OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Evaluation of the National Tobacco Prevention and Control Public Education Campaign

ICR 201201-0920-004 · OMB 0920-0923 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Non-Smoker Follow-up Questionnaire Form New Available
Non-Smoker Baseline Questionnaire Form New Repair queued
Smoker Follow-up Questionnaire Form New Repair queued
Smoker Baseline Questionnaire Form New Repair queued
Screening and Consent Form New Repair queued
Att I-1 Primary Secondary Outcomes and Survey Items.doc Supplementary Document Uploaded 2012-02-17 Repair queued
SS Part B_1-6-12 (REVISED 2-16-12)_(Alternate) Clean (1).docx Supporting Statement B Uploaded 2012-02-17 Available
Att F-1. KN Recruitment Procedures.DOC Supplementary Document Uploaded 2012-01-05 Available
Att H-2. Yeager et al POQ 2011.pdf Supplementary Document Uploaded 2012-01-05 Available
Att H-1. Chang & Krosnick Internet Surveys POQ 2009.pdf Supplementary Document Uploaded 2012-01-05 Repair queued
Att G. RTI IRB Approval Notice 12-06-11.pdf Supplementary Document Uploaded 2012-01-05 Available
Att F-2. KN Privacy and Security Procedures.doc Supplementary Document Uploaded 2012-01-05 Repair queued
Att B-2. Summary of Public Comments.doc Supplementary Document Uploaded 2012-01-05 Repair queued
Att B-1. Federal Register Notice.pdf Supplementary Document Uploaded 2012-01-05 Available
Att A-3. Public Law 111-148 Section 4004.pdf Supplementary Document Uploaded 2012-01-05 Available
Att A-2. Public Law 111-31 FSPTCA.PDF Supplementary Document Uploaded 2012-01-05 Available
Att A-1. Public Health Service Act.doc Supplementary Document Uploaded 2012-01-05 Repair queued
Att E-2 Email Notification and Reminders_1-6-12 (REVISED 2-7-12).doc Supplementary Document Uploaded 2012-02-17 Available
SS Part A_1-6-12 (REVISED 2-16-12)_(Alternate) Clean (1).docx Supporting Statement A Uploaded 2012-02-17 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
200741 Non-Smoker Follow-up Questionnaire Form New
200740 Non-Smoker Baseline Questionnaire Form New
200739 Smoker Follow-up Questionnaire Form New
200738 Smoker Baseline Questionnaire Form New
200737 Screening and Consent Form New
ICR Details
0920-0923 201201-0920-004
Historical Active
HHS/CDC
Evaluation of the National Tobacco Prevention and Control Public Education Campaign
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 02/17/2012
Retrieve Notice of Action (NOA) 01/11/2012
Approved consistent with the following terms: All communications about the evaluation results via these uses of the information, including any and all Congressional testimony, will carefully enumerate and describe any underlying limitations of the data and ensure that evaluation results are interpreted with appropriate care and caution. CDC acknowledges that study design limitations decrease their capacity to draw nationally representative conclusions about either smoking-related knowledge and behavior or the impact of the campaign on long-term quit rates in sub-populations.
  Inventory as of this Action Requested Previously Approved
02/28/2013 12 Months From Approved
55,926 0 0
10,015 0 0
0 0 0
CDC's Office on Smoking and Health (OSH) requests OMB approval of baseline and follow-up data collection to assess awareness of and exposure to tobacco education campaign advertisements that will be launched early in 2012. In addition, information will be collected about smokers' and non-smokers' knowledge, attitudes and beliefs related to smoking.
PL: Pub.L. 111 - 148 4004 Name of Law: Patient Protection and Affordable Care Act
   PL: Pub.L. 111 - 31 203 Name of Law: Family Smoking Prevention and Tobacco Control Act
   US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  76 FR 40914 07/12/2011
77 FR 508 01/05/2012
Yes
  Total Approved 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 55,926 0 0 55,926 0 0
Annual Time Burden (Hours) 10,015 0 0 10,015 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new data collection.
$742,557
Yes Part B of Supporting Statement
No
Yes
No
No
Uncollected
Carol Walker 4046394773
  No
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
01/11/2012