Of the seven studies identified, only four evaluated the effect of organizational changes on study participants' quitting status. Of these, two found that organizational changes helped people to quit smoking, but the other two studies reported that they did not, and hence no conclusion could be drawn on this factor. Activities such as counselling to quit, recording smoking status in patient health records, and referring smokers to an outside stop-smoking clinic improved after those changes were made. Of the three studies which evaluated factors such as asking about tobacco use and advising to quit, two reported that organizational changes could improve both of those factors.

The overall quality of the evidence was judged to be low because of the small number of available studies and inadequate study designs. More well-conducted studies are needed to fill this knowledge gap. Some studies are already underway but need to be evaluated in detail to include in the review.