Tobacco use in children and adolescents with Attention deficit hyperactivity disorder: An exploratory study

  • Rahul Mathur MBBS, MD Psychiatry
  • Sonali Jhanjee
  • Rajesh Sagar
  • Bichitra N. Patra
  • Siddharth Sarkar


Background: Substance use disorders are now conceptualized as having their developmental roots in childhood. The risk of substance use has been reported to be higher among children with Attention Deficit Hyperactivity Disorder (ADHD) as compared to the normal population. We aimed to examine the proportion of tobacco use in children and adolescents with ADHD and compare it with healthy age-matched controls.

Methodology: Cross-sectional observational study, with a sample size of 50 male cases of ADHD and 50 healthy age-matched controls. Following informed consent from parents and assent from children, participants and parents were interviewed using a semi-structured questionnaire and MINI Kid. The severity of ADHD was assessed using Conner's parent rating scale-short form (CPRS-S).

Results: Tobacco use was present significantly more among the cases of ADHD as compared to the control group (34% versus 4%, p < 0.001). The most common tobacco product used by the case group was chewable (smokeless) tobacco. No differences were found in the tobacco use pattern among those with ADHD alone and those with ADHD and comorbid conduct/oppositional defiant disorder.

Conclusion: There is an increased risk of tobacco use in children and adolescents with ADHD. This underscores the importance of incorporating screening for tobacco use as a necessary component of the evaluation of cases with ADHD.

Luke Clack Award Paper