Dear Doctor,

Recently we got a surprise we hadn't counted on. Our oldest boy has been diagnosed with ADHD. He is 15, a love and doesn't stop much. While I was doing his laundry, I found a pack of cigarettes. When I talked with him about it, he said he had been smoking some. He said he would quit, but we have been smelling tobacco on him when he comes home. Neither my husband or I smoke. He was always death on it, saying it was gross. Is there a plan to help him?

— No Smoke

Dear No Smoke,

Smoking is a powerful addiction, and one we know little about, at least scientifically.

Since your son is diagnosed with ADHD, smoking may make him feel better than it does for most. There are studies showing that nicotine helps with focus and concentration. The real intrigue for ADHD kids may be their love of adventure and risk. By the way, I am not recommending it as a treatment. Heaven forbid.

We know that teens develop addictions to tobacco more swiftly than we might like to think. One researcher has discovered that even a handful of cigarettes can cause addictive behaviors. After 100 cigarettes, 95 percent of teens are addicted.

Tobacco offers an immediate and direct physiological reward in the form of pleasure. Further, neurological "gates" block the negative reactions and increase rewarding physiological processes in the brain. This perverse pattern rapidly increases craving and addiction.

The research is unclear on how to get teens to stop. My own suggestion would be to try several things at once.

First, make it clear that no smoking is allowed in or about the house. If you find cigarettes, you will destroy them. Second, contact your son's school, especially if he plays a sport. Talk to his coach or teachers, (hopefully non-smoking ones), and ask them to speak with him. Third, do not nag and preach. Finally, find an addiction counselor and have him attend a few sessions. Many licensed psychotherapists can help.

As a reformed smoker, I can tell you this is no easy battle.

ÔÇæÔÇæÔÇæ

Dr. Larry Larsen is an Andover psychologist. If you would like to ask a question, or respond to one, you can e-mail him at lrryllrsn@CS.com.