Ana M Progovac1,2, Yue-Fang Chang3, Chung-Chou H Chang4,5, Karen A Matthews6, Julie M Donohue7, Michael F Scheier8, Elizabeth B Habermann9, Lewis H Kuller10, Joseph S Goveas11, Benjamin P Chapman12,13, Paul R Duberstein12,14, Catherine R Messina15, Kathryn E Weaver16, Nazmus Saquib17, Robert B Wallace18, Robert C Kaplan19, Darren Calhoun20, J Carson Smith21, Hilary A Tindle22. 1. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA. progovac@hcp.med.harvard.edu. 2. Health Equity Research Lab, Department of Psychiatry, Cambridge Health Alliance, 1035 Cambridge St. Suite 26, Cambridge, MA, 02141, USA. progovac@hcp.med.harvard.edu. 3. Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, USA. 4. Department of Biostatistics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA. 5. Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 6. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 7. Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA. 8. Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA. 9. Division of Health Care Policy & Research and Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA. 10. Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA. 11. Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. 12. Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA. 13. Department of Public Health Sciences, University of Rochester Medical Medical Center, Rochester, NY, USA. 14. Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA. 15. Department of Family, Population, & Preventive Medicine, Stony Brook University, Stony Brook, NY, USA. 16. Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC, USA. 17. College of Medicine, Sulaiman Al Rajhi Colleges, Al-Qassim, Kingdom of Saudi Arabia. 18. Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, USA. 19. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA. 20. Medstar Research Institute, Phoenix, AZ, USA. 21. Department of Kinesiology, University of Maryland School of Public Health, College Park, MD, USA. 22. Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA.
Abstract
BACKGROUND: Optimism and cynical hostility independently predict morbidity and mortality in Women's Health Initiative (WHI) participants and are associated with current smoking. However, their association with smoking cessation in older women is unknown. PURPOSE: The purpose of this study is to test whether optimism (positive future expectations) or cynical hostility (mistrust of others) predicts smoking cessation in older women. METHODS: Self-reported smoking status was assessed at years 1, 3, and 6 after study entry for WHI baseline smokers who were not missing optimism or cynical hostility scores (n = 10,242). Questionnaires at study entry assessed optimism (Life Orientation Test-Revised) and cynical hostility (Cook-Medley, cynical hostility subscale). Generalized linear mixed models adjusted for sociodemographics, lifestyle factors, and medical and psychosocial characteristics including depressive symptoms. RESULTS: After full covariate adjustment, optimism was not related to smoking cessation. Each 1-point increase in baseline cynical hostility score was associated with 5% lower odds of cessation over 6 years (OR = 0.95, CI = 0.92-0.98, p = 0.0017). CONCLUSIONS: In aging postmenopausal women, greater cynical hostility predicts lower smoking cessation over time. Future studies should examine whether individuals with this trait may benefit from more intensive cessation resources or whether attempting to mitigate cynical hostility itself may aid smoking cessation.
BACKGROUND: Optimism and cynical hostility independently predict morbidity and mortality in Women's Health Initiative (WHI) participants and are associated with current smoking. However, their association with smoking cessation in older women is unknown. PURPOSE: The purpose of this study is to test whether optimism (positive future expectations) or cynical hostility (mistrust of others) predicts smoking cessation in older women. METHODS: Self-reported smoking status was assessed at years 1, 3, and 6 after study entry for WHI baseline smokers who were not missing optimism or cynical hostility scores (n = 10,242). Questionnaires at study entry assessed optimism (Life Orientation Test-Revised) and cynical hostility (Cook-Medley, cynical hostility subscale). Generalized linear mixed models adjusted for sociodemographics, lifestyle factors, and medical and psychosocial characteristics including depressive symptoms. RESULTS: After full covariate adjustment, optimism was not related to smoking cessation. Each 1-point increase in baseline cynical hostility score was associated with 5% lower odds of cessation over 6 years (OR = 0.95, CI = 0.92-0.98, p = 0.0017). CONCLUSIONS: In aging postmenopausal women, greater cynical hostility predicts lower smoking cessation over time. Future studies should examine whether individuals with this trait may benefit from more intensive cessation resources or whether attempting to mitigate cynical hostility itself may aid smoking cessation.
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