THIS PERSONAL PLANNER FOR SMOKING CESSATION SUCCESS BELONGS TO:

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RIPI – Reflect, Indentify, Plan, Initiate

Age I started smoking: __________________

Maximum number of packs I smoked in a day (for at least 3-6 months) __________________

(Be honest, this is your Personal Planner for Success)

Number of years I’ve smoked (current age minus the age you started) __________________

(Do not subtract years you were smoke-free unless you quit for 10-15 years before starting again)

Number of “Pack Years” I’ve smoked (Maximum packs per day multiplied by number years smoked). (20 Pack Years is significant but I’ve had patients well over 100 Pack Years!)

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Date I was sure I was ready to quit smoking (your Quit Date): __________________

Date I started My Planner / formulating my plan: __________________

Date I started A+ Smoker‘s Control® (the night before your Quit Date): __________________

Date I was comfortable stopping A+ Smoker’s Control®: __________________

Date I told the first person “I’m an EX-smoker”: __________________