Att 3a_Online Questionnaire for Rough Cut Testing of Television Advertisements (English version)

Form Approved

OMB No. 0920-0910

Exp. Date 9/30/2026

National Tobacco Education Campaign

Online Questionnaire for

Rough Cut Testing of Television Advertisements

(English Version of Cycle 2 Spanish Ads, revised August 1, 2024)

Public reporting burden of this collection of information is estimated to average 13 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).

{Internal reference, do not display: Demographics}

{Base: All respondents}

DEMO1. What sex were you assigned at birth, on your original birth certificate?

01 Female

02 Male

DEMO5. How do you currently describe yourself (mark all that apply)?

01 Female

02 Male

03 Transgender

04 I use a different term [free-text]

DEM06. Just to confirm, you were assigned [FILL DEMO1 response] at birth and now you describe yourself as [FILL DEMO5 response]. Is that correct?

01 Yes

02 No <skip back to DEMO1 and/or DEM05 to correct> {Programmer instruction: return to DEMO1 and display prompt “Please confirm your choice”}

DEMO8. Which of the following best represents how you think of yourself?

01 Gay or lesbian

02 Straight, this is not gay or lesbian

03 Bisexual

04 I use a different term [free-text]

05 I don’t know

06 Prefer not to answer/Decline

{Internal reference, do not display: Section: Attitudes and Behaviors}

{Internal reference, do not display: Smoking Behavior}

{Internal reference, do not display: PREAMBLE4}

The next questions are about cigarettes, which are any form of tobacco wrapped in paper that does not contain tobacco. Cigarettes typically come in packages of 20, and some brand examples include Marlboro, Newport, Camel, Lucky Strike, and Pall Mall.

Please note that use of e-cigarettes should not be considered “cigarettes” in the following questions.

{Base: Respondents who SMOKE EVERY DAY (IF SCREENER.TS2 = 01)}

TS1a. On average, about how many cigarettes a day do you now smoke?

{{1 PACK = 20 CIGARETTES}

{{RANGE 1-100}

{Numeric response}

{Base: Respondents who SMOKE ON SOME DAYS (IF SCREENER.TS2 = 02)}

TS1b. On the days that you do smoke, how many cigarettes a day do you now smoke?

{{1 PACK = 20 CIGARETTES}

{{RANGE 1-100}

{Numeric response}

{Base: Respondents who SMOKE EVERY DAY (IF SCREENER.TS2 = 01)}

TS2. On the days that you smoke, how soon after you wake up do you usually have your first cigarette? Would you say…

1. Within 5 minutes

2. Within 6-30 minutes

3. Within 31-60 minutes

4. After 60 minutes

B3. Currently, when you smoke cigarettes, do you usually smoke menthol cigarettes?

01 Yes

02 No

03 Don’t know/Not sure

04 Refused

{B5 Base: Respondents who SMOKE MENTHOL CIGARETTES (IF B3 = 01)}

B5. For each of the following, please indicate whether it’s a reason you usually smoke menthol cigarettes. Please answer “yes” or “no” or “I don’t know” for each.

{Display each statement as a row in a grid. Columns are Yes, No, and I don’t know. Randomize and record response order}

B5_1. They are less harmful than non-menthol cigarettes.

B5_2. They have a better flavor than non-menthol cigarettes.

B5_3. They are less harsh on your THROAT than non-menthol cigarettes.

B5_4. They are less harsh on your CHEST than non-menthol cigarettes.

B5_5. They are easier to smoke than non-menthol cigarettes.

B6a. Are menthol cigarettes less harmful, no different, or more harmful than other (non-menthol) cigarettes?

1. Less harmful

2. No different

3. More harmful

B7a: Please tell us if you agree or disagree with the following statements about menthol cigarettes:

01 Strongly Agree

02 Agree

03 Neither Agree nor Disagree

04 Disagree

05 Strongly Disagree

{ANSWER ALL, DISPLAY AS GRID, RANDOMIZE ORDER}:

01 They are less harsh on your THROAT than non-menthol cigarettes.

02 They are less harsh on your CHEST than non-menthol cigarettes.

03 They are harder to quit compared to non-menthol cigarettes.

04 They are just as damaging as non-menthol cigarettes.

05 Tobacco companies aggressively target many communities with menthol cigarette advertising.

{Base: All respondents}

C1. Do you believe quitting smoking can decrease depression, anxiety, and stress?

01 Yes

02 No

03 Not sure/Uncertain

C3. Do you believe your risk for a smoking-related disease starts to drop as soon as you quit smoking?

01 Yes

02 No

03 Not sure/Uncertain

{Internal reference, do not display: Quit Attempts}

{Base: All respondents}

QA1. During the past 3 months, how many times have you stopped smoking cigarettes for one day or longer because you were trying to quit smoking cigarettes for good?

_____ Number of times

{Base: If QA1 > 0}

QA2. When you last tried to quit smoking cigarettes, did you do any of the following?

1. YES

2. NO

{ANSWER ALL, RANDOMIZE ORDER}

QA2_A. Give up cigarettes all at once

QA2_B. Gradually cut back on cigarettes

QA2_C. Substitute some of your cigarettes with heated tobacco products (using “heat not burn” tobacco products, iQOS, Glo, or Eclipse)

QA2_D. Switch completely to e-cigarettes, vapes, or mods (popular brands include NJOY, Blu, Logic, Vuse, Puff Bar and JUUL)

QA2_E. Switch to a different brand of cigarettes

QA2_F. Use nicotine replacement medications like the nicotine patch, nicotine gum, nicotine lozenges, nicotine nasal spray, or nicotine inhaler

QA2_G. Use medications like Wellbutrin, Zyban, Bupropion, Chantix, or Varenicline

QA2_H. Get help from a telephone quitline

QA2_I. Get help from a website such as Smokefree.gov or cdc.gov/tips

QA2_J. Get help from a doctor or other health professional

QA2_K. Get help from a pharmacist

QA2_L. Use a texting program to help you quit smoking

QA2_M. Use a mobile app to help you quit smoking

QA2_N. Switch to smokeless tobacco (such as snuff, chew or snus) or dissolvable tobacco

{Base: If QA1 > 0}

QA30. When you last tried to quit smoking, did any of the following motivate you to try to quit?

Select all that apply.

1. A family member or friend encouraged me to try to quit

2. Anti-tobacco television commercials, online ads or videos, radio ads, or other types of advertisements that focus on the health consequences of smoking

3. My doctor or other health professional advised me to quit smoking

4. Workplace restrictions on smoking

5. Costs of cigarettes is too high

6. Concern about COVID-19

7. Other, please specify:

{Base: All respondents}

QA4. How much do you want to quit smoking cigarettes for good? Would you say you want to quit…

1. Not at all

2. A little

3. Somewhat

4. A lot

{Base: All respondents}

QA5. Do you plan to quit smoking cigarettes for good….

1. In the next 7 days

2. In the next 30 days

3. In the next 6 months

4. In the next 1 year

5. More than 1 year from now

6. I do not plan to quit smoking cigarettes for good

7. Not sure/Uncertain

{Base: If QA1 > 0}

QA102. Has your doctor talked to you about quitting smoking?

01 Yes

02 No

03 Not sure/Uncertain

If you decided to give up smoking altogether in the next 12 months, how likely do you think you would be to succeed? Would you say…

01 Extremely likely

02 Very likely

03 Somewhat likely

04 Very unlikely

05 Extremely unlikely

{Internal reference, do not display: Psychographic/Attitudinal}

{Base: All respondents}

P5b2. Are you afraid of living with a tobacco-related disease?

1. Yes

2. No

{Base: All respondents}

P5d. How likely do you think you are to develop a smoking-related disease as a result of smoking?

1. Extremely likely

2. Very likely

3. Somewhat likely

4. Very unlikely

5. Extremely unlikely

{Internal reference, do not display: Section: Rough Cut Testing}

{Randomly select an eligible ad}

We would now like to show you a television ad and then gather your reactions to that ad. Note that you can review the ad multiple times prior to moving forward. Please make sure the volume on your computer is turned up, so that you can both see and hear the video. Please click the forward arrow to continue. {Each respondent will review one ad}

{Programmer instruction: Display selected ad through entirety before showing the “next” button}

{Internal reference, do not display: Unaided Response}

{Base: All respondents}

M1. What are the first three words that come to mind about this ad?

{OPEN END}

{Base: All respondents}

M2. What do you believe is the main message of this ad?

{OPEN END}

{Internal reference, do not display: Aided Response}

{At top of page, before question, insert thumbnail image of ad for the rest of the questions in this survey}

{Base: All respondents}

RC5a. How believable or unbelievable {PN: if ad has one spokesperson featured, pipe: “was the person in the ad?”; if ad has more than one spokesperson featured, pipe “were the people in the ad?”}

1. Extremely believable

2. Moderately believable

3. Slightly believable

4. Neither believable nor unbelievable

5. Slightly unbelievable

6. Moderately unbelievable

7. Extremely unbelievable

{Base: RC5a = 4-7}

RC5b. What was unbelievable about the {PN: if ad has one spokesperson featured, pipe: “person in the ad?”; if ad has more than one spokesperson featured, pipe “people in the ad?”}

{OPEN END}

{Base: All respondents}

M3. People sometimes have different emotional reactions when they see ads like the one above.

On a scale from 1 to 5, where 1 indicates not feeling any emotion, and 5 indicates feeling emotion with extreme intensity, please indicate how much this ad made you feel:

1. I did not feel this emotion

2. Slight emotion

3. Moderate emotion

4. Very intense emotion

5. Extreme and intense emotion

{RANDOMIZED}

M3_1. Angry

M3_2. Afraid

M3_3. Ashamed

M3_4. Sad

M3_5. Hopeful

M3_6. Understood

M3_7. Surprised

M3_8. Trusting

M3_9. Motivated

M3_10. Regretful

{Base: All respondents}

M4. On a scale from 1 to 5, where 1 indicates that you strongly disagree, and 5 indicates that you strongly agree, please indicate how much you disagree or agree with the following statements.

1. Strongly disagree

2. Somewhat disagree

3. Neither agree nor disagree

4. Somewhat agree

5. Strongly agree

{RANDOMIZED}

M4_1. This ad is convincing

M4_2. This ad grabbed my attention

M4_3. This ad was easy to understand

M4_4. I learned something new from this ad

M4_5. I trust the information in this ad

M4_6. This ad is believable

M4_7. I would talk to someone else about this ad

M4_8. This ad is annoying

M4_9. This ad is worth remembering

M4_10. This ad is powerful

M4_11. This ad is informative

M4_12. This ad is meaningful

M4_13. I can identify with what this ad says

M4_14. This ad influenced me about whether or not to smoke cigarettes

{Internal reference, do not display: Confusion}

{Base: All respondents}

M5a. Is there anything about the ad that is confusing, unclear, or hard to understand?

{Allow select all that apply for 01-03. If 01, 02, and/or 03 are selected, do not allow 04.}

01 Confusing

02 Unclear

03 Hard to understand

04 None of the above

{Base: If M5a = 01-03}

M5b. What was confusing, unclear, or hard to understand? Please be as specific as possible.

{Open End}

{Internal reference, do not display: Behavioral Intention – Quit Smoking}

{Base: All respondents}

M6a. Does this ad make you want to quit smoking cigarettes?

1. Yes

2. No

{Base: M6a = 02}

M7b. What was it about the ad that didn’t make you want to quit smoking cigarettes? Please be as specific as possible.

{Open End}

{Base: M6a = 01}

M8a. What about the ad made you want to quit smoking cigarettes? Please be as specific as possible.

{Open End}

{Base: All respondents}

M600. Do you plan to quit smoking cigarettes for good...

1. In the next 7 days

2. In the next 30 days

3. In the next 6 months

4. In the next 1 year

5. More than 1 year from now

6. I do not plan to quit smoking cigarettes for good

7. Not sure/Uncertain

{Base: All respondents}

RC14. In the future, if you saw this ad on television, on a scale from 1 to 5, where 1 indicates not at all likely and 5 is extremely likely, how likely would you be to take the following actions in the next 6 months?

1. Call 1-800-QUIT-NOW for assistance in quitting smoking

2. Visit an informational government website, such as www.cdc.gov/tips or Smokefree.gov for information on quitting

3. Download an app to help you quit smoking

4. Talk to your doctor about quitting smoking

5. Not smoke around others

6. Follow the Tips campaign on social media (e.g., Twitter, Facebook, Pinterest)

7. Try to quit on your own

8. Use an electronic vaping product to help quit smoking cigarettes

9. Support smoke-free laws in your community

10. Use a texting program to help you quit smoking

11. Do nothing

Scale for items RC14.A-K:

1. Not at all likely

2. A little likely

3. Moderately likely

4. Very likely

5. Extremely likely

{Internal reference, do not display: Perceptions of Menthol Cigarettes]

B6b. Are menthol cigarettes less harmful, no different, or more harmful than other (non-menthol) cigarettes?

1. Less harmful

2. No different

3. More harmful

B7b: Please tell us if you agree or disagree with the following statements about menthol cigarettes:

01 Strongly Agree

02 Agree

03 Neither Agree nor Disagree

04 Disagree

05 Strongly Disagree

{ANSWER ALL, DISPLAY AS GRID, RANDOMIZE ORDER}:

01 They are less harsh on your THROAT than non-menthol cigarettes.

02 They are less harsh on your CHEST than non-menthol cigarettes.

03 They are harder to quit compared to non-menthol cigarettes.

04 They are just as damaging as non-menthol cigarettes.

05 Tobacco companies aggressively target many communities with menthol cigarette advertising.

{Internal reference, do not display: Risk Perceptions}

{Base: All respondents}

RC31. On a scale of 1 (not at all) to 5 (extremely), to what degree did the ad focus on the consequences of smoking cigarettes?

1. Not at all

2. Slightly

3. Moderately

4. Very

5. Extremely

RC32. Do you believe cigarette smoking is related to:

{Display each statement as a row in a grid. Randomize and record response order.}

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. Peripheral artery disease

D21_22. Kidney Cancer

Answers in columns:

1. Yes

2. No

{Base: All Respondents}

UAR_Art1. A few seconds before the ad you just saw ended, a written message was in white letters on a black screen. In addition to {PN: for Felicita Déjelo Tip pipe: “You can quit smoking. For free help, call 1-855-DÉJELO-YA”; for Brett and Felicita Tip and Rose Memorial Tip pipe: “To receive free help, call 1-855-DÉJELO-YA”}, what other written message do you remember?

[OPEN-END]

{Base: All Respondents}

AR_Art2. Which of the following written messages do you remember from the ad you just saw?

If you have seen or heard the following messages before but NOT as part of the ad you just saw, please do NOT select them.

{Multi-Select, Randomized}

1. You can quit. For free help visit cdc.gov/tips.

2. Smoking causes heart disease.

3. Smoking can cause gum disease and tooth loss.

4. You can quit. For free help call 1-800-QUIT-NOW.

5. Menthol cigarettes are just as damaging as other cigarettes.

6. Smoking causes heart attacks.

7. Quitting smoking reduces the risk of heart disease.

8. Quitting smoking can decrease depression, anxiety and stress.

9. Tobacco companies aggressively target many communities with menthol cigarette advertising.

10. Quitting smoking lowers your risk for having a stroke.

11. Your risk for a smoking-related disease starts to drop as soon as you quit.

12. The people you love are worth quitting for.

13. Smoking causes throat cancer.

14. Menthol cigarettes can be harder to quit than other cigarettes.

15. Smoking can cause gum disease.

16. Lung cancer is the #1 killer of women among cancers. It killed Rose. At 60 years.

17. I do not remember any written messages in the ad I just saw. {single select, exclusive, anchor}

{Internal reference, do not display: General Thank You Message}

Thank you for your participation in this study. We appreciate your enthusiasm for our study and hope you will join us on future surveys!

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