Measure ID

Percentage of adult patients with smoking status documented within 365 days prior to any procedure requiring anesthesia

Measure Type
Available for Provider Feedback

Tobacco use is the single greatest preventable cause of disease and premature death in America today.1 In addition, smoking is an established perioperative risk factor impacting up to 25% of surgical patients.2 According to the Centers for Disease Control (CDC), 70% of smokers report they would like to quit however, only 15% of smokers in Michigan receive smoking cessation treatment.3,4 Making every contact count (MECC) is an approach to behavior change that is clinically proven to help patients quit smoking and results in better health outcomes.5 More so, there is evidence to support that the preoperative setting offers an opportunity to address smoking cessation options.6

Measure Time Period

365 days prior to Anesthesia Start to Anesthesia End


Adult patients requiring anesthesia.

Success Criteria

Smoking status (current, former, or non-smoker) documented in anesthesia preoperative evaluation within 365 days prior to Anesthesia End

Other Measure Details

*This measure will include valid MPOG cases defined by the Is Valid Case MPOG phenotype.

Risk Adjustment

Not applicable

Provider Attribution

Provider(s) signed in at Anesthesia Start

MPOG Concept Used

MPOG Concept ID

Concept Description

Smoking Status Concepts


History- Social History - Alcohol


History- Illicit Drug Use


History- Social History - Tobacco


History- Social History - Tobacco (Current Smoker)


History- Social History - Tobacco (Former Smoker)


History- Social History - Tobacco (Non Smoker)


History- Social History - Tobacco Details Pack Years


History- Social History - Tobacco Details Current vs Past


General - Past Medical History ICD-9 Code


General - Past Medical History ICD-10 Code


History - Social History - General


General - PONV Risk Factors

MPOG Phenotypes Used
  1. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014
  2. Schmid M, Sood A, Campbell L, et al. Impact of smoking on perioperative outcomes after major surgery. Am J Surg 2015;210:221–9.
  3. Babb S, Malarcher A, Schauer G, Asman K, Jamal A. Quitting Smoking Among Adults - United States, 2000-2015. MMWR Morb Mortal Wkly Rep. 2017;65(52):1457-1464.
  4. Analysis provided by the Michigan Value Collaborative for Blue Cross Blue Shield of Michigan PPO Pharmacy plan members in 2019-2020.
  5. Public Health England. Making Every Contact Count (MECC): Consensus statement.  Public Health England, NHS England, Health Education England, and the national MECC advisory group, April 2016 (
  6. Nayan S, Gupta MK, Strychowsky JE, Sommer DD. Smoking cessation interventions and cessation rates in the oncology population: an updated systematic review and meta-analysis. Otolaryngol Head Neck Surg 2013;149:200–11.
Measure Authors

 Measure Author


 Nirav Shah, MD

 University of Michigan

 Kate Buehler, MS, RN

 University of Michigan

 Genevieve Bell

 University of Michigan

 MPOG Quality Committee



Measure Reviewer(s)
Next Review: 2025
 Date Reviewed  QC Presentation  Reviewer  Institution  Summary  QC Vote







Published Date: 04/2022
 Date  Criteria  Revision
 10/13/2023  Exclusion ASA 5&6 cases and Block only procedures.
 05/05/2023  Description/Success Updated from 30 days before surgery to 365 days before
 04/17/2023  Exclusion Intubation Only cases