A research from Duke Medicine in Durham, NC has discovered that of those suffering from attention deficit hyperactivity disorder (ADHD) and being treated with stimulant medication, are less likely to smoke. The medication includes Adderall, Ritalin and Vyvanse.
Children undergone through this treatment were about half as likely to smoke as children with the same disorder who were not treated with these medications.
Attention deficit hyperactivity disorder (ADHD) is a group of behavioural symptoms that include inattentiveness, hyperactivity and impulsiveness. Attention deficit disorder (ADD) is a sub-type of ADHD.
Stimulants regulate impulsive behavior and improve attention span and focus by increasing the levels of certain chemicals in the brain, primarily dopamine, which transmit signals between nerves.
Stimulants are an effective way of managing ADHD symptoms. They can be used individually or in combination with behavior therapy.
“Given that individuals with ADHD are more likely to smoke, our study supports the use of stimulant treatment to reduce the likelihood of smoking in youth with ADHD,” Scott Kollins, senior author and professor of psychiatry and behavioral sciences and director of the Duke ADHD Program, said in a statement. “The risk is further lowered when adherence to medication treatment is consistent, presumably since this increases the chances that symptoms are managed effectively.”
ADHD “can be very much in flux” around the pre-teen and teen years when smoking experimentation typically begins, says ADHD researcher Paul Hammerness, assistant professor of psychiatry at Harvard Medical School, who was not the part of the new study. As teens with ADHD face increasing academic and social-emotional demands, they may turn to smoking to improve focus or reduce restlessness, or “as an example of being impulsive,” he says. “This is often a tenuous development period.”
The study published in the journal Pediatrics included the examination of 14 longitudinal studies of cigarette smoking and ADHD treatment, including a total of 2,360 individuals (1,424 were treated with medication; 936 were not) with ADHD. This accounts as the largest meta-analysis on the issue to date.
“The message is not just that treatment is effective in reducing this risk, but that well-managed and consistent treatment over time is really what’s associated with a lower risk,” Kollins says.
The study results “don’t really say anything about those kids who might not actually meet the criteria for ADHD, but who might be getting stimulant medication,” he adds.
Lead author Erin Schoenfelder, PhD, clinical associate and a psychologist in the Duke ADHD Program, explains:
“Nicotine operates on the same pathways in the brain as stimulant medications, and the relationship between stimulants and smoking has been controversial. It has been suggested that some people with ADHD ‘self-medicate’ their attention deficits using nicotine.”
Dr. Schoenfelder concludes, “My hope is that this research can help inform our efforts to prevent negative outcomes for kids with ADHD, including cigarette smoking. This population hasn’t been targeted for smoking prevention efforts, despite the well-known connection between ADHD and smoking.”
