Key Points: Tobacco control programs seek to promote tobacco treatment in health care settings. Many facilities continue to be challenged to implement systems to identify and intervene with tobacco users and to document these efforts. This poster presents results from a case study evaluation of two hospitals, two community health centers and a large physician practice in Massachusetts. Each case study describes systems in place regarding: documentation of tobacco use status, interventions provided, referrals to more intensive treatment, billing for services, and use of diagnostic coding. Common challenges reported include lack of reimbursement, competing priorities, lack of staff time and limitations of diagnostic codes. Facilitators included champions within the agency, external reporting requirements and ease of documentation. These case studies suggest the need for increased external motivators such as policies, performance standards or regulations; and a better understanding of factors within healthcare facilities that are critical determinants of positive outcomes for tobacco users.

Learning Objectives: Poster presentation

Benefits: Participants will be able to describe practical lessons learned in a variety of health care settings and begin to apply lessons to their own work settings.