Asiye Arıcı GÜRBÜZ, Hatice ALTUN, Feyza Hatice EKİCİ, Hüseyin SARIKAYA, Semiha Cömertoğlu ARSLAN
Bağımlılık Dergisi - 2026;27(3):199-215
Objective: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder associated with an increased susceptibility to nicotine and other substance use. This study aimed to compare Maraş powder (smokeless tobacco) use among adolescents with and without ADHD, identify related factors, examine differences by ADHD treatment status, and assess adolescents' knowledge and beliefs about its use. Method: This cross-sectional comparative study, included 50 adolescents aged 11-17 with ADHD and 50 age- and sex-matched healthy controls. Participants completed a sociodemographic form, a study-specific Maraş powder knowledge, belief and use questionnaire, the DSM-IV Disruptive Behavior Disorders Rating Scale (DBDRS), the Kovacs Children's Depression Inventory and the State-Trait Anxiety Inventory. Results: Current regular Maraş powder use was reported by 28.0% of the ADHD group and 10.0% of the control group (OR=3.50, 95% CI 1.15-10.63; Fisher p=0.040); while ever use was 32.0% versus 10.0% (OR=4.24, 95% CI 1.41-12.70; p=0.007). After adjusted for age and sex, ADHD remained associated with regular use (aOR=3.44, 95% CI 1.12-11.99, p=0.031). Within the ADHD group, regular use was reported by 4.2% of adolescents with medical treatment versus 50.0% of untreated adolescents (Fisher p<0.001; aOR=0.04, 95% CI 0.003-0.31). Regular users had higher DBDRS, depressive, and state-anxiety scores, but not trait-anxiety scores (all Benjamini-Hochberg-corrected p<0.05). Overall, 57.0% of participants either agreed with, or were unsure about, the statement that Maraş powder helps smoking cessation, and substantial misconceptions regarding its harms and regulation were observed in both groups. Conclusion: In this study, ADHD, lower symptom control and the absence of regular ADHD treatment were associated with a higher prevalence of Maraş powder use. Misconceptions about the harms and the regulation of Maraş powder were common among adolescents in both groups.
