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Help and advice on quitting smoking

Analyze your relapse

In analyzing the circumstances of your last relapse, you can develop strategies that will help you prevent relapses in similar circumstances, next time. This analysis is a success factor for the future.

PDF version to fill
PDF version to fill


To pre-fill the analyze of your relapse, please fill in the fields below and click on the button at the bottom of the page.

Date of relapse:
Day of the Week:
My activity:
People present:
My mood:
The reason that pushed me into lighting up a cigarette:
How to avoid picking up a cigarette in this situation the next time: