IQuit

No. of sticks smoked per day *

Quit Method Preferred *

Cold Turkey

Reduction

NRT

Intended Quit journey Start Date *

Reasons for Smoking *

select those which are applicable to you

I need a cigarette as soon as I wake up.

I think smoking is really enjoyable.

I smoke to be more awake and to think better.

I feel weak if I do not smoke.

I feel uncomfortable without a cigarette in my hand.

I enjoy smoking during my break or after a meal.

I need to smoke every few hours.

I am less stressed after I smoke.

I smoke when I am angry or upset.

I enjoy the process of lighting up, tapping a cigarette and flicking the lighter.

I cannot last half a day without smoking

I find myself smoking sometimes but cannot remember lighting up!

* are mandatory fields

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