Parents survey on Youth and Substance Abuse
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1. Default Section

 

1. What is your zip code?

2. What percent of Kewanee youth, grades 6 - 12, do you believe have had more than just a few sips of alcohol during the past 30 days?

3. What percentage of Kewanee youth, grades 6-12, do you believe have smoked regularly or used smokeless tobacco (1-2 times/day) within the last 30 days?

4. What percentage of Kewanee youth, grades 6-12, do you believe have used marijuana during the past 30 days?

5. What percentage of Kewanee youth, grades 6-12, do you believe have used over-the-counter drugs without medical advise during the past 30 days?

6. What percentage of Kewanee youth, grades 6-12, do you believe have used a prescription drug without medical advice during the past 30 days?

7. During the past school year, how often have you talked to your 6-12th grader-aged children about...

 Never1-2 Times3-4 Times5-6 Times7 or more Times
The risks of alcohol use (injury, accidents, death, ect.)
The risks of tobacco use (addiction, effects on lungs, ect.)
The risks of marijuana use (effects on lungs, judgememnt, ect.)
Your rules and consequences related to alcohol, tobacco, and other drug use.

8. During the past school year, how often have you talked to your child about "NOT" drinking/doing drugs and driving?

9. During the past school year how many times have you talked to your child about "NOT" riding with an impaired driver?

10. We have set clear rules for our children "NOT" to use the following..

 YesNoDon't Remember
Alcohol
Tobacco
Marijuana

11. How much do you agree or disagree with the following statements?

 Strongly DisagreeDisagreeNeither Agree or DisagreeAgreeStrongly Agree
It is okay for parents to give alcohol to their own junior/high school aged children as long as the parents are there to supervise (not including religious reasons)
It is okay to give alcohol to other people’s junior/high school aged children (when their parents have not been consulted) as long as adults are there to supvise (not including religious reasons).
It’s okay for parents to give alcohol to other people’s junior/high school aged children (when their parents have been consulted) as long as adults are there to supervise (not including religious reasons).

12. How much do you think people under 21 risk harming themselves if they smoke cigarettes?

13. How much do you think people under 21 risk harming themselves if they smoke marijuana?

14. How much to you think people under 21 risk harming themselves if they drink beer, wine or hard liquor?

15. How much do you think people under 21 risk harming themselves if they use illegal drugs or take drugs when they are not sick?

16. Which of the following best describes your attitude about alcohol use by your children?

17. Which of the following best describes your attitude about tobacco use by your children?

18. Which of the following best describes your attitude about marijuana use by our children?

19. How often do you ask your jr/high school age child to call you if he or she is going to be late getting home?

20. How likely is it that you would know if your jr/high school age child "DID NOT" come home on time?

21. When your child is away from home how often do you or another adult in your home know where they are and who they are with?

22. If your child drank beer, wine or liquor without your permission how likely is it you would know?

23. If your jr/high school age child rode with someone who had been drinking or was high, how likely is it you would know?

24. If your child drove drunk or high how likely is it you would know?

25. How wrong do you feel it would be for your child to drink beer, wine or liquor regularly?

26. How wrong do you think it would be your child to smoke or use smokeless tobacco?

27. How wrong do you think it would be for your child to smoke marijuana?

28. Please answer the following questions.

29. Please make additional comments you may have about Kewanee youth and substance use.

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