David B Abrams
David Abrams
Scroll
Professor of Social and Behavioral Sciences
-
Professional overview
-
Dr. David Abrams' career focuses on systems and social learning frameworks to inform population health enhancement. He has experience in testing theory, research design, measuring mechanisms of behavior change and outcome, and evaluating clinical trials (behavioral and pharmacological). His interests span topics from basic bio-behavioral mechanisms and clinical treatments to policy across risk factors and behaviors (e.g. tobacco/nicotine; alcohol, obesity, co-morbidity of medical and mental health), disease states (cancer; cardiovascular; HIV-AIDS), levels (biological, individual, organizational, worksite, community, global, and internet based), populations and disparities. His interests converge in the domain of implementation science to cost-efficiently inform evidence-based public health practice and policymaking.
Through transdisciplinary and translational research strategies, Dr. Abrams provides scientific leadership in tobacco control. His current focus is in strengthening global and United States tobacco and nicotine management strategies. Deaths of 1 billion smokers are estimated by 2100 caused overwhelmingly by use of combustible (smoked) tobacco products, not nicotine. Harm minimization is a key overarching systems strategy to speed the net public health benefit of emergent disruptive technologies for cleaner nicotine delivery. The goal is more rapid elimination of preventable deaths, disease burdens, and the widening gap in health disparities driven disproportionately by disparities in smoking.
Dr. Abrams was a professor and founding director of the Centers for Behavioral and Preventive Medicine at Brown University Medical School. He then directed the Office of Behavioral and Social Sciences Research at the National Institutes of Health (NIH). Until 2017, he was Professor of Health Behavior and Society at Johns Hopkins Bloomberg School of Public Health and the founding Executive Director of the Schroeder National Institute of Tobacco Research and Policy Studies at Truth Initiative (formerly the American Legacy Foundation).
Dr. Abrams has published over 250 peer reviewed scholarly articles and been a Principal Investigator on numerous NIH grants. He is lead author of The Tobacco Dependence Treatment Handbook: A Guide to Best Practices. He has served on expert panels at NIH and National Academies of Sciences, Engineering and Medicine on Obesity, Alcohol Misuse and Ending the Tobacco Problem: A Blueprint for the Nation. He has also served on the Board of Scientific Advisors of the National Cancer Institute (NIH-NCI) and was President of the Society of Behavioral Medicine.
For a complete list of Dr. Abrams' published work, click here.
-
Education
-
BSc (Hons), Psychology and Computer Science, University of the Witwatersrand, Johannesburg, South AfricaMS, Clinical Psychology, Rutgers University, New Brunswick, NJPhD, Clinical Psychology, Rutgers University, New Brunswick, NJPostdoctoral Fellow, Brown Medical School, Providence, RI
-
Honors and awards
-
Research Laureate Award, American Academy of Health Behavior (2014)Joseph W. Cullen Memorial Award for Tobacco Research, American Society for Preventive Oncology (2008)Distinguished Alumni Award: Rutgers University, The Graduate School, New Brunswick, NJ (2007)The Musiker-Miranda Distinguished Service Award, American Psychological Association (2006)Distinguished Service Award, Society of Behavioral Medicine (2006)Outstanding Research Mentor Award, Society of Behavioral Medicine (2006)Book of the Year Award: Tobacco Dependence Treatment Handbook. American Journal of Nursing (2005)Distinguished Scientist Award, Society of Behavioral Medicine (1998)
-
Areas of research and study
-
Behavioral ScienceChronic DiseasesEvaluationsImplementation and Impact of Public Health RegulationsImplementation sciencePopulation HealthPublic Health PedagogyPublic Health SystemsResearch DesignSystems IntegrationSystems InterventionsTobacco ControlTranslational science
-
Publications
Publications
Cue exposure treatment for smoking relapse prevention : A controlled clinical trial
AbstractAbrams, D., Niaura, R. S., Abrams, D. B., Shadel, W. G., Rohsenow, D. J., Monti, P. M., & Sirota, A. D. (n.d.).Publication year
1999Journal title
AddictionVolume
94Issue
5Page(s)
685-695AbstractAims. In an additive design, test the efficacy of cue exposure treatment for smoking relapse prevention as an adjunct to current standard cognitive behavioral and pharmacological treatments. Design. Randomized, controlled clinical trial. Setting. Outpatient behavioral medicine clinic. Participants. One hundred and twenty-nine cigarette smokers recruited through newspaper advertisements. Intervention. After receiving an initial counseling session for cessation and setting a quit day, 129 smokers were randomly assigned to one of four relapse prevention treatment conditions: (1) brief cognitive behavioral; (2) cognitive behavioral and nicorette gum; (3) cognitive behavioral and cue exposure; and (4) cognitive behavioral and cue exposure with nicorette gum. All smokers met individually with their counselor for six RP sessions. Measures. Seven-day, point-prevalence abstinence rates (CO verified) taken at 1, 3, 6 and 12-months post-treatment and time to first slip. Findings. All manipulation checks and process measures suggested that the treatments were delivered as intended. There were no significant differences between conditions in point-prevalence abstinence rates or in time to first slip. Conclusions. These, results call into question the utility of cue exposure treatment for smoking relapse prevention.Do processes of change predict smoking stage movements? A prospective analysis of the transtheoretical model
AbstractAbrams, D., Herzog, T. A., Abrams, D. B., Emmons, K. M., Linnan, L. A., & Shadel, W. G. (n.d.).Publication year
1999Journal title
Health PsychologyVolume
18Issue
4Page(s)
369-375AbstractThe transtheoretical model (TTM) posits that processes of change and the pros and cons of smoking predict progressive movement through the stages of change. This study provides both a cross-sectional replication and a prospective test of this hypothesis. As part of a larger study of worksite cancer prevention (the Working Well Trial), employees of 26 manufacturing worksites completed a baseline and 2 annual follow-up surveys. Of the 63% of employees completing baseline surveys, 27.7% were smokers (N = 1,535), and a cohort of these smokers completed the 2-year follow-up. Cross-sectional results replicated previous studies with virtually all the processes of change and the cons of smoking increasing in linear fashion from precontemplation to preparation (all ps < .00001), and the pros of smoking decreasing (p < .01). However, contrary to the hypothesis, the baseline processes of change and the pros and cons of smoking failed to predict progressive stage movements at either the 1- or the 2-year follow-ups. Possible explanations for these findings and concerns about the conceptual internal consistency of the TTM are discussed.History and symptoms of depression among smokers during a self-initiated quit attempt
AbstractAbrams, D., Niaura, R. S., Britt, D. M., Borrelli, B., Shadel, W. G., Abrams, D. B., & Goldstein, M. G. (n.d.).Publication year
1999Journal title
Nicotine and Tobacco ResearchVolume
1Issue
3Page(s)
251-257AbstractHistory of depression in smokers has been associated with an inability to quit smoking and with an increased likelihood of smoking relapse. This study prospectively tracked nicotine withdrawal symptoms, symptoms of depression, and ability to quit smoking between smokers with and without a probable history of major depression who were trying to quit smoking with minimal assistance. Results indicated that prior to quitting, smokers with a history of depression smoked to reduce negative affect, in response to craving, and in social situations. Additionally, positive history smokers scored higher on the Center for Epidemiological Studies Depression Scale (CES-D) than did smokers without such a history. Following a quit attempt, positive history smokers were somewhat more likely to experience greater symptoms of nicotine withdrawal than negative history smokers. However, among the positive history smokers, depressive symptoms as measured by the CES-D increased significantly 4 weeks after trying to quit, compared to a decline among negative history smokers. Positive and negative history smokers did not significantly differ on ability to quit smoking within the 30-day follow-up period. History of depression appears to be associated with a delayed increase in symptoms of depression following a quit attempt. However, it remains to be demonstrated whether such an increase in depressive symptoms may influence later probability of relapse.Increasing the impact of nicotine dependence treatment: Conceptual and practical considerations in a stepped care plus treatment-matching approach
AbstractAbrams, D., Clark, M., & King, T. (n.d.). (J. Tucker, D. Donovan, & A. Marlatt, Eds.).Publication year
1999Abstract~Naltrexone's effect on cue-elicited craving among alcoholics in treatment
AbstractAbrams, D., Monti, P. M., Rohsenow, D. J., Hutchison, K. E., Swift, R. M., Mueller, T. I., Colby, S. M., Brown, R. A., Gulliver, S. B., Gordon, A., & Abrams, D. B. (n.d.).Publication year
1999Journal title
Alcoholism: Clinical and Experimental ResearchVolume
23Issue
8Page(s)
1386-1394AbstractBackground: Advancing knowledge of biobehavioral effects of interventions can result in improved treatments. Thus, a standardized laboratory cue reactivity assessment has been developed and validated to assess the cognitive and psychophysiological responses to a simulated high- risk situation: alcohol cues. The present study investigates the effects of a pharmacotherapy (naltrexone) on a laboratory-based, cue-elicited urge to drink among abstinent alcoholics in treatment. Methods: Alcohol-dependent subjects were randomized to 12 weeks of naltrexone or placebo after completing a partial hospital program. After ~1 week on medication, all received cue reactivity assessment. Results: Significantly fewer patients taking naltrexone reported any urge to drink during alcohol exposure than did those on placebo. Those with any urges reported no decrement in level of the urges. Mean arterial pressure decreased significantly for those on placebo, but not for those on naltrexone, whereas cue-elicited decreases in heart rate were not affected by the medication. Conclusions: The results have implications for models of relapse and naltrexone's effects. Cue reactivity methodology has utility for investigating hypothesized mediators of therapeutic effects of pharmacotherapies as well as behavioral treatments.Nicotine addiction : paradigms for research in the 21st century
AbstractAbrams, D., & Abrams, D. B. (n.d.).Publication year
1999Journal title
Nicotine & tobacco research : official journal of the Society for Research on Nicotine and TobaccoVolume
1 Suppl 2Page(s)
S211-215Abstract~The efficacy of exercise as an aid for smoking cessation in women : A randomized controlled trial
AbstractAbrams, D., Marcus, B. H., Albrecht, A. E., King, T. K., Parisi, A. F., Pinto, B. M., Roberts, M., Niaura, R. S., & Abrams, D. B. (n.d.).Publication year
1999Journal title
Archives of Internal MedicineVolume
159Issue
11Page(s)
1229-1234AbstractBackground: Smoking prevalence rates among women are declining at a slower rate than among men. Objective: To determine if exercise, a healthful alternative to smoking, enhances the achievement and maintenance of smoking cessation. Methods: Two hundred eighty-one healthy, sedentary female smokers were randomly assigned to either a cognitive-behavioral smoking cessation program with vigorous exercise (exercise) or to the same program with equal staff contact time (control). Subjects participated in a 12-session, group- based smoking cessation program. Additionally, exercise subjects were required to attend 3 supervised exercise sessions per week and control subjects were required to participate in 3 supervised health education lectures per week. Abstinence from smoking was based on self-report, was verified by saliva cotinine level, and was measured at 1 week after quit day (week 5), end of treatment (week 12), and 3 and 12 months later (20 and 60 weeks after quit day, respectively). Results: Compared with control subjects (n = 147), exercise subjects (n = 134) achieved significantly higher levels of continuous abstinence at the end of treatment (19.4% vs 10.2%, P = .03) and 3 months (16.4% vs 8.2%, P = .03) and 12 months (11.9% vs 5.4%, P = .05) following treatment. Exercise subjects had significantly increased functional capacity (estimated VO2 peak, 25 ± 6 to 28 ± 6, PThe working healthy project : A worksite health-promotion trial targeting physical activity, diet, and smoking
AbstractAbrams, D., Emmons, K. M., Linnan, L. A., Shadel, W. G., Marcus, B., & Abrams, D. B. (n.d.).Publication year
1999Journal title
Journal of Occupational and Environmental MedicineVolume
41Issue
7Page(s)
545-555AbstractWorksites are a key channel for delivery of interventions designed to reduce chronic disease among adult populations. Although some evaluations of worksite physical-activity interventions have been conducted, to date very few randomized trials of worksite health promotion have included the goal of increasing physical-activity levels as part of a comprehensive multiple risk factor approach to worksite health promotion. This article presents the results regarding behavior change found among the cohort of 2055 individuals who completed three health-behavior assessments as part of their worksites' participation in The Working Healthy Project (WHP), a multiple risk factor intervention implemented in 26 manufacturing worksites. In this study, a randomized matched-pair design was used. Fifty-one percent (n = 2,761) of the employees who completed the baseline assessment also completed the interim survey. Eighty-three percent of those who completed the interim assessment also completed the final survey. The WHP intervention targeted smoking, nutrition, and physical activity. At baseline, 38% of the sample reported engaging in regular exercise, and subjects reported consuming an average of 2.7 servings of fruits and vegetables per day, 7.9 grams of fiber per 1000 kilocalories, and 35.4% calories from fat per day; 28% of the sample were smokers. By the time of both the interim (intervention midpoint) and final (end of intervention) assessments, participants in the intervention condition had significantly increased their exercise behavior, compared with the control condition. There was also increased consumption of fruits and vegetables and fiber in the intervention condition by the time of the final assessment, compared with the control condition. No differences by condition were found with regard to percentage of calories from fat consumed or smoking cessation. These results suggest that among a cohort of participants in a worksite health promotion study, there were significant health behavior changes across two risk factors over time. These data suggest that further investigation of multiple risk factor worksite health promotion is warranted, particularly with a focus on ways to increase participation in these programs and to diffuse intervention effects throughout the entire workforce.Transdisciplinary paradigms for tobacco prevention research
AbstractAbrams, D., & Abrams, D. B. (n.d.).Publication year
1999Journal title
Nicotine and Tobacco ResearchVolume
1Issue
SUPPL. 1Page(s)
S15-23Abstract~Adherence to treatment for nicotine dependence
AbstractAbrams, D., Abrams, D. S., Borrelli, B., Shadel, W., King, T., Bock, B., & Niaura, R. S. (n.d.). (S. Shumaker & J. Ockene, Eds.; 2nd ed.).Publication year
1998Page(s)
137-165Abstract~Characteristics of patients adhering to a hospital's no-smoking policy
AbstractAbrams, D., Emmons, K. M., Cargill, B. R., Hecht, J., Goldstein, M., Milman, R., & Abrams, D. B. (n.d.).Publication year
1998Journal title
Preventive MedicineVolume
27Issue
6Page(s)
846-853AbstractObjectives. The purpose of this paper is to examine the characteristics of smokers who adhere to a hospital smoking ban, compared to those who do not. Design. The data presented in this paper are baseline and discharge survey data collected among hospitalized smokers. Setting. This study was conducted in two teaching hospitals in a northeastern city. Patients/participants. The subjects were 358 smokers who participated in a larger smoking intervention trial. Main results. Seventy-six percent of the subjects reported adhering to the smoke-free policy during their hospital stay. In a multivariate model, demographic factors that predicted adherence included being older, having shorter length of stay, not reporting recreational drug use in the previous 12 months, and not having alcohol- related problems. Smoking history variables that predicted adherence included having had at least 24 h of abstinence in the 7 days prior to hospitalization; self-efficacy variables (e.g., confidence in ability to quit smoking in 1 month and less anticipated difficulty refraining from smoking during hospitalization) also predicted adherence. Conclusions. Understanding the factors that predict adherence to health care policies can provide useful information for health promotion interventions in a medical setting. The implications of these findings are discussed.Durability, dissemination, and institutionalization of worksite tobacco control programs : Results from the working well trial
AbstractAbrams, D., Sorensen, G., Thompson, B., Basen-Engquist, K., Abrams, D. S., Kuniyuki, A., DiClemente, C., & Biener, L. (n.d.).Publication year
1998Journal title
International Journal of Behavioral MedicineVolume
5Issue
4Page(s)
335-351AbstractDurability, dissemination and institutionalization of tobacco control activities are reported, based on the Working Well worksite cancer control intervention study (n = 83 worksites). Tobacco control activities increased significantly in intervention worksites as a result of research-supported activities but were not sustained 2 years after the conclusion of the intervention. Intervention sites were more likely than control sites to initiate and maintain structures for institutionalizing programs, such as assigning a committee responsibility for health-promotion programs or providing a budget for health-promoting activities. Dissemination of the program to control worksites had little impact on the level of smoking control activities in control worksites. Although program durability was not a primary aim of this intervention study, these analyses provide an important assessment of program maintenance beyond a funded intervention and underscore the need for additional research to identify effective organizational strategies for institutionalization of worksite health-promotion programs.Evaluation of motivationally tailored vs. Standard self-help physical activity interventions at the workplace
AbstractAbrams, D., Marcus, B. H., Emmons, K. M., Simkin-Silverman, L. R., Linnan, L. A., Taylor, E. R., Bock, B. C., Roberts, M. B., Rossi, J. S., & Abrams, D. B. (n.d.).Publication year
1998Journal title
American Journal of Health PromotionVolume
12Issue
4Page(s)
246-253AbstractPurpose. This study compares the efficacy of a self-help intervention tailored to the individual's stage of motivational readiness for exercise adoption with a standard self-help exercise promotion intervention. Design. Interventions were delivered at baseline and 1 month; assessments were collected at baseline and 3 months. Setting. Eleven worksites participating in the Working Healthy Research Trial. Subjects. Participants (n = 1559) were a subsample of employees at participating worksites, individually randomized to one of two treatment conditions. Intervention. Printed self-help exercise promotion materials either (1) matched to the individual's stage of motivational readiness for exercise adoption (motivationally tailored), or (2) standard materials (standard). Measures. Measures of stage of motivational readiness for exercise and items from the 7-Day Physical Activity Recall. Results. Among intervention completers (n = 903), chi- square analyses showed that, compared to the standard intervention, those receiving the motivationally tailored intervention were significantly more likely to show increases (37% vs. 27%) and less likely to show either no change (52% vs. 58%) or regression (11% vs. 15%) in stage of motivational readiness. Multivariate analyses of variance showed that changes in stage of motivational readiness were significantly associated with changes in self- reported time spent in exercise. Conclusions. This is the first prospective, randomized, controlled trial demonstrating the efficacy of a brief motivationally tailored intervention compared to a standard self-help intervention for exercise adoption. These findings appear to support treatment approaches that tailor interventions to the individual's stage of motivational readiness for exercise adoption.Exercise, smoking cessation, and short-term changes in serum lipids in women : A preliminary investigation
AbstractAbrams, D., Niaura, R. S., Marcus, B., Albrecht, A., Thompson, P., & Abrams, D. S. (n.d.).Publication year
1998Journal title
Medicine and Science in Sports and ExerciseVolume
30Issue
9Page(s)
1414-1418AbstractPurpose: This study investigated the combined effects of exercise and smoking cessation on serum lipids. Methods: Eighteen female smokers quit smoking using standard behavioral methods combined with exercise (N = 9) or with a nonexercise contact time control (N = 9). The smoking cessation program for both groups consisted of 12 weekly 1-h behavioral modification sessions held over 12 wk. Exercise training consisted of three supervised 45- min sessions per week for 12 wk. Contact control consisted of three health education lectures/discussions per week for 12 wk. Fitness (estimated V̇O2 peak), dietary variables, and fasting serum lipids and lipoproteins were assessed before and at the end of treatment. V̇O2 peak increased in the exercise subjects compared with the controls. Results: Total caloric intake as well as total fat and carbohydrate increased significantly after smoking cessation in the controls, but there were no dietary changes in the exercise group, high density lipoprotein (HDL)-C2 increased (7.6 mg·dL-1, P < 0.01) in the exercise group, whereas the increases in HDL and its subfractions did not attain statistical significance in the contact control group. Total cholesterol, low density lipoprotein (LDL)-C, and triglycerides did not change in either group. Conclusions: We conclude that exercise training magnifies the increase in HDL-C that usually occurs with smoking cessation.Individual differences in cue reactivity among smokers trying to quit : Effects of gender and cue type
AbstractAbrams, D., Niaura, R. S., Shadel, W. G., Abrams, D. B., Monti, P. M., Rohsenow, D. J., & Sirota, A. (n.d.).Publication year
1998Journal title
Addictive BehaviorsVolume
23Issue
2Page(s)
209-224AbstractAcross studies, when presented with a variety of smoking cues, smokers and ex-smokers evidence distinct patterns of self-reported, physiological, and behavioral reactions. However, few studies have compared more than two different kinds of cues within the same experiment. Furthermore, despite the importance of examining the moderating effect of gender on smoking outcomes, few studies have examined gender differences in smoking cue reactivity. We examined the effect of eight distinct cue manipulations on heart rate, mean arterial pressure, smoking urges, and self-efficacy in a sample of 129 participants (50% female) who had recently quit smoking. Cue manipulations included (a) in vivo exposure, (b) an idiographically designed exposure of subjects' most recent relapse, (c) an idiographically designed exposure to subjects' highest risk situation, and (d) affectively valenced standardized scripts depicting situations generally associated with relapse. These manipulations were compared to a standard cognitive stressor (mental arithmetic) and to a resting baseline. Results revealed differences in the degree of reactivity to different manipulations, with in vivo cues producing the greatest changes. Gender differences in reactivity between the type of cues presented were found for mean arterial pressure, with standardized scripts producing greater changes for women. These findings have implications for understanding the reasons for differences in cue reactivity across manipulations and for gender differences in cue reactivity.Scripted imagery manipulations and smoking cue reactivity in a clinical sample of self-quitters
AbstractAbrams, D., Shadel, W. G., Niaura, R. S., Abrams, D. B., Goldstein, M. G., Rohsenow, D. J., Sirota, A. D., & Monti, P. M. (n.d.).Publication year
1998Journal title
Experimental and Clinical PsychopharmacologyVolume
6Issue
2Page(s)
179-186AbstractThe affectively valenced scripts used by S. Tiffany (1990) suggest that different scripts produce relatively equivalent levels of cue reactivity, although it is unclear if these laboratory findings generalize to clinical samples. In this study, cessation-motivated smokers were tested 7 days before they tried to quit smoking and were exposed to 3 audiotaped scripts that depicted different affectively valenced situations (neutral, positive, or negative). The latter 2 scripts also contained smoking cues. The findings using a clinical sample differed considerably from those using analogue laboratory samples across affective, cognitive, and physiological response measures. Reactivity to these standardized scripts failed to predict treatment outcome through a 30-day follow-up. The use of affectively valenced scripts beyond a laboratory sample is questioned.Brief coping skills treatment for cocaine abuse : Substance use outcomes at three months
AbstractAbrams, D., Monti, P. M., Rohsenow, D. J., Michalec, E., Martin, R. A., & Abrams, D. B. (n.d.).Publication year
1997Journal title
AddictionVolume
92Issue
12Page(s)
1717-1728AbstractAims. Coping skills training, a promising treatment approach for alcoholics, was adapted for use with cocaine abusers and effects on outcome were investigated. Design. A cocaine-specific coping skills training (CST) package was compared to an attention placebo control when both were added to a comprehensive treatment program. Setting. The sites were two private substance abuse treatment facilities, one residential and rural, and one an urban partial hospital. Participants. Substance abusers in treatment with cocaine abuse or dependence were selected. Intervention. The CST intervention was conducted in individual sessions. It involved functional analysis of high risk situations and coping skills training based on the functional analysis. Findings. Clients who received CST had significantly fewer cocaine use days and the length of their longest binge was significantly shorter during the 3-month follow-up period compared to clients in the control condition. CST did not affect relapse rates or use of other substances. Conclusions. Results support the notion that cocaine-specific CST is a promising adjunct to treatment for cocaine abusers.Effects of alcohol cues on smoking urges and topography among alcoholic men
AbstractAbrams, D., Rohsenow, D. J., Monti, P. M., Colby, S. M., Gulliver, S. B., Sirota, A. D., Niaura, R. S., & Abrams, D. B. (n.d.).Publication year
1997Journal title
Alcoholism: Clinical and Experimental ResearchVolume
21Issue
1Page(s)
101-107AbstractAlthough the prevalence of smoking among alcoholics ranges up to 97%, little is known about mechanisms underlying the co-occurrence of smoking and alcohol use, or the role tobacco may play in alcohol treatment recovery. Adult male alcoholics in treatment (n = 30) were randomly assigned to visual and olfactory exposure either to alcohol cues or to control cues, and then were allowed to smoke while continuing visual exposure to the same cues. Exposure to alcohol cues resulted in significantly greater self-reported urge to drink and urge to smoke but had no significant effect on the topography of smoking behavior. When variance due to urge to smoke was controlled, greater urge to drink correlated negatively with number of cigarette puffs. The results provide some support for a priming hypothesis of tobacco's role on alcoholism recovery. Clinical and theoretical implications are discussed.Health behavior and health education: The past, present, and future
AbstractAbrams, D., Abrams, D. S., Emmons, K., & Linnan, L. (n.d.). (K. Glanz, F. Lewis, & B. Rimer, Eds.; 2nd ed.).Publication year
1997Page(s)
453-478Abstract~Rationale, design, and baseline data for Commit to Quit : An exercise efficacy trial for smoking cessation among women
AbstractAbrams, D., Marcus, B. H., King, T. K., Albrecht, A. E., Parisi, A. F., & Abrams, D. B. (n.d.).Publication year
1997Journal title
Preventive MedicineVolume
26Issue
4Page(s)
586-597AbstractBackground. The Commit to Quit trial was designed to address the methodological problems of prior studies that have examined the contribution of exercise to smoking cessation. Methods. This paper provides an overview of the study design and describes the sample of women who participated in this trial (N = 281). Interrelationships among eating, exercise, and smoking behavior are examined. Results. Subjects randomized into the study compared with the sample of women who completed the initial assessment but were not randomized were more likely to be white, to have at least a high school education, and to smoke fewer cigarettes per day. Overall, the most frequent ineligibility criteria were health-related issues and scheduling conflicts. On average, participants in this study smoked more cigarettes per day than national samples of women smokers. Significant interrelationships include the positive association of motivational readiness for quitting smoking and enhanced levels of dietary restraint and the positive association of motivational readiness for exercise adoption and high levels of weight concern. Conclusions. This study represents the first adequately powered randomized controlled clinical trial comparing the relative efficacy of a cognitive-behavioral smoking cessation treatment plus vigorous exercise with the same treatment plus contact control.Withdrawal dynamics and smoking relapse : Implications for theory, assessment, and intervention
AbstractAbrams, D., Piasecki, T. M., Fiore, M. C., Niaura, R., Shadel, W., Abrams, D., Goldstein, M., & Baker, T. B. (n.d.).Publication year
1997Journal title
Journal of Addictive DiseasesVolume
16Issue
4Abstract~Cognitive-behavioral mediators of changing multiple behaviors : Smoking and a sedentary lifestyle
AbstractAbrams, D., King, T. K., Marcus, B. H., Pinto, B. M., Emmons, K. M., & Abrams, D. B. (n.d.).Publication year
1996Journal title
Preventive MedicineVolume
25Issue
6Page(s)
684-691AbstractBackground. A significant percentage of the U.S. population has multiple poor health behaviors. Understanding the relationship among these behavioral risk factors is important for designing effective multiple risk factor interventions. While there is some evidence suggesting that participation in physical exercise may have a positive impact on smoking cessation, there is much to be learned about the relationships between cognitive-behavioral (self-efficacy, decisional-balance) and motivational mechanisms (stage of change) which have been shown to mediate changes in both exercise and smoking behavior. Methods. The sample comprised 332 smokers employed at two workplaces-a government agency and a medical center-recruited as part of a larger worksite health promotion project and who completed questionnaires on their smoking and exercise behaviors. Results. The results revealed significant relationships between smoking variables and exercise variables. Smokers who rated as important the positive benefits of smoking also rated as important the costs associated with increased physical activity. Similarly, the negative consequences of smoking were significantly associated with the positive benefits of physical activity. Self-efficacy for one behavior was significantly associated with self-efficacy for the other. Significant differences by exercise and smoking stage of change were found on the cross- behavior sets of variables (self-efficacy, pros, cons). Smokers who were contemplating a more active lifestyle reported the negative consequences of smoking to be significantly more important to them than smokers who were not considering adoption of a more active lifestyle. Smokers who were exercising regularly reported significantly more confidence in their ability to refrain from smoking than smokers not exercising regularly. Finally, smokers preparing for quitting reported less confidence in their ability to exercise than smokers who had already taken action to change their smoking behavior. Conclusions. The cognitive mechanisms associated with changes in smoking behavior are related to the cognitive variables which have been shown to predict changes in exercise behavior. Significant relationships in mediating mechanisms including decisional balance and self-efficacy between smoking and exercise provide preliminary information on how change in one risk behavior may relate to change in another. These associations have implications for future intervention research and for methods research on multiple risk factor interactions.Development of major depressive disorder during smoking-cessation treatment
AbstractAbrams, D., Borrelli, B., Niaura, R. S., Keuthen, N. J., Goldstein, M. G., DePue, J. D., Murphy, C., & Abrams, D. B. (n.d.).Publication year
1996Journal title
Journal of Clinical PsychiatryVolume
57Issue
11Page(s)
534-538AbstractBackground: Several studies have shown an association between smoking and major depressive disorder (MDD), but few have prospectively examined subjects who develop MDD after quitting smoking. This descriptive study evaluated the development of MDD after smoking cessation, as assessed by a structured clinical interview at both baseline and the end of treatment. Method: Nondepressed participants (N = 114) in a trial investigating the effect of fluoxetine on smoking cessation were administered the Structured Clinical Interview for DSM-III-R at baseline ad posttreatment to evaluate the impact of quitting smoking on the development of MDD. Depressive symptoms were additionally assessed with the Beck Depression Inventory and the Hamilton Rating Scale for Depression. Results: At baseline, 32% of the subjects reported a history of MDD. Sixty-nine subjects completed the SCID at baseline and posttreatment. At posttreatment, 5 subjects (7%) met threshold criteria for MDD; one were taking the highest dose of fluoxetine (60 mg), 4 were taking 30 mg, and 1 was taking placebo. All 5 had a history of MDD; 3 were women. Four had a history of substance abuse and attained at least 3 consecutive biochemically verified weeks of smoking abstinence. Those who developed MDD after treatment scored significantly higher on measures of depressed mood at baseline than those who did not develop MDD after smoking- cessation treatment. Conclusion: The results from this descriptive study suggest that a subset of smokers may be at risk for developing MDD after smoking cessation.Integrating individual and public health perspectives for treatment of tobacco dependence under managed health care : A combined stepped-care and matching model
AbstractAbrams, D., Abrams, D. B., Orleans, C. T., Niaura, R. S., Goldstein, M. G., Prochaska, J. O., & Velicer, W. (n.d.).Publication year
1996Journal title
Annals of Behavioral MedicineVolume
18Issue
4Page(s)
290-304AbstractThere is an increasing momentum to integrate prevention into mainstream health care. Three decades of research on tobacco dependence can provide insights into the conceptual, clinical, economic, and service delivery challenges to such an integration. Biological sciences, cognitive-behavioral, clinical treatment outcome, and public health arenas are selectively reviewed. The key conceptual issues are explored relevant to the optimal delivery of quality smoking cessation treatments for the general population of adult smokers at reasonable cost. A comprehensive model for adult smoking cessation treatment is developed. The model consists of an overarching public health approach, focusing on enhancing motivational level from low motivation to quit to high motivation. A common outcome metric of overall impact is proposed to facilitate comparisons between clinical and public health interventions. Smokers are then assessed and triaged into one of three treatment steps of minimal, moderate, and maximal intensity and cost. Smoker individual differences at both the population and individual level are also taken into account as part of a tailoring or matching strategy within and across the stepped interventions. Smoker profiles include sociocultural, nicotine dependence, and comorbidity factors. The result is a hybrid stepped- care matching model. The model serves to illustrate some of the needs and challenges facing future tobacco dependence research and practice. Comparisons are made between tobacco control and other preventive medicine practices in terms of cost per quality adjusted life-year saved. The barriers and opportunities under managed care are explored. The conceptual principles identified here could be used as a guidepost for integrating other preventive medicine programs into the evolving managed health care system.Interventions for alcoholics who smoke
AbstractAbrams, D., Abrams, D. B., Monti, P. M., Niaura, R. S., Rohsenow, D. J., & Colby, S. M. (n.d.).Publication year
1996Journal title
Alcohol health and research worldVolume
20Issue
2Page(s)
111-117AbstractMore than 85 percent of adults with a history of alcohol abuse also smoke, and they may be more addicted to nicotine than are smokers without a history of drinking. Alcoholics who smoke also have higher risks of cancer and cardiovascular disease. Indeed, it has been reported that more alcoholics die from tobacco-related diseases than from disorders related to their alcoholism. The complex interaction that exists between alcoholism recovery and tobacco is discussed. In addition, methods are presented for helping alcoholics to stop smoking, including motivating patients, using innovative interventions, and matching effective interventions to the motivational level of the alcoholic. By better understanding the interaction between alcohol and tobacco, scientists can improve treatment outcome and cost-effectiveness for alcoholics who smoke.