Survey Screenshots

Testing and Evaluation of Tobacco Communication Activities

Att 5_Screenshots v6 0 IC#12

Copy Testing of Television and Print Ads

OMB: 0920-0910

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Screener	
  -­‐	
  Pages	
  2	
  through	
  25	
  
Tobacco	
  A5tudes	
  and	
  Behaviors	
  -­‐	
  Pages	
  26-­‐84	
  
Demographic	
  InformaBon	
  -­‐	
  Pages	
  85-­‐91	
  
Technology	
  and	
  Media	
  -­‐	
  Pages	
  92-­‐103	
  
Media	
  and	
  Awareness	
  -­‐	
  Pages	
  104-­‐109	
  	
  
Rough	
  Cut	
  /	
  Copy	
  TesBng	
  -­‐	
  Pages	
  110-­‐124	
  

Demo5	
  

Demo5	
  

Demo5	
  

If	
  respondent	
  selected	
  female	
  in	
  
last	
  quesBon,	
  ask	
  the	
  following	
  
quesBon:	
  	
  
	
  

If	
  respondent	
  selected	
  male	
  in	
  the	
  
quesBon	
  two	
  slides	
  previous	
  from	
  
this	
  slide,	
  ask	
  the	
  following	
  
quesBon:	
  
	
  

Afghanistan	
  or	
  Iraq.	
  

Those	
  respondents	
  who	
  do	
  not	
  
qualify	
  see	
  the	
  following	
  screen:	
  
	
  

Qualified	
  respondents	
  see	
  the	
  
main	
  porBon	
  of	
  the	
  quesBonnaire:	
  
	
  

20	
  	
  

What	
  was	
  the	
  date	
  you	
  last	
  stopped	
  smoking	
  tradiBonal	
  tobacco	
  cigareVes	
  for	
  more	
  than	
  30	
  days?	
  

Did	
  you	
  use	
  chewing	
  tobacco,	
  snuff,	
  or	
  dip	
  to	
  help	
  you	
  stop	
  smoking	
  tradiBonal	
  tobacco	
  cigareVes?	
  

Which	
  of	
  the	
  following	
  did	
  you	
  use	
  when	
  you	
  looked	
  for	
  informaBon	
  on	
  qui5ng	
  smoking	
  tradiBonal	
  tobacco	
  cigareVes?	
  	
  Select	
  all	
  that	
  apply.	
  	
  

The	
  last	
  Bme	
  you	
  stopped	
  smoking	
  tradiBonal	
  tobacco	
  cigareVes	
  for	
  more	
  than	
  30	
  days,	
  what	
  was	
  the	
  final	
  event	
  or	
  trigger	
  that	
  made	
  you	
  want	
  to	
  quit	
  
smoking	
  tradiBonal	
  tobacco	
  cigareVes?	
  

Doctor	
  or	
  other	
  health	
  professional	
  

nor	
  

nor	
  

nor	
  

nor	
  

nor	
  

The	
  next	
  secBon	
  are	
  the	
  demographic	
  quesBons:	
  

Select	
  one	
  answer.	
  

Select	
  one	
  or	
  more.	
  

nor	
  

nor	
  


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