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

Integrating basic, clinical, and public health research for alcohol- tobacco interactions

Abrams, D., & Abrams, D. S. (n.d.). (J. Fertig & J. Allen, Eds.).

Publication year

1995

Abstract

Abstract

~

Integrating individual and public health perspectives for treatment of tobacco dependence under managed health care : A combined stepped-care and matching model

Abrams, D., Abrams, D. B., Orleans, C. T., Niaura, R. S., Goldstein, M. G., Prochaska, J. O., & Velicer, W. (n.d.).

Publication year

1996

Journal title

Annals of Behavioral Medicine

Volume

18

Issue

4

Page(s)

290-304

10.1007/BF02895291

Abstract

Abstract

There is an increasing momentum to integrate prevention into mainstream health care. Three decades of research on tobacco dependence can provide insights into the conceptual, clinical, economic, and service delivery challenges to such an integration. Biological sciences, cognitive-behavioral, clinical treatment outcome, and public health arenas are selectively reviewed. The key conceptual issues are explored relevant to the optimal delivery of quality smoking cessation treatments for the general population of adult smokers at reasonable cost. A comprehensive model for adult smoking cessation treatment is developed. The model consists of an overarching public health approach, focusing on enhancing motivational level from low motivation to quit to high motivation. A common outcome metric of overall impact is proposed to facilitate comparisons between clinical and public health interventions. Smokers are then assessed and triaged into one of three treatment steps of minimal, moderate, and maximal intensity and cost. Smoker individual differences at both the population and individual level are also taken into account as part of a tailoring or matching strategy within and across the stepped interventions. Smoker profiles include sociocultural, nicotine dependence, and comorbidity factors. The result is a hybrid stepped- care matching model. The model serves to illustrate some of the needs and challenges facing future tobacco dependence research and practice. Comparisons are made between tobacco control and other preventive medicine practices in terms of cost per quality adjusted life-year saved. The barriers and opportunities under managed care are explored. The conceptual principles identified here could be used as a guidepost for integrating other preventive medicine programs into the evolving managed health care system.

Intensive Longitudinal Study of the Relationship between Cigalike E-cigarette Use and Cigarette Smoking among Adult Cigarette Smokers without Immediate Plans to Quit Smoking

Abrams, D., Pearson, J. L., Zhou, Y., Smiley, S. L., Rubin, L. F., Harvey, E., Koch, B., Niaura, R. S., & Abrams, D. B. (n.d.).

Publication year

2021

Journal title

Nicotine and Tobacco Research

Volume

23

Issue

3

Page(s)

527-534

10.1093/ntr/ntaa086

Abstract

Abstract

Introduction: This study examined the association between the introduction of an e-cigarette and subsequent change in cigarette smoking among smokers who were not immediately interested in quitting. Aims and Methods: The Moment Study was a 21-day intensive longitudinal study with an online follow-up survey at 30 days. After observing baseline cigarette smoking for 1 week, participants received 10 cigalike e-cigarettes on study days 6 and 13. Participants reported cigarettes per day, e-cigarette puffs per day, and e-cigarette satisfaction using text-message-based surveys. Results: The sample of 96 daily smokers was majority female (53.1%), African American (67.7%), and non-Hispanic (95.8%). When e-cigarettes were provided (day 6), average cigarettes per day dropped by 1.82 cigarettes (p

Interdisciplinarity and Systems Science to Improve Population Health. A View from the NIH Office of Behavioral and Social Sciences Research

Abrams, D., Mabry, P. L., Olster, D. H., Morgan, G. D., & Abrams, D. B. (n.d.).

Publication year

2008

Journal title

American journal of preventive medicine

Volume

35

Issue

2 SUPPL.

Page(s)

S211-224

10.1016/j.amepre.2008.05.018

Abstract

Abstract

Fueled by the rapid pace of discovery, humankind's ability to understand the ultimate causes of preventable common disease burdens and to identify solutions is now reaching a revolutionary tipping point. Achieving optimal health and well-being for all members of society lies as much in the understanding of the factors identified by the behavioral, social, and public health sciences as by the biological ones. Accumulating advances in mathematical modeling, informatics, imaging, sensor technology, and communication tools have stimulated several converging trends in science: an emerging understanding of epigenomic regulation; dramatic successes in achieving population health-behavior changes; and improved scientific rigor in behavioral, social, and economic sciences. Fostering stronger interdisciplinary partnerships to bring together the behavioral-social-ecologic models of multilevel "causes of the causes" and the molecular, cellular, and, ultimately, physiological bases of health and disease will facilitate breakthroughs to improve the public's health. The strategic vision of the Office of Behavioral and Social Sciences Research (OBSSR) at the National Institutes of Health (NIH) is rooted in a collaborative approach to addressing the complex and multidimensional issues that challenge the public's health. This paper describes OBSSR's four key programmatic directions (next-generation basic science, interdisciplinary research, systems science, and a problem-based focus for population impact) to illustrate how interdisciplinary and transdisciplinary perspectives can foster the vertical integration of research among biological, behavioral, social, and population levels of analysis over the lifespan and across generations. Interdisciplinary and multilevel approaches are critical both to the OBSSR's mission of integrating behavioral and social sciences more fully into the NIH scientific enterprise and to the overall NIH mission of utilizing science in the pursuit of fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to extend healthy life and reduce the burdens of illness and disability.

Interdisciplinary health sciences and health systems

Abrams, D., Terpstra, J., Best, A., Abrams, D. S., & Moor, G. (n.d.). (R. Frodeman, C. Mitcham, & J. Klein, Eds.).

Publication year

2010

Abstract

Abstract

~

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.

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

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

Publication year

2006

Journal title

Nicotine and Tobacco Research

Volume

8

Issue

SUPPL. 1

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.

Interrelationship of smoking and alcohol dependence, use and urges to use

Abrams, D., Gulliver, S. B., Rohsenow, D. J., Colby, S. M., Dey, A. N., Abrams, D. B., Niaura, R. S., & Monti, P. M. (n.d.).

Publication year

1995

Journal title

Journal of Studies on Alcohol

Volume

56

Issue

2

Page(s)

202-206

10.15288/jsa.1995.56.202

Abstract

Abstract

Objective: The relationship between tobacco dependence and alcohol dependence has received little empirical scrutiny. The present study of alcoholics in treatment for alcoholism investigated pretreatment tobacco and alcohol history and dependence, as well as subjective responsivity to alcohol cues. Method: Eighty-three male alcoholics underwent a questionnaire assessment of smoking and drinking pretreatment followed by a laboratory assessment of reactivity to alcohol cues. Results: The analyses demonstrate that (1) pretreatment tobacco dependence and pretreatment alcohol dependence are related, (2) alcohol dependence predicts urges to smoke during alcohol treatment, (3) exposure to alcohol cues results in increased urge to smoke, (4) smoking when ill predicts urge to drink during alcohol cue exposure and (5) urge to smoke is positively correlated with urge to drink. Conclusions: These data, collected in a population of alcoholics not currently receiving smoking interventions, indicate that smoking may be a factor to address during alcohol treatment. The clinical importance of these data is discussed.

Interventions for alcoholics who smoke

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

Publication year

1996

Journal title

Alcohol health and research world

Volume

20

Issue

2

Page(s)

111-117

Abstract

Abstract

More than 85 percent of adults with a history of alcohol abuse also smoke, and they may be more addicted to nicotine than are smokers without a history of drinking. Alcoholics who smoke also have higher risks of cancer and cardiovascular disease. Indeed, it has been reported that more alcoholics die from tobacco-related diseases than from disorders related to their alcoholism. The complex interaction that exists between alcoholism recovery and tobacco is discussed. In addition, methods are presented for helping alcoholics to stop smoking, including motivating patients, using innovative interventions, and matching effective interventions to the motivational level of the alcoholic. By better understanding the interaction between alcohol and tobacco, scientists can improve treatment outcome and cost-effectiveness for alcoholics who smoke.

Introduction to tobacco, nicotine, and youth : The Tobacco Etiology Research Network

Abrams, D., Clayton, R. R., Ries Merikangas, K., & Abrams, D. B. (n.d.).

Publication year

2000

Journal title

Drug and alcohol dependence

Volume

59

Page(s)

1-4

10.1016/S0376-8716(99)00160-X

Abstract

Abstract

~

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

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

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.

Irrational beliefs, urges to drink and drinking among alcoholics

Abrams, D., Rohsenow, D. J., Monti, P. M., Zwick, W. R., Nirenberg, T. D., Liepman, M. R., Binkhoff, J. A., & Abrams, D. B. (n.d.).

Publication year

1989

Journal title

Journal of Studies on Alcohol

Volume

50

Issue

5

Page(s)

461-464

10.15288/jsa.1989.50.461

Abstract

Abstract

The relationship of various irrational beliefs to alcohol dependence, urges to drink, anxiety and drinking after treatment was investigated for 63 male alcoholics, using Jones' Irrational Beliefs Test (IBT). Alcohol dependence was most strongly associated with problem avoidance. Urges to drink, anxiety and difficulty during alcohol-related role-plays were strongly correlated with problem avoidance and dwelling on negative events. The IBT was unrelated to pretreatment drinking measures but did predict 6-month posttreatment drinking (n = 48) which suggests these beliefs can mediate treatment response. Feeling doomed by the past was the best predictor of both frequency of drinking and average quantity consumed during follow-up. Treatment implications include targeting specific beliefs for intervention.

Is Nicotine Reduction in Cigarettes Enough?

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

Publication year

2020

Journal title

JAMA network open

Volume

3

Issue

10

Page(s)

e2019367

10.1001/jamanetworkopen.2020.19367

Abstract

Abstract

~

Keke C, Wilson Z, Lebina L, Motlhaoleng K, Abrams DB… et al, & Elf JL. A cross-sectional analysis of the nicotine metabolite ratio and its association with sociodemographic and smoking characteristics among people with HIV who smoke in South Africa.

Abrams, D. (n.d.).

Publication year

2023

Journal title

Int. J. Environ. Res. Public Health

Volume

20(6),

Issue

5090;

Abstract

Abstract

~

Lay volunteer delivery of a community-based cardiovascular risk factor change program

Abrams, D. (n.d.). (S. Weiss & L. Weiss, Eds.).

Publication year

1984

Abstract

Abstract

~

Lifetime characteristics of participants and non-participants in a smoking cessation trial : Implications for external validity and public health impact

Abrams, D., Graham, A. L., Papandonatos, G. D., DePue, J. D., Pinto, B. M., Borrelli, B., Neighbors, C. J., Niaura, R., Buka, S. L., & Abrams, D. B. (n.d.).

Publication year

2008

Journal title

Annals of Behavioral Medicine

Volume

35

Issue

3

Page(s)

295-307

10.1007/s12160-008-9031-1

Abstract

Abstract

Background: Detailed information about the characteristics of smokers who do and do not participate in smoking cessation treatment is needed to improve efforts to reach, motivate, and treat smokers. Purpose: The aim of this study is to explore a broad range of characteristics related to participation in a smoking cessation trial. Methods: Eligible smokers were recruited from a longitudinal birth cohort. Participants and non-participants were compared on a broad range of sociodemographics, smoking, psychiatric and substance abuse disorders, personality, and prospective measures from early childhood. Eligible smokers were compared to a matched regional subsample of the Behavioral Risk Factor Surveillance System (BRFSS). Results: Few differences were observed, most of which were statistically significant but not clinically meaningful. Compared to non-participants, participants were more likely to be single, have lower income, be more nicotine-dependent, be more motivated to quit, and have higher levels of depressed mood and stress even after covariance of gender, income, and marital status. Sociodemographic differences between participants and the BRFSS sample reflect the skew toward lower socioeconomic status in the original birth cohort. Conclusions: The encouraging conclusion is that smokers who enroll in cessation trials may not differ much from non-participants. Information about treatment participants can inform the development of recruitment strategies, improve the tailoring of treatment to individual smoker profiles, help to estimate potential selection bias, and improve estimates of population impact.

Linking Global Youth Tobacco Survey Data to the WHO Framework Convention on Tobacco Control : the Case for Egypt

Abrams, D., El-Shahawy, O., Nicksic, N. E., Ramôa, C., Jawad, M., Niaura, R. S., Abrams, D. S., & Sherman, S. E. (n.d.).

Publication year

2018

Journal title

Current Addiction Reports

Volume

5

Issue

1

Page(s)

54-64

10.1007/s40429-018-0184-0

Abstract

Abstract

Purpose: Limited publications from Egypt have focused on prevalence of tobacco use and tobacco control policy. We used four waves of the Egypt Global Youth Tobacco Survey (GYTS) between 2001 and 2014 and a cigarette affordability measure, to evaluate the implementation of the World Health Organization’s MPOWER recommendations. Findings: Despite Egypt’s implementation of several MPOWER recommendations, the enforcement of laws and regulations may be limited, and therefore had little to no impact on youth current smoking prevalence through 2014. Notably, experimentation with cigarette smoking has significantly increased between waves 2001 and 2014. Summary: There is a missed opportunity for implementing evidence-based interventions for youth tobacco control in Egypt. There is a strong need for initiatives aiming at meaningful taxation, enforcement of smoking bans in public places, promoting smoke-free homes, appropriate mass media counter-advertising, and effective cessation activities.

Longitudinal e-Cigarette and cigarette use among US Youth in the PATH Study (2013-2015)

Abrams, D., Stanton, C. A., Bansal-Travers, M., Johnson, A. L., Sharma, E., Katz, L., Ambrose, B. K., Silveira, M. L., Day, H., Sargent, J., Borek, N., Compton, W. M., Johnson, S. E., Kimmel, H. L., Kaufman, A. R., Limpert, J., Abrams, D. S., Cummings, K. M., Goniewicz, M. L., … Pearson, J. L. (n.d.).

Publication year

2019

Journal title

Journal of the National Cancer Institute

Volume

111

Issue

10

Page(s)

1088-1096

10.1093/jnci/djz006

Abstract

Abstract

Background: Evidence is accumulating that youth who try Electronic Nicotine Delivery Systems (ENDS, e-cigarettes) may go on to try cigarettes. This analysis examines the bidirectional patterns of ENDS and cigarette use among US youth over one year and uses propensity score matching (PSM) to examine frequency of ENDS use on changes in cigarette smoking. Methods: Our analysis included 11 996 participants who had two waves of available data (Wave 1 [W1] 2013-2014; Wave 2 [W2] 2014-2015) drawn from the longitudinal Population Assessment of Tobacco and Health Study. Cross-sectional weighted prevalence estimates are reported for cigarettes and ENDS. We used PSM to estimate the likelihood of ENDS use at W1 and to draw matched analytic samples, then used regression (logistic or linear) models to examine the effect of W1 ENDS use on W2 cigarette smoking. All statistical tests were two-sided. Results: In weighted analyses, 69.3% of W1 past-30-day cigarette smokers exhibited past-30-day smoking at W2; 42.2% of W1 past-30-day ENDS users were using ENDS at W2. W1 ever use of either product was similarly associated with W2 new use of the other product. Unweighted PSM models indicated W1 cigarette-naïve ENDS use was associated with W2 ever-cigarette smoking (n = 676; adjusted odds ratio = 3.21, 95% confidence interval [CI] = 1.95 to 5.45, P

Longitudinal tobacco use transitions among adolescents and young adults : 2014-2016

Abrams, D., Hair, E. C., Romberg, A. R., Niaura, R. S., Abrams, D. B., Bennett, M. A., Xiao, H., Rath, J. M., Pitzer, L., & Vallone, D. (n.d.).

Publication year

2019

Journal title

Nicotine and Tobacco Research

Volume

21

Issue

4

Page(s)

458-468

10.1093/ntr/ntx285

Abstract

Abstract

Introduction: Among youth, the frequency and prevalence of using more than one tobacco (small cigar, cigarette, and hookah) or nicotine-containing product (e-cigarettes-ENDS) are changing. These shifts pose challenges for regulation, intervention, and prevention campaigns because of scant longitudinal data on the stability of use patterns in this changing product landscape. Methods: A nationally representative longitudinal survey of 15- to 21-year olds (n = 15,275) was used to describe transitions between never use, noncurrent use, and past 30-day use of combustible tobacco, e-cigarettes (ENDS), and dual use of both kinds of products. A multistate model was fit to observations collected every 6 months across 2.5 years to estimate the probability of transitions between states (TPs), the average time in state (sojourn time), and the effect of age on transitions. Results: Current state strongly predicted future state over time intervals of 1 year or less, but only weakly predicted future state at longer intervals: TP to noncurrent use was higher for ENDS-only than combustible-only users over a 6-month interval but was similar for both groups over a 2-year interval. Sojourn time was significantly longer for combustible-only (0.52 years) and dual use (0.55 years) than ENDS-only use (0.27 years); older youth were more likely than younger youth to stay combustible tobacco users or noncurrent users. Conclusions: The dynamics of transitions between combustible tobacco products and ENDS in a population of youth and young adults suggest that policy and prevention efforts must consider the frequent changes and instability over a 1-year or less time period in use patterns among young people. Implications: The study addresses an urgent need in public health for timely information on how youth and young adults use tobacco and nicotine products. We found that youth, particularly adolescents, moved frequently between using ENDS and combustible tobacco products either alone or together. Importantly, the utility of current-use states for predicting future use states declined for time horizons longer than 1 year. Our results demonstrate a need for caution in interpreting product transitions. Longitudinal data with frequent observations and coverage of a wide range of possible product types is required to fully characterize usage patterns in youth.

Managing nicotine without smoke to save lives now : Evidence for harm minimization

Abrams, D., Abrams, D. B., Glasser, A. M., Villanti, A. C., Pearson, J. L., Rose, S., & Niaura, R. S. (n.d.).

Publication year

2018

Journal title

Preventive Medicine

Volume

117

Page(s)

88-97

10.1016/j.ypmed.2018.06.010

Abstract

Abstract

Tobacco control has made strides in prevention and cessation, but deaths will not decline rapidly without massive behavior change. Currently, inhaled smoke from combusting tobacco is chiefly responsible for prematurely killing 7.2 million people worldwide and 530,000 in the United States annually. An array of noncombustible nicotine products (NNPs) has emerged and has disrupted the marketplace. Saving lives more speedily will require societal acceptance of locating a “sweet spot” within a three-dimensional framework where NNPs are simultaneously: 1. Less toxic, 2. Appealing (can reach smokers at scale), and 3. Satisfying (adequate nicotine delivery) to displace smoking. For this harm minimization framework to eliminate smoking, a laser focus on “smoking control” (not general tobacco control) is needed. By adopting these economically viable NNPs as part of the solution, NNPs can be smoking control's valued ally. Synthesis of the science indicates that policy and regulation can sufficiently protect youth while speeding the switch away from smoking. Despite some risks of nicotine dependence that can be mitigated but not eliminated, no credible evidence counters the assertion that NNPs will save lives if they displace smoking. But scientific evidence and advocacy has selectively exaggerated NNP harms over benefits. Accurate communication is crucial to dispel the misperception of NNPs harms and reassure smokers they can successfully replace smoking cigarettes with NNPs. Saving more lives now is an attainable and pragmatic way to call for alignment of all stakeholders and factions within traditional tobacco control rather than perpetuate the unrealized and unrealizable perfection of nicotine prohibition.

Managing the obese patient

Abrams, D., Abrams, D. S., & Follick, M. (n.d.).

Publication year

1987

Journal title

Practicum

Abstract

Abstract

~

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

~

Matching high-dependence and low-dependence smokers to self-help treatment with or without nicotine replacement

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

Publication year

1994

Journal title

Preventive Medicine

Volume

23

Issue

1

Page(s)

70-77

10.1006/pmed.1994.1010

Abstract

Abstract

Background. This study investigated the effect of matching smokers to nicotine replacement therapy (nicotine gum) on the basis of the pretreatment level of nicotine dependence. Methods. One hundred seventy-three smokers, classified as high or low on nicotine dependence using the Fagerstrom Tolerance Questionnaire, were assigned at random to receive nicotine gum (2 mg), chewed ad libitum, or to not receive nicotine gum. All smokers participated concurrently in a 5-week treatment program consisting of four brief counseling sessions combined with a self-help manual provided by the American Lung Association. Results. Results showed that smokers with high levels of nicotine dependence were significantly more likely to quit smoking during treatment if they received nicotine gum (31.9%) than high-dependence smokers who did not receive the gum (12.2%). There was a tendency for smokers with low levels of nicotine dependence to do worse during treatment if they received gum (13.5% quit) than they did when they received no gum (20% quit), although this difference was not statistically significant. The relative differences in outcomes persisted after 1 year of follow-up, but the high overall rate of relapse (92.5%) rendered the absolute size of the differences statistically insignificant. Conclusion. The results of the study are discussed in terms of strategies that might improve the success of treatment-matching approaches with newer forms of nicotine replacement therapies.

Mathematical modeling in tobacco control research : Initial Results From a Systematic Review

Abrams, D., Feirman, S. P., Donaldson, E., Glasser, A. M., Pearson, J. L., Niaura, R., Rose, S. W., Abrams, D. B., & Villanti, A. C. (n.d.).

Publication year

2016

Journal title

Nicotine and Tobacco Research

Volume

18

Issue

3

Page(s)

229-242

10.1093/ntr/ntv104

Abstract

Abstract

Objectives: The US Food and Drug Administration has expressed interest in using mathematical models to evaluate potential tobacco policies. The goal of this systematic review was to synthesize data from tobacco control studies that employ mathematical models. Methods: We searched five electronic databases on July 1, 2013 to identify published studies that used a mathematical model to project a tobacco-related outcome and developed a data extraction form based on the ISPOR-SMDM Modeling Good Research Practices. We developed an organizational framework to categorize these studies and identify models employed across multiple papers. We synthesized results qualitatively, providing a descriptive synthesis of included studies. Results: The 263 studies in this review were heterogeneous with regard to their methodologies and aims. We used the organizational framework to categorize each study according to its objective and map the objective to a model outcome. We identified two types of study objectives (trend and policy/intervention) and three types of model outcomes (change in tobacco use behavior, change in tobaccorelated morbidity or mortality, and economic impact). Eighteen models were used across 118 studies. Conclusions: This paper extends conventional systematic review methods to characterize a body of literature on mathematical modeling in tobacco control. The findings of this synthesis can inform the development of new models and the improvement of existing models, strengthening the ability of researchers to accurately project future tobacco-related trends and evaluate potential tobacco control policies and interventions. These findings can also help decision-makers to identify and become oriented with models relevant to their work.

Mechanisms in Multiple Risk Factor Interventions : Smoking, Physical-Activity, and Dietary-Fat Intake Among Manufacturing Workers

Abrams, D., Emmons, K. M., Marcus, B. H., Linnan, L., Rossi, J. S., & Abrams, D. B. (n.d.).

Publication year

1994

Journal title

Preventive Medicine

Volume

23

Issue

4

Page(s)

481-489

10.1006/pmed.1994.1066

Abstract

Abstract

Background. Individuals who have multiple poor health behaviors account for a disproportionately large percentage of the preventable U.S. health care cost burden. Understanding the relationships between multiple risk factors is important for the design of both individual and public health interventions. There have been few efforts to examine the cooccurrence of psychosocial and motivational mechanisms that mediate smoking, dietary fat intake, and physical activity in a defined population of blue collar workers. Methods. The sample comprised 1,559 manufacturing workers who participated in a self-help physical activity intervention and who completed a computerized assessment battery about their smoking, dietary fat intake, physical activity, and demographic characteristics. Results. Twenty-six percent of the sample were smokers, 51% did not exercise regularly, and 35% consumed more than an estimated 40% of calories per day from fat. Almost half of the sample was in the later stages of readiness for physical activity and dietary fat intake, compared with only 3% for smoking. Only 12% of the smokers had smoking as their only risk factor. Smokers were significantly more likely to engage in poor dietary and physical activity behaviors, compared with nonsmokers. The relationship among smoking status and the other risk factors was apparent both in terms of dietary fat and physical activity behaviors, as well as mediators such as motivation for change. Lower dietary fat intake was associated with an absence of the other two risk factors. Conclusions. The results suggest that there are important mediating mechanisms both within and among workers with one or more risk factors. Smokers are a particularly important target for health promotion interventions, and it may be possible to make initial contact with them through other health programs at the worksite. The role of other lifestyle changes as a gateway to smoking cessation has not yet been explored, but may have potential for reaching smokers who are very low in their motivational readiness to change. The implications of these findings for research and the design of multiple risk factor interventions are discussed.