Survey_030523

Assessing Physiological, Neural and Self-Reported Response to Tobacco Education Message

Start of Block: Identification

Q97 Video Number

• Group 1 or 2

• Group 3 or 4

Q98 Participant Identification

________________________________________________________________

End of Block: Identification

Start of Block: PRA Statement

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-XXXX. The time required to complete this information collection is estimated to average 85 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.

Start of Block: 1. SOCIODEMOGRAPHICS

Q76 How old are you?

• Less than 13 years old

• 13 years old

• 14 years old

• 15 years old

• 16 years old

• 17 years old

• 18 years old

• 19 years old

• 20 years old

• 21 years old

• 22 years old

• 23 years old

• 24 years old

• Over 24 years old

Q74 What is your gender identity (select all that apply)?

• Woman/girl

• Man/boy

• Non-binary or gender non-conforming

• Transgender woman/girl

• Transgender man/boy

• Another gender identity

• Prefer not to answer

Which of these best describes your racial and/or ethnic background? (Select all that apply)

1. American Indian or Alaska Native

2. Asian

3. Black or African American

4. Hispanic or Latino

5. Native Hawaiian or Other Pacific Islander

6. White

Page Break

Display This Question:

If Q76 = 18 years old

Or Q76 = 19 years old

Or Q76 = 20 years old

Or Q76 = 21 years old

Or Q76 = 22 years old

Or Q76 = 23 years old

Or Q76 = 24 years old

1.3 What is the highest grade or level of school you have completed?

• High school or less

• Some college

• College graduate or higher

1.4 What is your current employment status?

• Full-time

• Part-time

• Don’t currently work

Page Break

Display This Question:

If Q76 = 13 years old

Or Q76 = 14 years old

Or Q76 = 15 years old

Or Q76 = 16 years old

Or Q76 = 17 years old

1.5 How much money does your family have?

• Not enough to get by    

• Just enough to get by   

• Only have to worry about money for fun or extras 

• Never have to worry about money  

Display This Question:

If Q76 = 18 years old

Or Q76 = 19 years old

Or Q76 = 20 years old

Or Q76 = 21 years old

Or Q76 = 22 years old

Or Q76 = 23 years old

Or Q76 = 24 years old

1.6 Considering your own income and the income from any other people who help you, how much money do you have?

• Not enough to get by    

• Just enough to get by   

• Only have to worry about money for fun or extras 

• Never have to worry about money  

Page Break

End of Block: 1. SOCIODEMOGRAPHICS

Start of Block: 2. Tobacco Use Behaviors

Preface The next questions are about your experience with cigarettes.

Page Break

Display This Question:

If Q97=Group 3

2.1 Have you ever tried cigarette smoking, even one or two puffs?

• Yes

• No

• Don't know

• Prefer not to answer

Page Break

Display This Question:

If 2.1 = Yes

Q73 How many cigarettes have you smoked in your entire life? A pack usually has 20 cigarettes in it. 

• 1 or more puffs but never a whole cigarette

• 1 cigarette

• 2 to 10 cigarettes (about 1/2 pack total)

• 11 to 20 cigarettes (about 1/2 pack to 1 pack)

• 21 to 50 cigarettes (more than 1 pack but less than 3 packs)

• 51 to 99 cigarettes (more than 2 1/2 packs but less than 5 packs)

• 100 or more cigarettes (5 packs or more)

• Don't know

• Prefer not to answer

Page Break

Display This Question:

If 2.1 = No

Or 2.1 = Don't know

2.2 Have you ever been curious about smoking a cigarette?

• Very curious

• Somewhat curious

• A little curious

• Not at all curious

• Don't know

• Prefer not to answer

Display This Question:

If 2.1 = No

Or 2.1 = Don't know

Q2.2b Do you think you will smoke a cigarette in the next year?

• Definitely yes

• Probably yes

• Probably not

• Definitely not

• Don't know

• Prefer not to answer

Display This Question:

If 2.1 = No

Or 2.1 = Don't know

Q2.2c Do you think that you will try a cigarette soon?

• Definitely yes

• Probably yes

• Probably not

• Definitely not

• Don't know

• Prefer not to answer

Display This Question:

If 2.1 = No

Or 2.1 = Don't know

Q2.2d If one of your best friends were to offer you a cigarette, would you smoke it?

• Definitely yes

• Probably yes

• Probably not

• Definitely not

• Don't know

• Prefer not to answer

Page Break

Display This Question:

If 2.1 = Yes

2.3 Do you now smoke cigarettes ...

• Every day

• Some days

• Not at all

• Don't know

• Prefer not to answer

Page Break

The next questions are about vaping products like e-cigarettes, vape pens, JUULs, mods, or other personal vaporizers. These products are battery-powered and produce vapor or aerosol instead of smoke. Vapes typically use a nicotine liquid, although the amount of nicotine can vary, and some may not contain any nicotine at all.

Please do NOT include vapes with marijuana, THC, or CBD when answering these questions.

Page Break

2.4 Have you ever used a vaping product or vape, even one or two times? (Electronic nicotine products include e-cigarettes, vape pens, personal vaporizers and mods, e-cigars, e-pipes, e-hookahs, and hookah pens.)  

• Yes

• No

• Don't know

• Prefer not to answer

Page Break

Display This Question:

If 2.4 = No

2.5 Have you ever been curious about using a vaping product or vape? (Electronic nicotine products include e-cigarettes, vape pens, personal vaporizers and mods, e-cigars, e-pipes, e-hookahs, and hookah pens.) 

• Very curious

• Somewhat curious

• A little curious

• Not at all curious

• Don't know

• Prefer not to answer

Q2.5b Do you think you will try a vaping product or vape in the next year?

• Definitely yes

• Probably yes

• Probably not

• Definitely not

• Don't know

• Prefer not to answer

Q2.5c Do you think that you will try a vaping product soon?

• Definitely yes

• Probably yes

• Probably not

• Definitely not

• Don't know

• Prefer not to answer

Q2.5c If one of your best friends were to offer you a vaping product or vape, would you try it?

• Definitely yes

• Probably yes

• Probably not

• Definitely not

• Don't know

• Prefer not to answer

Page Break

Display This Question:

If 2.4 = Yes

2.6 Do you now use a vaping product or vape ... 

• Every day

• Some days

• Not at all

• Don't know

• Prefer not to answer

Display This Question:

If 2.4 = Yes

2.7 How many times have you used a vaping product or vape in your entire life?

• 1 time, even just a few puffs

• 2 to 10 times

• 11 to 20 times

• 21 to 50 times

• 51 to 99 times

• 100 or more times

• Don't know

• Prefer not to answer

Page Break

End of Block: 2. Tobacco Use Behaviors

Start of Block: 3. SOCIAL INFLUENCES

3.1 Does anyone who lives with you now use any tobacco? This includes cigarettes, e-cigarettes, vapes or vaping products, cigars, cigarillos, little cigars, pipes filled with tobacco, hookah or water pipe, bidis, and smokeless tobacco such as chewing tobacco, snuff, dip, snus, or dissolvable tobacco.

• No

• Yes

• Don't know

• Prefer not to answer

3.2 How many of your four closest friends smoke cigarettes?

• None

• One

• Two

• Three

• Four

• Don't know

• Prefer not to answer

3.3 How many of your four closest friends use e-cigarettes or other electronic nicotine products?

• None

• One

• Two

• Three

• Four

• Don't know

• Prefer not to answer

End of Block: 3. SOCIAL INFLUENCES

Start of Block: Video Instructions

Q219 In the next part of the study, you will watch four videos. The researcher will start the video for you. After each video, you will answer questions about what you saw.

Q220 When you are ready, please let the researcher know to begin the first video.

End of Block: Video Instructions

Programming note: Four videos will be presented in random order; participants will answer questions after each video.

Start of Block: OUTCOME VARIABLES pt. 1

4.1 Have you seen this advertisement before this study?

• No

• Yes

• Don't know

• Prefer not to answer

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

[Randomize order of statements]

	Strongly disagree	Disagree	Neither disagree nor agree	Agree	Strongly agree	Prefer not to answer
This ad was worth remembering.
This ad grabbed my attention.
This ad was powerful.
This ad was informative.
This ad was meaningful to me.
This ad was convincing.

4.3 Please indicate the extent to which you agree with the following statements: 

[Randomize order of statements]

	Strongly disagree	Disagree	Neither disagree not agree	Agree	Strongly agree	Prefer not to answer
This message discourages me from wanting to smoke.
This message makes me concerned about the health effects of smoking.
This message makes smoking seem unpleasant to me.

4.4 When I was watching this ad, I paid close attention during __ of the time the ad was playing.

• All

• Most

• About half

• Some

• None

4.5 When I was watching this ad, I paid the most attention to (select one response):

• The characters in the ad

• The animation or visuals

• The information provided

• The music that was playing

• Something else: _____________

DISPLAY IF Q97=GROUP 4

4.6 How much does this ad make you worry about what smoking cigarettes will do to you?

• Not at all

• Very little

• Somewhat

• Quite a bit

• A great deal

DISPLAY IF Q97=GROUP 1 OR GROUP 2

4.7 How much does this ad make you think smoking cigarettes is a bad idea?

• Not at all

• Very little

• Somewhat

• Quite a bit

• A great deal

DISPLAY IF Q97=GROUP 1 OR GROUP 2

4.8 How much does this ad discourage you from smoking cigarettes?

• Not at all

• Very little

• Somewhat

• Quite a bit

• A great deal

DISPLAY IF Q97=GROUP 1 OR GROUP 2

4.9 How much does this ad make you worry about what vaping will do to you?

• Not at all

• Very little

• Somewhat

• Quite a bit

• A great deal

DISPLAY IF Q97=GROUP 3

4.10 How much does this ad make you think vaping is a bad idea?

• Not at all

• Very little

• Somewhat

• Quite a bit

• A great deal

DISPLAY IF Q97=GROUP 3

4.11 How much does this ad discourage you from vaping?

• Not at all

• Very little

• Somewhat

• Quite a bit

• A great deal

DISPLAY IF Q97=GROUP 3

4.12 If you were going to tell a friend what this ad was about, how would you describe the main message of the ad to them? Please be as specific as possible.

________________________________________________________________

4.13 Please tell us if you strongly disagree, disagree, agree, or strongly agree with the following statement: I found this ad to be confusing, unclear, or hard to understand.

• Strongly Disagree

• Disagree

• Agree

• Strongly Agree

4.14 [Ask if 4.13=Agree or Strongly Agree What is confusing, unclear, or hard to understand about this ad? Please be as specific as possible. ______________

Q4.15What do you like about this advertisement? Please be as specific as possible. 

________________________________________________________________

Q4.16 What do you dislike about this advertisement? Please be as specific as possible. 

________________________________________________________________

5.1 Please indicate how much you disagree or agree with the following statements.

[Randomize order of statements]

	Strongly disagree	Disagree	Neither disagree nor agree	Agree	Strongly agree	Prefer not to answer
This ad is trying to manipulate me.
The health effect in this ad is overblown.
This ad annoys me.

Q5.2 To what extent did the ad make you feel ... ?

[Randomize order of each emotion]

	Not at all				Extremely	Prefer not to answer
Scared
Inspired
Sad
Angry
Annoyed
Irritated
Ashamed
Understood
Uneasy
Surprised
Regretful
Guilty
Curious Motivated Hopeful Amused Happy

5.3 Think about the ad you watched and answer the following questions.

[Randomize order of statements]

	Not at all						Very much	Prefer not to answer
I could picture myself in the scene of the events in the ads.
I was mentally involved in the ad while viewing it.
I wanted to learn how the ad ended.
The ad affected me emotionally.

Q5.4 Think about the ad you watched, and answer the following questions.

[Randomize order of statements]

	Strongly disagree	Disagree	Neither disagree nor agree	Agree	Strongly agree	Prefer not to answer
This ad is believable
This ad is different from other anti-tobacco ads I’ve seen or heard.
This ad told me things I never knew before about [vapes if Group 3][cigarettes if Group 1, 2 or 4].
I trust the information in this ad.
This ad seemed to be written with someone like me in mind.

Q5.5 Think about the ad you watched and answer the following questions.

[Randomize order of statements]

	Not at all									A great deal	Prefer not to answer
How similar are you to the characters in the ad?
How much do you like the characters in the ad?
How do you feel like you know the characters in the ad?
How much would you like to be like the characters in the ad?

Page Break

Q5.6a Please indicate the extent to which you agree with the following statements. 

[Randomize order of statements]
If I smoke cigarettes [if Group 1 or 2], I will...

	Strongly disagree	Disagree	Neither disagree nor agree	Agree	Strongly agree	Prefer not to answer
Become addicted to smoking
Harm my body
Harm my lungs
Develop serious health problems
Inhale harmful chemicals
Develop cancer
Be less attractive to others
Miss out on activities and things I enjoy
Increase the chances that my younger brother or sister smokes

Q5.6b Please indicate the extent to which you agree with the following statements.

[Randomize order of statements]  

If I vape [if Group 3] I will

	Strongly disagree	Disagree	Neither disagree nor agree	Agree	Strongly agree	Prefer not to answer
Become addicted to vaping
Harm my body
Harm my lungs
Develop serious health problems
Inhale harmful chemicals
Be exposed to toxic metals
Develop worse mental health
Be less attractive to others
Harm my relationships

4Q5.6c Please indicate the extent to which you agree with the following statements. 

[Randomize order of statements]
If I smoke cigarettes [if Group 4], I will...

	Strongly disagree	Disagree	Neither disagree nor agree	Agree	Strongly agree	Prefer not to answer
Become addicted to smoking
Harm my body
Harm my lungs
Develop serious health problems
Inhale harmful chemicals
Develop cancer
Damage my appearance
Be less attractive to others
Miss out on activities and things I enjoy

Q5.7 Please indicate the extent to which you agree with the following statements. 

Very bad

Very good

Prefer not to answer

0

1

2

3

4

5

[Smoking cigarettes if Group 1, 2 or 4] [Vaping if Group 3] is ... ()

Q5.8

Unenjoyable

Enjoyable

Prefer not to answer

0

1

2

3

4

5

[Smoking cigarettes if Group 1, 2 or 4] [Vaping if Group 3] is ... ()

Q5.9 In the next year, how likely are you to vape? [Asked if Group 3]

A. Very unlikely

B. Somewhat unlikely

C. Neither likely nor unlikely

D. Somewhat likely

E. Very likely

Q5.10 In the next year, how likely are you to smoke a cigarette? [Asked if Group 1, 2 or 4]

A. Very unlikely

B. Somewhat unlikely

C. Neither likely nor unlikely

D. Somewhat likely

E. Very likely

Start of Block: 6. Psychosocial Variables

6.1 People often identify with particular groups, subcultures, or types of people. Please indicate how much you identify with each group by dragging the bar across the green Dragging the bar to 100 means you identify with this group very much and dragging the bar to 0 means you do not identify with this group at all.

[Randomize order of groups]

0

10

20

30

40

50

60

70

80

90

100

Prefer not to answer

Hipsters ()
Skaters ()
Jocks ()
Athletes ()
Rockers ()
Goth ()
Emo ()
Gangster ()
Partyers ()
Hip-hop ()
Country ()
Popular ()
Mainstream ()
Alternative ()

Page Break

Q6.2 Please answer how much you agree or disagree with each of the following statements.

[Randomize order of statements]

	Strongly disagree	Disagree	Neither disagree nor agree	Agree	Strongly agree	Prefer not to answer
I like to do frightening things
I like new and exciting experiences, even if I have to break the rules
I prefer friends who are exciting and unpredictable
I like to explore strange places

6.3 Please answer how much you agree or disagree with each of the following statements. 

[Randomize order of statements]

	Strongly disagree	Disagree	Somewhat disagree	Neither disagree nor agree	Somewhat agree	Agree	Strongly agree	Prefer not to answer
I become frustrated when I am unable to make free and independent decisions
It irritates me when someone points out things which are obvious to me
I become angry when my freedom of choice is restricted
Regulations trigger a sense of resistance in me
I find contradicting others stimulating
When something is prohibited, I usually think, "That's exactly what I am going to do."
I resist the attempts of others to influence me
It makes me angry when another person is held up as a role model for me to follow
When someone forces me to do something, I feel like doing the opposite
I consider advice from others to be an intrusion
Advice and recommendations usually induce me to do just the opposite

End of Block: 6. Psychosocial Variables