The questions on the Bismarck-Burleigh Public Health Student Survey can be found below. This short questionnaire will take less than 15 minutes to take.
- What is your sex?
- Male
- Female
- What grade are you in?
- 6th
- 7th
- 8th
- 9th
- 10th
- 11th
- 12th
- During the past 30 days, on how many days did you drink one or more drinks of an alcoholic beverage?
- 0 days
- 1 or 2 days
- 3 to 5 days
- 6 to 9 days
- 10 to 19 days
- 20 or more days
- During the past 30 days, on how many days did you smoke part or all of a cigarette?
- 0 days
- 1 or 2 days
- 3 to 5 days
- 6 to 9 days
- 10 to 19 days
- 20 or more days
- During the past 30 days, on how many days did you use marijuana?
- 0 days
- 1 or 2 days
- 3 to 5 days
- 6 to 9 days
- 10 to 19 days
- 20 or more days
- During the past 30 days, on how many days have you used prescription drugs not prescribed to you?
- 0 days
- 1 or 2 days
- 3 to 5 days
- 6 to 9 days
- 10 to 19 days
- 20 or more days
- How wrong or not wrong do your friends feel it would be for you to have one or two drinks of an alcoholic beverage nearly everyday?
- Very wrong
- Wrong
- A little bit wrong
- Not wrong at all
- How wrong or not wrong do your friends feel it would be for you to smoke tobacco?
- Very wrong
- Wrong
- A little bit wrong
- Not wrong at all
- How wrong or not wrong do your friends feel it would be for you to smoke marijuana?
- Very wrong
- Wrong
- A little bit wrong
- Not wrong at all
- How wrong or not wrong do your friends feel it would be for you to use prescription drugs not prescribed to you?
- Very wrong
- Wrong
- A little bit wrong
- Not wrong at all
The next four questions ask about your parents, which means your biological parents, adoptive parents, stepparents, or adult guardians, whether or not they live with you.
- How wrong do your parents or guardians feel it would be for you to have one or two drinks of an alcoholic beverage nearly every day?
- Very wrong
- Wrong
- A little bit wrong
- Not wrong at all
- How wrong do your parents or guardians feel it would be for you to smoke tobacco?
- Very wrong
- Wrong
- A little bit wrong
- Not wrong at all
- How wrong do your parents or guardians feel it would be for you to use marijuana (smoke, vape, eat, drink)?
- Very wrong
- Wrong
- A little bit wrong
- Not wrong at all
- How wrong do your parents or guardians feel it would be for you to use prescription drugs not prescribed to you?
- Very wrong
- Wrong
- A little bit wrong
- Not wrong at all
- How much do you think people risk harming themselves (physically or in other ways) if they have five or more drinks of an alcoholic beverage once or twice a week?
- No risk
- Slight risk
- Moderate risk
- Great risk
- How much do you think people risk harming themselves (physically or in other ways) if they smoke one or more packs of cigarettes per day?
- No risk
- Slight risk
- Moderate risk
- Great risk
- How much do you think people risk harming themselves (physically or in other ways) if they try marijuana once or twice a week?
- No risk
- Slight risk
- Moderate risk
- Great risk
- How much do you think people risk harming themselves (physically or in other ways) if they use prescription drugs that are not prescribed to them?
- No risk
- Slight risk
- Moderate risk
- Great risk
- Have you ever smoked marijuana in a vaping device?
- Yes
- No
- Unsure/don’t know
- What places (if any) did you use marijuana during the past 12 months? (Mark all that apply)
- I didn’t use marijuana
- At the river
- At the desert
- In a car
- At a park
- On the street
- In a parking lot
- At a concert
- At my home
- At a friend’s home
- At a community event
- At a sporting event
- At a restaurant
- At school
- At work