Cases are considered compliant with the SMOK-02 measure when documentation includes any of the following tobacco cessation interventions:  

• Counseling: Advising patients to quit and set a quit date and providing counseling on cessation; counseling intervention MUST be provided by the clinical care team that is being assessed for VBR/P4P; cannot count other clinical sites providing support; team-based approach acceptable; physician counseling/referring not required but recommended over other clinical team members. 

• Pharmacotherapy: Providing prescription for cessation medications (nicotine replacement therapy or anti-cravings medications) or documented use/intention for over-the-counter medications. Note: Nicotine replacement therapies and certain cessation medications may be contraindicated in some surgical populations (e.g., spine or orthopedic surgery). In these settings, counseling, establishing quit dates, and providing cessation support resources may be preferred interventions.  

• • • Over-the-counter medications: nicotine gum, patches, lozenge; nicotine replacement therapies (NRT); documentation of:  
      • • Generic: nicotine polacrilex
        • Nicorette® (gum or patch)  
        • Commit® (lozenge) 
        • NicoDerm® (patch) 
          • Note: these medications are contraindicated in certain surgical populations and counseling, setting quit dates, and providing cessation support resources are preferred in these settings (ex: spine surgery, ortho surgery) 
      • Prescription medications:  
        • • Chantix® (varenicline) 
          • Zyban® (buproprion) 
          • Other anti-craving medications or prescription NRT regimens used to support cessation or facilitate insurance coverage 
          • Nicotine inhaler  

• Patient refusal: Documentation indicating the patient declined counseling or intervention, expressed no interest in quitting, or refused cessation support also qualifies as a passed case for the measure.