Quit Smoking Programme Check-in
Weekly cessation support: cravings, slips without shame, and what is working.
5 questions · 1 page · about 2 minutes to answer · fully editable after you start
Quitting is a series of weeks survived, and support works when slips are data rather than shame. This weekly check-in tracks the quit honestly: smoke-free days, craving intensity and trigger moments, use of replacements or medication, and the confidence trend, a read on the coming fortnight that willpower speeches cannot give.
The trigger-moment answers personalise the coaching; the confidence dip is the intervention signal, best answered with contact within days.
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Page 1
This week's quit progress
This check-in asks how your week has gone while you quit smoking. Your answers help your support team see how you are doing and what would help. It takes about 2 minutes. This form is not an emergency service. If you need urgent medical help, call your local emergency number.
Q1.How did this week go?*
- Completely smoke-free
- One or two slips
- Several slips
- Back to smoking - want to restart
Q2.Craving intensity this week?*
Q3.When were cravings worst? What was happening?
Q4.Confidence you will be smoke-free in a month?
Q5.What support would help most right now?
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