Information Collection

The Population Assessment of Tobacco and Health (PATH) Study- Focus Groups to Support Development of E-Cigarette and Hookah Questionnaire Items

IC 210595 under ICR 201303-0925-001 · OMB 0925-0675.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0675 can be found here:

Documents and Forms

Document Name Document Type
Form B. The Population Assessment of Tobacco and Health (PATH) Study- Focus Groups to Support Development of E-Cigarette and Hookah Questionnaire Items Form and Instruction
B. Screener for E-cigarette and Hookah Focus focus group B. E-cigarette hookah focus group screener 2-20-14.pdf Form and Instruction
C. E-Cigarette Focus Group Moderator Guide C. E-cigarette moderators guide 2-20-14.pdf Form and Instruction
D, Hookah Moderator's Guide D. Hookah moderators guide_in person 2-20-14.pdf Form and Instruction
E. Hookah Focus Group Moderator Guide - Online E. Hookah moderators guide_online 2-20-14.pdf Form and Instruction
F. Consent for Participation in a In-person Focus Group for F. In-person focus group consent form_2-20-14 (1).pdf Form and Instruction
E-cig Hookah Focus Groups -- the PATH Study Generic Clearance for Methodological Studies 2-20-14.docx E-cig Hookah Focus Groups IC Document
A. Recruitment materials 2-20-14.pdf A. Recruitment Materials IC Document
0675 PATH Generic E-cig Hookah ASPE Comments and PCB note 03.03.2014.doc ASPE Comments IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	The Population Assessment of Tobacco and Health (PATH) Study- Focus Groups to Support Development of E-Cigarette and Hookah Questionnaire Items	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	B.	Screener for E-cigarette and Hookah Focus focus group	B. E-cigarette hookah focus group screener 2-20-14.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	C.	E-Cigarette Focus Group Moderator Guide	C. E-cigarette moderators guide 2-20-14.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	D,	Hookah Moderator's Guide	D. Hookah moderators guide_in person 2-20-14.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	E.	Hookah Focus Group Moderator Guide - Online	E. Hookah moderators guide_online 2-20-14.pdf	Yes	Yes	Fillable Fileable
Form and Instruction	F.	Consent for Participation in a In-person Focus Group for the PATH Study	F. In-person focus group consent form_2-20-14 (1).pdf	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title: 09-25-0200	FR Citation: 67 FR 60741

Number of Respondents: 218	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	218	0	0	0	0	0
Annual IC Time Burden (Hours)	115	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
E-cig Hookah Focus Groups	E-cig Hookah Focus Groups -- the PATH Study Generic Clearance for Methodological Studies 2-20-14.docx	02/21/2014
A. Recruitment Materials	A. Recruitment materials 2-20-14.pdf	02/21/2014
ASPE Comments	0675 PATH Generic E-cig Hookah ASPE Comments and PCB note 03.03.2014.doc	03/03/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.