Tobacco Assessment Survey

1. Default Section

 
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1. Classification?
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2. Gender?
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3. Age?
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4. If an employee, in which department do you work?
If a student, in which clubs/organization are you a member?
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5. Where do you live?
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6. What is the current tobacco policy at CBU?
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7. Second hand smoke is defined as the smoke from a burning tobacco product and the exhaled smoke from a person smoking. How often do you notice second hand smoke around the entrances of campus buildings?
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8. To what degree are you currently exposed to second hand smoke at CBU?
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9. Do you have asthma, respiratory issues, or allergies that are affected by breathing in secondhand cigarette smoke?
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10. Given a choice, would you choose to enroll in, work at or live on a tobacco free campus?
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11. If you are in favor of tobacco free campus at CBU, would you prefer that tobacco free be defined as:
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12. Do you mind being around smokers?
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13. How often do you use tobacco?
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