Tobacco use disorder is a problematic pattern of tobacco use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:
- Tobacco is often taken in larger amounts or over a longer period than was intended
- There is persistent desire or unsuccessful efforts to cut down or control tobacco use
- A great deal of time is spent in activities necessary to obtain or use tobacco
- Craving, or a strong desire to use tobacco
- Recurrent tobacco use resulting in failure to fulfill major role obligations
- Continued tobacco use despite persistent social or interpersonal problems
- Important social or recreational activities are reduced or ceased because of the use
- Recurrent tobacco use in hazardous situations
- Tobacco use is continued despite knowledge of having a problem
- Tolerance and/or withdrawal symptoms
When we consider substance use disorder, we often think of substance dependence. Individuals are considered dependent on a substance when symptoms of tolerance and withdrawal are present:
- Tolerance is a need for markedly increased amounts of a substance to achieve its desire effect.