Smoking Status Update

We are currently updating your medical record and need to know about your smoking status. This is very important for those that smoke, used to smoke, or have particular medical conditions (e.g. asthma, heart disease, high blood pressure, diabetes, and stroke). Up-to-date information about your smoking status enables us to offer you the best health advice and support.

Please take a moment of your time to fill in the form below stating whether you are a smoker, an ex-smoker, or have never smoked. If relevant, indicate how much you smoke per day, in the space provided.

Kindly ignore this message and please accept our apologies if, you already have updated us about your smoking status within the last 3 weeks.

Smoking Status Update
Please use the format DD/MM./YYYY

Stopping smoking is good for everyone’s health, particularly if you have any of the conditions listed above. If you were smoking and have managed to stop, congratulations! If you do smoke and would like to give up, Parkbury House surgery run a Stop Smoking clinic on a weekly basis, please contact reception if you need support or contact Hertfordshire Stop Smoking Service on 0800 389 3 998 (free from landline) or 01442 453 071 or text SMOKEFREE to 80818 or email

See more information on the Stop Smoking Clinic at Parkbury House.

Thank you for helping us to keep your medical record up to date, and to offer you the best possible care.


Smoking is one of the biggest causes of death and illness in the UK.

Every year around 100,000 people in the UK die from smoking, with many more living with debilitating smoking-related illnesses.
Smoking increases your risk of developing more than 50 serious health conditions. Some may be fatal and others can cause irreversible long-term damage to your health.
You can become ill:

  • if you smoke yourself
  • through other people’s smoke (passive smoking)

For further information please visit the following links