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Client-ID-no

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									Client ID no.

NHS Stop Smoking Service Client Satisfaction Survey
______________________________________________________________________________
It is important that NHS Stop Smoking Services know if there is anything that they could do to improve the support that they provide to smokers. Your views about your local NHS Stop Smoking Service are very important to us and are completely anonymous. The results of this survey will be used for research and service development purposes. Please answer the following questions as honestly as you can and return the questionnaire in the FREEPOST envelope provided within two days. Thank you. _____________________________________________________________________________________

Please circle the appropriate number for each question:
1. Overall, how satisfied were you with the support you received to stop smoking? Very Satisfied Satisfied Unsure Unsatisfied 1 2 3 4 2. Would you recommend this service to other smokers who want to stop smoking? 3. In the event that you started smoking again would you go back to the service for help with stopping smoking? 4. If you returned to the service for help with stopping smoking do you think that you would be welcomed back? 5. Have you smoked since your last appointment with the service? No, not a single puff Yes, just a few puffs Yes, 1-5 cigarettes 1 2 3 6. Was it easy to contact the stop smoking service when you had decided that you wanted to stop smoking? No 0 No 0 No 0 Very Unsatisfied 5 Unsure 1 Unsure 1 Unsure 1 Yes 2 Yes 2 Yes 2

More than 5 cigarettes 4 No 0 Unsure 1 Yes 2

7. When you contacted the stop smoking service were you given an No Unsure Yes appointment date or told how long you would have to wait to see someone / 0 1 2 attend a group? 8. How long did you have to wait before your first appointment / group (please enter number of days in box) ……… days 9. Was the length of time you had to wait for your first appointment / group acceptable to you? 10. Was there contact from the stop smoking service before your appointment to encourage and motivate you to attend treatment? 11. Were the appointment / group times you were given convenient for you? No 0 No 0 No 0 No 0 Not applicable 4 No 0 No 0 Unsure 1 Unsure 1 Unsure 1 Unsure 1 Unsure 1 Unsure 1
May 2008

Yes 2 Yes 2 Yes 2 Yes 2 Yes 2 Yes 2

12. Was the venue convenient for you to get to?

13. Were you offered support with child care costs?

14. Were you given a choice of an individual appointment or a group?

Smoking Cessation Service Research Network (SCSRN)

Client ID no.
15. How satisfied were you with how supportive staff were? Very Satisfied Satisfied Unsure 1 2 3

Unsatisfied 4

Very Unsatisfied 5

16. How helpful was the information and advice that staff gave to you during your appointment / group session? Very Helpful Unsure Unhelpful Very unhelpful helpful 1 2 3 4 5 17. How helpful was the written information that staff gave to you? None given Very Helpful Unsure helpful 0 1 2 3

Unhelpful 4

Very unhelpful 5

18. If you were treated in a group did you find being with other smokers helpful? Not treated in Very Helpful Unsure Unhelpful group helpful 0 1 2 3 4

Very unhelpful 5

19. Did you find having your carbon monoxide (CO) reading done at every visit helpful? CO not taken Very Helpful Unsure Unhelpful Very unhelpful every visit helpful 0 1 2 3 4 5 20. What medication did you use during your stop smoking attempt? None 0 NRT (patches, gum etc) 1 Champix 2 No 0 Unsure 1 Zyban 3 Yes 2

21. Was the information that you were given about the choice of medication helpful? 22. How did you get your medication? With a GP prescription 1 Bought from a chemist 2 From a chemist with a voucher 3

From chemist with service letter/prescription 4 No 0

From the stop smoking service 5 Unsure 1 Yes 2

23. Was it easy to get hold of your medicine once you had chosen which medication you were going to use for your stop smoking attempt?

If there are any changes that you would like to see to the Stop Smoking Service, or if there was anything they did particularly well, then please write them here:

Thank you for completing this survey. Please return this questionnaire in the FREEPOST envelope provided within the next two days.
Smoking Cessation Service Research Network (SCSRN) May 2008


								
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