Ready to Quit Smoking?

It's been said that the easiest thing to do is to quit, but the hardest is to stay quit. It takes mental commitment to become a non-smoker. Use this questionnaire and I will help you understand whether you're ready at the sub-conscious level to make this life enhancing change.

How long have you been smoking and why did you start?
   
How many do you smoke a day?
   
Have you given up before?
   YesNo
If you've quit and started again, what do you think you learnt about quitting?
   
Do you believe that one day you will be a non-smoker?
   YesNoMaybe
Can you imagine you as a non-smoker?
   YesNo
Think of a time or challenge you faced when you succeeded well or against the odds and describe briefly.
   
Now that you think about your answer to the previous question what motivated you?
   
Do you believe you have willpower?
   YesNo
Do you believe you have never learnt how to do something new?
   YesNo
Were you born smoking?
   YesNo
Can you remember yourself as a non smoker?
   YesNo
What will you enjoy most about being a non-smoker?
   
Do you have imagination?
   YesNo
Do you think you look after yourself and your health?
   YesNoSometimes
Who or what is important to you?
   
Who do you admire and why? Can by anyone, famous or otherwise.
   
Is there any reason why you should continue to be a smoker?
   
If yes to the previous answer please give reason.
   
Do you deserve to live a longer healthier life?
   YesNo
Your Name:
Your Email: