Thomas Kirchner
Thomas Kirchner
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Associate Professor of Social and Behavioral Sciences
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Professional overview
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Dr. Thomas Kirchner is a clinical-health psychologist and methodologist interested in the analysis and graphical representation of longitudinal and geographic data, including methodologies that link individual behavior to the real-time context in which it occurs. Dr. Kirchner’s research targets momentary influences on the maintenance of health-related behavior utilizing both field-based (ecological momentary assessment) and laboratory-based paradigms. These geographic information systems and analytical methods can then inform public health, research, and policy.
As the Director and Principal Investigator of the mHealth (mobile health) Lab, Dr. Kirchner uses GIS to understand health-related behavior and decision-making in real time (e.g., how people make decisions about what they eat and drink, the places they go to exercise in their neighborhoods, the amount of time they spend outdoors, and whether they smoke cigarettes and/or marijuana). In the Lab, students apply mHealth tools to explore geospatial systems, technology, research, and community advocacy. Students learn how to leverage the power of their cell phones to collect data about neighborhoods and experiences.
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Education
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MS, Clinical and Biological/Health Psychology, University of Pittsburgh, Pittsburgh, PAPhD, Clinical and Biological/Health Psychology, University of Pittsburgh, Pittsburgh, PA
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Areas of research and study
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Behavioral Determinants of HealthGeographic Information Science (GIS)Geographically-explicit EMALongitudinal Data AnalysisSocial BehaviorsUrban InformaticsUrban Science
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Publications
Publications
The Moment Study: Protocol for a mixed method observational cohort study of the Alternative Nicotine Delivery Systems (ANDS) initiation process among adult cigarette smokers
AbstractPearson, J. L., Smiley, S. L., Rubin, L. F., Anesetti-Rothermel, A., Elmasry, H., Davis, M., De Atley, T., Harvey, E., Kirchner, T., & Abrams, D. B. (n.d.).Publication year
2016Journal title
BMJ openVolume
6Issue
4AbstractIntroduction: Alternative Nicotine Delivery Systems (ANDS) such as e-cigarettes are battery-powered devices that aerosolize nicotine and other substances to simulate smoking without using tobacco. Little is known about the ANDS initiation process among adult smokers. The aims of this research are threefold to: (1) examine how ANDS use affects cigarette use; (2) examine how the immediate environmental and psychosocial contexts of cigarette and ANDS use vary within - and between - participants in general and by menthol preference and race; and, (3) examine participants' 'lived experience' of the subjective perceptions, meaning, influences and utility of cigarette and ANDS use. Methods and analyses: This study's mixed method, 6-week longitudinal design will produce a detailed description of the ANDS initiation process among adult smokers (N=100). Qualitative and quantitative data collection will include 3 weeks of: (1) ecological momentary assessment of patterns of cigarette/ANDS use, satisfaction, mood and craving; (2) geospatial assessment of participants' environment, including indoor and outdoor cigarette/ANDS norms and rules; (3) in-depth interviews about the meaning and utility o cigarette smoking and ANDS use; and, (4) saliva cotinine and exhaled carbon monoxide (CO) biomarkers. A diverse sample will be recruited with an equal number of menthol and non-menthol cigarette smokers. As the primary independent variable, we will investigate how ANDS use affects cigarette consumption. We will also examine how smoking related and ANDS-related rules and norms surrounding product use influence cigarette and ANDS product use, and how the subjective effects of ANDS use affect ANDS perceptions, beliefs and use. Ethics and dissemination: This study was funded by the National Institute on Drug Abuse of the US National Institutes of Health (1R21DA036472), registered at ClinicalTrials.gov (NCT02261363), and approved by the Chesapeake IRB (Pro00008526). Findings will be disseminated to the scientific and lay community through presentations, reports and scientific publications.Tobacco retail outlet density and young adult tobacco initiation
AbstractCantrell, J., Pearson, J. L., Anesetti-Rothermel, A., Xiao, H., Kirchner, T. R., & Vallone, D. (n.d.).Publication year
2016Journal title
Nicotine and Tobacco ResearchVolume
18Issue
2Page(s)
130-137AbstractBackground: A growing body of evidence indicates that the density of tobacco retail outlets around the home residence may influence tobacco use among youth and adults. The purpose of this study was to examine the impact of neighborhood tobacco retail outlet density on young adult initiation of different tobacco product types. Methods: Cross-sectional data from a 2013 nationally representative sample of young adults aged 18-34 was examined in relation to a 2012 geocoded listing of all outlets likely to sell tobacco in the United States. Separate multivariable logistic regression analyses examined associations between neighborhood outlet density and past 6 months first use of cigarettes, non-cigarette combustible products, and noncombustible products among adults aged 18-24 and 25-34. Results: Outlet density was significantly associated with recent initiation of cigarettes and other combustibles, but this impact varied for younger and older groups. Increased density was significantly associated with a higher likelihood of initiating cigarette use among adults aged 25-34 (OR = 3.75, 95% CI = 1.18, 11.90), and of initiating non-cigarette combustible use among 18-24 year olds (OR = 3.16, 95% CI = 1.03, 9.74). There was no impact of outlet density on recent noncombustible product initiation among either group. Conclusion: This study is the first to examine the impact of tobacco outlet density on young adult initiation of cigarettes and other tobacco products. Findings demonstrate that residential neighborhood outlet density is associated with recent initiation of combustible products and this effect varies by product type and age. The tobacco outlet environment may be a critical factor in promoting young adult tobacco use initiation.Cigarette price variation around high schools: Evidence from Washington DC
AbstractCantrell, J., Ganz, O., Anesetti-Rothermel, A., Harrell, P., Kreslake, J. M., Xiao, H., Pearson, J. L., Vallone, D., & Kirchner, T. R. (n.d.).Publication year
2015Journal title
Health and PlaceVolume
31Page(s)
193-198AbstractThis study examines lowest cigarette prices in all tobacco retail outlets in Washington D.C. (. n=750) in relation to the type and number of high schools nearby, controlling for confounders. The lowest overall and Newport menthol prices were significantly lower at outlets near public non-charter and charter schools compared with outlets near private schools. Given higher smoking prevalence and more price-sensitive youth subgroups in U.S. public schools, exposure to low prices may contribute to tobacco-related health disparities in minority and low-income populations. Tobacco taxes combined with policies to minimize the increasing use of price as a marketing tool are critical.Cue reactivity in converted and native intermittent smokers
AbstractShiffman, S., Dunbar, M. S., Kirchner, T. R., Li, X., Tindle, H. A., Anderson, S. J., Scholl, S. M., & Ferguson, S. G. (n.d.).Publication year
2015Journal title
Nicotine and Tobacco ResearchVolume
17Issue
1Page(s)
119-123AbstractIntroduction: Nondaily, or intermittent smokers (ITS), who constitute a substantial fraction of U.S. smokers, are thought to smoke in response to cues. Previous cue reactivity research showed no difference between ITS and daily smokers in response to cues. This report examines whether "converted" ITS (CITS) with a history of past daily smoking differ from "native" ITS (NITS) in craving and smoking in response to cues. Methods: A total of 146 CITS (who previously smoked daily for at least 6 months) and 73 NITS participated. Participants were exposed to 5 active cues (smoking, alcohol, negative affect, positive affect, and smoking prohibitions) and a control neutral cue, in separate sessions. Changes in craving were assessed pre-post cue exposure. Smoking behavior (smoking [y/n], smoking latency, number of cigarettes, number of puffs, and increase in carbon monoxide [CO]) was observed. Analyses contrasted response to each active cue compared to the neutral cue and controlled for order effects and for time since last cigarette, which differed between groups. Results: Regardless of cues, CITS reported higher craving and greater change in craving, were more likely to smoke, tended to progress faster to smoking, and showed greater increases in CO when they did smoke. NITS and CITS showed similar cue reactivity on most measures, though NITS took more puffs after viewing smoking cues (compared to neutral) than did CITS. Conclusions: Though CITS show some remnants of their history of daily smoking, CITS and NITS demonstrate similar cue reactivity, suggesting that they would not require different behavioral approaches to help them quit.Electronic cigarette advertising at the point-of-sale: A gap in tobacco control research
Ganz, O., Cantrell, J., Moon-Howard, J., Aidala, A., Kirchner, T. R., & Vallone, D. (n.d.).Publication year
2015Journal title
Tobacco controlVolume
24Page(s)
e110-e112Implementation of a multimodal mobile system for point-of-sale surveillance: Lessons learned from case studies in washington, dc, and new york city
AbstractCantrell, J., Ganz, O., Ilakkuvan, V., Tacelosky, M., Kreslake, J., Moon-Howard, J., Aidala, A., Vallone, D., Anesetti-Rothermel, A., & Kirchner, T. R. (n.d.).Publication year
2015Journal title
JMIR Public Health and SurveillanceVolume
1Issue
2AbstractBackground: In tobacco control and other fields, point-of-sale surveillance of the retail environment is critical for understanding industry marketing of products and informing public health practice. Innovations in mobile technology can improve existing, paper-based surveillance methods, yet few studies describe in detail how to operationalize the use of technology in public health surveillance. Objective: The aims of this paper are to share implementation strategies and lessons learned from 2 tobacco, point-of-sale surveillance projects to inform and prepare public health researchers and practitioners to implement new mobile technologies in retail point-of-sale surveillance systems. Methods: From 2011 to 2013, 2 point-of-sale surveillance pilot projects were conducted in Washington, DC, and New York, New York, to capture information about the tobacco retail environment and test the feasibility of a multimodal mobile data collection system, which included capabilities for audio or video recording data, electronic photographs, electronic location data, and a centralized back-end server and dashboard. We established a preimplementation field testing process for both projects, which involved a series of rapid and iterative tests to inform decisions and establish protocols around key components of the project. Results: Important components of field testing included choosing a mobile phone that met project criteria, establishing an efficient workflow and accessible user interfaces for each component of the system, training and providing technical support to fieldworkers, and developing processes to integrate data from multiple sources into back-end systems that can be utilized in real-time. Conclusions: A well-planned implementation process is critical for successful use and performance of multimodal mobile surveillance systems. Guidelines for implementation include (1) the need to establish and allow time for an iterative testing framework for resolving technical and logistical challenges; (2) developing a streamlined workflow and user-friendly interfaces for data collection; (3) allowing for ongoing communication, feedback, and technology-related skill-building among all staff; and (4) supporting infrastructure for back-end data systems. Although mobile technologies are evolving rapidly, lessons learned from these case studies are essential for ensuring that the many benefits of new mobile systems for rapid point-of-sale surveillance are fully realized.National enforcement of the Family Smoking Prevention and Tobacco Control Act at point-of-sale
Kirchner, T., Villanti, A. C., Tacelosky, M., Anesetti-Rothermel, A., Gao, H., Pearson, J. L., Ganz, O., Cantrell, J., Vallone, D., & Abrams, D. (n.d.).Publication year
2015Journal title
Tobacco Regulatory ScienceVolume
1Issue
1Page(s)
24-35National Enforcement of the FSPTCA at Point-of-Sale
Kirchner, T. R., Villanti, A. C., Tacelosky, M., Anesetti-rothermel, A., Gao, H., Pearson, J., Ganz, O., Cantrell, J., Vallone, D. M., & Abrams, D. B. (n.d.).Publication year
2015Journal title
Tobacco Regulatory ScienceVolume
1Issue
1Page(s)
24-35The impact of the tobacco retail outlet environment on adult cessation and differences by neighborhood poverty
AbstractCantrell, J., Anesetti-Rothermel, A., Pearson, J. L., Xiao, H., Vallone, D., & Kirchner, T. R. (n.d.).Publication year
2015Journal title
AddictionVolume
110Issue
1Page(s)
152-161AbstractAims: This study examined the impact of tobacco retail outlets on cessation outcomes over time among non-treatment-seeking smokers and assessed differences by neighborhood poverty and individual factors. Design: Observational longitudinal cohort study using geospatial data. We used generalized estimating equations to examine cessation outcomes in relation to the proximity and density of tobacco retail outlets near the home. Setting: Eight large Designated Media Areas across the United States. Participants: A total of 2377 baseline smokers followed over three waves from 2008 to 2010. Measurements: Outlet addresses were identified through North American Industry Classification System codes and proximity and density measures were constructed for each participant at each wave. Outcomes included past 30-day abstinence and pro-cessation attitudes. Findings: Smokers in high poverty census tracts living between 500m and 1.9km from an outlet were over two times more likely to be abstinent than those living fewer than 500m from an outlet (P<0.05). Density within 500m of home was associated with reduced abstinence [odds ratio (OR)=0.94; confidence interval (CI)=0.90, 0.98) and lower pro-cessation attitudes (Coeff=-0.07, CI=-0.10, -0.03) only in high poverty areas. In low poverty areas, density within 500m was associated with greater pro-cessation attitudes (OR=0.06; CI=0.01, 0.12). Gender, education and heaviness of smoking did not moderate the impact of outlet proximity and density on cessation outcomes. Conclusions: In the United States, density of tobacco outlets within 500m of the home residence appears to be negatively associated with smoking abstinence and pro-cessation attitudes only in poor areas.Tobacco retail outlet advertising practices and proximity to schools, parks and public housing affect Synar underage sales violations in Washington, DC
AbstractKirchner, T. R., Villanti, A. C., Cantrell, J., Anesetti-Rothermel, A., Ganz, O., Conway, K. P., Vallone, D. M., & Abrams, D. B. (n.d.).Publication year
2015Journal title
Tobacco controlVolume
24Page(s)
e52-e58AbstractObjective To examine the cross-sectional association between illicit sales of tobacco to minors, Washington DC tobacco outlet advertising practices, retail store type, the demographic make-up of the area surrounding each outlet, and the proximity of each outlet to high schools, recreational parks and public housing. Participants Seven hundred and fifty tobacco outlets in the DC area, n=347 of which were randomly selected for inspection by the Synar Inspection Program in 2009–2010. Main outcome measures The presence of tobacco advertisements on the interior and exterior of each outlet, and illicit tobacco sales to Synar Inspection Program youth volunteers. Results The presence of tobacco advertisements on the exterior of gas stations was much greater than on other retail store types (OR=6.68; 95% CI 4.05 to 11.01), as was the absence of any advertisements at bars or restaurants that sold tobacco (OR=0.33; 95% CI 0.22 to 0.52). Exterior tobacco advertisements were also more likely in predominantly African–American areas of the city (OR=3.11; 95% CI 2.28 to 4.25), and particularly likely on storefronts located closer to parks (OR=1.87; 95% CI 1.06 to 3.28). Illicit sales to minors were more common at gas stations (OR=3.01; 95% CI 1.5 to 6.3), outlets that displayed exterior tobacco advertisements closer to parks (OR=3.36; 95% CI 1.38 to 8.21), and outlets located closer to high schools in majority African– American block groups (OR=1.29; 95% CI 1.07 to 1.58). Conclusions Findings demonstrate that while illicit tobacco sales to minors are occurring at acceptably low rates by Synar standards, illicit sales vary considerably by retail store type, advertising approach and proximity to high schools, parks and African–American residential areas. Future work may help inform regulatory efforts to reduce youth access at the neighbourhood, city, state and national levels.Cameras for public health surveillance: A methods protocol for crowdsourced annotation of point-of-sale photographs
AbstractIlakkuvan, V., Tacelosky, M., Ivey, K. C., Pearson, J. L., Cantrell, J., Vallone, D. M., Abrams, D. B., & Kirchner, T. R. (n.d.).Publication year
2014Journal title
JMIR Research ProtocolsVolume
3Issue
2AbstractBackground: Photographs are an effective way to collect detailed and objective information about the environment, particularly for public health surveillance. However, accurately and reliably annotating (ie, extracting information from) photographs remains difficult, a critical bottleneck inhibiting the use of photographs for systematic surveillance. The advent of distributed human computation (ie, crowdsourcing) platforms represents a veritable breakthrough, making it possible for the first time to accurately, quickly, and repeatedly annotate photos at relatively low cost. Objective: This paper describes a methods protocol, using photographs from point-of-sale surveillance studies in the field of tobacco control to demonstrate the development and testing of custom-built tools that can greatly enhance the quality of crowdsourced annotation. Methods: Enhancing the quality of crowdsourced photo annotation requires a number of approaches and tools. The crowdsourced photo annotation process is greatly simplified by decomposing the overall process into smaller tasks, which improves accuracy and speed and enables adaptive processing, in which irrelevant data is filtered out and more difficult targets receive increased scrutiny. Additionally, zoom tools enable users to see details within photographs and crop tools highlight where within an image a specific object of interest is found, generating a set of photographs that answer specific questions. Beyond such tools, optimizing the number of raters (ie, crowd size) for accuracy and reliability is an important facet of crowdsourced photo annotation. This can be determined in a systematic manner based on the difficulty of the task and the desired level of accuracy, using receiver operating characteristic (ROC) analyses. Usability tests of the zoom and crop tool suggest that these tools significantly improve annotation accuracy. The tests asked raters to extract data from photographs, not for the purposes of assessing the quality of that data, but rather to assess the usefulness of the tool. The proportion of individuals accurately identifying the presence of a specific advertisement was higher when provided with pictures of the product's logo and an example of the ad, and even higher when also provided the zoom tool (χ2 2=155.7, P<.001). Similarly, when provided cropped images, a significantly greater proportion of respondents accurately identified the presence of cigarette product ads (χ2 1=75.14, P<.001), as well as reported being able to read prices (χ2 2=227.6, P<.001). Comparing the results of crowdsourced photo-only assessments to traditional field survey data, an excellent level of correspondence was found, with area under the ROC curves produced by sensitivity analyses averaging over 0.95, requiring on average 10 to 15 crowdsourced raters to achieve values of over 0.90. Results: Further testing and improvement of these tools and processes is currently underway. This includes conducting systematic evaluations that crowdsource photograph annotation and methodically assess the quality of raters' work. Conclusions: Overall, the combination of crowdsourcing technologies with tiered data flow and tools that enhance annotation quality represents a breakthrough solution to the problem of photograph annotation, vastly expanding opportunities for the use of photographs rich in public health and other data on a scale previously unimaginable.Cantrell et al. Respond
Cantrell, J., Kreslake, J., Ganz, O., Pearson, J. L., Vallone, D. M., Anesetti-Rothermel, A., Xiao, H., & Kirchner, T. R. (n.d.). In American journal of public health (1–).Publication year
2014Volume
104Issue
4Page(s)
e1-e2Crowdsourcing applications for public health
AbstractBrabham, D. C., Ribisl, K. M., Kirchner, T. R., & Bernhardt, J. M. (n.d.).Publication year
2014Journal title
American journal of preventive medicineVolume
46Issue
2Page(s)
179-187AbstractCrowdsourcing is an online, distributed, problem-solving, and production model that uses the collective intelligence of networked communities for specific purposes. Although its use has benefited many sectors of society, it has yet to be fully realized as a method for improving public health. This paper defines the core components of crowdsourcing and proposes a framework for understanding the potential utility of crowdsourcing in the domain of public health. Four discrete crowdsourcing approaches are described (knowledge discovery and management; distributed human intelligence tasking; broadcast search; and peer-vetted creative production types) and a number of potential applications for crowdsourcing for public health science and practice are enumerated.Longitudinal human mobility and real-time access to a national density surface of retail outlets
Kirchner, T., Gao, H., Anesetti-Rothermel, A., Carlos, H., & House, B. (n.d.).Publication year
2014Journal title
ACM Urban ComputingNicotine dependence, "background" and cue-induced craving and smoking in the laboratory
AbstractDunbar, M. S., Shiffman, S., Kirchner, T. R., Tindle, H. A., & Scholl, S. M. (n.d.).Publication year
2014Journal title
Drug and alcohol dependenceVolume
142Page(s)
197-203AbstractBackground: Nicotine dependence has been associated with higher "background" craving and smoking, independent of situational cues. Due in part to conceptual and methodological differences across past studies, the relationship between dependence and cue-reactivity (CR; e.g., cue-induced craving and smoking) remains unclear. Methods: 207 daily smokers completed six pictorial CR sessions (smoking, negative affect, positive affect, alcohol, smoking prohibitions, and neutral). Individuals rated craving before (background craving) and after cues, and could smoke following cue exposure. Session videos were coded to assess smoking. Participants completed four nicotine dependence measures. Regression models assessed the relationship of dependence to cue-independent (i.e., pre-cue) and cue-specific (i.e., pre-post cue change for each cue, relative to neutral) craving and smoking (likelihood of smoking, latency to smoke, puff count). Results: Dependence was associated with background craving and smoking, but did not predict change in craving across the entire sample for any cue. Among alcohol drinkers, dependence was associated with greater increases in craving following the alcohol cue. Only one dependence measure (Wisconsin Inventory of Smoking Dependence Motives) was consistently associated with smoking reactivity (higher likelihood of smoking, shorter latency to smoke, greater puff count) in response to cues. Conclusion: While related to cue-independent background craving and smoking, dependence is not strongly associated with laboratory cue-induced craving under conditions of minimal deprivation. Dependence measures that incorporate situational influences on smoking correlate with greater cue-provoked smoking. This may suggest independent roles for CR and traditional dependence as determinants of smoking, and highlights the importance of assessing behavioral CR outcomes.Rapid grading of fundus photographs for diabetic retinopathy using crowdsourcing
AbstractBrady, C. J., Villanti, A. C., Pearson, J. L., Kirchner, T. R., Gupta, O. P., & Shah, C. P. (n.d.).Publication year
2014Journal title
Journal of medical Internet researchVolume
16Issue
10AbstractBackground: Screening for diabetic retinopathy is both effective and cost-effective, but rates of screening compliance remain suboptimal. As screening improves, new methods to deal with screening data may help reduce the human resource needs. Crowdsourcing has been used in many contexts to harness distributed human intelligence for the completion of small tasks including image categorization. Objective: Our goal was to develop and validate a novel method for fundus photograph grading. Methods: An interface for fundus photo classification was developed for the Amazon Mechanical Turk crowdsourcing platform. We posted 19 expert-graded images for grading by Turkers, with 10 repetitions per photo for an initial proof-of-concept (Phase I). Turkers were paid US $0.10 per image. In Phase II, one prototypical image from each of the four grading categories received 500 unique Turker interpretations. Fifty draws of 1-50 Turkers were then used to estimate the variance in accuracy derived from randomly drawn samples of increasing crowd size to determine the minimum number of Turkers needed to produce valid results. In Phase III, the interface was modified to attempt to improve Turker grading. Results: Across 230 grading instances in the normal versus abnormal arm of Phase I, 187 images (81.3%) were correctly classified by Turkers. Average time to grade each image was 25 seconds, including time to review training images. With the addition of grading categories, time to grade each image increased and percentage of images graded correctly decreased. In Phase II, area under the curve (AUC) of the receiver-operator characteristic (ROC) indicated that sensitivity and specificity were maximized after 7 graders for ratings of normal versus abnormal (AUC=0.98) but was significantly reduced (AUC=0.63) when Turkers were asked to specify the level of severity. With improvements to the interface in Phase III, correctly classified images by the mean Turker grade in four-category grading increased to a maximum of 52.6% (10/19 images) from 26.3% (5/19 images). Throughout all trials, 100% sensitivity for normal versus abnormal was maintained. Conclusions: With minimal training, the Amazon Mechanical Turk workforce can rapidly and correctly categorize fundus photos of diabetic patients as normal or abnormal, though further refinement of the methodology is needed to improve Turker ratings of the degree of retinopathy. Images were interpreted for a total cost of US $1.10 per eye. Crowdsourcing may offer a novel and inexpensive means to reduce the skilled grader burden and increase screening for diabetic retinopathy.Cue reactivity in non-daily smokers: Effects on craving and on smoking behavior
AbstractShiffman, S., Dunbar, M. S., Kirchner, T. R., Li, X., Tindle, H. A., Anderson, S. J., Scholl, S. M., & Ferguson, S. G. (n.d.).Publication year
2013Journal title
PsychopharmacologyVolume
226Issue
2Page(s)
321-333AbstractRationale: Non-daily, or intermittent smokers (ITS), are increasingly prevalent. Their smoking may be more situational than that of daily smokers (DS), and thus is hypothesized to be more influenced by cues. Objectives: To assess ITS' response to cues, and compare it to that of DS. Methods: Samples of 239 ITS and 207 DS (previously reported in Shiffman et al. 2012a) were studied in 2,586 laboratory cue-reactivity sessions. Craving (Questionnaire of Smoking Urges) and smoking (probability, latency, puff parameters, and carbon monoxide increases) in response to cues was assessed following exposure to neutral cues and cues related to smoking, alcohol, negative affect, positive affect, and smoking prohibitions. Mixed effects models, generalized estimating equations and random-effects survival analyses were used to assess response to cues and differences between DS and ITS. Results: ITS' craving increased following exposure to smoking and alcohol cues and decreased following positive affect cues, but cues had little effect on smoking behaviors. Cue reactivity was similar in ITS and DS. Among ITS, craving intensity predicted smoking probability, latency, and intensity, and the effects on latency were stronger among ITS than DS. Conclusions: Contrary to hypotheses, ITS were not more responsive to laboratory cues than DS. Results show that ITS do experience craving and craving increases that are then associated with smoking.Ecological Momentary Assessment
AbstractKirchner, T. R., & Shiffman, S. (n.d.). In The Wiley-Blackwell Handbook of Addiction Psychopharmacology (1–).Publication year
2013Page(s)
541-565AbstractThis chapter addresses application of ecological momentary assessment (EMA) to substance use research, outlining principles of EMA design and analysis, and illustrates them with examples. It considers the way technological innovations are facilitating the rapid evolution of EMA systems, and provides recommendations on current best practices. The chapter reviews data on methodological issues such as compliance and reactivity. EMA sampling design focuses on the way assessments of individual- and systems-level processes are distributed over time and space. EMA methods reveal substance use patterns not captured by questionnaires or retrospective data, and hold great promise for substance use research and treatment. As EMA methods are further developed and broadly applied, they offer even more detailed insight into substance use and abuse. Further, application of EMA approaches to on-the-spot intervention with substance users holds potential to revolutionize treatment delivery. This edition first published 2013Geospatial exposure to point-of-sale tobacco: Real-time craving and smoking-cessation outcomes
AbstractKirchner, T. R., Cantrell, J., Anesetti-Rothermel, A., Ganz, O., Vallone, D. M., & Abrams, D. B. (n.d.).Publication year
2013Journal title
American journal of preventive medicineVolume
45Issue
4Page(s)
379-385AbstractBackground: Little is known about the factors that drive the association between point-of-sale marketing and behavior, because methods that directly link individual-level use outcomes to real-world point-of-sale exposure are only now beginning to be developed. Purpose: Daily outcomes during smoking cessation were examined as a function of both real-time geospatial exposure to point-of-sale tobacco (POST) and subjective craving to smoke. Methods: Continuous individual geospatial location data collected over the first month of a smoking-cessation attempt in 2010-2012 (N=475) were overlaid on a POST outlet geodatabase (N=1060). Participants' mobility data were used to quantify the number of times they came into contact with a POST outlet. Participants recorded real-time craving levels and smoking status via ecological momentary assessment (EMA) on cellular telephones. Results: The final data set spanned a total of 12,871 days of EMA and geospatial tracking. Lapsing was significantly more likely on days with any POST contact (OR=1.19, 95% CI=1.18, 1.20), and increasingly likely as the number of daily POST contacts increased (OR=1.07, 95% CI=1.06, 1.08). Overall, daily POST exposure was significantly associated with lapsing when craving was low (OR=1.22, 95% CI=1.20, 1.23); high levels of craving were more directly associated with lapse outcomes. Conclusions: These data shed light on the way mobility patterns drive a dynamic interaction between individuals and the POST environment, demonstrating that quantification of individuals' exposure to POST marketing can be used to identify previously unrecognized patterns of association among individual mobility, the built environment, and behavioral outcomes.Marketing little cigars and cigarillos: Advertising, price, and associations with neighborhood demographics
AbstractCantrell, J., Kreslake, J. M., Ganz, O., Pearson, J. L., Vallone, D., Anesetti-Rothermel, A., Xiao, H., & Kirchner, T. R. (n.d.).Publication year
2013Journal title
American journal of public healthVolume
103Issue
10Page(s)
1902-1909AbstractObjectives. We have documented little cigar and cigarillo (LCC) availability, advertising, and price in the point-of-sale environment and examined associations with neighborhood demographics. Methods. We used a multimodal real-time surveillance system to survey LCCs in 750 licensed tobacco retail outlets that sold tobacco products in Washington, DC. Using multivariate models, we examined the odds of LCC availability, the number of storefront exterior advertisements, and the price per cigarillo for Black & Mild packs in relation to neighborhood demographics. Results. The odds of LCC availability and price per cigarillo decreased significantly in nearly a dose-response manner with each quartile increase in proportion of African Americans. Prices were also lower in some young adult neighborhoods. Having a higher proportion of African American and young adult residents was associated with more exterior LCC advertising. Conclusions. Higher availability of LCCs in African American communities and lower prices and greater outdoor advertising in minority and young adult neighborhoods may establish environmental triggers to smoke among groups susceptible to initiation, addiction, and long-term negative health consequences.Smoker reactivity to cues: Effects on craving and on smoking behavior
AbstractShiffman, S., Dunbar, M., Kirchner, T., Li, X., Tindle, H., Anderson, S., & Scholl, S. (n.d.).Publication year
2013Journal title
Journal of abnormal psychologyVolume
122Issue
1Page(s)
264-280AbstractWe assessed craving and smoking in response to smoking-relevant cues. Two hundred seven daily smokers viewed images related to 1 of 6 cue sets (cigarettes, positive and negative affect, alcohol, smoking prohibitions, and neutral cues) in separate sessions. Compared with neutral cues, cigarette cues significantly increased craving, and positive affect cues significantly decreased craving. When subjects were then allowed to smoke during continuing cue exposure, cues did not affect the likelihood of smoking or the amount smoked (number of cigarettes, number of puffs, puff time, or increased carbon monoxide). However, craving intensity predicted likelihood of smoking, latency to smoke, and amount smoked, with craving increases after cue exposure making significant independent contributions. Some craving effects were curvilinear, suggesting that they are subject to thresholds and might not be observed under some circumstances.Alcohol and Group Formation: A Multimodal Investigation of the Effects of Alcohol on Emotion and Social Bonding
AbstractSayette, M. A., Creswell, K. G., Dimoff, J. D., Fairbairn, C. E., Cohn, J. F., Heckman, B. W., Kirchner, T. R., Levine, J. M., & Moreland, R. L. (n.d.).Publication year
2012Journal title
Psychological ScienceVolume
23Issue
8Page(s)
869-878AbstractWe integrated research on emotion and on small groups to address a fundamental and enduring question facing alcohol researchers: What are the specific mechanisms that underlie the reinforcing effects of drinking? In one of the largest alcohol-administration studies yet conducted, we employed a novel group-formation paradigm to evaluate the socioemotional effects of alcohol. Seven hundred twenty social drinkers (360 male, 360 female) were assembled into groups of 3 unacquainted persons each and given a moderate dose of an alcoholic, placebo, or control beverage, which they consumed over 36 min. These groups' social interactions were video recorded, and the duration and sequence of interaction partners' facial and speech behaviors were systematically coded (e.g., using the Facial Action Coding System). Alcohol consumption enhanced individual- and group-level behaviors associated with positive affect, reduced individual-level behaviors associated with negative affect, and elevated self-reported bonding. Our results indicate that alcohol facilitates bonding during group formation. Assessing nonverbal responses in social contexts offers new directions for evaluating the effects of alcohol.Relapse dynamics during smoking cessation: recurrent abstinence violation effects and lapse-relapse progression.
AbstractKirchner, T. R., Shiffman, S., & Wileyto, E. P. (n.d.).Publication year
2012Journal title
Journal of abnormal psychologyVolume
121Issue
1Page(s)
187-197AbstractSmoking cessation is a process that unfolds over time and is characterized by intermittent lapses. We used parametric recurrent event survival analyses to better understand the dynamic relationship between a set of Abstinence Violation Effect (AVE, Marlatt & Gordon, 1985) responses to lapsing and subsequent lapse-relapse progression. Participants were 203 smokers who achieved abstinence and responded to items assessing three core components of the AVE (internal attribution, abstinence self-efficacy and guilt) following a total of 1,001 lapse episodes in near real time. Neither self-blame, self-efficacy, nor guilt following participants' first lapse predicted relapse. Controlling for responses to their first lapse, responses to each additional lapse did prospectively predict lapse progression, such that drops in self-efficacy were associated with accelerated progression to a subsequent lapse (HR = 1.09, CI = 1.02-1.15), while increases in internal attributions of blame actually protected against lapsing (HR = 0.98, CI = 0.97-0.99). Treatment with nicotine patches slowed recurrent lapse progression (HR = 0.58, CI = 0.48-0.70), but this effect dissipated over multiple lapses, and was moderated by elevated ratings of postlapse guilt (HR = 1.08, CI = 1.01-1.18), which predicted accelerated progression within the active patch group, while protecting against lapse in the placebo group. Results highlight the dynamic nature of lapse responses during smoking cessation, indicating that self-efficacy predicts progression from one lapse to the next, while attributions of self-blame and guilt influenced progression in unexpected ways. PsycINFO Database Record (c) 2012 APA, all rights reserved.Do smokers crave cigarettes in some smoking situations more than others? Situational correlates of craving when smoking
AbstractDunbar, M. S., Scharf, D., Kirchner, T., & Shiffman, S. (n.d.).Publication year
2010Journal title
Nicotine and Tobacco ResearchVolume
12Issue
3Page(s)
226-234AbstractIntroduction: Smokers tend to smoke when experiencing craving, but even within smoking occasions, craving may vary. We examine variations in craving when people were smoking in various real-world situations. Methods: Using Ecological Momentary Assessment, 394 smokers recorded smoking, craving, and smoking context in real time on electronic diaries over 2 weeks of ad libitum smoking. Assessments occurred immediately prior to smoking. Mixed modeling was used to analyze associations between craving and situational variables. Results: Craving varied across smoking situations, but the differences were small (<1 on a 0-10 scale). Specifically, craving was higher in smoking situations where smoking was restricted, likely because high craving leads smokers to violate restrictions. Controlling for restrictions, craving was higher when cigarettes were smoked while eating or drinking, were with other people (vs. alone), were in a group of people (vs. other people simply in view), during work (vs. leisure), and during activity (vs. inactivity). In addition, craving was higher for cigarettes smoked early in the day. No differences in craving were observed in relation to drinking alcohol or caffeine (vs. doing anything else), being at work (vs. home), being at a bar or restaurant (vs. all other locations), interacting with others (vs. not interacting), or other people smoking (vs. no others smoking). Discussion: Even though most craving reports prior to smoking were high, and situations were thus expected to have little influence on craving, results suggest that some cigarettes are craved more than others across different smoking situations, but differences are small.Cigarette-by-Cigarette Satisfaction During Ad Libitum Smoking
AbstractShiffman, S., & Kirchner, T. R. (n.d.).Publication year
2009Journal title
Journal of abnormal psychologyVolume
118Issue
2Page(s)
348-359AbstractSmoking is thought to produce immediate reinforcement, and subjective satisfaction with smoking is thought to influence subsequent smoking. The authors used ecological momentary assessment (A. A. Stone & S. Shiffman, 1994) to assess cigarette-by-cigarette smoking satisfaction in 394 heavy smokers who subsequently attempted to quit. Across 14,882 cigarettes rated, satisfaction averaged 7.06 (0-10 scale), but with considerable variation across cigarettes and individuals. Women and African American smokers reported higher satisfaction. More satisfied smokers were more likely to lapse after quitting (HR = 1.1, p < .03), whereas less satisfied smokers derived greater benefit from patch treatment to help them achieve abstinence (HR = 1.23, p < .001). Cigarettes smoked in positive moods were more satisfying, correcting for mood at the time of rating. The best predictor of subsequent smoking satisfaction was the intensity of craving prior to smoking. Understanding subjective smoking satisfaction provides insight into sources of reinforcement for smoking.