The Cost of Smoking
- How Tobacco Affects Your Body
- Smoking Cost Calculator
How to Quit Tobacco
I’m Ready to Quit
- Sign Up for a Smoking Cessation Program
- Nicotine Withdrawal Symptoms

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The Cost of Smoking
- How Tobacco Affects Your Body
- Smoking Cost Calculator
How to Quit Tobacco
I’m Ready to Quit
- Sign Up for a Smoking Cessation Program
- Nicotine Withdrawal Symptoms
Español

Set a Quit Date “Relapse” Survey

We’d love to learn more about what triggered your relapse. The more we know, the more we can help people like you in our community get on the road to a tobacco free life. Please take a few moments to answer the questions below.

Please note that your information is saved on our server as you enter it.
What made you reset your quit date?*
- A relapse
- A social event
- An unplanned situation that led to stress
- Lacking/ineffective preparation
Which of our tools were you using before you reset your quit date?
- Quit Tools (Nicotine Replacement Therapy, Group Quit, Quit Coach®, etc.)
- Cost Calculator
- “The Big Why” exercise
- “Tell your friends and family” exercise
- “Tell your doctor" exercise
- “Triggers” exercise
- Rewards List
- Quit Tips
- None
Which of our tools are you considering for your new quit date?
- Quit Tools (Nicotine Replacement Therapy, Group Quit, Quit Coach®, etc.)
- Cost Calculator
- “The Big Why” exercise
- “Tell your friends and family” exercise
- “Tell your doctor" exercise
- “Triggers” exercise
- Rewards List
- Quit Tips
- None
On a scale of 1 to 5, how hopeful do you feel about restarting your journey to quit tobacco?
- 1 : Not hopeful
- 2
- 3
- 4
- 5 : Very hopeful
Your feedback helps us offer the right tools and services to you. Tell us how we could have done to serve you better.

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You are leaving Tobacco Free Florida’s Website

You are leaving the Tobacco Free Florida website to sign up for services administered by a partner organization.

You are leaving Tobacco Free Florida’s Website

You are leaving the Tobacco Free Florida website to sign up for services administered by a partner organization.

You are leaving Tobacco Free Florida’s Website

You are leaving the Tobacco Free Florida website to sign up for services administered by a partner organization.

Call
1-877-822-6669
to sign up for Web Quit.

Call
1-877-822-6669
to sign up for Phone Quit.

ARE YOU THINKING ABOUT QUITTING TOBACCO?

Tobacco Free Florida is here to provide you the information and resources to help you create a quit journey customized to your needs.

Click here for full terms and conditions

WE’RE GLAD YOU ARE THINKING ABOUT QUITTING.

Research shows that selecting a quit date within 30 days will enhance your chances of quitting. Would you like to select a new quit date?

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We’re so glad you found us!

Are you interested in participating in a personalized program over email or text message to help you quit tobacco?
Agree to Survey
- YES
- NO

What is your preferred method of communication?
Communication
- EMAIL
- TEXT
- BOTH

When do you plan to start your tobacco quit journey?
Quit Date
- Today
- Within 1 month
- Within 3 months
- Within 6 months
- In more than 6 months

Have you previously signed up for any of the quit methods offered below by Tobacco Free Florida? (Check all that apply)
Smoking Cessation Program Approval
- YES
- NO
Smoking Cessation Program*
- Quit Coach
- Web Quit
- Email Tips
- Nicotine Replacement Kit
- Text2Quit
- Quit Guide
- Group Quit
Comments
This field is for validation purposes and should be left unchanged.