FDA Tobacco Prevention Broad Quantitative Research Package (CTP)

OMB No. 0910-0810

Exp. Date: 10/31/2021

Attachment F: Youth Questionnaire

FDA Tobacco Prevention Broad Quantitative Research Package

Youth Questionnaire

AGE CHECK

“Please answer each question as accurately as possible. Click on the “next” button at the bottom of the page to continue with the survey after you answer each question.”

1.A. How old are you?

1. Under 13 years old

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

[IF PARTICIPANT SELECTS B-F, CONTINUE TO PART A. IF PARTICIPANT SELECTS A or G, CONTINUE TO END PAGE.]

END PAGE

Thanks for your participation! Unfortunately, you are not eligible to complete the survey.

WELCOME PAGE

[TEXT FOR PARTICIPANTS]: “Please answer the questions on the following pages as accurately as possible. Remember to read the instructions carefully.”

[Each item on the Copy Testing Questionnaire will be presented in a separate page, separated by a “NEXT” button. There will also be a “BACK” button presented on each page in case youth accidentally skip a question.]

[Not all questions will be asked to all participants, participants will get questions based on how they screen into the study. All surveys will take no longer than 20 minutes to complete]

PART I

[Questions to be presented prior to showing rough-cut advertisements to ALL PARTICIPANTS – (Part 1 questions are only asked once]

A1. Does anyone who lives with you now… (Select all that apply)

1. Smoke cigarettes?

2. Use vapes, electronic cigarettes, e-cigs, vape pens, mods or a hookah pen?

3. Use smokeless tobacco (such as dip, spit, chewing tobacco, snus pouches, or moist snuff)?

4. Use any other form of tobacco?

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

[A1 = E is an exclusive response and cannot be selected in conjunction with option A, B, C, or D]

A2. How many of your four closest friends [vape/smoke a cigarette/use a cigar, cigarillo, or little cigar/ use smokeless/use hookah]?

1. 0

2. 1

3. 2

4. 3

5. 4

A3. [RANDOMIZE ORDER. ALL ITEMS WILL BE PRESENTED ON THE SAME PAGE.]

A3_1. I like to explore strange places.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

A3_2. I like to do frightening things.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

A3_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

A3_4. I prefer friends who are exciting and unpredictable.

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

A3_5. My family and community are very important to me

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

A3_6. My school life is an important aspect of my life

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

PART II

[(Questions to be provided after 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.”

The ad will play twice before questions begin.

[Perceived Ad Effectiveness]

B1. What do you think is the main message of this advertisement? Please be as specific as possible.

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

1. Yes

2. No

[If B4 = Yes, Ask B5. If B4 = No, Ask B6]

B5. What is confusing about this ad?

[FREE RESPONSE BOX]

B6. People sometimes have different emotional reactions when they see 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]

1. Sad

2. Afraid

3. Irritated

4. Ashamed

5. Understood

6. Angry

7. Amused

8. Disgusted

9. Happy

10. Uneasy

11. Surprised

12. Informed

B7. Please tell us if you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree with the following statements:

[RANDOMIZE ORDER]

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. I trust the information in this ad

11. This ad told me things I never knew before about vapes

12. This ad is relevant to me

13. This ad gave me a reason not to use vapes

14. I can identify with what the ad says

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

B8. 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

B9. On a scale of 1 to 5, indicate whether the ad made [smoking cigarettes/smoking little cigars/using hookah/vaping/using smokeless tobacco] look like something you would or would not want to do.

Makes me want to use vapes				Makes me not want to use vapes
1	2		3		4	5

B10. If you saw this advertisement, on a scale from 1 to 5, where 1 is not at all likely and 5 is very likely, how likely would you be to do each of the following:

Not at all			Very
1	2	3		4	5

1. Tell a friend about the ad

2. Look for more information online

3. Visit The Real Cost website or Facebook page

4. Share The Real Cost YouTube channel with a friend

5. Mention or like it on social media such as Facebook, Twitter, or Instagram

6. Do nothing

PART III

[Both ad exposure and control groups will see these questions]

[TEXT FOR PARTICIPANTS]: “Please answer each question as accurately as possible. Click on the button at the bottom of the page to continue with the survey.”

[Attitudes, Beliefs and Risk Perceptions]

How much do you agree or disagree with following statement:

C1. If I [vape/smoke a cigarette/use a cigar, cigarillo, or little cigar/ use smokeless/use hookah] I will…

C1_1. Damage my body

A. Strongly Disagree

B. Disagree

C. Neither Agree or Disagree

D. Agree

E. Strongly Agree

C1_2. Damage my lungs

A. Strongly Disagree

B. Disagree

C. Neither Agree or Disagree

D. Agree

E. Strongly Agree

C1_3. Vaping can change the way my brain works

1. Strongly Disagree

2. Disagree

3. Neither Agree or Disagree

4. Agree

5. Strongly Agree

C1_4. Become addicted to vaping

A. Strongly Disagree

B. Disagree

C. Neither Agree or Disagree

D. Agree

E. Strongly Agree

C1_5. Be exposed to harmful chemicals (like formaldehyde and acrolein)

A. Strongly Disagree

B. Disagree

C. Neither Agree or Disagree

D. Agree

E. Strongly Agree

C1_6. Develop serious health problems

A. Strongly Disagree

B. Disagree

C. Neither Agree or Disagree

D. Agree

E. Strongly Agree

C1_7. Be exposed to metal particles (like nickel, tin, and aluminum)

A. Strongly Disagree

B. Disagree

C. Neither Agree or Disagree

D. Agree

E. Strongly Agree

C2. [Vaping/smoking a cigarette/using a cigar, cigarillo, or little cigar/ using smokeless/using hookah] is . . .

1. Very Bad

2. Bad

3. Neither Good or Bad

4. Good

5. Very Good

C3. [Vaping/smoking a cigarette/using a cigar, cigarillo, or little cigar/ using smokeless/using hookah] . . .

1. Very Unenjoyable

2. Unenjoyable

3. Neither enjoyable or unenjoyable

4. Enjoyable

5. Very Enjoyable

C4. Out of every 10 people your age, how many do you think [vape/smoke a cigarette/use a cigar, cigarillo, or little cigar/ use smokeless/use hookah]? (Select one)

0 1 2 3 4 5 6 7 8 9 10

people people

[Attention-check items will be inserted randomly]

“Sometimes we ask different kinds of questions to make sure that our participants are reading the questions carefully and answering as accurately as possible.”

D1. Please select Tuesday and Friday from the list below. [RANDOMIZE ORDER]

1. Sunday

2. Tuesday

3. Thursday

4. Friday

“Sometimes we ask different kinds of questions to make sure that our participants are reading the questions carefully and answering as accurately as possible.”

D2. Jack’s favorite color is red. What is Jack’s favorite color?

1. Blue

2. Red

3. Green

4. Yellow

END PAGE

[TEXT FOR PARTICIPANTS]: “Thanks for completing the survey!

Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 20 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.