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* 1. Do you reside in the Village of Malvern?

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* 2. What is your age?

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* 3. On a scale of 1 to 10, where 1 is "Not Concerned" and 10 is "Very Concerned", how concerned are you about the increasing usage of electronic cigarettes by youth in your community?

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* 4. On a scale of 1 to 10, where 1 is “Not Supportive” and 10 is “Very Supportive”, how supportive are you for the Village Council to pass an ordinance banning the sale of flavored tobacco products in the Village of Malvern?

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* 5. On a scale of 1 to 10, where 1 is “Not Supportive” and 10 is “Very Supportive”, how supportive are you for the Village Council to pass an ordinance banning the sale of tobacco products 1,000 ft. within a school or a park in the Village of Malvern?

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* 6. On a scale of 1 to 10, where 1 is “Not Supportive” and 10 is “Very Supportive”, how supportive are you for the Village Council to pass an ordinance increasing the legal age to purchase tobacco products from 18 years old to 21 years old?

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* 7. Other feedback regarding tobacco use in your community?

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