Collected under the authority of the Statistics Act, Revised Statutes of Canada, 1985, Chapter S19.
Language of interview
English. . . 1
Statistics Canada will keep your answers PRIVATE. No one from your home or your school will see what you write.
To all Students:
Thousands of students across Canada, just like you, have been selected to take part in this survey.
This important survey will help Health Canada to prepare information related to youth smoking.
There are NO RIGHT or WRONG ANSWERS. This is NOT a test. DO NOT WRITE YOUR NAME ON THE QUESTIONNAIRE.
All your answers will be kept confidential by Statistics Canada. No one, not even your parents or teachers, will ever know what you answered. So please, be honest and accurate when you answer the questions.
While your participation is voluntary, your help today is very important to us.
Thank You!
I am __ years old
1)
girl?
2)
boy?
3)
English
4)
French
5)
English and French
6)
Other (specify)
1)
No
2)
Yes, North American Indian (e.g. Cree, Micmac)
3)
Yes, Métis
4)
Yes, Inuit (Eskimo)
|
|
Never |
Less than |
1 to 3 |
4 or more |
a) |
played sports or done physical activities WITHOUT a coach or an instructor (e.g., biking, skateboarding, etc.)? |
01 |
02 |
03 |
04 |
b) |
played sports WITH a coach or instructor, other than in gym class (swimming lessons, baseball, hockey, etc.)? |
05 |
06 |
07 |
08 |
c) |
taken part in dance, gymnastics, karate or other groups or lessons, other than in gym class? |
09 |
10 |
11 |
12 |
d) |
taken part in art, drama or music groups, clubs or lessons outside of class? |
13 |
14 |
15 |
16 |
e) |
taken part in clubs or groups such as Guides or Scouts, 4-H club, community, church or other religious groups? |
17 |
18 |
19 |
20 |
f) |
done a hobby or craft (drawing, model building, etc.)? |
21 |
22 |
23 |
24 |
g) |
played computer or video games? |
25 |
26 |
27 |
28 |
h) |
done odd jobs (a paper route, babysitting, etc.)? |
29 |
30 |
31 |
32 |
1)
I don't watch TV or videos
2)
Less than one hour a day
3)
1 to 2 hours a day
4)
3 to 4 hours a day
5)
5 to 6 hours a day
6)
7 or more hours a day
1)
Every day
2)
A few times a week
3)
Once a week
4)
A few times a month
5)
Less than once a month
6)
Almost never
1)
Less than I weigh now
2)
Same as I weigh now
3)
More than I weigh now
4)
I don't know
|
|
False |
Mostly |
Some- |
Some- |
Mostly |
True |
a) |
In general, I like the way I am. |
01 |
02 |
03 |
04 |
05 |
06 |
b) |
Overall, I have a lot to be proud of. |
07 |
08 |
09 |
10 |
11 |
12 |
c) |
A lot of things about me are good. |
13 |
14 |
15 |
16 |
17 |
18 |
d) |
When I do something, I do it well. |
19 |
20 |
21 |
22 |
23 |
24 |
e) |
I like the way I look. |
25 |
26 |
27 |
28 |
29 |
30 |
1)
I already smoke
2)
Yes
3)
No
4)
I don't know
1)
I already smoke
2)
Difficult
3)
Easy
4)
I don't know
5)
Yes
6)
No
95 I have never smoked a whole cigarette
OR
I was __ years old
1)
Yes
2)
No
3)
I don't know
4)
Yes
5)
No
6)
I don't know
95)
I have never done this OR I was __ years old
97)
I don't know
1)
None
2)
1 - 5 days
3)
6 - 10 days
4)
11 - 20 days
5)
21 - 29 days
6)
30 days (everyday)
1)
I didn't smoke in the last 30 days
2)
5 or less cigarettes
3)
6 - 10 cigarettes
4)
11 - 15 cigarettes
5)
16 - 20 cigarettes
6)
21 - 25 cigarettes
7)
More than 25 cigarettes
8) I did not smoke over the last 7 days OR How many cigarettes did you smoke on...
(Find yesterday's day on the wheel and follow the arrows for the past 7 days.)

1)
I don't smoke
2)
Yes
3)
No
01) I don't smoke
02)
I don't have a usual brand
03)
My friends smoke the same brand
04)
My parents smoke the same brand
05)
I like the packaging
06)
This brand costs less than other brands
07)
I like the image of the brand
08)
I like the taste
09)
Those are the only ones I can get
10)
They have less tar
11)
For the nicotine buzz
12)
Other reason (specify) _____________
1) I don't smoke
2)
Yes
3)
No
01) I don't smoke
02)
I buy them from a vending machine
03)
I buy them at a small grocery/corner store
04)
I buy them at another kind of store (excluding vending machine)
05)
I buy them from a friend or someone else
06)
I buy them on the internet
07)
My brother or sister gives them to me
08)
My mother or father gives them to me
09)
A friend or someone else gives them to me
10)
I take them from my mother/father/sister/brother
1) I don't smoke
2)
I do not buy cigarettes from stores
3)
I try to look older
4)
I carry fake ID
5)
I make sure I know the clerk
6)
I don't do anything special
7)
When I buy cigarettes from a store, I do something else
(specify)
1) I have never bought cigarettes in a store
2)
Yes
3)
No
4) I have never bought cigarettes in a store
5)
Yes
6)
No
1) I have never bought cigarettes in a store
2)
Yes
3)
No
4)
Yes
5)
No
1) I don't smoke
2) Yes
31b. Where do you buy them? (Mark all that apply)
4)
At a small grocery/corner store
5)
In another kind of store
6)
I buy them from a friend or someone else
3)
No
1)
I have never smoked or have only smoked a few times
2)
Yes
3)
No
94) I have never smoked or have only smoked a few times
OR
95) I have never tried to quit
OR
___ Number of times I have tried to quit smoking
OR
97) I don't know
94) I have never smoked or have only smoked a few times
OR
95) I have never tried to quit
OR
I was ___ years old
1)
In the last 6 months, I have not smoked or have only smoked a few times
2)
Yes
3)
No
01)
I have never smoked or have only smoked a few times
02)
I have never tried to quit
03)
1 day or less
04)
2 - 7 days
05)
8 - 31 days
06)
1 - 3 months
07)
4 - 6 months
08)
7 - 12 months
09)
More than 1 year
10)
I don't know
1) Yes
2) No
37b. Did he ever smoke?
5)
Yes
6)
No
7)
I don't know
3) I don't know
4) I don't live with a father or anyone who is like a father
1)
I don't smoke
2)
He approves
3)
He doesn't care
4)
He doesn't like it
5)
He doesn't know that I smoke
6)
I don't live with a father or anyone who is like a father
1) Yes
2) No
39b. Did she ever smoke?
5)
Yes
6)
No
7)
I don't know
3) I don't know
4) I don't live with a mother or anyone who is like a mother
1) I don't smoke
2)
She approves
3)
She doesn't care
4)
She doesn't like it
5)
She doesn't know that I smoke
6)
I don't live with a mother or anyone who is like a mother
___ Write in number (If none, enter 00)
1) I don't smoke
2)
Yes
3)
No
___ Write in number (If none, enter 00)
___ Write in number (If none, enter 00)
1)
not at all?
2)
less than now?
3)
the same as now?
4)
more than now?
5)
I don't know
|
|
Yes |
No |
I don't know |
a) |
Do people have to smoke for many years before it will hurt their health? |
01 |
02 |
03 |
b) |
Is there any danger to your health from an occasional cigarette? |
04 |
05 |
06 |
c) |
Can smoking help people when they are bored? |
07 |
08 |
09 |
d) |
Does smoking help people relax? |
10 |
11 |
12 |
e) |
Does quitting smoking reduce health |
13 |
14 |
15 |
f) |
Does smoking help people stay slim? |
16 |
17 |
18 |
g) |
Can people become addicted to tobacco? |
19 |
20 |
21 |
h) |
Can tobacco smoke be harmful to the health of non-smokers? |
22 |
23 |
24 |
i) |
Is it nicer to date people who don't smoke? |
25 |
26 |
27 |
j) |
Can smokers quit anytime they want? |
28 |
29 |
30 |
k) |
Do you think smoking is cool? |
31 |
32 |
33 |
1)
Their friends smoke
2)
Their mother or father smokes
3)
Their brother or sister smokes
4)
The popular kids smoke
5)
It's relaxing
6)
Curiosity - just to try it
7)
Curiosity - just to try it
8)
To lose weight or stay slim
9)
For something to do
10)
It's cool
11)
Other (specify) _______________
___ Years old
OR
97) I don't know
1) Yes
50b. In your own words, write or describe the ones you remember. (Please print clearly)
2) No
1)
Never
2)
Less than once a week
3)
About once a week
4)
Once every 2 or 3 days
5)
About once a day
6)
A few times a day
7)
More than a few times a day
1)
agree a lot?
2)
agree a little?
3)
neither agree nor disagree?
4)
disagree a little?
5)
disagree a lot?
1)
Yes
2)
No
3)
I don't know
4)
I have not seen them
1)
better than average?
2)
average?
3)
below average?
4)
I don't think there are any rules
5)
On school property smoking is allowed only in some areas
6)
Smoking is not allowed anywhere on school property
7)
I don't know
1)
I don't think there is a rule
2)
Yes
3)
No
4)
I don't know
1) I don't smoke
2)
I don't think there is a rule
3)
Because of that rule, I don't smoke at school
4)
Because of that rule, I smoke less at school
5)
It does not make any difference; I smoke at school as much as I want
6)
It does not make any difference; I wouldn't smoke at school anyway
7)
Other (specify) ___________________
1)
Yes
2)
No
3)
I don't know
$ ___ .00 (Write in amount or 0 if you get no money)
97) I don't know
1)
Yes
2)
No
3)
Yes
4)
No
1) I don't smoke
2)
Yes
3)
No
4)
Yes
5)
No
1)
Yes
2)
No
|
|
Agree |
Disagree |
I don't know |
a) |
Cigarette smoking causes more deaths each year than alcohol. |
01 |
02 |
03 |
b) |
Cigarette smoking causes more deaths each year than illegal drugs. |
04 |
05 |
06 |
c) |
Cigarette smoking causes more deaths each year than car accidents. |
07 |
08 |
09 |
d) |
Cigarette smoking causes more deaths each year than AIDS. |
10 |
11 |
12 |
e) |
Cigarette smoking causes more deaths each year than suicides. |
13 |
14 |
15 |
f) |
Cigarette smoking causes more deaths each year than murders. |
16 |
17 |
18 |
1)
1,000
2)
5,000
3)
15,000
4)
25,000
5)
45,000
6)
75,000
7)
100,000
8)
More than 100,000
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