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Release Notes:
Data Element
Version 2010A1

Data Element Name: Adult Smoking Counseling
Collected For: AMI-4, HF-4, PN-4,
Definition:Documentation in the medical record that smoking cessation advice or counseling was given during this hospital stay.

THE JOINT COMMISSION NOTE: This data is only populated if the Adult Smoking History is entered Y (Yes).

Suggested Data Collection Question:Was the adult patient/caregiver given smoking cessation advice or counseling during this hospital stay?
Allowable Values:

Y   (Yes)   Patient/caregiver received smoking cessation advice/counseling during hospital stay.

N   (No)   Smoking cessation advice/counseling not given or unable to determine from medical record documentation.

Notes for Abstraction:
  • If the patient refused smoking cessation advice or counseling during this hospital stay, select “Yes.”
  • If the patient has a history of cigarette smoking within the year prior to the arrival date but the patient does not currently smoke, they should be advised to continue not smoking. For these patients, if this advice/counseling was not done, select “No.”
  • If the patient is prescribed Wellbutrin/bupropion, it should not be assumed that this is a smoking cessation aid unless specifically noted as such. It is sometimes used as an antidepressant unrelated to smoking.
  • In cases where a document provides a checkbox for this information and the checkbox is left unchecked, credit for giving smoking cessation counseling to the patient/caregiver should not be taken. E.g., Checkbox on discharge instruction sheet which reads, “For more information on quitting smoking classes, please contact 1-800-xxx-xxxx “ is left unchecked – select “No.”
  • The caregiver is defined as the patient’s family or any other person (e.g., home health, VNA provider) who will be responsible for care of the patient after discharge.
Suggested Data Sources:
  • Consultation notes
  • Emergency department record
  • History and physical
  • Respiratory therapy notes
  • Nursing notes
  • Progress notes
  • Discharge summary
  • Medication administration record (MAR)
  • Discharge instruction sheet
  • Teaching sheet
  • Excluded Data Sources:
    Any documentation dated/timed after discharge, except discharge summary and operative/procedure/diagnostic test reports (from procedure done during hospital stay).

    Additional Notes:
    Guidelines for Abstraction:
    Inclusion Exclusion

    • Direct discussion with patient/caregiver about stopping smoking (e.g., “advised patient to stop smoking”)
    • Prescription of smoking cessation aid (e.g., Habitrol, NicoDerm, Nicorette, Nicotrol, Prostep, Zyban) during hospital stay or at discharge
    • Prescription of Wellbutrin/bupropion during hospital stay or at discharge, if prescribed as smoking cessation aid
    • Referral to smoking cessation class/program
    • Smoking cessation brochures/ handouts/ video

    • None

    Adult Smoking Counseling
    Specifications Manual for Joint Commission National Quality Core Measures (2010A1)
    Discharges 04-01-10 (2Q10) through 09-30-10 (3Q10)