Steven L. Bernstein, MD

Research Interests

Emergency Medicine; Technology; Smoking Cessation; Healthcare Disparities

Research Organizations

School of Public Health: Chronic Disease Epidemiology

Faculty Research

Yale Cancer Center: Cancer Prevention and Control

Office of Cooperative Research

Research Summary

Dr. Bernstein's chief interest is in clinical trials of tobacco dependence treatment. He developed a screening and treatment intervention for tobacco users in the hospital emergency department, and programs to train providers in tobacco control. He has additional interests in tobacco policy, clinical informatics, implementation science, and the social and behavioral determinants of acute illness and injury.

Extensive Research Description

Steven L. Bernstein M.D. is Professor and Vice Chair for Academic Affairs in the Department of Emergency Medicine at Yale. His work focuses on the implementation of tobacco dependence treatment in various clinical settings. Dr. Bernstein pioneered the development of tobacco dependence treatment interventions in the ED. A recent trial was the first to demonstrate the efficacy of a multicomponent intervention to help ED smokers quit. A current project is assessing the ability of decision support and an order set embedded in an electronic medical record to help doctors improve treatment of hospitalized smokers. A newer line of research entails testing the ability of a measure he developed using techniques adapted from network analysis to measure the relationships between adherence, abstinence, and clinical outcomes. Dr. Bernstein also leads a new program to train junior investigators in implementation science.

 His work has been supported by the National Cancer Institute, National Heart, Lung, and Blood Institute, National Institute on Drug Abuse, Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the American Legacy Foundation, among others. His work led to EDs being mentioned as appropriate venues for tobacco control in the 2008 Public Health Service guideline on tobacco dependence treatment, and a report by the Institute of Medicine. Dr. Bernstein has served in an advisory capacity developing tobacco policies and measures for national groups including the Centers for Medicare and Medicaid Services, the Joint Commission and the National Committee for Quality Assurance. He recently served on a panel for the National Cancer Institute that drafted research priorities in tobacco control. At Yale, Dr. Bernstein has appointments at the School of Public Health, the Comprehensive Cancer Center, and serves as core faculty for the National Clinician Scholars Program. He is the founding director of the Yale Emergency Scholars (YES) program, a new residency track that will train the next generation of clinician-scientists in emergency medicine. YES graduates will earn a Masters in Health Science degree.

Selected Publications

• Undertreatment of tobacco use relative to other chronic conditions

  Bernstein SL, Yu S, Dziura J, Post L, Rigotti N. Undertreatment of tobacco use relative to other chronic conditions. Am J Public Health Published online ahead of print June 13, 2013: e1–e7. doi:10.2105/AJPH.2012.301112

• Substance Use and Behavioral Health in US Emergency Departments: Transforming the Model of Emergency Care

  Bernstein SL, D’Onofrio G. Substance Use and Behavioral Health in US Emergency Departments: Transforming the Model of Emergency Care. Health Affairs 2013; 32:2122-2128.

• Cigarette Smoking Behaviors in Persons Living with HIV/AIDS

  Shuter J, Bernstein SL, Moadel A. Cigarette Smoking Behaviors in Persons Living with HIV/AIDS. Am J Health Behavior 2012;36:75-85.

• A Randomized Trial of a Multicomponent Cessation Strategy for Emergency Department Smokers

  Bernstein SL, Bijur P, Cooperman N, Jearld S, Arnsten JH, Moadel A, Gallagher EJ. A Randomized Trial of a Multicomponent Cessation Strategy for Emergency Department Smokers. Acad Emerg Med 2011;18:575-583.

• Disparities in Access to Cigarettes and Nicotine Replacement Products in New York City Pharmacies

  Bernstein SL, Cabral L, Maantay J, Arno P, Peprah D, Lounsbury D, Shelley D. Disparities in Access to Cigarettes and Nicotine Replacement Products in New York City Pharmacies. Am J Public Health 2009;99:1699-1704.

• The clinical impact of health behaviors on ED visits

  Bernstein SL. The clinical impact of health behaviors on ED visits. Acad Emerg Med 2009;16:1054-1059.

• Design and Implementation of Decision Support for Tobacco Dependence Treatment in an Inpatient Electronic Medical Record Bernstein SL, Rosner J, DeWitt M, Tetrault J, Hsiao A, Dziura J, Sussman D, O’Connor P, Toll B. Translational Behav Med, 2017. doi:10.1007/s13142-017-0470-8

Full List of PubMed Publications

• Baldassarri SR, Bernstein SL, Chupp GL, Slade MD, Fucito LM, Toll BA: Electronic cigarettes for adults with tobacco dependence enrolled in a tobacco treatment program: A pilot study. Addict Behav. 2018 May; 2017 Nov 28. PMID: 29304395
• Chou SC, Deng Y, Smart J, Parwani V, Bernstein SL, Venkatesh AK: Insurance Status and Access to Urgent Primary Care Follow-up After an Emergency Department Visit in 2016. Ann Emerg Med. 2018 Apr; 2017 Oct 9. PMID: 29032870
• Bernstein SL, Dziura J, Weiss J, Miller T, Vickerman KA, Grau LE, Pantalon MV, Abroms L, Collins LM, Toll B: Tobacco dependence treatment in the emergency department: A randomized trial using the Multiphase Optimization Strategy. Contemp Clin Trials. 2018 Mar; 2017 Dec 27. PMID: 29287665
• Chou SC, Rothenberg C, Agnoli A, Wiechers I, Lott J, Voorhees J, Bernstein SL, Venkatesh AK: Patient centered medical homes did not improve access to timely follow-up after ED visit. Am J Emerg Med. 2018 Feb 4; 2018 Feb 4. PMID: 29452920
• Hawk K, D'Onofrio G, Fiellin DA, Chawarski MC, O'Connor PG, Owens PH, Pantalon MV, Bernstein SL: Past-year Prescription Drug Monitoring Program Opioid Prescriptions and Self-reported Opioid Use in an Emergency Department Population With Opioid Use Disorder. Acad Emerg Med. 2017 Nov 22; 2017 Nov 22. PMID: 29165853
• Busch SH, Fiellin DA, Chawarski MC, Owens PH, Pantalon MV, Hawk K, Bernstein SL, O'Connor PG, D'Onofrio G: Cost-effectiveness of emergency department-initiated treatment for opioid dependence. Addiction. 2017 Nov; 2017 Aug 16. PMID: 28815789
• Lemhoefer C, Rabe GL, Wellmann J, Bernstein SL, Cheung KW, McCarthy WJ, Lauridsen SV, Spies C, Neuner B: Emergency Department-Initiated Tobacco Control: Update of a Systematic Review and Meta-Analysis of Randomized Controlled Trials. Prev Chronic Dis. 2017 Oct 5; 2017 Oct 5. PMID: 28981403
• Cooperman NA, Lu SE, Richter KP, Bernstein SL, Williams JM: Pilot Study of a Tailored Smoking Cessation Intervention for Individuals in Treatment for Opioid Dependence. Nicotine Tob Res. 2017 Aug 30; 2017 Aug 30. PMID: 29059389
• Bernstein SL, D'Onofrio G: Screening, treatment initiation, and referral for substance use disorders. Addict Sci Clin Pract. 2017 Aug 7; 2017 Aug 7. PMID: 28780906
• D'Onofrio G, Chawarski MC, O'Connor PG, Pantalon MV, Busch SH, Owens PH, Hawk K, Bernstein SL, Fiellin DA: Emergency Department-Initiated Buprenorphine for Opioid Dependence with Continuation in Primary Care: Outcomes During and After Intervention. J Gen Intern Med. 2017 Jun; 2017 Feb 13. PMID: 28194688
• Bernstein SL, Rosner J, DeWitt M, Tetrault J, Hsiao AL, Dziura J, Sussman S, O'Connor P, Toll B: Design and implementation of decision support for tobacco dependence treatment in an inpatient electronic medical record: a randomized trial. Transl Behav Med. 2017 Jun. PMID: 28194729
• Schindler-Ruwisch JM, Abroms LC, Bernstein SL, Heminger CL: A content analysis of electronic health record (EHR) functionality to support tobacco treatment. Transl Behav Med. 2017 Jun. PMID: 27800564
• Dashevsky M, Bernstein SL, Barsky CL, Taylor RA: Agreement Between Serum Assays Performed in ED Point-of-Care and Hospital Central Laboratories. West J Emerg Med. 2017 Apr; 2017 Mar 13. PMID: 28435491
• Grau LE, Pham T, O'Leary T, Weiss J, Toll B, Bernstein SL: Smokers' Perspectives on Texting for Tobacco Dependence Treatment: A Qualitative Analysis. Nicotine Tob Res. 2017 Mar 1. PMID: 27613935
• Bernstein SL, Weiss JM, Toll B, Zbikowski SM: Association Between Utilization of Quitline Services and Probability of Tobacco Abstinence in Low-Income Smokers. J Subst Abuse Treat. 2016 Dec; 2016 Aug 21. PMID: 27776679
• Bernstein SL, Rosner JM, Toll B: Cell Phone Ownership and Service Plans Among Low-Income Smokers: The Hidden Cost of Quitlines. Nicotine Tob Res. 2016 Aug; 2016 Feb 26. PMID: 26920647
• Bernstein SL, Rosner J, Toll B: A Multicomponent Intervention Including Texting to Promote Tobacco Abstinence in Emergency Department Smokers: A Pilot Study. Acad Emerg Med. 2016 Jul; 2016 Jul 1. PMID: 27146116
• Bernstein SL, Rosner J, Toll B: Concordance between timeline follow-back and single-question assessment of self-reported smoking in a clinical trial. Subst Abus. 2016 Jul-Sep. PMID: 27007476
• Jenssen BP, Shelov ED, Bonafide CP, Bernstein SL, Fiks AG, Bryant-Stephens T: Clinical Decision Support Tool for Parental Tobacco Treatment in Hospitalized Children. Appl Clin Inform. 2016; 2016 May 25. PMID: 27437049
• Cooperman NA, Lu SE, Richter KP, Bernstein SL, Williams JM: Influence of Psychiatric and Personality Disorders on Smoking Cessation Among Individuals in Opiate Dependence Treatment. J Dual Diagn. 2016 Apr-Jun; 2016 Apr 11. PMID: 27064523
• Bernstein SL: Electronic cigarettes: more light, less heat needed. Lancet Respir Med. 2016 Feb; 2016 Jan 14. PMID: 26776876
• Lewis Hunter AE, Spatz ES, Bernstein SL, Rosenthal MS: Factors Influencing Hospital Admission of Non-critically Ill Patients Presenting to the Emergency Department: a Cross-sectional Study. J Gen Intern Med. 2016 Jan; 2015 Jun 18. PMID: 26084975
• D'Onofrio G, Bernstein SL: Screening, brief intervention and referral of emergency department patients with unhealthy drug use: efficacious or not? Evid Based Ment Health. 2015 Nov; 2015 Oct 12. PMID: 26459472
• Pines JM, Bernstein SL: Solving the worldwide emergency department crowding problem - what can we learn from an Israeli ED? Isr J Health Policy Res. 2015; 2015 Oct 17. PMID: 26478811
• Bernstein SL, Feldman J: Incentives to participate in clinical trials: practical and ethical considerations. Am J Emerg Med. 2015 Sep; 2015 May 29. PMID: 26095131
• Bernstein SL, D'Onofrio G, Rosner J, O'Malley S, Makuch R, Busch S, Pantalon MV, Toll B: Successful Tobacco Dependence Treatment in Low-Income Emergency Department Patients: A Randomized Trial. Ann Emerg Med. 2015 Aug; 2015 Apr 24. PMID: 25920384
• Post LA, Vaca FE, Biroscak BJ, Dziura J, Brandt C, Bernstein SL, Taylor R, Jagminas L, D'Onofrio G: The Prevalence and Characteristics of Emergency Medicine Patient Use of New Media. JMIR Mhealth Uhealth. 2015 Jul 8; 2015 Jul 8. PMID: 26156096
• D'Onofrio G, O'Connor PG, Pantalon MV, Chawarski MC, Busch SH, Owens PH, Bernstein SL, Fiellin DA: Emergency department-initiated buprenorphine/naloxone treatment for opioid dependence: a randomized clinical trial. JAMA. 2015 Apr 28. PMID: 25919527
• Bernstein SL, Stoney CM, Rothman RE: Dissemination and implementation research in emergency medicine. Acad Emerg Med. 2015 Feb; 2015 Jan 29. PMID: 25640627
• Bernstein SL, Shayne P: Ebola, physicians in training, and the duty to treat. Acad Emerg Med. 2015 Jan; 2014 Dec 26. PMID: 25546128
• Langhan ML, Shabanova V, Li FY, Bernstein SL, Shapiro ED: A randomized controlled trial of capnography during sedation in a pediatric emergency setting. Am J Emerg Med. 2015 Jan; 2014 Oct 5. PMID: 25445871
• Bernstein SL, Barsky CL, Powell E: Professional Societies, Political Action Committees, and Party Preferences. Am J Public Health. 2015 Jan. PMID: 25393192
• Bernstein SL: ED care: available, competent, affordable. Acad Emerg Med. 2014 Jan; 2013 Dec 9. PMID: 24321023
• Bernstein SL, Yu S, Post LA, Dziura J, Rigotti NA: Undertreatment of tobacco use relative to other chronic conditions. Am J Public Health. 2013 Aug; 2013 Jun 13. PMID: 23763395
• Ginde AA, Sullivan AF, Bernstein SL, Camargo CA Jr, Boudreaux ED: Predictors of Successful Telephone Contact After Emergency Department-based Recruitment into a Multicenter Smoking Cessation Cohort Study. West J Emerg Med. 2013 May; 2013 Feb 15. PMID: 25685252
• Murphy MK, Bijur PE, Rosenbloom D, Bernstein SL, Gallagher EJ: Feasibility of a computer-assisted alcohol SBIRT program in an urban emergency department: patient and research staff perspectives. Addict Sci Clin Pract. 2013 Jan 16; 2013 Jan 16. PMID: 23324597
• Bernstein SL, Bijur P, Cooperman N, Jearld S, Arnsten JH, Moadel A, Gallagher EJ: Efficacy of an emergency department-based multicomponent intervention for smokers with substance use disorders. J Subst Abuse Treat. 2013 Jan; 2012 Jul 2. PMID: 22763199
• D'Onofrio G, Fiellin DA, Pantalon MV, Chawarski MC, Owens PH, Degutis LC, Busch SH, Bernstein SL, O'Connor PG: A brief intervention reduces hazardous and harmful drinking in emergency department patients. Ann Emerg Med. 2012 Aug; 2012 Mar 28. PMID: 22459448
• Ryan SA, Martel S, Pantalon M, Martino S, Tetrault J, Thung SF, Bernstein SL, Auinger P, Green ML, Fiellin DA, O'Connor PG, D'Onofrio G: Screening, brief intervention, and referral to treatment (SBIRT) for alcohol and other drug use among adolescents: evaluation of a pediatric residency curriculum. Subst Abus. 2012. PMID: 22738002
• Tetrault JM, Green ML, Martino S, Thung SF, Degutis LC, Ryan SA, Martel S, Pantalon MV, Bernstein SL, O'Connor PG, Fiellin DA, D'Onofrio G: Developing and implementing a multispecialty graduate medical education curriculum on Screening, Brief Intervention, and Referral to Treatment (SBIRT). Subst Abus. 2012. PMID: 22489589
• Bernstein SL, Bijur P, Cooperman N, Jearld S, Arnsten JH, Moadel A, Gallagher EJ: A randomized trial of a multicomponent cessation strategy for emergency department smokers. Acad Emerg Med. 2011 Jun. PMID: 21676054
• Landman AB, Bernstein SL, Hsiao AL, Desai RA: Emergency department information system adoption in the United States. Acad Emerg Med. 2010 May. PMID: 20536810
• Bernstein SL: The clinical impact of health behaviors on emergency department visits. Acad Emerg Med. 2009 Nov. PMID: 20053222
• Bernstein SL, Cabral L, Maantay J, Peprah D, Lounsbury D, Maroko A, Murphy M, Shelley D: Disparities in access to over-the-counter nicotine replacement products in New York City pharmacies. Am J Public Health. 2009 Sep; 2009 Jul 28. PMID: 19638596
• Bernstein SL, Boudreaux ED, Cabral L, Cydulka RK, Schwegman D, Larkin GL, Adams AL, McCullough LB, Rhodes KV: Efficacy of a brief intervention to improve emergency physicians' smoking cessation counseling skills, knowledge, and attitudes. Subst Abus. 2009 Apr-Jun. PMID: 19347755
• Bernstein SL, Jearld S, Prasad D, Bax P, Bauer U: Rapid implementation of a smokers' quitline fax referral service in an urban area. J Health Care Poor Underserved. 2009 Feb. PMID: 19202246
• Bernstein SL, Gallagher EJ, Cabral L, Bijur P: Race and ethnicity do not affect baseline self-report of pain severity in patients with suspected long-bone fractures. Pain Med. 2009 Jan. PMID: 19222774

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