David B Abrams
David Abrams
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Professor of Social and Behavioral Sciences
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Professional overview
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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.
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Education
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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
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Honors and awards
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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)
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Areas of research and study
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Behavioral ScienceChronic DiseasesEvaluationsImplementation and Impact of Public Health RegulationsImplementation sciencePopulation HealthPublic Health PedagogyPublic Health SystemsResearch DesignSystems IntegrationSystems InterventionsTobacco ControlTranslational science
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Publications
Publications
NIH electronic cigarette workshop: Developing a research agenda
AbstractWalton, K. M., Abrams, D. B., Bailey, W. C., Clark, D., Connolly, G. N., Djordjevic, M. V., Eissenberg, T. E., Fiore, M. C., Goniewicz, M. L., Haverkos, L., Hecht, S. S., Henningfield, J. E., Hughes, J. R., Oncken, C. A., Postow, L., Rose, J. E., Wanke, K. L., Yang, L., & Hatsukami, D. K. (n.d.).Publication year
2015Journal title
Nicotine and Tobacco ResearchVolume
17Issue
2Page(s)
259-269AbstractBackground: Electronic cigarettes (e-cigarettes) represent an emerging public health issue. These devices deliver nicotine along with other constituents, including flavorants, via an inhalable aerosol. Their uptake is rapidly increasing in both adults and youths, primarily among current smokers. Public debate is increasing on how these devices should be regulated and used, yet only limited peer-reviewed research exists. To develop a informed policy for e-cigarettes, their effects on human behavior, physiology, and health need to be understood. Purpose: This paper describes proceedings from a National Institutes of Health-sponsored workshop, which was held in November 2013, to identify research needs related to the effects of e-cigarettes. Discussion topics included e-cigarette risks and abuse potential; the potential role for e-cigarettes in harm reduction and smoking cessation; unintended consequences of e-cigarette use, such as becoming a gateway to conventional cigarettes; and dual use of both e-cigarettes and conventional cigarettes. Results and Conclusions: The research needs identified by the workshop participants included the following: standards to measure the contents and emissions of e-cigarettes; biomarkers of exposure; physiological effects of e-cigarettes on tissues and organ systems, including pulmonary and cardiovascular; information on e-cigarette users, how the devices are used, and identification of the best tools to assess these measures; factors that drive use and influence patterns of use; and appropriate methods for evaluating a potential role for e-cigarettes in smoking or nicotine cessation. To understand fully the challenges and the opportunities that e-cigarettes represent, expertise will be needed in basic, behavioral, translational, and clinical sciences.Tobacco retail outlet advertising practices and proximity to schools, parks and public housing affect Synar underage sales violations in Washington, DC
AbstractKirchner, 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
2015Journal title
Tobacco controlVolume
24Page(s)
e52-e58AbstractObjective 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.Cameras for public health surveillance: A methods protocol for crowdsourced annotation of point-of-sale photographs
AbstractIlakkuvan, V., Tacelosky, M., Ivey, K. C., Pearson, J. L., Cantrell, J., Vallone, D. M., Abrams, D. B., & Kirchner, T. R. (n.d.).Publication year
2014Journal title
JMIR Research ProtocolsVolume
3Issue
2AbstractBackground: Photographs are an effective way to collect detailed and objective information about the environment, particularly for public health surveillance. However, accurately and reliably annotating (ie, extracting information from) photographs remains difficult, a critical bottleneck inhibiting the use of photographs for systematic surveillance. The advent of distributed human computation (ie, crowdsourcing) platforms represents a veritable breakthrough, making it possible for the first time to accurately, quickly, and repeatedly annotate photos at relatively low cost. Objective: This paper describes a methods protocol, using photographs from point-of-sale surveillance studies in the field of tobacco control to demonstrate the development and testing of custom-built tools that can greatly enhance the quality of crowdsourced annotation. Methods: Enhancing the quality of crowdsourced photo annotation requires a number of approaches and tools. The crowdsourced photo annotation process is greatly simplified by decomposing the overall process into smaller tasks, which improves accuracy and speed and enables adaptive processing, in which irrelevant data is filtered out and more difficult targets receive increased scrutiny. Additionally, zoom tools enable users to see details within photographs and crop tools highlight where within an image a specific object of interest is found, generating a set of photographs that answer specific questions. Beyond such tools, optimizing the number of raters (ie, crowd size) for accuracy and reliability is an important facet of crowdsourced photo annotation. This can be determined in a systematic manner based on the difficulty of the task and the desired level of accuracy, using receiver operating characteristic (ROC) analyses. Usability tests of the zoom and crop tool suggest that these tools significantly improve annotation accuracy. The tests asked raters to extract data from photographs, not for the purposes of assessing the quality of that data, but rather to assess the usefulness of the tool. The proportion of individuals accurately identifying the presence of a specific advertisement was higher when provided with pictures of the product's logo and an example of the ad, and even higher when also provided the zoom tool (χ2 2=155.7, P<.001). Similarly, when provided cropped images, a significantly greater proportion of respondents accurately identified the presence of cigarette product ads (χ2 1=75.14, P<.001), as well as reported being able to read prices (χ2 2=227.6, P<.001). Comparing the results of crowdsourced photo-only assessments to traditional field survey data, an excellent level of correspondence was found, with area under the ROC curves produced by sensitivity analyses averaging over 0.95, requiring on average 10 to 15 crowdsourced raters to achieve values of over 0.90. Results: Further testing and improvement of these tools and processes is currently underway. This includes conducting systematic evaluations that crowdsource photograph annotation and methodically assess the quality of raters' work. Conclusions: Overall, the combination of crowdsourcing technologies with tiered data flow and tools that enhance annotation quality represents a breakthrough solution to the problem of photograph annotation, vastly expanding opportunities for the use of photographs rich in public health and other data on a scale previously unimaginable.Future directions for postdoctoral training in cancer prevention: Insights from a panel of experts
AbstractNelson, D. E., Faupel-Badger, J., Phillips, S., Belcher, B., Chang, S., Abrams, D. B., Kramer, B. S., White, M. C., O’Malley, M., Varanasi, A. P., Fabian, C. J., Wiest, J. S., Colditz, G. A., Hall, K., Shields, P. G., & Weitzel, J. N. (n.d.).Publication year
2014Journal title
Cancer Epidemiology Biomarkers and PreventionVolume
23Issue
4Page(s)
679-683AbstractCancer prevention postdoctoral fellowships have existed since the 1970s. The National Cancer Institute facilitated a meeting by a panel of experts in April 2013 to consider four important topics for future directions for cancer prevention postdoctoral training programs: (i) future research needs; (ii) underrepresented disciplines; (iii) curriculum; and (iv) career preparation. Panelists proffered several areas needing more research or emphasis, ranging from computational science to culture. Health care providers, along with persons from nontraditional disciplines in scientific training programs such as engineers and lawyers, were among those recognized as being underrepresented in training programs. Curriculum suggestions were that fellows receive training in topics such as leadership and human relations, in addition to learning the principles of epidemiology, cancer biologic mechanisms, and behavioral science. For career preparation, there was a clear recognition of the diversity of employment options available besides academic positions, and that programleaders should do more to help fellows identify and prepare for different career paths. The major topics and strategies covered at this meeting can help form the basis for cancer prevention training programleaders to consider modifications or new directions, and keep them updated with the changing scientific and employment climate for doctoral degree recipients and postdoctoral fellows.Informing policy through tobacco regulatory science: an evolving process
Villanti, A., Abrams, D., & Delnevo, C. (n.d.).Publication year
2014Journal title
Health Behavior and Policy ReviewVolume
1Issue
2Page(s)
97-102Motivational interviewing versus brief advice for cigarette smokers in residential alcohol treatment
AbstractRohsenow, D. J., Martin, R. A., Monti, P. M., Colby, S. M., Day, A. M., Abrams, D. B., Sirota, A. D., & Swift, R. M. (n.d.).Publication year
2014Journal title
Journal of Substance Abuse TreatmentVolume
46Issue
3Page(s)
346-355AbstractResidential treatment for substance use disorders (SUD) provides opportunity for smoking intervention. A randomized controlled trial compared: (1) motivational interviewing (MI) to brief advice (BA), (2) in one session or with two booster sessions, for 165 alcoholics in SUD treatment. All received nicotine replacement (NRT). MI and BA produced equivalent confirmed abstinence, averaging 10% at 1. month, and 2% at 3, 6 and 12. months. However, patients with more drug use pretreatment (>. 22. days in 6. months) given BA had more abstinence at 12. months (7%) than patients in MI or with less drug use (all 0%). Boosters produced 16-31% fewer cigarettes per day after BA than MI. Substance use was unaffected by treatment condition or smoking cessation. Motivation to quit was higher after BA than MI. Thus, BA plus NRT may be a cost-effective way to reduce smoking for alcoholics with comorbid substance use who are not seeking smoking cessation.Noncombustible tobacco product advertising: How companies are selling the new face of tobacco
AbstractRichardson, A., Ganz, O., Stalgaitis, C., Abrams, D., & Vallone, D. (n.d.).Publication year
2014Journal title
Nicotine and Tobacco ResearchVolume
16Issue
5Page(s)
606-614AbstractBackground: With declining cigarette sales, increasing restrictions, and recent Food and Drug Administration (FDA) regulation of cigarettes, there has been a dramatic rise in the marketing of noncombustible tobacco products (NCPs). However, little is known about how NCPs are advertised and to whom. Methods: Two full-service advertising firms were used to systematically collect all U.S. advertisements for NCPs (e-cigarettes, snus, dissolvables, and chew/dip/snuff,) running between June 1 and September 1, 2012. The advertisement and associated metadata (brand, media channel, observations, spend, and estimated reach) were examined. Attributes of print advertisements were examined relative to target demographics of the publications in which they ran. Results: Over 3 months, almost $20 million was spent advertising NCPs. Although the greatest amount spent was on the promotion of smokeless (̃$8 million) and snus (̃$10 million), e-cigarette advertisements were the most widely circulated. Print advertisements, the majority of which were e-cigarettes and chew/dip/snuff, were heavily tailored to middle-aged White males. Many e-cigarette print ads suggested harm reduction and use when one cannot smoke (poly-use), while chew/dip/snuff focused on masculinity. Conclusions: Robust ongoing surveillance of NCP advertising is critical to inform the FDA and to protect public health. Both commercial advertising and public health media campaigns must ensure that content is not misleading and that it educates consumers about harm based on the available science. The way messages are framed have the potential to decrease tobacco use by promoting rather than undermining cessation of combusted products and/or by encouraging exclusive use of less harmful NCPs rather than poly-use of combusted and NCPs.Potential and Pitfalls of e-Cigarettes: in Reply
Abrams, D. (n.d.).Publication year
2014Journal title
JAMAVolume
311Issue
18Page(s)
1922-3The Changing Landscape of Tobacco Control Current Status and Future Directions
Abrams, D., Villanti, A., & Warner, K. (n.d.). In The Health Consequences of Smoking-50 Years of Progress: A Report of the Surgeon General (1–).Publication year
2014Page(s)
845-64The FDA, e-cigarettes, and the demise of ckombusted tobacco
Cobb, N. K., & Abrams, D. B. (n.d.).Publication year
2014Journal title
New England Journal of MedicineVolume
371Issue
16Page(s)
1469-1471Tobacco cessation among low-income smokers: Motivational enhancement and nicotine patch treatment
AbstractBock, 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. (n.d.).Publication year
2014Journal title
Nicotine and Tobacco ResearchVolume
16Issue
4Page(s)
413-422AbstractIntroduction: 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.A Cost-Utility Analysis of Lung Cancer Screening and the Additional Benefits of Incorporating Smoking Cessation Interventions
AbstractVillanti, A. C., Jiang, Y., Abrams, D. B., & Pyenson, B. S. (n.d.).Publication year
2013Journal title
PloS oneVolume
8Issue
8AbstractBackground:A 2011 report from the National Lung Screening Trial indicates that three annual low-dose computed tomography (LDCT) screenings for lung cancer reduced lung cancer mortality by 20% compared to chest X-ray among older individuals at high risk for lung cancer. Discussion has shifted from clinical proof to financial feasibility. The goal of this study was to determine whether LDCT screening for lung cancer in a commercially-insured population (aged 50-64) at high risk for lung cancer is cost-effective and to quantify the additional benefits of incorporating smoking cessation interventions in a lung cancer screening program.Methods and Findings:The current study builds upon a previous simulation model to estimate the cost-utility of annual, repeated LDCT screenings over 15 years in a high risk hypothetical cohort of 18 million adults between age 50 and 64 with 30+ pack-years of smoking history. In the base case, the lung cancer screening intervention cost $27.8 billion over 15 years and yielded 985,284 quality-adjusted life years (QALYs) gained for a cost-utility ratio of $28,240 per QALY gained. Adding smoking cessation to these annual screenings resulted in increases in both the costs and QALYs saved, reflected in cost-utility ratios ranging from $16,198 per QALY gained to $23,185 per QALY gained. Annual LDCT lung cancer screening in this high risk population remained cost-effective across all sensitivity analyses.Conclusions:The findings of this study indicate that repeat annual lung cancer screening in a high risk cohort of adults aged 50-64 is highly cost-effective. Offering smoking cessation interventions with the annual screening program improved the cost-effectiveness of lung cancer screening between 20% and 45%. The cost-utility ratios estimated in this study were in line with other accepted cancer screening interventions and support inclusion of annual LDCT screening for lung cancer in a high risk population in clinical recommendations.Compensation predicts smoking cessation failure
AbstractNiaura, R. S., Pearson, J. L., & Abrams, D. B. (n.d.).Publication year
2013Journal title
PsychopharmacologyVolume
230Issue
2Page(s)
261-266AbstractRationale: Compensation is a potential result of decreasing the available nicotine and tar dose in cigarettes. There is little published data linking compensation with cessation. Objectives: We sought to examine whether compensation in response to restricted cigarette yield is associated with difficulty quitting smoking. Methods: Questionnaires and blood samples were collected from 174 smokers interested in quitting smoking as part of a larger smoking cessation study. Participants were instructed to use a filter designed to remove 50 % of tar and nicotine from the cigarette but otherwise smoke normally. Participants returned after 3 days of using the filter for follow-up data collection. Results: Nicotine levels and cigarettes per day decreased after use of the filter. Baseline nicotine and change in nicotine pre/post filter use, but not cigarettes per day or change in cigarettes per day were associated with smoking abstinence at 30 days. Conclusions: Smokers who demonstrate sensitivity to the biological or behavioral consequences of decreased nicotine content in tobacco smoke have greater difficulty quitting. These findings suggest the need for personalized cessation treatment linked to behavioral compensation.Cost-effectiveness of internet and telephone treatment for smoking cessation: An economic evaluation of the iQUITT study
AbstractGraham, A. L., Chang, Y., Fang, Y., Cobb, N. K., Tinkelman, D. S., Niaura, R. S., Abrams, D. B., & Mandelblatt, J. S. (n.d.).Publication year
2013Journal title
Tobacco controlVolume
22Issue
6AbstractBackground Internet and telephone treatments for smoking cessation can reach large numbers of smokers. There is little research on their costs and the impact of adherence on costs and effects. Objective To conduct an economic evaluation of The iQUITT Study, a randomised trial comparing Basic Internet, Enhanced Internet and Enhanced Internet plus telephone counselling ('Phone') at 3, 6, 12 and 18 months. Methods We used a payer perspective to evaluate the average and incremental cost per quitter of the three interventions using intention-to-treat analysis of 30-day single-point prevalence and multiple-point prevalence (MPP) abstinence rates. We also examined results based on adherence. Costs included commercial charges for each intervention. Discounting was not included given the short time horizon. Results Basic Internet had the lowest cost per quitter at all time points. In the analysis of incremental costs per additional quitter, Enhanced Internet+Phone was the most cost-effective using both single and MPP abstinence metrics. As adherence increased, the cost per quitter dropped across all arms. Costs per quitter were lowest among participants who used the 'optimal' level of each intervention, with an average cost per quitter at 3 months of US$7 for Basic Internet, US$164 for Enhanced Internet and US$346 for Enhanced Internet +Phone. Conclusions 'Optimal' adherence to internet and combined internet and telephone interventions yields the highest number of quitters at the lowest cost. Cost-effective means of ensuring adherence to such evidence-based programmes could maximise their population-level impact on smoking prevalence.Engagement promotes abstinence in a web-based cessation intervention: Cohort study
AbstractRichardson, A., Graham, A. L., Cobb, N., Xiao, H., Mushro, A., Abrams, D., & Vallone, D. (n.d.).Publication year
2013Journal title
Journal of medical Internet researchVolume
15Issue
1AbstractBackground: Web-based smoking cessation interventions can have a public health impact because they are both effective in promoting cessation and can reach large numbers of smokers in a cost-efficient manner. Their potential impact, however, has not been realized. It is still unclear how such interventions promote cessation, who benefits most, and how to improve their population impact. Objective: To examine the effectiveness of a highly promoted Web-based smoking cessation intervention to promote quit behavior over time, identify the most effective features, and understand who is most likely to use those features by using unweighted and weighted analyses to estimate the impact in the broader pool of registered site users. Methods: A sample of 1033 new adult registrants was recruited from a Web-based smoking cessation intervention by using an automated study management system. Abstinence was assessed by self-report through a mixed-mode follow-up (online survey with telephone follow-up for nonrespondents) at 1, 3, and 6 months. Software tracked respondents' online activity. Generalized estimating equations (GEE) were used to examine predictors of website utilization and how utilization promoted abstinence using unweighted and weighted data. Results: The 7-day point prevalence abstinence rates at 6 months ranged from 20.68% to 11.13% in the responder and intent-to-treat samples, respectively. Predictors of abstinence in unweighted analyses included number of visits to the website as well as accessing specific interactive or engaging features. In weighted analyses, only number of visits was predictive of abstinence. Motivation to quit was a key predictor of website utilization, whereas negative partner support decreased the likelihood of increasing visits or accessing engaging features. Conclusions: Engagement is critical to promoting smoking cessation. The next generation of Web-based smoking cessation interventions needs to maximize the initial engagement of all new visitors and work to retain those smokers who proceed to register on the site.Geospatial exposure to point-of-sale tobacco: Real-time craving and smoking-cessation outcomes
AbstractKirchner, T. R., Cantrell, J., Anesetti-Rothermel, A., Ganz, O., Vallone, D. M., & Abrams, D. B. (n.d.).Publication year
2013Journal title
American journal of preventive medicineVolume
45Issue
4Page(s)
379-385AbstractBackground: Little is known about the factors that drive the association between point-of-sale marketing and behavior, because methods that directly link individual-level use outcomes to real-world point-of-sale exposure are only now beginning to be developed. Purpose: Daily outcomes during smoking cessation were examined as a function of both real-time geospatial exposure to point-of-sale tobacco (POST) and subjective craving to smoke. Methods: Continuous individual geospatial location data collected over the first month of a smoking-cessation attempt in 2010-2012 (N=475) were overlaid on a POST outlet geodatabase (N=1060). Participants' mobility data were used to quantify the number of times they came into contact with a POST outlet. Participants recorded real-time craving levels and smoking status via ecological momentary assessment (EMA) on cellular telephones. Results: The final data set spanned a total of 12,871 days of EMA and geospatial tracking. Lapsing was significantly more likely on days with any POST contact (OR=1.19, 95% CI=1.18, 1.20), and increasingly likely as the number of daily POST contacts increased (OR=1.07, 95% CI=1.06, 1.08). Overall, daily POST exposure was significantly associated with lapsing when craving was low (OR=1.22, 95% CI=1.20, 1.23); high levels of craving were more directly associated with lapse outcomes. Conclusions: These data shed light on the way mobility patterns drive a dynamic interaction between individuals and the POST environment, demonstrating that quantification of individuals' exposure to POST marketing can be used to identify previously unrecognized patterns of association among individual mobility, the built environment, and behavioral outcomes.Improving adherence to web-based cessation programs: a randomized controlled trial study protocol.
AbstractGraham, A. L., Cha, S., Papandonatos, G. D., Cobb, N. K., Mushro, A., Fang, Y., Niaura, R. S., & Abrams, D. B. (n.d.).Publication year
2013Journal title
Unknown JournalVolume
14AbstractReducing smoking prevalence is a public health priority that can save more lives and money than almost any other known preventive intervention. Internet interventions have the potential for enormous public health impact given their broad reach and effectiveness. However, most users engage only minimally with even the best designed websites, diminishing their impact due to an insufficient 'dose'. Two approaches to improve adherence to Internet cessation programs are integrating smokers into an online social network and providing free nicotine replacement therapy (NRT). Active participation in online communities is associated with higher rates of cessation. Integrating smokers into an online social network can increase support and may also increase utilization of cessation tools and NRT. Removing barriers to NRT may increase uptake and adherence, and may also increase use of online cessation tools as smokers look for information and support while quitting. The combination of both strategies may exert the most powerful effects on adherence compared to either strategy alone. This study compares the efficacy of a smoking cessation website (WEB) alone and in conjunction with free NRT and a social network (SN) protocol designed to integrate participants into the online community. Using a 2 (SN, no SN) x 2 (NRT, no NRT) randomized, controlled factorial design with repeated measures at baseline, 3 months, and 9 months, this study will recruit N = 4,000 new members of an internet cessation program and randomize them to: 1) WEB, 2) WEB + SN, 3) WEB + NRT, or 4) WEB + SN + NRT. Hypotheses are that all interventions will outperform WEB and that WEB + SN + NRT will outperform WEB + NRT and WEB + SN on 30-day point prevalence abstinence at 9 months. Exploratory analyses will examine theory-driven hypotheses about the mediators and moderators of outcome. Addressing adherence in internet cessation programs is critical and timely to leverage their potential public health impact. This study is innovative in its use of a social network approach to improve behavioral and pharmacological treatment utilization to improve cessation. This approach is significant for reducing tobacco's devastating disease burden and for optimizing behavior change in other arenas where adherence is just as critical. ISRCTN:ISRCTN45127327.Menthol cigarettes and mortality: Keeping focus on the public health standard
Villanti, A. C., Giovino, G. A., Burns, D. M., & Abrams, D. B. (n.d.). In Nicotine and Tobacco Research (1–).Publication year
2013Volume
15Issue
2Page(s)
617-618Public support for mandated nicotine reduction in cigarettes
AbstractPearson, J. L., Abrams, D. B., Niaura, R. S., Richardson, A., & Vallone, D. M. (n.d.).Publication year
2013Journal title
American journal of public healthVolume
103Issue
3Page(s)
562-567AbstractObjectives. We assessed public support for a potential Food and Drug Administration (FDA)-mandated reduction in cigarette nicotine content. Methods. We used nationally representative data from a June 2010 crosssectional survey of US adults (n = 2649) to obtain weighted point estimates and correlates of support for mandated nicotine reduction. We also assessed the potential role of political ideology in support of FDA regulation of nicotine. Results. Nearly 50% of the public supported mandated cigarette nicotine reduction, with another 28% having no strong opinion concerning this potential FDA regulation. Support for nicotine reduction was highest among Hispanics, African Americans, and those with less than a high school education. Among smokers, the odds of supporting FDA nicotine regulation were 2.77 times higher among smokers who intended to quit in the next 6 months than among those with no plans to quit. Conclusions. Mandating nicotine reduction in cigarettes to nonaddictive levels may reduce youth initiation and facilitate adult cessation. The reasons behind nicotine regulation need to be communicated to the public to preempt tobacco industry efforts to impede such a regulation.Smoking prevention policies and programs
Villanti, A., & Abrams, D. (n.d.). In M. Gellman & J. Turner (Eds.), Encyclopedia of Behavioral Medicine (1–).Publication year
2013A ban on menthol cigarettes: Impact on public opinion and smokers' intention to quit
AbstractPearson, J. L., Abrams, D. B., Niaura, R. S., Richardson, A., & Vallone, D. M. (n.d.).Publication year
2012Journal title
American journal of public healthVolume
102Issue
11Page(s)
e107-e114AbstractObjectives. We assessed support for a ban by the Food and Drug Administration on menthol in cigarettes and behavioral intentions among menthol smokers in the event of such a ban. Methods. We surveyed 2649 never, former, and current smokers and used ordinal logistic regression to calculate weighted point estimates and predictors of support for a menthol ban among the adult population and menthol smokers only. For menthol smokers, we also calculated weighted point estimates and predictors of behavioral intentions. Results. Overall, 28.2% of adults opposed, 20.0% supported, and 51.9% lacked a strong opinion about a menthol ban. Support was highest among Hispanics (36.4%), African Americans (29.0%), never smokers (26.8%), and respondents with less than a high school education (28.8%). Nearly 40% of menthol smokers said they would quit if menthol cigarettes were no longer available, 12.5% would switch to a nonmenthol brand, and 25.2% would both switch and try to quit. Conclusions. Support for a menthol ban is strongest among populations with the highest prevalence of menthol cigarette use. A menthol ban might motivate many menthol smokers to quit.A transdisciplinary approach to protocol development for tobacco control research: A case study
AbstractClark, M. A., Rogers, M. L., Boergers, J., Kahler, C. W., Ramsey, S., Saadeh, F. M., Abrams, D. B., Buka, S. L., Niaura, R., & Colby, S. M. (n.d.).Publication year
2012Journal title
Translational Behavioral MedicineVolume
2Issue
4Page(s)
431-440AbstractThe increasing complexity of scientific problems related to lifestyle risk factors has prompted substantial investments in transdisciplinary or team science initiatives at the biological, psychosocial, and population levels of analysis. To date, the actual process of conducting team science from the perspectives of investigators engaged in it has not been well documented. We describe the experience of developing and implementing data collection protocols using the principles of transdisciplinary science. The New England Family Study Transdisciplinary Tobacco Use Research Center was a 10-year collaboration involving more than 85 investigators and consultants from more than 20 disciplines as well as more than 50 research staff. We used a two-phase process in which all the study personnel participated in the developing and testing of 160 instruments. These instruments were used in 4,378 assessments with 3,501 participants. With substantial effort, it is possible to build a team of scientists from diverse backgrounds that can develop a set of instruments using a shared conceptual approach, despite limited or no experience working together previously.Are smokers with HIV using information and communication technology? implications for behavioral interventions
AbstractChander, G., Stanton, C., Hutton, H. E., Abrams, D. B., Pearson, J., Knowlton, A., Latkin, C., Holtgrave, D., Moore, R. D., & Niaura, R. (n.d.).Publication year
2012Journal title
AIDS and BehaviorVolume
16Issue
2Page(s)
383-388AbstractSmoking is highly prevalent among persons living with HIV/AIDS (PLWHA) and associated with adverse outcomes including malignancy and cardiovascular disease. Information and communication technology (ICT) may be effective in disseminating cessation interventions among PLWHA. This study examines the prevalence of ICT use among 492 PLWHA attending an urban clinic and characteristics associated with ICT use. Participants completed a survey of demographics, smoking status, and ICT use. Factors associated with ICT use were examined with logistic regression. Overall, 63% of participants smoked with 73% of smokers owning their own cell phone. Use of other modalities was lower, with 48% of smokers reporting any internet use, 39% text messaging, and 31% using email. Higher education was associated with the use of all modalities. Cell phone interventions may have the broadest reach among PLWHA, though with almost half using the internet, this may also be a low-cost means of delivering cessation interventions.Development and reliability of the lifetime interview on smoking trajectories
AbstractColby, S. M., Clark, M. A., Rogers, M. L., Ramsey, S., Graham, A. L., Boergers, J., Kahler, C. W., Papandonatos, G. D., Buka, S. L., Niaura, R. S., & Abrams, D. B. (n.d.).Publication year
2012Journal title
Nicotine and Tobacco ResearchVolume
14Issue
3Page(s)
290-298AbstractIntroduction: Assessments of lifetime smoking history are useful in many types of research including surveillance, epidemiology, prevention, intervention, and studies of genetic phenotypes and heritability. Because prospective assessment is impractical for most research, our objective was to develop a reliable retrospective measure of lifetime smoking history. This paper presents descriptive and test-retest reliability data on smoking history variables assessed using the Lifetime Interview on Smoking Trajectories (LIST). Methods: Data were collected on a birth cohort sample of 1,625 men and women (ages 34-44) from the Collaborative Perinatal Project. A subsample of 344 was invited to participate in a retest interview 4-8 weeks later and 220 participated. Indices of test-retest reliability were evaluated for smoking history variables, including: (a) early smoking experiences; (b) age at various smoking milestones, such as first puff, and progression to weekly and daily smoking; (c) smoking rate and time to first cigarette within initial, current, most recent, and heaviest phases; and (d) prolonged nonsmoking phases. Results: Responses to whether each of 5 major smoking milestones occurred were all highly reliable (k = .78 - .92), and of the 20 phase-specific variables assessed, more than half were reported at the highest level of reliability. None of the variables demonstrated low reliability. Conclusions: Although retrospective reports have unavoidable limitations, our findings indicate that the LIST is a reliable instrument for assessing detailed retrospective smoking history data and can be used to add to the knowledge base of how patterns of use relate to a variety of outcomes of interest.E-cigarette awareness, use, and harm perceptions in US adults
AbstractPearson, J. L., Richardson, A., Niaura, R. S., Vallone, D. M., & Abrams, D. B. (n.d.).Publication year
2012Journal title
American journal of public healthVolume
102Issue
9Page(s)
1758-1766AbstractObjectives. We estimated e-cigarette (electronic nicotine delivery system) awareness, use, and harm perceptions among US adults. Methods. We drew data from 2 surveys conducted in 2010: a national online study (n = 2649) and the Legacy Longitudinal Smoker Cohort (n = 3658). We used multivariable models to examine e-cigarette awareness, use, and harm perceptions. Results. In the online survey, 40.2% (95% confidence interval [CI] = 37.3, 43.1) had heard of e-cigarettes, with awareness highest among current smokers. Utilization was higher among current smokers (11.4%; 95% CI = 9.3, 14.0) than in the total population (3.4%; 95% CI = 2.6, 4.2), with 2.0% (95% CI = 1.0, 3.8) of former smokers and 0.8% (95% CI = 0.35, 1.7) of never-smokers ever using e-cigarettes. In both surveys, non-Hispanic Whites, current smokers, young adults, and those with at least a high-school diploma were most likely to perceive e-cigarettes as less harmful than regular cigarettes. Conclusions. Awareness of e-cigarettes is high, and use among current and former smokers is evident. We recommend product regulation and careful surveillance to monitor public health impact and emerging utilization patterns, and to ascertain why, how, and under what conditions e-cigarettes are being used.