Nicotine & ADHD

Research shows that ADHD-related smoking risk begins at a young age, progresses rapidly, and becomes resistant to cessation attempts by adulthood. Prevention efforts should acknowledge the speed of uptake; treatments should target the higher relapse risk in this vulnerable population. Further studies show that adults with ADHD are more prone to subjective feelings of pleasure on nicotine exposure than are typical adults. Moreover, genetic studies show that there is a substantial overlap between the genetic liability to ADHD and the genetic liability to nicotine dependence suggesting shared genetics for both disorders.The implications of these findings are discussed.

You can find more information on this topic in my books, Taking Charge of Adult ADHD

References

[BirdwithaBrush]

After I quit smoking there was one consequence that I never mentioned to others trying to quit - it was a big hit to my ability to focus. Tasks that required sustained focus became much more challenging. I stopped reading as much. Since diagnosis and treatment a year ago I now realize that smoking was probably a form of self-medication for me.

[tayzonday]

The 40mg dose of Vyvanse and half-dose of Auvelity that I’m on now works significantly better for my ADHD symptoms than Nicotine.

I’ve been very nicotine dependent at times, but the bupropion in Auvelity makes it possible (though not easy) for me to quit.

[Guackmonster]

This channel consistently puts out the best and most personally relevant content on ADHD on the internet. Keep it up, Dr. Barkley! Hugely appreciate your work.

[dchick]

This explains why I reacted the way I did when I quit the first time. On top of the normal quitting symptoms, I became completely non-functional. I would just walk around my kitchen table in circles for hours, my brain basically frozen. I lasted five weeks, but my life tanked, and I started again--I'd gone from 4.0 average to almost failing. It took a long time to regain that ground.

[MiffoKarin]

Fascinating! I have ADHD and started smoking at 18. I found that it greatly lessens my anxiety and self harm impulses.
While I no longer smoke, I use nicotine products from the pharmacy to "take the edge off" so to speak. It's not the cheapest form of self medication, but at least I managed to avoid alcohol and illegal drugs.

[garcia]

As a 60 year old man with ADHD smoking is a friend it allows me to leave a room and have discussions and ideas with myself. I've been smoking for 42 years . This video brought a strange feeling because it was about being addicted to nicotine because of my ADHD . I'd also like to thank you for all the information you've shared. For me it's been 2 years watching your videos . Thank you. Due to ADHD I had to write here before I forget .

[JustDisc]

Dr Barkley, you are one of the best if not the best adhd doctor worldwide.

The only issue I have with psychiatrist trying to help you eliminate an addiction is that they often want to prescribe a medication. To me (and from my experience), giving another medication to correct an issue doesn’t solve anything. It simply masks the issue. So when you eventually do stop smoking, now what? Stoping the medication afterwards will be just as hard

[Amy-Sparks]

This is so validating. I smoked my way through high school and college. Once I quit I never felt like I recovered my emotional balance, focus or motivation even after quitting for years. I relapsed many times and experienced terrible withdrawals every time. I finally went down enough Reddit rabbit holes that I decided I likely had ADHD and got myself diagnosed. I have never seen this sort of research but it completely correlates with my lived experience.

[jamiejohnson]

I'm very glad I bought into the propaganda that drugs are bad when I was younger.

I've always known I have an addictive personality. I learned this about myself when I was 12 and given a computer - I was quickly addicted to the internet and addicted to playing video games. When I was told by adults or teachers that drugs were addictive, I believed them and refused everything I was offered by friends. I had an intuitive sense that when I liked something, I was not able to put it down. I've never smoked cigarettes or weed or tried recreational drugs. I have tried alcohol and caffeine (coffee and energy drinks). Caffeine was definitely addictive, especially the energy drinks. I started stimulant medication recently and haven't craved caffeine at all, it's great. Sometimes I'd enjoy the pleasure of enjoying a warm beverage but I can always have an herbal tea.

Interesting video. Hopefully it's especially helpful to kids with ADHD and their parents to prevent them from smoking to begin with.

[timgogym]

WOW. Im studying psychology, with a minor in biology. I also have ADHD and struggle with nicotine dependence.
So this video was extremely interesting to me.
Also, the speaker is amazing at clearly explaining his thoughts, and at describing the data. Great video!

[GallumA]

quitting-smoking has ZERO feedback. it's so hard.. like, all you do is feel like your failing constantly until you finally smoke where you finally accept you failed, and can move on for a moment. it's SO hard.

[brycewalat]

I have wondered if one factor in the idea that “we didn’t have ADHD back in the day” is that back in the day, smoking cigarettes was far more prevalent and a
significant number of smokers smoked to self medicate for ADHD, and we didn’t think much of it.

[caustinolino]

It's unfortunate that nicotine is being conflated with the dangers of tobacco. There is evidence that nicotine via a safe delivery method like gum can help with ADHD. Nicotine has been stigmatized due to the tobacco connection, and who knows how much opportunity cost that is incurring.

6:34 The fact that the nicotine niave test subjects in this study were made dizzy suggests they were given a very large dose. Again, a conflation, here with the effects of a substance in moderation vs the overconsumption of it. You can induce negative effects with anything if you give a high enough dose.

[ArheIy]

I tend to think that using nicotine as self-medication may be harmful *or* positive depending on your self-control. It's bad to smoke every hour or so, but lighting a cig right before you're about to write an exam or before an important lecture is exactly what's saving me in uni: mental noise goes silent at least for half an hour - it's not much generally, but just enough to make this «final stand».
It's especially important because in this case nicotine acts as quick-release Adderall or other stimulants, and in some countries (like mine - Russia) these are heavily restricted. So cigarettes or nicotine gum may pass for a makeshift replacement.
Though, there's a hazy line between self-medication and addiction. I wouldn't recommend it to anyone, just know that this is one of the factors why people with ADHD smoke more.

[melcenahorn]

Please do a study on ADHD and Nicotine tables or Nicotinamide Receptors as to how Nicotine Not Smoking tobacco but just Nicotine being used as medication to help focus and the ability to balance out both dopamine and serotonin.

[kikitauer]

So this explains a lot! I was smoking for 16 years. I was able to quit cold turkey almost ten years ago but I still have cravings. Dreams where I smoke. I started similarly to those test subjects. I started it just as experiment but it was very pleasurable to me and soon I was smoking two packs a day. I don't have kids myself but I will definitely explain this in detail to my sister's boys. Sister used to smoke too even though she apparently doesn't have ADHD unlike me. She also doesn't have cravings. Weird how this works right?

[JM-cfyn]

Thank you! This describes my late father exactly and my friend’s husband exactly also. This disorder is so destructive to physical health. Thank you Dr. Barkley for this video. My father died from bladder cancer due to excessive cigarette smoking. I wish there was some kind of “magic” cure for this disorder. These educational videos are so helpful raise awareness and understanding and reduce stigma and misinformation. TY 👍🏻

[mikerope]

Great video Dr Russell. Wish I'd have got diagnosed when I was younger. The signs were there but I wasn't quite disruptive enough. It's basically impossible to get diagnosed as an adult in the UK if you weren't as a child. I've been hooked on smoking or nicotine nasal spray for 20 years, flirted with addiction numerous times, and was forced to drop out of STEM degree because of my chaotic approach/lack of organisation/sense of time. Thanks for helping me understand what the research says from a subject matter expert's perspective.

[guillaumebousquet]

I started smoking at 12 yo. Tried to stop many times but I always seemed to lack the genuine will to quit. Last year, before I knew about ADHD I tried to quit (and failed again). A friend I just met at the time who also smoked cigarette admitted he was amazed at the speed ans dynamics of my thoughts. That's when it clicked. I have always ''felt'' like it was harder for me, that the self-sabotaging ideas and depressive thought-patterns typical to smoking cessation came in higher number and intensity than normal smokers. But you don't want to say that because people will just say that you too weak.

This past summer, at 34 years old, I made my most serious attempt ever at quitting and that made my still unknown ADHD at the time something I couldn't ignore anymore. Picture this: I had quit alcohol a year before and with trying to quit cigarette my life went absolutely out of control. The f****ng irony! I was mad!

I got diagnosed. I understood the beast. I take meds and I'm 4-months free from nicotine.

[kellyalsaleh]

I could never understand people who could just smoke socially or just have a few a day. I progressed really fast to nicotine dependency. My mum was a chain-smoker (60 a day) and yes she smoked in pregnancy (this was the early 70s).

I've since switched to vaping (which unfortunately led to the activation of Ulcerative Colitis... probably the tobacco toxins offered some immunosuppression). Not sure I'll ever quit nicotine consumption... for me it's a mental version of rolling your sleeves up to start a task and stay the course.