Quantitative Study of
Tobacco Facts Designed to Inform Youth Tobacco Prevention Messaging
You
have been asked to take part in a study called [STUDY NAME]. The
study is being led by RTI International, which is a company that
does research. The online survey will ask 1500 youth ages
13-17 about several tobacco-related facts. Your
answers will help us make ads that keep kids from smoking. It
will take about 20 minutes for you to complete this survey.
You
will not be harmed by being in this study. There is a small
chance that you might feel embarrassed or upset by the questions
asked in the survey. However, you can skip any questions you
don't want to answer.
If
you decide to take the survey, your parent will receive ‘points’
that are about $5 in value. The points can be redeemed for items
or gift cards through the GfK system. There are no additional
benefits from completing the survey.
It
is your choice to take part in this study. You may stop taking the
survey at any time without penalty. Your identity will not be
known in the results of the study. The researchers will not have
access to any of your personal information (such as your name).
Your
answers will not be shared with your parent. The
"GfK’s Privacy & Terms of Use Policy" explain
the ways your information will be kept private.
If
you have any questions about the study, you may contact the
research team through Annice Kim of RTI at 1‑800‑334‑8571.
If
you have any questions about your rights as a study participant,
you may call RTI’s Office of Research Protection at
1-866-214-2043.
I understand the study purpose and process.
Would
you like to participate in this survey?
Yes, I want to take the survey.
No, I do NOT want to take the survey.
A
copy of the form will be sent to your email address.
Paperwork Reduction Act
Statement: The
public reporting burden for this information collection has been
estimated to average 5 minutes per response (the time to read and
complete). You can send comments regarding this burden estimate or
any other aspects of this information collection, including
suggestions for reducing burden, to PRAStaff@fda.hhs.gov.