OVERVIEW: UW-CTRI releases a research update in January and July of each year. This report summarizes manuscripts, presentations, grants, and financials of the Center.
SUMMARY: In 2022, UW-CTRI has produced:
- 46 published papers or chapters (p. 1)
- 1 paper in press (p. 12)
- 60 presentations and posters (p. 12)
- 1 new study (p. 17)
- 6 active studies (p. 18)
- 7 studies recently completed (p. 19)
- Financials (p. 24)
THANK YOU: UW-CTRI is grateful to its partners, including the National Cancer Institute, Centers for Disease Control, Department of Veterans Affairs, Food and Drug Administration, Health Resources and Services Administration, National Heart, Lung, and Blood Institute, National Institute on Aging, Centers for Medicare and Medicaid Services, National Institutes of Health, UW Department of Family Medicine, UW Institute for Clinical and Translational Research, UW Comprehensive Cancer Center, UW Department of Medicine, UW School of Medicine and Public Health, Wisconsin Alzheimer’s Disease Research Center, Wisconsin Department of Health Services, Wisconsin Division of Care and Treatment, Wisconsin Partnership Program and Wisconsin Women’s Health Foundation.
Note: Names in bold are current UW-CTRI employees.
Baker TB, Burris JL, Fiore MC. (2022) Helping African American Individuals Quit Smoking: Finally, Some Progress.327(22):2192-2194.
- Summary: The researchers applauded a new study, also published in JAMA, of 500 African Americans that shows that active varenicline plus culturally appropriate counseling more than doubled quit rates, even though they were people who mostly smoked fewer cigarettes per day. They urged healthcare providers to use electronic health records to reach out to every patient who smokes and offer this combination treatment to Black patients. They encouraged the FDA to officially ban menthols.
Baker TB, Fiore MC. (2022) Combined Varenicline With Nicotine Patch and Extended Duration of Therapy for Smoking Cessation—Reply. 327(4):391-392.
- Summary: In this reply, the authors assert that it remains important that standardized smoking treatments are identified that can be delivered routinely in busy health-care settings and can yield strong benefits. After all, the greatest constraint to helping patients quit smoking is almost certainly the low rates of smoking treatment delivery and engagement that occur in health care.
Bray M, Chang Y, Baker TB, Jorenby DE, Carney RM, Fox L, Pham G, Stoneking F, Smock N, Amos CI, Bierut L, Chen L-S. (2022) The Promise of Polygenic Risk Prediction in Smoking Cessation: Evidence from Two Treatment Trials. Nicotine & Tobacco Research. Online February 16, 2022.
- Summary: There is a potential for polygenic risk scores to inform future clinical medicine, and a great need for evidence on whether these scores predict clinically meaningful outcomes. This meta-analysis provides early evidence for the potential utility of using them to predict the outcomes of attempts to quit smoking.
Burris JL, Borger TN, Baker TB, Bernstein SL, Ostroff JS, Rigotti NA, Joseph AM. (2022) Proposing a Model of Proactive Outreach to Advance Clinical Research and Care Delivery for Patients Who Use Tobacco. Journal of General Internal Medicine.
- Summary: This commentary introduces a comprehensive yet flexible model of proactive outreach and describes how proactive outreach can optimize clinical research and care delivery in these domains: (1) identifying the population, (2) offering treatment, and (3) delivering treatment. Adoption of the proposed proactive outreach model could improve the precision and rigor with which tobacco cessation research and tobacco treatment programs report data, which could have a positive effect on patient care.
Buu A, Tong Z, Cai Z, Li R, Yang JJ, Jorenby DE, Piper ME. (2022) Subtypes of Dual Users of Combustible and Electronic Cigarettes: Longitudinal Changes in Product Use and Dependence Symptomatology. Nicotine & Tobacco Research. Online June 23, 2022.
- Summary: This study characterizes subtypes of people who both smoke and vape, based on the dynamic interactions between cigarette use and e-cigarette use, as well as product-specific trajectories of dependence. People who predominantly vape appeared to engage in substitution, as they decreased their smoking and increased their e-cigarette dependence. Smoking bans may promote substitution of cigarettes with e-cigarettes.
Cai X, Coffman DL, Piper ME, Li R. (2022) Estimation and Inference for the Mediation Effect in a Time-Varying Mediation Model. BMC Medical Research Methodology. 22:113.
- Summary: Researchers presented a model for estimating time-varying mediation effects, building on previous work to allow a time-varying outcome as well as a time-varying mediator. They also presented a method for obtaining point-wise confidence intervals for the product of two time-varying coefficient functions (ie, a time-varying mediation effect), evaluated its feasibility in a small simulation study, and applied the method to evaluate the time-varying mediation effects of three quit-smoking medications.
Chakraborti Y, Coffman DL, Piper ME. (2022) Time-Varying Mediation of Pharmacological Smoking Cessation Treatments on Smoking Lapse Via Craving, Cessation Fatigue and Negative Mood. Nicotine & Tobacco Research.
- Summary: Researchers reported a statistically significant time-varying mediation effect of varenicline on smoking status through craving. They didn’t find significant time-varying mediation effects through negative mood and cessation fatigue. This study supports the importance of craving suppression in order to quit smoking. They identified specific time points when withdrawal symptoms increased that would likely benefit from targeted interventions.
Christiansen B, Riemer D, Conner K, Fiore MC. (2022) The Bucket Approach: Developing and Implementing an Online Training Program in Tobacco Dependence Interventions Tailored for Behavioral Health Clinicians. Community Mental Health Journal. Online September 2022.
- Summary: People coping with behavioral health disorders have a very high prevalence of smoking. The Bucket Approach, a free online training, tailors evidence-based tobacco dependence interventions for behavioral health. More than 1,000 people have enrolled in (and more than 447 people completed) the training. Individuals who completed the training evaluated it highly, with an overall mean score of 8.4 out of 10. The training resulted in substantial changes in beliefs about treating tobacco dependence.
Coffman DL, Dziak JJ, Litson K, Chakraborti Y, Piper ME, Li R. A Causal Approach to Functional Mediation Analysis with Application to a Smoking Cessation Intervention. Multivariate Behavioral Research. Online November 17, 2022.
- Summary: The authors developed a new approach for examining the mediation effects of a treatment that results in a binary outcome (quit smoking vs. didn’t quit smoking). This methodological innovation allows researchers to understand how mechanisms that are measured repeatedly using ecological momentary assessments can be analyzed to help understand how a treatment exerts its effects on a binary outcome. The authors used simulated datasets to test this methodology and then used the Wisconsin Smokers’ Health Study 2 data to validate the approach. These innovative analyses found that varenicline reduced craving and this effect becomes slightly stronger during the first week post-quit.
Cofresí RU, Piasecki TM, Bartholow BD, Schachtman TR. (2022) Enhanced Conditioned “Liking” of Novel Visual Cues Paired with Alcohol or Non-Alcohol Beverage Container Images Among Individuals at Higher Risk for Alcohol Use Disorder. Psychopharmacology. 239, 3567–3578. Online September 12, 2022.
- Summary: Novel, arbitrary visual cues can come to be evaluated more positively (ie, “liked” more) after repeated pairing with existing, “naturalistic” visual cues for alcohol (associations acquired through pairings encountered in daily life), and that this effect scaled with the heaviness of alcohol use. Additionally, researchers found that arbitrary visual cues can come to be evaluated less positively (ie, “liked” less) after pairings with “naturalistic” alcohol cues among nondrinkers.
Cofresí RU, Kohen C, Motschman C, Wiers RW, Piasecki TM, Bartholow BD. (2022) Behavioral Response Bias and Event-Related Brain Potentials Implicate Elevated Incentive Salience Attribution to Alcohol Cues in Emerging Adults with Lower Sensitivity to Alcohol. Addiction. 117(4):892-904.
- Summary: In this study, young adult drinkers participated in a behavioral task in which they used a joystick to “avoid” pictures of alcoholic and non-alcoholic beverages (by pushing them away on the computer screen) and to “approach” them (by pulling them toward themselves on the screen). Relative to their higher sensitivity peers, lower sensitivity drinkers showed an alcohol approach bias, reacting more quickly when approaching vs. avoiding alcohol cues. Measures of electrical brain activity collected during the task indicated these at-risk drinkers had exaggerated motivated attention when approaching alcohol and more ambivalence when avoiding alcohol. Traits associated with stronger “wanting” reactions to drug cues may be important risk factors for addiction.
Cofresí RU, Piasecki TM, Bartholow BD. (2022) Acute Sensitization of the P3 Event-related Potential Response to Beverage Images and the Risk for Alcohol Use Disorder. Addiction Neuroscience. Online October 28, 2022.
- Summary: Whereas incentive value attribution may be a mechanism for alcohol cue-triggered attentional biases for both lower sensitivity and high-sensitivity individuals, lower sensitivity individuals more consistently over-attribute incentive value to alcohol cues.
Coleman SRM, Piper ME, Byron MJ, Bold KW. Dual Use of Combustible Cigarettes and E-cigarettes: A Narrative Review of Current Evidence. Current Addiction Reports. 9(4):353-362. Online October 17, 2022.
- Summary: Nearly half of e-cigarette users concurrently use cigarettes, and many smoke more frequently than they vape. This is concerning because dual users are exposed to both cigarette and potential e-cigarette toxicants and the data are mixed regarding the ability of e-cigarettes to promote smoking cessation.
Cox CM, Westrick J, McCarthy DE, Carpenter MJ, Mathew AR. (2022) Practice Quit Attempts: Scoping Review of a Novel Intervention Strategy. Journal of Studies on Alcohol and Drugs. 2022 Jan;83(1):115-125. Online January 19, 2022.
- Summary: Researchers conducted a systematic literature search of 3,879 articles on practice quit attempts. They found that fostering practice quit attempts for people trying to quit smoking through behavioral and pharmacological interventions offers a promising technique for cessation induction that warrants future research.
D’Angelo H, Hohl SD, Rolland B, Adsit RT, Pauk D, Fiore MC, Baker TB. (2022) Reach and Effectiveness of the NCI Cancer Moonshot-funded Cancer Center Cessation Initiative. Translational Behavioral Medicine. Online February 23, 2022.
- Summary: Researchers found that engagement by leadership at cancer centers had a favorable impact on the reach of those centers to help cancer patients quit smoking. Investment in technology may also help cancer centers reach more patients to help them quit smoking. Understanding which implementation and intervention strategies facilitate greater reach and effectiveness of treatment to quit smoking could lead to improved outcomes among cancer patients who smoke.
Dash GF, Gizer IR, Slutske WS. (2022) Contextualizing Prescription Opioid Misuse and Heroin Use Within Dimensional Models of Drug Involvement. Drug and Alcohol Dependence Reports. Online December 2022.
- Summary: Opioid misuse and heroin use are often conceptualized as two sides of the same “opioid use” coin, with prescription opioid misuse implicated as a step on the path to heroin use. However, studies aiming to address this topic often do so while insufficiently addressing the broader drug use context in which most opioid (mis)use occurs. This study identified evidence for unidimensionality in both drug (mis)use and drug use disorder, which aligns with often overlooked findings showing that non-opioid drug use predicts heroin use at least as robustly as does prescription opioid misuse.
Dash GF, Martin NG, Agrawal A, Lynskey MT, Slutske WS. (2022) Are Prescription Misuse and Illicit Drug Use Etiologically Distinct? A Genetically-Informed Analysis of Opioids and Stimulants. Psychological Medicine. 2022 18 July. 52(14), 3176-3183.
- Summary: This study provides a novel examination of genetic and environmental contributions to opioid and stimulant use, with disaggregated effects of prescription misuse and illicit use. The results presented here support the idea of disaggregation by demonstrating potentially distinct etiologies across prescription opioid misuse and illicit opioid use.
Davis CN, Gizer IR, Colodro-Conde L, Statham DJ, Martin NG, Slutske WS. Educational Attainment Polygenic Scores: Examining Evidence for Gene–Environment Interplay with Adolescent Alcohol, Tobacco and Cannabis Use. Twin Research and Human Genetics. Online October 3, 2022.
- Summary: There was no evidence that adolescent alcohol, tobacco or cannabis use interacted with Educational Attainment Polygenic Scores (EA-PGS) to influence educational attainment. However, there was a significant, positive gene-environment correlation with adolescent alcohol use at all PGS thresholds. Higher EA-PGS were associated with an increased likelihood of using alcohol as an adolescent.
Davis CN, Gizer IR, Lynskey MT, Statham DJ, Heath AC, Martin NG, Slutske WS. (2022) Adolescent Substance Use and Educational Attainment: Exploring the Nature of the Relationship Using a Discordant Twin Design. Addiction. 118(1):167-176. Online July 11, 2022.
- Summary: Adolescent substance use is associated with early school dropout, with the effects of any given substance largely because of the confounding factors of parental education, childhood conduct disorder symptoms, and use of other substances. Two exceptions to this were sedatives and inhalants/solvents. These substances had effects on high school noncompletion that could not be explained by polysubstance use or familial factors. There may be specific mechanisms by which these substances produce changes that lead to impairments and reduced education.
Fiore MC, Smith SS, Adsit RT, Bolt DM, Conner KL, Bernstein SL, Eng OD, Lazuk D, Gonzalez A, Jorenby DE, D’Angelo H, Kirsch JA, Williams B, Nolan MB, Hayes-Birchler T, Kent S, Kim H, Piasecki TM, Slutske WS, Lubanski S, Yu M, Suk Y, Cai Y, Kashyap N, Mathew JP, McMahan G, Rolland B, Tindle HA, Warren GW, An LC, Boyd AD, Brunzell DH, Carrillo V, Chen L-S, Davis JM, Dilip D, Ellerbeck EF, Iturrate E, Jose T, Khanna N, King A, Klass E, Newman M, Shoenbill KA, Tong E, Tsoh JY, Wilson KM, Theobald WE, Baker TB. (2022) The First 20 Months of the Covid-19 Pandemic: Mortality, Intubation, and ICU Rates Among 104,590 Patients Hospitalized at 21 United States Health Systems. PLOS ONE. Online September 28, 2022.
- Summary: Rates of death, intubation, and admission to intensive care improved markedly during the first 20 months of the pandemic among adults hospitalized with COVID-19, according to a nationwide study led by the University of Wisconsin. However, some patient groups had relatively high mortality rates both early and late in the pandemic: Males, Medicare members, people who are severely obese, and those aged 60 and older.
Heiden BT, Smock N, Pham G, Chen J, Baker TB, Bierut LJ, Chen L-S. (2022) Assessment of Formal Tobacco Treatment and Smoking Cessation in Dual Users of Cigarettes and E-Cigarettes. Thorax. 0:1–7. Online July 20, 2022.
- Summary: The researchers found that dual users of cigarettes and e-cigarettes benefit from formal tobacco treatment. Clinicians should consider offering formal tobacco treatment to such patients, though future trials are needed.
Hohl SD, Bird JE, Nguyen CVT, Pauk D, D’Angelo H, Minion M, Adsit RT, Fiore MC, Nolan MB, Rolland B. (2022) Operationalizing Leadership and Clinician Buy-In to Implement Evidence-Based Tobacco Treatment Programs in Routine Oncology Care: A Mixed-Method Study of the U.S. Cancer Center Cessation Initiative. Current Oncology. 29(4), c. March 29, 2022.
- Summary: At least 75 percent of participating cancer centers secured administrative, clinical, and IT leadership buy-in and support. Six themes emerged from interviews on what factors facilitated their efforts to help cancer patients quit smoking: engaging leadership, access to resources, leveraging federal funding support to build leadership interest, designating champions, identifying training needs, and ensuring staff roles and IT workflows.
Hohl SD, Shoenbill KA, Taylor KL, Minion M, Bates-Pappas GE, Hayes RB, Nolan MB, Simmons VN, Steinberg MB, Park ER, Ashing K, Beneventi D, Sanderson Cox L, Goldstein O, King A, Kotsen C, Presant CA, Sherman SE, Sheffer CE, Warren GW, Adsit RT, Bird JE, D’Angelo H, Fiore MC, Nguyen CVT, Pauk D, Rolland B, Rigotti NA. (2022) The Impact of the COVID-19 Pandemic on Tobacco Treatment Program Implementation at NCI-Designated Cancer Centers. Nicotine & Tobacco Research. Online July 2, 2022.
- Summary: This work describes how NCI-designated cancer centers participating in the Cancer Center Cessation Initiative (C3I) adapted to challenges to sustain evidence-based tobacco treatment during the COVID-19 pandemic. This work offers a model for resilience and rapid transition to remote tobacco treatment and proposes a policy and research agenda for telehealth services as an approach to sustaining tobacco treatment.
Hohl SD, Matulewicz RS, Salloum RG, Ostroff JS, Baker TB, Schnoll R, Warren G, Bernstein SL, Minion M, Lenhoff K, Dahl N, Juon HS, Tsosie U, Fleisher L, D’Angelo H, Ramsey AT, Ashing KT, Rolland B, Nolan MB, Bird JE, Nguyen CVT, Paul D, Adsit RT, Tindle H, Shoenbill K, Yeung S, Presat CA, Wiseman K, Wen K, Chichester L, Chen L. Integrating Tobacco Treatment into Oncology Care: Reach and Effectiveness of Evidence-Based Tobacco Treatment Across NCI-Designated Cancer Centers. Journal of Clinical Oncology. December 6, 2022.
- Summary: This cross-sectional study used survey data from 28 Cancer Center Cessation Initiative (C3I) centers that reported tobacco treatment data during the first 6 months of 2021. Of the total 692,662 unique patients seen, 44,437 reported current smoking. Across centers, a median of 96% of patients were screened for tobacco use, median smoking prevalence was 7.4%, median reach was 15.4%, and median effectiveness was 18.4%. Dedicating staff to tobacco treatment may help outcomes.
Ives K, Christiansen BA, Nolan MB, Kaye JT, Fiore MC. (2022) Nine Years of Smoking Data from Incarcerated Men: A Call to Action for Tobacco Dependence Interventions. Preventive Medicine Reports. Oct;29:101921. Online July 22, 2022.
- Summary: Nearly all people who smoked when they were sent to prison return to smoking shortly after release. Smoking prevalence prior to prison remains very high and is not changing. Most prison survey respondents do not consider themselves addicted. Prison survey respondents have become less interested in help to stay tobacco-free. Survey results suggest possible elements for tobacco interventions.
Johnson AL, Seep E, Norton DL, Mundt MP, Wyman MF, James TT, Zuelsdorff M, Lambrou NH, McLester-Davis LWY, Umucu E, Gleason CE. Wisconsin Healthcare Utilization Cost Among American Indians/Alaska Natives with and without Alzheimer’s Disease and Related Dementias. Journal of Alzheimer’s Disease. Online November 9, 2022.
- Summary: Based on the national population estimate of American Indian/Alaska Native adults ages 65 or older and prevalence rates of Alzheimer’s disease and related dementias (ADRD) in this population, researchers estimated ADRD among indigenous people costs $880.45 million to $1.91 billion annually in additional healthcare-related costs. Moreover, they estimated ADRD and possible misdiagnoses in American Indian/Alaska Native costs an additional $1.17 billion to $2.54 billion annually.
Johnson AL, Schlam TR, Baker TB, Piper ME. (2022) Understanding What Changes Adults in a Smoking Cessation Study Believe They Need to Make to Quit Smoking: A Qualitative Analysis of Pre- and Post-Quit Perceptions. Psychology of Addictive Behaviors. Online June 23, 2022.
- Summary: Prior to quitting, more than a third of participants were unable to identify changes to increase cessation success. The others said they focused on triggers and cues for smoking. Participants who quit reported using the strategies they learned from counselors—such as the 4 D’s strategies (delay, drink water, deep breathing, distract), avoiding cues to smoke, changing routine, and getting support. Using FDA-approved medications was the least-reported theme.
Kohen CB, Cofresí RU, Bartholow BD, Piasecki TM. (2022) Alcohol Craving in the Natural Environment: Moderating Roles of Cue Exposure, Drinking, and Alcohol Sensitivity. Experimental and Clinical Psychopharmacology. Online January 13, 2022.
- Summary: Craving during drinking episodes in the natural environment is magnified by the presence of alcohol cues, potentially contributing to the maintenance or acceleration of drinking episodes. Moreover, people who drink with lower sensitivity may be particularly susceptible to the combined effects of cue exposure and post-drinking status on alcohol craving.
Koh HK, Fiore MC. (2022) The Tobacco Industry and Harm Reduction. Online November 4, 2022.
- Summary: In a Viewpoint piece, the authors call out the tobacco industry for a fundamental hypocrisy—promoting harm reduction while continuing to market and sell combustible cigarettes that cause harm in the first place. During a time when the FDA has proposed some major policy changes, the researchers call for the industry to adhere to their stated goals of harm reduction and embrace a future where the tobacco industry isn’t killing off half of their own customers.
LeFoll B, Piper ME, Fowler CD. (2022) Tobacco and Nicotine Use. Nature Reviews Disease Primer. 8(19). Online March 24, 2022.
- Summary: Given that the majority of people who smoke ultimately relapse, the researchers asserted that it’s important to enhance the reach of available interventions and to continue to develop novel ones. These efforts, associated with innovative policy regulations (aimed at reducing nicotine content or eliminating tobacco products), have the potential to reduce the prevalence of tobacco and nicotine use and their enormous adverse impact on population health.
Lowy DR, Fiore MC, Willis G, Mangold KN, Bloch MH, Baker TB. (2022) Treating Smoking in Cancer Patients; An Essential Component of Cancer Care – the new National Cancer Institute Tobacco Control Monograph. Journal of Clinical Oncology. Online October 22, 2022.
- Summary: UW-CTRI Founders Dr. Tim Baker and Dr. Michael Fiore edited the new Monograph. They found that high rates of tobacco treatment reach and engagement can be achieved in oncology clinics treating cancer patients who smoke. While there’s no one-size-fits all approach to treat cancer patients who smoke, a team approach—including clinicians, IT staff, clinic administrators, rooming staff, and often nurses and pharmacists—can get the job done.
McCarthy DE, Baker TB, Zehner ME, Adsit RA, Kim N, Zwaga D, Coates K, Wallenkamp H, Nolan MB, Steiner M, Skora A, Kastman C, Fiore MC. (2022) A Comprehensive Electronic Health Record-Enabled Smoking Treatment Program: Evaluating Reach and Effectiveness in Primary Care in a Multiple Baseline Design. Preventive Medicine. Online May 28, 2022.
- Summary: Implementation of a comprehensive, opt-out, chronic-care program aimed at all patients who smoke was associated with increases in the rates of pharmacotherapy and counseling delivery and quitting smoking. Proactive outreach may help reduce disparities in treatment access. Telephone treatment reach was particularly high in historically underserved groups, including African American, Hispanic, and Medicaid-eligible patients.
Nolan M, Spicer A, Remington P, Malecki K, McCarthy D. (2022) Missing Out: Underutilization of Primary Care by Wisconsin Patients Who Smoke and Its Implications for Tobacco Treatment Access. Wisconsin Medical Journal. Online December 20, 2022.
- Summary: Those currently smoking were more likely than former- or never-smoking respondents to report emergency departments as their “usual place to go when sick” (12% vs 3%) or report they had “no place to go when sick” (16% vs 7%). This suggests some Wisconsin adults who smoke do not receive primary care every year and that they delay care or seek care in emergency departments. As a result, such individuals may be missing out on evidence-based tobacco cessation treatment.
Nolan MB, Piasecki TM, Smith SS, Baker TB, Fiore MC, Adsit RT, Bolt DM, Conner KL, Bernstein SL, Eng OD, Lazuk D, Gonzalez A, Hayes-Birchler T, Jorenby DE, D’Angelo H, Kirsch JA, Williams BS, Kent S, Kim H, Lubanski SA, Yu M, Suk Y, Cai Y, Kashyap N, Mathew J, McMahan G, Rolland B, Tindle HA, Warren GW, Abu-El-Rub N, An LC, Boyd AD, Brunzell DH, Carrillo VA, Chen LS, Davis JM, Deshmukh VG, Dilip D, Goldstein A, Ha PK, Iturrate E, Jose T, Khanna N, King A, Klass E, Lui M, Mermelstein RJ, Poon C, Tong E, Wilson KM, Theobald WE, Slutske WS. (2022) Relations of Current and Past Cancer with Severe Outcomes among 104,590 Hospitalized COVID-19 Patients: The COVID EHR Cohort at the University of Wisconsin. Cancer Epidemiology, Biomarkers & Prevention. 2022 Aug 15:EPI-22-0500. Online August 15, 2022.
- Summary: Current cancer, especially amongst younger patients, posed a substantially increased risk for death and ICU admission among COVID-19 patients; prior COVID-19 vaccination mitigated the risk associated with current cancer. Past history of cancer was not associated with higher risks for severe COVID-19 outcomes for most cancer types.
Nuako A, Liu J, Pham G, Smock N, James A, Baker TB, Bierut L, Colditz G, Chen L-S. (2022) Quantifying Rural Disparity in Healthcare Utilization in the United States: Analysis of a Large Midwestern Healthcare System. PLOS One. Online February 10, 2022.
- Summary: Within a large healthcare system, patients in rural clinics had lower outpatient healthcare utilization compared to their urban counterparts despite having potentially elevated health needs reflected by a higher number of unique health diagnoses documented in their electronic health records after adjusting for multiple factors.
Piasecki T, Smith SS, Baker TB, Slutske WS, Adsit RT, Bolt DM, Conner KL, Bernstein SL, Eng OD, Lazuk D, Gonzalez A, Jorenby DE, D’Angelo H, Kirsch JA, Williams BS, Nolan MB, Hayes-Birchler T, Kent S, Kim H, Lubanski S, Yu M, Suk Y, Cai Y, Kashyap N, Mathew JP, McMahan G, Rolland B, Tindle HA, Warren GW, An LC, Boyd AD, Brunzell DH, Carrillo V, Chen L-S, Davis JM, Deshmukh VG, Dilip D, Ellerbeck EF, Goldstein A, Iturrate E, Jose T, Khanna N, King A, Klass E, Mermelstein RJ, Tong E, Tsoh JY, Wilson KM, Theobald WE, Fiore MC. (2022) Smoking Status, Nicotine Medication, Vaccination, and COVID-19 Hospital Outcomes; Findings From the COVID EHR Cohort at the University of Wisconsin (CEC-UW) Study. Nicotine Tobacco Research. Online August 30, 2022.
- Summary: Among current smokers hospitalized with COVID-19, prescriptions for nicotine patches, lozenges, or gum were associated with reduced mortality. Of the smokers prescribed these meds, 4.5% died, a significantly lower rate of mortality compared to 7.7% of smokers who weren’t. Nicotine may activate anti-inflammatory mechanisms that might help protect against severe disease. But note these observational findings cannot establish a causal effect of this medication.
Piper ME, Maddox R, Castro Y, Hinds JT, Henderson PN, Clark H, Guy MC, Choi K. (2022) Lessons Learned on Addressing Racism: Recommendations from The Society for Research on Nicotine & Tobacco’s Racial Equity Task Force. Online June 25, 2022.
- Summary: In this editorial, the authors review the recommendations of the Society for Research on Nicotine and Tobacco’s Racial Equity Task Force on how to address individual and institutional racism within academia in general and within the field of commercial tobacco and nicotine science.
Ramsey AT, Baker TB, Stoneking F, Smock N, Chen J, Pham G, James AS, Colditz GA, Govindan R, Bierut LJ, Chen L-S. (2022) Increased Reach and Effectiveness With a Low-Burden Point-of-Care Tobacco Treatment Program in Cancer Clinics. Journal of the National Comprehensive Cancer Network. Online May 17, 2022.
- Summary: This study of 13,651 oncology patients examined whether a health system could leverage their electronic health system to identify patients who smoke and offer help to quit. It worked. The system had a low burden on oncology staff and was delivered at point-of-care. This improved access to (and the impact of) evidence-based treatment to quit smoking. It could be implemented at cancer centers across the country to bolster reach to patients who smoke to help them quit, improving cancer outcomes.
Shafie-Khorassani F, Piper ME, Jorenby DE, Baker TB, Benowitz ML, Hayes-Birchler T, Maza R, Brouwer AF. (2022) Associations of Demographics, Dependence, and Biomarkers with Transitions in Tobacco Product Use in a Cohort of Cigarette Users and Dual Users of Cigarettes and E-Cigarettes. Nicotine and Tobacco Research. ntac207. Online August 29, 2022.
- Summary: Dual users were more likely to quit smoking than cigarette-only users, but the overall impact was small because most dual users returned to cigarette-only use. Moreover, e-cigarette dependence promoted continued dual use rather than smoking cessation.
Slutske WS, Richmond-Rakerd LS, Piasecki TM, Ramrahka S, Poulton R, Moffitt TE, Caspi A. (2022) Disordered Gambling in a Longitudinal Birth Cohort: From Childhood Precursors to Adult Life Outcomes. Psychological Medicine. Online October 18, 2022.
- Summary: Data from a population-representative cohort from New Zealand followed from birth to age 45 were used to document the long-term course, childhood precursors, and adult-life outcomes associated with disordered gambling. Disordered gambling usually occurred at only a single time point and recurrence was uncommon. Lower childhood social class, general intelligence, and self-control predicted disordered gambling, which was associated with occupational, educational, and financial problems.
Slutske WS, Davis CN, Lynskey MT, Heath AC, Martin NG. (2022) An Epidemiologic, Longitudinal, and Discordant-Twin Study of the Association Between Gambling Disorder and Suicidal Behaviors. Clinical Psychological Science. Online January 10, 2022.
- Summary: The association of suicidal thoughts with disordered gambling was non-causally explained by common genetic influences among women but not men. Conversely, there was evidence consistent with a potentially causal influence of disordered gambling on suicide attempts among men only. This might have been related to gambling-related financial problems. The causes of the association with disordered gambling differed for suicidal ideation, plan, and attempt (and differed by gender).
Spychala K, Gizer IR, Davis CN, Dash GF, Piasecki TM, Slutske WS. (2022). Predicting Disordered Gambling Across Adolescence and Young Adulthood from Polygenic Contributions to Big 5 Personality Traits in a UK Birth Cohort. 117, 690-700.Online August 3, 2021.
- Summary: This study tested associations between genetic measurements related to broad personality traits and disordered gambling outcomes in 4,279 young adult participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Polygenic contributions to low agreeableness and high neuroticism were related to problem gambling severity and pathological gambling-symptom counts.
Waddell JT, Bartholow BD, Piasecki TM. (2022). Changes in Affect and Alcohol Craving During Naturally Occurring Drinking Episodes: The Role of Day-Level Drinking Motives. Experimental and Clinical Psychopharmacology.Online September 15, 2022.
- Summary: For many drinkers, occasional use of alcohol to cope with negative moods may be a self-limiting phenomenon. However, post-drinking mood changes may promote desire for continued alcohol use in drinkers who habitually turn to alcohol for emotional relief. These findings suggest that coping motives may operate differently at the event-level and person-level of analysis.
Yang J, Kuo J, Su W-C, Jorenby DE, Piper ME, Buu A. (2022) A New Statistical Model for Longitudinal Ecological Momentary Assessment Data on Dual Use of Electronic and Combustible Cigarettes. Methods in Addiction Research. Online January 31, 2022.
- Summary: This study proposed a new statistical method to analyze data from the measurement burst design (eg hourly, daily measurements are embedded in a larger longitudinal study). The proposed method is highly applicable as it can be easily implemented by substance use researchers and the results can be straightforwardly interpreted. The results suggest that vaping may play a role in promoting a long-term reduction in smoking among dual users.
Yang JJ, Lin HC, Ou TS, Tong Z, Li R, Piper ME, Buu A. (2022) The Situational Contexts and Subjective Effects of Co-use of Electronic Cigarettes and Alcohol Among College Students: An Ecological Momentary Assessment (EMA) Study. Drug Alcohol Dependence. 239:109594. Online October 1, 2022.
- Summary: Frequent co-use of e-cigarettes and alcohol carries elevated risk for dependence. Higher alcohol consumption is associated with higher e-cigarette consumption. Menthol and fruit flavors may promote more vaping. E-cigarette and alcohol use increase positive affect and craving for e-cigarettes.
Zehner ME, Kirsch JA, Adsit RT, Gorrilla A, Hayden K, Skora A, Rosenblum M, Baker TB, Fiore MC, McCarthy DE. (2022) Electronic Health Record (EHR) Closed-Loop Referral (“eReferral”) to a State Tobacco Quitline: A Retrospective Case Study of Primary Care Implementation Challenges and Adaptations. Implementation Science Communications. 8;3(1):107. Online October 8, 2022.
- Summary: Two health systems both used Epic EHR but had different approaches to interfacing with the quitline vendor and integrating eReferral into clinician workflows. System-wide implementation of quitline eReferral in primary care outpatient clinics is feasible but requires extensive coordination across stakeholders, tailoring to local health system EHR configurations, and sensitivity to system- and clinic-specific workflows.
Williams BS, Piper ME, Piasecki T, Kaye J, Fiore MC. Trends in E-cigarette Use in Callers to the Wisconsin Tobacco Quit Line. Wisconsin Medical Journal.
To search a sortable database of all UW-CTRI papers since inception, click here.
Research Presentations and Posters
Note: Names in bold are current UW-CTRI employees.
Chakraborti Y, Coffman D, Litson K, Piper ME. Using Mixture Models to Identify Smoking Cessation Profiles Based on Self-Efficacy, Positive Expectancy, Motivation, and Cessation Fatigue: An Exploratory Latent Profile and Latent Transition Analysis. Society for Research on Nicotine & Tobacco Conference. Poster. Baltimore, MD. March 2022.
Cofresí R, Upton S, Rodgers M, Brown A, Piasecki TM, Froeliger B, Bartholow BD. Alcohol Sensitivity Moderates Alcohol Cue Reactivity in Anterior Insula and Medial Prefrontal Cortex: An fMRI Pilot Study. Research Society on Alcoholism. Poster. Orlando, FL. June 2022.
Cofresí R, Morales S, Piasecki TM, Bartholow B. Time-Frequency Power and Phase-Synchrony Signatures of Reactivity to Visual Alcohol Cues. Society for Psychophysiological Research. Poster. Vancouver, Canada. September 2022.
Cofresí R, Fleming K, Schachtman T, Piasecki TM, Bartholow B. Second-Order Alcohol Cue Conditioning in The Human Laboratory: Preliminary Studies of Individual Differences. Society for Psychophysiological Research. Presentation. Vancouver, Canada, September 2022.
Coleman SRM, Piper ME, Byron MJ, Bold KW. Dual Use of Combustible Cigarettes and E-Cigarettes: A Narrative Review of Current Evidence. Tobacco Regulatory Science Meeting. Poster. October 2022.
Conner, K. COVID-19 and Smoking EHR Data: 1 Million Patients and Counting. National Conference on Tobacco or Health. Presentation. New Orleans, LA. June 2022.
Cook JW, Piper ME, McCarthy DE, Schlam TR, Zwaga D, Kaye JT, Johnson AL, Baker TB. Anhedonia: Relations with Withdrawal and Abstinence During a Smoking Cessation Attempt in a Randomized Controlled Trial. Society for Research on Nicotine & Tobacco Conference. Poster. Baltimore, MD. March 2022.
Correa-Fernández V, Tavakoli N, Motsenbocker M, Llaneza D, Rabello L, Cartagenova D, Kim H, Wetter DW, Canino G, Li L, Piper ME. Telehealth Smoking Cessation Intervention for Latinx who Smoke and Had Depression and/or Anxiety: Findings from a Feasibility Study. Society for Research on Nicotine & Tobacco Conference. Poster. Baltimore, MD. March 2022.
Creswell P, McCarthy DE, Trapskin P, Sheehy A, Skora A, Adsit RT, Zehner ME, Baker TB, Fiore MC. Can Inpatient Pharmacists Move the Needle on Smoking Cessation? Evaluation Reach and Representativeness of a Pharmacist-Led Opt-Out Smoking Cessation Intervention Protocol for Hospital Settings. Society for Research on Nicotine & Tobacco Conference. Baltimore, MD. March 2022.
Fiore MC. Predicting Patient Outcomes in Wisconsin and Nationwide Using the University of Wisconsin’s COVID EHR Cohort Database. UW-Wisconsin Partnership Program (WPP) PERC Meeting. Virtual presentation. January 2022.
Fiore MC. Breathe 2 Training. UW Health Union Corners. Virtual presentation. January 2022.
Fiore MC. Tobacco Dependence and Treatments. UW-CTRI & Cessation Research Overview for UW SMPH 4th Years’ Spring Elective. Virtual presentation. February 2022.
Fiore MC. BREATHE2: Project 3: National Cancer Institute Research Program to Help UW-Health Patients Quit Smoking. UW Health Primary Care Leadership Council (PCLC) Meeting. Virtual presentation. March 2022.
Fiore MC, Hohl SD, Salloum RG, Bernstein SL, Minion M, Lenhoff K, Dahl N, Juon HS, Tsosie U, Fleisher L, Rolland B, D’Angelo H, Ramsey AT, Ostroff JS, Ashing KT, Scholl R, Chen LS. Optimizing Reach and Effectiveness of Tobacco Treatment in Cancer Patients: Lessons from the Cancer Moonshot Cancer Center Cessation Initiative. Society for Research on Nicotine & Tobacco Conference. Presentation. Baltimore, MD. March 2022.
Fiore MC. Tenure Track for Adrienne Johnson, PhD. Division of General Internal Medicine –UW-CTRI DOM Executive Meeting. Virtual presentation. March 2022.
Fiore MC. Center Update / UW-CTRI 30th UW-CTRI All-Staff Meeting. Madison, WI. April 2022.
Fiore MC. Helping Cancer Patients Who Smoke: Future Directions. American Association for Cancer Research Annual Meeting. New Orleans, LA. Presentation. April 2022.
Fiore MC. Unfinished Business: The Achievable Goal of Eliminating All Tobacco Product Use in the United States by 2030. American Thoracic Society (ATS) Annual Conference. Keynote Presentation. San Francisco, CA. May 2022.
Fiore MC. Integrating Tobacco Cessation Treatment on the Cancer Journey. National Conference on Tobacco or Health. Poster. New Orleans, LA. June 2022.
Garner BR, Tueller SJ, Bradshaw M, Mungo J, McDaniel S, Ford II JH, Zehner ME, Roosa MR, Speck KJ, Satre DD, Martino S. Integrating Motivational Interviewing within HIV Service Organizations: Preliminary Findings from a Type 3 Hybrid Trial. Colorado Pragmatic Research in Health Virtual Conference. Poster. Aurora, CO. May 2022.
Garner BR, Tueller SJ, Bradshaw M, Speck K, Vandersloot D, Roosa MR, Zehner ME, Mungo J, McDaniel S, Ruwala R, Satre DD, Rash C, Ford JH. Improving Implementation of a Motivational Interviewing-Based Brief Intervention for Substance Use Disorders in HIV Service Settings: Enhancing Facilitation with Financial Incentives. Presentation. Society for Implementation Research Collaboration Conference. San Diego, CA. September 2022.
Garner BR, Tueller SJ, Bradshaw M, Speck K, Vandersloot D, Ford JH, Roosa MR, Zehner ME, Mungo J, McDaniel S, Ruwala R, Satre DD. Using Pay-for-Performance as a Strategy to Improve the Consistency and Quality of Implementing a Motivational Interviewing-Based Brief Intervention for People with HIV and Substance Use Disorders. Presentation. International Network on Brief Interventions for Alcohol & Other Drugs Conference. Edinburgh, UK. September 2022.
Garner BR, Tueller SJ, Bradshaw M, Speck K, Vandersloot D, Satre DD, Ford JH, Roosa MR, Zehner ME, Mungo J, McDaniel S, Ruwala R, Rash C. Pay-for-Performance is a Financing Strategy that Improved Implementation Effectiveness: Results from a 25-site Cluster-Randomized Type 3 Hybrid Trial. Presentation. 15th Annual Conference on the Science of Dissemination and Implementation. Washington, DC. December 2022.
Gorrilla A, Skora A, Thompson S, Lundsten S, Conner K. Improving Access to Tobacco Dependence Treatment for People Who Are Justice-Involved. National Conference on Tobacco or Health. Poster. New Orleans, LA. June 2022.
Gorrilla A, Skora A, Thompson S, Lundsten S, Conner K. Improving Access to Tobacco Dependence Treatment for People Who Are Justice-Involved. Wisconsin Public Health in Practice Conference. Presentation. Oshkosh, WI. August 2022.
Hollenback C, Jorenby DE, Fiore MC. Using Instagram to Refer Teens to Teen.Smokefree.gov. Society for Research on Nicotine & Tobacco Conference. Poster. Baltimore, MD. March 2022.
Hughey CM, Piasecki TM, Korcarz CE, Hansen KM, Ott NR, Tattersall MC, Fiore MC, Baker TB, Stein JH. Differences in Treadmill Exercise Stress Testing Parameters Among Electronic Cigarette Vapers, Combustible Cigarette Smokers, and Controls: The CLUES Study. University of Wisconsin Department of Medicine Research Day. Madison, WI. October 2022.
Hughey CM, Piasecki TM, Korcarz CE, Hansen KM, Ott NR, Tattersall MC, Fiore MC, Baker TB, Stein JH. (2022) Differences in Treadmill Exercise Stress Testing Parameters Among Electronic Cigarette Vapers, Combustible Cigarette Smokers, and Controls: The CLUES Study. Poster. Chicago, IL. November 2022.
Johnson AL, Gleason CE, Cook JM, Mahoney JE, Piper ME. Motivating Change in Older Adults: Motivational Cessation Message Development Findings. Society for Research on Nicotine & Tobacco Conference. Poster. Baltimore, MD. March 2022.
Johnson AL, Kaye J. Motivating Change in Older Adults: Motivational Cigarette Smoking Cessation Message Testing. University of Wisconsin Department of Medicine Research Day. Madison, WI. October 2022.
Johnson AL, Kaye J. Motivating Change in Older Adults: Motivational Cigarette Smoking Cessation Message Testing. Gerontological Society of America Annual Scientific Meeting. Presentation. Indianapolis, IN. November 2022.
Johnson AL. Novel Interventions for Smoking Cessation (Chair). Gerontological Society of America Annual Scientific Meeting. Symposium. Indianapolis, IN. November 2022.
Jorenby DE. Smoking Cessation 2022: CVD Core (Prevention). UW Hospital and Clinics Cardiovascular Disease Fellowship. Madison, WI. June 2022.
Kaye JT, Ives K, Christiansen B, Nolan MB, Fiore MC. Rethinking Tobacco Treatment for Incarcerated Adults to Achieve Health Equity. Society for Research on Nicotine & Tobacco Conference. Poster. Baltimore, MD. March 2022.
Kaye JT, Ives K, Christiansen B, Nolan MB, Fiore MC. Presented by Conner K. Rethinking Tobacco Treatment for Incarcerated Adults to Achieve Health Equity. National Conference on Tobacco or Health. Poster. New Orleans, LA. June 2022.
Kim N, McCarthy DE, Coffman D, Piper ME, Bolt D, Stein JH, Baker TB. Time-Varying Mediators of Pre- and Post-Quit Nicotine Patch Therapy in Adults Attempting to Quit Smoking with Varenicline. Society for Research on Nicotine & Tobacco Conference. Pre-recorded digital presentation only. Baltimore, MD. March 2022.
Kirsch J, Zehner M, Adsit R, McCarthy D, Gorrilla A, Hayden K, Skora A, Rosenblum M, Fiore MC, Baker TB. Electronic Health Record Closed-loop Referral (eReferral) to a State Tobacco Quitline: Primary Care Implementation Challenges and Adaptations. Society for Research on Nicotine & Tobacco Conference. Poster. Baltimore, MD. March 2022.
Kohen CB, Cofresí RU, Bartholow BD, Piasecki TM. Alcohol Cue Event-Related Potential Response and Ecologically Assessed Drinking Behavior in Emerging Adults. Research Society on Alcoholism. Poster. Orlando, FL. June 2022.
Piper ME. SRNT Presidential Symposium. Society for Research on Nicotine & Tobacco Conference. Baltimore, MD. March 2022.
Piper ME (Chair), Cummings M, Munafo M, Castro Y, Benowitz N, Meyers M, Rigotti N, Hatsukami D, Carroll D, Leischow S, et al. It’s All About the Science: How Do We Do It Thoughtfully in a Changing Environment? Society for Research on Nicotine & Tobacco Conference. Symposium. Baltimore, MD. March 2022.
Piper ME, Zeller M. Updates on the FDA Center for Tobacco Products with Mitch Zeller. Society for Research on Nicotine & Tobacco Conference. Symposium. Baltimore, MD. March 2022.
Piper ME. Smoking and Mental Illness. National Cancer Institute Tobacco Control Research Branch Scientific Staff Meeting. Virtual presentation. October 2022.
Piper ME. Mhealth Interventions to Support Long-Term Cessation. Joint work group of the National Cancer Institute and the French National Cancer Institute. Presentation. Paris, France. November 2022.
Piper ME, Schlam TR, Kobinsky KH, Donny EC, Jorenby DE. The Real-world Impact of Three Alternate Nicotine-delivery Products on Combustible Cigarette Use. University of Wisconsin Department of Medicine Research Day. Madison, WI. October 2022.
McCarthy DE, Baker TB, Zehner M, Adsit R, Kim N, Zwaga D, Coates K, Wallenkamp H, Nolan MB,Steiner M, Skora A, Kastman C, Fiore MC. Evaluation of an Opt-out Chronic Care Program to Treat Smoking in Adult Primary Care. Presentation. Baltimore, MD. March 2022.
Macmaster D. Presented by Conner K. Tobacco Use Disorder Excluded from Substance Use Disorders for Nearly Half a Century. Society for Research on Nicotine & Tobacco Conference. Poster. Baltimore, MD. March 2022.
Mundt MP, McCarthy DE, Baker TB, Zehner ME, Zwaga D, Fiore MC. Cost-Effectiveness of a Chronic Care Smoking Treatment Program in Primary Care. Society for Research on Nicotine & Tobacco Conference. Poster. Baltimore, MD. March 2022.
Mundt MP, McCarthy DE, Baker TB, Zehner ME, Zwaga D, Fiore MC. The Cost-Effectiveness of a Tobacco Treatment Intervention with Certified Tobacco Treatment Specialists in Real-World Primary Care Clinics. Podium presentation at the Academy Health Conference, Washington, DC, June 2022.
Mundt MP, McCarthy DE, Baker TB, Zehner ME, Zwaga D, Zakletskaia LI, Fiore MC. The Cost-Effectiveness of a Comprehensive Tobacco Treatment Intervention in Real-World Primary Care Clinics. North American Primary Research Group (NAPCRG) Conference. Presentation. Phoenix, AZ. November 2022.
Sales Leite J, Jorenby DE. The Impact of the Nicotine Patch on Sleep in Patients Undergoing Smoking Cessation Treatment. University of Wisconsin Undergraduate Research Symposium. Poster. December 2022.
Salloum RG, Hohl SD, Nolan MB, D’Angelo H, Asvat Y, Chen L-S, Day AT, Goldstein AO, Hitsman B, Hudson D, King AC, Lam CY, Lenhoff K, Levinson AH, Prochaska J, Shoenbill KA, Taylor K, Tindle H, Tong E, White JS, Warren GW, Fiore MC, Rolland B. Evaluating the Efficiency of Tobacco Treatment Programs in the Cancer Moonshot Cancer Center Cessation Initiative: Data Envelopment Analysis. Society for Research on Nicotine & Tobacco Conference. Poster. Baltimore, MD. March 2022.
Schlam TR, Baker TB, Cook JW, Zwaga D, Smith SS, Fiore MC, Piper ME. Next Steps Following Unsuccessful Smoking Cessation Treatment: The Value of Chronic Care. Society for Research on Nicotine & Tobacco Conference. Pre-recorded paper online plus poster session. Baltimore, MD. March 2022.
Schlam TR, Baker TB, Piper ME, Cook JW, Smith SS, Zwaga D, Jorenby DE, Bolt DM, Collins LM, Mermelstein R, Fiore MC. Relapse Recovery Treatment: An Experimental Evaluation of Multiple Approaches to Smoking Treatment. Annual Meeting of the Society of Behavioral Medicine (SBM). Poster. Baltimore, MD. April 2022.
Tattersall MC, Esnault S, Stewart R, Swanson S, Steill J, Korcarz CE, Hansen KM, Zhang J, Baker TB, Stein JH. Effects of Nicotine-Containing Product Challenges on Interleukin-6 (IL-6) Pathway Expression in Human Pluripotent-Derived Arterial Endothelial Cells: The CLUES Study. University of Wisconsin Department of Medicine Research Day. Madison, WI. October 2022.
Tattersall MC, Hughey CM, Piasecki TM, Korcarz CE, Hansen KM, Ott NR, Fiore MC, Baker TB, Stein JH. Acute Effects of Nicotine-Containing Product Challenges on Cardiovascular and Autonomic Function Among Electronic Cigarette Vapers, Combustible Cigarette Smokers, and Controls: The CLUES Study. University of Wisconsin Department of Medicine Research Day. Madison, WI. October 2022.
Tattersall MC, Hughey CM, Piasecki TM, Korcarz CE, Hansen KM, Ott NR, Fiore MC, Baker TB, Stein JH. (2022) Acute Effects of Nicotine-Containing Product Challenges on Cardiovascular and Autonomic Function Among Electronic Cigarette Vapers, Combustible Cigarette Smokers, and Controls: The CLUES Study. Poster. Chicago, IL. November 2022.
Tattersall MC, Esnault S, Stewart R, Swanson S, Steill J, Korcarz CE, Hansen KM, Zhang J, Baker TB, Stein JH. Effects of Nicotine-Containing Product Challenges on Interleukin-6 (IL-6) Pathway Expression in Human Pluripotent-Derived Arterial Endothelial Cells: The CLUES Study. Poster. Chicago, IL. November 2022.
Terry DS, Piasecki TM, Bartholow BD. Depression, Real-Time Drinking to Cope, and Drinking-Relief Contingency: Results from an Ecological Momentary Assessment Study of Young Adults. Research Society on Alcoholism. Poster. Orlando, FL. June 2022.
Zehner ME, Kirsch JA, McCarthy DE, Adsit RT, Gorrilla A, Hayden K, Skora A, Rosenblum M, Baker TB, Fiore MC. An Application of the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS) to Implementation of Electronic Health Record Closed-Loop Referral from Primary Care to a State Tobacco Quitline (“eReferral”). Presentation. 15th Annual Conference on the Science of Dissemination and Implementation. Washington, DC. December 2022.
Zwaga D, McCarthy DE, Baker TB, Zehner ME, Adist RT, Skora A, Kastman K, Steiner M, Wallenkamp H, Coates K, Fiore MC. Clinicians Who Provide More Chronic and Frequent Primary Care to Adult Patients Adopt and Implement Comprehensive Chronic Tobacco Treatment at Higher Rates. Society for Research on Nicotine & Tobacco Conference. Poster. Baltimore, MD. March 2022.
R35 Outstanding Investigator Award. This seven-year grant will empower UW-CTRI to identify and disseminate effective, innovative ways to help cancer patients quit smoking. Specifically, UW-CTRI researchers, led by Dr. Michael Fiore, will further evaluate innovative approaches to helping cancer patients who smoke to quit. They’ll advance knowledge regarding interventions and health-system changes that will help more patients living with cancer break free from tobacco dependence. Research studies supported by this grant will help to identify effective interventions that help people with cancer achieve lasting tobacco abstinence, as well as efficient and equitable ways to connect cancer patients with such treatments. UW-CTRI will work with diverse cancer-care programs across the nation to assist with implementing evidence-based smoking treatment for patients living with cancer. They’ll develop guides to disseminate the best strategies to cancer centers nationwide. In addition to Fiore, UW-CTRI Co-Director of Research Dr. Danielle McCarthy and UW-CTRI Associate Director Dr. Tim Baker will lead the science. UW-CTRI Researcher Mark Zehner will manage the project. December 2022-December 2029, $6.5 million. Funded by the National Cancer Institute. Dr. Michael Fiore, PI.
Predicting Patient Outcomes in Wisconsin and Nationwide Using the University of Wisconsin’s COVID-19 EHR Cohort Database. The major goal of this study is to utilize the COVID EHR Cohort at the University of Wisconsin (CEC-UW) database to improve the health and well-being of the people of Wisconsin. This will be accomplished by examining predictors of patient outcomes at the UW Health site specifically and conducting focused contrasts of effects found at UW Health to those at other participating health systems. February 2022-January 2024, $300,000. Funded by Wisconsin Partnership Program. Michael Fiore and Tom Piasecki, PIs.
Breaking Addiction to Tobacco for Health 2 (BREATHE 2). In a first, researchers at the University of Wisconsin are comparing the most effective treatments to help people quit smoking in real-world clinics, with a goal of tailoring and optimizing help to people who smoke. UW-CTRI is partnering with health systems to treat more than 4,000 clinic patients. They’re reaching out to patients listed as people who smoke in electronic health records to help those who are ready to quit and motivate those who aren’t. About 25 million people who smoke in America make a primary care visit each year, but only about five percent of people who smoke who try to quit use the cessation counseling and medication we know can help. In this study, the research team will reach out to them and offer these treatments. May 2019-May 2024, $12.5 million. Funded by NCI. Drs. Timothy Baker and Michael Fiore, PIs.
VA Merit Grant. US Department of Veterans Affairs awarded a grant to UW-CTRI Researcher Dr. Jessica Cook and the William S. Middleton Memorial Veterans Hospital (VA) in Madison to be the first ever to evaluate a chronic care system designed to help Veterans who are both ready and not ready to quit smoking. Many Veterans become addicted to tobacco during their military service. The team is implementing the grant at the VA, offering telemedicine visits for all Veterans who smoke, including rural Veterans who cannot afford to drive into Madison for visits. It’s a way of giving back to Veterans who have sacrificed so much for our country by assisting those who need it most. The Enhanced Chronic Care system provides ongoing motivational interventions and interpersonal support to Veterans who use tobacco but are not ready to quit. The treatment is designed to encourage Veterans to use evidence-based tobacco treatment and to ultimately help them quit. Cook works with UW-CTRI colleagues Elana Brubaker and Kirsten Webster to recruit 250 Veterans who smoke to receive the Enhanced Chronic Care intervention, and another 250 to receive the Standard Care (brief advice to quit once per year). The researchers hope this study will help identify an effective smoking treatment strategy for VA clinical practice. January 2019-December 2023, $1 million. Funded by the VA. Dr. Jess Cook, PI.
Motivating Change in Aging People Who Smoke. This K23 award funds a research study to increase smoking cessation in adults age 50 and older. While these adults smoke at lower rates (8.2%) than the general population (13%), their cessation rates are also lower because they are less likely to be advised to quit or offered help by providers. A common misperception is that mature adults can’t or won’t quit and, if they do, they won’t benefit from it. But the research reflects the contrary. When they do try to quit, they’re generally more successful than younger people, especially when they use evidenced-based treatments (which double their success). The study will run qualitative interviews to look at what might motivate older adults to quit. One potential incentive is pointing out that quitting smoking can reduce risk for cognitive decline—commonly cited as the greatest fear among mature adults, but one yet to be used for motivation with smoking cessation. UW-CTRI will recruit participants via signs, posters, calls from each person’s clinic, and a letter to motivate and offer treatment. Researchers will compare that to a clinic with no message and a clinic with a standard motivational method. The group plans to run the study at three clinics in the same health system. They’ll be tuned into any behavioral health symptoms and the socioeconomic status of the participants to better analyze and interpret results. Drs. Megan Piper, Carey Gleason, Jane Mahoney, and Jessica Cook are serving as co-mentors to Principal Investigator Dr. Adrienne Johnson. May 2021-Feb 2026, $782,000. Funded by the National Institute on Aging of the National Institutes of Health. Dr. Adrienne Johnson, PI.
Improving Quitline Support Study (IQS). This project is evaluating promising strategies to enhance quit-smoking success among low-income people who smoke. Researchers are enrolling 1,408 Medicaid-eligible or uninsured people who smoke who continued smoking four months after engaging in standard services from the Wisconsin Tobacco Quit Line. These people who smoke have been invited to participate in an experiment to evaluate the value of augmenting standard Quit Line treatment with more intensive counseling, more intensive nicotine replacement, NCI’s SmokefreeTXT text support program, and/or financial incentives for using Quit Line and SmokefreeTXT support. Analyses will examine the main and interactive effects of these four treatment components at 26 weeks, as well as other quit-smoking outcomes in this at-risk population. August 2017-July 2023, $3 million. Funded by the National Cancer Institute of the National Institutes of Health. Drs. Danielle McCarthy and Michael Fiore, PIs.
Alzheimer’s Disease Research Center (ADRC) Developmental Grant. This project aims to develop a tailored intervention for African Americans age 50 and older to motivate them to quit smoking. African Americans are disproportionately more likely than white adults to develop dementia and suffer health effects of smoking. For this project, UW-CTRI Researcher Dr. Adrienne Johnson is collaborating with Lorraine Lathen, Director of the Wisconsin African American Tobacco Prevention Network. April 2021-March 2023, $150,000. Funded by the Wisconsin Alzheimer’s Disease Research Center with funds from the National Institute on Aging of the National Institutes of Health. Adrienne Johnson, PI.
Recently Completed Studies
COVID EHR Cohort at the University of Wisconsin (CEC-UW). The National Cancer Institute asked UW-CTRI researchers to reach out to health systems associated with the Cancer Center Cessation Initiative (C3I), coordinated at UW, to help better understand COVID-19. The goal was to explore whether patient demographics or other electronic health record (EHR) variables—including smoking status and cancer—in patients diagnosed with COVID-19 were associated with disease severity, complications and/or mortality. Twenty-one health systems across the nation participated in the project, most of which were also C3I sites. Data collection for the project concluded at the end of January 2022. EHR data on approximately 1.6 million patients who tested positive for, or were diagnosed with, COVID-19 was collected, including 149,989 hospitalized patients. May 2020-September 2022, $3 million. Funded by NCI. Dr. Michael Fiore, PI.
Options Study. The Options Study was conducted by UW-CTRI in the Madison and Milwaukee areas. Participants temporarily switched from just smoking to alternative products. These products included Juul e-cigarettes or cigarettes with very low nicotine content. Participants were paid up to $380. All study participants didn’t want to quit smoking, but were willing to switch from their cigarettes to something new for a week. The four weeks of the study had different goals:
- Week 1: Try out the study product they were randomly assigned to use: Juul e-cigarettes, VLN cigarettes or no alternative product. They could smoke their own cigarettes as usual.
- Week 2 (Switch Week): Don’t smoke their own cigarettes but use a patch (active or placebo) and their assigned study product.
- Week 3: Smoke their own cigarettes and use their study product as much as they want.
- Week 4 (Switch Week): Don’t smoke their own cigarettes but use a patch (if they had an active patch with nicotine in Week 2 they now had a placebo patch with no nicotine or vice versa) and their assigned study product.
Researchers will examine how well Juul or low-nicotine cigarettes can substitute for regular smoking, and how nicotine patches factor into it and why. May 2019-April 2022, $1.4 million. Funded by NCI and FDA. Dr. Megan Piper, PI.
Transforming the Treatment of Tobacco Use in Healthcare: Seizing the Potential of the Electronic Health Record (EHR) to Deliver Comprehensive Chronic Care Treatment for Smoking. This R35 grant to Dr. Michael Fiore was designed to offer flexibility to researchers in the quest to overcome barriers in helping primary-care patients quit smoking. In other words, it sparked innovation to translate efficacious treatments into clinical use. Projects have included:
- Tobacco Cessation Quitline eReferral. This study was a two-group, non-blinded, randomized, controlled trial to assess the impact of an EHR-based eReferral system relative to the current standard fax referral method. UW-CTRI partnered with Ascension WI-Wheaton Franciscan Healthcare and Gundersen Health System on the clinical trial to test eReferrals versus fax referrals. The trial, known as the Quit Line Referral Method Study, included 23 clinics, a dozen from Wheaton Franciscan Healthcare and 11 from Gundersen Health System. In each system, half of the clinics tested the closed-loop, HIPAA-compliant eReferral to the Quit Line, while the others operated the Fax to Quit program. Across both healthcare systems, eReferral produced referral rates that were 3-4 times higher than those produced by Fax to Quit. While the rates improved, challenges include increasing enrollment rates as well as sustaining use outside of a research study. A main outcomes paper was published in the Journal of the American Medical Informatics Association.
- SmokefreeTXT Pilot. This pilot project integrated NCI’s SmokefreeTXT program that sends text messages to participants’ phone to inspire and support an attempt to quit smoking. At two participating Gundersen Health System clinics, if a patient was ready to quit smoking, the “best practice alert” in electronic health records (EHR) prompted clinicians to refer to SmokefreeTXT via an eReferral order. Data from this small pilot study indicated feasibility of the approach, and presented questions on which members of a care team may be best suited to intervene with this approach. Based on study findings, researchers reported in a paper in Translational Behavioral Medicine that interoperable eReferral via outpatient EHR to SmokefreeTXT was feasible and acceptable to clinic staff, enrolled roughly 3% of people who smoke, and the individual clinic context and implementation approach may influence reach.
- Tolerability of 3 Medications for Smoking Cessation. A single-group, open-label, pilot study of 37 patients explored the tolerability and feasibility of combining varenicline with combination nicotine-replacement medications. An innovative “triple therapy” of three FDA-approved medications taken together—along with coaching on how to quit smoking—appeared to be safe and showed promise, according to a UW-CTRI research paper published in the Journal of Smoking Cessation.
- Comprehensive Chronic Care Smoking Treatment System. Given that only about half of people who smoke in America are advised to quit during clinic visits, UW-CTRI teamed with Epic and GHC-SCW in a program designed to reach out to all GHC patients who smoke. GHC Tobacco Cessation Outreach Specialists ensured patients had the tools they needed to quit smoking for good. All six GHC primary-care sites were actively participating in this project.
- Financial Incentives for Smoking Treatment Engagement. Building upon the robust treatment program implemented at Group Health Cooperative-South Central Wisconsin (GHC), this project evaluated modest financial incentives to people who smoke who engaged in quit planning with the GHC Tobacco Cessation Outreach Specialists. More than 500 patients who smoked were randomized to three different incentive levels to encourage engagement in quit-smoking treatment planning over the phone.
- Tablet Technology Pilot Project with Low-Income People Who Smoke. A tablet-based smoking-cessation intervention for clients was pilot tested at two Salvation Army sites. The goals were to gauge integration and scalability of technology-assisted interventions and to reach out to potential treatment-delivery sites that serve populations who smoke at a higher rate. Following the intervention, researchers interviewed staff and clients about their experiences, affirming acceptability of the tablet intervention.
- Learn, Connect, and Quit. Researchers conducted a pilot of a tablet app featuring videos for people who smoke visiting one primary-care clinic. Unfortunately, clinic staff gave the tablet to patients much less frequently than researchers anticipated. Of the 30 patients who engaged with the app, 15 watched at least 1 video: 10 watched 1 video, 3 watched 2 videos and 2 watched 3 videos.
August 2015-July 2022, $6.1 million. Funded by the National Cancer Institute of the National Institutes of Health. Dr. Michael Fiore, PI.
Quit Line eReferral with Feedback and Nicotine Patch Sampling. UW-CTRI partnered with Ascension Wisconsin to develop strategies to enhance system-wide implementation of electronic referral (eReferral) to the Wisconsin Tobacco Quit Line for adult primary care patients who smoke. UW-CTRI continues to work with 32 Ascension clinics to evaluate the effectiveness of monthly implementation feedback and provision of free nicotine patch samples in an ongoing experiment to identify strategies that increase the reach of Quit Line treatment. November 2019-February 2022, $150,000. Funded by the UW Institute for Clinical and Translational Research. Dr. Danielle McCarthy, PI.
Withdraw from Tobacco Study. This study recruited more than 200 people to quit without medication for the first week. All participants received eight weeks of combination nicotine-replacement medication (nicotine patch and mini lozenge). Study staff provided coaching to help participants quit smoking and confirm their smoking status 9 weeks after the quit date. One of the important products of our research at UW-CTRI is the Wisconsin Smoking Withdrawal Scale (WSWS) and a recently revised version (WSWS2). The UW Withdraw from Tobacco Study, led by Dr. Tim Baker and Dr. Jesse Kaye, will be critical to validating the revised scale, making it congruent with recent research on the nature of smoking withdrawal. July 2021-September 2022, $1.2 Million. Funded by the National Heart, Lung, and Blood Institute of the National Institutes of Health. Drs. Timothy Baker and Jesse Kaye, PIs.
First Breath Families: Helping Low-Income Moms Quit Smoking and Babies Grow Up Smoke-Free. The Wisconsin Women’s Health Foundation (WWHF) received a $1 million grant from the Wisconsin Partnership Program and expanded efforts to bring quit-smoking services to high-risk individuals, families and communities across Wisconsin. UW-CTRI collaborated with WWHF on this project. The group sparked systems changes that will provide sustainable funding for these services. The First Breath Families team partnered with local agencies to serve pregnant and postpartum women and their families, provide statewide access to local WWHF Quit Coaches, and develop participant-informed services. January 2018-December 2022, $1,000,000. Funded by the Wisconsin Partnership Program/Oversight & Advisory Committee (WPP/OAC). Karen Conner and Dr. Michael Fiore, Academic Partners. Lisette Kahlil, Wisconsin Women’s Health Foundation Community Lead.
Cardiac and LUng E-cigarette smoking Study (CLUES). The UW Atherosclerosis Imaging Research Program (UW AIRP) and UW-CTRI collaborated on a study on the acute and chronic effects of vaping and dual use of cigarettes and e-cigarettes. UW AIRP Director and Cardiologist Dr. James Stein and UW-CTRI Director of Research Dr. Tim Baker led the team that enrolled 440 participants representing four groups: people who vape, smoke, vape and smoke, or never used. Participants received $200 for two study visits. The study used an array of tests to explore relations between:
Acute smoking and/or vaping with possible cardiovascular and pulmonary disease mechanisms.
Longer-term patterns of smoking and/or vaping with measures of cardiovascular and pulmonary dysfunction and injury.
These outcome biomarkers will predict future disease risk and measure injury to arteries and lungs. For cardiovascular disease (CVD), the primary biomarkers are brachial artery flow-mediated dilation (FMD, a measure of endothelial function that predicts CVD) and carotid intima-media thickness (IMT, a measure of subclinical arterial injury and atherosclerosis that also predicts CVD events). For pulmonary disease, the primary biomarkers are predicted lung volumes and flow rates obtained by spirometry. In secondary analyses, researchers will:
Characterize carotid artery echogenicity (a novel measure of arterial injury).
Perform treadmill exercise stress testing (to measure exercise capacity, heart rate recovery, heart rate reserve, and rate-pressure product).
Electrocardiography (to measure heart rate variability).
Measure blood pressure, fasting lipids, HbA1c, markers of inflammation and oxidation (leukocyte count, C-reactive protein, F2 isoprostanes), and exhaled nitric oxide. These tests index the degree of dysfunction, injury mechanisms, and future risks of cardiovascular and pulmonary disease.
UW-AIRP Manager Dr. Claudia Korcarz coordinated the study and UW-CTRI Director of Clinical Services Dr. Doug Jorenby served as the on-site and operational scientific lead. Dr. Nathan Sando oversaw all pulmonary measurements. UW-AIRP Research Specialist Kristin Hansen assisted with tests. Holly Prince of UW-CTRI managed study visits in Madison. September 2018-August 2022, $1.8 million. Funded by NIH. Drs. Timothy Baker and James Stein, PIs.