YOUR ANSWERS ARE CONFIDENTIAL PLEASE DO NOT COPY

1 Thousands of students across Canada, just like you, have been asked to takepart in this survey. This important survey will help Health Canada to betterunderstand tobacco, alcohol, and drug use among young people in value your help use a pencil to complete this mark all youranswers with full, darkmarks like this: Even if you don't use tobacco, alcohol, or drugs, PLEASE make sure youanswer each question so that all students take the same amount of time tocomplete the questionnaire. This is NOT a test. All of your ANSWERS will be kept CONFIDENTIAL . No one,not even your parents or teachers, will ever know what you be honest when you answer the questions. Mark only one option per question unless the instructions tell you to dosomething else.

2 If you do not understand a question, or do not wish to answer a question,leave it blank and continue to the next question. Choose the option that is the closest to what you think/feel is true for Her Majesty the Queen in Right of Canada (2016)YOUR ANSWERS ARE CONFIDENTIALFor office use only[ SERIAL ] PLEASE DO NOT COPY2. How old are you today?11 years or younger12 years13 years14 years15 years4. How would you describe yourself? (Mark all that apply)WhiteBlackWest Asian/ArabSouth Asian (Indian, ..)East/Southeast Asian (Chinese, ..)Latin American/HispanicAboriginal (First Nations, M tis, Inuit, ..)Other:Grade 7 Grade 8 Grade 9 Grade 10 Grade 11 Grade 121. What grade are you in?

3 3. Are you female or male?FemaleMale6. How old were you when you first tried smokingcigarettes, even just a few puffs?YesNo5. Have you ever tried cigarette smoking, even just a few puffs?7. Do you think in the future you might trysmoking cigarettes?Definitely yesProbably yesProbably notDefinitely notDefinitely yesProbably yesProbably notDefinitely not9. At any time during the next year do you think you will smoke a cigarette?Definitely yesProbably yesProbably notDefinitely not10. Have you ever smoked a whole cigarette?YesNo8. If one of your best friends was to offer you acigarette, would you smoke it?11. Have you ever smoked 100 or more whole cigarettes in your life?

4 YesNoNone1 day2 to 3 days4 to 5 days6 to 10 days11 to 20 days21 to 29 days30 days (every day)12. Have you ever smoked every day for at least 7 days in a row?YesNo13. On how many of the last 30 days did you smoke one or more cigarettes? 16 years17 years18 years19 years or older14 years15 years16 years17 years18 years or older 8 years or younger9 years10 years11 years12 years13 yearsI have never done thisI do not knowTobacco UsePLEASE DO NOT COPYI did not buy cigarettes in the last 12 monthsI do not remember the priceLess than 10 cents10 cents to 50 cents51 cents to $ $ to $ $ to $ $ to $ Thinking about the last time you bought cigarettes in the last 12 months, how much did you pay?

5 $ to $ $ to $ $ to $ $ to $ $ to $ $ or more[ SERIAL ][ SERIAL ]I have never smokedI did not smoke in the last 7 daysI smoked every dayI smoked on weekend days only (after school Friday - Sunday)I smoked on week days onlyI smoked on week days and weekend days, but not every day14. Thinking back over the last 7 days, which daysdid you smoke at least one whole cigarette?15. Over the last 7 days, in total, how many wholecigarettes did you smoke?I have never used a tobacco productYesNo20. When you first tried a tobacco product (notincluding e-cigarettes), was it flavoured(including menthol)?21. Which did you try first: a cigarette or ane-cigarette (vaporizer with e-juice, vape pen,tank, mod)?

6 I have never tried a cigarette nor an e-cigaretteI have only tried a cigarette and never tried ane-cigarette I have only tried an e-cigarette and never trieda cigarette I have tried both and tried a cigarette first I have tried both and tried an e-cigarette first I do not remember 22. On how many of the last 30 days did you usean e-cigarette (vaporizer with e-juice, vapepen, tank, mod)?None1 day2 to 3 days4 to 5 days6 to 10 days11 to 20 days21 to 29 days30 days (every day)I have never smokedI have only smoked a few timesI have never tried to quitI have tried to quit onceI have tried to quit 2 or 3 timesI have tried to quit 4 or 5 timesI have tried to quit 6 or more times16.

7 Have you ever tried to quit smoking cigarettes? I do not smokeI buy them myself at a storeI buy them from a friendI buy them from someone elseI ask someone to buy them for meMy brother or sister gives them to meMy mother or father gives them to meA friend gives them to meSomeone else gives them to meI take them from my mother, father, or siblingsOther17. Where do you usually get your cigarettes? (Mark only one)I did not buy cigarettes in the last 12 monthsA single cigaretteA pack of 20 cigarettesA pack of 25 cigarettesA bag of 200 cigarettesA carton (200 cigarettes)A can or pouch of tobacco (loose tobacco)Another amount18. Thinking about the last time you bought cigarettes in the last 12 months, what did you buy?

8 For office use only012345678901234567890123456789 Number of whole cigarettes smoked: PLEASE DO NOT COPY23. Where do you usually get your e-cigarettes and supplies (vaporizers, e-juice, vape pens, tanks,mods)? (Mark all that apply)I do not use e-cigarettesI buy them from a vape shopI ask someone to buy them for meI buy them onlineA family member gives them to meA friend gives them to meSomeone else gives them to meI use my mother s, father s, or siblings without their permissionI use someone else s without their permissionOther24. Have you ever tried any of the following?25. In the last 30 days, did you use any of the following? a) Little cigars or cigarillos (plain or flavoured)b) Cigars (not including little cigars or cigarillos, plain or flavoured) c) Roll-your-own cigarettes (tobacco only, in rolling papers) d) Smokeless tobacco (chewing tobacco, pinch, snuff, or snus) e) Nicotine patches, nicotine gum, nicotine lozenges, nicotine inhalers, or nicotine sprayf) A water-pipe (hookah) to smoke shisha (herbal or tobacco)g) Blunt wraps (a tube made of tobacco used to roll cigarette tobacco) h) E-cigarettes (vaporizers with e-juice, vape pens, tanks, mods)None1 day2 to 3 days4 to 5 days6 to 10 days11 to 20 days21 to 29 days30 days (every day)26.

9 In the last 30 days, how often did you smoke little cigars or cigarillos (plain or flavoured)?a) Smoking little cigars or cigarillos (plain or flavoured)b) Smoking cigars (not including little cigars or cigarillos, plain or flavoured) c) Smoking roll-your-own cigarettes (tobacco only, in rolling papers) d) Using smokeless tobacco (chewing tobacco, pinch, snuff, or snus) e) Using nicotine patches, nicotine gum, nicotine lozenges, nicotine inhalers, or nicotine spray f) Using a water-pipe (hookah) to smoke shisha (herbal or tobacco)g) Using blunt wraps (a tube made of tobacco used to roll cigarette tobacco) h) Using e-cigarettes (vaporizers with e-juice, vape pens, tanks, mods)27.

10 In the last 30 days, did you use any of the following flavoured tobacco products?a) Menthol cigaretteb) Flavoured little cigar or cigarilloc) Flavoured cigard) Flavoured smokeless tobaccoe) Flavoured tobacco in a water-pipe (hookah)f) Flavoured e-cigarette (vaporizer with e-juice, vape pen, tank, mod)NoYesNoYesNoYesPLEASE DO NOT COPYA lcohol UseA DRINK means: 1 regular sized bottle, can, or draft of beer; 1 glass of wine; 1 bottle of cooler; 1 shot ofliquor (rum, whisky, Baileys , etc.); or 1 mixed drink (1 shot of liquor with pop, juice, energy drink, etc.).YesNo28. Have you ever had a drink of alcohol that was more than just a sip? I have never had a drink of alcohol that was more than just a sipI have not done this in the last 30 daysOnce or twiceOnce or twice a week3 or 4 times a week5 or 6 times a weekEvery dayI do not know31.