Attention-deficit/hyperactivity disorder (ADHD) symptoms, craving to smoke, and tobacco withdrawal symptoms in adult smokers with ADHD

AbstractBackgroundTobacco withdrawal symptoms may be confounded with attention-deficit/hyperactivity disorder (ADHD) symptoms among smokers with ADHD.Objective(1) To assess overlap between ADHD symptoms and tobacco/nicotine withdrawal symptoms and craving; (2) to assess the relationship between craving or withdrawal symptoms and the effect of osmotic-release oral system methylphenidate (OROS-MPH) on ADHD symptoms; (3) to assess the association of ADHD symptoms, craving, and withdrawal symptoms with abstinence.MethodsSecondary analysis of a randomized, placebo controlled smoking cessation trial assessing the efficacy of OROS-MPH taken in addition to nicotine patch among individuals with ADHD. ADHD symptoms, withdrawal symptoms, and craving were assessed at baseline and 2, 4 and 6 weeks after a target quit day.ResultsWithdrawal symptoms and craving showed limited and modest overlap with ADHD symptoms prior to abstinence but more extensive and stronger correlation after quit day. Compared to placebo, OROS-MPH reduced ADHD symptoms; this effect was attenuated by controlling for withdrawal symptoms, but not by craving. Craving, but not ADHD symptoms and withdrawal symptoms, was associated with abstinence during the trial.ConclusionWhen treating smokers with ADHD (1) craving, rather than tobacco withdrawal symptoms or ADHD symptoms may be the more effective therapeutic smoking cessation targets; (2) careful distinction of craving, withdrawal symptoms, and ADHD symptoms when assessing withdrawal phenomena is needed

Tobacco Use and Suicide Attempt: Longitudinal Analysis with Retrospective Reports

International audienceBackgroundSuicide has been associated with smoking/tobacco use but its association of and change in smoking/tobacco use status with suicide attempt (SA) is not well established.MethodsWe investigated whether persistent, former tobacco use, initiation, quitting tobacco use, relapse to tobacco use, and DSM-IV nicotine dependence predict independently SA using Wave 1 and 2 data of the National Epidemiologic Survey of Alcohol and Related Conditions. Data from 34,653 US adults interviewed at Wave 1 (2001-02) and Wave 2 (2004-05) were analyzed. The main outcome measure was SA between Wave 1 and Wave 2 as reported at Wave 2.ResultsAmong the 1,673 respondents reporting lifetime SA at Wave 2, 328 individuals reported SA between Wave 1 and Wave 2. Current and former tobacco use at Wave 1 predicted Wave 2 SA independently of socio-demographic characteristics, psychiatric history, and prior SA (Adjusted Odds Ratio (AOR): 1.49; 95% CI: 1.13-1.95, AOR: 1.31; 95% CI:1.01-1.69, respectively versus never tobacco users). The strongest association with SA was observed among former tobacco users who relapsed after Wave 1 (AOR: 4.66; 95% CI: 3.49-6.24) and among tobacco use initiators after Wave 1 (AOR: 3.16; 95% CI: 2.23-4.49). Persistent tobacco use (current tobacco use at both Wave 1 and Wave 2) also had an increased risk of SA (AOR: 1.89; 95% CI: 1.47-2.42). However, former tobacco users in both Waves 1 and 2 did not show a significantly elevated risk for SA in Wave 2 (AOR:1.09, 95% CI: 0.78-1.52) suggesting that the risk resided mainly in Wave 1 former tobacco users who relapsed to tobacco use by Wave 2. DSM-IV nicotine dependence did not predict SA at Wave 2.ConclusionIn a representative sample of US adults, relapse, tobacco use initiation, and persistent tobacco use, which are amenable to intervention, were associated with risk of SA

Tobacco Use and Suicide Attempt: Longitudinal Analysis with Retrospective Reports

Background Suicide has been associated with smoking/tobacco use but its association of and change in smoking/tobacco use status with suicide attempt (SA) is not well established. Methods We investigated whether persistent, former tobacco use, initiation, quitting tobacco use, relapse to tobacco use, and DSM-IV nicotine dependence predict independently SA using Wave 1 and 2 data of the National Epidemiologic Survey of Alcohol and Related Conditions. Data from 34,653 US adults interviewed at Wave 1 (2001-02) and Wave 2 (2004-05) were analyzed. The main outcome measure was SA between Wave 1 and Wave 2 as reported at Wave 2. Results Among the 1,673 respondents reporting lifetime SA at Wave 2, 328 individuals reported SA between Wave 1 and Wave 2. Current and former tobacco use at Wave 1 predicted Wave 2 SA independently of socio-demographic characteristics, psychiatric history, and prior SA (Adjusted Odds Ratio (AOR): 1.49; 95% CI: 1.13-1.95, AOR: 1.31; 95% CI:1.01-1.69, respectively versus never tobacco users). The strongest association with SA was observed among former tobacco users who relapsed after Wave 1 (AOR: 4.66; 95% CI: 3.49-6.24) and among tobacco use initiators after Wave 1 (AOR: 3.16; 95% CI: 2.23-4.49). Persistent tobacco use (current tobacco use at both Wave 1 and Wave 2) also had an increased risk of SA (AOR: 1.89; 95% CI: 1.47-2.42). However, former tobacco users in both Waves 1 and 2 did not show a significantly elevated risk for SA in Wave 2 (AOR:1.09, 95% CI: 0.78-1.52) suggesting that the risk resided mainly in Wave 1 former tobacco users who relapsed to tobacco use by Wave 2. DSM-IV nicotine dependence did not predict SA at Wave 2. Conclusion In a representative sample of US adults, relapse, tobacco use initiation, and persistent tobacco use, which are amenable to intervention, were associated with risk of SA

Smokers' response to combination bupropion, nicotine patch, and counseling treatment by race/ethnicity.

Abstract available at publisher's web site

Comparison of lifetime nicotine dependence and different tobacco use variables in the multiple logistic regression models predicting Wave 1 to Wave 2 suicide attempt.

<p>Adjusted for all covariates listed in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122607#pone.0122607.t001" target="_blank">Table 1</a>.</p><p>*Reference group: No nicotine dependence, controlling for all other variables.</p><p>^# For Model 3B, the five individual coefficients for tobacco use status change (from Wave 1 to Wave 2, see bottom of <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122607#pone.0122607.t001" target="_blank">Table 1</a>) are not presented; AOR values range from 0.97 to 4.98, and have the same pattern of statistical significance for the AORs as shown in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0122607#pone.0122607.t001" target="_blank">Table 1</a>.</p><p>Comparison of lifetime nicotine dependence and different tobacco use variables in the multiple logistic regression models predicting Wave 1 to Wave 2 suicide attempt.</p

Weighted Percentages, Standard Errors, Unadjusted and Adjusted Odds Ratios (OR and AOR) and 95% Confidence Intervals (CI) of Suicide Attempts (SA) Occurred Between Wave 1 and 2 (mean: 3.1 years) by Wave 1 Characteristics.

<p>(N = 34,653).</p><p>^#OR estimates from logistic regression of Wave 2 suicide attempts on Wave 1 current smoker or former smoker, and all categories of control variables except smoking status changes.</p><p>^§OR estimates from multiple logistic regression of Wave 2 suicide attempt on smoking status changes, race and ethnicity, sex, and Wave 1 measurements for age group, marital status, household income group, unemployment, census region, urbanicity, educational group, previous suicide attempt(s) and psychopathology.</p><p>* significant at alpha ≤0.05</p><p>** significant at alpha ≤0.01</p><p>Weighted Percentages, Standard Errors, Unadjusted and Adjusted Odds Ratios (OR and AOR) and 95% Confidence Intervals (CI) of Suicide Attempts (SA) Occurred Between Wave 1 and 2 (mean: 3.1 years) by Wave 1 Characteristics.</p