A study of a million UK women, published in The Lancet, has shown that happiness itself has no direct effect on mortality, and that the widespread but mistaken belief that unhappiness and stress directly cause ill health came from studies that had simply confused cause and effect. Life-threatening poor health can cause unhappiness, and for this reason unhappiness is associated with increased mortality. In addition, smokers tend to be unhappier than non-smokers. However, after taking account of previous ill health, smoking, and other lifestyle and socio-economic factors, the investigators found that unhappiness itself was no longer associated with increased mortality. The lead author, Dr Bette Liu, now at the University of New South Wales, Australia said: ‰ÛÏIllness makes you unhappy, but unhappiness itself doesn‰Ûªt make you ill.‰Û The main analyses included 700 000 women, average age 59 years, and over the next 10 years these women were followed by electronic record linkage for mortality, during which time 30 000 of the women died. After allowing for any differences already present in health and lifestyle, the overall death rate among those who were unhappy was the same as the death rate among those who were generally happy. Co-author Professor Sir Richard Peto, of the University of Oxford, Oxford, UK said: ‰ÛÏMany still believe that stress or unhappiness can directly cause disease, but they are simply confusing cause and effect.” I’d be interested in the push-back people give on this. I believe that stress does cause inflammation in the body, which can lead to disease. I think it helped hasten my sister’s death after she was diagnosed with lung cancer. Of course then there is my mom, a smoker up until a few months ago, unhappy as can be, and still going strong at 94, living in an independent living community. Go figure.