OBJECTIVES

To identify how to define smoking status in previous studies with large databases of EMR/EHR or claims.

METHODS

A literature search was conducted using the PubMed database (1980-2017). Search terms and strategies for PubMed were as followed: using [all fields] to search “smoking status” (or “smoker”) and “database” (or “dataset”). Included studies: a) had clearly defined smoking status; b) used databases of EMR/EHR or claims; c) had a sample size over 10,000 patients.

RESULTS

A total of 1449 studies were initially retrieved and reviewed. After further review from the retrieved studies, 47 studies that met all eligibility criteria were finally selected. These studies mainly included databases of American College of Surgeons National Surgical Quality Improvement Program, QRESEARCH, The Health Improvement Network and Veteran Affairs (VA). Overall, smoking status was often stored in narrative text in medical records in these studies. 22 studies defined smoking status based on current-smoker status (within a given time period). 10 studies used daily tobacco smoked amount variable to categorize smoking status. At last, in other 15 studies, smoking status was defined based on a combination of current smoking status and smoking history (pack year or cigarettes amount). International Classification of Diseases (ICD) code to identify smoking status was not clarified in these studies.

CONCLUSIONS

With various studies taking smoking status into consideration, there is still lack of a universal method to define and most of studies with EMR/EHR, or claims databases just mentioned categories.