Thank you for your interest in research at Penn State Health. We are currently conducting several studies involving smokers and people who use other nicotine products. You should know that none of our studies involve people under 21 years of age. Also, all of our studies require that you live nearby and can come into the study center.
For more information about our studies click here.
In order to find out which study you may be eligible for, we would like to go through a few questions with you. If you are eligible for one of our studies a research coordinator will contact you with more information about a specific study. Please be sure to leave a phone number or email where you can be reached in the future.
By completing these questions you are consenting to allow us to pre-screen you for our studies and to contact you in the future regarding research opportunities. All information you provide will be kept secure and confidential and only the research team will have access to it. Your participation is voluntary and you may decide to stop at any time. You do not have to answer any questions that you do not want to answer.
Would you like to continue with the questions?
* must provide value
Yes
No
What is today's date?
* must provide value
Today M-D-Y
What is your date of birth?
* must provide value
Today M-D-Y
View equation Thank you for your interest in our research opportunities. At this time,we do not have any study opportunities available for participants under the age of twenty-one.
Where or how did you hear about the study?
Flyer or poster
Email from researchers
Penn State Center for Research on Tobacco and Health Website at https://research.med.psu.edu/smoking
Mailer/postcard
Penn State Health Daily Brief email newsletter
Penn State Health on-hold message
Facebook
Heard about it from a friend or relative
Heard about it from one of the researchers
Heard about it from a medical professional (doctor, nurse, or other)
A past participant in another study
Craigslist
Public Event
Matchbook
Pen
Study business card
Notepad
Brochure
Email from Penn State Health
Google or other online search
Lion's Eye TV screen at Penn State Health
Table tent card
StudyFinder website
Penn State Health clinical website, such as https://hmc.pennstatehealth.org
ResearchMatch
Other
Don't Know
Flyer or poster
Email from researchers
Penn State Center for Research on Tobacco and Health Website at https://research.med.psu.edu/smoking
Mailer/postcard
Penn State Health Daily Brief email newsletter
Penn State Health on-hold message
Facebook
Heard about it from a friend or relative
Heard about it from one of the researchers
Heard about it from a medical professional (doctor, nurse, or other)
A past participant in another study
Craigslist
Public Event
Matchbook
Pen
Study business card
Notepad
Brochure
Email from Penn State Health
Google or other online search
Lion's Eye TV screen at Penn State Health
Table tent card
StudyFinder website
Penn State Health clinical website, such as https://hmc.pennstatehealth.org
ResearchMatch
Other
Don't Know
Choose only one
What is your biological sex?
* must provide value
Male
Female
Other
Are you currently pregnant, trying to become pregnant, or nursing?
* must provide value
Yes
No
Can you understand, read, and write in English?
* must provide value
Yes
No
Do you consider yourself Hispanic or Latino?
Yes
No
What race best describes you?
American Indian or Alaska Native
Asian
Black or African American
Native American or Other Pacific Islander
White
Other
American Indian or Alaska Native
Asian
Black or African American
Native American or Other Pacific Islander
White
Other
What race best describes you?
Do you smoke cigarettes?
* must provide value
Yes
No
Have you smoked at least 100 cigarettes in your entire life?
* must provide value
Yes
No
Do you currently smoke cigarettes every day, some days, or not at all?
* must provide value
Every day
Some days
Not at all
Every day
Some days
Not at all
How many cigarettes per day do you usually smoke?
* must provide value
Do you roll your own cigarettes?
* must provide value
Yes
No
Do you hand-roll your cigarettes or are they made by a machine?
* must provide value
I hand roll my cigarettes
They are made by a machine (e.g. at-home machine or large automatic machine)
I hand roll my cigarettes
They are made by a machine (e.g. at-home machine or large automatic machine)
Do you use filters with roll-your-own-cigarettes?
* must provide value
Never
Sometimes
Always
In the past month, what brand of tobacco have you used?
* must provide value
Criss Cross
The Good Stuff
Rave
Smoking G'
Texas Roll Em'
Natural American Spirit
Other
Criss Cross
The Good Stuff
Rave
Smoking G'
Texas Roll Em'
Natural American Spirit
Other
Are these cigarettes menthol or non-menthol?
* must provide value
Menthol
Non-Menthol
In the past month, what brand of cigarettes have you smoked?
Basic
Camel
Capri
Doral
Eagle 20's
Kool
L&M
Marlboro
Maverick
Merit
Misty
More
Newport
Natural American Spirit
Pall Mall
Parliament
Pyramid
Rave
Salem
USA Gold
Virginia Slims
Winston
Other
Basic
Camel
Capri
Doral
Eagle 20's
Kool
L&M
Marlboro
Maverick
Merit
Misty
More
Newport
Natural American Spirit
Pall Mall
Parliament
Pyramid
Rave
Salem
USA Gold
Virginia Slims
Winston
Other
Is this your typical brand?
Yes
No
What other brand do you typically smoke?
Basic
Camel
Capri
Doral
Eagle 20's
Kool
L&M
Marlboro
Maverick
Merit
Misty
More
Newport
North American Spirit
Pall Mall
Parliament
Pyramid
Rave
Salem
USA Gold
Virginia Slims
Winston
Other
Basic
Camel
Capri
Doral
Eagle 20's
Kool
L&M
Marlboro
Maverick
Merit
Misty
More
Newport
North American Spirit
Pall Mall
Parliament
Pyramid
Rave
Salem
USA Gold
Virginia Slims
Winston
Other
Have you ever regularly used electronic cigarettes/vape pens, cigars, pipes, snus/snuff/dip, chew, hookah/waterpipe, or dissolvables?
* must provide value
Yes
No
What types of tobacco products do you use? Check all that apply?
* must provide value
Cigars
Pipes
Snus/Snuff/Dip
Chew
Electronic nicotine product (e-cigs, vape pens, hookah pens, vaporizers)
Hookah/waterpipe
Dissolvable tobacco (lozenge, strips, or sticks)
Nicotine pouches
Heat not burn tobacco (ie, IQOS)
Cigars
Pipes
Snus/Snuff/Dip
Chew
Electronic nicotine product (e-cigs, vape pens, hookah pens, vaporizers)
Hookah/waterpipe
Dissolvable tobacco (lozenge, strips, or sticks)
Nicotine pouches
Heat not burn tobacco (ie, IQOS)
When was the last time you smoked a cigar?
* must provide value
Days
Months
Years
How many days ago?
* must provide value
How many months ago?
* must provide value
How many years ago?
* must provide value
When was the last time you smoked a pipe?
* must provide value
Days
Months
Years
How many days ago?
* must provide value
How many months ago?
* must provide value
How many years ago?
* must provide value
When was the last time you used snus/snuff/dip?
* must provide value
Days
Months
Years
How many days ago?
* must provide value
How many months ago?
* must provide value
How many years ago?
* must provide value
When was the last time you used chew?
* must provide value
Days
Months
Years
How many days ago?
* must provide value
How many months ago?
* must provide value
How many years ago?
* must provide value
When was the last time you used an e-cig?
* must provide value
Days
Months
Years
How many days ago?
* must provide value
How many months ago?
* must provide value
How many years ago?
* must provide value
When was the last time you smoked a hookah?
* must provide value
Days
Months
Years
How many days ago?
* must provide value
How many months ago?
* must provide value
How many years ago?
* must provide value
When was the last time you used dissolvable tobacco?
* must provide value
Days
Months
Years
How many days ago?
* must provide value
How many months ago?
* must provide value
How many years ago?
* must provide value
When was the last time you used nicotine pouches?
* must provide value
Days
Months
Years
How many days ago?
* must provide value
How many months ago?
* must provide value
How many years ago?
* must provide value
When was the last time you used heat not burn tobacco (ie, IQOS)?
* must provide value
Days
Months
Years
How many days ago?
* must provide value
How many months ago?
* must provide value
How many years ago?
* must provide value
What type of e-cig do you use most often? Please select the type that most closely resembles your device.
* must provide value
Type 1
Type 2
Type 3
Type 4
What is the brand name of the e-cig you use most often?
* must provide value
Aspire
Blu
eGo
Eleaf
GeekVape
Green Smoke
Halo
iStick
Joyetech
Juul
KangerTech
Logic
MarkTen
Mig Vapor
NJOY
Om Vapors
SMOK
South Beach
V2
Vapor4Life
VaporFi
Vuse
Don't know
Other
Aspire
Blu
eGo
Eleaf
GeekVape
Green Smoke
Halo
iStick
Joyetech
Juul
KangerTech
Logic
MarkTen
Mig Vapor
NJOY
Om Vapors
SMOK
South Beach
V2
Vapor4Life
VaporFi
Vuse
Don't know
Other
What is the brand name of your electronic cigarette?
We have numerous studies that we are recruiting participants for. The following statement will determine which study may be appropriate for you.
* must provide value
I have no plans to quit or cut back a lot on my smoking
I am interested in cutting back my smoking
I am interested in quitting smoking in the next month or so
I have no plans to quit or cut back a lot on my smoking
I am interested in cutting back my smoking
I am interested in quitting smoking in the next month or so
What is the highest grade or level of school you have completed or the highest degree you have received?
I did not complete high school and I do not have a GED
I graduated from high school or I received a GED
I have completed some college, technical school, or I have an associate's degree
I have graduated from a college or university with a bachelor's degree or more
I did not complete high school and I do not have a GED
I graduated from high school or I received a GED
I have completed some college, technical school, or I have an associate's degree
I have graduated from a college or university with a bachelor's degree or more
Some of our studies are designed to include people who have previous or current mental health conditions.
Yes
No
Have you ever received treatment, counseling or medication for a mental health condition?
Yes
No
Do you have a phone number at which you will be able to consistently receive calls?
* must provide value
Yes
No
Please note that because of the COVID-19 pandemic, we have adjusted our study procedures to be completed remotely (from home) whenever possible. However, some in-person visits to the Milton S Hershey Medical Center in Hershey, Pa are required. We have taken many precautions to reduce any risks to you as a participant such as limited face-to-face contact and increased sanitizing.
* must provide value
Yes
No
Do you have access to transportation to Hershey Medical Center?
* must provide value
Yes
No
If you are provided with a mode transportation to and from Hershey Medical Center would you be willing to attend study visits in Hershey, PA?
Yes
No
Are you currently enrolled in any of our studies? (i.e. E-cig Switching Study, Nicotine Film Cessation Study)
Yes
No
Which study are you enrolled in?
E-cig Switching Study
Nicotine Film Cessation Study
E-cig Blood Nicotine fMRI Study
VLN Cigarettes and fMRI Study
E-cig Aerosol Study
E-cig Cue Reactivity Study
Other
E-cig Switching Study
Nicotine Film Cessation Study
E-cig Blood Nicotine fMRI Study
VLN Cigarettes and fMRI Study
E-cig Aerosol Study
E-cig Cue Reactivity Study
Other
Are you currently enrolled in any research studies with another researcher or organization?
Yes
No
Have you been enrolled in one of our studies in the past? (i.e. Reduced Nicotine Cigarette Studies, Novel Tobacco Products Study, Nicotine Film Pharmacokinetics Study, TXT2QUIT Chantix Study, Get Quit- Stay Quit, TXT2STAYQUIT Inpatient Texting Study, E-cig fMRI Study, PASS (Appalachia/Non-Daily Smokers) Study, E_cig Switching Study, Nicotine Film Cessation Study)
Yes
No
Which study did you participate in most recently?
Reduced Nicotine Cigarettes (Low SES)
Reduced Nicotine Cigarettes (Mood & Anxiety Disorders)
Reduced Oxidant or Nicotine Content Cigarettes Lab Study
Novel Tobacco Products Study
Nicotine Film Pharmacokinetics Study
TXT2QUIT Chantix Study
Get Quit- Stay Quit
TXT2STAYQUIT Inpatient Texting Study
E-cig fMRI Study
PASS (Appalachia/Non-Daily Smokers) Study
E-cig Switching Study
Nicotine Film Cessation Study
VLN and fMRI study
E-cig Blood Nicotine and fMRI study
Other
Reduced Nicotine Cigarettes (Low SES)
Reduced Nicotine Cigarettes (Mood & Anxiety Disorders)
Reduced Oxidant or Nicotine Content Cigarettes Lab Study
Novel Tobacco Products Study
Nicotine Film Pharmacokinetics Study
TXT2QUIT Chantix Study
Get Quit- Stay Quit
TXT2STAYQUIT Inpatient Texting Study
E-cig fMRI Study
PASS (Appalachia/Non-Daily Smokers) Study
E-cig Switching Study
Nicotine Film Cessation Study
VLN and fMRI study
E-cig Blood Nicotine and fMRI study
Other
How long ago did you complete this study?
Days
Months
Years
How many days ago did you complete the study?
How many months ago did you complete the study?
How many years ago did you complete the study?
Please list any of our other studies that you have participated in:
Are any members of your household currently enrolled in one of our studies?
Yes
No
Which study are they enrolled in?
E-cig Switching Study
Nicotine Film Cessation Study
E-cig Blood Nicotine fMRI Study
VLN Cigarettes and fMRI Study
E-cig Aerosol Study
E-cig Cue Reactivity Study
VLN and E-cig Study
Other
E-cig Switching Study
Nicotine Film Cessation Study
E-cig Blood Nicotine fMRI Study
VLN Cigarettes and fMRI Study
E-cig Aerosol Study
E-cig Cue Reactivity Study
VLN and E-cig Study
Other
Have any members of your household participated in one of our studies in the past two months?
Yes
No
Which study did they participate in?
E-cig Switching Study
Nicotine Film Cessation Study
E-cig Blood Nicotine fMRI Study
VLN Cigarettes and fMRI Study
E-cig Switching Study
Nicotine Film Cessation Study
E-cig Blood Nicotine fMRI Study
VLN Cigarettes and fMRI Study
Would you like to be contacted about future research studies on mood disorders within the Penn State Department of Psychiatry and Behavioral Health? This registry includes both individuals with and without mood disorders. If you answer yes, we will provide your name, phone number, address, and email to the Mood Disorders Research Registry so you can be notified about future research opportunities.
Yes
No
Please provide your contact information below so that we may contact you if you are eligible for any of our current research studies. By providing your contact information, you are consenting to allow us to contact you in the future regarding research opportunities.
What is your first name?
* must provide value
What is the best phone number to reach you at?
Please provide the area code first followed by the number
Extension (if necessary):
Are you able to be contacted via text message at this phone number?
Yes
No
Is there a particular time of day that is best to reach you? If so, please let us know below.
Do you have an email address where we can reach you?
Please enter your mailing address where we can contact you.
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