• PhD, University at Buffalo, SUNY

My research program seeks to: (1) understand the mechanisms that underlie health behavior among people at increased risk for poor health outcomes; (2) explore the role of health inequities on behavioral health among those with medical comorbidities; and (3) address adverse clinical outcomes including pain, mental health, neurocognition, and quality of life. This interdisciplinary research focuses on: (1) the mechanisms and outcomes of and treatments for tobacco use among people with HIV (PWH); (2) cannabis use for symptom management among patients with cancer; and (3) increasing awareness of and access to mental health support in the Black community.

PWH smoke at higher rates than people without HIV and due to the widespread use of antiretroviral therapy, PWH actually lose more life years to tobacco use than to HIV. My research seeks to understand: (1) the mechanisms that underlie high smoking rates; (2) why existing treatments are less effective and relapse rates are higher among PWH; and (3) how HIV and smoking may act synergistically and ultimately lead to worse clinical outcomes including cancer and impaired immune function. 

More patients with cancer are using cannabis to help manage symptoms related to cancer and our work seeks to understand how and why patients with cancer use cannabis. Specifically, we are studying whether cannabis may reduce opioid use for managing cancer-related pain and the benefits and harms of cannabis use among patients undergoing immunotherapy. We are also examining how inequities in access to cannabis may impact cancer-related outcomes.

Lastly, we are collaborating with a community-based organization, the National Witness Project (Dee Johnson, Director), to understand and address mental health service barriers in Buffalo’s Black community. Through this community-based participatory research we are developing a novel health communication outreach program tailored to strategies for reaching, educating, and navigating the community to mental health services.

• Levy S, Schnoll R, Wileyto EP, Thompson M, Azad M, Metzger D, Leone F, Ashare R. Differences in Cognition and Smoking Abstinence Rates among People with and without HIV. Nicotine & Tobacco Research, in press.
• Greene B, Schnoll RA, Gross R, Ashare RL. The role of alternative reinforcers in smoking outcomes among people with and without HIV. Psychol Addict Behav. 2025 Jun 5. doi: 10.1037/adb0001071. Epub ahead of print. PMID: 40471817.
• Levy S, Hirschman K, Matus A, Thomas G, Riegel B, Ashare R. Do coping style and future time perspective relate to surrogate decision-making preparedness? A cross-sectional analysis of heart failure caregivers. Aging Ment Health. 2025 May;29(5):874-880.
• Yadav A, Gionet G, Karaj A, Kossenkov AV, Kannan T, Putt ME, Stephens Shields AJ, Ashare RL, Collman RG. Association of smoking with neurocognition, inflammatory and myeloid cell activation profiles in people with HIV on antiretroviral therapy. AIDS. 2024 Dec 1;38(15):2010-2020.
• Ashare RL, Worster B, Nugent SM, Smith DM, Morasco BJ, Leader AE, Case AA, Meghani SH. Cannabis and opioid perceptions, co-use, and substitution among patients across 4 NCI-Designated Cancer Centers. J Natl Cancer Inst Monogr. 2024 Aug 15;2024(66):267-274.
• Worster B, Meghani SH, Leader AE, Nugent SM, Jones KF, Yeager KA, Liou K, Ashare RL. Toward reducing racialized pain care disparities: Approaching cannabis research and access through the lens of equity and inclusion. Cancer. 2024 Feb 15;130(4):497-504.
• Medaglio D, Bilker WB, Han X, Merlin JS, Plankey M, Martin J, Crane HM, Hojat LS, Bamford L, Schnoll R, Tyndale RF, Gross R, Ashare RL. Nicotine Metabolite Ratio Decreases After Switching Off Efavirenz-Based Therapy in People With HIV Who Smoke. Clin Pharmacol Ther. 2024 Jan;115(1):80-85.
• Greene B, Bernardo L, Thompson M, Loughead J, Ashare R. An Embedded Recruitment Trial of Behavioral Economic Strategies to Improve Enrollment Rates in Clinical Research. JMIR Formative Research. 2023 Jul 21;7:e47121..
• Ashare R, Turay E, Worster B, Wetherill R, Bidwell L, Doucette A, et al. Social Determinants of Health Associated with How Cannabis is Obtained and Used in Patients with Cancer Receiving Care a Cancer Treatment Center in Pennsylvania. Cannabis, 2023;6(2):1-12.
• Arens Y, Bilker WB, Han X, Plankey M, Ware D, Friedman MR, D’Souza G, Stosor V, Shoptaw S, Schnoll RA, Tyndale RF, Gross R, Ashare RL. HIV Infection Does Not Explain Higher Nicotine Metabolism in People Living with HIV. JAIDS, 91(5): 497-501, Dec 2022
• Ashare RL, Kelly E, Hajjar ER, Pant S, Meghani SH, Worster B. Characterizing Anxiety, Pain, Sleep, and Quality of Life among Patients in a State Medical Marijuana Program. Complementary Therapies in Clinical Practice, 48:101612, Aug 2022.
• Bien-Gund CH, Bilker W, Schnoll RA, Tyndale RF, Ho JI, Bremner R, Gross R, Ashare RL: Nicotine metabolism ratio increases in HIV-positive smokers on effective antiretroviral therapy: a cohort study. JAIDS, 89(4): 428-432, Apr 2022.
• Ashare RL, Brewer B, Patterson F, Hubbard A, Longacre ML: Psychological and Behavioral Moderators of Physical Health among Caregivers and Non-Caregivers. Geriatric Nursing, 43: 77-84, Jan-Feb 2022.
• Meghani SH, Quinn R, Ashare R, Levoy K, Worster B, Naylor M, Chittams J, Cheatle M: Impact of cannabis use on least pain scores among African American and White patients with cancer pain: A moderation analysis. Journal of Pain Research 14: 3493-3502, Nov 2021.
• Ashare, R. L., Thompson, M., Serrano, K., Leone, F., Metzger, D. S., Frank, I., Gross, R., Hole, A., Mounzer, K., Weisbrot, J., Collman, R. G., Wileyto, E. P., Schnoll, R.: A Placebo-Controlled Randomized Clinical Trial Testing the Efficacy and Safety of Varenicline for Smokers with HIV. Drug and Alcohol Dependence 200: 26-33, July 2019.