Cigarette Smoking Progression Among Young Adults Diagnosed With ADHD in Childhood: A 16-year Longitudinal Study of Children With and Without ADHD.

INTRODUCTION: Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for smoking cigarettes, but there is little longitudinal research on the array of smoking characteristics known to be prognostic of long-term smoking outcomes into adulthood. These variables were studied into early adulthood in a multisite sample diagnosed with ADHD combined type at ages 7-9.9 and followed prospectively alongside an age- and sex-matched local normative comparison group (LNCG). METHODS: Cigarette smoking quantity, quit attempts, dependence, and other characteristics were assessed in the longitudinal Multimodal Treatment Study of Children with ADHD (MTA) eight times to a mean age of 24.9 years: ADHD n = 469; LNCG n = 240. RESULTS: In adulthood, the ADHD group had higher rates of daily cigarette smoking, one or more quit attempts, shorter time to first cigarette of the day, and more severe withdrawal than the LNCG. The ADHD group did not appear to have better smoking cessation rates despite a higher proportion quitting at least once. Smoking quantity and nicotine dependence did not differ between groups. The ADHD group reported younger daily smoking onset and faster progression from smoking initiation to daily smoking across assessments. Finally, ADHD symptom severity in later adolescence and adulthood was associated with higher risk for daily smoking across assessments in the ADHD sample. CONCLUSIONS: This study shows that ADHD-related smoking risk begins at a young age, progresses rapidly, and becomes resistant to cessation attempts by adulthood. Prevention efforts should acknowledge the speed of uptake; treatments should target the higher relapse risk in this vulnerable population. IMPLICATIONS: Although childhood ADHD predicts later smoking, longitudinal studies of this population have yet to fully characterize smoking behaviors into adulthood that are known to be prognostic of long-term smoking outcome. The current study demonstrates earlier and faster progression to daily smoking among those with a childhood ADHD diagnosis, as well as greater risk for failed quit attempts. Prevention efforts should address speed of smoking uptake, while treatments are needed that address smoking relapse risk. The current study also demonstrates ADHD symptom severity over development increases daily smoking risk, implicating the need for continuous ADHD symptom management.

Narrative review of the safety and efficacy of marijuana for the treatment of commonly state-approved medical and psychiatric disorders.

The present investigation aimed to provide an objective narrative review of the existing literature pertaining to the benefits and harms of marijuana use for the treatment of the most common medical and psychological conditions for which it has been allowed at the state level. Common medical conditions for which marijuana is allowed (i.e., those conditions shared by at least 80 percent of medical marijuana states) were identified as: Alzheimer's disease, amyotrophic lateral sclerosis, cachexia/wasting syndrome, cancer, Crohn's disease, epilepsy and seizures, glaucoma, hepatitis C virus, human immunodeficiency virus/acquired immunodeficiency syndrome, multiple sclerosis and muscle spasticity, severe and chronic pain, and severe nausea. Post-traumatic stress disorder was also included in the review, as it is the sole psychological disorder for which medical marijuana has been allowed. Studies for this narrative review were included based on a literature search in PsycINFO, MEDLINE, and Google Scholar. Findings indicate that, for the majority of these conditions, there is insufficient evidence to support the recommendation of medical marijuana at this time. A significant amount of rigorous research is needed to definitively ascertain the potential implications of marijuana for these conditions. It is important for such work to not only examine the effects of smoked marijuana preparations, but also to compare its safety, tolerability, and efficacy in relation to existing pharmacological treatments.

Concordance of adolescent reports of friend alcohol use, smoking, and deviant behavior as predicted by quality of relationship and demographic variables.

OBJECTIVE: The strongest predictor of adolescent alcohol use is affiliation with friends who drink, use other drugs, or engage in deviant behavior. Most studies measure this variable using adolescent perceptions of friend problem behavior, but some research suggests these perceptions may be inaccurate. The current study's objective was to determine the concordance between adolescent perceptions of their friend's drinking, smoking, and deviant behavior and the friend's self-report. Relationship characteristics and demographic variables were explored as predictors of report concordance. METHOD: Participants (targets) were 232 adolescents ages 13 or 15 (53% girls) from Wave 9 of the Tween to Teen Project. At least one reciprocally endorsed friend participated for 59% of target adolescents (n = 232/390). Targets completed computer-assisted interviews. Friends completed telephone interviews. RESULTS: The relations between target perceptions of friend and friend self-reports of drinking and smoking were statistically significant (p < .001), but concordance was driven largely by agreement regarding the absence of behavior. Although 22% of friends drank and 8.6% smoked, fewer than 60% of targets perceived these behaviors. Deviant behavior reports correlated moderately (r = .45), with 51% of adolescents underreporting friend deviance. There were few predictors of report concordance. CONCLUSIONS: Adolescents and their friends generally provided concordant reports of one another's drinking and smoking behaviors, but most agreement concerned the absence of behavior; most targets provided underreports of their friend's engagement in deviant behaviors. These findings suggest that adolescent perceptions of friends' problem behavior do not exaggerate the involvement of their friends in these behaviors.