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Attachment 5
Summary of Changes to
PATH Study Instruments for Wave 2
June 26, 2014
Attachment 5 - Summary of Changes to PATH Study Instruments
The purpose of this attachment is to provide a high-level overview of changes to the PATH questionnaires
from Wave 1 to Wave 2. This overview includes the change in total item counts per section across Waves
(tables ‘a’), as well as a description summary of the content that was added or deleted in Wave 2 that
corresponds to the fluctuations in item counts (tables ‘b’).
The following tables outline changes in the (a) item counts and (b) questionnaire content across Waves for
the:
- Adult Questionnaire (see Tables 1a and 1b),
- Youth Questionnaire (see Tables 2a and 2b),
- Parent Questionnaire (see Tables 3a and 3b), and
- Nicotine Exposure Questionnaire (see Tables 4a and 4b).
Table 1a. ADULT QUESTIONNAIRE - Change in Total Item Counts from Wave 1 to Wave 2
Total Number of Items per Section
Adult Questionnaire Section
Wave 1
Introductory Demographics
Wave 2
Change in Total Item
Count from W1 to W2
Extended
Aged-In
Extended
Aged-In
13
3
3
-10
-10
Tobacco Use (includes ENDS items)
54
129
129
+75
+75
Cigarette
56
53
57
-3
+1
E-Cigarette
55
61
65
+6
+10
Cigar
47
42
46
-5
-1
Pipe
41
38
42
-3
+1
Hookah
53
49
53
-4
0
Smokeless Tobacco and Snus
51
47
51
-4
0
Dissolvable Tobacco
47
43
47
-4
0
Polyuse
5
5
5
0
0
Nicotine Dependence
71
72
72
+1
+1
Packaging and Health Warnings
27
17
17
-10
-10
Product Regulation
29
34
34
+5
+5
Media Use
13
15
15
+2
+2
Secondhand Smoke Exposure
8
10
10
+2
+2
Peer and Family Influences
3
4
4
+1
+1
Health (includes substance use items)
148
112
154
-36
+6
Marketing, Advertising and Promotion
16
23
29
+7
+13
Additional Demographics
17
25
25
+8
+8
Product Barcode Scanning
--
10
10
+10
+10
Contact Information
22
25
25
+3
+3
Total (Entire Questionnaire)
776
817
893
+41
+117
*Note: This table reflects total item counts; it does not account for the conditions in which the items are asked. For
example, due to skip patterns, every respondent is not asked all items reflected in these counts. Consequently, the
average time to complete the Adult interview remains at 60 minutes for both the Wave 1 and Wave 2 Extended
instruments, and increases to 68 minutes for the Wave 2 Aged-In instrument.
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Attachment 5 - Summary of Changes to PATH Study Instruments
TABLE 1b. ADULT QUESTIONNAIRE – Description of Content Changes from Wave 1 to Wave 2
Wave 2 Section
Wave 2
Change
Added
Introductory
Demographics
Rationale for Change
Adults
On respondent’s marital status.
To inform Wave 2 weighting.
For adults in Wave 1, this information was used for sampling and for baseline
demographic information; therefore, no need to ask again in Wave 2. For
youth in Wave 1 that age-in to the adult cohort, this information was captured
in the Wave 1 youth survey; therefore, no need to ask again in Wave 2.
Adults
On respondent’s sex, race, and
ethnicity.
Added
Adults
On respondent’s tobacco use status at
Wave 2 to compare with tobacco use
status reported at Wave 1.
Young
adults
On non-user respondent's susceptibility
to becoming a tobacco user.
Young adults aged 18-to-24 initiate tobacco use at higher rates than older
adults; susceptibility to initiate tobacco use is assessed among youth in Wave 1
and Wave 2; assessing susceptibility in young adults will help to elucidate its
role in the initiation process during late adolescence/ early adulthood.
Adults
On respondent use of electronic
nicotine delivery devices (ENDS),
including e-hookahs, e-cigars, and epipes, including on whether they have
heard of these products.
To assess patterns of use of new and emerging electronic nicotine delivery
devices, and to help inform the interpretation of bio-specimen data.
Adults
On whether respondent has heard of a
given product.
All products were described to respondents at Wave 1; thus it is not necessary
to ask this again of any adult respondents in Wave 2. For products that are
added to the PATH study in Wave 2 and beyond, these items will be retained
for those products.
Adults
On specific flavors of cigarettes used,
including first flavored cigarette used,
regular brand used, and product used in
past 30 days.
Added
Deleted
Added
Cigarette
Description of Questions
Deleted
Added
Tobacco Use
(includes
questions on
ENDS)
Affected
Respondent
Category
Added
Added
For longitudinal assessment of change in tobacco use status and to reconcile
different information on tobacco use status at Wave 1 versus Wave 2.
To assess for use of flavored cigarettes and/or roll-your-own cigarette tobacco;
and its association with tobacco product use and cessation or initiation within
persons, across the cohort and over time.
Young
adults
On the initiation process and experience
associated with use of first cigarette.
To assess the process and experience of tobacco use initiation among young
adults aged 18-to-24, a group that initiates tobacco use at higher rates than
older adults; similar to assessments of the process and experience of tobacco
use initiation among youth in the Youth cohort at Wave 1, and specifically
among those youth who age-in to the adult cohort at Wave 2.
Adults
On perceived harm of using menthol
cigarettes compared to non-menthol
cigarettes.
To inform understanding of adults' perceptions of harm in use of mentholflavored cigarettes versus non-mentholated cigarettes relative to tobacco
product use patterns.
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Attachment 5 - Summary of Changes to PATH Study Instruments
Wave 2 Section
Wave 2
Change
Deleted
Affected
Respondent
Category
Description of Questions
Rationale for Change
Adults
On past use of cigarettes (age at first
use and use patterns 12 months ago).
For adults in Wave 1, this information was captured in the Wave 1 adult survey;
therefore, no need to ask again in Wave 2. For youth in Wave 1 that age-in to
the adult cohort, this information was captured in the Wave 1 youth survey;
therefore, no need to ask again in Wave 2.
Adults
Added
Adults
Added
Adults
On whether anyone else who lives in
the household owns an e-cigarette.
To assess the presence of e-cigarettes in the respondent's household to inform
the social context of use patterns.
Added
Adults
On cost of usual or last purchase of ecigarettes, e-cigarette cartridges, or eliquid.
To provide information on purchasing behavior and its association with
patterns of tobacco use.
Deleted
Adults
On past/previous use of e-cigarettes
(age at first use and pattern of use 12
months ago).
For adults in Wave 1, this information was captured in the Wave 1 adult survey;
therefore, no need to ask again in Wave 2. For youth in Wave 1 that age-in to
the adult cohort, this information was captured in the Wave 1 youth survey;
therefore, no need to ask again in Wave 2.
Added
Adults
Added
Adults
Deleted
Pipe
To assess for use of flavored e-cigarettes and/or e-liquid; and its association
with product use and cessation or initiation within persons, across the cohort
and over time.
Added
E-Cigarette
Cigar
On specific flavors of e-cigarette
products used (first flavored e-cigarette
product, regular brand and past 30 day
use).
On use of types of e-cigarette devices,
including the tank system; and on the
respondent’s experience with refills and
types of modifications that can be made
to a device.
Added
On specific flavors of cigars used (first
product, regular brand and past 30 day
use).
On perceived harm; expanded to cover
each cigar type.
To assess use of new and emerging types of e-cigarette devices, the refill
experience, and the nature of any modifications respondents make to their ecigarette devices.
To assess for use of flavored cigars; and its association with tobacco product
use and cessation or initiation within persons, across the cohort and over time.
To acquire data on harm perceptions for each cigar type.
Adults
On past use of cigars (age at first use
and pattern of use 12 months ago).
For adults in Wave 1, this information was captured in the Wave 1 adult survey;
therefore, no need to ask again in Wave 2. For youth in Wave 1 that age-in to
the adult cohort, this information was captured in the Wave 1 youth survey;
therefore, no need to ask again in Wave 2.
Adults
On use of flavored pipe tobacco
(including first use of flavored pipe
tobacco, regular flavor or brand of pipe
tobacco used, and past 30 day use).
To assess for use of flavored pipe tobacco; and its association with product use
and cessation or initiation within persons, across the cohort and over time.
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Attachment 5 - Summary of Changes to PATH Study Instruments
Wave 2 Section
Hookah
Smokeless
Tobacco and
Snus
Dissolvable
Tobacco
Wave 2
Change
Affected
Respondent
Category
Description of Questions
Rationale for Change
Added
Adults
On the cost of usual or last purchase of
pipe tobacco.
Deleted
Adults
On past use of pipe tobacco (age at first
use and pattern of use 12 months ago).
To provide information on purchasing behavior and its association with
patterns of tobacco use.
For adults in Wave 1, this information was captured in the Wave 1 adult survey;
therefore, no need to ask again in Wave 2. For youth in Wave 1 that age-in to
the adult cohort, this information was captured in the Wave 1 youth survey;
therefore, no need to ask again in Wave 2.
Added
Adults
On use of flavored hookah tobacco
(including first use of flavored hookah
tobacco or shisha, regular flavor or
brand of hookah tobacco used, and past
30 day use).
Added
Adults
On smoking marijuana in a hookah pipe.
Added
Adults
Added
Adults
Deleted
Adults
On past/previous use of hookah (age at
first use and pattern of use 12 months
ago).
Adults
On use of specific flavors of smokeless
tobacco (first use of flavored smokeless
tobacco, regular flavor or brand used,
and past 30 day use).
To assess for use of flavored smokeless tobacco; and its association with
tobacco product use and cessation or initiation within persons, across the
cohort and over time.
Adults
On past/previous use of smokeless
tobacco (age at first use and pattern of
use 12 months ago).
For adults in Wave 1, this information was captured in the Wave 1 adult survey;
therefore, no need to ask again in Wave 2. For youth in Wave 1 that age-in to
the adult cohort, this information was captured in the Wave 1 youth survey;
therefore, no need to ask again in Wave 2.
Adults
On use of specific flavors of dissolvable
tobacco (first use of flavored dissolvable
tobacco, regular flavor or brand used,
and past 30 day use).
To assess for use of flavored dissolvable tobacco; and its association with
tobacco product use and cessation or initiation within persons, across the
cohort and over time.
Added
Deleted
Added
On the cost of usual or last purchase of
shisha tobacco.
On whether anyone else living in the
household owns a hookah.
To assess for use of flavored shisha or hookah tobacco; and its association with
tobacco product use and cessation or initiation within persons, across the
cohort and over time.
To assess use of hookah to smoke marijuana in addition to or instead of
tobacco for the analysis of tobacco product use patterns; and to inform the
interpretation of bio-specimen data.
To provide information on purchasing behavior and its association with
patterns of tobacco use.
To assess the presence of a hookah in the respondent's household to inform
the social context of use patterns.
For adults in Wave 1, this information was captured in the Wave 1 adult survey;
therefore, no need to ask again in Wave 2. For youth in Wave 1 that age-in to
the adult cohort, this information was captured in the Wave 1 youth survey;
therefore, no need to ask again in Wave 2.
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Attachment 5 - Summary of Changes to PATH Study Instruments
Wave 2 Section
Affected
Respondent
Category
Description of Questions
Deleted
Adults
On past/previous use of dissolvable
tobacco (age at first use and pattern of
use 12 months ago).
Added
Adults
On peer or family use of e-cigarettes.
Wave 2
Change
Nicotine
Dependence
Packaging and
Health Warnings
Product
Regulation Modified Risk
Tobacco
Products
Media Use
Secondhand
Smoke Exposure
Rationale for Change
For adults in Wave 1, this information was captured in the Wave 1 adult survey;
therefore, no need to ask again in Wave 2. For youth in Wave 1 that age-in to
the adult cohort, this information was captured in the Wave 1 youth survey;
therefore, no need to ask again in Wave 2.
To elucidate the role of social context in relation to the use of e-cigarettes. This
item is associated with the WISDM scale which is used to measure dependence.
On health warning labels on cigarette
packs and smokeless tobacco
containers, including how often a
respondent looks closely at them; tries
to avoid looking at or thinking about
them; how believable they are; how
they make a respondent feel about use
or the health risks associated with use;
and if they affect the likelihood of
initiation.
On perceived harm/risk in using
To assess respondents’ understanding and perceptions of harm/risk associated
modified risk tobacco products.
with use of modified risk products.
Asked in Wave 1 and removed for Wave 2; may be considered again in a future
wave depending on regulatory changes regarding health warning labels.
Deleted
Adults
Added
Adults
Added
Adults
On perceived link between cigarette
smoking and diabetes and liver cancer.
To assess respondents’ understanding and perceptions of harm associated with
smoking and its now documented link to diabetes and liver cancer.
Added
Adults
On use of various technologies to access
the internet.
To assess the technologies respondents use to access the internet to better
understand modes of exposure to messages and advertising that is health
and/or tobacco focused.
Added
Adults
Added
Young
adults
Added
Adults
Deleted
Added
On respondents’ use of tobacco
cessation smart phone applications.
On exposure to tobacco brands on
various social media.
To contribute to understanding what types of tobacco-related
information/applications respondents’ access with smartphone technology.
Adults
On exposure to tobacco brands in
online games.
On the number of texts sent on a typical
day.
To assess the extent to which young adults are exposed to tobacco product
advertising through various social media.
To assess the extent of tobacco brand exposure from advertisements placed in
online games.
This item is no longer of research priority to the PATH Study; therefore it is not
necessary to ask again in Wave 2 of any respondent category.
Adults
On whether respondent lives alone.
To drive a skip pattern in the absence of updated household member size being
collected in Wave 2.
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Attachment 5 - Summary of Changes to PATH Study Instruments
Wave 2 Section
Peer and Family
Influences
Health
(formerly named
"Health Effects
Outcome")
Marketing,
Advertising and
Promotion
(formerly named
"Industry
Advertising and
Promotion"
section)
Affected
Respondent
Category
Description of Questions
Rationale for Change
Added
Older adults
On multi-unit housing.
To inform secondhand smoke exposure. (Note: There is a separate question in
the instrument on residence type that captures this information for Young
Adults)
Added
Adults
Wave 2
Change
On peer or family disapproval of using
e-cigarettes.
Added
Adults
On physical activity levels.
Added
Adults
On asthma and respiratory health
conditions.
Added
Adults
On rapid vision loss.
Added
Adults
On in-utero exposure to tobacco.
Added
Adults
and high cholesterol.
Deleted
Adults
On height.
On family history of high blood pressure
Deleted
Adults
On disability status.
Deleted
Adults
On age of diagnosis of specified health
condition.
On exposure to tobacco-related public
Added
Adults
Added
Adults
On ever receiving free samples of ecigarettes, e-liquid and other tobacco
products.
Added
Adults
On the placing of tobacco product
advertisement.
education campaigns.
To elucidate the role of social context in relation to the use of e-cigarettes.
Physical activity level may be an intermediate measure subject to change with
changes in tobacco use and disease state and may be used to help interpret
biomarker data; asthma/respiratory health conditions and rapid vision loss can
be possible outcomes subject to change as tobacco use status changes; in utero
exposure and family history data are covariates that may impact one’s risk of
various health conditions. These additions will obtain more granular
information on the respondent’s health and the health effects associated with
use of tobacco products; asking these in Wave 2 will permit analysis of withinperson change over the past year; data will also support the analysis and
interpretation of bio- specimen data.
Asked in Wave 1; not necessary to ask older adults again in Wave 2 given the
relative stability of height after young adulthood; will continue to be asked of
young adults in Wave 2, including youth that age-in to the adult cohort.
The HHS Standard Disability items were asked at Wave 1; not necessary to ask
again in Wave 2; however, they will be asked of youth who age-in to the adult
cohort. In Wave 2, there are other measures in this section that can inform
respondents’ disability status in the absence of these items.
Asked at Wave 1; not necessary to ask again in Wave 2; however, will be asked
of youth who age-in to the adult cohort.
To assess a respondent’s exposure and familiarity with national tobacco-related
public education campaigns over the past year via various media outlets such as
TV, radio, the internet, etc.
To assess a respondent’s extent of exposure to tobacco product marketing,
advertisements, promotions, and sweepstakes.
6
Attachment 5 - Summary of Changes to PATH Study Instruments
Wave 2 Section
Affected
Respondent
Category
Description of Questions
Added
Adults
On participation in tobacco-sponsored
sweepstakes.
Deleted
Adults
product advertisements and specific
advertisements.
Added
Adults
On home ownership.
To inform Wave 2 weighting.
Added
Young
adults
On residence type, socio-economic
status, parent education levels, and
parent household income.
To characterize the socio-economic status of the young adult respondent; to
inform the analysis of these factors in association with tobacco product use
behaviors in late adolescence/young adulthood.
Added
Adults
On gender identity (transgender).
From the Massachusetts’ “State Optional Module” for the 2014 BRFSS; to
better characterize tobacco use among transgender population.
Deleted
Adults
On respondent's main job title or
occupation.
Asked in Wave 1; given the resources required to create occupational codes for
this analysis, not asked again in Wave 2.
Wave 2
Change
On exposure to images of tobacco
Additional
Demographics
Rationale for Change
Asked in Wave 1 and removed for Wave 2; may be considered again in a future
wave depending on research priorities for PATH.
Product Barcode
Scanning
Module
(formerly
embedded in
Additional
Demographics)
Added
Adults
On whether the last product used was
from the scanned package or container.
To inform the interpretation of bio-specimen. Note: This question is asked for
each tobacco product the respondent agrees to have scanned. We scan up to
10 tobacco product packages. It is unlikely that a respondent would receive all
10 questions in this section.
Contact
Information
Added
Adults
On second home ownership.
To aid contacting and tracing efforts for Wave 3.
7
Attachment 5 - Summary of Changes to PATH Study Instruments
Table 2a. YOUTH QUESTIONNAIRE - Change in Total Item Counts from Wave 1 to Wave 2
Total Number of Items per Section
Youth Questionnaire Section
Wave 1
Wave 2
Change in Total Item
Count from W1 to W2
Extended
Aged-In
Extended
Aged-In
Introductory Demographics
4
0
3
-4
-1
Cigarette
43
47
49
+4
+6
Electronic Nicotine Delivery Systems (ENDS)
46
60
63
+14
+17
Cigar
46
66
70
+20
+24
Pipe
38
12
13
-26
-25
Hookah
50
56
59
+6
+9
Smokeless Tobacco and Snus
44
49
52
+5
+8
Dissolvable Tobacco
43
4
5
-39
-38
Bidis and Kreteks
41
4
5
-37
-36
First Tobacco Product
1
1
1
0
0
Reasons to Use Tobacco
17
17
17
0
0
Nicotine Dependence
11
12
12
+1
+1
Cessation / Quitter
8
8
8
0
0
Packaging and Health Warnings
26
16
26
-10
0
Product Regulation
3
3
3
0
0
Media Use
16
16
18
0
+2
Secondhand Smoke Exposure
4
4
4
0
0
Health
50
46
57
-4
+7
Marketing, Advertising and Promotion
11
26
26
+15
+15
Peer and Family Influences
8
8
+8
+8
Accessibility
-1
3
3
+2
+2
Psychosocial
14
12
12
-2
-2
Substance Use
32
18
29
-14
-3
Additional Demographics
14
17
17
+3
+3
Contact Information (Emancipated Youth)
21
25
25
+4
+4
584
530
585
-54
+1
Total (Entire Questionnaire)
*Note: This table reflects total counts of items; it does not account for the conditions in which the items are asked. For
example, due to skip patterns, every respondent is not asked all items reflected in these counts. Consequently, the average time
to complete the Youth interview remains at 32 minutes for both the Wave 1 and Wave 2 Extended instruments, and increases to
42 minutes for the Wave 2 Aged-In instrument.
8
Attachment 5 - Summary of Changes to PATH Study Instruments
TABLE 2b. YOUTH QUESTIONNAIRE – Description of Content Changes from Wave 1 to Wave 2
Wave 2 Section
Introductory
Demographics
Cigarette
Wave 2
Change
Affected
Respondent
Category
Description of Questions
Rationale for Change
Deleted
Youth
On race and ethnicity.
For youth in Wave 1, this information was used to capture baseline
demographic information; therefore, no need to ask again in Wave 2.
These items will be retained and asked of youth who 'age-in' to the
youth cohort as new respondents in Wave 2.
Added
Youth
On ever smoking cigarettes regularly and
at what age.
To assess regular smoking and at what age in association with
progression of use over time.
Added
Youth
On specific flavors of cigarettes smoked
in the past 30 days.
To assess for use of flavored cigarettes; and its association with patterns
of tobacco use, cessation or initiation within persons, across the cohort
and over time.
Added
Youth
On the cost of last cigarette purchase.
To provide information on purchasing behavior and its association with
patterns of tobacco use.
On perceived harm of using menthol
Added
Deleted
Electronic Nicotine
Delivery Systems
(ENDS)
(formerly named
"E-Cigarette")
Youth
Youth
Added
Youth
Added
Youth
Added
Youth
Added
Youth
cigarettes compared to non-menthol
cigarettes.
On the respondent’s age when first
smoked a cigarette.
On whether respondent has heard of and
used electronic nicotine delivery devices,
including e-cigarettes, e-hookahs, ecigars, and e-pipes.
On non-user respondent's susceptibility
to becoming a user of any electronic
nicotine products.
On use of types of e-cigarette devices,
including the tank system; and on the
respondent’s experience with refills and
types of modifications that can be made
to a device.
On ever using e-cigarettes regularly and
at what age.
To inform understanding of youths’ perceptions of harm associated with
use of menthol-flavored cigarettes versus non-mentholated cigarettes.
Asked at Wave 1; not necessary to ask again in Wave 2; however, these
will continue to be asked of youth who 'age-in' to the youth cohort as
new respondents in Wave 2.
To assess the youth respondent’s use of new and emerging electronic
nicotine delivery products.
To assess susceptibility to initiation of electronic nicotine products.
To assess use of new and emerging types of e-cigarette devices, the
refill experience, and the nature of any modifications respondents make
to their e-cigarette devices.
To assess regular use of e-cigarettes and at what age in association with
progression of use over time.
9
Attachment 5 - Summary of Changes to PATH Study Instruments
Wave 2 Section
Wave 2
Change
Affected
Respondent
Category
Description of Questions
Rationale for Change
Added
Youth
On use of specific flavors of e-cigarettes
or e-liquid in the past 30 days.
Added
Youth
On the cost of last e-cigarette, ecigarette cartridge, or e-liquid purchase
including the unit size of the purchase
(box or pack, singles, etc.).
To assess for use of flavored e-cigarettes and/or e-liquid; and its
association with product use and cessation or initiation within persons,
across the cohort and over time.
Added
Youth
On whether anyone else living in the
household owns an e-cigarette.
To assess the presence of e-cigarettes in the respondent's household to
inform the social context of use patterns.
Deleted
Youth
On whether respondent has heard of ecigarettes.
All products were described to respondents at Wave 1; thus it is not
necessary to ask this again in Wave 2; however, these will continue to
be asked of youth who 'age-in' to the youth cohort as new respondents
in Wave 2.
Deleted
Youth
On how old the respondent was when
first used an e-cigarette.
Asked at Wave 1; not necessary to ask again in Wave 2; however, these
will continue to be asked of youth who 'age-in' to the youth cohort as
new respondents in Wave 2.
Added
Youth
On non-user youth respondent’s
susceptibility to using a
cigar/cigarillo/filtered cigar.
To help elucidate the role of susceptibility in the youth respondent’s
process and experience of initiation of cigars, cigarillos and filtered
cigars.
Added
Youth
On ever smoking cigars/cigarillos/filtered
cigars regularly and at what age.
To assess regular smoking and at what age in association with
progression of use over time.
Added
Youth
On the specific flavors of
cigars/cigarillos/filtered cigars used in
the past 30 days.
To assess for use of flavored cigars; and its association with patterns of
tobacco use, cessation or initiation within persons, across the cohort
and over time.
Youth
On the cost of last
cigars/cigarillos/filtered cigars purchase,
including the unit size of the purchase
(box or pack, singles, etc.).
To provide information on purchasing behavior and its association with
patterns of tobacco use.
Youth
On whether respondent has heard of
cigars/cigarillos/filtered cigars.
All products were described to respondents at Wave 1; thus it is not
necessary to ask this again in Wave 2; however, these will continue to
be asked of youth who 'age-in' to the youth cohort as new respondents
in Wave 2.
Cigar
Added
Deleted
To provide information on purchasing behavior and its association with
patterns of tobacco use.
10
Attachment 5 - Summary of Changes to PATH Study Instruments
Wave 2 Section
Pipe
Hookah
Smokeless
Tobacco and Snus
Wave 2
Change
Affected
Respondent
Category
Description of Questions
Rationale for Change
Deleted
Youth
On how old the respondent was when
first used a cigar/cigarillo/filtered cigar
deleted.
Asked at Wave 1; not necessary to ask again in Wave 2; however, these
will continue to be asked of youth who 'age-in' to the youth cohort as
new respondents in Wave 2.
Deleted
Youth
On patterns of pipe use.
Added
Youth
Added
Youth
Added
Youth
Added
Youth
Added
Youth
On the cost of the last hookah tobacco
purchase.
On setting up the hookah.
Added
Youth
On smoking marijuana in a hookah.
To assess use of hookah to smoke marijuana in addition to or instead of
tobacco for the analysis of tobacco product use patterns.
Deleted
Youth
On whether a respondent has heard of a
given product.
All products were described to respondents at Wave 1; thus it is not
necessary to ask this again in Wave 2; however, these will continue to
be asked of youth who 'age-in' to the youth cohort as new respondents
in Wave 2.
Deleted
Youth
On how old the respondent was when
first smoked hookah.
Asked at Wave 1; not necessary to ask again in Wave 2; however, these
will continue to be asked of youth who 'age-in' to the youth cohort as
new respondents in Wave 2.
Added
Youth
On a non-user's susceptibility to
becoming a smokeless tobacco user.
To help elucidate the role of susceptibility in the youth respondent’s
process and experience of initiation of smokeless tobacco.
Added
Youth
On ever using smokeless tobacco/snus
regularly and at what age.
To assess regular use and at what age in association with progression of
use over time.
Added
Youth
On the specific flavors of smokeless
tobacco/snus used in the past 30 days.
To assess for use of flavored smokeless tobacco; and its association with
product use and cessation or initiation within persons, across the cohort
and over time.
On a non-user's susceptibility to
becoming a hookah smoker.
On ever smoking hookah tobacco
regularly and at what age.
On the specific flavors of hookah tobacco
used in the past 30 days.
Asked at Wave 1; not necessary to ask again in Wave 2, except for past
30 day use and purchasing patterns.
To help elucidate the role of susceptibility in the youth respondent’s
process and experience of initiation of hookah.
To assess regular smoking and at what age in association with
progression of use over time.
To assess for use of flavored shisha or hookah tobacco; and its
association with product use and cessation or initiation within persons,
across the cohort and over time.
To provide information on purchasing behavior and its association with
patterns of tobacco use.
To inform understanding of hookah initiation and use.
11
Attachment 5 - Summary of Changes to PATH Study Instruments
Affected
Respondent
Category
Description of Questions
Rationale for Change
Youth
On cost of the last smokeless
tobacco/snus purchase, including the
unit size of the purchase (number of
pouches in container, etc.).
To provide information on purchasing behavior and its association with
patterns of tobacco use.
Deleted
Youth
On whether respondent has heard of
smokeless tobacco/snus.
All products were described to respondents at Wave 1; thus it is not
necessary to ask this again in Wave 2; however, these will continue to
be asked of youth who 'age-in' to the youth cohort as new respondents
in Wave 2.
Deleted
Youth
On how old the respondent was when
first used smokeless tobacco/snus.
Asked at Wave 1; not necessary to ask again in Wave 2; however, these
will continue to be asked of youth who 'age-in' to the youth cohort as
new respondents in Wave 2.
Dissolvable
Tobacco
Deleted
Youth
On patterns of dissolvable tobacco use.
Bidis and Kreteks
Deleted
Youth
On patterns of bidi/kretek use.
Nicotine
Dependence
Added
Youth
On peer or family use of e-cigarettes.
Wave 2 Section
Wave 2
Change
Added
Added
Youth
Packaging and
Health Warnings
Media Use
Deleted
Youth
Added
Youth
Health warnings on cigar packages were
expanded to be asked about each
specific cigar type (traditional cigars,
cigarillos and filtered cigars).
On health warning labels on cigarette
packs and smokeless tobacco containers,
including how often a respondent looks
closely at them; tries to avoid looking at
or thinking about them; how believable
they are; how they make a respondent
feel about use or the health risks
associated with use; and if they affect
the likelihood a respondent will start
using the product.
On use of various technologies to access
the internet.
Asked at Wave 1; not necessary to ask again in Wave 2, except for ever
and current use.
Asked at Wave 1; not necessary to ask again in Wave 2, except for ever
and current use.
To elucidate the role of social context in relation to the use of ecigarettes. This item is associated with the WISDM scale which is used
to measure dependence.
To assess the level of exposure to health warning labels on cigars,
cigarillos and filtered cigars, and associated perceptions of harm of
tobacco use.
Asked in Wave 1 and removed for Wave 2; may be considered again in
a future wave depending on regulatory changes regarding health
warning labels; however, these will continue to be asked of youth who
'age-in' as new respondents in Wave 2.
To assess the technologies respondents use to access the internet in
order to better understand modes of exposure to messages and
advertising that is health and/or tobacco focused.
12
Attachment 5 - Summary of Changes to PATH Study Instruments
Wave 2 Section
Health
(formerly
embedded within
Demographics
section)
Wave 2
Change
Affected
Respondent
Category
Description of Questions
Rationale for Change
Added
Youth
On tobacco cessation smart phone apps.
To contribute to understanding what types of tobacco-related
information/applications respondents’ access with smartphone
technology.
Added
Youth
On online exposure to tobacco brands.
To contribute to understanding exposure to tobacco advertising,
particularly through social media.
Deleted
Youth
On visiting tobacco brand websites.
Asked in Wave 1; not necessary to ask again in Wave 2. These items will
not be retained for youth that age-in to the youth cohort at Wave 2.
Deleted
Youth
On the number of texts sent on a typical
day.
This item is no longer of research priority to the PATH Study; therefore it
is not necessary to ask again in Wave 2 of any respondent category.
Deleted
Youth
On scanning a QR code, and if that code
led to a tobacco company website.
Asked in Wave 1; not necessary to ask again in Wave 2; however, these
will continue to be asked of youth who 'age-in' as new respondents in
Wave 2.
Added
Youth
On physical, mental and overall health.
Added
Youth
On height and weight.
Added
Youth
On physical activity levels.
Added
Youth
On asthma and respiratory health
conditions.
Deleted
Deleted
Emancipated
youth
Emancipated
youth
On disability status.
On age of diagnosis of specified health
condition.
Physical, mental and overall health; height and weight (to calculate
BMI); and physical activity levels may be intermediate measures subject
to change with changes in tobacco use and disease state. Asthma and
respiratory health conditions can be possible outcomes subject to
change as tobacco use status changes. These additions will obtain
more granular information on the respondent’s health and the health
effects associated with use of tobacco products; asking these in Wave 2
will permit analysis of within-person change over the past year.
The HHS Standard Disability items were asked at Wave 1; not necessary
to ask again in Wave 2; however, they will be asked of emancipated
youth who age-in as new respondents. In Wave 2, there are other
measures in this section that can inform respondents’ disability status in
the absence of these items.
Not necessary to ask in Wave 2 for youth who receive a diagnosis of a
health condition since the Wave 1 interview; this can be determined
administratively as having occurred in the past 12 months. These items
will be retained and asked of emancipated youth who 'age-in' to the
youth cohort as new respondents in Wave 2.
13
Attachment 5 - Summary of Changes to PATH Study Instruments
Wave 2
Change
Affected
Respondent
Category
Description of Questions
Rationale for Change
Added
Youth
On samples of e-cigarettes and e-liquid.
To assess a respondent’s extent of exposure to tobacco product
marketing, advertisements, promotions, and sweepstakes.
Added
Youth
On tobacco-related public education
campaigns.
Added
Youth
Deleted
Youth
product advertisements and specific
advertisements.
Influences
(new section)
Added
Youth
On peer use of tobacco products.
Accessibility
Added
Wave 2 Section
Marketing,
Advertising and
Promotion
(formerly named
"Marketing" and
"Ad Exposure"
sections)
On tobacco product advertisement
placement.
On exposure to images of tobacco
Peer and Family
Substance Use
Additional
Demographics
(formerly named
"Demographics"
section)
Contact
Information
On likelihood of purchasing cigarettes or
Youth
other tobacco products in the next 30
days.
Deleted
Youth
On age of first use of alcohol, marijuana
and other illicit substances.
Deleted
Youth
On sensation seeking behaviors.
Added
Emancipated
youth
On household income and home
ownership.
Added
Youth
On whether the youth respondent works
for pay.
Added
To assess a respondent’s exposure and familiarity with national tobaccorelated public education campaigns over the past year via various media
outlets such as TV, radio, the internet, etc.
To assess a respondent’s extent of exposure to tobacco product
marketing, advertisements, promotions, and sweepstakes.
Asked in Wave 1 and removed for Wave 2; may be considered again in a
future wave depending on research priorities for PATH.
To elucidate the role of social context in relation to the patterns of
tobacco use, particularly susceptibility of initiation by non-users.
To help inform the process and experience of tobacco product use
among youth.
Asked at Wave 1; not necessary to ask again in Wave 2; however, these
will continue to be asked of youth who 'age-in' to the youth cohort as
new respondents in Wave 2.
Asked in Wave 1 and removed for Wave 2; will be cycled back in and
asked in future waves.
To characterize the socio-economic status and home ownership of the
respondent's household; and to help in the analysis of these factors in
the process and experience of tobacco product use initiation and
patterns of tobacco product use among youth.
Emancipated
youth
On second home ownership.
To aid contacting and tracing efforts for Wave 3.
14
Attachment 5 - Summary of Changes to PATH Study Instruments
Table 3a. PARENT QUESTIONNAIRE - Change in Total Item Counts from Wave 1 to Wave 2
Total Number of Items per Section
Parent Questionnaire Section
Wave 1
Wave 2
Change in Total Item
Count from W1 to W2
Extended
Aged-In
Extended
Aged-In
Family Composition
12
12
19
0
+7
School, Home, and Tobacco Use
11
9
9
-2
-2
Health
35
21
38
-14
+3
Respondent Characteristics
4
9
9
+5
+5
Contact Information
23
27
27
+4
+4
Total (Entire Questionnaire)
85
78
102
-7
+17
*Note: This table reflects total counts of items; it does not account for the conditions in which the items are asked. For
example, due to skip patterns, every respondent is not asked all items reflected in these counts. Consequently, the
average time to complete the Parent interview remains at 14 minutes for both the Wave 1 and Wave 2 Extended
instruments, and increases to 17 minutes for the Wave 2 Aged-In instrument.
15
Attachment 5 - Summary of Changes to PATH Study Instruments
TABLE 3b. PARENT QUESTIONNAIRE – Description of Content Changes from Wave 1 to Wave 2
Wave 2 Section
Wave 2
Status
Affected
Respondent
Category
Description of Questions
Family
Composition
(new section)
Deleted
Parent
On youth respondents that are twins or
part of a multiple birth.
Added
Parent
On family history of high blood pressure
and high cholesterol.
Deleted
Parent
On disability status of youth.
Deleted
Parent
On age of diagnosis of youth's specified
health condition.
Added
Parent
On the education level of the parent
respondent's spouse; on household
income; and on home ownership.
To characterize the socio-economic status of the parent and youth
respondents' household and the association of such factors in the
process of tobacco use initiation and in patterns of tobacco use.
Added
Parent
On the parent respondent's perceived
harm of using tobacco products.
To assess the parent respondent's perception of harm in tobacco
use; to relate parent respondent's harm perceptions to youth
respondent's perceptions and use of tobacco.
Added
Parent
On owning a second home.
To aid contacting and tracing efforts for Wave 3.
Health
(new section)
Respondent
Characteristics
(new section)
Contact
Information
Rationale for Change
Asked at Wave 1; not necessary to ask again of parent respondents
for youth in Wave 2; however, will be asked of parent respondents
for "new baseline" youth who 'age-in' at Wave 2.
Added in Wave 2 and asked of the parents because they are likely
more knowledgeable of this information than the youth respondent.
The data are useful as a covariate to put one at greater or lesser risk
of heart disease, which is important in a long-term study assessing
the health status of tobacco users.
The HHS Standard Disability items were asked at Wave 1; not
necessary to ask again in Wave 2; however, they will be asked of
parents of youth who age-in to the youth cohort.
Not necessary to ask parents in Wave 2 for youth who receive a
diagnosis of a health condition since the Wave 1 interview; this can
be determined administratively as having occurred in the past 12
months. These items will be retained and asked of parents of youth
who 'age-in' to the youth cohort as new respondents in Wave 2.
16
Attachment 5 - Summary of Proposed Changes to PATH Study Instruments
Table 4a. NICOTINE EXPOSURE QUESTIONNAIRE - Change in Total Item Counts from Wave 1 to Wave 2
NEQs
Wave 1
Wave 2
Change since Wave 1
Total (Entire Questionnaire)
28
38
+10
*Note: This table reflects total counts of items; it does not account for the conditions in which the items are
asked. For example, due to skip patterns, every respondent is not asked all items reflected in these
counts. Consequently, the average time to complete the Nicotine Exposure Questionnaire remains at 4
minutes for both the Wave 1 and Wave 2 Extended and Aged-In interviews. NEQs are asked of all respondents
that consent to bio-specimen collection; there is no distinction made between the extended and aged-in
respondent categories.
17
Attachment 5 - Summary of Proposed Changes to PATH Study Instruments
TABLE 4b. NICOTINE EXPOSURE QUESTIONNAIRE – Description of Content Changes from Wave 1 to Wave 2
Wave 2 Section
Wave 2
Status
Affected
Respondent
Category
Changes from Wave 1
Rationale for Change
NEQs
Added
Adults
On use of electronic nicotine devices other
than e-cigarettes (such as e-hookahs, ecigars or e-pipes).
To assess whether the respondent has used an electronic nicotine
delivery device before collecting the respondent's bio-specimens.
Note: E-cigarettes are asked about separately.
18
| File Type | application/pdf |
| File Modified | 2014-07-22 |
| File Created | 2014-06-30 |