Smoking - tabular view

This template should be used to represent the patient's current average tobacco consumption.

N.B. if other descriptions of smoking are to be used (e.g. recording of pack years) then the lifestyle observation template should be used.

A SnomedCT code taken from the vocabulary SmokingSnCT.

The Concept Descriptor (CD) with CDA URL datatype/flavour shall be used to carry this information as follows:

• The code attribute shall contain a code from the relevant vocabulary
• The codeSystem attribute shall contain the OID for SnomedCT
• The displayName attribute shall carry a description associated with the code in SnomedCT
• The originalText element can be used to carry a reference element. This can link the coded item to the relevant text in the CDA section
• qualifier (s) may be used if required

Note the implementation guidance for the domain where this template is used should be consulted regarding correct usage of the originalText element.

N.B. if other descriptions of smoking not covered by this subset are to be used (e.g. recording of pack years) then the lifestyle observation template should be used.

Where ever possible this should be populated with the date the smoking observation started (low attribute) and the date it finished (high attribute) if that is the case.

For example that a patient was smoking 20 cigarettes per day from 1999 until Feb 2005.

A single low attribute should be used for smoking observation which is still current with the patient.

For example that a patient started smoking 10 cigarettes per day in Feb 2005 and continues to do so.

A single central data point should be used when it is unknown when the smoking observation started or finished but it was known to be true at that particular date.

The time or duration that the Smoking observation was relevant.

The date range shall be carried as follows:

If a single point in time is to be carried the Date or Time Point data type shall be used:

• The center attribute shall contain the date.

If both a start date and an end date are present the Date or Time Interval Complete data type shall be used:

• The low attribute shall contain the start date.
• The high attribute shall contain the end date.

If only a start date is present the Date or Time Interval After data type shall be used:

• The low attribute shall contain the start date.

If only an end date is present the Date or Time Interval Before data type shall be used:

• The high attribute shall contain the end date.

This is a unique identifier for this instance of a Smoking observation.

The Identifier Global datatype flavour is used to carry the first identifiers follows:

• The root attribute shall contain a DCE UUID.

The status of the observation about the patient's smoking choices / preferences.

The Coded Only data type flavour is used to carry this information as follows:

• The code attribute will contain a one of the following codes from the Act Status vocabulary:
• nullified
• completed.

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

• The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
• The extension attribute shall contain the fixed value.

A quantity associated with the patient's smoking habit.

The value associated is dependant upon the particular observation

Note the table below gives guidance for when a value is required. The codes stated are examples only and may not be valid codes. The latest TRUD should be consulted for the current codes in this subset.

Code	Display text	Value
8392000	Non-smoker	None required
230056004	Cigarette consumption	Cigarettes per day
230057008	Cigar consumption	Cigars per day
230058003	Pipe tobacco consumption	Grams per day
266919005	Never smoked tobacco	None Required
266920004	Trivial cigarette smoker (less than one cigarette/day)	None Required

Refers to the person who is the author of the observation about the patient's choices / perferences with regards to smoking.

This author is only required if the author is different from the inherited author or no author is inherited.

Specifies how this author contributes to the context of the observation about the patient's choices / preferences with regards to smoking and whether it may be propagated to descendent acts whose association allows such propagation.

"O" (Overriding)- the association replaces any context of the same or more specific type that has been conducted from the parent act.

"P" (Propagating)- the association is conducted to all child acts where the ActRelationship.contextConductionInd is set to "true."

This attribute, when valued in an instance, provides a unique forward pointing identifier for a template which constrains the classes and attributes which follow.

The attribute is intended simply as a structural navigational aid and should not be relied upon as an indicator of semantic meaning.

The IdentifierExternal datatype flavour is used to carry this information as follows:

• The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.16"
• The extension attribute shall contain the template artifact Id.

A code from the vocabulary shown indicating the function of the document author

The Coded Plain flavour of Coded Value (CV) datatype shall be used to carry this information as follows:

• The code attribute shall contain the value
• The codeSystem attribute shall contain the OID for the vocabulary concerned.
• The displayName attribute shall contain the text associated with the code

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

• The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
• The extension attribute shall contain the fixed value.

Refers to the person who informed the author about the patient's choices / preferences with regards to smoking.

This is only required if the informant is different from the inherited informant.

Specifies how this participation contributes to the context of the current act and whether it may be propagated to descendent acts whose association allows such propagation.

"O" (Overriding)- the association replaces any context of the same or more specific type that has been conducted from the parent act.

"P" (Propagating)- the association is conducted to all child acts where the ActRelationship.contextConductionInd is set to "true."

This attribute, when valued in an instance, provides a unique forward pointing identifier for a template which constrains the classes and attributes which follow.

The attribute is intended simply as a structural navigational aid and should not be relied upon as an indicator of semantic meaning.

The IdentifierExternal datatype flavour is used to carry this information as follows:

• The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.16"
• The extension attribute shall contain the template artifact Id.

The fixed value of this attribute provides a unique identifier for the template and the classname within that template.

The IdentifierExternal datatype flavour is used to carry this information as follows:

• The root attribute shall contain the OID "2.16.840.1.113883.2.1.3.2.4.18.2"
• The extension attribute shall contain the fixed value.

The choice of author templates.

The choice of informant templates

A link to the informant templates