Skip to main navigation menu Skip to main content Skip to site footer

Research Article

Vol. 7 No. 1 (2003)

Sub-clinical levels of attention deficit-hyperactivity disorder are associated with tobacco consumption in male but not in female smokers

  • Rebecca L. Douglas
  • Sean P. Barrett
  • Neil T. Hanley
  • Robert O. Pihl
November 7, 2020


An abudance of evidence has demonstrated an association between symptoms of attention deficit hyperactivity disorder (ADHD) and tobacco consumption. However, previous research has focused solely on populations meeting full diagnostic criteria for ADHD, despite evidence suggesting that symptoms below diagnostic threshold can be associated with impairment. Furthermore, the role of gender in the relationship between ADHD symptoms and tobacco consumption has not been determined. To examine the relationship between ADHD symptoms, tobacco use, and gender in a non-clinical population, symptoms of inattention, hyperactivity and impulsivity were assessed in 230 undergraduate students (22 male and 45 female smokers, and 66 male and 97 female nonsmokers). Overall, relative to nonsmokers, the smoking subjects reported significantly higher levels of inattention and hyperactivity. In male smokers, both inattentive and hyperactive/impulsive symptoms were positively associated with the number of cigarettes smoked daily. This relationship did not hold for female smokers, for whom no association was found between symptoms and nicotine consumption. Findings imply that even sub-clinical levels of inattention and hyperactivity/impulsivity are related to indices of tobacco use in males, and support previous research suggesting that significant gender differences may exist in tobacco smoking motives. Results also have potential implications for tobacco cessation programs, which may require more individual tailoring.l glutamic pyruvic transaminase is identified in an elderly subject.


  1. American Psychiatric Association. Diagnostic and StatisticalManual of Mental Disorders, 4th ed.. Washington, DC: American Psychiatric Association, 1994.
  2. Biederman J. Attention-Deficit/Hyperactivity Disorder: A Life Span Perspective. Journal of Clinical Psychiatry, 59: 4-16; 1998.
  3. Troller JN. Attention Deficit Hyperactivity Disorder in Adults: Conceptual and Clinical Issues. Medical Journal of Australia, 171: 421-425; 1999.
  4. Wender PH. Attention-Deficit Hyperactivity Disorder in Adults. The Psychiatric Clinics of North America, 21: 761-774; 1998.
  5. Levy F, Hay D, McStephen M, Wood C, Waldman I. Attention- Deficit Hyperactivity Disorder: A Category or a Continuum? Genetic Analysis of a Large-scale Twin Study. Journal of American Academy of Child and Adolescent Psychiatry, 36:737-744; 1997.
  6. Neuman RJ, Todd RD, Heath AC, et al. Evaluation of ADHD Typology in Three Contrasting Samples: A Latent Class Approach. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 25-33; 1999.
  7. Hudziak J, Heath A, Madden P et al. The Latent Class and Factor Analysis of DSM-IV ADHD: A Twin Study of Female Adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 37: 848-857; 1998.
  8. Biederman J, Wilens T, Mick E, Milberger S, Spencer TJ, Faraone SV. Psychoactive Substance Use Disorders in Adults with Attention Deficit Hyperactivity Disorder (ADHD): Effects of ADHD and Psychiatric Comorbidity. American Journal of Psychiatry, 152: 1652-1658; 1995.
  9. Milberger S, Biederman J, Faraone SV, Chen L, Jones J. ADHD is Associated With Early Initiation of Cigarette Smoking in Children and Adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 36: 37-44; 1997.
  10. Lambert NM. & Hartsough CS. Prospective Study of Tobacco Smoking and Substance Disorders Among Samples of ADHD and Non ADHD Participants. Journal of Learning Disabilities, 31: 533-544; 1998.
  11. Hornig M. Addressing Comorbidity in Adults with Attention- Deficit/Hyperactivity Disorder. Journal of Clinical Psychiatry, 59: 69-75; 1998.
  12. Koelega HS. Stimulant Drugs and Vigilance Performance: A Review. Psychopharmacology, 111:1-16; 1993.
  13. Levin ED & Rezvani AH. Development of Nicotinic Drug Therapy for Cognitive Disorders. European Journal of Pharmacology, 393: 141 146; 2000.
  14. Wonnacott S, Kaiser S, Mogg A, Soliakor l, Jones IW. Presynaptic Nicotinic Receptors Modulating Dopamine Release in the Rat Striatum. European Journal of Pharmacology, 393: 51-58; 2002.
  15. Yu H, Matsubayashi H, Amano T, Cai J, Sasa M. Activation by Nicotine of Striatal Neurons Receiving Excitatory Input from the Substantia Nigra Via Dopamine Release. Brain Research, 872:223-226; 2000.
  16. Lahey BB, Applegate B, McBurnett K et al. DSM-IV Field Trials for Attention Deficit Hyperactivity disorder in Children and Adolescents. American Journal of Psychiatry, 151: 1673-1685; 1994.
  17. Perkins KA, Donny E, Caggiula AR. Sex Differences in Nicotine Effects and Self-Administration: A Review of Human and Animal Evidence. Nicotine & Tobacco Research, 1: 301-315; 1999.
  18. O'Donnell JP, McCann KK, Pluth S. Assessing Adult ADHD Using a Self-Report Symptom Checklist. Psychological Reports. Vol 88: 871-881; 2001.
  19. Murphy P, Schachar R. Use of Self-Ratings in the Assessment of Symptoms of Attention Deficit Hyperactivity Disorder in Adults. American Journal of Psychiatry. Vol 157: 1156-1159; 2000.
  20. Mehringer, AM, Downey KK, Schuh LM, Pomerleau CS, Snedecor SM, Schubiner H. The Assessment of Hyperactivity and Attention: Development and Preliminary Validation of a Brief Self-Assessment of Adult ADHD. Journal of Attention Disorders. Vol 5: 223-231; 2002.


Download data is not yet available.