WORKSHEET revised 1-26-07

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www.quitline.com WORKSHEET FOR YOUR QUIT PLAN 1-800-QUIT-NOW By thinking things through in advance and by choosing a quit date, you greatly increase your chance of success. Answering these ten questions will help you make a plan and stay tobaccofree. 1. Why do you want to quit? 2. What are the benefits of quitting? 3. If you tried to quit in the past, what helped? What didn’t help? 4. What times of day do you crave tobacco, and what routine activities do you associate with it? (Examples: After lunch or while you’re reading the newspaper). 5. How will you handle situations where the temptation to smoke is high? 6. Who will support you when you need someone to talk to about the quitting process? 7. What should you expect from withdrawal symptoms and how can you prepare? 8. Will you consider using medication to help you succeed? 9. How will you reward yourself for staying tobacco-free? 10. What will your quit date be?

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