0920-0621 Cognitive Interview Item Form

National Youth Tobacco Surveys 2024 2026

0621_NYTS_Att_N5_Cognitive Interview Items_20240520_clean_

OMB: 0920-0621

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2024 NYTS Cognitive Interview Questionnaire

Question/Screen


  1. Demographics


The first four questions ask some background information about you.


  1. How old are you? [Note to interviewer: This should be an open-ended question and the unit should be in years.]



_____________


  1. What grade are you in? [Note to interviewer: This should be open-ended].

_____________


  1. What is your race and/or ethnicity?

Select all that apply.



  1. American Indian or Alaska Native For example, Navajo Nation, Blackfeet Tribe of the Blackfeet Indian Reservation of Montana, Native Village of Barrow Inupiat Traditional Government, Nome Eskimo Community, Aztec, Maya, etc.

  2. Asian For example, Chinese, Asian Indian, Filipino, Vietnamese, Korean, Japanese, etc.

  3. Black or African American For example, African American, Jamaican, Haitian, Nigerian, Ethiopian, Somali, etc.

  4. Hispanic or Latino For example, Mexican, Puerto Rican, Salvadoran, Cuban, Dominican, Guatemalan, etc.

  5. Middle Eastern or North African For example, Lebanese, Iranian, Egyptian, Syrian, Iraqi, Israeli, etc.

  6. Native Hawaiian or Pacific Islander For example, Native Hawaiian, Samoan, Chamorro, Tongan, Fijian, Marshallese, etc.

  7. White For example, English, German, Irish, Italian, Polish, Scottish, etc.



  1. E-cigarette use

PURPOSE: Provide additional information on evolving terminology used to describe e-cigarettes

  1. What do you call these products?

PURPOSE: Test current version of e-cigarette questions to see if problems arise with the use of the term e-cigarette. Test variations in questions about content in vapes.

The next several questions are about electronic cigarettes or e-cigarettes, such as JUUL, Vuse, NJOY, Elf Bar or blu. You also may know them as vapes, mods, e-cigs, e-hookahs, or vape-pens.



For the rest of this survey, these products and devices will be called e-cigarettes



E-cigarettes are battery powered devices that usually contain a nicotine-based liquid that is vaporized and inhaled.




  1. Have you ever used an e-cigarette, even once or twice?

  1. Yes

  2. No

[INTERVIEWER: CONTINUE BELOW FOR EVER E-CIGARETTE USERS. NEVER E-CIGARETTE USERS WILL SKIP TO Section 1.4.]

Question Universe: ever e-cigarette users [known]

  1. How old were you when you first used an e-cigarette, even once or twice?

  1. 8 years old or younger

  2. 9 years old

  3. 10 years old

  4. 11 years old

  5. 12 years old

  6. 13 years old

  7. 14 years old

  8. 15 years old

  9. 16 years old

  10. 17 years old

  11. 18 years old

  12. 19 years old or older

Question Universe: ever e-cigarette users [known]

  1. In total, on how many days have you used e-cigarettes in your entire life?

  1. 1 day

  2. 2 to 10 days

  3. 11 to 20 days

  4. 21 to 50 days

  5. 51 to 100 days

  6. Over 100 days

Question Universe: ever e-cigarette users [or unknown]

  1. During the past 30 days, on how many days did you use e-cigarettes?



Specify: |__|__| (Range 0 – 30)

Question Universe: ever/current e-cigarette users [known]

  1. When was the last time you used an e-cigarette, even one or two times? (Please choose the first answer that fits)

  1. Earlier today

  2. Not today, but sometime during the past 7 days

  3. Not during the past 7 days, but sometime during the past 30 days

  4. Not during the past 30 days, but sometime during the past 6 months

  5. Not during the past 6 months, but sometime during the past year

  6. 1 to 4 years ago

  7. 5 or more years ago

Question Universe: ever/current e-cigarette users [known]

  1. Why did you first use an e-cigarette? (Select one or more)

  1. Peer pressure

  2. A friend used them

  3. A family member used them

  4. To try to quit using other tobacco products, such as cigarettes

  5. They cost less than other tobacco products, such as cigarettes

  6. They were easier to get than other tobacco products, such as cigarettes

  7. I’ve seen people on TV, online, or in movies use them

  8. They are less harmful than other forms of tobacco, such as cigarettes

  9. They were available in flavors, such as menthol, mint, candy, fruit, or chocolate

  10. I could use them unnoticed at home or at school

  11. I could use them to do tricks

  12. I was curious about them

  13. I was feeling anxious, stressed, or depressed

  14. To get a high or buzz from nicotine

  15. I used them for some other reason [Specify:__________]

Question Universe: current e-cigarette users [known]

INTERVIEWER: ASK IF CURRENT E-CIGARETTE USER. OTHERWISE, SKIP TO SECTION 1.3



  1. Why do you currently use e-cigarettes? (Select one or more)

  1. Peer pressure

  2. A friend uses them

  3. A family member uses them

  4. I am addicted to them

  5. To try to quit using other tobacco products, such as cigarettes

  6. They cost less than other tobacco products, such as cigarettes

  7. They are easier to get than other tobacco products, such as cigarettes

  8. I’ve seen people on TV, online, or in movies use them

  9. They are less harmful than other forms of tobacco, such as cigarettes

  10. They are available in flavors, such as menthol, mint, candy, fruit, or chocolate

  11. I can use them unnoticed at home or at school

  12. I can use them to do tricks

  13. I am curious about them

  14. Because I feel anxious, stressed, or depressed

  15. To get a high or buzz from nicotine

  16. I use them for some other reason [Specify:__________]

Question Universe: past 30-day e-cigarette user [known]

  1. 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.

  1. A disposable e-cigarette (for example, Elf Bar, or Kangvape)

  2. An e-cigarette that uses pre-filled or refillable pods or cartridges (for example, JUUL, Vuse, or Suorin)

  3. An e-cigarette with a tank that you refill with liquids (including mod systems that can be customized by the user)

  4. I don’t know the type

Question Universe: past 30-day e-cigarette user [known]

  1. During the past 30 days, what e-cigarette brands did you use? (Select one or more)

  1. blu

  2. Breeze

  3. Elf Bar

  4. Esco Bars

  5. Fume

  6. JUUL

  7. HQD

  8. Kangvape (including Onee Stick)

  9. Logic

  10. Mr. Fog

  11. NJOY

  12. SMOK (including NOVO)

  13. Suorin (including Air Bar)

  14. Vuse

  15. Some other brand(s) not listed here [Specify:__________]

  16. Not sure / I don’t know the brand

Question Universe: past 30-day e-cigarette user reporting >1 brand [known]

  1. During the past 30 days, what brand of e-cigarettes did you usually use? (Choose only one answer)

  1. I did not use a usual brand

  2. blu

  3. Breeze

  4. Elf Bar

  5. Esco Bars

  6. Fume

  7. JUUL

  8. HQD

  9. Kangvape (included Onee Stick)

  10. Logic

  11. Mr. Fog

  12. NJOY

  13. SMOK (including NOVO)

  14. Suorin (including Air Bar)

  15. Vuse

  16. Some other brand not listed here [Specify:__________]

  17. Not sure / I don’t know the brand

Question Universe: past 30-day e-cigarette users [known]

  1. Did any of the e-cigarettes that you used in the past 30 days contain nicotine?

A. Yes

B. No

C. Don’t know

Question Universe: past 30-day e-cigarette users [known]

The next two questions use the term “vape” instead of “e-cigarettes.”

16a. On how many DAYS (if any) during the LAST 30 DAYS have you vaped nicotine?

  1. 0 Days

  2. 1-2 Days

  3. 3-5 Days

  4. 6-9 Days

  5. 10-19 Days

  6. 20-29 Days

  7. 30 Days

16b. On how many DAYS (if any) during the LAST 30 DAYS have you vaped just flavoring?

  1. 0 Days

  2. 1-2 Days

  3. 3-5 Days

  4. 6-9 Days

  5. 10-19 Days

  6. 20-29 Days

  7. 30 Days


Question Universe: past 30-day e-cigarette users [known]

  1. Nicotine salts, otherwise known as “nic salts” or “salt nics”, 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?

  1. Yes

  2. No

  3. Don’t know

Question Universe: past 30-day users of e-cigarettes

  1. In the past 30 days when you used e-cigarettes, what flavors did you use? (Select one or more)

  1. Tobacco-flavor

  2. Menthol

  3. Mint

  4. Spice (such as cinnamon, vanilla, or clove)

  5. Fruit

  6. Chocolate

  7. Alcoholic drinks (such as wine, margarita, or other cocktails)

  8. Non-alcoholic drinks (such as coffee, soda, lemonade, or other beverage)

  9. Candy, desserts, or other sweets

  10. Unflavored

  11. Some other flavor not listed here [Specify:__________]

Question Universe: past 30-day user of flavored e-cigarettes

  1. 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)?

  1. Yes

  2. No

  3. Don’t know

Question Universe: past 30-day user of flavored e-cigarettes

  1. 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?



  1. Yes [Specify:__________]

  2. No

  3. Don’t know


Question Universe: past 30-day e-cigarette user [known]

  1. During the past 30 days, how did you get your e-cigarette devices, pods, cartridges, or e-liquid refills? (Select one or more)

  1. I bought them myself

  2. I had someone else buy them for me

  3. I asked someone to give me some

  4. Someone offered them to me

  5. I got them from a friend

  6. I got them from a family member

  7. I took them from a store or another person

  8. I got them in some other way [Specify:__________]

Question Universe: past 30-day e-cigarette user [known]

  1. During the past 30 days, where did you buy your e-cigarette devices, pods, cartridges, or e-liquid refills? (Select one or more)

  1. I did not buy e-cigarettes during the past 30 days [EXCLUSIVE RESPONSE]

  2. I bought them from another person (a friend, family member, or someone else)

  3. A gas station or convenience store

  4. A grocery store

  5. A drugstore

  6. A mall or shopping center kiosk/stand

  7. On the Internet (such as a product website, online vape or tobacco store or other online marketplace)

  8. Through the mail

  9. Through a delivery service (such as GoPuff, DoorDash, or Postmates)

  10. A vape shop or tobacco shop

  11. Some other place not listed here [Specify:__________]

Question Universe: past 30-day e-cigarette user (who got a product from someone else)

  1. 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)

  1. A new e-cigarette device (including disposable devices)

  2. A pod, cartridge, or e-liquid refill

  3. A hit or a drag from another person’s e-cigarette device

  4. Something else [Specify:__________]

Question Universe: ever e-cigarette user [known]

  1. 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?

  1. Yes

  2. No

Question Universe: past 30-day e-cigarette user [known]

  1. During the past 30 days, how often did you use someone else’s e-cigarette device?

  1. Never

  2. Rarely

  3. Sometimes

  4. Most of the Time

  5. Always

Question Universe: past 30-day users of e-cigarettes [known]

  1. Are you seriously thinking about quitting e-cigarettes? (Please choose the first answer that fits)

  1. Yes, during the next 30 days

  2. Yes, during the next 6 months

  3. Yes, during the next 12 months

  4. Yes, but not during the next 12 months

  5. No, I am not thinking about quitting e-cigarettes

Question Universe: past 30-day users of e-cigarettes [known]

  1. 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?

  1. I did not try to quit during the past 12 months

  2. 1 time

  3. 2 times

  4. 3 to 5 times

  5. 6 to 9 times

  6. 10 or more times

Question Universe: e-cigarette users who reported ≥1 quit attempt in past 12 months [known]

  1. When you tried to quit using e-cigarettes, did you use any of the following? (Select one or more)

  1. I did not use any resources [EXCLUSIVE]

  2. Help or advice from a parent or caregiver

  3. Help or advice from a friend or peer

  4. Help or advice from a teacher or coach

  5. Help, advice, or counseling from a doctor or health care provider

  6. Treatment from a hospital, medical center, or some other facility

  7. Help or advice you found on the Internet

  8. A mobile app or texting program

  9. A telephone helpline or Quitline

  10. Something else [Specify:__________]

Question Universe: never e-cigarette users [known]



  1. Have you ever been curious about using an e-cigarette?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

Question Universe: never e-cigarette users [known]

  1. Do you think that you will try an e-cigarette soon?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

Question Universe: never e-cigarette users [known]

  1. Do you think you will use an e-cigarette in the next year?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

Question Universe: never e-cigarette users [known]

  1. If one of your best friends were to offer you an e-cigarette, would you use it?

  1. Definitely yes

  2. Probably yes

  3. Probably not

  4. Definitely not

  1. Marijuana


PURPOSE: Determine if youth can tell the difference between dabs (which are inhaled) and vaping marijuana. Find out whether youth are able to distinguish between marijuana (i.e., THC) products and CBD-only products and whether they are using the latter. Determine if youth are using “wellness” vapes that contain a substance other than nicotine or marijuana.

The next set of questions ask about marijuana. We will use the term “marijuana” (also known as cannabis, pot, weed, THC, hash, kush, or CBD) to refer to all of the different forms, including smoked, vaped, or ingested types of marijuana or cannabis. Please include both medicinal and recreational use of marijuana or cannabis when answering. Remember all the information you give will be kept private.

  1. Have you ever used marijuana?

A. Yes

B. No

C. Don’t know

The next two questions are about using or vaping marijuana liquids or cannabis oils in electronic nicotine products such as e-cigarettes, vape pens, or other vaping devices. Please think only about marijuana liquids or cannabis oils when answering the following questions.



  1. Have you ever used marijuana in an e-cigarette, vape pen, or electronic nicotine product?

  1. Yes

  2. No

  3. Don’t know




  1. On how many of the past 30 days did you use marijuana in an e-cigarette?

__________Days

Don’t know

The next two questions are about dabbing. Dabbing is the process of heating up a highly concentrated form of THC typically in the form of a wax or oil and inhaling the vapors.



  1. Have you ever dabbed marijuana?

  1. Yes

  2. No



  1. On how many of the past 30 days did you dab marijuana?

__________Days

Don’t know


  1. Have you ever vaped CBD or CBD oils? This includes items you’ve purchased at a store, bought off the street, or that were given to you by someone.

A. Yes

B. No


  1. During the past 30 days, on how many days did you vape CBD or CBD oils? Enter 0 if you did not vape CBD or CBD oils in the past 30 days [Range 0-30]

Number of days (1)____________________________________

  1. Have you ever vaped wellness vapes, such as vitamin vapes, melatonin vapes, or coffee vapes? These products are sometimes marketed as zero-nicotine vapes. This includes items you’ve purchased at a store, bought off the street, or that were given to you by someone.

A. Yes

B. No

  1. During the past 30 days, on how many days did you use wellness vapes, such as vitamin vapes, melatonin vapes, or coffee vapes? Enter 0 if you did not use any wellness vapes in the past 30 days. [Range 0-30]

Number of days (1) ________________________________________________

  1. E-cigarette use intensity/frequency

PURPOSE: Test e-cigarette intensity/frequency items for comprehension (lack of established items for this purpose)

Question Universe: ever e-cigarette users [known]

  1. On average, on the days that you use e-cigarettes, how many times each day do you pick up your e-cigarette to use it, whether you take one puff or several?

_____times

  1. Each time you pick up your e-cigarette to use it, about how many puffs do you take?

_____puffs

  1. Adolescent Discrimination Distress Index


  1. After each statement, tell us whether you have experienced each of the following types of discrimination because of your race or ethnicity. Remember we are only interested in occasions when racial-ethnic discrimination was at least partly responsible for your experience.

Response options: Yes, No

  • You were discouraged from joining an advanced level class.

  • You were wrongly disciplined or given after-school detention.

  • You were given a lower grade than you deserved.

  • You were discouraged from joining a club.

  • Others your age did not include you in their activities.

  • People expected more of you than they expected of others your age.

  • People expected less of you than they expected of others your age.

  • People assumed your English was poor.

  • You were hassled by police.

  • You were hassled by a store clerk or store guard.

  • You were called racially insulting names.

  • You received poor service at a restaurant or store.

  • People acted as if they thought you were not smart.

  • People acted as if they were afraid of you.

  • You were threatened.


  1. If you had this experience, did it upset you?

Response options: Not at all, Slightly, Moderately, Considerably, Extremely

  • You were discouraged from joining an advanced level class.

  • You were wrongly disciplined or given after-school detention.

  • You were given a lower grade than you deserved.

  • You were discouraged from joining a club.

  • Others your age did not include you in their activities.

  • People expected more of you than they expected of others your age.

  • People expected less of you than they expected of others your age.

  • People assumed your English was poor.

  • You were hassled by police.

  • You were hassled by a store clerk or store guard.

  • You were called racially insulting names.

  • You received poor service at a restaurant or store.

  • People acted as if they thought you were not smart.

  • People acted as if they were afraid of you.

  • You were threatened.



  1. Neighborhood Environment Scale

  1. How true are each of the following statements about your neighborhood?

Response options: Not at all true, A little true, Sort of true, Very true

  • There are plenty of safe places to walk or spend time outdoors in my neighborhood.

  • Every few weeks, some kid in my neighborhood gets beat-up or mugged.

  • Every few weeks, some adult gets beat-up or mugged in my neighborhood.

  • I have seen people using or selling drugs in my neighborhood.

  • In the morning or later in the day, I often see drunk people on the street in my neighborhood.

  • Most adults in my neighborhood respect the law.

  • I feel safe when I walk around my neighborhood by myself during the day.

  • People who live in my neighborhood often damage or steal each other’s property.

  • I feel safe when I walk around my neighborhood by myself at night.

  • In my neighborhood, the people with the most money are the drug dealers.

  1. How much do you agree with the following statements?

My neighborhood is a safe place to be.

  1. Strongly disagree

  2. Disagree

  3. Agree

  4. Strongly agree

I am afraid of the violence in my neighborhood.

A. Strongly disagree

B. Disagree

C. Agree

D. Strongly agree


I am afraid I will get hurt by someone in my neighborhood.

A. Strongly disagree

B. Disagree

C. Agree

D. Strongly agree

  1. Sexual orientation and gender identity

  1. What sex were you assigned at birth?

  1. Male

  2. Female

  1. Sexual orientation is a person’s emotional, romantic, and/or sexual attraction to another person. There are many ways a person can describe their sexual orientation and many labels a person can use. Which of these options best describes your sexual orientation?

  1. Straight or heterosexual

  2. Gay or lesbian

  3. Bisexual, pansexual, or queer

  4. Asexual

  5. I am not sure or I am questioning

  6. I do not know what this question means

  7. Something else not included here [Specify:________________]

  8. Decline to answer

Question Universe: all students

  1. Which of the following best describes your gender?

  1. Girl or woman

  2. Boy or man

  3. Nonbinary, genderfluid, or genderqueer

  4. Something else not included here [Specify:______________]

  5. I am not sure or I am questioning

  6. Decline to answer

  1. Some people describe themselves as transgender when their sex at birth does not match the way they think or feel about their gender. Are you transgender?

  1. No, I am not transgender

  2. Yes, I am transgender

  3. I am not sure or I am questioning if I am transgender

  4. I do not know what this question means

  5. Decline to answer

  1. Health Equity/SDoH/Neighborhood Context

PURPOSE: Test SDOH items to inform their inclusion

  1. Does your family own a vehicle (such as a car, van, or truck)?

  1. No

  2. Yes, one

  3. Yes, two or more

  1. Do you have your own bedroom?

  1. No

  2. Yes

  1. How many computers (including laptops and tablets, not including game consoles and smartphones) does your family own?

  1. None

  2. One

  3. Two

  4. More than two

  1. How many times did you and your family travel out of the U.S. for a holiday/vacation last year?

  1. Not at all

  2. Once

  3. Twice

  4. More than twice

  1. Does your family have a dishwasher at home?

  1. No

  2. Yes

  1. How many bathrooms (rooms with a bath/shower or both) are in your home?

  1. None

  2. One

  3. Two

  4. More than two

  1. What is the highest level of education obtained by your parent(s)? If your parents obtained different levels of education, select the highest one.

  1. Elementary/Junior High School

  2. Some High School

  3. High School graduate/GED

  4. Some college

  5. 2-year college degree

  6. 4-year college degree

  7. Graduate or professional degree (Master’s, Ph.D., M.D, J.D., etc.)

  8. Don’t know





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