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Electronic Nicotine Delivery Systems Formative Data Collection to Inform Experimenter and Established User Definitions
Generic Clearance for the Collection of Quantitative Data on Tobacco Products and Communications
OMB: 0910-0810
IC ID: 235300
OMB.report
HHS/FDA
OMB 0910-0810
ICR 201907-0910-006
IC 235300
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0810 can be found here:
2023-08-08 - No material or nonsubstantive change to a currently approved collection
2022-11-22 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
Attachment A SurveyENDS_StudyScreener.docx
Other-Study Screener
Attachment B SurveyENDS_Study Questionnaire.docx
Other-Study Questionnaire
Attachment C SurveyENDS_ParentRecruitmentEmail.docx
Other-Parental Recruitment Email
Attachment D SurveyENDS_ParentPermission.docx
Other-Parent Permission
Attachment E SurveyENDS_YouthAssent.docx
Other-Youth Assent
SS Part A ENDSPrimaryDataCollection.docx
Supporting Statement Part A - Electronic Nicotine Delivery Systems
IC Document
SS Part B ENDSPrimaryDataCollection.docx
Supporting Statement Part B - Electronic Nicotine Delivery Systems
IC Document
Attachment F ApprovalLetter_RTI-IRB_STUDY00020494_20494.pdf
Approval Letter
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Electronic Nicotine Delivery Systems Formative Data Collection to Inform Experimenter and Established User Definitions
Agency IC Tracking Number:
CTP
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Study Screener
Attachment A SurveyENDS_StudyScreener.docx
Yes
No
Paper Only
Other-Study Questionnaire
Attachment B SurveyENDS_Study Questionnaire.docx
Yes
Yes
Fillable Fileable
Other-Parental Recruitment Email
Attachment C SurveyENDS_ParentRecruitmentEmail.docx
Yes
No
Paper Only
Other-Parent Permission
Attachment D SurveyENDS_ParentPermission.docx
Yes
No
Paper Only
Other-Youth Assent
Attachment E SurveyENDS_YouthAssent.docx
Yes
No
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Consumer Health and Safety
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
15,110
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
100 %
Requested
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
15,110
0
0
0
0
15,110
Annual IC Time Burden (Hours)
1,191
0
0
0
0
1,191
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Supporting Statement Part A - Electronic Nicotine Delivery Systems
SS Part A ENDSPrimaryDataCollection.docx
03/12/2019
Supporting Statement Part B - Electronic Nicotine Delivery Systems
SS Part B ENDSPrimaryDataCollection.docx
03/12/2019
Approval Letter
Attachment F ApprovalLetter_RTI-IRB_STUDY00020494_20494.pdf
03/12/2019
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.