2014 NYTS Change Requst (CTG and OSH) 8 15 2013

Change Request

2012 – 2014 National Youth Tobacco Survey (NYTS)

(OMB no. 0920-0621, approved 01/04/2012, exp. date 01/31/2015)

August 15, 2013

Summary

Information collection for the National Youth Tobacco Survey consists of:

(1) a paper and pencil survey administered to U.S. middle and high school students.

We request the following:

OMB approval of new questions (some of which appeared on the 2012 NYTS) on the survey in order for the Center for Tobacco Products (CTP) to generate national estimates of key tobacco-related measures to inform CTP’s regulatory authority. The proposed change affects the National Youth Tobacco Survey Questionnaire, Attachment I-1.

Background and Justification

In the fall of 2011, the Centers for Disease Control and Prevention Office on Smoking and Health (OSH) and the Food and Drug Administration Center for Tobacco Products (CTP) entered into a collaboration to conduct the NYTS on an annual basis, with each Agency funding alternate years. OSH and CTP agreed that in order to minimize unnecessary duplication and redundancy, they would collaborate to leverage the NYTS to meet both Agencies’ goals. The collaboration agreement between OSH and CTP is that in even numbered years a portion of the NYTS content will focus more on the specific priorities of CTP and on odd number years a portion of the content will focus more on the specific priorities of OSH. The agreement was described in the Supporting Statement for the current NYTS clearance (see Section A.4, “In order to meet the needs of both CDC and FDA, the NYTS will be conducted annually, with questions of particular relevance to FDA being asked in even years, and questions relevant to CDC’s non-regulatory public health approaches being asked in the odd years. Thus, the survey is specifically being designed to avoid duplication while meeting the needs of both sister agencies.”)

In October 2012, OMB approved changes for the 2013 administration of the NYTS that reflected an emphasis on topics of particular interest to CDC (see http://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=201210-0920-006). The current Change Request will adjust survey content in 2014 to reflect emphasis on topics of particular interest to FDA.

Agency Points of Contact

René A. Arrazola, MPH Catherine G. Corey, MSPH

CDC FDA

(770) 488-2414 (301) 796-7396

rarrazola@cdc.gov Catherine.Corey@fda.hhs.gov

Below is a summary of the 35 questions to be removed from the 2013 NYTS for the 2014 cycle of data collection.

20. During the past 30 days, how did you get your own cigarettes? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER)

    1. I did not get cigarettes during the past 30 days

    2. I bought a pack of cigarettes myself

    3. I had someone else buy a pack of cigarettes for me

    4. I asked someone to give me a cigarette

    5. Someone offered me a cigarette

    6. I bought cigarettes from another person

    7. I took cigarettes from a store or another person

    8. I got cigarettes some other way

20. During the past 30 days, where did you buy your own cigarettes? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER)

    1. I did not buy cigarettes during the past 30 days

    2. A gas station or convenience store

    3. A grocery store

    4. A drugstore

    5. A vending machine

    6. Over the Internet

    7. Through the mail

    8. Some other place not listed here

20. During the past 30 days, did anyone refuse to sell you cigarettes because of your age?

    1. I did not try to buy cigarettes during the past 30 days

    2. Yes

    3. No

26. During the past 30 days, how did you get your own cigars, cigarillos, or little cigars? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER)

    1. I did not get cigars, cigarillos, or little cigars during the past 30 days

    2. I bought them myself

    3. I had someone else buy them for me

    4. I asked someone to give me one

    5. Someone offered it to me

    6. I bought them from another person

    7. I took them from a store or another person

    8. I got them some other way

26. During the past 30 days, where did you buy your own cigars, cigarillos, or little cigars? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER)

    1. I did not buy cigars, cigarillos, or little cigars during the past 30 days

    2. A gas station or convenience store

    3. A grocery store

    4. A drugstore

    5. A vending machine

    6. Over the Internet

    7. Through the mail

    8. Some other place not listed here

31. During the past 30 days, how did you get your own chewing tobacco, snuff, or dip? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER)

    1. I did not get chewing tobacco, snuff, or dip during the past 30 days

    2. I bought it myself

    3. I had someone else buy it for me

    4. I asked someone to give me some

    5. Someone offered it to me

    6. I bought it from another person

    7. I took it from a store or another person

    8. I got it some other way

31. During the past 30 days, where did you buy your own chewing tobacco, snuff, or dip? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER)

1. I did not buy chewing tobacco, snuff, or dip during the past 30 days

2. A gas station or convenience store

3. A grocery store

4. A drugstore

5. A vending machine

6. Over the Internet

7. Through the mail

8. Some other place not listed here

31. Have you ever tried smoking tobacco in a pipe, even one or two puffs?

    1. Yes

    2. No

31. During the past 30 days, on how many days did you smoke tobacco in a pipe?

    1. 0 days

    2. 1 or 2 days

    3. 3 to 5 days

    4. 6 to 9 days

    5. 10 to 19 days

    6. 20 to 29 days

    7. All 30 days

31. Which of the following tobacco products have you ever heard of? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER)

    1. Roll-your-own cigarettes

    2. Flavored cigarettes, such as Camel Crush

    3. Bidis (small brown cigarettes wrapped in a leaf)

    4. Clove cigars (kreteks)

    5. Flavored little cigars (such as mint, clove, spice, alcohol (wine, cognac), candy, fruit, chocolate, or other sweets)

    6. Smoking tobacco from a hookah or a waterpipe

    7. Snus, such as Camel or Marlboro Snus

    8. Dissolvable tobacco products, such as Ariva, Stonewall, Camel orbs, Camel sticks, or Camel strips

    9. Electronic Cigarettes or E-cigarettes, such as Ruyan or NJOY

    10. Some other new tobacco products not listed here

    11. I have never heard of any of the products listed above or any new tobacco product

38. How easy would it be for you to get tobacco products if you wanted some?

    1. Very easy

    2. Somewhat easy

    3. Not easy at all

38. Do you believe that tobacco companies try to get young people under 18 to use tobacco products?

    1. Yes

    2. No

44. During the past 30 days, how often did you see any ads or promotions for cigarettes or other tobacco products that were outdoors on a billboard or could be seen from outside a store?

    1. I did not see an ad for cigarettes or other tobacco products during the past 30 days

    2. Never

    3. Rarely

    4. Sometimes

    5. Most of the time

    6. Always

46. What is the name of your favorite cigarette brand? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER)

    1. American Spirit

    2. Camel

    3. GPC, Basic, or Doral

    4. Kool

    5. Marlboro

    6. Newport

    7. Some other brand not listed here

    8. I don’t have a favorite cigarette brand

    9. Not sure

46. Have you seen or heard advertisements against tobacco with any of the following? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER)

    1. A man who lost his legs from amputations (removal of body parts)

    2. A woman who lost her fingers and toes from amputations (removal of body parts)

    3. A man with a scar on his chest from a heart attack

    4. A woman putting on a wig and putting in her teeth while getting dressed

    5. A son bathing and caring for his mother on her bed because she had a stroke

    6. A mom giving her son an inhaler because he has breathing problems from being around adults who smoke cigarettes

    7. A man in the shower covering the hole in his neck

    8. A child scratching because of chicken pox

    9. Don’t know/Not sure

    10. I haven’t seen or heard any of these advertisements

51. Think about each time that you visited a doctor, dentist, or nurse in the past 12 months. During any of these visits were you asked if you used tobacco that is smoked or put in your mouth?

    1. I did not see a doctor, dentist, or nurse during the past 12 months

    2. Yes

    3. No

51. During the past 12 months, did any doctor, dentist, or nurse give you advice not to use tobacco that is smoked or put in your mouth?

    1. I did not see a doctor, dentist, or nurse during the past 12 months

    2. Yes

    3. No

55. When you last tried to quit for good, how long did you stay off cigarettes? (PLEASE CHOOSE THE FIRST ANSWER THAT FITS)

    1. I have never smoked cigarettes

    2. I have never tried to quit

    3. Less than a day

    4. 1 to 7 days

    5. More than 7 days but less than 30 days

    6. More than 30 days but less than 6 months

    7. More than 6 months but less than 1 year

    8. 1 year or more

58. In the past 12 months, did you do any of the following to help you quit using tobacco of any kind for good? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER)

    1. I did not use tobacco of any kind during the past 12 months

    2. I did not try to quit during the past 12 months

    3. Attended a program in my school

    4. Attended a program in the community

    5. Called a telephone help line or telephone quit line

    6. Used nicotine gum

    7. Used nicotine patch

    8. Used any medicine to help quit

    9. Visited an Internet quit site

    10. Got help from family or friends

    11. Used another method, such as hypnosis or acupuncture

    12. Tried to quit on my own or quit “cold turkey”

61. During the past 7 days, on how many days did you breathe the smoke from someone who was smoking a tobacco product at your school, including school buildings, school grounds, and school parking lots?

    1. 0 days

    2. 1 day

    3. 2 days

    4. 3 days

    5. 4 days

    6. 5 days

    7. 6 days

    8. 7 days

61. During the past 7 days, on how many days did you breathe the smoke from someone who was smoking tobacco products in the place where you work?

    1. I do not have a job

    2. I did not work during the past 7 days

    3. 0 days

    4. 1 day

    5. 2 days

    6. 3 days

    7. 4 days

    8. 5 days

    9. 6 days

    10. 7 days

61. During the past 7 days, on how many days did you breathe the smoke from someone who was smoking tobacco products in an indoor or outdoor public place? Examples of indoor public places are school buildings, stores, restaurants, and sports arenas. Examples of outdoor public places are school grounds, parking lots, stadiums and parks.

    1. 0 days

    2. 1 day

    3. 2 days

    4. 3 days

    5. 4 days

    6. 5 days

    7. 6 days

    8. 7 days

61. Inside your home (not counting decks, garages, or porches) is smoking…

    1. Always allowed

    2. Allowed only at some times or in some places

    3. Never allowed

61. In the vehicles that you and family members who live with you own or lease, is smoking…

    1. Always allowed

    2. Sometimes allowed

    3. Never allowed

67. How many of your closest friends use any form of tobacco?

    1. None

    2. One

    3. Two

    4. Three

    5. Four

    6. Five or more

    7. Not sure

69. In your opinion, inside your home, smoking tobacco products should….

1. Always be allowed

2. Be allowed only at some times or in some places

3. Never be allowed

69. In your opinion, in their vehicles, people should …

1. Always allow smoking

2. Sometimes allow smoking

3. Never allow smoking

72. Do you believe any of the following are less harmful than smoking cigarettes? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER)

1. Smoking tobacco from a hookah or waterpipe

2. Smoking tobacco from a pipe other than a waterpipe

3. Smoking Bidis (small brown cigarettes wrapped in a leaf)

4. Smoking Clove cigarettes (kreteks)

5. Smoking flavored cigars, little cigars, and cigarillos (such as mint, clove, spice, alcohol (wine, cognac), candy, fruit, chocolate, or other sweets)

6. Smoking cigars, cigarillos, or little cigars (those that are not flavored)

7. Using electronic cigarettes, such as Ruyan or NJOY

8. Do not know

9. I do not believe that any of the above products are less harmful than cigarettes.

72. Do you believe any of the following are less harmful than smoking cigarettes? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER)

1. Using chewing tobacco, snuff, or dip

2. Using snus, such as Camel or Marlboro Snus

3. Using dissolvable tobacco products, such as Ariva, Stonewall, Camel orbs, Camel sticks, Marlboro sticks, or Camel strips

4. Using electronic cigarettes, such as Ruyan or NJOY

5. Do not know

6. I do not believe that any of the above products are less harmful than cigarettes

76. Would your parents or guardians strongly disapprove if you used tobacco products?

1. I don’t use tobacco products, and my parents would strongly disapprove if I did

2. I don’t use tobacco products, and my parents would not strongly disapprove if I did

3. I use tobacco products, and my parents strongly disapproved when they first found out

4. I use tobacco products, and my parents did not strongly disapprove when they first found out

5. I use tobacco products, but my parents don’t know, and they would strongly disapprove if they knew

6. I use tobacco products, but my parents don’t know, and they would not strongly disapprove if they knew

76. During the past 12 months, have you been involved in any organized activities to keep people your age from using any form of tobacco product?

1. Yes

2. No

76. During this school year, were you taught in any of your classes about why you should not use tobacco products?

1. Yes

2. No

76. During the past 30 days, to your knowledge, has anyone, including yourself, smoked a tobacco product on school property when he or she was not supposed to?

1. Yes

2. No

76. During the past 30 days, to your knowledge, has anyone, including yourself, used some other type of tobacco product (that is, one that is not smoked) on school property when he or she was not supposed to?

1. Yes

2. No

76. During the past 30 days, how many days did you miss at least one class period because you skipped or "cut" or just did not want to be there?

1. 0 days

2. 1 day

3. 2 to 5 days

4. 6 to 10 days

5. 11 or more days

(continued on next page)

The 2014 NYTS will reinstate 16 questions that were included in the 2012 NYTS, but dropped in the 2013 NYTS:

9. Have you ever been curious about smoking a cigarette?

   1. Definitely yes

   2. Probably yes

   3. Probably not

   4. Definitely not

21. How likely is it that you will try to purchase cigarettes within the next 30 days?

    1. I do not smoke cigarettes

    2. Very likely

    3. Somewhat likely

    4. Somewhat unlikely

    5. Very unlikely

21. Have you ever been curious about smoking a cigar, cigarillo, or little cigar such as Black and Mild, Swisher Sweets, Dutch Masters, White Owl, or Phillies Blunts?

1. Definitely yes

2. Probably yes

3. Probably not

4. Definitely not

27. Have you ever been curious about using chewing tobacco, snuff, or dip, such as Redman, Levi Garrett, Beechnut, Skoal, Skoal Bandits, or Copenhagen?

    1. Definitely yes

    2. Probably yes

    3. Probably not

    4. Definitely not

40. How easy do you think it is for kids your age to buy tobacco products in a store?

    1. Easy

    2. Somewhat easy

    3. Not easy at all

41. During the past 30 days, have you had a strong craving or felt like you really needed to use a tobacco product of any kind (such as smoking a cigarette or cigar, or using chewing tobacco)?

    1. Yes

    2. No

42. During the past 30 days, was there a time when you wanted to use a tobacco product so much that you found it difficult to think of anything else?

    1. Yes

    2. No

44. How true is this statement for you? I feel restless and irritable when I don’t use tobacco for a while.

    1. I do not use tobacco

    2. Not at all true

    3. Sometimes true

    4. Often true

    5. Always true

49. How much do you think people harm themselves when they smoke cigarettes some days but not every day?

    1. No harm

    2. Little harm

    3. Some harm

    4. A lot of harm

53. How much do you think people harm themselves when they use chewing tobacco, snuff, dip, or snus, some days but not every day?

    1. No harm

    2. Little harm

    3. Some harm

    4. A lot of harm

57. Do you believe that e-cigarettes are (LESS HARMFUL, EQUALLY HARMFUL, or MORE HARMFUL) than regular cigarettes?

    1. Less harmful

    2. Equally harmful

    3. More harmful

    4. I have never heard of e-cigarettes

    5. I don’t know enough about these products

59. How strongly do you agree with the statement ‘All tobacco products are dangerous’?

    1. Strongly agree

    2. Agree

    3. Disagree

    4. Strongly disagree

66. In the past 30 days, how often have you thought about the harmful chemicals in tobacco products?

    1. Never

    2. Rarely

    3. Sometimes

    4. Often

    5. Very often

66. A warning label tells you if a product is harmful to you and can be either a picture or words. During the past 30 days, how often did you see a warning label on a cigarette pack?

    1. I did not see a cigarette pack during the past 30 days

    2. Never

    3. Rarely

    4. Sometimes

    5. Most of the time

    6. Always

66. During the past 30 days, how often did you see a warning label on a smokeless tobacco product such as chewing tobacco, snuff, dip, or snus?

    1. I did not see a smokeless tobacco product during the past 30 days

    2. Never

    3. Rarely

    4. Sometimes

    5. Most of the time

    6. Always

76. Out of every 10 students in your grade at school, how many do you think use tobacco products other than cigarettes?

1. 0

2. 1

3. 2

4. 3

5. 4

6. 5

7. 6

8. 7

9. 8

10. 9

11. 10

(continued on next page)

The 2014 NYTS will include 19 new questions:

Original Question (Before Cognitive Testing)	Changes Made Based on Cognitive Testing	Final Question (After Cognitive Testing)
26. During the past 30 days, on the days that you smoked, about how many cigars, cigarillos, or little cigars did you smoke per day? A. I did not smoke cigars, cigarillos, or little cigars during the past 30 days B. Less than 1 cigar, cigarillo or little cigar per day C. 1 D. 2 to 5 E. 6 to 10 F. 11 to 20 G. More than 20	“Per day” was added to response options C-G.	26. During the past 30 days, on the days that you smoked, about how many cigars, cigarillos, or little cigars did you smoke per day? A. I did not smoke cigars, cigarillos, or little cigars during the past 30 days B. Less than 1 cigar, cigarillo or little cigar per day C. 1 per day D. 2 to 5 per day E. 6 to 10 per day F. 11 to 20 per day G. More than 20 per day
Have you ever been curious about smoking a cigarette? A. Definitely yes B. Probably yes C. Probably not D. Definitely not Have you ever been curious about smoking a cigar, cigarillo, or little cigar such as Black and Mild, Swisher Sweets, Dutch Masters, White Owl, or Phillies Blunts? A. Definitely yes B. Probably yes C. Probably not D. Definitely not Have you ever been curious about using chewing tobacco, snuff, or dip such as Redman, Levi Garrett, Beechnut, Skoal, Skoal Bandits, or Copenhagen? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	On 2012 NYTS, curiosity was asked about 3 tobacco products: cigarettes, cigars/cigarillos/little cigars, smokeless tobacco. In 2014, the identical question stem and response options were applied to e-cigarettes.	31. Have you ever been curious about using an electronic cigarette or e-cigarette such as blu, 21st Century Smoke, or NJOY? A. Definitely yes B. Probably yes C. Probably not D. Definitely not
32. Have you ever tried an electronic cigarette or e-cigarette such as blu, 21st Century Smoke, or NJOY? A. Yes B. No	No changes were made.	32. Have you ever tried an electronic cigarette or e-cigarette such as blu, 21st Century Smoke, or NJOY? A. Yes B. No
33. During the past 30 days, on how many days did you use electronic cigarettes or e-cigarettes such as blu, 21st Century Smoke, or NJOY? A. 0 days B. 1 or 2 days C. 3 to 5 days D. 6 to 9 days E. 10 to 19 days F. 20 to 29 days G. All 30 days	No changes were made.	33. During the past 30 days, on how many days did you use electronic cigarettes or e-cigarettes such as blu, 21st Century Smoke, or NJOY? A. 0 days B. 1 or 2 days C. 3 to 5 days D. 6 to 9 days E. 10 to 19 days F. 20 to 29 days G. All 30 days
Were any of the tobacco products you used in the past 30 days flavored to taste like menthol (mint), alcohol (wine, cognac), candy, fruit, chocolate, or other sweets? A. I did not use any flavored products in the past 30 days B. Yes C. No Tobacco products can have flavors like menthol (mint), fruit (grape, strawberry, peach), wine, candy or other sweets. During the past 30 days, did you use: A. Flavored cigars, cigarillos, or little cigars B. Flavored smokeless tobacco such as chewing tobacco, snuff, or dip c. Flavored electronic cigarettes or e-cigarettes D. I did not use flavored cigars, smokeless tobacco or e-cigarettes during the past 30 days	A flavored product question on 2012 NYTS proved analytically challenging although cognitive testing did not show confusion with the question. In 2014 a question on flavors was tested that included multiple product-specific response option. Participants had no difficulty answering the question and suggested removing the examples in parentheses to shorten the question. To address analytic challenges, on NYTS 2012, the question was updated for 2014 with specific tobacco product response options.	36. Were any of the following tobacco products you used in the past 30 days flavored to taste like menthol (mint), alcohol (wine, cognac), candy, fruit, chocolate or other sweets? A. Cigars, cigarillos, or little cigars B. Chewing tobacco, snuff, or dip C. Electronic cigarettes or e-cigarettes D. Smoking tobacco out of a hookah or waterpipe E. Pipes filled with tobacco (not waterpipe) F. Snus G. Dissolvable tobacco products H. I did not use flavored tobacco products during the past 30 days
During the past 30 days, how did you get your own cigarettes? A. I did not get cigarettes during the past 30 days B. I bought a pack of cigarettes myself C. I had someone else buy a pack of cigarettes for me D. I asked someone to give me a cigarette E. Someone offered me a cigarette F. I bought cigarettes from another person G. I took cigarettes from a store or another person F. I got cigarettes some other way During the past 30 days, how did you get your own cigars, cigarillos, or little cigars? A. I did not get cigars, cigarillos or little cigars during the past 30 days B. I bought them myself C. I had someone else buy them for me D. I asked someone to give me one E. Someone offered it to me F. I bought them from another person G. I took them from a store or another person F. I got them some other way During the past 30 days, how did you get your own chewing tobacco, snuff, or dip? A. I did not get chewing tobacco, snuff, or dip during the past 30 days B. I bought it myself C. I had someone else buy it for me D. I asked someone to give me some E. Someone offered it to me F. I bought it from another person G. I took it from a store or another person F. I got it some other way	For 2013 NYTS the concept of how participants got their tobacco products was cognitively tested for cigarettes, cigars/cigarillos/little cigars and smokeless tobacco questions. Subsequent data analysis indicated responses to where students got their own tobacco did not vary by tobacco product type. For 2014 NYTS, Q37 uses the identical question stem and comparable response options to 2013, and asks about tobacco products collectively. (continued from above)	37. During the past 30 days, how did you get your own tobacco products? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER) A. I did not get any tobacco products during the past 30 days B. I bought them myself C. I had someone else buy them for me D. I asked someone to give me some E. Someone offered them to me F. I bought them from another person G. I took them from a store or another person H. I got them some other way (continued from above)
During the past 30 days, where did you buy your own cigarettes? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER). A. I did not buy cigarettes during the past 30 days B. A gas station or convenience store C. A grocery store D. A drugstore E. A vending machine F. Over the Internet G. Through the mail H. Some other place not listed here During the past 30 days, where did you buy your own cigars, cigarillos, or little cigars? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER). A. I did not buy cigars, cigarillos or little cigars during the past 30 days B. A gas station or convenience store C. A grocery store D. A drugstore E. A vending machine F. Over the Internet G. Through the mail H. Some other place not listed here During the past 30 days, where did you buy your own chewing tobacco, snuff, or dip? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER). A. I did not buy chewing tobacco, snuff, or dip during the past 30 days B. A gas station or convenience store C. A grocery store D. A drugstore E. A vending machine F. Over the Internet G. Through the mail H. Some other place not listed here	For 2013 NYTS the concept of where participants bought tobacco was cognitively tested for cigarettes, cigars/cigarillos/little cigars and smokeless tobacco questions. Subsequent data analysis indicated responses to where students bought their own tobacco did not vary by product type. For 2014 NYTS, Q38 uses the identical question stem and comparable response options as 2013, and asks about tobacco products collectively.	38. During the past 30 days, where did you buy your own tobacco products? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER) A. I did not buy tobacco products during the past 30 days B. A gas station or convenience store C. A grocery store D. A drugstore E. A vending machine F. Over the Internet G. Through the mail H. Some other place not listed here
Q39. During the past 30 days, did anyone working at a store or gas station refuse to sell you any tobacco products because of your age? A. I did not try to buy tobacco products at a store or gas station during the past 30 days B. Yes C. No	Participants had no difficulty answering the question. The phrase store or gas station was removed.	Q39. During the past 30 days, did anyone refuse to sell you any tobacco products because of your age? A. I did not try to buy any tobacco products during the past 30 days B. Yes C. No
Q50. How much do you think people harm themselves when they smoke little cigars or cigarillos such as Black and Milds, Swisher Sweets or Philies Blunts? A. No harm B. Little harm C. Some harm D. A lot of harm E. Don’t know	Updated to add ‘cigars’ since some participants were thinking about traditional cigars when answering the question--using the 3 cigar product list is consistent with products described in the tobacco use section. Added statement “some days but not every day” to clarify the frequency of use in thinking about the harms of cigar smoking. By clarifying frequency, removed response option don’t know. Removed brand examples to make it easier to read and because participants tended to refer to these products by the brand name anyway.	Q50. How much do you think people harm themselves when they smoke cigars, cigarillos or little cigars some days but not every day? A. No harm B. Little harm C. Some harm D. A lot of harm
Q51. Do you believe that little cigars or cigarillos, such as Black and Milds, Swisher Sweets, White Owls, or Phillies Blunts, are (LESS HARMFUL, EQUALLY HARMFUL, OR MORE HARMFUL) than regular cigarettes? A. Less harmful B. Equally harmful C. More harmful D. I have never heard of little cigars or cigarillos E. I don’t know enough about little cigars or cigarillos	Updated to add ‘cigars’ since some participants were thinking about traditional cigars when answering harm perception questions--using the 3 cigar product list is consistent with products described in tobacco use section. Remove brand examples to make it easier to read and because participants tended to refer to these products by the brand name. Revised option E to reflect all products identified in the question.	Q51. Do you believe that cigars, cigarillos, or little cigars are (LESS HARMFUL, EQUALLY HARMFUL, or MORE HARMFUL) than cigarettes? A. Less harmful B. Equally harmful C. More harmful D. I have never heard of cigars, little cigars or cigarillos E. I don’t know enough about these products
Q52. Do you believe that little cigars or cigarillos, such as Black and Milds, Swisher Sweets, or Phillies Blunts are (LESS ADDICTIVE, EQUALLY ADDICTIVE, OR MORE ADDICTIVE) than cigarettes? A. Less addictive B. Equally addictive C. More addictive D. I have never heard of little cigars or cigarillos E. I don’t know enough about little cigars or cigarillos	Updated to add ‘cigars’ since some participants were thinking about traditional cigars when answering harm perception questions--using the 3 cigar product list is consistent with products described in the tobacco use section. Remove brand examples to make it easier to read and because participants tended to refer to these products by the brand name. Revised option E to reflect all products identified in the question.	Q52. Do you believe that cigars, cigarillos or little cigars are (LESS ADDICTIVE, EQUALLY ADDICTIVE, or MORE ADDICTIVE) than cigarettes? A. Less addictive B. Equally addictive C. More addictive D. I have never heard of cigars, cigarillos, or little cigars E. I don’t know enough about these products
Q51. Do you believe that little cigars or cigarillos, such as Black and Milds, Swisher Sweets, White Owls, or Phillies Blunts, are (LESS HARMFUL, EQUALLY HARMFUL, OR MORE HARMFUL) than regular cigarettes? A. Less harmful B. Equally harmful C. More harmful D. I have never heard of little cigars or cigarillos E. I don’t know enough about little cigars or cigarillos	The concept of relative harm between cigarettes and another tobacco product was tested with e-cigarettes for NYTS 2012 and cigarillos for 2014; participants did not have difficulty with the question. For 2014 NYTS, Q54 uses the identical question stem and comparable response options as Q51, and replaces cigarillos with smokeless tobacco.	Q54. Do you believe that chewing tobacco, snuff, dip, or snus is (LESS HARMFUL, EQUALLY HARMFUL, or MORE HARMFUL) than cigarettes? A. Less harmful B. Equally harmful C. More harmful D. I have never heard of chewing tobacco, snuff, dip or snus E. I don’t know enough about these products
Q52. Do you believe that little cigars or cigarillos, such as Black and Milds, Swisher Sweets, or Phillies Blunts are (LESS ADDICTIVE, EQUALLY ADDICTIVE, OR MORE ADDICTIVE) than cigarettes? A. Less addictive B. Equally addictive C. More addictive D. I have never heard of little cigars or cigarillos E. I don’t know enough about little cigars or cigarillos	The concept of relative addictiveness between cigarettes and another tobacco product was tested with cigarillos for NYTS 2014; participants did not have difficulty with Q52. For 2014 NYTS, Q55 uses the identical question stem and comparable response options as Q52, and replaces cigarillos with smokeless tobacco.	Q55. Do you believe that chewing tobacco, snuff, dip or snus is (LESS ADDICTIVE, EQUALLY ADDICTIVE, or MORE ADDICTIVE) than cigarettes? A. Less addictive B. Equally addictive C. More addictive D. I have never heard of chewing tobacco, snuff, dip or snus E. I don’t know enough about these products
Q49. How much do you think people harm themselves when they smoke cigarettes some days but not every day? A. No harm B. Little harm C. Some harm D. A lot of harm Q53. How much do you think people harm themselves when they use chewing tobacco, snuff, dip, or snus, some days but not every day? A. No harm B. Little harm C. Some harm D. A lot of harm	The concept of harm and tobacco product exposure frequency was tested with cigarettes and smokeless tobacco for NYTS 2012; participants did not have difficulty with the questions. For 2014 NYTS, Q56 uses the identical question stem and comparable response options as Q49 and Q53, and applies e-cigarettes as the tobacco product.	Q56. How much do you think people harm themselves when they use e-cigarettes some days but not every day? A. No harm B. Little harm C. Some harm D. A lot of harm
Q52. Do you believe that little cigars or cigarillos, such as Black and Milds, Swisher Sweets, or Phillies Blunts are (LESS ADDICTIVE, EQUALLY ADDICTIVE, OR MORE ADDICTIVE) than cigarettes? A. Less addictive B. Equally addictive C. More addictive D. I have never heard of little cigars or cigarillos E. I don’t know enough about little cigars or cigarillos	The concept of relative addictiveness between cigarettes and another tobacco product was tested with cigarillos for NYTS 2014; participants did not have difficulty with Q52. For 2014 NYTS, Q58 uses the identical question stem and comparable response options as Q52, and replaces cigarillos with smokeless tobacco.	Q58. Do you believe that e-cigarettes are (LESS ADDICTIVE, EQUALLY ADDICTIVE, or MORE ADDICTIVE) than cigarettes? A. Less addictive B. Equally addictive C. More addictive D. I have never heard of e-cigarettes E. I don’t know enough about these products
Q71. Do you think smoking cigars, cigarillos or little cigars makes young people look cool or fit in? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	No changes were made.	Q71. Do you think smoking cigars, cigarillos or little cigars makes young people look cool or fit in? A. Definitely yes B. Probably yes C. Probably not D. Definitely not
Q72. Do you think young people who smoke cigars, cigarillos or little cigars have more friends? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	No changes were made.	Q72. Do you think young people who smoke cigars, cigarillos or little cigars have more friends? A. Definitely yes B. Probably yes C. Probably not D. Definitely not
Q72. Do you think young people who smoke cigars, cigarillos or little cigars have more friends? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	The concept of social norms around non-cigarette products was tested with cigars/cigarillos/little cigars for NYTS 2014; participants did not have difficulty with the questions. For 2014 NYTS, Q73 uses the identical question stem and comparable response options as Q72, and replaces cigars/cigarillos/little cigars with smokeless tobacco.	Q73. Do you think young people who use chewing tobacco, snuff, or dip have more friends? A. Definitely yes B. Probably yes C. Probably not D. Definitely not
Q72. Do you think young people who smoke cigars, cigarillos or little cigars have more friends? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	The concept of social norms around non-cigarette products was tested with cigars/cigarillos/little cigars for NYTS 2014; participants did not have difficulty with the questions. For 2014 NYTS, Q74 uses the identical question stem and comparable response options as Q72, and replaces cigars/cigarillos/little cigars with smokeless tobacco.	Q74. Do you think young people who use e-cigarettes have more friends? A. Definitely yes B. Probably yes C. Probably not D. Definitely not

(continued on next page)

Effect of Proposed Changes on the Burden Estimate

None. The 2014 NYTS will include 81 questions and there is no change in the overall question count or the estimated burden per response. There is no change in the estimated number of respondents.

Effect of Proposed Changes on Currently Approved Instruments and Attachments

Replace current version of Attachment I-1, “2013 NYTS Questionnaire,” with new version revised on 08/14/2013. To see the proposed change in context, refer to the revised instrument.

8