Tri-State Tobacco and Alcohol Research Center, University of Cincinnati Reading Campus, 2120 E. Galbraith Road, Building A, Cincinnati, OH 45237, USA.
Nicotine Tob Res. 2010 Mar;12(3):243-50. doi: 10.1093/ntr/ntp200. Epub 2010 Jan 18.
Symptoms of inattention and hyperactivity/impulsivity that fall below the DSM-IV diagnostic threshold for attention-deficit hyperactivity disorder (ADHD) may be associated with the high prevalence of smoking among individuals with alcohol dependence, yet no studies to date have examined the relationship between subthreshold ADHD symptoms and cigarette smoking in this group. We hypothesized that increasing levels of ADHD symptoms would be associated with increasing risk of lifetime smoking and nicotine dependence, concentration problems secondary to nicotine withdrawal, and maintenance of smoking.
Participants were alcohol-dependent adults (n = 242) who did not meet criteria for ADHD or a current Axis I disorder other than alcohol and nicotine dependence. All participants were involved in treatment for alcohol dependence but not smoking cessation. The Semi-Structured Assessment for the Genetics of Alcoholism was administered to collect demographic and smoking history data and to assess symptoms of ADHD and other psychiatric disorders.
A higher number of self-reported ADHD symptoms were associated with increased likelihood of ever smoking (p = .026), nicotine dependence (p = .017), and impaired concentration as a symptom of nicotine withdrawal (p = .046). There was no relationship between the number of ADHD symptoms and classification as a former versus current smoker (p = .333).
Childhood symptoms of inattention and hyperactivity/impulsivity are related to cigarette smoking and nicotine dependence among alcohol-dependent individuals at levels below the ADHD diagnostic threshold. Conceptualization of ADHD symptoms as occurring on a continuum may aid identification of and early intervention for individuals who are at highest risk for initiating smoking and developing nicotine dependence.
注意力不集中和多动/冲动症状低于 DSM-IV 注意力缺陷多动障碍（ADHD）的诊断标准下限，可能与酒精依赖个体中吸烟的高患病率有关，但迄今为止尚无研究检查该亚阈值 ADHD 症状与该组人群中吸烟之间的关系。我们假设 ADHD 症状水平的升高与终生吸烟和尼古丁依赖的风险增加、尼古丁戒断引起的注意力问题以及吸烟的维持有关。
参与者为酒精依赖的成年人（n = 242），他们不符合 ADHD 或除酒精和尼古丁依赖以外的当前轴 I 障碍的标准。所有参与者均参与治疗酒精依赖，但不戒烟。半结构化酒精遗传评估用于收集人口统计学和吸烟史数据，并评估 ADHD 和其他精神障碍的症状。
报告的 ADHD 症状数量较多与吸烟的可能性增加（p =.026）、尼古丁依赖（p =.017）和作为尼古丁戒断症状的注意力不集中（p =.046）有关。ADHD 症状数量与是否为曾经吸烟者与当前吸烟者之间没有关系（p =.333）。
在 ADHD 诊断标准以下的酒精依赖个体中，儿童期注意力不集中和多动/冲动症状与吸烟和尼古丁依赖有关。将 ADHD 症状概念化为连续体可能有助于识别和早期干预那些开始吸烟和发展尼古丁依赖风险最高的个体。
