Smoking Review

If you would like to give up smoking please use this form and the advisor will get back to you.

Smoking Review

Smoking Review

Smoking Review

Do you currently smoke?

Do not currently smoke section

Have you smoked in the past?
How many cigarettes did you smoke in a day?

Do currently smoke section

How many cigarettes do you smoke in a day?
Would you like to give up smoking?
*

Please ask at reception for more information about giving up smoking.