Randomized controlled trials

Bentz 2007

Guideline actions increased within the intervention clinics for smoking status (94.5% vs 88.1% p<0.05), advised to quit (71.6% vs 52.7%, p<0.001), assessed interest in quitting 65.5% vs 40.1% p<0.001), and provided assistance (20.1% vs 10.5%, p < 0.001).

Quitline referral increased in the intervention clinics (adjusted OR 1.53)

Linder 2009

Significantly more smokers in the intervention clinics were subsequently documented as nonsmokers compared to smokers in the control clinics (5.3% vs 1.9%, p < 0.001)

Significantly more smokers were referred to cessation counselling in the intervention clinics (4.5% vs 0.4% in control clinics, p<0.001), and significantly more smokers from intervention clinics made contact with a cessation counsellor (3.9% vs 0.3% in control clinics, p<0.001). No difference in the proportion of documented smokers from control or intervention clinics prescribed any cessation medication (2.0% vs 2.0%).

Rindal 2013

Significantly more smoking patients from intervention clinics versus control clinic patients reported dental provider actions: discussed interest in quitting (87% vs 70%); discussed quitting (47% vs 26%); and referral to quitline (37% vs 17%).

Sherman 2008

The average number of smokers per month referred to telephone counselling increased from 1.0 to 15.6 (p< 0.001) among intervention clinic providers, and from 0.2 to 0.7 (p<0.04) among control clinic providers.

Vidrine 2013

Patients from intervention clinics were more likely to enroll in quitline treatment compared to control clinics (15% vs 0.5%).

Vidrine 2013a

Patients from intervention clinics were more likely to enroll in quitline treatment compared to control clinics (8% vs 0.6%).

Controlled trials

Bentz 2002

Documentation of tobacco use was unchanged in the paper chart clinic, but increased from 79% to 88% in the enhanced EHR clinic.

Frank 2004

Assessment of smoking status was unchanged between intervention and control patient visits (2.0% vs 1.8%, RR 1.12 , 95% CI 0.90 to 1.39).

Szpunar 2006

Asking about tobacco use increased in the intervention clinics from 88.4% to 92.8%.

Uncontrolled trials

Adsit 2014

The proportion of patients referred to the quitline increased from <1% to 14%. 5% enrolled in quitline treatment.

Koplan 2008

The proportion of smoking patients referred to cessation counselling increased from 0.8% to 2.1% (p < 0.001); medication ordered increased from 1.6% to 2.5% (p < 0.001).

Lindholm 2010

Tobacco use status in the EHR increased from 71.6% to 78.4% (p < 0.001).

Mathias 2012

The percentage of documented smokers with a change in smoking status from active to quit during the pre‐ or postintervention period increased from 17.1% in the preintervention cohort to 20.5% in the postintervention cohort (p = .06)

In the post enhancement period, cessation medication prescribing did not change (14.4% vs. 13.4%, p = .5), but quitline referral increased from 2% to 7% (p < 0.001).

McCullough 2009

Tobacco use status increased from 71% to 84% (p < 0.001). Assessement of plan to quit increased from 25.% to 51% (p < 0.005), and smokers assessed for a plan to quit were more likely to receive cessation counselling (46% vs 14% among smokers not assessed, p < 0.001).

Ragucci 2009

Of 90 smokers in the study, 29 were quit at 6 months (32%)

Spencer 1999

Recording of tobacco use status increased from 18.4% to 80.3%.