OMB#
0910-0796
Exp. 12/31/2024
Recruitment Screener
Version 06/22/2022
[Display at bottom of Introduction screen] Paperwork Reduction Act Statement: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0910-0796. The time required to complete this information collection is estimated to average 3 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing burden to PRASTAFF@fda.hhs.gov. |
U.S.
Food and Drug Administration
Center for Tobacco Products
[Text within brackets will not show to participants]
[Appendix B:
Recruitment
Screener]
Menthol User Audience Research
In-depth Interview (IDI) Web Screener
Note: This screener is to identify (n=24) eligible participants in 1) localities with a menthol ban (n=12) and 2) localities without a menthol ban (n=12). Localities with a menthol ban currently in effect in the United States include Massachusetts (sales and on-site consumption restricted to licensed smoking bars effective 6/1/20), San Francisco (sales ban enforced 1/1/2019), and Minneapolis/St. Paul (sales restricted to select tobacco products shops and liquor stores 8/1/2018 and 11/1/2018). Participants must meet the core eligibility criteria in Table 1.
Table 1. Core Participant Eligibility Criteria
To ensure our sample reflects the population of people who use menthol cigarettes, participants will be recruited based on the priority enrollment characteristics in Table 2.
Table 2. Priority Enrollment Characteristics
|
INTRODUCTION
Thank you for your interest in this study sponsored by the U.S. Food and Drug Administration (FDA). Please answer the following questions to see if you are eligible to participate in an online interview about menthol cigarette use.
The interview will be led by a researcher through an online video platform. If you’re eligible for the interview, you can participate from home using a computer, tablet, or smartphone. The discussion will last an average of 90 minutes, and you will receive a $75 token of appreciation for participating.
To determine your eligibility for this study, we need to ask you a few questions. These questions should take no more than 3 minutes.
[WILLING] Are you willing to answer a few questions to see if you are qualified to participate in the study?
Yes
No
[IF WILLING = 1, CONTINUE]
[IF WILLING = 2, TERMINATE AND DISPLAY: “Thank you for your time.”]
[NOTE: PLEASE USE THE FOLLOWING TERMINATION LANGUAGE IMMEDIATELY AFTER ANY RESPONSE THAT LEADS TO THE OPTION TERMINATE: “Thank you answering these questions. Unfortunately, you are not eligible to participate in this interview. Thank you for your time.”]
[ASK ALL]
[AGE] What is your age?
___ years [NUMERIC, WHOLE NUMBERS ONLY. ALLOW 1-99]
[TERMINATE IF AGE < 21]
[ASK ALL]
[ZIP_1] What is your current 5-digit zip code?
_ _ _ _ _ [NUMERIC, VALIDATE 5-DIGIT ZIP CODE FORMAT]
[PROGRAMMER: CREATE AREA_1 VARIABLE FROM ZIP_1 WITH THE FOLLOWING CATEGORIES:
MASSACHUSETTS
SAN FRANCISCO
MINNEAPOLIS/ST. PAUL
ANY OTHER AREA
[ASK IF AREA_1 = MASSACHUSETTS OR SAN FRANCISCO OR MINNEAPOLIS/ST. PAUL]
[ZIP_2] What was your 5-digit zip code at the beginning of [IF AREA_1 = MASSACHUSETTS: “2020” OR IF AREA_1 = SAN FRANCISCO: “2019” OR IF AREA_1 = MINNEAPOLIS/ST. PAUL: “2018”]?
Same as current
Other, specify: _ _ _ _ _ [NUMERIC, VALIDATE 5-DIGIT ZIP CODE FORMAT]
Don’t know [TERMINATE]
[PROGRAMMER: CREATE AREA_2 VARIABLE FROM ZIP_2 WITH THE FOLLOWING CATEGORIES:
MASSACHUSETTS
SAN FRANCISCO
MINNEAPOLIS/ST. PAUL
ANY OTHER AREA
[TERMINATE IF AREA_1 ≠ AREA_2]
[ASK ALL]
Have you ever worked for…? [MULTIPLE SELECT]
[WRK_TOB] A tobacco company [TERMINATE]
[WRK_FED] The U.S. federal government (not including as a member of the military) [TERMINATE]
[WRK_NON] None of the above
[ASK ALL]
[FG] When was the last time you participated in an interview or a focus group for a research study?
Within the last 6 months [TERMINATE]
7 months to less than 2 years ago
2 years to less than 3 years ago
3 years ago or more
Never
Don't know [TERMINATE]
[ASK ALL]
[AUDIO] Are you okay with being audio recorded during the interview?
Yes
No [TERMINATE]
[ASK ALL]
[SMK_100] Have you smoked at least 100 cigarettes in your entire life?
Yes
No [TERMINATE]
[ASK IF AREA_2 = MASSACHUSETTS OR SAN FRANCISCO OR MINNEAPOLIS/ST. PAUL]
[SMK_30DB] In the year before [IF AREA_2 = MASSACHUSETTS: “June 2020” OR IF AREA_2 = SAN FRANCISCO: “January 2019” OR IF AREA_2 = MINNEAPOLIS/ST. PAUL: “August 2018”], about how many days per month did you smoke? (Your best guess is fine)
1-19
20+
0 [TERMINATE]
[ASK IF AREA_2 = MASSACHUSETTS OR SAN FRANCISCO OR MINNEAPOLIS/ST. PAUL AND (SMK_30DB = 1 OR 2)]
[MENTH_B] In the year before [IF AREA_2 = MASSACHUSETTS: “June 2020” OR IF AREA_2 = SAN FRANCISCO: “January 2019” OR IF AREA_2 = MINNEAPOLIS/ST. PAUL: “August 2018”], was your usual cigarette brand menthol or non-menthol?
Menthol
Non-menthol [TERMINATE]
Both
No usual brand [TERMINATE]
[ASK ALL]
[SMK_30D] During the past 30 days, on how many days did you smoke cigarettes?
____ [NUMERIC, WHOLE NUMBERS ONLY. ALLOW 0-30]
[ASK IF SMK_30D = 1-30]
[MENTH_NB] Is your current usual cigarette brand menthol or non-menthol?
Menthol
Non-menthol
Both
No usual brand
[TERMINATE IF AREA_1 = ANY OTHER AREA AND MENTH_NB = 2 OR 4]
[GENERATE VARIABLE SAMPLE WITH THE FOLLOWING VALUES:
IF (AREA_2 = MASSACHUSETTS OR SAN FRANCISCO OR MINNEAPOLIS/ST. PAUL) AND (MENTH_B = 1 OR 3), DESIGNATE AS SAMPLE GROUP 1 (BAN)
IF AREA_1 = ANY OTHER AREA AND SMK_30D = 1-30 AND (MENTH_NB = 1 OR 3), DESIGNATE AS SAMPLE GROUP 2 (NO BAN)]
[IF CRITERIA IS NOT MET FOR SAMPLE GROUP 1 (BAN) OR 2 (NO BAN), TERMINATE]
[ASK IF SMK_30D = 1-30]
[QUIT] Do you plan to quit smoking cigarettes for good...
In the next 7 days
In the next 30 days
In the next 3 months
In the next 6 months
In the next year
More than one year from now
I do not plan to quit smoking cigarettes for good
Not sure/uncertain
[ASK ALL]
[EDUC] What is the highest level of education you have completed?
Less than high school diploma
High school graduate or GED
Some college
Technical or associates degree (2-year)
4-year degree
Graduate or professional degree
[ASK ALL]
[RACE] Which of these best describes your racial and/or ethnic background? You may select more than one.
American Indian or Alaska Native
Asian
Black or African American
Hispanic, Latin(a/o), Latinx
Pacific Islander or Native Hawaiian
White
Prefer not to answer [EXCLUSIVE]
[ASK ALL]
[INC] Considering your own income and the income from any other people who help you, how much money do you have?
Not enough money to get by
Just enough money to get by
Enough to only worry about money for fun or extras
Never have to worry about money
Prefer not to answer
[ASK ALL]
[EMPLOY] Are you currently…? Please select the option that best describes you.
Employed for wages
Self-employed
Out of work for 1 year or more
Out of work for less than 1 year
A homemaker
A student
Retired
Unable to work
[ASK ALL]
[URBAN] Would you consider the area that you live in to be urban, rural, or suburban?
Urban
Rural
Suburban
[ASK ALL]
[SEXOR] Which of the following best represents how you think of yourself? Select all that apply.
Straight or heterosexual
Bisexual
Gay or lesbian
Pansexual
Queer
Asexual
I am not sure yet
Something else
Prefer not to answer [EXCLUSIVE]
[ASK ALL]
[GENDID] What is your gender identity? Select all that apply.
Woman
Man
Transgender woman
Transgender man
Non-binary or gender non-conforming
Another gender identity
Prefer not to answer [EXCLUSIVE]
[ASK ALL]
[MARITAL] What is your marital status?
Married
Widowed
Divorced
Separated
Never married
[ASK ALL]
Over the last 2 weeks, how often have you been bothered by the following problems?
[NERVE] Feeling nervous, anxious, or on edge
Not at all
Several days
More than half the days
Nearly every day
[WORRY] Not being able to stop or control worrying
Not at all
Several days
More than half the days
Nearly every day
[INTEREST] Having little interest or pleasure in doing things
Not at all
Several days
More than half the days
Nearly every day
[DOWN] Feeling down, depressed or hopeless
Not at all
Several days
More than half the days
Nearly every day
CLOSING SCRIPTS
DECLINED TO BEGIN SCREENER: “Thank you for your time.”
COMPLETED SCREENER: “You have completed the online screener. One of our recruiters will be in touch if you qualify for this study. Thank you for your time. If you have any questions, you can contact us at [VENDOR PHONE NUMBER] or [VENDOR EMAIL].”
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Showalter, Rachel |
| File Modified | 0000-00-00 |
| File Created | 2023-08-27 |