No Butts: Leveraging the Electronic Medical Record to Address Tobacco Cessation

Assistant Clinical Professor of Medicine, Division of General Internal Medicine

Tobacco use remains the largest preventable cause of death in the United States[i]. Tobacco cessation involves multiple quit attempts over time—but with provider engagement, patients are more likely to remain smoke-free. A 2014 Cochrane review showed that documentation of tobacco use and referral to cessation counseling appeared to increase following implementation of EMR-based tools[ii]. Although few studies in this review included assessment of quit rates, many of them evaluated changes in any of the 5A actions, which have been associated with higher tobacco cessation rates.[iii] Tobacco screening and counseling are important priorities for UCSF Health, given that they are a combined metric for PRIME (Public Hospital Redesign Incentive Program), with a target goal of 95.8% of adult patients in Primary Care being screened for tobacco use, and counseling and/or cessation treatment/referrals provided for active smokers.