The frequency of asking and advising adult patients about tobacco use was measured after an intervention to adopt smoking as a vital sign at 7 community health centers. The intervention consisted of training staff, revising forms and vital sign stamps, and disseminating educational materials. Documentation in medical charts was reviewed for 1571 randomly sampled patients in 2002 and 2003. The point prevalence (last encounter) and period prevalence (any annual encounter) of asking patients about smoking increased significantly from 2002 to 2003 (59% to 85%, and 71% to 97%, respectively) overall and at each health center. On advising smokers to quit, 4 health centers improved, but the overall point prevalence, 26%, and period prevalence, 46%, were unchanged over time. An intervention using multiple strategies may have contributed to improving the rates of asking but did not have as large or consistent an impact on rates of advising smokers to quit.
Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291:1238-1245.
2.
Office on Smoking and Health.The Health Benefits of Smoking Cessation. Atlanta, GA: National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control; 1990.
3.
Fiore MC, Bailey WC, Cohen SJ, et al.Treating Tobacco Use and Dependence. Tobacco Cessation Guideline. Rockville, MD: US Department of Health and Human Services; 2000. Available at: http://www.surgeongeneral.gov/tobacco. Accessed April 24, 2003.
4.
The Tobacco Use and Dependence Clinical Practice Guideline Panel, Staff, and Consortium Representatives. A clinical practice guideline for treating tobacco use and dependence: a US Public Health Service report. JAMA. 2000;283:3244-3254.
5.
Hughes JR, Goldstein MG, Hurt RD, Shiffman S.Recent advances in the pharmacotherapy of smoking. JAMA. 1999;281:72-76.
6.
National Committee on Quality Assurance.Health Plan Employer Data and Information Set (HEDIS), 2004. Technical Specifications. Volume 2. Washington, DC: National Committee on Quality Assurance; 2003:237-238.
7.
Ward MM, Doebbeling BN, Vaughn TE, et al.Effectiveness of a nationally implemented smoking cessation guideline on provider and patient practices. Prev Med. 2003;36: 265-271.
8.
Robinson MD, Laurent Sl, Little JM.Including smoking status as a new vital sign: it works!J Fam Pract. 1995;40:556-561.
9.
Piper ME, Fiore MC, Smith SS, et al.Use of the vital sign stamp as a systematic screening tool to promote smoking cessation. Mayo Clin Proc. 2003;78:716-722.
10.
Ahluwalia JS, Gibson CA, Kenney RE, Wallace DD, Resnicow K.Smoking as a vital sign. J Gen Intern Med. 1999;14:402-408.
11.
Boyle R, Solberg LI.Is making smoking status a vital sign sufficient to increase cessation support actions in clinical practice. Ann Fam Med. 2004;2:22-25.
12.
Bombard J, Trosclair A, Schooley M.State-specific prevalence of current cigarette smoking among adults—United States, 2002. MMWR. 2004;52:1277-1280.
13.
Husten C, Jackson K.Cigarette smoking among adults—United States, 2002. MMWR. 2004;53:427-431.
14.
U.S. Department of Health and Human Services.Tobacco use. Objective 27.1a. In: Healthy People 2010: Understanding and Improving Health. 2nd ed.Washington, DC: U.S. Government Printing Office; 2000. Available at: http://www.healthypeople.gov/document/HTML/Volume2/27Tobacco.htm. Accessed April 24, 2003.
