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Rainham and Upminster Medical Centre NHS GP surgery in Essex

Smoking review

Which surgery are you registered at? *

Rainham Health Centre

Upminster Medical Centre

Review

Smoking status: *

Smoker

Never smoked

Ex-smoker

Smoker

What do you mainly smoke?

Cigarettes

Cigars

Rollups

Pipe

E Cigarettes

How many cigarettes do you smoke in a day? *

1 to 9

10 to 19

20 to 39

40 or more

How many cigars do you smoke in a day? *

1 to 9

10 to 19

20 to 39

40 or more

Rollups – How many grams of tobacco do you smoke per week? *

Pipe – How many grams of tobacco do you smoke per week? *

Would you like to give up smoking? *

Yes

If you would like help or advice to stop smoking, please visit NHS Quit Smoking.

Ex smoker

What did you mainly smoke?

Cigarettes

Cigars

Rollups

Pipe

E Cigarettes

How many cigarettes did you smoke in a day? *

1 to 9

10 to 19

20 to 39

40 or more

How many cigars did you smoke in a day? *

1 to 9

10 to 19

20 to 39

40 or more

Rollups – How many grams of tobacco did you smoke per week? *

Pipe – How many grams of tobacco did you smoke per week? *

When did you give up smoking? *

Terms and conditions *

I confirm that this is not an emergency and understand the surgery cannot help while it is closed. If I need help right now, I will use the NHS 111 service. In an emergency, I will call 999 or go to A&E.

If you are human, leave this field blank.

Rainham Health Centre
Upminster Road South
Rainham
RM13 9AB

Get directions

01708 796579

Upminster Medical Centre
224 – 226 St Mary’s Lane
Upminster
Essex
RM14 3DH

Get directions

01708 251407

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