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

Obsolete tobacco control themes can be hazardous to public health : The need for updating views on absolute product risks and harm reduction

Abrams, D., Kozlowski, L. T., & Abrams, D. B. (n.d.).

Publication year

2016

Journal title

BMC public health

Volume

16

Issue

1

10.1186/s12889-016-3079-9

Abstract

Abstract

Background: Leading themes have guided tobacco control efforts, and these themes have changed over the decades. When questions arose about health risks of tobacco, they focused on two key themes: 1) how bad is the problem (i.e., absolute risk) and 2) what can be done to reduce the risk without cessation (i.e., prospects for harm reduction). Using the United States since 1964 as an example, we outline the leading themes that have arisen in response to these two questions. Initially, there was the recognition that "cigarettes are hazardous to health" and an acceptance of safer alternative tobacco products (cigars, pipes, light/lower-tar cigarettes). In the 1980s there was the creation of the seminal theme that "Cigarettes are lethal when used as intended and kill more people than heroin, cocaine, alcohol, AIDS, fires, homicide, suicide, and automobile crashes combined." By around 2000, support for a less-dangerous light/lower tar cigarette was gone, and harm reduction claims were avoided for products like cigars and even for smokeless tobacco which were summarized as "unsafe" or "not a safe alternative to cigarettes." Discussion: The Surgeon General in 2014 concluded that by far the greatest danger to public health was from cigarettes and other combusted products. At the same time the evidence base for smokeless tobacco and alternative nicotine delivery systems (ANDS) had grown. Product innovation and tobacco/nicotine bio-behavioral, epidemiological and public health sciences demonstrate that low nitrosamine smokeless tobacco (e.g., Swedish snus), and ANDS have substantially lower harms than cigarettes. Going forward, it is important to sharpen themes and key messages of tobacco control, while continuing to emphasize the extreme lethality of the inhaled smoke from cigarettes or from use of any combusting tobacco product. Summary: Implications of updating the leading themes for regulation, policymaking and advocacy in tobacco control are proposed as an important next step. A new reframing can align action plans to more powerfully and rapidly achieve population-level benefit and minimize harm to eliminate in our lifetime the use of the most deadly combustible tobacco products and thus prevent the premature deaths of 1 billion people projected to occur worldwide by 2100.

Patterns of electronic cigarette use among adults in the United States

Abrams, D., Delnevo, C. D., Giovenco, D. P., Steinberg, M. B., Villanti, A. C., Pearson, J. L., Niaura, R. S., & Abrams, D. B. (n.d.).

Publication year

2016

Journal title

Nicotine and Tobacco Research

Volume

18

Issue

5

Page(s)

715-719

10.1093/ntr/ntv237

Abstract

Abstract

Introduction: Amid increasing rates of electronic cigarette (e-cigarette) use in the United States, there is an urgent need to monitor patterns of use at the population level in order to inform practice, policy and regulation. This article examines how patterns of e-cigarette use among adults differ between users and nonusers of cigarettes using the most current national data. Methods: We analyzed data from the 2014 National Health Interview Survey. We estimated prevalence of ever, current, and daily e-cigarette use and examined how use patterns differed by demographic subgroups and measures of cigarette smoking status that accounted for the recent availability of e-cigarettes in the US marketplace. Results: Current e-cigarette use is extremely low among never cigarette smokers (0.4%) and former smokers who quit cigarettes 4 or more years ago (0.8%). Although e-cigarette experimentation is most common among current cigarette smokers and young adults, daily use is highest among former smokers who quit in the past year (13.0%) and older adults. Compared to daily cigarette smokers, recently quit smokers were more than four times as likely to be daily users of e-cigarettes (AOR: 4.33 [95% CI: 3.08-6.09]). Conclusions: Extremely low e-cigarette use among never-smokers and longer term former smokers suggest that e-cigarettes neither promote widespread initiation nor relapse among adults. Recognition of the heterogeneity of smokers, including the time since quitting, is critical to draw accurate conclusions about patterns of e-cigarette use at the population level and its potential for public health benefit or harm. Implications: Data from 2014 National Health Interview Survey indicate that e-cigarettes have not been attracting adult non-smokers or promoting relapse in longer term former smokers. Moreover, the data are suggestive that some recent quitters may have done so with the assistance of e-cigarettes. Creating measures of smoking status that treat former smokers as a homogenous group is insufficient to assess the epidemiology of e-cigarette use and the potential impact on public health.

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 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.

Young adult smokers' neural response to graphic cigarette warning labels

Abrams, D., Green, A. E., Mays, D., Falk, E. B., Vallone, D., Gallagher, N., Richardson, A., Tercyak, K. P., Abrams, D. B., & Niaura, R. S. (n.d.).

Publication year

2016

Journal title

Addictive Behaviors Reports

Volume

3

Page(s)

28-32

10.1016/j.abrep.2016.02.001

Abstract

Abstract

Introduction: The study examined young adult smokers' neural response to graphic warning labels (GWLs) on cigarette packs using functional magnetic resonance imaging (fMRI). Methods: Nineteen young adult smokers (M age 22.9, 52.6% male, 68.4% non-white, M 4.3 cigarettes/day) completed pre-scan, self-report measures of demographics, cigarette smoking behavior, and nicotine dependence, and an fMRI scanning session. During the scanning session participants viewed cigarette pack images (total 64 stimuli, viewed 4 s each) that varied based on the warning label (graphic or visually occluded control) and pack branding (branded or plain packaging) in an event-related experimental design. Participants reported motivation to quit (MTQ) in response to each image using a push-button control. Whole-brain blood oxygenation level-dependent (BOLD) functional images were acquired during the task. Results: GWLs produced significantly greater self-reported MTQ than control warnings (p < .001). Imaging data indicate stronger neural activation in response to GWLs than the control warnings at a cluster-corrected threshold p < .001 in medial prefrontal cortex, amygdala, medial temporal lobe, and occipital cortex. There were no significant differences in response to warnings on branded versus plain cigarette packages. Conclusions: In this sample of young adult smokers, GWLs promoted neural activation in brain regions involved in cognitive and affective decision-making and memory formation and the effects of GWLs did not differ on branded or plain cigarette packaging. These findings complement other recent neuroimaging GWL studies conducted with older adult smokers and with adolescents by demonstrating similar patterns of neural activation in response to GWLs among young adult smokers.

Cigarettes: The Rise and Decline But Not Demise of the Greatest Behavioral Health Disaster of the 20th Century

Abrams, D., Abrams, D. S., Glasser, A., Villanti, A., & Niaura, R. S. (n.d.). (R. Kaplan, M. Spittel, & D. David, Eds.).

Publication year

2015

Page(s)

143-168

Abstract

Abstract

~

Differential trends in cigarette smoking in the USA : Is menthol slowing progress?

Abrams, D., Giovino, G. A., Villanti, A. C., Mowery, P. D., Sevilimedu, V., Niaura, R. S., Vallone, D. M., & Abrams, D. B. (n.d.).

Publication year

2015

Journal title

Tobacco control

Volume

24

Issue

1

Page(s)

28-37

10.1136/tobaccocontrol-2013-051159

Abstract

Abstract

Introduction: Mentholated cigarettes are at least as dangerous to an individual’s health as non-mentholated varieties. The addition of menthol to cigarettes reduces perceived harshness of smoke, which can facilitate initiation. Here, we examine correlates of menthol use, national trends in smoking menthol and non-menthol cigarettes, and brand preferences over time.Methods: We estimated menthol cigarette use during 2004–2010 using annual data on persons ≥12 years old from the National Surveys on Drug Use and Health. We adjusted self-reported menthol status for selected brands that were either exclusively menthol or nonmenthol, based on sales data. Data were weighted to provide national estimates.Results: Among cigarette smokers, menthol cigarette use was more common among 12–17 year olds (56.7%) and 18–25 year olds (45.0%) than among older persons (range 30.5% to 34.7%). In a multivariable analysis, menthol use was associated with being younger, female and of non-Caucasian race/ethnicity. Among all adolescents, the percentage who smoked non-menthol cigarettes decreased from 2004–2010, while menthol smoking rates remained constant; among all young adults, the percentage who smoked non-menthol cigarettes also declined, while menthol smoking rates increased. The use of Camel menthol and Marlboro menthol increased among adolescent and young adult smokers, particularly non-Hispanic Caucasians, during the study period.Conclusions: Young people are heavy consumers of mentholated cigarettes. Progress in reducing youth smoking has likely been attenuated by the sale and marketing of mentholated cigarettes, including emerging varieties of established youth brands. This study should inform the Food and Drug Administration regarding the potential public health impact of a menthol ban.

Incorporating a Smoking Cessation Intervention into Lung Cancer Screening Programs : Preliminary Studies

Abrams, D., Hagerman, C. J., Tomko, C. A., Stanton, C. A., Kramer, J. A., Abrams, D. B., Anderson, E. D., & Taylor, K. L. (n.d.).

Publication year

2015

Journal title

Journal of Psychosocial Oncology

Volume

33

Issue

6

Page(s)

703-723

10.1080/07347332.2015.1082171

Abstract

Abstract

Two preliminary studies assessed whether telephone counseling (TC) is a feasible smoking cessation intervention following lung cancer screening. Seven older smokers undergoing lung cancer screening (pack years = 61.5) completed three TC sessions, which incorporated the screening result as motivation to quit. Participation (87.5%) and retention (85.7%) rates were good, and four smokers quit smoking (three of whom received abnormal results). We conducted four focus groups with 16 current and former older smokers (pack years = 55). Most believed that an abnormal scan would motivate them to quit and expressed interest in TC. TC may be feasible and potentially efficacious within lung screening programs.

Internet and telephone treatment for smoking cessation : Mediators and moderators of short-term abstinence

Abrams, D., Graham, A. L., Papandonatos, G. D., Cobb, C. O., Cobb, N. K., Niaura, R. S., Abrams, D. B., & Tinkelman, D. G. (n.d.).

Publication year

2015

Journal title

Nicotine and Tobacco Research

Volume

17

Issue

3

Page(s)

299-308

10.1093/ntr/ntu144

Abstract

Abstract

Introduction: This study examined mediators and moderators of short-term treatment effectiveness from the iQUITT Study (Quit Using Internet and Telephone Treatment), a 3-arm randomized trial that compared an interactive smoking cessation Web site with an online social network (enhanced Internet) alone and in conjunction with proactive telephone counseling (enhanced Internet plus phone) to a static Internet comparison condition (basic Internet). Methods: The analytic sample was N = 1,236 participants with complete 3-month data on all mediating variables. The primary outcome was 30-day point prevalence abstinence (ppa) at 3 months. Recognizing the importance of temporal precedence in mediation analyses, we also present findings for 6-month outcomes. Purported mediators were treatment utilization and changes in psychosocial constructs. Proposed moderators included baseline demographic, smoking, and psychosocial variables. Mediation analyses examined the extent to which between-arm differences in 30-day ppa could be attributed to differential Web site utilization, telephone counseling, and associated changes in smoking self-efficacy and social support for quitting. Effect modification analyses fitted interactions between treatment and prespecified moderators on abstinence. Results: Significant mediators of 30-day ppa were changes in smoking temptations, quitting confidence, and positive and negative partner support, which were strongly associated with increased Web site utilization. The addition of telephone counseling to an enhanced Web site further improved abstinence rates, partly via an association with increased quitting confidence. Baseline smoking rate was the only significant moderator. Conclusions: Increased treatment utilization and associated changes in several psychosocial measures yielded higher abstinence rates. Findings validate the importance of treatment utilization, smoking self-efficacy, and social support to promote abstinence.

Markov Modeling to Estimate the Population Impact of Emerging Tobacco Products: A Proof-Of-Concept Study

Abrams, D. (n.d.).

Publication year

2015

Journal title

Tobacco Regulatory Science

Volume

1

Issue

2

Page(s)

121-41

Abstract

Abstract

~

National enforcement of the Family Smoking Prevention and Tobacco Control Act at point-of-sale

Abrams, D., Kirchner, T., Villanti, A. C., Tacelosky, M., Anesetti-Rothermel, A., Gao, H., Pearson, J. L., Ganz, O., Cantrell, J., Vallone, D., & Abrams, D. S. (n.d.).

Publication year

2015

Journal title

Tobacco Regulatory Science

Volume

1

Issue

1

Page(s)

24-35

Abstract

Abstract

~

NIH electronic cigarette workshop : Developing a research agenda

Abrams, D., Walton, 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

2015

Journal title

Nicotine and Tobacco Research

Volume

17

Issue

2

Page(s)

259-269

10.1093/ntr/ntu214

Abstract

Abstract

Background: 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.

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.

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.

Cameras for public health surveillance : A methods protocol for crowdsourced annotation of point-of-sale photographs

Abrams, D., Ilakkuvan, V., Tacelosky, M., Ivey, K. C., Pearson, J. L., Cantrell, J., Vallone, D. M., Abrams, D. B., & Kirchner, T. R. (n.d.).

Publication year

2014

Journal title

JMIR Research Protocols

Volume

3

Issue

2

10.2196/resprot.3277

Abstract

Abstract

Background: 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

Erratum : Exploring scenarios to dramatically reduce smoking prevalence: a simulation model of the three-part cessation process (American Journal of Public Health (2010) 100:7 (1253-1259) DOI: 10.2105/AJPH.2009.166785)

Abrams, D., Levy, D. T., Mabry, P. L., Graham, A. L., Orleans, C. T., & Abrams, D. B. (n.d.).

Publication year

2014

Journal title

American journal of public health

Volume

104

Issue

2

Page(s)

e4

10.2105/AJPH.2009.166785e

Abstract

Abstract

~

Future directions for postdoctoral training in cancer prevention : Insights from a panel of experts

Abrams, D., Nelson, 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

2014

Journal title

Cancer Epidemiology Biomarkers and Prevention

Volume

23

Issue

4

Page(s)

679-683

10.1158/1055-9965.EPI-13-1209

Abstract

Abstract

Cancer 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

Abrams, D., Villanti, A., Abrams, D. S., & Delnevo, C. (n.d.).

Publication year

2014

Journal title

Health Behavior and Policy Review

Volume

1

Issue

2

Page(s)

97-102

Abstract

Abstract

~

Motivational interviewing versus brief advice for cigarette smokers in residential alcohol treatment

Abrams, D., Rohsenow, 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

2014

Journal title

Journal of Substance Abuse Treatment

Volume

46

Issue

3

Page(s)

346-355

10.1016/j.jsat.2013.10.002

Abstract

Abstract

Residential 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

Abrams, D., Richardson, A., Ganz, O., Stalgaitis, C., Abrams, D. S., & Vallone, D. (n.d.).

Publication year

2014

Journal title

Nicotine and Tobacco Research

Volume

16

Issue

5

Page(s)

606-614

10.1093/ntr/ntt200

Abstract

Abstract

Background: 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., & Abrams, D. S. (n.d.).

Publication year

2014

Journal title

JAMA

Volume

311

Issue

18

Page(s)

1922-3

Abstract

Abstract

~

Promise and peril of e-cigarettes can disruptive technology make cigarettes obsolete?

Abrams, D., & Abrams, D. B. (n.d.).

Publication year

2014

Journal title

JAMA - Journal of the American Medical Association

Volume

311

Issue

2

Page(s)

135-136

10.1001/jama.2013.285347

Abstract

Abstract

~

The Changing Landscape of Tobacco Control Current Status and Future Directions

Abrams, D., Abrams, D. S., Villanti, A., & Warner, K. (n.d.).

Publication year

2014

Page(s)

845-64

Abstract

Abstract

~

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

~

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.