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Tobacco Dependence Assessment and Treatment Sheila K. Stevens, MSW Mayo Clinic Tobacco Treatment Specialist Certification 2013 MAYO FOUNDATION FOR MEDICAL EDUCATION AND RESEARCH. ALL RIGHTS RESERVEDOutline
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How to fill out tobacco dependence

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To fill out a tobacco dependence form, follow these steps:
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- Start by providing your personal information such as your name, age, and contact details.
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- Next, answer the questions related to your smoking habits, including the duration of smoking, average number of cigarettes smoked per day, and any previous attempts to quit smoking.
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- You may also be required to complete a tobacco dependence assessment questionnaire, which will ask about your level of nicotine dependence, withdrawal symptoms, and motivations to quit smoking.
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- Finally, review your answers and ensure all the necessary information is provided before submitting the form.

Who needs tobacco dependence?

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Individuals who are struggling with tobacco addiction and want to receive support in overcoming their dependence on tobacco products.
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Tobacco dependence is a condition where a person is unable to stop using tobacco despite the negative health consequences.
Individuals who are addicted to tobacco or have a dependence on tobacco products are required to file tobacco dependence.
To fill out tobacco dependence, individuals must provide information about their tobacco usage, any previous attempts to quit, and any withdrawal symptoms experienced.
The purpose of tobacco dependence is to assess and track the level of addiction individuals have to tobacco products.
Information such as tobacco usage habits, previous quit attempts, and withdrawal symptoms must be reported on tobacco dependence forms.
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