2005 Massachusetts
Youth Risk Behavior Survey
This survey is about health behavior. It has been developed so you
can tell us what you do that may affect your health. The information you
give will be used to develop better health education for young people
like yourself.
DO NOT write your name on this survey. The answers you give will be
kept private. No one will know what you write. Answer the questions
based on what you really do.
Completing the survey is voluntary. Whether or not you answer the
questions will not affect your grade in this class. If you are not
comfortable answering a question, just leave it blank.
The questions that ask about your background will be used
only to describe the types of students completing this survey. The
information will not be used to find out your name. No names will ever
be reported.
Make sure to read every question. Fill in the ovals completely. When
you are finished, follow the instructions of the person giving you the
survey.
THANK YOU VERY MUCH FOR YOUR HELP.
1. How old are you?
a. 12 years old or younger
b. 13 years old
c. 14 years old
d. 15 years old
e. 16 years old
f. 17 years old
g. 18 years old or older
2. What is your sex?
a. Female
b. Male
3. In what grade are you?
a. 9th grade
b. 10th grade
c. 11th grade
d. 12th grade
e. Ungraded or other grade
4. How do you describe yourself? (Select one or more
responses.)
a. American Indian or Alaska Native
b. Southeast Asian American (such as Cambodian,
Vietnamese, Laotian, Thai)
c. Asian American (such as Chinese, Japanese,
Korean, East Indian)
d. Black or African American
e. Hispanic or Latino
f. Native Hawaiian or Other Pacific
Islander
g. White
5. During the past 12 months, how would you describe your
grades in school?
a. Mostly A's
b. Mostly B's
c. Mostly C's
d. Mostly D's
e. Mostly F's
f. None of these grades
g. Not sure
6. How tall are you without your shoes on?
[Directions are given to write in feet and inches, and shade
boxes in a table.]
Height -
Feet: Inches:
7. How much do you weigh without your shoes on?
[Directions are given to write in pounds, and shade
box in a table.]
Weight -
Pounds:
8. How long have you lived in the United States?
a. Less than one year
b. 1 to 3 years
c. 4 to 6 years
d. More than 6 years, but not my whole life
e. I have always lived in the United States
9. What is your primary nighttime residence? (In other
words, where do you typically sleep at night?)
a. At home with my parents/guardians
b. At a friend's or relative's house with my
parents/guardians
c. At a friend's or relative's house without my
parents/guardians
d. In a supervised shelter with my
parents/guardians
e. In a supervised shelter without my
parents/guardians
f. In a hotel/motel, car, park, campground or
other public place with my parents/guardians
g. In a hotel/motel, car, park, campground or
other public place without my parents/guardians
h. Other
10. Which of the following best describes you?
a. Heterosexual (straight)
b. Gay or lesbian
c. Bisexual
d. Not sure
11. Are you receiving special education services? (That
is, do you have an IEP?)
a. Yes
b. No
c. Not sure
12. Is there at least one teacher or other adult in this
school that you can talk to if you have a problem?
a. Yes
b. No
c. Not sure
13. Outside of school, is there an adult (or adults) you
can talk to about things that are important to you?
a. Yes, parent or other adult family member
b. Yes, non-family adult (such as religious
leader, club advisor, neighbor, etc.)
c. Yes, both family and non-family adults
d. No
e. Not sure
The next 3 questions ask about personal safety.
14. How often do you wear a seat belt when riding in a car
driven by someone else?
a. Never
b. Rarely
c. Sometimes
d. Most of the time
e. Always
15. During the past 30 days, how many times did you ride
in a car or other vehicle driven by someone who had been drinking
alcohol?
a. 0 times
b. 1 time
c. 2 or 3 times
d. 4 or 5 times
e. 6 or more times
16. During the past 30 days, how many times did you drive
a car or other vehicle when you had been drinking alcohol?
a. 0 times
b. 1 time
c. 2 or 3 times
d. 4 or 5 times
e. 6 or more times
The next 12 questions ask about violence-related
behaviors.
17. During the past 30 days, on how many days did you
carry a weapon such as a gun, knife, or club?
a. 0 days
b. 1 day
c. 2 or 3 days
d. 4 or 5 days
e. 6 or more days
18. During the past 30 days, on how many days did you
carry a gun?
a. 0 days
b. 1 day
c. 2 or 3 days
d. 4 or 5 days
e. 6 or more days
19. During the past 30 days, on how many days did you
carry a weapon such as a gun, knife, or club on school property?
a. 0 days
b. 1 day
c. 2 or 3 days
d. 4 or 5 days
e. 6 or more days
20. During the past 30 days, on 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?
a. 0 days
b. 1 day
c. 2 or 3 days
d. 4 or 5 days
e. 6 or more days
21. During the past 12 months, how many times have you
been bullied at school? (Being bullied includes being repeatedly teased,
threatened, hit, kicked, or excluded by another student or group of
students.)
a. 0 times
b. 1 time
c. 2 or 3 times
d. 4 or 5 times
e. 6 or 7 times
f. 8 or 9 times
g. 10 or 11 times
h. 12 or more times
22. 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?
a. 0 times
b. 1 time
c. 2 or 3 times
d. 4 or 5 times
e. 6 or 7 times
f. 8 or 9 times
g. 10 or 11 times
h. 12 or more times
23. 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?
a. 0 times
b. 1 time
c. 2 or 3 times
d. 4 or 5 times
e. 6 or 7 times
f. 8 or 9 times
g. 10 or 11 times
h. 12 or more times
24. During the past 12 months, how many times were you in
a physical fight?
a. 0 times
b. 1 time
c. 2 or 3 times
d. 4 or 5 times
e. 6 or 7 times
f. 8 or 9 times
g. 10 or 11 times
h. 12 or more times
25. During the past 12 months, how many times were you in
a physical fight in which you were injured and had to be treated by a
doctor or nurse?
a. 0 times
b. 1 time
c. 2 or 3 times
d. 4 or 5 times
e. 6 or more times
26. During the past 12 months, how many times were you in
a physical fight on school property?
a. 0 times
b. 1 time
c. 2 or 3 times
d. 4 or 5 times
e. 6 or 7 times
f. 8 or 9 times
g. 10 or 11 times
h. 12 or more times
27. Have you ever been hurt physically or sexually by a
date or someone you were going out with? This might include being hurt
by being shoved, slapped, hit, or forced into any sexual activity.
a. I have never been on a date or gone out with
anyone.
b. No, I have never been hurt by a date or
someone I was going out with.
c. Yes, I was hurt physically.
d. Yes, I was hurt sexually.
e. Yes, I was hurt both physically and
sexually.
28. During the past 12 months, have you been a member of a
gang?
a. Yes
b. No
The next 6 questions ask about deliberately hurting
yourself, sad feelings, and attempted suicide. Sometimes people feel so
depressed about the future that they may consider attempting suicide,
that is, taking some action to end their own life.
29. During the past 12 months, how many times did you hurt
or injure yourself on purpose without wanting to die? (For example, by
cutting, burning, or bruising yourself on purpose.)
a. 0 times
b. 1 or 2 times
c. 3 to 5 times
d. 6 to 9 times
e. 10 to 19 times
f. 20 or more times
30. During the past 12 months, did you ever feel so sad or
hopeless almost every day for two weeks or more in a row that you stopped
doing some usual activities?
a. Yes
b. No
31. During the past 12 months, did you ever seriously
consider attempting suicide?
a. Yes
b. No
32. During the past 12 months, did you make a plan about
how you would attempt suicide?
a. Yes
b. No
33. During the past 12 months, how many times did you
actually attempt suicide?
a. 0 times
b. 1 time
c. 2 or 3 times
d. 4 or 5 times
e. 6 or more times
34. If you attempted suicide during the past 12 months,
did any attempt result in an injury, poisoning, or overdose that had to
be treated by a doctor or nurse?
a. I did not attempt suicide during the past 12
months
b. Yes
c. No
The next 10 questions ask about tobacco use.
35. Have you ever tried cigarette smoking, even one or two
puffs?
a. Yes
b. No
36. How old were you when you smoked a whole cigarette for
the first time?
a. I have never smoked a whole cigarette
b. 8 years old or younger
c. 9 or 10 years old
d. 11 or 12 years old
e. 13 or 14 years old
f. 15 or 16 years old
g. 17 years old or older
37. During the past 30 days, on how many days did you
smoke cigarettes?
a. 0 days
b. 1 or 2 days
c. 3 to 5 days
d. 6 to 9 days
e. 10 to 19 days
f. 20 to 29 days
g. All 30 days
38. During the past 30 days, on the days you smoked, how
many cigarettes did you smoke per day?
a. I did not smoke cigarettes during the past
30 days
b. Less than 1 cigarette per day
c. 1 cigarette per day
d. 2 to 5 cigarettes per day
e. 6 to 10 cigarettes per day
f. 11 to 20 cigarettes per day
g. More than 20 cigarettes per day
39. During the past 30 days, on how many days did you
smoke cigarettes on school property?
a. 0 days
b. 1 or 2 days
c. 3 to 5 days
d. 6 to 9 days
e. 10 to 19 days
f. 20 to 29 days
g. All 30 days
40. Have you ever smoked cigarettes daily, that is, at
least one cigarette every day for 30 days?
a. Yes
b. No
41. How many times have you tried to quit smoking
cigarettes?
a. I have never smoked cigarettes.
b. I have never tried to quit smoking
cigarettes.
c. 1 or 2 times
d. 3 to 5 times
e. 6 to 9 times
f. 10 or more times
42. During the past 30 days, on how many days did you use
chewing tobacco, snuff, or dip, such as Redman, Levi Garrett, Beechnut,
Skoal, Skoal Bandits, or Copenhagen?
a. 0 days
b. 1 or 2 days
c. 3 to 5 days
d. 6 to 9 days
e. 10 to 19 days
f. 20 to 29 days
g. All 30 days
43. During the past 30 days, on how many days did you use
chewing tobacco, snuff, or dip on school property?
a. 0 days
b. 1 or 2 days
c. 3 to 5 days
d. 6 to 9 days
e. 10 to 19 days
f. 20 to 29 days
g. All 30 days
44. During the past 30 days, on how many days did you
smoke cigars, cigarillos, or little cigars?
a. 0 days
b. 1 or 2 days
c. 3 to 5 days
d. 6 to 9 days
e. 10 to 19 days
f. 20 to 29 days
g. All 30 days
The next 5 questions ask about drinking alcohol. This
includes drinking beer, wine, wine coolers, hard lemonade or hard cider,
and liquor such as rum, gin, vodka, or whiskey. For these questions,
drinking alcohol does not include drinking a few sips of wine for
religious purposes.
45. During your life, on how many days have you had at
least one drink of alcohol?
a. 0 days
b. 1 or 2 days
c. 3 to 9 days
d. 10 to 19 days
e. 20 to 39 days
f. 40 to 99 days
g. 100 or more days
46. How old were you when you had your first drink of
alcohol other than a few sips?
a. I have never had a drink of alcohol other
than a few sips
b. 8 years old or younger
c. 9 or 10 years old
d. 11 or 12 years old
e. 13 or 14 years old
f. 15 or 16 years old
g. 17 years old or older
47. During the past 30 days, on how many days did you have
at least one drink of alcohol?
a. 0 days
b. 1 or 2 days
c. 3 to 5 days
d. 6 to 9 days
e. 10 to 19 days
f. 20 to 29 days
g. All 30 days
48. During the past 30 days, on how many days did you have
5 or more drinks of alcohol in a row, that is, within a couple of
hours?
a. 0 days
b. 1 day
c. 2 days
d. 3 to 5 days
e. 6 to 9 days
f. 10 to 19 days
g. 20 or more days
49. During the past 30 days, on how many days did you have
at least one drink of alcohol on school property?
a. 0 days
b. 1 or 2 days
c. 3 to 5 days
d. 6 to 9 days
e. 10 to 19 days
f. 20 to 29 days
g. All 30 days
The next 4 questions ask about
marijuana use. Marijuana
also is called grass, pot, weed, or reefer.
50. During your life, how many times have you used
marijuana?
a. 0 times
b. 1 or 2 times
c. 3 to 9 times
d. 10 to 19 times
e. 20 to 39 times
f. 40 to 99 times
g. 100 or more times
51. How old were you when you tried marijuana for the
first time?
a. I have never tried marijuana
b. 8 years old or younger
c. 9 or 10 years old
d. 11 or 12 years old
e. 13 or 14 years old
f. 15 or 16 years old
g. 17 years old or older
52. During the past 30 days, how many times did you use
marijuana?
a. 0 times
b. 1 or 2 times
c. 3 to 9 times
d. 10 to 19 times
e. 20 to 39 times
f. 40 or more times
53. During the past 30 days, how many times did you use
marijuana on school property?
a. 0 times
b. 1 or 2 times
c. 3 to 9 times
d. 10 to 19 times
e. 20 to 39 times
f. 40 or more times
The next 11 questions ask about cocaine, ecstasy, and
other drugs.
54. During your life, how many times have you used any
form of cocaine, including powder, crack, or freebase?
a. 0 times
b. 1 or 2 times
c. 3 to 9 times
d. 10 to 19 times
e. 20 to 39 times
f. 40 or more times
55. During your life, how many times have you used ecstasy
(MDMA, also called "E" or "X")?
a. 0 times
b. 1 or 2 times
c. 3 to 9 times
d. 10 to 19 times
e. 20 to 39 times
f. 40 or more times
56. During your life, how many times have you used heroin
(also called smack, junk, or China White)?
a. 0 times
b. 1 or 2 times
c. 3 to 9 times
d. 10 to 19 times
e. 20 to 39 times
f. 40 or more times
57. During the past 30 days, how many times did you use
heroin (also called smack, junk, or China White)?
a. 0 times
b. 1 or 2 times
c. 3 to 9 times
d. 10 to 19 times
e. 20 to 39 times
f. 40 or more times
58. During your life, how many times have you used
methamphetamines (also called speed, crystal, crank, or ice)?
a. 0 times
b. 1 or 2 times
c. 3 to 9 times
d. 10 to 19 times
e. 20 to 39 times
f. 40 or more times
59. During your life, how many times have you taken
steroid pills or shots without a doctor's prescription?
a. 0 times
b. 1 or 2 times
c. 3 to 9 times
d. 10 to 19 times
e. 20 to 39 times
f. 40 or more times
60. During your life, how many times have you used any
other type of illegal drug such as inhalants, LSD (acid), PCP, mushrooms,
Ketamine (Special K), Rohypnol (Roofies), or GHB?
a. 0 times
b. 1 or 2 times
c. 3 to 9 times
d. 10 to 19 times
e. 20 to 39 times
f. 40 or more times
61. During your life, how many times have you used a
needle to inject any illegal drug into your body?
a. 0 times
b. 1 time
c. 2 or more times
62. During the past 30 days, how many times did you sniff
glue, breathe the contents of aerosol spray cans, or inhale any paints or
sprays to get high?
a. 0 times
b. 1 or 2 times
c. 3 to 9 times
d. 10 to 19 times
e. 20 to 39 times
f. 40 or more times
63. During the past 30 days, how many times did you use
any illegal drug other than marijuana, heroin, or inhalants? This
includes any drug such as cocaine, methamphetamines, ecstasy, or other
illegal drugs.
a. 0 times
b. 1 or 2 times
c. 3 to 9 times
d. 10 to 19 times
e. 20 to 39 times
f. 40 or more times
64. During the past 12 months, has anyone offered, sold,
or given you an illegal drug on school property?
a. Yes
b. No
The next 4 questions concern communication and education
about sexuality, AIDS prevention, and other health education.
65. During the past 12 months, about how often have you
had a conversation with your parents or other adults in your family about
sexuality or ways to prevent HIV infection, other sexually transmitted
diseases (STDs) or pregnancy?
a. Not at all in the past 12 months
b. About once in the past 12 months
c. About once every few months
d. About once a month
e. More than once a month
66. Have you ever been taught about AIDS or HIV infection
in school?
a. Yes
b. No
c. Not sure
67. In school, have you ever been taught how to use
condoms?
a. Yes
b. No
c. Not sure
68. Have you had any health education in school this
year?
a. Yes, I had health education in a health
course.
b. Yes, I had health education in a wellness
course (such as a combined PE and health course).
c. Yes, I had health education in another
subject course (such as science or social studies).
d. No, I have not had any health education this
year.
The next 12 questions concern
sexual behavior.
69. Have you ever had sexual intercourse?
a. Yes
b. No
70. How old were you when you had sexual intercourse for
the first time?
a. I have never had sexual intercourse
b. 11 years old or younger
c. 12 years old
d. 13 years old
e. 14 years old
f. 15 years old
g. 16 years old
h. 17 years old or older
71. During your life, with how many people have you had
sexual intercourse?
a. I have never had sexual intercourse
b. 1 person
c. 2 people
d. 3 people
e. 4 people
f. 5 people
g. 6 or more people
72. During the past 3 months, with how many people did you
have sexual intercourse?
a. I have never had sexual intercourse
b. I have had sexual intercourse, but not
during the past 3 months
c. 1 person
d. 2 people
e. 3 people
f. 4 people
g. 5 people
h. 6 or more people
73. During your life, the person(s) with whom you have had
sexual contact is (are)…
a. I have not had sexual contact with
anyone
b. Female(s)
c. Male(s)
d. Female(s) and male(s)
74. Did you drink alcohol or use drugs before you had
sexual intercourse the last time?
a. I have never had sexual intercourse
b. Yes
c. No
75. The last time you had sexual intercourse, did you or
your partner use a condom?
a. I have never had sexual intercourse
b. Yes
c. No
76. The last time you had sexual intercourse, what one
method did you or your partner use to prevent pregnancy? (Select only one
response.)
a. I have never had sexual intercourse
b. No method was used to prevent pregnancy
c. Birth control pills
d. Condoms
e. Depo-Provera (injectable birth control)
f. Withdrawal
g. Some other method
h. Not sure
77. How many times have you been pregnant or gotten
someone pregnant?
a. 0 times
b. 1 time
c. 2 or more times
d. Not sure
78. Have you ever been tested for HIV infection or other
sexually transmitted diseases (STDs) such as genital herpes, chlamydia,
syphilis, or genital warts?
a. No, I have never been tested for HIV or
other STDs.
b. Yes, I have been tested for HIV.
c. Yes, I have been tested for other STDs.
d. Yes, I have been tested for both HIV and for
other STDs.
79. Have you ever been told by a doctor or other health
care professional that you had HIV infection or any other sexually
transmitted disease (STD)?
a. No
b. Yes
80. Has anyone ever had sexual contact with you against
your will?
a. No one has ever had sexual contact with me
against my will
b. Yes, within the past 12 months
c. Yes, more than 12 months ago
d. Yes, both "b" and "c"
The next 6 questions ask about body weight.
81. How do you describe your weight?
a. Very underweight
b. Slightly underweight
c. About the right weight
d. Slightly overweight
e. Very overweight
82. Which of the following are you trying to do about your
weight?
a. Lose weight
b. Gain weight
c. Stay the same weight
d. I am not trying to do anything about my
weight.
83. During the past 30 days, did you exercise or eat less
food, fewer calories, or foods low in fat to lose weight or to keep from
gaining weight?
a. Yes, I exercised.
b. Yes, I ate less food, fewer calories, or
foods low in fat.
c. Yes, I both exercised and ate less food,
fewer calories, or foods low in fat.
d. No, I did not exercise or eat less food,
fewer calories, or foods low in fat.
84. During the past 30 days, did you go without eating for
24 hours or more (also called fasting) to lose weight or to keep from
gaining weight?
a. Yes
b. No
85. During the past 30 days, did you take any diet pills,
powders, or liquids without a doctor's advice to lose weight or to keep
from gaining weight? (Do not include meal replacement products such as
Slim Fast.)
a. Yes
b. No
86. During the past 30 days, did you vomit or take
laxatives to lose weight or to keep from gaining weight?
a. Yes
b. No
The next 6 questions ask about food you ate or drank
during the past 7 days. Think about all the meals and snacks you had
from the time you got up until you went to bed. Be sure to include food
you ate at home, at school, at restaurants, or anywhere else.
87. During the past 7 days, how many times did you eat
fruit or drink 100% fruit juices? (Do not count punch, Kool-Aid, sports
drinks, or other fruit-flavored drinks.)
a. I did not eat fruit or drink 100% fruit
juice during the past 7 days
b. 1 to 3 times during the past 7 days
c. 4 to 6 times during the past 7 days
d. 1 time per day
e. 2 times per day
f. 3 times per day
g. 4 or more times per day
88. During the past 7 days, how many times did you eat
green salad?
a. I did not eat green salad during the past 7
days
b. 1 to 3 times during the past 7 days
c. 4 to 6 times during the past 7 days
d. 1 time per day
e. 2 times per day
f. 3 times per day
g. 4 or more times per day
89. During the past 7 days, how many times did you eat
potatoes? (Do not count french fries, fried potatoes, or potato
chips.)
a. I did not eat potatoes during the past 7
days
b. 1 to 3 times during the past 7 days
c. 4 to 6 times during the past 7 days
d. 1 time per day
e. 2 times per day
f. 3 times per day
g. 4 or more times per day
90. During the past 7 days, how many times did you eat
other vegetables such as carrots, peas, broccoli, etc.? (Do not count
green salad or potatoes.)
a. I did not eat other vegetables during the
past 7 days
b. 1 to 3 times during the past 7 days
c. 4 to 6 times during the past 7 days
d. 1 time per day
e. 2 times per day
f. 3 times per day
g. 4 or more times per day
91. During the past 7 days, how many glasses of milk did
you drink? (Include the milk you drank in a glass or cup, from a carton,
or with cereal. Count the half pint of milk served at school as equal to
one glass.)
a. I did not drink milk during the past 7
days
b. 1 to 3 glasses during the past 7 days
c. 4 to 6 glasses during the past 7 days
d. 1 glass per day
e. 2 glasses per day
f. 3 glasses per day
g. 4 or more glasses per day
92. On how many of the past 7 days did you eat breakfast?
a. 0 days
b. 1 day
c. 2 days
d. 3 days
e. 4 days
f. 5 days
g. 6 days
h. 7 days
The next 4 questions ask about physical activity.
93. On how many of the past 7 days did you exercise or
participate in physical activity for at least 20 minutes that made you
sweat and breathe hard, such as basketball, soccer, running, swimming
laps, fast bicycling, fast dancing, or similar aerobic activities?
a. 0 days
b. 1 day
c. 2 days
d. 3 days
e. 4 days
f. 5 days
g. 6 days
h. 7 days
94. On how many of the past 7 days did you participate in
physical activity for at least 30 minutes that did not make you sweat or
breathe hard, such as fast walking, slow bicycling, skating, pushing a
lawn mower, or mopping floors?
a. 0 days
b. 1 day
c. 2 days
d. 3 days
e. 4 days
f. 5 days
g. 6 days
h. 7 days
95. In an average week when you are in school, on how many
days do you go to physical education (PE) classes?
a. 0 days
b. 1 day
c. 2 days
d. 3 days
e. 4 days
f. 5 days
The next 4 questions ask about how you spend your free
time.
96. During the past 12 months, on how many sports teams
did you play? (Include any teams run by your school or community
groups.)
a. 0 teams
b. 1 team
c. 2 teams
d. 3 or more teams
97. On an average school day, how many hours do you watch
TV?
a. I do not watch TV on an average school
day
b. Less than 1 hour per day
c. 1 hour per day
d. 2 hours per day
e. 3 hours per day
f. 4 hours per day
g. 5 or more hours per day
98. In an average month, how many hours do you spend on
volunteer work, community service, or helping people outside of your home
without getting paid? (Do not include community service work that you are
required to do as a punishment.)
a. 0 hours
b. 1 to 4 hours
c. 5 to 9 hours
d. 10 or more hours
99. On how many of the past 7 days did you take part in
organized afterschool, evening, or weekend activities (such as school
clubs, community center groups, music/art/dance lessons, drama, church,
or other supervised activities)?
a. 0 days
b. 1 day
c. 2 days
d. 3 days
e. 4 days
f. 5 days
g. 6 days
h. 7 days
THIS IS THE END OF THE SURVEY.
THANK YOU VERY MUCH FOR YOUR HELP.
