It is well known that ADHD extends into adulthood, but if left untreated, has consequences in a range of areas. In this case report, a young man is described who, since childhood, has tried to draw attention to his problems with attention management. He smoked 60 cigarettes a day to deal with inner turmoil and restlessness. His medical history, interview with DIVA 2.0 and testing with CPT-3 point to significant problems in executive functions. Initiating medical treatment improves his level of function markedly. The clinician must uncover potential use of coping strategies when screening for ADHD.

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