At this point in our field, tobacco use is on the checklist of topics barely addressed beyond the most mechanistic and minimal of ways – if at all.
One evidence of this is a very large proportion of in-bound medical records I see from providers of all disciplines and settings where “Social History” is the place on the form that one’s smoking history is documented. With almost nothing else listed, and no care plan at all.
To me that is not client-centered.
The header where tobacco and nicotine use should be addressed should be something like “substance use history” or at least “tobacco/nicotine use history”.
Making the topic a checklist item under the “Social History” header speaks volumes about the way we systematically ignore this topic. “Social history”, then ignore or under-treat. That is a failure.
That’s an excerpt from my monograph titled, “Addiction Treatment Except for Tobacco and Nicotine: A Call for Change.”
