Effects of smoking abstinence on smoking-reinforced responding, withdrawal, and cognition in adults with and without attention deficit hyperactivity disorder
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Individuals with attention deficit hyperactivity disorder (ADHD) have a more difficult time quitting smoking compared to their non-ADHD peers. Little is known about the underlying behavioral mechanisms associated with this increased risk.
This study aims to assess the effects of 24-h smoking abstinence in adult smokers with and without ADHD on the following outcomes: smoking-reinforced responding, withdrawal, and cognitive function.
Thirty-three (n = 16 with ADHD, 17 without ADHD) adult smokers (more than or equal to ten cigarettes/day) were enrolled. Each participant completed two experimental sessions: one following smoking as usual and one following biochemically verified 24-h smoking abstinence. Smoking-reinforced responding measured via a progressive ratio task, smoking withdrawal measured via questionnaire, and cognition measured via a continuous performance test (CPT) were assessed at each session.
Smoking abstinence robustly increased responding for cigarette puffs in both groups, and ADHD smokers responded more for puffs regardless of condition. Males in both groups worked more for cigarette puffs and made more commission errors on the CPT than females, regardless of condition. Smoking abstinence also increased ratings of withdrawal symptoms in both groups and smokers with ADHD, regardless of condition, reported greater symptoms of arousal, habit withdrawal, and somatic complaints. Across groups, smoking abstinence decreased inhibitory control and increased reaction time variability on the CPT. Abstinence-induced changes in inhibitory control and negative affect significantly predicted smoking-reinforced responding across groups.
Smokers with ADHD reported higher levels of withdrawal symptoms and worked more for cigarette puffs, regardless of condition, which could help explain higher levels of nicotine dependence and poorer cessation outcomes in this population. Abstinence-induced changes in smoking-reinforced responding are associated with changes in inhibitory control and negative affect regardless of ADHD status, a finding that may lead to novel prevention and treatment programs.
KeywordsADHD Nicotine Reinforcement Self-administration
Funding for this project was from grants 1R01DA025653 (Kollins) and 1R01DAK24023464 (Kollins).
- Bekker EM, Bocker KB, Van Hunsel F, van den Berg MC & Kenemans JL (2005) Acute effects of nicotine on attention and response inhibition. Pharmacol Biochem BehavGoogle Scholar
- Berlin I, Hu MC, Covey LS & Winhusen T (2012) Attention-deficit/hyperactivity disorder (ADHD) symptoms, craving to smoke, and tobacco withdrawal symptoms in adult smokers with ADHD. Drug Alcohol DependGoogle Scholar
- Conners CK (2000) The Conners Continuous Performance Test, Secondth edn. Multi-Health Systems, North TonawandaGoogle Scholar
- Conners CK, Erhardt D, Sparrow E, Staff MHS (1998) The Conners ADULT ADHD Rating Scale (CAARS). Multi-Health Systems, Inc, TorontoGoogle Scholar
- Epstein JN, Johnson D, Conners CK (2000) Conners’ Adult ADHD Diagnostic Interview for DSM-IV. Multi-Health Systems, Inc, North TonawandaGoogle Scholar
- First MB, Gibbon M, Williams JBW, Spitzer RL (1997) SCID Screen Patient Questionnaire. Extended Version. Multi-Health Systems, Inc, North TonawandaGoogle Scholar
- Ghahremani DG, Lee B, Robertson CL, Tabibnia G, Morgan AT, De Shetler N, … London ED (2012) Striatal dopamine D(2)/D(3) receptors mediate response inhibition and related activity in frontostriatal neural circuitry in humans. J Neurosci 32: 7316–7324Google Scholar
- Hamidovic A, Dlugos A, Skol A, Palmer AA, de Wit H (2009) Evaluation of genetic variability in the dopamine receptor D2 in relation to behavioral inhibition and impulsivity/sensation seeking: an exploratory study with d-amphetamine in healthy participants. Exp Clin Psychopharmacol 17:374–383PubMedCrossRefGoogle Scholar
- Hatsukami D, Fletcher L, Morgan S, Keenan R, Amble P (1989) The effects of varying cigarette deprivation duration on cognitive and performance tasks. J Subst Abus 1:407–416Google Scholar
- Johansen EB, Killeen PR, Russell VA, Tripp G, Wickens JR, Tannock R, … Sagvolden T (2009) Origins of altered reinforcement effects in ADHD. Behav Brain Funct 5: 7Google Scholar
- Kaufman AS, Kaufman NL (2004) Kaufman Brief Intelligence Test, Second Edition (KBIT-II). AGS Publishing, Circle PinesGoogle Scholar
- Kessler RC, Adler L, Barkley R, Biederman J, Conners CK, Demler O, … Zaslavsky AM (2006) The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry 163: 716–723Google Scholar
- Kollins SH, English JS, Itchon-Ramos N, Chrisman AK, Dew R, O’Brien B, McClernon FJ (2012) A Pilot study of lis-dexamfetamine dimesylate (LDX/SPD489) to facilitate smoking cessation in nicotine-dependent adults with ADHD. J Atten Disord. doi: 10.1177/1087054712440320
- Lavin MR, Siris SG, Mason SE (1996) What is the clinical importance of cigarette smoking in schizophrenia? Am J Addict 5:189–208Google Scholar
- McClernon FJ, Van Voorhees EE, English J, Hallyburton M, Holdaway A, Kollins SH (2011) Smoking withdrawal symptoms are more severe among smokers with ADHD and independent of ADHD symptom change: results from a 12-day contingency-managed abstinence trial. Nicotine Tob Res 13:784–792PubMedCrossRefGoogle Scholar
- Sigmon SC, Tidey JW, Badger GJ, Higgins ST (2003) Acute effects of d-amphetamine on progressive-ratio performance maintained by cigarette smoking and money. Psychopharmacology (Berl) 167:393–402Google Scholar
- Volkow ND, Wang GJ, Kollins SH, Wigal TL, Newcorn JH, Telang F, … Swanson JM (2009) Evaluating dopamine reward pathway in ADHD: clinical implications. JAMA 302: 1084–1091Google Scholar
- Volkow ND, Wang GJ, Newcorn JH, Kollins SH, Wigal TL, Telang F, … Swanson JM (2011) Motivation deficit in ADHD is associated with dysfunction of the dopamine reward pathway. Mol Psychiatry 16: 1147–1154Google Scholar
- Winhusen TM, Somoza EC, Brigham GS, Liu DS, Green CA, Covey LS, … Dorer EM (2010) Impact of attention-deficit/hyperactivity disorder (ADHD) treatment on smoking cessation intervention in ADHD smokers: a randomized, double-blind, placebo-controlled trial. J Clin Psychiatry 71: 1680–1688Google Scholar