Sub-clinical levels of attention deficit-hyperactivity disorder are associated with tobacco consumption in male but not in female smokers

An abundance of evidence has demonstrated an association between symptoms of attention deficit hyperactivity disorder (ADHD) and tobacco consumption. However, previous research has focused solely on populations meeting full diagnostic criteria for ADHD, despite evidence suggesting that symptoms below diagnostic threshold can be associated with impairment. Furthermore, the role of gender in the relationship between ADHD symptoms and tobacco consumption has not been determined. To examine the relationship between ADHD symptoms, tobacco use, and gender in a non-clinical population, symptoms of inattention, hyperactivity and impulsivity were assessed in 230 undergraduate students (22 male and 45 female smokers, and 66 male and 97 female nonsmokers). Overall, relative to nonsmokers, the smoking subjects reported significantly higher levels of inattention and hyperactivity. In male smokers, both inattentive and hyperactive/impulsive symptoms were positively associated with the number of cigarettes smoked daily. This relationship did not hold for female smokers, for whom no association was found between symptoms and nicotine consumption. Findings imply that even sub-clinical levels of inattention and hyperactivity/impulsivity are related to indices of tobacco use in males, and support previous research suggesting that significant gender differences may exist in tobacco smoking motives. Results also have potential implications for tobacco cessation programs, which may require more individual tailoring.