Form NHTSA Form 1485 NHTSA Form 1485 Drug Impaired Drving Survey

Online Survey Questionnaire OMB Control No. 2127-0682

Drug-Impaired Driving Prevention Expiration Date 8/31/2021

Please note that recruitment quotas will be established to be representative to the U.S. Census for males 18-34 years old for race/ethnicity, income, age, and region.

INTRODUCTION SCREEN:

Thank you for taking this survey. Your opinions are important to us! Please be honest when answering the survey. Your answers are anonymous and confidential, and none of your individual information will be shared with any third parties.

[INCLUDE ON ITS OWN SEPARATE SCREEN AFTER THE INTRODUCTION SCREEN] This collection of information is voluntary and will be used for formative purposes only so that we may develop communications programs designed to reduce the number of traffic-related injuries and deaths. A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control Number. The OMB Control Number for this information collection is 2127-0682. Public reporting for this collection of information is estimated to be approximately 10 minutes per response, including the time for reviewing instructions, completing and reviewing the collection of information. All responses to this collection of information are voluntary. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to: Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave, S.E., Washington, DC, 20590

1. What is your gender? ACCEPT ONE

• Male

• Female [TERMINATE]

2. What is your age? _________ NUMERIC. RANGE 0-99. PROGRAMMER NOTE: MUST BE 18-34 TO CONTINUE

PROGRAMMER: PLEASE ADD THE FOLLOWING TRACKING VARIABLES:

18-24 years

25-34 years

3. What state do you live in? DROP DOWN LIST

4. Are you of Hispanic or Latino origin? [ACCEPT ONE] [*Add popup option: “Why do we ask this question?”]

• Yes

• No

5. What is your race? (Please select all that apply). [*Add popup option: “Why do we ask this question?”]

ACCEPT MULTIPLE

• White

• Black or African-American

• Asian

• Native Hawaiian or other Pacific Islander

• American Indian or Alaska Native

6. Today, we are looking for people who work in certain industries or fields. Are you, or is any member of your immediate household, employed in any of the following sectors? Please select all that apply.

• Marketing, advertising, public relations or marketing research (1)

• Law enforcement (2)

• Local, state or federal government (3)

• Manufacturing, distribution or sales of marijuana (4)

• Banking (5)

• Insurance (6)

• None of the above (anchor, single punch) (7)

TERMINATE IF SELECT 1, 2, OR 4; OTHERWISE CONTINUE

7. What is the highest level of education that you have completed? [ACCEPT ONE]

• 8th grade or below

• 9th grade to 11th grade

• High school graduate

• Some college

• Associate degree

• Bachelor's degree

• Some postgraduate study

• Graduate-school degree

• Trade school

• None of the above/ Prefer not to state

8. Which classification best describes your total pre-tax household income? [*Add popup option: “Why do we ask this question?”] [ACCEPT ONE]

• Under $10,000

• $10,000-$19,999

• $20,000-$29,999

• $30,000-$39,999

• $40,000-$49,999

• $50,000-$74,999

• $75,000-$99,999

• $100,000-$124,999

• $125,000-$149,999

• $150,000-$174,999

• $175,000-$199,999

• More than $200,000

• Prefer not to state

9. Which of the following activities do you do at least three times a week?

[Yes/No Grid]

• Working out

• Driving an automobile

• Reading a book

• Playing online games

MUST SELECT ‘YES’ FOR “DRIVING AN AUTOMOBILE” TO CONTINUE

10. Which of the following have you done at least once in the past three months?

[Yes/No Grid]

• Consumed an alcoholic beverage

• Drank an energy drink

• Smoked or consumed marijuana recreationally (Please do not select yes if you only consume marijuana with a prescription for medical purposes.)

MUST SELECT ‘YES’ FOR “SMOKED OR CONSUMED MARIJUANA RECREATIONALLY”

[INTRO SCREEN PRIOR TO Q10] The next set of questions are about the use of marijuana (also commonly referred to as cannabis, pot, weed, or grass). In this case, we mean any form of marijuana that contains the psychoactive component THC. It could be smoked or consumed by a variety of other methods; examples include edibles, waxes, and oils.

As a reminder, your answers in this survey are confidential and anonymous. We want to hear your opinions, so please be honest when answering.

11. How often do you typically use marijuana?

• Daily

• A couple times a week

• Once per week

• 1-3 times per month

• Less than once per month

12. When it comes to driving after using marijuana, which of the following best describes your behavior?

• I never drive high

• I rarely drive high

• I sometimes drive high

• I often drive high

• I always drive high

13. Some people are concerned about driving after using marijuana and some people aren’t. Which statement below best describes your mindset about driving after using marijuana?

• I’ll drive without thinking twice about it

• I’ll think twice about driving, but usually I will drive

• I’ll think twice about driving, and I will not drive if I’m high

• I won’t drive

• Not applicable – I’ve never been in that situation

14. Thinking about your typical experience, how does using marijuana affect your ability to drive?

• Makes me a worse driver

• Makes me a better driver

• Does not make a difference one way or the other

• Not sure

• Not applicable – I’ve never driven after using marijuana

15. In the past six months, have you driven somewhere while feeling the effects of marijuana?

• Yes

• No

16. Have you ever been in a situation where you decided to NOT drive because you had used marijuana, even though you had originally planned to drive?

• Yes

• No

• Not sure

[PROGRAMMER NOTE: IF SELECTED ‘YES’, MOVE TO Q16. IF SELECTED ‘NO’, MOVE TO Q17]

17. When was the last time you were in a situation where you decided to NOT drive because you had used marijuana, even though you had originally planned to drive?

• Within the last 3 months

• 4-6 months ago

• 7-12 months ago

• More than a year ago

• Not sure

18. How personally concerned are you about having other drivers on the road who have used marijuana before driving?

Randomize scale 1-5, 5-1

• Extremely concerned

• Very concerned

• Somewhat concerned

• Not too concerned

• Not at all concerned

19. Have you ever visited a website to get information about marijuana use and driving?

• Yes

• No

• Not Sure

20. Have you have recently seen or heard messages about the risks of marijuana and driving in advertising, publicity, the media, or other places?

• Yes

• No

• Not Sure

[IF YES IN Q20, ask Q21; IF SELECTED NO/NOT SURE, MOVE TO Q22]

21. Where was that…?

• TV program

• TV ad

• Radio program or podcast

• Radio commercial

• Print (magazine or newspaper)

• Website or social media content

• Website ad

• Outdoor billboards or posters

• From friends or family

• Other, please specify___________

22. Have you ever seen or heard any messages with the tagline, “If you feel different, you drive different?”

• Yes

• No

• Not Sure

[INTRO SCREEN PRIOR TO Q23] On the following pages, we will show you examples of some public service advertisements (PSAs) that you may have seen or heard on TV, online, radio, a poster or billboard, or in a magazine or newspaper. Please indicate for each ad type, whether or not you have seen or heard any of the ads.

[Randomize order of ad recognition questions. Keep media type together in block. Respondent will only evaluate 11 pieces of creative to reduce respondent fatigue. Split samples will be used to accommodate additional ads if needed.]

[Repeat for each :30 video ad]

Below is an ad you might see on TV or online.

(Please note that the ‘continue’ button will appear at the bottom of the screen, once the ad is almost completed)

PN: Play video file.

23. Have you seen this ad?

• Yes

• No

• Not sure

[Repeat for each :30 audio ad.]

PN: Play audio file.

(Please note that the ‘continue’ button will appear at the bottom of the screen, once the ad is almost completed)

24. Have you heard this public service ad on the radio or streaming online?

• Yes

• No

• Not sure

[Repeat for each OOH/print ad montage.]

PN: Insert jpeg of outdoor or print montage

25. Have you seen any of these ads on a billboard, poster, or some other place?

• Yes

• No

• Not sure

[Repeat for each online banner ad montage.]

PN: Insert jpeg of banner montage.

26. Have you seen any of these ads online?

• Yes

• No

• Not sure

[INTRO SCREEN PRIOR TO Q27] The following background questions will help us divide the interviews into groups.

27. What is your marital status? [ACCEPT ONE]

• Single (never married)

• Living together but not married

• Married

• Separated or Divorced

• Widowed

• Prefer not to state

28. Do you live in the city, suburbs, or some other area? [ACCEPT ONE]

• City

• Suburbs

• Some other area

29. Are you the parent or guardian of any children under the age of 18 who are living in your household? [ACCEPT ONE]

• Yes

• No

30. Have you used marijuana within the last 2 hours prior to taking this survey?

• Yes

• No

• Prefer not to answer

NHTSA Form 1485

* These questions about [race/income] are important so that we make sure the voices of people in all different populations are represented. In this way, we can be fair and objective by adjusting our results based on the proportions of the various groups in the larger population.

Collecting data from all respondents on this question is important so that we can better and more reliably report differences and similarities between people of different backgrounds.

We understand that you might be concerned about sharing this information. Please be assured that the responses you provide are kept completely confidential. Any identifying information will be separated from your answers. Results are reported using the average, or pooled answers to the questions, instead of the responses of any one individual.