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I am voluntarily giving you information so that you may use it in your research study related to helping the Deaf community. I understand that my information will be kept private and never be shared or sold.
I also understand that my responses will be combined with the responses from everyone else in this research study. The discoveries will be reported for the whole group and never reported individually. |
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| Your answers will help us measure how well we teach. |
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Knowledge (True of False)
We need to understand what information you already have |
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| * 1. Skin cancer is the leading cause of death from cancer. |
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| * 2. More women die from breast cancer than from lung cancer. |
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| * 3. More men die from lung cancer than from prostate cancer. |
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| * 4. The hardest time during a quit attempt is days 3 through 7. |
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| * 5. The risk of stroke is reduced to that of a non-smoker 5 years after you quit. |
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| * 6. The rates of smoking cessation improve when the smoker chooses a specific quit date. |
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| * 7. More people die each year from car crashes than from tobacco-related disease. |
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| * 8. You can decrease the harm smoking has already done to your body. |
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| * 9. Most nicotine withdrawal symptoms have resolved within 4-5 days after quitting. |
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| * 10. The most successful way to quit smoking is to use several nicotine replacement strategies together at the same time. |
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| * 11. The patch has substantially higher quit rate than nicotine gum. |
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| * 12. It is ok to smoke while using the patch. |
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| * 13. The levels of dangerous gas in your blood drop to normal 12 hours after quitting. |
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| * 14. Most people gain more than 10 pounds after quitting. |
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| * 15. Tobacco is a little less addictive than other drugs, such as heroin and cocaine. |
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| * 16. Smoking only affects your lungs. |
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| * 17. Smoking causes about 75% of lung cancer deaths in men and women. |
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| * 18. In 2003, about 75,000 people died from lung cancer. |
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| * 19. Smoking can lead to cancer of the bladder. |
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| * 20. Chronic pulmonary disease is the 4th leading cause of death in the U.S. |
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| * 21. Cigarettes contain toilet cleaner |
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| * 22. Smoking causes wrinkles to develop on the face and other parts of the body. |
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| * 23. Twenty minutes after you stop smoking, your heart rate slows down. |
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| * 24. You are responsible to call Smokers' hotline on the day of your quit date and other times in order to stay motivated. |
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| * 25. Nicotine nasal sprays don't work well in hot weather. |
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| * 26. Insecticide can be found in cigarettes. |
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| * 27. More than 100,000 people die each year from chronic pulmonary disease each year. |
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| * 1. Would you be likely to view this video again if you have your own copy? |
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| * 2. Would you be likely to share your copy of this video with other people you know? |
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| * 3. If this video were on the Internet, would you likely to tell others to see it? |
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| * 4. Do you think the smokers you know would be willing to view this video if you asked them to look at it with you? |
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| * 5. How much do you think this video increased your knowledge about smoking and health? |
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| * 6. How much did the visuals help you learn about the consequences of smoking? |
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* 7. Do you think this video would help:
A) Young deaf children to not start smoking? |
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| * B) Deaf teenagers to not start smoking? |
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| * C) Deaf teenagers to quit smoking? |
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| * 8. How could this video be improved? | | |
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Part Three
Questions for Smokers only |
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| * 9. Did this video give you knowledge you need to help you to quit smoking? |
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| * 10. Did seeing this video interest you in trying to quit smoking? |
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| * 11. Would you like to stop smoking now? |
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* 12. Want to set a date to quit smoking?
Yes |
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