Cigarette Smoking Associated with Attention Deficit Hyperactivity Disorder

Objective

To evaluate the association between attention deficit hyperactivity disorder (ADHD) and severity of physical dependence on nicotine in a controlled study of adolescents and young adults with ADHD.

Study design

In controlled longitudinal family studies of ADHD, we examined self-reports on the modified Fagerström Tolerance Questionnaire (mFTQ) for degrees of physical dependence on nicotine.

Results

We obtained mFTQ data from 80 ADHD probands and 86 control probands (mean age, 19.2 years). The smokers with ADHD had significantly higher scores on the mFTQ, indicative of more severe physical dependence on nicotine. Similarly, in current smokers, a positive linear relationship was found between mFTQ score and both inattentive and hyperactive ADHD symptoms. Environmental factors, such as current parental smoking, peer smoking, and living with a smoker, all increased the risk for smoking in those with ADHD compared with controls.

Conclusion

Male and female smokers with ADHD manifest more severe physical dependence on smoking compared with controls. Important environmental factors appear to add to the risk of smoking associated with ADHD.

Abbreviations: ADHD, Attention deficit hyperactivity disorder, CD, Conduct disorder, DSM, Diagnostic and Statistical Manual of Mental Disorders, FTQ, Fagerström Tolerance Questionnaire, K-SADS-E, Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Epidemiologic Version, mFTQ, Modified Fagerström Tolerance Questionnaire, SES, Socioeconomic status, SCID, Structured Clinical Interview for DSM-IV