Online Qualitative Study of Youth Reactions to Strategic Concepts Designed to Prevent Youth Tobacco Use

NON-TRIER PHASE 1 RESEARCH – Discussion Guide

DISCUSSION GUIDE: ONLINE QUALITATIVE STUDY OF YOUTH REACTIONS TO STRATEGIC CONCEPTS DESIGNED TO PREVENT YOUTH TOBACCO USE

NOTE TO REVIEWER: This is an online focus group. Question probes are italicized below each main question and may change or be invalidated based on participant response. These are suggestions for the moderator to follow, however will be used as deemed relevant and necessary in the natural flow of discussion. Please refer to attached stimuli when reviewing days 2 and 3.

OMB No: 0910-0674 Expiration Date: 03/31/2016

Paperwork Reduction Act Statement: The public reporting burden for this collection of information has been estimated to average 2 hours per response (the time estimated to sign this letter and submit it to FDA.) Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing burden to PRAStaff@fda.hhs.gov

Guidelines to be posted/available within the online forum:

1. No full names

• Do not put your full name on any of your assignments.

• Do not use your friends’, teachers’, classmates, or parents/guardians’ full names on any of your assignments. Use a single initial like “K” or “M”. At the bottom of the assignment, create a glossary that tells us the gender and age of each person you write about. (For example: K=18 year old female; E=16 year old male).

2. No other private information

• Do not write down or record any identifying information about yourself or anyone else.

• Identifying information includes telephone numbers, names of schools or towns, street addresses, or anything else that could be used to figure out who someone is.

3. No identifying pictures

• For some assignments we will ask you to upload pictures to illustrate key points. Be sure that these pictures do not include anyone’s face or other identifying features.

• Similarly, when you complete your assignments do not use any images that would violate the privacy of anyone – you, your friends, your schoolmates, or adults in your life.

4. Do not share information from this research project

• Keep all the information that you learn in the course of this research private.

• Please do not share pictures, written information, conversations or anything else from this study with anyone outside of the research study.

ELEMENTS TO INCLUDE IN PROFILE PAGE (Approximately 5 minutes)

• Where I live (City and State only):

• A favorite thing to do:

• People would describe me as:

• Character in a movie or on TV that I most relate to:

• Favorite music groups/bands:

• Favorite brands:

• Person I most admire:

• One celebrity/influencer/personality that is doing things right:

• Things that surprise me:

• My biggest fear:

• The best thing that happened to me this month:

• A song that currently describes my life:

DAY 1: MY LIFE TODAY (Approximately 35 minutes)

Thank you so much for taking part in this online forum. Over the next three days, we will be asking you a series of questions about you, about your life, your friends and will be asking you to review some concepts. We want to learn as much as we can about you and your opinions. As such, it is very important that you answer each question as honestly and in as much detail as possible. And remember to check out your fellow participants’ profile pages and get to know each other.

Most importantly, there are no wrong answers – we value your opinions and appreciate your time and effort in responding to our questions. We will be spending quite a bit of time together over the next three days. I am sure you will find the discussion very engaging. So, let’s get started.

1. What three words would you use to describe yourself? Why did you choose these words?

   1. What words do you think your friends would use to describe you? Why?

   2. What words do you think your parents would use to describe? How are these words different than the words your friends would use and why?

   3. If people were to see your Facebook profile how do you think they would describe you (if that’s all they had to go on)? Is this person any different than the “you” whom you described earlier? If so, how? If not, why not?

2. What is a typical school day for you? What is a typical weekend day for you? Please explain a full day to us from when you wake up in the morning until when you go to sleep at night.

   1. What part of your day do you most look forward to/least look forward to? Why?

   2. If you had to create a hashtag to define your life at the moment, what would it be? Why?

   3. What are you most proud of in your life right now? Why?

3. What are some of the things you want to achieve in the next year? What about 10 years from now?

[PROBE AROUND PARENT INFLUENCE, FRIEND INFLUENCE]

1. Is there anything holding you back from achieving these things? If so, tell us about it.

[PROBE AROUND PEERS OR SOCIAL DYNAMICS HOLDING THEM BACK]

2. Is there anything that you hope you DON’T become?

1. What scares you about your future?

2. Is there anything that you are working hard to prevent from happening in your life in the future?

4. What are some of the things that frustrate you? Think about the people you meet, the situations you find yourself in and the age you are right now.

   1. How do you deal with these frustrations?

[PROBE AROUND COPING MECHANISMS]

2. When you’re experiencing these frustrations or pressures, is there anyone you feel you can count or depend on? Why? How important are these people to you?

3. When you’re experiencing these frustrations or pressures, is there anyone you feel you can’t count or depend on? Why? How important are these people to you?

5. Think about a few of your best friends. What do you like to do together?

   1. What do you and these friends have in common? What do you like to do when you’re hanging out?

   2. What do you like best about your friends? Is there anything you dislike?

   3. In your group of friends what role do you think you play and why?

6. What role does technology play in your life right now? Talk us through the technology you use on a typical day and what you’re using it to do.

   1. How do you and your friends use technology?

   2. What do you like most about the technology you use?

      1. Is there anything you dislike? Please explain.

   3. What technology (if any) could you absolutely not live without right now and tell us why?

7. What are some informational websites you use? Please list the ones you use the most and tell us why (give us the full website address if you can as well).

   1. In general, if a website ends in “.com” what do you think about it? What kind of website is it?

[PROBE TRUSTWORTHINESS, BELIEVABILITY, WILLINGNESS TO ENGAGE/RETURN]

1. Would you share a web site that ends in “.com” with a friend? Why/why not?

1. In general, if a web site ends in “.gov” what do you think about it? What kind of website is it?

[PROBE TRUSTWORTHINESS, BELIEVABILITY, WILLINGNESS TO ENGAGE/RETURN]

1. Would you share a web site that ends in “.gov” with a friend? Why/why not?

1. Say you googled something and there was the option to choose a search result with a “.com” or a search result with a “.gov”. Which would you choose and why?

8. Now I’d like to ask you your thoughts on a few words:

   1. Addiction – What do you think of when you hear a story about addiction or that someone is an addict? What do you think of? Feel free to upload an image of what you’re thinking.

[PROBE: DOES ANYTHING ABOUT ADDICTION SEEM COOL/BADGE OF HONOR?]

1. Have you ever felt “addicted” to anything? If so, what was it? If not, why do you think you’ve never felt this?

2. What would you think if one of your friends were addicted to something?

1. Cool – What do you think of when you hear the world cool? Is this a word that you and your friends use when you talk, chat or text with one another?

   1. If they answer yes: If so, use it in a sentence to give us an example.

   2. If they answer no: What word would you use in its place?

   3. What expression would you use to say that something was cool but now it’s not?

2. Pressure – What does pressure mean to you? When you feel pressure (if you do)? What do you think of? Feel free to upload an image of what you’re thinking.

DAY 2: REVIEW OF CONCEPTS — CAMPAIGN (Approximately 40 minutes)

Hi Guys, welcome to day two of our online discussion.

Today we’ve got some new ideas for you to take a look at and give us your opinion on. The ideas we’re going to show you aren’t finished yet so don’t worry about each and every word, what we’d like to do is get your reaction to the overall message they are giving you and how you feel about it.

Concept A – We’ve Moved On from Cigarettes

[EXPOSE TO CONCEPT- ATTACHMENT SLIDE 3]

1. In your own words, what is the main idea of what you just read?

1. What visual comes to mind when you read this? Can you upload an image that reflects what you’re thinking?

2. How does seeing this make you feel about smoking?

3. Did this tell you anything new?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

[PROBE AROUND THOUGHTS ON THE RELEVANCE OF CIGARETTE SMOKING/IF SMOKING IS “COOL” TODAY]

2. Now take a look at these images and tell me what comes to mind.

[EXPOSE IMAGES THAT REPRESENT THE INSIGHT- ATTACHMENT SLIDE 4]

1. How do these images make you feel?

   1. Is there one in particular that stands out to you? If so, why?

2. How well do you feel these images fit with the wording you saw earlier? Please explain.

[RE-EXPOSE TO CONCEPT WORDING]

3. Now how do these words with the images make you feel about smoking?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

Concept B – Friendship Is About More Than Cigarettes

[EXPOSE TO CONCEPT-SEE ATTACHMENT SLIDE 5]

3. In your own words, what is the main idea of what you just read?

   1. What visual comes to mind when you read this? Can you upload an image that reflects what you’re thinking?

   2. How does seeing this make you feel about smoking?

   3. Did this tell you anything new?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

[PROBE AROUND FRIENDS AS A SUPPORT MODEL AND WHAT FRIENDSHIPS ARE BASED ON, REFERENCING LEARNINGS FROM DAY 1]

4. Now take a look at these images and tell me what comes to mind.

[EXPOSE IMAGES THAT REPRESENT THE INSIGHT- ATTACHMENT SLIDE 6]

1. How do these images make you feel?

   1. Is there one in particular that stands out to you? If so, why?

2. How well do you feel these images fit with the wording you saw earlier? Please explain.

[RE-EXPOSE TO CONCEPT WORDING]

3. Now how do these words with the images make you feel about smoking?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

Concept C – Smoking Is a Fake to Fitting In

[EXPOSE TO CONCEPT-SEE ATTACHMENT SLIDE 7]

5. In your own words, what is the main idea of what you just read?

   1. What visual comes to mind when you read this? Can you upload an image that reflects what you’re thinking?

   2. How does seeing this make you feel about smoking?

   3. Did this tell you anything new?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

[PROBE AROUND HAVING THINGS IN COMMON WITH PEERS FRIENDS, REFERENCING LEARNINGS FROM DAY 1]

6. Now take a look at these images and tell me what comes to mind.

[EXPOSE IMAGES THAT REPRESENT THE INSIGHT- ATTACHMENT SLIDE 8]

1. How do these images make you feel?

1. Is there one in particular that stands out to you? If so, why?

2. How well do you feel these images fit with the wording you saw earlier? Please explain.

[RE-EXPOSE TO CONCEPT WORDING]

3. Now how do these words with the images make you feel about smoking?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

Concept D – Tobacco Makes You Gross

[EXPOSE TO CONCEPT- ATTACHMENT SLIDE 9]

7. In your own words, what is the main idea of what you just read?

   1. What visual comes to mind when you read this? Can you upload an image that reflects what you’re thinking?

   2. How does seeing this make you feel about smoking?

   3. Did this tell you anything new?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

8. Now take a look at these images and tell me what comes to mind.

[EXPOSE IMAGES THAT REPRESENT THE INSIGHT- ATTACHMENT SLIDE 10]

1. How do these images make you feel?

   1. Is there one in particular that stands out to you? If so, why?

2. How well do you feel these images fit with the wording you saw earlier? Please explain.

[RE-EXPOSE TO CONCEPT WORDING]

3. Now how do these words with the images make you feel about smoking?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

Imagery: Consequences of Tobacco Use

9. How do you feel when you see these images? Is there one in particular that grabs your attention more than others? Why?

[EXPOSE IMAGES THAT REPRESENT THE CONSEQUENCES OF SMOKING, E.G., THE LUNGS, YELLOW TEETH & NAILS, AGING AND COSMETIC-ORIENTED CONSEQUENCES- ATTACHMENT SLIDE 12]

1. What word do you use to describe something yucky/disgusting? Would you use the word gross?

Most Effective Concept

[QUESTION WILL APPEAR AT 5PM AFTER RESPONDENTS HAVE HAD TIME TO REVIEW ALL IDEAS]

10. Please look back to the four “concepts” you saw and rank them in the order of effectiveness. With “1” being the one that would most get your attention and prevent you from thinking about smoking and “4” being the one that least would get your attention and prevent you from thinking about smoking.

[PROBE ON MOST EFFECTIVE AND LEAST EFFECTIVE CONCEPTS]

DAY 3: REVIEW OF CONCEPTS — BRAND (Approximately 40 minutes)

Hi Guys, welcome to day three of our online discussion.

Today we’ve got some more new ideas for you to take a look at and give us your opinion on, very much the same way you did yesterday. The ideas we’re going to show you aren’t finished yet so don’t worry about each and every word, what we’d like to do is get your reaction to the overall message they are giving you and how you feel about it.

Concept A – Be Bigger Than a Cigarette

1. In your own words, what is the main idea of what you just read?

[SHOW SHORT FORM COPY OF CONCEPT- ATTACHMENT SLIDE 14]

1. What visual comes to mind when you read this? Can you upload an image that reflects what you’re thinking?

2. How does seeing this make you feel about smoking?

3. Did this tell you anything new?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

4. Thinking about the line “Be Bigger Than a Cigarette,” what does this mean to you?

1. How well does it fit with the overall idea here? Please explain.

2. Now take a look at these images and tell me what comes to mind.

[EXPOSE IMAGES THAT REPRESENT THE BRAND CONCEPT- ATTACHMENT SLIDE 15]

1. How do these images make you feel?

   1. Is there one in particular that stands out to you? If so, why?

2. How well do you feel these images fit with the wording you saw earlier? Please explain.

[RE-EXPOSE TO CONCEPT WORDING]

3. Now how do these words with the images make you feel about smoking?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

Concept B – Smoking Sucks, You Don’t Have To

3. In your own words, what is the main idea of what you just read?

[SHOW SHORT-FORM COPY OF CONCEPT- ATTACHMENT SLIDE 16]

1. What visual comes to mind when you read this? Can you upload an image that reflects what you’re thinking?

2. How does seeing this make you feel about smoking?

3. Did this tell you anything new?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

4. Thinking about the line “Smoking Sucks, You Don’t Have To,” what does this mean to you?

1. How well does it fit with the overall idea here? Please explain.

[IF THERE IS PUSHBACK ON SMOKING SUCKS, WE WILL PRESENT “LIFE GETS BETTER, SMOKING DOESN’T” TO GAUGE WHAT THIS LINE MEANS TO THEM]

4. Now take a look at these images and tell me what comes to mind.

[EXPOSE IMAGES THAT REPRESENT THE BRAND CONCEPT- ATTACHMENT SLIDE 17]

1. How do these images make you feel?

   1. Is there one in particular that stands out to you? If so, why?

2. How well do you feel these images fit with the wording you saw earlier? Please explain.

[RE-EXPOSE TO CONCEPT WORDING]

3. Now how do these words with the images make you feel about smoking?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

Concept C – Don’t Let Cigarettes Tell You What to Do

5. In your own words, what is the main idea of what you just read?

[SHOW SHORT-FORM COPY OF CONCEPT- ATTACHMENT SLIDE 18]

1. What visual comes to mind when you read this? Can you upload an image that reflects what you’re thinking?

2. How does seeing this make you feel about smoking?

3. Did this tell you anything new?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

4. Thinking about the line “Don’t Let Cigarettes Tell You What to Do,” what does this mean to you?

1. How well does it fit with the overall idea here? Please explain.

6. Now take a look at these images and tell me what comes to mind.

[EXPOSE IMAGES THAT REPRESENT THE BRAND CONCEPT- ATTACHMENT SLIDE 19]

1. How do these images make you feel?

   1. Is there one in particular that stands out to you? If so, why?

2. How well do you feel these images fit with the wording you saw earlier? Please explain.

[RE-EXPOSE TO CONCEPT WORDING]

3. Now how do these words with the images make you feel about smoking?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

[PROBE ON IF TEEN TAKES “ADDICTION” AWAY FROM THIS CONCEPT. DOES THAT IMPACT POSITIVELY OR NEGATIVELY?]

Concept D – Don’t Let Tobacco Label You

7. In your own words, what is the main idea of what you just read?

[SHOW SHORT-FORM COPY OF CONCEPT- ATTACHMENT SLIDE 20]

1. What visual comes to mind when you read this? Can you upload an image that reflects what you’re thinking?

2. How does seeing this make you feel about smoking?

3. Did this tell you anything new?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

4. Thinking about the line “Don’t Let Tobacco Label You,” what does this mean to you?

1. How well does it fit with the overall idea here? Please explain.

8. Now take a look at these images and tell me what comes to mind.

[EXPOSE IMAGES THAT REPRESENT THE BRAND CONCEPT- ATTACHMENT SLIDE 21]

1. How do these images make you feel?

   1. Is there one in particular that stands out to you? If so, why?

2. How well do you feel these images fit with the wording you saw earlier? Please explain.

[RE-EXPOSE TO CONCEPT WORDING]

3. Now how do these words with the images make you feel about smoking?

[PROBE ON MORE OR LESS LIKELY TO PREVENT YOU FROM THINKING ABOUT SMOKING]

Most Effective Concept

[QUESTION WILL APPEAR AT 5PM AFTER RESPONDENTS HAVE HAD TIME TO REVIEW ALL IDEAS]

9. Please look back to the four “concepts” you saw and rank them in the order of effectiveness. With “1” being the one that would get most your attention and prevent you from thinking about smoking and “4” being the one that would get least your attention and prevent you from thinking about smoking.

[PROBE ON MOST EFFECTIVE AND LEAST EFFECTIVE CONCEPTS]

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