Questionnaire

1. Name:
2. Age :
3. Sex: [ ] Male [ ] Female
4. Civil Status [ ] Single [ ] Married [ ] Separated [ ] Widow
5. Educational Attainment: _______________________________________
6. Occupation: _______________________________________
7. Have you ever smoked? [ ] Yes [ ] No

8. At what age did you smoke?

9. On average, how many cigarettes a day do you smoke? ____________
10. Do you still smoke? [ ] Yes [ ] No
11. If you are an ex-smoker, what was the reason for stopping
smoking?
[ ] Health [ ] Finance
[ ] Religion [ ] all of above
[ ] Parent [ ] other ___________

12. How long have you stopped smoking? ____________

13. Are you aware of the dangers of smoking? [ ] Yes
[ ] No
14. If yes, what was your source of information?
[ ] Doctor [ ] Media [ ] Friends [ ] Others ____________
15. If media, which of the following form(s) of media was the source
of information?
[ ] television
[ ] radio
[ ] newspaper
[ ] magazines
[ ] internet
[ ] others _____________________________________
16. Which of the following risks of smoking do you know?
[ ] heart attack
[ ] hypertension
[ ] respiratory disease
[ ] small baby
[ ] cancer of the lung
[ ] delayed wound healing
17. How should information about the dangers of smoking on health
be made available to the people in your area?
[ ] Health education, posters and lectures
 [ ] Mass propaganda via radio, television, newspaper
18. What do you think should be done to discourage smoking?
[ ] increase price of cigarettes
[ ] ban sales of cigarettes
[ ] restrict smoking in public places and transports
[ ] ban advertisements on cigarettes
[ ] adverse effects of smoking written on cigarette packets
19. Are you happy that you quit smoking? [ ] Yes
[ ] No
20. What advise can you give to others who are still smoking?
Mass media interventions for smoking cessation in adults.

Can anti-smoking television advertising affect smoking behaviour?

Fagerstrom questionnaires

http://www.ispub.com/journal/the-internet-journal-of-epidemiology/volume-8-
number-1/cigarette-smoking-habits-among-adolescents-in-northeast-nigeria.html

http://www.nice.org.uk/nicemedia/pdf/SmokingCessationMassMediaEvidenceTables.p
df
Mass media interventions involve communication through television, radio,
newspapers, billboards, posters, leaflets or booklets, with the intention of
encouraging smokers to stop, and of maintaining abstinence in non-smokers. It is
likely that they contribute to a reduction in smoking when used as part of a complex
set of interventions, but it is difficult to establish their independent role and value in
this process. Eleven studies are included in this review, but they are of variable
scale and quality. Five large studies out of the nine which reported smoking
prevalence found some positive changes in smoking behaviour. Three large studies
out of seven that measured the quantity of tobacco smoked found reductions. Over
half of the studies which measured quit rates reported significant increases in
abstinence, but this finding was difficult to interpret because studies used different
definitions of smoking, smokers and quit attempts. The intensity and duration of
mass media campaigns may influence effectiveness, but length of follow up and
concurrent events in the community can make this difficult to verify. We found no
consistent patterns between the effects of the campaigns and age, education,
ethnicity or gender of those taking part.

Cigarette smoking is the top cause of preventable death and disease in the U.S., and about 90%
of those who die from smoking begin as adolescents. Because smoking-related mass media
messages (such as episodes of smoking in films and advertisements) significantly increase
adolescent smoking, media literacy, defined as analysis and evaluation of mass media messages,
presents a promising new framework for development of innovative school-based tobacco
control programs. Media literacy may be more effective than standard tobacco education among
the populations that are at greatest risk for smoking, such as African-Americans and the socio-
economically disadvantaged, and national organizations have called for use of media literacy to
reduce smoking. However, anti-smoking media literacy programs have been neither widely
implemented nor well-evaluated.
The aims of this project are to determine if a theory-driven, school-based, 3-session anti-smoking
media literacy curriculum delivered to 9th grade students can affect clinically relevant factors
mediating adolescent smoking according to the widely accepted Theory of Reasoned Action:
intention to smoke, smoking behavior, attitude toward smoking, and norms involving smoking. It
is hypothesized that, compared with those exposed to a currently accepted school-based smoking
prevention program, students exposed to the media literacy program will develop more negative
attitudes toward smoking, a more negative sense of smoking norms, less intention to smoke, and
less smoking. We also expect that the curriculum will improve smoking media literacy scores as
measured by a reliable, valid scale.
Over two years, eight high schools will be recruited to randomize all 9th grade health classrooms
to receive either the 3-session media literacy anti-smoking curriculum or a currently accepted
anti-smoking program of equivalent length. This recruitment will occur via two prominent
community organizations responsible for anti-tobacco programming in 50 local school districts.
Experienced health educators will be trained in implementation of both experimental and control
curricula. Outcome measures, demographic data, and other important covariates will be collected
by a questionnaire given three times: at baseline, immediately post-intervention, and after one
year. Questionnaire items are reliable, valid, and pilot-tested. Process evaluation will be
conducted to assess implementation fidelity, to confirm or refute the findings of the quantitative
assessment, to help explain outcome data, to refine the intervention, and to inform future
replications of the curriculum.
Given the substantial nationwide morbidity and mortality due to tobacco use, the role of mass
media messages in adolescent initiation of smoking, and the potential power of media literacy as
an agent for health behavior change, it is essential to study the utility of media literacy in altering
smoking behaviors and antecedents in this age group. If media literacy programs are successful
in buffering the impact of mass media on adolescent smoking, similar interventions can be
developed to prevent other harmful behaviors related to mass media messages.
Mass Media Intervention to Reduce Youth Smoking, a joint program between Baylor
College of Medicine and the University of Vermont, sought to develop methods of
design and delivery of comprehensive, theory-based media campaigns to reduce
the prevalence of cigarette smoking among ethnically diverse adolescents, and to
assess the effects of these methods on the prevention and cessation of tobacco use
among these populations. The study has three project components: Project 1,
message development using audience research to conduct formative research to
develop theory-based smoking prevention and cessation messages for media
campaigns; Project 2, reducing youth smoking using mass media to develop
media messages in four-year campaigns to prevent smoking among adolescents
and evaluate their effectiveness in four intervention mass media markets versus
four comparison sites; and Project 3, youth smoking cessation using mass media
to develop a three-year campaign to help adolescents stop smoking and evaluate
their effectiveness with a cohort of weekly smokers established at a baseline in four
intervention mass media markets versus four comparison sites. Baylor College of
Medicine is responsible for Project 1s staff training and coordination for formative
research activities.