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

Nicotine dependence: Assessment and management

Brown, R., Goldstein, M., Niaura, R. S., Emmons, K., & Abrams, D. S. (n.d.). (A. Stoudemire & B. Vogel, Eds.; 2nd ed.).

Publication year

1992

Abstract

Abstract

~

Psychological Factors Affecting Physical Condition : Cardiovascular Disease Literature Review

Niaura, R. S., & Goldstein, M. G. (n.d.).

Publication year

1992

Journal title

Psychosomatics

Volume

33

Issue

2

Page(s)

146-155

10.1016/S0033-3182(92)71990-2

Abstract

Abstract

~

Psychological Factors Affecting Physical Condition : Cardiovascular Disease Literature Review

Goldstein, M. G., & Niaura, R. S. (n.d.).

Publication year

1992

Journal title

Psychosomatics

Volume

33

Issue

2

Page(s)

134-145

10.1016/S0033-3182(92)71989-6

Abstract

Abstract

A subcommittee of the American Psychiatric Association's Psychiatric Systems Interface Disorders Work Group was charged with examining the diagnostic category, Psychological Factors Affecting Physical Condition, for possible revision in the DSM-IV. As members of this subcommittee, we conducted a literature review to better characterize the current state of knowledge regarding the relationship between psychological factors and cardiovascular disease. This review, divided into two parts, focuses on three problems: coronary artery disease, sudden death, and hypertension. For each of these cardiovascular disorders, we describe models for understanding the relationship of psychological factors to the disorder, review the results of relevant research studies, and provide recommendations for further research.

Psychological factors affecting physical condition. Cardiovascular disease literature review. Part II: Coronary artery disease and sudden death and hypertension.

Niaura, R. S., & Goldstein, M. (n.d.).

Publication year

1992

Journal title

Psychosomatics

Volume

33

Issue

2

Page(s)

146-155

Abstract

Abstract

~

Psychological factors affecting physical condition: Cardiovascular disease literature review. Part 2. Acute situational disturbance and hypertension.

Niaura, R. S., & Goldstein, M. (n.d.).

Publication year

1992

Journal title

Psychosomatics

Volume

33

Issue

2

Page(s)

146-155

Abstract

Abstract

~

Repressive coping and blood lipids in men and women

Niaura, R. S., Niaura, R., Herbert, P. N., McMahon, N., & Sommerville, L. (n.d.).

Publication year

1992

Journal title

Psychosomatic Medicine

Volume

54

Issue

6

Page(s)

698-706

10.1097/00006842-199211000-00010

Abstract

Abstract

Studies have suggested that a repressive coping style, characterized by defensiveness against negative emotions, may be related to several adverse health outcomes. This study examined whether repressive coping is associated with blood lipids, and whether this association is influenced by age or sex. One hundred fourteen healthy adults completed the Marlowe-Crowne scale (MC) and the Bendig version of the Taylor Manifest Anxiety scale (TMAS) prior to having their blood drawn after an overnight fast. Hierarchical regression analyses showed a significant interaction of sex, MC, and TMAS on total cholesterol (F(1, 104) = 4.41, p < 0.05), after controlling for the influence of age, body mass index, and other main effects and interactions. Results showed that male repressors (high MC; low TMAS) had the highest cholesterol levels, while truly low anxious males (low MC; low TMAS) had the lowest levels. The opposite pattern was noted for women. There were no interactive effects of age and coping style on lipids. The results suggest that males who repress negative emotions may be at greater risk for atherosclerotic diseases.

Self-efficacy and the stages of exercise behavior change

Niaura, R. S., Marcus, B. H., Selby, V. C., Nlaura, R. S., & Rossi, J. S. (n.d.).

Publication year

1992

Journal title

Research Quarterly for Exercise and Sport

Volume

63

Issue

1

Page(s)

60-66

10.1080/02701367.1992.10607557

Abstract

Abstract

This study examined the application of constructs concerning stage of readiness to change and selfefficacy to exercise. We developed two scales to measure stages of change for exercise behavior. Prevalence information on a sample of1, 063 government employees and 429 hospital employees was then obtained. Next, the ability of a questionnaire measuring exercise self-efficacy to differentiate employees according to stage of readiness to change was tested Results from both stages-of change scales revealed that 34-39% of employees were regularly participating in physical activity. Scores on efficacy items significantly differentiated employees at most stages. Results indicated employees who had not yet begun to exercise, in contrast with those who exercised regularly, had little confidence in their ability to exercise. Continued work at understanding the stages of exercise behavior and exercise self-efficacy could yield important information for enhancing exercise adoption and adherence.

Smokers' reactions to interpersonal interaction and presentation of smoking cues

Niaura, R. S., Abrams, D. B., Pedraza, M., Monti, P. M., & Damaris J., R. (n.d.).

Publication year

1992

Journal title

Addictive Behaviors

Volume

17

Issue

6

Page(s)

557-566

10.1016/0306-4603(92)90065-4

Abstract

Abstract

This study examined smokers' reactions to smoking cues and interpersonal interaction. Fifty-six smokers were assigned at random to the six cells of a factorial design which varied the level of interpersonal interaction (role play with a confederate vs. confederate absent) and the level of exposure to smoking cues (no cues vs. visual cues vs. visual plus olfactory cues). Measures of reactivity included changes from resting baseline on blood pressure, heart rate, self-reported smoking urge, and a measure of ad lib smoking behavior obtained after exposure to the experimental procedures. Results showed that blood pressure responses increased significantly from baseline only during the role play situation where the confiderate manipulated an unlic cigarette or smoked a cigarette in view of the subjects. Although not significant, heart rate changes paralleled blood pressure changes, but urge ratings showed a different pattern of response to the manipulations. The latency to smoking a cigarette after the experimental manipulations was unaffected by the cues. The results suggest that modelling of smoking by others and exposure to some kinds of smoking cues may increase cardiovascular activation.

Smoking and treatment outcome for alcoholics : Effects on coping skills, urge to drink, and drinking rates

Abrams, D. B., Rohsenow, D. J., Niaura, R. S., Pedraza, M., Longabaugh, R., Beattie, M. C., Binkoff, J. A., Noel, N. E., & Monti, P. M. (n.d.).

Publication year

1992

Journal title

Behavior Therapy

Volume

23

Issue

2

Page(s)

283-297

10.1016/S0005-7894(05)80386-7

Abstract

Abstract

The interrelationship between alcohol and tobacco addiction is beginning to receive more attention because it has conceptual and practical significance for understanding and treating addictive disorders. This investigation focuses on the effects of smoking on risk for relapse after alcoholism treatment. The relationships between smoking and: (1) alcohol consumption rate and dependence at pretreatment, (2) reactions to coping with alcohol high-risk-for-relapse role plays, and (3) alcohol treatment outcome were investigated. These relationships were studied first in a sample of male VA alcoholics (n=45) and then replicated and extended in a different sample from a private hospital (n=53 females, 110 males). Smoking and drinking rate, and smoking and alcohol dependence, were significantly correlated at pretreatment. Smokers with greater dependence on cigarettes (i.e., higher Fagerstrom Tolerance Questionnaire scores; shorter latency to smoking first cigarette of the day) experienced significantly greater urge to drink, urge to smoke, difficulty, and anxiety in role plays of alcohol high-risk situations, independent of their pretreatment drinking rate or alcohol dependence. Smoking dependence did not predict mean number of drinks per day or frequency of drinking days during 6-month follow-up. In the private hospital sample, among alcoholics who drank at all during follow-up, the more dependent smokers drank more alcohol on drinking days than did the less dependent smokers. Implications for theory and treatment of addictive disorders are discussed.

The stages and processes of exercise adoption and maintenance in a worksite sample.

Niaura, R. S., Marcus, B. H., Rossi, J. S., Selby, V. C., Niaura, R. S., & Abrams, D. B. (n.d.).

Publication year

1992

Journal title

Health psychology : official journal of the Division of Health Psychology, American Psychological Association

Volume

11

Issue

6

Page(s)

386-395

10.1037/0278-6133.11.6.386

Abstract

Abstract

We applied the model of the stages and processes of change to exercise adoption and maintenance. This model has shown promise in advancing theory and treatment of the addictions and other negative health behaviors, but there have been few systematic attempts to apply the model to positive health behaviors, such as exercise adoption. Questionnaires dealing with the stages and processes of exercise change were developed and administered to a sample of 1,172 participants in a worksite health promotion project. The sample was split randomly into halves for (a) initial model development and testing and (b) confirmatory measurement model testing. Additional model confirmation was obtained by examining the hierarchical structure of the processes of change and by conducting Stage x Process analyses. Results suggest that the underlying constructs derived from smoking cessation and other addictive behaviors can be generalized to exercise behavior. Understanding the stages and processes of exercise behavior change may yield important information for enhancing exercise adoption, adherence, and relapse prevention at both individual and public health levels.

A bioinformational systems perspective on tobacco dependence

Niaura, R. S., GOLDSTEIN, M., & ABRAMS, D. S. (n.d.).

Publication year

1991

Journal title

British Journal of Addiction

Volume

86

Issue

5

Page(s)

593-597

10.1111/j.1360-0443.1991.tb01814.x

Abstract

Abstract

Recent thinking about tobacco dependence has been influenced largely by a focus on the pharmacological effects of nicotine. We advocate a return to earlier views of dependence as comprising both pharmacological and non‐pharmacological aspects. Moreover, we suggest that it may be profitable to reformulate research on dependence in terms of a bioinformational process model. The basic tenets of such a model are outlined, as are the challenges in exploring the nature of dependence simultaneously across the cognitive, physiological and behavioral domains of function.

Cue reactivity in addictive behaviors : Theoretical and treatment implications

Niaura, R. S., Rohsenow, D. J., Childress, A. R., Monti, P. M., Niaura, R. S., & Abrams, D. B. (n.d.).

Publication year

1991

Journal title

International Journal of the Addictions

Volume

25

Issue

7-8 A

Page(s)

957-993

10.3109/10826089109071030

Abstract

Abstract

Several learning theory based models propose that substance users may have conditioned reactions to stimuli (cues) associated with substance use and that these reactions may increase the probability of relapse. The conditioned withdrawal, conditioned compensatory response, and appetitive motivational models were evaluated in light of empirical evidence from cue reactivity studies with alcoholics, smokers, opiate users, and cocaine users. The nature of the stimuli that elicit reactivity and the nature of the responses elicited are most consistent with an appetitive motivational model and do not appear to support the other two models. A few studies have been conducted or are underway that investigate the use of cue exposure with response prevention as a treatment to decrease cue reactivity. Preliminary work with alcoholics, opiate users and cocaine users is promising but insufficient evidence exists to evaluate this approach. The implications for theory and treatment are discussed.

Cue reactivity in addictive behaviors: Theoretical and clinical implications

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

Publication year

1991

Journal title

International Journal of the Addictions

Volume

25

Page(s)

957-994

Abstract

Abstract

~

Lipid and Lipoprotein Responses to Episodic Occupational and Academic Stress

Niaura, R. S., Herbert, P. N., Saritelli, A. L., Goldstein, M. G., Flynn, M. M., Follick, M. J., Gorkin, L., & Ahern, D. K. (n.d.).

Publication year

1991

Journal title

Archives of Internal Medicine

Volume

151

Issue

11

Page(s)

2172-2179

10.1001/archinte.1991.00400110036008

Abstract

Abstract

We examined the effects of psychological stress on plasma lipid, lipoprotein, and apolipoprotein levels in three related studies. In the first study, tax accountants (N = 20) and a comparable control group (N = 20) were assessed during and after the tax season. In the second and third studies, first-year medical students (N = 24 and N =16) were assessed at midsemester and immediately before the examinations. Across studies, the stressors induced significant psychological distress. There were no corresponding changes in lipid and lipoprotein levels. Mean stress-induced change in total cholesterol level was -0.04 mmol/L (— 1.6 mg/dL) (95% confidence interval, —0.23 to 0.16 mmol/L [— 9 to 6 mg/dL]) for the accountants and 0 mmol/L (0 mg/dL) (95% confidence interval, — 0.16 to 0.21 mmol/L —6 to 8 mg/dL]) and 0.10 mmol/L (4 mg/dL) (95% confidence interval, —0.18 to 0.39 mmol/L [—7 to 15 mg/dL]) for medical students in the second and third studies, respectively. In all studies, change in total cholesterol level correlated with change in total serum protein levels (r=.42 to.60). These results suggest that commonly occurring stressful situations do not produce significant changes in plasma lipid and lipoprotein levels.

Medical and behavioral treatment of nicotine dependence

Goldstein, M., Niaura, R. S., & Abrams, D. S. (n.d.). (A. Stoudemire & B. Fogel, Eds.).

Publication year

1991

Abstract

Abstract

~

Medical and behavioral treatment of nicotine dependence: Nicotine as a drug of abuse

Goldstein, M., Niaura, R. S., & Abrams, D. S. (n.d.). (A. Stoudemire & B. Fogel, Eds.).

Publication year

1991

Page(s)

541-596

Abstract

Abstract

~

Nicotine gum: Pharmacological and clinical aspects

Goldstein, M., & Niaura, R. S. (n.d.). (J. Cocores, Ed.).

Publication year

1991

Page(s)

181-195

Abstract

Abstract

~

Self-Efficacy in Weight Management

Clark, M. M., Abrams, D. B., Niaura, R. S., Eaton, C. A., & Rossi, J. S. (n.d.).

Publication year

1991

Journal title

Journal of consulting and clinical psychology

Volume

59

Issue

5

Page(s)

739-744

10.1037/0022-006X.59.5.739

Abstract

Abstract

Self-efficacy is an important mediating mechanism in advancing understanding of the treatment of obesity. This study developed and validated the Weight Efficacy Life-Style Questionnaire (WEL), improving on previous studies by the use of clinical populations, cross-validation of the initial factor analysis, exploration of the best fitting theoretical model of self-efficacy, and examination of change in treatment. The resulting 20-item WEL consists of five situational factors: Negative Emotions, Availability, Social Pressure, Physical Discomfort, and Positive Activities. A hierarchical model was found to provide the best fit to the data. Results from two separate clinical treatment studies (total N = 382) show that the WEL is sensitive to changes in global scores as well as to a subset of the five situational factor scores. Treatment programs may be incomplete if they change only a subset of the situational dimensions of self-efficacy. Theoretical and clinical implications are discussed.

Tobacco dependence : An integration of individual and public health perspectives

Abrams, D. B., Emmons, K. M., Niaura, R. S., Goldstein, M. G., & Sherman, C. B. (n.d.).

Publication year

1991

Journal title

Annual Review of Addictions Research and Treatment

Volume

1

Issue

C

Page(s)

391-436

Abstract

Abstract

~

Usefulness of physical exercise for maintaining smoking cessation in women

Marcus, B. H., Albrecht, A. E., Niaura, R. S., Abrams, D. B., & Thompson, P. D. (n.d.).

Publication year

1991

Journal title

The American Journal of Cardiology

Volume

68

Issue

4

Page(s)

406-407

10.1016/0002-9149(91)90843-A

Abstract

Abstract

Successful smoking cessation is a problem for many smokers and the 1-year quit ratio among smokers is

Relation of psychosocial and stress reactivity variables to ventricular arrhythmias in the Cardiac Arrhythmia Pilot Study (CAPS)

Follick, M. J., Ahern, D. K., Gorkin, L., Niaura, R. S., Herd, J. A., Ewart, C., Schron, E. B., Kornfeld, D. S., Capone, R. J., & The CAPS Investigators, C. I. (n.d.).

Publication year

1990

Journal title

The American Journal of Cardiology

Volume

66

Issue

1

Page(s)

63-67

10.1016/0002-9149(90)90737-L

Abstract

Abstract

Both animal and human data implicate psychosocial distress and cardiovascular reactivity in response to challenge in the etiology of sudden cardiac death. In this study, the relation of these bio-behaviorial factors to frequency of ventricular premature complexes, a predictor of sudden death was investigated. The study population was made up of patients enrolled in the National Heart, Lung, and Blood Institute's Cardiac Arrhythmia Pilot Study (CAPS). Ventricular premature complexes (VPCs) were assessed by multiple, 24-hour ambulatory electrocardiographic recordings. Patients completed trait psychosocial measures assessed at baseline and state psychosocial measures assessed periodically during a 1-year follow-up period. Psychosocial measures included self-reports of depression, anxiety, anger and type A behavior pattern. A competitive challenge using a video game was used as a stressor to elicit cardiovascular reactivity and was administered at baseline and during follow-up sessions. Cardiovascular reactivity was defined as peak level during stressor exposure minus the mean of resting levels for systolic and diastolic blood pressure and pulse rate. Results indicated that biobehavioral factors were not associated with diurnal VPC rates. Furthermore, biobehavioral factors did not predict response to antiarrhythmic therapy. Based upon the results of this study, it is speculated that the established relation between behavioral factors and sudden death may not be mediated by VPC rates.

Effects of behavioral skills training and schedule of nicotine gum administration on smoking cessation

Niaura, R. S., Goldstein, M. G., Niaura, R., Follick, M. J., & Abrams, D. B. (n.d.).

Publication year

1989

Journal title

American Journal of Psychiatry

Volume

146

Issue

1

Page(s)

56-60

10.1176/ajp.146.1.56

Abstract

Abstract

Eighty-nine smokers were randomly assigned to four nicotine gum treatments for smoking cessation: behavioral treatment plus a fixed schedule of nicotine gum, behavioral treatment plus an ad lib schedule, education plus a fixed schedule, and education plus an ad lib schedule. The four treatment conditions produced similar rates of abstinence (40.9% to 58.3%) at the end of 11 weeks of treatment. However, at 6-month follow-up, the subjects who had received behavioral treatment had a significantly better abstinence rate (36.7%) than those receiving education (17.5%). Nicotine gum schedule had no effect on treatment outcome.

Reactivity to high risk situations and smoking cessation outcome.

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

Publication year

1989

Journal title

Journal of substance abuse

Volume

1

Issue

4

Page(s)

393-405

Abstract

Abstract

Smokers' reactions to a laboratory assessment that simulated high-risk-for-smoking-relapse situations were monitored prior to and at the end of treatment for smoking cessation. Measures included self-reported urges to smoke, efficacy, anxiety, behaviorally rated coping effectiveness, and heart rate. Observed pretreatment responses were unrelated to smoking outcome at the end of treatment. Univariate analyses indicated that decreased efficacy and coping effectiveness and increased urges at the end of treatment were related to relapse during 6-month follow-up. However, multivariate analysis demonstrated that these relationships were a function of the end-of-treatment smoking level. When end-of-treatment smoking rate was controlled for statistically, only increased heart rate response during the assessment predicted smoking status at 6 months. The theoretical significance of the findings is discussed.

Reasons for Smoking and Severity of Residual Nicotine Withdrawal Symptoms When Using Nicotine Chewing Gum

Niaura, R. S., GOLDSTEIN, M. G., WARD, K. D., & ABRAMS, D. B. (n.d.).

Publication year

1989

Journal title

British Journal of Addiction

Volume

84

Issue

6

Page(s)

681-687

10.1111/j.1360-0443.1989.tb03485.x

Abstract

Abstract

Prior to smoking cessation treatment using nicotine chewing gum, 65 smokers completed the Horn Reasons for Smoking Test, the Fagerstrom Tolerance Questionnaire and were assessed on measures of smoking history including saliva cotinine concentration. These measures were used to predict severity of residual nicotine withdrawal symptoms and urges to smoke assessed on a daily basis during the first 2 weeks of attempted abstinence. Univariate analyses indicated that smoking for reasons of handling, craving and to cope with negative affect correlated positively with both residual withdrawal symptoms and urges during the first week. Smoking for reasons of stimulation and habit were also correlated positively with residual withdrawal, and smoking for pleasure correlated with urges to smoke. After controlling for concurrent level of nicotine gum use, analyses suggested that only smoking for reasons of stimulation predicted residual withdrawal. Urges to smoke were positively related to level of smoking during treatment and also to smoking for reasons of craving and handling. Thus, it appears that individual differences in reasons for smoking influence severity of residual nicotine withdrawal symptoms and urges to smoke while chewing nicotine gum. The findings for stimulation smoking and withdrawal are discussed in terms of the reinforcing properties of nicotine with different routes of administration.

Responses to smoking-related stimuli and early relapse to smoking

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

Publication year

1989

Journal title

Addictive Behaviors

Volume

14

Issue

4

Page(s)

419-428

10.1016/0306-4603(89)90029-4

Abstract

Abstract

Prior to engaging in treatment for smoking cessation, subjects were tested for their responsiveness to cigarette smoking cues. Subjects performed a role-play with a confederate who lit their preferred brand of cigarette. Heart rate (HR) and galvanic skin conductance were assessed continuously, while urge to smoke and anxiety were rated subjectively after the role-play. Three months after treatment ended, subjects were divided into groups of continuous quitters, verified by expired carbon monoxide measurement, and relapsers. The results showed a significant difference between the groups in the pattern of pretreatment HR response to the lighting of the cigarette; relapsers displayed a sharp HR deceleration in response to the stimulus, while quitters' HR did not decelerate. The theoretical and clinical significance of these results is discussed.