Smoking Review

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

CAMQUIT is your local Cambridgeshire stop smoking service.

Smoking Review

Smoking Review

About You

Please use this date format: DD/MM/YYYY.
Any responses we send will go to this email address.

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

How many cigarettes do you smoke in a day?
Would you like to give up smoking?
We would encourage you to consider stop smoking to benefit your health. Please arrange to see our surgery smoking cessation adviser by contacting reception on 01353 663434 option 1
*

Please ask at reception for more information about giving up smoking.

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