Evaluation of the National Tobacco Prevention and Control Public Education Campaign

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-0923 2013 Non-Smoker Follow-up Questionnaire (Phase 2)	Form and Instruction	Modified	Available
2013 Smoker Follow-up Questionnaire (Phase 2)	Form and Instruction	Modified	Available
Form 0920-0923 Screening and Consent Process (Phase 2Survey)	Form and Instruction	Modified	Available
0920-0923 Change Request_5 29 2013.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2013-06-05	Repair queued
Att I-c. 2012 Nonsmoker Baseline Survey (D-1).pdf	Supplementary Document	Uploaded 2013-02-13	Available
Att D-2b. Nonsmoker Survey_Screenshots Rev Dec28 v2.pdf	Supplementary Document	Uploaded 2013-02-07	Available
Att I-a. 2012 Smoker_Baseline_Questionnaire (C-1).docx	Supplementary Document	Uploaded 2013-02-13	Available
Att C-2b. Smoker Survey_Screenshots Rev Dec28 v2.pdf	Supplementary Document	Uploaded 2013-02-07	Available
Att E-2. Email Notification and Reminders.doc	Supplementary Document	Uploaded 2013-02-04	Repair queued
Att F-1. KN Recruitment Procedures.DOC	Supplementary Document	Uploaded 2013-02-07	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
200741	2013 Non-Smoker Follow-up Questionnaire (Phase 2)	Form and Instruction	Modified
200739	2013 Smoker Follow-up Questionnaire (Phase 2)	Form and Instruction	Modified
200737	Screening and Consent Process (Phase 2Survey)	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-0923	ICR Reference No: 201306-0920-006
Status: Historical Active	Previous ICR Reference No: 201302-0920-014
Agency/Subagency: HHS/CDC	Agency Tracking No: 19741
Title: Evaluation of the National Tobacco Prevention and Control Public Education Campaign
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/19/2013
	Date Received in OIRA: 06/13/2013
Terms of Clearance: Previous terms continue: All communications about the evaluation results via these uses of the information, including any and all Congressional testimony, will carefully enumerate and describe any underlying limitations of the data and ensure that evaluation results are interpreted with appropriate care and caution. CDC acknowledges that study design limitations decrease their capacity to draw nationally representative conclusions about either smoking-related knowledge and behavior or the impact of the campaign on long-term quit rates in sub-populations.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2014	04/30/2014	04/30/2014
Responses	61,273	0	61,273
Time Burden (Hours)	8,765	0	8,765
Cost Burden (Dollars)	0	0	0

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Abstract: In 2012, CDC's Office on Smoking and Health (OSH) conducted baseline and follow-up surveys to assess awareness of and exposure to tobacco education advertisements that were launched in the Tips from Former Smokers campaign (TIPS Phase 1). New ads will be fielded in 2013 (TIPS Phase 2). CDC requests OMB approval conduct an additional follow-up survey in 2013.

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Authorizing Statute(s): PL: Pub.L. 111 - 31 203 Name of Law: Family Smoking Prevention and Tobacco Control Act
   US Code: 42 USC 301 Name of Law: Public Health Service Act
   PL: Pub.L. 111 - 148 4004 Name of Law: Patient Protection and Affordable Care Act
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Screening and Consent Process (Phase 2Survey)	0920-0923	Att E-2. Email Notification and Reminders
2013 Smoker Follow-up Questionnaire (Phase 2)	None	Evaluation of the National Tobacco Prevention and Control Public Education Campaign - Smoker Phase 2 Follow-up Questionnaire -
2013 Non-Smoker Follow-up Questionnaire (Phase 2)	0920-0923	Att D-2a. Nonsmoker Follow-up Survey_1 9-13

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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	61,273	61,273	0	0	0	0
Annual Time Burden (Hours)	8,765	8,765	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $2,096,533

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? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

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

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Common Form ICR:  No

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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: 06/13/2013

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