Effects of smoking abstinence on adult smokers with and without attention deficit hyperactivity disorder: results of a preliminary study.
BACKGROUND
Individuals with attention deficit hyperactivity disorder (ADHD) smoke at higher rates than the general population; however, little is known about the mechanisms underlying this comorbidity.


OBJECTIVE
This study evaluated the effects of overnight abstinence on withdrawal symptoms and cognitive performance in adult smokers with and without ADHD.


METHODS
Individuals smoking > or = 15 cigarettes per day were recruited from the community and underwent an evaluation to establish a diagnosis of ADHD (n = 12) or not (n = 14). Withdrawal symptoms, mood, craving, cognitive performance, and smoking cue reactivity were measured during two laboratory sessions-in a 'Satiated' condition participants smoked up to and during the session while in an 'Abstinent' condition, participants were required to be smoking abstinent overnight and remain abstinent during the session.


RESULTS
The effects of abstinence on ADHD and non-ADHD smokers did not differ for withdrawal symptom severity, mood, craving or cue reactivity. Significant Group x Condition interactions were observed for measures of attention and response inhibition on the Conners' CPT. For reaction time (RT) variability and errors of commission, the ADHD group exhibited greater decrements in performance after overnight abstinence compared to the non-ADHD group. The effects of abstinence on other cognitive measures (e.g., rapid visual information processing task, cued Go/No-Go task) did not differ between the two groups.


CONCLUSIONS
This preliminary study is the first to systematically evaluate the effects of acute smoking abstinence in adult smokers diagnosed with ADHD. Individuals with the disorder may smoke at higher rates due to greater worsening of attention and response inhibition after abstinence.
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 2701, Durham, NC, 27708, USA. mccle011@mc.duke.edu
F Joseph
FJ
McClernon
Scott H
SH
Kollins
Avery M
AM
Lutz
David P
DP
Fitzgerald
Desiree W
DW
Murray
Christina
C
Redman
Jed E
JE
Rose
D000328:Adult; D000339:Affect; D001143:Arousal; D001288:Attention; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003463:Cues; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D009042:Motivation; D009483:Neuropsychological Tests; D009538:Nicotine / Q000009:adverse effects*; D010364:Pattern Recognition, Visual; D011597:Psychomotor Performance; D011930:Reaction Time; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology / Q000523:psychology; D016540:Smoking Cessation; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000523:psychology*
D009538:Nicotine