FDA Consumer Perception Research on New and Emerging Tobacco Products

Informed Consent for Participation in a
Discussion Group
RTI International is conducting discussion groups on behalf of the Food and Drug Administration (FDA)
to better understand consumers’ thoughts and knowledge about tobacco products. We have invited you to
participate in a discussion with other consumers to share your thoughts and knowledge about these
products.
If you consent to participate in the discussion, here are some things you should know:
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Your participation is totally voluntary.

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Your name will not be used in any reports about this discussion group. We will be taking notes
during the discussion about what was said, but we will not record who made the comments.

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The discussion will be video-taped so that when we write our report we can make sure we
understand everything that was said. The recordings will be given to the FDA and destroyed at the
end of the project.

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Anything discussed during the group will be kept private. No personally identifiable information will
be recorded or disclosed.

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There will be observers from the Food and Drug Administration and RTI International in another
room taking notes during this discussion.

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You will receive $50 for participating in the group.

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You may discontinue participation at any time, either by leaving the discussion group or not
answering a question, without penalty or loss of benefits.

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The discussion group will last approximately 90 minutes.

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Any questions you have about the discussion groups will be answered before we begin our
discussion. Contact information is provided below for any questions that arise after the discussion.

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There is no known physical risk to you from being in this study. Though unlikely, there is a small
chance that you might feel embarrassed or upset by the things that are talked about during the
discussion. You can say you do not want to talk about any topic for any reason. You can also stop
participating at any time.

•

You will be provided with a copy of this form to take with you.

If you have questions about the group, you can call Julia Kish Doto at 1-800-334-8571 (Extension
x28280). If you have questions about your rights, or if you have concerns or complaints, or if you think
you have been injured, you can call RTI’s Office of Research Protection toll-free at 1-866-214-2043.

Your signature below indicates that you understand the above and agree to participate in this group.
Print your name:

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Date:

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Signature:

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Witness:

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