Tobacco-Free Parks Community Survey

This survey is intended for Will County, IL residents and should take less than 5 minutes to complete.

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* 1. What city do you live in?

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* 2. Check the statement that best describes how you feel about whether the following places should be tobacco-free:

(A tobacco-free policy prohibits all tobacco use including smoking and smokeless tobacco.)

  Strongly Disagree Disagree Neutral Agree Strongly Agree
Parks
Playgrounds
Skateboard/bike parks
Hiking/walking trails
Outdoor sports fields
Outdoor sports spectator viewing areas (Ex: Bleachers, etc.)
Beaches
Golf Courses
Outdoor festivals

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* 3. Do you think litter from tobacco products is a problem in any of the places listed above?

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* 4. Have you been bothered by tobacco smoke at any of the places listed above?

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* 5. Do you believe that outdoor tobacco smoke is harmful to your health?

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* 6. What is your age?

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* 7. Are you a...

(Please check all that apply)

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* 8. Additional Comments:

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