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. Akhtar WZ, Mundt MP, Koepke R, Krechel S, Fiore MC, Seal DW, Westergaard R. (2020) Prevalence of Tobacco Use Among People Who Inject Drugs in Rural Communities. JAMA Network Open. Online March 10, 2020. 3(3):e200493.

Summary: Among this large sample of rural-dwelling individuals who were actively injecting opioids and/or stimulants, an extremely high proportion reported that they currently smoked cigarettes. The smoking rate of more than 90 percent is among the highest reported among any subpopulation and exceeds that of many other groups with a high prevalence of smoking, including adults with schizophrenia. In contrast, the overall adult smoking prevalence rate in the US in 2018 was 13.8 percent. Novel approaches to eliminating tobacco use among this population are needed.

  1. Baker TB, Fiore MC. (2020) What We Do Not Know About E-cigarettes Is a Lot. JAMA Network Open. 2020;3(6):e204850.

Summary: The authors warn against jumping to conclusions about vaping before we know answers to questions like: What will be the fate(s) of the dual users of vaping and smoking and what are the long-term health consequences? How will legal restrictions affect youth vaping? How will youth vaping relate to future harms, including cigarette prevalence? To what degree can vaping help people quit smoking? How does that compare with the most effective FDA-approved medications? How will vape products evolve? How does COVID-19 impact vaping? Much more research is needed.

  1. Berg K, Gruber SJ, Jorenby D. (2020) Helping Women Veterans Quit Smoking: A Qualitative Analysis of Successful and Unsuccessful Attempts. BMC Women’s Health. 2020 Mar 30;20(1):63.

Summary: Women Veterans’ quit smoking attempts demonstrate four main themes: baseline health and wellbeing, acknowledging smoking as an addiction, the participant’s optimism towards quitting, and resilience. Patterns were observed within themes with respect to whether the individual currently smoked or had experienced a prolonged quit attempt in the past. Further research is needed to help women Veterans quit smoking.

  1. Culverhouse RC, Chen L-S, Saccone NL, Ma Y, Piper ME, Baker TB, Bierut LJ. (2020) Variants in the CHRNA5-CHRNA3-CHRNB4 Region of Chromosome 15 Predict Gastrointestinal Adverse Events in the TTURC Smoking Cessation Trial. Nicotine & Tobacco Research. 2020.

Summary: Reducing adverse events from pharmacologic treatment is an important goal of precision medicine and identifying genetic predictors of adverse events is a step toward this goal. The UW Transdisciplinary Tobacco Use Research Center (TTURC) conducted a multiarmed, placebo-controlled smoking cessation trial of bupropion and nicotine replacement therapy that included 985 genotyped participants. Variants in the CHRNA5-CHRNA3-CHRNB4 region of chromosome 15 are associated with gastrointestinal adverse events in smoking cessation, reflecting biological response to the meds.

  1. D’Angelo H, Ramsey AT, Rolland B, Chen LS, Bernstein SL, Fucito LM, Webb HM, Adsit R, Pauk D, Rosenblum MS, Cinciripini PM, Joseph A, Ostroff JS, Warren GW, Fiore MC, Baker TB. (2020)Pragmatic Application of the RE-AIM Framework to Evaluate the Implementation of Tobacco Cessation Programs Within NCI-Designated Cancer Centers. Frontiers in Public Health. 8;221.

Summary: The authors examined a pragmatic application of the RE-AIM framework (reach, effectiveness, adoption, implementation, and maintenance) to evaluate tobacco treatment programs at three cancer centers. The RE-AIM measures are flexible enough to work in different settings and for different types of tobacco treatment programs but are robust enough to evaluate. The measures can be applied across different healthcare systems and EHR platforms. Delivering tobacco treatment to cancer patients who smoke should be a routine and integrated part of cancer care.

  1. Dindo L, Johnson AL, Lang B, Rodriguez M, Martin L, Jorge R. (2020) Development and Evaluation of an 1-Day Acceptance and Commitment Therapy (ACT) Workshop for Veterans with Comorbid Chronic Pain, TBI, and Psychological Distress: Outcomes From a Pilot Study. Contemporary Clinical Trials. Mar (90), 105954.

Summary: Researchers developed and implemented a 1-day, transdiagnostic workshop for military Veterans with mild traumatic brain injury, stress-based psychopathology, and pain. Preliminary results support the feasibility, acceptability, and promising effects on psychological distress and community reintegration for Veterans. Future research examining the effectiveness of this workshop with a larger sample size is necessary.

  1. Fiore MC, Adsit R, Baker TB. (2020) Clinical-, System-, and Population-level Strategies that Promote Smoking Cessation. In: Smoking cessation – A Report of the Surgeon General.Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention, Office on Smoking and Health; 2020:577-640, Chapter 7.
  2. Fronk GE, Sant’Ana SJ, Kaye JT, Curtin JJ. (2020) Stress Allostasis in Substance Use Disorders: Promise, Progress, and Emerging Priorities in Clinical Research. Annual Review of Clinical Psychology. Online February 10, 2020. Print volume 16, 2020, 401-430.

Summary: Biological systems that mediate stress allostasis (the process by which the body responds to stressors over time in order to ‘reset’) are highly interactive, but distinct patterns of stressor allostasis are possible across systems among individuals with substance use disorders (SUDs). For instance, people with SUDS generally display decreased stress allostasis in the peripheral nervous system, but increased stress allostasis in the central nervous system. Stressors cause craving in the laboratory, but at this point there is insufficient evidence of stressor-induced use in humans. Understanding the role of stressor characteristics (such as predictability, controllability, intensity) should be a high research priority.

  1. Johnson AL, Kaye JT, Baker TB, Fiore MC, Cook JW, Piper ME. (2020) 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, print February 2020.

Summary: Psychiatric diagnosis was significantly related to lower likelihood of quitting smoking in the short term, but not the long term, in the Wisconsin Smokers’ Health Study. Lifetime psychiatric diagnosis was related to elevated nicotine dependence. History of psychiatric diagnosis was related to increased craving. There was little evidence that psychiatric diagnostic status moderated the effects of varenicline or combination nicotine-replacement medication on long-term cessation.

  1. Klemperer EM, Mermelstein R, Baker TB, Hughes JR, Fiore MC, Piper ME, Schlam TR, Jorenby DE, Collins LM, Cook J. (2020) Predictors of Smoking Cessation Attempts and Success Following Motivation-Phase Interventions Among People Initially Unwilling to Quit Smoking. Nicotine & Tobacco Research. Online April 2020.

Summary: What leads smokers who are unwilling to try to quit smoking to change their minds and then try to quit? Researchers explored this question in a new paper based on UW-CTRI data which showed that increases in two factors—the time before smokers light up their first cigarette each morning, and the belief they can quit—predicted which unwilling smokers would change their minds and try to quit. In simple terms, smokers were more likely to try to quit if they were less dependent on nicotine, that is, go later in the day before lighting up, and if they were rather confident that they could quit.

  1. Mundt MP, Baker TB, Piper ME, Smith SS, Fraser DL, Fiore MC. (2020) Financial Incentives to Medicaid Smokers for Engaging Tobacco Quit Line Treatment: Maximising Return on Investment. Tobacco Control. 29:320-325.

Summary: Modeling suggests that financial incentives in the amount of $20 per call for taking the first four quitline calls and $70 for taking a fifth quitline call maximize ROI to engage low-income smokers with evidence-based smoking-cessation treatment. Using variable payments, the minimal cost per additional smoker who quit was $2125 when incentives for the first four calls to the Wisconsin Tobacco Quit Line were set at $20, and the financial payment for the fifth call was set at $70.

  1. Piper ME, Baker TB, Benowitz NL, Jorenby DE. (2020) Changes in Use Patterns OVER ONE YEAR Among Smokers and Dual Users of Combustible and Electronic Cigarettes. Nicotine and Tobacco Research. Online 2019. Print 2020. 21(5):672-680.

Summary: In this community sample, the majority of dual users transitioned to exclusive smoking. A higher percentage of dual users quit smoking than smokers, but attrition and baseline differences between the groups compromised strong conclusions. Sustained e-cigarette use was related to baseline e-cigarette dependence. Dual use 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. Dual users were more likely to quit smoking than exclusive smokers, but this may be due to factors other than their dual use.

  1. Piper ME, Bullen C, Krishnan-Sarin S, Ossip DJ, Rigotti NL. Steinberg ML, Streck JM, Jospeh AM. (2020) Defining and Measuring Abstinence in Clinical Trials of Smoking Cessation Interventions: An Updated Review.Nicotine & Tobacco Research. 1-9.

Summary: Defining abstinence requires specification of which products a user must abstain from using, the type of abstinence (i.e., point prevalence or continuous), and the duration of abstinence. These recommendations are intended to serve as guidelines for investigators as they collect the necessary data to accurately describe participants’ abstinence during smoking-cessation clinical trials. The authors recommend continuing to define it as: no use of smoking, vaping, or smokeless products.

  1. Piper ME, Brown DC, Hendershot TP, Swan GE. (2020) PhenX Host: Social/Cognitive Measures for Tobacco Regulatory Research. Tobacco Control. 2020;29:s5-s12.

Summary: A working group of experts recommended 11 social/cognitive measures for a toolkit of measures for biomedical research on tobacco use. Of these, 10 were self-administered measures: frequency of communication with parents about smoking, quality of communication with parents about smoking, susceptibility to tobacco use, behavior economics/purchase behavior, motivation to quit (both single and multi-item measures), hedonic tone or response to pleasurable situations, multigroup ethnic identity, peer and family influence on smoking, attentional control and house rules about tobacco use.

  1. Ramsey AT, Baker TB, Pham G, Stoneking F, Smock N, Colditz GA, James AS, Liu J, Bierut LJ, Chen LS. (2020) Low Burden Strategies are Needed to Reduce Smoking in Rural Healthcare Settings: A Lesson from Cancer Clinics.International Journal of Environmental Research and Public Health. 17(5): 1-11.

Summary: Smoking prevalence was particularly high and treatment engagement was particularly low among patients seen in rural clinics, where quit-smoking programs are inconsistent. In the cancer care setting, patients were more likely to receive smoking treatment in clinics that implemented the EHR-based ELEVATE module versus clinics that didn’t. The point-of-care treatment approach supported by ELEVATE offers a promising solution for rural settings, both in and outside of the context of cancer care. Including decision support within EHR systems offers potential to extend reach.

  1. Schlam TR, Baker TB, Smith SS, Bolt DM, McCarthy DE, Cook JW, Hayes-Birchler T, Fiore MC, Piper ME. Electronically Monitored Nicotine Gum Use Before and After Smoking Lapses: Relations with Lapse and Relapse. Nicotine and Tobacco Research. Online June 2020.

Summary: In a smoking cessation attempt using nicotine patch plus gum, lapsers versus matched non-lapsers used less gum immediately preceding and following their first lapse. Lower mean gum use, before and after lapses, predicted a more rapid escalation to relapse. Decreased nicotine gum use both precedes and follows returns to smoking during cessation attempts.

  1. Smits JA, Kauffman BY, Lee-Furman E, Zvolensky MJ, Otto MW, Piper ME, Powers MB, Rosenfield D. (2020) Enhancing Panic and Smoking Reduction Treatment with D-Cycloserine: A Pilot Randomized Controlled Trial. Drug and Alcohol Dependence. 2020.

Summary: D-cycloserine (DCS) facilitated greater reductions in anxiety sensitivity which in turn predicted better smoking outcomes early on. However, long-term, there was no evidence DCS made a significant difference in helping participants to quit smoking.

  1. Wyman MF, Voils CI, Gleason CE, Trivedi R, Umucu E, Johnson AL, Zuelsdorff M. (2020). Perspectives of Veterans Affairs Mental Health Providers on Working with Older Adults with Dementia and Their Caregivers. Gerontology & Geriatrics Research. Online May 18, 2020.

Summary: Researchers surveyed 65 mental health (MH) providers at a Veterans Affairs medical center on working with older persons with dementia (PwD) and informal caregivers. Respondents believed PwD can benefit from MH treatments, yet identified several barriers to providing care, including time and staffing. Interest in geriatric training topics was high. Findings demonstrate that MH providers at this site value care provision to PwD and caregivers and desire additional training to serve this population. System-level barriers to MH care for PwD should also be identified and addressed.

Research Reports