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 on the Internet : Content, quality, and usability

Bock, 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

2004

Journal title

Nicotine and Tobacco Research

Volume

6

Issue

2

Page(s)

207-219

10.1080/14622200410001676332

Abstract

Abstract

The 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

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

Publication year

2004

Journal title

Addictive Behaviors

Volume

29

Issue

4

Page(s)

811-815

10.1016/j.addbeh.2004.02.014

Abstract

Abstract

This 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

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

Publication year

2004

Journal title

Journal of Behavioral Medicine

Volume

27

Issue

5

Page(s)

463-475

10.1023/B:JOBM.0000047610.07195.b0

Abstract

Abstract

Cigarette 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

Erblich, J., Boyarsky, Y., Spring, B., Niaura, R. S., & Bovbjerg, D. H. (n.d.).

Publication year

2003

Journal title

Addiction

Volume

98

Issue

5

Page(s)

657-664

10.1046/j.1360-0443.2003.00351.x

Abstract

Abstract

Aims: 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

Niaura, R. S., McCaffery, J. M., Niaura, R., Swan, G. E., & Carmelli, D. (n.d.).

Publication year

2003

Journal title

Nicotine and Tobacco Research

Volume

5

Issue

1

Page(s)

77-83

10.1080/14622200307259

Abstract

Abstract

Self-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

Goldstein, M. G., Niaura, R. S., Willey, C., Kazura, A., Rakowski, W., DePue, J., & Park, E. (n.d.).

Publication year

2003

Journal title

Preventive Medicine

Volume

36

Issue

2

Page(s)

185-196

10.1016/S0091-7435(02)00018-X

Abstract

Abstract

Background. 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

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

Publication year

2003

Journal title

American Journal of Epidemiology

Volume

157

Issue

8

Page(s)

701-711

10.1093/aje/kwg045

Abstract

Abstract

The 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

Park, E. R., DePue, J. D., Goldstein, M. G., Niaura, R. S., Harlow, L. L., Willey, C., Rakowski, W., & Prokhorov, A. V. (n.d.).

Publication year

2003

Journal title

Annals of Behavioral Medicine

Volume

25

Issue

2

Page(s)

120-126

10.1207/S15324796ABM2502_08

Abstract

Abstract

Baseline 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. S., & Shadel, W. (n.d.).

Publication year

2003

Abstract

Abstract

~

Associations between repression, general maladjustment, body weight, and body shape in older males : The normative aging study

Niaura, R. S., Stroud, L. R., Todaro, J., Ward, K. D., Spiro, A., Aldwin, C., Landsberg, L., & Weiss, S. T. (n.d.).

Publication year

2003

Journal title

International Journal of Behavioral Medicine

Volume

10

Issue

3

Page(s)

221-238

10.1207/S15327558IJBM1003_03

Abstract

Abstract

We 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. S. (n.d.).

Publication year

2003

Abstract

Abstract

~

Depressive symptoms and metabolic risk in adult male twins enrolled in the National Heart, Lung, and Blood Institute Twin Study

McCaffery, J. M., Niaura, R. S., Todaro, J. F., Swan, G. E., & Carmelli, D. (n.d.).

Publication year

2003

Journal title

Psychosomatic Medicine

Volume

65

Issue

3

Page(s)

490-497

10.1097/01.PSY.0000041545.52924.82

Abstract

Abstract

Objective: 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?

David, S. P., Niaura, R. S., 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

2003

Journal title

Nicotine and Tobacco Research

Volume

5

Issue

6

Page(s)

935-942

10.1080/14622200310001615295

Abstract

Abstract

Bupropion 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)

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

Publication year

2003

Journal title

American Journal of Cardiology

Volume

92

Issue

8

Page(s)

901-906

10.1016/S0002-9149(03)00967-6

Abstract

Abstract

Negative 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

Niaura, R. S., Lerman, 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

2003

Journal title

Health Psychology

Volume

22

Issue

5

Page(s)

541-548

10.1037/0278-6133.22.5.541

Abstract

Abstract

This 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

Niaura, R. S., Brown, 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

2003

Journal title

Tobacco control

Volume

12

Issue

SUPPL. 4

Page(s)

IV3-10

Abstract

Abstract

Objective: 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

Shiffman, S., Shadel, W. G., Niaura, R. S., Khayrallah, M. A., Jorenby, D. E., Ryan, C. F., & Ferguson, C. L. (n.d.).

Publication year

2003

Journal title

Psychopharmacology

Volume

166

Issue

4

Page(s)

343-350

10.1007/s00213-002-1338-1

Abstract

Abstract

Rationale: 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

Buka, S. L., Shenassa, E. D., & Niaura, R. S. (n.d.).

Publication year

2003

Journal title

American Journal of Psychiatry

Volume

160

Issue

11

Page(s)

1978-1984

10.1176/appi.ajp.160.11.1978

Abstract

Abstract

Objective: 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.

Erratum : Depressive symptoms and metabolic risk in adult male twins enrolled in the National Heart, Lung, and Blood Institute twin study (Psychosomatic Medicine (2003) 65 (490-497))

Niaura, R. S., McCaffery, J. M., Niaura, R., Todaro, J. F., Swan, G. E., & Carmelli, D. (n.d.).

Publication year

2003

Journal title

Psychosomatic Medicine

Volume

65

Issue

4

Abstract

Abstract

~

History of depression and smoking cessation outcome : A meta-analysis

Hitsman, B., Borrelli, B., McChargue, D. E., Spring, B., & Niaura, R. S. (n.d.).

Publication year

2003

Journal title

Journal of consulting and clinical psychology

Volume

71

Issue

4

Page(s)

657-663

10.1037/0022-006X.71.4.657

Abstract

Abstract

The authors conducted a meta-analysis of published studies to (a) evaluate the premise that a history of major depression is associated with failure to quit smoking and (b) identify factors that moderate the relationship between history of depression and cessation outcome. Fifteen studies met the selection requirements and were coded for various study methodology and treatment characteristics. DSTAT was used to calculate individual study effect sizes, determine the mean effect size across studies, and test for moderator effects. No differences in either short-term (≤ 3 months) or long-term abstinence rates (≥ 6 months) were observed between smokers positive versus negative for history of depression. Lifetime history of major depression does not appear to be an independent risk factor for cessation failure in smoking cessation treatment.

History of major depressive disorder among smokers in cessation treatment : Associations with dysfunctional attitudes and coping

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

Publication year

2003

Journal title

Addictive Behaviors

Volume

28

Issue

6

Page(s)

1033-1047

10.1016/S0306-4603(02)00234-4

Abstract

Abstract

We examined baseline differences in dysfunctional attitudes and coping associated with a history of major depressive disorder (MDD) among 435 smokers participating in a smoking cessation trial. Consistent with expectations, MDD history was associated with greater dysfunctional attitudes, greater use of maladaptive coping, less use of adaptive coping, and greater dysphoria and negative mood. The effects of MDD history on cognition and coping were independent from the effects of a history of alcohol dependence (AD), indicating that MDD history is a unique risk factor for variables associated with vulnerability to depression. Finally, regression analyses showed that the effects of MDD history on depressive symptoms and negative mood were mediated by dysfunctional attitudes and by both adaptive and maladaptive coping. Results indicate that smokers with an MDD history seeking cessation treatment possess characteristics that may be targets for cognitive-behavioral treatments (CBT) aimed at addressing vulnerability to depression and negative moods during smoking cessation.

Intergenerational transmission of tobacco use and dependence : A transdisciplinary perspective

Shenassa, E. D., McCaffery, J. M., Swan, G. E., Khroyan, T. V., Shakib, S., Lerman, C., Lyons, M., Moutappa, M., Niaura, R. S., Buka, S. L., Leslie, F., & Santangelo, S. L. (n.d.).

Publication year

2003

Journal title

Nicotine and Tobacco Research

Volume

5

Issue

SUPPL. 1

Page(s)

S55-S69

10.1080/14622200310001625500

Abstract

Abstract

Numerous questions remain regarding the intergenerational transmission of tobacco use and dependence, and some of these questions are best approached from a transdisciplinary perspective. For example, considering both genetic and environmental influences on cigarette smoking promises to be a fruitful venue for future investigations. In this paper, we consider the evidence regarding intergenerational influences on the transmission of tobacco use and nicotine dependence in both humans and animal models; our focus will be on genetic influences, in utero exposure to nicotine, and some postnatal influences. Research gaps that exist between scientific disciplines are highlighted, and some directions for future research are suggested.

Measures of abstinence in clinical trials : Issues and recommendations

Niaura, R. S., Hughes, J. R., Keely, J. P., Niaura, R. S., Ossip-Klein, D. J., Richmond, R. L., & Swan, G. E. (n.d.).

Publication year

2003

Journal title

Nicotine and Tobacco Research

Volume

5

Issue

1

Page(s)

13-25

10.1080/14622200307270

Abstract

Abstract

A workgroup formed by the Society for Research on Nicotine and Tobacco reviewed the literature on abstinence measures used in trials of smoking cessation interventions. We recommend that trials report multiple measures of abstinence. However, at a minimum we recommend that trial: (a) report prolonged abstinence (i.e., sustained abstinence after an initial period in which smoking is not counted as a failure) as the preferred measure, plus point prevalence as a secondary measure; (b) use 7 consecutive days of smoking or smoking on ≥ 1 day of 2 consecutive weeks to define treatment failure; (c) include non-cigarette tobacco use, but not nicotine medications in definitions of failure; and (d) report results from survival analysis to describe outcomes more fully. Trials of smokers willing to set a quit date should tie all follow-ups to the quit date and report 6- and/or 12-month abstinence rates. For these trials, we recommend an initial 2-week grace period for prolonged abstinence definitions; however, the period may vary, depending on the presumed mechanism of the treatment. Trials of smokers who may not be currently trying to quit should tie follow-up to the initiation of the intervention and should report a prolonged abstinence measure of ≥6-month duration and point prevalence rates at 6- and 12-month follow-ups. The grace period for these trials will depend on the time necessary for treatment dissemination, which will vary depending on the treatment, setting, and population. Trials that use short-term follow-ups (≤ 3 months) to demonstrate possible efficacy should report a prolonged abstinence measure of ≥ 4 weeks. We again recommend a 2-week grace period; however, that period can vary.

Ongoing research and future directions

Monti, P., Niaura, R. S., & Abrams, D. S. (n.d.).

Publication year

2003

Abstract

Abstract

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Planning evidence-based treatment of tobacco dependence

Abrams, D. S., & Niaura, R. S. (n.d.).

Publication year

2003

Abstract

Abstract

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