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Keep your home and car smokefree Sign up here to make the Step Right Out promise today!

To make my home and car a healthier place, I am making the following promise: I / We promise to keep the house and car totally smoke free at all times!

Name

Telephone

Email

Address

Postcode

1. How many children live at this address?
Aged 0-5
Aged 6-16

2. Number of smokers who live at this address?

3. Where was smoking allowed in the house before you made the Step Right Out promise?

4. Would you like to stop smoking?
We can help. Select yes and we will contact you.
YesNo

If you have any suggestions or comments, please feel free to enter them in the box below (optional)

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