Non-Substantive Change Request 04JUN2021

Change Request

Proposed Changes to the National Tobacco Education Campaign Survey

(OMB No. 0920-1083 Exp. Date 3/31/2023)

Summary

This is to request OMB approval of non-substantive modifications to the 2020-2022 National Tobacco Education Campaign survey. Specifically, we request the inclusion of COVID-19 as an option in three currently approved questions.

Attachments

-Attachment_K_NonSub_Change_Crosswalk_2020_to_2023_NTEC_Evaluation_(OMB_0920-1083)

-Attachment L1_Waves A-I Smoker NTEC Survey Modification _English

-Attachment L2_Waves A-I Smoker NTEC Survey Modification _Spanish

-Attachment M 1_Waves A-I Nonsmoker NTEC Survey Modification _English

-Attachment M 2_Waves A-I Nonsmoker NTEC Survey Modification _Spanish

Background and Justification

This request is to make non-substantive changes to an existing OMB approved (#0920-1083) online survey that is used to collect information to evaluate the CDC’s Tips From Former Smokers® campaign. To consider the potential impact of COVID-19 on cigarette smoking cessation and the potential impact on campaign outcomes (e.g. calls to the quitline (1-800-QUIT-NOW), smoking cessation behaviors), we are proposing to add one additional response related to COVID-19, to 3 existing questions, e.g. “When you last tried to quit smoking, did any of the following motivate you to try to quit?'(among 7 options, “concerns about COVID-19”, is an option); 'Do you believe cigarette smoking is related to...' (there are 20 choices and “COVID-19” is included); 'Have you been diagnosed by a physician or other qualified medical professional with any of the following medical conditions?' (there are 25 choices and “COVID-19” is included in the list). The proposed modifications are included in the supporting information immediately below in Table 1. These are the only changes that are being requested in this change request. The table below illustrates where in the questionnaire changes are proposed under each section.

Table 1 List of Changes to the NTEC Evaluation
Section	Previously Approved Text	New Text	Reason For Change
SECTION C: Smoking Cessation	C5 (smoker survey); NB5 (nonsmoker survey). When you last tried to quit smoking, did any of the following motivate you to try to quit? Statements in row: C5_1. A family member or friend encouraged me to try to quit C5_2. Anti-tobacco television commercials, online ads or videos, radio ads, or other types of advertisements that focus on the health consequences of smoking C5_3. My doctor or other health professional advised me to quit smoking C5_4. Workplace restrictions on smoking C5_5. Cost of cigarettes is too high C5_6. Other, please specify: [O] _____	C5 (smoker survey); NB5 (nonsmoker survey) When you last tried to quit smoking, did any of the following motivate you to try to quit? Statements in row: C5_1. A family member or friend encouraged me to try to quit C5_2. Anti-tobacco television commercials, online ads or videos, radio ads, or other types of advertisements that focus on the health consequences of smoking C5_3. My doctor or other health professional advised me to quit smoking C5_4. Workplace restrictions on smoking C5_5. Cost of cigarettes is too high C5_6. Concern about COVID-19 C5_7. Other, please specify: [O] _____	To consider the potential impact of COVID-19 on cigarette smoking cessation.
SECTION D: Attitudes And Beliefs Related To Cessation	D21 (smoker survey); NC1 (nonsmoker survey. Do you believe cigarette smoking is related to: Statements in row (randomize and record response order): D21_1. Lung Cancer D21_2. Cancer of the mouth or throat D21_3. Heart Disease D21_4. Diabetes D21_5. Emphysema D21_6. Stroke D21_7. Hole in throat (stoma or tracheotomy) D21_8. Buerger’s Disease D21_9. Amputations (removal of limbs) D21_10. Asthma D21_11. Gallstones D21_12. COPD or Chronic bronchitis D21_13. Periodontal or Gum Disease D21_14. Premature birth D21_15. Colorectal Cancer D21_16. Macular degeneration or blindness D21_17. Depression D21_18. Anxiety Disorder D21_19. Colon Cancer Answers in columns: 1. Yes 2. No	D21 (smoker survey); NC1 (nonsmoker survey Do you believe cigarette smoking is related to: Statements in row (randomize and record response order): D21_1. Lung Cancer D21_2. Cancer of the mouth or throat D21_3. Heart Disease D21_4. Diabetes D21_5. Emphysema D21_6. Stroke D21_7. Hole in throat (stoma or tracheotomy) D21_8. Buerger’s Disease D21_9. Amputations (removal of limbs) D21_10. Asthma D21_11. Gallstones D21_12. COPD or Chronic bronchitis D21_13. Periodontal or Gum Disease D21_14. Premature birth D21_15. Colorectal Cancer D21_16. Macular degeneration or blindness D21_17. Depression D21_18. Anxiety Disorder D21_19. Colon Cancer D21_20. COVID-19 Answers in columns: 1. Yes 2. No	To consider perceptions of the relationship of COVID-19 and cigarette smoking.
SECTION G: Closing Questions	G15. Have you been diagnosed by a physician or other qualified medical professional with any of the following medical conditions? You may choose not to answer the question by simply clicking “Next”. Statements in row (randomize and record response order, with G15_24 always last): G15_1. Acid reflux disease G15_2. ADHD or ADD G15_3. Anxiety disorder G15_4. Asthma, chronic bronchitis, or COPD G15_5. Cancer (any type except skin cancer) G15_6. Chronic pain (such as low back pain, neck pain, or Fibromyalgia) G15_7. Depression G15_8. Diabetes G15_9. Heart attack G15_10. Heart disease G15_11. High blood pressure G15_12. High cholesterol G15_13. HIV/AIDS G15_14. Kidney disease G15_15. Mental health condition G15_16. Multiple sclerosis G15_17. Osteoarthritis, joint pain or inflammation G15_18. Osteoporosis or osteopenia G15_19. Rheumatoid arthritis G15_20. Seasonal allergies G15_21. Skin cancer G15_22. Sleep disorders such as sleep apnea or insomnia G15_23. Stroke G15_24. Something else [anchor] Answers in columns: 1. Yes 2. No	G15 Have you been diagnosed by a physician or other qualified medical professional with any of the following medical conditions? You may choose not to answer the question by simply clicking “Next”. Statements in row (randomize and record response order, with G15_24 always last): G15_1. Acid reflux disease G15_2. ADHD or ADD G15_3. Anxiety disorder G15_4. Asthma, chronic bronchitis, or COPD G15_5. Cancer (any type except skin cancer) G15_6. Chronic pain (such as low back pain, neck pain, or Fibromyalgia) G15_7. Depression G15_8. Diabetes G15_9. Heart attack G15_10. Heart disease G15_11. High blood pressure G15_12. High cholesterol G15_13. HIV/AIDS G15_14. Kidney disease G15_15. Mental health condition G15_16. Multiple sclerosis G15_17. Osteoarthritis, joint pain or inflammation G15_18. Osteoporosis or osteopenia G15_19. Rheumatoid arthritis G15_20. Seasonal allergies G15_21. Skin cancer G15_22. Sleep disorders such as sleep apnea or insomnia G15_23. Stroke G15_24. COVID-19 G15_25. Something else [anchor] Answers in columns: 1. Yes 2. No	To consider the potential association of COVID-19 on cigarette smoking cessation.

Effect of Proposed Changes on the Burden Estimate

No increases are anticipated in the currently approved estimated burden, (Table A.12.1. Estimated Annualized Burden Hours) presented below in Table 2.

Table 2
Original: Table A.12.1. Estimated Annualized Burden Hours
(Type of) Respondents	Form Name	Number of Respondents	Number of Responses per Respondent	Average Burden per Response (in Hours)	Total Burden (in Hours)
General Population	Screening & Consent (English)	16,167	1	5/60	1,347
	Screening & Consent (Spanish)	500	1	5/60	42
Adult Smokers, ages 18-54, in the United States	Smoker Survey Wave A (English)	2,587	1	20/60	862
	Smoker Survey Wave A (Spanish)	80	1	20/60	27
	Smoker Survey Wave B (English)	1,617	1	20/60	539
	Smoker Survey Wave B (Spanish)	50	1	20/60	17
	Smoker Survey Wave C (English)	1,617	1	20/60	539
	Smoker Survey Wave C (Spanish)	50	1	20/60	17
	Smoker Survey Wave D (English)	1,617	1	20/60	539
	Smoker Survey Wave D (Spanish)	50	1	20/60	17
	Smoker Survey Wave E (English)	1,617	1	20/60	539
	Smoker Survey Wave E (Spanish)	50	1	20/60	17
	Smoker Survey Wave F (English)	1,617	1	20/60	539
	Smoker Survey Wave F (Spanish)	50	1	20/60	17
	Smoker Survey Wave G (English)	1,617	1	20/60	539
	Smoker Survey Wave G (Spanish)	50	1	20/60	17
	Smoker Survey Wave H (English)	1,617	1	20/60	539
	Smoker Survey Wave H (Spanish)	50	1	20/60	17
	Smoker Survey Wave I (English)	1,617	1	20/60	539
	Smoker Survey Wave I (Spanish)	50	1	20/60	17
Adult Nonsmokers, ages 18-54, in the United States	Nonsmoker Survey Wave A (English)	1,000	1	20/60	333
	Nonsmoker Survey Wave A (Spanish)	100	1	20/60	33
	Nonsmoker Survey Wave B (English)	808	1	20/60	269
	Nonsmoker Survey Wave B (Spanish)	25	1	20/60	8
	Nonsmoker Survey Wave C (English)	808	1	20/60	269
	Nonsmoker Survey Wave C (Spanish)	25	1	20/60	8
	Nonsmoker Survey Wave D (English)	808	1	20/60	269
	Nonsmoker Survey Wave D (Spanish)	25	1	20/60	8
	Nonsmoker Survey Wave E (English)	808	1	20/60	269
	Nonsmoker Survey Wave E (Spanish)	25	1	20/60	8
	Nonsmoker Survey Wave F (English)	808	1	20/60	269
	Nonsmoker Survey Wave F (Spanish)	25	1	20/60	8
	Nonsmoker Survey Wave G (English)	808	1	20/60	269
	Nonsmoker Survey Wave G (Spanish)	25	1	20/60	8
	Nonsmoker Survey Wave H (English)	808	1	20/60	269
	Nonsmoker Survey Wave H (Spanish)	25	1	20/60	8
	Nonsmoker Survey Wave I (English)	808	1	20/60	269
	Nonsmoker Survey Wave I (Spanish)	25	1	20/60	8
	Total				9,311

Effect of Proposed Changes on Currently Approved Instruments and Attachments

The following table describes those attachments which have the requested changes to the National Tobacco Education Campaign Survey (OMB No. 0920-1083 Exp. Date 3/31/2023). All updates are highlighted in yellow in Table 1 of this document.

Change Request Attachment Title

Attachment K Crosswalk of Non-Substantive Questionnaire Changes, 2020 to 2023 NTEC

Attachment L1 Waves A-I Smoker NTEC Survey Modification _English

Attachment L2 Waves A-I Smoker NTEC Survey Modification _Spanish

Attachment M1 Waves A-I Nonsmoker NTEC Survey Modification _English

Attachment M2 Waves A-I Nonsmoker NTEC Survey Modification _Spanish

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