Dr. Abrams has played a leadership role in several initiatives to better understand consumer use behavior, consumer demand, and direct to consumer marketing in an effort to increase impact of smoking cessation services on cessation rates. Some of this ongoing work culminated in a special supplement to the American Journal of Preventive Medicine in March 2010 where Schroeder Institute faculty led five of the papers published. Three of these papers were based on an integrative systems framework and simulation modeling of combined effects of multilevel contexts. The Health and Human Services Secretary Sebelius’ recent report “DHHS Tobacco Control Strategic Plan for the Nation” (Nov 14^th, 2010) cited one of these papers as “...the most current and authoritative model of the effect of comprehensive tobacco control measures…” Examples of papers from this supplement include:

• Orleans CT, Mabry PL, Abrams DB. Increasing Tobacco Cessation in America: A Consumer Demand Perspective. Am J Prev Med. 2010 Mar;38(3 Suppl):S303-S306. PMID: 20176300. No abstract available.
• Abrams DB, Graham AL, Levy DT, Mabry PL, Orleans CT. Boosting Population Quits Through Evidence-Based Cessation Treatment and Policy. Am J Prev Med. 2010 Mar;38(3 Suppl):S351-63. PMID: 20176308. Abstract.
• Levy DT, Graham AL, Mabry PL, Abrams DB, Orleans CT. Modeling the impact of smoking-cessation treatment policies on quit rates. Am J Prev Med. 2010 Mar;38(3 Suppl):S364-S372. PMID: 20176309. Full text.
• Levy DT, Mabry PL, Graham AL, Orleans CT, Abrams DB. Reaching Healthy People 2010 by 2013: A SimSmoke simulation. Am J Prev Med. 2010 Mar;38(3 Suppl):S373-81. PMID: 20176310. Full text.

Dr. Abrams has spearheaded efforts to examine the extraordinary opportunity for research to support the FDA’s Center for Tobacco Products (CTP) in its effort to regulate tobacco products and protect public health. Ongoing examples of these efforts are as follows: (1) Commissioned expert panels for knowledge synthesis of the evidence related to menthol cigarettes; (2) Executed research and secondary data analysis and conducted simulation modeling to support removal of mentholated cigarettes from the marketplace; (3) Conducted surveys and developed items to examine public awareness/opinions concerning the new FDA regulatory authority and included items to assess consumer sentiment related to various anticipated regulatory changes; (4) Partnered with Georgetown University and Arista Laboratories to examine the product characteristics and the marketing of e-cigarettes; (5) Fielded a nationally-representative survey to obtain baseline data on public attitudes related to FDA tobacco regulation, a menthol ban, reducing nicotine levels in cigarettes, use of e-cigarettes (ENDS) to gain insight into the influence of regulatory activities on consumer knowledge, attitudes and behavior; (6) Established a coalition and a coordinating committee able to quickly involve experts from the tobacco research community to respond rapidly to FDA needs or emerging opportunities. Sample publications from this work are listed below:

• Tauras JA, Levy D, Chaloupka FJ, Villanti AC, Niaura RS, Vallone DM, Abrams DB. Menthol and non-menthol smoking: the impact of prices and smoke-free air laws. Addiction. 2010 Dec;105 Suppl 1:115-23. PMID: 21059142. Full text.
• Cobb NK, Byron MJ, Abrams DB, Shields PG. Novel nicotine delivery systems and public health: The rise of the "e-cigarette". Am J Public Health 2010, Dec;100(12):2340-2 100. PMID: 21068414. No abstract available.
• Levy DT, Pearson JP, Villanti AC, Niaura RS, Abrams DB. Modeling the effects of a menthol ban on smoking-attributable deaths in the United States. Am J Public Health. 2011 May 12. [Epub ahead of print]. PMID: 21566034. Abstract.
• Levy DT, Blackman K, Tauras JA, Chaloupka FJ, Villanti AC, Niaura RS, Vallone DM, Abrams DB. Quit Attempts and Quit Rates among Menthol and non-Menthol Smokers. Am J Public Health. 2011;101(7):Published online ahead of print May 12, 2011. PMID: 21566032. Abstract.
• Villanti A, Vargyas E, Niaura R, Beck S, Pearson J, Abrams D. Food and Drug Administration Regulation of Tobacco: Integrating Science, Law, Policy and Advocacy. Am J Public Health. 2011 May 12. [Epub ahead of print]. PMID: 21566020. Abstract.
• Winickoff J, McMillen R, Vallone D, Pearson J, Tanski S, Dempsey J, G Healton C, Klein J, Abrams D. US Attitudes About Banning Menthol in Cigarettes: Results From a Nationally Representative Survey. Am J Public Health. 2011 May 12. [Epub ahead of print]. PMID: 21566038. Abstract.

Practical counseling, social support, and nicotine replacement therapy (NRT) are components of tobacco dependence treatment that increase the chances of cessation. Web-based interventions are a promising delivery channel for tobacco dependence treatment. Although millions of smokers use the Internet for cessation assistance each year, most users engage only minimally with even the best designed cessation websites, diminishing their impact due to limited exposure/use of effective treatment components (an insufficient “dose”). The goal of this study is to compare the effectiveness of two approaches to improve adherence to the elements of tobacco dependence treatment delivered via the Internet. Addressing adherence to Internet cessation programs is critical and timely to leverage the potential public health impact of this “broad reach” treatment modality. The proposed study is unconventional and innovative in its use of a social network intervention approach to improve both behavioral and pharmacological treatment adherence to enhance cessation outcomes.

Principal Investigator:  Amanda L. Graham, PhD

SI/Legacy Collaborators: Nathan Cobb, MD, David Abrams, PhD, Raymond Niaura, PhD

Collaborators at other institutions: George Papandonatos, PhD (Brown University), Larry An, PhD (University of Michigan), Dave Heilmann (SparkPeople.com)

Funding Agency: National Cancer Institute (1R01CA155489-01A1)

Project Period:  7/2011 – 6/2016

This project seeks to determine the elements of an application for smoking cessation that determine diffusion (viral spread). Based on previous pilot work, we plan to create a smoking cessation application within Facebook where multiple elements can be turned on or off. This allows us to randomize individuals to one of dozens of potential possible applications, and look for effect and interaction effects using a factorial model. The primary outcome of this project is to look at dissemination (as opposed to effectiveness).

Principal Investigator: Nathan K. Cobb, MD

SI/Legacy Collaborators: Amanda Graham, PhD, David Abrams, PhD

Collaborators at other institutions: Tom Valente, PhD (UCS), E. Paul Wileyto, PhD (U Penn), Linda Collins, PhD (Penn State)

Funding Agency: National Cancer Institute (1R01CA155369-01A1)

Project Period: 8/2011 - 6/30/2014

Smoking cessation remains the single most effective public health tool to improve the nation’s health and reduce the huge burden of preventable disease on our economy. While tobacco use among white and Latino Washington, DC residents declined between 1996 and 2007, the percentage of African American residents who use tobacco increased from 21.5 percent to 23.9 percent (CDC, 2008).  In DC, as is the case nationally, smoking rates are higher in neighborhoods with lower per capita incomes and higher rates of poverty (CDC, 2008).  Tobacco cessation telephone counseling lines (“quitlines”) have the potential to reach large numbers of underserved smokers with effective treatments, yet utilization remains low, and we know very little about how best to engage and retain contact with quitters.  This project represents a collaborative effort that utilizes web-enabled mobile devices to enhance the effectiveness of an established quitline program benefiting underserved communities in Washington, DC.  This translational work is unconventional and innovative in the way it leverages web-based real-world, real-time contact (“ecological momentary assessment” methodology) to literally close the loop between research and practice. Via a partnership between the DC Department of Health Tobacco Quitline and the Schroeder Institute for Tobacco Research and Policy Studies at the American Legacy Foundation, this project is uniquely positioned to deliver and evaluate smoking cessation support services to underserved communities characterized by the highest rates of smoking prevalence, providing both an immediate and potentially lasting benefit to these communities.

Principal Investigator:  Thomas R. Kirchner, PhD

SI/Legacy Collaborators: David Abrams, PhD, Amanda Graham, PhD, Nathan Cobb, MD

Collaborators at other institutions: Saul Shiffman, PhD (University of Pittsburgh)

Funding agency: National Institute on Drug Abuse (1RC1 DA028710)

Project Period:  9/2009 – 9/2011

This project seeks to develop a set of integrated, online tools for smokers to quit and stay quit, assisted by other individuals in their social environment. The system as envisioned will include a series of interlocking components: access to a social network for support and dissemination, text messaging for proactive content, and IVR and mobile applications for access at any time. This project is funded internally and supplemented with external funding.

Principal Investigator: Nathan K. Cobb, MD

SI/Legacy Collaborators: Amanda Graham, PhD, David Abrams, PhD, Tom Kirchner, PhD

Funding: Internal

Opportunities are available to conduct additional analyses and work on manuscripts from a rich and extensive dataset housed at the Schroeder Institute. The original study was conducted at The Brown University Transdisciplinary Tobacco Use Research Center (TTURC). It was a retrospective and prospective study of the parents and 2 generations of offspring of the National Collaborative Perinatal Cohort, first sampled from 1959 to 1964 for prospective examination of the effects of in-utero and early childhood environment on psychosocial and school adjustment up to age 7. The sample was re-contacted when offspring were aged about 40. Over 1600 probands were interviewed for retrospective and current behaviors and biological samples were collected for genetic studies. Measures are extensive and include tobacco use behavior, lifetime trajectories of patterns of tobacco use, mental illness/psychiatric and alcohol/substance abuse comorbidity, in-utero exposure during pregnancy, phenotypes. Data were also collected for methodological studies such as assessing reliability, validity and response bias to surveys and household interviews. Ongoing analyses pertain to: the natural history and patterns of smoking trajectories and transitions from uptake to regular use to relapse episodes; tobacco use and comorbid mental illness, alcohol and substance abuse; in-utero exposure to smoking during pregnancy and effects on offspring; and measures of dependence phenotypes to examine genotypes. Sample publications to date include:

• Abrams DB, Leslie F, Mermelstein R, Kobus K, Clayton RR. Transdisciplinary tobacco use research.  Nicotine Tob Res. 2003 Dec;5 Suppl 1:S5-10. PMID: 14668083. No abstract available.
• Gilman SE, Rende R, Boergers J, Abrams DB, Buka SL, Clark MA, Colby SM, Hitsman B, Kazura AN, Lipsitt LP, Lloyd-Richardson EE, Rogers ML, Stanton CA, Stroud LR, Niaura RS. Parental smoking and adolescent smoking initiation: an intergenerational perspective on tobacco control. Pediatrics. 2009 Feb;123(2):e274-81. PMID: 19171580. Full text.
• Kahler CW, Daughters SB, Leventhal AM, Rogers ML, Clark MA, Colby SM, Boergers J, Ramsey SE, Abrams DB, Niaura R, Buka SL. Personality, psychiatric disorders, and smoking in middle-aged adults. Nicotine Tob Res. 2009 Jul;11(7):833-41. Epub 2009 May 26. PMID: 19470795. Full text.
• Kahler CW, Leventhal AM, Daughters SB, Clark MA, Colby SM, Ramsey SE, Boergers J, Abrams DB, Niaura R, Buka SL. Relationships of personality and psychiatric disorders to multiple domains of smoking motives and dependence in middle-aged adults. Nicotine Tob Res. 2010 Apr;12(4):381-9. Epub 2010 Feb 18. PMID: 20167635. Full text.
• Graham AL, Papandonatos GD, DePue JD, Pinto BM, Borrelli B, Neighbors CJ, Niaura R, Buka SL, Abrams DB. Lifetime characteristics of participants and non-participants in a smoking cessation trial: implications for external validity and public health impact. Ann Behav Med. 2008 Jun;35(3):295-307. Epub 2008 Apr 15. PMID: 18414962. Abstract.

Principal Investigators:  David Abrams, PhD, and Raymond Niaura, PhD

SI/Legacy Collaborators: Amanda Graham, PhD

Collaborators at other institutions: Suzanne Colby, PhD (Brown University), Stephen Buka, ScD (Brown University), Christopher Kahler, PhD (Brown University), Melissa Clark PhD, (Brown University), George Papandonatos, PhD (Brown University), Belinda Borrelli, PhD (Brown University), and others.

Funding agency: National Cancer Institute (P50 CA084719)

Project Period:  09/30/2009 – 09/29/2011