Sweitzer Maggie M, Lazzari Julianna, Lunsford-Avery Jessica, McClernon Francis Joseph, Kollins Scott H, Perkins Kenneth A, Engelhard Matthew
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
J Psychopharmacol. 2025 Jul;39(7):694-702. doi: 10.1177/02698811251344687. Epub 2025 Jun 28.
People with attention deficit hyperactivity disorder (ADHD) use nicotine products at higher rates than those without. Greater initial sensitivity to nicotine's cognitive effects may explain this association.
This study examined associations between cognitive effects of nicotine administration and subsequent preference for nicotine versus placebo among young adults naïve to nicotine with and without ADHD.
Participants ( = 61 ADHD, = 75 Control) completed subjective (concentration, alertness) and objective (continuous performance task (CPT)) cognitive assessments in response to 3 doses of intranasal nicotine (0, 0.5, 1.0 mg; 1 dose per session). Choice to self-administer nicotine versus placebo (i.e., nicotine preference) was then assessed in two subsequent sessions under different task conditions-high cognitive demand and low demand. Analyses examined cognitive effects of nicotine dose and related those responses to nicotine preference under different task conditions.
RESULTS/OUTCOMES: Nicotine increased subjective concentration and alertness for participants with ADHD but not controls; improved concentration predicted greater nicotine preference. In both groups, nicotine decreased errors of omission but increased errors of commission on the CPT, which predicted increased and decreased nicotine preference, respectively, during high cognitive demand. During the non-demanding condition, increased errors of commission predicted lower nicotine preference only for controls.
CONCLUSIONS/INTERPRETATION: Perceived cognitive enhancement by nicotine may serve as a mechanism of risk for continued use in individuals with ADHD experimenting with nicotine. These findings help to clarify mechanisms underlying ADHD/nicotine use comorbidity and underscore the importance of early prevention.Declaration of interest/Funding:This work was supported by the National Institutes of Health.
注意力缺陷多动障碍（ADHD）患者使用尼古丁产品的比例高于非ADHD患者。对尼古丁认知效应的更高初始敏感性可能解释了这种关联。
本研究调查了在初次接触尼古丁的有和没有ADHD的年轻成年人中，尼古丁给药的认知效应与随后对尼古丁与安慰剂的偏好之间的关联。
参与者（n = 61名ADHD患者，n = 75名对照）对3剂鼻内尼古丁（0、0.5、1.0毫克；每次给药1剂）完成主观（注意力、警觉性）和客观（连续性能任务（CPT））认知评估。然后在随后的两个不同任务条件（高认知需求和低需求）的环节中评估自我给药尼古丁与安慰剂的选择（即尼古丁偏好）。分析研究了尼古丁剂量的认知效应，并将这些反应与不同任务条件下的尼古丁偏好相关联。
结果/结果：尼古丁提高了ADHD患者的主观注意力和警觉性，但对对照组没有影响；注意力改善预示着对尼古丁的偏好更高。在两组中，尼古丁减少了CPT上的漏报错误，但增加了虚报错误，这分别预示着在高认知需求期间尼古丁偏好的增加和减少。在非需求条件下，虚报错误增加仅预示着对照组对尼古丁的偏好较低。
结论/解读：尼古丁引起的认知增强可能是ADHD患者尝试使用尼古丁后持续使用的风险机制。这些发现有助于阐明ADHD/尼古丁使用共病的潜在机制，并强调早期预防的重要性。利益声明/资金：本研究得到了美国国立卫生研究院的支持。
