Focus Group Study of Adolescent and Young Adult Perceptions Related to Cigarette Smoking

Pretesting of Tobacco Communications

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0674 can be found here:

Documents and Forms

Document Name Document Type
Doc02_Adol Consent.pdf Other-Consent Form
Doc03_Adult Informed Consent.pdf Other-Consent Form
Doc04_FinalModGuideAdol YA Percept.pdf Other-Moderator Script
Doc05_FnlScrAdolYA Percept RelCigSmok.pdf Other-Screener Form
Doc01_Generic Memo_Adole YAt Percpt.pdf Summary Supporting Statement for Focus Group Study of Adolescent and Young Adult Perceptions Related to Cigarette Smoking IC Document

Information Collection (IC) Details

IC Title:	Focus Group Study of Adolescent and Young Adult Perceptions Related to Cigarette Smoking	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Consent Form	Doc02_Adol Consent.pdf	Yes	Yes	Printable Only
Other-Consent Form	Doc03_Adult Informed Consent.pdf	Yes	No	Printable Only
Other-Moderator Script	Doc04_FinalModGuideAdol YA Percept.pdf	Yes	No	Printable Only
Other-Screener Form	Doc05_FnlScrAdolYA Percept RelCigSmok.pdf	Yes	No	Printable Only

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 76	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	76	0	0	0	0	0
Annual IC Time Burden (Hours)	122	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
Summary Supporting Statement for Focus Group Study of Adolescent and Young Adult Perceptions Related to Cigarette Smoking	Doc01_Generic Memo_Adole YAt Percpt.pdf	06/14/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.