ASSESSMENT OF SMOKING EXPOSURE DURING PREGNANCY
Please complete the fields below to determine exposure parameters during pregnancy.
1) On average how many days per week do you smoke?
2) On an average day how many cigarettes do you smoke?
3) How many days have you smoked 10 or more cigarettes in last month?
4) What is the most cigarettes you smoked on any one day during this pregnancy?
EXPOSURE PARAMETERS
Smoking Days
(Estimates number of smoking days during this pregnancy)
Percent of Days Exposed During Pregnancy
(Estimates days exposed during this pregnancy)
Number of Cigarettes during Pregnancy
(Estimates cumulative number of cigarettes during pregnancy)
Number of packs
(Estimates cumulative exposure in packs during this pregnancy)
Questions? Send them to
Laburd@medicine.nodak.edu
.