Copyable prompts beside a filled fictional plan
This is an invented example for Sam. The date and actions illustrate how the lines fit together; they are not a tested treatment plan.
| Item | Prompt to copy | Sam's fictional answer |
|---|---|---|
| Reason | My reason, in my own words: ______. | Reason: I want my lunch break to stop revolving around finding somewhere to smoke. |
| Start | My start date and time, or next preparation step if not yet decided: ______. | Start: 6 October 2026, after breakfast. |
| Situation A | Situation A — when and where: ______. My next action: ______. If that is unavailable: ______. | Situation A: leaving the work canteen at lunchtime. Action: walk to the quiet courtyard instead of the smoking spot. If it is raining: use the indoor non-smoking seating area. |
| Situation B | Situation B — when and where: ______. My next action: ______. If that is unavailable: ______. | Situation B: waiting for the bus home. Action: stand at the non-smoking end of the stop and read my book. If I forgot it: read this plan and choose where to stand. |
| Surroundings | One change I can make to my own cigarettes, lighter or usual break spot: ______. | Surroundings: remove my cigarettes and lighter from my work bag before the start. |
| Agreed support | Support agreed with someone — who, what help, and when they are available: ______. If unavailable, my own next step: ______. | Support: Alex agreed to a ten-minute call after work on Tuesday, not calls all day. If Alex cannot answer: take my planned break, do not keep calling, and contact Alex later according to what we have already agreed. |
| Professional question | One question for a qualified professional, and where I will ask: ______. | Professional question: ‘What support can I arrange alongside this plan?’ Ask my healthcare professional; use the Smokefree plan's support information to prepare the contact. |
| Review | Review at: ______. One line to keep or change after trying it: ______. | Review: Tuesday at 8 pm. Check whether the rainy-day break spot was usable; change that line if it was not. |
Why include situations rather than only a promise?
The US National Cancer Institute's Smokefree planner includes a quit date, personal reasons, triggers, ways to handle them and support. It also encourages writing to organise patterns and adjusting after a setback. Those are the basis for the categories here; the eight-line layout and Sam's example are editorial illustrations, not an official NCI form.
Keep the paper reachable, not necessarily on display
Choose somewhere you can reach at the relevant break: a folded sheet in your own bag may suit you better than a shared kitchen noticeboard. Paper can still be read by someone else. You do not need your full name, address, smoking history or medication list on this quick plan, nor to upload a photograph of it.
After a difficult situation, replace the line that did not fit: ‘walk outside’ may become ‘use the indoor break area’ when you cannot leave the building. You can also fill a plan after you have already stopped. Leave medicine decisions with your clinician or pharmacist; removing your own smoking items is not an instruction to stop prescribed treatment or nicotine replacement.
What to keep in mind
Sources
The central claims on this page were checked against the sources below.
- US National Cancer Institute / Smokefree.gov: Build Your Quit Plan
Sources checked: 2026-10-03
A personal organising aid, not a treatment plan or a promise of quitting. Bring health and medicine questions to a qualified professional.