Smoking Linked to Teenage ADHD Impulsivity, Inattention

Early smoking behavior among adolescents and young adults with ADHD is associated with a greater risk of inattention, impulsivity, and delay discounting, according to new findings presented at The American Professional Society of ADHD and Related Disorders (APSARD) 2021 Annual Conference.

In new data presented at the meeting this weekend by investigators from the MIND Institute at the University of California Davis School of Medicine, a link between multiple cognitive systems and smoking experimentation among young patients with ADHD appears pronounced. Now, the research team believes the findings could inform measured interventions for at-risk populations.

The research, presented by Prerona Mukherjee, PhD, is driven by the fact that early smoking experimentation—already increased among those with ADHD—could become habitual, dependent on an individual’s ability to delay gratification for longer-term rewards.

Such a trait, along with impulsivity, is key in ADHD, and could be actually driving smoking experimentation in young patients, investigators hypothesize.

“Furthermore, inattention, also important in ADHD, is linked to nicotine, but may be less important for early experimentation, than sustained consumption,” investigators wrote.

Mukherjee and colleagues conducted a comparison of impulsivity and inattention, and delay discounting between individuals had and had not ever smoked in a cohort of 66 ADHD patients and 88 neurotypical (NT) individuals.

Impulsivity and inattention were measured via Conners, Parent and Conners’ Adult ADHD Rating Scale (CAARS) self-reporting. Delay discounting was measured by intertemporal preferences, or choices between immediate and delayed rewards, from a paradigm previously published by the research group. Individual smoking status was gauged via the Youth Risk Behavior Survey.

Investigators observed greater impulsivity (P <.000) inattention (P = .001), and delay discounting scores (P = .068) among those with ADHD who smoked, versus those who did not. No such significant difference was observed among NT individuals.

“These findings illustrate that inattention, as well as impulsivity and delay discounting are correlated with early smoking behavior in the ADHD, but not NT group, suggesting multiple cognitive systems are linked to experimentation with smoking in ADHD,” they wrote.

From this, Mukherjee and colleagues believe targeted early interventions could be conceived for young, at-risk ADHD patients based on this observation.

“Furthermore, data from our multi-dimensional longitudinal study will lead us to investigation of neural basis and long-term impact of these relationships,” they concluded.

The study, “Impulsivity and the Likelihood of Smoking in ADHD,” was presented at APSARD 2021.