Raymond S Niaura

Professor of Social and Behavioral Sciences

Professional overview

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.

Education

BA, Psychology (First Class Honors), McGill University, Montreal, Canada

MS, Psychology, Rutgers University, New Brunswick, NJ

PhD, Psychology, Rutgers University, New Brunswick, NJ

Honors and awards

Research Laureate, American Academy of Health Behavior (2009)

University Scholar Award, McGill University (1979)

Areas of research and study

Alcohol, Tobacco and Driving Policies

Evaluations

Health Disparities

Substance Abuse

Tobacco Control

Publications

Publications

Adherence to treatment for nicotine dependence

Abrams, D. S., Borrelli, B., Shadel, W., King, T., Bock, B., & Niaura, R. S. (n.d.). (S. Shumaker & J. Ockene, Eds.; 2nd ed.).

Publication year

1998

Page(s)

137-165

Abstract

Abstract

~

Adolescent tobacco use and substance abuse treatment outcomes

de Dios, M. A., Vaughan, E. L., Stanton, C. A., & Niaura, R. S. (n.d.).

Publication year

2009

Journal title

Journal of Substance Abuse Treatment

Volume

37

Issue

1

Page(s)

17-24

10.1016/j.jsat.2008.09.006

Abstract

Abstract

This study investigated the relationship between cigarette-smoking status and 12-month alcohol and marijuana treatment outcomes in a sample of 1,779 adolescents from the Drug Abuse Treatment Outcomes Study for Adolescents. Participants were classified into four groups based on change in cigarette-smoking status from intake to the 12-month follow-up: persistent smokers, nonsmokers, quitters, and smoking initiators. Logistic regression was used to predict likelihood of relapse to alcohol, marijuana, and other drugs after controlling for intake levels and demographic/treatment characteristics. Results found persistent smokers and smoking initiators to have significantly greater odds of alcohol and marijuana relapse compared with quitters. Furthermore, persistent smokers and smoking initiators were also found to have distinctively shorter periods to marijuana relapse at follow-up. Implications for the implementation of tobacco cessation treatment in the context of substance abuse treatment for adolescents are discussed.

Adolescents' reactions to the imagery displayed in smoking and antismoking advertisements

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

Publication year

2002

Journal title

Psychology of Addictive Behaviors

Volume

16

Issue

2

Page(s)

173-176

10.1037/0893-164X.16.2.173

Abstract

Abstract

This study compared adolescents' unbiased perceptions of the images displayed in smoking and antismoking advertising. Twenty-nine adolescents (ages 11-17) were shown images taken from both advertising types; all images were digitally edited so that no product information appeared in them. Participants described each image in a free-response format and rated each image on self-report dimensions. Content analyses of free-response descriptions and analyses of self-reports revealed that adolescents viewed images taken from cigarette advertisements more positively compared with images taken from antismoking advertisements. These findings suggest that 1 reason for the potency of cigarette advertising, compared with antismoking advertising, is the inherent positive appeal of the images displayed. Antismoking advertising may be more effective at limiting adolescent smoking if the images displayed have a more positive valence.

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

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

Publication year

2004

Journal title

Addictive Behaviors

Volume

29

Issue

9

Page(s)

1735-1744

10.1016/j.addbeh.2004.03.042

Abstract

Abstract

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

Adult interest in using a hypothetical modified risk tobacco product : findings from wave 1 of the Population Assessment of Tobacco and Health Study (2013–14)

Pearson, J. L., Johnson, A. L., Johnson, S. E., Stanton, C. A., Villanti, A. C., Niaura, R. S., Glasser, A. M., Wang, B., Abrams, D. B., Cummings, K. M., & Hyland, A. (n.d.).

Publication year

2018

Journal title

Addiction

Volume

113

Issue

1

Page(s)

113-124

10.1111/add.13952

Abstract

Abstract

Background and aims: The US Family Smoking Prevention and Tobacco Control Act provides a pathway for manufacturers to market a modified risk tobacco product (MRTP). This study examines socio-demographic and tobacco use correlates of interest in a hypothetical MRTP in a nationally representative sample of US adults. Design: Cross sectional wave 1 data from the 2013–14 Population Assessment of Tobacco and Health (PATH) Study. Setting: Household Audio-Computer Assisted Self-Interviews of US adults conducted in 2013–14. Participants: A total of 32 320 civilian, non-institutionalized adults in the United States. Measurements: Interest in using a hypothetical MRTP (‘If a tobacco product made a claim that it was less harmful to health than other tobacco products, how likely would you be to use that product?’), socio-demographics, tobacco use history and mental health and substance use problems. All estimates were weighted. Findings: Overall, 16.7% [95% confidence interval (CI) = 16.28, 17.18] of US adults reported interest in a hypothetical MRTP. Tobacco use was associated significantly with interest in a hypothetical MRTP, with interest most common among current established smokers (54.4%; 95% CI = 53.31, 55.39) and least common among never tobacco users (3.0%; 95% CI = 2.49, 3.55). Interest in a hypothetical MRTP was associated with experimental e-cigarette use among current experimental, current established and former smokers. Among non-smokers, race, age, education and substance use were associated with interest in using a hypothetical MRTP. Conclusions: Among adults in the United States, interest in using a hypothetical modified risk tobacco product is low overall, and highest among current experimental and established smokers. A small percentage of non-smokers are interested in using a hypothetical hypothetical modified risk tobacco product.

Advice on using over-the-counter nicotine replacement therapy-patch, gum, or lozenge-to quit smoking

Kozlowski, L. T., Giovino, G. A., Edwards, B., DiFranza, J., Foulds, J., Hurt, R., Niaura, R. S., Sachs, D. P., Selby, P., Dollar, K. M., Bowen, D., Cummings, K. M., Counts, M., Fox, B., Sweanor, D., & Ahern, F. (n.d.).

Publication year

2007

Journal title

Addictive Behaviors

Volume

32

Issue

10

Page(s)

2140-2150

10.1016/j.addbeh.2007.01.030

Abstract

Abstract

Although the use of over the counter (OTC) nicotine replacement therapy (NRT) is effective for smoking cessation, many concerns and misunderstandings persist that may reduce the effectiveness of NRT. Clinical practice and public health experts responded to a questionnaire that explored challenges associated with promoting proper NRT use and gathered recommendations on overcoming these challenges. Two predominant themes emerged including the identification of policies and practices that hinder NRT use, and smokers' views regarding NRT use. To address these needs, a two-part consensus statement about the use of OTC NRT to quit smoking was developed. The first part of the consensus statement identifies policy issues. The second part of the consensus statement was developed for smokers to reduce misperceptions and concerns about NRT by providing information on safety and the most effective use of NRT. The statement integrates state of the art clinical practice guidelines in a patient-centered format and presents information for policy makers to effectively support quit attempts.

Alcohol and the disinhibition of sexual responsiveness

Niaura, R. S., Wilson, G. T., & Niaura, R. (n.d.).

Publication year

1984

Journal title

Journal of Studies on Alcohol

Volume

45

Issue

3

Page(s)

219-224

10.15288/jsa.1984.45.219

Abstract

Abstract

~

Alcohol and tobacco: From basic science to clinical practice. Overview and commentary on psychosocial and biological mechanisms

Niaura, R. S., & Shiffman, S. (n.d.).

Publication year

1995

Page(s)

159-168

Abstract

Abstract

~

Alcohol cue reactivity : Effects of detoxification and extended exposure

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

Publication year

1993

Journal title

Journal of Studies on Alcohol

Volume

54

Issue

2

Page(s)

235-245

10.15288/jsa.1993.54.235

Abstract

Abstract

Alcoholics' reactions to drinking-related stimuli (cue reactivity) have been well documented and alcohol cue exposure treatment has been conducted recently in several clinical trials. Prior to conducting large-scale clinical trials it is important to know what effects detoxification may have on cue reactivity. However, no information is available about the effects of stage of detoxification or of detoxification medication on alcohol cue reactivity. In this study, 45 male alcoholics, detoxified without medication, were assessed during either their second, fourth or sixth day of withdrawal. Further, their reactivity was compared to that of alcoholics detoxified with chlordiazepoxide (n = 15), and to that of alcoholics in their fourth week after drinking (n = 28). Cue reactivity assessment investigated salivation and urge to drink after 3 minutes of water cue exposure and then after 3 minutes of alcohol cue exposure. Urges to drink were assessed during an additional 15 minutes of alcohol exposure to explore latency to maximum reactivity and habituation. Reactivity did not differ as a function of group membership, although salivation was elevated to both beverages during the first week of detoxification. Of the sample, 70% reacted to alcohol with increased urge and 65% with increased salivation, with no difference between groups in proportions of reactors. The maximum urge to drink occurred in the first 6 minutes of alcohol exposure, followed by a gradual and significant decrease. There were no differences on these measures between alcoholics in their first or fourth week after their last drink. Implications for theory and clinical applications are discussed.

Alcohol, selective attention and sexual arousal in men

Niaura, R. S., Wilson, G. T., Niaura, R. S., & Adler, J. L. (n.d.).

Publication year

1985

Journal title

Journal of Studies on Alcohol

Volume

46

Issue

2

Page(s)

107-115

10.15288/jsa.1985.46.107

Abstract

Abstract

~

An academic detailing intervention to disseminate physician-delivered smoking cessation counseling : Smoking cessation outcomes of the Physicians Counseling Smokers Project

Goldstein, M. G., Niaura, R. S., Willey, C., Kazura, A., Rakowski, W., DePue, J., & Park, E. (n.d.).

Publication year

2003

Journal title

Preventive Medicine

Volume

36

Issue

2

Page(s)

185-196

10.1016/S0091-7435(02)00018-X

Abstract

Abstract

Background. Little is known about the effectiveness of interventions to disseminate smoking cessation interventions among a population of primary care physicians. This study's objective was to determine the effect of a community-based academic detailing intervention on the quit rates of a population-based sample of smokers. Methods. This community-based, quasi-experimental study involved representative samples of 259 primary care physicians and 4295 adult smokers. An academic detailing intervention was delivered to physicians in intervention areas over a period of 15 months. Analyses were performed on the data from the 2346 subjects who reported at least one physician visit over 24 months. Multivariate regression analyses were conducted to determine the impact of the intervention on self-reported smoking quit rates, reported by adjusted odds ratios. Results. Among smokers reporting a physician visit during the study period, there was a borderline significant effect for those residing in intervention areas versus control areas (OR = 1.35; 95% CI .99-1.83; P = 0.057). Among a subgroup of 819 smokers who reported a visit with an enrolled physician, we observed a significant effect for those residing in intervention areas (OR = 1.80; 95% CI 1.16-2.75; P = 0.008). Conclusion. An academic detailing intervention to enhance physician delivered smoking cessation counseling is an effective strategy for disseminating smoking cessation interventions among community-based practices.

An African-specific haplotype in MRGPRX4 is associated with menthol cigarette smoking

Niaura, R. S., Kozlitina, J., Risso, D., Lansu, K., Olsen, R. H., Sainz, E., Luiselli, D., Barik, A., Frigerio-Domingues, C., Pagani, L., Wooding, S., Kirchner, T., Niaura, R., Roth, B., & Drayna, D. (n.d.).

Publication year

2019

Journal title

PLoS genetics

Volume

15

Issue

2

10.1371/journal.pgen.1007916

Abstract

Abstract

In the U.S., more than 80% of African-American smokers use mentholated cigarettes, compared to less than 30% of Caucasian smokers. The reasons for these differences are not well understood. To determine if genetic variation contributes to mentholated cigarette smoking, we performed an exome-wide association analysis in a multiethnic population-based sample from Dallas, TX (N = 561). Findings were replicated in an independent cohort of African Americans from Washington, DC (N = 741). We identified a haplotype of MRGPRX4 (composed of rs7102322[G], encoding N245S, and rs61733596[G], T43T), that was associated with a 5-to-8 fold increase in the odds of menthol cigarette smoking. The variants are present solely in persons of African ancestry. Functional studies indicated that the variant G protein-coupled receptor encoded by MRGPRX4 displays reduced agonism in both arrestin-based and G protein-based assays, and alteration of agonism by menthol. These data indicate that genetic variation in MRGPRX4 contributes to inter-individual and inter-ethnic differences in the preference for mentholated cigarettes, and that the existence of genetic factors predisposing vulnerable populations to mentholated cigarette smoking can inform tobacco control and public health policies.

An experimental study of the effects of electronic cigarette warnings on young adult nonsmokers' perceptions and behavioral intentions

Mays, D., Smith, C., Johnson, A. C., Tercyak, K. P., & Niaura, R. S. (n.d.).

Publication year

2016

Journal title

Tobacco Induced Diseases

Volume

14

Issue

1

10.1186/s12971-016-0083-x

Abstract

Abstract

Background: Electronic cigarette ("e-cigarette") manufacturers use warning labels on their advertising that vary widely in content and the U.S. Food and Drug Administration has issued a warning label requirement for e-cigarettes. There is limited data on the effects of these warnings on e-cigarette perceptions and other potential predictors of future tobacco use behavior in populations of interest to inform future regulatory requirements. This study examined the effects of e-cigarette warnings on perceptions of e-cigarettes and cigarettes and other cognitive precursors to tobacco use among young adult non-smokers. Methods: Non-smoking young adults ages 18 to 30 years (n = 436) were recruited through an internet-based crowdsourcing platform for an online experiment. Participants completed pre-exposure measures of demographics, tobacco use, and other relevant constructs and were randomized to view 1 of 9 e-cigarette stimuli in a 3 (Ad/Warning condition: Ad Only, Ad with Warning, Warning Only) x 3 (E-cigarette brand: Blu, MarkTen, Vuse) design. After viewing e-cigarette stimuli, participants reported perceptions of e-cigarettes and behavioral intentions to use e-cigarettes. Participants in the Ad Only and Ad with Warning conditions also completed a heat-mapping task assessing aspects of the ads that captured their attention. Then, participants were randomized to view cigarette ads from 1 of 3 major cigarette brands and reported perceptions of cigarettes and intentions to smoke cigarettes. Results: Participants in the Warning Only condition reported significantly greater perceived harm and addictiveness of e-cigarettes and thoughts about not using e-cigarettes than the Ad Only and Ad with Warning conditions (p's

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

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

Publication year

2000

Journal title

Cognitive Therapy and Research

Volume

24

Issue

3

Page(s)

345-359

10.1023/A:1005567405173

Abstract

Abstract

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

Analysis of E-cigarette use in the 2014 Eurobarometer survey : calling out deficiencies in epidemiology methods

Niaura, R. S., Polosa, R., Caponnetto, P., Niaura, R., & Abrams, D. S. (n.d.).

Publication year

2017

Journal title

Internal and Emergency Medicine

Volume

12

Issue

6

Page(s)

733-735

10.1007/s11739-017-1667-z

Abstract

Abstract

~

Anxiety Characteristics Independently and Prospectively Predict Myocardial Infarction in Men. The Unique Contribution of Anxiety Among Psychologic Factors

Shen, B. J., Avivi, Y. E., Todaro, J. F., Spiro, A., Laurenceau, J. P., Ward, K. D., & Niaura, R. S. (n.d.).

Publication year

2008

Journal title

Journal of the American College of Cardiology

Volume

51

Issue

2

Page(s)

113-119

10.1016/j.jacc.2007.09.033

Abstract

Abstract

Objectives: This study investigated whether anxiety characteristics independently predicted the onset of myocardial infarction (MI) over an average of 12.4 years and whether this relationship was independent of other psychologic variables and risk factors. Background: Although several psychosocial factors have been associated with risk for MI, anxiety has not been examined extensively. Earlier studies also rarely addressed whether the association between a psychologic variable and MI was specific and independent of other psychosocial correlates. Methods: Participants were 735 older men (mean age 60 years) without a history of coronary disease or diabetes at baseline from the Normative Aging Study. Anxiety characteristics were assessed with 4 scales (psychasthenia, social introversion, phobia, and manifest anxiety) and an overall anxiety factor derived from these scales. Results: Anxiety characteristics independently and prospectively predicted MI incidence after controlling for age, education, marital status, fasting glucose, body mass index, high-density lipoprotein cholesterol, and systolic blood pressure in proportional hazards models. The adjusted relative risk (95% confidence interval [CI]) of MI associated with each standard deviation increase in anxiety variable was 1.37 (95% CI 1.12 to 1.68) for psychasthenia, 1.31 (95% CI 1.05 to 1.63) for social introversion, 1.36 (95% CI 1.10 to 1.68) for phobia, 1.42 (95% CI 1.14 to 1.76) for manifest anxiety, and 1.43 (95% CI 1.17 to 1.75) for overall anxiety. These relationships remained significant after further adjusting for health behaviors (drinking, smoking, and caloric intake), medications for hypertension, high cholesterol, and diabetes during follow-up and additional psychologic variables (depression, type A behavior, hostility, anger, and negative emotion). Conclusions: Anxiety-prone dispositions appear to be a robust and independent risk factor of MI among older men.

Application of functional neuroimaging to examination of nicotine dependence

David, S. P., Sweet, L. H., Cohen, R. A., MacKillop, J., Mulligan, R. C., & Niaura, R. S. (n.d.).

Publication year

2011

Page(s)

117-145

10.1007/978-1-4419-6373-4_9

Abstract

Abstract

Functional neuroimaging approaches have advanced the field of nicotine and tobacco research by making it possible to study neurobiological mechanisms associated with behaviors predictive of nicotine dependence severity and smoking cessation. This chapter provides a review of the state of the science intended to provide an introductory guide to investigators interested in the design and conduct of future studies.

Applying genetic approaches to the treatment of nicotine dependence

Lerman, C., & Niaura, R. S. (n.d.).

Publication year

2002

Journal title

Oncogene

Volume

21-48

Issue

6

Page(s)

7412-7420

10.1038/sj.onc.1205801

Abstract

Abstract

To advance the science of tobacco control, an enhanced understanding of the bio-behavioral basis of nicotine addiction is needed. In this study, we provide an overview of data from investigations of genetic factors in smoking behavior, discuss potential bio-behavioral mechanisms and effect modifiers, and suggest avenues for pharmacogenetics research in the area of smoking cessation treatment. The evidence to date is very consistent with respect to the significance of genetic contributions to smoking behavior. However, attempts to elucidate the role of specific genetic variants have met with mixed success. Explanations for the lack of consistency in the results of genetic association studies include biases in ascertainment, ethnic admixture, lack of attention to covariates or modifiers of genetic risk, and the need for more refined phenotypes. As the field of genetics and smoking research progresses, increasing attention is being devoted to gene-environment interactions, with particular attention to the identification of genetic variants that may modify the effects of pharmacological treatment for smoking. With advances in molecular biology and genomics technology, individualized tailoring of smoking cessation therapy to genotype is within our grasp. Such research has the potential to improve treatment outcome, thereby reducing morbidity and mortality from smoking-related disease.

Are adolescent smokers dependent on nicotine? A review of the evidence

Colby, S. M., Tiffany, S. T., Shiffman, S., & Niaura, R. S. (n.d.).

Publication year

2000

Journal title

Drug and alcohol dependence

Volume

59

Issue

SUPPL. 1

Page(s)

83-95

10.1016/S0376-8716(99)00166-0

Abstract

Abstract

This paper reviews the empirical literature on adolescent nicotine dependence, withdrawal, and their associated features. Data documenting nicotine dependence scores, diagnoses, and individual features among adolescents are reviewed in detail and compared to observations based on adult smokers. These data are derived from a broad variety of sources, including national surveys, school-based surveys, and smoking cessation studies. Overall, results indicate that one to three out of five adolescent smokers is dependent on nicotine, with some adolescent groups clearly at higher risk for dependence (those who are incarcerated, in vocational schools, daily smokers, and/or heavy smokers). Across studies, data consistently indicate that a large majority (two-thirds or more) of adolescent smokers report experiencing withdrawal symptoms during attempts to quit or reduce their smoking. Craving or strong desire to smoke was the most commonly reported withdrawal symptom in every study reviewed. Although analyses of concurrent validity generally support the dependence and withdrawal findings among adolescents, data on the predictive validity of measures used are needed. Moreover, studies of adolescent tobacco withdrawal rely almost exclusively on retrospective self-report data. Recommendations for enhancing methodology and advancing our understanding of adolescent nicotine dependence and withdrawal are offered. Copyright (C) 2000 Elsevier Science Ireland Ltd.

Are emergency chest pain patients ready to quit smoking?

Bock, B. C., Becker, B. M., Partridge, R., & Niaura, R. S. (n.d.).

Publication year

2007

Journal title

Preventive cardiology

Volume

10

Issue

2

Page(s)

76-82

10.1111/j.1520-037X.2007.06443.x

Abstract

Abstract

This study examined predictors of readiness to quit smoking among emergency chest pain patients admitted to the observation unit (OU) to rule out myocardial infarction. While in the OU, patients (n=543) completed surveys assessing smoking history, nicotine dependence, readiness to quit, and other relevant variables. Participants smoked an average of 18.8 (SD=12.6) cigarettes per day. More than half (58%) had made at least 1 serious quit attempt > or = 24 hours) in the past year. Most had never used nicotine replacement medications. Nicotine dependence, perceived risk from smoking, and patient perceptions that smoking might be related to their chest pain were significantly associated with readiness to quit (P

Are metabolic risk factors one unified syndrome? Modeling the structure of the metabolic syndrome X

Shen, B. J., Todaro, J. F., Niaura, R. S., McCaffery, J. M., Zhang, J., Spiro, A., & Ward, K. D. (n.d.).

Publication year

2003

Journal title

American Journal of Epidemiology

Volume

157

Issue

8

Page(s)

701-711

10.1093/aje/kwg045

Abstract

Abstract

The metabolic syndrome, manifested by insulin resistance, obesity, dyslipidemia, and hypertension, is conceived to increase the risk for coronary heart disease and type II diabetes. Several studies have used factor analysis to explore its underlying structure among related risk variables but reported different results. Taking a hypothesis-testing approach, this study used confirmatory factor analysis to specify and test the factor structure of the metabolic syndrome. A hierarchical four-factor model, with an overarching metabolic syndrome factor uniting the insulin resistance, obesity, lipid, and blood pressure factors, was proposed and tested with 847 men who participated in the Normative Aging Study between 1987 and 1991. Simultaneous multigroup analyses were also conducted to test the stability of the proposed model across younger and older participants and across individuals with and without cardiovascular disease. The findings demonstrated that the proposed structure was well supported (comparative fit index = 0.97, root mean square error approximation = 0.06) and stable across subgroups. The metabolic syndrome was represented primarily by the insulin resistance and obesity factors, followed by the lipid factor, and, to a lesser extent, the blood pressure factor. This study provides an empirical foundation for conceptualizing and measuring the metabolic syndrome that unites four related components (insulin resistance, obesity, lipids, and blood pressure).

Are smokers with HIV using information and communication technology? implications for behavioral interventions

Chander, G., Stanton, C., Hutton, H. E., Abrams, D. B., Pearson, J., Knowlton, A., Latkin, C., Holtgrave, D., Moore, R. D., & Niaura, R. S. (n.d.).

Publication year

2012

Journal title

AIDS and Behavior

Volume

16

Issue

2

Page(s)

383-388

10.1007/s10461-011-9914-1

Abstract

Abstract

Smoking is highly prevalent among persons living with HIV/AIDS (PLWHA) and associated with adverse outcomes including malignancy and cardiovascular disease. Information and communication technology (ICT) may be effective in disseminating cessation interventions among PLWHA. This study examines the prevalence of ICT use among 492 PLWHA attending an urban clinic and characteristics associated with ICT use. Participants completed a survey of demographics, smoking status, and ICT use. Factors associated with ICT use were examined with logistic regression. Overall, 63% of participants smoked with 73% of smokers owning their own cell phone. Use of other modalities was lower, with 48% of smokers reporting any internet use, 39% text messaging, and 31% using email. Higher education was associated with the use of all modalities. Cell phone interventions may have the broadest reach among PLWHA, though with almost half using the internet, this may also be a low-cost means of delivering cessation interventions.

Are stress eaters at risk for the metabolic syndrome?

Niaura, R. S., Epel, E., Jimenez, S., Brownell, K., Stroud, L., Stoney, C., & Niaura, R. (n.d.).

Publication year

2004

Journal title

Annals of the New York Academy of Sciences

Volume

1032

Page(s)

208-210

10.1196/annals.1314.022

Abstract

Abstract

Stress eating is a health behavior that has been overlooked in much of health psychology research. It is largely unknown why some tend to eat during or after stressful periods, whereas others tend to lose their appetite and lose weight. Furthermore, it is unknown if such transient changes in food intake or macronutrient composition during stress have clinically significant consequences in terms of weight and metabolic health. The Brown University Medical Student Study examined students during a baseline control period as well as during two examination periods. This design enabled an examination of weight changes in self-proclaimed stress eaters vs stress-less eaters over time. Stress eaters tended to gain more weight and demonstrated increases in nocturnal levels of insulin, cortisol, and blood levels of total/HDL cholesterol ratio, during exam periods, controlling for the baseline control period. These data show prospectively that stress eating may indeed have short-term consequences on metabolic health. Future research will need to determine whether this confers a greater risk of disease over time.

Assessing the transtheoretical model of change constructs for physicians counseling smokers

Park, E. R., DePue, J. D., Goldstein, M. G., Niaura, R. S., Harlow, L. L., Willey, C., Rakowski, W., & Prokhorov, A. V. (n.d.).

Publication year

2003

Journal title

Annals of Behavioral Medicine

Volume

25

Issue

2

Page(s)

120-126

10.1207/S15324796ABM2502_08

Abstract

Abstract

Baseline data from a population-based sample of 259 primary care physicians were used to examine the interrelations of 3 central constructs of the Transtheoretical Model of Change (TTM; stages of change, self-efficacy, and decisional balance) in regard to smoking cessation counseling behavior. In this article we explore the potential use of the TTM for future interventions to help understand and guide physicians' behavior change toward increasing adoption of smoking cessation interventions with their patients. It was hypothesized that self-efficacy and the decisional balance of counseling would be significantly related to physicians' stages of change, which in turn would be related to self-reported physician counseling behavior. Principal components analyses were conducted to examine the self-efficacy and decisional balance constructs. Coefficient alphas were .90 for self-efficacy and .84 and .78 for the pros and cons scales, respectively. Consistent with the TTM, analyses of variance revealed that later stages of physicians' readiness to provide smoking cessation counseling were associated with higher self-efficacy scores. Earlier stages showed significantly higher cons and lower pros of smoking cessation counseling. Structural equation modeling procedures supported the hypothesized path analysis model in which 3 constructs related to stage of readiness, which in turn related to reported physicians' counseling behavior.

Assessment of quality of life as observed from the baseline data of the Studies of Left Ventricular Dysfunction (SOLVD) trial quality-of-life substudy

Gorkin, L., Norvell, N. K., Rosen, R. C., Charles, E., Shumaker, S. A., McIntyre, K. M., Capone, R. J., Kostis, J., Niaura, R. S., Woods, P., Hosking, J., Garces, C., Handberg, E., Ahern, D. K., Follick, M. J., & The SOLVD Investigators, S. I. (n.d.).

Publication year

1993

Journal title

The American Journal of Cardiology

Volume

71

Issue

12

Page(s)

1069-1073

10.1016/0002-9149(93)90575-W

Abstract

Abstract

The improvement of aspects of a patient's quality of life may be as important as prolonging survival in evaluating clinical trials of heart failure. The purpose off this study was to analyze the psychometric properties of the baseline measures from the quality-of-life substudy from the Studies of Left Ventricular Dysfunction (SOLVD) trial. The measures included the 6-Minute Walk Test, Dyspnea Scale, Living with Heart Failure, Physical Limitations, Psychologic Distress and Health Perceptions, as reported by both patients and staff. Cognitive functioning, such as Vocabulary, Digit Span and Trails Making, was also assessed. Patients were classified as New York Heart Association class I (n = 158) versus II or III (n = 150). The internal consistencies (i.e., reliabilities) of the self-report measures were high, except for the Health Perceptions of Class II or III patients. Reliability of the SOLVD quality-of-life battery was confirmed by significantly better life quality among New York Heart Association class I patients versus class II or III patients combined on the Walk Test, Physical Limitations, Dyspnea, Living with Heart Failure, Psychologic Distress and staff perceptions of patient health. In accordance with prior studies, the measures were uncorrelated with left ventricular ejection fraction. By demonstrating strong internal consistencies, reliability based on physician reports, and independence of ejection fraction levels, use of this quality-of-life assessment battery in this and other clinical trials of compromised ventricular functioning is supported.