Mark W Vander Weg

Publications (41)99.61 Total impact

• Article: A randomized controlled trial of cognitive training using a visual speed of processing intervention in middle aged and older adults.

  Fredric D Wolinsky, Mark W Vander Weg, M Bryant Howren, Michael P Jones, Megan M Dotson
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  ABSTRACT: Age-related cognitive decline is common and may lead to substantial difficulties and disabilities in everyday life. We hypothesized that 10 hours of visual speed of processing training would prevent age-related declines and potentially improve cognitive processing speed. Within two age bands (50-64 and≥65) 681 patients were randomized to (a) three computerized visual speed of processing training arms (10 hours on-site, 14 hours on-site, or 10 hours at-home) or (b) an on-site attention control group using computerized crossword puzzles for 10 hours. The primary outcome was the Useful Field of View (UFOV) test, and the secondary outcomes were the Trail Making (Trails) A and B Tests, Symbol Digit Modalities Test (SDMT), Stroop Color and Word Tests, Controlled Oral Word Association Test (COWAT), and the Digit Vigilance Test (DVT), which were assessed at baseline and at one year. 620 participants (91%) completed the study and were included in the analyses. Linear mixed models were used with Blom rank transformations within age bands. All intervention groups had (p<0.05) small to medium standardized effect size improvements on UFOV (Cohen's d = -0.322 to -0.579, depending on intervention arm), Trails A (d = -0.204 to -0.265), Trails B (d = -0.225 to -0.320), SDMT (d = 0.263 to 0.351), and Stroop Word (d = 0.240 to 0.271). Converted to years of protection against age-related cognitive declines, these effects reflect 3.0 to 4.1 years on UFOV, 2.2 to 3.5 years on Trails A, 1.5 to 2.0 years on Trails B, 5.4 to 6.6 years on SDMT, and 2.3 to 2.7 years on Stroop Word. Visual speed of processing training delivered on-site or at-home to middle-aged or older adults using standard home computers resulted in stabilization or improvement in several cognitive function tests. Widespread implementation of this intervention is feasible. ClinicalTrials.gov NCT-01165463.
  PLoS ONE 01/2013; 8(5):e61624. · 4.09 Impact Factor
• Source

  Available from: Wasim Maziak

  Article: Randomized trial of the effectiveness of combined behavioral/pharmacological smoking cessation treatment in Syrian primary care clinics.

  Kenneth D Ward, Taghrid Asfar, Radwan Al Ali, Samer Rastam, Mark W Vander Weg, Thomas Eissenberg, Wasim Maziak
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  ABSTRACT: AIM: Effectiveness of nicotine replacement therapy (NRT) for smoking cessation has not been evaluated in low income countries, such as Syria, where it is expensive and not widely available. We evaluated whether nicotine patch boosts smoking cessation rates when used in conjunction with behavioral support in primary care clinics in Aleppo, Syria. DESIGN: Two arm, parallel group, randomized, placebo controlled, double-blinded multi-site trial. SETTING: Four primary care clinics in Aleppo, Syria. PARTICIPANTS: 269 adult primary care patients received behavioral cessation counseling from a trained primary care physician and were randomized to receive 6 weeks of treatment with nicotine vs. placebo patch. MEASUREMENTS: Primary endpoints were prolonged abstinence (no smoking after a 2 week grace period) at end of treatment and 6 and 12 months post-quit day, assessed by self-report and exhaled carbon monoxide levels of <10 ppm. FINDINGS: Treatment adherence was excellent and nicotine patch produced expected reductions in urges to smoke and withdrawal symptoms, but no treatment effect was observed. The proportion of patients in the nicotine and placebo groups with prolonged abstinence was 21.6% and 20.0%, respectively, at end of treatment, 13.4% and 14.1% at 6 months, and 12.7% and 11.9% at 12 months. CONCLUSIONS: Nicotine patches may not be effective in helping smokers in low income countries to stop when given as an adjunct to behavioural support.
  Addiction 08/2012; · 4.31 Impact Factor
• Article: The relationships between ethnicity, gender, and short-term changes in energy balance following smoking cessation

  Mark W. Vander Weg, Robert C. Klesges, Linda H. Eck Clemens, Andrew W. Meyers, Randy W. Pascale
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  ABSTRACT: Although weight gain is a well-established consequence of quitting smoking, the energy balance mechanisms responsible for postcessation weight gain are not clear. Furthermore, although gender and ethnicity are important predictors of postcessation weight gain, no studies have evaluated the effects of these variables on changes in energy balance. This study investigated short-term changes in energy balance following smoking cessation in 95 smokers. In as little as 2 weeks, smoking cessation was associated with a significant increase in body weight (1.05 kg). Smoking cessation was also associated with an increase in energy intake (1440 kJ/day), and no changes in energy expenditure (physical activity; resting energy expenditure, REE) were observed. Changes in body weight and energy balance did not differ by gender or ethnicity. Predictors of weight gain included baseline carbon monoxide (CO) level, baseline REE per kg of body weight, and changes in energy intake. These findings provide valuable information about the mechanisms responsible for at least the early stages of postcessation weight gain.
  International Journal of Behavioral Medicine 04/2012; 8(2):163-177. · 2.63 Impact Factor
• Article: Variability in veterans' alcohol use by place of residence.

  Mark W Vander Weg, Xueya Cai
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  ABSTRACT: Rates of risky alcohol use appear to be elevated among active duty and veteran military personnel. Little is known, however, about characteristics associated with alcohol misuse in these groups. Furthermore, although there is evidence to suggest that patterns of alcohol use differ according to place of residence, no prior studies have investigated variability in alcohol use according to level of rurality and geographic region in US military veterans. The present study evaluated variations in alcohol use (ie, past 30-day use, heavy use, and binge drinking) and drinking and driving according to place of residence among 55,452 US military veterans participating in the Behavioral Risk Factor Surveillance System. Veterans residing in rural areas were significantly less likely than those from suburban and urban areas to have consumed alcohol in the past 30 days (p < .001). Conversely, rural-dwelling veterans who did drink alcohol had higher odds of binge drinking (p < .005) and (relative to urban residents) drinking and driving (p = .013). Veterans residing in the South were significantly less likely than those from other geographic regions to report past 30-day alcohol use (p < .001). In addition, veterans living in the Midwest were significantly more likely than those from the South to report drinking and driving (p = .017). No differences in heavy alcohol use were observed based on location of residence. 
  American Journal on Addictions 01/2012; 21(1):31-7. · 1.74 Impact Factor
• Article: Use of routine clinical preventive services among daily smokers, non-daily smokers, former smokers, and never-smokers.

  Mark W Vander Weg, M Bryant Howren, Xueya Cai
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  ABSTRACT: Studies examining differences in clinical preventive services between smokers and nonsmokers have yielded mixed results. While some have noted reduced rates of certain preventive services among smokers relative to nonsmokers, others have reported no differences based on smoking status. These inconsistencies may be due, at least in part, to the way in which smoking status was measured. The present investigation examined variability in utilization of six common preventive services including immunization (influenza and pneumococcal) and cancer screening (breast, cervical, colorectal, and prostate) using more specific categories of smoking history and status. Data from the 2008 Behavioral Risk Factor Surveillance System were used to estimate rates of preventive services among U.S. adults. Use of vaccination and cancer screening services across four categories of smoking status (never-smoker, daily smoker, non-daily smoker, and former smoker) were examined using multivariable logistic regression analyses adjusting for sociodemographics and health care access. Relative to never-smokers, daily smokers had significantly reduced rates of all services with the exception of pneumococcal vaccination. Although non-daily smokers were similar to never-smokers on most outcomes, they demonstrated lower rates of mammography but were more likely to have received a recent Papanicolaou test. Except for mammography, the odds of using preventive services were 15%-47% higher among former relative to never-smokers. Despite increased risk for respiratory disease and cancer, daily smokers are less likely to receive influenza vaccination and cancer screening. Smokers should be considered an at-risk group to be aggressively targeted for routine preventive clinical services.
  Nicotine & Tobacco Research 12/2011; 14(2):123-30. · 2.58 Impact Factor
• Article: Drinking and driving and riding with an alcohol impaired driver among United States Air Force recruits.

  Margaret DeBon, Mark W Vander Weg, Deborah Sherrill-Mittleman, Robert C Klesges, Gerald W Talcott
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  ABSTRACT: To identify the prevalence and correlates of binge drinking, driving after drinking, and riding in a vehicle with a driver who had consumed alcohol in US Air Force active duty recruits. A military cohort (N = 31,108; 25.1% female) was analyzed to identify variables associated with binge drinking, drinking and driving, and riding with a driver who had consumed alcohol. Results indicated that 53 percent (including 45% of those under the legal drinking age) reported alcohol use in the month prior to entering basic military training (BMT). Thirty-eight percent of all active duty recruits reported binge drinking (ie, consuming 5 or more drinks on a single occasion) at least one time in the past 30 days. Nearly 1 in 4 (23%) reported 1 to 3 episodes of binge drinking. Three percent of reported alcohol users drove after consuming five or more drinks, and 9 percent rode as a passenger in a vehicle with a driver who had been drinking heavily. Several demographic, behavioral, and attitudinal correlates of risky drinking patterns were identified. Prevention efforts are needed to address the implications of these findings because they influence the health, safety, and military readiness of active duty personnel.
  Traffic injury prevention 04/2011; 12(2):128-35.
• Article: Adverse childhood experiences and cigarette smoking: the 2009 Arkansas and Louisiana Behavioral Risk Factor Surveillance Systems.

  Mark W Vander Weg
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  ABSTRACT: Adverse childhood experiences (ACEs) such as neglect, verbal, sexual, and physical abuse, household dysfunction, and other childhood stressors are associated with a range of negative health outcomes and risk behaviors. Although there is evidence that ACEs are related to an increased risk for cigarette smoking, additional studies in more diverse samples are needed. Adults taking part in the 2009 Arkansas (n = 3,125) and Louisiana (n = 7,152) Behavioral Risk Factor Surveillance Systems were surveyed regarding their smoking history and exposure to 11 ACEs. Multivariable logistic regression was used to examine independent associations between individual and total number of ACEs and both lifetime and current smoking adjusting for sociodemographic characteristics. Exposure to each type of ACE was associated with a significantly increased risk for both lifetime (odds ratios [ORs]: 1.35-3.65) and current (ORs: 1.31-2.43) cigarette smoking among residents of both states. Total number of ACEs was also related to the odds of smoking in a generally graded fashion such that Arkansas residents reporting 5 or more ACEs were 3.97 (95% CI: 2.46-6.41) and 2.70 (95% CI: 1.64-4.43) times as likely as those reporting no ACEs to be lifetime and current smokers, respectively. Corresponding odds for those living in Louisiana were 3.06 (95% CI: 2.32-4.02) for lifetime smoking and 2.80 (95% CI: 2.07-3.77) for current smoking. ACEs are associated with an increased likelihood of cigarette smoking in adulthood among residents of Arkansas and Louisiana. Efforts to prevent abuse, neglect, and other ACE may include among their benefits reduced risk for later smoking-related illness.
  Nicotine & Tobacco Research 03/2011; 13(7):616-22. · 2.58 Impact Factor
• Article: Tobacco use and exposure in rural areas: Findings from the Behavioral Risk Factor Surveillance System.

  Mark W Vander Weg, Cassie L Cunningham, M Bryant Howren, Xueya Cai
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  ABSTRACT: Evidence suggests that those residing in rural areas may be disproportionately affected by the health burden of tobacco use. The present study examined tobacco use, self-reported exposure to tobacco smoke, and policies regarding public smoking according to area of residence using data from the 2006 and 2008 Behavioral Risk Factor Surveillance System. Results indicated that, relative to those from suburban and urban locations, adults residing in rural areas were significantly more likely to smoke cigarettes (22.2% versus 17.3% (suburban) and 18.1% (urban), p<.001) and to use smokeless tobacco (p<.001). Rural residents were also more likely than those living in suburban and urban areas to report that someone had smoked in their presence during the past seven days both at home (p<.001) and at work (p<.001). Finally, rural participants reported policies that afforded less protection from tobacco smoke both at home and in the workplace. These findings suggest that those living in rural areas are at increased risk for tobacco-related illness due to both their own tobacco use and exposure to others' cigarette smoke.
  Addictive behaviors 03/2011; 36(3):231-6. · 2.25 Impact Factor
• Source

  Available from: PubMed Central

  Article: Interim analyses from a randomised controlled trial to improve visual processing speed in older adults: the Iowa Healthy and Active Minds Study.

  Fredric D Wolinsky, Mark W Vander Weg, M Bryant Howren, Michael P Jones, Rene Martin, Tana M Luger, Kevin Duff, Megan M Dotson
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  ABSTRACT: Objectives The Iowa Healthy and Active Minds Study is a four-arm randomised controlled trial of a visual processing speed training programme (Road Tour). This article presents the preplanned interim results immediately after training (6-8 weeks post-randomisation) for the primary outcome. Design Within two age strata (50-64 vs ≥65), 681 men and women attending general internal and family medicine clinics were randomised to four training groups: (1) supervised, on-site standard (10 h) dose of Road Tour training; (2) supervised, on-site standard dose of Road Tour training with 4 h of subsequent booster training scheduled to occur at 11 months post-randomisation (ie, no booster training had occurred at the time of this interim analysis); (3) supervised, on-site standard dose of attention control (crossword puzzles) training and (4) self-administered, at-home standard dose of Road Tour training. The primary outcome was the Useful Field of View (UFOV) test. Three intent-to-treat interim analyses were conducted, including (1) multiple linear regression models of composite UFOV scores using Blom rank transformations, (2) general linear mixed effects models and (3) multiple logistic regression models among the 620 participants (91%) with complete data. Results In the linear regression analyses of both age strata, random assignment to any Road Tour training group versus the attention control group was significant (p<0.001), with an effect size of -0.558 (adjusted for the Blom rank transformed UFOV score at randomisation). Similar results were obtained for each Road Tour group and within each age stratum and from the general linear and logistic regression models. Conclusions Assignment to a standard dose of Road Tour training yielded medium-sized post-training improvements in visual processing speed. Road Tour was equally effective whether administered under laboratory supervision or self-administered in the patient's home and for participants in both age strata (50-64 vs ≥65). Clinical trial registration number NCT01165463.
  BMJ open. 01/2011; 1(2):e000225.
• Source

  Available from: PubMed Central

  Article: Protocol for a randomised controlled trial to improve cognitive functioning in older adults: the Iowa Healthy and Active Minds Study.

  Fredric D Wolinsky, Mark W Vander Weg, M Bryant Howren, Michael P Jones, Rene Martin, Tana M Luger, Kevin Duff, Christopher Goerdt, Steven Wolfe, Megan M Dotson
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  ABSTRACT: OBJECTIVES: Gradual age-related cognitive deteriorations are common and are hypothesised to be partially attributable to declines in information-processing speed. The Iowa Healthy and Active Minds Study will evaluate the efficacy and effectiveness of a computerised visual processing speed training programme (Road Tour, Posit Science Corporation, San Francisco, California). METHODS AND ANALYSIS: Using a 3:3:4:4 ratio within two age strata (50-64 vs ≥ 65 years old), 681 men and women attending family care clinics were randomised to four treatment groups: 10 h of on-site Road Tour training, 10 h of on-site Road Tour training with 4 h of booster training at 11 months postrandomisation, 10 h of on-site attention control using computerised crossword puzzles (Boatload of Crosswords, Boatload Puzzles, LLC, Yorktown Heights, New York) and 10 h of at-home Road Tour training using the participant's personal computer. The primary outcome, visual processing speed, was assessed at randomisation and post-training (6-8 weeks postrandomisation), and is being reassessed at 1-year postrandomisation using the Useful Field of View test. Five secondary outcomes (Symbol Digit Modalities Test, Trail Making Tests A and B, Controlled Oral Word Association Test, Digit Vigilance Test, and the Stroop Colour and Word Test) were assessed at randomisation and will be reassessed at 1-year postrandomisation. Seven hypotheses will be tested using intent-to-treat analyses involving multiple linear, logistic, Poisson and negative binomial regression. ETHICS AND DISSEMINATION: Ethics approval was provided by the University of Iowa Institutional Review Board (IRB-03 protocol 200908789). All participants completed signed informed consent prior to enrollment. Road Tour is commercially available from Posit Science Corporation, which provided it to Iowa Healthy and Active Minds Study at no cost. All participants will receive a free copy of Road Tour for unlimited perpetual use at study completion. Clinical Trial Registration Number NCT01165463.
  BMJ open. 01/2011; 1(2):e000218.
• Source

  Available from: Kenneth D Ward

  Article: Are primary health care providers prepared to implement an anti-smoking program in Syria?

  Taghrid Asfar, Radwan Al-Ali, Kenneth D Ward, Mark W Vander Weg, Wasim Maziak
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  ABSTRACT: To document primary health care (PHC) providers' tobacco use, and how this influences their smoking cessation practices and attitudes towards tobacco-control policies. Anonymous questionnaires were distributed to PHC providers in 7 randomly selected PHC centers in Aleppo, Syria. All PHC providers completed the questionnaires (100% response rate). A quarter of these providers smoke cigarettes and more than 10% smoke waterpipes. Physicians who smoke were less likely to advise patients to quit (OR=0.29; 95% CI, 0.09-0.95), assess their motivation to quit (OR=0.13, 95% CI=0.02-0.72), or assist them in quitting (OR=0.24, 95% CI=0.06-0.99). PHC providers who smoke were less likely to support a ban on smoking in PHC settings (68.2% vs. 89.1%) and in enclosed public places (68.2% vs. 86.1%) or increases in the price of tobacco products (43.2% vs. 77.4%) (P<0.01 for all comparisons). Smoking, including waterpipe, continues to be widespread among PHC providers in Syria and will negatively influence implementation of anti-smoking program in PHC settings. Smoking awareness and cessation interventions targeted to PHC providers, and training programs to build providers' competency in addressing their patients' smoking is crucial in Syria.
  Patient Education and Counseling 12/2010; 85(2):201-5. · 2.31 Impact Factor
• Article: Differences between intermittent and light daily smokers in a population of U.S. military recruits.

  Theodore V Cooper, Thom Taylor, Ashley Murray, Margaret W DeBon, Mark W Vander Weg, Robert C Klesges, G Wayne Talcott
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  ABSTRACT: Few studies have assessed differences between intermittent and light smokers, particularly among young adults. Exploring these differences promotes a systematic approach to research and treatment in low-level smokers. This study explored demographic, tobacco-related, and psychosocial predictors of intermittent nondaily smoking relative to light smoking among basic military training (BMT) recruits. The impact of smoking status on abstinence rates at follow-up was also assessed. Participants were 5,603 U.S. Air Force BMT intermittent nondaily (n = 3,134) or light daily (n = 2,469) smoking recruits participating in a population-based group randomized trial targeting tobacco use prevention and cessation (Klesges et al., 2006, Efficacy of a tailored tobacco control program on long-term use in a population of U.S. military troops. Journal of Consulting and Clinical Psychology, 74, 295-306.). Participants completed baseline measures assessing demographics; tobacco use and history; and common social, attitudinal, and behavioral risk factors for tobacco use. Flights of recruits were randomly assigned to a tobacco use intervention or health education control intervention. At the 1-year follow-up, participants reported 7-day point prevalence and continuous abstinence. Intermittent nondaily smoking relative to light daily smoking was associated with lesser perceived addiction, intermittent and daily use of smokeless tobacco, nonsmoking male and female heads of household, lesser likelihood of smoking while stressed or while bored, and higher likelihood of intentions to quit smoking. Intermittent smokers were significantly more likely than light daily smokers to report abstinence at follow-up. Intermittent and daily light smokers differ on several tobacco-related and psychosocial variables. Attending to these factors in prevention and cessation programs may enhance abstinence in both groups.
  Nicotine & Tobacco Research 03/2010; 12(5):465-73. · 2.58 Impact Factor
• Article: Speed of processing training protects self-rated health in older adults: enduring effects observed in the multi-site ACTIVE randomized controlled trial.

  Fredric D Wolinsky, Henry Mahncke, Mark W Vander Weg, Rene Martin, Frederick W Unverzagt, Karlene K Ball, Richard N Jones, Sharon L Tennstedt
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  ABSTRACT: We evaluated the effects of cognitive training on self-rated health at 1, 2, 3, and 5 years post-baseline. In the ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) randomized controlled trial, 2,802 older adults (>or=65 years) were randomly assigned to memory, reasoning, speed of processing, or no-contact control intervention groups. Complete data were available for 1,804 (64%) of the 2,802 participants at five years. A propensity score model was adjusted for attrition bias. The self-rated health question was coded using the Diehr et al. (2001) transformation (E = 95/VG = 90/G = 80/F = 30/P = 15), and analyzed with change-score regression models. The speed of processing (vs. no-contact control) group had statistically significant improvements (or protective effects) on changes in self-rated health at the 2, 3 and 5 year follow-ups. The 5-year improvement was 2.8 points (p = 0.03). No significant differences were observed in the memory or reasoning groups at any time. The speed of processing intervention significantly protected self-rated health in ACTIVE, with the average benefit equivalent to half the difference between excellent vs. very good health.
  International Psychogeriatrics 12/2009; 22(3):470-8. · 2.24 Impact Factor
• Article: Does cognitive training improve internal locus of control among older adults?

  Fredric D Wolinsky, Mark W Vander Weg, René Martin, Frederick W Unverzagt, Sherry L Willis, Michael Marsiske, George W Rebok, John N Morris, Karlene K Ball, Sharon L Tennstedt
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  ABSTRACT: We evaluated the effect of cognitive training among 1,534 participants in the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) randomized controlled trial (RCT) on 5-year improvements in 3 cognitive-specific measures of locus of control-internal, chance, and powerful others. ACTIVE was a multisite RCT (age > or = 65), with 4 groups (memory, reasoning, speed of processing, and no-contact control). Complete 5-year follow-up data were available for 1,534 (55%) of the 2,802 participants. A propensity score model was used to adjust for potential attrition bias. Clinically important improvements (and decrements) in the cognitive-specific locus of control scale scores were defined as greater than or equal to 0.5 SD (medium) and greater than or equal to 1.0 SD (large). Multinomial logistic regression was used to simultaneously contrast those who improved and those who declined with those whose locus of control scale score was unchanged. Statistically significant effects reflecting medium-sized (> or = 0.5 SD) improvements in internal locus of control between baseline and the 5-year follow-up were found for the reasoning and speed of processing intervention groups who were 76% (p < .01) and 68% (p < .05) more likely, respectively, to improve than the no-contact control group. No improvement effects were found on the chance or powerful others locus of control measures or for the memory intervention group. Cognitive training that targets reasoning and speed of processing can improve the cognitive-specific sense of personal control over one's life in older adults.
  The Journals of Gerontology Series B Psychological Sciences and Social Sciences 12/2009; 65(5):591-8. · 2.62 Impact Factor
• Article: The ACTIVE cognitive training interventions and the onset of and recovery from suspected clinical depression.

  Fredric D Wolinsky, Henry W Mahncke, Mark W Vander Weg, Rene Martin, Frederick W Unverzagt, Karlene K Ball, Richard N Jones, Sharon L Tennstedt
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  ABSTRACT: We evaluated the effects of the 3 cognitive interventions fielded in the Advanced Cognitive Training for Independent and Vital Elderly study on 2 subsets of participants-1,606 without and 424 with suspected clinical depression at baseline. In the former group, only the speed of processing (vs. no-contact control) intervention had a significant effect, with its participants being 38% less likely to develop suspected clinical depression at 1 year (adjusted odds ratio = 0.62; p < .01). None of the interventions had a significant effect on recovery from suspected clinical depression in the latter group. Although the etiological mechanism of the speed of processing's protective effect was not isolated, it may result from successful adaptation to age-related changes through selective optimization with compensation.
  The Journals of Gerontology Series B Psychological Sciences and Social Sciences 08/2009; 64(5):577-85. · 2.62 Impact Factor
• Article: The effect of speed-of-processing training on depressive symptoms in ACTIVE.

  Fredric D Wolinsky, Mark W Vander Weg, Rene Martin, Frederick W Unverzagt, Karlene K Ball, Richard N Jones, Sharon L Tennstedt
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  ABSTRACT: We evaluated the effects of three cognitive training interventions on depressive symptoms at 1 and 5 years. Advanced Cognitive Training for Independent and Vital Elderly is a multisite randomized controlled trial (age >or= 65 years), with four groups (memory, reasoning, speed-of-processing, and no-contact control). Complete data were available for 2,014 (72%) and 1,516 (54%) of 2,802 participants at 1 and 5 years. Separate propensity score models adjusted for potential attrition bias. Clinically important increases in depressive symptoms were defined as: (a) Center for Epidemiological Studies-Depression scale (CES-D)-12 score increases >or=0.5 SD and (b) CES-D-12 score increases >or=1.0 SD. Multivariable logistic regression was used. The speed-of-processing group (vs the no-contact control group) was 30% less likely to experience clinically important increases in depressive symptoms at 1-year (adjusted odds ratio [AOR] = 0.700, p = .012) and 5-year (AOR = 0.698, p = .023) posttraining for the >or=0.5 SD threshold. Similar results (AOR = .669 with p = .039 at 1 year; AOR = 0.651 with p = .059 at 5 years) were obtained for the >or=1.0 SD threshold. No differences were observed among the control, memory, or reasoning groups at either time period or at either threshold. The speed-of-processing intervention reduced the risk of clinically important increases in depressive symptoms at 1- and 5-years postbaseline.
  The Journals of Gerontology Series A Biological Sciences and Medical Sciences 01/2009; 64(4):468-72. · 4.60 Impact Factor
• Article: Relationship between smoking status and body weight in a military population of young adults.

  Deborah Sherrill-Mittleman, Robert C Klesges, Virginia Massey, Mark W Vander Weg, Margaret DeBon
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  ABSTRACT: The purpose of the present study was to determine the association between smoking and body weight in a cohort of young U.S. Air Force recruits (mean age=20 years) enrolled in basic military training (N=35986). Twenty-two percent of recruits smoked daily prior to basic military training (n=8087) and were compared to never smokers, former smokers, and experimental or nondaily smokers. A three-way interaction among smoking status, gender and ethnicity suggested a small effect for daily smoking among White male recruits only and no significant differences for female recruits or members of any other ethnic group. Although there was a statistically significant relationship between smoking and body weight in White males, the effect size was approximately 1 kg. These results suggest that the energy balance differences in body weight between young smokers and nonsmokers are minimal and that it would take decades to accrue the differences typically seen in adult smokers.
  Addictive behaviors 12/2008; 34(4):400-2. · 2.25 Impact Factor
• Article: Trial design: blood pressure control and weight gain prevention in prehypertensive and hypertensive smokers: the treatment and prevention study.

  Mark W Vander Weg, Robert C Klesges, Jon O Ebbert, Ellen J Lichty, Margaret DeBon, Frederick North, Darrell R Schroeder, Patricia M Dubbert
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  ABSTRACT: Cigarette smokers with elevated blood pressure (BP) are at substantially higher risk for cardiovascular events compared to normotensive smokers. Although smoking cessation should be a primary treatment goal for these patients, increases in body weight accompanying smoking abstinence may further increase BP. Intervention strategies that facilitate smoking cessation and modify adverse changes in body weight and BP are needed. We describe an ongoing multi-site, two-phase, five-year randomized clinical trial. Participants are cigarette smokers with Prehypertension or Stage I Hypertension. In the first phase, participants receive a smoking cessation intervention combining behavioral counseling and nicotine replacement in an open-label fashion. In the second phase, participants who successfully quit smoking are randomly assigned to one of three lifestyle interventions: 1) weight gain prevention, 2) blood pressure control, or 3) usual lifestyle. Participants are followed for one year to assess changes in blood pressure, body weight, dietary intake, and physical activity. Results from the proposed study will provide important insights into the efficacy of various approaches to lifestyle modification in smokers at increased risk for cardiovascular events.
  Contemporary Clinical Trials 04/2008; 29(2):281-92. · 1.81 Impact Factor
• Article: Prevalence of alternative forms of tobacco use in a population of young adult military recruits.

  Mark W Vander Weg, Alan L Peterson, Jon O Ebbert, Margaret Debon, Robert C Klesges, C Keith Haddock
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  ABSTRACT: Recent evidence suggests that the popularity of certain alternative forms of tobacco may be increasing in adolescents. Little is known, however, about the use of these products among young adults. This study examined the use of alternative tobacco products including bidis, cigars, kreteks (clove cigarettes), pipes, and smokeless tobacco in a large sample of young adult military recruits (N=31107). Overall, 18.5% of participants were using some form of alternative tobacco product prior to entry into Basic Military Training. Results revealed a relatively high prevalence of cigar (12.3%) and smokeless tobacco use (6.7%). Use of other products was less common, including 1.1% for pipes, 2.0% for bidis, and 3.0% for kreteks. With the exception of kreteks, which did not differ by gender, the prevalence of use of alternative tobacco products was greater for males than for females (p<.001). Patterns of use also differed according to other demographic characteristics including race, ethnicity, age, and income. Implications for surveillance and tobacco control efforts are discussed.
  Addictive Behaviors 01/2008; 33(1):69-82. · 2.09 Impact Factor
• Article: Characteristics of Air Force personnel who choose pharmacological aids for smoking cessation following an involuntary tobacco ban and tobacco control program.

  Robert C Klesges, Lisa M Klesges, Mark W Vander Weg, Margaret DeBon, Walker S Carlos Poston, Jon Ebbert, J Taylor Hays, C Keith Haddock
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  ABSTRACT: The objective of this study was to compare characteristics of smokers who did and did not report use of cessation aids as part of a tobacco control program in a military setting (n = 8994). The study is a longitudinal epidemiological study where the relationship between smoking status at follow-up and use of pharmacologic aids to quit smoking were assessed. Smoking cessation, post baseline use of cessation aids to quit smoking. Individuals remaining abstinent were 70% less likely to have used NRT/pharmacological aids compared to those that relapsed. NRT/pharmacological aid users were more likely to report plans to smoke after military training, to have friends who smoke, and to accept a cigarette from a friend. NRT/pharmacological aid users were more likely to believe that using NRT was safer than smoking and to have engaged in harm reduction strategies. Our findings suggest that selection bias related to such characteristics may explain some of the discrepancies between effect sizes reported in efficacy compared to effectiveness studies of NRT and smoking outcomes currently reported in the literature.
  Health Psychology 10/2007; 26(5):588-97. · 3.87 Impact Factor