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If 600 puffs are like smoking 48 cigarettes, then thats about 12.5 puffs per cigarette

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Use for tobacco use screening Z77.22 Contact with and exposure to environmental tobacco smoke Other Codes for Reporting Tobacco Dependence P98.81 Exposure to tobacco smoke in the perinatal period O99.33 Tobacco use during pregnancy (Tobacco use disorder complicating pregnancy, childbirth, and the puerperium T65.2 Toxic effect of tobacco and nicotine Accurate documentation of the patients smoking status is essential to ensure the correct code assignment