F. Consent for Participation in a In-person Focus Group for

Consent for Participation in a Focus Group for the
Population Assessment of Tobacco and Health (PATH) Study
The Population Assessment of Tobacco and Health or PATH Study is a longitudinal data collection
by the National Institutes of Health (NIH), through the National Institute on Drug Abuse (NIDA), in
partnership with the Food and Drug Administration (FDA). NIDA is conducting the PATH Study
through Westat, the prime contractor.
As part of the PATH Study, Westat is partnering with the American Legacy Foundation to conduct
focus groups on e-cigarette and hookah use. This focus group will last about an hour and a half.
You will receive $40.00 after the focus group to thank you for your participation.
Your participation is voluntary. You may choose not to answer any questions, and you can stop
participating at any time.
From time to time, researchers from NIDA and FDA may observe the focus group discussion.
There are no known risks to you for taking part in this focus group. Your name will never be linked
to your comments nor will it appear in any written reports or publications. There are no direct
benefits to you for taking part in this focus group, but your comments will help the PATH Study
develop new questions about e-cigarette and hookah use to improve its measurement of use
behaviors. This focus group will be audio-recorded. The recording and any study materials that
identify you will be destroyed within three months after completion of the study.
If you have any questions about this study, contact Jennifer Pearson at (202) 454-5768. If you
have questions about your rights and welfare as a research participant, please call the Westat
Human Subjects Protections office at 1-888-920-7631. Please leave a message with your full
name, the name of the research study that you are calling about, and a phone number beginning
with the area code. Someone will return your call as soon as possible.
If you agree to participate in this focus group, please read the following statement and sign your
name below.

I have read the information above about this project and my rights as a participant. I consent to
participate in this research and to have this discussion audio taped.

Signature: ___________________________________________ Date: _________
Print Name: __________________________________________