Duke ADHD Program, Department of Psychiatry, Duke University School of Medicine, 2608 Erwin Road, Pavilion East, Suite 300, Durham, NC 27705, USA.
Psychopharmacology (Berl). 2013 May;227(1):19-30. doi: 10.1007/s00213-012-2937-0. Epub 2012 Dec 18.
Individuals with attention deficit hyperactivity disorder (ADHD) have a more difficult time quitting smoking compared to their non-ADHD peers. Little is known about the underlying behavioral mechanisms associated with this increased risk.
This study aims to assess the effects of 24-h smoking abstinence in adult smokers with and without ADHD on the following outcomes: smoking-reinforced responding, withdrawal, and cognitive function.
Thirty-three (n = 16 with ADHD, 17 without ADHD) adult smokers (more than or equal to ten cigarettes/day) were enrolled. Each participant completed two experimental sessions: one following smoking as usual and one following biochemically verified 24-h smoking abstinence. Smoking-reinforced responding measured via a progressive ratio task, smoking withdrawal measured via questionnaire, and cognition measured via a continuous performance test (CPT) were assessed at each session.
Smoking abstinence robustly increased responding for cigarette puffs in both groups, and ADHD smokers responded more for puffs regardless of condition. Males in both groups worked more for cigarette puffs and made more commission errors on the CPT than females, regardless of condition. Smoking abstinence also increased ratings of withdrawal symptoms in both groups and smokers with ADHD, regardless of condition, reported greater symptoms of arousal, habit withdrawal, and somatic complaints. Across groups, smoking abstinence decreased inhibitory control and increased reaction time variability on the CPT. Abstinence-induced changes in inhibitory control and negative affect significantly predicted smoking-reinforced responding across groups.
Smokers with ADHD reported higher levels of withdrawal symptoms and worked more for cigarette puffs, regardless of condition, which could help explain higher levels of nicotine dependence and poorer cessation outcomes in this population. Abstinence-induced changes in smoking-reinforced responding are associated with changes in inhibitory control and negative affect regardless of ADHD status, a finding that may lead to novel prevention and treatment programs.
与非 ADHD 同龄人相比，患有注意缺陷多动障碍（ADHD）的个体戒烟更为困难。目前尚不清楚与这种风险增加相关的潜在行为机制。
本研究旨在评估 24 小时吸烟戒断对有和无 ADHD 的成年吸烟者以下结果的影响：吸烟强化反应、戒断和认知功能。
招募了 33 名（n=16 名有 ADHD，17 名无 ADHD）成年吸烟者（每天吸烟超过或等于 10 支）。每个参与者都完成了两个实验阶段：一个是在照常吸烟后，另一个是在经过生物化学验证的 24 小时吸烟戒断后。在每个阶段都通过递增比率任务来评估吸烟强化反应，通过问卷来评估吸烟戒断，通过连续性能测试（CPT）来评估认知。
两组吸烟者在吸烟戒断后，吸烟量的反应都明显增加，而 ADHD 吸烟者无论在何种情况下，对吸烟量的反应都更多。无论条件如何，两组男性吸烟者比女性吸烟者都更愿意为吸烟量而工作，并且在 CPT 上犯更多的commission 错误。两组吸烟者无论条件如何，在吸烟戒断后，戒断症状的评分都增加了，ADHD 吸烟者报告说，觉醒、习惯戒断和躯体抱怨的症状更严重。在整个群体中，吸烟戒断降低了 CPT 上的抑制控制和反应时变异性。CPT 上的抑制控制和负面情绪的戒断诱导变化与整个群体的吸烟强化反应显著相关。
无论条件如何，ADHD 吸烟者报告的戒断症状水平更高，为吸烟量工作的次数更多，这可以帮助解释该人群中尼古丁依赖程度更高和戒烟效果更差的原因。无论 ADHD 状态如何，吸烟强化反应的戒断诱导变化与抑制控制和负面情绪的变化相关，这一发现可能导致新的预防和治疗方案。
