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Novelty seeking, a trait common among individuals with ADHD,[8,9] is associated with smoking risk.[10] The quantity of present ADHD symptoms appears to be associated with the risk for early smoking initiation, increased smoking amount, and increasing dependence on nicotine.[11] Some studies have suggested that IN symptoms drive this association,[12] while others have suggested that HI symptoms are more predictive of cigarette smoking,[13,14] or that the relative contributions of IN and HI symptoms to risk for nicotine dependence may differ depending on developmental period (adolescence versus young adulthood).[15] Still others have maintained that the link between ADHD and smoking is largely driven by common co-morbidities, such as conduct disorder, which itself is a robust predictor of nicotine dependence and substance abuse in general.[16] In a sample (n=334) of college students, our research group found that both HI and IN symptoms were associated with cigarette smoking.[17] Another recent study revealed that some genetic polymorphisms may interact with ADHD symptoms to increase risk for smoking.[18] In addition to possessing an increased risk for cigarette smoking and nicotine dependence, individuals with ADHD may also have more difficulty quitting cigarettes.[19,20] Given that nicotine administration has been shown to acutely reduce ADHD symptoms even among nonsmokers,[21,22] it has been suggested that smokers with ADHD may be self-medicating with nicotine to reduce ADHD symptoms.[23,24] When attempting to quit smoking, individuals with ADHD may have more severe withdrawal symptoms, including irritability and difficulty concentrating.[25] A recent controlled laboratory study demonstrated that nicotine abstinence among smokers with ADHD is associated with greater worsening of attention and response inhibition.[26] In an analysis of over 400 adult participants in smoking cessation treatment studies, childhood ADHD diagnosis was significantly associated with treatment failure.[19] Neurobiological processes may underlie the link between cigarette smoking and ADHD
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