Signup A | Stop Smoking Center

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Step 1 of 2

Congratulations on quitting. A lot of people find that quitting is the hardest but most rewarding thing they’ve ever done. Many quitters are surprised to find quitting is more of a process than a single event and often find they need some help along the way.

Please tell us a bit about yourself so we can personalize the tools that can best help you stay smoke-free. This should only take you about 5 minutes.

Are you a health care professional or a researcher? Please note that use of this program is for your personal, non-professional use. Yes
No
1. What best describes your pattern of smoking?
I have at least one cigarette a day
I only smoke occasionally
I recently quit smoking
2. When was your last cigarette?
Less than 24 hours
More than 24 hours
3.How many cigarettes do you or did you smoke per day?

4. How many years have you smoked?

5. How soon after you wake up do you or did you have your first cigarette?
Within 5 minutes
6-30 minutes
31-60 minutes
After 60 minutes
6. How many times have you tried to quit in the past, and lasted 24 hours or more?

7. How many other smokers do you live with?

8. What's your date of birth?

9. You are: Female
Male
10. About how much does a pack of cigarettes cost you? [Example: 6.50]

11. In some countries, packs contain different amounts of cigarettes. About how many cigarettes are in the packs you bought?