Form A - Healthy Youth Survey - 2012 Page 9
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16B. Got arrested?
70. How wrong do YOU think it is for someone your
a. Never have
age to:
b. 10 or younger
A. Drink beer, wine, or hard liquor (for example
c. 11
vodka, whiskey, or gin) regularly?
d. 12
a. Very wrong
e. 13
b. Wrong
f. 14
c. A little bit wrong
g. 15
d. Not wrong at all
h. 16
B. Smoke cigarettes?
i. 17 or older
a. Very wrong
C. Carried a handgun?
b. Wrong
a. Never have
c. A little bit wrong
b. 10 or younger
d. Not wrong at all
c. 11
C. Smoke marijuana?
d. 12
a. Very wrong
e. 13
b. Wrong
f. 14
c. A little bit wrong
g. 15
d. Not wrong at all
h. 16
i. 17 or older
D. Use LSD, cocaine, amphetamines, or another
illegal drug?
D. Attacked someone with the idea of seriously
a. Very wrong
hurting them?
b. Wrong
a. Never have
c. A little bit wrong
b. 10 or younger
d. Not wrong at all
c. 11
d. 12
71. During the past 30 days, how many times did
e. 13
you ride in a car or other vehicle driven by
f. 14
someone who had been drinking alcohol?
g. 15
a. 0 times
h. 16
b. 1 time
i. 17 or older
c. 2 – 3 times
d. 4 – 5 times
67. During the past 12 months, have you been a
e. 6 or more times
member of a gang?
a. No
72. During the past 30 days, how many times did
b. Yes
you drive a car or other vehicle when you had
been drinking alcohol?
68. During the past 30 days, on how many days did
a. 0 times
you carry a weapon such as a gun, knife, or club
b. 1 time
on school property?
c. 2 – 3 times
a. 0 days
d. 4 – 5 times
b. 1 – 5 days
e. 6 or more times
c. 6 or more days
73. In the past 12 months, how often have you
The next questions ask for your opinions.
gambled (bet) for money or possessions?
a. Never in the past year
b. Once or twice in the past year
69. Think about the students in your school. If you
c. A few times in the past year
had to guess, how wrong do most students in
d. Once or twice a month
your grade think it is to drink alcohol regularly?
e. At least once a week
a. Very wrong
b. Wrong
74. Has YOUR gambling ever caused you problems at
c. A little bit wrong
home, school or with your friends?
d. Not wrong at all
a. I have not gambled
b. Yes
c. No
A
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