The Real Cost Campaign: 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⚠️ Notice: This information collection may be referencing outdated material.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
A TRC Copy Testing Youth Screener.docx Other-TRC Copy Testing Youth Screene
B TRC Copy Testing Adult Screener.docx Other-TRC Copy Testing Adult Screene
C TRC Copy Testing Youth Questionnaire.docx Other-TRC Copy Testing Youth Questio
D TRC Copy Testing Adult Questionnaire.docx Other-TRC Copy Testing Adult Questio
E TRC Copy Testing Parental Notification and Opt-Out.docx Other-TRC Copy Testing Parental Noti
F TRC Copy Testing Youth Assent Form.doc Other-TRC Copy Testing Youth Assent
G TRC Copy Testing Adult Participant Consent Form.doc Other-TRC Copy Testing Adult Partici
H TRC Copy Testing Stimuli.docx Other-TRC Copy Testing Stimuli.
I TRC IRB Letter.pdf TRC IRB Letter IC Document
TRC Copy Testing Part A.docx TRC Copy Testing Memo Part A IC Document
TRC Copy Testing Part B.docx TRC Copy Testing Memo Part B IC Document

Information Collection (IC) Details

IC Title:	The Real Cost Campaign: 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-TRC Copy Testing Youth Screener	A TRC Copy Testing Youth Screener.docx	Yes	Yes	Fillable Fileable Signable
Other-TRC Copy Testing Adult Screener	B TRC Copy Testing Adult Screener.docx	Yes	Yes	Fillable Fileable Signable
Other-TRC Copy Testing Youth Questionnaire	C TRC Copy Testing Youth Questionnaire.docx	Yes	Yes	Fillable Fileable Signable
Other-TRC Copy Testing Adult Questionnaire	D TRC Copy Testing Adult Questionnaire.docx	Yes	Yes	Fillable Fileable Signable
Other-TRC Copy Testing Parental Notification and Opt-Out	E TRC Copy Testing Parental Notification and Opt-Out.docx	No		Printable Only
Other-TRC Copy Testing Youth Assent Form	F TRC Copy Testing Youth Assent Form.doc	Yes	Yes	Fillable Fileable Signable
Other-TRC Copy Testing Adult Participant Consent Form	G TRC Copy Testing Adult Participant Consent Form.doc	Yes	Yes	Fillable Fileable Signable
Other-TRC Copy Testing Stimuli.	H TRC Copy Testing Stimuli.docx	No		Printable Only

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 17,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	17,000	17,000
Annual IC Time Burden (Hours)	1,732	1,732
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

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