The relationship between insecure attachment and nicotine dependence among users of classic cigarettes, e-cigarettes, and heated tobacco products: a moderated mediation model

• Published in: Substance abuse treatment, prevention and policy prevention and policy, 2024-09, Vol.19 (1), p.43-11
• Main Authors: Turliuc, Maria Nicoleta, Candel, Octav-Sorin, Jitaru, Mihaela
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Cross-Sectional Studies; Drugs and youth; Electronic cigarettes; Electronic Nicotine Delivery Systems - statistics & numerical data; Emotion dysregulation; Emotion regulation; Female; Health aspects; Humans; Insecure attachment; Male; Mediation; Metacognitions about smoking; Methods; Middle Aged; Nicotine dependence; Object Attachment; Patient outcomes; Prevention; Product introduction; Psychological capital; Risk factors; Smoking cessation programs; Tobacco habit; Tobacco Products; Tobacco Use Disorder - psychology; Young Adult
• ISSN: 1747-597X; 1747-597X
• DOI: 10.1186/s13011-024-00623-9

Previous research has investigated the association between attachment styles and smoking behaviors, indicating a positive association of insecure attachment styles with nicotine dependence. However, these links were mostly explored in adolescent and student samples. Moreover, the explanatory mechanisms and the variables influencing the strength of this relationship remained understudied. In this context, the present study aims to: (1) examine the associations between attachment anxiety, avoidance, and nicotine dependence; (2) investigate the mediating role of emotion dysregulation and metacognitions about smoking; and (3) test the moderating roles of psychological capital and type of tobacco product used by the participants. This cross-sectional study was conducted on a convenience sample of 447 participants who reported smoking. The age range of participants was 18 to 64 (M = 26.76; 59.7% women). All participants have completed five questionnaires measuring nicotine dependence, adult attachment, emotion dysregulation, metacognitions about smoking, and psychological capital. They also reported the type of tobacco product commonly used: classic cigarettes, e-cigarettes, or heated tobacco products. Our findings show that the direct link between insecure attachment and nicotine dependence is rather inconsistent. However, it was mediated by the metacognitions about smoking. Psychological capital can act as a protective factor against the effects of attachment on nicotine dependence, especially for those using alternative tobacco products alongside classic cigarettes. The findings highlight the possibility of developing better-tailored interventions and treatments to discourage smoking and increase smoking cessation. These should focus on eliminating the dysfunctional beliefs related to the metacognitions about smoking and on improving the levels of psychological capital. In addition, targeting attachment insecurities in early adolescence can also function as a mean to prevent smoking.