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Illinois Department of Public Health
Survey of Tobacco Use and Attitudes Among College Students

This survey will gather information on knowledge, attitudes and behaviors about tobacco use from students at State universities and community colleges. Information from the survey will be used by the Illinois Department of Public Health and statewide and community partners to plan initiatives to prevent young adults from starting tobacco use, help tobacco users quit and eliminate secondhand smoke exposure in public spaces. 
1.Have you ever tried any of the following tobacco products, even one time? (Check all that apply)(Required.)
2.During the past 30 days, on how many days did you use a tobacco product?
3.Do you want to quit tobacco for good?
4.Do you plan to quit tobacco for good within the next...
5.During the past 12 months, how many times have you stopped tobacco use for one day or longer because you were trying to quit for good?
6.Have you ever used a telephone quitline to help you quit tobacco? (A quitline is a free telephone-based service that connects people who smoke cigarettes or use other tobacco products with a person who can help them quit).
7.Would you consider using a telephone quitline in the future to help you quit tobacco?
8.Have you ever used an electronic nicotine delivery device (also known as e-cigarettes, e-cigars, e- cigarillos, e-pipes, e-hookahs, personal vaporizers (PV), vape pens, or hookah pens) even once?(Required.)
9.How often do you use electronic nicotine delivery devices (also known as e-cigarettes, e-cigars, e- cigarillos, e-pipes, e-hookahs, personal vaporizers (PV), vape pens, or hookah pens)?
10.Do you think use of any tobacco product is...(Required.)
11.Do you think breathing smoke from other people's cigarettes or other tobacco products is...(Required.)
[For questions 12-14 please let us know whether any of the following messages would impact your motivation to quit smoking. The following statements are designed to assess which messages are effective in impacting motivation to quit among young adults.]
12.Smoking can cause cancer, heart disease, stroke, chronic lung diseases (including emphysema), gum disease and many other illnesses.(Required.)
13.On average in the state of Illinois, a pack of cigarettes a day cost about $9, equal to $3,285 a year.(Required.)
14.Smoking can have a negative impact on your social and professional life. People around you may notice the smell of cigarettes from your clothes, hair and breath; staining on your fingernails, skin and teeth; and smoker’s cough.(Required.)
15.What is your age.(Required.)
16.What is your gender.(Required.)
17.Do you consider yourself to be...(Required.)
18.Are you...(Check all that apply)(Required.)
19.Which school do you attend.(Required.)
20.Please provide your email to be entered to win a $50 gift card of your choosing to Starbucks, Netflix, or Amazon.(Required.)
Thank you for participating in this survey. If you have questions about this survey, please contact the Illinois Department of Public Health / Tobacco Prevention and Control Program at 217-782-3300 or by e-mail at DPH.tobaccocontrol@illinois.gov.

Get help to quit using tobacco products by calling the Illinois Tobacco Quitline at 866-QUIT-YES.

This survey was funded by the Illinois Department of Public Health, Tobacco Control Program, through cooperative agreement 5 NU58DP005314-02-00 from the U.S. Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Human Services.
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