Att I-8_Crosswalk of Non-substantive Changes

Crosswalk of non-substantive changes from 2015 NYTS to create proposed 2016 NYTS

Type of change code: M = Modification, R = Reinstatement from previous cycle of NYTS, O = Order change, I = Instructions change, N = New addition, D = Deletion

Type of Change	Current Question/Item	Requested Change
National Youth Tobacco Survey (NYTS)
M	The next five sections of questions ask about your use of particular kinds of tobacco products.	We request to change the preamble for the tobacco product section to reflect the addition of hookah section and to identify each of the tobacco products that will be asked about in the survey. The updated preamble is below: The next six sections of questions ask about your use of particular kinds of tobacco products, such as cigarettes, cigars, smokeless tobacco, electronic cigarettes, hookah, pipe, snus, dissolvable tobacco, and bidis.
M	The first eleven questions are about smoking conventional cigarettes (ones that have to be lit and burned).	We request to change the preamble for the cigarette section to reflect the addition of an extra question to this section The updated preamble is below: The first 12 questions are about smoking conventional cigarettes (ones that have to be lit and burned).
R	Not applicable – reinstate a question from previous NYTS cycle	We request to reinstate a question from a previous cycle of NYTS, OSH/CTP periodically cycle in questions that have been asked in previous cycles of the NYTS. Proposed reinstated question is below: 6. Have you ever been curious about smoking a cigarette? A. Definitely yes B. Probably yes C. Probably not D. Definitely not
O	6. Have you ever tried cigarette smoking, even one or two puffs? A. Yes B. No	We request to change the order of the question from Q6 to Q7.
O	7. Do you think you will smoke a cigarette in the next year? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	We request to change the order of the question from Q7 to Q9.
O	9. If one of your best friends were to offer you a cigarette, would you smoke it? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	We request to change the order of the question from Q9 to Q10.
O	10. How old were you when you first tried cigarette smoking, even one or two puffs? A. I have never smoked cigarettes, not even one or two puffs B. 8 years old or younger C. 9 years old D. 10 years old E. 11 years old F. 12 years old G. 13 years old H. 14 years old I. 15 years old J. 16 years old K. 17 years old L. 18 years old M. 19 years old or older	We request to change the order of the question from Q10 to Q11.
O	11. About how many cigarettes have you smoked in your entire life? A. I have never smoked cigarettes, not even one or two puffs B. 1 or more puffs but never a whole cigarette C. 1 cigarette D. 2 to 5 cigarettes E. 6 to 15 cigarettes (about 1/2 a pack total) F. 16 to 25 cigarettes (about 1 pack total) G. 26 to 99 cigarettes (more than 1 pack, but less than 5 packs) H. 100 or more cigarettes (5 or more packs)	We request to change the order of the question from Q11 to Q12.
O	12. During the past 30 days, on how many days did you smoke cigarettes? A. 0 days B. 1 or 2 days C. 3 to 5 days D. 6 to 9 days E. 10 to 19 days F. 20 to 29 days G. All 30 days	We request to change the order of the question from Q12 to Q13.
O	13. During the past 30 days, on the days you smoked, about how many cigarettes did you smoke per day? A. I did not smoke cigarettes during the past 30 days B. Less than 1 cigarette per day C. 1 cigarette per day D. 2 to 5 cigarettes per day E. 6 to 10 cigarettes per day F. 11 to 20 cigarettes per day G. More than 20 cigarettes per day	We request to change the order of the question from Q13 to Q14
O, I	14. When was the last time you smoked a cigarette, even one or two puffs? (PLEASE CHOOSE THE FIRST ANSWER THAT FITS) A. I have never smoked cigarettes, not even one or two puffs B. Earlier today C. Not today but sometime during the past 7 days D. Not during the past 7 days but sometime during the past 30 days E. Not during the past 30 days but sometime during the past 6 months F. Not during the past 6 months but sometime during the past year G. 1 to 4 years ago H. 5 or more years ago	We request to change the order of the question from Q14 to Q15 and the instructions at the end of the question from being all capital letter to just having the first letter on the first word capitalized to be consistent with other instructions. Proposed new order and question is below: 15. When was the last time you smoked a cigarette, even one or two puffs? (Please choose the first answer that fits) A. I have never smoked cigarettes, not even one or two puffs B. Earlier today C. Not today but sometime during the past 7 days D. Not during the past 7 days but sometime during the past 30 days E. Not during the past 30 days but sometime during the past 6 months F. Not during the past 6 months but sometime during the past year G. 1 to 4 years ago H. 5 or more years ago
O, I	15. During the past 30 days, what brand of cigarettes did you usually smoke? (CHOOSE ONLY ONE ANSWER) A. I did not smoke cigarettes during the past 30 days B. I did not smoke a usual brand C. American Spirit D. Camel E. GPC, Basic, or Doral F. Kool G. Lucky Strike H. Marlboro I. Newport J. Parliament K. Virginia Slims L. Some other brand not listed here M. Not sure	We request to change the order of the question from Q15 to Q16 and the instructions at the end of the question from being all capital letter to just having the first letter on the first word capitalized to be consistent with other instructions. Proposed new order and question is below: 16. During the past 30 days, what brand of cigarettes did you usually smoke? (Choose only one answer) A. I did not smoke cigarettes during the past 30 days B. I did not smoke a usual brand C. American Spirit D. Camel E. GPC, Basic, or Doral F. Kool G. Lucky Strike H. Marlboro I. Newport J. Parliament K. Virginia Slims L. Some other brand not listed here M. Not sure
O	16. Menthol cigarettes are cigarettes that taste like mint. During the past 30 days, were the cigarettes that you usually smoked menthol? A. I did not smoke cigarettes during the past 30 days B. Yes C. No D. Not sure	We request to change the order of the question from Q16 to Q17.
M	The next seven questions are about the use of cigars, cigarillos or little cigars such as Black and Mild, Swisher Sweets, Dutch Masters, White Owl, or Phillies Blunts.	We request to change the preamble of the cigar section to reflect the deletion of three questions. New preamble is below: The next four questions are about the use of cigars, cigarillos or little cigars such as Black and Mild, Swisher Sweets, Dutch Masters, White Owl, or Phillies Blunts.
D	17. Have you ever been curious about smoking a cigar, cigarillo, or little cigar such as Black and Mild, Swisher Sweets, Dutch Masters, White Owl, or Phillies Blunts? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
D	19. Do you think that you will try a cigar, cigarillo or little cigar soon? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
D	20. If one of your best friends were to offer you a cigar, cigarillo or little cigar, would you smoke it? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
O	21. How old were you when you first tried smoking a cigar, cigarillo, or little cigar, even one or two puffs? A. I have never smoked cigars, cigarillos, or little cigars, not even one or two puffs B. 8 years old or younger C. 9 years old D. 10 years old E. 11 years old F. 12 years old G. 13 years old H. 14 years old I. 15 years old J. 16 years old K. 17 years old L. 18 years old M. 19 years old or older	We request to change the order of the question from Q21 to Q19.
O	22. During the past 30 days, on how many days did you smoke cigars, cigarillos, or little cigars? A. 0 days B. 1 or 2 days C. 3 to 5 days D. 6 to 9 days E. 10 to 19 days F. 20 to 29 days G. All 30 days	We request to change the order of the question from Q22 to Q20.
O	23. During the past 30 days, on the days that you smoked, about how many cigars, cigarillos, or little cigars did you smoke per day? A. I did not smoke cigars, cigarillos, or little cigars during the past 30 days B. Less than 1 cigar, cigarillo or little cigar per day C. 1 per day D. 2 to 5 per day E. 6 to 10 per day F. 11 to 20 per day G. More than 20 per day	We request to change the order of the question from Q23 to Q21.
M	The next three questions are about the use of chewing tobacco, snuff or dip. Do not think about snus when you answer these questions.	We request to change the preamble of the smokeless tobacco section to clarify the exclusion of dissolvable tobacco products. Proposed preamble is below: The next three questions are about the use of chewing tobacco, snuff, or dip. Do not think about snus or dissolvable tobacco products when you answer these questions.
O	24. Have you ever used chewing tobacco, snuff, or dip, such as Redman, Levi Garrett, Beechnut, Skoal, Skoal Bandits, or Copenhagen, even just a small amount? A. Yes B. No	We request to change the order of the question from Q24 to Q22.
O	25. How old were you when you used chewing tobacco, snuff, or dip for the first time? A. I have never used chewing tobacco, snuff, or dip B. 8 years old or younger C. 9 years old D. 10 years old E. 11 years old F. 12 years old G. 13 years old H.14 years old I. 15 years old J. 16 years old K. 17 years old L. 18 years old M. 19 years old or older	We request to change the order of the question from Q25 to Q23.
O	26. During the past 30 days, on how many days did you use chewing tobacco, snuff, or dip? A. 0 days B. 1 or 2 days C. 3 to 5 days D. 6 to 9 days E. 10 to 19 days F. 20 to 29 days G. All 30 days	We request to change the order of the question from Q26 to Q24.
M	The next twelve questions are about e-cigarettes. E-cigarettes are battery powered devices that usually contain a nicotine-based liquid that is vaporized and inhaled. You may know them as vape-pens, hookah-pens, e-hookahs, e-cigars, e-pipes, or personal vaporizers or mods. Some brand examples include NJOY, Blu, Vuse, MarkTen, Finiti, Starbuzz, and Fantasia.	We request to change the preamble for the e-cigarette section to reflect the addition of a new question and to update the brand names of e-cigarettes based on market scan data from CTP. Proposed modified preamble is below: The next 13 questions are about electronic cigarettes or e-cigarettes. E-cigarettes are battery powered devices that usually contain a nicotine-based liquid that is vaporized and inhaled. You may know them as vape-pens, hookah-pens, e-hookahs, e-cigars, e-pipes, personal vaporizers or mods. Some brand examples include NJOY, Blu, Vuse, MarkTen, Logic, Vapin Plus, eGo, Halo.
O, M	27. Have you ever been curious about using an electronic cigarette or e-cigarette, even once or twice? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	We request to change the order of this question from Q27 to Q25 and to modify it by removing ‘electronic cigarettes’ and ‘even once or twice’. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. The removal of ‘even once or twice’ is requested to align with curiosity questions asked about other products. Proposed new order and modified question is below: 25. Have you ever been curious about using an e-cigarette? A. Definitely yes B. Probably yes C. Probably not D. Definitely not
O, M	28. Have you ever used an electronic cigarette or e-cigarette, even once or twice? A. Yes B. No	We request to change the order of the question from Q28 to Q26 and to modify it by removing ‘electronic cigarettes’ from the question. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Proposed new order and modified question is below: 26. Have you ever used an e-cigarette, even once or twice? A. Yes B. No
O, M	29. Do you think that you will try an electronic cigarette or e-cigarette soon? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	We request to change the order of the question from Q29 to Q27 and to modify it by removing ‘electronic cigarettes’ from the question. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Proposed new order and modified question is below: 27. Do you think that you will try an e-cigarette soon? A. Definitely yes B. Probably yes C. Probably not D. Definitely not
M	Not applicable – modified question	We request addition of a modified question for e-cigarettes. This question is an incremental modification of a question that appears in previous cycles of NYTS for cigarettes and in an earlier section of proposed questionnaire (proposed question 9). Cognitive testing on previous cycles showed that youth understood what is meant by each product. Proposed modified question is below: 28. Do you think you will use an e-cigarette in the next year? A. Definitely yes B. Probably yes C. Probably not D. Definitely not
O, M	30. If one of your best friends were to offer you an electronic cigarette or e-cigarette, would you use it? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	We request to change the order of the question from Q30 to Q29 and to modify it by removing ‘electronic cigarettes’ from the question. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Proposed new order and modified question is below: 29. If one of your best friends were to offer you an e-cigarette, would you use it? A. Definitely yes B. Probably yes C. Probably not D. Definitely not
O, M	31. How old were you when you first tried using an electronic cigarette or e-cigarette, even once or twice? A. I have never used electronic cigarettes or e-cigarettes B. 8 years old or younger C. 9 years old D. 10 years old E. 11 years old F. 12 years old G. 13 years old H. 14 years old I. 15 years old J. 6 years old K. 17 years old L. 18 years old M. 19 years old or older	We request to change the order of the question from Q31 to Q30 and to modify it by removing ‘electronic cigarettes’ from the question. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Proposed new order and modified question is below: 30. How old were you when you first tried using an e-cigarette, even once or twice? A. I have never used e-cigarettes B. 8 years old or younger C. 9 years old D. 10 years old E. 11 years old F. 12 years old G. 13 years old H. 14 years old I. 15 years old J. 16 years old K. 17 years old L. 18 years old M. 19 years old or older
O, M	32. During the past 30 days, on how many days did you use electronic cigarettes or e-cigarettes? A. 0 days B. 1 or 2 days C. 3 to 5 days D. 6 to 9 days E. 10 to 19 days F. 20 to 29 days G. All 30 days	We request to change the order of the question from Q32 to Q31 and to modify it by removing ‘electronic cigarettes’ from the question. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Proposed new order and modified question is below: 31. During the past 30 days, on how many days did you use e-cigarettes? A. 0 days B. 1 or 2 days C. 3 to 5 days D. 6 to 9 days E. 10 to 19 days F. 20 to 29 days G. All 30 days
O, M	33. In total, on how many days have you used an electronic cigarette or e-cigarette in your entire life? A. 0 days B. 1 day C. 2 to 10 days D. 11 to 20 days E. 21 to 50 days F. 51 to 100 days G. Over 100 days	We request to change the order of the question from Q33 to Q32 and to modify it by removing ‘electronic cigarette’ from the question. The removal of ‘electronic cigarette’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Also, in order to better align this question with how other e-cigarette questions are asked we would like to modify ‘e-cigarette’ to ‘e-cigarettes’. Proposed new order and modified question is below: 32. In total, on how many days have you used an e-cigarettes in your entire life? A. 0 days B. 1 day C. 2 to 10 days D. 11 to 20 days E. 21 to 50 days F. 51 to 100 days G. Over 100 days
O, M, I	34. What brands of electronic cigarettes or e-cigarettes have you ever tried? (CHOOSE ALL THAT APPLY) A. I have never tried electronic cigarettes or e-cigarettes B. Blu C. NJOY D. MarkTen E. Logic F. VUSE G. Finiti H. Starbuzz I. Fantasia J. Some other brand not listed here K. I do not know the brand name	We request to change the order of the question from Q34 to Q33 and of the instructions at the end of the question from ‘CHOOSE ALL THAT APPLY’ to ‘Select one or more’ to align to the way other questions that allow multiple selections have these instructions worded. We request to modify the question by removing ‘electronic cigarettes’ from the question. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Also, we request to modify the questions response options ‘G’, ‘H’, and ‘I’ to be updated based on results from recent market scan data from CTP and e-cigarette focus group findings. Proposed new order and modified question is below: 33. What brands of e-cigarettes have you ever tried? (Select one or more) A. I have never tried e-cigarettes B. Blu C. NJOY D. MarkTen E. Logic F. VUSE G. Vapin Plus H. eGo I. Halo J. Some other brand not listed here K. I do not know the brand name
O, M	35. Thinking about all types of electronic cigarettes or e-cigarettes, have you used the disposable kind or rechargeable/refillable tank kind? A. I have never tried an electronic cigarette or e-cigarette B. Only the disposable kind C. Only the rechargeable/refillable tank kind D. Both the disposable kind and rechargeable/refillable tank kind	We request to change the order of the question from Q35 to Q34 and to modify it by removing ‘electronic cigarettes’ from the question. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. We also request to add a ‘/’ between ‘refillable’ and ‘tank kind’ both in the question and in the response option. This is to reflect that rechargeable, refillable and tank descriptors applied to e-cigarette cannot necessarily be differentiated. Proposed new order and modified question is below: 34. Thinking about all types of e-cigarettes, have you used the disposable kind or rechargeable/refillable/tank kind? A. I have never tried an e-cigarette B. Only the disposable kind C. Only the rechargeable/refillable/tank kind D. Both the disposable kind and rechargeable/refillable/tank kind
D	36. Which of the following statements best applies to your cigarette or electronic cigarette use? A. I have never tried cigarettes or electronic cigarettes B. I have only tried cigarettes C. I have only tried electronic cigarettes D. I tried cigarettes before I ever tried electronic cigarettes E. I tried electronic cigarettes before I ever tried cigarettes	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new and alternate questions.
O, M, I	37. What are the reasons why you have used electronic cigarettes or e-cigarettes? (CHOOSE ALL THAT APPLY) A. I have never tried an electronic cigarette B. Friend or family member used them C. To try to quit using tobacco products, such as cigarettes D. They cost less than other tobacco products, such as cigarettes E. Famous people on TV or in movies use them F. They are less harmful than other forms of tobacco, such as cigarettes G. They are available in flavors, such as mint, candy, fruit, or chocolate H. They can be used in areas where other tobacco products, such as cigarettes, are not allowed I. I used them for some other reason	We request to change the order of the question from Q37 to Q36 and of the instructions at the end of the question from ‘CHOOSE ALL THAT APPLY’ to ‘Select one or more’ to align to the way other questions that allow multiple selections have these instructions worded. We request to modify the question by removing ‘electronic cigarettes’ from the question and also removing ‘why’ from the question. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. We also request for the addition of an additional response option of ‘They are easier to get that other tobacco products, such as cigarettes’ as the fifth option ‘E’ and moving the other options down one letter. We request to modify response option ‘C’ by adding the word ‘other’ preceding ‘tobacco products’ to align with option ‘D’. Proposed new order and modified question is below: 36. What are the reasons you have used e-cigarettes? (Select one or more) A. I have never tried an e-cigarette B. Friend or family member used them C. To try to quit using other tobacco products, such as cigarettes D. They cost less than other tobacco products, such as cigarettes E. They are easier to get than other tobacco products, such as cigarettes F. Famous people on TV or in movies use them G. They are less harmful than other forms of tobacco, such as cigarettes H. They are available in flavors, such as mint, candy, fruit, or chocolate I. They can be used in areas where other tobacco products, such as cigarettes, are not allowed J. I used them for some other reason
O, M, I	38. Have you ever used an electronic cigarette or e-cigarette device for any other substance other than for nicotine? A. Yes B. No	We request to change the order of the question from Q38 to Q37 and modify the question by deleting ‘other than for’ and updated it with ‘besides’. We request to further modify the question by removing ‘electronic cigarettes’ from the question. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Also we request to update the response categories to be able to better understand what other substances are being used in these devices given changes in the regulatory landscape. States are beginning to legalize marijuana for medical and recreational purposes which may be impacting the use of these substances among youth. Data show an increase in exclusive current marijuana use among youth and current use of marijuana among current combustible tobacco users1. Other data have shown significant use of substances other than nicotine in these devices2. Cognitive testing demonstrated that youth understood the previously approved question to mean other substances beyond just nicotine containing liquid (the main substance that came up was marijuana but there was also mentioned of crack cocaine). In addition we request to modify the instructions to add ‘Select one or more’ to align to the way other questions that allow multiple selections have these instructions asked. Proposed new order and modified question is below: 37. Have you ever used an e-cigarette device with a substance besides nicotine? (Select one or more) A. Yes, I have used an e-cigarette device with Marijuana, THC or hash oil, or THC wax B. Yes, I have used an e-cigarette device with another substance that is not marijuana, THC or hash oil, or THC wax C. No, I have only used an e-cigarette device with nicotine D. No, I have never used an e-cigarette device E. Don’t Know / Not Sure
N	Not applicable – new preamble	We request the addition of a new preamble for the hookah section of the questionnaire. Cognitive testing on previous cycles showed that youth understood the general constructs that were being asked and that they also understood what is meant by each tobacco product. The new preamble is adapted from the PATH study. The next eight questions are about smoking tobacco in a hookah, which is a type of waterpipe. Shisha (or hookah tobacco) is smoked in a hookah.
M	Not applicable – modified question	We request addition of a modified question for hookah. This question is an incremental modification of a similar question appears in previous cycles of NYTS for cigarettes and in an earlier section of proposed questionnaire (proposed question 6). Cognitive testing on previous cycles showed that youth understood what is meant by each product. Proposed modified question is below: 38. Have you ever been curious about smoking tobacco in a hookah or waterpipe? A. Definitely yes B. Probably yes C. Probably not D. Definitely not
M	Not applicable – modified question	We request addition of a modified question for hookah. This question is an incremental modification of a similar question appears in previous cycles of NYTS for cigarettes and in an earlier section of proposed questionnaire (proposed question 7). Cognitive testing on previous cycles showed that youth understood what is meant by each product. Proposed modified question is below: 39. Have you ever tried smoking tobacco in a hookah or waterpipe, even one or two puffs? A. Yes B. No
M	Not applicable – modified question	We request addition of a modified question for hookah. This question is an incremental modification of a similar question appears in previous cycles of NYTS for cigarettes and in an earlier section of proposed questionnaire (question 8). Cognitive testing on previous cycles showed that youth understood what is meant by each product. Proposed modified question is below: 40. Do you think that you will try smoking tobacco in a hookah or waterpipe soon? A. Definitely yes B. Probably yes C. Probably not D. Definitely not
M	Not applicable – modified question	We request addition of a modified question for hookah. This question is an incremental modification of a similar question appears in previous cycles of NYTS for cigarettes and in an earlier section of proposed questionnaire (question 9). Cognitive testing on previous cycles showed that youth understood what is meant by each product. Proposed modified question is below: 41. Do you think you will smoke tobacco in a hookah or waterpipe in the next year? A. Definitely yes B. Probably yes C. Probably not D. Definitely not
M	Not applicable – modified question	We request addition of a modfied question for hookah. This question is an incremental modification of a similar question appears in previous cycles of NYTS for cigarettes and in an earlier section of proposed questionnaire (proposed question 10). Cognitive testing on previous cycles showed that youth understood what is meant by each product. Proposed modified question is below: 42. If one of your best friends were to offer you a hookah or waterpipe with tobacco, would you try it? A. Definitely yes B. Probably yes C. Probably not D. Definitely not
M	Not applicable – modified question	We request addition of a modified question for hookah. This question is an incremental modification of a similar question appears in previous cycles of NYTS for cigarettes and in an earlier section of proposed questionnaire (proposed question 11). Cognitive testing on previous cycles showed that youth understood what is meant by each product. Proposed modified question is below: 43. How old were you when you first tried smoking tobacco in a hookah or waterpipe, even one or two puffs? A. I have never smoked tobacco from a hookah or waterpipe B. 8 years old or younger C. 9 years old D. 10 years old E. 11 years old F. 12 years old G. 13 years old H. 14 years old I. 15 years old J. 16 years old K. 17 years old L. 18 years old M. 19 years old or older
M	Not applicable – modified question	We request addition of a modified question for hookah. This question is an incremental modification of a similar question appears in previous cycles of NYTS for cigarettes and in an earlier section of proposed questionnaire (proposed question 13). Cognitive testing on previous cycles showed that youth understood what is meant by each product. Proposed modified question is below: 44. During the past 30 days, on how many days did you smoke tobacco in a hookah or waterpipe? A. 0 days B. 1 or 2 days C. 3 to 5 days D. 6 to 9 days E. 10 to 19 days F. 20 to 29 days G. All 30 days
N	Not applicable – new question	We request addition of a new question for hookah. This question will allow collection of essential data to inform tobacco control programs and policies as recent NYTS analyses has shown that hookah is a rapidly emerging tobacco product among youth3 The question and response options were adapted from similar survey questions that were published in peer-reviewed studies.4,5,6 Proposed new question is below: 45. During the past 30 days, where did you smoke tobacco in a hookah or waterpipe? (Select one or more) A. I did not smoke tobacco in a hookah or waterpipe during the past 30 days B. At my house C. At a friend’s house D. At a family member’s house, other than my house E. At a hookah bar F. At a café or restaurant G. Some other place not listed here
O, M, I	39. Which of the following tobacco products have you ever tried, even just one time? (CHOOSE ALL THAT APPLY) A. Roll-your-own cigarettes B. Flavored cigarettes, such as clove, alcohol (wine, cognac), candy, fruit, chocolate, or other sweets (DO NOT include menthol cigarettes) C. Bidis (small brown cigarettes wrapped in a leaf) D. Flavored cigars, cigarillos, and little cigars (such as mint, clove, alcohol (wine, cognac), candy, fruit, chocolate, or other sweets) E. Hookah or a waterpipe used with tobacco F. Pipe filled with tobacco (not waterpipe) G. Snus, such as Camel or Marlboro Snus H. Dissolvable tobacco products, such as Ariva, Stonewall, Camel orbs, Camel sticks, or Camel strips I. I have never tried any of the products listed above	We request to change the order of the question from Q39 to Q46 and to modify the question by removing response options for ‘flavored cigarettes’ as they are no longer legally sold in the U.S. and for ‘Hookah or a waterpipe used with tobacco’ as hookah is now ascertained as stand-alone questions. We request to change the order of the question and of the instructions at the end of the question from ‘CHOOSE ALL THAT APPLY’ to ‘Select one or more’ to align to the way other questions that allow multiple selections have these instructions worded. We request to change response option ‘D’ to ‘Flavored cigars, cigarillos, and little cigars (such as mint, clove, alcohol [wine, cognac], candy, fruit, chocolate, or other flavors)’. Proposed new order and modified question is below: 46. Which of the following tobacco products have you ever tried, even just one time? (Select one or more) A. Roll-your-own cigarettes B. Flavored cigars, cigarillos, and little cigars (such as mint, clove, alcohol (wine, cognac), candy, fruit, chocolate, or other flavors) C. Pipe filled with tobacco (not waterpipe) D. Snus, such as Camel, Marlboro, or General Snus E. Dissolvable tobacco products such as Ariva, Stonewall, Camel orbs, Camel sticks, Marlboro sticks or Camel strips F. Bidis (small brown cigarettes wrapped in a leaf) G. I have never tried any of the products listed above
O, M, I	40. In the past 30 days, which of the following products have you used on at least one day? (CHOOSE ALL THAT APPLY) A. Roll-your-own cigarettes B. Flavored cigarettes, such as clove, alcohol (wine, cognac), candy, fruit, chocolate, or other sweets (DO NOT include menthol cigarettes) C. Bidis (small brown cigarettes wrapped in a leaf) D. Hookah or a waterpipe used with tobacco E. Pipe filled with tobacco (not waterpipe) F. Snus, such as Camel or Marlboro Snus G. Dissolvable tobacco products, such as Ariva, Stonewall, Camel orbs, Camel sticks, or Camel strips H. I did not use any of the products listed above in the past 30 days	We request to change the order of the question from Q40 to Q47 and to modify the question by removing response options for ‘flavored cigarettes’ as they are no longer legally sold in the U.S. and for ‘Hookah or a waterpipe used with tobacco’ as hookah is now ascertained as stand-alone questions. We request to change the instruction from ‘CHOOSE ALL THAT APPLY’ to ‘Select one or more’ to align to the way other questions that allow multiple selections have these instructions asked. The response option order has been change for pipes, snus, dissolvable tobacco, and bidis Proposed updated question with updated instruction is below: 47. In the past 30 days, which of the following products have you used on at least one day? (Select one or more) A. Roll-your-own cigarettes B. Pipe filled with tobacco (not waterpipe) C. Snus, such as Camel, Marlboro, or General Snus D. Dissolvable tobacco products such as Ariva, Stonewall, Camel orbs, Camel sticks, Marlboro sticks or Camel strips E. Bidis (small brown cigarettes wrapped in a leaf) F. I have not used any of the products listed above in the past 30 days
N	Not applicable – new preamble	We request the addition of a new preamble for question about use of all tobacco products previously inquired about in the prior six sections ofthe questionnaire. Cognitive testing on previous cycles showed that youth understood what is meant by each product. Proposed new preamble is below: Now thinking about your responses to questions from the last six sections about past 30 day use of cigarettes, cigars, smokeless tobacco, electronic cigarettes, hookah, pipe, snus, dissolvable tobacco, and bidis.
M	Not applicable – modified question	We request the addition of a modified question for total number of days any tobacco products was used in the past 30 days. This question is an incremental modification of a similar question appears in previous cycles of NYTS for cigarettes, cigars, smokeless tobacco, and e-cigarettes and in an earlier section of proposed questionnaire (proposed question 13, 20, 24, 31). Proposed modified question is below: 48. During the past 30 days, on how many days did you use any tobacco product(s)? A. 0 days B. 1 to 2 days C. 3 to 5 days D. 6 to 9 days E. 10 to 19 days F. 20 to 29 days G. All 30 days
M	The next question asks about flavors in tobacco products.	We request to change the preamble for flavor tobacco products to reflect the addition of a new flavor question. Proposed modified preamble is below: The next two questions ask about flavors in tobacco products.
O, M, I	41. Which of the following tobacco products that you used in the past 30 days were flavored to taste like menthol (mint), alcohol (wine, cognac), candy, fruit, chocolate or other sweets? (CHOOSE ALL THAT APPLY) A. Cigars, such as Macanudo, Romeo y Julieta, or Arturo Fuente B. Cigarillos, such as Black and Mild, Swisher Sweets, Dutch Masters, or Phillies Blunts C. Little cigars, such as Prime Time little filtered cigars or Winchester little filtered cigars D. Chewing tobacco, snuff, or dip E. Electronic cigarettes or e-cigarettes F. Hookah or a waterpipe used with tobacco G. Pipe filled with tobacco (not waterpipe) H. Snus, such as Camel or Marlboro Snus I. Dissolvable tobacco products, such as Ariva, Stonewall, Camel orbs, Camel sticks, or Camel strips J. I did not use any of the flavored products listed above in the past 30 days	We request to change the order of the question from Q41 to Q49 and to modify the question by removing separate response options for ‘cigars’, ‘cigarillos’, and ‘little cigars’ and creating a new response option that has all three categories collapsed together. We request to modify the response option for e-cigarettes by removing ‘electronic cigarettes’ from the response option. The removal of ‘electronic cigarettes’ from the response option is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. We request to include a new response option for ‘Bidis’. We request modification of response options for ‘Snus’ and “Dissolvable tobacco products’ by removing the example of the products. We request to change wording of question to ‘Which of the following tobacco products that you used in the past 30 days were flavored to taste like menthol (mint), alcohol (wine, cognac), candy, fruit, chocolate or any other flavors?’ We request to change the instruction from ‘CHOOSE ALL THAT APPLY’ to ‘Select one or more’ to align to the way other questions that allow multiple selections have these instructions asked. Proposed new order and modified question is below: 49. Which of the following tobacco products that you used in the past 30 days were flavored to taste like menthol (mint), alcohol (wine, cognac), candy, fruit, chocolate or any other flavors? (Select one or more) A. Cigars, cigarillos, or little cigars B. Chewing tobacco, snuff, or dip C. E-cigarettes D. Tobacco in a hookah or waterpipe E. Pipe filled with tobacco (not waterpipe) F. Snus G. Dissolvable tobacco products H. Bidis I. I did not use any of the flavored tobacco products listed above in the past 30 days
N	Not applicable – new question	We request to add a new question that assesses what flavors are used in tobacco products. This data is essential to inform tobacco control programs and policies as recent data has shown that 70% of current youth tobacco users use a flavored tobacco product7. Proposed new question is below: 50. What flavors of tobacco products have you used in the past 30 days? (Select one or more) A. Menthol or mint B. Clove or spice C. Fruit D. Chocolate E. Alcoholic drink (such as wine, cognac, margarita or other cocktails) F. Candy, desserts or other sweets G. Some other flavor not listed here H. I did not use flavored tobacco products in the past 30 days
D	The next question asks about the first tobacco product you ever tried.	We request to delete the preamble. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete preambles and applicable questions to allow for the addition of new or alternate preambles and questions.
D	42. Which of the following tobacco products did you try first? (CHOOSE ONLY ONE ANSWER) A. Cigarettes B. Cigars, cigarillos, or little cigars C. Electronic cigarettes or e-cigarettes D. Chewing tobacco, snuff, or dip E. Hookah or a waterpipe used with tobacco F. Pipe filled with tobacco (not waterpipe) G. Snus, such as Camel or Marlboro snus H. Bidis (small brown cigarettes wrapped in a leaf) I. Dissolvable tobacco products, such as Ariva, Camel orbs, Camel sticks, or Camel strips J. Not sure about the product I tried first K. I have never tried any of the products listed above	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new and alternate questions.
O, I	43. During the past 30 days, how did you get your own tobacco products? (CHOOSE ALL THAT APPLY) A. I did not get any of my own tobacco products during the past 30 days B. I bought them myself C. I had someone else buy them for me D. I asked someone to give me some E. Someone offered them to me F. I bought them from another person G. I took them from a store or another person H. I got them some other way	We request to change the order of the question from Q43 to Q51 and of the instructions at the end of the question from ‘CHOOSE ALL THAT APPLY’ to ‘Select one or more’ to align to the way other questions that allow multiple selections have these instructions worded. We request to modify response option A from ‘I did not get any of my own tobacco products during the past 30 days’ to ‘I did not get any tobacco products during the past 30 days’ Proposed new order and question is below: 51. During the past 30 days, how did you get your own tobacco products? (Select one or more) A. I did not get any tobacco products during the past 30 days B. I bought them myself C. I had someone else buy them for me D. I asked someone to give me some E. Someone offered them to me F. I bought them from another person G. I took them from a store or another person H. I got them some other way
O, I	44. During the past 30 days, where did you buy your own tobacco products? (CHOOSE ALL THAT APPLY) A. I did not buy my own tobacco products during the past 30 days B. A gas station or convenience store C. A grocery store D. A drugstore E. A vending machine F. Over the Internet G. Through the mail H. Some other place not listed here	We request to change the order of the question from Q44 to Q52 and of the instructions at the end of the question from ‘CHOOSE ALL THAT APPLY’ to ‘Select one or more’ to align to the way other questions that allow multiple selections have these instructions worded. We request to change response option A was changed from ‘I did not buy my own tobacco products during the past 30 days’ to ‘I do not buy tobacco products during the past 30 days’ and response option F ‘Over the Internet’ to ‘On the Internet’ Proposed new order and question is below: 52. During the past 30 days, where did you buy your own tobacco products? (Select one or more) A. I did not buy tobacco products during the past 30 days B. A gas station or convenience store C. A grocery store D. A drugstore E. A vending machine F. On the Internet G. Through the mail H. Some other place not listed here
O, M, I	45. During the past 30 days, where did you get or buy the electronic e-cigarettes that you have used? (CHOOSE ALL THAT APPLY) A. I have never tried an electronic e-cigarette B. A gas station or convenience store C. A grocery store D. A drugstore E. A mall or shopping center kiosk/stand F. Over the Internet G. A store that sells electronic cigarettes, such as a “vape shop ” H. Some other place I. From a family member J. From a friend K. Some other person that is not a family member or a friend	We request to change the order of the question fromQ4 to Q35 and to modify it by removing ‘electronic cigarettes’ from the question. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. We also request to modify response option ‘F’ from ‘Over the Internet’ to ‘On the Internet’ and response option ‘K’ from ‘Some other person that is not a family member or friend’ to ‘From some other person that is not a family member or friend’. Also we request to change the instructions at the end of the question from ‘CHOOSE ALL THAT APPLY’ to ‘Select one or more’ to align to the way other questions that allow multiple selections have these instructions asked. Proposed new order and modified question is below: 35. During the past 30 days, where did you get or buy the e-cigarettes that you have used? (Select one or more) A. I have never tried an e-cigarette in the past 30 days B. A gas station or convenience store C. A grocery store D. A drugstore E. A mall or shopping center kiosk/stand F. On the Internet G. A vape shop or other store that only sells e-cigarettes H. Some other place not listed here I. From a family member J. From a friend K. From some other person that is not a family member or a friend
O	46. During the past 30 days, did anyone refuse to sell you any tobacco products because of your age? A. I did not try to buy any tobacco products during the past 30 days B. Yes C. No	We request to change the order of the question from Q46 to Q53
R	Not applicable – reinstate a question from previous NYTS cycle	We request to reinstate a question from a previous cycle of NYTS. OSH/CTP periodically cycle in questions that have been asked in previous cycles of the NYTS. Proposed reinstated question is below: 54. How easy do you think it is for kids your age to buy tobacco products in a store? A. Easy B. Somewhat easy C. Not easy at all
M	The next four questions are about issues related to urges or needs to use tobacco products.	We request to change the preamble to reflect the number of question that will be asked Proposed modified preamble is below: The next two questions are about issues related to urges or needs to use tobacco products.
O	47. During the past 30 days, have you had a strong craving or felt like you really needed to use a tobacco product of any kind? A. Yes B. No	We request to change the order of the question from Q47 to Q55
O	48. How soon after you wake up do you want to use a tobacco product? A. I do not want to use tobacco B. Within 5 minutes C. From 6 to 30 minutes D. From more than 30 minutes to 1 hour E. After more than 1 hour but less than 24 hours F. I rarely want to use tobacco	We request to change the order of the question from Q48 to Q56
D	49. How true is this statement for you? I feel restless and irritable when I don’t use tobacco for a while. A. I do not use tobacco B. Not at all true C. Sometimes true D. Often true E. Always true	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
D	50. How true is this statement for you? When I go without using a tobacco product for a few hours, I experience cravings A. I do not use tobacco B. Not true at all C. Sometimes true D. Often true E. Always true	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
D	The next two questions are about quitting conventional cigarettes.	We request to delete the preamble. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically deletes preambles. The current preamble preceding question 57 for ‘quitting tobacco products’ covers cigarettes.
O, M, I	51. Are you seriously thinking about quitting cigarettes? (PLEASE CHOOSE THE FIRST ANSWER THAT FITS) A. I do not smoke cigarettes B. Yes, within the next 30 days C. Yes, within the next 6 months D. Yes, within the next 12 months E. Yes, but not within the next 12 months F. No, I am not thinking about quitting cigarettes	We request to change the order from Q51 to Q59 and the instructions at the end of the question from ‘PLEASE CHOOSE THE FIRST ANSWER THAT FITS to ‘Please choose the first answer that fits’ to align the format of the instruction to the way other questions that have instructions are formatted. We also request to modify the response options that contain ‘within’ to ‘during’ in response options ‘B’ to ‘E’. Proposed new order and modified question is below: 59. Are you seriously thinking about quitting cigarettes? (Please choose the first answer that fits) A. I do not smoke cigarettes B. Yes, during the next 30 days C. Yes, during the next 6 months D. Yes, during the next 12 months E. Yes, but not during the next 12 months F. No, I am not thinking about quitting cigarettes
O	52. During the past 12 months, how many times have you stopped smoking cigarettes for one day or longer because you were trying to quit smoking cigarettes for good? A. I did not smoke cigarettes during the past 12 months B. I did not try to quit during the past 12 months C. 1 time D. 2 times E. 3 to 5 times F. 6 to 9 times G. 10 or more times	We request to change the order or the question from Q52 to Q60
M	The next three questions are about quitting all types of tobacco products	We request to modify the preamble to reflect the questions about quitting tobacco Proposed modified preamble is below: The next four questions are about quitting tobacco products.
O, M, I	53. Are you seriously thinking about quitting the use of all tobacco products? (PLEASE CHOOSE THE FIRST ANSWER THAT FITS) A. I do not use tobacco products B. Yes, within the next 30 days C. Yes, within the next 6 months D. Yes, within the next 12 months E. Yes, but not within the next 12 months F. No, I am not thinking about quitting the use of all tobacco products	We request to change the order from Q53 to Q57 and the instructions at the end of the question from ‘PLEASE CHOOSE THE FIRST ANSWER THAT FITS to ‘Please choose the first answer that fits’ to align the format of the instruction to the way other questions that have instructions are formatted. We also request to modify the response options that contain ‘within’ to ‘during’ in response options ‘B’ to ‘E’. Proposed new order and modified question is below: 57. Are you seriously thinking about quitting the use of all tobacco products? (Please choose the first answer that fits) A. I do not use tobacco products B. Yes, during the next 30 days C. Yes, during the next 6 months D. Yes, during the next 12 months E. Yes, but not during the next 12 months F. No, I am not thinking about quitting the use of all tobacco products
O	54. During the past 12 months, how many times have you stopped using all tobacco products for one day or longer because you were trying to quit all tobacco products for good? A. I did not use tobacco products during the past 12 months B. I did not try to quit all tobacco products during the past 12 months C. 1 time D. 2 times E. 3 to 5 times F. 6 to 9 times G. 10 or more times	We request to change the order or the question from Q54 to Q58.
D	55. In the past 12 months, did you do any of the following to help you quit using tobacco of any kind for good? (You can CHOOSE ONE ANSWER or MORE THAN ONE ANSWER) A. I did not use tobacco of any kind during the past 12 months B. I did not try to quit during the past 12 months C. Attended a program in my school D. Attended a program in the community E. Called a telephone help line or telephone quit line F. Used nicotine gum G. Used nicotine patch H. Used any medicine to help quit I. Visited an Internet quit site J. Got help from family or friends K. Used another method, such as hypnosis or acupuncture L. Tried to quit on my own or quit “cold turkey”	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
M	The next questions ask about your thoughts on different types of tobacco products.	We request to change the preamble for the thoughts on tobacco products section to reflect the actual number questions asked in this section to be consistent with preambles in other sections. Proposed modified preamble is below: The next twelve questions ask about your thoughts on tobacco products.
O	56. How much do you think people harm themselves when they smoke cigarettes some days but not every day? A. No harm B. Little harm C. Some harm D. A lot of harm	We request to change the order or the question from Q56 to Q61.
D	57. How much do you think people harm themselves when they smoke cigars, cigarillos or little cigars some days but not every day? A. No harm B. Little harm C. Some harm D. A lot of harm	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
O	58. How much do you think people harm themselves when they use chewing tobacco, snuff, dip, or snus, some days but not every day? A. No harm B. Little harm C. Some harm D. A lot of harm	We request to change the order or the question from Q58 to Q62.
R	Not applicable – reinstate a question from previous NYTS cycle	We request to reinstate a question from a previous cycle of NYTS, OSH/CTP periodically cycle in questions that have been asked in previous cycles of the NYTS. Proposed reinstated question is below: 63. Do you believe that chewing tobacco, snuff, dip or snus is (LESS ADDICTIVE, EQUALLY ADDICTIVE, or MORE ADDICTIVE) than cigarettes? A. Less addictive B. Equally addictive C. More addictive D. I have never heard of chewing tobacco, snuff, dip or snus E. I don’t know enough about these products
O	59. How much do you think people harm themselves when they use e-cigarettes some days but not every day? A. No harm B. Little harm C. Some harm D. A lot of harm	We request to change the order or the question from Q59 to Q64.
R	Not applicable – reinstate a question from previous NYTS cycle	We request to reinstate a question from a previous cycle of NYTS, OSH/CTP periodically cycle in questions that have been asked in previous cycles of the NYTS. Proposed reinstated question is below: 65. Do you believe that e-cigarettes are (LESS ADDICTIVE, EQUALLY ADDICTIVE, or MORE ADDICTIVE) than cigarettes? A. Less addictive B. Equally addictive C. More addictive D. I have never heard of e-cigarettes E. I don’t know enough about these products
M	Not applicable – modified question	We request to add a modified question. This question is an incremental modification of a question that a similar question appears in previous cycles of NYTS for cigarettes, smokeless tobacco and e-cigarettes and in an earlier section of proposed questionnaire (proposed questions 56, 58, and 64). Cognitive testing on previous cycles showed that youth understood what is meant by each product. Proposed modified question is below: 66. How much do you think people harm themselves when they smoke tobacco in a hookah or waterpipe some days but not every day? A. No harm B. Little harm C. Some harm D. A lot of harm
M	Not applicable – modified question	We request to add a modified question. A similar question appears in previous cycles of NYTS for smokeless tobacco and e-cigarettes and in an earlier section of proposed questionnaire (proposed questions 63 and 65). Cognitive testing on previous cycles showed that youth understood what is meant by each product. Proposed modified question is below: 67. Do you believe that smoking tobacco in a hookah or waterpipe is (LESS ADDICTIVE, EQUALLY ADDICTIVE, or MORE ADDICTIVE) than cigarettes? A. Less addictive B. Equally addictive C. More addictive D. I have never heard of smoking tobacco in a hookah or waterpipe E. I don’t know enough about these products
O	60. How strongly do you agree with the statement ‘All tobacco products are dangerous’? A. Strongly agree B. Agree C. Disagree D. Strongly disagree	We request to change the order of the question from Q60 to Q68.
O, M	61. Do you think that breathing smoke from other people’s cigarettes or other tobacco products causes… A. No harm B. Little harm C. Some harm D. A lot of harm	We request to change the order from Q61 to Q69 and modify the question by including in the beginning of the question “Not including the vapor from e-cigarettes”. We request the modification in order to delineate exposure to secondhand smoke from combustible tobacco products from exposure to secondhand aerosol from e-cigarettes and cognitive testing on previous cycles showed that youth understood what is meant by each product. Proposed new order and modified question is below: 69. Not including the vapor from e-cigarettes, do you think that breathing smoke from other people’s cigarettes or other tobacco products causes… A. No harm B. Little harm C. Some harm D. A lot of harm
D	62. Do you think the minimum age to buy tobacco products should be 21? A. Definitely yes B. Probably yes C. Probably not D. Definitely not	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
D	The next two questions are about visits to a doctor, dentist, nurse, or other health professional.	We request to delete the preamble. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete preambles for sections that are not asked and to allow for addition of new or alternate section.
D	63. Think about each time that you visited a doctor, dentist, or nurse in the past 12 months. During any of these visits were you asked if you used tobacco that is smoked or put in your mouth? A. I did not see a doctor, dentist, or nurse during the past 12 months B. Yes C. No	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
D	64. During the past 12 months, did any doctor, dentist, or nurse give you advice not to use tobacco that is smoked or put in your mouth? A. I did not see a doctor, dentist, or nurse during the past 12 months B. Yes C. No	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
D	The next four questions ask about issues related to tobacco advertisement. Do not think of electronic cigarettes.	We request to delete the preamble. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete preambles for sections that are not asked and to allow for addition of new section.
D	65. When you are using the Internet, how often do you see ads or promotions for cigarettes or other tobacco products? A. I do not use the Internet B. Never C. Rarely D. Sometimes E. Most of the time F. Always	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
D	66. When you read newspapers or magazines, how often do you see ads or promotions for cigarettes or other tobacco products? A. I do not use read newspapers or magazines B. Never C. Rarely D. Sometimes E. Most of the time F. Always	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
D	67. When you go to a convenience store, supermarket, or gas station, how often do you see ads or promotions for cigarettes or other tobacco products? A. I never go to a convenience store, supermarket, or gas station B. Never C. Rarely D. Sometimes E. Most of the time F. Always	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
D	68. When you watch TV or go to the movies, how often do you see actors and actresses using cigarettes or other tobacco products? A. I do not watch TV or go to the movies B. Never C. Rarely D. Sometimes E. Most of the time F. Always	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
M	The next four questions ask about issues related to electronic cigarette advertisement.	We request to modify the preamble for the e-cigarette advertisement section by removing ‘electronic cigarettes’ from the preamble. The removal of ‘electronic cigarettes’ from the preamble is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood Proposed modified preamble is below: The next four questions ask about issues related to e-cigarette advertisement.
O, M	69. When you are using the Internet, how often do you see ads or promotions for electronic cigarettes or e-cigarettes? A. I do not use the Internet B. Never C. Rarely D. Sometimes E. Most of the time F. Always	We request to change the order of this question from Q69 to Q73 and to modify it by removing ‘electronic cigarettes’. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Proposed new order and modified question is below: 73. When you are using the Internet, how often do you see ads or promotions for e-cigarettes? A. I do not use the Internet B. Never C. Rarely D. Sometimes E. Most of the time F. Always
O, M	70. When you read newspapers or magazines, how often do you see ads or promotions for electronic cigarettes or e-cigarettes? A. I do not use read newspapers or magazines B. Never C. Rarely D. Sometimes E. Most of the time F. Always	We request to change the order of this question from Q70 to Q74 and to modify it by removing ‘electronic cigarettes’. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Proposed new order and modified question is below: 74. When you read newspapers or magazines, how often do you see ads or promotions for e-cigarettes? A. I do not read newspapers or magazines B. Never C. Rarely D. Sometimes E. Most of the time F. Always
O, M	71. When you go to a convenience store, supermarket, or gas station, how often do you see ads or promotions for electronic cigarettes or e-cigarettes? A. I never go to a convenience store, supermarket, or gas station B. Never C. Rarely D. Sometimes E. Most of the time F. Always	We request to change the order of this question from Q71 to Q75 and to modify it by removing ‘electronic cigarettes’. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Proposed new order and modified question is below: 75. When you go to a convenience store, supermarket, or gas station, how often do you see ads or promotions for e-cigarettes? A. I never go to a convenience store, supermarket, or gas station B. Never C. Rarely D. Sometimes E. Most of the time F. Always
O, M	72. When you watch TV, how often do you see ads or promotions for electronic cigarettes or e-cigarettes? A. I do not watch TV B. Never C. Rarely D. Sometimes E. Most of the time F. Always	We request to change the order of this question from Q72 to Q76 and to modify it by removing ‘electronic cigarettes’. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Proposed new order and modified question is below: 76. When you watch TV, how often do you see ads or promotions for e-cigarettes? A. I do not watch TV B. Never C. Rarely D. Sometimes E. Most of the time F. Always
M	The next four questions ask about you being around other people’s tobacco smoke or vapor from electronic cigarettes or e-cigarettes.	We request to modify the preamble by removing ‘electronic cigarettes’. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Proposed modified preamble is below: The next three questions ask about you being around other people’s tobacco smoke. Do not include exposure to vapor from e-cigarettes.
O	73. During the past 7 days, on how many days did someone smoke tobacco products in your home while you were there? A. 0 days B. 1 day C. 2 days D. 3 days E. 4 days F. 5 days G. 6 days H. 7 days	We request to change the order or the question from Q73 to Q77.
O, M	74. During the past 7 days, on how many days did you ride in a vehicle were someone was smoking a tobacco product? A. 0 days B. 1 day C. 2 days D. 3 days E. 4 days F. 5 days G. 6 days H. 7 days	We request to change the order from Q74 to Q78 and modify the question. The modification is grammatical and is to change ‘were’ to ‘when’ in the question. Proposed new order and modified question is below: 78. During the past 7 days, on how many days did you ride in a vehicle when someone was smoking a tobacco product? A. 0 days B. 1 day C. 2 days D. 3 days E. 4 days F. 5 days G. 6 days H. 7 days
O	75. During the past 30 days, on how many days did you breathe the smoke from someone who was smoking tobacco products in an indoor or outdoor public place? Examples of indoor public places are school buildings, stores, restaurants, and sports arenas. Examples of outdoor public places are school grounds, parking lots, stadiums and parks. A. 0 days B. 1 or 2 days C. 3 to 5 days D. 6 to 9 days E. 10 to 19 days F. 20 to 29 days G. All 30 days	We request to change the order of the question. From Q75 to Q79
N	Not applicable – new preamble	We request the addition of a new preamble. The addition of this preamble is to separate exposure to secondhand aerosols from e-cigarettes from the section on exposure to secondhand smoke. Cognitive testing on previous cycles showed that youth understood what is meant by each product. Proposed new preamble is below: The next question asks about being around other people’s e-cigarette vapor. Do not include exposure to smoke from tobacco products.
O, M	76. During the past 30 days, on how many days did you breathe the vapor from someone who was using an electronic cigarette or e-cigarette in an indoor or outdoor public place? Examples of indoor public places are school buildings, stores, restaurants, and sports arenas. Examples of outdoor public places are school grounds, parking lots, stadiums and parks. A. 0 days B. 1 or 2 days C. 3 to 5 days D. 6 to 9 days E. 10 to 19 days F. 20 to 29 days G. All 30 days	We request to change the order of this question from Q76 to Q80 and to modify it by removing ‘electronic cigarettes’. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone was well understood. Proposed new order and modified question is below: 80. During the past 30 days, on how many days did you breathe the vapor from someone who was using an e-cigarette in an indoor or outdoor public place? Examples of indoor public places are school buildings, stores, restaurants, and sports arenas. Examples of outdoor public places are school grounds, parking lots, stadiums and parks. A. 0 days B. 1 or 2 days C. 3 to 5 days D. 6 to 9 days E. 10 to 19 days F. 20 to 29 days G. All 30 days
O, M, I	77. Does anyone who lives with you now…? (CHECK ALL THAT APPLY). A. Smoke cigarettes B. Smoke cigars, cigarillos, or little cigars C. Use chewing tobacco, snuff, or dip D. Use electronic cigarettes or e-cigarettes E. Smoke tobacco out of a hookah or waterpipe F. Smoke pipes filled with tobacco (not waterpipes) G. Use snus H. Use dissolvable tobacco products I. Smoke bidis (small brown cigarettes wrapped in a leaf) J. No one who lives with me now uses any form of tobacco	We request to change the order from Q77 to Q81 and modify the question by removing ‘electronic cigarettes’ from response option ‘D’. The removal of ‘electronic cigarettes’ from the response option is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. We also request to change the instruction from ‘CHOOSE ALL THAT APPLY’ to ‘Select one or more’ to align to the way other questions that allow multiple selections have these instructions asked. We request to change response option E from ‘Smoke tobacco out of a hookah or waterpipe’ to ‘Smoke tobacco in a hookah or waterpipe’ Proposed new order and modified is below: 81. Does anyone who lives with you now…? (Select one or more) A. Smoke cigarettes B. Smoke cigars, cigarillos, or little cigars C. Use chewing tobacco, snuff, or dip D. Use e-cigarettes E. Smoke tobacco in a hookah or waterpipe F. Smoke pipes filled with tobacco (not waterpipes) G. Use snus H. Use dissolvable tobacco products I. Smoke bidis (small brown cigarettes wrapped in a leaf) J. No one who lives with me now uses any form of tobacco
D	The last four questions are about your experiences at home and at school.	We request to delete the preamble. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete preambles for sections that are not asked and to allow for addition of new or alternate sections.
O,M	78. Out of every 10 students in your grade at school, how many do you think use electronic cigarettes or e-cigarettes? A. 0 B. 1 C. 2 D. 3 E. 4 F. 5 G. 6 H. 7 I. 8 J. 9 K. 10	We request to change the order from Q78 to Q71 and modify the question by removing ‘electronic cigarettes’ from the question. The removal of ‘electronic cigarettes’ from the question is requested because cognitive testing from PATH demonstrated that use of e-cigarettes alone in the preamble was well understood. Proposed new order and modified question is below: 71. Out of every 10 students in your grade at school, how many do you think use e-cigarettes? A. 0 B. 1 C. 2 D. 3 E. 4 F. 5 G. 6 H. 7 I. 8 J. 9 K. 10
R	Not applicable – reinstate a question from previous NYTS cycle	We request to reinstate a question from a previous cycle of NYTS. OSH/CTP periodically cycle in questions that have been asked in previous cycles of the NYTS. Proposed reinstated question is below: 70. Out of every 10 students in your grade at school, how many do you think smoke cigarettes? A. 0 B. 1 C. 2 D. 3 E. 4 F. 5 G. 6 H. 7 I. 8 J. 9 K. 10
M	Not applicable – modified question	We request to add a modified question. This question is an incremental modification of a similar question appears in previous cycles of NYTS for cigarettes and in an earlier section of proposed questionnaire (proposed question 70). Cognitive testing on previous cycles showed that youth understood what is meant by each product Proposed modified question is below: 72. Out of every 10 students in your grade at school, how many do you think smoke tobacco in a hookah or waterpipe? A. 0 B. 1 C. 2 D. 3 E. 4 F. 5 G. 6 H. 7 I. 8 J. 9 K. 10
D	79. During the past 30 days, how many days did you miss at least one class period because you skipped or "cut" or just did not want to be there? A. 0 days B. 1 day C. 2 to 5 days D. 6 to10 days E. 11 or more days	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
D	80. Do you speak a language other than English at home? A. Yes B. No	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.
D	81. Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering, or making decisions? A. Yes B. No	We request to delete the question. To maintain the length of the survey and to keep respondent burden the same, OSH/CTP periodically delete questions to allow for the addition of new or alternate questions.

1 Rolle IV, Kennedy SM, Agaku I, et al. Cigarette, cigar, and marijuana use among high school students — United States, 1997–2013. MMWR 2015;64(40):1136-41.

2 Morean ME, Kong G, Camenga DR, et al. High school students’ use of electronic cigarettes to vaporize cannabis. Pediatrics 2015;136(4)”611-6.

3 Arrazola RA, Singh T, Corey CG, et al. Tobacco use among middle and high school students—United States, 2011–2014. MMWR 2015;64(14):381–5

4 Barnett TE, Smith T, He Y, et al. Evidence of emerging hookah use among university students: a cross-sectional comparison between hookah and cigarette use. BMC Public Health 2013;13:302

5 Sterling KL, Mermelstein R. Examining hookah smoking among a cohort of adolescent ever smokers. Nicotine Tob Res 2011;13(12):1202-9

6 Jamil H, Elsouhag D, Hiller S, et al. Sociodemographic risk indicators of hookah smoking among White Americans: a pilot study. Nicotine Tob Res 2010;12(5):525-9

7 Corey CG, Ambrose BK, Apelberg BJ, King BA. Flavored tobacco product use among middle and high school students — United States, 2014. MMWR 2015;64(38):1066-70

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