Smoking behavior characteristics of non-selected smokers with childhood attention-deficit/hyperactivity disorder (AD/HD) history: a systematic review and meta-analysis

  • Guillaume Fond
  • Anderson Loundou
  • Sebastien Guillaume
  • Xavier Quantin
  • Alexandra Macgregor
  • Régis Lopez
  • Philippe Courtet
  • Paquito Bernard
  • Daniel Bailly
  • Mocrane Abbar
  • Marion Leboyer
  • Laurent Boyer
Original Paper


It is unclear whether adult smokers with childhood attention-deficit/hyperactivity disorder history (CH) have more severe smoking behavior than non-CH smokers, while it is clearly suggested that CH adolescents have more severe smoking behavior than CH adolescents. The aim of the present comprehensive meta-analysis is to determine whether CH smokers have more severe smoking behavior characteristics than those without and the effect of age on the association between CH and smoking behavior. We included all case–control studies and first round data collection of observational studies addressing the difference in smoking behavior characteristics of CH smokers versus non-CH smokers, with validated scales or structured interviews, without any language or date restriction. Nine studies (including 365 smokers with CH and 1,708 smokers without) were included. Compared to non-CH smokers, CH smokers smoked significantly more cigarettes [standardized mean differences (SMD) = 0.15, 95 % CI 0.01–0.28, p = 0.04] and began to regularly smoke earlier (SMD = −0.28, 95 % CI −0.49; −0.07, p = 0.01) but were not significantly more nicotine dependent (SMD = 0.23, 95 % CI −0.04 to 0.48, p = 0.08). After removing the single adolescent study, the significant association between CH and number of daily smoked cigarettes disappeared, and subgroups analyses confirmed that the significant association between CH and number of daily smoked cigarettes disappeared as age increased. Our meta-analysis illustrates a clinically important link between CH and tobacco smoking in adolescence but not later in life. Further high-quality studies are needed to confirm this finding, as only two studies included participants with a mean age below 20 years.


Attention-deficit/hyperactivity disorder (AD/HD) Smoking Nicotine dependence Tobacco 



We express all our thanks to the patients who participated in the studies included in the present meta-analysis, and all the authors that answered us for completing missing data. This work was supported by INSERM, Assistance Publique-Hôpitaux de Paris, RTRS Santé Mentale (Fondation Fondamental) and was supported (in part) by the Investissements d’Avenir program managed by the ANR under reference ANR-11-IDEX-0004-02.

Conflict of interest

None declared.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Guillaume Fond
    • 1
  • Anderson Loundou
    • 4
  • Sebastien Guillaume
    • 2
  • Xavier Quantin
    • 3
  • Alexandra Macgregor
    • 2
  • Régis Lopez
    • 5
  • Philippe Courtet
    • 2
  • Paquito Bernard
    • 3
  • Daniel Bailly
    • 5
    • 7
  • Mocrane Abbar
    • 6
  • Marion Leboyer
    • 1
  • Laurent Boyer
    • 4
  1. 1.Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, INSERM U955, Eq 15, Fondation FondaMental, Fondation de Coopération Scientifique en Santé MentaleUniversité Paris EstCréteilFrance
  2. 2.Inserm U1061, Montpellier, Services Universitaires de Psychiatrie, CHU MontpellierUniversité Montpellier 1MontpellierFrance
  3. 3.Département Universitaire de Pneumologie et d’addictologie, Epsylon EA 4556, Institut Régional du Cancer de Montpellier, CHU MontpellierUniversité Montpellier 1MontpellierFrance
  4. 4.EA 3279 – Public Health, Chronic Diseases and Quality of Life - Research UnitAix-Marseille UnitMarseilleFrance
  5. 5.INSERM 1061, Centre de Reference National Narcolepsie Hypersomnie Idiopathique, Unité des Troubles du Sommeil, CHU MontpellierUniversité Montpellier 1MontpellierFrance
  6. 6.CHU Carémeau, service de psychiatrie adulteUniversité de NîmesNîmesFrance
  7. 7.Service hospitalo-universitaire de psychiatrie, Hôpital Sainte-MargueriteMarseilleFrance

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