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
Experimenter-defined quit dates for smoking cessation: Adherence improves outcomes for women but not for men
AbstractBorrelli, B., Papandonatos, G., Spring, B., Hitsman, B., & Niaura, R. (n.d.).Publication year
2004Journal title
AddictionVolume
99Issue
3Page(s)
378-385AbstractAims: 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
AbstractCollins, 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
2004Journal title
Nicotine and Tobacco ResearchVolume
6Issue
1Page(s)
27-37AbstractAmong 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.Hostility in smokers with past major depressive disorder: Relation to smoking patterns, reasons for quitting, and cessation outcomes
AbstractKahler, C. W., Strong, D. R., Niaura, R., & Brown, R. A. (n.d.).Publication year
2004Journal title
Nicotine and Tobacco ResearchVolume
6Issue
5Page(s)
809-818AbstractWe examined trait hostility in 85 participants in a clinical trial of cessation treatment for smokers with a history of major depressive disorder. Consistent with hypotheses, trait hostility, as indexed by the Cook-Medley Hostility Scale, was associated with greater smoking in social situations, greater expectations of being evaluated negatively by others because of smoking, and stronger extrinsic social reasons for quitting. Greater hostility was associated with significantly lower odds of smoking abstinence after treatment. Hostility was not associated significantly with smoking to manage negative affect, nor did it predict change in negative mood during treatment. Results suggest hostility may play an important role in smoking motivation and cessation outcomes among smokers with past major depression.Influence of fluoxetine on positive and negative affect in a clinic-based smoking cessation trial
AbstractCook, J. W., Spring, B., McChargue, D. E., Borrelli, B., Hitsman, B., Niaura, R., Keuthen, N. J., & Kristeller, J. (n.d.).Publication year
2004Journal title
PsychopharmacologyVolume
173Issue
1Page(s)
153-159AbstractRationale: Fluoxetine improves affect in clinical syndromes such as depression and premenstrual dysphoric disorder. Little is known about fluoxetine's influence on mood changes after quitting smoking, which often resemble sub-clinical depression. Objectives: The present study, a re-analysis of previously published data (Niaura et al. 2002), examined fluoxetine's effect on changes in negative and positive affect following quitting smoking. Methods: Adult smokers (n=175) without clinically significant depression were randomized on a double-blind basis to receive fluoxetine hydrochloride (30 or 60 mg daily) or placebo for 10 weeks in combination with cognitive-behavioral therapy (CBT) for smoking cessation. We postulated that fluoxetine would beneficially influence post-cessation changes in positive and negative affect. Results: Mood change across treatment was analyzed using mixed linear modeling controlling for initial level of nicotine dependence, plasma fluoxetine metabolites, and change in cotinine (a nicotine metabolite) at each visit. Relative to placebo, those on 60 mg fluoxetine experienced an elevation in positive affect that increased across time [t(526)=2.50, P=0.01], and a reduction in negative affect that returned to baseline across time [t(524)=2.26, P=0.02]. There were no differences between 30 mg and placebo on changes in positive or negative affect. Conclusions: Results indicate that 60 mg of fluoxetine improves both positive and negative mood states after quitting smoking and that diminished positive affect may be an overlooked affective response to smoking cessation.Investigating the big five personality factors and smoking: Implications for assessment
AbstractShadel, W. G., Cervone, D., Niaura, R., & Abrams, D. B. (n.d.).Publication year
2004Journal title
Journal of Psychopathology and Behavioral AssessmentVolume
26Issue
3Page(s)
185-191AbstractGlobal personality dispositions may be important for understanding population-based individual differences in smoking outcomes, yet few studies have been executed using measures of these global dispositional constructs from the contemporary field of personality. This study explored whether the Big Five personality factors (Extraversion, Neuroticism, Agreeableness, Conscientiousness, and Intellect) were concurrently associated with key smoking (e.g., nicotine dependence, smoking rate, age at first cigarette) and cessation (e.g., self-efficacy to quit, motivation to quit, number of prior quit attempts, length of most recent quit) variables in a sample of regular smokers (n = 130). Of the 35 correlations computed, only 2 were significant: Intellect was positively correlated with motivation to quit and number of 24-hr quit attempts in the last year. These results have implications for using trait variables to study individual differences in smokers.Neural and endocrine correlates of sadness in women: Implications for neural network regulation of HPA activity
AbstractOttowitz, W. E., Dougherty, D. D., Sirota, A., Niaura, R., Rauch, S. L., & Brown, W. A. (n.d.).Publication year
2004Journal title
Journal of Neuropsychiatry and Clinical NeurosciencesVolume
16Issue
4Page(s)
446-455AbstractIn order to evaluate the suprahypothalamic neuroanatomical sites of relevance to adrenocorticotropic hormone (ACTH) and cortisol regulation, single photon emission computed tomography (SPECT) investigation of induced sadness was combined with a linear regression analysis of these hormone levels during mood induction. Images from eight healthy women were analyzed by statistical parametric mapping (SPM), replicating many findings from prior sadness induction studies. Statistical parametric mapping endocrine covariate analysis showed that the ventromedial prefrontal, anterior cingulate, and insular cortices may regulate ACTH and the insular cortex may be related to regulation of cortisol during sadness. Dysfunction of these sites may contribute to the cortisol dysregulation observed in some subjects with major depression.Olanzapine attenuates cue-elicited craving for tobacco
AbstractHutchison, K. E., Rutter, M. C., Niaura, R., Swift, R. M., Pickworth, W. B., & Sobik, L. (n.d.).Publication year
2004Journal title
PsychopharmacologyVolume
175Issue
4Page(s)
407-413AbstractRationale: Recent biological conceptualizations of craving and addiction have implicated mesolimbic dopamine activity as a central feature of the process of addiction. Imaging, and pharmacological studies have supported a role for dopaminergic structures in cue-elicited craving for tobacco. Objective: If mesolimbic dopamine activity is associated with cue-elicited craving for tobacco, a dopamine antagonist should attenuate cue-elicited craving for tobacco. Thus, the aim of the present study was to determine whether an atypical antipsychotic (olanzapine, 5 mg) decreased cue-elicited craving for tobacco. Method: Participants were randomly assigned to 5 days of pretreatment with olanzapine (5 mg; n=31) or were randomly assigned to 5 days of a matching placebo (n=28). Approximately 8 h after the last dose, participants were exposed to a control cue (pencil) followed by exposure to smoking cues. Participants subsequently smoked either nicotine cigarettes or de-nicotinized cigarettes. Results: Olanzapine attenuated cue-elicited craving for tobacco but did not moderate the subjective effects of smoking. Discussion: This study represents one of the first investigations of the effect of atypical antipsychotics on cue-elicited craving for tobacco. The results suggest that medications with similar profiles may reduce cue-elicited craving, which in turn, may partially explain recent observations that atypical antipsychotics may reduce substance use.Smoking cessation treatment on the Internet: Content, quality, and usability
AbstractBock, B. C., Graham, A. L., Sciamanna, C. N., Krishnamoorthy, J., Whiteley, J., Carmona-Barros, R., Niaura, R. S., & Abrams, D. B. (n.d.).Publication year
2004Journal title
Nicotine and Tobacco ResearchVolume
6Issue
2Page(s)
207-219AbstractThe explosive growth in access to the Internet suggests that the Internet may be a viable channel through which we can reach and treat the large population of smokers who are unlikely to use other modes of intervention. We applied national guidelines from the U.S. Public Health Service to assess the quality of interventions for smoking cessation that are available on the Internet. The Public Health Service guidelines were codified into two instruments to record and to rate quality of the intervention contents. Usability guidelines established by the National Cancer Institute were used to develop an instrument to assess Web site usability. Of the 202 Web sites identified in searches, 77% did not provide direct intervention over the Internet and were excluded from analyses. A total of 46 Web sites were included in our review. Usability assessments showed mixed results. Web sites were visually well organized and used consistent graphical design; however, reading difficulty averaged above the 8th-grade level. Over 80% of Web sites provided no coverage of one or more of the key components of tobacco treatment recommended in the guidelines. Ironically, areas receiving the least coverage were those most amenable to the interactive capabilities of the Internet, such as providing tailored, personalized advice to quit and arranging follow-up contact. Smokers seeking quality tobacco dependence treatment on the Internet may have difficulty distinguishing among the numerous Web sites available. Web sites that provide direct treatment often fail to fully implement treatment guidelines and do not take full advantage of the interactive and tailoring capabilities of the Internet.Thinking about craving: An experimental analysis of smokers' spontaneous self-reports of craving
AbstractShadel, W. G., Niaura, R., & Abrams, D. B. (n.d.).Publication year
2004Journal title
Addictive BehaviorsVolume
29Issue
4Page(s)
811-815AbstractThis study evaluated whether smokers generate spontaneous expressions of craving (i.e., expressions of an urge, craving, desire, want, or need) in response to cues designed to provoke a craving state. In a 2 (smoking deprivation: 1 and 12 h)×2 (cue type: neutral, active) within-subjects design, smokers were asked to think aloud in an unstructured way (i.e., "describe everything you are thinking and feeling right now"). Results revealed a main effect for cue type on think-aloud craving responses: Smokers spontaneously generated a greater number of craving-related cognitions during active cue exposure compared with neutral cue exposure, both during both 1- and 12-h deprivation. This same pattern of effects was not found for a self-report assessment of craving, which was insensitive to cue-provoked changes in craving in the 1-h deprivation condition. These results suggest that smokers do spontaneously experience craving, independent of an explicit assessment of craving and that think-aloud methods may provide a novel assessment of craving that may be relatively more sensitive than self-report methods under some circumstances.Who am I? The role of self-conflict in adolescents' responses to cigarette advertising
AbstractShadel, W. G., Niaura, R., & Abrams, D. B. (n.d.).Publication year
2004Journal title
Journal of Behavioral MedicineVolume
27Issue
5Page(s)
463-475AbstractCigarette advertising may be partly responsible for adolescent smoking initiation, but few studies have investigated the advertising and individual difference factors that may be responsible. This study evaluated whether individual differences in the number of self-conflicts (i.e., conflicts between personality attributes experienced as part of self-concept development) interacts with stage of development (early versus middle adolescence) to predict responses to cigarette advertising imagery. One hundred and one never smoking adolescents judged the self-relevance of various cigarette advertisements. As predicted, self-conflict was related to judgments of self-relevance for early adolescents only: early adolescents who are having the most difficulty defining themselves are more likely to look to the powerful images displayed by cigarette advertisements for help. These results have implications for understanding the impact of cigarette advertising on smoking initiation for some adolescents.A family history of smoking predicts heightened levels of stress-induced cigarette craving
AbstractErblich, J., Boyarsky, Y., Spring, B., Niaura, R., & Bovbjerg, D. H. (n.d.).Publication year
2003Journal title
AddictionVolume
98Issue
5Page(s)
657-664AbstractAims: Individuals with histories of smoking in first-degree relatives are significantly more likely to be persistent smokers themselves. The mechanisms underlying this relationship are unknown. Considerable research has demonstrated that smokers display heightened levels of cigarette craving after being exposed to stressful situations, and the magnitude of these craving responses is thought to be predictive of later cessation failure. Based on this research, we tested experimentally the hypothesis that smokers with two or more first-degree relatives who smoked (FH+) would exhibit stronger craving reactions following stressful stimuli than smokers without such family histories (FH-). Participants: We recruited 83 smokers by advertisement (mean age = 41.2 years. 57% female, 41% completed some college, 59% African American). Setting: The study was conducted in an interview room in an urban medical center. Design: Participants were exposed to a neutral situation (changing a lightbulb) and a stressful situation (dental work) using script-guided imagery. Measurements: Participants completed background measures of demographics, distress and smoking behavior. In addition, participants completed cigarette craving and anxiety questionnaires immediately before and after each condition. Findings: Supporting the study hypothesis, FH+ smokers (n= 39) selectively displayed stronger craving reactions to dental imagery (P < 0.03) than did FH- smokers (n = 44). Conclusion: The higher levels of stress-induced cigarette craving demonstrated experimentally for individuals with family histories of smoking suggest one mechanism for their poorer cessation success.A study of depressive symptoms and smoking behavior in adult male twins from NHLBI twin study
AbstractMcCaffery, J. M., Niaura, R., Swan, G. E., & Carmelli, D. (n.d.).Publication year
2003Journal title
Nicotine and Tobacco ResearchVolume
5Issue
1Page(s)
77-83AbstractSelf-report measures of depressive symptoms, such as the Center for Epidemiological Studies - Depression Scale (CES-D), correlate with current and lifetime smoking status. In one previous study of adult female twins, genetic factors accounted for the covariation of liability to a diagnosis of major depressive disorder and liability to lifetime smoking (Kendler, Neale, MacLean, Heath, Eaves, & Kessler, 1993b, Archives of General Psychiatry, 50, 36-43); however, it remained unclear whether genetic effects also account for the covariation between subclinical depressive symptomology and smoking behavior. In this study, we use twin structural equation modeling to explore whether genetic and/or environmental influences contribute to the covariation between depressive symptoms, as measured by the CES-D, and current and lifetime smoking status among 120 monozygotic and 114 dizygotic Caucasian male twin pairs (aged 59-69). In this sample, depressive symptoms showed small but significant correlations with current and lifetime smoking status. Univariate twin analyses indicated that additive genetic and non-shared environmental factors contributed significantly to liability to current and lifetime smoking. However, the majority of variance in CES-D scores was attributable to non-shared (individual) environment. In bivariate analyses, non-shared environmental factors accounted for the majority of covariation between liability to depressive symptoms (CES-D scores ≥ 8; above the 75th percentile) and liability to current and lifetime smoking status. Taken together with the previous literature, these results suggest that the etiology of covariation among depressive symptoms and smoking behavior may vary by measurement and severity of depressive symptomology.An academic detailing intervention to disseminate physician-delivered smoking cessation counseling: Smoking cessation outcomes of the Physicians Counseling Smokers Project
AbstractGoldstein, M. G., Niaura, R., Willey, C., Kazura, A., Rakowski, W., DePue, J., & Park, E. (n.d.).Publication year
2003Journal title
Preventive MedicineVolume
36Issue
2Page(s)
185-196AbstractBackground. Little is known about the effectiveness of interventions to disseminate smoking cessation interventions among a population of primary care physicians. This study's objective was to determine the effect of a community-based academic detailing intervention on the quit rates of a population-based sample of smokers. Methods. This community-based, quasi-experimental study involved representative samples of 259 primary care physicians and 4295 adult smokers. An academic detailing intervention was delivered to physicians in intervention areas over a period of 15 months. Analyses were performed on the data from the 2346 subjects who reported at least one physician visit over 24 months. Multivariate regression analyses were conducted to determine the impact of the intervention on self-reported smoking quit rates, reported by adjusted odds ratios. Results. Among smokers reporting a physician visit during the study period, there was a borderline significant effect for those residing in intervention areas versus control areas (OR = 1.35; 95% CI .99-1.83; P = 0.057). Among a subgroup of 819 smokers who reported a visit with an enrolled physician, we observed a significant effect for those residing in intervention areas (OR = 1.80; 95% CI 1.16-2.75; P = 0.008). Conclusion. An academic detailing intervention to enhance physician delivered smoking cessation counseling is an effective strategy for disseminating smoking cessation interventions among community-based practices.Are metabolic risk factors one unified syndrome? Modeling the structure of the metabolic syndrome X
AbstractShen, B. J., Todaro, J. F., Niaura, R., McCaffery, J. M., Zhang, J., Spiro, A., & Ward, K. D. (n.d.).Publication year
2003Journal title
American Journal of EpidemiologyVolume
157Issue
8Page(s)
701-711AbstractThe metabolic syndrome, manifested by insulin resistance, obesity, dyslipidemia, and hypertension, is conceived to increase the risk for coronary heart disease and type II diabetes. Several studies have used factor analysis to explore its underlying structure among related risk variables but reported different results. Taking a hypothesis-testing approach, this study used confirmatory factor analysis to specify and test the factor structure of the metabolic syndrome. A hierarchical four-factor model, with an overarching metabolic syndrome factor uniting the insulin resistance, obesity, lipid, and blood pressure factors, was proposed and tested with 847 men who participated in the Normative Aging Study between 1987 and 1991. Simultaneous multigroup analyses were also conducted to test the stability of the proposed model across younger and older participants and across individuals with and without cardiovascular disease. The findings demonstrated that the proposed structure was well supported (comparative fit index = 0.97, root mean square error approximation = 0.06) and stable across subgroups. The metabolic syndrome was represented primarily by the insulin resistance and obesity factors, followed by the lipid factor, and, to a lesser extent, the blood pressure factor. This study provides an empirical foundation for conceptualizing and measuring the metabolic syndrome that unites four related components (insulin resistance, obesity, lipids, and blood pressure).Assessing the transtheoretical model of change constructs for physicians counseling smokers
AbstractPark, E. R., DePue, J. D., Goldstein, M. G., Niaura, R., Harlow, L. L., Willey, C., Rakowski, W., & Prokhorov, A. V. (n.d.).Publication year
2003Journal title
Annals of Behavioral MedicineVolume
25Issue
2Page(s)
120-126AbstractBaseline data from a population-based sample of 259 primary care physicians were used to examine the interrelations of 3 central constructs of the Transtheoretical Model of Change (TTM; stages of change, self-efficacy, and decisional balance) in regard to smoking cessation counseling behavior. In this article we explore the potential use of the TTM for future interventions to help understand and guide physicians' behavior change toward increasing adoption of smoking cessation interventions with their patients. It was hypothesized that self-efficacy and the decisional balance of counseling would be significantly related to physicians' stages of change, which in turn would be related to self-reported physician counseling behavior. Principal components analyses were conducted to examine the self-efficacy and decisional balance constructs. Coefficient alphas were .90 for self-efficacy and .84 and .78 for the pros and cons scales, respectively. Consistent with the TTM, analyses of variance revealed that later stages of physicians' readiness to provide smoking cessation counseling were associated with higher self-efficacy scores. Earlier stages showed significantly higher cons and lower pros of smoking cessation counseling. Structural equation modeling procedures supported the hypothesized path analysis model in which 3 constructs related to stage of readiness, which in turn related to reported physicians' counseling behavior.Assessment to inform smoking cessation treatment
Niaura, R., & Shadel, W. (n.d.). In The tobacco dependence treatment handbook: A guide to best practices (1–).Publication year
2003Associations between repression, general maladjustment, body weight, and body shape in older males: The normative aging study
AbstractNiaura, R. S., Stroud, L. R., Todaro, J., Ward, K. D., Spiro, A., Aldwin, C., Landsberg, L., & Weiss, S. T. (n.d.).Publication year
2003Journal title
International Journal of Behavioral MedicineVolume
10Issue
3Page(s)
221-238AbstractWe examined relationships between repression, general maladjustment, body mass Index (BMI), and waist-to-hip ratio (WHR). The participants were 1,081 healthy older men from the Normative Aging Study. Repression and General Maladjustment Scales of the Minnesota Multiphasic Personality Inventory were composite measures of personality. Repression was associated with lower BMI and WHR, and maladjustment with higher BMI and WHR. However, associations between WHR and personality dimensions were no longer significant when controlling for BMI, but associations between BMI and personality dimensions remained significant when controlling for WHR. These effects were explained by differing relationships between WHR, repression, and maladjustment for normal weight, overweight, and obese individuals. Specifically, associations between repression, maladjustment, and body shape were significant for normal weight and overweight individuals, but not for obese individuals. Health behaviors including smoking did not mediate relationships between repression, maladjustment, and body shape, but might be considered in future studies as mechanisms underlying links between personality and body shape.Brief behavioral treatment
Shadel, W., & Niaura, R. (n.d.). In The tobacco dependence treatment handbook: A guide to best practices (1–).Publication year
2003Depressive symptoms and metabolic risk in adult male twins enrolled in the National Heart, Lung, and Blood Institute Twin Study
AbstractMcCaffery, J. M., Niaura, R., Todaro, J. F., Swan, G. E., & Carmelli, D. (n.d.).Publication year
2003Journal title
Psychosomatic MedicineVolume
65Issue
3Page(s)
490-497AbstractObjective: To determine the extent to which depressive symptoms are associated with metabolic risk factors and whether genetic or environmental factors account for this association. Method: Twin structural equation modeling was employed to estimate genetic and environmental contributions to the covariation of depressive symptoms, as indexed by the Centers for Epidemiological Studies-Depression Scale, and common variance among blood pressure, body mass index, waist-to-hip ratio, and serum triglycerides and glucose among 87 monozygotic and 86 dizygotic male twin pairs who participated in the NHLBI twin study. Results: Depressive symptoms were associated with individual components of the metabolic syndrome and common variance among the risk factors. Twin structural equation modeling indicated that the associations were attributable to environmental (nongenetic) factors. Conclusions: These results support the hypothesis that depressive symptoms may increase risk for a pattern of physiological risk consistent with the metabolic syndrome.Does the DRD2-Taq1 A polymorphism influence treatment response to bupropion hydrochloride for reduction of the nicotine withdrawal syndrome?
AbstractDavid, S. P., Niaura, R., Papandonatos, G. D., Shadel, W. G., Burkholder, G. J., Britt, D. M., Day, A., Stumpff, J., Hutchison, K., Murphy, M., Johnstone, E., Griffiths, S. E., & Walton, R. T. (n.d.).Publication year
2003Journal title
Nicotine and Tobacco ResearchVolume
5Issue
6Page(s)
935-942AbstractBupropion hydrochloride is effective in promoting long-term abstinence from smoking and may reduce risk for relapse through attenuation of withdrawal symptoms and craving. Bupropion is a weak dopamine reuptake inhibitor, and individual genetic variation in the dopamine D2 receptor has been associated with nicotine dependence in case-control studies. Thirty smokers were randomly assigned to bupropion or placebo and interviewed using the Minnesota Nicotine Withdrawal Scale on two occasions: prior to starting medication and after 14 days on bupropion or placebo. The individual symptoms of craving, irritability, and anxiety were significantly reduced in the bupropion group, whereas no withdrawal symptoms were diminished in the placebo group. Within the bupropion group, subgroup analyses with stratification by genotype demonstrated that craving, irritability, and anxiety were significantly attenuated only among subjects with DRD2-Taq1 A2/A2 genotypes. In the DRD2-Taq1 A1/A1 and A1/A2 groups, no significant reduction was seen in any individual symptom of the nicotine withdrawal syndrome. These data suggest that bupropion attenuates specific symptoms of the nicotine withdrawal syndrome and that this effect may be modified by genotype for the dopamine D2 receptor.Effect of negative emotions on frequency of coronary heart disease (The Normative Aging Study)
AbstractTodaro, J. F., Shen, B. J., Niaura, R., Spiro, A., & Ward, K. D. (n.d.).Publication year
2003Journal title
American Journal of CardiologyVolume
92Issue
8Page(s)
901-906AbstractNegative emotions, such as depression and anxiety, have been associated with the development of coronary heart disease (CHD). In multivariate models, negative emotions have predicted CHD outcomes, such as nonfatal myocardial infarction and CHD mortality. Few studies, however, have investigated this relation while controlling for variables associated with the metabolic syndrome or those indicative of sympathetic nervous system activity. We prospectively examined the relation between negative emotions and incident CHD in older men (mean 60.3 ± 7.9 years) participating in the Normative Aging Study (NAS). Four hundred ninety-eight men who completed the Minnesota Multiphasic Personality Inventory (MMPI) and who participated in a subsequent laboratory assessment were included in the study. All men were not on medication and free of diagnosed CHD and diabetes. Negative emotions were measured by the MMPI Welsh A scale, which is comprised of 39 items measuring symptoms of depression and anxiety. Negative emotion score, sociodemographic characteristics, health behaviors, components of the metabolic syndrome, and stress hormones were used to predict incident CHD over a 3-year follow-up period. During follow-up, 45 CHD events were observed. In unadjusted logistic regression analyses, negative emotions significantly predicted the incidence of CHD (odds ratio [OR] 1.06, 95% confidence interval [CI] 1.01 to 1.10, p = 0.02). After adjusting for potential covariates, negative emotions continued to predict the incidence of CHD (OR 1.06, 95% CI 1.01 to 1.12, p = 0.02) A linear, dose-response relation was observed (chi-square 10.8, degree of freedom 2, p = 0.005): participants who had the highest level of negative emotions experienced the greatest incidence of CHD.Effects of dopamine transporter and receptor polymorphisms on smoking cessation in a bupropion clinical trial
AbstractLerman, C., Wileyto, E. P., Audrain, J., Pinto, A., Kucharski, S., Niaura, R., Shields, P. G., Hawk, L. H., Krishnan, S., & Epstein, L. H. (n.d.).Publication year
2003Journal title
Health PsychologyVolume
22Issue
5Page(s)
541-548AbstractThis study examined the role of dopaminergic genes in prospective smoking cessation and response to bupropion treatment in a placebo-controlled clinical trial. Smokers of European ancestry (N = 418) provided blood samples for genetic analysis and received either bupropion or placebo (10 weeks) plus counseling. Assessments included the dopamine D2 receptor (DRD2) genotype, dopamine transporter (SLC6A3) genotype, demographic factors, and nicotine dependence. Smoking status was verified at the end of treatment (EOT) and at 6-month follow-up. The results provided evidence for a significant DRD2 X SLC6A3 interaction effect on prolonged smoking abstinence and time to relapse at EOT, independent of treatment condition. Such effects were no longer significant at 6-month follow-up, however. These results provide the first evidence from a prospective clinical trial that genes that alter dopamine function may influence smoking cessation and relapse during the treatment phase.Effects of motivational interviewing on smoking cessation in adolescents with psychiatric disorders
AbstractBrown, R. A., Ramsey, S. E., Strong, D. R., Myers, M. G., Kahler, C. W., Lejuez, C. W., Niaura, R., Pallonen, U. E., Kazura, A. N., Goldstein, M. G., & Abrams, D. B. (n.d.).Publication year
2003Journal title
Tobacco controlVolume
12Page(s)
IV3-10AbstractObjective: To test the hypothesis that among adolescent smokers hospitalised for psychiatric and substance use disorders, motivational interviewing (MI) would lead to more and longer quit attempts, reduced smoking, and more abstinence from smoking over a 12 month follow up. Design: Randomised control trial of MI versus brief advice (BA) for smoking cessation, with pre- and post-intervention assessment of self efficacy and intentions to change, and smoking outcome variables assessed at one, three, six, nine, and 12 month follow ups. Setting: A private, university affiliated psychiatric hospital in Providence, Rhode Island, USA. Patients or other participants: Consecutive sample (n = 191) of 13-17 year olds, admitted for psychiatric hospitalisation, who smoked at least one cigarette per week for the past four weeks, had access to a telephone, and did not meet DSM-IV criteria for current psychotic disorder. Interventions: MI versus BA. MI consisted of two, 45 minute individual sessions, while BA consisted of 5-10 minutes of advice and information on how to quit smoking. Eligible participants in both conditions were offered an eight week regimen of transdermal nicotine patch upon hospital discharge. Main outcome measures: Point prevalence abstinence, quit attempts, changes in smoking rate and longest quit attempt. Proximal outcomes included intent to change smoking behaviour (upon hospital discharge), and self efficacy for smoking cessation. Results: MI did not lead to better smoking outcomes compared to BA. MI was more effective than BA for increasing self efficacy regarding ability to quit smoking. A significant interaction of treatment with baseline intention to quit smoking was also found. MI was more effective than BA for adolescents with little or no intention to change their smoking, but was actually less effective for adolescents with pre-existing intention to cut down or quit smoking. However, the effects on these variables were relatively modest and only moderately related to outcome. Adolescents with comorbid substance use disorders smoked more during follow up while those with anxiety disorders smoked less and were more likely to be abstinent. Conclusions: The positive effect of MI on self efficacy for quitting and the increase in intention to change in those with initially low levels of intentions suggest the benefits of such an intervention. However, the effects on these variables were relatively modest and only moderately related to outcome. The lack of overall effect of MI on smoking cessation outcomes suggests the need to further enhance and intensify this type of treatment approach for adolescent smokers with psychiatric comorbidity.Efficacy of acute administration of nicotine gum in relief of cue-provoked cigarette craving
AbstractShiffman, S., Shadel, W. G., Niaura, R., Khayrallah, M. A., Jorenby, D. E., Ryan, C. F., & Ferguson, C. L. (n.d.).Publication year
2003Journal title
PsychopharmacologyVolume
166Issue
4Page(s)
343-350AbstractRationale: Acute cravings, often provoked by exposure to smoking cues, appear to be important triggers for smoking relapse. Relief of acute craving may therefore be an important step in preventing relapse. Objectives: This study was undertaken to assess the effectiveness of nicotine gum in relieving acute craving. Methods: A multi-center, randomized, placebo-controlled study was conducted with smokers (n=296) who quit by using either active or inactive gum for 3 days. On their third day of abstinence, smokers participated in a laboratory session in which they were exposed to a provocative smoking cue, chewed active or inactive gum, and then rated their craving at 5-min intervals for 35 min. Results: Craving initially decreased in both groups. After 15 min, however, the smokers using active nicotine gum experienced significantly greater craving reductions. Conclusions: These results suggest that nicotine gum can effectively reduce acute craving following exposure to smoking cues.Elevated risk of tobacco dependence among offspring of mothers who smoked during pregnancy: A 30-year prospective study
AbstractBuka, S. L., Shenassa, E. D., & Niaura, R. (n.d.).Publication year
2003Journal title
American Journal of PsychiatryVolume
160Issue
11Page(s)
1978-1984AbstractObjective: The authors' goal was to investigate whether maternal smoking during pregnancy is associated with an increased risk of nicotine dependence among adult offspring. Method: Prospective data from two samples of offspring in the National Collaborative Perinatal Project, a long-term prospective investigation from pregnancy through adulthood, were combined (N= 1,248). Maternal smoking during pregnancy was assessed during each prenatal visit. Offspring smoking behavior and life-time risk of nicotine dependence were obtained by structured interview with the Diagnostic Interview Schedule; the mean age of the offspring at the time of interview was 29 years. Results: Offspring whose mothers reported smoking a pack or more of cigarettes during their pregnancy were significantly more likely to meet DSM criteria for lifetime tobacco dependence than offspring of mothers who reported that they never smoked during pregnancy The odds of progressing from smoking to nicotine dependence were almost twice as great for offspring whose mothers smoked heavily during pregnancy. These significant differences remained after adjustments for participants' gender and age and maternal socioeconomic status and age at pregnancy. Results were comparable for men and women. The findings were specific for tobacco dependence; odds of marijuana dependence were not significantly elevated among the offspring of tobacco smokers. Conclusions: Offspring of mothers who smoked a pack or more of cigarettes during pregnancy are at elevated risk of developing nicotine dependence but not marijuana dependence as adults. Maternal smoking during pregnancy is a risk factor for subsequent nicotine dependence among offspring.