Get Smoking Assessment Questionnaire

The Smoking Assessment Questionnaire is a vital tool for understanding smoking habits and planning cessation strategies. This guide will help you navigate the online form, ensuring that you complete each section accurately and efficiently.

Follow the steps to complete the questionnaire with ease.

1. Click ‘Get Form’ button to access the Smoking Assessment Questionnaire and open it in the editor.
2. Fill in your name, today's date, address, and date of birth in the designated fields. Ensure the information is accurate as it may be used for follow-up.
3. In the Smoking History section, answer each question regarding your smoking habits. Provide the age you started smoking, the number of cigarettes smoked on weekdays and weekends, and details of your heaviest smoking period.
4. Indicate how many times you have attempted to quit smoking by selecting one option, and specify how long you have gone without smoking since you began.
5. Check the methods you have tried to stop smoking in question 10. You can select multiple options that apply to you, including other methods you might have used.
6. In the Current Plan to Stop Smoking section, assess your motivation and confidence regarding quitting. This is essential for understanding your readiness to change.
7. Identify whether the people around you smoke and if family members are supportive or discouraging of your quitting efforts.
8. Review all of your answers for accuracy. Once confirmed, you can save the changes, download the document, print it, or share it as needed.

Complete your Smoking Assessment Questionnaire online today to take a step toward a healthier future.