5=Strongly agree
4=Agree
3=Don't know
2=Disagree
1=Strongly disagree
1. Sometimes I black out after a night of partying.
1 2 3 4 5

2. I have a bong in my house.
1 2 3 4 5

3.Occasionally I smoke crack.
1 2 3 4 5

4.I have a friend who "shoots up".
1 2 3 4 5

5.My idea of a good time is going to a keg party.
1 2 3 4 5

6.I try to get my homework done in the evenings, but then my friends come by and we go out.
1 2 3 4 5

7.Smoking is my method of relaxation and stress - reduction.
1 2 3 4 5

8. I have been arrested for driving under the influence.
1 2 3 4 5

9.My grades would be higher if I didn't spend so much time partying.
1 2 3 4 5

10. I have slept with someone I really didn't love because I was so wasted.
1 2 3 4 5



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