From: Can tobacco dependence provide insights into other drug addictions?
DSM 5 criteria | Comments in relation to tobacco use |
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A problematic pattern of tobacco use leading to clinically significant impairment or distress | Â |
 1. Tobacco is taken in larger amounts or over a longer period than was intended. | As benders do not occur with tobacco, this criterion is met when the user has failed in an attempt to quit or cut down. |
 2. There is a persistent desire or unsuccessful efforts to cut down or control tobacco use. | The user has failed in an attempt to quit or cut down. |
 3. A great deal of time is spent in activities necessary to obtain or use tobacco. | Such as chain smoking, or minors loitering in front of a store asking adults to buy tobacco for them. |
 4. Craving, or a strong desire or urge to use tobacco. | This criterion would be met by individuals at the craving or needing stages of physical dependence. |
 5. Recurrent tobacco use resulting in a failure to fulfill major role obligations at work, school, or home. | As tobacco is not intoxicating, this criterion is not particularly relevant to tobacco. |
 6. Continued tobacco use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of tobacco (e.g., arguments with others about tobacco use). |  |
 7. Important social, occupational, or recreational activities are given up or reduced because of tobacco use. | This would typically happen when a short latency to withdrawal makes a person uncomfortable when smoking is not allowed. |
 8. Recurrent tobacco use in situations in which it is physically hazardous (e.g., smoking in bed). |  |
 9. Tobacco use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by tobacco. | Continued use generally reflects failed attempts at cessation. |
 10. Tolerance, as defined by either of the following: |  |
  a. A need for markedly increased amounts of tobacco to achieve the desired effect. | As tobacco is not intoxicating, this criterion does not apply to tobacco use. |
  b. A markedly diminished effect with continued use of the same amount of tobacco. | A shortening of the latency to withdrawal indicates that a cigarette has a markedly diminished effect on sustaining the asymptomatic phase of withdrawal. |
 11. Withdrawal, as manifested by either of the following: |  |
  a. The characteristic withdrawal syndrome for tobacco. (See Table 2) | Physical dependence can be present long before it is of sufficient severity to cause at least 4 withdrawal symptoms. |
  b. Tobacco (or a closely related substance, such as nicotine) is taken to relieve or avoid withdrawal symptoms. | Wanting, craving and needing are withdrawal symptoms. Smoking in response to these symptoms indicates smoking to relieve withdrawal. |