ARCHETYPE Smokeless tobacco summary (openEHR-EHR-EVALUATION.smokeless_tobacco_summary.v1)

ARCHETYPE IDopenEHR-EHR-EVALUATION.smokeless_tobacco_summary.v1
ConceptSmokeless tobacco summary
DescriptionSummary or persistent information about smokeless tobacco use by an individual.
UseUse to record summary or persistent information about smokeless tobacco use by an individual. This archetype is to be used to record information about both current and previous use of smokeless tobacco. The specific scope of this archetype includes the use of all types of smokeless tobacco because of the associated health risks. Amount of nicotine, as well as use of bags and additives has been left outside of scope for the core archetype, but could be added into the 'Type details' SLOT if required. The 'Per type' cluster of data elements allows for recording of specific details and episodes about each type of tobacco used and can be repeated once per type. In many situations the individual will only use one type of smokeless tobacco, such as snus or snuff. If other types of tobacco are used the details will be recorded in another instance of the 'Per type' cluster. The history of varying use for each type of tobacco over time can be captured using the repeatable 'Per episode' cluster. This cluster of data elements allows for a very detailed pattern of tobacco usage behaviour to be recorded for each type of tobacco used such as daily usage of snus, alongside occasional use of chewing tobacco while on holiday. Triggers for closing one episode and commencing a new one will largely reflect local data collection preferences, including if the individual: - quits for a significant period of time (which will likely be locally defined); or - significantly changes their amount of use or pattern of their usage. To incorporate narrative descriptions of smokeless tobacco usage habits within existing or legacy clinical systems into an archetyped format, use the 'Overall description' data element.
MisuseNot to be used to record event-or period-based information about usage of smokeless tobacco, such as actual daily use or the average use over a specified period of time - use the OBSERVATION.smokeless_tobacco archetype (not yet developed). Not to be used for recording specific consumption of nicotine - including patches, chewing gum, spray and powder - or e-cigarettes. Use separate archetypes for this purpose. Not to be used to record information about tobacco smoking. Use the EVALUATION.tobacco_smoking_summary archetype for this purpose.
PurposeTo record summary or persistent information about smokeless tobacco use by an individual.
ReferencesTobacco smoking summary, Published archetype [Internet]. openEHR Foundation, openEHR Clinical Knowledge Manager [cited: 2018-06-01]. Available from: https://ckm.openehr.org/ckm/#showArchetype_1013.1.2466

Gupta PC. Gutka: a major new tobacco hazard in India. Tob Control. 1999 Summer;8(2):134. PubMed PMID: 10478395; PubMed Central PMCID: PMC1759702.

Hedström AK, Bäärnhielm M, Olsson T, Alfredsson L. Tobacco smoking, but not Swedish snuff use, increases the risk of multiple sclerosis. Neurology. 2009 Sep 1;73(9):696-701. doi: 10.1212/WNL.0b013e3181b59c40. PubMed PMID: 19720976

Idris AM, Ibrahim SO, Vasstrand EN, Johannessen AC, Lillehaug JR, Magnusson B, Wallström M, Hirsch JM, Nilsen R. The Swedish snus and the Sudanese toombak: are they different? Oral Oncol. 1998 Nov;34(6):558-66. Review. PubMed PMID: 9930371.

Niaz K, Maqbool F, Khan F, Bahadar H, Ismail Hassan F, Abdollahi M. Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer. Epidemiol Health. 2017 Mar 9;39:e2017009. doi: 10.4178/epih.e2017009. eCollection 2017. Review. PubMed PMID: 28292008; PubMed Central PMCID: PMC5543298.
Copyright© openEHR Foundation, Nasjonal IKT HF
AuthorsAuthor name: Heather Leslie
Organisation: Atomica Informatics, Australia
Email: heather.leslie@atomicainformatics.com
Date originally authored: 2009-06-21
Other Details LanguageAuthor name: Heather Leslie
Organisation: Atomica Informatics, Australia
Email: heather.leslie@atomicainformatics.com
Date originally authored: 2009-06-21
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/., custodian_organisation=openEHR Foundation, references=Tobacco smoking summary, Published archetype [Internet]. openEHR Foundation, openEHR Clinical Knowledge Manager [cited: 2018-06-01]. Available from: https://ckm.openehr.org/ckm/#showArchetype_1013.1.2466 Gupta PC. Gutka: a major new tobacco hazard in India. Tob Control. 1999 Summer;8(2):134. PubMed PMID: 10478395; PubMed Central PMCID: PMC1759702. Hedström AK, Bäärnhielm M, Olsson T, Alfredsson L. Tobacco smoking, but not Swedish snuff use, increases the risk of multiple sclerosis. Neurology. 2009 Sep 1;73(9):696-701. doi: 10.1212/WNL.0b013e3181b59c40. PubMed PMID: 19720976 Idris AM, Ibrahim SO, Vasstrand EN, Johannessen AC, Lillehaug JR, Magnusson B, Wallström M, Hirsch JM, Nilsen R. The Swedish snus and the Sudanese toombak: are they different? Oral Oncol. 1998 Nov;34(6):558-66. Review. PubMed PMID: 9930371. Niaz K, Maqbool F, Khan F, Bahadar H, Ismail Hassan F, Abdollahi M. Smokeless tobacco (paan and gutkha) consumption, prevalence, and contribution to oral cancer. Epidemiol Health. 2017 Mar 9;39:e2017009. doi: 10.4178/epih.e2017009. eCollection 2017. Review. PubMed PMID: 28292008; PubMed Central PMCID: PMC5543298., current_contact=Heather Leslie, Atomica Informatics, Australia, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=4EB59C00695D1C5302B5B3672B4E8588, build_uid=f3de05c8-eae6-4d32-803f-ee0acb37d2c3, revision=1.0.0}
Keywordstobacco, snus, snuff, dip, gutka, iqmik, naswar, toombak, shammah, mawa, gadakhu, habit, babul, zarda, dokta, paan, pan, khilli, pan masala, dohra, tombol, sada pata, chadha, kapoori, manipuri, twist, niswar, nass, nasway, nasvay, sute, ammari, saood, sauté, gudakhu, kiwam, mishri, gul, tuibur, hidakpha, hsaypaung yay, chaw, chewing, oral, spitting
Lifecyclepublished
UID3e00db0d-6078-49cc-8016-ecee504fa71a
Language useden
Citeable Identifier1013.1.2817
Revision Number1.0.0
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Summary or persistent information about smokeless tobacco use by an individual., archetypeConceptComment=null, otherContributors=Amund Aakerholt, Helse Stavanger, KORFOR, Norway
Vebjørn Arntzen, Oslo University Hospital, Norway (openEHR Editor)
Heidi Aursand, Oslo universitetssykehus, Norway
Silje Ljosland Bakke, Nasjonal IKT HF, Norway (openEHR Editor)
SB Bhattacharyya, Sudisa Consultancy Services, India
Fatemeh Chalabianloo, Helse Bergen, Norway
Lisbeth Dahlhaug, Helse Midt - Norge IT, Norway
Kåre Flø, DIPS ASA, Norway
Mikkel Gaup Grønmo, FSE, Helse Nord, Norway
Helge Hagen, Norway
Hilde Hollås, DIPS AS, Norway
Lars Ivar Mehlum, Helse Bergen HF, Norway
Lars Morgan Karlsen, DIPS ASA, Norway
Nils Kolstrup, Skansen Legekontor og Nasjonalt Senter for samhandling og telemedisin, Norway
Heather Leslie, Atomica Informatics, Australia (openEHR Editor)
Neranga Liyanaarachchi, Ministry of Health, Postgraduate Institute of Medicine, Sri Lanka
Manisha Mantri, C-DAC, India
Siv Marie Lien, DIPS ASA, Norway
James McClay, University of Nebraska Medical Center, United States
Ian McNicoll, Ocean Informatics UK, United Kingdom
Paul Miller, SCIMP NHS Scotland, United Kingdom
Jayashree Panickar, Karolinska Institute, Sweden
Niclas Skyttberg, Karolinska Institutet, Sweden
Trine Strand, Oslo Universitetssykehus (OUS), Norway
Norwegian Review Summary, Nasjonal IKT HF, Norway
Erik Sundvall, Region Östergötland + Linköping University, Sweden
Nyree Taylor, Ocean Informatics, Australia (openEHR Editor)
Micaela Thierley, Helse Bergen/Haraldsplass sykehus, Norway
Anders Thurin, SU, Sweden
John Tore Valand, Helse Bergen, Norway (openEHR Editor)
Lin Zhang, Taikang Insurance Group, China, originalLanguage=en, translators=Swedish: Carrick Gillespie / Erik Sundvall, Omniq AB / Region Östergötland + Linköping University, carrickg@gmail.com / erik.sundvall@regionostergotland.se
Norwegian Bokmål: Kristian Berg, Universitetssykehuset Nord Norge - Regional forvaltning EPJ, kristian.berg@unn.no, *
, subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={details=[], identities=[], source=[], credentials=[], context=[], description=[], ism_transition=[], events=[], content=[], items=[], capabilities=[], other_participations=[], contacts=[], target=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0089], code=at0089, itemType=ELEMENT, level=2, text=Overall status, description=Statement about current use of all types of smokeless tobacco., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Never used [Individual has never used any type of smokeless tobacco.]
  • Current user [The individual is a current user of any type of smokeless tobacco.]
  • Former user [The individual has previously used smokeless tobacco, but is not a current user.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0043], code=at0043, itemType=ELEMENT, level=2, text=Overall description, description=Narrative summary about the individual's overall smokeless tobacco use pattern and history., comment=Use this data element to record a narrative description only where the structured data does not adequately reflect the smokeless tobacco use for this individual or to incorporate unstructured information about smokeless tobacco use from existing or legacy clinical systems into an archetyped format., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0015], code=at0015, itemType=ELEMENT, level=2, text=Regular use commenced, description=The date or partial date when the individual first started frequent or regular, but non-daily, use of smokeless tobacco of any type., comment=Can be a partial date, for example, only a year. For example, this date could represent when the individual commenced using smokeless tobacco every Friday night or at parties., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0080], code=at0080, itemType=ELEMENT, level=2, text=Daily use commenced, description=The date or partial date when the individual first started daily use of smokeless tobacco of any type., comment=Can be a partial date, for example, only a year., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029], code=at0029, itemType=CLUSTER, level=2, text=Per type, description=Details about use of a specified type of smokeless tobacco., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0098], code=at0098, itemType=ELEMENT, level=3, text=Type, description=The name of the specific type or grouping of smokeless tobacco., comment=For example: A specific type could be 'snus' or 'gutka', while a group could be 'chewing tobacco'., uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0052], code=at0052, itemType=ELEMENT, level=3, text=Status, description=Statement about current use of the specified type of smokeless tobacco., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Current user [The individual is a current user of the specified type of smokeless tobacco.]
  • Former user [The individual has previously used the specified smokeless tobacco, but is not a current user.]
  • Never used [The individual has never used the specified type of smokeless tobacco.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0053], code=at0053, itemType=ELEMENT, level=3, text=Description, description=Narrative summary about use of the specified type of smokeless tobacco., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0064], code=at0064, itemType=CLUSTER, level=3, text=Per episode, description=Details about a discrete period of use of the specified type of smokeless tobacco., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0064]/items[at0081], code=at0081, itemType=ELEMENT, level=4, text=Episode label, description=Identification of an episode of smokeless tobacco use., comment=The label may be represented either as a number in a sequence and/or a named event. For example: '2' as the second episode within a sequence of episodes; or 'Pregnancy with twins' if describing the use of smokeless tobacco during a health event such as during a specific pregnancy., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Count
    min: >=1

  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0064]/items[at0013], code=at0013, itemType=ELEMENT, level=4, text=Episode start date, description=Date when this episode commenced., comment=Can be a partial date, for example, only a year., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0064]/items[at0082], code=at0082, itemType=ELEMENT, level=4, text=Episode end date, description=Date when this episode ceased., comment=Can be a partial date, for example, only a year. This data field will be empty if the episode is current and ongoing., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0064]/items[at0030], code=at0030, itemType=ELEMENT, level=4, text=Pattern, description=Details about a discrete period of use of the specified type of smokeless tobacco., comment=The typical pattern of use can be made more granular by coding the free text option with a terminology or a local value set in a template., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Daily [Use of the specified type of smokeless tobacco at least once every day.]
    • Non-daily [Not using the specified type of smokeless tobacco every day.]
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0064]/items[at0065], code=at0065, itemType=ELEMENT, level=4, text=Typical use, description=Estimate of the amount of loose tobacco used., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Flow rate, mass
Units:
  • >=0.0 g/d
    Limit decimal places: 0
  • >=0.0 g/wk
    Limit decimal places: 0
  • [oz_av]/d
  • [oz_av]/wk
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0064]/items[at0023], code=at0023, itemType=ELEMENT, level=4, text=Typical frequency, description=Estimate of number of times that an individual uses smokeless tobacco per time period., comment=For example: the number of 'bags', 'pinches' or 'portions' per day or per week., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Frequency
Units:
  • >=0.0 1/d
    Limit decimal places: 0
  • >=0.0 1/wk
    Limit decimal places: 0
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0064]/items[at0025], code=at0025, itemType=ELEMENT, level=4, text=Number of quit attempts, description=Total number of times the individual has attempted to stop using the specified type of smokeless tobacco within this episode., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=0

, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0064]/items[at0026], code=at0026, itemType=SLOT, level=4, text=Episode details, description=Additional structured details about the specified episode of smokeless tobacco use., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
openEHR-EHR-CLUSTER.cessation_attempts.v1 and specialisations Or
openEHR-EHR-CLUSTER.cessation_attempts.v0 and specialisations, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0064]/items[at0087], code=at0087, itemType=ELEMENT, level=4, text=Episode comment, description=Details about a discrete period of use of the specified type of smokeless tobacco., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0014], code=at0014, itemType=ELEMENT, level=3, text=Quit date, description=Date when the individual last used the specified type of tobacco., comment=Can be a partial date, for example, only a year. Definitions for a 'Quit date' vary enormously and can be defined using the 'Quit data definition' data element in the Protocol section of this archetype. This date will be identical to the 'Episode end date' for the most recent episode. This date could be used by decision support guidance to determine if the individual is at risk of relapse, for example in the first 12 months since quitting., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0077], code=at0077, itemType=SLOT, level=3, text=Type details, description=Additional structured details relating to the specified type of smokeless tobacco use., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
All not explicitly excluded archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0017], code=at0017, itemType=ELEMENT, level=3, text=Pack years, description=Estimate of the cumulative amount of smokeless tobacco used over a lifetime, for the specified type of smokeless tobacco., comment=Commonly used in assessment of snus use. It is calculated by multiplying the number of packs of snus used per day by the number of years the individual has used. One pack-year is the equivalent of using one packet of snus daily for 1 year. The definition of a pack can be recorded in the protocol of this archetype using the 'Pack definition' data element., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=0

, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0029]/items[at0069], code=at0069, itemType=ELEMENT, level=3, text=Comment, description=Additional narrative about the use of the specified type of smokeless tobacco, not captured in other fields., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0086], code=at0086, itemType=SLOT, level=2, text=Overall details, description=Additional structured details about the overall smokeless tobacco use., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
All not explicitly excluded archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0016], code=at0016, itemType=ELEMENT, level=2, text=Overall quit date, description=The date when the individual last ceased using smokeless tobacco of any type., comment=Can be a partial date, for example, only a year. This date could be used by decision support guidance to determine if the individual is at risk of relapse, for example in the first 12 months since quitting., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0074], code=at0074, itemType=ELEMENT, level=2, text=Overall pack years, description=Estimate of the cumulative amount of smokeless tobacco used over a lifetime, for all types of smokeless tobacco., comment=Commonly used in assessment of snus use. It is calculated by multiplying the number of packs of snus, or other types of smokeless tobacco, used per day by the number of years the individual has used. One pack-year is the equivalent of using one packet of smokeless tobacco daily for 1 year. The definition of a pack can be recorded in the protocol of this archetype using the 'Pack definition' data element., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=0

, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/items[at0019], code=at0019, itemType=ELEMENT, level=2, text=Overall comment, description=Additional narrative about all smokeless tobacco use, not captured in other fields., comment=For example: stopped snusing or reduced amount on becoming pregnant., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null]], relationships=[], state=[], protocol=[ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0073], code=at0073, itemType=SLOT, level=2, text=Extension, description=Additional information required to capture local content or to align with other reference models/formalisms., comment=For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
All not explicitly excluded archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0071], code=at0071, itemType=ELEMENT, level=2, text=Quit date definition, description=The applied definition for the 'Quit date' data elements used in this archetype., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0085], code=at0085, itemType=ELEMENT, level=2, text=Quit attempt definition, description=The applied definition for a Quit attempt used to determine value for the 'Number of quit attempts' data element used in this archetype., comment=For example: 'stopped snusing for one day or longer with the intention of quitting'., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0075], code=at0075, itemType=ELEMENT, level=2, text=Current user definition, description=The applied definition for the 'Current user' value in each of the 'Status' data elements used in this archetype., comment=Definition may need to be specified per type., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0076], code=at0076, itemType=ELEMENT, level=2, text=Former user definition, description=The applied definition for the 'Former user' value in each of the 'Status' data elements used in this archetype., comment=Definition may need to be specified per type., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0079], code=at0079, itemType=ELEMENT, level=2, text=Never used definition, description=The applied definition for the 'Never used' value in each of the 'Status' data elements used in this archetype., comment=Definition may need to be specified per type. For example, the definition may not be zero, but less than a specified amount used during a specified time interval., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0072], code=at0072, itemType=ELEMENT, level=2, text=Pack definition, description=The definition of the size of pack used as part of the algorithm for calculating 'Pack years' data elements used in this archetype., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Count
    min: >=0

  •  Quantity
    Property: Mass
    Units:
    • g
      Limit decimal places: 0
    • [oz_av]
      Limit decimal places: 0
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0022], code=at0022, itemType=ELEMENT, level=2, text=Last updated, description=The date this smokeless tobacco summary was last updated., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null]], activities=[], provider=[]}, topLevelItems={data=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0001], code=at0001, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=1..1, cardinalityText=mandatory, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null], protocol=ResourceSimplifiedHierarchyItem [path=ROOT_/protocol[at0021], code=at0021, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=1..1, cardinalityText=mandatory, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=protocol, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0073], code=at0073, itemType=SLOT, level=2, text=Extension, description=Additional information required to capture local content or to align with other reference models/formalisms., comment=For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
All not explicitly excluded archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0071], code=at0071, itemType=ELEMENT, level=2, text=Quit date definition, description=The applied definition for the 'Quit date' data elements used in this archetype., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0085], code=at0085, itemType=ELEMENT, level=2, text=Quit attempt definition, description=The applied definition for a Quit attempt used to determine value for the 'Number of quit attempts' data element used in this archetype., comment=For example: 'stopped snusing for one day or longer with the intention of quitting'., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0075], code=at0075, itemType=ELEMENT, level=2, text=Current user definition, description=The applied definition for the 'Current user' value in each of the 'Status' data elements used in this archetype., comment=Definition may need to be specified per type., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0076], code=at0076, itemType=ELEMENT, level=2, text=Former user definition, description=The applied definition for the 'Former user' value in each of the 'Status' data elements used in this archetype., comment=Definition may need to be specified per type., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0079], code=at0079, itemType=ELEMENT, level=2, text=Never used definition, description=The applied definition for the 'Never used' value in each of the 'Status' data elements used in this archetype., comment=Definition may need to be specified per type. For example, the definition may not be zero, but less than a specified amount used during a specified time interval., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0072], code=at0072, itemType=ELEMENT, level=2, text=Pack definition, description=The definition of the size of pack used as part of the algorithm for calculating 'Pack years' data elements used in this archetype., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Count
    min: >=0

  •  Quantity
    Property: Mass
    Units:
    • g
      Limit decimal places: 0
    • [oz_av]
      Limit decimal places: 0
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/protocol[at0021]/items[at0022], code=at0022, itemType=ELEMENT, level=2, text=Last updated, description=The date this smokeless tobacco summary was last updated., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_DATE_TIME, bindings=null, values=, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]