Tobacco Assessment Survey
Exit this survey
1. Default Section
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1
. Classification?
Classification?
Undergraduate
Graduate
University Staff
Faculty
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2
. Gender?
Gender?
Male
Female
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3
. Age?
Age?
Below 18
18 -22
22 or above
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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?
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?
Where do you live?
On Campus
Off Campus
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6
. What is the current tobacco policy at CBU?
What is the current tobacco policy at CBU?
Have no knowledge of the current tobacco policy
Use tobacco where I want
No smoking inside buildings
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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?
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?
Frequently
Occasionally
Rarely
Never
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8
. To what degree are you currently exposed to second hand smoke at CBU?
To what degree are you currently exposed to second hand smoke at CBU?
None
Somewhat
Very Much
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9
. Do you have asthma, respiratory issues, or allergies that are affected by breathing in secondhand cigarette smoke?
Do you have asthma, respiratory issues, or allergies that are affected by breathing in secondhand cigarette smoke?
Yes
No
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10
. Given a choice, would you choose to enroll in, work at or live on a tobacco free campus?
Given a choice, would you choose to enroll in, work at or live on a tobacco free campus?
Yes
No
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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:
If you are in favor of tobacco free campus at CBU, would you prefer that tobacco free be defined as:
100% tobacco free campus
Tobacco free campus with a designated smoking area
I am not in favor of a tobacco free campus
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12
. Do you mind being around smokers?
Do you mind being around smokers?
I do not like it
I don’t care
I try my best to avoid it
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13
. How often do you use tobacco?
How often do you use tobacco?
None
(socially)1-5 times per day
(occasionally)5-10 times per day
(moderately)10-15 times per day
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