Anti-Vaping Survey

This is anonymous, so please answer honestly.


A red asterisk (*) indicates required questions.

  1. Are you male or female?*
    Male
    Female


  1. Do you know what a Juul or e-cigarette is?*
    Yes
    No
    Heard of them, but not exactly sure what they are


  1. Have you ever used a Juul or e-cigarette?*
    Yes
    No


  1. If yes, how often do you use them?*
    3-4 times a week
    3-4 times a month
    Once
    Never


  1. Does anyone in your household use Juuls or e-cigarettes?
    Yes
    No


  1. Do you know anyone in Council Grove Junior High that used Juuls or e-cigarettes?
    Yes
    No


  1. If so how many people?
    0
    1-3
    4-6
    7-10
    more


  1. Personally, do you think vaping makes you look cool?
    Yes
    No





Mrs. Coover
Council Grove High School