Item
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Currently
Approved Question Text
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Currently
Approved Responses
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Revision
Type
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Revised
Question Text
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Revised
Responses
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NB4
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When you last tried to quit smoking, did you
do any of the following?
NB4_1. Give up cigarettes all at once
NB4_2. Gradually cut back on cigarettes
NB4_3. Switch completely to vaping (using
e-cigarettes, vape pens, JUULs, mods, or other personal
vaporizers)
NB4_4. Substitute some of your regular
cigarettes with vaping (using e-cigarettes, vape pens, JUULs,
mods, or other personal vaporizers)
NB4_5. Switch to mild or some other brand of
cigarettes
NB4_6. Use nicotine replacements like the
nicotine patch, nicotine gum, nicotine lozenges, nicotine nasal
spray, or nicotine inhaler
NB4_7. Use medications like Wellbutrin,
Zyban, buproprion, Chantix, or varenicline
NB4_8. Get help from a telephone quit line
NB4_9. Get help from a website such as
Smokefree.gov or CDC.gov/Tips
NB4_10. Get help from a doctor or other
health professional
NB4_11. Get help from a pharmacist
NB4_12. Use a mobile App to help you quit
smoking
NB4_13. Use a texting program to help you
quit smoking
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1. Yes
2. No
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Revision to
update response options for clarity and to match them to current
terminology for e-cigarettes (e.g., NJOY, Blu, Logic, Vuse, Puff
Bar)
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When you last tried to quit smoking, did you
do any of the following?
NB4_1. Give up cigarettes all at once
NB4_2. Gradually cut back on cigarettes
NB4_3.
Switch completely to e-cigarettes, vapes, or mods (popular brands
include NJOY, Blu, Logic, Vuse, and JUUL) NB4_4. Substitute some
of your regular cigarettes with e-cigarettes, vapes, or mods
(popular brands include NJOY, Blu, Logic, Vuse, Puff Bar, and
JUUL) NB4_4a. Switch completely
to
heated tobacco products (using “heat not burn” tobacco
products, iQOS [eye-kos], Glo, or Eclipse).
NB4_4b.
Substitute some of your regular cigarettes with heated tobacco
products (using “heat not burn” tobacco products, iQOS
[eye-kos], Glo, or Eclipse).
NB4_5. Switch to a different brand of
cigarettes
NB4_5a. Switch to smokeless tobacco (such as
snuff, chew, or snus) or dissolvable tobacco
NB4_6. Use nicotine replacements medications
like the nicotine patch, nicotine gum, nicotine lozenges, nicotine
nasal spray, or nicotine inhaler
NB4_7. Use medications like Wellbutrin,
Zyban, buproprion, Chantix, or varenicline
NB4_8. Get help from a telephone quit line
NB4_9. Get help from a website such as
Smokefree.gov or CDC.gov/Tips
NB4_10. Get help from a doctor or other
health professional
NB4_11. Get help from a pharmacist
NB4_12. Use a mobile App to help you quit
smoking
NB4_13. Use a texting program to help you
quit smoking
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1. Yes
2. No
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NB8
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The next
questions are about e-cigarette or vape products that usually
contain nicotine, flavors, and other ingredients. You may also
know them as JUUL, electronic cigarettes, e-cigarettes, vape pens,
Suorin or mods. Some look like cigarettes, and others look like
small boxes, pens, or pipes. Questions
related to vaping in this survey do not include products used for
marijuana.
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N/A
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Revision:
Updating instructions to improve ability to capture vaping. Note:
The image and terminology may need to be updated to adjust to
trends in the market and changes in terminology over time (e.g.,
NJOY, Blu, Logic, Vuse, Puff Bar)
|
The next
questions are about electronic or e-cigarettes. You may also know
them as vape pens, e-hookah, vapes, or mods. Some popular brands
include NJOY, Blu, Logic, Vuse, Puff Bar, and JUUL. Please
do not include marijuana, cannabis, and THC products (including
concentrates, waxes or hash oils) for these questions.
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N/A
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NB9a
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On the days
that you vape, how often do you vape?
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1. Rarely
2. Sometimes
3. Often
4. Very often
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Deletion
because other items on e-cigarettes are more useful.
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NB13
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In your opinion, regularly vaping and
smoking cigarettes is….
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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
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Simplifying
response options to make question easier to answer
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Do
you believe that e-cigarettes and vape products are less harmful,
equally harmful, or more harmful to your health than smoking
regular cigarettes?
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1. Less harmful
2. Equally harmful
3. More harmful
4. I don’t
know
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NC1
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Do you believe cigarette smoking is related
to:
Statements
in row (randomize and record response order):
NC1_1. Lung Cancer
NC1_2. Cancer of the mouth or throat
NC1_3. Heart Disease
NC1_4. Diabetes
NC1_5. Emphysema
NC1_6. Stroke
NC1_7. Hole in throat (stoma or tracheotomy)
NC1_8. Buerger’s Disease
NC1_9. Amputations (removal of limbs)
NC1_10. Asthma
NC1_11. Gallstones
NC1_12. COPD or Chronic bronchitis
NC1_13. Periodontal or Gum Disease
NC1_14. Premature birth
NC1_15. Colorectal Cancer
NC1_16. Macular Degeneration or blindness
NC1_17. Depression
NCI_18. Anxiety disorder
NC1_19. Colon Cancer
NC1_20. COVID-19
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Answers
in columns:
1. Yes
2. No
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Revision:
Adding Kidney Disease, Peripheral Artery Disease, Premature death
and Walking difficulties to list of diseases to capture beliefs
about smoking-related diseases as found in new Tips ads.
|
Do you believe cigarette smoking is related
to:
Statements
in row (randomize and record response order):
NC1_1. Lung Cancer
NC1_2. Cancer of the mouth or throat
NC1_3. Heart Disease
NC1_4. Diabetes
NC1_5. Emphysema
NC1_6. Stroke
NC1_7. Hole in throat (stoma or tracheotomy)
NC1_8. Buerger’s Disease
NC1_9. Amputations (removal of limbs)
NC1_10. Asthma
NC1_11. Gallstones
NC1_12. COPD or Chronic bronchitis
NC1_13. Periodontal or Gum Disease
NC1_14. Premature birth
NC1_15. Colorectal Cancer
NC1_16. Macular Degeneration or blindness
NC1_17. Depression
NCI_18. Anxiety disorder
NC1_19. Colon Cancer
NC1_20. COVID-19
NC1_21. Kidney Disease
NC1_22. Premature death
NC1_23. Walking difficulties
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Answers
in columns:
1. Yes
2. No
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ND19_NEW
[S]
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Please tell
us if you strongly disagree, disagree, agree, or strongly agree
with the following statements.
Statements
in row (randomize list):
ND15. Using
e-cigarettes and vape products can result in serious lung injury
or death.
ND19.
Smoking cigarettes can cause medical complications and diseases
that require surgeries and medical procedures to treat.
damaging as
other cigarettes.
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Answers
in columns:
1. Strongly disagree
2. Disagree
3. Agree
4. Strongly agree
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Adding
‘menthol’ survey items to list to determine message
effectiveness of new ads titled ‘Angie: Love Yourself Tip,’
‘Angie: Angry Tip,’ and ‘Ethan: Cool Tip’
and Noel.
|
Please tell us if you strongly disagree,
disagree, agree, or strongly agree with the following statements.
Statements in row (randomize list):
ND15. Using e-cigarettes and vape products
can result in serious lung injury or death.
ND19. Smoking cigarettes can cause medical
complications and diseases that require surgeries and medical
procedures to treat.
ND19a. Menthol cigarettes are just as
damaging as other cigarettes.
ND19b. Tobacco companies aggressively target
communities with menthol cigarette advertising.
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Answers
in columns:
1. Strongly disagree
2. Disagree
3. Agree
4. Strongly agree
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NE1a
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|
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Addition to
improve understanding of media use for program planning
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How do you usually watch television
these days?
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A
digital antenna
A
cable or satellite subscription
A
streaming service on the Internet
Some
other way
Don’t
watch television
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NE1b
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|
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Addition to
improve understanding of media use for program planning
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How
often do you watch television or movies, on a TV set or any other
device? Do you do this every day or almost every day, at least
once a week, at least once a month, or less often?
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Every
day or almost every day
At
least once a week
At
least once a month
Less
often
Never
do this
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NE3
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On an average day, how many hours do you use
the Internet for personal reasons?
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1. None
2. Less than one hour
3. About 1 hour
4. About 2 hours
5. About 3 hours
6. About 4 hours
7. 5 hours or more
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Revision to
improve ability to capture social media exposure
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On an average day, how many hours do you use
the following social media platforms:
F3_1.
Facebook
F3_2.
Instagram
F3_3.
Twitter
F3_4.
Snapchat
F3_5.
TikTok
F3_6. Reddit
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1. None
2. Less than one hour
3. About 1 hour
4. About 2 hours
5. About 3 hours
6. About 4 hours
7. 5 hours or more
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NF38
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When you go to a convenience store,
supermarket, or gas station, how often do you see ads or
promotions for vaping products?
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1. I never go to a convenience store,
supermarket, or gas station
2. Never
3. Rarely
4. Sometimes
5. Most of the time
6. Always
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Deletion
because no longer a priority item
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|
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NF39
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|
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Addition to
expand current measures of receptivity to ads
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Did you talk to anyone about any of these
ads?
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Yes
No
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NF40
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|
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Addition to
expand current measures of receptivity to ads
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When you talked about the ads, did you talk
about any of the following topics?
1. These ads were not good.
2. I should not smoke cigarettes.
3. The person I was talking to or someone
else I know should not smoke cigarettes.
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1. Yes
2. No
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QEDUC_HSGED
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|
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Addition to
include number of participants with GEDs
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Do
you have a high school diploma or a GED?
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1.
High school diploma
2.
GED
3. Don’t Know
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G15
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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_23a. COVID-19
G15_24. Something else [anchor]
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1.Yes
2. No
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Addition to
include peripheral artery related disease and disability included
in new Tips
ads
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Have you been diagnosed by a physician or
other qualified medical professional with any of the following
medical conditions?
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_23a. COVID-19
G15_23b. walking difficulties due to artery
blockage
G15_24. Something else
[anchor]
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1.Yes
2. No
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G16
|
|
|
Addition to
assess non-diagnosed experiences of anxiety and depression
(potential causes of disparities in smoking cessation)
|
Over the
last 2 weeks, how often have you been bothered by the following
problems?
Statements
in row:
G16_1. Little interest or pleasure in doing
things
G16_2. Feeling down, depressed or hopeless
G16_3.
Feeling nervous, anxious or on edge
G16_4. Not being able to
stop or control worrying
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1. Not at all
2. Several days
3.
More than half the days
4. Nearly every day
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G17
|
|
|
Added to
assess the role of discrimination potentially related to stress
and smoking
|
G17. In your day-to-day life, how often have
any of the following things happened to you?
G17_1. You are treated with less courtesy
or respect than other people.
G17_2. You receive poorer service than
other people at restaurants or stores.
G17_3. People act as if they think you
are not smart.
G17_4. People act as if they are afraid
of you.
G17_5.
You are threatened or harassed. [GRID]
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1. Almost every day
2. At least once a week
3. A few times a month
4. A few times a year
5. Less than once a year
6. Never
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G18
|
|
|
G17 and G18
are both part of the same scale
|
G18. What do you think is the main
reason for these experiences?
|
1. Your ancestry or national origins
2. Your gender
3. Your race or ethnicity
4. Your age
5. Your religion
6. Your height
7. Your weight
8. Some other aspect of your physical
appearance
9. Your sexual orientation
10. Your education or income level
11. A physical disability
12. Other [specify]:
_________________________
|
G23
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Do you consider yourself to be…
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1. Heterosexual or straight
2. Gay
3. Lesbian
4. Bisexual
5. Other, please specify
|
Revised to
reflect HHS recommendations
|
Which of the
following best represents how you think of yourself?
|
1. Gay
(lesbian or gay)
2.
Straight, this is not gay (or lesbian or gay)
3. Bisexual
4.
Something else
5. I don’t
know the answer
|
NG22
|
|
|
Addition to
address community context and social connectedness, potentially
related to stress and smoking.
|
NG22 [Grid; S Across]
Using the scale below, please tell us how
much you agree or disagree with the following statements.
NG21a. I feel safe in my area or
neighborhood.
NG21b. If I
had a problem, I would feel comfortable asking a neighbor for
help.
|
1. Strongly agree
2. Somewhat agree
3. Neither agree nor disagree
4. Somewhat disagree
5. Strongly
disagree
|