The Bethany, Orange, Woodbridge Drug/Alcohol Action Committee (BOWDAAC)wants to learn more about adult perceptions and attitudes towards the use of alcohol and other substances by youth under age 21. Through this survey we will be able to better serve our youth with local prevention programming and information on underage drinking and other drug use. Your answers will also help BOWDAAC identify ways we can support Bethany, Orange, and Woodbridge parents.
This survey is completely anonymous and does NOT ask for information which could identify you.

* 1. Your gender

* 2. Your age:

* 3. Your race:

* 4. Your ethnicity:

* 5. Town you reside in:

* 6. Do you have a child of school age (grade 12 or below) who resides in Bethany, Orange, or Woodbridge?

* 7. How many children do you have that are in middle school and/or high school?

* 8. How familiar are you with the CT Social Host Law?
Social hosting is providing and/or serving alcohol to a person who is under the age of 21. In Connecticut, it is illegal to host a party where alcohol is consumed by minors. Anyone under 21 is prohibited from possessing alcohol on public OR private property.

* 9. Do you think teenagers risk harming themselves (physically or in other ways) if they...

  Yes No
Drink 5 or more alcoholic beverages, once or twice a week?
Use marijuana 1 to 2 times a week?
Use prescription drugs (not their own prescription)?
Smoke cigarettes 1 to 2 times per week?
Smoke electronic cigarettes (e-cigs)?
Please answer the remaining survey questions with respect to your oldest school age child:

* 10. Do you think teenagers should be allowed to...

  Yes No
Drink alcohol (more than a few sips)?
Use tobacco or cigarettes?
Smoke marijuana?
Use prescription drugs (not prescribed to them)?
Smoke electronic cigarettes (e-cigs)?

* 11. How easy or hard is it for students in your child’s grade to get…

  Easy Hard
Tobacco / Cigarettes
Prescription Drugs (not prescribed to them)
A drug like cocaine or heroin
Drug paraphernalia (pipes, bongs, syringes)
Electronic cigarettes (e-cigs)

* 12. Where do you think Bethany, Orange or Woodbridge youth who drink get their alcoholic beverages?

  Never Sometimes (at least once a month) Often (more than once a month)
Home, with parental permission
Home, without parental permission
From a friend’s home
At a party or gathering with only youth present
An older sibling buys it for them
A friend buys it for them
From a store in Bethany, Orange or Woodbridge
From a store outside of Bethany, Orange or Woodbridge
Using a fake ID
Other (fill in below)

* 13. Please provide your opinion about the following statements:

  Yes No
I am concerned about alcohol and drug use by youth in this community.
Drinking alcohol is a part of growing up.
Smoking marijuana is a part of growing up.

* 14. My family has clear rules that discourage my child from…

  Yes No
drinking alcohol.
smoking cigarettes.
using marijuana.
using other illicit drugs.
using prescription drugs (not prescribed to him/her)

* 15. Please provide your opinion about the following statements…

  Yes No
When my child goes out I know where they are and who they are with.
If my child had an important concern about drugs, alcohol, or some other serious issue, they would talk to me about it.
I talk to my child about the harmful effects of using tobacco, alcohol and drugs.
I take steps to ensure that minors don’t have access to any drugs or alcohol in my home.
In my own choices about using drugs and alcohol, I have considered the behavior I am modeling for my child.
I know a lot about the effects of alcohol on a teenager’s physical and mental development.
I know a lot about the effects of marijuana on a teenager’s physical and mental development.
I think teenagers should be allowed to drink, so they learn how to drink responsibly.

* 16. In the past 30 days, I think my child:

  Yes No
Drank an alcohol beverage.
Used marijuana.
Used an illicit drug like cocaine or heroin.
Used a prescription drug not prescribed to him/her.
Smoked at least one cigarette.
Used an electronic cigarette (e-cig).

* 17. Does anyone living in your home (over the age of 21) do the following:

  Yes No
Drink alcohol in your home?
Keep alcohol in your home?
Smoke cigarettes in your home?
Smoke marijuana in your home?
Abuse prescription drugs in your home?

* 18. Are the following substances harmful to your child’s health?

  Yes No
Prescription Drugs (not prescribed to them)
Electronic Cigarettes (e-cigs)

* 19. Do you feel confident and knowledgeable about talking with your child about the harmful effects of:

  Yes No
Prescription drugs
Electronic cigarettes (e-cigs)