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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-0856
ICR Reference No:
201401-0920-003
Status:
Historical Active
Previous ICR Reference No:
201305-0920-014
Agency/Subagency:
HHS/CDC
Agency Tracking No:
21302
Title:
National Quitline Data Warehouse
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
01/13/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
01/09/2014
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
10/31/2015
10/31/2015
10/31/2015
Responses
564,621
0
564,621
Time Burden (Hours)
89,035
0
89,035
Cost Burden (Dollars)
0
0
0
Abstract:
The NQDW Quitline Services Survey has been redesigned to reflect the design and display of the NQDW data in State Tobacco Activities and Evaluation System. Clarified instructions are provided.
Authorizing Statute(s):
US Code:
42 USC 241
Name of Law: Public Health Service Act
PL:
Pub.L. 111 - 148 4002
Name of Law: Patient Protection and Affordable Care Act PPHF
PL:
Pub.L. 111 - 5 1
Name of Law: American Recovery and Reinvestment Act of 2009
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
5
IC Title
Form No.
Form Name
Follow-up for Callers who Received a Quitline Service
F1
NQDW 7-Month Follow-Up Questionnaire
Instructions for submitting caller intake and follow up
Intake Information for Callers who Contact the Quitline for Personal Use
E1(a)
NQDW Intake Questionnaire
Intake Information for Callers who Contact the Quitline for Someone Else
E1(b)
NQDW Intake Questionnaire Subset Final
Quitline Services Questionnaire
G1, G1 (2), none
Quitline Serivces Online Survey
,
G1 Quitline Services Online Survey file 2
,
G3 Quitline Services Survey
ICR Summary of Burden
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
564,621
564,621
0
0
0
0
Annual Time Burden (Hours)
89,035
89,035
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$2,085,301
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
Yes
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
Yes
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Catina Conner 4046394775
Common Form ICR:
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
01/09/2014
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