Transcription of Smoking Cessation Pre Class Questionnaire
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Smoking Cessation Pre Class Questionnaire
Smoking Cessation Pre Class Questionnaire CURRENT tobacco USE 1. About how long have you used tobacco ? _____year(s) _____months 2. What kind of tobacco products do you use? Cigarettes Smokeless tobacco (Snuff or Chew) Other (please describe): _____ 3. How many cigarettes do you usually smoke per day? (1 pack = 20 cigarettes) ___cigarettes 4. How much smokeless tobacco (snuff/chew) do you usually use per day? ____dips 5. How soon after you wake up do you use tobacco ? Within 30 minutes After 30 minutes 6. How many people in your household use tobacco ?
Smoking Cessation Pre‐Class Questionnaire CURRENT TOBACCO USE 1. About how long have you used tobacco? _____year(s) _____months 2. What kind of tobacco products do you use?
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