3/13/2018 Electronic Cigarette Use (Vaping) High School Principal Survey

Electronic Cigarette Use (Vaping) High School PrincipalSurvey The OPI Health Enhancement and Safety Division would like to have a greater understanding about electronic cigarette use in Montana schools. Thank you very much for taking the time to respond to this short survey. Your individual school information will be kept confidential but in combination with others will greatly assist our efforts to provide Montana schools with timely and helpful tobacco use prevention resources.

REFILLABLE, RECHARGEABLE VAPING DEVICES

Vape Pens

1. The above are examples of rechargeable,refillable vape pens. These are more traditionaland less expensive vaping devices.Approximately how many student tobacco useviolations involving vape pens have you hadsince the beginning of this school year?

Mods

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3/13/2018 Electronic Cigarette Use (Vaping) High School Principal Survey

2. The picture above contains examples ofrechargeable, refillable "Mods." These arelarger vaping devices, varied in design andthey often contain a computerized regulatorycomponent. Mods typically produce a largeraerosol "cloud" than traditional vape pens andare more commonly used for "vape tricks."Approximately how many student tobacco useviolations involving mods have you had sincethe beginning of this school year?

E-Juice

3. Vape pens and Mods are used with e-Juice. E-Juice comes in over 7000 flavors. What flavorsof e-juice have you found in your school?

Check all that apply.

We have had zero tobacco violations associated with E-Juice

Fruity Flavors like blueberry, green apple and watermelon

Dessert flavors like chocolate, vanilla, banana split or cream puff

Candy flavors like skittles, gummy bear or cotton candy

Non sweet flavors like tobacco, mint or menthol

Other

JUUL

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3/13/2018 Electronic Cigarette Use (Vaping) High School Principal Survey

4. We've been hearing a lot in the national mediaabout youth using Juul electronic cigarettes inschools. These vaping devices look like USBthumb drives and can be easier to camouflagein schools. They come with cartridges alreadyfilled with e-juice and can be recharged from aUSB port. Approximately how many studenttobacco use violations involving Juuls haveyou had since the beginning of this schoolyear?

Disposable Vaping Devices

Disposable E-Hookahs

5. Above are samples of disposable e-hookahs.Approximately how many student tobacco useviolations involving e-hookahs have you hadsince the beginning of this school year?

Cig-A-Likes

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3/13/2018 Electronic Cigarette Use (Vaping) High School Principal Survey

6. The images above are samples of cig-a-likesthat tend to have the same shape orappearance as combustible cigarettes. Someare disposable, some have rechargeablecomponents with disposable cartridges.Approximately how many student tobacco useviolations involving cig-a-likes have you hadsince the beginning of this school year?

School Related Electronic Cigarette Incidences

7. Incidences of student electronic cigarette use seems to have __________________ in ourschool this year. Mark only one oval.

Stayed about the same

Decreased

Increased

8. Please estimate the numbers of student electronic cigarette violations you've had so far thisschool year by grade level. Mark only one oval per row.

zero 1-2 3-5 6-9 10 or more

9th Grade

10th Grade

11th Grade

12th Grade

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3/13/2018 Electronic Cigarette Use (Vaping) High School Principal Survey

9. Student electronic cigarette use occurs more often _______________________. Check all that apply.

Inside our school building during school hours

Outside our school building during school hours

Inside our school building before or after school

Outside our school building before or after school

At school sponsored events, on or off campus

We've had no student electronic cigarette use at our school this year

10. Most student electronic cigarette use in our school involves_______________. Mark only one oval.

Males

Females

An equal proportion of males and females

We've had no student electronic cigarette use in our school this year

11. We have had incidences of electronic cigarette use on school property or at school sponsoredevents by_________________. Mark only one oval per row.

Zero Times 1-2 Times 3-5 Times 6-9 Times More than 10 Times

Staff Visitors

12. Approximately how many student TOBACCOviolations of any kind have you had at yourschool since the beginning of this schoolyear?

13. Please share any anecdotal information that may be helpful for the OPI or other schools toknow about electronic cigarette use in schools.

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3/13/2018 Electronic Cigarette Use (Vaping) High School Principal Survey

14. My school is a Class ___________ school. Mark only one oval.

C

B

A

AA

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