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PRIMARY CARE CARDIOVASCULAR DISEASE THE CHAMPLAINSMOKING CESSATION ASK, ADVISE, PREVENTION & MANAGEMENT GUIDELINESMOKING CESSATION Adapted from the following sources: University of Ottawa Model for
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How to fill out smoking cessation - ask:

01
Start by gathering all the necessary information, such as your personal details, smoking history, and any previous attempts to quit smoking.
02
Use a pen or a computer to fill out the form. Make sure to follow the instructions carefully and provide accurate information.
03
Begin by entering your full name, date of birth, and contact information in the designated fields.
04
Next, provide details about your smoking history, including the number of cigarettes smoked per day, the duration of smoking, and any previous quit attempts.
05
The form may ask about your motivation to quit smoking, such as health concerns or financial reasons. Be honest and express your true reasons for wanting to quit.
06
You may be required to answer questions about your current health condition, allergies, or any medications you are currently taking. It is important to disclose any relevant information to ensure your safety during the quitting process.
07
Lastly, review your answers and make any necessary corrections before submitting the form. Double-check for any missing or incomplete information to ensure the form is properly filled out.

Who needs smoking cessation - ask:

01
Individuals who are currently smoking and wish to quit.
02
Smokers who have tried to quit in the past but have been unsuccessful.
03
People who are concerned about the health risks associated with smoking and want to improve their overall well-being.
04
Those who want to save money by eliminating the expenses related to purchasing cigarettes.
05
Individuals who have noticed a decline in their lung function or have experienced smoking-related health issues.
06
People who are ready and committed to making a positive change in their lives by quitting smoking.
07
Smokers who would like to take advantage of resources, support, and guidance provided by smoking cessation programs or services.
Remember, quitting smoking is a journey, and everyone's experience may vary. It is always recommended to seek professional advice and support when attempting to quit smoking.
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Smoking cessation is the process of quitting smoking and no longer using tobacco products.
All individuals or organizations who are mandated by law to report their smoking cessation efforts.
Smoking cessation forms can usually be filled out online or in person, providing details about the steps taken to quit smoking.
The purpose of smoking cessation is to reduce the health risks associated with smoking and improve overall well-being.
Information such as the date of quitting, methods used to quit, and any support or resources utilized during the cessation process must be reported on smoking cessation forms.
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