Online Quantitative Study of Youth Reactions to Rough-Cut Advertising Designed to Prevent Youth Tobacco Use

Copy Testing – Screener

ONLINE QUALITATIVE STUDY OF YOUTH REACTIONS TO STRATEGIC CONCEPTS DESIGNED TO PREVENT YOUTH TOBACCO USE

SCREENER

OMB No: 0910-0674 Expiration Date: 03/31/2016

Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 5 minutes (the time estimated to answer the following screening questions). You can send comments regarding this burden estimate or any other aspects of this information collection, including suggestions for reducing burden, to PRAStaff@fda.hhs.gov.

Demographics

1. How old are you?

A. 11 years or younger [SCREEN OUT]

B. 12 years old

C. 13 years old

D. 14 years old

E. 15 years old

F. 16 years old

G. 17 years old

H. 18 years old or older [SCREEN OUT]

2. Do you or any member of your immediate family or a close friend work for…?

A. A market research company [SCREEN OUT]

B. An advertising agency or public relations firm [SCREEN OUT]

C. The media (TV/radio/newspapers/magazines) [SCREEN OUT]

D. A healthcare professional (doctor, nurse, pharmacist, dietician, etc.) [SCREEN OUT]

E. None of these

3. Are you…?

A. Female

B. Male

Cigarette Use

4. Have you ever tried cigarette smoking, even one or two puffs?

A. Yes

B. No

[If A4 = Yes, Ask A5. If A4 = No, Ask A8]

5. During the past 30 days, on how many days did you smoke cigarettes?

A. 0 days

B. 1 or 2 days

C. 3 to 5 days

D. 6 to 9 days

E. 10 to 19 days

F. 20 to 29 days

G. All 30 days

[If A5 = 0 days, Ask A7. Otherwise, Ask A6.]

6. Menthol cigarettes are cigarettes that taste like mint. During the past 30 days, were the cigarettes that you usually smoked menthol?

A. Yes

B. No

C. Not sure

7. About how many cigarettes have you smoked in your entire life? Your best guess is fine.

A. I have never smoked cigarettes, not even one or two puffs [SCREEN OUT]

B. 1 or more puffs but never a whole cigarette

C. 1 cigarette

D. 2 to 5 cigarettes

E. 6 to 15 cigarettes (about 1/2 a pack total)

F. 16 to 25 cigarettes (about 1 pack total)

G. 26 to 99 cigarettes (more than 1 pack, but less than 5 packs)

H. 100 or more cigarettes (5 or more packs) [SCREEN OUT]

[If A7 = B, Ask A8 & A9. If A7 = C - G, Ask Only A8]

Susceptibility

Thinking about the future…

8. Do you think you will be smoking cigarettes one year from now?

1. Definitely yes

2. Probably yes

3. Probably not

4. Definitely not

9. If one of your best friends were to offer you a cigarette, would you smoke it?

1. Definitely yes

2. Probably yes

3. Probably not

4. Definitely not

[If A7 = B (1 or more puffs only), A8 = D and A9 = D, SCREENOUT]

[If A7 = C – G (1 – 99 cigarettes), and A8 = D, SCREENOUT]