Quit Smoking Prepsheet

Write down the answers (up to 5) to each question below.

Bring your answers to the STOP SMOKING session.

What are your fears about continuing smoking?

What concerns or fears do you have about NOT smoking?

Give 5 reasons on what may trigger you to take up smoking again.

Do you smoke during times of stress and if so, what stress do you have in your life?

Do you smoke because you are bored?

Do you think you are not addicted to nicotine?

When you light up a cigarette, do you think you can always stop smoking anyway?

Do you generally drink alcohol when you smoke?

Do you socially drink and smoke?

If you have previously attempted to give up smoking did you experience withdrawal symptoms and if so what were they?

Who suffers most now because you smoke?

Who would suffer the most if you were to becomes seriously ill as the result of smoking?

Write down their names and how they relate to you.

Are there times of the day, places, actions, or events where smoking is extra pleasurable for you?

Name something that you find obnoxious of which the sight, sound or smell makes you heave or vomit or overcome with nausea.

If you are asked by someone in authority to do something that you may not agree with, would you:

(a) comply and do it anyway, or

(b) do the opposite in defiance, or

(c) put it off indefinitely, or

(d) not do it at all?

Please give a past experience when you achieved something that was and still is of great importance to you. Indicate how that memory makes you feel.

Please give a future experience when you can see that you have achieved something that is and will be of great importance to you. Indicate how seeing yourself in that picture makes you feel.

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