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Questionnaire #:________

Date: ________
Dear Fellow Student,
In an attempt to understand policies regarding cigarette smoking as well as your knowledge,
attitude and views about smoking consumption, we, 4th year AB in Legal Management Students from
the University of Santo Tomas has undertaken a Study on the Smoking Ban Policy and the Smoking
Behavior of Students around the University of Santo Tomas. Your cooperation is a valuable asset to
our research.
Put a check on only one option per question unless the instructions tell you to do something
else. This is NOT a test. Your information will be kept secure and confidential and will be used for
academic purposes only. So, please be honest when you answer the questions and please do not
leave any question unanswered. Please make sure you answer each question.
Name (Optional):

Major: ___________________________

Year Level: __________

Age: ___

Gender: Male __
Female __
Strongly
agree
1. You are a cigarette smoker.
2. You might try cigarette smoking in
the future.
3. You always see people smoking near
schools/universities every day.
4. Students like you smoke cigarette
because they enjoy it.

Somewhat
agree

Neutral

Somewhat
disagree

Strongly
disagree

5. Students smoke cigarette as a form of


stress reliever.
6. Students smoke cigarettes for selfimage.
7. Students smoke cigarettes because of
peer pressure.
8. The people you see smoking around
your school/university are mostly
students or minors.
9. You are bothered by people smoking.
There is easy access on cigarettes
near your school/university.
11. You want to prevent/stop people from
smoking cigarettes around
schools/universities.
12. You believe that there are a lot of
diseases that can be acquired from
cigarette smoking.
13. You are aware of secondhand smoke.
10.

14.

You are aware that even when

smoking indoors with windows open


or in open air areas, the studies prove
that the smoke still reaches other
people from a distance and is can be
affected by it.
Students are well-informed of the
health risks associated with cigarette
smoking and tobacco use.
16.
You are aware of Manila
Ordinance 7952 or the Manila
Smoking Ban Odinance.
17.
There exists a smoking ban policy
in the University of Santo Tomas.
18.
Students are not supposed to
smoke around school premises.
19. Alternatively, universities should
provide smoking areas for students.
20. Smoking bans should also apply to
areas directly outside of it.
15.

21. Habitually taking breaks between


classes to smoke is a common
phenomenon (phenomena?) with
students.
22.
A professor smoking with
students inside school perimeters is
alright.
23.
Smoking a cigarette near a school
while an enforcer is present is alright.
24.
Local authorities are consistent
with the implementation of the
smoking ban policy.
25.
Student smokers are aware of the
penalties imposed by the smoking
ban policy.
26.
There are a lot of students directly
violating the smoking ban policy.
27.
You are pleased with the smoking
ban's effects in your university.
28.
The smoking ban policy is strictly
implemented within school
perimeters.
29. The smoking ban policy in Manila
will successfully regulate cigarette
smoking
30. The smoking ban policy has a direct
impact on the smoking behavior of
students.