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Nicotine & Tobacco Research Advance Access published online on March 23, 2009

Nicotine & Tobacco Research, doi:10.1093/ntr/ntp001
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© The Author 2009. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Association between smoking and retrospectively reported attention-deficit/hyperactivity disorder symptoms in a large sample of new mothers

Michael T. Willoughby, Scott H. Kollins, F. Joseph McClernon and The Family Life Investigative Group

Michael T. Willoughby, Ph.D., FPG Child Development Institute, University of North Carolina at Chapel Hill, Carrboro, NC
Scott H. Kollins, Ph.D., Department of Psychiatry, Duke University Medical Center, Durham, NC
F. Joseph McClernon, Ph.D., Department of Psychiatry, Duke University Medical Center, Durham, NC

Corresponding Author: Michael T. Willoughby, Ph.D., FPG Child Development Institute, University of North Carolina at Chapel Hill, Campus Box 8185 521, South Greensboro Street, Carrboro, NC 27510, USA. Telephone: 919-966-5482. Fax: 919-962-5771. Email: willoughby{at}unc.edu


   Abstract

Introduction: This study investigated the association between retrospectively reported attention-deficit/hyperactivity disorder (ADHD) symptoms experienced during childhood and five cigarette smoking–related outcomes in adulthood.

Methods: A large sample (N = 1,117) of new mothers participating in an ongoing longitudinal study completed retrospective reports of their childhood ADHD symptomatology, as well as concurrent and retrospective reports of their smoking behavior. Linear regression models tested the association between ADHD symptomatology and smoking outcomes.

Results: Childhood ADHD symptomatology was predictive of the number of cigarettes smoked per day currently and during pregnancy, as well as the age at onset of smoking. We found nonlinear associations between hyperactive–impulsive symptoms and the number of cigarettes smoked per day in pregnancy, as well as between inattentive symptoms and the number of cigarettes smoked per day currently. Women who retrospectively reported intermediate levels of ADHD symptoms during their childhood reported smoking more cigarettes per day than women who reported low or high levels of ADHD symptoms during childhood. We also found multiplicative relationship between inattentive and hyperactive–impulsive symptoms, such that inattentive symptoms were predictive of an earlier age at smoking onset only when hyperactive–impulsive symptoms were low; moreover, the magnitude of this association was stronger for Black relative to White women.

Discussion: These findings demonstrate the importance of considering differential effects of ADHD symptoms and smoking outcomes as a function of sex and race. They also represent a potentially indirect means through which women who have even a moderate childhood history of ADHD symptomatology may create a set of circumstances that compromise the health and well-being of their own children.

Received: August 13, 2007; Accepted: June 16, 2008
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