ADHD & Nicotine: Potential Links, Side Effects, And Consequences To Look For
Attention Deficit Hyperactive Disorder (ADHD) can be linked to numerous causes and triggers. Researchers continue to work to discover what exactly can cause ADHD to uncover aspects of the condition that can be predicted in order to better understand it and prevent or treat it.
The running research on causation shows some links between addictive materials like nicotine and an ADHD diagnosis or the increase in the severity of its symptoms. Here’s how the two are linked.
ADHD and nicotine: Pregnancy
Family history can play a significant determining role in the development of ADHD. The exact "how" may not be known, but there can be causative links between certain family illnesses and ADHD, including a family history of ADHD and other learning or behavioral disorders.
Problems in utero can also play a role, as there have been links discovered between children with restricted growth and other problems in utero and the later development of ADHD. One of these problems can be directly related to parental behavior in utero: nicotine use.
Doctors routinely discourage pregnant women from smoking, chewing, and using other forms of tobacco during pregnancy, as there can be definite links between tobacco use in pregnancy and a host of complications, including premature labor, fetal complications, and even miscarriage. The same is true of nicotine, despite its reputation as being a safer alternative to tobacco. Because nicotine can be habit-forming, there is also the increased risk of a child developing a dependency later in life.
In adults, there can be countless health risks associated with nicotine use: the possibility of cancer, cardiovascular disease, toxicity, gastrointestinal harm, and the possibility of birth defects in pregnant women. Birth defects can be readily visible at birth, as is the case when a child is missing a hand or has a cleft palate. Birth defects also may show up later, as is the case in children with some muscular conditions and intellectual and behavioral disorders.
Although nicotine is sometimes marketed as a safe alternative to tobacco use, it can prove just as harmful for children exposed during development and can have just as many risks involved for adults who smoke.
Cigarette smoking and beyond
Aside from pregnancy, there can be other ties between nicotine and ADHD. As a habit-forming substance, nicotine should be avoided as a rule, but be especially careful when ADHD is involved; some studies have found that individuals with ADHD can be more susceptible to addiction. Consequently, nicotine addiction and increased smoking progression have been found in higher concentrations in teenagers with ADHD than their neurotypical peers.
Despite this, however, nicotine has also been purported to have some value in the treatment of ADHD; like Adderall and Ritalin, the two most prescribed ADHD medications, nicotine is a stimulant treatment and can have a calming effect on some of the symptoms of ADHD. It is possible, then, that some people have turned to smoking as a form of self-prescription for ADHD. One study determined that 40% of people with ADHD were smokers, compared to approximately 20% of the general population, suggesting that both ADHD self-prescription and predisposition to addiction could be at play.
That being said, another study found that nicotine was not only an effective form of ADHD treatment but provided the same relief without the side effects of standard ADHD treatment options. In this study, a man was given a transdermal nicotine patch to treat nicotine withdrawal symptoms and ADHD symptoms simultaneously, and the man in question (using the moniker "Mr. A") reported a decrease in both his symptoms of ADHD and his desire to smoke while wearing the patch.
Using nicotine with attention-deficit/hyperactivity disorder
Currently, the two most common treatment methods for ADHD may be cognitive therapy and pharmaceutical medication. For people with ADHD, beginning nicotine use with a doctor is the best option because your dosage can be tailored to fit your needs, and the dosage can be delivered transdermally via a nicotine patch. This method is unlikely to be used with children any time soon but may be an effective treatment method for people with adult ADHD struggling with difficulty focusing, impulsivity, and hyperactivity.
Smoking does not deliver the same effects as a transdermal patch as smoking fails to provide a consistent, measured dosage of nicotine and is habit-forming. There are other forms of nicotine replacement therapies, too; for example, nicotine nasal spray may also help curb heavy cravings. Smoking should never take the place of an actual prescription of nicotine, and could actually lead to adverse health effects, such as disease and substance addiction, both things that can aggravate ADHD symptoms.
For adult smokers who have ADHD and are working to quit smoking, nicotine seems to be particularly helpful. According to a placebo-controlled trial at Duke University Medical Center, it can pull double duty, working as both an effective smoking replacement and a means of treating ADHD. Because addiction can be so powerful for people with ADHD, finding a reliable method of relieving addiction might be another important tool to develop for ADHD treatment. Nicotine patches have been shown to significantly improve the cessation outcomes of people with ADHD trying to give up smoking. Many study participants were able to stop smoking without intense withdrawal symptoms or adverse effects, such as an increase in anxiety or depression symptoms.
The future
Because many studies have shown adverse effects when using nicotine, the substance should be used with particular caution and should not be applied as a one-size-fits-all treatment source for ADHD. For people within a specific niche, however, in those with smoking addiction and ADHD, or those who are having adverse side effects from standard ADHD medication, nicotine has potentially enormous value and could replace other pharmaceutical ADHD treatment options in some populations.
The reality of nicotine dangers during pregnancy should not be ignored. People who are pregnant, nursing, or trying to conceive should make every effort to quit nicotine use. While dosages might not be large enough to replicate the effect of smoking, the possibility for birth defects should not be ignored or compounded in someone whose medical history provides a predisposition for behavioral, developmental, or intellectual disorders.
Teenagers may be particularly susceptible to the soothing effects of nicotine, and their lack of inhibitory control may put them at greater risk for developing a smoking habit than people who have already reached adulthood without having tobacco dependence. Aside from regular monitoring, teenagers should be made aware of the possible risks and side effects of smoking. If they are already trying nicotine, they may need to discuss changing the dosage, frequency, or medication altogether if they are still having difficulty concentrating, controlling impulsive behavior, and maintaining energy. The quick effectiveness of a cigarette could prove too difficult to resist for a teenager struggling with this disorder, which is why finding the best, personalized treatment option through a doctor becomes paramount.
Once people with ADHD experience smoking initiation, quitting smoking can become more difficult than it is for those in the general population; as many as 48% of the typical population gives up smoking in their lifetime, while only 29% of people with ADHD successfully let go of the habit. Avoidance of trouble down the road may be one of the best reasons for avoiding nicotine altogether unless it is administered in the form of medication designed to aid ADHD symptoms nicotine.
Online therapy for ADHD
Online therapy can be a helpful option for various circumstances, like ADHD. For example, some study findings suggest that online text chats can be extremely useful to facilitate smoking cessation. Other studies have shown that online therapy can be incredibly helpful for people with ADHD status and their families, especially people who are having trouble getting off the waiting list for therapists in their area.
If you or a loved one are interested in nicotine as a potential ADHD treatment, or if you are looking for assistance with a nicotine addiction complicated by ADHD, consider turning to the licensed professionals of BetterHelp.
Takeaway
ADHD and smoking behavior have several links, each of them distinct from the other. The substance can have a positive effect on ADHD patients and can be a useful method to treat the disorder, while in other circumstances, it can also aggravate ADHD symptoms like behavioral inhibition, could be part of what causes those symptoms in the first place, and could perpetuate a cycle of familial health issues. For this reason, nicotine should be treated as a volatile substance, requiring a therapist's guidance, a doctor's care, and supervision before use.
Does nicotine worsen attention-deficit hyperactivity disorder?
Those with attention-deficit hyperactivity disorder are significantly more likely to use tobacco products than those without the condition. However, the evidence does not support the conclusion that nicotine worsens ADHD symptoms. Evidence does suggest that those with this disorder will find it harder to quit smoking.
In the past, researchers theorized that the increased difficulty was because this substance reduced ADHD symptoms, called the self-medication hypothesis. However, recent research indicated that those with ADHD struggled to quit just as much when their symptoms were managed than when they were not. Those who took stimulant medication as prescribed and learned behavioral strategies to manage their symptoms were still challenged by nicotine dependence, regardless of how well their symptoms were controlled.
Why do people with attention-deficit hyperactivity disorder crave nicotine?
Evidence suggests that some of the genetic variations that can lead to attention-deficit hyperactivity disorder also make a person more susceptible to cigarette smoking and nicotine dependence. Researchers point to dysregulation of the dopaminergic and nicotinic-acetylcholinergic circuits in the brain as a likely cause. This substance stimulates those areas of the brain, which may temporarily reduce anxiety and slightly increase cognitive function. The inability of the brain to regulate dopamine properly may also be part of the reason why smokers with an attention disorder find it more challenging to quit smoking than those without the condition.
Does smoking help you focus?
There is some evidence to suggest that nicotine improves attention and memory. However, the effects are likely not substantial enough to alleviate symptoms in young adults diagnosed with an attention disorder. Smoking cessation is often more challenging for smokers with ADHD, and researchers once theorized that cigarette use was a form of self-medication. However, that theory has not been supported by research, leading scientists to further examine the link between nicotine, focus, and ADHD.
Is vaping bad for ADHD?
Vaping is not known to exacerbate attention-deficit hyperactivity disorder symptoms, but while vaping is thought to be less harmful than smoking, the risks associated with it are still poorly understood. Vaping may be useful as a smoking cessation intervention or harm-reduction technique, but evidence is still unclear regarding its utility. The use of a well-established smoking cessation treatment, like counseling or medication, is likely to be more effective than simply trying to switch to a vape.
Young adults with attention-deficit hyperactivity disorder who smoke may find that their path to smoking abstinence becomes simpler with vaping. It is sometimes considered a pseudo-nicotine replacement therapy, but there are better replacement therapy options that are better understood and likely offer a lower risk of relapse.
Nicotine is not likely to worsen symptoms. However, there is some overlap between smoking withdrawal symptoms and ADHD symptoms. Everyone who uses this substance is likely to experience at least a slight increase in difficulty concentrating, restlessness, and anxiety, regardless of if they have an attention disorder. For those who do have the diagnosis, the combination of smoking withdrawal and ADHD may appear as though their symptoms are worse. It is likely that if a person commits to quitting smoking and can abstain from smoking or vaping for a sustained period, their ADHD symptoms will return to baseline levels.
The evidence suggests that people with ADHD smoke significantly more than the general population. Recent research indicates that around 14% of US adults smoke cigarettes regularly. The number of chronic cigarette smokers continues to drop worldwide as awareness about the dangers of smoking increases and anti-smoking interventions become more effective. Despite the overall downward trend, those with ADHD and other psychiatric disorders continue to smoke at much higher rates. Evidence suggests that around 40% of people with ADHD are smokers, more than double the rate of the general population.
Why are people with attention-deficit/hyperactivity disorder prone to addiction?
Researchers theorize that certain genes are a risk factor for both ADHD and addiction. Evidence suggests that dysregulation of the dopaminergic circuits in the brain, part of the brain’s reward pathways, may be partially to blame. Addiction disrupts the brain's reward system, leading to the cravings and adverse effects associated with substance addiction. The underlying genetic risk factors associated with ADHD likely reduce the resilience and adaptability of the reward system, increasing the likelihood that a person will become addicted.
Is ADHD considered to be a disability?
Attention-deficit hyperactivity disorder is a neurodevelopmental disorder. It is considered a disability, and adult patients diagnosed with it can receive reasonable accommodations under the Americans with Disabilities Act. It is important to note that “reasonable accommodations” are decided between the employee and their employer, and an employer does not have to grant every accommodation requested by the employee. Some of the most common accommodations include:
- Providing a quiet workspace
- Allowing the use of noise-cancelling headphones
- Working from home
- Additional breaks as needed
- Allowing assistive technology like timers and calendars.
How do you stop an ADHD meltdown?
Stopping an ADHD meltdown requires learning appropriate self-soothing and emotional control skills. Relaxation techniques that work for stress, anger, and anxiety are likely to be helpful. It is important to remember that those with ADHD have a more challenging time controlling their impulses and regulating their emotions. It does not mean that they are crazy or dangerous, but adults with ADHD should take time to learn ways to manage difficult emotions. Besides learning relaxation techniques, other common strategies include having a designated place to calm down, examining emotions through mindfulness techniques, and engaging in meditation.
How long does nicotine stay in your system?
Nicotine remains in the blood for one to three days after quitting tobacco. The major metabolite of this substance, cotinine, remains detectable in blood for up to ten days. Cotinine is what is commonly tested for with a nicotine test. It is more stable than nicotine and takes longer to break down. In some cases, a test may required for employment, custody cases, or before certain surgeries. The most common way to detect recent nicotine use is with a saliva test, which can detect it up to four days after it is used.
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