Approximately 27,000 Texans a year are diagnosed with tobacco related cancers. The number one cause of cancer deaths among Texas men and women is lung cancer--nearly 90% of these deaths in men are attributed to smoking. Effective interventions are needed to motivate existing and former tobacco users to quit.

Primary health care settings are ideal intervention sites and research shows that the advice of a health care professional can more than double cessation success rates. However, only 13% of physicians say they usually refer smokers to appropriate treatments and only 17% say they usually arrange for follow-up visits to address tobacco. A system-wide change is needed that will make it easi...

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Approximately 27,000 Texans a year are diagnosed with tobacco related cancers. The number one cause of cancer deaths among Texas men and women is lung cancer--nearly 90% of these deaths in men are attributed to smoking. Effective interventions are needed to motivate existing and former tobacco users to quit.

Primary health care settings are ideal intervention sites and research shows that the advice of a health care professional can more than double cessation success rates. However, only 13% of physicians say they usually refer smokers to appropriate treatments and only 17% say they usually arrange for follow-up visits to address tobacco. A system-wide change is needed that will make it easier for healthcare providers to regularly identify smokers and provide treatment to tobacco users who are ready to quit.

A major change is already underway that is expected to revolutionize the practice of medicine in the United States - the move away from paper-based to computer-based electronic health records. Healthcare providers utilizing electronic health records (EHRs) lie at the core of the emerging health information technology infrastructure and offer a unique opportunity for improving the quality of care for patients.

The proposed intervention will train healthcare providers on the use of an evidence-based electronic health records tobacco cessation template that conforms to U.S. Public Health Services Tobacco Cessation Guidelines and document and evaluate adoption of the intervention by healthcare systems. Hospital system information officers will be approached in the early stages of their EHR development and encouraged to embed the research-based template and training tool for tobacco control into their electronic health records system. Healthcare providers will receive ongoing education online and in person on the use of a standard tool that also makes it easy to meet federally mandated meaningful use guidelines, accurately bill for insurance reimbursement, counsel and prescribe the appropriate treatment. The electronic health record template will deliver brief intervention opportunities to tobacco users during every visit, record patient quit attempts and, help the patient quit the habit.

This proposed project will document the adoption and training process and evaluate the impact of the intervention in a sample of Texas hospital systems. It has the potential to reduce the prevalence of tobacco-related cancers in multiple sites, including lung, mouth, lips, nasal cavity and sinuses, larynx, pharynx, esophagus, stomach, pancreas, kidney, bladder, uterine cervix, breast, colon and acute myeloid leukemia. Ultimately, the proposed project has the potential to reduce the number of tobacco-related deaths.

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