University of Vermont

College of Medicine

Vermont Center on Behavior and Health

 

Publications

 

VCBH publications reflect latest research on a wide range of topics related to drug abuse and other health behaviors, behavioral economics, and behavioral pharmacology. The work of our investigators has appeared in a number of high-impact journals. A list of publications by VCBH faculty is accessible from PubMed via our directory page.

 

 


 

Special Issues: Preventive Medicine

 

The VCBH has collaborated with Preventive Medicine in the creation of two special issues, 2014 & 2015. In 2012, Stephen T. Higgins, Ph.D., and colleagues worked with the journal to develop a supplemental issue. See below for links.

 

Special Issue: Behavior Change, Health, and Health Disparities

November 2015
Volume 80, Supplement, Pages 1-106
Edited by Stephen T. Higgins

 

Special Issue: Behavior Change, Health, and Health Disparities

November 2014
Volume 68, Supplement, Pages S1-S80
Edited by Stephen T. Higgins
 

Supplemental Issue on Incentives and Health

November 1, 2012
Volume 55, Supplement, Pages S1-S124 (1 November 2012) Incentives on Health
Edited by Stephen T. Higgins, Kenneth Silverman, Stacey C. Sigmon and Neal A. Naito

 


Selected Articles

 

Following is a list of selected articles from select publications. A complete list of publications by VCBH faculty is accessible from PubMed via our directory page.

 

Comparison of Nicotine Dependence Indicators in Predicting Quitting Among Pregnant Smokers

Experimental and Clinical Psychopharmacology, February 2016
Allison N Kurti, Danielle R Davis, Joan M Skelly, Ryan Redner, Stephen T Higgins

 

Research in the general population of smokers indicates that across various measures of nicotine dependence, time to first cigarette (TTFC) is the strongest single-item predictor of quitting success. Whether those findings generalize to pregnant smokers is unclear. To investigate this matter, we compared TTFC with cigarettes per day (CPD) and the Heaviness of Smoking Index (HSI; Kozlowski, Porter, Orleans, Pope, & Heatherton, 1994) in predicting late-pregnancy abstinence among 289 pregnant women enrolled in 4 smoking-cessation trials assessing the efficacy of financial incentives.

 

Partnership Status and Socioeconomic Factors in Relation to Health Behavior Changes after a Diagnosis of Ductal Carcinoma In Situ

Cancer Epidemiology Biomarkers & Prevention, January 2016
Sherrie Khadanga, Susan G. Lakoski, Vicki Hart, Brian L. Sprague, Yi Ba, John M. Hampton, Stephen T. Higgins, Philip A. Ades, Polly A. Newcomb, and Amy Trentham-Dietz

 

Change in health behaviors can occur among women newly diagnosed with ductal carcinoma in situ (DCIS). We sought to understand whether partnership status and socioeconomic status (SES) affected behavioral changes in body weight, physical activity, alcohol consumption, and smoking.

 

Financial Incentives to Promote Extended Smoking Abstinence in Opioid-Maintained Patients: A Randomized Trial

Addiction, January 2016
Stacey C. Sigmon, Mollie E. Miller, Andrew C. Meyer, Kathryn Saulsgiver, Gary J. Badger, Sarah H. Heil, and Stephen T. Higgins
 

Prior studies by our group demonstrated the efficacy of a brief but intensive behavioral intervention for producing initial smoking abstinence among opioid-dependent patients. In the present study, our aim was to promote longer-duration abstinence in this population. Following an initial 2-week incentive intervention for smoking abstinence, we examined whether a 10-week maintenance arm involving continuation of contingent reinforcement will produce greater smoking abstinence than a similar duration of noncontingent reinforcement.

 

Bridging Waitlist Delays with Interim Buprenorphine Treatment: Initial Feasibility

Addictive Behaviors, December 2015
Stacey C. Sigmon, Andrew C. Meyer, Bryce Hruska, Taylor Ochalek, Gail Rose, Gary J. Badger, John R. Brooklyn, Sarah H. Heil, Stephen T. Higgins

 

Despite the effectiveness of agonist maintenance for opioid dependence, individuals can remain on waitlists for months, during which they are at significant risk for morbidity and mortality. Interim dosing, consisting of daily medication without counseling, can reduce these risks. In this pilot study, we examined the initial feasibility of a novel technology-assisted interim buprenorphine treatment for waitlisted opioid-dependent adults.

 

Predicted Impact of Nicotine Reduction on Smokers with Affective Disorders

Tobacco Regulatory Science, July 2015
Diann E. Gaalema, Mollie E. Miller, Jennifer W. Tidy
 

In 2009 the FDA acquired the authority to reduce the nicotine content in cigarettes if appropriate for public health, prompting research to evaluate the implications of this policy scientifically. Studies in non-psychiatric populations show that reducing the nicotine content of cigarettes to non-addictive levels reduces smoking rates and nicotine dependence. However, few studies have examined this hypothesis in vulnerable populations.

 

Is Impulsivity a Symptom of Initial Tobacco Withdrawal? A Meta-Analysis and Qualitative Systematic Review

Nicotine and Tobacco Research,  May 2015
Hughes JR, Dash M, Callas PW

 

We conducted searches of PubMed, PsychInfo and other sources to find experimental studies that measured self-reported impatience, delay discounting (DD), or response inhibition (RI) while smoking and during initial abstinence in untreated smokers.

 

The Untapped Potential of Office-Based Buprenorphine Treatment

JAMA Psychiatry, February 2015
Stacey C. Sigmon
 

Opioid abuse and dependence are reaching epidemic proportions in the United States, resulting in a staggering number of overdose deaths and economic costs that exceed $56 billion annually. Medication-assisted therapies, such as buprenorphine (Suboxone) and methadone, represent the most efficacious treatments for opioid dependence. Office-based buprenorphine treatment is especially well positioned to provide a rapid response to the opioid crisis, particularly in rural areas where efforts to expand methadone clinics often face size- able barriers and opioid-dependent patients are widely dispersed throughout a large geographic area. However, there has been increasing concern that these life-saving medications are severely underused.

 

Examining Two Different Schedules of Financial Incentives for Smoking Cessation Among Pregnant Women

Preventive Medicine,  April 2014
Higgins, S. T., Washio, Y., Lopez, A. A., Heil, S. H., Solomon, L. J., Lynch, M. E., ... & Bernstein, I. M.
 

Cigarette smoking is the leading preventable cause of poor pregnancy outcomes in the U.S. and other industrialized countries, increasing risk for catastrophic pregnancy complications as well as adverse effects that extend into childhood and beyond. This study examines whether an efficacious voucher-based incentives intervention for decreasing smoking during pregnancy and increasing fetal growth could be improved without increasing costs. The strategy was to redistribute the usual incentives so that higher values were available early in the quit attempt.

 

Improving Medicaid Health Incentives Programs: Lessons from Substance Abuse Treatment Research

Preventive Medicine, March 2014
Hand, D. J., Heil, S. H., Sigmon, S. C., & Higgins, S. T.
 

This commentary addresses the efforts of Medicaid programs in several US states to employ financial incentives to increase healthy behavior among their beneficiaries. While these Medicaid incentive programs have been successful at boosting rates of less effortful behaviors, like semiannual dental visits, they have fallen short in promoting more complex behaviors, like smoking cessation, drug abstinence, and weight management. Incentives have been extensively studied as a treatment for substance use disorders for over 20 years, with good success. We identify two variables shown by meta-analysis to moderate the efficacy of incentive interventions in substance abuse treatment, the immediacy of incentive delivery and size (or magnitude) of the incentive, that are lacking in current Medicaid incentive program. We also offer some guidance on how these moderating variables could be addressed within Medicaid programs. This is a critical time for such analysis, as more than 10 states are employing incentives in their Medicaid programs, and some are currently reevaluating their incentive strategies.

 

Access to Treatment for Opioid Dependence in Rural America: Challenges and Future Directions

JAMA Psychiatry, February 2014
Sigmon, S. C.
 

Opioid abuse is reaching epidemic proportions in the United States. The consequences of opioid abuse and dependence include emergency department visits, premature death, HIV, hepatitis, criminal activity, lost workdays, and economic costs that in the United States exceed $56 billion annually. Agonist maintenance is the most efficacious treatment for opioid dependence and dramatically reduces morbidity, mortality, and spread of infectious disease. However, demand for opioid maintenance treatment far exceeds available capacity. Due to inadequate public funding, unfavorable zoning regulations, and requirements for comprehensive care in programs that increase their cost, an alarming number of methadone clinics have extensive waitlists. Further, while approval of buprenorphine in 2002 extended agonist maintenance into general medical practices, many areas of the country have an insufficient number of physicians willing to prescribe buprenorphine, in part due to concerns about induction logistics, reimbursement challenges, potential for medication diversion, lack of professional support for the clinicians, and lack of psychosocial services for patients. One result of the current situation is that opioid-dependent patients can remain on waitlists for years, during which they are at substantial risk for illicit drug use, criminal activity, infectious disease, overdose, and mortality.

 

Examining the Effects of Initial Smoking Abstinence on Response to Smoking-Related Stimuli and Response Inhibition in a Human Laboratory Model

Psychopharmacology, November 2013
Bradstreet, M. P., Higgins, S. T., McClernon, F. J., Kozink, R. V., Skelly, J. M., Washio, Y., ... & Parry, M. A.

 

This study aims to investigate the effects of different durations of initial abstinence on sensitivity to smoking-related stimuli and response inhibition in the context of a larger battery of outcome measures.

 

Maternal Body Mass Index Moderates the Influence of Smoking Cessation on Breast Feeding

Nicotine & Tobacco Research, November 2013
Vurbic, D., Higgins, S. T., McDonough, S. R., Skelly, J. M., & Bernstein, I. M.

 

Smoking cessation is associated with greater breast feeding in newly postpartum women, while being overweight or obese is associated with lower rates of breast feeding. The purpose of this study is to examine whether the increases in breast feeding associated with smoking cessation are moderated by maternal body mass index (BMI). To our knowledge, the interaction of maternal smoking status and overweight/obesity on breast feeding has not been previously reported. Results suggest that overweight/obesity attenuates the positive relationship between smoking abstinence and greater breast feeding among newly postpartum women.

 

A Randomized, Double-blind Evaluation of Buprenorphine Taper Duration in Primary Prescription Opioid Abusers

JAMA Psychiatry, October 2013
Sigmon, S. C., Dunn, K. E., Saulsgiver, K., Patrick, M. E., Badger, G. J., Heil, S. H., ... & Higgins, S. T.
 

Although abuse of prescription opioids (POs) is a significant public health problem, few experimental studies have investigated the treatment needs of this growing population. This study represents a rigorous experimental evaluation of outpatient buprenorphine stabilization, brief taper, and naltrexone maintenance for treatment of PO dependence. Results suggest that a meaningful subset of PO-dependent outpatients may respond positively to a 4-week taper plus naltrexone maintenance intervention.

 

Vulnerability to Smokeless Tobacco Use Among Those Dependent on Alcohol or Illicit Drugs

Nicotine & Tobacco Research, September 2013
Redner, R., White, T. J., Harder, V. S., & Higgins, S. T. (2014). vulnerability to smokeless tobacco Use among those Dependent on alcohol or illicit Drugs., 16(2), 216-223..

 

Smoking cessation is associated with greater breast feeding in newly postpartum women, while being overweight or obese is associated with lower rates of breast feeding. The purpose of this study is to examine whether the increases in breast feeding associated with smoking cessation are moderated by maternal body mass index (BMI). To our knowledge, the interaction of maternal smoking status and overweight/obesity on breast feeding has not been previously reported. Results suggest that overweight/obesity attenuates the positive relationship between smoking abstinence and greater breast feeding among newly postpartum women.

 

 

Last modified February 08 2016 10:46 AM