Wave 3 Online Quantitative Study of Reactions to Rough-Cut Advertising Designed to Prevent Multicultural Youth Tobacco Use

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

Questionnaire

ASSENT/CONSENT PAGE

[TEXT FOR PARTICIPANTS]: “Please answer the questions on the following pages as honestly as possible. As a thank you, once you complete and submit this survey you will receive a $10 online gift card! Please scroll and read through the document, and select YES if you would like to participate by providing your assent (ages 13-17) or consent (age 18).”

[ASSENT/CONSENT FORM PRESENTED TO PARTICIPANTS]

I have read, understand, and had time to consider all of the information above. I have no more questions about this study at this time.

○ Yes, I want to participate.

○ No, I do NOT want to participate.

*If you choose YES, we will email you the form for your records

[Each item or series of items on the Questionnaire will be presented on a separate page separated by a “NEXT” button as indicated in programming instructions. There will also be a “BACK” button presented on each page in case youth accidentally skip a question.]

AGE CHECK

“Please answer each question as honestly as possible. Click on the button at the bottom of

the page to continue with the survey.”

Z1. How old are you?

1. 13 years old

2. 14 years old

3. 15 years old

4. 16 years old

5. 17 years old

6. 18 years old or older

[IF PARTICIPANT SELECTS A-E, CONTINUE TO PART A. IF PARTICIPANT SELECTS F, CONTINUE TO END PAGE [18 YEAR OLDS].]

END PAGE [18 YEAR OLDS]

Thanks for coming back to complete the full survey! Unfortunately, you are not eligible to continue on with the survey.

Thank you for your willingness to participate!

Please note that you can only submit this survey once.

The FDA does not encourage the use or sale of tobacco products. It is illegal in most states for adolescents younger than 18 years old to use tobacco, and it is illegal in all states for adolescents under 18 to buy tobacco.

Form Approved

OMB No. 0910-0810

Exp. Date 11/30/2018

RIHSC #17-093CTP

Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 25 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.”

PART A

[Questions to be presented to ALL PARTICIPANTS]

A1. [RANDOMIZE ORDER. ALL ITEMS WILL BE PRESENTED ON THE SAME PAGE.]

1. I would like to explore strange places.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

2. I like to do frightening things.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

3. I like new and exciting experiences, even if I have to break the rules.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

4. I prefer friends who are exciting and unpredictable.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

A2. Does anyone who lives with you now do any of the following? (Select all that apply)

1. Smoke cigarettes

2. Smoke cigars, cigarillos, or little cigars (e.g. Swisher Sweets or Black and Mild)

3. Smoke electronic cigarettes, e-cigarettes, vape pens, or hookah pens (e.g. Fin, NJOY, JUUL, Blu, e-Go, or Vuse)

4. Smoke tobacco from a waterpipe or hookah

5. Use any other form of tobacco

6. No one who lives with me now uses any form of tobacco

[A2 = F is an exclusive response and cannot be selected in conjunction with options A-E]

A3. How many of your four closest friends smoke cigarettes?

1. 0

2. 1

3. 2

4. 3

5. 4

[A4-A6 will be considered a set of “Lifetime Use” questions. The order of questions within this “Lifetime Use” set will be randomized. Each question will be presented on a separate page.]

A4. How many cigars, cigarillos, or little cigars, such as Black and Milds, Swisher Sweets, Dutch Masters, White Owl, or Phillies Blunts, have you smoked in your entire life? Your best guess is fine.

1. I have never smoked a cigar, cigarillo, or little cigar, not even one or two puffs.

2. 1 or more puffs but never a whole one

3. 1

4. 2 to 10

5. 11 to 20

6. 21 to 50

7. 51 to 99

8. 100 or more

A5. How many times have you smoked tobacco from a hookah or waterpipe in your entire life? Count each sitting or session where you smoked tobacco in a hookah, whether alone or with others. Your best guess is fine.

1. I have never smoked tobacco from a hookah, not even one or two puffs.

2. 1

3. 2 to 10

4. 11 to 20

5. 21 to 50

6. 51 to 99

7. 100 or more

A6. How many times have you used an electronic cigarette, e-cigarette, vape pen, or hookah pen, such as Fin, NJOY, JUUL, Blu, e-Go, or Vuse, in your entire life? Your best guess is fine.

1. I have never used an electronic cigarette, e-cigarette, vape pen, or hookah pen, not even one or two puffs.

2. 1 time, even just a few puffs

3. 2 to 10 times

4. 11 to 20 times

5. 21 to 50 times

6. 51 to 99 times

7. 100 or more times

A7. In the past 30 days, I have personally… (Select all that apply)

1. Smoked cigarettes

2. Smoked cigars, cigarillos, or little cigars (e.g. Swisher Sweets or Black and

3. Mild)

4. Smoked electronic cigarettes, e-cigarettes, vape pens, or hookah pens, such as Fin, NJOY, JUUL, Blu, e-Go, or Vuse

5. Smoked tobacco from a hookah or waterpipe

6. Used smokeless tobacco (e.g. snus pouches, moist snuff, dip, spit, or chewing tobacco)

7. Not used any form of tobacco

[A7 = G is an exclusive response and cannot be selected in conjunction with options A - F]

PART B

[(Questions to be provided after the rough-cut advertisement) – AD VIEW PARTICIPANTS ONLY]

[TEXT FOR PARTICIPANTS]:

“Please watch the video below. Please make sure your device volume is on so you can hear the audio.

To start watching the video, click on the video or press the play button. When the video ends, click on the button at the bottom of the page to continue with the survey.”

B1. What do you think [or would you say] is the main message of this advertisement?

[FREE RESPONSE BOX]

B2. What do you like about this advertisement? Please be as specific as possible.

[FREE RESPONSE BOX]

B3. What do you dislike about this advertisement? Please be as specific as possible.

[FREE RESPONSE BOX]

B4. People sometimes have different emotional reactions when they see or hear advertisements. On a scale from 1 to 5, where 1 means “not at all” and 5 means “very”, please indicate how much this ad made you feel:

Not at all Very

1 2 3 4 5

[RANDOMIZE ORDER. ITEMS WILL BE PRESENTED ACROSS 4 PAGES, WITH 4 ITEMS PER PAGE.]

1. Sad

2. Afraid

3. Irritated

4. Ashamed

5. Discouraged

6. Hopeful

7. Motivated

8. Understood

9. Angry

10. Amused

11. Disgusted

12. Worried

13. Inspired

14. Happy

15. Uneasy

16. Surprised

B5. Please tell us if you strongly disagree, disagree, neither agree nor disagree, agree, or strongly agree with the following statements:

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

[RANDOMIZE ORDER. ITEMS WILL BE PRESENTED ACROSS 4 PAGES, WITH 4 ITEMS PER PAGE.]

1. This ad is worth remembering

2. This ad grabbed my attention

3. This ad is powerful

4. This ad is informative

5. This ad is meaningful to me

6. This ad is convincing

7. This ad is terrible

8. This ad is silly

9. This ad is annoying

10. This ad was difficult to watch

11. I trust the information in this ad

12. This ad told me things I never knew before about tobacco

13. The person/people in this ad are like me

14. This ad gave me a reason not to use tobacco

15. I can identify with what the ad says

16. This ad is different from other anti-tobacco ads I’ve seen or heard

B6. On a scale of 1 to 5, how would you rate the claims or arguments in this ad:

Not believable Believable

1 2 3 4 5

B7. On a scale of 1 to 5, indicate whether the ad made smoking look like something you would or would not want to do.

Makes me want to smoke Makes me not want to smoke

1 2 3 4 5

B8. Is there anything confusing, unclear, or hard to understand in this ad?

1. Yes

2. No

[If B8 = Yes, Ask B9. If B8 = No, proceed to Part C]

B9. What is confusing about this ad?

[FREE RESPONSE BOX]

PART C

[Questions to be presented to ALL PARTICIPANTS]

[The following questions will be grouped into three tobacco product sets plus two attention-check sets. Each single question from the three tobacco product sets will be presented on a different survey page, with the order of the question pages randomized within the set.

The order of the sets will also be randomized, so that the first, third, and fourth sets a participant receives will always be a randomized tobacco set, and the second and fifth sets will always be a randomized attention-check set.]

[Set 1: Cigarettes]

[TEXT FOR PARTICIPANTS]: “The following three questions will ask for your opinions about smoking cigarettes. Please answer the questions as honestly as possible.”

C1. How much do you disagree or agree with the following statement: If I smoke cigarettes, I will be controlled by tobacco.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

C2. How much do you disagree or agree with the following statement: If I smoke cigarettes, I will consume harmful chemicals.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

C3. Smoking cigarettes is . . .

1. Very Bad

2. Bad

3. Neither Good or Bad

4. Good

5. Very Good

[Set 2: Cigar products]

[TEXT FOR PARTICIPANTS]: “The following three questions will ask for your opinions about smoking cigars, cigarillos, and little cigars. Some common brands include Black and Milds, Swisher Sweets, Dutch Masters, White Owl, and Phillies Blunts. Please answer the questions as honestly as possible.”

C4. How much do you disagree or agree with the following statement: If I smoke cigars, cigarillos, or little cigars, I will be controlled by tobacco.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

C5. How much do you disagree or agree with the following statement: If I smoke cigars, cigarillos, or little cigars, I will consume harmful chemicals.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

C6. Smoking cigars, cigarillos, or little cigars is . . .

1. Very Bad

2. Bad

3. Neither Good or Bad

4. Good

5. Very Good

[Set 3: Hookah]

[TEXT FOR PARTICIPANTS]: “The following three questions will ask for your opinions about smoking tobacco from a hookah or waterpipe. Please answer the questions as honestly as possible.”

C7. How much do you disagree or agree with the following statement: If I smoke tobacco from a hookah or waterpipe, I will be controlled by tobacco.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

C8. How much do you disagree or agree with the following statement: If I smoke tobacco from a hookah or waterpipe, I will consume harmful chemicals.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

C9. Smoking tobacco from a hookah or waterpipe is . . .

1. Very Bad

2. Bad

3. Neither Good or Bad

4. Good

5. Very Good

[Set 4: Attention-Check Item 1]

[TEXT FOR PARTICIPANTS]: “Please answer the question as honestly as possible.”

C10. Please select “strongly disagree” for this question.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

[Set 5: Attention-Check Item 2]

[TEXT FOR PARTICIPANTS]: “Please answer the question as honestly as possible.”

C11. Please select “neither agree or disagree” for this question.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

END PAGE [13-17 YEAR OLDS]

[TEXT FOR PARTICIPANTS]:

“Thanks for completing the survey! You will receive your $10 gift card by email within 72 hours.

Please note that you can only submit this survey once and receive one gift card. Fraudulent or duplicate surveys will not be eligible to receive a gift card.

The FDA does not encourage the use or sale of tobacco products. It is illegal in most states for adolescents younger than 18 years old to use tobacco, and it is illegal in all states for adolescents under 18 to buy tobacco.

Form Approved

OMB No. 0910-0810

Exp. Date 11/30/2018

RIHSC #17-093CTP

Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 25 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.”

Questionnaire

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