National Adult Tobacco Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Appendix E. Item-Level Justification Related to FDAs Mission in Regulating Tobacco Products.docx	Supplementary Document	Uploaded 2012-06-20	Available
Part_B_NATS_OMB_4_26_2012.doc	Supporting Statement B	Uploaded 2012-05-08	Available
Appendix_J_Non-Disclosure_Agreement_Signed_by_Interviewers_NATS_March_2012.doc	Supplementary Document	Uploaded 2012-05-08	Available
Appendix_G_Consultants_on_the_Development_of_the_NATS_March 2012.doc	Supplementary Document	Uploaded 2012-05-08	Available
Appendix_F_Item-Level_Justification_for_Supplemental_Uses_of_Data_NATS_March_2012.docx	Supplementary Document	Uploaded 2012-05-08	Available
Appendix_D_Summary of Public Comments.pdf	Supplementary Document	Uploaded 2012-05-08	Available
Appendix_B_FDA_Logic_Model_NATS_March_2012.pdf	Supplementary Document	Uploaded 2012-05-08	Available
Appendix_K_Sample_Table_Shells_NATS_March_2012.docx	Supplementary Document	Uploaded 2012-05-08	Available
Appendix_L_Advance_Dear_Resident_Letter_NATS_March_2012.doc	Supplementary Document	Uploaded 2012-05-08	Available
Corrected addresses.docx	Supplementary Document	Uploaded 2012-05-08	Available
Appendix_A_Authorizing_Legislation_NATS_March_2012.docx	Supplementary Document	Uploaded 2012-05-08	Available
Part_A_NATS_OMB_04 15 2012.doc	Supporting Statement A	Uploaded 2012-05-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
202260	National Adult Tobacco Survey - end of cell	Instruction	New
202259	National Adult Tobacco Survey - Landline	Instruction	New
190631	National Adult Tobacco Survey Screener	Instruction	Modified
190630	National Adult Tobacco Survey Screener for landline users	Instruction	Modified

ICR Details

OMB Control No: 0920-0828	ICR Reference No: 201205-0920-003
Status: Historical Active	Previous ICR Reference No: 200911-0920-007
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: National Adult Tobacco Survey
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/30/2012
	Date Received in OIRA: 05/11/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2015	36 Months From Approved
Responses	241,000	0	0
Time Burden (Hours)	29,850	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: CDC plans to conduct three annual cycles of the National Adult Tobacco Survey (NATS) in 2012, 2013, and 2014. The NATS seeks to determine tobacco use prevalence and the factors promoting and impeding tobacco use among adults in a nationally representative sample of adults. NATS represents a partnership between CDC's Office on Smoking and Health (OSH), and the FDA's Center for Tobacco Products.

---

Authorizing Statute(s): PL: Pub.L. 111 - 301 203 Name of Law: Family Smoking Prevention and tobacco Control Act
   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:
	77 FR 1938	01/12/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 27065	05/08/2012
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
National Adult Tobacco Survey Screener for landline users
National Adult Tobacco Survey Screener
National Adult Tobacco Survey - Landline
National Adult Tobacco Survey - end of cell

---

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	241,000	0	0	241,000	0	0
Annual Time Burden (Hours)	29,850	0	0	29,850	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: The burden per response has not changed from the prior cycle of NATS. There is an overall reduction in burden due to a reduction in the number of respondents. The prior cycle of NATS was designed to generate state-level estimates. The new cycles of NATS will generate national estimates.

---

Annual Cost to Federal Government: $2,684,601

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: 05/11/2012

---