Hello NNADAP and First Nations Community Addiction Workers

The Youth Solvent Addiction Committee (YSAC) is conducting a short community survey to determine the extent of sniffing that is still taking place in communities across Canada. YSAC is a network of residential treatment centres across Canada for youth (and young adult) who abuse solvent/inhalants. We appreciate you taking the time to tell us a little about the current solvent abuse situation in your community. The results will be used for program planning, to improve prevention efforts as well as to target information about the centres and the referral procedures. The survey is voluntary and results will be grouped by poprovince to ensure your idividual community anonimity.

If you choose to complete it, we will send you a community based solvent abuse prevention manual at your request. If you have questions about the survey, please contact Debra at ysac@shaw.ca or 306-382-0989 or email ysacsolventsurvey@gmail.com

* 1. Survey Completed By:

* 2. Demographics

* 3. Province or Territory

* 4. Which community do you primarily work in?

* 5. What languages are spoken in your community?

* 6. What is your primary role?

* 7. What is the population of your community

* 8. Would you say sniffing is a problem in your community?

* 9. Thinking of the last 10-12 years, would you say:

* 10. How many youth would you estimate are presently sniffing in your community?

* 11. How many are male

* 12. How many are female

* 13. Please indicate below, the products that are being used.

* 14. Of the products above, what is the most commonly abused product in your area?

* 15. (If applicable only)Please indicate the things you feel contribute to the amount of people in your community that are sniffing?

* 16. Does your community do structured solvent abuse prevention ( either at school or health program)

* 17. If No, why not?

* 18. Please indicate the supports your comunity has that contributes to the fact you have no sniffing, or reduced sniffing.

* 19. Do you have a standard solvent/inhalant abuse prevention project in your addictions or school program?

* 20. As a Thank you for completing this survey, we would like to send you a community solvent abuse prevention manual, if you feel it would be useful to your community. If you would like one, please check YES below, and ensure your correct mailing address is completed at the beginning of the survey.

* 21. Would you be interested in seeing a " National Inhalants Awareness week campaign happen for your community? Something that is coordinated nationally and involves tools your community can use in inhalant prevention?

* 22. Do you wish to add anything about solvent/inhalant abuse, prevention or your community?