title: Do stimulants reduce the risk for cigarette smoking in youth with attention-deficit hyperactivity disorder? A prospective, long-term, open-label study of extended-release methylphenidate.
abstract: OBJECTIVE
  Although attention-deficit hyperactivity disorder (ADHD) is a well-known risk factor for cigarette smoking, prospective studies aimed at reducing smoking risk in this population are critically needed.
  
  
  METHODS
  This was a 2-year, prospective, open-label clinical trial of extended-release methylphenidate for smoking prevention in adolescents with ADHD (n = 154). Smoking outcomes were assessed with the Fagerstrom Tolerance Questionnaire. Comparisons were made using data from a historical, naturalistic sample of ADHD (n = 103) and non-ADHD comparators (n = 188) of similar age and sex assessed with the same assessment battery as that used in subjects participating in the clinical trial.
  
  
  RESULTS
  The smoking rate at endpoint (mean, 10 months of methylphenidate treatment) was low in the clinical trial subjects and not significantly different from that in the non-ADHD comparators or the ADHD comparators receiving stimulants naturalistically (7.1% vs 8.0% vs 10.9%; P > .20). In contrast, the smoking rate was significantly lower in the clinical trial subjects than in the naturalistic sample of ADHD comparators who were not receiving stimulant treatment (7.1% vs 19.6%; P = .009 [not significant], adjusting for comorbid conduct disorder and alcohol and drug abuse).
  
  
  CONCLUSIONS
  Although considered preliminary until replicated in future randomized clinical trials, the findings from this single-site, open-label study suggest that stimulant treatment may contribute to a decreased risk for smoking in adolescents with ADHD. If confirmed, this finding would have significant clinical and public health impacts.
authors.affiliation: Clinical and Research Program in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02138, USA. phammerness@partners.org
authors.forename: Paul
authors.initials: P
authors.lastname: Hammerness
authors.forename: Gagan
authors.initials: G
authors.lastname: Joshi
authors.forename: Robert
authors.initials: R
authors.lastname: Doyle
authors.forename: Anna
authors.initials: A
authors.lastname: Georgiopoulos
authors.forename: Daniel
authors.initials: D
authors.lastname: Geller
authors.forename: Thomas
authors.initials: T
authors.lastname: Spencer
authors.forename: Carter R
authors.initials: CR
authors.lastname: Petty
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D011446:Prospective Studies; D012307:Risk Factors; D000074606:Smoking Prevention; D013997:Time Factors
chemical_list: D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D018765:Dopamine Uptake Inhibitors; D008774:Methylphenidate