2012 - 2014 National Youth Tobacco Survey (NYTS)

Forms and Documents

Document Name	Status
2012 NYTS OMB Part B_12 20 2011.doc Supporting Statement B	2011-12-22
Attachment L. Detailed Sampling and Weighting Plan - 06 08 2011.doc Supplementary Document	2011-09-15
Attachment K. SampleTable Shells - 06 08 2011.doc Supplementary Document	2011-09-15
Attachment J. IRB-Cont-Exp-Memo.12.10.docx Supplementary Document	2011-09-15
Attachment I-8. Summary of Questionnaire Changes_ 12 20 2011.doc Supplementary Document	2011-12-21
Attachment D. Publications from Prior Cycles of the NYTS - 2011_05_24.doc Supplementary Document	2011-09-15
Attachment B-2. Public Comments and CDC Response.pdf Supplementary Document	2011-09-15
Attachment B-1. Federal Register Notice.pdf Supplementary Document	2011-09-15
Attachment A. Authorizing Legislation.doc Supplementary Document	2011-09-15
Attachment I-6. Parental permission form reminder notice (Spanish version) 06 08 2011.doc Supplementary Document	2011-09-15
Attachment I-5. Parental Permission Form Reminder Notice (English version) - 06 08 2011.doc Supplementary Document	2011-09-15
Attachment I-3. Parental Permission Form and Fact Sheet (English version) - 06 08 2011.doc Supplementary Document	2011-09-15
Attachment I-4. Parental Permission Form and Fact Sheet (Spanish Version) - 06 08 2011.doc Supplementary Document	2011-09-15
Attachment I-2. Parental Permission Form Distribution Script - 06 08 2011.doc Supplementary Document	2011-09-15
Attachment H-2. Letter to Teachers in Participating Schools - 06 08 2011.doc Supplementary Document	2011-09-15
Attachment G-3. Letter to Agreeing Schools - 06 08 2011.doc Supplementary Document	2011-09-15
Attachment G-2. School Letter of Invitation and NYTS Fact Sheet - 06 08 2011.doc Supplementary Document	2011-09-15
Attachment F-2. Districtl Letter of Invitation - 06 08 2011.doc Supplementary Document	2011-09-15
Attachment E-2. State Letter of Invitation - 06 08 2011.doc Supplementary Document	2011-09-15
2012 NYTS OMB Part A_12 20 2011.doc Supporting Statement A	2011-12-21

IC Document Collections

IC ID	Document Title	Status
7087	RECRUITMENT OF STATES Other-WORD	Modified
185555	STUDENTS 2012 - 2014 NATIONAL YOUTH TOBACCO SURVEYS Other-Word	Modified
185554	TEACHERS' DATA COLLECTION CHECKLIST Other-WORD	Modified
185553	RECRUITMENT OF SCHOOLS Other-WORD	Modified
185552	RECRUITMENT OF DISTRICTS Other-WORD	Modified

ICR Details

OMB Control No: 0920-0621	ICR Reference No: 201109-0920-004
Status: Historical Active	Previous ICR Reference No: 200807-0920-001
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: 2012 - 2014 National Youth Tobacco Survey (NYTS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/04/2012
	Date Received in OIRA: 09/21/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2015	36 Months From Approved	01/31/2012
Responses	25,836	0	14,116
Time Burden (Hours)	18,862	0	10,213
Cost Burden (Dollars)	0	0	0

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Abstract: CDC plans to conduct the National Youth Tobacco Survey (NYTS) in 2012-2013, and 2014. The NYTS is a nationally representative, school-based survey of students in grades 6-12. The NYTS collects information about tobacco use; knowledge and attitudes; media and advertising; access to tobacco products and enforcement of restrictions on access; school curriculum; environmental tobacco smoke exposure; and cessation.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 34997	06/15/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 58515	09/21/2011
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
RECRUITMENT OF STATES
RECRUITMENT OF DISTRICTS
RECRUITMENT OF SCHOOLS
TEACHERS' DATA COLLECTION CHECKLIST
STUDENTS 2012 - 2014 NATIONAL YOUTH TOBACCO SURVEYS

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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	25,836	14,116	0	11,720	0	0
Annual Time Burden (Hours)	18,862	10,213	0	8,649	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a revision. The increase in burden are attributable to an increase in the frequency of data collection (from biennial to annual), and to increase representation of minority youth in the sample.

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Annual Cost to Federal Government: $615,400

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? Yes

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

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Common Form ICR:  No

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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: 09/21/2011

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