Screening
The US Preventive Services Task Force (USPSTF) recommends that clinicians ask all adults about tobacco use at each visit, advise them to quit using tobacco, provide behavioral interventions to all adults who use tobacco, and provide US Food and Drug Administration (FDA)-approved pharmacotherapy for cessation to nonpregnant adults who use tobacco.[71] The American Academy of Pediatrics (AAP) recommends that all teenagers be screened for tobacco and nicotine use in primary care, and that adolescents who want to quit smoking or tobacco use are offered smoking cessation treatment, referral, or both.[60] UK guidance from the National Institute for Health and Care Excellence (NICE) advises that health professionals ask people at every opportunity if they smoke, and if they smoke, deliver a brief intervention for smoking cessation, and refer to their local smoking cessation service.[63]
Smoking status should be readily visible to the physician or healthcare professional at the point of care.[73][74]
A prompt in the electronic health record to mention smoking cessation may be beneficial, in addition to decision support tools and links to resources. These tools may increase the rate of physician cessation interventions, the proportion of smokers receiving behavioral counseling, and quit rates.[95]
Screening for smoking with CO monitoring is recommended routinely for all pregnant women at prenatal appointments in some locations, including the UK.[63][Figure caption and citation for the preceding image starts]: Prompt for smoking, with additional questions automatically opened depending on each answerEMR (Epic MyPractice trademark 2022), used with permission [Citation ends].
[Figure caption and citation for the preceding image starts]: Prompt for e-cigarette use, typically completed by the intake staff and discussed by the healthcare providerEMR (Epic MyPractice trademark 2022), used with permission [Citation ends].
[Figure caption and citation for the preceding image starts]: Example script and color-coded sticker system for identifying smoking status with vital signsFrom the collection of Dr Theodore W. Marcy [Citation ends].
[Figure caption and citation for the preceding image starts]: Example method to indicate smoking status on the vital signs recordFrom the collection of Dr Theodore W. Marcy [Citation ends].
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