DSM criteria for tobacco use disorder and tobacco withdrawal: a critique and proposed revisions for DSM‐5*

Abstract

Aims This paper aims to identify appropriate criteria for tobacco dependence assessment, evaluate relevant research, and suggest revisions that may be incorporated into DSM-5. Methods Desirable conceptual and psychometric features of tobacco dependence assessments were identified, including the types of outcomes against which such assessment should be validated. DSM-IV criteria were matched against these criteria and compared with other dependence measures. Results DSM-IV criteria were found to be ambiguous, little used in tobacco research, and have relatively low predictive validity. Other dependence measures were found to have greater validity in the prediction of important dependence features such as relapse likelihood. Strength of urges to smoke on typical smoking days and during abstinence, markers of nicotine intake or frequency of smoking, and latency to smoke soon after waking were found to be useful dependence measures. Conclusion The use and utility of DSM-5 will be enhanced by eliminating most DSM-IV criteria and adding new ones based on smoking pattern, smoking heaviness, and the severity of craving during periods of smoking and withdrawal.

Craving y abstinencia de la nicotina en fumadores españoles en un tratamiento para dejar de fumar

“…Indeed, these results are consistent with previous studies that established craving and NWS as symptoms of dependence and predictors of smoking cessation success (Hughes et al, 1990;Tiffany et al, 2009), consistent with DSM-5 criteria. Moreover, these relationships between craving, ND, and smoking cessation outcomes are consistent with Robinson et al (2011) who found that more dependent smokers also experienced greater craving, and Baker et al (2012), who considered craving as a NWS symptom and as the symptom most associated with tobacco dependence.…”

“…Accordingly, it has been considered craving as a subjective experience of a desire or intense need for substance use (APA, 2013), as an important symptom of tobacco dependence (Baker, Breslau, Covey, & Shiffman, 2012;Tiffany, Warthen, & Goedeker, 2009), and there is evidence that it plays a causal role in smoking relapse (Baker et al, 2004;Shiffman, Paty, Gnys, Kassel, & Hickcox, 1996).…”

Development of a Questionnaire for Assessing Dependence on Electronic Cigarettes Among a Large Sample of Ex-Smoking E-cigarette Users

“…12 It is a 10-item questionnaire that has good psychometric properties, but many adult smokers reach the ceiling score and the average smoker trying nicotine replacement therapy scores 8/10 and so it is less sensitive at the high end of the spectrum. 13 The FTND is not designed to help assess DSM-4 or 5 criteria for nicotine dependence, 14 and the FTND does not relate well to DSM-based assessments. 15 Given the strengths and weaknesses of existing measures of nicotine dependence, we developed a new nicotine dependence index comprising some of the most predictive items from various prior studies, but designed to be easily adapted for different nicotine products.…”

Illness Perceptions of Addiction and Substance Use Patterns among Psychology Students

“…Nicotine is considered as a highly addictive substance. Though nicotine use is accepted in many societies, regular nicotine use should in fact often be considered as an addiction [29]. It can be expected that regular nicotine users more often display addictive behaviour as compared to those regularly using alcohol or cannabis.…”