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

Pharmacogenetic clinical trial of sustained-release bupropion for smoking cessation

David, 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. (n.d.).

Publication year

2007

Journal title

Nicotine and Tobacco Research

Volume

9

Issue

8

Page(s)

821-833

10.1080/14622200701382033

Abstract

Abstract

This 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 values <.01). We found a significant DRD2 × bupropion interaction (B=1.28, SE=0.59, p=12) and a three-way DRD2 × bupropion × craving interaction on 6-month smoking cessation outcomes (B=-0.45, SE=0.22, p=.038), such that smokers with the A2/A2 genotype demonstrated the greatest craving reduction and the highest abstinence rates with bupropion. Furthermore, there was a significant DRD2 × CYP2B6 interaction (B=1.43, SE=0.56, p=.01), such that individuals with the DRD2-Taq1 A2/A2 genotype demonstrated a higher odds of abstinence only if they possessed the CYP2B6 1459 T/T or C/T genotype. Because the sample size of this study was modest for pharmacogenetic investigations, the results should be interpreted with caution. Although these results require replication, the data suggest preliminarily that the DRD2-Taq1A polymorphism may influence treatment response to bupropion for smoking cessation and, further, that exploration of gene × gene and gene × craving interactions in future, larger studies may provide mechanistic insights into the complex pharmacodynamics of bupropion.

Prevalence of anxiety disorders in men and women with established coronary heart disease

Todaro, J. F., Shen, B. J., Raffa, S. D., Tilkemeier, P. L., & Niaura, R. (n.d.).

Publication year

2007

Journal title

Journal of Cardiopulmonary Rehabilitation and Prevention

Volume

27

Issue

2

Page(s)

86-91

10.1097/01.HCR.0000265036.24157.e7

Abstract

Abstract

PURPOSE: 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

Stein, M. D., Anderson, B. J., & Niaura, R. (n.d.).

Publication year

2007

Journal title

Nicotine and Tobacco Research

Volume

9

Issue

3

Page(s)

421-428

10.1080/14622200701188885

Abstract

Abstract

To 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, p <.001). Past quit attempts, self-efficacy, and constant nicotine replacement were associated with duration of abstinence among methadone-maintained smokers. Attention to these domains in future intervention studies may improve treatment success.

Time to first cigarette in the morning as an index of ability to quit smoking: Implications for nicotine dependence

Baker, 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., Perkins, K., & Toll, B. (n.d.).

Publication year

2007

Journal title

Nicotine and Tobacco Research

Volume

9

Page(s)

555-570

10.1080/14622200701673480

Abstract

Abstract

An 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

A single factor underlies the metabolic syndrome: A confirmatory factor analysis: Response to Pladevall et al. [14]

McCaffery, J. M., Shen, B. J., Todaro, J. F., & Niaura, R. S. (n.d.). In Diabetes Care (1–).

Publication year

2006

Volume

29

Issue

7

Page(s)

1719-1720

10.2337/dc06-0583

A smoking cessation intervention for the methadone-maintained

Characteristics of smokers reached and recruited to an internet smoking cessation trial: A case of denominators

Cognitive status of young and older cigarette smokers: Data from the international brain database

Paul, R. H., Brickman, A. M., Cohen, R. A., Williams, L. M., Niaura, R., Pogun, S., Clark, C. R., Gunstad, J., & Gordon, E. (n.d.).

Publication year

2006

Journal title

Journal of Clinical Neuroscience

Volume

13

Issue

4

Page(s)

457-465

10.1016/j.jocn.2005.04.012

Abstract

Abstract

Previous 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.

Early life stress and adult emotional experience: An international perspective

Early Life Stress and Morphometry of the Adult Anterior Cingulate Cortex and Caudate Nuclei

Efficacy of naltrexone in smoking cessation: A preliminary study and an examination of sex differences

Elevated positive mood: A mixed blessing for abstinence

Doran, N., Borrelli, B., Hitsman, B., Niaura, R., Spring, B., McChargue, D., & Hedeker, D. (n.d.).

Publication year

2006

Journal title

Psychology of Addictive Behaviors

Volume

20

Issue

1

Page(s)

36-43

10.1037/0893-164X.20.1.36

Abstract

Abstract

The present study, a secondary analysis of published data (B. Hitsman et al., 1999), assessed (a) the influence of initial positive mood (PM) on smoking cessation and (b) whether smokers low in PM benefited from fluoxetine versus placebo for cessation. Euthymic adult smokers (N = 103) received 10 weeks of cessation treatment. Analyses showed a Time X PM interaction, indicating that higher baseline PM predicted decreased abstinence during treatment but increased abstinence afterward, mediated by time to dropout. Dichotomous initial PM interacted with drug, suggesting a benefit of fluoxetine for low-PM smokers. Results indicate that lower pretreatment PM may inhibit long-term cessation. Smokers with lower baseline PM may benefit from treatment that increases PM.

Estimating genetic and environmental influences on depressive symptoms in adolescence: Differing effects on higher and lower levels of symptoms

Rende, R., Slomkowski, C., Lloyd-Richardson, E., Stroud, L., & Niaura, R. (n.d.).

Publication year

2006

Journal title

Journal of Clinical Child and Adolescent Psychology

Volume

35

Issue

2

Page(s)

237-243

10.1207/s15374424jccp3502_7

Abstract

Abstract

We estimate the relative effect sizes of genetic and environmental influences on both higher and lower levels of depressive symptoms with attention to persistence over a 1-year period in the genetically informative subsample of adolescents participating in the National Longitudinal Study of Adolescent Health (Add Health). Shared environmental effects were significant for persistent higher levels of depressive symptoms but not nonpersistent symptoms. Genetic effects were significant for both persistent and nonpersistent lower levels of depressive symptoms. Nongenetic factors that promote similarity between siblings for high levels of depressive symptoms are important and should be considered in both etiological and applied research. Genetic contributions to lack of susceptibility to depression should be considered in biological models of depression suppression.

Fresh from the pipeline: Varenicline

Niaura, R., Jones, C., & Kirkpatrick, P. (n.d.).

Publication year

2006

Journal title

Nature Reviews Drug Discovery

Volume

5

Issue

7

Page(s)

537-538

10.1038/nrd2088

Hostility and urine norepinephrine interact to predict insulin resistance: The VA normative aging study

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

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

Publication year

2006

Journal title

Nicotine and Tobacco Research

Volume

8

Page(s)

S49-57

10.1080/14622200601045367

Abstract

Abstract

The Internet offers a promising channel to conduct smoking cessation research. Among the advantages of Internet research are the ability to access large numbers of participants who might not otherwise participate in a cessation trial, and the ability to conduct research efficiently and cost-effectively. To leverage the opportunity of the Internet in clinical research, it is necessary to establish that measures of known validity used in research trials are reliable when administered via the Internet. To date, no published studies examine the psychometric properties of measures administered via the Internet to assess smoking variables and psychosocial constructs related to cessation (e.g., stress, social support, quit methods). The purpose of the present study was to examine the reliability of measures of previous quit methods, perceived stress, depression, social support for cessation, smoking temptations, alcohol use, perceived health status, and income when administered via the Internet. Participants in the present study were enrolled in a randomized controlled trial of the efficacy of Internet smoking cessation. Following baseline telephone assessment and randomization into the parent trial, participants were recruited to the reliability substudy. An email was sent 2 days after the telephone assessment with a link to the Internet survey and instructions to complete the survey that day. Of the 297 individuals invited to participate, 213 completed the survey within 1 week. Results indicate that the internal consistency and test-retest reliability of the measures examined are comparable when self-administered via the Internet or when interviewer-administered via telephone.

Links between physical fitness and cardiovascular reactivity and recovery to psychological stressors: A meta-analysis

Nicotine replacement therapy: Patterns of use after A quit attempt among methadone- maintained smokers

Posttraumatic stress disorder and late-onset smoking in the Vietnam Era Twin Registry

Koenen, K. C., Lyons, M. J., Niaura, R., Goldberg, J., True, W., Hitsman, B., Stroud, L., McCaffery, J., Eisen, S. A., & Tsuang, M. (n.d.).

Publication year

2006

Journal title

Journal of consulting and clinical psychology

Volume

74

Issue

1

Page(s)

186-190

10.1037/0022-006X.74.1.186

Abstract

Abstract

Epidemiological and clinical studies have consistently reported associations between smoking and posttraumatic stress disorder (PTSD). This study analyzed diagnostic interview data on 6,744 members of the Vietnam Era Twin Registry to clarify the PTSD - smoking relation and to examine whether genetic liability for smoking moderated this relation. Preexisting active (unremitted) PTSD increased risk of late-onset daily smoking. Remitted PTSD decreased risk. Active PTSD increased risk of smoking at all levels of genetic liability; the effect was strongest for those with least genetic liability. This suggests PTSD represents a nongenetic pathway to late-onset smoking among individuals who were nonsmokers prior to developing PTSD. If replicated, these results identify PTSD as a risk factor for smoking that should lead to early tobacco control treatment in this population.

Role of functional genetic variation in the dopamine D2 receptor (DRD2) in response to bupropion and nicotine replacement therapy for tobacco dependence: Results of two randomized clinical trials

A twin registry study of the relationship between posttraumatic stress disorder and nicotine dependence in men

A twin-sibling study of tobacco use in adolescence: Etiology of individual differences and extreme scores

Rende, R., Slomkowski, C., McCaffery, J., Lloyd-Richardson, E. E., & Niaura, R. (n.d.).

Publication year

2005

Journal title

Nicotine and Tobacco Research

Volume

7

Issue

3

Page(s)

413-419

10.1080/14622200500125609

Abstract

Abstract

A database is emerging that examines the relative contributions of genes and the environment to the etiology of smoking in adolescence. We present analyses derived from a genetically informative subsample of sibling pairs (monozygotic and dizygotic twins, full siblings, and half-siblings) participating in two waves of the National Longitudinal Study of Adolescent Health to estimate these parameters on both individual differences in smoking and extreme levels of smoking. Evidence indicated both genetic and shared environmental influences on high levels of smoking frequency, as well as on individual differences in smoking. No notable gender differences in these parameters emerged. Shared environmental effects were especially notable for high levels of smoking frequency and significantly greater than those found for individual differences. These findings were compatible with prior studies of both adolescent and adult smoking and reinforce the importance of familial influences on high levels of smoking frequency in adolescence.

Combined effect of the metabolic syndrome and hostility on the incidence of myocardial infarction (The Normative Aging Study)

Comparative efficacy of rapid-release nicotine gum versus nicotine polacrilex gum in relieving smoking cue-provoked craving