Myra L Muramoto
- Chair, Family and Community Medicine
- Professor, Family and Community Medicine
- Professor, Public Health
- MPH Epidemiology
- Arizona Graduate Program in Public Health, University of Arizona, Tucson, Arizona
- College of Medicine, University of Arizona, Tucson, Arizona
- B.S. Nutritional Science, with High Distinction
- University of Arizona, Tucson, Arizona, United States
- Fellow, Hedwig van Ameringen Executive Leadership in Academic Medicine
- Hedwig van Ameringen Executive Leadership in Academic Medicine Program, Spring 2016
- Fellow, American Academy of Family Physicians
- American Academy of Family Physicians, Fall 2014
Licensure & Certification
- American Board of Addition Medicine (2009)
- American Society of Addiction Medicine (1991)
- American Board of Obesity Medicine (2015)
- Arizona License, Arizona Board of Medical Examiners (1993)
- Lesotho Medical, Dental and Pharmacy Council (1992)
- American Board of Family Medicine (1988)
tobacco cessation, obesity, clinical and community-based interventions for lifestyle-related chronic disease prevention and treatment, health disparities
Obesity medicine, tobacco dependence treatment
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- Bernstein, A., McGuffin, B., Conolly, T., Campbell, J., Muramoto, M. L., & Allen, A. M. (2019). Multi-method formative research to improve the training and delivery of tobacco cessation interventions in behavioral health settings. Journal of Addiction Medicine, 6, 470-475.
- Muramoto, M. L., Silva Torres, G. E., Szalacha, L. A., Heslin, K. M., & Loescher, L. J. (2019). Online Skin Cancer Prevention Training for Massage Therapists: Protocol for the MTsSHARE Study: A Research Protocol. Journal of Medical Internet Research Protocols, 8(5), 4-15. doi:doi:10.2196/13480
- Jacobs, T. A., Jacobs, T. A., Christiansen, S. M., Christiansen, S. M., Muramoto, M. L., Muramoto, M. L., Cunningham, J. K., Cunningham, J. K., Armin, J. S., Armin, J. S., Gordon, J. S., & Gordon, J. S. (2017). Lessons learned in the development and evaluation of RxCoach™, an mHealth app to increase tobacco cessation medication adherence.omen smokers.. Patient Education & Counseling, 100(4), 720-727. doi:10.1016/j.pec.2016.11.003
- Campbell, J., Mays, M. Z., Yuan, N. P., & Muramoto, M. L. (2007). Who are health influencers? Characterizing a sample of tobacco cessation interveners. American journal of health behavior, 31(2), 181-92.More infoTo describe characteristics of health influencers (HIs) prior to training in brief tobacco cessation interventions (BI).
- Floden, L., Taren, D. L., Muramoto, M. L., & Leischow, S. J. (2016). BMI changes in adolescents treated with bupropion SR for smoking cessation. Obesity (Silver Spring, Md.), 24(1), 26-9.More infoAdolescent overweight and obesity and smoking continue to be very important health challenges because of their lasting effects on overall health. Weight gain after smoking cessation is a barrier to quitting as well as a negative consequence to health. This study reports changes in the body mass index (BMI) z-scores of adolescent smokers participating in a dose-ranging clinical trial of bupropion SR (150 mg/day and 300 mg/day) for smoking cessation.
- Gordon, J. S., Armin, J. S., Cunningham, J. K., Muramoto, M. L., Christiansen, S. M., & Jacobs, T. A. (2016). Lessons learned in the development and evaluation of RxCoach™, an mHealth app to increase tobacco cessation medication adherence.omen smokers.. Patient Education & Counseling. doi:10.1016/j.pec.2016.11.003
- Gordon, J. S., Armin, J. S., Cunningham, J. K., Muramoto, M. L., Christiansen, S., & Jacobs, T. (2016). Development of RxCoach™: A theory-based mobile app to improve adherence to smoking cessation medication. Patient Education & Counseling. doi:10.1016/j.pec.2016.11.003
- Muramoto, M. L., Howerter, A., Eaves, E. R., Hall, J. R., Buller, D. B., & Gordon, J. S. (2016). Online Tobacco Cessation Training and Competency Assessment for Complementary and Alternative Medicine (CAM) Practitioners: Protocol for the CAM Reach Web Study. JMIR research protocols, 5(1), e2.More infoComplementary and alternative medicine (CAM) practitioners, such as chiropractors, acupuncturists, and massage therapists, are a growing presence in the US health care landscape and already provide health and wellness care to significant numbers of patients who use tobacco. For decades, conventional biomedical practitioners have received training to provide evidence-based tobacco cessation brief interventions (BIs) and referrals to cessation services as part of routine clinical care, whereas CAM practitioners have been largely overlooked for BI training. Web-based training has clear potential to meet large-scale training dissemination needs. However, despite the exploding use of Web-based training for health professionals, Web-based evaluation of clinical skills competency remains underdeveloped.
- Muramoto, M. L., Muramoto, M. L., Gordon, J. S., Gordon, J. S., Bell, M. L., Bell, M. L., Nichter, M., Nichter, M., Floden, L., Floden, L., Howerter, A., Howerter, A., Ritenbaugh, C., & Ritenbaugh, C. (2016). Tobacco Cessation Training for Complementary and Alternative Medicine Practitioners: Results of a Practice-Based Trial.. American journal of preventive medicine.
- Cunningham, J. K., Floden, L. L., Howerter, A. L., Matthews, E., Gordon, J. S., & Muramoto, M. (2015). Complementary and Alternative Medicine (CAM) practitioners’ readiness for tobacco intervention training: Development and psychometric properties of a new measure. Advances in Integrative Medicine.
- Floden, L., Howerter, A., Matthews, E., Nichter, M., Cunningham, J. K., Ritenbaugh, C., Gordon, J. S., & Muramoto, M. L. (2015). Considerations for practice-based research: a cross-sectional survey of chiropractic, acupuncture and massage practices. BMC complementary and alternative medicine, 15, 140.More infoComplementary and alternative medicine (CAM) use has steadily increased globally over the past two decades and is increasingly playing a role in the healthcare system in the United States. CAM practice-based effectiveness research requires an understanding of the settings in which CAM practitioners provide services. This paper describes and quantifies practice environment characteristics for a cross-sectional sample of doctors of chiropractic (DCs), licensed acupuncturists (LAcs), and licensed massage therapists (LMTs) in the United States.
- Hamm, E., Muramoto, M. L., Howerter, A., Floden, L., & Govindarajan, L. (2014). Use of provider-based complementary and alternative medicine by adult smokers in the United States: Comparison from the 2002 and 2007 NHIS survey. American journal of health promotion : AJHP, 29(2), 127-31. doi:doi: 10.4278/ajhp.121116-QUAN-559.More infoTo provide a snapshot of provider-based complementary and alternative medicine (pbCAM) use among adult smokers and assess the opportunity for these providers to deliver tobacco cessation interventions.
- Leischow, S. J., Muramoto, M. L., Matthews, E., Floden, L. L., & Grana, R. A. (2015). Adolescent Smoking Cessation With Bupropion: The Role of Adherence. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.More infoWhile many medications can be effective aids to quitting tobacco, real world adherence to smoking cessation medications may render a potentially effective medication ineffective. The present study investigated the role of adherence on treatment outcomes in a bupropion dose-response study among adolescent smokers trying to quit smoking.
- Muramoto, M. L., Matthews, E., Ritenbaugh, C. K., & Nichter, M. A. (2015). Intervention development for integration of conventional tobacco cessation interventions into routine CAM practice. BMC complementary and alternative medicine, 15, 96.More infoPractitioners of complementary and alternative medicine (CAM) therapies are an important and growing presence in health care systems worldwide. A central question is whether evidence-based behavior change interventions routinely employed in conventional health care could also be integrated into CAM practice to address public health priorities. Essential for successful integration are intervention approaches deemed acceptable and consistent with practice patterns and treatment approaches of different types of CAM practitioners - that is, they have context validity. Intervention development to ensure context validity was integral to Project CAM Reach (CAMR), a project examining the public health potential of tobacco cessation training for chiropractors, acupuncturists and massage therapists (CAM practitioners). This paper describes formative research conducted to achieve this goal.
- Muramoto, M. L., Hall, J. R., Nichter, M., Nichter, M., Aickin, M., Connolly, T., Matthews, E., Campbell, J. Z., & Lando, H. A. (2014). Activating lay health influencers to promote tobacco cessation. American journal of health behavior, 38(3), 392-403.More infoTo evaluate the effect of tobacco cessation brief-intervention (BI) training for lay "health influencers," on knowledge, self-efficacy and the proportion of participants reporting BI delivery post-training.
- Muramoto, M. L., Wassum, K., Connolly, T., Matthews, E., & Floden, L. (2010). Helpers program: A pilot test of brief tobacco intervention training in three corporations. American journal of preventive medicine, 38(3 Suppl), S319-26.More infoQuitlines and worksite-sponsored cessation programs are effective and highly accessible, but limited by low utilization. Efforts to encourage use of cessation aids have focused almost exclusively on the smoker, overlooking the potential for friends, family, co-workers, and others in a tobacco user's social network to influence quitting and use of effective treatment.
- Muramoto, M. L., & Lando, H. (2009). Faculty development in tobacco cessation: training health professionals and promoting tobacco control in developing countries. Drug and alcohol review, 28(5), 498-506.More infoCessation programs are essential components of comprehensive tobacco control. Health-care providers, especially physicians, have major responsibility for role modeling and promoting cessation. For successful, sustainable cessation training programs, countries need health-care professionals with knowledge and skills to deliver and teach tobacco cessation.
- Lando, H. A., Borrelli, B., Muramoto, M. L., & Ward, K. D. (2006). Perspectives on the role of the Society for Research on Nicotine and Tobacco in promoting global tobacco research and reducing tobacco harm. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 8(6), 761-5.More infoThe Society for Research on Nicotine and Tobacco (SRNT) has a critical role to play in advancing tobacco research globally. To date SRNT has sponsored a number of successful initiatives including meetings held by the society's European affiliate, establishment of the Global Network Committee in 1999, and the 2003 and 2005 global tobacco pre-conferences. The most recent SRNT conference was held for the first time outside of North America and attracted over 900 participants from 50 countries. SRNT also has sponsored workshops, provided member scholarships to researchers from low- and middle-income countries, and partnered with the World Health Organization to host www.treatobacco.net. Although these initiatives are impressive, SRNT can further support global tobacco research by (a) working with other organizations to support global tobacco science and policy (this is especially timely given the recent coming into force of the Framework Convention on Tobacco Control), (b) providing more resources including increased funding and access to online journals for those in low- and middle-income countries, (c) increasing the representation of science at world and national tobacco conferences, and (d) expanding the role of the Training Committee to place increased emphasis on mentoring tobacco scientists from low- and middle-income countries. Science will be crucial in addressing the global tobacco pandemic, and SRNT is uniquely positioned to further tobacco science and research capacity on a global basis.
- Mohan, S., Pradeepkumar, A. S., Thresia, C. U., Thankappan, K. R., Poston, W. S., Haddock, C. K., Pinkston, M. M., Muramoto, M. L., Nichter, M., Nichter, M., & Lando, H. A. (2006). Tobacco use among medical professionals in Kerala, India: the need for enhanced tobacco cessation and control efforts. Addictive behaviors, 31(12), 2313-8.More infoIn developing nations where reductions in tobacco use have not been realized, it is critical that health professionals be encouraged to abstain from tobacco use. Data on tobacco use among health professionals in India are limited. We conducted cross-sectional surveys among 110 male medical school faculty (MSF), 229 physicians (67% male), 1130 medical students (46% male), and 73 female nursing students. Information on tobacco use and quit attempts was collected using structured questionnaires. Among the male respondents, current smokers were 15.1% of MSF, 13.1% of physicians, and 14.1% of medical students. Among current smokers, 42% of MSF and physicians and 51% of medical students had not attempted quitting in the last year. However, one third of MSF and physicians and 16% of medical students had attempted to quit at least 4 times. This is one of the first studies among health care professionals in India. Our findings show that a substantial proportion of physicians and medical students in Kerala continue to smoke. Smoking cessation programs are warranted in medical schools in Kerala. An initiative is presently underway by the authors to incorporate tobacco education into the medical school curriculum.
- Muramoto, M. L., Connolly, T., Strayer, L. J., Ranger-Moore, J., Blatt, W., Leischow, R., & Leischow, S. (2000). Tobacco cessation skills certification in Arizona: application of a state wide, community based model for diffusion of evidence based practice guidelines. Tobacco control, 9(4), 408-14.More infoTo describe the development and preliminary results from a community based certification model for training in tobacco cessation skills in Arizona.
- Murãmoto, M. L. (2000). Improved pediatric weighing device for use with portable hanging scales. Journal of tropical pediatrics, 46(2), 117-8.More infoPortable hanging scales are a common means of weighing young children. Weighing trousers used to suspend children from a hanging scale are uncomfortable and require insertion of the child's legs through the trousers. The 'weighing seat' holds the child in a more natural, comfortable, and secure position, thus increasing the child's acceptance of the weighing procedure, and making the procedure less traumatic for the child and easier for the examiner.
- Muramoto, M. L., & Leshan, L. (1993). Adolescent substance abuse. Recognition and early intervention. Primary care, 20(1), 141-54.More infoAdolescent substance abuse is a common problem, with 90% of high school seniors reporting alcohol use and nearly half reporting some illicit drug use. Substance abuse interferes with the developmental tasks of adolescence: establishing an adult identity, achieving independence from parents and family, and learning to form intimate relationships with others. Although not all adolescent substance abuse leads to chemical dependency, even initial experimentation can have disastrous or fatal consequences. The early signs and symptoms of substance abuse are subtle, frequently presenting as behavioral changes, and less often as physical or laboratory findings. Early stages of substance abuse may be treated by the primary care physician in outpatient treatment settings. More advanced stages usually require inpatient treatment and should be referred to specialists in adolescent substance abuse treatment. Family involvement is a critical part of the treatment process. In addition to a key role in the early diagnosis, intervention, and referral of substance abuse problems, the primary care physician is an important source of support, reinforcement, and continuity in the aftercare program once the adolescent has completed initial substance abuse treatment.
- Seale, J. P., & Muramoto, M. L. (1993). Substance abuse among minority populations. Primary care, 20(1), 167-80.More infoSubstance abuse problems and their solutions not only vary considerably depending on the ethnicity of the patient, but also are influenced by factors such as age, gender, education, and socioeconomic status. Familiarity with the epidemiology of substance abuse problems of different sociocultural groups can help the clinician better understand and anticipate the needs of the patient population she or he is serving. The five-part sociocultural assessment model provides a framework to help the practitioner assess the sociocultural needs of an individual patient. Application of this model can help reveal the individual patient's beliefs, motivations, and sociocultural strengths and liabilities with regard to substance abuse. With this information, the clinician can then better address special treatment needs.
- Muramoto, M. L., Aceves, B., Rivers, P. S., & Lutrick, K. (2019, Fall). The state of dissemination and implementation science research focused on clinical interventions in primary care: a scoping review. Dissemination & Implementation Science. Washington, DC: Academy Health & NIH.
- Hatsukami, D., Muramoto, M. L., al'Absi, M., Allen, S. S., Eberly, L., Lundeen, K., & Allen, A. M. (2018, Spring). Hormonal Contraceptive Use is Associated with Smoking Motives. Society for Research on Nicotine and Tobacco. Baltimore, MD.
- Hatsukami, D., Muramoto, M. L., al'Absi, M., Allen, S., Eberly, L., Lundeen, K., & Allen, A. M. (2018, February). Hormonal contraceptive use is associated with smoking motives. Society for Research on Nicotine and Tobacco. Baltimore, MD.
- Muramoto, M. L., Kutob, R. M., Howerter, A., & Algotar, A. (2017, Oct/2017). Group visits are effective in lowering blood pressure in an under served population. American College of Lifestyle Medicine Annual Conference. Tucson, AZ: American College of Lifestyle Medicine.
- Muramoto, M. L., Muramoto, M. L., Garland, L. L., Garland, L. L., Ali-Akbarian, L., Ali-Akbarian, L., Armin, J. S., & Armin, J. S. (2017, April). Improving advance care planning for cancer patients through better care coordination. UACC Scientific Retreat. Tucson, AZ: UACC.
- Armin, J. S., Ali-Akbarian, L., Debo, M., Hamann, H., Muramoto, M. L., & Calhoun, E. (2016, June). Implementing an Advance Care Planning Video Decision Aid in a Cancer Center’s Supportive Care Clinic. 8th Biennial Cancer Survivorship Research Conference: Innovation in a Rapidly Changing Landscape. Washington DC.
- Muramoto, M. L., Garland, L. L., Ali-Akbarian, L., & Armin, J. S. (2017, April). Improving advance care planning for cancer patients through better care coordination. UACC Scientific Retreat. Tucson, AZ: UACC.
- Leischow, S. J., Ranger-Moore, J., Muramoto, M. L., & Matthews, E. (2016). Effectiveness of the nicotine inhaler for smoking cessation in an OTC setting. American journal of health behavior.More infoTo evaluate the effectiveness of the Nicotrol nicotine inhaler as an aid to smoking cessation in over-the-counter (OTC) versus health-care-provider (HCP) conditions.
- Leischow, S. J., Ranger-Moore, J., Muramoto, M. L., & Matthews, E. (2015). Effectiveness of the nicotine inhaler for smoking cessation in an OTC setting. American journal of health behavior.More infoTo evaluate the effectiveness of the Nicotrol nicotine inhaler as an aid to smoking cessation in over-the-counter (OTC) versus health-care-provider (HCP) conditions.
- Muramoto, M. L., Howerter, A., Matthews, E., Floden, L., Gordon, J., Nichter, M., Cunningham, J., & Ritenbaugh, C. (2014). Tobacco brief intervention training for chiropractic, acupuncture, and massage practitioners: protocol for the CAM reach study. BMC complementary and alternative medicine.More infoTobacco use remains the leading cause of morbidity and mortality in the US. Effective tobacco cessation aids are widely available, yet underutilized. Tobacco cessation brief interventions (BIs) increase quit rates. However, BI training has focused on conventional medical providers, overlooking other health practitioners with regular contact with tobacco users. The 2007 National Health Interview Survey found that approximately 20% of those who use provider-based complementary and alternative medicine (CAM) are tobacco users. Thus, CAM practitioners potentially represent a large, untapped community resource for promoting tobacco cessation and use of effective cessation aids. Existing BI training is not well suited for CAM practitioners' background and practice patterns, because it assumes a conventional biomedical foundation of knowledge and philosophical approaches to health, healing and the patient-practitioner relationship. There is a pressing need to develop and test the effectiveness of BI training that is both grounded in Public Health Service (PHS) Guidelines for tobacco dependence treatment and that is relevant and appropriate for CAM practitioners.
- Muramoto, M. L., Leischow, S. J., Sherrill, D., Matthews, E., & Strayer, L. J. (2007). Randomized, double-blind, placebo-controlled trial of 2 dosages of sustained-release bupropion for adolescent smoking cessation. Archives of pediatrics & adolescent medicine.More infoTo assess the safety and efficacy of sustained-release bupropion hydrochloride for adolescent smoking cessation.
- Muramoto, M. L., Ranger-Moore, J., & Leischow, S. J. (2003). Efficacy of oral transmucosal nicotine lozenge for suppression of withdrawal symptoms in smoking abstinence. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.More infoNicotine replacement therapy relieves withdrawal symptoms, significantly improving smoking cessation rates. Oral transmucosal nicotine (OT-NIC) is a novel nicotine delivery system consisting of a lozenge (OT-NIC unit) containing 4 mg of nicotine, which is dissolved in the cheek pouch, releasing nicotine for absorption through the buccal mucosa. Theoretical advantages of OT-NIC include that it does not require special chewing methods or interfere with dental work, it provides sensory oral effect, and it can be dosed to effect. This study aimed to determine the preliminary safety and efficacy of OT-NIC for suppression of nicotine withdrawal symptoms over 8 days of smoking abstinence and to assess flavor preference, sensory characteristics, and acceptability. In an open-label, within-subjects design, 11 smokers used three different flavors of OT-NIC ad lib in response to withdrawal symptoms and craving. On days 1 and 8, withdrawal symptoms were measured with pre- and postadministration scores for each of the first three OT-NIC units used (three different flavors presented in random order). Flavor preference, desire to smoke, sensory characteristics, acceptability, and overall OT-NIC performance were rated at the end of each day. A generalized estimating equation analysis was conducted to account for the repeated-measures design. Use of OT-NIC resulted in a significant decrease in a composite withdrawal score aggregating scores from all eight symptoms (decline of.57 units in a possible range of 4, p
- Jorenby, D. E., Leischow, S. J., Nides, M. A., Rennard, S. I., Johnston, J. A., Hughes, A. R., Smith, S. S., Muramoto, M. L., Daughton, D. M., Doan, K., Fiore, M. C., & Baker, T. B. (1999). A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation. The New England journal of medicine.More infoUse of nicotine-replacement therapies and the antidepressant bupropion helps people stop smoking. We conducted a double-blind, placebo-controlled comparison of sustained-release bupropion (244 subjects), a nicotine patch (244 subjects), bupropion and a nicotine patch (245 subjects), and placebo (160 subjects) for smoking cessation. Smokers with clinical depression were excluded. Treatment consisted of nine weeks of bupropion (150 mg a day for the first three days, and then 150 mg twice daily) or placebo, as well as eight weeks of nicotine-patch therapy (21 mg per day during weeks 2 through 7, 14 mg per day during week 8, and 7 mg per day during week 9) or placebo. The target day for quitting smoking was usually day 8.