Information Collection

Electronic Nicotine Delivery Systems Formative Data Collection to Inform Experimenter and Established User Definitions

IC 235300 under ICR 201907-0910-006 · 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⚠️ Notice: This information collection may be referencing outdated material.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 SurveyENDS_StudyScreener.docx	Other-Study Screener
Attachment B SurveyENDS_Study Questionnaire.docx	Other-Study Questionnaire
Attachment C SurveyENDS_ParentRecruitmentEmail.docx	Other-Parental Recruitment Email
Attachment D SurveyENDS_ParentPermission.docx	Other-Parent Permission
Attachment E SurveyENDS_YouthAssent.docx	Other-Youth Assent
SS Part A ENDSPrimaryDataCollection.docx Supporting Statement Part A - Electronic Nicotine Delivery Systems	IC Document
SS Part B ENDSPrimaryDataCollection.docx Supporting Statement Part B - Electronic Nicotine Delivery Systems	IC Document
Attachment F ApprovalLetter_RTI-IRB_STUDY00020494_20494.pdf Approval Letter	IC Document

IC Title:

Electronic Nicotine Delivery Systems Formative Data Collection to Inform Experimenter and Established User Definitions

Agency IC Tracking Number:

CTP

IC Status: Unchanged

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-Study Screener	Attachment A SurveyENDS_StudyScreener.docx	Yes	No	Paper Only
Other-Study Questionnaire	Attachment B SurveyENDS_Study Questionnaire.docx	Yes	Yes	Fillable Fileable
Other-Parental Recruitment Email	Attachment C SurveyENDS_ParentRecruitmentEmail.docx	Yes	No	Paper Only
Other-Parent Permission	Attachment D SurveyENDS_ParentPermission.docx	Yes	No	Paper Only
Other-Youth Assent	Attachment E SurveyENDS_YouthAssent.docx	Yes	No	Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 15,110

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	15,110	15,110
Annual IC Time Burden (Hours)	1,191	1,191
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement Part A - Electronic Nicotine Delivery Systems	SS Part A ENDSPrimaryDataCollection.docx	03/12/2019
Supporting Statement Part B - Electronic Nicotine Delivery Systems	SS Part B ENDSPrimaryDataCollection.docx	03/12/2019
Approval Letter	Attachment F ApprovalLetter_RTI-IRB_STUDY00020494_20494.pdf	03/12/2019

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