Qualitative Study on Cigarettes and Smoking: Knowledge, Beliefs, and Misperceptions about cigarettes and cigarette smoking

OMB No. 0910-0674 Exp. Date: 3/31/16

Qualitative Study on Cigarettes and Smoking: Knowledge, Beliefs, and Misperceptions about Cigarettes and Cigarette Smoking

Moderator Guide

Research Questions

1. What knowledge (accurate and misperceptions) do people possess with regard to cigarette smoking?

2. What information do people take away from the draft warning statements?

3. Do people think the draft warning statements are believable/realistic/factual?

4. Do people think that the draft warning statements will provide new information and/or knowledge to the public?

5. To whom should these statements be attributed so that they are the most believable/realistic/factual and attended to?

Introduction and Ground Rules [3 minutes]

MODERATOR: Welcome and thank you for participating in tonight’s discussion. My name is _________________. Tonight, I am interested in hearing your opinions about tobacco products. You have been asked to participate in tonight’s discussion [all groups except adolescent susceptible: because you have smoked cigarettes].

Before we begin, I want to go over a few ground rules for our discussion tonight, which will last about an hour.

• Your participation is voluntary and you have the right to not answer any question or withdraw from the study at any time.

• If at any time you are uncomfortable with my questions, you can choose not to answer. Just let me know that you prefer not to answer.

• Everything we discuss today will be kept private to the extent allowable by law. Your name and contact information, which only the study staff knows, will not be given to anyone else, and no one will contact you after this discussion is over.

• Tonight’s discussion will be audio-recorded. The recordings will help me write the final report and will be kept in a secure location and then destroyed at the end of the study. No names will be mentioned in the final report created from these interviews.

• Behind me is a one-way mirror. Behind that are some of my colleagues. We are also videostreaming our group. They’re watching to make sure that I ask you all of the questions I have for you today. Near the end of our conversation, I’m going to go into the back and see if they have any last minute questions for you.

• Most importantly, there are no right or wrong answers. I want to know your opinions. I do not work for the people sponsoring this research and I didn’t write the questions we’re going to look at, so don’t hold back on giving me your honest opinions.

• I’m not a medical doctor or an expert on smoking or tobacco, so I can’t answer specific questions.

• Please silence your cell phones.

• Do you have any questions before we begin?

Warm-up [2 minutes]

• What would you be doing if you weren’t here?

General Probes – Apply throughout:

• Knowledge/information source: Where did you hear this?

• If topic moves to other tobacco products - Remind participants that in this discussion we are asking them to only focus on cigarettes.

“The only tobacco product we’ll be talking about today is cigarettes.”

Part I: Beliefs about the harms of smoking [12-15 Minutes]

1. I’d like to know what first comes to mind when you think of cigarettes, and, in particular, what concerns you have about cigarette smoking.

Probes:

• (if no health effects brought up by participants):

  • What have you heard about the health risks of cigarette smoking?

• (if health effect brought up, write effect on white board and probe:)

  • If “Cancer” is mentioned ask “What kind of cancer?”

  • If “Lung damage” or other general lung effects are brought up ask “What does that mean”

  • Can you tell me more about that?

  • Is that something that is likely to happen for smokers or is it pretty rare?

  • (if they say they have heard something but don’t believe it) Why not?

  • Is that something that you think might happen to you (if you continued smoking (for susceptible youth: if you smoked?)

  • (Be sure to ask this for EVERY health effect mentioned): Is that for people who smoke cigarettes or from being exposed to secondhand smoke or both?

  • If someone gets that, what would happen to them? (trying to get physical consequences…death, having to be on oxygen, etc….)

• (to probe for additional health effects not mentioned by participants):
  What other things have you heard about the health risks of cigarette smoking? (ask all probes in red text above for each new health effect mentioned)

2. Which of these effects do you hear about most often? Which of these effects do you hear most often for secondhand exposure to cigarette smoking? Which of these do you not hear about much? Are any of the risks/harmful effects that we discussed things that you haven’t heard before today?

Part II: Reactions to Warning Statements [40-45 Minutes]

Transition: Now that we’ve talked about what you know about the health risks of smoking we’re going to focus on warnings on cigarette packs and ads

1. What comes to mind when you think about/ warnings on cigarette packs or ads?

2. How much do you notice (or pay attention to) warnings on cigarette packs or ads?

Probes:

• (if they bring up the Surgeon General) Who is the Surgeon General [interested in the job/duties/responsibilities, not the SG’s name]/What do they do? Do you trust information from the Surgeon General?

Now we’re going to show you some warnings that could appear on cigarette packs or ads and ask for your reactions to them.

[Show warnings one at a time, repeat items for each warning statement]

3. What do you think this statement means in your own words?

4. Is there anything unclear/confusing about it?

Probes:

• Would explaining how this (outcome) happens make it clearer?

5. How believable is this statement? (why/why not?)

6. Does this apply to you? (why/why not?)

[Show all warnings on the board in front of the group]

7. If you saw any of these statements on cigarette packs, who would you think put them there? Who should these warnings come from to be the most believable? Would you trust the information more or less if it came from…

Probes:

• Surgeon General

• Food and Drug Administration (FDA)

• Department of Health and Human Services

• Medical/Public Health Experts

• Federal Government

8. We’ve heard that some of this information is new to a lot of people. Some statements might be more informative to you than others. We’re interested in knowing which statements we talked about taught you something new about cigarettes or smoking that you didn’t know before today. Please take a minute to use the sheet we gave you called “New Information” and place a check mark in the box next to the statements that taught you something new about cigarettes or smoking.

[wait for participants to finish]

Now we’ll quickly talk about each statement. For statement # [1], what did you learn that you did not know before you came here? [repeat for all statements]

Probe:

• Was there any part of the statement that was different from something you already knew?

[if time permits]

I’m going to step out of the room for a minute to see if my colleagues have any additional questions for you. In the meantime, I’m going to pass out a handout with all of the statements that we talked about today. The statements are the same ones that are up on the board. While I am out of the room, please put an X in the boxes next to the 3 statements that grabbed your attention the most. On the line under each of those three statements, please write a brief reason why that statement got your attention.

False close [3 minutes]

[Check back room for any additional or follow-up questions]

Before we wrap up, I’d like to quickly hear from you about which statements grabbed your attention the most.” When participants name the statements, the moderator will ask participants to say what features of the chosen statements were attention-grabbing.

Conclusion and Debrief [2 minutes]

I would like to thank you for coming here today and participating in this discussion. This research was sponsored by the Food and Drug Administration also known as the FDA. FDA would like to thank you for sharing your opinions as they will be very useful in helping them to understand people’s reactions and thoughts about the tobacco products we have talked about.