Social Sba Sample – Questionnaire on Drugs

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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

 

  1. Do you use drugs

 

Yes           No

 

  1. Do you know of least one teenager in your community that uses drugs?

 

Yes          No

 

  1. 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

 

  1. Are drugs easily available to teenagers in your community?

 

Yes         No

 

  1. What types of drugs are used by teenagers in your community?

 

Alcohol          Marijuana           Cocaine             Heroine            Others

 

If others please specify:                                                                                 

                                                                                                                       

                                                                                                                       

 

  1. If yes to question 2, who introduced you to drugs?

 

Friends                  Family

 

  1. If yes to question 2, why do you try drugs?

                                                                                                                       

                                                                                                                       

                                                                                                                       

 

  1. 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:                                                                                 

                                                                                                                       

                                                                                                                       

 

  1. Are punishments against the possession of drugs strictly enforced in your community?

 

Yes                   No

 

  1. 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:                                                                                 

                                                                                                                       

                                                                                                                       

 

 

  1. 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

 

  1. 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?                                                                                                               

                                                                                                           

                                                                                                           

 

  1. What crimes teenagers committed after abusing drugs?

                                                                                                                                                                                                                                               

                                                                                                           

 

Contribution made possible by an anonymous author. 

 Download Drug Abuse Questionnaire bellow.

[sociallocker]drug-abuse-questionaire[/sociallocker]

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