Merchant Interview&Youth Focus Groups Reactions to Tobacco Product Flavor Bans

Pretesting of Tobacco Communications

Documents and Forms

Document Name Document Type
Attachment 2-Chicago Merchant Interview Guide.docx Other-Survey
Attachment 1-NYC Merchant Interview Guide.docx Other-Survey
Attachment 3-Chicago Demographic Questionnaire.doc Other-Questionnaire
Attachment 4-Chicago Focus Group Guide.docx Other-Group Guide
Attachment 5-Chicago Parental Consent.doc Other-Consent Form
Attachment 6-Chicago Participant Consent.doc Other-Consent Form
Attachment 7-Chicago Youth Assent.docx Other-Assent Form
Attachment 8 - Merchant Interview Recruitment Script_2-9-15.docx Other-Merchant Recruitment Script
Attachment 9-NYC Merchant Interviews Recruitment Script.docx Other-Recruitment Script
Attachment 10-Focus Group Recruitment Script.docx Other-Youth Recruitment Script
Chicago Recruitment Flyer.pub Chicago Youth Recruitment Flyer IC Document
NYC-Chicago_FDA_Abbr_Memo_-_Generic_Clearance_0910_0674.docx Merchant Interviews & Youth Focus Group Reactions to Tobacco Flavor Bans IC Document

Information Collection (IC) Details

IC Title:	Merchant Interview&Youth Focus Groups Reactions to Tobacco Product Flavor Bans	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-Survey	Attachment 2-Chicago Merchant Interview Guide.docx	Yes	Yes	Fillable Printable
Other-Survey	Attachment 1-NYC Merchant Interview Guide.docx	Yes	Yes	Fillable Printable
Other-Questionnaire	Attachment 3-Chicago Demographic Questionnaire.doc	Yes	Yes	Fillable Printable
Other-Group Guide	Attachment 4-Chicago Focus Group Guide.docx	Yes	Yes	Fillable Printable
Other-Consent Form	Attachment 5-Chicago Parental Consent.doc	Yes	Yes	Fillable Printable
Other-Consent Form	Attachment 6-Chicago Participant Consent.doc	Yes	Yes	Fillable Printable
Other-Assent Form	Attachment 7-Chicago Youth Assent.docx	Yes	Yes	Fillable Printable
Other-Merchant Recruitment Script	Attachment 8 - Merchant Interview Recruitment Script_2-9-15.docx	Yes	Yes	Fillable Printable
Other-Recruitment Script	Attachment 9-NYC Merchant Interviews Recruitment Script.docx	Yes	Yes	Fillable Printable
Other-Youth Recruitment Script	Attachment 10-Focus Group Recruitment Script.docx	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 945	Number of Respondents for Small Entity: 345

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	1,100	1,100
Annual IC Time Burden (Hours)	193	193
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Chicago Youth Recruitment Flyer	Chicago Recruitment Flyer.pub	02/10/2015
Merchant Interviews & Youth Focus Group Reactions to Tobacco Flavor Bans	NYC-Chicago_FDA_Abbr_Memo_-_Generic_Clearance_0910_0674.docx	02/11/2015

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