Information Collection

Qualitative Research to Design Advertising to Encourage Quitting Among Adult Cigarette Smokers (SGM Population) (CTP

IC 239957 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⚠️ Notice: This information collection may be referencing outdated material.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 - Virtual.docx	Other-Consent Form - Virtual
Attachment A - Consent Form In-Person.docx	Other-Consent Form - In Person
Attachment B - Participant Screener SGM OMB 3.13.20 Clean.docx	Other-Screener
Attachment C -Screener Contact.docx	Other-Screener Contact
Attachment D - Discussion Guide SGM OMB-3.13.20 Clean.docx	Other-Discussion Guide
Attachment E - Concept Rating.docx	Other-Concept Rating
Attachment F - Stimuli_SGM OMB 3.13.2020 Clean.docx	Other-Stimuli
0796 OMB Approval Memo for Research to Design Ad to Encourage Quitting Smoking (SGM Pop) 2020.docx 0796 OMB Approval Memo	IC Document
IRB Approval Letter 2020.pdf IRB Approval Letter	IC Document

IC Title:

Qualitative Research to Design Advertising to Encourage Quitting Among Adult Cigarette Smokers (SGM Population) (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	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Consent Form - Virtual	Attachment A - Consent Form - Virtual.docx	Yes	Yes	Fillable Fileable
Other-Consent Form - In Person	Attachment A - Consent Form In-Person.docx	Yes	Yes	Fillable Printable
Other-Screener	Attachment B - Participant Screener SGM OMB 3.13.20 Clean.docx	Yes	No	Paper Only
Other-Screener Contact	Attachment C -Screener Contact.docx	Yes	Yes	Fillable Fileable
Other-Discussion Guide	Attachment D - Discussion Guide SGM OMB-3.13.20 Clean.docx	Yes	No	Printable Only
Other-Concept Rating	Attachment E - Concept Rating.docx	Yes	Yes	Fillable Fileable
Other-Stimuli	Attachment F - Stimuli_SGM OMB 3.13.2020 Clean.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: 600

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	600	600
Annual IC Time Burden (Hours)	450	450
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0796 OMB Approval Memo	0796 OMB Approval Memo for Research to Design Ad to Encourage Quitting Smoking (SGM Pop) 2020.docx	02/13/2020
IRB Approval Letter	IRB Approval Letter 2020.pdf	02/13/2020

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