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Woonona Medical Practice Smoking Management Programme Registration

The managing smoking programme has been informed by Professor Renee Bittoun and further developed by Professors Garry Egger and John Stevens. The programme runs as a medical consultation process called shared medical appointments (SMA) to create a unique and truly effective lifestyle based Smoking Management programme. You will be supported by Dr Adele Stewart, long term GP with extended skills in Psychological Medicine and by your peers who can truly empathise with many of your issues.
You and a group of 10 or so other people with a desire for improved management of their smoking and will attend 5 sessions, face to face. We are sure that you will enjoy this program and we know it can help you on your way to a happier, healthier life with improved control over your smoking. There is one initial standard consult charge and otherwise this programme is FREE, Medicare will be billed appropriately.*
The unique factors of this programme are:
- it’s non-judgmentmental
- there’s no pressure to quit immediately
- the goal is to be more in control
- quitting would be a bonus
- it looks at management options that work – for you
- a main objective is feedback and long-term relapse-prevention. As part of this carbon monoxide monitoring will be offered. *You have 2 options: Either you can attend the nurse for a free appointment for baseline monitoring prior to the course OR there will be a one off extra charge of $50 for your baseline monitoring on the first day of the course- either way you will then be monitored cost free each subsequent week over the 5 weeks.
The programme is run as 1.5 hour group sessions over 5 weeks at Woonona Medical Practice:

Wednesday 21st October 2026 5-6.30pm
Wednesday 28th October 2026 5-6.30pm
Wednesday 4th November 2026 5-6.30pm
Wednesday 11th November 2026 5-6.30pm
Wednesday 18th November 2026 5-6.30pm
POSSIBLE SESSION: Wednesday 25th November 2026 5-6.30pm

The sessions are spaced a week apart, to get quick results. You’re helped to do this by the Shared Medical Appointments (SMA) approach where you get a group educational session as well as a personal medical consultation, where all in the group can listen, learn and contribute. In each session, you will be given just 3 main issues to remember and put into practice (a total of 15 issues over the duration of the program). Do-able actions will be summarised for you at the end of each session, as a reminder of the main principles of the program.

The overall goal is to smooth the transition from being a smoker to being a non-smoker.

Your session titles are:
1. Session 1: The Biology - Understanding nicotine addiction
2. Session 2: The Psychology - Preparation for quitting
3. Session 3: The Management (1) - Knowing what’s available to help
4. Session 4: The Management (2) - Trouble shooting
5. Session 5: Long-term Maintenance - Maintenance and relapse prevention.
Please fill out the form as best you can. It is confidential - seen by Dr Adele only.
Name

Preferred First NameLast Name
DOB
E-mail
example@example.com
Mobile
Format: 0000000000.
Medicare Number:
Only if not already a WMP patient
Medicare position on card:
Only if not already a WMP patient
How did you hear about the course?
Occupation
Do you smoke, vape or both?
What age did you start smoking or vaping?
Roughly, how long after you wake up in the morning do you have your first smoke or vape? (minutes or hours)
Roughly, how many cigarettes, vapes or rollies per day do you have?
How many cans of Coca Cola or Pepsi do you have per day?
How many cups of coffee do you have per day?
How many energy drinks do you have per day?
How many cans of beer do you have per day?
How many other alcoholic drinks do you have per day?
If you feel comfortable please let Adele know about any other substances you use eg marijuahna. (this form is confidential)
Do you suffer from stress?
Do you suffer from anxiety?
Do you suffer from depression?
Do you suffer from psychosis?
Any other comments on your smoking, vaping, general physical or mental health?
Have you previously attended WMP before?
If you have not attended WMP before, or only attended as a visitor, please select the below to acknowledge you are aware of conditions of course registration. (you may need to click on text box):
Please tick below (you may need to click on text box)
Carbon monoxide monitoring. This is recommended for all smokers. (But not if you only vape). Please choose an option.

Other
Height in cm and weight in kg if known:
Should be Empty:

Woonona Medical Practice Smoking Management Programme Registration