Confidence Test

Posted on Wednesday, August 7th, 2013
  1. Positive that you would not be able to resist the urge.
  2. Quite sure you would not be able to resist the urge.
  3. You might not be able to resist the urge to smoke
  4. You're not sure whether you would resist.
  5. You might be able to resist the urge to smoke.
  6. You most likely would be able to resist the urge.
  7. You positively would resist the urge to smoke.

Below is a list of several situations in which people often smoke. Read each statement carefully. Then, using the scale above, rate your confidence in your ability to resist the urge to smoke if the situation would arise in the future.

  1. When you feel impatient.
  2. When you are waiting for someone or something.
  3. When you feel frustrated.
  4. When you are worried.
  5. When you want something in your mouth.
  6. When you want to cheer up.
  7. When you want to keep yourself busy.
  8. When you are trying to pass time.
  9. When someone offers you a cigarette.
  10. When you are drinking an alcoholic beverage.
  11. When you are drinking coffee or tea.
  12. When you feel uncomfortable.
  13. When you are embarrassed.
  14. When you are in a situation in which you feel smoking is a part of your self image.
  15. When you want to reward yourself for completing a task.
  16. When you want to relax.
  17. When you find a pack of your previous brand of cigarettes.
  18. When you are out with friends who smoke.
  19. When you realize you have gained weight.
  20. Using the same scale as above, how confident are you that you will not be smoking a year from now?

Quitline Iowa

The Quitline offers 2-weeks of free Nicotine Replacement Therapy (patches or gum) to everyone who calls (except Medicaid clients, who have better benefits).

1-800-QUIT-NOW (1-800-784-8669)
www.quitlineiowa.org

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If there is an accommodation you need in order to participate in a WRS program or activity, please contact WRC 101 at (319) 273-6275.


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