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smoking cessation, health promotion, health services research, implementation research
A. Personal Statement
My work over the last two decades has focused on innovative ways to deliver tobacco use cessation treatment within health care, particularly to populations with high rates of smoking or low rates of treatment. Initially, consistent with recommendations at that time, I focused on referring all smokers to a multi-disciplinary smoking cessation program. However, I found that approach, despite a higher individual rate of success, had limited impact because of low acceptance of the referral by smokers and poor attendance at the program. As a result, I shifted my studies and policy efforts from a specialty-clinic model (referral to a smoking cessation clinic) to a primary care-based model. I have studied different approaches to increase tobacco use cessation treatment in primary care, such as use of an on-call counselor and simple referral to a telephone care coordination program for smoking. Over the last 10 years, my studies have increasingly focused on a population-health approach to treatment, identifying all smokers within a system and increasing delivery of evidence-based cessation treatment. This has included targeting specific segments of the population with higher smoking rates, such as smokers with mental health diagnoses, smokers with low income or hospitalized smokers.
Tobacco control has shifted, with decreasing rates of smoking and greatly increased use of alternative tobacco products. I have been studying patterns of use of alternative tobacco products, including electronic cigarettes and hookah. We are currently conducting pilot studies looking at the process and impact of switching from combustible cigarettes to electronic cigarettes. My particular area of focus is the extent to which – if at all – electronic cigarettes reduce harm when someone switches to them from combustible cigarettes.
I have also been very interested in research on virtual care and am Principal Investigator (PI) for two national research centers. The Virtual Care Consortium of Research, funded by the Veterans Health Administration (VA) Health Services Research & Development Service, is a consortium of the ~250 investigators in the VA conducting research on/with virtual care. I am also PI of the Telehealth Research and Innovation for Veterans with Cancer (THRIVE) Center, which is funded by National Cancer Institute as one of the inaugural programs in the Cancer Moonshot 2.0 initiative. THIRVE is evaluating the use of telehealth for delivery of cancer care across the entire VA healthcare system, particularly looking at the impact of telehealth on quality of care and on health equity.
I have been continuously funded for over 25 years as PI on R01-level federal research grants, including 15-20 behavioral clinical trials of smoking cessation/tobacco control interventions. I recently completed a K24 mid-career mentoring award, and mentoring remains a central part of my position. I am currently PI/MPI on 7 large grants, including 3 clinical trials, which includes the following projects:
NCI 1P50CA271358-01 / Sherman/Makarov/Zullig (MPI) / 8/2022 – 7/2027
Telehealth Research and Innovation for Veterans with Cancer (THRIVE)
NIDA 1R01 DA045688-01A1 - Wali/Sherman/Ladapo (MPI) - 2/2019 – 12/2023
Financial incentive strategies for smoking cessation in high-risk, hospitalized patients
NIAAA 1R01AA028240-01A1 / Epstein/Smelson/Sherman (MPI) / 2/2021 – 1/2026
A female-specific cognitive behavioral therapy group for alcohol use disorder in VA primary care
NIA 1R24 AG063725-01 / Chodosh/Trinh/Sherman (MPI) / 09/2019 – 05/2023
Engagement in Longevity and Medicine (ELM)
NYU/Abu Dhabi Institute / Ali/Sherman (MPI) / 03/2012 – 08/2024
VA HSR&D COR 20-199 / Sherman/Hogan/Zulman (MPI) / 05/2020 – 04/2025
VA HSR&D IIR 17-056 / Sherman/Fu (MPI) / 08/2018 – 07/2023
Comparing an opt-out to an opt-in approach for smoking cessation in VA primary care clinics
B. Positions, Scientific Appointments, and Honors
Positions and Scientific Appointments
2021-2023 Standing member, NIH Health Services Quality and Effectiveness (HSQE) Study Section
2019-2020 Standing member, NIH Health Services Organization and Development (HSOD) Study Section
2017-present Professor of Global Public Health, New York University (NYU)
2017-present Professor of Population Health, Medicine and Psychiatry, NYU School of Medicine
2013-present Co-Chair, Recruitment and Retention Core, NYU-HHC Clinical and Transl. Science Institute
2013-2020 Co-Chair, Sect. on Tobacco, Alcohol and Drug Use, Dept. of Pop. Health, NYU Sch. of Medicine
2013-2017 Associate Professor of Global Public Health, New York University
2013-2017 Associate Professor of Population Health, Medicine and Psychiatry, NYU School of Medicine
2008-2013 Program Director, Fellowship in Geriatric Medicine, NYU School of Medicine
2008-2012 Interim Chief, Section of Geriatric Medicine, NYU School of Medicine
2007-2013 Associate Professor of Medicine and Psychiatry, NYU School of Medicine
2005-2007 Associate Professor of Medicine, New York University School of Medicine
2004-2005 Professor of Medicine, UCLA
2002-2006 Chair, VA Smoking and Tobacco Use Cessation Technical Advisory Group
2001-2005 Smoking Cessation Coordinator, VA Greater Los Angeles Healthcare System
1998-2004 Associate Professor of Medicine, UCLA
1994-1998 Facilitator-in-training, American Academy on Physician & Patient
1993-2005 Sepulveda VA Site Coordinator, VA Center for Study of Healthcare Provider Behavior
1992-2005 Director, Smoking Cessation Clinic, Sepulveda VA Medical Center
1991-1998 Assistant Professor of Medicine, UCLA
1991-2005 Staff Physician, Internal Medicine, Sepulveda VA Medical Center
1994-1996 Career Development Award, UCLA Claude D. Pepper Older Americans Independence Center.
1992 Finalist, Associates Competition, American College of Physicians Annual meeting. Poster Presentation of “Should elderly people exercise?: Results from the Framingham Heart Study.”
1991 Individual National Research Service Award, Agency for Health Care Policy and Research, for “Study of Exercise Counseling by Physicians.”
C. Contributions to Science
Below I highlight my contributions to science in several different areas, including related publications. A link to the full list of my publications (over 200) can be found at the end of this section.
1. Exercise for health promotion
During my fellowship and the initial few years of my career, I focused on the health benefits of exercise. I published several papers from the Framingham Heart Study, showing that women obtained the same benefits (increased longevity, decreased cardiovascular risk) as men, and that this benefit extended into old age for both men and women. I also showed that what was most important was recent physical activity, not how active a person had been in the distant past. I also studied the exercise counseling practices of internists and found that while many believed exercise to be beneficial, there was much room for improvement in their counseling.
a. Sherman SE, D'Agostino RB, Cobb JL, Kannel WB. Does exercise reduce mortality in the elderly?: Results from the Framingham Heart Study. Am Heart J. 1994; 128: 965-72. PMID: 7942491
b. Sherman SE, D'Agostino RB, Cobb JL, Kannel WB. Physical activity and mortality in women in the Framingham Heart Study. Am Heart J. 1994; 128: 879-84. PMID: 7942478
c. Sherman SE, D'Agostino RB, Silbershatz H, Kannel WB. Comparison of past vs. recent physical activity in the prevention of premature death and coronary artery disease. Am Heart J. 1999; 138: 900-7. PMID: 10539821
d. Sherman SE, Hershman WY. Exercise counseling: How do general internists do? J Gen Intern Med. 1993; 8: 243-8. PMID: 8505682
2. Identifying alternative approaches to help smokers quit within health care
Since referring to smoking cessation clinics did not seem to be an effective strategy, I studied other approaches to delivering evidence-based treatment. Having an on-call counselor increased referrals, counseling and use of medications. More importantly, creating a telephone care coordination program and making referral from primary care very easy had a profound effect, generating large numbers of referrals and resulting in an excellent cessation rate. Approaching smokers while hospitalized was also effective at helping them quit smoking.
a. Sherman SE, Estrada M, Lanto AB, Farmer MM, Aldana I. Effectiveness of an on-call counselor at increasing smoking treatment. J Gen Intern Med., 2007; 22: 1125-31. PMCID: PMC2305728
b. Sherman SE, Krebs P, York LS, Cummins SE, Kuschner W, Guvenc-Tuncturk S, Zhu SH. Telephone care co-ordination for tobacco cessation: randomised trials testing proactive versus reactive models. Tob Control. 2018 Jan; 27(1): 78-82. PMID: 28190003.
c. Sherman SE, Link AR, Roger ES, Krebs P, Ladapo JA, Shelley D, Fang Y, Wang B, Grossman E. Smoking-cessation interventions for urban hospital patients: A randomized comparative-effectiveness trial. Am J Prev Med. 2016; 51(4): 566–77. PMCID: PMC5089173.
3. Helping smokers with mental health disorders quit smoking
As tobacco control efforts have progressed and the prevalence of smoking has declined, it has become increasingly important to identify populations with higher rates of smoking or with special needs. People with mental health disorders smoke at rates two to four times higher than the general population. Rather than focus on people with specific diagnoses (e.g., schizophrenia, depression), I have looked at the special needs of the whole population of people with mental health disorders and whether interventions can successfully be shifted from primary care to mental health care. In general, I have found that – contrary to popular attitudes and beliefs – people with mental health disorders are interested in quitting and are able to quit, and quitting smoking does not make their mental health worse.
a. Rogers ES, Sherman SE. Tobacco Use Screening and Treatment by Outpatient Psychiatrists Before and After American Psychiatric Association Treatment Guidelines for Nicotine Dependence. Am J Public Health. 2014; 104: 90-5. PMCID: PMC3910050
b. Rogers ES, Gillespie C, Smelson D, Sherman SE. A qualitative evaluation of mental health clinic staff perceptions of barriers and facilitators to treating tobacco use. Nicotine Tob Res. 2018 Sep 4; 20(10): 1223-30. PMID: 29059344.
c. Rogers ES, Smelson DA, Gillespie CC, Elbel B, Poole S, Hagedorn H, Kalman D, Krebs PM, Fang Y, Wang B, Sherman SE. Telephone Smoking-Cessation Counseling for Smokers in Mental Health Clinics: A Patient-Randomized Controlled Trial. Am J Prev Med. 2016 Apr; 50(4): 518-27.
d. Rogers ES, Fu SS, Krebs P, Noorbaloochi S, Nugent SM, Gravely A, Sherman SE. Proactive tobacco treatment for smokers using VA mental health clinics: a randomized controlled trial. Am J Prev Med. 2018 May; 54(5): 620-9. PMID: 29551324.
4. A population-based approach to care and innovative recruitment strategies
Based on 15 years of practice, research and policy within the VA, I published a paper outlining a framework for how health systems improve their care for smoking (as well as for other conditions). Briefly, systems typically progress through four stages: Stage 1 – no system for smoking cessation; Stage 2 – systematic visit-based screening; Stage 3 – systematic visit-based treatment; and Stage 4 – systematic population-based treatment. My recent and current studies are focused on how to deliver evidence-based care to the entire population, without waiting for them to come in for a visit. This is a central part of the Patient Centered Medical Home or Patient Aligned Care Team model, and it is the one that has been most challenging to implement. This has typically involved identifying the entire population with a specific condition and implementing a program to reach out to them independent of clinic visits. In our panel management study (Schwartz et al), we reached out through the primary care provider, while in our proactive outreach studies (Fu et al; Rogers et al), we reached out directly to patients.
a. Sherman SE. A Framework for Tobacco Control: Lessons learnt from Veterans Health Administration. BMJ, 2008; 336: 1016-9. PMCID: PMC2364861
b. Schwartz MD, Jensen A, Wang B, Bennett B, Dembitzer A, Strauss S, Schoenthaler A, Gillespie C, Sherman S. Panel Management to Improve Smoking and Hypertension Outcomes by VA Primary Care Teams: A Cluster-Randomized Controlled Trial. J Gen Intern Med. 2015. PMCID: PMC4471025
c. Fu SS, van Ryn M, Sherman SE, Burgess DJ, Noorbaloochi S, Clothier B, Taylor BC, Schlede CM, Burke RS, Joseph AM. Proactive Tobacco Treatment and Population-Level Cessation: A Pragmatic Randomized Controlled Trial. JAMA Intern Med. 2014; 174: 671-7. PMID: 24615217
d. Krebs P, Sherman SE, Wilson H, El-Shahawy O, Abroms LL, Zhao X, Nahvi S, Shelley D. Text2Connect: A Health System Approach to Engage Tobacco Users in Quitline Cessation Services via Text Messaging. Translational Behav. Med. 2020; 10(1): 292-301. PMID: 32011721.
5. Understanding alternative tobacco and nicotine products (ATNP)
The last 10-20 years has seen tremendous changes in patterns of use of tobacco and nicotine products, with steady decreases in cigarette smoking and rapid increases in the use of electronic cigarettes, hookah (waterpipe tobacco) and other ATNPs. I have been helping advance knowledge about many different aspects of ATNP use, particularly focusing on electronic cigarettes, hookah and midwakh (a tobacco pipe used frequently in parts of the Persian Gulf/Arabian Gulf and Eastern Mediterranean regions). This has included studies on the epidemiology, health effects, knowledge/attitudes/beliefs and other aspects of these products. It has also included understanding whether there is a role for electronic cigarettes in reducing harms from cigarette smoking.
a. El Shahawy O, Park SH, Duncan DT, Lee L, Tamura K, Shearston JA, Weitzman M, Sherman SE. Evaluating State-level Differences in E-Cigarette and Cigarette Use among Adults in the United States between 2012 and 2014: Findings from the National Adult Tobacco Survey. Nicotine Tob Res. 2019 Jan 1; 21(1): 71-80. PMCID: PMC6329407.
b. Cawkwell PB, Lee L, Weitzman M, Sherman SE. Tracking Hookah Bars in New York: Utilizing Yelp as a Powerful Public Health Tool. JMIR Public Health Surveill. 2015 Nov 20; 1(2): e19. PMCID: PMC4869217.
c. Wang J, Rogers E, Fu S, Gravely A, Noorbaloochi S, Sherman S. Characterizing e-cigarette use in veteran smokers with mental health conditions. Journal of Smoking Cessation. 2019; 14: 239-44.
d. Jawad M, Al-Houqani M, Ali R, El Sayed Y, ElShahawy O, Weitzman M, Sherman SE. Prevalence, attitudes, behaviours and policy evaluation of midwakh smoking among young people in the United Arab Emirates: Cross-sectional analysis of the Global Youth Tobacco Survey. PLoS One. 2019; 14(4): e0215899. PMCID: PMC6481845.
Complete List of Published Work in MyBibliography: http://www.ncbi.nlm.nih.gov/sites/myncbi/scott.sherman.2/bibliography/43891276/public/
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