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Relationship between meaning in life and smoking status: Results of a national representative survey
Addictive Behaviors 34 (2009) 117–120
Contents lists available at ScienceDirect
Addictive Behaviors
Short communication
Relationship between meaning in life and smoking status: Results of a national representative survey Barna Konkolÿ Thege a,b,⁎, Yaacov G. Bachner a, Talma Kushnir a, Maria S. Kopp b a b
Department of Sociology of Health, Ben-Gurion University of the Negev, P.O.B. 653, 84105 Be'er Sheva, Israel Institute of Behavioral Sciences, Semmelweis University, Nagyvárad tér 4. XX. em., H-1089 Budapest, Hungary
a r t i c l e
i n f o
Keywords: Smoking status Meaning in life Gender National representative sample Hungary
a b s t r a c t Very little is known about the association between cigarette use and perceived level of meaning in life, although the connection of other addictive behaviors with the feeling of meaninglessness has been widely investigated. The aim of the present study was to examine the relationship between life meaning and smoking status in a large national representative sample. A total of 12,643 people were interviewed in the Hungarostudy 2002 survey, representing the Hungarian population according to gender, age, and sub-regions of the country. Multinomial logistic regression analysis showed that meaning in life scores significantly differentiated between current and never smokers, as well as between current and former smokers. In addition, the difference in life meaning scores between never and ex-smokers was insignificant, and gender did not interact with life meaning in relation to smoking status. Further research is needed to clarify the nature and mediators of the observed relationship between life meaning and smoking in order to better understand the role of existential concerns in cigarette use. © 2008 Elsevier Ltd. All rights reserved.
1. Introduction Smoking is an established risk factor for several serious diseases and it also increases the incidence of minor complaints; therefore, it is one of the most important public health problems, particularly in Europe, where the highest cigarette consumption was observed among the WHO regions (WHO, 2003). A better understanding of factors predicting smoking may be useful in developing public health interventions to reduce nicotine use. One potential factor, that has already been found to be associated with several addictive behaviors (for review, see Batthyany & Guttmann, 2006), is decreased level of meaning in life. Issues considered integral to life meaning are having a sense of clear aims, a sense of achieving life goals, and a feeling that one's experiences and daily activities are worthwhile and meaningful. Having a weaker sense of meaning and purpose in life results in an increased proneness to boredom (Melton & Schulenberg, 2007) and an enlarged sensitivity to societal pressures (cf. Frankl, 1946/2006), hereby raising the probability of cigarette use, especially in those societies where the attitudes toward smoking are still relatively permissive or encouraging. To date, most of the studies investigating the association between life meaning and substance use have concentrated on harmful alcohol consumption and illicit drug use giving little attention to the relationship between meaning in life and cigarette use. However, previous studies on this latter question confirmed that smoking was also a correlate of a weaker sense of meaning in life (Brassai & Pikó, 2007; Konkolÿ Thege, 2006; Konkolÿ Thege, Bachner, Martos, & Kushnir, in press). Although these examinations utilized several life meaning measures, including the most often used scale of meaning in life: the Purpose in Life Test as well, the ecological validity of the findings is still uncertain because of the relatively small convenience samples employed in these investigations.
⁎ Corresponding author. Institute of Behavioral Sciences, Semmelweis University, Nagyvárad tér 4., XX. em., H-1089 Budapest, Hungary. Tel.: +36 1 210 2953; fax: +36 1 210 2955. E-mail addresses: [email protected] (B. Konkolÿ Thege), [email protected] (Y.G. Bachner), [email protected] (T. Kushnir), [email protected] (M.S. Kopp). 0306-4603/$ – see front matter © 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.addbeh.2008.09.001
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B. Konkolÿ Thege et al. / Addictive Behaviors 34 (2009) 117–120
The aim of the present study was to examine, in a large representative sample, whether meaning in life is associated with smoking status even after controlling for numerous previously identified predictors of cigarette use. According to existential theorists, addictive behaviors are maladaptive ways of coping with—among other difficulties—meaninglessness in life. We hypothesized, therefore, that current smokers would have lower meaning in life scores compared to never and former smokers, and further that the perceived meaning in life of individuals who never smoked cigarettes and of those quitting smoking would not differ. Given that several investigations show that the patterns of the relationships between meaning in life and health risk behaviors can be different for males and females (e.g., Harlowe, Newcomb, & Bentler, 1986), the interaction between meaning in life and gender in predicting smoking status was also examined. 2. Method 2.1. Sample and procedure The Hungarostudy 2002 is a cross-sectional survey of the mental and physical health status of Hungarian adults, representing the population according to gender, age and the 150 sub-regions in the country. The sampling methods are described in detail elsewhere (Rózsa et al., 2003; Skrabski, Kopp, Rózsa, Réthelyi, & Rahe, 2005). Altogether 12,643 persons (44.8% male, 55.2% female) were interviewed in their homes in 2002. Characteristics for the study sample, stratified by smoking status, are summarized in Table 1. 2.2. Measures Besides demographic characteristics (gender, age, education, and marital status), data about smoking status (never, former, and current), life-time drug use (yes or no), coffee consumption (cups per day), alcohol abuse, depressive symptomatology, general wellbeing and meaning in life were included in the present analyses. Alcohol misuse was measured by the Hungarian version (Gerevich, Bácskai, & Rózsa, 2006) of the Alcohol Use Disorder Identification Test (AUDIT). Depressive symptomatology was assessed by a shortened version (Rózsa, Szádóczky, & Füredi, 2001) of the Beck Depression Inventory (α = .86), while well-being was measured by the five-item version (Susánszky, Konkolÿ Thege, Stauder, & Kopp, 2006) of the WHO Well-Being Index (α = .85). In a large representative survey using a great variety of psychosocial variables, there is little chance to use long and complex instruments like the Purpose in Life Test. Therefore, in this study, the easy to understand six-item Life Meaning Subscale (Konkolÿ Thege, Martos, Skrabski, & Kopp, 2008) from the Brief Stress and Coping Inventory (Rahe & Tolles, 2002; Rózsa et al., 2005) was administered to assess meaning in life (α = .69). 2.3. Statistical analyses At the univariate level, the chi-square test was used to analyze the categorical independent variables, and the Kruskal–Wallis test was performed for continuous data because of their non-normal distribution. Significant correlates of smoking status and the gender-meaning in life interaction were analyzed by multinomial logistic regression. 3. Results At the univariate level, all independent variables, except depressive symptomatology and well-being, were significantly associated with smoking status (Table 1). Table 2 presents the results of the first multinomial logistic regression (Cox & Snell Table 1 Characteristics of the sample, stratified by smoking status, and bivariate associations between smoking and the independent variables
N Gender Male Female Age Education (1–6) Marital status Single Married/cohabitated Divorced/widowed Life-time drug use No Yes Hazardous drinking (0–40) Coffee consumption (cups per day) Well-being (0–15) Depressive symptoms (0–27) Meaning in life (0–12) NS
non-significant; ‡p b .1; ⁎⁎⁎p ≤ .001.
Never
Former
Current
6678 (53.7)
2245 (18.1)
3506 (28.2)
2226 (33.4) 4443 (66.6) 49.8 (19.3) 3.5 (1.6)
1397 (62.3) 845 (37.7) 49.6 (16.8) 3.6 (1.4)
1940 (55.4) 1563 (44.6) 42.2 (14.2) 3.3 (1.3)
1278 (19.2) 3775 (56.6) 1613 (24.2)
271 (12.1) 1591 (71.0) 379 (16.9)
684 (19.5) 2192 (62.6) 624 (17.8)
6372 (99.0) 62 (1.0) 1.7 (2.7) 1.0 (1.0) 7.7 (3.8) 3.6 (4.6) 8.0 (2.6)
2104 (97.7) 50 (2.3) 3.2 (3.6) 1.4 (1.2) 7.8 (3.7) 3.6 (4.4) 7.9 (2.5)
3234 (95.7) 147 (4.3) 3.7 (4.3) 2.1 (1.6) 7.7 (3.7) 3.6 (4.5) 7.5 (2.6)
Difference χ2 = 788.3⁎⁎⁎ K.–W.-χ2 = 400.3⁎⁎⁎ K.–W.-χ2 = 34.0⁎⁎⁎ χ2 = 179.1⁎⁎⁎
χ2 = 120.2⁎⁎⁎ K.–W.-χ2 = 963.3⁎⁎⁎ K.–W.-χ2 = 1190.8⁎⁎⁎ K.–W.-χ2 = 0.9NS K.–W.-χ2 = 5.8‡ K.–W.-χ2 = 105.2⁎⁎⁎
B. Konkolÿ Thege et al. / Addictive Behaviors 34 (2009) 117–120
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Table 2 Results of the first multinomial logistic regression predicting smoking status
Gender Male Female Age Education Marital status Single Married/cohabitated Divorced/widowed Life-time drug use No Yes Hazardous drinking Coffee consumption Meaning in life NS
Never vs. current OR (95% CI)
Former vs. current OR (95% CI)
Former vs. never OR (95% CI)
0.59 (0.52–0.66)⁎⁎⁎ 1.00 1.03 (1.03–1.04)⁎⁎⁎ 1.18 (1.14–1.22)⁎⁎⁎
1.60 (1.40–1.83)⁎⁎⁎ 1.00 1.03 (1.03–1.04)⁎⁎⁎ 1.19 (1.14–1.24)⁎⁎⁎
2.74 (2.42–3.09)⁎⁎⁎ 1.00 1.00 (0.99–1.00)NS 1.01 (0.97–1.05)NS
2.01 (1.66–2.43)⁎⁎⁎ 1.23 (1.08–1.41)⁎⁎ 1.00
1.11 (0.87–1.42)NS 1.47 (1.24–1.73)⁎⁎⁎ 1.00
0.55 (0.44–0.69)⁎⁎⁎ 1.19 (1.03–1.38)⁎ 1.00
2.91 (2.08–4.08)⁎⁎⁎ 1.00 0.87 (0.86–0.89)⁎⁎⁎ 0.53 (0.51–0.55)⁎⁎⁎ 1.06 (1.04–1.08)⁎⁎⁎
1.16 (0.82–1.65)⁎⁎⁎ 1.00 0.95 (0.93–0.96)⁎⁎⁎ 0.71 (0.67–0.74)⁎⁎⁎ 1.04 (1.02–1.07)⁎⁎⁎
0.40 (0.27–0.60)⁎⁎⁎ 1.00 1.09 (1.07–1.11)⁎⁎⁎ 1.33 (1.27–1.39)⁎⁎⁎ 0.98 (0.96–1.01)NS
non-significant; ⁎p b .05; ⁎⁎p b .01; ⁎⁎⁎p ≤ .001.
Pseudo R2 = .229; p b .001). Meaning in life scores significantly differentiated between current and never smokers, as well as between current and former smokers, even after controlling for the covariates (p b .001). The difference in life meaning scores between never and ex-smokers was insignificant (p = .127). Entering the interaction term based on gender and life meaning in a second regression, the explanatory power of the model did not improve, and the interaction term was insignificant in the current vs. never, as well as the current vs. former and the former vs. never smoker relations (p = .653, p = .108 p = .173, respectively). 4. Discussion The purpose of this study was to determine if meaning in life is a significant correlate of smoking status and whether gender moderates this association. This is the first study investigating the relationship between life meaning and smoking using a large representative sample. Consistent with our assumptions and the previous findings, the results show that having a stronger sense of meaning in life is related with a somewhat decreased likelihood of being a smoker, even after controlling for several other predictors of cigarette use. In addition, former and never smokers did not differ in their sense of life meaning indicating that quitting smoking may co-occur with the easing of existential tensions. The interaction between life meaning and gender was not significant in predicting smoking status, demonstrating that similarly to illicit drug use and harmful alcohol consumption, smoking can also be such a health damaging behavior for both genders that—at least partly—aims to reduce the psychological tension caused by the feeling of meaninglessness. If so, then smoking prevention and cessation programs should also include components to help individuals find satisfying life purposes and meaning in their every-day experiences (Gyamerah & Lantz, 2002). The findings presented in this paper must be interpreted in light of some limitations. Although the internal consistency of our life meaning measure proved to be quite good in several previous investigations (see Konkolÿ Thege et al., 2008), in the present study, the alpha value corresponded only to the acceptable range. In addition, the cross-sectional design of this study does not allow drawing conclusions on causality between smoking and most of the independent variables. Consequently, we also cannot exclude the possibility, that either the physiological effects or some psychosocial correlates of cigarette use affect the development of meaning in life and not the reverse as it is supposed by the existential theory. Further research with longitudinal designs is needed to shed light on the direction of the potential causal relations and mediators corresponding to the observed connection between meaning in life and smoking in order to better understand the role of existential concerns in cigarette use and to help in developing more effective smoking prevention and cessation programs. Acknowledgments The authors thank the Hungarostudy 2002 team (János Réthelyi, Adrienne Stauder, Csilla Csoboth, György Gyukits, János Lőke, Andrea Ódor, Katalin Hajdu, Csilla Raduch, András Székely, László Szűcs, Sándor Rózsa), the network of district nurses for the home interviews, Professor András Klinger for the sampling procedure, and the National Population Register for the selection of the sample. This study was supported by OTKA-73754/2008 and ETT-100/2006 grants. References Batthyany, A., & Guttmann, D. (2006). Empirical research on logotherapy and meaning-oriented psychotherapy, 1st ed. Phoenix: Zeig, Tucker & Theisen (Chapter 3). Brassai, L., & Pikó, B. (2007). Protektív pszichológiai jellemzők szerepe a serdülők egészséggel kapcsolatos magatartásában. Mentálhigiéné és Pszichoszomatika, 8, 211−227. Frankl, V.E. (2006). Man’s search for meaning (Lasch, I. Trans., 5th ed.). Boston: Bacon Press. (Original work published 1946). Gerevich, J., Bácskai, E., & Rózsa, S. (2006). A kockázatos alkoholfogyasztás prevalenciája. Psychiatria Hungarica, 21(1), 45−56.
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Gyamerah, J., & Lantz, J. (2002). Meaning, technology, and smoking cessation. International Forum for Logotherapy, 25(2), 83−88. Harlowe, L., Newcomb, M., & Bentler, P. (1986). Depression, self-derogation, substance abuse, and suicide ideation: Lack of purpose in life as a mediational factor. Journal of Clinical Psychology, 42, 5−21. Konkolÿ Thege, B. (2006). Die Beziehung zwischen existenzieller Frustration und gesundheitsschädlichem Verhalten. Existenzanalyse, 23(1), 68−72. Konkolÿ Thege, B., Bachner, Y.G., Martos, T., & Kushnir, T. (in press). Meaning in life: Does it play a role in smoking? Substance Use & Misuse. Konkolÿ Thege, B., Martos, T., Skrabski, Á., & Kopp, M. (2008). A Rövidített Stressz és Megküzdés Kérdőív élet értelmességét mérő alskálájának (BSCI-LM) pszichometriai jellemzői. Mentálhigiéné és Pszichoszomatika, 9, 243−261. Melton, A. M., & Schulenberg, S. E. (2007). On the relationship between meaning in life and boredom proneness: Examining a logotherapy postulate. Psychological Reports, 101(3 Pt 2), 1016−1022. Rahe, R. H., & Tolles, R. L. (2002). The Brief Stress and Coping Inventory: A useful stress management instrument. International Journal of Stress Management, 9(2), 61−70. Rózsa, S., Kő, N., Csoboth, Cs., Purebl, Gy., Beöthy-Molnár, A., Szebik, I., Berghammer, R., Réthelyi, J., Skrabski, Á., & Kopp, M. (2005). Stressz és megküzdés. A Raheféle Rövidített Stressz és Megküzdés Kérdőívvel szerzett hazai eredmények ismertetése. Mentálhigiéné és Pszichoszomatika, 6, 275−294. Rózsa, S., Réthelyi, J., Stauder, A., Susánszky, É., Mészáros, E., Skrabski, Á., & Kopp, M. (2003). A Hungarostudy 2002 országos reprezentatív felmérés általános módszertana és a felhasznált tesztbattéria pszichometriai jellemzői. Psychiatria Hungarica, 18, 83−94. Rózsa, S., Szádóczky, E., & Füredi, J. (2001). A Beck Depresszió Kérdőív rövidített változatának jellemzői hazai mintán. Psychiatria Hungarica, 16, 384−402. Skrabski, Á., Kopp, M. S., Rózsa, S., Réthelyi, J., & Rahe, R. (2005). Life meaning: An important correlate of health in the Hungarian population. International Journal of Behavioral Medicine, 12(2), 78−85. Susánszky, É., Konkolÿ Thege, B., Stauder, A., & Kopp, M. (2006). A WHO Jól-lét Kérdőív rövidített (WBI-5) magyar változatának validálása a Hungarostudy 2002 országos lakossági egészségfelmérés alapján. Mentálhigiéné és Pszichoszomatika, 7, 247−255. World Health Organization (2003). Tobacco control country profiles, bhttp://www.who.int/tobacco/global_data/country_profiles/Introduction.pdfN. February 21, 2008.
Contents lists available at ScienceDirect
Addictive Behaviors
Short communication
Relationship between meaning in life and smoking status: Results of a national representative survey Barna Konkolÿ Thege a,b,⁎, Yaacov G. Bachner a, Talma Kushnir a, Maria S. Kopp b a b
Department of Sociology of Health, Ben-Gurion University of the Negev, P.O.B. 653, 84105 Be'er Sheva, Israel Institute of Behavioral Sciences, Semmelweis University, Nagyvárad tér 4. XX. em., H-1089 Budapest, Hungary
a r t i c l e
i n f o
Keywords: Smoking status Meaning in life Gender National representative sample Hungary
a b s t r a c t Very little is known about the association between cigarette use and perceived level of meaning in life, although the connection of other addictive behaviors with the feeling of meaninglessness has been widely investigated. The aim of the present study was to examine the relationship between life meaning and smoking status in a large national representative sample. A total of 12,643 people were interviewed in the Hungarostudy 2002 survey, representing the Hungarian population according to gender, age, and sub-regions of the country. Multinomial logistic regression analysis showed that meaning in life scores significantly differentiated between current and never smokers, as well as between current and former smokers. In addition, the difference in life meaning scores between never and ex-smokers was insignificant, and gender did not interact with life meaning in relation to smoking status. Further research is needed to clarify the nature and mediators of the observed relationship between life meaning and smoking in order to better understand the role of existential concerns in cigarette use. © 2008 Elsevier Ltd. All rights reserved.
1. Introduction Smoking is an established risk factor for several serious diseases and it also increases the incidence of minor complaints; therefore, it is one of the most important public health problems, particularly in Europe, where the highest cigarette consumption was observed among the WHO regions (WHO, 2003). A better understanding of factors predicting smoking may be useful in developing public health interventions to reduce nicotine use. One potential factor, that has already been found to be associated with several addictive behaviors (for review, see Batthyany & Guttmann, 2006), is decreased level of meaning in life. Issues considered integral to life meaning are having a sense of clear aims, a sense of achieving life goals, and a feeling that one's experiences and daily activities are worthwhile and meaningful. Having a weaker sense of meaning and purpose in life results in an increased proneness to boredom (Melton & Schulenberg, 2007) and an enlarged sensitivity to societal pressures (cf. Frankl, 1946/2006), hereby raising the probability of cigarette use, especially in those societies where the attitudes toward smoking are still relatively permissive or encouraging. To date, most of the studies investigating the association between life meaning and substance use have concentrated on harmful alcohol consumption and illicit drug use giving little attention to the relationship between meaning in life and cigarette use. However, previous studies on this latter question confirmed that smoking was also a correlate of a weaker sense of meaning in life (Brassai & Pikó, 2007; Konkolÿ Thege, 2006; Konkolÿ Thege, Bachner, Martos, & Kushnir, in press). Although these examinations utilized several life meaning measures, including the most often used scale of meaning in life: the Purpose in Life Test as well, the ecological validity of the findings is still uncertain because of the relatively small convenience samples employed in these investigations.
⁎ Corresponding author. Institute of Behavioral Sciences, Semmelweis University, Nagyvárad tér 4., XX. em., H-1089 Budapest, Hungary. Tel.: +36 1 210 2953; fax: +36 1 210 2955. E-mail addresses: [email protected] (B. Konkolÿ Thege), [email protected] (Y.G. Bachner), [email protected] (T. Kushnir), [email protected] (M.S. Kopp). 0306-4603/$ – see front matter © 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.addbeh.2008.09.001
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B. Konkolÿ Thege et al. / Addictive Behaviors 34 (2009) 117–120
The aim of the present study was to examine, in a large representative sample, whether meaning in life is associated with smoking status even after controlling for numerous previously identified predictors of cigarette use. According to existential theorists, addictive behaviors are maladaptive ways of coping with—among other difficulties—meaninglessness in life. We hypothesized, therefore, that current smokers would have lower meaning in life scores compared to never and former smokers, and further that the perceived meaning in life of individuals who never smoked cigarettes and of those quitting smoking would not differ. Given that several investigations show that the patterns of the relationships between meaning in life and health risk behaviors can be different for males and females (e.g., Harlowe, Newcomb, & Bentler, 1986), the interaction between meaning in life and gender in predicting smoking status was also examined. 2. Method 2.1. Sample and procedure The Hungarostudy 2002 is a cross-sectional survey of the mental and physical health status of Hungarian adults, representing the population according to gender, age and the 150 sub-regions in the country. The sampling methods are described in detail elsewhere (Rózsa et al., 2003; Skrabski, Kopp, Rózsa, Réthelyi, & Rahe, 2005). Altogether 12,643 persons (44.8% male, 55.2% female) were interviewed in their homes in 2002. Characteristics for the study sample, stratified by smoking status, are summarized in Table 1. 2.2. Measures Besides demographic characteristics (gender, age, education, and marital status), data about smoking status (never, former, and current), life-time drug use (yes or no), coffee consumption (cups per day), alcohol abuse, depressive symptomatology, general wellbeing and meaning in life were included in the present analyses. Alcohol misuse was measured by the Hungarian version (Gerevich, Bácskai, & Rózsa, 2006) of the Alcohol Use Disorder Identification Test (AUDIT). Depressive symptomatology was assessed by a shortened version (Rózsa, Szádóczky, & Füredi, 2001) of the Beck Depression Inventory (α = .86), while well-being was measured by the five-item version (Susánszky, Konkolÿ Thege, Stauder, & Kopp, 2006) of the WHO Well-Being Index (α = .85). In a large representative survey using a great variety of psychosocial variables, there is little chance to use long and complex instruments like the Purpose in Life Test. Therefore, in this study, the easy to understand six-item Life Meaning Subscale (Konkolÿ Thege, Martos, Skrabski, & Kopp, 2008) from the Brief Stress and Coping Inventory (Rahe & Tolles, 2002; Rózsa et al., 2005) was administered to assess meaning in life (α = .69). 2.3. Statistical analyses At the univariate level, the chi-square test was used to analyze the categorical independent variables, and the Kruskal–Wallis test was performed for continuous data because of their non-normal distribution. Significant correlates of smoking status and the gender-meaning in life interaction were analyzed by multinomial logistic regression. 3. Results At the univariate level, all independent variables, except depressive symptomatology and well-being, were significantly associated with smoking status (Table 1). Table 2 presents the results of the first multinomial logistic regression (Cox & Snell Table 1 Characteristics of the sample, stratified by smoking status, and bivariate associations between smoking and the independent variables
N Gender Male Female Age Education (1–6) Marital status Single Married/cohabitated Divorced/widowed Life-time drug use No Yes Hazardous drinking (0–40) Coffee consumption (cups per day) Well-being (0–15) Depressive symptoms (0–27) Meaning in life (0–12) NS
non-significant; ‡p b .1; ⁎⁎⁎p ≤ .001.
Never
Former
Current
6678 (53.7)
2245 (18.1)
3506 (28.2)
2226 (33.4) 4443 (66.6) 49.8 (19.3) 3.5 (1.6)
1397 (62.3) 845 (37.7) 49.6 (16.8) 3.6 (1.4)
1940 (55.4) 1563 (44.6) 42.2 (14.2) 3.3 (1.3)
1278 (19.2) 3775 (56.6) 1613 (24.2)
271 (12.1) 1591 (71.0) 379 (16.9)
684 (19.5) 2192 (62.6) 624 (17.8)
6372 (99.0) 62 (1.0) 1.7 (2.7) 1.0 (1.0) 7.7 (3.8) 3.6 (4.6) 8.0 (2.6)
2104 (97.7) 50 (2.3) 3.2 (3.6) 1.4 (1.2) 7.8 (3.7) 3.6 (4.4) 7.9 (2.5)
3234 (95.7) 147 (4.3) 3.7 (4.3) 2.1 (1.6) 7.7 (3.7) 3.6 (4.5) 7.5 (2.6)
Difference χ2 = 788.3⁎⁎⁎ K.–W.-χ2 = 400.3⁎⁎⁎ K.–W.-χ2 = 34.0⁎⁎⁎ χ2 = 179.1⁎⁎⁎
χ2 = 120.2⁎⁎⁎ K.–W.-χ2 = 963.3⁎⁎⁎ K.–W.-χ2 = 1190.8⁎⁎⁎ K.–W.-χ2 = 0.9NS K.–W.-χ2 = 5.8‡ K.–W.-χ2 = 105.2⁎⁎⁎
B. Konkolÿ Thege et al. / Addictive Behaviors 34 (2009) 117–120
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Table 2 Results of the first multinomial logistic regression predicting smoking status
Gender Male Female Age Education Marital status Single Married/cohabitated Divorced/widowed Life-time drug use No Yes Hazardous drinking Coffee consumption Meaning in life NS
Never vs. current OR (95% CI)
Former vs. current OR (95% CI)
Former vs. never OR (95% CI)
0.59 (0.52–0.66)⁎⁎⁎ 1.00 1.03 (1.03–1.04)⁎⁎⁎ 1.18 (1.14–1.22)⁎⁎⁎
1.60 (1.40–1.83)⁎⁎⁎ 1.00 1.03 (1.03–1.04)⁎⁎⁎ 1.19 (1.14–1.24)⁎⁎⁎
2.74 (2.42–3.09)⁎⁎⁎ 1.00 1.00 (0.99–1.00)NS 1.01 (0.97–1.05)NS
2.01 (1.66–2.43)⁎⁎⁎ 1.23 (1.08–1.41)⁎⁎ 1.00
1.11 (0.87–1.42)NS 1.47 (1.24–1.73)⁎⁎⁎ 1.00
0.55 (0.44–0.69)⁎⁎⁎ 1.19 (1.03–1.38)⁎ 1.00
2.91 (2.08–4.08)⁎⁎⁎ 1.00 0.87 (0.86–0.89)⁎⁎⁎ 0.53 (0.51–0.55)⁎⁎⁎ 1.06 (1.04–1.08)⁎⁎⁎
1.16 (0.82–1.65)⁎⁎⁎ 1.00 0.95 (0.93–0.96)⁎⁎⁎ 0.71 (0.67–0.74)⁎⁎⁎ 1.04 (1.02–1.07)⁎⁎⁎
0.40 (0.27–0.60)⁎⁎⁎ 1.00 1.09 (1.07–1.11)⁎⁎⁎ 1.33 (1.27–1.39)⁎⁎⁎ 0.98 (0.96–1.01)NS
non-significant; ⁎p b .05; ⁎⁎p b .01; ⁎⁎⁎p ≤ .001.
Pseudo R2 = .229; p b .001). Meaning in life scores significantly differentiated between current and never smokers, as well as between current and former smokers, even after controlling for the covariates (p b .001). The difference in life meaning scores between never and ex-smokers was insignificant (p = .127). Entering the interaction term based on gender and life meaning in a second regression, the explanatory power of the model did not improve, and the interaction term was insignificant in the current vs. never, as well as the current vs. former and the former vs. never smoker relations (p = .653, p = .108 p = .173, respectively). 4. Discussion The purpose of this study was to determine if meaning in life is a significant correlate of smoking status and whether gender moderates this association. This is the first study investigating the relationship between life meaning and smoking using a large representative sample. Consistent with our assumptions and the previous findings, the results show that having a stronger sense of meaning in life is related with a somewhat decreased likelihood of being a smoker, even after controlling for several other predictors of cigarette use. In addition, former and never smokers did not differ in their sense of life meaning indicating that quitting smoking may co-occur with the easing of existential tensions. The interaction between life meaning and gender was not significant in predicting smoking status, demonstrating that similarly to illicit drug use and harmful alcohol consumption, smoking can also be such a health damaging behavior for both genders that—at least partly—aims to reduce the psychological tension caused by the feeling of meaninglessness. If so, then smoking prevention and cessation programs should also include components to help individuals find satisfying life purposes and meaning in their every-day experiences (Gyamerah & Lantz, 2002). The findings presented in this paper must be interpreted in light of some limitations. Although the internal consistency of our life meaning measure proved to be quite good in several previous investigations (see Konkolÿ Thege et al., 2008), in the present study, the alpha value corresponded only to the acceptable range. In addition, the cross-sectional design of this study does not allow drawing conclusions on causality between smoking and most of the independent variables. Consequently, we also cannot exclude the possibility, that either the physiological effects or some psychosocial correlates of cigarette use affect the development of meaning in life and not the reverse as it is supposed by the existential theory. Further research with longitudinal designs is needed to shed light on the direction of the potential causal relations and mediators corresponding to the observed connection between meaning in life and smoking in order to better understand the role of existential concerns in cigarette use and to help in developing more effective smoking prevention and cessation programs. Acknowledgments The authors thank the Hungarostudy 2002 team (János Réthelyi, Adrienne Stauder, Csilla Csoboth, György Gyukits, János Lőke, Andrea Ódor, Katalin Hajdu, Csilla Raduch, András Székely, László Szűcs, Sándor Rózsa), the network of district nurses for the home interviews, Professor András Klinger for the sampling procedure, and the National Population Register for the selection of the sample. This study was supported by OTKA-73754/2008 and ETT-100/2006 grants. References Batthyany, A., & Guttmann, D. (2006). Empirical research on logotherapy and meaning-oriented psychotherapy, 1st ed. Phoenix: Zeig, Tucker & Theisen (Chapter 3). Brassai, L., & Pikó, B. (2007). Protektív pszichológiai jellemzők szerepe a serdülők egészséggel kapcsolatos magatartásában. Mentálhigiéné és Pszichoszomatika, 8, 211−227. Frankl, V.E. (2006). Man’s search for meaning (Lasch, I. Trans., 5th ed.). Boston: Bacon Press. (Original work published 1946). Gerevich, J., Bácskai, E., & Rózsa, S. (2006). A kockázatos alkoholfogyasztás prevalenciája. Psychiatria Hungarica, 21(1), 45−56.
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Gyamerah, J., & Lantz, J. (2002). Meaning, technology, and smoking cessation. International Forum for Logotherapy, 25(2), 83−88. Harlowe, L., Newcomb, M., & Bentler, P. (1986). Depression, self-derogation, substance abuse, and suicide ideation: Lack of purpose in life as a mediational factor. Journal of Clinical Psychology, 42, 5−21. Konkolÿ Thege, B. (2006). Die Beziehung zwischen existenzieller Frustration und gesundheitsschädlichem Verhalten. Existenzanalyse, 23(1), 68−72. Konkolÿ Thege, B., Bachner, Y.G., Martos, T., & Kushnir, T. (in press). Meaning in life: Does it play a role in smoking? Substance Use & Misuse. Konkolÿ Thege, B., Martos, T., Skrabski, Á., & Kopp, M. (2008). A Rövidített Stressz és Megküzdés Kérdőív élet értelmességét mérő alskálájának (BSCI-LM) pszichometriai jellemzői. Mentálhigiéné és Pszichoszomatika, 9, 243−261. Melton, A. M., & Schulenberg, S. E. (2007). On the relationship between meaning in life and boredom proneness: Examining a logotherapy postulate. Psychological Reports, 101(3 Pt 2), 1016−1022. Rahe, R. H., & Tolles, R. L. (2002). The Brief Stress and Coping Inventory: A useful stress management instrument. International Journal of Stress Management, 9(2), 61−70. Rózsa, S., Kő, N., Csoboth, Cs., Purebl, Gy., Beöthy-Molnár, A., Szebik, I., Berghammer, R., Réthelyi, J., Skrabski, Á., & Kopp, M. (2005). Stressz és megküzdés. A Raheféle Rövidített Stressz és Megküzdés Kérdőívvel szerzett hazai eredmények ismertetése. Mentálhigiéné és Pszichoszomatika, 6, 275−294. Rózsa, S., Réthelyi, J., Stauder, A., Susánszky, É., Mészáros, E., Skrabski, Á., & Kopp, M. (2003). A Hungarostudy 2002 országos reprezentatív felmérés általános módszertana és a felhasznált tesztbattéria pszichometriai jellemzői. Psychiatria Hungarica, 18, 83−94. Rózsa, S., Szádóczky, E., & Füredi, J. (2001). A Beck Depresszió Kérdőív rövidített változatának jellemzői hazai mintán. Psychiatria Hungarica, 16, 384−402. Skrabski, Á., Kopp, M. S., Rózsa, S., Réthelyi, J., & Rahe, R. (2005). Life meaning: An important correlate of health in the Hungarian population. International Journal of Behavioral Medicine, 12(2), 78−85. Susánszky, É., Konkolÿ Thege, B., Stauder, A., & Kopp, M. (2006). A WHO Jól-lét Kérdőív rövidített (WBI-5) magyar változatának validálása a Hungarostudy 2002 országos lakossági egészségfelmérés alapján. Mentálhigiéné és Pszichoszomatika, 7, 247−255. World Health Organization (2003). Tobacco control country profiles, bhttp://www.who.int/tobacco/global_data/country_profiles/Introduction.pdfN. February 21, 2008.