Community Tobacco Survey Question Title * 1. What is your zip code? Question Title * 2. How often does someone in your family visit a local park? Once per week or more 1-3 times per month A few times per year Never Question Title * 3. Please select, if any, the following places that you feel should be tobacco free: Parks Playgrounds Outdoor sports fields Skateboard/bike parks Hiking/biking trails Beaches Golf courses Swimming pools Outdoor festivals Question Title * 4. Do you think litter from tobacco products is a problem in these places? Yes No Question Title * 5. Have you been bothered by tobacco smoke at any of the above places? Yes No Question Title * 6. Do you think outdoor smoke is harmful? Yes No Question Title * 7. What is your age? Under 10 11-17 18-24 25-39 40-50 51+ Question Title * 8. Please check all the boxes that apply to you. I am a... Sports team/league participant Sports coach, leader of official Golfer Parent Grandparent Non-smoker Smoker Ex-smoker Question Title * 9. Has tobacco smoke at any of the above places affected you, and if so how? Yes No Other (please specify) Question Title * 10. Is there anything else you would like to share? Done