Tobacco Use Disorder 571
Tobacco-Related Disorders
Tobacco Use Disorder
Tobacco Withdrawal
Other Tobacco-Ind uced Disorders
Unspecified Tobacco-Related Disorder
Tobacco Use Disorder
Diagnostic Criteria  
A. A problematic pattern of tobacco use leading to clinically significant impairment or dis-
tress, as manifested by at least two of the following, occurring within a 12-month period:
1. Tobacco is often taken in larger amounts or over a longer period than was intended.
2. There is a persistent desire or unsuccessful efforts to cut down or control tobacco use.
3. A great deal of time is spent in activities necessary to obtain or use tobacco.
4. Craving, or a strong desire or urge to use tobacco.
5. Recurrent tobacco use resulting in a failure to fulfill major role obligations at work,
school, or home (e.g., interference with work).
6. Continued tobacco use despite having persistent or recurrent social or interper-
sonal problems caused or exacerbated by the effects of tobacco (e.g., arguments
with others about tobacco use).
7. Important social, occupational, or recreat ional activities are given up or reduced be-
cause of tobacco use.
8. Recurrent tobacco use in situations in which it is physically hazardous (e.g., smok-
ing 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.
10. Tolerance, as defined by either of the following:
a. A need for markedly increased amounts of tobacco to achieve the desired effect.
b. A markedly diminished effect with conti nued use of the same amount of tobacco.
11. Withdrawal, as manifested by either of the following: