Changes to Nonsmoker Survey for Waves A-E

Attachment E-2. Changes to Waves A-E Nonsmoker Survey

Item	Currently Approved	Change Type	Revised	Justification
NB3	How long has it been since you last smoked a cigarette? __________ [ENTER NUMBER] Hours (0 – 24) Days (0 – 10) Weeks (0 – 26) Months (0 – 6)	Deletion	N/A	Question is no longer needed.
NB4	When you last tried to quit smoking, did you do any of the following? 1. Yes 2. No NB4_1. Give up cigarettes all at once. NB4_2. Gradually cut back on cigarettes NB4_3. Switch completely to electronic vapor products such as e-cigarettes, vape-pens, hookah-pens, electronic hookahs (e-hookahs), electronic cigars (e-cigars), electronic pipes (e-pipes), or e-vaporizers NB4_4. Substitute some of your regular cigarettes with electronic vapor products such as e-cigarettes, vape-pens, hookah pens, electronic hookahs (e-hookahs), electronic cigars (e-cigars), electronic pipes (e-pipes), or e-vaporizers NB4_5. Switch to mild or some other brand of cigarettes NB4_6. Use nicotine replacements like the nicotine patch, nicotine gum, nicotine lozenges, nicotine nasal spray, or nicotine inhaler NB4_7. Use medications like Wellbutrin, Zyban, buproprion, Chantix, or varenicline NB4_8. Get help from a telephone quit line NB4_9. Get help from a website such as Smokefree.gov NB4_10. Get help from a doctor or other health professional	Revision (Minor)	When you last tried to quit smoking, did you do any of the following? 1. Yes 2. No NB4_1. Give up cigarettes all at once. NB4_2. Gradually cut back on cigarettes NB4_3. Switch completely to electronic vapor products such as e-cigarettes, vape-pens, hookah-pens, electronic hookahs (e-hookahs), electronic cigars (e-cigars), electronic pipes (e-pipes), or e-vaporizers NB4_4. Substitute some of your regular cigarettes with electronic vapor products such as e-cigarettes, vape-pens, hookah pens, electronic hookahs (e-hookahs), electronic cigars (e-cigars), electronic pipes (e-pipes), or e-vaporizers NB4_5. Switch to mild or some other brand of cigarettes NB4_6. Use nicotine replacements like the nicotine patch, nicotine gum, nicotine lozenges, nicotine nasal spray, or nicotine inhaler NB4_7. Use medications like Wellbutrin, Zyban, buproprion, Chantix, or varenicline NB4_8. Get help from a telephone quit line NB4_9. Get help from a website such as Smokefree.gov NB4_10. Get help from a doctor or other health professional NB4_11. Get help from a pharmacist	Added “pharmacist” to grid list to account for additional avenues of help from health professionals that smokers may seek out in attempting to quit.
NB5a	During the past 6 months, that is since [FILL DATE], have you talked to any of the following types of doctors or health care professionals about quitting smoking? 1. Yes 2. No NB5a_1. Primary care physician NB5a_2. Nurse NB5a_3. Physician’s Assistant (PA) or Nurse Practitioner (NP) NB5a_4. Pharmacist NB5a_5. Dentist or dental hygienist NB5a_6. Eye doctor, optometrist, or ophthalmologist NB5a_7. Therapist, psychologist, psychiatrist NB5a_8. Cardiologist NB5a_9. Gastroenterologist or colorectal surgeon	Deletion	N/A	Item is no longer needed as the next phases of The Campaign do not feature messages that are focused on health professionals. There is no need to track this item.
NB9a	N/A	Addition	On the days that you use electronic vapor products, how often do you use them? Rarely Sometimes Often Very Often	This item is being added to provide a more rigorous measurement of e-cigarette consumption to capture intensity or levels of consumption.
NC1	Do you believe cigarette smoking is related to Yes No NC1_1. Lung cancer NC1_2. Cancer of the mouth or throat NC1_3. Heart Disease NC1_4. Diabetes NC1_5. Emphysema NC1_6. Stroke NC1_7. Hole in throat (stoma or tracheotomy) NC1_8. Buerger’s Disease NC1_9. Amputations (removal of limbs) NC1_10. Asthma NC1_11. Gallstones NC1_12. COPD or Chronic bronchitis NC1_13. Periodontal or gum disease NC1_14. Premature birth NC1_15. Colorectal cancer NC1_16. Macular degeneration or blindness NC1_17. Depression NC1_18. Anxiety Disorder	Revision (Minor)	Do you believe cigarette smoking is related to Yes No NC1_1. Lung cancer NC1_2. Cancer of the mouth or throat NC1_3. Heart Disease NC1_4. Diabetes NC1_5. Emphysema NC1_6. Stroke NC1_7. Hole in throat (stoma or tracheotomy) NC1_8. Buerger’s Disease NC1_9. Amputations (removal of limbs) NC1_10. Asthma NC1_11. Gallstones NC1_12. COPD or Chronic bronchitis NC1_13. Periodontal or gum disease NC1_14. Premature birth NC1_15. Colorectal cancer NC1_16. Macular degeneration or blindness NC1_17. Depression NC1_18. Anxiety Disorder NC1_19. Colon cancer	Added “Colon Cancer” to the smoking-related diseases grid as future Campaign ads will feature messages that focus on this disease condition.
NC1b	In the past 4 months, during any of the weeks listed below did you quit smoking entirely for at least one day because you were trying to quit smoking?	Deletion	N/A	Question is no longer needed as we will have full baseline data for purposes of tracking pre-campaign to post-campaign changes in key variables.
NC1c	On which days did you try to quit smoking during these weeks over the past 4 months? Using your cursor, click on each day that you did not smoke cigarettes because you were trying to quit smoking. Your best guess is fine. If you did not try to quit smoking on any day during the following weeks in the past four months, select the ‘Did Not’ response below.	Deletion	N/A	Question is no longer needed as we will have full baseline data for purposes of tracking pre-campaign to post-campaign changes in key variables.
NC1d_1	Did you use electronic vapor products on at least one day during any of the following weeks in the past 4 months?	Deletion	N/A	Question is no longer needed as we will have full baseline data for purposes of tracking pre-campaign to post-campaign changes in key variables.
ND19	N/A	Addition	Please tell us if you strongly disagree, disagree, agree, or strongly agree with the following statements. Strongly disagree Disagree Agree Strongly agree ND19. Smoking cigarettes can cause medical complications and diseases that require surgeries and medical procedures to treat.	This item is being added as future Campaign ads may feature messages that highlight smoking-related medical procedures and surgeries.
NF24d_x	You previously indicated that you have seen this ad on either a laptop or desktop computer. When you saw this ad on your computer, did you… Yes No NF24d_x_1. Notice the ad on a Website that you were visiting? NF24d_x_2. Search for the ad on YouTube, Google, or other Internet search engine?	Deletion	N/A	This item is no longer needed for analysis.
NF25_x	Please tell us if you strongly disagree, disagree, neither agree nor disagree, agree, or strongly agree with the following statements. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree NF25a_x. This ad is worth remembering NF25b_x. This ad grabbed my attention NF25c_x. This ad is powerful NF25d_x. This ad is informative NF25e_x. This ad is meaningful to me NF25f_x. This ad is convincing NF25g_x. This ad is ridiculous NF25h_x. This ad is terrible NF25i_x. This ad was difficult to watch	Revision (Minor)	Please tell us if you strongly disagree, disagree, neither agree nor disagree, agree, or strongly agree with the following statements. Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree NF25a_x. This ad is worth remembering NF25b_x. This ad grabbed my attention NF25c_x. This ad is powerful NF25d_x. This ad is informative NF25e_x. This ad is meaningful to me NF25f_x. This ad is convincing	Items NF25g_x, NF25h_x, and NF25i_x have been removed from this grid as these questions are no longer needed for analysis.
NF26_x	On a scale of 1 to 5, where 1 means “not at all” and 5 means “very,” please indicate how much this ad made you feel…. 1 (not at all) 2 3 4 5 (very) NF26a_x. Sad NF26b_x. Afraid NF26c_x. Irritated NF26d_x. Ashamed NF26e_x. Discouraged NF26f_x. Hopeful NF26g_x. Motivated NF26h_x. Understood NF26i_x. Angry	Revision (Minor)	On a scale of 1 to 5, where 1 means “not at all” and 5 means “very,” please indicate how much this ad made you feel…. 1 (not at all) 2 3 4 5 (very) NF26a_x. Sad NF26b_x. Afraid NF26d_x. Ashamed NF26f_x. Hopeful NF26g_x. Motivated NF26h_x. Understood	Items NF26c_x, NF26e_x, and NF26i_x have been removed from this grid as these questions are no longer needed for analysis.
NF35_x	N/A	Addition	Have you heard this ad on the radio in the past [FILL MONTHS] months, since [FILL CAMPAIGN LAUNCH DATE]? Yes No	Item added to capture basic awareness of Campaign radio ads.
NF35a_x	In the past [FILL MONTHS SINCE CAMPAIGN LAUNCH], how frequently have you heard this ad on the radio? Rarely Sometimes Often Very Often	Deletion	N/A	This item is no longer needed for analysis. Measurement of simple awareness (yes/no) is sufficient for these purposes.
NF38	N/A	Addition	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? I never go to a convenience store, supermarket, or gas station Never Rarely Sometimes Most of the time Always	This question has been added to measure exposure to e-cigarette advertising at the point-of-sale as this is the most common type of e-cigarette advertising. This is important to measure since exposure to these messages may moderate or mediate impact of The Campaign on smoking-related outcomes.
NG8a	N/A	Addition	In your main job, what kind of work do you do? Select one answer only. Medical Doctor (such as physician, surgeon, dentist, veterinarian) Other Health Care Practitioner (such as nurse, pharmacist, chiropractor, dietician) Health Technologist or Technician (such as paramedic, lab technician) Health Care Support (such as nursing aide, orderly, dental assistant) Service Protective Service ( police, firefighters) Food Preparation and Serving Building and Grounds Cleaning and Maintenance Personal Care and Service(hair stylists, gaming workers, entertainment) Sales Sales Representative Retail Sales Other Sales Office and Administrative Support Farming, Forestry, and Fishing Precision Production, Craft and Repair  Construction and Extraction Installation, Maintenance, and Repair Precision Production (such as machinist, welder, baker, printer, tailor) Transportation and Material Moving Armed Forces Other, please specify________ Management Business and Financial Operations Professional  Computer and Mathematical Architecture and Engineering Life, Physical, and Social Sciences Community and Social Services Lawyer or Judge Teacher, except college and university Teacher, college and university Other Professional	Occupation has been added to facilitate enhanced analysis of the campaign’s impact among subgroups of smokers and nonsmokers.
NG11	N/A	Addition	Are you currently covered by any of the following types of health insurance or health coverage plans? Mark “yes” or “no” for each type of coverage. Yes No G15_1. Insurance through a current or former employer or union G15_2. Insurance purchased directly from an insurance company G15_3. Medicare, for people age 64 and over, or people with certain disabilities G15_4. Medicaid, or any kind of government assistance plan for those with low incomes or disability G15_5. TRICARE or other military health care G15_6. VA (including those who have ever enrolled for or used VA health care) G15_7. Indian Health Service G15_8. Any other type of health insurance or health coverage plan	Type of insurance coverage has been added to enable stratified analyses of Campaign effects by types of insurance coverage. This will potentially allow the evaluation to address how the campaign benefits populations that are served by particular insurance programs and health systems such as Medicaid. This will potentially expand the evidence base for The Campaign’s cost effectiveness.