Information Collection

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

IC 239951 under ICR 202007-0910-005 · 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⚠️ Notice: This information collection may be referencing outdated material.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: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Consent Form	Yes	Yes	Printable Only
Other-Screener	Yes	Yes	Fillable Printable
Other-Screener Contact Sheet	Yes	Yes	Fillable Printable
Other-Discussion Guide	Yes	No	Printable Only
Other-Concept Rating Sheet	No		Paper Only
Other-Stimuli	Yes	No	Printable 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
	Requested	Previously Approved
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		02/13/2020
IRB Approval Letter		02/13/2020

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

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