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Effects of Nicotine Reduction on Smoking Behavior in ADHD Smokers

Principal Investigator: Scott H. Kollins and Frances J. McClernon

Funding Mechanism: National Institutes of Health - Grant

ID number: 1 R01 HD083404-01

Award Date: 7/13/2015

Institution: Duke University


Compared to the general population, individuals with attention deficit hyperactivity disorder (ADHD) are more likely to smoke, start smoking at a younger age, smoke more, become more dependent, and have a harder time quitting. Reducing the nicotine content of cigarettes has shown promising beneficial effects in the general population, but individuals with ADHD may respond with compensatory increases in smoking, potentially increasing exposure and adverse health effects. The goal of this project is to examine the effects of very low nicotine content (VLNC) cigarettes on smoking behavior and clinical functioning in 200 young adult smokers (ages 18-40) with ADHD. Researchers will randomly assign participants to smoke experimental cigarettes with very low (0.05 mg/cigarette) or conventional (0.8 mg/cigarette) nicotine yield for six weeks, during which participants will provide daily feedback using a telephone-based interactive voice response system and attend weekly visits during which researchers will measure a range of smoking and ADHD-related outcomes. Specific aims are: (1) to assess how VLNC cigarettes impact cigarette smoking and related biomarkers (i.e., expired air carbon monoxide, urine cotinine) and nicotine dependence; (2) to assess how reduced nicotine content influences ADHD symptoms and related measures of cognition (i.e., inhibitory control, working memory) and overall clinical functioning; and (3) to evaluate outcomes associated with acceptability (i.e., withdrawal, study dropout, compliance) and safety/adverse outcomes (i.e., changes in physical health, alcohol/drug use, use of other tobacco products). Data from this study may inform regulatory activities regarding reduced-nicotine tobacco products.