Relationship between social support, life satisfaction, and smoking status among US adults with cardiovascular risks

Social support and life satisfaction are important determinants of health behaviors and health outcomes. Cigarette smoking, a health risk behavior that increases the risk of cardiovascular diseases, is deemed to have association with perceived social support and life satisfaction. This study assessed this relationship among US adults with one or more cardiovascular (CV) risks, namely, hypertension, high cholesterol, diabetes, and obesity. Using nationally representative data from the 2021 National Health Interview Survey on 17,557 adults with at least one CV risk, we examined whether individuals with low life-satisfaction and weak social-support were more likely to smoke compared to those with high life-satisfaction and strong social support. At different levels of social support (strong and weak), the odds of smoking were higher among individuals with low level of life satisfaction. Likewise, at different levels of life satisfaction (high, medium, and low), smoking prevalence was the highest among individuals with weak social support. Estimates of the multivariable logistic regressions, with controls for various demographic and socioeconomic correlates, suggested that the adjusted odds of current smoking for individuals with low life-satisfaction and weak social-support were 3.07 (95% CI: 2.34, 4.03) times that of individuals with high life-satisfaction and strong social support. This association was robust across all four CV risk factors, and across different sociodemographic (i.e., sex, age, race and ethnicity) and socioeconomic (i.e., income, urban/rural residence) sub-groups.