Measure ID

Percentage of adult patients who are documented as current tobacco smokers and also receive an approved smoking cessation intervention from an anesthesia provider 

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

30 days prior to Anesthesia Start through Anesthesia End


Adult patients requiring anesthesia and determined to be a ‘current smoker’ within 30 days prior to Anesthesia Start through Anesthesia End per the MPOG Smoking Tobacco Classification

Success Criteria

Smoking cessation intervention documented within 30 days prior to surgery and before Anesthesia End

Other Measure Details
  • Measure start time determined by first assessing Anesthesia Start and calculating 30 days prior
  • Documentation of smoking cessation intervention includes:
    • Counseling provided
    • Treatment offered
    • Referral for tobacco cessation counseling
    • Patient refusal or documentation suggesting ‘no interest in quitting’ or ‘patient declined’ 
  • For Michigan sites participating in the Value Based Reimbursement program: Please visit Smoking Cessation Frequently Asked Questions

*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

Smoking Cessation Treatment Concept


Tobacco Cessation Intervention

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


 Kate Buehler, MS, RN

 University of Michigan

 Mark Dehring

 University of Michigan

 Nirav Shah, MD

 University of Michigan


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







Published Date: 07/2022
Date Criteria Revision
 10/13/2023  Exclusion ASA 5&6 cases including organ harvest, and block only procedures.
 04/17/2023  Exclusion Intubation Only Cases
 03/27/2023   Exclusion  Patients with unknown smoking status not documented within 30 days prior to surgery trhough anesthesia end (ie 'Flagged' for SMOK-01)