OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Extended Evaluation of the National Tobacco Prevention and Control Public Education Campaign

ICR 202209-0920-012 · OMB 0920-1083 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-1083 Nonsmoker Survey - Wave I Form and Instruction Modified Repair queued
Form 0920-1083 Nonsmoker Survey - Wave H Form and Instruction Modified Repair queued
Form 0920-1083 Nonsmoker Survey - Wave G Form and Instruction Modified Repair queued
Form 0920-1083 Nonsmoker Survey - Wave F Form and Instruction Modified Repair queued
Form 0920-1083 Smoker Survery - Wave I Form and Instruction Modified Repair queued
Form 0920-1083 Smoker Survery - Wave H Form and Instruction Modified Repair queued
Form 0920-1083 Smoker Survery - Wave G Form and Instruction Modified Repair queued
Form 0920-1083 Smoker Survery - Wave F Form and Instruction Modified Repair queued
Form 0920-1083 Nonsmoker Survey - Wave E Form and Instruction Modified Repair queued
Form 0920-1083 Smoker Survey - Wave E Form and Instruction Modified Repair queued
Form 0920-1083 Smoker Survey - Wave A Form and Instruction Modified Repair queued
Form 0920-1083 Non-smoker Survey - Wave D Form and Instruction Modified Repair queued
Form 0920-1083 Non-smoker Survey - Wave C Form and Instruction Modified Repair queued
Form 0920-1083 Non-smoker Survey - Wave B Form and Instruction Modified Repair queued
Form 0920-1083 Non-smoker Survey - Wave A Form and Instruction Modified Repair queued
Form 0920-1083 Smoker Survey - Wave D Form and Instruction Modified Repair queued
Form 0920-1083 Smoker Survey - Wave C Form and Instruction Modified Repair queued
Form 0920-1083 Smoker Survey - Wave B Form and Instruction Modified Repair queued
Form 0920-1083 Screening and Consent Form and Instruction Modified Missing upstream
Attachment C-1. Changes to Waves A-I Screener Survey (004).docx Supplementary Document Uploaded 2022-09-30 Repair queued
privacy-narrative-form 08_05_22 OMB 0920_1083.pdf Supplementary Document Uploaded 2022-09-30 Repair queued
Attachment J. Source of Respondents for Each Wave of Data Collection.docx Supplementary Document Uploaded 2022-09-30 Repair queued
Attachment I-3. ABS Sample Postcard Reminders.pdf Supplementary Document Uploaded 2022-09-30 Repair queued
Attachment I-2. KnowledgePanel Email Invitation Reminders (005)_final.docx Supplementary Document Uploaded 2022-09-30 Repair queued
Attachment I-1. ABS Sample Invitation Letters.pdf Supplementary Document Uploaded 2022-09-30 Missing upstream
Attachment H. Ipsos Privacy and Security Procedures.docx Supplementary Document Uploaded 2022-09-30 Repair queued
STARS_Project-Summary-0900f3eb81ccd0c4-9-9-2022-10_58_51.pdf Supplementary Document Uploaded 2022-09-30 Repair queued
Attachment F. KnowledgePanel Recruitment Procedures_.docx Supplementary Document Uploaded 2022-09-30 Missing upstream
Attachment E-2. Changes to Wave A-I Nonsmoker Survey (006)_.docx Supplementary Document Uploaded 2022-09-30 Repair queued
Attachment D-2. Changes to Waves A-I Smoker Survey_.docx Supplementary Document Uploaded 2022-09-30 Repair queued
Attachment B-1. 60-day Federal Register Notice, Docket No. CDC_2022-0071.pdf Supplementary Document Uploaded 2022-09-30 Repair queued
Attachment A-3. PPHF.pdf Supplementary Document Uploaded 2022-09-30 Missing upstream
Attachment A-2. Familly Smoking Prevention & Tobacco Control Act.PDF Supplementary Document Uploaded 2022-09-30 Repair queued
Attachment A-1. Public Health Service Act.docx Supplementary Document Uploaded 2022-09-30 Available
SSB 2022 Part B_Evaluation ICR (002)_bcl_clean_8_24_22v2_final.docx Supporting Statement B Uploaded 2022-09-30 Repair queued
SSA_2022 Part A_Evaluation ICR (003) (002) Clean 8_24_22_1_final.docx Supporting Statement A Uploaded 2022-09-30 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
237915 Nonsmoker Survey - Wave I Form and Instruction Modified
237914 Nonsmoker Survey - Wave H Form and Instruction Modified
237912 Nonsmoker Survey - Wave G Form and Instruction Modified
237911 Nonsmoker Survey - Wave F Form and Instruction Modified
237910 Smoker Survery - Wave I Form and Instruction Modified
237909 Smoker Survery - Wave H Form and Instruction Modified
237907 Smoker Survery - Wave G Form and Instruction Modified
237906 Smoker Survery - Wave F Form and Instruction Modified
228674 Nonsmoker Survey - Wave E Form and Instruction Modified
228673 Smoker Survey - Wave E Form and Instruction Modified
218056 Smoker Survey - Wave A Form and Instruction Modified
217194 Non-smoker Survey - Wave D Form and Instruction Modified
217193 Non-smoker Survey - Wave C Form and Instruction Modified
217192 Non-smoker Survey - Wave B Form and Instruction Modified
217191 Non-smoker Survey - Wave A Form and Instruction Modified
217190 Smoker Survey - Wave D Form and Instruction Modified
217189 Smoker Survey - Wave C Form and Instruction Modified
217188 Smoker Survey - Wave B Form and Instruction Modified
217186 Screening and Consent Form and Instruction Modified
ICR Details
0920-1083 202209-0920-012
Received in OIRA 202204-0920-015
HHS/CDC 0920-1083
Extended Evaluation of the National Tobacco Prevention and Control Public Education Campaign
Revision of a currently approved collection   No
Regular 09/30/2022
  Requested Previously Approved
36 Months From Approved 03/31/2023
40,434 40,434
9,308 9,308
232,096 232,096
This study will enable Centers for Disease Control and Prevention (CDC) to continue to measure exposure and awareness of the Tips From Former Smokers ® campaign and to evaluate its impact on campaign-targeted outcomes among smokers and nonsmokers in the United States. This Revision primarily encompasses changes in the content and wording of the survey instruments and does not involve burden or respondent edits.
PL: Pub.L. 111 - 148 4001 Name of Law: Affordable Care Act
   PL: Pub.L. 111 - 31 123 Name of Law: Family Smoking Prevention and Tobacco Control
   US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  87 FR 33491 06/02/2022
87 FR 59424 09/30/2022
Yes
  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 40,434 40,434 0 0 0 0
Annual Time Burden (Hours) 9,308 9,308 0 0 0 0
Annual Cost Burden (Dollars) 232,096 232,096 0 0 0 0
No
No
$4,030,745
Yes Part B of Supporting Statement
    Yes
    No
Yes
No
No
No
Kevin Joyce 404 639-1944 [email protected]
  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.
09/30/2022