What is your current age?

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* 1. What is your current age?

What is your sex or gender?

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* 2. What is your sex or gender?

Your Ethnicity

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* 3. Your Ethnicity

Your Race

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* 4. Your Race

In what county do you currently live?

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* 5. In what county do you currently live?

Your Zip Code

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* 6. Your Zip Code

Why do you think youth drink alcohol. Pick the number one reason.

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* 7. Why do you think youth drink alcohol. Pick the number one reason.

Why do you think youth use marijuana?  Pick the number one reason.

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* 8. Why do you think youth use marijuana?  Pick the number one reason.

Why you think youth use other drugs? Pick the number one reason.

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* 9. Why you think youth use other drugs? Pick the number one reason.

Why you think youth use tobacco (chew/smoke). Pick the number one reason.

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* 10. Why you think youth use tobacco (chew/smoke). Pick the number one reason.

Where do you think youth get alcohol most often?  Pick one.

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* 11. Where do you think youth get alcohol most often?  Pick one.

What do you think is the number one way youth get marijuana most often?  Pick one answer.

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* 12. What do you think is the number one way youth get marijuana most often?  Pick one answer.

What do you think is the number one way youth get other drugs most often? Pick one.

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* 13. What do you think is the number one way youth get other drugs most often? Pick one.

What is the number one way you think youth get tobacco products most often?

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* 14. What is the number one way you think youth get tobacco products most often?

Would you allow kids under the age of 21 to have a party at your house where alcohol is consumed?

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* 15. Would you allow kids under the age of 21 to have a party at your house where alcohol is consumed?

How much do you think a parent's use of alcohol, tobacco, marijuana or other drugs negatively influences their child/children to use alcohol, tobacco, marijuana or other drugs?

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* 16. How much do you think a parent's use of alcohol, tobacco, marijuana or other drugs negatively influences their child/children to use alcohol, tobacco, marijuana or other drugs?

I think adults should do the following to reduce youth's alcohol and other drug use.  Check all that apply

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* 17. I think adults should do the following to reduce youth's alcohol and other drug use.  Check all that apply

Do you know it is illegal to purchase or provide alcohol to anyone under 21 years of age?

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* 18. Do you know it is illegal to purchase or provide alcohol to anyone under 21 years of age?

Do you think other adults in your community know it is illegal to purchase or provide alcohol to persons under the age of 21 years of age?

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* 19. Do you think other adults in your community know it is illegal to purchase or provide alcohol to persons under the age of 21 years of age?

Would you allow kids to have a party at your house where marijuana is used?

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* 20. Would you allow kids to have a party at your house where marijuana is used?

Have you gambled for money or anything of value, purchased lottery tickets, casino games, etc. at any time in the last year?

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* 21. Have you gambled for money or anything of value, purchased lottery tickets, casino games, etc. at any time in the last year?

If you answered Yes to the previous question, what is your preferred type of gambling activity?  Please check all that apply.  If you answered No to previous question check I do not gamble.

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* 22. If you answered Yes to the previous question, what is your preferred type of gambling activity?  Please check all that apply.  If you answered No to previous question check I do not gamble.

Have you ever had the need to bet more and more money?

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* 23. Have you ever had the need to bet more and more money?

Have you ever lied to people important to you about how much you gamble?

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* 24. Have you ever lied to people important to you about how much you gamble?

Have you experienced any financial problems as a result of spending money gambling?

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* 25. Have you experienced any financial problems as a result of spending money gambling?

Have you ever borrowed money, stolen money or used credit to bet/gamble?

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* 26. Have you ever borrowed money, stolen money or used credit to bet/gamble?

Do you know someone you think may have a gambling problem?

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* 27. Do you know someone you think may have a gambling problem?

If you have been personally affected by the gambling behaviors of someone else, please check all the apply.  If you have not been personally affected please check the I have not been personally affected by the gambling behaviors of someone else.

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* 28. If you have been personally affected by the gambling behaviors of someone else, please check all the apply.  If you have not been personally affected please check the I have not been personally affected by the gambling behaviors of someone else.

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