Sheffield NHS Stop Smoking Service

Group support 1 to 1 support

Yes No

If no, was there anything more that either the adviser or the Service could have helped you do to help you to quit?

Yes No

Comments on venue?

Local freephone helpline

National Helpline

Poster/Advert - Where (eg. Exposed magazine):

Newspaper - Name of paper:

Event - Where:

Radio Which station & when:

GP

Dentist

Hospital

Word of mouth

Pharmacy

Internet

Friend / Relative

Other , Details:

Yes No

If No, what further information do you think may have been helpful?

All of the time Some of the time None of the time

Please feel free to write any comments about the approaches taken by the adviser:

Nicotine Replacement Therapy (NRT):

• Micro-tab
• Chewing Gum
• Lozenges
• Patches
• Inhalator
• Nasal Spray

Buproprion (Zyban)

Varenicline (Champix)

Did not use any medication

Any other method (please state)

Yes No

Under 18 18 - 34 35 - 44 45 - 59 60+

Male Female