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Table 2 DSM-5 tobacco withdrawal criteria [7]

From: Can tobacco dependence provide insights into other drug addictions?

DSM-5 tobacco withdrawal criteria

Comments

A. Daily use of tobacco for at least several weeks.

But the DSM text notes that withdrawal occurs in nondaily smokers.

B. Abrupt cessation of tobacco use, or reduction in the amount of tobacco use, followed within 24 h by four (or more) of the following signs and symptoms:

Irritability, frustration, or anger.

Anxiety.

Difficulty concentrating.

Increased appetite.

Restlessness.

Depressed mood.

Insomnia.

Smokers with a latency to withdrawal of greater than 24 h do not experience withdrawal symptoms within 24 h.

C. The signs or symptoms in Criteria B cause clinically significant distress or impairment in social, occupation, or other important areas of functioning.

Tobacco withdrawal symptoms are rarely severe enough to preclude normal occupational functioning.

D. The signs or symptoms are not attributed to another medical condition and are not better explained by another mental disorder, including intoxication or withdrawal from another substance.

Experienced smokers would never be confused as to the cause of the listed withdrawal symptoms as they would simultaneously experience craving for tobacco.