UW-CTRI
UW Center for Tobacco Research and Intervention

Published Papers

Below are the 18 research papers UW-CTRI published from January-July 2020. For a complete list of all UW-CTRI publications since inception, click here.

Note: Names in bold are current UW-CTRI employees.

  1. Baker TB, Berg KM, Adsit RT, Skora AD, Swedlund MP, Zehner ME, McCarthy ME, Glasgow R, Fiore MC. (2021) Closed-loop eReferral from Primary Care Clinics to a State Tobacco Cessation Quitline; Effects Using Real World Implementation Training. American Journal of Preventive Medicine. Volume 60, Issue 3, Supplement 2, March 2021, Pages S113-S122.

Summary: Real-world implementation of an electronic health record–based electronic referral system markedly increased assessment of participants’ readiness to quit as well as rates of quitline referral in primary-care patients. Future research should focus on implementation methods that produce more consistent implementation and better maintenance of electronic referral.

  1. Baker TB, Bolt DM, Smith SS. Barriers to Building More Effective Treatments: Negative Interactions Among Smoking-Intervention Components. Clinical Psychological Science.

Summary: This research on behavioral health shows that across multiple factorial experiments, researchers observed a pattern such that, when components were combined, they yielded less benefit than the sum of their individual effects. This pattern was attributed to negative interactions among components that occurred across multiple experiments, change measures, and intervention types. Moreover, these negative interactions may suppress estimates of component main effects when multiple components are used together.

  1. Baker TB, McCarthy DE. Smoking Treatment; A Report Card on Progress and Challenges. Annual Review of Clinical Psychology. Vol. 17:1-309.

Summary: This review evaluates the reach and effectiveness of pharmacotherapy and psychosocial interventions for smoking. Historically, the reach of smoking treatment has been low, and therefore its impact has been limited, but new reach strategies (such as digital interventions and health care system changes) offer great promise. Pharmacotherapy tends to be more effective than psychosocial intervention when used clinically. However, new approaches are needed.

  1. Bartels CM, Johnson L, Ramly E, Panyard DJ, Gilmore‐Bykovskyi A, Johnson HM, McBride P, Li Z, Sampene E, Lauver DR, Lewicki K, Piper ME. (2021) Impact of a Rheumatology Clinic Protocol on Tobacco Cessation Quit Line Referrals. Arthritis Care & Research. April 6, 2021.

Summary: Implementing “Quit Connect” in three rheumatology clinics was feasible and improved referrals to a state‐run tobacco quitline. Nurses used electronic health records to prompt an intervention with patients that included a referral to a quitline. Given the importance of smoking cessation to reduce cardiopulmonary and rheumatic disease risk, future studies should investigate disseminating cessation protocols like Quit Connect to refer to quitlines.

  1. Bray MJ, Chen L-S, Fox L, Ma Y, Grucza RA, Hartz SM, Culverhouse RC, Saccone NL, Hancock DB, Johnson EO, McKay JD, Baker TB, Bierut LJ. Studying the Utility of Using Genetics to Predict Smoking-Related Outcomes in a Population Based Study and a Selected Cohort. Nicotine & Tobacco Research.

Summary: This study shows that including both genetic ancestry and polygenic risk scores in a single model increases the ability to predict smoking behaviors compared to the model including only demographic characteristics. This finding is observed for every smoking-related outcome. Even though adding genetics is more predictive, the demographics alone confer substantial and meaningful predictive power.

  1. Buu A, Cai Z, Li R, Wong S-W, Lin H-C, Su W-C, Jorenby DE, Piper ME. (2021) The Association Between Short-Term Emotion Dynamics and Cigarette Dependence: A Comprehensive Examination of Dynamic Measures. Drug and Alcohol Dependence. 218:108341.

Summary: This study conducted secondary analysis on the data from a community sample of 101 people who smoke and 136 people who both smoke and vape, including data collected in real time via their phones. Researchers found that inertia and instability are important emotion dynamics indicating dependence. Negative and positive emotions are both essential for understanding dependence. People who only smoke show different emotion-dependence associations than those who both smoke and vape.

  1. Buu A, Cai Z, Li R, Wong S-W, Lin H-C, Su W-C, Jorenby DE, Piper ME. (2021) Validating E-cigarette Dependence Scales Based on Dynamic Patterns of Vaping Behaviors. Nicotine and Tobacco Research.

Summary: Given that the majority of adult e-cigarette users also use combustible cigarettes, it is important to determine whether e-cigarette dependence scales capture the product-specific dependence. This study provides empirical support for three vaping dependence measures known as PS-ECDI, e-FTCD, and e-WISDM, based on dynamic patterns of vaping and craving revealed by real-time data collected via phones. The e-cigarette dependence scales may capture the product-specific average consumption—but not the instability of consumption.

  1. Christiansen B, Smith S, Fiore MC. (2021) Measuring Therapeutic Alliance for Tobacco Cessation Counseling for Behavioral Health Clinicians. Journal of Smoking Cessation. Vol. 2021, Article ID 6671899.

Summary: Those coping with significant mental illness smoke at a high prevalence rate. The purpose of this study was to examine the validity of the Working Alliance Inventory for Tobacco (WAIT-3) to gauge the effectiveness of behavioral health clinicians to help patients quit tobacco use. Based on an anonymous, brief survey to 1,930 clients, WAIT-3 scores were correlated with quitting-related variables. Compared to those with lower WAIT-3 scores, those with higher scores reported more attempts, motivation and goals to reduce smoking or fully quit.

  1. Cook JW, Baker TB, Fiore MC, Collins LM, Piper ME, Schlam TR, Bolt DM, Smith SS, Zwaga D, Jorenby DE, Mermelstein R. (2021) Evaluating Four Motivation-Phase Intervention Components for Use with Primary Care Patients Unwilling to Quit Smoking: A Randomized Factorial Experiment. Addiction. Online April 28, 2021.

Summary: Nicotine mini-lozenges may increase smoking abstinence in people initially unwilling to quit smoking, but their effectiveness declines when used with smoking reduction counseling or other behavioral interventions. Reduction counseling decreases the likelihood of making a quit attempt in people initially unwilling to quit smoking.

  1. D’Angelo H, Webb Hooper M, Burris JL, Rolland B, Adsit R, Pauk D, Rosenblum M, Fiore MC, Baker TB. (2021) Achieving Equity in the Reach of Smoking Cessation Services Within the NCI Cancer Moonshot-funded Cancer Center Cessation Initiative. Health Equity. 2021;5.1:424-430.

Summary: These cancer centers achieved gains in providing quit-smoking treatment to cancer patients, thereby reducing disparities that had existed across important subgroups. Taking a population-based approach to integrating tobacco treatment into cancer care has potential to increase reach equity. Implementation strategies—including targeted and proactive outreach to patients and interventions to increase providers’ adoption this treatment—may advance reach even further.

  1. Fiore MC, Baker TB. (2021) Quitline Commentary: 10 Million Calls and Counting: Progress and Promise of Tobacco Quitlines in the United States. American Journal of Preventive Medicine. Volume 60, Issue 3, Supplement 2, S99-S102, March 01, 2021.

Summary: Since 2004, the National Network of Tobacco Cessation Quitlines has received more than ten million calls, reaching half a million people who smoke per year. The combination of evidence-based treatment, FDA approved medications and contributions from trained counselors has resulted in a 60% increased quit rate compared to self-help or little-to-no counseling. Quitlines offer barrier-free care for at-risk groups with no need to travel, no need for healthcare/insurance and no cost to the caller.

  1. Hammond D, Reid JL, Rynard VL, O’Connor R, Goniewicz ML, McNeill A, Piper ME, Bansal-Travers  M. Indicators of Dependence and Efforts to Quit Vaping and Smoking Among Youth in Canada, England, and the United States. Tobacco Control.

Summary: The proportion of ever-users who vaped frequently was significantly higher in 2019 compared with 2017 for all outcomes in each country. Prevalence of dependence symptoms among young vapers increased between 2017 and 2019, more so in Canada and the USA compared with England. Dependence symptom prevalence was lower for vaping than smoking; however, the gap has narrowed over time.

  1. Ho JTK, Tyndale R, Baker TB, Amos C, Chiu A, Smock N, Chen J, Bierut L, Chen L-S. (2021) Racial Disparities in Intensity of Smoke Exposure and Nicotine Intake Among Low-Dependence Smokers. Drug and Alcohol Dependence. Volume 221, 1 April 2021, 108641.

Summary: As a group, Black people who smoke have higher disease risk despite smoking fewer cigarettes per day. Biomarkers of smoke exposure and nicotine intake may more accurately reflect risk. Dependence relates to biomarkers differently in Black vs. white people who smoke. Biomarkers measured as intensity-per-cigarette may help explain differences. Low-dependence Black people who smoke had higher incremental risk per cigarette than whites.

  1. Johnson AL, McLeish AC, Shear PK, Privitera M, Luberto CM. (2021) Smokers with and without Epilepsy Show Similar Smoking Rate, Dependence Level, Cessation Attempts, and Motives. Translational Behavioral Medicine. Online February 5, 2021.

Summary: People with epilepsy who smoke do not appear to differ significantly from people without epilepsy who smoke in terms of smoking-related behaviors and cognitions—and may therefore benefit from current evidence-based treatments for smoking cessation that are not contraindicated for epilepsy (i.e., bupropion, varenicline).

  1. Johnson AL, Nystrom NC, Piper ME, Cook J, Norton DL, Zuelsdorff M, Wyman MF, Benton SF, Lambrou NH, O’Hara J, Chin NA, Asthana S, Carlsson C, Gleason CE. (2021) Cigarette Smoking Status, Cigarette Exposure, and Duration of Abstinence Predicting Incident Dementia and Death: A Multistate Model Approach. Journal of Alzheimer’s Disease. Online February 19, 2021.

Summary: Current smoking increases the risk for dementia and death, but dementia is better attributed to smoking recency than lifetime exposure. Smoking cessation at any age might reduce these risks for cognitively healthy individuals.

  1. Klemperer EM, Hughes JR, Peasley-Miklus CE, Callas PW, Cook JW, Streck JM, Morley NE. (2021) Possible New Symptoms of Tobacco Withdrawal III: Positive Affect- A Meta-Analysis. Nicotine and Tobacco Research. 2021 Jan 22;23(2):259-266.

Summary: Findings suggest that (1) abstinence from cigarettes decreases positive affect and (2) this decrease may represent a withdrawal effect (vs. an offset effect). However, it is unclear whether abstinence-induced losses in positive affect are independent from increased negative affect.

  1. Lydon-Staley DM, Leventhal AM, Piper ME, Schnoll RA, Bassett DS. (2021) Temporal Networks of Tobacco Withdrawal Symptoms During Smoking Cessation Treatment. Journal of Abnormal Psychology. 2021 Jan;130(1):89-101.

Summary: A network perspective of withdrawal posits that withdrawal symptoms influence each other and are not solely caused by deprivation. The paper uses real-time withdrawal data from 1,210 participants quitting smoking and constructs person-specific withdrawal networks. Results indicate substantial moment-to-moment associations among withdrawal symptoms and between-person differences in withdrawal network structure. The relations among withdrawal symptoms are significantly smaller among participants receiving combination smoking cessation medication. A network perspective is an innovative and promising way to think about withdrawal.

  1. Piirtola M, Kaprio J, Baker TB, Piasecki TM, Piper ME, Korhonen T. (2021) The Associations of Smoking Dependence Motives with Depression Among Daily Smokers. Addiction. Online 24 February 2021.

Summary: Depression and smoking dependence are associated with one another independently of shared familial influences. These associations are robust with adjustment for several single or a combination of confounders, except neuroticism, which attenuates the association. Regarding clinical implications, higher dependence and smoking to regulate emotions should be considered while helping depressed people who smoke to quit.

  1. Ramsey AT, Bourdon JL, Bray M, Dorsey A, Zalik M, Pietka A, Salyer P, Chen L-S, Baker TB, Munafò MR, Bierut LJ. (2021) Proof of Concept of a Personalized Genetic Risk Tool to Promote Smoking Cessation: High Acceptability and Reduced Cigarette Smoking. Cancer Prevention and Research. 2021;14(2):253-262.

Summary: This study demonstrates that personal genetic information can be incorporated into a risk feedback tool that was highly acceptable to current smokers and associated with reductions in smoking. These findings may pave the way for effectiveness and implementation research on genetically-informed behavior change interventions to enhance cancer prevention efforts.

  1. Salloum RG, D’Angelo H, Theis RP, Rolland B, Hohl S, Pauk D, LeLaurin JH, Asvat Y, Chen LS, Day AT, Goldstein AO, Hitsman B, Hudson D, King AC, Lam CY, Lenhoff K, Levinson AH, Prochaska J, Smieliauskas F, Taylor K, Thomas J, Tindle H, Tong E, White JS, Vogel WB, Warren GW and Fiore MC. (2021) Mixed-Methods Economic Evaluation of the Implementation of Tobacco Treatment Programs in National Cancer Institute-Designated Cancer Centers. Implementation Science Communications. 2, 41.

Summary: The nationwide Cancer Center Cessation Initiative (C3I), part of the National Cancer Institute’s (NCI) Cancer Moonshot Initiative, has the goal of helping cancer patients to quit tobacco use. Researchers evaluated system-level implementation costs across 15 of the C3I-funded cancer centers. Among most centers that have progressed in integrating treatment of tobacco dependence, cost-per-quit was modest relative to other prevention interventions, with varied program reach and effectiveness.

  1. Smith SS, Piper ME, Bolt DM, Kaye JT, Fiore ME, Baker TB. (2021) Revision of the Wisconsin Smoking Withdrawal Scale: Development of Brief and Long Forms. Vol. 33, No. 3, 255–266.

Summary: The authors describe a revised version of the 28-item Wisconsin Smoking Withdrawal Scale. For the revised Wisconsin Smoking Withdrawal Scale 2 (WSWS2), a candidate pool of 37 items was developed to measure nine withdrawal constructs using data from three UW-CTRI studies. Derivation and validation sample analyses yielded a longer version of the WSWS2 (WSWS2-L) with 19 items and six subscales (Craving, Negative Affect, Hunger, Sleep, Restlessness, and Concentration) and a brief six-item version (WSWS2-B). Both demonstrated good reliability and validity.

  1. Trapskin PJ, Sheehy A, Creswell PD, McCarthy DE, Skora A, Adsit RT, Rose AE, Bishop C, Bugg J, Iglar E, Zehner ME, Shirley D, Williams BS, Hood AJ, McElray K, Baker TB, Fiore MC. (2021) Development of a Pharmacist-Led Opt-Out Smoking Cessation Treatment Protocol in Inpatient Settings. Hospital Pharmacy. Online March 5, 2021.

Summary: People who smoke are overrepresented in inpatient settings but are infrequently connected with smoking cessation treatment during hospitalization. UW Hospital pharmacists were delegated authority to prescribe nicotine replacement therapy and refer inpatients who smoked cigarettes to the Wisconsin Tobacco Quit Line. Refining implementation strategies increased the percentage of eligible patients offered cessation support from 37 percent to 76 percent, the percentage prescribed medications from 2 percent to 44 percent, and the percentage referred to the Quit Line from 3 percent to 32 percent.

  1. Williams BS, Smith SS, Marbin JN, Huang MZ, Garell CL, Kosack AS, Shaikh U, Tebb KP, Fiore MC. (2021) Addressing Environmental Smoke Exposure During Inpatient Pediatric Hospital Stays; Attitudes and Practices of Pediatric Nurses Versus Respiratory Therapists. Respiratory Care. 2-21;66(2):275-280.

Summary: Compared to in-patient pediatric RNs, respiratory therapists reported higher rates of confidence in providing cessation interventions, screening for smoke exposure, and counseling on reducing smoke exposure, suggesting that they may be better positioned for intervening. These results can inform the design of an in-patient cessation intervention for caregivers of hospitalized children.

Research Reports