Implementing an Evidence-Based Smoking Cessation Referral Tool Kit in a High-Risk Lung Cancer Screening Clinic

BACKGROUND: Smoking cessation is a healthcare priority, particularly for those at high risk for lung cancer; however, referrals to smoking cessation programs remain inconsistent. OBJECTIVES: This quality improvement project implemented a provider-driven smoking cessation referral tool kit to increase smoking cessation referrals and improve billing practices in a lung cancer screening clinic. METHODS: A smoking cessation referral tool kit, including provider education, communication training, and sample scripting aids, was implemented. Smoking cessation referrals and billing practices were assessed prior to and after implementation. FINDINGS: In January, referrals rose from 13% in 2024 to 33% in 2025, and in February, referrals rose from 16% to 34%, representing gains of 20% and 18%, respectively. Eligible patients billed increased in January from 70% in 2024 to 85% in 2025, and in February from 76% in 2024 to 100% in 2025. Nurses can implement this tool kit to improve smoking cessation referrals and standardize billing practices.