Recognizing Tobacco Use and Improving Smoking Cessation Rates with Electronic Medical Records

Sarah Schwiesow, PharmD

Introduction/Background. Although nearly 50 million Americans report smoking, only half say they have discussed tobacco use with their primary care provider. When a physician provides smoking cessation advice quit rates up to 10% have been observed. The electronic medical record (EMR) may be used to identify smokers and improve the management of tobacco abuse. The purpose of this project was to use the EMR to influence patient shifts in readiness to quit and quit rates in the MUSC Family Medicine Center.

Methods. A smoking cessation “quick text” was designed based on the National Cancer Institute’s key cessation activities and inserted into existing EMR templates. An advisory group of six physicians piloted the “quick text”. Utilization of quick text, patient shifts in readiness to quit, and quit rate over a six-month period were measured in patients seen by the advisory group physicians. Patients were identified using the search term “Smoker.” Data were analyzed using descriptive statistics.

Results. Between November 14, 2003 and May 15, 2004 the “quick text” was used 928 times by all Family Medicine physicians and 23% of the time (215/928) by the advisory group. Of 208 patients included in the study, 36 (17%) were noted to be smokers. Of those 36 patients, 10 (28%) were interested in quitting within the next 6 months. There were no shifts in readiness to quit or successful quit attempts noted.

Conclusion. The “quick text” appears to be a well-received documentation/intervention tool despite the fact that no patients demonstrated a shift in readiness to quit or quit attempt during the project period.