Name of the Procedure:

Tobacco Use Assessed (CAD, CAP, COPD, PV) (DM)

Common Name(s): Tobacco Assessment, Smoking Status Evaluation Medical Terms: Nicotine Use Assessment, Tobacco Use Screening

Summary

A tobacco use assessment is a simple evaluation conducted to determine if a patient uses any form of tobacco, such as cigarettes, cigars, or electronic cigarettes. This assessment is particularly crucial for patients with certain chronic conditions like coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), and diabetes mellitus (DM).

Purpose

Assessing tobacco use is essential for identifying and managing health risks associated with tobacco consumption. It aims to:

• Understand the patient's tobacco use habits.
• Provide appropriate interventions or counseling.
• Aid in the management and treatment of related chronic conditions.

Indications

This assessment is particularly warranted for patients with:

• Coronary Artery Disease (CAD)
• Chronic Obstructive Pulmonary Disease (COPD)
• Cerebrovascular Accident (CVA)
• Peripheral Vascular Disease (PVD)
• Diabetes Mellitus (DM) Factors making the assessment appropriate include:
• Chronic cough or respiratory issues
• Recent diagnosis of cardiovascular or respiratory diseases
• Routine chronic disease management

Preparation

The patient may be asked to provide information on their tobacco use history, including:

• Duration and frequency of tobacco use
• Types of tobacco products used
• Any previous attempts to quit smoking No specific fasting or medication adjustments are typically required.

Procedure Description

1. Initial Consultation: The healthcare provider asks the patient about their smoking habits, including the type and amount of tobacco used.
2. Medical History Review: The provider reviews the patient’s medical history, focusing on any tobacco-related illnesses.
3. Questionnaire: A standardized questionnaire may be used to gather detailed information about the patient’s tobacco use.
4. Discussion of Findings: The provider discusses the findings with the patient, exploring the risks and potential impacts on their chronic conditions.
5. Counseling & Intervention: Based on the assessment, the provider may offer cessation resources, medications, or referrals to support groups.

Tools/Equipment: Questionnaires, electronic health records systems. Anesthesia/Sedation: Not applicable.

Duration

The assessment typically takes about 15-30 minutes.

Setting

This procedure can be performed in various settings, such as:

• Outpatient clinic
• Hospital
• Physician's office

Personnel

• Primary Care Physician or Nurse Practitioner
• Medical Assistant or Registered Nurse for support

Risks and Complications

As a non-invasive assessment, there are minimal risks. Potential risks include:

• Emotional distress due to discussing personal habits.
• False reporting by the patient due to stigma or fear.

Benefits

• Identification of tobacco use, enabling timely intervention.
• Reduction in the risk of tobacco-related complications.
• Improvement in managing chronic conditions.
• Enhanced overall health and well-being.

Recovery

No physical recovery is needed. Patients may need follow-up appointments for ongoing management or support in quitting tobacco use.

Alternatives

• Self-reported Surveys: Patients can fill out surveys on their own.
• Biochemical Verification: Tests like saliva or blood nicotine levels to confirm tobacco use (more invasive and costly).

Pros of Alternatives:

• Self-reported surveys can be completed at home.
• Biochemical tests offer objective confirmation of tobacco use.

Cons of Alternatives:

• Self-reports may lack accuracy.
• Biochemical tests can be invasive and expensive.

Patient Experience

During the assessment, the patient will engage in a conversation about their tobacco use, filling out questionnaires, and possibly discussing sensitive issues. Compassionate and non-judgmental communication can enhance comfort. If needed, providers will discuss pain management strategies for withdrawal symptoms and provide resources for quitting smoking.