Extended Evaluation of the National Tobacco Prevention and Control Public Education Campaign

Forms and Documents

Document Name	Status
Smoker Survey - Wave A Form	New
Non-smoker Survey - Wave D Form	New
Non-smoker Survey - Wave C Form	New
Non-smoker Survey - Wave B Form	New
Non-smoker Survey - Wave A Form	New
Smoker Survey - Wave D Form	New
Smoker Survey - Wave C Form	New
Smoker Survey - Wave B Form	New
Screener and Consent Form and Instruction	New
Att J. Source of Respondents for Each Wave of Data Collection_091015.docx Supplementary Document	2015-09-10
Att J. Source of Respondents for Each Wave of Data Collection_091015.docx Supplementary Document	2015-09-10
Att I-3. ABS Sample Postcard Reminders.docx Supplementary Document	2015-06-24
Att I-2. KnowledgePanel Email Invitation and Reminders.doc Supplementary Document	2015-06-24
Att I-1. ABS Sample Invitation Letter.docx Supplementary Document	2015-06-24
Att H. GfK Privacy and Security Procedures.doc Supplementary Document	2015-06-24
Att G. RTI IRB Approval Notice.pdf Supplementary Document	2015-06-24
Att F. KnowledgePanel Recruitment Procedures.doc Supplementary Document	2015-06-24
Att B. 60-Day Federal Register Notice.pdf Supplementary Document	2015-06-24
Att A-3. PPHF.pdf Supplementary Document	2015-06-24
Att A-2. Familly Smoking Prevention & Tobacco Control Act.pdf Supplementary Document	2015-06-24
Att A-1. Public Health Service Act.doc Supplementary Document	2015-06-24
SS Part B 0920-05PI Extended Evaluation of TPCPEC_091015.docx Supporting Statement B	2015-09-10
SS Part A 0920-15PI_09 10 15.docx Supporting Statement A	2015-09-10

IC Document Collections

IC ID	Document Title	Status
218056	Smoker Survey - Wave A Form	New
217194	Non-smoker Survey - Wave D Form	New
217193	Non-smoker Survey - Wave C Form	New
217192	Non-smoker Survey - Wave B Form	New
217191	Non-smoker Survey - Wave A Form	New
217190	Smoker Survey - Wave D Form	New
217189	Smoker Survey - Wave C Form	New
217188	Smoker Survey - Wave B Form	New
217186	Screener and Consent Form and Instruction	New

ICR Details

OMB Control No: 0920-1083	ICR Reference No: 201506-0920-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 15PI
Title: Extended Evaluation of the National Tobacco Prevention and Control Public Education Campaign
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/11/2015
	Date Received in OIRA: 07/10/2015
Terms of Clearance: 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. Also, per prior terms of clearance, approval of any future tobacco-related campaign evaluations (including future revisions of this package) will require a coordinated approach among federal partners (including CDC, FDA, NIH, and SAMHSA) on outcome measures and questionnaire items. Future data collection requests related to tobacco will include a section in supporting statement Part A describing this collaboration and what steps have been made to harmonize data elements and outcome measures as well as a description of steps taken to eliminate duplication of effort across the federal government in the area of tobacco information collection. Areas where there may be significant overlap include, but are not limited to, cessation behavior, perceptions of health risk, health status, etc.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2017	24 Months From Approved
Responses	52,000	0	0
Time Burden (Hours)	15,583	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Information will be collected in 2015 and 2016 from smokers and nonsmokers to evaluate media campaign ads scheduled for public release beginning in 2015. The media activities extend a CDC-sponsored tobacco education campaign that was initiated in 2012. Information has been collected to evaluate previous phases of the media campaign. The current plan extends the related evaluation effort.

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Authorizing Statute(s): PL: Pub.L. 111 - 31 123 Name of Law: Family Smoking Prevention and Tobacco Control
   US Code: 42 USC 241 Name of Law: Public Health Service Act
   PL: Pub.L. 111 - 148 4001 Name of Law: 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
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 10095	02/25/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 36992	06/29/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 9

IC Title	Form No.	Form Name
Non-smoker Survey - Wave A	none	Nonsmoker Survey Wave A
Screener and Consent	none	Screening and Consent Questionnaire
Smoker Survey - Wave B	none	Smoker Survey Wave B
Smoker Survey - Wave C	none	Smoker Survey Wave C
Smoker Survey - Wave D	none	Smoker Survey Wave D
Non-smoker Survey - Wave B	none	Nonsmoker Survey Wave B
Non-smoker Survey - Wave C	none	Nonsmoker Survey Wave C
Non-smoker Survey - Wave D	none	Nonsmoker Survey Wave D
Smoker Survey - Wave A	none	Smoker Survey Wave A

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ICR Summary 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	52,000	0	0	52,000	0	0
Annual Time Burden (Hours)	15,583	0	0	15,583	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new ICR.

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Annual Cost to Federal Government: $3,023,881

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: 07/10/2015

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