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World Health Organization: A Methodology For Student Drug-Use Surveys
World Health Organization: A Methodology For Student Drug-Use Surveys
D ru g -u s e S u rv e y s
R. G . S M A R T P. H . H U G H E S
Addiction Research Foundation, Division of Mental Health, World Health
Toronto, Canada Organization, Geneva, Switzerland
L. D . J O H N S T O N
Survey Research Centre,
University of Michigan,
Ann Arbor, MI, USA
A. A N U M O N Y E UKHANT M A R IA E L E N A M E D IN A M O R A
University of Lagos, Rangoon Psychiatric Mexican Centre of Mental Health
Nigeria Hospital, Burma Studies, Mexico City, Mexico
V. N A V A R A T N A M V IC H A I P O S H Y A C H IN D A V. K . V A R M A
University of Science Chulalongkorn University, Postgraduate Institute
ofMalaysia, Minden, Bangkok, Thailand of Medical Education & Research,
Penang, Malaysia Chandigarh, India
K. A. W A D U D
Pakistan Narcotics Control Board,
Islamabad. Pakistan
1. Introduction ....................................................... 7
1.1 Need for comparability and for a tested questionnaire............ 7
1.5 Nonmedical use of drugs, drug abuse, and drug dependence ......... 9
2. Development of the questionnaire and plan for its testing ............. 10
PREFACE
This report of the WHO Research and Reporting Project on the Epidemiology of Drug
Dependence describes the work of an international team of investigators to improve the
comparability and scientific quality of information on the use of drugs by young people.
In this collaborative study, teams in seven countries developed and tested a "self-adminis
tered drug use questionnaire" — i.e., a questionnaire that may be filled in by the
young people themselves. The object was to develop an operational methodology foruse
in many different settings to assess drug use among young people.
The report describes the study and its conclusions. It provides the general rationale
for the choice of questionnaire items as well as the reasons for using the self-adminis
tered type of questionnaire. In carrying out the study a number of reliability and
validity checks were made and the results of these are reported.
The report of the study is supplemented by a review of the methodology and practical
issues confronting the general researcher or epidemiologist who may be called upon to
implement a self-administered survey on drug use among students or other groups (Annex 1).
The review provides guidelines for selecting the sample and for the administration of
this type of survey, for carrying out checks of reliability and validity, and for ensuring
confidentiality and proper analysis of the data. The finalized questionnaire and instruc
tions for its use are presented in Annexes 2 and 3. Optional questions are listed in
Annex 4. An effort has been made to give practical information on how such studies
should be carried out in order to yield reliable results.
The core items in this questionnaire are comparable to those in other questionnaires
that are being developed by WHO and by the United Nations Division of Narcotic Drugs for
the collection of data on drug abuse. It is hoped that the use of similar methods and
thecollection of comparable data will improve the planning and coordination of inter
vention programmes by permitting national and international comparisons and the exchange
of information on the epidemiology of drug dependence.
Researchers and administrators who are planning surveys of drug use among students,
prisoners, military conscripts, or other youth groups capable of filling in questionnaires
themselves are invited to consider either using the present questionnaire or including its
core items in their studies. In this way, the data from their surveys will be comparable
with those of WHO collaborating investigators and others who may use the questionnaire. To
this end, it would be most helpful if investigators using the questionnaire or selected
items from it would send copies of their study reports, along with a description of the
methods used, to the Division of Mental Health, World Health Organization, 1211 Geneva 27,
Switzerland.
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ACKNOWLEDGEMENTS
The authors acknowledge the financial support given to the project by the United
Nations Fund for Drug Abuse Control and by the participating centres and the governments
concerned. They thank the United Nations Division of Narcotic Drugs for its close
collaboration and the International Narcotics Control Board and International Council on
Alcohol and Addictions for participating in meetings held in connexion with the project.
Thanks are due also to the Addiction Research Foundation, Toronto, Canada, which served as
a coordinating centre by providing special technical support and by analysing the data
for the study.
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1. INTRODUCTION
A large number of excellent surveys of drug use have been carried out among young
people. Unfortunately, it has been difficult to compare the findings because each team of
investigators has tended to gather a different type of data and to employ instruments and
methods different from those used by other teams. This report describes a WHO study that
tackled this issue by bringing together teams of experts from various parts of the world
to agree on the core data items for a student drug-use questionnaire. The object was to
develop a broadly acceptable methodology that would be practical for use in various age
groups and sociocultural settings. The experts were then invited to test the questionnaire
in a variety of languages and settings to determine its general effectiveness, reliability,
and validity. On the basis of the experience gained in testing it in seven countries, the
questionnaire was finalized at a second meeting of collaborating investigators in 1977.
The study was carried out as one of the initial activities of the WHO Research and
Reporting Project on the Epidemiology of Drug Dependence - a project developed in response
to World Health Assembly resolutions WHA23.42 and WHA28.80. The first aim of the project
is to develop instruments and methods to meet the priority data-collecting needs of develop
ing countries with serious problems of drug dependence. In addition to the research
described here, a number of studies have been carried out to develop additional methods of
obtaining information on drug abuse through case-reporting and intensive case-finding
systems, surveys of the general population and of non-student youth, and the evaluation of
methods of treating drug dependence. The results of these studies will be available soon.
To develop and test these methods, a network of collaborating institutions has been
established, primarily in developing countries with serious problems of drug dependence.
This network was mainly responsible for carrying out the present study.
The subject of this report - the development of a methodology for self-administered
surveys of drug use among students - was selected as one of the first priorities of the
project because, in many countries, young people run a high risk of becoming drug-dependent.
Furthermore, the use of self-administered questionnaires for this purpose is well estab
lished. For literate populations, such as students, that may be brought together at one
time and place, such questionnaires offer advantages over other methods - chiefly their low
cost, ease of administration, and relatively high validity and reliability. They may also
be used for postal surveys of incidence and prevalence, for follow-up studies, and to
monitor trends and evaluate prevention programmes.
Data on the rates of drug use found among the young people who participated in the
study are not reported, since the samples in individual countries were small and
unrepresentative of the total youth populations from which they were drawn. However,
because the study was directed towards the development of an operational questionnaire and
methods of using it, results are presented on the reliability and validity of the question
naire. These results showed the questionnaire to have satisfactory reliability and
validity in most settings, but additional methodological work is clearly needed. Some
centres reported that students had difficulty in understanding certain questions and were
not familiar with the questionnaire format originally presented. The questionnaire was
revised accordingly and its final version contains improvements in both questions and
format.
1.1 Need for comparability and for a tested questionnaire
The student drug-use survey is the most common form of epidemiological study of
drug abuse. A number of such surveys based on excellent methodology have been carried
out, though mostly in developed countries. Because planners in developing countries are
becoming increasingly interested in obtaining information on the use of drugs by young
people, there is a need for a practical methodology that could be adapted to most socio
cultural settings and applied at a relatively low cost. To be useful in developing
countries, such a methodology should yield reasonably reliable results in the hands of
researchers or epidemiologists who may not be experts in the special field of drug abuse.
An internationally acceptable methodology would also help to meet the need for compara
bility of epidemiological information on drug abuse. Until now, it has been the tendency
for each investigator to develop and use his own instrument and methods for assessing drug
abuse. For this reason, it has not been possible to compare the results of studies from
different countries, and it is rarely possible even to compare the studies of different
investigators within the same country. Such comparisons are important for planners, who
must examine trends over time in order to assess the effectiveness of legal, educational,
and treatment programmes. Drug use trends need to be compared and monitored both within
and between countries, but no methods are available for doing so.
At the international level, comparability of data would permit (1) the identifi
cation of real differences in the extent, patterns, and trends of drug use in different
sociocultural settings, and (2), where demographic and other explanatory variables occur
regularly, the possible identification of basic causal factors that are not peculiar to
particular settings.
For many years, people have been enquiring about the use of alcohol and drugs in
various populations. The method most frequently used is now the anonymous self-administered
questionnaire. This is popular for a number of reasons: it is inexpensive; it requires no
interviewers, since respondents complete the questionnaire themselves; it can be distri
buted quickly to large groups of literate persons; and the. data that it yields may be
processed relatively inexpensively and efficiently because the questions asked are usually
straightforward and their answers easily interpreted..
Self-administered surveys of drug use among young people have been conducted in many
countries. A partial list of such surveys is to be found in the reviews by Mercer &
Smart (1) and by Blumberg (2). Recent studies of students, by means of self-report
questionnaires, have also been carried out in many developing countries, including
Colombia (3), India (40, Malaysia (5), Mexico (6), and Thailand (7).
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1.3 Advantages and disadvantages of self-administered surveys
Like any other method, the self-administered survey has advantages and disadvantages.
Its overwhelming advantage is surely its relatively low cost. The method may be used with
populations of 10 000 or more, at a fraction of the field cost of an interview study,
depending, of course, on the salaries paid to interviewers and the geographical dispersion
of the population. The method is well accepted in many parts of the world and refusal
rates are often below 1%. In contrast, refusal rates in household surveys are frequently
20-30% and in postal surveys non-completion rates are typically 50-60%.
Many researchers would argue that the self-administered survey is the best way to
obtain information about private behaviour because the information may be obtained anony
mously. The method may also take advantage of the efficient technology available for
data processing, such as machine-readable and other easily processed forms. This expedites
data handling at every stage, tends to reduce costs and labour, and makes surveys of
large populations more manageable.
The limitations of the approach include the considerable technical skills, personnel
and equipment required for large-scale studies, e.g., of 3000 or more subjects, which might
not be available regularly in most developing countries. The skills involved are those
required for sampling, questionnaire administration, coding, and data analysis. Data
processing and handling are greatly facilitated if a computer is available for studies with
more than about 500 subjects and 30 or more questions. In addition, there are some
unsolved problems with reliability and validity, which will be discussed in detail later.
1.4 Youth populations suitable for this type of survey
In practice, the self-administered survey is typically used for studies of students,
soldiers, and prisoners, since these groups can be readily convened for survey administra
tion. The method is best used in situations where cooperation may be expected from the
participants as a matter of routine. Where cooperation is unlikely to be obtained without
individually tailored explanations, interview surveys are preferable. Within the field of
alcohol and drug research, most surveys of this type have been carried out on high-school
and college students — see reviews by Berg (8) and Mercer & Smart (_1). However, such
surveys have also been made on primary-school children (9) and in military groups and
prison populations (10).
A Working Group on Encouraging Comparability in Drug Use Surveys of Young People was
held in Geneva from 19 to 21 September 1976 to plan a WHO collaborative effort in that
field. A model self-administered questionnaire for use among students was to be developed
and tested in several countries by the centres participating in the trial. The main
purposes of the study were to determine whether comparable data on drug use in young people
might be obtained by means of the questionnaire and whether the answers given would be
reliable and valid.
2.1 General plan for the project
In each of the countries, some 300 students of both sexes, living in various environ
ments, were to complete the questionnaire. This was to be given to them anonymously
except when used to check the reliability of answers (in a test-retest reliability study).
In the latter case, the questionnaires were to be identified, e.g., by number, in order to
allow the first questionnaire to be matched with a second one given 4-8 weeks later. About
100 students were to be retested at each centre.
Validity studies also were planned. For this purpose, a lie scale and questions
asking the students whether they had responded honestly were included in the questionnaire.
At one centre, comparisons were made between self-report and interview methods and between
students from schools believed to have high and low drug use.
Pilot testing would permit centres with limited resources to determine the feasibility
and difficulties of student drug use surveys. Furthermore, a simultaneous study by teams
of investigators in a wide range of countries would permit a coordinated effort leading to
the revision of questionnaires and procedures so that they might be usable in most parts of
the world.
2.2 Rationale for the selection of data items and organization of the questionnaire
It was expected that most centres would need to keep their questionnaires short in
order to hold the interest of respondents, to minimize interference with school work, and
to reduce costs. It was therefore decided to develop a questionnaire with separate units
or blocks of items, some of which were essential or "core" items and others optional. All
centres were to test the core items and optional items of particular interest. Table 1
shows the structure of the questionnaire and the main areas covered.
Core questionnaire
Originally, 32 core items were chosen to give the essential demographic, drug-use, and
validity information. In order to ensure comparability with other WHO data-collecting
activities on drug abuse, many of the items were derived from a set of core data items
previously agreed by the collaborating investigators to be the minimum essential informa
tion required by planners of drug-abuse programmes. Most of the core items on the youth
survey questionnaire are therefore comparable with items on other WHO questionnaires for
collecting data on drug abuse and on those of the United Nations Division of Narcotic
Drugs (13)■
The demographic items included the basic variables of age, sex, and years of schooling.
For an understanding of drug use among young people, it was considered important also to
know the duration of parental education as a measure of socioeconomic status, and whether
the respondent was working full-time or part-time in addition to being at school.
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TABLE 1. CLASSIFICATION OF VARIABLES
Priority Drug-related
levels for 10 drug classes Demographic Other
**Further items and variables of possible interest to investigators may be obtained from
the review of Nehemkis et al. (11) or Elinson & Nurco (12) and from reference to papers
in the reviews by Mercer & Smart (1) or Blumberg (2).
Out of the large number of possible questions on drug abuse, a few were chosen. These
asked if a particular type of drug had ever been used, if it had been used in the past year
or in the past 30 days, and at what age it had first been used. The 10 types of drug
enquired about were:
tobacco hallucinogens
alcohol inhalants
cannabis tranquillizers
amphetamine or other sedatives
stimulants opiates
cocaine
Because of the importance of heroin and other opiates, such as methadone, morphine, and
codeine, additional questions were included on three subclasses of opiate. Most of these
items have been retained in the final questionnaire (see Annex 1).
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In order to facilitate the collection and analysis of data, WHO invited the Addiction
Research Foundation, Toronto, Canada, (one of the 7 collaborating institutions) to serve
as the coordinating centre for the study. Its tasks were to: (1) finalize the core
questionnaire and instructions for its use, (2) send copies of each to collaborating
investigators, (3) receive data collected by collaborators, (4) key-punch IBM cards for the
core questionnaire items, and (5) prepare analyses of the data.
The analyses performed by the coordinating centre included: (1) frequency of users by
centre for each drug; (2) frequency of drug use, age of first use for each drug in each
centre; (3) frequencies for all demographic items; (4) cross-tabulation of demographic
characteristics, validity questions, and reliability scores for each type of drug use;
and (5) multivariate analysis of the validity and lie scale items as predictors of drug use.
It was planned that each collaborating centre should be responsible for analysing its
own data on test-retest reliability from centres in countries other than Canada. It was
originally thought that, because of the limited time available, this would be too difficult
to do at long range. In retrospect, it seems that the analysis of these data should also
have been centrally managed, since only three centres reported reliability test results.
Islamabad centre. The Pakistan Narcotics Control Board is the national coordinating
agency for drug-abuse prevention, treatment, and control activities in the country. It is
responsible for implementing the WHO component of the United Nations Pakistan Programme on
Prevention and Treatment of Drug Dependence, supported by the United Nations Fund for Drug
Abuse Control. Pakistan is a country with a large population of opium and cannabis users,
with increasing use of psychotropic substances during recent years.
Lagos centre. The Department of Psychiatry of the University of Lagos had prior
experience in conducting drug-abuse surveys of young people. While drug abuse in Nigeria is
not as serious as in many other countries, there is moderate use of cannabis and psycho
tropic drugs. This appears to be a common pattern of drug abuse in many African countries.
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Mexico City centre. The Mexican Drug Dependence Centre was invited to participate
because of its expertise in drug—abuse surveys. The centre serves as the national
coordinating organization for drug-ahuse research, training, <jmd prevention activities in
Mexico and is a WHO collaborating centre for drug dependence. It has established
communications with investigators and governments in other Latin American countries, which
will facilitate dissemination of the results of WHO collaborative studies. Drug abuse in
Mexico City at the time of this study involved primarily the use of cannabis and psycho
tropic drugs by adolescents and young adults and the use of inhalants among children.
Penang centre. The Drug Abuse Research Project at the University of Science of
Malaysia has recently been designated as the Malaysian National Drug Dependence Research
Centre. The university has expertise and experience in drug-use surveys of young people,
and is responsible for implementing a national integrated data-reporting system for
problems of drug abuse. In addition to the long-standing traditional use of opium and
cannabis, the country has experienced in recent years a serious spread of heroin among
urban youth, as well as the increasing use of psychotropic substances.
Rangoon centre. The Rangoon Psychiatric Hospital of the Burmese Ministry of Health is
developing a programme of epidemiological and treatment evaluation research in drug depen
dence. Technical personnel in the Ministry are responsible for implementing the WHO
component of the United Nations/Burma Programme on Prevention and Treatment of Drug Depen
dence, which is supported by the United Nations Fund for Drug Abuse Control. The problem
of drug abuse in Burma includes the traditional use of opium among rural populations and,
in recent years, the use of heroin and psychotropic substances among urban youth.
The network of centres involved in this WHO study thus represents most regions of the
world, and most of the centres are in developing countries. The participants included
key technical personnel involved in implementing the WHO/United Nations country programmes
on the prevention and control of drug dependence in countries of the Eastern Mediterranean
and South-East Asia. The centres had varying degrees of expertise in the type of research
that was to be undertaken, and could be expected to identify the kinds of problem
encountered in such a study in developing countries.
Since this study was implemented, the functions of the centre have been expanded to
include activities in the field of mental health, and the centre is now called the Mexican
Centre of Mental Health Studies.
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3. RESULTS OF TESTING THE QUESTIONNAIRE IN SEVEN COUNTRIES
Approximately 300 questionnaires were handed out by each of the seven centres. Most
of the subjects surveyed were students, but the range in age, level of education, and
cultural setting permitted the questionnaire to be tested under widely varying circum
stances.
Of the 2118 questionnaires received from the seven centres, 463 (21%) were excluded
because of incomplete or inconsistent responses, leaving a total of 1655 for analysis.
The criterion for excluding questionnaires was the presence of four or more blanks or
inconsistent responses. For example, if a student answered that he had used a given drug
in the past month but not in the last year, his response was inconsistent.
3.1 Overview of testing experience at each centre
Chandigarh centre. Both Hindi and English questionnaires were used. Data were sent
for 411 students in primary and secondary schools and universities. The original sample
was reduced to 309 by deleting every fourth questionnaire. A further 53 were eliminated
because of incomplete or inconsistent responses, leaving a total of 256 for analysis.
Islamabad centre. The questionnaire was translated into Urdu and used in a bilingual
(English/Urdu) version. Two college student groups were sampled, plus some persons in
households. Of 329 questionnaires, 88 were eliminated because of inadequate responses,
leaving 241.
Lagos centre. The questionnaire was given in English to students in five post
secondary schools and universities. Of the 312 students surveyed,177 wereeliminated
because of blanks and inconsistencies. The final sample was135. Most ofthe blanks
and inconsistencies were on the items dealing with the use ofheroin and other opiates.
Because these drugs are rarely used in Nigeria, students weresimply not familiar with them
and chose either to leave these questions blank or to answer them inconsistently. There
were no other major difficulties with the survey.
Mexico City centre. The questionnaire was in Spanish. The study population was 335
pupils from several secondary schools. Many of the children had no previous experience with
instructions to skip certain items that did not apply. Instead they skipped entire sections
of the questionnaire. This contributed to the elimination of 106 questionnaires because of
blanks and inconsistencies, leaving 229. Both validity and reliability studies were
performed.
Penang centre. The questionnaire was translated into Malay, Chinese, and Tamil. A
stratified sample of 300 students was selected from two schools and 100 of these students
were retested 5 weeks later. No questionnaires were deleted because of blanks or inconsist
encies. The main problems encountered in the pilot study were that: (1) the format of
the tested questionnaire was not consistent with local practice, (2) translations were often
too literal, and (3) students found it difficult to follow the instruction to skip certain
questions.
Rangoon centre. The questionnaires were given in English. In all, 300 were given,
only 3 of which were eliminated because of blanks or inconsistencies. The questionnaires
were distributed in secondary schools believed to have high, low, and intermediate levels of
drug use.
At the Penang centre the questionnaire was administered to 150 students on two
occasions 5 weeks apart. The coefficients of association for the drug-use questions were
all significant except for alcohol and methaqualone (included as an optional item). It
may be that translation difficulties contributed to the lower statistical association for
these drugs. Consistency between tests was best for those with higher education levels.
In Toronto questionnaires were administered to 197 students on two occasions 8 weeks
apart. Students did not sign their names and a numbering system was used to compare
questionnaires for the same student from the two tests. Students' answers to demographic
questions were nearly identical at both tests. For the drug—use questions "ever used" and
"used in past 12 months", the correspondence was very high; for both sets of questions,
more than 90% of students gave the same answers at both tests. As expected, answers to
the questions on drug use in the last 30 days were less consistent. A drug-use score
comprising all reported drug use (ranging up to 96) showed a correlation of 0.88 Q?<.001)
for the two tests. However the lie-score correlation was only 0.53 (P'xO.OOl), indicating
somewhat lower reliability for the lie scale.
In Mexico City, the questionnaires we^e administered to 294 students on two occasions
about 6 weeks apart. Pearson correlations were calculated for all drugs except opium and
heroin, since there were too few answers for these two drugs to calculate correlations.
For the other drugs, the correlations ranged from 0.30 to 0.71, and all but one were over
0.60. This indicates relatively high reliability for drug-use items.
In summary, the test-retest studies at the three centres suggest generally high
reliability of answers to drug-use questions, except for rarely used drugs and some items
that might involve translation difficulties.
With this system two questionnaires are prepared, each with the student's name and
unique number typed on a two-part label, the part with the name being detachable. In class,
the student tears off the part with his name, leaving the number on the questionnaire on
both occasions when he completes the questionnaire. Of course, it is necessary to be sure
that students receive questionnaires with the same number at the first and second tests.
The numbers are used to bring together each student's questionnaires from the two tests.
Thus the student's name is not associated with his answers to drug questions and confiden
tiality is maintained.
2
The Pearson product moment correlation coefficient varies from -1 through 0 to +1.
A coefficient of -1 indicates a high negative relationship, 0 none at all, and +1 a high
positive relationship.
TABLE 2. CHARACTERISTICS OF STUDY POPULATIONS
Centre Language Level of Questionnaires Questionnaires Sex Median age
student received analysed M F (years)
Penang Chinese
Malay
Tamil Secondary 300 300 150 150 15-16
Two honesty questions were selected for testing on the prototype questionnaire. The
first was: "If you had ever used any cannabis /local term/, do you think that you would
have said so in this questionnaire?" The second asked the same about "opium or heroin".
The possible answers were "No", "Not sure", and "Yes". The aim of asking these questions
was to have some indication of the level of honesty or defensiveness in the students'
replies. Table 3 shows the response to these two questions in the countries concerned.
Overall, 68% said that they would have reported the use of cannabis, 18% said "No", and 14%
were "Not sure". The figures were much the same for opium or heroin: 68% said "Yes", i.e.,
they would have reported honestly, 19% said "No", and 13% were "Not sure". Thus only a
minority of the total population stated that they wouldnot report the use of cannabis or
of opium or heroin on the questionnaire.
However, there was considerable variation from one centre to another in the proportions
of students that would have answered honestly about their use of drugs. For all but two
centres (Table 3), more than 70% of the students said they would have admitted to using
cannabis, and less than 20% stated they would not have admitted using it. Findings for the
opium/heroin question were similar; in all but the same two countries, over 70% would have
admitted to using opium/heroin and less than 20% stated that they would not have admitted
doing so. These findings suggest that the questionnaire had some validity in most of the
centres involved.
Data from honesty questions were also examined for users andnon-users of drugs sep
arately. Those who answered untruthfully might be expected to report less use of all drugs
than those who were truthful. This expectation was borne out by the data, which showed that
students who said they would not have reported honestly were less likely to report the use
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TABLE 3. COMPARISON OF ANSWERS TO THE HONESTY ITEMS IN DIFFERENT COUNTRIES*
*The table does not include data from students with two or more "problem" answers
to the nine-item lie scale.
of tobacco, alcohol, and cannabis. They were also less likely to report the use of each of
the other 9 drugs, though few of the differences are statistically significant. The find
ings were similar for those who would have admitted to using opium or heroin. Furthermore,
both groups — those who would and those who would not have reported the use of opium or
heroin — did, in fact, report the same frequency of use of heroin, opiates, and opium.
Lie scale scores. The Eysenck lie scale (14) was included as a measure of defensive
ness and has been used in a number of studies. The scale consists of nine questions that
have been shown to yield highly reliable and valid answers.
All centres except one were found to have 40% or more students with high lie scores.
This is an unexpected result and is almost certainly due to cultural or social variations
in the way in which these questions are read and understood. It was found also that lie
scores did not differentiate between users and non-users of drugs in a practically useful
way. For these reasons, it was the view of the majority of the collaborating investigators
that the lie scale, without additional methodological work, appears to have limited useful
ness as a validity check for the prototype questionnaire.
Special studies of validity. Three special studies of validity were carried out by
the Mexico City centre. In one study, 50 students drawn from schools with a high preva
lence of drug use (according to school officials and official records) were compared with
50 students from low-prevalence schools. The results were in the expected direction.
Those in the high-prevalence schools reported rates of drug use 5 to 15 times as high as
those reported for the low-prevalence schools. Though these findings do not prove the
accuracy of answers to the questionnaire, they show that the questionnaire yielded responses
indicating more frequent drug use when other information suggested that there was, in fact,
more frequent drug use.
In another study, the answers to core questions were obtained from the same subjects
by two different methods of data collecting — i.e., by a personal interview followed one
week later by the self-administered questionnaire. The subjects were 50 young males in
training schools for delinquents. For one-half of the drugs (alcohol, cocaine, tranquil
lizers, opium, heroin, and other opiates), the total proportion of respondents reporting
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lifetime use was identical or within 3% on both occasions. The largest deviation for any
drug used on the two occasions was 9%. There was no consistent tendency for either data-
collecting method — i.e., questionnaire or interview - to give higher or lower results.
The third study carried out by the Mexico centre compared three methods of gathering
data on drug use among employees of the same business establishments. The methods were
(1) the seIf-administered questionnaire, (2) administration of the questionnaire at personal
interviews, and (3) obtaining estimates of the number of drug users among fellow employees.
All three methods were applied to the same small group of people and yielded very similar
results for both current and lifetime use of drugs.
Thus the results from the Mexico City centre support the validity of the questionnaire
findings, at least for the populations for which validity was checked.
3.5 Summary of results
Individual centres might be expected to have difficulties with various aspects of the
questionnaire. A wide range of countries was involved in the studies, and the testing
included both developing and developed countries. For a number of countries, the question
naire needed to be translated; others have little experience with self-administered
studies. In some countries, studies are further complicated by the cultural and social
diversity.
In general, collaborating investigators found that the questionnaire worked well with
student groups. It was found to have test-retest reliability in three centres and it gave
generally valid results in one centre where special validity checks were used. However,
there was agreement that use of the questionnaire raised certain general problems in
addition to particular problems encountered by individual centres. These problems were as
follows :
1. A lie scale was included in the tested questionnaire, but the items were difficult and
confusing for many students. Cultural and national problems in interpreting the results
made the scale difficult to use. Also, it was found to be somewhat less reliable than
other parts of the questionnaire. Furthermore, the lie scale had been developed especially
for use in the United Kingdom on students somewhat older than those in this study. For
these reasons, the lie scale was dropped from the final version of the questionnaire.
2. The "skip" instructions were confusing to many subjects in some countries, as has
already been mentioned. The format of the questionnaire was therefore changed so that the
student is required to answer every question on drug use. Now that the "skip" instructions
have been omitted from the final questionnaire, there should be fewer blank and inconsistent
responses.
A number of less serious problems were reported by some centres :
3. Investigators in Burma, Pakistan, and Thailand observed that the level of parental
education was not a good indicator of social status in those countries. Furthermore, it is
a culturally accepted pattern not to possess information of this type or, at least, not to
repeat it to strangers.
4. In Mexico City, the question about the type of community in which the respondent lived
proved impossible to answer. This question had no meaning for many respondents who do not
differentiate between living in cities, towns, or suburbs. Indeed large cities in some of
the collaborating countries do not have suburbs as seen in North America and some European
countries. Some of these cities also have small, semirural, village-like communities
within their limits, and this contributed to the difficulty that respondents had in
answering the question.
5. In Lagos, students often did not know their age, since births are often not registered
in Nigeria, and few accurate records of ages are kept.
- 20 -
6. In Penang, the questionnaire was translated into several languages some of which did
not have words for various types of drug (e.g., sedatives, tranquillizers) or their effects
(e.g., to settle the nerves).
7. Investigators in Mexico and Pakistan found that it was necessary to drop some descrip
tions of drugs and to omit completely drugs that are rarely used, because school officials
feared that to include them would encourage drug use.
8. In Nigeria and Thailand, at the time of the study, almost all drugs could be purchased
without a prescription. Thus the concept of "nonmedical" use or use without the advice of
a health worker would not suggest that the drug was obtained on the illicit market, as it
does in some settings.
9. In India, it was the impression of investigators that respondents often did not under
stand the questions_dealing with honesty of reporting — e.g., "Ifyou had ever used cannabis
/or opium or heroin/, do you think that you would have admitted itin this questionnaire?".
When asked these questions at interviews, many respondents found that they were too hypo
thetical and simply indicated that they had answered the questionsonthe use of these drugs
earlier. They then generally repeated their earlier answers.
The revised questionnaire (Annex 2) is being made available for use in countries where
self-reported measurements of drug use are needed. No other drug-use questionnaire has
been tried out in so many countries. The evidence of its validity and reliability should
generate some confidence in the use of this questionnaire in national and international
studies. Nevertheless, investigators planning to use the questionnaire should test its
validity and reliability in the particular settings where it will be used. It might also
be desirable to add to the core elements described here, in accordance with local needs or
interests. In addition, investigators might wish to add some of the optional items
suggested in Annex 4, such as those concerned with drug availability and the reasons for
use.
The revised questionnaire described in this report may be used in the following types
of study: (1) assessment of the prevalence of drug use in the populations studied at a
particular point in time, (2) comparison of trends in various types of drug use through
repeated surveys over time, (3) comparison of factors associated with drug use and
identification of high-risk groups, (4) assessment of the impact of changes in drug
policies or legislation on drug use, and (5) assessment of the effects of preventive
programmes through surveys of drug use before and after the programmes have been implemen
ted .
As pointed out earlier, this type of questionnaire is best used with high-risk
literate populations that can be readily brought together at one time and place. Students,
soldiers, and prisoners are therefore the most likely subjects for study. The question
naire may have to be translated into several languages if used in certain countries.
The self-administered survey is not often used to study groups or patients making
heavy use of drugs. These populations are generally studied in smaller numbers and in
greater depth through clinical interviews, psychological tests, or field observations (15).
It is rarely used for general adult populations, which are most frequently studied by means
of personal interviews or household surveys.
The questionnaire may also be used in postal surveys of drug use (16). The problem
with such surveys is that the number of questionnaires returned is frequently low, rates
below 50% being common. Although there have been no reliability studies with mailed drug-
use surveys, these may be used as an adjunct to school studies to obtain information from
students who are absent or who have recently dropped out of school. They may also be used
in general population surveys and follow-up studies, when subjects cannot be contacted
after repeated visits to their homes. However, there are likely to be serious difficulties
in conducting postal surveys in countries with low levels of literacy and with unreliable
postal services.
Further work to improve the validity and reliability of the current questionnaire
might also be considered. For example, test-retest reliability studies might be made
during a longer period - perhaps up to a year - or test results might be compared with
evidence of drug use from observers or official sources.
Annex 1
S a m p li n g , w ith s p e c ia l r e fe r e n c e to young p e o p le
T h e m a in ta s k in s a m p lin g is to s e le c t a g ro u p of p e o p le who a re r e p r e s e n t a t iv e of th e
to ta l or s p e c ia l p o p u la t io n of in t e r e s t in te rm s of its c h ie f c h a r a c te r is tic s . The v a r io u s
w a y s i n w h ic h s a m p lin g c a n b e d o n e h a v e b e e n t h e o b je c t o f d e t a i l e d r e v ie w s ( 1 7 , 1 8 ).
T h e se g u id e lin e s c o v e r o n ly t h e m a jo r c o n s id e r a t i o n s d i r e c t l y r e l a t e d t o s u r v e y s o f th e use
of a lc o h o l and d ru g s in s tu d e n t and o th e r y o u th p o p u la tio n s .
T o o o f t e n t h e p r o c e d u r e s u s e d f o r s a m p le s e le c t io n a r e n o t in c lu d e d i n s tu d y re p o rts .
For e x a m p le s o f s t u d i e s i n w h i c h t h e s a m p l i n g a p p ro a c h e s a r e d e s c r ib e d i n d e t a i l , th e
re a d e r is re fe rre d to R u s s e ll & H o lla n d e r (2 0 ), C h a m p io n (2 1 ), and J o h n s to n (2 2 ).
If, h o w e v e r, it is d e c id e d th a t a s a m p le is r e q u ir e d , th e s p e c if ic p o p u la tio n of
in t e r e s t m u s t be d e fin e d w ith th e n e c e s s a ry e x a c titu d e b e fo re an a p p r o p r ia te s a m p lin g schem e
ca n be c o n s tru c te d .
- 23 -
C o n s id e r a tio n s , i n s e le c t io n of s a m p le s iz e . The o b je c t of th e s a m p lin g schem e is to
y ie ld th e m o s t p r e c is e e s tim a te s of d ru g use p o s s ib le w ith in a g iv e n b u d g e t. In c h o o s in g a
schem e, s e v e ra l fa c to rs need to be c o n s id e r e d :
If th e p r e v a le n c e of use v a r ie s b e tw e e n s u b g ro u p s , it m ay b e d e s ir a b le to s e le c t
g r e a te r - th a n - p r o p o r tio n a l s a m p le s iz e s in s u b g ro u p s w h e re th e p r e v a le n c e is lo w . T h is
w ill e n s u re e q u a l p r e c is io n of p r e v a le n c e e s tim a te s in a ll s u b g r o u p in g .
I f th e p o p u la tio n is to be d iv id e d in t o s u b g ro u p s , in f o r m a t io n i s n e e d e d o n th e
s u b g ro u p s ta t u s f o r e a c h p e rs o n on th e l i s t . S uch l i s t s m ay b e v e r y c o s t l y o r im p o s s ib le
to o b ta in , h o w e v e r, and v e ry o fte n th e in f o r m a t io n needed to a s s ig n a p e rs o n to a s u b g ro u p
is not a v a ila b le . If, fo r e x a m p le , th e p o p u la tio n of in te r e s t is h ig h - s c h o o l y o u th in a
c e r ta in c ity , and no s u b g ro u p s of s tu d e n ts a re to be s tu d ie d , a lis tin g m ig h t be a v a ila b le
or c o m p ile d r e la t iv e ly q u ic k ly and c h e a p ly . If, on th e o th e r hand, s e p a ra te e s tim a te s
w e re r e q u ir e d fo r d iffe r e n c e s in d ru g use a c c o r d in g to sex, age, and s o c io e c o n o m ic s ta tu s ,
in f o r m a t io n on th e fir s t tw o v a r i a b l e s m ig h t b e r o u t i n e l y a v a ila b le ; in f o r m a t io n on th e
th ir d w o u ld g e n e r a lly becom e kno w n o n ly by a s p e c ia l e n q u ir y and c o m p ila tio n .
(d ) S a m p le d e s i g n i s a l s o a f f e c t e d b y a d m i n i s t r a t i v e c o n s id e r a t io n s . The s p o n s o r o f th e
s t u d y m a y g i v e r e a d y a c c e s s t o som e g r o u p s o f y o u t h s , b u t n o t to o th e rs . S tu d y , w o r k , o r
t r a i n i n g s c h e d u le s o f th e re s p o n d e n ts m ay d i c t a t e th e s e le c t io n o f a d m in is t r a t iv e ly d e fin e d
g ro u p s su ch as s c h o o l c la s s e s , f a c t o r y d e p a rtm e n ts , and m i l i t a r y s u b u n its , r a t h e r th a n a
s e le c t io n of p e rs o n s c u t t in g a c ro s s th e s e a d m in is tr a tiv e b o u n d a r ie s .
- 24 -
Types of s a m p lin g d e s ig n . The b a s ic c o n c e p t u n d e r ly in g a ll fo rm s of s c ie n t if ic
s a m p lin g is th a t of th e p r o b a b ilit y s a m p le . A p r o b a b ilit y s a m p le is one in w h ic h e v e ry
p e rs o n in th e p o p u la tio n of in te r e s t has a know n p r o b a b ilit y or chance of b e in g s e le c te d
fo r th e s a m p le . A ll of th e s a m p lin g d e s ig n s m e n tio n e d h e re in v o lv e p r o b a b ilit y s a m p lin g .
O th e r fo rm s of s a m p lin g not in v o lv in g p r o b a b ilit y s a m p lin g a ls o e x is t, such as h a p h a z a rd
s a m p lin g , w h e re p e rs o n s a re chosen by o th e r th a n ra n d o m m e a n s . T h e re is a ls o p u r p o s iv e or
q u o t a s a m p l i n g w h e r e " r e p r e s e n t a t i v e " i n d i v i d u a l s a r e s o u g h t o u t , a c c o r d i n g t o s o m e o n e 's
id e a o f w h a t i s r e p r e s e n t a t iv e . T h e s e n o n - p r o b a b i l i t y s a m p lin g m e th o d s w i l l n o t b e d e a l t
w ith h e re s in c e th e y do n o t a llo w e s tim a te s of b ia s or p r e c is io n to be m ade.
A n o th e r fo rm of ra n d o m s e le c t io n is s y s te m a tic s a m p lin g . In s te a d of ea ch p e rs o n
b e in g s e le c t e d at ra n d o m fro m th e o rd e re d p o p u la tio n lis t, o n ly th e in itia l s u b je c t is
s e le c te d r a n d o m ly . T h e re a fte r, e v e ry 1 0 th , 5 0 th , or n th p e rs o n is s e le c t e d fro m th e
o rd e re d lis t, th e v a lu e of n b e in g d e t e r m in e d by th e s iz e of th e p o p u la tio n lis t and th e
s a m p le s iz e d e s ir e d . T h is m e th o d has th e a d v a n ta g e th a t th e p ro c e s s of s e le c t io n is easy
and th e p o te n tia l a d v a n ta g e th a t th e s a m p le m a y b e s p re a d out over th e p o p u la tio n lis tin g .
W h e th e r i t p ro d u c e s a r e p r e s e n t a t iv e s a m p le depends upon th e b a s is of o r d e r in g of th e
p o p u la tio n lis t.
S t r a t if ie d s a m p lin g m ay be u s e d if th e p o p u la tio n of in te r e s t is th o u g h t to be h e te ro
geneous w ith re s p e c t to d ru g use, or if s p e c ia l e s tim a te s of d ru g use a re to b e m ade f o r
c e r ta in s u b g ro u p s . For th e s e p u rp o s e s a p r io r s tr a tific a tio n of th e p o p u la tio n is neces
s a ry ; a s e p a ra te and i n d e p e n d e n t p r o b a b i l i t y s a m p le i s s e l e c t e d w i t h i n e a c h d e fin e d
s tr a tu m o r s u b g ro u p . T h i s m e th o d p r o d u c e s i n d e p e n d e n t e s t i m a t e s o f d r u g u s e t o p e r m it
c o m p a r is o n s b e tw e e n s u b g ro u p s . T h e y m ay a ls o be c o m b in e d fo r e s tim a te s of th e to ta l
p o p u la tio n .
S t r a t i f i e d s a m p lin g i s o f t e n u s e d w h e r e c e r t a i n g r o u p s n e e d t o b e o v e r s a m p le d . T h is
c a n p e r m it e s t im a t e s o f e q u a l p r e c i s i o n t o b e m ade f o r s t r a t a w h e re d ru g use is r a re and
fo r s tra ta w h e re it is w id e s p r e a d .
- 25 -
In s u m m a ry , s tr a tifie d s a m p lin g is a way of e n s u r in g th e r e p r e s e n t a t iv e n e s s of a
s a m p le and of in c r e a s in g th e p r e c is io n of e s tim a te s . I t is use d when th e n e c e s s a ry
in f o r m a t io n on s tra ta is a v a ila b le in an a p p r o p r ia te fo rm to be in c o r p o r a te d in to th e
s a m p lin g schem e. It can be u t iliz e d w ith s im p le ra n d o m s a m p lin g or s y s te m a tic s a m p lin g
w ith in s tra ta . S t r a t if ie d s a m p lin g m ay a ls o be c o m b in e d w i t h th e o th e r tw o p r o b a b ilit y
s a m p lin g d e s ig n s m e n tio n e d b e lo w .
R a th e r th a n s e le c t in g in d iv id u a ls at ra n d o m th ro u g h o u t th e p o p u la tio n , it is som e
tim e s m o re e f f ic ie n t to s e le c t com pact c lu s te r s of in d iv id u a ls and to s u rv e y a ll in d iv i
d u a ls m a k in g up th e c lu s te r ; th is is know n as c lu s te r s a m p lin g . C lu s te r s of in d iv id u a ls
m ay be d e fin e d a c c o r d in g to th e ir n a tu ra l g r o u p in g s , such as a s c h o o l, a c la s s r o o m , or a
fa c t o r y d e p a rtm e n t. The c o s ts and l o g i s t i c p r o b le m s o f a d m i n i s t e r i n g a q u e s t io n n a ir e a r e
o f t e n le s s w hen a n a d m i n i s t r a t i v e l y d e fin e d u n i t , ( e . g . , a c la s s r o o m o r m i l i t a r y b a r r a c k s )
can be ta k e n as a w h o le . I t is o fte n o p e r a t io n a lly m o re e ff ic ie n t and a d m in is tr a tiv e ly
m o re c o n v e n ie n t fo r th e s u rv e y to use such c lu s te r s . As w ith s tr a tifie d s a m p lin g , h o w e v e r,
ea ch p e rs o n m u st be a s s o c ia t e d w ith one, and o n ly one, c lu s te r , and th e r e la t iv e s iz e of
th e c lu s te r s s h o u ld be know n. A s u rv e y in w h ic h th is a p p ro a c h is u s e d m ig h t b e d e s c r ib e d
fo r e x a m p le , as a s tu d e n t s u rv e y u s in g a c lu s te r s a m p le of s c h o o ls .
- th e r e la t iv e (p e rc e n ta g e ) or a b s o lu te p r e c is io n d e s ir e d fo r th e e s tim a te ;
- th e s u b g ro u p s in th e p o p u la tio n fo r w h ic h s e p a ra te e s tim a te s a re r e q u ir e d ;
- th e c o m p a r is o n s to b e m ade b e tw e e n s u b g ro u p s in th e p o p u la tio n .
To in c lu d e a s iz a b le n u m b e r o f c a s e s o f a r a r e b e h a v io u r , s u c h a s u s in g h e r o in , i n a
s u r v e y d e s ig n e d t o c h a r a c t e r i z e u s e r s , l a r g e r s a m p le s m u s t b e s u r v e y e d o r a d is p r o p o r tio n a te
num ber o f re s p o n d e n ts m u s t com e f r o m h ig h - r is k g ro u p s . C lu s te r s a m p le s a ls o need to be
la r g e r th a n s im p le ra n d o m s a m p le s s in c e th e y a re le s s p r e c is e (s e e J o h n s to n e t a l. (24) fo r
a s ta t is t ic a l m e th o d of c o r r e c tin g fo r c lu s te r e d s a m p lin g ) .
If th e p o p u la tio n of s tu d e n ts to b e ,s tu d ie d is le s s th a n 1000, th e y s h o u ld a ll be
in c lu d e d . I f th e y a re fe w e r th a n 5 0 0 0 , a s t u d y s a m p le o f 5 0 0 m a y b e s u f f i c i e n t . W ith
p o p u l a t i o n s g r e a t e r t h a n 5 0 0 0 , s a m p le s o f 1 0 0 0 w o u l d b e a m in im u m . P r o b a b l y a s a m p le o f
5000 is th e m a x im u m t h a t w o u ld be needed fo r d e t e r m in in g m ost ty p e s of d ru g use. T h a ts iz e
of s a m p le g e n e r a lly a llo w s a lm o s t any a n a ly s is to b e m ade a n d ra re ty p e s of d ru g use to be
d e te c te d . H o w e v e r, if t h e r e a r e 10 0 0 0 s t u d e n t s , s e l e c t a b o u t 10% o f t h e c la s s r o o m s . If
th e re a re m o re th a n 10 000, a s tr a tifie d s a m p lin g p la n w i l l b e n e c e s s a r y , w it h th e num ber
s e le c t e d in c r e a s in g w it h th e t o t a l p o p u la t io n . S a m p li n g e x p e rts m u st be c o n s u lte d on th e
s a m p le s i z e f o r l a r g e n a t i o n a l s t u d i e s .
P ro c e d u re s fo r a d m in is te r in g th e s u rv e y
O ne o f th e m ost im p o r ta n t s te p s in o r g a n iz in g a s u rv e y is th e p ilo t s tu d y . A ll
q u e s tio n n a ir e s s h o u ld be tr ie d out on a s m a ll n u m b e r o f s u b je c t s of th e ty p e to be s tu d ie d
in th e a c tu a l s u rv e y . T h is a llo w s a t e s t in g o f th e q u e s t io n n a ir e a n d t h e d e v e lo p m e n t o f
a n s w e r c a t e g o r ie s . It a ls o in d ic a t e s w h e th e r th e s u b je c t s u n d e r s ta n d th e q u e s tio n s an d c a n
r e p ly to th e m in th e tim e a v a ila b le . It is o fte n fo u n d , as a r e s u lt of p ilo t s tu d ie s , th a t
th e q u e s tio n n a ir e is to o lo n g , to o d if f ic u lt , or n o t u n d e rs to o d by som e s u b je c t s . The p i l o t
s tu d y m ay a ls o id e n tify d iffic u lt ie s in o b ta in in g c o o p e r a tio n fro m s u b je c t s , so th a t
p ro c e d u re s fo r s e le c t in g th e s a m p le and a d m in is te r in g th e s u r v e y m ay a ls o be m o d ifie d .
- 27 -
A d m in is tr a tiv e a p p ro a c h e s fo r s u rv e y s of s tu d e n t and m ilit a r y p o p u la tio n s w ill p r o b a b ly
v a ry fro m one c o u n try to a n o th e r. In m ost school s u rv e y s , it is e s s e n tia l to g a in th e
c o o p e r a tio n of at le a s t fo u r g ro u p s : th e a u t h o r it ie s r e s p o n s ib le fo r th e school d is t r ic t ,
th e p r in c ip a l or h e a d m a s te r of each s c h o o l, th e te a c h e rs , and, f in a lly , th e s tu d e n ts th e m
s e lv e s . The b e s t w ay is to s ta te th e re a s o n s fo r th e s u rv e y c le a r ly an d h o n e s tly to a ll
c o n c e rn e d and to e n li s t t h e i r c o o p e r a tio n . C o e r c io n at any le v e l is lik e ly to p ro d u c e
d is tu r b in g s id e - e f f e c t s .
I t i s o f t e n d i f f i c u l t t o e s t a b lis h th e v a l i d i t y o f in f o r m a t io n o n d ru g u s e b e c a u s e su c h
b e h a v i o u r i s o f t e n o f a p r i v a t e a n d s o m e t im e s i l l e g a l n a t u r e . I t i s n o t r e a d i l y s u b je c t t o
o b s e r v a t io n o r v e r if ic a t io n by o th e rs . Thus it is d if f ic u lt to o b ta in a n o u ts id e m e a s u re
- 29 -
a g a in s t w h ic h to c o m p a re s u rv e y r e s u lts fo r in d iv id u a l cases. A fu rth e r p r o b le m is th a t
s u rv e y s at best can re p o rt o n ly th e d ru g s th a t th e re s p o n d e n t b e lie v e s he to o k . It is know n
fro m la b o r a to r y a n a ly s e s th a t illic it d ru g s f r e q u e n tly do n o t c o n ta in any of th e s u b s ta n c e s
th a t th e y a re supposed to c o n ta in .
Q u e s tio n s on " fic titio u s " d ru g s . Some e a r l y s u rv e y s (3 3 ) e x a m in e d th e use of " fic ti
tio u s " d ru g s such as C .H .D ., L o v a r-2 5 (L o v e P ills ) , a n d m o n o x y t r ip t a m a t e (M O T) in an e ffo rt
to assess o v e r r e p o r tin g . A la r g e s u rv e y in T o ro n to in d ic a te d th a t o n ly 0 .8 % of re s p o n d e n ts
re p o rte d th e use of M O T. H o w e v e r, about 6% o f a d d ic ts under tre a tm e n t re p o rte d th e use of
fic titio u s d ru g s . P e rh a p s th e re is a g re a te r o v e r r e p o r tin g p r o b le m w ith heavy u s e rs .
The fo rm a t or p h y s ic a l la y o u t of th e q u e s tio n n a ir e is e x t r e m e ly im p o r ta n t f o r p u rp o s e s
of d a ta p r o c e s s in g . In s e lf- a d m in is te r e d s u rv e y s of d ru g use, th re e g e n e ra l ty p e s of
in s tr u m e n t have been u se d: f ill- in fo rm s , s e p a ra te answ er s h e e ts , a n d m a c h in e - r e a d a b le
fo r m s . E x a m p le s of th e d iffe r e n t ty p e s a re a v a ila b le in a p u b lic a tio n b y N e h e m k is et a l.
( 1 1 ) w h ic h c o n ta in s c o p ie s of so m e 4 0 q u e s tio n n a ir e s used in d ru g -u s e s u rv e y s in N o rth
A m e r ic a .
- 30 -
The f ill- in fo rm was u s e d in m any e a r l i e r s tu d ie s . W ith th is fo rm th e s u b je c t m a rk s
h is answ er d ir e c t ly on th e q u e s tio n n a ir e . The y o u th s u rv e y q u e s tio n n a ir e show n e a r lie r in
th is re p o rt is of th is ty p e . The a n s w e rs a re u s u a lly "c o d e d " or tra n s fe rre d by hand o n to
c o d in g s h e e ts , fo r w h ic h c o m p u te r punch c a rd s a re m ade. T h is m e th o d r e q u ir e s th e le a s t
fro m th e re s p o n d e n t: h e m e r e ly has to re a d th e q u e s tio n a n d m a rk h is a n sw e r w ith a tic k or
c ro s s , or in any o th e r o b v io u s w ay. T h is m e th o d w o r k s b e s t w ith c h ild r e n b e lo w th e age of
13, who o fte n have d if f ic u lt y w ith s e p a ra te answ er s h e e ts . T h e d is a d v a n ta g e of th e m e th o d
is th a t it te n d s to be la b o u r - in t e n s iv e , s in c e a s s is ta n ts a re r e q u ir e d to do th e c o d in g
and key p u n c h in g . These ta s k s a re m anual and r a th e r te d io u s , so th a t e rro rs a re lik e ly .
C a re fu l c h e c k in g of c o d in g and of key p u n c h in g a re n e c e s s a ry .
T h e m o s t m o d e r n m e th o d i n v o l v e s m a c h in e - r e a d a b le fo r m s . No p e r s o n n e l a r e r e q u ir e d to
code o r k e y - p u n c h th e a n s w e rs , s in c e t h e " r e a d e r " m a c h in e w i l l s c a n t h e a n s w e r sheet
v is u a lly and a u to m a tic a lly k e y -p u n c h th e a n s w e rs on to c a rd s or c o m p u te r ta p e . In som e
s tu d ie s , answ er s h e e ts have b e e n m ade m a c h in e - r e a d a b le and in o th e r s tu d ie s q u e s tio n n a ir e s
have b e e n m ade m a c h in e - r e a d a b le . B o th m e th o d s a re r e la t iv e ly c o s tly in te rm s o f m a te r ia ls
and e q u ip m e n t, but a re e x t r e m e ly la b o u r - e ffic ie n t. A fu rth e r p r o b le m is t h a t s tu d e n ts m ust
m a rk th e ir a n s w e rs c a r e fu lly and d is t in c t ly . S in c e s tra y m a rk s on th e p a g e m ay be re a d as
a n s w e rs , s u b je c t s m ust c o n s ta n tly be c a r e f u l w h e re th e y put th e ir a n s w e rs , e s p e c ia lly if
th e y le a v e b la n k s .
D a ta a n a ly s is
Types of q u e s tio n s in d ru g -u s e s u rv e y s fo r y o u th
W h a t s h o u ld be in c lu d e d i n a d ru g -u s e s u rv e y is la r g e ly a m a t t e r o f t h e g o a ls o f th e
s u r v e y , th e tim e a v a ila b le , and th e re s p o n d e n ts ' c a p a c it ie s . I f t h e s u r v e y g o a ls a r e
lim ite d to g ro s s e s tim a te s of th e fre q u e n c y of d ru g use, o n ly a fe w q u e s tio n s about th e
m a jo r p o p u la r d ru g s a re r e q u ir e d . The m o s t im p o r ta n t c a t e g o r ie s o f q u e s tio n have been
c o v e re d in th e d is c u s s io n o f c o r e an d o p t io n a l ite m s (c h a p te r 2 .2 ) . T he a d v a n ta g e o f
in c o r p o r a t in g ite m s fr o m th e q u e s t io n n a ir e m e n tio n e d in th is re p o rt i s t h a t th e d a ta
o b ta in e d w ill be c o m p a r a b le w i t h d a ta p ro d u c e d by o th e r in v e s t ig a to r s c o lla b o r a tin g w ith
WHO a n d th e U n ite d N a tio n s in th e assessm ent o f d ru g -a b u s e p r o b le m s . To cover a ll a re a s of
in q u ir y in a s e lf- a d m in is te r e d s u r v e y m ay b e im p o s s ib le and u n n e c e s s a ry . If d a ta on th e
c o r r e la te s of d ru g use a re d e s ir e d , at le a s t d e m o g r a p h ic c h a r a c te r is tic s s h o u ld be in c lu d e d .
Age, sex, o c c u p a tio n , and e d u c a tio n ha ve u s u a lly been c lo s e ly r e la t e d to a ll ty p e s of use
and a b u s e . O th e r c o r r e la t e s , s u c h a s a t t it u d e s o r p e r s o n a l i t y t r a i t s , m ay a ls o b e d e s ir e d
and a la r g e n u m b e r o f in v e s t ig a t io n s h a v e in c lu d e d q u e s tio n s on th e s e a s p e c ts (s e e M e rc e r &
S m a rt ÇO f o r a r e v ie w ) . H o w e v e r, i t h a s b e e n r e c o g n i z e d t h a t d r u g —u s e q u e s t i o n n a i r e s a re
u s u a l l y t o o lo n g a n d t e d io u s ( 1 2 ) . T h e y s h o u ld b e m ade a s s h o r t a n d i n t e r e s t i n g a s
p o s s ib le .
W hen s u r v e y s a re c o n d u c te d in c la s s r o o m s , th e y m u st be c o m p le te d in one c la s s p e r io d
(3 0 - 45 m i n u t e s ) . T h is in c lu d e s t im e f o r g i v i n g i n s t r u c t i o n s , a n s w e r in g q u e s t io n s , and
c o lle c t in g a n s w e r s h e e ts . T h e a c t u a l tim e s p e n t w i l l b e d i c t a t e d b y t h e r e a d in g and
a n s w e r in g s p e e d o f th e s lo w e s t c h i l d i n th e s a m p le b e i n g t e s t e d . T h u s s a m p le s t h a t i n c l u d e
a w id e r a n g e o f ages w i l l r e q u ir e d if f e r e n t le n g th s o f s u r v e y tim e . U s u a lly s tu d e n ts ag ed
1 2 - 13 y e a r s w i l l t a k e t w ic e a s lo n g t o a n s w e r a q u e s t io n n a ir e as th o s e a g e d 17 - 18 y e a r s .
R e a d in g l e v e l s m a y a l s o v a r y a m o n g s a m p le s o f t h e sa m e a g e , a n d s tu d e n ts r e c e iv in g s p e c ia l
e d u c a tio n fo r th e re ta rd e d or " s lo w p ro g re s s " c la s s e s w ill o fte n ta k e c o n s id e r a b ly lo n g e r to
c o m p le te q u e s tio n n a ir e s . C a re s h o u ld be ta k e n to p re te s t th e q u e s tio n n a ir e on th e s lo w e s t-
w o r k in g as w e ll as th e f a s t e s t - w o r k in g s u b je c t s of th e s a m p le . S o m e tim e s in v e s t ig a t o r s d ra w
- 32 -
up tw o q u e s tio n n a ir e s : one fo r younger s tu d e n ts , c o n ta in in g o n ly d e m o g r a p h ic and d ru g -u s e
ite m s , and a n o th e r fo r o ld e r s tu d e n ts , w ith th e sa m e i t e m s p lu s a d d itio n a l a t t it u d e or
p e r s o n a lity ite m s . T h is a llo w s e v e ry o n e to fin is h at about th e sam e t i m e and a ls o a llo w s
th e c o lle c tio n of som e d a t a on th e c o r r e la te s of d ru g u s e .
The g e n e ra l fo rm a t a n d w o r d in g of q u e s tio n n a ir e s a re im p o r ta n t. T h e re is a te n d e n c y
fo r som e in v e s t ig a to r s to p re fe r a n o p e n -e n d e d s ty le - i.e ., w h e re th e s u b je c t w r ite s in
th e a n s w e r - r a t h e r th a n a c lo s e d s t y l e , w h e re t h e p o s s ib le a n s w e rs a r e s p e c if ie d an d th e
r e s p o n d e n t m a rk s o n e o f th e m . T h e o r e t i c a l l y , o p e n -e n d e d q u e s t io n s a l l o w m o re s p e c i f i c i t y
a n d m a y b e m o re s e n s i t i v e t o c h a n g e s o v e r t im e . H o w e v e r, re s p o n d e n ts f r e q u e n t ly have
d i f f i c u l t y i n s p e c if y in g c e r t a i n i n f o r m a t io n — s u c h a s t h e e x a c t n u m b e r o f t im e s a d ru g w as
used— and a re a b le to m ake o n ly ro u g h e s tim a te s . S p e c ifie d answ er c a te g o r ie s ta k e th is
lim ita tio n in to account and m ay be p re c o d e d to s im p lify d a ta p r o c e s s in g . M any o p e n -e n d e d
q u e s tio n s , on th e o th e r hand, have to be coded e v e n t u a lly if th e y a re to be c o m p u te r-
p ro c e s s e d , and th is adds e n o r m o u s ly to th e d u r a tio n and cost of th e s u rv e y re s e a rc h .
U ncoded or o p e n -e n d e d q u e s tio n s a re best le ft fo r s m a ll p ilo t s tu d ie s .
A n u m b e r o f m e th o d s f o r p r o t e c t i n g t h e r i g h t s o f s u b je c t s h a v e b e e n d e v e lo p e d . I n som e
c a s e s , a c o d e h a s b e e n d e v e lo p e d w h e r e b y e a c h s u b je c t i s g iv e n a u n iq u e n u m b e r , w h ic h i s
p la c e d o n th e q u e s t io n n a ir e . F o r th e p e rs o n s c o n d u c tin g th e s u r v e y o r h a n d lin g th e s u rv e y
q u e s tio n n a ir e s th e d a ta a r e i d e n t i f i e d o n ly b y n u m b e r. A t h i r d p a r t y k e e p s th e lis t of
n u m b e rs w ith th e id e n tify in g n a m e s ., but does not have th e q u e s tio n n a ir e d a ta . In som e cases
th e n a m e -n u m b e r lis t w ill have been sent out of th e c o u n try to a d is ta n t th ir d p a rty .
A nnex 2
STUDENT D R U G -U SE Q U E S T IO N N A IR E
IN S T R U C T I O N S
H a v e you dr u n k a n y w a t e r d u r i n g the la st 30 da ys ?
□ A No
0 D Yes, on 20 or m o r e da ys
A r e you a m a l e o r a f e m a l e I I A Male
I I B Female
H o w m a n y ye ar s o f sc ho ol h a v e you Years
c o mp le te d? (Do n o t c o u n t k i n d e r g a r t e n )
I h a v e n o t w o r k e d on a p a i d j o b
F o r m o s t o f the l a s t 12 months, h a v e □ d u r i n g m o s t o f the last 12 m o n t h s
you w o r k e d on a p a i d job, f u l l - t i m e
I h a v e w o r k e d on a p a r t - t i m e p a i d
or p a r t - t i m e ?
jo b
I h a v e w o r k e d on a f u l l - t i m e p a i d
jo b
I h a v e n o t w o r k e d on an u n p a i d j o b
F o r m o s t o f the la st 12 months, h a v e □ d u r i n g m o s t o f the la st 12 m o n t h s
you w o r k e d on a n . u n pa id job, f u l l - t i m e
I h a v e w o r k e d on a p a r t - t i m e un pa id
or part-time? □ job
I h a v e w o r k e d on a f u l l - t i m e un pa id
□ job
FOR EVERY Q U E S T IO N YOU MUST READ PARTS (a ), (b ), (c ),.a n d (d ), AND ANSWER EACH PART
H a v e n e v e r smoked, chewed, or
(d) H o w o l d w e r e you w h e n you fi r s t □ n
sn if fe d to bacco p r o d u c t s
smoked, chewed, o r s n i f f e d a
to ba cc o p r o d u c t ? □ B l o year s old, or less
□ C 11-12 year s ol d
□ D 13-1 4 year s ol d
□ G 19 years o l d , or m o r e
- 38 -
8. (a) H a v e you e v e r dr u n k an y a l c o h o l i c □ il No
b e v e r a g e (including beer, wine,
□ B Yes
and spirits)?
(b) H a v e you dr un k a n y a l c o h o l i c □ A No
b e v e r a g e in the p a s t 12 m o n t h s ?
□ B Yes
(c) H a v e you d r u n k a n y a l c o h o l i c □ A No
b e v e r a g e d u r i n g the p a s t 30 days ?
□ B Yes, on 1-5 days
□ D Yes, on 20 o r m o r e days
1_
— 1 H a v e n e v e r dr un k alcoholic
(d) H o w o l d w e r e you wh en you fi rs t 1 1 /7i1
beverages
h a d a driiik o f beer, wine, or
s p ir it s — m o r e than j u s t a sip? □ B 1 0 years old, o r less
□ E 15 - 1 6 year s old
□ F 1 7 - 1 8 year s old
□ G 19 year s old, or m o r e
□ D Yes, on 2 0 o r m o r e days
□ C 11-1 2 year s ol d
□ F 17-1 8 year s o l d
□ G 19 year s old, o r m o r e
- 39 -
10. (a) H a v e you ev er taken a n y co caine? □ A No
□ B Yes
□ D Yes, on 20 or m o r e days
! 1 E 15 -1 6 year s o l d
□ F 17 -1 8 year s old
n G 19 years old, or m o r e
(c) H a v e y o u taken a n y a m p h e t a m i n e s or □ A No
o t h e r s t i m u l a n t s d u r i n g the p a s t
□ B Yes, on 1-5 days
30 da ys w i t h o u t a d o c t o r or h e a l t h
w o r k e r t e ll in g you to do so? □ C Yes, on 6-19 da ys
□ D Yes, on 2 0 o r m o r e days
□ E 15 - 1 6 ye ar s old
u G 19 years old, or m o r e
□ D Yes, on 20 o r m o r e days
□ C 11-1 2 year s o l d
D 13-1 4 year s o l d
. □
□ E 15 -1 6 ye ar s old
□ F 17 -1 8 ye ar s old
□ G 19 year s old, o r m o r e
(b) H a v e you s n i f f e d or i n h a l e d th in gs n A No
to get h i g h in the p a s t 12 m o n t h s ?
□ B Yes
(c) H a v e yo u s n i f f e d o r i n h a l e d things n A No
to g e t h i g h d u r i n g the p a s t 30 days ?
□ B Yes, on 1-5 days
□ D Yes, on 20 or m o r e d a y :
□ E 15-1 6 year s o l d
□ F 17 - 1 8 year s o l d
□ G 19 years old, o r m o r e
(e) I f y o u h a v e e v e r s n i f f e d or i n h a l e d
things, w r i t e in the n a m e o f the _
th i n g you h a v e s n i f f e d o r i n h a l e d
m o s t recently.
- 41 -
14. (a) H a v e you ev er taken any j | A No
t r an qu il li ze rs (Librium, Valium,
j 1 B Yes
Mi ltown) wi t h o u t a d o c t o r o r h e a l t h
w o r k e r t e l l i n g you to do so?
j D Yes, on 2 0 o r m o r e days
j D 13 -1 4 years old
j E 15 -1 6 year s old
1 F 17-18 years o l d
D Yes, on 2 0 or m o r e days
F 17-1 8 ye ar s o l d
G 19 years old, o r m o r e
(e) I f you h a v e ev er taken sedatives,
wr i t e in the n a m e o f the one you
h a v e taken m o s t recently.
- 42 -
you to do so?
(c) H a v e you s m o k e d or eaten any op i u m □ A No
d u r i n g the p a s t 30 da ys wi thout
a d o ct or o r h e a l t h w o r k e r te ll in g
p B Yes, on 1-5 days
□ D Yes, on 20 o r m o r e days
□ E 15-1 6 years ol d
□ F 1 7 - 1 8 years ol d
□ G 19 ye ar s old, or m o r e
□ . D Yes, on 20 or m o r e days
□ F 1 7 - 1 8 year s old
□ G 19 year s old, o r m o r e
- 43 -
18. (a) H a v e you e v e r taken a n y o t h e r op iate No
(methadone, morp hi ne / codeine,
□ B Yes
D e merol, p a re go ri c) wi t h o u t a d o c t o r
or h e a l t h w o r k e r t e ll in g you to do so?
□ D Yes, on 20 or m o r e days
□ E 15-1 6 ye ar s old
n G 19 years old, o r m o r e
19. (a) A r e th e r e a n y o t h e r dr u g s n o t □ A No
m e n t i o n e d that you h a v e taken in
□ B Yes
the p a s t y e a r w i t h o u t a d o c t o r or
h e a l t h w o r k e r t e l l i n g you to do so?
(b) I f yes, w r i t e in the n a m e o f the
d r u g o r drug s here.
P la n n in g of th e s u rv e y
T IM E -T A B L E FOR SURVEY IM P L E M E N T A T IO N
D u r a tio n (m o n th s )
A c tiv itie s
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
P la n n in g
Q u e s tio n n a ir e d e s ig n
S a m p li n g p la n
P ilo t te s t q u e s tio n n a ir e
and p ro c e d u re s
T r a in in g of s u p e r v is o r s
A d m in is tr a tio n of s u rv e y
D a ta a n a ly s is
W r itin g of re p o rt
S a m p lin g
Some f o r m of r a n d o m iz e d s a m p lin g is re c o m m e n d e d in s tu d e n t s u rv e y s . In o rd e r to do
th is , it is n e c e s s a ry to ha ve a lis t of c la s s e s and s c h o o ls fro m w h ic h to s a m p le . U s u a lly ,
c la s s e s and not s tu d e n ts a re th e s a m p lin g u n it in th e s e s tu d ie s . An a lt e r n a t iv e is to use
th e e n tir e s c h o o l p o p u la tio n of a g iv e n a re a or to use a ll c la s s e s of a c e r ta in ty p e of
s tu d e n t.
A d a p ta tio n of th e q u e s tio n n a ir e
A. N ever D. 6 to 9 o c c a s io n s
B. 1 or 2 o c c a s io n s E. 10 to 49 o c c a s io n s
C. 3 to 5 o c c a s io n s F. 50 o r m o re o c c a s io n s
- 45 -
The answ er c a t e g o r ie s c o u ld b e m o re or le s s d e ta ile d , d e p e n d in g on th e d is t in c t io n s needed
in th e r e s u lts . The q u e s tio n oh c a n n a b is use in th e p r e v io u s year /9 ( b m ig h t be e la b o
ra te d in m uch th e sam e w a y . For p u rp o s e s of in t e r n a t io n a l c o m p a r is o n , th e p r o p o r tio n s of
a n s w e rs to each of th e q u e s tio n s B -F m ay b e c o m b in e d . The r e s u lt in g p r o p o r tio n m ay be
c o m p a re d w ith th e p r o p o r tio n of "Y e s " a n s w e rs to th e q u e s tio n in its o r ig in a l fo rm . S uch
e la b o r a tio n s m ake th e q u e s tio n n a ir e lo n g e r and r e q u ir e m o re r e s p o n d e n t tim e , so it w o u ld
be a good id e a to p re te s t th e m b e fo re m a k in g a fin a l d e c is io n .
(5 ) Age c a t e g o r ie s f o r t h e f i r s t u s e o f a s u b s ta n c e m a y b e a l t e r e d , d e p e n d in g o n th e age
ra n g e o f t h e s a m p le s u r v e y e d . F o r e x a m p le , i f q u e s t i o n n a i r e s a r e a d m i n i s t e r e d t o u n iv e r s it y
s tu d e n ts o r a d u lt s , i t w i l l be n e c e s s a ry t o e xp a n d on th e re s p o n s e c h o ic e " 1 9 y e a r s o ld , or
m o r e " ( a n d t o c o m b in e y o u n g e r a g e r a n g e s ) f o r t h e ( d ) p a r t s o f t h e d r u g - u s e ite m s .
S im ila r ly , th e q u e s tio n m ig h t be changed to "In what year d id you fir s t ta k e .... (n a m e of
d ru g )? ". T h is w o u ld r e q u ir e answ er boxes to be p r o v id e d fo r th e y e a r, such as 19 ( [ |.
(6 ) R e g a r d in g th e ite m on to b a c c o u s e , th e i n v e s t i g a t o r m ay w is h to in q u ir e about th e m e th o d
of in g e s tio n b y p r o v id in g th e fo llo w in g re s p o n s e c a t e g o r ie s : c ig a r e tte s m o k in g , p ip e
s m o k in g , c i g a r , s m o k in g , to b a c c o c h e w in g , and to b a c c o s n iffin g . S im ila r ly , fo r o th e r ty p e s
of d ru g , it m ay be d e s ir a b le to o ffe r th e fo llo w in g re s p o n s e c a t e g o r ie s : b y m o u th , by
in je c tio n , by s m o k in g , by s n iffin g , or by in h a lin g .
(8 ) W h e re n e c e s s a r y , th e in v e s t ig a t o r m ay f e e l th a t th e fo llo w in g d e s c r ip tio n s of th e m e d i
cal a p p lic a tio n s of v a r io u s s u b s ta n c e s w ill h e lp th e re s p o n d e n t to d iffe r e n tia te d ru g
c la s s e s .In such cases, he m ay w is h to p r o v id e re s p o n d e n ts w ith th e f o llo w in g in f o r m a t io n .
T r a n q u illiz e r s D o c to rs p r e s c r ib e th e s e to c a lm p e o p le down.
S e d a tiv e s D o c to rs p r e s c r ib e th e s e to h e lp p e o p le to r e la x and fa ll a s le e p .
- 46 -
O p ia te s V a r io u s d r u g s a r e m ade fr o m o p iu m a n d m a y b e p r e s c r i b e d b y d o c to rs to
re d u c e p a in , s to p c o u g h in g , c o n t r o l d ia r r h o e a , and so o n . T h e y in c lu d e
s y n th e tic d ru g s , such a s m e th a d o n e , as w e ll as d e r iv a tiv e s of n a tu ra l
o p iu m .
(1 0 ) If an ite m on th e ty p e of c o m m u n it y is to be in c lu d e d — e .g ., p la c e of c u rre n t
r e s id e n c e : c i t y , s u b u rb , to w n , r u r a l a re a , o r v illa g e — t h e r e s p o n s e c a t e g o r ie s s h o u ld b e
a p p r o p r ia te t o l o c a l n o rm s . If re s p o n d e n ts a re c u r r e n t ly l i v i n g a w ay fr o m t h e i r hom es ( i n
s c h o o l r e s id e n c e s , i n s t i t u t i o n s , e t c . ) , th e i n v e s t ig a t o r m u s t d e t e r m in e b e fo r e h a n d w h e t h e r
th e d a ta a re to r e f e r t o t h e i r p r e s e n t l i v i n g a re a o r to t h e i r hom e l o c a t i o n , i f th e s e
d iffe r . Some i n v e s t i g a t o r s have fo u n d it u s e fu l to ask b o th th e p re s e n t a d d re s s and th e
p e rm a n e n t a d d r e s s . ,
T r a n s la t io n of th e q u e s tio n n a ir e
Q u e s tio n n a ir e a d m in is tr a tio n
The s ta n d a rd p ro c e d u re c a lls fo r r e s e a rc h s t a f f t o (a ) b r i e f l y in tr o d u c e th e s tu d y to
th e r e s p o n d e n t s , ( b ) r e m a in a v a ila b le t o a n s w e r q u e s tio n s w h ile th e q u e s t io n n a ir e s a r e b e in g
c o m p le te d , ( c ) c o l l e c t t h e q u e s t io n n a ir e s u p o n c o m p le tio n a n d , i f d e s ir e d ( d ) i n f o r m a l l y
d i s c u s s t h e q u e s t i o n n a i r e w i t h som e o r a l l o f t h e r e s p o n d e n t s a f t e r t h e s u r v e y a d m i n i s t r a
tio n is fin is h e d . It is s u g g e s te d th a t te a c h e rs s h o u ld not p a r tic ip a te in th e s e a c tiv i
tie s .
I t i s s t r o n g l y re c o m m e n d e d t h a t t h e q u e s t i o n n a i r e s h o u l d b e a d m i n i s t e r e d a n o n y m o u s l y ,
and t h a t n o na m es o r i d e n t i f y i n g m a rk s s h o u ld b e p la c e d o n i t , e x c e p tw h e re r e q u ir e d f o r
p u rp o s e s of fo llo w - u p or r e lia b ilit y and v a l i d i t y s tu d ie s .
D a ta a n a ly s is and r e p o r t in g
T h e m a in p u rp o s e of th e d a ta a n a ly s is w o u ld be to p r o v id e a s ta t is t ic a l p ic tu r e of th e
e x te n t of d ru g use in th e to ta l s a m p le and in v a r io u s s e g m e n ts of it , r e la t iv e to age, sex,
and s o c ia l c la s s g r o u p in g s . D a ta a n a ly s is w o u ld in c lu d e :
O P T IO N A L Q U E STIO N S
| 1S m o k in g
Wh at m e t h o d s h a v e you u s e d f o r t a k i n g
heroin? (Mark all that apply) | [ In je ct io n
| | By mo u t h
I | Ot h e r (please specify)
So u r c e o f i n t r o d u c t i o n to d r u g use I | Family
I | Casual ac qu ai n t a n c e
Who i n t r o d u c e d you to n o n m e d i c a l d r u g
use? (Please ch ec k o n e b o x only) I j Friends
| j D r u g pu s h e r
□ D o c t o r (physician)
H Other health practitioner
I | P h a r m a c i s t or d r u g gi st
! 1O t h e r (please specify)
[ | D o n 't k n o w
R eason fo r f i r s t n o n m e d i c a l d r u g use □ R e l i g i o u s c u st om
□ To b e a c c e p t e d b y ot hers
What was the r e a s o n f o r y o u r fi r s t
no n m e d i c a l d r u g use? (Please chec k □ To b e so ci ab le
o n e b o x only)
n En jo y m e n t
En h a n c e m e n t o f sex
Cu ri o s i t y
□ Tr ea tm en t o f h e a l t h d i s o r d e r
n R e l i e f o f p s y c h o l o g i c a l s t re ss
R e l i e f o f cold, hunger, o r fa t i g u e
Improvement of work performance
Other (please specify)
D o n 't k n o w
Q u e s t i o n s d r o p p e d f r o m the te st ed
questionnaire
In a s u bu rb o f a la r g e ci ty
□ In a la rg e city
- 50 -
H o w m u c h e d uc at io n d i d your f a t h e r □ N o fo rmal s c h o o l i n g
receive? (Mark the h i g h e s t level
□ P r i m a r y school
attended)
□ Se co n d a r y o r h i g h school
U n i v e r s i t y o r ot he r p o s t - s e c o n d a r y
□ educ at io n
□ D o n 't k n o w
C. H o w m u c h ed uc a t i o n d i d yo ur m o t h e r □ N o fo rm al s c h o o l i n g
r e c e iv e? (Mark the h i g h e s t level
attended)
□ P r i m a r y school
□ S e c o n d a r y o r h i g h school
Un i v e r s i t y or ot h e r p o s t - s e c o n d a r y
□ ed uc at io n
n D o n 't k n o w
5. A p p r o v a l o r d i s a pp ro va l o f d r u g use
In di v i d u a l s d i f f e r in w h e t h e r or n o t they
d i s a p p r o v e o f p e o p l e d o i n g c e rt ai n things.
D o you d i s a p p r o v e o f p e o p l e (who a r e 18 or
older) d o i n g the f o l l o w i n g ? (Mark one
b o x f o r each question)
A. S m o k i n g 2 0 o r m o r e c i ga re tt es a da y □ Do n ' t d i sa pp ro ve
□ Disapprove
□ Strongly disapprove
| | Strongly disapprove
| | Disapprove
I | St r o n g l y d i s a p p r o v e
I | Disapprove
I | St r o n g l y d i sa pp ro ve
E.
I | Don't disapprove
(Other d r u g - r e l a t e d b e h a v i o u r o f
I | Disapprove
in t e r e s t to the invest ig at or )
I | Strongly disapprove
- 51 -
6. Perceived availability
H o w di f f i c u l t do you thin k it w o u l d b e
fo r you to get each o f the f o l l o w i n g
types o f d r u g i f you w a n t e d some?
(Mark one b o x f o r each question)
□ Ve ry di ff ic ul t
□ F a i r l y difficult
□ F a i r l y easy
□ Very easy
□ Ve ry di ff ic ul t
□ F a i r l y diff ic ul t
Lj F a i r l y easy
□ Ve ry easy
c.
Probably impossible
(Other d r u g o f i n t e r e s t to the
in ves tig a t o r ) Very diff ic ul t
F a i r l y diff ic ul t
F a i r l y easy
□ Ve ry easy
D r u g use h a s d i f f e r e n t me a n i n g s for
d i f f e r e n t people. We w a n t to k n o w h o w
you th i n k m o s t p e o p l e o f y o u r a g e v i e w
o t h e r s w h o u s e v a ri ou s drugs.
□ L e s s than a v er ag e
□ A b o u t av erage
M o r e than a v er ag e
B. Antisocial M u c h le ss than av e r a g e
L e s s than av er ag e
H A b o u t av er ag e
M o r e than av er ag e
M u c h m o r e than av er ag e
- 52 -
Note
c. Co n f o r m i n g
D. Criminal
E. E m o t i o n a l l y unstable
F. Interesting
G. Reb e l l i o u s
H. S e n sible
I. Sexually permissive
J. W e ak-willed
REFERENCES
8. B ER G , D .F . The n o n - m e d ic a l u s e of d a n g e ro u s d ru g s in th e U n ite d S ta te s : a c o m p re
h e n s iv e r e v ie w . In te r n a tio n a l jo u r n a l of th e a d d ic tio n s , 5: 777 (1 9 7 0 )
22. JO H N S TO N , L . D ru g s a n d A m e r ic a n y o u t h . Ann A rb o r, M I, I n s t it u t e fo r S o c ia l
R e s e a rc h , 1973
24. JO H N S TO N , L. ET A L . D ru g u s e a m o n g A m e r ic a n h i g h school s tu d e n ts , 1 9 7 5 -1 9 7 7 .
W a s h in g to n , DC, G o v e rn m e n t P r i n t i n g O ffic e , 1977 ( N a t io n a l I n s t it u t e o n D ru g A b u s e p u b lic a
tio n )
33. W H IT E H E A D , P .C . & SMART, R .G . V a lid ity and r e lia b ilit y of s e lf- r e p o r te d d ru g use.
C a n a d ia n jo u r n a l of c r im in o lo g y and c o r r e c tio n , 14: 1 -7 (1 9 7 2 )
35. S TE P H E N S , R . The tr u th fu ln e s s of a d d ic t re s p o n d e n ts in re s e a rc h p r o je c ts .I n t e r
n a tio n a l jo u r n a l of a d d ic tio n s , 5 3 9 -5 5 8 (1 9 7 2 )
42. B LA C K F O R D , L . S u m m a ry r e p o r t - s u rv e y s o f s tu d e n t d ru g use. S a n M a te o C o u n t y ,
C a lifo r n ia . S an M a te o , 1977