During the past 12 months, did a doctor, nurse, or other health care professional…

1. Yes 2. No 7. Don’t know / Not sure 9. Refused

1 2 7 9 Ask you whether or not you smoke or use tobacco in any form?

1 2 7 9 Advise you to stop smoking or to stop tobacco?

1 2 7 9 Encourage you to set a specific quit date?

1 2 7 9 Prescribe or recommend medicines such as Zyban or the Nicotine patch, Nicotine gum,

Nicotine inhaler, or Nicotine nasal spray?

1 2 7 9 Give you information or refer you to a smoking cessation or tobacco cessation program?

(Source: CTRI / SSS)

SOURCE: Wisconsin Tobacco Survey, CTRI, 2001

(For former smoker/user) During the 12 months before you quit using tobacco, did a doctor, nurse, or other health care professional…

1. Yes 2. No 7. Don’t know / Not sure 9. Refused

1 2 7 9 Ask you whether or not you smoke or use tobacco in any form?

1 2 7 9 Advise you to stop smoking or to stop tobacco?

1 2 7 9 Encourage you to set a specific quit date?

1 2 7 9 Prescribe or recommend medicines such as Zyban or the Nicotine patch, Nicotine gum,

Nicotine inhaler, or Nicotine nasal spray?

1 2 7 9 Give you information or refer you to a smoking cessation or tobacco cessation program?

(Source: CTRI / SSS)

SOURCE: Wisconsin Tobacco Survey, CTRI, 2001