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Purpose in life and tobacco use among community-dwelling mothers of early adolescents
  1. Yuko Morimoto1,
  2. Syudo Yamasaki1,
  3. Shuntaro Ando1,2,
  4. Shinsuke Koike3,
  5. Shinya Fujikawa2,
  6. Sho Kanata4,
  7. Kaori Endo1,
  8. Miharu Nakanishi1,
  9. Stephani L Hatch5,
  10. Marcus Richards6,
  11. Kiyoto Kasai2,
  12. Mariko Hiraiwa-Hasegawa7,
  13. Atsushi Nishida1
  1. 1 Department of Psychiatry and Behavioral Science, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
  2. 2 Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
  3. 3 University of Tokyo Institute for Diversity & Adaptation of Human Mind (UTIDAHM), The University of Tokyo, Tokyo, Japan
  4. 4 Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
  5. 5 Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
  6. 6 MRC Unit for Lifelong Health and Aging, University College London, London, UK
  7. 7 School of Advanced Science, SOKENDAI (The Graduate University for Advanced Studies), Kanagawa, Japan
  1. Correspondence to Dr Atsushi Nishida; nishida-at{at}


Objectives The rising prevalence of tobacco use and tobacco-attributable deaths among women is of worldwide concern. In particular, smoking prevention for mothers in early midlife is a significant international public health goal. A higher sense of purpose in life (PIL) is thought to reduce detrimental health behaviours. However, little is known about the association between a sense of PIL and tobacco use. This study investigates this association among community-dwelling mothers of early adolescents.

Design This population-based cross-sectional study uses a self-reported questionnaire from the Tokyo Early Adolescence Survey, a large community-based survey conducted in Japan between 2012 and 2015.

Setting Participants were randomly recruited from the resident registries of three municipalities in Tokyo, Japan.

Participants A total of 4478 children and their primary parents participated. Responses from 4063 mothers with no missing data were analysed (mean age=42.0 years (SD=4.2)).

Measures Participants’ tobacco use, including the number of cigarettes smoked per day, was documented using a questionnaire. PIL was assessed using a Purpose in Life scale derived from Ryff’s Psychological Well-Being Scale.

Results Greater PIL was associated with a decreased likelihood of tobacco use, even when adjusted for confounders (OR=0.80, 95% CI 0.70 to 0.91). Multinomial logistic regression analyses revealed that PIL was inversely associated with tobacco consumption among mothers. These associations remained after controlling for psychological distress, socioeconomic factors and frequency of alcohol consumption among moderate to heavy smokers (OR=0.70, 95% CI 0.57 to 0.86), while attenuated among light smokers.

Conclusions Increasing PIL may be a valuable intervention for reducing tobacco use among women in early midlife. This study can contribute to our understanding of the psychology of smoking behaviour and shed light on the targeted intervention to reduce tobacco use among early midlife mothers.

  • purpose in life
  • mother
  • psychological distress
  • Tokyo Early Adolescence Survey (T-EAS)
  • tobacco use

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  • YM and SY contributed equally.

  • Contributors YM, SY, SA, SKo, AN, MH-H and KK involved in launching and maintaining the survey. SF, SKa and KE have mainly contributed to data collection. MN, SLH and MR mainly contributed to design the study and propose the analysis and interpretation of data. YM and SY wrote the first draft of the manuscript and all the other authors have critically reviewed it. All authors approved the final version of the manuscript.

  • Funding This study was supported by a Japan Scientific Research Grant on an Innovative Area from the Ministry of Education, Culture, Sports, Science and Technology (MEXT KAKENHI 23118002); a Japan Scientific Research Grant on an Innovative Area from the Japan Society for the Promotion of Science (JSPS KAKENHI 16H06395, 16H06398, 16K21720); a Grant-in-Aid for Challenging Exploratory Research from the Japan Society for the Promotion of Science (JSPS KAKENHI 16K13499); a Grant-in-Aid for Scientific Research (B) from the Japan Society for the Promotion of Science (JSPS KAKENHI 16H03745) and a Tokyo Metropolitan Institute of Medical Science Project Grant (Kokoronokenko H27-H31).

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval This study was approved by the ethics committees of the following three institutes: three research institutes: Tokyo Metropolitan Institute of Medical Science, The University of Tokyo and SOKENDAI (The Graduate University for Advanced Studies).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement When applying to the research ethics committee for the data set, the authors did not request this to be released as public data. However, the data can be made available to all interested researchers on request to Dr Atsushi Nishida (

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