What is Tobacco Use Disorder?

A diagnosis of “tobacco use disorder” is based on a problematic pattern of tobacco use (smoking cigarettes or pipes, or chewing tobacco), leading to significant impairment or distress as demonstrated by at least two of the following symptoms, occurring within a 12-month period:

• Tobacco use is often done in larger amounts or over a longer period than was intended.
• There is a persistent desire or unsuccessful efforts to reduce or control tobacco use.
• A great deal of time is spent trying to obtain tobacco, use it, or recover from its effects.
• A person has a craving or strong desire to use tobacco.
• Recurrent tobacco use results in a failure to fulfill major obligations at work, school, or home.
• A person continues tobacco use despite having persistent or recurrent social or interpersonal problems caused of exacerbated by the effects of its use (e.g., arguments with others about tobacco use).
• Important social, occupational, or recreational activities are given up or reduced because of tobacco use.
• There is recurrent use of tobacco in situations that are physically hazardous (e.g., smoking in bed).
• Tobacco use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely caused or exacerbated by tobacco.
• Tolerance is developed, as defined by either of the following:
  • A need for increased amounts of tobacco to achieve intoxication or desired effect.
  • A reduced effect with continued use of the same amount of tobacco.
• Withdrawal, as demonstrated by either of the following:
  • Characteristic withdrawal syndrome for tobacco.
  • Tobacco (or a closely related substance, such as nicotine) is taken to relieve or avoid withdrawal symptoms.

Stimulant use disorder is rated as mild with the presence of 2-3 symptoms, moderate with 4-5 symptoms, and severe with 6 or more symptoms.

A diagnosis of “unspecified stimulant disorder” may apply in situations in which a person shows symptoms characteristic of an opioid-related disorder, but the symptoms do not meet the full criteria for any specific opioid-related disorder or any of the disorders in the substance-related and addictive disorders diagnostic class.

Stimulant use disorder is rated as mild with the presence of 2-3 symptoms, moderate with 4-5 symptoms, and severe with 6 or more symptoms.

A diagnosis of “unspecified tobacco-related disorder” may apply in situations in which a person shows symptoms characteristic of a tobacco-related disorder, but the symptoms do not meet the full criteria for any specific tobacco-related disorder or any of the disorders in the substance-related and addictive disorders diagnostic class.