Effects of initial nicotine exposure on cognition and nicotine reinforcement among non-smoking young adults with and without attention deficit hyperactivity disorder

Abstract

Background:

People with attention deficit hyperactivity disorder (ADHD) use nicotine products at higher rates than those without. Greater initial sensitivity to nicotine’s cognitive effects may explain this association.

Aims:

This study examined associations between cognitive effects of nicotine administration and subsequent preference for nicotine versus placebo among young adults naïve to nicotine with and without ADHD.

Methods:

Participants (n = 61 ADHD, n = 75 Control) completed subjective (concentration, alertness) and objective (continuous performance task (CPT)) cognitive assessments in response to 3 doses of intranasal nicotine (0, 0.5, 1.0 mg; 1 dose per session). Choice to self-administer nicotine versus placebo (i.e., nicotine preference) was then assessed in two subsequent sessions under different task conditions—high cognitive demand and low demand. Analyses examined cognitive effects of nicotine dose and related those responses to nicotine preference under different task conditions.

Results/Outcomes:

Nicotine increased subjective concentration and alertness for participants with ADHD but not controls; improved concentration predicted greater nicotine preference. In both groups, nicotine decreased errors of omission but increased errors of commission on the CPT, which predicted increased and decreased nicotine preference, respectively, during high cognitive demand. During the non-demanding condition, increased errors of commission predicted lower nicotine preference only for controls.

Conclusions/Interpretation:

Perceived cognitive enhancement by nicotine may serve as a mechanism of risk for continued use in individuals with ADHD experimenting with nicotine. These findings help to clarify mechanisms underlying ADHD/nicotine use comorbidity and underscore the importance of early prevention.

Declaration of interest/Funding:

This work was supported by the National Institutes of Health.

Keywords

Nicotine cognition addiction risk attention ADHD

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