‘Current smoker’ is someone who has smoked greater than 100 cigarettes (including hand rolled cigarettes, cigars, cigarillos etc) in their lifetime and has smoked in the last 28 days.
Note that this definition may underestimate the prevalence of smoking in young people, and smoking status should be checked regularly in those aged under 30.
‘Ex-smoker’ is someone who has smoked greater than 100 cigarettes in their lifetime but has not smoked in the last 28 days*.
*The international convention is to treat someone as an ex-smoker once they have been smokefree for 1 month (at least 28 days).
Coding of ex-smokers
- For those practices using screening tools and decision support software, many of these have simple facilities that would make it easy to record smoking status using these conventions.
- There are a number of existing READ codes that relate to ex-smokers (such as 137K Stopped Smoking and 137S Ex-smoker). Clinicians could also use the ‘Date of Onset’ field to record the date of quitting if they want to track how long a patient has been smokefree.
- For those using ZCPI codes, the following classifications are available:
- Current Smoker
- Ex-smoker <12 months
- Ex-smoker >12 months*
- Never Smoker.
- It is good practice to record patients as ex-smokers after they have been smokefree for 28 days. However, smoking status should be checked at later time points as relapse to smoking is common.
*Statistically, the risk of relapse reduces dramatically after 12 months – for that reason, it has also become common for clinicians helping patients to quit to distinguish between an ‘Ex-smoker<12 months’ and an ‘Ex-smoker>12 months’.
‘Never smoker’ is someone who has not smoked greater than 100 cigarettes in their lifetime and does not currently smoke.
Non-daily, occasional and social smokers
People who smoke may respond in all kind of ways when asked if they smoke. Occasional smoking might mean once a week, in which case they would be defined as current smokers (assuming they have smoked more than 100 cigarettes in their lifetime).
People who define themselves as social smokers often only smoke when they are out socialising, but they may do this at least once a week. So you might need to ask about smoking frequency to code correctly.
We’ve provided some scenarios below just to check the definitions. See if these are helpful.
|50-year-old, currently smoking 10 cigs per day, recently cut down from 20||Current smoker|
|30-year-old ‘social smoker’ – smoking at most on 4 days per month, up to 5 cigarettes on each occasion. Has been smoking like this for 10 years.||Current smoker|
|17-year-old, tried smoking 2 cigarettes||Never smoker|
|25-year-old, smoked occasionally at university, but never more than 100 cigarettes||Never smoker|
|40-year-old, used to smoke 20 cigs per day, gave up 5 years ago||Ex-smoker|
|30-year-old, smoked socially at university (more than 100 cigarettes), but has not smoked for the last 6 years||Ex-smoker|
|36-year-old who admits to smoking a cigar ‘every now and then’ (less than once a year) and has never smoked cigarettes.||Never smoker|
|60-year-old, smokes the ‘occasional cigar’ (2–3 times per month), gave up smoking cigarettes daily 3 years ago.||Current smoker|
|32-year-old, ‘occasional smoker’ (smokes 1–2 times per year, last cigarette 6 months ago). Has not smoked more than 20 packets in lifetime.||Ex-smoker|