The Association Between Attention Deficit Hyperactivity Disorder and Nicotine Use Among Adolescents and Young Adults

Amanda Symmes, Ken C. Winters, Tamara Fahnhorst, Andria M. Botzet, Susanne Lee, Gerald J. August, George M. Realmuto

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Previous research indicates that youths with attention deficit hyperactivity disorder (ADHD) are more susceptible to nicotine use compared to those without ADHD, and one explanation for this association is the self-medication theory. The present study examines nicotine use in a prospective sample derived from a community sampling procedure rather than a clinical setting. Nicotine use was measured through young adulthood (mean ages: 18, 20, and 22), and three groups were compared based on childhood status: ADHD only, ADHD externalizers, and control groups. Results indicated that at all three data points, individuals with childhood ADHD plus an externalizing disorder reported higher nicotine use on all variables compared to the ADHD group absent of an externalizing disorder and the comparison group of non-ADHD youths. The group differences were significant even after controlling for possible confounding variables (age, gender, and current treatment with psychostimulant medication). Study results are discussed in light of the self-medication hypothesis and of the importance of including nicotine prevention programs for adolescents and young adults with ADHD and externalizing problems.

Original languageEnglish (US)
Pages (from-to)37-45
Number of pages9
JournalJournal of Child and Adolescent Substance Abuse
Issue number1
StatePublished - Jan 2 2015

Bibliographical note

Funding Information:
Amanda Symmes completed this work as part of her research project for the McNair Scholars Program at Augsburg College, Minneapolis, Minnesota. Support for this publication is provided by grants from the National Institute on Drug Abuse (DA12995, K02-DA015347, and P50-DA027841).


  • ADHD
  • externalizing disorder
  • nicotine
  • self-medication hypothesis


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