C. E-Cigarette Focus Group Moderator Guide

E-CIGARETTE FOCUS GROUP MODERATOR GUIDE
PATH ad hoc – E-cig and hookah formative research
NOTE -- ecig groups are online only

1. OVERVIEW

Thank
 you
 for
 agreeing
 to
 participate
 in
 a
 discussion
 about
 electronic
 cigarettes,
 or
 e-­‐cigarettes.

 My

name
 is
 ____________________
 and
 I
 will
 be
 leading
 the
 session
 tonight.

 With
 me
 is
 _____________,

who
 will
 be
 taking
 notes
 and
 helping
 me
 with
 the
 discussion.
 _________
 and
 I
 both
 work
 for
 Westat,
 a

company
 based
 in
 Rockville,
 MD.

 Through
 a
 contract
 from
 the
 National
 Institutes
 of
 Health
 (NIH)
 and

the
 Food
 and
 Drug
 Administration
 (FDA),
 Westat
 is
 developing
 materials
 and
 questionnaire
 items
 for
 a

study
 known
 as
 the
 Population
 Assessment
 of
 Tobacco
 and
 Health
 or
 PATH
 Study.
 The
 PATH
 Study
 is
 a

large
 national
 study
 to
 understand
 tobacco
 use
 and
 health
 among
 Americans.

Our
 interest
 is
 in
 being
 sure
 that
 people
 can
 understand
 and
 answer
 the
 questions
 we
 ask
 in
 the
 PATH

Study.

 Because
 e-­‐cigarette
 use
 is
 fairly
 new,
 people
 may
 think
 about
 it
 or
 talk
 about
 it
 in
 different
 ways.

The
 questions
 and
 materials
 in
 the
 PATH
 Study
 need
 to
 reflect
 how
 people
 talk
 and
 think
 about
 this

product.
 We
 hope
 to
 learn
 from
 you
 how
 we
 should
 ask
 about
 this
 product
 in
 the
 study
 questionnaires.

Today/tonight,
 we’ll
 ask
 questions
 about
 your
 experiences
 using
 e-­‐cigarettes,
 such
 as
 when
 you
 first

started
 using
 e-­‐cigarettes,
 what
 you
 like
 about
 using
 e-­‐cigarettes,
 how
 often
 you
 use
 e-­‐cigarettes,
 and

why
 you
 use
 e-­‐cigarettes.

 Just
 to
 be
 clear,
 I’ll
 say
 “e-­‐cigarette”
 today,
 but
 we
 also
 welcome
 comments

about
 things
 like
 e-­‐hookahs,
 e-­‐cigars,
 and
 other
 personal
 vaping
 devices.
 Please
 let
 us
 know
 when
 you’re

talking
 about
 one
 of
 these
 devices
 rather
 than
 what
 you’d
 consider
 an
 “e-­‐cigarette.”

This
 is
 a
 research
 project,
 and
 your
 participation
 is
 voluntary.
 The
 focus
 group
 will
 last
 about
 an
 hour

and
 a
 half.

 We
 will
 provide
 you
 $40.00
 after
 the
 focus
 group
 as
 a
 thank
 you
 for
 your
 participation.
 You

may
 choose
 not
 to
 answer
 any
 question.
 You
 may
 leave
 at
 any
 time
 during
 the
 session.

Your
 participation
 is
 anonymous.

 Findings
 from
 the
 focus
 group
 will
 be
 the
 ideas
 that
 you
 all
 share
 with

us
 today,
 not
 your
 names.
 Sometimes
 we
 will
 quote
 what
 the
 group
 says,
 but
 we
 will
 not
 use
 anyone’s

names
 in
 the
 findings.

 This
 study
 is
 interested
 in
 what
 is
 said,
 not
 in
 who
 says
 what.

 With
 this
 in
 mind,

please
 respect
 the
 privacy
 of
 the
 other
 people
 in
 the
 group
 and
 do
 not
 share
 what
 is
 said
 today/tonight

with
 others.
 On
 occasion,
 researchers
 from
 NIH
 and
 FDA
 may
 listen
 to
 this
 discussion
 today/tonight.

Do
 you
 have
 any
 questions
 so
 far?

 [ANSWER
 ALL
 QUESTIONS]

Are
 you
 willing
 to
 participate
 in
 this
 focus
 group?

[IF
 PERMISSION
 WAS
 GIVEN
 FOR
 INTERVIEW]
 Super.
 In
 addition,
 we
 need
 to
 audio
 record
 this
 focus

group
 session.
 This
 helps
 ______
 and
 me;
 I
 can
 listen
 better
 to
 what
 you
 are
 saying,
 and
 the
 recording

will
 help
 _____
 be
 sure
 that
 her
 notes
 are
 complete.
 We
 will
 destroy
 the
 audio
 recording
 and
 any

identifying
 information
 when
 the
 project
 ends.
 Are
 you
 okay
 with
 us
 recording?
 I
 will
 call
 on
 you
 one
 by

one
 for
 your
 answer.

 [CALL
 ON
 GROUP
 MEMBERS]

[IF
 PERMISSION
 WAS
 GIVEN
 TO
 RECORD]
 I’d
 like
 to
 start
 the
 audio
 recording
 now.

[TURN
 ON
 RECORDER]

v9
 2/14/14

1

E-CIGARETTE FOCUS GROUP MODERATOR GUIDE
PATH ad hoc – E-cig and hookah formative research
NOTE -- ecig groups are online only

For
 the
 purposes
 of
 the
 recording
 I
 am
 going
 to
 repeat
 my
 requests
 to
 participate
 in
 the
 focus
 group
 and

to
 allow
 us
 to
 record
 so
 I
 have
 your
 permission
 on
 tape.

 Are
 you
 willing
 to
 participate
 in
 this
 focus

group?

 I
 will
 call
 on
 you
 one
 by
 one
 for
 your
 answer.

 [CALL
 ON
 GROUP
 MEMBERS]

Are
 you
 okay
 with
 us
 recording?
 I
 will
 call
 on
 you
 one
 by
 one
 for
 your
 answer.

 [CALL
 ON
 GROUP

MEMBERS]

Just
 one
 last
 thing.
 I
 will
 call
 on
 you
 by
 your
 WebEx
 user
 name
 when
 appropriate.
 However,
 you
 don’t

have
 to
 wait
 for
 me
 to
 call
 on
 you.
 Feel
 free
 to
 speak
 naturally
 and
 interact
 with
 the
 other
 focus
 group

participants.
 When
 studying
 the
 transcripts
 from
 today’s
 session,
 it
 is
 helpful
 for
 me
 to
 know
 when
 we

change
 speakers.
 So,
 please
 identify
 yourself
 by
 user
 name
 when
 you
 speak
 so
 that
 we
 have
 that
 on

tape.
 Also,
 please
 try
 to
 speak
 one
 at
 a
 time
 and
 if
 you’re
 talking
 to
 another
 person
 in
 the
 focus
 group,

make
 sure
 to
 refer
 to
 them
 by
 their
 user
 name
 so
 that
 we
 know
 who
 you’re
 talking
 to.
 If
 it
 looks
 like

someone
 used
 their
 last
 name
 in
 their
 WebEx
 user
 name,
 please
 only
 refer
 to
 them
 by
 their
 first
 name.

For
 example,
 if
 the
 user
 name
 is
 “John
 Smith,”
 please
 just
 refer
 to
 him
 as
 “John
 S.”

Does
 anyone
 have
 any
 other
 questions?

 [ANSWER
 ALL
 QUESTIONS]

2. INTRODUCTIONS

Let’s
 start
 off
 by
 going
 around
 the
 room:
 state
 just
 your
 first
 name,
 say
 approximately
 how
 long
 you’ve

been
 using
 e-­‐cigarettes,
 and
 then
 tell
 us
 something
 unique
 about
 yourself
 –
 an
 interesting
 hobby,

famous
 relative
 or
 ancestor,
 something
 like
 that.

3. E-­‐CIGARETTE
 DEVICE

[GENERAL
 DISCUSSION
 –
 NO
 NEED
 TO
 ASK
 EVERYONE
 INDIVIDUALLY]

One
 thing
 we’re
 interested
 in
 learning
 about
 is
 why
 people
 use
 the
 type
 of
 e-­‐cigarette
 that
 they
 do.

Anyone
 can
 start
 this
 discussion,
 but
 I’d
 like
 you
 to
 tell
 me
 what
 kind
 of
 e-­‐cigarette
 you
 usually
 use
 and

why
 you
 selected
 that
 one.

a. What
 kind
 of
 e-­‐cigarette
 do
 you
 usually
 use?

i.
What
 do
 you
 like
 about
 it?

ii.
How
 did
 you
 pick
 that
 brand/type?
 Is
 the
 e-­‐cig
 you
 use
 now
 different
 than
 the
 one
 you

used
 in
 the
 past?

i. [IF
 YES]
 Why
 do
 you
 think
 that
 has
 changed?

b. How
 many
 e-­‐cigarettes
 do
 you
 own?

i.
Are
 they
 different
 kinds/brands?

c. What
 kind
 of
 battery
 does
 your
 e-­‐cig
 have?

d. Have
 you
 done
 anything
 to
 your
 e-­‐cig
 to
 change
 how
 it
 works
 or
 how
 it
 looks?

i.
What
 did
 you
 do?

e. Do
 you
 know
 anyone
 who
 has
 done
 something
 to
 their
 e-­‐cig
 to
 change
 how
 it
 works
 or
 how
 it

looks?

f. What
 do
 you
 look
 for
 when
 you
 buy
 an
 e-­‐cig?

i.
Design?
 Product
 characteristics?
 Price?

v9
 2/14/14

2

E-CIGARETTE FOCUS GROUP MODERATOR GUIDE
PATH ad hoc – E-cig and hookah formative research
NOTE -- ecig groups are online only

g.
 Consider
 these
 three
 categories
 of
 e-­‐cigs:
 non-­‐rechargeable
 and
 disposable
 e-­‐cigarette,

rechargeable
 e-­‐cigarette
 with
 replaceable
 cartridges,
 and
 rechargeable
 e-­‐cigarette
 that
 is

refillable
 with
 nicotine
 fluid.
 Can
 you
 easily
 put
 your
 e-­‐cigarette
 in
 one
 of
 these
 categories?

i.
Why
 or
 why
 not?

ii.
Has
 this
 changed
 over
 time?

iii.
Can
 you
 think
 of
 any
 e-­‐cigs
 that
 wouldn’t
 fit
 into
 these
 categories?
 Why
 do
 you
 say
 that?

4. E-­‐CIGARETTE
 USE
 BEHAVIOR

We
 believe
 that,
 like
 regular
 cigarette
 smokers,
 e-­‐cigarette
 users
 may
 have
 a
 pattern
 to
 how
 they
 use

the
 e-­‐cig
 throughout
 the
 day.

a. How
 do
 you
 typically
 use
 your
 e-­‐cig
 over
 the
 course
 of
 the
 day?

i.
How
 often
 do
 you
 use
 your
 e-­‐cig
 in
 a
 typical
 day?

ii.
How
 soon
 after
 you
 wake
 up
 do
 you
 usually
 use
 your
 e-­‐cig?

iii.
Where
 do
 you
 tend
 to
 use
 your
 e-­‐cig?

a. Why
 do
 you
 think
 that
 is?

iv.
For
 how
 long
 have
 you
 been
 using
 e-­‐cigs
 this
 way?

[ASK
 IF
 THE
 TERM
 “VAPE”
 COMES
 UP
 –
 otherwise
 ask
 at
 the
 end
 of
 this
 section]:

a. Has
 anyone
 else
 ever
 heard
 of
 the
 word
 “vape”
 or
 “vaping”
 to
 describe
 using
 an
 e-­‐cig?
 Or,
 do

you
 tend
 to
 use
 the
 words
 “puff”
 or
 “drag”?

b. Have
 you
 heard
 people
 use
 any
 other
 e-­‐cig
 slang
 that
 we
 haven’t
 mentioned
 yet
 today?

5. [DUAL
 USE
 GROUPS
 ONLY]
 DUAL
 USE

Everyone
 in
 this
 group
 indicated
 that
 you
 use
 both
 e-­‐cigarettes
 as
 well
 as
 regular
 cigarettes.
 Some
 of
 you

may
 typically
 use
 both
 products
 on
 the
 same
 day
 and
 some
 of
 you
 may
 alternate
 products
 over
 the

course
 of
 week.

 Tell
 me
 if
 your
 use
 is
 daily
 or
 weekly,
 and
 then
 talk
 about
 when
 you
 use
 one
 of
 the

other.

a. Do
 any
 of
 you
 use
 other
 tobacco
 products
 and
 e-­‐cigarettes
 in
 the
 same
 day?

i.
Tell
 me
 a
 little
 more
 about
 that

b. Do
 any
 of
 you
 use
 other
 tobacco
 products
 and
 e-­‐cigarettes
 in
 the
 same
 week?

i.
Tell
 me
 a
 little
 more
 about
 that

[PROBE
 AS
 NEEDED
 WITH
 SPECIAL
 ATTENTION
 TO
 PARTICIPANTS
 WHO
 DO
 NOT
 INDICATE
 DAILY
 DUAL

USE]:

c. At
 what
 times
 do
 you
 use
 e-­‐cigs
 and
 when
 do
 you
 use________
 ?

d. Why
 do
 you
 sometimes
 use
 e-­‐cigs
 and
 sometimes
 use
 __________?

e. Does
 your
 product
 use
 change
 by
 where
 you
 are,
 like
 at
 work
 or
 at
 home?

i.
Why
 do
 you
 think
 that
 is?

f. Does
 your
 product
 use
 change
 by
 who
 you
 are
 with,
 like
 friends
 or
 family?

a. Why
 do
 you
 think
 that
 is?

g. Do
 these
 patterns
 stay
 the
 same
 month
 to
 month,
 or
 does
 how
 you
 use
 e-­‐cigs
 and
 _______
 vary

a
 lot
 from
 month
 to
 month?

v9
 2/14/14

3

E-CIGARETTE FOCUS GROUP MODERATOR GUIDE
PATH ad hoc – E-cig and hookah formative research
NOTE -- ecig groups are online only

b. Why
 is
 that
 do
 you
 think?

6. QUANTITY

a. How
 much
 do
 you
 use
 your
 e-­‐cigarette
 throughout
 a
 day
 or
 week?

i.
How
 do
 you
 know
 that?

b. How
 much
 nicotine
 solution
 do
 you
 typically
 use
 in
 a
 day?

i.
How
 do
 you
 know
 that?/How
 can
 you
 tell?

c. Do
 you
 have
 a
 typical
 nicotine
 liquid
 brand
 that
 you
 like
 to
 use?

i.
What
 do
 you
 like
 about
 it?

d. How
 often
 do
 you
 switch
 nicotine
 liquid
 brands?

i.
Why
 do
 you
 do
 that?

[ASK
 IF
 THE
 TERM
 “E-­‐JUICE”
 COMES
 UP,
 otherwise
 ask
 at
 the
 end
 of
 the
 section]:

e. Have
 you
 heard
 of
 the
 term
 “e-­‐juice”?

f. What
 are
 other
 words
 for
 the
 nicotine
 solution
 that
 goes
 in
 e-­‐cigs?

In
 our
 surveys,
 we
 often
 want
 to
 learn
 how
 many
 cigarettes
 smokers
 are
 using.

 We
 thus
 typically
 ask
 a

question
 like
 the
 following
 [SHOW
 TO
 PARTICIPANTS]:

“On
 average,
 about
 how
 many
 cigarettes
 do
 you
 now
 smoke
 each
 day?

 A
 pack
 usually
 has
 20

cigarettes
 in
 it.”

g. If
 we
 were
 to
 ask
 about
 e-­‐cigarette
 use,
 does
 asking
 [SHOW]:

“On
 average,
 about
 how
 many
 times
 do
 you
 usually
 use
 an
 e-­‐cigarette
 each
 day?”
 make
 sense
 to

you?

 Explain.

h. [IF
 THE
 ABOVE
 WORKS]

 How
 meaningful
 would
 it
 be
 for
 us
 to
 then
 ask
 [SHOW]:

“Each
 time
 you
 use
 one,
 how
 many
 [FILL
 w/
 “inhales,”
 “vapes”]
 do
 you
 take?”

i. [IF
 QUEX
 DO
 NOT
 WORK]
 What
 would
 be
 a
 better
 way
 to
 ask
 the
 question?

Let’s
 take
 a
 look
 at
 an
 alternate
 question.

 Does
 this
 make
 sense
 to
 you?
 Why/not?

“How
 many
 days
 do
 you
 use
 an
 e-­‐cigarette
 before
 you
 have
 to
 replace
 it
 with
 a
 new
 one
 or
 put
 in

a
 new
 or
 refilled
 cartridge?”

j. It’s
 also
 informative
 for
 researchers
 to
 understand
 how
 strong
 the
 product
 is
 that
 people
 are

using?
 [OPEN
 DISCUSSION
 –
 NO
 NEED
 TO
 GO
 PERSON
 BY
 PERSON]
 What
 strength
 of
 e-­‐
cig/nicotine
 concentration
 do
 you
 usually
 use?

i.
[ASK
 IF
 DOESN’T
 COME
 UP]
 Do
 you
 think
 about
 the
 strength
 of
 your
 e-­‐cigarettes
 in

descriptive
 terms,
 such
 as
 “light,”
 “regular,”
 “bold,”
 etc.?

ii.
[ASK
 IF
 DOESN’T
 COME
 UP]
 Do
 you
 think
 about
 the
 strength
 of
 your
 e-­‐cigarettes
 in

terms
 of
 nicotine
 concentration,
 such
 as
 the
 percentage
 of
 or
 number
 of
 milligrams

of
 nicotine
 in
 the
 product?

v9
 2/14/14

4

E-CIGARETTE FOCUS GROUP MODERATOR GUIDE
PATH ad hoc – E-cig and hookah formative research
NOTE -- ecig groups are online only

iii.

Have
 you
 ever
 switched
 nicotine
 liquid
 strengths?

a. Why
 did
 you
 do
 that?

b. How
 often
 do
 you
 switch?

7. NICOTINE
 SOLUTION

a. Let’s
 talk
 about
 nicotine
 liquid
 flavors.
 What
 flavors
 have
 you
 used?

b. Do
 you
 have
 a
 typical
 nicotine
 fluid
 flavor
 that
 you
 like
 to
 use?

i.
What
 is
 it?
 How
 did
 you
 choose
 it?

c. What
 other
 flavors
 have
 you
 used?

d. What
 made
 you
 choose
 the
 flavors
 you’ve
 used?

e. How
 often
 do
 you
 switch
 flavors?

f. Do
 you
 think
 this
 list
 covers
 all
 the
 flavors
 that
 you’ve
 used?
 How
 would
 you
 change
 it?
 [POST

LIST
 ON
 SCREEN]:
 menthol,
 mint,
 clove,
 spice,
 candy,
 fruit,
 chocolate,
 alcohol
 (such
 as
 wine
 or

cognac),
 or
 other
 sweets.

k. What
 do
 you
 know
 about
 people
 making
 their
 own
 nicotine
 solution?

i.
Have
 you
 ever
 made
 your
 own
 nicotine
 solution?

a. Tell
 me
 more/Why
 did
 you
 do
 this?

8. MODIFICATIONS

a. What
 have
 you
 heard
 about
 people
 changing
 how
 their
 e-­‐cigs
 work?

b. Have
 you
 done
 anything
 to
 change
 how
 your
 e-­‐cig
 works?

i.
Why
 did
 you
 do
 this?

c. Do
 you
 know
 anyone
 who
 has
 done
 something
 to
 change
 how
 their
 e-­‐cig
 works?

i.
Why
 do
 people
 make
 these
 changes
 to
 their
 e-­‐cigs?

d. [If
 DRIPPING
 DOES
 NOT
 COME
 UP
 NATURALLY]
 Has
 anyone
 ever
 heard
 of
 “dripping”
 with
 your

e-­‐cig?

i.
What
 is
 it?

ii.
Does
 anyone
 do
 it?

iii.
Why
 do
 you
 think
 people
 drip?

e. What
 else
 can
 people
 use
 in
 e-­‐cigs?

9. E-­‐CIG
 PURCHASING

a. Where
 did
 you
 buy
 your
 current
 e-­‐cig?

i.
How
 often
 do
 you
 purchase
 e-­‐cigs
 or
 e-­‐cig
 components?

b. Where
 do
 you
 usually
 buy
 nicotine
 solution
 [e-­‐juice]
 for
 your
 e-­‐cig?

i.
How
 often
 do
 you
 purchase
 nicotine
 solution
 [e-­‐juice]?

CLOSE

Those
 are
 all
 the
 questions
 I
 have
 for
 you,
 but
 let
 me
 check
 with
 my
 colleagues
 to
 see
 if
 there
 are

issues
 you
 all
 raised
 about
 which
 they
 have
 additional
 questions.

[CHECK
 WITH
 OBSERVERS,
 RETURN
 AND
 ASK
 ADDITIONAL
 QUESTIONS,
 AS
 APPROPRIATE]

v9
 2/14/14

5

E-CIGARETTE FOCUS GROUP MODERATOR GUIDE
PATH ad hoc – E-cig and hookah formative research
NOTE -- ecig groups are online only

Thank
 you
 for
 your
 thoughts
 and
 your
 time
 today.

 We
 will
 send
 you
 $40
 as
 a
 thank
 you
 for
 your

particpation
 via
 FedEx.
 Do
 you
 have
 any
 other
 questions?

v9
 2/14/14

6