INSTRUCT_1:
The first five questions ask some background information about
you.
|
How
old are you?
9
years old
10
years old
11
years old
12
years old
13
years old
14
years old
15
years old
16
years old
17
years old
18
years old
19
years old or older
|
What
is your sex?
Male
Female
|
What
grade are you in?
6th
7th
8th
9th
10th
11th
12th
Ungraded
or other grade
|
Are
you Hispanic, Latino, Latina, or of Spanish origin? (Select
one or more)
No,
not of Hispanic, Latino, Latina, or Spanish origin
[EXCLUSIVE]
Yes,
Mexican, Mexican American, Chicano, or Chicana
Yes,
Puerto Rican
Yes,
Cuban
Yes,
Another Hispanic, Latino, Latina, or Spanish origin
|
What
race or races do you consider yourself to be? (Select
one or more)
American
Indian or Alaska Native
Asian
Black
or African American
Native
Hawaiian or Other Pacific Islander
White
|
INSTRUCT_2:
The next seven sections of questions ask about your use of
particular kinds of tobacco products, such as cigarettes, cigars,
smokeless tobacco, electronic cigarettes, hookahs, roll-your
own-cigarettes, pipes, snus, dissolvable tobacco, bidis, and
heated tobacco products.
|
INSTRUCT_2a:
The
next
several questions
are about smoking cigarettes (ones that have to be lit and
burned).
|
Have
you ever
tried
cigarette smoking, even one or two puffs?
Yes
No
[SKIP
TO QN14]
|
How
old were you when you first
tried
cigarette smoking, even one or two puffs?
8
years old or younger
9
years old
10
years old
11
years old
12
years old
13
years old
14
years old
15
years old
16
years old
17
years old
18
years old
19
years old or older
|
About
how many cigarettes have you smoked in your entire
life?
1
or more puffs but never a whole cigarette
1
cigarette
2
to 5 cigarettes
6
to 15 cigarettes (about 1/2 a pack total)
16
to 25 cigarettes (about 1 pack total)
26
to 99 cigarettes (more than 1 pack, but less than 5 packs)
100
or more cigarettes (5 or more packs)
|
When
was the last time you smoked a cigarette, even one or two puffs?
(Please
choose the first answer that fits)
Earlier
today
Not
today but sometime during the past 7 days
Not
during the past 7 days but sometime during the past 30 days
Not
during the past 30 days but sometime during the past 6 months
Not
during the past 6 months but sometime during the past year
1
to 4 years ago
5
or more years ago
IF
QN9 EQ (1-3 [A-C])
[CONTINUE TO QN10]
IF
QN9 EQ (4-7 [D-G])
[SKIP TO INSTRUCT_3]
|
During
the past
30 days,
on how many days did you smoke cigarettes?
Specify:
|__|__| (Range: 1 – 30)
[PROGRAMMING:
RANGE (1 – 30) ALLOWED]
|
During
the past 30 days, on
the days you smoked,
about how many cigarettes did you smoke per day? A pack usually
has 20 cigarettes in it.
Less
than 1 cigarette per day
1
cigarette per day
2
to 5 cigarettes per day
6
to 10 cigarettes per day
11
to 20 cigarettes per day
More
than 20 cigarettes per day
|
During
the past 30 days, what brand of cigarettes did you usually smoke?
(Choose
only one answer)
I
did not smoke a usual brand
American
Spirit
Camel
GPC,
Basic, or Doral
Kool
Marlboro
Newport
L&M
Pall
Mall
Winston
Some
other brand not listed here (Please specify:
_____________________)
Not
sure
|
Menthol
cigarettes are cigarettes that taste like mint. During the past
30 days, were the cigarettes that you usually smoked menthol?
Yes
No
Not
sure
|
Have
you ever been curious about smoking a cigarette?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
Do
you think that you will try a cigarette soon?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
Do
you think you will smoke a cigarette in the next year?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
If
one of your best friends were to offer you a cigarette, would you
smoke it?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
INSTRUCT_3:
The next several
questions
are about the use of cigars, cigarillos, or little cigars such
Swisher Sweets, Black and Mild, Garcia y Vega, Cheyenne, White
Owl, or Dutch Masters.
|
Have
you ever
tried
smoking cigars, cigarillos, or little cigars, such as Swisher
Sweets, Black and Mild, Garcia y Vega, Cheyenne, White Owl, or
Dutch Masters, even one or two puffs?
Yes
No
[SKIP
TO QN23]
|
How
old were you when you
first tried
smoking a cigar, cigarillo, or little cigar, even one or two
puffs?
8
years old or younger
9
years old
10
years old
11
years old
12
years old
13
years old
14
years old
15
years old
16
years old
17
years old
18
years old
19
years old or older
|
During
the past
30 days,
on how many days did you smoke cigars, cigarillos, or little
cigars?
Specify:
|__|__| (Range 0 – 30)
[PROGRAMMING:
RANGE (0 – 30) ALLOWED]
IF
RESPONSE EQ (0)
SKIP TO INSTRUCT_4.
ELSE
IF RESPONSE EQ (1-30)
CONTINUE TO QN 21.
|
During
the past 30 days, on
the days that you smoked,
about how many cigars, cigarillos, or little cigars did you smoke
per day?
Less
than 1 cigar, cigarillo, or little cigar per day
1
per day
2
to 5 per day
6
to 10 per day
11
to 20 per day
More
than 20 per day
|
During
the past 30 days, which of the following types of cigars have you
smoked? (Select
one or more)
Regular
cigars
Cigarillos
Little
Cigars
Don’t
Know
[EXCLUSIVE]
|
Have
you ever been curious about smoking a cigar, cigarillo, or little
cigar?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
Do
you think you will try a cigar, cigarillo, or little cigar soon?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
Do
you think you will smoke a cigar, cigarillo, or little cigar in
the next year?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
If
one of your best friends were to offer you a cigar, cigarillo, or
little cigar, would you smoke it?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
INSTRUCT_4:
The
next several
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.
|
Have
you ever
used chewing
tobacco, snuff, or dip, such as Copenhagen, Grizzly, Skoal, or
Longhorn, even just a small amount?
Yes
No
[SKIP
TO QN30]
|
How
old were you when you used
chewing
tobacco, snuff, or dip for the first time?
8
years old or younger
9
years old
10
years old
11
years old
12
years old
13
years old
14
years old
15
years old
16
years old
17
years old
18
years old
19
years old or older
|
During
the past
30 days,
on how many days did you use chewing tobacco, snuff, or dip?
Specify:
|__|__| (Range 0 – 30)
[PROGRAMMING:
RANGE (0 – 30) ALLOWED]
|
Have
you ever been curious about using chewing tobacco, snuff, or dip?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
Do
you think you will try chewing tobacco, snuff, or dip, soon?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
Do
you think you will use chewing tobacco, snuff, or dip in the next
year?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
If
one of your best friends were to offer you chewing tobacco,
snuff, or dip, would you use it?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
INSTRUCT_5:
The
next several
questions are about electronic cigarettes or e-cigarettes. Some
brand examples include JUUL, Vuse, MarkTen, and blu.
E-cigarettes
are battery powered devices that usually contain a nicotine-based
liquid that is vaporized and inhaled. You may also know them as
e-cigs, vape-pens, e-hookahs, vapes, or mods.
|
Have
you ever
used
an e-cigarette, even once or twice?
Yes
No
[SKIP TO QN43]
|
How
old were you when you first
tried using
an e-cigarette, even once or twice?
8
years old or younger
9
years old
10
years old
11
years old
12
years old
13
years old
14
years old
15
years old
16
years old
17
years old
18
years old
19
years old or older
|
In
total, on how many days have you used e-cigarettes in your entire
life?
1
day
2
to 10 days
11
to 20 days
21
to 50 days
51
to 100 days
Over
100 days
|
When
was the last time you used an e-cigarette, even one or two times?
(Please
choose the first answer that fits)
Earlier
today
Not
today, but sometime during the past 7 days
Not
during the past 7 days, but sometime during the past 30 days
Not
during the past 30 days, but sometime during the past 6 months
Not
during the past 6 months, but sometime during the past year
1
to 4 years ago
5
or more years ago
IF
QN37 EQ (1-3 [A-C])
[CONTINUE TO QN38]
IF
QN37 EQ (4-7 [D-G])
[SKIP TO QN42]
|
During
the past
30 days,
on how many days did you use e-cigarettes?
Specify:
|__|__| (Range 1 – 30)
[PROGRAMMING:
RANGE (1 – 30) ALLOWED]
|
Which
of the following best describes the type of e-cigarette you have
used in the past 30 days? If you have used more than one type,
please think about the one you use most often.
A
disposable e-cigarette
An
e-cigarette that uses pre-filled pods or cartridges (e.g. JUUL)
An
e-cigarette with a tank that you refill with liquids
A
mod system (a mod system is customized by the user with their own
combination of batteries, atomizers, etc.)
I
don’t know the type
|
During
the past 30 days, what brand of e-cigarettes did you usually use?
I
did not use a usual brand
Blu
JUUL
Logic
MarkTen
NJOY
Vuse
Some
other brand not listed here (specify):
______________________________
|
During
the past 30 days, where did you get or buy the e-cigarettes that
you have used? (Select
one or more)
A
gas station or convenience store
A
grocery store
A
drugstore
A
mall or shopping center kiosk/stand
On
the Internet
A
vape shop or other store that only sells e-cigarettes
Some
other place not listed here
From
a family member
From
a friend
From
some other person that is not a family member or a friend
|
What
are the reasons you have used e-cigarettes? (Select
one or more)
Friend
or family member used them
To
try to quit using other tobacco products, such as cigarettes
They
cost less than other tobacco products, such as cigarettes
They
are easier to get than other tobacco products, such as cigarettes
I’ve
seen people on TV, online, or in movies use them
They
are less harmful than other forms of tobacco, such as cigarettes
They
are available in flavors, such as mint, candy, fruit, or
chocolate
I
can use them unnoticed at home or at school
I
was peer pressured into using them
I
can use them to do tricks
I
was curious about them
I
used them for some other reason (specify: _____________________)
ALL
RESPONSES SKIP TO INSTRUCT_6.
|
Have
you ever been curious about using an e-cigarette?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
Do
you think that you will try an e-cigarette soon?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
Do
you think you will use an e-cigarette in the next year?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
If
one of your best friends were to offer you an e-cigarette, would
you use it?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
INSTRUCT_6:
The next several
questions
are about smoking tobacco in a hookah, which is a type of
waterpipe. Shisha (or hookah tobacco) is smoked in a hookah.
|
Have
you ever
tried
smoking tobacco in a hookah or waterpipe, even one or two puffs?
Yes
No
[SKIP TO QN51]
|
How
old were you when you first
tried
smoking tobacco in a hookah or waterpipe, even one or two puffs?
8
years old or younger
9
years old
10
years old
11
years old
12
years old
13
years old
14
years old
15
years old
16
years old
17
years old
18
years old
19
years old or older
|
During
the past
30 days,
on how many days did you smoke tobacco in a hookah or waterpipe?
Specify:
|__|__| (Range 0 – 30)
[PROGRAMMING:
RANGE (0 – 30) ALLOWED]
IF
RESPONSE EQ (0)
SKIP TO INSTRUCT_7.
ELSE
IF RESPONSE EQ (1-30)
CONTINUE TO QN 50.
|
During
the past
30 days,
where did you smoke tobacco in a hookah or waterpipe?
(Select
one or more)
At
my house
At
a friend’s house
At
a family member’s house, other than my house
At
a hookah bar
At
a café or restaurant
Some
other place not listed here
|
Have
you ever been curious about smoking tobacco in a hookah or
waterpipe?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
Do
you think that you will try smoking tobacco in a hookah or
waterpipe soon?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
Do
you think you will smoke tobacco in a hookah or waterpipe in the
next year?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
If
one of your best friends were to offer you a hookah or waterpipe
with tobacco, would you try it?
Definitely
yes
Probably
yes
Probably
not
Definitely
not
|
INSTRUCT_7:
The
next section is
about
the use of other tobacco products, not described in the previous
sections.
|
Which
of the following tobacco products have you ever
tried,
even just one time? (Select
one or more)
Roll-your-own
cigarettes
Pipes
filled with tobacco (not hookah or waterpipe)
Snus,
such as Camel, Marlboro, or General Snus
Dissolvable
tobacco products such as Ariva, Stonewall, Camel orbs, Camel
sticks, Marlboro sticks, or Camel strips
Bidis
(small brown cigarettes wrapped in a leaf)
I
have never tried any of the products listed above
[EXCLUSIVE]
[SKIP TO INSTRUCT_8]
|
In
the
past 30 days,
which of the following products have you used on at
least one day?
(Select
one or more)
Roll-your-own
cigarettes
Pipes
filled with tobacco (not hookah or waterpipe)
Snus,
such as Camel, Marlboro, or General Snus
Dissolvable
tobacco products such as Ariva, Stonewall, Camel orbs, Camel
sticks, Marlboro sticks, or Camel strips
Bidis
(small brown cigarettes wrapped in a leaf)
I
have not used any of the products listed above in the past 30
days
[EXCLUSIVE]
|
INSTRUCT_8:
The
next section is about “heated tobacco products”. Some
people refer to these products as “heat-not-burn”
tobacco products. “Heated tobacco products” heat
tobacco sticks or capsules to produce a vapor. They are different
from e-cigarettes, which heat a liquid to produce a vapor. Some
brands of “heated tobacco products” include iQOS, glo,
and Eclipse.
|
Before
today, have you heard of “heated tobacco products”?
Yes
No
Don’t
know/Not Sure
IF
QN57 EQ (1 [A])
[CONTINUE TO QN58]
IF
QN57 EQ (2-3 [B-C])
[SKIP TO INSTRUCT_9a]
|
Have
you ever tried a “heated tobacco product”, even just
one time?
Yes
No
Don’t
Know/Not Sure
IF
QN58 EQ (1 [A])
[CONTINUE TO QN59]
IF
QN58 EQ (2-3 [B-C])
[SKIP TO INSTRUCT_9a]
|
During
the past
30 days,
on how many days did you use a heated tobacco product?
Specify:
|__|__| (Range 0 – 30)
[PROGRAMMING:
RANGE (0 – 30) ALLOWED]
ALL
RESPONSES CONTINUE TO INSTRUCT_9a
|
INSTRUCT_9a:
(programming,
only)
IF
“never tobacco product user”
SKIP TO INSTRUCT_13a. (all tobacco products)
IF
[(QN6 EQ (2) AND QN18 EQ (2) AND QN27 EQ (2) AND QN34 EQ (2) AND
QN47 EQ (2) AND QN55F EQ (1) AND [((QN57 EQ (2-3)) OR (QN57 EQ (1)
AND QN58 EQ (2-3))]]
SKIP TO INSTRUCT_13a]
IF
“current tobacco product user”
CONTINUTE TO INSTRUCT_9. (of at least one product)
IF
[(QN6 EQ (1) AND QN9 EQ (1-3)) OR (QN18 EQ (1) AND QN20 EQ (1-30))
OR (QN27 EQ (1) AND QN29 EQ (1-30)) OR (QN34 EQ (1) AND QN37 EQ
(1-3)) OR (QN47 EQ (1) AND QN49 EQ (1-30)) OR (QN55A EQ (1) AND
QN56A EQ (1)) OR (QN55B EQ (1) AND QN56B EQ (1)) OR (QN55C EQ (1)
AND QN56C EQ (1)) OR (QN55D EQ (1) AND QN56D EQ (1)) OR (QN55E EQ
(1) AND QN56E EQ (1)) OR (QN58 EQ (1) AND QN59 EQ (1-30))]
CONTINUE TO INSTRUCT_9
IF
“former tobacco product user”
SKIP
TO INSTRUCT_11. (of at least one product)
IF
[(QN6 EQ (1) AND QN9 EQ (4-7)) OR (QN18 EQ (1) AND QN20 EQ (0)) OR
(QN27 EQ (1) AND QN29 EQ (0)) OR (QN34 EQ (1) AND QN37 EQ (4-7))
OR (QN47 EQ (1) AND QN49 EQ (0)) OR (QN55A EQ (1) AND QN56F EQ
(1)) OR (QN55B EQ (1) AND QN56F EQ (1)) OR (QN55C EQ (1) AND QN56F
EQ (1)) OR (QN55D EQ (1) AND QN56F EQ (1)) OR (QN55E EQ (1) AND
QN56F EQ (1)) OR (QN58 EQ (1) AND QN59 EQ (0))]
SKIP TO INSTRUCT_11
|
INSTRUCT_9:
Now think about your responses to the questions about past 30 day
use of cigarettes, cigars, smokeless tobacco, e-cigarettes,
hookahs, roll-your-own cigarettes, pipes, snus, dissolvable
tobacco, bidis, and heated tobacco products.
|
During
the past
30 days,
on how many days did you use any tobacco product(s)?
Specify:
|__|__| (Range 0 – 30)
[PROGRAMMING:
RANGE (0 – 30) ALLOWED]
|
INSTRUCT_10:
The next few questions ask about flavors in tobacco products.
|
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)
Cigars,
cigarillos, or little cigars
Chewing
tobacco, snuff, or dip
E-cigarettes
Tobacco
in a hookah or waterpipe
Pipe
filled with tobacco (not waterpipe)
Snus
Dissolvable
tobacco products
Bidis
Roll-your-own
cigarettes
Heated
tobacco products
I
did not use any flavored tobacco products in the past 30 days
[EXCLUSIVE]
IF
QN61 EQ (11 [K]) THEN SKIP TO INSTRUCT_11
IF
((QN61 EQ (1 [A]) OR (QN61 EQ (2 [B])) OR (QN61 EQ (3 [C])) OR
QN61 EQ (4 [D])) OR QN61 EQ (5 [E])) OR QN61 EQ (6 [F])) OR QN61
EQ (7[G])) OR QN61 EQ (8 [H])) OR QN61 EQ (9 [I])) OR QN61 EQ (10
[J]))) THEN CONTINUE TO QN62.
|
What
flavors of tobacco products have you used in the past 30 days?
(Select
one or more)
Menthol
or mint
Clove
or spice
Fruit
Chocolate
Alcoholic
drink (such as wine, cognac, margarita, or other cocktails)
Candy,
desserts or other sweets
Some
other flavor not listed here (Specify:
_____________________________)
ALL
RESPONSES CONTINUE TO INSTRUCT_11
|
INSTRUCT_11:
The
next two questions are about issues related to urges to use
tobacco products.
|
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?
Yes
No
|
How
soon after you wake up do you want to use a tobacco product?
I
do not want to use tobacco products
Within
5 minutes
From
6 to 30 minutes
From
more than 30 minutes to 1 hour
After
more than 1 hour but less than 24 hours
I
rarely want to use tobacco products
IF
current tobacco product user (any product), CONTINUE TO
INSTRUCT_12.
IF
[((QN6 EQ (1)) and (QN9 EQ (4-5))] SKIP TO INSTRUCT_12a.
ELSE
SKIP TO INSTRUCT_13a.
|
INSTRUCT_12:
The
next few questions are about quitting tobacco products.
|
Are
you seriously thinking about quitting the use of all
tobacco products?
(Please
choose the first answer that fits)
Yes,
during the next 30 days
Yes,
during the next 6 months
Yes,
during the next 12 months
Yes,
but not during the next 12 months
No,
I am not thinking about quitting the use of all tobacco products
|
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?
I
did not try to quit all tobacco products during the past 12
months
1
time
2
times
3
to 5 times
6
to 9 times
10
or more times
[IF
[((QN6 EQ (1)) AND (QN9 EQ (1-3))] CONTINUE TO QN68.]
[ELSE
SKIP TO INSTRUCT_13]
|
Are
you seriously thinking about quitting cigarettes?
(Please
choose the first answer that fits)
Yes,
during the next 30 days
Yes,
during the next 6 months
Yes,
during the next 12 months
Yes,
but not during the next 12 months
No,
I am not thinking about quitting cigarettes
[ALL
RESPONSES SKIP TO QN68]
|
INSTRUCT_12a:
The
next question is about quitting cigarettes.
|
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?
I
did not try to quit during the past 12 months
1
time
2
times
3
to 5 times
6
to 9 times
10
or more times
[IF
[((QN6 EQ (1)) AND (QN9 EQ (1-3))] CONTINUE TO INSTRUCT_13]
[IF
[((QN6 EQ (1)) and (QN9 EQ (4-5))] SKIP TO INSTRUCT_13a]
|
INSTRUCT_13:
The
next few questions are about getting tobacco products.
|
During
the past 30 days, how did you get your own tobacco products?
(Select
one or more)
I
bought them myself
I
had someone else buy them for me
I
asked someone to give me some
Someone
offered them to me
I
bought them from another person
I
took them from a store or another person
I
got them in some other way (specify:
______________________________________)
|
During
the past
30 days,
where did you buy
your own tobacco products? (Select
one or more)
I
did not buy tobacco products during the past 30 days
A
gas station or convenience store
A
grocery store
A
drugstore
A
vending machine
On
the Internet
Through
the mail
A
vape shop or tobacco shop
Some
other place not listed here (specify):
___________________________________
|
During
the past
30 days,
did anyone refuse
to sell you any tobacco products because of your age?
I
did not try to buy any tobacco products during the past 30 days
Yes
No
[ALL
RESPONSES SKIP TO QN72]
|
INSTRUCT_13a:
The
next two questions ask your thoughts about getting tobacco
products.
|
How
easy do you think it is for people your age to buy tobacco
products in a store?
Easy
Somewhat
easy
Not
easy at all
|
How
easy do you think it is for people your age to buy tobacco
products online?
Easy
Somewhat
easy
Not
easy at all
|
INSTRUCT_14:
The next four questions are about different issues related to
tobacco.
A
warning label tells you if a product is harmful to you and can be
either a picture or words.
|
During
the past 30 days, how often did you see a warning label on a
cigar, cigarillo, or little cigar package?
I
did not see a cigar, cigarillo, or little cigar package during
the past 30 days
Never
Rarely
Sometimes
Most
of the time
Always
|
During
the past 30 days, how often did you see a warning label on an
e-cigarette package?
I
did not see an e-cigarette package during the past 30 days
Never
Rarely
Sometimes
Most
of the time
Always
|
During
the past 30 days, how often did you see a warning label on a
package of hookah tobacco?
I
did not see a package of hookah tobacco during the past 30 days
Never
Rarely
Sometimes
Most
of the time
Always
|
In
the past 12 months, have you seen or heard The Real Cost, on
television, the internet, social media, or radio as part of ads
about tobacco?
Yes
No
Not
sure
|
INSTRUCT_15:
The
next 11 questions ask about your thoughts on tobacco products.
|
How
much do you think people harm themselves when they smoke
cigarettes
some days but not every day?
No
harm
Little
harm
Some
harm
A
lot of harm
|
How
much do you think people harm themselves when they use
chewing tobacco, snuff, dip, snus, or dissolvable tobacco
products,
some days but not every day?
No
harm
Little
harm
Some
harm
A
lot of harm
|
Do
you believe that chewing
tobacco, snuff, dip, snus, or dissolvable tobacco products
are (LESS ADDICTIVE, EQUALLY ADDICTIVE, or MORE ADDICTIVE) than
cigarettes?
Less
addictive
Equally
addictive
More
addictive
I
have never heard of chewing tobacco, snuff, dip, snus, or
dissolvable tobacco products
I
don’t know enough about these products
|
How
much do you think people harm themselves when they use
e-cigarettes
some days but not every day?
No
harm
Little
harm
Some
harm
A
lot of harm
|
Do
you believe that e-cigarettes
are (LESS ADDICTIVE, EQUALLY ADDICTIVE, or MORE ADDICTIVE) than
cigarettes?
Less
addictive
Equally
addictive
More
addictive
I
have never heard of e-cigarettes
I
don’t know enough about these products
|
How
much do you think people harm themselves when they smoke
tobacco in a hookah or waterpipe
some days but not every day?
No
harm
Little
harm
Some
harm
A
lot of harm
|
Do
you believe that smoking
tobacco in a hookah or waterpipe
is (LESS ADDICTIVE, EQUALLY ADDICTIVE, or MORE ADDICTIVE) than
cigarettes?
Less
addictive
Equally
addictive
More
addictive
I
have never heard of smoking tobacco in a hookah or waterpipe
I
don’t know enough about these products
|
Compared
to a typical cigarette, would you think that a cigarette
advertised as low nicotine would be…
Much
less harmful
Slightly
less harmful
Equally
harmful
Slightly
more harmful
Much
more harmful
|
How
strongly do you agree with the statement ‘All tobacco
products are dangerous’?
Strongly
agree
Agree
Disagree
Strongly
disagree
|
Not
including the vapor from e-cigarettes, do you think that
breathing smoke from other people’s cigarettes or other
tobacco products causes…
No
harm
Little
harm
Some
harm
A
lot of harm
|
Do
you think that breathing the vapor from other people’s
e-cigarettes causes…
No
harm
Little
harm
Some
harm
A
lot of harm
|
INSTRUCT_16:
The
next four questions ask about issues related to advertisements for
tobacco products such as cigarettes, cigars, smokeless tobacco,
hookahs, roll-your-own cigarettes, pipes, snus, dissolvable
tobacco, and bidis. Do
not think of electronic cigarettes.
|
When
you are using the Internet, how often do you see ads or
promotions for cigarettes or other tobacco products?
I
do not use the Internet
Never
Rarely
Sometimes
Most
of the time
Always
|
When
you read newspapers or magazines, how often do you see ads or
promotions for cigarettes or other tobacco products?
I
do not read newspapers or magazines
Never
Rarely
Sometimes
Most
of the time
Always
|
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?
I
never go to a convenience store, supermarket, or gas station
Never
Rarely
Sometimes
Most
of the time
Always
|
When
you watch TV or streaming services (such as Netflix, Hulu, or
Amazon Prime), or go to the movies, how often do you see ads or
promotions for cigarettes or other tobacco products?
I
do not watch TV or streaming services, or go to the movies
Never
Rarely
Sometimes
Most
of the time
Always
|
INSTRUCT_17:
The
next four questions ask about issues related to e-cigarette
advertisement. Do not think about cigarettes or other tobacco
products.
|
When
you are using the Internet, how often do you see ads or
promotions for e-cigarettes?
I
do not use the Internet
Never
Rarely
Sometimes
Most
of the time
Always
|
When
you read newspapers or magazines, how often do you see ads or
promotions for e-cigarettes?
I
do not read newspapers or magazines
Never
Rarely
Sometimes
Most
of the time
Always
|
When
you go to a convenience store, supermarket, or gas station, how
often do you see ads or promotions for e-cigarettes?
I
never go to a convenience store, supermarket, or gas station
Never
Rarely
Sometimes
Most
of the time
Always
|
When
you watch TV or streaming services (such as Netflix, Hulu, or
Amazon Prime), or go to the movies, how often do you see ads or
promotions for e-cigarettes?
I
do not watch TV or streaming services, or go to the movies
Never
Rarely
Sometimes
Most
of the time
Always
|
INSTRUCT_18:
The
next three questions ask about you being around other people’s
tobacco smoke. Do not include exposure to vapor from e-cigarettes.
|
During
the past
7 days,
on how many days did someone smoke tobacco products in your home
while you were there?
0
days
1
day
2
days
3
days
4
days
5
days
6
days
7
days
|
During
the past
7 days,
on how many days did you ride in a vehicle when someone was
smoking a tobacco product?
0
days
1
day
2
days
3
days
4
days
5
days
6
days
7
days
|
During
the past
30 days,
on how many days did you smell 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, stadiuns, and parks.
0
days
1
or 2 days
3
to 5 days
6
to 9 days
10
to 19 days
20
to 29 days
All
30 days
|
INSTRUCT_19:
The
next two questions asks
about being around other people’s e-cigarette vapor. Do not
include exposure to smoke from other tobacco products.
|
During
the past
30 days,
on how many days did you smell 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.
0
days
1
or 2 days
3
to 5 days
6
to 9 days
10
to 19 days
20
to 29 days
All
30 days
|
Have
you ever seen anyone using an e-cigarette, such as JUUL, Vuse,
MarkTen, or blu in any locations in or around your school?
(Select one or more)
No
[EXCLUSIVE]
Yes,
inside a school bathroom or locker room
Yes,
inside a classroom
Yes,
inside some other area of the school (hallway, cafeteria)
Yes,
outside of the school, such as in the parking lot, sidewalk, or
other school grounds
Yes,
somewhere else not listed here
|
INSTRUCT_20:
The
last three questions ask about your experiences at home and at
school.
|
Does
anyone who lives with you now…? (Select
one or more)
Smoke
cigarettes
Smoke
cigars, cigarillos, or little cigars
Use
chewing tobacco, snuff, or dip
Use
e-cigarettes
Smoke
tobacco in a hookah or waterpipe
Smoke
pipes filled with tobacco (not hookah or waterpipes)
Use
snus
Use
dissolvable tobacco products
Smoke
bidis (small brown cigarettes wrapped in a leaf)
Use
heated tobacco products
No
one who lives with me now uses any form of tobacco
[EXCLUSIVE]
|
Do
you speak a language other than English at home?
Yes
No
|
Because
of a physical, mental, or emotional condition, do you have
serious difficulty concentrating, remembering, or making
decisions?
Yes
No
|