Questionnaire Format for Drug addiction among university students: Reasons and remedies

Department of Business Administration

   Shahjalal University of Science & Technology, Sylhet

“Drug addiction among university students:

Reasons and remedies”

(The collected data will be used only for preparing report and will be kept confidential)

Questionnaire

1. Name:

2. Department:

3. Residence:          q Hall       q Mess       q Home

4. Father’s Profession: q Business q Public Job  q Private Job  q Farmer

5. Mother’s Profession: q Business q Public Job  q Private Job  q House Wife

6. Family Pattern: qNuclear qExtended

7. Size of Family Income: q Up to 10,000 q10,000-20,000 q above 20,000

8. Amount of money you get from your home:  q Below 5,000 q 5,000   q 5,000+

9. Do you earn extra money? q Below 2,000   q 2,000-5,000 q 5,000+ q No

10. Do you smoke?  qYes   q No

11. Do you take any other drug? qYes   q No

Questionnaire For Smokers

12. Why did you start smoking?

q  From curiosity q From depression q By the situation q By friend q Other

13. Who inspired you to Smoke?

14. How many Cigarette do you take in a day and which brand?

q  Below 6       (Brand)           q 6-10        (Brand)           q 10+      (Brand)

15. Smoking is so costly; does not it create financial crises for you? qYes   q No

16. How long time you are involved in smoking?

q  For 1 year q For 2 years q For 3 years q More than 3 years

17. Having lots of bad effects do you not think that smoking should be given up?

q   Yes   q No

Questionnaire For Drug Addicted students

18. Why did you addict by drug?

q  From curiosity q From depression q By the situation q By friend q Others

19. Who inspired you to take drug?

20. What types of drug do you take?  q Cocaine q Heroin  q Marijuana  q Wine  q Others

21. Did you take cigarette before you being addicted? qYes   q No

22. How long times are you addicted?

q  For 1 year q For 2 years q For 3 years q More than 3 years

23. From which source do you get drug?

24. How much money do you spend in a month for taking drug?

q   Below 1,000 q5,000   q 5,000+

25. What is the behavior of your family members for you?

      q Positive   q Negative  q  They don’t know

26. What’s the role of your friend? q Positive   q Negative q They don’t know

27. Can you continue your study properly? qYes   q No

28. If your answer no, what are the problems?

29. Do you want to give up drug? qYes   q No

30. What is the main barrier to give up drug?

Questionnaire For All

 

31. What do you think, why our students are being addicted by drug?

32. Who are the culprits for this problem?

33. What do you think what should do for stopping drug addiction?

(Thanks for your kind cooperation)