Screening for Tobacco Use


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First Step: Simply Ask

Guidelines from the U.S. Preventive Task Force (USPSTF) recommend that clinicians ask all adults about tobacco use, recommend that those who use tobacco stop using it, and provide behavioral interventions and FDA-approved pharmacotherapy to help them stop (Siu and U.S. Preventative Services Task Force, 2015).

Pre-screening questions help determine which patients require further screening/assessment. They are often included in forms filled out by the patient that are given to them by the front desk OR asked quickly by a medical assistant or nurse when the patient is taken to a treatment room. They help identify which patients use or have ever used tobacco.

Tobacco Pre-Screening Question:
Have you ever used tobacco?
  • If "Yes" Continue with screening questions on next page.
  • If "No:" Encourage them never to start


Ms. Ashley Mason, 28 yo female with upper respiratory infection

Ms. Mason is visiting the clinic for an upper respiratory infection. She gets several upper respiratory infections per year.

Nurse Brown asks Ashley whether she ever used tobacco, just as she asks every patient:

Nurse Brown: Have you ever used tobacco?

Ms. Mason: Yes, I do smoke

Nurse Brown realizes that further screening is indicated. On the next page you will see several questions that can follow quickly after a positive pre-screening.

Practice Tip

Ask about all tobacco use and not just smoking.

View ReferencesHide References
Centers for Disease Control and Prevention. Current Cigarette Smoking Among Adults in the United States. Smoking and Tobacco Use. CDCP Website. Content source: Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion. 2016; December 1: . Available at: Accessed on: 2017-01-09.
Centers for Disease Control and Prevention. Current Cigarette Smoking Among Adults — United States, 2005–2014. Morbidity and Mortality Weekly Report. 2015; 64(44): 1233-1240. Available at: Accessed on: 2015-11-12.
Fiore MC, Jaen CR, Baker TB, et al. Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: U.S. Department of Health and Human Services. Public Health Service. May 2008. Available at: Accessed on: 2013-09-26.
Siu AL, U.S. Preventive Services Task Force. Behavioral counseling and pharmacotherapy interventions for tobacco cessation in adults, including pregnant women: A review of reviews for the U.S. Preventive Services Task Force. Ann Intern Med. 2015. Available at: Accessed on: 2016-02-09.