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Smoking leads to nicotine receptor activation, which in turn stimulates the release of several neurotransmitters, including dopamine, norepinephrine, acetylcholine, glutamate, serotonin, beta-endorphin, and GABA, all of which then mediate various effects of nicotine use (i.e., pleasure, arousal, cognitive enhancement, appetite suppression, reduction in anxiety/tension).[27,28] The core symptoms of ADHD have been posited to reflect an underlying deficit in behavioral inhibition,[29] a process that may be modulated by cholinergic and catecholaminergic systems.[30] Nicotines robust effect on these systems, with resultant enhancement in behavioral inhibition, may in part explain smoking as self-medication among individuals with ADHD.[28] Individuals with ADHD may additionally seek out nicotine for cognitive enhancing effects.[31] B3

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