Health Communication & Social Marketing 1

Electronic-Cigarette Survey Questionnaire

The purpose of this questionnaire is to further our research of Electronic Cigarette use
across Georgia College & State University and South Georgia State College Campuses. This
questionnaire asks about your personal experience and attitude about e-cigarettes. Your
response will be completely anonymous and only accessed by our research team. This
questionnaire will take no more than 10-minutes to complete. We would greatly appreciate your
participation!
Section 1: Demographics 5. What is your academic
1. Select the option that best describes classification?
your sex assigned at birth a. Freshman
a. Male b. Sophomore
b. Female c. Junior
c. Intersex d. Senior
2. Select the option that best describes e. Graduate student
your gender identity 6. What is your major?
a. Man a. ________
b. Woman 7. Do you reside on or off campus?
c. Transgender a. On campus
d. Nonbinary b. Off campus
e. Genderfluid 8. How do you take your classes?
f. Other __________ a. In person
3. Select your race/ethnicity (select all b. Online
that apply) c. Hybrid
a. White/Caucasian
b. Black/African American
c. Hispanic/Latinx
d. Indigenous/Native American
e. Pacific Islander/Hawaiian
f. Native Alaskan
g. Other ______
4. How old are you?
a. _______
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Section 2: Campus
The following section asks about your experience with e-cigarettes on your college campus.

1. How do you perceive e-cigarettes?

a. Not harmful at all
b. Somewhat harmful
c. Harmful
d. Very harmful
2. How do you perceive second-hand e-cigarette use?
a. Not harmful at all
b. Somewhat harmful
c. Harmful
d. Very harmful
3. Are you aware of your university’s tobacco use policy?
a. My campus is tobacco free, including e-cigarettes
b. My campus is tobacco free, but does not specifically include e-cigarettes
c. My campus allows the use of tobacco/e-cigarettes, if you are legally of age
d. I do not know my campus’s policy
4. How often would you say your fellow students use e-cigarettes, on average?
a. Not at all
b. Used, but not in the last 30 days
c. Used 1-9 days
d. Used 10-29 days
e. Used all 30 days
5. How often have you used e-cigarettes?
a. Used, but not in the last 30 days
b. Used in the last 1-9 days
c. Used in the last 10-29 days
d. Used all past 30 days
e. I have never used e-cigarettes?
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Section 3: Behavior Surrounding E-cigarette Use

The questions in the following section pertain to your use of electronic nicotine delivery systems
(ENDS), also known as e-cigarettes, vape pens, pods, mods, and/or Juuls.
1. How old were you when you first
used an e-cigarette? 7. Do you openly use e-cigarettes?
a. _________ a. Yes, I do not care who sees
2. How were you introduced to e- b. Yes, but I try to be cautious
cigarettes? (select all that apply) of others around me
a. Family c. Yes, but only in designated
b. Friends smoke zones
c. Advertising d. No, I try to hide my use of e-
d. Other____ cigarettes
3. Why do you use e-cigarettes? (select 8. Have you ever tried to quit using e-
all that apply) cigarettes?
a. Reduce/quitting smoking a. Yes, successfully
b. Peer pressure b. Yes, unsuccessfully
c. Personal interest (fruity c. Not yet, but I want to
flavor appeal) d. No, and I don’t plan to
d. Other______ 9. How would you rate your desire to
4. How do you use e-cigarettes? (select quit using e-cigarettes?
all that apply) a. No desire
a. I use my own b. Low desire
b. I use someone else’s c. Somewhat desire
c. Other ________ d. Desire
5. Where do you primarily use e- e. Desire very much
cigarettes? 10. How likely are you to attempt to
a. At home/residence quit using e-cigarettes?
b. At work a. Not likely
c. At school b. Somewhat likely
d. Other_____ c. Likely
6. Have you ever used e-cigarettes d. Very likely
while on your college campus? 11. How successful do you feel you
a. Yes would be in an attempt to stop using
b. No e-cigarettes?
a. Very Successful
b. Successful
c. Unsuccessful
d. Very unsuccessful
12. In your own words, what barriers are currently stopping you from quitting e-cigarettes?
a. __________________________________________________________________
Section 4: Peers’ reaction to e-cigarette use
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The questions in this section pertain to the reactions/attitudes your peers have of using e-
cigarettes.
6. How often would you say your e. I don’t know how my family
fellow students use e-cigarettes, on feels about my use of e-
average? cigarettes
a. Not at all f. I no longer use e-cigarettes
b. Used, but not in the last 30 9. How often would you say your
days friends use e-cigarettes, on average?
c. Used 1-9 days a. Not at all
d. Used 10-29 days b. Used, but not in the last 30
e. Used all 30 days days
7. How often would you say your c. Used 1-9 days
family members use e-cigarettes, on d. Used 10-29 days
average? e. Used all 30 days
a. Not at all 10. What are your friend’s views
b. Used, but not in the last 30 concerning your use of e-cigarettes?
days a. My friends do not care that I
c. Used 1-9 days use e-cigarettes
d. Used 10-29 days b. My friends do not approve of
e. Used all 30 days my use of e-cigarettes and try
8. What are your family’s views to intervene
concerning your use of e-cigarettes? c. My friends do not approve of
a. My family does not care that my use of e-cigarettes but do
I use e-cigarettes nothing about it
b. My family does not approve d. My friends do not know I use
of my use of e-cigarettes and e-cigarettes
try to intervene e. I do not know how my
c. My family does not approve friends feel about my use of
of my use of e-cigarettes but e-cigarettes.
do nothing about it f. I no longer use e-cigarettes
d. My family does not know I
use e-cigarettes