Appendix G - Interview Guide_Menthol User Audience Research_Updated 062122

OMB# 0910-0796
Exp. 12/31/2024

Menthol User Audience Research

In-Depth Interview Guide

Version 06/21/2022

U.S. Food and Drug Administration
Center for Tobacco Products

[Text within brackets will not show to participants]

[Appendix G:
In-Depth Interview Guide]

Menthol User Audience Research

In-Depth Interview Guide

Menthol User Audience Research (average 90 minutes)

SECTION A: Menthol Use History Questionnaire (8 mins)
Upon joining the Zoom line, participants will be asked to complete a short questionnaire about their history of menthol cigarette use before getting started with the interview.

SECTION B: Welcome (3 mins)
The moderator will explain purpose of the interview, discuss the ground rules, provide any technical assistance, and answer any questions the participant has.

SECTION C: General Psychographics (8 mins)
The purpose of this section is to understand participants’ typical behaviors, interests, work, and goals.

SECTION D: Tobacco Use History (35 mins)
The purpose of this section is to gain a deep understanding of each participant’s personal experience with menthol cigarettes and, if applicable, other tobacco products and their experiences with quitting.

SECTION E: Tobacco Environment and Sociocultural Factors (16 mins)
The purpose of this section is to understand how tobacco interacts with participants’ lives, including tobacco/menthol cigarette norms, acceptability, family use and perceptions of others.

SECTION F: Summary / Messaging Territories (16 mins)
The purpose of this section is to understand which harms, motivators, and facilitators to quitting resonate most with participants. This section will inform message framing.

SECTION G: Closing (4 mins)
The interviewer wraps up discussion and ensures that all questions have been answered and all comments have been heard.

SECTION A. MENTHOL USE HISTORY QUESTIONNAIRE (8 MINUTES)

Thank you for making time to talk to me today. Before we get started, I have a short questionnaire for you to complete about your history of menthol cigarette use.

In the chat, I shared a link with you. Please use this link to complete the questionnaire and let me know once you’ve completed it.

SECTION B. WELCOME (3 MINUTES)

Welcome and thank you again for making time to talk with me today. My name is _______, and my colleague _______ is also on the line to help coordinate the session and take notes. We work for a nonprofit research organization called RTI International and are conducting this interview on behalf of The Food and Drug Administration, or FDA. The purpose of this interview is to help FDA understand menthol cigarette use. Our discussion will last on average 90 minutes.

I want to let you know that I’m not an expert on the topics we will discuss – you are the expert here. My role is to moderate our discussion and ensure you have the chance to express your ideas and opinions.

Before we begin, I want to review a few highlights from the consent form you were sent via email and signed digitally:

• Participation. First, your participation is voluntary. You don’t have to answer any questions you don’t want to answer, and you may stop participating at any time.

• Recording. We are audio recording our discussion so that I can give you my full attention and not take a lot of notes. Please minimize any background noise by finding a quiet location away from other people and distractions. If you haven’t already, please silence your cell phone and any other devices. We are not recording video.

• Observers. We may also have some members of the research team, including staff from FDA, watching our discussion so they can hear your opinions directly from you.

• Privacy. We will keep your identity secure to the extent permitted by law. Your name and contact information will not be given to anyone else, and no one will contact you about the study after our discussion is over.
  
  
  

I also want to highlight a few ground rules for our discussion:

• Timing. I have a discussion guide in front of me to help us stay on track. We have a lot of topics to cover, so I may have to move us on to the next topic if we’re running short on time.

• Technical Assistance. If you need technical assistance at any point, just let me know and we can try to resolve it.

• Honest Opinions. Most importantly, there are no right or wrong answers. I just want your honest opinions about the topics we’ll be discussing today. Please feel free to be honest and direct in your answers; you’re not going to hurt my feelings.

Do you have any questions before we begin?

SECTION C. GENERAL PSYCHOGRAPHICS (8 MINUTES)

Thanks so much. It’s great to meet you and I look forward to chatting for about the next 80 minutes.

Questions	Probes
Employment. To begin, can you tell me what you do for work?	Do you work from home or in the office/field?
Hobbies/Interests. What do you like to do for fun?	What are some of your hobbies? For example, do you like to: Work out? Play sports? Read? Watch TV? Watch sports? Cook? Visit family/friends? Go to events/parties?
Relationships. Which 1 or 2 people do you feel closest to in your life?	What’s your relationship with them? Why are they so important to you?

SECTION D: TOBACCO USE HISTORY (35 MINUTES)

Thank you for sharing the background. Now we’re going to switch gears and talk about cigarettes flavored to taste like menthol or mint, which you reported in your screening questionnaire that you [currently / used to] smoke.

CURRENT MENTHOL SMOKERS (8 MINUTES)

Questions	Probes
Menthol Smoking Initiation. When did you first start smoking menthol cigarettes?	How old were you? Why did you start? What appealed to you about menthol cigarettes, specifically?
Menthol Use Terminology. I’ve been calling this type of cigarettes “menthol cigarettes.” Is this how you refer to them?	What would you usually call them? [MOVE FORWARD WITH PARTICIPANT’S PREFERRED TERMINOLOGY]
Perceived Benefits. Why have you continued smoking menthols?	What do you enjoy about smoking menthols?
Current Menthol Use. When do you usually smoke menthols?	Are there certain circumstances when you smoke them? What about times of the day?
[SHOW SCREEN WITH IMAGES OF TOBACCO PRODUCTS] On your screen is an image with various types of products.
Other Product Use. Can you tell me which of these you have ever used?	Are you still using these? [If so] How often? [If not] What led you to stop? Are there certain situations when you use menthols instead of these? (or vice versa) Why do you choose to use menthols/the other product in those situations?

FORMER MENTHOL SMOKERS (8 MINUTES)

Questions	Probes
Menthol Smoking Initiation. When did you first start smoking menthol cigarettes?	How old were you? Why did you start? What appealed to you about menthol cigarettes, specifically?
Menthol Use Terminology. I’ve been calling this type of cigarettes “menthol cigarettes.” Is this how you refer to them?	What would you usually call them? [MOVE FORWARD WITH PARTICIPANT’S PREFERRED TERMINOLOGY]
Perceived Benefits. Why did you continue to smoke menthols?	What did you enjoy about smoking menthols?
Current Menthol Use. When did you usually smoke menthols?	Were there certain circumstances when you would smoke them? What about times of the day?
[SHOW SCREEN WITH IMAGES OF TOBACCO PRODUCTS] On your screen is an image with various types of products.
Other Product Use. Can you tell me which of these you have ever used?	Are you still using these? [If so] How often? [If not] What led you to stop? Were you using both menthols and [products]? Why? What appealed to you about the different products? Were there certain situations when you smoked menthols instead of these? (or vice versa) Why did you choose to use menthols/the other product in those situations?

ALL PARTICIPANTS (15 MINUTES)

Questions	Probes
Knowledge of Alternative Menthol Products. Have you ever used products that make regular cigarettes taste or smell like menthol?	[Yes] What products have you used? [Cards, capsules, drops, etc.] When you use those products, do you consider your cigarettes to be regular cigarettes or menthols? [No] Do you think that’s something you would try?
Harms: Regular Cigarettes. This next question is about cigarettes in general, not specifically menthols. What have you heard about the harms of smoking cigarettes?
Harms: Menthol Cigarettes. What about the harms of menthols, specifically? [COVER ALL PROBES]	[Listen/probe for: Addictiveness] What, if anything, have you heard about their addictiveness? [Listen/probe for: Health Effects] What, if anything, have you heard about the health effects of menthol cigarettes? Damage lungs? Natural, healthier, less risky, fewer chemicals? [Listen probe for: Nicotine] What, if anything, have you heard about the amount of nicotine in menthol cigarettes? More nicotine, less nicotine, same, don’t know? [Listen probe for: Menthol Flavoring] What, if anything, have you heard anything about the harms of the menthol flavoring itself? Tell me more about what you’ve heard.
Perceived Susceptibility: Menthols. Thinking about someone who smokes menthols every day, how likely is it that they will experience these harms?
Harms: Menthols vs. Regular Cigarettes. How do the harms of menthol cigarettes compare to regular cigarettes, meaning cigarettes that are not menthols?	Have you ever heard that “A cigarette is a cigarette—with all the health risks and chemicals that come with it. Menthol doesn’t change that.” Is this believable? Have you ever heard that “menthols may be even more addictive and harder to quit than other cigarettes?” Is this believable?
Perceived Severity. Of all the harms you mentioned, what concerns or worries you the most?	What concerns you least?

CURRENT MENTHOL SMOKERS (12 MINUTES)

Questions	Probes
Quit Attempts. Have you ever tried to quit menthols? [If no, skip to Q32]	Did you try to stop smoking menthols or quit all tobacco products?
Quit Outcomes. What happened when you tried to stop?	Did you use anything or try anything to help you stop? Listen/probe for: Quit cold turkey, made a plan to quit, slowly reduced use, switched to other tobacco products, DIY products, Quitline, NRT]
Quit Barriers. What was challenging? [Moderator: Write down challenges for Section F]
Quit Facilitators. Was there anything that would have helped or made it easier for you? [Moderator: Write down facilitators for Section F]
Quit Intention. Do you want to stop smoking menthols or quit using tobacco completely?	[If yes] Why? [Moderator: Write down motivators for Section F] [If no] Why not? What, if anything, would convince you to stop smoking menthols or to change your current smoking behavior? [Moderator: Write down motivators for Section F]
Quit Resources. If you wanted to stop today, who or where would you turn for help? [Moderator: Write down facilitators for Section F]	What information or resources would you want or need?
Intentions if Menthols Unavailable. If you were no longer able to buy menthol cigarettes in stores, what do you think you would do? [Probe Extensively]	[Listen/probe for: Quit tobacco products, quit menthols] [Listen/probe for: Switch to regular cigarettes] [Listen/probe for: Switch to other nicotine or tobacco product] [Listen/probe for: Switch to other available menthol flavored product (i.e. menthol e-cigarettes)] [Listen/probe for: Use DIY products or modified cigarettes with products, such as menthol cards, capsules, drops] [Listen/probe for: Find other ways to purchase menthol; other localities; black market]

FORMER MENTHOL SMOKERS (12 MINUTES)

Questions	Probes
Quit History. You mentioned that you have stopped smoking menthol cigarettes. Can you tell me about your experience with stopping menthols?	Did you quit smoking all together or just stop smoking menthols? What was the process of quitting/stopping like for you? How many attempts did it take until you stopped for good?
Quit Motivation/Benefits. What made you want to stop? [Moderator: Write down motivators for Section F]	What convinced you to stop smoking menthols for good? [Moderator: Write down motivators for Section F] [Listen/probe for: menthol restrictions] [Listen/probe for: doctor/healthcare provider, resources, encouragement, accountability]
Quit Resources. Did you use anything or try anything to help you stop?	[Listen/probe for: Quit cold turkey, made a plan to quit, slowly reduced use, switched to other tobacco products, DIY products, Quitline, NRT]
Quit Barriers. What was challenging? [Moderator: Write down challenges for Section F]
Quit Facilitators. Was there anything that helped or made it easier for you? [Moderator: Write down facilitators for Section F]
Quit Intention: Other Products. [If other tobacco product user] How did your use of [other tobacco products] change when you stopped smoking menthols?	Did you use [other products] more? Less? Did you switch to using [other products] exclusively after stopping menthols?

SECTION E: TOBACCO ENVIRONMENT AND SOCIOCULTURAL FACTORS [16 MINUTES]

Now we’re going to switch gears and I’d like to hear about other people in your life.

Questions	Probes
Menthol Use Acceptability. What do the people closest to you think about smoking menthols?	How does this compare to what they think about smoking other products (e.g., non-menthol cigarettes? Vapes?) Do they see some products as more harmful than others?
Family/Peer Use. Do any of the people close to you smoke menthols? Use other tobacco products?	Can you tell me who? Did anyone close to you smoke menthols in the past? What led them to stop?
Neighborhood/Community Use. How common do you think smoking menthols is among people where you live?	Who do you see in your neighborhood/community smoking menthols? (Age? Gender? Race/ethnicity?)
Menthol User Profile. Are there certain groups of people that you associate with smoking menthols?	[Listen for: African American, Hispanic, Other racial/ethnic minorities, Sexual or gender minorities, Youth or young adults, Lower education, Women]
Societal Views. How do you think others view people who smoke menthols?
Access to Menthols. Can you tell me about how you access menthols where you live?	How easy or hard is it to get menthols? Where do you buy them/get them? What do you think about the cost of menthols? How does the cost compare to other tobacco products?

SECTION F: MESSAGING TERRITORIES, PREFERRED MESSENGERS/CHANNELS (16 MINUTES)

Thanks so much for sharing all of this – as we’re getting close to the end, I want to recap. You’ve shared several motivators with me today. I’ve listed out a few of them that I’ve heard you say and I’m going to share my screen. [Share list of motivators]

Questions	Probes
Most Convincing Motivators. Which of these feels like the most important reason why you [stopped smoking / might try stopping] menthols?	Most convincing? Why? Least convincing? Why?

We’ve also talked about things that make it easier or harder to stop menthols.

Questions	Probes
Quit Facilitators. What one thing would be the most helpful if you decided to stop using menthols?	Why?
Quit Barriers. What one thing would be the most challenging if you decided to stop using menthols?	Why?

To wrap it up today, I’d like to hear about how we can reach people like you?

Questions	Probes
Outreach Channels. Where would be the best place to reach menthol smokers in your community?	Why? Social media: Which platforms?
Trusted Sources. Who would you trust most to share information with you about menthol cigarettes?	Would you trust the FDA as a source of information? Why/Why not?
Information Needs. What, if any, information do you still want to know about the risks or harms of menthol cigarettes?	What, if any, information do you still want to know about the quitting menthol cigarettes?
Other Resources. Are there any resources that we haven’t talked about yet that you’re interested in or that would be helpful for you to stop smoking menthols?

SECTION G: CLOSING (4 MINUTES)

[CHANGE SCREEN TO CLOSING SCREEN WITH SMOKEFREE.GOV INFO. ALSO INCLUDE A CLICKABLE LINK IN THE CHAT]

Those are all the questions I have for you. Is there anything else you would like to share before we wrap-up? Thank you so much for your time today. Your input has been very helpful.

If you’re interested in more information about quitting smoking, please go to the website that is shared on the screen and in the chat.

[smokefree.gov]

You will receive an email from [RECRUITMENT FIRM] about your $75 token of appreciation within the [TIMEFRAME]. For any questions about the token of appreciation, please contact [RECRUITMENT FIRM] at [PHONE NUMBER] or [EMAIL]. If you have questions about this study, you may call Matthew Eggers of RTI at 919-990-8380, or at 1‑800-334-8571, extension 28380 or send an email to meggers@rti.org. If you have any questions about your rights as a study participant, you may call RTI’s Office of Research Protection at 1-866-214-2043.

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