Quit Kit Request Form

Are you interested in more information regarding quitting tobacco either for yourself or for a friend?

CCDPH can help. If you are a suburban Cook County resident (lives in Cook County, excluding the city of Chicago, Skokie, Evanston, Oak Park or Stickney Township), then we can send you a quit kit free of charge while supplies last.

The Quit Kit includes information resources within suburban Cook County, tips to quit and stay quit, and other items recommended by other suburban Cook County residents that have tried to quit too.

The quit kit contains the following to help you quit smoking:

  • A mini-guide to quit smoking/tips to help you quit.
  • A smoke-free decal to declare your home or car as a smoke-free zone.
  • A cessation resource card so you can always find help to quit.
  • A stress ball to relieve stress or help pass a craving; and
  • An assortment of distractions including pieces of hard candy, tea and gum.

Please fill out the form below to receive free information.