Qualitative Study on Cigarettes and Smoking: Knowledge, Beliefs, and Misperceptions about cigarettes and cigarette smoking

OMB No. 0910-0674

Exp: 3/31/16

Qualitative Study on Cigarettes and Smoking
“Top 3 attention-grabbing statements” Worksheet

Adolescents – List A

Please put an X in the boxes next to the 3 statements that grabbed your attention the most. On the line under each of those three statements, please write a brief reason why that statement got your attention.

	Cigarettes cause fatal lung disease
	Smoking permanently damages your airways and lungs
	Smoking causes COPD, a serious lung disease, and permanently scars lung tissue
	Quitting smoking now greatly reduces serious risks to your health
	Quitting smoking now reduces risk of dying from cancer and heart disease
	Smoking causes sexual dysfunction in men
	Smoking causes diabetes
	Tobacco smoke causes fatal lung disease in nonsmokers

Paperwork Reduction Act Statement: The public reporting burden for this information collection has been estimated to average 1 minute per response to complete the worksheet (the time estimated to read, review, and complete). Send comments regarding this burden estimate or any other aspects of this information collection, including suggestions for reducing burden, to PRAStaff@fda.hhs.gov.