Attention Deficit Hyperactivity Disorder and Tobacco Addiction: Clinical and Social Characteristics in a Large Sample of Tobacco Smokers clinical and social characteristic in a large sample of tobacco smoker
Main Article Content
Abstract
Background: Several scientific studies indicate that Attention Deficit Hyperactivity Disorder (ADHD) is a risk factor for the development of pathological addiction, including Tobacco Use Disorder (TUD). Despite various hypotheses proposed to explain the reasons for this frequent comorbidity, the limited amount of research aimed at describing the characteristics of this population restricts our understanding of the nature of this relationship. Aims: The purpose of our descriptive and retrospective study is to examine the differences between a group of tobacco users with suspected ADHD and those without it, with respect to socio-demographic characteristics, factors related to tobacco addiction, alcohol consumption, past and current use of illicit substances, and comorbid psychiatric symptoms. Methods: A total of 1166 smokers who were referred to the Addiction Medicine Unit of the University Hospital in Verona between 2015 and 2021 were selected. Users for whom it was not possible to obtain all the necessary information were excluded from the sample. The remaining participants were divided into two groups based on their scores on an ADHD screening test. The group that scored negatively on the screening test (n = 964) was then compared to the group that scored positively on the same test (n = 114). Results: Statistically significant differences emerged between the two groups. Specifically, users in the positive group were found to be more likely to have the marital statuses of "Single" and "Separated/Divorced," as well as the occupational statuses of "Unemployed," "Student," "Teacher," "Housework," "Casual Worker," "Worker," and "Artisan/Trader." They also exhibited a higher level of nicotine addiction and reported an increase in smoking in the last 12 months. Furthermore, they had a history of both previous and current use of illicit substances and higher overall levels of anxious and depressive symptoms, regardless of gender. Conclusion: Several factors related to sociodemographic characteristics, smoking behavior, past and current use of illicit substances, and current levels of anxiety and depression could potentially mediate the relationship between ADHD and TUD. Clinicians involved in smoking cessation treatments should take comorbidity with adult ADHD into consideration.
Article Details
How to Cite
CONGIU, Alessio et al.
Attention Deficit Hyperactivity Disorder and Tobacco Addiction: Clinical and Social Characteristics in a Large Sample of Tobacco Smokers.
Medical Research Archives, [S.l.], v. 11, n. 10, oct. 2023.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/4548>. Date accessed: 15 may 2024.
doi: https://doi.org/10.18103/mra.v11i10.4548.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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2. Danielson ML, Holbrook JR, Blumberg SJ, et al. Prevalence of Parent-Reported ADHD Diagnosis and Associated Treatment Among U.S. Children and Adolescents. J Clin Child Adolesc Psychol; 2016; 47(2):199–212.
3. Mahone EM, Denckla MB. Attention-Deficit/Hyperactivity Disorder: a Historical Neuropsychological Perspective. J Int Neuropsychol Soc; 2017; 23(9-10): 916-29.
4. Salvi V, Ribuoli E, Servasi M et al. ADHD and Bipolar Disorder in Adulthood: clinical and Treatment Implications. Medicina (Kaunas); 2021; 57(7): 466.
5. Bagwell CL, Molina, BSG, Pelham, WE, et al. Attention-deficit hyperactivity disorder and problems in peer relationship: Predictions from childhood to adolescence. JAACAP; 2011; 40(11): 1285–92.
6. Kent KM, Pelham WE, Molina BSG, et al. The academic experience of male high school students with ADHD. J Abnorml Child Psychol; 2011; 39(3): 451–62.
7. Hechtman MD, Swanson JM, Sibley MH., et al. Functional adult outcomes 16 years after childhood diagnosis of Attention-Deficit/Hyperactivity Disorder: MTA results. J Am Acad Child Adolesc Psychiatry; 2016; 55(11):945–952.e2
8. Sibley MH, Pelham WE, Molina BSG, et al. When diagnosing ADHD in young adults emphasize informant reports, DSM items, and impairment. J Consult Clin Psychol; 2012; 80(6): 1052–61.
9. Barkley RA, Murphy KR, Fischer M. ADHD in adults: What the science says. New York, NY: Guilford Press. 2008.
10. Kessler RC, Adler LA, Ames M, et al. The World Health Organization adult ADHD self‐report scale (ASRS): a short screening scale for use in the general population. Psychol Med; 2005a;35(2): 245–56.
11. Kooij SJ, Bejerot S, Blackwell A, et al. European consensus statement on diagnosis and treatment of adult ADHD: the European Network Adult ADHD. BMC Psychiatry; 2010, 10:67.
12. Polanczyk G, de Lima MS, Horta BL, et al. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry; 2007; 164(6):942–8.
13. Faraone SV, Biederman J. Can attention-deficit/hyperactivity disorder onset occur in adulthood? JAMA Psychiatry; 2016; 73(7):655-6.
14. Volkow ND, Wang GJ, Kollins SH, et al. Evaluating dopamine reward pathway in ADHD: clinical implications. JAMA; 2009; 302(10): 1084–91.
15. Molina BSG, Pelham WE, Childhood predictors of adolescent substance use in a longitudinal study of children with ADHD. J Abnorml Psychol; 2003; 112(3):497–507.
16. Rhodes JD, Hawk LW. Smoke and mirrors: the overnight abstinence paradigm as an index of disrupted cognitive function. Psychopharmacology (Berl); 2016; 233(8), 1395–404
17. Sibley MH, Pelham WE, Molina BSG, et al. The role of early childhood ADHD and subsequent CD in the initiation and escalation of adolescent cigarette, alcohol, and marijuana use. J Abnorm Psychol; 2014; 123(2): 362–74.
18. Fuemmeler BF, Kollins SH, McClernon FJ. Attention deficit hyperactivity disorder symptoms predict nicotine dependence and progression to regular smoking from adolescence to young adulthood. J Pediatr Psychol; 2007; 32(10):1203–13.
19. Kollins SH, McClernon FJ, Fuemmeler BF. Association between smoking and attention-defcit/hyperactivity disorder symptoms in a population-based sample of young adults. Arch Gen Psychiatry; 2005; 62(10): 1142–7.
20. Rohde P, Kahler CW, Lewinsohn PM et al. Psychiatric disorders, familial factors, and cigarette smoking: II. Associations with progression to daily smoking. Nicotine and Tobacco Research; 2004; 6(1): 119–32.
21. Wilens TE, Vitulano M, Upadhyaya H, et al. Cigarette smoking associated with attention deficit hyperactivity disorder. J Pediatr; 2008; 153(3):414–9.
22. Tercyak KP, Lerman C, Audrain J. Association of attention-deficit/hyperactivity disorder symptoms with levels of cigarette smoking in a community sample of adolescents. J Am Acad Child Adolesc Psychiatry; 2002; 41:799–805.
23. McClernon FJ, Kollins SH. ADHD and smoking. Ann NY Acad Sci; 2008a; 1141(1): 131–47.
24. McClernon FJ, Van Voorhees EE, English J, et al. Smoking withdrawal symptoms are more severe among smokers with ADHD and independent of ADHD symptom change: results from a 12-day contingency-managed abstinence trial. Nicotine Tob Res; 2011; 13(9):784–92.
25. Covey LS, Manubay J, Jiang H, et al. Smoking cessation and inattention or hyperactivity/impulsivity: a post hoc analysis. Nicotine Tob Res; 2008; 10:1717–25.
26. Humfleet GL, Prochaska JJ, Mengis M, et al. Preliminary evidence of the association between the history of childhood attention-deficit/hyperactivity disorder and smoking treatment failure. Nicotine Tob Res; 2005; 7(3):453–60.
27. Mitchell JT, McIntyre EM, McClernon FJ, et al. Smoking motivation in adults with attention-deficit/hyperactivity disorder using the Wisconsin inventory of smoking dependence motives. Nicotine Tob Res; 2014; 16(1):120–5.
28. McClernon FJ, Kollins SH, Lutz AM, et al. Effects of smoking abstinence on adult smokers with and without attention deficit hyperactivity disorder: results of a preliminary study. Psychopharmacology (Berl); 2008b; 197(1):95–105.
29. Pomerleau CS, Downey KK, Snedecor SM, et al. Smoking patterns and abstinence effects in smokers with no ADHD, childhood ADHD, and adult ADHD symptomatology. Addict Behav; 2003; 28(6):1149–57.
30. Bukstein OG. Attention deficit hyperactivity disorder and substance use disorders. Curr Top Behav Neurosci; 2012; 9:145–72.
31. Galéra C, Bouvard MP, Messiah A, et al. Hyperactivity-inattention symptoms in childhood and substance use in adolescence: the youth gazel cohort. Drug Alcohol Depen; 2008: 94(1 3):30–7.
32. Gudjonsson GH, Sigurdsson JF, Sigfusdottir ID, et al. An epidemiological study of ADHD symptoms among young persons and the relationship with cigarette smoking, alcohol consumption and illicit drug use. J Child Psychol Psychiatry; 2012;53(3):304–12.
33. Molina BSG, Pelham WE. Attention-deficit/ hyperactivity disorder and risk of substance use disorder: developmental considerations, potential pathways, and opportunities for research. Annu Rev Clin Psychol; 2014; 10(1): 607–39.
34. Van Amsterdam J, van der Velde B, Schulte M, et al. Causal factors of increased smoking in ADHD: a systematic review. Subst Use Misuse; 2018; 53(3): 432–45.
35. Faraone SV, Larsson H. Genetics of attention deficit hyperactivity disorder. Molecular Psychiatry; 2019; 24(4): 562–75.
36. Vilar-Ribó L, Sánchez‐Mora C, Rovira P, et al. Genetic overlap and causality between substance use disorder and attention- deficit and hyperac tivity disorder. Am J Med Genet B: Neuropsychiatr Genet; 2020; 186(3): 140–50.
37. Doran N, Spring B, McChargue D, et al. Impulsivity and smoking relapse. Nicotine Tob Res; 2004; 6(4):641–7.
38. Slobodin O, van de Glind G, Johan F, et al. The role of different aspects of impulsivity as independent risk factors for substance use disorders in patients with ADHD: a review. Curr Drug Abuse Rev; 2015; 8(2): 119–33.
39. Ashare RL, Falcone M, Lerman C. Cognitive function during nicotine withdrawal: Implications for nicotine dependence treatment. Neuropharmacology; 2014; 76: 581–91.
40. Levin ED, Conners CK, Sparrow EE, et al. Nicotine effects on adults with attention deficit/hyperactivity disorder. Psychopharmacol; 1996; 123(1):55–63.
41. Kassel JD, Stroud LR, Paronis CA. Smoking, stress, and negative affect: correlation, causation, and context across stages of smoking. Psycholl Bull; 2003; 129(2): 270–304.
42. Hitchman SC, Fong GT, Zanna MP, et al. Socioeconomic status and smokers”number of smoking friends: findings from the International Tobacco Control (ITC) Four Country Survey. Drug Alcohol Depend; 2014; 143: 158–166.
43. Hiscock R, Bauld L, Amos A, et al. Socioeconomic status and smoking: a
review. Ann NY Acad Sci; 2012; 1248: 107–23.
44. Russell AE, Ford T, Williams R, et al. The Association Between Socioeconomic Disadvantage and Attention Defcit/Hyperactivity Disorder (ADHD): a Systematic Review. Child Psychiatry Hum Dev; 2016;47: 440–58.
45. Pomerleau OF, Downey KK, Stelson FW et al. Cigarette smoking in adult patients
diagnosed with attention deficit hyperactivity disorder. J Sub Abuse. 1995; 7(3):373–8.
46. Poltavski DV, Petros T. Effects of transdermal nicotine on attention in adult non-smokers with and without attentional deficits. Physiol Behav; 2006; 87(3):614–24.
47. Shytle RD, Silver AA, Wilkinson BJ, et al. A pilot controlled trial of transdermal nicotine in the treatment of attention deficit hyperactivity disorder. World J Biol Psychiatry; 2002; 3(3):150-5
48. Castle L, Aubert RE, Verbrugge RR, et al. Trends in medication treatment for ADHD. J Atten Disord; 2005; 10:335–42.
49. Lambert N. The contribution of childhood ADHD, conduct problems, and stimulant treatment to adolescent and adult tobacco and psychoactive substance abuse. Ethical Hum Psychol Psychiatry; 2005; 7(3):197–221.
50. Levin ED, Conners CK, Silva D, et al. Effects of chronic nicotine and methylphenidate in
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