Comox Valley Schools Vaping Survey

*What grade are you in?

*What school do you attend?

What gender do you identify with?

What extracurricular activities are you involved in?

Check all that apply

Do your parents or other family members vape?

Have you ever tried vaping?

Do you currently vape?

How long have you vaped for?

Do your parents know you vape?

Do you own a vape?

How did/do you acquire your vape/vaping products?

Check all that apply

How many times do you hit your vape per day?

Why do you vape?

Check all that apply

Does your vape contain nicotine?

Which chemicals do you know are inhaled when vaping?

Check all that apply

Are you aware that vaping is harmful to your health?

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.

Have you used any other substances (not including vaping) in the last 30 days?

Check all that apply

Are you wanting to quit vaping?

Are you interested in learning more about vaping, how it impacts your health, and how to get help quitting?


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