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Center for Lung Disease: Personal Risk Assessment
Step 1 of 3
*
Indicates required information.
Do you currently smoke or have you ever smoked?
Cigarettes:
Yes
No
*
Cigars:
Yes
No
*
Pipe:
Yes
No
*
How many years have you smoked?
*
Choose one
Never Smoked
Less than 10 years
Between 10 to 19 years
Between 20 to 29 years
Between 30 to 39 years
Between 40 to 49 years
Between 50 to 59 years
More than 60 years
If you have quit smoking, how long ago did you quit?
*
Choose one
Never smoked
Currently still smoke
Less than 1 year
Between 1 and 3 years
Between 4 and 6 years
Between 7 and 9 years
10 or more years
Have you been exposed to secondhand smoke at home or at work?
*
Yes
No
Have you been exposed to asbestos, arsenic, radon, cilica, chromium, nickel or tar?
*
Yes
No
Please note:
This risk assessment will determine if the Early Lung Cancer Screening Program is appropriate for you. If you would prefer to speak to someone please call the Center for Lung Disease at 201-833-LUNG (5864).
In This Section:
Center for Lung Disease
Our Services
Lung Cancer
Chronic Obstructive Pulmonary
Disease (COPD)
Smoking Cessation
Center for Sleep Medicine