• Institute for Clinical Systems Improvement (ICSI). Tobacco use prevention and cessation for adults and mature adolescents. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2004 Jun. 42 p. [46 references]

Does not apply to this measure

This measure assesses the percentage of patients with documented tobacco use or exposure at the latest visit who also have documentation that their cessation interest was assessed or that they received advice to quit.

The priority aim addressed by this measure is to improve the proportion of tobacco users whose interest in quitting is assessed or who receive cessation advice at any clinic encounter.

Tobacco use; cessation advice; assessment of interest or readiness to quit

Total number of tobacco users* audited

*Tobacco user = Any indication on a chart or in the note from the latest visit that the patient uses tobacco (or, for a child, is regularly exposed to tobacco smoke).

Number of tobacco users advised to quit or whose readiness to quit was assessed at the latest visit (see the related "Numerator Inclusions/Exclusions" field in the Complete Summary)

• A clinical practice guideline or other peer-reviewed synthesis of the clinical evidence

Unspecified

Current routine use

Internal quality improvement

Physician Group Practices/Clinics

Physicians

Group Clinical Practices

All patients visiting the practice, regardless of age, who have any indication on their charts that they are or may be users of tobacco, or in the case of children that they are regularly exposed to tobacco smoke

Either male or female

Unspecified

Each day, nearly 4,800 adolescents (ages 11 to 17) smoke their first cigarette; of these, nearly 2,000 will become regular smokers. That is almost two million annually! Tobacco use includes all forms of tobacco--smoking cigarettes, cigars or pipes, as well as using snuff or chewing tobacco.

• Institute for Clinical Systems Improvement (ICSI). Tobacco use prevention and cessation for adults and mature adolescents. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2004 Jun. 42 p. [46 references]

Tobacco cessation is particularly important during pregnancy. Tobacco cessation is also very important in those individuals with heart disease or other risk factors for heart disease.

• Institute for Clinical Systems Improvement (ICSI). Tobacco use prevention and cessation for adults and mature adolescents. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2004 Jun. 42 p. [46 references]

Key findings regarding secondhand smoke include:

• Secondhand smoke causes a significant number of heart attacks.
• Secondhand smoke causes increased risk of lung cancer.
• Secondhand smoke is a major cause of preventable heart disease.
• Secondhand smoke causes major illness in infants. For example, an estimated 7,500-15,000 infants and toddlers are hospitalized with bronchitis or pneumonia every year because they breathe tobacco smoke.
• The California Environmental Protection Agency concludes that there are between 22,669-69,553 cardiac deaths, between 7,564-26,473 lung cancer deaths, and 789,712 otitis media (ear infection) office visits related to secondhand smoke annually in the U.S.

• Institute for Clinical Systems Improvement (ICSI). Tobacco use prevention and cessation for adults and mature adolescents. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2004 Jun. 42 p. [46 references]

Unspecified

Unspecified

Staying Healthy

Effectiveness

Users of care only

Patients associated with provider

Inclusions
Total number of tobacco users* audited

*Tobacco user = Any indication on a chart or in the note from the latest visit that the patient uses tobacco (or, for a child, is regularly exposed to tobacco smoke).

Exclusions
Unspecified

All cases in the denominator are equally eligible to appear in the numerator

Encounter

Time window is a single point in time

Inclusions
Number of tobacco users* advised to quit or whose readiness to quit was assessed at the latest visit

*Tobacco user = Any indication on a chart or in the note from the latest visit that the patient uses tobacco (or, for a child, is regularly exposed to tobacco smoke). Documentation in the progress note from the latest visit with a clinician of either advice to quit or information about the user's current interest or readiness to quit will satisfy the rest of the definition.

Exclusions
Unspecified

The measure results are somewhat or substantially under the control of the health care professionals, organizations and/or policymakers to whom the measure applies.

Encounter or point in time

Medical record

Individual Case

Unspecified

Rate

Better quality is associated with a higher score

Unspecified

Internal time comparison

Unspecified

Percentage of patients with documented tobacco use or exposure at the latest visit who also have documentation that their cessation interest was assessed or that they received advice to quit.

Institute for Clinical Systems Improvement

The following Minnesota health plans provide direct financial support: Blue Cross and Blue Shield of Minnesota, HealthPartners, Medica, Metropolitan Health Plan, PreferredOne, and UCare Minnesota. In-kind support is provided by the Institute for Clinical Systems Improvement's (ICSI) members.

Work Group Members: David Klevan, MD (Work Group Leader) (HealthPartners Medical Group) (Internal Medicine); Thomas E. Kottke, MD (Mayo Clinic) (Cardiology); Donald A. Pine, MD (Park Nicollet Health Services) (Family Practice); Michael Schoenleber, MD (HealthPartners Medical Group) (Family Practice); David Rossmiller, MD (Family HealthServices Minnesota) (Family Practice); Renee Compo, RN, CNP (HealthPartners Medical Group) (Obstetrics/Gynecology Nurse Practitioner); Janice Taramelli (Methodist Hospital/Park Nicollet Institute) (Health Educator); Penny Carson (Institute for Clinical Systems Improvement) (Measurement/Implementation Advisor); Peter Lynch, MPH (Evidence Analyst) (Institute for Clinical Systems Improvement); Pam Pietruszewski, MA (Institute for Clinical Systems Improvement) (Facilitator)

Measure was not adapted from another source.

2003 Jul

2004 Jun

This is the current release of the measure.

This measure updates a previous version: Institute for Clinical Systems Improvement (ICSI). Tobacco use prevention and cessation for adults and mature adolescents. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2003 Jul. 36 p.

• Institute for Clinical Systems Improvement (ICSI). Tobacco use prevention and cessation for adults and mature adolescents. Bloomington (MN): Institute for Clinical Systems Improvement (ICSI); 2004 Jun. 42 p. [46 references]

This NQMC summary was completed by ECRI on March 29, 2004. This summary was updated by ECRI on October 5, 2004.

This NQMC summary (abstracted Institute for Clinical Systems Improvement [ICSI] Measure) is based on the original measure, which is subject to the measure developer's copyright restrictions.

The abstracted ICSI Measures contained in this Web site may be downloaded by any individual or organization. If the abstracted ICSI Measures are downloaded by an individual, the individual may not distribute copies to third parties.

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