Psychopharmacology

, Volume 235, Issue 1, pp 169–178 | Cite as

Abstinence-induced withdrawal severity among adolescent smokers with and without ADHD: disentangling effects of nicotine and smoking reinstatement

  • L. Cinnamon Bidwell
  • Sara G. Balestrieri
  • Suzanne M. Colby
  • Valerie S. Knopik
  • Jennifer W. Tidey
Original Investigation

Abstract

Rationale

Individuals with attention deficit hyperactivity disorder (ADHD) start smoking earlier, are more likely to progress to nicotine dependence, and 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, particularly at the adolescent stage.

Objective

This study aimed to assess the effects of overnight nicotine abstinence and smoking reinstatement on subjective withdrawal states in adolescent smokers with and without ADHD.

Methods

Adolescent daily smokers (27 with ADHD and 17 without ADHD) completed three experimental sessions: (1) a placebo patch followed by smoking a nicotine cigarette, (2) placebo patch followed by smoking a nicotine-free cigarette, and (3) nicotine patch followed by smoking a nicotine-free cigarette. Subjects abstained overnight before each session, and patches were administered 45 min before smoking. The primary outcome measure was a smoking withdrawal symptom questionnaire.

Results

ADHD smokers experienced greater difficulty concentrating and impatience/restlessness during abstinence than non-ADHD smokers. Smoking a cigarette improved abstinence-induced difficulty concentrating and restlessness, regardless of its nicotine content, and regardless of whether transdermal nicotine was received or not.

Conclusions

Thus, sensorimotor aspects of smoking, rather than nicotine itself, appeared to relieve withdrawal. Although ADHD smokers report greater withdrawal symptoms than non-ADHD smokers, they responded strongly to the sensorimotor aspects of smoking during withdrawal. These findings suggest that even lighter, adolescent smokers with ADHD are vulnerable to smoking progression through altered smoking abstinence and withdrawal relief processes.

Keywords

Adolescents ADHD NRT Sensorimotor replacement Attention Denicotinized cigarette 

References

  1. Berlin I, MC H, 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 Depend 124:268–273.  https://doi.org/10.1016/j.drugalcdep.2012.01.019 CrossRefPubMedPubMedCentralGoogle Scholar
  2. Bidwell LC, Ameringer KJ, Leventhal AM (2014) Associations of attention-deficit hyperactivity disorder symptom dimensions with smoking deprivation effects in adult smokers. Psychol Addict Behav 28:182–192.  https://doi.org/10.1037/a0035369 CrossRefPubMedPubMedCentralGoogle Scholar
  3. Bidwell LC, Leventhal AM, Tidey JW, Brazil L, Niaura RS, Colby SM (2012) Effects of abstinence in adolescent tobacco smokers: withdrawal symptoms, urge, affect, and cue reactivity. Nicotine Tob Res 15:457–464CrossRefPubMedPubMedCentralGoogle Scholar
  4. Bidwell LC, Leventhal AM, Tidey JW, Brazil L, Niaura RS, Colby SM (2013) Effects of abstinence in adolescent tobacco smokers: withdrawal symptoms, urge, affect, and cue reactivity. Nicotine Tob Res 15:457–464.  https://doi.org/10.1093/ntr/nts155 CrossRefPubMedGoogle Scholar
  5. Brennan AR, Arnsten AF (2008) Neuronal mechanisms underlying attention deficit hyperactivity disorder: the influence of arousal on prefrontal cortical function. Ann N Y Acad Sci 1129:236–245.  https://doi.org/10.1196/annals.1417.007 CrossRefPubMedPubMedCentralGoogle Scholar
  6. Clark DB, Cornelius J (2004) Childhood psychopathology and adolescent cigarette smoking: a prospective survival analysis in children at high risk for substance use disorders. Addict Behav 29:837–841.  https://doi.org/10.1016/j.addbeh.2004.02.019 CrossRefPubMedGoogle Scholar
  7. Colby SM et al (2009) Smoking abstinence and reinstatement effects in adolescent cigarette smokers. Nicotine Tob Res 12:19–28CrossRefPubMedPubMedCentralGoogle Scholar
  8. Colby SM et al (2010) Smoking abstinence and reinstatement effects in adolescent cigarette smokers. Nicotine Tob Res 12:19–28.  https://doi.org/10.1093/ntr/ntp167 CrossRefPubMedGoogle Scholar
  9. De Biasi M, Dani JA (2011) Reward, addiction, withdrawal to nicotine. Annu Rev Neurosci 34:105–130.  https://doi.org/10.1146/annurev-neuro-061010-113734 CrossRefPubMedPubMedCentralGoogle Scholar
  10. DHHS (2014) The health consequences of smoking—50 years of progress: a report of the Surgeon General. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 17, AtlantaGoogle Scholar
  11. Donny EC et al (2015) Randomized trial of reduced-nicotine standards for cigarettes. N Engl J Med 373:1340–1349CrossRefPubMedPubMedCentralGoogle Scholar
  12. Donny EC, Houtsmuller E, Stitzer ML (2007) Smoking in the absence of nicotine: behavioral, subjective and physiological effects over 11 days. Addiction 102:324–334CrossRefPubMedGoogle Scholar
  13. Higgins ST et al (2017) Response to varying the nicotine content of cigarettes in vulnerable populations: an initial experimental examination of acute effects. Psychopharmacology 234:89–98CrossRefPubMedGoogle Scholar
  14. Hughes JR, Hatsukami D (1986) Signs and symptoms of tobacco withdrawal. Arch Gen Psychiatry 43:289–294CrossRefPubMedGoogle Scholar
  15. Kessler RC et al (2005) The World Health Organization Adult ADHD Self-Report Scale (ASRS): a short screening scale for use in the general population. Psychol Med 35:245–256CrossRefPubMedGoogle Scholar
  16. Kollins SH, English JS, Roley ME, O'Brien B, Blair J, Lane SD, McClernon FJ (2013) Effects of smoking abstinence on smoking-reinforced responding, withdrawal, and cognition in adults with and without attention deficit hyperactivity disorder. Psychopharmacology 227:19–30.  https://doi.org/10.1007/s00213-012-2937-0 CrossRefPubMedGoogle Scholar
  17. Kollins SH, McClernon FJ, Fuemmeler BF (2005) Association between smoking and attention-deficit/hyperactivity disorder symptoms in a population-based sample of young adults. Arch Gen Psychiatry 62:1142–1147CrossRefPubMedGoogle Scholar
  18. Lewis-Esquerre JM, Colby SM, Tevyaw TO, Eaton CA, Kahler CW, Monti PM (2005) Validation of the timeline follow-back in the assessment of adolescent smoking. Drug Alcohol Depend 79:33–43.  https://doi.org/10.1016/j.drugalcdep.2004.12.007 CrossRefPubMedGoogle Scholar
  19. McClernon FJ, Kollins SH (2008) ADHD and smoking: from genes to brain to behavior. Ann N Y Acad Sci 1141:131–147.  https://doi.org/10.1196/annals.1441.016 CrossRefPubMedPubMedCentralGoogle Scholar
  20. McClernon FJ, Kollins SH, Lutz AM, Fitzgerald DP, Murray DW, Redman C, Rose JE (2008) Effects of smoking abstinence on adult smokers with and without attention deficit hyperactivity disorder: results of a preliminary study. Psychopharmacology 197:95–105.  https://doi.org/10.1007/s00213-007-1009-3 CrossRefPubMedGoogle Scholar
  21. 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 13:784–792.  https://doi.org/10.1093/ntr/ntr073 CrossRefPubMedPubMedCentralGoogle Scholar
  22. NCCDP (2012) Reports of the Surgeon General. Centers for Disease Control and Prevention (US), AtlantaGoogle Scholar
  23. Pomerleau CS, Downey KK, Snedecor SM, Mehringer AM, Marks JL, Pomerleau OF (2003) Smoking patterns and abstinence effects in smokers with no ADHD, childhood ADHD, and adult ADHD symptomatology. Addict Behav 28:1149–1157CrossRefPubMedGoogle Scholar
  24. Pomerleau OF, Downey KK, Stelson FW, Pomerleau CS (1995) Cigarette smoking in adult patients diagnosed with attention deficit hyperactivity disorder. J Subst Abus 7:373–378CrossRefGoogle Scholar
  25. Potter AS, Newhouse PA (2004) Effects of acute nicotine administration on behavioral inhibition in adolescents with attention-deficit/hyperactivity disorder. Psychopharmacology 176:182–194.  https://doi.org/10.1007/s00213-004-1874-y CrossRefPubMedGoogle Scholar
  26. Potter AS, Newhouse PA (2008) Acute nicotine improves cognitive deficits in young adults with attention-deficit/hyperactivity disorder. Pharmacol Biochem Behav 88:407–417CrossRefPubMedGoogle Scholar
  27. Prokhorov AV, De Moor C, Pallonen UE, Hudmon KS, Koehly L, Hu S (2000) Validation of the modified Fagerstrom tolerance questionnaire with salivary cotinine among adolescents. Addict Behav 25:429–433CrossRefPubMedGoogle Scholar
  28. Reich W, Leacock N, Shanfeld K (1997) DICA-IV Diagnostic Interview for children and Adolescents-IV. Multi-Health Systems, Inc., TorontoGoogle Scholar
  29. Rohde P, Kahler CW, Lewinsohn PM, Brown RA (2004) Psychiatric disorders, familial factors, and cigarette smoking: II. Associations with progression to daily smoking. Nicotine Tob Res 6:119–132.  https://doi.org/10.1080/14622200310001656948 CrossRefPubMedGoogle Scholar
  30. Rose JE (2006) Nicotine and nonnicotine factors in cigarette addiction. Psychopharmacology 184:274–285CrossRefPubMedGoogle Scholar
  31. Rose JE, Behm FM, Westman EC, Bates JE, Salley A (2003) Pharmacologic and sensorimotor components of satiation in cigarette smoking. Pharmacol Biochem Behav 76:243–250CrossRefPubMedGoogle Scholar
  32. Shiffman S, Ferguson SG, Gwaltney CJ (2006) Immediate hedonic response to smoking lapses: relationship to smoking relapse, and effects of nicotine replacement therapy. Psychopharmacology 184:608–618.  https://doi.org/10.1007/s00213-005-0175-4 CrossRefPubMedGoogle Scholar
  33. Sibley MH et al (2012) When diagnosing ADHD in young adults emphasize informant reports, DSM items, and impairment. J Consult Clin Psychol 80:1052CrossRefPubMedPubMedCentralGoogle Scholar
  34. Singh T, Arrazola RA, Corey CG, Husten CG, Neff LJ, Homa DM, King BA (2016) Tobacco use among middle and high school students—United States, 2011–2015 vol 65Google Scholar
  35. Tercyak KP, Lerman C, Audrain J (2002) Association of attention-deficit/hyperactivity disorder symptoms with levels of cigarette smoking in a community sample of adolescents. J Am Acad Child Adolesc Psychiatry 41:799–805.  https://doi.org/10.1097/00004583-200207000-00011 CrossRefPubMedGoogle Scholar
  36. Tidey JW, Rohsenow DJ, Kaplan GB, Swift RM, Ahnallen CG (2013) Separate and combined effects of very low nicotine cigarettes and nicotine replacement in smokers with schizophrenia and controls. Nicotine Tob Res 15:121–129.  https://doi.org/10.1093/ntr/nts098 CrossRefPubMedGoogle Scholar
  37. Upadhyaya HP, Deas D, Brady KT, Kruesi M (2002) Cigarette smoking and psychiatric comorbidity in children and adolescents. J Am Acad Child Adolesc Psychiatry 41:1294–1305.  https://doi.org/10.1097/00004583-200211000-00010 CrossRefPubMedGoogle Scholar
  38. Watson D, Clark LA, Tellegen A (1988) Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol 54:1063–1070CrossRefPubMedGoogle Scholar
  39. Westman E, Levin E, Rose J (1992) Smoking while wearing the nicotine patch-is smoking satisfying or harmful. In: Clinical Research, vol 4. SLACK INC 6900 GROVE RD, THOROFARE, NJ 08086, pp A871-A871Google Scholar
  40. Wilens TE, Vitulano M, Upadhyaya H, Adamson J, Sawtelle R, Utzinger L, Biederman J (2008) Cigarette smoking associated with attention deficit hyperactivity disorder. J Pediatr 153:414–419.  https://doi.org/10.1016/j.jpeds.2008.04.030 CrossRefPubMedPubMedCentralGoogle Scholar
  41. Willcutt EG et al (2012) Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes. J Abnorm Psychol 121:991–1010.  https://doi.org/10.1037/a0027347 CrossRefPubMedPubMedCentralGoogle Scholar
  42. Zucker M, Morris MK, Ingram SM, Morris RD, Bakeman R (2002) Concordance of self- and informant ratings of adults' current and childhood attention-deficit/hyperactivity disorder symptoms. Psychol Assess 14(4):379–389Google Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • L. Cinnamon Bidwell
    • 1
    • 2
  • Sara G. Balestrieri
    • 2
  • Suzanne M. Colby
    • 2
    • 3
    • 4
  • Valerie S. Knopik
    • 3
    • 5
    • 6
  • Jennifer W. Tidey
    • 3
    • 4
  1. 1.Institute of Cognitive ScienceUniversity of ColoradoBoulderUSA
  2. 2.Center for Alcohol and Addiction StudiesBrown UniversityProvidenceUSA
  3. 3.Department of Psychiatry and Human BehaviorAlpert Medical School of Brown UniversityProvidenceUSA
  4. 4.Department of Behavioral and Social Health Sciences, School of Public HealthBrown UniversityProvidenceUSA
  5. 5.Division of Behavioral Genetics, Rhode Island Hospital, Department of Psychiatry and Human BehaviorThe Warren Alpert Medical School of Brown UniversityProvidenceUSA
  6. 6.Department of Human Development and Family StudiesPurdue UniversityWest LafayetteUSA

Personalised recommendations