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Cigarette Smoking Progression Among Young Adults Diagnosed With ADHD in Childhood: A 16-year Longitudinal Study of Children With and Without ADHD.

Publication ,  Journal Article
Mitchell, JT; Howard, AL; Belendiuk, KA; Kennedy, TM; Stehli, A; Swanson, JM; Hechtman, L; Arnold, LE; Hoza, B; Vitiello, B; Lu, B ...
Published in: Nicotine Tob Res
April 17, 2019

INTRODUCTION: Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for smoking cigarettes, but there is little longitudinal research on the array of smoking characteristics known to be prognostic of long-term smoking outcomes into adulthood. These variables were studied into early adulthood in a multisite sample diagnosed with ADHD combined type at ages 7-9.9 and followed prospectively alongside an age- and sex-matched local normative comparison group (LNCG). METHODS: Cigarette smoking quantity, quit attempts, dependence, and other characteristics were assessed in the longitudinal Multimodal Treatment Study of Children with ADHD (MTA) eight times to a mean age of 24.9 years: ADHD n = 469; LNCG n = 240. RESULTS: In adulthood, the ADHD group had higher rates of daily cigarette smoking, one or more quit attempts, shorter time to first cigarette of the day, and more severe withdrawal than the LNCG. The ADHD group did not appear to have better smoking cessation rates despite a higher proportion quitting at least once. Smoking quantity and nicotine dependence did not differ between groups. The ADHD group reported younger daily smoking onset and faster progression from smoking initiation to daily smoking across assessments. Finally, ADHD symptom severity in later adolescence and adulthood was associated with higher risk for daily smoking across assessments in the ADHD sample. CONCLUSIONS: This study shows that ADHD-related smoking risk begins at a young age, progresses rapidly, and becomes resistant to cessation attempts by adulthood. Prevention efforts should acknowledge the speed of uptake; treatments should target the higher relapse risk in this vulnerable population. IMPLICATIONS: Although childhood ADHD predicts later smoking, longitudinal studies of this population have yet to fully characterize smoking behaviors into adulthood that are known to be prognostic of long-term smoking outcome. The current study demonstrates earlier and faster progression to daily smoking among those with a childhood ADHD diagnosis, as well as greater risk for failed quit attempts. Prevention efforts should address speed of smoking uptake, while treatments are needed that address smoking relapse risk. The current study also demonstrates ADHD symptom severity over development increases daily smoking risk, implicating the need for continuous ADHD symptom management.

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Published In

Nicotine Tob Res

DOI

EISSN

1469-994X

Publication Date

April 17, 2019

Volume

21

Issue

5

Start / End Page

638 / 647

Location

England

Related Subject Headings

  • Young Adult
  • Tobacco Use Disorder
  • Time Factors
  • Smoking Cessation
  • Public Health
  • Prognosis
  • Male
  • Longitudinal Studies
  • Humans
  • Female
 

Citation

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Mitchell, J. T., Howard, A. L., Belendiuk, K. A., Kennedy, T. M., Stehli, A., Swanson, J. M., … Molina, B. S. G. (2019). Cigarette Smoking Progression Among Young Adults Diagnosed With ADHD in Childhood: A 16-year Longitudinal Study of Children With and Without ADHD. Nicotine Tob Res, 21(5), 638–647. https://doi.org/10.1093/ntr/nty045
Mitchell, John T., Andrea L. Howard, Katherine A. Belendiuk, Traci M. Kennedy, Annamarie Stehli, James M. Swanson, Lily Hechtman, et al. “Cigarette Smoking Progression Among Young Adults Diagnosed With ADHD in Childhood: A 16-year Longitudinal Study of Children With and Without ADHD.Nicotine Tob Res 21, no. 5 (April 17, 2019): 638–47. https://doi.org/10.1093/ntr/nty045.
Mitchell JT, Howard AL, Belendiuk KA, Kennedy TM, Stehli A, Swanson JM, et al. Cigarette Smoking Progression Among Young Adults Diagnosed With ADHD in Childhood: A 16-year Longitudinal Study of Children With and Without ADHD. Nicotine Tob Res. 2019 Apr 17;21(5):638–47.
Mitchell, John T., et al. “Cigarette Smoking Progression Among Young Adults Diagnosed With ADHD in Childhood: A 16-year Longitudinal Study of Children With and Without ADHD.Nicotine Tob Res, vol. 21, no. 5, Apr. 2019, pp. 638–47. Pubmed, doi:10.1093/ntr/nty045.
Mitchell JT, Howard AL, Belendiuk KA, Kennedy TM, Stehli A, Swanson JM, Hechtman L, Arnold LE, Hoza B, Vitiello B, Lu B, Kollins SH, Molina BSG. Cigarette Smoking Progression Among Young Adults Diagnosed With ADHD in Childhood: A 16-year Longitudinal Study of Children With and Without ADHD. Nicotine Tob Res. 2019 Apr 17;21(5):638–647.
Journal cover image

Published In

Nicotine Tob Res

DOI

EISSN

1469-994X

Publication Date

April 17, 2019

Volume

21

Issue

5

Start / End Page

638 / 647

Location

England

Related Subject Headings

  • Young Adult
  • Tobacco Use Disorder
  • Time Factors
  • Smoking Cessation
  • Public Health
  • Prognosis
  • Male
  • Longitudinal Studies
  • Humans
  • Female