AST008 - Asthma smoking status

AST008 - Asthma smoking status

The information contained within this article is from version 49 of the Business Rules for Quality and Outcomes Framework (QOF).                                                                     
This indicator is protected in the contract year 2024/25 and will be paid at 2023/24 performance levels

Indicator definition


What do the business rules mean?

What makes a patient eligible?

In order to be included in the denominator (patients who are eligible for smoking status), patients must:
  1. be on the Asthma register
  2. not have turned 20 years old before the end of the contract year (ie: before the next 31st March)

How to achieve this indicator?

Patients must have had one of the following to achieve the indicator:
  1. have a smoking code added
  2. have a smoking exposure code added
  3. have a no smoking exposure code added

What will remove patients from eligibility?

The following will remove patients:
  1. Patients who chose not to disclose smoking data
  2. Patients for whom asthma quality indicator care was unsuitable in the contract year
  3. Patients who have chosen not to receive any asthma quality indicator care
  4. Patients who have been invited twice for an asthma review (using any of invite codes)
  5. Patients who were diagnosed with asthma in the last 3 months of the QOF year
  6. Patients who were registered with the practice in the last 3 months of the QOF year

If a patient achieves the indicator at any point during the year, any exclusions that have also been added are ignored.

SNOMED codes used in this indicator

The codes referenced in this article are taken from the NHS Technology Reference Update Distribution (TRUD).  Not all of these may be present or selectable in all clinical systems.

Smoking codes (SMOK_COD)

SNOMED code

SNOMED code description

1092031000000108

Ex-smoker amount unknown (finding)

1092041000000104

Ex-very heavy smoker (40+/day) (finding)

1092071000000105

Ex-heavy smoker (20-39/day) (finding)

1092091000000109

Ex-moderate smoker (10-19/day) (finding)

1092111000000104

Ex-light smoker (1-9/day) (finding)

1092131000000107

Ex-trivial smoker (<1/day) (finding)

134406006

Smoking reduced (finding)

160603005

Light cigarette smoker (1-9 cigs/day) (finding)

160604004

Moderate cigarette smoker (10-19 cigs/day) (finding)

160605003

Heavy cigarette smoker (20-39 cigs/day) (finding)

160606002

Very heavy cigarette smoker (40 + cigs/day) (finding)

160612007

Keeps trying to stop smoking (finding)

160613002

Admitted tobacco consumption possibly untrue (finding)

160616005

Trying to give up smoking (finding)

160617001

Stopped smoking (finding)

160619003

Rolls own cigarettes (finding)

160620009

Ex-pipe smoker (finding)

160621008

Ex-cigar smoker (finding)

160625004

Date ceased smoking (observable entity)

203191000000107

Wants to stop smoking (finding)

221000119102
Never smoked any substance (finding)
225934006
Smokes in bed (finding)
228486009
Time since stopped smoking (observable entity)
230056004
Cigarette consumption (observable entity)
230057008
Cigar consumption (observable entity)
230058003
Pipe tobacco consumption (observable entity)
230059006
Occasional cigarette smoker (finding)
230060001
Light cigarette smoker (finding)
230062009
Moderate cigarette smoker (finding)
230063004
Heavy cigarette smoker (finding)
230064005
Very heavy cigarette smoker (finding)
230065006
Chain smoker (finding)
266918002
Tobacco smoking consumption (observable entity)
266919005
Never smoked tobacco (finding)
266920004
Trivial cigarette smoker (less than one cigarette/day) (finding)
266921000
Ex-trivial cigarette smoker (<1/day) (finding)
266922007
Ex-light cigarette smoker (1-9/day) (finding)
266923002
Ex-moderate cigarette smoker (10-19/day) (finding)
266924008
Ex-heavy cigarette smoker (20-39/day) (finding)
266925009
Ex-very heavy cigarette smoker (40+/day) (finding)
266927001
Tobacco smoking consumption unknown (finding)
266928006
Ex-cigarette smoker amount unknown (finding)
266929003
Smoking started (finding)
281018007
Ex-cigarette smoker (finding)
308438006
Smoking restarted (finding)
360890004
Intolerant ex-smoker (finding)
360900008
Aggressive ex-smoker (finding)
394871007
Thinking about stopping smoking (finding)
394872000
Ready to stop smoking (finding)
394873005
Not interested in stopping smoking (finding)
401159003
Reason for restarting smoking (observable entity)
401201003
Cigarette pack-years (observable entity)
413173009
Minutes from waking to first tobacco consumption (observable entity)
428041000124106
Occasional tobacco smoker (finding)
446172000
Failed attempt to stop smoking (finding)
449868002
Smokes tobacco daily (finding)
48031000119106
Ex-smoker for more than 1 year (finding)
492191000000103
Ex roll-up cigarette smoker (finding)
53896009
Tolerant ex-smoker (finding)
56578002
Smokes tobacco daily (finding)
56771006
Heavy smoker (over 20 per day) (finding)
59978006
Cigar smoker (finding)
65568007
Cigarette smoker (finding)
735112005
Date ceased using moist tobacco (observable entity)
735128000
Ex-smoker for less than 1 year (finding)
77176002
Smoker (finding)
782516008
Number of calculated pack years for cumulative lifetime tobacco exposure (observable entity)
82302008
Number of calculated pack years for cumulative lifetime tobacco exposure (observable entity)
836001000000109
Waterpipe tobacco consumption (observable entity)
8517006
Ex-smoker (finding)

    Smoking exposure codes (SMOKEXPOS_COD)

    SNOMED code

    SNOMED code description

    228523000

    Exposed to tobacco smoke at work

    228524006

    Exposed to tobacco smoke at home

    228525007

    Exposed to tobacco smoke in public places

    43381005

    Passive smoker

    699009004

    History of exposure to second hand smoke

    714151003

    Environmental tobacco smoke exposure

    No smoking exposure codes (NOSMOKEXPOS_COD)

    SNOMED code

    SNOMED code description

    315213009

    Not a passive smoker

    711563001

    No known exposure to tobacco smoke

    Chosen not to disclose smoking status codes (SMOKSTATDEC_COD)

    SNOMED code

    SNOMED code description

    1098881000000103

    Declined to give smoking status

    11351000175103

    Tobacco use screening declined

    Patients who are unsuitable for asthma review (ASTPCAPU_COD)

    SNOMED code

    SNOMED code description

    717291000000103

    Excepted from asthma quality indicators - patient unsuitable

    Patients who have chosen not to receive any asthma quality indicator care (ASTPCADEC_COD)

    SNOMED code

    SNOMED code description

    716491000000100

    Excepted from asthma quality indicators - informed dissent

    Patients who have been invited twice for an asthma review (ASTINVITE_COD)

    SNOMED code

    SNOMED code description

    1110841000000103

    Quality and Outcomes Framework asthma quality indicator-related care invitation

    185731000
    Asthma monitoring call first letter
    185732007
    Asthma monitoring call second letter 
    185734008
    Asthma monitoring call third letter
    185735009
    Asthma monitoring call verbal invite
    185736005
    Asthma monitoring call telephone invite
    92161000000104
    Quality and Outcomes Framework asthma quality indicator-related care invitation using preferred method of communication
    928451000000107
    Asthma monitoring invitation short message service text message
    928511000000107
    Asthma monitoring invitation email
    959401000000101
    Asthma monitoring short message service text message first invitation
    959421000000105
    Asthma monitoring short message service text message second invitation
    959441000000103
    Asthma monitoring short message service text message third invitation





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