Comox Valley Schools Vaping Survey
*
What grade are you in?
5-6
7
8
9-10
11-12
*
What school do you attend?
Airport Elementary
Arden Elementary
Aspen Park Elementary
Brooklyn Elementary
Courtenay Elementary
Cumberland Community School
Denman Island Elementary
Ecole Puntledge Park Elementary
Ecole Robb Road Elementary
Georges P. Vanier Secondary
Glacier View Secondary
Highland Secondary
Hornby Island Elementary
Huband Park Elementary
Lake Trail Middle
Mark R. Isfeld Secondary
Miracle Beach Elementary
Nala'atsi Alternate
Navigate/NIDES
Queneesh Elementary
Royston Elementary
Valley View Elementary
What gender do you identify with?
Male
Female
Other
What extracurricular activities are you involved in?
Check all that apply
Sports
The arts (Dance, Music, etc.)
I do volunteer work
I have a job
None of the above
Do your parents or other family members vape?
Yes
No
I don't know
Have you ever tried vaping?
Yes
No
Do you currently vape?
Yes
No
How long have you vaped for?
Only tried it once or twice
Less than a year
More than a year
I don't vape
Do your parents know you vape?
Yes
No
I don't vape
Do you own a vape?
Yes
No
How did/do you acquire your vape/vaping products?
Check all that apply
Online
Parents
Older sibling
Friends
A boot
From my local retailer
I don't vape
How many times do you hit your vape per day?
1-2
3-4
5-6
More than 7
I don't vape
Why do you vape?
Check all that apply
Because my friends do it
To deal with stress
I don't know why I vape
I enjoy the flavours
For fun
Other
I don't vape
Does your vape contain nicotine?
Yes
No
I don't know
I don't vape
Which chemicals do you know are inhaled when vaping?
Check all that apply
Nicotine
Vegetable glycerine
Lead
Formaldehyde
Flavorants
Are you aware that vaping is harmful to your health?
Yes
No
Would you be willing to participate in a buy back program for your vaping products? For example: Your school exchanged your vape/products for restaurant gift cards or movie tickets.
Yes
No
Maybe
I don't vape
Have you used any other substances (not including vaping) in the last 30 days?
Check all that apply
Cigarettes
Marijuana (Weed)
Alchohol
Other
None of the above
Are you wanting to quit vaping?
Yes
No
I already have quit
I have never vaped
Are you interested in learning more about vaping, how it impacts your health, and how to get help quitting?
Yes
No
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