Stress, attention deficit hyperactivity disorder (ADHD) symptoms and tobacco smoking: The i-Share study

The contribution of mental health to the risk of smoking is increasingly acknowledged but still insufficiently studied during the key period of student life. In particular, the simultaneous action of stress and Attention Deficit Hyperactivity Disorder (ADHD) symptoms on the risk of smoking remains poorly understood.

To assess the effects of stress and ADHD symptoms on tobacco smoking.

Multivariate modeling was conducted on the French i-Share study (n=8110, median age 20.3 years, 74.8% females, 32.9% regular/occasional smokers) to evaluate the associations between stress, ADHD symptoms and tobacco smoking, adjusting for potential family/socio-demographic confounders.

Students with high levels of stress were more likely to smoke>10 cigarettes/day (adjusted odds ratio (aOR): 1.48, 95% CI: 1.12-1.96) than those with low levels of stress. Students with high levels of ADHD symptoms were more likely to smoke>10 cigarettes/day (aOR: 2.08, 95% CI: 1.58-2.75) than those with low levels of ADHD symptoms.

Stress and ADHD contribute independently to the risk of smoking. Interventions targeting each condition are likely to reduce the burden of tobacco use in students.