Wilmington REALITY Tobacco-Free Parks Community Survey 2015 Tobacco-Free Parks Community Survey This survey is intended for Wilmington, IL residents and should take less than 5 minutes to complete. Question Title * 1. What city do you live in? Aurora Beecher Bolingbrook Braidwood Channahon Coal City Crest Hill Crete Diamond Elwood Frankfort Godley Homer Glen Joliet Lemont Lockport Manhattan Matteson Minooka Mokena Monee Naperville New Lenox Orland Park Park Forest Peotone Plainfield Rockdale Romeoville Shorewood Steger Symerton Tinley Park University Park Wilmington Woodridge Other (please specify) Question Title * 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 Parks Strongly Disagree Parks Disagree Parks Neutral Parks Agree Parks Strongly Agree Playgrounds Playgrounds Strongly Disagree Playgrounds Disagree Playgrounds Neutral Playgrounds Agree Playgrounds Strongly Agree Skateboard/bike parks Skateboard/bike parks Strongly Disagree Skateboard/bike parks Disagree Skateboard/bike parks Neutral Skateboard/bike parks Agree Skateboard/bike parks Strongly Agree Hiking/walking trails Hiking/walking trails Strongly Disagree Hiking/walking trails Disagree Hiking/walking trails Neutral Hiking/walking trails Agree Hiking/walking trails Strongly Agree Outdoor sports fields Outdoor sports fields Strongly Disagree Outdoor sports fields Disagree Outdoor sports fields Neutral Outdoor sports fields Agree Outdoor sports fields Strongly Agree Outdoor sports spectator viewing areas (Ex: Bleachers, etc.) Outdoor sports spectator viewing areas (Ex: Bleachers, etc.) Strongly Disagree Outdoor sports spectator viewing areas (Ex: Bleachers, etc.) Disagree Outdoor sports spectator viewing areas (Ex: Bleachers, etc.) Neutral Outdoor sports spectator viewing areas (Ex: Bleachers, etc.) Agree Outdoor sports spectator viewing areas (Ex: Bleachers, etc.) Strongly Agree Beaches Beaches Strongly Disagree Beaches Disagree Beaches Neutral Beaches Agree Beaches Strongly Agree Golf Courses Golf Courses Strongly Disagree Golf Courses Disagree Golf Courses Neutral Golf Courses Agree Golf Courses Strongly Agree Outdoor festivals Outdoor festivals Strongly Disagree Outdoor festivals Disagree Outdoor festivals Neutral Outdoor festivals Agree Outdoor festivals Strongly Agree Question Title * 3. Do you think litter from tobacco products is a problem in any of the places listed above? Yes No Question Title * 4. Have you been bothered by tobacco smoke at any of the places listed above? Yes No Question Title * 5. Do you believe that outdoor tobacco smoke is harmful to your health? Yes No Question Title * 6. What is your age? Under 18 18-24 25-39 40-50 51+ Question Title * 7. Are you a...(Please check all that apply) Student Parent Grandparent Sports Official, Leader, or Coach Sports Team/ League Participant Smoker Non-Smoker Former Smoker Question Title * 8. Additional Comments: Next