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
Molecular genetics of successful smoking cessation : Convergent genome-wide association study results
AbstractNiaura, R. S., Uhl, G. R., Liu, Q. R., Drgon, T., Johnson, C., Walther, D., Rose, J. E., David, S. P., Niaura, R., & Lerman, C. (n.d.).Publication year
2008Journal title
Archives of General PsychiatryVolume
65Issue
6Page(s)
683-693AbstractContext: Smoking remains a major public health problem. Twin studies indicate that the ability to quit smoking is substantially heritable, with genetics that overlap modestly with the genetics of vulnerability to dependence on addictive substances. Objectives: To identify replicated genes that facilitate smokers' abilities to achieve and sustain abstinence from smoking (hereinafter referred to as quit-success genes) found in more than 2 genome-wide association (GWA) studies of successful vs unsuccessful abstainers, and, secondarily, to nominate genes for selective involvement in smoking cessation success with bupropion hydrochloride vs nicotine replacement therapy (NRT). Design: The GWA results in subjects from 3 centers, with secondary analyses of NRT vs bupropion responders. Setting: Outpatient smoking cessation trial participants from 3 centers. Participants: European American smokers who successfully vs unsuccessfully abstain from smoking with biochemical confirmation in a smoking cessation trial using NRT, bupropion, or placebo (N=550). Main Outcome Measures: Quit-success genes, reproducibly identified by clustered nominally positive single-nucleotide polymorphisms (SNPs) in more than 2 independent samples with significant P values based on Monte Carlo simulation trials. The NRT-selective genes were nominated by clustered SNPs that display much larger t values for NRT vs placebo comparisons. The bupropion-selective genes were nominated by bupropion-selective results. Results: Variants in quit-success genes are likely to alter cell adhesion, enzymatic, transcriptional, structural, and DNA, RNA, and/or protein-handling functions. Quit-success genes are identified by clustered nominally positive SNPs from more than 2 samples and are unlikely to represent chance observations (Monte Carlo PNonpharmacologic Therapy for Smoking Cessation : Characteristics and Efficacy of Current Approaches
AbstractNiaura, R. S. (n.d.).Publication year
2008Journal title
American Journal of MedicineVolume
121Issue
4 SUPPL.Page(s)
S11-S19AbstractThis article reviews the most common nonpharmacologic approaches used to support smoking cessation and, where possible, provides estimates of their efficacy in controlled clinical trials. Virtually all of the approaches that have been systematically evaluated to date have demonstrated modest efficacy in increasing quit rates. A cornerstone of effective treatment is tobacco dependence counseling, for which there is a dose-response relation between the intensity of counseling (total minutes of contact) and its effectiveness. New approaches in which treatment is tailored to individual patient characteristics appear promising for the future but require further study. Also, new technologies that permit delivery of smoking interventions to a wider range of patients could have a significant impact on reducing smoking prevalence worldwide in the future. Overall, the clinical literature strongly endorses combining nonpharmacologic interventions with pharmacotherapy to optimize support for smokers who are trying to quit.Smoking cessation among patients in an emergency chest pain observation unit : Outcomes of the Chest Pain Smoking Study (CPSS)
AbstractBock, B. C., Becker, B. M., Niaura, R. S., Partridge, R., Fava, J. L., & Trask, P. (n.d.).Publication year
2008Journal title
Nicotine and Tobacco ResearchVolume
10Issue
10Page(s)
1523-1531AbstractThis study examines the efficacy of a smoking cessation intervention on abstinence rates and motivation to quit smoking. Participants were adult smokers (N = 543) who presented to the emergency department with chest pain and who were admitted to an observation unit for 24-hour observation to rule out myocardial infarction. Participants were randomly assigned to either usual care or a tailored intervention employing motivational interviewing and telephone follow-up. All individuals choosing to quit were offered nicotine patch therapy. Follow-up assessments were conducted at 1, 3 and 6 months. Abstinence (7-day point prevalence) rates were significantly greater among participants receiving the tailored intervention compared with those given usual care (OR = 1.62, 95% CI [1.05-2.50]). The largest difference occurred at 1 month: 16.8% of usual care and 27.3% of the tailored intervention group were abstinent, with differences decreasing over time. One-third of participants who were quit at month 6 were late quitters whose initial abstinence began after the 1-month follow up. In addition to treatment assignment, psychosocial variables including motivation to quit, confidence, reduced temptation to smoke in response to negative affect, and the perception that their chest pain was related to their smoking, were significant predictors of cessation. Tailored interventions are effective in promoting initial quit attempts for emergency chest pain patients admitted to an observation unit. Additional intervention may be needed to assist late quitters and to prevent relapse.The effectiveness of covering smoking cessation services for medicare beneficiaries
AbstractJoyce, G. F., Niaura, R. S., Maglione, M., Mongoven, J., Larson-Rotter, C., Coan, J., Lapin, P., & Morton, S. (n.d.).Publication year
2008Journal title
Health Services ResearchVolume
43Issue
6Page(s)
2106-2123AbstractObjective. To examine whether reimbursement for Provider Counseling, Pharmacotherapies, and a telephone Quitline increase smoking cessation relative to Usual Care. Study Design. Randomized comparison trial testing the effectiveness of four smoking cessation benefits. Setting. Seven states that best represented the national population in terms of the proportion of those ≥65 years of age and smoking rate. Participants. There were 7,354 seniors voluntarily enrolled in the Medicare Stop Smoking Program and they were followed-up for 12 months. Intervention(s). (1) Usual Care, (2) reimbursement for Provider Counseling, (3) reimbursement for Provider Counseling with Pharmacotherapy, and (4) telephone counseling Quitline with nicotine patch. Main Outcome Measure. Seven-day self-reported cessation at 6- and 12-month follow-ups. Principal Findings. Unadjusted quit rates assuming missing data=smoking were 10.2 percent (9.0-11.5), 14.1 percent (11.7-16.5), 15.8 percent (14.4-17.2), and 19.3 percent (17.4-21.2) at 12 months for the Usual Care, Provider Counseling, Provider Counseling + Pharmacotherapy, and Quitline arms, respectively. Results were robust to sociodemographics, smoking history, motivation, health status, and survey nonresponse. The additional cost per quitter (relative to Usual Care) ranged from several hundred dollars to $6,450. Conclusions. A telephone Quitline in conjunction with low-cost Pharmacotherapy was the most effective means of reducing smoking in the elderly.The efficacy and safety of varenicline for smoking cessation using a flexible dosing strategy in adult smokers : A randomized controlled trial
AbstractNiaura, R. S., Hays, J. T., Jorenby, D. E., Leone, F. T., Pappas, J. E., Reeves, K. R., Williams, K. E., & Billing, C. B. (n.d.).Publication year
2008Journal title
Current Medical Research and OpinionVolume
24Issue
7Page(s)
1931-1941AbstractObjective: To determine whether self-regulated flexible dosing with varenicline tartrate is safe and effective for smoking cessation. Research design and methods: 320 healthy, motivated-to-quit smokers (≥10 cigarettes/day) aged 18-65 years, entered a multicenter, randomized, double-blind, placebo-controlled study - conducted between December 26, 2001 and June 24, 2003 - with a 12-week treatment phase and 40-week, double-blind, non-treatment follow-up. Treatment consisted of varenicline or placebo in fixed doses (Week 1: titrated from 0.5 to 1.0 mg/day) followed by a self-regulated flexible schedule (Weeks 2-12: 0.5-2.0 mg/day). Main outcome measures: Primary outcomes included carbon monoxide-confirmed continuous abstinence rate (CAR) from smoking for Weeks 4 through 7, 9 through 12, and 9 through 52. Secondary outcomes included CAR from Weeks 9 through 24, 7-day point prevalence of abstinence, safety assessments, and measures of craving, withdrawal, and smoking reward. Results: Superior CARs were observed in varenicline-treated (n = 157) versus placebo participants (n = 155) for Weeks 4 through 7 (38.2 vs. 11.6%), 9 through 12 (40.1 vs. 11.6%), 9 through 24 (28.0 vs. 9.0%), and 9 through 52 (22.3 vs. 7.7%) (all p < 0.001). Seven-day point prevalence was higher in varenicline-treated than placebo participants at Weeks 12 (46.5 vs. 14.2%; p < 0.001), 24 (32.5 vs. 13.5%; p < 0.001), and 52 (28.0 vs. 13.5%; p = 0.001). Overall, medication compliance was high, although varenicline-treated, but not placebo, participants tended to taper down their dosage over time. Total treatment-emergent AEs were 77.1% (varenicline: 121/157) and 65.8% (placebo: 102/155). Few AEs led to treatment discontinuation (varenicline: 11/157, 7.0% and placebo: 7/155, 4.5%). Participants were primarily healthy Caucasians, so more research is necessary to determine how applicable these findings are to other populations. Conclusions: A self-regulated, flexible dosing regimen of varenicline is well tolerated, with superior effectiveness versus placebo for smoking cessation.The prospective contribution of hostility characteristics to high fasting glucose levels
AbstractShen, B. J., Countryman, A. J., Spiro, A., & Niaura, R. S. (n.d.).Publication year
2008Journal title
Diabetes CareVolume
31Issue
7Page(s)
1293-1298AbstractOBJECTIVE - To assess whether psychological constructs of hostility, anger, type A behavior pattern, and depressive symptom severity 1) were associated with concurrent and prospective fasting glucose levels and 2) whether this association was moderated by marital status. RESEARCH DESIGN AND METHODS -Participants were 485 healthy men ([mean ± SD] age 59 plusmn 7 years) without a history of heart disease, diabetes, or taking related medications in the Veterans Affairs Normative Aging Study. Their fasting glucose levels between 1986 and 1995 were examined. Hierarchical linear regressions were conducted to investigate whether hostility, anger, type A behavior, and depressive symptoms were associated with concurrent fasting glucose levels as well as fasting glucose 9 years later, controlling for standard sociodemographic and biomedical covariates, including baseline fasting glucose, age, education, marital status, BMI, total cholesterol, and systolic blood pressure. RESULTS - Although none of the psychological variables were associated with concurrent fasting glucose, Cook-Medley hostility (β = 0.105), anger (β = 0.091), and type A behavior (β = 0.152) each were associated with prospective fasting glucose 9 years later, controlling for standard covariates. Depressive symptom severity was not associated with either concurrent or follow-up glucose levels. Further analysis showed that marital status moderated the effects of these characteristics on follow-up fasting glucose such that hostility, anger, and type A behavior were significant only among those who were not married (β = 0.348, 0.444, 0.439, respectively; all PThe relationship between early life stress and microstructural integrity of the corpus callosum in a non-clinical population
AbstractPaul, R., Henry, L., Grieve, S. M., Guilmette, T. J., Niaura, R. S., Bryant, R., Bruce, S., Williams, L. M., Richard, C. C., Cohen, R. A., & Gordon, E. (n.d.).Publication year
2008Journal title
Neuropsychiatric Disease and TreatmentVolume
4Issue
1 BPage(s)
193-201AbstractBackground: Previous studies have examined the impact of early life stress (ELS) on the gross morphometry of brain regions, including the corpus callosum. However, studies have not examined the relationship between ELS and the microstructural integrity of the brain. Methods: In the present study we evaluated this relationship in healthy non-clinical participants using diffusion tensor imaging (DTI) and self-reported history of ELS. Results: Regression analyses revealed significant reductions in fractional anisotropy (FA) within the genu of the corpus callosum among those exposed to the greatest number of early life stressors, suggesting reduced microstructural integrity associated with increased ELS. These effects were most pronounced in the genu of the corpus callosum compared to the body and splenium, and were evident for females rather than mates despite no differences in total ELS exposure between the sexes. In addition, a further comparison of those participants who were exposed to no ELS vs. three or more ELS events revealed lower FA in the genu of the corpus callosum among the ELS-exposed group, with trends of FA reduction in the body and the whole corpus callosum. By contrast, there were no relationships between ELS and volumetric analysis of the CC regions. The two group did not differ significantly on measures of current depression, stress or anxiety. Conclusion: Our results reveal that greater exposure to ELS is associated with microstructural alterations in the white matter in the absence of significant volumetric changes. Importantly, our results indicate that exposure to ELS is associated with abnormalities on DTI despite the absence of clinically significant psychiatric symptoms. Future studies are needed to determine whether specific types of ELS are more likely to impact brain structure and function.The role of negative affect in risk for early lapse among low distress tolerance smokers
AbstractAbrantes, A. M., Strong, D. R., Lejuez, C. W., Kahler, C. W., Carpenter, L. L., Price, L. H., Niaura, R. S., & Brown, R. A. (n.d.).Publication year
2008Journal title
Addictive BehaviorsVolume
33Issue
11Page(s)
1394-1401AbstractIndividual differences in the ability to tolerate negative affect due to psychological and/or physical discomfort (e.g., distress tolerance) are emerging as an important predictor of smoking cessation outcomes. The purpose of this study was to build on existing evidence by exploring the relationship between levels of distress tolerance (DT) and negative affect on quit date in relation to risk for early lapse. Eighty-one smokers (48% female; M age = 42.6 years) who completed laboratory-based, behavioral distress tolerance tasks prior to an unaided quit attempt were categorized into low, average, and high persistence on the tasks. Low persistence smokers were significantly more likely to lapse on the assigned quit day. Among smokers able to achieve abstinence on quit day, low persistence smokers demonstrated higher levels of negative affect and urges compared to high persistence smokers. Further, negative affect-related risk for early lapse was strongest among those with low persistence. These findings suggest that smokers low in distress tolerance may be particularly vulnerable to very early lapse to smoking and that increases in negative affect may contribute to the risk for early lapse in this high-risk group of smokers.Advice on using over-the-counter nicotine replacement therapy-patch, gum, or lozenge-to quit smoking
AbstractKozlowski, 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
2007Journal title
Addictive BehaviorsVolume
32Issue
10Page(s)
2140-2150AbstractAlthough 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.Are emergency chest pain patients ready to quit smoking?
AbstractBock, B. C., Becker, B. M., Partridge, R., & Niaura, R. S. (n.d.).Publication year
2007Journal title
Preventive cardiologyVolume
10Issue
2Page(s)
76-82AbstractThis 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 (PBupropion and cognitive-behavioral treatment for depression in smoking cessation
AbstractBrown, R. A., Niaura, R. S., Lloyd-Richardson, E. E., Strong, D. R., Kahler, C. W., Abrantes, A. M., Abrams, D. S., & Miller, I. W. (n.d.).Publication year
2007Journal title
Nicotine and Tobacco ResearchVolume
9Issue
7Page(s)
721-730AbstractThis study is a randomized, double-blind, placebo-controlled clinical trial examining the effects of an intensive cognitive-behavioral mood management treatment (CBTD) and of bupropion, both singularly and in combination, on smoking cessation in adult smokers. As an extension of our previous work, we planned to examine the synergistic effects of CBTD and bupropion on smoking cessation outcomes in general and among smokers with depression vulnerability factors. Participants were 524 smokers (47.5% female, Mage=44.27 years) who were randomized to one of four 12-week treatments: (a) standard, cognitive-behavioral smoking cessation treatment (ST) plus bupropion (BUP), (b) ST plus placebo (PLAC), (c) standard cessation treatment combined with cognitive-behavioral treatment for depression (CBTD) plus BUP, and (d) CBTD plus PLAC. Follow-up assessments were conducted 2, 6, and 12 months after treatment, and self-reported abstinence was verified biochemically. Consistent with previous studies, bupropion, in comparison with placebo, resulted in better smoking outcomes in both intensive group treatments. Adding CBTD to standard intensive group treatment did not result in improved smoking cessation outcomes. In addition, neither CBTD nor bupropion, either alone or in combination, was differentially effective for smokers with single-past-episode major depressive disorder (MDD), recurrent MDD, or elevated depressive symptoms. However, findings with regard to recurrent MDD and elevated depressive symptoms should be interpreted with caution given the low rate of recurrent MDD and the low level of depressive symptoms in our sample. An a priori test of treatment effects in smokers with these depression vulnerability factors is warranted in future clinical trials.Bupropion efficacy for smoking cessation is influenced by the DRD2 Taq1A polymorphism : Analysis of pooled data from two clinical trials
AbstractDavid, S. P., Strong, D. R., Munafò, M. R., Brown, R. A., Lloyd-Richardson, E. E., Wileyto, P. E., Evins, E. A., Shields, P. G., Lerman, C., & Niaura, R. S. (n.d.).Publication year
2007Journal title
Nicotine and Tobacco ResearchVolume
9Issue
12Page(s)
1251-1257AbstractWe analyzed pooled data from two comparable randomized placebo-controlled clinical trials of bupropion pharmacotherapy for smoking cessation for which data on DRD2 Taq1A genotype were available. A total of 722 smokers across the two trials were randomized to 10 weeks of sustained-release bupropion hydrochloride or placebo. General estimating equation analysis demonstrated a significant gene × drug interaction (B = 0.87, SE = 0;0.34, p = .009). Smokers with the A2/A2 genotype using bupropion were more than three times as likely, relative to placebo, to be abstinent at end of treatment (35.2% vs. 15.1%; OR = 3.25, 95% CI 2.00-5.28) and at 6 months of follow-up (26.7% vs. 12.2%; OR = 2.81, 95% CI 1.66-4.77), which was attenuated by 12 months (16.3% vs. 10.7%; OR = 1.70, 95% CI 0.95-3.05). We found no significant benefit of bupropion relative to placebo on smoking cessation outcomes at any time point in participants with A1/A1 or A1/A2 genotypes. These data suggest that bupropion may be effective for smoking cessation only in a subgroup of smokers with the DRD2 Taq1 A2/A2 genotype.Catechol-O-Methyltransferase (COMT) Gene Variants Predict Response to Bupropion Therapy for Tobacco Dependence
AbstractNiaura, R. S., Berrettini, W. H., Wileyto, E. P., Epstein, L., Restine, S., Hawk, L., Shields, P., Niaura, R., & Lerman, C. (n.d.).Publication year
2007Journal title
Biological PsychiatryVolume
61Issue
1Page(s)
111-118AbstractBackground: Although bupropion is efficacious for smoking cessation, only a minority of smokers are able to quit. Pharmacogenetic research may improve treatment outcomes through discovery of DNA sequences predictive of successful pharmacotherapy for subgroups of smokers. We investigated variants in the catechol-O-methyltransferase (COMT) gene in a smoking cessation trial of bupropion. Methods: A double-blind, placebo-controlled, 10-week trial of bupropion and counseling (with a 6-month follow-up period) was conducted at two university-based smoking cessation research programs. Abstinence was biochemically verified at the end of treatment and at 6 months after the target quit date. Results: At the end of the treatment phase, statistically significant interaction effects indicated that COMT haplotypes of two SNPs (rs737865 and rs165599) predicted the efficacy of bupropion compared with placebo. This interaction effect was attenuated at 6-month follow-up. Conclusions: COMT haplotypes at rs737865 and rs165599 may predict a favorable outcome for bupropion treatment for smoking cessation. European-American smokers with a G allele at both SNPs may not benefit from bupropion treatment. Small numbers of some COMT haplotypes limit interpretation of response. If study findings are confirmed in additional large studies, COMT genotyping could be applied to identify likely responders to bupropion treatment for smoking cessation.Consistency of self-reported smoking over a 6-year interval from adolescence to young adulthood
AbstractStanton, C. A., Papandonatos, G., Lloyd-Richardson, E. E., & Niaura, R. S. (n.d.).Publication year
2007Journal title
AddictionVolume
102Issue
11Page(s)
1831-1839AbstractAims: To examine the reliability of self-report cigarette smoking questions by describing recanting (denial of previous smoking reports) in a nationally representative sample of US adolescents followed throughout young adulthood. Predictors of recanting across stages of smoking uptake/progression are examined. Design: A total of 12 985 respondents to cigarette smoking questions during in-home interviews at waves I and III (6 years apart) of the National Longitudinal Study of Adolescent Health (Add Health). The sample survey procedures of Stata 9.0 were used to produce nationally representative estimates, with standard errors adjusted for both clustering at the school level and stratification by geographical region. Measurements: Recanting probabilities determined by reports of stages of smoking uptake/progression at each time-point were predicted by race/ethnicity, parental education, household income, poverty level, depression and peer daily smoking. Findings: Stage-specific results indicated that recanting is higher when the earlier smoking was less frequent/intense. Recanters were older, from lower-income households and had higher baseline depression levels. Non-Hispanic black youth were significantly more likely to recant previous smoking compared to non-Hispanic white youth, even in multivariate models controlling for socio-demographic variables. Predictors of recanting differed by level of tobacco involvement. The greater likelihood of non-Hispanic black respondents to deny previous smoking may be a reflection of less intense or more intermittent use of tobacco that leads to recall differences over time. Conclusions: Racial/ethnic subgroups and/or respondents endorsing depressive symptoms may be more vulnerable to misclassification during interpretation of national survey data and subsequently not identified properly for prevention/intervention programs.Effects of acute nicotine abstinence on cue-elicited ventral striatum/nucleus accumbens activation in female cigarette smokers : A functional magnetic resonance imaging study
AbstractDavid, S. P., Munafò, M. R., Johansen-Berg, H., MacKillop, J., Sweet, L. H., Cohen, R. A., Niaura, R. S., Rogers, R. D., Matthews, P. M., & Walton, R. T. (n.d.).Publication year
2007Journal title
Brain Imaging and BehaviorVolume
1Issue
3-4Page(s)
43-57AbstractTo achieve greater understanding of the brain mechanisms underlying nicotine craving in female smokers, we examined the influence of nicotine non-abstinence vs. acute nicotine abstinence on cue-elicited activation of the ventral striatum. Eight female smokers underwent an event-related functional magnetic resonance imaging (fMRI) paradigm presenting randomized sequences of smoking-related and non-smoking related pictures. Participants were asked to indicate by a key press the gender of individuals in smoking-related and non-smoking related pictures (gender discrimination task), to maintain and evaluate attention to the pictures. There was a significant effect of smoking condition on reaction times (RT) for a gender discrimination task intended to assess and maintain attention to the photographs-suggesting a deprivation effect of acute nicotine abstinence and a statistical trend indicating greater RTs for smoking cues than neutral cues. BOLD contrast (smoking vs. non-smoking cues) was greater in the non-abstinent vs. acutely abstinent conditions in the ventral striatum including the nucleus accumbens (VS/NAc). Moreover, a significant positive correlation was observed between baseline cigarette craving prior to scanning and VS/NAc activation (r = 0.84, p = 0.009), but only in the non-abstinent condition. These results may either be explained by ceiling effects of nicotine withdrawal in the abstinent condition or, may indicate reduced relative activation (smoking vs. neutral contrast) in the VS/NAc in the abstinent vs. non-abstinent conditions in this group of female smokers.Long-term stability of maternal prenatal steroid hormones from the National Collaborative Perinatal Project : Still valid after all these years
AbstractStroud, L. R., Solomon, C., Shenassa, E., Papandonatos, G., Niaura, R. S., Lipsitt, L. P., LeWinn, K., & Buka, S. L. (n.d.).Publication year
2007Journal title
PsychoneuroendocrinologyVolume
32Issue
2Page(s)
140-150AbstractLarge epidemiological samples, including the National Collaborative Perinatal Project (NCPP), in which blood/serum was collected during pregnancy and offspring followed longitudinally, offer the unique opportunity to examine neuroendocrine mechanisms underlying prenatal "programming" of adult health and disease. However, in order to conduct longitudinal analyses, it is critical to determine the validity of maternal prenatal samples stored over long periods. We investigated the validity of cortisol, testosterone, and their binding globulins (corticosteroid-binding globulin (CBG) and sex hormone-binding globulin (SHBG)) in maternal prenatal serum from the NCPP after over 40 years of storage. Study 1 included 64 maternal serum samples collected on the day of delivery; study 2 involved 1099 third trimester serum samples collected between gestational weeks 31 and 36. Across both studies, cortisol and testosterone concentrations were consistent with values from published studies of fresh samples collected at similar points in gestation. CBG and SHBG were present, but showed some differences from published studies. Results support the validity of cortisol and testosterone values following 40+ years of storage. Results also provide validation for future longitudinal tests of prenatal "programming" hypotheses within the NCPP. Stability of steroid hormones over decades suggests that stored samples from other longitudinal studies may also allow opportunities to investigate links between prenatal steroids and long-term offspring outcomes.Pharmacogenetic clinical trial of sustained-release bupropion for smoking cessation
AbstractDavid, S. P., Brown, R. A., Papandonatos, G. D., Kahler, C. W., Lloyd-Richardson, E. E., Munafò, M. R., Shields, P. G., Lerman, C., Strong, D., McCaffery, J., & Niaura, R. S. (n.d.).Publication year
2007Journal title
Nicotine and Tobacco ResearchVolume
9Issue
8Page(s)
821-833AbstractThis randomized, double-blinded, placebo-controlled trial examined genetic influences on treatment response to sustained-release bupropion for smoking cessation. Smokers of European ancestry (N=291), who were randomized to receive bupropion or placebo (12 weeks) plus counseling, were genotyped for the dopamine D2 receptor (DRD2-Taq1A), dopamine transporter (SLC6A3 3' VNTR), and cytochrome P450 2B6 (CYP2B6 1459 C→T) polymorphisms. Main outcome measures were cotinine-verified point prevalence of abstinence at end of treatment and at 2-, 6-, and 12-month follow-ups post quit date. Using generalized estimating equations, we found that bupropion, compared with placebo, was associated with significantly greater odds of abstinence at all time points (all p valuesPrevalence of anxiety disorders in men and women with established coronary heart disease
AbstractTodaro, J. F., Shen, B. J., Raffa, S. D., Tilkemeier, P. L., & Niaura, R. S. (n.d.).Publication year
2007Journal title
Journal of Cardiopulmonary Rehabilitation and PreventionVolume
27Issue
2Page(s)
86-91AbstractPURPOSE: Anxiety has been associated with the development and recurrence of coronary heart disease (CHD). The objective of this study was to estimate the prevalence of anxiety disorders in men and women with established CHD. METHODS: One hundred fifty CHD patients were evaluated via a semistructured, psychiatric interview to assess both current and lifetime prevalence rates of anxiety disorders. RESULTS: Approximately 36.0% (n = 54) of cardiac patients met the diagnostic criteria for at least 1 current anxiety disorder, and 45.3% (n = 68) presented with an anxiety disorder at some point in their lifetime. Social phobia and generalized anxiety disorder were the most prevalent anxiety disorders observed, with current prevalence rates of 21.3% and 18.7%, respectively, and a lifetime prevalence of 26%. In addition, the current prevalence rate of specific phobia was approximately 14.7%, whereas 15.3% met the lifetime criteria. Lower prevalence rates for panic disorder (current = 4.7%, lifetime = 5.3%), agoraphobia (current = 3.3%, lifetime = 4.7%), posttraumatic stress disorder (current = 0%, lifetime = 1.5%), and obsessive compulsive disorder (current = 0%, lifetime = 0.7%) were observed. Female cardiac patients evidenced significantly higher current (women = 58.3% vs. 25.5%, P < .001) and lifetime (women = 70.8% vs. men = 33.3%, P < .001) rates of anxiety disorders compared with their male counterparts. CONCLUSIONS: A considerable number of CHD patients evidence a significant history of anxiety. Greater efforts to identify and treat anxiety in outpatient cardiology and cardiac rehabilitation settings are needed.Smoking cessation patterns in methadone-maintained smokers
AbstractStein, M. D., Anderson, B. J., & Niaura, R. S. (n.d.).Publication year
2007Journal title
Nicotine and Tobacco ResearchVolume
9Issue
3Page(s)
421-428AbstractTo determine predictors of smoking cessation duration in a randomized clinical trial, we assigned participants to nicotine patch (8-12 weeks) plus either (a) a baseline tailored brief motivational intervention, a quit date behavioral skills counseling session, and a relapse prevention follow-up session, or (b) brief advice using the National Cancer Institute's 4A's model. A total of 383 smokers from five methadone maintenance treatment centers in Rhode Island were enrolled, of whom 312 (82%) completed 6-month follow-up assessments. The primary outcome was longest period of self-reported abstinence during follow-up. Participants were on average 40.5 years of age; 51.9% were male, and 77.6% were White. In multivariate analysis controlling for demographics, nicotine dependence, depressive symptoms, and smoking-related symptoms, we found longer periods of abstinence in persons reporting at least one 24-hr quit attempt in the year prior to baseline (OR = 1.97, p =.003), in those anticipating success in cessation (OR = 1.33, p =.024), and in those with a greater percentage of nicotine patch use days (OR = 2.78, pTime to first cigarette in the morning as an index of ability to quit smoking : Implications for nicotine dependence
AbstractBaker, T., Piper, M., McCarthy, D., Bolt, D., Smith, S., Kim, S. Y., Colby, S., Conti, D., Giovino, G., Hatsukami, D., Hyland, A., Krishnan-Sarin, S., Niaura, R. S., Perkins, K., & Toll, B. (n.d.).Publication year
2007Journal title
Nicotine and Tobacco ResearchVolume
9Issue
SUPPL. 4Page(s)
555-570AbstractAn inability to maintain abstinence is a key indicator of tobacco dependence. Unfortunately, little evidence exists regarding the ability of the major tobacco dependence measures to predict smoking cessation outcome. This paper used data from four placebo-controlled smoking cessation trials and one international epidemiological study to determine relations between cessation success and the Fagerström Test for Nicotine Dependence (FTND), the Heaviness of Smoking Index, the Nicotine Dependence Syndrome Scale, and the Wisconsin Inventory of Smoking Dependence Motives. Results showed that much of the predictive validity of the FTND could be attributed to its first item, time to first cigarette in the morning, and this item had greater validity than any other single measure. Thus the time-to-first-cigarette item appears to tap a pattern of heavy, uninterrupted, and automatic smoking and may be a good single-item measure of nicotine dependence.Young incarcerated men's perceptions of and experiences with HIV testing
AbstractKacanek, D., Eldridge, G. D., Nealey-Moore, J., MacGowan, R. J., Binson, D., Morrow, K., Flanigan, T., Fitzgerald, C., Lugo, R., Strother, D., Niaura, R. S., Khan, N., Joncgo, A., Zack, B., Bracho, R., Johnson, C., Silber, E., Kramer, K., Gaiter, J., … Sosman, J. (n.d.).Publication year
2007Journal title
American journal of public healthVolume
97Issue
7Page(s)
1209-1215AbstractWe analyzed incarcerated men's perceptions of and experiences with HIV testing. Interviews were conducted with 105 men, aged 18 to 29 years, in 4 states. Most men had received an HIV test while incarcerated because it was convenient or free or because they thought it was mandatory. At most sites, men believed they were HIV-negative because they never received test results. Some men did not know the diseases for which they had been tested. Some men avoided HIV testing outside prison because they lacked time, lacked resources, feared knowing the results, or perceived themselves to not be at risk. HIV testing programs for young men inside or outside prison should address barriers to HIV testing, communicate the meaning and extent of testing, and improve notification of those with HIV-negative results.A single factor underlies the metabolic syndrome : A confirmatory factor analysis: Response to Pladevall et al. [14]
AbstractMcCaffery, J. M., Shen, B. J., Todaro, J. F., & Niaura, R. S. (n.d.).Publication year
2006Journal title
Diabetes CareVolume
29Issue
7Page(s)
1719-1720Abstract~A smoking cessation intervention for the methadone-maintained
AbstractStein, M. D., Weinstock, M. C., Herman, D. S., Anderson, B. J., Anthony, J. L., & Niaura, R. S. (n.d.).Publication year
2006Journal title
AddictionVolume
101Issue
4Page(s)
599-607AbstractAim: To test, in combination with the nicotine patch, the incremental efficacy of a maximal, tailored behavioral treatment over a minimal treatment for smoking cessation. Design: Randomized clinical trial with 6-month follow-up. Setting: Five methadone maintenance treatment centers in Rhode Island. Participants: Three hundred and eighty-three methadone-maintained smokers. Intervention: Participants were assigned randomly to nicotine patch (8-12 weeks) plus either (1) a baseline tailored brief motivational intervention, a quit date behavioral skills counseling session and a relapse prevention follow-up session (Max) or (2) brief advice using the National Cancer Institute's 4 As model (Min). An intent-to-treat analysis with those lost to follow-up assumed to smoke was used. Measurements: Carbon monoxide (CO)-confirmed 7-day point smoking cessation prevalence at 3 and 6 months, and self-reported numbers of cigarettes smoked per day. Findings: Participants had a mean age of 40 years, were 53% male, 78% Caucasian, smoked 26.7 (± 12.2) cigarettes/day and had a mean methadone dose of 95.5 mg. At 3 months, 317 (83%) were reinterviewed; at 6 months, 312 (82%) were reinterviewed. The intent-to-treat, 7-day point prevalence estimate of cessation was 5.2% in the Max group and 4.7% in the Min group (P = 0.81) at 6 months. In logistic models with treatment condition, age, gender, race, Fagerström Test for Nicotine Dependence and cigarettes per day as covariates, males were more likely to be abstinent at 3 months (OR 4.67; P = 0.003) and 6 months (OR 4.01; P = 0.015). Conclusion: A tailored behavioral intervention did not increase quit rates over patch and minimal treatment. Smoking cessation rates in methadone-maintained smokers are low, with men having greater success.Characteristics of smokers reached and recruited to an internet smoking cessation trial : A case of denominators
AbstractGraham, A. L., Bock, B. C., Cobb, N. K., Niaura, R. S., & Abrams, D. B. (n.d.).Publication year
2006Journal title
Nicotine and Tobacco ResearchVolume
8Issue
SUPPL. 1Page(s)
S43-48AbstractThe Internet can deliver smoking cessation interventions to large numbers of smokers. Little is known about the feasibility, reach, or efficacy of Internet cessation interventions. Virtually no data exist on who enrolls in cessation programs or on differences between those who complete enrollment and those who do not. This paper reports recruitment and enrollment findings for the first 764 participants in an ongoing randomized controlled trial that tested the efficacy of a widely disseminated Internet smoking cessation service (www.QuitNet.com) alone and in conjunction with telephone counseling. Study participants were recruited through Internet search engines using an active user sampling protocol. During the first 16 weeks of the study, 28,297 individuals were invited. Of those, 11,147 accepted the invitation, 5,557 screened eligible, 3,614 were recruited, 1,489 provided online informed consent, and 764 were confirmed eligible and enrolled. Of those who were at least curious about a cessation trial (n=11,147), 6.9% enrolled. Of those who were eligible and recruited (n=3,614), 21.1% enrolled. Depending on the denominator selected, results suggest that 7% to 21% of smokers interested in cessation will enroll into a research trial. Internet recruitment provides unique challenges and opportunities for managing sample recruitment, analyzing subsamples to determine generalizability, and understanding the characteristics of individuals who participate in online research.Cognitive status of young and older cigarette smokers : Data from the international brain database
AbstractPaul, R. H., Brickman, A. M., Cohen, R. A., Williams, L. M., Niaura, R. S., Pogun, S., Clark, C. R., Gunstad, J., & Gordon, E. (n.d.).Publication year
2006Journal title
Journal of Clinical NeuroscienceVolume
13Issue
4Page(s)
457-465AbstractPrevious studies that have examined the impact of cigarette smoking on cognition have revealed mixed results; some studies report no impact and others report detrimental effects, especially in older individuals. Few studies, however, have examined the effects of cigarette smoking on both young and old healthy individuals using highly robust and standardized methods of cognitive assessment. This study draws on an international database to contrast cognitive differences between younger and older individuals who regularly smoke cigarettes and non-smokers. Data were sampled from 1000 highly screened healthy individuals free of medical or psychiatric health complications. A cohort of 62 regular smokers (n = 45 < 45 years of age; n = 17 {greater than or slanted equal to} 45 years) with a Fagerstrom nicotine dependency score of 1 or more were identified and matched to a cohort of 62 healthy nonsmokers (n = 43 < 45 years; n = 19 {greater than or slanted equal to} 45 years) on demographic variables and estimated intelligence. Performances on cognitive measures of attention, reaction time, cognitive flexibility, psychomotor speed, and memory were considered for analysis. As a group, smokers performed more poorly than nonsmokers on one measure of executive function. A significant age and smoking status interaction was identified with older smokers performing more poorly than older nonsmokers and younger smokers on a measure of long-delayed recall of new information. Cigarette smoking is associated with isolated and subtle cognitive difficulties among very healthy individuals.