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Clinical tools

Assessment tools

  • Smoking Progress Notes (PDF): A brief smoking assessment tool developed by the Ontario Ministry of Health and Long-Term Care and the Ontario Medical Association's Clinical Tobacco Intervention program. In Ontario, completion of this assessment allows physicians to bill Q041. The fourth page of the document is a brief introduction to motivational interviewing followed by selected smoking cessation resources for physicians.
  • Decisional Balance Sheet (PDF): A simple tool designed to facilitate a discussion between care providers and patients about the pros and cons of tobacco and other substance use.
  • Fagerström Test for Nicotine Dependence (PDF): A validated tool for assessing initial dosing of NRT patches.
  • Smoking Diary (PDF): A tool for tracking ongoing smoking when patients are attempting to reduce or quit smoking. The tool is intended to enhance patients' awareness of their smoking behaviours.