Changes to Smoker Survey

Attachment D-2. Changes to Waves A-I Smoker Survey

Item	Currently Approved Question Text	Currently Approved Responses	Revision Type/ Justification	Revised Question Text	Revised Responses
C3c	In the past 12 months, have you used any of the following medications to help you quit smoking: nicotine skin patch, nicotine gum, nicotine lozenges, nicotine nasal spray, a nicotine inhaler, or pills such as Wellbutrin, Zyban, bupropion, Chantix, or varenicline?	1. Yes 2. No	Deletion because information already captured in another item
C4	When you last tried to quit smoking, did you do any of the following? C4_1. Give up cigarettes all at once C4_2. Gradually cut back on cigarettes C4_3. Switch completely to vaping (using e-cigarettes, vape pens, JUULs, mods, or other personal vaporizers) C4_4. Substitute some of your regular cigarettes with vaping (using e-cigarettes, vape pens, JUULs, mods, or other personal vaporizers) C4_5. Switch to mild or some other brand of cigarettes C4_6. Use nicotine replacements like the nicotine patch, nicotine gum, nicotine lozenges, nicotine nasal spray, or nicotine inhaler C4_7. Use medications like Wellbutrin, Zyban, buproprion, Chantix, or varenicline C4_8. Get help from a telephone quit line C4_9. Get help from a website such as Smokefree.gov or CDC.gov/Tips C4_10. Get help from a doctor or other health professional C4_11. Get help from a pharmacist C4_12. Use a mobile App to help you quit smoking C4_13. Use a texting program to help you quit smoking	1. Yes 2. No	Revision to update response options for clarity and to match them to current terminology (e.g., NJOY, Blu, Logic, Vuse, Puff Bar)	C4_1. Give up cigarettes all at once C4_2. Gradually cut back on cigarettes C4_3. Switch completely to e-cigarettes, vapes, or mods (popular brands include NJOY, Blu, Logic, Vuse, Puff Bar, and JUUL) C4_4. Substitute some of your regular cigarettes with e-cigarettes, vapes, or mods (popular brands include NJOY, Blu, Logic, Vuse, and JUUL) C4_4a. Switch completely to heated tobacco products (using “heat not burn” tobacco products, iQOS [eye-kos], Glo, or Eclipse). C4_4b. Substitute some of your regular cigarettes with heated tobacco products (using “heat not burn” tobacco products, iQOS [eye-kos], Glo, or Eclipse). C4_5. Switch to a different brand of cigarettes C4_5a. Switch to smokeless tobacco (such as snuff, chew or snus) or dissolvable tobacco. C4_6. Use nicotine replacement medications like the nicotine patch, nicotine gum, nicotine lozenges, nicotine nasal spray, or nicotine inhaler C4_7. Use medications like Wellbutrin, Zyban, buproprion, Chantix, or varenicline C4_8. Get help from a telephone quit line C4_9. Get help from a website such as Smokefree.gov or CDC.gov/Tips C4_10. Get help from a doctor or other health professional C4_11. Get help from a pharmacist C4_12. Use a mobile App to help you quit smoking C4_13. Use a texting program to help you quit smoking	1.Yes 2. No
C23 [S]			Addition to capture use of CDC texting program	SmokefreeTXT is a free text-based service that connects people who smoke cigarettes with mobile text message-based support to help them quit smoking. Have you heard of SmokefreeTXT?	1. Yes 2. No
C23a [S]			Addition to capture use of texting programs	Have you heard of any other text messaging services to help you quit smoking?	1. Yes 2. No
C23b [S]			Addition to capture use of CDC texting program	Have you used SmokefreeTXT or any other text-based quitting smoking program in the past 3 months since [DOV_DATE2]?	1. Yes 2. No
B8	The next questions are about e-cigarette or vape products that usually contain nicotine, flavors, and other ingredients. You may also know them as JUUL, electronic cigarettes, e-cigarettes, vape pens, Suorin or mods. Some look like cigarettes, and others look like small boxes, pens, or pipes. Questions related to vaping in this survey do not include products used for marijuana. [SHOW IMAGE “UPDATED E-CIG PRODUCT IMAGE.PNG” centered on screen] Have you ever vaped, even one time?	1.Yes 2. No	Revision: Update instructions to improve ability to capture vaping (based on RTI research). Note: The image and terminology may need to be updated to adjust to trends in the market and changes in terminology over time (e.g., NJOY, Blu, Logic, Vuse, Puff Bar).	The next questions are about electronic or e-cigarettes. You may also know them as vape pens, e-hookah, vapes, or mods. Some popular brands include NJOY, Blu, Logic, Vuse, Puff Bar, and JUUL. Please do not include marijuana, cannabis, and THC products (including concentrates, waxes or hash oils) for these questions. [SHOW IMAGE “UPDATED E-CIG PRODUCT IMAGE.PNG” centered on screen] Have you ever vaped, even one time?	1.Yes 2. No
B9a	On the days that you vape, how often do you vape?	1. Rarely 2. Sometimes 3. Often 4. Very often	Deletion because current vaping and days vaped are more useful than this item.
B13	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 cigarettes	Revision to simplify question and make it easier to answer	Do you believe that e-cigarettes and vape products are less harmful, equally harmful, or more harmful to your health than smoking regular cigarettes?	1. Less harmful 2. Equally harmful 3. More harmful 4. I don’t know
D18_19 [Grid, S across]	The next few questions will ask about your opinions related to smoking, tobacco use, and cessation. (Randomize and record response order) Statements in row (randomize list): D10. I get upset when I think about my smoking. D11. I am disappointed in myself because I smoke. D12. I get upset when I hear or read about illnesses caused by smoking. D13. Warnings about the health risks of smoking upset me. D15. Using e-cigarettes and vape products can result in serious lung injury or death. D18. Smoking can cause immediate damage to your body. D19. Smoking can cause medical complications and diseases that require surgeries and medical procedures to treat.	Please tell us if you strongly disagree, disagree, agree, or strongly agree with the following statements.	Adding ‘menthol’ survey items to list to determine message effectiveness of new ads titled ‘Angie: Love Yourself Tip,’ ‘Angie: Angry Tip,’ and ‘Ethan: Cool Tip’ and Noel.	D18_19 [Grid, S across] The next few questions will ask about your opinions related to smoking, tobacco use, and cessation. (Randomize and record response order) Statements in row (randomize list): D10. I get upset when I think about my smoking. D11. I am disappointed in myself because I smoke. D12. I get upset when I hear or read about illnesses caused by smoking. D13. Warnings about the health risks of smoking upset me. D15. Using e-cigarettes and vape products can result in serious lung injury or death. D18. Smoking can cause immediate damage to your body. D19. Smoking can cause medical complications and diseases that require surgeries and medical procedures to treat. D19a. Menthol cigarettes are just as damaging as other cigarettes. D19b. Tobacco companies aggressively target communities with menthol cigarette advertising.	Please tell us if you strongly disagree, disagree, agree, or strongly agree with the following statements
D21	Do you believe cigarette smoking is related to: D21_1. Lung Cancer D21_2. Cancer of the mouth or throat D21_3. Heart Disease D21_4. Diabetes D21_5. Emphysema D21_6. Stroke D21_7. Hole in throat (stoma or tracheotomy) D21_8. Buerger’s Disease D21_9. Amputations (removal of limbs) D21_10. Asthma D21_11. Gallstones D21_12. COPD or Chronic bronchitis D21_13. Periodontal or Gum Disease D21_14. Premature birth D21_15. Colorectal Cancer D21_16. Macular degeneration or blindness D21_17. Depression D21_18. Anxiety Disorder D21_19. Colon Cancer D21_20. COVID-19	1.Yes 2. No	Adding Kidney Disease, Peripheral Artery Disease, Premature death and Walking difficulties to list of diseases to capture beliefs about smoking-related diseases as found in new Tips ads.	Do you believe cigarette smoking is related to: D21_1. Lung Cancer D21_2. Cancer of the mouth or throat D21_3. Heart Disease D21_4. Diabetes D21_5. Emphysema D21_6. Stroke D21_7. Hole in throat (stoma or tracheotomy) D21_8. Buerger’s Disease D21_9. Amputations (removal of limbs) D21_10. Asthma D21_11. Gallstones D21_12. COPD or Chronic bronchitis D21_13. Periodontal or Gum Disease D21_14. Premature birth D21_15. Colorectal Cancer D21_16. Macular degeneration or blindness D21_17. Depression D21_18. Anxiety Disorder D21_19. Colon Cancer D21_20. COVID-19 D21_21. Kidney Disease D21_22. Walking difficulties due to artery blockage D21_23. Premature death	1.Yes 2. No
E2			Addition to make consistent with non-smoker survey	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
E2a			Addition to make consistent with non-smoker survey	Are you seriously considering increasing restrictions on smoking in your household?	1. Definitely yes 2. Probably yes 3. Probably not 4. Definitely not
F1a			Addition to capture media use for program planning	How do you usually watch television these days?	A digital antenna A cable or satellite subscription A streaming service on the Internet Some other way Don’t watch television
F1b			Addition to capture media use for program planning	How often do you watch television or movies, on a TV set or any other device? Do you do this every day or almost every day, at least once a week, at least once a month, or less often?	Every day or almost every day At least once a week At least once a month Less often Never do this
F3	On an average day, how many hours do you use the Internet for personal reasons?	1. None 2. Less than one hour 3. About 1 hour 4. About 2 hours 5. About 3 hours 6. About 4 hours 7. 5 hours or more	Revision to capture media use	On an average day, how many hours do you use the following social media platforms: F3_1. Facebook F3_2. Instagram F3_3. Twitter F3_4. Snapchat F3_5. TikTok F3_6. Reddit	1. None 2. Less than one hour 3. About 1 hour 4. About 2 hours 5. About 3 hours 6. About 4 hours 7. 5 hours or more
F14	In the past 3 months, that is since [DOV_DATE2], have you seen or heard advertisements for medications or products to help people quit smoking such as Chantix, Wellbutrin, Zyban, varenicline, bupropion, nicotine patches, or nicotine gums?	1. Never 2. Rarely 3. Sometimes 4. Often 5. Always	Deletion based on content of current CDC ads
F38	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	Deletion because no longer a priority item
F39			Returning to survey to measure outcome activity	Did you talk to anyone about any of these ads?	Yes No
F40			Returning to survey to measure outcome activity	When you talked about the ads, did you talk about any of the following topics? 1. These ads were not good. 2. I should not smoke cigarettes. 3. The person I was talking to or someone else I know should not smoke cigarettes.	1. Yes 2. No
QEDUC_HSGED			Addition to capture number of participants with GEDs	Do you have a high school diploma or a GED?	1. High school diploma 2. GED 3. Don’t Know
G15	Have you been diagnosed by a physician or other qualified medical professional with any of the following medical conditions?	G15_1. Acid reflux disease G15_2. ADHD or ADD G15_3. Anxiety disorder G15_4. Asthma, chronic bronchitis, or COPD G15_5. Cancer (any type except skin cancer) G15_6. Chronic pain (such as low back pain, neck pain, or Fibromyalgia) G15_7. Depression G15_8. Diabetes G15_9. Heart attack G15_10. Heart disease G15_11. High blood pressure G15_12. High cholesterol G15_13. HIV/AIDS G15_14. Kidney disease G15_15. Mental health condition G15_16. Multiple sclerosis G15_17. Osteoarthritis, joint pain or inflammation G15_18. Osteoporosis or osteopenia G15_19. Rheumatoid arthritis G15_20. Seasonal allergies G15_21. Skin cancer G15_22. Sleep disorders such as sleep apnea or insomnia G15_23. Stroke G15_23a. COVID-19 G15_24. Something else [anchor]	Addition to capture peripheral artery related disease and disability included in new Tips ads.	Have you been diagnosed by a physician or other qualified medical professional with any of the following medical conditions?	G15_1. Acid reflux disease G15_2. ADHD or ADD G15_3. Anxiety disorder G15_4. Asthma, chronic bronchitis, or COPD G15_5. Cancer (any type except skin cancer) G15_6. Chronic pain (such as low back pain, neck pain, or Fibromyalgia) G15_7. Depression G15_8. Diabetes G15_9. Heart attack G15_10. Heart disease G15_11. High blood pressure G15_12. High cholesterol G15_13. HIV/AIDS G15_14. Kidney disease G15_15. Mental health condition G15_16. Multiple sclerosis G15_17. Osteoarthritis, joint pain or inflammation G15_18. Osteoporosis or osteopenia G15_19. Rheumatoid arthritis G15_20. Seasonal allergies G15_21. Skin cancer G15_22. Sleep disorders such as sleep apnea or insomnia G15_23. Stroke G15_23a. COVID-19 G15_23b. Peripheral artery disease G15_24. Something else [anchor]
G16			Added to assess non-diagnosed experience of anxiety and depression (potential cause of disparities in smoking cessation)	Over the last 2 weeks, how often have you been bothered by the following problems? Statements in row: G16_1. Little interest or pleasure in doing things G16_2. Feeling down, depressed or hopeless G16_3. Feeling nervous, anxious or on edge G16_4. Not being able to stop or control worrying	1. Not at all 2. Several days 3. More than half the days 4. Nearly every day
G17			Added to assess the role of discrimination potentially related to stress and smoking	G17. In your day-to-day life, how often have any of the following things happened to you? G17_1. You are treated with less courtesy or respect than other people. G17_2. You receive poorer service than other people at restaurants or stores. G17_3. People act as if they think you are not smart. G17_4. People act as if they are afraid of you. G17_5. You are threatened or harassed. [GRID]	1. Almost every day 2. At least once a week 3. A few times a month 4. A few times a year 5. Less than once a year 6. Never
G18			G17 and G18 are both part of the same scale	G18. What do you think is the main reason for these experiences?	1. Your ancestry or national origins 2. Your gender 3. Your race or ethnicity 4. Your age 5. Your religion 6. Your height 7. Your weight 8. Some other aspect of your physical appearance 9. Your sexual orientation 10. Your education or income level 11. A physical disability 12. Other [specify]: _________________________
G23	Do you consider yourself to be…	1. Heterosexual or straight 2. Gay 3. Lesbian 4. Bisexual 5. Other, please specify	Revised to reflect HHS recommendations	Which of the following best represents how you think of yourself?	1. Gay (lesbian or gay) 2. Straight, this is not gay (or lesbian or gay) 3. Bisexual 4. Something else 5. I don’t know the answer
NG22			Addition to address community context and social connectedness, potentially related to stress and smoking.	NG22 [Grid; S Across] Using the scale below, please tell us how much you agree or disagree with the following statements. NG21a. I feel safe in my area or neighborhood. NG21b. If I had a problem, I would feel comfortable asking a neighbor for help.	1. Strongly agree 2. Somewhat agree 3. Neither agree nor disagree 4. Somewhat disagree 5. Strongly disagree