Uzależnienie od nikotyny – Diagnostyka i diagnoza

Uzależnienie od nikotyny
Diagnostyka i diagnoza

Uzależnienie od nikotyny to złożony stan zależności fizycznej i psychicznej, diagnozowany za pomocą narzędzi takich jak Test Fagerströma (FTND), DSM-5 oraz ICD-10/11. FTND ocenia nasilenie uzależnienia fizycznego w skali 0-10, gdzie wynik ≥5 wskazuje na istotne uzależnienie psychologiczne. DSM-5 definiuje zaburzenie używania tytoniu na podstawie co najmniej 2 z 11 kryteriów w ciągu 12 miesięcy, obejmujących m.in. tolerancję, objawy odstawienia i kontynuację używania pomimo szkód zdrowotnych. ICD-10 klasyfikuje uzależnienie pod kodem F17.2, z różnymi podtypami uwzględniającymi remisję i powikłania. Dodatkowo stosuje się narzędzia takie jak NDSS i WISDM do wielowymiarowej oceny motywacji i cech uzależnienia. Diagnostyka uwzględnia także specyfikę użytkowników e-papierosów, dla których opracowano skalę EDS, a dokumentacja medyczna wykorzystuje standardowe kody ICD-10. Różnorodność narzędzi i ich różne wyniki w populacjach podkreślają konieczność indywidualnej oceny i uwzględnienia czynników genetycznych oraz środowiskowych.

Diagnostyka uzależnienia od nikotyny

Metody i narzędzia diagnostyczne
Wywiad kliniczny i pytania diagnostyczne
Interpretacja wyników i znaczenie diagnostyczne
Kody diagnostyczne ICD-10 dla uzależnienia od nikotyny

Znaczenie diagnostyki dla leczenia uzależnienia od nikotyny

Fazy gotowości do zaprzestania palenia
Indywidualizacja leczenia farmakologicznego
Znaczenie diagnostyki genetycznej

Wyzwania i ograniczenia w diagnostyce uzależnienia od nikotyny

Brak uniwersalnego testu diagnostycznego
Rozbieżność narzędzi diagnostycznych
Dychotomiczna natura diagnozy
Diagnozowanie uzależnienia od e-papierosów

Znaczenie diagnostyki w badaniach naukowych

Badania epidemiologiczne
Badania kliniczne
Badania genetyczne
Kolejne rozdziały

Diagnostyka uzależnienia od nikotyny

Uzależnienie od nikotyny (nikotynizm) to stan zależności od nikotyny, substancji zawartej w tytoniu, prowadzący do uzależnienia fizycznego i psychicznego. Charakteryzuje się przymusem używania nikotyny, trudnościami w kontrolowaniu jej używania, zwiększeniem priorytetu używania nad inne aktywności oraz utrzymywaniem się używania pomimo szkodliwych konsekwencji zdrowotnych i społecznych.¹²

Diagnoza uzależnienia od nikotyny ma kluczowe znaczenie w procesie planowania leczenia i określenia jego intensywności. Lekarze posiadają szereg narzędzi i kryteriów diagnostycznych, które umożliwiają ocenę stopnia uzależnienia oraz identyfikację osób wymagających interwencji w celu skutecznego zaprzestania używania tytoniu.³

Metody i narzędzia diagnostyczne

W diagnostyce uzależnienia od nikotyny stosuje się kilka standaryzowanych narzędzi oceny. Każde z nich koncentruje się na nieco innych aspektach uzależnienia, co pozwala na kompleksową ocenę stanu pacjenta:⁴⁵

Test Fagerströma (FTND)

Test Fagerströma (Fagerström Test for Nicotine Dependence) jest standardowym narzędziem do oceny nasilenia fizycznego uzależnienia od nikotyny. Test ten pomaga lekarzom udokumentować wskazania do przepisania leków na objawy odstawienia nikotyny.⁶⁷ Im wyższy wynik w skali Fagerströma, tym silniejsze jest fizyczne uzależnienie pacjenta od nikotyny.

Test Fagerströma składa się z 6 pytań samooceny i pozwala ocenić intensywność uzależnienia fizycznego od nikotyny. Całkowity wynik może wahać się od 0 do 10, przy czym wyższy wynik wskazuje na silniejsze uzależnienie, a wynik 5 lub więcej świadczy o znaczącym uzależnieniu psychologicznym.⁸⁹

Najważniejsze pytania w teście Fagerströma obejmują:¹⁰

Jak szybko po przebudzeniu sięgasz po pierwszego papierosa?
Ile papierosów wypalasz dziennie?
Który papieros w ciągu dnia jest dla ciebie najważniejszy?

Kryteria DSM-5

Diagnostyczny i Statystyczny Podręcznik Zaburzeń Psychicznych (DSM-5) zawiera kryteria dla Zaburzenia używania tytoniu (Tobacco Use Disorder), które zastąpiło diagnozę uzależnienia od nikotyny z poprzedniej wersji DSM-IV. Według DSM-5, problematyczny wzorzec używania tytoniu prowadzi do klinicznie znaczącego upośledzenia lub dystresu, co manifestuje się wystąpieniem co najmniej 2 z 11 objawów w okresie 12 miesięcy.¹¹¹²

Kryteria DSM-5 dla zaburzenia używania tytoniu obejmują:¹³

Zwiększone używanie tytoniu lub dłuższy czas używania niż pierwotnie zamierzony
Uporczywe pragnienie zmniejszenia lub zaprzestania używania tytoniu
Poświęcanie znacznej ilości czasu na zdobywanie lub używanie tytoniu
Używanie tytoniu w sytuacjach niebezpiecznych
Kontynuacja używania pomimo wiedzy o szkodliwości dla zdrowia
Doświadczanie głodu nikotynowego
Zakłócenie wypełniania obowiązków z powodu używania tytoniu
Kontynuacja używania pomimo problemów społecznych lub interpersonalnych
Ograniczenie aktywności społecznych, zawodowych lub rekreacyjnych z powodu używania tytoniu
Rozwój tolerancji – potrzeba zwiększania ilości tytoniu dla osiągnięcia pożądanego efektu
Występowanie objawów odstawienia przy zmniejszeniu używania tytoniu

Kryteria ICD-10/ICD-11

Międzynarodowa Klasyfikacja Chorób (ICD-10) klasyfikuje uzależnienie od nikotyny jako zaburzenie psychiczne i behawioralne spowodowane używaniem substancji psychoaktywnych pod kodem F17.2.¹⁴¹⁵

W klasyfikacji ICD-11 uzależnienie od nikotyny definiowane jest jako zaburzenie regulacji używania nikotyny wynikające z powtarzanego lub ciągłego używania nikotyny. Charakterystyczną cechą jest silny wewnętrzny przymus używania nikotyny, który objawia się zaburzeniem zdolności kontrolowania używania, zwiększeniem priorytetu używania nad inne aktywności i uporczywym używaniem pomimo szkody lub negatywnych konsekwencji.¹⁶

Cechy uzależnienia są zwykle widoczne przez okres co najmniej 12 miesięcy, ale diagnoza może być postawiona, jeśli używanie nikotyny jest ciągłe (codzienne lub prawie codzienne) przez co najmniej 3 miesiące.¹⁷

Skala NDSS

Nicotine Dependence Syndrome Scale (NDSS) to 19-elementowa skala samooceny, która została opracowana jako wielowymiarowe narzędzie do oceny uzależnienia od nikotyny z wykorzystaniem teorii syndromu uzależnienia Edwardsa. Skala NDSS bada różne wymiary uzależnienia i wykazuje akceptowalną spójność wewnętrzną.¹⁸¹⁹

Skala WISDM

Wisconsin Inventory of Smoking Dependence Motives (WISDM) składa się z 68 pozycji zaprojektowanych do oceny 13 różnych teoretycznie wyprowadzonych domen motywacyjnych związanych z uzależnieniem od nikotyny. Wszystkie podskale WISDM wykazują akceptowalną lub dobrą spójność wewnętrzną.²⁰

Wywiad kliniczny i pytania diagnostyczne

Lekarz rodzinny może ocenić zachowania związane z paleniem u swoich pacjentów w ciągu kilku minut, używając starannie dobranych pytań. Oprócz standardowych testów, lekarz może przeprowadzić wywiad kliniczny, zadając pacjentowi szereg pytań dotyczących zwyczajów związanych z używaniem tytoniu.²¹²²

Typowe pytania diagnostyczne mogą obejmować:²³²⁴

Ile papierosów palisz każdego dnia?
Jak szybko po przebudzeniu palisz?
Czy próbowałeś wcześniej przestać palić? Jeśli tak, co się wydarzyło? Co zadziałało? Co nie zadziałało?
Co motywuje cię do zaprzestania palenia teraz?
Czy masz jakieś problemy zdrowotne, takie jak choroba serca lub cukrzyca, które podejrzewasz, że są związane z paleniem?
Czy palenie spowodowało jakieś problemy w pracy lub w twoich relacjach?
Czy trudno ci powstrzymać się od palenia w miejscach, gdzie palenie jest zabronione?

Test czterech C (The Four Cs Test) może być również stosowany do oceny uzależnienia pacjenta od nikotyny. Lekarze rodzinni, którzy czują się komfortowo omawiając kwestie psychologiczne ze swoimi pacjentami, mogą preferować to podejście, które dokumentuje diagnozę uzależnienia od nikotyny opartą na DSM-IV.²⁵²⁶

Interpretacja wyników i znaczenie diagnostyczne

Im wyższy wynik w skali Fagerströma, tym intensywniejsze jest fizyczne uzależnienie pacjenta od nikotyny. Wyższe wyniki wskazują, że leczenie objawów odstawienia, zwykle przy użyciu nikotynowej terapii zastępczej, będzie ważnym czynnikiem w planie opieki nad pacjentem.²⁷

Badania wykazały, że różne narzędzia do pomiaru uzależnienia od nikotyny mogą dawać rozbieżne diagnozy w tej samej populacji. W jednym z badań przeprowadzonych wśród kanadyjskich dorosłych palaczy pochodzenia afroamerykańskiego, różne narzędzia dawały bardzo różne wskaźniki diagnostyczne uzależnienia od tytoniu: 91% osób było uzależnionych według DSM-IV, 48% było uzależnionych według ICD-10 i 48% było uzależnionych według FTND (wynik ≥3).²⁸²⁹

To podkreśla znaczenie:³⁰³¹

Rodzaju, sformułowania i punktacji pytań w narzędziach do pomiaru uzależnienia od tytoniu
Czynników specyficznych dla populacji, które mogą wpływać na ocenę uzależnienia od tytoniu

ICD-10 wydaje się mieć kilka zalet w porównaniu z DSM-IV i FTND. Po pierwsze, umożliwia szereg odpowiedzi na każde ze swoich pytań. Po drugie, ma charakter dyskryminacyjny, ponieważ diagnozuje około połowę palaczy jako uzależnionych od tytoniu. Po trzecie, wykazuje pewien stopień trafności teoretycznej, ponieważ koreluje zarówno z liczbą papierosów dziennie, jak i z własnym postrzeganiem uzależnienia.³²

Kody diagnostyczne ICD-10 dla uzależnienia od nikotyny

ICD-10 zawiera szereg kodów związanych z uzależnieniem od nikotyny, które są używane do celów dokumentacji medycznej i rozliczeń ubezpieczeniowych:³³³⁴³⁵

Kod ICD-10	Opis
F17.200	Uzależnienie od nikotyny, nieokreślone, niepowikłane
F17.201	Uzależnienie od nikotyny, nieokreślone, w remisji
F17.203	Uzależnienie od nikotyny, nieokreślone, z zespołem abstynencyjnym
F17.208	Uzależnienie od nikotyny, nieokreślone, z innymi zaburzeniami wywołanymi nikotyną
F17.209	Uzależnienie od nikotyny, nieokreślone, z nieokreślonymi zaburzeniami wywołanymi nikotyną
F17.210	Uzależnienie od nikotyny, papierosy, niepowikłane
F17.211	Uzależnienie od nikotyny, papierosy, w remisji
F17.213	Uzależnienie od nikotyny, papierosy, z zespołem abstynencyjnym
F17.218	Uzależnienie od nikotyny, papierosy, z innymi zaburzeniami wywołanymi nikotyną
F17.219	Uzależnienie od nikotyny, papierosy, z nieokreślonymi zaburzeniami wywołanymi nikotyną
F17.220-F17.229	Uzależnienie od nikotyny, tytoń do żucia (różne warianty)
F17.290-F17.299	Uzależnienie od nikotyny, inne produkty tytoniowe (różne warianty)
Z87.891	Osobisty wywiad dotyczący uzależnienia od nikotyny

Kod Z87.891 jest wykorzystywany, gdy lekarz stwierdził, że przeszłe uzależnienie pacjenta od nikotyny ma wpływ na jego obecny stan, przyczyniając się do powikłań, chorób (takich jak obrzęk płuc) lub chorób przewlekłych (takich jak przewlekła obturacyjna choroba płuc).³⁶³⁷

Znaczenie diagnostyki dla leczenia uzależnienia od nikotyny

Diagnoza uzależnienia od nikotyny ma kluczowe znaczenie w określeniu odpowiedniego planu leczenia. Właściwe rozpoznanie pozwala na podjęcie decyzji terapeutycznych dostosowanych do indywidualnych potrzeb pacjenta, identyfikację osób zagrożonych negatywnymi konsekwencjami używania tytoniu, określenie osób potrzebujących interwencji w celu skutecznego zaprzestania używania tytoniu oraz wskazanie rodzaju lub „dawki” leczenia.³⁸

Fazy gotowości do zaprzestania palenia

Wynik diagnostyczny może pomóc w określeniu fazy gotowości pacjenta do zaprzestania palenia. Lekarze mogą dostosować swoje podejście doradcze w zależności od fazy, w której znajduje się pacjent:³⁹⁴⁰

Faza prekontemplacji: Celem poradnictwa dla pacjentów w tej fazie jest wprowadzenie ambiwalencji, aby zaczęli rozważać rzucenie palenia; przepisywanie leków i strategii zaprzestania palenia nie pomaga tym pacjentom w rzuceniu palenia.
Faza kontemplacji: Celem poradnictwa dla pacjentów w tej fazie jest zbadanie obu stron ich ambiwalencji (z naciskiem na to, jak ich życie poprawi się po rzuceniu palenia), co pomaga im zdecydować się na rzucenie palenia.
Faza przygotowania: Celem poradnictwa dla pacjentów w tej fazie jest ocena ich wcześniejszych prób rzucenia palenia i zidentyfikowanie, co wcześniej zadziałało (aby bazować na wcześniejszych sukcesach) i jakie były bariery sukcesu w przeszłości.
Faza działania: Odpowiedzialność lekarza polega na prowadzeniu pacjentów etap po etapie do momentu, w którym faktycznie przestają palić.

Indywidualizacja leczenia farmakologicznego

Stopień uzależnienia od nikotyny określony w procesie diagnostycznym ma bezpośredni wpływ na wybór farmakoterapii. Pacjenci z wyższym wynikiem w skali Fagerströma będą prawdopodobnie wymagali intensywniejszego leczenia farmakologicznego.⁴¹⁴²

Najczęściej stosowane opcje farmakoterapii obejmują:⁴³

Nikotynowa terapia zastępcza (NRT): Dostępna w różnych formach, w tym plaster, guma, inhalator, spray, tabletki i pastylki. Stosowanie kombinacji więcej niż jednej formy NRT zwiększa prawdopodobieństwo skutecznego zaprzestania palenia.
Wareniklina: Częściowy agonista nikotynowego receptora acetylocholiny, który konkuruje z nikotyną w miejscu receptora, hamując jej wiązanie. Wareniklina jest najskuteczniejszą opcją farmakoterapii dla zaprzestania palenia, gdy jest stosowana jako monoterapia. Stosowanie warenikliny w połączeniu z plastrami nikotynowymi jest lepsze niż sama wareniklina.
Bupropion: Lek przeciwdepresyjny, który działa zarówno na układy dopaminergiczne, jak i noradrenergiczne, i uważa się, że zmniejsza właściwości wzmacniające nikotyny. Jest stosowany, gdy NRT lub wareniklina są nieskuteczne lub nie mogą być stosowane.

Znaczenie diagnostyki genetycznej

Badania pokazują, że warianty genetyczne związane z uzależnieniem od nikotyny i ilością palenia mogą również przewidywać, czy pacjenci skorzystają z leków wspomagających rzucenie palenia. Badacze wykazali, że palacze z haplotypem wariantu genetycznego wysokiego ryzyka mieli mniejsze szanse na samodzielne rzucenie palenia i większe szanse na odpowiedź na leczenie farmakologiczne przy użyciu bupropionu, nikotynowej terapii zastępczej lub obu tych metod, niż osoby z haplotypem niskiego ryzyka.⁴⁴

Jest to bardzo ważne nie tylko do identyfikacji pacjentów, którzy powinni otrzymać leki, ale także dla tych pacjentów, którzy mogą rzucić palenie samodzielnie i nie korzystają z leków, zwłaszcza niektórych pacjentów, którzy mogą potencjalnie doświadczyć skutków ubocznych, takich jak kobiety w ciąży lub osoby z chorobami serca.⁴⁵

Wyzwania i ograniczenia w diagnostyce uzależnienia od nikotyny

Mimo dostępności różnych narzędzi diagnostycznych, diagnozowanie uzależnienia od nikotyny wiąże się z pewnymi wyzwaniami i ograniczeniami.⁴⁶

Brak uniwersalnego testu diagnostycznego

Obecnie nie istnieje uniwersalny test diagnostyczny, który mógłby określić, czy ktoś jest uzależniony od nikotyny i w jakim stopniu. Diagnoza uzależnienia od nikotyny zazwyczaj pojawia się, gdy osoba szuka pomocy medycznej w związku z uzależnieniem.⁴⁷

Rozbieżność narzędzi diagnostycznych

Różne narzędzia do pomiaru uzależnienia od nikotyny mogą dawać rozbieżne diagnozy w tej samej populacji. Co więcej, to samo narzędzie do pomiaru uzależnienia od nikotyny może działać inaczej w zależności od populacji.⁴⁸⁴⁹

Jest to istotne, ponieważ ilustruje, że: ⁵⁰⁵¹

Różne narzędzia do pomiaru uzależnienia od tytoniu niekoniecznie diagnozują te same osoby jako uzależnione
Architektura narzędzia wydaje się być ważna dla rozbieżnych diagnoz, być może bardziej niż podstawowa konstrukcja narzędzia
Czynniki specyficzne dla populacji, takie jak poziom konsumpcji papierosów, mogą wpływać na diagnozę uzależnienia

Dychotomiczna natura diagnozy

Jednym z ograniczeń niektórych narzędzi diagnostycznych jest to, że klasyfikują one uzależnienie jako cechę dychotomiczną. Złożone cechy ludzkie są pod wpływem zarówno czynników środowiskowych, jak i genetycznych; w konsekwencji wykazują fenotypy wzdłuż kontinuum. Diagnoza uzależnienia od nikotyny powinna uwzględniać tę ciągłość.⁵²

Diagnozowanie uzależnienia od e-papierosów

W związku z rosnącą popularnością e-papierosów, pojawiają się wyzwania związane z diagnozowaniem uzależnienia od nikotyny u osób używających tych produktów. Skala Zależności od E-papierosów (E-cigarette Dependence Scale, EDS) to narzędzie, które zostało zwalidowane specjalnie dla użytkowników e-papierosów, chociaż należy uwzględnić stosowanie innych produktów nikotynowych przy określaniu zależności.⁵³

Przy dokumentowaniu korzystania z e-papierosów stosuje się te same kody ICD-10, co w przypadku innych form używania tytoniu. Jeśli dokumentacja wskazuje na uzależnienie od e-papierosów, stosuje się kod F17.200 dla uzależnienia od nikotyny, nieokreślonego, niepowikłanego (zakładając, że „sok” do e-papierosów zawiera nikotynę).⁵⁴

Znaczenie diagnostyki w badaniach naukowych

Diagnostyka uzależnienia od nikotyny ma istotne znaczenie dla badań naukowych, w tym badań epidemiologicznych, klinicznych i genetycznych.⁵⁵⁵⁶

Badania epidemiologiczne

Według danych epidemiologicznych, uzależnienie od nikotyny jest powszechne i dotyka około 23,6 miliona Amerykanów, czyli 8,5% osób w wieku 12 lat i starszych.⁵⁷ Rozpowszechnienie zaburzenia używania tytoniu szacuje się na około 13%.⁵⁸

Badania wykazały, że pacjenci na oddziałach ratunkowych palili umiarkowane ilości, z umiarkowanym poziomem uzależnienia i zainteresowania rzuceniem palenia. Mediana wyników w teście Fagerströma wynosiła 4, a mediana wyniku na dziewięciopunktowej drabinie kontemplacji wynosiła 5, co wskazuje na chęć rzucenia palenia w ciągu 6 miesięcy.⁵⁹

Badania kliniczne

W jednym z badań przeprowadzonych wśród pacjentów z rakiem płuc, którzy używali tytoniu w ciągu 12 miesięcy poprzedzających diagnozę, częstość występowania zaburzenia używania tytoniu według DSM-5 wynosiła 92,0%. Częstość występowania uzależnienia od nikotyny według DSM-IV wynosiła 78,5% w tym badaniu, co było niższe niż częstość występowania zaburzenia używania tytoniu według DSM-5 (92,0%).⁶⁰⁶¹

W innym badaniu oceniającym czynniki związane z zaprzestaniem palenia i porównującym charakterystykę i uzależnienie od nikotyny wśród palaczy z i bez przewlekłej obturacyjnej choroby płuc (POChP), wykazano, że wyższe wyniki w skali FTND były związane z lękiem/depresją i objawami oddechowymi w obu grupach. Wynik FTND i prosta wizualna skala analogowa do oceny własnej skuteczności wydają się być wartościowymi narzędziami do przewidywania zaprzestania palenia przez kilka lat, niezależnie od POChP, objawów oddechowych, obecności lęku/depresji i chorób serca.⁶²

Badania genetyczne

Uzależnienie od nikotyny wykazuje dziedziczność, a kilka grup badawczych przeprowadziło analizy sprzężeń w celu identyfikacji regionów genomowych wpływających na to zaburzenie, chociaż tylko ograniczona liczba wyników została potwierdzona.⁶³

Wyniki badań sugerują, że region chromosomowy 2q31.1 zwiększa ryzyko rozwoju uzależnienia od nikotyny i wpływa na szeroki zakres objawów uzależnienia od nikotyny, a nie na konkretny aspekt zaburzenia. Ponadto wyniki pokazują, że ten region nie jest sprzężony z uzależnieniem od alkoholu w tej populacji, a zatem może wpływać specyficznie na uzależnienie od nikotyny.⁶⁴

Badania genetyczne mają również znaczenie dla personalizacji terapii dla osób chcących rzucić palenie. Wyniki badań sugerują, że biologiczne efekty trzech haplotypów wpływają zarówno na ilość palenia, jak i na zdolność do rzucenia palenia, a leczenie farmakologiczne jest bardziej skuteczne u osób, które są genetycznie predysponowane do trudności w rzuceniu palenia.⁶⁵

Kolejne rozdziały

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Materiały źródłowe

#1 Nicotine dependence – ICD-11 MMS
https://www.findacode.com/icd-11/block-1699574100.html
Nicotine dependence is a disorder of regulation of nicotine use arising from repeated or continuous use of nicotine. The characteristic feature is a strong internal drive to use nicotine, which is manifested by impaired ability to control use, increasing priority given to use over other activities and persistence of use despite harm or negative consequences. […] The features of dependence are usually evident over a period of at least 12 months but the diagnosis may be made if nicotine use is continuous (daily or almost daily) for at least 3 months.
#2 Nicotine dependence – Wikipedia
https://en.wikipedia.org/wiki/Nicotine_dependence
Nicotine dependence is defined as a neurobiological adaptation to repeated drug exposure that is manifested by highly controlled or compulsive use, the development of tolerance, experiencing withdrawal symptoms upon cessation including cravings, and an inability to quit despite harmful effects. Nicotine dependence has also been conceptualized as a chronic, relapsing disease. […] There are different ways of measuring nicotine dependence. The five common dependence assessment scales are the Fagerstrm Test for Nicotine Dependence, the Diagnostic and Statistical Manual of Mental Disorders, the Cigarette Dependence Scale, the Nicotine Dependence Syndrome Scale, and the Wisconsin Inventory of Smoking Dependence Motives. […] The Fagerstrm Test for Nicotine Dependence focuses on measuring physical dependence which is defined „as a state produced by chronic drug administration, which is revealed by the occurrence of signs of physiological dysfunction when the drug is withdrawn; further, this dysfunction can be reversed by the administration of drug”.
#3 DSM Criteria for Tobacco Use Disorder and Tobacco Withdrawal: A Critique and Proposed Revisions for DSM-5 – PMC Lock
https://pmc.ncbi.nlm.nih.gov/articles/PMC3246568/
Diagnosis of tobacco dependence should help inform treatment decisions or recommendations, identify individuals who are at risk for negative consequences from tobacco use, identify those who need intervention in order to quit tobacco use successfully, and suggest what type or âdoseâ of treatment to use. […] The proposed DSM-5 will, apparently, include 11 criteria, which may be unnecessarily long â both in terms of criteria and time required. […] The DSM-IV criteria appear to have acceptable reliability. […] Valid measures predict key outcomes related to the construct that they are intended to assess. […] Proposed criteria for DSM-5 and associated sample items are presented below along with rationales for their inclusion. […] Considerable evidence suggests that the four core criteria displayed in Table 3 should be represented in DSM-5 if it is to possess optimal validity.
#4 Nicotine dependence – Wikipedia
https://en.wikipedia.org/wiki/Nicotine_dependence
The 4th edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) had a nicotine dependence diagnosis which was defined as „…a cluster of cognitive, behavioral, and physiological symptoms…” In the updated DSM-5 there is no nicotine dependence diagnosis, but rather Tobacco Use Disorder, which is defined as, „A problematic pattern of tobacco use leading to clinically significant impairment or distress, as manifested by at least 2 of the following [11 symptoms], occurring within a 12-month period.” […] Various methods exist for measuring nicotine dependence. Common assessment scales for cigarette smokers include the Fagerstrm Test for Nicotine Dependence, the Diagnostic and Statistical Manual of Mental Disorders criteria, the Cigarette Dependence Scale, the Nicotine Dependence Syndrome Scale, and the Wisconsin Inventory of Smoking Dependence Motives.
#5 Assessing dimensions of nicotine dependence
https://pmc.ncbi.nlm.nih.gov/articles/PMC2614360/
Considerable research, ranging from survey to clinical to genetic, has utilized traditional measures of tobacco dependence, such as the Fagerstrom Test of Nicotine Dependence (FTND) and the Diagnostic and Statistical Manual (DSM-IV) criteria, that focus on endpoint definitions of tobacco dependence such as heavy smoking, time to first cigarette in the morning, and smoking despite consequences. […] In an effort to better understand possible theories and mechanisms underlying tobacco dependence, which could be used to improve treatment and research, two multidimensional measures of tobacco dependence have been developed: the Nicotine Dependence Syndrome Scale (NDSS) and the Wisconsin Inventory of Smoking Dependence Motives (WISDM). […] The goal of this article is to evaluate the NDSS and the WISDM in terms of their ability to predict such clinically useful dependence criteria as relapse likelihood and withdrawal severity.
#6 Assessing Nicotine Dependence | AAFP
https://www.aafp.org/pubs/afp/issues/2000/0801/p579.html
Family physicians can assess the smoking behavior of their patients in a few minutes, using carefully chosen questions. The CAGE questionnaire for smoking (modified from the familiar CAGE questionnaire for alcoholism), the four Cs test and the Fagerstrm Test for Nicotine Dependence help make the diagnosis of nicotine dependence based on standard criteria. […] Family physicians can diagnose, evaluate and treat nicotine dependence within the limited time frame of an office visit. This article describes several assessment strategies. Family physicians can select the one that best fits their style of practice. The information gathered by these assessments can then be used to provide individualized treatment plans. […] The Fagerstrm Test for Nicotine Dependence is a standard instrument for assessing the intensity of this physical addiction. The Fagerstrm test helps family physicians document the indications for prescribing medication for nicotine withdrawal.
#7 NICOTINE DEPENDENCE – Office Instructions – BAY CLINIC
https://ehr.wrshealth.com/patient_v2/instructions.php?id=2037641&iid=6144
Family physicians can assess the smoking behavior of their patients in a few minutes, using carefully chosen questions. The CAGE questionnaire for smoking (modified from the familiar CAGE questionnaire for alcoholism), the four Cs test and the Fagerstrm Test for Nicotine Dependence help make the diagnosis of nicotine dependence based on standard criteria. […] The Fagerstrm Test for Nicotine Dependence is a standard instrument for assessing the intensity of this physical addiction. The Fagerstrm test helps family physicians document the indications for prescribing medication for nicotine withdrawal. The higher the Fagerstrm score, the more intense is the patient’s physical dependence on nicotine. […] The four Cs test can be used to assess a patient’s dependence on nicotine. Family physicians who feel comfortable discussing psychologic issues with their patients may prefer this approach, which documents a DSM-IVbased diagnosis of nicotine dependence.
#8 Nicotine Dependence: ICD 10 & Fagerstrom Test | Vaia
https://www.vaia.com/en-us/explanations/nursing/mental-health-nursing/nicotine-dependence/
The total score of the Fagerstrom Test can range from 0 to 10. A higher score signifies a higher level of physiological nicotine dependence, with a score of 5 or more indicating significant psychological dependence. […] Nicotine dependence counselling techniques like motivational interviewing, Cognitive Behavioural Therapy (CBT), relapse prevention techniques, and Nicotine Replacement Therapy (NRT) can be used to aid patients in overcoming nicotine dependence.
#9 FagerstrÃ¶m Test for Nicotine Dependence – Wikipedia
https://en.wikipedia.org/wiki/Fagerstr%C3%B6m_Test_for_Nicotine_Dependence
The Fagerstrm Test for Nicotine dependence is a standard instrument for assessing the intensity of addiction to nicotine. It evaluates the quantity of cigarette consumption, the compulsion to use, and dependence. […] In addition to this, the DSM-5 for tobacco use disorder can be used by physicians and nurse practitioners to make a diagnosis. […] The higher the total Fagerstrm score, the more intense is the patient’s physical dependence to nicotine. […] In many countries nurses and pharmacists can use Fagerstrm to assess nicotine use and may initiate Nicotine Replacement Therapy.
#10 Nicotine dependence | CAMH
https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/nicotine-dependence
Nicotine dependence involves physical and psychological factors that make it difficult to stop using tobacco, even if the person wants to quit. […] Health care providers determine whether a person has nicotine dependence, and how severe it is, by asking certain questions. […] The most important questions are: How soon after you wake up do you use tobacco? How many cigarettes do you smoke per day? Which is the most important cigarette of the day for you?
#11 Nicotine dependence – Wikipedia
https://en.wikipedia.org/wiki/Nicotine_dependence
The 4th edition of the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) had a nicotine dependence diagnosis which was defined as „…a cluster of cognitive, behavioral, and physiological symptoms…” In the updated DSM-5 there is no nicotine dependence diagnosis, but rather Tobacco Use Disorder, which is defined as, „A problematic pattern of tobacco use leading to clinically significant impairment or distress, as manifested by at least 2 of the following [11 symptoms], occurring within a 12-month period.” […] Various methods exist for measuring nicotine dependence. Common assessment scales for cigarette smokers include the Fagerstrm Test for Nicotine Dependence, the Diagnostic and Statistical Manual of Mental Disorders criteria, the Cigarette Dependence Scale, the Nicotine Dependence Syndrome Scale, and the Wisconsin Inventory of Smoking Dependence Motives.
#12 Tobacco (Nicotine) Use Disorder – PsychDB
https://www.psychdb.com/addictions/nicotine-tobacco/1-use-disorder
Tobacco (Nicotine) Use Disorder is a substance use disorder characterized by a problematic pattern of tobacco (nicotine) use leading to clinically significant impairment or distress. […] A problematic pattern of tobacco use leading to clinically significant impairment or distress, as manifested by at least 2 of the following, occurring within a 12-month period: […] Tobacco use disorder is uncommon in those who are not daily users. […] The prevalence of tobacco use disorder is estimated to be 13%. […] The characteristic withdrawal syndrome for tobacco (refer to Criteria A and B of the criteria set for tobacco withdrawal). […] Tobacco (or a closely related substance, such as nicotine) is taken to relieve or avoid withdrawal symptoms. […] Adding behavioural and psychological treatments to pharmacotherapy increases the chance of stopping use successfully (long-term abstinence rates approach 25 to 30%).
#13 Nicotine Dependence: Identification and Recommendations
https://www.gavinpublishers.com/article/view/nicotine-dependence-identification-and-recommendations
Nicotine dependence is a mental health disorder defined by the Diagnostic and Statistical Manual- 5 (DSM-5) as a Problematic pattern of tobacco use leading to clinically significant impairment or distress. To make the diagnosis of nicotine dependence, clients must experience two symptoms within a 12-month period. There are 11 specific symptoms that meet this diagnostic criterion. These symptoms include the increased use of tobacco or increased time spent than what was originally intended, a persistent desire to decrease use or quit tobacco use, spending a significant amount of time to obtain or use tobacco, using tobacco in hazardous situations, or continued use despite knowledge of health hazards. Other symptoms include experiencing a craving for tobacco, tobacco use interfering with role obligations, continued use despite having social or interpersonal problems because of the use of tobacco, and decreasing social, occupational or recreational activities because of tobacco use. Clients experiencing tolerance, needing increased amounts of tobacco to achieve the desired effect, also fulfills the DSM criterion, as does withdraw symptoms when use of tobacco is decreased.
#14 Nicotine Dependence: ICD 10 & Fagerstrom Test | Vaia
https://www.vaia.com/en-us/explanations/nursing/mental-health-nursing/nicotine-dependence/
Nicotine dependence is a state of reliance on nicotine, a substance found in tobacco, which leads to addiction. This dependence can lead to withdrawal symptoms upon cessation and the persistent use despite harmful effects. […] The World Health Organization’s ICD-10, which stands for International Classification of Diseases, refers to tobacco dependence as F17. Here, it’s listed under mental and behavioural disorders due to psychoactive substance use. […] Mental health nursing incorporates understanding and efforts to aid individuals with nicotine dependence. The ICD 10 classification holds significant importance in mental health nursing as it assists in the accurate diagnosis and treatment planning for this condition. […] The Fagerstrom Test for Nicotine Dependence is a primary method for assessing nicotine addiction intensity, helping with the initial assessment, treatment planning, and ongoing monitoring of patients’ progress.
#15 2025 ICD-10-CM Codes F17*: Nicotine dependence
https://www.icd10data.com/ICD10CM/Codes/F01-F99/F10-F19/F17-
Type 1 Excludes note indicates that the code excluded should never be used at the same time as F17. […] current nicotine dependence (F17.2-) […] nicotine dependence (F17.2-) […] tobacco dependence (F17.2-) […] Use Additional code from category F17 to identify type of tobacco nicotine dependence […] Type 2 Excludes note indicates that the condition excluded is not part of the condition it is excluded from but a patient may have both conditions at the same time. […] Type 2 Excludes nicotine dependence (F17.-)
#16 Nicotine dependence – ICD-11 MMS
https://www.findacode.com/icd-11/block-1699574100.html
Nicotine dependence is a disorder of regulation of nicotine use arising from repeated or continuous use of nicotine. The characteristic feature is a strong internal drive to use nicotine, which is manifested by impaired ability to control use, increasing priority given to use over other activities and persistence of use despite harm or negative consequences. […] The features of dependence are usually evident over a period of at least 12 months but the diagnosis may be made if nicotine use is continuous (daily or almost daily) for at least 3 months.
#17 Nicotine dependence – ICD-11 MMS
https://www.findacode.com/icd-11/block-1699574100.html
Nicotine dependence is a disorder of regulation of nicotine use arising from repeated or continuous use of nicotine. The characteristic feature is a strong internal drive to use nicotine, which is manifested by impaired ability to control use, increasing priority given to use over other activities and persistence of use despite harm or negative consequences. […] The features of dependence are usually evident over a period of at least 12 months but the diagnosis may be made if nicotine use is continuous (daily or almost daily) for at least 3 months.
#18 Assessing dimensions of nicotine dependence
https://pmc.ncbi.nlm.nih.gov/articles/PMC2614360/
Traditional measures of dependence tend to assess the end-products of dependence (e.g., heavy smoking, smoking despite consequences), rather than putative mechanisms of dependence. […] The two main tobacco dependence assessments that are used both clinically and in research are the FTND (Heatherton et al., 1991) and the Diagnostic and Statistical Manual, 4th Edition (DSM-IV; APA, 1994) criteria. […] While these traditional measures provide relatively little insight into the nature or mechanisms of dependence, they have been shown to predict clinically important dependence criteria such as smoking heaviness and relapse. […] The NDSS (Shiffman, Waters Hickcox, 2004) is a 19-item self-report measure that was developed as a multidimensional scale to assess nicotine dependence using Edwards theory of the dependence syndrome (Edwards, 1986).
#19 Assessing dimensions of nicotine dependence
https://pmc.ncbi.nlm.nih.gov/articles/PMC2614360/
The WISDM (Piper et al., 2004) comprises 68 items designed to assess 13 different theoretically-derived motivational domains. […] Psychometric analyses revealed that the NDSS subscales had rather poor internal consistencies (using the factor-scaled scores for all items; = .30-.59)1, but the overall measure had acceptable internal consistency ( = .79). […] The WISDM subscales all demonstrated acceptable to good internal consistency ( = .74-.94), as did the total WISDM ( = .96). […] Results revealed that, after controlling for treatment, the NDSS Drive and WISDM Negative Reinforcement scales showed the strongest relations with the empirical Bayes estimates of change in withdrawal on the quit day in both studies. […] The NDSS Total and the NDSS Priority subscale significantly predicted abstinence across all three time points, with odds ratios ranging from 1.21-1.28 for Priority and 1.17 to 1.23 for NDSS Total. […] Only two WISDM subscales predicted abstinence at all three time points: Automaticity and Tolerance, with odds ratios ranging from 1.10-1.15 and 1.15-1.24, respectively.
#20 Assessing dimensions of nicotine dependence
https://pmc.ncbi.nlm.nih.gov/articles/PMC2614360/
The WISDM (Piper et al., 2004) comprises 68 items designed to assess 13 different theoretically-derived motivational domains. […] Psychometric analyses revealed that the NDSS subscales had rather poor internal consistencies (using the factor-scaled scores for all items; = .30-.59)1, but the overall measure had acceptable internal consistency ( = .79). […] The WISDM subscales all demonstrated acceptable to good internal consistency ( = .74-.94), as did the total WISDM ( = .96). […] Results revealed that, after controlling for treatment, the NDSS Drive and WISDM Negative Reinforcement scales showed the strongest relations with the empirical Bayes estimates of change in withdrawal on the quit day in both studies. […] The NDSS Total and the NDSS Priority subscale significantly predicted abstinence across all three time points, with odds ratios ranging from 1.21-1.28 for Priority and 1.17 to 1.23 for NDSS Total. […] Only two WISDM subscales predicted abstinence at all three time points: Automaticity and Tolerance, with odds ratios ranging from 1.10-1.15 and 1.15-1.24, respectively.
#21 Nicotine dependence – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/nicotine-dependence/diagnosis-treatment/drc-20351590
Your doctor may ask you questions or have you fill out a questionnaire to see how dependent you are on nicotine. Knowing your degree of dependence will help your doctor determine the right treatment plan for you. The more cigarettes you smoke each day and the sooner you smoke after awakening, the more dependent you are. […] Some questions your doctor may ask include: How many cigarettes do you smoke each day? How soon after waking do you smoke? […] Have you previously tried to stop smoking? If so, what happened? What worked? What didn’t work? […] What is motivating you to stop smoking now? […] Do you have any physical health problems, such as heart disease or diabetes, which you suspect are related to smoking? […] Has smoking caused any problems at work or in your relationships?
#22 Assessing Nicotine Dependence | AAFP
https://www.aafp.org/pubs/afp/issues/2000/0801/p579.html
Family physicians can assess the smoking behavior of their patients in a few minutes, using carefully chosen questions. The CAGE questionnaire for smoking (modified from the familiar CAGE questionnaire for alcoholism), the four Cs test and the Fagerstrm Test for Nicotine Dependence help make the diagnosis of nicotine dependence based on standard criteria. […] Family physicians can diagnose, evaluate and treat nicotine dependence within the limited time frame of an office visit. This article describes several assessment strategies. Family physicians can select the one that best fits their style of practice. The information gathered by these assessments can then be used to provide individualized treatment plans. […] The Fagerstrm Test for Nicotine Dependence is a standard instrument for assessing the intensity of this physical addiction. The Fagerstrm test helps family physicians document the indications for prescribing medication for nicotine withdrawal.
#23 Nicotine dependence – Diagnosis and treatment – Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/nicotine-dependence/diagnosis-treatment/drc-20351590
Your doctor may ask you questions or have you fill out a questionnaire to see how dependent you are on nicotine. Knowing your degree of dependence will help your doctor determine the right treatment plan for you. The more cigarettes you smoke each day and the sooner you smoke after awakening, the more dependent you are. […] Some questions your doctor may ask include: How many cigarettes do you smoke each day? How soon after waking do you smoke? […] Have you previously tried to stop smoking? If so, what happened? What worked? What didn’t work? […] What is motivating you to stop smoking now? […] Do you have any physical health problems, such as heart disease or diabetes, which you suspect are related to smoking? […] Has smoking caused any problems at work or in your relationships?
#24 Nicotine Dependence: Symptoms, Prevention, Diagnosis and Treatment – MANO FOR HEALTH
https://manoforhealth.com/nicotine-dependence-symptoms-prevention-diagnosis-and-treatment/
Doctors often diagnose nicotine dependence by asking questions like: How soon after waking do you use tobacco? How many cigarettes do you smoke per day? Do you find it hard to not smoke in no-smoking areas? […] Theres also a tool called the Fagerstrom Test, which helps measure how dependent someone is on nicotine.
#25 Assessing Nicotine Dependence | AAFP
https://www.aafp.org/pubs/afp/issues/2000/0801/p579.html
The four Cs test can be used to assess a patient’s dependence on nicotine. Family physicians who feel comfortable discussing psychologic issues with their patients may prefer this approach, which documents a DSM-IVbased diagnosis of nicotine dependence. […] The higher the Fagerstrm score, the more intense is the patient’s physical dependence on nicotine. Higher scores indicate that treatment of withdrawal symptoms, usually with nicotine replacement therapy, will be an important factor in the patient’s plan of care. […] The goal of counseling patients in the pre-contemplation stage is to introduce ambivalence, so they will begin to consider quitting; prescribing medication and strategies for cessation does not help these patients quit smoking. […] The goal of counseling patients in the contemplation stage is to explore both sides of their ambivalence (with the emphasis on how their lives will improve after quitting), which helps them resolve in favor of quitting.
#26 NICOTINE DEPENDENCE – Office Instructions – BAY CLINIC
https://ehr.wrshealth.com/patient_v2/instructions.php?id=2037641&iid=6144
Family physicians can assess the smoking behavior of their patients in a few minutes, using carefully chosen questions. The CAGE questionnaire for smoking (modified from the familiar CAGE questionnaire for alcoholism), the four Cs test and the Fagerstrm Test for Nicotine Dependence help make the diagnosis of nicotine dependence based on standard criteria. […] The Fagerstrm Test for Nicotine Dependence is a standard instrument for assessing the intensity of this physical addiction. The Fagerstrm test helps family physicians document the indications for prescribing medication for nicotine withdrawal. The higher the Fagerstrm score, the more intense is the patient’s physical dependence on nicotine. […] The four Cs test can be used to assess a patient’s dependence on nicotine. Family physicians who feel comfortable discussing psychologic issues with their patients may prefer this approach, which documents a DSM-IVbased diagnosis of nicotine dependence.
#27 Assessing Nicotine Dependence | AAFP
https://www.aafp.org/pubs/afp/issues/2000/0801/p579.html
The four Cs test can be used to assess a patient’s dependence on nicotine. Family physicians who feel comfortable discussing psychologic issues with their patients may prefer this approach, which documents a DSM-IVbased diagnosis of nicotine dependence. […] The higher the Fagerstrm score, the more intense is the patient’s physical dependence on nicotine. Higher scores indicate that treatment of withdrawal symptoms, usually with nicotine replacement therapy, will be an important factor in the patient’s plan of care. […] The goal of counseling patients in the pre-contemplation stage is to introduce ambivalence, so they will begin to consider quitting; prescribing medication and strategies for cessation does not help these patients quit smoking. […] The goal of counseling patients in the contemplation stage is to explore both sides of their ambivalence (with the emphasis on how their lives will improve after quitting), which helps them resolve in favor of quitting.
#28 DSM-IV, ICD-10 and FTND: Discordant Tobacco Dependence Diagnoses in Adult Smokers | OMICS International
https://www.omicsonline.org/dsm-iv-icd-10-and-ftnd-discordant-tobacco-dependence-diagnoses-in-adult-smokers-2155-6105.1000105.php?aid=3
There are several measures that attempt to assess tobacco dependence but the most appropriate measure to use is often unclear. Tobacco dependence was assessed, in Canadian adult smokers of black African descent, with three measures: the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), the International Classification of Diseases (ICD-10) and the Fagerstrm Test for Nicotine Dependence (FTND). The different measures resulted in very different tobacco dependence diagnosis rates: 91% were dependent by DSM-IV, 48% were dependent by ICD-10 and 48% were dependent by FTND (score 3). […] Different dependence measures can give discordant diagnosis in the same population; moreover, the same nicotine dependence measure can perform differently depending on the population.
#29 Journal of Addiction Research & Therapy – DSM-IV, ICD-10 and FTND: Discordant Tobacco Dependence Diagnoses in Adult Smokers
https://www.omicsonline.org/open-access/dsmiv-icd10-and-ftnd-discordant-tobacco-dependence-diagnoses-in-adult-smokers-2155-6105-1000105-3.html
There are several measures that attempt to assess tobacco dependence but the most appropriate measure to use is often unclear. Tobacco dependence was assessed, in Canadian adult smokers of black African descent, with three measures: the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), the International Classification of Diseases (ICD-10) and the Fagerstrm Test for Nicotine Dependence (FTND). The different measures resulted in very different tobacco dependence diagnosis rates: 91% were dependent by DSM-IV, 48% were dependent by ICD-10 and 48% were dependent by FTND (score 3). […] Different dependence measures can give discordant diagnosis in the same population; moreover, the same nicotine dependence measure can perform differently depending on the population.
#30 DSM-IV, ICD-10 and FTND: Discordant Tobacco Dependence Diagnoses in Adult Smokers | OMICS International
https://www.omicsonline.org/dsm-iv-icd-10-and-ftnd-discordant-tobacco-dependence-diagnoses-in-adult-smokers-2155-6105.1000105.php?aid=3
This study is important because it illustrates that (a) different tobacco dependence measures do not necessarily diagnose the same individuals as dependent, (b) measure architecture appears to be important to the discordant diagnoses, perhaps more so than the underlying construct of the measure and (c) populations specific factors, like cigarette consumption level, can affect dependence diagnosis. […] The findings of the present study illustrate some limitations and strengths of the DSM-IV, ICD-10 and FTND in an adult population of black African descent. More generally, it highlights the importance of (a) the type, wording and scoring of the questions in tobacco dependence measures and (b) population specific factors that may confound tobacco dependence assessment.
#31 Journal of Addiction Research & Therapy – DSM-IV, ICD-10 and FTND: Discordant Tobacco Dependence Diagnoses in Adult Smokers
https://www.omicsonline.org/open-access/dsmiv-icd10-and-ftnd-discordant-tobacco-dependence-diagnoses-in-adult-smokers-2155-6105-1000105-3.html
This study is important because it illustrates that (a) different tobacco dependence measures do not necessarily diagnose the same individuals as dependent, (b) measure architecture appears to be important to the discordant diagnoses, perhaps more so than the underlying construct of the measure and (c) populations specific factors, like cigarette consumption level, can affect dependence diagnosis. […] Our aim in rescoring the DSM-IV and ICD-10 was to take advantage of the underlying continuity of tobacco dependence. Each measure’s outcome is artificially dichotomized to dependent and not dependent; this limits the sensitivity in assessing relationships. […] The DSM-IV and the FTND had no obvious criterion/question overlap; consistent with the DSM-IV identifying tobacco dependence as a psychological disorder, while the FTND focuses on physical tobacco dependence.
#32 Journal of Addiction Research & Therapy – DSM-IV, ICD-10 and FTND: Discordant Tobacco Dependence Diagnoses in Adult Smokers
https://www.omicsonline.org/open-access/dsmiv-icd10-and-ftnd-discordant-tobacco-dependence-diagnoses-in-adult-smokers-2155-6105-1000105-3.html
The ICD-10 appears to have several advantages over the DSM-IV and FTND. First, it allows for a range of answers for each of its questions. Second, it is discriminating as it diagnosed approximately half of the smokers as tobacco dependent. Third, it demonstrates a degree of construct validity in that it correlated with both cigarettes per day and self-perceived addiction. […] A limitation of this definition is it classifies dependence as a dichotomous trait. Complex human traits are influenced by both environmental and genetic factors; consequently, they exhibit phenotypes along a continuum. […] The findings of the present study illustrate some limitations and strengths of the DSM-IV, ICD-10 and FTND in an adult population of black African descent. More generally, it highlights the importance of (a) the type, wording and scoring of the questions in tobacco dependence measures and (b) population specific factors that may confound tobacco dependence assessment.
#33 2025 ICD-10-CM Diagnosis Code F17.200: Nicotine dependence, unspecified, uncomplicated
https://www.icd10data.com/ICD10CM/Codes/F01-F99/F10-F19/F17-/F17.200
F17.200 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. […] The 2025 edition of ICD-10-CM F17.200 became effective on October 1, 2024. […] This is the American ICD-10-CM version of F17.200 – other international versions of ICD-10 F17.200 may differ. […] Nicotine dependence. […] F17.200 uncomplicated.
#34
https://www.forwardhealth.wi.gov/kw/html/6177_ICD10.html
Nicotine dependence, unspecified, uncomplicated. […] Nicotine dependence, unspecified, in remission. […] Nicotine dependence, unspecified, with withdrawal. […] Nicotine dependence, unspecified, with other nicotine-induced disorders. […] Nicotine dependence, unspecified, with unspecified nicotine-induced disorders. […] Nicotine dependence, cigarettes, uncomplicated. […] Nicotine dependence, cigarettes, in remission. […] Nicotine dependence, cigarettes, with withdrawal. […] Nicotine dependence, cigarettes, with other nicotine-induced disorders. […] Nicotine dependence, cigarettes, with unspecified nicotine-induced disorders. […] Nicotine dependence, chewing tobacco, uncomplicated. […] Nicotine dependence, chewing tobacco, in remission. […] Nicotine dependence, chewing tobacco, with withdrawal.
#35 ICD-10 Coding for Tobacco Use, Dependence, and Exposure
https://www.outsourcestrategies.com/blog/icd-10-codes-for-tobacco-use-dependence-and-exposure/
According to the World Health Organization (WHO), more than 40 percent of smokers globally die from lung diseases, such as cancer, chronic respiratory diseases and tuberculosis. Tobacco use is the largest preventable cause of death and disease in the United States. […] When diagnosing for tobacco use, there are two coding options, depending on whether there is dependence on tobacco or not: […] ICD-10 F17 codes â if the patient is dependent on tobacco […] The sixth digit in ICD-10 code describes the patientâs dependence as follows: […] F17.20- Nicotine dependence, unspecified […] F17.210 Nicotine dependence, cigarettes, uncomplicated […] F17.22- Nicotine dependence, chewing tobacco […] F17.29- Nicotine dependence, other tobacco product […] Claims should be supported by proper documentation. […] While a physician coding service provider can help with ICD 10 code assignment, all payers require that the physician documents medical necessity and specifics of services provided.
#36 Z87.891 â Personal history of nicotine dependence | ICD-10-CM
https://www.carepatron.com/icd/z87-891
The ICD-10-CM code Z87.891 signifies a history of nicotine dependence. […] The Z87.891 is an ICD code that’s included in the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM, for short), and it is used to designate Personal history of nicotine dependence. […] This particular diagnosis code is one of the many codes designated as „Unacceptable Principal Diagnoses.” The reason for this is that this code doesn’t exactly point to a specific problem. It’s simply to say that a patient has a history of nicotine dependence. […] There are other ICD-10 codes for nicotine dependence, all under the F17 umbrella. Those are specific for diagnosing nicotine dependence, which is an actual problem. […] This ICD-10 code is only used when healthcare providers have surmised that a patient’s past nicotine dependence has impacted them by contributing to whatever complication, disease like pulmonary edema, or chronic disease, like chronic obstructive pulmonary disease, they are currently dealing with, but the problem hasn’t been identified.
#37 Z87.891 â Personal history of nicotine dependence | ICD-10-CM
https://www.carepatron.com/icd/z87-891
Given that, it should be used as a descriptor so other healthcare professionals and providers know that their history of nicotine dependence plays a role in what the patient is dealing with. […] Yes, the Z87.891 ICD-10 code is billable and can be used to designate a patient for reimbursement purposes. […] You use it when you have confirmed that a patients past history of nicotine dependence is impacting the patients current condition.
#38 DSM Criteria for Tobacco Use Disorder and Tobacco Withdrawal: A Critique and Proposed Revisions for DSM-5 – PMC Lock
https://pmc.ncbi.nlm.nih.gov/articles/PMC3246568/
Diagnosis of tobacco dependence should help inform treatment decisions or recommendations, identify individuals who are at risk for negative consequences from tobacco use, identify those who need intervention in order to quit tobacco use successfully, and suggest what type or âdoseâ of treatment to use. […] The proposed DSM-5 will, apparently, include 11 criteria, which may be unnecessarily long â both in terms of criteria and time required. […] The DSM-IV criteria appear to have acceptable reliability. […] Valid measures predict key outcomes related to the construct that they are intended to assess. […] Proposed criteria for DSM-5 and associated sample items are presented below along with rationales for their inclusion. […] Considerable evidence suggests that the four core criteria displayed in Table 3 should be represented in DSM-5 if it is to possess optimal validity.
#39 Assessing Nicotine Dependence | AAFP
https://www.aafp.org/pubs/afp/issues/2000/0801/p579.html
The four Cs test can be used to assess a patient’s dependence on nicotine. Family physicians who feel comfortable discussing psychologic issues with their patients may prefer this approach, which documents a DSM-IVbased diagnosis of nicotine dependence. […] The higher the Fagerstrm score, the more intense is the patient’s physical dependence on nicotine. Higher scores indicate that treatment of withdrawal symptoms, usually with nicotine replacement therapy, will be an important factor in the patient’s plan of care. […] The goal of counseling patients in the pre-contemplation stage is to introduce ambivalence, so they will begin to consider quitting; prescribing medication and strategies for cessation does not help these patients quit smoking. […] The goal of counseling patients in the contemplation stage is to explore both sides of their ambivalence (with the emphasis on how their lives will improve after quitting), which helps them resolve in favor of quitting.
#40 Assessing Nicotine Dependence | AAFP
https://www.aafp.org/pubs/afp/issues/2000/0801/p579.html
The goal of counseling patients in the preparation stage is to assess their previous attempts to quit and identify what worked before (to build on prior successes) and what were the barriers to success in the past. […] The physician’s responsibility is to guide patients one stage at a time toward the point where they actually stop smokingwhich is the action stage.
#41 Nicotine Dependence: Identification and Recommendations
https://www.gavinpublishers.com/article/view/nicotine-dependence-identification-and-recommendations
Pharmacologic therapy is a highly recommended method to help clients quit smoking. There are multiple options for pharmacotherapy and providers should be aware of the differences between each prescribed option. Nicotine replacement therapy and varenicline are considered primary treatment options and are the recommended medication treatment options. […] Nicotine Replacement Therapy (NRT) is designed to decrease nicotine withdrawal symptoms when clients are attempting smoking cessation. NRT is available in various formulations including a nicotine patch, gum, inhaler, spray, tablets, and lozenge. Using a combination of more than one form of NRT increases the likelihood of successful cessation. […] Varenicline is a non-nicotinic partial agonist of the nicotinic acetylcholine receptor, which competes with nicotine at the receptor site by inhibiting its binding. Varenicline is the most-effective pharmacotherapy option for smoking cessation when used as monotherapy.
#42 Nicotine Dependence: Identification and Recommendations
https://www.gavinpublishers.com/article/view/nicotine-dependence-identification-and-recommendations
If NRT or varenicline are ineffective or cannot be used to help a client with smoking cessation, bupropion is another option that may be effective. Bupropion is an antidepressant medication that is acts on both dopaminergic and noradrenergic systems and is believed to reduce the reinforcing properties of nicotine. […] Nurse practitioners must play a dominant role in the prevention, identification, and treatment of nicotine dependence to reduce the burden this disease causes to those around the globe.
#43 Tobacco (Nicotine) Use Disorder – PsychDB
https://www.psychdb.com/addictions/nicotine-tobacco/1-use-disorder
Nicotine replacement therapy (NRT) is recommended with either nicotine replacement first, followed by non-nicotine pharmacotherapies such as varenicline or bupropion. […] If the individual is a heavy smoker, or there are withdrawal symptoms despite nicotine replacement (e.g. – cravings, irritability, frustration, anger, anxiety, difficulty concentrating, and/or restlessness), consider adding non-nicotine pharmacotherapies such as: […] Using varenicline in conjunction with a nicotine replacement patch is better than varenicline alone. […] Comprehensive treatment approaches are required, with supportive counselling from a healthcare provider such as following the Ottawa Model for Smoking Cessation (OMSC).
#44 Study Shows Genes Associated with Nicotine Dependence Also Predict Response to Anti-Smoking Therapy | GenomeWebRSS FeedsVisit GenomeWeb on TwitterVisit GenomeWeb on LinkedIn
https://www.genomeweb.com/mdx/study-shows-genes-associated-nicotine-dependence-also-predict-response-anti-smok
A team led by researchers at Washington University in St. Louis has shown that genetic variants associated with nicotine dependence and smoking quantity are also predictive of whether patients will benefit from the use of smoking cessation medications. […] Overall, the researchers found that smokers with a high-risk genetic variant haplotype were less likely to succeed in quitting on their own and more likely to respond to drug treatment using bupropion, nicotine replacement, or both, than those with a low-risk haplotype. […] Li-Shiun Chen, the study’s first author and an assistant professor of psychiatry at the Washington University School of Medicine, told PGx Reporter this week that the group’s results suggest that genetic variants in the CHRNA5-CHRNA2-CHRNB4 region can be used to personalize smoking-cessation therapy by identifying those patients who are likely to benefit from nicotine replacement and bupropion treatment, and saving those who are not likely to benefit from unnecessary pharmacotherapy and associated side effects.
#45 Study Shows Genes Associated with Nicotine Dependence Also Predict Response to Anti-Smoking Therapy | GenomeWebRSS FeedsVisit GenomeWeb on TwitterVisit GenomeWeb on LinkedIn
https://www.genomeweb.com/mdx/study-shows-genes-associated-nicotine-dependence-also-predict-response-anti-smok
„This is very important, not only for identifying patients who should get medication,” Chen said, „but also for those patients who can quit on their own and don’t benefit from medication, especially certain patients who could potentially get side effects, like those who are pregnant, or with heart disease, or other conditions where these medications are not really as benign.” […] According to Chen, the study’s findings are a stepping stone toward the goal of personalizing therapy for those hoping to quit smoking. The results suggest that the biological effects of the three haplotypes that the group tracked, affect both smoking quantity and the ability to quit, and that pharmacologic treatments are more likely to be effective for those who are genetically predisposed to have difficulty quitting.
#46 Nicotine dependence: Symptoms, causes, and treatment
https://www.medicalnewstoday.com/articles/181299
Nicotine dependence can affect anyone who smokes. […] There is no current diagnostic test that can determine whether somebody is addicted to nicotine, and to what degree. […] A doctor can help the patient determine their degree of dependence by asking pertinent questions, or using a specific questionnaire. […] Often, a diagnosis of nicotine dependence will normally arise once a person seeks medical assistance for the addiction.
#47 Nicotine dependence: Symptoms, causes, and treatment
https://www.medicalnewstoday.com/articles/181299
Nicotine dependence can affect anyone who smokes. […] There is no current diagnostic test that can determine whether somebody is addicted to nicotine, and to what degree. […] A doctor can help the patient determine their degree of dependence by asking pertinent questions, or using a specific questionnaire. […] Often, a diagnosis of nicotine dependence will normally arise once a person seeks medical assistance for the addiction.
#48 DSM-IV, ICD-10 and FTND: Discordant Tobacco Dependence Diagnoses in Adult Smokers | OMICS International
https://www.omicsonline.org/dsm-iv-icd-10-and-ftnd-discordant-tobacco-dependence-diagnoses-in-adult-smokers-2155-6105.1000105.php?aid=3
There are several measures that attempt to assess tobacco dependence but the most appropriate measure to use is often unclear. Tobacco dependence was assessed, in Canadian adult smokers of black African descent, with three measures: the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), the International Classification of Diseases (ICD-10) and the Fagerstrm Test for Nicotine Dependence (FTND). The different measures resulted in very different tobacco dependence diagnosis rates: 91% were dependent by DSM-IV, 48% were dependent by ICD-10 and 48% were dependent by FTND (score 3). […] Different dependence measures can give discordant diagnosis in the same population; moreover, the same nicotine dependence measure can perform differently depending on the population.
#49 Journal of Addiction Research & Therapy – DSM-IV, ICD-10 and FTND: Discordant Tobacco Dependence Diagnoses in Adult Smokers
https://www.omicsonline.org/open-access/dsmiv-icd10-and-ftnd-discordant-tobacco-dependence-diagnoses-in-adult-smokers-2155-6105-1000105-3.html
There are several measures that attempt to assess tobacco dependence but the most appropriate measure to use is often unclear. Tobacco dependence was assessed, in Canadian adult smokers of black African descent, with three measures: the Diagnostic and Statistical Manual of Mental Disorders Fourth Edition (DSM-IV), the International Classification of Diseases (ICD-10) and the Fagerstrm Test for Nicotine Dependence (FTND). The different measures resulted in very different tobacco dependence diagnosis rates: 91% were dependent by DSM-IV, 48% were dependent by ICD-10 and 48% were dependent by FTND (score 3). […] Different dependence measures can give discordant diagnosis in the same population; moreover, the same nicotine dependence measure can perform differently depending on the population.
#50 DSM-IV, ICD-10 and FTND: Discordant Tobacco Dependence Diagnoses in Adult Smokers | OMICS International
https://www.omicsonline.org/dsm-iv-icd-10-and-ftnd-discordant-tobacco-dependence-diagnoses-in-adult-smokers-2155-6105.1000105.php?aid=3
This study is important because it illustrates that (a) different tobacco dependence measures do not necessarily diagnose the same individuals as dependent, (b) measure architecture appears to be important to the discordant diagnoses, perhaps more so than the underlying construct of the measure and (c) populations specific factors, like cigarette consumption level, can affect dependence diagnosis. […] The findings of the present study illustrate some limitations and strengths of the DSM-IV, ICD-10 and FTND in an adult population of black African descent. More generally, it highlights the importance of (a) the type, wording and scoring of the questions in tobacco dependence measures and (b) population specific factors that may confound tobacco dependence assessment.
#51 Journal of Addiction Research & Therapy – DSM-IV, ICD-10 and FTND: Discordant Tobacco Dependence Diagnoses in Adult Smokers
https://www.omicsonline.org/open-access/dsmiv-icd10-and-ftnd-discordant-tobacco-dependence-diagnoses-in-adult-smokers-2155-6105-1000105-3.html
This study is important because it illustrates that (a) different tobacco dependence measures do not necessarily diagnose the same individuals as dependent, (b) measure architecture appears to be important to the discordant diagnoses, perhaps more so than the underlying construct of the measure and (c) populations specific factors, like cigarette consumption level, can affect dependence diagnosis. […] Our aim in rescoring the DSM-IV and ICD-10 was to take advantage of the underlying continuity of tobacco dependence. Each measure’s outcome is artificially dichotomized to dependent and not dependent; this limits the sensitivity in assessing relationships. […] The DSM-IV and the FTND had no obvious criterion/question overlap; consistent with the DSM-IV identifying tobacco dependence as a psychological disorder, while the FTND focuses on physical tobacco dependence.
#52 Journal of Addiction Research & Therapy – DSM-IV, ICD-10 and FTND: Discordant Tobacco Dependence Diagnoses in Adult Smokers
https://www.omicsonline.org/open-access/dsmiv-icd10-and-ftnd-discordant-tobacco-dependence-diagnoses-in-adult-smokers-2155-6105-1000105-3.html
The ICD-10 appears to have several advantages over the DSM-IV and FTND. First, it allows for a range of answers for each of its questions. Second, it is discriminating as it diagnosed approximately half of the smokers as tobacco dependent. Third, it demonstrates a degree of construct validity in that it correlated with both cigarettes per day and self-perceived addiction. […] A limitation of this definition is it classifies dependence as a dichotomous trait. Complex human traits are influenced by both environmental and genetic factors; consequently, they exhibit phenotypes along a continuum. […] The findings of the present study illustrate some limitations and strengths of the DSM-IV, ICD-10 and FTND in an adult population of black African descent. More generally, it highlights the importance of (a) the type, wording and scoring of the questions in tobacco dependence measures and (b) population specific factors that may confound tobacco dependence assessment.
#53 Nicotine Cessation: Dependency Screening | Children’s Mercy Kansas City
https://www.childrensmercy.org/health-care-providers/evidence-based-practice/cpgs-cpms-and-eras-pathways/nicotine-cessation/dependency-screening/
E-cigarette Dependence Scale (EDS) […] Disclaimer: These questions have been validated for e-cigarette use. Consider the use of other nicotine products when determining dependence. […] Additional Dependency Scoring Tools […] Penn State Nicotine Dependence Index […] Modified Version of the Fagerstrom Tolerance Questionnaire.
#54 Wiki – Coding use of e-cigarettes | Medical Billing and Coding Forum – AAPC
https://www.aapc.com/discuss/threads/coding-use-of-e-cigarettes.149553/?srsltid=AfmBOoqyJHd0EhneWloC2u1N7PxrsV2WI6mGeNZfP4XkmmjUVcQVY3Kd
Z72.0 is for use of tobacco. It does not matter which route, i.e., cigarettes vs cigar vs E-cig. Per coding guidelines, only use dependence codes (F17.-) when documentation explicitly indicates dependence. If documentation states for example, „the patient has dependence on E-cigarettes” then the code would be F17.200 for nicotine dependence, unspecified, uncomplicated. Of course, this is assuming that the e-cig „juice” is nicotine. […] If documentation states tobacco abuse or use and no other detail, use Z72.0 tobacco use Nos because we do not know the mode of use. If it says cigarettes, chewing tobacco, cigar, vaping, etc., it’s coded to dependence on that product since we always code to the highest level of specificity per the tabular tobacco used disorder is an inclusion term under (dependence F17.200).
#55 Assessing dimensions of nicotine dependence
https://pmc.ncbi.nlm.nih.gov/articles/PMC2614360/
Considerable research, ranging from survey to clinical to genetic, has utilized traditional measures of tobacco dependence, such as the Fagerstrom Test of Nicotine Dependence (FTND) and the Diagnostic and Statistical Manual (DSM-IV) criteria, that focus on endpoint definitions of tobacco dependence such as heavy smoking, time to first cigarette in the morning, and smoking despite consequences. […] In an effort to better understand possible theories and mechanisms underlying tobacco dependence, which could be used to improve treatment and research, two multidimensional measures of tobacco dependence have been developed: the Nicotine Dependence Syndrome Scale (NDSS) and the Wisconsin Inventory of Smoking Dependence Motives (WISDM). […] The goal of this article is to evaluate the NDSS and the WISDM in terms of their ability to predict such clinically useful dependence criteria as relapse likelihood and withdrawal severity.
#56 Tobacco and nicotine use | Nature Reviews Disease Primers
https://www.nature.com/articles/s41572-022-00346-w
Tobacco smoking is a major determinant of preventable morbidity and mortality worldwide. […] Neurobiological findings have identified the mechanisms by which nicotine in tobacco affects the brain reward system and causes addiction. […] Effective approaches to screen, prevent and treat tobacco use can be widely implemented to limit tobaccos effect on individuals and society. […] The effectiveness of psychosocial and pharmacological interventions in helping people quit smoking has been demonstrated. […] As the majority of people who smoke ultimately relapse, it is important to enhance the reach of available interventions and to continue to develop novel interventions. […] These efforts associated with innovative policy regulations (aimed at reducing nicotine content or eliminating tobacco products) have the potential to reduce the prevalence of tobacco and nicotine use and their enormous adverse impact on population health.
#57 Nicotine Dependence: Causes, Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/24482-nicotine-dependence
Nicotine dependence occurs when your body gets used to having some level of nicotine in your system. […] Your healthcare provider can diagnose nicotine dependence by asking a few questions or having you fill out a questionnaire. This is called the Fagerstrm Test for Nicotine Dependence. […] Nicotine dependence is common, affecting about 23.6 million Americans or 8.5% of people ages 12 and older. […] You can cure nicotine dependence. Eliminating your need for nicotine takes time, but you can end your dependence for good. […] Treatments include medications approved by the U.S. Food and Drug Administration and behavioral therapies. […] Breaking nicotine dependence is hard but doable. It might not happen on your first try, but 3 in 5 adults who ever smoked have quit.
#58 Tobacco (Nicotine) Use Disorder – PsychDB
https://www.psychdb.com/addictions/nicotine-tobacco/1-use-disorder
Tobacco (Nicotine) Use Disorder is a substance use disorder characterized by a problematic pattern of tobacco (nicotine) use leading to clinically significant impairment or distress. […] A problematic pattern of tobacco use leading to clinically significant impairment or distress, as manifested by at least 2 of the following, occurring within a 12-month period: […] Tobacco use disorder is uncommon in those who are not daily users. […] The prevalence of tobacco use disorder is estimated to be 13%. […] The characteristic withdrawal syndrome for tobacco (refer to Criteria A and B of the criteria set for tobacco withdrawal). […] Tobacco (or a closely related substance, such as nicotine) is taken to relieve or avoid withdrawal symptoms. […] Adding behavioural and psychological treatments to pharmacotherapy increases the chance of stopping use successfully (long-term abstinence rates approach 25 to 30%).
#59 Nicotine dependence, motivation to quit, and diagnosis among adult emergency department patients who smoke: a national survey | WHO FCTC
https://extranet.who.int/fctcapps/fctcapps/fctc/kh/wts/wts-database/nicotine-dependence-motivation-quit-and-diagnosis-among-adult
Patients smoked a median of 10 cigarettes daily, with a median score on the Fagerstrom Test for Nicotine Dependence of 4, and a median score of 5 on the nine-point contemplation ladder, indicating a desire to quit within 6 months. […] Smokers with tobacco-related diagnoses, or who believed their emergency department visit was related to smoking, were more interested in quitting. […] Emergency department patients smoked at moderate amounts, with moderate levels of addiction and interest in quitting.
#60 Prevalence and analysis of tobacco use disorder in patients diagnosed with lung cancer | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220127
Tobacco use disorder (TUD), previously known as nicotine dependence, was associated with increased risk of lung cancer. […] The aim of the present study was to investigate the prevalence of TUD using DSM-5 diagnostic criteria in patients diagnosed with lung cancer and analyze their tobacco use characteristics. […] A total of 200 histologically confirmed lung cancer patients who used tobacco within the prior 12-month period at the time of diagnosis were recruited for this study. Participants were assessed using interviewer-administered questionnaires to determine TUD symptoms and smoking-related behaviors, and self-administered Fagerstrom Test for Nicotine Dependence (FTND) was also administered. […] The prevalence of DSM-5 TUD was 92.0% (n = 184). […] Smokers diagnosed with lung cancer showed a high prevalence of DSM-5 TUD. Their heavy and consistent tobacco use suggests reduced motivation to abstain from smoking.
#61 Prevalence and analysis of tobacco use disorder in patients diagnosed with lung cancer | PLOS One
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220127
Continued tobacco use despite awareness of persistent or recurrent physical or psychological ailments is one of the diagnostic criteria underlying tobacco use disorder (TUD) described in the Diagnostic and Statistical Manual of Mental Disorder, 5th edition (DSM-5) and nicotine dependence of DSM-IV. […] Thus, tobacco users with a diagnosis of lung cancer may manifest considerably high prevalence of TUD. […] The prevalence of DSM-IV nicotine dependence was 78.5% in this study, which was lower than that of DSM-5 TUD (92.0%). […] The prevalence of TUD in smokers with lung cancer was 92.0% in this study. […] We demonstrated that tobacco users diagnosed with lung cancer had a high prevalence of TUD based on DSM-5 criteria.
#62
https://www.tobaccoinduceddiseases.org/Low-nicotine-dependence-and-high-self-efficacy-can-predict-smoking-cessation-independent,67185,0,2.html
RESEARCH PAPER Low nicotine dependence and high self-efficacy can predict smoking cessation independent of the presence of chronic obstructive pulmonary disease: a three year follow up of a population-based study […] The aim of this study was to evaluate factors related to smoking cessation and to compare characteristics and nicotine dependence among smokers with and without COPD. […] The Fagerstrm Test for Nicotine Dependence (FTND) and motivation for smoking cessation were assessed for current smokers (n=299 total, 194 with COPD). […] Higher FTND scores were associated with anxiety/depression and respiratory symptoms in both groups. […] The FTND score and a simple visual analog scale for assessing self-efficacy seem to be valuable instruments for predicting smoking cessation over several years, independent of COPD, respiratory symptoms, presence of anxiety/depression, and heart disease.
#63 Linkage scan of nicotine dependence in the University of California, San Francisco (UCSF) Family Alcoholism Study | Psychological Medicine | Cambridge Core
https://www.cambridge.org/core/journals/psychological-medicine/article/linkage-scan-of-nicotine-dependence-in-the-university-of-california-san-francisco-ucsf-family-alcoholism-study/9A8C2E7F18D005C4214590F8A6D5DD62
Nicotine dependence has been shown to represent a heritable condition, and several research groups have performed linkage analysis to identify genomic regions influencing this disorder though only a limited number of the findings have been replicated. […] A modified version of the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) with additional questions that probe nicotine use was used to derive DSM-IV nicotine dependence diagnoses. […] The present report suggests that chromosome 2q31.1 confers risk to the development of nicotine dependence and that this region influences a broad range of nicotine dependence symptoms rather than a specific facet of the disorder. Further, the results show that this region is not linked to alcohol dependence in this population, and thus may influence nicotine dependence specifically.
#64 Linkage scan of nicotine dependence in the University of California, San Francisco (UCSF) Family Alcoholism Study | Psychological Medicine | Cambridge Core
https://www.cambridge.org/core/journals/psychological-medicine/article/linkage-scan-of-nicotine-dependence-in-the-university-of-california-san-francisco-ucsf-family-alcoholism-study/9A8C2E7F18D005C4214590F8A6D5DD62
Nicotine dependence has been shown to represent a heritable condition, and several research groups have performed linkage analysis to identify genomic regions influencing this disorder though only a limited number of the findings have been replicated. […] A modified version of the Semi-Structured Assessment for the Genetics of Alcoholism (SSAGA) with additional questions that probe nicotine use was used to derive DSM-IV nicotine dependence diagnoses. […] The present report suggests that chromosome 2q31.1 confers risk to the development of nicotine dependence and that this region influences a broad range of nicotine dependence symptoms rather than a specific facet of the disorder. Further, the results show that this region is not linked to alcohol dependence in this population, and thus may influence nicotine dependence specifically.
#65 Study Shows Genes Associated with Nicotine Dependence Also Predict Response to Anti-Smoking Therapy | GenomeWebRSS FeedsVisit GenomeWeb on TwitterVisit GenomeWeb on LinkedIn
https://www.genomeweb.com/mdx/study-shows-genes-associated-nicotine-dependence-also-predict-response-anti-smok
„This is very important, not only for identifying patients who should get medication,” Chen said, „but also for those patients who can quit on their own and don’t benefit from medication, especially certain patients who could potentially get side effects, like those who are pregnant, or with heart disease, or other conditions where these medications are not really as benign.” […] According to Chen, the study’s findings are a stepping stone toward the goal of personalizing therapy for those hoping to quit smoking. The results suggest that the biological effects of the three haplotypes that the group tracked, affect both smoking quantity and the ability to quit, and that pharmacologic treatments are more likely to be effective for those who are genetically predisposed to have difficulty quitting.