Life Satisfaction, Coping Resources, and Smoking Behavior: A Population-Based Analysis Among U.S. Adults

Purpose Examine associations between life satisfaction, sociodemographic factors, and smoking behavior among U.S. adults to inform health promotion interventions within a stress and coping framework. Design Cross-sectional secondary analysis using the Stress and Coping Theory framework. Setting United States civilian, non-institutionalized population. Sample 28,526 adults from the 2021 to 2023 National Health Interview Survey representing 233,334 680 weighted U.S. adults. The sample was 56.6% male and 43.4% female. Measures Life satisfaction (satisfied vs not satisfied), current smoking status, education, marital status, health status, and demographic characteristics. Analysis Weighted logistic regression models examined associations and interaction terms using complex survey procedures. Results Life dissatisfaction was associated with higher odds of smoking (OR = 1.24-1.30, P < .001). Higher educational attainment was associated with lower odds of smoking, while individuals who were not married had higher odds of smoking. Interaction analyses indicated variation by marital status and across racial and ethnic groups, with higher education associated with higher odds of smoking among some subgroups. Conclusion Smoking behavior was associated with life satisfaction and coping resources, highlighting the importance of incorporating stress-related factors into smoking prevention strategies.