Health plans helping smokers.

Tobacco use is the leading cause of preventable mortality in the United States. Therefore, health care organizations have an important role to play in the control of tobacco use both among their plan members and in the communities that they serve. To be effective, they need to adopt a policy that all tobacco users will be identified and provided with advice to quit smoking (or chewing) at each contact with a health care professional. This same policy ought to be adopted for parents of pediatric patients. The policy can be implemented by defining tobacco use as a "vital sign" and periodically assessing implementation rates with a chart review. Patients who express an interest in quitting should be supported through individual or group follow-up. To make clinical interventions more effective, to counteract tobacco promotion that is directed at youth, and to protect the health of non-smokers, HMOs will want to support local and regional tobacco control coalitions that are taking action against tobacco promotion and are promoting smoke-free public areas.