Tobacco Scorecard & Action Planning

Healthylife® QuitWell™

Part 6

Person writing in notebook.

You can make copies of this page to use. Place a slash in the box which indicated the time you used tobacco or nicotine.

Action Planning

Remember, an “okay” plan today beats a “great” plan tomorrow. Use this template to write out your quit plan. By this point, you probably know most of your expected triggers during the day. Write both your planned urge tamer/response to the trigger and another idea, in case you need it.

Chart of Action Planning.

© American Institute for Preventive Medicine