Does ADHD increase the risks associated with smoking?

In fact, scientific studies show that individuals with PHDare more likely to start smoking earlier, develop a stronger nicotine dependence and face greater challenges when trying to quit the habit.

But why is this connection so strong? 🤔

In this article, we explore the neurobiological, emotional and social factors that help explain the main risks of this relationship!

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Risk 1: Early onset and rapid progression

Individuals with PHDA tend to start smoking earlier and progress quickly to regular use.
👉 Why?Impulsivity and the difficulty in assessing future consequences, common in PHDA, make smoking more appealing to this group.

This trend is due to need for stimulation and the search for new experiences, characteristics frequently associated with PHDA.

Harvard researchers found, back in 1997, that children and adolescents with PHDA are more likely to start smoking early. This early start increases the risk of long-term dependence.

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Risk 2: More severe withdrawal symptoms

People with PHDA tend to experience more severe withdrawal symptoms when trying to quit smoking.

👉 Why?Nicotine interacts with dopaminergic systems, providing temporary relief from some symptoms of PHDA. However, this effect is transient and can lead to a cycle of dependence that exacerbates natural dopamine regulation in the long term.

Anxiety, irritability and an uncontrollable craving for nicotine are often more pronounced, making the cessation process more difficult!

Some studies indicate that individuals with PHDA experience an exacerbation of the effects of withdrawal, making it even more difficult to quit smoking.

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Risk 3: Neurobiological Alterations

The link between PHDA and smoking is deeply rooted in neurobiological factors.

👉 Why?Both are associated with dysfunctions in the dopaminergic pathways responsible for pleasure and reward.

Nicotine increases dopamine levels, providing temporary relief. This momentary effect can lead to the use of cigarettes as a form of “self-medication”.

Researchers suggest that “MAO (Monoamine Oxidase) inhibitors”, substances present in tobacco, can also temporarily alleviate the symptoms of PHDA, which can lead to a cycle of dependence.

*MAO inhibitors are compounds that affect how the brain processes certain neurotransmitters that play an important role in PHDA (such as dopamine). However, this effect is temporary and continued tobacco use can aggravate symptoms in the long term.

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Risk 4: Psychological and Emotional Changes

Emotional dysregulation, common in PHDA, is one of the factors that increase the risk of smoking.

👉 Why? Smoking is often used as a way to deal with difficult emotions or temporarily improve attention - a real “escape valve”.

People with PHDA often turn to tobacco to increase focus during monotonous or challenging tasks.

Although it seems like a quick solution to manage the stress, frustration or impulsiveness, this “false solution” ends up reinforcing the risk of dependence.

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Risk 5: The impact is even greater on women

Studies show that women with PHDA have a higher risk of smoking compared to men.

👉 Why?Apparently, inattention (more prevalent in female PHDA) is one of the main predictors of this behavior.

This trend has also been observed in adolescents: girls with PHDA are significantly more likely to develop smoking habits, often as a way to regulate their own emotions.

Understanding these differences can help create specific approaches to support women with PHDA!

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What can we do?

The relationship between PHDA and smoking is complex, and both prevention and intervention are essential.

Some strategies include:

• Early diagnosis:The earlier PHDA is identified, the less likely the child will turn to tobacco in the future to manage symptoms.
• Professional support: Behavioral therapy, smoking cessation programs and even sessions of Neurofeedbackadapted to the needs of those living with PHDA can help.
• Education:To sensitize parents, educators and health professionals to the associated risks.
• Personalized intervention:Approaches that combine emotional support and strategies to improve emotional regulation and attention.

Understanding the factors that link PHDA to smoking is essential to support those facing this challenge!

By disseminating science-based information, we promote awareness and help those who need it most. 😊

Note:Each person may experience smoking differently, and the challenges of quitting vary depending on individual factors, such as personal history, level of impulsivity and available support. Therefore, cessation strategies must be personalized, combining approaches that best suit each individual. If you are looking for specialized support, consult a healthcare professional to explore the best options for you.

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References:

Taylor, M., Carrasco, K., Carrasco, A., & Basu, A. (2022). Tobacco and ADHD: A Role of MAO Inhibition in Nicotine Dependence and Alleviation of ADHD Symptoms. Frontiers in Neuroscience, 16. doi: 10.3389/fnins.2022.845646

Mitchell, J., McClernon, F., Beckham, J., Brown, R., Lejuez, C., & Collins, S. (2019). Effects of smoking abstinence on emotion dysregulation in adult cigarette smokers with and without attention-deficit/hyperactivity disorder. Drug and alcohol dependence, 205, 107594. doi: 10.1016/j.drugalcdep.2019.107594

Elkins, I., Saunders, G., Malone, S., Keyes, M., Samek, D., McGue, M., & Iacono, W. (2018). Increased Risk of Smoking in Female Adolescents Who Had Childhood ADHD. The American journal of psychiatry, 175 1, 63—70. doi: 10.1176/appi.ajp.2017.17010009

Rhodes, J., Pelham, W., Ggrande, E., Shiffman, S., Derefinko, K., & Molina, B. (2016). Cigarette smoking and ADHD: An examination of prognostically relevant smoking behaviors among adolescents and young adults. Journal of Psychology of Addictive Behaviors of the Society of Psychologists in Addictive Behaviors, 30 5, 588-600. doi: 10.1037/adb0000188

Milberger, S., Biederman, J., Faraone, S., Chen, L., & Jones, J. (1997). ADHD is associated with early initiation of cigarette smoking in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 36 1, 37—44. doi: 10.1097/00004583-199701000-00015

Milberger, S., Biederman, J., Faraone, S., Chen, L., & Jones, J. (1997). Further evidence of an association between attention-deficit/hyperactivity disorder and cigarette smoking. Findings from a high-risk sample of siblings. The American journal on addictions, 6 3, 205-17.