This measure defines an active smoker as FIRST:"Diagnosis, Active: Smoking" starts before or during "Measurement Period". Measure 138 defines the same as "Patient Characteristic: Tobacco User". Ignoring the fact that the tobacco measure is intended to apply to tobacco users not limited to smokers, Measure 61 could still use the patient characteristic data element. The inconsistency is not warranted by the measure definitions. Smoking is almost never going to appear in the EHR as a diagnosis.