Study Examines ADHD's Role in Smoking

Are you easily forgetful, distracted, impulsive or fidgety? Do you find that smoking helps you alleviate these symptoms?

Columbia University Medical Center researchers are investigating whether these most common symptoms of attention deficit hyperactivity disorders (ADHD) could be causing people to smoke. If that is the case, will treatment for ADHD combined with the standard treatment to help people quit smoking - the patch with counseling - increase the quit rates for smokers trying to quit?

Lirio S. Covey, Ph.D., director of the Smoking Cessation Program at Columbia University Medical Center, is trying to find out.

Covey and her colleagues are recruiting smokers who have been diagnosed with ADHD or who may have symptoms of ADHD but have not yet been diagnosed, to be part of a study that will help them quit smoking. Approximately 7-8 million adults in the U.S. have ADHD. Smoking is twice as common in this population as in the general population.

Research has shown that most smoking in the U.S. occurs among people who have psychiatric conditions, such as alcohol or drug abuse, major depression, anxiety and ADHD. One line of research has shown that smokers with these conditions “self-medicate” their symptoms with nicotine, the primary addictive substance in tobacco.

Participants in the study will receive the nicotine patch, behavioral counseling, and a drug approved by the Food and Drug Administration for the treatment of ADHD called methylphenidate (brand name CONCERTA®). Because methylphenidate and nicotine act on the brain in a similar way, the premise is that treatment with methylphenidate when trying to quit smoking may reduce symptoms of ADHD while also reducing tobacco withdrawal symptoms. These benefits together may lead to increased success in quitting.

“Nicotine seems to quell the symptoms for ADHD, but unfortunately the other ingredients in cigarettes and the act of taking in nicotine through the lungs makes it very bad for you,” says Dr. Covey. “Our hope is that we can affect some of the same receptors and transmitters activated by nicotine with this ADHD treatment so that smokers are relieved from their ADHD symptoms and are less likely to light up.”

The Smoking Cessation Program at Columbia University Medical Center is seeking participants aged 18- to 55-years-old to enroll in this study. The study, being run out of the New York State Psychiatric Institute located on the CUMC campus on the upper west side of Manhattan, is one of six sites funded by the National Institute on Drug Abuse (NIDA) to carry out this study in the U.S.

Participation is conditional upon completion of screening procedures including assessments to determine the presence of ADHD and the smoker’s level of cigarette use. Qualified participants will be randomized to receive either methylphenidate or an identical-looking placebo or sugar pill. All participants will receive the nicotine patch and 11 weeks of behavioral counseling. Reimbursement for time and travel will be offered to research participants.