Implementing an Evidence-Based Smoking Cessation Referral Toolkit in a High-Risk Lung Cancer Screening Clinic
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Date
2025-05
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The Ohio State University
Abstract
Background: Smoking is the leading modifiable risk factor for lung cancer. Although the benefits of smoking cessation are well documented, referrals to smoking cessation programs
remain inconsistent. Barriers include a lack of provider knowledge regarding the integration of referral programs into practice and insufficient infrastructure to support tobacco cessation.
Ensuring that referrals are made to smoking cessation programs is a crucial step in promoting smoking cessation among high-risk patients.
Purpose: This project aimed to implement a provider-driven smoking cessation referral toolkit to increase smoking cessation referrals and improve billing practices within a high-risk
population.
Methods: A smoking cessation referral toolkit was developed alongside an educational session to (1) train providers on the 5As communication technique to enhance referrals and
(2) ensure accurate documentation and billing for cessation counseling. Providers received a templated electronic progress note to facilitate smoking cessation discussions, and a
centralized digital repository was created for easy toolkit access.
Outcomes: High-risk patient visits offer an ideal chance for smoking cessation education and referrals. Utilizing a provider-driven, evidence-based toolkit improved smoking cessation
referrals and enhanced billing practices. Referral rates increased from 12.8% (Jan 2024) to 33.3% (Jan 2025) and from 16.0% (Feb 2024) to 34.5% (Feb 2025). Proper billing for
smoking cessation counseling (CPT code 99406) also improved, rising from 70.2% to 85.2% (Jan) and from 76.0% to 100% (Feb).
Conclusion: A structured approach, including provider education, communication strategies, and documentation tools, can enhance smoking cessation referrals and optimize reimbursement opportunities, ultimately improving patient outcomes.
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Keywords
Smoking Cessation, Toolkit, quit smoking, high-risk lung cancer, tobacco cessation, referral