title: Attention-deficit/hyperactivity disorder (ADHD) symptoms, craving to smoke, and tobacco withdrawal symptoms in adult smokers with ADHD.
abstract: BACKGROUND
  Tobacco withdrawal symptoms may be confounded with attention-deficit/hyperactivity disorder (ADHD) symptoms among smokers with ADHD.
  
  
  OBJECTIVE
  (1) To assess overlap between ADHD symptoms and tobacco/nicotine withdrawal symptoms and craving; (2) to assess the relationship between craving or withdrawal symptoms and the effect of osmotic-release oral system methylphenidate (OROS-MPH) on ADHD symptoms; (3) to assess the association of ADHD symptoms, craving, and withdrawal symptoms with abstinence.
  
  
  METHODS
  Secondary analysis of a randomized, placebo controlled smoking cessation trial assessing the efficacy of OROS-MPH taken in addition to nicotine patch among individuals with ADHD. ADHD symptoms, withdrawal symptoms, and craving were assessed at baseline and 2, 4 and 6 weeks after a target quit day.
  
  
  RESULTS
  Withdrawal symptoms and craving showed limited and modest overlap with ADHD symptoms prior to abstinence but more extensive and stronger correlation after quit day. Compared to placebo, OROS-MPH reduced ADHD symptoms; this effect was attenuated by controlling for withdrawal symptoms, but not by craving. Craving, but not ADHD symptoms and withdrawal symptoms, was associated with abstinence during the trial.
  
  
  CONCLUSIONS
  When treating smokers with ADHD (1) craving, rather than tobacco withdrawal symptoms or ADHD symptoms may be the more effective therapeutic smoking cessation targets; (2) careful distinction of craving, withdrawal symptoms, and ADHD symptoms when assessing withdrawal phenomena is needed.
authors.affiliation: Département de Pharmacologie, Hôpital Pitié-Salpêtrière, AP-HP, Faculté de médicine, Université P. & M. Curie--INSERM U894, 47, bd de l'Hôpital, 75013 Paris, France. ivan.berlin@psl.aphp.fr
authors.forename: Ivan
authors.initials: I
authors.lastname: Berlin
authors.forename: Mei-Chen
authors.initials: MC
authors.lastname: Hu
authors.forename: Lirio S
authors.initials: LS
authors.lastname: Covey
authors.forename: Theresa
authors.initials: T
authors.lastname: Winhusen
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology*; D016739:Behavior, Addictive / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000009:adverse effects* / Q000627:therapeutic use; D012907:Smoking / Q000188:drug therapy / Q000523:psychology*; D016540:Smoking Cessation / Q000379:methods*; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis*; D061485:Tobacco Use Cessation Devices
chemical_list: D009538:Nicotine