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Treating Tobacco Use and Dependence in Hospitalized Patients

To download the entire manual: Click here

See below to download isolated portions of the manual

Table of Contents

Section 1, Introduction: Click here
Tobacco dependence treatment in the hospital setting, page 1
Why hospitals should implement the Joint Commission tobacco measure set, 3
The Joint Commission’s tobacco measure set, 5
Tobacco measure set specifications, 7
Tobacco dependence treatment inpatient flow chart, Click here, 8

Section 2, Developing a Successful Hospital-wide Tobacco Cessation Program to Meet the Joint Commission Tobacco Measure Set: Click here
Getting Started
Step 1:  Assemble a multidisciplinary team to develop the program, 9
Step 2:  Conduct an assessment of existing tobacco use treatment services, 9
Step 3:  Set measurable tobacco cessation goals to meet Joint Commission standards, 10
Step 4:  Train staff to deliver evidence-based tobacco cessation treatment, 10
Step 5:  Identify a tobacco cessation counselor or counseling team, 11
Step 6:  Assess current medical record system and modify as needed, 12

Implementation: Joint Commission Tobacco Measures: Click here
TOB-1 Tobacco Use Screening, 13
TOB-2 Tobacco Use Treatment Provided or Offered During the Hospital Stay, 15
TOB-3 Tobacco Use Treatment Provided or Offered at Discharge, 20
TOB-4 Tobacco Use: Assessing Status after Discharge, 23

Section 3, Other Considerations When Treating Tobacco Dependence in Hospitals: Click here
Coding/Billing/Reimbursement, 26
Tobacco users who are unwilling to quit, 28
Obstetrics/Maternity units, 31
Patient education, 32
Section 4, Resources: Click here
Resources, 33
Programs/Training, 36
Hospital references, 37

  • Appendix 1, Hospital Assessment of Tobacco Use Procedures and Policies Worksheet:  Click here

  • Appendix 2A, Physician’s Orders for Nicotine Dependence Treatment:  Click here

  • Appendix 2B, Tobacco Abstinence Standing Order Set: Click here

  • Appendix 3, Respiratory Therapy Referral Tobacco Cessation Intervention and Education: Click here

  • Appendix 4, Not Ready to Quit Tobacco Assessment and Education Form:  Click here

  • Appendix 5A, Prenatal Five A’s Tobacco Cessation Intervention Record: Click here

  • Appendix 5B, Postnatal Five A’s Tobacco Cessation Intervention Record: Click here

  • Appendix 5C, Smoke-Free Families Postpartum Assessment Form: Click here

  • Appendix 6, Wisconsin Tobacco Quit Line Fax to Quit Sample Form: Click here

  • Appendix 7, Wisconsin Tobacco Quit Line Fax to Quit Treatment Outcome Sample Form,  Click here

  • Appendix 8, Tobacco Cessation Discharge Plan: Click here

  • Appendix 9, Sample letter to Primary Care Provider Regarding a Hospital Tobacco Cessation Intervention: Click here

Selected text adapted with permission from Partnership for Prevention's Helping Patients Quit: Implementing the Joint Commission Tobacco Measure Set in Your Hospital: Click here

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