Georgia Student Health Survey II

Instructions

This survey is designed to collect information about a variety of topics including alcohol, tobacco, and other drugs; school violence; school climate; and nutrition. You must answer every question in each section before you can continue. Once you complete a section, you are not allowed to return. The survey is completely anonymous, so please answer all questions honestly. Thank you for your participation.

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Personal Information

Gender:	Female Male
Ethnicity:	Black or African American Hispanic or Latino White or Caucasian Asian or Pacific Islander Other
Grade:	6th 8th

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School Climate

1. I like school.	Always Sometimes Not at all
2. I feel successful at school.	Always Sometimes Not at all
3. I feel my school has high standards for achievement.	Always Sometimes Not at all
4. My school sets clear rules for behavior.	Always Sometimes Not at all
5. I know what to do if there is an emergency at my school.	Always Sometimes Not at all
6. Teachers treat me with respect.	Always Sometimes Not at all
7. The behaviors in my classroom allow the teacher to teach so I can learn.	Always Sometimes Not at all
8. Students are frequently recognized for their good behavior.	Always Sometimes Not at all
9. I know the name of my School Counselor.	Always Sometimes Not at all

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Within the past 30 days I have used…

1. alcohol (wine, wine coolers, beer, liquor)	0 days 1 or 2 days 3 to 5 days 6 to 9 days 10 to 19 days 20 to 29 days every day
2. smoking tobacco (cigarettes, cigars, pipes)	0 days 1 or 2 days 3 to 5 days 6 to 9 days 10 to 19 days 20 to 29 days every day
3. chewing tobacco (dip, snuff, spit tobacco)	0 days 1 or 2 days 3 to 5 days 6 to 9 days 10 to 19 days 20 to 29 days every day
4. marijuana (grass, pot)	0 days 1 or 2 days 3 to 5 days 6 to 9 days 10 to 19 days 20 to 29 days every day
5. cocaine (powder, rock, freebase, crack)	0 days 1 or 2 days 3 to 5 days 6 to 9 days 10 to 19 days 20 to 29 days every day
6. inhalants (sniffing or huffing glue, solvents, gas)	0 days 1 or 2 days 3 to 5 days 6 to 9 days 10 to 19 days 20 to 29 days every day
7. steroids	0 days 1 or 2 days 3 to 5 days 6 to 9 days 10 to 19 days 20 to 29 days every day
8. ecstasy	0 days 1 or 2 days 3 to 5 days 6 to 9 days 10 to 19 days 20 to 29 days every day
9. methamphetamines (meth, ice, crank)	0 days 1 or 2 days 3 to 5 days 6 to 9 days 10 to 19 days 20 to 29 days every day

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It is easy to get.…

1. alcohol (wine, wine coolers, beer, liquor)	Cannot Get Somewhat Easy Very Easy
2. smoking tobacco (cigarettes, cigars, pipes)	Cannot Get Somewhat Easy Very Easy
3. chewing tobacco (dip, snuff, spit tobacco)	Cannot Get Somewhat Easy Very Easy
4. marijuana (grass, pot)	Cannot Get Somewhat Easy Very Easy
5. cocaine (powder, rock, freebase, crack)	Cannot Get Somewhat Easy Very Easy
6. inhalants (sniffing or huffing glue, solvents, gas)	Cannot Get Somewhat Easy Very Easy
7. steroids	Cannot Get Somewhat Easy Very Easy
8. ecstasy	Cannot Get Somewhat Easy Very Easy
9. methamphetamines (meth, ice, crank)	Cannot Get Somewhat Easy Very Easy

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I started using ____ when I was…

1. alcohol (wine, wine coolers, beer, liquor)	Never Used 8 years old or younger 9 years old, 10 years old 11 years old 12 years old 13 years old 14 years old or older
2. smoking tobacco (cigarettes, cigars, pipes)	Never Used 8 years old or younger 9 years old, 10 years old 11 years old 12 years old 13 years old 14 years old or older
3. chewing tobacco (dip, snuff, spit tobacco)	Never Used 8 years old or younger 9 years old, 10 years old 11 years old 12 years old 13 years old 14 years old or older
4. marijuana (grass, pot)	Never Used 8 years old or younger 9 years old, 10 years old 11 years old 12 years old 13 years old 14 years old or older
5. cocaine (powder, rock, freebase, crack)	Never Used 8 years old or younger 9 years old, 10 years old 11 years old 12 years old 13 years old 14 years old or older
6. inhalants (sniffing or huffing glue, solvents, gas)	Never Used 8 years old or younger 9 years old, 10 years old 11 years old 12 years old 13 years old 14 years old or older
7. steroids	Never Used 8 years old or younger 9 years old, 10 years old 11 years old 12 years old 13 years old 14 years old or older
8. ecstasy	Never Used 8 years old or younger 9 years old, 10 years old 11 years old 12 years old 13 years old 14 years old or older
9. methamphetamines (meth, ice, crank)	Never Used 8 years old or younger 9 years old, 10 years old 11 years old 12 years old 13 years old 14 years old or older

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I think the following are harmful to my health.

1. alcohol (wine, wine coolers, beer, liquor)	Very harmful Somewhat harmful Not harmful
2. smoking tobacco (cigarettes, cigars, pipes)	Very harmful Somewhat harmful Not harmful
3. chewing tobacco (dip, snuff, spit tobacco)	Very harmful Somewhat harmful Not harmful
4. marijuana (grass, pot)	Very harmful Somewhat harmful Not harmful
5. cocaine (powder, rock, freebase, crack)	Very harmful Somewhat harmful Not harmful
6. inhalants (sniffing or huffing glue, solvents, gas)	Very harmful Somewhat harmful Not harmful
7. steroids	Very harmful Somewhat harmful Not harmful
8. ecstasy	Very harmful Somewhat harmful Not harmful
9. methamphetamines (meth, ice, crank)	Very harmful Somewhat harmful Not harmful

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Adults in my life would disapprove if I used…

1. alcohol	Always Maybe Not really
2. tobacco	Always Maybe Not really
3. marijuana	Always Maybe Not really
4. other illegal drugs	Always Maybe Not really

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My friends would disapprove if I used…

1. alcohol	Always Maybe Not really
2. tobacco	Always Maybe Not really
3. marijuana	Always Maybe Not really
4. other illegal drugs	Always Maybe Not really

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Where do your friends usually use ____?

(You may mark more than one response for each question)

1. alcohol	Do Not Use At Home At School In a Car Friend’s House Other
2. tobacco	Do Not Use At Home At School In a Car Friend’s House Other
3. marijuana	Do Not Use At Home At School In a Car Friend’s House Other
4. other illegal drugs	Do Not Use At Home At School In a Car Friend’s House Other

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When do your friends usually use ____?

(You may mark more than one response for each question)

1. alcohol	Do Not Use On the Way to School During School On the Way Home From School Week Nights Weekends
2. tobacco	Do Not Use On the Way to School During School On the Way Home From School Week Nights Weekends
3. marijuana	Do Not Use On the Way to School During School On the Way Home From School Week Nights Weekends
4. other illegal drugs	Do Not Use On the Way to School During School On the Way Home From School Week Nights Weekends

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During the past 30 days I…

1. have been bullied or threatened by other students	Yes No
2. bullied or threatened other students	Yes No
3. brought a weapon (gun, knife, club) to school	Yes No
4. have been absent from school because I have felt I would be unsafe at school or on my way to or from school.	Yes No
5. have participated in illegal gang activities.	Yes No
6. have friends who have participated in illegal gang activities.	Yes No
7. have been picked on or teased at school.	Yes No

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Nutrition Information

1. I eat at least three servings of dairy products each day.	Always Sometimes Never
2. I eat at least five servings of fruits or vegetables each day.	Always Sometimes Never
3.I learn about nutrition in class.	Always Sometimes Never
4. I learn about nutrition in the school cafeteria.	Always Sometimes Never
5. I can purchase snack foods/beverages at school.	Always Sometimes Never
6. I purchase snack foods at school.	Always Sometimes Never
7. I eat a school lunch three or more times a week.	Always Sometimes Never
8. I eat breakfast 3 or more times a week (at school or home).	Always Sometimes Never

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Student Information

1. I was taught about alcohol, tobacco and other drugs within the last year at school.	Yes No
2. I have been taught about AIDS or HIV infection within the last year at school.	Yes No
3. I have been taught about character education within the last year at school.	Yes No
4. Have you ever thought about dropping out of school?	Always Sometimes Not at all
5. If you were going to drop out of school, what would most likely be the reason?	I have not thought about dropping out of school Boring school work Family reasons Being bullied Other
6. On an average school day, how much unsupervised time do you spend watching TV?	I do not watch TV on an average school day Less than l hour per day l hour per day 2-3 hours per day 4-5 hours per day 6 or more hours per day
7. On an average school day, how much unsupervised time do you spend on the computer?	I do not spend any time on the computer on an average school day Less than l hour per day 2-3 hours per day 4-5 hours per day 6 or more hours per day
8. I have instant messaged people I do not even know.	Always Sometimes Not at all
9. Have you ever smoked a cigarette?	Yes No
10. Have you ever used the drug zenabrillatol (street name ‘ZB’)?	Yes No
11. In the past 30 days I have ridden in a car with a driver who had been drinking alcohol.	Yes No
12. I have drunk five or more drinks of alcohol at one sitting during the last 30 days.	0 times 1-2 times 3-5 times 6 times or more
13. I get along with other students and adults.	Always Sometimes Never
14. I would help someone who was being bullied.	Always Sometimes Never

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Student Information Continued

1. During the past 12 months, I have been offered, sold, or given illegal drugs on school property.	Yes No
2. School is a place at which I feel safe.	Always Sometimes Not really very safe No, it’s dangerous
3. During the past 12 months, I seriously considered attempting suicide.	Yes No
4. I have attempted suicide in the last year.	Yes No
5. I feel safe at home.	Always Sometimes Not really
6. I know an adult at school that I can talk with if I need help.	Yes No

I'm Finished!