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

Bupropion and cognitive-behavioral treatment for depression in smoking cessation

Brown, R. A., Niaura, R., Lloyd-Richardson, E. E., Strong, D. R., Kahler, C. W., Abrantes, A. M., Abrams, D., & Miller, I. W.

Publication year

2007

Journal title

Nicotine and Tobacco Research

Volume

9

Issue

7

Page(s)

721-730

10.1080/14622200701416955

Abstract

Abstract

This study is a randomized, double-blind, placebo-controlled clinical trial examining the effects of an intensive cognitive-behavioral mood management treatment (CBTD) and of bupropion, both singularly and in combination, on smoking cessation in adult smokers. As an extension of our previous work, we planned to examine the synergistic effects of CBTD and bupropion on smoking cessation outcomes in general and among smokers with depression vulnerability factors. Participants were 524 smokers (47.5% female, Mage=44.27 years) who were randomized to one of four 12-week treatments: (a) standard, cognitive-behavioral smoking cessation treatment (ST) plus bupropion (BUP), (b) ST plus placebo (PLAC), (c) standard cessation treatment combined with cognitive-behavioral treatment for depression (CBTD) plus BUP, and (d) CBTD plus PLAC. Follow-up assessments were conducted 2, 6, and 12 months after treatment, and self-reported abstinence was verified biochemically. Consistent with previous studies, bupropion, in comparison with placebo, resulted in better smoking outcomes in both intensive group treatments. Adding CBTD to standard intensive group treatment did not result in improved smoking cessation outcomes. In addition, neither CBTD nor bupropion, either alone or in combination, was differentially effective for smokers with single-past-episode major depressive disorder (MDD), recurrent MDD, or elevated depressive symptoms. However, findings with regard to recurrent MDD and elevated depressive symptoms should be interpreted with caution given the low rate of recurrent MDD and the low level of depressive symptoms in our sample. An a priori test of treatment effects in smokers with these depression vulnerability factors is warranted in future clinical trials.

Comprehensive Smoking Cessation: Systems Integration to Save Lives and Money

Abrams, D. In Ending the Tobacco Problem: A Blueprint for the Nation.

Publication year

2007

Page(s)

A1-A50

Applying transdisciplinary research strategies to understanding and eliminating health disparities

Abrams, D. B.

Publication year

2006

Journal title

Health Education and Behavior

Volume

33

Issue

4

Page(s)

515-531

10.1177/1090198106287732

Abstract

Abstract

This overview for the special issue of Health Education & Behavior on "Health Disparities and Social Inequities" briefly outlines the transdisciplinary (TD) approach to research and examines the scope of TD science. The need to embrace basic science as well as several domains of applied research is discussed along the TD "pipeline" from discovery to development to delivery to policy. The overview concludes with selected examples of the emerging TD science of disparities. One central challenge for a TD approach is the need to strengthen what is being called "the science of dissemination" along with improving the "dissemination of evidence-based science.".

Characteristics of smokers reached and recruited to an internet smoking cessation trial: A case of denominators

Graham, A. L., Bock, B. C., Cobb, N. K., Niaura, R., & Abrams, D. B.

Publication year

2006

Journal title

Nicotine and Tobacco Research

Volume

8

Page(s)

S43-48

10.1080/14622200601042521

Abstract

Abstract

The Internet can deliver smoking cessation interventions to large numbers of smokers. Little is known about the feasibility, reach, or efficacy of Internet cessation interventions. Virtually no data exist on who enrolls in cessation programs or on differences between those who complete enrollment and those who do not. This paper reports recruitment and enrollment findings for the first 764 participants in an ongoing randomized controlled trial that tested the efficacy of a widely disseminated Internet smoking cessation service (www.QuitNet.com) alone and in conjunction with telephone counseling. Study participants were recruited through Internet search engines using an active user sampling protocol. During the first 16 weeks of the study, 28,297 individuals were invited. Of those, 11,147 accepted the invitation, 5,557 screened eligible, 3,614 were recruited, 1,489 provided online informed consent, and 764 were confirmed eligible and enrolled. Of those who were at least curious about a cessation trial (n=11,147), 6.9% enrolled. Of those who were eligible and recruited (n=3,614), 21.1% enrolled. Depending on the denominator selected, results suggest that 7% to 21% of smokers interested in cessation will enroll into a research trial. Internet recruitment provides unique challenges and opportunities for managing sample recruitment, analyzing subsamples to determine generalizability, and understanding the characteristics of individuals who participate in online research.

Correlates of motivation to quit smoking among alcohol dependent patients in residential treatment

Martin, R. A., Rohsenow, D. J., MacKinnon, S. V., Abrams, D. B., & Monti, P. M.

Publication year

2006

Journal title

Drug and alcohol dependence

Volume

83

Issue

1

Page(s)

73-78

10.1016/j.drugalcdep.2005.10.013

Abstract

Abstract

Substance use and smoking co-occur at high rates and substance abusers smoke more and have greater difficulty quitting smoking compared to the general population. Methods of increasing smoking cessation among alcoholics are needed to improve their health. This study investigated predictors of motivation to quit smoking among patients early in residential treatment for substance abuse. The 198 alcohol dependent patients were participating is a larger smoking study at an inner-city residential substance abuse treatment program. Motivation was measured by the Contemplation Ladder. A hierarchical multiple regression was conducted to assess whether perceived barriers to smoking cessation and self-efficacy about quitting were associated with motivation to quit smoking independent of the influence of degree of tobacco involvement, substance use, and comorbid depressive symptoms. Motivation was higher with longer previous smoking abstinence, fewer barriers to quitting, and greater self-efficacy but was not influenced by smoking rate, dependence, or gender. While the combination of alcohol and drug use, alcohol and drug problem severity, and depressive symptoms predicted motivation, no one of these variables was significant. Since barriers to change and self-efficacy are potentially modifiable in treatment, these could be salient targets for intervention efforts. This could be integrated into treatment by assessing barriers and providing corrective information about consequences and methods of overcoming barriers and by providing coping skills to increase confidence in one's ability to quit smoking.

External validity: We need to do more

Internet- vs. Telephone-administered questionnaires in a randomized trial of smoking cessation

Graham, A. L., Papandonatos, G. D., Bock, B. C., Cobb, N. K., Baskin-Sommers, A., Niaura, R., & Abrams, D. B.

Publication year

2006

Journal title

Nicotine and Tobacco Research

Volume

8

Page(s)

S49-57

10.1080/14622200601045367

Abstract

Abstract

The Internet offers a promising channel to conduct smoking cessation research. Among the advantages of Internet research are the ability to access large numbers of participants who might not otherwise participate in a cessation trial, and the ability to conduct research efficiently and cost-effectively. To leverage the opportunity of the Internet in clinical research, it is necessary to establish that measures of known validity used in research trials are reliable when administered via the Internet. To date, no published studies examine the psychometric properties of measures administered via the Internet to assess smoking variables and psychosocial constructs related to cessation (e.g., stress, social support, quit methods). The purpose of the present study was to examine the reliability of measures of previous quit methods, perceived stress, depression, social support for cessation, smoking temptations, alcohol use, perceived health status, and income when administered via the Internet. Participants in the present study were enrolled in a randomized controlled trial of the efficacy of Internet smoking cessation. Following baseline telephone assessment and randomization into the parent trial, participants were recruited to the reliability substudy. An email was sent 2 days after the telephone assessment with a link to the Internet survey and instructions to complete the survey that day. Of the 297 individuals invited to participate, 213 completed the survey within 1 week. Results indicate that the internal consistency and test-retest reliability of the measures examined are comparable when self-administered via the Internet or when interviewer-administered via telephone.

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

Dierker, L., Lloyd-Richardson, E., Stolar, M., Flay, B., Tiffany, S., Collins, L., Bailey, S., Nichter, M., Nichter, M., Clayton, R., Abrams, D., Balster, R., Dahl, R., Giovino, G., Henningfield, J., Koob, G., McMahon, R., Merikangas, K., Shiffman, S., Prager, D., Segress, M., Agnew, C., Colder, C., Donny, E., Dorn, L., Eissenberg, T., Flaherty, B., Liang, L., Maylath, N., Shadel, W., & Stroud, L.

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.

Home health care nurses as a new channel for smoking cessation treatment: Outcomes from project CARES (Community-nurse Assisted Research and Education on Smoking)

Borrelli, B., Novak, S., Hecht, J., Emmons, K., Papandonatos, G., & Abrams, D.

Publication year

2005

Journal title

Preventive Medicine

Volume

41

Issue

5

Page(s)

815-821

10.1016/j.ypmed.2005.08.004

Abstract

Abstract

Background. Clinical guidelines for smoking cessation may not be sufficient for helping some subgroups of smokers quit. Incorporating smoking cessation into home-based medical care can proactively reach high-risk smokers who may not have access to (or spontaneously seek) smoking cessation. Method. Home health care nurses (N = 98) were randomly assigned to deliver either Motivational Enhancement (ME; Motivational Interviewing + Carbon Monoxide Feedback) or Standard Care (AHCPR Guidelines for smoking cessation) to their patients. Seventy percent of patients were eligible and willing to participate (N = 273; 54% female, mean age = 57 years, 83% Caucasian, 41% < high school education). The study was conducted in Providence, RI, USA from 1998 to 2003. Results. Biochemically verified continuous abstinence rates at the 12-month follow-up were 4.2% (SC) and 8.7% (ME) for intent to treat analyses, and 5.2% (SC) and 11.8% (ME) using all available cases (P > 0.05). ME reported more quit attempts and significantly greater reductions in the number of cigarettes smoked per day at all follow-ups through 12 months of post-treatment (all P values < 0.05). Conclusions. Use of an existing public health channel such as home health care to reach smokers who vary in their motivation to quit could have the potential for large public health impact.

Initial evaluation of a real-world internet smoking cessation system

Cobb, N. K., Graham, A. L., Bock, B. C., Papandonatos, G., & Abrams, D. B.

Publication year

2005

Journal title

Nicotine and Tobacco Research

Volume

7

Issue

2

Page(s)

207-216

10.1080/14622200500055319

Abstract

Abstract

To significantly reduce smoking prevalence, treatments must balance reach, efficacy, and cost. The Internet can reach millions of smokers cost-effectively. Many cessation Web sites exist, but few have been evaluated. As a result, the potential impact of the Internet on smoking prevalence remains unknown. The present study reports the results, challenges, and limitations of a preliminary, large-scale evaluation of a broadly disseminated smoking cessation Web site used worldwide (QuitNet). Consecutive registrants (N=1,501) were surveyed 3 months after they registered on the Web site to assess 7-day point prevalence abstinence. Results must be interpreted cautiously because this is an uncontrolled study with a 25.6% response rate. Approximately 30% of those surveyed indicated they had already quit smoking at registration. Excluding these participants, an intention-to-treat analysis yielded 7% point prevalence abstinence (for the responders only, abstinence was 30%). A range of plausible cessation outcomes (9.8%-13.1%) among various subgroups is presented to illustrate the strengths and limitations of conducting Web-based evaluations, and the tensions between clinical and dissemination research methods. Process-to-outcome analyses indicated that sustained use of QuitNet, especially the use of social support, was associated with more than three times greater point prevalence abstinence and more than four times greater continuous abstinence. Despite its limitations, the present study provides useful information about the potential efficacy, challenging design and methodological issues, process-to-outcome mechanisms of action, and potential public health impact of Internet-based behavior change programs for smoking cessation.

Reducing the cancer burden of lifestyle factors: Opportunities and challenges of the internet

Graham, A. L., & Abrams, D. B.

Publication year

2005

Journal title

Journal of medical Internet research

Volume

7

Issue

3

10.2196/jmir.7.3.e26

Abstract

Abstract

This paper focuses on the Internet as a tool for enhancing behavior and lifestyle changes to reduce the burden of cancer at a population level. The premise of this paper is that the Internet can and should be leveraged to bridge the chasm between basic science, clinical trials, and public health. Our focus is specifically on the opportunity to disseminate effective behavioral science interventions via the Internet in order to decrease the prevalence of behavioral risk factors for cancer. The examples herein are primarily drawn from tobacco use to illustrate issues that can be applied more generally to other behavioral risk factors for cancer. Four areas will be addressed: (1) the scientific basis and rationale for delivering lifestyle behavior change interventions via the Internet; (2) the need to determine the quality of Internet interventions; (3) methodological considerations in conducting evaluations of Internet interventions; and (4) recommendations for a transdisciplinary approach to Internet intervention development and evaluation.

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

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

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<.05), composed with the CBT group. No group diffrences were found at 12 months by either 7-day point prevalence (7.3% for CBT+EX vs. 8.3% for CBT) or continuous abstinence (0.9% for CBT+EX vs. 0.9% for CBT). Additionally, among participants in the CBT+EX group, those with higher to the exercise prescription were significantly more likely to achieve smoking cessation at the end of treatment than were participants reporting lower adherence to exercise our findings indicate that the emperical support for moderate-intensity exercise as an adjunctive treatment to CBT for smoking cessation may be limited. Perhaps future studies could compare moderate vs. vigorous-intensity physical activity to test their relative efficacy.

Adolescents' responses to the gender valence of cigarette advertising imagery: The role of affect and the self-concept

Shadel, W. G., Niaura, R., & Abrams, D. B.

Publication year

2004

Journal title

Addictive Behaviors

Volume

29

Issue

9

Page(s)

1735-1744

10.1016/j.addbeh.2004.03.042

Abstract

Abstract

The studies presented in this manuscript evaluated the role that affect and the self-concept play in adolescent never smokers' reactions to the gender valence of cigarette advertising imagery. Study 1 (n=29; 59% female) revealed that adolescent females have more positive affective reactions to female-valenced cigarette advertising imagery compared to male-valenced cigarette advertising imagery. Study 2 (n=101; 56% female) revealed that adolescent females viewed female-valenced cigarette advertising imagery as more relevant to their self-concepts compared to male-valenced cigarette advertising imagery. Across both studies, male adolescents did not respond differently as a function of the gender valence of cigarette advertising imagery. Thus, female-valenced cigarette advertising imagery may have specific effects on never smoking female adolescents by enhancing positive affect and suggesting that women who smoke hold the same characteristics as do the young women themselves.

Developing an integrative social-cognitive strategy for personality assessment at the level of the individual: An illustration with regular cigarette smokers

Shadel, W. G., Cervone, D., Niaura, R., & Abrams, D. B.

Publication year

2004

Journal title

Journal of Research in Personality

Volume

38

Issue

4

Page(s)

394-419

10.1016/j.jrp.2003.09.001

Abstract

Abstract

Basic advances in social cognition have not fully translated into similar advances for personality assessment. In this study, we evaluated whether an integrated social cognitive approach to personality assessment (i.e., one that employs an idiographic assessment of a multi-faceted self-system, priming procedures, and reaction time tasks) could be applied to assess a social cognitive personality system at the individual level in a particularly challenging population: Cigarette smokers. This integrative approach was necessary to detect the idiosyncratic content and contextualized structure of the three self-schemas (smoker self-schema, abstainer ideal possible self, abstainer ought possible self) that composed this social cognitive personality system. Priming different self-structures enhanced reaction times to contextually bound self-referent information. Results are discussed in terms of their implications for social cognitive theories of personality and personality assessment.

Effects of tobacco deprivation on alcohol cue reactivity and drinking among young adults

Colby, S. M., Rohsenow, D. J., Monti, P. M., Gwaltney, C. J., Gulliver, S. B., Abrams, D. B., Niaura, R. S., & Sirota, A. D.

Publication year

2004

Journal title

Addictive Behaviors

Volume

29

Issue

5

Page(s)

879-892

10.1016/j.addbeh.2004.03.002

Abstract

Abstract

Nicotine and alcohol may have common neurobiological mechanisms of reinforcement. Therefore, withholding one substance might result in compensatory increases in self-administration of the other. This laboratory study investigated the effects of brief tobacco deprivation on alcohol cue-elicited urges to drink, corresponding psychophysiological reactions, and alcohol consumption. Young adults (N=78) who were moderate to heavy smokers and drinkers were stratified and randomized to a 2×2 design. Participants were either deprived of tobacco for 5 h or not deprived and then exposed to in vivo alcohol or control beverage cues. Subsequently, participants engaged in a taste-rating task as an unobtrusive measure of alcohol consumption. Tobacco deprivation resulted in increased urge to smoke and decreased cardiovascular responses but did not increase alcohol urges or alcohol consumption. Results indicate that brief tobacco deprivation does not result in compensatory increases in alcohol consumption among young moderate to heavy drinkers.

Investigating the big five personality factors and smoking: Implications for assessment

Shadel, W. G., Cervone, D., Niaura, R., & Abrams, D. B.

Publication year

2004

Journal title

Journal of Psychopathology and Behavioral Assessment

Volume

26

Issue

3

Page(s)

185-191

10.1023/B:JOBA.0000022111.13381.0c

Abstract

Abstract

Global personality dispositions may be important for understanding population-based individual differences in smoking outcomes, yet few studies have been executed using measures of these global dispositional constructs from the contemporary field of personality. This study explored whether the Big Five personality factors (Extraversion, Neuroticism, Agreeableness, Conscientiousness, and Intellect) were concurrently associated with key smoking (e.g., nicotine dependence, smoking rate, age at first cigarette) and cessation (e.g., self-efficacy to quit, motivation to quit, number of prior quit attempts, length of most recent quit) variables in a sample of regular smokers (n = 130). Of the 35 correlations computed, only 2 were significant: Intellect was positively correlated with motivation to quit and number of 24-hr quit attempts in the last year. These results have implications for using trait variables to study individual differences in smokers.

Motivational enhancement and coping skills training for cocaine abusers: Effects on substance use outcomes

Rohsenow, D. J., Monti, P. M., Martin, R. A., Colby, S. M., Myers, M. G., Gulliver, S. B., Brown, R. A., Mueller, T. I., Gordon, A., & Abrams, D. B.

Publication year

2004

Journal title

Addiction

Volume

99

Issue

7

Page(s)

862-874

10.1111/j.1360-0443.2004.00743.x

Abstract

Abstract

Aims: This clinical trial investigated effects of motivational enhancement treatment (MET) and group coping-skills training (CST) tailored for cocaine dependence. Effects of MET were hypothesized to be greater with CST and for less motivated patients. Design and interventions: A 2 x 2 design investigated two individual sessions of MET compared to meditation-relaxation (MRT), followed by four group sessions of CST versus drug education (ED), as daily adjuncts to intensive treatment. Setting: The substance abuse program provided full-day treatment with a learning-theory and 12-Step orientation. Participants: Cocaine-dependent patients were recruited. Measurements: Assessment included treatment retention; change in cocaine-related urge, self-efficacy, pros and cons, and motivation; substance use and problems during 12-month follow-up. Findings: Of 165 patients, follow-up status is known for 90% (n=149). Patients in MET with low initial motivation to change reported less cocaine and alcohol relapse and use days and fewer alcohol problems than MET patients with higher initial motivation. MET produced more employment improvement than MRT, with no other significant benefit for MET. Patients with higher motivation had more cocaine use and alcohol problems after MET than MRT. Group CST reduced cocaine and alcohol use during follow-up for women only and reduced alcohol relapse for men and women. Conclusions: MET is more beneficial for patients with lower initial motivation than for patients with high initial motivation. CST reduced cocaine and alcohol use for women only and reduced alcohol relapses, in contrast to results with lengthier individual CST.

Smoking cessation treatment on the Internet: Content, quality, and usability

Bock, B. C., Graham, A. L., Sciamanna, C. N., Krishnamoorthy, J., Whiteley, J., Carmona-Barros, R., Niaura, R. S., & Abrams, D. B.

Publication year

2004

Journal title

Nicotine and Tobacco Research

Volume

6

Issue

2

Page(s)

207-219

10.1080/14622200410001676332

Abstract

Abstract

The explosive growth in access to the Internet suggests that the Internet may be a viable channel through which we can reach and treat the large population of smokers who are unlikely to use other modes of intervention. We applied national guidelines from the U.S. Public Health Service to assess the quality of interventions for smoking cessation that are available on the Internet. The Public Health Service guidelines were codified into two instruments to record and to rate quality of the intervention contents. Usability guidelines established by the National Cancer Institute were used to develop an instrument to assess Web site usability. Of the 202 Web sites identified in searches, 77% did not provide direct intervention over the Internet and were excluded from analyses. A total of 46 Web sites were included in our review. Usability assessments showed mixed results. Web sites were visually well organized and used consistent graphical design; however, reading difficulty averaged above the 8th-grade level. Over 80% of Web sites provided no coverage of one or more of the key components of tobacco treatment recommended in the guidelines. Ironically, areas receiving the least coverage were those most amenable to the interactive capabilities of the Internet, such as providing tailored, personalized advice to quit and arranging follow-up contact. Smokers seeking quality tobacco dependence treatment on the Internet may have difficulty distinguishing among the numerous Web sites available. Web sites that provide direct treatment often fail to fully implement treatment guidelines and do not take full advantage of the interactive and tailoring capabilities of the Internet.

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

Shadel, W. G., Niaura, R., & Abrams, D. B.

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.

Who am I? The role of self-conflict in adolescents' responses to cigarette advertising

Shadel, W. G., Niaura, R., & Abrams, D. B.

Publication year

2004

Journal title

Journal of Behavioral Medicine

Volume

27

Issue

5

Page(s)

463-475

10.1023/B:JOBM.0000047610.07195.b0

Abstract

Abstract

Cigarette advertising may be partly responsible for adolescent smoking initiation, but few studies have investigated the advertising and individual difference factors that may be responsible. This study evaluated whether individual differences in the number of self-conflicts (i.e., conflicts between personality attributes experienced as part of self-concept development) interacts with stage of development (early versus middle adolescence) to predict responses to cigarette advertising imagery. One hundred and one never smoking adolescents judged the self-relevance of various cigarette advertisements. As predicted, self-conflict was related to judgments of self-relevance for early adolescents only: early adolescents who are having the most difficulty defining themselves are more likely to look to the powerful images displayed by cigarette advertisements for help. These results have implications for understanding the impact of cigarette advertising on smoking initiation for some adolescents.

Alcohol specific role play test

Abrams, D., & Al., . In J. Allen & M. Columbus (Eds.), Assessing alcohol problems: A guide for clinicians and researchers.

Publication year

2003

Effects of motivational interviewing on smoking cessation in adolescents with psychiatric disorders

Brown, R. A., Ramsey, S. E., Strong, D. R., Myers, M. G., Kahler, C. W., Lejuez, C. W., Niaura, R., Pallonen, U. E., Kazura, A. N., Goldstein, M. G., & Abrams, D. B.

Publication year

2003

Journal title

Tobacco control

Volume

12

Page(s)

IV3-10

Abstract

Abstract

Objective: To test the hypothesis that among adolescent smokers hospitalised for psychiatric and substance use disorders, motivational interviewing (MI) would lead to more and longer quit attempts, reduced smoking, and more abstinence from smoking over a 12 month follow up. Design: Randomised control trial of MI versus brief advice (BA) for smoking cessation, with pre- and post-intervention assessment of self efficacy and intentions to change, and smoking outcome variables assessed at one, three, six, nine, and 12 month follow ups. Setting: A private, university affiliated psychiatric hospital in Providence, Rhode Island, USA. Patients or other participants: Consecutive sample (n = 191) of 13-17 year olds, admitted for psychiatric hospitalisation, who smoked at least one cigarette per week for the past four weeks, had access to a telephone, and did not meet DSM-IV criteria for current psychotic disorder. Interventions: MI versus BA. MI consisted of two, 45 minute individual sessions, while BA consisted of 5-10 minutes of advice and information on how to quit smoking. Eligible participants in both conditions were offered an eight week regimen of transdermal nicotine patch upon hospital discharge. Main outcome measures: Point prevalence abstinence, quit attempts, changes in smoking rate and longest quit attempt. Proximal outcomes included intent to change smoking behaviour (upon hospital discharge), and self efficacy for smoking cessation. Results: MI did not lead to better smoking outcomes compared to BA. MI was more effective than BA for increasing self efficacy regarding ability to quit smoking. A significant interaction of treatment with baseline intention to quit smoking was also found. MI was more effective than BA for adolescents with little or no intention to change their smoking, but was actually less effective for adolescents with pre-existing intention to cut down or quit smoking. However, the effects on these variables were relatively modest and only moderately related to outcome. Adolescents with comorbid substance use disorders smoked more during follow up while those with anxiety disorders smoked less and were more likely to be abstinent. Conclusions: The positive effect of MI on self efficacy for quitting and the increase in intention to change in those with initially low levels of intentions suggest the benefits of such an intervention. However, the effects on these variables were relatively modest and only moderately related to outcome. The lack of overall effect of MI on smoking cessation outcomes suggests the need to further enhance and intensify this type of treatment approach for adolescent smokers with psychiatric comorbidity.

Facilitating transdisciplinary research: The experience of the transdisciplinary tobacco use research centers

Morgan, G. D., Kobus, K., Gerlach, K. K., Neighbors, C., Lerman, C., Abrams, D. B., & Rimer, B. K.

Publication year

2003

Journal title

Nicotine and Tobacco Research

Volume

5

Page(s)

S11-19

10.1080/14622200310001625537

Abstract

Abstract

Cigarette smoking is the largest preventable cause of death and morbidity in the United States. Heightened recognition of this public health concern has led researchers from multiple and varied disciplines to address this complex and multidimensional behavior. The need for an alternative research paradigm, focusing on a transdisciplinary approach that integrates work across disciplines in order to advance the field most quickly, has been identified. This recognized need led to the development of the Transdisciplinary Tobacco Use Research Centers (TTURC) initiative, funded jointly by the National Cancer Institute, the National Institute on Drug Abuse, and The Robert Wood Johnson Foundation. This paper discusses the formation and early implementation stages of the initiative, including meetings that led to the development of the TTURCs, funders' and research centers' perspectives on implementation, and early observations about the products of the initiative.

Naltrexone treatment for alcoholics: Effect on cigarette smoking rates

Rohsenow, D. J., Monti, P. M., Colby, S. M., Gulliver, S. B., Swift, R. M., & Abrams, D. B.

Publication year

2003

Journal title

Nicotine and Tobacco Research

Volume

5

Issue

2

Page(s)

231-236

10.1080/1462220031000073298

Abstract

Abstract

Naltrexone (NTX), by its pharmacological action in the mesolimbic pathways, should decrease reinforcement from nicotine as well as from alcohol. By means of this mechanism, NTX could result in temporary increases in smoking followed by decreased smoking rates among alcoholics not motivated to quit smoking. The change from pretreatment in smoking rates of 73 recently abstinent alcoholics in a 12-week clinical trial of NTX vs. placebo during alcoholism treatment was compared during 8 of the 12 weeks. Only smokers compliant with NTX were included in the analyses. NTX was associated with decreased smoking at every time point, but the effect was significant at only one time point. When alcohol relapsers were excluded, NTX patients showed decreased smoking at every time point, but the effect was significant at only two time points, a reduction of about five cigarettes per day. When smoking stage of change was included in the analyses, NTX showed no significant main or interaction effects on smoking rate. Precontemplators showed significantly less change in smoking rate than all other patients at the first and last four time points. Therefore, NTX alone currently does not show promise for promoting smoking reduction among recently abstinent alcoholics who have not sought or been given smoking cessation treatment. Further research is needed on possible effects with smokers motivated to quit smoking and on other methods of promoting smoking cessation among alcoholics.

Ongoing research and future directions

Monti, P., Niaura, R., & Abrams, D. In The tobacco dependence treatment handbook: A guide to best practices.

Publication year

2003