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Nicotine Dependence: Documentation on Death Certificates and Hospital Discharge Sheets

Adoption Date:
April 1, 1989

Public Policy Statement on Nicotine Dependence: Documentation of Nicotine Dependence on Death Certificates and Hospital Discharge Sheets


**Note: This historical policy statement is available as part of ASAM's Policy Archives, but it is no longer considered current ASAM policy. Please contact ASAM's advocacy staff at advocacy@asam.org for questions related to ASAM's position on this topic.


Nicotine dependence is the most common drug dependence in the country. It contributed to 390,000 deaths in 1985, and to numerous hospitalizations. However, the precise dimensions of this contribution to morbidity are unclear.

Physicians have a major role to play in recognizing and managing nicotine dependence in their patients. Clear documentation of tobacco use as a contributing cause of death in death certification, and of tobacco use in relationship to hospitalization, should help to improve physician awareness of this disease, and may provide data that would document the extent to which nicotine dependence leads to hospitalization.

Position Statement

ASAM strongly recommends that:

1. Each state add a question to death certification forms, which ascertains whether tobacco use or nicotine dependence contributed to the death.

2. Each state add a question to hospital medical record fact sheets, for coding in the standard hospital discharge abstracts, which ascertains whether the patient currently uses, formerly used, or has never used tobacco products.