***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Summary The present study aim ed to examine the extent to which the co-occurrence of ADHD and smoking  in adolescents could be attributed to common genetic , environmental and psychopathological factors . Data are from an ongoing prospect i ve study of the outcome of early risk factors . At age 15 years , 305 adolescents completed self-report question naires measuring tobacco consumption and deviant peer affiliations . Lifetime psychiatric diagnoses were obtained using st and ardized interviews . DNA was genotyped for the  dopamine D4 receptor ( DRD4 ) gene exon III polymorphism . Adolescents with a lifetime diagnosis of ADHD displayed significantly higher smoking activity than non-ADHD controls . A major component of this association could be accounted for by deviant peer affiliations and the comorbidity with oppositional-defiant and conduct disorder , while a minor part was attributable to DRD4 in males but not in females . These findings suggest that the association of ADHD with smoking relies on risk factors shared by the two behaviors Rationale Methylpheni date ( Ritalin ® ) is commonly prescribed for behavioral problems associated with attention deficit/hyperactivity disorder ( ADHD ) . The results of previous studies suggest that methylpheni date increases cigarette smoking in participants without psychiatric diagnoses . Whether methylpheni date increases cigarette smoking in participants diagnosed with ADHD is unknown . Objective In this within-subjects , repeated measures experiment , the acute effects of a range of doses of methylpheni date ( 10 , 20 , and 40 mg ) and placebo were assessed in nine cigarette smokers who were not attempting to quit and met diagnostic criteria for ADHD but no other Axis I psychiatric disorders other than nicotine dependence . Methods Each dose of methylpheni date was tested once while placebo was tested twice . One hour after ingesting drug , participants were allowed to smoke ad libitum for 4 h. Measures of smoking included total cigarettes smoked , total puffs , and carbon monoxide levels . Snacks and decaffeinated drinks were available ad libitum ; caloric intake during the 4-h smoking session was calculated . Results Methylpheni date increased the total number of cigarettes smoked , total number of puffs , and carbon monoxide levels . Methylpheni date decreased the number of food items consumed and caloric intake . Conclusions The results of this experiment suggest that acutely administered methylpheni date  increases cigarette smoking in participants with ADHD , which is concordant with findings from previous studies that tested healthy young adults . These data indicate that clinicians may need to consider non-stimulant options or counsel their patients before starting methylpheni date when managing ADHD-diagnosed individuals who smoke Whereas the smoking prevalence rates in the general population are declining , rates among people diagnosed with attention-deficit/hyperactivity disorder ( ADHD ) continue to be elevated . Previous research has shown that nicotine may improve attention and mood , suggesting that nicotine may help ameliorate the attentional and emotional problems associated with ADHD . The present study examined the effects of nicotine with and without stimulant medication on ADHD symptoms , moods , and arousal in the everyday lives of smokers with ADHD . A total of 10 smokers with ADHD who were being treated with stimulant medication  were asked to abstain from smoking while participating in the study . Participants underwent four conditions in r and omized order : ( a ) Nicotine patch+stimulant medication , ( b ) nicotine patch only , ( c ) placebo patch+stimulant medication , and ( d ) placebo patch only . Each condition continued for 2 days , during which self-reports of ADHD symptoms and moods were obtained using electronic diaries . Lightweight ambulatory monitors recorded cardiovascular activity at each diary entry . Smoking abstinence was verified by expired carbon monoxide and salivary cotinine analysis . Results showed that nicotine patches and stimulant medication alone and in combination reduced difficulty concentrating and core ADHD symptoms compared with placebo patch only . Borderline improvement in impatience and self-control was seen with nicotine patch administration primarily on day 1 . Nicotine patches also tended to elevate systolic and diastolic blood pressure compared with placebo patch during day 2 . The findings suggest that smokers with ADHD experience nicotine-related reductions in ADHD symptoms during their everyday lives Background : ADHD involves impairing core symptoms of inattention and hyperactivity/impulsivity in children ( childhood ADHD = CH ) that may persist in adulthood ( adult ADHD = AD ) . Conflicting findings have been found regarding AD prevalences among adult smokers , and it is unclear whether AD is associated with a more severe smoking behavior in adulthood . Objective : The aim of this article is ( a ) to determine CH and AD prevalences in a nonselected sample of adult smokers , ( b ) to describe the characteristics of smokers with ADHD symptoms versus those without , and ( c ) to determine whether CH and /or AD symptoms are risk factors for more severe smoking in adulthood . Method : Three hundred and seventy-three participants aged 18 years and over were prospect ively recruited in a smoking-cessation unit . Participants were classified as “ no ADHD symptoms , ” “ CH symptoms , ” or “ AD symptoms ” according to their baseline score on the Wender Utah Rating Scale ( WURS ) alone ( for CH symptoms ) and WURS combined to the Adult Self Report Scale ( ASRS ) for AD symptoms . Other clinical variables were reported at first consultation . Results : ( a ) CH symptoms were reported in 15.3 % ( 57/373 ) of the total sample , 42.1 % ( 24/57 ) of whom also had persistent ADHD symptoms in adulthood ( prevalence of AD was 24/373 = 6.4 % ) . ( b ) In comparison with participants without ADHD symptoms , smokers with ADHD symptoms consume significantly more tobacco , but ADHD symptoms were no longer significantly associated with the daily number of smoked cigarettes after adjustment for sociodemographic variables . No significant association was found between the two groups and age at the first cigarette , age at onset daily smoking , and nicotine dependence . ( c ) Participants were categorized into three groups : Group 1 without ADHD symptoms lifetime ( NH ; n = 316 ) , Group 2 with childhood history of ADHD symptoms ( CH ; n = 33 ) , and Group 3 with Adult ADHD symptoms ( AD ; n = 24 ) . The association with tobacco consumption ( > 20 cigarettes/day ) was significant for CH only ( p = .02 ) . After adjustment for gender , age , professional status , and educational level , this association was not longer significant . Conclusion : Childhood and adult ADHD symptoms are both highly prevalent among nonselected smokers but our study failed to show more severe smoking characteristics among these participants after adjustment with sociodemographic variables OBJECTIVE To explore racial/ethnic difference in OROS-methylpheni date ( OMPH ) efficacy when added to nicotine patch and counseling for treating nicotine dependence among smokers with attention deficit hyperactivity disorder ( ADHD ) . METHOD Participants were adult smokers with ADHD ( 202 whites and 51 non-whites ) r and omly assigned to OMPH or placebo in a multi-site , r and omized controlled trial . Study outcomes were complete , prolonged , and point-prevalence abstinence at the end of treatment , and weekly ratings of ADHD symptoms , tobacco withdrawal symptoms , and desire to smoke . RESULTS The rate of four-week complete abstinence ( no slips or lapses ) was significantly higher with OMPH than placebo among non-white ( OMPH=42.9 % , placebo=13.3 % , chi(2)(1)=5.20 , p=0.02 ) but not white participants ( OMPH=23.1 % , placebo=23.5 % , chi(2)(1)=0.00 , p=0.95 ) . Patterns of prolonged and point-prevalence abstinence among non-whites were similar but fell short of statistical significance . OMPH reduced ADHD symptoms in both race/ethnic groups , and produced greater reductions in desire to smoke and withdrawal symptoms among the non-white than white participants . Change in desire to smoke , but not in withdrawal or ADHD symptoms predicted abstinence . The ability of OMPH to reduce desire to smoke among non-whites appeared to mediate the medication 's positive effect on abstinence . CONCLUSION Differential efficacy favoring non-whites of a medication for achieving smoking cessation is a potentially important finding that warrants further investigation . OROS-MPH could be an effective treatment for nicotine dependence among a subgroup of smokers OBJECTIVE Although attention-deficit hyperactivity disorder ( ADHD ) is a well-known risk factor for cigarette smoking , prospect i ve studies aim ed at reducing smoking risk in this population are critically needed . STUDY DESIGN This was a 2-year , prospect i ve , open-label clinical trial of extended-release methylpheni date for smoking prevention in adolescents with ADHD ( n = 154 ) .  Smoking outcomes were assessed with the Fagerstrom Tolerance Question naire . Comparisons were made using data from a historical , naturalistic sample of ADHD ( n = 103 ) and non-ADHD comparators ( n = 188 ) of similar age and sex assessed with the same assessment battery as that used in subjects participating in the clinical trial . RESULTS The smoking rate at endpoint ( mean , 10 months of methylpheni date treatment ) was low in the clinical trial subjects and not significantly different from that in the non-ADHD comparators or the ADHD comparators receiving stimulants naturalistically ( 7.1 % vs 8.0 % vs 10.9 % ; P > .20 ) . In contrast , the smoking rate was significantly lower in the clinical trial subjects than in the naturalistic sample of ADHD comparators who were not receiving stimulant treatment ( 7.1 % vs 19.6 % ; P = .009 [ not significant ] , adjusting for comorbid conduct disorder and alcohol and drug abuse ) . CONCLUSION Although considered preliminary until replicated in future r and omized clinical trials , the findings from this single-site , open-label study suggest that stimulant treatment may contribute to a decreased risk for smoking  in adolescents with ADHD . If confirmed , this finding would have significant clinical and public health impacts The authors examined the factor structure and discriminant validity of the  Wender Utah Rating Scale ( WURS ) in adults seeking evaluation for attention-deficit/hyperactivity disorder ( ADHD ) . Three factors ( Dysthymia , Oppositional/Defiant Behavior , and School Problems ) accounted for 59.4 % of the variance . In a stepwise discriminant function analysis , age and childhood school problems emerged as significant variables . The classification procedure correctly classified 64.5 % of patients . Among those who did not have ADHD , only 57.5 % were correctly classified compared with 72.1 % among those with ADHD . The WURS is sensitive in detecting ADHD , but it misclassifies approximately half of those who do not have ADHD Patients with Attention-Deficit/Hyperactivity disorder ( ADHD ) have higher smoking rates , a younger age of smoking onset , and increased difficulty to stop smoking as compared to controls . Methylpheni date induced acute effects of increased smoking in laboratory studies , but long-term effects are unknown . We studied the acute and long-term relationship between methylpheni date use and tobacco consumption and nicotine craving among ADHD patients naïve for methylpheni date ( N=325 ) . Patients filled out the Smoking Question naire ( SQ ) at baseline , and after two-weeks and three-months of methylpheni date use . The SQ involved questions on demographics , tobacco consumption , nicotine craving , life events , psychiatric diagnoses and use of medication . At baseline ,  smoking prevalence of ADHD patients was twice as high ( 50.2 % ) as the national norm ( 25.6 % ; p<.001 ) . Tobacco consumption increased with 1.3 cigarettes per day after three-months of methylpheni date use . When translated into pack years , tobacco consumption increased by about 23 packs per year . Reports of increased nicotine craving after methylpheni date , increased with 20.3 % after two weeks and 29.2 % after three months . Light smokers ( 1 - 12 cigarettes/day ) were especially at risk for increased tobacco consumption ( p<.05 ) . Thus although methylpheni date is the drug of choice in medical treatment for ADHD , tobacco consumption and nicotine craving increased acutely and stabilized at increased levels after three-months of methylpheni date use . Although the net effect of methylpheni date on smoking behavior and craving should be further investigated within a r and omized , placebo-controlled design , the results suggest that active prevention of increased smoking is needed in patients prescribed methylpheni date The diagnosis of adult attention deficit/hyperactivity disorder ( ADHD ) requires the retrospective assessment of ADHD symptoms in childhood . The Wender Utah Rating Scale ( WURS ) is helpful in detecting ADHD-associated symptomatology in childhood . A German short version ( WURS-k ) of this instrument has been made available recently . In the present study , we investigated the validity of the WURS-k . In a population of 63 adult ADHD patients ( according to ICD-10 and DSM-IV criteria ) and 1,303 male controls , ROC analysis indicated a sensitivity of 85 % and specificity of 76 % at a cutoff of 30 points . In ADHD patients , seven individual factors 
    Output:
    
Our meta- analysis illustrates a clinical ly important link between CH and tobacco smoking in adolescence but not later in life .