Sidekicks Youth Follow-Up Survey
Please complete this survey if you have been trained as a youth Sidekick and have had a follow-up meeting with your Adult Advisor, Adult Ambassador or District Tobacco Prevention Partner.

The results of this ANONYMOUS survey go to MaineHealth Center for Tobacco Independence's Tobacco Prevention Services team for review and helps us make sure we are meeting the needs of youth Sidekicks in Maine. Your feedback is extremely important!!

This survey uses the phrase “commercial tobacco” to describe tobacco that is commonly used in cigarettes, chew, hookahs and pipes; it is mass-produced and sold for profit. Commercial tobacco contains thousands of chemicals and produces over 7,000 chemical compounds when burned, many of which are carcinogenic, cause heart and other diseases, and premature death. The survey also refers to “nicotine” products, these include vapes, e-cigarettes, JUULs…..

If you have any questions about this survey and/or anything related to Sidekicks, please email or call MaineHealth Tobacco Prevention Services Program at tobaccopreventionservices@mainehealth.org or call 661-7835.

Thank you for taking the time to complete this survey. Your efforts are greatly appreciated!
Today's Date
Your Initials:
Your age *
Your town *
Your gender
What do you like most about the Sidekicks curriculum so far?
What do you like least about the Sidekicks curriculum so far?
How do you think youth are responding to Sidekicks in your community?
Share any examples of how you've seen Sidekicks impact youth and/or your community.
Since becoming a Sidekick, who have you talked to about their commercial tobacco/nicotine use?
If you haven't talked to anyone about their commercial tobacco/nicotine use since becoming a Sidekick, please share why.
Before becoming a Sidekick had you ever talked with anyone (friends, peers, family, etc) about their commercial tobacco/nicotine use? *
Please rate your confidence as a Sidekick today. *
What types of support do you need to continue being a Sidekick?
Please share anything else you'd like us to know about your experiences with Sidekicks so far:
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy