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

Medical and behavioral treatment of nicotine dependence

Abrams, D., Goldstein, M., Niaura, R. S., & Abrams, D. S. (n.d.). (A. Stoudemire & B. Fogel, Eds.).

Publication year

1991

Abstract

Abstract

~

Medical and behavioral treatment of nicotine dependence: Nicotine as a drug of abuse

Abrams, D., Goldstein, M., Niaura, R. S., & Abrams, D. S. (n.d.). (A. Stoudemire & B. Fogel, Eds.).

Publication year

1991

Page(s)

541-596

Abstract

Abstract

~

Medical costs and quality-adjusted life years associated with smoking : A systematic review

Abrams, D., Feirman, S. P., Glasser, A. M., Teplitskaya, L., Holtgrave, D. R., Abrams, D. B., Niaura, R. S., & Villanti, A. C. (n.d.).

Publication year

2016

Journal title

BMC public health

Volume

16

Issue

1

10.1186/s12889-016-3319-z

Abstract

Abstract

Background: Estimated medical costs ("T") and QALYs ("Q") associated with smoking are frequently used in cost-utility analyses of tobacco control interventions. The goal of this study was to understand how researchers have addressed the methodological challenges involved in estimating these parameters. Methods: Data were collected as part of a systematic review of tobacco modeling studies. We searched five electronic databases on July 1, 2013 with no date restrictions and synthesized studies qualitatively. Studies were eligible for the current analysis if they were U.S.-based, provided an estimate for Q, and used a societal perspective and lifetime analytic horizon to estimate T. We identified common methods and frequently cited sources used to obtain these estimates. Results: Across all 18 studies included in this review, 50 % cited a 1992 source to estimate the medical costs associated with smoking and 56 % cited a 1996 study to derive the estimate for QALYs saved by quitting or preventing smoking. Approaches for estimating T varied dramatically among the studies included in this review. T was valued as a positive number, negative number and $0; five studies did not include estimates for T in their analyses. The most commonly cited source for Q based its estimate on the Health Utilities Index (HUI). Several papers also cited sources that based their estimates for Q on the Quality of Well-Being Scale and the EuroQol five dimensions questionnaire (EQ-5D). Conclusions: Current estimates of the lifetime medical care costs and the QALYs associated with smoking are dated and do not reflect the latest evidence on the health effects of smoking, nor the current costs and benefits of smoking cessation and prevention. Given these limitations, we recommend that researchers conducting economic evaluations of tobacco control interventions perform extensive sensitivity analyses around these parameter estimates.

Menthol and Mint Cigarettes and Cigars : Initiation and Progression in Youth, Young Adults and Adults in Waves 1-4 of the PATH Study, 2013-2017

Abrams, D., Villanti, A. C., Johnson, A. L., Halenar, M. J., Sharma, E., Cummings, K. M., Stanton, C. A., Delnevo, C. D., Wackowski, O. A., Bansal-Travers, M., Pearson, J. L., Abrams, D. B., Niaura, R. S., Fong, G. T., Elton-Marshall, T., Hatsukami, D., Trinidad, D. R., Kaufman, A., Sawdey, M. D., … Hyland, A. (n.d.).

Publication year

2021

Journal title

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

Volume

23

Issue

8

Page(s)

1318-1326

10.1093/ntr/ntaa224

Abstract

Abstract

INTRODUCTION: This study examined in youth (12-17 years), young adults (18-24 years), and adults (25+ years): (1) the prevalence of the first menthol cigarette and menthol/mint cigar use among new tobacco users; (2) association between the first menthol/mint use, subsequent tobacco use, and nicotine dependence ~1 year later compared with the first non-menthol/mint use. AIMS AND METHODS: Longitudinal analysis of data from Waves 1 to 4 of the Population Assessment of Tobacco and Health (PATH) Study (2013-2017; 10 086 youth and 21 281 adults). Main outcome measures were past 12-month and past 30-day cigarette and cigar use, and nicotine dependence. RESULTS: Youth and young adult new cigarette users are more likely to smoke a menthol cigarette or indicate that they do not know the flavor compared with adults aged 25+. A greater proportion of adults aged 25+ first used menthol/mint-flavored cigars (13.4%) compared with youth (8.5%) and young adults (7.4%). Among young adults, first use of a menthol cigarette is associated with past 12-month use of cigarettes at the subsequent wave and first use of any menthol/mint-flavored cigars is associated with past 30-day use of these products at the subsequent wave in both youth and young adults. In youth and adults, there were no significant relationships between first use of a menthol/mint cigarette or cigar and nicotine dependence scores at a subsequent wave in multivariable analyses. CONCLUSIONS: The first use of menthol/mint cigarettes and cigars is associated with subsequent cigarette and cigar use in young people aged 12-24. IMPLICATIONS: This study examined the relationship between initiation with menthol cigarettes and menthol/mint cigars, subsequent tobacco use, and nicotine dependence in US youth, young adults, and adults who participated in Waves 1-4 of the Population Assessment of Tobacco and Health study. New use of menthol cigarettes was associated with greater past 12-month cigarette use in young adults and new use of menthol/mint-flavored cigars was associated with greater past 30-day cigar use in youth and young adults compared with non-menthol use. Initiation with menthol/mint cigarette and cigar products may lead to subsequent use of those products.

Menthol and non-menthol smoking : The impact of prices and smoke-free air laws

Abrams, D., Tauras, J. A., Levy, D. N., Chaloupka, F. J., Villanti, A., Niaura, R. S., Vallone, D., & Abrams, D. B. (n.d.).

Publication year

2010

Journal title

Addiction

Volume

105

Issue

SUPPL.1

Page(s)

115-123

10.1111/j.1360-0443.2010.03206.x

Abstract

Abstract

Aims To examine the relationship between menthol and non-menthol prices and smoke-free air laws and the choice between menthol and non-menthol cigarettes among current smokers. Design, setting and participants Data were extracted from the nationally representative (USA) 2003 and 2006/07 Tobacco Use Supplements to the Current Population Survey. A total of 57383 adult smokers (aged 18+) were examined. Measurements A regression model was used to estimate the probability of being a menthol smoker conditional on being a current smoker who had a distinct preference for either non-menthol or menthol cigarettes. Cigarette prices, smoke-free air laws and socio-economic and demographic characteristics were examined as covariates. Findings The prices of menthol and non-menthol cigarettes were associated with the choice between menthol and non-menthol cigarettes. However, smokers did not find menthol and non-menthol cigarettes to be close substitutes for one another. Non-menthol cigarettes were found to be less of a substitute for menthol cigarettes than vice versa. Young adults and African Americans were less responsive to prices with respect to switching between menthol and non-menthol cigarettes than were older adults and non-African Americans, respectively. Conclusions The US Food and Drug Administration (FDA) is grappling with the issue of whether or not to ban menthol cigarettes. The findings from this study suggest that smokers do not find menthol and non-menthol cigarettes to be close substitutes. The strong preference for mentholated cigarettes may serve as a lever to reduce smoking prevalence when combined with increased access to effective cessation treatments.

Menthol brand switching among adolescents and young adults in the national youth smoking cessation survey

Abrams, D., Villanti, A. C., Giovino, G. A., Barker, D. C., Mowery, P. D., Sevilimedu, V., & Abrams, D. B. (n.d.).

Publication year

2012

Journal title

American journal of public health

Volume

102

Issue

7

Page(s)

1310-1312

10.2105/AJPH.2011.300632

Abstract

Abstract

This study examines patterns of menthol and nonmenthol cigarette use from 2003 to 2005 in a cohort of smokers, aged 16 to 24 years in the National Youth Smoking Cessation Survey. At follow-up, 15.0% of baseline menthol smokers had switched to nonmentholated cigarettes; by contrast, 6.9% of baseline nonmenthol smokers had switched to mentholated cigarettes. Differences in switching patterns were evident by gender, race/ethnicity, parental education, and smoking frequency. These data support previous evidence that young smokers start with mentholated cigarettes and progress to nonmentholated cigarettes.

Menthol cigarettes and mortality : Keeping focus on the public health standard

Abrams, D., Villanti, A. C., Giovino, G. A., Burns, D. M., & Abrams, D. B. (n.d.).

Publication year

2013

Journal title

Nicotine and Tobacco Research

Volume

15

Issue

2

Page(s)

617-618

10.1093/ntr/nts176

Abstract

Abstract

~

Menthol cigarettes and the public health standard : A systematic review

Abrams, D., Villanti, A. C., Collins, L. K., Niaura, R. S., Gagosian, S. Y., & Abrams, D. B. (n.d.).

Publication year

2017

Journal title

BMC public health

Volume

17

Issue

1

10.1186/s12889-017-4987-z

Abstract

Abstract

Background: Although menthol was not banned under the Tobacco Control Act, the law made it clear that this did not prevent the Food and Drug Administration from issuing a product standard to ban menthol to protect public health. The purpose of this review was to update the evidence synthesis regarding the role of menthol in initiation, dependence and cessation. Methods: A systematic review of the peer-reviewed literature on menthol cigarettes via a PubMed search through May 9, 2017. The National Cancer Institute's Bibliography of Literature on Menthol and Tobacco and the FDA's 2011 report and 2013 addendum were reviewed for additional publications. Included articles addressing initiation, dependence, and cessation were synthesized based on study design and quality, consistency of evidence across populations and over time, coherence of findings across studies, and plausibility of the findings. Results: Eighty-two studies on menthol cigarette initiation (n = 46), dependence (n = 14), and cessation (n = 34) were included. Large, representative studies show an association between menthol and youth smoking that is consistent in magnitude and direction. One longitudinal and eight cross-sectional studies demonstrate that menthol smokers report increased nicotine dependence compared to non-menthol smokers. Ten studies support the temporal relationship between menthol and reduced smoking cessation, as they measure cessation success at follow-up. Conclusions: The strength and consistency of the associations in these studies support that the removal of menthol from cigarettes is likely to reduce youth smoking initiation, improve smoking cessation outcomes in adult smokers, and in turn, benefit public health.

Modeling the future effects of a menthol ban on smoking prevalence and smoking-attributable deaths in the United States

Abrams, D., Levy, D. T., Pearson, J. L., Villanti, A. C., Blackman, K., Vallone, D. M., Niaura, R. S., & Abrams, D. S. (n.d.).

Publication year

2011

Journal title

American journal of public health

Volume

101

Issue

7

Page(s)

1236-1240

10.2105/AJPH.2011.300179

Abstract

Abstract

We used a validated smoking simulation model and data from the 2003 Tobacco Use Supplement to the Current Population Survey to project the impact that a US menthol ban would have on smoking prevalence and smoking-attributable deaths. In a scenario in which 30% of menthol smokers quit and 30% of those who would have initiated as menthol smokers do not initiate, by 2050 the relative reduction in smoking prevalence would be 9.7% overall and 24.8% for Blacks; deaths averted would be 633252 overall and 237317 for Blacks.

Modeling the Impact of Smoking-Cessation Treatment Policies on Quit Rates

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

Publication year

2010

Journal title

American journal of preventive medicine

Volume

38

Issue

3 SUPPL. 1

Page(s)

S364-372

10.1016/j.amepre.2009.11.016

Abstract

Abstract

Background: Smoking-cessation treatment policies could yield substantial increases in adult quit rates in the U.S. Purpose: The goals of this paper are to model the effects of individual cessation treatment policies on population quit rates, and to illustrate the potential benefits of combining policies to leverage their synergistic effects. Methods: A mathematical model is updated to examine the impact of five cessation treatment policies on quit attempts, treatment use, and treatment effectiveness. Policies include: (1) expand cessation treatment coverage and provider reimbursement; (2) mandate adequate funding for the use and promotion of evidence-based, state-sponsored telephone quitlines; (3) support healthcare system changes to prompt, guide, and incentivize tobacco treatment; (4) support and promote evidence-based treatment via the Internet; and (5) improve individually tailored, stepped-care approaches and the long-term effectiveness of evidence-based treatments. Results: The annual baseline population quit rate is 4.3% of all current smokers. Implementing any policy in isolation is projected to increase the quit rate to between 4.5% and 6%. By implementing all five policies in combination, the quit rate is projected to increase to 10.9%, or 2.5 times the baseline rate. Conclusions: If fully implemented in a coordinated fashion, cessation treatment policies could reduce smoking prevalence from its current rate of 20.5% to 17.2% within 1 year. By modeling the policy impacts on the components of the population quit rate (quit attempts, treatment use, treatment effectiveness), key indicators are identified that need to be analyzed in attempts to improve the effect of cessation treatment policies.

Models of smoking relapse.

Abrams, D., Shiffman, S., Shumaker, S. A., Abrams, D. B., Cohen, S., Garvey, A., Grunberg, N. E., & Swan, G. E. (n.d.).

Publication year

1986

Journal title

Health Psychology

Volume

5 Suppl

Page(s)

13-27

Abstract

Abstract

~

Moderators of naltrexone's effects on drinking, urge, and alcohol effects in non-treatment-seeking heavy drinkers in the natural environment

Abrams, D., Tidey, J. W., Monti, P. M., Rohsenow, D. J., Gwaltney, C. J., Miranda, R., McGeary, J. E., MacKillop, J., Swift, R. M., Abrams, D. B., Shiffman, S., & Paty, J. A. (n.d.).

Publication year

2008

Journal title

Alcoholism: Clinical and Experimental Research

Volume

32

Issue

1

Page(s)

58-66

10.1111/j.1530-0277.2007.00545.x

Abstract

Abstract

Background: Naltrexone (NTX) has proven to be effective with alcoholics in treatment, with most controlled clinical trials showing beneficial effects on heavy drinking rates. However, little is known about the behavioral mechanisms underlying the effects of NTX on drinking, or about patient characteristics that may moderate NTX's effects on drinking. In this study, ecological momentary assessment (EMA) techniques were used to investigate some of the putative mechanisms of naltrexone's effects on drinking in heavy drinkers who were not seeking treatment for alcohol problems. Polymorphisms in the D4 dopamine receptor (DRD4) gene and the μ-opiate receptor (OPRM1) gene, family history of alcohol problems, age of onset of alcoholism and gender were explored as potential moderators of NTX's effects. Methods: After a 1-week placebo lead-in period, heavy drinkers (n = 180), 63% of whom were alcohol-dependent, were randomized to 3 weeks of daily naltrexone (50 mg) or placebo. Throughout the study, participants used EMA on palm-pilot computers to enter, in real time, drink data, urge levels, and subjective effects of alcohol consumption. Results: Naltrexone reduced percentage drinking days in all participants and reduced percent heavy drinking days in DRD4-L individuals; NTX decreased urge levels in participants with younger age of alcoholism onset; NTX increased time between drinks in participants who had more relatives with alcohol problems; and NTX reduced the stimulating effects of alcohol in women. OPRM1 status did not moderate any of NTX's effects. Conclusions: These results confirm earlier findings of NTX's effects on drinking and related subjective effects, and extend them by describing individual difference variables that moderate these effects in the natural environment, using data collected in real time.

Motivating parents of kids with asthma to quit smoking : The PAQS project

Abrams, D., Borrelli, B., McQuaid, E. L., Becker, B., Hammond, K., Papandonatos, G., Fritz, G., & Abrams, D. S. (n.d.).

Publication year

2002

Journal title

Health Education Research

Volume

17

Issue

5

Page(s)

659-669

10.1093/her/17.5.659

Abstract

Abstract

The Parents of Asthmatics Quit Smoking (PAQS) project contrasts two theory-based smoking cessation interventions for parents of children with asthma, and compares mechanisms of behavior change within and across theoretical perspectives. We hypothesize that enhancing the perception of risk to self and child will motivate smoking cessation more than standard approaches that emphasize building self-efficacy and coping skills for quitting in a population that is largely not motivated to quit smoking. Smokers (n = 288) and their asthmatic children who receive nurse-delivered in-home asthma education (as part of the insurance carrier's standard of care) are randomized into one of two treatment conditions: (1) the Behavioral Action Model (BAM), in which nurses emphasize goal setting and skill building to enhance self-efficacy to quit smoking, or 2) the Precaution Adoption Model (PAM), in which nurses tailor the intervention to the smoker's readiness to quit and incorporate biomarker feedback [i.e. level of carbon monoxide exposure to the smoker and level of environmental tobacco smoke (ETS) exposure to the child] in order to increase risk perception in smokers. In both conditions, smokers who are ready to quit receive the nicotine patch. Analyses will examine (1) quit rates, ETS level and motivation to quit as the primary dependent variables, (2) mediators of behavior change between and within conditions, and (3) relations between parent smoking outcomes and child asthma morbidity (i.e. ER visits and asthma symptoms) post-treatment. Results will help tailor interventions to this population, and identify mechanisms of behavior change that result in adaptive health outcomes for smokers and their children who have asthma.

Motivational characteristics of smokers at the workplace : A public health challenge

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

Publication year

1992

Journal title

Preventive Medicine

Volume

21

Issue

6

Page(s)

679-687

10.1016/0091-7435(92)90075-S

Abstract

Abstract

Background. Few studies have focused on the motivational characteristics of smokers who do not volunteer for cessation. This study examined the relationship between demographic and selected psychosocial factors and motivation and intention to quit smoking among employed smokers at five worksites. In addition, the distributions of smokers who are at different stages of readiness to change their smoking behavior are presented. Results. Results indicate that, overall, less than 8% of employed smokers are currently ready to quit smoking and that blue-collar workers are lower in motivation than white-collar workers. Predictors of higher levels of motivation to quit smoking included higher socioeconomic status, maleness, lower levels of self-reported nicotine dependence, and stronger perceptions that smoking was against the social norms of the workplace. Conclusion. Implications for intervention, evaluation, and policy are discussed in the context of the challenge of making a public health impact on reducing overall smoking prevalence.

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

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

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.

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

Abrams, D., Rohsenow, D. J., Martin, R. A., Monti, P. M., Colby, S. M., Day, A. M., Abrams, D. B., Sirota, A. D., & Swift, R. M. (n.d.).

Publication year

2014

Journal title

Journal of Substance Abuse Treatment

Volume

46

Issue

3

Page(s)

346-355

10.1016/j.jsat.2013.10.002

Abstract

Abstract

Residential treatment for substance use disorders (SUD) provides opportunity for smoking intervention. A randomized controlled trial compared: (1) motivational interviewing (MI) to brief advice (BA), (2) in one session or with two booster sessions, for 165 alcoholics in SUD treatment. All received nicotine replacement (NRT). MI and BA produced equivalent confirmed abstinence, averaging 10% at 1. month, and 2% at 3, 6 and 12. months. However, patients with more drug use pretreatment (>. 22. days in 6. months) given BA had more abstinence at 12. months (7%) than patients in MI or with less drug use (all 0%). Boosters produced 16-31% fewer cigarettes per day after BA than MI. Substance use was unaffected by treatment condition or smoking cessation. Motivation to quit was higher after BA than MI. Thus, BA plus NRT may be a cost-effective way to reduce smoking for alcoholics with comorbid substance use who are not seeking smoking cessation.

Multi-modal measurement of anxiety and social skills in a behavioral role-play test : Generalizability and discriminant validity

Abrams, D., Monti, P. M., Wallander, J. L., Ahern, D. K., Abrams, D. B., & Munroe, S. M. (n.d.).

Publication year

1984

Journal title

Behavioral Assessment

Volume

6

Issue

1

Page(s)

15-25

Abstract

Abstract

The Simulated Social Interaction Test (SSIT), a behavioral procedure for assessing anxiety and social skills, was evaluated using a generalizability approach with college students. In addition to self-report and behavioral ratings, heart rate responsivity during the SSIT was employed as an index of anxiety. For the most part, results of the generalizability analysis replicated previous findings with a psychiatric population, suggesting that the SSIT is a psychometrically sound procedure for obtaining judgments of anxiety and social skills. A moderate negative relationship was found between the ratings of anxiety and social skills, providing further support for the discriminative validity of these constructs. Finally, including a third measurement condition (physiological arousal) did not result in increased generalizability. Indeed, even when a subsample of "heart rate responders" was empirically identified, the unexplained residual variance was not decreased, suggesting a lack of convergence for different methods of measuring anxiety.

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

Abrams, D., Niaura, R. S., 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

10.1037/0022-006X.70.4.887

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.

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

Abrams, D., 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

10.1111/j.1530-0277.2001.tb02170.x

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.

Naltrexone treatment for alcoholics : Effect on cigarette smoking rates

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

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.

Naltrexone's effect on cue-elicited craving among alcoholics in treatment

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

Publication year

1999

Journal title

Alcoholism: Clinical and Experimental Research

Volume

23

Issue

8

Page(s)

1386-1394

10.1111/j.1530-0277.1999.tb04361.x

Abstract

Abstract

Background: Advancing knowledge of biobehavioral effects of interventions can result in improved treatments. Thus, a standardized laboratory cue reactivity assessment has been developed and validated to assess the cognitive and psychophysiological responses to a simulated high- risk situation: alcohol cues. The present study investigates the effects of a pharmacotherapy (naltrexone) on a laboratory-based, cue-elicited urge to drink among abstinent alcoholics in treatment. Methods: Alcohol-dependent subjects were randomized to 12 weeks of naltrexone or placebo after completing a partial hospital program. After ~1 week on medication, all received cue reactivity assessment. Results: Significantly fewer patients taking naltrexone reported any urge to drink during alcohol exposure than did those on placebo. Those with any urges reported no decrement in level of the urges. Mean arterial pressure decreased significantly for those on placebo, but not for those on naltrexone, whereas cue-elicited decreases in heart rate were not affected by the medication. Conclusions: The results have implications for models of relapse and naltrexone's effects. Cue reactivity methodology has utility for investigating hypothesized mediators of therapeutic effects of pharmacotherapies as well as behavioral treatments.

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

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

Publication year

2015

Journal title

Tobacco Regulatory Science

Volume

1

Issue

1

Page(s)

24-35

Abstract

Abstract

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Negative affect, stress, and smoking in college students: unique associations independent of alcohol and marijuana use

Abrams, D., Magid, V., Colder, C., Stroud, L., Nichter, M., & Abrams, D. S. (n.d.).

Publication year

2009

Journal title

Addictive Behaviors

Volume

34

Issue

11

Page(s)

973-5

Abstract

Abstract

~

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

Abrams, D., Kahler, C. W., Brown, R. A., Ramsey, S. E., Niaura, R. S., 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

10.1037/0021-843X.111.4.670

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.

Nicotine addiction : paradigms for research in the 21st century

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

Publication year

1999

Journal title

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

Volume

1 Suppl 2

Page(s)

S211-215

10.1080/14622299050012101

Abstract

Abstract

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