Survey Questionnaire: Smoking in Ponong High School and Its Effects on Students' Performance

Section 1: Demographic Information

1.) What is your gender?

a) Male

b) Female

c) Prefer not to say

2.) What is your age?

a) Under 15

b) 15-17

c) 18-20

d) 21 or above

3.) What grade are you currently in?

a) 9th grade

b) 10th grade

c) 11th grade

d) 12th grade

Section 2: Smoking Habits

4.) Have you ever smoked a cigarette?

a) Yes

b) No
5.) How frequently do you smoke cigarettes?

a) Daily

b) Weekly

c) Monthly

d) Rarely

e) I do not smoke

6.) At what age did you start smoking cigarettes?

a) Under 12 years

b) 12-14 years

c) 15-17 years

d) 18 years or above

e) I do not smoke

Section 3: Effects on Performance

7.) How do you perceive smoking affects your academic performance?

a) Greatly hampers my performance

b) Somewhat hampers my performance

c) No effect on my performance

d) Somewhat improves my performance

e) Greatly improves my performance

8.) Have you noticed any changes in your academic performance since you started smoking?

a) Yes, it has declined significantly

b) Yes, it has declined slightly

c) No change in my performance

d) Yes, it has improved slightly

e) Yes, it has improved significantly

f) I do not smoke

9.) Do you believe smoking affects your concentration and focus in class?

a) Yes, significantly

b) Yes, slightly

c) No, not at all

d) I do not smoke

10.) Have you faced any disciplinary action at school due to smoking-related incidents?

a) Yes, multiple times

b) Yes, once

c) No, never

d) I do not smoke