Adult - Survey

[PROTOCOL TITLE: Measuring Consumer Comprehension of Displays of Harmful and Potentially Harmful Constituents (HPHCs) in Tobacco Products

RTI PRINCIPAL INVESTIGATOR: Jessica Pepper

Version 7-2-20]

OMB# 0910-0880

EXP: 11/30/2022

[Note: bracketed text and survey item numbers will not be visible to participants]

Appendix K:
Online Survey Questionnaire

[PROGRAMMER: PROGRAM QUESTION AS OPTIONAL. IF QUESTION IS NOT ANSWERED, DISPLAY A SOFT ERROR MESSAGE STATING “Are you sure you want to skip this question?” ONLY DISPLAY THE ERROR MESSAGE ONCE FOR A GIVEN QUESTION.]

[PROGRAMMER: DO NOT ALLOW PARTICIPATION ON MOBILE DEVICES.]

[Pretest]

[HPHC General Knowledge]

1. Where do you think most of the harmful chemicals in cigarettes and cigarette smoke come from? (Select one)

1. Tobacco before it is made into cigarettes

2. Tobacco additives

3. The cigarette filter

4. The cigarette paper

5. Burning the cigarettes

2. The cigarette filter traps:

1. All of the harmful chemicals in cigarette smoke

2. A lot of the harmful chemicals in cigarette smoke

3. Some of the harmful chemicals in cigarette smoke

4. None of the harmful chemicals in cigarette smoke

[HPHC Information Seeking]

3. Have you ever looked for information on chemicals in cigarettes and cigarette smoke?

1. Yes

2. No

4. Where would you most like to see information on chemicals in cigarettes and cigarette smoke?

1. On cigarette packs

2. In stores

3. Online

[Harm Perception]

[RANDOMIZE ORDER OF ITEMS 5a to 5k. DO NOT DISPLAY “a”, “b”, etc. NEXT TO SURVEY ITEM]

5. If you were to use cigarettes every day, how likely is it that you would…

	Not at all likely 1	Slightly likely 2	Somewhat likely 3	Very likely 4	Extremely likely 5
a. Harm your overall health
b. Have a shorter life
c. Get sick often
d. Get cancer
e. Get a life-threatening disease
f. Have a heart attack
g. Get addicted
h. Have a permanent breathing problem
i. Have a stroke
j. Have a fetal development problem
k. Have a sexual problem

[Understanding]

[RANDOMIZE ORDER OF Q6 – Q10]

6. Does cigarette smoke contain ammonia?

1. Yes

2. No

3. Don’t know

7. Does cigarette smoke contain formaldehyde?

1. Yes

2. No

3. Don’t know

8. Does cigarette smoke contain 1-aminonaphthalene?

1. Yes

2. No

3. Don’t know

9. Does cigarette smoke contain acrylonitrile?

1. Yes

2. No

3. Don’t know

10. Does cigarette smoke contain isoprene?

1. Yes

2. No

3. Don’t know

[RANDOMIZE ORDER OF Q11 – Q17]

11. Does smoking cause addiction?

1. Yes

2. No

3. Don’t know

12. Does smoking cause heart attacks?

1. Yes

2. No

3. Don’t know

13. Does smoking cause cancer?

1. Yes

2. No

3. Don’t know

14. Does smoking cause fetal development problems?

1. Yes

2. No

3. Don’t know

15. Does smoking cause permanent breathing problems?

1. Yes

2. No

3. Don’t know

16. Does smoking cause strokes?

1. Yes

2. No

3. Don’t know

17. Does smoking cause sexual problems?

1. Yes

2. No

3. Don’t know

[Impact on Behavior]

[FOR ALL AGE GROUPS, IF SMOKED IN PAST 30 DAYS (S4 ≠1) GO TO Q18. ELSE GO TO SHOW STIMULUS]

18. If you learned that your cigarettes have a lot more of a dangerous chemical than other cigarettes, how likely, if at all, would you be to switch brands?

1. Extremely likely

2. Likely

3. Neutral

4. Unlikely

5. Extremely unlikely

[Show Stimulus

Randomize participants to one of 6 study conditions.]

[DISPLAY TEXT AND STIMULUS FOR 30 SECONDS BEFORE R CAN CLICK CONTINUE. TEXT SHOULD APPEAR ABOVE STIMULUS AND “CONTINUE” BUTTON UNDERNEATH STIMULUS.]

Please take a moment to read the information below. You can use the scroll bar on the right to see all the information. This information is about the chemicals that are in Durham cigarettes. Please read and use this information to answer the following questions.

The “Continue” button will appear in about 30 seconds.

Please click the “Continue” button below to continue.

[Post-test]

[RANDOMIZE ORDER OF Q19 – Q23. CONTINUE DISPLAYING STIMULUS ON SCREEN UNTIL Q47. THE STIMULUS SHOULD APPEAR ABOVE THE QUESTION AND RESPONSE OPTIONS.]

[Understanding]

19. Does cigarette smoke contain ammonia?

1. Yes

2. No

3. Don’t know

20. Does cigarette smoke contain formaldehyde?

1. Yes

2. No

3. Don’t know

21. Does cigarette smoke contain 1-aminonaphthalene?

1. Yes

2. No

3. Don’t know

22. Does cigarette smoke contain acrylonitrile?

1. Yes

2. No

3. Don’t know

23. Does cigarette smoke contain isoprene?

1. Yes

2. No

3. Don’t know

[RANDOMIZE ORDER OF Q24 – Q30]

24. Does smoking cause addiction?

1. Yes

2. No

3. Don’t know

25. Does smoking cause heart attacks?

1. Yes

2. No

3. Don’t know

26. Does smoking cause cancer?

1. Yes

2. No

3. Don’t know

27. Does smoking cause fetal development problems?

1. Yes

2. No

3. Don’t know

28. Does smoking cause permanent breathing problems?

1. Yes

2. No

3. Don’t know

29. Does smoking cause strokes?

1. Yes

2. No

3. Don’t know

30. Does smoking cause sexual problems?

1. Yes

2. No

3. Don’t know

[Format Clarity]

31. Please say how much you agree or disagree with this statement. The information about cigarettes clearly shows whether the amount of each chemical is harmful.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

[Misleading (For Stimulus)]

[Beliefs that Chemical Quantity Substantially Affects Risk]

[FOR ALL AGE GROUPS, IF SMOKED IN PAST 30 DAYS (S4 ≠1) GO TO Q32. ELSE GO TO Q33]

32. If you learned that your cigarettes have a lot more of a dangerous chemical than other cigarettes, how likely, if at all, would you be to switch brands?

1. Extremely likely

2. Likely

3. Neutral

4. Unlikely

5. Extremely unlikely

33. Please say how much you agree or disagree with this statement. If a person who smokes cigarettes can’t quit, they should switch to a brand with fewer chemicals.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

34. Please say how much you agree or disagree with this statement. It’s much safer to smoke cigarettes with fewer chemicals.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

[RANDOMIZE ORDER OF Q35-Q37]

35. Please say how much you agree or disagree with this statement. A cigarette is much safer to smoke if it has less arsenic than other cigarettes.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

36. Please say how much you agree or disagree with this statement. A cigarette is much safer to smoke if it has less crotonaldehyde than other cigarettes.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

37. Please say how much you agree or disagree with this statement. A cigarette is much safer to smoke if it has less 4-aminobiphenyl than other cigarettes.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

[Beliefs that Brands Vary in Risk]

38. Please say how much you agree or disagree with this statement. Some cigarette brands are much more harmful to smoke than others.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

39. Please say how much you agree or disagree with this statement. If a website had information like this for all cigarette brands, I would use it to see which cigarettes are safer than others.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

[Evidence of Making Comparisons with Incomplete Data]

[FOR ALL AGE GROUPS, IF SMOKED IN PAST 30 DAYS (S4 ≠1) GO TO Q40. ELSE GO TO Q43]

40. Please say how much you agree or disagree with this statement. My brand of cigarettes is probably safer than Durham.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

41. Please say how much you agree or disagree with this statement. My brand of cigarettes has fewer chemicals than Durham.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

[Perceptions that Smoking Is Less Dangerous]

42. Please say how much you agree or disagree with this statement. Reading this information about cigarettes makes me less likely to quit smoking.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

43. Please say how much you agree or disagree with this statement. After viewing this information about cigarettes, I now feel that smoking is less dangerous.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

44. How harmful are Durham cigarettes (the cigarettes described)?

1. Not at all harmful

2. A little harmful

3. Harmful

4. Very harmful

45. Please say how much you agree or disagree with this statement. It’s safer to smoke Durham cigarettes than most other cigarettes.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

46. Please say how much you agree or disagree with this statement. Durham cigarettes have fewer chemicals than other cigarettes.

1. Strongly agree

2. Agree

3. Neither agree nor disagree

4. Disagree

5. Strongly disagree

[Harm Perception]

[RANDOMIZE ORDER OF ITEMS 47a to 47k. DO NOT DISPLAY “a”, “b”, etc. NEXT TO SURVEY ITEM]

47. If you were to use cigarettes every day, how likely is it that you would…

	Not at all likely 1	Slightly likely 2	Somewhat likely 3	Very likely 4	Extremely likely 5
a. Harm your overall health
b. Have a shorter life
c. Get sick often
d. Get cancer
e. Get a life-threatening disease
f. Have a heart attack
g. Get addicted
h. Have a permanent breathing problem
i. Have a stroke
j. Have a fetal development problem
k. Have a sexual problem

Thank you for participating in this study. The purpose of this study is to understand how people think about the chemicals in tobacco products and smoke. “Durham,” the brand of cigarettes mentioned in this study, is a fictitious brand and is not a product currently for sale.

This research was sponsored by the U.S. Food and Drug Administration also known as the FDA. FDA would like to thank you for sharing your opinions as they will be very useful in helping to understand people’s reactions and thoughts to tobacco product information. If you are a tobacco user, or have a friend or family member who is a tobacco user, and you would like information on how to quit, please visit our webpage at https://smokefree.gov/.

Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 20 minutes per response to complete the survey (the time estimated to read, review, respond). 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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