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

Prog Neuropsychopharmacol Biol Psychiatry. 2014 Jul 3;52:70-8. doi: 10.1016/j.pnpbp.2014.02.002. Epub 2014 Feb 18.


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.

Keywords: ADHD; Dopamine; Reinforcement; Smoking.

Publication types

  • Review

MeSH terms

  • Attention Deficit Disorder with Hyperactivity / genetics
  • Attention Deficit Disorder with Hyperactivity / metabolism*
  • Attention Deficit Disorder with Hyperactivity / physiopathology*
  • Dopamine / genetics
  • Dopamine / metabolism*
  • Humans
  • Learning Disabilities / etiology
  • Reinforcement, Psychology*
  • Smoking
  • Synaptic Transmission / physiology*
  • Tobacco Use Disorder


  • Dopamine