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2022 | 2023 CBHC Tobacco/Nicotine Community Health Survey

  • CBHC is interested in your opinions and experiences about tobacco/nicotine use in the Black/African American Community.
  • There are no right or wrong answers. If there is any question you feel you can not answer please skip it.
  • The survey is anonymous, and ALL data captured is kept strictly confidential. 
1.What Is your race and/or ethnicity? 
2.What is your age group?
3.What's your gender?
4.What county do you live in?
5.Do you or your family speak another language at home other than English?
6.Is tobacco/nicotine use a problem in the Black/African American community? 
7.Are you a current menthol cigarette smoker or have you smoked menthol cigarettes within the past 12 months?
8.Are you a former smoker?
9.If yes, how long ago did you quit smoking?
10.Do you use other tobacco or flavored tobacco products (such as smokeless tobacco, vaping, e-cigarettes, cigars, cigarillos, hookah)?
11.If yes, what types?
12.Do you want to quit smoking/ using tobacco -nicotine products?
13.If you decide to quit smoking/ using tobacco-nicotine products, what method or methods do you think you'll try?
14.Have you ever heard of the Colorado QuitLine?
15.Have you ever called the Colorado QuitLine?
16.If yes, did you find the Colorado QuitLine helpful?
17.What is the number one tobacco flavor that Black/African American's use?
18.The following questions pertain to vaping and e-cigarette use.
Strongly disagree 
Disagree 
Neutral 
Agree
Strongly Agree
N/A
Are flavored tobacco products addicting?
Are vapes/e-cigarettes addicting?
Do vapes/e-cigarettes contain dangerous chemicals?
Do you see vaping/e-cigarettes as a way to achieve long term smoking cessation?
Do you know what resources are available to get help with a tobacco/nicotine addiction?
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