Methylphenidate does not influence smoking-reinforced responding or attentional performance in adult smokers with and without attention deficit hyperactivity disorder (ADHD).

Abstract

Individuals with Attention Deficit Hyperactivity Disorder (ADHD) smoke cigarettes at rates higher than the general population and questions have been raised about how stimulant drugs – the frontline pharmacological treatment for ADHD – influence smoking risk and behavior in those with ADHD. In the present study adult regular smokers with (n=16) and without (n=17) ADHD participated in 3 experimental sessions in which they completed a Progressive Ratio (PR) task to measure the relative reinforcing effects of cigarette smoking and money following oral administration of placebo and 2 active doses of methylphenidate (10 mg and 40 mg). We also measured attention and inhibitory control via a Continuous Performance Test (CPT). Methylphenidate had no effect on smoking-reinforced responding, attention, or inhibitory control in either group. Attention and inhibitory control were associated with smoking-reinforced responding, but unsystematically and only in the non-ADHD group. Several design features, such as the value of the monetary response option, the PR schedule, and the potential effects of smoking on attention and inhibitory control, could have contributed to the negative findings and are discussed as such. Although inconsistent with some previous human laboratory studies of stimulant drugs and smoking, results are consistent with recent trials of stimulant drugs as adjuncts for smoking cessation in adult smokers with ADHD. In general, methylphenidate at mild and moderate doses did not influence the relative reinforcing effects of cigarette smoking in adults with and without ADHD.

Stimulant Treatment of ADHD and Cigarette Smoking: A Meta-Analysis

“…[34][35][36][37][38][39][40] Although clinical trials of treatmentseeking smokers with ADHD have shown that neither methylphenidate nor amphetamine increase smoking, 41,42 studies have not examined how stimulant treatment might influence naturalistic smoking among individuals with ADHD who are not trying to quit. Such studies are necessary to resolve this discrepancy between laboratory studies and clinical trials of smoking cessation.…”

“…[34][35][36][37][38][39] In contrast, however, a recent study revealed no effect of methylphenidate on choices of cigarette puffs versus money for ADHD and non-ADHD adults. 40 Randomized clinical trials of stimulants to aid cessation among ADHD smokers have revealed no evidence that either methylphenidate or amphetamine products are more effective than placebo for facilitating smoking abstinence. 41,42 However, in contrast to some laboratory studies, both stimulant and placebotreated individuals in these studies reduced the number of cigarettes smoked daily, 42,43 and 1 open label study revealed that methylphenidate treatment decreased smoking to below the population rate.…”