HAB HIV Core Clinical Performance Measures for 

Adult/Adolescent Clients: Group 3

Final: April 2009  Page 19 

Performance Measure: Tobacco Cessation Counseling OPR-Related Measure: No 

Percentage of clients1 with HIV infection who received tobacco cessation counseling within the measurement 

year 

Numerator: Number of HIV-infected clients who received tobacco cessation counseling 

Denominator: 

Number of HIV-infected clients who: 

 used tobacco products within the measurement year; and 

 had a medical visit with a provider with prescribing privileges2 at least once in the 

measurement year 

Patient 

Exclusions: 1. Patients who deny tobacco use throughout the measurement year 

Data Elements: 

1. Is the client HIV-infected? (Y/N) 

a. If yes, did the client use tobacco during the reporting period? (Y/N) 

i. If yes, did the client receive tobacco cessation counseling 

during the measurement year? (Y/N) 

Data Sources: 

 Electronic Medical Record/Electronic Health Record 

 CAREWare, Lab Tracker, or other electronic data base 

 HIVQUAL reports on this measure for grantee under review 

 Medical record data abstraction by grantee of a sample of records 

 Billing records 

National Goals, 

Targets, or 

Benchmarks 

for 

Comparison 

National HIVQUAL Data:3

 2003 2004 2005 2006 2007 

Top 10% 100% 100% 100% 100% 100% 

Top 25% 93.3% 97.8% 98.4% 100% 100% 

Mean* 69.3% 75.0% 76.8% 81.8% 83.8% 

* HAB database 

Outcome 

Measures for 

Consideration: 

 Rate of head & neck and lung cancer 

 Rate of tobacco use in the clinic population 

Basis for Selection and Placement in Group 3: 

A recent study has shown that lung cancer rates are 2.7 times greater for people living with HIV.4 As tobacco 

use among HIV-infected patients poses significant health risks, tobacco-dependent patients should be 

provided assistance to enroll in smoking cessation programs. Various studies have shown that brief 

interventions by the clinician to encourage tobacco cessation and offer substitution programs can decrease 

smoking rates5

 and tobacco use.6 Cessation reduces the risk of incidence or the progression of tobacco-related 

diseases and increases life expectancy.7,8,9 HIV care providers should provide cessation assistance in the form 

of counseling, pharmacotherapy or referral to cessation programs. 
HAB HIV Core Clinical Performance Measures for 

Adult/Adolescent Clients: Group 3

Final: April 2009  Page 20 

The measure was placed in Group 3 because the feasibility of data collection can vary considerably across 

grantees.

US Public Health Guidelines: 

“The U.S. Preventive Services Task Force strongly recommends that clinicians screen all adults for tobacco 

use and provide tobacco cessation interventions for those who use tobacco products.”10 

References/Notes:

1 “Clients” includes all clients aged 13 years and older. 

2

 A “provider with prescribing privileges” is a health care professional who is certified in their jurisdiction to 

prescribe medications. 

3

Tobacco Use 

(http://www.hivguidelines.org/admin/files/qoc/hivqual/proj%20info/HQNatlAggScrs3Yrs.pdf) 

4

Philips, Abs 8, CROI, Boston, 2008. 

5

 Page AR, Walters DJ, Schlegel RP, Best JA. Smoking cessation in family practice: The effects of advice 

and nicotine chewing gum prescription. Addict Behav 1986;11(4):443-6. 

6

 Demers RY, Neale AV, Adams R, Trembath C, Herman SC. The impact of physicians' brief smoking 

cessation counseling: A MIRNET study. J Fam Pract 1990;31(6):625-9. 

7

 Rigotti NA. Treatment of tobacco use and dependence. N Engl J Med 2002;346:506-512. 

8

 Lancaster T, Stead L, Silagy C, Sowden A. Effectiveness of interventions to help people stop smoking: 

findings from the Cochrane Library. BMJ 2000;321:355-8. 

9

 Methods, Successes, and Failures of Smoking Cessation Programs E B Fisher Jr,, E Lichtenstein, D HaireJoshu, G D Morgan, H R Rehberg Annual Review of Medicine, February 1993, Vol. 44, Pages 481-513. 

10 Agency for Healthcare Research and Quality. The Guide to Clinical Preventive Services: 

Recommendations of the U.S. Preventive Services Task Force, June 2006, p. 120.