ADHD treatment associated with lower smoking rates

May 12, 2014
Smoking harms nearly every organ in the body and causes many diseases. Credit: CDC/Debora Cartagena

Treating attention deficit hyperactivity disorder (ADHD) with stimulant medication may reduce smoking risk, especially when medication is taken consistently, according to an analysis led by researchers at Duke Medicine.

The findings appear online May 12, 2014, in the journal Pediatrics.

"Given that individuals with ADHD are more likely to smoke, our study supports the use of stimulant treatment to reduce the likelihood of in youth with ADHD," said senior author Scott Kollins, Ph.D., professor of psychiatry and behavioral sciences and director of the Duke ADHD Program. "The risk is further lowered when adherence to medication treatment is consistent, presumably since this increases the chances that symptoms are managed effectively."

ADHD is a common childhood disorder that can continue through adolescence and adulthood, and is characterized by hyperactivity, difficulty paying attention and impulsivity. It is most commonly treated with (such as Vyvanse or Concerta), as well as with behavior therapy or a combination of the two.

Individuals with ADHD smoke at rates significantly higher than the general population, and they often start earlier. Studies have shown that youth with ADHD are two to three times more likely to smoke cigarettes than their peers, and 40 percent of adults with ADHD smoke regularly, more than twice the rate among adults without ADHD.

Research on how stimulant medications influence smoking behaviors in individuals with ADHD has led to mixed results. Some studies suggest an increase in smoking among those treated with stimulant medications, while others showed no effect or a decrease in smoking.

"Nicotine operates on the same pathways in the brain as stimulant medications, and the relationship between stimulants and smoking has been controversial," said lead author Erin Schoenfelder, Ph.D., clinical associate and a psychologist in the Duke ADHD Program.

"It has been suggested that some people with ADHD 'self-medicate' their attention deficits using nicotine," Schoenfelder said. "Our findings show that treating ADHD effectively with medication may prevent young people from picking up the habit."

The researchers examined 14 longitudinal studies of cigarette smoking and ADHD treatment, including a total of 2,360 individuals with ADHD, making this the largest meta-analysis on the issue to date.

Some of the studies used to measure smoking behaviors, although nicotine dependence may not be found in adolescents who recently started smoking. In order to capture an accurate picture of smoking behaviors, the researchers expanded their criteria beyond nicotine dependence to include smoking frequency and whether participants currently smoked.

The analysis revealed a significant association between stimulant treatment and lower smoking rates. The effect was larger in those with more severe ADHD and when participants took stimulant medications continuously.

The researchers noted that based on the design of the study, they were able to identify an association but not a causal relationship between reduced smoking risk and stimulant treatment. Additional studies are needed to determine the recommended timing and duration of stimulant treatment to help lower smoking risk.

"This study may debunk the perception that stimulants will increase one's risk for smoking," Kollins said. "It gives us more confidence when we talk with parents to reassure them that consistent ADHD treatment won't increase their children's risk of smoking, and in fact, may actually do the opposite."

"My hope is that this research can help inform our efforts to prevent negative outcomes for kids with ADHD, including cigarette smoking," Schoenfelder said. "This population hasn't been targeted for smoking prevention efforts, despite the well-known connection between ADHD and smoking."

Explore further: Nearly 50 percent of M.D.s believe diversion of ADHD stimulant medications among teens is a problem

Related Stories

Nearly 50 percent of M.D.s believe diversion of ADHD stimulant medications among teens is a problem

May 3, 2014
Two recent studies by investigators at the Cohen Children's Medical Center of New York examined physicians' perceptions and knowledge of diversion of stimulant medications for Attention Deficit Hyperactivity Disorder (ADHD) ...

Many Ivy League students don't view ADHD medication misuse as cheating

May 1, 2014
Nearly one in five students at an Ivy League college reported misusing a prescription stimulant while studying, and one-third of students did not view such misuse as cheating, according to a study to be presented Saturday, ...

ADHD medication can slow growth in teenage boys, study finds

January 21, 2013
(Medical Xpress)—Adolescent boys with attention deficit hyperactivity disorder (ADHD) are more likely to be shorter and slimmer than their same-age peers, according to a new study published in the Medical Journal of Australia ...

People with autistic tendencies vulnerable to alcohol problems

May 2, 2014
(Medical Xpress)—Young adults with autistic tendencies don't often engage in social or binge drinking, but if they drink, they are slightly more likely than their peers to develop alcohol problems, according to new research ...

Combination of treatments could lead to lower and safer doses of medication in children with ADHD

April 8, 2014
Balancing a low dose of behavior therapy with a low dose of medication may be the key to helping children with Attention Deficit Hyperactivity Disorder (ADHD), according to a new study by researchers at FIU's Center for Children ...

Recommended for you

For children with ADHD, a brief, school-based program can help dramatically with homework problems, study finds

December 6, 2017
Children with attention deficit hyperactivity disorder who took part in a brief, school-based program displayed significant improvements in their homework, organization and planning skills, according to a new study led by ...

What can twitter reveal about people with ADHD?

November 9, 2017
What can Twitter reveal about people with attention-deficit/hyperactivity disorder, or ADHD? Quite a bit about what life is like for someone with the condition, according to findings published by University of Pennsylvania ...

Brain imaging reveals ADHD as a collection of different disorders

November 8, 2017
Researchers have found that patients with different types of attention-deficit/hyperactivity disorder (ADHD) have impairments in unique brain systems, indicating that there may not be a one-size-fits-all explanation for the ...

Can adults develop ADHD? New research says probably not

October 20, 2017
Adults likely do not develop ADHD, according to new research by FIU clinical psychologist Margaret Sibley.

Nearly a third of college kids think ADHD meds boost grades

October 16, 2017
(HealthDay)—Many college students who abuse ADHD drugs mistakenly believe that doing so will lead to better grades, a new survey suggests.

School year 'relative age' causing bias in ADHD diagnosis, says research

October 9, 2017
Younger primary school children are more likely to be diagnosed with attention deficit hyperactivity disorder (ADHD) than their older peers within the same school year, new research has shown.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.