Children with attention deficit hyperactivity disorder (ADHD) are more likely than others to smoke in adulthood.

Indeed, the more severe the ADHD symptoms in childhood, the earlier cigarette use starts, and the heavier the smoking is likely to be -- thereby substantially increasing the risk of death or serious disability from the smoking.

Ritalin, a drug taken by many ADHD children to help control the problem and improve concentration, has been found in animal studies to intensify the desire for stimulants. Nicotine is a stimulant.

"That might make them biologically susceptible," says psychologist Nadine Lambert, University of California, Berkeley, who reported on her study at the American Psychological Association meeting in Toronto.

The study also showed that ADHD kids are also most likely to use cocaine or other stimulant drugs. This is not surprising, since nicotine has frequently been called the "gateway drug" because taking up its use in cigarette or chewing tobacco greatly multiplies the chances that a teen will go on to use illegal drugs.

Indeed, the U.S. Surgeon General has reported that:

* teens who smoke cigarettes are 100 TIMES (NOT just 100%) more likely to go on to marijuana, and

* teens who smoke cigarettes are 30 TIMES (NOT just 30%) more likely to go on to cocaine.

Other studies show that:

* about 65% of cocaine users started by smoking cigarettes

* adults who started to smoke early (before the age of 15) are 3 times (300%) as likely to be regular hard drug users as those who started smoking at 18 or older

* adults who started to smoke early (before the age of 15) are more than twice as likely to be regular cocaine users than those who started smoking at 18 or older

* children who smoke daily are 13 times (1300%) more likely to use heroin than children who smoke less often

* adolescents (as well as adults) believe that smoking cigarettes or drinking alcohol is the first step down the path toward illegal drug use.

The severity of ADHD symptoms in childhood also predicts the amount of stimulant and cocaine use.

Lambert began a study of 492 grade school children, about one-third with ADHD, in the late '60s.

She says cigarettes can improve mental focusing, a problem for kids with this disorder, so they may be "self-medicating" on nicotine in order to aid their concentration.

Parents whose youngsters show ADHD symptoms should monitor their behavior and get prompt help for any learning disabilities, Lambert advises. "Ritalin may fix them up on the surface, but they need some ongoing attention."

ASH also suggests that parents of children with ADHD -- or children who taken Ritalin for any reason -- should be especially forceful in urging their children not be try smoking, and to carefully monitor them for signs that they may have already taken it up.

Teachers, neighbors, and friends of such parents can help by showing them a copy of this posting.


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