David B Abrams

David Abrams
David Abrams
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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

Multicenter trial of fluoxetine as an adjunct to behavioral smoking cessation treatment

Niaura, R., Spring, B., Borrelli, B., Hedeker, D., Goldstein, M. G., Keuthen, N., Depue, J., Kristeller, J., Ockene, J., Prochazka, A., Chiles, J. A., & Abrams, D. B. (n.d.).

Publication year

2002

Journal title

Journal of consulting and clinical psychology

Volume

70

Issue

4

Page(s)

887-896
Abstract
Abstract
The authors evaluated the efficacy of fluoxetine hydrochloride (Prozac; Eli Lilly and Company, Indianapolis, IN) as an adjunct to behavioral treatment for smoking cessation. Sixteen sites randomized 989 smokers to 3 dose conditions: 10 weeks of placebo, 30 mg, or 60 mg fluoxetine per day. Smokers received 9 sessions of individualized cognitive-behavioral therapy, and biologically verified 7-day self-reported abstinence follow-ups were conducted at 1, 3, and 6 months posttreatment. Analyses assuming missing data counted as smoking observed no treatment difference in outcomes. Pattern-mixture analysis that estimates treatment effects in the presence of missing data observed enhanced quit rates associated with both the 60-mg and 30-mg doses. Results support a modest, short-term effect of fluoxetine on smoking cessation and consideration of alternative models for handling missing data.

Negative mood, depressive symptoms, and major depression after smoking cessation treatment in smokers with a history of major depressive disorder

Kahler, C. W., Brown, R. A., Ramsey, S. E., Niaura, R., Abrams, D. B., Goldstein, M. G., Mueller, T. I., & Miller, I. W. (n.d.).

Publication year

2002

Journal title

Journal of abnormal psychology

Volume

111

Issue

4

Page(s)

670-675
Abstract
Abstract
Negative mood, depressive symptoms, and major depressive episodes (MDEs) were examined in 179 smokers with a history of major depression in a trial comparing standard smoking cessation treatment to treatment incorporating cognitive-behavioral therapy for depression (CBT-D). Early lapses were associated with relatively large increases in negative mood on quit date. Mood improved in the 2 weeks after quit date among those returning to regular smoking but not among those smoking moderately. Continuous abstinence was associated with short- and long-term reductions in depressive symptoms. MDE incidence during follow-up was 15.3% and was not associated with abstinence. Unexpected was that CBT-D was associated with greater negative mood and depressive symptoms and increased MDE risk. Results suggest complex bidirectional associations between affect and smoking outcomes.

Patterns of change in depressive symptoms during smoking cessation: Who's at risk for relapse?

Burgess, E. S., Brown, R. A., Kahler, C. W., Niaura, R., Abrams, D. B., Goldstein, M. G., & Miller, I. W. (n.d.).

Publication year

2002

Journal title

Journal of consulting and clinical psychology

Volume

70

Issue

2

Page(s)

356-361
Abstract
Abstract
The authors examined patterns of change in depressive symptoms during smoking cessation treatment in 163 smokers with past major depressive disorder (MDD). Cluster analysis of Beck Depression Inventory (A. T. Beck, C. H. Ward, M. Mendelson, J. Mock, & J. Erbaugh, 1961) scores identified 5 patterns of change. Although 40% of participants belonged to clusters characterized by increasing depressive symptoms during quitting (rapid increasers, n = 31, and delayed increasers, n = 35), almost 47% were in clusters characterized by decreasing symptoms (delayed decreasers, n = 24, and rapid decreasers, n = 52). Both rapid and delayed increasers had especially poor smoking cessation outcomes. Results suggest that among smokers with an MDD history there is substantial heterogeneity in patterns of depressive symptoms during quitting and that patterns involving increased symptoms are associated with low abstinence rates.

Response to social stress, urge to smoke, and smoking cessation

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

Publication year

2002

Journal title

Addictive Behaviors

Volume

27

Issue

2

Page(s)

241-250
Abstract
Abstract
Motivational theories of drug use have assigned negative affect a central role in determining drug urges and drug relapse. The purpose of this study was to examine the effects of social stress on smoking urges in a controlled laboratory setting, and the relation of these responses to short-term (3-month) smoking cessation outcomes. Prior to a clinic-based smoking cessation program, 76 (64% female) smokers were assessed for their affective, cognitive, and physiological responses during the Borkovec social anxiety induction procedure. These responses were used to predict smoking urges immediately after the procedure and to predict abstinence at 3-month follow-up posttreatment. As expected, during the induction, urge to smoke was positively associated with anxiety ratings and negatively associated with self-efficacy to resist smoking. However, only heart rate increase and behavioral social skill (observed by independent judges) predicted smoking abstinence at 3 months. These results suggest that subjective affective and efficacy responses during a stressful social encounter are associated with smoking urges; however, urges and these responses may be related in different ways to the probability of smoking cessation.

Smoking cessation: Progress, priorities, and prospectus

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

Publication year

2002

Journal title

Journal of consulting and clinical psychology

Volume

70

Issue

3

Page(s)

494-509
Abstract
Abstract
The authors review developments in understanding smoking cessation interventions over the past decade. Noteworthy is the unprecedented growth of research and knowledge that has left a deeper understanding of how best to use new and existing behavioral and pharmacologic tools and strategies to help smokers quit. The status of public-health-level interventions is evaluated, questions are raised concerning their efficacy, and suggestions are offered for further refinement of these intervention strategies. Development of cessation guidelines is reviewed, and the state of knowledge concerning behavioral and pharmacologic interventions is summarized. The authors also present agendas for behavioral and pharmacologic research related to smoking cessation and discuss individual difference factors among smokers that may prove to be important in designing new and refining existing treatments.

Treating alcohol dependence: A coping skills training guide

Monti, P., Kadden, R., Rohsenow, D., Cooney, N., & Abrams, D. (n.d.). (2nd eds., 1–).

Publication year

2002

A content analysis of smoking craving

Shadel, W. G., Niaura, R., Brown, R. A., Hutchison, K. E., & Abrams, D. B. (n.d.).

Publication year

2001

Journal title

Journal of Clinical Psychology

Volume

57

Issue

1

Page(s)

145-150
Abstract
Abstract
The purpose of this study was to conduct a content analysis of smoking craving in order to investigate more precisely the subjective nature of the construct with the goal of informing assessment. Thirty-two smokers interested in cessation treatment provided free response written descriptions of the level of craving they normally experience. These responses were analyzed for subjective content along five theoretical domains: physiological, affective, cognitive, behavioral, and synonyms (of craving). Although there were no differences in the relative proportion of broad content terms smokers used to describe their craving (e.g., cognitive versus affective), this analysis revealed considerable diversity in the specific terms smokers used. Some smokers described their craving in purely physiological terms whereas others used primarily cognitive terms, and still others used affective terms. To assume that smoking craving is qualitatively similar across persons, then, may mask important variations that define the individual experience of craving.

Cognitive Avoidance as a Method of Coping with a Provocative Smoking Cue: The Moderating Effect of Nicotine Dependence

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

Publication year

2001

Journal title

Journal of Behavioral Medicine

Volume

24

Issue

2

Page(s)

169-182
Abstract
Abstract
Both nicotine dependence and coping are important determinants of smoking cessation, yet little is understood about mechanisms that link the two. This laboratory study investigated how nicotine dependence moderates execution of an avoidance coping strategy. High and low dependent smokers were exposed to a provocative smoking cue (in vivo) under two instructional sets: cognitive avoidance coping and no coping. Contrary to hypotheses, high dependent smokers reported greater increases in perceived self-efficacy to not smoke and also demonstrated greater facility in processing coping/nonsmoking-related information on a reaction time task, compared with low dependent smokers. These counterintuitive findings are discussed in terms of how nicotine dependence may affect the cognitive process of coping.

Cognitive-behavioral treatment for depression in smoking cessation

Brown, R. A., Kahler, C. W., Niaura, R., Abrams, D. B., Sales, S. D., Ramsey, S. E., Goldstein, M. G., Burgess, E. S., & Miller, I. W. (n.d.).

Publication year

2001

Journal title

Journal of consulting and clinical psychology

Volume

69

Issue

3

Page(s)

471-480
Abstract
Abstract
Cigarette smokers with past major depressive disorder (MDD) received 8 group sessions of standard, cognitive-behavioral smoking cessation treatment (ST; n = 93) or standard, cognitive-behavioral smoking cessation treatment plus cognitive-behavioral treatment for depression (CBT-D; n = 86). Although abstinence rates were high in both conditions (ST, 24.7%; CBT-D, 32.5%, at 1 year) for these nonpharmacological treatments, no main effect of treatment was found. However, secondary analyses revealed significant interactions between treatment condition and both recurrent depression history and heavy smoking (≥25 cigarettes a day) at baseline. Smokers with recurrent MDD and heavy smokers who received CBT-D were significantly more likely to be abstinent than those receiving ST (odds ratios = 2.3 and 2.6, respectively). Results suggest that CBT-D provides specific benefits for some, but not all, smokers with a history of MDD.

Cue exposure with coping skills training and communication skills training for alcohol dependence: 6- and 12-month outcomes

Rohsenow, D. J., Monti, P. M., Rubonis, A. V., Gulliver, S. B., Colby, S. M., Binkoff, J. A., & Abrams, D. B. (n.d.).

Publication year

2001

Journal title

Addiction

Volume

96

Issue

8

Page(s)

1161-1174
Abstract
Abstract
Aims. Cue exposure treatment (CET) has shown promise in preliminary studies with alcoholics, and Communication Skills Training (CST) has been found beneficial, especially in intensive treatment programs. The aim of the present study was to investigate the effects of CET and CST in a larger controlled study when both were added to intensive treatment programs. Design and interventions. A 2 × 2 design investigated the effects of CET with urge coping skills training compared to a meditation-relaxation control, and CST compared to an education control when all were added to intensive treatment programs for alcoholics. Setting. The sites were the inpatient or partial hospital substance abuse treatment programs at a private psychiatric hospital, a state-funded residential facility and a VA medical center. Participants. Patients diagnosed with alcohol dependence without active psychosis were eligible. Measurements. Participants were assessed for quantity and frequency of drinking, alcohol cue-reactivity, responses to high risk simulations and urge specific coping skills. Findings. Of 100 treated patients, 86% provided 6-month and 84% provided 12-month follow-up data. Patients who received either CET or CST had fewer heavy drinking days in the first 6 months than control patients. In the second 6 months, CET continued to result in fewer heavy drinking days among lapsers and interacted with CST to decrease quantity of alcohol consumed. CST resulted in fewer alcohol-related problems reported at 12 months. CET resulted in greater reductions in urge to drink in a measure of simulated high-risk situations. CET also resulted in greater reports of use of coping strategies during the follow-up, and many of the urge-specific strategies taught in CET were associated with reduced drinking. Conclusions. Both CET and CST continue to show promise as elements of comprehensive alcohol treatment programs. Limitations and directions for future research are discussed.

Depression in chronic medical illness: The case of coronary heart disease

Burg, M. M., & Abrams, D. (n.d.).

Publication year

2001

Journal title

Journal of Clinical Psychology

Volume

57

Issue

11

Page(s)

1323-1337
Abstract
Abstract
Depression is an important predictor of morbidity and mortality in patients with coronary disease, particularly after myocardial infarction, independent of previous cardiac history or CAD severity. Depression also is associated with poor long-term psychosocial outcomes. The prevalence of major depression among post-MI patients is 15 to 20%, with an additional 27% reporting symptoms of minor depression. This article briefly reviews the literature on depression in patients with coronary disease, including previously published efforts to treat the disorder in this group. A case review then is provided, highlighting important aspects of treatment.

Does completing a craving questionnaire promote increased smoking craving? An experimental investigation

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

Publication year

2001

Journal title

Psychology of Addictive Behaviors

Volume

15

Issue

3

Page(s)

265-267
Abstract
Abstract
The authors evaluated whether completing a multi-item assessment of smoking craving (the Questionnaire of Smoking Urges [QSU]) promoted increases in smoking craving. A sample of 39 regular smokers was randomly assigned to 1 of 3 manipulations (each of 3 min duration): (a) complete the QSU-Brief (10 items), (b) complete a noncraving questionnaire that was structurally identical to the QSU-Brief (scale-based control), and (c) a time-based control. Participants responded to an oral question assessing their degree of craving immediately before and after the manipulations. Results indicated that the QSU did not promote increases in craving compared to the 2 control conditions. Despite continuing debate over the most appropriate self-report measure of craving, investigators who use the QSU-Brief can be reasonably sure that the scores that result are not biased due to reactivity effects.

Effect of different cue stimulus delivery channels on craving reactivity: Comparing in vivo and video cues in regular cigarette smokers

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

Publication year

2001

Journal title

Journal of Behavior Therapy and Experimental Psychiatry

Volume

32

Issue

4

Page(s)

203-209
Abstract
Abstract
Exposure to smoking cues reliably produces increases in craving compared to exposure to appropriately matched neutral cues. While different types of stimuli have been used as cue materials in such studies, the channel through which cues are delivered is not often varied in a systematic fashion in smoking research. This study compared the effect of exposure to active in vivo cues compared to two cues, matched for content and time, delivered via videotape on self-reported smoking craving. Results revealed that active in vivo cues produced the highest craving ratings, followed next by active video cues, and last by neutral video cues. These results suggest that craving is sensitive to stimulus delivery channel and that video presentation of smoking cues is a viable manipulation option in cue reactivity studies.

How Do Adolescents Process Smoking and Antismoking Advertisements? A Social Cognitive Analysis with Implications for Understanding Smoking Initiation

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

Publication year

2001

Journal title

Review of General Psychology

Volume

5

Issue

4

Page(s)

429-444
Abstract
Abstract
Youth tobacco use has increased substantially in the United States during the past decade. This increase can be attributed, in part, to the potency of cigarette advertising and relative ineffectiveness of antismoking advertising. In this article, the authors argue that an understanding of the effects of these 2 competing forms of advertising on youth smoking is limited in current theoretical treatments and that an integrative theoretical perspective has yet to be advanced. The authors argue that the elaboration likelihood model (R.E. Petty & J.T. Cacioppo, 1986) offers a framework with sufficient explanatory power in this domain. Prevention and legislative interventions may benefit from this analysis, which ultimately may help to decrease youth tobacco use.

Individual differences in responses to the first cigarette following overnight abstinence in regular smokers

Niaura, R., Shadel, W. G., Goldstein, M. G., Hutchinson, K. E., & Abrams, D. B. (n.d.).

Publication year

2001

Journal title

Nicotine and Tobacco Research

Volume

3

Issue

1

Page(s)

37-44
Abstract
Abstract
We utilized cluster analysis to identify individual differences in response to the initial effects of smoking following overnight abstinence among 183 regular smokers. Participants smoked three cigarettes (1 mg nicotine, spaced 30 min apart) in standardized fashion and completed questionnaires about their subjective responses to each cigarette. Heart rate was monitored throughout the procedure. Participants were grouped into two clusters based on their reported subjective effects and heart rate changes to the first cigarette. Clusters differed in terms of greater increases in heart rate, reports of dizziness, sweating, unpleasantness, nausea, and buzzing sensations in one group compared to the other group. The smokers showing increased responses developed greater acute tolerance to the effects of smoking subsequent cigarettes on subjective negative effects and heart rate, and experienced greater negative affect after quitting. These results are partially consistent with a nicotine sensitivity interpretation or a tolerance model of the effects of initial smoking.

Naltrexone and cue exposure with coping and communication skills training for alcoholics: Treatment process and 1-year outcomes

Monti, P. M., Rohsenow, D. J., Swift, R. M., Gulliver, S. B., Colby, S. M., Mueller, T. I., Brown, R. A., Gordon, A., Abrams, D. B., Niaura, R. S., & Asher, M. K. (n.d.).

Publication year

2001

Journal title

Alcoholism: Clinical and Experimental Research

Volume

25

Issue

11

Page(s)

1634-1647
Abstract
Abstract
Background: Promising treatments for alcoholics include naltrexone (NTX), cue exposure combined with urge-specific coping skills training (CET), and communication skills training (CST). This study investigated the effects of combining these elements as treatment adjuncts. Methods: A 2 × 2 design investigated the effects of CET combined with CST, as compared with an education and relaxation control treatment, during a 2-week partial hospital program (n = 165) followed by 12 weeks of NTX (50 mg/day) or placebo during aftercare (n = 128). Drinking outcomes were assessed at 3, 6, and 12 months after discharge from the partial hospital. Process measures included urge, self-efficacy (confidence about staying abstinent in risky situations), and self-reported coping skills. Medically eligible alcohol-dependent patients were recruited. Results: Among those compliant with medication on at least 70% of days, those who received NTX had significantly fewer heavy drinking days and fewer drinks on days that they drank than those receiving placebo during the medication phase but not during the subsequent 9 months. CET/CST-condition patients were significantly less likely to report a relapse day and reported fewer heavy drinking days at the 6- and 12-month follow-ups than patients in the control treatment. Interactions of medication with behavioral treatments were not significant. Process measures showed that NTX resulted in lower weekly urge ratings, and those in CET/CST used more of the prescribed coping skills after treatment, reported fewer cue-elicited urges, and reported more self-efficacy in a posttest role-play test. Drinking reductions at 3, 6, and 12 months correlated with more use of coping skills, lower urge, and higher self-efficacy. Conclusions: The results suggest the probable value of keeping alcoholics on NTX for longer periods of time and the importance of increasing compliance with NTX. They also support the earlier promising effects of CET and CST as adjuncts to treatment programs for alcoholics by maintaining treatment gains over at least a year. The value of the urge-specific and general coping skills and of self-efficacy and urge constructs was demonstrated in their association with drinking outcomes.

Smoking-cessation counseling in the home: Attitudes, beliefs, and behaviors of home healthcare nurses

Borrelli, B., Hecht, J. P., Papandonatos, G. D., Emmons, K. M., Tatewosian, L. R., & Abrams, D. B. (n.d.).

Publication year

2001

Journal title

American journal of preventive medicine

Volume

21

Issue

4

Page(s)

272-277
Abstract
Abstract
Background: Despite advances in smoking treatment, cessation rates remain stagnant, possibly a function of the lack of new channels to reach heavily addicted smokers. This cross-sectional study examined home care nurses' attitudes, beliefs, and counseling behaviors regarding counseling their home care patients who smoke. Methods: Home healthcare nurses (N=98) from the Visiting Nurse Association of Rhode Island were randomly selected to participate in a study helping home-bound medically ill smokers to quit. At baseline, nurses completed a questionnaire that assessed a constellation of cognitive factors (self-efficacy, outcome expectations, perceived effectiveness, risk perception, motivation, and perceived patient adherence) as correlates of self-reported nurse counseling behaviors. Results: Nurses with higher outcome expectations spent more time counseling their patients about quitting (p<0.04). Nurses' self-efficacy was the only variable associated with consistent counseling (p<0.05). While the majority of nurses 'asked and advised' their patients, a minority of nurses 'assisted or arranged' follow-up. Perceived importance of counseling was associated with a greater likelihood of asking, advising and assisting (p<0.05). None of the nurses who currently smoked (n=13) provided follow-up to their patients. Nurses who reported higher levels of both risk perception (regarding the harmful effects of smoking) and perceived effectiveness were more likely to recommend the nicotine patch. Conclusions: Attitudes and beliefs about smoking are significantly associated with nurse counseling behaviors. Helping nurses to overcome their barriers to smoking counseling may open up new channels for smoking intervention.

Symptoms of depression and survival experience among three samples of smokers trying to quit

Niaura, R., Britt, D. M., Shadel, W. G., Goldstein, M., Abrams, D., & Brown, R. (n.d.).

Publication year

2001

Journal title

Psychology of Addictive Behaviors

Volume

15

Issue

1

Page(s)

13-17
Abstract
Abstract
Symptoms of depression have been associated with increased smoking prevalence and failure to quit smoking in several cross-sectional and population-based studies. Few studies, however, have prospectively examined the ability of current symptoms of depression to predict failure to quit smoking in treatment-motivated smokers. Pretreatment depressed mood was assessed by 3 different methods in 3 separate samples, 2 of which comprised smokers receiving combined pharmacological and behavioral treatments and a 3rd in which smokers received self-help materials only. In all studies, time in days from quit day until the 1st cigarette was ascertained to document survival. Survival analyses showed that in all 3 studies survival time was significantly and negatively related to measures of even very low levels of pretreatment depressed mood. Results were replicated across 3 independent samples and were robust and uniformly clear, indicating that low levels of depressive symptoms assessed at baseline predict time to 1st cigarette smoked after attempted quitting.

Transdisciplinary research to improve brief interventions for addictive behaviors

Abrams, D., & Clayton, R. (n.d.). In P. Monti, S. Colby, & T. O’Leary (Eds.), Adolescents, alcohol and substance abuse: Reaching teens through brief interventions (1–).

Publication year

2001

Will healthcare take tobacco addiction seriously? Using policy to drive practice.

Orleans, C. T., Abrams, D. B., & Gruman, J. C. (n.d.).

Publication year

2001

Journal title

MedGenMed : Medscape general medicine

Volume

3

Issue

2

Page(s)

15
Abstract
Abstract
Despite being the leading preventable cause of disability, death, and economic burden on society, tobacco-use detection and treatment is yet to be taken as seriously as the prevention and treatment of chronic diseases or other addictive behaviors (eg, hypertension, diabetes, alcohol/substance abuse, and mammography screening). This paper outlines the process of intervening at the policy level to incorporate tobacco-use screening and treatment in health practice. The National Committee for Quality Assurance (NCQA) call for new measures presented a window of opportunity. The NCQA report card (the Health Plan Employer Data Information Set [HEDIS]) is the most widely used and influential performance measure in managed care. Consequently, a 6-month process consisting of an expert panel review of research evidence and consensus building was initiated. Two measures were submitted to NCQA: (1) a primary measure based on chart review of tobacco-use screening and treatment implementation and (2) an adjunctive measure of population prevalence of tobacco use and physician advice to quit, based on a self-report survey of members. HEDIS eventually accepted the second measure. The mixed results, potential impact on societal disease burden and cost savings, and the lessons learned from the process are discussed.

An idiographic approach to understanding personality structure and individual differences among smokers

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

Publication year

2000

Journal title

Cognitive Therapy and Research

Volume

24

Issue

3

Page(s)

345-359
Abstract
Abstract
We present a social-cognitive theory which requires an idiographic assessment of individual differences in personality structure among smokers, and contrast this approach to traditional nomothetic trait approaches. A sample of 15 regular smokers completed idiographic assessment procedures designed to tap into three cognitive structures (smoker self-schema, abstainer ideal-possible self, abstainer ought-possible self) which are proposed to regulate individual differences in smoking behavior, coping behavior, and finally smoking cessation. Support for the idiographic approach was found. The three cognitive structures were distinguishable from one another, and had properties that self-schema are proposed to hold, and intraindividual patterns of schematic responding across situations were stable and predictable phenomena. These findings are not consistent with a nomothetic trait approach. We discuss the implications of these results for individual-differences assessment among smokers and suggest avenues for future research.

Brief coping skills treatment for cocaine abuse: 12-month substance use outcomes

Rohsenow, D. J., Monti, P. M., Martin, R. A., Michalec, E., & Abrams, D. B. (n.d.).

Publication year

2000

Journal title

Journal of consulting and clinical psychology

Volume

68

Issue

3

Page(s)

515-520
Abstract
Abstract
Patients (N = 108) in a study of cocaine-specific coping skills training (CST), which was found to reduce cocaine use during a 3-month follow-up, were followed for an additional 9 months. CST involved coping skills training in the context of high-risk situations. Control treatment used meditation-relaxation. Both were added to comprehensive private substance abuse treatment. Patients in CST who relapsed had significantly fewer cocaine use days than did the control group during the first 6 months, then both conditions did equally well. Patients in CST also drank alcohol more frequently in the last 6 months than did contrast patients but did not differ in heavy drinking days. For cocaine use outcomes, no interaction of treatment was found with gender, education, route of administration, drug use severity, sociopathy, or depression. Implications include the need to investigate different lengths and combinations of treatment.

Comorbidity, smoking behavior and treatment outcome

Keuthen, N. J., Niaura, R. S., Borrelli, B., Goldstein, M., DePue, J., Murphy, C., Gastfriend, D., Reiter, S. R., & Abrams, D. (n.d.).

Publication year

2000

Journal title

Psychotherapy and Psychosomatics

Volume

69

Issue

5

Page(s)

244-250
Abstract
Abstract
Background: A sizeable sector of the population continues to smoke cigarettes despite our efforts to prevent and treat this addiction. We explored the relationships between lifetime comorbidity, psychiatric symptomatology, smoking behavior and treatment outcome to better understand vulnerability to smoking and treatment response. Methods: One hundred and twenty smokers at two sites were enrolled in a multicenter, double-blind, randomized, 10-week smoking cessation trial with fluoxetine and behavioral treatment. The Structured Clinical Interview for DSM-III-R and Hamilton Depression Rating Scale were administered prior to treatment initiation. Self-report measures were used to assess psychiatric symptoms throughout treatment and during a 6-month follow-up period. Results: Overall 62.3% of our sample were diagnosed with a lifetime mood, anxiety or substance use disorder despite stringent study exclusion criteria. Lifetime comorbidity was shown to be related to higher smoking rates and nicotine dependence, depressed mood and greater self-report of anxiety and stress. Lifetime comorbidity, however, alone or in combination with treatment condition, failed to predict treatment outcome (at posttreatment or follow-up). Baseline depression scores (Beck Depression Inventory, BDI) were related to treatment outcome only for smokers without a positive history of any psychiatric disorder or depression, with lower BDI scores more frequent in those who were abstinent. Conclusions: High prevalence rates of lifetime psychiatric illness and substance use disorders are reported for chronic smokers. Subsyndromal psychiatric symptoms may play a role in smoking behavior in combination with diagnosable disorders. Clinicians need to carefully assess both psychiatric diagnoses and symptoms in chronic smokers to optimize patient-treatment matching. Copyright (C) 2000 S. Karger AG, Basel.

Current models of nicotine dependence: What is known and what is needed to advance understanding of tobacco etiology among youth

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

Publication year

2000

Journal title

Drug and alcohol dependence

Volume

59

Page(s)

S9-22
Abstract
Abstract
Youth smoking has risen dramatically during the last 5 years, leading one to the conclusion that prevention interventions have not been particularly effective. This paper provides an examination of features that define adult nicotine dependence and argues that these features need to be considered in any studied examination of youth etiology and development to nicotine dependence. We review the historical context for the concept of nicotine dependence, features that define the concept and current models of substance dependence more generally. Recommendations for future research are provided. Copyright (C) 2000 Elsevier Science Ireland Ltd.

Does the five factor model of personality apply to smokers? A preliminary investigation

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

Publication year

2000

Journal title

Journal of Applied Biobehavioral Research

Volume

5

Issue

2

Page(s)

114-120
Abstract
Abstract
The purpose of this study was to explore the relationship between the Big Five personality dimensions and smoking variables. Thirty-seven smokers completed a standard, reliable 80-item bipolar measure of the Big Five trait dimensions, as well as measures of nicotine dependence, smoking exposure, and quitting history. Despite finding some significant zero-order relationships between a few of the dimensions and the smoking variables, only one of the partial correlational analyses that controlled for relationships among the personality dimensions in their associations with the nicotine dependence and smoking history variables was significant. These results indicate the need for further research on personality traits and smoking.

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