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* 1. Age

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* 2. Gender

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* 3. Who do you live with most of the time? (Pick only one)

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* 4. Which of the following best describes you? (Pick all that apply)

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* 5. What grade are you in?

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* 6. What grades do you generally get in school? (Pick only one)

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* 7. About how many days were you absent from school last year?

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* 8. Cigarette smoking can cause your skin to wrinkle.

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* 9. Cigarette smoking can cause your teeth to turn yellow or brown.

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* 10. Cigarette smoking causes your heart to beat faster.

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* 11. Smoking cigarettes can cause mouth cancer.

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* 12. People who smoke cigarettes can usually stop anytime they want.

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* 13. Most teenagers smoke cigarettes. 

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* 14. Most adults smoke cigarettes.

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* 15. It's always best to make decisions quickly.

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* 16. You should always let other people influence your decisions.

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* 17. Advertisements are always true.

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* 18. Stress can cause you to get sick.

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* 19. When you feel stressed, there is nothing you can do to stop it.

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* 20. Even if someone doesn't say anything we can tell how they are feeling by the way they move their body.

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* 21. A good way to refuse to do something is to be assertive.

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* 22. Beginning your sentences with the word "I" is a good way to be assertive.

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* 23. Peer pressure means that an adult tries to get you to do something you do not want to do.

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* 24. There is nothing you can do about peer pressure except go along with it.

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* 25. When we feel bad about ourselves, it affects how well we do in school, sports, or other activities.

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* 26. Kids who smoke cigarettes have more fun than non-smokers.

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* 27. Kids who smoke cigarettes have more friends than non-smokers.

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* 28. Kids who smoke cigarettes look more grown-up than non-smokers.

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* 29. Kids who drink alcohol (beer, wine, or liquor) have more fun than non-drinkers.

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* 30. Kids who drink alcohol (beer, wine, or liquor) have more friends than non-drinkers.

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* 31. Kids who drink alcohol (beer, wine, liquor) look more grown-up than non-drinkers.

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* 32. Since a lot of people smoke cigarettes, it can't be that bad for you.

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* 33. Since a lot of people drink alcohol, it can't be that bad for you.

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* 34. When you need to make a decision, how often do you think about your choices and what will happen?

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* 35. When you see or hear an ad on TV or the radio, how often do you remember that ads might not be telling the truth?

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* 36. When you feel nervous or stressed out, how often do you take deep breaths to relax?

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* 37. When you feel nervous or stressed out, how often do you imagine something in your head to relax?

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* 38. When you want to communicate with someone better, how often do you try to say things that are clear and easy to understand?

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* 39. How often do you ask questions when you don't understand something?

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* 40. How likely would you be to tell someone to move if they cut ahead of you in line?

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* 41. How likely would you be to say hello to someone you don't know well?

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