Table of ContentsView AllTable of ContentsConnectionNicotine and ADHD SymptomsDrug InteractionsBenefits of QuittingAbstinence TipsFuture Strategies

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Connection

Nicotine and ADHD Symptoms

Drug Interactions

Benefits of Quitting

Abstinence Tips

Future Strategies

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Teens and adults withattention-deficit hyperactivity disorder(ADHD) are more likely to smoke cigarettes and become nicotine-dependent than those who don’t have ADHD.They’re also more likely to start smoking at an earlier age and have a more difficult time successfully quitting as compared to the general population.

This connection between nicotine and ADHD is a public health concern because the regular use of cigarettes is associated with a host ofnegative health consequences. In addition, for many people, cigarettes can be a gateway to other drugs—potentially opening the door to the use of marijuana and cocaine.

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Connection Between Nicotine and ADHD

These findings suggest that there may be common neurobiological factors that contribute to the development of ADHD and also increase a person’s risk for tobacco use. In addition, a review of 12 studies found that in utero smoking exposure is related to an increased risk of ADHD development in the unborn child.

Problems with impulse control might also explain why more teens and adults with ADHD are more likely to engage inrisky behaviorssuch as smoking.ADHD can make it more difficult to look clearly to the future and take into account the negative health consequences of current actions.

Nicotine is a central nervous system stimulant and appears to act on the brain in a way that is similar to thepsychostimulant drugscommonly used to treat ADHD (such as methylphenidate and dextroamphetamine). A number of studies have found that nicotine can improve cognitive performance.

“Nicotine exerts beneficial effects on a range of processes known to be disrupted in individuals with ADHD,” writes Dr. Scott Kollins, PhD, associate professor of psychiatry and medical psychology at the Duke University School of Medicine and director of the Duke ADHD Program. Dr. Kollins adds that the processes nicotine affects include “attention, inhibitory control, andworking memory.”

One study involving 52 adults with ADHD seems to confirm nicotine’s ability to improve ADHD symptoms. In this case, subjects using a nicotine patch for two days had an 8% reduction inADHD symptomsand a 9% reduction in negative mood, regardless of whether they smoked or not.

Based on findings such as these, it is possible that nicotine may help some people with ADHD compensate for the symptoms they experience. At the same time, some experts suggest that smoking may make hyperactivity worse.

For some people, nicotine may serve as a form of self-medication for ADHD symptoms.

Nicotine Interactions With ADHD Medications

Medicationsare often the first line of treatment with ADHD.If you have one of these prescriptions, you may be wondering whether nicotine interacts with your ADHD medication. At least one study suggests that the answer is yes.

It’s also important to know that cigarette smoking affects a number of psychiatric medications, such as those prescribed foranxiety,depression, andantipsychotics, potentially reducing their ability to work.Therefore, finding ways to quit nicotine may help increase the effectiveness of any other medications you are taking.

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Benefits of Quitting Nicotine When You Have ADHD

If nicotine seems to ease your ADHD symptoms, you may worry that quitting smoking will make your symptoms worse. Some studies do indicate that adult smokers with ADHD felt that their symptoms worsened when they abstained from nicotine.

However, in addition to the important health benefits associated withquitting smoking—which include a decrease in breathing issues, reduced risk of heart attack, and lower cancer risk—stopping the use of nicotine offers even more benefits for people with ADHD.

For example, one study found that when adult smokers quit their habit, their feelings of anxiety and depression decreased.So, giving up nicotine may help relieve other mental health issues.

Nicotine Abstinence for People With ADHD

If you have ADHD and want toquit smoking, there are a few strategies that can help.

We know that people with ADHD smoke at rates that are significantly higher than their non-ADHD peers. And some use nicotine as a form of self-medication for ADHD symptoms.Therefore, it is possible that identifying and treating ADHD earlier may prevent the onset of smoking altogether.

Studies show that treatment for ADHD may indeed contribute to a reduced risk of smoking inteens with ADHD.In one report, researchers at Massachusetts General Hospital and Harvard Medical School conducted a two-year, prospective clinical trial of extended-release methylphenidate for smoking prevention in adolescents.

They found that the smoking rate at the end of the study was significantly lower in ADHD subjects who were receiving stimulant treatment than in ADHD subjects who were not, and there was no significant difference between ADHD subjects receiving stimulant treatment and non-ADHD subjects.

A Word From Verywell

Future research is needed to help better explain the link between nicotine and ADHD so that more effective prevention and treatment strategies can be developed. In the meantime, finding a way to overcome your nicotine addiction if you have ADHD provides enough benefits to make it worth the effort.

What Happens When You Quit Smoking?

20 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Rhodes JD, Pelham WE, Gnagy EM, Shiffman S, Derefinko KJ, Molina BS.Cigarette smoking and ADHD: An examination of prognostically relevant smoking behaviors among adolescents and young adults.Psychol Addict Behav.2016;30(5):588-600. doi:10.1037/adb0000188Kollins S.Where there’s smoke, there’s ADHD: What the science says.Attention.Kandel E, Kandel D.A molecular basis for nicotine as a gateway drug.N Engl J Med. 2014;371:932-943. doi:10.1056/NEJMsa1405092Vink J, Treur J, Pasman J, Schellenkens A.Investigating genetic correlation and causality between nicotine dependence and ADHD in a broader psychiatric context.Am J Med Genetics Part B: Neuropsychiat Genetics. 2020;186(7):423-429. doi:10.1002/ajmg.b.32822He Y, Chen J, Zhu LH, Hua LL, Ke FF.Maternal smoking during pregnancy and ADHD: Results from a systematic review and meta-analysis of prospective cohort studies.J Attention Disord. 2017;24(12):1637-1647. doi:10.1177/10870547171696766Roberts W, Peters JR, Adams ZW, Lynam DR, Milich R.Identifying the facets of impulsivity that explain the relation between ADHD symptoms and substance use in a nonclinical sample.Addict Behav. 2014;39(8):1272-1277. doi:10.1016/j.addbeh.2014.04.005Piña J, Namba MD, Leyrer-Jackson JM, Cabrera-Brown G, Gipson CD.Chapter one - Social influences on nicotine-related behaviors.Int Rev Neurobiol.2018;140:1-3. doi:10.1016/bs.irn.2018.07.001Campos MW, Serebrisky D, Castaldelli-Maia JM.Smoking and cognition.Curr Drug Abuse Rev.2016;9(2):76-79. doi:10.2174/1874473709666160803101633Gehricke JG, Hong N, Whalen CK, Steinhoff K, Wigal TL.Effects of transdermal nicotine on symptoms, moods, and cardiovascular activity in the everyday lives of smokers and nonsmokers with attention-deficit/hyperactivity disorder.Psychol Addict Behav. 2009;23(4):644-55. doi:10.1037/a0017441Columbia University Irving Medical Center.Four things people with ADHD should know about smoking.Clavenna A, Bonati M.Pediatric pharmacoepidemiology - safety and effectiveness of medicines for ADHD.Expert Opin Drug Safety. 2017;16(12):1335-1345. doi:10.1080/14740338.2017.1389894Bron TI, Bijlenga D, Kasander MV, Spuijbroek AT.Long-term relationship between methylphenidate and tobacco consumption and nicotine craving in adults with ADHD in a prospective cohort study.Eur Neuropsychopharmacol. 2013;23(6):542-554. doi:10.1016/j.euroneuro.2012.06.004How smoking affects medications.Pharmacy Times.Liebrenz M, Fisher CE, Nellen R, et al.Adult attention-deficit/hyperactivity disorder and nicotine withdrawal: a qualitative study of patient perceptions.BMC Psychiatry. 2016;16:208. doi:10.1186/s12888-016-0911-9American Cancer Society.Health benefits of quitting smoking over time.Covey LS, Hu MC, Winhusen T, Lima J, Berlin I, Nunes E.Anxiety and depressed mood decline following smoking abstinence in adult smokers with attention deficit hyperactivity disorder.J Subst Abuse Treat. 2015;59:104-8. doi:10.1016/j.jsat.2015.07.004Bidwell LC, Karoly HC, Hutchinson KE, Bryan AD.ADHD symptoms impact smoking outcomes and withdrawal in response to varenicline treatment for smoking cessation.Drug Alc Depend. 2017;179:18-24. doi:10.1016/j.drugalcdep.2017.06.020Covey LS, Manubay J, Jiang H, Nortick M, Palumbo D.Smoking cessation and inattention or hyperactivity/impulsivity: a post hoc analysis.Nicotine Tob Res. 2008;10(12):1717-1725. doi:10.1080/14622200802443536Schoenfelder EN, Faraone SV, Kollins SH.Stimulant treatment of ADHD and cigarette smoking: A meta-analysis.Pediatrics. 2014;133(6):1070-1080. doi:10.2174/1874473709666160803101633Hammerness P, Joshi G, Doyle R, et al.Do stimulants reduce the risk for cigarette smoking in youth with attention-deficit hyperactivity disorder? A prospective, long-term, open-label study of extended-release methylphenidate.J Pediatr.2013;162(1):22-7.e2. doi:10.1016/j.jpeds.2012.06.046

20 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Rhodes JD, Pelham WE, Gnagy EM, Shiffman S, Derefinko KJ, Molina BS.Cigarette smoking and ADHD: An examination of prognostically relevant smoking behaviors among adolescents and young adults.Psychol Addict Behav.2016;30(5):588-600. doi:10.1037/adb0000188Kollins S.Where there’s smoke, there’s ADHD: What the science says.Attention.Kandel E, Kandel D.A molecular basis for nicotine as a gateway drug.N Engl J Med. 2014;371:932-943. doi:10.1056/NEJMsa1405092Vink J, Treur J, Pasman J, Schellenkens A.Investigating genetic correlation and causality between nicotine dependence and ADHD in a broader psychiatric context.Am J Med Genetics Part B: Neuropsychiat Genetics. 2020;186(7):423-429. doi:10.1002/ajmg.b.32822He Y, Chen J, Zhu LH, Hua LL, Ke FF.Maternal smoking during pregnancy and ADHD: Results from a systematic review and meta-analysis of prospective cohort studies.J Attention Disord. 2017;24(12):1637-1647. doi:10.1177/10870547171696766Roberts W, Peters JR, Adams ZW, Lynam DR, Milich R.Identifying the facets of impulsivity that explain the relation between ADHD symptoms and substance use in a nonclinical sample.Addict Behav. 2014;39(8):1272-1277. doi:10.1016/j.addbeh.2014.04.005Piña J, Namba MD, Leyrer-Jackson JM, Cabrera-Brown G, Gipson CD.Chapter one - Social influences on nicotine-related behaviors.Int Rev Neurobiol.2018;140:1-3. doi:10.1016/bs.irn.2018.07.001Campos MW, Serebrisky D, Castaldelli-Maia JM.Smoking and cognition.Curr Drug Abuse Rev.2016;9(2):76-79. doi:10.2174/1874473709666160803101633Gehricke JG, Hong N, Whalen CK, Steinhoff K, Wigal TL.Effects of transdermal nicotine on symptoms, moods, and cardiovascular activity in the everyday lives of smokers and nonsmokers with attention-deficit/hyperactivity disorder.Psychol Addict Behav. 2009;23(4):644-55. doi:10.1037/a0017441Columbia University Irving Medical Center.Four things people with ADHD should know about smoking.Clavenna A, Bonati M.Pediatric pharmacoepidemiology - safety and effectiveness of medicines for ADHD.Expert Opin Drug Safety. 2017;16(12):1335-1345. doi:10.1080/14740338.2017.1389894Bron TI, Bijlenga D, Kasander MV, Spuijbroek AT.Long-term relationship between methylphenidate and tobacco consumption and nicotine craving in adults with ADHD in a prospective cohort study.Eur Neuropsychopharmacol. 2013;23(6):542-554. doi:10.1016/j.euroneuro.2012.06.004How smoking affects medications.Pharmacy Times.Liebrenz M, Fisher CE, Nellen R, et al.Adult attention-deficit/hyperactivity disorder and nicotine withdrawal: a qualitative study of patient perceptions.BMC Psychiatry. 2016;16:208. doi:10.1186/s12888-016-0911-9American Cancer Society.Health benefits of quitting smoking over time.Covey LS, Hu MC, Winhusen T, Lima J, Berlin I, Nunes E.Anxiety and depressed mood decline following smoking abstinence in adult smokers with attention deficit hyperactivity disorder.J Subst Abuse Treat. 2015;59:104-8. doi:10.1016/j.jsat.2015.07.004Bidwell LC, Karoly HC, Hutchinson KE, Bryan AD.ADHD symptoms impact smoking outcomes and withdrawal in response to varenicline treatment for smoking cessation.Drug Alc Depend. 2017;179:18-24. doi:10.1016/j.drugalcdep.2017.06.020Covey LS, Manubay J, Jiang H, Nortick M, Palumbo D.Smoking cessation and inattention or hyperactivity/impulsivity: a post hoc analysis.Nicotine Tob Res. 2008;10(12):1717-1725. doi:10.1080/14622200802443536Schoenfelder EN, Faraone SV, Kollins SH.Stimulant treatment of ADHD and cigarette smoking: A meta-analysis.Pediatrics. 2014;133(6):1070-1080. doi:10.2174/1874473709666160803101633Hammerness P, Joshi G, Doyle R, et al.Do stimulants reduce the risk for cigarette smoking in youth with attention-deficit hyperactivity disorder? A prospective, long-term, open-label study of extended-release methylphenidate.J Pediatr.2013;162(1):22-7.e2. doi:10.1016/j.jpeds.2012.06.046

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Rhodes JD, Pelham WE, Gnagy EM, Shiffman S, Derefinko KJ, Molina BS.Cigarette smoking and ADHD: An examination of prognostically relevant smoking behaviors among adolescents and young adults.Psychol Addict Behav.2016;30(5):588-600. doi:10.1037/adb0000188Kollins S.Where there’s smoke, there’s ADHD: What the science says.Attention.Kandel E, Kandel D.A molecular basis for nicotine as a gateway drug.N Engl J Med. 2014;371:932-943. doi:10.1056/NEJMsa1405092Vink J, Treur J, Pasman J, Schellenkens A.Investigating genetic correlation and causality between nicotine dependence and ADHD in a broader psychiatric context.Am J Med Genetics Part B: Neuropsychiat Genetics. 2020;186(7):423-429. doi:10.1002/ajmg.b.32822He Y, Chen J, Zhu LH, Hua LL, Ke FF.Maternal smoking during pregnancy and ADHD: Results from a systematic review and meta-analysis of prospective cohort studies.J Attention Disord. 2017;24(12):1637-1647. doi:10.1177/10870547171696766Roberts W, Peters JR, Adams ZW, Lynam DR, Milich R.Identifying the facets of impulsivity that explain the relation between ADHD symptoms and substance use in a nonclinical sample.Addict Behav. 2014;39(8):1272-1277. doi:10.1016/j.addbeh.2014.04.005Piña J, Namba MD, Leyrer-Jackson JM, Cabrera-Brown G, Gipson CD.Chapter one - Social influences on nicotine-related behaviors.Int Rev Neurobiol.2018;140:1-3. doi:10.1016/bs.irn.2018.07.001Campos MW, Serebrisky D, Castaldelli-Maia JM.Smoking and cognition.Curr Drug Abuse Rev.2016;9(2):76-79. doi:10.2174/1874473709666160803101633Gehricke JG, Hong N, Whalen CK, Steinhoff K, Wigal TL.Effects of transdermal nicotine on symptoms, moods, and cardiovascular activity in the everyday lives of smokers and nonsmokers with attention-deficit/hyperactivity disorder.Psychol Addict Behav. 2009;23(4):644-55. doi:10.1037/a0017441Columbia University Irving Medical Center.Four things people with ADHD should know about smoking.Clavenna A, Bonati M.Pediatric pharmacoepidemiology - safety and effectiveness of medicines for ADHD.Expert Opin Drug Safety. 2017;16(12):1335-1345. doi:10.1080/14740338.2017.1389894Bron TI, Bijlenga D, Kasander MV, Spuijbroek AT.Long-term relationship between methylphenidate and tobacco consumption and nicotine craving in adults with ADHD in a prospective cohort study.Eur Neuropsychopharmacol. 2013;23(6):542-554. doi:10.1016/j.euroneuro.2012.06.004How smoking affects medications.Pharmacy Times.Liebrenz M, Fisher CE, Nellen R, et al.Adult attention-deficit/hyperactivity disorder and nicotine withdrawal: a qualitative study of patient perceptions.BMC Psychiatry. 2016;16:208. doi:10.1186/s12888-016-0911-9American Cancer Society.Health benefits of quitting smoking over time.Covey LS, Hu MC, Winhusen T, Lima J, Berlin I, Nunes E.Anxiety and depressed mood decline following smoking abstinence in adult smokers with attention deficit hyperactivity disorder.J Subst Abuse Treat. 2015;59:104-8. doi:10.1016/j.jsat.2015.07.004Bidwell LC, Karoly HC, Hutchinson KE, Bryan AD.ADHD symptoms impact smoking outcomes and withdrawal in response to varenicline treatment for smoking cessation.Drug Alc Depend. 2017;179:18-24. doi:10.1016/j.drugalcdep.2017.06.020Covey LS, Manubay J, Jiang H, Nortick M, Palumbo D.Smoking cessation and inattention or hyperactivity/impulsivity: a post hoc analysis.Nicotine Tob Res. 2008;10(12):1717-1725. doi:10.1080/14622200802443536Schoenfelder EN, Faraone SV, Kollins SH.Stimulant treatment of ADHD and cigarette smoking: A meta-analysis.Pediatrics. 2014;133(6):1070-1080. doi:10.2174/1874473709666160803101633Hammerness P, Joshi G, Doyle R, et al.Do stimulants reduce the risk for cigarette smoking in youth with attention-deficit hyperactivity disorder? A prospective, long-term, open-label study of extended-release methylphenidate.J Pediatr.2013;162(1):22-7.e2. doi:10.1016/j.jpeds.2012.06.046

Rhodes JD, Pelham WE, Gnagy EM, Shiffman S, Derefinko KJ, Molina BS.Cigarette smoking and ADHD: An examination of prognostically relevant smoking behaviors among adolescents and young adults.Psychol Addict Behav.2016;30(5):588-600. doi:10.1037/adb0000188

Kollins S.Where there’s smoke, there’s ADHD: What the science says.Attention.

Kandel E, Kandel D.A molecular basis for nicotine as a gateway drug.N Engl J Med. 2014;371:932-943. doi:10.1056/NEJMsa1405092

Vink J, Treur J, Pasman J, Schellenkens A.Investigating genetic correlation and causality between nicotine dependence and ADHD in a broader psychiatric context.Am J Med Genetics Part B: Neuropsychiat Genetics. 2020;186(7):423-429. doi:10.1002/ajmg.b.32822

He Y, Chen J, Zhu LH, Hua LL, Ke FF.Maternal smoking during pregnancy and ADHD: Results from a systematic review and meta-analysis of prospective cohort studies.J Attention Disord. 2017;24(12):1637-1647. doi:10.1177/10870547171696766

Roberts W, Peters JR, Adams ZW, Lynam DR, Milich R.Identifying the facets of impulsivity that explain the relation between ADHD symptoms and substance use in a nonclinical sample.Addict Behav. 2014;39(8):1272-1277. doi:10.1016/j.addbeh.2014.04.005

Piña J, Namba MD, Leyrer-Jackson JM, Cabrera-Brown G, Gipson CD.Chapter one - Social influences on nicotine-related behaviors.Int Rev Neurobiol.2018;140:1-3. doi:10.1016/bs.irn.2018.07.001

Campos MW, Serebrisky D, Castaldelli-Maia JM.Smoking and cognition.Curr Drug Abuse Rev.2016;9(2):76-79. doi:10.2174/1874473709666160803101633

Gehricke JG, Hong N, Whalen CK, Steinhoff K, Wigal TL.Effects of transdermal nicotine on symptoms, moods, and cardiovascular activity in the everyday lives of smokers and nonsmokers with attention-deficit/hyperactivity disorder.Psychol Addict Behav. 2009;23(4):644-55. doi:10.1037/a0017441

Columbia University Irving Medical Center.Four things people with ADHD should know about smoking.

Clavenna A, Bonati M.Pediatric pharmacoepidemiology - safety and effectiveness of medicines for ADHD.Expert Opin Drug Safety. 2017;16(12):1335-1345. doi:10.1080/14740338.2017.1389894

Bron TI, Bijlenga D, Kasander MV, Spuijbroek AT.Long-term relationship between methylphenidate and tobacco consumption and nicotine craving in adults with ADHD in a prospective cohort study.Eur Neuropsychopharmacol. 2013;23(6):542-554. doi:10.1016/j.euroneuro.2012.06.004

How smoking affects medications.Pharmacy Times.

Liebrenz M, Fisher CE, Nellen R, et al.Adult attention-deficit/hyperactivity disorder and nicotine withdrawal: a qualitative study of patient perceptions.BMC Psychiatry. 2016;16:208. doi:10.1186/s12888-016-0911-9

American Cancer Society.Health benefits of quitting smoking over time.

Covey LS, Hu MC, Winhusen T, Lima J, Berlin I, Nunes E.Anxiety and depressed mood decline following smoking abstinence in adult smokers with attention deficit hyperactivity disorder.J Subst Abuse Treat. 2015;59:104-8. doi:10.1016/j.jsat.2015.07.004

Bidwell LC, Karoly HC, Hutchinson KE, Bryan AD.ADHD symptoms impact smoking outcomes and withdrawal in response to varenicline treatment for smoking cessation.Drug Alc Depend. 2017;179:18-24. doi:10.1016/j.drugalcdep.2017.06.020

Covey LS, Manubay J, Jiang H, Nortick M, Palumbo D.Smoking cessation and inattention or hyperactivity/impulsivity: a post hoc analysis.Nicotine Tob Res. 2008;10(12):1717-1725. doi:10.1080/14622200802443536

Schoenfelder EN, Faraone SV, Kollins SH.Stimulant treatment of ADHD and cigarette smoking: A meta-analysis.Pediatrics. 2014;133(6):1070-1080. doi:10.2174/1874473709666160803101633

Hammerness P, Joshi G, Doyle R, et al.Do stimulants reduce the risk for cigarette smoking in youth with attention-deficit hyperactivity disorder? A prospective, long-term, open-label study of extended-release methylphenidate.J Pediatr.2013;162(1):22-7.e2. doi:10.1016/j.jpeds.2012.06.046

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