Lambert N M, Hartsough C S
School Psychology Program, University of California at Berkeley 94720-1670, USA.
J Learn Disabil. 1998 Nov-Dec;31(6):533-44. doi: 10.1177/002221949803100603.
This study focused on an audience at high risk for heavy use of licit and illicit substances: young adults who as children had attention-deficit/hyperactivity disorder (ADHD). The participants in this study were part of a longitudinal study of the life histories of 492 children, one third of whom were identified as hyperactive in 1974 and whose childhood symptom ratings and medical histories were used to establish Diagnostic and Statistical Manual of Mental Disorders (3rd ed., revised; DSM-III-R) ADHD diagnoses (American Psychiatric Association, 1987). The objectives of the study centered on describing (a) developmental history of tobacco use among ADHD and non-ADHD participants in a longitudinal sample, (b) the characteristic adult patterns of tobacco use from early adolescence through early adulthood, and (c) the relationship between ADHD status and tobacco and substance dependence outcomes. Adult data were obtained for 81% of the original 492 participants (77% of the ADHD and 86% of the controls). Lifetime and current tobacco use were assessed from child, adolescent, and adult data, yielding eight measures of smoking status. The study showed that participants with and without ADHD did not differ in age of initiation to smoking, but there was a significant difference in the age they began smoking regularly. By age 17, 46% of all participants with ADHD, as contrasted with 24% of the age-mate controls, reported smoking cigarettes daily. In adulthood, the proportion of participants with ADHD who were current smokers (42%) continued to exceed that of the age-mate controls (26%). Among current adult smokers, 35% with ADHD smoked daily as compared to 16% of the age-mate controls. There were significantly different lifetime tobacco dependence rates--40% compared to 19% for age-mate controls. The rates for cocaine dependence were 21% for participants with ADHD and 10% for age-mate controls. We reported a significant difference in rates of daily smoking and tobacco dependence for those with ADHD who had used stimulant medication in childhood in contrast to controls. Results were interpreted to support a possible link between ADHD treatment histories and levels of tobacco smoking and tobacco dependence in adulthood.
童年患有注意力缺陷多动障碍（ADHD）的年轻人。本研究的参与者是一项对492名儿童生活史进行的纵向研究的一部分，其中三分之一在1974年被认定为多动，其童年症状评分和病史被用于确立《精神疾病诊断与统计手册》（第3版，修订版；DSM - III - R）的ADHD诊断（美国精神病学协会，1987年）。该研究的目标集中在描述：（a）纵向样本中ADHD和非ADHD参与者的烟草使用发展历程；（b）从青春期早期到成年早期成年人典型的烟草使用模式；（c）ADHD状态与烟草及物质依赖结果之间的关系。从最初492名参与者中的81%获取了成人数据（ADHD参与者中的77%以及对照组中的86%）。从儿童、青少年和成人数据中评估终生及当前的烟草使用情况，得出八项吸烟状态指标。研究表明，患有和未患有ADHD的参与者在开始吸烟的年龄上没有差异，但在开始经常吸烟的年龄上存在显著差异。到17岁时，所有患有ADHD的参与者中有46%报告每天吸烟，相比之下同龄对照组为24%。在成年期，当前吸烟的ADHD参与者比例（42%）继续超过同龄对照组（26%）。在当前成年吸烟者中，患有ADHD的人中有35%每天吸烟，而同龄对照组为16%。终生烟草依赖率存在显著差异——患有ADHD的人为40%，同龄对照组为19%。可卡因依赖率方面，患有ADHD的参与者为21%，同龄对照组为10%。我们报告称，与对照组相比，童年使用过兴奋剂药物的患有ADHD的人在每日吸烟率和烟草依赖率上存在显著差异。研究结果被解释为支持ADHD治疗史与成年期吸烟水平及烟草依赖之间可能存在的联系。
