The Development of Cigarette Smoking Behavior Among Juvenile Offenders in Adolescence and Early Adulthood: ADHD Symptomatology as a Risk Factor

Abstract Background Cigarette use is a public health issue and juvenile offenders are at risk for engagement in substance use. Attention deficit hyperactivity disorder (ADHD) has been linked to elevated risk for cigarette use and juvenile offenders are at elevated risk for mental health issues. Objectives To elucidate general patterns of development of cigarette use among juvenile offenders and examine the role that ADHD symptomatology plays for predicting development. Methods The Pathways to Desistance data (2000–2010) follow 1,354 juvenile offenders across 84 months following a recent conviction for a serious offense. Using group-based trajectory modeling, this research sought to elucidate heterogeneity in general developmental patterns of cigarette use across adolescence and early adulthood. This research then extended the method by using multinomial logistic regression to investigate the relevance of ADHD symptomatology and covariates for predicting trajectory group assignment. Results A five-group trajectory model was found to best fit the data. Groups elucidated were: Abstaining, Late Onset, Decelerating, Moderate Chronic, and High Chronic. When all covariates were controlled, increases in ADHD symptomatology presentation were associated with increased risk of assignment to the High Chronic cigarette smoking group. This group was characterized by early onset and chronic course of daily cigarette use. Conclusions/importance: Juvenile offenders are at increased risk for participation in daily cigarette use and high and chronic levels of daily use during adolescence and early adulthood. ADHD symptomatology is a risk factor for early initiation and chronic daily cigarette-smoking behaviors.