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Quit smoking for good

You're 4 times more likely to quit smoking with medical treatments and healthcare professionals' support.

Update my quitting commitment

Smoking Questionnaire

Smoking status sheet

There are various questions your doctor, pharmacist or healthcare professional may ask you when you ask them for advice on quitting smoking. Complete this quick questionnaire, then print off a copy to take along to your appointment.

Remember, be honest - they won’t judge you, and it’s important they know what methods you’ve tried before. It takes on average 5 to 7 attempts before someone is successful at quitting so you are not alone. Giving your Healthcare Professional all the information on your previous quit attempts will mean they are better placed to decide on the best treatment for you.

Adopted from the Fagerström Test for Nicotine Dependence: Heatherton TF. The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire. Br J Addict. 1991;86:1119-1127

What will my doctor ask me?

How many years have you been a smoker?

How quickly do you smoke after waking up?

Do you smoke more frequently after waking up than during the rest of the day?

How many cigarettes do you smoke a day?

How difficult do you find it not to smoke where it's prohibited?

If you are ill in bed, would you still smoke?

What's your main reason for smoking?

What's your main reason for quitting?

How many times have you tried to quit before?

What methods have you previously tried?

How difficult do you think it will be for you to quit?

How motivated are you to stop smoking?

How confident are you that you’ll be successful?