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Counsellors' Manual for Commercial Tobacco Cessation Treatment

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Goal Statement<br />

The behaviour I want to/need to change is:<br />

_____________________________________________________<br />

_____________________________________________________<br />

_____________________________________________________<br />

What is your goal now<br />

_____________________________________________________<br />

_____________________________________________________<br />

_____________________________________________________<br />

Start date: ______________________________<br />

Achievement date: _______________________<br />

Tip – If you are not ready to quit commercial tobacco, think about what a small goal<br />

might be. One example might be to not smoke in your car, to smoke outside, or to not<br />

smoke <strong>for</strong> a three hour period each day <strong>for</strong> a week. Any others<br />

25

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