The importance of considering ADHD in smoking cessation clinical trials

摘要

Tobacco use is a leading cause of preventable death worldwide. A large proportion of smokers are motivated to quit smoking and there are a number of available treatments that can increase quit rates [1]. However, relapse to smoking is common, with only 10-40% achieving long-term abstinence even after undergoing intensive treatment [l]. Hence, there continues to be a critical need for the development of novel smoking cessation treatments and clinical trials to empirically test the efficacy of attention deficit/hyperactivity disorder (ADHD) treatments. While the literature has been instrumental in providing clear guidelines for statistical analysis and measurement of outcomes and mediators in smoking cessation clinical trials [2,3], less attention has been paid to patient characteristics, such as psychiatric disorders, which are clinically important to smoking cessation processes. ADHD - a common and disabling behavioral condition in both children and adults [4] - is strongly associated with nicotine dependence [5]. Importantly, ADHD may heighten risk for persistent smoking and poorer smoking cessation outcomes [6,7]. However, ADHD is rarely assessed or targeted in smoking cessation trials. The aim of this editorial is to highlight the importance of considering ADHD in smoking cessation clinical trials. Below, we describe ADHD symptomatology, assessment, and clinical issues related to smoking and cessation processes, with the goal of providing guidance for smoking cessation research. It is our hope that the following discussion will stimulate heightened consideration of ADHD in smoking cessation clinical trials, which we feel will ultimately advance the science of smoking cessation more broadly.