Date of Award

January 2015

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

James Dziura


Cigarette and tobacco use is common among ED patients from lower socioeconomic backgrounds. Our goal in this study was to conduct moderation and mediation analysis to evaluate the effectiveness of an enhanced smoking cessation intervention involving enhanced care as compared to standard care for adult smokers in the ED. Our study is a secondary analysis of a two-arm randomized clinical trial conducted by Dr. Bernstein, which involved two intervention arms; one with enhanced care where the subjects received a motivational interview by a trained research assistant, 6 weeks of nicotine replacement therapy (NRT) initiated in the ED, a faxed referral to the state smokers’ quitline, a booster call, and a brochure. The subjects in control arm subjects received the brochure, which provided quitline information. We used mediation analysis to assess the treatment effects of the mediators; NRT use and Quitline calls and moderation analysis to evaluate the effect modification or interaction of the moderators; baseline nicotine dependency and craving with the treatment. The outcomes were 7-day abstinence and number of cigarettes smoked per day at three months. We found significant mediation effects with the NRT use on both the outcomes. However, the speaking to a quitline counselor had only marginal mediation effects. We could not detect any interaction or effect modification with either of the two moderators on 7-day abstinence and no. of cigarettes smoked per day.


This is an Open Access Thesis.

Open Access

This Article is Open Access