Smoking and Covid survey

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

ASH Wales are asking for your help to find out more about young people's experiences with smoking, particularly during the Covid lockdown. This is an anonymous and confidential survey, and your responses will be used only for the purpose of helping improve services and support for young people. Please answer the questions below, whether you smoke or not, the survey should take less than 1-2 minutes to complete. Thank you!

Please select the school you go to:

Your current school year *

Year 7

Year 8

Year 9

Year 10

Year 11

Year 12

Year 13

Other:

Do you smoke? *

Yes, I smoke everyday

Yes, I smoke more than once a week

Yes, I smoke less than once a week but more than once a month

No, I don't smoke

Have you ever smoked?

Yes

I tried smoking cigarettes once or twice

Clear selection

Do you feel differently about smoking since the Covid pandemic? *

Yes, Covid has made me feel less likely to smoke

Yes, Covid has made me feel more likely to smoke

No, I feel the same about smoking since Covid

Did you know that smoking can make the symptoms of Covid worse? *

Yes

Does anyone you live with smoke? *

Yes

Does anyone smoke inside your house?

Yes, someone/some people smoke inside my house

No, they smoke outside

No, no one smokes either inside or just outside my house

Clear selection

Do you think you have been exposed to more second-hand smoke (passive smoking) during the lockdown than you were previously? In other words, have you been around people smoking around you more during lockdown than before? *

Yes

Don't know

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms