Add Smoking/Tobacco Use to a Chart Note

The Smoking/Tobacco Use dialog allows you to configure any applicable smoking/tobacco use for the patient, as well as any cessation materials provided. When smoking/tobacco use is entered it will appear in the specific chart note it was entered in. All of the smoking/tobacco use information entered in the patient chart notes will also tracked and can be viewed via the History tab. Use the following steps to configure smoking/tobacco use for a patient in a chart note.

1. Open the patient's chart note.
    

2. Click the button in the chart note. The Smoking/Tobacco Use dialog will appear.
    

3. The Smoking/Tobacco Use dialog is designed with a set of questions that allow you to configure whether or not the patient was asked about their tobacco use, which then activates more detailed options about their use, as well as being able to configure any cessation materials or appeals to cease using tobacco.
   
   In the "Have you smoked at least 100 cigarettes in your entire life?" section, click the Yes or No radio button as applicable.
   
   
   
    

4. In the "Have you used tobacco in the last 30 days?" section, click the Yes or No radio button, if applicable.
    

5. In the Smoking Status - CDC Terminology section, select the applicable Smoking Status for the patient from the list below.
   
   Smoking Status Definitions:
    

• Current every day smoker and/or Current some day smoker: an individual who has smoked at least 100 cigarettes during his/her lifetime and still regularly smokes everyday or periodically, yet consistently.

• Former smoker: an individual who has smoked at least 100 cigarettes during his/her lifetime but does not currently smoke.

• Never smoker: an individual who has not smoked 100 or more cigarettes during his/her lifetime.

• Smoker, current status unknown: an individual who was known to have smoked at least 100 cigarettes in the past, but whether they currently still smoke is unknown.

• Heavy tobacco smoker: an individual who has smoked at least 100 cigarettes during his/her lifetime and currently smokes 10 or more cigarettes everyday.

• Light tobacco smoker: an individual who has smoked at least 100 cigarettes during his/her lifetime and currently smokes 10 or less cigarettes everyday.

• Unknown if ever smoked

• None of the above

• Not asked
   

NOTE: If you clicked the Yes radio button in the "Have you ever smoked at least 100 cigarettes in your entire life?" or the "Have you used tobacco in the last 30 days?" section above, the Never smoker, Unknown if ever smoked, and Not Asked options will be grayed out.

5. In the "Do you use smokeless tobacco?" section, click the Yes or No radio button, if applicable.
    

6. In the "Have you used smokeless tobacco products in the last 30 days?" section, click the Yes or No radio button, if applicable.
    

7. In the Smoking subsection of Tobacco Details section, configure the Cigarettes per day, Years smoked, Start Year, and the End Year in the corresponding fields as needed.
   
   NOTE: The End field only becomes accessible if the Former Smoker option is selected in the Smoking Status – CDC Terminology section.
    

8. Check the Advised to quit tobacco use, Cessation materials/counseling provided, and/or Cessation materials/counseling not done for medical reason options if applicable, and then configure the applicable Date in which these options were provided in the corresponding field.
   
   NOTE: If the Cessation materials/counseling provided option is selected, the Cessation materials/counseling not done for medical reason option will be grayed out and unavailable for selection. Likewise, if the Cessation materials/counseling not done for medical reason option is selected, the Cessation materials/counseling provided option will be grayed out and unavailable for selection.
    

9. In the "Are you at risk for secondhand smoke?" section, click the Yes or No radio button, if applicable.
    

10. Check the Tobacco use screening not performed medical reasons option, if applicable. When this option is selected all of the fields above will be disabled and set to Not Asked.
     

11. If the date of the chart note is before 01/01/2017, check the Tobacco use screening not performed due to life expectancy option, if applicable. When this option is selected all of the fields above will be disabled and set to Not Asked.
    
    If the date of the chart note is 01/01/2017 or later, the Tobacco use screening not performed due to limited life expectancy option will NOT be displayed, as it no longer applies to the 2016 version of the Clinical Quality Measure NQF 0028 for Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention.
     

12. In the Comments field, enter any additional Comment or Note for the patient's smoking/tobacco use.
     

13. Check the Display results in list format box if you want the smoking history to appear as a list instead of in paragraph format.
    
    
    
     

14. When finished, click the OK button and the smoking history information will appear in the chart note as well as in the History. Likewise, when applicable options are selected in the Smoking/Tobacco Use dialog any applicable SNOMED and/or LOINC codes will be attached and used when calculating applicable Meaningful Use Quality Measures (NQF 0028).