesota 1999
Has your smoking affected your health?
1. Yes
2. No
77. Don’t Know
99. Refused
If so, which of these health concerns have been affected? (check all that apply)
_____ Heart trouble/problem
_____ High blood pressure
_____ Cancer
_____ Emphysema
_____ Cough
_____ Shortness of breath
_____ Cold/flu/virus
_____ Other respiratory problem
_____ Sore throat
_____ Pregnancy
_____ Other: _________________________________________________
DK
Source:1987 NHIS
Did you ever try to quit smoking because of a health condition you had at the time?
1. Yes
2. No
Source:1987 NHIS
What was the health condition? (check all that apply)
_____ Heart trouble/problem
_____ High blood pressure
_____ Cancer
_____ Emphysema
_____ Cough
_____ Shortness of breath
_____ Cold/flu/virus
_____ Other respiratory problem
_____ Sore throat
_____ Pregnancy
_____ Other
77. DK
99. Refused
When you are inside a public place that has no rules about smoking, what are you most likely to do?
1. Light up a cigarette and smoke if you wish
2. Look around to see if others are smoking and then light up
3. Ask if others would mind
4. Just not smoke
5. Do something else
77. DK
99. Refused
Source:1992 NHIS