David B Abrams

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 Africa

MS, Clinical Psychology, Rutgers University, New Brunswick, NJ

PhD, Clinical Psychology, Rutgers University, New Brunswick, NJ

Postdoctoral 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 Science

Chronic Diseases

Evaluations

Implementation and Impact of Public Health Regulations

Implementation science

Population Health

Public Health Pedagogy

Public Health Systems

Research Design

Systems Integration

Systems Interventions

Tobacco Control

Translational science

Publications

Publications

The efficacy of moderate intensity exercise as an aid for smoking cessation in women : A randomized controlled trial

Abrams, D., Marcus, B. H., Lewis, B. A., Hogan, J., King, T. K., Albrecht, A. E., Bock, B., Parisi, A. F., Niaura, R. S., & Abrams, D. B. (n.d.).

Publication year

2005

Journal title

Nicotine and Tobacco Research

Volume

7

Issue

6

Page(s)

871-880

10.1080/14622200500266056

Abstract

Abstract

Evidence suggests that vigorous-intensity exercise interventions may be effective for smoking cessation among women; however, few studies have examined the efficacy of a moderate-intensity exercise program. The present study examined the efficacy of moderate-intensity exercise for smoking cessation among female smokers. Healthy, sedentary female smokers (N = 217) were randomly assigned to an 8-week cognitive-behavioral smoking cessation program plus moderate-intensity exercise (CBT+EX) or to the same cessation program plus equal contact (CBT). A subsample received nicotine replacement therapy. Results indicated that the CBT+EX and CBT groups were equally likely to attain smoking cessation at the end of treatment, as measured by cotinine-verified 7-day point-prevalence abstinence (20.2% for CBT+EX vs. 18.5% for CBT). The CBT+EX group was more likely to report smoking cessation, as measured by 7-day point prevalence at the 3-month follow-up (11.9% vs. 4.6%, p

The evolution of cancer control research : An international perspective from Canada and the United States

Abrams, D., Best, A., Hiatt, R. A., Cameron, R., Rimer, B. K., & Abrams, D. B. (n.d.).

Publication year

2003

Journal title

Cancer Epidemiology Biomarkers and Prevention

Volume

12

Issue

8

Page(s)

705-712

Abstract

Abstract

Four phases in the evolution of cancer control frameworks are reviewed, highlighting how national Canadian and United States planning and implementation activities have built on each other's work to define and guide cancer control research. Hallmarks have come to be: (a) coordination of the cycle that applies research to practice and policy decisions; (b) synthesis of knowledge at each phase of cancer control framework; (c) a focus on populations and public health with feedback loops between fundamental and applied research; and (d) interdisciplinary integration of the biological, behavioral, social, and other population sciences. Current research priorities and initiatives based on the research framework now common to both Canada and the United States are described. We conclude by calling for an international forum for the systematic advancement of cancer control research, and closer ties between the cancer control communities in North America.

The FDA, e-cigarettes, and the demise of ckombusted tobacco

Abrams, D., Cobb, N. K., & Abrams, D. B. (n.d.).

Publication year

2014

Journal title

New England Journal of Medicine

Volume

371

Issue

16

Page(s)

1469-1471

10.1056/NEJMp1408448

Abstract

Abstract

~

The importance of science-informed policy and what the data really tell us about e-cigarettes

Abrams, D., Abrams, D. B., & Niaura, R. S. (n.d.).

Publication year

2015

Journal title

Israel Journal of Health Policy Research

Volume

4

Issue

1

10.1186/s13584-015-0021-z

Abstract

Abstract

A possible future end-game for cigarettes is explored in the context of the historical progress made to date by tobacco control. Despite good progress, there remains an urgent need to increase the use of proven tobacco control policies and practices for prevention and cessation. The problem is worse than previously thought and the 50th anniversary United States Surgeon General's report indicates the overwhelming majority of avoidable deaths are caused by combusting of tobacco, primarily cigarettes. The report highlights for the first time the addition of a harm minimization strategy to enhance proven tobacco control efforts and thus much more rapidly speed the obsolescence of cigarettes. Harm minimization can be two pronged. First, it can boost proven tobacco control polices to make cigarettes more expensive and less appealing and accessible to maximize the fact that cigarettes are orders of magnitude the most harmful of all tobacco delivery systems. Second, harm minimization can support use of substantially less harmful but appealing alternatives to substitute for lethal cigarettes for those users who are unable or unwilling to quit smoking. A future end-game might prudently manage emerging new products like e-cigarettes to help boost the difference in harm between them and lethal cigarettes. Harm minimization could help to accelerate the end of the century-long dominance of the cigarette in what has been called "the golden holocaust". Rather than these emerging delivery devices being used to replace lethal cigarettes in what might be termed a David versus Goliath strategy to disrupt the status quo, there is also legitimate concern that these new products could undermine historically successful tobacco control efforts, especially youth prevention, if allowed free reign. What can the data really tell us about the potential for e-cigarettes to be helpful or harmful? The emerging but limited scientific evidence and the inherent methodological constraints in study designs, points to the need for caution in prematurely interpreting results in a manner that could mislead policymakers.

The influence of attribution of alcohol intoxication on interpersonal interaction patterns

Abrams, D., Wilson, G., Perold, E., & Abrams, D. S. (n.d.).

Publication year

1981

Journal title

Journal of Cognitive Therapy and Research

Volume

5

Page(s)

251-264

Abstract

Abstract

~

The Moment Study : Protocol for a mixed method observational cohort study of the Alternative Nicotine Delivery Systems (ANDS) initiation process among adult cigarette smokers

Abrams, D., Pearson, J. L., Smiley, S. L., Rubin, L. F., Anesetti-Rothermel, A., Elmasry, H., Davis, M., De Atley, T., Harvey, E., Kirchner, T., & Abrams, D. B. (n.d.).

Publication year

2016

Journal title

BMJ open

Volume

6

Issue

4

10.1136/bmjopen-2016-011717

Abstract

Abstract

Introduction: Alternative Nicotine Delivery Systems (ANDS) such as e-cigarettes are battery-powered devices that aerosolize nicotine and other substances to simulate smoking without using tobacco. Little is known about the ANDS initiation process among adult smokers. The aims of this research are threefold to: (1) examine how ANDS use affects cigarette use; (2) examine how the immediate environmental and psychosocial contexts of cigarette and ANDS use vary within - and between - participants in general and by menthol preference and race; and, (3) examine participants' 'lived experience' of the subjective perceptions, meaning, influences and utility of cigarette and ANDS use. Methods and analyses: This study's mixed method, 6-week longitudinal design will produce a detailed description of the ANDS initiation process among adult smokers (N=100). Qualitative and quantitative data collection will include 3 weeks of: (1) ecological momentary assessment of patterns of cigarette/ANDS use, satisfaction, mood and craving; (2) geospatial assessment of participants' environment, including indoor and outdoor cigarette/ANDS norms and rules; (3) in-depth interviews about the meaning and utility o cigarette smoking and ANDS use; and, (4) saliva cotinine and exhaled carbon monoxide (CO) biomarkers. A diverse sample will be recruited with an equal number of menthol and non-menthol cigarette smokers. As the primary independent variable, we will investigate how ANDS use affects cigarette consumption. We will also examine how smoking related and ANDS-related rules and norms surrounding product use influence cigarette and ANDS product use, and how the subjective effects of ANDS use affect ANDS perceptions, beliefs and use. Ethics and dissemination: This study was funded by the National Institute on Drug Abuse of the US National Institutes of Health (1R21DA036472), registered at ClinicalTrials.gov (NCT02261363), and approved by the Chesapeake IRB (Pro00008526). Findings will be disseminated to the scientific and lay community through presentations, reports and scientific publications.

The need for a comprehensive framework

Abrams, D., Levy, D. T., Fong, G. T., Cummings, K. M., Borland, R., Abrams, D. B., Villanti, A. C., & Niaura, R. (n.d.).

Publication year

2017

Journal title

Addiction

Volume

112

Issue

1

Page(s)

22-24

10.1111/add.13600

Abstract

Abstract

~

The nonverbal communication of social anxiety: A validation of the impact of beliefs on behavior.

Abrams, D., Woolfolk, A., Abrams, L., Abrams, D. S., & Wilson, G. (n.d.).

Publication year

1979

Journal title

Journal of Environmental Science and Nonverbal Behavior

Volume

3

Page(s)

205-218

Abstract

Abstract

~

The proximal association between smoking and alcohol use among first year college students

Abrams, D., Dierker, L., Lloyd-Richardson, E., Stolar, M., Flay, B., Tiffany, S., Collins, L., Bailey, S., Nichter, M., Clayton, R., Abrams, D. S., Balster, R., Dahl, R., Giovino, G., Henningfield, J., Koob, G., McMahon, R., Merikangas, K., Shiffman, S., … Stroud, L. (n.d.).

Publication year

2006

Journal title

Drug and alcohol dependence

Volume

81

Issue

1

Page(s)

1-9

10.1016/j.drugalcdep.2005.05.012

Abstract

Abstract

Objective: This study was undertaken to evaluate the association between patterns of day-to-day smoking and drinking among first year college students. Method: Using 210 days of weekly time-line follow-back diary data, the authors examined the within-person relationships between smoking and drinking. Bivariate time series procedures were utilized. Results: Findings revealed a high degree of significant cross-correlations between smoking and drinking in which the amount of use of one substance could be predicted by current, as well as past and future use of the other. For the majority of participants, smoking and drinking were positively associated with the alternate behavior. The most common pattern of prediction for individuals was within day (i.e. synchronous correlations). When examining rates of individuals showing significant cross-correlations according to their level of either smoking or drinking, those smoking less than one cigarette on average per day were found to be less likely to demonstrate a synchronous cross-correlation between the two behaviors than those smoking at higher rates. No significant association was found between level of drinking and the rate of significant synchronous cross-correlations between smoking and drinking. Conclusions: Reports of daily behavior over long periods of time have the potential to provide insight into the more proximal influences of smoking and alcohol use on one another. Future research is needed to establish the specific factors (i.e. third variables) and related mechanisms that may drive both behaviors.

The relations between false positive and negative screens and smoking cessation and relapse in the National Lung Screening Trial : Implications for public health

Abrams, D., Clark, M. A., Gorelick, J. J., Sicks, J. R., Park, E. R., Graham, A. L., Abrams, D. B., & Gareen, I. F. (n.d.).

Publication year

2016

Journal title

Nicotine and Tobacco Research

Volume

18

Issue

1

Page(s)

17-24

10.1093/ntr/ntv037

Abstract

Abstract

Introduction: Lung screening is an opportunity for smoking cessation and relapse prevention, but smoking behaviors may differ across screening results. Changes in smoking were evaluated among 18 840 current and former smokers aged 55-74 scheduled to receive three annual lung screenings. Methods: Participants were randomized to low-dose computed tomography or single-view chest radiography in the American College of Radiology/National Lung Screening Trial. Outcome measures included point and sustained (6-month) abstinence and motivation to quit among smokers; and relapse among smokers who quit during follow-up, recent quitters (quit < 6 months), and long-term former smokers (quit ≥6 months). Results: During five years of follow-up, annual point prevalence quit rates ranged from 11.6%-13.4%; 48% of current smokers reported a quit attempt and 7% of long-term former smokers relapsed. Any false positive screening result was associated with subsequent increased point (multivariable hazard ratio HR = 1.23, 95% CI = 1.13, 1.35) and sustained (HR = 1.28, 95% CI = 1.15, 1.43) abstinence among smokers. Recent quitters with ≥1 false positive screen were less likely to relapse (HR = 0.72, 95% CI = 0.54, 0.96). Screening result was not associated with relapse among long-term former smokers or among baseline smokers who quit during follow-up. Conclusions: A false positive screen was associated with increased smoking cessation and less relapse among recent quitters. Consistently negative screens were not associated with greater relapse among long-term former smokers. Given the Affordable Care Act requires most health plans to cover smoking cessation and lung screening, the impact and cost-effectiveness of lung screening could be further enhanced with the addition of smoking cessation interventions.

The relationship of e-cigarette use to cigarette quit attempts and cessation : Insights from a large, nationally representative U.S. Survey

Abrams, D., Levy, D. T., Yuan, Z., Luo, Y., & Abrams, D. B. (n.d.).

Publication year

2018

Journal title

Nicotine and Tobacco Research

Volume

20

Issue

8

Page(s)

931-939

10.1093/ntr/ntx166

Abstract

Abstract

Objectives: While cessation from cigarettes is a top priority for public health, controversy surrounds the role of e-cigarettes for quitting cigarettes. This study examines the role of e-cigarettes in quit attempts and 3-month cigarette abstinence using a large, recent nationally representative US sample. Methods: Data from the 2014/15 Tobacco Use Supplement-Current Population Survey (TUS-CPS) on cigarette and e-cigarette use and individual characteristics were supplemented with information on state tobacco control policies. We estimated frequencies and multivariate logistic equations for making a quit attempt among those who smoked 1 year earlier and for remaining abstinent at least 3 months among those making a quit attempt. These two outcomes were related to demographic characteristics, tobacco control policies and different frequency measures of e-cigarette use (ever, at least 1, 5, 20 of the last 30 days, a continuous measure of days use). Results: Having made a quit attempt was more likely among smokers using e-cigarettes than non-users. Among those making at least one quit attempt, quit success was lower among ever users, but higher among those with at least 5 days use of e-cigarettes in the last month. Both quit attempts and quit success were linearly related to the frequency of e-cigarette use. Conclusions: Consistent with randomized trials and those observational studies that measure frequency of e-cigarette use, both quit attempts and quit success were positively associated with increased frequency of e-cigarette use. Frequency of e-cigarette use was important in gauging the nature of these relationships. Implications: Previous studies have obtained mixed results regarding the relationship of e-cigarette use to cigarette smoking cessation. This study provides a more precise methodology for considering the relationship of e-cigarette use to quit attempts and to quit success, and finds that quit attempts and quit success increase with the number of days use in the past month.

The relevance of social skills training for alcohol and drug abuse problems

Abrams, D., Monti, P., Abrams, D. S., Zwick, W., & Binkoff, J. (n.d.). (C. Hollin & P. Trower, Eds.).

Publication year

1986

Abstract

Abstract

~

The role of public policies in reducing smoking : The minnesota simsmoke tobacco policy model

Abrams, D., Levy, D. T., Boyle, R. G., & Abrams, D. B. (n.d.).

Publication year

2012

Journal title

American journal of preventive medicine

Volume

43

Issue

5 SUPPL. 3

Page(s)

S179-S186

10.1016/j.amepre.2012.07.037

Abstract

Abstract

Background: Following the landmark lawsuit and settlement with the tobacco industry, Minnesota pursued the implementation of stricter tobacco control policies, including tax increases, mass media campaigns, smokefree air laws, and cessation treatment policies. Modeling is used to examine policy effects on smoking prevalence and smoking-attributable deaths. Purpose: To estimate the effect of tobacco control policies in Minnesota on smoking prevalence and smoking-attributable deaths using the SimSmoke simulation model. Methods: Minnesota data starting in 1993 are applied to SimSmoke, a simulation model used to examine the effect of tobacco control policies over time on smoking initiation and cessation. Upon validating the model against smoking prevalence, SimSmoke is used to distinguish the effect of policies implemented since 1993 on smoking prevalence. Using standard attribution methods, SimSmoke also estimates deaths averted as a result of the policies. Results: SimSmoke predicts smoking prevalence accurately between 1993 and 2011. Since 1993, a relative reduction in smoking rates of 29% by 2011 and of 41% by 2041 can be attributed to tobacco control policies, mainly tax increases, smokefree air laws, media campaigns, and cessation treatment programs. Moreover, 48,000 smoking-attributable deaths will be averted by 2041. Conclusions: Minnesota SimSmoke demonstrates that tobacco control policies, especially taxes, have substantially reduced smoking prevalence and smoking-attributable deaths. Taxes, smokefree air laws, mass media, cessation treatment policies, and youth-access enforcement contributed to the decline in prevalence and deaths averted, with the strongest component being taxes. With stronger policies, for example, increasing cigarette taxes to $4.00 per pack, Minnesota's smoking rate could be reduced by another 13%, and 7200 deaths could be averted by 2041.

The Smoking Effects Questionnaire for adult populations : Development and psychometric properties

Abrams, D., Rohsenow, D. J., Abrams, D. B., Monti, P. M., Colby, S. M., Martin, R., & Niaura, R. S. (n.d.).

Publication year

2003

Journal title

Addictive Behaviors

Volume

28

Issue

7

Page(s)

1257-1270

10.1016/S0306-4603(02)00254-X

Abstract

Abstract

Outcome expectancies are central to a social learning model of smoking and of smoking cessation. The Smoking Effects Questionnaire (SEQ) was developed for use in general adult populations. Items were administered to 257 smokers and ex-smokers including worksite employees, hospital visitors, and clients entering smoking cessation treatment. Principal components analysis (PCA) found seven components with good reliability that were reduced into scales of four or five items each with internal consistencies above α=.80. The final measure has 33 items. The scales were divided by secondary factor analysis into three negative effect and four positive effect scales. The SEQ showed good construct and concurrent validity in comparison with measures of similar constructs and with other smoking variables. Women expected fewer negative physical effects and attributed more importance to positive stimulating effects from smoking but otherwise were comparable to men in expected effects of smoking. More dependent smokers ascribed more importance to negative physical effects and positive stimulating effects than did less dependent smokers but did not differ significantly on other expectancy domains. Both true/false scoring and importance ratings of effects produced mostly comparable results so that either scoring method could be used. Treatment implications were discussed. This brief scale is likely to be useful in a variety of research and clinical settings.

The stages and processes of exercise adoption and maintenance in a worksite sample.

Abrams, D., Marcus, B. H., Rossi, J. S., Selby, V. C., Niaura, R. S., & Abrams, D. B. (n.d.).

Publication year

1992

Journal title

Health psychology : official journal of the Division of Health Psychology, American Psychological Association

Volume

11

Issue

6

Page(s)

386-395

10.1037/0278-6133.11.6.386

Abstract

Abstract

We applied the model of the stages and processes of change to exercise adoption and maintenance. This model has shown promise in advancing theory and treatment of the addictions and other negative health behaviors, but there have been few systematic attempts to apply the model to positive health behaviors, such as exercise adoption. Questionnaires dealing with the stages and processes of exercise change were developed and administered to a sample of 1,172 participants in a worksite health promotion project. The sample was split randomly into halves for (a) initial model development and testing and (b) confirmatory measurement model testing. Additional model confirmation was obtained by examining the hierarchical structure of the processes of change and by conducting Stage x Process analyses. Results suggest that the underlying constructs derived from smoking cessation and other addictive behaviors can be generalized to exercise behavior. Understanding the stages and processes of exercise behavior change may yield important information for enhancing exercise adoption, adherence, and relapse prevention at both individual and public health levels.

The tobacco dependence treatment handbook: A guide to best practices

Abrams, D., Abrams, D. S., Niaura, R. S., Brown, R., Emmons, K., Goldstein, M., & Monti, P. (n.d.).

Publication year

2003

Abstract

Abstract

~

The use of nicotine replacement therapy during hospitalization

Abrams, D., Emmons, K. M., Goldstein, M. G., Roberts, M., Cargill, B., Sherman, C. B., Millman, R., Brown, R., & Abrams, D. B. (n.d.).

Publication year

2000

Journal title

Annals of Behavioral Medicine

Volume

22

Issue

4

Page(s)

325-329

10.1007/BF02895669

Abstract

Abstract

Recent findings suggest that smokers who are hospitalized experience significant craving for cigarettes. Thus, nicotine replacement therapy (NRT) may be a particularly important tool for use during hospitalization. The goal of this study is to evaluate the utilization of the transdermal nicotine patch and/or nicotine gum by hospitalized smokers. The data represented in this article are from 580 smokers who participated in a study of a motivational intervention for smoking cessation that was delivered during hospitalization. The primary outcome for this analysis was use of NRT during hospitalization. The results revealed that, among the entire sample, only 7.1% of the overall sample used NRT during hospitalization; 6% of the hospitalized smokers used the transdermal nicotine patch, and 1.1% used nicotine gum. Use of NRT was significantly greater among patients who reported that they were doing anything to help themselves quit smoking at the time of admission (OR = 4.1), those who were seriously planning to quit smoking within the next 30 days (OR = 2.36), those who were nicotine dependent (OR = 2.81), and those for whom a physician had ever offered to prescribe NRT (OR = 1.9). The finding that there is a very low rate of NRT use during hospitalization provides important information to hospital-based care providers and smoking cessation intervention planners. Barriers to NRT use among hospitalized patients should be identified, and strategies designed to maximize use when appropriate. The AHCPR Guideline on Smoking Cessation recommends routine use of NRT in health care settings. Further research is needed to determine why NRT use was so low. In addition, these data suggest that efforts to increase NRT use during hospitalization are needed.

The working healthy project : A worksite health-promotion trial targeting physical activity, diet, and smoking

Abrams, D., Emmons, K. M., Linnan, L. A., Shadel, W. G., Marcus, B., & Abrams, D. B. (n.d.).

Publication year

1999

Journal title

Journal of Occupational and Environmental Medicine

Volume

41

Issue

7

Page(s)

545-555

10.1097/00043764-199907000-00003

Abstract

Abstract

Worksites 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.

The Working Well Trial : Baseline Dietary and Smoking Behaviors of Employees and Related Worksite Characteristics

Abrams, D., Heimendinger, J., Feng, Z., Emmons, K., Stoddard, A., Kinne, S., Biener, L., Sorensen, G., Abrams, D. S., Varnes, J., & Boutwell, B. (n.d.).

Publication year

1995

Journal title

Preventive Medicine

Volume

24

Issue

2

Page(s)

180-193

10.1006/pmed.1995.1032

Abstract

Abstract

Background. The Working Well Trial, the largest randomized worksite health promotion trial to date, tests the effects of cancer prevention and control interventions on dietary and smoking behaviors of employees and the worksite environment. The trial is a 5-year cooperative agreement conducted in 57 matched pairs of worksites in 16 states by four study centers, a coordinating center, and the National Cancer Institute. The dual aims of this paper are to: (a) present a baseline description of the dietary and smoking habits of 20,801 employees, who are predominantly blue-collar workers; and (b) describe the social and physical environments of their worksites that may facilitate or hinder health behavior changes. Methods. The self-administered baseline survey of individuals consisted of a core set of questions common across all study centers on diet and smoking. The organizational survey consisted to eight instruments administered via interviews with key informants in each worksite. Continuous variables were analyzed by a mixed linear model and binary data were analyzed by the Generalized Estimating Equation. Results. The population represented is largely male (67.5%) and blue collar (53.5%). Mean levels of fat and fiber intakes were close to the national averages (36.6% of calories as fat and 13.1 g of fiber). Smoking prevalence (25.2%) was slightly lower than the national average. The worksites had a high level of health promotion activites (42% had nutrition programs, 53% had smoking control programs), but lacked environmental support for dietary behavior change and perceived support for smoking cessation. Conclusions. These findings replicate and extend previous research results to a large sample of diverse, largely blue-collar worksites. In addition the baseline results lay a foundation for the development of new insight into the relationship between individual and organizational level variables that may interact to influence behavioral and cultural norms.

Thinking about craving : An experimental analysis of smokers' spontaneous self-reports of craving

Abrams, D., Shadel, W. G., Niaura, R. S., & Abrams, D. B. (n.d.).

Publication year

2004

Journal title

Addictive Behaviors

Volume

29

Issue

4

Page(s)

811-815

10.1016/j.addbeh.2004.02.014

Abstract

Abstract

This study evaluated whether smokers generate spontaneous expressions of craving (i.e., expressions of an urge, craving, desire, want, or need) in response to cues designed to provoke a craving state. In a 2 (smoking deprivation: 1 and 12 h)×2 (cue type: neutral, active) within-subjects design, smokers were asked to think aloud in an unstructured way (i.e., "describe everything you are thinking and feeling right now"). Results revealed a main effect for cue type on think-aloud craving responses: Smokers spontaneously generated a greater number of craving-related cognitions during active cue exposure compared with neutral cue exposure, both during both 1- and 12-h deprivation. This same pattern of effects was not found for a self-report assessment of craving, which was insensitive to cue-provoked changes in craving in the 1-h deprivation condition. These results suggest that smokers do spontaneously experience craving, independent of an explicit assessment of craving and that think-aloud methods may provide a novel assessment of craving that may be relatively more sensitive than self-report methods under some circumstances.

Tobacco cessation among low-income smokers : Motivational enhancement and nicotine patch treatment

Abrams, D., Bock, B. C., Papandonatos, G. D., De Dios, M. A., Abrams, D. B., Azam, M. M., Fagan, M., Sweeney, P. J., Stein, M. D., & Niaura, R. S. (n.d.).

Publication year

2014

Journal title

Nicotine and Tobacco Research

Volume

16

Issue

4

Page(s)

413-422

10.1093/ntr/ntt166

Abstract

Abstract

Introduction: Despite decades of tobacco use decline among the general population in the United States, tobacco use among low-income populations continues to be a major public health concern. Smoking rates are higher among individuals with less than a high school education, those with no health insurance, and among individuals living below the federal poverty level. Despite these disparities, smoking cessation treatments for low-income populations have not been extensively tested. In the current study, the efficacy of 2 adjunctive smoking cessation interventions was evaluated among low-income smokers who were seen in a primary care setting. Methods: A total of 846 participants were randomly assigned either to motivational enhancement treatment plus brief physician advice and 8 weeks of nicotine replacement therapy (NRT) or to standard care, which consisted of brief physician advice and 8 weeks of NRT. Tobacco smoking abstinence was at 1, 2, 6, and 12 months following baseline. Results: The use of the nicotine patch, telephone counseling, and positive decisional balance were predictive of increased abstinence rates, and elevated stress levels and temptation to smoke in both social/habit and negative affect situations decreased abstinence rates across time. Analyses showed intervention effects on smoking temptations, length of patch use, and number of telephone contacts. Direct intervention effects on abstinence rates were not significant, after adjusting for model predictors and selection bias due to perirandomization attrition. Conclusions: Integrating therapeutic approaches that promote use of and adherence to medications for quitting smoking and that target stress management and reducing negative affect may enhance smoking cessation among low-income smokers.

Tobacco dependence : An integration of individual and public health perspectives

Abrams, D., Abrams, D. B., Emmons, K. M., Niaura, R. S., Goldstein, M. G., & Sherman, C. B. (n.d.).

Publication year

1991

Journal title

Annual Review of Addictions Research and Treatment

Volume

1

Issue

C

Page(s)

391-436

Abstract

Abstract

~

Tobacco retail outlet advertising practices and proximity to schools, parks and public housing affect Synar underage sales violations in Washington, DC

Abrams, D., Kirchner, T. R., Villanti, A. C., Cantrell, J., Anesetti-Rothermel, A., Ganz, O., Conway, K. P., Vallone, D. M., & Abrams, D. B. (n.d.).

Publication year

2015

Journal title

Tobacco control

Volume

24

Issue

E1

Page(s)

e52-e58

10.1136/tobaccocontrol-2013-051239

Abstract

Abstract

Objective To examine the cross-sectional association between illicit sales of tobacco to minors, Washington DC tobacco outlet advertising practices, retail store type, the demographic make-up of the area surrounding each outlet, and the proximity of each outlet to high schools, recreational parks and public housing. Participants Seven hundred and fifty tobacco outlets in the DC area, n=347 of which were randomly selected for inspection by the Synar Inspection Program in 2009–2010. Main outcome measures The presence of tobacco advertisements on the interior and exterior of each outlet, and illicit tobacco sales to Synar Inspection Program youth volunteers. Results The presence of tobacco advertisements on the exterior of gas stations was much greater than on other retail store types (OR=6.68; 95% CI 4.05 to 11.01), as was the absence of any advertisements at bars or restaurants that sold tobacco (OR=0.33; 95% CI 0.22 to 0.52). Exterior tobacco advertisements were also more likely in predominantly African–American areas of the city (OR=3.11; 95% CI 2.28 to 4.25), and particularly likely on storefronts located closer to parks (OR=1.87; 95% CI 1.06 to 3.28). Illicit sales to minors were more common at gas stations (OR=3.01; 95% CI 1.5 to 6.3), outlets that displayed exterior tobacco advertisements closer to parks (OR=3.36; 95% CI 1.38 to 8.21), and outlets located closer to high schools in majority African– American block groups (OR=1.29; 95% CI 1.07 to 1.58). Conclusions Findings demonstrate that while illicit tobacco sales to minors are occurring at acceptably low rates by Synar standards, illicit sales vary considerably by retail store type, advertising approach and proximity to high schools, parks and African–American residential areas. Future work may help inform regulatory efforts to reduce youth access at the neighbourhood, city, state and national levels.

Tobacco, alcohol, and marijuana use among first-year U.S. college students : A time series analysis

Abrams, D., Dierker, L., Stolar, M., Lloyd-Richardson, E., Tiffany, S., Flay, B., Collins, L., Nichter, M., Bailey, S., Clayton, R., Abrams, D. S., Balster, R., Dahl, R., Giovino, G., Henningfield, J., Koob, G., McMahon, R., Merikangas, K., Shiffman, S., … Stroud, L. (n.d.).

Publication year

2008

Journal title

Substance Use and Misuse

Volume

43

Issue

5

Page(s)

680-699

10.1080/10826080701202684

Abstract

Abstract

The present study sought to evaluate the day-to-day patterns of tobacco, alcohol, and marijuana use among first-year college students in the United States. Using 210 days of weekly time-line follow-back diary data collected in 2002 to 2003, the authors examined within-person patterns of use. The sample was 48% female and 90% Caucasian. Sixty-eight percent of the participants were permanent residents of Indiana. Univariate time series analysis was employed to evaluate behavioral trends for each substance across the academic year and to determine the predictive value of day-to-day substance use. Some of the most common trends included higher levels of substance use at the beginning or end of the academic year. Use on any given day could be predicted best from the amount of corresponding substance use 1 day prior. Conclusions: Although universal intervention might best be focused in the earliest weeks on campus and at the end of the year when substance use is at its highest, the diversity of substance use trajectories suggests the need for more targeted approaches to intervention. Study limitations are noted.

Trajectories of smoking among freshmen college students with prior smoking history and risk for future smoking : Data from the University Project Tobacco Etiology Research Network (UpTERN) study

Abrams, D., Colder, C. R., Flay, B. R., Segawa, E., Hedeker, D., Abrams, D. B., Agnew, C., Balster, R. L., Clayton, R. R., Collins, L. M., Dahl, R. E., Dierker, L. C., Donny, E. C., Dorn, L., Eissenberg, T., Flaherty, B. P., Giovino, G. A., Henningfield, J., Koob, G. F., … Tiffany, S. (n.d.).

Publication year

2008

Journal title

Addiction

Volume

103

Issue

9

Page(s)

1534-1543

10.1111/j.1360-0443.2008.02280.x

Abstract

Abstract

Aims: Little is known about smoking during the transition to college. The current study examined trajectories of smoking among college freshmen, how trajectories predicted later smoking and the social context of smoking. Design: Weekly assessments of daily smoking were collected via the web during the first year of college for a large cohort with a previous history of smoking. Participants and setting: A total of 193 college freshmen from a large public university with a previous history of smoking who smoked frequently enough to be included in trajectory analysis. Measurements: Measures included weekly reports of daily smoking, family smoking, perceived peer attitudes and smoking, social norms and social smoking environment. Findings: Seven trajectories were identified: one of low-level sporadic smoking, one of low-level smoking with a small increase during the year, two classes with a substantial decrease during the year, two classes with relatively small decreases and one class with a substantial increase in smoking. Trajectories of smoking in the freshman year predicted levels of sophomore year smoking, and some social context variables tended to change as smoking increased or decreased for a given trajectory class. Conclusions: The transition into college is marked by changes in smoking, with smoking escalating for some students and continuing into the sophomore year. Shifts in social context that support smoking were associated with trajectories of smoking. Despite the focus of developmental models on smoking in early adolescence, the transition into college warrants further investigation as a dynamic period for smoking.