Allow us to understand your smoker profile
Survey Questions
No. of sticks smoked per day?
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Quit Method Preferred
*
Cold Turkey: stop smoking completely on your selected quit date
Reduction: reduce number of cigarettes smoked gradually to zero over a period of time
Nicotine replacement therapy (NRT): NRT is a type of treatment designed to supply nicotine to the body to replace the nicotine from cigarettes. For purchase of NRT, please consult your doctor/pharmacist.
How many attempts have you tried to quit before?
*
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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