6 Study Protocol - Spanish

Generic Clearance for Cognitive Testing of Instrumentation and Materials for the PATH Study (NIDA)

PATH OMB Attachment F English-Language Protocols 072214

Cognitive Interviews to Support Development of Questionnaire Items for Wave 3

OMB: 0925-0663

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 0925-0663 can be found here:

2015-10-20 - Revision of a currently approved collection

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OMB Control Number: 0925-0663
Expiration Date: 11/30/2015

Population Assessment of Tobacco and Health (PATH) Study

English-Language Protocol

Please note that respondents will be randomly assigned a subset of the following modules. Modules that are restricted solely to adult or youth respondents are noted in the module name, (e.g., Adult Tobacco Use Module).

No single respondent will receive more than 7 modules and each interview will be limited to 56 minutes.

Screening and Polyuse Module 4

Screening 4

Polyuse 5

Electronic Products 7

E-cigarettes 17

E-cigarette Nicotine Dependence 40

Adult Hookah Module 50

Hookah 58

Hookah Nicotine Dependence 75

Adult Nicotine Dependence Module 85

Dependency items 85

Quitting 91

Withdrawal 91

Considered quitting 94

Youth Nicotine Dependence 95

Adult Tobacco Use Module 101

Cigarettes 101

Cigars 108

Use of Non-tobacco Products 132

Pipes 135

Smokeless Tobacco 141

Dissolvable Tobacco 154

Youth Tobacco Use Module 156

Cigarettes 156

Electronic Products 170

Smokeless Tobacco 256

Dissolvable Tobacco 272

Harm Module 274

Relative Harm 274

Advertising Claims about Relative Harm 276

Media Module 285

Internet Use 285

General Use, Games, and Videos 285

Social Media 287

Apps 294

Health Promotion 296

Marketing and Promotion Items 297

Adult Demographics Module 303

Youth Demographics Module 311

Allowance 311

Adult Pregnancy Module 312

Youth Health Module 318

Adult Barcode Scanning Module 322

Screening and Polyuse Module

adult and youth respondents

Screening

PATH ID: SCREENING

RESEARCH QUESTIONS

Determine respondent’s current use.

I have a set of cards here, each labeled with a type of tobacco product. On one side is the name and picture of the product. On the back is a description. Are you unfamiliar with any of these products? IF YES, Which ones?

Which of these products (YOUTH ONLY: , if any,) have you ever used, even just once?

FOR EACH PRODUCT EVER USED,
Did you try it just once or twice, or did you use it regularly?
Do you still use it?
 MARK each product currently uses ON SKIP SHEET

NOTE ANY REACTIONS RESPONDENT HAS TO PICTURES OR DESCRIPTIONS, IF APPLICABLE.

Besides these products, are you aware of any other products that contain nicotine?

PROBE MORE ON ANY PRODUCT R MENTIONS (PARTICULARLY NICOTINE GEL OR OR NICOTINE WATER) THAT IS NOT A CESSATION AID

if not a polyuser (CURRENTLY USING 2 or more TOBACCO PRODUCTS)  go to next module

Polyuse

PATH ID: Polyuse

Research questions

We want to explore dual use and why polyusers choose one product over another. The purpose is to get a portrait of respondents’ polyuse. We want to know about use patterns; when and why they use certain products; distinguish between what's used most; what's most important; what's considered to be primary versus secondary.

You said you use more than one tobacco product. I’d like to ask you a few questions about these products to get a better sense of when and why you use them.

IF ONLY TWO PRODUCTS:

Do you consider one product to be more important to you than the other?
IF YES, Which one? Why do you consider it most important?

Which one do you use most often? IF DIFFERENT FROM MOST IMPORTANT, PROBE TO FIND OUT WHY.

Tell me about when you use [PRIMARY PRODUCT] versus [SECONDARY PRODUCT]? How do you decide which one to use?

Are there certain places that you use [PRIMARY PRODUCT] instead of [SECONDARY PRODUCT] and vice versa? IF NEEDED, Where do you use each?

IF MORE THAN TWO PRODUCTS
Do you consider one product to be more important than the others? IF YES, Which one? Why do you consider it most important?

Which one do you use most often? IF DIFFERENT FROM MOST IMPORTANT, PROBE TO FIND OUT WHY.

Which one is next in importance? Why?
Which one is least important to you? Why?

Tell me more about how you decide which product to use at any given time.

Are there certain places that you use particular products? IF NEEDED, Where do you use each product?

Electronic Products

Screening

Research questions

The introduction and first few items are newly revised to ask about all electronic products. Testing is needed.

Additionally, how do the various users of different electronic device types report on daily use? What’s the best unit for these users to report on dosage – puffs versus volume (number of cartridges)?

BOX ID: R02_AOT01

The next questions are about electronic nicotine products, such as e-cigarettes, e-cigars, e-hookahs, e-pipes, vape pens, hookah pens and personal vaporizers. These products are battery-powered, use nicotine fluid rather than tobacco leaves, and produce vapor instead of smoke. Some common brands include Fin, NJOY, Blu, e-Go and Vuse.

What reaction, if any, did you have to this description and the picture? In your own words, what is “vapor”?

Are you familiar with all of these products? IF NO, Which ones are new to you?

Are these the words you use, or do you call these products by different names?

All of these products together are called “electronic nicotine products.” What do you think of that name? Is there another word you use to refer to all of these products?

PATH ID: R02_AO9034

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

Yes
No  go to next MODULE
DON’T KNOW  go to next MODULE

In your own words, what is this question asking?

In your own words, what is an “electronic nicotine product”?

PATH ID: R02_AO9035

Which type of electronic nicotine product have you ever used? Choose all that apply.

E-cigarette (including vape pens and personal vaporizers)  MARK ON SKIP SHEET
E-cigar  MARK ON SKIP SHEET
E-hookah (including hookah pens)  MARK ON SKIP SHEET
E-pipe  MARK ON SKIP SHEET
Something else SPECIFY:___________________
DON’T KNOW

Tell me more about your answer. PROBE ON WHETHER RESPONDENT KNOWS THE DIFFERENCE BETWEEN THESE PRODUCTS. DETERMINE IF RESPONDENT IS MARKING MULTIPLE CATEGORIES FOR A SINGLE PRODUCT.Do you have your [E-cigarette/E-cigar/E-hookah/E-pipe] here with you? IF YES, Is it okay if I take a picture of it/them?

if do not use any electronic products  go to next MODULE

E-cigarette

if do not use e-cigarettes  go to Q11

Use

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AE1003_ECIG

Do you now use e-cigarettes…

Every day
Some days
Rarely  go to Q7
Not at all  go to Q11

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF FREQUENCY OF USE.

In the past 30 days, how many days did you use e-cigarettes?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between using e-cigarettes “some days” and using e-cigarettes “rarely”?

IF RESPONDENT SELECTS “RARELY,” If “rarely” hadn’t been an answer choice, how would you have answered this question? IF NEEDED, Would you have chosen “not at all” or “sometimes”? Why?

PATH ID: R02_AE0100_ECig

When did you last use an e-cigarette?

In the past hour  go to Q6
Sometime today
Yesterday
Day before yesterday
Three or more days ago  go to Q7

research question

Testing the new response options.

PATH ID: R02_AE0102_E-CIG

When you last used an e-cigarette, was it…

Midnight to 6 AM
After 6 AM but before noon
Noon to 6 PM
After 6 PM but before midnight

When exactly did you last use an e-cigarette?

How easy or difficult was it for you to answer this question? What made it easy or difficult?

PATH ID: R02_AE0103_ECIG

On the day you last used e-cigarette, how many puffs did you take?

______________________

DON’T KNOW

Tell me more about your answer. How did you decide on your answer? What do you consider to be a “puff”? PROBE TO SEE IF RESPONDENTS ARE REPORTING PUFFS OR TIMES OR ACTUAL E-CIGARETTES.

How easy or difficult was it to answer this question?

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_AE1130_ECIGFLAVOR

In the past 30 days, were any of the e-cigarettes you used flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q9
I don’t know  go to Q9

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_AE1131_ECIGFLAVOR_Past30

Which flavors have you used in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different e-cigarette, or did a single e-cigarette have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

PATH ID: R02_YE1146

Some e-cigarettes come in flavors like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets.

Are flavored e-cigarettes easier to use, about the same, or harder to use than unflavored e-cigarettes?

Easier to use
About the same
Harder to use

How did you decide on your answer?

What does “harder to smoke” mean? What does “easier to smoke” mean?

Have you heard of menthol or mint flavored e-cigarettes? What have you heard? In your own words, what is “menthol”?

What does “unflavored” e-cigarettes mean to you? Would it make more sense if we asked about “regular” e-cigarettes?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_AX0307_REVISED_ECIG

Have you thought about switching from e-cigarettes to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
Traditional cigars
Cigarillos
Filtered cigars
Pipes
Hookahs
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

Tell me more about your answer.
IF SELECTED PRODUCTS, Why have you thought about switching from X to X?
IF HAVE NOT THOUGHT ABOUT SWITCHING, Tell me more about why you haven’t thought about switching to these other products?

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Other Electronic Nicotine Devices

if do not use e-cigars, E-HOOKAHS, OR E-PIPES  go to NEXT SECTION

Box ID: R02_AOT01

The following questions ask about electronic nicotine products other than e-cigarettes. This includes e-cigars, e-hookahs, e-pipes, vape pens, hookah pens and personal vaporizers. We will ask about e-cigarettes later.

PATH ID: R02_AO1005

How many times have you used other electronic nicotine products in your entire life?

1 or more puffs but never a whole one
1 to 10
11 to 20
21 to 50
51 to 99
100 or more

Tell me more about your answer.

What do you consider to be a “puff”? Do you typically call them “puffs” or is there another term you use?

IF NEEDED, Which products were you including in your answer? DETERMINE IF RESPONDENT WAS INCLUDING E-CIGARETTES.

PATH ID: R02_AO9010

Do the electronic nicotine products you usually use contain nicotine?

Tell me more about your answer. How did you know whether or not it contained nicotine?

PATH ID: R02_AO9029

About how long has it been since you last took a puff from an electronic nicotine product?

______________________________

PATH ID: R02_AO1008

When you first started using electronic nicotine products, were they flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q6
I don’t know  go to Q6

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_AO1011

Which flavor did you first start using? If multiple flavors were mixed together, choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different e-cigarette, or did a single e-cigarette have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

PATH ID: R02_AO1100

Have you ever used electronic nicotine products fairly regularly?

In your own words, what is this question asking? IF NEEDED, What does it mean to say someone is using electronic nicotine products “fairly regularly”?

E-cigarettes

Description and Image

Research question

Test the revised introduction and images, which now includes the term “vaping” and a picture of a vaporizer. Determine if respondents properly distinguish between e-cigarettes and other electronic products.

Box ID: R02_AET02

The next questions are about e-cigarettes.

Some e-cigarettes can be bought as one-time, disposable products, while others can be bought as re-usable kits with a cartridge or tank system. Some people refill their own e-cigarettes with nicotine fluid, sometimes called “e-liquid”.

Disposable e-cigarettes, e-cigarette cartridges and e-liquid come in many different flavors and nicotine concentrations. Some common brands include Fin, NJOY, Blu, e-Go and Vuse.

Please think only about e-cigarettes as you answer these questions.

What reaction, if any, did you have to this description of e-cigarettes?
What did you think of the pictures?

Is there anything that you found confusing?
Is there anything that we left out that we should add?

Are you familiar with the different types of e-cigarettes? What type do you usually use?

Do you call the fluid “e-juice,” “e-liquid,” or something else?

Does e-liquid always have nicotine in it?

Determining Type

Research question

Determine if this series of items correctly identifies respondent e-cigarette types and appropriate fills for subsequent items.

PATH ID: R02_AE9005

Please think about the e-cigarette you use most of the time.

Is your e-cigarette rechargeable?

Yes  MARK ON SKIP SHEET AS RECHARGEABLE
No  go to Q4

Do you call them rechargeable e-cigarettes or do you call them something else?

PATH ID: R02_AE9008

Does your e-cigarette use cartridges?

Yes  go to Q4
No

Do you call them cartridges or do you call them something else?

PATH ID: R02_AE9038

Does your e-cigarette use a tank system?

Yes
No
Not sure

What is a tank system? Are you familiar with the term “tank system”? Is there another term that you use?

What reaction, if any, did you have to the picture? Was the picture helpful? Why or why not?

What reaction, if any, did you have to these questions?

How easy or difficult was it to answer these questions?

What brand of e-cigarette do you have? What type or version of [BRAND] is it?

PATH ID: R02_AE9009

Can you refill your e-cigarette or e-cigarette cartridges with “e-liquid”?

Yes  MARK ON SKIP SHEET as refillable
No  go to NEXT SECTION
ASK: Respondents who have used an e-cigarette (AO9035[1]=1)

PATH ID: R02_AE9036

Who refills your e-cigarette or e-cigarette cartridge with “e-liquid”?

I refill it myself
I get it refilled at a vape shop or vapor lounge
I buy it already filled
I get it refilled some other way

Are you familiar with the term “vape shop” or “vapor lounge”? Is there another term that you use?

Disposable E-cigarettes

Dosage

Research question

Testing has shown that asking respondents about the number of “puffs” taken in a given time period can be tricky, particularly for respondents who use refillable e-cigarettes, who may be able to more accurately report the volume of e-fluid. These new items attempt to give respondents more flexibility in reporting. Test effectiveness of new items.

PATH ID: R02_AE1021_DISPOSABLE

On average, about how many e-cigarettes do you now use each day?

Less than 1 each day
_______________________

Tell me more about your answer. How did you come up with a number?

How easy or difficult was it to answer?

Is there a better way we could ask this question?

PATH ID: R02_AE1022_Disposable_Past30

On how many of the past 30 days did you use an e-cigarette?

_______________________

0  go to Q9

PATH ID: R02_AE9029_Disposable_Lastpuff

About how long has it been since you last took a puff from an e-cigarette?

_______________________

Do you typically call them “puffs” or is there another term you use?

PATH ID: R02_AE9010_DisposableNicotine

Does the e-cigarette you usually use contain nicotine?

Yes
No  go to Q11

Tell me more about your answer. How did you know whether or not it contained nicotine?

PATH ID: R02_AE9006_DisposableConcentration

What concentration of nicotine do you usually use?

I don’t know the concentration
0 mg or 0%
1-12 mg or 0.1-0.6%
13-17 mg or 0.7-1.2%
18-24 mg or 1.3-1.8%
25+ mg or 1.9+%

IF ABLE TO SPECIFY CONCENTRATION:
How did you decide your answer? How certain are you that you know the exact concentration?

Is concentration something you normally notice when you’re buying e-cigarettes or e-liquid?

Do you usually know the mg or the % or both?

This question asks you about the number of milligrams or the percentage of nicotine. Are there other ways you know how much nicotine is in an e-cigarette that you use? IF NEEDED: Have you ever heard people describing the nicotine as “strong” or “full flavored”?

Modification

Research question

New item added for Wave 2. Test whether respondents can correctly answer this item. Also probe on ways in which respondents modify e-cigarettes, including modifications to the battery or voltage.

PATH ID: R02_AE9032_Disposable_Mod

Have you modified your e-cigarette at all?

Yes  go to Q28
No  go to Q28

In your own questions, what is this question asking?

IF YES, How have you modified it? Why did you modify it?
PROBE HOW AND WHY RESPONDENTS MODIFY THEIR E-CIGARETTES (E.G., TO IMPROVE BATTERY LIFE, CHANGE AMOUNTS OF E-LIQUID VAPORIZED, ETC.)

Where did you learn how to modify your e-cigarette?

IF NO, Have you ever heard of modifying e-cigarettes? Where did you hear about it? What types of modifications have you heard of?

Non-refillable Cartridges

Dosage

Research question

PATH ID: R02_AE1021_NOn-Refillable

On average, about how many e-cigarette cartridges do you now use each day?

Less than 1 each day
_______________________

Tell me more about your answer. How did you come up with a number?

How easy or difficult was it to answer?

Is there a better way we could ask this question?

PATH ID: R02_AE1022-Non-Refillable_Past30

On how many of the past 30 days did you use an e-cigarette?

_______________________

0  go to Q15

PATH ID: R02_AE9029_Non-Refillable_Lastpuff

About how long has it been since you last took a puff from an e-cigarette?

_______________________

Do you typically call them “puffs” or is there another term you use?

PATH ID: R02_AE9010_Non-RefillableNicotine

Does the e-cigarette cartridge you usually use contain nicotine?

Yes
No  go to Q17

Tell me more about your answer. How did you know whether or not it contained nicotine?

PATH ID: R02_AE9006_Non-refillableconcentration

What concentration of nicotine do you usually use?

I don’t know the concentration
0 mg or 0%
1-12 mg or 0.1-0.6%
13-17 mg or 0.7-1.2%
18-24 mg or 1.3-1.8%
25+ mg or 1.9+%

IF ABLE TO SPECIFY CONCENTRATION:
How did you decide your answer? How certain are you that you know the exact concentration?

Is concentration something you normally notice when you’re buying e-cigarettes or e-liquid?

Do you usually know the mg or the % or both?

Modification

Research question

New item added for Wave 2. Test whether respondents can correctly answer this item. Also probe on ways in which respondents modify e-cigarettes, including modifications to the battery or voltage.

IF NOT RECHARGEABLE  go to Q18

PATH ID: R02_AE9037_Disposable_Voltage

Can you change the voltage on your e-cigarette?

Yes
No
Not sure

In your own words, what is this question asking? IF NEEDED, What does it mean to change the voltage?

IF YES, Have you changed the unit’s voltage? Why or why not?

PATH ID: R02_AE9032_Non-refillable_Mod

Have you modified your e-cigarette at all?

In your own words, what is this question asking?

IF YES, How have you modified it? Why did you modify it?
PROBE HOW AND WHY RESPONDENTS MODIFY THEIR E-CIGARETTES (E.G., TO IMPROVE BATTERY LIFE, CHANGE AMOUNTS OF E-LIQUID VAPORIZED, ETC.)

Where did you learn how to modify your e-cigarette?

IF NO, Have you ever heard of modifying e-cigarettes? Where did you hear about it? What types of modifications have you heard of?

Research question

Test new items that ask about customization of constituents in e-liquids, particularly flavoring choices and modification of nicotine content.

PATH ID: Non-Refillable E-Cig Modify NEW

Do you customize or modify the e-liquid you use in your e-cigarette?

Yes  go to Q28
No  go to Q28

IF YES, Tell me more about how you customize or modify the e-liquid. Why do you customize or modify the e-liquid?
PROBE TO DETERMINE HOW AND WHY RESPONDENTS ARE MODIFYING E-LIQUID (E.G., CHANGE NICOTINE CONTENT, CHANGE FLAVOR)

In this question, do the words customize and modify mean the same thing to you or do they mean different things? IF NEEDED: Tell me more.

Where did you learn how to customize or modify your e-liquid?

IF NO, Have you ever heard of modifying e-liquid? Where did you hear about it? What types of modifications have you heard of?

Have you ever heard of the term “dripping”? IF YES, Can you tell me more about it?

Refillable Cartridges or Tank

Dosage

Research question

PATH ID: R02_AE1021_REfillable

On average, about how many milliliters of e-liquid do you now use each day?

Less than 1 each day
_______________________

Tell me more about your answer. How did you come up with a number?

How easy or difficult was it to answer? How confident are you in your answer?

Is there a better way we could ask this question?

PATH ID: R02_AE1022_REfillable_Past30

On how many of the past 30 days did you use an e-cigarette?

_______________________

0  go to Q23

PATH ID: R02_AE9029_Refillable_Lastpuff

About how long has it been since you last took a puff from an e-cigarette?

_______________________

Do you typically call them “puffs” or is there another term you use?

PATH ID: R02_AE9010_REfillableNicotine

Does the e-liquid you usually use contain nicotine?

Yes
No  go to Q25

Tell me more about your answer. How did you know whether or not it contained nicotine?

PATH ID: R02_AE9006_REfillableConcentration

What concentration of nicotine do you usually use?

I don’t know the concentration
0 mg or 0%
1-12 mg or 0.1-0.6%
13-17 mg or 0.7-1.2%
18-24 mg or 1.3-1.8%
25+ mg or 1.9+%

IF ABLE TO SPECIFY CONCENTRATION:
How did you decide your answer? How certain are you that you know the exact concentration?

Is concentration something you normally notice when you’re buying e-cigarettes or e-liquid?

Do you usually know the mg or the % or both?

Modification

Research question

New item added for Wave 2. Test whether respondents can correctly answer this item. Also probe on ways in which respondents modify e-cigarettes, including modifications to the battery or voltage.

IF NOT RECHARGEABLE  go to Q26

PATH ID: R02_AE9037_Refillable_Voltage

Can you change the voltage on your e-cigarette?

Yes
No
Not sure

In your own words, what is this question asking? IF NEEDED, What does it mean to change the voltage?

IF YES, Have you changed the unit’s voltage? Why or why not?

PATH ID: R02_AE9032_Refillable_Mod

Have you modified your e-cigarette at all?

In your own words, what is this question asking?

IF YES, How have you modified it? Why did you modify it?
PROBE HOW AND WHY RESPONDENTS MODIFY THEIR E-CIGARETTES (E.G., TO IMPROVE BATTERY LIFE, CHANGE AMOUNTS OF E-LIQUID VAPORIZED, ETC.)

Where did you learn how to modify your e-cigarette?

IF NO, Have you ever heard of modifying e-cigarettes? Where did you hear about it? What types of modifications have you heard of?

Research question

Test new items that ask about customization of constituents in e-liquids, particularly flavoring choices and modification of nicotine content.

PATH ID: Refillable e-Cig Modify NEW

Do you customize or modify the e-liquid you use in your e-cigarette?

Where did you learn how to customize or modify your e-liquid?

IF NO, Have you ever heard of modifying e-liquid? Where did you hear about it? What types of modifications have you heard of?

Have you ever heard of the term “dripping”? IF YES, Can you tell me more about it?

Use of Non-tobacco Products

Research question

Develop and test new items about smoking something other than tobacco in e-cigarette. Previous testing revealed confusion with the concepts of smoking marijuana in an e-cigarette vs. using e-liquid flavored to taste like marijuana vs. using e-liquid made from marijuana.

PATH ID: E-Liquid Non-Tobacco

Have you ever used an e-liquid made from something other than tobacco?

Yes
No
Don’t know

ALL RESPONDENTS, Can you give me examples of what, other than tobacco, an e-liquid might be made from?

IF YES, What was it made from?

IF RESPONDENT SAYS MARIJUANA, Was it flavored like marijuana, or did it contain actual marijuana?
IF NEEDED, Could it get you high?

Have you ever heard of an e-liquid made from marijuana concentrates, waxes or hash oils? What do you know about it?
Does it contain actual marijuana?
IF NEEDED, Could it get you high?

PATH ID: E-cigarette with Pot

Have you ever smoked pot or hash from an e-cigarette?

Yes
No
Don’t know

IF YES, Tell me more about your answer. How do you smoke pot from an e-cigarette?

E-cigarette Nicotine Dependence

adult CURRENT e-cigarette users

research questions

Test applicability of the items on dependency, quitting and withdrawal for users of less standard tobacco products such as hookah, e-cigarette, and smokeless tobacco. Do they seem inappropriate or difficult to answer for users of these products?

Additionally, do respondents who are using e-cigarettes as cessation devices find any of these questions confusing and/or difficult to answer?

Dependency items

R02_ANT01_ECIG

The next questions ask about your experience with e-cigarettes.

PATH ID: R02_AN0010_ECIGDEPENDENCY

Do you consider yourself addicted to e-cigarettes?

No, not at all
Yes, somewhat addicted
Yes, very addicted

In your own words, what does it mean to be “addicted” to e-cigarettes?

IF NO, NOT AT ALL, Tell me more about your answer.

How easy or difficult was it to answer this question? What made it easy/difficult?

PATH ID: R02_AN0015_Ecig_Cravings

Do you ever have strong cravings to use e-cigarettes?

PATH ID: R02_AN0020_Ecig_REallyNeed

Have you ever felt like you really needed to use e-cigarettes?

What does it mean to “really need” to smoke/use a [ND FILL 1]?

PATH ID: R02_AN0055_Ecig_Agreement

Please rate your level of agreement for each statement using the following scale:
1= not true of me at all to 5=extremely true of me.

I find myself reaching for e-cigarettes without thinking about it.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0025_Ecig_Craving

I frequently crave e-cigarettes.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0030_Ecig_urges

My urges keep getting stronger if I don’t use e-cigarettes.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0035_Ecig_Control

E-cigarettes control me.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0045_Ecig_outofControl

My e-cigarette use is out of control.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0060_Ecig_WAkeup

I usually want to use e-cigarettes right after I wake up.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0065_Ecig_Fewhours

I can only go a couple of hours without using e-cigarettes.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0050_Ecig_Nothought

I frequently use e-cigarettes without thinking about it.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0070_Ecig_FeelBetter

Using e-cigarettes really helps me feel better if I’ve been feeling down.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0075_ECIG_Thinkbetter

Using e-cigarettes helps me think better.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0332

Most of the people I spend time with use e-cigarettes.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0255

Most of the people I spend time with use tobacco.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0080_Ecig_Alone

I would feel alone without my e-cigarettes.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0085_Ecig_HardToStop

I would find it really hard to stop using e-cigarettes.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0090_Ecig_1week

I would find it hard to stop using e-cigarettes for a week.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0095_Ecig_Irritable

After not using e-cigarettes for a while, I need to use e-cigarettes in order to feel less restless and irritable.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0100_Ecig_Discomfort

After not using e-cigarettes for a while, I need to use e-cigarettes in order to keep myself from experiencing any discomfort.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0813_ECIG_Permitted

In the past 12 months, did you find it difficult to keep from using e-cigarettes in places where it was not permitted?

PATH ID: R02_AN0812_Ecig_Activities

In the past 12 months, did you give up or cut down on activities that were enjoyable or important to you because e-cigarette use was not permitted at the activity?

What reaction, if any, do you have to this last set of questions about your experiences with e-cigarettes?

How easy or difficult was it to answer these questions? What did you think of the answer choices?

What did you think of being asked these questions? IF NEEDED, Do you think it makes sense to ask these questions of people who use e-cigarettes?

Were you thinking just about e-cigarettes when you were answering, or were you also including other electronic products, such as e-hookahs, e-cigars, etc.?

Quitting

research question

Explore what respondents used to quit, especially for pipe, cigar, dissolvable tobacco, and hookah users. Do respondents use other things like an “app” or a “doctor” to help them quit?

PATH ID: R02_AN0105_Ecig_Triedtoquit

In the past 12 months, have you tried to quit using e-cigarettes? Choose all that apply.

Yes, I have tried to quit completely
Yes, I have tried to quit by reducing or cutting back
No, I have reduced or cut back instead of trying to quit
No, I have not tried to quit at all  go to Q31

Tell me more about your answer. How did you decide which answer choice to choose?

In your own words, what is the difference between trying to quit completely and trying to quit by reducing or cutting back?

IF YES, Can you tell me how you tried to quit? What did you use to quit?

IF NEEDED: Did you rely on the support of friends and family to help you quit?

Did you use counseling, a telephone help line or quit line, books, pamphlets, videos, a quit tobacco clinic, class, or support group, or an internet or web-based program?

Did you use an app?

Did you use any different tobacco product to help you quit?

Did you use a nicotine patch, gum, inhaler, nasal spray, lozenge or pill?

Did a doctor help you?

Did you use a prescription drug like Chantix, varenicline, Wellbutrin, Zyban, or bupropion?

Is there anything else that you used to help you quit?

Withdrawal

research questions

Test applicability of these items for users of less standard tobacco products such as hookah, e-cigarette, and smokeless tobacco. Do they seem inappropriate or difficult to answer for users of these products?

PATH ID: R02_AN0804_Eicg_Withdrawal

The next questions ask about how you felt within days after the last time you tried to quit using e-cigarettes in the past 12 months.

Within days after stopping or cutting down on your e-cigarette use in the past 12 months, did you….

Feel depressed?

PATH ID: R02_AN0805_Ecig_DifficultSleeP

Within days after stopping or cutting down on your e-cigarette use in the past 12 months, did you….

Have difficulty falling asleep or staying asleep?

PATH ID: R02_AN0806_Ecig_Concentration

Within days after stopping or cutting down on your e-cigarette use in the past 12 months, did you….

Have difficulty concentrating?

PATH ID: R02_AN0807_Ecig_Weight

Within days after stopping or cutting down on your e-cigarette use in the past 12 months, did you….

Eat more than usual or gain weight?

PATH ID: R02_AN0808_Ecig_Angry

Within days after stopping or cutting down on your e-cigarette use in the past 12 months, did you….

Become easily irritated, angry, or frustrated?

PATH ID: R02_AN0809_Ecig_Anxious

Within days after stopping or cutting down on your e-cigarette use in the past 12 months, did you….

Feel anxious or nervous?

PATH ID: R02_AN0810_Ecig_Restless

Within days after stopping or cutting down on your e-cigarette use in the past 12 months, did you….

Feel more restless than usual?

What reaction, if any, do you have to these last few questions about your experiences with quitting?

How easy or difficult was it to answer these questions?

IF NEEDED, Do you think it makes sense to ask these questions of people who use e-cigarettes?

Considered quitting

research questions

Test applicability of this item for users of less standard tobacco products such as Hookah, e-cigarette, and smokeless tobacco. Does this item make sense for current users of these products?

PATH ID: R02_AN0230_Ecig_Interestinquitting

Overall, on a scale from 1 to 10 where 1 is not at all interested and 10 is extremely interested, how interested are you in quitting e-cigarette use? Please enter a number from 1 to 10.

Not at all interested
2
3
4
5
6
7
8
9
Extremely Interested

What reaction, if any, do you have to this question?

IF NEEDED, Do you think it makes sense to ask these questions of people who use e-cigarettes?

Adult Hookah Module

ALL CURRENT Hookah users

research questioNS

Due to constraints in earlier testing, the hookah module was only tested with a small number of hookah users. Test with a larger number of respondents.

Screening

PATH ID: R02_AHT01

We next ask about smoking tobacco in a hookah, which is a type of water pipe. It is sometimes also called a “narghile” pipe. From now on, we will use “hookah” to refer to a water pipe or narghile pipe that is often used to smoke tobacco.

There are many types of hookahs. People often smoke tobacco in hookahs in groups at cafes or in hookah bars. The picture below shows a typical hookah.

What reaction, if any, did you have to this description and pictures of hookah?

PATH ID: YH1002

Have you ever smoked tobacco in a hookah, even one or two puffs?

Yes  go to next module
No

Was this a regular hookah, or an electronic hookah (e-hookah)?

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AH1003

Do you now smoke hookah…

Every day
Some days
Rarely  go to Q6
Not at all  go to next module

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF SMOKING FREQUENCY.

In the past 30 days, how many days did you smoke hookah?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between smoking “some days” and smoking “rarely”?

PATH ID: R02_AH0100

When did you last smoke hookah?

In the past hour  go to Q5
Sometime today
Yesterday
Day before yesterday
Three or more days ago  go to Q6

research question

Testing the new response options.

PATH ID: R02_AH0102

When you last smoked hookah, was it…

Midnight to 6 AM
After 6 AM but before noon
Noon to 6 PM
After 6 PM but before midnight

When exactly did you last smoke hookah?

How easy or difficult was it for you to answer this question? What made it easy or difficult?

PATH ID: R02_AH0103

On the day you last smoked hookah, how many puffs did you take?

___________________________________

DON'T KNOW

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

PATH ID: R02_AH1130

In the past 30 days, was any of the shisha or hookah tobacco you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q8
I don’t know  go to Q8

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_AH1131

Which flavors have you smoked in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different package of shisha, or did a single package of shisha have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

PATH ID: R02_YH1146

Some shisha or hookah tobacco comes in flavors like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets.

Is flavored shisha or hookah tobacco easier to smoke, about the same, or harder to smoke than unflavored shisha or hookah tobacco?

Easier to smoke
About the same
Harder to smoke

How did you decide on your answer?

What does “harder to smoke” mean? What does “easier to smoke” mean?

Have you heard of menthol or mint flavored shisha or hookah tobacco? What have you heard? In your own words, what is “menthol”?

What does “unflavored” shisha or hookah tobacco mean to you? Would it make more sense if we asked about “regular” shisha or hookah tobacco?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_AX0307_REVISED_Hookah

Have you thought about switching from hookahs to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Traditional cigars
Cigarillos
Filtered cigars
Pipes
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Hookah

PATH ID: Hookah Intro

The next few questions are about smoking tobacco in a hookah. A hookah pipe is a type of water pipe that is sometimes also called a narghile pipe. From now on, we will use hookah to refer to a water pipe or narghile pipe that is often used to smoke tobacco.

There are many types of hookahs. People often smoke tobacco in hookahs in groups at cafes or in hookah bars.

People smoke shisha or hookah tobacco in a hookah. Some shisha contains tobacco and some does not. Shisha comes in many flavors.

What reaction, if any, did you have to this description and pictures of shisha?

Do you usually refer to it as shisha, or is there another term you use?

Frequency of Use

PATH ID: R02_AH1005

How many times have you smoked hookah in your entire life? Count each sitting or session where you smoked tobacco in a hookah, whether alone or with others.

1 to 10
11 to 20
21 to 50
51 to 99
100 or more

Tell me more about how you came up with your answer.

How easy or difficult was it for you to answer this question? What made it easy/difficult?

RESEARCH QUESTION

Given the atypical nature of hookah use, how do respondents interpret the phrase “fairly regularly”?

PATH ID: R02_AH1100

Have you ever smoked hookah fairly regularly?

Yes
No  go to Q4

What does it mean to smoke hookah ‘fairly regularly’?

PATH ID: R02_AH1007

How old were you when you first started smoking hookah fairly regularly?

___________________________________

How did you remember how old you were when you first started smooking hookah fairly regularly?

PATH ID: R02_AH9003

Which of the following choices best describes your hookah smoking? Usually I smoke hookah…

Every day  go to Q7
Weekly  go to Q6
Monthly
Every couple of months  go to Q9
About once a year  go to Q9

How did you decide to answer [ANSWER]? How easy or difficult was it to answer this question?

When do you smoke hookah?
PROBE TO SEE IF HOOKAH USE IS REGULAR (VERSUS SPORADIC).

IF ANSWER COUPLE OF MONTHS OR ABOUT ONCE A YEAR, Over a year, about how often do you smoke hookah? Count each sitting or session where you smoked tobacco in a hookah, whether alone or with others.

PATH ID: R02_AH9004

On average, about how many times do you smoke hookah in a month? Count each sitting or session where you smoked tobacco in a hookah, whether alone or with others.

___________________________________  go to Q8

How did you come up with your answer? How confident are you in your answer?

IF NEEDED, Do you smoke hookah about the same amount every month, or do you smoke less or more in some months?

Do you call it a “sitting” or “session,” or do you use another word?

PATH ID: R02_AH9005

On average, about how many times do you smoke hookah in a week? Count each sitting or session where you smoked tobacco in a hookah, whether alone or with others.

___________________________________  go to Q8

How did you come up with your answer? How confident are you in your answer?

IF NEEDED, Do you smoke hookah about the same amount every week, or do you smoke less or more in some weeks?

Do you call it a “sitting” or “session,” or do you use another word?

PATH ID: R02_AH9006

On average, about how many times do you smoke hookah each day? Count each sitting or session where you smoked tobacco in a hookah, whether alone or with others.

___________________________________

How did you come up with your answer? How confident are you in your answer?

IF NEEDED, Do you smoke hookah about the same amount every day, or do you smoke less or more in some days?

Do you call it a “sitting” or “session,” or do you use another word?

PATH ID: R02_AH1024

On the days that you smoke hookah, how soon after you wake up do you typically take your first puff from a hookah?

___________________________________

How easy or difficult was it for you to answer this question?

Do you usally call it a “puff,” or is there another word you use?
IF NEEDED, Do you ever use the word “drag”?

PATH ID: R02_AH1009

About how long has it been since you last smoked hookah?

___________________________________

How easy or difficult was it for you to answer this question?

Ownership and How/Where to use

PATH ID: R02_AH1090

Do you own a hookah?

PATH ID: R02_AH9041

Does anyone else living in your home own a hookah?

PATH ID: R02_AH9011

Where do you usually smoke hookah? Choose all that apply.

At home
In a hookah bar or cafe
At a friend’s house
Somewhere else (SPECIFY:__________)

PATH ID: R02_AH9012

Do you usually share the same hookah with others when you smoke?

Yes
No  go to Q15

PATH ID: R02_AH9013

How many people do you usually share hookah with?

1 other person
2 other people
3 other people
4 or more other people

Do you usually smoke hookah with the same number of people, or does it change? IF CHANGES, How did you decide on your answer?

PATH ID: R02_AH9014

On average, how long is one hookah session for you (and the people you share it with)? A session is one sitting in which you smoke hookah, whether alone or with others.

Less than 30 minutes
More than 30 minutes up to 1 hour
1 to 2 hours
More than 2 hours

PATH ID: R02_AH9015

On average, when you smoke hookah, how many times do you refill it with tobacco?

0 times
1 time
2 to 3 times
4 or more times

Are you usually the one who refills it? IF NOT, Who usually refills it?

PATH ID: R02_AH9016

How often do you personally set up the hookah?

Every time
Most of the time
Some of the time
Rarely
Never, someone else always sets it up for me

Tell me more about your answer. IF NEEDED, what does it mean to ‘set up the hookah’?

Purchasing

PATH ID: R02_AH1097

The next questions ask about your experience buying shisha or hookah tobacco.

In the past 30 days, have you used a coupon when buying shisha or hookah tobacco?

Yes
No  go to Q20

IF YES, Where did you use the coupon? Was it at a restaurant, café, a tobacco store, etc.? IF NEEDED, Was the coupon just for the shisha, or did it include other things, such as the use of a hookah pipe?

IF YES, Where do you usually get your coupons? Have you ever used “Groupon” or something similar?

IF NO, Have you ever seen a coupon when buying shisha or hookah tobacco? Have you ever used one?

Do you usually buy the shisha or hookah tobacco? IF NO, How did you decide on your answer?

Have you ever bought shisha online? IF YES, If you did buy it online, and you used a discount code, how would you answer this question?
DETERMINE IF RESPONDENT INCLUDES A DISCOUNT CODE AS A COUPON.

PATH ID: R02_AH1098

In the past 30 days, how many times have you used a coupon when buying shisha or hookah tobacco?

___________________________________

PATH ID: R02_AH1030

How do you usually buy shisha or hookah tobacco for yourself? Is it…

In person (such as at a store or hookah bar)
From the internet  go to Q23
By telephone  go to Q23
I do not buy my own shisha or hookah tobacco  go to Q23

PATH ID: R02_AH1032

Do you usually buy shisha or hookah tobacco...?

In your own state
In another state
Outside the US

PATH ID: R02_AH1033

Where do you buy your shisha or hookah tobacco most of the time?

A hookah bar or cafe
A convenience store or gas station
A supermarket, grocery store, or drug store
A warehouse club, such as Sam’s or Costco
A smoke shop, tobacco specialty store or tobacco outlet store
A duty free shop or military commissary
A bar, pub, restaurant or casino
A friend or relative
A swap meet or flea market
A liquor store
Or from somewhere else SPECIFY: ____________________________

IF ANSWERS HOOKAH BAR OR CAFÉ, Do you usually call it a hookah bar or café, or is there another term you use?

Are there any places missing from this list?

Is there anything here you haven’t heard of?

Regular Brand

PATH ID: R02_AH1047

Do you have a regular brand of shisha or hookah tobacco that you usually smoke?

How did you come up with your answer?

In your own words, what is a “regular” brand?

PATH ID: R02_AH1048

What brand of shisha or hookah tobacco did you last smoke?

SHOW RESPONDENT BRAND LIBRARY

___________________________________  go to Q26

Something else

PATH ID: R02_AH1049

You said that your brand was not pictured. What is it?

___________________________________

PATH ID: R02_AH1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] did you last smoke?

SHOW RESPONDENT BRAND LIBRARY

___________________________________  go to Q28

Something else

PATH ID: R02_AH1071

You said that the type of [BRANDFILL]s that you smoke is not pictured. What type is it?

___________________________________

PATH ID: R02_AH9108

Does this brand of shisha contain tobacco?

How confident are you in your answer? How do you know whether or not your shisha contains tobacco?

Are you familiar with shisha that doesn’t have tobacco?

PATH ID: R02_AH1051

About how long have you been smoking your regular brand of shisha or hookah tobacco?

___________________________________

I don’t have a regular brand

Tell me more about how you came up with your answer. IF NEEDED, how do you remember when you first started smoking your regular brand of shisha or hookah tobacco?

Reasons to Use

BEFORE RESPONDENT SEES QUESTIONS, PROBE GENERALLY,
Tell me more about why you smoke hookah.

PATH ID: R02_AH1060

The next questions are about the reasons people smoke hookah. Please select which reasons apply to you.

I smoke hookah because…

It is affordable.

PATH ID: R02_AH1061

People in the media or other public figures smoke hookah.

PATH ID: R02_AH1085

I can smoke hookah at times when or in places where smoking cigarettes isn’t allowed.

PATH ID: R02_AH1062

It might be less harmful than smoking cigarettes.

PATH ID: R02_AH1063

Shisha or hookah tobacco comes in flavors I like.

PATH ID: R02_AH1064

Smoking hookah helps people to quit smoking cigarettes.

PATH ID: R02_AH1068

People who are important to me smoke hookah.

PATH ID: R02_AH1069

I like socializing while smoking hookah.

PATH ID: R02_AH1072

The advertising for hookah appeals to me.

PATH ID: R02_AH1073

Smoking hookah is part of my cultural tradition.

How easy or difficult was it to answer this series of questions?

What did you think of these possible reasons to smoke hookah? Are there any that seemed strange or out of place? Are there other reasons someone might have for choosing a particular brand that are missing?

Use of Non-tobacco Products

research question

Developing new items to capture misuse of tobacco products, particularly the use of herbal substances which users think do not contain tobacco (but which might) and the use of liquid other than water in hookahs (e.g., alcohol, milk, Kool-Aid).

The next questions are about things other than shisha or hookah tobacco that someone might smoke in a hookah.

PATH ID: NEW_ HOOKAH MARIJUANA MISUSE

Have you ever smoked marijuana from a hookah?

Tell me more about how you came up with your answer.

IF YES, How do you smoke marijuana from a hookah?
IF NEEDED, Is it just marijuana, or do you mix it with tobacco?

IF NO, Have you heard of people smoking marijuana from a hookah? What have you heard about it?

PATH ID: NEW_ HOOKAH OTHER SUBSTANCES MISUSE

Have you ever smoked anything else in a hookah?

In your own words, what is this question asking?

If YES, What else have you smoked in a hookah? Where did you learn that was something you could smoke from a hookah?

IF NO, Have you ever heard of people smoking something other than marijuana, shisha or hookah tobacco in a hookah? What have you heard? Where did you hear about it?

PATH ID: NEW_ HOOKAH LIQUID MISUSE

Have you ever used another liquid besides water in the bowl of the hookah?

IF YES, What type of liquid did you use? Where did you first hear about using liquid other than water in a hookah?

IF NO, Have you ever heard of using a liquid other than water in the bowl of the hookah? What kinds of liquids? Where did you hear about them?

PATH ID: NEW_ SHISHA WITH TOBACCO CLARIFICATION

Do you usually smoke shisha with tobacco when you smoke a hookah?

How do you know if shisha contains tobacco or not?

What kind of shisha do you usually smoke?

Hookah Nicotine Dependence

adult CURRENT Hookah tobacco users

research questions

Dependency items

PATH ID: R02_ANT01_Hookah

Now we would like to ask about your experience with hookah. Please think only about hookah as you answer these questions.

PATH ID: R02_AN0010_HookahDependency

Do you consider yourself addicted to hookah?

No, not at all
Yes, somewhat addicted
Yes, very addicted

In your own words, what does it mean to be “addicted” to hookah?

IF NO, NOT AT ALL, Tell me more about your answer.

How easy or difficult was it to answer this question? What made it easy/difficult?

PATH ID: R02_AN0015_Hookah_Cravings

Do you ever have strong cravings to smoke hookah?

PATH ID: R02_AN0020_Hookah_Reallyneed

Have you ever felt like you really needed to smoke hookah?

What does it mean to “really need” to smoke a hookah?

PATH ID: R02_AN0055_Hookah_Agreement

Please rate your level of agreement for each statement using the following scale: 1= not true of me at all to 5=extremely true of me.

I find myself reaching for hookah without thinking about it.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0025_Hookah_Craving

I frequently crave hookah.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0030_Hookah_urges

My urges keep getting stronger if I don’t smoke hookah.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0035_Hookah_Control

Hookah smoking controls me.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0045_Hookah_Outofcontrol

My hookah smoking is out of control.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0060_Hookah_wakeup

I usually want to smoke hookah right after I wake up.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0065_Hookah_Fewhours

I can only go a couple of hours without smoking hookah.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0050_Hookah_nothought

I frequently smoke hookah without thinking about it.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0070_Hookah_feelbetter

Smoking hookah really helps me feel better if I’ve been feeling down.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0075_Hookah_ThinkBetter

Smoking hookah helps me think better.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0255

Most of the people I spend time with are tobacco users.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0080_Hookah_Alone

I would feel alone without my hookah.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0085_Hookah_hardtostop

I would find it really hard to stop smoking hookah.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0090_Hookah_1week

I would find it hard to stop smoking hookah for a week.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0095_Hookah_Irritable

After not smoking hookah for a while, I need to smoke hookah in order to feel less restless and irritable.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0100_hookah_Discomfort

After not smoking hookah for a while, I need to smoke hookah in order to keep myself from experiencing any discomfort.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0813_Hookah_Permitted

In the past 12 months, did you find it difficult to keep from smoking hookah in places where it was not permitted?

PATH ID: R02_AN0812_Hookah_Activities

In the past 12 months, did you give up or cut down on activities that were enjoyable or important to you because hookah smoking was not permitted at the activity?

What reaction, if any, do you have to this last set of questions about your experiences with hookah?

How easy or difficult was it to answer these questions? What did you think of the answer choices?

What did you think of being asked these questions? IF NEEDED, Do you think it makes sense to ask these questions of people who smoke hookah?

Quitting

research question

Explore what respondents used to quit, especially for pipe, cigar, dissolvable tobacco, and hookah users. Do respondents use other things like an “app” or a “doctor” to help them quit?

PATH ID: R02_AN0105_Hookah_Triedtoquit

In the past 12 months, have you tried to quit smoking hookah? Choose all that apply.

Yes, I have tried to quit completely
Yes, I have tried to quit by reducing or cutting back
No, I have reduced or cut back instead of trying to quit
No, I have not tried to quit at all  go to Q30

Tell me more about your answer. How did you decide which answer choice to choose?

In your own words, what is the difference between tyring to quit completely and trying to quit by reducing or cutting back?

IF YES, Can you tell me how you tried to quit? What did you use to quit?

IF NEEDED: Did you rely on the support of friends and family to help you quit?

Did you use counseling, a telephone help line or quit line, books, pamphlets, videos, a quit tobacco clinic, class, or support group, or an internet or web-based program?

Did you use an app?

Did you use any different tobacco product to help you quit?

Did you use a nicotine patch, gum, inhaler, nasal spray, lozenge or pill?

Did a doctor help you?

Did you use a prescription drug like Chantix, varenicline, Wellbutrin, Zyban, or bupropion?

Is there anything else that you used to help you quit?

Withdrawal

research questions

PATH ID: R02_AN0804_Hookah_Withdrawal

The next questions ask about how you felt within days after the last time you tried to quit smoking hookah in the past 12 months.

Within days after stopping or cutting down on your hookah smoking in the past 12 months, did you….

Feel depressed?

PATH ID: R02_AN0805_Hookah_DifficultSleep

Within days after stopping or cutting down on your hookah smoking in the past 12 months, did you….

Have difficulty falling asleep or staying asleep?

PATH ID: R02_AN0806_Hookah_Concentration

Within days after stopping or cutting down on your hookah smoking in the past 12 months, did you….

Have difficulty concentrating?

PATH ID: R02_AN0807_Hookah_Weight

Within days after stopping or cutting down on your hookah smoking in the past 12 months, did you….

Eat more than usual or gain weight?

PATH ID: R02_AN0808_Hookah_angry

Within days after stopping or cutting down on your hookah smoking in the past 12 months, did you….

Become easily irritated, angry, or frustrated?

PATH ID: R02_AN0809_Hookah_Anxious

Within days after stopping or cutting down on your hookah smoking in the past 12 months, did you….

Feel anxious or nervous?

PATH ID: R02_AN0810_Hookah_Restless

Within days after stopping or cutting down on your hookah smoking in the past 12 months, did you….

Feel more restless than usual?

What reaction, if any, do you have to these last few questions about your experiences with quitting?

How easy or difficult was it to answer these questions?

IF NEEDED, Do you think it makes sense to ask these questions of people who smoke hookah?

Considered quitting

research questions

Test applicability of this item for users of less standard tobacco products such as Hookah, e-cigarette, and smokeless tobacco. Does this item make sense for current users of these products?

PATH ID: R02_AN0230_Hookah_Interestinquitting

Overall, on a scale from 1 to 10 where 1 is not at all interested and 10 is extremely interested, how interested are you in quitting smoking hookah? Please enter a number from 1 to 10.

Not at all interested
2
3
4
5
6
7
8
9
Extremely Interested

What reaction, if any, do you have to this question?

IF NEEDED, Do you think it makes sense to ask these questions of people who smoke hookah?

Adult Nicotine Dependence Module

adult CURRENT smokeless tobacco users

research questions

Test applicability of the items on dependency, quitting and withdrawal for users of smokeless tobacco. Do they seem inappropriate or difficult to answer for users of smokeless tobacco?

Dependency items

PATH ID: R02_ANT01_Smokeless

Now we would like to ask about your experience with smokeless tobacco. Please think only about smokeless tobacco as you answer these questions.

PATH ID: R02_AN0010_SmokelessTobaccoDEPENDENCY

Do you consider yourself addicted to smokeless tobacco?

No, not at all
Yes, somewhat addicted
Yes, very addicted

In your own words, what does it mean to be “addicted” to smokeless tobacco?

IF NO, NOT AT ALL, Tell me more about your answer.

How easy or difficult was it to answer this question? What made it easy/difficult?

PATH ID: R02_AN0015_Smokeless_Cravings

Do you ever have strong cravings to use smokeless tobacco?

PATH ID: R02_AN0020_Smokeless_Reallyneed

Have you ever felt like you really needed to use smokeless tobacco?

What does it mean to “really need” to use smokeless tobacco?

PATH ID: R02_AN0055_Smokeless_Agreement

Please rate your level of agreement for each statement using the following scale: 1= not true of me at all to 5=extremely true of me.

I find myself reaching for smokeless tobacco without thinking about it.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0025_Smokeless_Craving

I frequently crave smokeless tobacco.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0030_Smokeless_Urges

My urges keep getting stronger if I don’t use smokeless tobacco.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0035_Smokeless_Control

Smokeless tobacco controls me.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0045_Smoekless_outofcontrol

My smokeless tobacco use is out of control.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0060_Smokeless_Wakeup

I usually want to use smokeless tobacco right after I wake up.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0065_Smokeless_Fewhours

I can only go a couple of hours without using smokeless tobacco.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0050_Smokeless_nothought

I frequently use smokeless tobacco without thinking about it.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0070_Smokeless_Feelbetter

Using smokeless tobacco really helps me feel better if I’ve been feeling down.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0075_Smokeless_ThinkBetter

Using smokeless tobacco helps me think better.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0332

Most of the people I spend time with use e-cigarettes.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0255_Tobacco

Most of the people I spend time with use tobacco.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0080_SmokelessTobacco_Alone

I would feel alone without my smokeless tobacco.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0085_Smokeless_hardtostop

I would find it really hard to stop using smokeless tobacco.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0090_Smokeless_1week

I would find it hard to stop using smokeless tobacco for a week.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0095_Smokeless_irritaBle

After not using smokeless tobacco for a while, I need to use smokeless tobacco in order to feel less restless and irritable.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0100_Smokeless_Discomfort

After not using smokeless tobacco for a while, I need to use smokeless tobacco in order to keep myself from experiencing any discomfort.

1 Not true of me at all
2
3
4
5 Extremely true of me

PATH ID: R02_AN0813_Smokeless_Permitted

In the past 12 months, did you find it difficult to keep from using smokeless tobacco in places where it was not permitted?

PATH ID: R02_AN0812_Smokeless_Activities

In the past 12 months, did you give up or cut down on activities that were enjoyable or important to you because smokeless tobacco use was not permitted at the activity?

What reaction, if any, do you have to this set of questions about your experiences with smokeless tobacco?

How easy or difficult was it to answer these questions?

What did you think of the answer choices?

What did you think of being asked these questions? IF NEEDED, Do you think it makes sense to ask these questions of people who use smokeless tobacco?

Quitting

research question

Explore what respondents used to quit. Do respondents use other things like an “app” or a “doctor” to help them quit?

PATH ID: R02_AN0105_Smokeless_TriedToquit

In the past 12 months, have you tried to quit using smokeless tobacco? Choose all that apply.

Yes, I have tried to quit completely
Yes, I have tried to quit by reducing or cutting back
No, I have reduced or cut back instead of trying to quit
No, I have not tried to quit at all  go to Q31

Tell me more about your answer. How did you decide which answer choice to choose?

In your own words, what is the difference between tyring to quit completely and trying to quit by reducing or cutting back?

IF YES, Can you tell me how you tried to quit? What did you use to quit?

IF NEEDED: Did you rely on the support of friends and family to help you quit?

Did you use counseling, a telephone help line or quit line, books, pamphlets, videos, a quit tobacco clinic, class, or support group, or an internet or web-based program?

Did you use an app?

Did you use any different tobacco product to help you quit?

Did you use a nicotine patch, gum, inhaler, nasal spray, lozenge or pill?

Did a doctor help you?

Did you use a prescription drug like Chantix, varenicline, Wellbutrin, Zyban, or bupropion?

Is there anything else that you used to help you quit?

Withdrawal

research questions

PATH ID: R02_AN0804_Smokeless_Withdrawal

The next questions ask about how you felt within days after the last time you tried to quit using smokeless tobacco in the past 12 months.

Within days after stopping or cutting down on your smokeless tobacco use in the past 12 months, did you….

Feel depressed?

PATH ID: R02_AN0805_Smokeless_DifficultSleep

Within days after stopping or cutting down on your smokeless tobacco use in the past 12 months, did you….

Have difficulty falling asleep or staying asleep?

PATH ID: R02_AN0806_Smokeless_Concentration

Within days after stopping or cutting down on your smokeless tobacco use in the past 12 months, did you….

Have difficulty concentrating?

PATH ID: R02_AN0807_Smokeless_Weight

Within days after stopping or cutting down on your smokeless tobacco use in the past 12 months, did you….

Eat more than usual or gain weight?

PATH ID: R02_AN0808_Smokeless_Angry

Within days after stopping or cutting down on your smokeless tobacco use in the past 12 months, did you….

Become easily irritated, angry, or frustrated?

PATH ID: R02_AN0809_Smokeless_Anxious

Within days after stopping or cutting down on your smokeless tobacco use in the past 12 months, did you….

Feel anxious or nervous?

PATH ID: R02_AN0810_Smokeless_restless

Within days after stopping or cutting down on your smokeless tobacco use in the past 12 months, did you….

Feel more restless than usual?

What reaction, if any, do you have to these last few questions about your experiences with quitting?

How easy or difficult was it to answer these questions?

IF NEEDED, Do you think it makes sense to ask these questions of people who use smokeless tobacco?

Considered quitting

research questions

Test applicability of this item for users of less standard tobacco products such as Hookah, e-cigarette, and smokeless tobacco. Does this item make sense for current users of these products?

PATH ID: R02_AN0230_Smokeless_Interestinquitting

Overall, on a scale from 1 to 10 where 1 is not at all interested and 10 is extremely interested, how interested are you in quitting smokeless tobacco use? Please enter a number from 1 to 10.

Not at all interested
2
3
4
5
6
7
8
9
Extremely Interested

What reaction, if any, do you have to this question?

IF NEEDED, Do you think it makes sense to ask these questions of people who use smokeless tobacco?

Youth Nicotine Dependence

Youth tobacco users

research questions

Given limitations of earlier testing, we’d like to test these items with additional youth. We are primarily concerned whether these items are appropriate for youth respondents. Are youth able to answer these items - do they even think about things like having strong cravings?

We also want to know how these items work for users of less standard tobacco products such as hookah, e-cigarette, and smokeless tobacco. Do these items seem inappropriate or more difficult to answer for users of these products?

PATH ID: R02_YN0703

The next questions ask about your experience with tobacco products.

How soon after you wake up do you want to use tobacco?

Within 5 minutes
From 6 to 30 minutes
From more than 30 minutes to 1 hour
After more than 1 hour but less than 24 hours
I rarely want to use tobacco
Don’t know

PATH ID: R02_YN0704

Do you ever have strong cravings to use tobacco?

Yes
No
Don’t know

In your own words, what does it mean to have ‘strong cravings’ to use tobacco products?

What kind(s) of tobacco product(s) were you thinking about when you answered this question?

IF YES, tell me more about your answer.

PATH ID: R02_YN0705

Have you ever felt like you really needed to use tobacco?

Yes
No
Don’t know

PATH ID: R02_YN0055

Please rate your level of agreement for each statement using the following scale: 1= not true of me at all to 5=extremely true of me.

I find myself reaching for a tobacco product without thinking about it.

1 Not true of me at all
2
3
4
5 Extremely true of me
Don’t know

PATH ID: R02_YN0025

I frequently crave tobacco.

1 Not true of me at all
2
3
4
5 Extremely true of me
Don’t know

PATH ID: R02_YN0045

My tobacco use is out of control.

1 Not true of me at all
2
3
4
5 Extremely true of me
Don’t know

PATH ID: R02_YN0070

Using tobacco really helps me feel better if I’ve been feeling down.

1 Not true of me at all
2
3
4
5 Extremely true of me
Don’t know

PATH ID: R02_YN0075

Using tobacco helps me think better.

1 Not true of me at all
2
3
4
5 Extremely true of me
Don’t know

PATH ID: R02_YN0080

I would feel alone without my tobacco.

1 Not true of me at all
2
3
4
5 Extremely true of me
Don’t know

PATH ID: R02_YN0060

I usually want to use tobacco right after I wake up.

1 Not true of me at all
2
3
4
5 Extremely true of me
Don’t know

PATH ID: R02_YN0332

Most of the people I spend time with use e-cigarette.

1 Not true of me at all
2
3
4
5 Extremely true of me
Don’t know

PATH ID: R02_YN0255

Most of the people I spend time with use tobacco.

1 Not true of me at all
2
3
4
5 Extremely true of me
Don’t know

What reaction, if any, do you have to this series of questions about your experiences with tobacco products?

What did you think of being asked these questions?

How easy or difficult was it to answer these questions? What did you think of the answer choices?

IF NEEDED, Do you think it makes sense to ask these questions of people who [smoke hookah/use e-cigarettes/use smokeless tobacco]?

Adult Tobacco Use Module

Cigarettes

Screening

PATH ID: YC1002

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

Yes
No  go to CIGARS

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AC1003

Do you now smoke cigarettes…

Every day
Some days
Rarely  go to Q8
Not at all  go to CIGARS

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF SMOKING FREQUENCY.

In the past 30 days, how many days did you smoke cigarettes?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between smoking “some days” and smoking “rarely”?

PATH ID: R02_AC0100

When did you last smoke a cigarette?

In the past hour  go to Q5
Sometime today
Yesterday
Day before yesterday
Three or more days ago  go to Q8

research question

Testing the new response options.

PATH ID: R02_AC0102

When you last smoked a cigarette, was it…

Midnight to 6 AM
After 6 AM but before noon
Noon to 6 PM
After 6 PM but before midnight

When exactly did you last smoke a cigarette?

How easy or difficult was it for you to answer this question? What made it easy or difficult?

PATH ID: R02_AC0103

On the day you last smoked, how many cigarettes did you smoke? A pack usually has 20 cigarettes in it.

___________________________________

PATH ID: R02_AC1022

On how many of the past 30 days did you smoke cigarettes?

___________________________________

DON'T KNOW

RESEARCH QUESTION

How well can respondents report quantities?

PATH ID: R02_AC1023

On average, on those days you smoked, how many cigarettes did you usually smoke each day? A pack usually has 20 cigarettes in it.

 Cigarettes per day

___________________________________  Packs per day

DON'T KNOW

How did you come up with your answer? How confident are you in your answer?

IF NEEDED, How easy or difficult was it to answer this question?

Research questions

Questions about smokers self-perceptions (i.e., do they value it and consider it part of their identity versus feeling ambivalent) are being developed in order to allow for later analysis on the relationship between e-cigarette use and the value assigned to smoking by smokers.

PATH ID: R02_AC9022

Do you consider yourself a smoker?

Yes
No
DON'T KNOW

Tell me more about your answer. How did you decide yes/no?
IF NO, Tell me more about why you don’t consider yourself a smoker?

In your own words, what makes someone a “smoker”?

PATH ID: new smoker identity

Do you consider being a smoker part of your identity?

Yes
No
DON'T KNOW

Tell me more about your answer. How did you decide yes/no?

IF NO, Why don’t you consider smoking part of your identity?

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

PATH ID: R02_AC1130

In the past 30 days, were any of the cigarettes you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q12
I don’t know  go to Q12

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_AC1131

Which flavors have you smoked in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different cigarette, or did a single cigarette have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_AX0307_REVISED_Cigarettes

Have you thought about switching from cigarettes to any of the following products? Choose all that apply.

I have not thought about switching to another product
E-cigarettes
Traditional cigars
Cigarillos
Filtered cigars
Pipes
Hookahs
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Cigars

Screening

RESEARCH QUESTIONS

Need further testing with cigar items. We want to know if we are routing cigar users correctly.

PATH ID: R02_AGT01

The next questions are about traditional cigars, cigarillos, and filtered cigars. These products go by lots of different names, so please use these descriptions and photos to understand what they are.

Traditional cigars contain tightly rolled tobacco that is wrapped in a tobacco leaf. Some common brands of traditional cigars include Macanudo, Romeo y Julieta, and Arturo Fuente, but there are many others.

PATH ID: R02_AGT02

Cigarillos and filtered cigars are smaller than traditional cigars. They are usually brown. Some are the same size as cigarettes, and some come with filters or with plastic or wooden tips. Some common brands are Black & Mild, Swisher Sweets, Dutch Masters, Phillies Blunts, Prime Time, and Winchester.

PATH ID: R02_AGD01

PATH ID: YG1002

Have you ever smoked a traditional cigar, cigarillo, or filtered cigar, even one or two puffs?

Yes
No  GO TO NEXT SECTION

PATH ID: YG9104

Which type of cigar have you ever smoked?

Traditional cigars like Macanudo, Romeo y Julieta, Arturo Fuente, or others  MARK ON SKIP SHEET as traditional cigar user  GO TO Q4
Cigarillos or filtered cigars like Black & Mild, Swisher Sweets, Dutch Masters, Phillies Blunts, Prime Time, Winchester, or others

PATH ID: R02_AG9009

Which of the following kinds of cigarillos or filtered cigars have you smoked? Choose all that apply. The kind…

With a plastic or wooden tip  MARK ON SKIP SHEET as cigarillo
With a filter (like a cigarette filter)  MARK ON SKIP SHEET as little filtered cigar
Without a tip or filter  MARK ON SKIP SHEET as cigarillo
DON'T KNOW

Did you bring a cigar with you? Can I take a picture of it?

Traditional cigars

if do not use traditional cigars  go to Q11

PATH ID: R02_AGD02_CIGARSPic

The next questions are about traditional cigars, like those shown below. As you answer these questions, please think ONLY about your use of traditional cigars.

Use

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AG1003

Do you now smoke traditional cigars…

Every day
Some days
Rarely  go to Q8
Not at all  go to Q11

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF SMOKING FREQUENCY.

In the past 30 days, how many days did you smoke traditional cigars?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between smoking “some days” and smoking “rarely”?

PATH ID: R02_AG0100_Cigar_Last

When did you last smoke a traditional cigar?

In the past hour  go to Q7
Sometime today
Yesterday
Day before yesterday
Three or more days ago  go to Q8

research question

Testing the new response options.

PATH ID: R02_AG0102_Cigar_Timeofday

When you last smoked a traditional cigar, was it…

Midnight to 6 AM
After 6 AM but before noon
Noon to 6 PM
After 6 PM but before midnight

When exactly did you last smoke a traditional cigar?

How easy or difficult was it for you to answer this question? What made it easy or difficult?

PATH ID: R02_AG0103_Cigars_howmany

On the day you last smoked, how many traditional cigars did you smoke? (If less than 1, enter 1.)

______________________

DON'T KNOW

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_AG1130_Cigars_30dayFlavor

In the past 30 days, were any of the traditional cigars that you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q10
I don’t know  go to Q10

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_AG1131_Cigars_Whichflavors

Which flavors have you smoked in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different cigar, or did a single cigar have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_AX0307_REVISED_CIGARS

Have you thought about switching from traditional cigars to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Cigarillos
Filtered cigars
Pipes
Hookahs
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Cigarillos

if do not smoke cigarillos go to Q18

PATH Id: R02_AGD02_CIGARILLOSPIC

The next questions are about cigarillos, like those shown below. As you answer these questions, please think ONLY about your use cigarillos.

Use

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AG1003

Do you now smoke cigarillos…

Every day
Some days
Rarely  go to Q15
Not at all  go to Q18

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF SMOKING FREQUENCY.

In the past 30 days, how many days did you smoke cigarillos?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between smoking “some days” and smoking “rarely”?

PATH ID: R02_AG0100_Cigarillo_Last

When did you last smoke a cigarillo?

In the past hour  go to Q14
Sometime today
Yesterday
Day before yesterday
Three or more days ago  go to Q15

research question

Testing the new response options.

PATH ID: R02_AG0102_Cigarillo_TimeofDay

When you last smoked a cigarillo, was it …

Midnight to 6 AM
After 6 AM but before noon
Noon to 6 PM
After 6 PM but before midnight

When exactly did you last smoke a cigarillo?

How easy or difficult was it for you to answer this question? What made it easy or difficult?

PATH ID: R02_AG0103_Cigarillos_howmany

On the day you last smoked, how many cigarillos did you smoke? (If less than 1, enter 1.)

______________________

DON'T KNOW

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_AG1130_Cigarillos_30dayflavor

In the past 30 days, were any of the cigarillos that you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q17
I don’t know  go to Q17

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_AG1131_Cigarillos_Whichflavors

Which flavors have you smoked in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different cigarillo, or did a single cigarillo have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_AX0307_REVISED_CIGARILLOS

Have you thought about switching from cigarillos to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Traditional cigars
Filtered cigars
Pipes
Hookahs
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Filtered cigars

if do not smoke little filtered cigars  go to next Section

PATH ID: R02_AGD02_FilteredcigarsPic

The next questions are about filtered cigars, like those shown below. As you answer these questions, please think ONLY about your use of filtered cigars.

Use

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AG1003

Do you now smoke filtered cigars…

Every day
Some days
Rarely  go to Q22
Not at all  go to next Section

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF SMOKING FREQUENCY.

In the past 30 days, how many days did you smoke filtered cigars?How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between smoking “some days” and smoking “rarely”?

PATH ID: R02_AG0100_FilteredCigar_Last

When did you last smoke a filtered cigar?

In the past hour  go to Q21
Sometime today
Yesterday
Day before yesterday
Three or more days ago  go to Q22

research question

Testing the new response options.

PATH ID: R02_AG0102_FilteredCigar_TimeofDay

When you last smoked a filtered cigar, was it…

Midnight to 6 AM
After 6 AM but before noon
Noon to 6 PM
After 6 PM but before midnight

When exactly did you last smoke a filtered cigar?

How easy or difficult was it for you to answer this question? What made it easy or difficult?

PATH ID: R02_AG0103_Filteredcigars_Howmany

On the day you last smoked, how many filtered cigars did you smoke? (If less than 1, enter 1.)

______________________

DON'T KNOW

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_AG1130_FilteredCigar_30dayFlavor

In the past 30 days, were any of the filtered cigars that you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q24
I don’t know  go to Q24

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_AG1131_FilteredCigars_Whichflavors

Which flavors have you smoked in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different filtered cigar, or did a single filtered cigar have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_AX0307_REVISED_FILTEREDCIGARS

Have you thought about switching from filtered cigars to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Traditional cigars
Cigarillos
Pipes
Hookahs
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Use of Non-tobacco Products

All Respondents

research question

Test items with larger sample size including different cigar usage types. Additionally, identify the appropriateness of the current items we are asking blunt users and whether we are defining blunt users appropriately. Lastly, seek out information about which cigar types are associated with blunt use.

Screening

PATH ID: R02_AG9107

Sometimes people take tobacco out of a traditional cigar, cigarillo or filtered cigar and replace it with marijuana. This is sometimes called a “blunt”.

In the past 12 months, have you smoked part or all of a traditional cigar, cigarillo or filtered cigar with marijuana in it?

Yes
No  go to next module

In your own words, what is this question asking?

Are you familiar with the term “blunt”? Is it one you use? Are there other terms you use?

PATH ID: R02_AG9106

In the past 12 months, when you smoked a traditional cigar, cigarillo or filtered cigar, how often has tobacco been replaced with any marijuana?

Every time
Most of the time
Sometimes
Rarely
Never

In your own words, what is this question asking?

How easy or difficult was it to answer?

When you smoke a blunt, do you remove all of the tobacco, or do you leave some in?

PATH ID: R02_AG1095

Please look at this picture. Which group is most like the type of cigar you usually smoke as a blunt? Choose all that apply.

Group 1
Group 2
Group 3
Group 4

How easy or difficult was it for you to answer this question? What made it easy or difficult?

PROBE TO ENSURE RESPONDENT IS BEING CATEORIZED CORRECTLY

Pipes

Screening

PATH ID: R02_APT01

The next questions are about smoking tobacco in pipes.

Pipes come in many shapes and sizes. They all have a bowl that holds the tobacco and a stem. Pipe tobacco is often sold loose in packages or tins. In the following section, we are only asking about smoking pipes filled with tobacco. The picture below shows a typical pipe and some pipe tobacco.

PATH ID: YP1002

Have you ever smoked a pipe filled with tobacco, even one or two puffs?

Yes
No  go to next section

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AP1003

Do you now smoke a pipe filled with tobacco…

Every day
Some days
Rarely  go to Q6
Not at all  go to next Section

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF SMOKING FREQUENCY.

In the past 30 days, how many days did you smoke a pipe filled with tobacco?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between smoking “some days” and smoking “rarely”?

PATH ID: R02_AP0100

When did you last smoke a pipe filled with tobacco?

In the past hour  go to Q5
Sometime today
Yesterday
Day before yesterday
Three or more days ago  go to Q6

research question

Testing the new response options.

PATH ID: R02_AP0102

When you last smoked a pipe filled with tobacco, was it…

Midnight to 6 AM
After 6 AM but before noon
Noon to 6 PM
After 6 PM but before midnight

When exactly did you last smoke a pipe?

How easy or difficult was it for you to answer this question? What made it easy or difficult?

research question

Need further testing with pipe users.

PATH ID: R02_AP0103

On the day you last smoked, how many bowls filled with pipe tobacco did you smoke? (If less than 1, enter 1.)

___________________________________

DON'T KNOW

In your own words, what is a bowl? Do you usually talk about “bowls,” are do you call it something else?

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

PATH ID: R02_AP1130

In the past 30 days, was any of the pipe tobacco you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q8
I don’t know  go to Q8

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_AP1131

Which flavors have you smoked in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different pipe tobacco, or did a single pipe tobacco have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_AX0307_REVISED_Pipe

Have you thought about switching from pipes to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Traditional cigars
Cigarillos
Filtered cigars
Hookahs
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Smokeless Tobacco

Screening

PATH ID: R02_AST01

The next questions ask about smokeless tobacco which you put in your mouth. Frequently you chew, suck or spit while using smokeless tobacco, although there is no need to do so for some types. Snus, for instance, is a type of smokeless tobacco that comes in a small pouch that you put inside your lip.

There are many kinds of smokeless tobacco, such as snus pouches, loose snus, moist snuff, dip, spit, and chewing tobacco. Common brands include Redman, Levi Garrett, Beechnut, Skoal, Grizzly, Nordic Ice and Copenhagen.

PATH ID: YS1002

Have you ever used any of the following smokeless tobacco products, even one or two times? Choose all that apply.

Snus pouches  MARK ON SKIP SHEET as snus user
Loose snus, moist snuff, dip, spit, or chewing tobacco  MARK ON SKIP SHEET as smokeless tobacco user
I have never used a smokeless tobacco product go to NEXT SECTION

Snus

if do not use snus  go to Q10

Use

PATH ID: R02_AU1003_SNUS

You mentioned that you have used snus pouches. There are many brands of snus pouches. Have you ever used the brand called Skoal Bandits?

Yes, I have used only Skoal Bandits  go to Q10
Yes, I have used both Skoal Bandits and other brands of snus pouches
No, I have not used Skoal Bandits
DON'T KNOW  go to Q10

R02_AUT01

The next questions are about snus pouches. Common brands of snus pouches include Camel snus, General snus, Marlboro snus, and Nordic Ice, but there are many others.

Please think about your use of snus pouches as you answer these questions.

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AS1003_SNUS_USENOW_YOUTH

Do you now use snus…

Every day
Some days
Rarely  go to Q7
Not at all  go to Q10

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF FREQUENCY OF USE.

In the past 30 days, how many days did you use snus?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between using snus “some days” and using snus “rarely”?

PATH ID: R02_AS0100_SNUS

When did you last use snus?

In the past hour  go to Q6
Sometime today
Yesterday
Day before yesterday
Three or more days ago  go to Q7

research question

Testing the new response options.

PATH ID: R02_AS0102_SNUS_TIMEofday

When you last used snus, was it…

Midnight to 6 AM
After 6 AM but before noon
Noon to 6 PM
After 6 PM but before midnight

When exactly did you last use snus?

How easy or difficult was it for you to answer this question? What made it easy or difficult?

PATH ID: R02_AS0103_SNUS_HOWMANY

On the day you last used snus, how many snus pouches did you use?

___________________________________

DON'T KNOW

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_AS1130_Snus_Past30Flavor

In the past 30 days, were any of the snus pouches you used flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q9
I don’t know  go to Q9

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_AS1131_WHICHFLAVORS

Which flavors have you used in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

Was each flavor a different pouch of snus, or did a single pouch of snus have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_AX0307_REVISED_SNUS

Have you thought about switching from snus pouches to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Traditional cigars
Cigarillos
Filtered cigars
Pipes
Hookahs
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Smokeless Tobacco

if do not use smokeless tobacco  go to next Section

The next questions are about your use of other kinds of smokeless tobacco, not including snus pouches. The questions will use the phrase “smokeless tobacco” to refer to these products.

Use

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AS1003_SMOKELESS_USENOW

Do you now use smokeless tobacco…

Every day
Some days
Rarely  go to Q14
Not at all  go to next Section

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF FREQUENCY OF USE.

In the past 30 days, how many days did you use smokeless tobacco?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between using smokeless tobacco “some days” and using smokeless tobacco “rarely”?

PATH ID: R02_AS0100_Smokeless

When did you last use smokeless tobacco?

In the past hour  go to Q13
Sometime today
Yesterday
Day before yesterday
Three or more days ago  go to Q14

research question

Testing the new response options.

PATH ID: R02_AS0102_SMOKELESS_TIMEOFDAY

When you last used smokeless tobacco, was it…

Midnight to 6 AM
After 6 AM but before noon
Noon to 6 PM
After 6 PM but before midnight

When exactly did you last use smokeless tobacco?

How easy or difficult was it for you to answer this question? What made it easy or difficult?

PATH ID: R02_AS0103_SMOKELESS_HowMANYTIMES

On the day you last used smokeless tobacco, how many times did you use it?

___________________________________

DON'T KNOW

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_AS1130_Smokeless_PAST30Flavor

In the past 30 days, was any of the smokeless tobacco you used flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q16
I don’t know  go to Q16

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_AS1131_SMOKELESS_WHIChFLAVORS

Which flavors have you used in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different package of smokeless tobacco, or did a single package of smokeless tobacco have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_AX0307_REVISED_SMOKELESS

Have you thought about switching from smokeless tobacco to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Traditional cigars
Cigarillos
Filtered cigars
Pipes
Hookahs
Snus pouches
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Dissolvable Tobacco

Screening

Research questions

We need further testing of dissolvable tobacco items.

R02_ADT01

The next questions ask about another type of tobacco called dissolvable tobacco. You don’t smoke dissolvable tobacco products – they are made of finely ground flavored tobacco that dissolves in your mouth.

Dissolvable tobacco products come in a variety of shapes, including small round pellets, thin sticks and flat strips. Some common brands are Ariva, Stonewall, and Camel Orbs, Sticks or Strips.

PATH ID: YD1002

Have you ever used dissolvable tobacco products, such as Ariva, Stonewall, or Camel Orbs, Sticks, or Strips, even one or two times?

Yes
No  GO TO next module

IF YES, Tell me about the product you used. What was its name? How did you use it? What did it look like? Where did you get it?

Youth Tobacco Use Module

youth tobacco users

Cigarettes

Screening

PATH ID: YC1002

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

Yes
No  go to Q20

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AC1003_Youth

Do you now smoke cigarettes…

Every day
Some days
Rarely
Not at all  go to Q20

research question

We need further testing of this item, especially with youth.

PATH ID: R02_YC9022

Do you consider yourself a smoker?

Yes
No
DON'T KNOW

Tell me more about your answer. How did you decide yes/no?
IF NO, Tell me more about why you don’t consider yourself a smoker?

In your own words, what makes someone a “smoker”?

Research questions

PATH ID: new smoker identity YOUTH

Do consider being a smoker part of your identity?

Yes
No
DON'T KNOW

Tell me more about your answer. How did you decide yes/no?

IF NO, Why don’t you consider smoking part of your identity?

research question

We are testing how respondents interpret “fairly regularly” and “stayed off.” This item is new for the youth respondents. We need further testing with cigarette smokers.

PATH ID: R02_AC9002

About how long have you been smoking fairly regularly? Do not count any time you may have stayed off cigarettes.

___________________________________

I have never smoked cigarettes fairly regularly

In your own words, what is this question asking? IF NEEDED, What does it mean to say someone is smoking “fairly regularly”?

What does it mean to “stay off” cigarettes?

IF YES: During the TIME PERIOD you’ve been smoking fairly regularly, has there ever been a time when you weren’t smoking? Have you been smoking about the same amount the entire time, or have there been times when you’ve smoked less or more?

research questions

This is a new item. We want to test the construct of “regular use” further, especially with youth.

PATH ID: NEW regularly item

Have you ever used tobacco or nicotine regularly, which means at least once a week, for at least one month, counting all forms of tobacco and nicotine you have ever used? Select only one response.

Yes, I have used tobacco or nicotine at least once a week
No, I have never used tobacco or nicotine at least once a week

How easy or difficult was it for you to answer this question? What made it easy or difficult?

In your own words, what is this question asking? IF NEEDED, What does it mean to use tobacco or nicotine “regularly”?

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_YC1130

In the past 30 days, were any of the cigarettes you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q9
I don’t know  go to Q9
Didn’t smoke a cigarette in the past 30 days  go to Q9

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_YC1131

Which flavors have you smoked in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different cigarette, or did a single cigarette have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

PATH ID: R02_YC9118

Are cigarettes flavored like menthol or mint harder to smoke, about the same, or easier to smoke than regular cigarettes?

Harder to smoke
About the same
Easier to smoke

How did you decide on your answer?

What does “harder to smoke” mean? What does “easier to smoke” mean?

Have you heard of menthol or mint flavored cigarettes? What have you heard? In your own words, what is “menthol”?

PATH ID: R02_YC9040

Are cigarettes flavored like menthol or mint less harmful, no different, or more harmful than regular cigarettes?

Less harmful
No different
More harmful

What does “regular” cigarettes mean? If we said “compared to non-menthol cigarettes instead,” would that make this question easier or harder to understand?

Purchasing

youth

research questions

Further testing is needed with youth cigarette purchasing items.

PATH ID: R02_YC1123 – youth only

In the past 30 days, did anyone refuse to sell you cigarettes because of your age?

Yes
No
I did not try to buy cigarettes in the past 30 days

PATH ID: R02_YC1118 – youth only

In the past 30 days, how did you usually get your own cigarettes?

I gave someone else money to buy cigarettes for me go to Q16
I bought cigarettes myself
I asked someone to give me a cigarette  go to Q19
Someone offered me a cigarette  go to Q19
I bought cigarettes from another person  go to Q19
I took cigarettes from a store or another person  go to Q19
I got cigarettes some other way  go to Q19

SPECIFY __________________________

I haven’t smoked cigarettes in the past 30 days

Tell me how you came up with your answer.

How easy or difficult was it for you to answer this question?

Other than the ones listed here, are there any other ways people get cigarettes?

bought by self

PATH ID: R02_YC1033 – youth only_BOUGHT BY SELF

Where do you buy your cigarettes most of the time?

A convenience store or gas station
A supermarket, grocery store, or drug store
A warehouse club, such as Sam’s or Costco
A smoke shop, tobacco specialty store or tobacco outlet store
A duty free shop or military commissary
A bar, pub, restaurant or casino
A friend or relative
A swap meet or flea market
A store on an Indian reservation
Or from somewhere else SPECIFY: ____________________________

How easy or difficult was it for you to answer this question?

Are there any places missing from this list?

Is there anything here you haven’t heard of?

research questions

This item is being added to the youth section and has never been tested before. We want to test whether youth respondents have issues with reporting. Can youth users report cost information in general? Are there any issues reporting cost for youth that purchase themselves vs. youth that give money to someone else to buy for them? Does the question wording work across the various product types? How do people formulate an answer, what factors are they including in the cost?

PATH ID: R02_YC1034 – test with youth only_BOUGHTFORSELF

Think about the last time you bought cigarettes. How much did you pay for them?

$ ______________________

DON'T KNOW

Tell me how you came up with your answer. PROBE ON WHETHER THERE WAS ANY DIFFICULTY COMING UP WITH COST.

PATH ID: R02_YC1039_CIGARETTESBOUGHTBYSELF

The last time you bought cigarettes, did you buy them by the carton, pack, or as single cigarettes?

Carton  go to Q19
Pack  go to Q19
Single Cigarette  go to Q19
DON'T KNOW  go to Q19

bought by someone else

PATH ID: R02_YC1033 – youth only_BOUGHTBYSOMEONEELSE

Where do they buy your cigarettes most of the time?

A convenience store or gas station
A supermarket, grocery store, or drug store
A warehouse club, such as Sam’s or Costco
A smoke shop, tobacco specialty store or tobacco outlet store
A duty free shop or military commissary
A bar, pub, restaurant or casino
A friend or relative
A swap meet or flea market
A store on an Indian reservation
Or from somewhere else SPECIFY: ____________________________

How easy or difficult was it for you to answer this question?

Are there any places missing from this list?

Is there anything here you haven’t heard of?

research questions

PATH ID: R02_YC1034 – test with youth only_BOUGHTBYSOMEONEELSE

Think about the last time you gave money to someone else to buy you cigarettes. How much did you pay for them?

$ ______________________

DON'T KNOW

Tell me how you came up with your answer. PROBE ON WHETHER THERE WAS ANY DIFFICULTY COMING UP WITH COST.

Did you pay the person extra to buy the cigarettes for you? IF YES: Did you include that in your answer here?

PATH ID: R02_YC1039_CIGARETTESBOUGHTBYSOMEONEELSE

The last time you gave money to someone else to buy you cigarettes, did they buy them by the carton, pack, or as single cigarettes?

Carton
Pack
Single Cigarette
DON'T KNOW

FOR THOSE WHO HAD SOMEONE ELSE PURCHASE, How confident are you in your answer?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_YX0307_REVISED_Cigarettes

Have you thought about switching from cigarettes to any of the following products? Choose all that apply.

I have not thought about switching to another product
E-cigarettes
Traditional cigars
Cigarillos
Filtered cigars
Pipes
Hookahs
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Friends

research questions

This is a new item. We want to understand how respondents are answering this item, how respondents calculate their “four best friends,” and whether or not they know how many of their friends smoke cigarettes.

PATH ID: Best friends Smoke

How many of your best friends smoke cigarettes?

None
A few
Some
Most
All

How easy or difficult was it for you to answer this question? What made it easy or difficult?

Who were you thinking about when you answered this question? IF NEEDED: Were you thinking about specific people, or just about your friends in general?

How confident are you that [FILL ANSWER] of your best friends have smoked cigarettes? What makes you confident/not confident?

Electronic Products

Screening

Research questions

The intro and first few items are new. Testing is needed.

BOX ID: R02_YET01

What reaction, if any, did you have to this description and the picture? In your own words, what is “vapor”?

Are you familiar with all of these products? IF NO, Which ones are new to you?

Are these the words you use, or do you call these products by different names?

All of these products together are called “electronic nicotine products.” What do you think of that name? Is there another word you use to refer to all of these products?

PATH ID: R02_YO1002

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

Yes
No  go to Q30
DON’T KNOW  go to Q30

In your own words, what is this question asking?

In your own words, what is an “electronic nicotine product”?

PATH ID: R02_YO9035

Which type of electronic nicotine product have you ever used? Choose all that apply.

E-cigarette (including vape pens and personal vaporizers)  MARK ON SKIP SHEET
E-cigar  MARK ON SKIP SHEET
E-hookah (including hookah pens)  MARK ON SKIP SHEET
E-pipe  MARK ON SKIP SHEET
Something else SPECIFY:___________________
DON’T KNOW  go to Q30

Tell me more about your answer. PROBE ON WHETHER RESPONDENT KNOWS THE DIFFERENCE BETWEEN THESE PRODUCTS.

E-cigarette

if do not use e-cigarettes  go to Q32

Description and Image

Research question

Box ID: R02_AET02_Youth

The next questions are about e-cigarettes.

Disposable e-cigarettes, e-cigarette cartridges and e-liquid come in many different flavors and nicotine concentrations. Some common brands include Fin, NJOY, Blu, e-Go and Vuse.

Please think only about e-cigarettes as you answer these questions.

What reaction, if any, did you have to this description of e-cigarettes?
What did you think of the pictures?

Is there anything that you found confusing?
Is there anything that we left out that we should add?

Are you familiar with the different types of e-cigarettes? What type do you usually use?

Do you call nicotine fluid “e-juice,” “e-liquid,” or something else?

Does it always have nicotine in it?

Use

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AE1003_ECIG_YOUTH

Do you now use e-cigarettes…

Every day
Some days
Rarely
Not at all  go to NEXT SECTION

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF FREQUENCY OF USE.

In the past 30 days, how many days did you use e-cigarettes?

Determining Type

Research question

Determine if this series of items correctly identifies respondent e-cigarette types and appropriate fills for subsequent items.

PATH ID: R02_yE9005

Please think about the e-cigarette you use most of the time.

Is your e-cigarette rechargeable?

Yes  MARK ON SKIP SHEET AS RECHARGEABLE
No  go to Q7

Do you call them rechargeable e-cigarettes or do you call them something else?

PATH ID: R02_yE9008

Does your e-cigarette use cartridges?

Do you call them cartridges or do you call them something else?

PATH ID: R02_yE9038

Does your e-cigarette use a tank system?

Yes
No
Not sure

What is a tank system? Are you familiar with the term “tank system”? Is there another term that you use?

What reaction, if any, did you have to the picture? Was the picture helpful? Why or why not?

What reaction, if any, did you have to these questions?

How easy or difficult was it to answer these questions?

PATH ID: R02_yE9009

Can you refill your e-cigarette or e-cigarette cartridges with “e-liquid”?

Yes  MARK ON SKIP SHEET as refillable
No  go to NEXT SECTION
ASK: Respondents who have used an e-cigarette (AO9035[1]=1)

PATH ID: R02_yE9036

Who refills your e-cigarette or e-cigarette cartridge with the e-liquid that you use?

I refill it myself
I get it refilled at a vape shop or vapor lounge
I buy it already filled
I get it refilled some other way

Are you familiar with the term “vape shop” or “vapor lounge”? Is there another term that you use?

What brand of e-cigarette do you have? What type or version of [BRAND] is it?

Box ID: R02_AED01

User type	Rechargeable? (R02_AE9005)	Cartridges? (R02_AE9008)	Refillable? (R02_AE9009)	Tank? (R02_AE9038)
Disposable	No	Skip	No	Skip	 go to Q9
Non-refillable Cartridges	Yes	Yes	No	Skip	 go to Q13
Refillable Cartridges	Yes	Yes	Yes	Skip	 go to Q19
Refillable Tank System	Yes	No	Yes	Yes	 go to Q19
‘Unknown’	When combination of answers don’t fit into the above categories.

Disposable E-cigarettes

Dosage

Research question

PATH ID: R02_AE1021_Disposable_YOUTH

On average, about how many e-cigarettes do you now use each day?

Less than 1 each day
_______________________

Tell me more about your answer. How did you come up with a number?

How easy or difficult was it to answer?

Is there a better way we could ask this question?

PATH ID: R02_yE1022

On how many of the past 30 days did you use an e-cigarette?

_______________________

PATH ID: R02_AE9029_Disposable_LastPuff_Youth

About how long has it been since you last took a puff from an e-cigarette?

_______________________

Modification

Research question

New item added for Wave 2. Test whether respondents can correctly answer this item. Also probe on ways in which respondents modify e-cigarettes, including modifications to the battery or voltage.

PATH ID: R02_AE9032_Disposable_Mod_Youth

Have you modified your e-cigarette at all?

Yes  go to Q25
No  go to Q25

In your own words, what is this question asking?

IF YES, How have you modified it? Why did you modify it?
PROBE HOW AND WHY RESPONDENTS MODIFY THEIR E-CIGARETTES (E.G., TO IMPROVE BATTERY LIFE, CHANGE AMOUNTS OF E-LIQUID VAPORIZED, ETC.)

Where did you learn how to modify your e-cigarette?

IF NO, Have you ever heard of modifying e-cigarettes? Where did you hear about it? What types of modifications have you heard of?

Non-refillable Cartridges

Dosage

Research question

PATH ID: R02_AE1021_Non-Refillable_YOUTH

On average, about how many e-cigarette cartridges do you now use each day?

Less than 1 each day
_______________________

Tell me more about your answer. How did you come up with a number?

How easy or difficult was it to answer?

Is there a better way we could ask this question?

PATH ID: R02_AE1022_Non-Refillable_Past30_YOuth

On how many of the past 30 days did you use an e-cigarette?

_______________________

PATH ID: R02_AE9029_Non-REfillable_LastPuff_Youth

About how long has it been since you last took a puff from an e-cigarette?

_______________________

Do you typically call them “puffs” or is there another term you use?

Modification

Research question

New item added for Wave 2. Test whether respondents can correctly answer this item. Also probe on ways in which respondents modify e-cigarettes, including modifications to the battery or voltage.

IF NOT RECHARGEABLE  go to Q17

PATH ID: R02_AE9037_Non-refillable_Voltage_Youth

Can you change the voltage on your e-cigarette?

Yes
No
Not sure

In your own words, what is this question asking? IF NEEDED, What does it mean to change the voltage?

IF YES, Have you changed the unit’s voltage? Why or why not?

PATH ID: R02_AE9032_Non-refillable_mod_youth

Have you modified your e-cigarette at all?

In your own words, what is this question asking?

IF YES, How have you modified it? Why did you modify it?
PROBE HOW AND WHY RESPONDENTS MODIFY THEIR E-CIGARETTES (E.G., TO IMPROVE BATTERY LIFE, CHANGE AMOUNTS OF E-LIQUID VAPORIZED, ETC.)

Where did you learn how to modify your e-cigarette?

IF NO, Have you ever heard of modifying e-cigarettes? Where did you hear about it? What types of modifications have you heard of?

Research question

Test new items that ask about customization of constituents in e-liquids, particularly flavoring choices and modification of nicotine content.

PATH ID: NEW

Do you customize or modify the e-liquid you use in your e-cigarette?

Yes  go to Q25
No  go to q25

In this question, do the words customize and modify mean the same thing to you or do they mean different things? IF NEEDED: Tell me more.

Where did you learn how to customize or modify your e-liquid?

IF NO, Have you ever heard of modifying e-liquid? Where did you hear about it? What types of modifications have you heard of?

Have you ever heard of the term “dripping”? IF YES, Can you tell me more about it?

Refillable Cartridges or Tank

Dosage

Research question

PATH ID: R02_AE1021_REfillable_YOUTH

On average, about how many milliliters of e-liquid do you now use each day?

Less than 1 each day
_______________________

Tell me more about your answer. How did you come up with a number?

How easy or difficult was it to answer?

Is there a better way we could ask this question?

PATH ID: R02_AE1022_REfillable_Past30_YOUTH

On how many of the past 30 days did you use an e-cigarette?

_______________________

PATH ID: R02_AE9029_REfillable_LastPuff_Youth

About how long has it been since you last took a puff from an e-cigarette?

_______________________

Do you typically call them “puffs” or is there another term you use?

Modification

Research question

New item added for Wave 2. Test whether respondents can correctly answer this item. Also probe on ways in which respondents modify e-cigarettes, including modifications to the battery or voltage.

IF NOT RECHARGEABLE  go to Q23

PATH ID: R02_AE9037_REfillable_Voltage_youth

Can you change the voltage on your e-cigarette?

Yes
No
Not sure

In your own words, what is this question asking? IF NEEDED, What does it mean to change the voltage?

IF YES, Have you changed the unit’s voltage? Why or why not?

PATH ID: R02_AE9032_Refillable_Mod_Youth

Have you modified your e-cigarette at all?

In your own words, what is this question asking?

IF YES, How have you modified it? Why did you modify it?
PROBE HOW AND WHY RESPONDENTS MODIFY THEIR E-CIGARETTES (E.G., TO IMPROVE BATTERY LIFE, CHANGE AMOUNTS OF E-LIQUID VAPORIZED, ETC.)

Where did you learn how to modify your e-cigarette?

IF NO, Have you ever heard of modifying e-cigarettes? Where did you hear about it? What types of modifications have you heard of?

Research question

Test new items that ask about customization of constituents in e-liquids, particularly flavoring choices and modification of nicotine content.

NEW

Do you customize or modify the e-liquid you use in your e-cigarette?

Where did you learn how to customize or modify your e-liquid?

IF NO, Have you ever heard of modifying e-liquid? Where did you hear about it? What types of modifications have you heard of?

Have you ever heard of the term “dripping”? IF YES, Can you tell me more about it?

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_AE1130_ECIGFLAVOR_YOuth

In the past 30 days, were any of the e-cigarettes or e-liquid you used flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q27
I don’t know  go to Q27
Didn’t use an e-cigarette in the past 30 days go to Q27

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_AE1131_ECIGFLAVOR_PAST30_YOUTH

Which flavors have you used in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different e-cigarette, or did a single e-cigarette have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

PATH ID: R02_YE1146_YOUTH

Some e-cigarettes come in flavors like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets.

Are flavored e-cigarettes easier to use, about the same, or harder to use than unflavored e-cigarettes?

Easier to use
About the same
Harder to use

How did you decide on your answer?

What does “harder to use” mean? What does “easier to use” mean?

Have you heard of menthol or mint flavored e-cigarettes? What have you heard? In your own words, what is “menthol”?

What does “unflavored” e-cigarettes mean to you? Would it make more sense if we asked about “regular” e-cigarettes?

Purchasing

research questions

PATH ID: R02_YE1034 – youth only

Think about the last time you bought (or gave money to someone else to buy you) e-cigarettes or e-liquid. How much did you pay for them?

$ ______________________

DON'T KNOW

Tell me how you came up with your answer. PROBE ON WHETHER THERE WAS ANY DIFFICULTY COMING UP WITH COST.

How easy or difficult was it for you to answer this question? What made it easy or difficult?

IF R gave money to someone else to buy the e-cigarettes: Did you pay the person extra to buy the e-cigarettes for you? IF YES: Did you include that in your answer here?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_YX0307_REVISED_ecig

Have you thought about switching from e-cigarettes to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
Traditional cigars
Cigarillos
Filtered cigars
Pipes
Hookahs
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Use of Non-tobacco Products

Research question

PATH ID: E-Liquid Non Tobacco

Have you ever used an e-liquid made from something other than tobacco?

Yes
No
Don’t know

IF YES, What was it made from?

Have you ever used an e-liquid made from marijuana concentrates, waxes or hash oils?

IF YES, What exactly was the e-liquid made from?

Was it flavored like marijuana, or did it contain actual marijuana?
IF NEEDED, Could it get you high?

IF NO, Have you ever heard of this type of e-liquid? What do you know about it? Is it flavored like marijuana, or does it contain actual marijuana?
IF NEEDED, Could it get you high?

PATH ID: POT from e-cig

Have you ever smoked pot or hash from an e-cigarette?

Yes
No
Don’t know

IF YES, Tell me more about your answer. How do you smoke pot from an e-cigarette?

Friends

research questions

PATH ID: Best Friends that Smoke E-cig

How many of your best friends smoke e-cigarettes?

None
A few
Some
Most
All

How easy or difficult was it for you to answer this question? What made it easy or difficult?

Who were you thinking about when you answered this question? IF NEEDED: Were you thinking about specific people, or just about your friends in general?

How confident are you that [FILL ANSWER] of your best friends have smoked e-cigarettes? What makes you confident/not confident?

Cigars

Screening

RESEARCH QUESTIONS

Need further testing with cigar items. We want to know if we are routing cigar users correctly.

R02_AGT01_Youth

R02_AGT02_YOuth

R02_AGD01

PATH ID: YG1002_YOUTH

Have you ever smoked a traditional cigar, cigarillo, or filtered cigar, even one or two puffs?

Yes
No  GO TO NEXT SECTION

PATH ID: YG9104_YOUTH

Which type of cigar have you ever smoked?

Traditional cigars like Macanudo, Romeo y Julieta, Arturo Fuente, or others  MARK ON SKIP SHEET as traditional cigar user  GO TO Q4
Cigarillos or filtered cigars like Black & Mild, Swisher Sweets, Dutch Masters, Phillies Blunts, Prime Time, Winchester, or others

PATH ID: R02_AG9009_Youth

Which of the following kinds of cigarillos or filtered cigars have you smoked? Choose all that apply. The kind…

With a plastic or wooden tip  MARK ON SKIP SHEET as cigarillo
With a filter (like a cigarette filter)  MARK ON SKIP SHEET as little filtered cigar
Without a tip or filter  MARK ON SKIP SHEET as cigarillo
DON'T KNOW

Did you bring a cigar with you? Can I take a picture of it?

Traditional cigars

if do not use traditional cigars  go to Q10

R02_AGV01_CIGARS_YOuth

R02_AGD02_CigarsPic_youth

The next questions are about traditional cigars, like those shown below. As you answer these questions, please think ONLY about your use of traditional cigars.

Use

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AG1003

Do you now smoke traditional cigars…

Every day
Some days
Rarely
Not at all  go to Q10

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF SMOKING FREQUENCY.

In the past 30 days, how many days did you smoke traditional cigars?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between smoking “some days” and smoking “rarely”?

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_yG1130_CIGARS_FLAVOR

In the past 30 days, were any of the traditional cigars that you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q7
I don’t know  go to Q7
Didn’t smoke a traditional cigar in the past 30 days go to Q7

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_yG1131_CIGARS_WHICHFLAVORS

Which flavors have you smoked in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different traditional cigar, or did a single cigar have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

PATH ID: R02_YG9146

Some traditional cigars come in flavors like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets.

Are flavored traditional cigars easier to smoke, about the same, or harder to smoke than unflavored traditional cigars?

Easier to smoke
About the same
Harder to smoke

How did you decide on your answer?

What does “harder to smoke” mean? What does “easier to smoke” mean?

Have you heard of menthol or mint flavored traditional cigars? What have you heard? In your own words, what is “menthol”?

What does “unflavored” traditional cigar mean to you? Would it make more sense if we asked about “regular” traditional cigars?

Purchasing

research questions

PATH ID: R02_YG1034 – youth only_CIGARS

Think about the last time you bought (or gave money to someone else to buy you) traditional cigars. How much did you pay for them?

$ ______________________

DON'T KNOW

Tell me how you came up with your answer. PROBE ON WHETHER THERE WAS ANY DIFFICULTY COMING UP WITH COST.

How easy or difficult was it for you to answer this question? What made it easy or difficult?

IF R gave money to someone else to buy the CIGARS: Did you pay the person extra to buy the traditional cigars for you? IF YES: Did you include that in your answer here?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_YX0307_REVISED_Cigar

Have you thought about switching from traditional cigars to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Cigarillos
Filtered cigars
Pipes
Hookahs
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Friends

research questions

PATH ID: Best friends smoke Cigars

How many of your best friends smoke traditional cigars?

None
A few
Some
Most
All

How easy or difficult was it for you to answer this question? What made it easy or difficult?

Who were you thinking about when you answered this question? IF NEEDED: Were you thinking about specific people, or just about your friends in general?

How confident are you that [FILL ANSWER] of your best friends have smoked traditional cigars? What makes you confident/not confident?

Cigarillos

if do not smoke cigarillos go to Q17

R02_AGV01_CIGARILLOS_YOUTH

R02_AGD02_CigarillosPic_Youth

The next questions are about cigarillos, like those shown below. As you answer these questions, please think ONLY about your use of cigarillos.

Use

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AG1003

Do you now smoke cigarillos…

Every day
Some days
Rarely
Not at all  go to Q17

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF SMOKING FREQUENCY.

In the past 30 days, how many days did you smoke cigarillos?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between smoking “some days” and smoking “rarely”?

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_yG1130_CIGARILLOS_FLAVOR

In the past 30 days, were any of the cigarillos that you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q14
I don’t know  go to Q14
Didn’t smoke a cigarillo in the past 30 days  go to Q14

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_yG1131_CIGARILLOS_WHICHFLAVORS

Which flavors have you smoked in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different cigarillo, or did a single cigarillo have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

PATH ID: R02_YG9147

Some cigarillos come in flavors like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Are flavored cigarillos easier to smoke, about the same, or harder to smoke than unflavored cigarillos?

Easier to smoke
About the same
Harder to smoke

How did you decide on your answer? IF NEEDED, Did you answer based on your own experience or based on what you’ve heard? IF HEARD, Where did you hear that?

What does “harder to smoke” mean? What does “easier to smoke” mean?

Have you heard of menthol or mint flavored cigarillos? What have you heard? In your own words, what is “menthol”?

What does “unflavored” filtered cigarillo mean to you? Would it make more sense if we asked about “regular” cigarillos?

Purchasing

research questions

PATH ID: R02_YG1034 – youth only_CIGARILLOs

Think about the last time you bought (or gave money to someone else to buy you) cigarillos. How much did you pay for them?

$ ______________________

DON'T KNOW

Tell me how you came up with your answer. PROBE ON WHETHER THERE WAS ANY DIFFICULTY COMING UP WITH COST.

How easy or difficult was it for you to answer this question? What made it easy or difficult?

IF R gave money to someone else to buy the CIGARILLOS: Did you pay the person extra to buy the cigarillos for you? IF YES: Did you include that in your answer here?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_YX0307_REVISED_cigarillos

Have you thought about switching from cigarillos to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Traditional cigars
Filtered cigars
Pipes
Hookahs
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Friends

research questions

PATH ID: Best Friends Smoke Cigarillos

How many of your best friends smoke cigarillos?

None
A few
Some
Most
All

How easy or difficult was it for you to answer this question? What made it easy or difficult?

Who were you thinking about when you answered this question? IF NEEDED: Were you thinking about specific people, or just about your friends in general?

How confident are you that [FILL ANSWER] of your best friends have smoked cigarillos? What makes you confident/not confident?

Filtered cigars

if do not smoke little filtered cigars  go to Q24

R02_AGD02_FilteredCigarsPic_Youth

The next questions are about filtered cigars, like those shown below. As you answer these questions, please think ONLY about your use of filtered cigars.

Use

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AG1003

Do you now smoke filtered cigars…

Every day
Some days
Rarely
Not at all  go to Q24

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF SMOKING FREQUENCY.

In the past 30 days, how many days did you smoke filtered cigars?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between smoking “some days” and smoking “rarely”?

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_yG1130_FILTEREDCIGARS_FLAVOR

In the past 30 days, were any of the filtered cigars that you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q21
I don’t know  go to Q21
Didn’t smoke a filtered cigar in the past 30 days go to Q21

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_yG1131_FILTEREDCIGARS_WHICHFLAVORS

Which flavors have you smoked in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different filtered cigar, or did a single filtered cigar have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

PATH ID: R02_YG9148

Some filtered cigars come in flavors like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Are flavored filtered cigars easier to smoke, about the same, or harder to smoke than unflavored filtered cigars?

Easier to smoke
About the same
Harder to smoke

How did you decide on your answer? IF NEEDED, Did you answer based on your own experience or based on what you’ve heard? IF HEARD, Where did you hear that?

What does “harder to smoke” mean? What does “easier to smoke” mean?

Have you heard of menthol or mint flavored filtered cigars? What have you heard? In your own words, what is “menthol”?

What does “unflavored” filtered cigar mean to you? Would it make more sense if we asked about “regular” filtered cigars?

Purchasing

research questions

PATH ID: R02_YG1034 – youth only_FILTERED CIGARS

Think about the last time bought (or gave money to someone else to buy you) filtered cigars. How much did you pay for them?

$ ______________________

DON'T KNOW

Tell me how you came up with your answer. PROBE ON WHETHER THERE WAS ANY DIFFICULTY COMING UP WITH COST.

How easy or difficult was it for you to answer this question? What made it easy or difficult?

IF R gave money to someone else to buy the FILTERED CIGARS: Did you pay the person extra to buy the filtered cigars for you? IF YES: Did you include that in your answer here?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_YX0307_REVISED_FilteredCigar

Have you thought about switching from filtered cigars to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Traditional cigars
Cigarillos
Pipes
Hookahs
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Friends

research questions

PATH ID: Best friends smoke filtered cigars

How many of your best friends smoke filtered cigars?

None
A few
Some
Most
All

How easy or difficult was it for you to answer this question? What made it easy or difficult?

Who were you thinking about when you answered this question? IF NEEDED: Were you thinking about specific people, or just about your friends in general?

How confident are you that [FILL ANSWER] of your best friends have smoked filtered cigars? What makes you confident/not confident?

Use of Non-tobacco Products

All Respondents

research question

Screening

PATH ID: R02_yG9107

Sometimes people take tobacco out of a traditional cigar, cigarillo or filtered cigar and replace it with marijuana. This is sometimes called a “blunt”.

In the past 12 months, have you smoked part or all of a traditional cigar, cigarillo or filtered cigar with marijuana in it?

Yes
No  go to next Section

In your own words, what is this question asking?

Are you familiar with the term “blunt”? Is it one you use? Are there other terms you use?

PATH ID: R02_yG9106

In the past 12 months, when you smoked a traditional cigar, cigarillo or filtered cigar, how often has tobacco been replaced with any marijuana?

Every time
Most of the time
Sometimes
Rarely
Never

In your own words, what is this question asking?

How easy or difficult was it to answer?

When you smoke a blunt, do you remove all of the tobacco, or do you leave some in?

PATH ID: R02_yG1095

Which group is most like the traditional cigar, cigarillo, or filtered cigar you last smoked as a blunt?

Group 1
Group 2
Group 3
Group 4

How easy or difficult was it for you to answer this question? What made it easy or difficult?

PROBE TO ENSURE RESPONDENT IS BEING CATEORIZED CORRECTLY

Pipes

Screening

R02_APT01_YOUTH

The next questions are about smoking tobacco in pipes.

We first ask about smoking tobacco in a regular pipe. There are many different types of regular pipes. They all have a bowl that holds the tobacco and a stem. The picture below shows a typical pipe.

PATH ID: YP1002

Have you ever smoked a pipe filled with tobacco, even one or two puffs?

Yes
No  go to next section

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AP1003_YOUTH

Do you now smoke a pipe filled with tobacco…

Every day
Some days
Rarely
Not at all  go to next Section

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF SMOKING FREQUENCY.

In the past 30 days, how many days did you smoke a pipe filled with tobacco?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between smoking “some days” and smoking “rarely”?

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

PATH ID: R02_yP1130

In the past 30 days, was any of the pipe tobacco you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q5
I don’t know  go to Q5
Didn’t smoke a pipe in the past 30 days  go to Q5

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_yP1131

Which flavors have you smoked in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different pipe tobacco, or did a single pipe tobacco have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

PATH ID: R02_YP1146

Some pipe tobacco comes in flavors like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets.

Is flavored pipe tobacco easier to smoke, about the same, or harder to smoke than unflavored pipe tobacco?

Easier to smoke
About the same
Harder to smoke

How did you decide on your answer?

What does “harder to smoke” mean? What does “easier to smoke” mean?

What does “unflavored” pipe tobacco mean to you? Would it make more sense if we asked about “regular” pipe tobacco?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_YX0307_REVISED_PIPe

Have you thought about switching from pipes to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Traditional cigars
Cigarillos
Filtered cigars
Hookahs
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Hookah

PATH ID: Hookah intro YOUTH

research questioNS

Due to constraints in earlier testing, the hookah module was only tested with a small number of hookah users. Test with a larger number of respondents.

There are many types of hookahs. People often smoke tobacco in hookahs in groups at cafes or in hookah bars.

What reaction, if any, did you have to this description and pictures of hookah?

People smoke shisha or hookah tobacco in a hookah. Some shisha contains tobacco and some does not. Shisha comes in many flavors.

What reaction, if any, did you have to this description and pictures of shisha?

Do you usually refer to it as shisha, or is there another term you use?

Screening

PATH ID: YH1002_YOuth

Have you ever smoked tobacco in a hookah, even one or two puffs?

Yes
No  go to next section

Was this a regular hookah, or an electronic hookah (e-hookah)?

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AH1003_Youth

Do you now smoke hookah…

Every day
Some days
Rarely
Not at all  go to next Section

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF SMOKING FREQUENCY.

In the past 30 days, how many days did you smoke hookah?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between smoking “some days” and smoking “rarely”?

Frequency of Use

PATH ID: R02_YH1005

How many times have you smoked hookah in your entire life? Count each sitting or session where you smoked tobacco in a hookah, whether alone or with others.

1
2 to 10
11 to 20
21 to 50
51 to 99
100 or more

Tell me more about how you came up with your answer.

How easy or difficult was it for you to answer this question? What made it easy/difficult?

RESEARCH QUESTION

Given the atypical nature of hookah use, how do respondents interpret the phrase “fairly regularly”?

PATH ID: R02_YH1100

Have you ever smoked hookah fairly regularly?

Yes
No  go to Q6

What does it mean to smoke hookah ‘fairly regularly’?

PATH ID: R02_yH1007

How old were you when you first started smoking hookah fairly regularly?

___________________________________

How did you remember how old you were when you first started smoking hookah fairly regularly?

PATH ID: R02_YH9003

Which of the following choices best describes your hookah smoking? Usually I smoke hookah…

Every day  go to Q9
Weekly  go to Q8
Monthly
Every couple of months  go to Q10
About once a year  go to Q10

How did you decide to answer [ANSWER]? How easy or difficult was it to answer this question?

When do you smoke hookah?
PROBE TO SEE IF HOOKAH USE IS REGULAR (VERSUS SPORADIC).

IF ANSWER COUPLE OF MONTHS OR ABOUT ONCE A YEAR, Over a year, about how often do you smoke hookah? Count each sitting or session where you smoked tobacco in a hookah as one time, whether alone or with others.

PATH ID: R02_YH9004

On average, about how many times do you smoke hookah in a month? Count each sitting or session where you smoked tobacco in a hookah, whether alone or with others.

___________________________________  go to Q10

How did you come up with your answer? How confident are you in your answer?

IF NEEDED, Do you smoke hookah about the same amount every month, or do you smoke less or more in some months?

Do you call it a “sitting” or “session,” or do you use another word?

PATH ID: R02_YH9005

On average, about how many times do you smoke hookah in a week? Count each sitting or session where you smoked tobacco in a hookah, whether alone or with others.

___________________________________  go to Q10

How did you come up with your answer? How confident are you in your answer?

IF NEEDED, Do you smoke hookah about the same amount every week, or do you smoke less or more in some weeks?

Do you call it a “sitting” or “session,” or do you use another word?

PATH ID: R02_YH9006

On average, about how many times do you smoke hookah each day? Count each sitting or session where you smoked tobacco in a hookah, whether alone or with others.

___________________________________

How did you come up with your answer? How confident are you in your answer?

IF NEEDED, Do you smoke hookah about the same amount every day, or do you smoke less or more in some days?

Do you call it a “sitting” or “session,” or do you use another word?

Ownership and How/Where to use

PATH ID: R02_YH1090

Do you own a hookah?

FOR YOUTH: Do your parents/guardians own a hookah? How confident are you that they own/don’t own a hookah?

PATH ID: R02_YH9041

10a. Does anyone else living in your home own a hookah?

PATH ID: R02_YH9011

Where do you usually smoke hookah? Choose all that apply.

At home
In a hookah bar or cafe
At a friend’s house
Somewhere else (SPECIFY:__________)

PATH ID: R02_YH9012

Do you usually share the same hookah with others when you smoke?

Yes
No  go to Q14

PATH ID: R02_YH9013

How many people do you usually share hookah with?

1 other person
2 other people
3 other people
4 or more other people

Do you usually smoke hookah with the same number of people, or does it change? IF CHANGES, How did you decide on your answer?

PATH ID: R02_YH9014

On average, how long is one hookah session for you (and the people you share it with)? A session is one sitting in which you smoke hookah, whether alone or with others.

Less than 30 minutes
30 minutes – 1 hour
More than 1 hour – 2 hours
More than 2 hours

PATH ID: R02_YH9015

On average, when you smoke hookah, how many times do you refill it with tobacco?

0 times
1 time
2 to 3 times
4 or more times

Are you usually the one who refills it? IF NOT, Who usually refills it?

PATH ID: R02_yH9016

How often do you personally set up the hookah?

Every time
Most of the time
Some of the time
Rarely
Never, someone else always sets it up for me

Tell me more about your answer. IF NEEDED, what does it mean to ‘set up the hookah’?

Regular Brand

PATH ID: R02_Ay1047

Do you have a regular brand of shisha or hookah tobacco that you usually smoke?

How did you come up with your answer?

In your own words, what is a “regular” brand?

PATH ID: R02_Ay1048

What brand of shisha or hookah tobacco did you last smoke?

SHOW RESPONDENT BRAND LIBRARY

___________________________________  go to Q20

Something else

PATH ID: R02_Ay1049

You said that your brand was not pictured. What is it?

___________________________________

PATH ID: R02_Ay1070

You selected [BRANDFILL] as your brand. What kind of [BRANDFILL] did you last smoke?

SHOW RESPONDENT BRAND LIBRARY

___________________________________  go to Q22

Something else

PATH ID: R02_Ay1071

You said that the type of [BRANDFILL]s that you smoke is not pictured. What type is it?

___________________________________

PATH ID: R02_yH9108

Does this brand of shisha contain tobacco?

How confident are you in your answer? How do you know whether or not your shisha contains tobacco?

Are you familiar with shisha that doesn’t have tobacco?

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_yH1130

In the past 30 days, was any of the shisha or hookah tobacco you smoked flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q25
I don’t know  go to Q25
Didn’t smoke hookah in the past 30 days  go to Q25

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_yH1131

Which flavors have you smoked in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different package of shisha, or did a single package of shisha have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

PATH ID: R02_YH1146_YOUTH

Some shisha or hookah tobacco comes in flavors like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets.

Is flavored shisha or hookah tobacco easier to smoke, about the same, or harder to smoke than unflavored shisha or hookah tobacco?

Easier to smoke
About the same
Harder to smoke

How did you decide on your answer?

What does “harder to smoke” mean? What does “easier to smoke” mean?

Have you heard of menthol or mint flavored shisha or hookah tobacco? What have you heard? In your own words, what is “menthol”?

What does “unflavored” shisha or hookah tobacco mean to you? Would it make more sense if we asked about “regular” shisha or hookah tobacco?

Purchasing

PATH ID: R02_yH1097

The next questions ask about your experience buying shisha or hookah tobacco.

In the past 30 days, did you use a coupon when buying shisha or hookah tobacco?

Yes
No  go to Q28

IF YES, Where do you usually get your coupons? Have you ever used “Groupon” or something similar?

IF NO, Have you ever seen a coupon when buying shisha or hookah tobacco? Have you ever used one?

Do you usually buy the shisha or hookah tobacco? IF NO, How did you decide on your answer?

Have you ever bought shisha online? IF YES, If you did buy it online, and you used a discount code, how would you answer this question?
DETERMINE IF RESPONDENT INCLUDES A DISCOUNT CODE AS A COUPON.

PATH ID: R02_yH1098

How many times in the past 30 days have you used a coupon to buy shisha or hookah tobacco?

___________________________________

PATH ID: R02_yH1030

How do you usually buy your shisha or hookah tobacco? Is it…

In person (such as at a store or hookah bar)
From the internet  go to Q31
By telephone  go to Q31
I do not buy my own shisha or hookah tobacco  go to Q31

PATH ID: R02_yH1032

Do you usually buy shisha or hookah tobacco...?

In your own state
In another state
Outside the US

PATH ID: R02_Ay1033

Where do you buy your shisha or hookah tobacco most of the time?

A hookah bar or cafe
A convenience store or gas station
A supermarket, grocery store, or drug store
A warehouse club, such as Sam’s or Costco
A smoke shop, tobacco specialty store or tobacco outlet store
A duty free shop or military commissary
A bar, pub, restaurant or casino
A friend or relative
A swap meet or flea market
A liquor store
Or from somewhere else SPECIFY: ____________________________

IF ANSWERS HOOKAH BAR OR CAFÉ, Do you usually call it a hookah bar or café, or is there another term you use?

Are there any places missing from this list?

Is there anything here you haven’t heard of?

research questions

PATH ID: R02_YH1034

Think about the last time you bought (or gave money to someone else to buy you) shisha or hookah tobacco. How much did you pay for it?

$ ______________________

DON'T KNOW

Tell me how you came up with your answer. PROBE ON WHETHER THERE WAS ANY DIFFICULTY COMING UP WITH COST.

How easy or difficult was it for you to answer this question? What made it easy or difficult?

IF R gave money to someone else to buy the SHISHA OR HOOKAH TOBACCO: Did you pay the person extra to buy the shisha or hookah tobacco for you? IF YES: Did you include that in your answer here?

Reasons to Use

BEFORE RESPONDENT SEES QUESTIONS, PROBE GENERALLY,
Tell me more about why you smoke hookah.

PATH ID: R02_YH1060

The next questions are about the reasons people smoke hookah. Please select which reasons [apply to you I applied to you when you used to smoke hookah].

I smoke hookah because…

It is affordable.

PATH ID: R02_YH1061

People in the media or other public figures smoke hookah.

PATH ID: R02_YH1085

I can smoke hookah at times when or in places where smoking cigarettes isn’t allowed.

PATH ID: R02_YH1062

It might be less harmful than smoking cigarettes.

PATH ID: R02_YH1063

Shisha or hookah tobacco comes in flavors I like.

PATH ID: R02_YH1064

Smoking hookah helps people to quit smoking cigarettes.

PATH ID: R02_YH1068

People who are important to me smoke hookah.

PATH ID: R02_YH1069

I like socializing while smoking hookah.

PATH ID: R02_YH1072

The advertising for hookah appeals to me.

PATH ID: R02_YH1073

Smoking hookah is part of my cultural tradition.

How easy or difficult was it to answer this series of questions?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_YX0307_REVISED_Hookah

Have you thought about switching from hookahs to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Traditional cigars
Cigarillos
Filtered cigars
Pipes
Snus pouches
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Use of Non-tobacco Products

research question

The next questions are about things other than shisha or hookah tobacco that someone might smoke in a hookah.

PATH ID: NEW_ HOOKAH MARIJUANA MISUSE YOUTH

Have you ever smoked marijuana from a hookah?

Tell me more about how you came up with your answer.

IF YES, how do you smoke marijuana from a hookah?

IF NEEDED, Is it just marijuana, or do you mix it with tobacco?

IF NO, have you heard of people smoking marijuana from a hookah? What have you heard about it?

PATH ID: NEW_ HOOKAH OTHER SUBSTANCES MISUSE YOUTH

Have you ever smoked anything else in a hookah?

In your own words, what is this question asking?

If YES, What else have you smoked in a hookah? Where did you learn that was something you could smoke from a hookah?

IF NO, Have you ever heard of people smoking something other than marijuana, shisha or hookah tobacco in a hookah? What have you heard? Where did you hear about it?

PATH ID: NEW_ HOOKAH LIQUID MISUSE YOUTH

Have you ever used another liquid besides water in the bowl of the hookah?

IF YES, What type of liquid did you use? Where did you first hear about using liquid other than water in a hookah?

IF NO, Have you ever heard of using a liquid other than water in the bowl of the hookah? What kinds of liquids? Where did you hear about them?

PATH ID: NEW_ SHISHA WITH TOBACCO CLARIFICATION YOUTH

Do you usually smoke shisha with tobacco when you smoke a hookah?

How do you know if shisha contains tobacco or not?

What kind of shisha do you usually smoke?

Smokeless Tobacco

Screening

R02_AST01_YOUTH

PATH ID: YS1002

Have you ever used any of the following smokeless tobacco products, even one or two times? Choose all that apply.

Snus pouches  MARK ON SKIP SHEET as snus user
Loose snus, moist snuff, dip, spit, or chewing tobacco  MARK ON SKIP SHEET as smokeless tobacco user
I have never used a smokeless tobacco product  go to Q15

Snus

if do not use snus  go to Q11

Use

PATH ID: R02_AU1003_SNUS_YOUTH

You mentioned that you have used snus pouches. There are many brands of snus pouches. Have you ever used the brand called Skoal Bandits?

Yes, I have used only Skoal Bandits  go to Q9
Yes, I have used both Skoal Bandits and other brands of snus pouches
No, I have not used Skoal Bandits
DON'T KNOW  go to Q9

R02_AUT01_YOuTH

The next questions are about snus pouches. Common brands of snus pouches include Camel snus, General snus, Marlboro snus, and Nordic Ice, but there are many others.

Please think about your use of snus pouches as you answer these questions.

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AS1003_SNUS_USENOW

Do you now use snus…

Every day
Some days
Rarely
Not at all  go to Q9

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF FREQUENCY OF USE.

In the past 30 days, how many days did you use snus?

How easy or difficult was it to choose your answer from this list of choices? In your own words, what is the difference between using snus pouches “some days” and using snus pouches “rarely”?

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_yS1130_SNUS

In the past 30 days, were any of the snus pouches you used flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q6
I don’t know  go to Q6
Didn’t use snus pouches in the past 30 days  go to Q6

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_yS1131_SNUS_WHICHFLAVORS

Which flavors have you used in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different pouch of snus, or did a single pouch of snus have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

PATH ID: R02_YS1146_SNUS

Some snus pouches comes in flavors like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets.

Is flavored snus pouches easier to use, about the same, or harder to use than unflavored snus pouches?

Easier to use
About the same
Harder to use

How did you decide on your answer?

What does “harder to use” mean? What does “easier to use” mean?

Have you heard of menthol or mint flavored snus pouches? What have you heard? In your own words, what is “menthol”?

What does “unflavored” snus pouchesmean to you? Would it make more sense if we asked about “regular” snus pouches?

Purchasing

research questions

PATH ID: R02_YS1034_SNUS_BOUGHT

Think about the last time you bought (or gave money to someone else to buy you) snus pouches. How much did you pay for it?

$ ______________________

DON'T KNOW

Tell me how you came up with your answer. PROBE ON WHETHER THERE WAS ANY DIFFICULTY COMING UP WITH COST.

How easy or difficult was it for you to answer this question? What made it easy or difficult?

IF R gave money to someone else to buy the SNUS POUCHES: Did you pay the person extra to buy the snus pouches for you? IF YES: Did you include that in your answer here?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_YX0307_REVISED_SNUS

Have you thought about switching from snus pouches to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Traditional cigars
Cigarillos
Filtered cigars
Pipes
Hookahs
Smokeless tobacco such as loose snus, moist snuff, dip, spit, or chewing tobacco
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Smokeless Tobacco

if do not use smokeless tobacco  go to Q15

The next questions are about your use of other kinds of smokeless tobacco, not including snus pouches. The questions will use the phrase “smokeless tobacco” to refer to these products.

Use

research question

Revised item. Testing inclusion of a fourth response category, “rarely.”

PATH ID: R02_AS1003_SMOKELESS_USENOW_YOUTH

Do you now use smokeless tobacco…

Every day
Some days
Rarely
Not at all  go to Q15

Tell me more about your answer. PROBE TO GET A BETTER SENSE OF FREQUENCY OF USE.

In the past 30 days, how many days did you use smokeless tobacco?

Flavor

Research questions

Previous testing showed some recall issues and difficulties assigning categories to flavors. Test if respondents can identify flavors and whether the list is exhaustive.

Additionally, try to tease out if respondents consider non-flavored products to be unflavored, regular, tobacco flavored, traditional, etc.

Some youth previously showed confusion on the meaning of “menthol.” Test further.

PATH ID: R02_yS1130_SMOKELESS

In the past 30 days, was any of the smokeless tobacco you used flavored to taste like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets?

Yes
No  go to Q12
I don’t know  go to Q12
Did not use smokeless tobacco in the past 30 days  go to Q12

IF NO, Are you familiar with these flavors? Which ones have you heard of?

IF NO, Was it flavored at all? Would you call it “unflavored” or “regular” or something else?

PATH ID: R02_yS1131_SMOKELESS_WHICHFLAVORs

Which flavors have you used in the past 30 days? Choose all that apply.

Menthol or mint
Clove or spice
Fruit
Chocolate
An alcoholic drink (such as wine, cognac, margarita or other cocktails)
Candy or other sweets
Some other flavor
DON'T KNOW

IF CANDY, FRUIT, OR SWEETS, PROBE FOR EXACT FLAVOR.

IF CHECK MULTIPLE FLAVORS, Was each flavor a different package of smokeless tobacco, or did a single package of smokeless tobacco have multiple flavors?

How easy/difficult was it for you to answer this question?

How confident are you in your response(s)?

Are there any flavors we left out?

PATH ID: R02_YS1146_SMOKELESS

Some smokeless tobacco comes in flavors like menthol, mint, clove, spice, fruit, chocolate, alcoholic drinks, candy or other sweets.

Is flavored smokeless tobacco easier to use, about the same, or harder to use than unflavored smokeless tobacco?

Easier to use
About the same
Harder to use

How did you decide on your answer?

What does “harder to use” mean? What does “easier to use” mean?

Have you heard of menthol or mint flavored smokeless tobacco? What have you heard? In your own words, what is “menthol”?

What does “unflavored” smokeless tobacco mean to you? Would it make more sense if we asked about “regular” smokeless tobacco?

Purchasing

research questions

PATH ID: R02_YS1034_SMOKELESS_BOUGHT

Think about the last time you bought (or gave money to someone else to buy you) smokeless tobacco. How much did you pay for it?

$ ______________________

DON'T KNOW

Tell me how you came up with your answer. PROBE ON WHETHER THERE WAS ANY DIFFICULTY COMING UP WITH COST.

How easy or difficult was it for you to answer this question? What made it easy or difficult?

IF R gave money to someone else to buy the SMOKELESS TOBACCO: Did you pay the person extra to buy the smokeless tobacco for you? IF YES: Did you include that in your answer here?

Switching

Research question

Earlier testing revealed that “switching” may not be a meaningful concept for all tobacco products (e.g., hookah users). Test further.

Test whether asking “Have you thought about…” works better than “Have you considered…” for respondents.

PATH ID: R02_YX0307_REVISED_SMOKeless

Have you thought about switching from smokeless tobacco to any of the following products? Choose all that apply.

I have not thought about switching to another product
Cigarettes
E-cigarettes
Traditional cigars
Cigarillos
Filtered cigars
Pipes
Hookahs
Snus pouches
Dissolvable tobacco

What reaction, if any, did you have to this question?
NOTE IF RESPONDENT FINDS CONCEPT OF “SWITCHING” TO BE INAPPROPRIATE FOR A PARTICULAR PRODUCT

In your own words, what does it mean to “switch” to another product?
PROBE IF RESPONDENT INTERPRETS IT AS GIVING THE FIRST PRODUCT UP COMPLETELY

If this question asked “Have you considered switching…” instead of “Have you thought about switching…”, would that have changed your answer? Why or why not?
Which do you prefer? Why?

Friends

research questions

PATH ID: Best friends smokeless tobacco

How many of your best friends smoke smokeless tobacco?

None
A few
Some
Most
All

How easy or difficult was it for you to answer this question? What made it easy or difficult?

Who were you thinking about when you answered this question? IF NEEDED: Were you thinking about specific people, or just about your friends in general?

How confident are you that [FILL ANSWER] of your best friends have smoked smokeless tobacco? What makes you confident/not confident?

Dissolvable Tobacco

Screening

Research questions

We need further testing of dissolvable tobacco items.

R02_ADT01_Youth

Dissolvable tobacco products come in a variety of shapes, including small round pellets, thin sticks and flat strips. Some common brands are Ariva, Stonewall, and Camel Orbs, Sticks or Strips.

YD1002

Have you ever used dissolvable tobacco products, such as Ariva, Stonewall, or Camel Orbs, Sticks, or Strips, even one or two times?

Yes
No  GO TO next module

IF YES, Tell me about the product you used. What was its name? How did you use it? What did it look like? Where did you get it?

Harm Module

ALL RESPONDENTS

Relative Harm

research question

Discover how respondents conceive the idea of “harm,” particularly when assigning relative harm among different tobacco products. Are respondents considering the intrinsic toxicity of different products (e.g., e-cigarettes have fewer carcinogens than regular cigarettes), the typical frequency of use (e.g., people usually only smoke hookah occasionally, but they smoke cigarettes every day), the delivery mechanism (e.g., cigars produce smoke that harm your lungs, while you just chew smokeless tobacco), or impact on others (e.g., items that product second-hand smoke are the worst because they harm others).

PATH ID: CARDSORT HARMFUL

I have here a set of cards with the name of different types of tobacco products.
What I’d like you to do is to sort the cards in a line from least harmful to most harmful. If you think two products are equally harmful, you can place them side-by-side.

ALLOW RESPONDENTS TO SORT CARDS. RECORD SORT ORDER IN YOUR NOTES.

Tell me how you decided the order of the cards.

IF NEEDED, How did you decide X was most harmful? That X was least harmful?

IF NEEDED, How did you decide X was more harmful than X? How did you decide X was less harmful than X? How did you decide these were equally harmful?

PROBE TO DETERMINE WHAT RESPONDENTS ARE CONSIDERING WHEN ASSIGNING RELATIVE HARM.

If you were thinking specifically about lung disease, would the order change? Why? What about emphysema? Or mouth cancer?

PATH ID: CARDSORT BLANK

I have here a blank card. It represents not using any tobacco product. Where would you place it?

Why did you place it here?

IF RESPONDENT FEELS NOT USING IS MORE HARMFUL THAN USING A PRODUCT, PROBE TO FIND OUT WHY.

PATH ID: CARDSORT ADDICTIVE

Now I’d like you to sort the cards from least addictive to most addictive.

Tell me how you decided the order of the cards.

IF NEEDED, How did you decide X was most addictive? That X was least addictive?

Advertising Claims about Relative Harm

Research question

Test asking about product-specific permutations rather than the current wording of AR0143 (If a tobacco product made a claim that it was less harmful to health than other tobacco products, how likely would you be to use that product?)

ask respondents only about products they currently use (REFER TO SKIP SHEET)
YOuth who do not use  go to next module

cigarettes

PATH ID: AR0143_Cigarettes

If a cigarette brand made a claim that it was less harmful to health than other cigarette brands, how likely would you be to use that product?

Very likely
Somewhat likely
Somewhat unlikely
Very unlikely

Tell me more about your answer. Why would you be {RESPONSE CHOICE} to use it?

What could make a particular brand less harmful than another brand?

If a brand claimed it was less harmful than other brands, how likely would you be to believe them? Why?

e-cigarettes

PATH ID: AR0143_E-Cigarette

If an e-cigarette brand made a claim that it was less harmful to health than other e-cigarette brands, how likely would you be to use that product?

Very likely
Somewhat likely
Somewhat unlikely
Very unlikely

Tell me more about your answer. Why would you be {RESPONSE CHOICE} to use it?

What could make a particular brand less harmful than another brand?

If a brand claimed it was less harmful than other brands, how likely would you be to believe them? Why?

cigar

AR0143_Cigar

If a traditional cigar brand made a claim that it was less harmful to health than other traditional cigar brands, how likely would you be to use that product?

Very likely
Somewhat likely
Somewhat unlikely
Very unlikely

Tell me more about your answer. Why would you be {RESPONSE CHOICE} to use it?

What could make a particular brand less harmful than another brand?

If a brand claimed it was less harmful than other brands, how likely would you be to believe them? Why?

cigarillo

PATH ID: AR0143_Cigarillo

If a cigarillo brand made a claim that it was less harmful to health than other cigarillo brands, how likely would you be to use that product?

Very likely
Somewhat likely
Somewhat unlikely
Very unlikely

Tell me more about your answer. Why would you be {RESPONSE CHOICE} to use it?

What could make a particular brand less harmful than another brand?

If a brand claimed it was less harmful than other brands, how likely would you be to believe them? Why?

filtered cigar

PATH ID: AR0143_Filtered Cigar

If a filtered cigar brand made a claim that it was less harmful to health than other filtered cigar brands, how likely would you be to use that product?

Very likely
Somewhat likely
Somewhat unlikely
Very unlikely

Tell me more about your answer. Why would you be {RESPONSE CHOICE} to use it?

What could make a particular brand less harmful than another brand?

If a brand claimed it was less harmful than other brands, how likely would you be to believe them? Why?

pipe

PATH ID: AR0143_Pipe

If a pipe tobacco brand made a claim that it was less harmful to health than other pipe tobacco brands, how likely would you be to use that product?

Very likely
Somewhat likely
Somewhat unlikely
Very unlikely

Tell me more about your answer. Why would you be {RESPONSE CHOICE} to use it?

What could make a particular brand less harmful than another brand?

If a brand claimed it was less harmful than other brands, how likely would you be to believe them? Why?

hookah

PATH ID: AR0143_Hookah

If a hookah tobacco brand made a claim that it was less harmful to health than other hookah tobacco brands, how likely would you be to use that product?

Very likely
Somewhat likely
Somewhat unlikely
Very unlikely

Tell me more about your answer. Why would you be {RESPONSE CHOICE} to use it?

What could make a particular brand less harmful than another brand?

If a brand claimed it was less harmful than other brands, how likely would you be to believe them? Why?

smokeless tobacco

PATH ID: AR0143_Smokeless Tobacco

If a smokeless tobacco brand made a claim that it was less harmful to health than other smokeless tobacco brands, how likely would you be to use that product?

Very likely
Somewhat likely
Somewhat unlikely
Very unlikely

Tell me more about your answer. Why would you be {RESPONSE CHOICE} to use it?

What could make a particular brand less harmful than another brand?

If a brand claimed it was less harmful than other brands, how likely would you be to believe them? Why?

dissolvable tobacco

PATH ID: AR0143_Dissolvable Tobacco

If a dissolvable tobacco brand made a claim that it was less harmful to health than other dissolvable tobacco brands, how likely would you be to use that product?

Very likely
Somewhat likely
Somewhat unlikely
Very unlikely

Tell me more about your answer. Why would you be {RESPONSE CHOICE} to use it?

What could make a particular brand less harmful than another brand?

If a brand claimed it was less harmful than other brands, how likely would you be to believe them? Why?

Media Module

ALL RESPONDENTS

RESEARCH QUESTION

Identify whether individuals use tobacco related applications rather than just downloading them. Test Items that ask about whether media has influenced the misuse of products. Test items that determine respondent level of engagement.

Internet Use

PATH ID: R02_AX0315

Do you ever go on-line to access the Internet or World Wide Web, or to send and receive e-mail?

Yes
No  go to Q18

General Use, Games, and Videos

PATH ID: R02_AX0489

In the past 12 months, have you done any of the following online? Choose all that apply.

Signed up for any email alerts about tobacco products, including e-cigarettes
Read any articles online about tobacco products, including e-cigarettes
Watched a video online about tobacco products, including e-cigarettes
None of the above

Tell me more about your answer.

PATH ID: NEW_ SocialMediaVideos

Have you ever used YouTube or another online video site to get information about a tobacco product or e-cigarette?

IF YES, what website did you use? Tell me more about the video that you saw PROBE TO FIND OUT CONTENT OF VIDEO.
IF NEEDED, Did any of the videos show how to modify or customize a tobacco product or e-cigarette?

Are there other kinds of videos about tobacco products you have seen online, what were they? How did you come across this video- were you actively searching for it or did you just happen to come upon it?

IF NO, Have you heard of online videos that talk about tobacco products or e-cigarettes? What kinds of videos have you seen or heard?

Social Media

PATH ID: R02_AX0062

Sometimes people use the Internet to connect with other people online through social networks like Facebook, Google Plus, YouTube, MySpace, Linkedin, Twitter, Tumblr, Instagram, Pinterest, or Snapchat. This is often called “social media.”

Do you have a social media account?

Yes
No  go to Q18

What reaction, if any, did you have to this list of examples of social media? Are there any that you feel don’t belong? Anything we should add?

Do you usually use the term “social media”? IF NO, is there another term you use?

IF YES, tell me about the social media accounts that you have. What kinds of things do you use them for?

IF NO, have you heard of social media accounts? Which have you heard of?

PATH ID: R02_AX0317

How often do you visit your social media accounts? Your best guess is fine.

Several times a day
About once a day
3-5 days a week
1-2 days a week
Every few weeks
Less often
Never  go to Q18

How easy or difficult was this question for you to answer?

IF R HAS MULTIPLE ACCOUNTS: You talked about using multiple social media accounts. Did you answer for a particular account, or did you average across all of them? PROBE TO SEE IF RESPONDENT HAD DIFFICULY GIVING A SINGLE FREQUENCY FOR MULTIPLE ACCOUNTS.

PATH ID: R02_AX0320

On a typical day, about how much time do you spend on social media sites? Your best guess is fine.

Up to 30 minutes
More than 30 minutes, up to 3 hours
More than 3 hours, up to 6 hours
More than 6 hours

How did you come up with your answer? How easy or difficult was it for you to come up with your answer?

What does a ‘typical day’ mean to you in this question?

PATH ID: R02_AX0321

In the past 12 months, have you seen content posted about tobacco products (including e-cigarettes) on social media sites?

IF YES, What have you seen and where did you see it?

PROBE TO SEE IF THEY ARE THINKING ABOUT THINGS THEY POST ON THEIR OWN WALL OR FROM THEIR OWN TWITTER HANDLE, VERSUS SOMETHING THAT JUST SHOWS UP IN THEIR NEWS FEED.

PATH ID: R02_AX0506

In the past 12 months, have you posted content about tobacco products (including e-cigarettes) on any of your social media accounts?

IF YES, What did you post? Where did you post it? IF NEEDED, Did you post on your own page or on other people’s pages?

IF NO, Do you post other types of things?
CONFIRM RESPONDENT UNDERSTANDS CONCEPT OF POSTING. Have you heard of or seen people post content related to tobacco? What kinds of things have you heard of or seen people post?

if never posted to ANYTHING  go to Q15

RESEARCH QUESTION

PATH ID: NEW_ SocialMedia Engagement

Do you follow an individual or company that posts about tobacco products on any of the following social media sites? Mark all that apply.

Blogs
Facebook
Twitter
Pinterest
YouTube
I don’t follow any

In your own words, what is this question asking?

IF FOLLOWS, Who do you follow? What type of content do they post?

PATH ID: NEW_ SOCIAL MEDIA SITE POSTS

Have you posted content related to tobacco (including e-cigarettes) on any of the following social media sites? Mark all that apply.

Blogs  MARK on Skip sheet
Facebook
Twitter
Pinterest  Mark on skip sheet
YouTube

In your own words, what is this question asking?

Are there other sites you use?

PATH ID: NEW_ SOCIAL MEDIA POSTS

What have you posted? Mark all that apply.

Photo of yourself using tobacco
Video of yourself using tobacco
Video of your friends using tobacco
Never posted these things

IF SELECTED ANYTHING BUT ‘NEVER’, tell me about the photo/video that you/your friends posted.

PATH ID: NEw_ SOCIAL MEDIA RE-TWEET

How often do you re-post or re-tweet someone else’s discussion, videos or photos of tobacco?

Never
Rarely
Sometimes
Often
Always

Tell me more about your answer. How did you decide between {ANSWER CHOICE} and {OPTION JUST ABOVE OR BELOW}?

IF ANYTHING OTHER THAN NEVER OR RARELY, What kinds of things have you re-posted or re-tweeted?

PATH ID: NEW_ SOCIAL MEDIA BLOG

if never posted to BLOGS  go to Q15

How often do you blog about quitting tobacco?

Never
Rarely
Sometimes
Often
Always

Tell me more about your answer. How did you decide between {ANSWER CHOICE} and {OPTION JUST ABOVE OR BELOW}?

What does it mean to have a blog post about quitting tobacco?

PATH ID: NEW _PINTEREST

if never posted to PINTEREST  go to Q16

Which of the following have you done on Pinterest?

Pinned a tobacco or e-cigarette product
Created a board related to tobacco
Liked a pin about tobacco or e-cigarette products

Tell me more about your answer. What kinds of products/items did you pin or like on pinterest?

PATH ID: R02_AX0686

Have you liked or followed any of the following brands on Facebook, Twitter or other social media sites?

Camel
Marlboro
Newport
Swisher Sweets
Blu
Fin
Vuse
NJOY
None of the above

In your own words, what is this question asking?
IF NEEDED, What does it mean to ‘like’ a brand? What does it mean to ‘follow’a brand?

FOR BRANDS CHECKED, What kinds of things does [BRAND] post about? Have you ever re-posted, shared or re-tweeted any content that [BRAND] posted?

PATH ID: R02_AX0687

Have you sent a link or information about any of the following brands to others on Facebook, Twitter or other social media sites?

Camel
Marlboro
Newport
Swisher Sweets
Blu
Fin
Vuse
NJOY
None of the above

IF YES, What did you share? Who did you share it with? How did you share it? PROBE TO SEE IN WHAT WAY THEY ARE SENDING IT (THROUGH PRIVATE MESSAGING, POSTING ON SOMEONE’S WALL, POSTING IT ON THEIR OWN WALL).

PATH ID: R02_AX0688

Have you played an online game related to any of the following brands?

Camel
Marlboro
Newport
Swisher Sweets
Blu
Fin
Vuse
NJOY
None of the above

IF YES, What game did you play? Tell me more about that game- how does it work? Where did you find the game?

IF NO, have you heard of any games related to any of these brands? What have you heard?

Apps

PATH ID: R02_AX0503

Please indicate if you have any of the following. Choose all that apply.

Tablet computer, such as an iPad, Samsung Galaxy, Motorola Xoom, or Kindle Fire
Smartphone, such as an iPhone, Android, Blackberry, or Windows phone
Cell phone
I do not have any of the above

if do not have tablet or smartphone  go to Q22

Is there anything that is missing from this list?

PATH ID: R02_AX0504

Have you ever used a tobacco-related application (or app) on your tablet computer or smart phone?

Yes
No  go to Q22

In your own words, what is a “tobacco-related app”?
PROBE TO DETERMINE BOTH FAMILIARITY WITH TERM “APP” AND THE CONCEPT OF A TOBACCO-RELATED APP.

IF YES, what kinds of apps have you used?

IF NO, have you heard of these kinds of apps? What ones have you heard of?

PATH ID: R02_AX0505

Have you ever used an app on your tablet computer or smart phone to help you quit using tobacco?

IF YES, what app did you use? Tell me more about how you use it. How did you hear about this app?

IF NO, Have you heard of any apps that help you quit using tobacco? What have you heard?

NEW_ ProTobaccoApp

Other than apps that help people quit smoking, have you ever used an app on your smart phone or tablet computer that is related to using tobacco products?

Yes
No
Don’t Know

IFYES, What app did you use? How did you use it? How did you hear about this app? Why did you decide to get this app?

IF NO, have you heard of any of these kinds of apps? Which have you heard of? What do you know about them?

Health Promotion

RESEARCH QUESTION

Test new health promotion items.

PATH ID: NEW_HealthPromotion1

In the past 12 months, have you seen or heard the following slogan or theme?

*X0192. Tips from Former Smokers (Tips) [INSERT PHOTO]
*X0199. Truth Campaign Brand [INSERT PHOTO]
*X0201. The Real Cost [INSERT PHOTO]
Haven’t seen or heard any of the above

IF SELECTED ANY, Tell me more about the slogan/theme you have seen or heard. Where did you hear/see it?

PATH ID: NEW_ HealthPromotion2

In the past 12 months, have you seen or heard of any ads on television or radio with the following themes or slogans?

*X0234. Tips from Former Smokers (Tips) [INSERT CAMPAIGN MESSAGE OR THEME]
*X0235. Truth Campaign Brand [INSERT CAMPAIGN MESSAGE OR THEME]
*X0236. The Real Cost [INSERT CAMPAIGN MESSAGE OR THEME]
*X0674. The Real Cost [INSERT CAMPAIGN MESSAGE OR THEME]
Haven’t seen or heard any of the above

IF SELECTED ANY, Tell me more about any ads you have seen on TV or radio with those themes/slogans.

Marketing and Promotion Items

RESEARCH QUESTION

Test items measuring respondent exposure to marketing and promotion tools.

PATH ID: R02_YX0477

In the past 30 days, have you received any discount coupons or promotions for tobacco products or e-cigarettes, whether it was online or some other way?

1 Yes
2 No  go to Q28

IF NO, Do you ever receive discount coupons or promotions?

PATH ID: R02_YX0478

Where did you get discount coupons or promotions from? Choose all that apply.

The mail
E-mail  MARK ON SKIP SHEET
The Internet
Social Networks (such as Facebook and Twitter)
A text message
On a cigarette pack or other tobacco product
From a friend or other person
Some other way: SPECIFY___________________

Are there any other places we should add to this list?

if did not receive via mail  go to Q27

PATH ID: R02_YX0216

Which products did you receive discount coupons or promotions for in the mail? Choose all that apply.

Cigarettes
E-cigarettes
Cigars
Smokeless tobacco
Other tobacco products

if did not receive via e-mail  go to Q28

PATH ID: R02_YX0204

Which products did you receive discount coupons or promotions for in an e-mail message? Choose all that apply.

Cigarettes
E-cigarettes
Cigars
Smokeless tobacco
Other tobacco products

PATH ID: R02_YX0182

In the past 30 days, how often did you visit a convenience store, small market, or liquor store?

Never  go to Q30
Once a month
2-3 times per month
Once a week
2-3 times per week
Almost every day

How easy or difficult was it to answer this question?

Are there other places besides the ones listed where you see tobacco ads?

PATH ID: R02_YX0183

In the past 30 days, when you visited convenience stores, small markets, or liquor stores, how often did you see ads for e-cigarettes?

Never
Rarely
Sometimes
Often

PATH ID: R02_YX0297

What is the brand of your favorite e-cigarette advertisement? Choose only one.

If you do not see the brand listed below, select “Something else”.

I do not have a favorite e-cigarette advertisement
Blu
eSmoke
Fin
GreenSmoke
Logic
MarkTen
NJOY
ProVape
Smoking Everywhere
Vapor King
Vuse
V2Cigs
Something else SPECIFY: __________________

Tell me about your favorite ad.

How easy or difficult was it to remember the brand? What made it easy/difficult?

PATH ID: R02_AX0475

In the past 30 days, have you seen a tobacco sweepstakes ad?

Have you ever seen a “tobacco sweepstakes ad”? IF YES, Describe it to me.

IF YES, tell me more about the ad you saw.

PATH ID: R02_AX0476

In the past 30 days, have you participated in a tobacco sponsored sweepstakes?

IF YES, tell me more about the sweepstakes you participated in.

IF do not use e-cigarette  go to Q34

PATH ID: R02_AX0678

In the past 30 days, have you gotten a free sample of an e-cigarette or e-liquid?

IF YES, what free sample did you get? Where or how did you get it?

IF NO, have you heard of people getting free samples of e-cigarettes or e-liquid?

PATH ID: R02_AX0481

In the past 30 days, have you gotten a free sample of a tobacco product?

IF YES, what free sample did you get?

PATH ID: R02_AX0223_NB

In the past 30 days, has this happened just once or twice, a few times, or quite regularly?

Once or twice
A few times
Quite regularly

PATH ID: R02_AX0203

In the past 30 days, have you noticed e-cigarettes being advertised in any of the following places?

On posters or billboards
In newspapers or magazines
On websites or social media sites
On radio
On television
At events like fairs, festivals, or sporting events
Haven’t noticed any advertisements

Tell me more about the e-cigarette ad(s) that you saw.

How easy or difficult was it to answer this? What made it easy/difficult?

Is there any place that you have seen advertising that we didn’t mention in this list?

When you were answering, were you thinking just about e-cigarettes, or were you including other electronic products such as e-hookah, e-cigars, or vape pens?

PATH ID: R02_AX0677

In the past 30 days, have you noticed cigarettes or other tobacco products being advertised in any of the following places?

On posters of billboards
In newspapers or magazines
On websites or social media sites
On radio
On television
At events like fairs, festivals, or sporting events
Haven’t noticed any advertisements

Tell me more about the cigarette ad(s) that you saw.

How easy or difficult was it to answer this? What made it easy/difficult?

Is there any place that you have seen advertising that we didn’t mention in this list?

Adult Demographics Module

Adult respondents

R02_AMT01 (MODIFIED)

Finally, we have a few additional questions about you, your income, and health insurance.

Income

asked of adult respondents

Research question

Do respondents have difficulty reporting their income within the response categories given, and do they include all types of income specified?

PATH ID: R02_AM0030

Which of the following categories best describes your total household income in the past 12 months?

This is the total income before taxes of all persons in your household combined. Please include money from jobs, relatives, pensions, dividends, interest, social security payments or retirement benefits, net income from business, farm or rent, and any other money received by household members.

Less than $10,000  go to Q3
$10,000 to $14,999  go to Q3
$15,000 to $24,999  go to Q3
$25,000 to $34,999  go to Q3
$35,000 to $49,999  go to Q3
$50,000 to $74,999  go to Q3
$75,000 to $99,999  go to Q3
$100,000 to $149,999  go to Q3
$150,000 to $199,999  go to Q3
$200,000 or more  go to Q3
DON'T KNOW

How easy or difficult was it to answer this question? What made it easy or difficult?

You don’t have tell me specific amounts, but can you tell me what types of income you included when you were coming up with your answer?

IF NEEDED, Did you include everyone in your household?

IF NEEDED, Did you include money you might have received from relatives?

IF NEEDED, Did you include other types of income, such as social security or retirement benefits, alimony, interest from investments, or money from a part-time job?

PATH ID: R02_AM0031

Is your total household income during the past 12 months above or below $50,000?

Above $50,000
Below $50,000
DON'T KNOW

How confident are you of your answer?

How easy or difficult was it to decide whether it was above or below $50,000?

Residence

asked of young adult respondents

if age 25 or up  go to Q7

Research question

Do young adults (particularly college students) have difficulty selecting a single response? Is the list comprehensive and mutually exclusive?

PATH ID: R02_AM0038

Where do you currently live?

At home with parents or guardians
In a dorm or other campus housing
In a fraternity or sorority house
In an apartment, condo or house on my own (without a spouse, children or roommates)
In an apartment, condo or house with a spouse or romantic partner
In an apartment, condo or house with friends or other roommates
In an apartment, condo or house with another relative or family friend
Someplace else

Tell me more about where you currently live.

IF NEEDED: Do you live here year-round? IF NO, Where else do you live? How did you decide how to answer?

IF RESPONDENT SELECTS MORE THAN ONE, Tell me about your answer.
NOTE IF RESPONDENT IS SELECTING MULTIPLE BECAUSE THEIR RESIDENCE CHANGES THROUGHOUT THE YEAR, OR BECAUSE MULTIPLE OPTIONS APPLY (E.G., LIVES WITH BOYFRIEND AND OTHER ROOMATES).
If you had to select only one response, how would you decide which one to pick?

What do you think of these answer choices? Are there any that seem out-of-place, or anything we should add?

Ladder

asked of young adult respondents

Research question

Identify if young adults have difficulty answering this question, particularly college students who may currently have little money and no job, but are obtaining an education and expect to have a respected job.

PATH ID: R02_AM0040

Think of this ladder as representing where people stand in the United States.

At the top of the ladder (step 10) are the people who have the most money and education, and the most respected jobs.

At the bottom of the ladder (step 1) are the people who have the least money and education, and the least respected jobs or no job.

W here would you place yourself on this ladder? Pick the number for the step that shows where you think you stand at this time in your life, relative to other people in the United States.

Ten
Nine
Eight
Seven
Six
Five
Four
Three
Two
One

How easy or difficult was it to answer this question? What made it easy or difficult?

How did you decide on your answer?

Parents Income

asked of young adult respondents

Research question

Do respondents have difficulty reporting their parents’ income within the response categories given, and do they include all types of income specified?

PATH ID: R02_AM0036

Which of the following categories best describes your parents’ total household income in the past 12 months?

This is the total income before taxes of all persons in your parents’ household combined. Please include money from jobs, relatives, pensions, dividends, interest, social security payments or retirement benefits, net income from business, farm or rent, and any other money received by household members.

Less than $10,000  go to Q7
$10,000 to $14,999  go to Q7
$15,000 to $24,999  go to Q7
$25,000 to $34,999  go to Q7
$35,000 to $49,999  go to Q7
$50,000 to $74,999  go to Q7
$75,000 to $99,999  go to Q7
$100,000 to $149,999  go to Q7
$150,000 to $199,999  go to Q7
$200,000 or more  go to Q7
DON'T KNOW

How easy or difficult was it to answer this question? What made it easy or difficult?

How confident are you in your answer?

IF NEEDED, Did you include things such as social security or retirement benefits, alimony, interest from investments, or gifts from relatives? Would you know how much those amounts are?

PATH ID: R02_AM0037

Is your parents’ total household income during the past 12 months above or below $50,000?

Above $50,000
Below $50,000
DON'T KNOW

How confident are you of your answer?

How easy or difficult was it to decide whether it was above or below $50,000?

Health Insurance

asked of ADULT respondents

Research question

Do respondents have any difficulty reporting their type of health insurance?

PATH ID: R02_AM0026

Are you currently covered by any of the following types of health insurance or health coverage plans?

Insurance through a current or former employer or union (of yourself or a family member)
Insurance purchased directly from an insurance company (by yourself or a family member)
Medicare, for people 65 and older, or people with certain disabilities
Medicaid, Medical Assistance, or any kind of government-assistance plan for those with low incomes or a disability
TRICARE or other military health care
VA (including those who have ever enrolled for or used VA health care)
Indian Health Service
Any other type of health insurance or health coverage plan
I don’t have health insurance
DON'T KNOW

How easy or difficult was it to answer this question? What made it easy/difficult?

Are you familiar with “VA health care”? If we asked about “Veterans Affairs Health Care” instead would that be more or less clear? Why?

PATH ID: R02_AM0029

To your knowledge, compared to people who don’t use tobacco, do you pay more for your health insurance coverage because of your tobacco use?

IF YES, How do you know you pay more?

Youth Demographics Module

YOUTH respondents

Allowance

asked of YOUTH respondents

Research question

Do respondents whose allowance is monthly, or who have irregular income have difficulty giving an average for each week?

PATH ID: R02_YM0008

During an average week, how much money do you receive in total? Please include money from a job, your family, an allowance, or any other sources.

None
Less than $1
$1 to $5
$6 to $10
$11 to $20
$21 to $50
$51 to $100
$101 to $150
$151 or more
DON'T KNOW

How easy or difficult was it to answer this question? What made it easy or difficult?

Does the amount of money you receive vary widely from week to week or is it typically the same amount each week?
IF VARIES, How did you decide on your answer?

Adult Pregnancy Module

adult females under the age of 40 who are/have been pregnant

research questions

During previous phases of testing, respondents have exhibited social desirability when answering this series. In addition to assessing respondents’ overall reactions for the whole pregnancy module, we are particularly interested in applicability of the new alcohol consumption items, which ask respondents to report average weekly alcohol consumption by trimester, rather than for an entire pregnancy. We are also concerned about respondents’ understanding and interpretation of the phrase “developmental delays.”

PATH ID: R02_AX0134

The next questions are about your pregnancy history.

Have you ever been pregnant? Please include current pregnancy, live births, miscarriages, abortions, ectopic or tubal pregnancies and stillbirths.

Yes
No  go to next module
Don’t know  go to next module

PATH ID: R02_AX0135_NB

Have any of your pregnancies ended in the following? Choose all that apply.

Miscarriage
Abortion
Ectopic or tubal pregnancy
Stillbirth
None of the above
Don’t know

Are there any terms that you were unfamiliar with?

PATH ID: R02_AX0308_NB

How many of your pregnancies have resulted in a live birth?

___________________________________

None  go to Q6

PATH ID: R02_AX0300_NB

For those births, did any of the following occur? Choose all that apply.

Preterm birth (birth of baby less than 37 weeks gestational age)
Baby with low birth weight (less than 5 pounds 8 ounces)
Baby with birth defects
Placenta Previa
Placenta Abruption
Pre-eclampsia
None of the above

Are there any terms that you were unfamiliar with?

if low weight did not occur  go to Q6

research questions

We are concerned whether respondents understand the phrase “developmental delays” as intended and whether they have any reaction to being asked this item in conjuction with the alcohol and smoking items.

PATH ID: R02_AX0299

Do any of your children have any developmental delays?

Yes
No
Don’t know

In your own words, what is this question asking?

IF NEEDED: What does the phrase “development delays” mean to you?

PATH ID: R02_AX0136

Are you pregnant now?

Yes
No  go to Q8
Don’t know  go to Q8

PATH ID: R02_AX0137

How many months or weeks pregnant are you? Please enter the number of months or weeks.

I___I___I Months I___I___I Weeks  go to Q9

Don’t know  go to Q9

PATH ID: R02_AX0309

In thinking of your most recent pregnancy, in what year did you become pregnant?

I___I___I___I___I

Don’t know

research items

Respondents may have difficulty reporting alcohol consumption before pregnancy.

The next questions are about drinking alcohol around the time of your most recent pregnancy. (If you are currently pregnant, answer for this pregnancy.)

A drink is a can or bottle of beer; a wine cooler or a glass of wine, champagne, or sherry; a shot of liquor or a mixed drink or cocktail.

PATH ID: NEW PREGNANCY 1

During the 3 months before you got pregnant, how many alcoholic drinks did you have in an average week?

14 drinks or more a week
7 to 13 drinks a week
4 to 6 drinks a week
1 to 3 drinks a week
Less than 1 drink a week
I didn’t drink then  go to q11

PATH ID: NEW PREGNANCY 2

During the 3 months before you got pregnant, how many times did you drink 4 alcoholic drinks or more in one sitting? A sitting is a two hour time span.

6 or more times
4 to 5 times
2 to 3 times
1 time
I didn’t have 4 drinks or more in 1 sitting

research items

We are concerned with respondents’ reactions to, and applicability of, the new alcohol consumption items. Instead of asking about the “average week” over the course of the entire pregnancy, we are now asking about the “average week” by trimester. We want to know whether respondents are able to answer by trimester and how easy or difficult it is to respond to these items.

PATH ID: NEW PREGNANCY 3

During the first trimester of your pregnancy, how many alcoholic drinks did you have in an average week?

14 drinks or more a week
7 to 13 drinks a week
4 to 6 drinks a week
1 to 3 drinks a week
Less than 1 drink a week
I didn’t drink then  go to q13

PATH ID: NEW PREGNANCY 4

During the first trimester of your pregnancy, how many times did you drink 4 alcoholic drinks or more in one sitting? A sitting is a two hour time span.

6 or more times
4 to 5 times
2 to 3 times
1 time
I didn’t have 4 drinks or more in 1 sitting

PATH ID: NEW PREGNANCY 5

During the second trimester of your pregnancy, how many alcoholic drinks did you have in an average week?

14 drinks or more a week
7 to 13 drinks a week
4 to 6 drinks a week
1 to 3 drinks a week
Less than 1 drink a week
I didn’t drink then  go to Q15
My pregnancy did not reach (or has not yet reached) the second trimester  go to next module

PATH ID: NEW PREGNANCY 6

During the second trimester of your pregnancy, how many times did you drink 4 alcoholic drinks or more in one sitting? A sitting is a two hour time span.

6 or more times
4 to 5 times
2 to 3 times
1 time
I didn’t have 4 drinks or more in 1 sitting

PATH ID: NEW PREGNANCY 7

During the third trimester of your pregnancy, how many alcoholic drinks did you have in an average week?

14 drinks or more a week
7 to 13 drinks a week
4 to 6 drinks a week
1 to 3 drinks a week
Less than 1 drink a week
I didn’t drink then  go to next module
My pregnancy did not reach (or has not yet reached) the /third trimester  go to next module

PATH ID: NEW PREGNANCY 8

During the third trimester of your pregnancy, how many times did you drink 4 alcoholic drinks or more in one sitting? A sitting is a two hour time span.

6 or more times
4 to 5 times
2 to 3 times
1 time
I didn’t have 4 drinks or more in 1 sitting

In your own words, what is a “trimester”?

How easy or difficult was it to answer this series of questions about how many alcoholic drinks you had during your pregnancy? What made it easy or difficult?

IF NEEDED: How easy or difficult was it to answer alcohol consumption by trimester?

How easy or difficult was it to answer about alcohol consumption in the three months before you were pregnant? What made it easy or difficult?

What does the phrase “average week” mean to you?

Youth Health Module

Youth Respondents

REsearch Question

Conduct testing of item revisions with youth to ensure they understand that the question is asking about a health condition rather than an isolated incident.

PATH ID: R02_YX0239

Do you have shortness of breath compared to your peers?

In your own words, what is this question asking about?

IF NEEDED, what does it mean to have ‘shortness of breath compared to your peers’?

How confident of your answer are you?

IF NEEDED, How do you know if your peers experience shortness of breath?

PATH ID: R02_YX0240

Is it hard to exercise compared to your peers?

In your own words, what is this question asking about?

IF NEEDED, what does ‘hard to exercise compared to your peers’ mean?

How confident are you of your answer?

How do you know if your peers have a hard time exercising?

PATH ID: R02_YX0046

Have you ever had wheezing or whistling in the chest at any time in the past?

Yes
No  go to Q6

What does it mean to have ‘wheezing or whistling’ in your chest?

How often has/does this happen[ed]? When does the wheezing or whistling happen (e.g., exercise, when you are sick, at night, all the time)?

PATH ID: R02_YX0048

How many attacks of wheezing have you had in the past 12 months?

None  go to Q6
1 to 3
4 to12
More than 12

In your own words, what is this question asking? IF NEEDED, What does it mean to have an ‘attack of wheezing’?

How easy or difficult was it to answer this? IF NEEDED, How did you remember how many ‘attacks of wheezing’ you had?

PATH ID: R02_YX0050

In the past 12 months, has wheezing ever been severe enough to limit your speech to only one or two words between breaths?

In your own words, what is this question asking?

What does it mean to have wheezing that is severe enough to limit your speech?

PATH ID: R02_YX0053

In the past 12 months, have you had a dry cough at night, apart from a cough associated with a cold or chest infection?

Tell me how you came up with your answer.
CONFIRM RESPONDENTS ARE ONLY THINKING ABOUT A DRY COUGH AT NIGHT AND EXCLUDING COLDS OR CHEST INFECTIONS.

How easy or difficult was it to answer this question? What made it easy/difficult?

In your own words, what is a ‘dry cough’?

Adult Barcode Scanning Module

adult tobacco users

Reserch questions

The barcode scanning section is being revised for Wave 2 and includes two new interviewer-administered questions. The purpose of testing is to refine and streamline the scanning procedures, instructions and question wording. We want to know whether respondents understand the introduction and whether they might be willing to comply.

Next, I’d like you to read some instructions that will appear at the end of the actual survey. Once you have finished reading, please let me know when you are finished.

PATH ID: R02_AX0214

We would like to scan the bar code on any tobacco products that you have right now for your own use. We are only interested in the products that you have used or intend to use soon.

Our interviewer will do the scanning for you. The interviewer will also ask you a couple of questions about the products we are scanning. Other people in your home might see the products as you hand them to the interviewer or hear the questions we ask you about the products. Is it OK to scan your tobacco products now?

What do you think about what you just read? What do you think might happen next?

How likely do you think you would be to let the interviewer scan your products? Why is that?

IF NEEDED: How do you think the scanning will work? Why do you think we are scanning the products?

I don’t have a scanner with me, but I’d like to ask you a few questions about each product you use. Do you have any of your products with you today?

IF NO: GO TO NEXT MODULE

IF YES: ASK THE FOLLOWING ITEMS FOR EACH PRODUCT R HAS WITH HIM/HER.

PATH ID: R02_AX0233_1

Think about the very last time you used this type of tobacco. Was it from this specific package or container?

Yes
No
DON'T KNOW

PATH ID: R02_AX0232_1_ITAH

How much did you pay for this?

$_________ . ______

DOLLARS CENTS

DON'T KNOW

FOR EACH PRODUCT, NOTE ANY DIFFICULTY RESPONDENTS HAVE ANSWERING QUESTIONS ABOUT A GENERIC “THIS” INSTEAD OF THE SPECIFIC PRODUCT NAME.

AFTER ASKING ABOUT ALL PRODUCTS:

How easy or difficult was it to answer these questions about your products? What made it easy or difficult?

How confident are you in each of your answers?

Public reporting burden for this collection of information is estimated to average 56 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. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0663). Do not return the completed form to this address.

File Type	application/vnd.openxmlformats-officedocument.wordprocessingml.document
Author	Stephanie Beauvais
File Modified	0000-00-00
File Created	2021-01-30

6 Study Protocol - Spanish

Generic Clearance for Cognitive Testing of Instrumentation and Materials for the PATH Study (NIDA)

PATH OMB Attachment F English-Language Protocols 072214

Cognitive Interviews to Support Development of Questionnaire Items for Wave 3

OMB: 0925-0663

Table of Contents

Screening and Polyuse Module

Screening

Polyuse

Electronic Products

Screening

E-cigarette

Use

Flavor

Switching

Other Electronic Nicotine Devices

E-cigarettes

Description and Image

Determining Type

Disposable E-cigarettes

Dosage

Modification

Non-refillable Cartridges

Dosage

Modification

Refillable Cartridges or Tank

Dosage

Modification

Use of Non-tobacco Products

E-cigarette Nicotine Dependence

Dependency items

Quitting

Withdrawal

Considered quitting

Adult Hookah Module

Screening

Flavor

Switching

Hookah

Frequency of Use

Ownership and How/Where to use

Purchasing

Regular Brand

Reasons to Use

Use of Non-tobacco Products

Hookah Nicotine Dependence

Dependency items

Quitting

Withdrawal

Considered quitting

Adult Nicotine Dependence Module

Dependency items

Quitting

Withdrawal

Considered quitting

Youth Nicotine Dependence

Adult Tobacco Use Module

Cigarettes

Screening

Flavor

Switching

Cigars

Screening

Traditional cigars

Use

Flavor

Switching

Cigarillos

Use

Flavor

Switching

Filtered cigars

Use

Flavor

Switching

Use of Non-tobacco Products

Screening

Pipes

Screening

Flavor