This free survey is powered by
0%
Exit Survey
 
 
Questionnaire


How does smoking affect teen grades?
 
 
 
Gender?
 
Male
 
Female
 
 
 
Age?
 
13-15
 
16-17
 
18+
 
 
 
Do you smoke?
 
Yes
 
No
 
Occasionally
 
 
 
If you do, Do you skip class or risk being late for class?
 
Yes
 
No
 
 
 
How much do you smoke a week?
 
2 smokes
 
1 pack
 
2 packs
 
3 or more
 
 
 
How much would you spend on smokes?
 
$100-$200
 
$300-$400
 
$500+
 
 
 
How often do you buy smokes?
 
once a week
 
twice a weeks
 
3 times+ a week
 
 
 
Smoking makes your clothes and breathe smell?
 
Yes
 
No
 
 
 
if you were given the chance to quit would you ?
 
Yes
 
No