Individuals with attention deficit hyperactivity disorder (ADHD) are at increased risk for adverse cigarette smoking outcomes, and little is known about factors underlying this risk. This study sought to evaluate the effects of initial nicotine exposure in young adults with and without ADHD using a novel paradigm of exposure to model initial smoking experiences. Participants were young adult nonsmokers (n = 61 ADHD, n = 75 Control) between the ages of 18-25 years (inclusive) who reported never having smoked a full cigarette, and no tobacco use in the prior 3 years. Participants were exposed to three different blinded doses of intranasally administered nicotine (0, 0.5, 1.0 mg) across three separate fixed dose experimental sessions. In subsequent sessions, participants were given the opportunity to self-administer nicotine under two different conditions-high and low cognitive demand. Physiological, subjective, and reinforcing effects of nicotine were the main outcomes. Nicotine plasma levels, and no group differences in effects of nicotine on heart rate or blood pressure, confirmed comparable dosing exposure across groups. ADHD participants reported significantly greater dizziness following nicotine, and greater pleasant subjective effects across all conditions, compared to non-ADHD non-smokers. There were no group differences on subjective reports of bad or unpleasant effects. Subsequent nicotine self-administration was significantly higher among non-smokers with ADHD, and their choices of nicotine were not influenced by cognitive condition. There are meaningful differences between young adults with and without ADHD with respect to the initial subjective and reinforcing effects of nicotine; and interventions to prevent use should start prior to typical age of experimentation among ADHD patients.

中文翻译：

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与匹配的同龄人相比，患有注意缺陷多动障碍（ADHD）的年轻成年人的初始尼古丁暴露增加的主观和增强作用：首次使用烟草的实验模型得出的结果。

注意缺陷多动障碍（ADHD）患者的不良吸烟后果风险增加，而对该风险的潜在因素知之甚少。这项研究试图使用一种新的模型来模拟初始吸烟经历，来评估在有和没有ADHD的年轻人中，初始尼古丁暴露的影响。参与者是18至25岁（含）之间的年轻成人不吸烟者（n = 61 ADHD，n = 75对照），他们报告从未抽过完整烟，并且在过去3年中没有吸烟。在三个单独的固定剂量实验阶段中，将参与者暴露于鼻内给药的三种不同盲剂量的尼古丁（0、0.5、1.0 mg）。在随后的会议中，参与者有机会在两种不同的条件下（高和低认知需求）自我管理尼古丁。尼古丁的生理，主观和增强作用是主要结果。尼古丁的血浆水平，以及尼古丁对心率或血压的影响在各组之间均无差异，证实了各组剂量的可比性。与非多动症非吸烟者相比，多动症参与者在尼古丁治疗后头晕明显增加，并且在所有情况下的主观感觉都更为愉悦。关于不良或不愉快影响的主观报告没有群体差异。在患有多动症的非吸烟者中，随后的尼古丁自我管理明显更高，并且他们对尼古丁的选择不受认知状况的影响。有和没有ADHD的年轻人在尼古丁的初始主观和增强作用方面存在有意义的差异。并且应在多动症患者的典型实验年龄之前开始采取预防使用的干预措施。