Att. 3j - Moderator's Guide For Adults Who Smoke Cigarettes and Use E-cigarettes

Form Approved

OMB No. 0920-0910

Exp. Date 03/31/2018

Moderator’s Guide for IDI: Dual Use

Public reporting burden of this collection of information is estimated to average 30 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. 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 (0920-0910).

Adult Informed Consent

The Centers for Disease Control and Prevention (CDC) invites you to be in a study. The purpose of this study is to help CDC learn more about your opinions and ideas regarding tobacco use and related health effects. In addition, we would also like to ask your opinions on messages about the long-term health effects of e-cigarette use as well as their use as cessation tools; some of these health effects are still being studied have yet to be explored by researchers and the evidence is not yet available or conclusive. Thus, some of the messages we will present to you have not yet been supported by scientific evidence and are intended to be purely exploratory. You will be asked to give your opinions on how information is presented, whether the information is easy to understand, and whether you think the information would be effective in changing behavior. Please feel free to ask questions as I explain the study.

If you agree to participate, you will be interviewed by a trained moderator. The total time spent in the interview will be approximately 30 minutes. You will receive points that can be redeemed for other items, such as Amazon gift cards. The information will be used to help CDC develop advertisements and materials for people about smoking and the health consequences of tobacco use.

The information you give us will be kept private. Your name will not appear in the report. All notes and materials will be kept in a secure location on a password-protected server. No one outside this project will have access to the materials, notes and other items. Materials will be deleted after the study. CDC will treat data in a secure manner and will not disclose unless otherwise compelled by law. The interview poses no physical risks to you. If you begin to feel uncomfortable at any time, you can refuse to answer questions or leave the interview. There is no commercial intent. You will not be asked to purchase anything.

There will be observers from the Centers for Disease Control and Prevention and its contractor, The PlowShare Group, watching the interview via a secure, password protected site on the internet. A video recording will be made of the stream.

Your participation is voluntary. If you have questions about this project, please call Carol Haney, the project’s principal investigator, at 802-254-2117. Your click on the button “Accept” below indicates that you understand the above and agree to participate in this group.

INTRODUCTION and RULES OF ENGAGEMENT

Hello! Welcome! I'm ____________ and I'll be leading our interview.

I am looking forward to talking with you and getting your feedback. My job is to understand your personal opinions and ideas - positive or negative - so please be honest in your responses. Remember, there are no right or wrong answers. No one will judge your answers.

When answering my questions, please fully describe your thoughts, elaborate, and be as specific as possible. If you like or don’t like something, please explain WHAT you like or don’t like about it and WHY. All answers are acceptable and criticism is encouraged! – So let’s get started.

DISCUSSION GUIDE (Dual Users)

Tobacco Use Behavior & Perceptions

1. I’d like to learn more about you so let’s start with an introduction. Please tell me where you're from, and a hobby of yours.
   
   

1. Let’s move on to the main topic of conversation today: Tell me how you started smoking regular cigarettes – {PROMPT} were you with friends?

3. Tell me about why you use e-cigarettes in combination with regular cigarettes – when you have an urge to smoke regular cigarettes or use e-cigarettes, what do you do?
   
   

4. Which e-cigarettes did you try? Why? What’s the difference for you between e-cigarettes that come in a variety of flavors and regular cigarettes?
   
   

5. What benefits do you think there are to you in using e-cigarettes?

6. Do you think there are any problems with e-cigarettes? If so, what negatives are there about using e-cigarettes?

Quit Motivation

7. Do you want to quit smoking regular cigarettes?
   
   

{MODERATOR probe on the following questions if the response is yes:}

• Why do you want to quit regular cigarettes?

• Does the desire to quit regular cigarettes come and go, or is quitting regular cigarettes something that is always on your mind?

8. Thinking back to the most recent time you tried to quit smoking regular cigarettes, walk me through the process you went through. Did you quit regular cigarettes “cold turkey” all at once without medication, or did you use medication such as Zyban, Chantix, nicotine patch or nicotine gum? Did you reduce the number of regular cigarettes when you were trying to quit? {MODERATOR: Probe on whether or not they cut back on their regular cigarettes and didn’t quit or they cut back and had a successful quit}

9. Have you ever used e-cigarettes to help quit regular cigarettes?

10. Does the desire to quit regular cigarettes come and go, or is quitting something that is always on your mind?

{Probe}

• Were there specific times/places you chose to use e-cigarettes (instead of smoking a regular cigarette)?

• How did it make you feel to start using those e-cigarettes? {Probe on healthier, smarter?}

11. Do you think cutting down on regular cigarettes decreases your risk of getting a tobacco-related disease?

12. In your opinion, is there a difference between cutting down the amount of regular cigarettes you smoke and quitting regular cigarettes completely? Why/why not?

Message Feedback

Now I am going to read to you a series of messages about using e-cigarettes in combination with regular cigarettes.

{MESSAGE TEXT FILL ON SECTION FROM MESSAGE ALREADY REVIEWED}

Going through each message:

1. Are there any words or phrases that you think are especially attention-getting or scary to you?

2. How does this message make you feel? {Probe: de-motivated; shamed; lectured; motivated; energized; afraid}

3. Where there any phrases that put you off or that you thought were not effective or had unintended effects?

5. Do you believe this message? Why or why not?

6. What additional information would you need in order to more strongly believe this message?

Message comparison:

7. Looking over the different messages we have discussed, which is the most effective to make you want to quit smoking regular cigarettes completely?

8. What makes it most effective?

9. Which one of the messages is least effective?

10. What makes it least effective?

Exploratory Questions

Before we conclude, we have just a few more exploratory questions for you about your opinions about the potential health effects of e-cigarette use. Please note that messages concerning the long-term health effects of e-cigarettes or their efficacy as cessation tools are still being studied or have yet to be explored by researchers and the evidence is not yet available or conclusive. Thus, the messages we will present to you have not yet been supported by scientific evidence and are intended to be purely exploratory. Our primary goal when presenting these hypothetical messages to you is to gauge your opinions on how information is presented, whether the information is easy to understand, and whether you think the information would be effective in changing behavior.

1. Are you aware of any harmful chemicals being inhaled in e-cigarettes?

{If answer to #1 is No, follow up with]

• Why do you think there are no harmful chemicals in e-cigarettes?

{If answer to #1 is Yes, follow up with}

• Why do you think that you may be inhaling harmful chemicals in e-cigarettes?

• Do you think that the harmful chemicals in e-cigarettes might cause you to develop a lung disease so severe that it may require a lung transplant?

{ASK OF PARENTS ONLY}

2. Do you think that e-cigarettes are harmful to kids?

{If answer to #2 is No, follow up with}

-Why do you think e-cigarettes are not harmful to kids?

{ASK OF PARENTS ONLY}

3. Do you think that e-cigarettes deliver nicotine, an addictive substance that can damage the way kid’s brains function?

{ASK OF ALL RESPONDENTS}

4. Do you think that e-cigarettes can keep you addicted to nicotine and increase your chances of staying addicted to regular cigarettes?

{if answer to #4 is No, follow up with}

• Why do you think e-cigarettes would allow you to stop being addicted to regular cigarettes?

{if answer to #4 is Yes, follow up with}

• Why would you use e-cigarettes to quit smoking regular cigarettes, if e-cigarettes will keep you addicted to nicotine?

{ASK OF ALL RESPONDENTS}

5. Do you think that continuing to smoke regular cigarettes while using e-cigarettes can cause devastating illnesses that can lead to a painful death?

{if answer to #5 is No, follow up with}

- Why do you think e-cigarettes would stop you from getting a devastating illness?

{if answer to #5 is Yes, follow up with}

- If e-cigarettes will not stop you from getting a devastating illness, why would you use e-cigarettes while continuing to smoke regular cigarettes?

{ASK OF ALL RESPONDENTS}

6. Do you think that using e-cigarettes to cut down on smoking is enough to decrease your risk of cancer and having a heart attack, even if that means you were smoking just a few cigarettes a day?

{if answer to #6 is Yes, follow up with}

- Why do you think using e-cigarettes to cut down on smoking would decrease your risk of cancer?

{if answer to #6 is No, follow up with}

- Why do you think using e-cigarettes to cut down on smoking would not decrease your risk of cancer, even if that means you were smoking just a few cigarettes a day?

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