Raymond S Niaura
Raymond S Niaura
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Professor of Social and Behavioral Sciences
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Professional overview
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Dr. Raymond Niaura is a psychologist and an expert on tobacco dependence and treatment, as well as substance use and addiction to alcohol. Dr. Niaura researches the biobehavioral substrates of tobacco dependence, including factors that influence adolescent and early adult tobacco use trajectories. He also evaluates behavioral and pharmacological treatments for tobacco cessation, with a particular interest in cessation in disadvantaged population to address public health disparities in tobacco-related burdens of illness and disability.
For eight year, Dr. Niaura was the Director of Science and Training at the Schroeder Institute (SI) for Tobacco Research and Policy Studies at the Truth Initiative, where he also supervised the pre- and post-doctoral training programs. Dr. Niaura has previously taught and conducted research at Brown University, Johns Hopkins Bloomberg School of Public Health, the Georgetown Medical Center, and the School of Public Health at University of Maryland. He was also a former President of the Society for Research on Nicotine and Tobacco and is a Deputy Editor of the Nicotine and Tobacco Research.
With grants from the National Institutes of Health, numerous foundations, and private industry, Dr. Niaura has published over 400 peer-reviewed articles, commentaries, and book chapters, including the book The Tobacco Dependence Treatment Handbook: A Guide to Best Practices.
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Education
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BA, Psychology (First Class Honors), McGill University, Montreal, CanadaMS, Psychology, Rutgers University, New Brunswick, NJPhD, Psychology, Rutgers University, New Brunswick, NJ
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Honors and awards
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Research Laureate, American Academy of Health Behavior (2009)University Scholar Award, McGill University (1979)
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Areas of research and study
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Alcohol, Tobacco and Driving PoliciesEvaluationsHealth DisparitiesSubstance AbuseTobacco Control
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Publications
Publications
Role of social-cognitive factors in the relationship between e-cigarette use and subsequent cigarette smoking among U.S. youth: A causal mediation analysis
AbstractXu, S., Coffman, D. L., Luta, G., Mai, A., Jiang, N., & Niaura, R. S. (n.d.).Publication year
2025Journal title
Addictive BehaviorsVolume
161AbstractObjective: E-cigarette use is associated with subsequent cigarette smoking among youth. The current study examined the mediating role of social-cognitive factors in this association. Methods: Data from four waves of the Population Assessment of Tobacco and Health study (2013/4 – 2017/8) were analyzed. Among youth who had heard about e-cigarettes at Wave 1 but never used cigarettes before Wave 2, we conducted both causal and traditional mediation analyses to examine the mediated effect of social-cognitive factors (including relative harm perception of e-cigarettes versus cigarettes, harm perception of e-cigarette use, perceptions of addictiveness of e-cigarette use, and e-cigarette use among best friends) in the association between e-cigarette use and subsequent cigarette ever or current smoking, adjusting for covariates. We included sampling weights in all analyses; hence, results are generalizable to the U.S. youth (12 – 14 years) from the 2013–2014 cohort. Results: Results from causal mediation analyses indicated that the total effect of e-cigarette use, compared to no use, increased the risk of cigarette ever smoking (20.9 %) and current smoking (4.6 %). A portion of this effect (4.2 % − 15.1 % for ever smoking; less than 10.6 % for current smoking) can be attributed to changes in social-cognitive factors induced by e-cigarette use. However, these mediated effects were small in magnitude relative to their standard errors and not statistically significant. Results from the traditional mediation analyses largely aligned with these findings, except for a few small sized pathways. Conclusions: For the U.S. youth population, social-cognitive factors may only minimally or not at all mediate the association between e-cigarette use and subsequent cigarette smoking. Further investigation into the mediation role of social-cognitive factors is warranted. Tobacco control interventions that focus on cigarette smoking initiation among youth should target other mediating factors.Use of nicotine products, prescription drug products, and other methods to stop smoking by US adults in the 2022 National Health Interview Survey
Cardiovascular disease outcomes among established cigar users 40 years and older: Findings from the population assessment of tobacco and health (PATH) study, waves 1–5 (2013–2019)
Longitudinal association between e-cigarette use and respiratory symptoms among US adults: Findings from the Population Assessment of Tobacco and Health Study Waves 4–5
Noticing Voluntary E-Cigarette Warning Labels and Associations With Harm Perceptions and Use Intentions: A Baseline Cross-Sectional Analysis of Wave 4 of the Population Assessment of Tobacco and Health Study Prior to the Food and Drug Administration Manda
Relationship Between Tobacco Product Use and Health-Related Quality of Life Among Individuals With COPD in Waves 1–5 (2013–2019) of the Population Assessment of Tobacco and Health Study
Temporal Trends in Tobacco Smoking Prevalence During the Period 2010–2020 in Vietnam: A Repeated Cross-Sectional Study
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
Author Response to E-cigarettes and Respiratory Disorder: The Broader Research Context
Changes in Tobacco Dependence and Association with Onset and Progression of Use by Product Type from Wave 1 to Wave 3 of the Population Assessment of Tobacco and Health (PATH) Study
AbstractStrong, D. R., Pierce, J. P., White, M., Stone, M. D., Abrams, D. B., Glasser, A. M., Wackowski, O. A., Cummings, K. M., Hyland, A., Taylor, K., Edwards, K. C., Silveira, M. L., Kimmel, H. L., Lambert, E. Y., Compton, W. M., Hull, L. C., & Niaura, R. (n.d.).Publication year
2023Journal title
Nicotine and Tobacco ResearchVolume
25Issue
3Page(s)
571-579AbstractIntroduction: This study examined trajectories of tobacco dependence (TD) in relation to changes in tobacco product use and explored the effects of product-specific adding, switching, or discontinued use on dependence over time. Aims and Methods: Data were analyzed from the first three waves of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative, longitudinal study of adults and youth in the United States. Data included 9556 Wave 1 (2013/2014) adult current established tobacco users who completed all three interviews and had established use at ≥2 assessments. Groups included cigarettes-only users, e-cigarettes-only users, cigars-only users, hookah-only users, any smokeless-only users, cigarette + e-cigarette dual users, and multiple product users. A validated 16-item scale assessed TD across product users. Results: Wave 1 e-cigarette-only users' who maintained exclusive e-cigarette use increased levels of TD through Wave 3 as did those who added or switched to another product. Wave 1 multiple product users' TD decreased across waves. TD for all other Wave 1 user groups remained about the same. For Wave 1 cigarette-only smokers, switching to another product or moving to a pattern of no established use was associated with lower levels of TD than smokers whose use stayed the same. Movement to no established use of any tobacco product was consistently associated with lower TD for all other product users. Conclusions: Except for Wave 1 e-cigarette-only users, TD among US tobacco product users was stable over time, with daily users less likely to vary from baseline. Implications: The level of TD among most US tobacco users was stable over the first three waves of the PATH Study and trends in levels of TD were predominantly unrelated to changes in patterns of continued product use. Stable levels of TD suggest a population at persistent risk of health impacts from tobacco. Wave 1 e-cigarette users, including those maintaining exclusive e-cigarette use, experienced increasing levels of TD over time, perhaps because of increases in quantity or frequency of their e-cigarette product use or increasing efficiency of nicotine delivery over time.Changes in Tobacco Dependence and Association With Onset and Progression of Use by Product Type From Waves 1 to 3 of the Population Assessment of Tobacco and Health (PATH) Study
Efficacy and safety of combination behavioral activation for smoking cessation and varenicline for treating tobacco dependence among individuals with current or past major depressive disorder: A 2 × 2 factorial, randomized, placebo-controlled trial
Indicators of Tobacco Dependence Among Youth: Findings From Wave 1 (2013-2014) of the Population Assessment of Tobacco and Health Study
Prevalence and Correlates of Cardiovascular, Pulmonary, Cancer, and Mental Health Comorbidities Among Adults With HIV Who Smoke
Tutorial on Causal Mediation Analysis With Binary Variables: An Application to Health Psychology Research
Use of electronic nicotine delivery system (ENDS) devices among U.S. Youth and adults: Findings from the Population Assessment of Tobacco and Health Study Waves 1–5
Validating Wave 1 (2014) Urinary Cotinine and TNE-2 Cut-points for Differentiating Wave 4 (2017) Cigarette Use from Non-use in the United States Using Data from the PATH Study
A Randomized Trial of Telephone-Based Smoking Cessation Treatment in the Lung Cancer Screening Setting
A scoping review of studies on the health impact of electronic nicotine delivery systems
AbstractHajat, C., Stein, E., Shantikumar, S., Niaura, R., Ferrara, P., & Polosa, R. (n.d.).Publication year
2022Journal title
Internal and Emergency MedicineVolume
17Issue
1Page(s)
241-268AbstractWe conducted a scoping review of studies on health outcomes from electronic nicotine delivery systems (ENDS). The objective was to identify, narratively synthesize, assess the strength and quality of evidence and critically appraise studies that have reported disease end points associated with the use of ENDS. We included published literature on the health impact of ENDS from 01/01/2015 until 01/02/2020 following the PRISMA guidelines using PubMed, Embase, Scopus and Google Scholar. The database search identified 755 studies, and other sources 265; 37 studies met final eligibility criteria. Levels of evidence included 24(65%) cross-sectional, one (2.7%) case–control and six (16%) case studies, four (11%) cohort studies, one (2.7%) randomized controlled trial (RCT) and one (2.7%) meta-analysis; 27(73%) studies reported only on harms, eight (22%) reported on benefits, two (2%) on benefits and harms. Quality ratings were poor in 20 (54%), fair in 9(24%) and good in 8(22%) of studies. In our review, ENDS was not shown to be causative for harmful cardiovascular disease (CVD) outcomes and shown to be beneficial for hypertensive patients. Switching from cigarettes to e-cigarettes resulted in reduced exacerbations of chronic obstructive pulmonary disease (COPD), with no evidence of long-term deterioration in lung function. Mental Health, cancer and mortality were not adequately studied to form any consensus. Our review has not demonstrated ENDS to be causative of harmful CVD outcomes; furthermore switching from cigarettes to e-cigarettes was associated with improved hypertensive control and reduced exacerbations of COPD, with no evidence of increased asthma risk or long-term respiratory harm. Mental health, cancer and mortality outcomes have not been adequately studied to form a conclusion. Overall, the findings of our review did not provide evidence to counter the consensus held by many that ENDS use is safer than the risks posed from smoking cigarettes.Association of tobacco product use with chronic obstructive pulmonary disease (COPD) prevalence and incidence in Waves 1 through 5 (2013–2019) of the Population Assessment of Tobacco and Health (PATH) Study
Balfour et al. Respond
Balfour et al. Respond
Cardiovascular Outcomes among Combustible-Tobacco and Electronic Nicotine Delivery System (ENDS) Users in Waves 1 through 5 of the Population Assessment of Tobacco and Health (PATH) Study, 2013–2019
AbstractMahoney, M. C., Rivard, C., Kimmel, H. L., Hammad, H. T., Sharma, E., Halenar, M. J., Sargent, J., Cummings, K. M., Niaura, R., Goniewicz, M. L., Bansal-Travers, M., Hatsukami, D., Gaalema, D., Fong, G., Gravely, S., Christensen, C. H., Haskins, R., Silveira, M. L., Blanco, C., … Hyland, A. (n.d.).Publication year
2022Journal title
International journal of environmental research and public healthVolume
19Issue
7AbstractBackground: Prior studies have not clearly established risk of cardiovascular disease (CVD) among smokers who switch to exclusive use of electronic nicotine delivery systems (ENDS). We compared cardiovascular disease incidence in combustible-tobacco users, those who transitioned to ENDS use, and those who quit tobacco with never tobacco users. Methods: This prospective cohort study analyzes five waves of Population Assessment of Tobacco and Health (PATH) Study data, Wave 1 (2013–2014) through Wave 5 (2018–2019). Cardiovascular disease (CVD) incidence was captured over three intervals (Waves 1 to 3, Waves 2 to 4, and Waves 3 to 5). Participants were adults (40+ years old) without a history of CVD for the first two waves of any interval. Change in tobacco use status, from exclusive past 30 day use of any combustible-tobacco product to either exclusive past 30 day ENDS use, dual past 30 day use of ENDS and combustible-tobacco, or no past 30 day use of any tobacco, between the first two waves of an interval was used to predict onset of CVD between the second and third waves in the interval. CVD incidence was defined as a new self-report of being told by a health professional that they had congestive heart failure, stroke, or a myocardial infarction. Generalized estimating equation (GEE) analyses combined 10,548 observations across intervals from 7820 eligible respondents. Results: Overall, there were 191 observations of CVD among 10,548 total observations (1.7%, standard error (SE) = 0.2), with 40 among 3014 never users of tobacco (1.5%, SE = 0.3). In multivariable models, CVD incidence was not significantly different for any tobacco user groups compared to never users. There were 126 observations of CVD among 6263 continuing exclusive combustible-tobacco users (adjusted odds ratio [AOR] = 1.44; 95% confidence interval (CI) 0.87–2.39), 15 observations of CVD among 565 who transitioned to dual use (AOR = 1.85; 0.78–4.37), and 10 observations of CVD among 654 who quit using tobacco (AOR = 1.18; 0.33–4.26). There were no observations of CVD among 53 who transitioned to exclusive ENDS use. Conclusions: This study found no difference in CVD incidence by tobacco status over three 3 year intervals, even for tobacco quitters. It is possible that additional waves of PATH Study data, combined with information from other large longitudinal cohorts with careful tracking of ENDS use patterns may help to further clarify this relationship.Changes in Biomarkers of Tobacco Exposure among Cigarette Smokers Transitioning to ENDS Use: The Population Assessment of Tobacco and Health Study, 2013–2015
Correlates of tobacco product initiation among youth and young adults between waves 1–4 of the population assessment of tobacco and Health (PATH) study (2013–2018)