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Introduction

The Steuben Prevention Coalition is conducting an Adult Perception Survey to learn more about how Steuben County residents view underage drinking, marijuana and drug use.  Please take 10 minutes to answer these 37 questions to complete the following survey.  All of your answers will be kept confidential and will not be shared with any other agency.

The results of this survey will be used to guide the efforts of the Steuben Prevention Coalition and provide data for future funding opportunities.

Thank you for your time.

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* 1. What is your Zip Code?

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* 2. Please choose the location that best describes where you live.

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* 3. What is your age?

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* 4. What is your gender?

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* 5. What is your household income range?

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* 6. What is your marital status?

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* 7. What is your highest level of education?

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* 8. Do you have a child in school (check all that apply)?

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* 9. Which of the following is a problem for young people in your community? (check all that apply)

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* 10. How big of a problem is alcohol use by underage youth in your community?

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* 11. Do you think parents/adults host parties in your community where alcohol is available or provided to young people under the age of 21?

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* 12. How much do you think young people under 21 risk harming themselves if they drink beer, wine or hard liquor?

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* 13. Which of the following best describes your attitude about alcohol use by underage youth (under 21)?

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* 14. Are you familiar with the Social Host Law in Steuben County?

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* 15. How wrong do you feel it would be for youth under 21 to drink beer, wine or liquor regularly?

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* 16. If a young person under 21 in your community wanted to get beer, wine or liquor (for example vodka, whiskey or gin) how easy would it be for them?

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* 17. Where do you think most young people (under 21) in your community get alcohol?

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* 18. Who influences a young person's (under 21) decision to drink? (check all that apply)

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* 19. Which of the following messages would you want to share with youth under 21? (please check one)

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* 20. How much do you think young people under 21 risk harming themselves if they smoke marijuana?

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* 21. If a young person under 21 in your community wanted to get marijuana, how easy would it be for them?

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* 22. Where do you think most young people under 21 get marijuana in your community? (check all that apply)

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* 23. Which of the following best describes your attitude about marijuana use by young people under 21?

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* 24. I would approve of a legal marijuana retail outlet in my community?

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* 25. If there was a New York State Referendum to legalize the recreational use of marijuana, would you support it?  Recreational use - used without medical justification.

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* 26. Do you feel that marijuana is addictive?

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* 27. For the general population (adults age 21 and older), I believe that marijuana use is okay under the following condition:

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* 28. How much do you think young people under 21 risk harming themselves if they use other illegal drugs (example: synthetic marijuana, cocaine, crack, heroin, LSD, bath salts, etc.)?

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* 29. Which of the following best describes your attitude about use of other illegal drugs by young people under 21?

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* 30. How much do you think young people under 21 risk harming themselves if they take prescription drugs that are not prescribed for them (example:  Vicodin, Oxycontin, Adderrall, etc.)?

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* 31. Does your child (under the age of 18) have their own social media account? (Facebook, Instagram, SnapChat, YouTube, etc.)

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* 32. Are you concerned about the amount of time young people under the age of 18 spend in front of screens? (computer, tablet, video games, cell phones, smart phones, TV, etc.)

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* 33. Do you think the use of screens as listed above by young people under the age of 18 contributes to any of the following? (check all that apply)

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* 34. Do you think that the use of social media by young people under the age of 18 contributes to any of the following? (check all that apply)

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* 35. Do you know where to go for help if you are having concerns with a young person's use of alcohol, marijuana or other drugs?

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* 36. Are you interested in joining the Steuben Prevention Coalition or wish to obtain more information about us?

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* 37. If you are interested in joining the Steuben Prevention Coalition or wish to obtain more information about us, please list your name and e-mail address.  All of your information will be kept confidential and will not be share with any other agency.

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