Focus Group Study of Youth Reactions to Strategic and Creative Advertising Concepts Designed to Prevent Youth Tobacco Use among Multicultural Youth

Creative Concept Survey						Unique ID:			OMB Control # 0910-0674
									Expires 3/31/2016
Version ____________
Ad #1__________
Instructions: For each statement in the left column, circle the * that best represents your level of agreement or disagreement with that statement.
					Completely Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Completely Agree
(a) This ad would convince people my age to LIVE TOBACCO-FREE.					*	*	*	*	*
(b) I would TALK ABOUT this ad with my friends.					*	*	*	*	*
(c) This ad would be RELEVANT TO MY FRIENDS AND ME.					*	*	*	*	*
Ad #2__________
Instructions: For each statement in the left column, circle the * that best represents your level of agreement or disagreement with that statement.
					Completely Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Completely Agree
(a) This ad would convince people my age to LIVE TOBACCO-FREE.					*	*	*	*	*
(b) I would TALK ABOUT this ad with my friends.					*	*	*	*	*
(c) This ad would be RELEVANT TO MY FRIENDS AND ME.					*	*	*	*	*
Ad #3__________
Instructions: For each statement in the left column, circle the * that best represents your level of agreement or disagreement with that statement.
					Completely Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Completely Agree
(a) This ad would convince people my age to LIVE TOBACCO-FREE.					*	*	*	*	*
(b) I would TALK ABOUT this ad with my friends.					*	*	*	*	*
(c) This ad would be RELEVANT TO MY FRIENDS AND ME.					*	*	*	*	*
Ad #4__________
Instructions: For each statement in the left column, circle the * that best represents your level of agreement or disagreement with that statement.
					Completely Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Completely Agree
(a) This ad would convince people my age to LIVE TOBACCO-FREE.					*	*	*	*	*
(b) I would TALK ABOUT this ad with my friends.					*	*	*	*	*
(c) This ad would be RELEVANT TO MY FRIENDS AND ME.					*	*	*	*	*
Ad #5__________
Instructions: For each statement in the left column, circle the * that best represents your level of agreement or disagreement with that statement.
					Completely Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Completely Agree
(a) This ad would convince people my age to LIVE TOBACCO-FREE.					*	*	*	*	*
(b) I would TALK ABOUT this ad with my friends.					*	*	*	*	*
(c) This ad would be RELEVANT TO MY FRIENDS AND ME.					*	*	*	*	*
Ad #6__________
Instructions: For each statement in the left column, circle the * that best represents your level of agreement or disagreement with that statement.
					Completely Disagree	Somewhat Disagree	Neither Agree nor Disagree	Somewhat Agree	Completely Agree
(a) This ad would convince people my age to LIVE TOBACCO-FREE.					*	*	*	*	*
(b) I would TALK ABOUT this ad with my friends.					*	*	*	*	*
(c) This ad would be RELEVANT TO MY FRIENDS AND ME.					*	*	*	*	*
Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated
to average 45 minutes per response to complete (the time estimated to read, complete, and review responses in group discussion).
Send comments regarding this burden estimate or any other aspects of this information collection, including suggestions for reducing burden, to PRAStaff@fda.hhs.gov.