Below are the 33 research papers UW-CTRI published in 2019. For a complete list of all UW-CTRI publications since inception, click here.
Note: Names in bold are current UW-CTRI employees.
Adams D, Bolt D, Deng S, Smith S, Baker T. Using Multidimensional IRT to Evaluate How Response Styles Impact Measurement. British Journal of Mathematical and Statistical Psychology. 2019.
Summary: The paper involves examining a measurement issue that has been the focus of much recent attention in the psychometrics literature. When people fill out self-report surveys involving rating scales, they often display stylistic differences in how they respond, for example some tend to respond with extreme answers while others avoid the extremes. Understanding and measuring these differences can contribute to how people interpret scores and to efforts to further improve item and test development.
Alaniz K, Christiansen B, Sullivan TT, Khalil L, Fiore MC. Helping Low Income Pregnant Women Quit Smoking: Improving the First Breath Program. Wisconsin Medical Journal. 2019;118(3):120-125.
Summary: The Wisconsin Women’s Health program developed the First Breath program to address and minimize the challenges faced by women who smoke during pregnancy, specifically targeting low-income women. To help improve the program, various methods of implementation science were used, including focus groups and a randomized control trial to test new postpartum services. The authors concluded that sustaining this community-based tobacco intervention requires continuous improvement built on measured outcomes and response to changes in the health care delivery system.
Alaniz K, Christiansen B, Sullivan, TT, Khalil L, Fiore MC. Addressing Postpartum Smoking Relapse Among Low Income Women; A Randomized Controlled Trial. Journal of Patient-Centered Research and Reviews. 2019;6(4):233-242.
Summary: Among low-income women who quit smoking during pregnancy, postpartum relapse is likely. Participants were assigned to either the standard First Breath program or an enhanced form of the program. The standard First Breath program provided cessation care at every prenatal visit, but the enhanced program provided more than that, including some in-home counseling, three postpartum counseling calls, and gift cards. More than twice the amount in the enhanced program quit than in the control program. Postpartum intervention may prevent smoking relapse.
Barrett JR, Cherney-Stafford L, Alagoz E, Piper ME, Cook JW, Campbell-Flohr S, Weber SM, Winslow ER, Ronnkleiv-Kelly SM, Abbott DE. Smoking and Gastrointestinal Cancer Patients—Is Smoking Cessation an Attainable Goal? Journal of Surgical Oncology. 2019;120(8):1335-1340.
Summary: Participant interviews revealed three consistent themes: (a) Smoking cessation is not necessarily desired by many patients who have received a cancer diagnosis; (b) Failure in past quit attempts may lead to feelings of hopelessness about future attempts, especially during cancer treatment; (c) Patients perceived little to no access to quit-smoking treatment at the time of their cancer diagnosis. The authors recommend that oncology teams offer patients ready, free access to treatments to quit smoking.
Benowitz N, Bernert J, Foulds J, Hecht S, Jacob P, Jarvis M. Joseph A, Oncken C, Piper M. Biochemical Verification of Tobacco Use and Abstinence: 2019 Update. Nicotine & Tobacco Research.
Summary: This paper discusses whether and how to use biochemical verification of tobacco use and abstinence. The authors share guidelines on which biomarkers to use, which biospecimens to use, optimal cutpoints, time windows to detection, and methodology for biochemical verifications. Use of combinations of biomarkers is recommended for assessment of vaping. Biochemical verification increases scientific rigor, but there are drawbacks that need to be assessed to determine whether the benefits of biochemical verification outweigh the scientific challenges and monetary costs.
Croyle RT, Morgan GD, Fiore MC. Addressing a Core Gap in Cancer Care – the NCI Moonshot Program to Help Oncology Patients Stop Smoking. New England Journal of Medicine. 2019;380(6):512-515.
Summary: Only about half of cancer patients who smoke are offered help to quit by their oncology teams. That’s a lost opportunity, wrote experts in this commentary. Research shows quitting smoking after a cancer diagnosis is associated with longer survival and a reduced risk of new cancers. A 2009 survey of 58 cancer centers in America designated by the National Cancer Institute (NCI) revealed that 21 percent offered no tobacco-use treatment services. This manuscript describes a new NCI initiative to improve cessation treatment delivery in 42 NCI-funded cancer centers.
Culverhouse RC, Chen L-S, Saccone NL, Ma Y, Piper ME, Baker TB, Bierut LJ. Variants in the CHRNA5-CHRNA3-CHRNB4 Region of Chromosome 15 Predict Gastrointestinal Adverse Events in the TTURC Smoking Cessation Trial. Nicotine & Tobacco Research. 2019.
Summary: Variants in the CHRNA5-CHRNA3-CHRNB4 region of chromosome 15 are associated with gastrointestinal adverse events while taking medications to quit smoking. Adherence to medication in this study was a strong predictor of successful smoking cessation. However, neither adverse events nor the genetic variants associated with them predicted adherence or successful cessation in this study.
D’Angelo H, Rolland B, Adsit R, Baker T, Rosenblum M, Pauk D, Morgan GD, Fiore MC. Tobacco Treatment Program Implementation at NCI Cancer Centers: Progress of the NCI Cancer Moonshot-Funded Cancer Center Cessation Initiative. Cancer Prevention and Research.
Summary: The Cancer Center Cessation Initiative (C3I) supports NCI-Designated Cancer Centers in taking a population-based approach to providing tobacco treatment services for all patients with cancer who smoke. The first cohort of C3I-funded centers demonstrated progress over a single year of funding. While the average patient reach rate was modest (about 25%), it should be interpreted in light of the fact that reach rates for tobacco treatment in primary care settings are typically 15% or much lower.
Engle J, Mermelstein R, Baker T, Smith S, Schlam T, Piper M, Jorenby D, Collins L, Cook J. Effects of Motivation Phase Intervention Components on Quit Attempts in Smokers Unwilling to Quit; A Factorial Experiment. Drug and Alcohol Dependence. 2019;197:149-157.
Summary: Nicotine gum significantly increased the likelihood of making a quit attempt by six weeks (23% vs. 15% without gum). Conversely, nicotine patch reduced quit attempts when used with Behavioral Reduction Counseling. Nicotine gum is a promising motivation-phase intervention that may spur quit attempts amongst smokers initially unwilling to quit.
Fiore MC, Adsit R, Zehner M, McCarthy DE, Lundsten S, Hartlaub P, Mahr T, Gorrilla A, Skora A, Baker TB. An EHR-based Interoperable eReferral System to Enhance Quitline Smoking Treatment in Primary Care. Journal of the American Medical Informatics Association. 2019;26(8-9):778-786.
Summary: Twenty-three primary care clinics from two healthcare systems in Wisconsin were randomized to one of two referral methods to connect patients who smoke with tobacco quitlines: either paper-based fax-to-quit or electronic referral via medical records, aka eReferral. Electronic health record-based eReferral provided an effective, closed-loop, interoperable means of referring patients who smoke to telephone quitline services, producing referral rates three to four times higher than the current standard of care (fax referral), including especially high rates of referral of under-served individuals.
Fiore MC, D’Angelo H, Baker TB. Effective Cessation Treatment for Patients with Cancer Who Smoke – The Fourth Pillar of Cancer Care. JAMA Network Open. 2019;2(9):e1912264.
Summary: Until recently, there have only been three primary pillars of cancer care: surgery, radiotherapy, and chemotherapy. A report issued by the Surgeon General in 2014, however, stated that continued smoking after cancer diagnosis makes things worse for the patient and increases patient mortality. The Cancer Care Cessation Initiative (C3I), funded by the National Cancer Institute, is designed to help cancer centers seamlessly incorporate tobacco treatment into their standard care.
Fletcher TL, Johnson AL, Kim B, Yusuf Z, Benzer J, Smith T. Provider Perspectives on a Clinical Demonstration Project to Transition Patients with Stable Mental Health Conditions to Primary Care. Tranlational Behavioral Medicine. 2019 December 3.
Summary: Practitioners in this study perceived that transitioning stabilized mental health patients back to primary care resulted in increased access to specialty mental healthcare for patients in acute need, that transitioning to a lower level of care indicated patients’ mental health status was improving, and that specialized mental health providers felt less stress related to caseloads and increased ability to offer evidence-based psychotherapy.
Garey L, Manning K, McCarthy DE, Gallagher MW, Shepherd JM, Orr MF, Schmidt NB, Rodic B, Zvolensky MJ. Understanding Quit Patterns from a Randomized Clinical Trial: Latent Classes, Predictors, and Long-Term Abstinence. Addictive Behaviors. 2019;95:16-23.
Summary: Results suggest that there are four relevant classes of quit behavior, each with specific predictor variables, including: age, motivation to quit, smoking urges, and number of quit attempts. These classes relate to long-term abstinence. These results have the potential to inform manualized smoking cessation treatment interventions based on relevant subgroups of quit behavior.
Johnson AL, McLeish AC, Shear PK, Sheth A, Privitera M. The Role of Cigarette Smoking in Epilepsy Severity and Epilepsy-Related Quality of Life. Epilepsy and Behavior. 2019;93:38-42.
Summary: Smokers with epilepsy, compared with nonsmokers with epilepsy, were at increased risk to have seizures in the past year after controlling for the effect of Medicaid status. Smoking with epilepsy was also associated with lower quality of life; however, this finding did not remain significant when Medicaid status was taken into consideration. Contrary to the hypotheses, smokers with epilepsy were not at an increased risk of having refractory epilepsy compared with nonsmokers with epilepsy. Nevertheless, patients with epilepsy should be advised of the dangers of smoking specific to epilepsy.
Johnson AL, Kaye J, Baker TB, Fiore MC, Cook JW, Piper ME. Psychiatric Comorbidities In a Comparative Effectiveness Smoking Cessation Trial: Relations with Cessation Success, Treatment Response, and Relapse Risk Factors. Drug and Alcohol Dependence. Online 2019.
Summary: Psychiatric diagnosis was significantly related to lower likelihood of short-term smoking cessation, but not significantly to long-term cessation likelihood. Lifetime psychiatric diagnosis was related to elevated nicotine dependence. History of psychiatric diagnosis was related to increased craving related to withdrawal. There was little evidence that mental illness moderated the effects of quit-smoking medications (varenicline or nicotine patch plus lozenge) on long-term abstinence.
Kaye JT, Fronk GE, Zgierska AE, Cruz MR, Rabago D, Curtin JJ. Acute Prazosin Administration Does Not Reduce Stressor Reactivity In Healthy Adults. Psychopharmacology. 2019;236(11):3371-3382.
Summary: Prazosin is a medication primarily used to treat high blood pressure, symptoms of an enlarged prostate, and posttraumatic stress disorder (PTSD). A single acute dose (2 mg) of prazosin did not reduce stress reactivity in a healthy adult sample. Neither startle potentiation nor self-reported anxiety was reduced by prazosin (vs. placebo) during unpredictable (vs. predictable) stressors.
Kim N, McCarthy DE, Loh W-Y, Cook JW, Piper ME, Schlam TR, Baker TB. Predictors of Adherence to Nicotine Replacement Therapy: Machine Learning Evidence that Perceived Need Predicts Medication Use. Drug and Alcohol Dependence. 2019;205:107668.
Summary: To address the problem of nonadherence to smoking cessation medication, it may be useful to identify pre-quit risk factors for nonadherence that could be targeted for intervention prior to quitting. Researchers identified subgroups of smokers and characterized them based on their adherence to nicotine replacement therapy. Those who believed the medication was safe and easy to use had greater adherence, and adherence was especially high in those who were more dependent and more exposed to smoking triggers.
Matheny JD, Stevens EM, Chen S, Christiansen BA, Kowitt SD, Osman A, Vidrine D. The RICO Verdict and Corrective Statements as Catalysts for Public Policy. Tobacco Regulatory Science. 2019;5(3):206-228. 2019.
Summary: A federal court ruled tobacco companies violated racketeering laws and ordered them to publish corrective statements. This study assessed effects of exposure to the statements. People who saw the statements were less likely to think lawmakers should trust tobacco companies as much as other companies or that lawmakers should trust tobacco company lobbyists to provide accurate information, compared to the unexposed group. The exposed group also was more likely to support requiring graphic warning labels and point-of-sale quitline signs.
McCarthy DE, Adsit R, Zehner M, Skora A, Kim N, Baker TB, Fiore MC. Closed-Loop Electronic Referral to SmokeFreeTXT for Smoking Cessation Support; A Demonstration Project in Outpatient Care. Translational Behavioral Medicine. 2019 Jun 7.
Summary: Electronic referral (eReferral) to SmokefreeTXT for adult patients who smoke was implemented in two clinics in a health system. Interoperable, HIPAA-compliant eReferral returned referral outcomes to the EHR. During clinician implementation, 43 of 299 adult smokers (14.4%) were eReferred. During medical assistant (MA) implementation, 36 of 401 adult smokers (9.0%) were eReferred. Overall, among those eReferred, 25.7% completed SmokefreeTXT enrollment (3.1% of patients eligible for eReferral). Staff survey responses indicated that eReferral was efficient and easy.
Mitchell C, Piper ME, Smith SS, Korcarz C, Fiore MC, Baker TB, Stein J. Changes In Carotid Artery Structure With Smoking Cessation. Vascular Medicine. 2019;24(6):493-500.
Summary: Carotid artery grayscale ultrasound results can predict cardiovascular disease events. The authors evaluated the longitudinal effects of quitting smoking on four grayscale ultrasound measures. They found that changes in carotid ultrasound results during a smoking cessation attempt are modest and mostly related to weight gain.
Mundt MP, Baker TB, Fraser DL, Smith SS, Piper ME, Fiore MC. Paying Low-Income Smokers to Quit? The Cost-Effectiveness of Incentivizing Tobacco Quit Line Engagement for Medicaid Recipients Who Smoke. Value in Health. 2019;22(2):177-184. 2019.
Summary: The incentive treatment produced higher six-month CO-confirmed seven-day point-prevalence abstinence than did the control treatment (21.6 vs. 13.8%). The incremental cost-effectiveness ratio (ICER) of the financial-incentive intervention was $2316 per additional person who quit. The study ICER compares favorably with other treatments, such as varenicline combined with proactive telephone counseling, whose ICER has been estimated at $2600 per additional smoker who quits. Use of financial incentives to engage with tobacco quitline treatment was cost-effective.
Mundt MP, Baker TB, Piper ME, Smith SS, Fraser DL, Fiore MC. Financial Incentives to Medicaid Smokers for Engaging Tobacco Quit Line Treatment: Maximizing Return on Investment. Tobacco Control. 2019 May 30.
Summary: This study offered financial incentives for smokers to engage with the Wisconsin Tobacco Quit Line to quit smoking. The minimal cost per additional smoker who quit was $2125 when incentives for the first four calls to the Quit Line were set at $20 and the financial payment for the fifth call was set at $70. Modelling suggests that financial incentives at these levels maximize return on investment to engage low-income smokers with evidence-based smoking cessation treatment.
Piper ME, Baker TB, Benowitz NL, Jorenby DE. Changes in Use Patterns Over One Year Among Smokers and Dual Users of Combustible and Electronic Cigarettes. Nicotine & Tobacco Research. 2019.
Summary: In this community sample, the majority of dual users transitioned to exclusive smoking. After a year, a higher percentage of dual users (8.0%) quit smoking than smokers (1.9%), but attrition and baseline differences between the groups compromise strong conclusions. Sustained e-cigarette use was related to baseline e-cigarette dependence. This research suggests that dual use of combustible and electronic cigarettes is not a sustained pattern for the majority of dual users, but it is more likely to be a continued pattern if the user is more dependent on e-cigarettes.
Piper ME, Baker TB, Benowitz NL, Jorenby DE. E-cigarette Dependence Measures in Dual Users; Reliability and Relations with Dependence Criteria and E-cigarette Cessation. Nicotine & Tobacco Research. 2019.
Summary: This research provides empirical support for three e-cigarette dependence measures: the e-cigarette Fagerström Test of Cigarette Dependence (e-FTCD), the Penn State Electronic Cigarette Dependence Index (PS-ECDI), and the e-cigarette Wisconsin Inventory of Smoking Dependence Motives (e-WISDM) among dual users of e-cigarettes and combustible cigarettes. The PS-ECDI and e-WISDM are more reliable, but all three measures were strongly correlated with key dependence constructs such as heavy use and continued use over time.
Piper ME, Bullen C, Krishnan-Sarin S, Ossip DJ, Rigotti NA, Steinberg ML, Streck JM, Joseph AM. Defining and Measuring Abstinence in Clinical Trials of Smoking Cessation Interventions: An Updated Review. Nicotine & Tobacco Research. 2019.
Summary: Changes in tobacco products, use patterns, and assessment technology in the last 15 years led the SRNT Treatment Research Network to call for an update to the 2003 SRNT recommendations for assessing abstinence in clinical trials of smoking cessation interventions. Defining abstinence requires specification of which products a user must abstain from using, the type of abstinence (i.e., point-prevalence, continuous), and the duration of abstinence.
Piper ME, Drobes DJ, Walker N. Behavioral and Subjective Effects of Reducing Nicotine in Cigarettes: A Cessation Commentary. Nicotine & Tobacco Research. Online December 2019;21(Suppl 1): S19-S21.
Summary: This commentary addresses the impact of the use of reduced nicotine cigarettes (RNC). There is moderate evidence RNCs increase the likelihood of making a quit attempt among smokers unmotivated to quit and among smokers motivated to quit who also used nicotine replacement therapy (NRT). There was limited evidence that RNC combined with NRT increased smoking abstinence, regardless of motivation to quit. The data suggest that abrupt reduction in the level of nicotine in combustible cigarettes could increase quit attempts and eventual smoking cessation.
Piper ME, Mermelstein R, Baker TB. Progress in Treating Youth Smoking: Imperative, Difficult, Slow. JAMA Pediatrics. 2019;173(12):1131-1132.
Summary: Helping teens quit smoking is daunting, even with the state-of-the science treatment for adult smokers—varenicline plus intensive counseling—proving ineffective with youth because most didn’t come in for treatment. The authors suggest further research and different tactics could help, such as using texting or other phone-based technologies. Interventions that address dual addictions and/or adverse childhood events could also help.
Ramsey AT, Chiu A, Baker TB, Smock N, Chen U, Lester T, Jorenby D, Bierut LJ, Chen L-S. Care-Paradigm Shift Promoting Smoking Cessation Treatment Among Cancer Center Patients Via a Low-Burden Strategy, Electronic Health Record-Enabled Evidence-Based Smoking Cessation Treatment. Translational Behavioral Medicine.
Summary: In this study, the Electronic Health Record-Enabled Evidence-Based Smoking Cessation Treatment program was implemented in the cancer center clinics. Five-month pre- and post-implementation data from the electronic health record (EHR) were analyzed. The percentage of cancer patients assessed for tobacco use significantly increased from 48% to 90%, the percentage of smokers referred for cessation counseling increased from 0.72% to 1.91%, and the percentage of smokers with cessation medication significantly increased from 3% to 17%.
Rojewski AM, Bailey SR, Bernstein SL, Cooperman NA, Gritz ER, Karam-Hage MA, Piper ME, Rigotti NA, Warren GW. Considering Systematic Barriers to Treating Tobacco Use in Clinical Settings in the United States. Nicotine & Tobacco Research, 21, 1453-1461.
Summary: Three vignettes highlighted in this article illustrate some systemic barriers to providing tobacco treatment for patients being treated for comorbid conditions. The authors explore the barriers to tobacco treatment and offer suggestions for changes in training, health care systems, clinical workflow, and payment systems that could enhance the reach and the quality of tobacco treatment within the US health care system.
Schlam TR, Baker TB, Smith SS, Cook JW, Piper ME. Anxiety Sensitivity and Distress Tolerance in Smokers: Relations with Tobacco Dependence, Withdrawal, and Quitting Success. Nicotine & Tobacco Research. 2019.
Summary: Those with a high ability to tolerate distress may be more likely to quit smoking and remain smoke-free a year later. Anxiety sensitivity (the fear of feelings associated with anxiety) was found to be unrelated to abstinence from cigarettes. However, the study found that a greater ability to tolerate distress was associated with higher quit rates and early abstinence, regardless of nicotine dependence or withdrawal symptoms that participants experienced.
Schlam TR, Baker TB. Playing Around With Quitting Smoking: A Randomized Pilot Trial of Mobile Games As a Craving Response Strategy. Games for Health. 2019.
Summary: In this study, 30 smokers interested in quitting were offered 4 weeks of nicotine patch plus counseling and randomized to quit with or without access to mobile games. Of those randomized to quit using nicotine patches plus mobile games, 31 percent quit smoking the entire month. This intervention may provide a helpful distraction from cravings. The authors recommend a fully powered trial of this intervention.
Schmidt KM, Hansen KM, Johnson AL, Gepner AD, Korcarz CE, Fiore MC, Baker TB, Piper ME, Stein JH. Longitudinal Effects of Cigarette Smoking and Smoking Cessation on Aortic Wave Reflections, Pulse Wave Velocity, and Carotid Artery Distensibility. Journal of the American Heart Association. 2019;8(24):e013939.
Summary: Arterial wave reflection and stiffness measures were associated more strongly with age, blood pressure, and waist circumference than smoking heaviness. Smoking cessation was associated with weight gain and increased insulin resistance. Changes in arterial measures were predicted by changes in blood pressure, highlighting the need to address weight gain and blood pressure changes during a quit attempt.
Wattiaux A, Bettendorf M, Block L, Gilmore-Bykovskyi A, Ramley E, Piper ME, Rosenthal A, Sadusky J, Cox E, Chewning B, Bartels CM. Patient Perspective on Smoking Cessation and Interventions in Rheumatology Clinics. Arthritis Care & Research. 2019.
Summary: Participant-reported barriers included viewing smoking as “a crutch” amid rheumatic disease, rarely receiving cessation counseling in rheumatology, and very limited awareness that smoking can worsen rheumatic diseases or reduce efficacy of some rheumatology medications. Participants endorsed the cessation protocol with rheumatology-specific education and accessible resources like the quitline. Beyond quitting, participants valued knowing why and how to quit. Emphasizing rheumatologic health benefits and cessation resources are essential for rheumatology patients who smoke.