title: Attention Deficit Hyperactivity Disorder symptoms and smoking trajectories: race and gender differences.
abstract: OBJECTIVE
  This study examined the influence of Attention Deficit Hyperactivity Disorder (ADHD) symptoms severity and directionality (hyperactive-impulsive symptoms relative to inattentive symptoms) on trajectories of the probability of current (past month) smoking and the number of cigarettes smoked from age 13 to 32. Racial and gender differences in the relationship of ADHD symptoms and smoking trajectories were also assessed.
  
  
  METHODS
  A subsample of 9719 youth (54.5% female) was drawn from the National Longitudinal Study of Adolescent to Adult Health (Add Health). Cohort sequential design and zero-inflated Poisson (ZIP) latent growth modeling were used to estimate the relationship between ADHD directionality and severity on smoking development.
  
  
  RESULTS
  ADHD severity's effect on the likelihood of ever smoking cigarettes at the intercept (age 13) had a greater impact on White males than other groups. ADHD severity also had a stronger influence on the initial number of cigarettes smoked at age 13 among Hispanic participants. The relationships between ADHD directionality (hyperactive-impulsive symptoms relative to inattentive symptoms) and a higher number of cigarettes smoked at the intercept were stronger among Hispanic males than others. Gender differences manifested only among Whites.
  
  
  CONCLUSIONS
  ADHD severity and directionality had unique effects on smoking trajectories. Our results also highlight that the risk of ADHD symptoms may differ by race and gender.
authors.affiliation: School of Family Life, Brigham Young University, JSFB 2083, Provo, UT 84602, United States. Electronic address: chienti_lee@byu.edu.
authors.forename: Chien-Ti
authors.initials: CT
authors.lastname: Lee
authors.affiliation: School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro St., CB #3550, Chapel Hill, NC 27599, United States.
authors.forename: Trenette T
authors.initials: TT
authors.lastname: Clark
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC 27705, United States.
authors.forename: Scott H
authors.initials: SH
authors.lastname: Kollins
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, 2608 Erwin Road, Suite 300, Durham, NC 27705, United States.
authors.forename: F Joseph
authors.initials: FJ
authors.lastname: McClernon
authors.affiliation: Department of Community and Family Medicine, Duke University School of Medicine, DUMC 104006, Durham, NC 27710, United States.
authors.forename: Bernard F
authors.initials: BF
authors.lastname: Fuemmeler
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000208:ethnology* / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D044469:Racial Groups / Q000208:ethnology* / Q000523:psychology; D012189:Retrospective Studies; D012727:Sex Characteristics; D012907:Smoking / Q000208:ethnology* / Q000523:psychology / Q000639:trends*; D055815:Young Adult
keywords: ADHD symptoms; Racial and gender differences; Smoking trajectories