Arizona Youth Risk Behavior Survey Template Page 7
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1442.
Have you ever used chewing
46.
Have you ever used a waterpipe
tobacco, snuff, or dip, such as
(also called a hookah, shisha, or
Redman, Levi Garrett, Beechnut,
narghile) to smoke tobacco, even one
Skoal, Skoal Bandits, or
or two puffs?
Copenhagen?
A.
Yes
A.
Yes
B.
No
B.
No
47.
During the past 30 days, on how
many days did you use a waterpipe
43.
During the past 30 days, on how
many days did you use chewing
(also called a hookah, shisha, or
tobacco, snuff, or dip, such as
narghile) to smoke tobacco?
Redman, Levi Garrett, Beechnut,
A.
0 days
Skoal, Skoal Bandits, or
B.
1 or 2 days
Copenhagen?
C.
3 to 5 days
A.
0 days
D.
6 to 9 days
B.
1 or 2 days
E.
10 to 19 days
C.
3 to 5 days
F.
20 to 29 days
D.
6 to 9 days
G.
All 30 days
E.
10 to 19 days
F.
20 to 29 days
48.
During the past 7 days, on how many
G.
All 30 days
days were you in the same room with
someone who was smoking
44.
During the past 30 days, on how
cigarettes?
many days did you use chewing
A.
0 days
tobacco, snuff, or dip on school
B.
1 day
property?
C.
2 days
A.
0 days
D.
3 days
B.
1 or 2 days
E.
4 days
C.
3 to 5 days
F.
5 days
D.
6 to 9 days
G.
6 days
E.
10 to 19 days
H.
All 7 days
F.
20 to 29 days
G.
All 30 days
49.
Which of these best describes the
rules about smoking cigarettes inside
45.
During the past 30 days, on how
the home where you live?
many days did you smoke cigars,
A.
Never allowed inside my
cigarillos, or little cigars?
home
A.
0 days
B.
Allowed only at some times
B.
1 or 2 days
or in some places inside my
C.
3 to 5 days
home
D.
6 to 9 days
C.
Always allowed inside my
E.
10 to 19 days
home
F.
20 to 29 days
G.
All 30 days
-7-
2013 Arizona YRBS
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