Robin Mermelstein

Robin Mermelstein
University of Illinois at Chicago | UIC · Institute for Health Research and Policy

Ph.D.

About

224
Publications
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35,407
Citations

Publications

Publications (224)
Article
The prevalence of cigarette smoking in young adults is higher among those with socioeconomic disadvantage than those without. Low treatment-seeking among young adult smokers is compounded by few efficacious smoking cessation interventions for this group, particularly socioeconomically-disadvantaged young adults (SDYA) who smoke cigarettes. The goal...
Article
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Background Longitudinal assessments of usage are often conducted for multiple substances (e.g., cigarettes, alcohol and marijuana) and research interests are often focused on the inter-substance association. We propose a multivariate longitudinal modeling approach for jointly analyzing the ordinal multivariate substance use data. Methods We descri...
Preprint
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Cannabis legalization has been welcomed by many U.S. states but its role in escalation from tobacco e-cigarette use to cannabis vaping is unclear. Meanwhile, cannabis vaping has been associated with new lung diseases and rising adolescent use. To understand the impact of cannabis legalization on escalation, we design an observational study to estim...
Article
Aims: To assess the effectiveness of intervention components designed to increase quit attempts and promote abstinence in patients initially unwilling to quit smoking. Design: A 4-factor, randomized factorial experiment. Setting: 16 primary care clinics in southern Wisconsin. Participants: 577 adults who smoke (60% women, 80% White) recruite...
Article
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Hidden Markov models (HMM) presents an attractive analytical framework for capturing the state-switching process for auto-correlated data. These models have been extended to longitudinal data setting where simultaneous multiple processes are observed by including subject specific random effects. However, application of HMMs for intensive longitudin...
Article
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Ecological Momentary Assessment (EMA) studies aim to explore the interaction between subjects’ psychological states and real environmental factors. During the EMA studies, participants can receive prompted assessments intensively across days and within each day, which results in three-level longitudinal data, e.g., subject-level (level-3), day-leve...
Article
Objective: The aim of this study was to examine dependence on combustible and e-cigarettes among users of both products (dual users), which may provide important insights into long-term use patterns. Method: Dual users (smoking daily for 3 months, using e-cigarettes at least once/week for the past month; N = 256; 45% women, 71% White, M age 39.0 y...
Article
Despite the need for sensitivity analysis to nonignorable missingness in intensive longitudinal data (ILD), such analysis is greatly hindered by novel ILD features, such as large data volume and complex nonmonotonic missing‐data patterns. Likelihood of alternative models permitting nonignorable missingness often involves very high‐dimensional integ...
Article
Introduction Population studies highlight that alcohol and marijuana use are correlated with cigarette smoking and other tobacco use. The aim of our study was to describe the ways in which alcohol and drug use may affect cigarette smoking and cessation in socioeconomically-disadvantaged young adult (SDYA) smokers. Methods Thirty-six SDYA smokers a...
Article
Introduction: Most people who smoke cigarettes are not willing (i.e., not ready) to make a quit attempt (QA) at any given time. Unfortunately, interventions intended to increase QAs and the success of QAs are only modestly effective. Identifying processes leading to QAs and quitting success could guide intervention development. Methods: This is...
Article
In this issue of JAMA Pediatrics, the article by Gray and colleagues¹ addresses a critical public health question: How can we help adolescents and young adults quit smoking before they incur its full human and economic costs? Adolescent and young adult smokers are a critical population, given the substantial benefits of quitting smoking in young ad...
Article
Background: Rapid advances in the capability and affordability of digital technology have begun to allow for the intensive monitoring of psychological and physiological processes associated with affective disorders in daily life. This technology may enable researchers to overcome some limitations of traditional methods for studying risk in affecti...
Article
Background: Smoking reduction treatment is a promising approach to increase abstinence amongst smokers initially unwilling to quit. However, little is known about which reduction treatment elements increase quit attempts and the uptake of cessation treatment amongst such smokers. Methods: This study is a secondary analysis of a 4-factor randomiz...
Article
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In this paper, we address the problem of accounting for informative missing in the context of ecological momentary assessment studies (sometimes referred to as intensive longitudinal studies), where each study unit gets measured intensively over time and intermittent missing is usually present. We present a shared parameter modeling approach that l...
Article
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As adolescents cross the threshold to young adulthood, they encounter more opportunities to engage in or accelerate previously discouraged or prohibited behaviors. Young adults, therefore, are more apt to initiate cigarette smoking and, more importantly, to accelerate their use if they tried and experimented as an adolescent. Preventing the escalat...
Article
Background The effectiveness of smoking cessation treatment is limited in real-world use, perhaps because we have not selected the components of such treatments optimally nor have treatments typically been developed for and evaluated in real-world clinical settings. Purpose To validate an optimized smoking cessation treatment package that comprise...
Article
Smokers unwilling to make a quit attempt can still benefit from smoking intervention. However, it is unclear what proportion of smokers will enter such a Motivation phase intervention, and whether such an intervention attracts different types of smokers than does abstinence oriented treatment. We conducted a study from June 2010 to October 2013 bas...
Article
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Background and aims: The implications of the rapid rise in electronic cigarette (e-cigarette) use remain unknown. We examined mutual associations between e-cigarette use, conventional cigarette use, and nicotine dependence over time to 1) test the association between e-cigarette use and later conventional smoking (both direct and via nicotine depe...
Article
Introduction: E-cigarettes (Electronic Nicotine Delivery Systems, or ENDS) are an increasingly popular tobacco product among youth. Some evidence suggests that e-cigarettes may be effective for harm reduction and smoking cessation, although these claims remain controversial. Little is known about how nicotine dependence may contribute to e-cigaret...
Article
Objective: The objective of this study was to examine associations between symptoms of alcohol hangover and depression, both cross-sectionally and prospectively. Method: Data were from a survey of young adults (N = 986, 60% female) initially recruited as part of an observational study of youth smoking. Participants reported past-year hangover sy...
Article
The phenomenon of "social smoking" emerged in the past decade as an important area of research, largely due to its high prevalence in young adults. The purpose of this study was to identify classes of young adult ever smokers based on measures of social and contextual influences on tobacco use. Latent class models were developed using social smokin...
Article
Background: Theory implies that individuals who use alcohol to cope with negative emotions experience the acute mood-altering effects they desire. However, no study to date has directly tested whether alcohol coping motives map onto alcohol-induced changes in mood in real-time or how co-occurring internalizing symptoms (i.e., depression and anxiet...
Article
Factorial experiments have rarely been used in the development or evaluation of clinical interventions. However, factorial designs offer advantages over randomized controlled trial designs, the latter being much more frequently used in such research. Factorial designs are highly efficient (permitting evaluation of multiple intervention components w...
Article
Background: Understanding how smoking cessation treatments exert their effects can inform treatment development and use. Factorial designs allow researchers to examine whether multiple intervention components affect hypothesized change mechanisms, and whether the affected mechanisms are related to cessation. Methods: This is a secondary data ana...
Article
Background: The development of tobacco use treatments that are effective for all smokers is critical to improving clinical and public health. The Multiphase Optimization Strategy (MOST) uses highly efficient factorial experiments to evaluate multiple intervention components for possible inclusion in an optimized tobacco use treatment. Factorial ex...
Article
Full-text available
In health studies, questionnaire items are often scored on an ordinal scale, for example on a Likert scale. For such questionnaires, item response theory (IRT) models provide a useful approach for obtaining summary scores for subjects (i.e., the model’s random subject effect) and characteristics of the items (e.g., item difficulty and discriminatio...
Article
Introduction: Prior research suggests the CHRNA5A3B4 and CHRNB3A6 gene clusters have independent effects on smoking progression in young smokers. Here classification tree analysis uncovers conditional relations between these genes. Methods: Conditional classification tree and random forest analyses were employed to predict daily smoking at 6-year f...
Article
There is often a need to assess the dependence of standard analyses on the strong untestable assumption of ignorable missingness. To tackle this problem, past research developed simple sensitivity index measures assuming a linear impact of nonignorability and missingness in outcomes only. These restrictions limit their applicability for studies wit...
Article
Full-text available
Background: There is little research on how young adults or young adult subgroups utilize and engage with Web-based cessation interventions when trying to quit smoking. Addressing this knowledge gap is important to identify opportunities to optimize the effectiveness of online cessation programs across diverse young adult users. Objective: This stu...
Article
Background: There is little research on how young adults or young adult subgroups utilize and engage with Web-based cessation interventions when trying to quit smoking. Addressing this knowledge gap is important to identify opportunities to optimize the effectiveness of online cessation programs across diverse young adult users. Objective: This stu...
Article
A national survey of 591 community-based youth smoking cessation programs provided an opportunity to assess the sustainability of health promotion programming over a 3-year period. Initial survey questions were mapped to five sustainability domains (local ownership, organizational alignment, resources, demand, and standard operating procedures) and...
Article
Full-text available
Novice and light adolescent smokers can develop symptoms of nicotine dependence, which predicts smoking behavior several years into the future. However, little is known about how the association between these early - emerging symptoms and later smoker behaviors may change across time from early adolescence into young adulthood. Data were drawn from...
Article
Adolescents who smoke are more likely to escalate their smoking frequency if they believe smoking is self-defining. Knowing factors that are associated with development of a smoker identity among adolescents who smoke may help to identify who will become a regular smoker. We investigated whether smoker identity development is associated with intern...
Article
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Background: Despite the highly replicated relationship between symptoms associated with both alcohol and nicotine, little is known about this association across time and exposure to both drinking and smoking. In the present study, we evaluate if problems associated with alcohol use are related to emerging nicotine dependence symptoms and whether t...
Article
Mood processes are theorized to play a role in the initiation and progression of smoking behavior. Available work using real-time assessments in samples of young smokers, including several reports from the Social and Emotional Contexts of Adolescent Smoking Patterns (SECASP) study, has indicated that smoking events acutely improve mood and that esc...
Article
Background and aims: The neuropsychological correlates of simultaneous marijuana and tobacco use are largely unknown, which is surprising as both substances have similar neural substrates and have opposing influences on working memory (WM). This study examined the effects of marijuana alone, tobacco alone and simultaneous marijuana and tobacco use...
Article
AimsTo identify promising intervention components that help smokers attain and maintain abstinence during a quit attempt. DesignA 2x2x2x2x2 randomized factorial experiment. SettingEleven primary care clinics in Wisconsin, USA. ParticipantsA total of 544 smokers (59% women, 86% white) recruited during primary care visits and motivated to quit. Inter...
Article
Aim To identify promising intervention components intended to help smokers to attain and maintain abstinence in their quit smoking attempts. DesignA fully crossed, six-factor randomized fractional factorial experiment. SettingEleven primary care clinics in southern Wisconsin, USA. ParticipantsA total of 637 adult smokers (55% women, 88% white) moti...
Article
AimsTo screen promising intervention components designed to reduce smoking and promote abstinence in smokers initially unwilling to quit. DesignA balanced, four-factor, randomized factorial experiment. SettingEleven primary care clinics in southern Wisconsin, USA. ParticipantsA total of 517 adult smokers (63.4% women, 91.1% white) recruited during...
Article
Background and aims: A chronic care strategy could potentially enhance the reach and effectiveness of smoking treatment by providing effective interventions for all smokers, including those who are initially unwilling to quit. This paper describes the conceptual bases of a National Cancer Institute-funded research program designed to develop an op...
Article
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Introduction: In very novice smokers, CYP2A6 genotypes that reduce nicotine metabolism to an intermediate rate may increase smoking risk, relative to both normal and slow rates. The present study examined the hypothesis that intermediate metabolism variants are associated with greater pleasurable effects of the initial smoking attempt than either...
Article
Exercise and sedentary behavior have different physiologic effects, which have yet to be fully explained. Time spent in sedentary behavior has been associated with glucose intolerance in adults at risk for type 2 diabetes, but these data have come largely from cross-sectional studies that have not explored this relationship in adults with diabetes....
Article
Deficits in decision-making and episodic memory are often reported among heavy cannabis users, yet little is known on how they influence negative consequences from cannabis use. Individual differences in decision-making may explain, in part, why some individuals experience significant problems from their cannabis use whereas others do not. We hypot...
Article
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As prevalence of marijuana use increases, it is important that we better understand how factors like gender, cigarette use, and depression are related to marijuana use during adolescence and young adulthood. We examined longitudinal relationships among these variables in adolescents moving into young adulthood who were studied longitudinally for si...
Article
Neuropsychological performance has historically been measured in laboratory settings using standardized assessments. However, these methods may be inherently limited in generalizability. This concern may be mitigated with paradigms such as ecological momentary assessment (EMA). We evaluated the initial feasibility and acceptability of administering...
Article
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Earlier initiation of cannabis use is associated with poorer neuropsychological functioning across several domains. Given well-documented sex differences in neuromaturation during adolescence, initiation of cannabis use during this time may affect neuropsychological functioning differently for males and females. In the current study, we examined se...
Article
Young adults have the highest rates of alcohol, tobacco, and other drug use relative to any other age group. Few studies have examined the co-occurrence of substance use with new and emerging tobacco products in this vulnerable group, or the underlying personality factors that may explain these associations. To address this gap, this study examined...
Article
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The present study evaluated the predictive validity of individual early emerging nicotine dependence symptoms in adolescence on smoking behavior in young adulthood. A total of 492 adolescents who, at baseline, had not smoked more than 100 cigarettes in their lifetime and 123 adolescents who smoked more than 100 cigarettes lifetime, and who particip...
Article
Full-text available
The present study sought to identify time-dependent within-participant effects of CYP2A6 genotypes on smoking frequency and nicotine dependence in young smokers. Predicted nicotine metabolic rate based on CYP2A6 diplotypes (CYP2A6 Diplotype Predicted Rate [CDPR]) was partitioned into Normal, Intermediate, and Slow categories using a metabolism metr...
Article
Full-text available
Introduction Despite the highly replicated relationship between depression and nicotine dependence, little is known about this association across both time and levels of lifetime smoking exposure. In the present study, we evaluate if symptoms of depression are associated with emerging nicotine dependence after accounting for smoking exposure and wh...
Article
Objective: Co-occurring cannabis and tobacco use has become increasingly prevalent among young adults, but it is not clear how tobacco use may alter the neurocognitive profile typically observed among cannabis users. Although there is substantial evidence citing cannabis and tobacco's individual effect on episodic memory and related brain structur...
Article
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A bivariate mixed-effects location-scale model is proposed for estimation of means, variances, and covariances of two continuous outcomes measured concurrently in time and repeatedly over subjects. Modeling the two outcomes jointly allows examination of BS and WS association between the outcomes and whether the associations are related to covariate...
Article
Introduction: Physical activity (PA) and smoking are inversely related. However, evidence suggests that some types of PA, namely work-related PA, may show an opposite effect. Despite growing knowledge, there remains a paucity of studies examining the context of these behaviors in naturalistic settings or in young adults, a high-risk group for esca...
Article
Full-text available
Introduction: Theories of nicotine addiction emphasize the initial role of positive reinforcement in the development of regular smoking behavior, and the role of negative reinforcement at later stages. These theories are tested here by examining the effects of amount smoked per smoking event on smoking-related mood changes, and how nicotine depend...
Article
The multiphase optimization strategy (MOST) is a framework for not only evaluating but also optimizing behavioral interventions. A tool critical for MOST is the screening experiment, which enables efficient gathering of information for deciding which components to include in an optimized intervention. This article outlines a procedure for making de...
Article
Full-text available
Patterns of youth tobacco use in the U.S. are becoming increasingly complex with the greater availability, marketing, and promotion of a diverse set of tobacco products. Using data from the 2012 National Youth Tobacco Survey (NYTS), the series of papers in this issue present a multifaceted examination of the attitudes and behaviors surrounding the...
Conference Paper
Introduction: It is vital to enhance the progress of smoking cessation treatment research. Using the Multiphase Optimization Strategy (MOST) we have attempted to identify effective smoking cessation intervention components that can be combined in an evidence-based manner to produce an optimized treatment package that significantly improves cessatio...
Article
Objectives: To examine the impact of telephone reinforcement (TR) on predictors of physical activity (PA) maintenance in older adults with osteoarthritis. Methods: Mixed effects modeling was conducted of data from a randomized PA trial that used negotiated maintenance contracts, supplemented by TR, to test impact of TR on barriers, decisional ba...
Article
Full-text available
Binge drinking is responsible for over half of all alcohol-related deaths and results in significant health and economic costs to individuals and society. Knowledge of genetic aspects of this behavior, particularly as it emerges in young adulthood, could lead to improved treatment and prevention programs. We have focused on the association of varia...
Article
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Ecological momentary assessments (EMAs) are increasingly used in smoking research to understand contextual and individual differences related to smoking and changes in smoking. To date, there has been little detailed research into the predictors of EMA compliance. However, patterns or predictors of compliance may affect key relationships under inve...
Article
Full-text available
Ecological momentary assessments (EMAs) are useful in understanding both between- and within-subject dynamic changes in smoking and mood. Modeling 2 moods (positive and negative affect, PA and NA) simultaneously will better enable researchers to explore the association of the mood variables and what influences them at both the momentary and subject...
Article
Full-text available
Almost 35 million U.S. smokers visit primary care clinics annually, creating a need and opportunity to identify such smokers and engage them in evidence-based smoking treatment. The purpose of this study is to examine the feasibility and effectiveness of a chronic care model of treating tobacco dependence when it is integrated into primary care sys...
Article
Ecological momentary assessment (EMA) investigations have shown that the antecedents of smoking vary with individual differences in tobacco dependence. This has been interpreted as indicating that the transition to dependence is characterized by an erosion of external stimulus control over smoking. Rigorously testing this requires collecting multip...
Article
Full-text available
Few studies have sought to identify specific genetic markers associated with cigarettes per day (CPD) during adolescence and young adulthood, the period of greatest vulnerability for the development of nicotine dependence. A longitudinal design was used to investigate the effect of neuronal nicotinic acetylcholine receptor (CHRN) subunit genes on C...