Attention-Deficit/Hyperactivity Disorder Symptoms and Later E-Cigarette and Tobacco Use in US Youths
McCabe SE, Pasman E, Wilens T, et al. Attention-Deficit/Hyperactivity Disorder Symptoms and Later E-Cigarette and Tobacco Use in US Youths. JAMA Netw Open. 11 Feb 2025;8(2):e2458834. doi:10.1001/jamanetworkopen.2024.58834
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2830092
1881 participants (14.1%; 95% CI, 13.2%-15.0%) were diagnosed with ADHD. Multivariable logistic regression analyses indicated that the adjusted odds of incident e-cigarette use, cigarette smoking, other tobacco use, and dual use did not significantly differ between those with asymptomatic ADHD (with or without pharmacotherapy) compared with population controls. In contrast, all subgroups who had three or more ADHD symptoms (with or without pharmacotherapy) had significantly higher adjusted odds of e-cigarette use (adjusted odds ratio [AOR], 1.60; 95% CI, 1.34-2.04), cigarette smoking (AOR, 1.52; 95% CI, 1.22-1.89), other tobacco use (AOR, 1.61; 95% CI, 1.27-2.02), and dual use (AOR, 1.72; 95% CI, 1.38-2.14) compared with youths with asymptomatic ADHD or population controls. Among youths with ADHD, those with highly symptomatic ADHD were significantly more likely to initiate e-cigarette (AOR, 1.68; 95% CI, 1.16-2.44) and dual use (AOR, 1.82; 95% CI, 1.17-2.83) than youths without symptoms.
Conclusions and Relevance In this cohort study of US youths, ADHD symptoms were associated with the onset of nicotine and tobacco use. Findings highlight the importance of early diagnosis and effective treatment of ADHD to alleviate symptoms and reduce the risk of later nicotine and tobacco use.
TRC Research Commentary
Shi R, Khayat A, Lee J, et al. Electronic Nicotine Delivery System Advertisement Trends After US Federal Policy Changes. JAMA Netw Open. 12 Feb 2025;8(2):e2459188. doi:10.1001/jamanetworkopen.2024.59188
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2830113
“Conclusions and Relevance This qualitative study found immediate compliance with nicotine warning statements but no significant reduction in use of flavor cues and an increase in youth-appealing features in the first year after regulatory measures. The findings suggest a need for continued close monitoring of youth appeals in ENDS advertisements on all platforms to inform potential policies and interventions that can be used to counter the reach, appeal, and impact of these advertisements.”
Comment: It is not just what you say but what you show that appeals to youth. The tobacco industry knows this. Stephen Hamann
