Raymond S Niaura
Raymond S Niaura
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
Cardiovascular disease, Part II: Coronary artery disease and sudden death and hypertension
AbstractNiaura, R. S., & Goldstein, M. (n.d.). (A. Stoudemire & B. Fogel, Eds.).Publication year
1995Page(s)
39-56Abstract~Exercise enhances the maintenance of smoking cessation in women
AbstractMarcus, B. H., Albrecht, A. E., Niaura, R. S., Taylor, E. R., Simkin, L. R., Feder, S. I., Abrams, D. B., & Thompson, P. D. (n.d.).Publication year
1995Journal title
Addictive BehaviorsVolume
20Issue
1Page(s)
87-92AbstractWe examined the effects of physical exercise on smoking relapse. Twenty previously sedentary female smokers were randomly assigned to smoking cessation plus exercise or smoking cessation with frequency contact control. The smoking cessation program included 12 professionally led sessions over 12 weeks. Exercise treatment included three supervised exercise sessions per week for 15 weeks. Contact control included three women's health/wellness lectures per week for 15 weeks. Smoking abstinence was validated by carbon monoxide and saliva cotinine. Mean exercise attendance for exercise subjects was 88% with an increase in estimated VO2 of 25%. The percentage of subjects who quit for 24 hours was 80% for the exercise and 90% for the contact group. One subject in the contact group remained abstinent at the end of the 12-week treatment and at 1-, 3-, and 12-month follow-ups, whereas three subjects in the exercise group were abstinent at these time points. These results suggest that exercise training improves short-term quit rates and may prove a useful strategy for long-term maintenance of smoking cessation.Interrelationship of smoking and alcohol dependence, use and urges to use
AbstractNiaura, R. S., Gulliver, S. B., Rohsenow, D. J., Colby, S. M., Dey, A. N., Abrams, D. B., Niaura, R. S., & Monti, P. M. (n.d.).Publication year
1995Journal title
Journal of Studies on AlcoholVolume
56Issue
2Page(s)
202-206AbstractObjective: The relationship between tobacco dependence and alcohol dependence has received little empirical scrutiny. The present study of alcoholics in treatment for alcoholism investigated pretreatment tobacco and alcohol history and dependence, as well as subjective responsivity to alcohol cues. Method: Eighty-three male alcoholics underwent a questionnaire assessment of smoking and drinking pretreatment followed by a laboratory assessment of reactivity to alcohol cues. Results: The analyses demonstrate that (1) pretreatment tobacco dependence and pretreatment alcohol dependence are related, (2) alcohol dependence predicts urges to smoke during alcohol treatment, (3) exposure to alcohol cues results in increased urge to smoke, (4) smoking when ill predicts urge to drink during alcohol cue exposure and (5) urge to smoke is positively correlated with urge to drink. Conclusions: These data, collected in a population of alcoholics not currently receiving smoking interventions, indicate that smoking may be a factor to address during alcohol treatment. The clinical importance of these data is discussed.Obesity Level and Attrition : Support for Patient‐Treatment Matching in Obesity Treatment
AbstractClark, M. M., Guise, B. J., & Niaura, R. S. (n.d.).Publication year
1995Journal title
Obesity ResearchVolume
3Issue
1Page(s)
63-64AbstractObesity treatment studies report attrition rates front 20% to 45%. To reduce attrition, researchers have proposed matching patients to treatment based upon level of obesity. The current study attempted to validate the commonly held assumption that a mismatch between obesity level and treatment will promote attrition. The level of obesity and attrition rates of 39 adults who enrolled in a 12‐session behavior therapy program were examined. As obesity level increased, so did attrition. Sixty‐nine percent of subjects with mild obesity, 43% of subjects with moderate obesity and 0% of subjects with severe obesity completed treatment. 1995 North American Association for the Study of Obesity (NAASO)Plasma lipids and their relationships with psychosocial factors in older adults
AbstractVitaliano, P. P., Russo, J., & Niaura, R. S. (n.d.).Publication year
1995Journal title
Journals of Gerontology - Series B Psychological Sciences and Social SciencesVolume
50 BIssue
1Page(s)
P18-P24AbstractCorrelations of psychosocial factors (e.g., anger, avoidance coping, Type A behavior) with plasma lipid levels have been observed primarily in men younger than 60 years of age. This study examined these relationships in two groups of older women and men — spouse caregivers of individuals with Alzheimer’s disease (n = 98) and controls (n = 91) group-matched for age and gender. Regression analyses determined whether psychosocial variables could explain variability in plasma lipids beyond relevant covariates. Covariates examined were gender, age, alcohol intake, smoking, body mass index, cardiovascular medications, diet (saturated fat), exercise, and estrogen use. Even with statistical controls, combinations of anger held-in, Type A behavior, anger-out, controlled anger, avoidance coping, and caregiving status explained significant variability in triglycerides (TG), high-density lipoproteins (HDLC), and low-density lipoproteins (LDLC). Male caregivers had higher TG and lower HDLC values than male controls. Results are discussed in the context of current thinking in the health psychology of aging.Self-guided solutions for problem drinking
AbstractNiaura, R. S. (n.d.).Publication year
1995Journal title
Contemporary PsychologyVolume
40Issue
5Page(s)
425-426Abstract~Changes in eating inventory scores following obesity treatment
AbstractClark, M. M., Marcus, B. H., Pera, V., & Niaura, R. S. (n.d.).Publication year
1994Journal title
International Journal of Eating DisordersVolume
15Issue
4Page(s)
401-405AbstractEating Inventory scores may predict compliance, attrition, and outcome to obesity treatment. Research documenting change on the Eating Inventory subsequent to treatment is limited. In Study 1, 29 obese patients demonstrated significant improvement on all three factors of the Eating Inventory (Cognitive Restraint, Disinhibition, and Hunger) following a 26‐week multidisciplinary weight management program. In Study 2, a second sample of 18 obese patients also demonstrated significant improvement on all three factors on the Eating Inventory following treatment. These results provide initial guidelines for the amount of change that patients may demonstrate on the Eating Inventory following treatment.Cue Reactivity as a Predictor of Drinking Among Male Alcoholics
AbstractRohsenow, D. J., Monti, P. M., Rubonis, A. V., Sirota, A. D., Niaura, R. S., Colby, S. M., Wunschel, S. M., & Abrams, D. B. (n.d.).Publication year
1994Journal title
Journal of consulting and clinical psychologyVolume
62Issue
3Page(s)
620-626AbstractSocial learning theories suggest that conditioned responses may increase the risk for relapse. Responses to alcohol use cues (cue reactivity) are associated with variables suggestive of risk but little research exists on the relationship of cue reactivity to treatment outcome. Alcoholic men admitted for detoxification to a treatment program (n = 45) underwent a cue reactivity assessment protocol, and 91% received 3-month follow-up interviews. Greater salivary reactivity predicted greater frequency of drinking during follow-up. Attentional factors added independent variance to the prediction of drinking outcome, with greater attention to stimulus or to response predicting less drinking. Cue reactivity did not predict length of hospital stay or latency to first drink. Results are discussed in the context of information processing, social learning theories, and clinical implications for relapse prevention.Dissemination of physician-based smoking cessation interventions
AbstractGoldstein, M., MacDonald, N., Niaura, R. S., & Dube, C. (n.d.).Publication year
1994Abstract~Matching high-dependence and low-dependence smokers to self-help treatment with or without nicotine replacement
AbstractNiaura, R. S., Goldstein, M. G., & Abrams, D. B. (n.d.).Publication year
1994Journal title
Preventive MedicineVolume
23Issue
1Page(s)
70-77AbstractBackground. This study investigated the effect of matching smokers to nicotine replacement therapy (nicotine gum) on the basis of the pretreatment level of nicotine dependence. Methods. One hundred seventy-three smokers, classified as high or low on nicotine dependence using the Fagerstrom Tolerance Questionnaire, were assigned at random to receive nicotine gum (2 mg), chewed ad libitum, or to not receive nicotine gum. All smokers participated concurrently in a 5-week treatment program consisting of four brief counseling sessions combined with a self-help manual provided by the American Lung Association. Results. Results showed that smokers with high levels of nicotine dependence were significantly more likely to quit smoking during treatment if they received nicotine gum (31.9%) than high-dependence smokers who did not receive the gum (12.2%). There was a tendency for smokers with low levels of nicotine dependence to do worse during treatment if they received gum (13.5% quit) than they did when they received no gum (20% quit), although this difference was not statistically significant. The relative differences in outcomes persisted after 1 year of follow-up, but the high overall rate of relapse (92.5%) rendered the absolute size of the differences statistically insignificant. Conclusion. The results of the study are discussed in terms of strategies that might improve the success of treatment-matching approaches with newer forms of nicotine replacement therapies.Social support and the progression and treatment of cardiovascular disease
AbstractGorkin, L., Niaura, R. S., & Follick, M. (n.d.). (S. Shumaker & S. Cjakowski, Eds.).Publication year
1994Abstract~The effects of cue exposure on reaction time in male alcoholics
AbstractNiaura, R. S., Sayette, M. A., Monti, P. M., Rohsenow, D. J., Gulliver, S. B., Colby, S. M., Sirota, A. D., Niaura, R., & Abrams, D. B. (n.d.).Publication year
1994Journal title
Journal of Studies on AlcoholVolume
55Issue
5Page(s)
629-633AbstractThe present study investigates reaction time (RT) as a measure of attentional deficits produced during alcohol cue exposure. Twenty-four male alcoholic patients responded to a series of computer-generated tones as rapidly as possible during baseline and again during either an alcohol cue exposure period or exposure to a control beverage (water). Patients required increased time to respond to the tones when exposed to alcohol cues. No such increase in RT was found during exposure to a control beverage. In addition, RT was significantly correlated with self-reported urge to drink. These data provide initial validation for the use of RT as an objective measure of cue reactivity. Both theoretical and clinical implications for the use of RT as a measure of the effects of cue exposure are discussed.Alcohol cue reactivity : Effects of detoxification and extended exposure
AbstractNiaura, R. S., Monti, P. M., Rohsenow, D. J., Rubonis, A. V., Niaura, R. S., Sirota, A. D., Colby, S. M., & Abrams, D. B. (n.d.).Publication year
1993Journal title
Journal of Studies on AlcoholVolume
54Issue
2Page(s)
235-245AbstractAlcoholics' reactions to drinking-related stimuli (cue reactivity) have been well documented and alcohol cue exposure treatment has been conducted recently in several clinical trials. Prior to conducting large-scale clinical trials it is important to know what effects detoxification may have on cue reactivity. However, no information is available about the effects of stage of detoxification or of detoxification medication on alcohol cue reactivity. In this study, 45 male alcoholics, detoxified without medication, were assessed during either their second, fourth or sixth day of withdrawal. Further, their reactivity was compared to that of alcoholics detoxified with chlordiazepoxide (n = 15), and to that of alcoholics in their fourth week after drinking (n = 28). Cue reactivity assessment investigated salivation and urge to drink after 3 minutes of water cue exposure and then after 3 minutes of alcohol cue exposure. Urges to drink were assessed during an additional 15 minutes of alcohol exposure to explore latency to maximum reactivity and habituation. Reactivity did not differ as a function of group membership, although salivation was elevated to both beverages during the first week of detoxification. Of the sample, 70% reacted to alcohol with increased urge and 65% with increased salivation, with no difference between groups in proportions of reactors. The maximum urge to drink occurred in the first 6 minutes of alcohol exposure, followed by a gradual and significant decrease. There were no differences on these measures between alcoholics in their first or fourth week after their last drink. Implications for theory and clinical applications are discussed.Assessment of quality of life as observed from the baseline data of the Studies of Left Ventricular Dysfunction (SOLVD) trial quality-of-life substudy
AbstractGorkin, L., Norvell, N. K., Rosen, R. C., Charles, E., Shumaker, S. A., McIntyre, K. M., Capone, R. J., Kostis, J., Niaura, R. S., Woods, P., Hosking, J., Garces, C., Handberg, E., Ahern, D. K., Follick, M. J., & The SOLVD Investigators, S. I. (n.d.).Publication year
1993Journal title
The American Journal of CardiologyVolume
71Issue
12Page(s)
1069-1073AbstractThe improvement of aspects of a patient's quality of life may be as important as prolonging survival in evaluating clinical trials of heart failure. The purpose off this study was to analyze the psychometric properties of the baseline measures from the quality-of-life substudy from the Studies of Left Ventricular Dysfunction (SOLVD) trial. The measures included the 6-Minute Walk Test, Dyspnea Scale, Living with Heart Failure, Physical Limitations, Psychologic Distress and Health Perceptions, as reported by both patients and staff. Cognitive functioning, such as Vocabulary, Digit Span and Trails Making, was also assessed. Patients were classified as New York Heart Association class I (n = 158) versus II or III (n = 150). The internal consistencies (i.e., reliabilities) of the self-report measures were high, except for the Health Perceptions of Class II or III patients. Reliability of the SOLVD quality-of-life battery was confirmed by significantly better life quality among New York Heart Association class I patients versus class II or III patients combined on the Walk Test, Physical Limitations, Dyspnea, Living with Heart Failure, Psychologic Distress and staff perceptions of patient health. In accordance with prior studies, the measures were uncorrelated with left ventricular ejection fraction. By demonstrating strong internal consistencies, reliability based on physician reports, and independence of ejection fraction levels, use of this quality-of-life assessment battery in this and other clinical trials of compromised ventricular functioning is supported.Cue Exposure With Coping Skills Treatment for Male Alcoholics : A Preliminary Investigation
AbstractMonti, P. M., Rohsenow, D. J., Rubonis, A. V., Niaura, R. S., Sirota, A. D., Colby, S. M., Goddard, P., & Abrams, D. B. (n.d.).Publication year
1993Journal title
Journal of consulting and clinical psychologyVolume
61Issue
6Page(s)
1011-1019AbstractAlthough early investigations were promising, no controlled follow-up studies have investigated the effectiveness of cue exposure treatment for alcoholics. In this study, inpatient alcoholics received either cue exposure integrated with urge coping skills training (CET, n = 22) or a contrast condition (CC) involving daily contact with assessment only (n = 18) in addition to standard treatment. Comprehensive assessment measures were used to investigate change in process and outcome variables. In the second 3 months after treatment, the CET group included more patients who were completely abstinent, had a higher percentage of abstinent days, and tended to report fewer drinks per day than did patients in the contrast condition. The significantly greater use of coping skills during follow-up by the CET group and the significant relationship of these coping skills to decreased drinking suggest that treatment effects were due, at least in part, to the coping skills training, consistent with recent formulations. Theoretical and treatment implications are discussed.Endocrine correlates of sadness and elation
AbstractBrown, W., Sirota, A., Niaura, R. S., & Engebretson, T. (n.d.).Publication year
1993Journal title
Psychosomatic MedicineVolume
55Issue
5Page(s)
458-467Abstract~Nicotine dependence: Assessment and management
AbstractNiaura, R. S. (n.d.). (A. Stoudemire & B. Fogel, Eds.).Publication year
1993Page(s)
877-902Abstract~Stress and lipoprotein metabolism : Modulators and mechanisms
AbstractBrindley, D. N., McCann, B. S., Niaura, R. S., Stoney, C. M., & Suarez, E. C. (n.d.).Publication year
1993Journal title
MetabolismVolume
42Issue
9 SUPPL. 1Page(s)
3-15AbstractElevated concentrations of triglycerides and low-density lipoprotein (LDL) cholesterol,1 especially in combination with low concentrations of high-density lipoprotein (HDL) cholesterol,2 are associated with an increased risk of atherosclerosis, coronary heart disease, and stroke. While several dietary and genetic factors contribute to atherogenic lipoprotein profiles,3,4 stress also contributes to unfavorable concentrations of lipoproteins that may predispose to cardiovascular disease.5,6 This report reviews the data supporting a link between stress and lipid metabolism, with particular focus on the mechanisms whereby stress could be related to increased lipid concentrations, and several factors which could modulate a relationship between stress and lipid levels. Following a brief discussion of stress, this report is divided into three main sections. First, data that support a relationship between stress and lipoprotein metabolism are considered. Data from laboratory studies, studies of episodic and chronic stress, studies on personality, and experiments from the animal literature are reviewed. The second major section discusses mechanisms that could account for stress effects on lipoprotein metabolism. This section considers the metabolic effects of stress, the effects of stress on hemoconcentration, and behavioral responses to stress that could affect lipid concentrations. The final major section reviews various modulators of the stress-lipid relationship, including intervening personality variables, gender, diet, seasonal variations in lipoprotein concentrations, and genetics and polymorphism. The concluding comments in this review address several promising areas for further research.The role of primary care physicians in smoking cessation.
AbstractGoldstein, M. G., DePue, J., & Niaura, R. S. (n.d.).Publication year
1993Journal title
Rhode Island medicineVolume
76Issue
10Page(s)
515-522Abstract~Treatment issues: Towards a stepped care model
AbstractAbrams, D. S., Orleans, C., Niaura, R. S., Goldstein, M., Velicer, W., & Prochaska, J. (n.d.).Publication year
1993Journal title
Tobacco ControlVolume
2 (suppl)Page(s)
S17-S37Abstract~A cocaine high-risk situations questionnaire : Development and psychometric properties
AbstractMichalec, E., Zwick, W. R., Monti, P. M., Rohsenow, D. J., Varney, S., Niaura, R. S., & Abrams, D. B. (n.d.).Publication year
1992Journal title
Journal of substance abuseVolume
4Issue
4Page(s)
377-391AbstractAlthough high-risk situations have been identified for alcoholism, opiate abuse, and smoking, further research is needed to identify high-risk situations for cocaine abuse. A 233-item Cocaine High-Risk Situations Survey was developed based on a comprehensive literature review and was administered to 179 cocaine users in treatment. Situations that occurred infrequently or that were not often associated with cocaine use were eliminated and the remaining 89 items were factor analyzed using half the sample with confirmatory factor analysis on the remainder of the sample. Only one factor was found for frequency of cocaine use in these situations. The 21 items with high factor loadings and a diverse range of content were retained for subsequent analyses and renamed the Cocaine High-Risk Situations Questionnaire (CHRSQ). Reliability and convergent and discriminant validity of this scale were demonstrated. Frequency of alcohol use in the same situations was not significantly related to cocaine use and abuse, supporting discriminant validity. The findings suggest that the frequency of ongoing cocaine use is not determined by specific situations. Theoretical and clinical implications are discussed.Cue elicited urge to drink and salivation in alcoholics : Relationship to individual differences
AbstractRohsenow, D. J., Monti, P. M., Abrams, D. B., Rubonis, A. V., Niaura, R. S., Sirota, A. D., & Colby, S. M. (n.d.).Publication year
1992Journal title
Advances in Behaviour Research and TherapyVolume
14Issue
3Page(s)
195-210AbstractSocial learning models of relapse have included a focus on the learned reactions of substance abusers to the presence of substance use cues, but the relative roles played by cue-elicited psychophysiological reactions and urges to use have been unclear. The relationships of these kinds of cue-elicited reactions to each other, to measures of individual differences, to attentional processes, and to relapse are reviewed across three recent studies (published or to be published elsewhere). Alcoholic males who participated in one of three studies were assessed for cue reactivity (salivation and urge to drink while sniffing an alcoholic beverage versus water) as well as individual difference measures. Salivation and urge to drink have a weak or nonsignificant relationship to each other. Cue-elicited urge to drink generally correlates with negative mood, awareness of somatic reactions, attention to alcohol, and enjoyment of the sight and smell of alcohol. Salivation tends not to be related to these conscious processes although it is greater among those who expect more positive effects from alcohol, and among those with more alcohol dependence. Salivation but not urge to drink was predictive of quantity and frequency of drinking during the first three months post-detoxification. Results are generally consistent with appetitive-motivation models of alcohol use and with Tiffany's (1990) hypothesis that automatic processes are more important than conscious processes in drug-use behavior.Increased Saliva Cotinine Concentrations in Smokers During Rapid Weight Loss
AbstractNiaura, R. S., Clark, M. M., Raciti, M. A., Pera, V., & Abrams, D. B. (n.d.).Publication year
1992Journal title
Journal of consulting and clinical psychologyVolume
60Issue
6Page(s)
985-987AbstractAlthough the effect of smoking cessation on weight gain is well-documented, little is known about the effect of weight loss on smoking. We examined the association between saliva cotinine levels and weight loss in a group of 9 obese female smokers during participation in a protein-sparing modified fast (Optifast). For the first 3 months of treatment, subjects consumed only the protein-sparing supplement; for the next 3 months, food was gradually reintroduced. Body mass index and saliva cotinine concentration were assessed at study entry and at 3 and 6 months. A significant weight loss was noted at 3 and 6 months, yet the cotinine level increased significantly over this time. It is unclear whether the cotinine increase is due to metabolic changes or an actual increase in nicotine intake. The results suggest that smoking-related health risks may increase during periods of significant weight loss.Lipids in psychological research : The last decade
AbstractNiaura, R. S., Stoney, C. M., & Herbert, P. N. (n.d.).Publication year
1992Journal title
Biological PsychologyVolume
34Issue
1Page(s)
1-43AbstractWe review the recent literature examining lipid changes during stressful experiences, and the psychological and constitutional differences that influence lipid levels at rest and that may modulate lipid response to stress. Mild forms of chronic or episodic stress are apparently not associated with alterations in lipids and lipoproteins, but severe forms of real or perceived stress do appear to alter lipid levels. Acute laboratory stress is frequently associated with short-term alterations in lipids and lipoproteins, but the significance of these changes is unclear. Several individual characteristics, such as heightened neuroendocrine or autonomic reactivity to Stressors, Type A component behavior, and other aspects of personality, appear to be associated with an atherogenic lipid profile. Stress may influence lipid concentrations and metabolism through a variety of physiological and behavioral mechanisms, but none have been clearly elucidated. Future research should concentrate on understanding these mechanisms.National working conference on smoking and body weight. Task Force 1 : Mechanisms relevant to the relations between cigarette smoking and body weight.
AbstractNiaura, R. S., Grunberg, N. E., Greenwood, M. R., Collins, F., Epstein, L. H., Hatsukami, D., Niaura, R., O'Connell, K., Pomerleau, O. F., Ravussin, E., & Rolls, B. J. (n.d.).Publication year
1992Journal title
Health PsychologyVolume
11 SupplPage(s)
4-9AbstractCareful, comprehensive, and empirical observations provide the building blocks of the sciences, whereas theory and mechanisms provide the "cement" to hold the blocks together and serve as blueprints to direct future building. This article resulted from several days of discussion regarding theories that may underlie the relation between cigarette smoking and body weight and the relation between smoking cessation and body weight. The working group composed of social and biological scientists who addressed this assignment considered what is already known within the smoking and body weight literature and also considered relevant findings from studies of smoking or body weight regulation that have not directly addressed the interaction of these variables. As expected, we were successful at listing some of what is not known and what is worth knowing. We also tried to identify fruitful possibilities for research activity that might clarify mechanisms of action and eventually lead to theoretical development. Because we do not believe that the present state of our deliberations merits the label of theories, we decided, instead, to report the summary of these deliberations as potential mechanisms relevant to the relation between smoking and body weight.