2023 Community Survey on Student Substance Use
Influence the Choice is a nonprofit in east King County working to prevent student substance use. This survey is anonymous. You may skip any question or stop the survey at any time. Thank you for helping inform and improve our prevention programs for youth! www.influencethechoice.org 
Sign in to Google to save your progress. Learn more
1. How much of a problem do you think each of the following is among youth (6th - 12th grade) in our eastside community?
Not a problem
A minor problem
A moderate problem
A serious problem
Don't Know
Alcohol Use
Marijuana or cannabis
Prescription drug misuse (using medication without a prescription or in a way other than prescribed
Other drugs (specify below)
Tobacco use
E-cigarettes or other electronic vapor products
Driving under the influence of alcohol
Driving under the influence of marijuana
Depression
Suicide
Bullying
Bullying on social media
Clear selection
1(a) If you selected "other drugs" in question 1, please write the name of those substances below.
2. If youth wanted to get some alcohol, how hard would it be for them to get? 
Very east
Sort of easy
Sort of hard
Very hard
Don't know
Middle School youth (6th-8th grade)
High School youth (9th-12th grade)
Clear selection
3. If youth wanted to get some marijuana, how easy would it be for them to get?
Very easy
Sort of easy
Sort of hard
Very hard
Don't know
Middle School youth (6th-8th grade)
High School youth (9th-12th grade)
Clear selection
4. How much do you think youth risk harming themselves if they try marijuana once or twice?
No risk
Slight risk
Moderate risk
High risk
Don't know
Middle School youth (6th-8th grade)
High School youth (9th-12th grade)
Clear selection
5. How much do you think youth risk harming themselves if they try marijuana regularly (once or twice per week?)
No risk
Slight risk
Moderate risk
High risk
Don't know
Middle School youth (6th-8th grade)
High School youth (9th-12th grade)
Clear selection
6. How much do you think youth risk harming themselves if they use prescription drugs that are not prescribed to them?
No risk
Slight risk
Moderate risk
High risk
Don't know
Middle School youth (6th-8th grade)
High School youth (9th-12th grade)
Clear selection
7. If you currently have prescription medication at your home, where is the medication usually kept?
Clear selection
8. Do you know where in your community you could get rid of prescription drugs that you no longer need?
Clear selection
9. There is a group of volunteers in your community who are working to reduce youth alcohol and other drug use. Had you heard of Influence the Choice before today?
Clear selection
10. Are you a parent or guardian with any children in 6th-12th grade?
Clear selection
11. Parents/Guardians - please answer the following questions based on the school grade of your child/children. If you have children in both middle and high school, please respond to both categories provided.
How wrong do you think it would be for your child/children....
Not at all wrong
A little bit wrong
Wrong
Very wrong
Don't know
To drink alcohol in 6th-8th grade
To drink alcohol in 9th-12th grade
To use marijuana in 6th-8th grade
To use marijuana in 9th-12th grade
To use prescription drugs not prescribed to them in 6th-8th grade
To use prescription drugs not prescribed to them in 9th-12th grade
Clear selection
12. What is your age?
Clear selection
13. How do you currently identify yourself? Select all that apply
Clear selection
14. Are you of Hispanic, Latino/Latina or Spanish origin?
Clear selection
15. What is your race? Select all that apply.
Clear selection
16. What languages are spoken in your home? Select all that apply
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Dianne Bugge. Report Abuse
Google Forms