Information Collection

Qualitative Research to Design Advertising to Encourage Quitting Among Adult Cigarette Smokers (General Populations) CTP

IC 239951 under ICR 202002-0910-001 · 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⚠️ Notice: This information collection may be referencing outdated material.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
Attachment A - Consent Form.docx	Other-Consent Form
Attachment B Participant Screener.docx	Other-Screener
Attachment C - Screener Contact Sheet.docx	Other-Screener Contact Sheet
Attachment D - Discussion Guide_OMB_Clean.docx	Other-Discussion Guide
Attachment E - Concept Rating Sheet.docx	Other-Concept Rating Sheet
Attachment F - Stimuli.docx	Other-Stimuli
0796 OMB Approval Memo 2020.docx 0796 Approval Memo	IC Document
IRB Approval Letter.pdf IRB Approval Letter	IC Document

IC Title:

Qualitative Research to Design Advertising to Encourage Quitting Among Adult Cigarette Smokers (General Populations) CTP

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-Stimuli	Attachment F - Stimuli.docx	Yes	No	Printable Only
Other-Screener	Attachment B Participant Screener.docx	Yes	Yes	Fillable Printable
Other-Screener Contact Sheet	Attachment C - Screener Contact Sheet.docx	Yes	Yes	Fillable Printable
Other-Consent Form	Attachment A - Consent Form.docx	Yes	Yes	Printable Only
Other-Discussion Guide	Attachment D - Discussion Guide_OMB_Clean.docx	Yes	No	Printable Only
Other-Concept Rating Sheet	Attachment E - Concept Rating Sheet.docx	No		Paper Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 675

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	675	675
Annual IC Time Burden (Hours)	507	507
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0796 Approval Memo	0796 OMB Approval Memo 2020.docx	02/13/2020
IRB Approval Letter	IRB Approval Letter.pdf	02/13/2020

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