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Anyone who smokes or lives with a smoker is familiar with the symptoms of two of the three nicotine-related disorders in DSM-IV; they are Nicotine Dependence and Nicotine Withdrawal. Perhaps no one is familiar with the third, Nicotine-Related Disorder Not Otherwise Specified. As to the first two, most smokers are addicted to cigarettes, and thus have the symptoms of Nicotine Dependence. And most of those who are addicted have tried to quit, abstaining for a few hours to a few weeks, and thus have familiarized themselves and those around them with the symptoms of nicotine withdrawal. The criteria for substance dependence, as applied to Nicotine Dependence, include tolerance to nicotine. Evidence for tolerance include the need for increasing amounts, and lessened effects of nicotine (for example, experienced smokers no longer experience nausea as a result of smoking). Diagnosing dependence also requires that withdrawal from the substance brings about symptoms specific to the substance; when nicotine is withdrawn, the user becomes unhappy, restless, irritable, anxious, insomniac, and sometimes angry or hungry. Then the individual typically uses nicotine to relieve the withdrawal symptoms. To be diagnosable, the symptoms must, as with nearly all diagnoses, cause clinically significant distress or impairment in important areas of functioning. The
percentage of smokers has been declining, but very slowly. Lawsuits
over the last decade have resulted in penalties for tobacco
companies, with a significant portion of the money going into
anti-smoking ads, largely of unknown effectiveness. Nicotine
patches, nicotine gum, and behavioral approaches increase the
success rates for people who want to stop smoking; other approaches
have shown less promise, and relapse rates are high for all
approaches. However, if you are one of those trying to quit,
remember that each time you try to quit, even for a day, you
are one step closer to being successful. Most ex-smokers had
to try several times before finally succeeding. If all you want is more information, visit Nasa's web site on the subject. Last updated 12/19/03 |
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