Four-year prospective evaluation of the relationship between meaning in life and smoking status

Background: To date, all investigations on the relationship between smoking and perceived level of meaning in life have used cross-sectional designs. Therefore, the purpose of the present prospective study, conducted with a four-year time lag, was to test the predictive power of the life meaning construct concerning changes in smoking status. Methods: The data of 4,294 respondents (40.3% male, M-age = 54.7 +/- 16.5 yrs) from the Hungarian Epidemiological Panel Survey were analyzed using the Kruskal-Wallis and Mann-Whitney U-test and structural equation modeling (SEM) with a nominal outcome variable. Gender, age, and educational level were included in the study as covariates. Results: On the bivariate level, results showed that both baseline and follow-up meaning in life scores were higher in stable non-smokers when compared to stable smokers. However, quitters and starters differed from stable nonsmokers in their baseline but not in follow-up life meaning scores. The other relationships (stable smokers vs. quitters; stable smokers vs. starters, starters vs. quitters) were non-significant in both time points. According to the SEM-analysis, a higher sense of meaning in life measured at baseline and follow-up is associated with a lower likelihood (OR = 0.54, z = 2.80, p = 0.005; OR = 0.64, z = 2.88, p = 0.004, respectively) of being a stable smoker compared to being a stable non-smoker, confirming the expected relationship between smoking and decreased level of meaning in life. However, neither baseline nor follow-up life meaning scores predicted significantly quitting and uptake of smoking. Conclusions: If future research from other cultures verifies the protective role of a higher level of meaning in life against smoking, then smoking prevention and cessation programs will also have to include such components that help individuals experience more meaning in their lives.