View Information Collection Request (ICR) Package
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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:
0920-1083
ICR Reference No:
202204-0920-015
Status:
Historical Active
Previous ICR Reference No:
202106-0920-001
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-1083-22DG
Title:
Extended Evaluation of the National Tobacco Prevention and Control Public Education Campaign
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:
05/10/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/02/2022
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2023
03/31/2023
03/31/2023
Responses
40,434
0
40,434
Time Burden (Hours)
9,308
0
9,308
Cost Burden (Dollars)
232,096
0
232,096
Abstract:
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 Non-Substantive Change Request is submitted to consider the potential impact of COVID-19 on cigarette smoking cessation and the potential impact on campaign outcomes.
Authorizing Statute(s):
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
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
60-day Notice:
Federal Register Citation:
Citation Date:
84 FR 16863
04/23/2019
30-day Notice:
Federal Register Citation:
Citation Date:
84 FR 54151
10/09/2019
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
19
IC Title
Form No.
Form Name
Non-smoker Survey - Wave A (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Nonsmoker Survey - Wave A
,
Nonsmoker Survey - Wave A Spanish
,
Nonsmoker Survey Wave A_English 04JUN2021
,
Nonsmoker Survey Wave A_Spanish 04JUN2021
Non-smoker Survey - Wave B (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Nonsmoker Survey - Wave B
,
Nonsmoker Survey - Wave B Spanish
,
Nonsmoker Survey Wave B_English 04JUN2021
,
Nonsmoker Survey Wave B_Spanish 04JUN2021
Non-smoker Survey - Wave C (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Nonsmoker Survey - Wave C
,
Nonsmoker Survey - Wave C Spanish
,
Nonsmoker Survey Wave C_English 04JUN2021
,
Nonsmoker Survey Wave C_Spanish 04JUN2021
Non-smoker Survey - Wave D (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Nonsmoker Survey - Wave D
,
Nonsmoker Survey - Wave D Spanish
,
Nonsmoker Survey Wave D_English 04JUN2021
,
Nonsmoker Survey Wave D_Spanish 04JUN2021
Nonsmoker Survey - Wave E (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Nonsmoker Survey - Wave E
,
Nonsmoker Survey - Wave E Spanish
,
Nonsmoker Survey Wave E_English 04JUN2021
,
Nonsmoker Survey Wave E_Spanish 04JUN2021
Nonsmoker Survey - Wave F (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Nonsmoker Survey - Wave F
,
Nonsmoker Survey - Wave F Spanish
,
Nonsmoker Survey Wave F_English 04JUN2021
,
Nonsmoker Survey Wave F_Spanish 04JUN2021
Nonsmoker Survey - Wave G (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Nonsmoker Survey - Wave G
,
Nonsmoker Survey - Wave G Spanish
,
Nonsmoker Survey Wave G_English 04JUN2021
,
Nonsmoker Survey Wave G_Spanish 04JUN2021
Nonsmoker Survey - Wave H (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Nonsmoker Survey - Wave H
,
Nonsmoker Survey - Wave H Spanish
,
Nonsmoker Survey Wave H_English 04JUN2021
,
Nonsmoker Survey Wave H_Spanish 04JUN2021
Nonsmoker Survey - Wave I (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Nonsmoker Survey - Wave I
,
Nonsmoker Survey - Wave I Spanish
,
Nonsmoker Survey Wave I_English 04JUN2021
,
Nonsmoker Survey Wave I_Spanish 04JUN2021
Screening and Consent (English and Spanish)
0920-1083, 0920-1083
Screening and Consent
,
Screener and Consent Spanish
Smoker Survery - Wave F (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Smoker Survey - Wave F
,
Smoker Survey - Wave F Spanish
,
Smoker Survey Wave F_English 04JUN2021
,
Smoker Survey Wave F_Spanish 04JUN2021
Smoker Survery - Wave G (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Smoker Survey - Wave G
,
Smoker Survey - Wave G Spanish
,
Smoker Survey Wave G_English 04JUN2021
,
Smoker Survey Wave G_Spanish 04JUN2021
Smoker Survery - Wave H (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Smoker Survey - Wave H
,
Smoker Survey - Wave H Spanish
,
Smoker Survey Wave H_English 04JUN2021
,
Smoker Survey Wave H_Spanish 04JUN2021
Smoker Survery - Wave I (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Smoker Survey - Wave I
,
Smoker Survey - Wave I Spanish
,
Smoker Survey Wave I_English 04JUN2021
,
Smoker Survey Wave I_Spanish 04JUN2021
Smoker Survey - Wave A (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Smoker Survey - Wave A
,
Smoker Suvey - Wave A Spanish
,
Smoker Survey Wave A_English 04JUN2021
,
Smoker Survey Wave A_Spanish 04JUN2021
Smoker Survey - Wave B (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Smoker Survey - Wave B
,
Smoker Survey - Wave B Spanish
,
Smoker Survey Wave B _English 04JUN2021
,
Smoker Survey Wave B_Spanish 04JUN2021
Smoker Survey - Wave C (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Smoker Survey - Wave C
,
Smoker Survey -- Wave C Spanish
,
Smoker Survey Wave C_English 04JUN2021
,
Smoker Survey Wave C_Spanish 04JUN2021
Smoker Survey - Wave D (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Smoker Suvey - Wave D
,
Smoker Survey - Wave D Spanish
,
Smoker Survey Wave D_English 04JUN2021
,
Smoker Survey Wave D_Spanish 04JUN2021
Smoker Survey - Wave E (English and Spanish)
0920-1083, 0920-1083, 0920-1083, 0920-1083
Smoker Survey - Wave E
,
Smoker Survey - Wave E Spanish
,
Smoker Survey Wave E_English 04JUN2021
,
Smoker Survey Wave E_Spanish 04JUN2021
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
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
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:
$3,530,745
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
Yes
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Yes
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)?
No
Is this ICR related to the Pandemic Response?
No
Agency Contact:
Odion Clunis 770 488-0045 lta2@cdc.gov
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:
05/02/2022
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