A comparison of personality types considering tobacco use.

Abstract: Tobacco-related health problems are due, in part, to the outcome of the personal choice of the individual. This study investigated the relationship between psychological types, as determined by the Myers-Briggs Type Indicator (MBTI), and tobacco use among young adults. A cross-sectional survey of 1,029 university students using the MBTI and the Tobacco Use Inventory yielded psychological type and tobacco use data. Results suggest there exist several psychological types that have a higher than expected association with tobacco use than other types. Use of the MBTI may provide insight into disease prevention efforts regarding the impact of personality on tobacco use prevention.

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College students have received recent renewed attention regarding the rise in prevalence and incidence of tobacco use (Moskal, Dziuban, & West, 1999). While tobacco use prevalence overall appears to be on the decline, the same cannot be said about young adult tobacco use (USDHHS, 1998; Schorling, Gutgesell, Klas, Smith, & Keller, 1994). Wechsler, Rigotti, Gledhill-Hoyt and Lee (1998) found that, although college students have appeared more resistant than other young adults, tobacco use is definitively on the rise on college campuses in all subgroups and types of colleges. In addition to the rise of cigarette smoking prevalence, smoking initiation is a concern as at least 11% of college students are beginning to smoke while in college, almost one third of college students had smoked cigarettes daily at least some time during their lives, almost 30% were current cigarette smokers, and 16.5% were currently frequent cigarette smokers (Douglas, Collins, Warren, Kann, Gold, Clayton, Ross, & Kolbe, 1997).

Tobacco use is associated with a number of diseases and is linked with more deaths in the United States than any other risk factor (USDHHS, 1994). The most significant diseases associated with smoking are lung cancer and coronary heart disease. Tobacco-related health problems are due, in part, to the outcome of the personal choice of the individual. Social, demographic, and attitudinal factors also play a role. However, the choice a person makes is greatly influenced by his or her personality (Bearinger & Blum, 1997; House, Shane, Herrold, 1996; Pinkerton, 1995).

Personality appears to play a key role regarding the tobacco use behavior of young adults. Eysenck (1991) suggested personality is critical to understanding the nature of tobacco use status. Lynch (1995) proposed that the failure of anti-tobacco use programs may have been inevitable by not considering intrinsic psychological factors due to the prevailing assumptions that young adults are driven solely by extrinsic and social factors when choosing to smoke or not to smoke. The Myers Briggs Type Indicator (MBTI), a personality composite based upon Jung's (1971) theory of personality, assesses basic preferences rather than traits. Although the MBTI has been utilized in previous health behavior research (Newman, 1979; Fyfe, Carskadon, & Thorne, 1986; Gross, 1995; Roberts & Roberts, 1988 Anchors & Dana, 1989), there appears to be a lack of research with regard to the practical application of Jung's theory in the form of the 16 MBTI psychological types and tobacco use behavior. Therefore, the purpose of the study was to investigate the relationship of personality types, as measured by the MBTI, and tobacco use among college students.

METHODS

The study sample of 1,085 college students was recruited from 8 pre-selected Georgia colleges and universities. Although all completed the Myers-Briggs Type Indicator and the Tobacco Use Inventory, 56 surveys were eliminated because they were not properly completed or did not qualify for analysis based upon the age restriction (only students aged 18-24 included), yielding a sample of 1,029 for analysis. The schools represent a purposively selected, cross-section of Georgia's higher education institutions. Of the schools, five are public institutions and three are private. Regarding school enrollment, there was one large school (more than 10,000 enrolled), three medium-sized schools (5,000 to 10,000 students), and four small schools (5,000 or fewer students) represented in this study. Half of the schools are located in an urban or suburban setting with the remainder in a small town or rural setting. Two of the schools have a religious affiliation.

All of the subjects were volunteers and enrolled in their respective college or university at the time of data collection during the fall semester of 1998. The students were from 32 intact personal wellness classes or introductory psychology classes. The instructor from each class read the instructions, communicated the purpose of the study and that no credit or penalty was given for participation or lack thereof, and collected the survey data. All enrolled students who were present the day of the survey administration completed the questionnaires. Documentation procedures of review and approval of research for the protection of human subjects were obtained.

MEASURES

The MBTI, Form G, was used to collect information about psychological type. Form G consisted of 126 forced-choice self-report items taken from all four preference scales and mixed together in the questionnaire. The aim of the MBTI is to determine which of the two extreme functions or attitudes is preferred. The forced-choice format is used with each item presented separately and each pole representing a dichotomous extreme for one attitude or function. Conversion of type and preference scores into a single value is generally thought to violate the basic premises of Jungian theory. However, it is a generally accepted practice, as shown by Carlson (1985) who assessed the reliability and validity of two dozen research studies.

Split-half reliability coefficients (Pearson r's) were reported as generally exceeding 0.80 (Carlyn, 1977). Other researchers examined the test-retest reliability studies and concluded that scores seemed to be reasonably stable over time in terms of type classification (Salter, Evans, & Forney, 1997). After a five-week interval, the reliabilities of test-retest continuous scores for the MBTI ranged from 0.78 to 0.87 and did not demonstrate a significant difference as a result of mood manipulations (Carskadon, 1979). Johnson and Saunders (1990) performed a confirmatory factor analysis using the LISREL computer program on MBTI scores from 500 adults. Results, cross validated with 500 other scores, supported the four factors as well-defined. Available research studies on the reliability of the MBTI have shown satisfactory internal consistency of the four scales and satisfactory stability of scores across several months (Steele & Kelly, 1976).

Regarding construct validity, researchers generally concur that the MBTI does adequately represent Jung's theoretical constructs (Carlyn, 1977; Steele & Kelley, 1976). Inter-test correlations with other personality measures have mainly concentrated on the El scale of the four scales (e.g., Eysenck's Personality Questionnaire and Rotter's locus of control scale)(Carlson, 1985). Mendelsohn (1975) concluded that the MBTI scores related meaningfully to variables of personality, interest, and behavior ratings among others. In general, the MBTI has been consistently validated as an instrument that has value as a research procedure for assessing individual differences (Carlson, 1985; Carskadon & Cook, 1982).

The Tobacco Use Inventory questions were adopted from the 1995 National College Health Risk Behavior Survey as designed by the Division of Adolescent and School Health, a division of the National Center for Chronic Disease Prevention and Health Promotion of the Centers for Disease Control and Prevention (Douglas et al., 1997). Eight questions regarding tobacco use were selected in order to measure smoking status, levels and frequencies of smoking, and age of initiation.

TREATMENT OF DATA

Data collected were entered into the SPSS computer program. Subjects were categorized into different groups in terms of MBTI type and smoking status. A total of 16 psychological types was generated by the MBTI inventory and used as the independent variable. Levels of tobacco use were defined as follows: nonsmokers -- subjects who never smoked or smoked less than 100 cigarettes in entire life, smokers -- subjects who had ever smoked cigarettes on more than one of the 30 days preceding the survey (USDHHS, 1998). Former smokers are included in the group with smokers as this purpose of this exploratory study is to investigate the proportion of smokers (including those who ever smoked) and nonsmokers relative to their MBTI type.

Thus, the hypothesis derived is that there is no difference between young adult smokers and nonsmokers concerning psychological types. To test this hypothesis, a 2 x 16 contingency table was created and chi-square test was used as the data is represented by unordered numeric categorical variables. The results revealed the proportion of smokers and nonsmokers relative to personality types. Since chi-square analysis requires a minimum of 5 cell members, selected variables were grouped for meaningful analysis. Type of institution (size, location, and 2 or 4 year), smokers (current and former), and gender were grouped together in order to provide an acceptable cell member amount.

RESULTS

Respondents ranged in age from 18 to 24 years, with a mean of 19.85 years (SD = 1.86 yrs.), a median of 19 years and a mode of 18 years. The sample consisted of an approximately equal number of men and women. The gender distribution of the subjects comprised 52% females and 48% males. Race/ethnicity characteristics of the subjects were as follows: Caucasian (82.9%), African American/black (14.0%), Hispanic/Latino (1.6%), Asian or Pacific Islander (0.8%), and American Indian (0.8%).

Among the study participants, the most prevalent MBTI types were Extraversion-Sensing-Feeling-Perceiving [ESFP] (18.7%) and Extraversion-Sensing-Thinking-Perceiving [ESTP] (12.0%)(Table 1). The percentage distribution of psychological types for this sample was not significantly different from a large national sample of college students (Myers & McCaulley, 1985).

Regarding smoking status, 43.4% of the students reported to be smokers and 56.6% indicated they were nonsmokers. With respect to age of smoking onset, 7.4% initially smoked at age 12 or younger, 14.8% started smoking at age 13 or 14, 18.3% began smoking at age 15 or 16, 17% reported smoking onset at age 17 or 18, 3.4% began smoking at age 19 or 20, and 1.2% indicated smoking onset at age 21 to 24. It is critical to note that nearly 22% of students aged 17 to 24 reported smoking for the first time.

Concerning the difference between smokers and nonsmokers based upon their MBTI type, there appeared to be certain MBTI types that were overrepresented and underrepresented for both smokers and nonsmokers. The discrepancy was statistically significant [X.sup.2](15, N = 1029) = 48.34, p < .001), and therefore, rejected the hypothesis. The MBTI types Introversion-Sensing-Thinking-Judging [ISTJ], Introversion-Intuitive-Thinking-Perceiving [INTP], and Extraversion-Intuitive-Thinking-Perceiving [ENTP] appeared to contribute more to the sum of calculations when computing the chi-square. These three types contributed 67.8% of the overall chi-square value. Specifically, ISTJ represented half as many smokers as expected and slightly greater than one and one third more nonsmokers than expected. For INTP, there were 1.71 times as many smokers and 0.44 times as many nonsmokers as expected. Similar to ISTJ, MBTI type ENTP was underrepresented by smokers (0.52 as many) and over represented by nonsmokers (1.38 as many).

DISCUSSION

Since this appears to be the initial study investigating personality type as measured by the MBTI and smoking, it is consistent with the nature of exploratory studies to investigate the selected variables with a broader, more general approach. As such, the variable smokers included both current smokers and former smokers. Smokers were defined as current cigarette users, or subjects who had smoked cigarettes on more than one of the 30 days preceding the survey and former smokers, or subjects who reported being abstinent from smoking for at least one year. Nonsmokers were defined as subjects who never smoked or smoked less than 100 cigarettes in their entire life (USDHHS, 1998). Evidence of a relationship between certain MBTI types and tobacco use opens the door for more scrutiny of this association. Still, a brief explanation of the overall chi-square results is warranted. What is it about certain MBTI types that have higher levels than expected of smokers or nonsmokers?

When considering type ISTJ, the question of what influence did sensing (S), thinking (T), or judging (J) have regarding a person's choice to not smoke must be asked. Regarding the SN preference, those who preferred sensing are observant, more conscious of the external environment as opposed to intuitive types, who are more imaginative at the expense of observation. Sensing types are imitative, desiring to have what other people have and do what other people do, and are very dependent on their physical surroundings (Myers, 1993). If cigarette smoking presented an undesirable present atmosphere (smell and taste), it might be logical that a person with ISTJ would resist smoking.

The introverted sensing type (ISTJ) represented a person who is oriented toward introversion, and had dominant functioning via sensing due to his or her preference in dealing with the outside world, i.e., judging. Persons with this type are understood to have solid and evident virtues, absorb, and are able to enjoy using an immense number of facts, emphasize logic, analysis, and decisiveness. Interpreted in this manner, when an ISTJ considers the inordinate prevalence of information regarding smoking and disease, it is plausible that ISTJ would tend to be associated with those who choose to not smoke.

What is it about ENTP that indicates a higher than expected number of smokers? Persons who prefer NT (INTP, ENTP) focus on possibilities by developing theoretical concepts while at the same time they tend to be analytical and logical. These persons might be those who tend to rebel against the facts regarding smoking and health (White, Hill, & Hopper, 1996). While this might help to explain the association of INTP and smoking, it does not do so for the association of ENTP and a lower than expected number of smokers. Another combination of preferences to consider is direction of energy (E or I) and external orientation (J or P). The combinations of EP, characterized as adaptable extraverts, tend to be sociable, deal with change readily, and seek new experiences (Myers, 1993). Interpreted one way, an ENTP who is sociable and ready for change might be extremely perceptive to the views of others.

This contradictory nature of ENTP might be reasonable and even expected. Extraverted intuitives (such as ENTP) are hard to describe because of their infinite variety, yet are stubbornly loyal to their guiding principle. An extraverted intuitive possesses a sense of originality and independence strong in initiative and creative impulse. It might be these characteristics that provide a kind of resistance to uptake of smoking. This understanding of type ENTP would lend insight to the present findings. However, there is clearly another way to interpret this finding. The independent nature of an ENTP, combined with creative impulsiveness, may also be understood as being bold, even rebellious, a personality characteristic often associated with smoking (White, Hill, & Hopper, 1996).

Preference for coping strategies might influence smoking behavior. Some persons chose negative coping strategies, such as smoking, to deal with stressful situations and some used more positive strategies. With regard to psychological type and ways of coping, Stevens (1994) found that EN used more positive reappraisal as a coping strategy more so than did IN. This might help explain why there was a greater association of smoking with type INTP and a lower association of smoking for ENTP. For example, when confronted with a stressful situation, a person with type ENTP might select a positive coping strategy, such as positive reappraisal, whereas a person with type INTP might not select a positive coping strategy and choose to smoke.

The findings of this exploratory study emphasize the need for continued attention to the potential impact of personality and tobacco use. A cautionary note reminds the reader that since age, gender, and type of institution were grouped, future research should also investigate the effect of variables such as gender, younger college students versus older college students, socioeconomic status, race/ ethnicity, parental tobacco use, and how personality type interacts with these social and personal factors. In the college setting, students may be susceptible to new peer and adult influences to tobacco use: therefore, it would also be useful to focus on the choice of initiation. Another approach to clarifying the relationship between personality and tobacco use would be to target certain psychological types and preferences and present their tobacco use behaviors and levels of use in more detail. This type of research would help to identify and corroborate which tobacco use prevention approaches are effective with particular psychological types.

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Terrence P. O'Toole, MDiv, Ph.D. is an Assistant Professor in the Department of Physical Education and Recreation at the State University of West Georgia and Mohammad R. Torabi, Ph.D., MPH, is Professor and Chair of the Department of Applied Health Science at Indiana University. Address all correspondence to Dr. O'Toole at the Department of PER; State University of West Georgia; Carrollton, GA 30118. Email: [e-mail].