Information Collection

Point-of-Sale Campaign: Online Quantitative Study of Reactions to Rough-Cut Advertising Designed to Encourage Adult Smokers to Quit Smoking

IC 223487 under ICR 201411-0910-008 · OMB 0910-0810.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0810 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Attachment A_Informed Consent Form.docx	Other-Informed Consent Form
Attachment B_Screener.docx	Other-Screener
Attachment C_Copy Testing Questionnaire.docx	Other-Copy Testing Questionnaire
Attachment D_ Advertisement Stimuli 1.pdf	Other-Advertisement Stimuli 1
Attachment D_ Advertisement Stimuli 2.pdf	Other-Advertisement Stimuli 2
Attachment F_Recruitment Email Script.docx	Other-Recruitment Email Script
Part A - Quantitative Supporting Statement (POS Campaign).docx Part A - Quantitative Supporting Statement (POS Campaign)	IC Document
Part B - Quantitative Supporting Statement (POS Campaign).docx Part B - Quantitative Supporting Statement (POS Campaign)	IC Document
Attachment E_IRB Approval Letter.pdf IRB Approval Letter	IC Document

IC Title:

Point-of-Sale Campaign: Online Quantitative Study of Reactions to Rough-Cut Advertising Designed to Encourage Adult Smokers to Quit Smoking

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?	Can Be Submitted Electronically?	Electronic Capability
Other-Informed Consent Form	Attachment A_Informed Consent Form.docx	Yes	Yes	Fillable Fileable
Other-Screener	Attachment B_Screener.docx	Yes	Yes	Fillable Fileable
Other-Copy Testing Questionnaire	Attachment C_Copy Testing Questionnaire.docx	Yes	Yes	Fillable Fileable
Other-Advertisement Stimuli 1	Attachment D_ Advertisement Stimuli 1.pdf	No		Printable Only
Other-Advertisement Stimuli 2	Attachment D_ Advertisement Stimuli 2.pdf	No		Printable Only
Other-Recruitment Email Script	Attachment F_Recruitment Email Script.docx	Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 8,816

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	8,816	8,816
Annual IC Time Burden (Hours)	1,305	1,305
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Part A - Quantitative Supporting Statement (POS Campaign)	Part A - Quantitative Supporting Statement (POS Campaign).docx	09/19/2016
Part B - Quantitative Supporting Statement (POS Campaign)	Part B - Quantitative Supporting Statement (POS Campaign).docx	09/19/2016
IRB Approval Letter	Attachment E_IRB Approval Letter.pdf	09/19/2016

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