What is ADHD and how does ADHD affect me? 

Attention-deficit/hyperactivity disorder (ADHD) is a behavioral condition that makes focusing on everyday requests and routines demanding (1). Living with this disorder, you might experience that daily challenges like getting organized, staying focused, and planning are more difficult for you. ADHD affects all aspects of life and health behavior is not an exception. Did you know that this condition is related to disordered eating and nicotine dependence?

Smoking daily is twice as common amongst people with ADHD. Even without a clinical diagnosis, ADHD symptoms represent a risk factor for cigarette consumption. (2) This data is concerning, as according to WHO, tobacco kills up to half of its users. (3) Let’s take a look at why ADHD can make it harder to quit!

Can ADHD stand behind relapse? 

Both smoking and ADHD are complex and heterogeneous phenomena, but it didn’t stop scientists from investigating their relationship. After following 500 people living with ADHD for 16 years, researchers explored ADHD smoking patterns. They found that the ADHD group not only had higher rates of daily smoking, but they also smoked their first cigarette of the day earlier than others. The study also shows that ADHD-related smoking begins at a young age and progresses rapidly. One day you try cigarettes, and the next moment you find yourself chain smoking. When trying to kick the habit, ADHD participants reported more withdrawal symptoms. Nicotine withdrawal involves physical, mental, and emotional symptoms, such as headaches, insomnia, craving, and depression. Restlessness and irritability are especially common complaints for those who live with ADHD. Evidence suggests that there is a linear relationship between ADHD and smoking: you will get hooked quicker and it is harder to stop. (2)

Blame my genes: do I smoke because I have ADHD? 

Studies suggest that both ADHD and smoking are highly heritable: there are genetic factors that may give rise to this comorbidity. To better understand, we need to look at the neurotransmitter dopamine. The dysfunction of the dopaminergic system makes us more impulsive and reward-sensitive and causes control deficits, thus worsening nicotine withdrawal and promoting relapse. 

But that’s not all: nicotine was found to reduce both attention deficit and hyperactivity symptoms. This means that tobacco might be used as “self-medication”, the ADHD individual uses cigarettes to stay focused and organized. (4) Moreover, cigarettes seem to be a quick fix for the ADHD nervous system, as they boost dopamine levels and give an immediate sense of reward. However, the long term effects of nicotine are deadly. Smoking increases the risk of heart disease, diabetes and cancer. 

How should I quit then?

If you have ADHD and struggle with cessation, don’t hesitate to seek professional help. There are psychological and pharmacological interventions that can help you reach abstinence. The research proposes to treat ADHD symptoms before quitting smoking. There is also medication that can make cessation easier. Certain psychostimulants can reduce the risk of smoking. Cognitive-behavioral therapy (CBT) and smoking cessation aids, like NRT, bupropion or varenicline can be used for further treatment. And don’t get discouraged: giving up smoking usually takes more than one attempt. (4, 5)

The more you know about your condition, the easier it is to manage. Learn more about overcoming ADHD challenges here and feel free to ask for support from a professional!

Roza Sara Somlai is an Educational Psychology and Counselling student at Eotvos Lorand University. She is currently an intern at Willingness.

​​(1) ADHD. (n.d.). www.apa.org. Retrieved July 7, 2022, from https://www.apa.org/topics/adhd

(2) Mitchell, J. T., Howard, A. L., Belendiuk, K. A., Kennedy, T. M., Stehli, A., Swanson, J. M., Hechtman, L., Arnold, L. E., Hoza, B., Vitiello, B., Lu, B., Kollins, S. H., & Molina, B. (2019). Cigarette Smoking Progression Among Young Adults Diagnosed With ADHD in Childhood: A 16-year Longitudinal Study of Children With and Without ADHD. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 21(5), 638–647. https://doi.org/10.1093/ntr/nty045

(3) Tobacco. (2022, May 24). Tobacco; www.who.int. https://www.who.int/news-room/fact-sheets/detail/tobacco

(4) McClernon, F. J., & Kollins, S. H. (2008). ADHD and smoking: from genes to brain to behavior. Annals of the New York Academy of Sciences, 1141, 131–147. https://doi.org/10.1196/annals.1441.016

(5) Schoenfelder, E. N., Faraone, S. V., & Kollins, S. H. (2014). Stimulant treatment of ADHD and cigarette smoking: a meta-analysis. Pediatrics, 133(6), 1070–1080. https://doi.org/10.1542/peds.2014-0179