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Step 4 Questions

The Questionnaire & Quotable Quotes

"From Nicotine Anonymous: The Book"  (Taken from Version I)

 

I. WHAT WAS IT LIKE

 

1. What did you feel like when the morning alarm went off?

 

2. How long after the alarm until you first thought of a cigarette?

 

3. When did you smoke your day's first cigarette?

 

4. Then how did you feel?

 

5. How long before the next cigarette?

 

6. Was your morning smoking routine the same each day?

 

7. Did you associate smoking with certain: emotions; activities; physical surroundings: times of day; people? Give brief explanation.

 

8. Did you smoke when you were nervous? If yes, did it help and for how long?

 

9.  Were you troubled by the irrationality of your behavior?

 

10. Were you embarrassed to be a smoker or to be seen smoking or to know that people could smell smoke on you?

 

11.  What effect did advertising have on your brand selection and loyalty? Did you choose a brand by its packaging design and color or by it tar/nicotine content.

 

12.  Did the Surgeon General's warning have any effect on you?

 

13. At what age did you begin smoking continuously?

 

14.  Did you have to learn to smoke?  Describe briefly.

 

15. Did you feel peer pressure to smoke? Comment briefly.

 

16. Did your parents smoke?

 

17. Did you smoke more when drinking alcohol?

 

18. Did you smoke more when feeling: lonely, tired, hungry, mad, hurt; happy?

 

19. Have you ever been told, while hospitalized, not to smoke and had to sneak about to find a way to have a cigarette?

 

20 Has your smoking stopped you from getting involved in the certain activities? List them.

 

21. Has anyone indicated they thought you were weak because you could not stop smoking?

 

22. Have you ever lied about your smoking?

 

23. Have you ever stolen cigarettes?

 

24. Did you feel that you were a "serious' smoker, that while others could quit, you would smoke until you died?

 

25. Did you feel unattractive because you smoked?

 

26. Was it uncomfortable to be around non-smokers?

 

27. Did you feel guilty about smoking?

 

28. Did smoking mask fear of anything?

 

29. Did smoking affect your performance (indicate the appropriate) professionally; athletically; during leisure time: sexually, when with friends?

 

30. Did you have to make a choice between cigarettes and jobs/promotions; friends, lovers, sports?

 

31 Did you feel increasingly isolated when you smoked?

 

32 Did you experience a "high" feeling when you smoked?

 

33 Would you go to any lengths to get a cigarette?

 

34. Did you ever think of yourself as "less than others" because you couldn't quit smoking?

 

35. Why did you start smoking?

 

36. What support did you get to keep smoking?

 

37. Did you see yourself as a nicotine addict while still smoking?

 

38. How did you try to control your smoking?

 

39.  What is the worst consequence of your smoking?

 

40. Did societal pressure to modify your smoking bother you?

 

41. Did you have conflicts with others as a result of your smoking? If so, describe such an incident in detail.

 

42. How many times did you try to quit smoking? How long did you last each time?

 

43. Did the immediate cost of smoking worry you? Was it clear to you what the cost was? Did you know how many dollars per year you spent on cigarettes?

 

44. When you had stopped smoking, what event(s) or feeling(s) provoked you to smoke again?

 

45. Were you defiant toward any person, regulation or propaganda that suggested you should quit?

 

46. What was your emotional reaction when you failed to stay stopped?

 

47. Did you smoke to alleviate shyness?

 

48. Did you want to create a smokescreen around yourself? If so, for what purpose?

 

49. List some words that describe how you saw yourself when you smoked?

 

50. While still smoking, could you imagine life and your usual activities (e.g.. telephone, sex, dinner) without cigarettes?

 

51. Did you have medical problems connected with smoking?

 

52. Did you ruin clothes, bedclothes or furniture with burns or ashes?

 

53. Did you wreck a car due to smoking?

 

54. Did you lose time on the job due to smoking?

 

55. Were you honest?

 

56. Were you a reasonably happy and well-adjusted person or did you seem to have more than your share of problems?

 

57. Were you problems the result of other people's malice and mistakes?

 

58. Did others have to change in order for your life to be all it should be?

 

59. Did you promptly attend to disagreeable chores or did you usually procrastinate?

 

60. When faced with too much to do, would you escape into a drug?

 

61. Did you make use of alcohol or drugs for recreation?

 

62. Did smoke make you feel more secure socially?

 

63. How did smoking regulations affect you?

 

64. How did your smoking affect those around you?

 

65. Were you bothered by other people's smoking?

 

66. Did you have any physical symptoms resulting from smoking?

 

67. How did you try to overcome the smell of smoke on you and in your home?

 

 

II. WHAT HAPPEN

 

68. Did you stop smoking before or after getting to your first Nicotine Anonymous meeting?

 

69. Did you tell many people beforehand that you were going to stop?

 

70. What other methods or organizations did you use to try to stop smoking before you came to Nicotine Anonymous?

 

71. Was there a particular situation, person or place related to your doing something about your nicotine problem?

 

73. Did anyone intervene?

 

74. Did you find that your recovery in another 12 Step program was contingent on gutting nicotine?

 

75. Was nicotine threatening your job? Your love life?

 

76. Did a doctor tell you  had the beginnings of emphysema or some other ailment?

 

77. Did you start feeling like an air polluter?  Did tossing cigarettes butts begin to bother you?

 

78. Did you feel victimized by the tobacco advertising industries?

 

79.  Did Humphrey Bogart's and Yul Brynner's public anti-smoking testimony have any effect on you decision?

 

80. Did you experience a sudden "moment of clarity" about your smoking?

 

81. What made you realize that "NOW" is the time to stop?

 

82. Any Particular "Last Straw"?

 

83. Was there a unique "miracle" that led you to Nicotine Anonymous" Describe.

 

84. Did stopping nicotine use correspond to a "getting in the shape" program you set out upon?

 

85, What role, if any, did a feeling of dishonesty to yourself play a role in your decision to stop?

 

86. Did you become sick and tired of being sick and tired?

 

87. Did the probable reversal of damage to your body encourage you to stop?

 

88. Have you slipped since coming to Nicotine Anonymous? If so, what did you learn?

 

89. Did you feel utterly hopeless about quitting nicotine?

 

90. What, if any, did friends' stopping play in your decision?

 

91. When you first came to Nicotine Anonymous, did you think you could quit?

 

92.  How long did your acute physical withdrawal last?

 

93. How long has your emotional withdrawal lasted?

 

94. Was Nicotine Anonymous your first 12 Step Program?

 

95. What were your earliest impressions of Nicotine Anonymous?

 

96. How did you learn of Nicotine Anonymous?

 

97. Were you afraid to quit?

 

98. How long before the 12 Steps began to make any sense to you?

 

99. Do you have a sponsor?  Are you someone's sponsor?

 

100. Did you have trouble with the concept of "powerlessness"? What happened to give it meaning to you?

 

101. How did you initially relate to the concept of a "higher power'?  Has your attitude changed? Describe.

 

102 Describe "hitting bottom" as you experienced it.

 

103. Did you believe you had to be off nicotine before going to your first Nicotine Anonymous meeting?

 

104. Did you go to your first meeting alone or with a friend or relative?

 

105. Were you surprised to learn the Nicotine Anonymous is a spiritual program and not a smoking cessation program?

 

106. Did you feel welcome at your first Nicotine Anonymous meeting?

 

107. If you had a slip after joining Nicotine Anonymous, Did you avoid meetings or keep coming to them? How long did the slip last?

 

108. If you've had a year or more of smobriety, do you still attend Nicotine Anonymous meetings on a regular basis?

 

 

III. WHAT ARE YOU LIKE NOW?

 

109. Are you a member of another 12 Step program? If so, do you find that you need a separate participation in Nicotine Anonymous?

 

110. What attitudes have changed in you as a result of coming to Nicotine Anonymous?

 

111. Do you feel more hones? How, if at all, do your feelings about your honesty related to your continued freedom from nicotine?

 

112. What is your understanding of the Serenity Prayer:

       a. What are the things you cannot change? Are able to accept them?

       b. What are the things you can change? Have you the courage? Where does the courage come from, or has it always been there?

       c. How do you know the difference between the things you can and cannot change?

 

113. Is your main concern still with avoiding nicotine?

 

114. Has your life improved or worsen since coming to Nicotine Anonymous? In what ways?

 

115. Have you learned, through meetings, things about living that you're glad to know? Describe.

 

116. Do you believe in miracles?

 

117. Have you had a spiritual awakening?

 

118. Do you feel safe that you won't smoke again?

 

119. Did/do you crave sugar or sweets?

 

120. Do you feel more anger than you did while smoking? If so, how do you deal with it?

 

121. If you feel more anger, are you afraid of losing control? How do you handle that?

 

122. How do meetings help you remain nicotine-free?

 

123. Have you been a speaker at a Nicotine Anonymous meetings?

 

124. Are you particularly concerned with helping the newcomer?

 

125. Do you feel safe at Nicotine Anonymous meetings?

 

126. How do you work the Steps?

 

127. Have you been secretary of a meetings? Do you do any other service? If so, what?

 

128. Do you socialize with other members of Nicotine Anonymous? If not, would you like to?

 

129. How does your spouse/significant other feel about your involvement with Nicotine Anonymous?

 

130. If you moved to a place without a Nicotine Anonymous meeting, would you start one?

 

131 Would you be interested in writing your story for the possible inclusion in the Nicotine Anonymous Big Book?

 

132. How has your physical health changed?

 

133. If you have made new friends in Nicotine Anonymous how have these friendships helped I staying stopped?

 

134. For those belonging to other 12-Step programs, how do you handle frequency of meetings for your respective programs?

 

135. What meeting formats do you like?

 

136. What factors do you think keep people coming back to meetings?

 

137. Why do you think some people stop coming to meetings?

 

138. Do people who smoke react negatively to your having stopped? If so, how do you handle them?

 

139. Do you reveal your Nicotine Anonymous membership when the subject of smoking arises?

 

140. Do you live or work closely with someone who smokes? If so, how does this affect you?

 

141. Do you do anything now for entertainment that you couldn't or wouldn't do while smoking?

 

142. Are you a smoker's rights advocate?

 

143. What are you like now?

 

144. Do you feel that you have more time now? What that is new, are you doing with your time?

 

145. Did you notice an increase in putting something in your mouth?

 

146. Do you feel increased physical energy?

 

147. Have you begun a regular exercise program since stopping smoking?

 

148. Do you think that your physical appearance has improved? If so, does this play an important role in keeping you off nicotine?

 

149. What new emotions have cropped up? What Nicotine Anonymous tools or message, if any, do you use to deal with these new feelings?

 

150. Do any of these feelings endanger your continued smoberity? Which?

 

151. Have your concepts of "God," however you define the term, changed since you came to Nicotine Anonymous?

 

152. How, if at all, do you get the concept of God to relate to you and your daily living?

 

153. Did you meditate on a regular basis before coming to Nicotine Anonymous? Do you now? If your practices have changed, describe what happen.

 

154. Did you pray on a regular basis before coming to Nicotine Anonymous? Do yo know? If your practices have changed, describe what happen.

 

155. What about Nicotine Anonymous was most important for you during initial detoxification?

 

156. What about Nicotine Anonymous is most important to you maintaining freedom from nicotine?

 

157. Has your self-esteem improved?

 

158. Do you ever experience cravings for nicotine?

 

159. Do you have a relationship with a higher power?

 

160.  Are you more in touch with your feelings now?

 

161. Have you gained weight?

 

162. How long do you expect to need meetings?

 

163. Do you use the phone to call someone when you need help?

 

164. Have you become involved in another 12-step program since coming to Nicotine Anonymous?

 

165. Do you think that Nicotine Anonymous places enough emphasis on the Steps and spirituality?

 

166. What do you get from going to meetings?

 

167. What about Nicotine Anonymous would you change?

 

168. Do you feel that you: Have more energy? Are Less tired? Look better? Look younger?

 

169. Do you have different friends? Do you still associate with smoking friends?

 

170. Do you move away from smokers in public places?

 

171. Do you experience fewer mood swings?

 

172. Are you more tolerant?

 

173. Do you feel less volatile, edgy?

 

174. Would you say your general health is better? Describe.

 

175. Have you cultivated new interest? Describe.

 

176. Overall, are you more interested in life? Describe.

 

177. Do you think your sex life has benefit? Describe, if you wish.

 

178. Have you friends/relatives come back into your life?

 

179. Have often do you crave a cigarette?

 

180. Have you substituted some positive action for smoking? Describe.

 

181. Did you have to give up some habits that accompanied smoking in order to give up/stay off nicotine?

 

182. Do you have more confidence in your inner self? In your outer self?

 

183. Do you think you're smarter, i.e., can comprehend faster? More?

 

184. Have you become evangelical about not smoking? About Nicotine Anonymous?

 

185. Is not using nicotine a daily struggle? An occasional one?

 

186. Do you know of others who have been inspired by you to quit?

 

187. Do you work with newcomers? How?

 

188. How many Nicotine Anonymous meetings per week do you attend?

 

189. Are you glad for your powerlessness over nicotine and for what it has brought into your life?

 

190.  What do you feel when you see a person smoking?

 

191. Do you feel fortified by the recent public reactions against smoking? Irritated by them?

 

192. What, if anything do you do for your health (besides not smoke!) that you didn't do before?

 

193. Tell us whatever else you think is important concerning "What it is like now" for you in your freedom from nicotine.

 

 
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