Information Collection

Qualitative Study on Acute Nicotine Toxicity Warnings for E-Liquids: Knowledge, Beliefs, and Perceptions

IC 229710 under ICR 201411-0910-007 · OMB 0910-0796.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0796 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Appendix 1._Moderator Guide.docx	Other-Moderator Guide
Appendix 2._Adult Screener.docx	Other-Adult Screener
Appendix 3._Youth Screener.docx	Other-Youth Screener
Appendix 4._Study Adult Consent.doc	Other-Study Adult Consent
Appendix 5._Youth Assent.docx	Other-Youth Assent
Appendix 6._Parental Permission Form.docx	Other-Parental Permission Form
RIHSC Approval.pdf RIHSC Approval	IC Document
RTI IRB Approval Notice.pdf RTI IRB Approval Notice	IC Document
OMB Justification Memo.docx OMB Justification Memo	IC Document

IC Title:

Qualitative Study on Acute Nicotine Toxicity Warnings for E-Liquids: Knowledge, Beliefs, and Perceptions

Agency IC Tracking Number:

CTP

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Electronic Capability
Other-Moderator Guide	Appendix 1._Moderator Guide.docx	No	Printable Only
Other-Adult Screener	Appendix 2._Adult Screener.docx	No	Printable Only
Other-Youth Screener	Appendix 3._Youth Screener.docx	No	Printable Only
Other-Study Adult Consent	Appendix 4._Study Adult Consent.doc	No	Paper Only
Other-Youth Assent	Appendix 5._Youth Assent.docx	No	Paper Only
Other-Parental Permission Form	Appendix 6._Parental Permission Form.docx	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 2,304

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,304	2,304
Annual IC Time Burden (Hours)	392	392
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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