No Cost CONSULTATION Los Alamitos/Long Beach Orange County San Fernando Valley

Smoking
Cessation

 
Want to Stop Smoking?

Enrolling in our smoking cessation research program may help you to finally stop smoking!

The Centers for Disease Control and Prevention (CDC) estimates that from 1995 to 1999 cigarette smoking caused approximately 443,000 Americans' premature deaths each year, or one in every five. This resulted in roughly $193 billion in health-related economic losses in the United States. The associated human suffering and overall impacts on quality of life are tremendous. Go to www.CDC.gov/tobacco for more information.

While cigarette smoking is a potentially life-threatening addiction, there is substantial clinical and preclinical information available to support the rationale for the development of medicines to assist one's efforts to stop smoking.
 

 

 


Smoking Cessation
Self-Test

Find out if you qualify for a Smoking Cessation Research Study at PRI.  Please complete the questionnaire below to determine if you may be a candidate.


In the boxes below, please indicate Yes, No or Not Applicable as appropriate.
 

Yes

No

Not Applicable
Are you at least 18 years of age? *    
Do you have a history of seizures or any seizure disorder? *    
Are you currently pregnant or nursing a baby? *  

In the below boxes, indicate if you experience these symptoms:
0-9/day, 10-20/day, or >20/day.
QUANTITY
0-9/day
10-20/day
>20/day

On average, for the past 3 months how many cigarettes per day do you smoke?
DURATION
0-3 mo.
3-6 mo.
>6 mo.
How many months have you been smoking on a consistent basis?
MOTIVATION
1-4
5-7
8-10

Many people "quit smoking" several times each year. On a scale of 1 [a little motivated] to 10 [extremely motivated], how motivated are you to stop smoking at this time?

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