“…Second, Hypothesis 2 is represented by the overlapping ovals of female sex and nicotine, reflecting that nicotine may have unique affects in adult females by interacting with estrogen and the dopamine reward system in ways that increase both the positive and the negative reinforcement afforded by smoking [21, 31, 104, 106, 114, 117, 119, 121, 129–132, 143]. Third, the overlapping ovals of female sex and ADHD represent Hypothesis 3, indicating that ovarian hormones may act within the dopamine reward system to exacerbate deficits in the capacity to form conditioned associations, thereby worsening attentional and response inhibition deficits of ADHD [36, 37, 135, 136]. Finally, all three ovals overlap to represent Hypothesis 4, reflecting the two hypothesized mechanisms by which sex, ADHD, and nicotine may interact over the course of the menstrual cycle: 1) during the follicular phase, estrogen may interact with nicotine within the dopamine reward system to ameliorate ADHD-related conditioned learning deficits that are particularly pronounced with females with the disorder; and 2) during the luteal phase, nicotine may diminish the compounded discomfort of premenstrual symptoms, nicotine withdrawal, and ADHD symptoms.…”