HIGH SCHOOL MODULE
2009 – 2013
TABLE OF CONTENTS
Section 1: Survey Questions and Summary Variables – 2009 to 2013
Demographics
How old are you? / 1
What is your sex? / 1
In what grade are you? / 1
Are you Hispanic or Latino? / 1
What is your race? / 1
How tall are you without your shoes on? / 1
How much do you weigh without your shoes on? / 2
What language is spoken most often at home? / 2
Which of the following best describes you? (Sexual orientation) / 2
Unintentional Injury
When you rode a bicycle during the past 12 months, how often did you wear a helmet? / 2
How often do you wear a seat belt when riding in a car driven by someone else? / 2
How often do you wear a seat belt when driving a car? / 2, 3
During the past 30 days, how many times did you ride in a car or other vehicle driven by someone who had been drinking alcohol? / 3
During the past 30 days, how many times did you drive a car or other vehicle when you had been drinking alcohol? / 3
During the past 30 days, how many times did you ride in a car or other vehicle driven by someone who had been taking illegal drugs such as marijuana? / 3
During the past 30 days, how many times did you do other activities while driving a car, such as eating, talking on a cell phone, combing your hair, etc.? / 3
Violence
How many times in the past year (12 months) have you taken a gun to school? / 3
During the past 30 days, on how many days did you carry a weapon such as a gun, knife, or club on school property? / 4
During the past 30 days, on how many days did you not go to school because you felt you would be unsafe at school or on your way to or from school? / 4
If you wanted to get a gun, how easy would it be for you to get one? / 4
During the past 12 months, how many times has someone threatened or injured you with a weapon such as a gun, knife, or club? / 4
During the past 12 months, how many times has someone threatened or injured you with a weapon such as a gun, knife, or club on school property? / 4
During the past 12 months, how many times has someone stolen or deliberately damaged your property such as your car, clothing, or books on school property? / 4
During the past 12 months, how many times were you in a physical fight? / 4
During the past 12 months, how many times were you in a physical fight in which you were injured and had to be treated by a doctor or nurse? / 5
During the past 12 months, how many times were you in a physical fight on school property? / 5
During the past 12 months, did your boyfriend or girlfriend ever hit, slap, or physically hurt you on purpose? / 5
Do you agree or disagree with the following statement? "I feel safe at my school." / 5
Have you ever been physically forced to have sexual intercourse when you did not want to? / 5
During the past 12 months, how many times did someone you were dating or going out with physically hurt you on purpose? (Count such things as being hit, slammed into something, or injured with an object or weapon.) / 5
TABLE OF CONTENTS (cont.)
PageViolence (cont.)
Have you ever been forced (physically or otherwise) to have sexual contact? / 5
Has violence in your home, or the threat of violence, ever made you want to leave your home, even just for a short while? / 6
Do you agree or disagree with the following statement: "I have a safe neighborhood."? / 6
How often is the following statement true for you? "I resolve conflicts without anyone getting hurt." / 6
Bullying
During the past 12 months, have you ever been bullied on school property? / 6
During the past 12 months, have you ever been bullied away from school property? / 6
During the past 12 months, have you ever been electronically bullied? (Count being bullied through e-mail, chat rooms, instant messaging, websites, or texting.) / 6
Harassment
Has anyone ever made offensive racial comments or attacked you based on your race or ethnicity at school or on your way to or from school? / 6
Has anyone ever made offensive comments or attacked you because of your perceived sexual orientation at school or on your way to or from school? / 7
Has anyone ever made offensive sexual comments to you at school or on your way to or from school? / 7
Has anyone ever made offensive comments or attacked you at school or on your way to or from school because of how masculine or feminine you are (that is, acting "too much like a girl" if you are a boy, or acting "too much like a boy" if you are a girl)? / 7
What are the chances you would be seen as cool if you defended someone who was being verbally abused at school? / 7
Suicide & Depression
During the past 12 months, did you ever feel so sad or hopeless almost every day for two weeks or more in a row that you stopped doing some usual activities? / 7
During the past 12 months, when you felt sad or hopeless, from whom did you get help? / 7
During the past 12 months, did you ever seriously consider attempting suicide? / 7
During the past 12 months, did you make a plan about how you would attempt suicide? / 7
During the past 12 months, how many times did you actually attempt suicide? / 8
Self-Injury
During the past 12 months, how many times did you do something to purposely hurt yourself without wanting to die, such as cutting or burning yourself on purpose? / 8
Have you ever participated in the Choking Game or assisted another person to do so? / 8
Tobacco
Have you ever tried cigarette smoking, even one or two puffs? / 8
During the past 30 days, on how many days did you smoke cigarettes? / 8
How old were you when you smoked a whole cigarette for the first time? / 8
During the past 30 days, on the days you smoked, how many cigarettes did you smoke per day? / 8
During the past 30 days, how did you usually get your own cigarettes? / 9
During the past 30 days, on how many days did you use chewing tobacco, snuff, or dip, such as Redman, Levi Garrett, Beechnut, Skoal, Skoal Bandits, or Copenhagen? / 9
During the past 30 days, on how many days did you smoke cigars, cigarillos, or little cigars? / 9
During the past 7 days, on how many days were you in the same room with someone who was smoking cigarettes? / 10
TABLE OF CONTENTS (cont.)
PageTobacco (cont.)
During the past 12 months, were you taught in any of your classes about the dangers of tobacco use? / 10
How wrong do your parents feel it would be for you to smoke cigarettes? / 10
How much do you think people risk harming themselves (physically or in other ways) if they smoke one or more packs of cigarettes per day? / 10
If you wanted to get some cigarettes, how easy would it be for you to get some? / 10
During the past 30 days, did anyone ever refuse to sell you cigarettes because of your age? / 10
Have your parents ever told you not to smoke cigarettes? / 10
When you go to a supermarket, grocery store, convenience store or gas station mini-mart, how often do you see tobacco industry advertisements on signs or poster boards? / 11
How much do you think people risk harming themselves (physically or in other ways) if they are exposed to other people's cigarette smoke? / 11
How many times during the past 12 months have you stopped smoking for one day or longer because you were trying to quit smoking? / 11
Do you think you would be able to quit smoking cigarettes if you tried? / 11
Do you think that you will try a cigarette soon? / 11
Do you think you will smoke a cigarette at any time during the next year? / 11
Think of your four best friends. How many in the past year have smoked cigarettes? / 11
What are the chances you would be seen as cool if you smoked cigarettes? / 11
If one of your best friends offered you a cigarette, would you smoke it? / 12
During this school year, did you practice ways to say NO to tobacco in any of your classes (for example, by role-playing)? / 12
During the past 12 months, was the information you received in school helpful in making decisions about tobacco use? / 12
Has a doctor or someone in a doctor's office talked to you about the danger of tobacco use in the past 12 months? / 12
Has a dentist or someone in a dentist's office talked to you about the danger of tobacco use in the past 12 months? / 12
During the past 7 days, on how many days were you in the same car with someone who was smoking cigarettes? / 12
Besides yourself, does anyone who lives in your home smoke cigarettes now? / 12
How wrong do you think it is for someone your age to smoke cigarettes? / 13
Alcohol
During your life, how many days have you had at least one drink of alcohol? / 13
How old were you when you had your first drink of alcohol other than a few sips? / 13
During the past 30 days, on how many days did you have at least one drink of alcohol? / 13
During the past 30 days, on how many days did you have 5 or more drinks of alcohol in a row, that is, within a couple of hours? / 13
During the past 30 days, how did you usually get the alcohol you drank? / 14
During the past 30 days, on how many days did you have at least one drink of alcohol on school property? / 14
If you wanted to get some alcohol, how easy would it be for you to get some? / 14
How wrong do your parents feel it would be for you to drink alcohol regularly? / 14
If you drank some alcohol without your parents' permission, would you be caught by your parents? / 14
If a kid drank some alcohol in your neighborhood, would he or she be caught by the police? / 15
How much do you think people risk harming themselves (physically or in other ways) if they have 1 or 2 drinks of an alcoholic beverage nearly every day? / 15
TABLE OF CONTENTS (cont.)
PageAlcohol (cont.)
How much do you think people risk harming themselves (physically or in other ways) if they have 5 or more drinks of an alcoholic beverage in a row once or twice a week? / 15
What are the chances you would be seen as cool if you began drinking alcoholic beverages regularly, that is, at least once or twice a month? / 15
How wrong would most adults (over 21) in your neighborhood think it is for kids your age to drink alcohol? / 15
How wrong do you think it is for someone your age to drink alcohol regularly? / 15
How do you feel about someone your age having 1 or 2 drinks of an alcoholic beverage nearly every day? / 16
Think back over the last two weeks. How many times have you had five or more alcoholic drinks in a row? / 16
When you are an adult, will you drink alcohol? / 16
Think of your four best friends. How many in the past year have tried alcohol when their parents didn't know about it? / 16
How much do you think people risk harming themselves (physically or in other ways) if they have 3 or 4 drinks of alcohol nearly every day? / 16
How wrong do your friends feel it would be for you to have 1 or 2 drinks of an alcoholic beverage nearly every day? / 16
How wrong do your parents feel it would be for you to have 1 or 2 drinks of an alcoholic beverage nearly every day? / 16
How wrong do you think it is for someone your age to have 5 or more drinks of alcohol once or twice each week? / 16
Marijuana
During your life, how many times have you used marijuana? / 17
How old were you when you tried marijuana for the first time? / 17
During the past 30 days, how many times did you use marijuana? / 17
If you wanted to get some marijuana, how easy would it be for you to get some? / 17
How wrong do your parents feel it would be for you to smoke marijuana? / 17
How much do you think people risk harming themselves (physically or in other ways) if they smoke marijuana regularly? / 17
How much do you think people risk harming themselves (physically or other ways) if they smoke marijuana occasionally? / 17
How much do you think people risk harming themselves (physically or in other ways) if they smoke marijuana once or twice a week? / 17
What are the chances you would be seen as cool if you smoked marijuana? / 18
How wrong would most adults (over 21) in your neighborhood think it is for kids your age to use marijuana? / 18
How wrong do your friends feel it would be for you to smoke marijuana? / 18
If a kid smoked marijuana in your neighborhood, would he or she be caught by the police? / 18
How wrong do you think it is for someone your age to smoke marijuana? / 18
During the past 30 days, how many times did you use marijuana on school property? / 18
Think of your four best friends. How many in the past year have used marijuana? / 18
Other Drugs
During your life, how many times have you sniffed glue, breathed the contents of aerosol spray cans, or inhaled any paints or sprays to get high? / 18
During the past 30 days, how many times did you sniff glue, breathe the contents of aerosol spray cans, or inhale any paints or sprays to get high? / 19
During your life, how many times have you taken a prescription drug (such as OxyContin, Percocet, Vicodin, codeine, Adderall, Ritalin, or Xanax) without a doctor's prescription? / 19
During the past 30 days, how many times did you take a prescription drug (such as OxyContin, Percocet, Vicodin, codeine, Adderall, Ritalin, or Xanax) without a doctor's prescription? / 19
During your life, how many times have you used any form of cocaine, including powder, crack, or freebase? / 19
TABLE OF CONTENTS (cont.)
PageOther Drugs (cont.)
During your life, how many times have you used heroin (also called smack, junk, or China White)? / 19
During your life, how many times have you used stimulants (“amphetamines”, “meth”, “crystal”, “crank”)? / 19
During your life, how many times have you used methamphetamines (also called speed, crystal, crank, or ice)? / 20