My Smoking Pattern Form | Mind Power Activatio

Do you consume cigarettes / cigars / pipe / tobacco / other?

Number per day, or grams /oz per week?

How soon after waking do you smoke your 1st cigarette? (minutes)

Do you smoke more frequently during the first hours after waking?

Which cigarette would you hate most to give up?

Is it difficult to refrain from smoking in places where it is forbidden?

Do you smoke if you are so ill that you are in bed most of the day?

What are your “critical” times or activities when you must smoke? e.g. Alcohol, Coffee, Meals, On waking, Parties, TV, Telephone, Work, Other

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