The reference guide used by clinicians to diagnose mental health disorders is known as the Diagnostic and Statistical Manual of Mental Disorders (DSM). The most recent version of the manual is the 5th Edition (“DSM-5”).

According to the DSM-5, 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:

1.      Loss of control (inability to stop using)

2.      Persistent desire/unsuccessful efforts to stop using

3.      Craving (a strong desire to use the substance)

4.      Failure to fulfill major role obligations due to use

5.      A great deal of time is spent obtaining, using, and recovering from the use of substances

6.      Continued use of substances despite having social or interpersonal problems caused or made worse by the use

7.      Important activities are reduced or given up because of the use

8.      Substance use in situations where it is physically hazardous

9.      Continued use of substances despite having physical or psychological caused or made worse by the use

10.  Tolerance

11.  Withdrawal.