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

Smoking cessation treatment : Pharmacogenetics assessment

Munafò, M. R., Lerman, C., Niaura, R. S., 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. S., 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. S., & 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

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. S., 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. S., & Abrams, D. B. (n.d.).

Publication year

2004

Journal title

Addictive Behaviors

Volume

29

Issue

9

Page(s)

1735-1744

10.1016/j.addbeh.2004.03.042

Abstract

Abstract

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

Are stress eaters at risk for the metabolic syndrome?

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

Publication year

2004

Journal title

Annals of the New York Academy of Sciences

Volume

1032

Page(s)

208-210

10.1196/annals.1314.022

Abstract

Abstract

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

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. S. (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.

Niaura, R. S., 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

Abstract

Abstract

~

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. S. (n.d.).

Publication year

2004

Journal title

Nicotine and Tobacco Research

Volume

6

Issue

4

Page(s)

743-749

10.1080/14622200410001727902

Abstract

Abstract

~

Depression proneness in treatment-seeking smokers : A taxometric analysis

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

Niaura, R. S., 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, Ó., Puig, C., Vall, O., Pacifici, R., Pichini, S., Lester, B. M., Law, K. L., Stroud, L. R., LaGasse, L. L., Liu, J., & Niaura, R. S. (n.d.).

Publication year

2004

Journal title

Pediatrics

Volume

113

Issue

3 I

Page(s)

623-624

10.1542/peds.113.3.623-a

Abstract

Abstract

~

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. S. (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. S. (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. S., 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.

Hostility in smokers with past major depressive disorder : Relation to smoking patterns, reasons for quitting, and cessation outcomes

Kahler, C. W., Strong, D. R., Niaura, R. S., & Brown, R. A. (n.d.).

Publication year

2004

Journal title

Nicotine and Tobacco Research

Volume

6

Issue

5

Page(s)

809-818

10.1080/1462220042000282546

Abstract

Abstract

We 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

Cook, J. W., Spring, B., McChargue, D. E., Borrelli, B., Hitsman, B., Niaura, R. S., Keuthen, N. J., & Kristeller, J. (n.d.).

Publication year

2004

Journal title

Psychopharmacology

Volume

173

Issue

1-2

Page(s)

153-159

10.1007/s00213-003-1711-8

Abstract

Abstract

Rationale: 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

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

Publication year

2004

Journal title

Journal of Psychopathology and Behavioral Assessment

Volume

26

Issue

3

Page(s)

185-191

10.1023/B:JOBA.0000022111.13381.0c

Abstract

Abstract

Global 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

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

Publication year

2004

Journal title

Journal of Neuropsychiatry and Clinical Neurosciences

Volume

16

Issue

4

Page(s)

446-455

10.1176/jnp.16.4.446

Abstract

Abstract

In 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

Hutchison, K. E., Rutter, M. C., Niaura, R. S., Swift, R. M., Pickworth, W. B., & Sobik, L. (n.d.).

Publication year

2004

Journal title

Psychopharmacology

Volume

175

Issue

4

Page(s)

407-413

10.1007/s00213-004-1837-3

Abstract

Abstract

Rationale: 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.