title: Is there a link between adolescent cigarette smoking and pharmacotherapy for ADHD?
abstract: There is continuing concern that pharmacotherapy for attention-deficit/hyperactivity disorder (ADHD) may raise the risk of smoking (the gateway hypothesis). Alternatively, unmedicated people with ADHD may use nicotine to improve attentional and self-regulatory competence (the self-medication hypothesis). From a community sample of 511 adolescents participating in a longitudinal health study, 27 were identified as having ADHD, and 11 of these were receiving pharmacotherapy. Self-report surveys, electronic diaries, and salivary cotinine all indicated that adolescents treated with pharmacotherapy for ADHD smoked less than their untreated counterparts over 2 years of high school. These convergent findings from 3 disparate indicators lend support to the self-medication hypothesis over the gateway hypothesis, although alternative explanations need further study. The findings also suggest that early treatment of psychological and behavioral problems may prevent or delay smoking initiation.
authors.affiliation: Department of Psychology and Social Behavior, University of California, Irvine, CA, USA. ckwhalen@uci.edu
authors.forename: Carol K
authors.initials: CK
authors.lastname: Whalen
authors.forename: Larry D
authors.initials: LD
authors.lastname: Jamner
authors.forename: Barbara
authors.initials: B
authors.lastname: Henker
authors.forename: Jena-Guido
authors.initials: JG
authors.lastname: Gehricke
authors.forename: Pamela S
authors.initials: PS
authors.lastname: King
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008499:Medical Records; D012651:Self Medication; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D013334:Students
chemical_list: D000697:Central Nervous System Stimulants