Survey

Testing and Evaluation of Tobacco Communication Activities

Att 1b - Survey Main Subpopulations v20

Copy Testing of Television and Print Ads

OMB: 0920-0910

Document [docx]
Download: docx | pdf

Form Approved

OMB No. 0920-0910

Exp. Date 01/31/2015









National Tobacco Prevention and Control Public Education Campaign:


Copy testing of television ads
for current smokers
who are active military or veterans,
have anxiety or depression,
or
are lesbian, gay,
bisexual, or transgender

Main Questionnaire



















Public reporting burden of this collection of information is estimated to average 20 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 CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0910).

{PREAMBLE SHOWN DURING SCREENER}

On behalf of the Centers for Disease Control and Prevention (CDC), we're conducting a study about health and smoking-specific advertising that you see in the media. Your opinions are very important to us! Please be assured that the purpose of this survey is to gather feedback regarding health and smoking-specific advertising. We will not report your answers individually and will only report the results from this survey for all participants combined. Thank you for taking the time to help us!


Your participation in this survey is voluntary.



Section: Attitudes and Behaviors


Overall Health Impression

OH1. Would you say your health in general is excellent, very good, good, fair, or poor?

  1. Excellent

  2. Very Good

  3. Good

  4. Fair

  5. Poor


Tobacco Smoking Behavior

{PREAMBLE}

The next questions are about traditional tobacco cigarettes which are any roll of tobacco wrapped in paper. Below is an image of a traditional tobacco cigarette.

{Base = all qualified smokers}

TS1. On average, how many traditional tobacco cigarettes do you now smoke a day?

[1 PACK = 20 TRADITIONAL TOBACCO CIGARETTES]

[RANGE 1-100]


{Numeric response}


{Base = Respondents who SMOKE EVERY DAY (IF TS2 = 1)}

TS2. When do you typically have your first traditional tobacco cigarette after waking up?

  1. Within 5 minutes

  2. 6-30 minutes

  3. 31-60 minutes

  4. After 60 minutes


{Base = current smokers}

TS3. How old were you the first time you smoked part or all of a traditional tobacco cigarette, even one or two puffs? Please enter age in years.

_ _ _ age in years


{Base = current smokers}

TS4. Where do you smoke most often?

  1. At home

  2. At work

  3. Friend’s or family’s house

  4. In my car or other type of vehicle

  5. Someone else’s car or other type of vehicle

  6. At a party

  7. At a restaurant

  8. At a bar

  9. Outdoors

  10. Somewhere else (other specify)


{Base = Current smokers}

P1. Please rank the top two reasons why you smoke traditional tobacco cigarettes where “1” is the main reason and “2” is the second most important reason.

{RANDOMIZE}

  1. Smoking traditional tobacco cigarettes is a social thing to do when I’m out with friends

  2. Smoking traditional tobacco cigarettes is something to do at parties

  3. I’m addicted to smoking

  4. Smoking traditional tobacco cigarettes goes well with/after meals

  5. I like the taste of tobacco cigarettes

  6. Smoking traditional tobacco cigarettes helps me relax

  7. Smoking traditional tobacco cigarettes goes well when I’m drinking alcohol

  8. Smoking traditional tobacco cigarettes helps me stay awake

  9. Smoking traditional tobacco cigarettes helps when I’m stressed

  10. Smoking traditional tobacco cigarettes excites me

  11. Smoking traditional tobacco cigarettes is something to do when I’m bored

  12. Smoking traditional tobacco cigarettes helps me lose weight / not gain weight

  13. I have tried to quit smoking traditional tobacco cigarettes and cannot

  14. Smoking traditional tobacco cigarettes is something I can do with others while working

  15. It helps me when I’m depressed

  16. It helps me when I’m anxious

  17. Other specify


{Base = current smokers}

PA9. How much do you agree or disagree with each of the following statements?

  1. I know everything/almost everything there is to know about the physical effects of smoking traditional tobacco cigarettes

  2. I wish I knew more about the physical effects of smoking traditional tobacco cigarettes

  3. I think that smoking traditional tobacco cigarettes is addictive

  4. Nicotine Replacement Therapy, such as nicotine gum or patch, makes it easier to quit smoking traditional tobacco cigarettes


PA10b. How much do you agree or disagree with each of the following statements?

  1. There’s nothing wrong with smoking traditional tobacco cigarettes

  2. Smoking traditional tobacco cigarettes is not such a big deal, it’s just a lot of negative hype

  3. I would consider quitting smoking traditional tobacco cigarettes because I don’t want to harm my family or friends with second-hand smoke

  4. Smoking traditional tobacco cigarettes seems acceptable because I see it all the time in movies and/or on TV shows

  5. When someone quits smoking traditional tobacco cigarettes, the risk of getting a tobacco-related illness goes down a lot or goes away

  6. Smoking traditional tobacco cigarettes is a reward

  7. I have more respect for people who have quit smoking traditional tobacco cigarettes than for people who have never smoked

  8. Non-smokers don’t want to date someone who smokes traditional tobacco cigarettes

  9. People who smoke traditional tobacco cigarettes have more friends

  10. There is nothing wrong with using electronic cigarettes/e-cigarettes


Scale for each of the items in PA10b:

  1. Strongly agree

  2. Somewhat agree

  3. Neither agree nor disagree

  4. Somewhat disagree

  5. Strongly disagree


{Base = current smokers}

PA4. How much does smoking traditional tobacco cigarettes relieve stress for you?

  1. Extremely stress-relieving

  2. Very stress-relieving

  3. Somewhat stress-relieving

  4. Slightly stress-relieving

  5. Not at all stress-relieving


{Base=current smokers}

PA24. Would quitting smoking traditional tobacco cigarettes positively or negatively impact your relationship with family or friends?

  1. It would positively impact my relationship with family or friends

  2. It would positively impact some relationships with some family or friends, and negatively impact some relationships with other family or friends

  3. It would neither positively nor negatively impact my relationship with family or friends

  4. It would negatively impact my relationship with family or friends


{Base = current smokers}

PA2. How dangerous or safe do you think smoking traditional tobacco cigarettes is?

  1. Very dangerous

  2. Dangerous

  3. Neither dangerous nor safe

  4. Safe

  5. Very safe


{Base = All Smokers}

PA27. If you had to do it over again, would you have started smoking traditional tobacco cigarettes? Would you say...

  1. Definitely not

  2. Probably not

  3. Probably yes

  4. Definitely yes

  5. Not Sure


E-cigarette Use and Alternative forms Of Tobacco


{PREAMBLE}

The next questions are about electronic vapor products, which include e-cigarettes or electronic cigarettes. For the purposes of this study, we will use the words “electronic cigarette/e-cigarette.” An electronic vapor product can looks like a traditional tobacco cigarette, but it runs on a battery and produces vapor instead of smoke. There are several hundred brands of electronic vapor products, which come in a variety of different sizes, shapes, and flavors.



E1a. Have you ever used electronic cigarettes or e-cigarettes, such as NJOY, Blu or LOGIC, even one time?


  1. Yes

  2. No


{Base = Answers Yes to E1a}

E2. Do you now use electronic cigarettes or e-cigarettes….

  1. Every day

  2. Some days

  3. Rarely

  4. Not at all


{Base = uses e-cigarettes every day or some days}

D100e. How old were you the first time you used electronic cigarettes or e-cigarettes? Please enter age in years.

_ _ _ age in years



{Base = Answers E2.01 or E2.02}

E1b. Do you usually use disposable electronic cigarettes/e-cigarettes, an electronic cigarette/e-cigarette that uses cartridges, or an electronic cigarette/e-cigarette that uses tanks?

  1. Disposable electronic cigarettes/e-cigarettes

  2. Electronic cigarette/e-cigarette that uses cartridges

  3. Electronic cigarette/e-cigarette that uses tanks


{Base = Answers E2.01 or E2.02 or E2.03}

E10a. Did you start using electronic cigarettes/e-cigarettes to reduce the health risk of smoking traditional tobacco cigarettes?

  1. Yes

  2. No

{Base = current smokers}

E11. Do you believe there are health benefits to using electronic cigarettes/e-cigarettes even if you keep smoking traditional tobacco cigarettes as well?

  1. Yes

  2. No



{Base = current smokers & those who do not use e-cigs every day, some day or rarely}

E2. How likely are you to use electronic cigarettes or e-cigarettes, for any reason, in the future?

  1. Very Likely

  2. Likely

  3. Neither Likely nor Unlikely

  4. Unlikely

  5. Very Unlikely


{Base = current smokers}

E3. Have you ever used chewing tobacco, snuff, or dip, such as Redman, Levi Garrett, Beechnut, Skoal, Skoal Bandits, or Copenhagen?

  1. Yes

  2. No


{Base = current smokers}

E5. is a spitless smokeless tobacco usually sold in individual or pre-packaged small pouches that are placed under the lip against the gum. Have you ever used snus, such as Camel Snus or Marlboro Snus?

  1. Yes

  2. No


{Base = uses chewing tobacco}

D100a. How old were you the first time you used chewing tobacco, snuff or dip? Please enter age in years.

_ _ _ age in years


{Base = uses snus}

D100b. How old were you the first time you used snus? Please enter age in years.

_ _ _ age in years



E7. Do you think there are health risks associated with using smokeless tobacco products, such as chewing tobacco, snuff, dip, or snus, or are there no health risks from using them?

  1. There are definitely health risks associated with using smokeless tobacco products

  2. There are probably some health risks associated with using smokeless tobacco products

  3. There are probably no health risks associated with using smokeless tobacco products

  4. There are definitely no health risks associated with using smokeless tobacco products


PA201. Do you believe there are health benefits to using chewing tobacco, snuff or dip even if you keep smoking traditional tobacco cigarettes as well, if it means that you cut down smoking even one or two cigarettes?

  1. Yes

  2. No


PA202. Do you believe there are health benefits to using snus, even if you keep smoking traditional tobacco cigarettes as well, if it means that you cut down smoking even one or two cigarettes?

  1. Yes

  2. No


{BASE = used chewing tobacco}

E10b. Did you start using chewing tobacco, snuff or dip in order to cut down smoking traditional tobacco cigarettes?

  1. Yes

  2. No


{BASE = used snus}


E10c. Did you start using snus in order to cut down smoking traditional tobacco cigarettes?

  1. Yes

  2. No


{Base = current smokers}

PA11. How stressed, if at all, would you say you are by each of the following?

  1. Issues related to job/work

  2. Taking care of other family members (children, parents, etc.)

  3. Expectations of family and friends

  4. Technology

  5. Your weight / physical appearance

  6. Your health

  7. Money / Paying Bills

  8. Saving for the future

  9. Societal expectations

  10. Your relationship with your spouse or significant other

  11. Your relationships with other family members (children, parents, etc.)

  12. You relationships with friends

  13. Other specify


Scale for each of the items in PA11:

  1. Not Stressed At All

  2. Somewhat Stressed

  3. Very Stressed

  4. Extremely Stressed

  1. Does Not Apply


{Base = answers 02-04 to PA11}

PA12a. Of the stresses you selected in the last question, for which ones do you use traditional tobacco cigarette smoking as a stress-reliever, if at all?

{Show the answers selected in PA11 where respondent answered 03, 04 or 05}


Scale for each of the selected items in PA12:

  1. I use traditional tobacco cigarette smoking to relieve stress

  2. I do not use traditional tobacco cigarette smoking to relieve stress




Quit Attempts


{Base = current traditional tobacco cigarette smokers}

QA1. During the past 3 months, how many times have you stopped smoking for one day or longer because you were trying to quit smoking traditional tobacco cigarettes for good?


_____ Number of times


{Base = current smokers}

QA20. Have you ever stopped smoking traditional tobacco cigarettes for more than 30 days?

  1. Yes

  2. No

  3. DON’T KNOW/NOT SURE

  4. REFUSED


{Answered 01 to QA20 yet are current (relapsed) smokers}

QA26. What was the date you last stopped smoking traditional tobacco cigarettes for more than 30 days?


{CALENDAR PICKER + Data Entry for Month, Day, and Year}


{Answered 01 to QA20 yet are current (relapsed) smokers}

QA6. Did you use electronic cigarettes/e-cigarettes to help you stop smoking?

  1. Yes

  2. No


{Answered 01 to QA20 yet are current (relapsed) smokers}

QA7. Did you use [TEXT FILL BASED ON CATEGORY: (“chewing tobacco, snuff or dip” if chewing tobacco user), (“snus” if snus user) or (“chewing tobacco, snuff, dip, or snus” if both chewing tobacco and snus user)] to help you stop smoking traditional tobacco cigarettes?

  1. Yes

  2. No


{Answered 01 to QA20 yet are current (relapsed) smokers}

QA8b. When you were trying to quit smoking traditional tobacco cigarettes, did you seek information on quitting smoking traditional tobacco cigarettes?

  1. Yes

  2. No


{Answered 01 to QA20 yet are current (relapsed) smokers}

QA8c. Which of the following did you use when you looked for information on quitting smoking traditional tobacco cigarette? Select all that apply.

  1. Online resource

  2. 1-800-QUIT NOW

  3. Family or friends

  4. Doctor or clinic

  5. Other specify


{Answered 01 to QA20 yet are current (relapsed) smokers}

QA9. The last time you stopped smoking traditional tobacco cigarettes for more than 30 days, What was the final event or trigger that made you want to quit smoking traditional tobacco cigarettes?

  1. Friend or family asked you to quit

  2. Current health problem

  3. Concerns over future health problem

  4. Social pressure from people other than family and friends

  5. Smoking traditional tobacco cigarettes became too expensive

  6. Lack of places that allow smoking

  7. Impact of my smoking on friend or family

  8. Other specify


{Base = current smokers who answered 1 or more to QA1}

QA2. When you last tried to quit smoking, did you do any of the following?

[PRESENT IN RANDOM ORDER]

  1. YES

  2. NO


QA3_A. Give up traditional tobacco cigarettes all at once

QA3_B. Gradually cut back on traditional tobacco cigarettes

QA3_C. Substitute some of your traditional tobacco cigarettes with electronic cigarettes/e-cigarettes

QA3_D. Switch completely to electronic cigarettes/e-cigarettes

QA3_E. Switch to mild or some other brand of traditional tobacco cigarettes

QA3_F. Use nicotine replacement products such as a nicotine patch or nicotine gum

QA3_G. Use medications like Zyban or Chantix

QA3_H. Get help from a telephone quit line

QA3_I. Get help from a website such as Smokefree.gov

QA3_J. Get help from a doctor or other health professional


{Base = current traditional tobacco cigarette smokers}

QA3. Do you want to quit smoking traditional tobacco cigarettes for good?

  1. Yes

  2. No


{Base = current traditional tobacco cigarette smokers and answered 01 to QA3}

QA4. How much do you want to quit smoking? Would you say you want to quit…

  1. Not at all

  2. A little

  3. Somewhat

  4. A lot


{Base = current traditional tobacco cigarette smokers and answered 01 to QA3}

QA5. Do you plan to quit smoking for good….

  1. In the next 7 days,

  2. In the next 30 days,

  3. In the next 6 months,

  4. In the next 1 year, or

  5. More than 1 year from now

  6. I don’t plan to quit smoking traditional tobacco cigarettes

  7. Not sure/Uncertain



{Base = Current smokers}

QA8a. If you were to look for information on quitting smoking traditional tobacco cigarettes ... which of the following would you use? Select all that apply.

  1. Online resource

  2. 1-800-QUIT NOW

  3. Family or friends

  4. Doctor or clinic

  5. Other specify


Attitudinal

{Base = current smokers}

PA8. Thinking about the last time you had a health issue, where did you first look to get information?

  1. Friends or family

  2. Your doctor or healthcare professional

  3. Internet

  4. Pharmacy

  5. Mobile App

  6. Other specify



{Base = current smokers}

PA13. How important is smoking traditional tobacco cigarettes a social activity to do with friends?

  1. Extremely important

  2. Very important

  3. Somewhat important

  4. Slightly important

  5. Not at all important


{Base = current smokers}

Health10a. Have you ever performed poorly during a fitness evaluation due to the health impact of smoking traditional tobacco cigarettes?

  1. I have performed poorly during a fitness evaluation due to the health impact of smoking traditional tobacco cigarettes

  2. I have not performed poorly during a fitness evaluation due to the health impact of smoking traditional tobacco cigarettes

  3. I have not had a fitness evaluation since I starting smoking traditional tobacco cigarettes



{Base = current smokers}

P2. Who or what do you trust when you need information about quitting smoking? Is it a friend, family, co-worker, doctor, a website, or someone or something else?

  1. Friends

  2. Family

  3. Co-workers

  4. Doctor or other health professional

  5. Website

  6. Someone or something else? (SPECIFY)



{Base=current smokers}

P5. Are you afraid of dying from a tobacco-related disease?

  1. Yes

  2. No


{Base=current smokers}

P6a. Please tell us if you strongly disagree, somewhat disagree, neither agree nor disagree, somewhat agree, or strongly agree with the following statements.


      1. Strongly disagree

      2. Somewhat disagree

      3. Neither agree nor disagree

      4. Somewhat agree

      5. Strongly agree

Response Items:

P6a_1. I get upset when I think about my smoking.

P6a_2. I am disappointed in myself because I smoke.

P6a_3. I get upset when I hear or read about illnesses caused by smoking.

P6a_4. Warnings about the health risks of smoking upset me.

P6a_5. Smoking will severely lower my quality of life in the future.

P6a_6. Smokers should take warnings about traditional tobacco cigarette smoking and lung cancer seriously.


{Base=current smokers}

P6b. Please tell us if you strongly disagree, somewhat disagree, neither agree nor disagree, somewhat agree, or strongly agree with the following statements.


  1. Strongly disagree

  2. Somewhat disagree

  3. Neither agree nor disagree

  4. Somewhat agree

  5. Strongly agree

Response Items:

P6b_3. I need more hours in the day to do all the things that are expected from me.

P6b_4. I can’t ever seem to get caught up.

P6b_5. I don’t ever seem to have any time for myself.

P6b_6. There are times when I cannot meet everyone’s expectations.

P6b_7. Sometimes I feel as if there are not enough hours in the day.

P6b_8. Many times I have to cancel my commitments.

P6b_9. I seem to have to overextend myself in order to be able to finish everything I have to do.

P6b_10. I seem to have more commitments to overcome than some of my friends do.

P6b_12. I feel I have to do things hastily and maybe less carefully in order to get everything done.

P6b_13. I just cannot find the energy in me to do all the things expected of me.


QK5. Please tell us how much you agree or disagree with the following statements.


{Base = electronic cigarettes/e-cigarette smokers}

  1. I feel healthier when I smoke electronic cigarettes/e-cigarettes instead of traditional tobacco cigarettes.

  2. Electronic cigarettes/e-cigarettes have helped me quit smoking traditional tobacco cigarettes completely.

  3. Electronic cigarettes/e-cigarettes have helped me reduce the number of traditional tobacco cigarettes I smoke, but not to quit completely.


{Base = snus}

  1. I feel healthier when I use snus instead of smoking traditional tobacco cigarettes.

  2. Using snus has helped me quit smoking traditional tobacco cigarettes completely.

  3. Snus has helped me reduce the number of traditional tobacco cigarettes I smoke, but not to quit completely.



  1. Strongly disagree

  2. Somewhat disagree

  3. Neither agree nor disagree

  4. Somewhat agree

  5. Strongly agree


{Base = chewing tobacco/snuff/dip}

  1. I feel healthier when I use chewing tobacco, snuff, or dip instead of smoking traditional tobacco cigarettes.

  2. Using chewing tobacco, snuff, or dip has helped me quit smoking traditional tobacco cigarettes completely.

  3. Using chewing tobacco, snuff, or dip has helped me reduce the number of traditional tobacco cigarettes I smoke, but not to quit completely.


  1. Strongly disagree

  2. Somewhat disagree

  3. Neither agree nor disagree

  4. Somewhat agree

  5. Strongly agree


Demographics

{Base for this question is MILITARY only}

MIL10. When did you serve on active duty in the U.S. Armed Forces? Select each period in which you served, even if you served for part of the period.

  1. October 2010 to the present

  2. September 2001 to September 2010

  3. August 1990 to August 2001 (including Persian Gulf war)

  4. September 1980 to July 1990

  5. May 1975 to August 1980

  6. Vietnam era (August 1964 to April 1975)



{Base for this question is MILITARY only}

MIL11. During your active duty career, have you been deployed for more than 30 consecutive days?

  1. Yes, in the past 24 months

  2. Yes, but not in the past 24 months

  3. No



DEMO2. How many children (under age 18) live in your household:

  1. None

  2. 1-2 children

  3. 3-4 children

  4. 5 or more children

DEMO3. What is your marital status?

  1. Now married

  2. Living with my partner

  3. Widowed

  4. Divorced

  5. Separated

  6. Never married

  7. Prefer not to answer



{PREAMBLE}

Please indicate your race or ethnic background. Are you….?


SELECT ONE

DEMO6. Ethnicity

  1. Hispanic or Latino

  2. Not Hispanic or Latino


SELECT ONE OR MORE

DEMO7. Race:

  1. White

  1. Black or African American

  2. American Indian or Alaska Native

  3. Native Hawaiian or Other Pacific Islander

  4. Asian


SES1. What is the highest level of education you have completed or the highest degree you have received? If you received your education in another country, please indicate the equivalent level below.

  1. Less than high school

  2. Completed high school
    10 Completed General Education Diploma (GED)

  3. Job-specific training program(s) after high school

  4. Some college, but no degree

  5. Associate Degree

  6. College (such as B.A., B.S.)

  7. Some graduate school, but no degree

  8. Graduate degree (such as MBA, MS, M.D., Ph.D.)

  9. Prefer not to answer


DEMO8. Which of the following income categories best describes your total 2013 household income before taxes?

  1. Less than $15,000

  2. $15,000 to $19,999

  3. $20,000 to $24,999

  4. $25,000 to $29,999

  5. $30,000 to $34,999

  6. $35,000 to $49,999

  7. $50,000 to $74,999

  8. $75,000 to $99,999

  9. $100,000 or more

  10. Prefer not to answer



DEMO9. Which statement best describes your current employment status?

01 Working – as a paid employee

02 Working – self-employed

03 Not working – on temporary layoff from a job

04 Not working – looking for work

05 Not working – retired

06 Not working – disabled

07 Not working – other

08 Prefer not to answer



Technology/Media

{BASE for this section is all respondents}


T1. Think about the last time you went online to look for information...How did you begin looking?

01 At a search engine such as Google, Bing or Yahoo

02 At a site that specializes in topical information, like WebMD

03 At a more general site like Wikipedia, that contains information on all kinds of topics

04 At a social network site like Facebook

05 Other specify


T2. Do you currently own a cell phone?

  1. Yes

  2. No

  3. Don’t Know/Not Sure

{BASE = answers T2_01}

T3. Some cell phones are called "smartphones" because they have Internet access. Is your cell phone a smartphone, such as an iPhone, Android, Blackberry or Windows phone?

  1. Yes,

  2. No

  3. Not sure

{BASE = answers T3_01 & Current Smoker}

T40. Would you consider using your smartphone to find information, apps or websites that will help you quit smoking traditional tobacco cigarettes?

  1. Yes

  2. No

  3. Don’t Know/Not Sure



{BASE = answers T2_01}

T4. How often do you access the Internet on your smartphone?

  1. More than once per day

  2. Once per day

  3. A few times per week

  4. Once per week

  5. Less than once per week

  6. Rarely

  7. Never



T5. During the past month, how often did you read a newspaper, either in print or on the Internet?

  1. Every day

  2. A few times a week

  3. A few times

  4. Once

  5. Not at all


{Base = T5.01 or T5.02}

T51. What newspapers do you frequently read?

{Open-End}


T50. During the past month, how often did you read a magazine in print or on the Internet?

  1. Every day

  2. A few times a week

  3. A few times

  4. Once

  5. Not at all



T7. During the past month, how often did you watch television on a television set?

  1. Every day

  2. A few times a week

  3. A few times

  4. Once

  5. Not at all


T70. During the past month, how often did you watch television on the Internet?

  1. Every day

  2. A few times a week

  3. A few times

  4. Once

  5. Not at all



T8. During the past month, how often did you listen to the radio?

  1. Every day

  2. A few times a week

  3. A few times

  4. Once

  5. Not at all


T8. During the past month, how often did you listen to a streaming music source, like iTunes or Pandora?

  1. Every day

  2. A few times a week

  3. A few times

  4. Once

  5. Not at all




Section: Overall Awareness of Publicly Available Ads


{Base = current smokers}

EAD1. Have you ever seen or heard an advertisement for electronic cigarettes/e-cigarettes?

  1. Yes

  2. No

{if EAD1 = 01}

EAD2. Where have you seen or heard an advertisement for electronic cigarettes/e-cigarettes? (Select all that apply)

  1. On the Internet

  2. In newspapers or magazines

  3. Convenience stores, supermarkets, gas stations, or shopping malls

  4. On TV

  5. At the movies

  6. On the radio

  7. On billboards or other outdoor ads

  8. Other specify


EAD6. After seeing or hearing an advertisement for electronic cigarettes/e-cigarettes, did you ever have an urge to smoke a traditional tobacco cigarette?

  1. Yes

  2. No



{Base = current smokers}

OAS1. Are you aware of any advertising or tobacco education campaigns against smoking, using other tobacco products such as smokeless, or against tobacco companies that are taking place now?

  1. Yes

  2. No



{Base = recall anti-smoking advertising (OAS1/1)}

OAS2. Please comment on what you remember about these ads or tobacco education campaigns against smoking, tobacco products, or tobacco companies.

[OPEN END]


{If OAS1.01}

OAS3. Did the advertising against smoking, tobacco products, or tobacco companies help you quit smoking traditional tobacco cigarettes?

  1. Yes

  2. No




Section: Copy Test


{Base in this section = all respondents or as indicated}


We would now like to show you a television ad and then gather your reactions to that ad. Please make sure the volume on your computer is turned up, so that you can both see and hear the video. Please click “Next” to continue.


[Respondent will review one of three ads}

{Image of ad should be at top of page when the rest of the questions are asked}

RC1. What do you believe is the main message of this ad?

[OPEN END]


RC2. How believable or unbelievable was the person in the ad?

      1. Extremely believable

      2. Believable

      3. Neither believable nor unbelievable

      4. Unbelievable

      5. Extremely unbelievable


RC3. People sometimes have different emotional reactions when they see or hear advertisements.

On a scale from 1 to 5, where 1 indicates not feeling any emotion, and 5 indicates feeling emotion with extreme intensity, please indicate how much this advertisement made you feel:


  1. Angry

  2. Afraid

  3. Ashamed

  4. Sad

  5. Hopeful

  6. Understood

  7. Surprised

  8. Trusting

  9. Motivated

  10. Regretful


Scale for items RC3.A-J:

  1. I did not feel this emotion

  2. Slight emotion

  3. Moderate emotion

  4. Very intense emotion

  5. Extreme and intense emotion


RC4. On a scale from 1 to 5, where 1 indicates that you strongly disagree, and 5 indicates that you strongly agree, please indicate how much you disagree or agree with the following statements.

  1. This ad is convincing

  2. This ad grabbed my attention

  3. This ad was easy to understand

  4. I learned something new by viewing or hearing this ad

  5. I trust the information in this ad

  6. This ad is believable

  7. I would talk to someone else about this ad

  8. This ad is annoying

  9. The people in this ad are believable

  10. This ad is worth remembering

  11. This ad is powerful

  12. This ad is informative

  13. This ad is meaningful

  14. I can identify with what the ad says

  15. This ad speaks to me


Scale for items RC4.A-N:

  1. Strongly disagree

  2. Somewhat disagree

  3. Neither agree nor disagree

  4. Somewhat agree

  5. Strongly agree


RC5. Is there anything about the ad that is confusing, unclear, or hard to understand?

  1. Confusing

  2. Unclear

  3. Hard to understand

  4. None of the above


[Base = IF RC5 is any of 1, 2, or 3]

RC6. What was confusing, unclear or hard to understand? Please be as specific as possible.

{Open End}


RC7. Was there anything about the ad that you liked?

  1. Yes

  2. No


{Base = answered Rc7.01}

RC8. What, if anything, do you like about this ad? Please be as specific as possible.

{Open End}


RC9. Was there anything about the ad that you disliked?

  1. Yes

  2. No


{Base = ask only if Rc9.01}

RC10. What, if anything, do you dislike about this ad? Please be as specific as possible.

{Open End}


{Base = Current smokers}

RC11. Does this ad make you want to quit smoking cigarettes?

  1. Yes

  2. No


{Base = ask only if Rc11.02}

RC12. Why doesn’t the ad make you want to quit smoking cigarettes? Please be as specific as possible.

{Open End}



{Base = ask only if Rc11.01}

RC13. What about the ad made you want to quit smoking cigarettes? Please be as specific as possible.

{Open End}


{Base = current smokers}

RC14. In the future, if you saw or heard this ad on television, on a scale from 1 to 5, where 1 indicates not at all likely and 5 is very likely, how likely would you be to take the following actions in the next 6 months?


  1. Call 1-800-QUIT-NOW for assistance in quitting smoking

  2. Visit an informational government website, such as www.cdc.gov/tips for information on quitting

  3. Talk with my doctor or other health professionals about quitting smoking

  4. Not smoke around others

  5. Visit the Twitter site for the campaign.

  6. Try to quit on my own

  7. Use an electronic cigarette/ e-cigarette to help quit smoking

  8. Support smoke-free laws in my community

  9. Do nothing


Scale for items RC14.A-H:


  1. Very Unlikely

  2. Unlikely

  3. Neither Likely Nor Unlikely

  4. Likely

  5. Very Likely


Page 41


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleOSH Media Rough Cut Survey
AuthorCarol Haney
File Modified0000-00-00
File Created2021-01-28

© 2024 OMB.report | Privacy Policy