RESEARCH ARTICLE Open Access
Gende di e ences in pe sonali y pa e ns
and smoking s a us a e a smoking cessa ion
ea men
Bá ba a Piñei o
1*†
, Ana López-Du án
1†
, Elena Fe nández del Río
1,2†
, Ú sula Ma ínez
1†
and Elisa do Becoña
1†
Abs ac
Backg ound: The lack o conclusi e esul s and he sca ce use o he Millon Clinical Mul iaxial In en o y-III
(MCMI-III) in he s udy o he ela ionship be ween smoking and pe sonali y a e he easons ha mo i a ed he
s udy epo ed he e. The aim o he p esen s udy was o analyze he in luence o pe sonali y pa e ns, assessed
wi h he MCMI-III, and o nico ine dependence on ea men ou comes a he end o he ea men and a 12
mon hs ollow-up in men and women smoke s ecei ing cogni i e-beha io al ea men o smoking cessa ion.
Me hods: The sample was made up o 288 smoke s who ecei ed cogni i e-beha io al ea men o smoking
cessa ion. Pe sonali y pa e ns we e assessed wi h he Millon Clinical Mul iaxial In en o y-III (MCMI-III). Abs inence
a he end o he ea men and a 12-mon h ollow-up was alida ed wi h he es o ca bon monoxide in
expi ed ai .
Resul s: The esul s showed signi ican di e ences by pe sonali y pa e ns ha p edic nico ine dependence
(Na cissis ic and An isocial in men and Schizoid in women). A he end o he ea men i is mo e likely ha qui
smoking males wi h a Compulsi e pa e n and less likely in hose sco ing high in Dep essi e, An isocial, Sadis ic,
Nega i is ic, Masochis ic, Schizo ypal and Bo de line. In women, i is less likely ha qui smoking hose wi h he
Schizoid pa e n. A 12 mon hs ollow-up i is mo e likely ha con inue abs inen hose males wi h a high sco e in
he Compulsi e pa e n. Fu he mo e, nico ine dependence was an impo an a iable o p edic ing ou come a
he end o he ea men and smoking s a us a 12 mon hs ollow-up in bo h men and women.
Conclusions: We ound subs an ial di e ences by gende in some pe sonali y pa e ns in a sample o smoke s
who ecei ed cogni i e-beha io al ea men o smoking cessa ion. We should conside he exis ence o di e en
pe sonali y pa e ns in men and women who seek ea men o smoking cessa ion.
Backg ound
In ecen yea s, a la ge numbe o publica ions and s udies
ha e ocused on he analysis o he ela ionship be ween
pe sonali y ai s, om di e en heo e ical models,
and ciga e e smoking. A pa o such esea ch has
concen a ed on desc ibing which pe sonali y ai s a e
mos equen ly ound in smoke s [1-3]. Fo example,
Malou e al. [4], in a me a-analysis o s udies ca ied ou
om he Big Fi e-Fac o Model, ound ha smoke s sco e
highe on Neu o icism and lowe on Ag eeableness and
Conscien iousness han ne e -smoke s.
O he s udies ha e assessed he ex en o which
ce ain pe sonali y ai s a e ela ed o success o ailu e
in smoking cessa ion and main aining abs inence [5,6].
Fo example, Hoo en e al. [7] ound ha acco ding o
he Big Fi e-Fac o model, low sco es on Neu o icism
and Openness we e associa ed wi h obacco abs inence.
She e al. [8] ound ha Psycho icism and Neu o icism
acco ding o Eysenck’s pe sonali y model, and Sensa ion-
seeking acco ding o Cloninge ’s model, p edic elapse.
Cosci e al. [9], based on Eysenck’s pe sonali y model,
epo ha high sco es in Neu o icism and Psycho icism
inc eased isk o elapse in he i s yea o ollow-up a e
ea men . Fu he mo e, acco ding o Nie a e al. [10],
* Co espondence: [email p o ec ed]
†
Equal con ibu o s
1
Smoking Cessa ion Uni , Depa men o Clinical Psychology and
Psychobiology, Facul y o Psychology, Uni e si y o San iago de Compos ela,
San iago de Compos ela, Spain
Full lis o au ho in o ma ion is a ailable a he end o he a icle
© 2013 Piñei o e al.; licensee BioMed Cen al L d. This is an Open Access a icle dis ibu ed unde he e ms o he C ea i e
Commons A ibu ion License (h p://c ea i ecommons.o g/licenses/by/2.0), which pe mi s un es ic ed use, dis ibu ion, and
ep oduc ion in any medium, p o ided he o iginal wo k is p ope ly ci ed.
Piñei o e al. BMC Public Heal h 2013, 13:306
h p://www.biomedcen al.com/1471-2458/13/306
who made hei analysis in he con ex o he al e na i e
i e- ac o model [11], smoke s’gende plays a key ole in
explaining smoking elapse, which in men is ela ed o a
high sco e in Impulsi eness, and in women o a high sco e
in Sociabili y.
O he esea ch, based on Millon’spe sonali ymodel,
has ied o iden i y which pe sonali y pa e ns a e mos
common among smoke s. Millon de ines he pe sonali y
pa e ns as a se o a ibu es ha a e nei he a ca ego y
no a dimension, bu a he a syn hesis o bo h o hem.
Pa e ns ha make up he pe sonali y o he indi idual a e
he esul s o he in e - ela ion be ween con ex ual and
cons i u ional ac o s, and a e conside ed o be dynamic
s yles on a con inuum om no mali y o pa hology, which
makes possible in e en ion and change [12]. No mal and
abno mal pe sonali ies a e iden i ied on he basis o
Millon’s E olu iona y Pe sonali y Theo y [13].
Thus, Fe nández del Río e al. [14], using he Millon
Clinical Mul iaxial In en o y-II (MCMI-II), ound ha
smoke s sco ed highe han non-smoke s on he A oidan ,
His ionic and Nega i is ic (Passi e-Agg essi e) scales.
Becoña e al. [15], wi h he MCMI-III, ound he An isocial
and His ionic pa e ns o be mo e equen in nico ine-
dependen smoke s, whils he Schizoid pa e n was mo e
common among non-dependen smoke s. The e a e also
s udies ha analyze whe he pe sonali y pa e ns in luence
he esul s o smoking-cessa ion ea men . Fo example,
Pe ea e al. [16] ound ha smoke s wi h A oidan , Sel -
des uc i e, Passi e-Agg essi e, Schizo ypal o Bo de line
pe sonali y pa e ns we e mo e likely o elapse a 6
mon hs ollow-up, whe eas he Dependen pa e n was
associa ed wi h a g ea e likelihood o main aining ab-
s inence. In con as , Fe nández del Río e al. [17], using
he MCMI-II, ound ha he Dependen pe sonali y
pa e n was associa ed wi h a lowe pe cen age o
abs inence a 6-mon h ollow-up.
The e o e, on he basis o Millon’s model, esea ch
sugges s ha ce ain pe sonali y pa e ns a e associa ed
wi h g ea e di icul y o smoking cessa ion and wi h
highe likelihood o elapse, while o he s would be
associa ed wi h he main enance o abs inence. Howe e ,
he esul s a e s ill somewha inconclusi e and u he
esea ch is necessa y.
The lack o conclusi e esul s and he sca ce use o
he MCMI-III [18] in he s udy o he ela ionship
be ween smoking and pe sonali y a e he easons ha
mo i a ed he s udy epo ed he e. Mo eo e , and as
Nie a e al. [10] poin ou , he e a e ha dly any s udies
ha assess he esul s o a smoking cessa ion ea men
and he ela ionship be ween nico ine dependence,
pe sonali y and gende . I is necessa y o include he
a iable o nico ine dependence in he s udies ha assess
he esul s o a ea men o qui smoking, as i is one o
he a iables ha bes p edic s he esul s bo h a he
end o he ea men and du ing he ollow-ups [19-21].
Those smoke s mo e nico ine dependen ha e mo e
di icul ies o qui [22,23] and hose less dependen a e
mo e likely o succeed [24].
The aim o his s udy is o analyze he in luence o he
pe sonali y pa e ns, assessed wi h he MCMI-III, and o
nico ine dependence on ea men ou comes a he end
o he ea men and a 12 mon hs ollow-up in men and
women smoke s ecei ing cogni i e-beha io al ea men
o smoking cessa ion.
Me hods
Pa icipan s
The sample was made up o smoke s seeking smoking
cessa ion ea men a he Smoking Cessa ion Uni o
he Facul y o Psychology a he Uni e si y o San iago
de Compos ela (Spain) du ing he pe iod Janua y 2009
o June 2011. Pa icipan s we e ec ui ed h ough he
media, by GPs’ ecommenda ion and by wo d o mou h
om people who had aken he ea men p e iously.
Inclusion c i e ia we e: age 18 o o e ; a wish o pa icipa e
in he ea men p og am; and smoking a minimum o 10
ciga e es a day. Exclusion c i e ia we e: a diagnosis o
se e e men al diso de (bipola diso de and/o psycho ic
diso de ); concu en dependence on o he subs ances
(cannabis, cocaine and/o he oin); ha ing pa icipa ed in
he same o simila ea men o e he p e ious yea ;
ha ing ecei ed ano he ype o e ec i e smoking cessa ion
ea men (nico ine eplacemen he apy, bup opion,
a enicline) in he pas yea ; su e ing om a physical
pa hology wi h a high li e isk which would equi e imme-
dia e indi idual in e en ion (e.g., ecen myoca dial
in a c ion); smoking a ype o obacco o he han ciga e es
(e.g., ciga s); e using o be ideo- eco ded du ing he
sessions; and ailing o a end he i s ea men session.
F om an ini ial sample o 332 smoke s, 42 we e excluded
o ha ing ul illed one o he exclusion c i e ia and wo
because hei MCMI-III sco e was in alid ( alidi y scale
sco e = 3). The e o e he inal sample was made up o 288
smoke s (41% men, 59% women). Thei a e age age was
41.49 yea s (SD =10.55).
Measu es
All he smoke s we e assessed wi h he Smoking Habi
Ques ionnai e (Cues iona io sob e el hábi o de uma
[25]), which collec s in o ma ion on sociodemog aphic
a iables (gende , age) and abou smoking (numbe o
ciga e es smoked p e- ea men ).
Fo he assessmen o pe sonali y pa e ns we used he
Millon Clinical Mul iaxial In en o y-III (MCMI-III [18];
Spanish adap a ion by Ca denal e al. [26]). This is a
175-i em sel - epo scale wi h wo esponse op ions
( ue- alse) ha assesses 14 pe sonali y pa e ns and 10
clinical synd omes. The pe sonali y pa e ns assessed
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a e: Schizoid, A oidan , Dep essi e, Dependen , His ionic,
Na cissis ic, An isocial, Sadis ic (Agg essi e), Compulsi e,
Nega i is ic (Passi e-Agg essi e), Masochis ic (Sel -
De ea ing), Schizo ypal, Bo de line, and Pa anoid. On he
MCMI-III, aw sco es a e ans o med in o p e alence
sco es (PREV), and such sco es a e used in wo ways: 1) a
PREV sco e o 75 and 85 is conside ed o indica e clinical
pe sonali y ai s, while sco es o 85 and o e indica e a
ch onic and mode a ely se e e le el o unc ioning, a
pe sonali y diso de [27,28]; and 2) PREV a e used as
con inuous sco es wi hou applying cu -o poin s [29,30].
In he o iginal sample, he C onbach’s alpha coe icien s o
he clinical scales ange be ween 0.66 and 0.90; in he
s anda dized Spanish scale (N = 964) hey ange om 0.65
o 0.88, being, in gene al, e y simila o hose ob ained in
US popula ion [26].
Fo he assessmen o nico ine dependence we used
he Fage s öm Tes o Nico ine Dependence (FTND
[31]), in i s alida ed Spanish e sion by Becoña e al.
[32]. This scale is made up o 6 i ems and i is he mos
widely used ins umen o a ing nico ine dependence.
In he p esen sample he eliabili y ob ained by means
o C onbach’s alpha was 0.65.
We used he Mic o
+
Smoke lyze
W
(Bed on Scien i ic
L d, Si ingbou ne, England) o measu e ca bon monoxide
(CO) in expi ed ai , so as o co obo a e sel - epo ed
abs inence a he end o he ea men and a 12-mon h
ollow-up.
P ocedu e
Ini ial assessmen o he smoke s was ca ied ou in a
single session in which all he smoke s ga e hei
in o med consen o pa icipa ion in he s udy. The
s udy was au ho ized by he Bioe hics Commi ee o he
Uni e si y o San iago de Compos ela.
The cogni i e-beha io al ea men applied was he
Smoking Cessa ion P og am (P og ama pa a Deja de
Fuma , [33]). This is a cogni i e-beha io al ea men
has demons a ed i s e icacy in p e ious s udies [34].
I is composed by six sessions (one pe week o abou
1 hou ), applied in g oup o ma . This ea men
p og am in ol es componen s o ea men con ac ,
sel -moni o ing o smoking, and g aphic ep esen a ion o
ciga e e consump ion, gene al in o ma ion abou obacco,
nico ine ading, s imulus con ol, ac i i ies o a oiding
nico ine-wi hd awal synd ome, physiological eedback on
ciga e e consump ion, and elapse-p e en ion s a egies
(asse i eness, p oblem sol ing, changes in e oneous
belie s, anxie y and ange managemen , physical exe cise,
weigh con ol, and sel -suppo ). The g oups we e
composed by 6–8 pa icipan s and he assignmen o
hem was done based on hei schedule a ailabili y.
Sociodemog aphic o consump ion cha ac e is ics we e
no aken in o accoun o his end. G oups we e conduc ed
by ou di e en psychologis s and no di e ences we e
ound on ea men esul s acco ding o he he apis o
he g oup.
A e he ea men he e was ace- o- ace ollow-up a
12 mon hs. Sel - epo o abs inence a he end o he
ea men and in he ollow-up was es ed by measu es
o ca bon monoxide (CO) in expi ed ai , using he Mic o
+
Smoke lyze
W
. The Wes e al. [35] c i e ia we e adop ed
o poin p e alence abs inence a he end o he
ea men (no ha ing smoked in he pas 24 hou s,
CO < 10 ppm) and con inuous abs inence a 12 mon hs
ollow-up (no ha ing smoked, no e en a pu , since he
end o he ea men , CO < 10 ppm).
In he ollow-up, in hose cases in which i was no
possible o loca e he pa icipan s, hey we e conside ed
o be smoke s, and a he same le el (in e ms o numbe
o ciga e es and nico ine con en ) as in he p e ea men
assessmen .
Da a analysis
Fi s , a desc ip i e analysis was made o he o al sample
(N = 288). Nex , we analyzed he co ela ions be ween
pe sonali y pa e ns and measu es o nico ine dependence
(FTND sco e and numbe o ciga e es smoked pe day).
In o de o es di e ences be ween abs aine s and
smoke s a he end o he ea men and a he 12-mon h
ollow-up o be ween gende , we used S uden ’s - es s
and Cohen’s d o es ima e he e ec size. We also
examined he con ibu ion o pe sonali y pa e ns o
nico ine dependence (acco ding o FTND sco e) using a
s epwise mul iple eg ession analysis. In he nex pa o
he analysis we examined he con ibu ion o pe sonali y
pa e ns o ea men ou comes. Fo his s ep, a s epwise
logis ic eg ession analysis was ca ied ou o examine
pe sonali y pa e ns as p edic o s o smoking cessa ion a
he end o he ea men and a he 12-mon h ollow-up,
adjus ed o ini ial le els o nico ine dependence. All
s a is ical analyses we e pe o med using he SPSS
so wa e (19.0; © SPSS Inc., 2010). The signi icance le el
was se a p < 0.05.
Resul s
Pa icipan s (N = 288; 41% men, 59% women) smoked a
mean o 21.7 ciga e es/day (SD = 8.37, ange 10–50),
ob aining a mean FTND sco e o 5.07 (SD = 2.19, ange
0–10). As a as smoking a e is conce ned, women
smoked ewe ciga e es/day han men while no signi ican
gende di e ences we e ound ega ding he le el o
nico ine dependence (Table 1).
When analyzing he sco es on MCMI-III pe sonali y
pa e ns, we ound ha women sco ed signi ican ly
highe han men on he His ionic and Compulsi e
pa e ns, whils men sco ed highe on he Na cissis ic
pa e n (see Table 1).
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O he 288 smoke s in he s udy, 58% (n = 167) had
s opped smoking by he end o he ea men and his
p opo ion o abs aine s we e con i med h ough he
ca bon monoxide in expi ed ai measu e (CO < 10 ppm).
A 12 mon hs ollow-up, 19.8% (n = 57) o he sample
we e abs inen .
Rela ionship be ween pe sonali y pa e ns and nico ine
dependence
Table 2 shows he bi a ia e co ela ions be ween he 14
pe sonali y pa e ns o he MCMI-III, sco es on he
FTND and p e- ea men ciga e es/day. In he ela ionship
be ween nico ine dependence and MCMI-III pe sonali y
pa e ns in he o al sample we ound a posi i e ela ion-
ship be ween nico ine dependence and he Schizoid,
Dep essi e, Sadis ic (Agg essi e), Nega i is ic, Schizo ypal,
and Bo de line pa e ns; and a nega i e ela ionship wi h
he His ionic pa e n. This ela ionship a ies acco ding
o smoke ’s gende . In he case o women, we ound
a posi i e ela ionship be ween nico ine dependence
and he Schizoid, Sadis ic (Agg essi e), Nega i is ic,
and Pa anoid pa e ns; and a nega i e ela ion wi h he
His ionic pa e n. In he case o men, we only ound
a posi i e co ela ion be ween FTND sco e and he
Schizoid and An isocial pa e ns, oge he wi h a nega i e
co ela ion wi h he Na cissis ic pa e n. Ne e heless, we
ha e o no e ha some co ela ions be ween nico ine
dependence (sco e on FTND) and pe sonali y pa e ns
we e qui e low (be ween -.12 and .18), e en hough
s a is ically signi ican . I is consis en wi h he low
pe cen age o a iance explained by he eg ession model.
We ound no ela ionship be ween numbe o ciga e es/
day and all he pe sonali y pa e ns. As he esul s we e
di e en acco ding o gende , we decided o pe o m
u he analyses o men and women sepa a ely.
In a second s ep, s epwise mul iple eg ession was
pe o med by gende , including he 14 pe sonali y pa e ns.
Two pe sonali y pa e ns, Na cissis ic (B = −0.04) and
An isocial (B = 0.02), we e in ol ed in he model (F = 4.59,
p < .05), explaining 5.8% o FTND a iance o men. Fo
women, only he Schizoid pe sonali y pa e n (B = 0.02)
was in ol ed in he model (F = 4.68, p < .05), explaining
2.1% o he a iance.
Rela ionship be ween pe sonali y pa e ns and ea men
ou comes in men and women
Men who did no manage o gi e up smoking by he
end o he ea men sco ed highe in he Dep essi e,
An isocial, Sadis ic (Agg essi e), Nega i is ic, Masochis ic,
Schizo ypal and Bo de line pa e ns, and hose who
did manage o gi e up smoking sco ed highe in he
Compulsi e pa e n. In he women’s g oup we only
ound di e ences in he Schizoid pa e n, in which
hose who did no gi e up smoking by he end o he
ea men sco ed highe (Table 3).
Table 1 Desc ip i e s a is ics in smoking, nico ine dependence and pe sonali y pa e n a iables
To al (N = 288) Men (N = 118) Women (N = 170)
Mean SD Mean SD Mean SD
CPD 21.70 8.37 23.07 8.74 20.75 7.99 2.33*
FTND 5.07 2.19 4.94 2.34 5.16 2.07 −0.83
Pe sonali y pa e ns
Schizoid 38.75 20.47 37.63 20.63 39.53 20.39 −0.76
A oidan 35.95 24.55 35.87 24.07 36.01 24.95 −0.05
Dep essi e 31.88 25.72 30.22 24.97 33.03 26.23 −0.91
Dependen 37.45 23.81 37.89 21.56 37.15 25.31 0.26
His ionic 55.77 21.09 50.14 19.62 59.68 21.24 −3.87***
Na cissis ic 60.01 16.43 67.27 13.00 54.98 16.71 6.71***
An isocial 46.41 20.25 43.88 20.66 48.17 19.84 −1.77
Sadis ic (Agg essi e) 42.93 21.30 42.32 22.71 43.35 20.32 −0.40
Compulsi e 58.08 18.42 54.20 18.18 60.76 18.15 −3.02**
Nega i is ic (Passi e-Agg essi e) 39.92 22.18 40.28 22.42 39.66 22.08 0.23
Masochis ic (Sel -De ea ing) 28.28 23.17 25.94 22.64 29.91 23.47 −1.43
Schizo ypal 24.03 24.43 23.88 24.38 24.14 24.54 −0.09
Bo de line 34.03 22.64 33.12 22.93 34.66 22.48 −0.57
Pa anoid 34.73 25.53 34.85 24.63 34.65 26.21 0.07
CPD = Ciga e es pe day; FTND = Fage s öm Tes o Nico ine Dependence.
*p < .05; **p < .01; ***p < .001.
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Table 2 Co ela ions be ween pe sonali y pa e ns, nico ine dependence (FTND) and numbe o ciga e es smoked pe day (CPD)
1234567891011121314FTNDCPD
1. Schizoid - .58** .49** .26** -.69** -.46** .11 .22** -.10 .39** .45** .52** .38** .41** .18** .04
2. A oidan .61**
(.57**)
- .67** .58** -.70** -.65** .13* .22** -.14* .49** .62** .63** .50** .47** .10 -.04
3. Dep essi e .39**
(.55**)
.56**
(.75**)
- .62** -.50** -.54** .24** .34** -.26** .59** .73** .67** .68** .51** .13* .02
4. Dependen .24**
(.27**)
.54**
(.60**)
.55**
(.66**)
- -.33** -.45** .18** .26** -.17** .54** .65** .53** .53** .44** .05 .04
5. His ionic -.73**
(−.72**)
-.72**
(−.72**)
-.38**
(−.62**)
-.27**
(−.37**)
- .53** -.05 -.21** .17** -.38** -.41** -.56** -.37** -.40** -.12* -.04
6. Na cissis ic -.47**
(−.49**)
-.62**
(−.75**)
-.46**
(−.62**)
-.45**
(−.51**)
.57**
(.73**)
- -.11 -.11 .04 -.37** -.48** -.41** -.38** -.27** -.11 .04
7. An isocial .25**
(.01)
.12(.13) .23**
(.23**)
.14(.20**) -.14(−.04) -.02(−.11) - .69** -.61** .52** .32** .27** .55** .26** .10 .01
8. Sadis ic-
Agg essi e
.30**
(.16*)
.25**
(.20**)
.34**
(.35**)
.25**
(.27**)
-.29**
(−.17*)
-.09(−.13) .75**
(.64**)
- -.47** .66** .43** .40** .61** .45** .13* .06
9. Compulsi e -.18*
(−.06)
-.09(−.18*) -.25**
(−.28**)
-.11
(−.20**)
.15(.12) -.01(.18*) -.63**
(−.65**)
-.46**
(−.50**)
- -.44** -.28** -.29** -.49** -.18** -.04 -.02
10. Nega i is ic .41**
(.37**)
.44**
(.52**)
.50**
(.65**)
.54**
(.54**)
-.32**
(−.44**)
-.36**
(−.43**)
.53**
(.53**)
.66**
(.67**)
-.38**
(−.49**)
- .64** .57** .79** .65** .13* .04
11. Masochis ic .44**
(.45**)
.51**
(.70**)
.66**
(.77**)
.59**
(.69**)
-.37**
(−.48**)
-.39**
(−.54**)
.43**
(.23**)
.52**
(.36**)
-.33**
(−.28**)
.67**
(.63**)
- .63** .69** .50** .08 .01
12. Schizo ypal .49**
(.54**)
.61**
(.64**)
.62**
(.70**)
.56**
(.52**)
-.52**
(−.60**)
-.38**
(−.47**)
.37**
(.20**)
.52**
(.30**)
-.32**
(−.28**)
.59**
(.57**)
.62**
(.64**)
- .63** .54** .13* .09
13. Bo de line .38**
(.37**)
.42**
(.56**)
.62**
(.72**)
.49**
(.56**)
-.31**
(−.44**)
-.34**
(−.43**)
.54**
(.55**)
.63**
(.60**)
-.45**
(−.55**)
.75**
(.82**)
.69**
(.69**)
.67**
(.60**)
- .50** .14* .07
14. Pa anoid .48**
(.36**)
.53**
(.43**)
.46**
(.53**)
.47**
(.42**)
-.37**
(−.43**)
-.32**
(−.27**)
.33**
(.22**)
.46**
(.45**)
-.16(−.19*) .61**
(.69**)
.49**
(.51**)
.53**
(.54**)
.47**
(.52**)
- .11 -.01
FTND .19*
(.17*)
.07(.11) .14(.12) .01(.09) -.10(−.16*) -.20*(−.05) .19*(.02) .10(.16*) -.15(.03) .10(.16*) .04(.10) .11(.14) .14(.14) .05
(.16*)
- .61**
CPD .02(.07) -.03(−.04) .06(.01) -.01(.06) .02(−.03) -.07(.02) -.10(−.03) -.05(.08) -.09(.08) .04(.05) .05(−.01) .09(.09) .07(.08) -.07
(.04)
.69**
(.56**)
-
FTND = Fage s öm Tes o Nico ine Dependence; CPD = Ciga e es pe day;
The uppe igh quad an shows he co ela ions ob ained wi h he o al sample (N = 288). The lowe le quad an shows he co ela ions acco ding o gende (co ela ions in he women’s g oup in b acke s).
*p < .05; **p < .01.
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Table 3 Mean sco es (s anda d de ia ions) in he pe sonali y pa e ns and esul s a he end o he ea men
Men (N = 118) Women (N = 170) To al (N = 288)
Pe sonali y pa e ns Abs inen
(n = 63)
Smoke s
(n = 55)
Cohen’s d Abs inen
(n = 104)
Smoke s
(n = 66)
Cohen’s d Abs inen
(n = 167)
Smoke s
(n = 121)
Cohen’sd
Schizoid 36.19 (18.83) 39.27 (22.58) −0.81 36.85 (20.20) 43.76 (20.11) −2.18* 0.17 36.60 (19.64) 41.72 (21.29) −2.11* 0.12
A oidan 33.44 (23.16) 38.65 (25.01) −1.18 34.41 (23.39) 38.52 (27.22) −1.05 34.05 (23.23) 35.58 (26.13) −1.55
Dep essi e 23.59 (21.99) 37.82 (26.17) −3.21** 0.30 32.16 (25.08) 34.39 (28.10) −0.54 28.93 (24.26) 35.95 (27.18) −2.31* 0.15
Dependen 35.02 (20.55) 41.18 (22.39) −1.56 36.65 (25.97) 37.94 (24.42) −0.32 36.04 (24.01) 39.41 (23.48) −1.19
His ionic 51.46 (18.29) 48.64 (21.11) 0.78 61.24 (20.20) 57.23 (22.72) 1.20 57.55 (20.02) 53.32 (22.33) 1.69
Na cissis ic 68.67 (11.40) 65.67 (14.57) 1.25 56.87 (15.43) 52.00 (18.27) 1.86 61.32 (15.14) 58.21 (17.97) 1.59
An isocial 39.29 (20.83) 49.15 (19.33) −2.65** 0.24 48.16 (19.21) 48.18 (20.94) −0.01 44.81 (20.24) 48.62 (20.14) −1.58
Sadis ic (Agg essi e) 37.71 (23.97) 47.60 (20.11) −2.41* 0.22 43.36 (20.83) 43.35(19.65) 0.01 41.23 (22.16) 45.28 (19.89) −1.60
Compulsi e 58.54 (17.54) 49.24 (17.77) 2.86** 0.26 62.64 (16.16) 57.80 (20.69) 1.71 61.10 (16.76) 53.91 (19.81) 3.33** 0.19
Nega i is ic (Passi e-Agg essi e) 36.35 (22.07) 44.78 (22.15) −2.07* 0.19 39.41 (22.48) 40.06 (21.60) −0.19 38.26 (22.31) 42.21 (21.89) −1.49
Masochis ic (Sel -De ea ing) 20.05 (20.52) 32.69 (23.25) −3.14** 0.29 29.04 (23.54) 31.29 (23.46) −0.61 25.65 (22.81) 31.93 (23.27) −2.29* 0.13
Schizo ypal 18.24 (21.71) 30.35 (25.83) −2.77** 0.26 22.88 (24.38) 26.12 (24.83) −0.84 21.13 (23.45) 28.04 (25.27) −2.39* 0.14
Bo de line 27.44 (21.88) 39.62 (22.56) −2.97** 0.27 33.12 (21.97) 37.09 (23.23) −1.12 30.98 (22.04) 38.24 (22.87) −2.72** 0.16
Pa anoid 33.37 (23.56) 36.55 (25.93) −0.70 35.32 (25.76) 33.59 (27.07) 0.42 34.58 (24.90) 34.93(26.49) −0.12
*p < .05; **p < .01.
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Rega ding smoking s a us a 12 mon hs ollow-up we
only ound signi ican di e ences in he men’s g oup:
hose who we e abs inen sco ed highe in he Compulsi e
pa e n [Mean = 61.23 (SD = 18.66) o abs aine s and
52.59 (SD = 17.78) o smoke s; = 2.04, d = 168, p < .05].
Pe sonali y pa e ns as p edic o s o smoking cessa ion
and main enance o abs inence in men and women
We ca ied ou a s epwise logis ic eg ession, aking as
p edic o a iables he sco es on he MCMI-III pe son-
ali y pa e ns, adjus ed o le els o nico ine dependence
(based on ini ial FTND sco es) sepa a ed acco ding o
gende . The c i e ion a iable was “abs inence”a he
end o he ea men and a he 12-mon h ollow-up
(1=Yes, 0=No).
A he end o he ea men , in women none o he
14 pe sonali y pa e ns p edic ed abs inence, and only
nico ine dependence (FTND) appea s as a p edic o
a iable. In men, he Masochis ic pe sonali y pa e n and
FTND we e associa ed wi h abs inence a he end o
he ea men . Men and women wi h highe nico ine
dependence we e less likely o gi e up smoking. In he
case o men, we also ound ha hose who sco e
highe in he Masochis ic pa e n we e less likely o
achie e abs inence (Table 4).
In con inuous abs inence a 12 mon hs ollow-up,
in bo h women and men, no pe sonali y pa e n was in-
ol ed in he model, and he only signi ican p edic o o
con inuous abs inence was nico ine dependence (Table 4).
Discussion
The aim o his s udy was o analyze he in luence o
pe sonali y pa e ns assessed wi h he MCMI-III and
nico ine dependence on smoking s a us (a he end o
he ea men and a 12 mon hs ollow-up) in a sample
o 288 men and women smoke s ecei ing cogni i e-
beha io al ea men o smoking cessa ion. The esul s
indica ed di e ences be ween men and women in he
pe sonali y pa e ns analyzed in he p esen s udy,
and ha nico ine dependence plays a ele an ole in
ea men ou comes.
When assessing he pe sonali y pa e ns o smoke s
seeking smoking cessa ion ea men , we ound ha
women sco e signi ican ly highe in he His ionic and
Compulsi e pa e ns, whils in men he Na cissis ic
pa e n is he mos p e alen . This esul is in line wi h
hose o o he s udies, such as ha o Be lin e al. [36],
who concluded ha he e a e di e en easons o smoking
in men and in women: women smoked mo e o ension
educ ion/ elaxa ion, s imula ion and social easons
han men. In a simila line, Millon [37] a gues ha he
Compulsi e pa e n is cha ac e ized by con inuous ension,
and he His ionic pa e n by a need o con inual social
ein o cemen .
We did ind di e ences ega ding o which pa e ns
p edic such dependence. In men, nico ine dependence
was p edic ed by a high sco e in he An isocial pa e n
and a low sco e in he Na cissis ic pa e n, and in
women i was p edic ed by a high sco e in he Schizoid
pe sonali y pa e n. Nie a e al. [10] had al eady ound
ha low Sociabili y p edic s nico ine dependence in men,
bu in he women’s g oup no pe sonali y scale eme ged as
a signi ican p edic o o nico ine dependence.
On he o he hand, we did ind di e ences by gende
in ela ion o he pa e ns mos s ongly ela ed o
smoking abs inence a he end o he ea men . Men
wi h a high sco e in he Compulsi e pa e n we e likely
o s op smoking, bu high sco es in he Dep essi e,
An isocial, Sadis ic, Nega i is ic, Masochis ic, Schizo ypal
and Bo de line pe sonali y pa e ns we e associa ed
wi h lowe pe cen ages o abs inence a he end o he
ea men . The An isocial and Bo de line pa e ns ha e
in common he Impulsi eness ai , which acco ding o
Nie a e al. [10] is ela ed o smoking elapse in men.
Table 4 Logis ic eg ession analysis a he end o he ea men and a 12-mon h ollow-up, by gende
Time B
a
Wald p OR C.I. (95%)
Men (n = 118)
C i e ion a iable = Abs inence a he end o ea men
Masochis ic (Sel -De ea ing) -.028 8.962 .003 .972 .955-.990
FTND -.319 11.334 .001 .727 .604-.875
C i e ion a iable = Abs inence a 12-mon h ollow-up
FTND −0.276 5.875 .015 .759 .607-.949
Women (n = 170)
C i e ion a iable = Abs inence a he end o ea men
FTND -.236 8.195 .004 .789 .671-.928
C i e ion a iable = Abs inence a 12-mon h ollow-up
FTND -.182 3.820 .051 .833 .694-1.000
a
Coding o he g oups in he model was Abs inen = 1 and Smoke s = 0.
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The only pe sonali y pa e n associa ed wi h ea men
ou comes in women was Schizoid. Women wi h a high
sco e on his pe sonali y pa e n we e less likely o s op
smoking. Acco ding o he esul s ob ained in he
p esen s udy, his pa e n is ela ed o a highe nico ine
dependence in women who seek ea men and nico ine
dependence is ela ed o highe di icul ies o qui
smoking [19].
Long- e m ou comes we e also di e en acco ding
o pe sonali y pa e ns. In men, a high sco e in he
Compulsi e pa e n was ela ed o con inuous abs inence
a 12-mon hs ollow-up, while in women no pa e n was
signi ican . P e ious s udies ca ied ou om Millon’s
pe sonali y model [12], wi hou aking in o accoun
gende , also ound good esul s among smoke s wi h his
pe sonali y pa e n. A plausible explana ion is ha people
wi h his pa e n a e highly pe ec ionis and in lexible
in hei decisions, an example o which would be he
decision o a end a speci ic ea men smoking cessa ion
p og am. I we bea in mind ha he c i e ion in he
p esen s udy o classi ying a pa icipan as abs inen a
12-mon hs ollow-up was no ha ing smoked a ciga e e,
no e en a pu , since he end o he ea men , i would
no be su p ising o ind ha pa icipan s wi h his
pe sonali y pa e n a e hose wi h he highes p obabili y
o emaining abs inen in he long e m. In he same line,
ano he e lec ion o he high le el o con ol in people
wi h his pa e n a e he esul s o s udies ca ied ou wi h
psychoac i e subs ance use s, in which his pe sonali y
pa e n shows low p e alence [38,39].
Conce ning he eg ession analysis, nico ine dependence
is he de e mining a iable o smoking s a us in bo h
sho and long e m, ega dless o gende . In men only,
he Masochis ic pa e n pa ly explains poo ou comes
a he end o he ea men . Nico ine dependence is
conside ed he key a iable o explaining he esul s o
smoking cessa ion in e en ions acco ding o p e ious
s udies [19,40,41], which ha e concluded ha people wi h
highe nico ine dependence ha e mo e p oblems o
main ain long e m abs inence.
Howe e , he esul s also indica ed ha ce ain
pe sonali y pa e ns p edic nico ine dependence and
ha he e we e signi ican di e ences acco ding o gende .
On he one hand, he Schizoid pa e n has been linked
o smoking a he end o he ea men in women, and
on he o he hand, highe sco es in his pa e n was
associa ed wi h highe nico ine dependence. The An isocial
pe sonali y pa e n has been linked o lowe pe cen ages
o abs inence, and has been a pa e n ha con ibu es o
explain he a iance o FTND in men. Thus, we know
ha ce ain pe sonali y pa e ns, which di e acco ding
o gende (e.g., Schizoid in women), a e ela ed o g ea e
dependence, which in u n p edic s poo e esul s bo h a
he end o he ea men and a he 12-mon h ollow-up.
Some limi a ions in his s udy should be no ed. Fi s ,
he sample is no ep esen a i e o he o al popula ion
o smoke s, since i includes only hose who sough
smoking cessa ion ea men , and we know ha his ype
o popula ion has di e en cha ac e is ics om hose o
smoke s om he gene al popula ion. The e o e, we
could expec ha he pa e ns and he di e ences ound
by gende could a y in he p o ile o smoke s who s op
smoking wi hou ollowing a speci ic ea men , so ha
ou esul s could be ex apola ed only o simila clinical
samples. As Hughes e al. [42] and Le S a e al. [43]
poin ou , he esul s ob ained in s udies wi h smoke s
who seek ea men a e no gene alizable o smoke s o
he gene al popula ion due o he pa icula cha ac e is ics
o pe sons who seek ea men . Thus, i would be
necessa y o conduc s udies ou o clinical samples
o know how esul s would be. Secondly, he ins umen
used o he assessmen o pe sonali y pa e ns, he
MCMI-III, is based on a speci ic heo e ical pe spec i e.
Theodo e Millon’s pe sonali y model has la ge numbe s o
bo h ad oca es and de ac o s, bu despi e i s c i ics
i is one o he mos widely used wi h clinical popula ion
in he s udy o pe sonali y [44,45]. Howe e , o ou
knowledge, his is he i s s udy which examines he
ela ionship be ween pe sonali y acco ding o Millon’s
model and smoking cessa ion ou comes in a la ge clinical
sample, aking in o accoun he con ibu ion o gende o
his ela ionship.
Conclusions
In summa y, as a as we know, his is he i s s udy which
examines he ela ionship be ween Millon’spe sonali y
pa e ns and smoking s a us in a clinical sample aking
in o accoun he in luence o gende . Ou esul s show
ha he pe sonali y pa e ns o men and women who seek
ea men o qui smoking a e di e en , and also ha he e
a e signi ican di e ences be ween pe sonali y pa e ns
and nico ine dependence and hei in luence on ea men
ou comes by gende . Howe e , only nico ine dependence
had a signi ican ole in p edic ing con inuous abs inence
a he 12-mon h ollow-up. Bu as Ma que a e al. [46]
indica e, al hough he gende a iable may no explain
much in he models p edic ing he esul s o smoking
cessa ion in e en ions, i should be aken in o accoun
o wo easons. Fi s , because gende is ela ed o a de e -
minan ac o o ea men success, which is nico ine
dependence. And second, because he pe sonali y p o iles
o smoke s who seek ea men o smoking cessa ion a e
di e en in men and in women. Be lin e al. [36]
e en p opose designing speci ic in e en ions o men
and women, so ha we would ha e o ake in o accoun
hei cha ac e is ics i we a e o imp o e smoking
cessa ion ou comes.
Piñei o e al. BMC Public Heal h 2013, 13:306 Page 8 o 10
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Compe ing in e es s
The au ho s decla e ha hey ha e no compe ing in e es s.
Au ho ’s con ibu ions
BP, EB designed he s udy and w o e he p o ocol. BP, ALD, EFR, UM
conduc ed li e a u e sea ches and p o ided summa ies o p e ious esea ch
s udies. BP, ALD, EFR, UM conduc ed he s a is ical analysis. BP, ALD, EFR
w o e he i s d a o he manusc ip , and all au ho s con ibu ed o and
ha e app o ed he inal manusc ip .
Acknowledgemen s
Funding o his s udy was p o ided by he Spanish Minis y o Science and
Inno a ion (Minis e io de Ciencia e Inno ación) (Na ional Basic Resea ch
P ojec s). P ojec e e ence: PSI2008-02597/PSIC. Bá ba a Piñei o is he
bene icia y o a P e-Doc o al Resea ch T aining G an (FPI) om he Minis y
o Science and Inno a ion; e e ence BES-2009-012929.
Au ho de ails
1
Smoking Cessa ion Uni , Depa men o Clinical Psychology and
Psychobiology, Facul y o Psychology, Uni e si y o San iago de Compos ela,
San iago de Compos ela, Spain.
2
Depa men o Psychology and Sociology,
Uni e si y o Za agoza, Za agoza, Spain.
Recei ed: 8 Janua y 2013 Accep ed: 28 Ma ch 2013
Published: 8 Ap il 2013
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