Intermediate Outcome Indicators

Reducing Commercial Tobacco Use Indicators

Indicators in this Section
Related Pages
Utilization of Preventive Services

Surveillance Data

Potential Measures

Source and Frequency

Potential Measures

Number of Quitline Calls

  • Quitline Call Volume.
  • Total Quitline call volume by quarter.

Source and Frequency

State Quitline Vendor/State

Monthly or quarterly

Potential Measures

Quitline Text Messaging Program Use

  • Total number of enrollments in quitline text message program by quarter

Source and Frequency

State Quitline Vendor/State

Monthly or quarterly

Potential Measures

Quitline Treatment Reach

  • Number and proportion of persons who use tobacco who received a service through the Quitline.
  • Quitline reach among persons with low socioeconomic status who use tobacco.
  • Quitline reach among Medicaid enrollees who use tobacco.

Source and Frequency

State Quitline Vendor/State

Monthly or quarterly

Potential Measures

Quitline Use Among People Trying to Quit Smoking – (survey item SUB1o,pdf iconexternal icon (Health Center Patient Survey (HCPS)external icon)

Source and Frequency

HCPSexternal icon for Health Resources and Services Administration (HRSA)-funded health centers
Every 5 years

Potential Measures

Doctor/Dentist/Health Professional Advice to Stop Smoking, past 12 months:

Source and Frequency

TUS-CPSexternal icon
Every 3-4 years

HCPSexternal icon
Every 5 years

Utilization of Preventive Services

Quality Measures

Note: If National Quality Forum (NQF) site links to technical specifications are broken:

Go to: www.qualityforum.org.external icon

In upper right, select NQF Work.

Select Find Measures.

Enter NQF Measure number in the Measure Search field.

Potential Measures

Source and Frequency

Potential Measures

Medical Assistance with Smoking and Tobacco Use Cessation

NQF 0027/Measure MSC-AD specifications: NQFexternal icon, Quality Rating System (QRS)pdf iconexternal icon, Adult Core Setexternal icon – click on ”2021 Technical Specifications and Resource Manual”; see pages 98-101.

Note: NQF 0027pdf iconexternal icon is derived from Consumer Assessment of Healthcare Providers and Systems (CAHPSexternal icon) survey data.  Many states (most with managed care), their health plans, or both, collect the CAHPS survey every year or every other year.  CAHPS survey data capture patients’ self-reported patient experience of health care, which cannot be derived from claims or health record data.

Source and Frequency

Consumer Assessment of Healthcare Providers and Systems (CAHPS)external icon

Every 1 or 2 years; depends on frequency of CAHPS survey

Potential Measures

Tobacco Use: Screening and Cessation Intervention (ambulatory setting)

NQF 0028/0028e/Centers for Medicare and Medicaid Services (CMS) CMS138v9 specifications: NQFexternal icon, CMS Electronic Clinical Quality Measure (eCQM)external icon with submission criteria, Merit-based Incentive Payment System (MIPS)pdf iconexternal icon with billing codes (PDF).

Source and Frequency

Health Record; Uniform Data System (UDS) for HRSA funded health centers; Claims Data

Quarterly

Potential Measures

Tobacco Use Screening and Follow-up for People with Serious Mental Illness or Alcohol or Other Drug Dependence

NQF 2600external icon

Note: The proposed health plan measure is adapted from an existing provider-level measure for the general population (Preventive Care & Screening: Tobacco Use: Screening & Cessation Intervention NQF #0028). This measure is currently stewarded by the American Medical Association-convened Physician Consortium for Performance Improvement (AMA-PCPI) and used in the Physician Quality Reporting System (PQRS).

Source and Frequency

Health Record; Uniform Data System (UDS) for HRSA funded health centers; Claims Data

Quarterly

Potential Measures

Tobacco Use and Help Quitting Among Adolescents (12-20 years old) (ambulatory setting)

NQF 2803/Quality ID #402 specifications NQFexternal icon

NQF 2803/Quality ID #402 specifications MIPSpdf iconexternal icon

Source and Frequency

Health Record; Claims Data

Quarterly

Potential Measures

Risky Behavior Assessment or Counseling by Age 13 Years

NQF 1406 specificationsexternal icon

Source and Frequency

Health Record; Claims Data

Quarterly

Potential Measures

Risky Behavior Assessment or Counseling by Age 18 Years

NQF 1507 specificationsexternal icon

Source and Frequency

Health Record; Claims Data

Quarterly

Potential Measures

Tobacco Use Screening at Hospitalization (inpatient setting)

NQF 1651 specificationsexternal icon

Source and Frequency

Health Record; Claims Data

Quarterly

Potential Measures

Tobacco Use Treatment Provided or Offered During Hospitalization (inpatient setting)

NQF 1654 specificationsexternal icon

Source and Frequency

Health Record; Claims Data

Quarterly

Potential Measures

Tobacco Use Treatment Provided or Offered at Discharge from Hospital (inpatient setting)

NQF 1656 specificationsexternal icon

Source and Frequency

Health Record; Claims Data

Quarterly

Utilization of Preventive Services

Billing codes

Potential Measures

Source and Frequency

Potential Measures

Utilization of codes for tobacco use and delivery of cessation services: Billing guidepdf iconexternal icon

Examples of codes: Current Procedural Terminology (CPT), HCPCS, and G codes to calculate NQF 0028.

There are multiple diagnostic and service-provision codes that can be queried for tobacco use and delivery of cessation services. Some of these codes are outlined in this billing guidepdf iconexternal icon.

Tracking cessation code utilization data over time may help you with your quality improvement (QI) efforts.

  • You might expect to see increased utilization of cessation codes increase after major outreach campaigns. If you do not see increases in utilization, consider revisiting your implementation approach to look for areas for improvement.
  • You may track utilization of selected tobacco cessation codes through Medicaid administrative claims data.
  • You might conduct queries monthly, or as frequently as is feasible for your team.
  • The claims do not have to be “fully adjudicated” claims that have a lag time of a year.
  • It is important to partner with Medicaid agency staff who: have access to claims data, can make claims data query requests, or both.
  • To track utilization of tobacco cessation Medicaid benefits, states may work with their state Medicaid Programs to pull and analyze tobacco dependence screening and treatment Medicaid claims data. This is likely a large request, but is an invaluable resource for tracking.

Caution:

  • You may also query and analyze tobacco cessation prescriptions. However, caution is warranted with regard to bupropion as this medication is also used to treat depression and it may be difficult to tell when it is prescribed for tobacco cessation.
  • Using diagnostic codes in administrative claims will likely result in underestimation of the population of enrollees who use tobacco.

Source and Frequency

Medicaid or Medicare administrative claims

Monthly or as frequently as available

Note: Medicaid administrative claims can be run every month or as frequently as your team can get them. The claims do not have to be the “fully adjudicated” claims that are not available for a year.

Some of these measures look similar. Which ones are most aligned with my program activities and target audience?

To compare measures and identify the one(s) most relevant to you, use the Compareexternal icon tab in the upper left-hand corner of the page on qualityforum.org:

  1. Go to the first measure you want to compare, either by:
    1. Clicking on the measure’s “NQF” link in the table above, or
    2. Entering the measure number in the NQF measure search boxexternal icon.
  2. Click the “Add to Compare” tab above the measure name.
  3. Repeat, to compare up to three measures at the same time.
  4. Click “Compare.”
  5. Click “Export” if you want to save the comparison as an Excel file.

Related measures you might compare, using the Compare tab:

  • NQF 0028 and 0028e, 2600
    • NQF 0028, 0028e (Tobacco Use: Screening and Cessation Intervention)
      • These are identical, but the data source for NQF 0028 is claims and registries and the data source for NQF 0028e is electronic health records (EHR).
    • NQF 2600 (Tobacco Use Screening and Follow-Up For Persons With Serious Mental Illness or Alcohol or Other Drug Dependence)
      • This measure is adapted from NQF 0028, which is a measure for the general population.
  • NQF 0027, 2600, and 2803
    • NQF 0027 (Medical Assistance with Smoking and Tobacco Use Cessation)
    • NQF 2600 (Tobacco Use Screening and Follow-Up For Persons With Serious Mental Illness or Alcohol or Other Drug Dependence)
    • NQF 2803 (Tobacco Use and Help Quitting Among Adolescents (ambulatory setting))
  • NQF 1651, 1654, and 1656
    • NQF 1651 (Tobacco Use Screening at Hospitalization (inpatient setting))
    • NQF 1654 (Tobacco Use Treatment Provided or Offered During Hospitalization (inpatient setting))
    • NQF 1656 (Tobacco Use Treatment Provided or Offered at Discharge from Hospital (inpatient setting))
  • NQF 1406 and 1507
    • NQF 1406 (Risky Behavior Assessment or Counseling by Age 13)
    • NQF 1507 (Risky Behavior Assessment or Counseling by Age 18)

Quit attempts

Potential Measures

Source and Frequency

Potential Measures

Quit attempts – adults (age 18+ or 13+): Proportion of adult smokers who have made a quit attempt during the past 12 months.

Survey item C09.03/STOPSMK2.pdf icon

Survey item BRFSS (age 18+)

Survey item SUB1f1.pdf iconexternal icon

Survey item HCPS (age 13+)external icon

Source and Frequency

BRFSS
Every year

HCPSexternal icon
Every 5 years

Potential Measures

Quit Attempts – some-day smokers: Proportion of some-day smokers (smoked <12 days in the past 30 days) who have made a quit attempt during the past 12 months (survey item Da, Db).pdf iconexternal icon

Quit Attempts – every-day and some-day smokers: Proportion of every-day and some-day smokers (smoked <12 days in the past 30 days) who have made a quit attempt during the past 12 months (survey item D1R).pdf iconexternal icon

Source and Frequency

TUS-CPSexternal icon
Every 3-4 years

Potential Measures

Quit attempts – young smokers (grades 9-12): Proportion of young smokers who have made a quit attempt in the past 12 months (survey item 39).pdf icon

Source and Frequency

Potential Measures

Quit attempts using evidence-based cessation services (former smoker): Proportion of former smokers (quit within the last 2 years) who have made a quit attempt using:

An evidence-based cessation service, such as:

Source and Frequency

TUS-CPSexternal icon
Every 3-4 years

Potential Measures

Quit attempts using evidence-based cessation services (past 12 months, (age 18+ or 13+)): Proportion of adult smokers who have made a quit attempt during the past 12 months using an evidence-based cessation service, such as:

Source and Frequency

TUS-CPSexternal icon
Every 3-4 years

Filled prescription claims data

HCPSexternal icon
Every 5 years

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Page last reviewed: November 18, 2021
Content source: Centers for Disease Control and Prevention, The 6|18 Initiative: Accelerating Evidence into Action