Table 1Systems Strategy. Implement a tobacco user identification system in every clinic

ActionStrategies for implementation
Implement an office-wide system that ensures that for every patient at every clinic visit, tobacco use status is queried and documented.Office system change:
Expand the vital signs to include tobacco use, or implement an alternative universal identification system.

Responsible staff:
Nurse, medical assistant, receptionist, or other individual already responsible for recording the vital signs. These staff must be instructed regarding the importance of this activity and serve as nonsmoking role models.

Frequency of utilization:
Every visit for every patient, regardless of the reason for the visit.a

System implementation steps:
Routine smoker identification can be achieved by modifying electronic medical record data collection fields or progress notes in paper charts to include tobacco use status as one of the vital signs.

Blood Pressure: ______________________
Pulse: _______ Weight: _________
Temperature: ________________________
Respiratory Rate: _____________________
Tobacco Use (circle one): Current Former Never

Repeated assessment is not necessary in the case of the adult who has never used tobacco or who has not used tobacco for many years, and for whom this information is clearly documented in the medical record.

From: 5, Systems Interventions—Importance to Health Care Administrators, Insurers, and Purchasers

Cover of Treating Tobacco Use and Dependence: 2008 Update
Treating Tobacco Use and Dependence: 2008 Update.
Tobacco Use and Dependence Guideline Panel.

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