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ADHD Symptoms Linked to Onset of Nicotine, Tobacco Use in Youth

Youths with highly symptomatic ADHD significantly more likely to initiate e-cigarette use, dual use

By Elana Gotkine HealthDay Reporter

FRIDAY, Feb. 14, 2025 (HealthDay News) — Attention-deficit/hyperactivity disorder (ADHD) symptoms are associated with onset of nicotine and tobacco use in U.S. youths, according to a study published online Feb. 11 in JAMA Network Open.

Sean Esteban McCabe, Ph.D., from the University of Michigan in Ann Arbor, and colleagues examined whether ADHD diagnosis, symptom severity, and pharmacotherapy are associated with incident electronic cigarette (e-cigarette) and tobacco use. A nationally representative sample of U.S. youths and their parents in the Population Assessment of Tobacco and Health Study were followed via questionnaires from wave 1 (September 2013 to December 2014) to waves 2 to 7 (October 2014 to April 2023).

An estimated 1,881 (14.1 percent) of the 13,572 youths aged 12 to 17 years at wave 1 were diagnosed with ADHD. The researchers found that the adjusted odds of incident e-cigarette use, cigarette smoking, other tobacco use, and dual use did not differ significantly between those with asymptomatic ADHD and population controls. Compared with youths with asymptomatic ADHD or population controls, all subgroups with three or more ADHD symptoms had significantly higher adjusted odds of e-cigarette use, cigarette smoking, other tobacco use, and dual use. Among youths with ADHD, those with highly symptomatic ADHD were significantly more likely to initiate e-cigarette and dual use compared with those without symptoms.

“Findings highlight the importance of early diagnosis and effective treatment of ADHD — with or without pharmacotherapy — to alleviate ADHD symptoms and thus reduce the risk of later nicotine and tobacco use among U.S. youths,” the authors write.


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