Identification of the healthy neurotic: Personality traits predict smoking after disease onset

• We examine the interaction of conscientiousness and neuroticism on smoking.
• We examine smoking in older adults, before the onset of a major disease and after.
• Conscientiousness and neuroticism predict smoking in the general sample.
• Healthy neuroticism predicts the least smoking after the onset of several diseases.
• The interaction is not present generally or before the onset of disease.

Personality traits are known predictors of health behaviors and health status. However, most of this work focuses exclusively on how personality influences health outcomes rather than how personality influences response to disease. Using a large, national study (N = 7051), we investigated whether conscientiousness and neuroticism were associated with smoking behavior after the onset of a disease. After the onset of a major chronic disease, high levels of neuroticism predicted less smoking when paired with high levels of conscientiousness, a combination described as healthy neuroticism. Healthy neuroticism only predicted smoking behavior after the onset of disease, not before, suggesting that the relationship between personality and responses to health problems differs from the relationship between personality and the onset of health problems.