Tobacco Consult Service Brochure 2021 | Page 4

MY QUIT PLAN __________________________

How ready am I to quit tobacco ? 0 1 2 3 4 5 6 7 8 9 10
Not ready Somewhat ready READY !
The REASONS I am ready to quit :__________________________________________ ____________________________________________________________________ My LAST date of tobacco use :_____________________________________________ My support person for quitting :____________________________________________ My tobacco TRIGGERS and how I will OVERCOME them : Mark plan ( s ) to overcome triggers .
• EMOTIONAL :
Being stressed or upset :
n Deep breaths
n Call someone
n Exercise
n Other ______________________________________________________________
• SOCIAL :
Drinking alcohol :
n Drink something different
n Chew gum
n Avoid alcohol for now
Being with smokers :
n Go somewhere else
n Ask them not to smoke by you
n Chew gum
• HABIT : After eating : n Start the dishes n Go for a walk n Drink water n Have a low-cal treat Drinking coffee : n Drink something else n Change routine n Take a shower Boredom : n Think of reasons to quit n Start a hobby n Do something you put off

TREATMENT I WILL USE TO HELP ME QUIT

Using a medication AND talking with a counselor increases your chances of quitting for good .
• Medication in the hospital : n Zyban™ n Nicotine patch n Nicotine gum n Chantix™
• Ask for prescription medication upon discharge : n Zyban™ n Nicotine patch n Nicotine gum n Chantix™
• Sign up for the Alabama Quitline ( 800-QUIT-NOW ): Telephone counseling and , if you qualify , free nicotine patches : n Yes n No
• Other :______________________________________________________________ ____________________________________________________________________