Location

National

ADVICE RE CODING EX-SMOKERS

We've had queries from several practices asking for guidance on the best approach to the coding of ex-smokers.

Based on international conventions, we recommend the following:

The international convention is to treat someone as an ex-smoker once they have been smokefree (not one puff) for one month (at least 28 days). This convention is promoted by the WHO and captured in the ICD coding most DHBs use.

Statistically, the risk of relapse reduces dramatically after 12 months - for that reason, it has also become common for clinicians helping patients to quit to distinguish between an "Ex-smoker<12 months" and an "Ex-smoker>12 months."

Clinicians may be able to implement this in the following ways:

For those practices using screening tools and decision support software, many of these have simple facilities that would make it easy to record smoking status using these conventions. We'd encourage you to discuss this with your vendors.

Similarly, for those using ZCPI codes, the following classifications could be available for the ZCPI system: Current Smoker; Ex-smoker <12 months; Ex-smoker >12 months; Never Smoker.

Lastly, there are a number of existing READ codes that relate to ex-smokers (such as 137K Stopped Smoking and 137S Ex-smoker). Clinicians could also use the "Date of Onset" field to record the date of quitting if they want to track how long a patient has been smokefree.

Detailed smoking status information will be used only by clinicians. Its purpose is to guide clinical practice to support patients to actively manage their smokefree status.
It is good practice to record patients as ex-smokers after they have been smokefree for 28 days, but it is likely they will need more active support in the initial 12 months.

For further information please contact Monique Leerschool at or phone (04) 496 2085.