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

Differences between Latino and non-Latino White smokers in cognitive and behavioral characteristics relevant to smoking cessation

Bock, B. C., Niaura, R. S., Neighbors, C. J., Carmona-Barros, R., & Azam, M. (n.d.).

Publication year

2005

Journal title

Addictive Behaviors

Volume

30

Issue

4

Page(s)

711-724

10.1016/j.addbeh.2004.08.017

Abstract

Abstract

Adult smokers were recruited during routine health care visits at primary care clinics located in three urban hospitals and were given a brief intervention and nicotine replacement therapy. Analyses compared bicultural (BC: n=60) or less acculturated (LA: n=138) Latinos and non-Latino White (NL: n=417) participants. Both Latino groups were significantly different from NL subjects in smoking rate and nicotine dependence. However, BC and NL subjects differed significantly from LA subjects in perceived benefits of quitting, perceived risk from smoking, and negative affect smoking. LA subjects had higher cessation rates than either BC or NL groups. Regression analyses showed that nicotine dependence and confidence in quitting predicted cessation at month 6, and acculturation appeared to moderate the relationship between smoking cessation and both confidence in quitting and nicotine dependence. These results provide support for the viability of brief interventions for smoking provided through health care delivery systems. Results also suggest that characteristics previously shown to be predictive of successful cessation in mixed or non-Latino populations may not be equally predictive of cessation across members of diverse populations.

Prevalence of depressive disorders in men and women enrolled in cardiac rehabilitation

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

Publication year

2005

Journal title

Journal of Cardiopulmonary Rehabilitation

Volume

25

Issue

2

Page(s)

71-77

10.1097/00008483-200503000-00003

Abstract

Abstract

PURPOSE: Epidemiological studies have demonstrated that depression is an independent risk factor for the development and recurrence of coronary heart disease (CHD). The prevalence of depressive disorders, however, is not well documented in CHD patients enrolled in cardiac rehabilitation (CR). The purpose of this study was to estimate the prevalence of current and lifetime depressive disorders in the CR setting. METHODS: One hundred ten men and women diagnosed with CHD and enrolled in a phase II CR program were screened via a psychiatric, structured interview to assess current and lifetime history of major depressive disorder, minor depression, and dysthymic disorder. RESULTS: A total of 17 (15.5%) individuals screened positive for a current depressive disorder at entry into the CR program, with 10 (9.1 %) individuals screening positive for major depressive disorder, 7 (6.4%) for minor depression, and 6 (5.5%) for dysthymic disorder. With respect to lifetime prevalence of mood disorders, 29 (26.4%) individuals met the diagnostic criteria for at least one depressive disorder during their lifetime. The lifetime prevalence of major depressive disorder, minor depression, and dysthymic disorder was 11.8%, 14.5%, and 10.9%, respectively. Female CR participants evidence significantly higher current and lifetime prevalence rates for depressive disorders compared to their male counterparts. CONCLUSIONS: The results of this study suggest that a substantial number of CHD patients enrolled in CR report a clinically significant history of depression. Efforts to assess and treat depression are needed in the CR setting and may be associated with better adherence to lifestyle modification programs.

Recurrent event analysis of lapse and recovery in a smoking cessation clinical trial using bupropion

Wileyto, E. P., Patterson, F., Niaura, R., Epstein, L. H., Brown, R. A., Audrain-McGovern, J., Hawk, L. W., & Lerman, C. (n.d.).

Publication year

2005

Journal title

Nicotine and Tobacco Research

Volume

7

Issue

2

Page(s)

257-268

10.1080/14622200500055673

Abstract

Abstract

We report a reanalysis of data from a prior study describing the event history of quitting smoking aided by bupropion, using recurrent-event models to determine the effect of the drug on occurrence of lapses and recoveries from lapse (resumption of abstinence). Data were collected on 1,070 subjects across two similar double-blind randomized clinical trials of bupropion versus placebo and fitted with separate Cox regression models for lapse and recovery. Analyses were split using discrete time-varying covariates between the treatment (weeks 1-10) and follow-up phases (end of treatment to 12 months). Bupropion was associated with slower lapse during treatment for both sexes, and being female was associated with faster lapse across both phases. Drug did not affect time to recovery for males but was associated with faster recovery among females, allowing women to recover as quickly as men. High levels of nicotine dependence did not affect time to lapse but were associated with slower recovery from lapse across treatment and follow-up phases. During the treatment phase, higher levels of baseline depression symptoms had no effect on time to lapse but were associated with slower recovery from lapse. Results highlight the asymmetry in factors preventing lapse versus promoting recovery. Specifically, dependence, depression symptoms, and a sex × drug interaction were found to affect recovery but not lapse. Further research disentangling lapse and recovery events from summary abstinence measures is needed to help us develop interventions that take advantage of bupropion at its best and that compensate where it is weak.

Sibling effects on smoking in adolescence: Evidence for social influence from a genetically informative design

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

Publication year

2005

Journal title

Addiction

Volume

100

Issue

4

Page(s)

430-438

10.1111/j.1360-0443.2004.00965.x

Abstract

Abstract

Aims: Behavioral genetic research has suggested that sibling effects on smoking may reflect social rather than genetic processes. We utilize a genetically informative sample of adolescents to test this proposition, focusing on sibling relationship processes (social connectedness) shown to be influential in studies of deviancy. Design: A combined twin-sibling design was employed to disentangle genetic and non-genetic effects. Participants: We utilized a sample of 1421 adolescent sibling pairs participating in the US National Longitudinal Study of Adolescent Health (Add Health). These sibling pairs represent a spectrum of genetic relatedness and include monozygotic twins, dizygotic twins, biological siblings, half-siblings and unrelated siblings. Measurements: Participants completed self-report questionnaires on smoking behavior, quality of relationship with their sibling (social connectedness) and peer and parental smoking. Findings: Main effects of both shared environment and genetics were found on adolescent smoking frequency. Social connectedness between siblings moderated shared environmental influences on smoking frequency at each time period, as well as on change in smoking frequency. Shared environmental effects were more pronounced when siblings reported high levels of social connectedness. These environmental sibling effects on smoking were significant after controlling for parent and peer smoking. Conclusions: This report extends prior research on sibling effects on smoking by identifying specific relationship dynamics that underlie transmission of risk within sibships and providing evidence that such relationship dynamics represent social rather than genetic processes.

Sibling effects on substance use in adolescence: Social contagion and genetic relatedness

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

Publication year

2005

Journal title

Journal of Family Psychology

Volume

19

Issue

4

Page(s)

611-618

10.1037/0893-3200.19.4.611

Abstract

Abstract

Prior research on sibling contagion for substance use has not attended to individual differences in the sibling relationship that may be influenced by genetic similarity. The authors utilizing data on a sample of twin and nontwin siblings participating in the National Longitudinal Study of Adolescent Health (Add Health). Although monozygotic twins had the highest levels of sibling contact and mutual friendships, the pattern of results for other sibling types were not consistent with genetic models, and biometric analysis indicated that shared environmental factors influenced these sibling relationship features. Application of DeFries-Fulker regression models provided evidence that sibling contact and mutual friendships represent a source of social contagion for adolescent smoking and drinking independent of genetic relatedness. The results are interpreted using a social contagion framework and contrasted with other competing models such as those focused on the equal environments assumption and niche selection.

Smoking cessation treatment: Pharmacogenetics assessment

Munafò, M. R., Lerman, C., Niaura, R., Shields, A. E., & Swan, G. E. (n.d.).

Publication year

2005

Journal title

Current Opinion in Molecular Therapeutics

Volume

7

Issue

3

Page(s)

202-208

Abstract

Abstract

This review focuses on the current status and future directions of pharmacogenetics research into responses to treatments for nicotine dependence and smoking cessation. Research remains in its infancy and, although the potential for individualized treatment tailored to genotype is promising, there are practical, ethical and social considerations that must be addressed before such research is translated into clinical practice. In particular, future studies that need to be conducted before such research is translated into clinical practice and potential limitations and barriers to this translation are described.

Suppressed hostility predicted hypertension incidence among middle-aged men: The normative aging study

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

Publication year

2005

Journal title

Journal of Behavioral Medicine

Volume

28

Issue

5

Page(s)

443-454

10.1007/s10865-005-9016-5

Abstract

Abstract

This study tested whether suppressed hostility predicted incident hypertension (HTN) in initially nonhypertensive men, using prospective data from the Normative Aging Study. Six hundred twenty-seven men who completed the MMPI and participated in a subsequent laboratory assessment were included in the study. The Cook-Medley Hostility scale (Ho), a suppression factor, and other risk factors were used to predict incident HTN over a 3-year period. Logistic regression showed a significant three-way interaction among Ho, suppression, and age in predicting incident HTN. Among middle-aged men (≤60 years) with higher suppression, a 1-point decrease in the Ho score was associated with an 18% increase in HTN risk. This relationship remained significant after controlling for relevant risk factors. Among older participants, the Ho x Suppression interaction was not predictive of HTN incidence. These results provide support for the Suppressed Hostility hypothesis in middle-aged men.

The efficacy of moderate intensity exercise as an aid for smoking cessation in women: A randomized controlled trial

Marcus, B. H., Lewis, B. A., Hogan, J., King, T. K., Albrecht, A. E., Bock, B., Parisi, A. F., Niaura, R., & Abrams, D. B. (n.d.).

Publication year

2005

Journal title

Nicotine and Tobacco Research

Volume

7

Issue

6

Page(s)

871-880

10.1080/14622200500266056

Abstract

Abstract

Evidence suggests that vigorous-intensity exercise interventions may be effective for smoking cessation among women; however, few studies have examined the efficacy of a moderate-intensity exercise program. The present study examined the efficacy of moderate-intensity exercise for smoking cessation among female smokers. Healthy, sedentary female smokers (N = 217) were randomly assigned to an 8-week cognitive-behavioral smoking cessation program plus moderate-intensity exercise (CBT+EX) or to the same cessation program plus equal contact (CBT). A subsample received nicotine replacement therapy. Results indicated that the CBT+EX and CBT groups were equally likely to attain smoking cessation at the end of treatment, as measured by cotinine-verified 7-day point-prevalence abstinence (20.2% for CBT+EX vs. 18.5% for CBT). The CBT+EX group was more likely to report smoking cessation, as measured by 7-day point prevalence at the 3-month follow-up (11.9% vs. 4.6%, p<.05), composed with the CBT group. No group diffrences were found at 12 months by either 7-day point prevalence (7.3% for CBT+EX vs. 8.3% for CBT) or continuous abstinence (0.9% for CBT+EX vs. 0.9% for CBT). Additionally, among participants in the CBT+EX group, those with higher to the exercise prescription were significantly more likely to achieve smoking cessation at the end of treatment than were participants reporting lower adherence to exercise our findings indicate that the emperical support for moderate-intensity exercise as an adjunctive treatment to CBT for smoking cessation may be limited. Perhaps future studies could compare moderate vs. vigorous-intensity physical activity to test their relative efficacy.

The impact of early life stress on psychophysiological, personality and behavioral measures in 740 non-clinical subjects

Mcfarlane, A., Clark, C. R., Bryant, R. A., Williams, L. M., Niaura, R., Paul, R. H., Hitsman, B. L., Stroud, L., Alexander, D. M., & Gordon, E. (n.d.).

Publication year

2005

Journal title

Journal of Integrative Neuroscience

Volume

4

Issue

1

Page(s)

27-40

10.1142/S0219635205000689

Abstract

Abstract

Early Life Stress (ELS) has been associated with a range of adverse outcomes in adults, including abnormalities in electrical brain activity [1], personality dimensions [40], increased vulnerability to substance abuse and depression [14]. The present study seeks to quantify these proposed effects in a large sample of non-clinical subjects. Data for the study was obtained from The Brain Resource International Database (six laboratories: two in USA, two in Europe, two in Australia). This study analyzed scalp electrophysiological data (EEG eyes open, closed and target auditory oddball data) and personality (NEO-FFI), history of addictive substance use and ELS) data that was acquired from 740 healthy volunteers. The ELS measures were collected via a self-report measure and covered a broad range of events from childhood sexual and physical abuse, to first-hand experience of traumatizing accidents and sustained domestic conflict [41]. Analysis of covariance, controlling for age and gender, compared EEG data from subjects exposed to ELS with those who were unexposed. ELS was associated with significantly decreased power across the EEG spectrum. The between group differences were strongest in the eyes closed paradigm, where subjects who experienced ELS showed significantly reduced beta (F1,405 = 12.37, p = .000), theta (F1,405 = 20.48, p = .000), alpha (F1,405 = 9.65, p = .002) and delta power (F1,450 = 36.22, p = .000). ELS exposed subjects also showed a significantly higher alpha peak frequency (F1,405 = 6.39, p = .012) in the eyes closed paradigm. Analysis of covariance on ERP components revealed that subjects who experienced ELS had significantly decreased N2 amplitude (F1,405 = 7.73, p = .006). Analyses of variance conducted on measures of personality revealed that subjects who experienced ELS had significantly higher levels of neuroticism (F1,264 = 13.39, p = .000) and openness (F1,264 = 17.11, p = .000), but lower levels of conscientiousness, than controls (F1,264 = 4.08, p = .044). The number of ELS events experienced was shown to be a significant predictor of scores on the DASS questionnaire [27], which rates subjects on symptoms of depression (F3,688 = 16.44, p = .000, R2 = .07), anxiety (F3,688 = 14.32, p = .000, R2 = .06) and stress (F3,688 = 20.02, p = .000, R2 = .08). Each additional early life stressor was associated with an increase in these scores independent of age, gender and the type of stressor. Furthermore, the number of ELS experiences among smokers was also found to be a positive predictor of the nicotine dependency score (Faegstrom Test For Nicotine Dependence, [19]) (F3,104 = 10.99, p = .000, R2 = .24), independent of age, gender and type of stressor. In conclusion, we highlight the impact of a history of ELS showed significant effects on brain function (EEG and ERP activity), personality dimensions and nicotine dependence.

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

Shadel, W. G., Niaura, R., & 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.

Are stress eaters at risk for the metabolic syndrome?

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.

Bupropion SR for relapse prevention: A "slips-allowed" analysis

Durcan, M. J., Johnston, J. A., White, J., Gonzales, D., Sachs, D. P., Rigotti, N., & Niaura, R. (n.d.).

Publication year

2004

Journal title

American Journal of Health Behavior

Volume

28

Issue

5

Page(s)

456-463

10.5993/AJHB.28.5.8

Abstract

Abstract

Objective: To assess the efficacy of bupropion SR on smoking abstinence using a "slips allowed" analysis. Methods: Retrospective analysis, which did not consider brief episodic "slips" as a return to regular smoking, of data from a multicenter, randomized, double- blind, placebo-controlled relapse prevention study. Results: Using a slips-allowed analysis, median time to relapse on bupropion SR was 65 weeks versus 30 weeks on placebo. This is compared to 32 and 20 weeks, respectively, using a traditional analysis not allowing for slips. Conclusion: Bupropion SR is efficacious for the prevention of smoking relapse. A slips-allowed analysis may provide a more clinically relevant assessment of efficacy.

Cognitive and affective probes of the HPA axis: a SPECT study.

Ottowitz, W. E., Dougherty, D. D., Sirota, A. D., Niaura, R., Rauch, S. L., & Brown, W. A. (n.d.).

Publication year

2004

Journal title

Brain and cognition

Volume

54

Issue

2

Page(s)

138-140

Comments on "History of depression and smoking cessation outcome: A meta-analysis" (multiple letters)

Covey, L. S., Hitsman, B., Spring, B., Borrelli, B., McChargue, D., & Niaura, R. (n.d.). In Nicotine and Tobacco Research (1–).

Publication year

2004

Volume

6

Issue

4

Page(s)

743-749

10.1080/14622200410001727902

Depression proneness in treatment-seeking smokers: A taxometric analysis

Strong, D. R., Brown, R. A., Kahler, C. W., Lloyd-Richardson, E. E., & Niaura, R. (n.d.).

Publication year

2004

Journal title

Personality and Individual Differences

Volume

36

Issue

5

Page(s)

1155-1170

10.1016/S0191-8869(03)00207-1

Abstract

Abstract

Using taxometric procedures, we examined latent distribution of depression proneness and the construct validity of the Depression Proneness Inventory (DPI) within a group of 439 non-depressed smokers participating in a smoking cessation trial. Three taxometric procedures MAMBAC, MAXEIG, and L-MODE, supported the presence of a distinct subgroup of depression prone smokers. A set of indicators including cognitive vulnerabilities, self-reported tendencies to feel inadequate and experience depressive symptoms, as well as recent experiences of depressive symptoms prior to anticipated cessation treatment behaved taxonically suggesting a shared relationship with an underlying taxonic causal factor. The DPI was found to be an efficient index of taxon membership and a strong predictor of depression history. The DPI identifies a subgroup of smokers seeking cessation treatment that carry affective risk factors known to impede successful smoking cessation and might benefit from interventions targeting depression and negative mood.

Developing an integrative social-cognitive strategy for personality assessment at the level of the individual: An illustration with regular cigarette smokers

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

Publication year

2004

Journal title

Journal of Research in Personality

Volume

38

Issue

4

Page(s)

394-419

10.1016/j.jrp.2003.09.001

Abstract

Abstract

Basic advances in social cognition have not fully translated into similar advances for personality assessment. In this study, we evaluated whether an integrated social cognitive approach to personality assessment (i.e., one that employs an idiographic assessment of a multi-faceted self-system, priming procedures, and reaction time tasks) could be applied to assess a social cognitive personality system at the individual level in a particularly challenging population: Cigarette smokers. This integrative approach was necessary to detect the idiosyncratic content and contextualized structure of the three self-schemas (smoker self-schema, abstainer ideal possible self, abstainer ought possible self) that composed this social cognitive personality system. Priming different self-structures enhanced reaction times to contextually bound self-referent information. Results are discussed in terms of their implications for social cognitive theories of personality and personality assessment.

Do Men and Women Achieve Similar Benefits from Cardiac Rehabilitation?

Todaro, J. F., Shen, B. J., Niaura, R., Tilkemeier, P. L., & Roberts, B. H. (n.d.).

Publication year

2004

Journal title

Journal of Cardiopulmonary Rehabilitation

Volume

24

Issue

1

Page(s)

45-51

10.1097/00008483-200401000-00009

Abstract

Abstract

The findings of this review demonstrate that women appear to use CR services less frequently than men and, when they enroll, present differently at entry to CR. Women often are older, likely because they experience later onset of CHD; present with greater medical comorbidities; and perceive greater psychosocial challenges such as less social support and quality of life. Given these additional burdens experienced by female CR participants, women may have fewer physical and emotional resources for fully attending, adhering to, and, ultimately, benefiting from CR than men. Previously reported studies have indicated that men and women participating in CR appear to experience improvements in exercise capacity and QOL. However, whether women in particular are able to sustain these benefits has not been examined. There is some emerging evidence that women may struggle more psychosocially than their male counterparts. Whether these psychosocial challenges persist in the years after participation in CR, or whether these challenges influence long-term medical outcomes such as incidence of restenosis, reinfarction, or CHD mortality remains unanswered and continues to be an important focus for future research.

Do small lapses predict relapse to smoking behavior under bupropion treatment?

Wileyto, E. P., Patterson, F., Niaura, R., Epstein, L. H., Brown, R. A., Audrain-McGovern, J., Hawk, L. W., & Lerman, C. (n.d.).

Publication year

2004

Journal title

Nicotine and Tobacco Research

Volume

6

Issue

2

Page(s)

357-367

10.1080/1462220042000202463

Abstract

Abstract

Although bupropion is known to be an effective aid to smoking cessation, little is known about its mode of action. In the present study we tested the hypothesis that bupropion reduces the likelihood that a smoking lapse, or slip, leads to a subsequent relapse. This hypothesis was tested in the context of a clinical trial of bupropion as a smoking cessation aid, using Cox regression and representing lapse history as a discrete time-varying covariate. Bupropion treatment reduced the probability of relapse during the treatment phase (hazard ratio, or HR =.421, p≤.000) but not during the follow-up phase (end of treatment to 6 months, HR =.896, p≤.67). As anticipated, having small lapses during treatment contributed to or predicted subsequent relapse, both during treatment (HR = 2.897, p≤.000) and during follow-up (HR = 2.320, p≤.008). Although an interaction was found between drug treatment and lapse history in predicting subsequent failure during the treatment phase, the finding suggested that drug slightly increased the effect of lapse on eventual failure during treatment (HR = 1.706, p≤ .012). No evidence was found that the effect of this interaction carried forward into follow-up (HR = 1.500, p≤.30). Although the mechanisms of action of bupropion may best be addressed in a human laboratory study, results from this clinical trial suggest that the effectiveness of bupropion treatment is not attributable to reducing the effect of a lapse in predicting relapse.

Effect of bupropion on depression symptoms in a smoking cessation clinical trial

Lerman, C., Niaura, R., Collins, B. N., Wileyto, P., Audrain-McGovern, J., Pinto, A., Hawk, L., & Epstein, L. H. (n.d.).

Publication year

2004

Journal title

Psychology of Addictive Behaviors

Volume

18

Issue

4

Page(s)

362-366

10.1037/0893-164X.18.4.362

Abstract

Abstract

Bupropion is an antidepressant shown to be efficacious for smoking cessation. This study examined the short- and long-term effects of bupropion (300 mg/day for 10 weeks) versus placebo on depression symptoms among 497 smokers attempting to quit in a randomized trial of bupropion plus behavioral counseling. Depression symptoms were assessed via the Center for Epidemiological Studies Depression Scale (L. Radloff, 1977) at baseline, end of treatment, and at 6-month follow-up. Baseline nicotine dependence level was assessed with the Fagerström Test for Nicotine Dependence (T. F. Heatherton, L. T. Kozlowski, R. C. Frecker, & K. O. Fagerström, 1991). A regression model of depression symptoms demonstrated a significant interaction between nicotine dependence and treatment for the treatment phase and during follow-up. Depression symptoms did not mediate the effects of bupropion on abstinence at either time point. Highly nicotine-dependent smokers who receive bupropion are more likely to experience a decrease in depressive symptoms during active treatment but are also more likely to experience a rebound in depressive symptoms when bupropion is discontinued.

Effects of Maternal Smoking during Pregnancy on Newborn Neurobehavior: Neonatal Nicotine Withdrawal Syndrome [2] (multiple letters)

García-Algar, Óscar, Puig, C., Vall, O., Pacifici, R., Pichini, S., Lester, B. M., Law, K. L., Stroud, L. R., LaGasse, L. L., Liu, J., & Niaura, R. (n.d.). In Pediatrics (1–).

Publication year

2004

Volume

113

Issue

3

Page(s)

623-624

10.1542/peds.113.3.623-a

Effects of tobacco deprivation on alcohol cue reactivity and drinking among young adults

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

Publication year

2004

Journal title

Addictive Behaviors

Volume

29

Issue

5

Page(s)

879-892

10.1016/j.addbeh.2004.03.002

Abstract

Abstract

Nicotine and alcohol may have common neurobiological mechanisms of reinforcement. Therefore, withholding one substance might result in compensatory increases in self-administration of the other. This laboratory study investigated the effects of brief tobacco deprivation on alcohol cue-elicited urges to drink, corresponding psychophysiological reactions, and alcohol consumption. Young adults (N=78) who were moderate to heavy smokers and drinkers were stratified and randomized to a 2×2 design. Participants were either deprived of tobacco for 5 h or not deprived and then exposed to in vivo alcohol or control beverage cues. Subsequently, participants engaged in a taste-rating task as an unobtrusive measure of alcohol consumption. Tobacco deprivation resulted in increased urge to smoke and decreased cardiovascular responses but did not increase alcohol urges or alcohol consumption. Results indicate that brief tobacco deprivation does not result in compensatory increases in alcohol consumption among young moderate to heavy drinkers.

Efficacy of bupropion for relapse prevention in smokers with and without a past history of major depression

Cox, L. S., Patten, C. A., Niaura, R. S., Decker, P. A., Rigotti, N., Sachs, D. P., Sonia Buist, A., & Hurt, R. D. (n.d.).

Publication year

2004

Journal title

Journal of general internal medicine

Volume

19

Issue

8

Page(s)

828-834

10.1111/j.1525-1497.2004.30423.x

Abstract

Abstract

BACKGROUND: This study evaluated the efficacy of bupropion for relapse prevention in smokers with and without a past history of major depressive disorder. Changes in depressive symptoms were also examined. DESIGN: Data were gathered prospectively from a randomized, double-blind relapse prevention trial of bupropion conducted at five study sites. A total of 784 smokers (54% female, 97% white) were enrolled. Using the Structured Clinical Interview for Depression, 17% of the subjects reported a past history of major depressive disorder at baseline. All subjects received open-label bupropion SR (300 mg/d) for 7 weeks. Subjects abstinent from smoking at the end of 7 weeks (N = 429) were randomized to bupropion SR (300 mg/d) or placebo for the remainder of the year and followed for 1 year off medication. The primary outcome measures were median time to relapse to smoking and the 7-day point-prevalence smoking abstinence rate. Self-reported abstinence from smoking was verified by expired air carbon monoxide. The Beck Depression Inventory was used to assess depressive symptoms at baseline and at weeks 8 and 12. RESULTS: Median time to relapse did not differ by past history of major depressive disorder. Bupropion was associated with higher point-prevalence smoking abstinence at the end of medication compared to placebo (P = .007), independent of a past history of major depressive disorder. Moreover, change in depressive symptoms during the double-blind phase did not differ for those with and without a past history of major depressive disorder. CONCLUSIONS: Extended use of bupropion for relapse prevention is effective for smokers with and without a history of major depression.

Ethnic differences in cardiovascular responses to laboratory stress: A comparison between Asian and white Americans

Shen, B. J., Stroud, L. R., & Niaura, R. (n.d.).

Publication year

2004

Journal title

International Journal of Behavioral Medicine

Volume

11

Issue

3

Page(s)

181-186

10.1207/s15327558ijbm1103_7

Abstract

Abstract

Compared to other ethnic groups, Asian Americans show significantly lower rates of cardiovascular disease (CVD). We tested the hypothesis that Asian Americans would show reduced cardiovascular responses to laboratory Stressors than Caucasians. Forty-three Asians (18 men, 25 women) and 77 Caucasians (36 men, 41 women) with a mean age of 24 years (SD = 3.93) participated in a stress reactivity protocol consisting of four tasks (speech, serial subtraction, mirror tracing, handgrip) while heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were measured. Asian Americans demonstrated overall lower reactivity across tasks for SBP F(1,117 = 7.48, p < .01) and a trend toward lower HR response F(1,117 = 3.18, p < .10). A significant ethnicity by task interaction was observed for HR reactivity F(3,351 = 2.94, p < .05) such that Caucasians showed greater responses for the subtraction task.

Experimenter-defined quit dates for smoking cessation: Adherence improves outcomes for women but not for men

Borrelli, B., Papandonatos, G., Spring, B., Hitsman, B., & Niaura, R. (n.d.).

Publication year

2004

Journal title

Addiction

Volume

99

Issue

3

Page(s)

378-385

10.1111/j.1360-0443.2004.00648.x

Abstract

Abstract

Aims: Smoking cessation treatment trials often require that smokers quit on or before a protocol-defined date. The goals of this paper were to: (1) identify factors associated with adherence to a protocol-defined quit date and (2) determine whether such adherence predicts cessation outcome (relapse). Design: A quasi-experimental secondary analysis of data collected from a randomized placebo-controlled trial of fluoxetine (60 mg or 30 mg) versus placebo for smoking cessation. Setting and participants: Clinic-based smoking cessation treatment program comprising 989 non-depressed smokers. Intervention: Participants received cognitive behavioral therapy for smoking cessation and either study medication or placebo for 10 weeks. They were required to set a quit date within 2 weeks of their second study visit (by visit 4). Findings Significant predictors of quit date adherence were low nicotine dependence and active drug treatment. High-dose fluoxetine (60 mg) and male gender were protective against relapse. Adherence to quit date was not an independent predictor of relapse; instead there was a significant interaction between quit date adherence and gender. Among non-adherers to the quit date, women were more than 2.5 times as likely as men to relapse; among adherers to the quit date, women were only 1.3 times as likely as men to relapse. Conclusions: Although women were more likely than men to relapse regardless of quit date adherence, adherence was strongly protective against relapse for women.

Gender differences in smoking cessation in a placebo-controlled trial of bupropion with behavioral counseling

Collins, B. N., Wileyto, E. P., Patterson, F., Rukstalis, M., Audrain-McGovern, J., Kaufmann, V., Pinto, A., Hawk, L., Niaura, R., Epstein, L. H., & Lerman, C. (n.d.).

Publication year

2004

Journal title

Nicotine and Tobacco Research

Volume

6

Issue

1

Page(s)

27-37

10.1080/14622200310001656830

Abstract

Abstract

Among smokers, women may be at greater risk than men for developing smoking-related diseases, perhaps because they have greater difficulty quitting smoking, as suggested by numerous studies. In the present study, we hypothesized that bupropion would reduce this gender disparity among 314 women and 241 men enrolled in a placebo-controlled, randomized trial using behavioral counseling plus 10 weeks of bupropion (300 mg). Prolonged abstinence and biochemically verified point prevalence outcomes were measured at end of treatment (8 weeks after the quit date) and at 6-month follow-up. A logistic regression model of 6-month prolonged abstinence and a Cox regression (survival analysis) model revealed a significant gender by smoking rate by drug interaction and a main effect for marital status. This three-way interaction suggests that bupropion particularly benefited men who smoked more than one pack of cigarettes per day at baseline and, conversely, women who smoked a pack or less. The point prevalence logistic regression model showed no evidence that either gender or smoking rate modified the effect of treatment. These results suggest that bupropion treatment may reduce the gender disparity in prolonged abstinence rates among lighter smokers.