Changes to Nonsmoker Survey

Attachment E-3. Changes to Waves A-I Nonsmoker Survey

Item	Currently Approved Question Text	Currently Approved Responses	Revision Type	Revised Question Text	Revised Responses
NA4_x	Was the last time you smoked a cigarette, even one or two puffs…?	Within the past 24 hours Within the past 7 days Within the past 30 days Within the past 3 months Within the past 6 months Within the past 1 year Within the past 5 years Within the past 10 years Within the past 15 years More than 15 years ago	Revision	Was the last time you smoked a cigarette, even one or two puffs…?	1.Within the past 24 hours 2. Within the past 7 days 3. Within the past 30 days 4. Within the past 3 months 5. Within the past 6 months 6. Within the past 1 year 7. More than one year ago.
NB4	When you last tried to quit smoking, did you do any of the following?	Across: Yes No Down: 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), e-vaporizers, or tank systems 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), e-vaporizers, or tanksystems 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 or CDC.gov/Tips NB4_10. Get help from a doctor or other health professional NB4_11. Get help from a pharmacist	Revision	When you last tried to quit smoking, did you do any of the following?	Across: 1. Yes 2. No Down: NB4_1. Give up cigarettes all at once NB4_2. Gradually cut back on cigarettes NB4_3. Switch completely to vaping (using e-cigarettes, vape pens, JUULs, mods, or other personal vaporizers) NB4_4. Substitute smoking some of your regular cigarettes with vaping (using e-cigarettes, vape pens, JUULs, mods, or other personal 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 or CDC.gov/Tips NB4_10. Get help from a doctor or other health professional NB4_11. Get help from a pharmacist NB4_12. Use a mobile App to help you quit smoking NB4_13. Use a texting program to help you quit smoking
E-Cig Intro	The next questions are about electronic vapor products. These are devices that usually contain a nicotine-based liquid that is vaporized and inhaled. You may also know them as e-cigarettes, vape-pens, hookah-pens, electronic hookahs (e-hookahs), electronic cigars (e-cigars), electronic pipes (e-pipes), or e-vaporizers. Some brand examples are Blu, NJOY, Vuse, MarkTen, Fin, and Logic. Some examples of electronic vapor products are pictured below.		Revision	The next questions are about vaping (using e-cigarettes, vape pens, JUULs, mods, other personal vaporizers). Vaping products are battery-powered and produce vapor instead of smoke. They typically use a nicotine liquid, although the amount of nicotine can vary and some may not contain any nicotine at all. Some common brands are JUUL, Vuse, MarkTen, Logic, and Blu. These questions concern electronic vaping products for nicotine use. The use of electronic vaping products for marijuana use is not included in these questions.
NB8	Have you ever used electronic vapor products, even one time?	1. Yes 2. No	Revision	Have you ever vaped, even one time?	1. Yes 2. No
NB8a	During the past 30 days, on how many days did you use electronic vapor products?	1. 0 days 2. 1 or 2 days 3. 3 to 5 days 4. 6 to 9 days 5. 10 to 19 days 6. 20 to 29 days 7. All 30 days	Revision	During the past 30 days, on how many days did you vape?	1. 0 days 2. 1 or 2 days 3. 3 to 5 days 4. 6 to 9 days 5. 10 to 19 days 6. 20 to 29 days 7. All 30 days
NB9	Do you now use electronic vapor products…	1. Every day 2. Some days 3. Not at all	Revision	Do you now vape…	1. Every day 2. Some days 3. Not at all
NB9a	On the days that you use electronic vapor products, how often do you use them?	1. Rarely 2. Sometimes 3. Often 4. Very Often	Revision	On the days that you vape, how often do you vape?	1. Rarely 2. Sometimes 3. Often 4. Very Often
NB9a_date	How long ago did you first try an electronic vapor product?	1. 1 to 2 weeks ago 2. 3 to 4 weeks ago 3. 1 to 3 months ago 4. 4 to 6 months ago 5. 7 to 12 months ago 6. More than 1 year ago	Deletion	N/A	N/A
NB9a	Do you usually use disposable electronic vapor products, rechargeable vapor products that use cartridges, or rechargeable vapor products that use refillable tanks?	Please indicate the type of electronic vapor product that you use the most. 1. Disposable devices that are not rechargeable or refillable 2. Rechargeable devices that are used with non-refillable cartridges 3. Rechargeable devices that have small refillable cartridges for e-liquid 4. Rechargeable devices that have large refillable tanks for e-liquid 5. Unknown device type	Revision	Do you usually vape with disposable devices, rechargeable devices that use pods or cartridges, or rechargeable devices that use large refillable tanks?	Please indicate the type of device that you vape most often. 1. Disposable devices that are not rechargeable or refillable 2. Rechargeable devices that use pods or cartridges, like JUULs 3. Rechargeable devices that have large refillable tanks 5. Unknown device type
NB9b	On average, about how many do you now use each week?	_________[ENTER NUMBER]	Deletion	N/A	N/A
NB9b_1	When you use your electronic vapor product, does the liquid/contents usually contain nicotine?	1. Yes 2. No 3. Don’t know	Revision	When you vape, does the liquid/contents usually contain nicotine?	1. Yes 2. No 3. Don’t know
NB9c	Where did you get or buy the electronic vapor products that you have used?	NB9c_1. A gas station or convenience store NB9c_2. A grocery store NB9c_3. A drugstore NB9c_4. A mall or shopping center kiosk/stand NB9c_5. Over the Internet NB9c_6. A store that sells electronic vapor products, such as a “vape shop” NB9c_11. Mass merchandisers or supercenters like Walmart, Target, or Costco NB9c_8. From a family member NB9c_9. From a friend NB9c_10. Some other person that is not a family member or a friend NB9c_7. Other, specify	Deletion	N/A	N/A
NB9d	Which of those is the main way you usually get your electronic vapor products?	[Show list of responses provided in B9c]	Deletion	N/A	N/A
NB10	Are any of the following a reason why you first tried/currently use electronic vapor products?	NB10_1. They cost less than other forms of tobacco NB10_2. They can be used in places where smoking cigarettes isn’t allowed NB10_3. They might be less harmful to me than regular cigarettes NB10_4. They might be less harmful to people around me than regular cigarettes NB10_5. Electronic vapor products come in flavors I like NB10_6. Electronic vapor products can help me quit smoking regular cigarettes NB10_7. Electronic vapor products can help me reduce the number of regular cigarettes I smoke NB10_8. Electronic vapor products don’t smell NB10_9. Using an electronic vapor product feels like smoking a regular cigarette NB10_10. Electronic vapor products don’t bother people who don’t use tobacco NB10_11. The advertising for electronic vapor products appeals to me NB10_12. They help me deal with cravings to smoke NB10_13. I have a friend or family member who suggested I use electronic vapor products as a way to quit smoking NB10_14. I was curious about electronic vapor products NB10_15. Other, specify	Revision	Are any of the following a reason why you first tried/currently vape?	NB10_1. I can vape when or where smoking cigarettes is not allowed NB10_2. Vaping might be less harmful to me than smoking cigarettes NB10_3. I like the flavors NB10_4. Vaping can help me quit or cut back on smoking cigarettes NB10_5. Vaping helps me deal with cravings to smoke NB10_6. A friend or family member suggested I vape as a way to quit smoking NB10_7. A friend or family member [IF B9=3 insert: shared/ IF B9=1 or 2 insert: shares] their vaping device with me NB10_8. Vaping is popular among people my age NB10_9. I [IF B9=3 insert: was/ IF B9=1 or 2 insert: am] curious about vaping NB10_10. Other, specify
NB11	Which of those is the main reason you first tried/currently use electronic vapor products?	[Show list of responses provided in B10]	Deletion	N/A	N/A
NB11a	You indicated previously that you have tried electronic vapor products before but do not currently use them every day or some days. Please indicate the reasons why you do not use electronic vapor products now	_____[OPEN ENDED]	Deletion	N/A	N/A
NB12	Do you use electronic vapor products in places where smoking regular cigarettes is not allowed?	1. Yes 2. No	Deletion	N/A	N/A
NB12a	Do you use electronic vapor products in any of the following places?	NB12a_1. Restaurants or bars NB12a_2. Stores or shopping malls NB12a_3. Airplanes NB12a_4. Beaches, parks, or other outdoor places NB12a_5. In your car or other type of vehicle NB12a_6. In your home NB12a_7. Somewhere else, specify	Deletion	N/A	N/A
NB13	As far as you know or believe is the use of electronic vapor products in combination with regular cigarettes less harmful than smoking only regular cigarettes, more harmful than smoking only regular cigarettes, or equally as harmful as smoking only regular cigarettes? Please indicate your answer on a scale of 1 to 5, where one is much less harmful, 3 is the same as regular cigarettes, and 5 is much more harmful.	1.Much less harmful than smoking only regular cigarettes 2. Slightly less harmful than smoking regular cigarettes 3. Equally harmful as smoking only regular cigarettes 4. Slightly more harmful than smoking regular cigarettes 5. Much more harmful than smoking only regular cigarettes	Revision	In your opinion, regularly vaping and smoking cigarettes is…	1.Much less harmful to one’s health than only smoking cigarettes 2. Slightly less harmful to one’s health than only smoking cigarettes 3. Equally harmful to one’s health as only smoking cigarettes 4. Slightly more harmful to one’s health than only smoking cigarettes 5. Much more harmful to one’s health than only smoking regular cigarettes
NB14	Do you want to quit using electronic vapor products for good?	1.Yes 2. No	Revision	Do you want to quit vaping for good?	1. Yes 2. No
NB15	Do you plan to quit using electronic vapor products….	1. In the next 7 days, 2. In the next 30 days, 3. In the next 6 months, 4. In the next 1 year, or 5. More than 1 year from now? 6. I do not plan to quit using electronic vapor products for good 7. Not sure/Uncertain	Deletion	N/A	N/A
NC4b	How likely do you think it is that smoking will worsen medical complications from diabetes such as blindness, renal failure, or amputations?	1. Extremely likely 2. Very likely 3. Somewhat likely 4. Very unlikely 5. Extremely unlikely	Deletion	N/A	N/A
NC3	Do you think that breathing smoking from other people’s cigarettes or from other tobacco products is…	1. Not at all harmful to one’s health 2. Somewhat harmful to one’s health 3. Very harmful to one’s health	Deletion	N/A	N/A
NC4	How likely do you think it is that regularly breathing secondhand tobacco smoke would cause children to have asthma or breathing problems?	1. Extremely likely 2. Very likely 3. Somewhat likely 4. Very unlikely 5. Extremely unlikely	Deletion	N/A	N/A
NC4a	How likely is it that regularly breathing secondhand tobacco smoke would cause nonsmokers to have asthma, infections, or lung damage?	1. Extremely likely 2. Very likely 3. Somewhat likely 4. Very unlikely 5. Extremely unlikely	Revision	In your opinion how likely is it that regularly breathing secondhand tobacco smoke would worsen asthma or cause infections or lung damage among nonsmokers?	1. Extremely likely 2. Very likely 3. Somewhat likely 4. Very unlikely 5. Extremely unlikely
ND1a	During the past 7 days, that is, since [DATE], on how many days did you breathe vapor from someone else who was using electronic vapor products in an indoor or outdoor place?	__________[# Days]	Deletion	N/A	N/A
ND1b	During the past 7 days, that is, since [DATE], on how many days did you breathe vapor from someone else who was smoking cigarettes in an indoor or outdoor place?	__________[# Days]	Deletion	N/A	N/A
NE10c	In the past 6 months, that is since [DATE], have you recommended any family members or friends that smoke to talk with a health care professional such as a physician, nurse, or dentist about quitting smoking?	1. Yes 2. No	Deletion	N/A	N/A
ND6	Among close friends, do…	1. All of them smoke? 2. Most of them smoke? 3. Most of them NOT smoke? 4. None of them smoke?	Deletion	N/A	N/A
ND7	Among close relatives, do…	1. All of them smoke? 2. Most of them smoke? 3. Most of them NOT smoke? 4. None of them smoke?	Deletion	N/A	N/A
NE8b	N/A	N/A	Addition	Not counting decks, porches, or garages, inside your home, is smoking…	1.Always allowed 2. Allowed only at some times or in some places 3. Never allowed
NE9_1	N/A	N/A	Addition	Are you seriously considering increasing restrictions on smoking in your household?	1. Definitely yes 2. Probably yes 3. Probably not 4. Definitely not
NE9	A telephone quitline is a free telephone-based service that connects people who smoke cigarettes with someone who can help them quit. Are you aware of any telephone quitline services that are available to help smokers?	1. Yes 2. No	Deletion	N/A	N/A
NE19	Where have you seen or heard about the TIPS campaign?	Across: 1. Yes 2. No Down: NE19_1. On TV NE19_2. On the radio NE19_3. In newspapers or magazines NE19_4. On the Internet NE19_5. Billboards or other outdoor ads	Deletion	N/A	N/A
NF4	What type of Internet connection do you have for your home computer or other primary computer?	1.Cable/DSL/Broadband/High-Speed 2. Dial-Up 3. Not Sure	Deletion	N/A	N/A
NF20	Sometimes people use the Internet specifically for health-related reasons. In the past 30 days, have you used the Internet for any of the following reasons?	Across: 1. Yes 2. No Down: NF20_1. Looked for information about quitting smoking NF20_2. Looked for information about electronic vapor products (e.g., e-cigarettes, e-vaporizers) NF20_3. Looked for information about nicotine replacement therapies (e.g., patches, gum, lozenges) NF20_4. Downloaded a mobile App to help you quit smoking	Revision	Sometimes people use the Internet specifically for health-related reasons. In the past 30 days, have you used the Internet for any of the following reasons?	Across: 1. Yes 2. No Down: NF20_1. Looked for information about quitting smoking NF20_2. Looked for information about vaping (using e-cigarettes or other vaping products) NF20_3. Looked for information about nicotine replacement therapies (e.g., patches, gum, lozenges) NF20_4. Downloaded a mobile App to help you quit smoking NF20_5. Signed up for a texting program to help you quit smoking NF20_6. Created an online plan to help you quit smoking
NF21	In the past 30 days, have you shared information via email, social media, blog or online forum/support group about any of the following?	Across: 1. Yes 2. No Down: NF21_1. How to quit smoking NF21_2. CDC Tips campaign messages/videos NF21_3. Electronic vapor products (e.g., e-cigarettes, e-vaporizers) NF21_4. Nicotine replacement therapies (e.g., patches, gum, lozenges)	Deletion	N/A	N/A
NF27_x	Would this ad make you want to encourage someone you care about to quit smoking?	1. Yes 2. No	Deletion	N/A	N/A
NF28_1x	On a scale of 1 (not at all) to 5 (extremely), to what degree did the ad focus on the benefits of quitting smoking cigarettes?	1. Not at all 2. Slightly 3. Moderately 4. Very 5. Extremely	Deletion	N/A	N/A
NF28_2x	On a scale of 1 (not at all) to 5 (extremely), to what degree did the ad focus on the consequences of continuing to smoke cigarettes?	1. Not at all 2. Slightly 3. Moderately 4. Very 5. Extremely	Deletion	N/A	N/A
NF28_3x	Please rate the overall tone of the ad on a scale from 1 (extremely negative) to 5 (extremely positive)	1. Extremely negative 2. Slightly negative 3. Neither negative nor positive 4. Slightly positive 5. Extremely positive	Deletion	N/A	N/A
NF29	Did seeing these ads on television make you want to encourage someone you care about to quit smoking?	1. Yes 2. No	Deletion	N/A	N/A
NF30	Did you talk to anyone about any of these ads?	1. Yes 2. No	Deletion	N/A	N/A
NF37	Where did you see these advertisements?	Across: 1.Yes 2.No Down: NF37_1. Magazines or print publications NF37_2. Websites online NF37_3. Public places such as bus shelters, bus interiors, outdoor bulletins, etc.	Revision	Where did you see these advertisements?	NF37_1. Magazines or print publications NF37_2. Websites online
NF37a	N/A	N/A	Addition	In the past XX Months, since [DATE], have you seen any of these ads in public places outside your home such as billboards, bus shelters, or bus interiors?	1. Yes 2. No
NF38	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?	1. I never go to a convenience store, supermarket, or gas station 2. Never 3. Rarely 4. Sometimes 5. Most of the time 6. Always	Revision	When you go to a convenience store, supermarket, or gas station, how often do you see ads or promotions for vaping products?	1. I never go to a convenience store, supermarket, or gas station 2. Never 3. Rarely 4. Sometimes 5. Most of the time 6. Always
NG1	How many children aged 17 or younger live in your household 6 months or more of the year?	_______Number of children	Revision	How many people are 17 years of age or younger and currently live in your household at least 50% of the time? If none, enter “0.” Include babies and small children. Your answer will help represent the entire U.S. population and will be kept confidential. Thank you!	________Number of children
NG6	The next question is about the total income of YOUR HOUSEHOLD for the PAST 12 MONTHS. Please include your income PLUS the income of all members living in your household (including cohabiting partners and armed forces members living at home). Please count income BEFORE TAXES and from all sources (such as wages, salaries, tips, net income from a business, interest, dividends, child support, alimony, and Social Security, public assistance, pensions, or retirement benefits). Was your total HOUSEHOLD income in the past 12 months…	1. Below $35,000 2. $35,000 or more 3. Don’t Know	Revision	How much is the combined income of all members of YOUR HOUSEHOLD for the PAST 12 MONTHS? Please include your income PLUS the income of all members living in your household (including cohabiting partners and armed forces members living at home). Please count income BEFORE TAXES and from all sources (such as wages, salaries, tips, net income from a business, interest, dividends, child support, alimony, and Social Security, public assistance, pensions, or retirement benefits).	1. Below $50,000 2. $50,000 or more 3. Don’t Know
NG6a	We would like to get a better estimate of your total HOUSEHOLD income in the past 12 months before taxes. Was it…	1.Less than $5,000 2. $5,000 to $7,499 3. $7,500 to $9,999 4. $10,000 to $12,499 5. $12,500 to $14,999 6. $15,000 to $19,999 7. $20,000 to $24,999 8. $25,000 to $29,999 9. $30,000 to $34,999	Revision	We would like to get a better estimate of your total HOUSEHOLD income in the past 12 months before taxes. Was it…	1.Less than $5,000 2. $5,000 to $7,499 3. $7,500 to $9,999 4. $10,000 to $12,499 5. $12,500 to $14,999 6. $15,000 to $19,999 7. $20,000 to $24,999 8. $25,000 to $29,999 9. $30,000 to $34,999 10. $35,000 to $39,999 11. 40,000 to $49,999
NG6b	We would like to get a better estimate of your total HOUSEHOLD income in the past 12 months before taxes. Was it…	1. $35,000 to $39,999 2. $40,000 to $49,999 3. $50,000 to $59,999 4. $60,000 to $74,999 5. $75,000 to $84,999 6. $85,000 to $99,999 7. $100,000 to $124,999 8. $125,000 to $149,999 9. $150,000 to $174,999 10. $175,000 or more	Revision	We would like to get a better estimate of your total HOUSEHOLD income in the past 12 months before taxes. Was it…	1. $50,000 to $59,999 2. $60,000 to $74,999 3. $75,000 to $84,999 6. $85,000 to $99,999 4. $100,000 to $124,999 5. $125,000 to $149,999 6. $150,000 to $174,999 10. $175,000 to $199,999 11. $200,000 to $249,999 12. $250,000 or more
NG7	Are you now married, widowed, divorced, separated, never married, or living with a partner?	1.Married 2. Widowed 3. Divorced 4. Separated 5. Never married 6. Living with a partner	Revision	Are you now…	1. Married 2. Widowed 3. Divorced 4. Separated 5. Never married
NG7a	N/A	N/A	Addition	Are you currently living with a partner to whom you are not married?	1.Yes 2. No
NADD1	Those are all of our questions. Thanks so much for your participation in our survey. As a token of our appreciation, we would like to send you [IF SAMPLE = KP WITHDRAWN, “$15”; IF SAMPLE=ABS, “$20”]. Would you please provide your name and mailing address so that we can put the check in the mail. This information will not be connected with your survey responses in any way. After you have entered your information, please make sure to click “Next.”	Name (First/Last): Street Address (If applicable, include unit number): City: State: Zip Code:	Revision	Those are all of our questions.  Thanks so much for your participation in our survey.  As a token of our appreciation, we would like to send you $[IF SAMPLE = KP WITHDRAWN, $15; IF SAMPLE=ABS, INSERT INCENTIVE VALUE FROM LOOKUP TABLE based on MNO; IF SAMPLE=ABS and incentive value is missing from lookup table, insert: $20].  Please verify your name and mailing address so that we can put the check in the mail. To ensure that you will be able to deposit or cash the check, please be sure to provide us with your full first AND last name; if you provide incomplete or inaccurate information, you may not be able to deposit the check. This information will not be connected with your survey responses in any way. Please select the field(s) that you’d like to update. If all of the information is correct, please select “All of the above are correct”.	1.Name (First/Last): 2.Mailing Address: 3.All of the above are correct
NADD1_1	N/A	N/A	Addition	Please type in the name to whom you’d like us to send the incentive check:	Name___________
NADD1_2	N/A	N/A	Addition	Please type in the address to where we should send the incentive check:	Street Address: City: State: Zip Code:
NADD2	N/A	N/A	Addition	Is the contact information below now up-to-date?	1. Yes 2. No
NCONTACT_A	N/A	N/A	Addition	Thank you for your participation in this important study! If you entered your address information on the previous question, your check for participation will arrive in the next 4 – 6 weeks. The CDC will also have the opportunity to do at least one more survey in the future, with additional rewards and prizes for participation. Would you be willing to participate in another survey for the CDC?	1. Yes 2. No
NCONTACT_A1	N/A	N/A	Addition	Is this the address where you would like us to send your next CDC survey invitation?	1. Yes 2. No
NCONTACT_A2	N/A	N/A	Addition	Please provide us with the address that you would like us to use to send you your next CDC survey invitation	Street Address: City: State: Zip Code:
NCONTACT_B	N/A	N/A	Addition	So that you can participate in the future if you choose to do so, please provide your e-mail address and best phone number to reach you below. Remember, you can decline to do any survey at that time if you do not want to do it.	My email address is: The best phone number to reach me:
NCONTACT2_A	N/A	N/A	Addition	In case we are unable to reach you through the email address or phone number you provided in the previous question, is there an alternate email address or a phone number to be able to reach? It is very important for us to hear back from you for future surveys that we will be sending out so we can ensure that the researchers have complete data for this new and important study.	Alternate Email: Alternate phone number to reach you: