Quit to Win! Challenge

To fill out to be eligible for the prize draw and to get support.

First name*

Birth year (e.g. 1985)*

Sex*: Male Female

Postal code*

I’m quitting smoking on:

To be eligible for the Quit to Win! Challenge, you must stop smoking between December 17, 2020 and February 8, 2021 and not smoke from February 8 to March 21, 2021 inclusively.

I QUIT Now helpline

Quebec residents only

I would like a specialist from the I QUIT NOW helpline to call me in the coming weeks to get personalized support to help me quit smoking.

* Mandatory ** Rules and regulations available at quitchallenge.ca