ADHD, altered dopamine neurotransmission, and disrupted reinforcement processes: Implications for smoking and nicotine dependence

• ADHD is a risk factor for adverse outcomes related to cigarette smoking.
• ADHD is associated with altered dopamine neurotransmission.
• ADHD is associated with disrupted reinforcement processes.
• ADHD smoking risk can be clarified by studying dopamine-reinforcement links.

Attention deficit hyperactivity disorder (ADHD) is a common and impairing disorder affecting millions of children, adolescents, and adults. Individuals with ADHD smoke cigarettes at rates significantly higher than their non-diagnosed peers and the disorder also confers risk for a number of related adverse smoking outcomes including earlier age of initiation, faster progression to regular use, heavier smoking/greater dependence, and more difficulty quitting. Progress in our understanding of dopamine neurotransmission and basic behavioral reinforcement processes in ADHD may help increase our understanding of the ADHD-smoking comorbidity. This review will examine how these areas have been studied and how further work may aid in the development of better prevention and treatment for smoking in those with ADHD.