Current tobacco use ≥3 months at any quantity (cigarettes, cigars, pipe, smokeless tobacc...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-UNIVERSAL-CURRENT-SMOKER-MULTI-CANCER`
Type	Red flag
Status	reviewed 2026-05-18 \| pending_clinical_signoff
Diseases	None declared
Sources	`SRC-IARC-100A-TOBACCO-SMOKING` `SRC-USPSTF-LUNG-LDCT-2021` `SRC-WCRF-AICR-CUP-2018`

Red Flag Origin

Definition	Current tobacco use ≥3 months at any quantity (cigarettes, cigars, pipe, smokeless tobacco, hookah / waterpipe). IARC Monograph 100A (2012) classifies tobacco smoking as Group 1 carcinogen with sufficient evidence in humans for cancers of: oral cavity, oro- / hypo- / nasopharynx, paranasal sinuses, larynx, oesophagus, stomach, colon and rectum, liver, pancreas, lung, kidney (RCC and renal pelvis / ureter urothelial), urinary bladder, uterine cervix, ovary (mucinous), and myeloid leukaemia (≥17 sites). Smokeless tobacco adds oral / oesophageal / pancreas associations. Current-smoker status is the highest-yield intervention point in cancer prevention — dose-response is steep and cessation benefits accrue from year 1 with measurable lung-cancer risk reduction by year 5 and continuing for ≥20y. Universal RedFlag (relevant_diseases ["*"]) — routes to structured cessation (combined behavioura...
Clinical direction	investigate
Category	other

Trigger Logic

{
  "any_of": [
    {
      "finding": "current_tobacco_use_documented",
      "value": true
    }
  ],
  "type": "composite_score"
}

Notes

Pre-triage universal RedFlag — current tobacco use (≥3 mo, any quantity) per IARC 100A 17-cancer cluster. Authoring intent: highest-yield prevention intervention. Routes to (1) structured cessation — combined behavioural + first-line pharmacotherapy (varenicline / bupropion / NRT-combination) per USPHS 2008 + NICE / NCQA, and (2) USPSTF 2021 LDCT eligibility evaluation (annual LDCT for 50-80yo with ≥20 pack-y history, current smoker or quit ≤15y). With relevant_diseases=["*"], engine does NOT attach Indication tracks via prevention path (plan.py:297 excludes "*") — universal Indications anchored to DIS-NSCLC are documentation / sidecar candidates pending future engine extension. STUB pending two-Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode.

Used By

Indications

IND-UNIVERSAL-CURRENT-SMOKER-PREVENTION-BRIEF-NRT - IND-UNIVERSAL-CURRENT-SMOKER-PREVENTION-BRIEF-NRT
IND-UNIVERSAL-CURRENT-SMOKER-PREVENTION-CESSATION-LDCT - IND-UNIVERSAL-CURRENT-SMOKER-PREVENTION-CESSATION-LDCT