TY - JOUR T1 - Smoking As a Vital Sign: Prompts to Ask and Assess Increase Cessation Counseling JF - The Journal of the American Board of Family Medicine JO - J Am Board Fam Med SP - 625 LP - 632 DO - 10.3122/jabfm.2009.06.080211 VL - 22 IS - 6 AU - Anna McCullough AU - Michael Fisher AU - Adam O. Goldstein AU - Kathryn D. Kramer AU - Carol Ripley-Moffitt Y1 - 2009/11/01 UR - http://www.jabfm.org/content/22/6/625.abstract N2 - Background: Strategies to improve smoking cessation counseling in clinical settings are critical to supporting smokers’ attempts to quit. This study evaluates the impact of adding 2 smoking-related vital sign questions in an electronic medical records system on identification, assessment, and counseling for patients who smoke: “Current smoker?” and “Plan to quit?”Methods: Baseline data and data after intervention were collected through record review of 899 randomly selected patient visits across 3 outpatient clinics.Results: From before to after intervention, identification of smokers increased 18% (from 71% to 84%; P < .001), and assessment for a plan to quit increased 100% (from 25.5% to 51%; P < .005). Among all smokers, cessation counseling increased 26% (from 23.6% to 29.8%; P = .41). Significantly more smokers who received the assessment for a plan to quit received cessation counseling (46% vs. 14%, P < .001). Regression analysis showed that patients receiving an assessment for plan to quit were 80% more likely to receive cessation counseling (OR 0.209; 95% CI, 0.095–0.456).Conclusions: Physician-documented counseling rates are significantly higher when patients are asked about smoking and assessed for a plan to quit. Two questions that ask about smoking status and assess plans to quit may provide prompts to increase the likelihood that patients who smoke receive cessation counseling. ER -