New Links Between ADHD, Stimulants, and Smoking Behavior

Children and adolescents suffering from attention-deficit hyperactivity disorder (ADHD) have a higher risk of smoking as they enter adulthood. This is particularly problematic given that nearly 20% of all teenage boys suffer from ADHD, and 10% are taking prescription medications. Even toddlers, over 10000 of them in the US, are taking prescription medications to treat ADHD, which is rather alarming.

The symptoms of ADHD are most commonly treated with a range of prescription stimulants, such as Addrall, Ritalin, Concerta, Daytrana, Metadate CD, Methylin, Vyvanse, Dexedrine, Focalin, or Dextroamphetamine. These medications are often quite effective at relieving many symptoms of ADHD such as restlessness and impusivity, but it is unknown whether these medications may also reduce the likelihood that teenagers with ADHD will develop a smoking habit.

To test whether this could be the case, scientists from Duke University and SUNY-Upstate Medical Center conducted a large-scale meta-analysis that re-analyzed data from 14 existing studies. They asked whether, across these studies, there would be any significant evidence that ADHD medications might reduce the risk of teen smoking.

The authors found that rates of teen smoking were reduced when taking ADHD medications. This pattern was especially pronounced for women and relatively serious cases of ADHD.

This study suggests that the increased smoking rates among teens with ADHD might be reduced through ADHD stimulant medications. It could be the case that the typical impulsivity and lower inhibitory control in ADHD that leads to sensation-seeking behaviors such as smoking are reduced, thus decreasing impulsivity and increasing inhibition; ultimately decreasing teens' perceived need to smoke. Continuing research is necessary to tease out some of the underlying neural, motivational, and behavioral mechanisms responsible for these effects.

Cited research: Schoenfelder, E. N., Faraone, S. V., & Kollins, S. H. (2014). Stimulant treatment of ADHD and cigarette smoking: A meta-analysis. Pediatrics, doi 10.1542/peds.2014-0179.


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