National Youth Tobacco Surveys (NYTS) 2021-2023

Forms and Documents

Document Name	Status
Form 0920-0621 National Youth Tobacco Survey (NYTS) 2020 Questionnaire Form and Instruction	Modified
Form 0920-0621 NYTS Cognitive Testing Youth Recruitment Screener Questionnaire Form and Instruction	Modified
Form 0920-0621 Data Collection Checklist Form and Instruction	Unchanged
Form 0920-0621 School Level Recruitment Script Form and Instruction	Unchanged
(0920-0621)_2023_NYTS_NS_Change_Memo_Combined_(2022.03.21).docx Justification for No Material/Nonsubstantive Change	2022-04-05
0621 NYTS Att P_Summary of School Arrangements (SSA) forms.pdf Supplementary Document	2021-01-14
0621 NYTS Att O_G1_NYTS Online Teacher Landing Page-Class Enrollment Form.pdf Supplementary Document	2021-01-14
0621 NYTS Att N_Student and Teacher Video Scripts.pdf Supplementary Document	2021-01-14
0621~9%N.PDF Supplementary Document	2021-01-14
0621~4%Y.PDF Supplementary Document	2021-01-14
0621 NYTS Att M2_Dear Teacher Letter_On-Campus Instruction_Passive Permission.pdf Supplementary Document	2021-01-14
0621 NYTS Att M1_Dear Teacher Letter_On-Campus Instruction_Active Permission.pdf Supplementary Document	2021-01-14
Justification for SOGI questions.docx Supplementary Document	2020-08-25
0621 NYTS PIA FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att L_2021 Sampling Design FINAL.docx Supplementary Document	2020-08-14
0621 NYTS Att K_SampleTable Shells FINAL.docx Supplementary Document	2020-08-14
0621 NYTS Att J2 Contractor IRB Approval FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att J1_CDC IRB Approval FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att I 2019 Refusal Conversion and Nonresponder Cover Memos FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att H9_Questionnaire Administration Script FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att H8_SPANISH Parental Permission Form Reminder - FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att H7_ENGLISH Parental Permission Form Reminder - FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att H6_SPANISH Parental Permission Form and Fact Sheet - Passive FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att H5_SPANISH Parental Permission Form and Fact Sheet - Active FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att H4_ENGLISH Parental Permission Form and Fact Sheet - Passive FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att H3_ENGLISH Parental Permission Form and Fact Sheet - Active FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att H2_Parental Permission Form Distribution Script FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att G2_NYTS 2021 Dear Teacher Ltr FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att F3_NYTS Letter to Agreeing Schools FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att F2_NYTS School Invitation Letter FINAL.pdf Supplementary Document	2020-08-14
0621 NYTS Att E2_NYTS District Invitation Letter FINAL.pdf Supplementary Document	2020-08-10
0621 NYTS Att D2_NYTS State Invitation Letter FINAL.pdf Supplementary Document	2020-08-10
0621 NYTS Att C NYTS Publications FINAL.docx Supplementary Document	2020-08-10
0621 NYTS Att B State Tobacco Control Rpts of NYTS Data 0919 FINAL.docx Supplementary Document	2020-08-10
0621 NYTS Att A2 60 Day FRN Published FINAL.pdf Supplementary Document	2020-08-10
0621 Att A1_Authorizing Legislation FINAL.docx Supplementary Document	2020-08-10
0621 NYTS SSB_final 12 17 2020_clean.docx Supporting Statement B	2021-01-14
0621 NYTS SSA_Final 01.13.2021.docx Supporting Statement A	2021-01-13

IC Document Collections

IC ID	Document Title	Status
7087	State Level Recruitment Script Instruction	Unchanged
233208	National Youth Tobacco Survey (NYTS) 2020 Questionnaire Form and Instruction	Modified
229816	NYTS Cognitive Testing Youth Recruitment Screener Questionnaire Form and Instruction	Modified
229814	Survey Pretests Other-Future document	Unchanged
214643	Cognitive Testing Instruction	Modified
185554	Data Collection Checklist Form and Instruction	Unchanged
185553	School Level Recruitment Script Form and Instruction	Unchanged
185552	District Recruitment Script Instruction	Unchanged

ICR Details

OMB Control No: 0920-0621	ICR Reference No: 202203-0920-009
Status: Received in OIRA	Previous ICR Reference No: 202008-0920-003
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0621-22DV
Title: National Youth Tobacco Surveys (NYTS) 2021-2023
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 04/06/2022

	Requested	Previously Approved
Expiration Date	01/31/2024	01/31/2024
Responses	26,397	26,397
Time Burden (Hours)	18,874	18,874
Cost Burden (Dollars)	0	0

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Abstract: Request OMB approval within this Change Request to field the revised NYTS questionnaire content for 2023 in accordance with the current OMB terms of clearance. The NYTS employs a stratified, three-stage cluster sample design to produce a nationally representative sample of U.S. middle and high school students. There are no requested changes to the sampling plan or recruitment methodology. The NYTS will continue to be administered as an electronic survey. In the most recently completed administration of the NYTS (2021), after exclusion of outliers, the average survey completion time was approximately 22 minutes. However, students will continue to be allotted up to one class period (approximately 45 minutes) to complete the survey. Thus, no changes to the estimated burden per response or the total estimated burden hours are requested.

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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:
	85 FR 3916	01/23/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 53379	08/28/2020
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 8

IC Title	Form No.	Form Name
Cognitive Testing	0920-0621, 0920-0621	NYTS Cognitive Testing Parent/ Guardian Screener ,   NYTS Cognitive Testing Youth Screener
Data Collection Checklist	0920-0621	Data Collection Checklist
District Recruitment Script
NYTS Cognitive Testing Youth Recruitment Screener Questionnaire	0920-0621	NYTS Cognitive Testing Youth Recruitment Screener Questionnaire
National Youth Tobacco Survey (NYTS) 2020 Questionnaire	0920-0621	National Youth Tobacco Survey (NYTS)
School Level Recruitment Script	0920-0621	School Level Recruitment Script
State Level Recruitment Script
Survey Pretests

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ICR Summary of Burden

	Total Request	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	26,397	26,397	0	0	0	0
Annual Time Burden (Hours)	18,874	18,874	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $3,083,213

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

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? No

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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: 04/06/2022

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