Use to record summary information about the inidividual's pattern of smoking of tobacco and tobacco-containing products.
This archetype is to be used to record information about both current and previous smoking behaviour.
The specific focus of this archetype is on documentation about the use of all types of inhaled tobacco because of the associated health risks from direct inhalation of tobacco and associated chemicals. Amount of nicotine and tar, use of filters and additives has been left outside of scope for the core archetype, but could be added into the Episode SLOT if required.
The 'Per type' cluster of data elements allows for recording of specific details and episodes about each type of tobacco smoked and can be repeated once per type. The list of tobacco types listed in the 'Per type' run-time name constraint identifies the type of tobacco. This name constraint can be applied during template modelling or at run-time within a software application.
In many situations the individual will only smoke one type of tobacco, such as manufactured cigarettes. If other types of tobacco are smoked, the details will be recorded in another instance of the 'Per type' cluster.
The history of waxing and waning of use for each type of tobacco over time can be captured using the repeatable 'Per episode' cluster. This cluster of data elements allows for a very detailed pattern of smoking behaviour to be recorded for each type of tobacco smoked such as daily 'roll-your-own' cigarette smoking, alongside weekly cigar smoking every Friday night and occasional Bidi smoking while on holiday in Bali.
Triggers for closing one episode and commencing a new one will largely reflect local data collection preferences, including if the individual:
- quits for a significant period of time (which will likely be locally defined); or
- significantly changes their amount of use or pattern of their smoking.
If only one type of tobacco is smoked, the value for 'Pack years' will be identical to the 'Overall pack years' data element. If more than one type of tobacco is smoked, the calculation for the value for 'Overall pack years' will required a more complex algorithm such as http://smokingpackyears.com/.
Tobacco Use Summary, Draft Archetype [Internet]. nehta, Australia, nehta Clinical Knowledge Manager [cited: 2016-06-06]. Available from: http://dcm.nehta.org.au/ckm/#showArchetype_1013.1.1026.
Tobacco Use Summary, Rejected Archetype [Internet]. openEHR Foundation, openEHR Clinical Knowledge Manager [cited: 2016-06-06]. Available from: http://www.openehr.org/ckm/#showArchetype_1013.1.1520.
Wood DM, Mould MG, Ong SB, Baker EH. "Pack year" smoking histories: what about patients who use loose tobacco? Tob Control. 2005 Apr;14(2):141-2. PubMed PMID: 15791025; PubMed Central PMCID: PMC1748001.
Organisation: Ocean Informatics
Email: heather.leslie@oceaninformatics.com
Date originally authored: 2009-06-21
Organisation: Ocean Informatics
Email: heather.leslie@oceaninformatics.com
Date originally authored: 2009-06-21
- Licence: This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/.
- Custodian Organisation: Ocean Informatics
- References: Masters N & Tutt C. Smoking Pack Years [Internet]. United Kingdom: Highfield Surgery; 2007. Available from: http://smokingpackyears.com/. Tobacco Use Summary, Draft Archetype [Internet]. nehta, Australia, nehta Clinical Knowledge Manager [cited: 2016-06-06]. Available from: http://dcm.nehta.org.au/ckm/#showArchetype_1013.1.1026. Tobacco Use Summary, Rejected Archetype [Internet]. openEHR Foundation, openEHR Clinical Knowledge Manager [cited: 2016-06-06]. Available from: http://www.openehr.org/ckm/#showArchetype_1013.1.1520. Wood DM, Mould MG, Ong SB, Baker EH. "Pack year" smoking histories: what about patients who use loose tobacco? Tob Control. 2005 Apr;14(2):141-2. PubMed PMID: 15791025; PubMed Central PMCID: PMC1748001.
- Current Contact: Heather Leslie, Ocean Informatics, heather.leslie@oceaninformatics.com
- Original Namespace: com.oceaninformatics
- Original Publisher: Ocean Informatics
- Custodian Namespace: com.oceaninformatics
- MD5-CAM-1.0.1: 5F1B5EFB2B26563345A2BE0748FF2EBF
- Build Uid: a463c155-4616-497e-9f0c-67d59cab3a91
- Revision: 0.0.1-alpha
For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents.
Include:
All not explicitly excluded archetypes
Definition may need to be specified per type.
Definition may need to be specified per type.
Definition may need to be specified per type. For example, the definition may not be zero, but less than a specified amount (as units or mass) smoked during a specified time interval.
Definition may need to be specified per type. For example, the number of units in a pack used for cigarettes may be different to cigars; the mass of loose tobacco in a pack used for hand-rolled cigarettes or pipes.
Choice of:
Count
min: >=0
Quantity
Property: Mass
Units:- >=0.0 g
Limit decimal places: 0 - >=0.0 oz (avoirdupois)
Limit decimal places: 0
- >=0.0 g
- Never smoked [Individual has never smoked any type of tobacco.]
- Current smoker [Individual is a current smoker of tobacco.]
- Former smoker [Individual has previously smoked tobacco but is not a current smoker.]
For example: smoking every Friday night or at parties. Can be a partial date, for example, only a year.
Can be a partial date, for example, only a year.
The run-time name constraint on this Cluster enables simple templates for each required type to be designed in templates, or the types to be managed exclusively at run-time. The list of names can be extended at run-time if additional types of tobacco smoking are identified locally.
Runtime name constraint:
- Cigarettes [Also known as manufactured cigarettes.
Processed tobacco, manufactured into cylinder made of paper or a substance that does not contain tobacco. ] - Hand-rolled cigarettes [Also known as "rollies" or "roll-ups".
Loose tobacco, hand rolled into a cylinder using cigarette papers. ] - Cigars [Also known as "large cigar".
Roll of tobacco wrapped within a leaf tobacco or in a substance that contains tobacco. ] - Cigarillos [Also known as mini cigars.
Short and narrow cigar. ] - Pipe [Loose tobacco placed inside a pipe bowl.
] - Waterpipe [Also known as "hookah", "shisha", "narguileh" and "hubble-bubble".
Tobacco, often flavoured, is burned then cooled through a basin of water and consumed through a hose and mouthpiece. ] - Bidis [Also known as Beedis.
Thin hand-rolled cigarettes filled with tobacco and wrapped in a leaf, often tied with colorful string at one or both ends. They can be flavoured or unflavoured. ] - Kreteks [Also known as clove cigarettes.
Cigarettes that contain a mixture of tobacco, cloves and other additives. ]
- Current smoker [Individual is a current smoker of the specified type of tobacco.]
- Former smoker [Individual has previously smoked the specified type of tobacco but is not a current smoker.]
- Never smoked [Individual has never smoked the specified type of tobacco.]
For example: '2' as the second episode within a sequence of episodes; or 'Pregnancy with twins' if describing the smoking activity during a health event such as during a specific pregnancy.
Choice of:
- Count
min: >=1 
Text
Can be a partial date, for example, only a year.
Can be a partial date, for example, only a year. This data field will be empty if the episode is current and ongoing.
The typical pattern of use can be coded with a terminology or a local value set in a template.
- Daily [Smoking the specified type of tobacco at least once every day.]
- Non-daily [Not smoking the specified type of tobacco every day.]
For example: the number of 'sticks' or 'full pipes' per day or per week. This data element is redundant if a value is recorded for 'Typical use(mass)'.
Property: Frequency
Units:
- 1/d
- 1/wk
This data element will typically be used for pipes and hand-rolled cigarettes and is redundant if a value is recorded for 'Typical use (units)'.
Property: Flow rate, mass
Units:
- >=0.0 g/d
Limit decimal places: 0 - >=0.0 g/wk
Limit decimal places: 0 - [oz_av]/d
- [oz_av]/wk
min: >=0
Include:
openEHR-EHR-CLUSTER.cessation_
Can be a partial date, for example, only a year. Definitions for a 'Quit date' vary enormously and can be defined using the 'Quit data definition' data element in the Protocol section of this archetype. This date will be identical to the 'Episode end date' for the most recent episode.
Include:
openEHR-EHR-CLUSTER.change.v1 and specialisations
Commonly used in assessment of cigarette use. It is calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the individual has smoked. One pack year equals 365 packs of cigarettes. Details about how to calculate pack years for other types of tobacco can be found at http://smokingpackyears.com.
min: >=0
Include:
openEHR-EHR-CLUSTER.change.v1 and specialisations
min: >=0
For example: stopped smoking or reduced amount on becoming pregnant.
Rita Apelt, Department of Health,NT, Australia
Vebjørn Arntzen, Oslo universitetssykehus HF, Norway (Nasjonal IKT redaktør)
Silje Ljosland Bakke, Nasjonal IKT HF, Norway (Nasjonal IKT redaktør)
Lars Bitsch-Larsen, Haukeland University Hospital, Bergen, Norway
Fredrik Borchsenius, Oslo universitetssykehus, Norway
Chris Bullen, University of Auckland, New Zealand
Stephen Chu, NEHTA, Australia (Editor)
Lisbeth Dahlhaug, Helse Midt - Norge IT, Norway
Are Edvardsen, SKDE, Norway
Einar Fosse, UNN HF, Norwegian Centre for Integrated Care and Telemedicine, Norway
Liv Grøtvedt, Folkehelseinstituttet, Norway
Sam Heard, Ocean Informatics, Australia
Kristian Heldal, Telemark Hospital Trust, Norway
Anca Heyd, DIPS ASA, Norway
Tom Jarl Jakobsen, Helse Bergen, Norway
Lars Morgan Karlsen, DIPS ASA, Norway
Heather Leslie, Ocean Informatics, Australia
Siv Marie Lien, DIPS ASA, Norway
Camilla Lund, Institute for Cancer Genetics and Informatics, Norway
Hallvard Lærum, Oslo Universitetssykehus HF, Norway
Ian McNicoll, Ocean Informatics UK, United Kingdom
Bjørn Næss, DIPS ASA, Norway
Jeremy Oats, NT Health, Australia
Rosalie Schultz, Anyinginyi Health Aboriginal Corporation, Australia
Arne Løberg Sæter, DIPS ASA, Norway
Jon Tysdahl, Furst medlab AS, Norway
John Tore Valand, Haukeland Universitetssjukehus, Norway (Nasjonal IKT redaktør)