Research shows that routine screening is a critical component of treating tobacco use and contributes to increased rates of physician intervention (Rothemich et al., 2008; Stead et al., 2008). The 2008 US guidelines “Treating Tobacco Use and Dependence (Fiore et al., 2008) concludes that “tobacco use presents a rare confluence of circumstances: (1) a highly significant health threat; (2) a disinclination among clinicians to intervene consistently; and (3) the presence of effective interventions.” You should refer to your country’s guidelines for details specific to your country.
Among its ten key guideline recommendations, the US guidelines emphasize the need to screen for tobacco users in healthcare settings and to intervene appropriately (Stead et al., 2008). Tobacco screening and brief interventions have been identified as one of the top three priorities among effective clinical preventive services which are as cost-effective as aspirin chemoprophylaxis and childhood immunizations (Maciosek et al., 2006).
The guidelines also recommend that screening take place at every visit with the patient as smoking status can change between visits. Tobacco dependence is a chronic, relapsing condition. One of the goals is to trigger as many patients as possible to make a quit attempt (West and Shiffman, 2007).
The guidelines also recommend expanding the vital signs to include tobacco use, using tobacco stickers on all patient charts, or indicating tobacco use status either through the physician’s electronic medical record or any other form of computerized reminder system employed by the physician. Such a system would ensure systematic identification of all tobacco users at every visit.