Tobacco Cessation Program for Someone with Attention Deficit Hyperactivity Disorder

As part of our tobacco cessation program, a few months ago I had the pleasure of speaking with the staff of The Chesapeake Center in Bethesda, Maryland, about the unique challenges faced by individuals with Attention Deficit Hyperactivity Disorder (ADHD) who want to quit tobacco. The Chesapeake Center specializes in ADHD treatment across the lifespan and was founded by Dr. Kathleen Nadeau, a nationally recognized expert in the field. Dr. Nadeau has authored several widely respected books, including her most recent, Still Distracted After All These Years: Help and Support for Older Adults with ADHD.

I’ve been fortunate to benefit from Dr. Nadeau’s mentorship over the years. Together, we’ve even co-led therapy groups focused on individuals struggling with both ADHD and substance use disorders. So when I had the opportunity to speak with her staff, we dove into a topic that intersects both our areas of expertise: tobacco use and cessation among people with ADHD.

Why Do People with ADHD Smoke?

It’s well-documented—and reflected in our experiences at Triple Track’s tobacco cessation program—that people with ADHD are more likely to smoke cigarettes or use e-cigarettes. But why is that?

People with ADHD often experience chronic difficulties with focus, attention, and impulse control. These challenges can be especially frustrating in environments that demand sustained mental effort or contain low-interest tasks—like school or structured work settings. For many, especially those not yet diagnosed or treated, nicotine becomes a form of self-medication.

Nicotine mimics the effects of stimulant medications such as Ritalin, Adderall, or Vyvanse. It stimulates the release of neurotransmitters like acetylcholine and dopamine, which temporarily enhance concentration and alertness. In this way, smoking or vaping can feel like a quick fix for ADHD symptoms—even though it ultimately becomes a trap.

The Unique Risk for Nicotine Dependence

Research indicates that people with ADHD are significantly more likely to start smoking, become nicotine dependent, and struggle with quitting—as compared to their non‑ADHD peers. When exposed to nicotine, individuals with ADHD often:

• Experience an enhanced pleasure response

• Are more likely to develop an addiction

• Struggle more when trying to quit compared to neurotypical individuals

This increased vulnerability is both biological and behavioral. People with ADHD tend to have higher levels of impulsivity, risk-taking, and sensation-seeking—all traits that can make them more likely to start smoking or vaping at an early age. Without adequate support, these habits often become deeply entrenched.

Unfortunately, the long-term consequences are serious. Studies suggest that individuals with ADHD who smoke have a significantly shortened life expectancy, in part due to the higher prevalence of tobacco use and the many health risks that come with it.

Quitting Nicotine with ADHD: What Works?

For individuals with ADHD, quitting nicotine is often more challenging—but not impossible. A strong, individualized tobacco cessation program can make a meaningful difference, particularly when it accounts for the complexities of ADHD.

At Triple Track, we take a comprehensive approach that often includes:

• A re-evaluation of existing medications: Those already on stimulant treatment may need dosage adjustments to offset withdrawal symptoms.

• Consideration of non-stimulant medications like bupropion: Originally marketed as Wellbutrin for depression and later used for ADHD, this medication also gained FDA approval for smoking cessation under the name Zyban.

• Therapeutic support focused on behavioral strategies, stress reduction, and mindfulness.

• Accountability and relapse prevention through group support or one-on-one counseling.

  
  

By tailoring our approach to the unique neurobiology of ADHD, we’ve helped many clients replace nicotine with healthier tools for managing focus and stress.

Seeking Help 

If you or someone you care about is struggling with nicotine use and also has ADHD, know that you’re not alone—and that quitting is possible. A well-structured tobacco cessation program, like the one offered at Triple Track, can provide both the clinical tools and compassionate support needed to succeed.

Whether you’re ready to quit today or just gathering information, we’re here to help. Reach out to learn more about our specialized approach to tobacco cessation for people with ADHD.