ADHD symptom type and gender influenced risk for smoking, according to recent findings that indicated greater association between ADHD and smoking outcomes in females.
“Cigarette use among U.S. adolescents has declined markedly, reflecting successful policy changes and health initiatives,” Irene J. Elkins, PhD, of University of Minnesota, Twin Cities, and colleagues wrote. “Nevertheless, it remains a persistent problem, with 38% of 12th graders having smoked tobacco cigarettes and the rising popularity of e-cigarettes prompting a new warning from the Surgeon General.”
To determine associations between ADHD symptoms and development of smoking in adolescents, researchers analyzed three population-based, same-sex twin samples (n = 3,762) using twin difference methods. One sample included a higher number of female adolescents with childhood ADHD.
Adolescents with more severe ADHD symptoms in childhood were more likely to begin smoking and start smoking earlier.
ADHD symptoms were associated with daily smoking, number of cigarettes per day, and nicotine dependence. These associations were greater among females.
Nicotine involvement was greater among monozygotic female twins with greater attentional problems, compared with their co-twins. This association remained when considering co-occurring externalizing behaviors and stimulation medication.
Hyperactivity-impulsivity was primarily noncausal, despite a stronger association to smoking in female adolescents, according to researchers.
“This study confirms that specific relationships between inattention and smoking observed in previous research may arise partially from causal effects, which has implications for intervention,” the researchers wrote. “Diminishing inattention should reduce initiation and progression to heavy smoking, particularly for females. Preventing nicotine exposure among females with ADHD is critical, as adolescent females may be more susceptible to nicotine’s neurotoxic effects.” – by Amanda Oldt
: The researchers report no relevant financial disclosures.