Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul;39(7):694-702.
doi: 10.1177/02698811251344687. Epub 2025 Jun 28.

Effects of initial nicotine exposure on cognition and nicotine reinforcement among non-smoking young adults with and without attention deficit hyperactivity disorder

Maggie M Sweitzer  1 , Julianna Lazzari  1 , Jessica Lunsford-Avery  1 , Francis Joseph McClernon  1 , Scott H Kollins  1 , Kenneth A Perkins  2 , Matthew Engelhard  3
Affiliations

Effects of initial nicotine exposure on cognition and nicotine reinforcement among non-smoking young adults with and without attention deficit hyperactivity disorder

Maggie M Sweitzer et al. J Psychopharmacol. 2025 Jul.

Abstract

Background: People with attention deficit hyperactivity disorder (ADHD) use nicotine products at higher rates than those without. Greater initial sensitivity to nicotine's cognitive effects may explain this association.

Aims: This study examined associations between cognitive effects of nicotine administration and subsequent preference for nicotine versus placebo among young adults naïve to nicotine with and without ADHD.

Methods: Participants (n = 61 ADHD, n = 75 Control) completed subjective (concentration, alertness) and objective (continuous performance task (CPT)) cognitive assessments in response to 3 doses of intranasal nicotine (0, 0.5, 1.0 mg; 1 dose per session). Choice to self-administer nicotine versus placebo (i.e., nicotine preference) was then assessed in two subsequent sessions under different task conditions-high cognitive demand and low demand. Analyses examined cognitive effects of nicotine dose and related those responses to nicotine preference under different task conditions.

Results/outcomes: Nicotine increased subjective concentration and alertness for participants with ADHD but not controls; improved concentration predicted greater nicotine preference. In both groups, nicotine decreased errors of omission but increased errors of commission on the CPT, which predicted increased and decreased nicotine preference, respectively, during high cognitive demand. During the non-demanding condition, increased errors of commission predicted lower nicotine preference only for controls.

Conclusions/interpretation: Perceived cognitive enhancement by nicotine may serve as a mechanism of risk for continued use in individuals with ADHD experimenting with nicotine. These findings help to clarify mechanisms underlying ADHD/nicotine use comorbidity and underscore the importance of early prevention.Declaration of interest/Funding:This work was supported by the National Institutes of Health.

Keywords: ADHD; Nicotine; addiction risk; attention; cognition.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SHK is a full-time employee of Aura and has equity options in the company. He also serves as a consultant for Virtual Therapeutics. The remaining authors declared no conflicts of interest with respect to the research, authorship, and/or publication of this article.

Similar articles

See all similar articles

References

    1. Almeida NL, Rodrigues SJ, Goncalves LM, et al. (2020) Opposite effects of smoking and nicotine intake on cognition. Psychiatry Res 293: 113357. - PubMed
    1. Behler O, Breckel TP and Thiel CM (2015) Nicotine reduces distraction under low perceptual load. Psychopharmacology (Berl) 232(7): 1269–1277. - PubMed
    1. Birdsey J, Cornelius M, Jamal A, et al. (2023) Tobacco Product Use Among U.S. Middle and High School Students - National Youth Tobacco Survey, 2023. MMWR Morb Mortal Wkly Rep 72(44): 1173–1182. - PMC - PubMed
    1. Bitsko RH, Claussen AH, Lichstein J, et al. (2022) Mental Health Surveillance Among Children - United States, 2013-2019. MMWR Suppl 71(2): 1–42. - PMC - PubMed
    1. Castellano-Garcia F, Benito A, Jovani A, et al. (2022) Sex Differences in Substance Use, Prevalence, Pharmacological Therapy, and Mental Health in Adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). Brain Sci 12(5). - PMC - PubMed

LinkOut - more resources