Health Status and Health- related Habits

1. What is the status of your general health?

________________________
2. Do you have any chronic or long-term diseases?
o Yes. Please specify: _________
o No
3. Do you suffer from constant or recurrent medical symptoms?
o Yes. Please specify: _________
o No
4. When was the last time you had a dental check-up?
o 1–2 years ago
o 3–5 years ago
o Over 5 years ago
5. Your height _____ cm and weight _____ kg
6. How healthy would you say your eating habits are?
7. How many times a day do you eat or drink something (other than water or coffee/tea
without sugar)?
o 6 times or less
o 7–10 times
o More than 10 times
8. Do you exercise?
o Yes, for approx. ____ hours per week. Please specify: __________________
o No
9. Do you use alcohol?
o Yes
o No
10. Have you experimented or used any drugs (or taken alcohol and medication at the same
time in order to get intoxicated)?
o Never
o Yes, 1–4 times
o Yes, 5 times or more often
11. Do you smoke cigarettes or use any other type of tobacco products (for example, chew
tobacco or “snus”)?
o No
o Yes, occasionally
o Yes, daily
12. How often do you brush your teeth normally?
o 2 times a day or more often
 o Once a day
o Less frequently than once a day
13. At dental check-ups, do you usually have cavities that require fillings?
o Never
o Occasionally
o Frequently or every time

Resource: Kunttu, K., Kaila, M., Seilo, N., Autio, R., & Paldanius, S. (2020). Screening
University Students for Health Checks With an Electronic Health Questionnaire in Finland:
Protocol for a Retrospective, Register-Based Cohort Study. JMIR Research Protocols, 9(1),
e14535. https://doi.org/10.2196/14535 @ https://www.researchprotocols.org/2020/1/e14535/?
utm_source=TrendMD&utm_medium=cpc&utm_campaign=JMIR_TrendMD_0

Physical/Health effects

No Health effects Always Often Sometimes Rarely Never

1 How often do you feel sneezing,
runny nose, dry throat and eye
irritation?
2 How often do you feel shortness of
breath/reduced lung functioning?
3 How often do you have coughing or
wheezing?
4 How often do you get headaches
and dizziness?
5 How often do you ever feel reduced
energy levels in your body?
6 How often do you feel sleep
deprivation or sleeping disorder
such as insomnia?

Resource: Sana Ullah, Sohail Ahmed Rajper, Zhongqiu Li (2018). Exposure to air pollution and
self-reported effects on Chinese students: A case study of 13 megacities.
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0194364