ADULT INTERVIEW GUIDE ON SUBSTANCE USE
1. Where do you live?
______Name of city/town
______Name of county
2. If you are a parent, what is your child or children’s age(s)?
______0-5 ______6-10 ______11-14
______15-17 ______18-20 ______21+
Alcohol Use
3a. Do you think alcohol use in ______County is a problem?
______Yes ______No
b. Why do you give that answer?
4a.Do you think drinking and driving is a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
5a. Do you think underage drinking is a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
6a. Do you think binge drinking among youth is a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
7a. If I saw youth in my community using alcohol, I would consider it a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
8a. How many parents or adults that you know permit youths under the age of 21 to
consume alcoholin their homes? ______
b. What are your thoughts about that?
9. What, if any, other alcohol related issues have you observed?
Tobacco Use
10a.Do you think tobacco use in ______County is a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
11a.Do you think cigarette smoking among minorsis a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
12a. If I saw youth in my community smoking cigarettes, I would consider it a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
13a. How many parents or adults that you know of, permit youths under the age of 18 to
use tobacco products in their homes? ______
b. What are your thoughts about that?
14a.Do you think smokeless tobacco use in general isa…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
15a.Do you think smokeless tobacco use among minors isa…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
16.What, if any, other tobacco related issues have you observed?
Marijuana and Other Illicit Drugs
17a. Do you think marijuana use in ______Countyis a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
18a. Do you think marijuana use among youth is a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
19a. How many parents or adults that you know permit youth to consume marijuana in their
homes? ______
b. What are your thoughts about that?
20a. Do you think use of other illicit drugs such as cocaine, crack, heroin and methamphetamine
in general is a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
21a. Do you think use of other illicit drugs such as cocaine, crack, heroin and methamphetamine
among youth is a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
22. What, if any, other marijuana or other illicit drug related issues have you observed?
Prescription and Non-prescription Drug Use
23a. Do you think illegal prescription drug use in ______County
is a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
24a. Do you think illegal prescription drug use among youth is a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
25. Please describe any specific illegal prescription drug use related issues that you feel
exist in this community.
26a. Do you think illegal non-prescription drug use, such as the use of Sudafed with the
intention of getting “high” or otherwise altering moodis a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
27a. Do you think illegal non-prescription drug use, such as the use of Sudafed with the
intention of getting “high” or otherwise altering mood, among youth is a…
______Serious problem ______Minor problem
______Somewhat serious ______Not a problem
b. Why do you give that answer?
28. Please describe any specific illegal non-prescription drug use related issues that you
feelexist in this community.
29a.What are the two most significant drug concerns for this community?
1)______
2)______
b. Why do you give that answer?
30. Other comments?