Tobacco Research

Illustration by John Cuneo

The Institute provides a home at Dartmouth for researchers who focus on behavior and non-communicable diseases. We conduct research that has a measurable impact on the risk of these diseases.

Tobacco is by far the deadliest commodity.  The 6 trillion cigarettes produced and consumed each year contribute to millions of deaths worldwide.  The tobacco industry pioneered public relations campaigns that undermined science showing tobacco causes chronic disease; they manipulate governments to avoid regulation of cigarettes in violation of international convention.  C. Everett Koop envisioned a world free of tobacco, and the Koop Institute pursues research and policies that will promote the end of cigarette smoking.  This includes studies of cigarette marketing and youth use of cigarettes, as well as studies that promote a better understanding of how alternate nicotine delivery systems like e-cigarettes might affect cigarette smoking and health.

Koop Institute members are required to disclose all conflicts of interests. Access this information on the Conflicts of Interest Page.

Selected publications

Discordance Between Insurance Coverage of Antiviral Medications and Nicotine Replacement Therapy Among Individuals With Human Immunodeficiency Virus Who Smoke
Bernstein SL, Yager JE, Sigel K, Porter E, Do T, Payne E, Bold K, Ledgerwood D, Edelman EJ. J Addict Med. 2024 Apr 12. doi: 10.1097/ADM.0000000000001302. Online ahead of print. PMID: 38606851

Tobacco, Alcohol, and Drug Use Among Young Adults with Serious Mental Illness
Ferron JC, Brunette MF, Aschbrenner KA, ElSayed MW, Pratt SI. Community Ment. Health J. 2024 Mar 1. doi: 10.1007/s10597-024-01246-x. Online ahead of print. PMID: 38427276

A selective review of smoking cessation interventions in the emergency department
Pettit N, Pope I, Neuner B, Lash R, Bernstein SL.
Emerg Cancer Care 2022;1. Doi:10.1186/s44201-022-00006-5.

Relationship Between Tobacco Product Use and Health-Related Quality of Life Among Individuals With COPD in Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study. Paulin LM, Halenar MJ, Edwards KC, Lauten K, Taylor K, Brunette M, Tanski S, MacKenzie T, Stanton CA, Hatsukami D, Hyland A, Mahoney MC, Niaura R, Trinidad D, Blanco C, Compton W, Gardner LD, Kimmel HL, Cummings KM, Lauterstein D, Roh EJ, Marshall D, Sargent JD. Chronic Obstr Pulm Dis. 2024 Jan 25;11(1):68-82. doi: 10.15326/jcopdf.2023.0422.
PMID: 38113525

Indoor Pollution and Lung Function Decline in Current and Former Smokers: SPIROMICS AIR.
Hansel NN, Woo H, Koehler K, Gassett A, Paulin LM, Alexis NE, Putcha N, Lorizio W, Fawzy A, Belz D, Sack C, Barr RG, Martinez FJ, Han MK, Woodruff P, Pirozzi C, Paine R 3rd, Barjaktarevic I, Cooper CB, Ortega V, Zusman M, Kaufman JD. Am J Respir Crit Care Med. 2023 Nov 15;208(10):1042-1051. doi: 10.1164/rccm.202302-0207OC. PMID: 37523421

Impact of Nicotine Replacement Therapy on Breast Surgery Outcomes.
Patel SM, Junn A, Sasson D, Dinis J, Duan K, Islam S, Fucito L, Bernstein SL, Hsia HC.
J Reconstr Microsurg. 2024 Mar;40(3):239-244. doi: 10.1055/a-2133-1130. Epub 2023 Jul 19.
PMID: 37467771

Childhood Cigarette Smoking and Risk of Chronic Obstructive Pulmonary Disease in Older U.S. Adults. Sargent JD, Halenar M, Steinberg AW, Ozga J, Tang Z, Stanton CA, Paulin LM.
Am J Respir Crit Care Med. 2023 Aug 15;208(4):428-434. doi: 10.1164/rccm.202303-0476OC.
PMID: 37348105

A Secondary Analysis of a Preliminary Contingency Management Intervention for Presurgical Cancer Patients: Evaluating Individual Participant Data. Sanford BT, Toll BA, Fucito LM, Baker NL, Krishnan-Sarin S, Carpenter MJ, Bernstein SL, Rojewski AM. Nicotine Tob Res. 2023 Aug 19;25(9):1614-1618. doi: 10.1093/ntr/ntad071. PMID: 37156634

Cost-Effectiveness of Smoking Cessation Approaches in Emergency Departments.
Miller TR, Johnson MB, Dziura JD, Weiss J, Carpenter KM, Grau LE, Pantalon MV, Abroms L, Collins LM, Toll BA, Bernstein SL. Am J Prev Med. 2023 Jul;65(1):39-44. doi: 10.1016/j.amepre.2023.01.006. Epub 2023 Jan 28. PMID: 36710199

Successful Optimization of Tobacco Dependence Treatment in the Emergency Department: A Randomized Controlled Trial Using the Multiphase Optimization Strategy.
Bernstein SL, Dziura J, Weiss J, Brooks AH, Miller T, Vickerman KA, Grau LE, Pantalon MV, Abroms L, Collins LM, Toll B. Ann Emerg Med. 2023 Feb;81(2):209-221. doi: 10.1016/j.annemergmed.2022.08.018. Epub 2022 Dec 28. PMID: 36585318

Integrating Tobacco Treatment Into Oncology Care: Reach and Effectiveness of Evidence-Based Tobacco Treatment Across National Cancer Institute-Designated Cancer Centers.
Hohl SD, Matulewicz RS, Salloum RG, Ostroff JS, Baker TB, Schnoll R, Warren G, Bernstein SL, Minion M, Lenhoff K, Dahl N, Juon HS, Tsosie U, Fleisher L, D'Angelo H, Ramsey AT, Ashing KT, Rolland B, Nolan MB, Bird JE, Nguyen CVT, Pauk D, Adsit RT, Tindle HA, Shoenbill K, Yeung S, Presant CA, Wiseman KP, Wen KY, Chichester LA, Chen LS. J Clin Oncol. 2023 May. 20;41(15):2756-2766. doi: 10.1200/JCO.22.00936. Epub 2022 Dec 6. PMID: 36473135

Smoking Status, Nicotine Medication, Vaccination, and COVID-19 Hospital Outcomes: Findings from the COVID EHR Cohort at the University of Wisconsin (CEC-UW) Study.
Piasecki TM, Smith SS, Baker TB, Slutske WS, Adsit RT, Bolt DM, Conner KL, Bernstein SL, Eng OD, Lazuk D, Gonzalez A, Jorenby DE, D'Angelo H, Kirsch JA, Williams BS, Nolan MB, Hayes-Birchler T, Kent S, Kim H, Lubanski S, Yu M, Suk Y, Cai Y, Kashyap N, Mathew JP, McMahan G, Rolland B, Tindle HA, Warren GW, An LC, Boyd AD, Brunzell DH, Carrillo V, Chen LS, Davis JM, Deshmukh VG, Dilip D, Ellerbeck EF, Goldstein AO, Iturrate E, Jose T, Khanna N, King A, Klass E, Mermelstein RJ, Tong E, Tsoh JY, Wilson KM, Theobald WE, Fiore MC. Nicotine Tob Res. 2023 May 22;25(6):1184-1193. doi: 10.1093/ntr/ntac201. PMID: 36069915

Correlates of tobacco product initiation among youth and young adults between waves 1-4 of the population assessment of tobacco and Health (PATH) study (2013-2018).
Cooper M, Day HR, Ren C, Oniyide O, Corey CG, Ambrose BK, Michael Cummings K, Sargent J, Niaura R, Pierce JP, Kaufman A, Choi K, Goniewicz ML, Stanton CA, Villanti A, Kasza K, Bansal-Travers M, Silveira ML, Kimmel HL, Hull LC, Koblitz A, Poonai K, Paredes A, Taylor K, Borek N, Hyland AJ. Addict Behav. 2022 Nov;134:107396. doi: 10.1016/j.addbeh.2022.107396. Epub 2022 Jun 7. PMID: 35749867

A qualitative study of smokers' assessments of four smoking cessation interventions delivered in a hospital emergency department. Grau LE, Jurczak E, Zahid M, Brooks AH, Weiss J, O'Leary TK, Pham T, Bernstein SL. Drug Alcohol Depend. 2022 Aug 1;237:109512. doi: 10.1016/j.drugalcdep.2022.109512. Epub 2022 May 27. PMID: 35714533

The effectiveness of smoking cessation interventions for socio-economically disadvantaged women: a systematic review and meta-analysis. O'Connell N, Burke E, Dobbie F, Dougall N, Mockler D, Darker C, Vance J, Bernstein SL, Gilbert H, Bauld L, Hayes CB. Syst Rev. 2022 Jun 2;11(1):111. doi: 10.1186/s13643-022-01922-7. Epub 2022 Jun 2. PMID: 35655281

Practices, attitudes, and confidence related to tobacco treatment interventions in HIV clinics: a multisite cross-sectional survey. Bold KW, Deng Y, Dziura J, Porter E, Sigel KM, Yager JE, Ledgerwood DM, Bernstein SL, Edelman EJ. Transl Behav Med. 2022 Jul 7;12(6):726-733. doi: 10.1093/tbm/ibac022. PMID: 35608982

Proposing a Model of Proactive Outreach to Advance Clinical Research and Care Delivery for Patients Who Use Tobacco. Burris JL, Borger TN, Baker TB, Bernstein SL, Ostroff JS, Rigotti NA, Joseph AM. J Gen Intern Med. 2022 Aug;37(10):2548-2552. doi: 10.1007/s11606-022-07553-x. Epub 2022 Apr 26. PMID: 35474504

Introduction to the Cancer Center Cessation Initiative Working Groups: Improving Oncology Care and Outcomes by Including Tobacco Treatment. Cancer Center Cessation Initiative Coordinating Center and Expert Advisory Panel. Cancer Center Cessation Initiative Coordinating Center and Expert Advisory Panel: Betsy Rolland , Sarah D. Hohl, Mara Minion 1, Robert Adsit, Margaret B. Nolan, Danielle Pauk, Steven L. Bernstein, Jessica L. Burris, Paul M. Cinciripini, Anne Joseph, Jamie Ostroff, Graham W. Warren, Michael C. Fiore.  J Natl Compr Canc Netw. 2021 Nov;19(Suppl_1):S1-S3. doi: 10.6004/jnccn.2021.7095. PMID: 34872051

Preoperative contingency management intervention for smoking abstinence in cancer patients: trial protocol for a multisite randomised controlled trial. Rojewski AM, Fucito LM, Baker NL, Palmer AM, Foster MG, Warren GW, Bernstein SL, Toll BA. BMJ Open. 2021 Jun 29;11(6):e051226. doi: 10.1136/bmjopen-2021-051226. Epub 2021 Jun 29. PMID: 34187835

A Brief Negotiation Interview Adherence Scale for Smoking Cessation: A psychometric evaluation. Pantalon MV, Dziura J, Li FY, D'Onofrio G, Weiss J, Bernstein SL. J Subst Abuse Treat. 2021 Jul;126:108398. doi: 10.1016/j.jsat.2021.108398. Epub 2021 Apr 20. PMID: 34116807

A SMARTTT approach to Treating Tobacco use disorder in persons with HIV (SMARTTT): Rationale and design for a hybrid type 1 effectiveness-implementation study. Edelman EJ, Dziura J, Deng Y, Bold KW, Murphy SM, Porter E, Sigel KM, Yager JE, Ledgerwood DM, Bernstein SL. Contemp Clin Trials. 2021 Nov;110:106379. doi: 10.1016/j.cct.2021.106379. Epub 2021 Mar 29. PMID: 33794354

COVID-19 Challenges Confronted by Smoking Cessation Clinical Trials for People Living With HIV: The Experience of Grantees of the US National Cancer Institute. Schnoll R, Bernstein SL, Kaufman A, Gross R, Catz SL, Cioe PA, Hitsman B, Marhefka SL, Pacek LR, Vidrine DJ, Vilardaga R, Edelman EJ, McClure JB, Ashare R, Lockhart E, Crothers K. Nicotine Tob Res. 2021 Aug 18;23(9):1629-1632. doi: 10.1093/ntr/ntab035. PMID: 33657227

A Preoperative Contingency Management Intervention for Smoking Abstinence in Cancer Patients: A Preliminary Randomized Controlled Trial. Rojewski AM, Fucito LM, Baker NL, Krishnan-Sarin S, Carpenter MJ, Bernstein SL, Toll BA. Nicotine Tob Res. 2021 May 24;23(6):1064-1067. doi: 10.1093/ntr/ntaa266. PMID: 33340400

The United States National Cancer Institute's Coordinated Research Effort on Tobacco Use as a Major Cause of Morbidity and Mortality among People with HIV. Ashare RL, Bernstein SL, Schnoll R, Gross R, Catz SL, Cioe P, Crothers K, Hitsman B, Marhefka SL, McClure JB, Pacek LR, Vidrine DJ, Vilardaga R, Kaufman A, Edelman EJ. Nicotine Tob Res. 2021 Jan 22;23(2):407-410. doi: 10.1093/ntr/ntaa155. PMID: 32803251

Pragmatic Application of the RE-AIM Framework to Evaluate the Implementation of Tobacco Cessation Programs Within NCI-Designated Cancer Centers. D'Angelo H, Ramsey AT, Rolland B, Chen LS, Bernstein SL, Fucito LM, Webb Hooper M, Adsit R, Pauk D, Rosenblum MS, Cinciripini PM, Joseph A, Ostroff JS, Warren GW, Fiore MC, Baker TB. Front Public Health. 2020;8:221. doi: 10.3389/fpubh.2020.00221. Epub 2020 Jun 12. PMID: 32596200

The Association of Nicotine Replacement Therapy With Outcomes Among Smokers Hospitalized for a Major Surgical Procedure. Stefan MS, Pack Q, Shieh MS, Pekow PS, Bernstein SL, Raghunathan K, Nason KS, Lindenauer PK. Chest. 2020 May;157(5):1354-1361. doi: 10.1016/j.chest.2019.10.054. Epub 2019 Nov 29. PMID: 31790653

Feasibility of text messaging to augment brief advice and nicotine replacement therapy for smoking cessation in college students. Camenga DR, Bernstein SL, Dziura J, Fiellin L, Krishnan-Sarin S. J Am Coll Health. 2021 Jan;69(1):1-8. doi: 10.1080/07448481.2019.1643730. Epub 2019 Aug 2. PMID: 31373882

National medical expenditures by smoking status in American adults: an application of Manning's two-stage model to nationally representative data. Swedler DI, Miller TR, Ali B, Waeher G, Bernstein SL. BMJ Open. 2019 Jul 16;9(7):e026592. doi: 10.1136/bmjopen-2018-026592. Epub 2019 Jul 16. PMID: 31315859

A randomized trial of decision support for tobacco dependence treatment in an inpatient electronic medical record: clinical results. Bernstein SL, Weiss J, DeWitt M, Tetrault JM, Hsiao AL, Dziura J, Sussman S, Miller T, Carpenter K, O'Connor P, Toll B. Implement Sci. 2019 Jan 22;14(1):8. doi: 10.1186/s13012-019-0856-8. Epub 2019 Jan 22. PMID: 30670043

Effectiveness of stop smoking interventions among adults: protocol for an overview of systematic reviews and an updated systematic review. Hersi M, Traversy G, Thombs BD, Beck A, Skidmore B, Groulx S, Lang E, Reynolds DL, Wilson B, Bernstein SL, Selby P, Johnson-Obaseki S, Manuel D, Pakhale S, Presseau J, Courage S, Hutton B, Shea BJ, Welch V, Morrow M, Little J, Stevens A. Syst Rev. 2019 Jan 19;8(1):28. doi: 10.1186/s13643-018-0928-x. Epub 2019 Jan 19. PMID: 30660199

Electronic decision support for treatment of hospitalized smokers: A qualitative analysis of physicians' knowledge, attitudes, and practices. Grau LE, Weiss J, O'Leary TK, Camenga D, Bernstein SL. Drug Alcohol Depend. 2019 Jan 1;194:296-301. doi: 10.1016/j.drugalcdep.2018.10.006. Epub 2018 Oct 26. PMID: 30469101

Considering Systemic Barriers to Treating Tobacco Use in Clinical Settings in the United States. Rojewski AM, Bailey SR, Bernstein SL, Cooperman NA, Gritz ER, Karam-Hage MA, Piper ME, Rigotti NA, Warren GW. Nicotine Tob Res. 2019 Oct 26;21(11):1453-1461. doi: 10.1093/ntr/nty123. PMID: 29917118

Tobacco dependence treatment in the emergency department: A randomized trial using the Multiphase Optimization Strategy. Bernstein SL, Dziura J, Weiss J, Miller T, Vickerman KA, Grau LE, Pantalon MV, Abroms L, Collins LM, Toll B.Contemp Clin Trials. 2018 Mar;66:1-8. doi: 10.1016/j.cct.2017.12.016. Epub 2017 Dec 27. PMID: 29287665