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Sample Questionnaire


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A sample questionnaire

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Sample Questionnaire

  1. 1. Questionnaire Instructions: Please put a tick in the box next to the answer of your choice or write in the space provided as the case may be. Sex Male Female Age 13-14 15-16 17-19 Religion Christianity Islam Rastafarian Other 1. What type of family are you from? Nuclear Sibling house hold Single parent Extended 2. Do you use drugs Yes No 3. Do you know of least one teenager in your community that uses drugs? Yes No 4. If your answer is yes to question 2 (two), how often do you use drugs? Every day Every 2-3 days Once a week Every fortnight Once a month every 2 months 5. Are drugs easily available to teenagers in your community? Yes No 6. What types of drugs are used by teenagers in your community? Alcohol Marijuana Cocaine Heroine Others If others please specify: 1
  2. 2. 7. If yes to question 2, who introduced you to drugs? Friends Family 8. If yes to question 2, why do you try drugs? 9. Which of the following are reasons why teenagers in your community try drugs? Peer pressure Depression Curiosity In the influence of the media To cope with home problems Lack of parental guidance To deal with school Because of Rastafarian beliefs Others If others please specify: 10. Are punishments against the possession of drugs strictly enforced in your community? Yes No 11. How have teenagers in your community been affected by drug abuse? Become physically ill Developed mental illnesses Becomes vagrants Turn to theft Turn to prostitution Behave violently Others If others please specify: 2
  3. 3. 12. If you answer yes to question 2, approximately how much do you spend on drugs on a monthly basis? $5 – $10 $21 – $30 $41 – $50 $61– $70 $81 – $90 $11 – $20 $31 – $40 $51 – $60 $71 – $80 $90 – $100 $100 and more 13. What do you think can be done to solve the drug abuse problem among teenagers in your community? Greater education of young people in the community The establishment of more youth groups and clubs The establishment of recreational facilities The passage of stricter laws against drugs Greater parental guidance What else can you recommend to be done to solve the drug abuse problem at La Clery? 14. What crimes teenagers committed after abusing drugs? 3