Government of Canada, to conduct a study of online too1s and information with current smokers and former smokers who have recently quit smoking.
IF RESPONDENT SAYS THAT HE/SHE DOES NOT SMOKEIHAS NEVER SMOKED, ASK IF THERE IS ANYONE ELSE IN THE HOUSEHOLD WHO IS A CURRENT/FORMER SMOKER (QUIT WITHIN PAST YEAR). IF THEY SAY 'NO', THANK THEM AND DISCONTINUE CALL. IF THEY SAY 'YES', ASK TO SPEAK TO THAT PERS ON AND START OVER.
RECRUITERS CAN IDENTIFY THAT AN HONORARIUM WILL BE PAID TO RESEARCH P ARTICIP ANTS, BUT CANNOT IDENTIFY THE AMOUNT UNTIL THE END OF THE RECRUITMENT PROCESS. WE DO NOT W ANT RESPONDENTS TO BE ENCOURAGED BY THE $200 INCENTIVE TO FALSIFY INFORMATION SO AS TO BE ELIGIBLE TO PARTICIPATE IN THE STUDY.
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Your participation in the research is comp1ete1y voluntary and your decision to participate or not will not affect any dea1ings you may have with the Government of Canada. AlI information collected, used or disclosed will be used for research purposes on1y and administered according to the requirements of the Privacy Act.
May 1 ask you a few questions to see whether you qua1ify for the research?
IF RESPONDENT ASKS FOR DETAILS ABOUT THE RESEARCH BEFORE PROCEEDING FURTHER, READ THEM/OFFER TO SEND THEM BY EMAIL THE ONE-PAGE OVERVIEW NOTE DESCRIBING THE REQUIREMENTS OF PARTICIPATION IN THE STUDY. IF IT IS SENT BY EMAIL, SCHEDULE A SPECIFIC TIME TO CALL BACK REGARDING POSSIBLE PARTICIPATION IN THE STUDY.
1. Do you current1y smoke or have you ever been a smoker? By this, we mean smoking cigarettes, not other tobacco products such as cigars or pipes.
Yes, current smoker Yes, former smoker No, never smoked
THANKIDISCONTINUE UNLESS OTHER IN HOUSEHOLD IS APPROPRIATE.
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2. When did you stop smoking? (READ LIST IF NECESSARY) Within the past year
More than a year ago
1 2
GOTOQ.9
THANKIDISCONTINUE UNLESS OTHER IN HOUSEHOLD IS APPROPRIATE.
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Recruitment Questionnaire - Health Canada Smoking Cessation Study 11
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3. At present, do you smoke every day or occasionally (i.e. less than every day)1
Every day Occasionally1
2 THANK/DISCONTINUE
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4. OIi average, how many cigarettes do you smoke per day?
Number of cigarettes per day: _ ACCEPT RANGE. GET MIX ..
5. Have you ever tried to quit smoking?
Yes No
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2 THANK/DISCONTINUE
6. How many times have you tried to quit smoking in the past? (GET MIX BUT FOCUS ON THOSE WHO HAVE TRIED MORE THAN ONCE)
1 1 '1 1
Once 2-5 times
More than 5 times
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7. In your attempt(s) to quit smoking, what's the longest you were able to go without smoking? (GET MIX. ACCEPT TlMEFRAME PROVIDED BY RESPONDENT)
Length of time: _ ACCEPT DA YS, WEEKS, MONTHS.
8. Are you seriously considering quitting smoking within the next six months?
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Yes No
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2 THANK/DISCONTINUE
9. Do you currently have access to and use the Internet from your home?
Yes No
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2 THANK/DISCONTINUE
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10. How often would you say you use the Internet, not including email? (READ LIS1'; GET MIX)
Less than 2 hours per week 1 2-5 hours per week 2 6-10 hours per week 3 More than 10 hours per week 4
THANK/DISCONTINUE
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Recruitment Questionnaire - Health Canada Smoking Cessation Study 21
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Il. Do you have a printer for your computer at home?1
Yes No 2 1 THANKJDISCONTINUE1
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12. Could you please tell me which of the following age groups you fall into? (READ LIST;
WANT GOOD MIX)
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Less than 18 18-24 25-34 35-44 45-54 55-64 65+
1 2 3 4 5 6 7
THANKJDISCONTINUE
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13. What is the highest level of education you have completed? (READ LIST IF NECESSARY;W ANT GOOD MIX)
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Less than high school 1
High school 2
Sorne college/technical school/CEGEP 3 Graduated college/technical school/CEGEP 4
Sorne university 5
Graduated university 6
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14. Have you ever attended a discussion group or interview which was arranged in advance and for which you received a small sum of money?1
Yes No 2 1 (GO TO QI7)1
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15. When did you last attend one of these discussion groups or interviews?
Less than 12 months ago 1 (THANK/DISCONTINUE UNLESS FORMER SMOKER)
Over 12 months ago 2
16. Have you attended more than five discussion groups or paid interviews in your lifetime?
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Yes 1 (THANK/DISCONTINUE UNLESS FORMERSMOKER)
No 2
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Recruitment Questionnaire - Health Canada Smoking Cessation Study 31
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17. Do you, or do es any member of your household or immediate family, work in any of the following fields? (READ LIST)1 1
. ADVERTISING
MARKET RESEARCH
THE MEDIA (radio, television, newspapers, magazines etc.) HEALTH CANADA
TOBACCO INDUSTRY
[] Yes (THANKIDISCONTINUE) [] No (CONTINUE)
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RECORD GENDER BY OBSERVATION (ENSURE APPROXIMATE SPLIT) FemaleThe research we are conducting is designed to assess the effectiveness of a set of online tools and information designed to help CUITent and former smokers develop strategies for staying smoke-free. The research will take place over a three-week period during which participants will work on their own reviewing and using the on-line tools. Following this, participants will be contacted for a phone interview lasting approximately 30-40 minutes which will focus on their experience with and perceptions of the online materials. A short, 10-15 minute follow-up interview may be conducted approximately 6 months later. People who take part in this research will receive $200 for their time and effort. Would you be willing to participate?
Yes PARTICIPATION IN THIS STUDY (I.E. THE AMOUNT OF WORK THEY NEED TO DO), READ THEMIOFFER TO SEND THEM BY EMAIL THE ONE-PAGE OVERVIEW NOTE DESCRIBING THE REQUIREMENTS OF PARTICIPATION IN THE STUDY. HOWEVER, DO NOT TRY TO PUSH THEM INTO PARTICIPATING. IF THE OVERVIEW NOTE IS SENT BY EMAIL, SCHEDULE A SPECIFIC TIME TO CALL BACK REGARDING POSSIBLE PARTICIPATION IN THE STUDY.
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participation in the study and send you an instruction sheet by email. The instruction sheet will describe the tasks that you will need to perform and will contain a link to the web pages where the online tools and information are located.Could l please confirm your name, phone number, and email address?
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RESPONDENT'S NAME: _
PHONE#: HOME
EMAIL ADDRESS: _
Thank you,
Recruitment Questionnaire - Health Canada Smoking Cessation Study 4
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Étude de Santé Canada sur l'abandon de la cigarette (POR-04-06) Questionnaire de recrutement
Profile characteristics:
- 30 participants recruited from Halifax, Quebec City (French), Montreal (French), Toronto, Calgary, and Vancouver (and perhaps other urban centres).
- Canadian residents who are 18 years of age or older, who are current or former smokers.
o 'Current' smokers will have made at least one attempt to quit smoking and will be
seriously considering quitting within the next six months (with a mix of participants by amount smoked and number, length/success of previous quit attempts.)
o 'Former' smokers will have quit smoking within the past year. This is a significantly harder group to recruit so that these recruits will be included
regardless ofprevious participation in public opinion research. No firm quota for this group - 'best efforts' to recruit up to 15 participants (1j).
- One-third (10 participants) to be native French speaking from Quebec.
- All participants must have access to and use the Internet, and have a computer and printer athome.
- Mix of participants by age, gender, and level of education (with the expectation that the demographies of smokers will result in more participants with lower levels of education).
- Participants to be paid $200 (only to be revealed at end of the recruitment process).
- Sponsorship of study to be revealed (i.e. Health Canada).
- If respondent does not qualify, discontinue screener after completing 2-3 more questions.