Tobacco Use Panel Questionnaire Example - XML Representation

Health eData 1 Sandbox, published by HL7 International / Cross-Group Projects. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/argonautproject/USCDIV7/ and changes regularly. See the Directory of published versions
: Tobacco Use Panel Questionnaire Example - XML Representation

Active as of 2026-05-20
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<Questionnaire xmlns="http://hl7.org/fhir">
  <id value="88028-6"/>
  <meta>
    <extension url="http://hl7.org/fhir/StructureDefinition/instance-name">
      <valueString value="Tobacco Use Panel Questionnaire Example"/>
    </extension>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/instance-description">
      <valueMarkdown
                     value="LOINC 88028-6 *Tobacco use panel* rendered as a structured FHIR Questionnaire. Generated using the NIH SDC LHC-Forms application at &lt;https://lhcforms.nlm.nih.gov/lforms-fhir-app/&gt;. The paired QuestionnaireResponse captures the source data used to derive the *US Core Tobacco Use* panel Observation."/>
    </extension>
    <profile
             value="http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: Questionnaire 88028-6</b></p><a name="88028-6"> </a><a name="hc88028-6"> </a><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px"/><p style="margin-bottom: 0px">Profile: <a href="http://hl7.org/fhir/uv/sdc/STU3/StructureDefinition-sdc-questionnaire.html">SDCBaseQuestionnaire</a></p></div><b>Structure</b><table border="1" cellpadding="0" cellspacing="0" style="border: 1px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top;"><tr style="border: 2px #F0F0F0 solid; font-size: 11px; font-family: verdana; vertical-align: top"><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The linkID for the item">LinkID</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Text for the item">Text</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Minimum and Maximum # of times the item can appear in the instance">Cardinality</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="The type of the item">Type</a></th><th style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; padding-top: 3px; padding-bottom: 3px" class="hierarchy"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Additional information about the item">Description &amp; Constraints</a><span style="float: right"><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/></a></span></th></tr><tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck1.png)" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon_q_root.gif" alt="." style="background-color: white; background-color: inherit" title="QuestionnaireRoot" class="hierarchy"/> TobaccoUsePanel</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Questionnaire</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">http://hl7.org/fhir/us/core/Questionnaire/88028-6#0.1.0</td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item./74011-8" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-decimal.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="decimal" class="hierarchy"/> /74011-8</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Lifetime tobacco use</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item./74011-8-help" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: white; background-color: inherit" title="display" class="hierarchy"/> /74011-8-help</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Tobacco use (e.g. by packs or cigarettes) per period of time (e.g. per year) over the patient's lifetime.</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item./11366-2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-string.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="string" class="hierarchy"/> /11366-2</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">History of Tobacco use Narrative</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-string">string</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item./88029-4" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-decimal.png" alt="." style="background-color: white; background-color: inherit" title="decimal" class="hierarchy"/> /88029-4</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Tobacco use duration</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item./88029-4-help" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> /88029-4-help</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Amount of time (e.g. years) the patient has used smoking or smokeless tobacco products</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item./72166-2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> /72166-2</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Tobacco smoking status</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./72166-2">8 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item./88031-0" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> /88031-0</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Smokeless tobacco status</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./88031-0">5 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item./82769-1" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> /82769-1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Smoked or non-smoked tobacco</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./82769-1">8 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck11.png)" id="item./81228-9" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="coding" class="hierarchy"/> /81228-9</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Tobacco product</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..*</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Options: <a href="#opt-item./81228-9">9 options</a></td></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck100.png)" id="item./81228-9-help" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vline.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: white; background-color: inherit" title="display" class="hierarchy"/> /81228-9-help</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The type(s) of tobacco used for known tobacco users. Examples include cigarettes, cigars, pipe tobacco and smokeless tobacco. This term was created for, but is not limited in use to, the Joint Commission's tobacco treatment eCQM, which uses separate OIDs for each recommended answer and associated SNOMED CT code rather than a single OID for the answer list as a whole. The answer OIDs that are available as of the date this term was created are specified in the description for each answer in the LOINC answer list, and new OIDs will be added as they become available and are reported to the LOINC development team.</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item./8663-7" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-decimal.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="decimal" class="hierarchy"/> /8663-7</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Cigarettes smoked current (pack per day) - Reported</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item./74010-0" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-decimal.png" alt="." style="background-color: white; background-color: inherit" title="decimal" class="hierarchy"/> /74010-0</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Date quit tobacco smoking</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck10.png)" id="item./88030-2" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-decimal.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="decimal" class="hierarchy"/> /88030-2</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Date quit smokeless tobacco</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-decimal">decimal</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: white"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck01.png)" id="item./48766-0" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-coding.png" alt="." style="background-color: white; background-color: inherit" title="coding" class="hierarchy"/> /48766-0</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">Source of info</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-choice">choice</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: white; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr style="border: 1px #F0F0F0 solid; padding:0px; vertical-align: top; background-color: #F7F7F7"><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px; white-space: nowrap; background-image: url(tbl_bck000.png)" id="item./48766-0-help" class="hierarchy"><img src="tbl_spacer.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_blank.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="tbl_vjoin_end.png" alt="." style="background-color: inherit" class="hierarchy"/><img src="icon-q-display.png" alt="." style="background-color: #F7F7F7; background-color: inherit" title="display" class="hierarchy"/> /48766-0-help</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">The information or data source may be a person, organization, information system, reference to some other data object, etc.</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy">0..1</td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"><a href="https://hl7.org/fhir/R4/codesystem-item-type.html#item-type-display">display</a></td><td style="vertical-align: top; text-align : var(--ig-left,left); background-color: #F7F7F7; border: 1px #F0F0F0 solid; padding:0px 4px 0px 4px" class="hierarchy"/></tr>
<tr><td colspan="5" class="hierarchy"><br/><a href="https://hl7.org/fhir/R4/formats.html#table" title="Legend for this format"><img src="data:image/png;base64,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" alt="doco" style="background-color: inherit"/> Documentation for this format</a></td></tr></table><hr/><p><b>Options Sets</b></p><a name="opt-item./72166-2"> </a><p><b>Answer options for /72166-2 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA18976-3 (&quot;Current every day smoker&quot;)</li><li style="font-size: 11px">http://loinc.org#LA18977-1 (&quot;Current some day smoker&quot;)</li><li style="font-size: 11px">http://loinc.org#LA15920-4 (&quot;Former smoker&quot;)</li><li style="font-size: 11px">http://loinc.org#LA18978-9 (&quot;Never smoker&quot;)</li><li style="font-size: 11px">http://loinc.org#LA18979-7 (&quot;Smoker, current status unknown&quot;)</li><li style="font-size: 11px">http://loinc.org#LA18980-5 (&quot;Unknown if ever smoked&quot;)</li><li style="font-size: 11px">http://loinc.org#LA18981-3 (&quot;Heavy tobacco smoker&quot;)</li><li style="font-size: 11px">http://loinc.org#LA18982-1 (&quot;Light tobacco smoker&quot;)</li></ul><a name="opt-item./88031-0"> </a><p><b>Answer options for /88031-0 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA28391-3 (&quot;Current every day user&quot;)</li><li style="font-size: 11px">http://loinc.org#LA28392-1 (&quot;Current some day user&quot;)</li><li style="font-size: 11px">http://loinc.org#LA28393-9 (&quot;Former user&quot;)</li><li style="font-size: 11px">http://loinc.org#LA4519-0 (&quot;Never used&quot;)</li><li style="font-size: 11px">http://loinc.org#LA4489-6 (&quot;Unknown&quot;)</li></ul><a name="opt-item./82769-1"> </a><p><b>Answer options for /82769-1 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA26671-0 (&quot;Smoked tobacco only&quot;)</li><li style="font-size: 11px">http://loinc.org#LA26672-8 (&quot;Non-smoked tobacco only&quot;)</li><li style="font-size: 11px">http://loinc.org#LA26673-6 (&quot;Use of both smoked and non-smoked tobacco products&quot;)</li><li style="font-size: 11px">http://loinc.org#LA137-2 (&quot;None&quot;)</li><li style="font-size: 11px">http://loinc.org#LA26674-4 (&quot;Use of smoked tobacco but no information about non-smoked tobacco use&quot;)</li><li style="font-size: 11px">http://loinc.org#LA21413-2 (&quot;No information&quot;)</li><li style="font-size: 11px">http://loinc.org#LA4489-6 (&quot;Unknown&quot;)</li><li style="font-size: 11px">http://loinc.org#LA46-8 (&quot;Other&quot;)</li></ul><a name="opt-item./81228-9"> </a><p><b>Answer options for /81228-9 </b></p><ul><li style="font-size: 11px">http://loinc.org#LA15332-2 (&quot;Cigarettes&quot;)</li><li style="font-size: 11px">http://loinc.org#LA15333-0 (&quot;Cigars&quot;)</li><li style="font-size: 11px">http://loinc.org#LA26091-1 (&quot;Pipe tobacco&quot;)</li><li style="font-size: 11px">http://loinc.org#LA26092-9 (&quot;Smokeless tobacco&quot;)</li><li style="font-size: 11px">http://snomed.info/sct#598111000005109 (&quot;Nicotine pouch (product)&quot;)</li><li style="font-size: 11px">http://snomed.info/sct#698289004 (&quot;Hookah pipe smoker (finding)&quot;)</li><li style="font-size: 11px">http://snomed.info/sct#81911001 (&quot;Chewing tobacco (substance)&quot;)</li><li style="font-size: 11px">http://snomed.info/sct#39789004 (&quot;Snuff tobacco (substance)&quot;)</li><li style="font-size: 11px">http://snomed.info/sct#1303239008 (&quot;Electronic cigarette liquid containing nicotine (substance)&quot;)</li></ul></div>
  </text>
  <url value="http://hl7.org/fhir/us/core/Questionnaire/88028-6"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.40.2.35.7"/>
  </identifier>
  <version value="0.1.0"/>
  <name value="TobaccoUsePanel"/>
  <title value="Tobacco use panel"/>
  <status value="active"/>
  <experimental value="true"/>
  <subjectType value="Patient"/>
  <date value="2026-05-20"/>
  <publisher value="HL7 International / Cross-Group Projects"/>
  <contact>
    <name value="HL7 International / Cross-Group Projects"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cgp"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="cgp@lists.HL7.org"/>
    </telecom>
  </contact>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <copyright
             value="This material contains content from LOINC (http://loinc.org). LOINC is copyright 1995-2026, Regenstrief Institute, Inc. and the LOINC Committee, and is available at no cost under the license at http://loinc.org/license."/>
  <code>
    <system value="http://loinc.org"/>
    <code value="88028-6"/>
    <display value="Tobacco use panel"/>
  </code>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-unit">
      <valueCoding>
        <system value="http://unitsofmeasure.org"/>
        <code value="/a"/>
        <display value="/a"/>
      </valueCoding>
    </extension>
    <linkId value="/74011-8"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="74011-8"/>
      <display value="Lifetime tobacco use"/>
    </code>
    <text value="Lifetime tobacco use"/>
    <type value="decimal"/>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="help"/>
            <display value="Help-Button"/>
          </coding>
          <text value="Help-Button"/>
        </valueCodeableConcept>
      </extension>
      <linkId value="/74011-8-help"/>
      <text
            value="Tobacco use (e.g. by packs or cigarettes) per period of time (e.g. per year) over the patient's lifetime."/>
      <type value="display"/>
    </item>
  </item>
  <item>
    <linkId value="/11366-2"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="11366-2"/>
      <display value="History of Tobacco use Narrative"/>
    </code>
    <text value="History of Tobacco use Narrative"/>
    <type value="string"/>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-unit">
      <valueCoding>
        <system value="http://unitsofmeasure.org"/>
        <code value="a"/>
        <display value="a"/>
      </valueCoding>
    </extension>
    <linkId value="/88029-4"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="88029-4"/>
      <display value="Tobacco use duration"/>
    </code>
    <text value="Tobacco use duration"/>
    <type value="decimal"/>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="help"/>
            <display value="Help-Button"/>
          </coding>
          <text value="Help-Button"/>
        </valueCodeableConcept>
      </extension>
      <linkId value="/88029-4-help"/>
      <text
            value="Amount of time (e.g. years) the patient has used smoking or smokeless tobacco products"/>
      <type value="display"/>
    </item>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
      <valueCodeableConcept>
        <coding>
          <system value="http://hl7.org/fhir/questionnaire-item-control"/>
          <code value="drop-down"/>
          <display value="Drop down"/>
        </coding>
        <text value="Drop down"/>
      </valueCodeableConcept>
    </extension>
    <linkId value="/72166-2"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="72166-2"/>
      <display value="Tobacco smoking status"/>
    </code>
    <text value="Tobacco smoking status"/>
    <type value="choice"/>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA18976-3"/>
        <display value="Current every day smoker"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA18977-1"/>
        <display value="Current some day smoker"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA15920-4"/>
        <display value="Former smoker"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA18978-9"/>
        <display value="Never smoker"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA18979-7"/>
        <display value="Smoker, current status unknown"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA18980-5"/>
        <display value="Unknown if ever smoked"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA18981-3"/>
        <display value="Heavy tobacco smoker"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA18982-1"/>
        <display value="Light tobacco smoker"/>
      </valueCoding>
    </answerOption>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
      <valueCodeableConcept>
        <coding>
          <system value="http://hl7.org/fhir/questionnaire-item-control"/>
          <code value="drop-down"/>
          <display value="Drop down"/>
        </coding>
        <text value="Drop down"/>
      </valueCodeableConcept>
    </extension>
    <linkId value="/88031-0"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="88031-0"/>
      <display value="Smokeless tobacco status"/>
    </code>
    <text value="Smokeless tobacco status"/>
    <type value="choice"/>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA28391-3"/>
        <display value="Current every day user"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA28392-1"/>
        <display value="Current some day user"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA28393-9"/>
        <display value="Former user"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA4519-0"/>
        <display value="Never used"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA4489-6"/>
        <display value="Unknown"/>
      </valueCoding>
    </answerOption>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
      <valueCodeableConcept>
        <coding>
          <system value="http://hl7.org/fhir/questionnaire-item-control"/>
          <code value="drop-down"/>
          <display value="Drop down"/>
        </coding>
        <text value="Drop down"/>
      </valueCodeableConcept>
    </extension>
    <linkId value="/82769-1"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="82769-1"/>
      <display value="Smoked or non-smoked tobacco"/>
    </code>
    <text value="Smoked or non-smoked tobacco"/>
    <type value="choice"/>
    <answerOption>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
        <valueString value="01"/>
      </extension>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA26671-0"/>
        <display value="Smoked tobacco only"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
        <valueString value="02"/>
      </extension>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA26672-8"/>
        <display value="Non-smoked tobacco only"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
        <valueString value="03"/>
      </extension>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA26673-6"/>
        <display value="Use of both smoked and non-smoked tobacco products"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
        <valueString value="04"/>
      </extension>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA137-2"/>
        <display value="None"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
        <valueString value="05"/>
      </extension>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA26674-4"/>
        <display
                 value="Use of smoked tobacco but no information about non-smoked tobacco use"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
        <valueString value="NI"/>
      </extension>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA21413-2"/>
        <display value="No information"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
        <valueString value="UN"/>
      </extension>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA4489-6"/>
        <display value="Unknown"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-optionPrefix">
        <valueString value="OT"/>
      </extension>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA46-8"/>
        <display value="Other"/>
      </valueCoding>
    </answerOption>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
      <valueCodeableConcept>
        <coding>
          <system value="http://hl7.org/fhir/questionnaire-item-control"/>
          <code value="drop-down"/>
          <display value="Drop down"/>
        </coding>
        <text value="Drop down"/>
      </valueCodeableConcept>
    </extension>
    <linkId value="/81228-9"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="81228-9"/>
      <display value="Tobacco product"/>
    </code>
    <text value="Tobacco product"/>
    <type value="choice"/>
    <repeats value="true"/>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA15332-2"/>
        <display value="Cigarettes"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA15333-0"/>
        <display value="Cigars"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA26091-1"/>
        <display value="Pipe tobacco"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://loinc.org"/>
        <code value="LA26092-9"/>
        <display value="Smokeless tobacco"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://snomed.info/sct"/>
        <code value="598111000005109"/>
        <display value="Nicotine pouch (product)"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://snomed.info/sct"/>
        <code value="698289004"/>
        <display value="Hookah pipe smoker (finding)"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://snomed.info/sct"/>
        <code value="81911001"/>
        <display value="Chewing tobacco (substance)"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://snomed.info/sct"/>
        <code value="39789004"/>
        <display value="Snuff tobacco (substance)"/>
      </valueCoding>
    </answerOption>
    <answerOption>
      <valueCoding>
        <system value="http://snomed.info/sct"/>
        <code value="1303239008"/>
        <display
                 value="Electronic cigarette liquid containing nicotine (substance)"/>
      </valueCoding>
    </answerOption>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="help"/>
            <display value="Help-Button"/>
          </coding>
          <text value="Help-Button"/>
        </valueCodeableConcept>
      </extension>
      <linkId value="/81228-9-help"/>
      <text
            value="The type(s) of tobacco used for known tobacco users. Examples include cigarettes, cigars, pipe tobacco and smokeless tobacco. This term was created for, but is not limited in use to, the Joint Commission's tobacco treatment eCQM, which uses separate OIDs for each recommended answer and associated SNOMED CT code rather than a single OID for the answer list as a whole. The answer OIDs that are available as of the date this term was created are specified in the description for each answer in the LOINC answer list, and new OIDs will be added as they become available and are reported to the LOINC development team."/>
      <type value="display"/>
    </item>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-unit">
      <valueCoding>
        <system value="http://unitsofmeasure.org"/>
        <code value="{#}/d"/>
        <display value="{#}/d"/>
      </valueCoding>
    </extension>
    <linkId value="/8663-7"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="8663-7"/>
      <display value="Cigarettes smoked current (pack per day) - Reported"/>
    </code>
    <text value="Cigarettes smoked current (pack per day) - Reported"/>
    <type value="decimal"/>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-unit">
      <valueCoding>
        <system value="http://unitsofmeasure.org"/>
        <code value="{mm/dd/yyyy}"/>
        <display value="{mm/dd/yyyy}"/>
      </valueCoding>
    </extension>
    <linkId value="/74010-0"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="74010-0"/>
      <display value="Date quit tobacco smoking"/>
    </code>
    <text value="Date quit tobacco smoking"/>
    <type value="decimal"/>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-unit">
      <valueCoding>
        <system value="http://unitsofmeasure.org"/>
        <code value="{mm/dd/yyyy}"/>
        <display value="{mm/dd/yyyy}"/>
      </valueCoding>
    </extension>
    <linkId value="/88030-2"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="88030-2"/>
      <display value="Date quit smokeless tobacco"/>
    </code>
    <text value="Date quit smokeless tobacco"/>
    <type value="decimal"/>
  </item>
  <item>
    <extension
               url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
      <valueCodeableConcept>
        <coding>
          <system value="http://hl7.org/fhir/questionnaire-item-control"/>
          <code value="drop-down"/>
          <display value="Drop down"/>
        </coding>
        <text value="Drop down"/>
      </valueCodeableConcept>
    </extension>
    <linkId value="/48766-0"/>
    <code>
      <system value="http://loinc.org"/>
      <code value="48766-0"/>
      <display value="Source of info"/>
    </code>
    <text value="Source of info"/>
    <type value="choice"/>
    <item>
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/questionnaire-itemControl">
        <valueCodeableConcept>
          <coding>
            <system value="http://hl7.org/fhir/questionnaire-item-control"/>
            <code value="help"/>
            <display value="Help-Button"/>
          </coding>
          <text value="Help-Button"/>
        </valueCodeableConcept>
      </extension>
      <linkId value="/48766-0-help"/>
      <text
            value="The information or data source may be a person, organization, information system, reference to some other data object, etc."/>
      <type value="display"/>
    </item>
  </item>
</Questionnaire>