12.07.2015 Views

Clearing the Air - Smokefree

Clearing the Air - Smokefree

Clearing the Air - Smokefree

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My Quitting WorksheetReview what you have done so far to prepare yourself to quit smokingsuccessfully.My reasons to quit are_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________My nicotine addiction test score is _______________________________My triggers❑ Waking in <strong>the</strong> morning❑ Drinking coffee, tea, oralcohol❑ Smelling a cigarette❑ Being with o<strong>the</strong>r smokers❑ Seeing someone smoke❑ Taking a break❑ Talking on <strong>the</strong> phone❑ Checking email❑ Surfing <strong>the</strong> Internet❑ Watching TV❑ Driving my car❑ Being a passenger❑ After eating❑ After having sex❑ After completing a task❑ Feeling stressed❑ Feeling lonely or depressed❑ Being or feeling less tolerant❑ Feeling bored❑ Feeling angry, irritable,or impatient.I will deal with my triggers by_________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________9

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