Success Story Submission Form: Tobacco Cessation

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Thank you for sharing your tobacco cessation success story with us! Please answer the following questions and a WFHTN team member will get back to you (unless you choose to remain anonymous). With permission, some success
stories may be filmed.

Please complete the photo waiver form if you choose to submit a photo(s) with your success story.
Photo waiver: https://forms.gle/XCZz59SbzBXRdVq76

Would you like to hear about successes from other state employees? Go here: https://www.tn.gov/wfhtn/success-stories.html

Agency *

Name

You can choose to remain anonymous.

Tell us about the healthy changes you’ve made. What results have you seen because of these changes? *

What inspired you to make those changes? *

How many years did you smoke or use tobacco products? *

What resources, if any, did you use to quit? *

How do you stay motivated to stay tobacco-free? *

Have you participated in any of your agency's Wellness Council challenges or events? If so, which ones? *

What’s your favorite part of your agency’s Wellness Council challenges or events? *

What obstacles did you face during your journey and how did you tackle them? *

What’s your advice for others? *

What have you learned about yourself during this journey? *

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