General Market Campaign: Wave 3 Online Quantitative Study of Reactions to Rough-Cut Advertising Designed to Prevent Youth Tobacco Use

OMB Control # 0910-0810

Exp. Date: 11/30/18

General Market Campaign: Wave 3 Online Quantitative Study of Reactions to Rough-Cut Advertising Designed to Prevent Youth Tobacco Use

SCREENER

Demographics

1. How old are you?

1. 12 years old or younger [SCREEN OUT]

2. 13 years old

3. 14 years old

4. 15 years old

5. 16 years old

6. 17 years old

7. 18 years old or older [SCREEN OUT]

2. Do you or any member of your immediate family or a close friend work for…?

1. A market research company

2. An advertising agency or public relations firm

3. The media (TV/radio/newspapers/magazines)

4. A healthcare professional (doctor, nurse, pharmacist, dietician)

5. The tobacco industry (manufacturers, distributors, or importers of tobacco products) [SCREEN OUT]

6. None of these

3. When was the last time you participated in a research study?

1. Within the past 6 months [SCREEN OUT]

2. More than 6 months ago

3. I have never participated in a research study

4. Are you…?

1. Female

2. Male

5. Are you Hispanic or Latino?

1. Yes

2. No

6. What race or races do you consider yourself to be? (mark one or more answers)

1. American Indian or Alaska Native

2. Asian

3. Black or African American

4. Native Hawaiian or Other Pacific Islander

5. White

Cigarette Use

7. Have you ever tried cigarette smoking, even one or two puffs?

1. Yes

2. No

[If A7 = A, Ask A8. If A7 = B, Ask A9 – A11]

8. About how many cigarettes have you smoked in your entire life? Your best guess is fine.

1. 1 or more puffs but never a whole cigarette

2. 1 cigarette

3. 2 to 5 cigarettes

4. 6 to 15 cigarettes (about 1/2 a pack total)

5. 16 to 25 cigarettes (about 1 pack total)

6. 26 to 99 cigarettes (more than 1 pack, but less than 5 packs)

7. 100 or more cigarettes (5 or more packs) [SCREEN OUT]

[If A8 = A – F, youth qualifies to participate in study. ]

Susceptibility

Thinking about the future…

9. Do you think you will try a cigarette soon?

1. Definitely yes

2. Probably yes

3. Probably not

4. Definitely not

5. Don’t know

10. Do you think you will smoke a cigarette at any time in the next year?

1. Definitely yes

2. Probably yes

3. Probably not

4. Definitely not

5. Don’t know

11. If one of your best friends were to offer you a cigarette, would you smoke it?

1. Definitely yes

2. Probably yes

3. Probably not

4. Definitely not

5. Don’t know

[If A9 – A11 All = D, SCREENOUT; otherwise youth qualifies to participate in study.]

Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 5 minutes per response to complete this survey (the time estimated to read and complete). Send comments regarding this burden estimate or any other aspects of this information collection, including suggestions for reducing burden, to PRAStaff@fda.hhs.gov.

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