AddicFree
Quit Smoking Now!
Study Details
REGISTER FOR STUDY!
Session Format
About Ellen Barner
To qualify for the study, please answer the following:
How many cigarettes do you smoke a day ?
*
place the average number in the box
What is your age?
*
Less than 18
18-25
26-35
36-45
46-55
56-65
Over 65
Have you quit for at least once for 1 week or more?
*
Yes
No
Are you on medication for anxiety and/or depression?
*
Yes
No
Maybe
Are you on medication to quit smoking?
*
Yes, right now
No, not now
Have taken in past
Examples: 1. nicotine replacement therapy Nicoderm, Nicotrol or other brand of nicotine (oral, transdermal or nasal spray) 2. bupropion (Wellbutrin, Zyban) 3. varenicline (Chantix) 4. clonidine (Catapres) 5. nortriptyline (Pamelor)
Have you been diagnosed with a mental or personality disorder (i.e., anxiety or depression)?
*
Yes, recently
No, never
In the past
Not Sure
Choose the best answer
Do you wish to quit smoking?
*
Yes, now
No, never
Your Name
*
Put first and last name in box.
Your Location
*
Type your City and State in the box.
Zip code
*
Just place 5 digit zip code in box
Your Phone Number
*
-
-
The best number to reach you
Email
*
Submit