Occupational Nicotine Poisoning Risk Assessment Tool

Do you have a habit of smoking cigarettes daily?

Non-smoker

Smoke less than 5 cigarettes per day

Smoke 5 to 10 cigarettes per day

Smoke more than 10 cigarettes per day

Have you worked in environments with cigarette smoke?

Never

Sometimes

Often

Daily

Are you aware of the health consequences of smoking?

Highly aware

Aware but not concerned

Slightly aware

Not aware

Do you feel discomfort or fatigue when working with smokers?

Never

Sometimes

Often

Daily

Have you tried to quit smoking multiple times but failed?

Never

Once

Twice

Three times or more

Do you experience symptoms such as cough, wheezing, or difficulty breathing?

Never

Sometimes

Often

Daily