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Review: childhood ADHD increases the risk of nicotine use in adolescence and alcohol use in young adulthood

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Does childhood attention-deficit/hyperactivity disorder (ADHD) increase the risk of substance use disorders (SUDs) in adolescence and young adulthood?


Persistent substance use, abuse or dependence meeting DSM-IV TR (Diagnostic and Statistical Manual, Fourth Edition, Text Revision) criteria for SUDs. Single substance categories included alcohol, cannabis, cigarettes, tobacco or nicotine; other outcomes included any psychoactive SUD (excluding nicotine) or drug use disorder (DUD; excluding alcohol and nicotine).



Systematic review with meta-analysis.

Data sources

MEDLINE, CINHAL, PsycINFO and EMBASE were searched from the database inception to October 2009. Additional articles were identified by hand search of reference lists.

Study selection and analysis

Inclusion criteria were English language prospective cohort studies comparing substance use in primary school children (≤12 years) with and without ADHD (DSM-III, DSM-III-R, DSM-IV criteria or DSM-II hyperkinetic disorder) and following participants to a mean age of 18 years or older. Inclusion criteria for nicotine use were extended to include adolescents aged 14–16 years because of the few eligible studies. A single reviewer selected studies and assessed internal validity with a second reviewer appraising a random sample. Studies of historical cohorts or …

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  • Sources of funding Ontario Mental Health Foundation, Ontario Ministry of Health and Long Term Care, McMaster University Evidence-Based Practice Center, sponsored by the US Agency for Healthcare Research and Quality, Hospital for Sick Children Department of Psychiatry Endowment Fund and the Canadian Institutes of Health Research.


  • Competing interests None.