Screen for tobacco use or secondhand
exposure at every encounter (Table 1)
Advise to quit Yes
Is patient willing
to make a quit attempt
at this time or in the
next 30 days?
education (5 Rs) or
** Hospitalized patients may also be
interested in pharmacotherapy to
minimize withdrawal symptoms.
Connect to or provide
1) Connection to quit line
2) Group/individual counseling
Complete follow-up contacts
beginning within the first
week after quit date or 30
days after discharge
Patients age > 18 years:
Reinforce tobacco-free lifestyle.
Patients age 5-17 years:
Provide education and anticipatory
guidance to prevent initiation.
on health risks associated with
secondhand smoke exposure.
Provide referral to parent/
caregivers as appropriate.
lifestyle and assess
challenges, need for
support and risk of
Tobacco Use Assessment and Interventions in
Nonpregnant Adolescent and Adult Patients
Reference: UW Health Tobacco Use Assessment and
Cessation Clinical Practice Guideline
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 10/2016CCKM@uwhealth.org