Assessment and Use of Electronic Patient Records for Smoking Cessation Support in Hospital Setting: A Cross-Sectional...

Tobacco use remains a leading cause of preventable illness and death. Hospital admissions offer a critical opportunity to support smoking cessation. Electronic patient record (ePR) systems can enable systematic identification and coordination of cessation care; however, clinician engagement with smoking-related ePR functionality is not well understood. This study examined smoking-related assessment and documentation practices, and determinants influencing use of the ePR for smoking cessation support in a regional Australian hospital.

A cross-sectional survey was distributed to clinicians working on inpatient wards. The survey assessed how often clinicians asked about smoking, what information they collected and documented, and clinicians' knowledge and use of ePR functionality to support cessation. Barriers and enablers were explored using the NASSS (Non-adoption, Abandonment, Scale-up, Spread, Sustainability) framework, which considers technology use across clinical, organisational and system levels.

Of the 101 respondents, 93% reported routinely asking about smoking status. However, only 50% indicated that they knew how to identify smoking status within the ePR, and fewer than 20% reported confidence in using the system to assess nicotine dependence or provide structured cessation support. Only 6% had received relevant training. Reported barriers included lack of knowledge, limited training, low system usability and competing priorities within workflows.

While most clinicians ask about smoking, effective use of the ePR to deliver comprehensive cessation support remains limited. SO WHAT?: Improving smoking cessation support in hospital settings requires more than clinician intent. Training, embedded decision support and better system integration are needed to close the gap between clinical opportunity and evidence-based care.