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
Non-smoker Follow-up Survey Wave 4	Form	Unchanged	Available
Non-smoker Follow-up Survey Wave 3	Form	Unchanged	Available
Non-smoker Follow-up Survey Wave 2	Form	Unchanged	Available
Smoker Follow-up Survey Wave 5	Form	Unchanged	Available
Smoker Follow-up Survey Wave 4	Form	Unchanged	Repair queued
Smoker Follow-up Survey Wave 3	Form	Unchanged	Available
Smoker Follow-up Survey Wave 2	Form	Unchanged	Available
Non-Smoker Survey Wave 1	Form	Unchanged	Available
Smoker Wave 1 Survey	Form and Instruction	Unchanged	Available
Screening and Consent	Form	Unchanged	Repair queued
0920-0923 Change Request Justification_8-07-14.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2014-08-07	Available
Attachment C-3 REVISED Smoker Follow-Up Survey (Waves 2-5).docx	Supplementary Document	Uploaded 2014-08-07	Available
Attachment C-5 REVISED Nonsmoker Follow-Up (Waves 2-5).docx	Supplementary Document	Uploaded 2014-08-07	Available
SS Part B_01 31 2014.docx	Supporting Statement B	Uploaded 2014-02-10	Available
Attachment G-3 ABS Sample Post Card Reminders.docx	Supplementary Document	Uploaded 2014-02-10	Repair queued
Attachment G-2 KnowledgePanel Email Invitation Reminders 1-15-14.doc	Supplementary Document	Uploaded 2014-02-10	Available
Attachment G-1 ABS Sample Invitation Letter 2 6 2014.docx	Supplementary Document	Uploaded 2014-02-10	Repair queued
Attachment F-1 GfK Privacy and Security Procedures.doc	Supplementary Document	Uploaded 2014-02-10	Available
Attachment E-1 RTI IRB Approval Notice.pdf	Supplementary Document	Uploaded 2014-02-10	Available
Attachment D-1 KnowledgePanel Recruitment Procedures.DOC	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-6 Summary of Key Construct Changes.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment B-2 Summary of Public Comments.pdf	Supplementary Document	Uploaded 2014-02-10	Available
Attachment B-1 Federal Register Notice.pdf	Supplementary Document	Uploaded 2014-02-10	Repair queued
Attachment A-3 PPHF.pdf	Supplementary Document	Uploaded 2014-02-10	Available
Attachment A-2 Familly Smoking Prevention & Tobacco Control Act.PDF	Supplementary Document	Uploaded 2014-02-10	Available
Attachment A-1 Public Health Service Act.doc	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-5 (Spanish) 2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-5 (Spanish) 2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-5 Nonsmoker Follow-Up Survey (Waves 2-5) 2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-5 (Spanish) 2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-5 Nonsmoker Follow-Up Survey (Waves 2-5) 2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-3 (Spanish) 2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-3 Smoker Follow-Up Survey (Waves 2-5)_2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-3 (Spanish) 2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Repair queued
Attachment C-3 Smoker Follow-Up Survey (Waves 2-5)_2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Repair queued
Attachment C-3 (Spanish) 2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-3 Smoker Follow-Up Survey (Waves 2-5)_2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Repair queued
Attachment C-3 (Spanish) 2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-2 (Spanish) 2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-2 Smoker Wave 1 Survey_2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-4 Nonsmoker Wave 1 Survey 2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Repair queued
Attachment C-4 (Spanish) 2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-2 Smoker Wave 1 Survey_2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-2 (Spanish) 2-6-14.docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-1 Screening Questionnaire 2-6-14 (FINAL).docx	Supplementary Document	Uploaded 2014-02-10	Available
Attachment C-1 (Spanish) 2-6-14.doc	Supplementary Document	Uploaded 2014-02-10	Available
SS Part A_02 06 2014.docx	Supporting Statement A	Uploaded 2014-02-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
210363	Non-smoker Follow-up Survey Wave 4	Form	Unchanged
210362	Non-smoker Follow-up Survey Wave 3	Form	Unchanged
210361	Non-smoker Follow-up Survey Wave 2	Form	Unchanged
210360	Smoker Follow-up Survey Wave 5	Form	Unchanged
210359	Smoker Follow-up Survey Wave 4	Form	Unchanged
210358	Smoker Follow-up Survey Wave 3	Form	Unchanged
210357	Smoker Follow-up Survey Wave 2	Form	Unchanged
200741	Non-Smoker Survey Wave 1	Form	Unchanged
200739	Smoker Wave 1 Survey	Form and Instruction	Unchanged
200737	Screening and Consent	Form	Unchanged

ICR Details

OMB Control No: 0920-0923	ICR Reference No: 201408-0920-002
Status: Historical Inactive	Previous ICR Reference No: 201402-0920-011
Agency/Subagency: HHS/CDC	Agency Tracking No: 21420
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: Improperly submitted and continue	Conclusion Date: 09/02/2014
	Date Received in OIRA: 08/11/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2017	03/31/2017	03/31/2017
Responses	28,447	0	28,447
Time Burden (Hours)	8,777	0	8,777
Cost Burden (Dollars)	0	0	0

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Abstract: CDC requests non-substantive changes to portions of this data collection activity due to the rapidly changing landscape of electronic vapor products and their advertising.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 4004 Name of Law: Patient Protection and Affordable Care Act
   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
  

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
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 69680	11/20/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 8910	02/11/2014
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 10

table that charts list of burden

IC Title	Form No.	Form Name
Screening and Consent	none, none	Screening Questionnaire - Spanish Screenshots ,   Screening Questionnaire - screenshots
Smoker Wave 1 Survey	none, none	Smoker Wave 1 Questionnaire - screenshots ,   Smoker Wave 1 Questionnaire - Spanish screenshots
Non-Smoker Survey Wave 1	none, none	Non-smoker Survey Wave 1 - Spanish screenshots ,   Non-smoker Survey Wave 1 screenshots
Smoker Follow-up Survey Wave 2	none, none	Smoker Follow-up Survey Wave 2 - screenshots ,   Smoker Follow-up Survey Wave 2 - Spanish screenshots
Smoker Follow-up Survey Wave 3	none, none	Smoker Follow-up Survey Wave 3 - Screenshots ,   Smoker Follow-up Survey Wave 3 - Spanish screenshots
Smoker Follow-up Survey Wave 4	none, none	Smoker Follow-up Survey Wave 4 - Spanish screenshots ,   Smoker Follow-up Survey Wave 4 - Screenshots
Smoker Follow-up Survey Wave 5	none, none	Smoker Follow-up Survey Wave 5 - Screenshots ,   Smoker Follow-up Survey Wave 5 - Spanish screenshots
Non-smoker Follow-up Survey Wave 2	none, none	Non-smoker Survey Wave 2 - screenshots ,   Non-smoker Survey Wave 2 - Spanish screenshots
Non-smoker Follow-up Survey Wave 3	none, none	Non-smoker Survey Wave 3 - screenshots ,   Non-smoker Follow-up Survey Wave 3 - Spanish screenshots
Non-smoker Follow-up Survey Wave 4	none, none	Non-smoker Follow-up Survey Wave 4 - screenshots ,   Non-smoker Follow-up Survey Wave 4 - Spanish screenshots

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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: CDC proposes to assess long-term campaign effects. More intensive follow-up will be conducted with a smaller number of respondents. Five surveys will be conducted with smokers and 4 surveys with non-smokers. New ICs were created for the additional follow-up surveys.

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Annual Cost to Federal Government: $3,329,673

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: 08/11/2014

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