Survey Example Essay Example for Free

Survey Example Essay We the students of communication skills 14 are conducting a research paper regarding the causes and effects of smoking and drinking to 2nd year students of Centro Escolar University, Manila school year 2012-2013. Here are some questions below, please answer it by putting check on the answers provided before the line. Thankfully yours, (name of respondents) Researchers Questions For Drinkers: 1. Have you ever consumed alcohol? __yes __no 2. At what age did you start consuming alcohol? ________ 3. . Why did you start consuming alcohol? __ peer pressure __family problems __curiosity __to have fun Other(please specify____________) 4. Have you ever passed out or experience memory loss due to drinking? ___ yes ____no 5. What alcoholic beverages do you often drink? ____ beer ____ cocktails ____ rhum ____ whistkey 6. How often do you drink? ____ once a week ____ twice a week ____ once every two weeks Others: (please specify) _____ 7. Do you drink to escape pain, either physical or emotional? ___ Yes ___ No 8. How does it affect your condition the next day? ____ makes you lazy ____ makes you feel sleepy ____ makes you feel out of the mood ____ makes you feel sick 9. Have you ever skipped or missed class because of drinking? ___Yes ___ No 10. How does it affect your performance in school? ____ gives you poor outcome in class participation ____ makes you feel lazy to come to class ____ makes you feel sleepy during class ____ gives you low grades 11. Have you ever skipped or missed class because of drinking? ___Yes ___No 12. Did you ever get into any fights while drinking? ___Yes ___No 13. Any future plans to stop? ___ Yes ___ No Questions for Smokers: 1. When did you start to smoke? ____ 10-12 years old ____ 13-15 years old ____ 16-19 years old Others: (Please specify) _____________ 2. Why did you start smoking? ____ peer pressure ____ stress ____ curiosity Other(please specify) ______________ 3. What do you get from smoking? ____Relaxation ____ Habit ____Good time Others(please specify) ___ 4. Who among in your household smokes? ____Father ____ Sister ____Mother ____ Brother Others(please specify) ____ 5. How many sticks did you used when smoking? ____1 to 2 sticks ____ 2 to 3 sticks ____ 3 to 4 sticks Others(please specify) ____________ 6. How often do you smoke? ____ everyday ____ every other day ____ once a week Others( please specify) ____________ 7. What influenced you to start smoking? ____ peer pressure ____ to gain new experience ____ being done in the family Other(please specify) _____________ 8. Why do you smoke? ____Relaxation ____ Habit ____ Good times Others(please specify)____ 9. Are you aware of the effects of smoking to yourself and to the people around you? ____ Yes ____ No 10. Any future plans to stop? ____ Yes ____ No