VictoriaList
New member
- May 1, 2011
- 0
- 0
- 0
SURVEY
My name is Vicky and I am conducting a study on the influences of underage drinking.
I would appreciate it if you could answer the following survey questions and aid my research.
The information provided in this survey will be used as a research aid and no information or identities will be passed on to any authorities. This information will strictly be used for educational purposes.
Please circle the appropriate answer.
1.Gender: M or F
2. Age:12-1314-1516-17
3.What is your standing on underage drinking:ForAgainst
4.Have you ever drunk alcohol?YesNo (If no, skip to 8.)
5.What is your preferred alcoholic beverage?
BeerReady to drink (RTD)CiderPure spirits
6.How often do you drink alcohol?
Daily 1-2 times a week Once a fortnight Once a month Once every six months Never
7.Are you a binge drinker? (Consume more than 4 drinks in a session)YesNo
8.How easy do you find it to get alcohol?
EasyChallengingImpossible
9.At what age did you first try alcohol? ____________________
10.Was this in the presence of a parent or guardian?YesNo
11.Why do you choose to drink alcohol?
_________________________________________________________________________
12.Have you ever used alcohol in a social situation? YesNo
13.Do you believe alcohol is required to have a good time? YesNo
14.Have you ever engaged in drinking to satisfy your peers?YesNo
15.Have you ever been offered alcohol by a peer?YesNo
Please explain you reaction.
_________________________________________________________________________
16.Have you ever drunk alcohol to lose grip on reality? YesNo
17.Do you ever drink alcohol just to get drunk?YesNo
18. Do you drink alcohol to fit in?YesNo
19. Do you use alcohol to self medicate? (To help you sleep, to make you happier) YesNo
20.How would you rank your drinking experience?
Very unpleasant. Unpleasant. Neither enjoyable or unpleasant. Enjoyable.
Very enjoyable.
21 Do you find drinking satisfying? YesNo
22. Do you find the pressure to drink overwhelming? YesNo
Please explain
_________________________________________________________________________
23. Do you consider peer pressure to be a major contributor to underage drinking?
YesNo
24. What do you think are the three main causes of drinking? Please rank high to low.
1____________________ 2____________________ 3____________________
25. Has a person ever “tricked” you into drinking alcohol or given you a
Beverage when you were unaware there was alcohol in it? YesNo
26. Has alcohol ever effected your judgement and lead to a situation that you would have avoided if sober? YesNo
27. Have you ever regretted drinking?YesNo
28. Have you ever had an experience that has resulted in you no longer drinking alcohol? YesNo
Please explain
__________________________________________________________________________
29. If drink alcohol, are your parents aware? YesNo
30. Do your parents drink alcohol? YesNo
31. Do you believe your parents decision to drink alcohol has affected your decision to drink alcohol?
YesNo
32. Do you believe your parents are setting an example when it comes to drinking alcohol? YesNo
Please explain.
_________________________________________________________________________
33. Have you ever had any alcohol education? YesNo
Please explain.
_________________________________________________________________________
34. Did you find it useful? YesNo
Please explain.
_________________________________________________________________________
35. Are you aware alcohol is a drug? YesNo
36. Are you aware the legal drinking age in Australia is 18 years old and it is illegal to drink alcohol if you are under 18 years old? YesNo
37. Are you aware that drinking alcohol while in your adolescent years can cause memory problems and if drinking in excess is known to cause the hippocampus to shrink by up to 10%? YesNo
38. If you drink, do you believe drinking has had an effect on you health? YesNo
39. Was this health effect positive or negative?PositiveNegative
Please explain.
_________________________________________________________________________
40. Do you believe the rewards of drinking alcohol out way the risks? YesNo
(I.e. Social acceptance.)
41. If you drink, do you believe you made the right choice when you began to drink alcohol? YesNo
Please explain.
________________________________________________________________________
Thank you for your time.
Its says circle, i forgot to change it, this is originally a print survey.
Please cut and paste to answer questions.
one takes about 5min of your time
My name is Vicky and I am conducting a study on the influences of underage drinking.
I would appreciate it if you could answer the following survey questions and aid my research.
The information provided in this survey will be used as a research aid and no information or identities will be passed on to any authorities. This information will strictly be used for educational purposes.
Please circle the appropriate answer.
1.Gender: M or F
2. Age:12-1314-1516-17
3.What is your standing on underage drinking:ForAgainst
4.Have you ever drunk alcohol?YesNo (If no, skip to 8.)
5.What is your preferred alcoholic beverage?
BeerReady to drink (RTD)CiderPure spirits
6.How often do you drink alcohol?
Daily 1-2 times a week Once a fortnight Once a month Once every six months Never
7.Are you a binge drinker? (Consume more than 4 drinks in a session)YesNo
8.How easy do you find it to get alcohol?
EasyChallengingImpossible
9.At what age did you first try alcohol? ____________________
10.Was this in the presence of a parent or guardian?YesNo
11.Why do you choose to drink alcohol?
_________________________________________________________________________
12.Have you ever used alcohol in a social situation? YesNo
13.Do you believe alcohol is required to have a good time? YesNo
14.Have you ever engaged in drinking to satisfy your peers?YesNo
15.Have you ever been offered alcohol by a peer?YesNo
Please explain you reaction.
_________________________________________________________________________
16.Have you ever drunk alcohol to lose grip on reality? YesNo
17.Do you ever drink alcohol just to get drunk?YesNo
18. Do you drink alcohol to fit in?YesNo
19. Do you use alcohol to self medicate? (To help you sleep, to make you happier) YesNo
20.How would you rank your drinking experience?
Very unpleasant. Unpleasant. Neither enjoyable or unpleasant. Enjoyable.
Very enjoyable.
21 Do you find drinking satisfying? YesNo
22. Do you find the pressure to drink overwhelming? YesNo
Please explain
_________________________________________________________________________
23. Do you consider peer pressure to be a major contributor to underage drinking?
YesNo
24. What do you think are the three main causes of drinking? Please rank high to low.
1____________________ 2____________________ 3____________________
25. Has a person ever “tricked” you into drinking alcohol or given you a
Beverage when you were unaware there was alcohol in it? YesNo
26. Has alcohol ever effected your judgement and lead to a situation that you would have avoided if sober? YesNo
27. Have you ever regretted drinking?YesNo
28. Have you ever had an experience that has resulted in you no longer drinking alcohol? YesNo
Please explain
__________________________________________________________________________
29. If drink alcohol, are your parents aware? YesNo
30. Do your parents drink alcohol? YesNo
31. Do you believe your parents decision to drink alcohol has affected your decision to drink alcohol?
YesNo
32. Do you believe your parents are setting an example when it comes to drinking alcohol? YesNo
Please explain.
_________________________________________________________________________
33. Have you ever had any alcohol education? YesNo
Please explain.
_________________________________________________________________________
34. Did you find it useful? YesNo
Please explain.
_________________________________________________________________________
35. Are you aware alcohol is a drug? YesNo
36. Are you aware the legal drinking age in Australia is 18 years old and it is illegal to drink alcohol if you are under 18 years old? YesNo
37. Are you aware that drinking alcohol while in your adolescent years can cause memory problems and if drinking in excess is known to cause the hippocampus to shrink by up to 10%? YesNo
38. If you drink, do you believe drinking has had an effect on you health? YesNo
39. Was this health effect positive or negative?PositiveNegative
Please explain.
_________________________________________________________________________
40. Do you believe the rewards of drinking alcohol out way the risks? YesNo
(I.e. Social acceptance.)
41. If you drink, do you believe you made the right choice when you began to drink alcohol? YesNo
Please explain.
________________________________________________________________________
Thank you for your time.
Its says circle, i forgot to change it, this is originally a print survey.
Please cut and paste to answer questions.
one takes about 5min of your time