The CK STOP PROGRAM is designed to assist those that use tobacco or e-cigarettes daily and are willing to set a "quit date" within the next 30 days. For those wanting to participate in the program, please complete the survey below in order to determine your eligibility. After the survey is completed, participants who are deemed eligible will be given instructions on how to register for the program and how to sign up for an in-person session. For those that do not qualify, they will be provided with additional information and offered guidance in accessing other supports that may be available to them. 

CONSENT TO PARTICIPATE: By completing this survey, you consent to CK Public Health screening your eligibility to participate in the CK STOP Clinic

CK STOP PROGRAM ELIGIBILITY

Program Eligibility Questions

Do you currently use tobacco products daily?(Required)
Tobacco products include: cigarettes, cigars and chewing tobacco
Do you currently use e-cigarettes daily?(Required)
E-cigarettes include: a variety of devices where users vape nicotine based liquids that may include pod, tank or disposable systems.
Are you 18 years of age or older?(Required)
Do you live in Chatham-Kent?(Required)
Have you accessed the STOP program in the previous 6 months?(Required)
Do you have a primary care practitioner in Chatham-Kent? (family doctor or nurse practitioner)(Required)
Are you pregnant or breastfeeding?(Required)
Do you have any generalized skin disorders? (e.g. severe eczema or allergy to medical adhesive)(Required)
Do you have any of the following: life threatening arrhythmias, severe (unstable) or worsening agina, allergy to any component of NRT, currently using Varenicline (Champix)?(Required)