title: The association of affective temperaments with smoking initiation and maintenance in adult primary care patients.
abstract: BACKGROUND
  Smoking behaviour and its course is influenced by personality factors. Affective temperaments could allow a more specific framework of the role trait affectivity plays in this seriously harmful health-behaviour. The aim of our study was to investigate if such an association exists in an ageing population with a special emphasis on gender differences.
  
  
  METHODS
  459 primary care patients completed the TEMPS-A, Beck Depression Inventory (BDI) and Hamilton Anxiety Rating Scale (HAM-A). Subjects were characterized according to their smoking behaviour as current, former or never smokers. Univariate analysis ANOVA and logistic regression were performed to analyse differences in the three smoking subgroups to predict smoking initiation and maintenance.
  
  
  RESULTS
  Current smokers were younger and less educated than former or never smokers. Males were more likely to try tobacco during their lifetime and were more successful in cessation. Depressive, cyclothymic and irritable temperament scores showed significant differences between the three smoking subgroups. Irritable temperament was a predictor of smoking initiation in females whereas depressive temperament predicted smoking maintenance in males with a small, opposite effect of HAM-A scores independent of age, education, lifetime depression and BDI scores. Whereas smoking initiation was exclusively predicted by a higher BDI score in males, smoking maintenance was predicted by younger age and lower education in females.
  
  
  CONCLUSIONS
  The cross-sectional nature of the study design may lead to selective survival bias and hinder drawing causal relationships.
  
  
  CONCLUSIONS
  Affective temperaments contribute to smoking initiation and maintenance independently of age, education, and depression. The significant contribution of depressive temperament in males and irritable temperament in females may highlight the role of gender-discordant temperaments in vulnerable subgroups.
authors.affiliation: Department of Family Medicine, Semmelweis University, 4 Kutvolgyi Street, Budapest H-1125, Hungary. Electronic address: ajandekeory@gmail.com.
authors.forename: Ajandek
authors.initials: A
authors.lastname: Eory
authors.affiliation: Center for Well-Being, Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States; Department of Personality and Health Psychology, Eötvös Loránd University, Budapest, Hungary.
authors.forename: Sandor
authors.initials: S
authors.lastname: Rozsa
authors.affiliation: Department of Clinical and Theoretical Mental Health, Kutvolgyi Clinical Center, Semmelweis University, Budapest, Hungary; Department of Pharmacodymanics, Semmelweis University, Budapest, Hungary; Laboratory for Suicide Research and Prevention, National Institute of Psychiatry and Addictions, Budapest, Hungary.
authors.forename: Xenia
authors.initials: X
authors.lastname: Gonda
authors.affiliation: Department of Clinical and Theoretical Mental Health, Kutvolgyi Clinical Center, Semmelweis University, Budapest, Hungary; Laboratory for Suicide Research and Prevention, National Institute of Psychiatry and Addictions, Budapest, Hungary.
authors.forename: Peter
authors.initials: P
authors.lastname: Dome
authors.affiliation: Department of Family Medicine, Semmelweis University, 4 Kutvolgyi Street, Budapest H-1125, Hungary.
authors.forename: Peter
authors.initials: P
authors.lastname: Torzsa
authors.affiliation: International Mood Center, University of California, San Diego, CA, USA.
authors.forename: Tatevik
authors.initials: T
authors.lastname: Simavorian
authors.affiliation: 3rd Department of Psychiatry, Division of Neurosciences, School of Medicine, Aristotle University of Thessaloniki, Greece.
authors.forename: Konstantinos N
authors.initials: KN
authors.lastname: Fountoulakis
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant׳Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Pompili
authors.affiliation: Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Center, Sant׳Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Serafini
authors.affiliation: International Mood Center, University of California, San Diego, CA, USA.
authors.forename: Knarig K
authors.initials: KK
authors.lastname: Akiskal
authors.affiliation: International Mood Center, University of California, San Diego, CA, USA.
authors.forename: Hagop S
authors.initials: HS
authors.lastname: Akiskal
authors.affiliation: Department of Clinical and Theoretical Mental Health, Kutvolgyi Clinical Center, Semmelweis University, Budapest, Hungary; Laboratory for Suicide Research and Prevention, National Institute of Psychiatry and Addictions, Budapest, Hungary.
authors.forename: Zoltan
authors.initials: Z
authors.lastname: Rihmer
authors.affiliation: Department of Family Medicine, Semmelweis University, 4 Kutvolgyi Street, Budapest H-1125, Hungary.
authors.forename: Laszlo
authors.initials: L
authors.lastname: Kalabay
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D015982:Bias; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D007508:Irritable Mood; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications*; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D057566:Self Report; D012737:Sex Factors; D012907:Smoking / Q000523:psychology*; D013694:Temperament
keywords: Affective temperament; Mood disorder; Sex; Smoking