Underage Possession of Tobacco Agency Commitment FormUPT Agency Commitment Form Below are some strategies to help you lower your risk related to tobacco use. These ideas have worked well for other students, youth and young adults. Please check those you have tried or those that might be useful to you.Behavior Research additional ways tobacco affects your health Become aware of how advertising targets teens Don’t bring tobacco products onto school property Track your spending on tobacco/nicotine products for one week or month Track your consumption of tobacco/nicotine for one day, week, or month Don’t sell tobacco products to other minors Set phone alarms or reminders to drink water Spend less time with friends who use tobacco Make a list of habits you have surrounding smoking (times of day, during certain activities, etc.) OtherOtherPreparing to Quit Become mindful of triggering emotions that lead to using Practice deep breathing, mindfulness, or meditation techniques when the urge to smoke comes Download a quit smoking app Ask a friend or relative how they succeeded in quitting smoking Share with friends and family your intention of quitting Ask for support in making a quit smoking plan from a family member or health professional Make a goal to reduce consumption of a tobacco product in half and create a timeline Send a message to a SmokeFree Teen textline Create a list of things to do when a craving occurs Find a substitute for smoking that replaces a muscle memory (for example: healthy snacking) Decide on a way to reward yourself as you reach goals for days without smoking Set a quit day and pledge to stick to it OtherOtherSocial Situations Tell your friends of your intention to quit smoking Ask a friend to be a quit buddy Avoid social situations where smoking is more prevalent Be aware of smoke breaks and the invitation to join someone on a smoke break Opt out of one smoke break this week and choose a healthy alternative Be aware of smoke breaks and the invitation to join someone on a smoke break Take one less smoke break at your next work shift OtherOtherThis section of this document, including your name, will be available to your referring agency if requested. This document is a commitment or agreement to future behaviors related to tobacco use. This document does not reflect any admission or denial of any prior action. Explain three (3) ways that you commit to reducing tobacco-related risk for yourself: * Additionally describe at least two (2) ways you can commit to reducing tobacco-related risk in your community: (What can you do to reduce risk in your community?) * Signature * /s/please sign with your full name Date * Submit
