Assessing Physiological, Neural and Self-Reported Response to Tobacco Education Message
Start of Block: Identification
Q97 Video Number
Group 1 or 2
Group 3 or 4
Q98 Participant Identification
________________________________________________________________
End of Block: Identification
Start of Block: PRA Statement
Paperwork Reduction Act Statement: According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0910-XXXX. The time required to complete this information collection is estimated to average 85 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing burden to [email protected].
Start of Block: 1. SOCIODEMOGRAPHICS
Q76 How old are you?
Less than 13 years old
13 years old
14 years old
15 years old
16 years old
17 years old
18 years old
19 years old
20 years old
21 years old
22 years old
23 years old
24 years old
Over 24 years old
Q74 What is your gender identity (select all that apply)?
Woman/girl
Man/boy
Non-binary or gender non-conforming
Transgender woman/girl
Transgender man/boy
Another gender identity
Prefer not to answer
Which of these best describes your racial and/or ethnic background? (Select all that apply)
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
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Display This Question:
If Q76 = 18 years old
Or Q76 = 19 years old
Or Q76 = 20 years old
Or Q76 = 21 years old
Or Q76 = 22 years old
Or Q76 = 23 years old
Or Q76 = 24 years old
1.3 What is the highest grade or level of school you have completed?
High school or less
Some college
College graduate or higher
1.4 What is your current employment status?
Full-time
Part-time
Don’t currently work
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Display This Question:
If Q76 = 13 years old
Or Q76 = 14 years old
Or Q76 = 15 years old
Or Q76 = 16 years old
Or Q76 = 17 years old
1.5 How much money does your family have?
Not enough to get by
Just enough to get by
Only have to worry about money for fun or extras
Never have to worry about money
Display This Question:
If Q76 = 18 years old
Or Q76 = 19 years old
Or Q76 = 20 years old
Or Q76 = 21 years old
Or Q76 = 22 years old
Or Q76 = 23 years old
Or Q76 = 24 years old
1.6 Considering your own income and the income from any other people who help you, how much money do you have?
Not enough to get by
Just enough to get by
Only have to worry about money for fun or extras
Never have to worry about money
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End of Block: 1. SOCIODEMOGRAPHICS
Start of Block: 2. Tobacco Use Behaviors
Preface The next questions are about your experience with cigarettes.
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Display This Question:
If Q97=Group 3
2.1 Have you ever tried cigarette smoking, even one or two puffs?
Yes
No
Don't know
Prefer not to answer
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Display This Question:
If 2.1 = Yes
Q73 How many cigarettes have you smoked in your entire life? A pack usually has 20 cigarettes in it.
1 or more puffs but never a whole cigarette
1 cigarette
2 to 10 cigarettes (about 1/2 pack total)
11 to 20 cigarettes (about 1/2 pack to 1 pack)
21 to 50 cigarettes (more than 1 pack but less than 3 packs)
51 to 99 cigarettes (more than 2 1/2 packs but less than 5 packs)
100 or more cigarettes (5 packs or more)
Don't know
Prefer not to answer
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Display This Question:
If 2.1 = No
Or 2.1 = Don't know
2.2 Have you ever been curious about smoking a cigarette?
Very curious
Somewhat curious
A little curious
Not at all curious
Don't know
Prefer not to answer
Display This Question:
If 2.1 = No
Or 2.1 = Don't know
Q2.2b Do you think you will smoke a cigarette in the next year?
Definitely yes
Probably yes
Probably not
Definitely not
Don't know
Prefer not to answer
Display This Question:
If 2.1 = No
Or 2.1 = Don't know
Q2.2c Do you think that you will try a cigarette soon?
Definitely yes
Probably yes
Probably not
Definitely not
Don't know
Prefer not to answer
Display This Question:
If 2.1 = No
Or 2.1 = Don't know
Q2.2d If one of your best friends were to offer you a cigarette, would you smoke it?
Definitely yes
Probably yes
Probably not
Definitely not
Don't know
Prefer not to answer
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Display This Question:
If 2.1 = Yes
2.3 Do you now smoke cigarettes ...
Every day
Some days
Not at all
Don't know
Prefer not to answer
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The next questions are about vaping products like e-cigarettes, vape pens, JUULs, mods, or other personal vaporizers. These products are battery-powered and produce vapor or aerosol instead of smoke. Vapes typically use a nicotine liquid, although the amount of nicotine can vary, and some may not contain any nicotine at all.
Please do NOT include vapes with marijuana, THC, or CBD when answering these questions.
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2.4 Have you ever used a vaping product or vape, even one or two times? (Electronic nicotine products include e-cigarettes, vape pens, personal vaporizers and mods, e-cigars, e-pipes, e-hookahs, and hookah pens.)
Yes
No
Don't know
Prefer not to answer
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Display This Question:
If 2.4 = No
2.5 Have you ever been curious about using a vaping product or vape? (Electronic nicotine products include e-cigarettes, vape pens, personal vaporizers and mods, e-cigars, e-pipes, e-hookahs, and hookah pens.)
Very curious
Somewhat curious
A little curious
Not at all curious
Don't know
Prefer not to answer
Q2.5b Do you think you will try a vaping product or vape in the next year?
Definitely yes
Probably yes
Probably not
Definitely not
Don't know
Prefer not to answer
Q2.5c Do you think that you will try a vaping product soon?
Definitely yes
Probably yes
Probably not
Definitely not
Don't know
Prefer not to answer
Q2.5c If one of your best friends were to offer you a vaping product or vape, would you try it?
Definitely yes
Probably yes
Probably not
Definitely not
Don't know
Prefer not to answer
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Display This Question:
If 2.4 = Yes
2.6 Do you now use a vaping product or vape ...
Every day
Some days
Not at all
Don't know
Prefer not to answer
Display This Question:
If 2.4 = Yes
2.7 How many times have you used a vaping product or vape in your entire life?
1 time, even just a few puffs
2 to 10 times
11 to 20 times
21 to 50 times
51 to 99 times
100 or more times
Don't know
Prefer not to answer
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End of Block: 2. Tobacco Use Behaviors
Start of Block: 3. SOCIAL INFLUENCES
3.1 Does anyone who lives with you now use any tobacco? This includes cigarettes, e-cigarettes, vapes or vaping products, cigars, cigarillos, little cigars, pipes filled with tobacco, hookah or water pipe, bidis, and smokeless tobacco such as chewing tobacco, snuff, dip, snus, or dissolvable tobacco.
No
Yes
Don't know
Prefer not to answer
3.2 How many of your four closest friends smoke cigarettes?
None
One
Two
Three
Four
Don't know
Prefer not to answer
3.3 How many of your four closest friends use e-cigarettes or other electronic nicotine products?
None
One
Two
Three
Four
Don't know
Prefer not to answer
End of Block: 3. SOCIAL INFLUENCES
Start of Block: Video Instructions
Q219 In the next part of the study, you will watch four videos. The researcher will start the video for you. After each video, you will answer questions about what you saw.
Q220 When you are ready, please let the researcher know to begin the first video.
End of Block: Video Instructions
Programming note: Four videos will be presented in random order; participants will answer questions after each video.
Start of Block: OUTCOME VARIABLES pt. 1
4.1 Have you seen this advertisement before this study?
No
Yes
Don't know
Prefer not to answer
4.2 Please tell us if you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree with the following statements:
[Randomize order of statements]
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Strongly disagree |
Disagree |
Neither disagree nor agree |
Agree |
Strongly agree |
Prefer not to answer |
This ad was worth remembering. |
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This ad grabbed my attention. |
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This ad was powerful. |
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This ad was informative. |
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This ad was meaningful to me. |
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This ad was convincing. |
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4.3 Please indicate the extent to which you agree with the following statements:
[Randomize order of statements]
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Strongly disagree |
Disagree |
Neither disagree not agree |
Agree |
Strongly agree |
Prefer not to answer |
This message discourages me from wanting to smoke. |
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This message makes me concerned about the health effects of smoking. |
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This message makes smoking seem unpleasant to me. |
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4.4 When I was watching this ad, I paid close attention during __ of the time the ad was playing.
All
Most
About half
Some
None
4.5 When I was watching this ad, I paid the most attention to (select one response):
The characters in the ad
The animation or visuals
The information provided
The music that was playing
Something else: _____________
DISPLAY IF Q97=GROUP 4
4.6 How much does this ad make you worry about what smoking cigarettes will do to you?
Not at all
Very little
Somewhat
Quite a bit
A great deal
DISPLAY IF Q97=GROUP 1 OR GROUP 2
4.7 How much does this ad make you think smoking cigarettes is a bad idea?
Not at all
Very little
Somewhat
Quite a bit
A great deal
DISPLAY IF Q97=GROUP 1 OR GROUP 2
4.8 How much does this ad discourage you from smoking cigarettes?
Not at all
Very little
Somewhat
Quite a bit
A great deal
DISPLAY IF Q97=GROUP 1 OR GROUP 2
4.9 How much does this ad make you worry about what vaping will do to you?
Not at all
Very little
Somewhat
Quite a bit
A great deal
DISPLAY IF Q97=GROUP 3
4.10 How much does this ad make you think vaping is a bad idea?
Not at all
Very little
Somewhat
Quite a bit
A great deal
DISPLAY IF Q97=GROUP 3
4.11 How much does this ad discourage you from vaping?
Not at all
Very little
Somewhat
Quite a bit
A great deal
DISPLAY IF Q97=GROUP 3
4.12 If you were going to tell a friend what this ad was about, how would you describe the main message of the ad to them? Please be as specific as possible.
________________________________________________________________
4.13 Please tell us if you strongly disagree, disagree, agree, or strongly agree with the following statement: I found this ad to be confusing, unclear, or hard to understand.
Strongly Disagree
Disagree
Agree
Strongly Agree
4.14 [Ask if 4.13=Agree or Strongly Agree What is confusing, unclear, or hard to understand about this ad? Please be as specific as possible. ______________
Q4.15What do you like about this advertisement? Please be as specific as possible.
________________________________________________________________
Q4.16 What do you dislike about this advertisement? Please be as specific as possible.
________________________________________________________________
5.1 Please indicate how much you disagree or agree with the following statements.
[Randomize order of statements]
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Strongly disagree |
Disagree |
Neither disagree nor agree |
Agree |
Strongly agree |
Prefer not to answer |
This ad is trying to manipulate me. |
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The health effect in this ad is overblown. |
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This ad annoys me. |
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Q5.2 To what extent did the ad make you feel ... ?
[Randomize order of each emotion]
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Not at all |
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Extremely |
Prefer not to answer |
Scared |
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Inspired |
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Sad |
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Angry |
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Annoyed |
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Irritated |
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Ashamed |
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Understood |
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Uneasy |
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Surprised |
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Regretful |
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Guilty |
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Curious
Motivated
Hopeful
Amused
Happy |
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5.3 Think about the ad you watched and answer the following questions.
[Randomize order of statements]
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Not at all |
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Very much |
Prefer not to answer |
I could picture myself in the scene of the events in the ads. |
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I was mentally involved in the ad while viewing it. |
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I wanted to learn how the ad ended. |
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The ad affected me emotionally. |
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Q5.4 Think about the ad you watched, and answer the following questions.
[Randomize order of statements]
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Strongly disagree |
Disagree |
Neither disagree nor agree |
Agree |
Strongly agree |
Prefer not to answer |
This ad is believable |
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This ad is different from other anti-tobacco ads I’ve seen or heard. |
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This ad told me things I never knew before about [vapes if Group 3][cigarettes if Group 1, 2 or 4]. |
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I trust the information in this ad. |
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This ad seemed to be written with someone like me in mind. |
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Q5.5 Think about the ad you watched and answer the following questions.
[Randomize order of statements]
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Not at all |
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A great deal |
Prefer not to answer |
How similar are you to the characters in the ad? |
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How much do you like the characters in the ad? |
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How do you feel like you know the characters in the ad? |
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How much would you like to be like the characters in the ad? |
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Q5.6a Please indicate the extent to which you agree with the following statements.
[Randomize order of statements]
If
I smoke cigarettes [if Group 1 or 2], I will...
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Strongly disagree |
Disagree |
Neither disagree nor agree |
Agree |
Strongly agree |
Prefer not to answer |
Become addicted to smoking |
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Harm my body |
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Harm my lungs |
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Develop serious health problems |
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Inhale harmful chemicals |
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Develop cancer |
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Be less attractive to others |
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Miss out on activities and things I enjoy |
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Increase the chances that my younger brother or sister smokes
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Q5.6b Please indicate the extent to which you agree with the following statements.
[Randomize order of statements]
If I vape [if Group 3] I will
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Strongly disagree |
Disagree |
Neither disagree nor agree |
Agree |
Strongly agree |
Prefer not to answer |
Become addicted to vaping |
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Harm my body |
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Harm my lungs |
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Develop serious health problems |
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Inhale harmful chemicals |
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Be exposed to toxic metals |
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Develop worse mental health |
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Be less attractive to others |
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Harm my relationships
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4Q5.6c Please indicate the extent to which you agree with the following statements.
[Randomize order of statements]
If
I smoke cigarettes [if Group 4], I will...
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Strongly disagree |
Disagree |
Neither disagree nor agree |
Agree |
Strongly agree |
Prefer not to answer |
Become addicted to smoking |
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Harm my body |
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Harm my lungs |
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Develop serious health problems |
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Inhale harmful chemicals |
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Develop cancer |
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Damage my appearance |
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Be less attractive to others |
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Miss out on activities and things I enjoy |
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Q5.7 Please indicate the extent to which you agree with the following statements.
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Very bad |
Very good |
Prefer not to answer |
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0 |
1 |
2 |
3 |
4 |
5 |
[Smoking cigarettes if Group 1, 2 or 4] [Vaping if Group 3] is ... () |
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Q5.8
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Unenjoyable |
Enjoyable |
Prefer not to answer |
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0 |
1 |
2 |
3 |
4 |
5 |
[Smoking cigarettes if Group 1, 2 or 4] [Vaping if Group 3] is ... () |
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Q5.9 In the next year, how likely are you to vape? [Asked if Group 3]
A. Very unlikely
B. Somewhat unlikely
C. Neither likely nor unlikely
D. Somewhat likely
E. Very likely
Q5.10 In the next year, how likely are you to smoke a cigarette? [Asked if Group 1, 2 or 4]
A. Very unlikely
B. Somewhat unlikely
C. Neither likely nor unlikely
D. Somewhat likely
E. Very likely
Start of Block: 6. Psychosocial Variables
6.1 People often identify with particular groups, subcultures, or types of people. Please indicate how much you identify with each group by dragging the bar across the green Dragging the bar to 100 means you identify with this group very much and dragging the bar to 0 means you do not identify with this group at all.
[Randomize order of groups]
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0 |
10 |
20 |
30 |
40 |
50 |
60 |
70 |
80 |
90 |
100 |
Prefer not to answer |
Hipsters () |
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Skaters () |
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Jocks () |
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Athletes () |
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Rockers () |
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Goth () |
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Emo () |
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Gangster () |
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Partyers () |
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Hip-hop () |
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Country () |
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Popular () |
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Mainstream () |
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Alternative () |
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Page Break |
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Q6.2 Please answer how much you agree or disagree with each of the following statements.
[Randomize order of statements]
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Strongly disagree |
Disagree |
Neither disagree nor agree |
Agree |
Strongly agree |
Prefer not to answer |
I like to do frightening things |
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I like new and exciting experiences, even if I have to break the rules |
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I prefer friends who are exciting and unpredictable |
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I like to explore strange places |
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6.3 Please answer how much you agree or disagree with each of the following statements.
[Randomize order of statements]
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Strongly disagree |
Disagree |
Somewhat disagree |
Neither disagree nor agree |
Somewhat agree |
Agree |
Strongly agree |
Prefer not to answer |
I become frustrated when I am unable to make free and independent decisions |
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It irritates me when someone points out things which are obvious to me |
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I become angry when my freedom of choice is restricted |
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Regulations trigger a sense of resistance in me |
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I find contradicting others stimulating |
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When something is prohibited, I usually think, "That's exactly what I am going to do." |
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I resist the attempts of others to influence me |
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It makes me angry when another person is held up as a role model for me to follow |
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When someone forces me to do something, I feel like doing the opposite |
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I consider advice from others to be an intrusion |
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Advice and recommendations usually induce me to do just the opposite |
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End of Block: 6. Psychosocial Variables
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
File Modified | 0000-00-00 |
File Created | 2023-09-02 |