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pdfPopulation Assessment of Tobacco and Health (PATH) Study (NIDA)
Attachment 4
Summary of
Changes to
Instruments for
Wave 4
Attachment 4 - Summary of Changes to Instruments for Wave 4
The purpose of this attachment is to provide a high-level overview of changes to the PATH Study
questionnaires from Wave 3 to Wave 4. This overview includes the change in total item counts per section
across Waves (tables ‘a’), as well as a description summary of the content that was added or deleted in
Wave 4 that corresponds to the fluctuations in item counts (tables ‘b’).
The following tables outline changes in the (a) item counts and (b) questionnaire content across Waves for
the:
- Adult Questionnaire (see Tables 1a and 1b),
- Youth Questionnaire (see Tables 2a and 2b),
- Parent Questionnaire (see Tables 3a and 3b), and
- Nicotine Exposure Questionnaire (see Tables 4a and 4b).
See section A.2b in Supporting Statement A for more information on the different types of questionnaires.
1
Table 1a. ADULT QUESTIONNAIRE - Change in Total Item Counts from Wave 3 to Wave 4
Total Number of Items per Section
Wave 3
Adult Questionnaire Section
Wave 4
Change in Total Item
Count from W3 to W4
Extended
AgedUp
Extended
Aged-Up/
New
Extended
Aged-Up/
New
Introductory Demographics
11
11
9
21
-2
+10
Tobacco Use
102
102
69
89
-33
-13
Cigarette
48
56
57
66
+9
+10
Electronic Nicotine Products
73
81
79
86
+6
+5
Cigar
63
79
79
86
+16
+7
Pipe
39
47
41
48
+2
+1
Hookah
51
59
51
58
--
-1
Snus
46
54
51
58
+5
+4
Smokeless Tobacco
43
51
50
57
+7
+6
5
5
5
5
--
--
5
5
5
5
--
--
Nicotine Dependence
146
146
147
147
+1
+1
Packaging and Health Warnings
25
25
41
41
+16
+16
Product Regulation-Modified Risk Tobacco Products
57
58
66
67
+9
+9
Media Use
10
10
11
11
+1
+1
Secondhand Smoke Exposure
12
12
11
12
-1
--
Social Norms-Peer and Family Influences
31
31
13
13
-18
-18
Health
160
221
180
240
+20
+19
Marketing, Advertising and Promotion
21
21
28
28
+7
+7
Additional Demographics
27
27
29
29
+2
+2
Product Barcode Scanning
26
26
26
26
--
--
Contact Information
Total (Entire Questionnaire)
29
29
29
29
--
--
1030
1156
1077
1222
+47
+66
New Product - Placeholder
2
Polyuse
1
This table reflects total item counts; it does not account for the conditions in which the items are asked. For example, the item counts for the ‘aged-up’
respondents are included in the item counts for the ‘new’ respondents in this table. However, due to skip patterns and programmed routing, every respondent is
not asked all items reflected in these counts. Consequently, the average time to complete the Adult interview remains at 60 minutes for the Wave 4 Extended
instruments, and increases to 68 minutes for the Wave 4 Aged-Up/New instrument.
2
The section enables the PATH Study to be responsive to the changing marketplace and can be rapidly deployed. The module collects basic usage information about
products that are not currently included in the PATH Study. The module will remain suppressed until such time that emerging products dictate its deployment.
1
Attachment 4 - Summary of Changes to Instruments for Wave 4
TABLE 1b. ADULT QUESTIONNAIRE – Description of Content Changes from Wave 3 to Wave 4
Affected
Wave 4
Wave 4 Section
Respondent
Description of Questions
Change
Category
On respondent’s sex, race, ethnicity, active
New Cohort
Added
duty military status, and residency in the U.S.
Adults
during 2014.
Introductory
Demographics
Deleted
Continuing
Adults
On military branch in which respondent
served.
Deleted
Continuing
Adults
On US citizenship.
Added
New Cohort
Adults
Added
All Adults Age
25+
Deleted
All Young
Adults Age
18-24
Deleted
All Adults Age
25+
Deleted
All Adults Age
25+
Tobacco Use
Deleted
All Adults
On whether respondent has heard of a given
product (not including cigarettes), and
whether respondent has ever used a given
product (including blunts).
On the likelihood of smoking a cigarette or
hookah, or using smokeless tobacco soon
among non-users.
On non-user’s susceptibility to becoming a
user of traditional cigars, cigarillos, filtered
cigars or pipe tobacco including curiosity
about using, likelihood of using in the next
year or using soon, and whether respondent
might use if offered by best friend.
On curiosity about using snus, likelihood of
using snus in the next year, and whether
respondent might use snus if it were offered
by best friend.
On non-user’s susceptibility to becoming an
ENDS user including curiosity about using,
likelihood of using in the next year or using
soon, and whether respondent might use if
offered by best friend.
On use of Skoal Bandits.
2
Rationale for Change
These questions collect baseline demographic
information from respondents who are new to the
PATH Study in Wave 4.
Assessed in previous waves. It is not necessary to ask
continuing respondents again; however, question will
be asked of youth who age-up to the adult cohort in
Wave 4.
Assessed in previous waves. It is not necessary to ask
known US citizens again; however, question will be
asked of all respondents who did not previously report
being a US citizen.
These questions collect baseline assessments of
tobacco use history from respondents who are new to
the PATH Study in Wave 4.
In Wave 3, these items were asked of young adult nonusers aged 18 to 24. In Wave 4, these items will be
asked of all non-user adults.
These questions were deleted for young adults aged 18
to 24 to make time for new questions that are of
higher priority.
These questions were deleted for adults aged 25 or
older to make time for new questions that are of
higher priority.
These questions were deleted for adults aged 25 or
older to make time for new questions that are of
higher priority; construct will still be assessed for young
adults aged 18 to 24.
The design has been changed in Wave 4 to ask about
pouched smokeless or snus use in the sections below.
It is no longer necessary to ask about Skoal Bandits
specifically.
Attachment 4 - Summary of Changes to Instruments for Wave 4
Wave 4 Section
Wave 4
Change
Affected
Respondent
Category
Description of Questions
Added
New Cohort
Adults
On age first smoked a cigarette and on the
amount smoked 12 months ago.
Added
All Adults
On disposal of cigarette butts and packs.
Cigarette
Electronic Nicotine
Products
(formerly the “Primary
Electronic Nicotine
Products” section)
On whether favorite cigarette to smoke is the
first one in the morning, if they smoke more
frequently in the first hours after waking, and
if they smoke when they are ill.
On frequency of coupon use when purchasing
cigarettes.
Added
All Adults
Deleted
All Adults
Added
All Adults
On ownership of a flavored ENDS product.
Added
New Cohort
Adults
On age first used ENDS and on the amount
used 12 months ago.
Added
All Adults
On frequency of flavored ENDS use in the past
30 days.
Added
All Adults
On dual use of cigarettes and ENDS.
Added
All Adults
Deleted
All Adults
Deleted
All Adults
On changing the voltage on ENDS devices.
Deleted
All Adults
On frequency of coupon use when purchasing
ENDS or e-liquid.
Deleted
All Adults
On use behaviors of secondary electronic
nicotine products.
Added
All Adults
On frequency of flavored cigar and blunt use
in the past 30 days.
On frequency of using ENDS to smoke
marijuana or marijuana derivatives.
On using ENDS as an alternative to quitting
tobacco.
N/A
(formerly the “Secondary
Electronic Nicotine
Products” section)
Cigars
3
Rationale for Change
These questions collect baseline assessments of
tobacco use history from respondents who are new to
the PATH Study in Wave 4.
To assess the potential environmental impact of
tobacco product and packaging disposal.
To further enhance assessment of nicotine
dependence.
These questions were deleted to make time for new
questions that are of higher priority.
To assess the context of use of flavored ENDS products.
These questions collect baseline assessments of
tobacco use history from respondents who are new to
the PATH Study in Wave 4.
To assess how often respondents used ENDS flavored
like menthol, mint or other flavors in the past 30 days.
To assess whether dual users of cigarettes and ENDS
use one product more than the other on days when
both products are used.
To identify respondents who use their ENDS device
solely for smoking marijuana.
This measure is assessed by other questions in the
PATH Study and was deleted to avoid redundancy.
These questions were cycled off to make time for new
questions that are of higher priority.
These questions were deleted to make time for new
questions that are of higher priority.
Previously, respondents who use more than one ENDS
product reported on their primary and secondary
products separately. In Wave 4, respondents will
report on their combined use of all ENDS products. As
such, this section is no longer relevant to the PATH
Study in Wave 4 and has been deleted.
To assess how often respondents smoked flavored
cigars or used flavored cigars to smoke blunts in the
past 30 days.
Attachment 4 - Summary of Changes to Instruments for Wave 4
Wave 4 Section
Pipe
Hookah
Snus
Wave 4
Change
Affected
Respondent
Category
Description of Questions
Added
All Adults
On cartons of filtered cigars.
Added
New Cohort
Adults
On age first smoked a cigar and on the
amount smoked 12 months ago.
Deleted
All Adults
Deleted
All Adults
Added
New Cohort
Adults
Deleted
All Adults
Deleted
All Adults
Added
New Cohort
Adults
Added
All Adults
Deleted
All Adults
Deleted
All Adults
On price paid for shisha.
Added
New Cohort
Adults
On age first used snus and on the amount
used 12 months ago.
Added
All Adults
On frequency of flavored snus use in the past
30 days.
Added
All Adults
On use of pouched or loose snus.
Deleted
All Adults
On using snus as an alternative to quitting
tobacco.
Deleted
All Adults
On using a coupon when purchasing snus.
On smoking cigars as an alternative to quitting
tobacco.
On frequency of coupon use when purchasing
traditional cigars, cigarillos, and filtered cigars.
On age first smoked a pipe and on the amount
smoked 12 months ago.
On smoking pipes as an alternative to quitting
tobacco.
On frequency of coupon use when purchasing
pipe tobacco.
On age first smoked hookah and on the
amount smoked 12 months ago.
On frequency of flavored shisha use in the
past 30 days.
On smoking hookah as an alternative to
quitting tobacco.
4
Rationale for Change
To assess whether respondents typically purchase by
the carton, number of packs contained in a carton, and
price paid for a carton of filtered cigars.
These questions collect baseline assessments of
tobacco use history from respondents that are new to
the PATH Study in Wave 4.
This measure is assessed by other questions in the
PATH Study and was deleted to avoid redundancy.
These questions were deleted to make time for new
questions that are of higher priority.
These questions collect baseline assessments of
tobacco use history from respondents who are new to
the PATH Study in Wave 4.
This measure is assessed by other questions in the
PATH Study and was deleted to avoid redundancy.
These questions were deleted to make time for new
questions that are of higher priority.
These questions collect baseline assessments of
tobacco use history from respondents who are new to
the PATH Study in Wave 4.
To assess how often respondents smoked flavored
shisha or hookah tobacco in the past 30 days.
This measure is assessed by other questions in the
PATH Study and was deleted to avoid redundancy.
These questions were deleted to make time for new
questions that are of higher priority.
These questions collect baseline assessments of
tobacco use history from respondents who are new to
the PATH Study in Wave 4.
To assess how often respondents use flavored snus in
the past 30 days.
To identify which type of snus the respondent uses and
the type used most often for users of both types.
This measure is assessed by other questions in the
PATH Study and was deleted to avoid redundancy.
These questions were deleted to make time for new
questions that are of higher priority.
Attachment 4 - Summary of Changes to Instruments for Wave 4
Wave 4 Section
Wave 4
Change
Affected
Respondent
Category
Description of Questions
Added
New Cohort
Adults
On age first used smokeless tobacco and on
the amount used 12 months ago.
Added
All Adults
On frequency of flavored smokeless tobacco
use in the past 30 days.
Added
All Adults
On use of pouched or loose smokeless
tobacco.
Added
All Adults
Deleted
All Adults
Deleted
All Adults
Added
All Adults
On reasons for using NRT.
All Adults
On whether respondent noticed health
warnings on packages of ENDS, traditional
cigars, cigarillos, filtered cigars, pipe tobacco,
and hookah tobacco.
Questions were cycled out in a previous wave; they are
cycled back in for Wave 4 to assess respondent
exposure to health warnings on packaging.
Added
All Adults
On health warning labels on ENDS, traditional
cigars, cigarillos, filtered cigars and hookah
tobacco packages including how often a
respondent looked closely at them and how
they make a respondent feel about the health
risks associated with use.
Questions were asked about other products in Wave 3;
they are added for ENDS, traditional cigars, cigarillos,
filtered cigars, and hookah in Wave 4 to assess
respondent exposure to and impact of health warnings
on packaging.
Added
All Adults
On perceived harmfulness of the nicotine in
cigarettes, ENDS, and NRT.
To assess whether respondents’ perceptions of harm of
nicotine vary by product.
Added
All Adults
On perceived addictiveness of reduced
nicotine cigarettes.
To assess respondents’ understanding and perceptions
of modified risk products.
Added
All Adults
On perceived harm of using flavored ENDS
compared to tobacco-flavored or unflavored
ENDS.
To assess whether respondents’ perceptions of harm
vary by flavoring.
Added
All Adults
On perceived harm of using e-cigarettes/ENDS
compared to NRT.
To assess respondent’s perception of harm amongst
reduced harm or modified risk products.
Smokeless Tobacco
Nicotine Dependence
Added
Packaging and Health
Warnings
Product Regulation –
Modified Risk
Tobacco Products
On quantity contained in a package of
pouched smokeless and length of time taken
to consume it.
On using smokeless tobacco as an alternative
to quitting tobacco.
On using a coupon when purchasing
smokeless tobacco.
5
Rationale for Change
These questions collect baseline assessments of
tobacco use history from respondents who are new to
the PATH Study in Wave 4.
To assess how often respondents use flavored
smokeless tobacco in the past 30 days.
To identify which type of smokeless tobacco the
respondent uses and the type used most often for
users of both types.
To complement other measures related to packaging
and dosage.
This measure is assessed by other questions in the
PATH Study and was deleted to avoid redundancy.
These questions were deleted to make time for new
questions that are of higher priority.
To explore whether respondents are using NRT for
reasons other than to quit tobacco.
Attachment 4 - Summary of Changes to Instruments for Wave 4
Wave 4 Section
Media Use
Health
Wave 4
Change
Affected
Respondent
Category
Description of Questions
Rationale for Change
Added
All Adults
On time spent online on weekdays and
weekends.
Added
All Adults
On device ownership.
Deleted
All Adults
On using online apps related to
tobacco/ENDS.
To assess respondent’s potential exposure to tobacco
campaign advertising via the internet.
To assess respondent ownership of e-book readers,
desktop or laptop computers, gaming consoles, MP3
players, and portable gaming devices in addition to
tablet computers, cellular phones, and smart phones
(which were assessed in Wave 3).
The question was deleted to make time for new
questions that are of higher priority.
Added
All Adults
On frequency of tooth brushing.
To inform analysis of oral/dental health.
Added
All Adults
On diagnosis of schizophrenia, schizoaffective
disorder or psychosis, or psychotic illness or
episode and age of diagnosis/onset.
To ascertain prevalence of these diagnoses among
respondents.
Added
New Cohort
Adults
On pregnancy history.
Added
New Cohort
Adults
On substance use history of alcohol,
marijuana, prescription drugs of abuse, and
illicit/street drugs.
Deleted
All Adults
On dental treatment for gum disease.
Deleted
Continuing
Adults
On respondent’s in-utero exposure to tobacco
products.
Deleted
All Adults
Deleted
All Adults
Deleted
All Adults
On ulcer or gastrointestinal bleeding.
Deleted
All Adults
On cataract or glaucoma.
Deleted
All Adults
On cancer and precancerous oral lesions.
Deleted
All Adults
On osteoporosis, fragile bones.
Deleted
All Adults
On rapid vision loss.
On COPD, chronic bronchitis, emphysema,
asthma, lung or respiratory conditions.
On gum disease, teeth cleaning, bone loss
around teeth.
6
These questions collect baseline assessments of
pregnancy history and outcomes from respondents
who are new to the PATH Study in Wave 4.
These questions collect baseline assessments of
substance use history from respondents who are new
to the PATH Study in Wave 4.
These questions were deleted to make time for new
questions that are of higher priority.
Asked at Wave 3; not necessary to ask again in Wave 4;
however, will be asked of youth who age-in to the
adult cohort.
Respondents who indicate they have not seen a
medical doctor and/or dentist in the past 12 months
will not be asked if a medical doctor and/or nurse told
them they had these conditions in the past 12 months;
past 12 month status for respondents who indicate
they have seen a medical doctor and/or dentist in the
past 12 months will be assessed for these conditions.
Attachment 4 - Summary of Changes to Instruments for Wave 4
Wave 4 Section
Marketing,
Advertising, and
Promotion
Wave 4
Change
Affected
Respondent
Category
Description of Questions
Rationale for Change
On heart conditions such as high blood
pressure, high cholesterol, congestive heart
failure, stroke, heart attack or bypass surgery.
On whether a doctor advised respondent to
stop using ENDS.
Deleted
All Adults
Deleted
All Adults
Added
All Adults
On brand of respondent’s favorite
advertisement for ENDS and other tobacco.
Questions were cycled out in a previous wave; they are
cycled back in for Wave 4.
Added
All Adults
On awareness of LGBT media campaign and
rural smokeless tobacco media campaign.
To assess exposure to media campaign logo and slogan.
Added
All Adults
On Point of Sale campaign.
Deleted
All Adults Age
25+
On whether respondent has a favorite tobacco
advertisement.
Added
All Adults
On interest in completing a web-based PATH
survey.
Deleted
All Adults
On whether tobacco users paid more for
health insurance premiums compared to nontobacco users.
Additional
Demographics
7
To assess exposure to campaign and whether exposure
changed purchasing behavior.
Question was deleted for adults aged 25 or older to
make time for new questions that are of higher
priority; construct will still be assessed for young adults
aged 18 to 24.
To assess interest in completing the PATH survey
online if it became available as a web survey in future
waves.
These questions were deleted to make time for new
questions that are of higher priority.
Attachment 4 - Summary of Changes to Instruments for Wave 4
1
Table 2a. YOUTH QUESTIONNAIRE - Change in Total Item Counts from Wave 3 to Wave 4
Total Number of Items per Section
Wave 3
Youth Questionnaire Section
Wave 4
Change in Total Item
Count from W3 to W4
Extended
Aged-Up
Extended
Aged-Up/
New
Extended
Aged-Up/
New
Introductory Demographics
8
11
7
10
-1
-1
Cigarette
33
41
44
46
+11
+5
Electronic Nicotine Products
62
69
69
72
+7
+3
Cigar
72
79
88
92
+16
+13
Pipe
10
11
13
14
+3
+3
Hookah
46
53
54
57
+8
+5
Snus
38
44
46
49
+8
+5
Smokeless Tobacco
34
40
45
48
+11
+8
Dissolvable Tobacco
2
3
2
4
--
+1
Bidis and Kreteks
2
4
2
4
--
--
Other Tobacco
1
1
1
1
--
--
5
5
5
5
--
--
First Tobacco Product
1
1
1
1
--
--
Nicotine Dependence and Cessation /Quitter
30
30
39
39
+9
+9
Packaging and Health Warnings
26
33
31
31
+5
-2
Product Regulation-Modified Risk Tobacco Products
43
43
56
56
+13
+13
Media Use
11
12
10
11
-1
-1
Secondhand Smoke Exposure
5
5
2
2
-3
-3
Health
40
40
46
49
+6
+9
Marketing, Advertising and Promotion
17
17
19
19
+2
+2
Social Norms-Peer and Family Influences
39
39
26
26
-13
-13
Accessibility
5
5
5
5
--
--
Psychosocial
12
15
12
15
--
--
Substance Use
19
29
18
33
-1
+4
Additional Demographics
11
11
16
16
-5
+5
Contact Information (Emancipated Youth)
Total (Entire Questionnaire)
29
29
29
27
--
-2
601
670
686
732
+85
+62
New Product - Placeholder
2
1
This table reflects total counts of items; it does not account for the conditions in which the items are asked. For example, due to skip patterns and programmed
routing, every respondent is not asked all items reflected in these counts. The average time to complete the Youth interview remains at 35 minutes for the Wave 4
Extended instrument, and 45 minutes for the Wave 4 Aged-Up/New instrument.
2
The section enables the PATH Study to be responsive to the changing marketplace and can be rapidly deployed. The module collects basic usage information about
products that are not currently included in the PATH Study. The module will remain suppressed until such time that emerging products dictate its deployment.
8
Attachment 4 - Summary of Changes to Instruments for Wave 4
TABLE 2b. YOUTH QUESTIONNAIRE – Description of Content Changes from Wave 3 to Wave 4
Affected
Wave 4
Wave 4 Section
Respondent
Description of Questions
Change
Category
Introductory
Demographics
Rationale for Change
Assessed in previous waves. It is not necessary to
ask known US citizens again; however, question
will be asked of all respondents who did not
previously report being a US citizen.
Urine biospecimens will be collected from youth
respondents in Wave 4; Nicotine Exposure
Questions (NEQs) will be asked of youth
respondents in Wave 4 to inform biospecimen
analysis.
Deleted
Continuing
Youth
On US citizenship.
Added
All Youth
On cigarette smoking in the past 3 days and on
identifying last brand smoked.
Added
All Youth
On disposal of cigarette butts and packs.
To assess the potential environmental impact of
tobacco product and packaging disposal.
Deleted
All Youth
On frequency of coupon use when purchasing
cigarettes.
These questions were deleted to make time for
new questions that are of higher priority.
Cigarette
Added
All Youth
On ENDS use in the past 3 days and on identifying
last brand used.
Urine biospecimens will be collected from youth
respondents in Wave 4; Nicotine Exposure
Questions (NEQs) will be asked of youth
respondents in Wave 4 to inform biospecimen
analysis.
Electronic Nicotine
Products
Added
All Youth
(formerly the
“Primary Electronic
Nicotine Products”
section)
On frequency of using ENDS to smoke marijuana or
marijuana derivatives.
To identify respondents who use their ENDS
device solely for smoking marijuana.
Added
All Youth
On frequency of flavored ENDS use in the past 30
days.
To assess how often respondents used ENDS
flavored like menthol or mint or other flavors.
Deleted
All Youth
On changing the voltage on ENDS devices and the
number of milliliters of e-liquid an ENDS tank system
holds.
These questions were cycled off to make time for
new questions that are of higher priority.
Deleted
All Youth
On frequency of coupon use when purchasing ENDS
or e-liquid.
These questions were deleted to make time for
new questions that are of higher priority.
On use behaviors of secondary electronic nicotine
products.
Previously, respondents who use more than one
ENDS product reported on their primary and
secondary products separately. In Wave 4,
respondents will report on their combined use of
all ENDS products. As such, this section is no
longer relevant to the PATH Study in Wave 4 and
has been deleted.
N/A
(formerly the
“Secondary Electronic
Nicotine Products”
section)
Deleted
All Youth
9
Attachment 4 - Summary of Changes to Instruments for Wave 4
Wave 4 Section
Cigar
Pipe
Wave 4
Change
Affected
Respondent
Category
Description of Questions
Rationale for Change
Urine biospecimens will be collected from youth
respondents in Wave 4; Nicotine Exposure
Questions (NEQs) will be asked of youth
respondents in Wave 4 to inform biospecimen
analysis.
To assess how often respondents smoked flavored
cigars or used flavored cigars to smoke blunts in
the past 30 days.
To assess whether respondents typically purchase
by the carton, number of packs contained in a
carton, and price paid for a carton of filtered
cigars.
Urine biospecimens will be collected from youth
respondents in Wave 4; Nicotine Exposure
Questions (NEQs) will be asked of youth
respondents in Wave 4 to inform biospecimen
analysis.
Urine biospecimens will be collected from youth
respondents in Wave 4; Nicotine Exposure
Questions (NEQs) will be asked of youth
respondents in Wave 4 to inform biospecimen
analysis.
Added
All Youth
On cigar and blunt smoking in the past 3 days and
on identifying last brand smoked.
Added
All Youth
On frequency of flavored cigar and blunt use in the
past 30 days.
Added
All Youth
On cartons of filtered cigars.
Added
All Youth
On pipe smoking in the past 3 days.
Added
All Youth
On hookah smoking in the past 3 days and on
identifying last brand smoked.
Added
All Youth
On frequency of flavored shisha use in the past 30
days.
To assess how often respondents smoked flavored
shisha or hookah tobacco in the past 30 days.
Deleted
All Youth
On price paid for shisha.
These questions were deleted to make time for
new questions that are of higher priority.
Hookah
Added
All Youth
On snus use in the past 3 days and on identifying
last brand used.
Added
All Youth
On frequency of flavored snus use in the past 30
days.
Added
All Youth
On use of pouched or loose snus.
Snus
10
Urine biospecimens will be collected from youth
respondents in Wave 4; Nicotine Exposure
Questions (NEQs) will be asked of youth
respondents in Wave 4 to inform biospecimen
analysis.
To assess how often respondents used flavored
snus in the past 30 days.
To identify which type of snus the respondent
uses and the type used most often for users of
both types.
Attachment 4 - Summary of Changes to Instruments for Wave 4
Wave 4 Section
Smokeless
Tobacco
Nicotine
Dependence and
Cessation/Quitter
Packaging and
Health Warnings
Wave 4
Change
Affected
Respondent
Category
Description of Questions
Rationale for Change
Deleted
All Youth
On use of Skoal Bandits.
Deleted
All Youth
On using a coupon when purchasing snus.
Added
All Youth
On smokeless tobacco use in the past 3 days and on
identifying last brand used.
Added
All Youth
On frequency of flavored smokeless tobacco use in
the past 30 days.
Added
All Youth
On use of pouched or loose smokeless tobacco.
Added
All Youth
On quantity contained in a package of pouched
smokeless and length of time taken to consume it.
Added
All Youth
On NRT and prescription stop smoking medication
use in the past 3 days.
Added
All Youth
On whether respondent noticed health warnings on
packages of ENDS, traditional cigars, cigarillos,
filtered cigars, pipe tobacco, and hookah tobacco.
Added
All Youth
On health warning labels on ENDS, traditional cigars,
cigarillos, filtered cigars and hookah tobacco
packages including how often a respondent looked
closely at them and how they make a respondent
feel about the health risks associated with use.
The design has been changed in Wave 4 to ask
about pouched smokeless or snus use. It is no
longer necessary to ask about Skoal Bandits
specifically.
These questions were deleted to make time for
new questions that are of higher priority.
Urine biospecimens will be collected from youth
respondents in Wave 4; Nicotine Exposure
Questions (NEQs) will be asked of youth
respondents in Wave 4 to inform biospecimen
analysis.
To assess how often respondents used flavored
smokeless tobacco in the past 30 days.
To identify which type of smokeless tobacco the
respondent uses and the type used most often for
users of both types.
To complement other measures related to
packaging and dosage.
To assess usage of these medications and to
inform biospecimen analysis. Urine biospecimens
will be collected from youth respondents in Wave
4; Nicotine Exposure Questions (NEQs) will be
asked of youth respondents in Wave 4 to inform
this analysis.
Questions were cycled out in a previous wave;
they are cycled back in for Wave 4 to assess
respondent exposure to health warnings on
packaging.
Questions were asked about other products in
Wave 3; they are added for ENDS, traditional
cigars, cigarillos, filtered cigars, and hookah in
Wave 4 to assess respondent exposure to and
impact of health warnings on packaging.
Deleted
All Youth
On noticing health warning labels on packages of
bidis and kreteks.
The question was deleted to make time for new
questions that are of higher priority.
11
Attachment 4 - Summary of Changes to Instruments for Wave 4
Wave 4 Section
Wave 4
Change
Deleted
Product Regulation
– Modified Risk
Tobacco Products
Affected
Respondent
Category
All Youth
Description of Questions
On health warnings on packages of snus and
smokeless tobacco including whether they stopped
respondent from using product, whether
respondent tried to avoid looking at them, how
believable they are, and degree to which they make
respondent never want to use the product again
(among ever users).
On whether health warnings on packages of snus
and smokeless tobacco made respondent less likely
to start using (among never users).
Rationale for Change
The questions were cycled off to make time for
new questions that are of higher priority.
Deleted
All Youth
Deleted
All Youth
On how frequently the respondent saw a list of
chemicals contained in tobacco products.
Added
All Youth
On perceived harmfulness of the nicotine in
cigarettes, ENDS, and NRT.
To assess whether respondents’ perceptions of
harm of nicotine vary by product.
Added
All Youth
On perceived harm of using flavored ENDS
compared to tobacco-flavored or unflavored ENDS.
To assess respondents’ perceptions of use/harm
as influenced by flavoring.
Added
All Youth
On likelihood of becoming addicted to cigarillos or
filtered cigars.
Added
All Youth
Added
All Youth
Deleted
All Youth
Added
All Youth
On time spent online on weekdays and weekends.
Added
All Youth
On device ownership.
On perceived harm of intermittent versus daily use
of cigarettes, cigarillos, filtered cigars, snus, and
smokeless tobacco.
On length of time product can be used before harm
occurs from smoking cigarettes, traditional cigars,
cigarillos, filtered cigars, shisha or hookah tobacco,
and using snus or smokeless tobacco.
On perceived ease of use between flavored and
flavored products for: ENDS, traditional cigars,
cigarillos, filtered cigars, shisha or hookah tobacco,
snus, and smokeless tobacco.
Media Use
12
Questions were cycled out in a previous wave;
they are cycled back in for Wave 4 to assess
respondent perceptions of addiction and harm.
The questions were cycled off to make time for
new questions that are of higher priority.
To assess respondent’s potential exposure to
tobacco campaign advertising via the internet.
To assess respondent ownership of e-book
readers, desktop or laptop computers, gaming
consoles, MP3 players, and portable gaming
devices, tablet computers, cellular phones, and
smart phones.
Attachment 4 - Summary of Changes to Instruments for Wave 4
Wave 4 Section
Secondhand
Smoke Exposure
Marketing,
Advertising, and
Promotion
Social Norms, Peer
and Family
Influences
Additional
Demographics
Wave 4
Change
Affected
Respondent
Category
Description of Questions
Rationale for Change
Deleted
All Youth
On using online apps related to tobacco/ENDS.
Deleted
All Youth
The questions were cycled off to make time for
new questions that are of higher priority.
Deleted
All Youth
Added
All Youth
Added
All Youth
On exposure to movies that depict tobacco use.
On rules of using combusted and non-combusted
tobacco products and ENDS inside the home.
On brand of respondent’s favorite advertisement for
ENDS and other tobacco.
On awareness of LGBT and rural smokeless media
campaigns.
Deleted
All Youth
Added
All Youth
The questions were cycled off to make time for
new questions that are of higher priority.
Questions were cycled out in a previous wave;
they are cycled back in for Wave 4.
To assess exposure to media campaign logo and
slogan.
On whether respondent bought a product because
of a promotion.
The question was cycled off to make time for new
questions that are of higher priority.
On how many of respondent’s best friends smoke
hookah.
On the proportion of respondent’s peers who smoke
cigarettes, hookah and use ENDS, smokeless
tobacco.
To assess the role of social context in relation to
the use of tobacco products.
Added
All Youth
Deleted
All Youth
On how many of respondent’s best friends smoke
traditional cigars and filtered cigars.
These questions were deleted to make time for
new questions that are of higher priority.
Added
All Youth age
17
On serving active duty in the military and branch in
which respondent served.
To inform Wave 4 weighting.
Added
All Youth
On interest in completing a web-based PATH survey.
To assess interest in completing the PATH survey
online if it became available as a web survey in
future waves.
13
Attachment 4 - Summary of Changes to Instruments for Wave 4
1
Table 3a. PARENT QUESTIONNAIRE - Change in Total Item Counts from Wave 3 to Wave 4
Total Number of Items per Section
Wave 3
Parent Questionnaire Section
Change in Total Item
Count form W3 to W4
Wave 4
Extended
AgedUp
Extended
Aged-Up/
New
Extended
Aged-Up/
New
Family Composition
13
20
24
32
+11
+12
School, Home, and Tobacco Use
9
9
9
9
--
--
Health
21
42
31
48
+10
+6
Respondent Characteristics
14
14
19
19
+5
+5
Contact Information
31
31
33
33
+2
+2
Total (Entire Questionnaire)
88
116
116
141
+28
+25
1
This table reflects total item counts; it does not account for the conditions in which the items are asked. For example, the item counts for the ‘agedup’ respondents are included in the item counts for the ‘new’ respondents in this table. However, due to skip patterns and programmed routing,
every respondent is not asked all items reflected in these counts. Consequently, the average time to complete the Parent interview remains 16
minutes for the Wave 4 Extended instrument, and 19 minutes for the Wave 4 New/ Aged-Up instrument.
14
Attachment 4 - Summary of Changes to Instruments for Wave 4
TABLE 3b. PARENT QUESTIONNAIRE – Description of Content Changes from Wave 3 to Wave 4
Affected
Wave 4
Wave 4 Section
Respondent Description of Questions
Status
Category
On the name, age and relationship youth
Family
Added
All Parents
respondent’s guardians who live in the
Composition
home.
On youth respondent’s diagnosis of
schizophrenia, schizoaffective disorder or
Health
Added
All Parents
psychosis, or psychotic illness or episode
and age of diagnosis/onset.
Contact
Information
Added
All Parents
On interest in completing a web-based
PATH survey.
15
Rationale for Change
To obtain information about any other parental figures or guardians
in the household in addition to youth’s parents.
To ascertain prevalence of these diagnoses among respondents.
To assess interest in completing the PATH survey online if it became
available as a web survey in future waves.
Attachment 4 - Summary of Changes to Instruments for Wave 4
1
Table 4a. NICOTINE EXPOSURE QUESTIONNAIRE - Change in Total Item Counts from Wave 3 to Wave 4
Total Number of Items
Change in Total Item Count from
NEQs
W3 to W4
Wave 3
Wave 4
Total (Entire Questionnaire)
38
38
1
--
This table reflects total counts of items; it does not account for the conditions in which the items are asked. For example, due to skip patterns and
programmed routing, every respondent is not asked all items reflected in these counts. The average time to complete the Nicotine Exposure
Questionnaire remains 5 minutes in the Wave 4 interview. NEQs are asked of all respondents that consent to bio-specimen collection; there is no
distinction made between the extended, new and aged-up respondent categories.
16
Attachment 4 - Summary of Changes to Instruments for Wave 4
TABLE 4b. NICOTINE EXPOSURE QUESTIONNAIRE – Description of Content Changes from Wave 3 to Wave 4
Affected
Wave 4
Wave 4 Section
Respondent
Changes from Wave 3
Rationale for Change
Status
Category
Urine biospecimens will be collected from youth respondents in Wave
NEQs
Added
All Youth
On tobacco use in the past 3 days.
4; Nicotine Exposure Questions (NEQs) will be asked of youth
respondents in Wave 4 to inform biospecimen analysis.
17
| File Type | application/pdf |
| Author | Carolyn Gatling |
| File Modified | 2016-06-28 |
| File Created | 2016-06-12 |