Introduction and Objective：Bowlby defined attachment as “an emotional bond formed between two specific people.” Attachment disorder is a condition in which inadequate attachment during childhood leads to difficulties in interpersonal relationships and emotional regulation. Severe attachment disorders can also result in social maladaptation. Previous literature suggests that pregnant women who smoke are likely to have low attachment to their children, highlighting a potential link between attachment disorder and smoking behavior.
Consequently, the present study explored the influence of attachment on smoking behavior and elucidated the potential impact of social support for mothers and the quality of mother–child relationships on smoking rates, with an aim to reduce them.
Methods：Data was collected through a questionnaire survey utilizing Okada’s (2013) attachment-style diagnostic test. Chi-square tests were used to analyze the relationship between each item of the attachment-style diagnostic test and smoking habits of the particiants and their parents Residual analysis was performed for items that showed a significant difference. Kruskal–Wallis tests were used to analyze the relationship between the attachment scores for secure, insecure, avoidant, and unresolved styles and the smoking habits of the participants and their parents.
Results：The participants were 217 university students (166 men, 47 women, and four anonymous individuals). However, significant differences in smoking habits among university students were observed in avoidant attachment scores (p=0.012) and specific items such as “Have you been frequently hurt by your parents (caregivers)?” (p=0.004), “Are you always calm and cool?” (p=0.041), and “Do you easily forget individuals you were once close to?” (p=0.008). Furthermore, residual analysis showed that individuals who were past smokers had a significantly higher number of “yes” responses. No significant differences were observed between parents’ smoking habits and attachment-related items or attachment scores.
Conclusion：The study findings do not indicate a clear relationship between smoking and attachment. However, former smokers among university students had the highest scores on avoidant attachment style. Additionally, significant differences were observed among the three groups: non-smokers, current smokers, and former smokers. This suggests that attachment may influence smoking behavior.

View full abstract