Many people self-medicate for ADHD with cigarettes. This connection can make quitting even more difficult.

Nicotine is one of the most widely used substances. Roughly 22% of adults in the United States have reported using nicotine or tobacco products in 2021.

People with attention deficit hyperactivity disorder (ADHD) are more likely to smoke cigarettes and use other nicotine-containing products.

Studies also suggest that people with ADHD have a higher risk of nicotine dependence and may have more trouble quitting nicotine.

This article explores the relationship between nicotine and ADHD, including how nicotine can affect ADHD symptoms, medications, and more.

When you use nicotine, it enters your body and activates the reward system in your brain, releasing dopamine. Dopamine, also known as the “feel-good” hormone, is a neurotransmitter associated with feelings of reward and pleasure.

When you feel the pleasure associated with a rush of dopamine, it encourages you to continue chasing the thing that caused that pleasure ― which is why nicotine has such a high potential for addiction.

Experts believe that people with ADHD may lack one of the genes responsible for regulating dopamine. This may, at least in part, explain why people with ADHD are more likely to use dopamine-producing substances like nicotine.

Another possible reason a higher percentage of people with ADHD use nicotine is the impact it appears to have on ADHD symptoms.

For example, a 2017 study suggests in people with ADHD, nicotine may improve:

Because nicotine might improve these symptoms, some people with ADHD may use nicotine as a form of self-medication. This can greatly increase the risk of dependence.

Are people with ADHD more likely to smoke or vape?

There’s no research that compares the different types of nicotine people with ADHD use. But there do appear to be differences in cigarette and vape use among different groups.

For example, one survey found that vaping was most common among men and people ages 25–34 years, with most vapers being former smokers. Survey respondents who vaped but had never smoked before were more likely to be younger, ages 18–24 years.

A Gallup poll from 2021 found that young adults ages 18–29 years are more likely to vape, while older adults ages 30–64 years are much more likely to smoke cigarettes.

However, ADHD rates in adults are distributed fairly evenly across age ranges. Without more research, it’s difficult to say which nicotine preference adults with ADHD might have.

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Several medication options can help reduce or manage ADHD symptoms, including:

Currently, there’s no recommendation against using both nicotine and ADHD medications together. But research on the relationship between the two is limited.

One 2011 study found that short-term methylphenidate use led to an increase in cigarette use in participants. However, this study only had nine participants and only explored short-term use, not long-term use.

Another 2011 study explored the side effects of osmotic-release methylphenidate treatment in adults and adolescents with ADHD. Results showed that the adult treatment group, who used nicotine patches during the study, reported more side effects from treatment.

Still, these studies show limited evidence of a relationship between nicotine and ADHD medications, so more research is needed.

Studies suggest that having ADHD may affect nicotine withdrawal and make it harder for people with ADHD to quit smoking or using nicotine.

In one study from 2016, researchers surveyed people with ADHD on their perceptions of quitting smoking with ADHD. Participants reported intense withdrawal symptoms when attempting to quit. They also noted an increase in ADHD symptoms while quitting.

A study published in 2017 investigated the effects of ADHD symptoms on treatment outcomes in participants using varenicline to quit smoking.

Results showed that varenicline reduced nicotine withdrawal in participants with high hyperactivity-impulsivity symptoms. Since varenicline reduced withdrawal symptoms in this group, it led to better treatment outcomes.

Resources for quitting with ADHD

If you have ADHD and want to quit smoking or using nicotine products, you’re not alone. Many resources can help:

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Studies suggest that adults with ADHD have an increased risk of smoking or using other nicotine-containing products. When people with ADHD decide to quit using nicotine, they tend to experience more withdrawal symptoms and have a harder time quitting.

However, treatment for both underlying ADHD symptoms and nicotine withdrawal symptoms may help improve the chances of someone with ADHD quitting nicotine.

If you live with ADHD and have found it difficult to quit smoking or using nicotine, consider reaching out to a doctor for help. With the right treatment options and support, you can find a way to quit for good.