Saul Shiffman

Introduction

Saul Shiffman is an American clinical psychologist who did more than anyone to move addiction research out of the clinic and into the moment. His central methodological claim is simple but consequential: what people say about their own behaviour weeks later is not a reliable record of what they did, and if you want to understand smoking, craving or relapse you have to catch it while it is happening. The method built on that claim — ecological momentary assessment — is now standard across behavioural medicine, and the largest body of real-time data on cigarette smoking in existence was collected by his laboratory.

He also spent a career on the substance of the problem: what withdrawal feels like, what triggers a lapse, why some smokers smoke every day and others do not, and what happens when smokers switch to products that deliver nicotine without combustion.

Early Life and Education

Shiffman was born on 27 November 1951 in Bogotá, Colombia, and is a United States citizen. He took his B.S. in psychology at Brooklyn College of the City University of New York in 1973, graduating summa cum laude with department honours and election to Phi Beta Kappa, and held a Danforth graduate fellowship.

He then went to the University of California, Los Angeles, for an M.A. in 1974 and a Ph.D. in clinical psychology in 1981, with minor fields in physiological psychology and philosophy. His master's thesis was on the tobacco withdrawal syndrome — the topic he would work on for the next fifty years — and his dissertation examined whether graduate training in clinical psychology improved performance in a psychotherapy analogue. From 1978 to 1981 he was associate director of the Laboratory for the Study of Smoking Behavior in UCLA's department of psychiatry and a clinical research psychologist at the Brentwood VA medical center.

Academic and Professional Career

Shiffman's first academic post was at the University of South Florida, where he was assistant professor of psychology and clinical assistant professor of psychiatry and behavioral medicine from 1981 to 1984. He moved to the University of Pittsburgh in 1984 and stayed: assistant professor to 1987, associate professor to 1991, professor from 1991 to 2000, and research professor from 2000, with joint appointments in psychiatry and later in pharmaceutical sciences and clinical and translational research. He spent 1990–91 as a visiting associate professor at the University of Washington.

His honours include the Ove Ferno Award from the Society for Research on Nicotine and Tobacco for groundbreaking advances in clinical research, a Lifetime Achievement Award from the Good Clinical Practices Journal, the Society of Behavioral Medicine's Research-to-Practice Award in 2013, election to APA's Board of Scientific Affairs, and fellowship in the Association for Psychological Science, the Society of Behavioral Medicine and three APA divisions. He was among the inaugural fellows of the Society for Research on Nicotine and Tobacco in 2017.

A second, parallel career runs alongside the academic one, and it is central to understanding his later work. From 1993 he has been a senior scientific advisor at Pinney Associates, a consultancy working on pharmaceutical and tobacco product issues; in 1998 he co-founded companies developing smoking cessation products that were later optioned to Niconovum; and from 1999 to 2012 he was co-founder and chief science officer of invivodata, which commercialized electronic patient diaries for clinical trials.

Major Contributions to Psychology

Ecological momentary assessment

Shiffman's methodological contribution is ecological momentary assessment: repeated sampling of behaviour, mood, craving and context in real time and in the person's ordinary environment, usually by electronic diary, replacing the retrospective questionnaire. With Arthur Stone and Michael Hufford he wrote the 2008 Annual Review of Clinical Psychology article that became the field's canonical reference, and with Stone he proposed reporting guidelines for momentary data so that studies could be compared.

The empirical demonstration that made the case is the paper diary work with Stone, Joseph Schwartz and Joan Broderick. Participants given paper diaries for pain or other symptoms reported excellent adherence; when the same diaries were fitted with electronic chips that recorded when the case was actually opened, adherence was far lower than reported — roughly nine of every ten entries had not been made at the time participants later said they had. Paper diaries, in other words, were often reconstructed at the clinic door. The finding is now a standard caution in clinical trial methodology and it motivated the move to electronic capture.

The real-time anatomy of relapse

Shiffman's earliest influential study, published in 1982, was a situational analysis of relapse following smoking cessation: ex-smokers were interviewed about the circumstances of their first lapse, and their reports converged on a small number of situations, notably drinking alcohol and being with other smokers.

The more important result came later, when real-time data made a within-subject design possible. In a 1996 study of first lapses to smoking, Shiffman and colleagues compared each lapse episode against randomly sampled moments when the same person resisted the urge. The comparison undercut the simple version of the high-risk-situation model: lapse moments and resisted temptations looked much more alike than expected, and negative affect and craving did not distinguish them as sharply as the clinical literature had assumed. That result is a good example of what momentary data can do — it can disconfirm the model that motivated it.

Dependence, withdrawal and intermittent smokers

Shiffman's substantive work covers the nicotine withdrawal syndrome, which he has studied since his master's thesis, and the measurement of dependence: with Andrew Waters and Mary Hickcox he developed the Nicotine Dependence Syndrome Scale, a multidimensional alternative to single-score dependence measures. From the 2000s he turned to intermittent, or non-daily, smokers — a growing and poorly understood fraction of adult smokers — running randomized trials of very low nicotine content cigarettes and of as-needed oral nicotine replacement in this group, with momentary assessment built into the design.

More recently his output has shifted heavily toward electronic nicotine delivery systems: pharmacokinetic studies of nicotine delivery, and actual-use and switching studies that ask what happens when established smokers move to e-cigarettes.

Major Publications

  • Shiffman, S. M., & Jarvik, M. E. (1976). "Smoking withdrawal symptoms in two weeks of abstinence." Psychopharmacology, 50(1), 35–39.
  • Shiffman, S. (1982). "Relapse following smoking cessation: A situational analysis." Journal of Consulting and Clinical Psychology, 50(1), 71–86.
  • Stone, A. A., Shiffman, S., Schwartz, J. E., Broderick, J. E., & Hufford, M. R. (2003). "Patient non-compliance with paper diaries." BMJ, 326(7397), 1192–1193.
  • Shiffman, S., Paty, J. A., Gnys, M., Kassel, J. A., & Hickcox, M. (1996). "First lapses to smoking: Within-subjects analysis of real-time reports." Journal of Abnormal Psychology, 105(3), 366–379.
  • Shiffman, S., Waters, A. J., & Hickcox, M. (2004). "The nicotine dependence syndrome scale: A multidimensional measure of nicotine dependence." Nicotine & Tobacco Research, 6(2), 327–348.
  • Shiffman, S., Stone, A. A., & Hufford, M. R. (2008). "Ecological momentary assessment." Annual Review of Clinical Psychology, 4, 1–32.

Impact and Legacy

Ecological momentary assessment is Shiffman's durable legacy. The method reshaped behavioural medicine — it is now used in pain, mood, eating, sleep, physical activity and medication adherence research — and the reporting standards he proposed with Stone helped make a sprawling literature comparable. His relapse work changed the unit of analysis: instead of asking ex-smokers to reconstruct a lapse months later, the field now measures the lapse as it happens, and the within-subject designs he introduced remain the template.

Three lines of criticism are worth taking seriously.

Funding and conflicts of interest. Shiffman has worked at the boundary of academia and industry for three decades: a senior advisor at Pinney Associates since 1993, co-founder of companies whose cessation products were optioned to a nicotine firm, chief science officer of an electronic-diary company, and more recently an author on a large body of studies of JUUL products, several with co-authors affiliated with the manufacturer. Tobacco research funded by companies with a commercial stake is a well-documented source of publication bias, and critics in tobacco control argue that evidence generated this way needs to be read with the funding in view. The counter-argument is that he discloses these relationships, publishes in leading peer-reviewed journals with registered trials, and that industry involvement is what made the e-cigarette switching data possible at all. Both things are true, and the reader has to hold them together.

Momentary data have their own problems. EMA solves recall bias and introduces others. Prompting people repeatedly can change the behaviour being measured, participants miss prompts selectively — often precisely when they are smoking or drinking — and the resulting data are sparse, nested and unbalanced, so conclusions can depend on modelling choices. The paper-diary findings, while striking, come from specific patient samples with specific diary instructions, and "non-compliance" covers everything from deliberate back-filling to ordinary forgetfulness. EMA is a better instrument than retrospective recall, not a transparent window.

The relapse model's yield has been modest. The situation-based account of relapse that Shiffman's early work supported has not translated into proportionally effective interventions: relapse prevention built on identifying high-risk situations produces small effects, and the within-subject data he himself collected showed that lapse moments are harder to distinguish from resisted temptations than the model implies. In that sense his most cited methodological contribution partly undercut his own early substantive conclusion — which is what good measurement is supposed to do, but it is worth saying plainly rather than presenting the 1982 situational model as settled.

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References

  • Shiffman, S., & Wills, T. A. (1985). Coping and Substance Use. Academic Press.

Last updated: 2026-10-20

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