Attachment F - Youth Moderator Guide

In-depth Interview Guide:
Youth Perceptions about New and Emerging Tobacco Products
I. Welcome-Introduction-Ground Rules (2 minutes)
Thank you for coming here today. Your participation is very important. I’m _____and I’m from
RTI, a non-profit research organization. I am working with a federal health agency on this
research. The purpose of this discussion is to learn about what you know about some new
tobacco products. I do not work for a tobacco company. Your thoughts are very important to us
and your time today is appreciated. We will have about an hour for our discussion.
As we begin, I want to review a few ground rules for our discussion.
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Your participation is voluntary and you have the right to withdraw from the study at any
time.

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You have probably noticed the microphones and/or tape recorder in the room. They are
here because we are video-taping our discussion. I want to give you my full attention and
not have to take a lot of notes. The files will be transcribed and your names and other
personally identifiable information will be taken out. At the end of our discussion, I have
to write a report and will refer to the video-tapes when writing the report. Additional
project staff may view the tapes at a later date. All tapes will be destroyed at the end of
the project.

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Behind me is a one-way mirror. Some of the people working on this project are observing
this discussion so that they can hear your opinions directly from you and take notes so that
your opinions are accurately captured. However, your identity and anything you
personally say here will remain confidential. Your name, address, and phone number will
not be given to anyone and no one will contact you after this interview is over.

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Please turn your cell phone and pager to vibrate or silent mode. The discussion will last
no more than an hour.

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If you need to go the restroom during the discussion, please feel free to do so.

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Most importantly, there are not right or wrong answers. We want to know your opinions
and what you think about the issues we will be discussing. Just a reminder, we are not
selling anything and I do not work for the people who make these products or who are
sponsoring this research, so don’t hold back form giving me your honest opinions.

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This conversation will be kept private, which means we won’t share anything you say
with anyone outside of the project team. We won’t tell your parents, teachers, or anyone
else what you say tonight. You won’t get in trouble for anything you say.

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Occasionally, we’ll talk about who uses tobacco products. In these cases, I don’t want you
to use the person’s name but rather their relationship with you. For example, instead of
saying “James” say “someone on my soccer team” or “my neighbor.”

Do you have any questions before we begin?
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--------------------------------------------------------------------------------------------------II. Warm up (2 minutes)
I would like to begin our discussion by having you tell me a little bit about yourself. Tell me how
old you are, what grade you’re in, and what you do for fun.
III. General Discussion about Tobacco Products (7 minutes)
Can you tell me about cigarettes usage among your family and friends?
[Probes]

Roughly about how many would you say smoke cigarettes?
A lot, half, very few?

How about you? What has your experience been with smoking cigarettes, both today and in the
past?
[IF NOT REPORT SMOKING] Have you ever thought about smoking a cigarette?
[IF REPORT SMOKING] When do you typically smoke? Do you usually smoke with others? If
so, who?
[Probes]

Weekends, at parties, etc.?

[INTERVIEWER HANDS OUT A PAPER AND PENCILS]
I’m going to give you a piece of paper and a pencil. I want you to imagine what a typical smoker
looks like. Think about the first things that come to your mind. Then either sketch out an image
of what the person looks like, or write out some words that describe that person. [Interviewer
waits 2-3 minutes]
Ok, tell me what your image of a smoker is like?
[Probes]
How old did you imagine the person to be?
Do they smoke around other people?
Do they want other people to know that they smoke? If yes, why and who?
What do they do during the day?
What other kinds of tobacco might they use?
Why do they smoke?
What do you think of when you think of smoking?
What do they do in their free time?
Hang on to your description, we’ll come back to them later.

List Activity (7 minutes)
Ok, now we’re going to talk about tobacco products other than cigarettes. Other than cigarettes,
can you tell me about other tobacco products you have heard of?
[INTERVIEWER LISTS THE TOBACCO PRODUCTS ON A FLIP CHART AND
SEPARATE THEM ACCORDING TO SMOKED AND SMOKELESS-DON’T PROVIDE
A HEADER ABOVE THE COLUMNS]
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[If they state a brand, ask them if they know what type of tobacco product it is. If participant
provides a description or brand of a tobacco product but does not know the type of product, refer
to the table below to identify the product type. This table is for your reference only and should
not be shared with participants.]
Cigarettes [Do not include cigarettes in list]
o Common Brands: Camel, Marlboro, Newport, Kool, Salem, Virginia Slims, Winston, Parliament,
Pall Mall
Cigars
Cigarillos
o Description: Also called ‘puritos’ or ‘chicos’, these are small, thin cigars that are wrapped in
tobacco leaf rather than paper, and are made by machine or handrolled.
o Common Brands: Black and Mild’s, Swisher Sweets Cigarillos, and Phillies Blunts
Pipes
Hookahs or water pipes
o Description: Flavored tobacco that is smoked from a water pipe; can be smoked alone or in groups
(e.g. hookah bars)
Snus
o Description: Snus is a moist, smokeless tobacco, usually sold in individual or pre-packaged small
pouches that are placed under the lip against the gum. This smokeless product doesn’t require
spitting.
o Common Brands: Marlboro, Camel
Chewing tobacco/dip/snuff
o Definition: finely ground, moistened smokeless tobacco that is placed between the gum and lip.
This smokeless product requires spitting.
o Common Brands: Skoal, Copenhagen, Grizzly, Husky, Kodiak, Longhorn, Red Man
Electronic cigarettes (e-cigarettes)
o Definition: plastic, electronic device that uses heat to produce vapor and simulate smoking; device
contains nicotine.
o Common Brands: Blu, NJoy, Green Smoke
Dissolvable tobacco products
o Definition: tobacco product that is placed in the mouth and dissolves. The product comes in
different shapes and sizes, including orbs, strips, sticks, and lozenges.
o Common Brands: Camel, Marlboro, Ariva, Stonewall, Skoal

Now let’s talk in more detail about these products [Point to the smoked products column]

How are these products used? [Pick out different ones listed and ask specifically how they are
used and how they may differ from the other in the column. For example pipe vs. a cigar]
Do you know anyone who uses these types of tobacco product? Which ones?
Do you use or have you ever tried using these types of tobacco products?
[If yes] Can you tell me about it? Do you remember the first time you used one of these
products? Can you tell me about it?
[If no] Do you ever think about trying these types of tobacco products?
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Why or why not?
Why do you think people use these types of tobacco products?
Now let’s move onto the products in this column [Smokeless products]

What kind of tobacco products are these?
How are these products used? [Pick out different ones listed and ask specifically how they are
used and how they may differ from the other in the column. For example snus vs. dip]
Do you know anyone who uses these types of tobacco product? Which ones?
Do you use or have you ever tried using these types of tobacco products?
[If yes] Can you tell me about it? Do you remember the first time you used one of these
products? Can you tell me about it?

[If no] Do you ever think about trying these types of tobacco products?
Why or why not?
Why do you think people use these types of tobacco products?
IV. Risk perceptions (5 minutes)
[INTERVIEWER USES THE MARKER AND ADD CIGARETTES TO THE LISTDISCUSSION ABOUT THE ENTIRE LIST OF PRODUCTS]
Looking at all of these types of tobacco products and now I am going to include cigarettes, let me
hear your overall thoughts about tobacco products as related to health.
Have you ever thought one type of tobacco product as being safer or less harmful than another?
Why or why not? If yes, which ones? What makes you think that it’s safer?
What does it mean to be safer or less harmful?
V. Dissolvable Tobacco Products—General Concept (7 minutes)
Now I’m now going to show you some new products. [INTERVIEWER SHOWS PHOTOS
OF PRODUCTS STRIPS, STICKS, ORBS, LOZENGES ONLY – NO PACKAGING]
What do you think these products are?
[Probe]
Do you think these are tobacco products?
Do you know what these products are called?
Have you ever seen or heard of these before?
[If yes] Where did you hear about them?
[Probe]
Friends
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Magazine or newspaper
Radio
Internet
Mail
Events like a sporting event
In stores-store advertising
What do you know or have you heard about these products?
[Probes]
What brands are these products?
How are these products described? (e.g. shape, use)

How do you think they are used?
How are they similar or different to other products you use or know of? How about other tobacco
products?
What can you tell me about the health risks of these products compared to other tobacco
products?
VI. Dissolvable Tobacco Products—Packaging (10 minutes)
[INTERVIEWER SHOWS EMPTY PRODUCT PACKAGES FOR PRODUCTS STRIPS,
ORBS, LOZENGES, AND STICKS]- CAMEL, MARLBORO, STONEWALL, AND
ARIVA BRANDS
[If answered never seen or heard of these before] Now that you know what the packages look
like, have you ever seen or heard of these before?
[If yes] Where did you hear about them?
[Probe]
Friends
Magazine or newspaper
Radio
Internet
Mail
Events like a sporting event
In stores-store advertising
Do you use or have you ever tried one of these products?
[If yes] Can you tell me about it? Do you remember the first time you used one of these
products? Can you tell me about it?
[If no] Have you ever thought about trying these types of tobacco products?
Why or why not? What do you think using this product would be like?
What would make you want to try this product?
[Probe]
Friends offer it to you, got a coupon or free sample/giveaway, etc.
Why do you think people would use these types of tobacco products?
[Probe] Describe a situation when someone might be tempted to try these products?
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Do you have friends or someone you know who use these products?
What comes to mind when you see these packages?
[Probes]
How are they different or the same as other tobacco products you have seen and/or use?
When you see these packages, would you know that they are tobacco products? Why or why not?
Do you have any thoughts about why they might be packaged this way?
How does this packaging make you feel about the product?
How does this packaging make you feel about other tobacco products?
How does this packaging make you feel about tobacco?

VII. Dissolvable Tobacco Products—National Advertising (7 minutes)
I’m now going to show you some advertising for some of these types of dissolvable tobacco
products.
[INTERVIEWER SHOWS 3-4 PRINT VERSIONS OF CAMEL ADVERTISEMENTS
FOR DISSOLVABLES]
Have you seen any of these advertisements?
What comes to mind when you see these advertisements?
[Probes]
Who do you think these products are for? What makes you think that?
How are they different or the same as other tobacco product advertisements you have seen?
Do you have any thoughts about why they might advertise these products this way?
How do the advertisements make you feel about the product?
How do these advertisements make you feel about other tobacco products?
How does this advertising make you feel about tobacco?

If you saw one of these in a magazine, would you know that they are advertisements for tobacco
products? Why or why not?
Does anything that you have been shown today, the packages, the advisements, cause you to
think differently about the tobacco products that are most familiar to you? If so, how does it cause
you to think differently? What in particular made you feel this way?
VIII. Dissolvable Tobacco Products-Perceptions about Safety (3 minutes)
[If not talked about in earlier section on risk perceptions] We talked earlier about how safe or
dangerous you thought different tobacco products were. Where do dissolvable tobacco products
fit in? How safe or harmful do you think they are? Why do you think that? [Probe for thoughts on
safety related to packaging, advertising, product size/shape]
IX. Dissolvable Tobacco Products Activity (7 minutes)
Now, I want you to do the same exercise as we did earlier, but this time, image a person who uses
dissolvable tobacco products. [Let participant look at product photos, packages, and ads.] I’ll give
you a couple of minutes [INTERVIEWER WAITS 2 MINUTES]. Ok, let’s talk about what your
image of a person who uses dissolvables is like.
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[Probes]
Now that you’ve seen more of this product, do you think differently about how safe /
unsafe it is?
How old did you imagine the person to be?
Do they use these products around other people?
Do they want other people to know that they use these products? If yes, why and who?
What do they do during the day?
What other kinds of tobacco might they use?
Why do they use these products?
What do you think of when you think of these dissolvable tobacco products?
What do they do in their free time?
Tell me what were some of the main differences between the smoker and the person who uses a
dissolvable tobacco product? How does this description differ from the one you did earlier of the
smoker?

[Probes]
How are they different than cigarette smokers, if at all?
Are they the same person (someone who uses both products)?
Is there an age difference?
Is there a difference between boys vs. girls or men and women?
Is there a difference in the amount of money they have or if they work?
Is there a difference in how popular they are with their friends, at work, at school?
Is there a difference in the amount they use these products?
Does one type of user care more or less about their health than the other?
What about the health of others around them?
What are your thoughts about these types of tobacco products? How do they compare to other
tobacco products we have discussed? [Probe for safety, ease of use….]
X. Closing (3 minutes)
Based on everything we discussed today, do you have any other thoughts or comments?
Give me a few minutes to step out of the room to ask the other people who are working on this
project if they have any further questions they would like to ask you.
XI. Debriefing
I would like to thank you for coming here today and participating in this discussion. This
research was sponsored by the Food and Drug Administration also known as the FDA. Our
discussion will be very useful helping the FDA understand teen reactions and thoughts about new
tobacco products. The FDA wants you to know that there is no safe tobacco product including
the dissolvables shown here today. They advise anyone using tobacco products of any type to
stop. There are many ways to help users quit. Here is a pamphlet with information for users to
quit. Feel free to share this pamphlet with tobacco users you might know.

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