No Smoking Contract

Contract to Quit Tobacco

The Contract to Quit Tobacco is a way to help you commit to your goal of quitting and staying tobacco-free. It is a short form you complete and sign in front of a witness, who could be a family member or close friend. By signing the form, you promise to quit smoking or using smokeless tobacco starting at a certain date, and to notify the witness if you relapse at any time.

The No Smoking Contract can be found on the American Heart Association Web Site.

A PDF Version of the No Smoking Contract is also available.

Smoking Fact

Cigarette smoking is a major cause of strokes, which are the third leading cause of death in the United States.