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Teacher Survey: Douglas County Youth and Tobacco Use (copy)

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Douglas County Oregon Youth Vaping and Tobacco Use - Parent and Guardian Survey

This survey is for Parents and Guardians who have students in grades 6th thru 12th attending schools in Douglas County Oregon only please. This is the only information we are seeking for this survey and will not be able to use data from other counties, states, or countries.
A coalition of community health partners in Douglas County (Douglas Public Health Network, Adapt Integrated Health Care, Thrive Umpqua, Aviva Health, Umpqua Health, CHI Mercy, and Cow Creek) is concerned about the increased use of e-cigarettes, vaping, and Juuls among our youth. WE NEED YOUR HELP to better understand this growing issue. Thank you for taking a few minutes to let us know your views regarding this subject.
The survey should take approximately 5-10 minutes to complete. At the end of the survey, you will see a link to opt-in for a $5 gift card to a local business in Douglas County sent by mail via USPS or picked up at the Thrive Umpqua Office located at 556 SE Jackson Street, Roseburg, OR 97470. Emailing of the gift card in not available. You will also be entered into a drawing for a $50 gift card to Grocery Outlet in the fall in appreciation for your time completing the survey. Any responses to the survey from from anyone who does not have students in grades 6th thru 12th attending schools in Douglas County Oregon will not be sent a gift card.
Your name and contact information will not be associated with your answers on the survey.

School *

At what grade level is your child(ren)? SELECT ALL THAT APPLY *

6th grade

7th grade

8th grade

9th grade

10th grade

11th grade

12th grade

What is your relationship to your (child)ren? *

Mother

Father

Grandparent

Guardian

Other (Please describe in next question)

If you answered other please explain

Do you know what electronic vape products are (i.e. e-cigarettes, vaping, Juuls)? *

Yes

No

Do you use any electronic vape products?

*

Yes

No

How knowledgeable do you feel about electronic vape products?

*

Very well informed

Well informed

Somewhat informed

Not well informed

Not informed at all

How many 6th graders do you think have tried an electronic vape product?

*

0-25%

25-50%

50-75%

75-100%

How many 7th graders do you think have tried an electronic vape product?

*

0-25%

25-50%

50-75%

75-100%

How many 8th graders do you think have tried an electronic vape product?

*

0-25%

25-50%

50-75%

75-100%

Why do you think youth choose to use electronic vape products? SELECT ALL THAT APPLY

*

Curiosity

Boredom

Coping Mechanism

Peer Pressure

A family member uses them

Appealing Flavors

Devices are seen as trendy

Do you know if your child(ren) uses e-cigarettes, vaping, and/or Juuls?

*

Yes, I have seen my child(ren) using an electronic vape product

No, I have not seen my child(ren) using an electronic vape product, but I think my child(ren) has used one

No, I have not seen my child(ren) using an electronic vape product, and I don't think my child(ren) has ever used one

No, I know my child(ren) has not used an electronic vape product.

I don't know if my child(ren) has ever used an electronic vape product.

If you answered Yes to the previous question, how did your child(ren) obtain the device?

Bought it themselves at a store or gas station

Bought it themselves online

Purchased by myself or another parent/caregiver

Purchased by a sibling or other family member

Purchased by a friend

Unsure

Do you think there is harm in using electronic vape products?

*

Yes

No

How concerned would you be if you discovered your child used an electronic vape product?

*

Not at all

Somewhat

Extremely

Do you think electronic vape products are a safer alternative to regular cigarettes?

*

Yes

No

I would feel ________ concerned if I discovered my child had smoked a regular cigarette compared to using an electronic vape product.

*

Much more

More

Equally

Less

Much less

How easy do you think it would be for your child to obtain an electronic vape product?

*

Very easy

Somewhat easy

Somewhat difficult

Very difficult

Do you talk about vaping and other drug prevention with your child(ren)?

*

Yes, all the time

Yes, a few times

Yes, one time

No, we've never talked about drug prevention

What do you think the disciplinary action should be if your child is caught using an electronic vape product on school property? SELECT ALL THAT APPLY

*

Off-campus suspension

On-campus suspension

Parent/guardian called

Education on vape products

No punishment

Would you like to receive more information on electronic vape products? If yes, please respond to this question with your email address.

Is there anything else you would like to share?

Unique Survey Number

*Prior to submitting survey, please copy or write down unique survey number. It must be provided when filling out the gift card registration form to receive gift card.

Thank you for taking the time to complete the survey!

Your information is completely confidential and anonymous. If you have questions, please contact Juli Baker at 541-390-7649 or juli@thriveumpqua.com.

Douglas County Oregon Youth Vaping and Tobacco Use - Parent and Guardian Survey

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