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
Nondisclosure of Smoking Status to Health Care Providers Among Current and Former Smokers in the United States
AbstractCurry, L. E., Richardson, A., Xiao, H., & Niaura, R. S. (n.d.).Publication year
2013Journal title
Health Education and BehaviorVolume
40Issue
3Page(s)
266-273AbstractAn unintended consequence of tobacco control's success in marginalizing smoking is that smokers may conceal their smoking from those who are best positioned to help them quit: health care providers (HCPs). The purpose of this study was to identify the prevalence of, and factors related to, nondisclosure of smoking to HCPs. Data were obtained from a cross-sectional survey of adults from a nationally representative Knowledge Networks online panel in March to April 2011. Current and former smokers (n = 2,803) were asked questions about nondisclosure, tobacco use, cessation behavior, and perceived social unacceptability of smoking. All variables significantly related (p<.05) to nondisclosure in bivariate logistic regression were included in the multivariate logistic regression model, which also adjusted for gender, age, race, marital status, and education. Approximately 1 in 10 smokers (12.9%) and 5.8% of former smokers has withheld their smoking status from HCPs. Ever smokers who were 18 to 34 years, those who had used a prescription medication or behavioral therapy in their last quit attempt, and those who were uncomfortable discussing smoking with their HCP were more likely to report nondisclosure than those in their respective comparison groups. Respondents who perceived either medium or high smoker-related stigma (odds ratio [OR] = 1.70, 95% confidence interval [CI] = 1.05, 2.77 and OR = 2.60, 95% CI = 1.51, 4.48, respectively) and those who reported concealing smoking to gain benefits from health insurance were also significantly more likely to have kept smoking a secret from an HCP (OR = 5.66, 95% CI = 1.88, 17.02). Smokers should be encouraged to be forthright about their smoking in order for practitioners to offer treatment and services that increase their chances of quitting.Past major depression and smoking cessation outcome: A systematic review and meta-analysis update
AbstractHitsman, B., Papandonatos, G. D., McChargue, D. E., Demott, A., Herrera, M. J., Spring, B., Borrelli, B., & Niaura, R. (n.d.).Publication year
2013Journal title
AddictionVolume
108Issue
2Page(s)
294-306AbstractAims: To update our prior meta-analysis that showed past major depression (MD+) to be unrelated to smoking cessation outcome. Methods: Eligible trials included 14 from our original review and 28 identified through an updated systematic review (2000-2009). We coded for assessment of past MD, exclusion for recent MD episode (MDE; ≤6 months versus no exclusion), duration/modality of cognitive behavioral treatment (CBT; face-to-face versus self-help) and other factors. To minimize influence of experimental treatments that may selectively benefit MD+ smokers we analyzed placebo/lowest intensity control arms only. Study-specific ORs for the effect of past MD on short-term (≤3 months) and long-term (≥6 months) abstinence were estimated and combined using random effects. Two-way interaction models of past MD with study methodology and treatment factors were used to evaluate hypothesized moderators of the past MD-abstinence association. Results: MD+ smokers had 17% lower odds of short-term abstinence (n=35, OR=0.83, 95% CI=0.72-0.95, P=0.009) and 19% lower odds of long-term abstinence (n=38, OR=0.81, 95% CI=0.67-0.97, P=0.023) than MD- smokers after excluding the sole study of varenicline because of its antidepressant properties. The association between past MD and abstinence was affected by methodological (recent MDE exclusion, type of MD assessment) and treatment (CBT modality) factors. Conclusions: Past major depression has a modest adverse effect on abstinence during and after smoking cessation treatment. An increased focus on the identification of effective treatments or treatment adaptations that eliminate this disparity in smoking cessation for MD+ smokers is needed.Pharmacogenetic smoking cessation intervention in a health care setting: A pilot feasibility study
AbstractMcClure, J. B., Swan, G. E., St. John, J., Fauver, R., Javitz, H. S., Bergen, A. W., Nishita, D., Niaura, R., Munafó, M. R., & David, S. P. (n.d.).Publication year
2013Journal title
Nicotine and Tobacco ResearchVolume
15Issue
2Page(s)
518-526AbstractIntroduction: There is increasing evidence that response to pharmacological treatment for nicotine dependence may be moderated by genetic polymorphisms. However, the feasibility, acceptability, and impact of genetically tailoring treatment in real-world clinical settings are unknown. Methods: We conducted a multiphased, mixed-methods feasibility study with current smokers to develop and evaluate a patient-centered, theoretically grounded personalized medicine treatment protocol. The initial research phase included formative work to develop intervention materials. The second phase included a randomized pilot trial to evaluate the intervention. Trial participants (n = 36) were genotyped for ANKK1 rs1800497 and were randomized to receive genetic feedback (GF) plus standard behavioral counseling (BC) for smoking cessation or BC without GF. All participants received genetically tailored pharmacotherapy (nicotine patch or bupropion). Results: The intervention was feasible to implement and was acceptable to participants based on satisfaction ratings and objective measures of participation. There was no evidence that the GF resulted in adverse psychological outcomes (e.g., depression, fatalism, reduced perceived control over quitting, differential motivation for quitting) based on quantitative or qualitative outcomes. Conclusions: Study results suggest that it is feasible to offer treatment within a health care setting that includes genetically tailored pharmacotherapy and doing so had no apparent adverse psychological impacts. Further evaluation of pharmacogenetically tailored smoking cessation interventions appears warranted.Prenatal tobacco exposure, biomarkers for tobacco in meconium, and neonatal growth outcomes
AbstractHimes, S. K., Stroud, L. R., Scheidweiler, K. B., Niaura, R. S., & Huestis, M. A. (n.d.).Publication year
2013Journal title
Journal of PediatricsVolume
162Issue
5Page(s)
970-975AbstractObjective: To assess relationships between marker concentrations of tobacco in meconium and weekly self-reported maternal cigarette consumption, and prediction of neonatal growth outcomes. Study design: Pregnant mothers (n = 119) from a longitudinal maternal smoking and infant neurobehavioral study (Behavior and Mood in Babies and Mothers [BAM BAM]) provided daily tobacco smoking histories. Nicotine, cotinine, and trans-3′-hydroxycotinine concentrations were quantified in 111 neonatal meconium specimens by liquid chromatography-tandem mass spectrometry. Results: Median self-reported third trimester smoking was 5.9 cigarettes per day among smokers. Meconium samples from infants born to non-smokers (n = 42) were negative for tobacco markers, while specimens from self-reported smokers (n = 41) were positive for (median, range) nicotine (50.1 ng/g, 3.9-294), cotinine (73.9 ng/g, 6.4-329), and trans-3′-hydroxycotinine (124.5 ng/g, 10.2-478). Quitters (n = 28) self-reported stopping smoking at gestational weeks 2-39. Four meconium specimens from quitters were positive for tobacco biomarkers. Reduced birth weight, length, and head circumference significantly correlated with presence of meconium markers but not with individual or total marker concentrations. Among quitters and smokers, reduced infant birth weight, head circumference, and gestational age correlated with total and average daily cigarette consumption in the second and third trimesters. Conclusion: Smoking cessation or reduction during pregnancy improved neonatal outcomes. The window of detection for tobacco in meconium appears to be the third trimester; however, low exposure in this trimester failed to be detected. These results will aid physicians in educating women who are pregnant or thinking about becoming pregnant on the negative consequences of smoking during pregnancy. In addition, infants at risk can be identified at birth to assist early intervention efforts.Public support for mandated nicotine reduction in cigarettes
AbstractPearson, J. L., Abrams, D. B., Niaura, R. S., Richardson, A., & Vallone, D. M. (n.d.).Publication year
2013Journal title
American journal of public healthVolume
103Issue
3Page(s)
562-567AbstractObjectives. We assessed public support for a potential Food and Drug Administration (FDA)-mandated reduction in cigarette nicotine content. Methods. We used nationally representative data from a June 2010 crosssectional survey of US adults (n = 2649) to obtain weighted point estimates and correlates of support for mandated nicotine reduction. We also assessed the potential role of political ideology in support of FDA regulation of nicotine. Results. Nearly 50% of the public supported mandated cigarette nicotine reduction, with another 28% having no strong opinion concerning this potential FDA regulation. Support for nicotine reduction was highest among Hispanics, African Americans, and those with less than a high school education. Among smokers, the odds of supporting FDA nicotine regulation were 2.77 times higher among smokers who intended to quit in the next 6 months than among those with no plans to quit. Conclusions. Mandating nicotine reduction in cigarettes to nonaddictive levels may reduce youth initiation and facilitate adult cessation. The reasons behind nicotine regulation need to be communicated to the public to preempt tobacco industry efforts to impede such a regulation.The social support and social network characteristics of smokers in Methadone Maintenance treatment
AbstractDe Dios, M. A., Stanton, C. A., Caviness, C. M., Niaura, R., & Stein, M. (n.d.).Publication year
2013Journal title
American Journal of Drug and Alcohol AbuseVolume
39Issue
1Page(s)
50-56AbstractBackground: Previous studies have shown social support and social network variables to be important factors in smoking cessation treatment. Tobacco use is highly prevalent among individuals in methadone maintenance treatment (MMT). However, smoking cessation treatment outcomes in this vulnerable subpopulation have been poor and social support and social network variables may contribute. Methods: The current study examined the social support and social network characteristics of 151 MMT smokers involved in a randomized clinical trial of smoking cessation treatments. Participants were 50% women and 78% Caucasian. A high proportion (57%) of MMT smokers had spouses or partners who smoke and over two-thirds of households (68.5%) included at least one smoker. Results: Our sample was characterized by relatively small social networks, but high levels of general social support and quitting support. The number of cigarettes per day was found to be positively associated with the number of smokers in the social network (r = .239, p < .05) and quitting self-efficacy was negatively associated with partner smoking (r = -.217, p < .001). Conclusions: Findings are discussed in the context of developing smoking cessation interventions that address the influential role of social support and social networks of smokers in MMT.A ban on menthol cigarettes: Impact on public opinion and smokers' intention to quit
AbstractPearson, J. L., Abrams, D. B., Niaura, R. S., Richardson, A., & Vallone, D. M. (n.d.).Publication year
2012Journal title
American journal of public healthVolume
102Issue
11Page(s)
e107-e114AbstractObjectives. We assessed support for a ban by the Food and Drug Administration on menthol in cigarettes and behavioral intentions among menthol smokers in the event of such a ban. Methods. We surveyed 2649 never, former, and current smokers and used ordinal logistic regression to calculate weighted point estimates and predictors of support for a menthol ban among the adult population and menthol smokers only. For menthol smokers, we also calculated weighted point estimates and predictors of behavioral intentions. Results. Overall, 28.2% of adults opposed, 20.0% supported, and 51.9% lacked a strong opinion about a menthol ban. Support was highest among Hispanics (36.4%), African Americans (29.0%), never smokers (26.8%), and respondents with less than a high school education (28.8%). Nearly 40% of menthol smokers said they would quit if menthol cigarettes were no longer available, 12.5% would switch to a nonmenthol brand, and 25.2% would both switch and try to quit. Conclusions. Support for a menthol ban is strongest among populations with the highest prevalence of menthol cigarette use. A menthol ban might motivate many menthol smokers to quit.A transdisciplinary approach to protocol development for tobacco control research: A case study
AbstractClark, M. A., Rogers, M. L., Boergers, J., Kahler, C. W., Ramsey, S., Saadeh, F. M., Abrams, D. B., Buka, S. L., Niaura, R., & Colby, S. M. (n.d.).Publication year
2012Journal title
Translational Behavioral MedicineVolume
2Issue
4Page(s)
431-440AbstractThe increasing complexity of scientific problems related to lifestyle risk factors has prompted substantial investments in transdisciplinary or team science initiatives at the biological, psychosocial, and population levels of analysis. To date, the actual process of conducting team science from the perspectives of investigators engaged in it has not been well documented. We describe the experience of developing and implementing data collection protocols using the principles of transdisciplinary science. The New England Family Study Transdisciplinary Tobacco Use Research Center was a 10-year collaboration involving more than 85 investigators and consultants from more than 20 disciplines as well as more than 50 research staff. We used a two-phase process in which all the study personnel participated in the developing and testing of 160 instruments. These instruments were used in 4,378 assessments with 3,501 participants. With substantial effort, it is possible to build a team of scientists from diverse backgrounds that can develop a set of instruments using a shared conceptual approach, despite limited or no experience working together previously.Are smokers with HIV using information and communication technology? implications for behavioral interventions
AbstractChander, G., Stanton, C., Hutton, H. E., Abrams, D. B., Pearson, J., Knowlton, A., Latkin, C., Holtgrave, D., Moore, R. D., & Niaura, R. (n.d.).Publication year
2012Journal title
AIDS and BehaviorVolume
16Issue
2Page(s)
383-388AbstractSmoking is highly prevalent among persons living with HIV/AIDS (PLWHA) and associated with adverse outcomes including malignancy and cardiovascular disease. Information and communication technology (ICT) may be effective in disseminating cessation interventions among PLWHA. This study examines the prevalence of ICT use among 492 PLWHA attending an urban clinic and characteristics associated with ICT use. Participants completed a survey of demographics, smoking status, and ICT use. Factors associated with ICT use were examined with logistic regression. Overall, 63% of participants smoked with 73% of smokers owning their own cell phone. Use of other modalities was lower, with 48% of smokers reporting any internet use, 39% text messaging, and 31% using email. Higher education was associated with the use of all modalities. Cell phone interventions may have the broadest reach among PLWHA, though with almost half using the internet, this may also be a low-cost means of delivering cessation interventions.Behavioral economic analysis of withdrawal- and cue-elicited craving for tobacco: An initial investigation
AbstractMackillop, J., Brown, C. L., Stojek, M. K., Murphy, C. M., Sweet, L., & Niaura, R. S. (n.d.).Publication year
2012Journal title
Nicotine and Tobacco ResearchVolume
14Issue
12Page(s)
1426-1434AbstractIntroduction: The role of craving in nicotine dependence remains controversial and may be a function of measurement challenges. The current study used behavioral economic approach to test the hypotheses that subjective craving from acute withdrawal and exposure to tobacco cues dynamically increases the relative value of cigarettes. Methods: Using a 2 (1-hr/12-hr deprivation) × 2 (neutral/tobacco cues) within-subjects design, 33 nicotine dependent adults completed 2 laboratory sessions. Assessment included subjective craving and behavioral economic indices of cigarette demand, namely Intensity (i.e., cigarette consumption at zero cost), Omax (i.e., maximum total expenditure), Breakpoint (i.e., highest acceptable price for cigarettes), Pmax (i.e., price at which consumption becomes sensitive to price), and elasticity (i.e., price sensitivity). Behavioral economic indices were generated using a Cigarette Purchase Task in which participants selected between cigarettes for a subsequent 2-hr self-administration period and money. Results: Main effects of deprivation and tobacco cues were present for subjective craving and multiple behavioral economic indices of cigarette demand. Interestingly, deprivation significantly increased Breakpoint (p ≤.01) and Pmax (p ≤.05) and had trend-level effects on Intensity and Omax (p ≤.10); whereas cues significantly reduced elasticity (p ≤ .01), reflecting lower sensitivity to increasing prices. Heterogeneous associations were evident among the motivational variables but with aggregations suggesting variably overlapping motivational channels. Conclusions: These findings further support a behavioral economic approach to craving and a multidimensional conception of acute motivation for addictive drugs. Methodological considerations, including potential order effects, and the need for further refinement of these findings are discussed.Development and reliability of the lifetime interview on smoking trajectories
AbstractColby, S. M., Clark, M. A., Rogers, M. L., Ramsey, S., Graham, A. L., Boergers, J., Kahler, C. W., Papandonatos, G. D., Buka, S. L., Niaura, R. S., & Abrams, D. B. (n.d.).Publication year
2012Journal title
Nicotine and Tobacco ResearchVolume
14Issue
3Page(s)
290-298AbstractIntroduction: Assessments of lifetime smoking history are useful in many types of research including surveillance, epidemiology, prevention, intervention, and studies of genetic phenotypes and heritability. Because prospective assessment is impractical for most research, our objective was to develop a reliable retrospective measure of lifetime smoking history. This paper presents descriptive and test-retest reliability data on smoking history variables assessed using the Lifetime Interview on Smoking Trajectories (LIST). Methods: Data were collected on a birth cohort sample of 1,625 men and women (ages 34-44) from the Collaborative Perinatal Project. A subsample of 344 was invited to participate in a retest interview 4-8 weeks later and 220 participated. Indices of test-retest reliability were evaluated for smoking history variables, including: (a) early smoking experiences; (b) age at various smoking milestones, such as first puff, and progression to weekly and daily smoking; (c) smoking rate and time to first cigarette within initial, current, most recent, and heaviest phases; and (d) prolonged nonsmoking phases. Results: Responses to whether each of 5 major smoking milestones occurred were all highly reliable (k = .78 - .92), and of the 20 phase-specific variables assessed, more than half were reported at the highest level of reliability. None of the variables demonstrated low reliability. Conclusions: Although retrospective reports have unavoidable limitations, our findings indicate that the LIST is a reliable instrument for assessing detailed retrospective smoking history data and can be used to add to the knowledge base of how patterns of use relate to a variety of outcomes of interest.Dopamine D4 receptor gene variation moderates the efficacy of bupropion for smoking cessation
AbstractLeventhal, A. M., David, S. P., Brightman, M., Strong, D., McGeary, J. E., Brown, R. A., Lloyd-Richardson, E. E., Munafò, M., Uhl, G. R., & Niaura, R. (n.d.).Publication year
2012Journal title
Pharmacogenomics JournalVolume
12Issue
1Page(s)
86-92AbstractSmokers (10 cigarettes per day, N331) of European ancestry taking part in a double-blind placebo-controlled randomized trial of 12 weeks of treatment with bupropion along with counseling for smoking cessation were genotyped for a variable number of tandem repeats polymorphism in exon III of the dopamine D4 receptor gene. Generalized estimating equations predicting point-prevalence abstinence at end of treatment and 2, 6 and 12 months after the end of treatment indicated that bupropion (vs placebo) predicted increased odds of abstinence. The main effect of Genotype was not significant. A Genotype × Treatment interaction (P0.005) showed that bupropion predicted increased odds of abstinence in long-allele carriers (odds ratios (OR)1.31, P0.0001), whereas bupropion was not associated with abstinence among short-allele homozygotes (OR1.06, P0.23). The Genotype × Treatment interaction remained when controlling for demographic and clinical covariates (P0.01) and in analyses predicting continuous abstinence (P's0.054). Bupropion may be more efficacious for smokers who carry the long allele, which is relevant to personalized pharmacogenetic treatment approaches.E-cigarette awareness, use, and harm perceptions in US adults
AbstractPearson, J. L., Richardson, A., Niaura, R. S., Vallone, D. M., & Abrams, D. B. (n.d.).Publication year
2012Journal title
American journal of public healthVolume
102Issue
9Page(s)
1758-1766AbstractObjectives. We estimated e-cigarette (electronic nicotine delivery system) awareness, use, and harm perceptions among US adults. Methods. We drew data from 2 surveys conducted in 2010: a national online study (n = 2649) and the Legacy Longitudinal Smoker Cohort (n = 3658). We used multivariable models to examine e-cigarette awareness, use, and harm perceptions. Results. In the online survey, 40.2% (95% confidence interval [CI] = 37.3, 43.1) had heard of e-cigarettes, with awareness highest among current smokers. Utilization was higher among current smokers (11.4%; 95% CI = 9.3, 14.0) than in the total population (3.4%; 95% CI = 2.6, 4.2), with 2.0% (95% CI = 1.0, 3.8) of former smokers and 0.8% (95% CI = 0.35, 1.7) of never-smokers ever using e-cigarettes. In both surveys, non-Hispanic Whites, current smokers, young adults, and those with at least a high-school diploma were most likely to perceive e-cigarettes as less harmful than regular cigarettes. Conclusions. Awareness of e-cigarettes is high, and use among current and former smokers is evident. We recommend product regulation and careful surveillance to monitor public health impact and emerging utilization patterns, and to ascertain why, how, and under what conditions e-cigarettes are being used.Interventions to address chronic disease and HIV: Strategies to promote smoking cessation among HIV-infected individuals
AbstractNiaura, R., Chander, G., Hutton, H., & Stanton, C. (n.d.).Publication year
2012Journal title
Current HIV/AIDS ReportsVolume
9Issue
4Page(s)
375-384AbstractTobacco use, especially cigarette smoking, is higher than average in persons living with HIV/AIDS (PLWHA). The Public Health Service Clinical Practice Guideline for Treating Tobacco Use and Dependence states that, during every medical encounter, all smokers should be offered smoking cessation counseling, along with approved medications. The Guideline also recognizes PLWHA as a priority population, given the scarcity of research on effective cessation treatments in this group. The scant evidence suggests that conventional treatments, though worthwhile, are not as successful as might be hoped for. The reasons for this are not entirely clear, butmay have to do with the complex array of medical and psychosocial factors that complicate their lives. Clinicians should consider re-treatment strategies for those patients who encounter difficulty when quitting smoking with conventional approaches, switching or augmenting treatments as needed to minimize adverseexperiences, and to maximize tolerability, adherence, and cessation outcomes.A national mass media smoking cessation campaign: Effects by race/ethnicity and education
AbstractVallone, D. M., Niederdeppe, J., Richardson, A. K., Patwardhan, P., Niaura, R., & Cullen, J. (n.d.).Publication year
2011Journal title
American Journal of Health PromotionVolume
25Page(s)
S38-S50AbstractPurpose. To assess the effectiveness of a large-scale, national smoking cessation media campaign, the EX campaign, across racial/ethnic and educational subgroups. Design. A longitudinal random-digit-dial panel study conducted prior to and 6 months following the national launch of the campaign. Setting. The sample was drawn from eight designated media markets in the United States. Subjects. The baseline survey was conducted on 5616 current smokers, aged 18 to 49 years, and 4067 (73% follow-up response rate) were resurveyed at the 6-month follow-up. Measures. The primary independent variable is confirmed awareness of the campaign advertising, and the outcome variables are follow-up cessation-related cognitions index score and quit attempts. Analysis. Multivariable logistic and linear regression analyses were conducted within racial/ ethnic and educational strata to assess the strength of association between confirmed awareness of campaign advertising and cessation-related outcomes. Results. Confirmed awareness of campaign advertising increased favorable cessation-related cognitions among Hispanics and quit attempts among non-Hispanic blacks, and increased favorable cessation-related cognitions and quit attempts among smokers with less than a high school education. Conclusions. These results suggest that the EX campaign may be effective in promoting cessationrelated cognitions and behaviors among minority and disadvantaged smokers who experience a disproportionate burden of tobacco-related illness and mortality.A randomized trial of internet and telephone treatment for smoking cessation
AbstractGraham, A. L., Cobb, N. K., Papandonatos, G. D., Moreno, J. L., Kang, H., Tinkelman, D. G., Bock, B. C., Niaura, R. S., & Abrams, D. B. (n.d.).Publication year
2011Journal title
Archives of Internal MedicineVolume
171Issue
1Page(s)
46-53AbstractBackground: This study aimed to determine the relative effect of Internet and Internet plus telephone treatment for smoking cessation on smoking abstinence among US adults. A priori hypotheses were that Internet enhanced with tailored content and social support would outperform basic Internet (BI) and that enhanced Internet (EI) plus proactive telephone counseling would outperform the other conditions. Methods: The Quit Using Internet and Telephone Treatment (iQUITT) study used a 3-group randomized controlled design comparing BI, EI, and EI and telephone combined (EI+P). The trial was conducted from March 8, 2005, through November 30, 2008. Current adult smokers in the United States who smoked 5 or more cigarettes per day were recruited via search engines. Characteristics of the 2005 participants include mean (SD) age of 35.9 (10.8) years, 51.1% women, and 86.5% white. The follow-up assessment rate at 18 months was 68.2%. The main outcome measure was 30-day point prevalence abstinence measured at 3, 6, 12, and 18 months after randomization using intent-to-treat analysis. Results: At 18 months, the 30-day multiple point prevalence abstinence rate across all follow-up intervals was 3.5% (BI), 4.5% (EI), and 7.7% (EI+P), with EI+P significantly outperforming BI and EI. At 18 months, 30-day single point prevalence abstinence rates were 19.0% (BI), 17.4% (EI), and 19.6% (EI+P) and did not differ among the groups. Conclusions: Combined Internet and telephone treatment outperforms static and dynamic Internet interventions. Trial Registration: clinicaltrials.gov Identifier: NCT00282009.Accuracy of a brief screening scale for lifetime major depression in cigarette smokers
AbstractHitsman, B., Buka, S. L., Veluz-Wilkins, A. K., Mohr, D. C., Niaura, R., & Gilman, S. E. (n.d.).Publication year
2011Journal title
Psychology of Addictive BehaviorsVolume
25Issue
3Page(s)
559-564AbstractHistory of major depression is increasingly being measured in smoking cessation trials using brief screening scales, typically only 1-2 items, despite that their validity has not been fully established. The aim of this study was to evaluate the positive predictive value (PPV) of a 4-item screening scale of lifetime major depressive episode (MDE). Current (n = 475), former (n = 401), and never (n = 646) smokers were asked about a history of depressed mood and anhedonia lasting several days or longer. Endorsers of either depressed mood or anhedonia were then asked about whether the symptom(s) lasted most of the day nearly every day for two weeks or longer. Symptom endorsers, regardless of symptom duration, were administered the depression module of the Composite International Diagnostic Interview. Eight hundred and thirty-five (54.9%) participants had no history of either screening symptom, 296 (20.9%) had a history of depressed mood and/or anhedonia < 2 weeks, and 369 (24.2%) had a history of depressed mood and/or anhedonia ≥ 2 weeks. PPV of depressed mood and/or anhedonia ≥ 2 weeks was high (84.8%) for detecting lifetime MDE, as compared to only 23.9% for symptom(s) <2 weeks. PPV did not vary by either smoking status or gender. This 4-item screening scale has high predictive value in detecting lifetime MDE. Smoking cessation trials that do not require a history of depressed mood and/or anhedonia for two weeks or longer may overestimate rates of lifetime MDE and confound tests of the association between depression and treatment outcome.Application of functional neuroimaging to examination of nicotine dependence
AbstractDavid, S. P., Sweet, L. H., Cohen, R. A., MacKillop, J., Mulligan, R. C., & Niaura, R. (n.d.). In Brain Imaging in Behavioral Medicine and Clinical Neuroscience (1–).Publication year
2011Page(s)
117-145AbstractFunctional neuroimaging approaches have advanced the field of nicotine and tobacco research by making it possible to study neurobiological mechanisms associated with behaviors predictive of nicotine dependence severity and smoking cessation. This chapter provides a review of the state of the science intended to provide an introductory guide to investigators interested in the design and conduct of future studies.Characteristics and predictors of readiness to quit among emergency medical patients presenting with respiratory symptoms
AbstractBock, B. C., Jennings, E., Becker, B. M., Partridge, R., & Niaura, R. S. (n.d.).Publication year
2011Journal title
International Journal of Emergency MedicineVolume
4Issue
1AbstractPurpose: To examine behavioral factors that lead patients to consider quitting smoking and features associated with readiness to quit among adults who are seeking treatment in the emergency department (ED) for respiratory symptoms. Methods: A toal of 665 adult smokers seeking treatment in an ED for respiratory symptoms and respiratory illness answered survey questions during the ED visit. Results: Patients self-reported "readiness to quit" was broadly distributed among this patient population. Patients with COPD, pneumonia or asthma perceived higher risks from smoking than other patients with respiratory complaints. Over half of all participants had scores indicative of depression. Regression analysis showed that prior efforts to quit, confidence, perceived importance of quitting and decisional balance were each significantly predictive of readiness to quit, accounting for 40% of the variance. Conclusions: While many of these patients appear unaware of the connection between their symptoms and their smoking, patients with diagnosed chronic respiratory illness perceived higher risks from their smoking. In patients who do not perceive these risks, physician intervention may increase perceived risk from smoking and perceived importance of quitting. Interventions designed for the ED setting targeting this patient population should consider screening for depressive symptoms and, when appropriate, making referrals for further evaluation and/or treatment. Medications that can help alleviate depression and withdrawal symptoms while quitting smoking, such as bupropion, may be particularly useful for this subset of patients, as depression is a substantial barrier to quitting.Food and drug administration regulation of tobacco: Integrating science, law, policy, and advocacy
Villanti, A. C., Vargyas, E. J., Niaura, R. S., Beck, S. E., Pearson, J. L., & Abrams, D. B. (n.d.).Publication year
2011Journal title
American journal of public healthVolume
101Issue
7Page(s)
1160-1162Modeling the future effects of a menthol ban on smoking prevalence and smoking-attributable deaths in the United States
AbstractLevy, D. T., Pearson, J. L., Villanti, A. C., Blackman, K., Vallone, D. M., Niaura, R. S., & Abrams, D. (n.d.).Publication year
2011Journal title
American journal of public healthVolume
101Issue
7Page(s)
1236-1240AbstractWe used a validated smoking simulation model and data from the 2003 Tobacco Use Supplement to the Current Population Survey to project the impact that a US menthol ban would have on smoking prevalence and smoking-attributable deaths. In a scenario in which 30% of menthol smokers quit and 30% of those who would have initiated as menthol smokers do not initiate, by 2050 the relative reduction in smoking prevalence would be 9.7% overall and 24.8% for Blacks; deaths averted would be 633252 overall and 237317 for Blacks.Online social networks and smoking cessation: A scientific research agenda
AbstractCobb, N. K., Graham, A. L., Byron, M. J., Niaura, R. S., Abrams, D. B., Workshop Participants, P., & Workshop Participants, P. (n.d.).Publication year
2011Journal title
Journal of medical Internet researchVolume
13Issue
4AbstractBackground: Smoking remains one of the most pressing public health problems in the United States and internationally. The concurrent evolution of the Internet, social network science, and online communities offers a potential target for high-yield interventions capable of shifting population-level smoking rates and substantially improving public health. Objective: Our objective was to convene leading practitioners in relevant disciplines to develop the core of a strategic research agenda on online social networks and their use for smoking cessation, with implications for other health behaviors. Methods: We conducted a 100-person, 2-day, multidisciplinary workshop in Washington, DC, USA. Participants worked in small groups to formulate research questions that could move the field forward. Discussions and resulting questions were synthesized by the workshop planning committee. Results: We considered 34 questions in four categories (advancing theory, understanding fundamental mechanisms, intervention approaches, and evaluation) to be the most pressing. Conclusions: Online social networks might facilitate smoking cessation in several ways. Identifying new theories, translating these into functional interventions, and evaluating the results will require a concerted transdisciplinary effort. This report presents a series of research questions to assist researchers, developers, and funders in the process of efficiently moving this field forward.Positive reactions to tobacco predict relapse after cessation
AbstractStrong, D. R., Leventhal, A. M., Evatt, D. P., Haber, S., Greenberg, B. D., Abrams, D., & Niaura, R. (n.d.).Publication year
2011Journal title
Journal of abnormal psychologyVolume
120Issue
4Page(s)
999-1005AbstractAmong chronic smokers, individual differences in subjective reactions to smoking may characterize important facets of nicotine dependence that relate to abstinence-induced craving, withdrawal symptom profiles, and risk for relapse. Although the negative reinforcing properties of smoking have achieved prominent positions in models of relapse (Baker, Brandon, & Chassin, 2004), vulnerability to relapse risk may also arise from seeking positive reinforcement from smoking (Shiffman & Kirchner, 2009). In this study, 183 cessation-motivated smokers provided subjective craving, positive and negative reactions to standardized cigarettes following overnight abstinence. Level of craving, negative mood, and positive mood after overnight abstinence were significantly predictive of withdrawal on quit-day. Increased positive reactions to smoking were uniquely predictive of relapse after quitting (Hazard Ratio = 1.22, p < .001). Individual differences in positive reactions to smoking may be important markers of neurobiological systems that promote dependence and interfere with cessation efforts.Quit attempts and quit rates among menthol and nonmenthol smokers in the United States
AbstractLevy, D. T., Blackman, K., Tauras, J., Chaloupka, F. J., Villanti, A. C., Niaura, R. S., Vallone, D. M., & Abrams, D. B. (n.d.).Publication year
2011Journal title
American journal of public healthVolume
101Issue
7Page(s)
1241-1247AbstractObjectives: We compared quit attempts and quit rates among menthol and nonmenthol cigarette smokers in the United States. Methods: We used data from the 2003 and 2006-2007 waves of the large, nationally representative Tobacco Use Supplement to the Current Population Survey with control for state-level tobacco control spending, prices, and smokefree air laws. We estimated mean prevalence, quit rates, and multivariate logistic regression equations by using self-respondent weights for menthol and nonmenthol smokers. Results: In 2003 and 2007, 70% of smokers smoked nonmenthol cigarettes, 26% smoked menthol cigarettes, and 4% had no preference. Quit attempts were 4.3% higher in 2003 and 8.8% higher in 2007 among menthol than nonmenthol smokers. The likelihood of quitting was 3.5% lower for quitting in the past year and 6% lower for quitting in the past 5 years in menthol compared with nonmenthol smokers. Quit success in the past 5 years was further eroded among menthol-smoking Blacks and young adults. Conclusions: Menthol smokers are more likely to make quit attempts, but are less successful at staying quit. The creation of menthol preference through marketing may reduce quit success.Tobacco use
AbstractNiaura, R., & Villanti, A. C. (n.d.). In Encyclopedia of Adolescence (1–).Publication year
2011Volume
3Page(s)
331-337AbstractTobacco use is the deadliest addiction in the United States and remains a problem for adolescents. Despite aggressive tobacco control efforts, adolescents continue to initiate smoking and lack the supportive resources to quit. This article addresses trends in adolescent tobacco use in the United States, stages of progression in cigarette smoking, and nicotine dependence in youth. It describes how tobacco use is learned from an adolescent's social environment and influenced by psychological and genetic factors. It presents the interventions used to reduce tobacco use and highlights the elements of a comprehensive tobacco control strategy, which produce changes in adolescent tobacco use prevalence.