All ETDs from UAB

Advisory Committee Chair

Peter S Hendricks

Advisory Committee Members

William C Bailey

Susan Davies

Burel Goodin

Suzanne Judd

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Public Health


Introduction: The substantial death toll from smoking combined with the low success rates of current treatment approaches warrants further investigation into mechanisms that promote cessation. While the role of negative affect has been studied extensively in relationship to smoking cessation, the role of psychological well-being (PWB; e.g., life satisfaction, optimism, positive affect, purpose in life, resilience) has received little attention. Treatment outcomes might improve with a better understanding of PWB’s role in smoking cessation. Methods: Relationships between smoking and PWB were examined in three studies. First, using panel data from the biennial, longitudinal Health and Retirement Study, I developed separate cross-lagged models examining the relationships between smoking status in 2006 and PWB in 2010 and of PWB in 2006 with smoking status in 2010. Second, using data collected from a pilot study of withdrawal regulation training for smoking cessation, I used logistic regression to model the effects of 1) baseline optimism and 2) the change in optimism on cessation outcomes at the three month follow-up. Third, using data from the same pilot study, Generalized Estimating Equations modeled the role of resilience in withdrawal symptom variation over time. Results: For the first study, greater life satisfaction, optimism, and positive affect in 2006 predicted a reduced likelihood of smoking in 2010. Being a smoker in 2006 predicted lower life satisfaction, lower optimism, and lower purpose in life in 2010. For study two, analyses showed no statistically significant relationship between pre-treatment optimism levels and smoking cessation. Alternatively, an increase in optimism from baseline to two month follow-up was associated with an increased likelihood of abstinence at three month follow-up. For study three, the resilience scales Planned Future and Structured Style were found to be psychological predictors of withdrawal symptoms, such that greater resilience predicted reduced withdrawal symptom severity. Conclusions: These initial findings that greater PWB reduces the likelihood of smoking and smoking reduces PWB, that an increase in optimism is associated with cessation outcomes, and that greater resilience may buffer against withdrawal symptoms warrant further exploration into the associations between PWB and smoking. Existing treatments may benefit from incorporating PWB-boosting components.

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