Free
E-newsletter
Subscribe to Housecall
Our weekly general interest
e-newsletter keeps you up to date
on a wide variety of health topics.
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Tests and diagnosis
By Mayo Clinic staffThere are no physical tests to determine the exact degree to which you're dependent on nicotine. Your doctor may ask you questions or have you complete a questionnaire to get a sense of how dependant you are on nicotine. The more cigarettes you smoke each day and the sooner you smoke after awakening, the more dependent you are.
In diagnosing nicotine dependence, your doctor likely will consider criteria detailed in a book called the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health providers to help them diagnose conditions and by insurance companies to reimburse for treatment.
DSM criteria for nicotine dependence include three or more of the following at any time in the same 12-month period:
- You've developed nicotine tolerance. The effect of nicotine is most intense the first time you use it. Common side effects, such as nausea and dizziness, will lessen the more and longer you smoke.
- You experience withdrawal symptoms when you stop using tobacco.
- You often take tobacco in larger amounts or over a longer period than intended.
- You spend a lot of time obtaining or maintaining your supply of tobacco.
- You've made persistent or unsuccessful efforts to cut down or control your tobacco use.
- You have limited or given up important social, occupational or recreational activities because of tobacco use.
- You continue to use tobacco despite knowing you have medical problems that are likely related to tobacco dependence.
Knowing your degree of dependence will help your doctor determine the best medication plan for you.
- Nicotine. NIDA for Teens. http://www.teens.drugabuse.gov/drnida/drnida_nic1.asp. Accessed Sept. 15, 2010.
- Questions about smoking, tobacco and health. American Cancer Society. http://www.cancer.org/Cancer/CancerCauses/TobaccoCancer/QuestionsaboutSmokingTobaccoandHealth/questions-about-smoking-tobacco-and-health-intro-and-background. Accessed Sept. 15, 2010.
- Rigotti NA, et al. Patterns of tobacco use and benefits of smoking cessation. http://www.uptodate.com/home/index.html. Accessed Sept. 15, 2010.
- Cigarettes and other tobacco products. NIDA. http://www.drugabuse.gov/infofacts/tobacco.html. Accessed Sept. 15, 2010.
- Renard SI, et al. Management of smoking cessation in adults. http://www.uptodate.com/home/index.html. Accessed Sept. 15, 2010.
- Sackey JA. Smoking cessation counseling strategies in primary care. http://www.uptodate.com/home/index.html. Accessed Sept. 15, 2010.
- Smoking and how to quit. The National Women's Health Information Center. http://www.womenshealth.gov/quit-smoking/parents/. Accessed Sept. 15, 2010.
- Leone FT, et al. Behavioral interventions in tobacco dependence. Primary Care Clinics in Office Practice. 2009;36:489.
- Hatsukami DK, et al. Tobacco addiction. The Lancet. 2008;371:2027.
- Parents who quit smoking when their kids are young may have a big influence on whether their offspring will quit smoking in young adulthood. The Society for the Study of Addiction. http://www.addictionjournal.org/viewpressrelease.asp?pr=26. Accessed Sept. 15, 2010.
- Nicotine dependence. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Sept. 15, 2010.
- Hurt RD (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 12, 2010.
- Hurt RD, et al. Treating Tobacco Dependence in a Medical Setting. CA: A Cancer Journal for Clinicians. 2009;59:314.
Find Mayo Clinic on