Attention deficit hyperactivity disorder (ADHD) is characterized by inattention, impulsivity,
and hyperactivity that are frequently treated with stimulant medications such as Ritalin.
Many people with ADHD smoke. The smoking prevalence rates are estimated to be 40% in adults
with ADHD compared to 20% in the general population. People with ADHD have also more
difficulty to quit smoking. Only 29% of smokers with ADHD quit smoking compared to 48.5% of
smokers in the general population. Nicotine is a stimulant, which may have properties similar
to stimulant medications (e.g., Ritalin) used to treat ADHD. Nicotine may increase attention
and reduce hyperactivity and impulsivity and, thus, may regulate behavior in individuals with
ADHD. Alleviating the symptoms of ADHD and increasing cardiovascular activity through smoking
may mimic the effects of stimulant medications and can be a form of self-medication.
The major objective of the study was to examine the effects of nicotine on ADHD symptoms,
moods, and cardiovascular activity. The study investigated the effects of nicotine patches on
behavioral regulation in adult smokers and nonsmokers with ADHD. Smokers and nonsmokers with
ADHD participated in two conditions: (1) nicotine patch and (2) placebo patch. During each
condition, symptoms, moods, and side effects were assessed for 2 days during waking hours. An
electronic handheld diary, programmed to prompt the participant twice per hour, recorded ADHD
symptoms (e.g., difficulty concentrating, impulsivity, etc.), negative moods (e.g., anger,
stress), and nicotine side effects (nausea, dizziness). Heart rate and blood pressure were
recorded with lightweight ambulatory monitors to indicate cardiovascular activity. Results
provided information about the effects of nicotine patches on behavioral regulation in adult
smokers and nonsmokers with ADHD.
The inclusion of nonsmokers was important to clarify whether the effects of nicotine on
smokers was due to smoking withdrawal. The findings help explain the increased smoking
prevalence rates and reduced quit rates associated with ADHD. Knowledge about nicotine's
effects on behavioral regulation can help to develop successful smoking cessation programs
for individuals with ADHD. The findings on cardiovascular activity may help determine the
potential risk for cardiovascular disease in smokers and nonsmokers with ADHD. The study
contributed to understanding nicotine's effects on behavioral regulation in a highly
vulnerable population such as people with ADHD.