OMB#XXX-XXXX
Exp: XX/XX/XXXX
Appendix K:
Online
Survey Questionnaire
[PROGRAMMER: DO NOT ALLOW PARTICIPATION ON MOBILE DEVICES.]
Where do you think most of the harmful chemicals in cigarettes and cigarette smoke come from? (Select one)
1. Tobacco before it is made into cigarettes
2. Tobacco additives
3. The cigarette filter
4. The cigarette paper
5. Burning the cigarettes
The cigarette filter traps:
1. All of the harmful chemicals in cigarette smoke
2. A lot of the harmful chemicals in cigarette smoke
3. Some of the harmful chemicals in cigarette smoke
4. None of the harmful chemicals in cigarette smoke
Have you ever looked for information on chemicals in cigarettes and cigarette smoke?
1. Yes
2. No
Where would you most like to see information on chemicals in cigarettes and cigarette smoke?
1. On cigarette packs
2. In stores
3. Online
[RANDOMIZE ORDER OF ITEMS 5a to 5k. DO NOT DISPLAY “a”, “b”, etc. NEXT TO SURVEY ITEM]
If you were to use cigarettes every day, how likely is it that you would…
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Not at all likely |
Slightly likely |
Somewhat likely |
Very likely |
Extremely likely |
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a. Harm your overall health |
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b. Have a shorter life |
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c. Get sick often |
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d. Get cancer |
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e. Get a life-threatening disease |
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f. Have a heart attack |
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g. Get addicted |
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h. Have a permanent breathing problem |
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i. Have a stroke |
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j. Have a fetal development problem |
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k. Have a sexual problem |
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[RANDOMIZE ORDER OF Q6 – Q10]
Does cigarette smoke contain ammonia?
1. Yes
2. No
3. Don’t know
Does cigarette smoke contain formaldehyde?
1. Yes
2. No
3. Don’t know
Does cigarette smoke contain 1-aminonaphthalene?
1. Yes
2. No
3. Don’t know
Does cigarette smoke contain acrylonitrile?
1. Yes
2. No
3. Don’t know
Does cigarette smoke contain isoprene?
1. Yes
2. No
3. Don’t know
[RANDOMIZE ORDER OF Q11 – Q17]
Does smoking cause addiction?
1. Yes
2. No
3. Don’t know
Does smoking cause heart attacks?
1. Yes
2. No
3. Don’t know
Does smoking cause cancer?
1. Yes
2. No
3. Don’t know
Does smoking cause fetal development problems?
1. Yes
2. No
3. Don’t know
Does smoking cause permanent breathing problems?
1. Yes
2. No
3. Don’t know
Does smoking cause strokes?
1. Yes
2. No
3. Don’t know
Does smoking cause sexual problems?
1. Yes
2. No
3. Don’t know
[FOR ALL AGE GROUPS, IF SMOKED IN PAST 30 DAYS (S4 ≠1) GO TO Q18. ELSE GO TO SHOW STIMULUS]
If you learned that your cigarettes have a lot more of a dangerous chemical than other cigarettes, how likely, if at all, would you be to switch brands?
1. Extremely likely
2. Likely
3. Neutral
4. Unlikely
5. Extremely unlikely
Randomize participants to one of 6 study conditions.
[DISPLAY TEXT AND STIMULUS FOR 30 SECONDS BEFORE R CAN CLICK NEXT. TEXT SHOULD APPEAR ABOVE STIMULUS AND “NEXT” BUTTON UNDERNEATH STIMULUS.]
Please take a moment to read the information below. You can use the scroll bar on the right to see all the information. This information is about the chemicals that are in Durham cigarettes. Please read and use this information to answer the following questions.
The “Next” button will appear in about 30 seconds.
Please click the “Next” button below to continue.
Does cigarette smoke contain ammonia?
1. Yes
2. No
3. Don’t know
Does cigarette smoke contain formaldehyde?
1. Yes
2. No
3. Don’t know
Does cigarette smoke contain 1-aminonaphthalene?
1. Yes
2. No
3. Don’t know
Does cigarette smoke contain acrylonitrile?
1. Yes
2. No
3. Don’t know
Does cigarette smoke contain isoprene?
1. Yes
2. No
3. Don’t know
[RANDOMIZE ORDER OF Q24 – Q30]
Does smoking cause addiction?
1. Yes
2. No
3. Don’t know
Does smoking cause heart attacks?
1. Yes
2. No
3. Don’t know
Does smoking cause cancer?
1. Yes
2. No
3. Don’t know
Does smoking cause fetal development problems?
1. Yes
2. No
3. Don’t know
Does smoking cause permanent breathing problems?
1. Yes
2. No
3. Don’t know
Does smoking cause strokes?
1. Yes
2. No
3. Don’t know
Does smoking cause sexual problems?
1. Yes
2. No
3. Don’t know
The information about cigarettes clearly shows whether the amount of each chemical is harmful.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
[FOR ALL AGE GROUPS, IF SMOKED IN PAST 30 DAYS (S4 ≠1) GO TO Q32. ELSE GO TO Q33]
If you learned that your cigarettes have a lot more of a dangerous chemical than other cigarettes, how likely, if at all, would you be to switch brands?
1. Extremely likely
2. Likely
3. Neutral
4. Unlikely
5. Extremely unlikely
If a person who smokes cigarettes can’t quit, they should switch to a brand with fewer chemicals.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
It’s much safer to smoke cigarettes with fewer chemicals.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
[RANDOMIZE ORDER OF Q35-Q37]
A cigarette is much safer to smoke if it has less arsenic than other cigarettes.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
A cigarette is much safer to smoke if it has less crotonaldehyde than other cigarettes.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
A cigarette is much safer to smoke if it has less 4-aminobiphenyl than other cigarettes.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
Some cigarette brands are much more harmful to smoke than others.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
If a website had information like this for all cigarette brands, I would use it to see which cigarettes are safer than others.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
[FOR ALL AGE GROUPS, IF SMOKED IN PAST 30 DAYS (S4 ≠1) GO TO Q40. ELSE GO TO Q43]
My brand of cigarettes is probably safer than Durham.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
My brand of cigarettes has fewer chemicals than Durham.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
Reading this information about cigarettes makes me less likely to quit smoking.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
After viewing this information about cigarettes, I now feel that smoking is less dangerous.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
How harmful are Durham cigarettes (the cigarettes described)?
1. Not at all harmful
2. A little harmful
3. Harmful
4. Very harmful
It’s safer to smoke Durham cigarettes than most other cigarettes.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
Durham cigarettes have fewer chemicals than other cigarettes.
1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
[RANDOMIZE ORDER OF ITEMS 47a to 47k. DO NOT DISPLAY “a”, “b”, etc. NEXT TO SURVEY ITEM]
If you were to use cigarettes every day, how likely is it that you would…
|
Not at all likely |
Slightly likely |
Somewhat likely |
Very likely |
Extremely likely |
|
a. Harm your overall health |
|
|
|
|
|
|
b. Have a shorter life |
|
|
|
|
|
|
c. Get sick often |
|
|
|
|
|
|
d. Get cancer |
|
|
|
|
|
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e. Get a life-threatening disease |
|
|
|
|
|
|
f. Have a heart attack |
|
|
|
|
|
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g. Get addicted |
|
|
|
|
|
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h. Have a permanent breathing problem |
|
|
|
|
|
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i. Have a stroke |
|
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j. Have a fetal development problem |
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k. Have a sexual problem |
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This research was sponsored by the U.S. Food and Drug Administration also known as the FDA. FDA would like to thank you for sharing your opinions as they will be very useful in helping to understand people’s reactions and thoughts to tobacco product information. If you are a smoker, or have a friend or family member who is a smoker, and you would like information on how to quit, please visit our webpage at https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm198176.htm.
Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 20 minutes per response to complete the survey (the time estimated to read, review, respond). Send comments regarding this burden estimate or any other aspects of this information collection, including suggestions for reducing burden, to [email protected].
K-
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Modified | 0000-00-00 |
File Created | 2021-01-15 |