Smoking Review

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

Smoking Review

Smoking Review


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?

There are many health benefits to giving up smoking and we recommend that everyone stops smoking. This can be difficult sometimes and there are many ways you can access help with this. Healthy lifestyles Gloucestershire can help if you call free on 0800 122 3788. We also have trained staff in the surgery who can help people give up smoking.

Would you like to give up smoking?

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