Cigarette and cannabis use trajectories among adolescents in treatment for attention-deficit/hyperactivity disorder and substance use disorders.

Cigarette smoking is common in adolescents with attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUD). However, little is known about the relationship between cigarette and cannabis use trajectories in the context of treatment for both ADHD and SUD. To address this research gap, collateral analyses of protocol CTN-0028, a 16-week randomized, controlled trial (n=303) of osmotic-release methylphenidate (OROS-MPH) in adolescents with ADHD concurrently receiving cognitive behavioral therapy (CBT) was performed to determine the relationships between cigarette smoking, cannabis use, and other variables. Results found that baseline (pre-treatment) cigarette smoking was positively correlated with cannabis use, and there was only a negligible decline in cigarette smoking during treatment for non-nicotine SUD in both medication groups. Regular cigarette and cannabis users at baseline who reduced their cannabis use by >50% also reduced cigarette smoking, however. These preliminary findings suggest that cigarette smoking does not increase in adolescents with ADHD during treatment for cannabis and other non-nicotine SUD with or without psychostimulant medication (like OROS-MPH), though further work is needed to develop evidence-based interventions targeting cigarette smoking in this especially vulnerable group. Concurrent cannabis and cigarette use in adolescents with ADHD is a challenging problem, but the results of this analysis demonstrate that changes in use of these substances during treatment may occur in parallel.

Related protocols: CTN-0028-A-1