title: Maternal bonding styles in smokers and non-smokers: a comparative study.
abstract: BACKGROUND
  Parental bonding has been implicated in smoking behavior, and the quality of maternal bonding (MB) has been associated with poor mental health and substance use. However, little is known about the association of MB and the smoking of the offspring.
  
  
  METHODS
  In our study, 129 smokers and 610 non-smoker medical students completed the parental bonding instrument, which measures MB along two dimensions: care and overprotection. Four categories can be created by high and low scores on care and overprotection: optimal parenting (OP; high care/low overprotection); affectionless control (ALC; low care/high overprotection); affectionate constraint (AC; high care/high overprotection), and neglectful parenting (NP; low care/low overprotection). Nicotine dependence was assessed by the Fagerstrom Nicotine Dependence Test, exhaled CO level, and daily cigarette consumption (CPD).
  
  
  RESULTS
  Higher CPD was significantly associated with lower overprotection (p= 0.016) and higher care (p= 0.023) scores. The odds for being a smoker were significantly higher in the neglectful maternal bonding style compared to the other rearing styles (p= 0.022). Besides, smokers showed significantly higher care and lower overprotection scores with the Mann-Whitney U-test than non-smokers, although these associations did not remain significant in multiple regression models.
  
  
  CONCLUSIONS
  Our results indicate that focusing on early life relationship between patient and mother can be important in psychotherapeutic interventions for smoking.Registration trialsretrospectively registered.
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary ; Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Iren
authors.initials: I
authors.lastname: Csala
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
authors.forename: Monika
authors.initials: M
authors.lastname: Elemery
authors.affiliation: Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Fruzsina
authors.initials: F
authors.lastname: Martinovszky
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary ; National Institute of Psychiatry and Addiction, Budapest, Hungary.
authors.forename: Peter
authors.initials: P
authors.lastname: Dome
authors.affiliation: Department of Tumor Biology, National Koranyi Institute of Pulmonology, Budapest, Hungary ; Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria ; Department of Thoracic Surgery, National Institute of Oncology and Semmelweis University, Budapest, Hungary ; Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Balazs
authors.initials: B
authors.lastname: Dome
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
authors.forename: Gabor
authors.initials: G
authors.lastname: Faludi
authors.affiliation: Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Imola
authors.initials: I
authors.lastname: Sandor
authors.affiliation: Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Zsuzsa
authors.initials: Z
authors.lastname: Gyorffy
authors.affiliation: Institute of Behavioral Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: Emma
authors.initials: E
authors.lastname: Birkas
authors.affiliation: Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
authors.forename: Judit
authors.initials: J
authors.lastname: Lazary
keywords: Depression; Nicotine dependence; Parental bonding style; Smoking onset