(6-12 characters, a-z, 0-9)
   
User Information
(6-25 characters, a-z)
Gender :
Age :
   
Smoking History
Q1. How long have you smoked (Please specify) ? year(s)
Q2.
Q3. Have you tried to quit smoking ?
 
       
 
   
Medical History
 
 

Do you want to quit smoking?

No
Yes,and I will take action within 6 months
Yes,and I will take action within 1 month
Yes,I want to quit now
All personal information collected are for registration purposes only and will be kept strictly confidential. For detail, please see Interactive Online Cessation Centre's Privacy Policy.

verification image, type it in the box

Smoking Cessation Hotline, Department of Health : 1833183

 
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