Appendix E- Survey

OMB# 0910-0810

Exp. 12/31/2024

APPENDIX E

SURVEY

TITLE OF INFORMATION COLLECTION:

The Real Cost Campaign: Media Tracking Study

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 survey 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 a question is accidentally skipped.]

[Not all questions will be asked to all participants, participants will receive questions based on how they screen into the study. All surveys will take no longer than 17 minutes to complete]

SECTION A: DEMOGRAPHICS

[IF ETHNICITY (Hispanic/Latino) = 1 (YES)]

You indicated earlier that you identify as Hispanic or Latino/a. How much do you agree or disagree with the following statement?

A1. Being Hispanic or Latino/a is important to my sense of identity.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

SECTION B: TOBACCO USE

B1. Earlier you said that you use vapes. What are the reasons why you have used vapes? Select all that apply.

1. They are affordable

2. They are easy to get

3. A friend or family member uses them

4. They are easy to hide from parents and/or teachers

5. They might be less harmful to me than smoking cigarettes

6. They come in flavors I like

7. They don't smell

8. They help me fit in

9. They help me socialize/make friends

10. They help me manage my anxiety, stress, or depression

11. To get high or a buzz from nicotine.

12. To do tricks.

13. I was curious about using vapes/just wanted to try it

14. They satisfy my cravings for nicotine

15. To try to quit other tobacco products, such as cigarettes

16. Other [please specify]

99. Prefer not to answer

B2. In thinking about all tobacco products. which was the first product that you ever used (if any)?

1. Cigarettes

2. Vapes

3. Cigarillos (examples include Black & Mild, Backwoods, and Swisher Sweets) or little cigars (examples include Cheyenne, Djarum, Talon, and 305s) WITHOUT marijuana

4. Cigarillos (examples include Black & Mild, Backwoods, and Swisher Sweets) or little cigars (examples include Cheyenne, Djarum, Talon, and 305s) WITH marijuana

5. Hookah

6. Smokeless tobacco, such as chewing tobacco or snuff

7. Other (please specify)

8. I have never used any tobacco products

99. Prefer not to answer

[For those who have experimented with both ENDS and cigarettes]

B3. You indicated earlier that you have used vapes, and you just said that you’ve also tried cigarettes. Which of these two products did you try first?

1. Cigarettes

2. Vapes

3. I don’t remember

4. It was around the same time

99. Prefer not to answer

B4. Which product do you use most often?

1. Cigarettes

2. Vapes

3. I use both equally as often

4. I do not use either product

99. Prefer not to answer

[If cigarettes (1) for previous response in B2]

B5_a. Why do you use cigarettes more often than vapes?

[OPEN END]

[If vapes (2) for previous response in B8]

B5_b. Why do you use vapes more often than cigarettes?

[OPEN END]

B6. Which product do you prefer?

1. Cigarettes

2. Vapes

3. I prefer them equally

99. Prefer not to answer

B7. Why do you prefer [cigarettes/vapes]?

[OPEN END]

B8. What other tobacco products have you tried (if any)? Select all that apply.

1. Cigarillos (examples include Black & Mild, Backwoods, and Swisher Sweets) or little cigars (examples include Cheyenne, Djarum, Talon, and 305s) WITHOUT marijuana

2. Cigarillos (examples include Black & Mild, Backwoods, and Swisher Sweets) or little cigars (examples include Cheyenne, Djarum, Talon, and 305s) WITH marijuana

3. Hookah

4. Smokeless tobacco, such as chewing tobacco or snuff

5. Other (please specify)

6. I have never used any other tobacco products

99. Prefer not to answer

SECTION C: PSYCHOGRAPHICS

How much do you agree or disagree with the following statements?

C1. My family is important to me.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

C2. My school life is an important aspect of my life.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

C3. In the last month, how often have you felt...

	0. Never	Almost Never	2. Sometimes	3. Fairly Often	4. Very Often	99. Prefer not to answer
C3_a. that you were unable to control the important things in your life?
C3_b. confident about your ability to handle your personal problems?
C3_c. that things were going your way?
C3_d. difficulties were piling up so high that you could not overcome them?

C4. How much do you agree or disagree with the following statements?

	Strongly Disagree	Disagree	3. Neither Disagree nor Agree	4. Agree	5. Strongly Agree	99. Prefer not to answer
C4_a. I tend to bounce back quickly after hard times
C4_b. It does not take me long to recover from a stressful event
C4_c. I usually come through difficult times with little trouble
C4_d. I have a hard time making it through stressful events
C4_e. It is hard for me to snap back when something bad happens
C4_f. I tend to take a long time to get over setbacks in my life

The next questions ask about your current relationship with your parents or guardians.

C5. How close do you typically feel to the adult or adults you live with?

1. Not at all close

2. Not very close

3. Somewhat close

4. Quite close

5. Very close

99. Prefer not to answer

C6. In the past 12 months, have your parents or guardians talked with you, even once, about not vaping?

1. Yes

2. No

99. Prefer not to answer

SECTION D: TOBACCO-RELATED KABS

How much do you agree or disagree with following statements:

If I vape I will…

D1_a. Become addicted.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D1_b. Be controlled by nicotine.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D1_c. Be a bad influence on others

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D1_d. Be more likely to smoke cigarettes

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D1_e. Inhale metal particles

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D1_f. Damage my body

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D1_g. Damage my lungs

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D1_h. Be exposed to harmful chemicals

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D1_i. Disappoint others around me

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D1_j. Inhale toxic chemicals (e.g., acrolein) that may damage my DNA

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2. How much do you agree or disagree with the following statements about vaping?

D2_a. Vaping just a little can make you crave more.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2_b. Vaping can lead to anxiety.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2_c. Vaping helps people reduce anxiety.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2_d. When people are not able to vape, their anxiety increases.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2_e. Vaping helps people relieve stress.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2_f. When people are not able to vape, their stress increases.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2_g. Most vapes that teens use contain nicotine.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2_h. The toxic metals in vapes can cause irreversible lung damage.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2_i. Most vapes contain really addictive amounts of nicotine.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2_j. Vaping prevention ads are just trying to scare us about vapes.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2_k. If I vape, my family will be disappointed.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2_l. If I vape, my friends will be disappointed.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2_m. If you were to vape every day, how likely is it that you, personally, would not be able to stop vaping even if you wanted to?

1. Not at all likely

2. A little likely

3. Somewhat likely

4. Very likely

5. Extremely likely

99. Prefer not to answer

D2_o. If you were to vape every day, how likely is it that you, personally, would inhale chemicals that harm your body?

1. Not at all likely

2. A little likely

3. Somewhat likely

4. Very likely

5. Extremely likely

99. Prefer not to answer

How much do you agree or disagree with the following statements?

D2_p. A vaping addiction could cause major problems for people.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D2_q. The chemicals in vapes are extremely harmful to one’s body.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

D3. How much do you agree or disagree with the following statements about cigarettes?

D3_a. Cigarette cravings can lead to anxiety.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

SECTION E: AD RECALL AND RECOGNITION

E1. Which of the following health-related advertising do you recall seeing or hearing in the past 3 months? Advertising can be on TV, on the radio, online or on billboards, magazines, or signs in public places.

Have you seen any advertising in the past 3 months that encourages you… (Select all that apply).

[RANDOMIZE ORDER]

1. Not to smoke cigarettes

2. Not to vape or use e-cigarettes

3. Not to dip or chew tobacco

4. Not to drink alcohol

5. Not to drink and drive

6. Not to bully others

7. Not to use drugs

8. None of the above

99. Prefer not to answer

[ASK AMONG THOSE WHO RECALL ENDS RELATED ADVERTISING]

[IF E1 DOES NOT INCLUDE 1, 2, OR 3, SKIP E2, E3]

E2. Do you recall seeing or hearing ads about the harmful effects vaping in these places? (Please choose all that apply).

1. On social media, such as Snapchat, Facebook, Instagram, or Reddit

2. On online video platforms, such as YouTube or Twitch

3. Online, on web pages other than social media and online video platforms

4. On music streaming services, such as Spotify or Pandora

5. Non-cable TV such as Hulu or Roku

6. Cable TV (e.g., ABC, FOX)

7. Somewhere else (Please write-in)

8. Don’t know

99. Prefer not to answer

E3. What, if anything, do you recall about the advertising that you saw? This may include images, characters, or situations in the advertising, themes or ideas, slogans, and more.

[OPEN END]

E4. Do you recognize these brands?

[MATRIX]

1. Yes

2. No

3. I’m not sure

99. Prefer not to answer

[RANDOMIZE ORDER - SHOW IMAGES OF LOGOS]

1. The Real Cost

2. The Truth Campaign

3. Tips from Former Smokers

4. Puff Bar

5. JUUL

6. Vuse

7. Posh

8. SMOK

9. Hyde

[IF E4_A = 2 OR 3, SKIP E5 AND E6]

E5. Which of the following do you associate with “The Real Cost” brand? (Select all that apply).

[RANDOMIZE ORDER]

1. Not to smoke cigarettes

2. Not to vape or use e-cigarettes

3. Not to dip or chew tobacco

4. Not to drink and drive

5. Not to eat sugary food or drink sugary drinks

6. None of the above

99. Prefer not to answer

E6. On the scales below, mark your impressions of The Real Cost Campaign about the risks of vaping. [EACH SCALE IS 1-5]

● Not scientific – Scientific

● Not truthful (or trustworthy/not trustworthy) – Truthful

● Not persuasive – Persuasive

● Doesn’t make me think – Makes me think

● I don’t know The Real Cost Campaign

E7. Which of these vaping or tobacco-related prevention advertising, if any, do you recall seeing any in the past 3 months? Please choose all that apply.

[RANDOMIZE ORDER]

[INCLUDE BOTH IMAGES AND DESCRIPTIONS OF IMAGES]

1. Images of metals that are inhaled by vaping

2. A guy on a movie set with a metal monster

3. An athlete missing the team bus because she can’t find her vape

4. A boy taking money from his mom’s purse to buy a vape

5. A girl dropping a vape into a toilet

6. A girl talking about how vaping caused her anxiety

7. Real teens sharing how vaping has negatively impacted their lives

8. A Little Lung character failing to skateboard with Tony Hawk

9. Animals demanding that JUUL not test on humans

10. A teen taking care of her vape baby as a result of nicotine addiction

11. None of these

99. Prefer not to answer

E8. In the last 3 months, do you recall seeing/hearing ads or promotions for vapes or vaping products in these places? E.g., Advertisements for Juul, Puffbar, or other brands (Please choose all that apply).

1. On social media, such as Snapchat, Facebook, Instagram, or Reddit

2. On online video platforms, such as YouTube or Twitch

3. Online, on web pages other than your social media sites

4. On music streaming services, such as Spotify or Pandora

5. Non-cable TV such as Hulu or Roku

6. Cable TV (i.e., ABC, FOX)

7. In a store, such as a convenience store, supermarket, or gas station

8. Somewhere else (Please write-in)

9. Don’t know

10. No, I haven’t seen any advertisements for vapes or vaping products

11. Prefer not to answer

[IF E8 = 8, 9, 10 or 11, SKIP E9]

E9. In the past week, how often do you see/hear ads or promotions for vapes or vaping products [insert selected response from above]? Please give us your best guess.

1. More than once a day

2. About once a day

3. A few times in the past week

4. About once in the past week

5. More than a week ago

[AD_INTRO]

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.

E10. Apart from this survey, how frequently have you seen this ad in the past 3 months?

1. Never

2. Rarely

3. Sometimes

4. Often

5. Very Often

99. Prefer not to answer

[IF E10 = 1 OR 99, SKIP E11]

E11. Do you recall seeing or hearing this ad in these places in the past 3 months? (Please choose all that apply).

1. On social media, such as Snapchat, Facebook, Instagram, or Reddit

2. On online video platforms, such as YouTube or Twitch

3. Online, on web pages other than your social media sites

4. On music streaming services, such as Spotify or Pandora

5. Non-cable TV such as Hulu or Roku

6. Cable TV (i.e., ABC, FOX)

7. Somewhere else (Please write-in)

8. Don’t know

99. Prefer not to answer

SECTION F: AD TRACKING

F1. 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.

[OPEN END]

F2. How much do you agree with the following statement? I found this ad to be confusing, unclear, or hard to understand.

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

[IF F2 = 1, 2, 3 OR 99, SKIP F3]

F3. What is confusing, unclear, or hard to understand about this ad?

[ALLOW “PREFER NOT TO ANSWER”]

[OPEN END]

F4. 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:

[MATRIX]

[ALLOW “PREFER NOT TO ANSWER”]

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. Uneasy

10. Surprised

11. Sick

12. Regretful

13. Guilty

F5. Please tell us if you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree with the following statements:

[MATRIX]

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

[RANDOMIZE ORDER]

1. This ad grabbed my attention

2. This ad is believable

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

F6. Please tell us if you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree with the following statements:

[MATRIX]

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

[RANDOMIZE ORDER]

1. I trust the information in this ad

2. This ad is worth remembering

3. This ad is relevant to me

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

5. This ad told me things I never knew before about cigarettes

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

7. This ad gave me a reason not to smoke cigarettes

F7. Please tell us if you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree with the following statements:

[MATRIX]

1. Strongly Disagree

2. Disagree

3. Neither Disagree nor Agree

4. Agree

5. Strongly Agree

99. Prefer not to answer

[RANDOMIZE ORDER]

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

2. This ad discourages me from wanting to vape

3. This ad discourages me from wanting to smoke cigarettes

4. This ad makes me concerned about the health effects of vaping

5. This ad makes me concerned about the health effects of smoking cigarettes

6. This ad makes vaping seem unpleasant to me

7. This ad makes smoking cigarettes seem unpleasant to me

F8. On a scale of 1 to 5, indicate whether the ad made vaping look like something you would or would not want to do.

[ALLOW “PREFER NOT TO ANSWER”]

Makes me want to use vapes Makes me not want to use vapes

1 2 3 4 5

F9. On a scale of 1 to 5, indicate whether the ad made smoking cigarettes look like something you would or would not want to do.

[ALLOW “PREFER NOT TO ANSWER”]

Makes me want to smoke cigarettes Makes me not want to smoke cigarettes

1 2 3 4 5

F10. After seeing this ad, on a scale from 1 to 5, where 1 is not at all likely and 5 is very likely, how likely are you to do each of the following:

[MATRIX]

[ALLOW “PREFER NOT TO ANSWER”]

Not at all Very

1 2 3 4 5

1. Tell friends or family about the ad

2. Look for more information online about vaping

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

F11. What do you think this ad applies to? Select all that apply.

1. Vaping with nicotine from tobacco

2. Vaping with tobacco-free nicotine

3. Vaping without nicotine

4. Don’t Know

5. Prefer Not to Answer

Some vapes may contain tobacco-free nicotine.

F12. Before you took this survey, had you heard of “tobacco-free nicotine”?

1. Yes

2. No

3. Don’t Know

4. Prefer Not to Answer

F13. What kind of vapes do people your age use most often?

1. Vaping with nicotine from tobacco

2. Vaping with tobacco-free nicotine

3. Vaping without nicotine

4. Don’t Know

5. Prefer Not to Answer

END PAGE

[TEXT FOR PARTICIPANTS]: “Thanks for completing the survey! Your incentive will be administered within 30 days of you completing the survey. If you have any questions or concerns about using vapes/e-cigarettes, please visit The Real Cost website for resources.”

Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 17 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.