General Market Campaign: Wave 3 Online Quantitative Study of Reactions to Rough-Cut Advertising Designed to Prevent Youth Tobacco Use

Generic Clearance for the Collection of Quantitative Data on Tobacco Products and Communications

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0810 can be found here:

Documents and Forms

Document Name Document Type
Attachment A - Parental Consent_Opt-Out Form.docx Other-Parental Consent Opt-Out Form
Attachment B - Youth Assent Form.docx Other-- Youth Assent Form
Attachment C - Screener.docx Other-Screener
Attachment D - Copy Testing Questionnaire.docx Other-Copy Testing Questionnaire
Attachment E - Advertisement Stimuli.docx Other-Advertisement Stimuli
Attachment F - Email Scripts.docx Other-Email Scripts
Part A - Quantitative Supporting Statement (General Market).docx Part A - Quantitative Supporting Statement (General Market) IC Document
Part B - Quantitative Supporting Statement (General Market).docx Part B - Quantitative Supporting Statement (General Market) IC Document
Attachment G - IRB Approval.pdf IRB Approval IC Document
Copy of Attachment H - Recruitment Locations.xlsx Recruitment Locations IC Document

Information Collection (IC) Details

IC Title:	General Market Campaign: Wave 3 Online Quantitative Study of Reactions to Rough-Cut Advertising Designed to Prevent Youth Tobacco Use	Agency IC Tracking Number:	CTP

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-Parental Consent Opt-Out Form	Attachment A - Parental Consent_Opt-Out Form.docx	No		Paper Only
Other-- Youth Assent Form	Attachment B - Youth Assent Form.docx	Yes	Yes	Fillable Fileable
Other-Screener	Attachment C - Screener.docx	Yes	Yes	Fillable Fileable
Other-Copy Testing Questionnaire	Attachment D - Copy Testing Questionnaire.docx	No		Paper Only
Other-Advertisement Stimuli	Attachment E - Advertisement Stimuli.docx	No		Paper Only
Other-Email Scripts	Attachment F - Email Scripts.docx	Yes	No	Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10,336	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 90 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	10,336	10,336
Annual IC Time Burden (Hours)	969	969
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Part A - Quantitative Supporting Statement (General Market)	Part A - Quantitative Supporting Statement (General Market).docx	06/23/2016
Part B - Quantitative Supporting Statement (General Market)	Part B - Quantitative Supporting Statement (General Market).docx	06/23/2016
IRB Approval	Attachment G - IRB Approval.pdf	06/23/2016
Recruitment Locations	Copy of Attachment H - Recruitment Locations.xlsx	06/23/2016

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