Smoking Review

If you have been advised by the surgery to submit a smoking review on a regular basis please use this form.

If you would like help quitting smoking, please visit the Let’s Get Healthy Dudley website.

Smoking Review

Smoking Review

Smoking Review

Do you currently smoke?

Do not currently smoke section

Have you smoked in the past?
How many cigarettes did you smoke in a day?

Do currently smoke section

Do you smoke any of the following:
Would you like to give up smoking?
Smoking is still one of the major causes of death in the UK, linked to many cancers and chronic health conditions such as COPD. If you smoke and would like to quit then please contact Lets Get Healthy Dudley by visiting www.lets-get.com/healthy-lifestyles/stop-smoking/ or call 0800 061 4962. *
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Please ask at reception for more information about giving up smoking.