OMB #0910-NEW
Expires XX/YY/20XX
RESPONDENTS WILL BE RECRUITED BASED ON THEIR PARTICIPATION IN A PREVIOUS SURVEY, TAKEN APPROXIMATELY 1-2 DAYS PRIOR. WITH EACH NEW DATA RECORD ON THIS CURRENT SURVEY, AN ID VARIABLE THAT ALLOWS LINKAGE TO THE PREVIOUS BASELINE SURVEY SHOULD BE PASSED THROUGH AND INCLUDED IN THE DATASET. DATA SHOULD ALSO INCLUDE AN INDICATOR FOR STUDY CONDITION AS ASSIGNED AT THE BASELINE SURVEY.
EACH RESPONDENT WILL BE RE-EXPOSED TO CIGARETTE WARNING STUMULI ACCORDING TO THEIR STUDY CONDITION, AS ASSIGNED IN THE PREVIOUS SURVEY. EACH RESPONDENT SHOULD SEE THE EXACT SAME STIMULI THEY SAW IN SESSION 1 (NOTE: FOR THE CONTROL GROUP, MAKE SURE TO SHOW THE SAME STIMULI ASSIGNED IN SESSION 1—DO NOT RANDOMLY RE-ALLOCATE TO 1 OF 4 SG STIMULI AS DONE IN SESSION 1).
EACH RESPONDENT WILL SEE THEIR ASSIGNED STIMULI IN 2 SEPARATE FORMATS (PACK AND AD) SEQUENTIALLY, IN RANDOM ORDER (FOLLOWING SAME PROTOCOL AS IN THE BASELINE SURVEY). ORDER OF STIMULI SHOULD BE RE-RANDOMIZED (I.E., WILL NOT NECESSARILY BE THE SAME ORDER AS IN SESSION 1).
SECTION D: SECOND STIMULI EXPOSURE
[DISPLAY THE STATEMENT BELOW ON A SINGLE PAGE]
[DISPLAY TEXT “OMB # 0910-NEW, expires XXXX” IN THE SAME PAGE]
Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 8 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.
[DISPLAY THIS STATEMENT ONLY ON A SINGLE PAGE]
INTRO_TEXT_1. We are going to ask you to view images of a cigarette pack and cigarette advertisement. Please view each image carefully and answer the questions that follow to the best of your ability.
[NEXT PAGE]
[RANDOMIZE ORDER OF PACK AND AD STIMULI. SHOW SINGLE STIMULI (PACK OR AD) AND CORRESPONDING INTRO TEXT ON A SINGLE SCREEN. FORCE MINIMUM OF 5 SECOND EXPOSURE. THEN, SHOW REMAINING STIMULI AND CORRESPONDING INTRO TEXT ON A FOLLOWING SCREEN. FORCE 5 SECOND EXPOSURE. RECORD LENGTH OF TIME ON EACH EXPOSURE PAGE]
PACK_INTRO. Please take a moment to look at the cigarette pack below. Note that you can scroll to zoom in and drag to rotate the image.
This 3D image may take up to 30 seconds to load . . . please be patient.
[SHOW PACK STIMULI]
AD_INTRO. Please take a moment to look at the cigarette advertisement below. Note that you can scroll to zoom in.
[SHOW AD STIMULI]
SECTION A: HEALTH BELIEFS
Next, we would like to ask you some questions about your beliefs about smoking-related health effects.
Please tell us how much you agree or disagree with the following statement:
[RANDOMIZE ORDER OF ITEM “BLOCKS” ACCORDING TO ITEM PREFIXES WITH NUMBERS (I.E. RANDOMIZE A1_, A2_, A3_ SERIES, ETC.). ALSO RANDOMIZE ORDER OF QUESTIONS WITHIN BLOCKS. DISPLAY AS SCROLLING LIST.
ALSO, RANDOMLY SELECT ACONT1_1, ACONT2_1, OR ACONT3_1 AND DISPLAY AFTER 4TH BLOCK. RANDOMLY SELECT AND DISPLAY ONE OF THE REMAINING TWO “ACONT_” ITEMS AFTER 8TH BLOCK. DISPLAY THE FINAL “ACONT_” ITEM AFTER 12TH BLOCK. ORDER OF ITEMS AND ITEM BLOCKS MAY BE DIFFERENT THAN ORDER FROM SESSION 1.]
[DO NOT DISPLAY: WARNING: Cigarettes are addictive]
A1_1. Cigarettes are addictive
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: WARNING: Tobacco smoke can harm your children]
A2_1. Tobacco smoke can harm your children
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: WARNING: Smoking can kill you]
A3_1. Smoking can kill you
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: WARNING: Smoking causes fatal lung disease in nonsmokers]
A4_1. Smoking causes fatal lung disease in nonsmokers
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: WARNING: Quitting smoking now greatly reduces serious risks to your health]
A5_1. Quitting smoking now greatly reduces serious risks to your health
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: WARNING: Smoking causes head and neck cancer]
A6_1. Smoking causes head cancer
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A6_2. Smoking causes neck cancer
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: Smoking causes bladder cancer, which can lead to bloody urine]
A7_1. Smoking causes bladder cancer, which can lead to bloody urine
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A7_2. Smoking causes bladder cancer
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: WARNING: Smoking during pregnancy stunts fetal growth]
A8_1. Smoking during pregnancy stunts fetal growth
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: WARNING: Smoking can cause heart disease and strokes by clogging arteries]
A9_1. Smoking causes heart disease
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A9_2. Smoking causes strokes
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A9_3. Smoking clogs arteries
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A9_4. Smoking clogs arteries, which causes heart disease
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A9_5. Smoking clogs arteries, which causes strokes
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: WARNING: Smoking causes COPD, a lung disease that can be fatal]
A10_1. Smoking causes COPD, a lung disease that can be fatal
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A10_2. Smoking causes COPD
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A10_3. Smoking causes lung disease that can be fatal
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: WARNING: Smoking reduces blood flow, which can cause erectile dysfunction]
A12_1. Smoking reduces blood flow, which can cause erectile dysfunction
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A12_2. Smoking reduces blood flow
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A12_3. Smoking can cause erectile dysfunction
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: WARNING: Smoking reduces blood flow to the limbs, which can require amputation]
A13_1. Smoking reduces blood flow to the limbs, which can require amputation
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A13_2. Smoking reduces blood flow to the limbs
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A13_3. Smoking can lead to amputation
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: WARNING: Smoking causes type 2 diabetes, which raises blood sugar]
A14_1. Smoking causes type 2 diabetes, which raises blood sugar
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A14_2. Smoking causes type 2 diabetes
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: WARNING: Smoking causes age-related macular degeneration, which can lead to blindness]
A15_1. Smoking causes age-related macular degeneration, which can lead to blindness
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A15_2. Smoking causes age-related macular degeneration
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A15_3. Smoking can lead to blindness
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: WARNING: Smoking causes cataracts, which can lead to blindness]
A16_1. Smoking causes cataracts, which can lead to blindness
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
A16_2. Smoking causes cataracts
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: CONTROL STATEMENT – NO ASSOCIATED WARNING LABEL]
ACONT1_1. Smoking causes migraines
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: CONTROL STATEMENT – NO ASSOCIATED WARNING LABEL]
ACONT2_1. Secondhand smoke causes sleep disorders like insomnia in children
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
[DO NOT DISPLAY: CONTROL STATEMENT – NO ASSOCIATED WARNING LABEL]
ACONT3_1. Smoking during pregnancy causes hearing loss in babies
1. Strongly disagree
2. Disagree
3. Neither agree nor disagree
4. Agree
5. Strongly agree
9. Prefer not to answer
ENDSCREEN: You’ve reached the end of the survey. Thank you for your participation. As a reminder, you will be invited to participate in one more survey as part of this study. As a thanks for your participation, [IF AGE >= 18: “you”; IF AGE < 18 “your parent”] will get 1,000 Lifepoints for each survey that you take. Please keep an eye out for an invitation to the next survey in the next two weeks.
[DISPLAY THE STATEMENT BELOW ON THE END SCREEN IN SMALLER FONT]
Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 8 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.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | SYSTEM |
| File Modified | 0000-00-00 |
| File Created | 2021-01-15 |