David B Abrams

David Abrams
David Abrams
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Professor of Social and Behavioral Sciences

Professional overview

Dr. David Abrams' career focuses on systems and social learning frameworks to inform population health enhancement. He has experience in testing theory, research design, measuring mechanisms of behavior change and outcome, and evaluating clinical trials (behavioral and pharmacological). His interests span topics from basic bio-behavioral mechanisms and clinical treatments to policy across risk factors and behaviors (e.g. tobacco/nicotine; alcohol, obesity, co-morbidity of medical and mental health), disease states (cancer; cardiovascular; HIV-AIDS), levels (biological, individual, organizational, worksite, community, global, and internet based), populations and disparities. His interests converge in the domain of implementation science to cost-efficiently inform evidence-based public health practice and policymaking.

Through transdisciplinary and translational research strategies, Dr. Abrams provides scientific leadership in tobacco control. His current focus is in strengthening global and United States tobacco and nicotine management strategies. Deaths of 1 billion smokers are estimated by 2100 caused overwhelmingly by use of combustible (smoked) tobacco products, not nicotine. Harm minimization is a key overarching systems strategy to speed the net public health benefit of emergent disruptive technologies for cleaner nicotine delivery. The goal is more rapid elimination of preventable deaths, disease burdens, and the widening gap in health disparities driven disproportionately by disparities in smoking.

Dr. Abrams was a professor and founding director of the Centers for Behavioral and Preventive Medicine at Brown University Medical School. He then directed the Office of Behavioral and Social Sciences Research at the National Institutes of Health (NIH). Until 2017, he was Professor of Health Behavior and Society at Johns Hopkins Bloomberg School of Public Health and the founding Executive Director of the Schroeder National Institute of Tobacco Research and Policy Studies at Truth Initiative (formerly the American Legacy Foundation).

Dr. Abrams has published over 250 peer reviewed scholarly articles and been a Principal Investigator on numerous NIH grants. He is lead author of The Tobacco Dependence Treatment Handbook: A Guide to Best Practices. He has served on expert panels at NIH and National Academies of Sciences, Engineering and Medicine on Obesity, Alcohol Misuse and Ending the Tobacco Problem: A Blueprint for the Nation. He has also served on the Board of Scientific Advisors of the National Cancer Institute (NIH-NCI) and was President of the Society of Behavioral Medicine.

For a complete list of Dr. Abrams' published work, click here.

Education

BSc (Hons), Psychology and Computer Science, University of the Witwatersrand, Johannesburg, South Africa
MS, Clinical Psychology, Rutgers University, New Brunswick, NJ
PhD, Clinical Psychology, Rutgers University, New Brunswick, NJ
Postdoctoral Fellow, Brown Medical School, Providence, RI

Honors and awards

Research Laureate Award, American Academy of Health Behavior (2014)
Joseph W. Cullen Memorial Award for Tobacco Research, American Society for Preventive Oncology (2008)
Distinguished Alumni Award: Rutgers University, The Graduate School, New Brunswick, NJ (2007)
The Musiker-Miranda Distinguished Service Award, American Psychological Association (2006)
Distinguished Service Award, Society of Behavioral Medicine (2006)
Outstanding Research Mentor Award, Society of Behavioral Medicine (2006)
Book of the Year Award: Tobacco Dependence Treatment Handbook. American Journal of Nursing (2005)
Distinguished Scientist Award, Society of Behavioral Medicine (1998)

Areas of research and study

Behavioral Science
Chronic Diseases
Evaluations
Implementation and Impact of Public Health Regulations
Implementation science
Population Health
Public Health Pedagogy
Public Health Systems
Research Design
Systems Integration
Systems Interventions
Tobacco Control
Translational science

Publications

Publications

Human immunodeficiency virus infection, AIDS, and smoking cessation: The time is now

Niaura, R., Shadel, W. G., Morrow, K., Tashima, K., Flanigan, T., & Abrams, D. B. (n.d.).

Publication year

2000

Journal title

Clinical Infectious Diseases

Volume

31

Issue

3

Page(s)

808-812
Abstract
Abstract
Treatments for persons who are infected with human immunodeficiency virus (HIV) or who have developed AIDS have advanced to the point where death is no longer the inevitable outcome of diagnosis. Combination antiretroviral therapy has made HIV infection less of a terminal condition and more of a medically manageable chronic disease. Thus, efforts to improve the health status and quality of life of HIV-infected persons have become one of the highest treatment priorities for the next decade. Cigarette smoking is highly prevalent among HIV-infected persons, and quitting smoking would greatly improve the health status of these individuals. However, to date, no studies have evaluated the efficacy of a smoking-cessation intervention specifically tailored to this population. This article reviews the evidence and rationale for advancing smoking-cessation treatments specifically tailored to the needs of HIV-infected persons and provides recommendations for future treatment studies.

Introduction to tobacco, nicotine, and youth: The Tobacco Etiology Research Network

Clayton, R. R., Ries Merikangas, K., & Abrams, D. B. (n.d.).

Publication year

2000

Journal title

Drug and alcohol dependence

Volume

59

Page(s)

1-4

Predicting increases in readiness to quit smoking: A prospective analysis using the contemplation ladder

Herzog, T. A., Abrams, D. B., Emmons, K. M., & Linnan, L. (n.d.).

Publication year

2000

Journal title

Psychology and Health

Volume

15

Issue

3

Page(s)

369-381
Abstract
Abstract
Most smokers are not motivated to quit. The transtheoretical model posits mechanisms (processes of change and pros and cons) by which smokers might increase their stage of readiness to quit. While cross-sectional relationships among the stages of change, processes of change, and pros and cons are well established, there is little evidence that processes of change and pros and cons predict progressive stage movements. This study uses data from a large worksite-based cancer prevention study (the Working Well Trial) to test the hypothesis that processes of change and the pros and cons of smoking predict progressive movement up the contemplation ladder, which is an alternative measure of motivation to quit smoking based on social cognitive theory. The results indicate that experiential processes of change promote increases in readiness to quit smoking. This study provides further evidence for the predictive validity of the contemplation ladder and sheds light on how unmotivated, nonvolunteer smokers can be motivated to consider cessation.

Smoking withdrawal dynamics in unaided quitters

Piasecki, T. M., Niaura, R., Shadel, W. G., Abrams, D., Goldstein, M., Fiore, M. C., & Baker, T. B. (n.d.).

Publication year

2000

Journal title

Journal of abnormal psychology

Volume

109

Issue

1

Page(s)

74-86
Abstract
Abstract
Considerable research shows that withdrawal severity is inconsistently related to smoking cessation outcomes. This may result from measurement problems or failure to scrutinize important dimensions of the withdrawal experience. Two recent studies demonstrated that withdrawal elevation and variations in the time course of withdrawal were related to relapse in smokers treated with the nicotine patch (T. M. Piasecki, M. C. Fiore, and T. B. Baker, 1998). This article reports a conceptual replication and extension of those findings in unaided quitters. Evidence for temporal heterogeneity was found across different types of withdrawal symptoms. Patterns or slopes of affect and urge reports over time predicted smoking status at follow-up, as did mean elevation in withdrawal symptoms. These results suggest that affect and urge withdrawal symptoms make independent contributions to relapse and that relapse is related to both symptom severity and trajectory.

Stages of change versus addiction: A replication and extension

Abrams, D. B., Herzog, T. A., Emmons, K. M., & Linnan, L. (n.d.).

Publication year

2000

Journal title

Nicotine and Tobacco Research

Volume

2

Issue

3

Page(s)

223-229
Abstract
Abstract
Data from the Working Well trial (n = 2379) were used to test the capacity of 19 variables to predict smoking cessation at 1- and 2-year follow-ups. Among the core constructs of transtheoretical model (TTM), stage of change was the best predictor. The processes of change and the pros and cons of smoking were relatively ineffective predictors. Among other variables, self-efficacy, cigarettes per day, duration of longest quit attempt during the previous year, and the contemplation ladder were the most effective stand-alone predictors. A composite of cigarettes per day and quit duration was particularly effective for predicting cessation. Consistent with Farkas et al. (Farkas AJ, Pierce JP, Zhu SH, Rosbrook B, Gilpin EA, Berry C, Kaplan RM, Addiction 91:1271-1280, 1996), multivariate analyses including the composite variable (cigarettes per day and quit duration) and the stages of change revealed the composite variable to be the better predictor of cessation.

The use of nicotine replacement therapy during hospitalization

Emmons, K. M., Goldstein, M. G., Roberts, M., Cargill, B., Sherman, C. B., Millman, R., Brown, R., & Abrams, D. B. (n.d.).

Publication year

2000

Journal title

Annals of Behavioral Medicine

Volume

22

Issue

4

Page(s)

325-329
Abstract
Abstract
Recent findings suggest that smokers who are hospitalized experience significant craving for cigarettes. Thus, nicotine replacement therapy (NRT) may be a particularly important tool for use during hospitalization. The goal of this study is to evaluate the utilization of the transdermal nicotine patch and/or nicotine gum by hospitalized smokers. The data represented in this article are from 580 smokers who participated in a study of a motivational intervention for smoking cessation that was delivered during hospitalization. The primary outcome for this analysis was use of NRT during hospitalization. The results revealed that, among the entire sample, only 7.1% of the overall sample used NRT during hospitalization; 6% of the hospitalized smokers used the transdermal nicotine patch, and 1.1% used nicotine gum. Use of NRT was significantly greater among patients who reported that they were doing anything to help themselves quit smoking at the time of admission (OR = 4.1), those who were seriously planning to quit smoking within the next 30 days (OR = 2.36), those who were nicotine dependent (OR = 2.81), and those for whom a physician had ever offered to prescribe NRT (OR = 1.9). The finding that there is a very low rate of NRT use during hospitalization provides important information to hospital-based care providers and smoking cessation intervention planners. Barriers to NRT use among hospitalized patients should be identified, and strategies designed to maximize use when appropriate. The AHCPR Guideline on Smoking Cessation recommends routine use of NRT in health care settings. Further research is needed to determine why NRT use was so low. In addition, these data suggest that efforts to increase NRT use during hospitalization are needed.

Transdisciplinary concepts and measures of craving: Commentary and future directions

Abrams, D. B. (n.d.).

Publication year

2000

Journal title

Addiction

Volume

95

Page(s)

S237-246
Abstract
Abstract
A new theoretical model of craving is needed that uses a common language and standardized measures. The new conceptual model must fully integrate discoveries from cellular biology, neuroscience, animal and human laboratory, cognitive-behavioral social learning and socio-cultural disciplines. A transdisciplinary synthesis can then guide methods and measurement development. Mapping the structural pathways and interactions among mediators and moderators of craving will improve the diagnostic and prognostic tools in order to inform new treatments and prevention strategies.

A prospective analysis of change in multiple risk factors for cancer

Emmons, K. M., Shadel, W. G., Linnan, L., Marcus, B. H., & Abrams, D. B. (n.d.).

Publication year

1999

Journal title

Cancer Research Therapy and Control

Volume

8

Issue

1

Page(s)

15-23
Abstract
Abstract
Problem: Cancer risk is increased among individuals who have more than one behavioral risk factor. The purpose of this paper is to expand our understanding of how risk factors co-occur by evaluating longitudinal changes in and predictors of naturalistic change in behavioral risk factors. Methods: The data presented in this paper were drawn from 1288 employees in the 12 standard care worksites that participated in the Working Healthy Project (WHP), a large randomized trial of worksite health promotion. Results: At baseline, the majority of the sample had two or more risk factors. At the final survey, there were very small changes in the overall risk factor profile among the entire sample. However, significant change occurred within baseline risk factor groups. Significant relationships between risk factors were also found. Conclusions: Multiple risk factors are prevalent, and little is known about how to best impact on risk profiles. Use of a multiple risk factor index score, that will allow investigators to begin to assess the impact of interventions on change in overall risk, may be an important part of efforts to develop more effective methods for reducing multiple risk factors for chronic disease.

Behavioral medicine strategies: Management of nicotine dependence, obesity, and cardiopulmonary rehabilitation exercise

Abrams, D., & Al., . (n.d.). In A. Stoudemire, B. Fogel, & D. Greenberg (Eds.), Psychiatric care of the medical patient (2nd eds., 1–).

Publication year

1999

Binge eating, body image, depression, and self-efficacy in an obese clinical population

Cargill, B. R., Clark, M. M., Pera, V., Niaura, R. S., & Abrams, D. B. (n.d.).

Publication year

1999

Journal title

Obesity Research

Volume

7

Issue

4

Page(s)

379-386
Abstract
Abstract
Objective: Binge eating disorder appears to be an important factor in obesity treatment. Researchers have proposed that specialized treatment programs be developed to address chronic binge eating behavior. This study was conducted to examine the relationships between binge eating, depression, body image, and self-efficacy. Based on related research, it was hypothesized that depression and negative body image would be greater for binge eaters whereas weight self-efficacy would be lower. Research Methods and Procedures: Subjects were 159 clinic patients participating in a multidisciplinary weight management program. Baseline measurements of binge eating status, body image and related eating behaviors, depression, and self-efficacy were obtained, whereas follow-up measures consisted of weight loss and attendance. Exploratory factor analyses were performed to obtain factors for items contained in the Eating Habits Questionnaire. Chisquare, t-tests, and logistic regression analyses determined relationships between binge eating, body image, depression, and self-efficacy. Results: Univariate comparisons indicated that increased perceptions of poor body image were significantly related to binge eating. Higher levels of depression and lower weight self-efficacy were related to binge eating, but the results were qualified after applying corrective statistics for multiple comparisons. A stepwise regression analysis indicated that body image, particularly characterized by a sense of shame and concern with public appearance, had the strongest relationship to binge eating among all the factors examined in this study. Discussion: These findings extend current understanding of the relationships between binge eating, body image, depression, and self-efficacy. The significance of body image, especially in relation to negative social consciousness, was determined when comparing several psychological and behavioral factors thought to influence binge eating. Further research is needed to determine the causal relationships between binge eating and the other factors examined in this study.

Challenges and future directions for tailored communication research

Abrams, D. B., Mills, S., & Bulger, D. (n.d.).

Publication year

1999

Journal title

Annals of Behavioral Medicine

Volume

21

Issue

4

Page(s)

299-306
Abstract
Abstract
As informatics technology advances, a growing number of research trials on tailored communications provide an accumulation of promising evidence to support their efficacy. These trials also reveal gaps and opportunities for future research. The scope and boundaries of tailoring must be redefined in terms of both new technology and the trade-offs between complexity, demand burden on participants, and the minimal information required for effective and efficient tailoring. Basic and methods research is needed to broaden theory, develop a common language, standardize measures, and isolate the key mediating mechanisms that facilitate tailored communications. Applied research must consider more rigorous research designs for efficacy trials and conduct more effectiveness trials to investigate the mechanisms of technology transfer to enhance large-scale diffusion of tailored communications. The role of contextual variables needs to be examined, as well as their interaction with different population groups, and also the channels, modes, and methods of tailored message delivery. Research is also needed on the feasibility of tailoring across clusters of multiple risk factors to identify the commonalities, differences, and interrelations among diverse behaviors. The potential cost-effectiveness of tailored communications must also be examined. No matter how efficacious, tailored communications delivered to large populations (i.e. mass-customization) will not make a public health impact unless proven to be practical and cost-efficient.

Cue exposure treatment for smoking relapse prevention: A controlled clinical trial

Niaura, R., Abrams, D. B., Shadel, W. G., Rohsenow, D. J., Monti, P. M., & Sirota, A. D. (n.d.).

Publication year

1999

Journal title

Addiction

Volume

94

Issue

5

Page(s)

685-695
Abstract
Abstract
Aims. In an additive design, test the efficacy of cue exposure treatment for smoking relapse prevention as an adjunct to current standard cognitive behavioral and pharmacological treatments. Design. Randomized, controlled clinical trial. Setting. Outpatient behavioral medicine clinic. Participants. One hundred and twenty-nine cigarette smokers recruited through newspaper advertisements. Intervention. After receiving an initial counseling session for cessation and setting a quit day, 129 smokers were randomly assigned to one of four relapse prevention treatment conditions: (1) brief cognitive behavioral; (2) cognitive behavioral and nicorette gum; (3) cognitive behavioral and cue exposure; and (4) cognitive behavioral and cue exposure with nicorette gum. All smokers met individually with their counselor for six RP sessions. Measures. Seven-day, point-prevalence abstinence rates (CO verified) taken at 1, 3, 6 and 12-months post-treatment and time to first slip. Findings. All manipulation checks and process measures suggested that the treatments were delivered as intended. There were no significant differences between conditions in point-prevalence abstinence rates or in time to first slip. Conclusions. These, results call into question the utility of cue exposure treatment for smoking relapse prevention.

Do processes of change predict smoking stage movements? A prospective analysis of the transtheoretical model

Herzog, T. A., Abrams, D. B., Emmons, K. M., Linnan, L. A., & Shadel, W. G. (n.d.).

Publication year

1999

Journal title

Health Psychology

Volume

18

Issue

4

Page(s)

369-375
Abstract
Abstract
The transtheoretical model (TTM) posits that processes of change and the pros and cons of smoking predict progressive movement through the stages of change. This study provides both a cross-sectional replication and a prospective test of this hypothesis. As part of a larger study of worksite cancer prevention (the Working Well Trial), employees of 26 manufacturing worksites completed a baseline and 2 annual follow-up surveys. Of the 63% of employees completing baseline surveys, 27.7% were smokers (N = 1,535), and a cohort of these smokers completed the 2-year follow-up. Cross-sectional results replicated previous studies with virtually all the processes of change and the cons of smoking increasing in linear fashion from precontemplation to preparation (all ps < .00001), and the pros of smoking decreasing (p < .01). However, contrary to the hypothesis, the baseline processes of change and the pros and cons of smoking failed to predict progressive stage movements at either the 1- or the 2-year follow-ups. Possible explanations for these findings and concerns about the conceptual internal consistency of the TTM are discussed.

History and symptoms of depression among smokers during a self-initiated quit attempt

Niaura, R., Britt, D. M., Borrelli, B., Shadel, W. G., Abrams, D. B., & Goldstein, M. G. (n.d.).

Publication year

1999

Journal title

Nicotine and Tobacco Research

Volume

1

Issue

3

Page(s)

251-257
Abstract
Abstract
History of depression in smokers has been associated with an inability to quit smoking and with an increased likelihood of smoking relapse. This study prospectively tracked nicotine withdrawal symptoms, symptoms of depression, and ability to quit smoking between smokers with and without a probable history of major depression who were trying to quit smoking with minimal assistance. Results indicated that prior to quitting, smokers with a history of depression smoked to reduce negative affect, in response to craving, and in social situations. Additionally, positive history smokers scored higher on the Center for Epidemiological Studies Depression Scale (CES-D) than did smokers without such a history. Following a quit attempt, positive history smokers were somewhat more likely to experience greater symptoms of nicotine withdrawal than negative history smokers. However, among the positive history smokers, depressive symptoms as measured by the CES-D increased significantly 4 weeks after trying to quit, compared to a decline among negative history smokers. Positive and negative history smokers did not significantly differ on ability to quit smoking within the 30-day follow-up period. History of depression appears to be associated with a delayed increase in symptoms of depression following a quit attempt. However, it remains to be demonstrated whether such an increase in depressive symptoms may influence later probability of relapse.

Increasing the impact of nicotine dependence treatment: Conceptual and practical considerations in a stepped care plus treatment-matching approach

Abrams, D., Clark, M., & King, T. (n.d.). In J. Tucker, D. Donovan, & A. Marlatt (Eds.), Changing addictive behavior: Moving beyond therapy-assisted change (1–).

Publication year

1999

Naltrexone's effect on cue-elicited craving among alcoholics in treatment

Monti, P. M., Rohsenow, D. J., Hutchison, K. E., Swift, R. M., Mueller, T. I., Colby, S. M., Brown, R. A., Gulliver, S. B., Gordon, A., & Abrams, D. B. (n.d.).

Publication year

1999

Journal title

Alcoholism: Clinical and Experimental Research

Volume

23

Issue

8

Page(s)

1386-1394
Abstract
Abstract
Background: Advancing knowledge of biobehavioral effects of interventions can result in improved treatments. Thus, a standardized laboratory cue reactivity assessment has been developed and validated to assess the cognitive and psychophysiological responses to a simulated high- risk situation: alcohol cues. The present study investigates the effects of a pharmacotherapy (naltrexone) on a laboratory-based, cue-elicited urge to drink among abstinent alcoholics in treatment. Methods: Alcohol-dependent subjects were randomized to 12 weeks of naltrexone or placebo after completing a partial hospital program. After ~1 week on medication, all received cue reactivity assessment. Results: Significantly fewer patients taking naltrexone reported any urge to drink during alcohol exposure than did those on placebo. Those with any urges reported no decrement in level of the urges. Mean arterial pressure decreased significantly for those on placebo, but not for those on naltrexone, whereas cue-elicited decreases in heart rate were not affected by the medication. Conclusions: The results have implications for models of relapse and naltrexone's effects. Cue reactivity methodology has utility for investigating hypothesized mediators of therapeutic effects of pharmacotherapies as well as behavioral treatments.

Nicotine addiction: paradigms for research in the 21st century

Abrams, D. B. (n.d.).

Publication year

1999

Journal title

Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco

Volume

1

Page(s)

S211-215

The efficacy of exercise as an aid for smoking cessation in women: A randomized controlled trial

Marcus, B. H., Albrecht, A. E., King, T. K., Parisi, A. F., Pinto, B. M., Roberts, M., Niaura, R. S., & Abrams, D. B. (n.d.).

Publication year

1999

Journal title

Archives of Internal Medicine

Volume

159

Issue

11

Page(s)

1229-1234
Abstract
Abstract
Background: Smoking prevalence rates among women are declining at a slower rate than among men. Objective: To determine if exercise, a healthful alternative to smoking, enhances the achievement and maintenance of smoking cessation. Methods: Two hundred eighty-one healthy, sedentary female smokers were randomly assigned to either a cognitive-behavioral smoking cessation program with vigorous exercise (exercise) or to the same program with equal staff contact time (control). Subjects participated in a 12-session, group- based smoking cessation program. Additionally, exercise subjects were required to attend 3 supervised exercise sessions per week and control subjects were required to participate in 3 supervised health education lectures per week. Abstinence from smoking was based on self-report, was verified by saliva cotinine level, and was measured at 1 week after quit day (week 5), end of treatment (week 12), and 3 and 12 months later (20 and 60 weeks after quit day, respectively). Results: Compared with control subjects (n = 147), exercise subjects (n = 134) achieved significantly higher levels of continuous abstinence at the end of treatment (19.4% vs 10.2%, P = .03) and 3 months (16.4% vs 8.2%, P = .03) and 12 months (11.9% vs 5.4%, P = .05) following treatment. Exercise subjects had significantly increased functional capacity (estimated VO2 peak, 25 ± 6 to 28 ± 6, P<.01) and had gained less weight by the end of treatment (3.05 vs 5.40 kg, P = .03). Conclusions: Vigorous exercise facilitates short- and longer-term smoking cessation in women when combined with a cognitive-behavioral smoking cessation program. Vigorous exercise improves exercise capacity and delays weight gain following smoking cessation.

The working healthy project: A worksite health-promotion trial targeting physical activity, diet, and smoking

Emmons, K. M., Linnan, L. A., Shadel, W. G., Marcus, B., & Abrams, D. B. (n.d.).

Publication year

1999

Journal title

Journal of Occupational and Environmental Medicine

Volume

41

Issue

7

Page(s)

545-555
Abstract
Abstract
Worksites are a key channel for delivery of interventions designed to reduce chronic disease among adult populations. Although some evaluations of worksite physical-activity interventions have been conducted, to date very few randomized trials of worksite health promotion have included the goal of increasing physical-activity levels as part of a comprehensive multiple risk factor approach to worksite health promotion. This article presents the results regarding behavior change found among the cohort of 2055 individuals who completed three health-behavior assessments as part of their worksites' participation in The Working Healthy Project (WHP), a multiple risk factor intervention implemented in 26 manufacturing worksites. In this study, a randomized matched-pair design was used. Fifty-one percent (n = 2,761) of the employees who completed the baseline assessment also completed the interim survey. Eighty-three percent of those who completed the interim assessment also completed the final survey. The WHP intervention targeted smoking, nutrition, and physical activity. At baseline, 38% of the sample reported engaging in regular exercise, and subjects reported consuming an average of 2.7 servings of fruits and vegetables per day, 7.9 grams of fiber per 1000 kilocalories, and 35.4% calories from fat per day; 28% of the sample were smokers. By the time of both the interim (intervention midpoint) and final (end of intervention) assessments, participants in the intervention condition had significantly increased their exercise behavior, compared with the control condition. There was also increased consumption of fruits and vegetables and fiber in the intervention condition by the time of the final assessment, compared with the control condition. No differences by condition were found with regard to percentage of calories from fat consumed or smoking cessation. These results suggest that among a cohort of participants in a worksite health promotion study, there were significant health behavior changes across two risk factors over time. These data suggest that further investigation of multiple risk factor worksite health promotion is warranted, particularly with a focus on ways to increase participation in these programs and to diffuse intervention effects throughout the entire workforce.

Transdisciplinary paradigms for tobacco prevention research

Abrams, D. B. (n.d.).

Publication year

1999

Journal title

Nicotine and Tobacco Research

Volume

1

Page(s)

S15-23

Adherence to treatment for nicotine dependence

Abrams, D., Borrelli, B., Shadel, W., King, T., Bock, B., & Niaura, R. (n.d.). In S. Shumaker & J. Ockene (Eds.), The handbook of health behavior change (2nd eds., 1–).

Publication year

1998

Page(s)

137-165

Characteristics of patients adhering to a hospital's no-smoking policy

Emmons, K. M., Cargill, B. R., Hecht, J., Goldstein, M., Milman, R., & Abrams, D. B. (n.d.).

Publication year

1998

Journal title

Preventive Medicine

Volume

27

Issue

6

Page(s)

846-853
Abstract
Abstract
Objectives. The purpose of this paper is to examine the characteristics of smokers who adhere to a hospital smoking ban, compared to those who do not. Design. The data presented in this paper are baseline and discharge survey data collected among hospitalized smokers. Setting. This study was conducted in two teaching hospitals in a northeastern city. Patients/participants. The subjects were 358 smokers who participated in a larger smoking intervention trial. Main results. Seventy-six percent of the subjects reported adhering to the smoke-free policy during their hospital stay. In a multivariate model, demographic factors that predicted adherence included being older, having shorter length of stay, not reporting recreational drug use in the previous 12 months, and not having alcohol- related problems. Smoking history variables that predicted adherence included having had at least 24 h of abstinence in the 7 days prior to hospitalization; self-efficacy variables (e.g., confidence in ability to quit smoking in 1 month and less anticipated difficulty refraining from smoking during hospitalization) also predicted adherence. Conclusions. Understanding the factors that predict adherence to health care policies can provide useful information for health promotion interventions in a medical setting. The implications of these findings are discussed.

Durability, dissemination, and institutionalization of worksite tobacco control programs: Results from the working well trial

Sorensen, G., Thompson, B., Basen-Engquist, K., Abrams, D., Kuniyuki, A., DiClemente, C., & Biener, L. (n.d.).

Publication year

1998

Journal title

International Journal of Behavioral Medicine

Volume

5

Issue

4

Page(s)

335-351
Abstract
Abstract
Durability, dissemination and institutionalization of tobacco control activities are reported, based on the Working Well worksite cancer control intervention study (n = 83 worksites). Tobacco control activities increased significantly in intervention worksites as a result of research-supported activities but were not sustained 2 years after the conclusion of the intervention. Intervention sites were more likely than control sites to initiate and maintain structures for institutionalizing programs, such as assigning a committee responsibility for health-promotion programs or providing a budget for health-promoting activities. Dissemination of the program to control worksites had little impact on the level of smoking control activities in control worksites. Although program durability was not a primary aim of this intervention study, these analyses provide an important assessment of program maintenance beyond a funded intervention and underscore the need for additional research to identify effective organizational strategies for institutionalization of worksite health-promotion programs.

Evaluation of motivationally tailored vs. Standard self-help physical activity interventions at the workplace

Marcus, B. H., Emmons, K. M., Simkin-Silverman, L. R., Linnan, L. A., Taylor, E. R., Bock, B. C., Roberts, M. B., Rossi, J. S., & Abrams, D. B. (n.d.).

Publication year

1998

Journal title

American Journal of Health Promotion

Volume

12

Issue

4

Page(s)

246-253
Abstract
Abstract
Purpose. This study compares the efficacy of a self-help intervention tailored to the individual's stage of motivational readiness for exercise adoption with a standard self-help exercise promotion intervention. Design. Interventions were delivered at baseline and 1 month; assessments were collected at baseline and 3 months. Setting. Eleven worksites participating in the Working Healthy Research Trial. Subjects. Participants (n = 1559) were a subsample of employees at participating worksites, individually randomized to one of two treatment conditions. Intervention. Printed self-help exercise promotion materials either (1) matched to the individual's stage of motivational readiness for exercise adoption (motivationally tailored), or (2) standard materials (standard). Measures. Measures of stage of motivational readiness for exercise and items from the 7-Day Physical Activity Recall. Results. Among intervention completers (n = 903), chi- square analyses showed that, compared to the standard intervention, those receiving the motivationally tailored intervention were significantly more likely to show increases (37% vs. 27%) and less likely to show either no change (52% vs. 58%) or regression (11% vs. 15%) in stage of motivational readiness. Multivariate analyses of variance showed that changes in stage of motivational readiness were significantly associated with changes in self- reported time spent in exercise. Conclusions. This is the first prospective, randomized, controlled trial demonstrating the efficacy of a brief motivationally tailored intervention compared to a standard self-help intervention for exercise adoption. These findings appear to support treatment approaches that tailor interventions to the individual's stage of motivational readiness for exercise adoption.

Exercise, smoking cessation, and short-term changes in serum lipids in women: A preliminary investigation

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

Publication year

1998

Journal title

Medicine and Science in Sports and Exercise

Volume

30

Issue

9

Page(s)

1414-1418
Abstract
Abstract
Purpose: This study investigated the combined effects of exercise and smoking cessation on serum lipids. Methods: Eighteen female smokers quit smoking using standard behavioral methods combined with exercise (N = 9) or with a nonexercise contact time control (N = 9). The smoking cessation program for both groups consisted of 12 weekly 1-h behavioral modification sessions held over 12 wk. Exercise training consisted of three supervised 45- min sessions per week for 12 wk. Contact control consisted of three health education lectures/discussions per week for 12 wk. Fitness (estimated V̇O2 peak), dietary variables, and fasting serum lipids and lipoproteins were assessed before and at the end of treatment. V̇O2 peak increased in the exercise subjects compared with the controls. Results: Total caloric intake as well as total fat and carbohydrate increased significantly after smoking cessation in the controls, but there were no dietary changes in the exercise group, high density lipoprotein (HDL)-C2 increased (7.6 mg·dL-1, P < 0.01) in the exercise group, whereas the increases in HDL and its subfractions did not attain statistical significance in the contact control group. Total cholesterol, low density lipoprotein (LDL)-C, and triglycerides did not change in either group. Conclusions: We conclude that exercise training magnifies the increase in HDL-C that usually occurs with smoking cessation.

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