Adolescents with inattention problems more likely to smoke

New study looks at link between ADHD symptoms and smoking in a community sample of high school students

Adolescents with symptoms of attention-deficit/hyperactivity disorder (ADHD) are more likely to experiment with smoking and become regular tobacco users, a study by researchers from the University of Pennsylvania School of Medicine and Georgetown University indicates. This study appears in the July issue of the Journal of the American Academy of Child and Adolescent Psychiatry.

ADHD is a neurobehavioral disorder that is characterized by impulsivity, hyperactivity and distractibility, or difficulty in sustaining attention. It is estimated that ADHD affects three-to-five percent of school-age children.

Previous research has linked ADHD with smoking in the clinical setting, but this study is the first to investigate the association of ADHD symptoms with smoking practices in a community sample of high school students. “This information is important because screening for symptoms of inattention might be useful in targeting tobacco control efforts toward high-risk youth, which could help to arrest their smoking at an earlier stage,” said senior author Janet Audrain, PhD, of the Abramson Cancer Center of the University of Pennsylvania, and an assistant professor in the Department of Psychiatry at Penn’s School of Medicine.

While research has yet to prove why ADHD is so strongly associated with smoking, the researchers note that one possible explanation might be that nicotine helps manage ADHD symptoms. According to study co-investigator and author Kenneth P. Tercyak, PhD, assistant professor of Oncology at Georgetown University Medical Center, “stimulation derived from nicotine may help some smokers with ADHD compensate for their difficulties sustaining attention and concentration.”

Audrain and her colleagues interviewed 1,066 tenth-grade students from five high schools. The students completed a survey that assessed ADHD symptoms, as well as current smoking practices and exposure to other smokers. These students are part of a four-year study Audrain is conducting to explore the social, psychological and genetic predictors of adolescent smoking adoption.

The researchers examined the extent to which symptoms of ADHD were associated with smoking practices. Adolescents with clinically significant symptoms of inattention were found to be over three times more likely to have ever smoked, and almost three times more likely to be current smokers. The researchers also found that while clinically significant symptoms of inattention were associated with smoking, symptoms of hyperactivity-impulsivity were not.