Stopping Smoking Questionnaire

Fields marked with * are required

Please put your first name and surname
Was it Hypnotherapy Directory? A generic Google search? Recommendation? Please be as detailed as possible as it helps me a lot. Thank you!
I like to thank people for referrals!
Please give any details you're happy to share.
If you have, please mention here
You can select multiple options
Please mention other times and places where you have tended to smoke
What do you like about it? What needs has it been meeting?
On an aeroplane? On the underground? When swimming? etc....
Please detail
Eg: Chest pain, Sickness, Rotten smell, Headache, Nausea, Felt Disgusted, Someone else looked terrible, etc.......
Please give ALL reasons
If so please detail here
If so please detail
(Eg: pass driving test, pass job interview, get date, etc...)
(Eg: quit a job, ended a relationship, moved house, etc....)
You will find this half way down the main stop smoking page