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The5A 'sofBrief35MinuteTobaccoInterventionTobaccoCessation 1.ASK Doyoucurrentlyusetobacco? No×cigarettes, cigars, pipe, snuff, chewing tobacco×Congratulations! Reinforce decisiontobea nonsmoker.
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How to fill out decisiontobea nonsmoker

How to fill out decision to be a nonsmoker:
01
Start by writing your personal information, such as your full name, date of birth, and contact details.
02
Next, indicate your current smoking habits, including the number of cigarettes you smoke per day and how long you have been smoking.
03
Consider describing your reasons for wanting to become a nonsmoker. This can include health concerns, personal goals, or the desire to save money.
04
Outline your plan for quitting smoking. This may involve setting a quit date, seeking support from friends or family, or using nicotine replacement therapy.
05
Include any previous attempts to quit smoking and the methods or strategies you used. Reflect on what worked and what didn't to inform your decision now.
06
Sign and date the decision to be a nonsmoker form, signifying your commitment to giving up smoking.
Who needs decision to be a nonsmoker:
01
Individuals who are currently smoking and want to quit for health or personal reasons.
02
People who have tried to quit smoking in the past and want to solidify their commitment to becoming a nonsmoker.
03
Anyone seeking support or documentation to hold themselves accountable in their journey to quit smoking.
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What is decisiontobea nonsmoker?
Decision to be a nonsmoker is a form or declaration made by an individual stating their decision to quit smoking.
Who is required to file decisiontobea nonsmoker?
Any individual who has decided to quit smoking is required to file decisiontobea nonsmoker.
How to fill out decisiontobea nonsmoker?
Decisiontobea nonsmoker can be filled out by providing personal information, signature, and the date of decision to quit smoking.
What is the purpose of decisiontobea nonsmoker?
The purpose of decisiontobea nonsmoker is to formally declare one's decision to quit smoking and potentially participate in programs or benefits for non-smokers.
What information must be reported on decisiontobea nonsmoker?
The information reported on decisiontobea nonsmoker typically includes full name, contact information, date of birth, and the date of decision to quit smoking.
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