Form Approved
OMB No. 0920-0621
Exp. Date 01/31/2024
Instructions:
Introduce yourself and ensure that tech is working; respondent should be able to access the web survey and share their screen.
Briefly discuss the goal of the larger survey and the goal of this interview (i.e., to understand how easy or hard these questions are to answer)
This is YOUR interview. YOUR chance to give important feedback so kids like you can have a better survey experience.
Remind the student of consent highlights:
If possible, take the survey in a private location, away from other family members or your parents.
Information will not be shared and is only used internally without your name and personal information
You can skip any question. But, if you feel the question is so uncomfortable that you want to skip it, I’ll ask you why you feel that way.
The interview will be recorded, and we will take notes.
Read the OMB statement:
CDC estimates the average public reporting burden for this collection of information as 2 hours per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-0621).
Explain process.
Read each question to yourself and answer it through the web survey.
Pause when you see a stop sign in the survey and I’ll ask you some questions about how you answered.
There are no wrong answers to any of the questions you will see. In fact, we aren’t going to use the answers you provide in any way. We are more interested in what you think of the questions and response choices you will see. We want your honest feedback about what you think about these questions and response choices. We didn’t write any of these questions so nothing you say about them will bother us.
Jump in with comments as you’re trying to answer.
Start with a practice question to make sure they understand how probes work.
Avoid use or reference to the National Youth Tobacco Survey or NYTS to minimize the introduction of bias.
After you explain the instructions ask if the respondent has any questions.
Generic probes (use these when the respondent hesitates or appears confused about an item):
In your own words, what is this question asking?
Are there any unfamiliar or confusing words in this question?
How sure are you about your answer? Why?
How do you think we could make this question less confusing or easier to understand?
Was anything about this question uncertain or uncomfortable?
If so, what is it?
If so, do you think others would not want to respond honestly to this question?
Question/Screen (verbatim from NYTS interview) |
Question-specific Probes (if required) |
Notes (for interviewer use) |
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The first eight questions ask some background information about you. |
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How old are you?
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What is your sex?
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What grade are you in?
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Are you Hispanic, Latino, Latina, or of Spanish origin? (Select one or more)
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[IF HISPANIC]:
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What race or races do you consider yourself to be? (Select one or more)
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Which of the following best describes you?
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What sex were you assigned at birth, on your original birth certificate?
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Do you currently describe yourself as male, female, or transgender?
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Question Group Probes:
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1.2 E-cigarette use |
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The next several sections of questions ask about your use of particular kinds of tobacco products, such as e-cigarettes, cigarettes, cigars, smokeless tobacco, hookahs, roll-your own-cigarettes, pipes, snus, dissolvable tobacco, bidis, heated tobacco products, and nicotine pouches.
At the beginning of each section, you will see a brief description and an image showing examples of each kind of tobacco product.
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The next several questions are about electronic cigarettes or e-cigarettes, such as JUUL, Vuse, NJOY, Puff Bar, blu, or Bidi Stick. You also may know them as vapes, mods, e-cigs, e-hookahs, or vape-pens.
E-cigarettes are battery powered devices that usually contain a nicotine-based liquid that is vaporized and inhaled.
For the rest of this survey, these products and devices will be called e-cigarettes.
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Have you ever used an e-cigarette, even once or twice?
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[INTERVIEWER: CONTINUE BELOW FOR EVER E-CIGARETTE USERS. NEVER E-CIGARETTE USERS WILL SKIP TO PAGE X.] |
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Question Universe: ever e-cigarette users [known] How old were you when you first used an e-cigarette, even once or twice?
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Question Universe: ever e-cigarette users [known] In total, on how many days have you used e-cigarettes in your entire life?
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[IF MORE THAN ONE DAY:]
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Question Universe: ever e-cigarette users [or unknown] During the past 30 days, on how many days did you use e-cigarettes?
Specify: |__|__| (Range 0 – 30) |
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Question Universe: ever/current e-cigarette users [known] When was the last time you used an e-cigarette, even one or two times? (Please choose the first answer that fits)
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Question Universe: ever/current e-cigarette users [known] Why did you first use an e-cigarette? (Select one or more)
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Question Universe: current e-cigarette users [known] INTERVIEWER: ASK IF CURRENT E-CIGARETTE USER. OTHERWISE, SKIP TO NEXT QUESTION. Why do you currently use e-cigarettes? (Select one or more)
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Question Universe: ever e-cigarette user [known] Have you ever purchased an e-cigarette device (including disposable devices), pod, cartridge, single hit, or e-liquid refill while at school or on school property?
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Question Group Probes:
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[INTERVIEWER: CONTINUE BELOW FOR PAST 30-DAY E-CIGARETTE USERS. OTHERWISE, SKIP TO PAGE X.] |
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Question Universe: past 30-day e-cigarette user [known] 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.
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Question Universe: past 30-day e-cigarette user [known] During the past 30 days, what e-cigarette brands did you use? (Select one or more)
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Question Universe: past 30-day e-cigarette user reporting >1 brand [known] During the past 30 days, what brand of e-cigarettes did you usually use? (Choose only one answer)
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Question Universe: past 30-day e-cigarette users [known] Did any of the e-cigarettes that you used in the past 30 days contain nicotine? A. Yes B. No C. Don’t know |
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Question Universe: past 30-day e-cigarette users [known] Nicotine salts, or “nic salts”, is a type of nicotine that is found in some e-liquids, pods, and cartridges. Did any of the e-cigarettes that you used in the past 30 days contain nicotine salts?
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Question Universe: past 30-day e-cigarette user [known] Were any of the e-cigarettes that you used in the past 30 days flavored to taste like menthol, mint, clove or spice, alcoholic drinks, candy, fruit, chocolate, or any other non-tobacco flavor? Do not think about tobacco flavor when answering this question.
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Question Universe: past 30-day e-cigarette user [known]
Were any of the e-cigarettes that you used in the past 30 days flavored to taste like tobacco?
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What does “flavored to taste like tobacco” mean to you? Did you think about added artificial flavorings, naturally occurring tobacco flavor, or both? |
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Question Universe: past 30-day users of flavored e-cigarettes What flavors were the e-cigarettes that you have used in the past 30 days? (Select one or more)
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What do you think of the answer choices? What’s the difference between menthol and mint?
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Question Universe: past 30-day user of flavored e-cigarettes Did any of the flavors that you used in the past 30 days have names or descriptions that included the word “ice” or “iced” (for example, blueberry ice or strawberry ice)?
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Question Universe: past 30-day user of flavored e-cigarettes Did any of the flavors that you used in the past 30 days have a name that did not describe a specific flavor, such as “solar,” “purple,” “jazz,” “island bash,” “fusion” or some other word or phrase?
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Question Universe: past 30-day e-cigarette user [known] During the past 30 days, how did you get your e-cigarette devices, pods, cartridges, or e-liquid refills? (Select one or more)
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Question Universe: past 30-day e-cigarette user [known] During the past 30 days, where did you buy your e-cigarette devices, pods, cartridges, or e-liquid refills? (Select one or more)
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Question Universe: past 30-day e-cigarette user (who got a product from someone else) Earlier you answered that you got or bought your e-cigarette devices, pods, cartridges, or e-liquid refills from another person, such as a friend or family member during the past 30 days. How old was this person?
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Question Universe: past 30-day e-cigarette user (who got a product from someone else) During the past 30 days, which of the following e-cigarette product(s) did you get or buy from another person? (Select one or more)
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Question Universe: past 30-day e-cigarette user [known] During the past 30 days, how often did you use someone else’s e-cigarette device?
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Question Universe: past 30-day users of e-cigarettes [known] Are you seriously thinking about quitting e-cigarettes? (Please choose the first answer that fits)
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If “no”, why not? Are they truly not interested in quitting, or do they not consider that they would even need to quit (e.g., they do not consider themselves to be e-cigarette users) |
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Question Universe: past 30-day users of e-cigarettes [known] During the past 12 months, how many times have you stopped using e-cigarettes for one day or longer because you were trying to quit using e-cigarettes for good?
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Question Universe: e-cigarette users who reported ≥1 quit attempt in past 12 months [known] When you tried to quit using e-cigarettes, did you use any of the following? (Select one or more)
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Question Group Probes:
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[INTERVIEWER: CONTINUE BELOW FOR NEVER E-CIGARETTE USERS. CURRENT E-CIGARETTE USERS WILL SKIP TO PAGE X.] |
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Question Universe: never e-cigarette users [known]
Have you ever been curious about using an e-cigarette?
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Question Universe: never e-cigarette users [known] Do you think that you will try an e-cigarette soon?
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Question Universe: never e-cigarette users [known] Do you think you will use an e-cigarette in the next year?
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Question Universe: never e-cigarette users [known] If one of your best friends were to offer you an e-cigarette, would you use it?
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Question Group Probes:
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Question/Screen (verbatim from NYTS interview) |
Question-specific Probes (if required) |
Notes (for interviewer use) |
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The next questions ask about other substances that could be vaped. |
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Have you ever vaped any of the following substances (even once)? Response options: Yes, No, Don’t Know
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Have you vaped any of the following substances during the past 30 days? Response options: Yes, No, Don’t Know
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Question Group Probes:
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The next section is about heated tobacco products such as iQOS or Eclipse. You may know them as heated cigarettes or “heat-not-burn” tobacco products. Heated tobacco products heat processed tobacco leaf in the form of sticks (“heatsticks”), plugs, or capsules to produce a vapor that the user inhales. They are different from e-cigarettes, which heat a liquid to produce a vapor. Do not think about e-cigarettes when answering these questions.
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Before today, have you heard of heated tobacco products?
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Have you ever used a heated tobacco product, even just one time?
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[IF DON’T KNOW]:
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[INTERVIEWER: CONTINUE BELOW FOR EVER (OR DK) HEATED TOBACCO USERS. NEVER USERS SKIP TO PAGE X.] |
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Question Universe: ever heated tobacco product user [or unknown/don’t know] During the past 30 days, on how many days did you use a heated tobacco product?
Specify: |__|__| (Range 0 – 30) |
[IF NOT ALREADY PROBED]:
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[INTERVIEWER: CONTINUE BELOW FOR PAST 30 DAY HEATED TOBACCO USERS. EVER USERS SKIP TO PAGE X.] |
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Question Universe: past 30-day heated tobacco product user [known] Were any of the heated tobacco products that you used in the past 30 days flavored to taste like menthol, mint, clove or spice, alcoholic drinks, candy, fruit, chocolate, or any other non-tobacco flavor? Do not think about tobacco flavor when answering this question.
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Question Universe: past 30-day heated tobacco product user [known] Were any of the heated tobacco products that you used in the past 30 days flavored to taste like tobacco?
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Question Universe: past 30-day users of flavored heated tobacco products What flavors were the heated tobacco products that you have used in the past 30 days? (Select one or more)
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Question Universe: past 30-day heated tobacco product user [known] During the past 30 days, how did you get your heated tobacco products? (Select one or more)
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Question Universe: past 30-day heated tobacco product user [known] During the past 30 days, where did you buy your heated tobacco products? (Select one or more)
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Question Group Probes:
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The next seven questions are about different topics related to antitobacco messaging. |
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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… Response options: Never, Rarely, Sometimes, Most of the time, Always, I didn’t see this tobacco product packaging in the past 30 days
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[IF NEVER USER AND RESPONDS]:
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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?
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The next five questions ask about e-cigarette advertisements. Do not think about cigarettes or other tobacco products when answering these questions. |
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When you are using the Internet, how often do you see ads or promotions for e-cigarettes?
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When you read newspapers or magazines, how often do you see ads or promotions for e-cigarettes?
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When you go to a convenience store, supermarket, gas station, kiosk/storefront, or shopping center, how often do you see ads or promotions for e-cigarettes?
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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?
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When you watch TV or streaming services (such as Netflix, Hulu, or Amazon Prime), or go to the movies, how often do you see people or characters using e-cigarettes?
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Question Group Probes:
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The next several questions ask about e-cigarettes and social media (such as YouTube, Instagram, Snapchat, Twitter, Facebook, Reddit, TikTok, or Twitch). Do not think about cigarettes or other tobacco products when answering these questions. |
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How often do you use social media?
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Question Universe: students who report using social media When you use social media, how often do you see posts or content (pictures, videos, or text) related to e-cigarettes?
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Question Universe: students who report seeing e-cigarette posts On which social media sites have you seen posts or content related to e-cigarettes? (Select one or more)
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Question Universe: students who report using social media When you use social media, how often do you post pictures or videos of yourself or someone else using e-cigarettes?
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Question Universe: students who report using social media When you use social media, how often have you liked, commented, or shared posts or content (pictures, videos, or text) related to e-cigarettes?
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Question Universe: students who report using social media Who usually posted the content related to e-cigarettes on your social media? (Select one or more)
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The next five questions ask about advertisements for cigarettes and other tobacco products (cigarettes, cigars, smokeless tobacco, hookahs, roll-your-own cigarettes, pipes, snus, dissolvable tobacco, bidis, heated tobacco products, and nicotine pouches). Do not think of e-cigarettes when answering these questions. |
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When you are using the Internet, how often do you see ads or promotions for cigarettes or other tobacco products?
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When you read newspapers or magazines, how often do you see ads or promotions for cigarettes or other tobacco products?
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When you go to a convenience store, supermarket, gas station, kiosk/storefront, or shopping center, how often do you see ads or promotions for cigarettes or other tobacco products?
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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?
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When you watch TV or streaming services (such as Netflix, Hulu, or Amazon Prime), or go to the movies, how often do you see people or characters using cigarettes or other tobacco products?
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Question Group Probes:
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File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Title | Report Template Blue |
Author | Microsoft Office User |
File Modified | 0000-00-00 |
File Created | 2022-04-07 |