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Qualitative Research to Design Advertising to Encourage Quitting Among Adult Cigarette Smokers (SGM Population) (CTP
Generic Clearance for the Collection of Qualitative Data on Tobacco Products and Communications
OMB: 0910-0796
IC ID: 239957
OMB.report
HHS/FDA
OMB 0910-0796
ICR 202007-0910-005
IC 239957
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0910-0796 can be found here:
2024-07-05 - Extension without change of 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 - Consent Form - Virtual.docx
Other-Consent Form - Virtual
Attachment A - Consent Form In-Person.docx
Other-Consent Form - In Person
Attachment B - Participant Screener SGM OMB 3.13.20 Clean.docx
Other-Screener
Attachment C -Screener Contact.docx
Other-Screener Contact
Attachment D - Discussion Guide SGM OMB-3.13.20 Clean.docx
Other-Discussion Guide
Attachment E - Concept Rating.docx
Other-Concept Rating
Attachment F - Stimuli_SGM OMB 3.13.2020 Clean.docx
Other-Stimuli
0796 OMB Approval Memo for Research to Design Ad to Encourage Quitting Smoking (SGM Pop) 2020.docx
0796 OMB Approval Memo
IC Document
IRB Approval Letter 2020.pdf
IRB Approval Letter
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Qualitative Research to Design Advertising to Encourage Quitting Among Adult Cigarette Smokers (SGM Population) (CTP
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-Consent Form - Virtual
Attachment A - Consent Form - Virtual.docx
Yes
Yes
Fillable Fileable
Other-Consent Form - In Person
Attachment A - Consent Form In-Person.docx
Yes
Yes
Fillable Printable
Other-Screener
Attachment B - Participant Screener SGM OMB 3.13.20 Clean.docx
Yes
No
Paper Only
Other-Screener Contact
Attachment C -Screener Contact.docx
Yes
Yes
Fillable Fileable
Other-Discussion Guide
Attachment D - Discussion Guide SGM OMB-3.13.20 Clean.docx
Yes
No
Printable Only
Other-Concept Rating
Attachment E - Concept Rating.docx
Yes
Yes
Fillable Fileable
Other-Stimuli
Attachment F - Stimuli_SGM OMB 3.13.2020 Clean.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:
600
Number of Respondents for Small Entity:
0
Affected Public:
Individuals or Households
Percentage of Respondents Reporting Electronically:
0 %
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
600
0
0
0
0
600
Annual IC Time Burden (Hours)
450
0
0
0
0
450
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
0796 OMB Approval Memo
0796 OMB Approval Memo for Research to Design Ad to Encourage Quitting Smoking (SGM Pop) 2020.docx
02/13/2020
IRB Approval Letter
IRB Approval Letter 2020.pdf
02/13/2020
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.