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
Lipid reactivity to stress: II. Biological and behavioral influences
AbstractStoney, C. M., Bausserman, L., Niaura, R., Marcus, B., & Flynn, M. (n.d.).Publication year
1999Journal title
Health PsychologyVolume
18Issue
3Page(s)
251-261AbstractThis study examined behavioral and physiological influences on lipid concentrations during acute and chronic stressors. One hundred men (n = 92) and women (n = 8) were tested during a chronic stressor and during 2 acute stressors. During chronic stress, diet, physical activity, exercise, and sleep were examined. During the acute stressors, catecholamines, cortisol, plasma volume, and cardiovascular responses were examined. None of the behavioral influences could explain the lipid response to chronic stress. Responses of the atherogenic lipids to acute stressors were not solely reflecting hemoconcentration of the plasma but were moderately correlated with cardiovascular, epinephrine, and cortisol reactivity. Diastolic blood pressure reactors to the acute stressors had larger lipid responses to the chronic stressor than did nonreactors. Elevations in blood lipids during stress are not artifacts and may be clinically significant.Quality of life and anxiety in a phase II cardiac rehabilitation program
AbstractEngebretson, T. O., Clark, M. M., Niaura, R. S., Phillips, T., Albrecht, A., & Tilkemeier, P. (n.d.).Publication year
1999Journal title
Medicine and Science in Sports and ExerciseVolume
31Issue
2Page(s)
216-223AbstractPurpose: Cardiac rehabilitation programs increasingly attempt to improve both quantity and quality of life (QOL). Documenting QOL changes requires appropriate instruments, and interpreting QOL data requires an understanding of the factors that influence such reports. Methods: To address both issues, we assessed QOL among 77 patients before and after participation in a 12-wk phase II cardiac rehabilitation program. Individual psychological differences in trait anxiety and defensiveness were also assessed. The sample was 76.6% male, 70.1% married, and had a mean age of 58.8 yr. Results: The QOL scales detected changes which occurred over the 12-wk testing period. QOL reports were strongly and differentially influenced by individual differences in trait anxiety, such that patients reporting high trait anxiety displayed poorer QOL than those low in trait anxiety. More specifically, trait anxiety influenced affect reports most strongly, functional aspects moderately, and physical aspects of QOL reports the least. Conclusions: Defensiveness was unrelated to QOL reports. The 17% of participants who voluntarily left the rehabilitation program prematurely were characterized as younger, having better self-perceived health, having a less severe cardiac history, and being high in both trait anxiety and defensiveness. Study benefits and limitations are discussed.Smoking cues decrease prepulse inhibition of the startle response and increase subjective craving in humans
AbstractHutchison, K. E., Niaura, R., & Swift, R. (n.d.).Publication year
1999Journal title
Experimental and Clinical PsychopharmacologyVolume
7Issue
3Page(s)
250-256AbstractThe present study investigated whether exposure to smoking cues would attenuate prepulse inhibition (PPI) of the startle reflex and increase craving among smokers across 2 experimental sessions. It was hypothesized that exposure to smoking cues would result in a decrease in PPI. Twenty-six smokers were exposed to smoking cues and control cues in 2 experimental sessions 1 week apart. Results indicate that smoking cues reliably attenuated PPI in both the 1st and 2nd sessions as compared with control cues. Findings also suggest that smoking cues reliably increased craving, increased negative affect, and reduced positive affect relative to baseline measures in both sessions. Results are consistent with the premise that exposure to smoking cues precipitates increases in dopamine activation or changes in information processing that cause a disruption of PPI.The efficacy of exercise as an aid for smoking cessation in women: A randomized controlled trial
AbstractMarcus, B. H., Albrecht, A. E., King, T. K., Parisi, A. F., Pinto, B. M., Roberts, M., Niaura, R. S., & Abrams, D. B. (n.d.).Publication year
1999Journal title
Archives of Internal MedicineVolume
159Issue
11Page(s)
1229-1234AbstractBackground: Smoking prevalence rates among women are declining at a slower rate than among men. Objective: To determine if exercise, a healthful alternative to smoking, enhances the achievement and maintenance of smoking cessation. Methods: Two hundred eighty-one healthy, sedentary female smokers were randomly assigned to either a cognitive-behavioral smoking cessation program with vigorous exercise (exercise) or to the same program with equal staff contact time (control). Subjects participated in a 12-session, group- based smoking cessation program. Additionally, exercise subjects were required to attend 3 supervised exercise sessions per week and control subjects were required to participate in 3 supervised health education lectures per week. Abstinence from smoking was based on self-report, was verified by saliva cotinine level, and was measured at 1 week after quit day (week 5), end of treatment (week 12), and 3 and 12 months later (20 and 60 weeks after quit day, respectively). Results: Compared with control subjects (n = 147), exercise subjects (n = 134) achieved significantly higher levels of continuous abstinence at the end of treatment (19.4% vs 10.2%, P = .03) and 3 months (16.4% vs 8.2%, P = .03) and 12 months (11.9% vs 5.4%, P = .05) following treatment. Exercise subjects had significantly increased functional capacity (estimated VO2 peak, 25 ± 6 to 28 ± 6, P<.01) and had gained less weight by the end of treatment (3.05 vs 5.40 kg, P = .03). Conclusions: Vigorous exercise facilitates short- and longer-term smoking cessation in women when combined with a cognitive-behavioral smoking cessation program. Vigorous exercise improves exercise capacity and delays weight gain following smoking cessation.Weight suppression and weight rebound in ex-smokers treated with fluoxetine
AbstractBorrelli, B., Spring, B., Niaura, R., Kristeller, J., Ockene, J. K., & Keuthen, N. J. (n.d.).Publication year
1999Journal title
Journal of consulting and clinical psychologyVolume
67Issue
1Page(s)
124-131AbstractFluoxetine's effect (30 mg, 60 mg, and placebo) on postcessation weight gain was Studied among participants from a randomized, double-blind 10-week smoking cessation trial who met strict criteria for abstinence and drag levels. It was hypothesized that (a) fluoxetine would dose-dependently suppress postcessation weight gain and (b) drug discontinuation would produce dose-dependent weight rebound. During the on-drug phase, placebo participants gained weight linearly (M = 2.61 kg), exceeding both fluoxetine groups (30- mg group M = 1.33 kg, 60-mg group M = 1.25 kg). Weight suppression was initially greater for 60 mg than 30 mg, but both were followed by weight gain. Six months off drag produced greater dose-dependent weight rebound for 60 mg than 30 mg or placebo. Considering both on- and off-drug phases, weight gain for 60 mg of fluoxetine (M = 6.5 kg) was comparable with that for placebo (M = 4.7 kg) but greater than that for 30 mg (M := 3.6 kg). Fluoxetine appears to forestall postcessation weight gain, allowing time for the weight-conscious smoker to focus on quitting smoking rather than on preventing weight gain.A population-based survey of physician smoking cessation counseling practices
AbstractGoldstein, M. G., DePue, J. D., Monroe, A. D., Lessne, C. W., Rakowski, W., Prokhorov, A., Niaura, R., & Dube, C. E. (n.d.).Publication year
1998Journal title
Preventive MedicineVolume
27Issue
5Page(s)
720-729AbstractBackground. To be most effective, physicians' smoking cessation interventions must go beyond advice, to include counseling and follow-up. A full profile of physician performance on the recommended activities to promote smoking cessation has not been provided previously. Methods. We surveyed a representative sample of 246 community-based primary care physicians who had agreed to participate in a 3-year study to evaluate a strategy for disseminating smoking cessation interventions, based on the National Cancer Institute 4-A model and on the Transtheoretical Model of Change. Results. A majority reported they Ask (67%) and Advise (74%) their patients about smoking, while few go beyond to Assist (35%) or Arrange follow-up (8%) with patients who smoke. The criteria for 'thorough' counseling was met by only 27% of physicians. More than half were not intending to increase counseling activity in the next 6 months. After controlling for other variables, physicians in private offices were more likely than physicians in HMO or other settings to be active with smoking cessation counseling. General Internal Medicine physicians were most active, and Ob/Gyn physicians were least active, with smoking cessation counseling among primary care specialty groups. Conclusions. Innovative approaches are needed to motivate, support, and reward physicians to counsel their patients who smoke, especially when considering the movement toward managed health care. Precis: A survey of primary care physicians focusing on national guidelines for smoking cessation counseling showed a majority Ask (67%) and Advise (74%) patients about smoking, but few Assist (35%) or Arrange follow- up.Adherence to treatment for nicotine dependence
Abrams, D., Borrelli, B., Shadel, W., King, T., Bock, B., & Niaura, R. (n.d.). In S. Shumaker & J. Ockene (Eds.), The handbook of health behavior change (2nd eds., 1–).Publication year
1998Page(s)
137-165Exercise, smoking cessation, and short-term changes in serum lipids in women: A preliminary investigation
AbstractNiaura, R., Marcus, B., Albrecht, A., Thompson, P., & Abrams, D. (n.d.).Publication year
1998Journal title
Medicine and Science in Sports and ExerciseVolume
30Issue
9Page(s)
1414-1418AbstractPurpose: This study investigated the combined effects of exercise and smoking cessation on serum lipids. Methods: Eighteen female smokers quit smoking using standard behavioral methods combined with exercise (N = 9) or with a nonexercise contact time control (N = 9). The smoking cessation program for both groups consisted of 12 weekly 1-h behavioral modification sessions held over 12 wk. Exercise training consisted of three supervised 45- min sessions per week for 12 wk. Contact control consisted of three health education lectures/discussions per week for 12 wk. Fitness (estimated V̇O2 peak), dietary variables, and fasting serum lipids and lipoproteins were assessed before and at the end of treatment. V̇O2 peak increased in the exercise subjects compared with the controls. Results: Total caloric intake as well as total fat and carbohydrate increased significantly after smoking cessation in the controls, but there were no dietary changes in the exercise group, high density lipoprotein (HDL)-C2 increased (7.6 mg·dL-1, P < 0.01) in the exercise group, whereas the increases in HDL and its subfractions did not attain statistical significance in the contact control group. Total cholesterol, low density lipoprotein (LDL)-C, and triglycerides did not change in either group. Conclusions: We conclude that exercise training magnifies the increase in HDL-C that usually occurs with smoking cessation.Individual differences in cue reactivity among smokers trying to quit: Effects of gender and cue type
AbstractNiaura, R., Shadel, W. G., Abrams, D. B., Monti, P. M., Rohsenow, D. J., & Sirota, A. (n.d.).Publication year
1998Journal title
Addictive BehaviorsVolume
23Issue
2Page(s)
209-224AbstractAcross studies, when presented with a variety of smoking cues, smokers and ex-smokers evidence distinct patterns of self-reported, physiological, and behavioral reactions. However, few studies have compared more than two different kinds of cues within the same experiment. Furthermore, despite the importance of examining the moderating effect of gender on smoking outcomes, few studies have examined gender differences in smoking cue reactivity. We examined the effect of eight distinct cue manipulations on heart rate, mean arterial pressure, smoking urges, and self-efficacy in a sample of 129 participants (50% female) who had recently quit smoking. Cue manipulations included (a) in vivo exposure, (b) an idiographically designed exposure of subjects' most recent relapse, (c) an idiographically designed exposure to subjects' highest risk situation, and (d) affectively valenced standardized scripts depicting situations generally associated with relapse. These manipulations were compared to a standard cognitive stressor (mental arithmetic) and to a resting baseline. Results revealed differences in the degree of reactivity to different manipulations, with in vivo cues producing the greatest changes. Gender differences in reactivity between the type of cues presented were found for mean arterial pressure, with standardized scripts producing greater changes for women. These findings have implications for understanding the reasons for differences in cue reactivity across manipulations and for gender differences in cue reactivity.Models for provider-patient interaction: Application to health behavior change
Goldstein, M., DePue, J., Kazura, J., & Niaura, R. (n.d.). In S. Shumaker, E. Schron, J. Ockene, & W. McBee (Eds.), The handbook of health behavior change (2nd eds., 1–).Publication year
1998Page(s)
85-113Scripted imagery manipulations and smoking cue reactivity in a clinical sample of self-quitters
AbstractShadel, W. G., Niaura, R., Abrams, D. B., Goldstein, M. G., Rohsenow, D. J., Sirota, A. D., & Monti, P. M. (n.d.).Publication year
1998Journal title
Experimental and Clinical PsychopharmacologyVolume
6Issue
2Page(s)
179-186AbstractThe affectively valenced scripts used by S. Tiffany (1990) suggest that different scripts produce relatively equivalent levels of cue reactivity, although it is unclear if these laboratory findings generalize to clinical samples. In this study, cessation-motivated smokers were tested 7 days before they tried to quit smoking and were exposed to 3 audiotaped scripts that depicted different affectively valenced situations (neutral, positive, or negative). The latter 2 scripts also contained smoking cues. The findings using a clinical sample differed considerably from those using analogue laboratory samples across affective, cognitive, and physiological response measures. Reactivity to these standardized scripts failed to predict treatment outcome through a 30-day follow-up. The use of affectively valenced scripts beyond a laboratory sample is questioned.Smoking
Goldstein, M., & Niaura, R. (n.d.). In E. Topol, M. Bristow, R. Califf, J. Isner, E. Prystowsky, P. Serruys, J. Swain, J. Thomas, & P. Thompson (Eds.), Textbook of cardiovascular medicine (1–).Publication year
1998Page(s)
145-169Effects of alcohol cues on smoking urges and topography among alcoholic men
AbstractRohsenow, D. J., Monti, P. M., Colby, S. M., Gulliver, S. B., Sirota, A. D., Niaura, R. S., & Abrams, D. B. (n.d.).Publication year
1997Journal title
Alcoholism: Clinical and Experimental ResearchVolume
21Issue
1Page(s)
101-107AbstractAlthough the prevalence of smoking among alcoholics ranges up to 97%, little is known about mechanisms underlying the co-occurrence of smoking and alcohol use, or the role tobacco may play in alcohol treatment recovery. Adult male alcoholics in treatment (n = 30) were randomly assigned to visual and olfactory exposure either to alcohol cues or to control cues, and then were allowed to smoke while continuing visual exposure to the same cues. Exposure to alcohol cues resulted in significantly greater self-reported urge to drink and urge to smoke but had no significant effect on the topography of smoking behavior. When variance due to urge to smoke was controlled, greater urge to drink correlated negatively with number of cigarette puffs. The results provide some support for a priming hypothesis of tobacco's role on alcoholism recovery. Clinical and theoretical implications are discussed.Physicians counseling smokers: A population-based survey of patients' perceptions of health care provider-delivered smoking cessation interventions
AbstractGoldstein, M. G., Niaura, R., Willey-Lessne, C., DePue, J., Eaton, C., Rakowski, W., & Dubé, C. (n.d.).Publication year
1997Journal title
Archives of Internal MedicineVolume
157Issue
12Page(s)
1313-1319AbstractObjective: To examine associations between sociodemographic and psychological characteristics of smokers and delivery of 5 types of smoking cessation counseling interventions by physicians and office staff. Methods: We used a telephone survey of a population-based sample of adult cigarette smokers (N=3037) who saw a physician in the last year. Primary outcomes included patients' report of whether a physician or other health care provider (1) talked about smoking, (2) advised them to quit, (3) offered help to quit, (4) arranged a follow-up contact, and (5) prescribed nicotine gum or other medication. Results: Fifty-one percent of smokers were talked to about their smoking; 45.5% were advised to quit; 14.9% were offered help; 3% had a follow-up appointment arranged; and 8.5% were prescribed medication. In multivariate analyses, the most consistent predictors of receipt of almost all counseling behaviors were medical setting (private physician's office only > care in other settings), health status (fair or poor > good, very good, or excellent), more years of education, greater number of cigarettes smoked per day, stage of readiness to quit smoking (preparation > precontemplation), and greater reported benefits of smoking. Conclusions: Physicians and other health care providers are not meeting the standards of smoking intervention outlined by the National Cancer Institute and the Agency for Health Care Policy and Research. Health care providers who intervene only with those patients who are ready to quit smoking are missing opportunities to provide effective smoking interventions to the majority of their patients. Interventions are also less likely to be provided to healthier and lighter smokers.Psychological factors in cardiac disease
Clark, M., Nash, J., Cohen, R., Chase, C., & Niaura, R. (n.d.). In P. Kleespies (Ed.), Emergencies in mental health practice: Evaluation and management (1–).Publication year
1997Temporal stability of lipid responses to acute psychological stress in middle-aged men
AbstractStoney, C. M., Niaura, R., & Bausserman, L. (n.d.).Publication year
1997Journal title
PsychophysiologyVolume
34Issue
3Page(s)
285-291AbstractThe purpose of this study was to establish the temporal stability of lipid responses to acute psychological stress. Eighteen men were tested twice an average of 16.2 months apart in identical laboratory reactivity protocols. Total cholesterol, triglycerides, high- and low-density lipoprotein- cholesterol, plasma volume, heart rate, and blood pressure were assessed during rest, serial subtraction, and speech. After correction for changes in plasma volume, significant elevations were recorded for all variables during the speech task, but fewer variables showed changes during the serial subtraction task. Strong intersession associations were found when considering levels of the variables during baseline and stress (rs ≤ .58). Correlations for the change scores ranged from .36 to .52 for the atherogenic lipids and from .39 to .87 for the cardiovascular variables. Little evidence was found for stability of plasma volume changes. There is moderate to high temporal stability of the atherogenic lipids when considering rest and stress levels and small to moderate temporal stability when considering change scores.Withdrawal dynamics and smoking relapse: Implications for theory, assessment, and intervention
Piasecki, T. M., Fiore, M. C., Niaura, R., Shadel, W., Abrams, D., Goldstein, M., & Baker, T. B. (n.d.).Publication year
1997Journal title
Journal of Addictive DiseasesVolume
16Issue
4Page(s)
119Depression, smoking, activity level, and health status: Pretreatment predictors of attrition in obesity treatment
AbstractClark, M. M., Niaura, R., King, T. K., & Pera, V. (n.d.).Publication year
1996Journal title
Addictive BehaviorsVolume
21Issue
4Page(s)
509-513AbstractConsistent predictors of attrition in obesity treatment have not been identified. This study examined whether pretreatment psychological and health behavior variables would predict attrition from a 26 week clinical multidisciplinary VLCD and behavior therapy program. Higher levels of depression, current smoking, being sedentary, and having nontreated high blood pressure were associated with treatment attrition. Thus, a biopsychosocial assessment which evaluates medical and psychiatric status may help clinicians to identify individuals at high risk for attrition.Development of major depressive disorder during smoking-cessation treatment
AbstractBorrelli, B., Niaura, R., Keuthen, N. J., Goldstein, M. G., DePue, J. D., Murphy, C., & Abrams, D. B. (n.d.).Publication year
1996Journal title
Journal of Clinical PsychiatryVolume
57Issue
11Page(s)
534-538AbstractBackground: Several studies have shown an association between smoking and major depressive disorder (MDD), but few have prospectively examined subjects who develop MDD after quitting smoking. This descriptive study evaluated the development of MDD after smoking cessation, as assessed by a structured clinical interview at both baseline and the end of treatment. Method: Nondepressed participants (N = 114) in a trial investigating the effect of fluoxetine on smoking cessation were administered the Structured Clinical Interview for DSM-III-R at baseline ad posttreatment to evaluate the impact of quitting smoking on the development of MDD. Depressive symptoms were additionally assessed with the Beck Depression Inventory and the Hamilton Rating Scale for Depression. Results: At baseline, 32% of the subjects reported a history of MDD. Sixty-nine subjects completed the SCID at baseline and posttreatment. At posttreatment, 5 subjects (7%) met threshold criteria for MDD; one were taking the highest dose of fluoxetine (60 mg), 4 were taking 30 mg, and 1 was taking placebo. All 5 had a history of MDD; 3 were women. Four had a history of substance abuse and attained at least 3 consecutive biochemically verified weeks of smoking abstinence. Those who developed MDD after treatment scored significantly higher on measures of depressed mood at baseline than those who did not develop MDD after smoking- cessation treatment. Conclusion: The results from this descriptive study suggest that a subset of smokers may be at risk for developing MDD after smoking cessation.Integrating individual and public health perspectives for treatment of tobacco dependence under managed health care: A combined stepped-care and matching model
AbstractAbrams, D. B., Orleans, C. T., Niaura, R. S., Goldstein, M. G., Prochaska, J. O., & Velicer, W. (n.d.).Publication year
1996Journal title
Annals of Behavioral MedicineVolume
18Issue
4Page(s)
290-304AbstractThere is an increasing momentum to integrate prevention into mainstream health care. Three decades of research on tobacco dependence can provide insights into the conceptual, clinical, economic, and service delivery challenges to such an integration. Biological sciences, cognitive-behavioral, clinical treatment outcome, and public health arenas are selectively reviewed. The key conceptual issues are explored relevant to the optimal delivery of quality smoking cessation treatments for the general population of adult smokers at reasonable cost. A comprehensive model for adult smoking cessation treatment is developed. The model consists of an overarching public health approach, focusing on enhancing motivational level from low motivation to quit to high motivation. A common outcome metric of overall impact is proposed to facilitate comparisons between clinical and public health interventions. Smokers are then assessed and triaged into one of three treatment steps of minimal, moderate, and maximal intensity and cost. Smoker individual differences at both the population and individual level are also taken into account as part of a tailoring or matching strategy within and across the stepped interventions. Smoker profiles include sociocultural, nicotine dependence, and comorbidity factors. The result is a hybrid stepped- care matching model. The model serves to illustrate some of the needs and challenges facing future tobacco dependence research and practice. Comparisons are made between tobacco control and other preventive medicine practices in terms of cost per quality adjusted life-year saved. The barriers and opportunities under managed care are explored. The conceptual principles identified here could be used as a guidepost for integrating other preventive medicine programs into the evolving managed health care system.Interventions for alcoholics who smoke
AbstractAbrams, D. B., Monti, P. M., Niaura, R. S., Rohsenow, D. J., & Colby, S. M. (n.d.).Publication year
1996Journal title
Alcohol health and research worldVolume
20Issue
2Page(s)
111-117AbstractMore than 85 percent of adults with a history of alcohol abuse also smoke, and they may be more addicted to nicotine than are smokers without a history of drinking. Alcoholics who smoke also have higher risks of cancer and cardiovascular disease. Indeed, it has been reported that more alcoholics die from tobacco-related diseases than from disorders related to their alcoholism. The complex interaction that exists between alcoholism recovery and tobacco is discussed. In addition, methods are presented for helping alcoholics to stop smoking, including motivating patients, using innovative interventions, and matching effective interventions to the motivational level of the alcoholic. By better understanding the interaction between alcohol and tobacco, scientists can improve treatment outcome and cost-effectiveness for alcoholics who smoke.Measuring nicotine dependence among high-risk adolescent smokers
AbstractProkhorov, A. V., Pallonen, U. E., Fava, J. L., Ding, L., & Niaura, R. (n.d.).Publication year
1996Journal title
Addictive BehaviorsVolume
21Issue
1Page(s)
117-127AbstractIn the present study we tested our hypothesis that because of the higher prevalence and greater intensity of cigarette smoking among vocational- technical students (N = 110; 51.8% males; mean age 17 years), adolescents might demonstrate the nicotine dependence patterns comparable to those measured in a similar fashion in a group of adult smokers (N = 173; 50% males; mean age 42 years). A modified version of the Fagerstrom Tolerance Questionnaire (FTQ) utilized in the adolescent sample was coded to make it comparable to the original FTQ used in the adult sample. The tests of item structure and internal consistency of the modified FTQ for adolescents were satisfactory; the overall mean FTQ score correlated significantly with the intensity and duration of smoking. Although the FTQ values were generally lower in the adolescent sample, 20% of students had an overall FTQ score of 6 and above, indicating substantial nicotine dependence (compared to 49% in adults). Reasons for failure of the existing adolescent smoking cessation programs as well as the rationale for adding a nicotine replacement option to the behavioral smoking cessation treatment for a subset of high risk nicotine-dependent adolescents are discussed.Psychological factors affecting physical condition
Niaura, R., & Al., . (n.d.). In T. Widiger, A. Frances, H. Pincus, R. Ross, M. First, & W. Davis (Eds.), DSM-IV sourcebook (1–).Publication year
1996Volume
2Page(s)
1051-1078The effect of cimetidine and ranitidine on cognitive function in postoperative cardiac surgical patients
AbstractKim, K. Y., Mccartney, J. R., Kaye, W., Boland, R. J., & Niaura, R. (n.d.).Publication year
1996Journal title
International Journal of Psychiatry in MedicineVolume
26Issue
3Page(s)
295-307AbstractObjective: To compare the incidence of delirium in postoperative cardiac surgical patients treated with either cimetidine or ranitidine. Method: Cardiac surgery patients were randomized to receive either cimetidine or ranitidine postoperatively. Each patient underwent three Mini-Mental Status Examinations (MMSE) and the medical record was reviewed for pertinent past medical history, laboratory data, and evidence of delirium on three occasions: one day preoperatively (before H-2 blocker was given), in the early postoperative period (while receiving the H-2 blocker); usually two days postoperatively on the day of hospital discharge (several days after the H-2 blocker had been discontinued). Results: Overall, both groups in the early postoperative period showed a significant decrease in the MMSE score (27.11 ± 4.44 to 25.38 ± 2.87, mean ± SD; t = 5.16, p < .0005), which resolved by the time of hospital discharge. There was no significant difference between cimetidine and ranitidine. Both age and preoperative MMSE score were strongly associated with the development of delirium. Conclusions: We found no significant difference between cimetidine's versus ranitidine's effect upon cognitive functioning in the postoperative cardiac surgical patient. This was true even when controlling for age and length of stay.Transdermal clonidine for smoking cessation: A double-blind randomized dose-response study
AbstractNiaura, R., Brown, R. A., Goldstein, M. G., Murphy, J. K., & Abrams, D. B. (n.d.).Publication year
1996Journal title
Experimental and Clinical PsychopharmacologyVolume
4Issue
3Page(s)
285-291AbstractA 4-week trial tested the effects of 4 doses (placebo, 0.1 mg/d, 0.2 mg/d, and 0.3 mg/d) of transdermal clonidine on smoking cessation and nicotine withdrawal. After a 1-week baseline, smokers (N = 72) started the drug and tried to quit by Week 3. Significantly fewer smokers who received a placebo were abstinent at 5 days after quitting as compared with smokers who received clonidine at any dose (19% vs. 57%, respectively, p = .007). Blood clonidine concentration interacted with nicotine dependence (p < .05): High-dependence smokers who achieved higher blood clonidine concentrations survived longer before smoking a cigarette after quitting, as compared with high-dependence smokers who achieved lower blood levels. Changes from baseline in heart rate, blood pressure, appetite, irritability, and anxiety were inversely associated with blood clonidine concentrations.