Directions:  This survey is vital to helping improve future health and prevention programs for youth.  Your answers are secret.  Answer all questions honestly.  Thank you.

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* 1. Are you...

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* 2. How old are you?

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* 3. What grade are you in?

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* 4. In the next year, how likely are you to get physical activity most days a week?

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* 5. In the next year, how likely are you to get 8 or more hours of sleep most nights?

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* 6. In the next year, how likely are you to eat mostly healthy foods most days?

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* 7. In the next year, how likely are you to drink any alcohol?

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* 8. In the next year, how likely are you to smoke any cigarettes?

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* 9. In the next year, how likely are you to use any marijuana?

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* 10. In the next year, how likely are you to use any e-cigarettes?

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* 11. In the next year, how likely are you to take action to reduce stress most days?

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* 12. In the next year, how likely are you to use any illegal drugs?

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* 13. If I drank alcohol regularly, it would harm my health or healthy habits.

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* 14. If I smoked cigarettes regularly, it would harm my health or healthy habits.

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* 15. If I used marijuana regularly, it would harm my health or healthy habits.

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* 16. If I used e-cigarettes regularly, it would harm my health or healthy habits.

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* 17. If I used illegal drugs regularly,  they would harm my health or healthy habits.

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* 18. So that we can compare your pre and post-program answers: What is the last 4 digits of your cellphone number followed by the first initial of your first name and then the first letter of the color of your eyes?  For example 2986gb

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