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Withdrawal Quiz

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Depression
Nicotine Addiction
Secondhand Smoke
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Withdrawal Quiz

Behavior Rating Scale

This quiz looks at your level of withdrawal symptoms. You may want to take the quiz every day in the first couple of weeks after you quit. The quiz can help you understand what you are going through and how it is changing. Remember, there are different medications and activities to help reduce your withdrawal symptoms and make them easier to handle. It is very common to have some level of symptoms even when you are using treatment.

Please rate yourself for the last day.

All questions are required and are marked with a *

None Slight Mild Moderate Severe  
1. Angry, irritable, frustrated *
2. Anxious, nervous *
3. Depressed mood, sad *
4. Desire or craving to smoke *
5. Difficulty concentrating *
6. Increased appetite, hungry, weight gain *
7. Insomnia, sleep problems, awakening at night *
8. Restless *
9. Impatient *
10. Constipation *
11. Dizziness *
12. Coughing *
13. Dreaming or nightmares *
14. Nausea *
15. Sore throat *
NCI NIH HHS USA.gov