National Adult Tobacco Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Survey - Spanish	Form and Instruction	Modified	Available
Survey - English	Form and Instruction	Modified	Available
Survey - Spanish	Form and Instruction	Modified	Available
Survey - English	Form and Instruction	Modified	Available
0920-0828 Itemized List of Changes 8-29-2013.docx	Supplementary Document	Uploaded 2013-08-30	Available
0920-0828 Change Request Justification 8-29-2013.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2013-08-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
202260	National Adult Tobacco Survey - Cell Phone	Form and Instruction	Modified	Survey - Spanish
202260	National Adult Tobacco Survey - Cell Phone	Form and Instruction	Modified	Survey - English
202259	National Adult Tobacco Survey - Landline	Form and Instruction	Modified	Survey - Spanish
202259	National Adult Tobacco Survey - Landline	Form and Instruction	Modified	Survey - English
190631	National Adult Tobacco Survey Screener - Cell Phone	Instruction	Modified
190630	National Adult Tobacco Survey Screener - Landline	Instruction	Modified

ICR Details

OMB Control No: 0920-0828	ICR Reference No: 201309-0920-003
Status: Historical Active	Previous ICR Reference No: 201205-0920-003
Agency/Subagency: HHS/CDC	Agency Tracking No: 20424
Title: National Adult Tobacco Survey
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: 09/30/2013
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/10/2013
Terms of Clearance:

table that charts list comparision

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

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Abstract: CDC plans to conduct three annual cycles of the National Adult Tobacco Survey (NATS) in 2012, 2013, and 2014. Questionnaire content modifications are requested for administration of the survey in 2013-2014. 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.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
   PL: Pub.L. 111 - 301 203 Name of Law: Family Smoking Prevention and tobacco Control 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: 4

table that charts list of burden

IC Title	Form No.	Form Name
National Adult Tobacco Survey - Cell Phone	none, none	Survey - English ,   Survey - Spanish
National Adult Tobacco Survey - Landline	none, none	Survey - English ,   Survey - Spanish
National Adult Tobacco Survey Screener - Cell Phone
National Adult Tobacco Survey Screener - Landline

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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	241,000	241,000	0	0	0	0
Annual Time Burden (Hours)	29,850	29,850	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: $2,684,601

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

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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: 09/10/2013

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