Adolescent caffeine use, ADHD, and cigarette smoking

The purpose of this study was to describe the prevalence of adolescent caffeine use and its association with attention deficit hyperactivity disorder (ADHD) and cigarette smoking. A total of 448 adolescents between the ages of 13 and 21 years consecutively presenting for routine, well-child care were studied. Twenty-four percent had a pre-existing diagnosis of ADHD, and 47% reported a positive lifetime history of cigarette smoking. Eighty-five percent of participants reportedly consumed a caffeinated beverage within the past 30 days; 38% had consumed 1+ cups of caffeinated coffee, and 78% had consumed 1+ glasses of another caffeinated beverage other than coffee (e.g., tea or soft drinks). After controlling for sociodemographic and other potential confounding factors, an ADHD diagnosis and a positive lifetime smoking history were significantly associated with caffeine use: Adolescents with ADHD were nearly twice as likely to use more caffeine than were adolescents without ADHD (odds ratio [OR] = 2.08; 95% confidence interval [CI] = 1.23, 3.50, p =.006); lifetime smokers were 80% more likely to use more caffeine than were adolescents who had never smoked (OR = 1.80; 95% CI = 1.16, 2.79, p =.009). Caffeine use is elevated among adolescents diagnosed with ADHD and those who have ever tried cigarette smoking. Although caffeine is a non-illicit psychostimulant, these findings add to the emerging data on substance use behaviors among adolescents with ADHD. Health care professionals who work with adolescents with ADHD should regularly screen for both cigarette and caffeine use among their patients.