Asthma/COPD Yes No Cancer Yes No If yes, please give details of the cancer: Smoking Smoking puts your health at risk, can shorten your life and serious illness. Do you smoke? Yes No If yes, how may per day on average? How many have you been a smoker? Are you an ex-smoker? Yes No If yes, how many did you smoke and for how many years?
Asthma/COPD Yes No Cancer Yes No If yes, please give details of the cancer: Smoking Smoking puts your health at risk, can shorten your life and serious illness. Do you smoke? Yes No If yes, how may per day on average? How many have you been a smoker? Are you an ex-smoker? Yes No If yes, how many did you smoke and for how many years?