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Vaping and Mental Health
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1.
Are you between the ages of
(Required.)
12-15
16-18
19-21
22-25
26+
None of the above
*
2.
Do you use a vape (Tobacco or e-cigarette)?
(Required.)
Yes
No
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3.
If yes, how often?
(Required.)
1–5 hits/day
6-12 hits/day
12 or more hits/day
Don’t vape
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4.
What is your household demographic?
(Required.)
Low income
Median income
High income
*
5.
What gender do you identify with?
(Required.)
Female
Male
Non-binary
None of the above
6.
Do you have any mental health diagnoses? (Ex.depression, Anxiety, Bipolar, etc.)
*
7.
Do you feel that you struggle with your mental health?
(Required.)
Yes
No
Maybe
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