Student Electronic Cigarette Survey


A red asterisk (*) indicates required questions.

  1. Are you a male or female?*
    Male
    Female


  1. Do you know what a juul, e-cigarette, suorin drop, or vape is?*
    Yes
    No


  1. If so, have you or anyone you know under the age of 18 tried a juul, e-cigarette, suorin drop, or vape?*
    Yes
    No


  1. If so, how often?
     
      1 2 3  
    Only tried once  All the time


  1. Are you aware of the risks of electronically smoking tobacco?*
    Yes
    No


  1. Do your parents or anyone in your household electronically smoke tobacco?
    *
    Yes
    No


  1. Do you think that people under the age of 18 should be electronically smoking tobacco?
    *
    Yes
    No


  1. Out of the list below, what are your top 3 favorite flavors? (Menthol, Mango, Orange, Cinnamon, Watermelon, Mint, Coconut, Peach, Cucumber, Coffee, Tobacco, Strawberries & Cream, Bourbon)*





Mrs. Coover
Council Grove High School