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2013
November
S
Substance Abuse/ Delinquency Relationship
Substance Abuse/ Delinquency Relationship
Substance Abuse/Delinquency Relationship Survey
0%
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Hello:
You are invited to participate in our survey regarding the relationship between substance abuse and delinquency among youths and adolescents. In this survey, approximately 1000 people will be asked to complete a survey that asks questions about personal experience. It will take approximately 4-6 minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact [Name of Survey Researcher] at [Phone Number] or by email at the email address specified below.
Thank you very much for your time and support. Please start with the survey now by clicking on the
Continue
button below.
Email Address
What is your date of birth?
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Do you smoke tobacco, such as cigarettes, cigars
Yes
No
Have you ever smoked in the past?
Yes
No
Last year prevalence of alcohol consumption
Did drink alcohol during last 12 months
Did not drink any alcohol during last 12 months
What is your gender?
Male
Female
Do you smoke marijuana?
Yes
No
If yes, how often?
Very Frequently
Frequently
Occasionally
Rarely
Very Rarely
Do you use any other drugs or substances not mentioned above?
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