May 2011 Questionnaire for Tobacco Use Supplements to the Current Population Survey (TUS-CPS) (NCI)

Forms and Documents

Document Name	Status
Form 3 Main 2010-2011 Tobacco Use Supplement Questionnaire (TUS-CPS) Form and Instruction	Modified
Form 1 2011 Follow-Up Questionnaire (TUS-CPS) Form and Instruction	Modified
TUS-CPS May 2011 Follow Up Q _AH finl2_OMB_PB_3-3_11.doc Supplementary Document	2011-03-10
Pass back Request Memo_TUS-CPS.doc Supplementary Document	2011-03-10
Change Request Memo_TUS-CPS_AH 1-20-11.doc Justification for No Material/Nonsubstantive Change	2011-02-01

IC Document Collections

IC ID	Document Title	Status
7287	Main 2010-2011 Tobacco Use Supplement Questionnaire (TUS-CPS) Form and Instruction	Modified
191981	2011 Follow-Up Questionnaire (TUS-CPS) Form and Instruction	Modified

ICR Details

OMB Control No: 0925-0368	ICR Reference No: 201102-0925-007
Status: Historical Active	Previous ICR Reference No: 201002-0925-002
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: May 2011 Questionnaire for Tobacco Use Supplements to the Current Population Survey (TUS-CPS) (NCI)
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: 03/10/2011
	Date Received in OIRA: 02/15/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2013	03/31/2013	03/31/2013
Responses	105,000	0	105,000
Time Burden (Hours)	15,000	0	15,000
Cost Burden (Dollars)	0	0	0

---

Abstract: The 2010-2011 TUS-CPS conducted by the Census Bureau will collect data from the U.S. civilian non-institutionalized population on smoking, other tobacco use, and attempts at cessation; policy information such as home and workplace smoking policies; health professional advice to stop smoking; and changes in smoking norms and attitudes. The TUS-CPS will be and has been in the past a key source of national, state, and some local-level data on these topics in U.S. households because it uses a large, nationally representative sample. This survey is part of a continuing series of surveys (OMB#- 0925-0368) that were sponsored by National Cancer Institute (NCI) and has been administered triennially as part of the U.S. Census Bureau's and the Bureau of Labor Statistics' CPS. The TUS-CPS has been fielded since 1992, most recently in 2006-07, and its data are available for public use. Government agencies, other researchers and the public can use the data to monitor progress in the control of tobacco use, conduct tobacco-related research, evaluate tobacco control programs, examine tobacco-use-related health disparities, and use this data to help determine services that need to be provided. A unique feature is the ability to link other social and economic Census Bureau and Bureau of Labor Statistics data and other sponsor-supported supplement data to the TUS-CPS data. Much of this data can also be linked to cancer and other cause-specific mortality data through the National Longitudinal Mortality Study. Data will be collected in May 2010, August 2010, January 2011, and May 2011 from approximately 265,000 respondents. The May 2011 Follow-Up questionnaire will consist of an abbreviated version of the main 2010-2011 questionnaire given to half of the May 2010 sample. It will provide estimates for demographic subgroups, and groups of states, as well as national estimates.

---

Authorizing Statute(s): US Code: 42 USC 412(285a-1) Name of Law: Public Health Service Act
   US Code: 42 USC 413(285a-2) Name of Law: Public Health Service Act
   US Code: 42 USC 411(285a) 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

Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
2011 Follow-Up Questionnaire (TUS-CPS)	1, 2	May 2011 Follow Up Q ,   TUS-CPS May 2011 Questionnaire Final
Main 2010-2011 Tobacco Use Supplement Questionnaire (TUS-CPS)	3, 2	TUS-CPS Q Spanish ,   TUS-CPS Q

---

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	105,000	105,000	0	0	0	0
Annual Time Burden (Hours)	15,000	15,000	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: $3,846,000

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? No

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)? No

Is this ICR related to the Pandemic Response? Uncollected

---

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: 02/15/2011

---