Information Collection Request

[NCCDPHP] Menthol-Flavored Tobacco Products Policy Evaluation

ICR 202412-0920-014 · OMB unassigned · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-23FN Community Focus Group Form New Repair queued
Form 0920-23FN Focus Group Screener Questionnaire Form and Instruction New Repair queued
Form 0920-23FN Community Web Panel Survey Form New Missing upstream
Form 0920-23FN Survey Screener Questionnaire Form New Repair queued
Attachment 8b CDC IRB Approval Letter_April 2024.pdf Supplementary Document Uploaded 2024-12-18 Repair queued
14. Attatchment 8a. IRB Approval_Menthol Policy Evaluation.pdf Supplementary Document Uploaded 2024-12-18 Repair queued
8. Attatchment 4b. Focus Group Eligibility Screener_Menthol Policy Evaluation.VF.2024.10.16.docx Supplementary Document Uploaded 2024-12-18 Repair queued
6. Attatchment 3b. Consent Form - Focus Group Consent to Participate Form_Menthol Policy.docx Supplementary Document Uploaded 2024-12-18 Available
5. Attatchment 3a. Consent Form - Survey Consent to Participate_Menthol Policy Evaluatio.docx Supplementary Document Uploaded 2024-12-18 Repair queued
3. Attatchment 2a. Survey Recruitment Language_Menthol Policy Evaluation.docx Supplementary Document Uploaded 2024-12-18 Repair queued
2. Attachement 1. Authorizing Language - Public Health Service Act_Menthol Evaluation.pdf Supplementary Document Uploaded 2024-12-18 Missing upstream
15. SSB_Menthol Policy Evaluation.VF.2024.10.16.docx Supporting Statement B Uploaded 2024-12-18 Repair queued
1. SSA_Menthol Policy Evaluation.VF.2024.11.19.docx Supporting Statement A Uploaded 2024-12-18 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
273140 Community Focus Group Form New
273139 Focus Group Screener Questionnaire Form and Instruction New
273138 Community Web Panel Survey Form New
273137 Survey Screener Questionnaire Form New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
15,411 0
1,751 0
0 0





Reginfo record details
4
table that charts list of burden
IC Title Form No. Form Name
Community Focus Group 0920-23FN Focus Group Moderator Guide
Community Web Panel Survey 0920-23FN Web-Based Data Collection Pages
Focus Group Screener Questionnaire 0920-23FN Survey
Survey Screener Questionnaire 0920-23FN Survey Eligibility Screener Screener

table that charts list of burden
  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 15,411 0 0 15,411 0 0
Annual Time Burden (Hours) 1,751 0 0 1,751 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No