Differential Diagnosis
The symptoms of tobacco with drawal overlap with those of other substance withdrawal
syndromes (e.g., alcohol withdrawal; sedative, hypnotic, or anxiolytic withdrawal; stim-
ulant withdrawal; caffeine withdrawal; opioid withdrawal); caffeine intoxication; anxiety,
depressive, bipolar, and sleep disorders; an d medication-induced akathisia. Admission to
smoke-free inpatient units or voluntary smoking cessation ca n induce withdrawal symp-
toms that mimic, intensify, or disguise othe r disorders or adverse effects of medications
used to treat mental disorders (e.g., irritabi lity thought to be du e to alcohol withdrawal
could be due to tobacco with drawal). Reduction in sympto ms with the use of nicotine
medications confirms the diagnosis. 
Other Tobacco-Induced Disorders
Tobacco-induced sleep disorder is discussed in the chapter “Sleep -Wake Disorders” (see
“Substance/Medication-In duced Sleep Disorder”).