Date of Award

Spring 5-21-2016

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Dr. Karen Macauley, PhD, DNP, MSN


Purpose: Improve the use of tobacco screening and cessation interventions by utilizing an Electronic Health Record (EHR) prompt in a university student health center.

Background: It is well known that the leading cause of preventable morbidity and mortality in the United States (US) is the use of tobacco products. Tobacco use accounts for $289 billion in direct health care costs and loss of productivity annually. Nearly all smokers (98 percent) start before 26 years of age making college campuses an important area for tobacco intervention.1 A southern California university recently adopted a comprehensive tobacco-free campus policy that prohibits the use of smoking and tobacco use on all campus property. In conjunction with a comprehensive policy, offering cessation assistance to tobacco users maximizes the impact of the policy.2,3

Practice Change: Two mandatory EHR prompts were created for tobacco screening and alerting the provider to intervene if screening was positive.

Outcomes: Screening for tobacco use increased from 89% to 99.5% for all students visiting the student health center. The percentage of patients offered tobacco cessation resources increased from 15% to 47%. The overall percentage of students receiving any intervention beyond screening increased from 65% to 81%.

Conclusions: This evidenced-based practice project resulted in an increase in the identification of tobacco users and an increase in tobacco cessation interventions by providers.