1. How old are you?
4. How do you describe yourself?
5. How often do you wear a seatbelt when riding in a car?
6. When you ride a bicycle, how often did you wear a helmet?
7. When you rollerblade or ride a skateboard, how often do you wear a helmet?
Drinking and Driving
8. Have you ever ridden in a car driven by someone who had been drinking alcohol?
9. Have you ever carried a gun as a weapon?
10. Have you ever carried any other type of weapon, such as a knife or club?
11. During the past 30 days, how many days did you not go to school because you felt you would be unsafe at school or on your way to or from school?
12. During the past 12 months, how many times has someone threatened or injured you with a weapon such as a gun, knife, or club on school property?
13. During the past 12 months, how many times has someone stolen or deliberately damaged your property such as your car, clothing, or books on school property?
14. In the past 12 months, have you ever been in a physical fight?
15. Have you ever been in a physical fight in which you were hurt and had to be treated by a doctor or nurse?
Harassment at School
16. During the past 30 days, have you been harassed or picked on at school by another student?
17. Have you ever seriously thought about killing yourself?
18. Have you ever tried to kill yourself?
19. Have you ever tried cigarette smoking?
20. How old were you when you smoked a whole cigarette for the first time?
21. During the past 30 days, on how many days did you smoke cigarettes?
22. How do you get your own cigarettes?
23. When you bought cigarettes in a store during the past 30 days, were you ever asked to show proof of age?
25. Do you think smoking is cool?
26. Does someone living in your house (other than you) smoke cigarettes?
24. Have you ever used chewing tobacco or snuff, such as Redman, Skoal Bandits, or Copenhagen?
27. Have you ever had a drink of alcohol, other than for religious reasons?
28. How old were you when you had your first drink of alcohol?
29. During the past 30 days, on how many days did you have at least one drink of alcohol?
30. Have you ever used marijuana?
31. How old were you when you first tried marijuana?
32. During the past 30 days, how many times did you use marijuana?
33. Have you ever had any form of cocaine?
34. How old were you when you tried any form of cocaine for the first time?
35. Have you ever sniffed glue, or breathed the contents of spray cans, or inhaled any paints or sprays to get high?
36. Have you ever used steroids?
38. Have you ever used a needle to inject any illegal drug into your body?
HIV Knowledge and Attitudes
39. Have you ever been taught about AIDS or HIV in school?
40. Have you ever talked about AIDS or HIV with your parents or other adults in your family?
41. Can you tell if people are infected with HIV (the AIDS virus) just by looking at them?
42. Is it safe to have unprotected sex (no condom used) with a person who has tested negative for HIV?
43. Can a person get AIDS/HIV infection from being bitten by mosquitoes or other insects?
44. Can a person get AIDS/HIV infection from donating blood?
Sexual Activity and Abstinence
45. Have you ever had sexual intercourse?
46. How old were you when you had intercourse for the first time?
47. With how many different people have you had sexual intercourse?
48. The last time you had sexual intercourse, did you or your partner use a condom?
Body Image and Dieting
49. How do you think of your weight?
50. Which of the following are you trying to do about your weight?
51. Have you ever vomited or taken laxatives to lose weight or to keep from gaining weight?
52. Have you ever taken diet pills to lose weight or to keep from gaining weight?
53. Yesterday, how many times did you eat fruit or drink fruit juice?
54. Yesterday, how many times did you eat raw or cooked vegetables (including green salad)?
55. Yesterday, did you eat hamburger, hot dogs, sausage, french fries or potato chips?
56. Yesterday, how many times did you eat cookies, doughnuts, pie, or cake?
57. On how many of the past 7 days did you exercise or play sports, such as basketball, soccer, running, swimming laps, tennis, or fast bicycling?
58. At this time, how many days per week do you usually go to physical education or gym class?
59. During the past 12 months, how many sports teams run by your school or by an organization outside your school, did you play?
60. When you are scared, worried, or concerned about yourself or your friends, is there a caring adult you can talk to?
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