Laura J Solomon

• PhD
• Research Professor Emerita at University of Vermont

We report results from a randomized clinical trial examining financial incentives for smoking cessation among 249 pregnant and newly postpartum women. Participants included 169 women assigned to best practices (BP) or BP plus financial incentives (BP + FI) for smoking cessation available through 12-weeks postpartum. A third condition included 80 ne...

Introduction: We recently conducted a large randomized controlled trial (RCT) (N = 560) that failed to replicate our initial RCT's findings that brief motivational and reduction interventions increased quit attempts (QA) and point-prevalence abstinence (PPA) in smokers not ready to quit. The present study aimed to test why our interventions were i...

Working alliance and empathy are believed to be important components of counseling, although few studies have empirically tested this. We recently conducted a randomized controlled trial in which brief motivational and reduction counseling failed to increase the number of participants who made a quit attempt (QA) in comparison to usual care (i.e.,...

Aims: To test whether, in comparison to usual care, brief motivational or reduction interventions increase quit attempts (QA) or abstinence among smokers who are not ready to quit. Design: A parallel-group randomized controlled trial of brief motivational (n = 185), reduction (n = 186) or usual care (n = 189) telephone interventions delivered ov...

Smoking during pregnancy is a leading preventable cause of poor pregnancy outcomes and immediate and longer-term adverse health outcomes among exposed offspring. Developing more effective smoking cessation interventions for pregnant women has been a public health priority for more than 30 years. We review developments over the past 3 years (2012–20...

We prospectively tested whether environmental cues prompts attempts to stop smoking. We recruited 134 smokers who intended to quit in the next 3 months to complete nightly calls to report cues as well as smoking status, intentions to smoke or not on the next day, and quit attempts over 12 weeks. We provided no treatment. Participants averaged 6.5 c...

Objective: To examine 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. Method: 118 pregnant smokers in gr...

Objective and method: Timeline Follow-back interviews were conducted with 107 pregnant women enrolling in smoking cessation and relapse prevention clinical trials in the Burlington, VT area between 2006 and 2009 to examine the time course of changes in smoking between learning of pregnancy and the first prenatal care visit. We know of no systemati...

This study provides a prospective, fine-grain description of the incidence and pattern of intentions to quit, quit attempts, abstinence, and reduction in order to address several clinical questions about self-quitting. A total of 152 smokers who planned to quit in the next three months called nightly for 12 weeks to an Interactive Voice Response sy...

Background: In a prior study, we found changing tobacco use was more complex than previously thought, with users often transitioning between intending to quit and not intending to quit, and among typical use, abstinence, and reduction, on multiple occasions. The current study attempted to replicate those results. Methods: A convenience sample of...

Smoking during pregnancy is the leading preventable cause of poor pregnancy outcomes in the U.S., causing serious immediate and longer-term adverse effects for mothers and offspring. In this report we provide a narrative review of research on the use of financial incentives to promote abstinence from cigarette smoking during pregnancy, an intervent...

The purpose of this study was to investigate the use of lung age to motivate a quit attempt among smokers presenting to a hospital pulmonary function testing (PFT) laboratory. Participants were randomized to receive a lung age-based motivational strategy (intervention group) versus standard care (control group). At 1 month, all participants were in...

Excessive maternal weight gain during pregnancy can result in serious adverse maternal and neonatal health consequences making it an important outcome to monitor in developing smoking-cessation interventions for pregnant women. Maternal weight gain was investigated in the present study with 154 pregnant participants in controlled trials investigati...

This study examined whether smoking cessation using voucher-based contingency management (CM) improves birth outcomes. Data were combined from three controlled trials. Each of the trials was conducted in the same research clinic devoted to smoking and pregnancy. Participants (n=166) were pregnant women who participated in trials examining the effic...

It is unclear whether offering online data collection to study participants affects compliance or produces bias. To compare response rates, baseline characteristics, test-retest reliability, and outcomes between cigarette smokers who chose to complete a survey by mail versus those who chose to complete it online. We surveyed cigarette smokers who i...

Most smoking cessation programs advise abrupt rather than gradual cessation. We conducted a randomized, controlled trial of gradual cessation (n=297) vs. abrupt cessation (n=299) vs. minimal treatment (n=150) among smokers who wanted to quit now and preferred to quit gradually. Participants were recruited via newspaper and radio advertisements. The...

Mass media interventions for reduction of youth cigarette smoking have been recommended based on a broad array of evidence, although few randomized community trials have been reported. Four matched pairs of independent media markets were identified; one member of each pair was randomized to receive the intervention. School surveys were conducted in...

The purpose of this study was to use data from controlled trials to examine whether smoking cessation increases breastfeeding duration. Correlational studies have confirmed associations between smoking status and breastfeeding duration, but whether smoking cessation increases breastfeeding duration has not been established. Participants (N = 158) w...

This study examined cognitive barriers that might prevent cigarette smokers who are interested in quitting from calling a smoking quitline. Using qualitative and quantitative methods, we developed a 53-item inventory of possible cognitive barriers to quitline access. A total of 641 daily smokers who reported high intentions to stop smoking in the n...

This study examined the influence of education on smoking status in a cohort (n=316) of pregnant women who were smokers at the time they learned of the current pregnancy. Subjects were participants in clinical trials examining the efficacy of monetary-based incentives for smoking-cessation and relapse prevention. In multivariate analyses, education...

This study examined whether voucher-based reinforcement therapy (VBRT) contingent upon smoking abstinence during pregnancy is an effective method for decreasing maternal smoking during pregnancy and improving fetal growth. A two-condition, parallel-groups, randomized controlled trial was conducted in a university-based research clinic. A total of 8...

Postpartum relapse is common among women who stop smoking during pregnancy. We examined predictors of postpartum relapse in 87 women who quit smoking during pregnancy, 48% of whom relapsed by 6 months postpartum. We also explored the circumstances surrounding their first postpartum cigarette. Multivariate analyses revealed that having more friends/...

Theory-driven, mass media interventions prevent smoking among youth. This study examined effects of a media campaign on adolescent smoking cessation. Four matched pairs of media markets in four states were randomized to receive or not receive a 3-year television/radio campaign aimed at adolescent smoking cessation based on social cognitive theory....

To test if goals indicate motivation to quit smoking and predict which smokers will make a quit attempt. A 28-day natural history feasibility study of smoking cessation and reduction. The study was conducted via telephone calls and mailings. A total of 186 cigarette smokers. At baseline participants reported one of the following goals for the next...

The present study was conducted to examine several different methods and cutpoints for determining smoking status in pregnant and recently postpartum women. Self-reported smoking status, urine cotinine levels determined by gas chromatography (GC) and by enzyme immunoassay testing (EMIT), and breath carbon monoxide (CO) levels were assessed at 28 we...

Any smoking during the initial 2 weeks of attempting to quit predicts poor short- and longer-term outcomes in the general population of cigarette smokers. The present study examined whether that rule applies to pregnant women. Data were obtained from 129 women participating in clinical trials on smoking-cessation examining the efficacy of voucher-b...

Relatively little is known about smoking cessation self-efficacy and outcome expectations for quitting smoking in adolescent smokers. In this study, we created measures of these two constructs and conducted factor analyses with data from a diverse sample of 1126 adolescent smokers. Results yielded a two-factor solution for the self-efficacy measure...

This study examined the relationship between smoking status and psychological symptoms in pregnant women across pregnancy. Participants were 45 women who quit smoking early in pregnancy (early quitters), 22 who quit later in pregnancy (later quitters), and 84 who smoked throughout pregnancy (never quitters). Assessments of smoking status and psycho...

Background: The Information-Motivation-Behavioral Skills (IMB) model of HIV preventive behavior (1-4) specifies that treatment effects on behavior occur largely as the result of treatment effects on behavioral skills, which follow from effects on information and motivation. Purpose: The objective was to determine whether the variables specified...

Maternal smoking has been associated with a reduction in newborn birth weight. We sought to estimate how the pattern of maternal smoking throughout pregnancy influences newborn size. One hundred sixty pregnant smoking women were enrolled in a prospective study. We collected data on maternal age, education, prepregnancy body mass index, and parity,...

This preliminary study examined the relationship between cigarette smoking and several environmental and psychological cues to smoke in college students who were lighter (2-8 cigarettes per day) and heavier (greater than 10 cigarettes per day) smokers. Nineteen lighter and 16 heavier smokers monitored their smoking behavior and certain smoking cues...

It is unclear whether proactive telephone support enhances smoking cessation beyond the provision of nicotine replacement therapy alone. We randomly assigned 330 low-income women smokers to receive either free nicotine patches (control condition) or free nicotine patches with up to 16 weeks of proactive telephone support (experimental condition). A...

This article describes a statewide, proactive telephone peer-support system to help low-income pregnant women stop smoking. From October 1994 to December 2000, 948 pregnant smokers attending the Women, Infants, Children program accepted an offer to receive support by telephone from a woman ex-smoker who called weekly, biweekly, and then monthly to...

We report results from a pilot study examining the use of vouchers redeemable for retail items as incentives for smoking cessation during pregnancy and postpartum. Of 100 study-eligible women who were still smoking upon entering prenatal care, 58 were recruited from university-based and community obstetric practices to participate in a smoking cess...

Smokers not currently interested in quitting (N = 616) were randomized to receive telephone-based (a) reduction counseling plus nicotine replacement therapy (NRT) plus brief advice to quit, (b) motivational advice plus brief advice, or (c) no treatment. More smokers in the reduction (43%) and motivational (51%) conditions made a 24-hr quit attempt...

This article reviews the empirical literature on spontaneous quitting of cigarette smoking among pregnant women. We define spontaneous quitting and discuss its prevalence and the characteristics that differentiate spontaneous quitters from women who continue to smoke during pregnancy. We examine the success of these women in abstaining throughout t...

Better understanding of the cognitive framework for decision making among legislators is important for advocacy of health-promoting legislation. In 1994, the authors surveyed state legislators from North Carolina, Texas, and Vermont concerning their beliefs and intentions related to voting for a hypothetical measure to enforce legislation preventin...

This study reports results of a controlled evaluation of a comprehensive community breast screening promotion program. This program promoted increased use of mammography, clinical breast examination, and breast self-examination through community organization, physician training, and public education. The program was conducted in one of three matche...

This study examined factors associated with fecal occult blood test (FOBT) and sigmoidoscopy screening use among Chinese-American women age 60 years and older. One hundred women were recruited from senior centers in two metropolitan areas on the east coast of the United States. Participants completed a questionnaire that included sections on demogr...

An adaptation of Andersen's behavioral model of health services utilization is used to examine the psychosocial and socio-demographic factors that directly and indirectly influence the likelihood of undergoing genetic susceptibility testing for cancer, and the amount of money that individuals would be willing to pay out-of-pocket for such a test. A...

To assess level of endorsement and expected consequences of worksite smoking restriction policies among correctional employees. Mailed survey to Vermont state correctional employees. Support for various policy alternatives for both staff and inmate smoking; expected consequences of restrictive smoking policies and smoking behaviour. 321 of 640 (50%...

This study examined screening utilization at least once and regular adherence to mammography, clinical breast exam, and breast self-exam among older Chinese-American women. One hundred women were recruited from senior centers in two metropolitan cities. Participants completed a questionnaire that included sections on demographics, health history, h...

This study tested the impact of free nicotine patches plus proactive telephone peer support to help low-income women stop smoking. A total of 214 Medicaid-eligible women smokers of childbearing age were randomized to receive free nicotine patches through the mail or free nicotine patches through the mail plus the provision of proactive support by t...

This intervention was implemented to reduce the prevalence of cigarette smoking among women. We used community organization approaches to create coalitions and task forces to develop and implement a multicomponent intervention in 2 counties in Vermont and New Hampshire, with a special focus on providing support to help women quit smoking. Evaluatio...

Studies on public perceptions of genetic susceptibility testing for cancer risks are few and tend to focus on specific cancer risks of higher-risk populations, ignoring the general population and their perceived risk of getting any cancers. This study develops and tests a psychosocial model of the proximal and distal influences on likelihood of und...

To determine baseline variables associated with low intentions of stopping smoking early in pregnancy. Cross sectional survey. Pregnant smokers pooled across seven Smoke-Free Families trials (n = 1314). 36% of pregnant smokers had low intentions of stopping smoking within the next 30 days. In contrast to pregnant smokers with higher intentions of q...

Most strategies to help pregnant women stop smoking have relied on cessation advice provided by health care professionals during prenatal visits and/or printed materials designed to encourage self quitting.1 Two meta-analyses of smoking cessation studies conducted within health care facilities1 2 revealed that repeated contact with multiple provide...

Health professionals are credible sources of smoking cessation advice. This study describes changes in health professionals' reported provision of smoking cessation counseling activities for women during a community health education project that took place in two intervention counties (I) and compares these to reports from health professionals in t...

Women in impoverished inner-city neighborhoods are at high risk for contracting HIV. A randomized, multisite community-level HIV prevention trial was undertaken with women living in 18 low-income housing developments in 5 US cities. Baseline and 12-month follow-up population risk characteristics were assessed by surveying 690 women at both time poi...

This study examined cultural factors as predictors of breast self-examination (BSE) and participation in cervical cancer screening in young Asian and Caucasian women in the United States. Comparisons between Asian and Caucasian samples revealed significant differences in ever performing BSE and obtaining a pap test; the Caucasian women reported hig...

Small Group Education (SGE) to promote breast cancer screening was implemented in a community-wide program. Based on diffusion of innovations theory, SGE initially was directed toward women at higher occupation and education levels and then progressively shifted toward more vulnerable populations of women at risk of not getting screening. During th...

Although AIDS rates have leveled among older gay men in large original epicenters, HIV seroincidence remains high among young men who have sex with men (MSM) in many areas of the country. This research examined patterns of risk behavior among young (age 25 years or less) and older (age 26 years and over) MSM. Nearly 2,000 men entering gay bars in 1...

This study prospectively examined rates of adherence to mammography, clinical breast examination (CBE), and breast self-examination (BSE) in a cohort of women over 3 years to determine whether participation in BSE influenced participation in the other two screening modalities. Women ages 51 and older (n = 450) who attended a small group educational...

Our objective was to examine the efficacy of physicians' advice and referral to individual counseling in preventing relapse to smoking among women who were smokers early in pregnancy, but quit prior to their first prenatal visit. A randomized controlled trial of prompted physician's advice and individual relapse prevention counseling during pregnan...

Introduction: Our objective was to examine the efficacy of physicians’ advice and referral to individual counseling in preventing relapse to smoking among women who were smokers early in pregnancy, but quit prior to their first prenatal visit.

Physicians' advice to help pregnant women quit smoking during prenatal care has had mixed results. Training and prompting physicians to provide consistent advice and referral to on-site support might improve cessation rates. Pregnant women who smoked were randomly assigned to receive structured advice from their physician and referral to individual...

This study analyzed influences on state legislators' decisions about cigarette tax increase votes using a research strategy based on political science and social-psychological models. Legislators from three states representing a spectrum of tobacco interests participated in personal interviews concerned with tobacco control legislation (n = 444). M...

This study examined the relative impact of different self-reward strategies on maintenance of breast self-examination (BSE) practice among 1649 women trained to do BSE. Training groups were randomized into four conditions: (a) self-reward instructions and materials delivered at the end of the BSE training session; (b) self-reward suggestions delive...

Community-level interventions may be helpful in population-focused HIV prevention. If members of populations at risk of HIV infection who are popular with other members can be engaged to advocate the benefits of behaviour change to peers, decreases in risk behaviour may be possible. We assessed a community-level intervention to lower the risk of HI...

This study describes state legislators' knowledge, attitudes, and voting intentions with regard to tobacco-related issues. A cross-sectional survey of state legislators was conducted in North Carolina, Texas, and Vermont in 1994. Most legislators agreed that secondhand smoke can cause lung cancer in nonsmokers, and a majority believed that smokers...

The predictive validity of state legislators' behavioral intentions in relation to their votes on tobacco control legislation was assessed by using the theory of planned behavior (I. Ajzen, 1991). Intentions to vote for cigarette tax increases were measured through interviews in the summer of 1994. A bill containing cigarette tax increases was cons...

To determine state legislators' perceptions about health and tobacco lobbyists, their frequency of contact with these lobbyists, and the amount of campaign contributions from health professional organisations and the tobacco industry. Cross-sectional study. State legislators from North Carolina, Texas, and Vermont (USA), serving in 1994. Perception...

This exploratory study examined the acceptability and efficacy of a videotape modeling smoking cessation as an adjunct to smoking cessation advice delivered during prenatal care. In a randomized controlled trial involving 60 women, we compared the delivery of brief smoking cessation advice and a tipsheet to the same advice and tipsheet plus provisi...

This article describes the development of a mass media smoking prevention intervention targeted primarily toward adolescent girls at increased risk for smoking and assesses its outcomes. A cohort of 5,458 students was surveyed at baseline in Grades 4-6 and annually for 4 years. Through diagnostic and formative research, media messages were created...

Our objectives were (1) to examine the relationship between women's intention of stopping smoking in the next month and a broad range of mediating variables and (2) to assess the implications of these relationships for intervention components of a comprehensive community-wide health education program to help women quit smoking. In preparation for t...

This study examined the effects of a smoking cessation intervention on stages of change in 349 low-income, pregnant women. At first prenatal visit, women were randomized into experimental or usual care condition and classified by stage of change: precontemplation, contemplation, preparation, or action. For each stage of change at the first prenatal...

This study describes the prevalence and predictors of human immunodeficiency virus (HIV) risk behaviors among women living in low-income, inner-city housing developments. Anonymous questionnaires were administered to 671 women living in 10 inner-city, low-income housing developments in five US cities to determine their levels of HIV risk behavior a...

Background and Objectives:: To examine prevalence and predictors of condom use and human immunodeficiency virus (HIV) test seeking among women living in inner‐city housing developments. Study Design:: Between April and June 1994, 671 women living in low‐income housing developments in five cities in the United States completed an anonymous self‐repo...

This report describes a proactive, peer support intervention delivered by telephone for women interested in quitting smoking. Trained female volunteers were matched with women interested in receiving support while they attempted to quit smoking. Telephone contacts were initiated by the peer support counselor just before a designated quit day (if on...

This study examined the effects of a smoking cessation intervention on stages of change in 349 low-income pregnant women. At first prenatal visit, women were randomized into experimental or usual care condition and classified by stage of change: precontemplation, contemplation, preparation, or action. For each stage of change at the first prenatal...

Research investigating HIV-risk sexual behaviors of men who have sex with men usually combines gay and bisexual men, treating them as a single, homogeneous group. However, gay and bisexual men may differ in their HIV risk behavior and in psychological characteristics indicative of risk. Exclusively gay (N = 1,180) and bisexual men (N = 136) complet...

The authors used a questionnaire to assess gender differences in barriers to condom use among 198 female and 89 male heterosexual undergraduate college students. Participants were divided into three groups--consistent users, inconsistent users, and nonusers--based on their reported condom use. Factor analyses on each gender revealed similar barrier...

While a number of studies have examined behavioural and psychosocial correlates of HIV test seeking, most of this research has relied on samples of urban gay men. Less is known about HIV testing rates and factors associated with testing among gay and bisexual men who live in smaller cities. The present research administered surveys to 3969 non-excl...

A sample of 671 predominantly single, young black women living in 10 low-income housing developments in five cities completed an anonymous questionnaire assessing factors related to their risk of contracting the human immunodeficiency virus, including their sexual behavior and condom use, and their partners' risk-related behaviors. In the two month...

Social diffusion theory has recently been recognized as a promising approach for large-scale disease prevention and health promotion efforts. This paper describes how principles and tactics from social cognitive theory, operant psychology, social psychology, social marketing, and the overarching stages of change model can be used to further develop...

Economically disadvantaged urban women are increasingly vulnerable to human immunodeficiency virus (HIV) infection. Research has documented increased HIV risk among urban women, but little attention has focused on the relationship between a woman's age and her HIV risk. The present study surveyed 671 women living in 10 inner-city housing developmen...

Six hundred and thirty smokers who intended to quit smoking themselves completed pre-cessation measures of self-efficacy, partner support, daily stresses and demographics. Subjects were contacted at 2, 7, 14, 30, 90 and 180 days post-cessation to determine smoking status and to re-administer the measures at 7, 14 and 30 days post-cessation. A serie...

Our objective was to examine the efficacy of the added effect of individualized smoking relapse prevention counseling on obstetricians' and nurse midwives' usual advice during prenatal care. One hundred and seventy-five pregnant women who were smoking early in their pregnancy, but had quit by first prenatal visit, were randomly assigned to receive...

The incidence of new AIDS diagnoses among gay males indicates that risk reduction in smaller communities may be lagging behind that reported in larger cities. Contradictory evidence exists, largely from urban areas, concerning the utility of HIV testing as a means of promoting behavioural change. This study examined the relationship between HIV ant...

Nearly 6,000 men entering gay bars in 16 small American cities were anonymously surveyed to assess their sexual behavior and to determine predictors of risky sexual practices. Excluding individuals in long-term exclusive relationships, 27% of the men reported engaging in unprotected anal intercourse in the past 2 months. Factors strongly predictive...

Assessed condom use, barriers to condom use, oral contraceptive use, partnership status and STD history in 457 15-30 year-old women attending four family planning clinics. Subjects were classified into three condom use groups: Non Users (37%); Current Users (33%); and Past Users (30%). Factor analysis revealed five barriers to condom use: Partner's...

Nearly 6,000 men entering gay bars in 16 small American cities were anonymously surveyed to assess their sexual behavior and to determine predictors of risky sexual practices. Excluding individuals in long-term exclusive relationships, 27% of the men reported engaging in unprotected anal intercourse in the past 2 months. Factors strongly predictive...

This study was designed to assess and compare the smoking cessation counseling activities of primary care physicians, dentists, dental hygienists, family planning counselors, WIC counselors, and community mental health counselors in four counties in the northeastern United States for planning appropriate education programs. Lists of the health prof...

We examined the efficacy of individualized smoking cessation counseling added to obstetricians' and nurse-midwives' advice. In a mixed private and publicly supported prenatal clinic 600 pregnant women who smoked were randomly assigned to receive the usual advice from their obstetrician or nurse-midwife or the usual advice plus individualized smokin...

Objectives: To determine whether alcohol use prior to sexual behavior influenced the occurrence of unprotected anal intercourse among bar-going gay men. Methods: Anonymous AIDS behavioral risk surveys were administered to men entering gay bars in 16 cities on three nights in February 1993 in six states in the United States. Results: Of the 1519 men...

This comprehensive, clinical text on tobacco dependence provides clinicians not only with information on how to diagnose and treat nicotine addicted patients, but also with the medical, epidemiological and behavioral science backgrounds necessary for understanding the process and dynamics of tobacco dependence. The book breaks new ground by definin...

In response to a recent study indicating that primary care physicians were interested in receiving breast-screening education, an office-based training program was developed and delivered to fourteen physicians in Vermont and Florida. A nonphysician trainer and simulated patient provided instruction and feedback in clinical breast examination and i...

Most research on acquired immunodeficiency syndrome has been conducted in several of the country's largest cities, and little is known about the current level of human immunodeficiency virus risk taking among gay men in other geographical areas. The purpose of this study was to determine the frequency of risk behavior practices among gay men in sma...

Our objective was to determine the effectiveness of training obstetric and family practice residents to provide smoking cessation advice. The effectiveness of the trained residents' advice was assessed from exit interviews of pregnant smokers taking part in a randomized, controlled trial of smoking cessation advice. Exit interview responses were co...

Increasing attention to self-detection of breast masses and clinical breast examination during this century have contributed to a progressive reduction in the size of breast cancers at detection and a progressive improvement in survival. Mammography is more sensitive than breast palpation for the detection of breast cancer, however, mammography doe...

It is possible that lesbians are as concerned with weight and dieting as are heterosexual women in order to be socially accepted in our society, while men (both gay and heterosexual) have more flexibility in this regard. On the other hand, lesbians, like heterosexual men, may be less concerned with weight than are heterosexual woman and gay men, si...

We examined cessation among 630 smokers who quit abruptly on their own. Continuous, complete abstinence rates were 33% at 2 days, 24% at 7 days, 22% at 14 days, 19% at 1 month, 11% at 3 months, 8% at 6 months postcessation, and 3% at 6 months with biochemical verification. Slipping (smoking an average of less than 1 cigarette/day) was common (9% to...

This article discusses three broad topics: (a) how beliefs about weight control influence smoking initiation and how preventive interventions might affect these beliefs, (b) whether weight gain affects smoking cessation and relapse, and (c) what primary gaps in our information still remain. Beliefs and behaviors relating to weight and their consequ...