2012 - 2014 National Youth Tobacco Survey (NYTS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
2012 NYTS OMB Part B_12 20 2011.doc	Supporting Statement B	Uploaded 2011-12-22	Available
Attachment L. Detailed Sampling and Weighting Plan - 06 08 2011.doc	Supplementary Document	Uploaded 2011-09-15	Available
Attachment K. SampleTable Shells - 06 08 2011.doc	Supplementary Document	Uploaded 2011-09-15	Available
Attachment J. IRB-Cont-Exp-Memo.12.10.docx	Supplementary Document	Uploaded 2011-09-15	Repair queued
Attachment I-8. Summary of Questionnaire Changes_ 12 20 2011.doc	Supplementary Document	Uploaded 2011-12-21	Repair queued
Attachment D. Publications from Prior Cycles of the NYTS - 2011_05_24.doc	Supplementary Document	Uploaded 2011-09-15	Available
Attachment B-2. Public Comments and CDC Response.pdf	Supplementary Document	Uploaded 2011-09-15	Available
Attachment B-1. Federal Register Notice.pdf	Supplementary Document	Uploaded 2011-09-15	Available
Attachment A. Authorizing Legislation.doc	Supplementary Document	Uploaded 2011-09-15	Available
Attachment I-6. Parental permission form reminder notice (Spanish version) 06 08 2011.doc	Supplementary Document	Uploaded 2011-09-15	Repair queued
Attachment I-5. Parental Permission Form Reminder Notice (English version) - 06 08 2011.doc	Supplementary Document	Uploaded 2011-09-15	Repair queued
Attachment I-3. Parental Permission Form and Fact Sheet (English version) - 06 08 2011.doc	Supplementary Document	Uploaded 2011-09-15	Repair queued
Attachment I-4. Parental Permission Form and Fact Sheet (Spanish Version) - 06 08 2011.doc	Supplementary Document	Uploaded 2011-09-15	Repair queued
Attachment I-2. Parental Permission Form Distribution Script - 06 08 2011.doc	Supplementary Document	Uploaded 2011-09-15	Repair queued
Attachment H-2. Letter to Teachers in Participating Schools - 06 08 2011.doc	Supplementary Document	Uploaded 2011-09-15	Repair queued
Attachment G-3. Letter to Agreeing Schools - 06 08 2011.doc	Supplementary Document	Uploaded 2011-09-15	Available
Attachment G-2. School Letter of Invitation and NYTS Fact Sheet - 06 08 2011.doc	Supplementary Document	Uploaded 2011-09-15	Available
Attachment F-2. Districtl Letter of Invitation - 06 08 2011.doc	Supplementary Document	Uploaded 2011-09-15	Available
Attachment E-2. State Letter of Invitation - 06 08 2011.doc	Supplementary Document	Uploaded 2011-09-15	Repair queued
2012 NYTS OMB Part A_12 20 2011.doc	Supporting Statement A	Uploaded 2011-12-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7087	RECRUITMENT OF STATES	Other-WORD	Modified
185555	STUDENTS 2012 - 2014 NATIONAL YOUTH TOBACCO SURVEYS	Other-Word	Modified
185554	TEACHERS' DATA COLLECTION CHECKLIST	Other-WORD	Modified
185553	RECRUITMENT OF SCHOOLS	Other-WORD	Modified
185552	RECRUITMENT OF DISTRICTS	Other-WORD	Modified

ICR Details

OMB Control No: 0920-0621	ICR Reference No: 201109-0920-004
Status: Historical Active	Previous ICR Reference No: 200807-0920-001
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: 2012 - 2014 National Youth Tobacco Survey (NYTS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/04/2012
	Date Received in OIRA: 09/21/2011
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2015	36 Months From Approved	01/31/2012
Responses	25,836	0	14,116
Time Burden (Hours)	18,862	0	10,213
Cost Burden (Dollars)	0	0	0

---

Abstract: CDC plans to conduct the National Youth Tobacco Survey (NYTS) in 2012-2013, and 2014. The NYTS is a nationally representative, school-based survey of students in grades 6-12. The NYTS collects information about tobacco use; knowledge and attitudes; media and advertising; access to tobacco products and enforcement of restrictions on access; school curriculum; environmental tobacco smoke exposure; and cessation.

---

Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 34997	06/15/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 58515	09/21/2011
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
RECRUITMENT OF STATES
RECRUITMENT OF DISTRICTS
RECRUITMENT OF SCHOOLS
TEACHERS' DATA COLLECTION CHECKLIST
STUDENTS 2012 - 2014 NATIONAL YOUTH TOBACCO SURVEYS

---

ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	25,836	14,116	0	11,720	0	0
Annual Time Burden (Hours)	18,862	10,213	0	8,649	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a revision. The increase in burden are attributable to an increase in the frequency of data collection (from biennial to annual), and to increase representation of minority youth in the sample.

---

Annual Cost to Federal Government: $615,400

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 09/21/2011

---