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Items to document may include the following elements: The patients tobacco use Advisement to quit and impact of smoking Assessed willingness to attempt to quit (or resistance to physicians counseling) Methods and skills for cessation Medication management of smoking session drugs Resources provided Setting a quit date Follow-up arranged Amount of time spent counseling patient An entry in the patients health record simply stating that the doctor spent 11 minutes counseling the patient on tobacco use will not cut it, and will not meet the standard for medical necessity