18 December 2019

Young adults with ADHD more vulnerable to nicotine

New research suggests that the first exposure to nicotine might be more pleasurable for individuals with ADHD, which in turn may lead to higher rates of dependence.

Young adults with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for nicotine addiction, new research shows.

For the study, a Duke University team used a nasal spray to determine how nicotine affected 136 non-smoking volunteers, aged 18 to 25.

ADHD sufferers choose nicotine

About half had been diagnosed with ADHD. The others had no diagnosed mental health conditions.

In the first three sessions, participants were given two different doses of nicotine spray as well as a placebo spray with no nicotine. In later sessions, the volunteers chose between a nicotine or placebo spray, but did they did not know which spray contained nicotine.

The participants first did this while relaxing and then while solving math problems.

"Regardless of demand conditions, the people with ADHD chose the spray with nicotine," said study lead author Scott Kollins. He's a professor in the department of psychiatry and behavioural sciences at Duke's School of Medicine.

"Meanwhile, the people who did not have ADHD chose nicotine more often when they had to work on the cognitively challenging math problems," he added.

The findings suggest "that the very first exposure to nicotine might be more pleasurable or reinforcing for individuals with ADHD, which in turn may lead to higher rates of dependence," Kollins said. "This is important both for combustible cigarette smoking and the possibility of getting hooked on e-cigarettes."

Potential risk for addiction

The study was published online recently in the journal Neuropsychopharmacology.

Nicotine affects brain physiology that's involved in ADHD, the researchers noted.

When the investigators followed up with the participants six months after the study to find out if any had started using nicotine or tobacco, they found that none had.

Even so, the findings underscore the importance of talking to young people with ADHD about the effects of nicotine and their potential risk for addiction, the study authors said.

"It's not enough for us to wait for kids and adolescents who have ADHD to have already experienced nicotine," Kollins said. "We should talk to them about that sooner, before they have their first puff of a cigarette or vape with e-cigarettes."

Image credit: iStock


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ADHD Expert

Dr Renata Schoeman has been in full-time private practice as a general psychiatrist (child, adolescent and adult psychiatry) since 2008, currently based in Oude Westhof (Bellville). Renata also holds appointments as senior lecturer in Leadership (USB) and as a virtual faculty member of USB Executive Development’s Neuroleadership programme. She serves on the advisory boards of various pharmaceutical companies, as a director of the Psychiatric Management Group (PsychMG) and is the co-convenor of the South African Society of Psychiatrist (SASOP) special interest group for adult ADHD, and co-founder of the Goldilocks and The Bear Foundation ( She is passionate about corporate mental health awareness and uses her neuroscience background to assist leaders in equipping them to become balanced, healthy and dynamic leaders that take their own and their team’s emotional, intellectual, social health and physical needs into account. Renata is academically active and enjoys research and collaborative work, has published in many peer-reviewed journals, and has presented at local and international congresses. She is regularly invited to present at conferences and to engage with the media. During her post-graduate studies, she trained at Harvard, Boston in neurocognition and neuroimaging. Her awards include, amongst others, the Young Minds in Psychiatry award from the American Psychiatric Association, the Discovery Foundation Fellowship award, a Thuthuka award from the NRF, and a MRC Fellowship. She also received the Top MBA student award and the Director’s award from USB for 2015. She was a finalist for the Businesswomen’s Association of South Africa’s Businesswoman of the Year Award for 2016, and received the Excellence in Media Work award from SASOP during 2016.

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