Honors Program

Honors in Nursing

Date of Award


Thesis Professor(s)

Florence Weierbach

Thesis Professor Department


Thesis Reader(s)

Karen Kornweibel, Loyd Glenn


Tobacco has been recognized as the number one cause of preventable death in America and results in almost 5.2 million years of potential life lost each year. The use of tobacco products is highly correlated with pulmonary disease, cardiovascular disease, and other forms of chronic illness in America. Within the last ten years new tobacco products have been trending in the tobacco market such as the water pipe/hookah and e-cigarettes. With e-cigarettes and other newer forms of tobacco on the rise, it is important to look at the underlying factors for using all kinds of tobacco products as a means of prevention. Certain adult attachment styles (secure, preoccupied, dismissing-avoidant, and fearful-avoidant) in emotionally meaningful relationships could be indicators for physical illness, mental illness, and even addiction. The researcher implemented a study that investigated whether or not there is a relationship between tobacco use and attachment style. Based on a university-wide survey that was sent out at East Tennessee State University with 522 participants, demographic data revealed 68.5% (n=358) did not currently use tobacco products. However, of those who did currently use tobacco products 54.5% (n=90) were male, 84.8% (n=140) were undergraduate students, and 66.7% (n=110) were between the ages of 18-25. For individuals who used tobacco 23.5% (n=38) were in the secure attachment group, 27.8% (n=45) were in the dismissing-avoidant attachment group, 30.2% (n=49) were in the fearful-avoidant attachment group, and 18.5% (n=30) were in the preoccupied attachment group. Chi Square analysis demonstrated that attachment style was significantly (p < 0.01) different between tobacco users and non-users. For anxiety, r=0.00209, which was weak. For avoidance, r=0.18875, which was slightly higher than the effect size for anxiety, but it was still weak. Considering that there was significance but the effect size was weak, the recommendation is that the study be repeated with a broader sample.

Document Type

Honors Thesis - Withheld

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