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  • Centers for Behavioral and Preventive Medicine

  • Nicotine and Substance Use

  • Examining a Text Message Intervention for Smoking Cessation

    Most smokers want to quit and nearly half attempt to quit each year. However, few actually succeed. The problem is particularly acute among young adult smokers who tend to under-utilize existing smoking cessation services, and have limited access to health insurance and healthcare. New, innovative approaches are needed that can reach out to younger adult smokers and help them quit. Intervention delivery modalities that can be inexpensively delivered in an appealing format with wide reach are particularly compelling for treating younger smokers. For this project we will develop and test a theoretically driven, evidence-based smoking cessation counseling intervention that can be delivered through SMS text messages. Text messaging is popular with younger adults (<35 years), over half of whom use text messaging, often sending 50 or more messages per week. Text messaging can be used to provide advice and interactive support adapted from evidence-based interventions for smoking cessation. However, thus far text messaging is an untapped medium and has been only rarely studied as an intervention delivery tool.  Existing studies have significant limitations which the proposed study will attempt to redress.

    Principal Investigator:Beth Bock, PhD

    Co-Investigators: Kathleen Morrow, PhD and Joseph Fava, PhD

    Funding Agency: National Institute on Drug Abuse

    Dates: 2009-2011

     


    The Sentinel Events Model: A Dynamic Model of Substance Use Cessation

    This study will develop and validate the Sentinel Events Model, a new dynamic model of behavior change predicated on the observation that quit attempts using addictive substances are often preceded by the experience of negative consequence of use, such as health problems. We seek to better understand the cognitive and affective mechanisms of action that mediate between sentinel events and behavior change milestones. Our study uses an innovative measurement strategy: cellular telephone-based ecological momentary assessment to measure these constructs.

    Principal Investigators:Beth Bock, PhD (Subcontract PI) and Edwin Boudreaux, PhD (Project PI)

    Co-Investigator: Bruce Becker, MD, MPH

    Funding Agency: National Institute on Drug Abuse

     

    Dates: 2008 - 2013


    Yoga for Women Attempting Smoking Cessation

    This study examines the feasibility and initial efficacy of yoga as an adjunct for smoking cessation treatment for women. Women smokers (n=60) will participate in a group-based CBT smoking cessation program and will be randomly assigned to either (1) a twice-weekly yoga program or (2) a wellness (contact control) program.

    Principal Investigator:Beth Bock, PhD

    Co-Investigators: Bess Marcus, PhD; David Williams, PhD; Bruce Becker, MD, MPH; Geoffrey Tremont, PhD; Kathleen Morrow, PhD; and Joseph Fava, PhD

    Funding Agency: National Center for Complementary and Alternative Medicine

    Dates: 2007 - 2009


    Sustaining Cessation in Parents of Kids with Asthma

    A renewal of our prior NHLBI grant, "Motivating the Parents of Kids with Asthma to Quit Smoking," this study compared two nurse-delivered home-based smoking cessation interventions for low-income caregivers of children receiving asthma treatment: one that focused on augmenting risk perception through the provision of biomarker feedback (PAM), and one that focused on building self-efficacy using the Agency for Healthcare Research and Quality guidelines (BAM). PAM achieved significantly greater quit rates than BAM at a 2 month follow-up, but both groups had high relapse rates by 6-months. The first aim of the current study utilized our previously demonstrated smoking cessation intervention (PAM) to examine the cognitive, affective, and behavioral processes hypothesized to underlie the teachable moment in smokers with kids who had a recent asthma exacerbation vs. smokers with healthy kids. The second aim attempts to sustain the excellent short-term quit rates we found in our first study by testing whether supplementing PAM with a telephone-based intervention improves and sustains quitting more than PAM plus contact control in the parents of kids with asthma. The telephone counseling is theory-based, targeting the constructs associated with quitting in our first study (perceived risk, precaution effectiveness, and self-efficacy). Our primary outcomes of interest are: point prevalence abstinence, Environmental Tobacco Smoke (ETS) reduction, asthma morbidity, and health care utilization. We will also examine mediators and moderators.

    Principal Investigator:Belinda Borrelli, PhD

    Co-Investigators: Elizabeth McQuaid, PhD; Bruce Becker, MD; S. Katherine Hammond, PhD; Scott Novak, PhD

    Funding Agency: National Heart, Lung, and Blood Institute

    Dates: 2005 - 2010


    Motivating Smokers with Mobility Impairments to Quit Smoking

    The aim of this project is to use community based participatory research to develop and produce a theory-based DVD for smoking cessation that is tailored for smokers with mobility impairments, and test the efficacy in a randomized clinical trial.

    Principal Investigator:Belinda Borrelli, PhD

    Co-Investigators: Beth Bock, PhD; Rosemary Hughes, PhD and Tom Lasater, PhD

    Funding Agency: National Cancer Institute

    Dates: 2009 - 2014


    Sustaining Cessation in Pregnant Smokers

    The primary aim of this project is to test whether a Sustained Telephone Counseling (STC) intervention can maintain post-partum abstinence from smoking cigarettes vs. standard care among women who quit at the start of their pregnancy.

    Principal Investigators:Belinda Borrelli, PhD (Subcontract PI)and Tom Lasater, PhD (Project PI)

    Co-Investigator: Scott Novak, PhD

    Funding Agency: National Heart, Lung, and Blood Institute

    Dates: 2005 - 2010


    School-based Asthma Therapy: Stage 2 Effectiveness Study - Revised

    The aim of this study is to increase asthma medication adherence and reduce environmental tobacco smoke exposure in the home.

    Principal Investigators:Belinda Borrelli, PhD (Subcontract PI) and Jill Halterman, MD (Project PI)

    Funding Agency: National Heart, Lung, and Blood Institute

    Dates: 2006 - 2010


    Motivating Smoking Cessation in a Low-income Housing Population

    Low-income smokers are less successful in quitting than higher-income smokers. Interventions to improve the rate of smoking cessation among low-income smokers are urgently needed, or else these smokers will bear an increasingly disparate burden of smoking-related disease and death. Using residents from low-income communities, such as public housing, to help their fellow residents quit smoking may be an effective method to increase the rate of smoking cessation. This is a randomized clinical trial that tests the efficacy of using either a) a peer-counseling model to motivate smoking cessation treatment entry (Motivational Interviewing) or b) standard education for smoking cessation to motivate smoking cessation treatment entry.

    Principal Investigators:Belinda Borrelli, PhD (Subcontract PI) and Daniel Brooks, PhD (Project PI)

    Funding Agency: National Cancer Institute

    Dates: 2009-2012


    Resistance Training as an Aid to Standard Smoking Cessation

    Cigarette smoking continues to be the leading, preventable cause of death among American adults; however, approximately 20.9 percent of US adults continue to smoke. Concerns about weight gain and mood-related withdrawal symptoms following smoking cessation are known predictors of relapse. Previous large-scale intervention trials indicate that exercise is a beneficial adjunct treatment for smoking cessation, as it positively impacts both weight concerns and negative mood states. The majority of these trials, however, have focused only on women, and only on aerobic exercise. Resistance training (i.e. weight lifting), may also offer smokers a beneficial adjunctive strategy to quit smoking, as it too can both improve mood and manage body weight. As such, the proposed pilot study will test the efficacy of a resistance training program as an aid to standard smoking cessation treatment on cessation among healthy adult male and female smokers. Specifically, we plan to compare the effects of a standard smoking cessation treatment, plus a 12-week resistance training program to the same standard smoking cessation treatment plus equivalent contact control among 60 healthy men and women. Smoking cessation outcomes (prolonged abstinence and point prevalence abstinence) will be verified by carbon monoxide and self-report.  Differences in 12-week and 3-month cessation rates between conditions will provide data for power estimates for an adequately powered clinical trial.

    Principal Investigator:Joseph T. Ciccolo, PhD

    Co-Investigators: Bess Marcus, PhD; David Williams, PhD

    Funding Agency: National Cancer Institute

    Dates: 2008 - 2010


    Imaging Individual Differences in Amphetamine Effects

    This project investigates the neural mechanisms underlying individual differences in how amphetamine affects mood and behavior. The objective of this study is to investigate the neural foundations of these individual differences and gender effects using a pharmacological challenge design and fMRI neuroimaging methods. The study utilizes a two-session, placebo-controlled amphetamine administration procedure. fMRI scans are timed during the peak period of drug effects. Individual differences in amphetamine-induced blood oxygenation level-dependent (BOLD) signal are assessed on two tasks: the Balloon Analogue Risk Task (BART) and International Affective Picture Set (IAPS), which test behavioral impulsivity and emotional reactivity, respectively. The major aims of the study are to investigate individual differences in amphetamine-induced increase in the neural activity and regions of activation associated with reward-related and punishment-related signal processing relevant to the drug's effects on mood and behavior.

    Principal Investigators:Ronald Cohen, PhD (Subcontract) and Tara White, PhD (Project PI)

    Funding Agency: National Institute on Drug Abuse

    Dates: 2007 - 2011


    Using a YMCA Exercise Program to Enhance Nicotine Dependence Treatment for Women

    This is a Stage III study to test our Commit to Quit (CTQ) smoking cessation program in the community setting of the greater Providence YMCAs. This trial compares cognitive-behavioral smoking cessation treatment plus a program of regular exercise to cognitive-behavioral smoking cessation treatment plus contact control.

    Principal Investigator:Bess Marcus, PhD

    Co-Investigators: Jessica Whiteley, PhD; David Williams, PhD; Beth Bock, PhD; Joe Ciccolo, PhD; Ernestine Jennings, PhD; Alfred Parisi, MD; Anna Albrecht, RN,MS; Joseph Hogan, ScD

    Funding Agency: National Institute on Drug Abuse

    Dates:  2006 - 2011

     


    Maternal Smoking, Fetal Behavior and Infant Withdrawal
    The BAM BAM (Behavior and Mood in Babies and Mothers) Study

    Although Maternal Smoking During Pregnancy (MSDP) has been linked to long-term neurobehavioral deficits in older offspring, relatively little attention has focused on the effects of MSDP on neurobehavioral deficits during the fetal and newborn periods. One key unanswered question is whether exposure to prenatal smoking induces neurobehavioral symptoms of withdrawal/abstinence in newborns. In this study, we are characterizing signs of abstinence and neurobehavior in infants and fetuses exposed and unexposed to MSDP. Specifically, the Behavior and Mood in Babies and Mothers (BAM BAM) study is an intensive, short-term, longitudinal study of signs of abstinence and neurobehavior during the fetal and newborn periods in continuously exposed and unexposed offspring. Results may lead to targeted intervention with newborns, education for parents to improve interactions with exposed newborns, and, potentially, early identification of high-risk infants and novel intervention and prevention efforts for pregnant smokers.

    Principal Investigator:Laura Stroud, PhD

    Co-Investigators: Raymond Niaura, PhD; George Papandonatos, PhD; Barry Lester, PhD; Amy Salisbury, PhD

    Funding Agency: National Institute on Drug Abuse

    Dates: 2005 - 2010


    Maternal Smoking:  Fetuses in Withdrawal?

    Exposure to maternal smoking during pregnancy is linked to numerous adverse fetal and neonatal health outcomes as well as longer-term neurobehavioral deficits in children and adults. Relatively little attention, however, has focused on effects of maternal smoking on fetal and neonatal neurobehavior. One key unanswered question is whether exposure to maternal cycles of daytime smoking and overnight abstinence results in symptoms of withdrawal/abstinence in the fetus. To examine the possibility of a fetal withdrawal syndrome from exposure to maternal smoking, aims of this study are: a) to characterize differences in fetal behavior including signs of abstinence under conditions of maternal satiation (daytime ad libitim smoking) versus overnight abstinence, b) to characterize links between fetal neurobehavior/withdrawal and newborn neurobehavior/withdrawal and c) to examine the influence of second-hand smoke exposure on fetal and infant neurobehavior/withdrawal (exploratory aim).

    Our group has pioneered the use of ultrasound technology to comprehensively evaluate fetal neurobehavior including signs of abstinence. In this study, we apply these techniques to examine the possibility of a fetal withdrawal process in offspring exposed to maternal smoking and second-hand smoke. This study is the first to examine effects of maternal smoking on fetal withdrawal. Results may lead to critical advances in understanding mechanisms underlying long-term effects of maternal smoking exposure. Results also have important clinical and public health implications, including early identification and targeted intervention efforts to protect at-risk offspring, and novel intervention efforts to help pregnant smokers quit.

     

    Principal Investigator:Laura Stroud, PhD

    Co-Investigators: Raymond Niaura, PhD; Amy Salisbury, PhD

    Funding Agency: Flight Attendant Medical Research Institute

    Dates: 2007 - 2010