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Smoking behavior characteristics of non-selected smokers with childhood attention-deficit/hyperactivity disorder (AD/HD) history: a systematic review and meta-analysis

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Abstract

It is unclear whether adult smokers with childhood attention-deficit/hyperactivity disorder history (CH) have more severe smoking behavior than non-CH smokers, while it is clearly suggested that CH adolescents have more severe smoking behavior than CH adolescents. The aim of the present comprehensive meta-analysis is to determine whether CH smokers have more severe smoking behavior characteristics than those without and the effect of age on the association between CH and smoking behavior. We included all case–control studies and first round data collection of observational studies addressing the difference in smoking behavior characteristics of CH smokers versus non-CH smokers, with validated scales or structured interviews, without any language or date restriction. Nine studies (including 365 smokers with CH and 1,708 smokers without) were included. Compared to non-CH smokers, CH smokers smoked significantly more cigarettes [standardized mean differences (SMD) = 0.15, 95 % CI 0.01–0.28, p = 0.04] and began to regularly smoke earlier (SMD = −0.28, 95 % CI −0.49; −0.07, p = 0.01) but were not significantly more nicotine dependent (SMD = 0.23, 95 % CI −0.04 to 0.48, p = 0.08). After removing the single adolescent study, the significant association between CH and number of daily smoked cigarettes disappeared, and subgroups analyses confirmed that the significant association between CH and number of daily smoked cigarettes disappeared as age increased. Our meta-analysis illustrates a clinically important link between CH and tobacco smoking in adolescence but not later in life. Further high-quality studies are needed to confirm this finding, as only two studies included participants with a mean age below 20 years.

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Acknowledgments

We express all our thanks to the patients who participated in the studies included in the present meta-analysis, and all the authors that answered us for completing missing data. This work was supported by INSERM, Assistance Publique-Hôpitaux de Paris, RTRS Santé Mentale (Fondation Fondamental) and was supported (in part) by the Investissements d’Avenir program managed by the ANR under reference ANR-11-IDEX-0004-02.

Conflict of interest

None declared.

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Authors and Affiliations

  1. Pôle de Psychiatrie des Hôpitaux Universitaires H Mondor, INSERM U955, Eq 15, Fondation FondaMental, Fondation de Coopération Scientifique en Santé Mentale, Université Paris Est, 94000, Créteil, France

    Guillaume Fond & Marion Leboyer

  2. Inserm U1061, Montpellier, Services Universitaires de Psychiatrie, CHU Montpellier, Université Montpellier 1, 34000, Montpellier, France

    Sebastien Guillaume, Alexandra Macgregor & Philippe Courtet

  3. Département Universitaire de Pneumologie et d’addictologie, Epsylon EA 4556, Institut Régional du Cancer de Montpellier, CHU Montpellier, Université Montpellier 1, 34000, Montpellier, France

    Xavier Quantin & Paquito Bernard

  4. EA 3279 – Public Health, Chronic Diseases and Quality of Life - Research Unit, Aix-Marseille Unit, 13005, Marseille, France

    Anderson Loundou & Laurent Boyer

  5. INSERM 1061, Centre de Reference National Narcolepsie Hypersomnie Idiopathique, Unité des Troubles du Sommeil, CHU Montpellier, Université Montpellier 1, 34000, Montpellier, France

    Régis Lopez & Daniel Bailly

  6. CHU Carémeau, service de psychiatrie adulte, Université de Nîmes, 30000, Nîmes, France

    Mocrane Abbar

  7. Service hospitalo-universitaire de psychiatrie, Hôpital Sainte-Marguerite, 270 boulevard de Sainte Marguerite, Marseille, France

    Daniel Bailly

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  1. Guillaume Fond
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  2. Anderson Loundou
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  3. Sebastien Guillaume
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  4. Xavier Quantin
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  8. Paquito Bernard
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  12. Laurent Boyer
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Correspondence to Guillaume Fond.

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Fond, G., Loundou, A., Guillaume, S. et al. Smoking behavior characteristics of non-selected smokers with childhood attention-deficit/hyperactivity disorder (AD/HD) history: a systematic review and meta-analysis. Eur Arch Psychiatry Clin Neurosci 264, 379–389 (2014). https://doi.org/10.1007/s00406-014-0497-5

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