Please answer all questions, there are no questions that identify who you are and all responses are confidential. We use this date to help provide and address issues in our community.

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* 1. What is your current age? 

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* 2. What is your sex or gender?

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* 3. Your race  

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* 4. Are you?

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* 5. Are you currently raising any children who are in middle or high school? 

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* 6. In which school district do you live in?

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* 7. When (about what age) did you first start drinking alcohol (beer, wine or liquor)?

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* 8. Would you allow youth under the age of 21 to consume alcohol at a party in your home? 

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* 9. Which one of the following statements best describes how you feel about underage drinking? 

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* 10. Do you personally know any youth under 21 years of age who drink alcoholic beverages until they pass out? 

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* 11. Do you personally know any youth under 18 years of age who use marijuana? 

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* 12. Do you think marijuana should be legal for medical use when prescribed by a health care professional? 

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* 13. Pennsylvania is currently considering the legalization of marijuana for recreational use.  If marijuana is legalized for recreational use by adults, do you think you would use marijuana?

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* 14. Do you think marijuana is less harmful than alcohol? 

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* 15. Do you personally know youth under 18 years of age who are vaping (using devices that heat up small quantities of liquid or oil until they produce a vapor that is inhaled)?

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* 16. Which one of the following statements best describes how you feel about vaping devices?

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* 17. Can vaping devices be used to get high on marijuana or other drugs? 

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* 18. Do you use Juul/vapes/e-cigarettes?

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* 19. Do you think Juul (e-cigarettes) are safe? 

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* 20. Have you ever used a prescription drug not prescribed for you by a health care professional? 

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* 21. Do you personally know anyone who had a problem with opioid use (prescription pain killers, heroin or other opioids)? 

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* 22. Do you think treatment programs addressing the opioid problem are effective? 

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* 23. Choose one answer that best describes how do you feel about the widespread use of Naloxone/Narcan to prevent opioid overdose death? 

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* 24. Do you know of any youth under 21 who you think may be suffering from depression (feeling unusually sad, loss of interest in usual activities, feeling like a failure, worthless, hopeless or thoughts of dying or suicide)?

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* 25. Do you know of any youth under 21 who has received medical treatment for a suicide attempt?

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* 26. Have you ever gambled for money or anything of value at any time during the past year?  This includes: purchasing lottery tickets, playing BINGO, buying raffle tickets, betting on sports, going to the casino, Internet gambling, horse track, etc.  

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* 27. What is your preferred type of gambling activity?

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* 28. Have you ever felt the need to bet/gamble more and more money?

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* 29. Have you ever lied to people about how much money you bet/gamble?

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* 30. Have you ever borrowed money, stolen money, or used credit to bet/gamble?

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* 31. Have you ever felt guilty about the way you bet/gamble or about what happens when you bet/gamble? 

Thank you so much for taking the time to complete the gambling survey!

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