Introduction
Identifying users
Determining readiness to change
Identifying users
Patients must first be screened for tobacco use. This simple screening can be done by asking the following questions, which can be done by the physician, nurse, or other clinic staff at the time vital signs are taken.
Do you use tobacco?

If yes: What kind(s) of tobacco product do you use? How much? For how long?

If no: Have you ever used tobacco?
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 If yes: How long ago did you quit?
It is helpful if numerous staff in the clinic are involved in identifying and addressing tobacco use. For example, a nurse aide or assistant can ask the screening questions before a patient sees the clinician.
It is especially important to indicate tobacco use in a patient's chart, so that the problem can be followed on subsequent visits and by different clinicians.
When including diagnostic codes in patient charts or discharge materials, use the ICD-9-CM code for Tobacco Use Disorder/Tobacco Dependence (code 305.1) or History of Tobacco Use (code V15.82).
For billing record purposes, use the appropriate billing codes, typically the Preventive Medicine, Individual Counseling code 99401, "Preventive medicine counseling and/or intervention to treat the risk factor of tobacco use provided to an individual (separate procedure); approximately 15 minutes." (Codes 99402, 99403, and 99404 are used for 30, 45, and 60 minutes, respectively.)