The Relationship Between ADHD Subtypes and Success in Quitting Smoking

Terry Matlen, ACSW Health Guide
  • According to the Centers for Disease Control and Prevention, an estimated, 20.8% of all adults (45.3 million people) smoke cigarettes in the United States. Cigarette smoking remains the leading preventable cause of death in the United States,1 accounting for approximately 1 of every 5 deaths (438,000 people) each year


    It's no mystery that many with ADHD find themselves addicted to smoking. In fact 40% of adults with ADHD smoke, compared to 26% of non-ADHD who smoke. Additionally, teens with ADHD are twice as likely to smoke than their non ADHD peers and have a harder time quitting than their counterparts without ADHD.

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    Like Ritalin, it has been found that nicotine, a stimulant,  too, has an effect on the brain's dopamine that helps people with ADHD improve their focus and impulse control.

    Because of the significant health risks associated with smoking and the high incidence of teens and adults with ADHD who smoke,  there have  been a number of studies published recently addressing the connection between ADHD and smoking.


    A new study, published in the Journal of the Society for Research on Nicotine and Tobacco,  shows that ADHD adults who are hyperactive and impulsive, regardless of their level of inattention, have a much harder time quitting smoking than the adult with inattentive ADHD. 


    Lirio Covey, Ph.D, professor of clinical psychology (in psychiatry) at Columbia University Medical Center and the New York State Psychiatric Institute and lead author of this most recent study notes:


    "Greater understanding of the divergent associations that exist between the different kinds of A.D.H.D. have important public health consequences for smoking cessation and decreased tobacco-related mortality in this population."


    This study is interesting because it is one of the only ones to specify the type of ADHD and how it relates to the difficulty in stopping smoking. Before, people with ADHD were studied without regard to their ADHD subtype; whether the person has impulsivity VS inattention.


    In this study, 583 adult smokers were studied for an initial 8-week phase. Of these, 43 had significant ADHD symptom subtypes, were treated with the medication Zyban (buproprion), a nicotine patch and were also given smoking cessation counseling. It was found that smokers of both subtypes had a more difficult time quitting than smokers without ADHD.


    When breaking down the ADHD group by subtype, researchers found that at the end of the treatment, those with the inattentive subtype were able to abstain at the same rate as those without ADHD (55% compared to 54%, respectively).


    Interestingly, the hyperactive ADHD subgroup, with or without inattention, had a lower quit rate throughout the study compared to the non ADHD smokers. The researchers found that differences only showed up in the hyperactive/impulsive smokers when compared to the non ADHD smokers or the inattentive ADHD smokers.


    "The knowledge gained from further study of how these early onset disorders of nicotine dependency and A.D.H.D. are related could lead to early prevention of either one or both of these conditions," concluded Dr. Covey. More research is needed to tease out why hyperactivity causes less cessation success."


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    Since we know that nicotine improves attention and performance in adults with ADHD, it's obvious that many use smoking as a way to "self-medicate" their symptoms. And as many adults with ADHD will admit, their smoking habits typically started at a very young age, thus the more reason to have your child evaluated early on if you think he might have ADHD. Proper treatment will then often prevent him from using cigarettes as a way to tame his ADHD symptoms.



Published On: December 08, 2008