Raymond S Niaura
Raymond S Niaura
Scroll
Professor of Social and Behavioral Sciences
-
Professional overview
-
Dr. Raymond Niaura is a psychologist and an expert on tobacco dependence and treatment, as well as substance use and addiction to alcohol. Dr. Niaura researches the biobehavioral substrates of tobacco dependence, including factors that influence adolescent and early adult tobacco use trajectories. He also evaluates behavioral and pharmacological treatments for tobacco cessation, with a particular interest in cessation in disadvantaged population to address public health disparities in tobacco-related burdens of illness and disability.
For eight year, Dr. Niaura was the Director of Science and Training at the Schroeder Institute (SI) for Tobacco Research and Policy Studies at the Truth Initiative, where he also supervised the pre- and post-doctoral training programs. Dr. Niaura has previously taught and conducted research at Brown University, Johns Hopkins Bloomberg School of Public Health, the Georgetown Medical Center, and the School of Public Health at University of Maryland. He was also a former President of the Society for Research on Nicotine and Tobacco and is a Deputy Editor of the Nicotine and Tobacco Research.
With grants from the National Institutes of Health, numerous foundations, and private industry, Dr. Niaura has published over 400 peer-reviewed articles, commentaries, and book chapters, including the book The Tobacco Dependence Treatment Handbook: A Guide to Best Practices.
-
Education
-
BA, Psychology (First Class Honors), McGill University, Montreal, CanadaMS, Psychology, Rutgers University, New Brunswick, NJPhD, Psychology, Rutgers University, New Brunswick, NJ
-
Honors and awards
-
Research Laureate, American Academy of Health Behavior (2009)University Scholar Award, McGill University (1979)
-
Areas of research and study
-
Alcohol, Tobacco and Driving PoliciesEvaluationsHealth DisparitiesSubstance AbuseTobacco Control
-
Publications
Publications
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 bioinformational systems perspective on tobacco dependence
AbstractNiaura, R. S., GOLDSTEIN, M., & ABRAMS, D. S. (n.d.).Publication year
1991Journal title
British Journal of AddictionVolume
86Issue
5Page(s)
593-597AbstractRecent thinking about tobacco dependence has been influenced largely by a focus on the pharmacological effects of nicotine. We advocate a return to earlier views of dependence as comprising both pharmacological and non‐pharmacological aspects. Moreover, we suggest that it may be profitable to reformulate research on dependence in terms of a bioinformational process model. The basic tenets of such a model are outlined, as are the challenges in exploring the nature of dependence simultaneously across the cognitive, physiological and behavioral domains of function.A cocaine high-risk situations questionnaire : Development and psychometric properties
AbstractMichalec, E., Zwick, W. R., Monti, P. M., Rohsenow, D. J., Varney, S., Niaura, R. S., & Abrams, D. B. (n.d.).Publication year
1992Journal title
Journal of substance abuseVolume
4Issue
4Page(s)
377-391AbstractAlthough high-risk situations have been identified for alcoholism, opiate abuse, and smoking, further research is needed to identify high-risk situations for cocaine abuse. A 233-item Cocaine High-Risk Situations Survey was developed based on a comprehensive literature review and was administered to 179 cocaine users in treatment. Situations that occurred infrequently or that were not often associated with cocaine use were eliminated and the remaining 89 items were factor analyzed using half the sample with confirmatory factor analysis on the remainder of the sample. Only one factor was found for frequency of cocaine use in these situations. The 21 items with high factor loadings and a diverse range of content were retained for subsequent analyses and renamed the Cocaine High-Risk Situations Questionnaire (CHRSQ). Reliability and convergent and discriminant validity of this scale were demonstrated. Frequency of alcohol use in the same situations was not significantly related to cocaine use and abuse, supporting discriminant validity. The findings suggest that the frequency of ongoing cocaine use is not determined by specific situations. Theoretical and clinical implications are discussed.A content analysis of smoking craving
AbstractShadel, W. G., Niaura, R. S., Brown, R. A., Hutchison, K. E., & Abrams, D. B. (n.d.).Publication year
2001Journal title
Journal of Clinical PsychologyVolume
57Issue
1Page(s)
145-150AbstractThe purpose of this study was to conduct a content analysis of smoking craving in order to investigate more precisely the subjective nature of the construct with the goal of informing assessment. Thirty-two smokers interested in cessation treatment provided free response written descriptions of the level of craving they normally experience. These responses were analyzed for subjective content along five theoretical domains: physiological, affective, cognitive, behavioral, and synonyms (of craving). Although there were no differences in the relative proportion of broad content terms smokers used to describe their craving (e.g., cognitive versus affective), this analysis revealed considerable diversity in the specific terms smokers used. Some smokers described their craving in purely physiological terms whereas others used primarily cognitive terms, and still others used affective terms. To assume that smoking craving is qualitatively similar across persons, then, may mask important variations that define the individual experience of craving.A Cross-Sectional Analysis of the Nicotine Metabolite Ratio and Its Association with Sociodemographic and Smoking Characteristics among People with HIV Who Smoke in South Africa
AbstractKeke, C., Wilson, Z., Lebina, L., Motlhaoleng, K., Abrams, D. S., Variava, E., Gupte, N., Niaura, R. S., Martinson, N., Golub, J. E., & Elf, J. L. (n.d.).Publication year
2023Journal title
International journal of environmental research and public healthVolume
20Issue
6AbstractThe nicotine metabolite ratio (NMR) is associated with race/ethnicity but has not been evaluated among smokers in the African region. We conducted a cross-sectional analysis of baseline data from a large randomized, controlled trial for smoking cessation among people with HIV (PWH) in South Africa. Urine samples were analyzed for the NMR and evaluated as a binary variable using a cutoff value of the fourth quartile to determine the fastest metabolizers. The median NMR was 0.31 (IQR: 0.31, 0.32; range: 0.29, 0.57); the cut-point for fast metabolizers was ≥0.3174 ng/mL. A high NMR was not associated with the number of cigarettes per day (OR = 1.10, 95% CI: 0.71, 1.70, p = 0.66) but was associated with 40% lower odds of a quit attempt in the past year (OR = 0.69; 95% CI: 0.44, 1.07, p = 0.09) and alcohol use (OR = 0.59, 95% CI: 0.32, 1.06, p = 0.07). No association was seen with marijuana or HIV clinical characteristics. As we found only minimal variability in the NMR and minimal associations with intensity of smoking, NMR may be of limited clinical value in this population, although it may inform which individuals are less likely to make a quit attempt.A family history of smoking predicts heightened levels of stress-induced cigarette craving
AbstractErblich, J., Boyarsky, Y., Spring, B., Niaura, R. S., & Bovbjerg, D. H. (n.d.).Publication year
2003Journal title
AddictionVolume
98Issue
5Page(s)
657-664AbstractAims: Individuals with histories of smoking in first-degree relatives are significantly more likely to be persistent smokers themselves. The mechanisms underlying this relationship are unknown. Considerable research has demonstrated that smokers display heightened levels of cigarette craving after being exposed to stressful situations, and the magnitude of these craving responses is thought to be predictive of later cessation failure. Based on this research, we tested experimentally the hypothesis that smokers with two or more first-degree relatives who smoked (FH+) would exhibit stronger craving reactions following stressful stimuli than smokers without such family histories (FH-). Participants: We recruited 83 smokers by advertisement (mean age = 41.2 years. 57% female, 41% completed some college, 59% African American). Setting: The study was conducted in an interview room in an urban medical center. Design: Participants were exposed to a neutral situation (changing a lightbulb) and a stressful situation (dental work) using script-guided imagery. Measurements: Participants completed background measures of demographics, distress and smoking behavior. In addition, participants completed cigarette craving and anxiety questionnaires immediately before and after each condition. Findings: Supporting the study hypothesis, FH+ smokers (n= 39) selectively displayed stronger craving reactions to dental imagery (P < 0.03) than did FH- smokers (n = 44). Conclusion: The higher levels of stress-induced cigarette craving demonstrated experimentally for individuals with family histories of smoking suggest one mechanism for their poorer cessation success.A framework for evaluating the public health impact of e-cigarettes and other vaporized nicotine products
AbstractNiaura, R. S., Levy, D. T., Cummings, K. M., Villanti, A. C., Niaura, R., Abrams, D. B., Fong, G. T., & Borland, R. (n.d.).Publication year
2017Journal title
AddictionVolume
112Issue
1Page(s)
8-17AbstractThe use of vaporized nicotine products (VNPs), especially e-cigarettes and, to a lesser extent, pressurized aerosol nicotine products and heat-not-burn tobacco products, are being adopted increasingly as an alternative to smoking combusted products, primarily cigarettes. Considerable controversy has accompanied their marketing and use. We propose a framework that describes and incorporates patterns of VNP and combustible cigarette use in determining the total amount of toxic exposure effects on population health. We begin by considering toxicity and the outcomes relevant to population health. We then present the framework and define different measures of VNP use; namely, trial and long-term use for exclusive cigarette smokers, exclusive VNP and dual (cigarette and VNP) use. Using a systems thinking framework and decision theory we considered potential pathways for current, former and never users of VNPs. We then consider the evidence to date and the probable impacts of VNP use on public health, the potential effects of different policy approaches and the possible influence of the tobacco industry on VNP and cigarette use.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. S., & Cullen, J. (n.d.).Publication year
2011Journal title
American Journal of Health PromotionVolume
25Issue
SUPPL.5Page(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 pilot randomized controlled trial of a tailored smoking cessation program for people living with HIV in the Washington, D.C. metropolitan area
AbstractKierstead, E. C., Harvey, E., Sanchez, D., Horn, K., Abroms, L. C., Spielberg, F., Stanton, C. A., Debnam, C., Cohn, A. M., Gray, T., Magnus, M., Patel, M., Niaura, R. S., & Elf, J. L. (n.d.).Publication year
2021Journal title
BMC research notesVolume
14Issue
1AbstractObjective: Morbidity and mortality from smoking-related diseases among people living with HIV (PLWH) in the U.S. surpasses that due to HIV itself. Conventional smoking cessation treatments have not demonstrated strong efficacy among PLWH. We conducted a pilot randomized controlled trial (RCT) to evaluate a tailored smoking cessation intervention based on the minority stress model. We compared standard of care counseling (SOC) to a tailored intervention (TI) including one face-to-face counseling session incorporating cognitive behavioral therapy to build resilience, and 30 days of 2-way text messaging. Results: The primary outcome was smoking cessation. Secondary outcomes included cigarettes per day (CPD), exhaled carbon monoxide (CO), and cessation self-efficacy. A total of 25 participants were enrolled (TI:11, SOC:14), and 2 were lost to follow-up. There were no significant differences in quit rates between study groups. However, there was a significantly greater decrease in CPD in the TI versus SOC (13.5 vs. 0.0, p-value:0.036). Additionally, self-efficacy increased in both groups (TI p-value:0.012, SOC p-value:0.049) and CO decreased in both groups (TI p-value: < 0.001, SOC p-value:0.049). This intervention shows promise to support smoking cessation among PLWH. A larger study is needed to fully evaluate the efficacy of this approach. Clinical trial: Trial Registration: Retrospectively registered (10/20/2020) NCT04594109.A pilot randomized trial examining the feasibility and acceptability of a culturally tailored and adherence-enhancing intervention for Latino smokers in the U.S.
Abstractde Dios, M. A., Cano, M. Á., Vaughan, E. L., Childress, S. D., McNeel, M. M., Harvey, L. M., & Niaura, R. S. (n.d.).Publication year
2019Journal title
PloS oneVolume
14Issue
1AbstractLatino smokers in the United States (US) are known to experience smoking cessation treatment disparities due to their under-utilization of services, limited access to health care, and poor smoking cessation treatment outcomes. A limited number of studies have focused on developing and testing smoking cessation treatments for Latino smokers in the US. The objectives of this study were to conduct a feasibility pilot randomized trial testing three smoking cessation interventions for Latinos. Twenty-five adult Latino smokers were randomized to one of three groups: Culturally-Tailored Smoking Cessation plus Adherence Enhancement (CT+AE), Culturally-Tailored Smoking Cessation (CTSC), and a Health Education (HE) control group. All participants received three counseling sessions along with nicotine replacement therapy (NRT). Data relating to intervention acceptability and NRT adherence were collected. Self-reported 7-day point prevalence smoking was collected at 3 and 6 month follow-up and biochemically verified with expired carbon monoxide testing. Overall, the interventions demonstrated high levels of feasibility and acceptability. Days of nicotine patch use were found to be higher in the CT+AE group (mean (M) = 81.3;standard deviation (SD) = 3.32) than the CTSC (M = 68.6;SD = 13.66) and HE (M = 64;SD = 17.70) groups. At 3-month follow-up, approximately 50% of the CT+AE group were smoking abstinent, 25% of the CTSC group, and 44% of the HE group. At 6-month follow-up, 37.5% of the CT+AE group were abstinent, 25% of the CTSC group, and 44.4% of the HE group. This study is the first to target Latino smokers in the US with a culturally-tailored intervention that addresses treatment adherence. Results support the preliminary feasibility and acceptability of the CT+AE intervention.A population-based survey of physician smoking cessation counseling practices
AbstractGoldstein, M. G., DePue, J. D., Monroe, A. D., Lessne, C. W., Rakowski, W., Prokhorov, A., Niaura, R. S., & Dube, C. E. (n.d.).Publication year
1998Journal title
Preventive MedicineVolume
27Issue
5 IPage(s)
720-729AbstractBackground. To be most effective, physicians' smoking cessation interventions must go beyond advice, to include counseling and follow-up. A full profile of physician performance on the recommended activities to promote smoking cessation has not been provided previously. Methods. We surveyed a representative sample of 246 community-based primary care physicians who had agreed to participate in a 3-year study to evaluate a strategy for disseminating smoking cessation interventions, based on the National Cancer Institute 4-A model and on the Transtheoretical Model of Change. Results. A majority reported they Ask (67%) and Advise (74%) their patients about smoking, while few go beyond to Assist (35%) or Arrange follow-up (8%) with patients who smoke. The criteria for 'thorough' counseling was met by only 27% of physicians. More than half were not intending to increase counseling activity in the next 6 months. After controlling for other variables, physicians in private offices were more likely than physicians in HMO or other settings to be active with smoking cessation counseling. General Internal Medicine physicians were most active, and Ob/Gyn physicians were least active, with smoking cessation counseling among primary care specialty groups. Conclusions. Innovative approaches are needed to motivate, support, and reward physicians to counsel their patients who smoke, especially when considering the movement toward managed health care. Precis: A survey of primary care physicians focusing on national guidelines for smoking cessation counseling showed a majority Ask (67%) and Advise (74%) patients about smoking, but few Assist (35%) or Arrange follow- up.A prospective examination of distress tolerance and early smoking lapse in adult self-quitters
AbstractBrown, R. A., Lejuez, C. W., Strong, D. R., Kahler, C. W., Zvolensky, M. J., Carpenter, L. L., Niaura, R. S., & Price, L. H. (n.d.).Publication year
2009Journal title
Nicotine and Tobacco ResearchVolume
11Issue
5Page(s)
493-502AbstractIntroduction: A significant percentage of smokers attempting cessation lapse to smoking within a matter of days, and current models of relapse devote insufficient attention to such early smoking lapse. Studies attempting to relate severity of nicotine withdrawal symptoms to short-term smoking cessation outcomes have yielded equivocal results. How one reacts to the discomfort of nicotine withdrawal and quitting smoking (i.e., distress tolerance) may be a more promising avenue of investigation with important treatment implications. Methods: The present investigation examined distress tolerance and early smoking lapse using a prospective design. Participants were 81 adult daily smokers recruited through newspaper advertisements targeted at smokers planning to quit smoking without assistance (i.e., no pharmacotherapy or psychosocial treatment; 42 males and 39 females; mean age = 42.6 years, SD = 12.20). Results: As hypothesized, both greater breath-holding duration and carbon dioxide-enriched air persistence were associated with a significantly lower risk of smoking lapse following an unaided quit attempt. These effects were above and beyond the risk associated with levels of nicotine dependence, education, and history of major depressive disorder, suggesting that distress tolerance and task persistence may operate independently of risk factors such as nicotine dependence and depressive history. In contrast to expectation, persistence on the Paced Auditory Serial Addition Test (a psychological challenge task) was not a significant predictor of earlier smoking lapse. Discussion: These results are discussed in relation to refining theoretical models of the role of distress tolerance in early smoking lapse and the utility of such models in the development of specialized treatment approaches for smoking cessation.A randomized trial for combination nicotine replacement therapy for smoking cessation among people with HIV in a low-resourced setting
AbstractElf, J. L., Lebina, L., Motlhaoleng, K., Chon, S., Niaura, R. S., Abrams, D. S., Variava, E., Gupte, N., Martinson, N., & Golub, J. E. (n.d.).Publication year
2025Journal title
AIDSVolume
39Issue
5Page(s)
526-534AbstractObjective: The purpose of this study was to evaluate the efficacy of combination nicotine replacement therapy (c-NRT) for smoking cessation among people with HIV (PWH) in South Africa. Design: We conducted an open-label, individually randomized clinical trial. Methods: Using a two-armed approach, PWH who smoke were randomized to receive either intensive antismoking behavioral counselling or intensive antismoking behavioral counseling plus c-NRT (nicotine patches augmented by nicotine gum). Self-reported smoking abstinence was biochemically validated with exhaled breath carbon monoxide (CO) and urine cotinine at 6 months. Recruitment, provision of trial interventions, and follow-up of participants took place in March 2014 through June 2016. Results: We randomly assigned 280 participants to the behavioral counseling arm and 281 participants to the behavioral counseling + c-NRT arm. Four hundred and thirty-eight (78%) participants were men and 123 (22%) were women. For our primary outcome of biochemically verified abstinence at 6 months, 41 (15%) were quit in the behavioral counseling + c-NRT arm vs. 28 (10%) in the behavioral counseling arm, resulting in a 5% [95% confidence interval (CI) -1 to 10%] absolute difference in relative risk and an adjusted odd ratio of 1.47 (95% CI 0.86-2.52) comparing the behavioral counseling + c-NRT to the behavioral counseling arm. Conclusion: Although our results did not reach statistical significance, we found augmentation of behavioral counseling with c-NRT to increase smoking abstinence at 6 months, which is consistent with performance in the general population. PWH in low-resource settings may benefit from the addition of c-NRT to existing tobacco cessation interventions.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.A Randomized Trial of Telephone-Based Smoking Cessation Treatment in the Lung Cancer Screening Setting
AbstractNiaura, R. S. (n.d.).Publication year
2022Journal title
Journal of the National Cancer InstituteVolume
114Issue
10Page(s)
1410-1419AbstractBACKGROUND: Lung cancer mortality is reduced via low-dose computed tomography screening and treatment of early-stage disease. Evidence-based smoking cessation treatment in the lung screening setting can further reduce mortality. We report the results of a cessation trial from the National Cancer Institute's Smoking Cessation at Lung Examination collaboration. METHODS: Eligible patients (n = 818) aged 50-80 years were randomly assigned (May 2017-January 2021) to the intensive vs minimal arms (8 vs 3 phone sessions plus 8 vs 2 weeks of nicotine patches, respectively). Bio-verified (primary) and self-reported 7-day abstinence rates were assessed at 3, 6, and 12 months post random assignment. Logistic regression analyses evaluated the effects of study arm. All statistical tests were 2-sided. RESULTS: Participants reported 48.0 (SD = 17.2) pack-years, and 51.6% were not ready to quit in less than 30 days. Self-reported 3-month quit rates were statistically significantly higher in the intensive vs minimal arm (14.3% vs 7.9%; odds ratio [OR] = 2.00, 95% confidence interval [CI] = 1.26 to 3.18). Bio-verified abstinence was lower but with similar relative differences between arms (9.1% vs 3.9%; OR = 2.70, 95% CI = 1.44 to 5.08). Compared with the minimal arm, the intensive arm was more effective among those with greater nicotine dependence (OR = 3.47, 95% CI = 1.55 to 7.76), normal screening results (OR = 2.58, 95% CI = 1.32 to 5.03), high engagement in counseling (OR = 3.03, 95% CI = 1.50 to 6.14), and patch use (OR = 2.81, 95% CI = 1.39 to 5.68). Abstinence rates did not differ statistically significantly between arms at 6 months (OR = 1.2, 95% CI = 0.68 to 2.11) or 12 months (OR = 1.4, 95% CI = 0.82 to 2.42). CONCLUSIONS: Delivering intensive telephone counseling and nicotine replacement with lung screening is an effective strategy to increase short-term smoking cessation. Methods to maintain short-term effects are needed. Even with modest quit rates, integrating cessation treatment into lung screening programs may have a large impact on tobacco-related mortality.A scoping review of studies on the health impact of electronic nicotine delivery systems
AbstractHajat, C., Stein, E., Shantikumar, S., Niaura, R. S., Ferrara, P., & Polosa, R. (n.d.).Publication year
2022Journal title
Internal and Emergency MedicineVolume
17Issue
1Page(s)
241-268AbstractWe conducted a scoping review of studies on health outcomes from electronic nicotine delivery systems (ENDS). The objective was to identify, narratively synthesize, assess the strength and quality of evidence and critically appraise studies that have reported disease end points associated with the use of ENDS. We included published literature on the health impact of ENDS from 01/01/2015 until 01/02/2020 following the PRISMA guidelines using PubMed, Embase, Scopus and Google Scholar. The database search identified 755 studies, and other sources 265; 37 studies met final eligibility criteria. Levels of evidence included 24(65%) cross-sectional, one (2.7%) case–control and six (16%) case studies, four (11%) cohort studies, one (2.7%) randomized controlled trial (RCT) and one (2.7%) meta-analysis; 27(73%) studies reported only on harms, eight (22%) reported on benefits, two (2%) on benefits and harms. Quality ratings were poor in 20 (54%), fair in 9(24%) and good in 8(22%) of studies. In our review, ENDS was not shown to be causative for harmful cardiovascular disease (CVD) outcomes and shown to be beneficial for hypertensive patients. Switching from cigarettes to e-cigarettes resulted in reduced exacerbations of chronic obstructive pulmonary disease (COPD), with no evidence of long-term deterioration in lung function. Mental Health, cancer and mortality were not adequately studied to form any consensus. Our review has not demonstrated ENDS to be causative of harmful CVD outcomes; furthermore switching from cigarettes to e-cigarettes was associated with improved hypertensive control and reduced exacerbations of COPD, with no evidence of increased asthma risk or long-term respiratory harm. Mental health, cancer and mortality outcomes have not been adequately studied to form a conclusion. Overall, the findings of our review did not provide evidence to counter the consensus held by many that ENDS use is safer than the risks posed from smoking cigarettes.A simple laboratory method for inducing anger : A preliminary investigation
AbstractEngebretson, T. O., Sirota, A. D., Niaura, R. S., Edwards, K., & Brown, W. A. (n.d.).Publication year
1999Journal title
Journal of Psychosomatic ResearchVolume
47Issue
1Page(s)
13-26AbstractTo facilitate the experimental study of anger, we developed a simple laboratory method to induce anger. This anger induction (AI) is similar in format to the Velten Mood Induction Procedure for depression (VMIP-D), and involves reading descriptors of anger experience, recalling relevant personal memories, and evoking the mood suggested by the sentence/memory. We administered the AI and VMIP-D to 81 undergraduate men and women and collected mood ratings before, during, and after each mood induction. The AI exhibited good sensitivity and specificity in that it induced moderate to greater increases in anger (>1 SD change) in 68% of the sample, significant decreases in happiness, and minimal changes in other emotions. Mood responses to the AI and VMIP-D were influenced by gender and order of presentation. Uses and limitations of this method are discussed.A single factor underlies the metabolic syndrome : A confirmatory factor analysis: Response to Pladevall et al. [14]
AbstractMcCaffery, J. M., Shen, B. J., Todaro, J. F., & Niaura, R. S. (n.d.).Publication year
2006Journal title
Diabetes CareVolume
29Issue
7Page(s)
1719-1720Abstract~A smoking cessation intervention for the methadone-maintained
AbstractStein, M. D., Weinstock, M. C., Herman, D. S., Anderson, B. J., Anthony, J. L., & Niaura, R. S. (n.d.).Publication year
2006Journal title
AddictionVolume
101Issue
4Page(s)
599-607AbstractAim: To test, in combination with the nicotine patch, the incremental efficacy of a maximal, tailored behavioral treatment over a minimal treatment for smoking cessation. Design: Randomized clinical trial with 6-month follow-up. Setting: Five methadone maintenance treatment centers in Rhode Island. Participants: Three hundred and eighty-three methadone-maintained smokers. Intervention: Participants were assigned randomly to nicotine patch (8-12 weeks) plus either (1) a baseline tailored brief motivational intervention, a quit date behavioral skills counseling session and a relapse prevention follow-up session (Max) or (2) brief advice using the National Cancer Institute's 4 As model (Min). An intent-to-treat analysis with those lost to follow-up assumed to smoke was used. Measurements: Carbon monoxide (CO)-confirmed 7-day point smoking cessation prevalence at 3 and 6 months, and self-reported numbers of cigarettes smoked per day. Findings: Participants had a mean age of 40 years, were 53% male, 78% Caucasian, smoked 26.7 (± 12.2) cigarettes/day and had a mean methadone dose of 95.5 mg. At 3 months, 317 (83%) were reinterviewed; at 6 months, 312 (82%) were reinterviewed. The intent-to-treat, 7-day point prevalence estimate of cessation was 5.2% in the Max group and 4.7% in the Min group (P = 0.81) at 6 months. In logistic models with treatment condition, age, gender, race, Fagerström Test for Nicotine Dependence and cigarettes per day as covariates, males were more likely to be abstinent at 3 months (OR 4.67; P = 0.003) and 6 months (OR 4.01; P = 0.015). Conclusion: A tailored behavioral intervention did not increase quit rates over patch and minimal treatment. Smoking cessation rates in methadone-maintained smokers are low, with men having greater success.A study of depressive symptoms and smoking behavior in adult male twins from NHLBI twin study
AbstractNiaura, R. S., McCaffery, J. M., Niaura, R., Swan, G. E., & Carmelli, D. (n.d.).Publication year
2003Journal title
Nicotine and Tobacco ResearchVolume
5Issue
1Page(s)
77-83AbstractSelf-report measures of depressive symptoms, such as the Center for Epidemiological Studies - Depression Scale (CES-D), correlate with current and lifetime smoking status. In one previous study of adult female twins, genetic factors accounted for the covariation of liability to a diagnosis of major depressive disorder and liability to lifetime smoking (Kendler, Neale, MacLean, Heath, Eaves, & Kessler, 1993b, Archives of General Psychiatry, 50, 36-43); however, it remained unclear whether genetic effects also account for the covariation between subclinical depressive symptomology and smoking behavior. In this study, we use twin structural equation modeling to explore whether genetic and/or environmental influences contribute to the covariation between depressive symptoms, as measured by the CES-D, and current and lifetime smoking status among 120 monozygotic and 114 dizygotic Caucasian male twin pairs (aged 59-69). In this sample, depressive symptoms showed small but significant correlations with current and lifetime smoking status. Univariate twin analyses indicated that additive genetic and non-shared environmental factors contributed significantly to liability to current and lifetime smoking. However, the majority of variance in CES-D scores was attributable to non-shared (individual) environment. In bivariate analyses, non-shared environmental factors accounted for the majority of covariation between liability to depressive symptoms (CES-D scores ≥ 8; above the 75th percentile) and liability to current and lifetime smoking status. Taken together with the previous literature, these results suggest that the etiology of covariation among depressive symptoms and smoking behavior may vary by measurement and severity of depressive symptomology.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. S., & 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.A twin registry study of the relationship between posttraumatic stress disorder and nicotine dependence in men
AbstractKoenen, K. C., Hitsman, B., Lyons, M. J., Niaura, R. S., McCaffery, J., Goldberg, J., Eisen, S. A., True, W., & Tsuang, M. (n.d.).Publication year
2005Journal title
Archives of General PsychiatryVolume
62Issue
11Page(s)
1258-1265AbstractContext: Recent studies indicate a strong association between posttraumatic stress disorder (PTSD) and nicotine dependence (ND). However, the explanation for the association remains unclear. Objective: To test competing explanations for the association between PTSD and ND. Design, Setting, and Participants: Analysis of data on 6744 members of the Vietnam Era Twin Registry, a national registry of all male-male twin pairs who served in the military during the Vietnam era interviewed in 1991-1992. Main Outcome Measures: Risk of PTSD and ND using the Diagnostic Interview Schedule for the DSM-III-R. Results: The prevalence of ND was elevated among trauma-exposed individuals (52.0%) and those with PTSD (71.7%) compared with unexposed individuals (40.5%). This association was significant for ND and for trauma without PTSD (odds ratio, 1.31; 95% confidence interval [CI], 1.18-1.45) and for PTSD (odds ratio, 2.34; 95% CI, 1.92-2.84) and was not entirely explained by shared risk factors. Shared genetic effects explained 63% of the PTSD-ND association; the remaining covariance was explained by individual-specific environmental effects. Using survival analysis with time-dependent covariates, ND was associated with a substantially increased risk of PTSD among trauma-exposed men (hazard ratio, 1.98; 95% CI, 1.61-2.42). Trauma (hazard ratio, 1.49; 95% CI, 1.35-1.64) and PTSD (hazard ratio, 1.36; 95% CI, 1.14-1.61) were less strongly but significantly associated with increased risk of ND onset after controlling for shared risk factors. Conclusions: Most of the PTSD-ND association is explained by shared genetic effects. However, there is a substantial, robust PTSD-ND association not explained by shared risk factors. Multiple explanations for the association were supported; however, the strongest association was consistent with preexisting ND increasing the risk of PTSD onset. These data suggest that male veterans with a history of ND may be at increased risk for PTSD. Further research on the biological mechanisms underlying PTSD-ND comorbidity is needed.A twin-sibling study of tobacco use in adolescence : Etiology of individual differences and extreme scores
AbstractRende, R., Slomkowski, C., McCaffery, J., Lloyd-Richardson, E. E., & Niaura, R. S. (n.d.).Publication year
2005Journal title
Nicotine and Tobacco ResearchVolume
7Issue
3Page(s)
413-419AbstractA database is emerging that examines the relative contributions of genes and the environment to the etiology of smoking in adolescence. We present analyses derived from a genetically informative subsample of sibling pairs (monozygotic and dizygotic twins, full siblings, and half-siblings) participating in two waves of the National Longitudinal Study of Adolescent Health to estimate these parameters on both individual differences in smoking and extreme levels of smoking. Evidence indicated both genetic and shared environmental influences on high levels of smoking frequency, as well as on individual differences in smoking. No notable gender differences in these parameters emerged. Shared environmental effects were especially notable for high levels of smoking frequency and significantly greater than those found for individual differences. These findings were compatible with prior studies of both adolescent and adult smoking and reinforce the importance of familial influences on high levels of smoking frequency in adolescence.Acceptability of computer assessments among ethnically diverse, low- income smokers
AbstractBock, B., Niaura, R. S., Fontes, A., & Bock, F. (n.d.).Publication year
1999Journal title
American Journal of Health PromotionVolume
13Issue
5Page(s)
299-304AbstractPurpose. To examine the acceptability of computer-based assessments among an ethnically diverse, low-income population of primary care patients. Although computers have been used to provide assessments and interventions in health care settings, members of ethnic minority and low-income households have less access to computers than other groups, and therefore the acceptability of computers as a health care assessment and delivery tool needs to be examined. Design. We examined the acceptability of computers for providing assessments of smoking history, nicotine dependence, and other related variables among an ethnically diverse, low-income primary care population. No intervention was used in this study. Setting. Three inner- city primary care clinics located in hospitals were used as sites for this study. These hospitals were located in areas of the city where low-income and ethnic minority households are overrepresented relative to the total population. Subjects. Adult male and female smokers (n = 522) were recruited while awaiting appointments in each primary care clinic. Measures. A questionnaire assessing smoking rate, patterns, history, motivation to quit smoking, and other smoking-related variables was administered using either a paper-and-pencil format or a laptop computer. Results. Frequency counts, analysis of variance, and χ2 tests were used where appropriate. Most subjects (78.5 %) used the computer to complete the baseline survey. Almost all subjects (92 %) rated the computer 'very easy' or 'easy' to use. Subjects who were Spanish-speaking, were born outside the United States, or were Hispanic tended to rate the program as slightly less easy to use than other subjects. Conclusions. Computer-based assessments appear highly acceptable to individuals in low-income populations.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. S., & 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)