Form 0920-1083 Smoker Suvey - Wave D

SMOKER WAVE A-I SURVEY, version 12/5/2018

Form Approved OMB No. 0920-1083

Exp. Date xx/xx/xxx

Extended Evaluation of the National Tobacco Prevention and Control Public Education Campaign Smoker Questionnaire

Public reporting burden of this collection of information is estimated to average 20 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 Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-1083).

SUBJECTS FOR QUESTIONNAIRE

SECTION A: INTRODUCTORY QUESTIONS SECTION B: TOBACCO USE QUESTIONS SECTION C: SMOKING CESSATION

SECTION D: ATTITUDES AND BELIEFS RELATED TO CESSATION SECTION E: SECONDHAND SMOKE

During the past 30 days, that is since [DATE FILL], on how many days did you smoke cigarettes?

Number of Days

SECTION F: MEDIA USE AND AWARENESS SECTION G: CLOSING QUESTIONS

SECTION A: INTRODUCTORY QUESTIONS A5.

SECTION B: TOBACCO USE QUESTIONS

	The next few questions are about tobacco use and smoking cessation.
B1.	On the average, about how many cigarettes a day do you now smoke?
	Number of cigarettes
B2.	On the days that you smoke, how soon after you wake up do you usually have your first cigarette? Would you say…
	Within 5 minutes 6-30 minutes From more than 30 minutes to 1 hour After more than 1 hour
	The next few questions ask about your attempts to quit smoking regular cigarettes at different times over the past year. In answering, please think specifically about the timeframe for each question.
C2.	During the past 3 months, how many times have you stopped smoking for one day or longer because you were trying to quit smoking cigarettes for good?
	Number of times
C2a.	During the past 6 months, that is since [FILL LAUNCH DATE], how many times have you stopped smoking for one day or longer because you were trying to quit smoking cigarettes for good?
	Number of times
C1.	During the past 12 months, that is, since [DATE FILL], how many times have you stopped smoking for one day or longer because you were trying to quit smoking cigarettes for good?
	Number of times

C3c.

C4.	When you last tried to quit smoking, did you do any of the following?
		1. Yes	2. No
		C4_1. Give up cigarettes all at once C4_2. Gradually cut back on cigarettes C4_3. Switch completely to vaping (using e-cigarettes, vape pens, JUULs, mods, or other personal vaporizers) C4_4. Substitute smoking some of your regular cigarettes with vaping (using e-cigarettes, vape pens, JUULs, mods, or other personal vaporizers) C4_5. Switch to mild or some other brand of cigarettes C4_6. Use nicotine replacements like the nicotine patch, nicotine gum, nicotine lozenges, nicotine nasal spray, or nicotine inhaler C4_7. Use medications like Wellbutrin, Zyban, buproprion, Chantix, or varenicline C4_8. Get help from a telephone quit line C4_9. Get help from a website such as Smokefree.gov or CDC.gov/Tips C4_10. Get help from a doctor or other health professional C4_11. Get help from a pharmacist C4_12. Use a mobile App to help you quit smoking C4_13. Use a texting program to help you quit smoking

C5.

C6a.	Do you want to quit smoking cigarettes for good? Yes No
C7b.	How much do you want to quit smoking? Would you say you want to quit…
	Not at all A little Somewhat A lot

C9.	Do you plan to quit smoking for good…
	In the next 7 days, In the next 30 days, In the next 6 months, In the next 1 year, or More than 1 year from now? I do not plan to quit smoking cigarettes for good Not sure/Uncertain
C10.	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…
	Extremely Likely Very Likely Somewhat Likely Very Unlikely Extremely Unlikely
C11.	How much do you think your health would improve if you were to quit smoking?
	Not at all A little Somewhat A lot
C14.	Among close friends, do…
	All of them smoke? Most of them smoke? Most of them not smoke? None of them smoke?

Electronic Vapor Product Questions

	The next questions are about vaping (using e-cigarettes, vape pens, JUULs, mods, other personal vaporizers). Vaping products are battery-powered and produce vapor instead of smoke. They typically use a nicotine liquid, although the amount of nicotine can vary and some may not contain any nicotine at all. Some common brands are JUUL, Vuse, MarkTen, Logic, and Blu. These questions concern electronic vaping products for nicotine use. The use of electronic vaping products for marijuana use is not included in these questions.
B8.	Have you ever vaped, even one time?
	Yes No
B8a.	During the past 30 days, on how many days did you vape?
	0 days 1 or 2 days 3 to 5 days 6 to 9 days 10 to 19 days 20 to 29 days All 30 days
B9.	Do you now vape…

	Every day Some days Not at all
B9a.	On the days that you vape, how often do you vape? Rarely Sometimes Often Very Often

B9a.	Do you usually vape with disposable devices, rechargeable devices that use pods or cartridges, or rechargeable devices that use large refillable tanks?
	Please indicate the type of device that you vape the most.
	1. Disposable devices that are not rechargeable or refillable 2. Rechargeable devices that use pods or cartridges, like JUULs 3. Rechargeable devices that have large refillable tanks 4. Unknown device type
B9b_1.	When you vape, does the liquid/contents usually contain nicotine?
	Yes No

B10. Are any of the following a reason why you first tried vaping/currently vape?

1. Yes 2. No

B10_1. I can vape when or where smoking cigarettes is not allowed

B10_2. Vaping might be less harmful to me than smoking cigarettes

B10_3. I like the flavors

B10_4. Vaping can help me quit or cut back on smoking cigarettes

B10_5. Vaping helps me deal with cravings to smoke

B10_6. A friend or family member suggested I vape as a way to quit smoking

B10_7. A friend or family member shared/shares their vaping device with me

B10_8. Vaping is popular among people my age

B13.	In your opinion, regularly vaping and smoking cigarettes is… 1.Much less harmful to one’s health than only smoking cigarettes 2. Slightly less harmful to one’s health than only smoking cigarettes 3. Equally harmful to one’s health as only smoking cigarettes 4. Slightly more harmful to one’s health than only smoking cigarettes 5. Much more harmful to one’s health than only smoking cigarettes.

B14.	Do you want to quit vaping for good?
	Yes No

QUITLINE USE AND AWARENESS

Now, we are going to ask you some additional questions about regular cigarettes.

C18.	A telephone quitline is a free telephone-based service that connects people who smoke cigarettes with someone who can help them quit. Are you aware of any telephone quitline services that are available to help you quit smoking?
	Yes No
C20.	Have you heard of 1-800-QUIT-NOW?
	Yes No
C20a.	Have you called 1-800-QUIT-NOW or any other telephone quit line in the past 3 months since [FILL DATE]?
	Yes No
C22.	In the past 3 months, did you receive any of the following medications for free from the 1-800-QUIT-NOW smokers’ quitline: nicotine patches, gum, lozenges, nasal spray, inhaler, or pills such as Wellbutrin, Zyban, buproprion, Chantix, or varenicline?
	Yes No

SECTION D: ATTITUDES AND BELIEFS RELATED TO CESSATION

The next few questions will ask about your opinions related to smoking, tobacco use, and cessation.

D8.	Please tell us if you strongly disagree, disagree, agree, or strongly agree with the following statements.
	Strongly disagree Disagree Agree Strongly agree
	I am eager for a life without smoking.

Concerns About Health

	Please tell us if you strongly disagree, disagree, agree, or strongly agree with the following statements.
	Strongly disagree Disagree Agree Strongly agree
D10.	I get upset when I think about my smoking.
D11.	I am disappointed in myself because I smoke.
D12.	I get upset when I hear or read about illnesses caused by smoking.
D13.	Warnings about the health risks of smoking upset me.

Risk Perception

Please tell us if you strongly disagree, disagree, agree, or strongly agree with the following statement.

D20.	How likely do you think you are to develop a smoking-related disease as a result of smoking? Strongly Agree Agree Disagree Strongly Disagree

D21.	Do you believe cigarette smoking is related to
	1. Yes 2. No
	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

SECTION E: SECONDHAND SMOKE

E1.	Other than yourself, does anyone who lives in your home smoke cigarettes now?
	Yes No

E8a.	In your opinion how likely is it that regularly breathing secondhand tobacco smoke would worsen asthma or cause infections or lung damage among nonsmokers?
	Extremely likely Very likely Somewhat Likely Very unlikely Extremely unlikely
E8b.	Not counting decks, porches, or garages, is smoking inside your home…
	Always allowed Allowed only at some times or in some places Never allowed
E9.	Are you seriously considering increasing restrictions on smoking in your household?
	Definitely yes Probably yes Probably not Definitely not

SECTION F: MEDIA USE AND AWARENESS

F1.	On an average day, how much television do you watch?
	None Less than one hour About 1 hour About 2 hours About 3 hours About 4 hours 5 hours or more
F2.	On an average day, how many hours do you listen to the radio?
	None Less than one hour About 1 hour About 2 hours About 3 hours About 4 hours 5 hours or more

F3.	On an average day, how many hours do you use the Internet for personal reasons?
	None Less than one hour About 1 hour About 2 hours About 3 hours About 4 hours 5 hours or more
F13.	Have you heard of the Website www.cdc.gov/Tips?
	Yes No
F13a.	Have you visited www.cdc.gov/Tips in the past 5 months, since [FILL DATE]?
	Yes No
F14.	In the past 5 months, that is since [FILL DATE], have you seen or heard advertisements for medications or products to help people quit smoking such as Chantix, nicotine patches, or nicotine gums?
	Never Rarely Sometimes Often Always

F17.	In the past [FILL # MONTHS PLANNED CAMPAIGN DURATION], that is since [FILL DATE], have you seen or heard of any ads on television or radio with the following themes or slogans?
			1. Yes	2. No
	F17_1.	TIPS FROM FORMER SMOKERS
	F17_2.	TRUTH
	F17_3.	BECOME AN EX
	F17_4.	EVERY CIGARETTE IS DOING YOU DAMAGE
	F17_5.	TOBACCO FREE LIVING
	F17_6.	THE REAL COST

Have you seen any of the following Facebook pages or groups when you have been online in the past 5 months, since [FILL DATE]? Please select each page that you have seen

F19_1a. Tips Facebook Page Image F19_1b. Unrelated Facebook Page Image F19_1c. Unrelated Facebook Page Image

F19_1.

Have you seen any of the following YouTube channels or pages when you have been online in the past 5 months, since [FILL DATE]? Please select each page that you have seen

F19_2a. Tips YouTube Page Image F19_2b. Unrelated YouTube Page Image F19_2c. Unrelated YouTube Page Image

F19_2.

Have you seen any of the following Twitter pages when you have been online in the past 5 months, since [FILL DATE]? Please select each page that you have seen

F19_3a. Tips Twitter Page Image F19_3b. Unrelated Twitter Page Image F19_3c. Unrelated Twitter Page Image

F19_3.

Sometimes people use the Internet specifically for health-related reasons. In the past 30 days, have you used the Internet for any of the following reasons?

1. Yes 2. No

F20_1. Looked for information about quitting smoking

F20_2. Looked for information about vaping (using e-cigarettes or other vaping

products)

F20_3. Looked for information about nicotine replacement therapies (e.g.,

patches, gum, lozenges)

1. F20_4. Downloaded a mobile App to help you quit smoking

2. F20_5. Signed up for a texting program to help you quit smoking

F20_6. Created an online plan to help you quit smoking

F20.

Exposure and Reaction to TV Ads

	Now, we would like you to view a series of advertisements that have been shown on television and online in the U.S. Please make sure your computer’s volume is set to an appropriate level. You may be prompted by your computer to download a program enabling video playback. If the videos do not work, you’ll still be able to see images and descriptions of the advertisements. When you are ready, please click on the link below to view the first advertisement. There is a total of [FILL # TOTAL ADS] ads to view. After you view each ad, there will be a few questions that ask about your opinions of the ad.
F21_x.	Were you able to view this video?
	Yes No

F23_x.	Now we would like to show you some screen shots from a television advertisement that has been shown in the U.S. Once you have viewed the images displayed below, please click on the forward arrow below to continue with the survey.
F24_x.	Have you seen this ad on television or online in the past [FILL # MONTHS SINCE CAMPAIGN LAUNCH] months, since [CAMPAIGN LAUNCH DATE]?
	Yes No
F24a_x_TV.	In the past [FILL # MONTHS SINCE CAMPAIGN LAUNCH] months, how frequently have you seen this ad on television?
	Never Rarely Sometimes Often Very often
F24a_x_ COMPUTER .	In the past [FILL # MONTHS SINCE CAMPAIGN LAUNCH] months, how frequently have you seen this ad on a laptop or desktop computer?
	Never Rarely Sometimes Often

F24a_x_

MOBILE.

F25_x.	Please tell us if you strongly disagree, disagree, neither agree nor disagree, agree, or strongly agree with the following statements.
	Strongly disagree Disagree Neither agree nor disagree Agree Strongly agree
	F25a_x. This ad is worth remembering. F25b_x. This ad grabbed my attention. F25c_x. This ad is powerful. F25d_x. This ad is informative. F25e_x. This ad is meaningful to me. F25f_x. This ad is convincing.

	F26_x.	On scale of 1 to 5, where 1 means “not at all” and 5 means “very,” please indicate how much this ad made you feel…
				1 Not at all	2	3	4	5 Very
		F26a_x.	Sad
		F26b_x.	Afraid
		F26d_x.	Ashamed
		F26f_x.	Hopeful
		F26g_x.	Motivated
		F26h_x.	Understood
		For the next few questions, think about all of the advertisements you just viewed and recalled seeing in the past [FILL # MONTHS SINCE CAMPAIGN LAUNCH] months.

Exposure to Radio Ads

	Now, we would like you to listen to a radio advertisement that has aired in the U.S. Please make sure your computer’s volume is set to an appropriate level. You may be prompted by your computer to download a program enabling audio playback. If you cannot hear the audio, you’ll still be able to read a description of the advertisement. There is a total of [FILL # TOTAL RADIO ADS] radio ads to listen to. When you are ready, please click on the link below to listen to the ad. After you listen to the ad, there will be a few questions that ask about your recent recall of the ad.
F32_x.	Were you able to listen to this ad?
	Yes No
F34_x.	Now we would like to show you a script from a radio advertisement that has been shown in the U.S. Once you have read the script displayed below, please click on the forward arrow below to continue with the survey.

Have you heard this ad on the radio in the past [FILL # MONTHS SINCE CAMPAIGN LAUNCH] months, since [CAMPAIGN LAUNCH DATE]?

1. Yes

2. No

F35_x.

Exposure to Display, Print, and Out-of-Home

	Next, you will see some advertisements that have recently appeared in magazines, on websites, and on signs in areas such as bus shelters, bus interiors, billboards and other public places. There are 3 sets of images to view, followed by a few questions about whether you have seen these ads before. When you are ready to view them, please click “Next.”
F36.	In the past [FILL # MONTHS SINCE CAMPAIGN LAUNCH], since [CAMPAIGN LAUNCH DATE], have you seen any of these ads in magazines, on Websites, or in public places outside your home?
	Yes No
F37.	Where did you see these advertisements?
	1. Yes 2. No
	F37_1. Magazines or print publications F37_2. Websites online

F37a.	In the past XX Months, since [DATE], have you seen any of these ads in public places outside your home such as billboards, bus shelters, or bus interiors? 1. Yes 2. No

AWARENESS OF E-CIGARETTE ADS

F38.	When you go to a convenience store, supermarket, or gas station, how often do you see ads or promotions for vaping products?
	I never go to a convenience store, supermarket, or gas station Never Rarely Sometimes Most of the time Always

SECTION G: CLOSING QUESTIONS

G1.		How many people are 17 years of age or younger and currently live in your household at least 50% of the time? If none, enter “0.” Include babies and small children. Your answer will help represent the entire U.S. population and will be kept confidential. Thank you!
		Number of Children
	G5.	What is the highest level of school you have completed?
		No formal education 1st, 2nd, 3rd, or 4th grade 5th or 6th grade 7th grade or 8th grade 9th grade 10th grade 11th grade 12th grade, no diploma High school graduate – high school Diploma or the equivalent (GED) Some college, no degree Associate degree Bachelor’s degree Master’s degree Professional or Doctorate degree

G6.

How much is the combined income of all members of YOUR HOUSEHOLD for the PAST 12 MONTHS? Please include your income PLUS the income of all members living in your household (including cohabiting partners and armed forces members living at home). Please count income BEFORE TAXES and from all sources (such as wages, salaries, tips, net income from a business, interest, dividends, child support, alimony, and Social Security, public assistance, pensions, or retirement benefits). 1.Below $50,000 2. $50,000 or more 3. Don’t Know

G6a.	We would like to get a better estimate of your total HOUSEHOLD income in the past 12 months before taxes. Was it…
	1.Less than $5,000 2. $5,000 to $7,499 3. $7,500 to $9,999 4. $10,000 to $12,499 5. $12,500 to $14,999 6. $15,000 to $19,999 7. $20,000 to $24,999 8. $25,000 to $29,999 9. $30,000 to $34,999 10. $35,000 to $39,999 11. 40,000 to $49,999
G6b.	We would like to get a better estimate of your total HOUSEHOLD income in the past 12 months before taxes. Was it…
	1. $50,000 to $59,999 2. $60,000 to $74,999 3. $75,000 to $84,999 6. $85,000 to $99,999 4. $100,000 to $124,999 5. $125,000 to $149,999 6. $150,000 to $174,999 10. $175,000 to $199,999 11. $200,000 to $249,999 12. $250,000 or more

	G7.	Are you now…
		Married Widowed Divorced Separated Never married
	G7a.	Are you currently living with a partner to whom you are not married?
		Yes No

Which statement best describes your current employment status?

1. Working – as a paid employee

2. Working – self-employed

3. Not working – on temporary layoff from a job

4. Not working – looking for work

5. Not working – retired

6. Not working –- disabled

7. Not working – other

G8.

In your MAIN job, what kind of work do you do? Select one answer only.

1. Medical Doctor (such as physician, surgeon, dentist, veterinarian)

2. Other Health Care Practitioner (such as nurse, pharmacist, chiropractor, dietician)

3. Health Technologist or Technician (such as paramedic, lab technician)

4. Health Care Support (such as nursing aide, orderly, dental assistant)

5. Protective Service ( police, firefighters)

6. Food Preparation and Serving

7. Building and Grounds Cleaning and Maintenance

8. Personal Care and Service(hair stylists, gaming workers, entertainment)

9. Sales Representative

10. Retail Sales

11. Other Sales

12. Office and Administrative Support

13. Farming, Forestry, and Fishing

14. Construction and Extraction

15. Installation, Maintenance, and Repair

16. Precision Production (such as machinist, welder, baker, printer, tailor)

17. Transportation and Material Moving

18. Armed Forces

19. Management

20. Business and Financial Operations Professional

21. Computer and Mathematical

22. Architecture and Engineering

23. Life, Physical, and Social Sciences

24. Community and Social Services

25. Lawyer or Judge

26. Teacher, except college and university

27. Teacher, college and university

28. Other, please specify _____________.

G8a.

How many smoking or tobacco related web surveys like this have you completed during the past year?

1. None

2. 1 survey

3. 2 surveys

4. 3 surveys

5. 4 surveys

6. 5 or more surveys

G9.

G10.	Please indicate your current military service status (select one). Active duty Reserves National Guard Veteran or Armed Services Retiree Veteran or Retiree with a service connected disability Civilian: NO military service record

G11.	Are you CURRENTLY covered by any of the following types of health insurance or health coverage plans? Mark “yes” or “no” for each type of coverage.
	1. Yes 2. No
	G11_1. Insurance through a current or former employer or union G11_2. Insurance purchased directly from an insurance company G11_3. Medicare, for people age 65 and over, or people with certain disabilities G11_4. Medicaid, or any kind of government assistance plan for those with low incomes or disability G11_5. TRICARE or other military health care G11_6. VA (including those who have ever enrolled for or used VA health care G11_7. Indian Health Service G11_8. Any other type of health insurance or health coverage plan

G15.	Have you been diagnosed by a physician or other qualified medical professional with any of the following medical conditions?
	1. Yes 2. No
	G15_1. Acid reflux disease G15_2. ADHD or ADD G15_3. Anxiety disorder G15_4. Asthma, chronic bronchitis, or COPD G15_5. Cancer (any type except skin cancer) G15_6. Chronic pain (such as low back pain, neck pain, or Fibromyalgia) G15_7. Depression G15_8. Diabetes G15_9. Heart attack G15_10. Heart disease G15_11. High blood pressure G15_12. High cholesterol G15_13. HIV/AIDS G15_14. Kidney disease G15_15. Mental health condition G15_16. Multiple sclerosis G15_17. Osteoarthritis, joint pain or inflammation G15_18. Osteoporosis or osteopenia G15_19. Rheumatoid arthritis G15_20. Seasonal allergies G15_21. Skin cancer G15_22. Sleep disorders such as sleep apnea or insomnia G15_23. Stroke G15_24. Something else

G20.	Do you or anyone in this household connect to the Internet from home?
	Yes No
G21.	Do you live in a metro or non-metro area?
	Non-metro (rural) Suburban Urban

G22.	Using the scale below, please tell us how much you agree or disagree with the following statements.
	Strongly agree Somewhat agree Neither agree nor disagree Somewhat disagree Strongly disagree
	G20a. I usually try new products before other people do. G20b. I often try new brands because I like variety and get bored with the same old thing. G20c. When I shop I look for what is new. G20d. I like to be the first among my friends and family to try something new. G20e. I like to tell others about new brands or technology.
G23.	Do you consider yourself to be… Heterosexual or straight Gay Lesbian Bisexual Other, please specify
	Thank you for completing today’s survey. Your input will greatly help researchers assess the impact of television ads about quitting smoking.
	You will be awarded [AMOUNT] bonus points credited to your KnowledgePanel account for completing the survey. A follow-up survey will be sent to you in about [FILL # MONTHS PLANNED CAMPAIGN DURATION] and you will be awarded [AMOUNT] bonus points for completing that survey.

ADD1.

Those are all of our questions.  Thanks so much for your participation in our survey.  As a token of our appreciation, we would like to send you $[IF SAMPLE = KP WITHDRAWN, $15; IF SAMPLE=ABS, INSERT INCENTIVE VALUE FROM LOOKUP TABLE based on MNO; IF SAMPLE=ABS and incentive value is missing from lookup table, insert: $20].  Please verify your name and mailing address so that we can put the check in the mail. To ensure that you will be able to deposit or cash the check, please be sure to provide us with your full first AND last name; if you provide incomplete or inaccurate information, you may not be able to deposit the check. This information will not be connected with your survey responses in any way. Please select the field(s) that you’d like to update. If all of the information is correct, please select “All of the above are correct”. 1.Name (First/Last): 2.Mailing Address: 3.All of the above are correct

ADD1_1.

Please type in the name to whom you’d like us to send the incentive check: Name ___________________

ADD1_2.

Please type in the address to where we should send the incentive check: Street Address: City: State: Zip Code:

ADD2.

Is the contact information below now up-to-date? 1. Yes 2. No

CONTACT_A.

Thank you for your participation in this important study! If you entered your address information on the previous question, your check for participation will arrive in the next 4 – 6 weeks. The CDC will also have the opportunity to do at least one more survey in the future, with additional rewards and prizes for participation. Would you be willing to participate in another survey for the CDC? 1. Yes 2. No

CONTACT_A1.

Is this the address where you would like us to send your next CDC survey invitation? 1.Yes 2. No

CONTACT_A2.

Please provide us with the address that you would like us to use to send you your next CDC survey invitation Street Address: City: State: Zip Code:

CONTACT_B.

So that you can participate in the future if you choose to do so, please provide your e-mail address and best phone number to reach you below. Remember, you can decline to do any survey at that time if you do not want to do it. My email address is: The best phone number to reach me:

CONTACT2_A.

In case we are unable to reach you through the email address or phone number you provided in the previous question, is there an alternate email address or a phone number to be able to reach? It is very important for us to hear back from you for future surveys that we will be sending out so we can ensure that the researchers have complete data for this new and important study. Alternate Email: Alternate phone number to reach you: