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. 2015 Feb 1:147:183-9.
doi: 10.1016/j.drugalcdep.2014.11.018. Epub 2014 Dec 2.

Association of attention-deficit/hyperactivity disorder and conduct disorder with early tobacco and alcohol use

William B Brinkman  1 , Jeffery N Epstein  2 , Peggy Auinger  3 , Leanne Tamm  4 , Tanya E Froehlich  5
Affiliations

Association of attention-deficit/hyperactivity disorder and conduct disorder with early tobacco and alcohol use

William B Brinkman et al. Drug Alcohol Depend. .

Abstract

Background: The association of attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) with tobacco and alcohol use has not been assessed in a young adolescent sample representative of the U.S. population.

Methods: Data are from the 2000-2004 National Health and Nutrition Examination Survey, a cross-sectional sample representative of the U.S. population. Participants were age 12-15 years (N=2517). Exposure variables included diagnosis of ADHD and CD, and counts of ADHD and CD symptoms based on caregiver responses to the Diagnostic Interview Schedule for Children. Primary outcomes were adolescent-report of any use of tobacco or alcohol and age of initiating use. Multivariate logistic regression and Cox proportional hazard models were conducted.

Results: Adolescents with ADHD+CD diagnoses had a 3- to 5-fold increased likelihood of using tobacco and alcohol and initiated use at a younger age compared to those with neither disorder. Having ADHD alone was associated with an increased likelihood of tobacco use but not alcohol use. Hyperactive-impulsive symptom counts were not independently associated with any outcome, while every one symptom increase in inattention increased the likelihood of tobacco and alcohol use by 8-10%. Although participants with a diagnosis of CD alone (compared to those without ADHD or CD) did not have a higher likelihood of tobacco or alcohol use, for every one symptom increase in CD symptoms the odds of tobacco use increased by 31%.

Conclusions: ADHD and CD diagnoses and symptomatology are linked to higher risk for a range of tobacco and alcohol use outcomes among young adolescents in the U.S.

Keywords: Alcohol; Attention-deficit/hyperactivity disorder; Conduct disorder; Early onset substance use; Tobacco.

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Conflict of interest statement

Conflict of Interest

Dr. Brinkman reports no biomedical financial interests or potential conflicts of interest. He receives research grant funding from NIH/NIMH.

Dr. Epstein reports no biomedical financial interests or potential conflicts of interest. He receives research grant funding from NIH/NIMH & NICHD.

Ms. Auinger reports no biomedical financial interests or potential conflicts of interest.

Dr. Tamm reports no biomedical financial interests or potential conflicts of interest. She receives research grant funding from NIH/NIMH & NICHD.

Dr. Froehlich reports no biomedical financial interests or potential conflicts of interest. She receives research grant funding from NIH/NIMH.

Figures

Figure 1
Figure 1. Joint Effects of ADHD (current DISC diagnosis) and CD Diagnosis on Substance Use
ADHD = attention-deficit/hyperactivity disorder, CD = conduct disorder, Ref = referent group * Differs from referent group, p<0.05 † Differs from ADHD alone group, p<0.05
Figure 2
Figure 2. Joint Effects of ADHD (past clinical diagnosis and/or current DISC diagnosis) and CD Diagnosis on Substance Use
ADHD = attention-deficit/hyperactivity disorder, CD = conduct disorder, Ref = referent group * Differs from referent group, p<0.05 † Differs from ADHD alone group, p<0.05 ^Differs from CD alone group, p<0.05
See this image and copyright information in PMC

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