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Tobacco Cessation Provider Survey
Purpose: To assess health care providers’ comfort levels and barriers related to discussing tobacco cessation with their patients.
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1.
What specialty do you practice?
(Required.)
Family Medicine
Internal Medicine
Pediatrics
OB/GYN
Pulmonology
Cardiology
Behavioral health
Other (please specify)
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2.
What county (our counties) do you practice in?
(Required.)