National Youth Tobacco Surveys (NYTS) 2015-2017

Forms and Documents

Document Name	Status
Instrument Testing Activities Form and Instruction	Unchanged
Form I-1 National Youth Tobacco Survey 2016 Questionnaire Form and Instruction	Modified
Teachers Data Collection Checklist Form	Unchanged
Change Request (20151203).docx Justification for No Material/Nonsubstantive Change	2015-12-03
Att I-8. Crosswalk 2015 to 2016 NYTS (20151203).docx Supplementary Document	2015-12-03
I-8. Crosswalk from 2015 to 2016 NYTS (20151106).docx Supplementary Document	2015-11-16
Change Request (20151106).docx Justification for No Material/Nonsubstantive Change	2015-11-16
Change Requst 1 20 2015.docx Justification for No Material/Nonsubstantive Change	2015-01-21
Attachment I8_Summary of Changes 2015 NYTS 2015.01.12.docx Supplementary Document	2015-01-14
Attachment L_NYTS Sampling Plan_JUNE 04.docx Supplementary Document	2014-12-15
Attachment K_SampleTable Shells.doc Supplementary Document	2014-12-15
Attachment J_CDC IRB Approval 12 01 2014.docx Supplementary Document	2014-12-15
Attachment D_Publications from Prior Cycles of the National Youth Tobacco Survey.doc Supplementary Document	2014-12-15
Attachment C_State Tobacco Control Reports that Cite National Youth Tobacco Survey Data.doc Supplementary Document	2014-12-15
Attachment B2_Summary of Public Comments 12 12 2014.pdf Supplementary Document	2014-12-15
Attachment B1_60-day FRN 6 25 2014.pdf Supplementary Document	2014-12-15
Attachment A_Authorizing Legislation.doc Supplementary Document	2014-12-15
NYTS Part B 2015.01.14.doc Supporting Statement B	2015-01-14
NYTS Part A 2015.01.14.doc Supporting Statement A	2015-01-14

IC Document Collections

IC ID	Document Title	Status
7087	Recruitment of States Instruction	Unchanged
214643	Instrument Testing Activities Form and Instruction	Unchanged
185555	National Youth Tobacco Survey 2016 Questionnaire Form and Instruction	Modified
185554	Teachers Data Collection Checklist Form	Unchanged
185553	Recruitment of Schools Instruction	Unchanged
185552	Recruitment of Districts Instruction	Unchanged

ICR Details

OMB Control No: 0920-0621	ICR Reference No: 201511-0920-010
Status: Historical Active	Previous ICR Reference No: 201501-0920-019
Agency/Subagency: HHS/CDC	Agency Tracking No: 16EA
Title: National Youth Tobacco Surveys (NYTS) 2015-2017
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 with change	Conclusion Date: 12/03/2015
	Date Received in OIRA: 11/20/2015
Terms of Clearance: This clearance is based on the expectation that the survey instrument will be revised to maintain relevance with emerging tobacco use behaviors control policies. Developmental testing of new survey content and incremental improvements to existing wording on the approved instrument (including dropping/adding of a small proportion of the questions), in a manner such that the overall content remains consistent with topics already covered, may be done through non-substantive changes. Other types of changes may require revisions. In addition, over the next three years, CDC will conduct a peer review of the statistical design to determine whether any aspects need to be refreshed. Before OMB extends approval of the NYTS past 2018, CDC must brief OMB on how they have responded to that peer review.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2018	01/31/2018	01/31/2018
Responses	21,605	0	21,605
Time Burden (Hours)	15,582	0	15,582
Cost Burden (Dollars)	0	0	0

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Abstract: A revised survey instrument was not uploaded with the most recent revision. This change request is to include the 2015 NYTS.

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Authorizing Statute(s): US Code: 42 USC 241 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:
	79 FR 36067	06/25/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 74096	12/15/2014
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
Recruitment of States
Recruitment of Districts
Recruitment of Schools
Teachers Data Collection Checklist	none	Data Collection Checklist
National Youth Tobacco Survey 2016 Questionnaire	none, I-1	National Youth Tobacco Survey (NYTS) 2016 Questionnaire ,   2016 NYTS
Instrument Testing Activities	none	Instrument Testing Activities

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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	21,605	21,605	0	0	0	0
Annual Time Burden (Hours)	15,582	15,582	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: $1,561,800

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]? 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: 11/20/2015

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