The Article in Brief

Effect on Cessation Counseling of Documenting Smoking Status as a Routine Vital Sign: An ACORN Study

Stephen F. Rothemich, MD, MS , and colleagues

Background Smoking is the leading cause of death in the United States. Advice from doctors, even brief and simple advice, has been shown to increase the rates at which patients quit smoking. This study examines whether documenting patients' smoking status along with other vital signs (such as blood pressure) makes a difference in the amount of advice patients receive about stopping smoking.

What This Study Found Asking about smoking status as a routine vital sign in primary care practice results in a modest increase in simple advice to quit but not in more extensive counseling about smoking. The study found an 8.6 % increase in counseling that consisted mainly of simple advice to quit, with little discussion of how to do so.

Implications

• Asking about smoking status as a routine vital sign in primary care practices can modestly increase the rates at which patients stop smoking.
• To offer more intensive counseling about quitting smoking, practices and health plans must redesign management systems and reimbursement plans, and work with other community resources.