The idea of the new smoking convention is really great, but we have something to add.
As @MPhilofsky pointed out
To cover that, the way to measure the amount a person has smoked over a long period of time was introduced: the pack-years. 1 pack-year is equal to smoking 1 pack per day for 1 year, or 2 packs per day for half a year, and so on, while the pack is containing 20 cigarettes.
Cumulative smoking exposure and intensity of smoking (daily exposure) are both frequently measured [e.g. 1.), 2]. In studies, based on cumulative smoking exposure, smokers are typically stratified to light, moderate and heavy, based on pack-years. Using the exact same terms we use to stratify smokers based on their daily dose of tobacco. So we can spot the situation when a person meets the criteria of light smoker based on the daily dose (e.g. 5 cigarettes daily) and moderate/heavy smoker based on total tobacco consumption (30 years of 5 cigarettes daily) and vice versa (very heavy tobacco smoker for only a few weeks). And body effects for them would differ significantly.
My proposal is to add the second definition of light, moderate, and heavy tobacco smokers based on the pack-years they smoked. I think these newly added concepts should live under the current classification: Light smoker defined as 0,1 - 20 pack-years as a child of light smoker, etc.
And integrate to this hierarchy the standard concept to keep time since smoking cessation in CDM.
We have good SNOMED (however, it Is observation) for that: Time since stopped smoking
There are at least 2 reasons for that: 1) smoking affects health significantly, but with time effects of it on the organism become less and less plus 2) smoking questionaries usually have that question in one or another form, we can easily store this information without any ‘History of’ concepts.
Also, this project can be good start for wide mapping table
Even with my proposals, I still have some concerns about calculating the observation period. We have a patient, who started smoking at the age of 16, now he is 81, and he ended smoking last week. What should we do?
What do you think?